bluuebunny/crossref_metadata_2025 huggingface dataset:
The importance of color in mate choice of the blue crab Callinectes sapidus
Authors: Baldwin Jamie , Johnsen Sönke
Published: October 2009

Visual displays often play a large role in animal communication,particularly in sexual interactions. The blue crab Callinectes sapidus is both colorful and highly visually responsive, yet almost all studies of their courtship have focused on chemical cues. In the blue crab's underwater environment, however, visual cues may function more rapidly and over a longer distance than chemical cues. Given that blue crabs are aggressive and cannibalistic, visual cues may therefore allow blue crabs to quickly evaluate potential mates from safer distances. In the present study we show that courtship and mate choice behavior in C. sapidus can be stimulated by visual cues alone. Further, we show that males have a preference for females with red claw dactyls. In binary choice experiments, males displayed more often to photographs of females with red claws than to those with white claws or to those with black claws that were isoluminant to the red ones. This strongly suggests that male blue crabs made their choices based on the hue of the red claws, further suggesting that blue crabs are capable of color vision and use color in mate choice.
Symbiotic bacteria living in the hoopoe's uropygial gland prevent feather degradation
Authors: Ruiz-Rodríguez M. , Valdivia E. , Soler Juan J. , Martín-Vivaldi M. , Martín-Platero A. M. , Martínez-Bueno M.
Published: October 2009

Among potential agents that might damage bird feathers are certain microorganisms which secrete enzymes that digest keratin, as is the case of the ubiquitous bacterium Bacillus licheniformis, present in both the feathers and skin of wild birds. It is therefore a good candidate for testing the effects of bird defences against feather-degrading microorganisms. One of these defences is the oil secreted by the uropygial gland, which birds use to protect their feathers against parasites. In previous studies we have shown how Enterococcus faecalis strains isolated from nestling hoopoes exert antagonistic effects against B. licheniformis, mediated by the production of bacteriocins. Consequently we hypothesized that this enterococcus and the bacteriocins it engenders might act as a defence against feather-degrading microorganisms in hoopoes. We investigated this hypothesis in a series of laboratory experiments and evaluated the extent to which the keratinolytic effects caused by B. licheniformis were reduced by the E. faecalis MRR10-3 strain, isolated from hoopoes, and its bacteriocins. In different treatments, feathers or pure keratin was incubated with B. licheniformis, B. licheniformis together with E. faecalis MRR10-3, and B. licheniformis together with the bacteriocins produced by E. faecalis MRR10-3. Our results were in accordance with the predicted effects on hoopoe feathers. There was a significant decrease both in pure keratin loss and in feather degradation in the presence of the symbiotic bacterium or its bacteriocin. These results suggest that by preening their feathers hoopoes benefit from their symbiotic relationship with bacteriocin-producing enterococci, which constitute a chemical defence against feather degradation.
Transectional heat transfer in thermoregulating bigeye tuna (Thunnus obesus) – a 2D heat flux model
Authors: Boye Jess , Musyl Michael , Brill Richard , Malte Hans
Published: October 2009

We developed a 2D heat flux model to elucidate routes and rates of heat transfer within bigeye tuna Thunnus obesus Lowe 1839 in both steady-state and time-dependent settings. In modeling the former situation, we adjusted the efficiencies of heat conservation in the red and the white muscle so as to make the output of the model agree as closely as possible with observed cross-sectional isotherms. In modeling the latter situation, we applied the heat exchanger efficiencies from the steady-state model to predict the distribution of temperature and heat fluxes in bigeye tuna during their extensive daily vertical excursions. The simulations yielded a close match to the data recorded in free-swimming fish and strongly point to the importance of the heat-producing and heat-conserving properties of the white muscle. The best correspondence between model output and observed data was obtained when the countercurrent heat exchangers in the blood flow pathways to the red and white muscle retained 99% and 96% (respectively) of the heat produced in these tissues. Our model confirms that the ability of bigeye tuna to maintain elevated muscle temperatures during their extensive daily vertical movements depends on their ability to rapidly modulate heating and cooling rates. This study shows that the differential cooling and heating rates could be fully accounted for by a mechanism where blood flow to the swimming muscles is either exclusively through the heat exchangers or completely shunted around them, depending on the ambient temperature relative to the body temperature. Our results therefore strongly suggest that such a mechanism is involved in the extensive physiological thermoregulatory abilities of endothermic bigeye tuna.
Adjustments of wingbeat frequency and air speed to air density in free-flying migratory birds
Authors: Schmaljohann H. , Liechti F.
Published: October 2009

