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Background Perioperative fluid management is an important component of enhanced recovery pathways for microsurgical breast reconstruction. Historically, fluid management has been liberal. Little attention has been paid to the biochemical effects of different protocols. This study aims to reduce the risk of postoperative hyponatremia by introducing a new fluid management protocol. Methods A single-institution cohort study comparing a prospective series of patients was managed using a new “modestly restrictive” fluid postoperative fluid management protocol to a control group managed with a “liberal” fluid management protocol. Results One-hundred thirty patients undergoing microsurgical breast reconstruction, at a single institution during 2021, are reported. Hyponatremia is demonstrated to be a significant risk with the original liberal fluid management protocol. At the end of the first postoperative day, mean fluid balance was +2,838 mL (± 1,630 mL). Twenty-four patients of sixty-five (36%) patients had low blood sodium level, 14% classified as moderate-to-severe hyponatremia. Introducing a new, “modestly-restrictive” protocol reduced mean fluid balance on day 1 to +844 mL (±700) (p ≤ 0.0001). Incidence of hyponatremia reduced from 36 to 14% (p = 0.0005). No episodes of moderate or severe hyponatremia were detected. Fluid intake, predominantly oral water, between 8am and 8pm on the first postoperative day is identified as the main risk factor for developing hyponatremia (odds ratio [OR]: 7; p = 0.019). Modest fluid restriction, as guided by the new protocol, protects patients from low sodium level (OR: 0.25; confidence interval: 95%; 0.11–1.61; p = 0.0014). Conclusion The original “liberal” fluid management protocol encouraged unrestricted postoperative oral intake of water. Patients were often advised to consume in excess of 5 L in the first 24 hours. This unintentionally, but frequently, was associated with moderate-to-severe hyponatremia. We present a new protocol characterized by early cessation of intravenous fluid and an oral fluid limit of 2,100 mL/day associated with a significant reduction in the incidence of hyponatremia and fluid overload.

The transverse upper gracilis flap is an important reconstructive option for patients who desire autologous reconstruction after mastectomy but in whom a deep inferior epigastric perforator flap is unavailable or undesirable. The authors present an analysis of outcomes and patient satisfaction results, from a consecutive series in a single institution.Using a prospectively populated free flap database, all patients undergoing transverse upper gracilis flap breast reconstruction for a mastectomy defect between January of 2013 and December of 2017 were identified. Retrospective review of clinical notes, admissions, and discharge information was conducted to identify outcomes, secondary operations, and complications. All patients were contacted by letter and invited to take part in a patient satisfaction survey a minimum of 12 months after free-flap surgery.Seventy-eight patients underwent transverse upper gracilis flap breast reconstruction using a total of 103 transverse upper gracilis flaps to reconstruct 99 breast mounds in the 5-year period studied. Patient satisfaction is evidenced by BREAST-Q scores showing 81 ± 19 percent Satisfaction with Breasts, 80 ± 20 percent Psychosocial Well-Being, and 84 ± 19 percent Physical Well-Being of the chest. Forty-six of 53 (87 percent) report satisfaction with the postoperative appearance of their thigh unclothed and 51 of 53 (96 percent) report satisfaction clothed.This is the first consecutive series of transverse upper gracilis flap breast reconstruction outcomes that presents BREAST-Q scores for multiple, postoperative reconstruction modules and details complications stratified by Clavien-Dindo score. The methodology can be easily replicated and benchmarked against. Our donor-site complication rates are lower than previous publications and patient satisfaction data reveal that this is a well-accepted option for patients.Therapeutic, IV.

In a retrospective study of a western pygmy marmoset ( Cebuella pygmaea) colony, postmortem examination of 1/8 juvenile and 29/47 adult animals identified vascular, cardiac, and renal lesions consistent with systemic hypertension. This included frequent renal arteriolar hypertrophy, hyaline and proliferative arteriolosclerosis, fibrinoid necrosis of arterioles, glomerulosclerosis, and nephrosclerosis. Affected animals ranged from 0.6 to 12 years of age (mean 6 years) and had an observed male predominance. Genealogical relatedness was evident in several breeding pairs and spanned multiple generations. Concurrent cardiac and renal disease was commonly identified, although frequently subclinical, and both were important causes of morbidity and mortality in affected animals. Cardiomegaly and hypertrophy were typical features and were accompanied by left atrial thrombosis in 10 animals. Signs of heart failure included chronic pulmonary edema in 20 cases and body cavity effusions in 17. In the kidneys, 19 cases had glomerular disease and hypertensive vasculopathy, and 26 cases had nephrosclerosis or glomerulosclerosis. Common extrarenal secondary causes of hypertension were excluded by necropsy examination. The pathogenesis is suggested to involve primary hypertension leading to renal and cardiac disease. Elevated sympathetic activity might be an underlying factor in the frequent development of primary systemic hypertension in the pygmy marmoset, as for the owl monkey.

