Activity Levels and Outcomes of a Standalone Regional Paediatric High Dependency Unit.

Aim The Paediatric High Dependency Unit (PHDU) at University Hospital Limerick (UHL) operates as the only standalone unit outside of Dublin centres. The aim of this study was to describe a regional PHDU population, compare outcomes with international standards (PICANet) and ensure adequate clinical governance. Methods This is a retrospective analysis of 126 admission records from January - December 2019. Results There were 126 admissions to PHDU in 2019, of which respiratory (n=81, 64.3%) and neurological (n=23, 18.3%) subgroups represented the largest populations. Median length of stay was two days with mean age of admission 3.97 ± 4.5 years and slightly more male admissions (56%). Of the total, 65% required oxygen, 32.1% needed CPAP directly and 38% commenced high-flow, of whom 29% transitioned to CPAP. Transfer for tertiary care was required in 10.3%, of whom 7.9% needed PICU. Conclusion The data show UHL PHDU to have a patient population reflecting international trends as well as producing satisfactory patient outcomes. With a low rate of transfer for tertiary care and given that 15 other paediatric units exist in the Republic of Ireland outside Dublin, development of regional PHDU capacity would provide great opportunity to decrease strain on PICU bed capacity, particularly during busy Winter months.

Bone induction at physiological doses of BMP through localization by clay nanoparticle gels.

Bone Morphogenic Protein 2 (BMP2) can induce ectopic bone. This ability, which first motivated the widespread application of BMP2 in fracture healing and spinal arthrodesis has, more recently, been indicated as one of several serious adverse effects associated with the supra-physiological doses of BMP2 relied upon for clinical efficacy. Key to harnessing BMPs and other agents safely and effectively will be the ability to localize activity at a target site at substantially reduced doses. Clay (Laponite) nanoparticles can self assemble into gels under physiological conditions and bind growth factors for enhanced and localized efficacy. Here we show the ability to localize and enhance the activity of BMP2 to achieve ectopic bone formation at doses within the sub-microgram per ml range of concentrations sufficient to induce differentiation of responsive cell populations in vitro and at approximately 3000 fold lower than those employed in clinical practice.

Does consumption of leafy vegetables grown in peri-urban agriculture pose a risk to human health?

Concentrations of potentially toxic elements were measured in soils and five contrasting tropical leafy vegetables grown in a replicated field trial at five contaminated urban agriculture sites in Kampala City, Uganda. Soil contamination at each site could be tentatively ascribed to known waste disposal practices. There was considerable variation in metal uptake between vegetable types. Washing leafy vegetables reduced chromium and lead concentrations but exogenous contamination of leaves also depended on vegetable type, with Gynandropsis gynandra L. showing a marked tendency to accumulate Pb and Cr. For the worst case scenario of children consuming unwashed vegetables, some metal 'hazard quotient' (HQ) limits (1.0) were violated at four of the five sites studied. For the 25 'site-vegetable' combinations assessed, the HQ for Pb exceeded 1.0 in 36% of cases. A vegetable-specific site screening tool based on soil extraction with 0.01 M CaCl(2) and extrapolation to provide HQ values was assessed.

Trace metal uptake by tropical vegetables grown on soil amended with urban sewage sludge.

Trace metal uptake was measured for tropical and temperate leafy vegetables grown on soil from an urban sewage disposal farm in the UK. Twenty-four leafy vegetables from East Africa and the UK were assessed and the five vegetable types that showed the greatest Cd concentrations were grown on eight soils differing in the severity of contamination, pH and other physico-chemical properties. The range of Cd concentrations in the edible shoots was greater for tropical vegetables than for temperate types. Metal uptake was modelled as a function of (i) total soil metal concentration, (ii) CaCl(2)-soluble metal, (iii) soil solution concentration and (iv) the activity of metal ions in soil pore water. Tropical vegetables were not satisfactorily modelled as a single generic 'green vegetable', suggesting that more sophisticated approaches to risk assessment may be required to assess hazard from peri-urban agriculture in developing countries.

