This study reviews published information on
Mugil cephalus
from around the world, with recent genetic studies indicating that the flathead mullet may indeed be a species complex. Disciplines that are ...covered range from the taxonomy, genetics and systematics, through a variety of biological and ecological attributes, to biomarker and fisheries studies. The eurytopic nature of
M. cephalus
is emphasized, with the migratory life history covering a succession of very different aquatic environments (e.g. rivers, estuaries, coastal lakes/lagoons, marine littoral, open ocean), each of which is occupied for varying lengths of time, depending on the population characteristics within a region and the life-history stage of the species. Interpretation of these movements over time has been greatly enhanced by the use of otolith micro-chemistry which has enabled scientists to map out the different habitats occupied by individual fish at the different life stages. The range of physico-chemical attributes within these environments necessitates a wide tolerance to differing conditions, especially with regard to salinity, turbidity, dissolved oxygen and temperature, all of which are discussed in this review. The importance of
M. cephalus
to the ecological functioning of coastal systems is emphasized, as well as the pivotal role that this species fulfills in fisheries in some parts of the world. The parasites range from internal trematode and cestode infestations, to external branchyuran and copepod parasites, which use
M. cephalus
as either an intermediate or final host. The value of the flathead mullet as a biomarker for the monitoring of the health of coastal habitats is discussed, as well as its potential as an indicator or sentinel species for certain ecosystems.
Introduction
The Jackson Hospital Crisis (Psychiatric ED) Center serves the entirety of Miami-Dade County in Florida and is considered one of the top three busiest and per capita of clinical staff ...likely the busiest nationally across the United States. Simultaneously, the management of mental health emergencies has ascended near the top of international priorities driven by multiple trends (e.g., growing social isolation associated with the pandemic, de-stigmatization). The crisis environment presents a uniquely difficult challenge in applying high quality medical care: frequent suicidal gestures, impulsive often intoxicated or psychotic patients, unprecedented demand, diminishing staff capacity, and requirements to consistently apply specific medical and psychiatric protocols. These challenges are specifically difficult for new trainees who are not yet accustoms to the high acuity situations found in psychiatry. Moreover, academic, institutional, and governmental policies change on a monthly, or even weekly basis, often with the objective of improving care. Nevertheless, such constant shifts in workflow result in opportunities for errors that impact patient trajectories.
Objectives
As such we endeavored to apply an evidence-based approach to improving the likelihood of success. One such vetted approach, the use of checklists, benefits from 10+ years of peer-reviewed research in “operational” medical specialties (e.g., surgery, ED, ICU) where work is segmented around interventions or time-shifts which share commonalities with the Psychiatric ED model. Yet the difficulty in implementing such models is typically not in the “hard” aspects of defining the checklist, but in the “soft” implementation dimensions of syndication, distribution, and enablement in the context of the individual unique settings.
Methods
We developed a checklist that will be implemented on the Jackson Crisis emergency department, with the aim of having first year trainees complete the check list on each individual patient. Surveys were administered before implementation of checklist and will be distributed on a quarterly basis to trainees to evaluate for changes in resident confidence and clinical care.
Results
Over six months, we launched this initiative with drivers of adoption focused on accelerating and easing new resident training, safety incident targeting, and in the balancing of “push” top/down and “pull” bottom/up dynamics. Initial learnings include rapidly improving resident satisfaction as well as various other impacts currently being observed throughout the institution.
Conclusions
Overall reception to the checklist has been positive from attendings and new trainees alike, further evidence will be analyzed and presented as the checklist is utilized throughout the psychiatric ED.
Disclosure of Interest
None Declared
This study aimed to determine the effect of lipopolysaccharide (LPS)-induced mastitis with or without nonsteroidal anti-inflammatory drug (NSAID) on dairy cows' clinical, physiological, and ...behavioral responses in the milking parlor and freestalls as well as the specificity (Sp) and sensitivity (Se) of behavioral responses in detecting cows with LPS-induced mastitis. Twenty-seven cows received an intramammary infusion of 25 µg of Escherichia coli LPS in 1 healthy quarter. Following LPS infusion, 14 cows received a placebo (LPS cows), and 13 cows received 3 mg/kg of body weight of ketoprofen i.m. (LPS+NSAID cows). Cow response to the challenge was monitored at regular intervals from 24 h before to 48 h postinfusion (hpi) through direct clinical observations, markers of inflammation in milk, and via point-in-time direct behavioral observations in the barn and at milking. In LPS cows, infusion induced a significant increase of plasma cortisol levels at 3 and 8 hpi, milk cortisol levels at 8 hpi, somatic cell counts from 8 to 48 hpi, IL-6 and IL-8 at 8 hpi, milk amyloid A (mAA) and haptoglobin at 8 and 24 hpi, rectal temperature at 8 hpi, and respiratory rate at 8 hpi. Their rumen motility rate decreased at 8 and 32 hpi. Compared with before the challenge, significantly more LPS cows stopped feeding/ruminating and pressed their tail between their legs at 3 and 5 hpi, increased feeding/ruminating at 24 hpi, and had the tendency to be less responsive, dropping their head, and dropping their ears at 5 hpi. At milking, compared with before challenge, significantly more LPS cows lifted their hooves at forestripping at 8 hpi. The 2 groups showed similar patterns of response for milk cortisol, somatic cell count, respiratory rate, mAA, haptoglobin, and IL-6, IL-1β, and IL-8. Compared with LPS cows, LPS+NSAID cows had significantly lower plasma cortisol levels at 3 hpi, their rectal temperature decreased at 8 hpi, their rumen motility rate increased at 8 and 32 hpi, and their heart rate increased at 32 hpi. Compared with LPS cows, a significantly larger proportion of LPS+NSAID cows were feeding/ruminating, a lower proportion had ears down at 5 hpi, and a larger proportion lied down at 24 hpi. At milking, whatever the phase of milking, for “hoof to belly,” 9 out of 14 cows did not show this behavior before infusion (Sp = 64%) and 14/14 did not kick during pre-infusion milking (Sp = 100%). Regarding sensitivity, at maximum, 5 cows out of 14 (Se = 36%) displayed “hoof to belly” after infusion. For “lifting hoof,” 14/14 did not show hoof-lifting before infusion (Sp = 100%) and 6/14 displayed it after infusion (Se = 43%) at forestripping only. In the freestall barn, 9 behaviors had a Sp >75% (at minimum, 10/14 did not show the behavior) whatever the time point but Se < 60% (at maximum, 8/14 displayed the behavior). Finally, “absence of feeding and ruminating” had Sp of 86% (12/14 ate/ruminated) and Se of 71% (10/14 did not eat/ruminate) at 5 hpi. This study shows that feeding/ruminating, tail position, and reactivity at forestripping could be used as behavioral indictors for early detection of mastitis-related pain in dairy cows.
