bluuebunny/crossref_metadata_2025 huggingface dataset:
Why do colder mothers produce larger eggs? An optimality approach
Authors: Bownds Celeste , Wilson Robbie , Marshall Dustin J.
Published: October 2010

One of the more common patterns of offspring size variation is that mothers tend to produce larger offspring at lower temperatures. Whether such variation is adaptive remains unclear. Determining whether optimal offspring size differs between thermal environments provides a direct way of assessing the adaptive significance of temperature-driven variation in egg size. Here, we examined the relationship between offspring size and performance at three temperatures for several important fitness components in the zebra fish, Danio rerio. The effects of egg size on performance were highly variable among life-history stages (i.e. pre- and post-hatching) and dependent on the thermal environment; offspring size positively affected performance at some temperatures but negatively affected performance at others. When we used these data to generate a simple optimality model, the model predicted that mothers should produce the largest size offspring at the lowest temperature, offspring of intermediate size at the highest temperature and the smallest offspring at the intermediate temperature. An experimental test of these predictions showed that the rank order of observed offspring sizes produced by mothers matched our predictions. Our results suggest that mothers adaptively manipulate the size of their offspring in response to thermally driven changes in offspring performance and highlight the utility of optimality approaches for understanding offspring size variation.
Measuring foraging activity in a deep-diving bird: comparing wiggles, oesophageal temperatures and beak-opening angles as proxies of feeding
Authors: Hanuise Nicolas , Bost Charles-André , Huin William , Auber Arnaud , Halsey Lewis G. , Handrich Yves
Published: October 2010

Quantification of prey consumption by marine predators is key to understanding the organisation of ecosystems. This especially concerns penguins, which are major consumers of southern food webs. As direct observation of their feeding activity is not possible, several indirect methods have been developed that take advantage of miniaturised data logging technology, most commonly: detection of (i) anomalies in diving profiles (wiggles), (ii) drops in oesophageal temperature and (iii) the opening of mouth parts (recorded with a Hall sensor). In the present study, we used these three techniques to compare their validity and obtain information about the feeding activity of two free-ranging king penguins (Aptenodytes patagonicus). Crucially, and for the first time, two types of beak-opening events were identified. Type A was believed to correspond to failed prey-capture attempts and type B to successful attempts, because, in nearly all cases, only type B was followed by a drop in oesophageal temperature. The number of beak-opening events, oesophageal temperature drops and wiggles per dive were all correlated. However, for a given dive, the number of wiggles and oesophageal temperature drops were lower than the number of beak-opening events. Our results suggest that recording beak opening is a very accurate method for detecting prey ingestions by diving seabirds at a fine scale. However, these advantages are counterbalanced by the difficulty, and hence potential adverse effects, of instrumenting birds with the necessary sensor/magnet, which is in contrast to the less accurate but more practicable methods of measuring dive profiles or, to a lesser extent, oesophageal temperature.
Vocal power and pressure–flow relationships in excised tiger larynges
Authors: Titze Ingo R. , Fitch W. Tecumseh , Hunter Eric J. , Alipour Fariborz , Montequin Douglas , Armstrong Douglas L. , McGee JoAnn , Walsh Edward J.
Published: October 2010

Despite the functional importance of loud, low-pitched vocalizations in big cats of the genus Panthera, little is known about the physics and physiology of the mechanisms producing such calls. We investigated laryngeal sound production in the laboratory using an excised-larynx setup combined with sound-level measurements and pressure–flow instrumentation. The larynges of five tigers (three Siberian or Amur, one generic non-pedigreed tiger with Bengal ancestry and one Sumatran), which had died of natural causes, were provided by Omaha's Henry Doorly Zoo over a five-year period. Anatomical investigation indicated the presence of both a rigid cartilaginous plate in the arytenoid portion of the glottis, and a vocal fold fused with a ventricular fold. Both of these features have been confusingly termed ‘vocal pads’ in the previous literature. We successfully induced phonation in all of these larynges. Our results showed that aerodynamic power in the glottis was of the order of 1.0 W for all specimens, acoustic power radiated (without a vocal tract) was of the order of 0.1 mW, and fundamental frequency ranged between 20 and 100 Hz when a lung pressure in the range of 0–2.0 kPa was applied. The mean glottal airflow increased to the order of 1.0 l s–1 per 1.0 kPa of pressure, which is predictable from scaling human and canine larynges by glottal length and vibrational amplitude. Phonation threshold pressure was remarkably low, on the order of 0.3 kPa, which is lower than for human and canine larynges phonated without a vocal tract. Our results indicate that a vocal fold length approximately three times greater than that of humans is predictive of the low fundamental frequency, and the extraordinarily flat and broad medial surface of the vocal folds is predictive of the low phonation threshold pressure.
Regulation of conduction velocity in axons from near-field receptors of the crayfish antennule
Authors: Mellon DeForest
Published: October 2010

