Assessment of heavy metals concentration in water, soil sediment and biological tissues of the lesser flamingos in four eastern rift valley lakes

The term heavy metal refers to any metallic chemical element that has a relatively high density and is toxic at low concentrations. This study was conducted in four eastern Rift Valley lakes which included Lakes Oloidien, Crater, Elementaita and Nakuru, to determine the presence and levels of lead, arsenic, cadmium and chromium concentration in water, soil sediments and biological tissues of the Lesser Flamingos (Phoeniconaias minor) and compare with the set standards. As these lakes catchments fall directly within a combination of agricultural and industrial regions, the run-offs and the resulting effluents will make the waters highly prone to chemical contamination. The methodology involved collection of water samples (n=40), sediments samples (n=51) and the Lesser Flamingos (live n= 6; dead n=2) for qualitative and quantitative toxicological analysis. The analysis was done using Graphite Furnace Atomic Absorption Spectrophotometer (GFAAS) model-Specter AA-10 Varian. Lead and arsenic were found to be in high concentration in soil sediments in all four lakes while chromium and cadmium were in low concentration. Soil sediments analysed from the inflow of the Nakuru sewerage drain (1754±22.81 ppb) and rivers to Lake Nakuru (1129±107 ppb) had the highest mean ± SD lead concentration. Arsenic, cadmium, chromium and lead were also observed in bird tissues. Metals in the Lesser Flamingo tissues were below the toxicological levels that are reported in literature to be harmful, except lead which was above the level recommended by the US Environmental Protection Agency.Keywords: Heavy metals, lesser flamingo, environmen

Microcirculatory perfusion is preserved during off-pump but not on-pump cardiac surgery

OBJECTIVE: This study investigated the perioperative course of microcirculatory perfusion in off-pump compared with on-pump surgery. Additionally, the impact of changes in systemic hemodynamics, hematocrit, and body temperature was studied. DESIGN: Prospective, nonrandomized, observational study. SETTING: Tertiary university hospital. PARTICIPANTS: Patients undergoing coronary artery bypass grafting with (n = 13) or without (n = 13) use of cardiopulmonary bypass. INTERVENTIONS: Microcirculatory measurements were obtained at 5 time points ranging from induction of anesthesia to ICU admission. MEASUREMENTS AND MAIN RESULTS: Microcirculatory recordings were performed with sublingual sidestream dark field imaging. Despite a comparable reduction in intraoperative blood pressure between groups, the perfused vessel density decreased more than 20% after onset of extracorporeal circulation but remained stable in the off-pump group. The reduction in microvascular perfusion in the on-pump group was further paralleled by decreased hematocrit and temperature. Although postbypass hematocrit levels and body temperature were restored to similar levels as in the off-pump group, the median microvascular flow index remained reduced after bypass (2.4 [2.3-2.7]) compared with baseline (2.8 [2.7-2.9]; p = 0.021). CONCLUSIONS: Microcirculatory perfusion remained unaltered throughout off-pump surgery. In contrast, microvascular perfusion declined after initiation of cardiopulmonary bypass and did not recover in the early postoperative phase

The ARID1B spectrum in 143 patients: from nonsyndromic intellectual disability to Coffin–Siris syndrome

Purpose: Pathogenic variants in ARID1B are one of the most frequent causes of intellectual disability (ID) as determined by large-scale exome sequencing studies. Most studies published thus far describe clinically diagnosed Coffin–Siris patients (ARID1B-CSS) and it is unclear whether these data are representative for patients identified through sequencing of unbiased ID cohorts (ARID1B-ID). We therefore sought to determine genotypic and phenotypic differences between ARID1B-ID and ARID1B-CSS. In parallel, we investigated the effect of different methods of phenotype reporting. Methods: Clinicians entered clinical data in an extensive web-based survey. Results: 79 ARID1B-CSS and 64 ARID1B-ID patients were included. CSS-associated dysmorphic features, such as thick eyebrows, long eyelashes, thick alae nasi, long and/or broad philtrum, small nails and small or absent fifth distal phalanx and hypertrichosis, were observed significantly more often (p < 0.001) in ARID1B-CSS patients. No other significant differences were identified. Conclusion: There are only minor differences between ARID1B-ID and ARID1B-CSS patients. ARID1B-related disorders seem to consist of a spectrum, and patients should be managed similarly. We demonstrated that data collection methods without an explicit option to report the absence of a feature (such as most Human Phenotype Ontology-based methods) tended to underestimate gene-related features

