Technology for trauma: testing the validity of a smartphone app for pre-hospital clinicians

Introduction: with the introduction of regional trauma networks in England, ambulance clinicians have been required to make triage decisions relating to severity of injury, and appropriate destination for the patient, which may require ‘bypassing’ the nearest Emergency Department. A ‘Trauma Unit Bypass Tool’ is utilised in this process. The Major Trauma Triage tool smartphone application (App) is a digital representation of a tool, available for clinicians to use on their smartphone. Prior to disseminating the application, validity and performance against the existing paper-based tool was explored.Methods: a case-based study using clinical scenarios was conducted. Scenarios, with appropriate triage decisions, were agreed by an expert panel. Ambulance clinicians were assigned to either the paper-based tool or smartphone app group and asked to make a triage decision using the available information. The positive predictive value (PPV) of each tool was calculated.Results: the PPV of the paper tool was 0.76 and 0.86 for the smartphone app. User comments were mainly positive for both tools with no negative comments relating to the smartphone app.Conclusion: the smartphone app version of the Trauma Unit Bypass Tool performs at least as well as the paper version and can be utilised safely by pre-hospital clinicians in supporting triage decisions relating to potential major traum

Effect of dietary carbohydrate-to-lipid ratios on growth and feed utilization in Chinese longsnout catfish (Leiocassis longirostris Gunther)

An 8-week growth trial was carried out in a semi-recirculation system at 26 +/- 0.5 degrees C to investigate the optimal dietary carbohydrate-to-lipid (CHO:L) ratio for carnivorous Chinese longsnout catfish (Leiocassis longirostris Gunther). Triplicate tanks of fish were assigned to each of five isocaloric and isonitrogenous diets with different carbohydrate-to-lipid ratios (0.75, 1.48, 1.98, 2.99 and 5.07). The results showed that a higher specific growth rate (SGR) and feed rate (FR) were observed in the fish fed diet ratios of 1.98 CHO:L (P 0.05). High dietary CHO:L ratio caused pathological changes in fish morphology and liver histology. Based on maximum growth, the optimal carbohydrate-to-lipid ratio was 1.98 for Chinese longsnout catfish.An 8-week growth trial was carried out in a semi-recirculation system at 26 +/- 0.5 degrees C to investigate the optimal dietary carbohydrate-to-lipid (CHO:L) ratio for carnivorous Chinese longsnout catfish (Leiocassis longirostris Gunther). Triplicate tanks of fish were assigned to each of five isocaloric and isonitrogenous diets with different carbohydrate-to-lipid ratios (0.75, 1.48, 1.98, 2.99 and 5.07). The results showed that a higher specific growth rate (SGR) and feed rate (FR) were observed in the fish fed diet ratios of 1.98 CHO:L (P 0.05). High dietary CHO:L ratio caused pathological changes in fish morphology and liver histology. Based on maximum growth, the optimal carbohydrate-to-lipid ratio was 1.98 for Chinese longsnout catfish

Biology and ecology of the invasive lionfishes, Pterois miles and Pterois volitans

The Indo-Pacific lionfishes, Pterois miles and P. volitans, are now established along the U.S. southeast coast, Bermuda, Bahamas, and are becoming established in the Caribbean. While these lionfish are popular in the aquarium trade, their biology and ecology are poorly understood in their native range. Given the rapid establishment and potential adverse impacts of these invaders, comprehensive studies of their biology and ecology are warranted. Here we provide a synopsis of lionfish biology and ecology including invasion chronology, taxonomy, local abundance, reproduction, early life history and dispersal, venomology, feeding ecology, parasitology, potential impacts, and control and management. This information was collected through review of the primary literature and published reports and by summarizing current observations. Suggestions for future research on invasive lionfish in their invaded regions are provided

Physiological and biochemical responses of Scytonema javanicum (cyanobacterium) to salt stress

