Worsening of cerebral hyperemia by the administration of terlipressin in acute liver failure with severe hepatic encephalopathy

There is increasing evidence that terlipressin is useful in patients with cirrhosis and hepatorenal syndrome, but there are no data of its use in patients with acute liver failure (ALF) in whom hepatorenal syndrome is common. Although terlipressin produces systemic vasoconstriction, it produces cerebral vasodilatation and may increase cerebral blood flow (CBF). Increased CBF contributes to intracranial hypertension in patients with ALF. The aim of this study was to evaluate the safety of terlipressin in patients with ALF with respect to cerebral haemodynamics. Six successive patients with ALF were electively ventilated for grade IV hepatic encephalopathy. Patients were monitored invasively and CBF was measured (Kety- Schmidt technique). Measurements were made before, at 1, 3 hour and 5 hours after intravenous (single bolus) administration of terlipressin (0.005 mg/kg) )intravenously (single bolus), median 0.25mg (range 0.2-0.3). There was no significant change in heart rate, mean arterial pressure or cardiac output. CBF and jugular venous oxygen saturation both increased significantly at 1 hour (p<0.0=0.016) respectively. Intracranial pressure increased significantly at 21 hours (p<0=.0.031), returning back to baseline values at 42 hours. This study shows that administration of terlipressin, at a dose that did not alter systemic haemodynamicshemodynamics, resulted in worsening of cerebral hyperemia and intracranial hypertension in patients with ALF and severe hepatic encephalopathy. These data suggest the need to exercise extreme caution in the use of terlipressin in these patients in view of its potentially deleterious consequences on cerebral haemodynamics

Detection of antibody-dependent complement mediated inactivation of both autologous and heterologous virus in primary HIV-1 infection

Specific CD8 T-cell responses to human immunodeficiency virus type 1 (HIV-1) are induced in primary infection and make an important contribution to the control of early viral replication. The importance of neutralizing antibodies in containing primary viremia is questioned because they usually arise much later. Nevertheless antienvelope antibodies develop simultaneously with, or even before, peak viremia. We determined whether such antibodies might control viremia by complement-mediated inactivation (CMI). In each of seven patients studied, antibodies capable of CMI appeared at or shortly after the peak in viremia, concomitantly with detection of virus-specific T-cell responses. The CMI was effective on both autologous and heterologous HIV-1 isolates. Activation of the classical pathway and direct viral lysis were at least partly responsible. Since immunoglobulin G (IgG)-antibodies triggered the CMI, specific memory B cells could also be induced by vaccination. Thus, consideration should be given to vaccination strategies that induce IgG antibodies capable of CMI

Improved hatchery and grow-out technology for marine finfish aquaculture in the Asia–Pacific region

This project focussed on improving marine finfish aquaculture production in the Asia-Pacific region by focussing on key constraints: improving hatchery technology to improve the availability of seedstock; evaluating the nutritional needs of groupers to support the development of compounded pellet diets; and improving communication and coordination of marine finfish aquaculture research and development activities in the Asia-Pacific region

Perspectives on safety culture

Overviewing selected elements from the literature, this paper locates the notion of safety culture within its parent concept of organisational culture. A distinction is drawn between functionalist and interpretive perspectives on organisational culture. The terms ‘culture’ and ‘climate’ are clarified as they are typically applied to organisations and to safety. A contrast is drawn between strategic top down and data-driven bottom up approaches to human factors as an illustrative aspect of safety. A safety case study is used to illustrate two measurement approaches. Key issues for future study include valid measurement of safety culture and developing methods to adequately represent mechanisms through which safety culture might influence, and be influenced by, other safety factors

Which trial do we need? Evaluation of systemic antibiotics as primary prophylaxis in mechanically ventilated patients with burn injuries

Burn injury is a frequent source of morbidity and mortality worldwide, and infection is a leading cause of death. In mechanically ventilated patients who sustain a burn injury, ventilator-associated pneumonia (VAP) is common and associated with poor outcomes and a high risk of recurrence

Gene-Environment Interaction in the Onset of Eczema in Infancy: Filaggrin Loss-of-Function Mutations Enhanced by Neonatal Cat Exposure

