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Prospective observational study of point-of-care creatinine in trauma.
Background:Patients with trauma are at risk for renal dysfunction from hypovolemia or urological injury. In austere environments, creatinine values are not available to guide resuscitation. A new portable device, the Stat Sensor Point-of-care (POC) Whole Blood Creatinine Analyzer, provides accurate results in <30 s and requires minimal training. This device has not been evaluated in trauma despite the theoretical benefit it provides. The purpose of this study is to determine the clinical impact of the POC device in trauma. Methods:40 patients with trauma were enrolled in a prospective observational study. One drop of blood was used for creatinine determination on the Statsensor POC device. POC creatinine results were compared to the laboratory. Turnaround time (TAT) for POC and laboratory methods was calculated as well as time elapsed to CT scan if applicable. Results:Patients (n=40) were enrolled between December 2014 and March 2015. POC creatinine values were similar to laboratory methods with a mean bias of 0.075±0.27 (p=0.08). Mean analytical TATs for the POC measurements were significantly faster than the laboratory method (11.6±10.0 min vs 78.1±27.9 min, n=40, p<0.0001). Mean elapsed time before arrival at the CT scanner was 52.9±34.2 min. Conclusions:The POC device reported similar creatinine values to the laboratory and provided significantly faster results. POC creatinine testing is a promising development for trauma practice in austere environments and workup of a subset of stable patients with trauma. Further study is warranted to determine clinical impact, both in hospital-based trauma and austere environments
Explorations, Vol. 5, No. 2
Articles include:
Cover: Brian McLain of New Harbor, measuring a V-notched lobster; slide taken by Robert C. Bayer, University of Maine Professor of Animal and Veterinary Sciences.
April is Aquaculture Month Guest Editorial, by Kathleen Lignell
Hospital Project Teams: Gaining Cooperation, by Mary Beth Pinto
The Maine Lobster Institute: Science and Industry Working Together, by Susan White
The Theory of Common Property Resources: Scientific Law or Myth? by James M. Acheson
What do Seedless Watermelons and Triploid Oysters have in Common? by Mary Lee
Technology and the Competitive Edge, by John Field and Eric Beenfeldt
Growing our State Tree Faster: Fertilizing White Pine, by Robert Shepard and M.W. Blumenstoc
Pine sawdust biochar as a potential amendment for establishing trees in Appalachian mine spoils
Early growth and survival of tree seedlings is often poor on reclaimed coal surface mines in Appalachia. Biochar produced in bioenergy generation has potential for use as an amendment to improve seedling performance. Mine soil was collected from a recently reclaimed coal surface mine in Wise County, Virginia and mixed with loblolly pine (Pinus taeda L.) sawdust biochar, simulating application rates of 2.3, 11.2 and 22.5 Mg ha-1. Unplanted leaching columns and 4 L tree planting pots were filled with these biochar-soil mixtures, plus controls of pure mine soil and pure biochar. For the tree planting pots, additional pots were created where the biochar was applied as a topdressing at the same application rates as in the mixtures. One-year-old seedlings of both American sycamore (Platanus occidentalis L.) and black locust (Robinia pseudoacacia L.) were planted. Unplanted leaching columns were leached with collected rainwater for six months to simulate weathering. Trees were grown for one growing season. Black locust had higher average above-ground dry woody biomass (24.4 g) than American sycamore (17.0 g), and also higher below-ground biomass (61.0 g compared to 30.2 g). The pure biochar produced greater average below-ground biomass (99.9 g) than the pure mine soil (46.9 g). All of the biochar treatments produced greater average above-ground woody biomass (19.1 g – 33.4 g) than the pure mine soil (10.9 g). After weathering, biochar provided less available soil phosphorus, calcium and iron than the mine soil itself while increasing soil carbon and organic matter. High (22.5 Mg ha-1) biochar applications increased soil volumetric water holding capacity to 18.6% compared to 13.4% for pure mine soil. Naturally-occurring herbaceous biomass in the pots was negatively correlated with above-ground woody biomass at r = -0.483. Topdressing and full incorporation of biochar were not significantly different in their effects on biomass. Results suggest that pine biochar either broadcast at 2.3 - 22.5 Mg ha‑1, or mixed in planting holes with backfill soil, will promote faster above-ground growth and larger root systems in seedlings in mine soils. Further studies should test these methods in the field over multiple years and further refine recommendations of the rate of biochar to use and how best to apply it. New systems are being developed in Appalachia to produce biofuels and biochar from local biomass and to recycle biochar into the land base to enhance future biomass productivity. Applying 4 L of biochar mixed with the backfill of newly-planted trees is the top recommended practice for tree performance
Simultaneous Quantification of Active Carbon- and Nitrogen-Fixing Communities and Estimation of Fixation Rates Using Fluorescence In Situ Hybridization and Flow Cytometry
Understanding the interconnectivity of oceanic carbon and nitrogen cycles, specifically carbon and nitrogen fixation, is essential
in elucidating the fate and distribution of carbon in the ocean. Traditional techniques measure either organism abundance or
biochemical rates. As such, measurements are performed on separate samples and on different time scales. Here, we developed a
method to simultaneously quantify organisms while estimating rates of fixation across time and space for both carbon and nitrogen.