The antennular flagella of the crayfish Procambarus clarkii each possess a linear array of near-field receptors, termed standing feathered sensilla, that are extremely sensitive to movement of the surrounding water. Previously it had been shown that, within each flagellum, the axonal conduction velocity of the sensory neuron pair associated with each feathered sensillum was linearly related to the position of the sensillum along the flagellar axis. In the current studies I show that the conduction velocity of axons within the proximal three segments of the antennules, between the flagellum and the brain, is somewhat higher than the corresponding conduction velocity of the same axons in the flagellum, especially for those whose flagellar conduction velocity is between 1 and 3 m s–1, even though there is no net change in axonal diameter within this part of the afferent pathway. One consequence of this change in axonal conduction properties is an effective compression of the temporal spread – potentially by as much as tenfold – which otherwise would occur in arrival times of initial spikes from each sensillum following a mechanical stimulus to the antennule. Furthermore, the pattern signature of initial spike volleys at the brain following a global hydrodynamic stimulus to the flagellum is remarkably consistent and conceivably could be recognized as such by central processing centers. I conclude that conduction velocity adjustments improve temporal summation and resolution from input volleys that originate in the highly sensitive and, hence, inherently noisy near-field receptors, thereby more effectively triggering startle response circuitry at the approach of potential predators.
Visual physiology underlying orientation and diel behavior in the sand beach amphipod Talorchestia longicornis
Authors: Cohen Jonathan H. , Cronin Thomas W. , Lessios Nicolas , Forward Richard B.
Published: October 2010

Talitrid amphipods employ vision for zonal recovery behaviors on sand beaches and for entraining circadian activity rhythms. Using a hierarchy of methods, we examined visual spectral and response–intensity functions in Talorchestia longicornis, a species in which orientation and rhythm entrainment are wavelength-specific behaviors. Microspectrophotometry, electroretinogram recording and behavioral assays were used to determine visual pigments, retinal spectral sensitivity and whole-animal spectral responsivity, respectively. Diel changes in absolute sensitivity were also investigated at retinal and whole-animal levels. Two receptor spectral classes were identified, with values for visual pigment λmax of 427 and 518 nm. Retinal spectral sensitivity varied with electrode position along the distal–proximal axis. Chromatic adaptation of distal and proximal photoreceptors resulted in sensitivity peaks at 430 and 522 nm, respectively. In accordance with identified visual pigments and spectral sensitivity, T. longicornis photobehavioral responsivity covered a broad range (420–580 nm). Collectively, a dual-pigment visual system underlies wavelength-specific behavior in T. longicornis, with the short-wavelength pigment likely to be localized in the distal R5 retinular cell. While response–intensity functions did not change over the diel cycle at the retinal level, behavioral photoresponsiveness varied between day and night. At a wavelength used by T. longicornis for celestial orientation (420 nm), photobehavior was heightened at night, potentially aiding in nocturnal orientation. By contrast, at a wavelength used to entrain its circadian rhythm (520 nm) and for routine visual tasks, photobehavior was heightened during the day, and spectral sensitivity matched to the twilight spectrum, facilitating crepuscular vision and entrainment by irradiance at sunrise and sunset.
Pulse sound generation, anterior swim bladder buckling and associated muscle activity in the pyramid butterflyfish, Hemitaurichthys polylepis
Authors: Boyle Kelly S. , Tricas Timothy C.
Published: October 2010

Acoustic behaviors are widespread among diverse fish taxa but mechanisms of sound production are known from relatively few species, vary widely and convergent mechanisms are poorly known. We examined the sound production mechanism in the pyramid butterflyfish, Hemitaurichthys polylepis, a member of the socially and ecologically diverse reef fish family Chaetodontidae. In the field, fish produce pulse trains at dusk during social interactions that are probably related to mate attraction and courtship. In laboratory experiments, sound production was synchronized to high-speed video to determine body movement associated with sound generation. In addition, electromyography (EMG) recordings tested the activity of six candidate muscles. Fish produced individual pulses with a mean peak frequency of 97 Hz in rapid succession. EMG experiments show that anterior hypaxial muscles contract at high bilaterally synchronous rates (up to 120 Hz) in near perfect association with rapid inward buckling visible outside the body over the anterior swim bladder. Muscle activity often showed EMG doublets that occurred within the time of a single sound pulse but was not sustained. Buckling and sound pulse rates correlated strongly (R2≈1.00) and sound pulse rate measured over two successive pulses (maximum of 38 pulses s–1) was lower than muscle firing rate. These results show that the extrinsic swim bladder muscles of pyramid butterflyfish involve single contractions that produce pulses in a manner similar to distantly related teleosts, but involve a novel doublet motor-neuron firing pattern. Thus, the sound production mechanism in pyramid butterflyfish is likely convergent with several percomorph taxa and divergent from the related chaetodontid genus Forcipiger.
Intergenerational Cultural Transmission as an Evolutionary Game
Authors: Montgomery James D
Published: October 2010

