Hyperbaric oxygen therapy in the ATLS/ACLS resuscitative management of acutely ill or severely injured patients with severe anemia: a review.

For short periods, even without the presence of red blood cells, hyperbaric oxygen can safely allow plasma to meet the oxygen delivery requirements of a human at rest. By this means, hyperbaric oxygen, in special instances, may be used as a bridge to lessen blood transfusion requirements. Hyperbaric oxygen, applied intermittently, can readily avert oxygen toxicity while meeting the body's oxygen requirements.

Decadal changes in microplastic accumulation in freshwater sediments: Evaluating influencing factors.

Microplastics are small plastic particles with sizes ranging between 1 μm and 5 mm. Microplastics can originate from macro plastics and degrade to a smaller size or be produced directly by manufacturers. Few studies have examined microplastic contamination in freshwater sediment cores to estimate changes in microplastic contamination over time.

Medical and surgical management of pneumothorax in diving and hyperbaric chambers.

The presence of a pneumothorax within a pressurized chamber represents unique diagnostic and management challenges. This is particularly the case in the medical and geographic remoteness of many chamber locations. Upon commencing chamber decompression, unvented intrapleural air expands.

Assessment of Functional and Physical Performances of Pre-filled Syringes in Deep Cold Storage Conditions.

The recent emergence of new drug technologies such as messenger ribonucleic acid-based vaccines developed to fight the outbreak of the COVID-19 global pandemic has driven increased demand for delivery solutions capable of withstanding deep cold storage conditions down to -50°C, and even down to -80°C. Although significant data exist for deep cold storage in vials, little evidence is available for pre-filled syringes. Because pre-filled syringes serve as both the storage container and the delivery mechanism, there are additional risks to performance that must be evaluated, such as plunger gliding performance, syringe lubrication, silicone layer stability, and container closure integrity (CCI).

Long-term annual soil nitrogen surplus across Europe (1850-2019).

Worldwide surface waters suffer from the presence of nitrogen (N) compounds causing eutrophication and deterioration of the water quality. Despite many Europe-wide legislation's, we still observe high N levels across many water bodies in Europe. Information on long-term annual soil N surplus is needed to better understand these N levels and inform future management strategies.

Nitrogen legacies in anthropogenic landscapes: a case study in the Mondego Basin in Portugal.

Nitrogen (N) legacies have built up in anthropogenic landscapes over decades of agricultural intensification, and these legacies lead to time lags in water quality change measurable even beyond the moment of application of N. It is important to understand these legacies to quantify the relationship between N inputs and N concentrations in streams and implement best management practices for water quality improvement; however, little is known about the magnitude of legacies in various landscape elements like soils and groundwater. Here, we have used the ELEMeNT (Exploration of Long-tErM Nutrient Trajectories) model to explore the buildup and depletion of N legacies over a 216-year period, across the Mondego River Basin, a 6645-km watershed in Portugal, where human interventions have considerably changed the characteristics of the basin to prevent floods and improve farming conditions in recent decades.

Agricultural phosphorus surplus trajectories for Ontario, Canada (1961-2016), and erosional export risk.

Management strategies aimed at reducing nutrient enrichment of surface waters may be hampered by nutrient legacies that have accumulated in the landscape. Here, we apply the Net Anthropogenic Phosphorus Input (NAPI) model to reconstruct the historical phosphorus (P) input trajectories for the province of Ontario, which encompasses the Canadian portion of the drainage basin of the Laurentian Great Lakes (LGL). NAPI considers P inputs from detergent, human and livestock waste, fertilizer inputs, and P outputs by crop uptake.

The need to integrate legacy nitrogen storage dynamics and time lags into policy and practice.

Increased fluxes of reactive nitrogen (N), often associated with N fertilizer use in agriculture, have resulted in negative environmental consequences, including eutrophication, which cost billions of dollars per year globally. To address this, best management practices (BMPs) to reduce N loading to the environment have been introduced in many locations. However, improvements in water quality associated with BMP implementation have not always been realised over expected timescales.

