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Summary Background Among asymptomatic patients with severe carotid artery stenosis but no recent stroke or transient cerebral ischaemia, either carotid artery stenting (CAS) or carotid endarterectomy (CEA) can restore patency and reduce long-term stroke risks. However, from recent national registry data, each option causes about 1% procedural risk of disabling stroke or death. Comparison of their long-term protective effects requires large-scale randomised evidence. Methods ACST-2 is an international multicentre randomised trial of CAS versus CEA among asymptomatic patients with severe stenosis thought to require intervention, interpreted with all other relevant trials. Patients were eligible if they had severe unilateral or bilateral carotid artery stenosis and both doctor and patient agreed that a carotid procedure should be undertaken, but they were substantially uncertain which one to choose. Patients were randomly allocated to CAS or CEA and followed up at 1 month and then annually, for a mean 5 years. Procedural events were those within 30 days of the intervention. Intention-to-treat analyses are provided. Analyses including procedural hazards use tabular methods. Analyses and meta-analyses of non-procedural strokes use Kaplan-Meier and log-rank methods. The trial is registered with the ISRCTN registry, ISRCTN21144362. Findings Between Jan 15, 2008, and Dec 31, 2020, 3625 patients in 130 centres were randomly allocated, 1811 to CAS and 1814 to CEA, with good compliance, good medical therapy and a mean 5 years of follow-up. Overall, 1% had disabling stroke or death procedurally (15 allocated to CAS and 18 to CEA) and 2% had non-disabling procedural stroke (48 allocated to CAS and 29 to CEA). Kaplan-Meier estimates of 5-year non-procedural stroke were 2·5% in each group for fatal or disabling stroke, and 5·3% with CAS versus 4·5% with CEA for any stroke (rate ratio [RR] 1·16, 95% CI 0·86–1·57; p=0·33). Combining RRs for any non-procedural stroke in all CAS versus CEA trials, the RR was similar in symptomatic and asymptomatic patients (overall RR 1·11, 95% CI 0·91–1·32; p=0·21). Interpretation Serious complications are similarly uncommon after competent CAS and CEA, and the long-term effects of these two carotid artery procedures on fatal or disabling stroke are comparable. Funding UK Medical Research Council and Health Technology Assessment Programme.

The impact of the rapidly changing Arctic on zooplankton community structure and seasonal behaviour is not yet understood. Here we examine 6 months of under-ice zooplankton observations from the N-ICE2015 expedition (January to June 2015) in the Nansen Basin and on the Yermak Plateau north of Svalbard. Stratified sampling in the water column was done with MultiNet during the entire expedition, and sampling in the upper 5 m below sea ice was performed during April-May by divers using a hand-held net. Hydrographic conditions were dominated by northward-flowing warm and saline Atlantic Water at intermediate depth, and southward-flowing cold Polar Surface Water in the upper 100 m. The mesozooplankton was dominated by copepods. Most numerous were the small ubiquitous Oithona similis in the upper 200 m, with Microcalanus spp. and Triconia borealis further down the water column. Calanus finmarchicus dominated among the Calanus species while Metridia longa was also numerous. The most abundant deep-water copepods were Paraeuchaeta spp. and Spinocalanus spp. Arrow worms (Chaetognatha) and comb jellies (Ctenophora) were the most numerous non-copepods. The mesozooplankton community was more dependent on surrounding water mass characteristics, such as salinity and depth, than geographical location. Algal food availability, which was closely linked to seasonality, explained the community changes seen in surface waters in May and June due to seasonal ascent and recruitment. Seasonal changes from winter to spring mostly involved an increase in the herbivorous C. finmarchicus and its nauplii in the upper 200 m of the water column coinciding with the peak of the phytoplankton bloom in late May. The Yermak Plateau and adjacent Nansen Basin were characterised by oceanic North Atlantic and Arctic species, many of which are deep water specialists. Despite the late onset of the spring bloom due to consolidated sea ice, both North Atlantic and Arctic species successfully reproduced in the study area. This explains the species-rich mesozooplankton community in this region as opposed to the less productive central Arctic Ocean. Future prospects of less sea ice and earlier onset of the bloom will likely be positive for the overall secondary production by both Arctic and boreal zooplankton in this region.