We generalize the Bisin-Verdier model of intergenerational transmission to permit an arbitrary number of cultural traits. A key observation—that this model is equivalent to an evolutionary game under replicator dynamics—facilitates our analysis. For two special cases, obtained by restricting the pattern of “cultural distastes” between traits, we demonstrate global stability of the long-run distribution of traits using recent results on stable games and potential games. For the general three-trait case, we show that all three traits survive in the long run only if each trait satisfies an “invasion condition” involving the cultural distaste parameters. (JEL C73, D91, Z13)
Security Price Informativeness with Delegated Traders
Authors: Gorton Gary , He Ping , Huang Lixin
Published: October 2010

Trade in securities markets is conducted by agents acting for principals, using “mark-to-market” contracts whereby performance is assessed using security market prices. We endogenize contract choices, information production, informed trading, and security price informativeness. But there is a contract externality. Prices are informative only because other principals induce their agents to trade based on privately produced information. The agent-traders then have an incentive to coordinate and shirk. The market price is less informative, reducing the effectiveness of mark-to-market contracts. By using managerial discretion to vary the contract type unpredictably, principals mitigate traders' coordinated manipulation and improve price informativeness. (JEL D82, D86, G12)
Identification and Semiparametric Estimation of Equilibrium Models of Local Jurisdictions
Authors: Epple Dennis , Peress Michael , Sieg Holger
Published: October 2010

We develop a new model of household sorting in a system of residential neighborhoods. We show that this model is partially identified without imposing parametric restrictions on the distribution of unobserved tastes for neighborhood quality and the shape of the indirect utility function. The proof of identification is constructive and can be used to derive a new semiparameteric estimator. Our empirical application focuses on residential choices in the Pittsburgh metropolitan area. We find that sorting of households with children exhibit more stratification by income than sorting of households without children. (JEL C51, D12, H41, J12, R21, R23)
Organizing for Synergies
Authors: Dessein Wouter , Garicano Luis , Gertner Robert
Published: October 2010

Large companies are usually organized into business units, yet some activities are almost always centralized in a company-wide functional unit. We first show that organizations endogenously create an incentive conflict between functional managers (who desire excessive standardization) and business-unit managers (who desire excessive local adaptation). We then study how the allocation of authority and tasks to functional and business-unit managers interacts with this endogenous incentive conflict. Our analysis generates testable implications for the likely success of mergers and for the organizational structure and incentives inside multidivisional firms. (JEL D23, D86, G34, L22)
Computer-aided surgical planning in the treatment of soft-tissue sarcoma
Authors: Seaward JR , Wilson PA , Stone CA
Published: October 2010

INTRODUCTION

Soft-tissue sarcoma resections are often highly complex procedures that demand meticulous pre-operative planning in order to maximise the potential for complete excision with clear margins, while preserving vital neurovascular structures and muscle groups.

SUBJECTS AND METHODS

We present a computer-aided model for surgical planning using Microsoft Powerpoint as a tool for cross referencing magnetic resonance images and normal anatomical diagrams.

RESULTS

Using this system the operator follows a sequence of pre-planned steps, minimising intra-operative decision making and unexpected adverse events. Four case studies are discussed.

CONCLUSIONS

The visual plan optimises the potential to meet surgical and oncological goals, and serves as an excellent nct to the operation note for documentation of the procedure.
Management of open tibial fractures – a regional experience
Authors: Townley WA , Nguyen DQA , Rooker JC , Dickson JK , Goroszeniuk DZ , Khan MS , Camp D
Published: October 2010

INTRODUCTION

The treatment of soft-tissue injuries associated with tibial diaphyseal fractures presents a clinical challenge that is best managed by a combined plastic and orthopaedic surgery approach. The current study was undertaken to assess early treatment outcomes and burden of service provision across five regional plastic surgery units in the South-West of England.

SUBJECTS AND METHODS

We conducted a prospective 6-month audit of open tibial diaphyseal fracture management in five plastic surgery units (Bristol, Exeter, Plymouth, Salisbury, Swansea) with a collective catchment of 9.2 million people. Detailed data were collected on patient demographics, injury pattern, surgical management and outcome followed to discharge.

RESULTS

The study group consisted of 55 patients (40 male, 15 female). Twenty-two patients presented directly to the emergency department at the specialist hospital (primary group), 33 patients were initially managed at a local hospital (tertiary group). The mean time from injury to soft tissue cover was significantly less (P < 0.001) in the primary group (3.6 ± 0.8 days) than the tertiary group (10.8 ± 2.2 days), principally due to a delay in referral in the latter group (5.4 ±1.7 days). Cover was achieved with 39 flaps (19 free, 20 local), eight split skin grafts. Nine wounds closed directly or by secondary intention. There were 11 early complications (20%) including one flap failure and four infections. The overall mean length of stay was 17.5 ± 2.8 days.

CONCLUSIONS

Multidisciplinary management of severe open tibial diaphyseal may not be feasible at presentation of injury depending on local hospital specialist services available. Our results highlight the need for robust assessment, triage and senior orthopaedic review in the early post-injury phase. However, broader improvements in the management of lower limb trauma will additionally require further development of combined specialist trauma centres.
Trends in the incidence rates of tonsil and base of tongue cancer in England, 1985–2006
Authors: Reddy VM , Cundall-Curry D , Bridger MWM
Published: October 2010

INTRODUCTION

The aim of this study was to investigate whether incidence rates of tonsil and base of tongue cancer in England are increasing using data from the UK cancer registry.

