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Background: Oxygen is liberally administered in intensive care units (ICUs). Nevertheless, ICU doctors' preferences for supplementing oxygen are inadequately described. The aim was to identify ICU doctors' preferences for arterial oxygenation levels in mechanically ventilated adult ICU patients.Methods: In April to August 2016, an online multiple-choice 17-part-questionnaire was distributed to 1080 ICU doctors in seven Northern European countries. Repeated reminder e-mails were sent. The study ended in October 2016.Results: The response rate was 63%. When evaluating oxygenation 52% of respondents rated arterial oxygen tension (PaO2 ) the most important parameter; 24% a combination of PaO2 and arterial oxygen saturation (SaO2 ); and 23% preferred SaO2 . Increasing, decreasing or not changing a default fraction of inspired oxygen of 0.50 showed preferences for a PaO2 around 8 kPa in patients with chronic obstructive pulmonary disease, a PaO2 around 10 kPa in patients with healthy lungs, acute respiratory distress syndrome or sepsis, and a PaO2 around 12 kPa in patients with cardiac or cerebral ischaemia. Eighty per cent would accept a PaO2 of 8 kPa or lower and 77% would accept a PaO2 of 12 kPa or higher in a clinical trial of oxygenation targets.Conclusion: Intensive care unit doctors preferred PaO2 to SaO2 in monitoring oxygen treatment when peripheral oxygen saturation was not included in the question. The identification of PaO2 as the preferred target and the thorough clarification of preferences are important when ascertaining optimal oxygenation targets. In particular when designing future clinical trials of higher vs lower oxygenation targets in ICU patients. [ABSTRACT FROM AUTHOR]

Background: Mortality rates in critically ill adult patients admitted to the intensive care unit (ICU) remains high, and numerous patient- and disease-related adverse prognostic factors have been identified. In recent years, studies in a variety of emergency conditions suggested that outcome is dependent on the time of hospital admission. The importance of out-of-hours admission to the ICU has been sparsely evaluated and with ambiguous findings. We assessed the association between out-of-hours (16:00 to 07:00) and weekend admission to the ICU, respectively, and 90-day mortality in a nationwide cohort.Methods: We included all Danish adult patients admitted to the ICU between 1 January 2011 and 30 June 2014, with an ICU stay > 24 h. The crude and adjusted association between out-of-hours and weekend admission and 90-day mortality was assessed (odds ratio (ORs) with 95% confidence intervals (CI)).Results: A total of 44,797 patients were included, 53.3% were admitted out-of-hours, and 22.6% during weekends. Median age was 67 years (interquartile range (IQR) 55-76), and median SAPS II was 42 (IQR 30-54). Patients admitted in-hours vs. out-of-hours displayed a 90-day mortality rate of 41.0% vs. 44.2%. The adjusted association (OR with 95% CI) between out-of-hours admission and 90-day mortality was 1.07 (1.02-1.11), and the adjusted association (OR with 95% CI) between weekend admission and 90-day mortality was 1.10 (1.05-1.15).Conclusion: This nationwide study suggests that critically ill adult patients admitted to the ICU during weekends and out-of-hours, and with an ICU stay > 24 h are at slightly increased risk of mortality. [ABSTRACT FROM AUTHOR]

Summary: Weedy plants pose a major threat to food security, biodiversity, ecosystem services and consequently to human health and wellbeing. However, many currently used weed management approaches are increasingly unsustainable. To address this knowledge and practice gap, in June 2014, 35 weed and invasion ecologists, weed scientists, evolutionary biologists and social scientists convened a workshop to explore current and future perspectives and approaches in weed ecology and management. A horizon scanning exercise ranked a list of 124 pre‐submitted questions to identify a priority list of 30 questions. These questions are discussed under seven themed headings that represent areas for renewed and emerging focus for the disciplines of weed research and practice. The themed areas considered the need for transdisciplinarity, increased adoption of integrated weed management and agroecological approaches, better understanding of weed evolution, climate change, weed invasiveness and finally, disciplinary challenges for weed science. Almost all the challenges identified rested on the need for continued efforts to diversify and integrate agroecological, socio‐economic and technological approaches in weed management. These challenges are not newly conceived, though their continued prominence as research priorities highlights an ongoing intransigence that must be addressed through a more system‐oriented and transdisciplinary research agenda that seeks an embedded integration of public and private research approaches. This horizon scanning exercise thus set out the building blocks needed for future weed management research and practice; however, the challenge ahead is to identify effective ways in which sufficient research and implementation efforts can be directed towards these needs. [ABSTRACT FROM AUTHOR]

Summary: Background: Twelve weeks of the pangenotypic direct‐acting antiviral (DAA) combination sofosbuvir/velpatasvir (SOF/VEL) was highly efficient in patients with hepatitis C virus (HCV) genotype 3 (GT3) infection in the ASTRAL‐3 approval study. However, presence of resistance‐associated substitutions (RASs) in the HCV nonstructural protein 5A (NS5A) was associated with lower treatment response. Aim: To assess the efficacy and safety of SOF/VEL ± ribavirin (RBV) and the impact of NS5A RASs and RBV use on treatment outcome in HCV GT3 infection in a real‐world setting. Methods: In this multicentre cohort study, GT3 patients from ten treatment centres across Germany were included. Sustained virological response was assessed 12 weeks after end‐of‐treatment (SVR12) in modified intention‐to‐treat (mITT) and per‐protocol analysis (PP). NS5A RASs were tested by population‐based sequencing. Results: A total of 293 GT3 patients were included. The median age was 48 years, 70% were male, 25.3% were cirrhotic, 9.2% were HCV/HIV co‐infected and 21.8% were treatment‐experienced, including 4.1% with DAA experience. Baseline NS5A RASs (Y93H, A30K, L31M) were detected in 11.2%. RBV was added in 5% of noncirrhotic and 58.9% of cirrhotic patients, respectively. SVR12 rates for SOF/VEL±RBV were 95.9% (mITT) and 99.5% (PP), respectively. Only 1 virological relapse occurred in a cirrhotic patient previously treated with SOF/RBV. No treatment‐related major adverse events occurred. Conclusion: Twelve weeks of SOL/VEL±RBV was safe and highly efficient in HCV GT3 across a diverse patient population. Baseline NS5A RASs were rarely observed and presence did not seem to impact SVR, regardless of the use of RBV. [ABSTRACT FROM AUTHOR]

Background: Very elderly patients are one of the fastest growing population in ICUs worldwide. There are lots of controversies regarding admission, discharge of critically ill elderly patients, and also on treatment intensity during the ICU stay. As a consequence, practices vary considerably from one ICU to another. In that perspective, we collected opinions of experienced ICU physicians across Europe on statements focusing on patients older than 80.Methods: We sent an online questionnaire to the coordinator ICU physician of all participating ICUs of an recent European, observational study of Very old critically Ill Patients (VIP1 study). This questionnaire contained 12 statements about admission, triage, treatment and discharge of patients older than 80.Results: We received answers from 162 ICUs (52% of VIP1-study) spanning 20 different European countries. There were major disagreements between ICUs. Responders disagree that: there is clear evidence that ICU admission is beneficial (37%); seeking relatives' opinion is mandatory (17%); written triage guidelines must be available either at the hospital or ICU level (20%); level of care should be reduced (25%); a consultation of a geriatrician should be sought (34%) and a geriatrician should be part of the post-ICU trail (11%). The percentage of disagreement varies between statements and European regions.Conclusion: There are major differences in the attitude of European ICU physicians on the admission, triage and treatment policies of patients older than 80 emphasizing the lack of consensus and poor level of evidence for most of the statements and outlining the need for future interventional studies. [ABSTRACT FROM AUTHOR]