Hatching success in sea turtles is hindered by a variety of biotic and abiotic factors. This study of the nesting ecology of leatherback (Dermochelys coriacea) and green (Chelonia mydas) sea turtles, investigated how several environmental factors and beach characteristics on Bioko Island, Equatorial Guinea influence sea turtle reproductive success. Average clutch hatching success was 40.4% for green turtles and 41.73% for leatherback turtles. For leatherback turtles, clutch elevation relative to the high tide line (HTL) was found to be the most influential factor in determining hatching success, highlighting the sensitivity of this species to sea level rise (SLR). Multiple linear regression analysis demonstrated that nest distance to vegetation and sand conductivity also played significant roles in leatherback clutch hatching success. For leatherback clutches, 33% percent of experimental nests were affected by inundation and 17% by predation. An optimum clutch elevation range for leatherback turtles was identified, where a distinct increase in hatching success was observed between -0.286 m to -0.0528 m above the HTL. For green sea turtles, 64% of experimental nests were affected by predation, confounding conclusions about the roles of environmental characteristics in green turtle hatching success. We propose further investigation into influential characteristics in green turtle nests and confirmation of the observed optimum elevation range on Bioko Island and other nesting grounds. Identified sensitivities of each species to SLR and beach characteristics will be used to encourage the government of Equatorial Guinea to consider the vulnerability of their resident turtle populations when planning for future coastal development.

Polar regions are currently warming at a rate above the global average. One issue of concern is the consequences on biodiversity in relation to the Northward latitudinal shift in distribution of temperate species. In the present study, lasting almost two years, we examined two phenological traits, i.e. the shell growth and behavioural rhythm of a recently re-established species in the high Arctic, the blue mussel Mytilus sp. We compared this with a native species, the Islandic scallop Chlamys islandica . We show marked differences in the examined traits between the two species. In Mytilus sp., a clear annual pattern of shell growth strongly correlated to the valve behaviour rhythmicity, whereas C. islandica exhibited a shell growth pattern with a total absence of annual rhythmicity of behaviour. The shell growth was highly correlated to the photoperiod for the mussels but weaker for the scallops. The water temperature cycle was a very weak parameter to anticipate the phenology traits of both species. This study shows that the new resident in the high Arctic, Mytilus sp., is a highly adaptive species, and therefore a promising bioindicator to study the consequences of biodiversity changes due to global warming.

This paper shows that imperfect information about school quality causes low-income families to live in neighborhoods with lower-performing, more segregated schools. We randomized the addition of school quality information onto a nationwide website of housing listings for families with housing vouchers. We find that this information causes families to choose neighborhoods with schools that have 1.5 percentage point higher proficiency rate on state exams. We use data from the experiment to estimate a dynamic model of families' search for housing on and off the website, as well as their location decisions. The model incorporates imperfect information about school quality and characterizes the bias that would arise from estimating neighborhood preferences ignoring this information problem. Having data from both the treatment and control groups allows us to estimate families' prior beliefs about school quality and each group's apparent valuation of school quality. Families tend to underestimate school quality conditional on neighborhood characteristics. If we had ignored imperfect information, we would have estimated that the control group valued school quality relative to their commute downtown by less than half that of the treatment group.

