The study of cardiac mechano-electric and mechano-mechanical coupling during heart development in zebrafish.

In the adult heart, acute adaptation of electrical and mechanical activity to changes in mechanical load occurs feedback processes known as "mechano-electric coupling" and "mechano-mechanical coupling." Whether this occurs during cardiac development is ill-defined, as acutely altering the heart's mechanical load while measuring functional responses in traditional experimental models is difficult, as embryogenesis occurs , making the heart inaccessible. These limitations can be overcome with zebrafish, as larvae develop in a dish and are nearly transparent, allowing for manipulation and measurement of cardiac structure and function.

Drivers of Sinoatrial Node Automaticity in Zebrafish: Comparison With Mechanisms of Mammalian Pacemaker Function.

Cardiac excitation originates in the sinoatrial node (SAN), due to the automaticity of this distinct region of the heart. SAN automaticity is the result of a gradual depolarisation of the membrane potential in diastole, driven by a coupled system of transarcolemmal ion currents and intracellular Ca cycling. The frequency of SAN excitation determines heart rate and is under the control of extra- and intracardiac (extrinsic and intrinsic) factors, including neural inputs and responses to tissue stretch.

Seeing the Light: The Use of Zebrafish for Optogenetic Studies of the Heart.

Optogenetics, involving the optical measurement and manipulation of cellular activity with genetically encoded light-sensitive proteins ("reporters" and "actuators"), is a powerful experimental technique for probing (patho-)physiological function. Originally developed as a tool for neuroscience, it has now been utilized in cardiac research for over a decade, providing novel insight into the electrophysiology of the healthy and diseased heart. Among the pioneering cardiac applications of optogenetic actuators were studies in zebrafish, which first demonstrated their use for precise spatiotemporal control of cardiac activity.

Global human influence maps reveal clear opportunities in conserving Earth's remaining intact terrestrial ecosystems.

Leading up to the Convention on Biological Diversity Conference of the Parties 15, there is momentum around setting bold conservation targets. Yet, it remains unclear how much of Earth's land area remains without significant human influence and where this land is located. We compare four recent global maps of human influences across Earth's land, Anthromes, Global Human Modification, Human Footprint and Low Impact Areas, to answer these questions.

Cardiac Electrophysiological Effects of Light-Activated Chloride Channels.

During the last decade, optogenetics has emerged as a paradigm-shifting technique to monitor and steer the behavior of specific cell types in excitable tissues, including the heart. Activation of cation-conducting channelrhodopsins (ChR) leads to membrane depolarization, allowing one to effectively trigger action potentials (AP) in cardiomyocytes. In contrast, the quest for optogenetic tools for hyperpolarization-induced inhibition of AP generation has remained challenging.

An Ecoregion-Based Approach to Protecting Half the Terrestrial Realm.

We assess progress toward the protection of 50% of the terrestrial biosphere to address the species-extinction crisis and conserve a global ecological heritage for future generations. Using a map of Earth's 846 terrestrial ecoregions, we show that 98 ecoregions (12%) exceed Half Protected; 313 ecoregions (37%) fall short of Half Protected but have sufficient unaltered habitat remaining to reach the target; and 207 ecoregions (24%) are in peril, where an average of only 4% of natural habitat remains. We propose a Global Deal for Nature-a companion to the Paris Climate Deal-to promote increased habitat protection and restoration, national- and ecoregion-scale conservation strategies, and the empowerment of indigenous peoples to protect their sovereign lands.

BIM and its benefits explained.

A high-level look at Building Information Modelling's key benefits, the potential pitfalls, and the priorities for successful implementation, in the wake of the recent Government mandate that all centrally procured public sector construction projects commenced after 4 April this year be implementing BIM Level 2, was given by Chartered Quantity Surveyor, Gary Allen, of IDC-Consult, at the first in a series of planned IHEEM/HefmA joint seminars on the topic held recently at the headquarters of the Royal Institution of Chartered Surveyors (RICS) in London. HEJ editor, Jonathan Baillie, reports.

Senior personnel meet to debate key issues.

Prior to the start of the second day of April's Hospital Innovations 2016 show at Olympia, London, and immediately before Lord Carter gave an address at the event updating conference delegates on progress with he and his team's review of the 'productivity and efficiency' of English NHS acute hospitals, IHEEM held an 'invitation only' Chief Executives' Breakfast Briefing, at which senior personnel from both the NHS and private sector discussed some of their key concerns against today's difficult economic backdrop for the sector. HEJ editor, Jonathan Baillie, reports.

Best practice not being sufficiently replicated.

