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The soft tick Ornithodoros erraticus occurs on pig farms in southern Portugal and Spain and transmits several important pathogens of humans and livestock. Its distribution is patchy and the determinants of its distribution are uncertain. Here, we use a Bayesian network model to explore possible associations between climate, farm management and the presence of O. erraticus. The resulting network confirms previous suggestions that the presence of O. erraticus is more likely in traditionally constructed pig housing, and indicates that carbon dioxide traps are highly effective for the detection of O. erraticus. Our approach also picked up several other intuitively reasonable relationships, including that traditional housing was more likely to be in poor condition and more likely to be out of use, and that buildings which were in use to house pigs were also less likely to be derelict. Neither temperature nor precipitation had any direct effect on the probability of the presence of O. erraticus, suggesting that the distribution of the species is primarily driven by farm management factors., (Copyright © 2013 Elsevier B.V. All rights reserved.)

The recent arrival in Northern and Western (NW) Europe of bluetongue virus (BTV), which causes the ruminant disease 'bluetongue', has raised the profile of this vector-borne ruminant disease and sparked discussions on the reasons for its sudden emergence so far north. This expansion has not happened in isolation and the disease has been expanding into Southern and Eastern Europe for the last decade. This shifting disease distribution is being facilitated by a number of different introduction mechanisms including the movement of infected livestock, the passive movement of infected Culicoides on the wind and, in NW Europe, an unknown route of introduction. The expansion of BTV in Europe has forced a re-evaluation of the importance of Palaearctic Culicoides species in transmission, as well as the importance of secondary transmission routes, such as transplacental transmission, in facilitating the persistence of the virus. The current European outbreak of BTV-8 is believed to have caused greater economic damage than any previous single-serotype outbreak. Although attempts are being made to improve the capacity of European countries to cope with future BTV incursions, the options available are limited by a lack of basic entomological data and limited virological surveillance.

Widening of the mediastinum on chest radiography is widely promoted as a useful criterion for detecting aortic injury. We sought to determine the reliability, sensitivity, and specificity of this sign. The initial chest radiographs from 30 subjects with aortic injury and 47 controls were independently reviewed by six radiologists, who were blinded to diagnosis. The radiologists were asked to decide whether the mediastinum was normal or not normal, as well as whether the mediastinum was widened. Agreement, sensitivity, and specificity were assessed. Agreement for overall assessment of the mediastinum was substantial (kappa = 0.64). Individual radiologists had sensitivity varying from 0.77 to 0.97 and specificity varying from 0.62 to 0.89. For "widening" of the mediastinum, agreement was moderate (kappa = 0.49). "Widening" was less sensitive than the radiologists' overall impression (P = 0.01), varying from 0.50 to 0.83, but no difference was detected in specificity (P = 0.36), varying from 0.81 to 0.94. Mediastinal width has unacceptable sensitivity for predicting aortic injury, with substantial inter-reader variability. Medical education has ingrained the widely promoted concept of mediastinum widening, which may be misleading.

Comparing skeletal structures between antemortem and postmortem chest radiographs is widely used by forensic specialists from many disciplines to positively identify unknown decedents. However, validity assessments of this method have been fairly limited. This study had three objectives: 1) to quantify the reliability of ante- and postmortem chest radiograph comparison for decedent identification; 2) to identify useful radiologic features supporting decedent identification; and 3) to recognize sources of error in decedent identification related to use of comparative radiographs. A forensic pathologist, a forensic anthropologist, and two radiologists participated in the study. Our results showed that chest radiograph comparisons proved reliable, if basic decedent information was provided, and antemortem and postmortem radiographs were adequately positioned and exposed. A "morphological approach" using normal anatomical structures for comparison may provide the most efficient method for accurate identification.

Objective: We proposed to characterize the radiologic spectrum of occipital condyle fractures in a large series of patients and to correlate fracture pathology with neurosurgical treatment and patient outcome., Materials and Methods: We conducted a retrospective review of the findings on conventional radiography, CT, and MR imaging in 95 patients with 107 occipital condyle fractures. We described fracture patterns according to two previously published classification systems. Clinical findings, neurosurgical management, and patient outcome were obtained from the medical records., Results: Inferomedial avulsions (Anderson and Montesano type III) were the most common type of occipital condyle fracture, constituting 80 (75%) of 107 overall fractures. Unilateral occipital condyle fractures were found in 73 (77%) of 95 patients, and 58 patients were treated nonoperatively; occipitocervical fusion was required in nine patients for complex C1-C2 injuries, and six patients died. Bilateral occipital condyle fractures or occipitoatlantoaxial joint injuries were seen in 22 (23%) of 95 patients. Occipitocervical fusion or halo traction for the craniocervical junction was required in 12 patients, all of whom had CT evidence of bilateral occipitoatlantoaxial joint disruption and six of whom showed normal craniocervical relationships on conventional radiographs. Six patients with nondisplaced fractures were treated nonoperatively, and four patients died. Thirty (32%) of 95 patients showed continued disability, whereas 55 (57.5%) of 95 patients had good outcomes at 1 month. Associated cervical spine injuries were present in 29 (31%) of 95 patients., Conclusion: Given their associated traumatic brain and cervical spine injuries, occipital condyle fractures are markers of high-energy traumas. That conventional radiographs alone may miss up to half of the patients with acute craniocervical instability has not been well established. Avulsion fracture type and fracture displacement are associated with both injury mechanism and the need for surgical stabilization. In this series, most unilateral occipital condyle fractures were treated nonoperatively, whereas bilateral occipitoatlantoaxial joint injuries with findings of instability usually required surgical stabilization.