Birds adjust their flight behaviour to the physical properties of the air. Lift and drag, the two major properties in aerodynamics, are highly dependent on air density. With decreasing air density drag is reduced and lift per wingbeat decreases. According to flight mechanical theory, wingbeat frequency and air speed should increase with decreasing air density, i.e. increasing flight altitude. Although wind tunnel experiments have shed light on many aspects of avian flight, the effect of air density remained ambiguous, because air density could not be adjusted in wind tunnels, until now. By means of radar we recorded tracks of several thousand free-flying individual birds during nocturnal migration. From these tracks we derived wingbeat frequencies and air speeds covering air densities from 0.84 kg m–3 to 1.13 kg m–3, corresponding to an altitudinal range of about 3000 m. We demonstrate here with this sample of nocturnal migrants that: (1)wingbeat frequency decreases with air density (which corresponds to an increase in flap-gliding flyers by 0.4 Hz km–1 and in bounding flyers by 1.1 Hz km–1), (2) reducing wingbeat frequency to equivalent sea level values did not abolish the dependency on air density, as expected by flight mechanical theory, and (3) bounding flyers show a higher response in their flight behavioural adjustments to changes in air density than flap-gliding flyers. With respect to air speed flap-gliding flyers increase their air speed by 1.0 m s–1km–1 and bounding flyers by 1.4 m s–1km–1.
Effects of serotonergic agents on survival and hemolymph composition of the larval mosquitoAedes aegypti(Diptera: Culicidae, L.)in vivo: does serotonin regulate hemolymph acid–base homeostasis?
Authors: Clark T. M. , Lawecki J. L. , Shepherd J. J. , Hirschler A. N. , Samandu T. R.
Published: October 2009

The role of serotonin in the regulation of larval Aedes aegyptihemolymph composition was investigated in vivo using two reuptake inhibitors (SSRIs), alaproclate HCl and 6-nitroquipazine maleate, and the receptor antagonist methiothepin mesylate. Larvae were placed in media differing in pH and salinity in the presence and absence of serotonergic agents. The toxicity of each agent was strongly influenced by ambient pH. For each agent, toxicity was negligible in acidic media, intermediate in neutral media and greatest in alkaline media. By contrast, toxicity of all agents was independent of salinity. No effects on mass-specific body water or hemolymph volume were observed whereas hemolymph osmotic pressure, Na+concentrations and pH differed significantly among treatments. 6-nitroquipazine caused a decrease in Na+ from 115±1.7 to 103±0.9 mmol l–1, and alaproclate caused alkalosis of the hemolymph from pH 7.55±0.026 to pH 7.72±0.044. Methiothepin decreased hemolymph osmotic pressure from 329±9.9 to 304±8.8 and showed the greatest overall toxicity. Control larvae excreted net base in pH 4 media (1.4 μmol g–1 h–1) and net acid in pH 7 (1.2 μmol g–1 h–1) and pH 11 (5.1μmol g–1 h–1) media. In pH 4 media,alaproclate and methiothepin caused a shift to net H+ excretion(1.1 and 1.5 μmol g–1 h1, respectively) whereas these agents did not influence acid excretion rates in pH 7 or pH 11 media. The hypothesis that serotonin is involved in hemolymph acid–base balance is discussed.
State-changes in the swimmeret system: a neural circuit that drives locomotion
Authors: Tschuluun N. , Hall W. M. , Mulloney B.
Published: October 2009

The crayfish swimmeret system undergoes transitions between a silent state and an active state. In the silent state, no patterned firing occurs in swimmeret motor neurons. In the active state, bursts of spikes in power stroke motor neurons alternate periodically with bursts of spikes in return stroke motor neurons. In preparations of the isolated crayfish central nervous system(CNS), the temporal structures of motor patterns expressed in the active state are similar to those expressed by the intact animal. These transitions can occur spontaneously, in response to stimulation of command neurons, or in response to application of neuromodulators and transmitter analogues. We used single-electrode voltage clamp of power-stroke exciter and return-stroke exciter motor neurons to study changes in membrane currents during spontaneous transitions and during transitions caused by bath-application of carbachol or octopamine (OA). Spontaneous transitions from silence to activity were marked by the appearance of a standing inward current and periodic outward currents in both types of motor neurons. Bath-application of carbachol also led to the development of these currents and activation of the system. Using low Ca2+–high Mg2+ saline to block synaptic transmission, we found that the carbachol-induced inward current included a direct response by the motor neuron and an indirect component. Spontaneous transitions from activity to silence were marked by disappearance of the standing inward current and the periodic outward currents. Bath-application of OA led promptly to the disappearance of both currents, and silenced the system. OA also acted directly on both types of motor neurons to cause a hyperpolarizing outward current that would contribute to silencing the system.
Skeletal muscle atrophy occurs slowly and selectively during prolonged aestivation inCyclorana alboguttata(Günther 1867)
Authors: Mantle Beth L. , Hudson Nicholas J. , Harper Gregory S. , Cramp Rebecca L. , Franklin Craig E.
Published: October 2009

