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.

Validation of plant dynamic model by online and laboratory measurements – a tool to predict online COD loads out of production of mechanical printing papers

COD discharges out of processes have increased in line with elevating brightness demands for mechanical pulp and papers. The share of lignin-like substances in COD discharges is on average 75%. In this thesis, a plant dynamic model was created and validated as a means to predict COD loading and discharges out of a mill. The assays were carried out in one paper mill integrate producing mechanical printing papers. The objective in the modeling of plant dynamics was to predict day averages of COD load and discharges out of mills. This means that online data, like 1) the level of large storage towers of pulp and white water 2) pulp dosages, 3) production rates and 4) internal white water flows and discharges were used to create transients into the balances of solids and white water, referred to as “plant dynamics”. A conversion coefficient was verified between TOC and COD. The conversion coefficient was used for predicting the flows from TOC to COD to the waste water treatment plant. The COD load was modeled with similar uncertainty as in reference TOC sampling. The water balance of waste water treatment was validated by the reference concentration of COD. The difference of COD predictions against references was within the same deviation of TOC-predictions. The modeled yield losses and retention values of TOC in pulping and bleaching processes and the modeled fixing of colloidal TOC to solids between the pulping plant and the aeration basin in the waste water treatment plant were similar to references presented in literature. The valid water balances of the waste water treatment plant and the reduction model of lignin-like substances produced a valid prediction of COD discharges out of the mill. A 30% increase in the release of lignin-like substances in the form of production problems was observed in pulping and bleaching processes. The same increase was observed in COD discharges out of waste water treatment. In the prediction of annual COD discharge, it was noticed that the reduction of lignin has a wide deviation from year to year and from one mill to another. This made it difficult to compare the parameters of COD discharges validated in plant dynamic simulation with another mill producing mechanical printing papers. However, a trend of moving from unbleached towards high-brightness TMP in COD discharges was valid.

Most of the Abundant Protein Fractions of Embryonic Cerebrospinal Fluid are Produced Out of the Brain Anlagen

The microenvironment of the central nervous system is important for neuronal function and development. During the early stages of embryo development the cephalic vesicles are filled by embryonic cerebrospinal fluid, a complex fluid containing different protein fractions, which contributes to the regulation of the survival, proliferation and neurogenesis of neuroectodermal stem cells. The protein content of embryonic cerebrospinal fluid from chick and rat embryos at the start of neurogenesis has already been determined. Most of the identified gene products are thought to be involved in the regulation of developmental processes during embryogenesis. However, due to the crucial roles played by embryonic cerebrospinal fluid during brain development, the embryological origin of the gene products it contains remains an intriguing question. According to the literature most of these products are synthesised in embryonic tissues other than the neuroepithelium. In this study we examined the embryological origin of the most abundant embryonic cerebrospinal fluid protein fractions by means of slot-blot analysis and by using several different embryonic and extraembryonic protein extracts, immunodetected with polyclonal antibodies. This first attempt to elucidate their origin is not based on the proteins identified by proteomic methods, but rather on crude protein fractions detected by SDS-PAGE analysis and to which polyclonal antibodies were specifically generated. Despite some of the limitations of this study, i.e. that one protein fraction may contain more than one gene product, and that a specific gene product may be contained in different protein fractions depending on post-translational modifications, our results show that most of the analysed protein fractions are not produced by the cephalic neuroectoderm but are rather stored in the egg reservoir; furthermore, few are produced by embryo tissues, thus indicating that they must be transported from their production or storage sites to the cephalic cavities, most probably via embryonic serum. These results raise the question as to whether the transfer of proteins from these two embryo compartments is regulated at this early developmental stage.

Genetic variation among pathogens causing "Helminthosporium" diseases of rice, maize and wheat

Twenty isolates of four fungal species, agents of "Helminthosporium" diseases in cereals, were collected from different regions: nine Bipolarisoryzae isolated from rice (Oryza sativa), seven B.sorokiniana from wheat (Triticum aestivum), two B. maydis, and two Exserohilumturcicum from maize (Zea mays). The strains were compared by PCR-RFLP and RAPD analysis. Size polymorphism among the isolates in the ITS region comprising the 5.8 S rDNA indicated genetic differences among the isolates, while a UPGMA phenogram constructed after the digestion of this region with restriction enzymes showed inter- and intra-specific polymorphism. The RAPD profiles indicated an expressive level of polymorphism among different species, compared with a low level of polymorphism among isolates of the same species. A UPGMA phenogram grouped the isolates according to the species and their host plant. RAPD profiles did not reveal polymorphism that directly correlated climatic factors with geographic source of the isolates of B. sorokiniana, and B. oryzae. Teleomorphic species revealed high similarity with their correspondent anamorphs.

