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Assessment of genetic diversity and connectivity between regions can inform conservation managers about risk of inbreeding, potential for adaptation and where population boundaries lie. The Gouldian finch (Erythrura gouldiae) is a threatened species in northern Australia, occupying the savannah woodlands of the biogeographically complex monsoon tropics. We present the most comprehensive population genetic analysis of diversity and structure the Gouldian finch using 16 microsatellite markers, mitochondrial control region and 3,389 SNPs from genotyping-by-sequencing. Mitochondrial diversity is compared across three related, co-distributed finches with different conservation threat-statuses. There was no evidence of genetic differentiation across the western part of the range in any of the molecular markers, and haplotype diversity but not richness was lower than a common co-distributed species. Individuals within the panmictic population in the west may be highly dispersive within this wide area, and we urge caution when interpreting anecdotal observations of changes to the distribution and/or flock sizes of Gouldian finch populations as evidence of overall changes to the population size of this species., Competing Interests: The authors have declared that no competing interests exist.

Clinical simulation has become established as a commonly used educational approach in respiratory therapy, though questions remain with regards to the evidence basis for its use in some contexts. In conjunction with the development of a new iteration of the National Competency Framework (NCF), the National Alliance of Respiratory Therapy Regulatory Bodies (NARTRB) reaffirmed its desire to continue to recognize the use of simulation as an educational tool. Given the expressed uncertainty as to best practices in the use of clinical simulation in entry-to-practice respiratory therapy education programs, the NARTRB requested the creation of an expert workgroup to develop a list of recommendations from which an implementation plan could be developed for the next iteration of the NCF. The resulting advisory workgroup recommendations are intended to inform the application of simulation in education programs relative to the attainment of entry-to-practice competencies as outlined in the current National Competency Profile. The recommendations presented focus on the use of clinical simulation for formative and summative assessment of respiratory therapy competencies. The recommendations indicate that the use of formative assessment in clinical simulations along with deliberate practice has been clearly shown to improve learning outcomes for which the simulations are designed. However, it is advised that the use of clinical simulation for the summative assessment of competency (e.g., to assess readiness for practice) be exercised cautiously in the context of respiratory therapy education. A number of requisite instructional design factors that should be considered before implementing summative simulation-based assessments are identified, including the validation of summative assessment tools.

Background: The optimal level of respiratory therapy staffing in Canadian intensive care units (ICUs) has not been described in the literature. An examination of practice patterns is an essential first step in developing an understanding of the contribution of respiratory therapists (RTs) to both short- and long-term patient outcomes in this context., Objective: To identify the ratio of mechanically ventilated patients to respiratory therapist (Vent:RT ratio) in the ICUs of Canadian teaching hospitals and the factors that influence this ratio., Methods: The present observational study investigated all adult ICUs (n=38) of the primary teaching hospital associated with each Canadian medical school. An electronic survey was administered at three intervals over a period of three months to control for seasonal variation. Data collected included the hours worked by all RTs, the number of mechanically ventilated patients receiving care, ICU characteristics and the practice patterns of the RTs. Data were used to calculate the Vent:RT ratio, and repeated measures ANOVA examined for variation between findings of each of the data collection points. Correlation analyses between key variables were performed and identified associations were further explored using the t test. Approval for the study was granted by the University of Manitoba Research Ethics Board (Winnipeg, Manitoba)., Results: A mean (± SD) Vent:RT ratio of 5.1:1±2.818 was determined. Repeated measures ANOVA demonstrated no significant differences between findings of the three data collection points (F [1.7,30.5]=0.695; P=0.492). Several variables were associated with a significant difference in the Vent:RT ratio including ICUs where RTs insert arterial monitoring lines (4.05±2.89 versus 6.97±2.85; t[17.6]=-2.64; P=0.02), neurological ICUs (4.04±2.76 versus 6.40±3.35; t[30]=-2.092; P=0.04) and coronary care units (5.72±2.80 versus 3.10±1.88; t[35]=2.72; P=0.01). Significant differences were also identified in the mean number of RT hours worked in ICUs where RTs intubated (31.40±9.71 versus 60.54±47.20; t(13)=-2.17; P=0.049) and procured arterial blood gases (41.68±30.85 versus 77.33±46.22; t[35]=-2.79; P=0.01)., Conclusions: The present study is the first to report the Vent:RT ratio and RT practice patterns in Canadian adult ICUs. The results serve as a baseline for comparison of staffing norms and will enlighten future research on the impact of RT staffing and practice patterns on patient outcomes.