Scytonema javanicum (Kutz.) Born et Flah (cyanobacterium) is one of the species distributed widely in the crust of desert soils regularly subjected to severe water stress. To investigate the response of the species to salt stress, many physiological and biochemical parameters, including growth rate, ratio of variable fluorescence to maximum fluorescence (Fv/Fm), reactive oxidative species (ROS), malondialdehyde (MDA), catalase (CAT), and superoxide dismutase (SOD), were determined in culture. The results showed that 50 mM NaCl inhibited growth and Fv/Fm in the medium BG-110, and that the inhibition was maximum after 1-2 days' exposure to salt stress; 50 mM NaCl also increased the contents of ROS and MDA in treated cells, which suggests that salt stress may lead to oxidative damage and lipid peroxidation in the alga. Further, changes in the antioxidative enzymes SOD and CAT in the treated alga were consistent with changes in ROS and MDA at certain extent. These observations suggest that oxidative stress resulting from salt stress in S. javanicum could result in the production of antioxidative enzymes to counteract the oxidative damage, and the enzymes may contribute to the ability of S. javanicum to survive the adverse desert environment. (c) 2007 Elsevier Ltd. All rights reserved.Scytonema javanicum (Kutz.) Born et Flah (cyanobacterium) is one of the species distributed widely in the crust of desert soils regularly subjected to severe water stress. To investigate the response of the species to salt stress, many physiological and biochemical parameters, including growth rate, ratio of variable fluorescence to maximum fluorescence (Fv/Fm), reactive oxidative species (ROS), malondialdehyde (MDA), catalase (CAT), and superoxide dismutase (SOD), were determined in culture. The results showed that 50 mM NaCl inhibited growth and Fv/Fm in the medium BG-110, and that the inhibition was maximum after 1-2 days' exposure to salt stress; 50 mM NaCl also increased the contents of ROS and MDA in treated cells, which suggests that salt stress may lead to oxidative damage and lipid peroxidation in the alga. Further, changes in the antioxidative enzymes SOD and CAT in the treated alga were consistent with changes in ROS and MDA at certain extent. These observations suggest that oxidative stress resulting from salt stress in S. javanicum could result in the production of antioxidative enzymes to counteract the oxidative damage, and the enzymes may contribute to the ability of S. javanicum to survive the adverse desert environment. (c) 2007 Elsevier Ltd. All rights reserved

Tissue distributions and seasonal dynamics of the hepatotoxic microcystins-LR and -RR in two freshwater shrimps, Palaemon modestus and Macrobrachium nipponensis, from a large shallow, eutrophic lake of the subtropical China

So far no information is available on microcystin (MC) contents in shrimps, prawns or crayfish from natural freshwaters. Tissue distributions and seasonal dynamics of the hepatotoxic MC-LR and -RR in two freshwater shrimps, Palaemon modestus and Macrobrachium nipponensis were studied monthly (during June-November, 2003) in a Chinese lake containing toxic cyanobacterial blooms. The shrimps P. modestus and M. nipponensis accumulated high MCs not only in the hepatopancreas (mean 4.29 and 0.53 mu g g(-1) DW, respectively) but also in the gonad (mean 1.17 and 0.48 mu g g-1 DW, respectively), and the crayfish Procambarus clarkii accumulated as much as 0.93 mu g g(-1) DW in the gonad. This indicates that gonads of these invertebrates are the second important target organ of MCs. P. modestus apparently accumulated more MCs in their organs than M. nipponensis, which might be a reflection of their difference in trophic niche. Eggs of the shrimps accumulated 8.4% (M. nipponensis, 0.27 mu g g(-1) DW) and 29.0% (P. modestus, 2.34 mu g g(-1) DW) of total toxin burden, indicating that MCs had been transferred into offspring from their adults. Among the shrimp muscle samples analyzed, 31% were above the provisional WHO TDI level, suggesting the risk of consuming shrimps in Lake Chaohu. (c) 2005 Elsevier Ltd. All rights reserved.So far no information is available on microcystin (MC) contents in shrimps, prawns or crayfish from natural freshwaters. Tissue distributions and seasonal dynamics of the hepatotoxic MC-LR and -RR in two freshwater shrimps, Palaemon modestus and Macrobrachium nipponensis were studied monthly (during June-November, 2003) in a Chinese lake containing toxic cyanobacterial blooms. The shrimps P. modestus and M. nipponensis accumulated high MCs not only in the hepatopancreas (mean 4.29 and 0.53 mu g g(-1) DW, respectively) but also in the gonad (mean 1.17 and 0.48 mu g g-1 DW, respectively), and the crayfish Procambarus clarkii accumulated as much as 0.93 mu g g(-1) DW in the gonad. This indicates that gonads of these invertebrates are the second important target organ of MCs. P. modestus apparently accumulated more MCs in their organs than M. nipponensis, which might be a reflection of their difference in trophic niche. Eggs of the shrimps accumulated 8.4% (M. nipponensis, 0.27 mu g g(-1) DW) and 29.0% (P. modestus, 2.34 mu g g(-1) DW) of total toxin burden, indicating that MCs had been transferred into offspring from their adults. Among the shrimp muscle samples analyzed, 31% were above the provisional WHO TDI level, suggesting the risk of consuming shrimps in Lake Chaohu. (c) 2005 Elsevier Ltd. All rights reserved

