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Catecholamine release increases in dogs with pheochromocytomas and in situations of stress. Although plasma catecholamines degrade rapidly, their metabolites, normetanephrine (NME) and metanephrine (ME), are stable in acidified urine. Our aim was to verify a human urine ELISA kit for the quantification of NME and ME in canine urine and to determine the effects on metabolite stability of sampling time (morning or midday) and day (ordinary or day spent in a clinic). We analyzed 179 urine samples from 17 healthy dogs. For NME, the mean intra-assay CV was 6.0% for all samples and 4.3% for the canine control; inter-assay CVs were 3.3, 3.8, and 12% for high and low concentration human urine positive controls supplied in the ELISA kit and a positive canine control, respectively; spike-recovery was 90–101%. For ME, mean intra-assay CV was 6.5% for samples and 9.0% for the canine control; inter-assay CVs were 12.7, 7.2, and 22.5% for high and low concentration human urine positive controls supplied in the ELISA kit and a positive canine control, respectively; spike-recovery was 85–89%. Dilution recovery was unsatisfactory for both metabolites. Based on our verification results, NME was selected for remaining analyses. We found no effect on NME concentrations of acidification or room temperature storage for up to 24 h. The NME:creatinine ratio was higher after the first of 3 clinic days compared to the same morning (111.2 ± 5.5 vs. 82.9 ± 5.3; p

PURPOSE Physical impairment after critical illness is recognized as a part of the post-intensive care syndrome (PICS). About one third of intensive care unit (ICU) survivors suffer from long-term physical disability, yet the underlying pathophysiological mechanisms remain poorly understood. The pro-inflammatory alarmin, high mobility group box 1 (HMGB1), promotes muscle dysfunction in experimental models, and HMGB1 stays elevated in some patients after ICU discharge. Accordingly, we investigated the relationship between HMGB1 plasma levels and physical performance in ICU survivors. METHODS Prospective cohort study of 100 ICU survivors from the general ICU at the Karolinska University Hospital, Sweden. Patients returned for follow up at 3 (58 patients) and 6 months (51 patients) after ICU discharge. Blood samples were collected, and a 6-minute walk test (6-MWT), a handgrip-strength test (HST), and a timed-stands test (TST) were performed. RESULTS Compared to reference values of the different physical tests, 16% of patients underperformed at all tests at 3 months and 12% at 6 months. All test results, except hand-grip strength left, improved significantly over the follow-up period (P

Objective Early mobilization is advocated for patients going through abdominal surgery; however, little is known about the patient experience of being mobilized immediately after surgery. The purpose of this study was to explore patient experiences of mobilization immediately after elective abdominal cancer surgery. Methods This interview study used qualitative content analysis. With the use of purposeful sampling, a total of 23 participants who had been mobilized immediately after abdominal surgery were recruited at a university hospital in Stockholm, Sweden. Individual face-to-face interviews were conducted within 1 to 4 days after surgery and took place at the surgical ward where the participants were treated. A semi-structured guide was used. All interviews were audio recorded and transcribed verbatim. Results The content analysis revealed 3 categories that emerged into 1 overarching theme: “to do whatever it takes to get home earlier.” The participants experienced that mobilization out of bed had an impact on their physical and mental well-being. Motivation and the experiences of themselves and others were factors that affected patient attitudes toward early mobilization. Preparation and competent caregivers were emphasized as important factors that enabled the patient to feel safe and confident during mobilization. Conclusions Patients experienced mobilization as an important part of the care that had an impact on recovery and well-being, physically as well as mentally, both immediately and over time. Impact As this is the first study to our knowledge to investigate patient experiences of mobilization immediately after abdominal surgery, this information can be used to support the development of early mobilization protocols in hospital settings.

Recent advances in induced pluripotent stem cells (iPSCs), genome editing technologies and 3D organoid model systems highlight opportunities to develop new in vitro human disease models to serve drug discovery programs. An ideal disease model would accurately recapitulate the relevant disease phenotype and provide a scalable platform for drug and genetic screening studies. Kidney organoids offer a high cellular complexity that may provide greater insights than conventional single-cell type cell culture models. However, genetic manipulation of the kidney organoids requires prior generation of genetically modified clonal lines, which is a time and labor consuming procedure. Here, we present a methodology for direct differentiation of the CRISPR-targeted cell pools, using a doxycycline-inducible Cas9 expressing hiPSC line for high efficiency editing to eliminate the laborious clonal line generation steps. We demonstrate the versatile use of genetically engineered kidney organoids by targeting the autosomal dominant polycystic kidney disease (ADPKD) genes: PKD1 and PKD2. Direct differentiation of the respective knockout pool populations into kidney organoids resulted in the formation of cyst-like structures in the tubular compartment. Our findings demonstrated that we can achieve > 80% editing efficiency in the iPSC pool population which resulted in a reliable 3D organoid model of ADPKD. The described methodology may provide a platform for rapid target validation in the context of disease modeling.

