AN OVERVIEW OF OBSERVATIONAL SLEEP RESEARCH WITH APPLICATION TO SLEEP STAGE TRANSITIONING

In this manuscript we give an overview of observational sleep research with a particular emphasis on sleep stage transitions. Sleep states represent a categorization of sleep electroencephalogram behavior over the night. We postulate that the rate of transitioning between sleep states is an important predictor of health. This claim is evaluated by comparing subjects with sleep disordered breathing to matched controls

Introduction to theory meets crisis collection

This collection consists of five contributions presented as plenaries at a conference, ‘Theory Meets Crisis’, held at the Robert Schuman Centre, European University Institute, in July 2016. The organizers of the conference asked leading scholars of varieties of capitalism, democracy, redistributional politics, European integration and political parties to engage the theoretical implications of Europe’s multiplex crisis. To what extent and how, we asked, has the European crisis confirmed, undermined or reshaped theoretically grounded expectations in these fields? Beyond the confirmation or disconfirmation of particular hypotheses, does the crisis impel us to take a fresh look at comparative politics

Dietary supplement use and nosebleeds in hereditary haemorrhagic telangiectasia - an observational study.

Understanding potential provocations of haemorrhage is important in a range of clinical settings, and particularly for people with abnormal vasculature. Patients with hereditary haemorrhagic telangiectasia (HHT) can report haemorrhage from nasal telangiectasia in real time, and suggested dietary factors may precipitate nosebleeds. To examine further, nosebleed severity, dietary supplement use, and blood indices were evaluated in an unselected group of 50 HHT patients recruited from a specialist UK service. Using the validated Epistaxis Severity Score, nosebleed severity ranged from 0 to 9.1 out of 10 (median 3.9). Using a Food Frequency Questionnaire, 24/50 (48%) participants reported use of dietary supplements in the previous year. A third (18/50; 36%) had used self prescribed, non-iron containing dietary supplements, ingesting between 1 and 3 different supplements each day. Eight (16%) used fish oils. Despite having more severe epistaxis (p = 0.012), the 12 iron supplement users had higher serum iron concentrations, and were able to maintain their red blood cell indices. In contrast, there was no evident benefit for the participants using non iron supplements. Furthermore, platelet counts and serum fibrinogen tended to be lower in fish oil/supplement users, and one fish oil user demonstrated reduced in vitro platelet aggregation. In conclusion, in this small study, a third of HHT patients used non-iron dietary supplements, and one in six ingested fish oils, unaware of their known anti-platelet activity. The scale of use, and potential of these "natural health supplements" to exacerbate nosebleeds has not been appreciated previously in HHT

Lactoferrin for the Prevention of Post-antibiotic Diarrhoea

Antibiotic-associated diarrhoea (AAD) is a common cause of morbidity and mortality. Older individuals in long-term care facilities are particularly vulnerable due to multisystem illnesses and the prevailing conditions for nosocomial infections. Lactoferrin, an antimicrobial protein in human breastmilk, was tested to determine whether it would prevent or reduce AAD, including Clostridium difficile in tube-fed long-term care patients. Thirty patients were enrolled in a randomized double-blind study, testing eight weeks of human recombinant lactoferrin compared to placebo for the prevention of antibiotic-associated diarrhoea in long-term care patients. Fewer patients in the lactoferrin group experienced diarrhoea compared to controls (p=0.023). Based on the findings, it is concluded that human lactoferrin may reduce post-antibiotic diarrhoea

Historical-institutionalist perspectives on the development of the EU budget system

The EU budget has only recently started to feature in theories of European integration. Studies typically adopt a historical-institutionalist framework, exploring notions such as path dependency. They have, however, generally been rather aggregated, or coarse-grained, in their approach. The EU budget has thus been treated as a single entity rather than a series of inter-linked institutions. This paper seeks to address these lacunae by adopting a fine-grained approach. This enables us to emphasize the connections that exist between EU budgetary institutions, in both time and space. We show that the initial set of budgetary institutions was unable, over time, to achieve consistently their treaty-based objectives. In response, rather than reform these institutions at potentially high political cost, additional institutions were layered on top of the extant structures. We thus demonstrate how some EU budgetary institutions have remained unchanged, whilst others have been added or changed over time

Coagulation status of critically ill patients with and without liver disease assessed using a novel thrombin generation analyzer

Funding Information: NHS Blood and TransplantPeer reviewedPublisher PD

Cryoprecipitate transfusion in trauma patients attenuates hyperfibrinolysis and restores normal clot structure and stability : Results from a laboratory sub-study of the FEISTY trial

Acknowledgements We acknowledge the Aberdeen Microscopy and Histology Core Facility and thank Judith de Vries for her guidance in analysing the confocal images. We thank Megan Simpson for measuring PAI-1 and uPA antigen levels in the fibrinogen preparations. We thank all of the FEISTY research staff who collected and processed the patient samples. Funding This work was supported by research grants from CSL Behring and Tenovus Scotland.Peer reviewedPublisher PD

Turkish Accession and Defining the Boundaries of Nationalism and Supranationalism: Discourses in the European Commission

The European Union in general and the European Commission in particular are characterised by supranational governance. The enlargement policy gives the Commission the opportunity to export and promote supranational norms and define the boundaries of Europe as a supranational polity through the conditionality of membership and intensive contact with the candidate countries. This article analyses the discourses of the Commission on Turkey and gives us insights into how well Turkey fits the supranational model in the eyes of Commission officials. It demonstrates how the boundaries of supranationalism are set and even challenged by the prospects of Turkey’s accession

Recombinant ADAMTS13 reduces abnormally up-regulated von Willebrand factor in plasma from patients with severe COVID-19

Thrombosis affecting the pulmonary and systemic vasculature is common during severe COVID-19 and causes adverse outcomes. Although thrombosis likely results from inflammatory activation of vascular cells, the mediators of thrombosis remain unconfirmed. In a cross-sectional cohort of 36 severe COVID-19 patients, we show that markedly increased plasma von Willebrand factor (VWF) levels were accompanied by a partial reduction in the VWF regulatory protease ADAMTS13. In all patients we find this VWF/ADAMTS13 imbalance to be associated with persistence of ultra-high-molecular-weight (UHMW) VWF multimers that are highly thrombogenic in some disease settings. Incubation of plasma samples from patients with severe COVID-19 with recombinant ADAMTS13 (rADAMTS13) substantially reduced the abnormally high VWF activity, reduced overall multimer size and depleted UHMW VWF multimers in a time and concentration dependent manner. Our data implicate disruption of normal VWF/ADAMTS13 homeostasis in the pathogenesis of severe COVID-19 and indicate that this can be reversed ex vivo by correction of low plasma ADAMTS13 levels. These findings suggest a potential therapeutic role for rADAMTS13 in helping restore haemostatic balance in COVID-19 patients