Impacts of cascade run-of-river dams on benthic diatoms in the Xiangxi River, China

The ecological effects of small run-of-river dams on aquatic ecosystems are poorly understood, especially on downstream benthic algal communities. We examined impacts of such dams on the benthic diatom community at a regional scale in the Xiangxi River, China. A total of 90 sites were visited, which were divided into five habitats (H1-H5) according to impact extent of each dam. Using partial least squares (PLS) modeling, we developed two predictive models (diatom species richness and total diatom density) based on environmental variables of an unregulated habitat (H1). These models were then used to predict species richness and total densities at impacted habitats (H2-H5) and residuals, i.e. the differences between observed and predicted values, were used to evaluate impact strength of flow regulation. Significant impacts of flow regulation on diatom species richness were detected at three impacted habitats (H3-H5), where observed species richness were significantly higher-70.6, 63.9 and 46.6%, respectively-than predicted values. Then, possible mechanisms for observed impacts were discussed. Further research is necessary to address the potential negative impacts of cascade run-of-river dams on other aquatic organisms in different seasons, and to explore more appropriate mechanisms for such impacts, which may lead to sustainable management strategies and help to determine the optimal ecological water requirement for the Xiangxi River

Simultaneous determination of microcystin-LR and its glutathione conjugate in fish tissues by liquid chromatography-tandem mass spectrometry

A sensitive and selective liquid chromatography-tandem mass spectrometry method was developed and validated for the simultaneous quantitative determination of microcystin-LR (MC-LR) and its glutathione conjugate (MC-LR-GSH) in fish tissues. The analytes were extracted from fish liver and kidney using 0.01 M EDTA-Na-2-5% acetic acid, followed by a solid-phase extraction (SPE) on Oasis HLB and silica cartridges. High-performance liquid chromatography (HPLC) with electrospray ionization mass spectrometry, operating in selected reaction monitoring (SRM) mode, was used to quantify MC-LR and its glutathione conjugate in fish liver and kidney. Recoveries of analytes were assessed at three concentrations (0.2, 1.0, and 5 mu g g(-1) dry weight [DW]) and ranged from 91 to 103% for MC-LR, and from 65.0 to 75.7% for MC-LR-GSH. The assay was linear within the range from 0.02 to 5.0 mu g g(-1) DW, with a limit of quantification (LOQ) of 0.02 mu g g(-1) DW. The limit of detection (LOD) of the method was 0.007 mu g g(-1) DW in both fish liver and kidney. The overall precision was determined on three different days. The values for within- and between-day precision in liver and kidney were within 15%. This method was applied to the identification and quantification of MC-LR and its glutathione conjugate in liver and kidney of fish with acute exposure of MC-LR. (c) 2007 Elsevier B.V. All rights reserved.A sensitive and selective liquid chromatography-tandem mass spectrometry method was developed and validated for the simultaneous quantitative determination of microcystin-LR (MC-LR) and its glutathione conjugate (MC-LR-GSH) in fish tissues. The analytes were extracted from fish liver and kidney using 0.01 M EDTA-Na-2-5% acetic acid, followed by a solid-phase extraction (SPE) on Oasis HLB and silica cartridges. High-performance liquid chromatography (HPLC) with electrospray ionization mass spectrometry, operating in selected reaction monitoring (SRM) mode, was used to quantify MC-LR and its glutathione conjugate in fish liver and kidney. Recoveries of analytes were assessed at three concentrations (0.2, 1.0, and 5 mu g g(-1) dry weight [DW]) and ranged from 91 to 103% for MC-LR, and from 65.0 to 75.7% for MC-LR-GSH. The assay was linear within the range from 0.02 to 5.0 mu g g(-1) DW, with a limit of quantification (LOQ) of 0.02 mu g g(-1) DW. The limit of detection (LOD) of the method was 0.007 mu g g(-1) DW in both fish liver and kidney. The overall precision was determined on three different days. The values for within- and between-day precision in liver and kidney were within 15%. This method was applied to the identification and quantification of MC-LR and its glutathione conjugate in liver and kidney of fish with acute exposure of MC-LR. (c) 2007 Elsevier B.V. All rights reserved