Introduction Glucagon-like peptide-1 (GLP-1) increases insulin secretion from pancreatic beta-cells and GLP-1 receptor (GLP-1R) agonists are widely used as treatment for type 2 diabetes mellitus. Studying occupancy of the GLP-1R in various tissues is challenging due to lack of quantitative, repeatable assessments of GLP-1R density. The present study aimed to describe the quantitative distribution of GLP-1Rs and occupancy by endogenous GLP-1 during oral glucose tolerance test (OGTT) in pigs, a species that is used in biomedical research to model humans.Research design and methods GLP-1R distribution and occupancy were measured in pancreas and gastrointestinal tract by ex vivo autoradiography using the GLP-1R-specific radioligand 177Lu-exendin-4 in two groups of pigs, control or bottle-fed an oral glucose load. Positron emission tomography (PET) data from pigs injected with 68Ga-exendin-4 in a previous study were used to retrieve data on biodistribution of GLP-1R in the gastrointestinal tract.Results High homogenous uptake of 177Lu-exendin-4 was found in pancreas, and even higher uptake in areas of duodenum. Low uptake of 177Lu-exendin-4 was found in stomach, jejunum, ileum and colon. During OGTT, there was no increase in plasma GLP-1 concentrations and occupancy of GLP-1Rs was low. The ex vivo autoradiography results were highly consistent with to the biodistribution of 68Ga-exendin-4 in pigs scanned by PET.Conclusion We identified areas with similarities as well as important differences regarding GLP-1R distribution and occupancy in pigs compared with humans. First, there was strong ligand binding in the exocrine pancreas in islets. Second, GLP-1 secretion during OGTT is minimal and GLP-1 might not be an important incretin in pigs under physiological conditions. These findings offer new insights on the relevance of porcine diabetes models.

Abel Evans's poem Vertumnus (1713) celebrates Jacob Bobart the Younger, second keeper of the Oxford Physick Garden (now the Oxford University Botanic Garden), as a model monarch to his botanical subjects. This paper takes Vertumnus as a point of departure from which to explore the early history of the Physick Garden (founded 1621), situating botanical collections and collecting spaces within utopian visions and projects as well as debates about order more widely in the turbulent seventeenth-century. Three perspectives on the Physick Garden as an ordered collection are explored: the architecture of the quadripartite Garden, with particular attention to the iconography of the Danby Gate; the particular challenges involved in managing living collections, whose survival depends on the spatial order regulating the microclimates in which they grow; and the taxonomic ordering associated with the hortus siccus collections. A final section on the ideal ‘Botanick throne’ focuses on the metaphor of the state as a garden in the period, as human and botanical subjects resist being order and can rebel, but also respond to right rule and wise cultivation. However, the political metaphor is Evans’s; there is little to suggest that Bobart himself was driven by utopian, theological and political visions. QC 20190823

Objective The aim of this study was to investigate if mobilization out of bed, within 2 hours after abdominal surgery, improved participants’ respiratory function and whether breathing exercises had an additional positive effect. Methods Participants were 214 consecutively recruited patients who underwent elective open or robot-assisted laparoscopic gynecological, urological, or endocrinological abdominal surgery with an anesthetic duration of >2 hours. They were recruited to a randomized controlled trial. Immediately after surgery, patients were randomly assigned to 1 of 3 groups: mobilization (to sit in a chair) and standardized breathing exercises (n = 73), mobilization (to sit in a chair) only (n = 76), or control (n = 65). The interventions started within 2 hours after arrival at the postoperative recovery unit and continued for a maximum of 6 hours. The primary outcomes were differences in peripheral oxygen saturation (SpO2, as a percentage) and arterial oxygen pressure (PaO2, measured in kilopascals) between the groups. Secondary outcomes were arterial carbon dioxide pressure, spirometry, respiratory insufficiency, pneumonia, and length of stay. Results Based on intention-to-treat analysis (n = 214), patients who received mobilization and breathing exercises had significantly improved SpO2 (mean difference [MD] = 2.5%; 95% CI = 0.4 to 4.6) and PaO2 (MD = 1.40 kPa; 95% CI = 0.64 to 2.17) compared with the controls. For mobilization only, there was an increase in PaO2 (MD = 0.97 kPa; 95% CI = 0.20 to 1.74) compared with the controls. In the per-protocol analysis (n = 201), there were significant improvements in SpO2 and PaO2 for both groups receiving mobilization compared with the controls. Secondary outcome measures did not differ between groups. Conclusion Mobilization out of bed, with or without breathing exercises, within 2 hours after elective abdominal surgery improved SpO2 and PaO2. Impact The respiratory effect of mobilization (out of bed) immediately after surgery has not been thoroughly evaluated in the literature. This study shows that mobilization out of bed following elective abdominal surgery can improve SpO2 and PaO2. Lay Summary Mobilization within 2 hours after elective abdominal surgery, with or without breathing exercises, can improve patients’ respiratory function.