Background Loss-of-function variants in the gene encoding filaggrin (FLG) are major determinants of eczema. We hypothesized that weakening of the physical barrier in FLG-deficient individuals may potentiate the effect of environmental exposures. Therefore, we investigated whether there is an interaction between FLG loss-of-function mutations with environmental exposures (pets and dust mites) in relation to the development of eczema. Methods and Findings We used data obtained in early life in a high-risk birth cohort in Denmark and replicated the findings in an unselected birth cohort in the United Kingdom. Primary outcome was age of onset of eczema; environmental exposures included pet ownership and mite and pet allergen levels. In Copenhagen(n = 379), FLG mutation increased the risk of eczema during the first year of life (hazard ratio [HR] 2.26, 95% confidence interval [CI] 1.27–4.00, p = 0.005), with a further increase in risk related to cat exposure at birth amongst children with FLG mutation (HR 11.11, 95% CI 3.79–32.60, p < 0.0001); dog exposure was moderately protective (HR 0.49, 95% CI 0.24–1.01, p = 0.05), but not related to FLG genotype. In Manchester (n = 503) an independent and significant association of the development of eczema by age 12 mo with FLG genotype was confirmed (HR 1.95, 95% CI 1.13–3.36, p = 0.02). In addition, the risk increased because of the interaction of cat ownership at birth and FLG genotype (HR 3.82, 95% CI 1.35–10.81, p = 0.01), with no significant effect of the interaction with dog ownership (HR 0.59, 95% CI 0.16–2.20, p = 0.43). Mite-allergen had no effects in either cohort. The observed effects were independent of sensitisation. Conclusions We have demonstrated a significant interaction between FLG loss-of-function main mutations (501x and 2282del4) and cat ownership at birth on the development of early-life eczema in two independent birth cohorts. Our data suggest that cat but not dog ownership substantially increases the risk of eczema within the first year of life in children with FLG loss-of-function variants, but not amongst those without. FLG-deficient individuals may need to avoid cats but not dogs in early life

Primakoff effect in eta-photoproduction off protons

We analyse data on forward eta-meson photoproduction off a proton target and extract the eta to gamma gamma decay width utilizing the Primakoff effect. The hadronic amplitude that enters into our analysis is strongly constrained because it is fixed from a global fit to available gamma p to p eta data for differential cross sections and polarizations. We compare our results with present information on the two-photon eta-decay from the literature. We provide predictions for future PrimEx experiments at Jefferson Laboratory in order to motivate further studies.Comment: 5 pages, 6 figures, gamma-gamma*-eta form factor included, version to appear in Eur. Phys. J. A

Vector meson production and nucleon resonance analysis in a coupled-channel approach for energies m_N < sqrt(s) < 2 GeV I: pion-induced results and hadronic parameters

We present a nucleon resonance analysis by simultaneously considering all pion- and photon-induced experimental data on the final states gamma N, pi N, 2 pi N, eta N, K Lambda, K Sigma, and omega N for energies from the nucleon mass up to sqrt(s) = 2 GeV. In this analysis we find strong evidence for the resonances P_{31}(1750), P_{13}(1900), P_{33}(1920), and D_{13}(1950). The omega N production mechanism is dominated by large P_{11}(1710) and P_{13}(1900) contributions. In this first part, we present the results of the pion-induced reactions and the extracted resonance and background properties with emphasis on the difference between global and purely hadronic fits.Comment: 54 pages, 26 figures, discussion extended, typos corrected, references updated, to appear in Phys. Rev.

Isotope Effect in the Presence of Magnetic and Nonmagnetic Impurities

The effect of impurities on the isotope coefficient is studied theoretically in the framework of Abrikosov-Gor'kov approach generalized to account for both potential and spin-flip scattering in anisotropic superconductors. An expression for the isotope coefficient as a function of the critical temperature is obtained for a superconductor with an arbitrary contribution of spin-flip processes to the total scattering rate and an arbitrary degree of anisotropy of the superconducting order parameter, ranging from isotropic s-wave to d-wave and including anisotropic s-wave and mixed (s+d)-wave as particular cases. It is found that both magnetic and nonmagnetic impurities enhance the isotope coefficient, the enhancement due to magnetic impurities being generally greater than that due to nonmagnetic impurities. From the analysis of the experimental results on La-Sr-Cu-M-O high temperature superconductor, it is concluded that the symmetry of the pairing state in this system differs from a pure d-wave.Comment: 4 pages, 3 figure

Centrifugal stretching from lifetime measurements in the 170Hf ground state band

Centrifugal stretching in the deformed rare-earth nucleus 170Hf is investigated using high-precision lifetime measurements, performed with the New Yale Plunger Device at Wright Nuclear Structure Laboratory, Yale University. Excited states were populated in the fusion-evaporation reaction 124Sn(50Ti,4n)170Hf at a beam energy of 195 MeV. Recoil distance doppler shift data were recorded for the ground state band through the J=16+ level. The measured B(E2) values and transition quadrupole moments improve on existing data and show increasing β deformation in the ground state band of 170Hf. The results are compared to descriptions by a rigid rotor and by the confined β-soft rotor model. © 2013 American Physical Society