Prognostic importance of hyponatremia in patients with acute pulmonary embolism

Although associated with adverse outcomes in other cardiopulmonary conditions, the prognostic value of hyponatremia, a marker of neurohormonal activation, in patients with acute pulmonary embolism (PE) is unknown.

Prognostic importance of anaemia in patients with acute pulmonary embolism

Although associated with adverse outcomes in other cardiopulmonary diseases, limited evidence exists on the prognostic value of anaemia in patients with acute pulmonary embolism (PE). We sought to examine the associations between anaemia and mortality and length of hospital stay in patients with PE. We evaluated 14,276 patients with a primary diagnosis of PE from 186 hospitals in Pennsylvania, USA. We used random-intercept logistic regression to assess the association between anaemia at the time of presentation and 30-day mortality and discrete-time logistic hazard models to assess the association between anaemia and time to hospital discharge, adjusting for patient (age, gender, race, insurance type, clinical and laboratory variables) and hospital (region, size, teaching status) factors. Anaemia was present in 38.7% of patients at admission. Patients with anaemia had a higher 30-day mortality (13.7% vs. 6.3%; p <0.001) and a longer length of stay (geometric mean, 6.9 vs. 6.6 days; p <0.001) compared to patients without anaemia. In multivariable analyses, anaemia remained associated with an increased odds of death (OR 1.82, 95% CI: 1.60-2.06) and a decreased odds of discharge (OR 0.85, 95% CI: 0.82-0.89). Anaemia is very common in patients presenting with PE and is independently associated with an increased short-term mortality and length of stay.

Importance of the sampled milk fraction for the prediction of total quarter somatic cell count

This study investigated the changes in somatic cell counts (SCC) in different fractions of milk, with special emphasis on the foremilk and cisternal milk fractions. Therefore, in Experiment 1, quarter milk samples were defined as strict foremilk (F), cisternal milk (C), first 400 g of alveolar milk (A1), and the remaining alveolar milk (A2). Experiment 2 included 6 foremilk fractions (F1 to F6), consisting of one hand-stripped milk jet each, and the remaining cisternal milk plus the entire alveolar milk (RM). In Experiment 1, changes during milking indicated the importance of the sampled milk fraction for measuring SCC because the decrease in the first 3 fractions (F, C, and A1) was enormous in milk with high total quarter SCC. The decline in SCC from F to C was 50% and was 80% from C to A1. Total quarter SCC presented a value of approximately 20% of SCC in F or 35% of SCC in C. Changes in milk with low or very low SCC were marginal during milking. Fractions F and C showed significant differences in SCC among different total SCC concentrations. These differences disappeared with the alveolar fractions A1 and A2. In Experiment 2, a more detailed investigation of foremilk fractions supported the findings of Experiment 1. A significant decline in the foremilk fractions even of F1 to F6 was observed in high-SCC milk at concentrations >350 x 10(3) cells/mL. Although one of these foremilk fractions presented only 0.1 to 0.2% of the total milk, the SCC was 2- to 3-fold greater than the total quarter milk SCC. Because the trait of interest (SCC) was measured directly by using the DeLaval cell counter (DCC), the quality of measurement was tested. Statistically interesting factors (repeatability, recovery rate, and potential matrix effects of milk) proved that the DCC is a useful tool for identifying the SCC of milk samples, and thus of grading udder health status. Generally, the DCC provides reliable results, but one must consider that SCC even in strict foremilk can differ dramatically from SCC in the total cisternal fraction, and thus also from SCC in the alveolar fraction.

The diagnostic value of a treadmill test in predicting lumbar spinal stenosis

Lumbar spinal stenosis is a frequent indication for spinal surgery. The predictive quality of treadmill testing and MRI for diagnostic verification is not yet clearly defined. Aim of the current study was to assess correlations between treadmill testing and MRI findings in the lumbar spine. Twenty-five patients with lumbar spinal stenosis were prospectively examined. Treadmill tests were performed and the area of the dural sac and neuroforamina was examined with MRI for the narrowest spinal segment. VAS and ODI were used for clinical assessment. The median age of the patients was 67 years. In the narrowest spinal segment the median area of the dural sac was 91 mm(2). The median ODI was 66 per cent. The median walking distance in the treadmill test was 70 m. The distance reached in the treadmill test correlated with the area of the dural sac (Spearman's rho = 0.53) and ODI (rho = -0.51), but not with the area of the neuroforamina and VAS. The distance reached in the treadmill test predicts the grade of stenosis in MRI but has a limited diagnostic importance for the level of clinical symptoms in lumbar spinal stenosis.

