Aetiologies of pulseless electrical activity in out-of-hospital cardiac arrests:A retrospective study and analysis of specific causes

Background: Pulseless electrical activity (PEA) cardiac arrest is defined as a cardiac arrest (CA) presenting with a residual organized electrical activity on the electrocardiogram. In the last decades, the incidence of PEA has regularly increased, compared to other types of CA like ventricular fibrillation or pulseless ventricular tachycardia. PEA is frequently induced by reversible conditions. The "4 (or 5) H" & "4 (or 5) T" are proposed as a mnemonic to asses for Hypoxia, Hypovolemia, Hypo- /Hyperkalaemia, Hypothermia, Thrombosis (cardiac or pulmonary), cardiac Tamponade, Toxins, and Tension pneumothorax. Other pathologies (intracranial haemorrhage, severe sepsis, myocardial contraction dysfunction) have been identified as potential causes for PEA, but their respective probability and frequencies are unclear and they are not yet included into the resuscitation guidelines. The aim of this study was to analyse the aetiologies of PEA out-of-hospital CA, in order to evaluate the relative frequencies of each cause and therefore to improve the management of patients suffering a PEA cardiac arrest. Method: This retrospective study was based on data routinely and prospectively collected for each PEMS intervention. All adult patients treated from January 1st 2002 to December 2012 31st by the PEMS for out-of-hospital cardiac arrest, with PEA as the first recorded rhythm, and admitted to the emergency department (ED) of the Lausanne University Hospital were included. The aetiologies of PEA cardiac arrest were classified into subgroups, based on the classical H&T's classification, supplemented by four other subgroups analysis: trauma, intra-cranial haemorrhage (ICH), non-ischemic cardiomyopathy (NIC) and undetermined cause. Results: 1866 OHCA were treated by the PEMS. PEA was the first recorded rhythm in 240 adult patients (13.8 %). After exclusion of 96 patients, 144 patients with a PEA cardiac arrest admitted to the ED were included in the analysis. The mean age was 63.8 ± 20.0 years, 58.3% were men and the survival rate at 48 hours was 29%. 32 different causes of OHCA PEA were established for 119 patients. For 25 patients (17.4 %), we were unable to attribute a specific cause for the PEA cardiac arrest. Hypoxia (23.6 %), acute coronary syndrome (12.5%) and trauma (12.5 %) were the three most frequent causes. Pulmonary embolism, Hypovolemia, Intoxication and Hyperkaliemia occurs in less than 10% of the cases (7.6 %, 5.6 %, 3.5%, respectively 2.1 %). Non ischemic cardiomyopathy and intra-cranial haemorrhage occur in 8.3 % and 6.9 %, respectively. Conclusions: According to our results, intra-cranial haemorrhage and non-ischemic cardiomyopathy represent noticeable causes of PEA in OHCA, with a prevalence equalling or exceeding the frequency of classical 4 H's and 4 T's aetiologies. These two pathologies are potentially accessible to simple diagnostic procedures (native CT-scan or echocardiography) and should be included into the 4 H's and 4 T's mnemonic.

Trace me if you can: the use of intrinsic biogeochemical markers in marine top predators

Human activities have serious impacts on marine apex predators. Inadequate knowledge of the spatial and trophic ecology of these marine animals ultimately compromises the viability of their populations and impedes our ability to use them as environmental biomonitors. Intrinsic biogeochemical markers, such as stable isotopes, fatty acids, trace elements, and chemical pollutants, are increasingly being used to trace the spatial and trophic ecology of marine top predators. Notable advances include the emergence of the first oceanographic"isoscapes" (isotopic geographic gradients), the advent of compound-specific isotopic analyses, improvements in diet reconstruction through Bayesian statistics, and tissue analysis of tracked animals to ground-truth biogeochemical profiles. However, most researchers still focus on only a few tracers. Moreover, insufficient knowledge of the biogeochemical integration in tissues, fractionation and routing processes, and geographic and temporal variability in baseline levels continue to hamper the resolution and potential of these markers in studying the spatial and feeding ecology of top predators.

