Linking the metabolic rate of individuals to species ecology and life history in key Arctic copepods

This study compares the active and resting metabolic rates of species and life stages of copepods during the Arctic winter. Measurements were taken on individuals, and rates were described as functions of body mass. Differences in metabolic rate between species and life stages with the same mass were taken as evidence of distinct lifestyles. Copepod species that opportunistically feed during winter had higher active metabolic rates than species in a dormant state, but their resting metabolic rates were similar. Furthermore, metabolic rate increased more rapidly with mass for males compared to females and juvenile copepods with the result that the largest males had much greater rates. Whether the copepod was active or at rest had the greatest effect on metabolic rate, followed by body mass, species, and life stage having the least effect. Individual measurements on copepods can facilitate comparisons of metabolic rate across mass and further enable the measurement of rates when the individuals are active or at rest. The plasticity in metabolic rate found in the present study enables winter active species to have as low metabolic rates as dormant species and then suddenly mobilize and increase metabolism, likely as an adaptation to the scarce and random food availability during winter

Exercise: a path to wellness during adjuvant chemotherapy for breast cancer?

Background: Breast cancer treatment can represent a threat to a patient’s wellness. The role of exercise in perceived wellness in women with breast cancer merits further study. Objective: The objective of this study was to describe how exercise is perceived by women to influence their physical and psychosocial wellness at the time they were receiving chemotherapy. Methods: Five focus group interviews with a total of 27 women with early-stage breast cancer were conducted. Prior to the focus groups, the women had participated in an exercise intervention during chemotherapy treatment. Results: Three themes emerged from the analysis: exercise shapes feelings of psychological wellness; exercise stimulates feelings of physical wellness; and exercise influences social wellness. The women reported feeling stronger in a psychological sense after exercising, that the strength exercise improved their upper-limb functioning, and that engaging in exercise triggered social support and interactions. Conclusions: Exercise during breast cancer treatment is perceived to enhance the patients’ wellness on several dimensions and in particular psychological wellness. Exercise might support the patients’ efforts to restore their sense of wellness and enhance their level of daily life functioning. Implications for Practice: Cancer nurses should promote exercise as a wellness-fostering intervention during chemotherapy treatment. Focusing on how exercise can contribute to feelings of wellness may help women with breast cancer choose exercise as a health-promoting activity that contributes to their recovery

Intravascular versus surface cooling for targeted temperature management after out-of-hospital cardiac arrest: an analysis of the TTH48 trial

BackgroundThe aim of this study was to explore the performance and outcomes for intravascular (IC) versus surface cooling devices (SFC) for targeted temperature management (TTM) after out-of-hospital cardiac arrest.MethodsA retrospective analysis of data from the Time-differentiated Therapeutic Hypothermia (TTH48) trial (NCT01689077), which compared whether TTM at 33 degrees C for 48h results in better neurologic outcomes compared with standard 24-h duration. Devices were assessed for the speed of cooling and rewarming rates. Precision was assessed by measuring temperature variability (TV), i.e., the standard deviation (SD) of all temperature measurements in the cooling phase. Main outcomes were overall mortality and poor neurological outcome, including death, severe disability, or vegetative status.ResultsA total of 352 patients had available data and were included in the analysis; of those, 218 (62%) were managed with IC. A total of 114/218 (53%) patients with IC and 61/134 (43%) with SFC were cooled for 48h (p=0.22). Time to target temperature (34 degrees C) was significantly shorter for patients treated with endovascular devices (2.2 [1.1-4.0] vs. 4.2 [2.7-6.0] h, p<0.001), but temperature was also lower on admission (35.0 [34.2-35.6] vs. 35.3 [34.5-35.8]degrees C; p=0.02) and cooling rate was similar (0.4 [0.2-0.8] vs. 0.4 [0.2-0.6]degrees C/h; p=0.14) when compared to SFC. Temperature variability was significantly lower in the endovascular device group when compared with SFC methods (0.6 [0.4-0.9] vs. 0.7 [0.5-1.0]degrees C; p=0.007), as was rewarming rate (0.31 [0.22-0.44] vs. 0.37 [0.29-0.49]degrees C/hour; p=0.02). There was no statistically significant difference in mortality (endovascular 65/218, 29% vs. others 43/134, 32%; p=0.72) or poor neurological outcome (endovascular 69/218, 32% vs. others 51/134, 38%; p=0.24) between type of devices.ConclusionsEndovascular cooling devices were more precise than SFC methods in patients cooled at 33 degrees C after out-of-hospital cardiac arrest. Main outcomes were similar with regard to the cooling methods

Electrolyte profiles with induced hypothermia: A sub study of a clinical trial evaluating the duration of hypothermia after cardiac arrest

