Increased Intracranial Pressure during Hemodialysis in a Patient with Anoxic Brain Injury

Dialysis disequilibrium syndrome (DDS) is a serious neurological complication of hemodialysis, and patients with acute brain injury are at increased risk. We report a case of DDS leading to intracranial hypertension in a patient with anoxic brain injury and discuss the subsequent dialysis strategy. A 13-year-old girl was admitted after prolonged resuscitation from cardiac arrest. Computed tomography (CT) revealed an inferior vena cava aneurysm and multiple pulmonary emboli as the likely cause. An intracranial pressure (ICP) monitor was inserted, and, on day 3, continuous renal replacement therapy (CRRT) was initiated due to acute kidney injury, during which the patient developed severe intracranial hypertension. CT of the brain showed diffuse cerebral edema. CRRT was discontinued, sedation was increased, and hypertonic saline was administered, upon which ICP normalized. Due to persistent hyperkalemia and overhydration, ultrafiltration and intermittent hemodialysis were performed separately on day 4 with a small dialyzer, low blood and dialysate flow, and high dialysate sodium content. During subsequent treatments, isolated ultrafiltration was well tolerated, whereas hemodialysis was associated with increased ICP necessitating frequent pauses or early cessation of dialysis. In patients at risk of DDS, hemodialysis should be performed with utmost care and continuous monitoring of ICP should be considered

A deliverable of the project: “Impact of the Third Sector as Social Innovation” (ITSSOIN), European Commission – 7th Framework Programme

This report from the ITSSOIN-project contains content and framing analyses of 8463 items on third sector activities sampled from the year 2013 in leading national and regional newspapers from nine European countries, posing the research question: How are third sector activities and social innovation framed by European news media? The analysis is one part of the deliverable D2.3 ‘Images of the Third Sector’ of the ITSSOIN project. D2.3 has been conceptualised to evaluate perceptions of media and citizens attitudes towards the third sector. Both perspectives are published as distinct and independent papers. Readers also interested in the citizen perception find more insights in the publication ‘Empirical analyses of citizen perceptions of the third sector in Europe’. The introduction (section 1) demonstrates that little relevant media research has been published specifically on third sector activities related to social innovation policy and civic engagement. Consequently, it is argued that more empirical research is urgently needed, and that a framing perspective, drawing upon the growing literatures of agenda-setting and diffusion of innovation, is particularly relevant for studies of this kind. The media content analysis (section 2) summarizes the major trends in mediated discourse on third sector activities in the Czech Republic, Denmark, France, Germany, Italy, the Netherlands, Spain, Sweden and the United Kingdom 2003-2013. These tendencies are related to social innovation policy streams documenting that the latter is covered to a minimal extent. In all the countries under study, journalism tends to neglect innovative performances by the third sector. In so doing, mass media may not directly influence public opinion by telling people what to think, but rather indirectly by indicating to the decision makers what (not) to act upon. The framing analysis (section 3) indicates that third sector activities – in marked contrast to business and politics – do not have high priority as a news reporting beat in their own right. The third sector is primarily mediated with localized references to specific organizations and individuals performing advocacy and services provision on a non-profit basis. In the relatively few instances where social innovation policy in a more general sense is related to the third sector media coverage, the reporting is overwhelmingly loyal to government views. Four hypotheses are tested (section 4) showing that the press framing of the third sector is generally positive. It is also demonstrated how social innovativeness is less pronounced in press coverage than other civil society values, e.g. voluntarism and civic engagement. Most of the press coverage is consensus-oriented leaving little room for anti-establishment frames. Especially after the financial crisis of 2008, “volunteering” and “civil society” have become political catchwords regarded by governments as well as journalist to be universal solutions to social problems. Finally, an affinity between the media framing of different third sector fields and civil society roles is indicated. Advocacy is particularly emphasised in relation to environmental sustainability and community development. Service provision is stronger in relation to social services and healthcare. Please note that the study is explorative rather than explanatory in scope. Accordingly, we advise caution in drawing general conclusion from the limited amount of data available (section 5), and call for more empirical and comparative research involving a broader variety of media platforms, including electronic- and social media

Effect of stress on NiO reduction in solid oxide fuel cells: A new application of energy-resolved neutron imaging

Recently, two new phenomena linking stress field and reduction rates in anode supported solid oxide fuel cells SOFCs have been demonstrated, so called accelerated creep during reduction and reduction rate enhancement and nucleation due to stress Frandsen et al., 2014 . These complex phenomena are difficult to study and it is demonstrated here that energy resolved neutron imaging is a feasible technique for combined mechanics chemical composition studies of SOFC components, including commercially produced ones. Cermet anode supports, which prior to the measurements were reduced under varying conditions such as different temperatures, various times and different values of applied stress, have been measured. Thus, samples with different contents and gradients of Ni and NiO phases were investigated. The first Bragg edge transmission neutron measurements applied for the studies of the reduction progress in these samples were performed at two neutron beamline facilities ISIS in the UK, Helmholtz Zentrum Berlin in Germany . The obtained results demonstrate the possibility to image and distinguish NiO and Ni phases within SOFC anode supports by energy resolved neutron imaging and the potential of the neutron imaging method for in situ studies of reduction processe

