Global assessment of marine plastic exposure risk for oceanic birds

Plastic pollution is distributed patchily around the world's oceans. Likewise, marine organisms that are vulnerable to plastic ingestion or entanglement have uneven distributions. Understanding where wildlife encounters plastic is crucial for targeting research and mitigation. Oceanic seabirds, particularly petrels, frequently ingest plastic, are highly threatened, and cover vast distances during foraging and migration. However, the spatial overlap between petrels and plastics is poorly understood. Here we combine marine plastic density estimates with individual movement data for 7137 birds of 77 petrel species to estimate relative exposure risk. We identify high exposure risk areas in the Mediterranean and Black seas, and the northeast Pacific, northwest Pacific, South Atlantic and southwest Indian oceans. Plastic exposure risk varies greatly among species and populations, and between breeding and non-breeding seasons. Exposure risk is disproportionately high for Threatened species. Outside the Mediterranean and Black seas, exposure risk is highest in the high seas and Exclusive Economic Zones (EEZs) of the USA, Japan, and the UK. Birds generally had higher plastic exposure risk outside the EEZ of the country where they breed. We identify conservation and research priorities, and highlight that international collaboration is key to addressing the impacts of marine plastic on wide-ranging species.

Leg-mounted data-loggers do not affect the reproductive performance of short-tailed shearwaters (Puffinus tenuirostris)

Context Attaching tracking devices to several avian species could produce negative outcomes. Of particular concern are potential alterations to birds’ reproductive, flight, diving and foraging performances. Attachment of devices may also lead to a bias in results or an inaccurate interpretation of results as birds may not behave ‘normally’. Aims The aims of the present study were to evaluate the possible effects of a 5.4-g global location-sensing (GLS) data-logger attached to a modified aluminium band on short-tailed shearwaters (Puffinus tenuirostris (Temminck, 1835)), representing 0.7–1% of adult body mass, breeding on Great Dog Island, Furneaux Group, Tasmania. Methods Eighty birds were monitored during two breeding seasons. Twenty-seven GLS data-loggers were attached to birds in 2007, with the remaining birds acting as controls. Breeding success, return rates and body condition were compared between equipped and non-equipped birds. Key results In the year of deployment, no evidence of negative effects of attaching data-loggers on hatching success, pre-fledging chick mass or survival was found. However, chicks reared by non-equipped adults were skeletally larger. After controlling for body size, no significant effect on chick body condition was detected between the two groups. In the year of recapture, significantly more GLS-equipped than non-equipped adults returned to the colony. There were no differences in adult body condition, egg size, hatching or fledging success between the two groups. After GLS devices were removed, chick mass and size at pre-fledging were equal between those raised by GLS-equipped and non-equipped adults. Conclusions These results suggest that appropriate-sized data-loggers are a relatively benign method of obtaining at-sea foraging and behavioural information from seabirds. However, loggers may be affecting parental care of offspring and this requires further investigation. Importantly, no carry-over effects were observed once the data-loggers were removed after 12 months. Implications Identifying any effects of data-logger attachment is imperative for animal welfare but also for the accuracy of tracking data and subsequent interpretation. GLS devices are rapidly becoming smaller and lighter, and if this trend continues, unlock unprecedented opportunities for pelagic seabird research. During long deployments, monitoring individuals and assessing their health and reproductive output should be considered an integral part of all bio-logging studies.

Exchange bias and domain evolution at 10 nm scales

For a fixed 2 μm×2 μm area of a Co/Pt-CoO perpendicular exchange bias system we image the ferromagnetic (FM) domains for various applied fields with 10-nm resolution by magnetic force microscopy (MFM). Using quantitative MFM we measure the local areal density of pinned uncompensated spins (pinUCS) in the antiferromagnetic (AFM) CoO layer and correlate the FM domain structure with the UCS density. Larger applied fields drive the receding domains to areas of proportionally higher pinUCS aligned antiparallel to FM moments. The data confirm that the evolution of the FM domains is determined by the pinUCS in the AFM layer, and also present examples of frustration in the system.