Background: Electrolyte disturbances can result from targeted temperature treatment (TTM) in out-of-hospital cardiac arrest (OHCA) patients. This study explores electrolyte changes in blood and urine in OHCA patients treated with TTM.Methods: This is a sub-study of the TTH48 trial, with the inclusion of 310 unconscious OHCA patients treated with TTM at 33°C for 24 or 48 h. Over a three-day period, serum concentrations were obtained on sodium potassium, chloride, ionized calcium, magnesium and phosphate, as were results from a 24-h diuresis and urine electrolyte concentration and excretion. Changes over time were analysed with a mixed-model multivariate analysis of variance with repeated measurements.Results: On admission, mean ± SD sodium concentration was 138 ± 3.5 mmol/l, which increased slightly but significantly (p Conclusions: Electrolytes mostly remained within the reference interval. A temporal change occurred in potassium, magnesium and calcium concentrations with TTM's different phases. No hypothermia effect on diuresis was detected, and urine excretion of electrolytes mostly stayed low.</p

Immediate thoracotomy for penetrating injuries: Ten years' experience at a Dutch level I trauma center

Background: An emergency department thoracotomy (EDT) or an emergency thoracotomy (ET) in the operating theater are both beneficial in selected patients following thoracic penetrating injuries. Since outcome-descriptive European studies are lacking, the aim of this retrospective study was to evaluate ten years of experience at a Dutch level I trauma center. Method: Data on patients who underwent an immediate thoracotomy after sustaining a penetrating thoracic injury between October 2000 and January 2011 were collected from the trauma registry and hospital files. Descriptive and univariate analyses were performed. Results: Among 56 patients, 12 underwent an EDT and 44 an ET. Forty-six patients sustained one or multiple stab wounds, versus ten with one or multiple gunshot wounds. Patients who had undergone an EDT had a lower GCS (p < 0. 001), lower pre-hospital RTS and hospital triage RTS (p < 0. 001 and p = 0. 009, respectively), and a lower SBP (p = 0. 038). A witnessed loss of signs of life generally occurred in EDT patients and was accompanied by 100 % mortality. Survival following EDT was 25 %, which was significantly lower than in the ET group (75 %; p = 0. 002). Survivors had lower ISS (p = 0. 011), lower rates of pre-hospital (p = 0. 031) and hospital (p = 0. 003) hemodynamic instability, and a lower prevalence of concomitant abdominal injury (p = 0. 002). Conclusion: The overall survival rate in our study was 64 %. The outcome of immediate thoracotomy performed in this level I trauma center was similar to those obtained in high-incidence regions like the US and South Africa. This suggests that trauma units where immediate thoracotomies are not part of the daily routine can achieve similar results, if properly trained

Impact Factor: outdated artefact or stepping-stone to journal certification?

A review of Garfield's journal impact factor and its specific implementation as the Thomson Reuters Impact Factor reveals several weaknesses in this commonly-used indicator of journal standing. Key limitations include the mismatch between citing and cited documents, the deceptive display of three decimals that belies the real precision, and the absence of confidence intervals. These are minor issues that are easily amended and should be corrected, but more substantive improvements are needed. There are indications that the scientific community seeks and needs better certification of journal procedures to improve the quality of published science. Comprehensive certification of editorial and review procedures could help ensure adequate procedures to detect duplicate and fraudulent submissions.Comment: 25 pages, 12 figures, 6 table

High expression of tumour-associated trypsin inhibitor correlates with liver metastasis and poor prognosis in colorectal cancer

Increased expression of tumour-associated trypsin inhibitor (TATI) in tumour tissue and/or serum has been associated with poor survival in various cancer forms. Moreover, a proinvasive function of TATI has been shown in colon cancer cell lines. In this study, we have examined the prognostic significance of tumour-specific TATI expression in colorectal cancer, assessed by immunohistochemistry (IHC) on tissue microarrays (TMAs) with tumour specimens from two independent patient cohorts. Kaplan–Meier analysis and Cox proportional hazards modelling were used to estimate time to recurrence, disease-free survival and overall survival. In both cohorts, a high (>50% of tumour cells) TATI expression was an independent predictor of a significantly shorter overall survival. In cohort II, in multivariate analysis including age, gender, disease stage, differentiation grade, vascular invasion and carcinoembryonal antigen (CEA), high TATI expression was associated with a significantly decreased overall survival (HR=1.82; 95% CI=1.19–2.79) and disease-free survival (HR=1.56; 95% CI=1.05–2.32) in curatively treated patients. Moreover, there was an increased risk for liver metastasis in both cohorts that remained significant in multivariate analysis in cohort II (HR=2.85; 95% CI=1.43–5.66). In conclusion, high TATI expression is associated with liver metastasis and is an independent predictor of poor prognosis in patients with colorectal cancer