Raising insects in a laboratory for release into the wild is a common conservation practice, but maintaining breeding colonies year‐round can be limited by seasonal food availability. Food availability is particularly challenging for insects which depend on specific host plants. For example, our early efforts to rear the imperiled Atala hairstreak butterfly (Eumaeus atala Poey) resulted in colony failure during winter due to lack of food. To overcome this barrier, we developed a modified freeze‐dried host plant diet to support the colony. The diet consisted of reconstituted freeze‐dried leaves and stems from fresh‐growth coontie (Zamia integrifolia), the host plant for the Atala butterflies. We fed larvae less than 9 mm on this freeze‐dried diet and transferred them to live coontie plants after they were more than 9 mm. We reared a colony of Atala butterflies using these methods for 859 days, resulting in more than 3400 animals released into the wild. Comparing colony counts during that time period to the 548 days we reared them without modified freeze‐dried diet showed a clear benefit in using freeze‐dried diet. A growth trial (N = 40) of larvae fed on only freeze‐dried diet compared to larvae fed on fresh coontie cuttings found no significant difference in larval or pupal development between groups (p = 0.71 and p = 0.47, respectively). We, therefore, conclude that the freeze‐dried diet provided an appropriate alternative for Atala colonies when fresh growth from the host plant is unavailable, and we recommend use of this technique for raising other host plant‐dependent insect species of conservation concern., Graphical abstract Graphical abstract created by Jennifer Torchalski, Disney's Animals, Science and Environment, Lake Buena Vista, Florida, USA., RESEARCH HIGHLIGHTS When rearing butterflies ex situ for conservation, many species of butterflies are highly host‐plant specific, and it can be difficult to provide enough food for them during nongrowing seasonsAfter a colony failure due to food shortage, we created a modified freeze‐dried diet for the imperiled Atala hairstreak butterfly (Eumaus atala) using methods that could potentially be replicated for other butterfliesThe diet was highly successful, leading to the rearing and release of over 3800 adult butterflies back into the wildKey to the methods was using pure, new‐growth host plant, and switching larger larvae back to mature leaves

Direct care of offspring by the father (sire) is relatively rare in primates. Besides humans, there are a number of species where the male is essential for the survival of offspring: marmosets, tamarins, titis and owl monkeys, some lemurs, and siamangs. All these species show reduced sexual dimorphism, territoriality, and biparental care. However, timing and levels of direct care may vary among these species. Here, relying on both lab and field data, we address the variability found in father's involvement with his infants, the behavioral, neuroendocrine and sensory systems that are a cause and consequence of paternal care, and social bonds between the breeding pair. We integrate studies of laboratory animals (where detailed observations and experimentation are possible) with field studies (which illuminate the ecological and evolutionary functions of paternal care) and discuss the future directions for examining the proximate and ultimate mechanisms of paternal care in nonhuman primates.

Cotton-top tamarins (Saguinus oedipus) are a critically endangered species found only in Colombia. Their survival is threatened by extensive habitat destruction and the illegal pet trade. Because many people in Colombia have a low level of awareness of cotton-top tamarins and even less understanding of the impacts that the illegal pet trade has on the species and its long-term survival, Proyecto Tití has developed a series of programs for children in rural elementary schools that introduce children to cotton-top tamarins. This study examines Proyecto Titi's efforts to reduce the desire to have a cotton-top tamarin as a pet with outcomes focused specifically on (1) creating an emotional connection between people and cotton-top tamarins, (2) identifying the feelings and understanding the challenges that cotton-top tamarin face when they are kept as pets, and (3) empowering students to make positive choices to help cotton-top tamarins. Both TITI KIDS and TITIRITIANDO programs helped students to (1) increase their knowledge of cotton-top tamarins, (2) understand the damage that the pet trade has on individual animals and the long-term survival of cotton-top tamarins and (3) provide practical actions that they can engage in to protect cotton-top tamarins for the future. Our hope is that students from our programs become advocates for conservation in their communities and assist in the long-term conservation activities to protect cotton-top tamarins in Colombia.