The end-Triassic mass extinction overlapped with the eruption of the Central Atlantic Magmatic Province (CAMP), and release of CO2 and other volcanic volatiles has been implicated in the extinction. However, the timing of marine biotic recovery versus CAMP eruptions remains uncertain. Here we use Hg concentrations and isotopes as indicators of CAMP volcanism in continental shelf sediments, the primary archive of faunal data. In Triassic-Jurassic strata, Muller Canyon, Nevada, Hg levels rise in the extinction interval, peak before the appearance of the first Jurassic ammonite, remain above background in association with a depauperate fauna, and fall to pre-extinction levels during significant pelagic and benthic faunal recovery. Hg isotopes display no significant mass independent fractionation within the extinction and depauperate intervals, consistent with a volcanic origin for the Hg. The Hg and palaeontological evidence from the same archive indicate that significant biotic recovery did not begin until CAMP eruptions ceased.

Technological advances have influenced practice patterns and innovation in many health disciplines, including respiratory therapy. Collaborative approaches and knowledge-sharing environments are vital in addressing problems and adopting emerging technology. This article illustrates how the emergence of low-cost three-dimensional printing technology to physically reproduce the results of computed tomography imaging data can provide ways to assess airway abnormalities and symptomology not explained by traditional diagnostic methods.

Understanding biogeochemical cycling of trace metals in the ocean requires information about variability in metal concentrations and distribution over short, e.g., diel, time scales. Such variability and the factors that influence it are poorly characterized. To address this shortcoming, we measured trace metal concentrations in the total dissolved, colloidal, and soluble fractions every 3-4 h for several consecutive days and nights in surface waters from a coastal station. Our results show that both the concentration and the size partitioning of some biologically essential (Fe, Cu, Co, and Cd) and anthropogenic (Pb) metals are subjected to diel variations that may be related to both inorganic and biological processes (e.g., photolysis of high-molecular-weight dissolved organic matter, photoinduced reduction/oxidation of metal(hydrous)oxides, uptake by growing phytoplankton, degradation of organic matter, lysis, and grazing). The largest fluctuations were observed in the soluble and colloidal pools. Soluble Fe varied during the day-night cycle by a factor of 40, and the contribution of colloidal Pb to the total dissolved fraction increased from 6±3% during the day to as much as 70-80% during the night. Our results suggest that changes occurring over time scales of hours need to be considered when collecting and interpreting trace metal data from the surface ocean.

The observed stability of Earth's climate over millions of years is thought to depend on the rate of carbon dioxide (CO2) release from the solid Earth being balanced by the rate of CO2 consumption by silicate weathering. During the Cenozoic era, spanning approximately the past 66 million years, the concurrent increases in the marine isotopic ratios of strontium, osmium and lithium suggest that extensive uplift of mountain ranges may have stimulated CO2 consumption by silicate weathering, but reconstructions of sea-floor spreading do not indicate a corresponding increase in CO2 inputs from volcanic degassing. The resulting imbalance would have depleted the atmosphere of all CO2 within a few million years. As a result, reconciling Cenozoic isotopic records with the need for mass balance in the long-term carbon cycle has been a major and unresolved challenge in geochemistry and Earth history. Here we show that enhanced sulphide oxidation coupled to carbonate dissolution can provide a transient source of CO2 to Earth's atmosphere that is relevant over geological timescales. Like drawdown by means of silicate weathering, this source is probably enhanced by tectonic uplift, and so may have contributed to the relative stability of the partial pressure of atmospheric CO2 during the Cenozoic. A variety of other hypotheses have been put forward to explain the 'Cenozoic isotope-weathering paradox', and the evolution of the carbon cycle probably depended on multiple processes. However, an important role for sulphide oxidation coupled to carbonate dissolution is consistent with records of radiogenic isotopes, atmospheric CO2 partial pressure and the evolution of the Cenozoic sulphur cycle, and could be accounted for by geologically reasonable changes in the global dioxygen cycle, suggesting that this CO2 source should be considered a potentially important but as yet generally unrecognized component of the long-term carbon cycle.

