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Introduction: In special populations, such as Reserve Officers' Training Corps (ROTC) cadets, body composition is used not only as a predictor of fitness but for additional purposes such as qualification for enlistment, load carriage, and duty fulfillment. Body mass index (BMI) is the initial measurement recorded and is considered a representation of health and physical performance capabilities. Personnel exceeding threshold values of body weight based upon their height measurement are typically further evaluated using a circumference-based method that predicts the cadets' percent body fat. Military personnel who fail to meet these body composition standards may be penalized by being denied specific positions or promotions or risk being relieved from all military duties. In order to differentiate and accurately assess the components that constitute body composition, other methods of measuring body composition that provide greater accuracy should be explored. The purpose of this study was to compare multiple body composition methods, including the military's method of circumference-based measurement, in order to identify a suitable method for Air Force ROTC programs. Materials and Methods: Participants were recruited from an Air Force ROTC Detachment at a large university in the Midwest United States. Anthropometric (height and weight) and body composition measurements (air displacement plethysmography [ADP], bioelectrical impedance analysis, skinfolds, and circumferences) were collected for each participant. A repeated-measure analysis of variance was used to compare body composition measurement methods. A Bonferroni adjustment was utilized for multiple comparisons. BMI and circumference results were displayed as a percentage of compliance according to Air Force Instruction guidelines. The university institutional review board approval was established to ensure that the design of this study protected the rights of the participants. Results: Twenty-four (21 males and 3 females) participants completed the study. A significant difference between skinfolds and bioelectrical impedance analysis occurred (P = .025). There were no other significant differences identified between other methods of body composition. Using the BMI and circumference compliant/non-compliant scale listed in the Air Force Instruction guidelines, a greater number of cadets fell into the non-compliant category according to BMI (n = 7) versus circumferences (n = 1). The circumference-based method underestimated body fat compared to the "gold standard" ADP. Conclusions: The findings from this investigation suggest that the circumference-based method can appropriately provide accurate body composition results among Air Force ROTC cadets. Results also determined that the military's circumference-based method underestimated body fat compared to the "gold standard" ADP. Although circumference-based measurements might be efficient for use in larger populations, Air Force ROTC programs should evaluate other methods of measuring body composition to best fit the needs of individual cadets. Further research should be conducted to identify body composition methods that are easy to implement and provide accurate results at the individual level. [ABSTRACT FROM AUTHOR]

Many ecological factors influence animal movement, including properties of the media that they move on or through. Animals moving in terrestrial environments encounter conditions that can be challenging for generating propulsion and maintaining stability, such as inclines and deformable substrates that can cause slipping and sinking. In response, tetrapods tend to adopt a more crouched posture and lower their center of mass on inclines and increase the surface area of contact on deformable substrates, such as sand. Many amphibious fishes encounter the same challenges when moving on land, but how these finned animals modulate their locomotion with respect to different environmental conditions and how these modifications compare with those seen within tetrapods is relatively understudied. Mudskippers (Gobiidae: Oxudercinae) are a particularly noteworthy group of amphibious fishes in this context given that they navigate a wide range of environmental conditions, from flat mud to inclined mangrove trees. They use a unique form of terrestrial locomotion called "crutching," where their pectoral fins synchronously lift and vault the front half of the body forward before landing on their pelvic fins, while the lower half of the body and tail are kept straight. However, recent work has shown that mudskippers modify some aspects of their locomotion when crutching on deformable surfaces, particularly those at an incline. For example, on inclined dry sand, mudskippers bent their bodies laterally and curled and extended their tails to potentially act as a secondary propulsor and/or anti-slip device. In order to gain a more comprehensive understanding of the functional diversity and context-dependency of mudskipper crutching, we compared their kinematics on different combinations of substrate types (solid, mud, and dry sand) and inclines (0°, 10°, and 20°). In addition to increasing lateral bending on deformable and inclined substrates, we found that mudskippers increased the relative contact time and contact area of their paired fins, while becoming more crouched, which are responses comparable to those seen in tetrapods and other amphibious fish. Mudskippers on these substrates also exhibited previously undocumented behaviors, such as extending and adpressing the distal portions of their pectoral fins more anteriorly, dorsoventrally bending their trunk, "belly-flopping" on sand, and "gripping" the mud substrate with their pectoral fin rays. Our study highlights potential compensatory mechanisms shared among vertebrates in terrestrial environments while also illustrating that locomotor flexibility and even novelty can emerge when animals are challenged with environmental variation. [ABSTRACT FROM AUTHOR]

