Trauma Associated Cardiac Injury & Dysfunction

PhDThe existence of a trauma induced secondary cardiac injury (TISCI) remains in doubt. The risk factors and pathological processes that lead to its development are not known, whilst the effects of TISCI on injured patient outcome are uncertain. Concurrently, the incidence of coronary heart disease (CHD) in a trauma population and its influence on mortality are inconclusive. The aim of this research project was to address these specific areas of uncertainty. Critically injured patients (n=135) were retrospectively investigated for the incidence and nature of adverse cardiac events (ACEs), and levels of the cardiac specific biomarkers Troponin I, B-type Natriuretic Peptide and Heart-type Fatty Acid Binding Protein were measured. Biomarkers and cardiac events were evaluated against outcome. Thereafter, the relationship of pro-inflammatory cytokines with TISCI was explored. A prospective cohort study of 199 trauma patients followed, to confirm the existence of TISCI and describe its clinical features, risk factors and outcomes. Finally, coronary artery calcium, as a marker of CHD, was evaluated on 432 CT scans of the chest of trauma patients aged 45 years or over, and its association with survival after injury was established. ACEs and early biomarker rises occurred in trauma patients and both were unrelated to the severity of chest injury. Each was associated with higher mortality, and confirmed the existence of TISCI. Risk factors for the development of the condition included increasing age, worsening tissue injury and shock. A relationship with cytokines was demonstrated, and implicated acute inflammation in the pathogenesis of TISCI. Calcification on CT scans revealed the incidence of CHD in an injured cohort approached 70%, although its presence did not impact survival. There exists a trauma induced secondary cardiac injury which was related to poorer outcome. The condition was associated with inflammation. CHD was widespread in older trauma patients but was not associated with increased in-hospital mortality

The history and evolution of HLA typing external proficiency testing schemes in UK NEQAS for H&I

The UK National External Quality Assessment Service (NEQAS) provide an external proficiency testing (EPT) service for clinical laboratories. UK NEQAS for Histocompatibility and Immunogenetics (H&I) has been providing EPT schemes for over 45 years and has grown during this time to provide 19 EPT schemes. Accurate human leucocyte antigen (HLA) typing is critical to support safe clinical services, including transplantation, therefore high quality, relevant EPT schemes are required as part of a laboratory’s quality assurance. This article reviews the development of the HLA typing EPT schemes, from the first HLA phenotyping scheme in 1975, via the first HLA genotyping scheme in 1992, through to the introduction in 2017 of HLA third field assessment results from next-generation sequencing technology. In addition, the introduction of EPT schemes to cover HLA associated diseases and pharmacogenetic reactions, including HLA-B27, HLA*B*57:01 and HLA-DQ for coeliac disease are discussed. The accuracy of laboratory EPT results for HLA phenotyping are >96% (2018–2022), HLA genotyping >99% (2020–2022), HLA-B27 testing >99% (2018–2022) and B*57:01 testing >99% (2017–2022). However, for HLA genotyping for coeliac disease 22%–46% of laboratories made errors in 2020–2022. On investigation, the high rate of unsatisfactory performance was attributed to laboratories lacking specific knowledge to interpret HLA genotyping results and accurately report HLA types for coeliac disease. A misleading commercial kit insert was also identified. The assessment of scheme results has uncovered several issues which have been addressed with the intention of educating participants and improving clinical services. The UK NEQAS for H&I EPT schemes have evolved over the past four decades to reflect changes in HLA typing technology, laboratory clinical practice and to cover post-analytical interpretative elements of HLA typing

Seamounts as refugia from ocean acidification for cold-water stony corals

Cold-water stony corals create habitat for a diverse range of deep-water species but are thought to be threatened by ocean acidification due to oceanic uptake of anthropogenic CO2. Knowledge of the severity of this threat is hampered by our limited understanding of the distribution and habitat requirements of these corals. Here we estimate the global acidification threat to these organisms using a global database of cold-water stony coral records and a species distribution modelling approach. We parameterised the models using present-day environmental data, and then replaced these data with future projections of ocean chemistry from the year 2099. We found suitable coral habitat to be very heterogeneously distributed, being concentrated in the northern North Atlantic and around New Zealand. Projected changes in ocean chemistry induced a pronounced reduction in habitat suitability in the North Atlantic, and a low-to-moderate impact elsewhere under both the IPCC IS92a and S650 scenarios. Seamount summits are impacted by these changes, but consistently provide more suitable habitat than the surrounding seafloor, with around 98% of seamount summits having higher suitability in both future scenarios; this is because they lie in shallower waters with a higher aragonite saturation state. These results suggest that anthropogenic-induced changes in ocean chemistry are likely to severely impact cold-water stony coral habitat in the deep-sea of the North Atlantic, and that impacts will be less severe elsewhere. We predict that coral communities on the summits and upper slopes of seamounts will be less susceptible to ocean acidification during this century than those on the surrounding seafloor, and thus that seamounts may serve as temporary refugia. © 2010 Blackwell Verlag GmbH