An automated online field instrument to quantify the oxidative potential of aerosol particles via ascorbic acid oxidation

Large-scale epidemiological studies have consistently shown that exposure to ambient particulate matter (PM) is responsible for a variety of adverse health effects. However, the specific physical and chemical properties of particles that are responsible for the observed health effects, as well as the underlying mechanisms of particle toxicity upon exposure, remain largely uncertain. Studies have widely suggested that the oxidative potential (OP) of aerosol particles is a key metric to quantify particle toxicity. OP is defined as the ability of aerosol particle components to produce reactive oxidative species (ROSs) and deplete antioxidants in vivo. Traditional methods for measuring OP using acellular assays largely rely on analyzing PM collected in filters offline. This is labor intensive and involves a substantial time delay between particle collection and OP analysis. It therefore likely underestimates particle OP because many reactive chemical components which contribute to OP are short-lived and therefore degrade prior to offline analysis. Thus, new techniques are required to provide a robust and rapid quantification of particle OP, capturing the chemistry of oxidizing and short-lived, highly reactive aerosol components and their concentration dynamics in the atmosphere. To address these measurement shortcomings, we developed a portable online instrument that directly samples particles into an ascorbic acid-based assay under physiologically relevant conditions of pH 6.8 and 37 ∘C, providing continuous, accurate OP measurements with a high time resolution (5 min). The instrument runs autonomously for up to 3 d and has a detection limit of about 5 µg m−3 in an urban environment, which allows the characterization of particle OP even in low-pollution areas.</p

Transcriptional alteration of cytoskeletal genes induced by microcystins in three organs of rats

This study explored the mechanisms of toxicity of microcystins by measuring the transcription levels of nine cytoskeletal genes (actin, tubulin, vimentin, ezrin, radixin, moesin, MAP1b, tau, stathmin) in the liver, kidney and spleen of male Wistar rats treated with microcystins at a dose of 80 mu g MC-LReq kg(-1) bw. Microcystins disrupted the transcriptional homeostasis of cytoskeletal genes in these organs. Changes in the transcription of four genes (beta-actin, ezrin, radixin and tau) in liver, one gene (stathmin) in kidney, and one gene (radixin) in spleen were significantly correlated with the tissue concentration of microcystins. However, the influences on the transcription of most genes we studied were greater in the liver than in the kidney or spleen. The effects of microcystins on the transcription of cytoskeletal genes may explain some of the morphological and pathological changes observed in these organs and provide new information on the hepatotoxicity of these compounds. Additionally, transcriptional changes in tumor-associated cytoskeletal genes (ezrin, moesin and stathmin) that were observed in the present study provide a possible clue to the tumor-promoting potential of microcystins and their influences on the transcription of MAP1b and tau imply possible neurological toxicity of microcystins in vertebrates. (C) 2010 Published by Elsevier Ltd