Die vorliegende Diplomarbeit soll einen Überblick über den Unternehmensübergang aus verkehrsteuerrechtlicher Sicht bieten. Dafür wurde der Unternehmensübergang in einzelne Übergangsarten aufgeteilt um einen besseren Einblick zu erhalten. Es wurde folgende Aufteilung vorgenommen: unentgeltlicher Erwerb, entgeltlicher Erwerb und der sogenannte „share deal“. Der unentgeltliche Erwerb unterteilt sich in den Erwerb von Todes wegen und den Erwerb durch Schenkung. Der entgeltliche Erwerb ist der unmittelbare Kauf des Unternehmens („asset deal“). Beim „share deal“ wird nicht das Unternehmen an sich gekauft, sondern die Gesellschaftsanteile der unternehmensführenden Gesellschaft. Diese Erwerbsvorgänge wurden jeder für sich aufbereitet, damit man einen Überblick über die Behandlung im jeweiligen Gesetz erhält. Es wurde jeder Unternehmensübergang auf seine umsatzsteuerliche und grunderwerbsteuerliche Behandlung untersucht. Hinsichtlich der Umsatzsteuer wurde vor allem die Frage der Steuerbarkeit des einzelnen Erwerbsvorgangs und die Frage des Vorsteuerabzuges erörtert. Hinsichtlich der Grunderwerbsteuer wurde vordergründig die Steuerbarkeit des einzelnen Erwerbsvorgangs und mögliche Steuerbefreiungen behandelt. In der Arbeit wird ebenfalls kurz auf das Umgründungssteuergesetz eingegangen, das für Umgründungen einheitliche Regelungen für die Umsatzsteuer und Grunderwerbsteuer im Zusammenhang mit Umgründungen im Sinne des Umgründungssteuergesetzes vorsieht. Diese Regelungen bieten für Umgründungen im Sinne des Umgründungssteuergesetzes Vorteile gegenüber den Regelungen des jeweiligen Materiengesetzes. Den Abschluss bildet eine Zusammenfassung, in der die wichtigsten Punkte der Arbeit wiedergegeben werden. The following thesis gives an overview about the transfer of undertaking from a transaction tax perspective. Therefore, the transfer of undertaking was split up into separate transfer types to obtain a better overview. Following split was taken: free acquisition, acquisition in return for payment and the so called “share deal”. The free acquisition is divided into the acquisition tue to death and the acquisition by donation. The acquisition in return for payment is the direct acquisition of the undertaking („asset deal“). Regarding the „share deal“ the undertaking is not directly purchased, but the shares of the undertaking are purchased. Each acquisition was covered separately to get an overview of the regulations in the respective law. Every kind of transfer of undertaking was examined both in the perspective of the value added tax and the land transfer tax. Additionally, the taxability and the input tax deduction was analysed in the context of the value added tax. Furthermore, the taxability and the tax exemptions concerning the land transfer tax were addressed. Moreover, the thesis briefly deals with reorganisation tax law, which contains consistent regulations for the value added tax and the land transfer tax related to reorganisations within the meaning of the reorganisation tax law. These regulations provide an advantage for reorganisations within the meaning of the reorganisation tax law towards the respective law. A summary of the most essential aspects of the thesis concludes this thesis. Arbeit an der Bibliothek noch nicht eingelangt - Daten nicht geprüft Abweichender Titel laut Übersetzung des Verfassers/der Verfasserin Karl-Franzens-Universität Graz, Diplomarbeit, 2020 (VLID)5324231

In the high Arctic, recruitment of hard-bottom benthic organisms has been studied at single locations, but little is known about how it varies spatially or temporally, or how it is influenced by abiotic factors. In this study, settlement plates were simultaneously deployed at five locations in three Svalbard (Norway) fjords at depths ranging from 7 m to 215 m. Recruitment was significantly different among fjords and among locations within a fjord. Recruits at each site co-occurred randomly even though interspecific overgrowth was observed. This finding provides further evidence that there is not necessarily a relationship between non-random co-occurrence and interspecific competition, such as is traditionally assumed for other isolated, island-like habitats. We found significantly lower recruitment in an Arctic-influenced fjord than in more Atlantic-influenced fjords. The abundance and richness of recruits was significantly lower in fall-winter than in spring-summer, but the spirorbid Circeis armoricana recruited in high abundance in fall-winter. Both the abundance and taxonomic richness of recruits declined exponentially with depth, with the hydroid Stegopoma plicatile dominating at 215 m in an Atlantic-influenced fjord. The most abundant recruiting taxa (C. armoricana, Semibalanus balanoides, Harmeria scutulata, Celleporella hyalina) can be described as pioneer (early-succession) species. Crustose coralline algae, a slow-growing superior competitor, also recruited at one location. Recruitment in Svalbard is highly variable, both spatially and temporally, and our results show the influence of local factors such as adult species composition.

Objectives To explore how the concept of randomization is described by clinicians and understood by patients in randomized controlled trials (RCTs) and how it contributes to patient understanding and recruitment. Study Design and Setting Qualitative analysis of 73 audio recordings of recruitment consultations from five, multicenter, UK-based RCTs with identified or anticipated recruitment difficulties. Results One in 10 appointments did not include any mention of randomization. Most included a description of the method or process of allocation. Descriptions often made reference to gambling-related metaphors or similes, or referred to allocation by a computer. Where reference was made to a computer, some patients assumed that they would receive the treatment that was “best for them”. Descriptions of the rationale for randomization were rarely present and often only came about as a consequence of patients questioning the reason for a random allocation. Conclusions The methods and processes of randomization were usually described by recruiters, but often without clarity, which could lead to patient misunderstanding. The rationale for randomization was rarely mentioned. Recruiters should avoid problematic gambling metaphors and illusions of agency in their explanations and instead focus on clearer descriptions of the rationale and method of randomization to ensure patients are better informed about randomization and RCT participation., Highlights • Practices commonly used to describe randomisation in RCT recruitment could confuse patients. • Patients found it difficult to comprehend gambling-related metaphors of randomisation. • Computer-agency descriptions led to patients believing they would receive the best treatment.

