Goal-directed fluid therapy has been shown to improve outcomes after colorectal surgery, but the optimal type of i.v. fluid to use is yet to be established. Theoretical advantages of using ...hydroxyethyl starch (HES) for goal-directed therapy include a reduction in the total volume of fluid required, resulting in less tissue oedema. Recent work has demonstrated that new generations of HES have a good safety profile, but their routine use in the perioperative setting has not been demonstrated to confer outcome benefit.
We randomly assigned 202 medium to high-risk patients undergoing elective colorectal surgery to receive either balanced 6% HES (130/0.4, Volulyte) or balanced crystalloid (Hartmann’s solution) as haemodynamic optimization fluid. The primary outcome measure was the incidence of gastrointestinal (GI) morbidity on postoperative day 5. Secondary outcome measures included the incidence of postoperative complications, hospital length of stay, and the effect of trial fluids on coagulation and inflammation.
No difference was seen in the number of patients who suffered GI morbidity on postoperative day 5 30% in the HES group vs 32% in the crystalloid group; adjusted odds ratio=0.96 (0.52–1.77). Subjects in the crystalloid group received more fluid median (inter-quartile ranges) 3175 (2000–3700) vs 1875 (1500–3000) ml, P<0.001 and had a higher 24 h fluid balance +4226 (3251–5779) vs +3610 (2443–4519) ml, P<0.001. No difference in the incidence of postoperative complications was seen between the groups.
Goal-directed fluid therapy is possible with either crystalloid or HES. There is no evidence of a benefit in using HES over crystalloid, despite its use resulting in a lower 24 h fluid balance.
ISRCTN41882213 and EudraCT-2009-013872-29.
Animal Migration Milner-Gulland, E. J; Fryxell, John M; Sinclair, Anthony R. E
01/2011
eBook
This book takes a comparative, integrated view of migration, linking evolution with ecology and management, theory with empirical research, and embracing all the major migratory taxa (including ...humans). The scope extends beyond the target organism to consider the ecosystem-level dynamics of migration. Rather than simply reviewing the field of migration as it stands today, the book highlights the lacunae in our knowledge and understanding. The emphasis is on exciting new research avenues that are now opening up, whether because of advances in our understanding of migration as a biological phenomenon or through the availability of a range of new technologies. Broad themes that emerge include smoothly integrating migration into the broad spectrum of movement behaviour; the need for a comparative and cross-taxonomic approach that considers migration at a range of temporal and spatial scales; and examination of the key roles of resource uncertainty and spatial heterogeneity in driving migratory behaviour. The chapters identify the potential for new tools to revolutionise the study of migration, including satellite-tracking technology, genomics and modelling – all of which are linked to increasing computing power. There is a current dearth of hypothesis-driven studies that fully integrate theory and empirical analyses, and a taxonomic bias towards birds in much migration research; both of these issues need to be resolved if we are to progress. We are on the verge of a breakthrough in migration research, which is crucial given the multiple threats that face the conservation of migration as a phenomenon, including climate change.
Approximately 80% of the ~1.5 million bovine embryos transferred in 2021 were in vitro produced. However, only ~27% of the transferred IVP embryos will result in live births. The ~73% pregnancy ...failures are partly due to transferring poor-quality embryos, a result of erroneous stereomicroscopy-based morphological evaluation, the current method of choice for pre-transfer embryo evaluation. Numerous microscopic (e.g., differential interference contrast, electron, fluorescent, time-lapse, and artificial-intelligence-based microscopy) and non-microscopic (e.g., genomics, transcriptomics, epigenomics, proteomics, metabolomics, and nuclear magnetic resonance) methodologies have been tested to find an embryo evaluation technique that is superior to morphologic evaluation. Many of these research tools can accurately determine embryo quality/viability; however, most are invasive, expensive, laborious, technically sophisticated, and/or time-consuming, making them futile in the context of
embryo evaluation. However accurate they may be, using complex methods, such as RNA sequencing, SNP chips, mass spectrometry, and multiphoton microscopy, at thousands of embryo production/collection facilities is impractical. Therefore, future research is warranted to innovate
, simple
using findings already available, particularly from omics-based research methodologies. Time-lapse monitoring and artificial-intelligence-based automated image analysis also have the potential for accurate embryo evaluation; however, further research is warranted to innovate economically feasible options for
applications.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Abstract
Introduction
Dramatic improvements in blood transfusion have occurred during the last two decades. Transfusion medicine services and practices in Africa remain underexplored.