SUBJECTS AND METHODS

Cancer registrations for oral cavity and oropharynx cancer from 1985–2006 in England were obtained from the National Cancer Information Service. Population estimates were obtained from the Office for National Statistics. Age-adjusted incidence rates and age-specific incidence rates were calculated. The sexes were considered separately as incidence rates are known to differ significantly between men and women. Linear regression was performed to establish whether there was a relationship between incidence rates and time.

RESULTS

There has been an increase in all oral cavity and oropharyngeal cancer in the study period. Linear regression analysis suggests that approximately 90% of the variance in age-adjusted incidence rates for men and women for tonsil, base of tongue and other oral cavity cancer is explained by the passage of time. For other oropharyngeal cancer, the variance is 62% and 46% in men and women, respectively. The estimated annual percentage change from 1985 to 2006 in age-adjusted incidence rates for tonsil and base of tongue cancer is 5.7% and 6.7% for men, and 4.3% and 6.5% for women, respectively.

CONCLUSIONS

This study confirms a wide-spread clinical impression that there has been an increase in age-adjusted incidence rates, between 1985 and 2006, in all oral cavity cancer in England. The age range 40–69 years has seen the biggest increases in age-specific incidence rates for tonsil and base of tongue cancer. This reflects the findings of similar studies in other countries.
RACE to protect brains
Authors: Rix Thomas E , Singh Inderjit , Insall Robert , Senaratne Jawaharlal
Published: October 2010

INTRODUCTION

Rapid-access carotid endarterectomy (RACE) is an evidence-based treatment for symptomatic carotid stenosis. Our vascular centre aims to provide this service within 48 h of symptoms in appropriate patients. This study audits safety and efficacy of the first year of RACE.

SUBJECTS AND METHODS

A clear trust protocol was publicised for the RACE pathway. A prospective database was established for all carotid endarterectomies (CEAs) performed. Outcomes were compared between elective (ECE) and rapid-access operations.

RESULTS

In 1 year, 96 patients received CE; 20 were performed urgently. There were no significant differences in age or gender between ECE and RACE groups. Twenty-three (30%) of ECE were for asymptomatic stenoses; no other significant differences in surgical indication were seen. Of symptomatic ECE, 43% were for completed stroke versus 55% for RACE. Median delay between diagnosis and surgery was 113 days for elective and 2 days for RACE patients. There was one death following ECE (1.3%) and one stroke after RACE (5%), all not significant. Anaesthetic method did not influence outcome. The main reasons for delaying surgery in RACE patients were optimisation of patient fitness and availability of theatre time.

CONCLUSIONS

The RACE pathway dramatically reduces delay without compromising patient safety. In the first year of service, we have treated 50% of suitable patients within 48 h. Further education of patients and colleagues should reduce delay and improve outcomes for symptomatic carotid disease.
Is there adequate provision of venous thrombo-embolism prophylaxis following hip arthroplasty? An audit and international survey
Authors: Rogers BA , Phillips S , Foote J , Drabu KJ
Published: October 2010

INTRODUCTION

The peak incidence of venous thrombo-embolism (VTE) occurs 3 weeks following hip arthroplasty surgery and current guidelines proposing VTE prophylaxis continuing for 4 weeks after surgery. This study first compares the duration of treatment and satisfaction between patients prescribed low molecular weight heparin (LMWH) and rivaroxaban, a new oral Factor Xa inhibitor, following elective hip arthroplasty; and second, surveys the duration of LMWH use in other units.

SUBJECTS AND METHODS

An international survey detailing the use of LMWH was performed. A prospective audit was performed of 100 hip replacements, with 50 prescribed 40 mg once daily of subcutaneous enoxaparin and subsequently 50 patients prescribed 10 mg once daily of oral rivaroxaban. The duration of treatment, patient satisfaction and complications for both cohorts was quantified and compared against published evidence-based guidelines.

RESULTS

The survey demonstrated that four out of 39 (10.2%) units that routinely prescribe LMWH do so for at least 4 weeks following surgery. The audit demonstrated that rivaroxaban afforded a superior mean duration of postoperative VTE prophylaxis (35 days vs 5.4 days; P < 0.05) and superior patient satisfaction. There was no difference in the incidence of bleeding, wound infection or thrombotic complications.

CONCLUSIONS

This study demonstrates that patients are exposed to an increased VTE risk following hip replacement surgery due to the inadequate prescription of LMWH. This is poor clinical practice, contrary to current evidence-based guidelines and has potential medicolegal implications. The prescription of rivaroxaban affords a superior patient compliance compared with subcutaneous LMWH, thus ensuring that patients receive VTE prophylaxis for the current recommend period of time.
Erect chest radiography in the setting of the acute abdomen: essential tool or an unnecessary waste of resources?
Authors: Alazzawi S , De Rover W Sprenger , Morris-Stiff G , Lewis MH
Published: October 2010

INTRODUCTION

It has been suggested that changes to the training schemes of junior doctors and the increased pressure on emergency departments to manage their patients within a limited time might increase the number of unnecessary investigations performed on emergency admission patients. This, in turn, may lead to an increased number of investigations with normal results. In this study we try to analyse the role of the chest X-ray (CXR) as a diagnostic tool in patients presenting with acute abdominal pain.