Assessing risk to human health from tropical leafy vegetables grown on contaminated urban soils.

Fifteen tropical leafy vegetable types were sampled from farmers' gardens situated on nine contaminated sites used to grow vegetables for commercial or subsistence consumption in and around Kampala City, Uganda. Trace metal concentrations in soils were highly variable and originated from irrigation with wastewater, effluent discharge from industry and dumping of solid waste. Metal concentrations in the edible shoots of vegetables also differed greatly between, and within, sites. Gynandropsis gynandra consistently accumulated the highest Cd, Pb and Cu concentrations, while Amaranthus dubius accumulated the highest Zn concentration. Cadmium uptake from soils with contrasting sources and severity of contamination was consistently lowest in Cucurbita maxima and Vigna unguiculata, suggesting these species were most able to restrict Cd uptake from contaminated soil. Concentrations of Pb and Cr were consistently greater in unwashed, than in washed, vegetables, in marked contrast to Cd, Ni and Zn. The risk to human health, expressed as a 'hazard quotient' (HQ(M)), was generally greatest for Cd, followed successively by Pb, Zn, Ni and Cu. Nevertheless, it was apparent that urban cultivation of leafy vegetables could be safely pursued on most sites, subject to site-specific assessment of soil metal burden, judicious choice of vegetable types and adoption of washing in clean water prior to cooking.

Ozone affects gas exchange, growth and reproductive development in Brassica campestris (Wisconsin fast plants).

Exposure to ozone (O(3)) may affect vegetative and reproductive development, although the consequences for yield depend on the effectiveness of the compensatory processes induced. This study examined the impact on reproductive development of exposing Brassica campestris (Wisconsin Fast Plants) to ozone during vegetative growth. Plants were exposed to 70 ppb ozone for 2 d during late vegetative growth or 10 d spanning most of the vegetative phase. Effects on gas exchange, vegetative growth, reproductive development and seed yield were determined. Impacts on gas exchange and foliar injury were related to pre-exposure stomatal conductance. Exposure for 2 d had no effect on growth or reproductive characteristics, whereas 10-d exposure reduced vegetative growth and reproductive site number on the terminal raceme. Mature seed number and weight per pod and per plant were unaffected because seed abortion was reduced. The observation that mature seed yield per plant was unaffected by exposure during the vegetative phase, despite adverse effects on physiological, vegetative and reproductive processes, shows that indeterminate species such as B. campestris possess sufficient compensatory flexibility to avoid reductions in seed production.

Phytoextraction of cadmium and zinc from arable soils amended with sewage sludge using Thlaspi caerulescens: development of a predictive model.

The objectives of this study were to assess the potential for using Thlaspi caerulescens as a phytoextraction plant and develop a user-advice model, which can predict the frequency of phytoextraction operation required under prescribed conditions. Pot and field trials were conducted using soil collected from a dedicated sewage sludge disposal facility. Soil amendments (sulphuric acid, potassium chloride and EDTA) intended to increase Cd solubility were also tested. Predictive models of Cd and Zn uptake were developed which were able to reproduce the observed pH-dependence of Cd uptake with an apparent maximum around pH 6. Chemical treatments did not significantly increase the uptake of Cd. The periodic use of phytoextraction with T. caerulescens to maintain soils below statutory metal concentration limits, when modern sewage sludges are repeatedly applied, seems very attractive given the non-intrusive and cost-effective nature of the process. The major limitations lie with the large-scale husbandry of T. caerulescens.

Effects of elevated carbon dioxide and ozone on the growth and yield of potatoes (Solanum tuberosum) grown in open-top chambers.