Background and Purpose
Single‐prolonged stress (SPS), a rat model of post‐traumatic stress disorder (PTSD), also induces long‐lasting hyperalgesia associated with hypocortisolism and elevated ...nociceptin/orphanin FQ (N/OFQ) levels in serum and CSF. Here, we determined the effect of JTC‐801 (N‐(4‐amino‐2‐methylquinolin‐6‐yl)‐2‐(4‐ethylphenoxymethyl) benzamide monohydrochloride), a nociceptin/orphanin FQ peptide (NOP) receptor antagonist, on symptoms of pain and anxiety in rats after SPS exposure, and examined N/OFQ‐NOP receptor system changes.
Experimental Approach
Male Sprague Dawley rats received JTC‐801 (6 mg kg−1 i.p., once daily) during days 7–21 of SPS. The ability of JTC‐801 to inhibit N/OFQ‐stimulated 35S‐GTPγS binding was confirmed in rat brain membranes. Anxiety‐like behaviour and pain sensitivity were monitored by changes in elevated plus maze performance and withdrawal responses to thermal and mechanical stimuli. Serum corticosterone and N/OFQ content in CSF, serum and brain tissues were determined by radioimmunoassay; NOP receptor protein and gene expression in amygdala, hippocampus and periaqueductal grey (PAG) were examined by immunoblotting and real‐time PCR respectively.
Key Results
JTC‐801 treatment reversed SPS‐induced mechanical allodynia, thermal hyperalgesia, anxiety‐like behaviour and hypocortisolism. Elevated N/OFQ levels in serum, CSF, PAG and hippocampus at day 21 of SPS were blocked by JTC‐801; daily JTC‐801 treatment also reversed NOP receptor protein and mRNA up‐regulation in amygdala and PAG.
Conclusion and Implications
JTC‐801 reversed SPS‐induced anxiety‐ and pain‐like behaviours, and NOP receptor system up‐regulation. These findings suggest that N/OFQ plays an important role in hyperalgesia and allodynia maintenance after SPS. NOP receptor antagonists may provide effective treatment for co‐morbid PTSD and pain.
Linked Articles
This article is part of a themed section on Opioids: New Pathways to Functional Selectivity. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2015.172.issue-2
► Implemented a novel support vector machine assembly epileptic seizure detector. ► Demonstrated easy patient specific tuning with the detector. ► Demonstrated superior tuning performance versus ...threshold tuning. ► Achieved the highest total accuracy within published results on the same dataset.
Automating the detection of epileptic seizures could reduce the significant human resources necessary for the care of patients suffering from intractable epilepsy and offer improved solutions for closed-loop therapeutic devices such as implantable electrical stimulation systems. While numerous detection algorithms have been published, an effective detector in the clinical setting remains elusive. There are significant challenges facing seizure detection algorithms. The epilepsy EEG morphology can vary widely among the patient population. EEG recordings from the same patient can change over time. EEG recordings can be contaminated with artifacts that often resemble epileptic seizure activity. In order for an epileptic seizure detector to be successful, it must be able to adapt to these different challenges. In this study, a novel detector is proposed based on a support vector machine assembly classifier (SVMA). The SVMA consists of a group of SVMs each trained with a different set of weights between the seizure and non-seizure data and the user can selectively control the output of the SVMA classifier. The algorithm can improve the detection performance compared to traditional methods by providing an effective tuning strategy for specific patients. The proposed algorithm also demonstrates a clear advantage over threshold tuning. When compared with the detection performances reported by other studies using the publicly available epilepsy dataset hosted by the University of BONN, the proposed SVMA detector achieved the best total accuracy of 98.72%. These results demonstrate the efficacy of the proposed SVMA detector and its potential in the clinical setting.
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