Direct observation of spin-torque driven magnetization reversal through nonuniform modes

We present time-resolved x-ray images with 30 nm spatial and 70 ps temporal resolution, which reveal details of the spatially resolved magnetization evolution in nanoscale samples of various dimensions during reversible spin-torque switching processes. Our data in conjunction with micromagnetic simulations suggest a simple unified picture of magnetic switching based on the motion of a magnetic vortex. With decreasing size of the magnetic element the path of the vortex core moves from inside to outside of the nanoelement, and the switching process evolves from a curled nonuniform to an increasingly uniform mode.

Time-resolved imaging of spin transfer switching: beyond the macrospin concept

Time-resolved images of the magnetization switching process in a spin transfer structure, obtained by ultrafast x-ray microscopy, reveal the limitations of the macrospin model. Instead of a coherent magnetization reversal, we observe switching by lateral motion of a magnetic vortex across a nanoscale element. Our measurements reveal the fundamental roles played independently by the torques due to charge and spin currents in breaking the magnetic symmetry on picosecond time scales.

A survey of domestic violence in a university emergency department

OBJECTIVES

To determine prevalence of domestic violence among female patients presenting to the department.

METHODS

An anonymous survey distributed to female patients presenting over a 30-day period.

RESULTS

Response rate was 12.5% (190 of 1,516). Forty-four percent of respondents reported being a victim of domestic violence in the past Seventy-nine percent knew where to get help, and 64% would report it. Eight percent reported their visit to the department resulted from domestic violence.

CONCLUSIONS

Prevalence of domestic violence from the sample was similar to previously reported rates. Physicians and nurses generally inquired when patients presented resulting from domestic violence, but screening rates need improvement.

Display of complete life cycle of human papillomavirus type 16 in cultured placental trophoblasts

Human papillomavirus (HPV) infection is threefold more prevalent in spontaneous abortion specimens compared to elective abortions preferentially targeting the placental trophoblasts in these specimens. Here by using infectious ceplar and Southern blot analysis, we demonstrate that the transfected HPV-16 genome de novo replicates in 3A trophoblasts in culture. Peak DNA replication occurred 9-24 days posttransfection, showing classic DNA forms I, II, and III and an 8-kb monomer band upon DpnI/BamHI digestion. Reverse transcription-polymerase chain reaction (RT-PCR) analysis of mRNA expression revealed that E6 and E2 were significantly expressed by day 9, coinciding with HPV-16 DNA replication. However, significant L1 expression was delayed until day 18. L1 protein expression on day 18, but not day 9, was also confirmed by Western blot analysis. The production of HPV-16 virions was demonstrated by three techniques: the appearance of HPV-16 infectious units coinciding with L1 expression, the neutralization of these infectious units with known neutralizing anti-HPV-16 antibodies, and the appearance of spliced E1-E4 and E6-E7 transcripts (RT-PCR) in normal keratinocyte rafts infected with these trophoblast-produced HPV-16 infectious units. These data suggest that HPV-16 is carrying out its complete life cycle in trophoblasts. Previously, HPVs were known to productively replicate only in differentiating keratinocytes of skin. These findings expand HPV biology, support the hypothesis of a possible link between HPV and some spontaneous abortions, and present a new technology for studying HPV.

Primary anaplastic large cell lymphoma of the small intestine

We describe the clinicopathologic, immunophenotypic, and molecular findings in 4 cases of anaplastic large cell lymphoma (ALCL) arising in the small intestine. All patients were men with acute symptoms of gastrointestinal tract obstruction. The clinical preoperative diagnosis was gastrointestinal carcinoma in 3 cases, and pancreatic carcinoma in 1 case. Histologic examination revealed cohesive aggregates of neoplastic cells, with multiple vesicular nuclei, prominent nucleoli, and abundant amphophilic cytoplasm. There was no clinical or histopathologic evidence of enteropathy. All cases were CD30+, and all showed evidence of T-cell lineage with cytotoxic potential by expression of CD3, CD43, or CD45RO; T-cell intracellular antigen-1; or perforin. One tumor showed p80 and anaplastic lymphoma kinase (ALK) overexpression corroborated by the presence of the t(2:5). One tumor expressed Epstein-Barr virus latent membrane protein. In all cases, the tumor cells were negative for CD20, CD15, CD56, and cytokeratin. Polymerase chain reaction revealed clonal rearrangements of the T-cell receptor gamma-chain gene, without evidence of immunoglobulin heavy-chain gene rearrangement. The diagnosis of primary bowel ALCL is facilitated by immunophenotypic and molecular studies. With 24 months of clinical follow-up, only the patient with the t(2:5)-positive tumor is alive and free of disease, suggesting that p80/ALK overexpression may be a good prognostic indicator.