We investigated the effect of prolonged immobilisation of six and nine months duration on the morphology and antioxidant biochemistry of skeletal muscles in the amphibian aestivator Cyclorana alboguttata. We hypothesised that, in the event of atrophy occurring during aestivation,larger jumping muscles were more likely to be preserved over smaller non-jumping muscles. Whole muscle mass (g), muscle cross-sectional area (CSA)(μm2), water content (%) and myofibre number (per mm2) remained unchanged in the cruralis muscle after six to nine months of aestivation; however, myofibre area (μm2) was significantly reduced. Whole muscle mass, water content, myofibre number and myofibre CSA remained unchanged in the gastrocnemius muscle after six to nine months of aestivation. However, iliofibularis dry muscle mass, whole muscle CSA and myofibre CSA was significantly reduced during aestivation. Similarly,sartorius dry muscle mass, water content and whole muscle CSA was significantly reduced during aestivation. Endogenous antioxidants were maintained at control levels throughout aestivation in all four muscles. The results suggest changes to muscle morphology during aestivation may occur when lipid reserves have been depleted and protein becomes the primary fuel substrate for preserving basal metabolic processes. Muscle atrophy as a result of this protein catabolism may be correlated with locomotor function, with smaller non-jumping muscles preferentially used as a protein source during fasting over larger jumping muscles. Higher levels of endogenous antioxidants in the jumping muscles may confer a protective advantage against oxidative damage during aestivation; however, it is not clear whether they play a role during aestivation or upon resumption of normal metabolic activity.
Neprilysin 4, a novel endopeptidase fromDrosophila melanogaster, displays distinct substrate specificities and exceptional solubility states
Authors: Meyer Heiko , Panz Mareike , Zmojdzian Monika , Jagla Krzysztof , Paululat Achim
Published: October 2009

Proteins belonging to the family of neprilysins are typically membrane bound M13 endopeptidases responsible for the inactivation and/or activation of peptide signaling events on cell surfaces. Mammalian neprilysins are known to be involved in the metabolism of various regulatory peptides especially in the nervous, immune, cardiovascular and inflammatory systems. Although there is still much to learn about their participation in various diseases, they are potential therapeutic targets. Here we report on the identification and first characterization of neprilysin 4 (NEP4) from Drosophila melanogaster. Reporter lines as well as in situ hybridization combined with immunolocalization demonstrated NEP4 expression during embryogenesis in pericardial cells, muscle founder cells, glia cells and male gonads. Western blot analysis confirmed the prediction of one membrane bound and one soluble isoform, a finding quite unusual among neprilysins with presumably strong physiological relevance. At least one NEP4 isoform was found in every developmental stage indicating protein activities required throughout the whole life cycle of Drosophila. Heterologously expressed NEP4 exhibited substrate preferences comparable to human neprilysin 2 with distinct cleavage of substance P and angiotensin I.
The intensity threshold of colour vision in two species of parrot
Authors: Lind Olle , Kelber Almut
Published: October 2009

We have used behavioural tests to determine the intensity thresholds of colour vision in Bourke's parrots (Neopsephotus bourkii) and budgerigars (Melopsittacus undulatus). We have also examined the relationship between these thresholds and the optical sensitivities of single photoreceptors using morphological methods. Bourke's parrots lose colour vision in brighter light (0.4 cd m–2) than budgerigars (0.1 cd m–2) and both birds lose colour vision in brighter light(`end of civil twilight') than humans (0.02 cd m–2,`moonlight'). The optical sensitivities of single cones are similar in both birds (budgerigar 0.27 μm2 sr, Bourke's parrot 0.25μm2 sr) but Bourke's parrots have more (cone to rod ratio,1.2:1.0), thinner (2.8 μm) and longer rods (18.5 μm) than budgerigars(2.1:1.0, 3.4 μm, 13.3 μm). Bourke's parrots thus have an eye type that,with a flexible pooling mechanism, allows for high resolution or high absolute sensitivity depending on the light conditions. The results nicely agree with the activity patterns of the birds, Bourke's parrots being active during the day and in twilight while budgerigars are not normally active before sunrise and after sunset. However, Bourke's parrots have fewer cones than budgerigars,which implies that a smaller number of cones are pooled within each retinal integration area. That could explain why Bourke's parrots have a higher intensity threshold of colour vision than budgerigars. Furthermore, the study emphasises the need to expand the sensitivity measure so that photoreceptor integration units are used rather than single receptors.
Strategies and limits in multi-stage single-point incremental forming
Authors: Skjoedt M , Silva M B , Martins P A F , Bay N
Published: October 2009

Multi-stage single-point incremental forming (SPIF) is a state-of-the-art manufacturing process that allows small-quantity production of complex sheet metal parts with vertical walls. This paper is focused on the application of multi-stage SPIF with the objective of producing cylindrical cups with vertical walls. The strategy consists of forming a conical cup with a taper angle in the first stage, followed by three subsequent stages that progressively move the conical shape towards the desired cylindrical geometry.

The investigation includes material characterization, determination of forming-limit curves and fracture forming-limit curves (FFLCs), numerical simulation, and experimentation, namely the evaluation of strain paths and fracture strains in actual multi-stage parts.