Prognostic importance of anaemia in HIV type-1-infected patients starting antiretroviral therapy: collaborative analysis of prospective cohort studies

BACKGROUND: In HIV type-1-infected patients starting highly active antiretroviral therapy (HAART), the prognostic value of haemoglobin when starting HAART, and of changes in haemoglobin levels, are not well defined. METHODS: We combined data from 10 prospective studies of 12,100 previously untreated individuals (25% women). A total of 4,222 patients (35%) were anaemic: 131 patients (1.1%) had severe (<8.0 g/dl), 1,120 (9%) had moderate (male 8.0-<11.0 g/dl and female 8.0- < 10.0 g/dl) and 2,971 (25%) had mild (male 11.0- < 13.0 g/ dl and female 10.0- < 12.0 g/dl) anaemia. We separately analysed progression to AIDS or death from baseline and from 6 months using Weibull models, adjusting for CD4+ T-cell count, age, sex and other variables. RESULTS: During 48,420 person-years of follow-up 1,448 patients developed at least one AIDS event and 857 patients died. Anaemia at baseline was independently associated with higher mortality: the adjusted hazard ratio (95% confidence interval) for mild anaemia was 1.42 (1.17-1.73), for moderate anaemia 2.56 (2.07-3.18) and for severe anaemia 5.26 (3.55-7.81). Corresponding figures for progression to AIDS were 1.60 (1.37-1.86), 2.00 (1.66-2.40) and 2.24 (1.46-3.42). At 6 months the prevalence of anaemia declined to 26%. Baseline anaemia continued to predict mortality (and to a lesser extent progression to AIDS) in patients with normal haemoglobin or mild anaemia at 6 months. CONCLUSIONS: Anaemia at the start of HAART is an important factor for short- and long-term prognosis, including in patients whose haemoglobin levels improved or normalized during the first 6 months of HAART.

Decision making in patients with acute abdominal pain at a university and at a rural hospital: Does the value of abdominal sonography differ?

Introduction and objectives Abdominal sonography is regarded as a quick and effective diagnostic tool for acute abdominal pain in emergency medicine. However, final diagnosis is usually based on a combination of various clinical examinations and radiography. The role of sonography in the decision making process at a hospital with advanced imaging capabilities versus a hospital with limited imaging capabilities but more experienced clinicians is unclear. The aim of this pilot study was to assess the relative importance of sonography and its influence on the clinical management of acute abdominal pain, at two Swiss hospitals, a university hospital (UH) and a rural hospital (RH). Methods 161 patients were prospectively examined clinically. Blood tests and sonography were performed in all patients. Patients younger than 18 years and patients with trauma were excluded. In both hospitals, the diagnosis before and after ultrasonography was registered in a protocol. Certainty of the diagnosis was expressed on a scale from 0% to 100%. The decision processes used to manage patients before and after they underwent sonography were compared. The diagnosis at discharge was compared to the diagnosis 2 – 6 weeks thereafter. Results Sensitivity, specificity and accuracy of sonography were high: 94%, 88% and 91%, respectively. At the UH, management after sonography changed in only 14% of cases, compared to 27% at the RH. Additional tests were more frequently added at the UH (30%) than at the RH (18%), but had no influence on the decision making process-whether to operate or not. At the UH, the diagnosis was missed in one (1%) patient, but in three (5%) patients at the RH. No significant difference was found between the two hospitals in frequency of management changes due to sonography or in the correctness of the diagnosis. Conclusion Knowing that sonography has high sensitivity, specificity and accuracy in the diagnosis of acute abdominal pain, one would assume it would be an important diagnostic tool, particularly at the RH, where tests/imaging studies are rare. However, our pilot study indicates that sonography provides important diagnostic information in only a minority of patients with acute abdominal pain. Sonography was more important at the rural hospital than at the university hospital. Further costly examinations are generally ordered for verification, but these additional tests change the final treatment plan in very few patients.

