Pediatric Emergency Cases Managed with Intraosseous Access: Indications, Complication and Outcomes

Intraosseous (IO) access is an alternative way of administering fluid and drug and also taking biopsies needed for clinical and laboratory tests in cases when peripheral venous access couldn’t be established. The IO route was successfully secured in all cases with a significant shorter time of vascular access insertion, shorter length of stay and reduction in mortality in IO group vs. IV group.  IO access was first used in 1922. This technique was widely used during 1940’s when emergency medical care was routinely needed for seriously injured patients in World War II. Since 1950’s after the introduction of peripheral venous access technique IO access lost its actuality. In management of Pediatric emergencies intravascular (venous) access is prior but sometimes establishing peripheral venous access is impossible or it may take too much time because of anatomical or physiological characteristics, such as an excessive subcutaneous fatty tissue and veins with a small diameter. Vasoconstriction, reduction of circulating blood volume and peripheral venous collapse takes place during cardiopulmonary arrest, septic or hypovolemic shock and prolonged status epilepticus. This features alone or in combination can make venous catheterization impossible.For pediatric resuscitation, vascular access must be established quickly, often in difficult circumstances. Alternative methods of peripheral access, such as umbilical catheter, central venous lines, venous cut-down, and ultrasound guided access, may be poor options because of the patient’s age or condition, the urgency of resuscitation, and/or the skill of available clinicians. Anatomically, the described site is suggested to offer a safe alternative access point for emergency infusion in severely hypovolemic newborns and infants, without the risk of damage to any anatomical structures. IO access complications are infection - cellulites, abscess, osteomyelitis and fracture. The most widespread complication is extravasation, which, if left unidentified, can cause compartment syndrome. The EZ-IO® device is easy to use and requires minimal training. These studies suggest that the EZ-IO® is an easy to use, easy to learn tool that can be used successfully in resuscitation scenarios with minimal training.  It is evident that blood samples drawn immediately after intraosseous cannulation can provide accurate laboratory and blood bank data to aid in resuscitation. More recently, the pharmacokinetics of intraosseous drug delivery has been compared with central venous drug delivery

Unpalatable Plants Protect Neighbors from Grazing and Increase Plant Community Diversity

Tasty plants can be protected from herbivores by unpalatable neighbors. We used experimental exclosures, removal of unpalatable species, and transplants of palatable and unpalatable species in subalpine meadows of the Caucasus Mountains of Georgia to study the effects of two unpalatable species on plant communities. We found that Cirsium obalatum and Veratrum lobelianum, two large native perennial herbs that invade after heavy grazing, had strong facilitative effects on communities through their indirect effects on livestock herbivores. These unpalatable invaders had different effects on community composition when livestock were present than when livestock were excluded. Furthermore, removing Cirsium and Veratrum where herbivory was permitted decreased the richness of associated communities, but inside a livestock exclosure removal of these species increased community richness. Transplanted palatable species (Anthoxanthum odoratum and Phleum alpinum) grew larger inside the exclosure, and in the exclosure Cirsium and Veratrum had no effect on their growth. However, outside of the exclosure, Cirsium and Veratrum had strong positive effects on the growth of A. odoratum and P. alpinum. Excluding livestock decreased the growth of Luzula pseudosudetica, another unpalatable species, and Cirsium and Veratrum had no effect on L. pseudosudetica outside the exclosure. In contrast, inside exclosures Cirsium and Veratrum had competitive effects on L. pseudosudetica. Our results indicate that Cirsium and Veratrum, which are in some ways undesirable rangeland weeds, may also play an important role in maintaining species and functional diversity of overgrazed plant communities in the Caucasus

Areas of high conservation value at risk by plant invaders in Georgia under climate change.

Invasive alien plants (IAP) are a threat to biodiversity worldwide. Understanding and anticipating invasions allow for more efficient management. In this regard, predicting potential invasion risks by IAPs is essential to support conservation planning into areas of high conservation value (AHCV) such as sites exhibiting exceptional botanical richness, assemblage of rare, and threatened and/or endemic plant species. Here, we identified AHCV in Georgia, a country showing high plant richness, and assessed the susceptibility of these areas to colonization by IAPs under present and future climatic conditions. We used actual protected areas and areas of high plant endemism (identified using occurrences of 114 Georgian endemic plant species) as proxies for AHCV. Then, we assessed present and future potential distribution of 27 IAPs using species distribution models under four climate change scenarios and stacked single-species potential distribution into a consensus map representing IAPs richness. We evaluated present and future invasion risks in AHCV using IAPs richness as a metric of susceptibility. We show that the actual protected areas cover only 9.4% of the areas of high plant endemism in Georgia. IAPs are presently located at lower elevations around the large urban centers and in western Georgia. We predict a shift of IAPs toward eastern Georgia and higher altitudes and an increased susceptibility of AHCV to IAPs under future climate change. Our study provides a good baseline for decision makers and stakeholders on where and how resources should be invested in the most efficient way to protect Georgia's high plant richness from IAPs

