Flanaganhanna8602
To identify factors affecting the progression of traumatic intracranial hemorrhagic injury (t-ICH) during interventional radiology (IVR) for the hemostasis of extracranial hemorrhagic injury.
This was a retrospective comparative study. Fifty-two patients with t-ICH who underwent hemostasis using IVR for extracranial trauma at our institute were included. Clinical and computed tomography scan data were collected to investigate factors associated with t-ICH progression.
Fifty-two subjects (36 men/16 women) with a mean age of 70.9±19.2years were analyzed. The mean Injury Severity Score was 34.9±11.2. In 29 patients (55.7%), t-ICH progressed during IVR. Hematoma progression frequently occurred in patients with acute subdural hematoma (56.2%) and traumatic intracerebral hematoma/hemorrhagic brain contusion (66.6%). Factors associated with t-ICH progression included age (
=0.029), consciousness level at admission (
=0.001), Revised Trauma Scale (
=0.036), probability of survival (
=0.043), platelet count (
=0.005), fibrinogen level (
=0.016), hemoglobin level (
=0.003), D-dimer level (
=0.046), and red blood cell transfusion volume (
=0.023).
Aggressive correction of anemia, thrombocytopenia, and low fibrinogen levels in severe consciousness disturbance patients with acute subdural hematoma and traumatic intracerebral hematoma/hemorrhagic brain contusion could improve the prognosis after IVR for hemostasis of extracranial hemorrhagic injuries.
Aggressive correction of anemia, thrombocytopenia, and low fibrinogen levels in severe consciousness disturbance patients with acute subdural hematoma and traumatic intracerebral hematoma/hemorrhagic brain contusion could improve the prognosis after IVR for hemostasis of extracranial hemorrhagic injuries.
The recommendation that patients with accidental hypothermia should be transported to specialized centers that can provide extracorporeal life support has not been validated, and the efficacy remains unclear.
This was a multicenter retrospective cohort study of patients with a body temperature of ≤35°C presenting at the emergency department of 12 hospitals in Japan between April 2011 and March 2016. We divided the patients into two groups based on the point of care delivery critical care medical center (CCMC) or non-CCMC. The primary outcome of this study was in-hospital death. In-hospital death was compared using a multivariable logistic regression analysis. Subgroup analyses were carried out according to patients with severe hypothermia (<28°C) or systolic blood pressure (sBP) of <90mmHg.
A total of 537 patients were included, 413 patients (76.9%) in the CCMC group and 124 patients (23.1%) in the non-CCMC group. The in-hospital death rate was lower in the CCMC group than in the non-CCMC group (22.3% versus 31.5%,
<0.001). The multivariable logistic regression analysis showed that the adjusted odds ratio (AOR) of the CCMC group was 0.54 (95% confidence interval, 0.32-0.90). In subgroup analyses, patients with systolic blood pressure <90mmHg in the CCMC group were less likely to experience in-hospital death (AOR 0.36; 95% CI, 0.23-0.56). However, no such association was observed among patients with severe hypothermia (AOR 1.08; 95% CI, 0.63-1.85).
Our multicenter study indicated that care at a CCMC was associated with improved outcomes in patients with accidental hypothermia.
Our multicenter study indicated that care at a CCMC was associated with improved outcomes in patients with accidental hypothermia.Methicillin-resistant Staphylococcus aureus (MRSA) is an increasingly prevalent pathogen. We studied the prevalence of MRSA and its association with vaginitis during pregnancy. Bacteriological investigations of high vaginal swabs of 350 healthy pregnant women attending antenatal clinics were carried out. Staphylococci were isolated from high vaginal swabs of 135 of the women. The staphylococcal isolates were resistant to multiple antibiotics. The PCR amplification of DNA of 20 selected isolates yielded six possessing the mecA gene and 13 the blaZ gene. MRSA possessing both the mecA and blaZ genes were isolated from subjects who reported vaginal discharge and itching.Leptospira was detected in 48.9% of blood samples from 182 febrile patients in north-central Bangladesh in 2019. Most Leptospira were classified as L. wolffii (93%) on the basis of phylogenetic analysis of 16S ribosomal RNA genes, while others were assigned to L. borgpetersenii and L. meyeri.Coronavirus disease 2019 (COVID-19) is the disease caused by the novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Genome sequencing of the virus revealed that it is a new zoonotic virus that might have evolved by jumping from bats to humans with one or more intermediate hosts. The immediate availability of the sequence information in the public domain has accelerated the development of quantitative RT-PCR-based diagnostics. Numerous clinical trials have been prioritized globally for testing new vaccines and treatments against this disease. This review provides a broad insight into different aspects of COVID-19, an introduction to SARS-CoV-2 mitigation strategies and the present status of diagnostics and therapeutics.
Long-distance seed dispersal (LDD) has strong impacts on the spatiotemporal dynamics of plants. Large animals are important LDD vectors because they regularly transport seeds of many plant species over long distances. While there is now ample evidence that behaviour varies considerably between individual animals, it is not clear to what extent inter-individual variation in behaviour alters seed dispersal by animals.