Conservation is an important organizational focus for zoos and aquariums. Organizational identity theory predicts a relationship between what is central to organizations, such as their mission statements, and their strategic activities. Based on this theory, we tested how organizational missions relate to their conservation strategies and practices. Tax forms and websites provided data from 173 zoos and 38 aquariums in the Association of Zoos and Aquariums in North America. We analyzed conservation mission strength, organizational characteristics, and project features with dependent variables representing the depth of organizational conservation commitments: amount of grants zoos funded, number of partner organizations, and number of projects per zoo. On tax forms, the average amount of total conservation grants donated to partner organizations per zoo was over $650,000, while the average number of partners reported on the tax forms was two. The content analysis of websites revealed an average of 14 conservation partners and 10 projects per zoo. Negative binomial regression models were significant. The financial analysis revealed that only the number of zoo personnel, as a surrogate for organization size, significantly predicted the amount of zoos' conservation grants. Website analyses found increasing budgets, organizational involvement, and geographic reach of the projects predicted increasing numbers of conservation projects and partnerships. However, our findings did not support the hypothesized relationship-strength of organizational mission did not predict strategy and activities. Zoos could do more to strategically activate their organizational identities and conservation missions to achieve their conservation goals.

Firearm offences in the UK, though not as high as in the USA, are increasing year upon year within both countries (Office for National Statistics, 2018 & Mervosh, 2018). This preliminary study looked into using Micro-CT scanning as a method to visualise impact damage and spray patterns caused by 12 test firings of both round and flat nosed bullets to porcine bone (shoulder and leg) suspended in ballistic gelatine and left with no covering, covered with a skin substitute, or covered with fabric (cotton or denim). Micro-CT scanning alongside VG Studio Max showed that overall, in the case of the shoulder bones the round nosed produced longer spray patterns (35.37 mm) within the gelatine blocks compared to the flat nosed bullet (27.33 mm); while with the leg bones the spray patterns were shorter, round nosed bullet (15.64 mm) and the flat nosed bullet (20.78 mm). These initial results showed that both bullet types produced considerable damage, from splitting to full penetration, which in turn illustrates how Micro-CT scanning has benefits within forensic ballistics, which should be further investigated.

Studies of cooperative breeding species have suggested that helpers are needed for infant survival and that helpers gain skills to successfully raise their own offspring. Studies of callitrichids in managed care and early field studies suggested that group size correlated with infant survival and that helpers needed to learn parental skills to be successful breeders. We present infant survival data from a 20-year field study of cotton-top tamarins (Saguinus oedipus) in Colombia involving 126 litters born to 41 females. There was no difference in the survival of male and female offspring to 6 months of age. However, litter size impacted survival, with triplet litters having lower survival and male triplets having lower survival than females. Loss of infants was highest in the first week of life and, of the animals remaining in the group at 6 months of age, 90% of them survived to 1 year. The mean length of time in the natal group was 2.3 years but some young migrated to other groups after 4 months of age. Group size and number of male helpers (>1 year) was not related to infant survival. However, groups with only one male had fewer surviving infants. Primiparous females had lower infant survival, but previous infant care experience by mothers as helpers had no effect on survival. A major cause of infant loss was group disruption due to deaths/evictions/loss of the reproductively active animals, or immigration of pregnant females. Thus, factors that cause a change in the stability of the reproductively active animals can disrupt group cohesion. Capture of individuals for the illegal pet trade, as well as habitat fragmentation, may increase competition between groups for access to territories and breeding opportunities. This may have long-term impacts to infant survival in this critically endangered species.

© 2020, International Society for Third-Sector Research. Volunteers are a critical operational resource for not-for-profit organisations in the health and welfare sector. However, trends towards episodic volunteering may be a source of disruption. This study examined contemporary management beliefs and practices about episodic volunteers in the sector. A cross-sectional online survey with 186 managers and coordinators of episodic volunteers across North America and the Asia Pacific examined organisational values and beliefs about volunteers; perceived benefits and challenges of working with episodic volunteers; volunteering management. Episodic volunteers were highly beneficial to organisational profile, mission, service profile, and cost savings. Challenges include matching recruitment to workplace and skill needs; lack of paid staff to supervise and train volunteers and inadequate administrative support. There is a disjunct between the perceived value provided to the not-for-profit sector by episodic volunteers and the extent to which episodic volunteering is supported through organisational training and management practices.