PATIENTS AND METHODS

A retrospective study was performed of the request forms and results of all chest radiography performed on patients admitted on the emergency surgical intake with acute abdominal pain through utilisation of the prospec-tively maintained electronic radiology database. The indications were compared to the guidelines published by the Royal College of Radiologists (RCR) which have been adopted as the standard of care.

RESULTS

A total of 334 chest X-rays were identified of which only 23 (7%) had new findings. Four (1%) patients had free gas under the diaphragm. Of the CXRs, 258 (77%) were reported normal whilst 53 (16%) had old changes which were described in their hospital records and previous radiographs. Of the CXRs with new findings, only 20 were clinically significant and, of these, four (1%) were surgically significant.

CONCLUSIONS

The majority of CXRs performed on emergency surgical admissions with abdominal pain are unnecessary. By obtaining a clear history, performing a thorough clinical examination and following the RCR guidelines most of the CXRs could be avoided. This would lead to less radiation exposure, reduce delays to diagnosis, and provide significant financial savings.
The benefit of radiologically-guided steroid injections for trapeziometacarpal osteoarthritis
Authors: Swindells MG , Logan AJ , Armstrong DJ , Chan P , Burke FD , Lindau TR
Published: October 2010

INTRODUCTION

Osteoarthritis of the trapeziometacarpal joint (TMJ) is a common condition causing significant disability. Conservative treatments include intra-articular steroid injections.

PATIENTS AND METHODS

This clinical, observational study prospectively reviewed the longevity of benefit of steroid injections into the TMJ. Eighty-three patients were recruited with a median age of 62 years and injected with steroid and local anaesthetic under radioscopic guidance. They were followed up until the analgesic effects ceased with a questionnaire including visual analogue scores.

RESULTS

Two-thirds of patients were improved at 2 months, with nearly half having a 3-month improvement. One in six patients had a 6-month benefit, with some patients still improved 2 years after injection. Previously injected patients had a reduced duration of benefit compared to their previous injection. Severity of osteoarthritis did not affect the injection efficacy.

CONCLUSIONS

Based on this study, we recommend steroid injections in all degrees of TMJ osteoarthritis.
Suspected testicular torsion – urological or general surgical emergency?
Authors: Tydeman C , Davenport K , Glancy D
Published: October 2010

INTRODUCTION

Suspected testicular torsion (TT) is a surgical emergency, usually requiring urgent scrotal exploration. Provision of urology on-call cover varies widely between hospitals and often falls under the remit of the general surgical team. The purpose of this study was to investigate whether the management of suspected TT differed between urology (UT) and surgical (ST) trainees in the Severn and South West Peninsula Deaneries.

SUBJECTS AND METHODS

An on-line questionnaire ( SurveyMonkey.com ) was sent to all UT and ST within the Deaneries. Questions covered training, on-call cover, intra-operative management and knowledge of complications following testicular fixation. Responses were analysed using an Excel spreadsheet and GraphPad statistical package.

RESULTS

Responses were received from 26/31 UT and 43/52 ST throughout 17 hospitals. Only three hospitals had separate middle-grade specialist urology cover. Scrotal exploration was taught by urologists to 72% of UT compared with 40% of ST (P = 0.012, Fisher's exact test). Variability in the number of operations performed, supervision and management of true TT was insignificant. However, ST were more likely to fix a normal testicle either in the absence of other pathology (53% vs 28%) or with a twisted appendix testis (42% vs 15%) than UT (P = 0.045 and P = 0.032, respectively). UT were more aware of evidence regarding chronic pain (47% vs 14%) and infertility (53% vs 18%) following testicular fixation than ST (P = 0.005 and P= 0.003, respectively). Medicolegally, 76% of UT would inform the on-call consultant prior to operation compared with 45% of ST(P = 0.012).

DISCUSSION

ST are significantly more likely to fix a normal testicle than UT (and then usually only on the affected side), contrary to best-practice. This variation may be due to the different sources of training received by the two groups. Knowledge of possible chronic pain and infertility following testicular fixation may also affect management.

