Complications related to tube thoracostomy in Southwest Finland hospital district between 2004 and 2014.

BACKGROUND AND AIMS: The purpose of this study was to describe the frequency and types of complications after tube thoracostomy among all patients treated with tube thoracostomy for both traumatic and non-traumatic indications. MATERIAL AND METHODS: Retrospective register-based study of patients treated with tube thoracostomy between the years 2004 and 2014 in a university hospital. RESULTS: In total, 1808 patients who had undergone tube thoracostomy were identified, complete data on tube thoracostomy treatment was available for 1169 patients. A total of 233 (19.9%) patients had 289 complications, 284 (98.3%) were positional resulting in tube malfunction. In 84 (7.2%) patients, malposition of the tube resulted in need for non-urgent operative treatment. There were 103 in-hospital deaths, but none due to tube thoracostomy complications. Empyema as a treatment indication was more frequent in patients with complications (15.9% vs 6.8%, p < 0.001) as was diabetes (21.9% vs 13.2%, p = 0.001). The likelihood of complications was lower with CH16 tubes (odds ratio 0.22, p < 0.001) and higher in diabetics (odds ratio 1.86, p = 0.001). CONCLUSION: Tube thoracostomy is a common procedure and complications occur in 19.9% of patients. Serious complications caused by the chest tube placement, however, are extremely rare. Complications were most common in patients treated for empyema and diabetics. Small CH16 tubes were associated with a lower incidence of complications.

Climate-driven shifts in sediment chemistry enhance methane production in northern lakes.

Freshwater ecosystems are a major source of methane (CH4), contributing 0.65 Pg (in CO2 equivalents) yr-1 towards global carbon emissions and offsetting ~25% of the terrestrial carbon sink. Most freshwater CH4 emissions come from littoral sediments, where large quantities of plant material are decomposed. Climate change is predicted to shift plant community composition, and thus change the quality of inputs into detrital food webs, with the potential to affect CH4 production. Here we find that variation in phenol availability from decomposing organic matter underlies large differences in CH4 production in lake sediments. Production is at least 400-times higher from sediments composed of macrophyte litter compared to terrestrial sources because of inhibition of methanogenesis by phenol leachates. Our results now suggest that earth system models and carbon budgets should consider the effects of plant communities on sediment chemistry and ultimately CH4 emissions at a global scale.

Wetlands as long-term sources of metals to receiving waters in mining-impacted landscapes.

Wetlands are prevalent in the Sudbury, Ontario region and often operate at the interface between terrestrial and aquatic ecosystems, modifying water chemistry and potentially affecting the recovery of impacted lakes. The deposition of metals and sulphur in Sudbury in 2010-2012 was far below that reported in the 1970's, but still higher than background values. Wetlands in the area have accumulated large quantities of metals, and high concentrations of these metals in streams occurred primarily in response to SO4-related acidification events or associated with high dissolved organic carbon production in early summer. Concentrations of most metals in streams exceeded provincial guidelines and fluxes of some metals from catchments exceeded deposition inputs to lakes by as much as 12 times. The release of metals long after emissions reductions have been achieved must be considered in ecosystem recovery studies, particularly as dry conditions may become more prevalent in boreal regions affected by mining.

Effects of neuregulin-1 genetic variation and depression symptom severity on longitudinal patterns of psychotic symptoms in primary care attendees.

A better understanding of the factors associated with psychotic symptoms could aid early identification and treatment of psychotic disorders. Previous studies have typically utilized cross-sectional study designs and have focused on individuals with psychotic disorders. Thus, examination of promising correlates of psychotic symptoms using longitudinal designs among more broadly defined populations is warranted. Two such correlates are neuregulin-1 (NRG1) genotypic variation and depression symptom severity. Both NRG1 and depression symptom severity have cross-sectional evidence for an association with psychosis but their affect on longitudinal patterns of psychotic symptoms and their potential interaction effects are less clear. Using repeated measures analysis of variance and covariance we modeled the main and interaction effects of NRG1 genotypic variation and depressive symptom severity on longitudinal psychotic symptom patterns in 301 primary care attendees assessed annually over 4 years. One-fifth (19.9%) of the participants reported one or more psychotic symptoms over the 4-year assessment period. We observed a curvilinear (i.e., cubic) association between depression symptom severity at baseline and longitudinal patterns of psychotic symptoms but did not observe a main effect for NRG1 genotypic variation on psychotic symptom patterns. However, NRG1 rs6994992 genotype moderated the curvilinear association between depression symptom severity and psychotic symptom patterns. Specifically, depression symptom severity had less of an effect on longitudinal psychotic symptoms among carriers of the rs6994992 TT genotype compared to CC and CT carriers. Our findings suggest a curvilinear association between depression symptom severity and longitudinal patterns of psychotic symptoms that is moderated by NRG1 genotype.