Delayed onset muscle soreness (DOMS) occurs within 1‐2 days after eccentric exercise, but the mechanism mediating hypersensitivity is unclear. This study hypothesized that eccentric exercise reduces the blood flow response following muscle contractions and cuff occlusion, which may result in accumulated algesic substances being a part of the sensitization in DOMS. Twelve healthy subjects (five women) performed dorsiflexion exercise (five sets of 10 repeated eccentric contractions) in one leg, while the contralateral leg was the control. The maximal voluntary contraction (MVC) of the tibialis anterior muscle was recorded. Blood flow was assessed by ultrasound Doppler on the anterior tibialis artery (ATA) and within the anterior tibialis muscle tissue before and immediately after 1‐second MVC, 5‐seconds MVC, and 5‐minutes thigh cuff occlusion. Pressure pain thresholds (PPTs) were recorded on the tibialis anterior muscle. All measures were done bilaterally at day 0 (pre‐exercise), day 2, and day 6 (post‐exercise). Subjects scored the muscle soreness on a Likert scale for 6 days. Eccentric exercise increased Likert scores at day 1 and day 2 compared with day 0 (P<.001). Compared with pre‐exercise (day 0), reduced PPT (~25%, P<.002), MVC (~22%, P<.002), ATA diameter (~8%, P<.002), ATA post‐contraction/occlusion blood flow (~16%, P<.04), and intramuscular peak blood flow (~23%, P<.03) were found in the DOMS leg on day 2 but not in the control leg. These results showed that eccentric contractions decreased vessel diameter, impaired the blood flow response, and promoted hyperalgesia. Thus, the results suggest that the blood flow reduction may be involved in the increased pain response after eccentric exercise. [ABSTRACT FROM AUTHOR]

Real-world studies are relevant to complement clinical trials on novel antiviral therapies against chronic hepatitis C; however, clinical practice data are currently limited. This study investigated effectiveness and safety of ombitasvir/paritaprevir/ritonavir ( OBV/ PTV/r)±dasabuvir ( DSV)±ribavirin ( RBV) for treatment of HCV genotype ( GT) 1 and GT4 infection in a large real-world cohort. The German Hepatitis C Registry is an observational cohort study prospectively collecting clinical practice data on direct-acting antiviral therapies. Patients with GT1/4 infection treated with OBV/ PTV/r± DSV± RBV were analysed. Effectiveness was assessed by sustained virologic response in 558 patients who reached post-treatment week 12 ( SVR12). Safety is reported in 1017 patients who initiated treatment. Of the patients, 892 (88%) had GT1 and 125 (12%) had GT4 infection. Prior treatment experience and cirrhosis were reported in 598 (59%) and 228 (22%) patients, respectively. Overall, SVR12 ( mITT) was 96% (486/505) in GT1- and 100% (53/53) in GT4 patients. SVR12 rates were high across subgroups including patients with cirrhosis (95%, 123/129), patients with moderate to severe renal impairment (100%, 34/34), and subgroups excluded from registrational trials like patients ≥70 years (96%, 64/67) and failures to prior protease inhibitor treatment (96%, 46/48). Adverse events (AEs) and serious AEs were reported in 52% (525/1017) and 2% (21/1017) of patients, respectively, and led to treatment discontinuation in 1.5% (15/1017) of patients. OBV/ PTV/r± DSV± RBV was effective and generally well tolerated for treatment of HCV infection in clinical practice. [ABSTRACT FROM AUTHOR]

Background: Extracorporeal Cardiopulmonary Resuscitation (ECPR) has emerged as a feasible rescue therapy for refractory, normothermic out-of-hospital cardiac arrest (OHCA). Reported survival rates vary and comparison between studies is hampered by heterogeneous study populations, differences in bystander intervention and in pre-hospital emergency service organisation. We aimed to describe the first experiences, treatment details, complications and outcome with ECPR for OHCA in a Danish health region.Methods: Retrospective study of adult patients admitted at Aarhus University Hospital, Denmark between 1 January 2011 and 1 July 2015 with witnessed, refractory, normothermic OHCA treated with ECPR. OHCA was managed with pre-hospital advanced airway management and mechanical chest compression during transport. Relevant pre-hospital and in-hospital data were collected with special focus on low-flow time and ECPR duration. Survival to hospital discharge with Cerebral Performance Category (CPC) of 1 and 2 at hospital discharge was the primary endpoint.Results: Twenty-one patients were included. Median pre-hospital low-flow time was 54 min [range 5-100] and median total low-flow time was 121 min [range 55-192]. Seven patients survived (33%). Survivors had a CPC score of 1 or 2 at hospital discharge. Five survivors had a shockable initial rhythm. In all survivors coronary occlusion was the presumed cause of cardiac arrest.Conclusion: Extracorporeal cardiopulmonary resuscitation is feasible as a rescue therapy in normothermic refractory OHCA in highly selected patients. Low-flow time was longer than previously reported. Survival with favourable neurological outcome is possible despite prolonged low-flow duration. [ABSTRACT FROM AUTHOR]

We present a new methodology to combine spatially dense high-resolution airborne electromagnetic (AEM) data and sparse borehole information to construct multiple plausible geological structures using a stochastic approach. The method developed allows for quantification of the performance of groundwater models built from different geological realizations of structure. Multiple structural realizations are generated using geostatistical Monte Carlo simulations that treat sparse borehole lithological observations as hard data and dense geophysically derived structural probabilities as soft data. Each structural model is used to define 3-D hydrostratigraphical zones of a groundwater model, and the hydraulic parameter values of the zones are estimated by using nonlinear regression to fit hydrological data (hydraulic head and river discharge measurements). Use of the methodology is demonstrated for a synthetic domain having structures of categorical deposits consisting of sand, silt, or clay. It is shown that using dense AEM data with the methodology can significantly improve the estimated accuracy of the sediment distribution as compared to when borehole data are used alone. It is also shown that this use of AEM data can improve the predictive capability of a calibrated groundwater model that uses the geological structures as zones. However, such structural models will always contain errors because even with dense AEM data it is not possible to perfectly resolve the structures of a groundwater system. It is shown that when using such erroneous structures in a groundwater model, they can lead to biased parameter estimates and biased model predictions, therefore impairing the model's predictive capability. [ABSTRACT FROM AUTHOR]

Transdisciplinary weed research ( TWR) is a promising path to more effective management of challenging weed problems. We define TWR as an integrated process of inquiry and action that addresses complex weed problems in the context of broader efforts to improve economic, environmental and social aspects of ecosystem sustainability. TWR seeks to integrate scholarly and practical knowledge across many stakeholder groups (e.g. scientists, private sector, farmers and extension officers) and levels (e.g. local, regional and landscape). Furthermore, TWR features democratic and iterative processes of decision-making and collective action that aims to align the interests, viewpoints and agendas of a wide range of stakeholders. The fundamental rationale for TWR is that many challenging weed problems (e.g. herbicide resistance or extensive plant invasions in natural areas) are better addressed systemically, as a part of broad-based efforts to advance ecosystem sustainability, rather than as isolated problems. Addressing challenging weed problems systemically can offer important new leverage on such problems, by creating new opportunities to manage their root causes and by improving complementarity between weed management and other activities. While promising, this approach is complicated by the multidimensional, multilevel, diversely defined and unpredictable nature of ecosystem sustainability. In practice, TWR can be undertaken as a cyclic process of (i) initial problem formulation, (ii) 'broadening' of the problem formulation and recruitment of stakeholder participants, (iii) deliberation, negotiation and design of an action agenda for systemic change, (iv) implementation action, (v) monitoring and assessment of outcomes and (vi) reformulation of the problem situation and renegotiation of further actions. Notably, 'purposive' disciplines (design, humanities and arts) have central, critical and recurrent roles in this process, as do integrative analyses of relevant multidimensional and multilevel factors, via multiple natural and social science disciplines. We exemplify this process in prospect and retrospect. Importantly TWR is not a replacement for current weed research; rather, the intent is to powerfully leverage current efforts. [ABSTRACT FROM AUTHOR]

