Leaf physiological and water soluble carbohydrate content responses to trinexapac-ethyl application of sports turf grasses exposed to water stress

Water stress causes alterations in physiological and metabolic processes in plants and is considered the primary environmental factor affecting the management of sports turf grass species.This glasshouse experiment was conducted to investigate the effect of trinexapac-ethyl (TE) on canopy net photosynthesis (Pn), cell membrane stability (CMS), turf quality (TQ) and water soluble carbohydrate (WSC) accumulation responses of sports turf cultivars [Cv] (100% fescue, Rootzone and Arena sports) subjected to water stress. Commercially obtained sods of turf plants were treated with 2 L/ ha TE and then exposed 7 days after to water stress. The treatments were: (i) water untreated, (ii) water TE-treated, (iii) water stress untreated; and (iv) water stress TE-treated and the experiment was a randomized complete block design with four replicates. Results showed that specifically in Cv. Rootzone, Pn was 50% higher for well water TE treated plants compared to the other treatments during the second and third week of the study. Similarly, at 14 days after application, the effect TE resulted to 35% and 50% reduction in cell membrane leakages respectively in well water and water stressed TE-treated Cv. Rootzone plants and this was statistically significant (P=0.05) different from the untreated plants. On a scale of 1-9, all turf types recorded TQ rating of ≥8 at the start of the experiment. By the fourth week of the study, it was observed that all water stress untreated plants had mean TQ (5.75) ratings lower than the minimum acceptable TQ (6). WSC content of well-watered TE-untreated plants was maintained below 60 mg/g DW throughout the study regardless of turf type. After 28 day of water stress duration, the WSC contents obtained in water stress TE-treated plants were 41%, 43% and 50% higher for Cv. Rootzone, 100% fescue and Cv. Arena sports, respectively , than in well water untreated plants. Summer preconditioning of plants with TE can be a possible management tool in alleviating the detrimental impacts of water stress in sport turf species

In vitro comparison of cryopreserved and liquid platelets: Potential clinical implications

Background Platelet (PLT) concentrates can be cryopreserved in dimethyl sulfoxide (DMSO) and stored at -80C for 2 years. These storage conditions improve availability in both rural and military environments. Previous phenotypic and in vitro studies of cryopreserved PLTs are limited by comparison to fresh liquid-stored PLTs, rather than PLTs stored over their clinically relevant shelf life. Further, nothing is known of the effect of reconstituting cryopreserved PLTs in plasma stored at a variety of clinically relevant temperatures. Study Design and Methods Apheresis PLTs were either stored at room temperature for 5 days or cryopreserved at -80C with 5% DMSO. Cryopreserved PLTs were thawed at 37C and reconstituted in plasma (stored at different temperatures) and compared to fresh and expired liquid-stored PLTs. In vitro assays were performed to assess glycoprotein expression, PLT activity, microparticle content, and function. Results Compared to liquid PLTs over storage, cryopreserved PLTs had reduced expression of the key glycoprotein receptors GPIbα and GPIIb. However, the proportion of PLTs expressing activation markers CD62P and CD63 was similar between cryopreserved and liquid-stored PLTs at expiry. Cryopreserved PLT components contained significantly higher numbers of phosphatidylserine- and tissue factor-positive microparticles than liquid-stored PLTs, and these microparticles reduced the time to clot formation and increased thrombin generation. Conclusion There are distinct differences between cryopreserved and liquid-stored PLTs. Cryopreserved PLTs also have an enhanced hemostatic activity. Knowledge of these in vitro differences will be essential to understanding the outcomes of a clinical trial comparing cryopreserved PLTs and liquid PLTs stored for various durations

Early sedation with dexmedetomidine in ventilated critically ill patients and heterogeneity of treatment effect in the SPICE III randomised controlled trial

