Baseline survey of marine sediments collected from the Kingdom of Bahrain: PAHs, PCBs, organochlorine pesticides, perfluoroalkyl substances, dioxins, brominated flame retardants and metal contamination.

A baseline survey of sediment contamination was undertaken at 14 locations around the coastline of Bahrain in May 2017, followed by a focused survey of 20 sites, in November 2019. Samples were assessed for industrial pollutants, including metals, PAHs and a suite of organohalogen compounds. The data generated indicated that levels of chemical contaminants were generally low and did not pose a toxicological risk when assessed against commonly applied sediment quality guidelines (SQG). The highest concentrations of PAHs and PCBs were identified in samples collected at coastal sites adjacent to a refinery area known to contain a diverse mix of industry. Tubli Bay, a heavily stressed small bay receiving high loads of sewage effluent, was also identified as an area warranting further investigation with elevated concentrations of BDE209, PFOS and metal contamination. Such data provides a useful baseline assessment of sediment contamination, against which management control measures can be assessed.

Early onset inflammatory bowel disease - What the radiologist needs to know.

Approximately 25% of Inflammatory Bowel Disease (IBD) patients present before the age of 18 years; early-onset IBD is defined as disease presenting before 10 years of age. Although early-onset disease is rare, it presents a particular challenge both in terms of treatment and diagnosis. There is a strong genetic component to these diseases and it is now possible to identify specific genetic mutations associated with certain patterns of early-onset IBD. All of these children require specific clinical work-up that is often performed at specialist centres. Young children with IBD, present a particular challenge to the radiologist because conventional bowel imaging techniques such as MR Enterography require general anaesthetic and other techniques such as CT or fluoroscopy must be carefully considered given the increased susceptibility to radiation in this young patient population. In this paper, we present a review of the aetiology, clinical work-up, differential diagnosis, and latest theories on the genetics of early-onset and very-early onset (<6 years) IBD. We also present our experience in the imaging of these children with particular focus on the difficulties and nuances that this group present to the radiologist.

Quantitative bowel apparent diffusion coefficient measurements in children with inflammatory bowel disease are not reproducible.

AIM: To investigate the intra-observer and interobserver variability of quantitative apparent diffusion coefficient (ADC) measurements in children with inflammatory bowel disease. MATERIALS AND METHODS: Nine readers were recruited. Six magnetic resonance imaging (MRI) enterography cases with known active disease in the jejunum, terminal ileum, or colon were analysed. Readers measured repeat ADC values from the known diseased site and an unaffected site, at two sittings. RESULTS: Seven readers completed the study. The Lin concordance coefficient for intra-observer agreement was poor (0.844, 95% confidence interval [CI]: 0.77, 0.896). Bland-Altman limits of agreement for intra-observer agreement were 0.66×10-3 mm2/s (95% CI: 0.46, 0.86), and -0.56×10-3 mm2/s (95% CI: -0.36, -0.76). Therefore, a single measured value would be compatible with no disease, superficial ulceration, or deep ulceration according to published thresholds. Interobserver variability was poor to moderate across all observers (intraclass correlation coefficient [ICC]: 0.51, 95% CI: 0.27, 0.77). Between the two best-agreeing observers, agreement was good using the ICC (ICC 0.85, 95% CI: 0.43, 1.0), but poor using the Lin correlation coefficient (Lin 0.83, 95% CI: 0.65, 0.93), and Bland-Altman. CONCLUSION: The intra-observer and interobserver agreement is inadequate to allow accurate characterisation of disease activity using previously published thresholds. Qualitative ADC assessment may be preferable.

There is good agreement between MR enterography and bowel ultrasound with regards to disease location and activity in paediatric inflammatory bowel disease.