Background: Long-term lung transplant success is limited by bronchiolitis obliterans syndrome (BOS), a form of chronic allograft rejection that manifests in the majority of patients by five years post-transplant. Frequent monitoring of pulmonary function measurements through the use of daily home spirometry may have the capability to detect the onset of BOS sooner than standard pulmonary function testing. Early detection of BOS would confer a treatment advantage that may improve survival outcomes for lung transplant recipients., Methods: A systematic review of current evidence was used to determine the effectiveness of daily home spirometry as a BOS detection tool, in addition to its impact and survival outcomes. Articles were included in the present systematic review if they were randomized control studies and if their purpose(s) included investigation of spirometry as a BOS detection tool in lung transplant patients., Results: A primary search of databases yielded 115 unique citations, with an additional four citations identified through a secondary review of the reference lists of retrieved articles. After application of all inclusion and exclusion criteria through abstract and full-text review, eight randomized controlled trials were included in the review., Discussion: Forced expiratory volume in 1 s (FEV1) has been identified as the most reliable diagnostic tool for detecting the onset of BOS. Two studies compared the use of traditionally scheduled pulmonary function testing with daily home spirometry and found BOS stage 1 to appear 341 days earlier with home spirometry (P<0.001). Other studies that investigated the impact early detection had on survival showed a positive trend toward freedom from BOS and reduced rates of retransplantation, although these results did not reach statistical significance (P<0.07)., Conclusion: Daily home spirometry has been shown to lead to earlier detection and staging of BOS when compared with standard pulmonary function testing. Although FEV1 has been shown to be the most sensitive and reliable marker of BOS onset, the impact of earlier staging via home spirometry on survival has not been reliably determined.

Chronic disease burden in Canada poses an imminent public health threat. The impact of respiratory disease in Canada alone is significant, affecting one in five and leading any other cause of repeat hospitalization in all age groups. Public health action is considered to be an important means of addressing these issues. Historical understanding of health has evolved to support the adoption of paradigms by professions that recognize the limitations of medical intervention in addressing the fundamental basis of disease when compared with the broader public health perspective. Several key historical events have shaped this understanding in the Canadian context including the Lalonde and Epp reports, and public health emergencies such as the severe acute respiratory syndrome outbreak in 2003. The profession of respiratory therapy has historically existed within a medicalized paradigm of practice; however, forces both internal and external to the profession are pressuring it to consider adopting broader social-and population-based approaches. As a rapidly evolving profession, there is a need to explore emerging areas of practice opportunities in the discipline. Investigating alternative knowledge and ideology can ensure that effective strategies for addressing the contemporary respiratory heath needs of Canadians are undertaken. The present article explores the rationale for a public health- and population-based approach to health in general, and its applicability to the respiratory therapist's role in addressing respiratory health-related issues in Canada.

Data protection and security are critical components of routine pathology practice because laboratories are legally required to securely store and transmit electronic patient data. With increasing connectivity of information systems, laboratory work-stations, and instruments themselves to the Internet, the demand to continuously protect and secure laboratory information can become a daunting task. This review addresses informatics security issues in the pathology laboratory related to passwords, biometric devices, data encryption, internet security, virtual private networks, firewalls, anti-viral software, and emergency security situations, as well as the potential impact that newer technologies such as mobile devices have on the privacy and security of electronic protected health information (ePHI). In the United States, the Health Insurance Portability and Accountability Act (HIPAA) govern the privacy and protection of medical information and health records. The HIPAA security standards final rule mandate administrative, physical, and technical safeguards to ensure the confidentiality, integrity, and security of ePHI. Importantly, security failures often lead to privacy breaches, invoking the HIPAA privacy rule as well. Therefore, this review also highlights key aspects of HIPAA and its impact on the pathology laboratory in the United States.

Aims: Catheter ablation for paroxysmal atrial fibrillation (AF) is rapidly becoming a standard practice. There is literature to support that catheter ablation of persistent AF requires additional 'substrate modification'. In clinical practice, operators rely on automated fractionation maps created by three-dimensional anatomic mapping systems to rapidly assess complex 'fractionated' signals (CFAE). These systems use differing algorithms to automate the process. The agreement between operators and contemporary algorithms has not been examined. We sought to assess the agreement between operators and a novel method of quantification calculating percentage fractionation (PF)., Methods and Results: Expert opinion on 80 atrial electrogram 4 s signals of varying levels of activity were gathered and pooled for comparison. Twelve independent experts visually quantified the signal fractionation and offered a threshold level for ablation. We developed an algorithm to find sites with high continuous electrical activity, or high PF. Correlation between experts and PF was 0.78 [P < 0.01, 95% confidence interval (CI) (0.68-0.86)]. Receiver operating characteristics curve sensitivity and specificity for PF were 0.7727 and 0.8103 at the optimal cut-off point of 58.45 PF with area under curve 0.89 CI (0.80-0.99)., Conclusion: The PF statistic represents a more robust and intuitive measure to represent fractionated atrial activity; importantly it demonstrates excellent agreement with expert users and presents a new standard for algorithm assessment. Use of a PF statistic should be considered in automated mapping systems.

