A retrospective study on the effects of illness severity and atrial fibrillation on outcomes in the intensive care unit

Introduction: Atrial fibrillation (AF) is common in patients in the intensive care unit (ICU) and has been associated with worse outcomes. However, it is unclear whether AF itself adds to the risk of death or is merely a marker of illness severity. We aimed to record the incidence and outcomes of all patients with different categories of AF and determine whether AF was an independent predictor of death.<p></p> Methods: This retrospective cohort study was undertaken in the ICU of a tertiary-referral university hospital. Category of AF, sex, C-reactive protein (CRP) level, APACHE II score, predicted hospital mortality and survival outcomes were analysed from 1084 records. Percentages, medians and interquartile ranges were used to describe the sample. Chi-square test and the non-parametric Mann–Whitney U test were used, as appropriate, for statistical analysis. Logistic regression analyses were performed to evaluate the association of AF with death in the ICU adjusting for age, sex, CRP level and APACHE II score.<p></p> Results: Overall, 13.6% of patients developed new-onset AF during their critical illness, while 4.3% had a pre-existing history. The hospital mortality rate was higher in those with AF compared with those without (47.9% vs. 30.9%, p<0.001) and higher in those with newly diagnosed AF compared with those with a prior history (53.1% vs. 31.9%, p=0.012). CRP levels were higher in those with AF (p<0.001) compared with those without and higher in those with newly diagnosed AF compared with those with a prior history (p=0.012). On multivariate logistic regression analysis, only the APACHE II score was found to be an independent predictor of death.<p></p> Conclusion: Despite the higher mortality rate in patients with AF, the APACHE II score was the only independent predictor of death within the ICU. Prospective studies are required to explore the apparently reduced risk of dying among those with a prior history of AF.<p></p&gt

Intra-dance variation among waggle runs and the design of efficient protocols for honey bee dance decoding

Noise is universal in information transfer. In animal communication, this presents a challenge not only for intended signal receivers, but also to biologists studying the system. In honey bees, a forager communicates to nestmates the location of an important resource via the waggle dance. This vibrational signal is composed of repeating units (waggle runs) that are then averaged by nestmates to derive a single vector. Manual dance decoding is a powerful tool for studying bee foraging ecology, although the process is time-consuming: a forager may repeat the waggle run 1- >100 times within a dance. It is impractical to decode all of these to obtain the vector; however, intra-dance waggle runs vary, so it is important to decode enough to obtain a good average. Here we examine the variation among waggle runs made by foraging bees to devise a method of dance decoding. The first and last waggle runs within a dance are significantly more variable than the middle run. There was no trend in variation for the middle waggle runs. We recommend that any four consecutive waggle runs, not including the first and last runs, may be decoded, and we show that this methodology is suitable by demonstrating the goodness-of-fit between the decoded vectors from our subsamples with the vectors from the entire dances

Human olfactory mesenchymal stromal cell transplants promote remyelination and earlier improvement in gait co-ordination after spinal cord injury

Autologous cell transplantation is a promising strategy for repair of the injured spinal cord. Here we have studied the repair potential of mesenchymal stromal cells isolated from the human olfactory mucosa after transplantation into a rodent model of incomplete spinal cord injury. Investigation of peripheral type remyelination at the injury site using immunocytochemistry for P0, showed a more extensive distribution in transplanted compared with control animals. In addition to the typical distribution in the dorsal columns (common to all animals), in transplanted animals only, P0 immunolabelling was consistently detected in white matter lateral and ventral to the injury site. Transplanted animals also showed reduced cavitation. Several functional outcome measures including end-point electrophysiological testing of dorsal column conduction and weekly behavioural testing of BBB, weight bearing and pain, showed no difference between transplanted and control animals. However, gait analysis revealed an earlier recovery of co-ordination between forelimb and hindlimb stepping in transplanted animals. This improvement in gait may be associated with the enhanced myelination in ventral and lateral white matter, where fibre tracts important for locomotion reside. Autologous transplantation of mesenchymal stromal cells from the olfactory mucosa may therefore be therapeutically beneficial in the treatment of spinal cord injury

Preparedness for use of the rapid result HIV self-test by gay men and other men who have sex with men (MSM): a mixed methods exploratory study among MSM and those involved in HIV prevention and care