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Epidemiology of celiac disease in The Netherlands

Contains fulltext : 25781___.PDF (publisher's version ) (Open Access

Brede School aan de Bremstraat, gemeente Hellevoetsluis : een inventariserend veldonderzoek (IVO) door middel van boringen en een veldverkenning

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Diversity in horse enthusiasts with respect to horse welfare: An explorative study

A reduced level of welfare of horses is related to management factors such as low forage feeding, short feeding time, social isolation, and lack of unrestrained exercise. It has been assumed that welfare problems can be reduced and/or partly prevented by improving the knowledge and skills of horse enthusiasts. It has also been assumed that to improve the provision of information to horse enthusiasts, it is important to explore and gain more insight into horse enthusiasts’ motives, knowl- edge, and behavior. The aim of this exploratory study was to identify the diversity of horse enthusiasts in the Netherlands, with respect to the way they search and find out information, their emotional in- volvement with horses, and their attitude, their knowledge, and daily practices with regard to equine welfare. A Web-based survey using a 30-item questionnaire resulted in 4,267 respondents. Most re- spondents (84.6%) were female; the average age of the respondents was 34.2 (613.5) years. More than half of the respondents (64.5%) believed that there were welfare problems throughout the whole horse industry. The most important reported source for information was the personal contact with other horse enthusiasts (82.8%), with veterinarians (74.5%), and with farriers (69.5%). It is, therefore, recom- mended that to disseminate relevant knowledge on equine welfare, particular attention should be paid to the acquisition and dissemination skills within the education programs of veterinarians and farriers. Although most respondents were aware of the issues that can compromise welfare, their knowledge did not always result in appropriate practices. Furthermore, a cluster analysis showed that horse enthusiasts can be categorized into 4 clusters from the way they search and find out information, their emotional involvement with horses, and their attitude, their knowledge, and daily practices with regard to the welfare of horses. To improve the provision of information to horse enthusiasts, it is recommended that the information provision to horse enthusiasts is organized around these 4 clusters of horse enthusiasts

Diversity in horse enthusiasts with respect to horse welfare: An explorative study

A reduced level of welfare of horses is related to management factors such as low forage feeding, short feeding time, social isolation, and lack of unrestrained exercise. It has been assumed that welfare problems can be reduced and/or partly prevented by improving the knowledge and skills of horse enthusiasts. It has also been assumed that to improve the provision of information to horse enthusiasts, it is important to explore and gain more insight into horse enthusiasts’ motives, knowl- edge, and behavior. The aim of this exploratory study was to identify the diversity of horse enthusiasts in the Netherlands, with respect to the way they search and find out information, their emotional in- volvement with horses, and their attitude, their knowledge, and daily practices with regard to equine welfare. A Web-based survey using a 30-item questionnaire resulted in 4,267 respondents. Most re- spondents (84.6%) were female; the average age of the respondents was 34.2 (613.5) years. More than half of the respondents (64.5%) believed that there were welfare problems throughout the whole horse industry. The most important reported source for information was the personal contact with other horse enthusiasts (82.8%), with veterinarians (74.5%), and with farriers (69.5%). It is, therefore, recom- mended that to disseminate relevant knowledge on equine welfare, particular attention should be paid to the acquisition and dissemination skills within the education programs of veterinarians and farriers. Although most respondents were aware of the issues that can compromise welfare, their knowledge did not always result in appropriate practices. Furthermore, a cluster analysis showed that horse enthusiasts can be categorized into 4 clusters from the way they search and find out information, their emotional involvement with horses, and their attitude, their knowledge, and daily practices with regard to the welfare of horses. To improve the provision of information to horse enthusiasts, it is recommended that the information provision to horse enthusiasts is organized around these 4 clusters of horse enthusiasts