Laurel wilt disease (LWD) is a highly virulent disease vectored by an invasive beetle. It was first observed in South Carolina in 2003, and it is now found in all Florida counties and nine southeastern US states. This disease causes extensive mortality of Lauraceae plants, an ecologically and economically important group. Many arthropods are associated with Lauraceae species, including palamedes (Papilio palamedes (Drury)) and spicebush (Papilio troilus (L.)) swallowtail butterflies, which host on swamp bay (Persea palustris) and redbay (Persea borbonia). It is thought that P. palamedes are at greatest risk from LWD. Limited information exists on the impacts on these butterflies after LWD becomes established. Therefore, we use a unique long-term tree and butterfly dataset in central Florida that spanned the introduction of LWD. We found that over two decades, swamp bay declined 90% in abundance. Interestingly, the majority (70%) of the swamp bays’ decline preceded the introduction of LWD. We suspect that a 5 year severe drought was the primary cause of mortality, since there was a 45% reduction in overall tree abundances. Despite these large reductions, a small number of swamp bay trees persisted, and others sprouted from basal roots. Butterfly monitoring began after 70% of the swamp bays had died. We found that, even though there was extensive loss of swamp bays, P. palamedes and P. troilus populations were relatively stable, and potentially were increasing. However, after LWD was confirmed in this area, these butterflies declined slightly. We also found that the reduction was slightly greater in P. palamedes than P. troilus. P. palamedes are more dependent on swamp bay whereas P. troilus are more adaptable at host-switching, perhaps to a Lauraceae tree Cinnamomum camphora (L.) J. Pesl. (Camphortree), which is common in our area and does not appear to be locally affected by LWD. Thus, while we found that swamp bay declined dramatically, dependent butterfly populations declined far less dramatically. Butterflies may be surviving because of host-switching, or because the remaining trees provide enough resources. Future research should focus on the persistence of these species, especially as this disease continues to spread throughout the southeastern US.

To understand both immediate and longer-term effects of a short duration, interpretive wildlife tourism program, we studied responses from participants in a sea turtle watch program. This program c...

Background: We investigated long‐term survival from head and neck cancer (HNC) using different survival approaches. Methods: Patients were followed‐up from the Scottish Audit of Head and Neck Cancer. Overall survival and disease‐specific survival were calculated using the Kaplan–Meier method. Net survival was calculated by the Pohar‐Perme method. Mutually adjusted Cox proportional hazards models were used to determine the predictors of survival. Results: A total of 1820 patients were included in the analyses. Overall survival at 12 years was 26.3% (24.3%, 28.3%). Disease‐specific survival at 12 years was 56.9% (54.3%, 59.4%). Net survival at 12 years was 41.4% (37.6%, 45.1%). Conclusion: Determinants associated with long‐term survival included age, stage, treatment modality, WHO performance status, alcohol consumption, smoking behavior, and anatomical site. We recommend that net survival is used for long‐term outcomes for HNC patients—it disentangles other causes of death, which are overestimated in overall survival and underestimated in disease‐specific survival.

The Widmark equation is commonly used when blood alcohol calculations are required in forensic and legal medicine, such as in road-traffic cases and alcohol-related deaths. An important biological variable in this connection is the volume of distribution (Vd) of ethanol, which is commonly referred to as the rho-factor. Although a person's Vd can be determined empirically through controlled drinking experiments, this approach is not very practical in reality. For this reason, a number of anthropometric equations have been developed that utilize sex, age, height and weight to estimate the person's total body water (TBW) and hence Vd of ethanol. To date, there are not any studies that compare Vd derived from anthropometric data with robust values measured empirically. From the literature we compiled information about the Vd of ethanol from drinking studies with 173 Caucasian males and 63 Caucasian females from Western Europe. These empirically derived values of Vd were then compared with estimates derived from various anthropometric equations. In males the Watson, Watson and Batt regression equation involving age, height and weight gave the most accurate results (bias was 0.00L/kg) and 95% range ±0.13L/kg. The equation derived by Forrest, which took into consideration a person's body mass index (BMI), gave the best estimates of Vd for females; mean bias -0.01L/kg and range ±0.15L/kg.

Diagnosis and prognosis of cancer are informed by the architecture inherent in cancer patient tissue sections. This architecture is typically identified by pathologists, yet advances in computational image analysis facilitate quantitative assessment of this structure. In this article, we develop a spatial point process approach to describe patterns in cell distribution within tissue samples taken from colorectal cancer (CRC) patients. In particular, our approach is centered on the Palm intensity function. This leads to taking an approximate-likelihood technique in fitting point processes models. We consider two Neyman-Scott point processes and a void process, fitting these point process models to the CRC patient data. We find that the parameter estimates of these models may be used to quantify the spatial arrangement of cells. Importantly, we observe characteristic differences in the spatial arrangement of cells between patients who died from CRC and those alive at follow up.