Attachment is imperative for many biological functions, such as holding position and climbing, but can be challenged by natural conditions. Adhesive toe pads and claws have evolved in multiple terrestrial lineages as important dynamic attachment mechanisms, and some clades (e.g. geckos) exhibit both features. The functional relationship of these features that comprise a complex attachment system is not well-understood, particularly within lizards (i.e. if pads and claws are redundant or multifunctional). Geckos exhibit highly adept frictional adhesive toe pads that continue to fuel biological inquiry and inspiration. However, gecko claws (the ancestral lizard clinging condition) have received little attention in terms of their functional or evolutionary significance. We assessed claw function in Thecadactylus rapicauda using assays of clinging performance and locomotor trials on different surfaces (artificial and natural) and inclines with claws intact, then partially removed. Area root mean square height (Sq), a metric of 3D surface roughness, was later quantified for all test surfaces, including acrylic, sandpaper, and two types of leaves (smooth and hairy). Maximum clinging force significantly declined on all non-acrylic surfaces after claw removal, indicating a substantial contribution to static clinging on rough and soft surfaces. With and without claws, clinging force exhibited a negative relationship with Sq. However, claw removal had relatively little impact on locomotor function on surfaces of different roughness at low inclines (≤30°). High static and dynamic safety factor estimates support these observations and demonstrate the species' robust frictional adhesive system. However, maximum station-holding capacity significantly declined on the rough test surface after partial claw removal, showing that geckos rely on their claws to maintain purchase on rough, steeply inclined surfaces. Our results point to a context-dependent complex attachment system within geckos, in which pads dominate on relatively smooth surfaces and claws on relatively rough surfaces, but also that these features function redundantly, possibly synergistically, on surfaces that allow attachment of both the setae and the claw (as in some insects). Our study provides important novel perspectives on gecko attachment, which we hope will spur future functional studies, new evolutionary hypotheses, and biomimetic innovation, along with collaboration and integration of perspectives across disciplines. [ABSTRACT FROM AUTHOR]

AIMS: The goal of this study was to better understand the predictive relationship in both directions between negative (anger, sadness) and positive (happiness) moods and alcohol consumption using daily process data among heavy drinkers. METHODS: Longitudinal daily reports of moods, alcohol use and other covariates such as level of stress were assessed over 180 days using interactive voice response telephone technology. Participants were heavy drinkers (majority meeting criteria for alcohol dependence at baseline) recruited through their primary care provider. The sample included 246 (166 men, 80 women) mostly Caucasian adults. Longitudinal statistical models were used to explore the varying associations between number of alcoholic drinks and mood scores the next day and vice versa with gender as a moderator. RESULTS: Increased alcohol use significantly predicted decreased happiness the next day (P < 0.005), more strongly for females than males. Increased anger predicted higher average alcohol use the next day for males only (P < 0.005). CONCLUSION: This daily process study challenges the notion that alcohol use enhances positive mood for both males and females. Our findings also suggest a strong association between anger and alcohol use that is specific to males. Thus, discussions about the effects of drinking on one's feeling of happiness may be beneficial for males and females as well as anger interventions may be especially beneficial for heavy-drinking males. [ABSTRACT FROM AUTHOR]

Background: Carotid endarterectomy (CEA) reduces the risk of stroke in patients with internal carotid stenosis of 50-99 per cent. This study assessed national surgical practice through audit of CEA procedures and outcomes. Methods: This was a prospective cohort study of UK surgeons performing CEA, using clinical audit data collected continuously and reported in two rounds, covering operations from December 2005 to December 2007, and January 2008 to September 2009. Results: Some 352 (92·6 per cent) of 380 eligible surgeons contributed data. Of 19 935 CEAs recorded by Hospital Episode Statistics, 12 496 (62·7 per cent) were submitted to the audit. A total of 10 452 operations (83·6 per cent) were performed for symptomatic carotid stenosis; among these patients, the presenting symptoms were transient ischaemic attack in 4507 (43·1 per cent), stroke in 3572 (34·2 per cent) and amaurosis fugax in 1965 (18·8 per cent). The 30-day mortality rate was 1·0 per cent (48 of 4944) in round 1 and 0·8 per cent (50 of 6151) in round 2; the most common cause of death was stroke, followed by myocardial infarction. The rate of death or stroke within 30 days of surgery was 2·5 per cent (124 of 4918) in round 1 and 1·8 per cent (112 of 6135) in round 2. Conclusion: CEA is performed less commonly in the UK than in other European countries and probably remains underutilized in the prevention of stroke. Increasing the number of CEAs done in the UK, together with reducing surgical waiting times, could prevent more strokes. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The article discusses a retrospective study of the effectiveness of open, retrograde angioplasty/stenting of supra-aortic arterial stenoses combined with transcranial Doppler-directed dextran therapy in preventing perioperative embolization. Over a 5-year interval, 12 patients underwent on-table, retrograde angioplasty of stenoses involving the proximal common carotid arteries (CCAs) or innominate arteries. It is concluded that retrograde angioplasty/stenting with or without synchronous carotid endarterectomy offers an alternative approach to treating patients with supra-aortic inflow disease.

