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The Maumee River is the primary source for nutrients fueling seasonal Microcystis-dominated blooms in western Lake Erie’s open waters though such blooms in the river are infrequent. The river also serves as source water for multiple public water systems and a large food services facility in northwest Ohio, USA. On 20 September 2017, an unprecedented bloom was reported in the Maumee River estuary within the Toledo metropolitan area, which triggered a recreational water advisory. Here we (1) explore physical drivers likely contributing to the bloom’s occurrence, and (2) describe the toxin concentration and bacterioplankton taxonomic composition. A historical analysis using ten-years of seasonal river discharge, water level, and local wind data identified two instances when high-retention conditions occurred over ≥10 days in the Maumee River estuary: in 2016 and during the 2017 bloom. Observation by remote sensing imagery supported the advection of cyanobacterial cells into the estuary from the lake during 2017 and the lack of an estuary bloom in 2016 due to a weak cyanobacterial bloom in the lake. A rapid-response survey during the 2017 bloom determined levels of the cyanotoxins, specifically microcystins, in excess of recreational contact limits at sites within the lower 20 km of the river while amplicon sequencing found these sites were dominated by Microcystis. These results highlight the need to broaden our understanding of physical drivers of cyanobacterial blooms within the interface between riverine and lacustrine systems, particularly as such blooms are expected to become more prominent in response to a changing climate.

Liquid chromatography-mass spectrometry (LC-MS) and tandem mass spectrometry (MS/MS) were used to provide qualitative and quantitative information about microcystin (MC) congeners in western Lake Erie. Samples were collected at eight open-water locations on selected days during harmful algal blooms (HABs) in 2016 and 2017. Seven MCs were identified and 20 MCs were tentatively identified using high-resolution mass accuracies and a unique fragment (Adda m/z 135). The most abundant MC was MC-LR, followed by MC-RR, MC-YR, and MC-LA, and these congeners were quantified. Total (extracellular and intracellular) MC concentrations ranged from 0.068 to 14.88 µg/L in 2016, and from 0.050 to 10.15 µg/L in 2017, with averages of 2.71 and 1.86 µg/L, respectively. Near-shore sites in Lake Erie had higher MC concentrations and Microcystis biovolumes than off-shore sites. This implies that nutrient loading from the Maumee River greatly influences Maumee Bay, and this influence decreases with distance from the river. Consequently, six MCs (MC-LR, MC-RR, MC-LA, MC-YR, MC-LW, and MC-LF) were quantified in water samples collected from the Maumee River and the Maumee Bay shore of Lake Erie in 2017, and MC-RR was the most abundant. The total MC concentrations in river samples ranged from 0.17 to 305.03 µg/L. Additionally, an MC degradation product (linear MC-LR) was detected at all open-water locations, and data indicated an increase in its concentration towards the end of the bloom. The trends for 2016 and 2017 HABs are comparable in terms of spatial distribution and MC congeners produced, though the intensity and peak dates change.

Monitoring of cyanobacterial bloom biomass in large lakes at high resolution is made possible by remote sensing. However, monitoring cyanobacterial toxins is only feasible with grab samples, which, with only sporadic sampling, results in uncertainties in the spatial distribution of toxins. To address this issue, we conducted two intensive “HABs Grabs” of microcystin (MC)-producing Microcystis blooms in the western basin of Lake Erie. These were one-day sampling events during August of 2018 and 2019 in which 100 and 172 grab samples were collected, respectively, within a six-hour window covering up to 2,270 km2 and analyzed using consistent methods to estimate the total mass of MC. The samples were analyzed for 57 parameters, including toxins, nutrients, chlorophyll, and genomics. There were an estimated 11,513 kg and 30,691 kg of MCs in the western basin during the 2018 and 2019 HABs Grabs, respectively. The bloom boundary poses substantial issues for spatial assessments because MC concentration varied by nearly two orders of magnitude over very short distances. The MC to chlorophyll ratio (MC:chl) varied by a factor up to 5.3 throughout the basin, which creates challenges for using MC:chl to predict MC concentrations. Many of the biomass metrics strongly correlated (r > 0.70) with each other except chlorophyll fluorescence and phycocyanin concentration. While MC and chlorophyll correlated well with total phosphorus and nitrogen concentrations, MC:chl correlated with dissolved inorganic nitrogen. More frequent MC data collection can overcome these issues, and models need to account for the MC:chl spatial heterogeneity when forecasting MCs.

Graphical abstract, This study is aimed at exploring the optimal ELISA standard curve fitting process for reducing measurement uncertainty. Using an ELISA kit for measuring cyanobacterial toxin (microcystin), we show that uncertainty associated with the estimated microcystin concentrations can be reduced by defining the standard curve as a four-parameter logistic function on the natural log concentration scale, instead of the current approach of defining the curve on the concentration scale. The model comparison method is outlined in this paper, allowing it to be transferable to test different statistical models for other ELISA test kits.

Venous thromboembolism (VTE) is a term used collectively for deep vein thrombosis (DVT) and pulmonary embolism. Without prophylaxis, the incidence of documented DVT in the orthopaedic surgery patient is reported in the range of 50%-60%. A multimodal approach to DVT prophylaxis is the standard of care for all patients undergoing total hip arthroplasty and total knee arthroplasty. At our local hospital, low-risk patients are being sent home with aspirin as the medication for VTE prophylaxis. This article will provide an overview of the pathophysiology of VTE and the current prevention guidelines including the use of aspirin.