Background: Insemination with spermatozoa, seminal plasma and extender, cause a rapid inflammatory response in the pig endometrium, which is characterized by an influx of neutrophils into the uterus. The transient inflammatory response to semen involves induction of cytokines. In this study, potential functions for Interleukin-23 (IL-23) in the inflammatory response to different insemination treatments were examined by studying mRNA expression and immunostaining in gilt oviduct and endometrium 35-40 h after insemination. Insemination was performed with either seminal plasma (SP, n = 4), spermatozoa in the extender Beltsville thawing solution (BTS) (SPZ, n = 4), or BTS alone (n = 4). In control gilts (n = 4) an insemination catheter was inserted without anything being inseminated. Results: Results showed that IL-23 mRNA was expressed in the oviduct and in the endometrium. There was an approximate 2-4-fold increase in expression of IL-23 mRNA in catheter-only control compared with SPZ, SP and BTS treatment groups. IL-23 immunolabelling was detected in a small number of separate cells as well as in the sub-epithelial connective tissue of the endometrium, the endosalpinx of the isthmus and infundibulum. Conclusions: All fluids used for insemination decreased the expression of IL-23 mRNA in the endometrium compared to catheter-insertion alone, indicating a possible role for IL-23 in the inflammatory response after insemination in gilts.

Introduction: Early mobilization (EM), is highly recommended after abdominal surgery. Caregivers play an important role in motivating patients, facilitating the mobilization, assisting and guiding EM. Since the caregivers’ engagement seems to be crucial for successful mobilization, it is important to explore their experience in initiating and participating in mobilization immediately after surgery. Aim: to explore the caregivers experiences of mobilizing patients within the first hours after abdominal surgery. Material and Methods: Face-to-face interviews, following a semi-structured guide were conducted with 17 caregivers who participated in an RCT where patients were mobilized at a postoperative recovery unit, within the first two hours after abdominal cancer surgery. The transcribed interviews were analyzed in an inductive manner using qualitative content analysis. Results: The preliminary results indicate that the caregivers consider mobilization as an important part of the care at the postoperative recovery unit. Negative attitudes was based on that the caregivers did not have enough time or knowledge to perform EM. Positive attitudes was based on that the caregivers experienced that the patients tends to favor physically as well as mentally by EM. However, to facilitate EM at the postoperative recovery unit, there is a need for; education and predefined protocols for EM and that the intervention is supported by the management. Finally, there is a need for physiotherapists available when the patients´ enter the postoperative recovery unit, to guide and lead the EM. Conclusion: Knowledge about how caregivers experience EM immediately after surgery can facilitate safe and efficient mobilization.

Background: Signaling between seminal fluid and the female reproductive tract is required for a successful pregnancy to occur. Insemination with spermatozoa, seminal plasma and extender, is known to cause a rapid inflammatory response in the pig endometrium, which is characterized by an influx of neutrophils into the uterus. The temporary inflammatory response to semen involves induction of cytokines. In this study, potential functions for Interleukin-23 (IL-23) in the inflammatory response to different insemination treatments were examined by studying mRNA expression and immunostaining in samples of gilt oviduct (isthmus and infundibulum) and endometrium collected 35-40 h after insemination. Insemination was performed with either seminal plasma (SP, n = 4), spermatozoa in the extender Beltsville thawing solution (BTS) (SPZ, n = 4), or BTS alone (n = 4). In control gilts (n = 4) an insemination catheter was inserted without anything being inseminated. Any relation between expression of IL-23 and the presence of polymorphonuclear neutrophilic granulocytes (PMNs) in the endometrium was examined. Results: Results showed that IL-23 mRNA was expressed in the oviduct and in the endometrium. There was a significantly lower IL-23 mRNA expression in samples from gilts in the SPZ, SP and BTS treatment groups, compared with the controls. The control group also displayed significantly more neutrophils in samples collected 35-40 h after insemination compared with samples from the SP group. IL-23 immunolabelling was detected in a small number of separate cells as well as in the sub-epithelial connective tissue of the endometrium, the endosalpinx of the isthmus and infundibulum.Conclusions: All fluids used for insemination decreased the expression of IL-23 mRNA in the endometrium compared to catheter-insertion alone, indicating a possible role for IL-23 in the inflammatory response after insemination in gilts.