Seed-attacking microorganisms have an undefined potential for management of the weed seedbank, either directly through inundative inoculation of soils with effective pathogenic strains, or indirectly by managing soils in a manner that promotes native seed-decaying microorganisms. However, research in this area is still limited and not consistently successful because of technological limitations in identifying the pathogens involved and their efficacy. We suggest that these limitations can now be overcome through application of new molecular techniques to identify the microorganisms interacting with weed seeds and to decipher their functionality. However, an interdisciplinary weed management approach that includes weed scientists, microbiologists, soil ecologists and molecular biologists is required to provide new insights into physical and chemical interactions between different seed species and microorganisms. Such insight is a prerequisite to identify the best candidate organisms to consider for seedbank management and to find ways to increase weed seed suppressive soil communities. [ABSTRACT FROM AUTHOR]

This meta-analysis of seven randomized, placebo-controlled studies (total 3222 patients) evaluated whether type 2 diabetes ( T2D) duration affects the changes in blood glucose control and body weight that can be achieved with liraglutide and placebo. With liraglutide 1.2 mg, shorter diabetes duration was associated with a significantly greater, but clinically non-relevant, difference in glycated haemoglobin ( HbA1c) reduction (p < 0.05), i.e. a 0.18% (1.96 mmol/mol) reduction in HbA1c per 10 years shorter diabetes duration. With liraglutide 1.8 mg, shorter diabetes duration was associated with a small but statistically significant trend for greater fasting plasma glucose ( FPG) reduction (p < 0.05), i.e. a 0.38 mmol/l reduction in FPG per 10 years shorter diabetes duration. Neither the liraglutide 1.8 mg nor placebo results showed a significant association between HbA1c and diabetes duration and neither the liraglutide 1.2 mg nor placebo results showed a significant association between FPG and diabetes duration. Likewise, neither liraglutide nor placebo showed a significant association between change in weight and diabetes duration. These results suggest diabetes duration has a clinically negligible effect on achievable blood glucose control and weight outcomes with liraglutide and placebo in patients with T2D. [ABSTRACT FROM AUTHOR]

ABSTRACT Animal models have historically provided an appropriate benchmark for understanding human pathology, treatment, and healing, but few animals are known to naturally develop intervertebral disc degeneration. The study of degenerative disc disease and its treatment would greatly benefit from a more comprehensive, and comparable animal model. Alpacas have recently been presented as a potential large animal model of intervertebral disc degeneration due to similarities in spinal posture, disc size, biomechanical flexibility, and natural disc pathology. This research further investigated alpacas by determining the prevalence of intervertebral disc degeneration among an aging alpaca population. Twenty healthy female alpacas comprised two age subgroups (5 young: 2-6 years; and 15 older: 10+ years) and were rated according to the Pfirrmann-grade for degeneration of the cervical intervertebral discs. Incidence rates of degeneration showed strong correlations with age and spinal level: younger alpacas were nearly immune to developing disc degeneration, and in older animals, disc degeneration had an increased incidence rate and severity at lower cervical levels. Advanced disc degeneration was present in at least one of the cervical intervertebral discs of 47% of the older alpacas, and it was most common at the two lowest cervical intervertebral discs. The prevalence of intervertebral disc degeneration encourages further investigation and application of the lower cervical spine of alpacas and similar camelids as a large animal model of intervertebral disc degeneration. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 33:1776-1783, 2015. [ABSTRACT FROM AUTHOR]

Recent development of site-specific weed management strategies suggests patch application of herbicides to avoid their excessive use in crops. The estimation of infestation of weeds and control thresholds are important components for taking spray decisions. If weed pressure is below a certain level in some parts of the field and if late germinating weeds do not affect yield, it may not be necessary the spray such places from an economic point of view. Consequently, it makes sense to develop weed control thresholds for patch spraying, based on weed cover early in the growing season. In Danish maize field experiments conducted from 2010 to 2012, we estimated competitive ability parameters and control thresholds of naturally established weed populations in the context of decision-making for patch spraying. The most frequent weed was Chenopodium album, accompanied by Capsella bursa-pastoris, Cirsium arvense, Lamium amplexicaule, Tripleurospermum inodorum, Poa annua, Polygonum aviculare, Polygonum persicaria, Stellaria media and Veronica persica. Relative leaf cover of weeds was estimated using an image analysis method. The relation between relative weed leaf cover and yield loss was analysed by nonlinear regression models. The competitive ability parameters and economic thresholds were estimated from the regression models. The competitive ability of weed mixtures was influenced by the increasing proportion of large size weeds in the mixtures. There was no significant effect of weeds which survived or established after the first herbicide application, indicating that early image analysis was robust for use under these conditions. [ABSTRACT FROM AUTHOR]

Background Sequential allergen desensitization provides temporary tolerance for allergic patients. We adapted a clinical protocol to desensitize human blood basophils ex vivo and investigated the mechanism and allergen specificity. Methods We included 28 adult, grass allergic subjects. The optimal, activating allergen concentration was determined by measuring activated CD63+ CD193+SSLow basophils in a basophil activation test with 8 log-dilutions of grass allergen. Basophils in whole blood were desensitized by incubation with twofold to 2.5-fold increasing allergen doses in 10 steps starting at 1 : 1000 of the optimal dose. Involvement of p38 mitogen-activated protein kinase ( MAPK) was assessed after 3 min of allergen stimulation ( n = 7). Allergen specificity was investigated by desensitizing cells from multi-allergic subjects with grass allergen and challenging with optimal doses of grass, birch, recombinant house dust mite (rDer p2) allergen or anti-IgE ( n = 10). Results Desensitization reduced the fraction of blood basophils responding to challenge with an optimal allergen dose from a median ( IQR) 81.0% (66.3-88.8) to 35.4% (19.8-47.1, P < 0.0001). CD63 MFI expression was reduced from 68 248 (29 336-92 001) to 30 496 (14 046-46 179, P < 0.0001). Basophils from multi-allergic subjects were desensitized with grass allergen. Challenge with grass allergen resulted in 39.6% activation (15.8-58.3). An unrelated challenge (birch, rDer p2 or anti-IgE) resulted in 53.4% activation (30.8-66.8, P = 0.16 compared with grass). Desensitization reduced p38 MAPK phosphorylation from a median 48.1% (15.6-92.8) to 26.1% (7.4-71.2, P = 0.047) and correlated with decrease in CD63 upregulation ( n = 7, r > 0.79, P < 0.05). Conclusion Desensitization attenuated basophil response rapidly and non-specifically at a stage before p38 MAPK phosphorylation. [ABSTRACT FROM AUTHOR]

Small unmanned aerial systems ( UAS) with cameras have not been adopted in weed research, but offer low-cost sensing with high flexibility in terms of spatial resolution. A small rotary-wing UAS was tested as part of a search for an inexpensive, user-friendly and reliable aircraft for practical applications in UAS imagery weed research. In two experiments with post-emergence weed harrowing in barley, the crop resistance parameter, which reflects the crop response to harrowing, was unaffected by image capture altitude in the range from 1 to 50 m. This corresponded to image spatial resolution in the range from 0.3 to 17.1 mm per pixel. This finding is important because spatial resolution is inversely related to sensing capacity. We captured 20 plots comprising a total of about 0.2 ha in one image at 50 m altitude without losing information about the cultivation impacts on vegetation compared with ground truth data. UAS imagery also gave excellent results in logarithmic sprayer experiments in oilseed rape, where we captured 37 m long plots in each image from an altitude of 35 m. Furthermore, perennial weeds could be mapped from UAS images. These first experiences with a small rotary-wing UAS show that it is relatively easy to integrate as a tool in weed research and offers great potential for site-specific weed management. [ABSTRACT FROM AUTHOR]

