Reconstructing thermocline hydrography using planktonic foraminiferal Mg/Ca: Implications for paleo-ENSO during the Holocene

Interannual variations in thermocline hydrography of the eastern tropical Pacific are today dominated by the El Niño/Southern Oscillation (ENSO). Mixed layer thickness, thermocline depth, and sea surface temperatures all decrease under La Niña conditions. Changes in these parameters are responsible for oceanographic and climate anomalies that have far reaching effects. Understanding how water column stratification of the eastern tropical Pacific has changed over time can lend insight into the past dynamics of ENSO, yet this is a poorly constrained area of study. We present a record of upper water column stratification history during the Holocene, using core PC14 from the Soledad Basin, Baja California (25.2N, 112.7W). We use Mg/Ca differences between G. bulloides, and N. pachyderma (d.) to reconstruct changes in the vertical stratification. G. bulloides reflects the upper most surface conditions during peak spring upwelling. N. pachyderma (d.) favors conditions near the bottom of the thermocline consistent with previous studies that it follows the Deep Chlorophyll Maximum (DCM). We apply this multi‐species approach to test the hypothesis, based on G. bulloides Mg/Ca, that the early to middle Holocene was characterized by millennial‐scale oscillations in ENSO mean state. Understanding the behavior of ENSO over long timescales can provide a path to evaluating the potential of orbital and solar forcing of ENSO dynamics

open surgery versus video-assisted thoracic surgery teaching—a clinical practice overview

Publisher Copyright: © AME Surgical Journal. All rights reserved.During the past few decades, thoracic surgery has been in constant evolution from open to more refined minimally invasive surgery techniques. Teaching and learning, in parallel with proficiency, competence and mastery are subject of debate nowadays. The aim of this paper is to describe the role of open surgery and video-assisted thoracic surgery (VATS) during training of the contemporary thoracic surgeon. The authors describe the learning process in different areas and phases throughout the paper. Open surgery, although less and less frequent, mainly for simple procedures, should not be under evaluated as it provides a unique source of learning opportunities. VATS, although globally adopted as the gold standard, must be part of any training program. Both open surgery and VATS provide complimentary learning methods and techniques and should happen simultaneously, not in a competitive way. Globally, despite the efforts from some institutions and experts, most countries do not present a unified and standardized approach to teaching new procedures. Introduction of standardized methods for quantification of training are recommended. Simulators, dry and wet labs and step-by-step programs should be implemented. The authors recommend implementation of surgical learning programs that have a rationale in their core that involves gradual evolution, including both open surgery and VATS to complement each other, and to create a training that is simultaneous and not competitive.publishersversionpublishe

Modeling and estimating the economic and social impact of the results of the project Re-search Alps

The idea behind the Re-search Alps project has been conceived inside within the EUSALP Action Group 1 - “to develop an effective research and innovation ecosystem” (AG1). EUSALP is the EU-Strategy for the Alpine Region, which is composed of seven countries: Austria, France, Germany, Italy Liechtenstein, Slovenia and Switzerland. The strategy aims at ensuring mutually beneficial interactions between the mountain regions at its core and the surrounding lowlands and urban areas. The goal of the Re-search Alps project is the publication on the web of an open dataset describing the private and public laboratories, research and innovation centers (hereinafter, referred as “labs”, in short) existing in the seven aforementioned countries, with particular reference to the 48 Regions constituting the Alpine Area

Surgical Stabilization for Multiple Rib Fractures: Whom the Benefit? -A Prospective Observational Study

Background: Surgical repair has demonstrated a beneficial effect on outcome for patients presenting with flail chest or with multiple rib fractures. We hypothesized that benefit on outcome parameters concerns predominantly patients being extubated within 24 hours post-operatively. Methods: We prospectively recorded all patients presenting with chest traumatism eligible for surgical repair with anticipated early extubation according to our institutional consensus (flail chest, major deformity, poor pain control, associated lesions requiring thoracotomy). We compared outcomes of patients extubated within 24 hours post-operatively to those who required prolonged ventilator support. We tested predictive factors for prolonged intubation with univariate and multivariate analysis. Results: From 2010 to 2014, 132 patients required surgical repair. Two thirds were extubated within 24 hours following surgical repair. Pneumonia was the main complication and occurred in 30.3% of all patients. Patients extubated within 24 hours following surgical repair had significantly shorter ICU stay and shorter in-hospital stay (P<0.0001 both). Pneumonia occurred significantly more often in patients with longer mechanical ventilation (over 24 hours) (P<0.0001) and the overall post-operative complications rate was higher (P=0.0001). Main independent risk factors for delayed extubation were bilateral chest rib fractures and initially associated pneumothorax. Conclusions: We conclude that patients extubated within 24 hours after repair have an improved outcome with reduced complication rate and shorter hospital stay. The initial extent of the trauma is an important risk factor for delayed extubation and high complication rate despite surgical stabilization

The second year has been completed

Among many other things, the last European Respiratory Society (ERS) International Congress in Munich brought changes to the ERS Junior Members Committee (JMC). The 3-year term of JMC representatives has seen Indre Butiene, who initiated the Committee 3 years ago, finish her tenure as chair, with Anders Bjerg, respiratory epidemiologist from Gothenburg, Sweden, being elected as her replacement. Indre’s departure has also led to the election of a new representative to the ERS Education Council. We congratulate Agnes Boots from the Netherlands on her election to this important position! Also, here in Breathe, the Doing Science series has been taken over by Georgia Hardavella, UK, whose ideas will take this practical educational series to new levels in 2015. The Hot Topics section is now coordinated by Neil Saad, UK, one of many Juniors outside the JMC who have volunteered for different JMC activities