Many university libraries hold cultural heritage collections that are unknown to the majority of students. The digitisation of these collections offers new ways of working with primary sources, and with it, an increasing interest in archives and older collections. This development has made us reflect on our information literacy classes within the humanities. Are we too influenced by the STEM and social science interpretations of information literacy and their focus on the peer-reviewed article? We want to challenge this view and discuss what a humanities approach to information literacy could incorporate. We want to invite you to a discussion on how we can integrate archival material and other primary sources into our classes, thus broadening mainstream information literacy to include primary source literacy (see ACRL’s Guidelines for primary source literacy, 2018). Our understanding is that this topic is generally not discussed at Nordic information literacy conferences, and our literature review indicates that this field is mostly addressed by special collections librarians and archivists (Hauck & Robinson, 2018; Hubbard & Lotts, 2013; Samuelson & Coker, 2014). In addition, in digital humanities pedagogy, there is need for reflection on data or sources beyond “tool-based thinking” which this approach would open up for (Giannetti, 2017). We will share two examples of how we have engaged students with primary sources and discuss the pedagogical challenges and opportunities. Our aim has been to go beyond show and tell and let the students actively work with primary sources. One example, from the Master’s Program in Digital Humanities, involved working with digitised sources using the platform Omeka. In the other, first year students from the Department of Conservation explored primary sources from the Gothenburg Exhibition held in 1923. Hopefully, this round table can be a stepping-stone for forming a network where we continue to share our experiences.

Catecholamines can be used to evaluate neuroendocrine tumors, stress, and potentially pain, but catecholamines degrade rapidly. Their metabolites normetanephrine (NME) and metanephrine (ME) have better stability in urine. In cats, urine sampling in a home environment would be beneficial to reduce effects of clinical stress and simplify sampling. We evaluated a human urine ELISA for analysis of NME and ME in feline urine, and investigated the effects of acidification, cat tray pellets, and storage time at room temperature up to 8.5 h. In 26 feline urine samples, mean NME concentration was 192 ± 80 ng/mL, mean intra- and inter-assay CV was 6.5% and 4.2%, respectively, and spike recovery was 98–101%, but dilutional recovery was unsatisfactory. For ME, mean intra- and inter-assay CV was 10.2% and 4.1%, respectively. Mean urine ME concentration was 32.1 ± 18.3 ng/mL, close to the kit’s lowest standard, and spike recovery was 65–90%; the ELISA could not be validated for ME. The stability study, performed for NME on 12 urine samples, did not identify differences between acidified and non-acidified samples, cat tray pellets, or storage time, and no interaction effects. The ME ELISA was not suitable for feline urine; performance of the NME ELISA was acceptable, except for dilution recovery. For analysis of NME, feline urine can be sampled at home using cat tray pellets and stored at room temperature up to 8.5 h without acidification.

Introduction: Early mobilization often in combination with breathing exercises is highly recommended after abdominal surgery. However, the isolated effect of early mobilization on respiratory function is still not evaluated. The overall aim was to evaluate the effects of immediate mobilization, within 2h (hours) after surgery on respiratory function in patients undergoing elective abdominal surgery. Material and methods: A total of 201 adult patients who underwent elective abdominal surgery, where the anesthetic time exceeded 2h, were randomized to: Mobilization - to sit in a chair + breathing exercises with PEP (n=68) Mobilization - to sit in a chair (n=69) Control - bedrest with maximum 30 degrees elevation (n=64) The interventions started within 2h of ended surgery and continued for a maximum of 6h. PaO2, SpO2 (primary outcomes) and PaCO2 were assessed every hour while breathing air. Information about pneumonia was retrieved from the patient´s medical record. Results: The premliminary analysis per protocol indicates that PaO2 as well as SpO2 increased over time (p Conclusion: Mobilization alone, or in combination with breathing exercises, within 2h after surgery, seems to improve PaO2 and SpO2 for patients who undergo elective abdominal surgery and to reduce the prevalence of pneumonia.

