Osmotic therapies added to antibiotics for acute bacterial meningitis

BACKGROUND: Every day children and adults die from acute community-acquired bacterial meningitis, particularly in low-income countries, and survivors risk deafness, epilepsy and neurological disabilities. Osmotic therapies may attract extra-vascular fluid and reduce cerebral oedema, and thus reduce death and improve neurological outcomes.This is an update of a Cochrane Review first published in 2013. OBJECTIVES: To evaluate the effects of osmotic therapies added to antibiotics for acute bacterial meningitis in children and adults on mortality, deafness and neurological disability. SEARCH METHODS: We searched CENTRAL (2017, Issue 1), MEDLINE (1950 to 17 February 2017), Embase (1974 to 17 February 2017), CINAHL (1981 to 17 February 2017), LILACS (1982 to 17 February 2017) and registers of ongoing clinical trials (ClinicalTrials.com, WHO ICTRP) (21 February 2017). We also searched conference abstracts and contacted researchers in the field (up to 12 December 2015). SELECTION CRITERIA: Randomised controlled trials testing any osmotic therapy in adults or children with acute bacterial meningitis. DATA COLLECTION AND ANALYSIS: Two review authors independently screened the search results and selected trials for inclusion. Results are presented using risk ratios (RR) and 95% confidence intervals (CI) and grouped according to whether the participants received steroids or not. We used the GRADE approach to assess the certainty of the evidence. MAIN RESULTS: We included five trials with 1451 participants. Four trials evaluated glycerol against placebo, and one evaluated glycerol against 50% dextrose; in addition three trials evaluated dexamethasone and one trial evaluated acetaminophen (paracetamol) in a factorial design. Stratified analysis shows no effect modification with steroids; we present aggregate effect estimates.Compared to placebo, glycerol probably has little or no effect on death in people with bacterial meningitis (RR 1.08, 95% CI 0.90 to 1.30; 5 studies, 1272 participants; moderate-certainty evidence), but may reduce neurological disability (RR 0.73, 95% CI 0.53 to 1.00; 5 studies, 1270 participants; low-certainty evidence).Glycerol may have little or no effect on seizures during treatment for meningitis (RR 1.08, 95% CI 0.90 to 1.30; 4 studies, 1090 participants; low-certainty evidence).Glycerol may reduce the risk of subsequent deafness (RR 0.64, 95% CI 0.44 to 0.93; 5 studies, 922 participants; low to moderate-certainty evidence).Glycerol probably has little or no effect on gastrointestinal bleeding (RR 0.93, 95% CI 0.39 to 2.19; 3 studies, 607 participants; moderate-certainty evidence). The evidence on nausea, vomiting and diarrhoea is uncertain (RR 1.09, 95% CI 0.81 to 1.47; 2 studies, 851 participants; very low-certainty evidence). AUTHORS' CONCLUSIONS: Glycerol was the only osmotic therapy evaluated, and data from trials to date have not demonstrated an effect on death. Glycerol may reduce neurological deficiency and deafness

The method of bladder drainage in spinal cord injury patients may influence the histological changes in the mucosa of neuropathic bladder – a hypothesis

BACKGROUND: In spinal cord injury (SCI) patients, no correlation was found between the number of bladder infections per year, the period since injury, the neurologic level of the spinal cord lesion and the histopathology of the urinary bladder mucosa. The use of chronic indwelling urethral and/or suprapubic catheters in SCI patients is often associated with inflammatory and proliferative pathological conditions in neuropathic bladder. PRESENTATION OF THE HYPOTHESIS: We propose a hypothesis that the type of bladder drainage in SCI patients influences the histological changes in the mucosa of neuropathic bladder. This hypothesis implies that SCI patients with long-term indwelling urinary catheters develop certain histological changes in bladder mucosa, which are seen less frequently in SCI patients, who do not use long-term indwelling catheters. The latter group includes patients, who perform regular intermittent catheterisation and those, who wear a penile sheath and empty their bladders satisfactorily by reflex voiding. We hypothesise that the following histological lesions are seen more frequently in the neuropathic bladder of SCI patients with long-term indwelling catheters. (1) Papillary or polypoid cystitis; (2) widespread cystitis glandularis; (3) moderate to severe, acute and chronic inflammatory changes in bladder mucosa; (4) follicular cystitis; (5) squamous metaplasia; and (6) urothelial dysplasia As per this hypothesis, it is postulated that the above pathological conditions are seen less often in SCI patients, who achieve complete, low-pressure emptying of the neuropathic bladder by regular intermittent catheterisation, and SCI patients with penile sheath drainage, who empty their bladders satisfactorily by reflex voiding. TESTING THE HYPOTHESIS: A large prospective study of bladder biopsies in SCI patients practising different methods of bladder drainage is required to validate this hypothesis that the histological changes in bladder mucosa are related to the method of bladder drainage in SCI patients. IMPLICATIONS OF THE HYPOTHESIS: We propose a hypothesis that the method of bladder drainage in SCI patients influences histological changes in the bladder mucosa. If this hypothesis is validated, methods of bladder drainage such as intermittent catheterisation, which do not require the use of chronic indwelling catheters, should be recommended, in order to minimise adverse histological changes in the mucosa of neuropathic bladder of spinal cord injury patients

Fingertip digital thermal monitoring: a fingerprint for cardiovascular disease?

