Protocol for a systematic review of the impact of resuscitation fluids on the microcirculation after haemorrhagic shock in animal models

BACKGROUND: Modern resuscitation strategies following haemorrhagic shock are influenced by global haemodynamic parameters such as blood pressure and cardiac output. Microcirculatory dysfunction in this context may persist even after restoration of satisfactory global parameters. Additional monitoring of the microcirculatory function may therefore be warranted in order to facilitate goal-directed therapy at a tissue oxygenation level. Although such a phenomenon is recognised in the case of sepsis, clinical evidence regarding the behaviour of the microcirculation following the delivery of resuscitation fluids after haemorrhagic shock is sparse. A summation of the current state of pre-clinical evidence is justified in order to direct avenues for future clinical research. METHODS/DESIGN: Systematic review methodology will be utilised in order to identify relevant studies, assess for bias, and extract data for analysis. Medical databases will be searched to find pre-clinical studies that monitor the microcirculatory function following haemorrhagic shock and subsequent fluid resuscitation. Different fluid types (e.g. blood products, crystalloid, and colloid fluids) will be compared. The search strategy will combine terms for the animal model, resuscitation fluid, and microcirculatory parameters. Randomised and non-randomised experiments, as well as case series, will be eligible for inclusion. Specific quality assessment tools for pre-clinical research will be used depending on study design. A combination of narrative and meta-analysis techniques will be used for the synthesis of data. DISCUSSION: The choice of type, sequence, and quantity of resuscitation fluid following haemorrhagic shock is controversial, and the optimal strategy for restoration of microcirculatory function is yet unknown. A detailed examination of pre-clinical data regarding the microcirculation is timely and will enable a focussed approach to clinical research for the improvement of resuscitation following haemorrhagic shock. SYSTEMATIC REVIEW REGISTRATION: Collaborative Approach to Meta Analysis and Review of Animal Data from Experimental Studies (CAMARADES) ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13643-015-0113-4) contains supplementary material, which is available to authorized users

A comparative HST imaging study of the host galaxies of radio-quiet quasars, radio-loud quasars and radio galaxies: Paper I

We present the first results from a major HST WFPC2 imaging study aimed at providing the first statistically meaningful comparison of the morphologies, luminosities, scalelengths and colours of the host galaxies of radio-quiet quasars, radio-loud quasars, and radio galaxies. We describe the design of this study and present the images which have been obtained for the first half of our 33-source sample. We find that the hosts of all three classes of luminous AGN are massive elliptical galaxies, with scalelengths ~=10 kpc, and R-K colours consistent with mature stellar populations. Most importantly this is the the first unambiguous evidence that, just like radio-loud quasars, essentially all radio-quiet quasars brighter than M_R = -24 reside in massive ellipticals. This result removes the possibility that radio `loudness' is directly linked to host galaxy morphology, but is however in excellent accord with the black-hole/spheroid mass correlation recently highlighted by Magorrian et al. (1998). We apply the relations given by Magorrian et al. to infer the expected Eddington luminosity of the putative black hole at the centre of each of the spheroidal host galaxies we have uncovered. Comparison with the actual nuclear R-band luminosities suggests that the black holes in most of these galaxies are radiating at a few percent of the Eddington luminosity; the brightest host galaxies in our low-z sample are capable of hosting quasars with M_R = -28, comparable to the most luminous quasars at z = 3. Finally we discuss our host-derived black-hole masses in the context of the radio-luminosity:black-hole mass correlation recently uncovered for nearby galaxies by Franceschini et al. (1998), and the resulting implications for the physical origin of radio loudness.Comment: Submitted for publication in the Astrophysical Journal, 55 pages of latex, plus 12 postscript figures (Figures 1a-1s (greyscales of images and model fits, and Figures 2a-2g (luminosity profiles and model fits) can be downloaded from http://www.roe.ac.uk/astronomy/html/rjm1.shtml

The worldwide costs of marine protected areas

Declines in marine harvests, wildlife, and habitats have prompted calls at both the 2002 World Summit on Sustainable Development and the 2003 World Parks Congress for the establishment of a global system of marine protected areas (MPAs). MPAs that restrict fishing and other human activities conserve habitats and populations and, by exporting biomass, may sustain or increase yields of nearby fisheries. Here we provide an estimate of the costs of a global MPA network, based on a survey of the running costs of 83 MPAs worldwide. Annual running costs per unit area spanned six orders of magnitude, and were higher in MPAs that were smaller, closer to coasts, and in high-cost, developed countries. Models extrapolating these findings suggest that a global MPA network meeting the World Parks Congress target of conserving 20–30% of the world’s seas might cost between $5 billion and$19 billion annually to run and would probably create around one million jobs. Although substantial, gross network costs are less than current government expenditures on harmful subsidies to industrial fisheries. They also ignore potential private gains from improved fisheries and tourism and are dwarfed by likely social gains from increasing the sustainability of fisheries and securing vital ecosystem services

How do farm models compare when estimating greenhouse gas emissions from dairy cattle production?