Methods
A ...survey of blood bank/transfusion medicine (BBTM) practices, available blood products, blood product source(s), pre‐transfusion testing, and blood donor infectious disease testing methodologies across Africa was performed using the American Society for Clinical Pathology (ASCP) listserv. Survey recipients included hospital‐based laboratories/blood banks, national transfusion medicine services, and free‐standing laboratories (collectively referred to as institutions).
Results
Responses from a total of 81 institutions across 22 countries were analyzed. All 81 institutions provide at least one type of blood product—whole blood, red blood cells (RBCs), platelets, plasma, and cryoprecipitate, with whole blood (90.1%, 73 of 81) and RBCs (79.0%, 64 of 81) most common, while cryoprecipitate is least common (12.4%, 10 of 81). Only five countries had a responding institution that provides all types of products. Among institutions that collect blood onsite, the most common sources of blood products are patients' family members (94.1%, 48 of 51) and pre‐screened on‐demand volunteer donors (82.4%, 42 of 51). The most commonly screened infectious agents are HIV and hepatitis B virus (both 81.5%), while 70.4% (57 of 81) test for hepatitis C virus (HCV) and
Treponema pallidum
.
Discussion
This study highlights significant variability and restrictions in blood product availability, pre‐transfusion testing, and blood donor infectious disease testing across Africa. Further studies are needed to ascertain barriers to improving blood donor availability, blood product safety, and infectious disease testing.
The Cretaceous-Tertiary biotic transition Macleod, N; Rawson, P. F; Forey, P. L ...
Journal of the Geological Society,
03/1997, Letnik:
154, Številka:
2
Journal Article
Recenzirano
Mass extinctions are recognized through the study of fossil groups across event horizons, and from analyses of long-term trends in taxonomic richness and diversity. Both approaches have inherent ...flaws, and data that once seemed reliable can be readily superseded by the discovery of new fossils and/or the application of new analytical techniques. Herein the current state of the Cretaceous-Tertiary (K-T) biostratigraphical record is reviewed for most major fossil clades, including: calcareous nannoplankton, dinoflagellates, diatoms, radiolaria, foraminifera, ostracodes, scleractinian corals, bryozoans, brachio-pods, molluscs, echinoderms, fish, amphibians, reptiles and terrestrial plants (macrofossils and palynomorphs). These reviews take account of possible biasing factors in the fossil record in order to extract the most comprehensive picture of the K-T biotic crisis available. Results suggest that many faunal and floral groups (ostracodes, bryozoa, ammonite cephalopods, bivalves, archosaurs) were in decline throughout the latest Maastrichtian while others (diatoms, radiolaria, benthic foraminifera, brachiopods, gastropods, fish, amphibians, lepidosaurs, terrestrial plants) passed through the K-T event horizon with only minor taxonomic richness and/or diversity changes. A few microfossil groups (calcareous nannoplankton, dinoflagellates, planktonic foraminifera) did experience a turnover of varying magnitudes in the latest Maastrichtian-earliest Danian. However, many of these turnovers, along with changes in ecological dominance patterns among benthic foraminifera, began in the latest Maastrichtian. Improved taxonomic estimates of the overall pattern and magnitude of the K-T extinction event must await the development of more reliable systematic and phylogenetic data for all Upper Cretaceous clades.