Assessment of numerical simulation with experimentation shows good agreement between computed and measured strain and strain paths. The results also reveal that the sequence of multi-stage forming has a large effect on the location of strain points in the principal strain space. Strain paths are linear in the first stage and highly non-linear in the subsequent forming stages. The overall results show that the experimentally determined FFLCs can successfully be employed to establish the forming limits of multi-stage SPIF.
Everybody's business: from policy to lived practice – the benefits of embedding specialist mental health workers in physical health-care systems
Authors: Read Jessica , Andrews Tresa
Published: October 2009

As Britain's population ages, health- and social-care systems face the challenge of continuing to provide high-quality care in the face of increased demand on services. Government policy has proposed meeting this challenge through integrated partnership working to enable people with complex, multiple needs to receive timely care closer to home. Co-morbid mental health needs, including dementia, are common in people with physical health issues, and must be addressed appropriately if systems are to provide the best possible all-round patient care. This paper describes how two senior clinical psychologists have developed an embedded living mental health resource within physical health care, and demonstrates how this has directly and positively impacted on both service performance indicators and patient experience.
Use of card sort methodology in the testing of a clinical leadership competencies model
Authors: Jahrami Haitham , Marnoch Gordon , Gray Ann Marie
Published: October 2009

The purpose of this paper is to examine the utility of a qualitative ‘card sort’ research tool – when it is merged with traditional quantitative data gathering methods – to add to our understanding about the nature of competency-based approaches to leadership studies. The study demonstrates how a qualitative technique (card sort) was used for the task of testing a clinical leadership competencies model. All the steps in the card sort methodology are described through its application to the research problem. The paper concludes that card sort has considerable use in adding to the validity of research into the competency approach to leadership. The study reports only one single case. Therefore, the technique must be repeated to secure its validation as a testing technique. The card sort method is proven to be a viable tool to ascertain the individual subjects perceptions regarding competencies. The methodology is described in sufficient detail so as to enable its replication and application by professionals and academic researchers alike. Both groups will find this methodology useful and interesting. The paper seeks to improve upon existing methods for studying leadership competencies. By addressing the limitations of different methods, and also by merging different independent approaches, this project provides an innovative integrated knowledge that can be of significant value.
Performance evaluation of ambulatory surgery centres: an efficiency approach
Authors: Iyengar Reethi N , Ozcan Yasar A
Published: October 2009

This paper evaluates the performance of 198 ambulatory surgery centres (ASCs) operating in the State of Pennsylvania during the fiscal year 2006. Performance is assessed from technical efficiency view using data envelopment analysis (DEA). Multi-input/output model included two inputs: number of operating rooms and labour, and patient surgical visits differentiated by age groups: 0–17, 18–64, 65+ as three outputs. Input oriented models were employed to assess various DEA efficiency models. Results show that about 48 (24%) of ASCs are efficient with a mean efficiency score of 0.60. The results also indicate that appropriate utilization of operating rooms and labour inputs are the main determinants of ASC efficiency.
Access to dental care for HIV patients: does it matter and does discrimination exist?
Authors: Levett T , Slide C , Mallick F , Lau R
Published: October 2009

A number of surveys highlight a shortage of dentists in the UK. There is also evidence of discrimination against those with HIV reported within the dental profession and service users. We decided to assess the extent of this problem in our HIV outpatients by conducting a cross-sectional survey, asking them to complete a questionnaire exploring issues related to dental care access, and using clients attending the routine genitourinary (GU) medicine outpatient clinic as controls. A total of 241 outpatients completed the survey, of whom 51 (21%) were HIV patients. Significantly, more HIV patients reported difficulty registering with a dentist than GU patients (58.8% versus 18.2%, χ2 with Yates correction = 8.76, P = 0.0031). They also report significantly more dental health problems compared with controls (54.9% versus 32.1%, χ2 with Yates correction = 8.02, P = 0.0046). In total, 34.6% of HIV patients who had declared their status to a dentist thought that it had negatively impacted on their care, with 6.2% being refused treatment. Our small survey confirms that discrimination in relation to access and level of dental care exists, with black African women being at most risk. Efforts are needed to raise professional standards and HIV awareness to prevent continuing inequalities in dental care provision.
Ritual Circumcision: No Longer a Problem for Health Services in the British Isles
Authors: Atkin GK , Butler C , Broadhurst J , Khan A , Nataraja R , Madden N , Haddad M , Clarke SA
Published: October 2009

INTRODUCTION

Primary care trust (PCT) funding of a ritual circumcision service has recently been withdrawn from our unit, raising concerns that this may result in greater morbidity from community circumcision. The aims of this study were to document our circumcision practice before and after the withdrawal of PCT funding and to determine its effect on the morbidity from circumcision. In addition, we wanted to survey all paediatric surgical centres in the British Isles to ascertain how many still offer a ritual circumcision service.

PATIENTS AND METHODS

We retrospectively reviewed our circumcision practice for 1 year prior to the removal of UK Government funding, and then performed a prospective audit of our practice for the 12 months following funding withdrawal. An e-mail survey was also performed of all paediatric surgical units to determine the ritual circumcision service provision throughout the British Isles.

RESULTS

A total of 213 boys underwent circumcision during the 12 months prior to the withdrawal of funding, of which 106 cases (50%) were ritual circumcisions. After funding withdrawal, 99 boys underwent circumcision, of which 98 cases (99%) were for medical reasons. A similar number of boys were re-admitted after a hospital circumcision during the two review periods (5 versus 4 patients), whereas the number admitted following a community circumcision rose after funding withdrawal (6 versus 11 patients). Only a third of British paediatric surgical centres offer a ritual circumcision service, and a significant proportion of these were either providing the service without PCT funding, or were reconsidering their decision to continue.