Background: There is growing interest in the role of matrix metalloproteinases in atherosclerosis. Excessive tissue remodelling and increased matrix metalloproteinase activity have been demonstrated during atherosclerotic plaque disruption, a frequent predeterminant of ischaemic cardiac events and stroke. These enzymes represent a potential target for therapeutic intervention to modify vascular pathology. Methods: The core of this review is derived from a Medline database literature search. Results: There is convincing evidence of increased matrix metalloproteinase activity during acute plaque disruption. Evidence for an imbalance promoting increased matrix degradation is less well documented. However, studies of matrix metalloproteinase inhibition in models of vascular disease suggest a potential therapeutic benefit. Conclusion: In vivo studies of matrix metalloproteinase inhibition are required to study the potential for reversal or deceleration of the excessive tissue remodelling that accompanies acute plaque disruption. [ABSTRACT FROM AUTHOR]

Discusses the abstract of a study examining the safety and durability of vein interposition grafting in carotid artery repair versus standard endarterectomy (CEA). Mortality rate for 30-day any stroke; Rate of restenosis.

Discusses the abstract of a study evaluating the safety of vein versus dacron patching during carotid endarterectomy. Patient characteristics; Stroke rate for dacron- versus vein-patched patients; Incidence of detecting emboli in dacron- versus vein-patched group.

Discusses the abstract of a study evaluating the effects of combination aspirin and the novel antiplatelet agent clopidrogel on platelet function in vivo and in vitro. Physiologic effect of clopidrogel; Dosage; Comparison of platelet reduction using aspirin versus drug combination group.

Presents an abstract of the article 'Intraoperative Change in Baroreceptor Function During Carotid Endarterectomy,' by M.E. Gaunt, D. Sigaudo-Roussel, R. Panerai, D.H. Evans, N.L. London, A.R. Naylor and P.R.F. Bell.

Presents an abstract of the article 'Methicillin-Resistant Staphyloccus aureus Infection in Vascular Patients,' by A. Nasim, M.M. Thompson, A.R. Naylor, P.R.F. Bell and N.J.M. London.

Presents an abstract of the article 'Thromboembolic Events After Carotid Endarterectomy are Not Prevented by Aspirin, but are Due to the Platelet Response to Adenosine 5'-diphosphate,' by P.D. hayes, H. Box, S. Tull, M.E. Gaunt, P.R.F. Bell, A.H. Goodall and A.R. Naylor.

Presents an abstract of the article 'Prospective, Multicenter Audit of Complex Vascular Wound and Graft Infections: The Impact of Methicillin-resistant Staphylococcus aureus,' by P.D. Hayes, S. Darke and A.R. Naylor.

Presents an abstract of the article 'Effect of Carotid Endarterectomy on Cognitive Function: Long-Term Follow-up,' by A.J. Lloyd, P.D. Hayes, A.R. Naylor and P.R.F. Bell.

Presents an abstract of the article 'Patient's Understanding of Risk and benefit Associated With Carotid Endarterectomy,' by A.J. Lloyd, P.D. Hayes, A.R. Naylor, and P.R.F. Bell.

Examines the effectiveness of low-dose Dextran-40 in preventing thromboembolic complications after carotid endarterectomy. Assessment of response to the therapeutic dose; Beneficial effects of Dextran in vivo; Use of whole-blood flow analysis of fibrinogen binding in response to adenosine.

Examines the durability of percutaneous transluminal angioplasty (PTA) in the treatment of severe leg ischemia. Distribution of risk factors; Rate of limb salvage; Technical failure of PTA.