Hydroxyapatite as a bone substitute

A bone substitute eliminates the need for autogenous and allogeneic bone grafting, along with the complications unique to each. Coralline hydroxyapatite is a synthetic bone void filler manufactured from marine coral, which has a natural trabecular structure similar to that of cancellous bone. While initial studies have been promising, the use of coralline hydroxyapatite may be limited in the foot and ankle owing to its inherent mechanical weakness and lack of biodegradation. In this retrospective study, 20 patients who received coralline hydroxyapatite implants were reviewed to determine associated complications and host reaction to the material. The results indicate that the material is biologically inert and safe to use as a small-defect filler in low-load applications. Long-term clinical trials are needed to determine the indications for this material in the foot and ankle.

Aortic dissection

The presentation of aortic dissection in the emergency department may be more subtle than the classic description of a shocked patient with "ripping" chest pain. The epidemiology, variation in presentation, investigation, and management of aortic dissection are reviewed.

Cytokeratin-positive cells in PBSC collections from normal donors and patients with non-epithelial cell-derived tumors

BACKGROUND

It is possible that post-transplant relapse in patients with breast cancer may result, in part, from residual tumor in the autologous PBSC product. It is unclear from the literature what effect residual breast tumor cells have on clinical outcome and whether purging tumor cells would be beneficial. We hypothesized that lack of standardization of assays for detection of residual breast tumor may be responsible for the inconclusive clinical data.

METHODS

We compared two assays routinely for detection of cytokeratin (CK)-positive cells in stem-cell grafts, immunohistochemistry (IHC) and flow cytometry (FCM). The patient population consisted of individuals with breast cancer, non-epithelial cell-derived tumors and normal donors. A rigorous statistical model was developed for evaluation of the data.

RESULTS

We found that the IHC assay out-performed the FCM assay. Importantly, both assays detected CK-positive cells in PBSC collections of patients with non-epithelial cell-derived tumors and in normal donors. No distinguishing morphological characteristics could be identified to differentiate potentially malignant from non-malignant CK-positive cells. Due to the inability to distinguish true positive from false positive results, we developed a statistical model to establish a quantitative threshold to discriminate positive from negative samples. Among the patients tested, no clinical outcome differences were detected, regardless of where the threshold of CK-positive cells was set.

DISCUSSION

We conclude the more stringent criteria and more specific markers, rather than the presence or absence of CK-positive cells, need to be established to determine the clinical significance of minimal residual disease in autologous breast-cancer

Disseminated intravascular coagulation: clinical and laboratory aspects

Disseminated intravascular coagulation (DIC) is a complex acquired coagulopathy resulting from excessive thrombin formation. Abnormal tissue factor (TF) expression is a major mechanism initiating DIC in many disorders, including obstetrical complications, sepsis, cancer, and trauma. Numerous laboratory tests are available to monitor DIC, but most patients are adequately managed using only routine hemostasis screening tests, and assays for fibrinogen and D-dimer. Treatment of DIC should focus on reversing the underlying disorder initiating the coagulopathy. Novel treatments are being investigated for treating DIC; many of these experimental modalities target the excessive TF activity that characterizes DIC.

Motorbike injuries in Bermuda: a risk for tourists

STUDY OBJECTIVE

To describe the incidence of injuries associated with motorbike use in Bermuda and discuss prevention strategies.

METHODS

We conducted a population-based study of all incident of traffic accidents involving motorbikes. Demographic characteristics and mechanisms, rates, and outcomes of injury for tourists and residents were compared.