The aim of this study was to determine the influence of the fillet structure on the deboning force required to remove salmon and trout pin bones. Salmon and trout fillets with differing fillet structure were used, in order to study the importance of the fillet structure on the deboning process. In the first test naturally gaping and non-gaping fillets were compared. To confirm the role that the collagen plays within the fillet structure, the fillets underwent series of treatments. Fillets were put into (i) a collagenase solution to remove the collagen in the fillet and (ii) a calcium chloride solution to determine if collagen was the main influential factor. Both treated salmon and trout fillets were again compared to untreated fillets from the same batch. The results indicate that collagenase and calcium chloride have a large interaction on deboning force compared to water or no treatments.

Engaging children in developing countries to care for wildlife, and to make appropriate choices to protect wildlife, are challenging tasks. Proyecto Titi works to conserve the cotton-top tamarin (Saguinus oedipus), a critically endangered endemic monkey from Colombia, using a multi-disciplinary approach that focuses on scientific research, community empowerment, habitat protection, and conservation education to protect this species. Proyecto Titi has developed a multi-tiered methodology for education in rural communities that increases knowledge and understanding of the cotton-top tamarin and the threats to its survival, generates attitudes and behavior that support conservation, and provides opportunities to develop the future generation of conservation leaders in Colombia. We evaluated TITI KIDS and CARTITILLA, two of Proyecto Titi’s educational programs, measuring the knowledge gained by students before and immediately after the program. For CARTITILLA, we also measured the retention of knowledge after five years, and if the program developed pro-conservation attitudes and behaviors. We analyzed the evaluations of over 6000 students who participated in programs from 2011 to 2016, using a paired t-test. Students significantly increased their knowledge of cotton-top tamarins (p ≪ 0.01) and their ability to identify and classify domesticated and wild animals in their regions (p ≪ 0.01). Five years after participating in the CARTITILLA program, students had retained their knowledge about cotton-top tamarins and demonstrated attitudes and behavior that support cotton-top tamarin conservation. The educational programs of Proyecto Titi provide evidence that engaging youth in meaningful conservation activities can assist in the protection of cotton-top tamarins.

The timing of migration can have important survival impacts, as birds must synchronize their movements with favourable environmental conditions to reach their destination. The timing of arrival at and duration of migratory stopover may be largely governed by environmental conditions experienced en route as well as by endogenous factors, but our understanding of these processes is limited. We used light-level geolocators to collect start-to-finish spatio-temporal migration data for a declining aerial insectivore, the Purple Martin (Progne subis), that travels seasonally between North and South America. Using data obtained for birds originating from range-wide breeding populations, our objectives were to test intrinsic and extrinsic hypotheses for migration stopover duration as well as to identify important stopover regions during fall migration. We examined whether breeding latitude, fall migration timing, age, sex or habitat quality at stopover sites (measured using Normalized Difference Vegetation Index) influenced the duration of stopovers. We found that most individuals rely on the eastern coast of the Yucatan Peninsula, Honduras, and Nicaragua for stopovers during fall migration, where duration ranged from 1 to 36 days (average 6.8 ± 8.2). Stopovers in these regions were later and of longer duration for more northern breeding populations. Only breeding latitude predicted stopover duration, and not habitat quality at stopovers, lending support to the hypothesis that duration is prescribed by endogenous factors. The important core stopover regions we documented could be targeted for conservation efforts, particularly for steeply-declining, more northern breeding populations that have greater stopover duration in these areas.

Migratory aerial insectivores are among the fastest declining avian groups, but our understanding of these trends has been limited by poor knowledge of migratory connectivity and the identification of critical habitat across the vast distances they travel annually. Using new, archival GPS loggers, we tracked individual purple martins Progne subis from breeding colonies across North America to determine precise ( 10 m) locations of migratory and overwintering roost locations in South America and to test hypotheses for fine-scale migratory connectivity and habitat use. We discovered weak migratory connectivity at the roost scale, and extensive, fine-scale mixing of birds in the Amazon from distant (> 2000 km) breeding sites, with some individuals sharing the same roosting trees. Despite vast tracts of contiguous forest in this region, birds occupied a much more limited habitat, with most (56%) roosts occurring on small habitat islands that were strongly associated with water. Only 17% of these roosts were in current protected areas. These data reflect a critical advance in our ability to remotely determine precise migratory connectivity and habitat selection across vast spatial scales, enhancing our understanding of population dynamics and enabling more effective conservation of species at risk.