Distinct in vitro binding properties of the anti-CD20 small modular immunopharmaceutical 2LM20-4 result in profound and sustained in vivo potency in cynomolgus monkeys

Objectives. To characterize the in vitro binding and effector function properties of CD20-directed small modular immunopharmaceutical (SMIP) 2LM20-4, and to compare its in vivo B-cell depletion activity with the mutated 2LM20-4 P331S [no in vitro complement-dependent cytotoxicity (CDC)] and rituximab in cynomolgus monkeys

Chitins and Chitosans as Immunoadjuvants and Non-Allergenic Drug Carriers

Due to the fact that some individuals are allergic to crustaceans, the presumed relationship between allergy and the presence of chitin in crustaceans has been investigated. In vivo, chitin is part of complex structures with other organic and inorganic compounds: in arthropods chitin is covalently linked to proteins and tanned by quinones, in fungi it is covalently linked to glucans, while in bacteria chitin is diversely combined according to Gram(+/−) classification. On the other hand, isolated, purified chitin is a plain polysaccharide that, at the nano level, presents itself as a highly associated structure, recently refined in terms of regularity, nature of bonds, crystallinity degree and unusual colloidal behavior. Chitins and modified chitins exert a number of beneficial actions, i.e., (i) they stimulate macrophages by interacting with receptors on the macrophage surface that mediate the internalization of chitin particles to be degraded by lysozyme and N-acetyl-β-glucosaminidase (such as Nod-like, Toll-like, lectin, Dectin-1, leukotriene 134 and mannose receptors); (ii) the macrophages produce cytokines and other compounds that confer non-specific host resistance against bacterial and viral infections, and anti-tumor activity; (iii) chitin is a strong Th1 adjuvant that up-regulates Th1 immunity induced by heat-killed Mycobacterium bovis, while down- regulating Th2 immunity induced by mycobacterial protein; (iv) direct intranasal application of chitin microparticles into the lung was also able to significantly down-regulate allergic response to Dermatophagoids pteronyssinus and Aspergillus fumigatus in a murine model of allergy; (v) chitin microparticles had a beneficial effect in preventing and treating histopathologic changes in the airways of asthmatic mice; (vi) authors support the fact that chitin depresses the development of adaptive type 2 allergic responses. Since the expression of chitinases, chitrotriosidase and chitinase-like proteins is greatly amplified during many infections and diseases, the common feature of chitinase-like proteins and chitinase activity in all organisms appears to be the biochemical defense of the host. Unfortunately, conceptual and methodological errors are present in certain recent articles dealing with chitin and allergy, i.e., (1) omitted consideration of mammalian chitinase and/or chitotriosidase secretion, accompanied by inactive chitinase-like proteins, as an ancestral defensive means against invasion, capable to prevent the insurgence of allergy; (2) omitted consideration of the fact that the mammalian organism recognizes more promptly the secreted water soluble chitinase produced by a pathogen, rather than the insoluble and well protected chitin within the pathogen itself; (3) superficial and incomplete reports and investigations on chitin as an allergen, without mentioning the potent allergen from crustacean flesh, tropomyosine; (4) limited perception of the importance of the chemical/biochemical characteristics of the isolated chitin or chitosan for the replication of experiments and optimization of results; and (5) lack of interdisciplinarity. There is quite a large body of knowledge today on the use of chitosans as biomaterials, and more specifically as drug carriers for a variety of applications: the delivery routes being the same as those adopted for the immunological studies. Said articles, that devote attention to the safety and biocompatibility aspects, never reported intolerance or allergy in individuals and animals, even when the quantities of chitosan used in single experiments were quite large. Therefore, it is concluded that crab, shrimp, prawn and lobster chitins, as well as chitosans of all grades, once purified, should not be considered as “crustacean derivatives”, because the isolation procedures have removed proteins, fats and other contaminants to such an extent as to allow them to be classified as chemicals regardless of their origin

Thymomectomy plus total thymectomy versus simple thymomectomy for early-stage thymoma without myasthenia gravis: A European Society of Thoracic Surgeons Thymic Working Group Study

OBJECTIVES: Resection of thymic tumours including the removal of both the tumour and the thymus gland (thymothymectomy; TT) is the procedure of choice and is recommended in most relevant articles in the literature. Nevertheless, in recent years, some authors have suggested that resection of the tumour (simple thymomectomy; ST) may suffice from an oncological standpoint in patients with early-stage thymoma who do not have myasthenia gravis (MG) (non-MG). The goal of our study was to compare the short-and long-term outcomes of ST versus TT in non-MG early-stage thymomas using the European Society of Thoracic Surgeons thymic database. METHODS: A total of 498 non-MG patients with pathological stage I thymoma were included in the study. TT was performed in 466 (93.6%) of 498 patients who had surgery with curative intent; ST was done in 32 (6.4%). The completeness of resection, the rate of complications, the 30-day mortality, the overall recurrence and the freedom from recurrence were compared. We performed crude and propensity score-adjusted comparisons by surgical approach (ST vs TT). RESULTS: TT showed the same rate of postoperative complications, 30-day mortality and postoperative length of stay as ST. The 5-year overall survival rate was 89% in the TT group and 55% in the ST group. The 5-year freedom from recurrence was 96% in the TT group and 79% in the ST group. CONCLUSION: Patients with early-stage thymoma without MG who have a TT show significantly better freedom from recurrence than those who have an ST, without an increase in postoperative morbidity rate