Haemophagocytic lymphohistiocytosis in adult critical care

Haemophagocytic lymphohistiocytosis (HLH) is a syndrome of severe immune dysregulation, characterised by extreme inflammation, fever, cytopaenias and organ dysfunction. HLH can be triggered by conditions such as infection, auto-immune disease and malignancy, amongst others. Both a familial and a secondary form have been described, the latter being increasingly recognised in adult patients with critical illness. HLH is difficult to diagnose, often underrecognised and carries a high mortality. Patients can present in a very similar fashion to sepsis and the two syndromes can co-exist and overlap, yet HLH requires specific immunosuppressive therapy. HLH should be actively excluded in patients with presumed sepsis who either lack a clear focus of infection or who are not responding to energetic infection management. Elevated serum ferritin is a key biomarker that may indicate the need for further investigations for HLH and can guide treatment. Early diagnosis and a multidisciplinary approach to HLH management may save lives

Can a single image processing algorithm work equally well across all phases of DCE-MRI?

Image segmentation and registration are said to be challenging when applied to dynamic contrast enhanced MRI sequences (DCE-MRI). The contrast agent causes rapid changes in intensity in the region of interest and elsewhere, which can lead to false positive predictions for segmentation tasks and confound the image registration similarity metric. While it is widely assumed that contrast changes increase the difficulty of these tasks, to our knowledge no work has quantified these effects. In this paper we examine the effect of training with different ratios of contrast enhanced (CE) data on two popular tasks: segmentation with nnU-Net and Mask R-CNN and registration using VoxelMorph and VTN. We experimented further by strategically using the available datasets through pretraining and fine tuning with different splits of data. We found that to create a generalisable model, pretraining with CE data and fine tuning with non-CE data gave the best result. This interesting find could be expanded to other deep learning based image processing tasks with DCE-MRI and provide significant improvements to the models performance

Daily and annual cycles in thermoregulatory behaviour and cardio‑respiratory physiology of black and white tegu lizards

This study was designed to determine the manner in which metabolism is suppressed during dormancy in black and white tegu lizards (Tupinambis merianae). To this end, heart rate (f H), respiration rate (f R), and deep body temperature (T b) were continuously monitored in outdoor enclosures by radio-telemetry for nine months. There was a continuous decline in nighttime breathing and heart rate, at constant T b, throughout the late summer and fall suggestive of an active metabolic suppression that developed progressively at night preceding the entrance into dormancy. During the day, however, the tegus still emerged to bask. In May, when the tegus made a behavioural commitment to dormancy, T b (day and night) fell to match burrow temperature, accompanied by a further reduction in f H and f R. Tegus, under the conditions of this study, did arouse periodically during dormancy. There was a complex interplay between changes in f H and T b associated with the direct effects of temperature and the indirect effects of thermoregulation, activity, and changes in metabolism. This interplay gave rise to a daily hysteresis in the f H/T b relationship reflective of the physiological changes associated with warming and cooling as preferred T b alternated between daytime and nighttime levels. The shape of the hysteresis curve varied with season along with changes in metabolic state and daytime and nighttime body temperature preferences

The Relationship Between Body Temperature, Heart Rate, Breathing Rate, and Rate of Oxygen Consumption, in the Tegu Lizard (Tupinambis merianae) at Various Levels of Activity

The present study determined whether EEG and/or EMG recordings could be used to reliably define activity states in the Brazilian black and white tegu lizard (Tupinambis merianae) and then examined the interactive effects of temperature and activity states on strategies for matching O2 supply and demand. In a first series of experiments, the rate of oxygen consumption (V˙O2), breathing frequency (f R), heart rate (f H), and EEG and EMG (neck muscle) activity were measured in different sleep/wake states (sleeping, awake but quiet, alert, or moving). In general, metabolic and cardio-respiratory changes were better indictors of the transition from sleep to wake than were changes in the EEG and EMG. In a second series of experiments, the interactive effects of temperature (17, 27 and 37 °C) and activity states on f R, tidal volume (V T), the fraction of oxygen extracted from the lung per breath (FIO2–FEO2), f H, and the cardiac O2 pulse were quantified to determine the relative roles of each of these variables in accommodating changes in V˙O2. The increases in oxygen supply to meet temperature- and activity-induced increases in oxygen demand were produced almost exclusively by increases in f H and f R. Regression analysis showed that the effects of temperature and activity state on the relationships between f H, f R and V˙O2 was to extend a common relationship along a single curve, rather than separate relationships for each metabolic state. For these lizards, the predictive powers of f R and f H were maximized when the effects of changes in temperature, digestive state and activity were pooled. However, the best r 2 values obtained were 0.63 and 0.74 using f R and f H as predictors of met abolic rate, respectively

Lemur Systematics and Hemoglobin Phylogeny a

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73526/1/j.1749-6632.1988.tb51443.x.pd

Exploring open access coverage of Wikipedia-cited research across the White Rose Universities

The popular online encyclopaedia Wikipedia is an important and influential platform that assists with the communication of science to a global audience. Using data obtained from Altmetric.com and Unpaywall, we looked at research from the White Rose Universities (Sheffield, Leeds and York) that is cited on Wikipedia. Of that research, we explored what percentage of citations were available open access (OA) and the location of those citations to ascertain whether they were hosted by publishers or within OA repositories. This article explores the importance of access to OA research within such an important and leading platform as Wikipedia and how well it supports effective scientific communication across society