Although estimates of sea turtle reproductive success are important to quantify population status and effects from threats, published representative values of these rates are rare. Most assessments involving hatching success have taken place as part of experimental analyses that did not spatiotemporally represent a population. To fill this gap, we analyzed an 11-yr time series (2004–2014) of sea turtle hatching and emergence success data for a 7-km stretch of Florida beach backed by mixed suburban and resort/recreational land use. Our analysis examined potential egg-mortality factors associated with the incubation of these nests. The data set included representative sampling of loggerhead (Caretta caretta) nests (n = 2,543, 34.4% of all nests made during the period) and green turtle (Chelonia mydas) nests (n = 972, 44.7% of all nests). Mean (± SD) annual hatching success was 68.6% ± 35.5% for loggerheads and 59.6% ± 39.5% for green turtles, and mean emergence success was 66.6% ± 35.7% for logger...

New discoveries from direct tracking of temperate-breeding passerines show that intratropical migration (ITM) occurs in a growing number of species, which has important implications for understanding their evolution of migration, population dynamics, and conservation needs. Our large sample size ([Formula: see text]) for purple martins (Progne subis subis) tracked with geolocators to winter sites in Brazil, combined with geolocator deployments at breeding colonies across North America, allowed us to test hypotheses for ITM, something which has not yet been possible to do for other species. ITM in purple martins was not obligate; only 44% of individuals exhibited ITM, and movements were not coordinated in time or space. We found no evidence to support the resource hypothesis; rainfall and temperature experienced by individual birds during their last 2 weeks at their first roost site were similar to conditions at their second roost site after ITM. Birds generally migrated away from the heavily forested northwestern Amazon to less forested regions to the south and east. ITM in this aerial insectivore appears to support the competition-avoidance hypothesis and may be triggered by increasing local density in the core wintering region. Full life cycle models and migratory networks will need to incorporate ITM to properly address seasonal carryover effects and identify which wintering regions are most important for conservation.

In long-distance migrants, it has been hypothesized that re-pairing in spring is facilitated if, on the wintering grounds, formerly mated individuals maintain close proximity or occupy ecologically similar habitat, which then results in more synchronized spring migration schedules. For songbirds, pair members have long been thought to migrate independently, but only recently has it been possible to directly track start-to-finish migration to test this prediction. We used light-sensor geolocators to track paired versus nonpaired purple martins, Progne subis subis, that breed in North America and winter in South America. In 6 of 12 pairs, pair members departed on autumn migration within 4 days of each other, but pairs rarely occupied nearby stopover sites in Central America and were separated by an average of 560 km upon arrival in Brazil. Formerly paired birds were not significantly more similar in autumn or spring migration timing, or winter roost location, compared with nonpaired birds tracked from the same colonies and years. Formerly mated pairs who were closer together in Brazil, or who occupied regions with similar amounts of forest cover, did not have more synchronized spring migration schedules. Only 1 of 12 pairs that were tracked remated after migration. Intense competition for nesting cavities combined with disparate spring migration schedules of former pairs probably contributes to the high divorce rate.

Background: Socioeconomic inequalities impact on the survival of head and neck cancer (HNC) patients, but there is limited understanding of the explanations of the inequality, particularly in long-term survival.\ud \ud Methods: Patients were recruited from the Scottish Audit of Head and Neck Cancer between 1999 and 2001 and were linked to mortality data as at 30th September 2013. Socioeconomic status was determined using the area-based Carstairs 2001 index. Overall and disease-specific survival were calculated using the Kaplan-Meier method with 95% confidence intervals (CI's) at 1-, 5-, and 12-years. Net survival at 1-, 5-, and 12-years was also computed with 95% CIs. Cox proportional hazard models with 95% CIs were used to determine the explanations for the inequality in survival by all-cause mortality and disease-specific mortality with 95% CIs.\ud \ud Results: Most patients were from the most deprived group, and were more likely to smoke, drink, have cancer of a higher stage and have a lower WHO Performance Status. A clear gradient across Carstairs fifths for unadjusted overall and disease-specific survival was observed at 1-, 5-, and 12-years for patients with HNC. Following the adjustment for multiple patient, tumor and treatment factors, the inequality in survival for patients with HNC had attenuated and was no longer statistically significant at 1-, 5-, and 12-years.\ud \ud Conclusion: A clear gradient across Carstairs fifths for unadjusted overall, disease-specific and net survival was observed at 1-, 5-, and 12-years for HNC patients in Scotland from 1999 to 2001. This study concludes that explanations for the inequality in the survival of patients with HNC are not straightforward, and that many factors including various patient, tumor and treatment factors play a part in the inequality in the survival of patients with HNC.