Purpose To quantify potential heterogeneity of treatment effect (HTE), of early sedation with dexmedetomidine (DEX) compared with usual care, and identify patients who have a high probability of lower or higher 90-day mortality according to age, and other identified clusters. Methods Bayesian analysis of 3904 critically ill adult patients expected to receive invasive ventilation > 24 h and enrolled in a multinational randomized controlled trial comparing early DEX with usual care sedation. Results HTE was assessed according to age and clusters (based on 12 baseline characteristics) using a Bayesian hierarchical models. DEX was associated with lower 90-day mortality compared to usual care in patients > 65 years (odds ratio [OR], 0.83 [95% credible interval [CrI] 0.68–1.00], with 97.7% probability of reduced mortality across broad categories of illness severity. Conversely, the probability of increased mortality in patients ≤ 65 years was 98.5% (OR 1.26 [95% CrI 1.02–1.56]. Two clusters were identified: cluster 1 (976 patients) mostly operative, and cluster 2 (2346 patients), predominantly non-operative. There was a greater probability of benefit with DEX in cluster 1 (OR 0.86 [95% CrI 0.65–1.14]) across broad categories of age, with 86.4% probability that DEX is more beneficial in cluster 1 than cluster 2. Conclusion In critically ill mechanically ventilated patients, early sedation with dexmedetomidine exhibited a high probability of reduced 90-day mortality in older patients regardless of operative or non-operative cluster status. Conversely, a high probability of increased 90-day mortality was observed in younger patients of non-operative status. Further studies are needed to confirm these findings.Yahya Shehabi, Ary Serpa Neto, Belinda D. Howe, Rinaldo Bellomo, Yaseen M. Arabi, Michael Bailey ... et al

Over view of major traumatic injury in Australia––Implications for trauma system design

Background: Trauma registries are known to drive improvements and optimise trauma systems worldwide. This is the first reported comparison of the epidemiology and outcomes at major centres across Australia. Methods: The Australian Trauma Registry was a collaboration of 26 major trauma centres across Australia at the time of this study and currently collects information on patients admitted to these centres who die after injury and/or sustain major trauma (Injury Severity Score (ISS) > 12). Data from 1 July 2016 to 30 June 2017 were analysed. Primary endpoints were risk adjusted length of stay and mortality (adjusted for age, cause of injury, arrival Glasgow coma scale (GCS), shock-index grouped in quartiles and ISS). Results: There were 8423 patients from 24 centres included. The median age (IQR) was 48 (28–68) years. Median (IQR) ISS was 17 (14–25). There was a predominance of males (72%) apart from the extremes of age. Transport-related cases accounted for 45% of major trauma, followed by falls (35.1%). Patients took 1.42 (1.03–2.12) h to reach hospital and spent 7.10 (3.64–15.00) days in hospital. Risk adjusted length of stay and mortality did not differ significantly across sites. Primary endpoints across sites were also similar in paediatric and older adult (>65) age groups. Conclusion: Australia has the capability to identify national injury trends to target prevention and reduce the burden of injury. Quality of care following injury can now be benchmarked across Australia and with the planned enhancements to data collection and reporting, this will enable improved management of trauma victims

A systematic review and meta-analysis of early goal-directed therapy for septic shock: the ARISE, ProCESS and ProMISe Investigators

Purpose: To determine whether early goal-directed therapy (EGDT) reduces mortality compared with other resuscitation strategies for patients presenting to the emergency department (ED) with septic shock. Methods: Using a search strategy of PubMed, EmBase and CENTRAL, we selected all relevant randomised clinical trials published from January 2000 to January 2015. We translated non-English papers and contacted authors as necessary. Our primary analysis generated a pooled odds ratio (OR) from a fixed-effect model. Sensitivity analyses explored the effect of including non-ED studies, adjusting for study quality, and conducting a random-effects model. Secondary outcomes included organ support and hospital and ICU length of stay. Results: From 2395 initially eligible abstracts, five randomised clinical trials (n\ua0=\ua04735 patients) met all criteria and generally scored high for quality except for lack of blinding. There was no effect on the primary mortality outcome (EGDT: 23.2\ua0% [495/2134] versus control: 22.4\ua0% [582/2601]; pooled OR 1.01 [95\ua0% CI 0.88–1.16], P\ua0=\ua00.9, with heterogeneity [I\ua0=\ua057\ua0%; P\ua0=\ua00.055]). The pooled estimate of 90-day mortality from the three recent multicentre studies (n\ua0=\ua04063) also showed no difference [pooled OR 0.99 (95\ua0% CI 0.86–1.15), P\ua0=\ua00.93] with no heterogeneity (I\ua0=\ua00.0\ua0%; P\ua0=\ua00.97). EGDT increased vasopressor use (OR 1.25 [95\ua0% CI 1.10–1.41]; P\ua