CONCLUSIONS

PCT funding withdrawal for ritual circumcision had an impact on our unit's procedural case volume. This represented a cost saving to the trust, despite a higher rate of admissions for postoperative complications. There is an inequality in healthcare provision throughout the British Isles for ritual circumcision, and we feel it is vital to offer support and training to medical and non-medical practitioners who are being asked to perform a greater number of circumcisions in the community.
Initial Experience of Laparostomy with Immediate Vacuum Therapy in Patients with Severe Peritonitis
Authors: Horwood James , Akbar Fayaz , Maw Andrew
Published: October 2009

INTRODUCTION

To report our initial experience of laparostomy and immediate intra-abdominal vacuum therapy in patients with severe peritonitis due to intra-abdominal catastrophes.

PATIENTS AND METHODS

Twenty-seven patients underwent emergency laparotomy and laparostomy formation with the application of immediate intra-abdominal TRAC–VAC® therapy (male:female ratio, 1:1.2; median age, 73 years; range, 34–84 years). Predicted mortality was assessed using the P-POSSUM score and compared with clinically observed outcomes.

RESULTS

Ten patients (37%) with a mean predicted P-POSSUM mortality of 72%, died of sepsis and multi-organ failure. Seventeen patients (mean P-POSSUM 48% expected mortality) survived to discharge. One patient with pancreatitis died from small bowel obstruction 1-year post discharge, two patients developed a small bowel fistula. One patient had an allergic reaction to the VAC dressing. Our patients, treated with laparostomy and TRAC VAC therapy, had a significantly improved observed survival when compared to P-POSSUM expected survival (P = 0.004).

CONCLUSIONS

Laparostomy with immediate intraperitoneal VAC therapy is a robust and effective system to manage patients with intra-abdominal catastrophes. There were significantly improved outcomes compared to the mortality predicted by P-POSSUM scores. Damage control surgery with laparostomy formation and intra-abdominal VAC therapy should be considered in patients with severe peritonitis.
Three-Year Audit and Cost Assessment of Open Abdominal Aortic Aneurysm Repair in a District General Hospital
Authors: Kafsi J El , Wake J , Lintott P , Northeast A , McLaren A
Published: October 2009

INTRODUCTION

The aims of this study were to audit the outcome of elective open abdominal aortic aneurysm (AAA) repair in a district general hospital, as well as investigate the true costs for this procedure in relation to the national tariff.

PATIENTS AND METHODS

A database is maintained on AAA surgery in the trust. Data were supplemented by drawing information from blood bank and clinical notes. Patients with symptomatic or emergency aneurysms were excluded. Data from January 2005 to December 2007 were obtained on demographics, morbidity, 30-day mortality and blood usage. Costs were obtained from the trust finance department.

RESULTS

Between January 2005 and December 2007, 79 elective AAA procedures were undertaken. Median age was 75 years (range, 52–85 years), median aneurysm size was 63 mm (range, 42–105 mm) and median ITU stay was 3 days (range, 1–41 days). Major morbidity rate was 20.3% (16 of 79 patients) and 30-day mortality overall was 5.1% (4 of 79 patients). Average cost per case was £15,012.91 (range, £4,040.03–£82,158.00), when National Tariff is £6,722.00 (£5,649.00 × local Market Forces Factor of 1.19). Loss per case for our trust was £8,290.91 with a total annual loss of £218,299.56.

CONCLUSIONS

Morbidity and mortality in this district general hospital compare well with national studies; however, the total cost is far in excess of the national tariff.
Update Experience of Surgery for Acute Limb Ischaemia in a District General Hospital – Are We Getting Any Better?
Authors: Morris-Stiff G , D'Souza J , Raman S , Paulvannan S , Lewis MH
Published: October 2009

INTRODUCTION

The aims of this study were to audit results of a 10-year experience of surgery for acute limb ischaemia (ALI) in terms of limb salvage and mortality rates, and to compare results with a historical published series from our unit.

PATIENTS AND METHODS

All emergency operations performed during the period 1993–2003 were identified from theatre registers and patient notes reviewed to determine indications for, and outcome of, surgery. Data were compared to a similar cohort who underwent surgery from 1980 to 1990.

RESULTS

There was a 33% increase in workload from 87 to 116 patients between the two time periods. The number of patients with idiopathic ALI reduced (24% versus 4%; P < 0.05), and there were fewer smokers (71% versus 39%; P < 0.05) and a greater number of claudicants (17% versus 35%; P < 0.05) in those treated from 1993–2003. Latterly, more patients underwent pre-operative heparinisation (33% versus 80%; P < 0.05), received prophylactic antibiotics (14% versus 63%; P < 0.05), and had anaesthetic presence in theatre (46% versus 88%; P < 0.05). There was also a reduction in local anaesthetic procedures (80% versus 41%; P < 0.05). Despite increased pre-operative (15% versus 47%; P < 0.05) and on-table imaging (0% versus 16%; P < 0.05) technical success did not improve. Whilst complication rates were identical at 62%, there were fewer cardiovascular complications in the recent cohort. The 30-day mortality rate for embolectomy fell from 45% to 33%. Multivariate analysis revealed age > 70 years, prolonged symptom duration, ASA score ≥ III, lack of prophylactic antibiotics, absence of an anaesthetist, and operations performed under local anaesthetic to be associated with increased risk of mortality. Factors adversely affecting limb salvage included prolonged duration from symptom onset to operation, and a history of claudication or smoking.

