The Journal: Print or Electronic?

The World Nutrition Journal was conceived on the premise of  academic and clinical education for healthcare providers caring for patients that require nutritional support.[1] The journal followed the open access (OA) methodology, allowing free access everywhere in the World. The main question that some asked was “why publish this journal electronically and not printed?”.  Most of us are aware that one of the most important hallmarks of academic achievement in medicine and other areas, is publication of scholarly-written articles. When discussing publishing a manuscript, the primary question is whether the target journal should be electronic or printed version. The many advantages of having electronic publications have created a series of websites, journals, webcasts that are useful for practitioners.[2

Prevalence, underlying causes, and preventability of sepsis-associated mortality in US acute care hospitals

Importance: Sepsis is present in many hospitalizations that culminate in death. The contribution of sepsis to these deaths, and the extent to which they are preventable, is unknown. Objective: To estimate the prevalence, underlying causes, and preventability of sepsis-associated mortality in acute care hospitals. Design, Setting, and Participants: Cohort study in which a retrospective medical record review was conducted of 568 randomly selected adults admitted to 6 US academic and community hospitals from January 1, 2014, to December 31, 2015, who died in the hospital or were discharged to hospice and not readmitted. Medical records were reviewed from January 1, 2017, to March 31, 2018. Main Outcomes and Measures: Clinicians reviewed cases for sepsis during hospitalization using Sepsis-3 criteria, hospice-qualifying criteria on admission, immediate and underlying causes of death, and suboptimal sepsis-related care such as inappropriate or delayed antibiotics, inadequate source control, or other medical errors. The preventability of each sepsis-associated death was rated on a 6-point Likert scale. Results: The study cohort included 568 patients (289 [50.9%] men; mean [SD] age, 70.5 [16.1] years) who died in the hospital or were discharged to hospice. Sepsis was present in 300 hospitalizations (52.8%; 95% CI, 48.6%-57.0%) and was the immediate cause of death in 198 cases (34.9%; 95% CI, 30.9%-38.9%). The next most common immediate causes of death were progressive cancer (92 [16.2%]) and heart failure (39 [6.9%]). The most common underlying causes of death in patients with sepsis were solid cancer (63 of 300 [21.0%]), chronic heart disease (46 of 300 [15.3%]), hematologic cancer (31 of 300 [10.3%]), dementia (29 of 300 [9.7%]), and chronic lung disease (27 of 300 [9.0%]). Hospice-qualifying conditions were present on admission in 121 of 300 sepsis-associated deaths (40.3%; 95% CI 34.7%-46.1%), most commonly end-stage cancer. Suboptimal care, most commonly delays in antibiotics, was identified in 68 of 300 sepsis-associated deaths (22.7%). However, only 11 sepsis-associated deaths (3.7%) were judged definitely or moderately likely preventable; another 25 sepsis-associated deaths (8.3%) were considered possibly preventable. Conclusions and Relevance: In this cohort from 6 US hospitals, sepsis was the most common immediate cause of death. However, most underlying causes of death were related to severe chronic comorbidities and most sepsis-associated deaths were unlikely to be preventable through better hospital-based care. Further innovations in the prevention and care of underlying conditions may be necessary before a major reduction in sepsis-associated deaths can be achieved

Treatment of von Willebrand disease

Summary. von Willebrand disease is the most frequent of inherited bleeding disorders (1:100 affected individuals in the general population). The aim of treatment is to correct the dual defects of haemostasis, i.e., abnormal coagulation expressed by low levels of factor VIII and abnormal platelet adhesion expressed by a prolonged bleeding time. There are two main options available for the management of von Willebrand disease: desmopressin and transfusion therapy with blood products. Desmopressin is the treatment of choice in patients with type 1 von Willebrand disease, who account for approximately 80% of cases. This pharmacological compound raises endogenous factor VIII and von Willebrand factors and thereby corrects the intrinsic coagulation defect and the prolonged bleeding time in most type 1 patients. In type 3 and in the majority of type 2 patients desmopressin is not effective, and it is necessary to resort to plasma concentrates containing factor VIII and von Willebrand factor. Treated with virucidal methods, these concentrates are effective and currently safe, but the bleeding time defect is not always corrected by them. Platelet concentrates or desmopressin can be used as adjunctive treatments when poor correction of the bleeding time after concentrates is associated with continued bleeding

Decrease in antibiotic resistance of Streptococcus pneumoniae between 2003 and 2009 in France and changes in serotype distribution: Ongoing survey of the French Pneumococcus Surveillance Network