Truancy correlates with many risky behaviors and adverse outcomes. We use detailed administrative data on by-class absences to construct social networks based on students who miss class together. We simulate these networks and use permutation tests to show that certain students systematically coordinate their absences. Leveraging a parent-information intervention on student absences, we find spillover effects from treated students onto peers in their network. We show that an optimal-targeting algorithm that incorporates machine-learning techniques to identify heterogeneous effects, as well as the direct effects and spillover effects, could further improve the efficacy and cost-effectiveness of the intervention subject to a budget constraint.

Many marine species are known to change their distribution in response to changing climatic conditions. One such example is the blue mussel Mytilus spp., spreading northward coincident with an increase in ocean temperatures. On Svalbard, the first living specimens of Mytilus spp. were discovered in 2004. Here we present an analysis of the current distribution of Mytilus spp. on Svalbard, with a focus on the west coast of Spitsbergen where strong Atlantification has been documented over the last few decades. We conducted diver-based surveys to develop a distributional map and to compare the current distribution with that of the Holocene. Furthermore, we investigate the recent history of recruitment of mussels on Svalbard to help identify invasion pathways. Our results show that blue mussels have been present on the archipelago at least since 2000 and are widespread along the west coast today. We also present evidence of local reproduction in one of the sites explored.

While leveraging parents has the potential to increase student performance, programs that do so are often costly to implement or they target younger children. We partner text-messaging technology with school information systems to automate the gathering and provision of information to parents at scale. In a field experiment across 22 middle and high schools, we used this technology to send automated text-message alerts to parents about their child’s missed assignments, grades and class absences. We pre-specified five primary outcomes. The intervention reduces course failures by 38% and increases class attendance by 17%. Students are more likely to be retained in the district. The positive effects are particularly large for students with below-average GPA and students in high school. There are no effects on standardized test scores however. We randomly chose either the mother or the father to receive the alerts, but there were no differential effects across these subgroups. As in previous research, the intervention appears to change parents’ beliefs about their child’s performance and increases parent monitoring. Our results show that this type of automated technology can improve student effort relatively cheaply and at scale.

Climate changes in the Arctic are predicted to alter distributions of marine species. However, such changes are difficult to quantify because information on present species distribution and the genetic variation within species is lacking or poorly examined. Blue mussels, Mytilus spp. are ecosystem engineers in the coastal zone globally. In order to improve knowledge of distribution and genetic structure of the Mytilus edulis complex in the Arctic, we analyzed 81 SNPs in 534 Mytilus spp. individuals sampled at 13 sites to provide baseline data for distribution and genetic variation of Mytilus mussels in the European Arctic. Mytilus edulis was the most abundant species found with a clear genetic split between populations in Greenland and the Eastern Atlantic. Surprisingly, analyses revealed the presence of M. trossulus in high Arctic NW Greenland (77°N) and M. galloprovincialis or their hybrids in SW Greenland, Svalbard and the Pechora Sea. Furthermore, a high degree of hybridization and introgression between species was observed. Our study highlights the importance of distinguishing between congener species, which can display local adaptation and suggests that information on dispersal routes and barriers are essential for accurate predictions of regional susceptibility to range expansions or invasions of boreal species in the Arctic. Climate changes in the Arctic are predicted to alter distributions of marine species. However, such changes are difficult to quantify because information on present species distribution and the genetic variation within species is lacking or poorly examined. Blue mussels, Mytilus spp. are ecosystem engineers in the coastal zone globally. In order to improve knowledge of distribution and genetic structure of the Mytilus edulis complex in the Arctic, we analyzed 81 SNPs in 534 Mytilus spp. individuals sampled at 13 sites to provide baseline data for distribution and genetic variation of Mytilus mussels in the European Arctic. Mytilus edulis was the most abundant species found with a clear genetic split between populations in Greenland and the Eastern Atlantic. Surprisingly, analyses revealed the presence of M. trossulus in high Arctic NW Greenland (77°N) and M. galloprovincialis or their hybrids in SW Greenland, Svalbard and the Pechora Sea. Furthermore, a high degree of hybridization and introgression between species was observed. Our study highlights the importance of distinguishing between congener species, which can display local adaptation and suggests that information on dispersal routes and barriers are essential for accurate predictions of regional susceptibility to range expansions or invasions of boreal species in the Arctic.