Longer and less overlapping food webs in anthropogenically disturbed marine ecosystems: confirmations from the past

The human exploitation of marine resources is characterised by the preferential removal of the largest species. Although this is expected to modify the structure of food webs, we have a relatively poor understanding of the potential consequences of such alteration. Here, we take advantage of a collection of ancient consumer tissues, using stable isotope analysis and SIBER to assess changes in the structure of coastal marine food webs in the South-western Atlantic through the second half of the Holocene as a result of the sequential exploitation of marine resources by hunter-gatherers, western sealers and modern fishermen. Samples were collected from shell middens and museums. Shells of both modern and archaeological intertidal herbivorous molluscs were used to reconstruct changes in the stable isotopic baseline, while modern and archaeological bones of the South American sea lion Otaria flavescens, South American fur seal Arctocephalus australis and Magellanic penguin Spheniscus magellanicus were used to analyse changes in the structure of the community of top predators. We found that ancient food webs were shorter, more redundant and more overlapping than current ones, both in northern-central Patagonia and southern Patagonia. These surprising results may be best explained by the huge impact of western sealing on pinnipeds during the fur trade period, rather than the impact of fishing on fish populations. As a consequence, the populations of pinnipeds at the end of the sealing period were likely well below the ecosystem's carrying capacity, which resulted in a release of intraspecific competition and a shift towards larger and higher trophic level prey. This in turn led to longer and less overlapping food webs.

Geographic patterns of genetic variation in a broadly distributed marine vertebrate: new insights into loggerhead turtle stock structure from expanded mitochondrial DNA sequences

Previous genetic studies have demonstrated that natal homing shapes the stock structure of marine turtle nesting populations. However, widespread sharing of common haplotypes based on short segments of the mitochondrial control region often limits resolution of the demographic connectivity of populations. Recent studies employing longer control region sequences to resolve haplotype sharing have focused on regional assessments of genetic structure and phylogeography. Here we synthesize available control region sequences for loggerhead turtles from the Mediterranean Sea, Atlantic, and western Indian Ocean basins. These data represent six of the nine globally significant regional management units (RMUs) for the species and include novel sequence data from Brazil, Cape Verde, South Africa and Oman. Genetic tests of differentiation among 42 rookeries represented by short sequences (380 bp haplotypes from 3,486 samples) and 40 rookeries represented by long sequences (~800 bp haplotypes from 3,434 samples) supported the distinction of the six RMUs analyzed as well as recognition of at least 18 demographically independent management units (MUs) with respect to female natal homing. A total of 59 haplotypes were resolved. These haplotypes belonged to two highly divergent global lineages, with haplogroup I represented primarily by CC-A1, CC-A4, and CC-A11 variants and haplogroup II represented by CC-A2 and derived variants. Geographic distribution patterns of haplogroup II haplotypes and the nested position of CC-A11.6 from Oman among the Atlantic haplotypes invoke recent colonization of the Indian Ocean from the Atlantic for both global lineages. The haplotypes we confirmed for western Indian Ocean RMUs allow reinterpretation of previous mixed stock analysis and further suggest that contemporary migratory connectivity between the Indian and Atlantic Oceans occurs on a broader scale than previously hypothesized. This study represents a valuable model for conducting comprehensive international cooperative data management and research in marine ecology.

Design of marine generators for alternative diesel-electric power systems

This study compares different electric propulsion systems. Results of the analysis of all the advantages and disadvantages of the different propulsion systems are given. This thesis estimates possibilities to apply different diesel-electric propulsion concepts for different vessel types. Small and medium size vessel’s power ranges are studied. The optimal delivery system is chosen. This choice is made on the base of detailed study of the concepts, electrical equipment market and comparison of mass, volume and efficiency parameters. In this thesis three marine generators are designed. They are: salient pole synchronous generator and two permanent magnet synchronous generators. Their electrical, dimensional, cost and efficiency parameters are compared. To understand all the benefits diagrams with these parameters are prepared. Possible benefits and money savings are estimated. As the result the advantages, disadvantages and boundary conditions for the permanent magnet synchronous generator application in marine electric-power systems are found out.