Objectives: To translate and culturally adapt the Chelsea Critical Care Physical Assessment Tool into Swedish and to test the inter-rater reliability of the Swedish version in critically ill patients. Design: This is an observational study. Methods: Translation and cross-cultural adaptation was performed in line with international recommendations, including forward and backward translation and expert round table discussions. The inter-rater reliability of the Chelsea Critical Care Physical Assessment Tool – Swedish was then explored in 50 critically ill adult patients, pragmatically recruited, in a University Hospital clinical setting. Reliability was calculated using intraclass correlation coefficient for aggregated scores and quadratic weighted Cohen’s kappa analysis for individual items Results: The expert round table discussion group agreed that the translation was a satisfactory equivalent to the original version and applicable for use within the clinical setting. Reliability of aggregated scores and individual items were very good (intraclass correlation coefficient of 0.97 and quadric weighted kappa values ranging from 0.88 to 0.98). The measurement error for aggregated scores was low, with a standard error of measurement of 1.79, smallest detectable change of 4.95, and limits of agreement of 5.20 and −4.76. The percentage agreement for individual items ranged from 64% to 88%. Conclusion: The Chelsea Critical Care Physical Assessment Tool – Swedish was found applicable and appropriate for assessment of functioning in critically ill patients in an acute setting in Sweden, and it displayed high inter-rater reliability. This implies that the Swedish version can be used as assessment tool within intensive care and acute wards in Sweden.Implications for rehabilitationThere is a lack of validated instruments to test the functional status of critically ill patients in Sweden.The Chelsea Critical Care Physical Assessment Tool is validated and reliable in English.The Chelsea Critical Care Physical Assessment Tool – Swedish is considered reliable for use by physiotherapist in intensive care settings in Sweden.The Swedish version is feasible for use within clinical practice due to its simplicity and strong clinical relevance. There is a lack of validated instruments to test the functional status of critically ill patients in Sweden. The Chelsea Critical Care Physical Assessment Tool is validated and reliable in English. The Chelsea Critical Care Physical Assessment Tool – Swedish is considered reliable for use by physiotherapist in intensive care settings in Sweden. The Swedish version is feasible for use within clinical practice due to its simplicity and strong clinical relevance.

Interfering antibodies in human serum and plasma are known to react with mammalian antibodies in immunoassays and cause false-positive test results. Although this phenomenon was recently shown in companion animals, knowledge regarding immunoassay interference in veterinary medicine is very limited.The aims of this study were to set up a species-independent immunoassay procedure to detect interference in serum samples, to screen for interference in a cross-section of canine and feline patient samples from an animal hospital, and to determine if the detected interference could be neutralized using an immunoassay based on nonmammalian reagents.A 2-site sandwich-type interference assay was set up using commercially available mouse reagents. A total of 369 serum samples from 320 dogs and 263 samples from 218 cats were analyzed using the interference assay. Multiple samples were submitted from 36 dogs and 39 cats. Nineteen samples identified as interference-positive were analyzed in an assay using chicken antibodies.Interference was detected in samples from 28 dogs (9%) and 10 cats (5%) screened with the interference assay. Except for 1 cat, consistent results were obtained for all 75 dogs and cats that submitted more than 1 sample. The interference was eliminated when analyzed in the chicken-based assay (P .001).Substances with reactivity toward mouse IgG can be detected in serum samples from dog and cat patients using a 2-site interference assay. The detected substances are most likely interfering antibodies, possibly originating from immunization with other mammalian species.

Digitisation is presenting new possibilities and challenges for the use of collections in both the humanities and the sciences. However, digitisation is also another layer in a longer process of selections shaping the collection—something which must be analysed on a case-by-case basis. This paper considers the epistemological implications of the digitisation of the Directors' Correspondence (DC) collection (1841-1928) at the Royal Botanic Gardens, Kew, made available through the Global Plants database. In order to avoid a polarised analysis of the end-products of archive and database, the selection process shaping this collection is traced from the writing of the letters and their reception into the DC at RBG, Kew, to the digitisation with corresponding metadata and the end-user searching the database. Particular attention is given the digitisation process and the knowledge produced by the project digitisers, as they combine close reading and database searches in writing the summaries of the letters for the metadata. This analysis of the DC engages with wider discussions about digitisation by emphasising the importance of taking a longer historical perspective, with particular attention to moments of selection, and highlighting the knowledge generated by those involved in the digitisation process. By doing so, the result is not a clear trajectory but a combination of losses and gains, disconnections and reconnections. Care is therefore needed to avoid replicating the invisible losses of extractive approaches to knowledge production, particularly in the context of collection-based biodiversity conservation.1

Development of physiologically relevant cellular models with strong translatability to human pathophysiology is critical for identification and validation of novel therapeutic targets. Herein we describe a detailed protocol for generation of an advanced 3-dimensional kidney cellular model using induced pluripotent stem cells, where differentiation and maturation of kidney progenitors and podocytes can be monitored in live cells due to CRISPR/Cas9-mediated fluorescent tagging of kidney lineage markers (SIX2 and NPHS1). Utilizing these cell lines, we have refined the previously published procedures to generate a new, higher throughput protocol suitable for drug discovery. Using paraffin-embedded sectioning and whole-mount immunostaining, we demonstrated that organoids grown in suspension culture express key markers of kidney biology (WT1, ECAD, LTL, nephrin) and vasculature (CD31) within renal cortical structures with microvilli, tight junctions and podocyte foot processes visualized by electron microscopy. Additionally, the organoids resemble the adult kidney transcriptomics profile, thereby strengthening the translatability of our in vitro model. Thus, development of human nephron-like structures in vitro fills a major gap in our ability to assess the effect of potential treatment on key kidney structures, opening up a wide range of possibilities to improve clinical translation.

