Perioperative factor concentrate therapy

Transfusion of allogeneic plasma has been a life-saving measure for decades in patients with severe trauma or suffering from major surgical blood loss. The safety of allogeneic blood components has improved in terms of pathogen transmission, but haemostatic efficacy of plasma is hindered by the large volume and time required for thawing and infusion. Several plasma-derived and recombinant factor concentrates are clinically available and indicated for targeted replacement of missing coagulation elements in hereditary disorders of thrombosis and haemostasis. When used appropriately, factor concentrate therapy can rapidly restore deficient factor(s) without causing volume overload. The haemostatic defect in perioperative patients is often multifactorial, and therefore careful clinical judgement and timely coagulation testing must be exercised before the administration of factor concentrates. In this review, the rationale for including factor concentrates in perioperative haemostatic management will be discussed in conjunction with the limitations of plasma transfusio

General anaesthetics do not impair developmental expression of the KCC2 potassium-chloride cotransporter in neonatal rats during the brain growth spurt

Background The developmental transition from depolarizing to hyperpolarizing γ-aminobutyric acid-mediated neurotransmission is primarily mediated by an increase in the amount of the potassium-chloride cotransporter KCC2 during early postnatal life. However, it is not known whether early neuronal activity plays a modulatory role in the expression of total KCC2 mRNA and protein in the immature brain. As general anaesthetics are powerful modulators of neuronal activity, the purpose of this study was to explore how these drugs affect KCC2 expression during the brain growth spurt. Methods Wistar rat pups were exposed to either a single dose or 6 h of midazolam, propofol, or ketamine anaesthesia at postnatal days 0, 5, 10, or 15. KCC2 expression was assessed using immunoblotting, immunohistochemistry, or quantitative polymerase chain reaction analysis up to 3 days post-exposure in the medial prefrontal cortex. Results There was a progressive and steep increase in the expression of KCC2 between birth and 2 weeks of age. Exposure to midazolam, propofol, or ketamine up to 6 h at any investigated stages of the brain growth spurt did not influence the expression of this cotransporter protein. Conclusion I.V. general anaesthetics do not seem to influence developmental expression of KCC2 during the brain growth spur

Ethane-beta-Sultam Modifies the Activation of the Innate Immune System Induced by Intermittent Ethanol Administration in Female Adolescent Rats

Intermittent ethanol abuse or ‘binge drinking’ during adolescence induces neuronal damage, which may be associated with cognitive dysfunction. To investigate the neurochemical processes involved, rats were administered either 1 g/kg or 2 g/kg ethanol in a ‘binge drinking’ regime. After only 3 weeks, significant activation of phagocytic cells in the peripheral (alveolar macrophages) and the hippocampal brain region (microglia cells) was present,as exemplified by increases in the release of pro-inflammatory cytokines in the macrophages and of iNOS in the microglia. This was associated with neuronal loss in the hippocampus CA1 region. Daily supplementation with a taurine prodrug, ethane-β-sultam, 0.028 g/kg, during the intermittent ethanol loading regime, supressed the release of the pro-inflammatory cytokines and of reactive nitrogen species, as well as neuronal loss, particularly in the rats administered the lower dose of ethanol, 1 g/kg. Plasma, macrophage and hippocampal taurine levels increased marginally after ethane-β-sultam supplementation. The ‘binge drinking’ ethanol rats administered 1 g/kg ethanol showed increased latencies to those of the control rats in their acquisition of spacial navigation in the Morris Water Maze, which was normalised to that of the controls values after ethane-β-sultam administration. Such results confirm that the administration of ethane-β-sultam to binge drinking rats reduces neuroinflammation in both the periphery and the brain, suppresses neuronal loss, and improved working memory of rats in a water maze study

The influence of long- and short-term volcanic strain on aquifer pressure:a case study from Soufrière Hills Volcano, Montserrat (W.I.)

Aquifers are poroelastic bodies that respond to strain by changes in pore pressure. Crustal deformation due to volcanic processes induces pore pressure variations that are mirrored in well water levels. Here, we investigate water level changes in the Belham valley on Montserrat over the course of two years (2004-2006). Using finite element analysis, we simulate crustal deformation due to different volcanic strain sources and the dynamic poroelastic aquifer response. While some additional hydrological drivers cannot be excluded, we suggest that a poroelastic strain response of the aquifer system in the Belham valley is a possible explanation for the observed water level changes. According to our simulations, the shallow Belham aquifer responds to a steadily increasing sediment load due to repeated lahar sedimentation in the valley with rising aquifer pressures. A wholesale dome collapse in May 2006 on the other hand induced dilatational strain and thereby a short-term water level drop in a deeper-seated aquifer, which caused groundwater leakage from the Belham aquifer and thereby induced a delayed water level fall in the wells. The system thus responded to both gradual and rapid transient strain associated with the eruption of Soufrière Hills Volcano (Montserrat). This case study gives field evidence for theoretical predictions on volcanic drivers behind hydrological transients, demonstrating the potential of hydrological data for volcano monitoring. Interrogation of such data can provide valuable constraints on stress evolution in volcanic systems and therefore complement other monitoring systems. The presented models and inferred results are conceptually applicable to volcanic areas worldwide

Children as experiencers: increasing engagement, participation and inclusion for young children in the museum

This research aimed to evaluate young children’s engagement, participation and inclusion within a city museum by utilising observations and semi structured interviews with children and families. Both groups requested more interactive exhibits, sensory experiences, making and doing activities and role play opportunities. In this article, we argue for increased visibility of children’s ‘intangible heritage’(Brookshaw, 2016) and opportunities for responding which make links with children’s lives contemporarily. We further argue that museums should view children as experiencers rather than learners