'Efficient productivity through innovation' was the theme of the first ever Hospital Innovations conference and exhibition at Olympia, London in late April. At the two-day event--supported by organisations including IHEEM, the Legionella Control Association, the Water Management Society, the BRE, and a sizeable number of English NHS Trusts--the Day Two keynote address by Lord Carter very much reflected this theme. Following his address at Healthcare Estates 2015, the Labour Peer focused further in London on his team's recent review of the 'productivity and efficiency' of English NHS Trusts, and explained how the initiative would progress in coming months.

How 'Big data' will drive future innovation.

Giving the opening keynote speech at last year's Healthcare Estates conference, Mike Hobbs, managing director of Carillion Health, drew on his 25 years' experience to discuss how innovation can help drive the greater efficiency and productivity that the NHS is charged with delivering, in the process cutting costs at a time when the service faces the tightest economic pressures in its history. He argued that as we enter a new world of 'Big data', the availability of accurate, comprehensive data on which to base key decisions will be the major enabler for the design and construction of high quality healthcare facilities in the future. It will equally be key, he said, to their efficient, low-cost, and optimal utilisation to provide the higher 'productivity' the Government says is essential.

Assessment unit meets Trust ambitions.

The quality of the care environment within a new 16-bedded modular-built ward, the Gilwern Assessment Unit, at Hereford County Hopsital, has won widespread praise from the clinicians and nurses staffing it--many of whom were recruited specially to work in it. The impressive new single-storey assessment unit for frail, older patients--which admitted its first patients just before Christmas--is formed from 14 separate modules erected offsite, delivered individually on low-loaders, craned into position, and then finished and fitted out to an extremely high standard, by off-site building specialist, MTX. The new ward was completed on budget to an extremely tight schedule, met--thanks to excellent teamwork--despite the added complication of the unit being built over a former burial ground.

Improving efficiency, securing savings.

The NHS in England could save £1 bn annually if all NHS acute Trustsachieved the median level of estates and facilities running costs, the second (and 'final') report by Lord Carter and his team into the 'productivity and efficiency' of acute NHS Trusts across England, published on 5 February,suggests. As HEJ, editor, Jonathan Baillie reports, Lord Carter's team'songoing recent discussions with senior personnel working in a range of disciplines at 32 NHS Trusts--which followed dialogue with an initial 22 Trusts--identified 'unwarranted variation' in the use of resources ranging from staff to land and buildings on such a scale that effectively addressing this 'variation' could, the DH-commissioned team says, potentially reduce by £5 bn annually the NHS in England's costs.

Hot and cold water issues deftly described.

Speaking at a Legionella Control Association Open Day on 9 October last year in Tamworth, Mike Quest, an LCA director and Committee Member who is an independent water hygiene and safety consultant and an NHS Authorising Engineer, presented his standpoint on effective risk assessment and monitoring of complex hot and cold water systems. He also focused on some of the challenges for engineering and estates teams in maintaining water temperatures within 'safe limits' in modern buildings, with reference to the complications he had seen in a hospital project he has recently been working on.

CCGs' role in the future of the estate.

With the backdrop of a 21st century healthcare landscape where a number of previous commissioning and provider organisations now no longer exist, and other new bodies have taken their place, 'The role of the Clinical Commissioning Group in determining the future of the NHS estate' was the title of a presentation by Helen Davis, a partner in the Healthcare Advisory team at Arcadis, on the second day of this year's Healthcare Estates conference. While acknowledging the part that CCGs could have in managing and running the estate, Helen Davis felt they not only needed to be better 'geared up' with estates-related knowledge and expertise to be able to make a valuable contribution, but that effective collaboration between all providers, commissioners, and users of the healthcare estate was vital to ensure optimal use of facilities in the future. HEJ editor, Jonathan Baillie, reports.

London Trusts proud to describe their work.

'Waste not, Want not' was the title of a recent IHEEM seminar which examined some of the key issues for those responsible for dealing with healthcare waste--from regulatory compliance and correct segregation of waste streams, to the opportunities for more on-site processing. HEJ editor, Jonathan Baillie, reports on the joint presentations given by key environmental and sustainability personnel at two of London's largest NHS Trusts, and their private sector waste management partners. These discussed some of the key initiatives that each Trust and its 'partner' have taken to not only significantly reduce the amount of waste generated on their estate, but also to dispose of it in an environmentally responsible way.

Europe's first children's hospital in a park.

Just a year after the centenary of the completion of the 1914-built children's hospital which it will soon replace, this autumn will see the opening of a new Alder Hey Children's Hospital in Liverpool, dubbed Alder Hey in the Park thanks to its attractive parkland setting. The 270-bedded hospital, designed by architects, landscape architects, and interior designers, BDP, and built by Laing O'Rourke, is located in Springfield Park on Liverpool's northern fringes, and features a highly striking external design, with the three distinctive 'fingers' housing the wards bordered by extensive greenery, and the buildings topped by green undulating roofs. All the inpatient bedrooms, and indeed many other internal spaces, will enjoy parkland views.