Book Review of Plants and Literature: Essays in Critical Plant Studies : Resena de Plants and Literature: Essays in Critical Plant Studies

Syftet med studien var att undersöka hur barn i förskolan upplever och tolkar olika miljöer utomhus. I samhället kategoriserar vuxna ofta miljöer utifrån vilka som är naturliga och vilka som är stadsmiljöer. Pedagoger i förskolans verksamhet kan ha liknande synsätt men det är inte säkert att de stämmer överens med barnens synsätt. Studien har utgått från ett fenomenologiskt perspektiv och använt fotoeliticering, vilket innebär att forskaren använder bilder som en samtalsgrund i en intervju. Studien är baserad på nio intervjuer med 4-5 åringar på en förskola. I resultatet presenteras kategorier som visar på hur barn upplever och tolkar olika miljöer utomhus. Erfarenheter, Sociala interaktioner, Lekmöjligheter, Risker samt Estetiska element är de kategorier som jag tolkat utifrån barnens berättelser. Studien kommer fram till att vi måste ha en medvetenhet kring barns tankar och erfarenheter när vi rör oss eller utformar miljöer i förskolans verksamhet. Barnen använder sig inte av kategoriseringarna natur- och stadsmiljö när de tolkar miljöer.

A new, robust method for measuring the average pore size of water-swollen, cellulose I rich fibres is presented. This method is based on the results of solid-state NMR, which measures the specific surface area (area/solids mass) of water-swollen samples, and of the fibre saturation point (FSP) method, which measures the pore volume (water mass/solids mass) of water-swollen samples. These results are suitable to combine since they are both recorded on water-swollen fibres in excess water, and neither requires the assumption of any particular pore geometry. The new method was used for three model samples and reasonable average pore size measurements were obtained for all of them. The structural characterization of water-swollen samples was compared with the dry structure of fibres as revealed using BET nitrogen gas adsorption after a liquid exchange procedure and careful drying. It was concluded that the structure of the water-swollen fibres sets an upper limit on what is obtainable in the dry state.

Summary Objectives To describe a multidisciplinary intensive care follow-up and the methods used for identifying and managing physical and psychological problems in ICU survivors. Methods Patients treated > four days in an intensive care unit (ICU) were invited three, six and 12 months after intensive care for screening of physical problems with function tests and psychological problems with the Impact of Event Scale (IES) and the Hospital Anxiety and Depression Scale (HADS). Results 40 of 61 patients had clinically impaired physical function, with no ongoing physical rehabilitation at three months. Twenty-two patients received specific training instructions and 18 patients were referred for physiotherapy. 34 of 61 patients had symptoms of moderate to severe posttraumatic stress and/or symptoms of clinically significant anxiety or depression. Twelve patients accepted referral for psychiatric evaluation and treatment. Conclusion Multidisciplinary follow-up after intensive care can be of value in identifying untreated physical and psychological problems in ICU survivors. Liaison with specialists enables referral for identified problems. Patients screened and treated in the first six months appear to have little need for further follow-up after intensive care.

The delivery of emulsified silicone oil to hydrophilic silica surfaces by mixtures of cationic polysaccharides and SDS has been studied by in situ null ellipsometry, dynamic light scattering, and turbidity measurements. The emulsion contained silicone oil droplets with a hydrodynamic radius of 18 rim, stabilized by anionic and nonionic surfactants. The investigated polysaccharides were cat-guar and cat-HEC. Both polyions have qualitatively similar adsorption and bulk properties in mixtures with surfactant and emulsion droplets, and both are able to deliver emulsion droplets to the hydrophilic silica surface under suitable conditions. However, there are important quantitative differences that are attributed to a more hydrophobic character of cat-HEC than of cat-guar. The differences in hydrophobicity affect the adsorption from polyelectrolyte/emulsion/surfactant mixtures to hydrophilic silica, especially when an initially surfactant-rich mixture is brought toward phase separation by dilution. Under these conditions, adsorption is obtained only for mixtures with cat-guar. Dynamic light scattering performed on the bulk solutions reveals different aggregation behavior of the cat-guar and the cat-HEC with the silicone oil droplets in the studied surfactant concentration range and the results agree with findings from the adsorption study. Adsorption during dilution of a polyelectrolyte-surfactant mixed solution in the presence of silicone oil droplets gives a larger adsorbed amount and a thicker layer compared to the polyelectrolyte-surfactant mixture without emulsion. (Less)