This study consisted of three parts to evaluate the performance of Lumicyano™ on a variety of fabrics. One part assessed the impact of dye percentage (8%, 9% and 10%) on visualisation of fingermark detail and luminescent brightness in split grab marks. A 9% dye produced the highest quality detail of grab impressions with least interference from background fluorescence. The second part investigated the optimal relative humidity (RH, 75-84%) for certain fabric types using Lumicyano on split, six-series depletion fingermarks. It was concluded that the recommended RH of 80% remained the ideal cyanoacrylate fuming environment. The final and third part of this study determined the impact of sequential addition of Basic Yellow 40 (BY40) on Lumicyano compared to traditional cyanoacrylate (CA) followed with BY40 application. Results from this study demonstrated that Lumicyano on its own developed fingermarks with superior quality to Lumicyano with sequential addition of BY40 or traditional cyanoacrylate followed by BY40. Inclusion of more fabrics, donors and longer ageing periods should be explored in future studies to determine what frameworks are best for certain types of fabrics.

Diagnosis and prognosis of cancer are informed by the architecture inherent in cancer patient tissue sections. This architecture is typically identified by pathologists, yet advances in computational image analysis facilitate quantitative assessment of this structure. In this article, we develop a spatial point process approach to describe patterns in cell distribution within tissue samples taken from colorectal cancer (CRC) patients. In particular, our approach is centered on the Palm intensity function. This leads to taking an approximate-likelihood technique in fitting point processes models. We consider two Neyman-Scott point processes and a void process, fitting these point process models to the CRC patient data. We find that the parameter estimates of these models may be used to quantify the spatial arrangement of cells. Importantly, we observe characteristic differences in the spatial arrangement of cells between patients who died from CRC and those alive at follow up.

Objectives To assess how type and number of symptoms are related to survival in patients with head and neck cancer. Design Patients were followed up for over 10 years from the Scottish Audit of Head and Neck Cancer (national cohort of head and neck cancer patients in Scotland 1999‐2001). September 2013, cohort was linked to national mortality data. First, second and third presenting symptoms were recorded at diagnosis. Setting National prospective audit—Scotland. Participants A subset of 1589 patients, from the original cohort of 1895, who had cancer arising from one of the four main subsites; larynx, oropharynx, oral cavity and hypopharynx. Main outcome measures Median survival in relation to patients’ presenting symptoms. Results A total of 1146 (72%) males and 443 (28%) females, mean age at diagnosis 64 years (13‐95). There was a significant difference in survival in relation to the number of the patient's presenting symptoms; one symptom had a median survival of 5.3 years compared with 1.1 years for three symptoms. Patients who presented with weight loss had a median survival of 0.8 years, compared to 4.2 years if they did not (P < .001). Patients who presented with hoarseness had a median survival of 5.9 years compared to 2.6 years without (P < .001). There was no significant difference in long‐term survival for patients who presented with an ulcer, compared to those that did not (P = .105). Conclusions This study highlights the importance of patients’ presenting symptoms, giving valuable information in highlighting appropriate “red flag” symptoms and subsequent treatment planning and prognosis.

Nesting in sea turtles involves a series of behavioral stages in which females ascend a coastal beach, move sand to bury and conceal eggs, and return to the sea. We created a partial ethog...

Here we report the first observation of alloparental care in a subadult female Key Largo woodrat. Maternal and other behaviors were scored for the subject dam and her subadult daughter at the birth of the dam’s second litter and the following 30 days. After assisting with birth, the subadult exhibited maternal behaviors and remained in close proximity to the pups. The rate of maternal care behaviors observed in the subject dam was lower than in solitary dams without an alloparent present. However, the total maternal care score for the dam and subadult combined approached the average score for single dams.