The prognostic significance of declining health-related quality of life scores at 6 months after coronary artery bypass surgery.

PURPOSE: Health-related quality of life (HRQoL) measured on the EQ-5D (European quality of life-5 dimensions)-questionnaire has been shown to improve after coronary artery bypass grafting (CABG), this study investigated whether changes in HRQoL predict later morbidity. METHODS: Included were 404 consecutive patients undergoing isolated CABG between 2008 and 2010 who filled the EQ-5D-questionnaire at baseline and 6 months postoperatively. Records were reviewed for later major adverse cardiac and cerebrovascular events (MACCE) after 6 months. Follow-up was 38.6 months (10-58). RESULTS: Patients who suffered later MACCE more often had suffered an in-hospital postoperative stroke, had a longer in-hospital stay, had lower HRQoL scores at 6 months and deteriorated on several EQ-5D-subscales. Logistic regression showed 6 months visual analogue scale scores and declining function scores to be independent predictors of later MACCE. CONCLUSION: Deteriorating function and HRQoL-scores at 6 months as compared to baseline postoperatively predict later adverse cardiovascular events after CABG.

Terrestrial organic matter as subsidies that aid in the recovery of macroinvertebrates in industrially damaged lakes.

The importance of allochthonous carbon to the productivity of stream ecosystems in temperate ecozones is well understood, but this relationship is less established in oligotrophic lakes. The nearshore littoral zones, at the interface of terrestrial and aquatic systems, are areas where the influence of terrestrial subsidies is likely greatest. We investigated the response of nearshore communities to variation in the quantity and composition of allochthonous materials, determined the landscape characteristics that regulate the variation of this subsidy, and explored the potential for terrestrial restoration practices to influence the export of organic matter to lakes. Stepwise multiple regressions revealed that diversity of nearshore macroinvertebrate families increased with the amount of fine particulate organic matter (FPOM) captured in sediment traps. The quantity of FPOM (g) increased with forest cover, and the relative amount of FPOM (percentage of total particulate material) in the traps increased with surface area of wetland in the catchments. These models suggest that terrestrially derived subsidies are important in smelter-impacted watersheds, and that the restoration of forests and wetlands will speed the return of nearshore consumer community diversity in industrially damaged lakes.

Exact vortex nucleation and cooperative vortex tunneling in dilute Bose-Einstein condensates.

With the imminent advent of mesoscopic rotating Bose-Einstein condensates in the lowest Landau level regime, we explore lowest Landau level vortex nucleation. An exact many-body analysis is presented in a weakly elliptical trap for up to 400 particles. Striking non-mean-field features are exposed at filling factors >>1. For example, near the critical rotation frequency pairs of energy levels approach each other with exponential accuracy. A physical interpretation is provided by requantizing a mean-field theory, where 1/N plays the role of Planck's constant, revealing two vortices cooperatively tunneling between classically degenerate energy minima. The tunnel splitting variation is described in terms of frequency, particle number, and ellipticity.

Anomalous hydrodynamics and normal fluids in rapidly rotating Bose-Einstein condensates.

In rapidly rotating condensed Bose systems we show that there is a regime of anomalous hydrodynamics which coincides with the mean field quantum Hall regime. A consequence is the absence of a normal fluid in any conventional sense. However, even the superfluid hydrodynamics is not described by conventional Bernoulli and continuity equations. We show that there are constraints which connect spatial variations of density and phase and that the vortex positions are not the simplest description of the dynamics. We demonstrate, inter alia, a simple relation between vortices and surface waves. We show that the surface waves can emulate a "normal fluid," allowing dissipation by energy and angular momentum absorbtion from vortex motion in the trap. The time scale is sensitive to the initial configuration, which can lead to long-lived vortex patches--perhaps related to those observed at JILA.

Quantum phases of vortices in rotating Bose-Einstein condensates.

We investigate the ground states of weakly interacting bosons in a rotating trap as a function of the number of bosons, N, and the average number of vortices, N(V). We identify the filling fraction nu identical with N/N(V) as the parameter controlling the nature of these states. We present results indicating that, as a function of nu, there is a zero temperature phase transition between a triangular vortex lattice phase, and strongly correlated vortex liquid phases. The vortex liquid phases appear to be the Read-Rezayi parafermion states.

Use of water clarity to monitor the effects of climate change and other stressors on oligotrophic lakes.

