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Background Quick Sepsis‐related Organ Failure Assessment (qSOFA) is recommended for use by the most recent international sepsis definition taskforce to identify suspected sepsis in patients outside the intensive care unit (ICU) at risk of adverse outcomes. Evidence of its comparative effectiveness with existing sepsis recognition tools is important to guide decisions about its widespread implementation. Aim To compare the performance of qSOFA with the adult sepsis pathway (ASP), a current sepsis recognition tool widely used in NSW hospitals and systemic inflammatory response syndrome criteria in predicting adverse outcomes in adult patients on general wards. Methods A retrospective observational cohort study was conducted which included all adults with suspected infections admitted to a Sydney teaching hospital between December 2014 and June 2016. The primary outcome was in‐hospital mortality with two secondary composite outcomes. Results Among 2940 patients with suspected infection, 217 (7.38%) died in‐hospital and 702 (23.88%) were subsequently admitted to ICU. The ASP showed the greatest ability to correctly discriminate in‐hospital mortality and secondary outcomes. The area under the receiver‐operating characteristic curve for mortality was 0.76 (95% confidence interval (CI): 0.74–0.78), compared to 0.64 for the qSOFA tool (95% CI: 0.61–0.67, P

POPs (persistente organische Schadstoffe), die an aquatischen Sedimenten binden, konnen zuruck in Nahrungsnetze gelangen und so zu einem Risiko fur aquatische Organismen werden. Dabei kann die Bioakkumulation solcher Substanzen in endobenthischen, sedimentfressenden Invertebraten (z.B. aquatische Oligochaeten) eine grose Rolle spielen. Diese Wurmer dienen vielen benthivoren Fischen als Nahrung. Letztere nehmen uber diesen Weg sedimentgebundene Chemikalien auf und konnen hierbei deutlich hohere Korperkonzentrationen (body residues) erreichen als durch die Anreicherung aus der Wasserphase. Die angereicherten Ruckstande konnen im weiteren Verlauf der Nahrungskette an Glieder hoherer trophischer Ebenen weitergegeben werden. Zur standardisierten Bestimmung der Bioakkumulation und — magnifikation wurde eine einfache, zwei trophische Stufen umfassende Labornahrungskette etabliert. Diese bestand aus dem endobenthischen Oligochaeten Tubifex tubifex und dem Dreistachligen Stichling (Gasterosteus aculeatus) als Pradator. Die Experimente wurden mit 14C-markiertem Hexachlorbenzol in dotiertem kunstlichem Sediment und rekonstituiertem Wasser durchgefuhrt. Um den Einfluss benthischer Beuteorganismen zu quantifizieren, wurden die Fische gegenuber dotiertem Wasser bzw. Sediment (Biokonzentration), vorexponierten Wurmern (Biomagnifikation) und Kombinationen dieser Aufnahmepfade exponiert. HCB wurde entlang der Labornahrungskette deutlich angereichert. Es konnte gezeigt werden, dass die Exposition gegenuber der Kombination samtlicher Aufnahmepfade zu deutlich hoherer Anreicherung in den Fischen fuhrte als im Falle einzelner Expositionspfade. Der Vergleich der Einzelergebnisse lies den Schluss zu, dass neben dem freien Wasserkorper die kontaminierte Nahrung der Hauptaufnahmeweg fur den Fisch war. Bei der Bewertung von POPs wie HCB hinsichtlich Biomagnifikation und ‘secondary poisoning’ sollten daher Nahrung und Sediment als Expositionspfade unter Verwendung von Nahrungsketten-modellen und/oder Labortests starker berucksichtigt werden.

The toxicity of lindane, hexachlorobenzene, and copper sulfate to Tubifex tubifex and Limnodrilus hoffmeisteri was determined using an easily applicable and standardizable 72-h short-term test system. It was designed for the quick assessment of sublethal and lethal effects of sediment-associated chemicals on the worms. An artificial sediment based on the Artificial Soil according to OECD Guideline No. 207 was used as test medium. The data confirm the common view that oligochaetes are highly tolerant of lethal effects. However, sublethal effects were detected at considerably lower concentrations than found for lethal effects. The EC 50 values for autotomy (172 mg/kg dry wt sediment) and sediment avoidance (217 mg/kg) for T. tubifex exposed to lindane-contaminated sediment were, for example, more than five times lower than the LC 50 value (>1000 mg/kg). The no-observed-effect concentration for reworking activity (8 mg/kg) was more than 125 times lower than the LC 50 . Tubificids thus turned out to represent useful test organisms for the assessment of the ecotoxicological hazard potential of chemicals in the sediment compartment, because the sublethal effects not only affect the individual, but can influence the population levels and, consequently, the composition of the benthic community.