Cardiac Dysfunction and Arrhythmia

Increased accuracy in computed tomography coronary angiography; a new body surface area adapted protocol

Vascular Biology and Interventio

Vegan and omnivorous high protein diets support comparable daily myofibrillar protein synthesis rates and skeletal muscle hypertrophy in young adults.

This is the final version. Available from Elsevier via the DOI in this record.Data availability: Data described in the manuscript may be made available upon request, pending application.BACKGROUND: It remains unclear whether non-animal-derived dietary protein sources (and therefore vegan diets) can support resistance training-induced skeletal muscle remodeling to the same extent as animal-derived protein sources. METHODS: In Phase 1, 16 healthy young adults (m = 8, f = 8; age: 23 ± 1 y; BMI: 23 ± 1 kg/m2) completed a 3-d dietary intervention (high protein, 1.8 g·kg bm-1·d-1) where protein was derived from omnivorous (OMNI1; n = 8) or exclusively non-animal (VEG1; n = 8) sources, alongside daily unilateral leg resistance exercise. Resting and exercised daily myofibrillar protein synthesis (MyoPS) rates were assessed using deuterium oxide. In Phase 2, 22 healthy young adults (m = 11, f = 11; age: 24 ± 1 y; BMI: 23 ± 0 kg/m2) completed a 10 wk, high-volume (5 d/wk), progressive resistance exercise program while consuming an omnivorous (OMNI2; n = 12) or non-animal-derived (VEG2; n = 10) high-protein diet (∼2 g·kg bm-1·d-1). Muscle fiber cross-sectional area (CSA), whole-body lean mass (via DXA), thigh muscle volume (via MRI), muscle strength, and muscle function were determined pre, after 2 and 5 wk, and postintervention. OBJECTIVES: To investigate whether a high-protein, mycoprotein-rich, non-animal-derived diet can support resistance training-induced skeletal muscle remodeling to the same extent as an isonitrogenous omnivorous diet. RESULTS: Daily MyoPS rates were ∼12% higher in the exercised than in the rested leg (2.46 ± 0.27%·d-1 compared with 2.20 ± 0.33%·d-1 and 2.62 ± 0.56%·d-1 compared with 2.36 ± 0.53%·d-1 in OMNI1 and VEG1, respectively; P 0.05). Resistance training increased lean mass in both groups by a similar magnitude (OMNI2 2.6 ± 1.1 kg, VEG2 3.1 ± 2.5 kg; P > 0.05). Likewise, training comparably increased thigh muscle volume (OMNI2 8.3 ± 3.6%, VEG2 8.3 ± 4.1%; P > 0.05), and muscle fiber CSA (OMNI2 33 ± 24%, VEG2 32 ± 48%; P > 0.05). Both groups increased strength (1 repetition maximum) of multiple muscle groups, to comparable degrees. CONCLUSIONS: Omnivorous and vegan diets can support comparable rested and exercised daily MyoPS rates in healthy young adults consuming a high-protein diet. This translates to similar skeletal muscle adaptive responses during prolonged high-volume resistance training, irrespective of dietary protein provenance. This trial was registered at clinicaltrials.gov as NCT03572127.Marlow Foods Ltd

Alkaline-Silicate REE-HFSE Systems

This is the final version. Available on open access from the Society of Economic Geologists via the DOI in this recordDevelopment of renewable energy infrastructure requires critical raw materials, such as the rare earth elements (REEs, including scandium) and niobium, and is driving expansion and diversification in their supply chains. Although alternative sources are being explored, the majority of the world’s resources of these elements are found in alkaline-silicate rocks and carbonatites. These magmatic systems also represent major sources of fluorine and phosphorus. Exploration models for critical raw materials are comparatively less well developed than those for major and precious metals, such as iron, copper, and gold, where most of the mineral exploration industry continues to focus. The diversity of lithologic relationships and a complex nomenclature for many alkaline rock types represent further barriers to the exploration and exploitation of REE-high field strength element (HFSE) resources that will facilitate the green revolution. We used a global review of maps, cross sections, and geophysical, geochemical, and petrological observations from alkaline systems to inform our description of the alkaline-silicate REE + HFSE mineral system from continental scale (1,000s km) down to deposit scale (~1 km lateral). Continental-scale targeting criteria include a geodynamic trigger for low-degree mantle melting at high pressure and a mantle source enriched in REEs, volatile elements, and alkalies. At the province and district scales, targeting criteria relate to magmatic-system longevity and the conditions required for extensive fractional crystallization and the residual enrichment of the REEs and HFSEs. A compilation of maps and geophysical data were used to construct an interactive 3-D geologic model (25-km cube) that places mineralization within a depth and horizontal reference frame. It shows typical lithologic relationships surrounding orthomagmatic REE-Nb-Ta-Zr-Hf mineralization in layered agpaitic syenites, roof zone REE-Nb-Ta mineralization, and mineralization of REE-Nb-Zr associated with peralkaline granites and pegmatites. The resulting geologic model is presented together with recommended geophysical and geochemical approaches for exploration targeting, as well as mineral processing and environmental factors pertinent for the development of mineral resources hosted by alkaline-silicate magmatic systems.European Union Horizon 202