Objective To examine the effects of an expressive writing intervention (EWI) on cancer-related distress, depressive symptoms, and mood in women treated for early stage breast cancer. Methods A nationwide sample of 507 Danish women who had recently completed treatment for primary breast cancer were randomly assigned to three 20-min home-based writing exercises, one week apart, focusing on either emotional disclosure (EWI group) or a non-emotional topic (control group). Cancer-related distress [Impact of Event Scale (IES)], depressive symptoms (Beck Depression Inventory-Short Form), and negative (37-item Profile of Moods State) and positive mood (Passive Positive Mood Scale) were assessed at baseline and at 3 and 9 months post-intervention. Choice of writing topic (cancer versus other), alexithymia (20-item Toronto Alexithymia Scale), and social constraints (Social Constraints Scale) were included as possible moderators. Results Significant ( p < 0.01) group differences in mood change from before to immediately after each session suggested successful manipulation. Reductions over time in psychological symptoms were seen in both groups ( p < 0.05), but no time × group interactions were found. Choice of writing topic moderated effects on IES, with women writing about other themes showing greater reductions in cancer-related avoidance than women writing about their cancer. Fewer depressive symptoms and higher levels of positive mood were seen 3 months post-intervention in women writing about their cancer when compared with the control group. Difficulties describing feelings and externally oriented thinking (20-item Toronto Alexithymia Scale) moderated effects on positive mood and IES-total, while no moderating effects were found of social constraints. Conclusions In concordance with the majority of previous results with cancer patients, no main effects of EWI were found for cancer-related distress, depressive symptoms, and mood. Moderator analyses suggested that choice of writing topic and ability to process emotional experiences should be studied further. Copyright © 2012 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Aim We wished to determine the effect of continuous β-receptor stimulation on alveolar fluid clearance and to elucidate the mechanisms behind this effect. Methods Alveolar fluid clearance was measured in anaesthetized rats pretreated for 72 h with the β-agonist isoproterenol (200 μg kg−1h−1 sc) or vehicle. Alveolar fluid clearance in artificially ventilated rats was determined over 1 h by infusion of isotonic Ringer solution containing 125I-albumin into the lungs. Additionally, alveolar fluid clearance was determined when amiloride or l-cis-diltiazem was added to the solution to block ENaC and cyclic nucleotide-gated ( CNG) channels respectively. Results Isoproterenol treatment induced a 42% increase in alveolar fluid clearance (18.9 ± 1.4%) vs. vehicle (13.3 ± 3.3%). Addition of amiloride resulted in a net decrease of 8% in both groups, while l-cis-diltiazem caused a net decrease of 12% in isoproterenol-treated animals, but only 5% in vehicle-treated animals. Western blotting showed that isoproterenol treatment increased the abundance of the α- ENaC and β- ENaC subunits (223 ± 51% and 274 ± 55% of vehicle, respectively) but we saw no changes in protein level of the γ-EnaC subunit. Conclusion Continuous β-adrenoceptor stimulation with isoproterenol enhances alveolar fluid clearance through alternative pathways involving l-cis-diltiazem-sensitive channels. [ABSTRACT FROM AUTHOR]

Aim: Congestive heart failure (CHF) is associated with increased renal sympathetic nerve activity and renal sodium retention. Rats with CHF display increased expression of the Na-K-2Cl cotransporter (NKCC2) in the renal medullary thick ascending limb of the loop of Henle (mTAL), and arginine vasopressin (AVP)-stimulated cAMP formation in mTAL segments is increased in rats with CHF. The aim of the study was to investigate the role of RSNA on cAMP formation and NKCC2 expression in mTAL in rats with CHF. Methods: Congestive heart failure was induced in male Wistar rats by ligation of the left anterior descending coronary artery. Bilateral surgical renal denervation (DNX) was performed 3 weeks later. Two weeks after DNX, mTAL segments were isolated and stimulated with AVP. Results: Congestive heart failure rats displayed increased mTAL NKCC2 expression (2.5 ± 0.5 vs. 1 ± 0.2 in Sham rats), which was abolished by DNX. Bilateral denervation decreased basal cAMP levels in unstimulated tubules from CHF rats (CHF: 12.56 ± 7.73 fmol μg−1 protein vs. DNX-CHF: 7.94 ± 4.33; P < 0.05), as well as from Sham rats (SHAM: 4.70 ± 1.38 vs. DNX-SHAM: 2.36 ± 1.52; P < 0.05). mTAL segments from DNX-CHF and DNX-Sham rats showed decreased AVP (10−6 m)-stimulated cAMP formation, compared with CHF (CHF: 11.92 ± 4.89 fmol μg−1 protein vs. DNX-CHF: 4.68 ± 2.47; P < 0.05) and Sham (SHAM: 10.78 ± 5.59 vs. DNX-SHAM: 4.89 ± 2.62; P < 0.05). Conclusion: These results indicate that the renal sympathetic nerves have an effect on NKCC2 expression in the mTAL and might have an effect on cAMP formation in the TAL in CHF. [ABSTRACT FROM AUTHOR]

Background Sevoflurane post-conditioning ( SePost) has been found to alleviate ischemic myocardial reperfusion injury through the activation of prosurvival kinases. Lowered myocardial oxygen demand from reduced cardiac work may also contribute to cardioprotection, and is much less well-studied. Our aim was to examine the simultaneous effects of SePost on cardiac work (here, rate-pressure product, RPP) and myocardial infarct size in a porcine model. Methods Anesthetized 25 kg pigs were randomly allocated to two groups and underwent 45 min regional coronary artery balloon occlusion and subsequent 2 h reperfusion. SePost ( n = 10) was given as sevoflurane 1.5-3% end-tidal concentration during reperfusion while controls ( n = 12) were untreated. Aortic blood pressure was measured directly, while mixed-venous oxygen saturation and cardiac output were measured in the pulmonary artery. Cardiac work was determined as RPP. Post-mortem, histologic myocardial infarct size ( IS), and area at risk were determined in transverse heart slices after tetrazolium stain. Results Myocardial infarct size was reduced from (control) 55.0 (mean) ± 13.6% (standard deviation) to 32.5 ± 13.4% in group SePost ( P = 0.0009). During reperfusion, SePost resulted in lower heart rate ( P = 0.0003), cardiac output ( P = 0.0123), mixed-venous oxygen saturation ( P = 0.0103), blood pressure, and RPP ( P < 0.0001). RPP was highly correlated to IS ( P = 0.0055). Conclusion SePost (1.5-3%) reduced infarct size after regional myocardial ischemia in vivo and reduced cardiac work was significantly correlated to myocardial salvage. [ABSTRACT FROM AUTHOR]

Objective: Recanalization of arterial obstruction is associated with improved clinical outcomes. There are no controlled data demonstrating whether arterial obstruction status predicts the treatment effect of intravenous (IV) tissue plasminogen activator (tPA). We aimed to determine if the presence of arterial obstruction improves the treatment effect of IV tPA over placebo in attenuating infarct growth.Methods: We analyzed 175 ischemic stroke patients treated in the 3-6 hour time window from the Echoplanar Imaging Thrombolytic Evaluation Trial (EPITHET) trial (randomized to IV tPA or placebo) and Diffusion and perfusion imaging Evaluation For Understanding Stroke Evolution (DEFUSE) study (all treated with IV tPA). Infarct growth was calculated as the difference between baseline diffusion-weighted imaging (DWI) and final T2 lesion volumes. Baseline arterial obstruction of large intracranial arteries was graded on magnetic resonance angiography (MRA).Results: Among the 116 patients with adequate baseline MRA and final lesion assessment, 72 had arterial obstruction (48 tPA, 24 placebo) and 44 no arterial obstruction (33 tPA, 11 placebo). Infarct growth was lower in the tPA than placebo group (median difference 26ml, 95% confidence interval [CI], 1-50) in patients with arterial obstruction, but was similar in patients with no arterial obstruction (median difference 5ml, 95%CI, -3 to 9). Infarct growth attenuation with tPA over placebo treatment was greater among patients with arterial obstruction than those without arterial obstruction by a median of 32ml (95%CI, 21-43, p < 0.001).Interpretation: The treatment effect of IV tPA over placebo was greater with baseline arterial obstruction, supporting arterial obstruction status as a consideration in selecting patients more likely to benefit from IV thrombolysis. [ABSTRACT FROM AUTHOR]