RESULTS

We identified 657 cases of road trauma that occurred between July and September 1993. Of these cases, 538 (81.9%) involved motorbikes. The tourist rate of motorbike-related injury was 94.1/1,000 person-years at risk, whereas that of the local population was 16.6/1,000. The injury rate among residents was highest for young males, whereas among tourists it was highest among older persons. The relative risk (RR) of injury for tourists was 5.6 (95% confidence interval [CI], 4.8 to 6.7). Tourists also had an increased risk of fracture (RR, 1.43; 95% CI, 1.22 to 1.67).

CONCLUSION

Tourists visiting Bermuda are at high risk of injury from motorbike use, with rates of injury much higher than the local population. Prevention strategies, particularly for older tourists, should be developed and implemented.

Epiglottitis in adults

Acute epiglottitis has become a disease of adults, probably as a result of immunization of children against Haemophilus influenzae. This article is a review of the literature on epiglottitis, including signs and symptoms, investigation, differential diagnosis, and treatment in the emergency department. The microbiology is discussed and the importance of prophylaxis in exposed persons is stressed.

Telephone advice about an infant given by after-hours clinics and emergency departments

AIMS

Studies have shown that telephone calls for advice constitute a significant portion of the workload of emergency departments in the United States and the United Kingdom. Reviews of the appropriateness of telephone advice given in emergency departments in the United States indicate that the information given is often inadequate or inaccurate. We performed a study to evaluate the telephone advice given in New Zealand.

METHODS

We identified 30 public hospital emergency departments and 20 private accident and emergency clinics. Twenty-six towns and cities were represented. We telephoned each of them and requested advice about the management of a fictitious febrile infant.

RESULTS

We were given medical advice by 36 of the centres. In the remaining 14 the caller was referred to an oncall duty doctor or general practitioner for further information. In the 36 departments providing advice, the information was given by a doctor in 5 of the cases, by a nurse in 26, and by a receptionist or unidentified respondent in 5. On average, the caller was asked 3.76 questions about the patient before advice was given. Even if a number of questions were asked, correct advice did not necessarily follow. Thirty five of the advice givers requested the age of the infant, but 16 of them gave inadequate advice despite this knowledge. We judged the advice given to be inadequate in 16 of the 36 institutions that provided it. There was no difference in the standard of advice given by private and public institutions.

DISCUSSION

This study demonstrates that there are deficiencies in the quality of telephone advice given by emergency departments and private accident and emergency clinics in New Zealand.

Diverse effects of antiemetics in children

AIMS

To present cases of dystonic reactions in paediatric patients related to the use of antiemetics and to remind practitioners of the potential hazards of these agents in the paediatric age group.

METHOD

Discussion of the presentations of three children at the Middlemore Hospital emergency department with neurological symptoms after exposure to prochlorperazine or metoclopramide and one child with a possible phenothiazine ingestion.

RESULTS

These cases illustrate that some physicians are unaware of the potential hazards of antiemetics in children.

CONCLUSIONS

Physicians prescribing antiemetics for children presenting with viral gastroenteritis should carefully consider the risks and benefits of these medications. If the drugs are prescribed, instructions about possible side effects should be emphasised so that corrective treatment can be initiated promptly. A full drug history should be obtained on all patients presenting to emergency departments. In addition, the emergency physician evaluating children with unusual neurological symptoms should always consider the possibility of an acute extrapyramidal reaction.

A cutaneous infection with Mycobacterium fortuitum

We report the case of a 24-year-old man with a cutaneous Mycobacterium fortuitum infection. The investigation and management of this patient are discussed, and literature pertaining to this organism is reviewed. The importance of considering mycobacteria in the pathogenesis of chronic cutaneous disease is stressed.