submitted by Peter Preyler Zusammenfassungen in deutscher und englischer Sprache Arbeit gesperrt bis Universität Linz, Univ., Masterarbeit, 2016

Given significant expenditures on education technologies, an important question is whether these products are adopted by their end users and are effective in practice. This paper studies the adoption, diffusion, and effects of one type of technology that is increasingly ubiquitous: school-to-parent communication technologies. Using data from a Learning Management Sys-tem in several hundred schools and a two-stage experiment to study the adoption of this technology by parents, I find: A quarter of parents ever use it; adoption follows an S-shape; significant spillovers occur along intensive but not extensive margins; and there is evidence student grades improve as a result.

This paper studies the impact of a desegregation ruling on several medium-run outcomes. This ruling mandates that seven school districts, which serve higher-income, predominantly-white families, accept a group of minority elementary school students who apply to transfer from a nearby, predominantly-minority school district. Slots are allocated via lottery. The offer to transfer raises college enrollment by 10 percentage points. This is due to greater attendance at two-year colleges and particularly for male students. There is evidence male students are also more likely to vote. In contrast, transferring increases the likelihood of arrest. This is driven by increases in non-violent offenses.

In contrast to numerous studies on the biomass of marine microphytobenthos from temperate coastal ecosystems, little is known from polar regions. Therefore, microphytobenthos biomass was measured at several coastal sites in Arctic Kongsfjorden (Spitsbergen) during the polar summer (June–August 2006). On sandy sediments, chla varied between 8 and 200 mg m-2 and was related to water depth, current/wave exposure and geographical location. Biomass was rather independent of abiotic parameters such as sediment properties, salinity, temperature or light availability. At three stations, sediments at water depths of 3–4, 10, 15, 20 and 30 m were investigated to evaluate the effect of light availability on microalgae. Significant differences in distribution patterns of biomass in relation to deeper waters >10 m were found. The productive periods were not as distinct as phytoplankton blooms. Only at 3–4 m water depth at all three stations were two- to threefold increases of biomass measured during the investigation period. Hydrodynamic conditions seemed to be the driving force for differences in sediment colonisation by benthic microalgae. In spite of the extreme Arctic environmental conditions for algal growth, microphytobenthos biomass was comparable to marine temperate waters.

This paper uses a field experiment to answer how information frictions between parents and their children affect investments in education and how much reducing these frictions can improve student achievement. In Los Angeles, a random sample of parents was provided de-tailed information about their child’s academic progress. I frame the results in the context of a persuasion game between parents and their children. Parents have upwardly-biased beliefs about their child’s effort and the information treatment reduces this bias while increasing parental monitoring. More information allows parents to induce more effort from their children, which translates into significant gains in achievement. Relative to other interventions, additional information to parents potentially produces gains in achievement at a low cost.

In theory, the publication of performance ratings may improve performance through reputation concerns and peer effects or impede performance by demoralizing employees. This paper uses school-district data and a regression discontinuity design to answer how consumers and employees respond to making performance information public. We find that high-performing students sorted into classrooms with highly-rated teachers as a result of publication. Teachers who were published do not perform better or worse than teachers who were not published on average. This average effect is due to the heterogeneous impact of publication; highly-rated teachers perform worse following publication while low-rated teachers perform better. On net, the gap between high and low-performing students closes slightly as a result.

In theory, the publication of performance ratings may improve performance through reputation concerns and peer effects or impede performance by demoralizing employees. This paper uses school-district data and a regression discontinuity design to answer how consumers and employees respond to making performance information public. We find that high-performing students sorted into classrooms with highly-rated teachers as a result of publication. Teachers who were published do not perform better or worse than teachers who were not published on average. This average effect is due to the heterogeneous impact of publication; highly-rated teachers perform worse following publication while low-rated teachers perform better. On net, the gap between high and low-performing students closes slightly as a result.

This paper uses a field experiment to answer how information frictions between parents and their children affect investments in education and how much reducing these frictions can improve student achievement. In Los Angeles, a random sample of parents was provided de-tailed information about their child’s academic progress. I frame the results in the context of a persuasion game between parents and their children. Parents have upwardly-biased beliefs about their child’s effort and the information treatment reduces this bias while increasing parental monitoring. More information allows parents to induce more effort from their children, which translates into significant gains in achievement. Relative to other interventions, additional information to parents potentially produces gains in achievement at a low cost.