Tyramide signal amplification fluorescence in situ hybridization (TSA-FISH) of mRNA for functionally specific oligonucleotide
probes for rbcL (ribulose-1,5-bisphosphate carboxylase/oxygenase; carbon fixation) and nifH (nitrogenase; nitrogen fixation)
was combined with flow cytometry to measure abundance and estimate activity. Cultured samples representing a diversity
of phytoplankton (cyanobacteria, coccolithophores, chlorophytes, diatoms, and dinoflagellates), as well as environmental samples
from the open ocean (Gulf of Mexico, USA, and southeastern Indian Ocean, Australia) and an estuary (Galveston Bay,
Texas, USA), were successfully hybridized. Strong correlations between positively tagged community abundance and 14C/15N
measurements are presented. We propose that these methods can be used to estimate carbon and nitrogen fixation in environmental
communities. The utilization of mRNA TSA-FISH to detect multiple active microbial functions within the same sample
will offer increased understanding of important biogeochemical cycles in the ocean
HydF as a scaffold protein in [FeFe] hydrogenase H-cluster biosynthesis
AbstractIn an effort to determine the specific protein component(s) responsible for in vitro activation of the [FeFe] hydrogenase (HydA), the individual maturation proteins HydE, HydF, and HydG from Clostridium acetobutylicum were purified from heterologous expressions in Escherichia coli. Our results demonstrate that HydF isolated from a strain expressing all three maturation proteins is sufficient to confer hydrogenase activity to purified inactive heterologously expressed HydA (expressed in the absence of HydE, HydF, and HydG). These results represent the first in vitro maturation of [FeFe] hydrogenase with purified proteins, and suggest that HydF functions as a scaffold upon which an H-cluster intermediate is synthesized
Case 27-2011: A 17-Year-Old Boy with Abdominal Pain and Weight Loss
Pr e sen tat ion of C a se Dr. Nina Mayer (Medicine-Pediatrics): A 17-year-old boy was seen in the pediatric gastroenterology clinic of this hospital because of abdominal pain and weight loss. The patient had been well until approximately 6 weeks earlier, when intermittent crampy abdominal pain developed. Approximately 3 weeks later, nonbloody diarrhea developed and lasted for a week, associated with one episode of emesis. Thereafter, abdominal pain occurred daily, was predominantly located in the right lower quadrant, radiated to the right flank, and was associated with lower back discomfort, borborygmi, and constipation. During the fourth week of illness, after the diarrhea had resolved, the patient saw his primary care physician. Serum levels of glucose, alanine aminotransferase, and thyrotropin were normal, as were tests of renal function. Tests for tissue transglutaminase IgA antibodies, hepatitis A virus, hepatitis C virus, and the human immunodeficiency virus (HIV) were negative. Results of tests for serum antibodies to Epstein-Barr virus (EBV) were consistent with past infection; testing was positive for hepatitis B virus surface antibody and negative for hepatitis B surface antigen, indicating immunity or past infection. Other results are shown in Two weeks later, the patient was seen in the pediatric gastroenterology clinic at this hospital. He rated the abdominal pain at 5 on a scale of 0 to 10, with 10 indicating the most severe pain. He reported one bowel movement of hard stool daily, and one episode of blood streaking on the stool after straining, with no mucus. He reported that he had lost 18.2 kg during the previous 2 years. The first 11 to 12 kg was intentional; however, during the 6 weeks before this evaluation, additional weight loss had occurred unintentionally. The body-mass index (the weight in kilograms divided by the square of the height in meters) had reportedly decreased from 27.0 (>95th percentile for his age) to 20.5 (25th to 50th percentile). He reported night sweats with chills but no fever. The patient had visited relatives in Haiti approximately 4 years earlier for 1 week; he reported no exposure to persons with respiratory or gastrointestinal symptoms while there or recently. Skin tests for tuberculosis were reportedly negative befor
The Global Burden of Disease Study 2010: Interpretation and Implications for the Neglected Tropical Diseases
The generality of the GUGA MRCI approach in COLUMBUS for treating complex quantum chemistry
The core part of the program system COLUMBUS allows highly efficient calculations using variational multireference (MR) methods in the framework of configuration interaction with single and double excitations (MR-CISD) and averaged quadratic coupled-cluster calculations (MR-AQCC), based on uncontracted sets of configurations and the graphical unitary group approach (GUGA). The availability of analytic MR-CISD and MR-AQCC energy gradients and analytic nonadiabatic couplings for MR-CISD enables exciting applications including, e.g., investigations of π-conjugated biradicaloid compounds, calculations of multitudes of excited states, development of diabatization procedures, and furnishing the electronic structure information for on-the-fly surface nonadiabatic dynamics. With fully variational uncontracted spin-orbit MRCI, COLUMBUS provides a unique possibility of performing high-level calculations on compounds containing heavy atoms up to lanthanides and actinides. Crucial for carrying out all of these calculations effectively is the availability of an efficient parallel code for the CI step. Configuration spaces of several billion in size now can be treated quite routinely on standard parallel computer clusters. Emerging developments in COLUMBUS, including the all configuration mean energy multiconfiguration self-consistent field method and the graphically contracted function method, promise to allow practically unlimited configuration space dimensions. Spin density based on the GUGA approach, analytic spin-orbit energy gradients, possibilities for local electron correlation MR calculations, development of general interfaces for nonadiabatic dynamics, and MRCI linear vibronic coupling models conclude this overview
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