The European Union Effort Sharing Regulation (ESR) will require a 30% reduction in greenhouse gas (GHG) emissions by 2030 compared with 2005 from the sectors not included in the European Emissions Trading Scheme, including agriculture. This will require the estimation of current and future emissions from agriculture, including dairy cattle production systems. Using a farm-scale model as part of a Tier 3 method for farm to national scales provides a more holistic and informative approach than IPCC (2006) Tier 2 but requires independent quality control. Comparing the results of using models to simulate a range of scenarios that explore an appropriate range of biophysical and management situations can support this process by providing a framework for placing model results in context. To assess the variation between models and the process of understanding differences, estimates of GHG emissions from four farm-scale models (DairyWise, FarmAC, HolosNor and SFARMMOD) were calculated for eight dairy farming scenarios within a factorial design consisting of two climates (cool/dry and warm/wet)×two soil types (sandy and clayey)×two feeding systems (grass only and grass/maize). The milk yield per cow, follower:cow ratio, manure management system, nitrogen (N) fertilisation and land area were standardised for all scenarios in order to associate the differences in the results with the model structure and function. Potential yield and application of available N in fertiliser and manure were specified separately for grass and maize. Significant differences between models were found in GHG emissions at the farm-scale and for most contributory sources, although there was no difference in the ranking of source magnitudes. The farm-scale GHG emissions, averaged over the four models, was 10.6 t carbon dioxide equivalents (CO2e)/ha per year, with a range of 1.9 t CO2e/ha per year. Even though key production characteristics were specified in the scenarios, there were still significant differences between models in the annual milk production per ha and the amounts of N fertiliser and concentrate feed imported. This was because the models differed in their description of biophysical responses and feedback mechanisms, and in the extent to which management functions were internalised. We conclude that comparing the results of different farm-scale models when applied to a range of scenarios would build confidence in their use in achieving ESR targets, justifying further investment in the development of a wider range of scenarios and software tools

An Internet-Based Tool for Use in Assessing the Likely Effect of Intensification on Losses of Nitrogen to the Environment

The EU Nitrates, Habitat and National Emissions Ceilings directives and the Kyoto Agreement mean that agricultural losses of NO3, NH3 and N2O are under scrutiny by national and international environmental authorities. When farmers wish to intensify their operations, the authorities must then assess the likely environmental impact of the change in operation. The FARM-N internet tool was developed to help farmers and authorities agree how the farm will be structured and managed in the future, and to provide an objective assessment of the environmental losses that will result

Observational study of the effects of traumatic injury, haemorrhagic shock and resuscitation on the microcirculation: a protocol for the MICROSHOCK study

Introduction: The microcirculation is the physiological site of oxygen and substrate exchange. Its effectiveness during circulatory shock is vital for the perfusion of tissues, and has a bearing on subsequent organ function and prognosis. Microcirculatory dysfunction following traumatic haemorrhagic shock (THS) has been understudied compared with other pathologies such as sepsis. The aim of the MICROSHOCK study is to investigate changes seen in the microcirculation of patients following THS, and to assess its response to resuscitation. A greater understanding of the behaviour and mechanisms of microcirculatory dysfunction in this context may direct future avenues of goal-directed resuscitation for these patients. Methods and analysis: This multicentre prospective longitudinal observational study includes patients who present as an emergency with THS. Microcirculatory parameters are recorded using sublingual incident dark field microscopy alongside measurements of global flow (oesophageal Doppler and transthoracic echocardiography). Patients are enrolled into the study as soon as feasible after they arrive in hospital, and then at subsequent daily time points. Blood samples are taken for investigation into the mechanisms of microcirculatory dysfunction. Sequential Organ Failure Assessment scores will be analysed with microcirculatory parameters to determine whether they correlate with greater fidelity than more conventional, global circulatory parameters. Ethics and dissemination: Research Ethics Committee approval has been granted for this study (Reference: 14/YH/0078). Owing to the nature of THS, capacity for informed consent will be absent on patient enrolment. This will be addressed according to the Mental Health Capacity Act 2005. The physician in charge of the patient's care (nominated consultee) may consent on behalf of the patient. Consent will also be sought from a personal consultee (close relative or friend). After capacity is regained, the participant will be asked for their consent. Results will be submitted for publication in peer-reviewed journal format and presented at relevant academic meetings

Magnetic Behavior in RRhX (R = rare earths; X=B, C) Compounds

We report on the magnetic behavior of RRhB (R = La, Ce, Pr, Nd, Gd, Tb and Tm) and RRhC (R = La, Ce, Pr and Gd) compounds crystallizing in the cubic perovskite type structure with space group Pm3m. The heat capacity data on Pauli-paramagnetic LaRhB and LaRhC indicate a high frequency vibrating motion of boron and carbon atoms in the unit cell. Ce is in -like nonmagnetic state in both the compounds. Pr compounds show a dominant crystal field effect with a nonmagnetic singlet ground state in PrRhB and a nonmagnetic quadrupolar doublet in PrRhC. Compounds with other rare earths order ferromagnetically at low temperatures except TmRhB in which the zero field evolution of magnetic interactions is relatively more complicated. The electrical resistivity of GdRhB decreases with increasing temperature in the paramagnetic state in the vicinity of T, which is rarely seen in ferromagnets. The behavior is discussed to be arising due to the short range spin fluctuation and a possible contribution from Fermi surface geometry.Comment: 14 Figs and a text fil

Inelastic Neutron scattering in CeSi_{2-x}Ga_x ferromagnetic Kondo lattice compounds

Inelastic neutron scattering investigation on ferromagnetic Kondo lattice compounds belonging to CeSi_{2-x}Ga_{x}, x = 0.7, 1.0 and 1.3, system is reported. The thermal evolution of the quasielastic response shows that the Kondo interactions dominate over the RKKY interactions with increase in Ga concentration from 0.7 to 1.3. This is related to the increase in k-f hybridization with increasing Ga concentration. The high energy response indicates the ground state to be split by crystal field in all three compounds. Using the experimental results we have calculated the crystal field parameters in all three compounds studied here.Comment: 12 Pages Revtex, 2 eps figures