Extremity Tourniquet Training at High Seas Yánez Benítez, Carlos; Ribeiro, Marcelo A. F.; Khan, Mansoor ...
World journal of surgery,
August 2021, Volume:
45, Issue:
8
Journal Article
Peer reviewed
Open access
Background
Future navy officers require unique training for emergency medical response in the isolated maritime environment. The authors issued a workshop on extremity bleeding control, using four ...different commercial extremity tourniquets onboard a training sail ship. The purposes were to assess participants' perceptions of this educational experience and evaluate self-application simplicity while navigating on high seas.
Methods
A descriptive observational study was conducted as part of a workshop issued to volunteer training officers. A post-workshop survey collected their perceptions about the workshops' content usefulness and adequacy, tourniquet safety, self-application simplicity, and device preference. Tourniquet preference was measured by frequency count while the rest of the studied variables on a one-to-ten Likert scale. Frequencies and percentages were calculated for the studied variables, and application simplicity means compared using the ANOVA test (
p
< 0.05).
Results
Fifty-one Spanish training naval officers, aged 20 or 21, perceived high sea workshop content’s usefulness, adequacy, and safety level at 8.6/10, 8.7/10, and 7.5/10, respectively. As for application simplicity, CAT and SAM-XT were rated equally with a mean of 8.5, followed by SWAT (7.9) and RATS (6.9), this one statistically different from the rest (
p
< 0.01). Windlass types were preferred by 94%.
Conclusions
The training sail ship’s extremity bleeding control workshop was perceived as useful and its content adequate by the participating midshipmen. Windlass types were regarded as easier to apply than elastic counterparts. They were also preferred by nine out of every ten participants.
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EMUNI, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Thymus L. is of great interest in horticulture as ornamentals, spices, and medicinal plants, as well as in the extracts industry due to the richness in bioactive specialized metabolites. The natural ...hybrid T. × josephi-angeli Mansanet & Aguil. is produced in Spain, as its horticultural forms are very popular for domestic uses and gardening. However, its micropropagation and chemical composition have not been studied yet. Therefore, the main objective of this work was to develop a micropropagation procedure for T. × josephi-angeli, and to check whether the in vitro culture had an impact on the chemical profile of the plants. The results showed a high initiation rate (>91%) after two sterilization treatments were applied. Moreover, a micropropagation rate of around 21 new rooted explants per culture cycle was obtained in treatment M7 (Murashige and Skoog with 0.064 µM 6-(γ,γ-Dimethylallylamino)purine) when compared to the other 10 treatments performed. Acclimatization was successful in all three approaches tested (>75%), and all plants kept growing after 4 months of outdoor cultivation. Finally, 36 volatiles were identified, and the content of major compounds remained not statistically different in acclimatized plants when compared to the wild-type plants according to the analyses made by HS-SPME-GC/MS and SPME-GC/MS. This chemical stability points out the uniformity of the microplants and the suitability of the procedure applied in this study for T.×josephi-angeli horticultural production using in vitro techniques.
This paper deals with the study of the kinetic migration of a series of organic compounds representative of potential contaminants in packaging materials and used as surrogates (o-xylene, ...acetophenone, dodecane, naphthalene, 2,3,4-trichloroanisole, benzophenone, isomeric mix of diisopropylnaphthalene, diisobutyl phthalate and methyl stearate). Migration to one side of a solid simulant, Tenax®, also referred to as MPPO (modified polyphenylene oxide), was investigated in this study. One spiked sample of multilayer material was used to optimise the extraction procedures for the multilayer paper-based material and the Tenax as well as to perform kinetic migration studies. Three sequential extractions using ethanol were necessary for the strips of the multilayer material but only one extraction was necessary for the solid simulant to obtain >70% recovery of the surrogates. These results enabled us to specify the extraction requirements of the multilayer sample and the solid simulant and as well as those of the migration tests at high temperature using Tenax as solid simulant. The matrix effect associated with the extraction of the contaminants from the multilayer sample is also discussed.
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DOBA, EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, IZUM, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UILJ, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Bearberry (Arctostaphylos uva-ursi) is a medicinal plant traditionally employed for the treatment of urinary tract infections due to high contents of arbutin (hydroquinone β-D-glucoside), which is ...now mainly used as a natural skin-whitening agent in cosmetics. Bearberry has also been proposed as a natural antioxidant additive due to the high contents of phenolic compounds in leaves. We studied the variation on phenolic compounds in 42 wild populations of bearberry, aiming to elucidate if intrinsic biological, climatic, and/or geographic factors affect phenolic contents across its natural distribution in the Iberian Peninsula. Bearberry leaves were collected during autumn over a three-year period (2014–2016) in populations across a latitude and altitude gradient. Methanolic extracts showed a wide range of variation in total phenols content, and different phenolic profiles regarding arbutin (levels of this major constituent varied from 87 to 232 mg/g dr wt), but also catechin and myricetin contents, which were affected by geographic and climatic factors. Moderate levels of variation on genome size—assessed by flow cytometry—and on two plastid DNA regions were also detected among populations. Genetic and cytogenetic differentiation of populations was weakly but significantly associated to phytochemical diversity. Elite bearberry genotypes with higher antioxidant capacity were subsequently identified.