Fungi associated to bark lesions of Eucalyptus globulus stems in plantations from Uruguay

Trees with stem bark lesions are frequently observed in Eucalyptus globulus Labill. plantations, particularly in the central west region of Uruguay. These lesions constitute a problem for trunk decortications at harvest and they also facilitate the access of fungi that could cause wood decay. Seven, three and oneyear-old plantations, located at three sites in close proximity were selected. Four types of trunk lesions were present in trees regardless the age of plantation and more than one type was found in each plantation. The aim of this study was to investigate the fungal composition associated with these lesions and compare them to healthy tissues and try to find out the origin of these symptoms. Another purpose was to elucidate the real role of the fungi considered pathogens by means of experimental inoculations. Segments from lesions and healthy tissues yielded 897 fungal isolates belonging to 32 taxa, 681 isolates from bark lesions and 216 from healthy tissues. Both healthy and symptomatic tissues showed similar fungal species composition, but with differences in frequencies of colonization. Cytospora eucalypticola Van der Westhuizen, Botryosphaeria spp., Pestalotiopsis guepinii (Desm.) Stey. and Penicillium spp. were the dominant species isolated. As symptoms were not reproduced after experimental inoculation with Botryosphaeria ribis Grossenb. & Duggar and B. eucalyptorum Crous, & M.J. Wingf, it could be suggested that these lesions were originated by unfavorable environmental conditions. The frost that occurred for several days out of season and flooding may have been involved in the development of bark lesion.

Physical-chemical characterization and wet milling yield of four maize hybrids

The influence of physical-chemical characteristics of maize grains and lactic acid concentrations on byproduct yields, generated by conventional wet milling, was studied during steeping, for four maize hybrids and two lactic acid concentrations (0.55 and 1.00%). For physical-chemical characterization, grain dimensions (length, thickness, and width) were determined, as well as mass of 100 grains, percentage of floating grains, volumetric mass, and centesimal composition. Statistical differences were found for percentage of floating grains (2.33 to 24.67%), volumetric mass (0.814 to 0.850 kg.L-1), mass of 100 grains (0.033 to 0.037 kg), water content (11.86 to 12.20%), proteins (8.21 to 9.06%), lipids (3.00 to 4.77%), and ashes (1.07 to 1.26%). There were no relationships of wet milling yields with maize appearance and physical-chemical characteristics. The addition of 1.00% lactic acid did not statistically improve byproduct yields; however, it favored separation of the grain components.

Peter Pan never goes out of style : nuorisotutkijat ymmällään

Kirjallisuusarvostelu

Weed interference on growth and yield of transgenic maize

Plants kept under competition tend to modify their morphology to optimize the use of production factors. This study aimed to evaluate the effects of competition between transgenic maize and five weed species on the growth and yield of transgenic maize hybrid. The experiment used a randomized block design with four replicates in a factorial 5 x 2 + 6 scheme consisting of a combination of maize under competition with five weed species (Bidens pilosa, Commelina benghalensis, Brachiaria brizantha, Sorghum arundinaceum and Ipomoea triloba) in two weed densities (15 or 30 plants m-2) plus six treatments corresponding to maize and weed species without competition. All the means for dry matter accumulated by maize plants in the stem and leaf in the density of 15 plants m ² were higher than the means for plants in coexistence with 30 plants m-². Number of kernels, diameter and length of cob were not affected by competition with weeds. The weeds that most interfered with maize biomass production were S.arundinaceum and B.brizantha. Leaf dry mass accumulation was more sensitive than the production of stem. It was observed that maize was usually very competitive with weeds, and there was a strong decrease in dry matter accumulation of all the weeds in the study when in coexistence with the crop.