Multiple system atrophy (MSA) is an adult-onset neurodegenerative disease characterised by Parkinsonian and autonomic symptoms and by widespread intracytoplasmic inclusion bodies in oligodendrocytes. These glial cytoplasmic inclusions (GCIs) are comprised of 9-10 nm filaments rich in the protein alpha-synuclein, also found in neuronal inclusion bodies associated with Parkinson's disease. Metallothioneins (MTs) are a class of low-molecular weight (6-7 kDa), cysteine-rich metal-binding proteins the expression of which is induced by heavy metals, glucocorticoids, cytokines and oxidative stress. Recent studies have shown a role for the ubiquitously expressed MT-I/II isoforms in the brain following a variety of stresses, whereas, the function of the brain-specific MT isoform, MT-III, is less clear. MT-III and MT-I/II immunostaining of post-mortem tissue in MSA and normal control human brains showed that the number of MT-III-positive cells is significantly increased in MSA in visual cortex, whereas MT-I/II isoforms showed no significant difference in the distribution of immunopositive cells in MSA compared to normal tissue. GCIs were immunopositive for MT-III, but were immunonegative for the MT-I/II isoforms. Immunofluorescence double labelling showed the co-localisation of alpha-synuclein and MT-III in GCIs in MSA tissue. In isolated GCIs, transmission electron microscopy demonstrated MT-III immunogold labelling of the amorphous material surrounding alpha-synuclein filaments in GCIs. High-molecular weight MT-III species in addition to MT-III monomer were detected in GCIs by Western analysis of the detergent-solubilised proteins of purified GCIs. These results show that MT-III, but not MT-I/II, is a specific component of GCIs, present in abnormal aggregated forms external to the alpha-synuclein filaments.

Anopheles gambiae s.s. Giles, An. stephensi Liston, An. freeborni Aitken, and An. quadrimaculatus Say are cultured and studied in molecular genetic and transgenic laboratories with increasing frequency. With limited research space, these mosquitoes are often maintained in the same insectary. Under these conditions, cross-contamination of colonies can occur and have devastating consequences to affected research programs. We have developed a polymerase chain reaction-based assay targeting the 28S large subunit ribosomal RNA gene to easily differentiate between these four taxa and An. funestus Giles, which occurs in sympatry with An. gambiae. The resulting assay identifies individual mosquito preparations as well as all taxa within a mixed or pooled DNA template preparation.

We sought to characterize the outcome in patients who were on long-term dialysis and who underwent primary percutaneous transluminal coronary angioplasty (PTCA) for acute myocardial infarction. Of 2,831 consecutive patients who underwent primary PTCA for acute myocardial infarction from 1993 to 2001, 15 patients on long-term dialysis were identified. This small cohort had a 40% incidence of cardiogenic shock on admission. Despite the angiographic success rate for primary PTCA of 80%, in-hospital mortality was 53%.

We report a case of myocardial stunning in a healthy patient. During gynecologic surgery, two brief episodes of asystole occurred. Following resuscitation there was a short period of severe hypertension and tachycardia. Electrocardiographic changes and elevations in troponin T and creatine-kinase-MB were observed. Angiography revealed normal coronary arteries and multiple areas of hypokinesis. Within 2 weeks, all abnormal values had returned to normal and the patient underwent an uneventful surgery.

Three experiments compared the performances of adult participants (three groups of 10) on a perceptuo-motor task in both real world (RW) and virtual environments (VEs). The task involved passing a hoop over a bent wire course, and three versions of the task were used: a 3-D wire course with no background, a flattened version of the 3-D course (2(1/2)-D course) with no background, and the 2(1/2)-D course with added background to provide spatial context. In all three experiments the participants had to prevent the hoop from touching the wire as they moved it. In the first experiment, the VE condition produced about 18 times more errors than the RW task. The VE 2(1/2)-D task was found to be as difficult as the 3-D, and the 2(1/2)-D with the added background produced more errors than the other two experiments. Taken together, the experiments demonstrate the difficulty of performing fine motor tasks in VEs, a phenomenon that has not been given due attention in many previous studies of motor control in VEs.