Mixtures of cationic guar (cat-guar) or cationic hydroxyethylcellulose (cat-HEC) with the anionic surfactants sodium dodecyl sulfate or sodium lauryl ether-3 sulfate have been investigated by a wide range of complementary techniques (phase studies, turbidity measurements, dynamic light scattering, gel-swelling experiments, and in situ null ellipsometry), with the following objectives in mind: (1) to establish the relationship between the bulk phase behavior (precipitation and redissolution) of the polyion/surfactant ion complexes and formation/deposition of such complexes at silica surfaces and (2) to obtain molecular interpretations of the large, previously unresolved, quantitative differences between the various investigated mixtures. There were clear similarities, for each studied system, between the bulk phase behavior, gel swelling, and surface deposition on increasing surfactant concentration. This is because all phenomena reflect the polyion/surfactant ion binding isotherm: an initial binding step at a low critical association concentration (cac) of the surfactant and a second more-or-less cooperative binding step beginning at a second cac, the cac(2). The details of the interactions are system-specific, however, and cat-guar/surfactant mixtures generally had larger precipitation regions and gave rise to larger adsorbed amounts on silica compared to mixtures with cat-HEC of a similar charge density. The observed quantitative differences are attributed to a difference in the hydrophobicity of the polyions. For cat-guar, the comparatively weak hydrophobic polyion/surfactant attraction is seen as a very gradual binding commencing at the cac(2) and continuing past the bulk critical micelle concentration of the surfactant, resulting in an unusually large phase-separation region. For cat-HEC, the dissolution of the precipitate takes place at lower surfactant concentrations because of a stronger hydrophobic interaction between the surfactant and the polyion. The results have implications for the successful design of oppositely charged polyelectrolyte/surfactant formulations for surface deposition applications.

Aim: To investigate the release of hydrophobic and hydrophilic substances from tablets containing Pemulen and Carbopol as excipients. Method: The dissolution patterns of a hydrophobic (diazepam) and a hydrophilic active substance (midodrine-HCl) from different tablet formulations containing a nonmodified polyacrylic microgel (Carbopol 981 F) or a hydrophobically modified polyacrylic microgel (Pemulen(R)) have been studied. Possible differences in dissolution in phosphate buffer (pH 6.8) and in 0.1 M HCl between tablets produced using wet granulation and direct compression were also investigated. Results: Tablets produced by wet granulation had a greater effect on the release of active substance from the tablets. No major differences were observed in the release patterns of the hydrophilic substance midodrine-HCl from wet granulated tablets based on Carbopol and Pemulen. However, the release pattern of the more hydrophobic drug substance, diazepam, differed considerably between the two polymers. Wet granulation gave reproducible release patterns. The release patterns from the polymers differed considerably at pH 6.8 but were similar at low pH. Conclusions: The release of the diazepam from the hydrophobic polymer Pemulen was very slow, and the release was close to zero order.

Wnts are secreted proteins with functions in differentiation, development and cell proliferation. Wnt signaling has also been implicated in neuromuscular junction formation and may function in synaptic plasticity in the adult as well. Secreted frizzled-related proteins (Sfrps) such as Sfrp1 can function as inhibitors of Wnt signaling. In the present study a potential role of Wnt signaling in denervation was examined by comparing the expression levels of Sfrp1 and key proteins in the canonical Wnt pathway, Dishevelled, glycogen synthase kinase 3beta and beta-catenin, in innervated and denervated rodent skeletal muscle. Sfrp1 mRNA and immunoreactivity were found to be up-regulated in mouse hemidiaphragm muscle following denervation. Immunoreactivity, detected by Western blots, and mRNA, detected by Northern blots, were both expressed in extrasynaptic as well as perisynaptic parts of the denervated muscle. Immunoreactivity on tissue sections was, however, found to be concentrated postsynaptically at neuromuscular junctions. Using beta-catenin levels as a readout for canonical Wnt signaling no evidence for decreased canonical Wnt signaling was obtained in denervated muscle. A role for Sfrp1 in denervated muscle, other than interfering with canonical Wnt signaling, is discussed.

Summary Background & aims Studies have shown that reproducibility of indirect calorimetry in healthy subjects is high, but none have studied this in chronic obstructive pulmonary disease. The aim was to examine the reproducibility of indirect calorimetry in chronic obstructive pulmonary disease patients and to compare measured resting metabolic rate to prediction equations of resting metabolic rate. Methods Resting metabolic rate was assessed twice the same week and was also predicted using four different equations in 41 (30 women, 11 men) underweight patients with stable chronic obstructive pulmonary disease. Results There was no statistical significant difference between the two measurement occasions. The mean between-day coefficient of variation was 4.1%. The difference between occasions of indirect calorimetry was 50 kJ with limits of agreement −740–640 kJ. The prediction equation assessing the largest part (68.3%) of the patient group within 90%–110% of measured resting metabolic rate was based on fat free mass. Conclusions Reproducibility of indirect calorimetry to assess resting metabolic rate in chronic obstructive pulmonary disease is high and prediction of resting metabolic rate shows poor agreement with measured resting metabolic rate. This finding underlines the importance of follow up of nutritional care.