Diallel cross analysis for young plants of brachytic maize (Zea mays L.) varieties

Six brachytic maize varieties were crossed in a diallel mating scheme. Both varieties and crosses were grown hydroponically in a greenhouse, in randomized complete blocks with three replications in two seasons. Four brachytic double cross hybrids were used as checks. Twenty-eight days after planting, data for eight traits were taken for weights of the total plant (TPW), top plant (TOW), total roots (TRW), seminal roots (SRW), and nodal roots (NRW) and number of total roots (TRN), seminal roots (SRN), and nodal roots (NRN). Ten plants were measured in each plot and all the analyses were accomplished with plot means. In the diallel cross the top plant contributed 57.6% of the total plant weight, for seminal roots 15.4%, and for nodal roots 27.0%. Root number distribution was 36.7% seminal roots and 63.3% nodal roots. Approximately the same ratios were observed in the checks. The average heterosis effects were nonsignificant for all traits; the other components of heterosis (variety and specific heterosis) also were not important sources of variation in young plants. The overall results suggest that nonadditive gene action is not an important source of variation for the plant and root system of young plants. The positive correlation coefficients for combinations of traits indicated that they are under the control of a polygenic system

Influence of season and pollution on the antioxidant defenses of the cichlid fish acará (Geophagus brasiliensis)

The livers of Geophagus brasiliensis collected from both a non-polluted site and a polluted site were analyzed for different antioxidant defenses, O2 consumption, thiobarbituric acid-reactive substance (TBARS) levels, and histological damage. Compared to controls (116.6 ± 26.1 nmol g-1), TBARS levels were enhanced at the polluted site (284.2 ± 25.6 nmol g-1), as also was oxygen consumption (86.6 ± 11.3 and 128.5 ± 9.8 µmol O2 min-1 g-1, respectively). With respect to enzymatic antioxidants, increased catalase activities (8.7 ± 1.3 and 29.2 ± 2.4 mmol min-1 g-1, respectively), unchanged superoxide dismutase activities (767.2 ± 113.3 and 563.3 ± 70.2 U g-1, respectively), and diminished glutathione S-transferase activities (29.0 ± 3.2 and 14.9 ± 3.2 µmol min-1 g-1, respectively) were detected. Reduced glutathione (1.91 ± 0.17 and 1.37 ± 0.25 mM, respectively), oxidized glutathione (1.50 ± 0.20 and 0.73 ± 0.17 mM, respectively), and total glutathione (3.40 ± 0.26 and 2.07 ± 0.27 mM, respectively) concentrations were also below control values at the polluted site. Nevertheless, the observed ethoxyresorufin-O-deethylase activities (1.34 ± 0.11 and 16.7 ± 0.21 pmol min-1 mg-1, respectively) showed enhanced values at the polluted site. The main histological damage observed in the hepatocytes from fish collected at the polluted site was characterized by heavy lipid infiltration. Fish collected at the end of spring showed higher O2 consumption, higher superoxide dismutase and glutathione S-transferase activities, and higher total and oxidized glutathione concentrations compared to the beginning of autumn. No seasonal changes were observed in catalase activities, glutathione or TBARS levels. Fish chronically exposed to relatively high pollution levels seem to be unable to set up adequate antioxidant defenses, probably due to severe injury to their hepatocytes. The higher antioxidant defenses found at the end of spring are probably related to the enhanced activities during high temperature periods in thermoconforming organisms.

Fundraising and investor relations in social enterprise: Marketing your way out of the pioneer gap in African off-grid renewable energy

Social enterprises apply the best of business for the pursuit of social or environmental mission while also generating revenues. Globally, nearly 1,3 billion people lack access to electricity, as well as another billion having access to only low quality and infrequent electricity. Off-grid renewable energy, like solar, will increasingly have a key role in the solution of the energy access issue. The pioneer gap in off-grid renewable energy consists of financing (or funding) gaps and capacity gaps, to do with both the early stage of the enterprises in question, as well as the early stage of the whole industry. The gaps are emphasised by specific characteristics of off-grid renewable energy business models and the requirements of operating in bottom-of-the-pyramid markets. The marketing perspective to fundraising is chosen to uncover the possible role enterprises themselves have in bridging the pioneer gap. The purpose of this thesis is to study how social enterprises operating in off-grid renewable energy in Africa utilise marketing activities in their investor relations in bridging the pioneer gap. This main research question is divided into the following sub-questions:  How does the pioneer gap affect fundraising for these enterprises?  How are the funding needs for these enterprises characterised?  How do these enterprises build trust in their investor relations? The theoretic framework is built on relationship marketing and investor relations, with an emphasis on creation of trust. The research is conducted as a thematical case study. Primary data is gathered via semi-structured interviews with six solar energy companies and two accelerators. According to the findings, the main components affecting trust-creation are diminished information asymmetry and perceived risk, mission alignment as well as a personal fit or relationship with the investor. Therefore, an enterprise can utilise e.g. the following marketing activities in their investor relations to bridge the pioneer gap: ensuring investor material, the enterprise story and presenting of them is clear, concise and complete to “package” the enterprise as an investment; taking investor needs and motivations into account as well as utilising existing investors as ambassadors.