Preparing stewards for tomorrow. A healthcare system's intern program provides mentors for potential trustees

Mentors can provide support essential to a person's advancement and growth in a new business or position. Because of the complex and rapidly changing nature of healthcare, mentors can be particularly valuable to persons interested in becoming healthcare facility trustees. Since 1987, the Sisters of Mercy Health System (SMHS), St. Louis, has implemented a comprehensive intern program for potential trustees. Each intern is assigned to a board and a board member mentor at an SMHS facility. The program lasts for two years and includes a didactic component, independent study, clinical experience, regularly scheduled meetings, and issuance of a certificate on completion. Thus far, the interns have been sisters from education, healthcare, social service, or other ministries. They must show abilities crucial for successful trustees (such as listening skills), an appreciation of and strong support for the ministry, and a willingness to commit the time and energy to the program. Mentors chosen for the program also must devote time to orientation and meetings and must assist interns in integrating mission and values into board activities. In addition, mentors help interns identify the focus of present structures and resources and their appropriateness and discuss the trustee's role and responsibilities and dynamics for quality decision making.

What's in a name? A survey looks at how systems define sponsorship and mission effectiveness functions

In late 1986 the Sisters of Mercy Health System-St. Louis surveyed selected Catholic healthcare systems to determine what works when defining sponsorship and mission effectiveness functions and positions. Additionally, it attempted to ascertain how the systems' age, growth pattern, and maturity affected their definition of the corporate and institutional roles of sponsorship or mission effectiveness. Fifteen of eighteen healthcare systems responded to the survey. The systems ranged in age from six months to 14 years. In 14 systems the sponsorship, mission, or mission effectiveness functions were corporate positions; the 15th considered this function consultative. The positions covered 21 "primary responsibility areas," among them ethics, human resources, planning, ministry development, canonical issues, and legal affairs. The primary responsibilities of the positions increased and gradually leveled off as the system matured. The survey indicated that the 15 systems needed about six years to develop and implement the sponsorship, mission, or mission effectiveness functions. The initial activity focused on sponsorship. The implementation phase seemed to reach a new level of maturity when mission effectiveness concerns became a priority. This evolution assumed a mature understanding and ownership of the sponsors' values and spirit.

Asthma and climatic conditions: experience from Bermuda, an isolated island community

A retrospective study of patients attending the emergency department with acute asthma was performed in Bermuda. Climatic data (barometric pressure, rainfall, humidity, and wind strength and direction) were obtained and compared with frequency of exacerbations of asthma. Three factors--namely, relative humidity, average daily temperature, and northeasterly winds--were found to be related to worsening asthma. Owing to Bermuda's lack of pollution and aeroallergens it was thought that these weather parameters had a direct effect on the asthmatic population.

Variation in rates of hospital admission for appendicitis in Wales

In a study designed to investigate the variations in rates of admission to hospital for appendicitis in Wales Hospital Activity Analysis listings were analysed according to the sex and age of the patients and the month and day of the week of admission. The incidence of hospitalisation was greatest among boys aged 10-14 and girls aged 15-19. The number of admissions was higher on weekdays than at weekends, but there were no seasonal variations. Durations of stay differed between the 17 health districts. We conclude that admission rates vary mainly because of differing hospital admission policies. Admission is not wholly governed by the sudden onset of abdominal pain; other factors include the threshold of consultation of each patient, the referral habits of general practitioners, the availability of hospital beds, and the degree to which doctors and patients expect admission.

The action of cyanate on human and pig kidney alkaline phosphatases

1. At concentrations of cyanate up to 0.2m there is an apparently reversible combination with alkaline phosphatase (EC 3.1.3.1), but higher concentrations inhibit alkaline phosphatase irreversibly by a process that is time-dependent. 2. The effect of 0.2m-cyanate on the enzymic reaction velocity depends on the substrate concentration. There is inhibition when the substrate concentration is 1.0mm or higher, but at lower substrate concentrations cyanate has an activating effect. 3. The pH-dependence of the reversible reaction suggests that cyanate may react with a thiol group at or near the active site of the enzyme, preventing a conformational change that is believed to be important in the mechanism of action of alkaline phosphatase. 4. Prolonged treatment with 0.6m-cyanate probably carbamoylates all free amino groups in the enzyme molecule and generates a new enzyme with decreased V(max.) and increased K(m).