CONCLUSIONS

Despite improvements in pre- and peri-operative management, arterial embolectomy/thrombectomy remains a procedure with a high morbidity and mortality. Further attempts to improve outcome must be directed at early diagnosis and referral as delay from symptom onset to surgery is a major determinant of outcome.
Indications for Tonsillectomy: Are We Documenting Them?
Authors: Toh Alex , Mullin Annemarie , Grainger Joe , Uppal Harpreet
Published: October 2009

INTRODUCTION

Tonsillectomy is one of the most frequently performed operations in the UK. Documentation of the indications for tonsillectomy is vital, and should fulfil evidence-based guidelines where possible. We present a completed audit, evaluating the documentation of our department's practice in meeting the recommendations made by the Scottish Intercollegiate Guideline Network (SIGN) on indications for tonsillectomy.

PATIENTS AND METHODS

A prospective audit of 100 children undergoing tonsillectomy for recurrent tonsillitis at a university hospital during two time periods: October 2007 to January 2008 and March to September 2008. Interventions including the production of posters and rubber stamps were agreed and implemented between the two audit periods.

RESULTS

Following the implementation of simple changes, significant improvements were seen in documentation relating to the SIGN guidelines for tonsillectomy. Overall, the number of children meeting all four SIGN criteria for tonsillectomy rose from 12% to 44% (χ2 = 57.8; P < 0.001). Furthermore, a significant reduction was seen in the number of children below the age of 5 years undergoing tonsillectomy for recurrent tonsillitis (χ2 = 14.66; P < 0.001).

CONCLUSIONS

With increasing scrutiny on tonsillectomy, it is important to ensure that the reasons for performing tonsillectomy are documented clearly and adhere to evidence-based guidance where possible. We have demonstrated that, with only simple and low-cost interventions, significant improvements in the documentation of tonsillectomy indications can be achieved.
Reading the Small Print – Labelling Recommendations for Orthopaedic Implants
Authors: Haene Roger A , Sandhu Ranbir S , Baxandall Richard
Published: October 2009

INTRODUCTION

There exist, currently, no clear guidelines regarding standards for surgical implant labelling. Dimensions of the laminar flow canopies in orthopaedic use fixes the distance at which implant labels can be read. Mistakes when reading the label on an implant box can pose health risks for patients, and financial consequences for medical institutions.

SUBJECTS AND METHODS

Using scientifically validated tools such as the Snellen Chart Formula, a theoretical minimum standard for text on implant labels was reached. This theoretical standard was then tested under real operating conditions. After discovering a minimum practical standard for implant labels, the authors then audited current labels in use on a wide range of orthopaedic implant packages. Furthermore, other non-text-related labelling problems were also noted.

RESULTS

There is a definite minimum standard which should be observed when implant labels are manufactured. Implants in current use bear labels on the packaging that are of an insufficient standard to ensure patient safety in theatre.

CONCLUSIONS

The authors have established text parameters that will increase the legibility of implant labels. In the interests of improving risk management in theatre, therefore, the authors propose a standard for orthopaedic implant labelling, and believe this will provide a useful foundation for further discussion between the orthopaedic community and implant manufacturers.
The Management of Spinal Metastases from Renal Cell Carcinoma
Authors: Langdon James , Way Adam , Heaton Samuel , Bernard Jason , Molloy Sean
Published: October 2009

INTRODUCTION

Osseous metastases occur in 50% of patients with renal cell carcinoma; of these, 15% occur in the spine. The treatment options for spinal metastases secondary to renal cell carcinoma are limited. This paper considers the current management options available for spinal metastases secondary to renal cell carcinoma.

PATIENTS AND METHODS

A review of four patients with spinal metastases secondary to renal cell carcinoma.

RESULTS

The presentation of four cases highlighting the current management options for spinal metastases secondary to renal cell carcinoma.

CONCLUSIONS

Historically, spinal metastases from renal cell carcinoma have been poorly managed; however, as the treatment of the primary disease improves, better treatment of the secondary disease is needed. Cement augmentation, used alone for prophylactic stabilisation or in conjunction with a posterior decompression and fixation, provides a useful addition in the management of these patients optimising their chance to remain ambulant, continent, and pain-free.
Volunteering at the Wellcome Museum of an Atomy and Pathology
Authors: Hill Ciaran
Published: October 2009

The Wellcome Museum of Anatomy and Pathology is a resource open to all doctors, nurses, allied health professionals, medical students and other technical professions, by prior appointment. It contains an excellent selection of specimens, covering the key surgical areas of head and neck, neurological, dental, orthopaedic, cardiac, respiratory, gastrointestinal, urological, gynaecological, endocrine, integumentary systems and embryology. Each area is subdivided into anatomical and pathological.
Blood and guts in Southwark: Other interesting places to visit while in London
Authors: Crumplin Michael , Ronald Nick
Published: October 2009