We present evidence from studies of lakes in Killarney Park, Ontario, Canada that water clarity is a key variable for monitoring the effects of climate change, high UV exposure and acidification. In small oligotrophic lakes, these stressors affect water clarity primarily by altering the concentration of DOC in lake water. Clear lakes (<2 mg L(-1) DOC) proved to be highly sensitive indicators of stressors, exhibiting large thermal and optical responses to small changes in DOC. Extremely clear (<0.5 mg L(-1) DOC) acidic lakes showed the effects of climate change and solar bleaching in recent decades. These lakes became much clearer even though they were slowly recovering from acidification.

Management of women with minor abnormalities of the cervix detected on screening: a qualitative study.

OBJECTIVE: To examine the consistency of decisions by pathology staff and general practitioners in managing women in whom minor cervical abnormalities are detected by screening, with current National Health and Medical Research (NHMRC) Council guidelines, and to look at reasons for inconsistencies. DESIGN: Qualitative interview study. PARTICIPANTS: 14 pathology staff (12 pathologists and two cytoscientists) from 10 of the 17 laboratories providing cervical cytology services in Victoria, and a sample of 22 GPs from metropolitan and rural locations in Victoria. MAIN OUTCOME MEASURES: Comparison of management practice with NHMRC guidelines; reasons for current decision-making practice. RESULTS: Most pathologists provided more cautious recommendations for minor abnormalities of the cervix than the NHMRC recommendations in all reporting categories except human papillomavirus. Pathologists had concerns about the appropriateness of the NHMRC recommendations, particularly for glandular atypia, lack of an endocervical component and inflammatory smears, where they believed that the NHMRC recommendations were not well supported by evidence. GPs generally followed the recommendations of their laboratories. Medicolegal concerns were a major influence on clinical decisions for both pathologists and GPs, and have contributed to the development of cautious management practice. Reporting and management practice of pathologists and GPs reflects the ambiguity of minor cervical abnormalities that the NHMRC guidelines fail to highlight. CONCLUSION: Many pathologists and GPs are reluctant to follow NHMRC guidelines because they believe they are inadequate for some minor cervical abnormalities. The cervical screening guidelines should be reviewed according to the NHMRC guidelines for developing clinical practice guidelines, to promote consistent practice based on an up-to-date, accurate evidence base.

Ultraviolet absorbance in lakes near the metal smelters in Sudbury, Canada.

Ultraviolet (UV)-dissolved organic carbon (DOC) models were developed using surface samples collected from 58 lakes located 8-128 km from the metal smelters in Sudbury, Canada. Highly significant (R2 = 0.93-0.95) relationships were found between absorbance coefficients (K(a)lambda) and DOC within the UV-A and UV-B range (310, 30, 365 nm). Changes in UV absorbance with water depth were assessed in a subset of four lakes. Two study lakes with intermediate levels of DOC (DOC = 10-2.5 mg L(-1)) showed very marked depth related absorbance profiles, with evidence of photodegradation and much reduced absorbance in surface waters, particularly evident in late summer. These changes may affect complexation of metals and UV habitat characteristics for sensitive biota. These findings suggest that UV absorbance is an important variable for inclusion in long-term monitoring programs.

Expression of fatty acyl-CoA binding proteins in colon cells: response to butyrate and transformation.

Fatty acyl-CoA affect many cellular functions as well as serving as cellular building blocks. Several families of cytosolic fatty acyl-CoA binding proteins may modulate the activities of fatty acyl-CoA. Intestinal enterocytes contain at least three unique families of cytosolic proteins that bind fatty acyl-CoA: acyl-CoA binding protein (ACBP), fatty acid binding proteins (including the liver, L-FABP and intestinal, I-FABP), and sterol carrier protein-2 (SCP-2). Immortalized rat colon epithelial cell lines expressed only ACBP and SCP-2 at levels of 0.75 +/- 0.13 and 0.42 +/- 0.02 ng/microgram protein. Ras and src transformation increased colon cell density and differentially altered ACBP and SCP-2 expression without affecting I-FABP or L-FABP levels. ACBP levels were 1.8-fold and 1.5-fold increased in ras- and src-transformed cells, respectively. In contrast, SCP-2 expression was significantly decreased 55 and 67% in ras- and src-transformed cells, respectively. Butyrate treatment of ras- and src-transformed cells decreased cell proliferation up to 60-85% as compared to 25-30% in control cells. Butyrate treatment decreased ACBP expression in all cell lines but had no effect on the levels of SCP-2, I-FABP, or L-FABP. These studies suggest that the differential expression of ACBP and SCP-2 in rat colonic cell lines, as well as their modulation by butyrate, may be altered by cell transformation.

Alteration of glycerolipid and sphingolipid-derived second messenger kinetics in ras transformed 3T3 cells.