Interpreting marine benthic ecosystem functioning in coastal waters: validating the biological trait concept

Coastal areas harbour high biodiversity, but are simultaneously affected by rapid degradations of species and habitats due to human interactions. Such alterations also affect the functioning of the ecosystem, which is primarily governed by the characteristics or traits expressed by the organisms present. Marine benthic fauna is nvolved in numerous functions such as organic matter transformation and transport, secondary production, oxygen transport as well as nutrient cycling. Approaches utilising the variety of faunal traits to assess benthic community functioning have rapidly increased and shown the need for further development of the concept. In this thesis, I applied biological trait analysis that allows for assessments of a multitude of categorical traits and thus evaluation of multiple functional aspects simultaneously. I determined the functional trait structure, diversity and variability of coastal zoobenthic communities in the Baltic Sea. The measures were related to recruitment processes, habitat heterogeneity, large-scale environmental and taxonomic gradients as well as anthropogenic impacts. The studies comprised spatial scales from metres to thousands of kilometres, and temporal scales spanning one season as well as a decade. The benthic functional structure was found to vary within and between seagrass landscape microhabitats and four different habitats within a coastal bay, in papers I and II respectively. Expressions of trait categories varied within habitats, while the density of individuals was found to drive the functional differences between habitats. The findings in paper III unveiled high trait richness of Finnish coastal benthos (25 traits and 102 cateogries) although this differed between areas high and low in salinity and human pressure. In paper IV, the natural reduction in taxonomic richness across the Baltic Sea led to an overall reduction in function. However, functional richness in terms of number of trait categories remained comparatively high at low taxon richness. Changes in number of taxa within trait categories were also subtle and some individual categories were maintained or even increased. The temporal analysis in papers I and III highlighted generalities in trait expressions and dominant trait categories in a seagrass landscape as well as a “type organism” for the northern Baltic Sea. Some initial findings were made in all four papers on the role of common and rare species and traits for benthic community functioning. The findings show that common and rare species may not always express the same trait categories in relation to each other. Rare species in general did not express unique functional properties. In order to advance the understanding of the approach, I also assessed some issues concerning the limitations of the concept. This was conducted by evaluating the link between trait category and taxonomic richness using especially univariate measures. My results also show the need to collaborate nationally and internationally on safeguarding the utility of taxonomic and trait data. The findings also highlight the importance of including functional trait information into current efforts in marine spatial planning and biomonitoring.

Floristic composition and similarity analysis of an Atlantic rain forest fragment in Cananéia, São Paulo State, Brazil

The aim of this study is to investigate the floristic composition of an Atlantic rain forest fragment located in Cananéia, São Paulo, Brazil, and to contribute to the knowledge on Atlantic forest through the comparative analysis of this and other floristic surveys both on the southern and southeastern Brazil, in different soil and relief types. We surveyed 215 species in 132 genera and 51 families. Classification and ordination analysis were applied to a binary matrix in order to analyze the similarity among 24 surveys, including the present one, of Atlantic forest from the south and southeast coast of Brazil. Higher floristic similarity was observed among this area and the ones where there was marine influence and more rugged relief. The surveys in areas with greater marine influence (sandy soil) were separated from those in other conditions, possibly indicating a species replacement gradient from the steep slopes towards the lowland and were probably related to different edaphic conditions. A latitudinal gradient was found among the surveys apparently confirming a continuous species replacement along the Atlantic forest, related to a restricted distribution of the species. This suggests that it is essential to preserve areas from the whole Atlantic coast. Atlantic forest distribution is quite complex and its composition cannot be adequately represented by small localized areas.