SummaryBackground: The aim of this study was to determine the ability of superficial venous surgery to heal venous ulcers in lower legs with isolated superficial venous incompetence. Methods: This was a prospective study of patients recruited from a venous ulcer assessment clinic. Ulcers were considered venous if the ankle : brachial pressure index was greater than 0·8 and duplex imaging showed venous reflux. Patients with isolated superficial venous incompetence were offered saphenofemoral and/or saphenopopliteal surgery. Neither perforator surgery, skin grafting nor postoperative compression hosiery or bandaging was used. Results: A total of 122 legs with normal deep veins underwent superficial venous surgery. Ninety procedures (74 per cent) were done under local and 32 (26 per cent) under general anaesthesia. Sixty operations (49 per cent) were done as a day case. The median time to healing was 18 (95 per cent confidence interval 14–21) weeks and the cumulative 6-, 12- and 18-month healing rates were 57, 74 and 82 per cent respectively. Conclusion: In patients with venous ulceration and isolated superficial venous incompetence, superficial venous surgery can produce ulcer healing in the majority of patients without the need for perforator surgery, postoperative compression bandaging or skin grafting. [ABSTRACT FROM AUTHOR]

Background Vascular surgeons perceive that carotid endarterectomy carries a higher risk of stroke if performed by a surgical trainee. Accordingly, some trainees consider that they receive a less than adequate training in carotid surgery before taking up a consultant position. The aim of this study was to establish whether the stroke rate was adversely affected if carotid endarterectomy was performed by a surgical trainee under consultant supervision. Methods This was a prospective study of 151 consecutive patients undergoing carotid endarterectomy between 1 January and 31 December 1996 using a standardized technique including intraoperative and postoperative transcranial Doppler monitoring and completion angioscopy. Results The overall mortality and/or disabling stroke rate was 0·7 per cent (one of 151 patients), whereas the mortality and/or any stroke rate was 1·3 per cent (two of 151). Surgical trainees performed 82 of 151 carotid endarterectomies, with a mortality rate of 1 per cent and a mortality and/or any stroke rate of 2 per cent. There was no significant difference in the incidence of retained thrombus or intimal flaps between trainees and consultants as detected by angioscopy. Conclusion Vascular surgical trainees can receive a comprehensive training in carotid artery surgery without incurring an unacceptable increase in operative risk. [ABSTRACT FROM AUTHOR]

A group of healthy elderly subjects (≥75 years) was selected by the strict criteria of the SENIEUR protocol, and compared with healthy young (≤35 years) volunteers. Mitogenic responses of peripheral blood mononuclear cells to phytohaemagglutinin and anti-CD3 were significantly reduced in the elderly (P < 0.0002), thereby confirming that even though in perfect health, elderly individuals show impaired cell-mediated immunity. However, no abnormality of intracellular free Ca2+ fluxes could be detected in purified T cells from the elderly subjects when stimulated with anti-CD3 antibody. Nevertheless, both the proliferative responses of purified T cells to phorbol ester and calcium ionophore (Ionomycin) and the phorbol ester-induced inhibition of the Ca2+ response were defective in the elderly subjects (P < 0.003 and P < 0.0002, respectively). These data suggest that signal transduction and the generation of second messengers proceed normally in T cells from the elderly, but downstream events mediated by activation of protein kinase C are dysfunctional. [ABSTRACT FROM AUTHOR]

Background The aim of the study was to investigate whether infrainguinal vein graft surveillance can be stopped at 1 year without prejudicing graft or leg survival. Methods Data were collected prospectively on 351 infrainguinal vein bypass grafts (326 patients) that had been entered into a vein graft surveillance programme between 1988 and 1997. Results Some 104 grafts (30 per cent) developed significant new vein graft stenoses, 95 (91 per cent) of which occurred within 12 months. After 1 year, the risk of developing a significant graft stenosis was 3 per cent per year. Sixty-nine grafted limbs (20 per cent) developed new arterial inflow or run-off stenoses that required intervention, but only 37 (54 per cent) occurred within the first year, after which the risk was 9 per cent per year. The overall risk of developing a new vein graft or arterial stenosis after 1 year was 10 per cent per year. Conclusion The incidence of vein graft stenosis decreases significantly 1 year after operation but there is still at risk of developing potentially graft-threatening arterial stenoses. Legs that have undergone infrainguinal vein bypass grafting should continue to be monitored in a surveillance programme for life. [ABSTRACT FROM AUTHOR]