One-hundred and seven different volatile compounds were identified in the samples of Arctostaphylos uva-ursi collected from nine locations in Spain. This plant is commonly brewed and used as tea. ...Volatile compounds profile was detected using solid-phase microextraction gas chromatography-mass spectrometry. The most interesting compounds detected from an antioxidant capacity point of view were esters, phenols, and aromatics compounds. All samples were discriminated by principal component analysis. The insolation and altitude of harvest areas, and latent structures were considered for interpretation of results. Discriminant analysis was applied to control the type and concentration of metabolites and determine the best plant antioxidant profiles of volatile compounds from plant origin. Moreover, a heatmap displayed correlations between detected compounds. The discriminant analysis led to 20 quality markers being identified for the analysed plants. The strongest antioxidant capacity was obtained in the samples from Pina de Montalgrao and Loarre (collected in September) for ORAC (33.11 ± 0.61 g Trolox/g sample) and DPPH (IC50 = 711 ± 12 µg/g) methods, respectively. The plant with the highest total phenolic content was Loarre collected in September (171.9 ± 19.4 mg GAE/g DW) and November (177.1 ± 11.0 mg GAE/g DW).
The presence of antinuclear antibodies (ANA) is associated with a wide range of ANA-associated autoimmune rheumatic diseases (AARD). The most commonly method used for the detection of ANA is indirect ...immunofluorescence (IIF) on HEp-2 cells. This method is very sensitive but unspecific. As a consequence, ANA testing on HEp-2 substrates outside a proper clinical specialist framework may lead to inappropriate referrals to tertiary care specialists and, worst case inappropriate and potentially toxic therapy for the patient. Among ANA, isolated anti-DFS70 antibodies represent a potentially important biomarker that can be clinically used to discriminate AARD from non-AARD patients in ANA IIF positive individuals. Therefore, their presence may avoid unnecessary follow-up testing and referrals. In our study, we investigated if the implementation of a new ANA workup algorithm allowing for the identification of anti-DFS70 antibodies is cost-effective through the reduction of both unnecessary follow-up testing and outpatient clinic visits generated by the clinical suspicion of a potential AARD. None of the 181 patients included with a positive monospecific anti-DFS70 antibody result developed SARD during the follow-up period of 10 years. The reduction in number of tests after ANA and anti-DFS70 positive results was significant for anti-ENA (230 vs. 114 tests; p < 0.001) and anti-dsDNA antibodies (448 vs. 114 tests; p < 0.001). In addition, the outpatient clinic visits decreased by 70 % (p < 0.001). In total, the adoption of the new algorithm including anti-DFS70 antibody testing resulted in a cost saving of 60869.53 € for this pilot study. In conclusion, the use of anti-DFS70 antibodies was clearly cost-efficient in our setting.