The utility of hyperbaric oxygen therapy in post-transplant cyclophosphamide-induced hemorrhagic cystitis: a case report and review of the literature.

Background: To date, there are only a few case reports of cyclophosphamide (Cy)-induced hemorrhagic cystitis (HC) in adult or pediatric allogeneic stem cell transplant (SCT) patients treated successfully with hyperbaric oxygen (HBO). In all the reported cases, Cy was used as a part of the conditioning regimen, rather than post-transplant for graft-versus-host-disease (GVHD) prophylaxis. More recently, the risk of HC in allogeneic SCT is further increased by the widespread use of post-transplantation cyclophosphamide (PTCy) as a highly effective strategy for GVHD prophylaxis.

Plasma flow distal to tourniquet placement provides a physiological mechanism for tissue salvage.

Military literature has demonstrated the utility and safety of tourniquets in preventing mortality for some time, paving the way for increased use of tourniquets in civilian settings, including perioperatively to provide a bloodless surgical field. However, tourniquet use is not without risk and the subsequent effects of tissue ischemia can impede downstream rehabilitative efforts to regenerate and salvage nerve, muscle, tissue and bone in the limb. Limb ischemia studies in both the mouse and pig models have indicated not only that there is residual flow past the tourniquet by means of microcirculation, but also that recovery from tissue ischemia is dependent upon this microcirculation.

Maximizing US nitrate removal through wetland protection and restoration.

Growing populations and agricultural intensification have led to raised riverine nitrogen (N) loads, widespread oxygen depletion in coastal zones (coastal hypoxia) and increases in the incidence of algal blooms.Although recent work has suggested that individual wetlands have the potential to improve water quality, little is known about the current magnitude of wetland N removal at the landscape scale. Here we use National Wetland Inventory data and 5-kilometre grid-scale estimates of N inputs and outputs to demonstrate that current N removal by US wetlands (about 860 ± 160 kilotonnes of nitrogen per year) is limited by a spatial disconnect between high-density wetland areas and N hotspots.

Response to Comment on "Legacy nitrogen may prevent achievement of water quality goals in the Gulf of Mexico".

Ballard argue that our prediction of a 30-year or longer recovery time for Gulf of Mexico water quality is highly uncertain, and that much shorter time lags are equally likely. We demonstrate that their argument, based on the use of a two-component regression model, does not sufficiently consider fundamental watershed processes or multiple lines of evidence suggesting the existence of decadal-scale lags.

Legacy nitrogen may prevent achievement of water quality goals in the Gulf of Mexico.

In August 2017, the Gulf of Mexico's hypoxic zone was declared to be the largest ever measured. It has been estimated that a 60% decrease in watershed nitrogen (N) loading may be necessary to adequately reduce eutrophication in the Gulf. However, to date there has been no rigorous assessment of the effect of N legacies on achieving water quality goals.

The role of groundwater discharge fluxes on Si:P ratios in a major tributary to Lake Erie.

Groundwater discharge can be a major source of nutrients to river systems. Although quantification of groundwater nitrate loading to streams is common, the dependence of surface water silicon (Si) and phosphorus (P) concentrations on groundwater sources has rarely been determined. Additionally, the ability of groundwater discharge to drive surface water Si:P ratios has not been contextualized relative to riverine inputs or in-stream transformations.

Hyperbaric Oxygen Promotes Proximal Bone Regeneration and Organized Collagen Composition during Digit Regeneration.

Oxygen is critical for optimal bone regeneration. While axolotls and salamanders have retained the ability to regenerate whole limbs, mammalian regeneration is restricted to the distal tip of the digit (P3) in mice, primates, and humans. Our previous study revealed the oxygen microenvironment during regeneration is dynamic and temporally influential in building and degrading bone.