Phylogenetic Analysis of Avidins and Expression of Novel Avidins from Lactrodectus hesperus and Hoeflea phototrophica

Avidins (Avds) are homotetrameric or homodimeric glycoproteins with typically less than 130 amino acid residues per monomer. They form a highly stable, non-covalent complex with biotin (vitamin H) with Kd = 10-15 M (for chicken Avd). The best-studied Avds are the chicken Avd from Gallus gallus and streptavidin from Streptomyces avidinii, although other Avd studies have also included Avds from various origins, e.g., from frogs, fishes, mushrooms and from many different bacteria. Several engineered Avds have been reported as well, e.g., dual-chain Avds (dcAvds) and single-chain Avds (scAvds), circular permutants with up to four simultaneously modifiable ligand-binding sites. These engineered Avds along with the many native Avds have potential to be used in various nanobiotechnological applications. In this study, we made a structure-based alignment representing all currently available sequences of Avds and studied the evolutionary relationship of Avds using phylogenetic analysis. First, we created an initial multiple sequence alignment of Avds using 42 closely related sequences, guided by the known Avd crystal structures. Next, we searched for non-redundant Avd sequences from various online databases, including National Centre for Biotechnology Information and the Universal Protein Resource; the identified sequences were added to the initial alignment to expand it to a final alignment of 242 Avd sequences. The MEGA software package was used to create distance matrices and a phylogenetic tree. Bootstrap reproducibility of the tree was poor at multiple nodes and may reflect on several possible issues with the data: the sequence length compared is relatively short and, whereas some positions are highly conserved and functional, others can vary without impinging on the structure or the function, so there are few informative sites; it may be that periods of rapid duplication have led to paralogs and that the differences among them are within the error limit of the data; and there may be other yet unknown reasons. Principle component analysis applied to alternative distance data did segregate the major groups, and success is likely due to the multivariate consideration of all the information. Furthermore, based on our extensive alignment and phylogenetic analysis, we expressed two novel Avds, lacavidin from Lactrodectus Hesperus, a western black widow spider, and hoefavidin from Hoeflea phototrophica, an aerobic marine bacterium, the ultimate aim being to determine their X-ray structures. These Avds were selected because of their unique sequences: lacavidin has an N-terminal Avd-like domain but a long C-terminal overhang, whereas hoefavidin was thought to be a dimeric Avd. Both these Avds could be used as novel scaffolds in biotechnological applications.

A zooarchaeological analysis of a late Dorset faunal assemblage from the KcFs-2 site (Nunavik, Quebec).

Ce mémoire consiste en une analyse zooarchéologique d’un assemblage faunique provenant d’un site Dorsétien des Îles Nuvuk dans l’Arctique canadien. Les données fauniques ont été analysées statistiquement en appliquant des indices d’utilité économique et des indices de densité des os. Une étude concernant le niveau de conservation de l’assemblage a révélé peu d’évidence de modification taphonomique des spécimens. Les analyses fauniques ont permis d’identifier une stratégie de subsistance de type généraliste et basée sur l’exploitation de mammifères marins, surtout des phoques annelés, pratiquée par les occupants du site de KcFs-2. Une prédominance d’individus immatures (phoques annelés) dans l’assemblage indique une abondance de ressources marines dans les régions du nord de la Baie d’Hudson et du détroit d’Hudson au moment de l’occupation, ce qui est aussi manifeste dans des études antérieures concernant les économies des peuples du Paléoesquimau tardif pour la période donnée. L’occupation du site de KcFs-2 s’est produite durant la période du Dorsétien récent au Nunavik (1500-800 B.P.), et la séquence est définie comme ayant été multi-saisonnière (de l’hiver à l’été). L’analyse des produits de l’industrie osseuse (têtes de harpons et sculptures en ivoire) a permis de confirmer l’affiliation culturelle des occupants.