Estimating population size is central to species-oriented conservation and management. However, in spite of recent development in monitoring protocols, there are gaps in our ability to accurately and ...quickly estimate numbers of individuals present, especially for the cryptic and often non-breeding components of structured vertebrate populations. Yet knowing the size and growth trajectory of all stage classes of a population is critical for species conservation. Here we use data from 2 years of non-invasive genetic sample collection from the cryptic, non-breeding component of an endangered bird of prey population to evaluate the impact of variability in population estimates on demographic models that underpin conservation efforts. A single non-invasive sample collection in 2003 conclusively identified 47 individual non-breeding imperial eagles, 2.8 times more than were visually counted. In 2004, our comprehensive genetic and observational analyses determined that 414 imperial eagles (n=308 non-breeders+68 territory holders+38 chicks) were present. This estimate was 326% larger than the 127 birds visually observed (n=21 non-breeders+68 territory holders+38 chicks) and 265% larger than the population size predicted by demographic models with the same number of breeders (n=156±7.2;±se). Our study builds on a body of work that demonstrates that conventional visual estimation of cryptic components of structured populations may not always be effective. Furthermore, we show that reliance on those estimates can result in inaccuracies in the demographic models that are often the foundation for subsequent conservation action.
The bimodal NW Etendeka province is located at the continental end of the Tristan plume trace in coastal Namibia. It comprises a high-Ti (Khumib type) and three low-Ti basalt (Tafelberg, Kuidas and ...Esmeralda types) suites, with, at stratigraphically higher level, interstratified high-Ti latites (three units) and quartz latites (five units), and one low-Ti quartz latite. Khumib basalts are enriched in high field strength elements and light rare earth elements relative to low-Ti types and exhibit trace element affinities with Tristan da Cunha lavas. The unradiogenic 206Pb/204Pb ratios of Khumib basalts are distinctive, most plotting to the left of the 132 Ma Geochron, together with elevated 207Pb/204Pb ratios, and Sr–Nd isotopic compositions plotting in the lower 143Nd/144Nd part of mantle array (EM1-like). The low-Ti basalts have less coherent trace element patterns and variable, radiogenic initial Sr (∼0·707–0·717) and Pb isotope compositions, implying crustal contamination. Four samples, however, have less radiogenic Pb and Sr that we suggest approximate their uncontaminated source. All basalt types, but particularly the low-Ti types, contain samples with trace element characteristics (e.g. Nb/Nb*) suggesting metasediment input, considered source-related. Radiogenic isotope compositions of these samples require long-term isolation of the source in the mantle and depletions (relative to unmodified sediment) in certain elements (e.g. Cs, Pb, U), which are possibly subduction-related. A geodynamic model is proposed in which the emerging Tristan plume entrained subducted material in the Transition Zone region, and further entrained asthenosphere during plume head expansion. Mixing calculations suggest that the main features of the Etendeka basalt types can be explained without sub-continental lithospheric mantle input. Crustal contamination is evident in most low-Ti basalts, but is distinct from the incorporation of a metasedimentary source component at mantle depths.
ABSTRACT
We present results from a multi-chord Pluto stellar occultation observed on 2015 June 29 from New Zealand and Australia. This occurred only two weeks before the NASA New Horizons flyby of ...the Pluto system and serves as a useful comparison between ground-based and space results. We find that Pluto's atmosphere is still expanding, with a significant pressure increase of 5 ± 2% since 2013 and a factor of almost three since 1988. This trend rules out, as of today, an atmospheric collapse associated with Pluto's recession from the Sun. A central flash, a rare occurrence, was observed from several sites in New Zealand. The flash shape and amplitude are compatible with a spherical and transparent atmospheric layer of roughly 3 km in thickness whose base lies at about 4 km above Pluto's surface, and where an average thermal gradient of about 5 K km
−1
prevails. We discuss the possibility that small departures between the observed and modeled flash are caused by local topographic features (mountains) along Pluto's limb that block the stellar light. Finally, using two possible temperature profiles, and extrapolating our pressure profile from our deepest accessible level down to the surface, we obtain a possible range of 11.9–13.7
μ
bar for the surface pressure.
Reports back on how urethral sphincter mechanism incompetence (USMI) can be corrected by hydraulic artificial urethral sphincter (HAUS) placement and the long term outcomes of this treatment. Details ...the aims, results and conclusions of the study. Source: National Library of New Zealand Te Puna Matauranga o Aotearoa, licensed by the Department of Internal Affairs for re-use under the Creative Commons Attribution 3.0 New Zealand Licence.
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