Background: The French regional pneumococcal observatories (ORP) network was created in 1995, it participates to the close monitoring of the trends in antimicrobial resistance and serotype distribution with the National Reference Centre for Pneumococci (NRCP) and the Institut de Veille Sanitaire (InVS). The aim of this survey was to assess the antibiotic resistance and the distribution of vaccine and non-vaccine serotypes in invasive pneumococcal disease (IPD) in adults and children as well in otitis in children in France in 2009. Methods: Antimicrobial susceptibility testing was performed on 5,194 isolates of S. pneumoniae recovered from cerebrospinal fluid (CSF), blood, middle ear fluid (MEF) and pleural fluid during the year 2009 by the 23 ORP. MICs of penicillin (P), amoxicillin (AMX) and cefotaxime (CTX) were determined by the agar dilution method and interpreted according to the Antibiotics Comity of the French Society of Microbiology breakpoints. Serotyping was performed at the NRCP with serotype-specific antisera, by latex agglutination test. Results: Results of susceptibility between 2003 and 2009 to P are presented in Table 1. The pneumococci with decreased susceptibility to penicillin G (PDSP) decreased significantly in all types of samples except for MEF’s isolates in children between 2007 and 2009. In the global population, the percentage of I+R (2003 vs 2009) decreased significantly for AMX (30.3% versus 9.6%) and for CTX (18.2% versus 10.5%). Strains highly resistant (MIC > 2 mg/L) remained rare: 0.4%, 1.1% and 0.2% for P, AMX and CTX respectively. The most frequent capsular types in CSF were 3, 7F, 19A, 6C, 23B for adults and 7F, 19A, 3, 33F and 15B for children. Serotypes included in the PCV-7 and PCV-13 vaccine accounted in children for 4% and 51% respectively and in adults for 12% and 48% respectively. By contrast, the serotype 19A remained highly predominant (80%) among MEF isolates. Conclusions: We observed a significant decrease of PDSP between 2003 and 2009 (50.2 to 33.0%). The decrease coincided with the introduction of PCV7 and with a general reduction in levels of antibiotic consumption in France. This continuous survey is necessary to underline modification in serotype distribution in France after PVC13 introduction (June 2010)

Demersal fish assemblages on seamounts and other rugged features in the northeastern Caribbean

© The Author(s), 2017. This is the author's version of the work and is distributed under the terms of the Creative Commons Attribution License. The definitive version was published in Deep Sea Research Part I: Oceanographic Research Papers 123 (2017): 90–104, doi:10.1016/j.dsr.2017.03.009.Recent investigations of demersal fish communities in deepwater (>50 m) habitats have considerably increased our knowledge of the factors that influence the assemblage structure of fishes across mesophotic to deep-sea depths. While different habitat types influence deepwater fish distribution, whether different types of rugged seafloor features provide functionally equivalent habitat for fishes is poorly understood. In the northeastern Caribbean, different types of rugged features (e.g., seamounts, banks, canyons) punctuate insular margins, and thus create a remarkable setting in which to compare demersal fish communities across various features. Concurrently, several water masses are vertically layered in the water column, creating strong stratification layers corresponding to specific abiotic conditions. In this study, we examined differences among fish assemblages across different features (e.g., seamount, canyon, bank/ridge) and water masses at depths ranging from 98 to 4060 m in the northeastern Caribbean. We conducted 26 remotely operated vehicle dives across 18 sites, identifying 156 species of which 42% of had not been previously recorded from particular depths or localities in the region. While rarefaction curves indicated fewer species at seamounts than at other features in the NE Caribbean, assemblage structure was similar among the different types of features. Thus, similar to seamount studies in other regions, seamounts in the Anegada Passage do not harbor distinct communities from other types of rugged features. Species assemblages, however, differed among depths, with zonation generally corresponding to water mass boundaries in the region. High species turnover occurred at depths <1200 m, and may be driven by changes in water mass characteristics including temperature (4.8–24.4 °C) and dissolved oxygen (2.2–9.5 mg per l). Our study suggests the importance of water masses in influencing community structure of benthic fauna, while considerably adding to the knowledge of mesophotic and deep-sea fish biogeography.Funding was provided by NOAA-OER for the 2014 E/V Nautilus cruise and by the USGS Environments and Hazards Program and Ocean Exploration Trust for the 2013 E/V Nautilus 807 cruise.2019-03-1

On the 'centre of gravity' method for measuring the composition of magnetite/maghemite mixtures, or the stoichiometry of magnetite-maghemite solid solutions, via Fe-57 Mossbauer spectroscopy

We evaluate the application of 57Fe Mössbauer spectroscopy to the determination of the composition of magnetite (Fe3O4)/maghemite (γ-Fe2O3) mixtures and the stoichiometry of magnetite-maghemite solid solutions. In particular, we consider a recently proposed model-independent method which does not rely on a priori assumptions regarding the nature of the sample, other than that it is free of other Fe-containing phases. In it a single parameter, δRT—the ‘centre of gravity’, or area weighted mean isomer shift at room temperature, T = 295 ± 5 K—is extracted by curve-fitting a sample’s Mössbauer spectrum, and is correlated to the sample’s composition or stoichiometry. We present data on highpurity magnetite and maghemite powders, and mixtures thereof, as well as comparison literature data from nanoparticulate mixtures and solid solutions, to show that a linear correlation exists between δRT and the numerical proportion of Fe atoms in the magnetite environment: α = Femagnetite/Fetotal = − ( ) δ δ RT o /m, where δo = 0.3206 ± 0.0022mm s−1 and m = 0.2135 ± 0.0076mm s−1 . We also present equations to relate α to the weight percentage w of magnetite in mixed phases, and the magnetite stoichiometry x = Fe2+/Fe3+ in solid solutions. The analytical method is generally applicable, but is most accurate when the absorption profiles are sharp; in some samples this may require spectra to be recorded at reduced temperatures. We consider such cases and provide equations to relate δ ( ) T to the corresponding α value