CONCLUSIONS

Due to the variation, we suggest urology departments should draw up guidelines for management; trainees should be encouraged to discuss the case pre-operatively with the consultant; core surgical training should include a urology placement.
Role of UK Hospitals in Supporting Surgical Training in Africa
Authors: Grimes Caris , Lavy Christopher
Published: October 2010

There are significant problems surrounding lack of access to surgical services, surgical training and surgical safety in Africa. There are many reasons for this. A recent report suggests that the ongoing healthcare workforce crisis is set to get worse in sub-Saharan Africa, with an estimated shortfall of 800,000 health professionals by 2015 and a required additional wage bill of approximately US $2.6 billion. Reasons include a lack of medical school places to meet demand; poor wages, facilities and infrastructure; impact of the HIV/AIDS epidemic; and migration to urban areas and developed countries. For example, although Kenya has trained 300 surgeons since 1972 only 120 of them remain in public service, with 27 of its 63 district hospitals having no qualified surgeons.
Building Bridges: Surgical Skills Training in Dubai
Authors: Gardiner MD , Skattum J , Weston-Underwood J , Smith CT Frank
Published: October 2010

The 2010 triennial College visit overseas was to Dubai and Bangalore. In advance of the trip the College was invited to hold a surgical skills course in Dubai. Basic surgical skills courses are well established in the UK as a key component of core surgical training. They continue to provide trainees with a safe way of performing common surgical procedures. There has been considerable international interest in the various courses and many have been successfully implemented around the world.
Polytrauma in a 'Violent' South Africa: A Short Visit in a Changing Society
Authors: Singh Joy
Published: October 2010

It was not without a little trepidation that I flew into OR Tambo Airport to arrive at Johannesburg, South Africa, for my month fellowship in emergency surgery at the Chris Hani Baragwanath Hospital, ('Bara'). My rationale for the trip was that I wanted to experience polytrauma first hand. My exposure to polytrauma has been limited like many UK graduates but a case involving a major penetrating abdominal injury made me realise that as a potential general surgical consultant, this was a necessity. Even in many sedate suburbs, life has the potential to be violent.
Are Foundation Year Assessors Adequately Trained?
Authors: Williamson JML , Martin AG
Published: October 2010

In 2005 the career path, training and assessment of UK junior doctors was fundamentally altered. The traditional progression from a pre-registered house officer year (immediately after graduation) to a senior house officer (SHO) grade (for a variable number of years) has been streamlined into two foundation years (FYs) and then entry into either a core training (CT) or specialty training (ST) programme. The foundation assessment programme (FAP) has developed a competency-based curriculum for training FYs 1–2 based on the Postgraduate Medical Education and Training Board's (PMETB's) standards.
Urology Consultations: The Hidden Workload?
Authors: Floyd Jr MS , Majumdar P , Seipp C , Anandaram PS , de Bolla Ar
Published: October 2010

Urology is unique as a surgical specialty. The emergency workload is minimal compared with its nearest relative, general surgery, and patient turnover is faster than in most disciplines. However, the elective workload is significant and with an ageing population is set to increase. Increased education and awareness about organ-specific cancers (eg prostate) combined with target demands for fast-track cancer referral has contributed to the workload of urologists.
Landmark Course Celebrates New Edition
Authors: Worrall Matthew
Published: October 2010

September marked the launch of the third edition of the College's popular three-day course, Care of the Critically Ill Surgical Patient (CCrISP®). Established in the early nineties with funding from the Hillsborough Trust, who wanted to support efforts to improve hospital care for seriously ill patients, the course has been a huge success with over 20,000 trainee surgeons completing it to date.
Post-CCT National Surgical Fellowship in Bariatric and Upper GI Surgery
Authors: Agrawal S
Published: October 2010

With fierce competition for the best consultant posts in surgery, a fellowship is almost becoming an essential requirement. There are numerous fellowships available but finding the right one and organising family life around it is extremely difficult. After a lot of scepticism from some trainees about the post-Certificate of Completion of Training (CCT) national surgical fellowships scheme, it was advertised in July 2008 through The Royal College of Surgeons of England in partnership with the surgical specialist associations. I was extremely fortunate to be successful in the interview in November 2008 as the first Fellow in Bariatric and Upper Gastrointestinal (GI) Surgery under the scheme and opted for the fellowship at Musgrove Park Hospital, Taunton, for one year.
Surgery in Haiti
Authors: Buller Laura
Published: October 2010

On 12 January 2010 a devastating earthquake struck Haiti. It killed more than 200,000 people and left 1.5 million homeless, almost 500,000 injured and tens of thousands in need of psychosocial support. The situation in the capital, Port-au-Prince, and other nearby areas was dire, with hundreds of thousands of people in urgent need of medical assistance. The British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) worked with Medical Emergency Relief International (Merlin) on the ground, in the wake of the earthquake, to provide reconstructive plastic surgery to Haitian people – predominantly treating crush injuries to limbs, head and face.
Clinical Fellowships in Surgery
Authors: Alderson Derek
Published: October 2010

A plethora of terms has appeared in recent years to describe posts that lie outside standard training programmes. The term 'clinical fellowship' (CF) is widely used to describe specialised posts undertaken at the end of training, that is, out-of-programme (OOP) experience (with variable degrees of recognition towards a Certificate of Completion of Training (CCT)). It is also often used to designate posts that combine elements of research, teaching and clinical work filled by individuals who wish to take time out from their training programme (often to obtain an additional qualification) or by those who have been unsuccessful in gaining a place within a training programme. The unknown number of such posts seriously jeopardises surgical workforce calculations.
The Faculty of Dental Surgery and research
Authors: Shepherd Jonathan
Published: October 2010