Panel report ECIS 2012: publication strategy for junior researchers: quantity vs. quality, importance of the first authorship and collaboration

The publication record is a key component of a successful academic career in IS. Despite its importance, its definition - especially for junior researchers―remains unclear. Is it better to have one A-publication or three Bpublications? Does being the third author on an A-publication carry more weight than being the first author on a Bpublication? Is it better to publish with as few co-authors as possible to demonstrate ability for independent work or is publishing with others a sign of good teamwork and academic excellence? Faced with these uncertainties, young researchers increasingly question the choices they make regarding their publication strategy. If unaddressed, these issues are bound to interfere with the quality of the IS research and scholars’ job satisfaction. This article raises these concerns associated with a publication strategy for junior researchers and reports the views voiced by five academics at a panel session at the European Conference on Information Systems 2012. In particular, the following topics are discussed: quantity vs. quality, value of the first authorship, the “optimal” number of authors, and the issues of co-authorship with an academic supervisor.

Let’s collaborate, but I will be the first author! Exploring the importance of the first authorship for IS researchers

Collaboration among researchers is typically seen as the quintessence of academic excellence, leading to improvements in the research quality, capitalization on the diversity of perspectives and gains in productivity. Despite these benefits, many research teams find themselves torn by competition, antagonism and resentment. Desire to be the first author and resultant underperformance of non-first co-authors is often at the root of these conflicts. At the same time little is known about what motivates researchers in general and IS researchers in particular to engage as first authors. To fill this gap, this study uses survey methodology to explore the attitudes of IS researchers and their resulting behavior when it comes to authors order. Qualitative and quantitative evidence collected from 398 IS researchers is used to support our analysis. We find that researchers’ desire to be the first authors is mainly driven by such determinants as career aspirations, visibility, leadership and sense of ownership, and less so by the desire to satisfy their self-esteem and self-actualization needs. In addition, the value placed on being the first author appears to be the function of researchers’ career level, with Ph.D. students attaching significantly higher value to it than senior scholars.

Does the importance of parent and peer relationships for adolescents' life satisfaction vary across cultures?

This study investigated whether the associations between (a) the quality of the parent-child relationship and peer acceptance and (b) early adolescents’ life satisfaction differed depending on the importance of family values in the respective culture. As part of the Value of Children Study, data from a sub-sample of N = 1,034 adolescents (58% female, M age = 13.62 years, SD = 0.60 years) from 11 cultures was analyzed. Multilevel analyses revealed a positive relation between parental admiration and adolescents’ life satisfaction independent of cultural membership. Further, the higher the importance

Adolescents' value of children and their intentions to have children: A cross-cultural and multilevel analysis

This study contributes to research regarding the value of children (VOC) by comparing adolescents' VOC and their intentions to have children across 12 cultures and by exploring the relations between these constructs at the individual and cultural levels using multilevel modeling. A total of 3,348 adolescents from 12 cultures participated in this study. On average, adolescents reported that they intended to have about two children and also reported emotional VOC as being highly important. Adolescents from cultures with a low as compared to a high level of economic development reported a higher importance of the utilitarian-normative VOC. Results of the multilevel analyses showed that the reported emotional VOC was positively related to the number of children adolescents intended to have at the individual level, whereas the utilitarian-normative VOC was not related to adolescents' intention to have children. At the cultural level, the VOC dimensions were only partly related to adolescents' intention to have children. The results are discussed with regard to adolescents' future family orientation and in relation to the VOC approach.

Influence of perylenediimide–pyrene supramolecular interactions on the stability of DNA-based hybrids: Importance of electrostatic complementarity

Aromatic pi–pi stacking interactions are ubiquitous in nature, medicinal chemistry and materials sciences. They play a crucial role in the stacking of nucleobases, thus stabilising the DNA double helix. The following paper describes a series of chimeric DNA–polycyclic aromatic hydrocarbon (PAH) hybrids. The PAH building blocks are electron-rich pyrene and electron-poor perylenediimide (PDI), and were incorporated into complementary DNA strands. The hybrids contain different numbers of pyrene–PDI interactions that were found to directly influence duplex stability. As the pyrene–PDI ratio approaches 1:1, the stability of the duplexes increases with an average value of 7.5 °C per pyrene–PDI supramolecular interaction indicating the importance of electrostatic complementarity for aromatic pi–pi stacking interactions.