Supplemental Information 1: Supplemental Materials

Here we describe an efficient and effective technique for rearing sexually-derived coral propagules from spawning through larval settlement and symbiont uptake with minimal impact on natural coral populations. We sought to maximize larval survival while minimizing expense and daily husbandry maintenance by experimentally determining optimized conditions and protocols for gamete fertilization, larval cultivation, induction of larval settlement by crustose coralline algae, and inoculation of newly settled juveniles with their dinoflagellate symbiont Symbiodinium. Larval rearing densities at or below 0.2 larvae mL−1 were found to maximize larval survival and settlement success in culture tanks while minimizing maintenance effort. Induction of larval settlement via the addition of a ground mixture of diverse crustose coralline algae (CCA) is recommended, given the challenging nature of in situ CCA identification and our finding that non settlement-inducing CCA assemblages do not inhibit larval settlement if suitable assemblages are present. Although order of magnitude differences in infectivity were found between common Great Barrier Reef Symbiodinium clades C and D, no significant differences in Symbiodinium uptake were observed between laboratory-cultured and wild-harvested symbionts in each case. The technique presented here for Acropora millepora can be adapted for research and restoration efforts in a wide range of broadcast spawning coral species

Protected-Area Boundaries as Filters of Plant Invasions

Límites de Áreas Protegidas como Filtros para la Invasión de Planta

Figure 4: Data-integrated estimated CoTS outbreak densities in the Cairns sector of the Great Barrier Reef, 2014.

Crown-of-thorns starfish (CoTS; Acanthaster spp.) are an outbreaking pest among many Indo-Pacific coral reefs that cause substantial ecological and economic damage. Despite ongoing CoTS research, there remain critical gaps in observing CoTS populations and accurately estimating their numbers, greatly limiting understanding of the causes and sources of CoTS outbreaks. Here we address two of these gaps by (1) estimating the detectability of adult CoTS on typical underwater visual count (UVC) surveys using covariates and (2) inter-calibrating multiple data sources to estimate CoTS densities within the Cairns sector of the Great Barrier Reef (GBR). We find that, on average, CoTS detectability is high at 0.82 [0.77, 0.87] (median highest posterior density (HPD) and [95% uncertainty intervals]), with CoTS disc width having the greatest influence on detection. Integrating this information with coincident surveys from alternative sampling programs, we estimate CoTS densities in the Cairns sector of the GBR averaged 44 [41, 48] adults per hectare in 2014

Soft-bottom fishes and spatial protection: findings from a temperate marine protected area

Numerous studies over the last decades have focused on marine protected areas (MPAs) and their effects on fish communities. However, there is a knowledge gap regarding how species that live associated with soft-substrates (e.g., sand, mud) respond to spatial protection. We analyzed abundance, biomass and total lengths of the soft-bottom fishes in a multiple-use MPA in the north-eastern Atlantic, the Luiz Saldanha Marine Park (Portugal), during and after the implementation of its management plan. Data were collected by experimental fishing in areas with three different levels of protection, during the implementation period and for three years after full implementation of the MPA. Univariate analysis detected significant biomass increases between the two periods. Fish assemblages were mainly structured by depth and substrate, followed by protection level. Community composition analyses revealed significant differences between protection levels and between the two periods. Species exhibited a broad variation in their response to protection, and we hypothesize that factors such as species habitat preferences, body size and late maturity might be underlying determinants. Overall, this study provides some evidence of protection effectiveness in soft-bottom fish communities, supported by the significant increase in biomass in the protected areas and the positive trends of some species.project LIFE-BIOMARES [LIFE06 NAT/P/000192]; project BUFFER (ERA-Net BiodivERsA); company SECIL-Companhia Geral de Cal e Cimento S.A.; FCT-Foundation for Science and Technology [CCMAR/Multi/04326/2013, SFRH/BD/80771/2011]; Foundation for Science and Technology [SFRH/BD/80771/2011]; 2012 Sesimbra Scientific Priz