Demonstration of novel, secure, real-time, portable ultrasound transmission from an austere international location.

There is not sufficient access to medical care or medical expertise in many parts of the world. An innovative telemedicine system has been developed to provide expert medical guidance to field caregivers [who have less medical expertise but can reach the patient population in need]. Real-time ultrasound video images have been securely transmitted from the Dominican Republic to Hackensack University Medical Center, Hackensack NJ (HackensackUMC), while the expert physician at HackensackUMC maintained direct voice communication with the field caregiver. Utilizing a portable ultrasound machine (Sonosite) integrated with portable broadcasting device (LiveU), extended Focused Assessment Sonography in Trauma (e-FAST) examinations were performed on healthy volunteers and transmitted via the local cellular network. Additionally, two e-FAST examinations were conducted from a remote location without cellular coverage and transmitted via broad ground area network (BGAN) satellites. The demonstration took the technology "out of the lab" and into a real life, austere environment. The conditions of the Dominican Republic ultrasound mission provided experience on how to manage and utilize this innovative technology in areas where reliable communications and medical coverage are not readily available. The resilient transmission capabilities coupled with the security features deem this portable Telesonography (TS) equipment highly useful in the telemedicine forefront by offering healthcare in underdeveloped areas as well as potentially enhancing throughput in disaster situations.

Experimental floral and inflorescence trait manipulations affect pollinator preference and function in a hummingbird-pollinated plant.

PREMISE OF THE STUDY: Controversy is ongoing regarding the importance of pollinator-mediated selection as a source of observed patterns of floral diversity. Although increasing evidence exists of pollinator-mediated selection acting on female reproductive success, there is still limited understanding of pollinator-mediated selection on floral traits via male reproductive success. Here we quantify potential selection by the ruby-throated hummingbird, Archilochus colubris, on four floral traits of hermaphroditic Silene exerted through male floral function. METHODS: In single trait manipulative experiments we quantified hummingbird visitation preference and/or fluorescent dye (a pollen analog) donation as a function of number of flowers displayed (inflorescence size), height of the floral display (inflorescence height), floral color, and corolla tube length. KEY RESULTS: Hummingbirds preferred to visit larger floral displays and floral displays at greater height, likely representing a general pollinator preference for larger, more visible signals and/or greater rewards. In addition, hummingbirds preferred to visit red flowers, and male function was greater in flowers manipulated to have longer corolla tubes. CONCLUSIONS: Selection pressures exerted by hummingbirds on S. virginica floral and inflorescence design through male reproductive success are consistent with the contemporary expression of floral traits of S. virginica relative to related Silene species with different pollinators, and they are consistent with the hummingbird syndrome of traits expressed by S. virginica.