We describe an integrated approach for automating protein analysis of bacterial cell extracts. The method uses electrospray LC/MS to generate chromatographic profiles of proteins present in an extract, along with a software program that automates the data analysis. The software program, Retana, automates the sequential summing, centroiding, and deconvolution of multiply charged proteins present in consecutive scans of the LC/MS analysis. This procedure generates a concise, single spectrum of proteins present in the extract, along with their retention time and relative abundance. A comparison of the method with "whole cell" MALDI analysis demonstrates improved mass resolution and mass accuracy, along with the appearance of a greater number of proteins. Additionally, it is possible to compare protein expression among strains of bacteria by normalizing the relative abundance of similar proteins in each analysis.

Enth.: Rede zur Vorstellung des Pfarrers, Herrn Tobias Höfer, bei der katholischen Gemeinde zu Gießen. Abschiedsrede, am dritten Sonntage des Advents 1823 an die katholische Gemeinde zu Gießen. Predigt zum Antritte des Pfarramtes in Gernsheim

Chromatographed peptide signals form the basis of further data processing that eventually results in functional information derived from data-dependent bottom-up proteomics assays. We seek to rank LC/MS parent ions by the quality of their extracted ion chromatograms (ExICs.) Ranked extracted ion chromatograms (RExICs) act as an intuitive physical/chemical preselection filter to improve the quality of MS/MS fragment scans submitted for database search. We identify more than 4,900 proteins when considering detector shifts of less than 7ppm. High quality parent ions for which the database search yields no hits become candidates for subsequent unrestricted analysis for post-translational modifications. Following this rational approach, we prioritize identification of more than 5,000 spectrum matches from modified peptides and confirmed the presence of acetylaldehyde modified His/Lys. We present a logical workflow that scores data-dependent selected ion chromatograms and leverage information about semi-analytical LC/LC dimension prior to mass spectrometry. Our method can be successfully used to identify unexpected modifications in peptides with excellent chromatography characteristics, independent of fragmentation pattern and activation methods. We illustrate analysis of ion chromatograms detected in two different modes by RF linear ion trap and electrostatic field orbitrap.

With the development of new synthesis procedures, an ever increasing number of chemical modifications can now be incorporated into synthetic oligonucleotides, representing new challenges for analytical chemists to efficiently identify and characterize such molecules. While conventional mass spectrometry (MS) has proven to be a powerful tool to study nucleic acids, new and improved methods and software are now needed to address this emerging challenge. In this report, we describe a simple yet powerful program that affords great flexibility in the calculation of theoretical masses for conventional as well as modified oligonucleotide molecules. This easy to use program can accept input oligonucleotide sequences and then calculate the theoretical mass values for full length products, process impurities, potential metabolites, and gas phase fragments. We intentionally designed this software so that modified nucleotide residues can be incorporated into oligonucleotide sequences, and corresponding mass values can be rapidly calculated. To test the utility of this program, two oligonucleotides that contain a large number of chemical modifications were synthesized. We have analyzed these samples using a Q-TOF mass spectrometer and compared the calculated masses to the observed ones. We found that all of the data matched very well with less than 30 ppm mass errors, well within the expectation for our instrument operated in its current mode. These data confirmed the validity of calculations performed with this new software.

We present the case of a 67-year-old male presenting with critical limb ischaemia following cardiac catheterisation. Immediately after deployment of an arterial closure device, the patient reported severe lower limb pain with impalpable pulses. Magnetic resonance angiography revealed an abrupt disruption of flow in the tibioperoneal trunk. Subsequent surgery revealed embolisation of the arterial closure device. The patient went on to make an unremarkable recovery.

We are surprised that the ankle brachial pressure index is not included in the Department of Health’s latest screening of vascular risk …

ObjectivesThe unit cost for crossmatching blood is £137.22 (€158.94). A maximum surgical blood order schedule for elective EVAR does not exist. We studied the crossmatch to transfusion ratio in our series to establish this recommendation.Materials and methodsA single centre retrospective study of consecutive EVAR cases between October 2001 and December 2010. Blood loss, units transfused and indication for transfusion per case were analysed.Results203 elective EVAR cases were studied. Median blood loss was 200 ml with a mean of 288 ml (range 50–8400 ml). A total of twelve patients (6%) required blood transfusion. Six cases (3%) for postoperative Hb

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