AIM: To investigate concordance of bowel ultrasound and magnetic resonance enterography (MRE) in identifying active disease in children with inflammatory bowel disease. MATERIALS AND METHODS: The imaging of children with inflammatory bowel disease who had undergone bowel ultrasound and MRE within 30 days were retrospectively reviewed, from January 2009 to November 2015. Ultrasound was without oral contrast medium; MRI was conducted with patients unsedated with oral contrast medium and gadolinium. Imaging data included bowel thickness, markers of activity, and complications. Endoscopy and biopsy reports were also reviewed. RESULTS: Forty-nine patients (median age 14 years, 33 male) met the inclusion criteria, and 31 children also had endoscopy within 30 days. Active inflammation was seen in 17.6% of bowel segments at ultrasound and 17.3% at MRE. There was good agreement between ultrasound and MRE on the location and activity of disease (Cohen's kappa 0.75, 95% confidence interval [CI]: 0.66-0.83). One patient had an inflammatory phlegmon detected at MRE only; there was no other significant discrepancy in identifying complications. In patients with histopathology, MRE, and ultrasound demonstrated high specificity 85.1% (77.9-90.6) and 86.6% (79.6-91.8) at the bowel segment level. Technical difficulties, including poor tolerance of oral contrast medium and movement, were more common in MRE. CONCLUSION: There was good concordance between MRE and ultrasound for disease location and activity, and fewer technical difficulties with ultrasound. Bowel ultrasound is useful in children, and its use is advocated.

Determining Good Environmental Status under the Marine Strategy Framework Directive: Case study for descriptor 8 (chemical contaminants).

The European Union Marine Strategy Framework Directive (MSFD) requires individual member states to develop a robust set of tools for defining eleven qualitative descriptors of Good Environmental Status (GES), such as demonstrating that "Concentrations of contaminants are at levels not giving rise to pollution effects" (GES descriptor 8). Adopting the recommendations of the ICES/OSPAR Study Group for the Integrated Monitoring of Contaminants and Biological Effects (SGIMC), we present a case study demonstrating how the proposed approach, using chemical contaminant (metals and polycyclic aromatic hydrocarbons and polychlorinated biphenyls) and biological effects (EROD, bile metabolites and pathology) data in different matrices (sediment and biota), could be used to contribute to the determination of GES in a region of the North Sea region off the east coast of the UK.

Microsecond resolution of cavitation bubble dynamics using a high-speed electrochemical impedance approach.

A new method to detect the uncompensated resistance, the capacitance and the Faradaic current at an electrode exposed to ultrasonic cavitation is presented. The method enables these parameters to be resolved with a 2 microsecond resolution and relies on the detection of the impedance of an electrode recorded as a function of time with a suitable AC excitation signal (here 500 kHz). Data obtained from an aluminium electrode, held under potentiostatic control, is used to illustrate the technique with particular relevance to the effects of cavitation bubbles generated by ultrasound. Analysis of the data recorded shows that the cavitation bubbles form close to the surface of the electrode and collapse, causing damage to the passive film formed at the aluminium surface. The capacitance, uncompensated resistance and Faradaic signals are used to explore the dynamic processes and show expansion and collapse of bubbles prior to erosion/corrosion. The close proximity of the bubbles to the surface is deduced from the reductions in capacitance and increases in resistance prior to bubble collapse, which is then shown to trigger the onset of a Faradaic signal, thus confirming the erosion/corrosion mechanism previously assumed.

Inferior vena cava calibre on paediatric trauma CT may be a useful predictor for the development of shock.

AIM: To investigate whether inferior vena cava (IVC) calibre on paediatric trauma computed tomography (CT) can help anticipate outcomes in children. MATERIALS AND METHODS: The imaging and clinical records of 52 paediatric trauma admissions to the level 1 major trauma centre at St George's Hospital, London, UK, were retrospectively reviewed. The IVC dimensions, evidence of significant haemorrhage on CT, and the presence of components of the classical hypoperfusion complex, such as bowel and adrenal hyperenhancement, were recorded. Clinical data included observations at the time of admission and for the subsequent 48-hour period where available, blood gas results, length of stay, and mortality. RESULTS: There was a significant relationship between IVC dimensions in this cohort and the development of shock during the 24-hour admission period. IVC dimensions did not, however, reflect the haemodynamic status at the time of admission, and were not predictive of a longer hospital stay. There were no mortalities among the cases. A weak correlation was also seen with serum lactate, a finding that has also been seen in adults, but is of uncertain clinical significance. CONCLUSIONS: IVC calibre was found to be a more useful predictor of shock than heart rate or blood pressure, and may, therefore, prove to be a useful predictor of impending haemodynamic instability in children as it is in adults. Although the study was carried out at a busy unit, the numbers are acknowledged to be small and a larger study would be needed to validate these findings and identify whether there is any variation in the CT appearances between different age groups.

Pleural fluid accumulation detectable on paediatric post-mortem imaging: a possible marker of interval since death?