A three-generation reproduction study of sucrose acetate isobutyrate (SAIB) in Fischer 344 rats and teratology studies in Fischer 344 rats and New Zealand white rabbits were performed. Dietary SAIB concentrations to provide dose levels of 0, 0.5, 1.0 and 2.0 g/kg body weight were used for the rat studies, and 0, 0.5, 0.85 and 1.2 g/kg body weight doses of SAIB in corn oil were administered by gavage in the rabbit studies. F0 generation male rats were fed SAIB for 10 wk, and female rats were fed SAIB for 2 wk prior to mating. F1 generation rats were raised on the test diets to maturity, mated to produce F2a litters, and remated to produce the F2b litters that were examined for teratology. F2a rats were mated to study fertility indices for the F3 pregnancy. A decrease in female fertility compared with controls was noted at the highest dose of SAIB during breeding of the F1 generation to produce the F2a litters. No difference in fertility rate between controls and treated animals was noted in the results of the other three matings that were performed, and it was concluded that the reduction in female fertility was not related to SAIB treatment. No morphological abnormalities of soft tissue or skeleton were observed in the rat or rabbit teratology studies. The highest dose levels administered, 2.0 g SAIB/kg body weight in the rat and 1.2 g SAIB/kg body weight in the rabbit, were considered to be no-observed-adverse effect levels (NOAEL).

Background: Most melanomas when first diagnosed clinically are larger than common benign melanocytic nevi ( > 6 mm). Smaller melanomas, however, may occasionally occur. Yet, very little is known about them., Objective: To determine the incidence and delineate the clinical and histologic characteristics of small-diameter invasive melanomas., Methods: Slides of all melanomas diagnosed between 1984-1993 were reviewed and measured. All invasive lesions less than 6 mm were further scrutinized clinically and morphologically., Results: Among 357 invasive melanomas, 16 (4.4%) were less than 6 mm. Most lesions lacked some of the histologic features usually seen in large melanomas. One half of them were over 0.75 mm deep. Patients with small melanomas were on average 15 years younger than those with large lesions. In females, sites on the upper extremities predominate. In females, small melanomas had clinical signs of melanoma, while in males they resembled nevi., Conclusion: Melanomas smaller than 6 mm are not rare. Clinicians and pathologists must learn their features in order to diagnose them properly.

A model was developed to study the multiplication of various Legionella spp. in tap water containing Hartmannella vermiformis. Tap water cultures prepared with the following components were suitable for the multiplication studies: Legionella spp., 10(3) CFU/ml; H. vermiformis, 10(4.4) cysts per ml; and killed Pseudomonas paucimobilis, 10(9) cells per ml. Cocultures were incubated at 37 degrees C for at least 1 week. The following legionellae multiplied in tap water cocultures in each replicate experiment: L. bozemanii (WIGA strain), L. dumoffii (NY-23 and TX-KL strains), L. micdadei (two environmental strains), and L. pneumophila (six environmental strains and one clinical isolate). Growth yield values for these strains were 0.6 to 3.5 log CFU/ml. Legionellae which did not multiply in replicate cocultures included L. anisa (one strain), L. bozemanii (MI-15 strain), L. micdadei (a clinical isolate), L. longbeachae, (one strain), and L. pneumophila (Philadelphia 1 strain). L. gormanii and an environmental isolate of L. pneumophila multiplied in only one of three experiments. None of the legionellae multiplied in tap water containing only killed P. paucimobilis. The mean growth yield (+/- standard deviation) of H. vermiformis in the cocultures was 1.2 +/- 0.1 log units/ml. H. vermiformis supports multiplication of only particular strains of legionellae, some of which are from diverse origins.

This study compares the histopathologic characteristics of photodistributed and nonphotodistributed lichenoid drug eruptions in 13 patients. Both types have been said to be, in an unknown proportion, different from idiopathic lichen planus in that they can involve the deep as well as the superficial plexus, can contain eosinophils, and have parakeratotic scale. We found that these features were most often present in nonphotodistributed lichenoid drug eruptions and were seldom present in photodistributed eruptions. Thus a biopsy specimen that shows the classic features of lichen planus should not be used as evidence against a drug eruption, especially if the lesions are photodistributed.