Inelastic Helium Atom Scattering from Sb2Te3(111): Phonon Dispersion, Focusing Effects and Surfing

We present an experimental study of inelastic scattering processes on the (111) surface of the topological insulator Sb2Te3 using helium atom scattering. In contrast to other binary topological insulators such as Bi2Se3 and Bi2Te3, Sb2Te3 is much less studied and the as-grown Sb2Te3 sample turns out to be p-doped, with the Fermi-level located below the Dirac-point as confirmed by angle-resolved photoemission spectroscopy. We report the surface phonon dispersion along both high symmetry directions in the energy region below 11 meV, where the Rayleigh mode exhibits the strongest intensity. The experimental data is compared with a study based on density functional perturbation theory calculations, providing good agreement except for a set of additional peculiar inelastic events below the Rayleigh mode. In addition, an analysis of angular scans with respect to a number of additional inelastic events is presented, including resonance enhancement, kinematical focusing, focused inelastic resonance and surfing. In the latter case, phonon-assisted adsorption of the incident helium atom gives rise to a bound state where the helium atom rides the created Rayleigh wave.The authors are grateful for financial support by the FWF (Austrian Science Fund) within the project P29641-N36, as well as by NAWI Graz. We would like to thank the Aarhus University Research Foundation, VILLUM FOUNDATION via the Centre of Excellence for Dirac Materials (Grant No. 11744) and the SPP1666 of the DFG (Grant No. HO 5150/1-2) for financial support. M. Bremholm acknowledges financial support from the Center of Materials Crystallography (CMC) and the Danish National Research Foundation (DNRF93)

Prophylactic anticoagulation with low molecular weight heparin in COVID-19: cohort studies in Denmark and Sweden

OBJECTIVES: To evaluate safety and effectiveness of prophylactic anticoagulation with low molecular weight heparin (LMWH) in individuals hospitalised for COVID-19. METHODS: Using healthcare records from the capital region of Denmark (March 2020-February 2021) and Karolinska University Hospital in Sweden (February 2020-September 2021), we conducted an observational cohort study comparing clinical outcomes 30 days after admission among individuals hospitalised for COVID-19 starting prophylactic LMWH during the first 48 hours of hospitalisation with outcomes among those not receiving prophylactic anticoagulation. We used inverse probability weighting to adjust for confounders and bias due to missing information. Risk ratios, risk differences and robust 95% confidence intervals (CI) were estimated using binomial regression. Country-specific risk ratios were pooled using random-effects meta-analysis. RESULTS: We included 1692 and 1868 individuals in the Danish and Swedish cohorts. Of these, 771 (46%) and 1167 (62%) received prophylactic LMWH up to 48 hours after admission. The combined mortality in Denmark and Sweden was 12% (N=432) and the pooled risk ratio was 0.89 (CI 0.61-1.29) comparing individuals who received LMWH to those who did not. The relative risk of ICU admission was 1.12 (CI 0.85-1.48), while we observed no increased risk of bleeding (RR 0.60, 0.14-2.59). The relative risk of venous thromboembolism was 0.68 (CI: 0.33-1.38) in Sweden. Less than 5 VTE events were observed among individuals receiving LMWH in Denmark, preventing a meaningful analysis. CONCLUSION: We found no benefit on mortality with prophylactic LMWH and no increased risk of bleeding among COVID-19 patients receiving prophylactic LMWH

Computational identification of insertional mutagenesis targets for cancer gene discovery

Insertional mutagenesis is a potent forward genetic screening technique used to identify candidate cancer genes in mouse model systems. An important, yet unresolved issue in the analysis of these screens, is the identification of the genes affected by the insertions. To address this, we developed Kernel Convolved Rule Based Mapping (KC-RBM). KC-RBM exploits distance, orientation and insertion density across tumors to automatically map integration sites to target genes. We perform the first genome-wide evaluation of the association of insertion occurrences with aberrant gene expression of the predicted targets in both retroviral and transposon data sets. We demonstrate the efficiency of KC-RBM by showing its superior performance over existing approaches in recovering true positives from a list of independently, manually curated cancer genes. The results of this work will significantly enhance the accuracy and speed of cancer gene discovery in forward genetic screens. KC-RBM is available as R-package

A high-throughput splinkerette-PCR method for the isolation and sequencing of retroviral insertion sites

Insertional mutagens such as viruses and transposons are a useful tool for performing forward genetic screens in mice to discover cancer genes. These screens are most effective when performed using hundreds of mice, however until recently a major limitation to performing screens on this scale has been the cost effective isolation and sequencing of insertion sites. Here we present a method for the high-throughput isolation of insertion sites using a highly efficient splinkerette-PCR method coupled with capillary or 454 sequencing. This protocol includes a description of the procedure for DNA isolation, DNA digestion, linker or splinkerette ligation, primary and secondary PCR amplification, and sequencing. This method, which takes about 1 week to perform, has allowed us to isolate hundreds of thousands of insertion sites from mouse tumours and, unlike other methods, has been specifically optimised for the isolation of insertion sites generated with the murine leukaemia virus (MuLV), and can easily be performed in 96 well plate format for the efficient multiplex isolation of insertion sites