Distal protection beneficial?

Vascular Biology and Interventio

A quantitative approach to study indirect effects among disease proteins in the human protein interaction network

<p>Abstract</p> <p>Background</p> <p>Systems biology makes it possible to study larger and more intricate systems than before, so it is now possible to look at the molecular basis of several diseases in parallel. Analyzing the interaction network of proteins in the cell can be the key to understand how complex processes lead to diseases. Novel tools in network analysis provide the possibility to quantify the key interacting proteins in large networks as well as proteins that connect them. Here we suggest a new method to study the relationships between topology and functionality of the protein-protein interaction network, by identifying key mediator proteins possibly maintaining indirect relationships among proteins causing various diseases.</p> <p>Results</p> <p>Based on the i2d and OMIM databases, we have constructed (i) a network of proteins causing five selected diseases (DP, disease proteins) plus their interacting partners (IP, non-disease proteins), the DPIP network and (ii) a protein network showing only these IPs and their interactions, the IP network. The five investigated diseases were (1) various cancers, (2) heart diseases, (3) obesity, (4) diabetes and (5) autism. We have quantified the number and strength of IP-mediated indirect effects between the five groups of disease proteins and hypothetically identified the most important mediator proteins linking heart disease to obesity or diabetes in the IP network. The results present the relationship between mediator role and centrality, as well as between mediator role and functional properties of these proteins.</p> <p>Conclusions</p> <p>We show that a protein which plays an important indirect mediator role between two diseases is not necessarily a hub in the PPI network. This may suggest that, even if hub proteins and disease proteins are trivially of great interest, mediators may also deserve more attention, especially if disease-disease associations are to be understood. Identifying the hubs may not be sufficient to understand particular pathways. We have found that the mediators between heart diseases and obesity, as well as heart diseases and diabetes are of relatively high functional importance in the cell. The mediator proteins suggested here should be experimentally tested as products of hypothetical disease-related proteins.</p

On the Polynomial Measurement Error Model

This paper discusses point estimation of the coefficients of polynomial measurement error (errors-in-variables) models. This includes functional and structural models. The connection between these models and total least squares (TLS) is also examined. A compendium of existing as well as new results is presented

The virtual supermarket: An innovative research tool to study consumer food purchasing behaviour

<p>Abstract</p> <p>Background</p> <p>Economic interventions in the food environment are expected to effectively promote healthier food choices. However, before introducing them on a large scale, it is important to gain insight into the effectiveness of economic interventions and peoples' genuine reactions to price changes. Nonetheless, because of complex implementation issues, studies on price interventions are virtually non-existent. This is especially true for experiments undertaken in a retail setting. We have developed a research tool to study the effects of retail price interventions in a virtual-reality setting: the Virtual Supermarket. This paper aims to inform researchers about the features and utilization of this new software application.</p> <p>Results</p> <p>The Virtual Supermarket is a Dutch-developed three-dimensional software application in which study participants can shop in a manner comparable to a real supermarket. The tool can be used to study several food pricing and labelling strategies. The application base can be used to build future extensions and could be translated into, for example, an English-language version. The Virtual Supermarket contains a front-end which is seen by the participants, and a back-end that enables researchers to easily manipulate research conditions. The application keeps track of time spent shopping, number of products purchased, shopping budget, total expenditures and answers on configurable questionnaires. All data is digitally stored and automatically sent to a web server. A pilot study among Dutch consumers (n = 66) revealed that the application accurately collected and stored all data. Results from participant feedback revealed that 83% of the respondents considered the Virtual Supermarket easy to understand and 79% found that their virtual grocery purchases resembled their regular groceries.</p> <p>Conclusions</p> <p>The Virtual Supermarket is an innovative research tool with a great potential to assist in gaining insight into food purchasing behaviour. The application can be obtained via an URL and is freely available for academic use. The unique features of the tool include the fact that it enables researchers to easily modify research conditions and in this way study different types of interventions in a retail environment without a complex implementation process. Finally, it also maintains researcher independence and avoids conflicts of interest that may arise from industry collaboration.</p