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BACKGROUND The VentriFlo® True Pulse Pump (VentriFlo, Inc, Pelham, NH, USA) is a new pulsatile blood pump intended for use during short-term circulatory support. The purpose of this study was to evaluate the feasibility of the VentriFlo and compare it to a conventional centrifugal pump (ROTAFLOW, Getinge, Gothenberg, Sweden) in acute pig experiments. METHODS Pigs (40-45 kg) were supported by cardiopulmonary bypass (CPB) with the VentriFlo (n = 9) or ROTAFLOW (n = 5) for 6 h. Both VentriFlo and ROTAFLOW circuits utilized standard CPB components. We evaluated hemodynamics, blood chemistry, gas analysis, plasma hemoglobin, and microcirculation at the groin skin with computer-assisted video microscopy (Optilia, Sollentuna, Sweden). RESULTS Pigs were successfully supported by CPB for 6 h without any pump-related complications in either group. The VentriFlo delivered an average stroke volume of 29.2 ± 4.8 ml. VentriFlo delivered significantly higher pulse pressure (29.1 ± 7.2 mm Hg vs. 4.4 ± 7.0 mm Hg, p

The VentriFlo True Pulse Pump (Design Mentor, Inc., Pelham, NH, USA) is the first blood pump designed to mimic human arterial waveforms in a standard oxygenation circuit. Our aim was to demonstrate the feasibility and safety of this pump in preparation for future studies to determine possible clinical advantages. We studied four piglets (41.4-46.2 kg): three with an implanted VentriFlo pulsatile pump and one with the nonpulsatile ROTAFLOW pump (MAQUET Holding B.V. & Co. KG, Rastatt, Germany) as a control. Hemodynamics was monitored during 6-h cardiopulmonary bypass (CPB) support and for 2 h after weaning off CPB. The VentriFlo demonstrated physiologic arterial waveforms with arterial pulse pressure of 24.6 ± 5.7 mm Hg. Pump flows (2.0 ± 0.1 L/min in ROTAFLOW; 1.9 ± 0.1 L/min in VentriFlo) and plasma free hemoglobin levels (27.9 ± 12.5 mg/dL in ROTAFLOW; 28.5 ± 14.2 mg/dL in VentriFlo) were also comparable, but systemic O2 extraction (as measured by arterial minus venous O2 saturation) registered slightly higher with the VentriFlo (63.2 ± 6.9%) than the ROTAFLOW (55.4 ± 6.5%). Histological findings showed no evidence of ischemic changes or thromboembolism. This pilot study demonstrated that the VentriFlo system generated pulsatile flow and maintained adequate perfusion of all organs during prolonged CPB.

Fish grown in open ocean aquaculture facilities from two commercial farms in Hawai’i were assessed for the presence of the marine toxin ciguatoxin. Facilities were surveyed for the presence of the marine benthic dinoflagellate, Gambierdiscus spp., which is known to produce the toxin. The dinoflagellate was detected in three submerged open ocean cages operated by Hukilau Foods (formerly known as Cates International Inc.) and one open ocean cage operated by Kona Blue Water Farms at relatively low levels averaging 142 cells Gambierdiscus spp./g algae, suggesting a low probability that fish cultured in open cages would be ciguatoxic. A total of 60 individual cultured almaco jack, Seriola rivoliana, or kahala, and 10 individual cultured Pacific threadfin, Polydactylus sexfilis ,o r moi, grown in open ocean aquaculture facilities have been examined for the presence of ciguatoxin using two methods: an immunoassay for detecting picogram levels of ciguatoxin in fish extract, and a neuroblastoma cell assay commonly used to screen for the presence of marine toxins in fish. Using the neuroblastoma assay, none of the cultured fish were found to contain ciguatoxin. Conversely, 81 wildcaught kahala were examined using both methods with 7.4% screening positive for ciguatoxin. These findings indicate that ciguatoxin is prevented from entering the culture process for both S. rivoliana and P. sexfilis raised in open ocean aquaculture facilities even when Gambierdiscus spp. is present. Ciguatera fish poisoning is an intoxication resulting in characteristic gastrointestinal and neurological symptoms following the ingestion of fish containing ciguatoxin (CTX) or one of its congeners. It is the most common marine toxin poisoning worldwide, with more

This paper describes the diffusion of an evidence-based stroke guidance system (SGS) in a field setting through participatory research. SGS enables physicians to review relevant evidence-based literature, from which patient orders are generated for managing cerebrovascular accident. The paper focuses on the question 'what are the barriers and enablers to adopting SOS?' The research site consisted of eight hospitals within two health regions in Alberta, with 47 physicians as the intended users. The data sources consisted of surveys, education sessions, design feedback, field observations, and usage logs. Preliminary results revealed an initial slow rate of adoption that gradually improved with the influence of clinical champions, more effective communication, sustained education, round-the-clock support and continued system refinement. These initial findings suggest that models of technological diffusion can help us better understand the complexities of changing physician practice behaviors.

The applicability of a new enzyme‐linked immunoassay (ELISA) for detecting ciguatoxin (CTX) in fish tissue was evaluated by testing three fish species commonly implicated in ciguatera fish poisoning in Hawaii. A total of 164 individual almaco jack (Seriola rivoliana) and greater amberjack (S. dumerili) and a total of 175 individuals of the blue‐spotted grouper (Cephalopholis argus) were caught at various locations in the Hawaiian Islands. Muscle tissue from each individual was assessed for the presence of CTX using two methods: a semi‐quantitative ELISA that was recently developed for detecting picogram levels of CTX in fish extract and a neuroblastoma (NB) cell assay commonly used to screen for marine toxins in fish. Results of the tests were highly correlated, with the ELISA indicating the presence of CTX in 9.4% of all fish samples, and the NB assay indicating toxicity in 6.8% of the fish samples. We conclude that the ELISA produces reliable and accurate results that are consistent with those provided by the accepted NB assay and that the ELISA has potential for future applications in screening fish populations for CTX. J. Clin. Lab. Anal. 22:246–253, 2008. © 2008 Wiley‐Liss, Inc.