In 1975, while a house surgeon at the Queen Victoria Hospital, East Grinstead, I was privileged to work for David Poswillo, a distinguished consultant oral surgeon and Professor at the Royal College of Surgeons. Infected by his enthusiasm and prompted by his treatment of a keratocyst with liquid nitrogen, I rapidly found myself studying the effects of very low temperatures on the dental pulp and periodontium at the College research establishment at Downe House in Kent. My first research paper followed. This formative event illustrates what the Faculty continues to strive for: timely, enthusiastic and expert support for young researchers in dental surgery that results in practical discoveries of real potential benefit for patients and career development.
Clinical observerships: ENT, head and neck surgery at Toronto University Health Network, Canada
Authors: Persaud Ricardo AP
Published: October 2010

Rotating to different institutions is considered an important method of enhancing the breadth of surgical training. Trainees typically arrange formal 6–12 month 'out of programme' attachments in sought-after units. Mr Persaud shares his experience of the shorter stints he has spent in such units as a clinical observer and outlines the reasons why this alternative would also be rewarding for surgeons in training.
DCP education: a continuing evolution
Authors: Hunter Sally
Published: October 2010

It is now two years since it became mandatory for all dental care professionals (DCPs) to be registered with the General Dental Council (GDC). Registration has given DCPs a new professional status and with that have come both responsibilities and opportunities. To reflect these developments, the Faculty of General Dental Practice (UK) (FGDP(UK)) aims to take a team approach to support the highest standards of patient care. However, the dental profession is fast evolving and the FGDP(UK) must evolve with it in order to continue to meet the needs of the dental team.
Party time
Authors: Black John
Published: October 2010

Another political party conference season has just finished and not unexpectedly has been the most eventful and interesting for many years. As a charity the College has a duty to enter into the national political arena in the interests of furthering its objectives, which are to obtain the highest possible standards of surgical patient care. Hence we sent a full team to all three conferences, consisting of myself and another Council member (John Getty at the Liberal Democrats, Bob Greatorex at Labour and Mike Parker at the Conservatives) with strong support from Alison Cook, Director of External Affairs, and her Policy Unit and Communications Department. The fascinating feature of course was that for the first time since 1945, two parties out of three are in government.
Determining Stability of Stored Samples Retrospectively: The Validation of Glycated Albumin
Authors: Nathan David M , Steffes Michael W , Sun Wanjie , Rynders Gregory P , Lachin John M
Published: October 2010

BACKGROUND

Determining the stability of stored samples for assays that were not available at the time of original collection is problematic. To assess sample stability for a relatively new assay of glycated albumin (GA), we first measured GA in fresh samples and in samples stored for 19–23 years. We then compared the regression of the contemporaneous glycohemoglobin (Hb A1c) values against the GA results from fresh vs stored samples, reasoning that similar slopes and intercepts would provide strong, albeit indirect, support for the stability of the stored samples for GA measurements.

METHODS

We assayed 90 samples frozen for 19–23 years and 90 fresh samples from participants in the Diabetes Control and Complications trial cohort for GA. Hb A1c was measured contemporaneously in fresh samples at each time period. A single normal-errors linear model regressed the Hb A1c values on the GA, with an additional effect for collection period (fresh vs stored for GA) and the interaction of period and GA.

RESULTS

Analysis of the regressions lines between GA and Hb A1c revealed intercepts (3.69 and 2.97 for the fresh and stored samples, respectively) and slopes (0.198 vs 0.187) that were not significantly different (P = 0.182 and P = 0.639, respectively).

CONCLUSIONS

This simple approach can be used to assess the stability of stored samples in new assays. Samples stored for as long as 23 years are suitable for the GA assay.
Direct Serum Assay for MicroRNA-21 Concentrations in Early and Advanced Breast Cancer
Authors: Asaga Sota , Kuo Christine , Nguyen Tung , Terpenning Marilou , Giuliano Armando E , Hoon Dave SB
Published: October 2010

BACKGROUND

MicroRNAs (miRs) are a class of small noncoding RNAs whose expression changes have been associated with cancer development and progression. Current techniques to isolate miRs for expression analysis from blood are inefficient. We developed a reverse-transcription quantitative real-time PCR (RT-qPCR) assay for direct detection of circulating miRs in serum. We hypothesized that serum concentrations of miR-21, a biomarker increased in breast tumors, would correlate with the presence and extent of breast cancer.

METHODS

The RT-qPCR applied directly in serum (RT-qPCR-DS) assay for circulating miR-21 was tested in sera from 102 patients with different stages of breast cancer and 20 healthy female donors.

RESULTS

The assay was sensitive for detection of miR-21 in 0.625 μL of serum from breast cancer patients. For differentiation of samples from patients with locoregional breast cancer from those from healthy donors, the odds ratio was 1.796 and the area under the curve was 0.721. In a multivariate analysis that included standard clinicopathologic prognostic factors, high circulating miR-21 concentrations correlated significantly (P < 0.001) with visceral metastasis.