Objectives: The aim of the study was to explore preparedness for the HIV self-test among men who have sex with men (MSM) and those involved in HIV prevention and care. Methods: A mixed methods exploratory research design was employed, detailing awareness and willingness to use the self-test and the perceived barriers and facilitators to implementation. Quantitative and qualitative data collection and analysis were completed in parallel. Descriptive and inferential analysis of cross-sectional bar-based survey data collected from MSM through a self-completed questionnaire and oral fluid specimen collection (n = 999) was combined with qualitative, thematic, analysis of data collected through 12 expert focus groups (n = 55) consisting of gay men, National Health Service (NHS) staff, community organizations, entrepreneurs and activists. Findings were subsequently combined and assessed for synergies. Results: Among MSM, self-test awareness was moderate (55%). Greater awareness was associated with increased educational attainment [adjusted odds ratio 1.51; 95% confidence interval (CI) 1.00–2.30; P = 0.05] and previous history of sexually transmitted infection (STI) testing (adjusted odds ratio 1.63; 95% CI 1.11–2.39; P = 0.01). Willingness to use the test was high (89%) and associated with meeting sexual partners online (unadjusted odds ratio 1.96; 95% CI 1.31–2.94; P < 0.001). Experts highlighted the overall acceptability of self-testing; it was understood as convenient, discreet, accessible, and with a low burden to services. However, some ambivalence towards self-testing was reported; it could reduce opportunities to engage with wider services, wider health issues and the determinants of risk. Conclusions: Self-testing represents an opportunity to reduce barriers to HIV testing and enhance prevention and access to care. Levels of awareness are moderate but willingness to use is high. Self-testing may amplify health inequalities

Persistent pain after caesarean section and its association with maternal anxiety and socioeconomic background

Background: Pain, both from the surgical site, and from other sources such as musculoskeletal backache, can persist after caesarean section. In this study of a predominantly socially deprived population we have sought to prospectively examine the association between antenatal maternal anxiety and socioeconomic background and the development of persistent pain of all sources after caesarean section. Methods: Demographic details and an anxiety questionnaire were completed by 205 women before elective caesarean section. On the first postoperative day, pain scores were recorded, and at four months patients were asked to complete a Brief Pain Inventory and an Edinburgh Postnatal Depression Score. Results: Of 205 parturients recruited, 186 records were complete at the hospital admission phase and 98 (52.7%) were complete at the four-month follow-up phase. At recruitment, 15.1% reported pain. At four months 41.8% (95% CI 32.1 to 51.6%) reported pain, of whom pain was a new finding in 35.7% (95% CI 26.2 to 45.2%). Antenatal anxiety was not a significant predictor of severity of new pain at four months (P=0.43 for state anxiety, P=0.52 for trait anxiety). However, four-month pain severity did correlate with social deprivation (P=0.011), postnatal depression (P<0.001) and pain at 24 h (P=0.018). Conclusion: Persistent pain from a variety of sources after caesarean section is common. Our findings do not support the use of antenatal anxiety scoring to predict persistent pain in this setting, but suggest that persistent pain is influenced by acute pain, postnatal depression and socioeconomic deprivation

Sensitivity to inflectional morphemes in the absence of meaning: evidence from a novel task

A number of studies in different languages have shown that speakers may be sensitive to the presence of inflectional morphology in the absence of verb meaning (Caramazza et al., 1988, Clahsen, 1999, Post et al., 2008). In this study, sensitivity to inflectional morphemes was tested in a purposely developed task with English-like nonwords. Native speakers of English were presented with pairs of nonwords and were asked to judge whether the two nonwords in each pair were the same or different. Each pair was composed either of the same nonword repeated twice, or of two slightly different nonwords. The nonwords were created taking advantage of a specific morphophonological property of English, which is that regular inflectional morphemes agree in voicing with the ending of the stem. Using stems ending in /l/, thus, we created: 1. nonwords ending in potential inflectional morphemes, vɔld, 2. nonwords without inflectional morphemes, vɔlt, and 3. a phonological control condition, vɔlb. Our new task endorses some strengths presented in previous work. As in Post et al. (2008) the task accounts for the importance of phonological cues to morphological processing. In addition, as in Caramazza et al. (1988) and contrary to Post et al. (2008), the task never presents bare-stems, making it unlikely that the participants would be aware of the manipulation performed. Our results are in line with Caramazza et al. (1988), Clahsen (1999) and Post et al. (2008), and offer further evidence that morphologically inflected nonwords take longer to be discriminated compared to uninflected nonwords

Semiclassical Treatment of Diffraction in Billiard Systems with a Flux Line

In billiard systems with a flux line semiclassical approximations for the density of states contain contributions from periodic orbits as well as from diffractive orbits that are scattered on the flux line. We derive a semiclassical approximation for diffractive orbits that are scattered once on a flux line. This approximation is uniformly valid for all scattering angles. The diffractive contributions are necessary in order that semiclassical approximations are continuous if the position of the flux line is changed.Comment: LaTeX, 17 pages, 4 figure

Bostonia. Volume 15

Founded in 1900, Bostonia magazine is Boston University's main alumni publication, which covers alumni and student life, as well as university activities, events, and programs