Les capitaines des troupes de la Marine de 1683 à 1739 : la carrière militaire en Nouvelle-France

En 1683, la monarchie française expédie en Nouvelle-France trois compagnies d’infanterie de la Marine afin de mettre un terme à la guerre contre les Iroquois qui menace la colonie sous juridiction de la Marine. Ce premier contingent se montrant incapable de mater l’ennemi, le roi envoie d’autres compagnies dirigées par des officiers qui détiennent soit une expérience dans le service de la Marine ou dans les régiments d’infanterie. La guerre dorénavant ouverte avec les colonies britanniques, force l’enracinement de ce corps d’armée au Canada. Les administrateurs vont l’appeler troupes de la Marine. Un autre facteur d’enracinement est la permission que les autorités royales accordent aux nobles de la colonie canadienne de s’engager dans le corps d’officiers. Les Canadiens y deviennent majoritaires quelques décennies plus tard. Plusieurs de ces officiers, notamment nés en colonie ont fait l’objet de biographies. Quelques études se sont penchées sur le corps d’officiers en tant qu’acteur social. Cependant, l’ensemble de la carrière militaire d’un officier des troupes de la Marine en Nouvelle-France n’a jamais été abordé. Les capitaines, étant parvenus au sommet de la hiérarchie des troupes de la Marine avant 1739, constituent le sujet de cette recherche. Ce sera donc les grandes étapes de leur expérience militaire coloniale que l’on tentera d’approfondir tout en prenant en considération le lieu de naissance de l’officier, ce qui nous permet dégager certaines tendances relatives à la carrière d’officiers militaires dans la société d’Ancien Régime.

Investigations on the Effects of Petroleum Hydrocarbons on the Marine Bivalves Perna viridis (Linnaeus) and Sunetta scripta (Linne')

The thesis deals with different aspects connected with the distribution and toxicity of PHC in crude oils in the aquatic environment and marine molluscs. Information has been gathered and presented on the present status of research in the field based on a thorough review of recent literature. It is seen from the literature that the resident time of PHC becomes lesser and lesser when crude oil is discharged in large quantities into the coastal waters where excess oxygenation light penetration, temperature availability and strong tidal currents persist. This results in the reduction of the onslaught of oil pollution. This probably shows that taxic insult of crude oil in tropical shores will be relatively lesser than that occurring in temperate and boreal waters. However, there is no record of major episodal oil pollution comparable in quantum and extent to that of Torrey Canyon or Amoco Cadiz which prevents a more reliable analysis on the issue. Considerable controversy exists on the method of estimation of PHC in seawater. However, Ultra-violet fluorescence spectroscopy has been widely recommended as an analytical tool for the determination of total hydrocarbons. Similarly representation of values as chrysene equivalents has been recognised as the most reliable method of Quantum representation.

Meiobenthos of the Shelf Waters of West Coast of India With Special Reference to Free-Living Marine Nematodes

Department of Marine Biology, Microbiology and Biotechnology, Cochin University of Science and Technology

Dynamics of Rifting Along the Southwest Continental margin of India Through Coherence and Process oriented Analysis of Gravity Data

Department of Marine Geology and Geophysics,Cochin University of Science and Technology