The effect of ras transformation (rasB fibroblasts) on basal and serum-stimulated diacylglycerol (DAG) composition and mass was examined over time with respect to changes in membrane phospholipid composition and ceramide mass. RasB cells vs. nontransformed control cells (rasD and NR6) had chronically elevated DAG levels (up to 240 min) following serum stimulation, indicating a defect in the recovery phase of the intracellular DAG pulse. Ras transformation also had a dramatic effect on DAG composition. Molecular species analysis revealed that DAG from unstimulated rasB cells was enriched in the delta 9 desaturase fatty acyl species (monoenoate 18:1(n - 7) and 18:1(n - 9)), and depleted in arachidonic acid (20:4(n - 6)). With the exception of glycerophosphoinositol (GPI), DAG remodeling paralleled the compositional alterations in individual phospholipid classes. Importantly, ras transformation altered the fatty acyl composition of sphingomyelin, a precursor to the ceramide second messenger. With the addition of serum, control cells (rasD) had a progressive increase in ceramide mass with levels approximately 5-fold higher by 240 min. In contrast, ceramide levels did not increase in rasB cells at either 4 or 240 min. These results demonstrate that ras-oncogene, in addition to its effects on DAG metabolism, can also abolish the cellular increase in ceramide mass in response to serum stimulation. Since DAG and ceramide may have opposing biological functions, the prolonged elevation of DAG and the suppression of ceramide levels would be consistent with an enhanced proliferative capacity.

NIH3T3 cells transfected with the yeast H(+)-ATPase have altered rates of protein turnover.

NIH3T3 cells transfected with the yeast plasma membrane H(+)-ATPase (RN1a line) or transfected with a low-activity mutant H(+)-ATPase (N-Mut line) were used to examine the relationship between cytosolic pH (pHcyt) and protein turnover. At an extracellular pH (pHex) of 7.15, NIH3T3 and N-Mut cells have a pHcyt of 7-7.1 and a vacuolar pH (pHvac) of 6.3, whereas in RN1a cells both the pHcyt and the pHvac are 0.3 unit more alkaline. Rates of protein synthesis and degradation are optimum at pHex 7.2 and are much more sensitive to pH changes in RN1a cells than in NIH3T3 cells. However, irrespective of pH, rates of protein degradation in RN1a cells are always less than those measured in NIH3T3 cells. Rates of protein synthesis are the same for sparse cultures of RN1a and NIH3T3 cells and show a density-dependent decline in NIH3T3 cells but remain high in RN1a cells even at high cell densities. These data indicate that the elevation of pHcyt caused by transformation with the H(+)-ATPase has no direct effect on protein synthesis. On the other hand, rates of protein degradation are consistently lower in RN1a cells than in NIH3T3 or N-Mut cells. Basal rates of protein degradation, measured in medium containing 10 mM 3-methyladenine or 10% serum or 1 microM insulin, as well as the autophagic response to serum or insulin withdrawal, are both significantly lower in RN1a cells. These data indicate that transformation with the H(+)-ATPase has a direct effect on rates of protein degradation, possibly through an elevation of pH. The higher pHvac will directly effect lysosomal protein breakdown and the higher pHcyt may be permissive for maintenance of low basal rates of protein breakdown. Overall, we conclude that transformation with the H(+)-ATPase provides a permissive environment for high rates of protein synthesis and low rates of protein degradation that result in high rates of growth and the tumor phenotype.

Protein turnover in 3T3 cells transformed with the oncogene c-H-ras1.

We have examined protein turnover, growth, DNA synthesis and proliferation in three independent clones of 3T3-NR6 cells transformed with the oncogene c-H-ras1. We find that, firstly, the half-maximum concentration of serum and insulin regulating protein turnover in ras-transformed cells is significantly reduced from 0.5 to 0.3% for serum and from 4 nM to 0.5 nM for insulin, and, secondly, ras-transformed cells consistently have lower rates of protein degradation. The catabolic effect of conditioned medium or serum withdrawal is attenuated in transformed lines by maintaining lower basal rates of protein breakdown and higher basal rates of DNA and protein synthesis. Serum stimulation of growth in transformed cells is achieved in the short term by lower rates of protein breakdown rather than higher rates of protein synthesis: rates of protein synthesis become significantly higher 24 h after serum stimulation. Therefore transformed cells have higher rates of proliferation and grow to higher densities, but display characteristics common to normal cells because rates of protein synthesis decrease and protein degradation increase as a function of cell density. We conclude that higher basal rates of protein synthesis and growth with retention of the normal proliferative response to serum result from the pleiotropic nature of ras transformation, whereas lower rates of protein degradation and increased sensitivity to serum and insulin imply a direct regulatory role for ras.