We study how inter-individual variation in the movement and feeding behaviour of one of Europe's largest herbivores (the red deer,
) affects internal seed dispersal (endozoochory) of multiple plant species. We combine movement data of 21 individual deer with measurements of seed loads in the dung of the same individuals and with data on gut passage time. These data serve to parameterize a model of passive dispersal that predicts LDD in three orientations (horizontal as well as upward and downward in elevation).With this model we investigate to what extent per-seed probabilities of LDD and se seed load that generally increased LDD potential.
Inter-individual variation in movement and feeding behaviour means that certain deer are substantially more effective LDD vectors than others. This inter-individual variation reduces the reliability of LDD and increases the sensitivity of LDD to the decline of deer populations. Variation in the dispersal services of individual animals should thus be taken into account in models in order to improve LDD projections.
Inter-individual variation in movement and feeding behaviour means that certain deer are substantially more effective LDD vectors than others. This inter-individual variation reduces the reliability of LDD and increases the sensitivity of LDD to the decline of deer populations. Variation in the dispersal services of individual animals should thus be taken into account in models in order to improve LDD projections.
Animal movement expressed through home ranges or space-use can offer insights into spatial and habitat requirements. However, different classes of estimation methods are currently instinctively applied to answer home range, space-use or movement-based research questions regardless of their widely varying outputs, directly impacting conclusions. Recent technological advances in animal tracking (GPS and satellite tags), have enabled new methods to quantify animal space-use and movement pathways, but so far have primarily targeted mammal and avian species.
Most reptile spatial ecology studies only make use of two older home range estimation methods Minimum Convex Polygons (MCP) and Kernel Density Estimators (KDE), particularly with the Least Squares Cross Validation (LSCV) and reference (
) bandwidth selection algorithms. These methods are frequently applied to answer space-use and movement-based questions. Reptile movement patterns are unique (e.g.
low movement frequency, long stop-over periods), promle across sampling regimes, making its use problematic for species exhibiting long-term sheltering behaviours. We found that dBBMMs minimized the effect of individual variation, maintained low error rates balanced between omission (false negative) and commission (false positive), and performed comparatively well even under low frequency sampling regimes (e.g., once a month).
We recommend dBBMMs as a valuable alternative to MCP and KDE methods for reptile VHF telemetry data, for research questions associated with space-use and movement behaviours within the study period they work under contemporary tracking protocols and provide more stable estimates. We demonstrate for the first time that dBBMMs can be applied confidently to low-resolution tracking data, while improving comparisons across regimes, individuals, and species.
accompanies this paper at 10.1186/s40462-020-00229-3.
Supplementary information accompanies this paper at 10.1186/s40462-020-00229-3.A 61-year-old male with a history of coeliac disease was diagnosed with organizing pneumonia (OP) on transbronchial and transthoracic lung biopsies. He then developed refractory coeliac disease type II and haemophagocytic lymphohistiocytosis. Nine months after his initial diagnosis of OP and after multiple biopsies of the lung, duodenum, and bone marrow, he was diagnosed with enteropathy-associated T-cell lymphoma (EATL). Although OP in patients with lymphoma is most commonly attributed to chemotherapeutic agents or bone marrow transplant, it may be seen in the absence of prior anticancer treatment. The mechanism linking OP and lymphoma is unclear but OP could represent a syndrome of T-cell dysfunction or develop as a direct reaction to malignant infiltration of the lung. P110δIN1 In patients with atypical presentations, exclusion of an alternate diagnosis must be pursued using surgical lung biopsy, wherever possible. This is the first reported case of OP associated with EATL.We report a rare case of early and extensive pulmonary invasion of malignant pleural mesothelioma (MPM) in a 70-year-old woman. She first presented with a hydropneumothorax and subsequent workup, including video-assisted thoracoscopy (VAT), confirmed MPM. After VAT, she developed dyspnoea, cough, and widespread pulmonary infiltrates of uncertain aetiology. These infiltrates progressed over the following months, failed to respond to antibiotics, and were strongly fluorodeoxyglucose (FDG)-avid on positron emission tomography (PET). Bronchoalveolar lavage (BAL) yielded extremely viscous fluid containing mesothelioma cells. These cells were also found in the sputum when nebulized deoxyribonuclease (DNase) was trialled to enhance clearance of the pulmonary fluid. The patient deteriorated rapidly with progressive mediastinal and contralateral MPM involvement and died one month later. This case highlights the importance of including tumour invasion as a differential diagnosis of non-resolving pulmonary infiltrates in patients with MPM.Visual and olfactory stimuli induce behavioural responses in fishes when applied independently, but little is known about how simultaneous exposure influences behaviour, especially in downstream migrating fishes. Here, downstream moving juvenile sea lamprey (Petromyzon marinus) were exposed to light and a conspecific chemosensory alarm cue in a flume and movement were monitored with overhead cameras and nets. When exposed to light, sea lamprey were more likely to be captured in a net closest to the light array. When exposed to the alarm cue, sea lamprey transit rate through the flume increased, but sea lamprey did not avoid the alarm cue plume by moving perpendicular to flow. When the alarm cue and light were applied simultaneously in a push and pull configuration, the alarm cue still triggered enhanced downstream movement (push downstream) and more sea lamprey was still captured in the net nearest the light (pull to the side), resulting in twice as many sea lamprey being captured in the lighted net relative to controls.