OBJECTIVES: The aim of this preliminary study is to evaluate whether pleural fluid accumulates following death in a predictable manner, in particular whether such collections are related to post-mortem interval. METHODS: Images acquired by post-mortem magnetic resonance imaging (PMMR) were both subjectively and objectively assessed for extent of pleural fluid accumulation. Total thoracic volume and pleural fluid volume were calculated using segmentation functions on OSIRIX software. The percentage of pleural fluid as a percentage of thoracic volume was calculated, to account for variation in subject size. The cause of death as per the final autopsy report and the interval from death to imaging were also recorded. RESULTS: Twelve perinatal deaths/stillbirths (mean gestation 38 weeks, range 24-48 weeks, male/female 5:7) and 11 childhood deaths (mean age 1 year, range 1 day-4 years, male/female 3:8) were assessed. The mean interval from death to imaging for all cases was 7.5 days (range 1-23 days). Pleural fluid was present in almost all cases, and the mean percentage pleural effusion as a proportion of thoracic volume was 3.3 % (range 0.2-9.5 %). There was a significant correlation between the post-mortem interval and the amount of pleural fluid in childhood deaths (p < 0.05) but no significant relationship for perinatal deaths. CONCLUSION: The accumulation of pleural fluid detectable on PMMR in children is related to post-mortem interval. If this holds for a larger population, it may therefore be a useful marker for estimating time of death. A similar relationship was not found for perinatal deaths and stillbirths, the reasons for which remain uncertain.

Baseline survey of marine sediments collected from the State of Kuwait: PAHs, PCBs, brominated flame retardants and metal contamination.

A geographically extensive baseline survey of sediment contamination was undertaken at twenty nine locations around Kuwait. Samples were assessed in relation to a wide range of industrial pollutants, including metals, PAHs, PCBs, PBDEs and HBCDs. The data generated indicated that levels of pollutants were generally low and below commonly applied sediment quality guidelines (SQGs). However, naturally high background concentrations of certain metals present in sediment from the region may prohibit the direct assessment against some of the routinely applied SQGs. Hot spots of contamination were identified for PAHs, PCBs and PBDEs, that were mainly associated with the Shuaiba Industrial Area, located south of the city, and known to contain a diverse mix of both light and heavy industry.

Microbial water quality and sedimentary faecal sterols as markers of sewage contamination in Kuwait.

Microbial water quality and concentrations of faecal sterols in sediment have been used to assess the degree of sewage contamination in Kuwait's marine environment. A review of microbial (faecal coliform, faecal streptococci and Escherichia coli) water quality data identified temporal and spatial sources of pollution around the coastline. Results indicated that bacterial counts regularly breach regional water quality guidelines. Sediments collected from a total of 29 sites contained detectable levels of coprostanol with values ranging from 29 to 2420 ng g(-1) (dry weight). Hot spots based on faecal sterol sediment contamination were identified in Doha Bay and Sulaibikhat Bay, which are both smaller embayments of Kuwait Bay. The ratio of epicoprostanol/coprostanol indicates that a proportion of the contamination was from raw or partially treated sewage. Sewage pollution in these areas are thought to result from illegal connections and discharges from storm drains, such as that sited at Al-Ghazali.

Histopathology and contaminant concentrations in fish from Kuwait's marine environment.

Kuwait has witnessed major socioeconomic and industrial development in recent decades. Consequently, a variety of contaminants related to these activities have been discharged directly into the marine environment. This paper describes the application of a histopathology baseline survey in two potential sentinel species, the Giant sea catfish (Arius thalassinus) and the Fourlined terapon (Pelates quadrilineatus) to assess the health of biota inhabiting Kuwait's marine environment. Histological analysis revealed several lesion types in both species, although the prevalence was generally considered low with no discernible differences between sampling locations. The analysis of contaminant burdens (metals, PCBs, PBDEs, HBCDD) in A. thalassinus, along with the analysis of bile for PAH metabolites in both species, indicated that levels of contaminant exposure was low. Overall the data show that both species appear to be susceptible to pathologies associated with environmental contaminants and therefore suitable for further investigation as sentinel organisms for biological effects monitoring.

NR2B- and NR2D-containing synaptic NMDA receptors in developing rat substantia nigra pars compacta dopaminergic neurones.