Potato (Solanum tuberosum cv. Bintje) was grown in open-top chambers under three carbon dioxide (ambient and seasonal mean concentrations of 550 and 680 mumol mol-1 CO2) and two ozone concentrations (ambient and an 8 h day-1 seasonal mean of 50 nmol mol-1 O3) between emergence and final harvest. Periodic non-destructive measurements were made and destructive harvests were carried out at three key developmental stages (24, 49 and 101 days after emergence) to establish effects on growth and tuber yield. Season-long exposure to elevated O3 reduced above-ground dry weight at final harvest by 8.4% (P < 0.05), but did not affect tuber yields. There was no significant interaction between CO2 and O3 for any of the growth and yield variables examined. Non-destructive analyses revealed no significant effect of elevated CO2 on plant height, leaf number or green leaf area ratio. However, destructive harvests at tuber initiation and 500 degrees Cd after emergence showed that above-ground dry weight (8 and 7% respectively) and tuber yield (88 and 44%) were significantly increased (P < 0.05) in the 550 mumol mol-1 CO2 treatment. Responses to 550 and 680 mumol mol-1 CO2 were not significantly different for most parameters examined, suggesting the existence of an upper limit to the beneficial influence of CO2 enrichment. Significant effects on above-ground dry weight and tuber yield were no longer apparent at final harvest, although tuber numbers were increased (P < 0.05) under elevated CO2, particularly in the smaller size categories. The results show that the O3 treatment imposed was insufficient to reduce tuber yields and that, although elevated CO2 enhanced crop growth during the early stages of the season, this beneficial effect was not sustained to maturity.

Tansley Review No. 115: Impact of ozone on the reproductive development of plants.

Sexual reproductive development is a crucial stage in the life cycle of higher plants as any impairment of the processes involved might have significant implications for the productivity of crop plants and the survival of native species. There is considerable evidence that exposure to ozone, even at current ambient levels in many industrialized countries, reduces grain and fruit yields and adversely affects yield quality. It is also well established that sensitivity to ozone may differ not only between species, but also between cultivars and populations of individual species, and that the impact of exposure is highly dependent on ozone concentration and the duration and timing of exposure. However, few studies have attempted to distinguish between the direct effects of air pollutants on reproductive development, and indirect effects mediated by injury to the vegetative organs and associated changes in the supply of assimilates and other essential resources to support reproductive growth, or the levels of endogenous growth regulators. This review considers the impact of ozone on the reproductive biology of agricultural and native species, and examines its direct effects on specific reproductive processes. The extent to which compensatory responses redress the adverse effects of exposure is also explored, with particular reference to recent studies of Brassica napus (oilseed rape), Brassica campestris (Wisconsin Fast Plants), Plantago major (greater plantain) and Triticum aestivum (wheat). contents Summary 421 I. introduction 421 II. effects of ozone on reproduction 423 III. influence of reproductive habit and implications for field-grown plants 438 IV. conclusions and future research 441 Acknowledgements 442 References 442.

Sap flow measurements of lateral tree roots in agroforestry systems.

Successful extension of agroforestry to areas of the semi-arid tropics where deep reserves of water exist requires that the tree species be complementary to the associated crops in their use of water within the crop rooting zone. However, it is difficult to identify trees suitable for dryland agroforestry because most existing techniques for determining water uptake by roots cannot distinguish between absorption by tree and crop roots. We describe a method for measuring sap flow through lateral roots using constant temperature heat balance gauges, and the application of this method in a study of complementarity of water use in agroforestry systems containing Grevillea robusta A. Cunn. Sap flow gauges were attached to the trunks and roots of Grevillea with minimum disturbance to the soil. Thermal energy emanating from the soil adversely affected the accuracy of sap flow gauges attached to the roots, with the result that the uncorrected values were up to eightfold greater than the true water uptake determined gravimetrically. This overestimation was eliminated by using a calibration method in which nonconducting excised root segments, with sap flow gauges attached, were placed adjacent to the live roots. The power consumption and temperature differentials of the excised roots were used to correct for external sources and internal losses of heat within the paired live root. The fraction of the total sap flow through individual trees supplied by the lateral roots varied greatly between trees of similar canopy size. Excision of all lateral roots, except for one to which a heat balance gauge was attached, did not significantly increase sap flow through the intact root, suggesting that it was functioning at near maximum capacity.