Marine Engineering Training in India -A Pedagogic Introspection

Indian marine engineers are renowned for employment globally due to their knowledge, skill and reliability. This praiseworthy status has been achieved mainly due to the systematic training imparted to marine engineering cadets. However, in an era of advancing technology, marine engineering training has to remain dynamic to imbibe latest technology as well as to meet the demands of the shipping industry. New subjects of studies have to be included in the curriculum in a timely manner taking into consideration the industry requirements and best practices in shipping. Technical competence of marine engineers also has to be subjected to changes depending upon the needs of the ever growing and over regulated shipping industry. Besides. certain soft skills are to be developed and improved amongst the marine engineers in order to alter or amend the personality traits leading to their career success.If timely corrective action is taken. Indian marine engineers can be in still greater demand for employment in global maritime field. In order to enhance the employability of our mmine engineers by improving their quality, a study of marine engineers in general and class IV marine engineers in particular was conducted based on three distinct surveys, viz., survey among senior marine engineers, survey among employers of marine engineers and survey of class IV marine engineers themselves.The surveys have been planned and questionnaires have been designed to focus the study of marine engineer officer class IV from the point of view of the three distinct groups of maritime personnels. As a result of this, the strength and weakness of class IV marine engineers are identified with regard to their performance on board ships, acquisition of necessary technical skills. employability and career success. The criteria of essential qualities of a marine engineer are classified as academic, technical, social, psychological. physical, mental, emergency responsive, communicative and leadership, and have been assessed for a practicing marine engineer by statistical analysis of data collected from surveys. These are assessed for class IV marine engineers from the point of view of senior marine engineers and employers separately. The Endings are delineated and graphically depicted in this thesis.Besides. six pertinent personality traits of a marine engineer viz. self esteem. learning style. decision making. motivation. team work and listening self inventory have been subjected to study and their correlation with career success have been established wherever possible. This is carried out to develop a theoretical framework to understand what leads a marine engineer to his career attainment. This enables the author to estimate the personality strengths and weaknesses of a serving marine engineer and eventually to deduce possible corrective measures or modifications in marine engineering training in India.Maritime training is largely based on International Conventions on Standard of Training. Certification and Watch keeping for Seafarers 1995. its associated Code and Merchant Shipping (STCW for Seafarers) Rules 1998. Further, Maritime Education, Training and Assessment (META) Manual was subjected to a critical scrutiny and relevant Endings of thc surveys arc superimposed on the existing rule requirement and curriculum. Views of senior marine engineers and executives of various shipping companies are taken into account before arriving at the revision of syllabus of marine engineering courses. Modifications in the pattern of workshop and sea service for graduate mechanical engineering trainees are recommended. Desirable age brackets of junior engineers and chief engineers. use of Training and Assessment Record book (TAR Book) during training etc. have also been evaluated.As a result of the pedagogic introspection of the existing system of marine engineering training in India. in this thesis, a revised pattern of workshop training of six months duration for graduate mechanical engineers. revised pattern of sea service training of one year duration and modified now diagram incorporating the above have been arrived at. Effects of various personality traits on career success have been established along with certain findings for improvement of desirable personality traits of marine engineers.

Finite Element Analysis of Warship Structures

Warships are generally sleek, slender with V shaped sections and block coefficient below 0.5, compared to fuller forms and higher values for commercial ships. They normally operate in the higher Froude number regime, and the hydrodynamic design is primarily aimed at achieving higher speeds with the minimum power. Therefore the structural design and analysis methods are different from those for commercial ships. Certain design guidelines have been given in documents like Naval Engineering Standards and one of the new developments in this regard is the introduction of classification society rules for the design of warships.The marine environment imposes subjective and objective uncertainties on ship structure. The uncertainties in loads, material properties etc.,. make reliable predictions of ship structural response a difficult task. Strength, stiffness and durability criteria for warship structures can be established by investigations on elastic analysis, ultimate strength analysis and reliability analysis. For analysis of complicated warship structures, special means and valid approximations are required.Preliminary structural design of a frigate size ship has been carried out . A finite element model of the hold model, representative of the complexities in the geometric configuration has been created using the finite element software NISA. Two other models representing the geometry to a limited extent also have been created —- one with two transverse frames and the attached plating alongwith the longitudinal members and the other representing the plating and longitudinal stiffeners between two transverse frames. Linear static analysis of the three models have been carried out and each one with three different boundary conditions. The structural responses have been checked for deflections and stresses against the permissible values. The structure has been found adequate in all the cases. The stresses and deflections predicted by the frame model are comparable with those of the hold model. But no such comparison has been realized for the interstiffener plating model with the other two models.Progressive collapse analyses of the models have been conducted for the three boundary conditions, considering geometric nonlinearity and then combined geometric and material nonlinearity for the hold and the frame models. von Mises — lllyushin yield criteria with elastic-perfectly plastic stress-strain curve has been chosen. ln each case, P-Delta curves have been generated and the ultimate load causing failure (ultimate load factor) has been identified as a multiple of the design load specified by NES.Reliability analysis of the hull module under combined geometric and material nonlinearities have been conducted. The Young's Modulus and the shell thickness have been chosen as the variables. Randomly generated values have been used in the analysis. First Order Second Moment has been used to predict the reliability index and thereafter, the probability of failure. The values have been compared against standard values published in literature.