Background: Chronic diseases are common among intensive care unit (ICU) patients and may worsen their prognosis. We examined the prevalence and impact of pre-admission/index morbidity among ICU patients compared with a general population cohort. Methods: Our study encompassed all 28,172 adult patients admitted to ICUs in northern Denmark in 2005-2007 and 281,671 age- and sex-matched individuals from the general population. We used a nationwide hospital registry to obtain a 5-year history of 19 chronic diseases and computed Charlson Comorbidity Index (CCI) for each study participant and grouped them into low (CCI=0), moderate (CCI=1-2), and high (CCI=3+) morbidity levels. We computed mortality and mortality rate ratios (MRRs) adjusted for confounders, and compared the mortality between ICU patients and the general population cohort. Results: Low, moderate, and high pre-admission morbidity levels were present in 51.5%, 34.1%, and 14.4% of ICU patients, respectively. In these groups, 30-day mortality was 10.8%, 18.4%, and 26.7%, respectively. Three-year mortality was 21.3%, 43.1%, and 63.2%, respectively. The adjusted 30-day MRR was 1.30 [95% confidence intervals (CI): 1.21-1.39] and 1.86 (95% CI: 1.71-2.01) for ICU patients with moderate and high morbidity levels, both compared with a low morbidity level. The general population had a lower morbidity level and mortality at all morbidity levels throughout the study period. Interaction between ICU admission and high morbidity level added 5.1% to the mortality during the second and third year of follow-up. Conclusion: A high pre-admission morbidity level was frequent among ICU patients and associated with a worsened prognosis. Morbidity had more impact on mortality among ICU patients compared with a general population cohort. [ABSTRACT FROM AUTHOR]

Aims The purpose was to elucidate the association between parity and the incidence of diabetes using national register data. Methods The study population consisted of all Danish women with a singleton delivery in 1982 / 1983 (n = 100 669), who subsequently had 74 966 deliveries. The included women were followed up via registries until the end of 2006 for subsequent deliveries, diagnosis of diabetes and death / emigration. Results a total of 2021 cases (2.0%) were diagnosed with diabetes in connection with hospitalization or outpatient treatment during follow-up. Analyses were adjusted for fetal weight and duration of gestation, both at index pregnancy. Cox regression analysis with parity as a time-varying exposure, stratified in two age groups, showed an association between parity and risk of a diagnosis of diabetes. In women <33 years of age, parity 2, 3 and 4 + were associated with an increased risk of being diagnosed with diabetes compared with parity 1 [relative risks: 1.6 (95% confidence interval 1.1-2.3), 2.8 (1.8-4.3) and 2.5 (1.3-4.8), respectively]. Among women >33 years of age, parity 2 was associated with a significantly lower risk of diabetes diagnosis compared with parity 1, whereas parity 4 + was associated with a significantly higher risk of diabetes diagnosis compared with parity 1. Conclusions The study shows that the risk of diabetes diagnosis increases with parity in young Danish women. This may support a causal association between diabetes and parity. [ABSTRACT FROM AUTHOR]

Soils are extremely rich in biodiversity, and soil organisms play pivotal roles in supporting terrestrial life, but the role that individual plants and plant communities play in influencing the diversity and functioning of soil food webs remains highly debated. Plants, as primary producers and providers of resources to the soil food web, are of vital importance for the composition, structure, and functioning of soil communities. However, whether natural soil food webs that are completely open to immigration and emigration differ underneath individual plants remains unknown. In a biodiversity restoration experiment we first compared the soil nematode communities of 228 individual plants belonging to eight herbaceous species. We included grass, leguminous, and non-leguminous species. Each individual plant grew intermingled with other species, but all plant species had a different nematode community. Moreover, nematode communities were more similar when plant individuals were growing in the same as compared to different plant communities, and these effects were most apparent for the groups of bacterivorous, carnivorous, and omnivorous nematodes. Subsequently, we analyzed the composition, structure, and functioning of the complete soil food webs of 58 individual plants, belonging to two of the plant species, Lotus corniculatus (Fabaceae) and Plantago lanceolata (Plantaginaceae). We isolated and identified more than 150 taxa/groups of soil organisms. The soil community composition and structure of the entire food webs were influenced both by the species identity of the plant individual and the surrounding plant community. Unexpectedly, plant identity had the strongest effects on decomposing soil organisms, widely believed to be generalist feeders. In contrast, quantitative food web modeling showed that the composition of the plant community influenced nitrogen mineralization under individual plants, but that plant species identity did not affect nitrogen or carbon mineralization or food web stability. Hence, the composition and structure of entire soil food webs vary at the scale of individual plants and are strongly influenced by the species identity of the plant. However, the ecosystem functions these food webs provide are determined by the identity of the entire plant community. [ABSTRACT FROM AUTHOR]

Diabet. Med. 27, 786–790 (2010) Aims Maternal diabetes is a known risk factor for perinatal complications, but there are little data on consequences for long-term intellectual outcome in offspring. We assess cognitive performance in military conscripts according to maternal blood glucose levels during pregnancy. Methods We identified a cohort of 60 Danish male offspring of insulin-treated diabetic mothers born between 1976 and 1984 and followed this cohort to military conscription. From medical records, we extracted data on all available values of maternal blood glucose categorized as fasting and non-fasting and by day in pregnancy, together with maternal White class, smoking habits and socio-economic status. The main outcome was cognitive performance at conscription measured with a validated intelligence test. The association between maternal blood glucose level and cognitive performance was assessed by multivariate linear regression and a fitted fractional polynomial. Results Median fasting blood glucose values in the second half of pregnancy was negatively associated with cognitive scores at conscription [adjusted coefficient –1.7; 95% confidence interval (CI) –3.0; –0.4]. Restriction to only first-born sibling slightly strengthened the association (coefficient –1.9; 95% CI –3.3; –0.5), but after exclusion of two pregnancies with the blood glucose > 10 mmol/l the association became insignificant (coefficient –0.6; 95% CI –2.6; 1.4). Conclusions Maternal blood glucose level during diabetic pregnancy is negatively associated with cognitive performance in offspring at military conscription. In pregnancies with fasting blood glucose levels below 10 mmol/l, the association is weak and considered to be without clinical relevance. [ABSTRACT FROM AUTHOR]

The impedance bandwidth (BW) improvement property of a self‐resonant folded spherical helix electric dipole and a spherical split ring (SSR) magnetic dipole is compared when a negative reactance element is loaded on the parasitic resonator of the antennas. They have the same electrical size of ka = 0.38 and both approach each lower Q‐bound. It is found that the impedance characteristic reacts more sensitively to the loaded element for the SSR antenna due to the inherent two‐times higher Q of the magnetic antenna. It is also found that a conventional non‐Foster circuit composed of a series negative inductor and a capacitor cannot be used for wide impedance matching of the SSR antenna due to the high sensitivity. Subsequently, a circuit topology that enables more precise matching of the reactive values for widened impedance matching in the high‐Q SSR antenna and satisfies the stable operating condition is proposed. It is observed that the improvement ratio of the BW is limited in practical situation. Nevertheless, the measured reflection coefficient of the 3D‐printed SSR antenna loaded with the designed active matching circuit shows two‐times wider impedance BW than passive matching, verifying the simulated result from the circuit and electromagnetic (EM) simulations. [ABSTRACT FROM AUTHOR]

Site-specific weed control technologies are defined as machinery or equipment embedded with technologies that detect weeds growing in a crop and, taking into account predefined factors such as economics, take action to maximise the chances of successfully controlling them. In this study, we describe the basic parts of site-specific weed control technologies, comprising weed sensing systems, weed management models and precision weed control implements. A review of state-of-the-art technologies shows that several weed sensing systems and precision implements have been developed over the last two decades, although barriers prevent their breakthrough. Most important among these is the lack of a truly robust weed recognition method, owing to mutual shading among plants and limitations in the capacity of highly accurate spraying and weeding apparatus. Another barrier is the lack of knowledge about the economic and environmental potential for increasing the resolution of weed control. The integration of site-specific information on weed distribution, weed species composition and density and the effect on crop yield, is decisive for successful site-specific weed management. [ABSTRACT FROM AUTHOR]