The Bulletin asked me to review a new surgical display within the London Dungeon® – the sort of crowd shocker that I'd not visited since childhood, when allowed to go to the Chamber of Horrors in Madame Tussauds. This particular exposition comes at a time of a plethora of publications, programmes, exhibitions, shows and lectures on medical history, clearly responding to public demand and curiosity. It was clear that this performance was not to be judged other than as entertainment.
Continuity in surgical care
Authors: Chilton Christopher
Published: October 2009

There are many influences both external and internal that have an impact on the continuity of care of surgical patients. External forces include EU legislation, such as the European Working Time Directive (EWTD); UK government imperatives, such as clinical targets; and Department of Health directives, for instance, Choose and Book. While all are laudable in principle their unintended consequences, however, have created unmanageable and potentially dangerous outcomes for patients.
Research: so what's new?
Authors: Renton Tara
Published: October 2009

With the recent development of the National Institute for Health Research (NIHR), conventional research and design (R&D) monies have been centralised. Historically funds were allocated to trusts, with little accountability as to the direct influence on research activity. Nearly £1 billion has been set aside for NHS clinical-based research so the opportunities for clinicians to get involved in research are now considerable.
Bariatric surgery: battling the bulge
Authors: Towell Elaine
Published: October 2009

With almost one in four people in the UK currently obese, some surgeons have predicted that bariatric surgery will soon become the most common procedure carried out by general surgeons. The claim may seem far-fetched with current NHS provision of bariatric surgery limited to say the least. While some primary care trusts (PCTs) are funding some bariatric surgery, others offer no provision at all.
EWTD update and the party conferences
Authors: Black John
Published: October 2009

May I thank all of you who responded to the recent College online survey on the implementation and effects of the European Working Time Directive (EWTD). Nearly 400 consultants and over 500 trainees replied, which gave us the facts from nearly every surgical unit in the country. These are powerful data.
What does a transdiagnostic approach have to offer the treatment of anxiety disorders?
Authors: McManus Freda. , Shafran Roz. , Cooper Zafra.
Published: October 2009

Purpose. The purpose of this paper is to review the rationale for ‘transdiagnostic’ approaches to the understanding and treatment of anxiety disorders.

Methods. Databases, searches and examination of the reference lists of relevant studies were used to identify papers of relevance.

Results. There is increasing recognition that diagnosis‐specific interventions for single anxiety‐disorders are of less value than might appear since a large proportion of patients have more than one coexisting anxiety disorder and the treatment of one anxiety disorder does not necessarily lead to the resolution of others. As transdiagnostic approaches have the potential to address multiple coexisting anxiety disorders they are potentially more clinically relevant than single anxiety disorder interventions. They may also have advantages in ease of dissemination and in treating anxiety disorder not otherwise specified.

Conclusions. The merits of the various transdiagnostic cognitive‐behavioural approaches that have been proposed are reviewed. Such approaches have potential benefits, particularly in striking the balance between completely idiosyncratic formulations and diagnosis‐driven treatments of anxiety disorders. However, caution is needed to ensure that transdiagnostic theories and treatments benefit from progress made by research on diagnosis‐specific treatments, and further empirical work is needed to identify the shared maintaining processes that need to be targeted in the treatment of anxiety disorders.
Are modern health worries, environmental concerns, or paranormal beliefs associated with perceptions of the effectiveness of complementary and alternative medicine?
Authors: Jeswani Mamta , Furnham Adrian
Published: October 2009

Objective. To investigate to what extent paranormal beliefs, modern health worries (MHWs), and environmental concerns were related to beliefs about, and behaviour associated with complementary and alternative medicine (CAM).

Methods. Of the participants, 150 completed a four‐part questionnaire measuring use and perception of CAM, MHWs, paranormal beliefs, and environmental concerns.

Results. A factor analysis on the CAM questions revealed three clear components, labelled efficacy of CAM, attitudes to CAM, and safety of CAM. Age, total MHWs, paranormal beliefs, and environmental concerns were used as predictor variables in regression analyses with efficacy as criterion variable. Age was found to be a significantly related to efficacy of CAM. When total MHW score, paranormal belief score, and environmental concern score were added to the model, the r2 increased by 29%. Environmental concern did not significantly relate to efficacy but spiritualism beliefs did. A factor analysis of the MHW scale items revealed nine factors. Out of these, radiation, doctors playing God, disasters, and epidemics, as well as harmful rays and air contaminants significantly predict belief in the efficacy of CAM.

