Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine.

No abstract

Enantioselectivity in ecotoxicity of chiral pesticides in the aquatic environment has been a subject of growing interest. In this study, the toxicological impacts of hexaconazole enantiomers were investigated with freshwater algae Scenedesmus obliquus. After 96 h of exposure, the EC(50) values for rac-hexaconazole, (+)-hexaconazole, and (-)-hexaconazole were 0.178, 0.355, and 0.065 mg l(-1) , respectively. Therefore, the acute toxicities of hexaconazole enantiomers were enantioselective. In addition, the different toxic effects were evaluated when S. obliquus were exposed to 0.2, 0.5, and 1.0 mg l(-1) of rac-hexaconazole, (+)-hexaconazole, and (-)-hexaconazole during 96 h, respectively. The chlorophyll a and chlorophyll b contents of S. obliquus treated by (-)-hexaconazole were lower than those exposed to (+)-hexaconazole, whereas the malondialdehyde contents of S. obliquus treated by (-)-form were higher than those exposed to (+)-form at higher concentrations. In general, catalase activities were significantly upregulated by exposure to (-)-enantiomer than (+)-enantiomer at all three concentrations. However, superoxide dismutase activities exposed to (-)-hexaconazole were lower than that exposed to (+)-hexaconazole at 0.2 mg l(-1) and 0.5 mg l(-1) . On the basis of these data, the acute toxicity and toxic effects of hexaconazole against S. obliquus were enantioselective, and such enantiomeric differences must be taken into consideration in pesticide risk assessment.

Fipronil is an effective insecticide, but it presents highly toxic effects in nontarget aquatic organisms. The present study examined the enantioselective toxicity and degradation of fipronil enantiomers in a freshwater algae Scenedesmus obliguus suspension. There was a substantial difference in the acute toxicity of the enantiomers to S. obliguus, with 72-h median effective concentrations (EC50s) of 0.29 mg L(-1) and 1.50 mg L(-1) for the R-fipronil and S-fipronil, respectively. The influences on the concentration of chlorophyll a, chlorophyll b, and carotenoids were determined, and the effects of fipronil on the concentration of chlorophyll a and chlorophyll b were also enantioselective. The degradation of fipronil in algae suspension was enantioselective, with half-lives for R-fipronil and S-fipronil of 2.9 d and 3.2 d, respectively, and the enantiomer fraction reaching 0.65 at the day 17. The enantiomeric differences should be taken into consideration for fipronil risk assessment.

In this study the stereoselective bioaccumulation and transformation of triadimefon and the toxicity of triadimefon and its metabolite triadimenol to the green algae Scenedesmus obliquus were studied. In growth inhibition experiments, triadimenol was more toxic than triadimefon, and (1S,2R)-triadimenol, which has the largest fungicidal activity, presented the highest toxicity to the algae. In bioaccumulation experiments, triadimefon was rapidly taken up by algae cells, and the decrease in the concentration of triadimefon was accompanied by an increase in triadimenol. The transformation of S-(+)- triadimefon was faster than that of the R-(-)-enantiomer, resulting in four triadimenol stereoisomers at different forming rates: B2 (1S, 2S) > B1 (1R, 2R) > A2 (1S, 2R) > A1 (1R, 2S). Thus, it is necessary to explore the enantioselective toxicology and ecological fate of these chiral pesticides in an environmental risk assessment. Also, their metabolites should be paid specific attention to since they may pose higher ecological risks.