Background: Recent studies have demonstrated that inhalation anaesthetics, like sevoflurane, confer cardioprotection both experimentally and clinically. However, coexisting cardiac disease might diminish anaesthetic cardioprotection and could partly explain why the clinical results of cardioprotection with anaesthetics remain controversial – in contrast to solid experimental evidence. Concomitant left ventricular hypertrophy is found in some cardiac surgery patients and could change cardioprotection efficacy. Hypertrophy could potentially render the heart less susceptible to sevoflurane cardioprotection and more susceptible to ischaemic injury. We investigated whether hypertrophy blocks sevoflurane cardioprotection, and whether tolerance to ischaemia is altered by left ventricular hypertrophy, in an established experimental animal model of ischaemia–reperfusion. Methods: Anaesthetized juvenile pigs ( n=7–12/group) were subjected to 45 min distal coronary artery balloon occlusion, followed by 120 min of reperfusion. Controls were given pentobarbital, while sevoflurane cardioprotection was achieved by 3.2% inhalation throughout the experiment. Chronic banding of the ascending aorta resulted in left ventricular hypertrophy development in two further groups and these animals underwent identical ischaemia–reperfusion protocols, with or without sevoflurane cardioprotection. Myocardial infarct sizes were compared post-mortem. Results: The mean myocardial infarct size (% of area-at-risk) was reduced from mean 55.0 (13.6%) (±SD) in controls to 17.5 (13.2%) by sevoflurane ( P=0.001). Sevoflurane reduced the infarct size in hypertrophied hearts to 14.6 (10.4%) ( P=0.001); however, in hypertrophic controls, infarcts were reduced to 34.2 (10.2%) ( P=0.001). Conclusion: Sevoflurane abrogated ischaemic injury to similar levels in both normal and left ventricular hypertrophied hearts. [ABSTRACT FROM AUTHOR]

AIMS: To assess hospitalization rates (HR) for poisoning with heroin, methadone or strong analgesics and relate them to quantities of prescribed methadone and strong analgesics in Denmark between 1998 and 2004. DESIGN: Population-based ecological study. SETTINGS: We extracted data on all emergency department visits and hospital admissions registered in the Danish National Patient Registry with a diagnosis of poisoning with heroin (n = 1688), methadone (n = 173) or strong analgesics (n = 384). To ascertain sale of prescribed medications we used data from the Danish Medicines Agency. MEASUREMENTS: Age- and gender-standardized HR and defined daily doses (DDD) per 1000 people per day. FINDINGS: HR for heroin poisoning was 4.4 [95% confidence interval (CI): 3.8-4.9] per 100,000 person-years (p-y) in 1998 and 4.6 (CI: 4.0-5.2) per 100,000 p-y in 2004. HR for methadone poisoning increased from 0.1 (CI: 0.0-0.2) per 100,000 p-y in 1998 to 1.1 (CI: 0.8-1.4) per 100,000 p-y in 2004. HR for poisoning with strong analgesics increased from 0.6 (CI: 0.4-0.9) per 100,000 p-y in 1998 to 2.1 (CI: 1.8-2.6) per 100,000 p-y in 2004. The sale of prescribed strong analgesics (5.0 DDD per 1000 people per day in 1998 to 5.9 DDD in 2004) and methadone (3.0 DDD per 1000 people per day in 1998 to 3.4 DDD in 2004) increased slightly between 1998 and 2004. CONCLUSION: Increasing sale of prescribed methadone and strong analgesics coincided with increasing HRs of poisoning with these drugs, whereas HR of heroin poisoning varied. Further longitudinal studies are important for the guidance of future policy making. [ABSTRACT FROM AUTHOR]

Background Peptic ulcer perforation is a serious surgical emergency with a substantial short-term mortality, but the influence of antipsychotic drug use on the prognosis remains unknown. Aim To examine the association between antipsychotic drug use and 30-day mortality following peptic ulcer perforation. Methods This cohort study comprised 2033 patients with a first-time hospitalization with peptic ulcer perforation, in Northern Denmark, between 1991 and 2004. Data on preadmission use of antipsychotics and other medications, psychiatric disease, other comorbidities and mortality were obtained through population-based medical databases. We used Cox regression analyses to compute adjusted mortality rate ratios (MRRs). Results One hundred and sixteen (5.7%) patients with peptic ulcer perforation were current users of antipsychotic drugs at the time of hospital admission and 205 (10.1%) were former users. The overall 30-day mortality was 27%. Among current users of antipsychotics 30-day mortality was 39%. The adjusted 30-day MRR for current users of antipsychotic drugs compared with non-users was 1.7 (95% CI: 1.2–2.3). Former use was not a predictor of mortality. The increase in mortality was equal in users of conventional and atypical antipsychotics. Conclusion Use of antipsychotic drugs is associated with substantially increased mortality following peptic ulcer perforation. [ABSTRACT FROM AUTHOR]

Background Primary hyperparathyroidism (PHPT) is associated with reduced bone mineral density (BMD) mainly at sites rich in cortical bone. However, successful parathyroidectomy causes an increase in BMD especially at sites rich in trabecular bone. Plasma 25-hydroxyvitamin D (25OHD) levels are typically reduced and plasma 1,25-dihydroxyvitamin D [1,25(OH)2D] slightly increased in PHPT. These variations in vitamin D metabolites may influence variations in BMD and fracture risk. Aim To investigate relations between preoperative vitamin D metabolites and skeletal consequences in patients with untreated PHPT and to appraise the influence of preoperative vitamin D metabolites on postoperative changes in BMD. Design Cross-sectional and cohort study. Materials Two hundred and forty-six consecutive Caucasian PHPT patients aged 19–91 years. (median 63, 87% females). Results BMD was reduced at the femoral neck ( P < 0·001) and forearm ( P < 0·001), but normal at the lumbar spine ( P = 0·11). Levels of biochemical bone markers were associated with high plasma PTH, high plasma 1,25(OH)2D and low plasma levels of 25OHD. Moreover, low plasma 25OHD was associated with low levels of BMD at the femoral neck ( rp = 0·23), the forearm ( rp = 0·19) and the whole body ( rp = 0·30), whereas plasma 1,25(OH)2D was inversely associated with BMD at all regional sites and the whole body. Plasma PTH only showed an inverse association with BMD at the forearm ( rp = –0·21). No association was observed between biochemical variables and prevalent spinal fractures, all peripheral fractures or osteoporotic peripheral fractures. The annual increase in spinal BMD after surgery was positively associated with preoperative plasma PTH ( rp = 0·40), whereas the annual increase in whole body BMD was inversely associated with plasma 25OHD ( rp = –0·32). No change in BMD at the femoral neck and forearm was observed 1 year after surgery. Conclusion Low vitamin D status and high plasma 1,25(OH)2D are associated with increased bone turnover and decreased BMD in patients with PHPT. [ABSTRACT FROM AUTHOR]

1. Recent findings indicate that the interactions among CO2, temperature and water can be substantial, and that the combined effects on the biological systems of several factors may not be predicted from experiments with one or a few factors. Therefore realistic multifactorial experiments involving a larger set of main factors are needed. 2. We describe a new Danish climate change-related field scale experiment, CLIMAITE, in a heath/grassland ecosystem. CLIMAITE is a full factorial combination of elevated CO2, elevated temperature and prolonged summer drought. The manipulations are intended to mimic anticipated major environmental changes at the site by year 2075 as closely as possible. The impacts on ecosystem processes and functioning (at ecophysiological levels, through responses by individuals and communities to ecosystem-level responses) are investigated simultaneously. 3. The increase of [CO2] closely corresponds with the scenarios for year 2075, while the warming treatment is at the lower end of the predictions and seems to be the most difficult treatment to increase without unwanted side effects on the other variables. The drought treatment follows predictions of increased frequency of drought periods in summer. The combination of the treatments does not create new unwanted side effects on the treatments relative to the treatments alone. [ABSTRACT FROM AUTHOR]