NMDA receptors are present at glutamatergic synapses throughout the brain, and are important for the development and plasticity of neural circuits. Their subunit composition is developmentally regulated. We have investigated the developmental profile of functional synaptic NMDA receptor subunits in dopaminergic neurones of the substantia nigra pars compacta (SNc). In SNc dopaminergic neurones from rats aged postnatal day (P)7, ifenprodil inhibited NMDA-EPSCs with an estimated IC(50) of 0.36 microm and a maximum inhibition of 73.5 +/- 2.7% (10 microm), consistent with a substantial population of NR1/NR2B-containing diheteromeric receptors. UBP141, a novel NR2D-preferring antagonist, inhibited NMDA-EPSCs with an estimated IC(50) of 6.2 microm. During postnatal development, the maximum inhibitory effect of 10 microm ifenprodil significantly decreased. However, NMDA-EPSCs were not inhibited by Zn(2+) (200 nM) or potentiated by the Zn(2+) chelator TPEN (1 microm), and the effect of UBP141 did not increase during development, indicating that NR2B subunits are not replaced with diheteromeric NR2A or NR2D subunits. The time course of the decay of NMDA-EPSCs was not significantly changed in ifenprodil at any age tested. Together, these data suggest that diheteromeric NR1/NR2A or NR1/NR2D receptors do not account for the ifenprodil-resistant component of the NMDA-EPSC. We propose that NR1/NR2B/NR2D triheteromers form a significant fraction of synaptic NMDA receptors during postnatal development. This is the first report of data suggesting NR2D-containing triheteromeric NMDA receptors at a brain synapse.

LPN role advancement: from blueprints to ribbon cutting.

The role of the Licensed Practical Nurse (LPN) in an acute care setting has been a point of debate for many years. Increasing LPN job responsibility has not been widely reported. In this article, the authors describe the process used to advance the LPN role. Emphasized here is the educators' contribution to the process from inception to implementation.

Transgenic mice expressing targeted HPV-18 E6 and E7 oncogenes in the epidermis develop verrucous lesions and spontaneous, rasHa-activated papillomas.

In order to create a transgenic model for human papilloma virus (HPV)-associated carcinogenesis, we have used the regulatory elements of a human keratin K1 (HK1) gene to target the expression of the E6 and E7 oncogenes of HPV-18 exclusively to the epidermis. All murine expressors were viable and lived normal lifetimes; older mice (> 1 year) possessed numerous small lesions with a verrucous (wart-like) histotype. Analysis of newborn epidermis and lesions revealed that the HPV-18 E6/E7 genes were being expressed with a predominance of the E6*/E7 transcript over the full length E6/E7 message. The long latency in lesion appearance may reflect the low level of intact E6 transcripts and the requirement for additional genetic or epigenetic events before production of an overt lesion. In agreement with this proposal, spontaneous papillomas developed that expressed an activated rasHa oncogene (codon 61, A-->T; codon 13, G-->T). All lesions expressed keratin genes K1, K6, and K13 in a fashion characteristic of hyperproliferative or benign tumors with no evidence of malignant conversion. Our results demonstrate that the mouse epidermis represents a relevant in vivo model system to analyze the interaction between HPV and cellular genes in neoplasia.

Cooperation between v-fos and v-rasHA induces autonomous papillomas in transgenic epidermis but not malignant conversion.

Transgenic mice have been previously established that express v-rasHa or v-fos exclusively in the epidermis by means of a targeting vector based on the human keratin 1 gene (HK1). Epidermal expression of v-rasHa (HK1.ras) or v-fos (HK1.fos) resulted in hyperplasia, hyperkeratosis, and later, in benign tumors. To assess the potential for oncogene cooperation in vivo mating experiments were performed. Resultant HK1.fos/ras mice exhibited an obvious increase in the severity of neonatal and juvenile preneoplastic phenotypes, together with the immediate onset of tumorigenesis as compared to single oncogene sibling controls. The HK1.fos/ras tumors grew aggressively and often compromised the animals by 10-12 weeks. However, tumors remained benign as determined by histotype and specific keratin markers. These data indicate that v-fos can cooperate with an initiating v-rasHa phenotype to generate autonomous papillomas, but additional events are required for malignant conversion.

Endoscopic sinus surgery. A 300 case review.

The introduction of ESS (endoscopic sinus surgery) has changed and vastly improved the potential of sinus surgery. It is now possible to visualize obstruction in the natural sinus ostia and remove diseased tissue, thereby promoting restoration of normal function. A series of 300 consecutively performed cases is reviewed; results and complications are reported. Findings include a success rate of 94%, with complications in less than 1%. ESS offers a major advancement in treatment of chronic sinusitis.