A sediment contact test (SCT) battery consisting of five ecotoxicological test systems was applied to 21 native freshwater sediments characterized by a broad variety of geochemical properties and anthropogenic contamination. Higher plants (Myriophyllum aquaticum), nematodes (Caenorhabditis elegans), oligochaetes (Lumbriculus variegatus), zebrafish embryos (Danio rerio), and bacteria (Arthrobacter globiformis), representing various trophic levels and exposure pathways, were used as test organisms. The test battery detected sediment toxicity caused by anthropogenic pollution, whereas the various tests provided site-specific, nonredundant information to the overall toxicity assessment. Based on the toxicity pattern derived from the test battery, the sediments were classified according to a newly proposed classification system for sediment toxicity assessment. The SCT-derived classification generally agreed well with the application of consensus-based sediment quality guidelines (SQGs), especially with regard to sediments with high toxic potential. For sediments with low to medium toxic potential, the SQGs often underestimated the toxicity that was detected by the SCTs, underpinning the need for toxicity tests in sediment quality assessment. Environ. Toxicol. Chem. 2013;32:144–155. © 2012 SETAC

In recent years there has been growing interest on the occurrence and the fate of pharmaceuticals in the aquatic environment. Nevertheless, few data are available covering the fate of the pharmaceuticals in the water/sediment compartment. In this study, the environmental fate of 10 selected pharmaceuticals and pharmaceutical metabolites was investigated in water/sediment systems including both the analysis of water and sediment. The experiments covered the application of four 14C-labeled pharmaceuticals (diazepam, ibuprofen, iopromide, and paracetamol) for which radio-TLC analysis was used as well as six nonlabeled compounds (carbamazepine, clofibric acid, 10,11-dihydro-10,11-dihydroxycarbamazepine, 2-hydroxyibuprofen, ivermectin, and oxazepam), which were analyzed via LC-tandem MS. Ibuprofen, 2-hydroxyibuprofen, and paracetamol displayed a low persistence with DT50 values in the water/sediment systemor =20 d. The sediment played a key role in the elimination of paracetamol due to the rapid and extensive formation of bound residues. A moderate persistence was found for ivermectin and oxazepam with DT50 values of 15 and 54 d, respectively. Lopromide, for which no corresponding DT50 values could be calculated, also exhibited a moderate persistence and was transformed into at least four transformation products. For diazepam, carbamazepine, 10,11-dihydro-10,11-dihydroxycarbamazepine, and clofibric acid, system DT90 values of365 d were found, which exhibit their high persistence in the water/sediment system. An elevated level of sorption onto the sediment was observed for ivermectin, diazepam, oxazepam, and carbamazepine. Respective Koc values calculated from the experimental data ranged from 1172 L x kg(-1) for ivermectin down to 83 L x kg(-1) for carbamazepine.

Sediments contaminated with poorly water-soluble organic chemicals pose a risk to aquatic food chains. Sediment-associated chemicals can be accumulated by endobenthic, sediment-ingesting invertebrates. Some tubificid species – or other benthic annelids – serve as food for benthivorous fish, which thereby ingest the sediment-borne chemicals and may accumulate contaminant concentrations far higher than from water exposure only, and transfer them to organisms of higher trophic levels. For measurement of biomagnification, a sediment based food chain was developed and established in the laboratory. The two-step food chain included the sediment-dwelling freshwater oligochaete Tubifex tubifex (Muller) as a representative species of benthic infauna. The three-spined stickleback (Gasterosteus aculeatus, Linne), a small teleost fish which often feeds primarily on benthic invertebrates, served as a model predator. Spiked artificial sediment and reconstituted water as the overlying medium were used. Experiments were performed using 14C-labelled hexachlorobenzene, a hydrophobic pollutant as a model compound. To examine the influence of benthic prey on the bioaccumulation of the test substance in the predator, fish were exposed to spiked water, spiked sediment, pre-contaminated prey organisms, or combinations of these exposure routes. The results of these experiments indicate that for hexachlorobenzene, the presence of contaminated Tubifex tubifex as a food source in combined exposure leads to significantly higher accumulation in fish than exposure to single pathways.

Lipophilic chemicals entering aquatic ecosystems often tend to adsorb to sediments. Although often not bioavailable to pelagic organisms, these compounds can be subject to bioaccumulation and thus pose a potential threat for sediment-dwelling organisms. The assessment of bioaccumulation is currently based on the extrapolation of fish bioconcentration data. Thus, measuring the bioaccumulation in benthic organisms gives more detailed information on the hazard of chemicals for aquatic ecosystems. The freshwater tubificids Tubifex tubifex and Limnodrilus hoffmeisteri were chosen as test organisms. Breeding of the oligochaetes as well as bioaccumulation studies were carried out in a system consisting of artificial sediment and reconstituted water. 14C-lindane (γ-hexachlorocyclohexane, γ-HCH) and 14C-hexachlorobenzene (HCB) served as model substances. Additionally, 14C-3,4-dichloroaniline (3,4-DCA) was tested. Uptake and elimination of lindane and HCB were examined. Bioaccumulation factors (BAF) were determined from the ratio of concentration in oligochaete tissue to concentration in sediment. The tubificids accumulated 14C-lindane, 14C— HCB, and 14C-3,4-DCA by factors of 4.7 (mean value; n = 4), 6.6 (mean value; n = 4) and 13.2, respectively, based on wet weight and radioactive concentrations. No major metabolites were detected in worms, sediment and water. Elimination kinetics were examined for 14C-lindane and 14C-HCB. When transferred to clean sediment, the worms eliminated both test substances rapidly and nearly completely. The tubificid bioaccumulation factors are contrasted with corresponding fish bioconcentration factors from literature. The presented data indicate once more that the assessment of bioaccumulation based exclusively on lipophilicity and on the extrapolation of fish bioconcentration data to other organisms or environmental compartments is not appropriate.