Background This paper describes local anaesthetic saphenous disconnection in elderly patients for the treatment of venous ulceration in legs with either saphenous venous reflux alone or in combination with deep venous reflux. Methods Ambulatory venous pressure was measured in 16 legs with saphenous vein reflux alone and in nine legs with combined deep and saphenous venous reflux before, immediately after and 3 months after saphenofemoral or popliteal disconnection. Ulcer area was measured by computerized planimetry before surgery and at 1 and 3 months after operation. No compression bandages or hose were applied after surgery unless the ulcers had not begun to heal after 1 month. Results In legs with saphenous reflux alone all ulcers healed without compression bandages at a median of 81 (range 14–253) days and the pressure relief index (PRI) improved significantly both after surgery and at follow-up. None of the ulcers in the nine limbs with saphenous and deep venous reflux healed without compression bandaging and the PRI was unchanged immediately following surgery and at follow-up. Conclusion Saphenous vein disconnection improves venous function and heals venous ulcers without compression bandaging if the deep veins are normal. This procedure under local anaesthetic may be particularly suitable for elderly patients, but long saphenous vein stripping should be added in young patients. [ABSTRACT FROM AUTHOR]

The article discusses the roles of carotid endarterectomy (CEA) and carotid artery stenting (CAS) in patients with symptomatic and asymptomatic carotid disease. In 2011, the U.S. Food and Drug Administration (FDA) gave its approval to the RX Acculink® Carotid Stent system for average-risk patients. Included is a list of key observations on CAS and CEA, along with unresolved issues surrounding the use of CAS.

Two hundred and eighteen subjects, out of 250 individuals taken from a general practice register, returned completed questionnaires giving details about rest cramps, and a further 15 were contacted by telephone. The overall prevalence of rest cramps in the survey population was 37%. The symptom was more prevalent in older subjects. Rest cramps were most commonly experienced in the muscles of the leg, in 83% of the 86 cramp sufferers. Symptoms were usually present at night (73%). On average cramp episodes lasted for 9 min (95%CI 6.7-11.2). Most cramps sufferers experienced symptoms infrequently, but 40% had cramp episodes more than three times per week and 6% complained of at least one episode per day or night. Twenty-one per cent of cramp sufferers described their symptoms as very distressing. A minority, 32% of the 86 cramp sufferers, had reported the symptoms to a general practitioner although the 86 subjects self-rated their health more negatively than the individuals without muscle cramps. There was a significant, positive association between rest cramps and symptoms of angina or intermittent claudication although these two factors only accounted for 12% of the variance, suggesting that peripheral vascular disease may play a relevant but limited role in the aetiology of rest cramps. [ABSTRACT FROM AUTHOR]

Background The aim of this study was to determine whether predischarge duplex imaging of an infrainguinal vein graft could predict the subsequent development of graft stenosis. Methods Patients with infrainguinal vein grafts underwent a duplex scan of the entire graft before discharge from hospital. Grafts were classified as abnormal or normal based on the presence or absence of flow abnormalities (peak velocity ratio 1·5 or greater). All grafts were re-examined 1 month after surgery, at 3-monthly intervals for the first year and then every 6 months thereafter. A significant stenosis requiring correction was defined by a duplex-derived peak systolic velocity ratio of 3·0 or more. The relationship between the predischarge scan and subsequent development of stenosis was examined. Results Forty-four grafts were recruited. Two occluded soon after a normal predischarge scan and were excluded from subsequent analysis. Predischarge abnormalities were found in 16 grafts. The abnormality in one graft required immediate correction. A further four grafts subsequently developed significant stenoses and required angioplasty. Of the 26 grafts with no predischarge abnormalities, 11 developed significant stenoses and underwent angioplasty. Abnormal predischarge duplex scans had a sensitivity and specificity of 31 and 58 per cent respectively for the development of stenoses. The positive and negative predictive values were 31 and 58 per cent respectively. Conclusion Predischarge duplex imaging cannot be used to predict the development of stenoses in infrainguinal vein grafts. [ABSTRACT FROM AUTHOR]

Examines the fatality of carotid endarterectomy in a study in Great Britain. Role of platelets in arterial thrombotic events; Number of patients enrolled in the study; Observation on emboli production.