Background: Limited data exist on the risk factors for acute renal failure (ARF) following cardiac surgery in children with congenital heart disease. This cohort study was conducted to examine this subject, as well as changes in the incidence of ARF from 1993 to 2002, the in-hospital mortality and the time spent in the intensive care unit (ICU). Methods: One thousand, one hundred and twenty-eight children, operated on for congenital heart disease between 1993 and 2002, were identified from our prospectively collected ICU database to obtain data on potential risk factors. Results: A total of 130 children (11.5%) developed ARF after surgery. A young age [≥1.0 vs. <0.1 year; odds ratio (OR), 0.23; 95% confidence interval (CI), 0.12–0.46], high Risk Adjusted Classification of Congenital Heart Surgery (RACHS-1) score (OR, 2.72; 95% CI, 1.66–4.45) and cardiopulmonary bypass (CPB) (<90 min vs. none; OR, 2.68; 95% CI, 1.03–6.96; ≥90 min vs. none; OR, 12.94; 95% CI, 5.46–30.67) were independent risk factors for ARF. The risk of ARF decreased during the study period. Children with ARF spent a significantly longer time in the ICU (2–7 days vs. <2 days, P = 0.002; ≥7 days vs. <2 days, P < 0.001) compared with non-ARF patients, and showed increased in-hospital mortality (20% vs. 5%, P < 0.001). Conclusion: A young age, high RACHS-1 score and CPB were independent risk factors for ARF after surgical procedures for congenital heart disease in children. The risk of ARF decreased during the study period. Children with severe ARF spent a longer time in the ICU, and the mortality in ARF patients was higher than that in non-ARF patients. [ABSTRACT FROM AUTHOR]

Introduction: Vasopressin (AVP) stimulates sodium reabsorption and Na,K,2Cl-cotransporter (NKCC2) protein level in the thick ascending limb (TAL) of Henle's loop in rats. Rats with congestive heart failure (CHF) have increased protein level of NKCC2, which can be normalized by angiotensin II receptor type-1 (AT1) blockade with losartan. Aim: In this study, we investigated whether CHF rats displayed changes in AVP stimulated cAMP formation in the TAL and examined the role of AT1 receptor blockade on this system. Method: CHF was induced by ligation of the left anterior descending coronary artery (LAD). SHAM-operated rats were used as controls. Half of the rats were treated with losartan (10 mg kg day−1 i.p.). Results: CHF rats were characterized by increased left ventricular end diastolic pressure. Measurement of cAMP in isolated outer medullary TAL showed that both basal and AVP (10−6 m) stimulated cAMP levels were significantly increased in CHF rats (25.52 ± 4.49 pmol cAMP μg−1 protein, P < 0.05) compared to Sham rats (8.13 ± 1.14 pmol cAMP μg−1 protein), P < 0.05). Losartan significantly reduced the basal level of cAMP in CHF rats (CHF: 12.56 ± 1.93 fmol μg−1 protein vs. Los-CHF: 7.49 ± 1.08, P < 0.05), but not in Sham rats (SHAM: 4.66 ± 0.59 vs. Los-SHAM: 4.75 ± 0.71). AVP-mediated cAMP accumulation was absent in both groups treated with losartan (Los-SHAM: 4.75 ± 0.71 and Los-CHF: 7.49 ± 1.08). Conclusion: The results indicate that the increased NKCC2 protein level in the mTAL from CHF rats is associated with increased cAMP accumulation in this segment. Furthermore, the finding that AT1 receptor blockade prevents AVP-mediated cAMP accumulation in both SHAM and CHF rats suggests an interaction between angiotensin II and AVP in regulation of mTAL Na reabsorption. [ABSTRACT FROM AUTHOR]

Background Limited data exist on the impact of the introduction of newer selective cyclo-oxygenase-2 inhibitors into clinical practice in 1999 on overall non-steroidal anti-inflammatory drug use and hospitalization rates of complicated peptic ulcer disease at the population level. Aim To examine these issues, we conducted a population-based study in western Denmark, within a population of 1.2 million. Methods All patients with perforated ( n = 1488) or bleeding peptic ulcer ( n = 6017) between 1996 and 2004 were identified in hospital discharge registries. We computed standardized annual hospitalization rates and hospitalization rate ratios using Poisson regression. Data on annual number of prescriptions for non-steroidal anti-inflammatory drugs were obtained through population-based prescription databases. Results Introduction of newer selective cyclo-oxygenase-2 inhibitors was followed by a 44% increase in the annual number of prescriptions for non-steroidal anti-inflammatory drugs – almost entirely due to increased use of newer selective cyclo-oxygenase-2 inhibitors. Annual standardized hospitalization rates for bleeding peptic ulcer remained stable. Standardized hospitalization rates for perforated peptic ulcer decreased from 17 per 100 000 person-years in 1996 to 12 per 100 000 person-years in 2004 (HRR 0.71; 95% CI: 0.57–0.88). Conclusion Introduction of newer selective cyclo-oxygenase-2 inhibitors was followed by substantial increase in overall non-steroidal anti-inflammatory drug use and coincided with stable and decreasing hospitalization rates for bleeding and perforated peptic ulcer, respectively. [ABSTRACT FROM AUTHOR]

Background Few data exist on the impact of non-steroidal anti-inflammatory drug use on peptic ulcer outcome. Aim To examine the 30-day mortality from peptic ulcer bleeding associated with the use of traditional non-steroidal anti-inflammatory drugs and newer selective cyclo-oxygenase-2 inhibitors. Methods Cohort study of patients with a first hospitalization for peptic ulcer bleeding in three Danish counties between 1991 and 2003. Data on pre-admission non-steroidal anti-inflammatory drug use, use of other ulcer-related drugs and comorbidities were obtained from population-based registries. Follow-up data on mortality were obtained from the Danish Civil Registry System. Results Of 7232 patients hospitalized for peptic ulcer bleeding, 28% were current non-steroidal anti-inflammatory drug users. Thirty-day mortality was 11% overall, and 13% among current non-steroidal anti-inflammatory drug users. Compared with never-use, the adjusted 30-day mortality rate ratios were 1.4 (95% CI: 1.1–1.9) for current use of non-steroidal anti-inflammatory drugs alone and 1.3 (95% CI: 1.0–1.7) for current use combined with other ulcer-related drugs. For users of celecoxib, alone and in combination, adjusted mortality rate ratios were 1.4 (95% CI: 0.5–3.9) and 2.0 (95% CI: 1.2–3.5), and for users of rofecoxib, 1.2 (95% CI: 0.4–3.9) and 0.9 (95% CI: 0.5–1.6). Conclusion Among patients hospitalized with peptic ulcer bleeding, use of non-steroidal anti-inflammatory drugs, including some newer cyclo-oxygenase-2 inhibitors, is associated with increased short-term mortality. [ABSTRACT FROM AUTHOR]