Plant and fungal use in Tusheti, Khevsureti, and Pshavi, Sakartvelo (Republic of Georgia), Caucasus

In this study, we documented traditional plant use in Tusheti, Khevsureti, and Pshavi and hypothesized that (i) plant use knowledge in general would be higher in isolated high elevation communities, and that (ii) use of home gardens would be much more restricted to lower elevation settings. Fieldwork was conducted in Khevsureti, Pshavi, and Tusheti. Interviews using semi-structured questionnaires were conducted with 74 participants. In the present study, we encountered 317 plant species belonging to 203 genera of 80 families being used in the research region. Of these, 197 species were exclusively wild-harvested, 73 were grown in homegardens, and 47 were both grown in gardens and sourced in the wild. The ordinations in plant-space and in use-space were significantly fit by elevation of informant community, and community itself. Age and gender did not significantly fit the distribution of informants across either plant-space or use-space, respectively. Number of use-reports was highest across all communities in the food and medicinal use-categories, and informant consensus. Species with especially high use-diversity (UD) tended to be woody species although. Species with high use-value (UV) were mostly managed/domesticated species from home orchards, gardens, or farms. Plant species, and uses, found in our study, showed clear relations to the wider Eurasian cultural complex. The species number found was, however, far higher than in any published study from either the region or the wiser Mediterranean and Eurasia. The maintenance of home gardens in Georgia serves as socio-ecological memory. While the great variety of plant species used in the Georgian Caucasus might provide a reservoir for food security climate change is starting to affect both natural floristic diversity and gardens both in the Caucasus as well as continent wide

Adapting Agriculture to Climate Change: A Synopsis of Coordinated National Crop Wild Relative Seed Collecting Programs across Five Continents

The Adapting Agriculture to Climate Change Project set out to improve the diversity, quantity, and accessibility of germplasm collections of crop wild relatives (CWR). Between 2013 and 2018, partners in 25 countries, heirs to the globetrotting legacy of Nikolai Vavilov, undertook seed collecting expeditions targeting CWR of 28 crops of global significance for agriculture. Here, we describe the implementation of the 25 national collecting programs and present the key results. A total of 4587 unique seed samples from at least 355 CWR taxa were collected, conserved ex situ, safety duplicated in national and international genebanks, and made available through the Multilateral System (MLS) of the International Treaty on Plant Genetic Resources for Food and Agriculture (Plant Treaty). Collections of CWR were made for all 28 targeted crops. Potato and eggplant were the most collected genepools, although the greatest number of primary genepool collections were made for rice. Overall, alfalfa, Bambara groundnut, grass pea and wheat were the genepools for which targets were best achieved. Several of the newly collected samples have already been used in pre-breeding programs to adapt crops to future challenges.info:eu-repo/semantics/publishedVersio

Biological flora of Central Europe: Cyperus esculentus L

This paper presents information on all aspects of the biology of Cyperus esculentus L. (yellow nutsedge) and deals with its taxonomy, morphology, genetic diversity, distribution, habitat requirements, ecology and life cycle, with special emphasis on uses and cultivation, history of introduction, impact and management in Europe. C. esculentus is a tuber geophyte and most likely originates from the Mediterranean and Southwest Asia. It is a variable plant and four wild-type varieties are presently recognized, in addition to a cultivated form. C. esculentus reproduces primarily by its underground tubers, although abundant seeds are produced. In temperate climates, tubers usually sprout in late spring and the plant withers at the beginning of the winter. C. esculentus is only cultivated in the València region in Spain. Invasion foci emerged across Europe at the beginning of the 1980s and at present, C. esculentus is most abundant on arable land and in ruderal habitats, followed by riverine vegetation. In heavily infested regions of Europe, C. esculentus causes substantial yield losses in field crops and although different management strategies are available, C. esculentus remains difficult to control.Follak, S.; Belz, R.; Bohren, C.; Castro, OD.; Guacchio, ED.; Pascual-Seva, N.; Schwarz, M.... (2016). Biological flora of Central Europe: Cyperus esculentus L. Perspectives in Plant Ecology, Evolution and Systematics. 23:33-51. doi:10.1016/j.ppees.2016.09.003S33512

Adapting agriculture to climate change: a synopsis of Coordinated National Crop Wild Relative Seed Collecting Programs across five continents.

Na publicação: Marcelo B. Medeiros