Signatures of human impact: size distributions and spatial organization of wetlands in the Prairie Pothole landscape.

More than 50% of global wetland area has been lost over the last 200 years, resulting in losses of habitat and species diversity as well as decreased hydrologic and biogeochemical functionality. Recognition of the magnitude of wetland loss as well as the wide variety of ecosystem services provided by wetlands has in recent decades led to an increased focus on wetland restoration. Restoration activities, however, often proceed in an ad hoc manner, with a focus on maximizing the total restored area rather than on other spatial attributes of the wetland network, which are less well understood.

Epidermal closure regulates histolysis during mammalian (Mus) digit regeneration.

Mammalian digit regeneration progresses through consistent stages: histolysis, inflammation, epidermal closure, blastema formation, and finally redifferentiation. What we do not yet know is how each stage can affect others. Questions of stage timing, tissue interactions, and microenvironmental states are becoming increasingly important as we look toward solutions for whole limb regeneration.

Catchment legacies and time lags: a parsimonious watershed model to predict the effects of legacy storage on nitrogen export.

Nutrient legacies in anthropogenic landscapes, accumulated over decades of fertilizer application, lead to time lags between implementation of conservation measures and improvements in water quality. Quantification of such time lags has remained difficult, however, due to an incomplete understanding of controls on nutrient depletion trajectories after changes in land-use or management practices. In this study, we have developed a parsimonious watershed model for quantifying catchment-scale time lags based on both soil nutrient accumulations (biogeochemical legacy) and groundwater travel time distributions (hydrologic legacy).

Endogenous bone regeneration is dependent upon a dynamic oxygen event.

Amputation of the digit tip within the terminal phalangeal bone of rodents, monkeys, and humans results in near-perfect regeneration of bone and surrounding tissues; however, amputations at a more proximal level fail to produce the same regenerative result. Digit regeneration is a coordinated, multifaceted process that incorporates signaling from bioactive growth factors both in the tissue matrix and from several different cell populations. To elucidate the mechanisms involved in bone regeneration we developed a novel multi-tissue slice-culture model that regenerates bone ex vivo via direct ossification.

The effect of hyperbaric oxygen on severe anemia.

As a respiratory pigment, hemoglobin allows blood to carry unnaturally high levels of nascent, molecular oxygen at one atmosphere of pressure in chemical solution to capillary beds and post-capillary venules supplying parenchymal cells of all organ systems in the body. When hemoglobin drops to critical levels to disallow proper oxygen delivery, hyperbaric oxygen therapy may be used as bridge therapy to emergently supply oxygen. Hyperbaric-administered oxygen allows oxygen to be dissolved in increased concentration in red blood cell-poor plasma or crystalloid/ colloid-diluted intravascular fluids in a volume-resuscitated patient.

Integrated and first trimester prenatal screening in California: program implementation and patient choice for follow-up services.

Objectives: The California Prenatal Screening Program serves over 350,000 women annually. This study examines utilization rates for the various screening options and patient choices regarding follow-up services.

Methods: The study tracked patients with first trimester positive results for Down syndrome to examine patient decisions regarding follow-up services and/or additional screening and to identify determinants of patient decisions.

Hyperbaric Oxygen Therapy as an Adjunct to Pre-hospital Advanced Trauma Life Support.

Most commercial diving operations and naval operations have 24/7, on-site availability of hyperbaric oxygen therapy to perform routine surface decompression or immediate treatment of arterial gas embolism or decompression sickness. Availability and prompt use of hyperbaric oxygen therapy in the field for treatment of divers with dysbaric conditions has demonstrated its efficacy in acute, co-morbid conditions such as acute exsanguination, blast injury, crush injury, and cardiopulmonary arrest affecting those same divers. Hyperbaric oxygen therapy applied in these cases has demonstrated its utility to augment the efficacy of conventional, pre-hospital advanced cardiac life support and advanced trauma life support.