Background. Little is known about temporal trends in the incidence and mortality of pneumonia in the general population. Methods. We conducted a population-based cohort study in three Danish counties (population 1.4 million) to examine changes in the incidence and 30- and 90-day mortality associated with hospitalized pneumonia between 1994 and 2004. All adults hospitalized with a first-time diagnosis of pneumonia ( n = 41 793) were identified in hospital discharge registries and followed for mortality through the Danish Civil Registry System. We determined age-standardized incidence rates and adjusted mortality rates associated with calendar year, gender, age and comorbidity. Results. Between 1994 and 2003, the incidence of hospitalized pneumonia amongst adults increased from 288 per 100 000 person-years to 442 per 100 000 person-years, equivalent to an age-standardized incidence rate ratio of 1.50. The cumulative mortality within 30 and 90 days of admission was 15.2% and 21.9%, respectively, ranging from a 90-day mortality of 2.5% in patients aged 15–39 years to 34.7% in those aged 80 and over. Advanced age was the most important poor prognostic factor, followed by a high comorbidity score and male gender. The adjusted mortality rate ratios amongst patients with hospitalized pneumonia in 1999–2004, when compared with 1994–1998, were 0.89 (95% CI 0.85–0.94) after 30 days and 0.91 (95% CI 0.88–0.95) after 90 days. Conclusions. The incidence of hospitalized pneumonia in Denmark has increased considerably during the last 10 years and, combined with persistently high mortality rates, is of clinical and public health concern. [ABSTRACT FROM AUTHOR]

Evaluation of the distribution of stresses and strains in relation to distension-induced sensation in the human oesophagus is valuable for understanding oesophageal biomechanics and mechano-sensation. In 12 healthy volunteers a specially designed oesophageal bag containing an endoscopic ultrasound probe was inflated to the moderate pain level. Ultrasound images, bag pressure and perceived sensation were recorded before and after pharmacological relaxation of the smooth muscle with butylscopolamine. The oesophagus was assumed to be circular and thick-walled. Distension induced a tensile circumferential stretch, radial compression and longitudinal shortening. Both circumferential strain and stress were highest at the mucosal surface and decreased throughout the wall. The stiffness increased throughout the wall and was highest at the outer surface (P < 0.001). The decrease in stiffness in response to butylscopolamine was non-significant. The infused volume (P = 0.012) and circumferential stress (P < 0.001) were most closely associated with the distension-induced sensation (adjusted R2 = 0.88). The perceived sensation was highly individual but was unaffected by butylscopolamine (P > 0.08). The present study provides a method for computation of the stress–strain distribution throughout the wall and the mechano-sensory interaction in the human oesophagus. In the future, this may be useful for understanding of mechanoreceptor responses and generation of symptoms in visceral organs in health and in disease. [ABSTRACT FROM AUTHOR]

Background Despite evidence that use of glucocorticoids increases the risk of complicated peptic ulcer disease, limited data exist on how use of oral glucocorticoids affects outcome for patients with peptic ulcer perforation. Aim To examine 30-day mortality from peptic ulcer perforation among pre-admission oral glucocorticoid users compared with non-users. Methods We identified 2061 patients with a first-time hospital discharge diagnosis of perforated peptic ulcer, using population-based discharge registries in three Danish counties. Data on use of glucocorticoids and other ulcer-related drugs, previous hospitalizations for uncomplicated peptic ulcer disease, and comorbidity were obtained from discharge registries and prescription databases. Follow-up data on mortality were provided by the Danish Civil Registry System. Results A total of 228 patients (11.1%) were exposed to glucocorticoids within 60 days of admission. Overall 30-day mortality rate was 25.2%, the corresponding rate among current glucocorticoid users was 39.4%. Compared with ‘never users’, the adjusted mortality ratio among current users of oral glucocorticoids alone was 2.1 (95% CI: 1.5–3.1). Among current users of oral glucocorticoids in combination with other ulcer-related drugs the mortality ratio was 1.5 (95% CI: 1.1–2.1). Conclusion Pre-admission use of oral glucocorticoids is associated with up to a twofold increase in 30-day mortality among patients hospitalized with perforated peptic ulcer. [ABSTRACT FROM AUTHOR]

Studies the real-time weed detection, decision making and patch spraying in maize, sugar beet, winter wheat and winter barley. Use of digital image analysis, computer-based decision making and global positioning systems; Measurement of the frequency of herbicide resistant and the demands for lower herbicide residues in food, water and soil.

Summary It has been established that weeds are spatially aggregated with a spatially varying composition of weed species within agricultural fields. Site-specific spraying therefore requires a decision method that includes the spatial variation of the weed composition and density. A computerized decision method that estimates an economic optimal herbicide dose according to site-specific weed composition and density is presented in this paper. The method was termed a ‘decision algorithm for patch spraying’ (DAPS) and was evaluated in a 5-year experiment, in Denmark. DAPS consists of a competition model, a herbicide dose–response model and an algorithm that estimates the economically optimal doses. The experiment was designed to compare herbicide treatments with DAPS recommendations and the Danish decision support system PC-Plant Protection. The results did not show any significant grain yield difference between DAPS and PC-Plant Protection; however, the recommended herbicide doses were significantly lower when using DAPS than PC-Plant Protection in all years. The main difference between the two decision models is that DAPS integrates crop–weed competition and estimates the net return as a continuous function of herbicide dose. The hypothesis tested is that the benefit of using lower herbicide doses recommended by DAPS would disappear after a few years because weed density will increase and thus require higher doses. However, the results of weed counting every year did not confirm this hypothesis. [ABSTRACT FROM AUTHOR]

A sugarbeet field experiment was conducted in 1999 and 2000 to measure beet yield where Sinapis arvensis or Lolium perenne were growing in the crop row at 2, 4 or 8 cm from the beet plants. The weeds were removed by cutting once in the growing season in either late May, mid-June or early July. The number of neighbouring beet plants to every target beet plant was recorded. Projected leaf cover of a subset of the data with non-cut weeds was analysed by using image analysis to investigate whether this could be used to predict beet yield loss early in the growing season. Increasing the distance between beet and weed from 2 to 8 cm increased the beet yield significantly by an average of 20%, regardless of weed species. The dry weight of non-cut and re-growing weeds at harvest time decreased when cutting was postponed to the period between mid-June and early July. The number of neighbours described a sigmoidal yield decline of the single beet plants. Results from image analysis showed that approximately 33 g of beet yield was lost in October/November for each per cent relative projected leaf cover of the weeds in May, despite variation in growing conditions. The results are discussed in relation to potentials for robotic in-row weed control. [ABSTRACT FROM AUTHOR]

Summary Stem thickness of the weed Solanum nigrum and the crop sugarbeet was determined with a He–Ne laser using a novel non-destructive technique measuring stem shadow. Thereafter, the stems were cut close to the soil surface with a CO2 laser. Treatments were carried out on pot plants, grown in the greenhouse, at two different growth stages, and plant dry matter was measured 2–5 weeks after treatment. The relationship between plant dry weight and laser energy was analysed using two different non-linear dose–response regression models; one model included stem thickness as a variable, the other did not. A binary model was also tested. The non-linear model incorporating stem thickness described the data best, indicating that it would be possible to optimize laser cutting by measuring stem thickness before cutting. The general tendency was that more energy was needed the thicker the stem. Energy uses on a field scale are discussed. [ABSTRACT FROM AUTHOR]

The spatial cross-correlation between weed species densities and six soil properties within fields was analysed using cross-semivariograms. The survey was carried out in three successive years in two fields. The most consistent relationship between weed species density (numbers m-2 ) and soil properties was negative cross-correlation between the density of Viola arvensis Murray and clay content. This correlation was found in both fields; however, the range of spatial dependence varied between fields. In one of the fields, the density of Lamium purpureum L. was positively cross-correlated with the phosphorus content in the soil in all years. The density of Veronica spp. and Poa annua L. was negatively cross-correlated with pH in all three years. Other spatial cross-correlations that were found in this study were inconsistent over time or field site. The densities of some of the weed species were spatially cross-correlated with more than one soil property. The results showed that the range of spatial dependence varied not only between fields, but also between weed species and soil properties, as well as between years. This study indicates that the weed pattern is field-specific and that the spatial variation in soil properties within a field is one of several factors affecting weed patchiness. [ABSTRACT FROM AUTHOR]

Investigates whether cutting of Chenopodium album, Sinapis arvensis, and Lolium perenne with a carbon dioxide laser could be a potential method of weed control. Relationship between dry weight and laser energy; Cutting height; Laser and scissors cutting conditions.