The immunology of the porcine skin and its value as a model for human skin.

The porcine skin has striking similarities to the human skin in terms of general structure, thickness, hair follicle content, pigmentation, collagen and lipid composition. This has been the basis for numerous studies using the pig as a model for wound healing, transdermal delivery, dermal toxicology, radiation and UVB effects. Considering that the skin also represents an immune organ of utmost importance for health, immune cells present in the skin of the pig will be reviewed. The focus of this review is on dendritic cells, which play a central role in the skin immune system as they serve as sentinels in the skin, which offers a large surface area exposed to the environment. Based on a literature review and original data we propose a classification of porcine dendritic cell subsets in the skin corresponding to the subsets described in the human skin. The equivalent of the human CD141(+) DC subset is CD1a(-)CD4(-)CD172a(-)CADM1(high), that of the CD1c(+) subset is CD1a(+)CD4(-)CD172a(+)CADM1(+/low), and porcine plasmacytoid dendritic cells are CD1a(-)CD4(+)CD172a(+)CADM1(-). CD209 and CD14 could represent markers of inflammatory monocyte-derived cells, either dendritic cells or macrophages. Future studies for example using transriptomic analysis of sorted populations are required to confirm the identity of these cells.

Etude de l'importance socio-économique des produits agricoles et des produits forestiers ligneux en vue d'une amélioration des revenus de la population locale. Cas de la zone de Mandraka

La zone de Mandraka, située sur la première falaise orientale, constitue une région typiquement forestière dont la topographie ne favorise pas l’extension agricole. Cependant, compte tenu des besoins de sécurisation alimentaire, le besoin graduel en terres fait que la population se trouve dans l’obligeance d’accroître les zones d’agriculture et ainsi de recourir aux ressources forestières. Cette étude dessine alors comme objectif de définir les lignes d’actions principales combinant la gestion des ressources agricoles et la valorisation durable des ressources forestières. Aussi, des enquêtes socioéconomiques (formelles et informelles) ont été entreprises afin de parvenir aux résultats escomptés. Malgré les efforts en matière de valorisation agricole, l’autosuffisance alimentaire reste encore un problème fondamental à surmonter. De ce fait, le revenu agricole ne constitue que 22,54% du revenu des ménages. Il est également constaté que l’exploitation forestière évaluée prometteuse (61,07% du revenu) semble majorer les intérêts des grands collecteurs au détriment de la masse paysanne. Par conséquent, les difficultés quant aux besoins financiers persistent et les actions tendent vers la production (exploitation) à outrance, de plus que la demande en ville ne cesse d’augmenter. Face à cette situation, l’amélioration progressive des formes d’exploitation agricole constitue une alternative complémentaire vivement incitée. De même, la rénovation de l’organisation de la filière « Produits forestiers ligneux », principalement le charbonnage demeure impérative. Il constitue la principale activité génératrice de revenu à court terme de la population. Cependant, à long terme, il contribue activement à la dégradation des ressources naturelles en l’occurrence les formations secondaires, vestige de la forêt naturelle. Il s’agit ainsi, de promouvoir les cultures vivrières et les cultures de rente visant le marché d’une part, et d’apporter des améliorations au niveau des techniques d’exploitation des ressources forestières en vue d’un rendement optimum d’autre part.

Value Priorities and Content of Religiosity - New Research Perspectives

In this study the relationship of religiosity and value priorities is differentiated, based on a multidimensional measurement of different contents of religiosity. The structure of values is conceptualized using Schwartz’ (1992) two orthogonal dimensions of Self-transcendence vs. Self-enhancement and Openness to change vs. Conservation. The relations between these two dimensions and eight religious contents, ranging from open-minded to more close-minded forms of religiosity, were tested in a sample of church attenders (N = 685), gathered in Germany. The results show, that depending on the content of religiosity, different values are preferred (self-direction, universalism, benevolence, tradition and security values). The results indicate the importance of the content of religiosity for predicting value-loaded behaviors.