The optimal treatment of Graves disease (GD) is still controversial. Surgery is one treatment option along with radioactive iodine (RAI) and antithyroid medication. In this evidence-based review, we examine four issues: (1) Is surgery better than RAI or long-term antithyroid medication? (2) What is the recommended surgical approach? (3) How does the presence of Graves' ophthalmopathy (GO) influence the role of surgery? (4) What is the role of surgery in children with GD?We conducted a systematic review of the literature using evidence-based criteria regarding these four issues.(1) There are no recommendations reaching any grade of evidence for which treatment to choose for adults with GD. (2) Total thyroidectomy has complication rates equal to those seen with lesser resections but it has higher cure rates and negligible recurrence rates (Level I-IV data leading to a grade A recommendation). (3) Data support surgery when severe GO is present, but RAI combined with glucocorticoids may be equally safe (Level II-IV data, grade B recommendation). The extent of thyroid resection does not influence the outcome of GO (Level II data, grade B recommendation). (4) Based on the available data, definitive treatment can be advocated for children (Level IV data, grade C recommendation) using either RAI or surgery. No recommendation can be given as to whether RAI or surgery is preferred owing to the lack of studies addressing this issue. Increased cancer risk with RAI in children below the age of 5 years supports surgery in this setting (Level I data, grade A recommendation).If surgery is considered for definitive management, evidence-based criteria support total thyroidectomy as the surgical technique of choice for GD. Available evidence also supports surgery in the presence of severe endocrine GO. Children with GD should be treated with an ablative strategy. Whether this is achieved by total thyroidectomy or RAI may still be debatable. Data on long-term cancer risk are missing or conflicting; and until RAI has proven harmless in children, we continue to recommend surgery in this group.

Palliative care seeks to enhance quality of life in the face of death by addressing the physical, psychological, social, and spiritual needs of patients with advanced disease. The purpose of this paper is to explore whether palliative patients' needs, nursing actions, and evaluation can be identified in the nursing documentation. Data consisted of reviews of patients' case records in a palliative care unit. Data were analyzed using content analysis and counting frequency of keywords used from the Well-being Integrity Prevention and Safety (VIPS) model, followed by an inductive analysis of the case record documentation aiming to identify palliative care components. The result shows that the documentation revealed physical care, especially pain, more frequently than other needs. Nursing documentation focuses on identification more than on nursing actions and evaluation.

Semaphorins are secreted or transmembrane proteins important for axonal guidance and for the structuring of neuronal systems. Semaphorin 6C, a transmembrane Semaphorin, has growth cone collapsing activity and is expressed in adult skeletal muscle. In the present study the expression of Semaphorin 6C mRNA and immunoreactivity has been compared in innervated and denervated mouse hind-limb and hemidiaphragm muscles. Microscopic localization of immunoreactivity was studied in innervated and denervated rat skeletal muscle. The results show that Semaphorin 6C mRNA expression and immunoreactivity on Western blots are down-regulated following denervation. The mRNA of Semaphorin 6C as well as immunoreactivity determined by Western blots are expressed in extrasynaptic as well as perisynaptic regions of muscle. Immunohistochemical studies, however, show Semaphorin 6C-like immunoreactivity to be concentrated at neuromuscular junctions. The results suggest a role for Semaphorin 6C in neuromuscular communication.

Structures of concentrated mixtures of associating polymer-surfactant mixtures are important in many technical applications. Yet an in-depth understanding of how molecular parameters affect these structures is lacking. We here summarize the results of ongoing work using a novel simplified approach to the study of associating oppositely charged polymer-surfactant mixtures, introducing a minimum number of components to the various mixtures. The results illustrate the relations between systems with and without polyions, as well as effects of systematic changes of parameters such as surfactant chain length, polyion length, polyion charge density, and the charge density of the surfactant aggregate.

The aim was to investigate the relationship between life events and social phobia. An inventory assessing life events during childhood, adulthood as well as life events experienced in relation to the onset of the disorder was administrated to 30 subjects with a DSM-IV diagnosis of social phobia. They were recruited by announcement and diagnosed by the Structured Clinical Interview for DSM-IV for axes I and II disorders. Seventy-five controls were selected by matching age and gender from the local population register. Individuals with social phobia reported significantly more life events during childhood and more life events with negative impact during the social phobia debuting year. Conversely, they described fewer events in the adult life than the controls. Close relatives with disabling conditions in the childhood, conflicts with wife/husband/cohabitant and divorces or similar were significantly more common in the debuting year in social phobic group. In adult life, the healthy individuals described significantly more often increased authority at work. A gender-specific analysis revealed significantly more experiences of a death of a relative/close friend during the year before the social phobia debut and significantly more negative life events in the women's adult life. In summary, the present results support that life events have a role in social phobia that may be gender influenced.