Bows and arrows are used more for recreation, sport and hunting in the Western world and tend not to be as popular a weapon as firearms or knives. Yet there are still injuries and fatalities caused by these low-velocity weapons due to their availability to the public and that a licence is not required to own them. This study aimed to highlight the penetration capabilities of aluminium arrows into soft tissue and bones in the presence of clothing. Further from that, how the type and fit of clothing as well as arrowhead type contribute to penetration capacity. In this study ballistic gelatine blocks (non-clothed and loose fit or tight fit clothed) were shot using a 24lb weight draw recurve bow and aluminium arrows accompanied by four different arrowheads (bullet, judo, blunt and broadhead). The penetration capability of aluminium arrows was examined, and the depth of penetration was found to be dependent on the type of arrowhead used as well as by the type and fit or lack thereof of the clothing covering the block. Loose fit clothing reduced penetration with half of the samples, reducing penetration capacity by percentages between 0% and 98.33%, at a range of 10m. While the remaining half of the samples covered with tight clothing led to reductions in penetration of between 14.06% and 94.12%. The damage to the clothing and the gelatine (puncturing, cutting and tearing) was affected by the shape of the arrowhead, with the least damaged caused by the blunt arrowheads and the most by the broadhead arrows. Clothing fibres were also at times found within the projectile tract within the gelatine showing potential for subsequent infection of an individual with an arrow wound. Ribs, femur bones and spinal columns encased in some of the gelatine blocks all showed varying levels of damage, with the most and obvious damage being exhibited by the ribs and spinal column. The information gleaned from the damage to clothing, gelatine blocks and bones could potentially be useful for forensic investigators, for example, when a body has been discovered with no weapons or gunshot residue present.

Touch technology is becoming more prevalent as functionality improves and cost decreases. Therefore, it is important that this technology is accessible to users with diverse abilities. The objective of this study was to investigate the effects of button and gap size on performance by individuals with varied motor abilities. Participants with (n = 38) and without (n = 15) a motor control disability completed a digit entry task. Button size ranged from 10 to 30 mm and gap size was either 1 or 3 mm. Results indicated that as button size increased, there was a decrease in misses, errors, and time to complete tasks. Performance for the non-disabled group plateaued at button size 20 mm, with minimal, if any gains observed with larger button sizes. In comparison, the disabled group's performance continued to improve as button size increased. Gap size did not affect user performance. These results may help to improve accessibility of touch technology.

The Key Largo woodrat (Neotoma floridana smalli) is an endangered rodent endemic to the island of Key Largo, FL. There is little information on vocal communication in this species and descriptions of the acoustic structure of calls are lacking. A captive breeding program was established as part of the recovery plan for the species, providing the opportunity to investigate the vocal repertoire and acoustic structure of calls in both wild and captive contexts. Audio and video recordings were conducted at the Crocodile Lake National Wildlife Refuge in Key Largo and at Disney's Animal Kingdom(®). Analysis of the acoustic structure of calls resulted in four provisional call types: "Tonal calls" consisted of "ultrasonic vocalizations" (40 kHz fundamental frequency, F(0)), "high squeaks" (10 kHz F(0)), and "squeaks" (1.8 kHz F(0)). "Noisy," broadband calls known as "raspy" vocalizations did not exhibit fundamental frequencies, but contained several prominent spectral peaks (from 9 to 40 kHz). The social contexts of vocal production showed that all four call types were associated with pup need or interactions between pups and dams, and that raspy vocalizations were associated with courtship and copulation. Adults without pups exhibited little or no vocal activity, which may result from solitary lifestyles and predator avoidance.

Accelerometers are motion-detection devices that, when attached to animals, are capable of detecting body orientation, overall activity levels, and specific behavior patterns. We deployed accelerometers in order to study the hypothesis that accelerometer output would allow us to distinguish between 4 behavior patterns in 3 adult female African elephants Loxodonta africana at Disney's Animal Kingdom®, Florida, USA. Tri-axial accelerometer data loggers were attached to the tops of collars worn around the elephants' necks. Behavior was documented on video while the accelerometer output was stored on the data logger. Feeding, bathing, and walk- ing behaviors were recorded in all 3 subjects, while swaying behavior could be recorded in only 1 subject. Data in the 3 physical dimensions (sway, surge, and heave) were analyzed in terms of overall magnitude of movement (dynamic acceleration) and in terms of the periodicity of move- ment. When classifying accelerometer data of unlabeled origin to the correct behavioral state, overall success ranged from 70 to 91%. Bathing was sometimes confused with feeding and walk- ing, but feeding, walking, and swaying were easily distinguished from each other. These results show that data from accelerometers can distinguish an elephant's behavioral states, and thus may be used to monitor elephant behavior remotely. Such devices could be deployed for a variety of purposes, ranging from monitoring elephant activity in zoos to an early-warning system that could alert the authorities when wild elephants are being illegally hunted.