Conclusion. Overall, older people, with more MHWs, and who believe in the paranormal are more likely to believe that CAM works, possibly because of a more intuitive, ‘holistic’, thinking style. Limitations of the study are considered.
Mitochondrial DNA (mtDNA) Biogenesis: Visualization and Duel Incorporation of BrdU and EdU Into Newly Synthesized mtDNA In Vitro
Authors: Lentz Stephen I. , Edwards James L. , Backus Carey , McLean Lisa L. , Haines Kristine M. , Feldman Eva L.
Published: October 2009

Mitochondria are key regulators of cellular energy and are the focus of a large number of studies examining the regulation of mitochondrial dynamics and biogenesis in healthy and diseased conditions. One approach to monitoring mitochondrial biogenesis is to measure the rate of mitochondrial DNA (mtDNA) replication. We developed a sensitive technique to visualize newly synthesized mtDNA in individual cells to study mtDNA replication within subcellular compartments of neurons. The technique combines the incorporation of 5-bromo-2-deoxyuridine (BrdU) and/or 5-ethynyl-2'-deoxyuridine (EdU) into mtDNA, together with a tyramide signal amplification protocol. Employing this technique, we visualized and measured mtDNA biogenesis in individual cells. The labeling procedure for EdU allows for more comprehensive results by allowing the comparison of its incorporation with other intracellular markers, because it does not require the harsh acid or enzyme digests necessary to recover the BrdU epitope. In addition, the utilization of both BrdU and EdU permits sequential pulse–chase experiments to follow the intracellular localization of mtDNA replication. The ability to quantify mitochondrial biogenesis provides an essential tool for investigating the alterations in mitochondrial dynamics involved in the pathogenesis of multiple cellular disorders, including neuropathies and neurodegenerative diseases.
Benthic microalgal production in the Arctic: applied methods and status of the current database
Authors: Glud Ronnie N. , Woelfel Jana , Karsten Ulf , Kühl Michael , Rysgaard Søren
Published: October 2009

The current database on benthic microalgal production in Arctic waters comprises 10 peer-reviewed and three unpublished studies. Here, we compile and discuss these datasets, along with the applied measurement approaches used. The latter is essential for robust comparative analysis and to clarify the often very confusing terminology in the existing literature. Our compilation demonstrates that i) benthic microalgae contribute significantly to coastal ecosystem production in the Arctic, and ii) benthic microalgal production on average exceeds pelagic productivity by a factor of 1.5 for water depths down to 30 m. We have established relationships between irradiance, water depth and benthic microalgal productivity that can be used to extrapolate results from quantitative experimental studies to the entire Arctic region. Two different approaches estimated that current benthic microalgal production in the Arctic is between 1.1 and 1.6×107 tons C year-1. Climate change is expected to increase the overall primary production and affect the balance between pelagic and benthic productivity in the Arctic. It is therefore imperative to get better quantitative understanding of the relationship between increased freshwater run-off, shrinking sea-ice cover, light availability and benthic primary production to assess future impact on the Arctic food web and trophic coupling.
Molecular and Morphometric Data Indicate a New Species of the Aphid GenusRhopalosiphum(Hemiptera: Aphididae)
Authors: Valenzuela I , Eastop V F , Ridland P M , Weeks A R
Published: October 2009

Here, we provide evidence for a new aphid species from the genus Rhopalosiphum Koch, based upon an Australian survey of variation in the mitochondrial cytochrome oxidase I gene, and subsequently validated by cytochrome b, nuclear microsatellites, nuclear sequence characterized amplified region locus, and karyotypic analyses. Despite the new species being morphologically very similar to Rhopalosiphum padi (L.), there was significant genetic differentiation, with the new species being closer to the Rhopalosiphum insertum (Walker) group. Karyotypic analyses indicated a putative hybrid origin for the new species, but mitochondrial and nuclear DNA sequence data showed that the available Australian and overseas populations of Rhopalosiphum spp. did not serve as parental lineages. Diagnostic methods were developed that enabled the identification of the new species based on morphometric data and a polymerase chain reaction-restriction fragment length polymorphism based molecular technique.
A Review of Pseudacteon (Diptera: Phoridae) That Parasitize Ants of the Solenopsis geminata Complex (Hymenoptera: Formicidae)
Authors: Plowes Robert M , Lebrun Edward G , Brown Brian V , Gilbert Lawrence E
Published: October 2009

Some phorid flies of the genus Pseudacteon Coquillett parasitize workers of Solenopsis geminata (F.) complex fire ants. The group is found to comprise at least 21 species of flies, of which 11 are new to science and described here: P. amuletum, P. andinus, P. annulus, P. catarinae, P. deltoides, P. hippeus, P. kungae, P. laticarinatus, P. palomita, P. quinni, and P. robustus. An identification key to the females is included. This expansion of known Pseudacteon species parasitizing the S. geminata complex makes it an interesting system for comparison with Pseudacteon flies that parasitize fire ants of the S. saevissima (Smith) complex.
Two New Species of Kalligrammatidae (Neuroptera) from the Jurassic of China, with Comments on Venational Homologies
Authors: Makarkin Vladimir N , Ren Dong , Yang Qiang
Published: October 2009

Two new fossil species of Kalligrammatidae (Neuroptera) are described from the Middle Jurassic locality at Daohugou, Inner Mongolia, China: Limnogramma hani n. sp. and Limnogramma mongolicum n. sp. Some venational homologies in Neuroptera are discussed briefly.