Higher fibrinogen concentrations for reduction of transfusion requirements during major paediatric surgery: A prospective randomised controlled trial†

Background Hypofibrinogenaemia is one of the main reasons for development of perioperative coagulopathy during major paediatric surgery. The aim of this study was to assess whether prophylactic maintenance of higher fibrinogen concentrations through administration of fibrinogen concentrate would decrease the volume of transfused red blood cell (RBCs). Methods In this prospective, randomised, clinical trial, patients aged 6 months to 17 yr undergoing craniosynostosis and scoliosis surgery received fibrinogen concentrate (30 mg kg−1) at two predefined intraoperative fibrinogen concentrations [ROTEM® FIBTEM maximum clot firmness (MCF) of <8 mm (conventional) or <13 mm (early substitution)]. Total volume of transfused RBCs was recorded over 24 h after start of surgery. Results Thirty children who underwent craniosynostosis surgery and 19 children who underwent scoliosis surgery were treated per protocol. During craniosynostosis surgery, children in the early substitution group received significantly less RBCs (median, 28 ml kg−1; IQR, 21 to 50 ml kg−1) compared with the conventional fibrinogen trigger of <8 mm (median, 56 ml kg−1; IQR, 28 to 62 ml kg−1) (P=0.03). Calculated blood loss as per cent of estimated total blood volume decreased from a median of 160% (IQR, 110-190%) to a median of 90% (IQR, 78-110%) (P=0.017). No significant changes were observed in the scoliosis surgery population. No bleeding events requiring surgical intervention, postoperative transfusions of RBCs, or treatment-related adverse events were observed. Conclusions Intraoperative administration of fibrinogen concentrate using a FIBTEM MCF trigger level of <13 mm can be successfully used to significantly decrease bleeding, and transfusion requirements in the setting of craniosynostosis surgery, but not scoliosis. Clinical trial registry number ClinicalTrials.gov NCT0148783

Isolation and expression of the human gametocyte-specific factor 1 gene (GTSF1) in fetal ovary, oocytes, and preimplantation embryos

Purpose: Gametocyte-specific factor 1 has been shown in other species to be required for the silencing of retrotransposons via the Piwi-interacting RNA (piRNA) pathway. In this study, we aimed to isolate and assess expression of transcripts of the gametocyte-specific factor 1 (GTSF1) gene in the human female germline and in preimplantation embryos. Methods: Complementary DNA (cDNA) libraries from human fetal ovaries and testes, human oocytes and preimplantation embryos and ovarian follicles isolated from an adult ovarian cortex biopsy were used to as templates for PCR, cloning and sequencing, and real time PCR experiments of GTSF1 expression. Results: GTSF1 cDNA clones that covered the entire coding region were isolated from human oocytes and preimplantation embryos. GTSF1 mRNA expression was detected in archived cDNAs from staged human ovarian follicles, germinal vesicle (GV) stage oocytes, metaphase II oocytes, and morula and blastocyst stage preimplantation embryos. Within the adult female germline, expression was highest in GV oocytes. GTSF1 mRNA expression was also assessed in human fetal ovary and was observed to increase during gestation, from 8 to 21 weeks, during which time oogonia enter meiosis and primordial follicle formation first occurs. In human fetal testis, GTSF1 expression also increased from 8 to 19 weeks. Conclusions: To our knowledge, this report is the first to describe the expression of the human GTSF1 gene in human gametes and preimplantation embryos

Physiological factors influencing female fertility in birds

Fertility is fundamental to reproductive success, but not all copulation attempts result in a fertilized embryo. Fertilization failure is especially costly for females, but we still lack a clear understanding of the causes of variation in female fertility across taxa. Birds make a useful model system for fertility research, partly because their large eggs are easily studied outside of the female's body, but also because of the wealth of data available on the reproductive productivity of commercial birds. Here, we review the factors contributing to female infertility in birds, providing evidence that female fertility traits are understudied relative to male fertility traits, and that avian fertility research has been dominated by studies focused on Galliformes and captive (relative to wild) populations. We then discuss the key stages of the female reproductive cycle where fertility may be compromised, and make recommendations for future research. We particularly emphasize that studies must differentiate between infertility and embryo mortality as causes of hatching failure, and that non-breeding individuals should be monitored more routinely where possible. This review lays the groundwork for developing a clearer understanding of the causes of female infertility, with important consequences for multiple fields including reproductive science, conservation and commercial breeding

A sex-linked supergene with large effects on sperm traits has little impact on reproductive traits in female zebra finches.

Despite constituting an essential component of fitness, reproductive success can vary remarkably between individuals and the causes of such variation are not well understood across taxa. In the zebra finch—a model songbird, almost all the variation in sperm morphology and swimming speed is maintained by a large polymorphic inversion (commonly known as a supergene) on the Z chromosome. The relationship between this polymorphism and reproductive success is not fully understood, particularly for females. Here, we explore the effects of female haplotype, and the combination of male and female genotype, on several primary reproductive traits in a captive population of zebra finches. Despite the inversion polymorphism's known effects on sperm traits, we find no evidence that inversion haplotype influences egg production by females or survival of embryos through to hatching. However, our findings do reinforce existing evidence that the inversion polymorphism is maintained by a heterozygote advantage for male fitness. This work provides an important step in understanding the causes of variation in reproductive success in this model species