HSP90 proteins are chaperones that play a pivotal role in controlling multiple regulatory pathways such as stress defense, hormone signalling, cell cycle control, cell proliferation and ...differentiation, and apoptosis. In this study, two cDNAs encoding for cytosolic HSP90, referred to as
HSP90AA and
HSP90AB, have been sequenced. Main features and sequence identities with other fish and mammals are described. Phylogenetic analysis grouped both genes into two separate clusters with their fish and mammalian counterparts. Expression profiles during larval development and in juvenile tissues were analyzed using a real-time PCR approach. In juvenile fish,
HSP90AB was constitutively expressed with lower transcript levels in skeletal muscle. In contrast,
HSP90AA was mainly expressed in heart, skeletal muscle and skin. During metamorphosis,
HSP90AB mRNA levels did not change whereas
HSP90AA transcripts decreased significantly at the beginning of metamorphosis with the lowest mRNA levels at the metamorphosis climax. Due to the role of thyroid hormones (THs) on sole metamorphosis, the transcriptional regulation of
HSP90 genes by THs was evaluated. Larvae exposed to the goitrogen thiourea (TU) exhibited higher
HSP90AA mRNA levels than untreated control. Moreover, adding exogenous T4 hormone to TU-treated larvae restored the steady-state levels with respect to the untreated control. Unlike
HSP90AA, the transcript levels of
HSP90AB did not vary under any treatments. The response of both
HSP90 genes to thermal stress in post-metamorphic individuals was also studied. A heat shock treatment (+
7.9 °C for 1 h) rapidly activated
HSP90AA (but not
HSP90AB) transcription, reaching a peak after 30 min and declining expression levels progressively in the following 24 h. No significant changes in
HSP90AA or
HSP90AB transcript levels after a cold shock (−
10 °C for 1 h) were observed. Overall, these results demonstrate that
HSP90AA transcription is down-regulated by THs and up-regulated after a heat shock in Senegalese sole.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
The definition of anti-HLA antibody profile in highly sensitized patients on a waiting list is crucial when virtual crossmatch is used in organ allocation systems, but also when used to identify the ...true deleterious anti-HLA antibodies. Here we propose different levels of risk based on the results of anti-HLA antibody testing in neat serum (N) and after sera dilution (DIL) and C1q test in 18 highly sensitized patients. This group was heterogeneous in terms of anti-HLA antibody titers and their ability to fix complement. After dilution, 15 out of 18 patients (83.3%) showed a reduction of positive bead counts whereas 4 patients showed a prozone effect and complement fixation was demonstrated. The high dilution of sera and ascertaining the complement fixation allow the accurate definition of risk anti-HLA antibody profiles in highly sensitized patients, as demonstrated in 5 of the sensitized patients who were transplanted.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Like other flatfishes, the Senegalese sole exhibits sexual growth dimorphism in favor of females and thus all-female stocks would be desirable. However, reproduction-associated problems persist and ...basic aspects of its biology such as sex determination and differentiation are still unknown. In this study, we histologically examined the process of gonadal sex differentiation in the Senegalese sole and tested the effects of treatment with sex steroids and an aromatase inhibitor on sex ratios. Sex differentiation in females started before 98days post fertilization (dpf), when fish had an average total length (TL) of ~33mm. In contrast, males began sex differentiation by 127dpf with a mean TL of ~44mm. At this time, an incipient growth advantage in favor of females was already observed. All fish were sexually differentiated by ~48mm TL (~170dpf). Treatment between 98 and 169 dpf with the synthetic androgen 17α-methyldihydrotestosterone (10mg/kg) or the aromatase inhibitor fadrozole (100mg/kg) significantly increased the proportion of males up to ~95% while the natural estrogen, estradiol-17β (10mg/kg), increased the proportion of females by about 50% but reduced growth with respect to the control values. Together, these results show that the Senegalese sole is a differentiated gonochoristic species in which gonads start to form within the first three months and sex differentiation is completed after animals reach their fifth month of age, with females differentiating earlier than males. Results also indicate that the labile period starts at <98dpf and lasts until ~125dpf. These results show that sex control can be achieved in the Senegalese sole, an important step towards the establishment of all-female stocks to improve the currently compromised production of this economically important species.
► The Senegalese sole is a highly prized fish with reproduction-associated problems. ► This species is a differentiated gonochoristic. ► Sex differentiation is completed after animals reach their fifth month of age. ► Sex differentiation can be manipulated during the first 4 months of age. ► Masculinization by fadrozole is more physiological than with synthetic androgen.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Induction therapy with rabbit antithymocyte globulin is frequently used in kidney transplant recipients and contributes to regulating the humoral alloantibody response. However, the effect of rabbit ...antithymocyte globulin on B-cell subpopulations, including plasma cells, has not been previously studied in humans in vivo.
We prospectively studied a cohort of 39 adult kidney transplant recipients. Twenty patients received rabbit antithymocyte globulin as induction therapy. Peripheral blood samples were obtained pretransplant and at 6 and 12 months posttransplant. T and B cells were acquired by flow cytometry.
Total lymphocytes and CD3 and CD4 cells significantly decreased at 6 and 12 months only in patients who received rabbit antithymocyte globulin. In contrast, the CD19 population did not change after rabbit antithymocyte globulin induction. One-year circulating plasma cells remained significantly lower than pretransplant levels in patients who received rabbit antithymocyte globulin. We observed sig-nificant differences in plasma cell numbers at 12 months after transplant between patients who received rabbit antithymocyte globulin and those patients who did not receive it (median of 5 and interquartile range of 3-17 vs median of 25 and interquartile range of 12-35; P = .001).
Rabbit antithymocyte globulin induction leads to a late reduction in the number of circulating plasma cells at 1 year after kidney transplant. This effect can contribute to down-regulation of the humoral alloantibody response.
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