CONCLUSIONS

A novel RT-qPCR-DS can improve the efficiency of miR assessment. Use of this assay to detect circulating miR-21 has diagnostic and prognostic potential in breast cancer.
Unilinguisme, bilinguisme et esthtique interculturelle dans les dramaturgies francophones du Canada
Authors: Ladouceur Louise
Published: October 2010

In Canada, Francophone communities outside Quebec constitute a small minority in a mainly anglophone environment. In these communities, French is seen as an identity language by francophones who are bilingual out of necessity. The bilingualism of the Franco-Canadian communities, previously
invested with the negative connotations specific to Quebec's perception of it, takes on a different added value within the context of globalisation. Furthermore, if it is seen as a corrupting influence on French within a context where French is the vehicular language, bilingualism becomes
an instrument of resistance in a predominantly English context where it constitutes a condition sine qua non for remaining francophone. The resulting heterolingualism of Franco-Canadian drama seems to be increasingly accentuated as one moves westward from Ontario. On display in certain
productions such as Roger Auger's Je m'en vais Rgina, Kenneth Brown's Cow-boy potr and Marc Prescott's Sex, Lies et les Franco-Manitobains, this heterolingualism represents a linguistic specificity within Canada's French-language drama repertoires. In order to reach a
larger audience, certain plays have recently been presented with English surtitles that enable an exploration of new intercultural aesthetics inspired by the realities of life for Francophones within a minority context.
Le thtre franco-ontarien: Entretien avec Jol Beddows, directeur artistique du Thtre la Catapulte, Ottawa, Canada
Authors: Ruprecht Alvina
Published: October 2010

The Thtre la Catapulte, officially created in 1991, is the most recent Franco-Ontarian theatre in the Ottawa area. It now benefits from an auditorium and rehearsal space at La Nouvelle Scne, a theatrical and cultural centre constructed in 1999, which has contributed enormously to the
development of francophone theatre and culture in Ottawa. Jol Beddows has been the Artistic Director of the Thtre la Catapulte since 1998. Jean Stphane Roy will be taking over from him in July 2010. Totally bilingual, and both a theatre director and a professor in the Department of Theatre
at the University of Ottawa, Jol Beddows has ensured a performance programme that has opened up new artistic possibilities for francophone theatre in Ontario. In the following discussion he retraces the history of the Thtre la Catapulte, setting it within the broader context of francophone
theatrical activity in the province from the creation of the first troupe, the Thtre des Lutins, in 1970.
Epigenetic regulation of protein glycosylation
Authors: Zoldoš Vlatka , Grgurević Srđana , Lauc Gordan
Published: October 2010

Protein N-glycosylation is an ancient metabolic pathway that still exists in all three domains of life (Archaea, Bacteria and Eukarya). The covalent addition of one or more complex oligosaccharides (glycans) to protein backbones greatly diversifies their structures and makes the glycoproteome several orders of magnitude more complex than the proteome itself. Contrary to polypeptides, which are defined by a sequence of nucleotides in the corresponding genes, the glycan part of glycoproteins are encoded in a complex dynamic network of hundreds of proteins, whereby activity is defined by both genetic sequence and the regulation of gene expression. Owing to the complex nature of their biosynthesis, glycans are particularly versatile and apparently a large part of human variation derives from differences in protein glycosylation. Composition of the individual glycome appears to be rather stable, and thus differences in the pattern of glycan synthesis between individuals could originate either from genetic polymorphisms or from stable epigenetic regulation of gene expression in different individuals. Studies of epigenetic modification of genes involved in protein glycosylation are still scarce, but their results indicate that this process might be very important for the regulation of protein glycosylation.
Constitutive Equations of Sheet Stamping Steel Based on DIC Measurement
Authors: Jiang J. H. , Wang Y. H. , Yang L. X.
Published: October 2010

Digital image correlation (DIC) is a full-field and non-contact technique for the measurement of displacement and strain. It has considerately high precision for measuring large deformation. Based on the experimental data of true stress-strain measured by DIC combined with the data from a tensile test machine, the methodology for establishing a constitutive model for sheet stamping steel is presented in this paper. The procedure is demonstrated by developing the constitutive equations for the DP600 sheet metal with a cold rolled advanced high-strength steel, designed predominately for the automotive industry, with enhanced ductility and formability. To verify the constitutive equations, a force-displacement diagram is simulated by finite element analysis (FEA). A comparison of force-displacement diagram obtained by FEA and the data from the tensile test machine shows that the method for establishing the constitutive equations for stamping steel presented in this paper is reliable and has reasonable accuracy. As a material constitutive model, the establishment of constitutive equations of stamping steel provides the experimental validation for FEA. It is particularly valuable when evaluating non-linear numerical simulation of the stamping process of structural parts with complicated geometry.
The Workplace Within: Psychodynamics of Organizational Life
Authors: Walck Christa L.
Published: October 2010

The Workplace Within: Psychodynamics of Organizational Life. Larry Hirschhorn. Cambridge, MA: The MIT Press, 1988,. + 265 pp.