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Muscle spindle abundance is highly variable within and across species, but we currently lack any clear picture of the mechanistic causes or consequences of this variation. Previous use of spindle abundance as a correlate for muscle function implies a mechanical underpinning to this variation, but these ideas have not been tested. Herein, we use integrated medical imaging and subject-specific musculoskeletal models to investigate the relationship between spindle abundance, muscle architecture and in vivo muscle behaviour in the human locomotor system. These analyses indicate that muscle spindle number is tightly correlated with muscle fascicle length, absolute fascicle length change, velocity of fibre lengthening and active muscle forces during walking. Novel correlations between functional indices and spindle abundance are also recovered, where muscles with a high abundance predominantly function as springs, compared to those with a lower abundance mostly functioning as brakes during walking. These data demonstrate that muscle fibre length, lengthening velocity and fibre force are key physiological signals to the central nervous system and its modulation of locomotion, and that muscle spindle abundance may be tightly correlated to how a muscle generates work. These insights may be combined with neuromechanics and robotic studies of motor control to help further tease apart the functional drivers of muscle spindle composition.

OMFS training is perceived as a long and expensive pathway although papers have shown it compares favourably with other surgical specialties. Every OMFS clinician has a vested interest and duty continually to improve the quality of training and minimise costs, especially to trainees at junior levels. Any serious proposal to fundamentally change the format of training, must be given due consideration by all stakeholders. In 2016, a British Medical Journal article whose authors included the BAOMS President of that year and OMFS Specialty Advisory Committee (SAC) Chair, posed the question - should the future of OMFS training revert to single dental degree, change to single medical degree - or continue as a dual degree specialty? The BMJ publication was discussed at the British Association of Oral and Maxillofacial Surgeons (BAOMS) Council in March 2016 and all present unanimously supported the dual degree pathway. Later that year a formal proposal was made by the BAOMS immediate past President that training in the UK change to single medical degree ‘Maxillofacial Surgery’ similar to the training in Spain, France or Italy. Evidence around the risks and benefits of making this change to OMFS training was assembled and reviewed by BAOMS Council in March 2017. BAOMS Council once again unanimously supported continuing OMFS as a dual degree specialty with the observation that the quality of patient care which this training provided was the specialty’s Unique Selling Point or USP. The requirement for both degrees to provide care for OMFS patients had been confirmed by external scrutiny on two separate occasions by the responsible regulators. In this paper, we outline the key steps to be considered when making major changes in the OMFS training pathways using this event as an example and the suggestion that those proposing changes should assemble and present evidence to support their proposal using the template provided.

Volunteer native pastures on widespread sodic texture contrast soils in northern New South Wales slopes and plains are known for their limited agricultural production. Fertilised tropical grass pastures on these soils are reported to have much increased pasture production, deeper, more abundant root mass and greater soil profile moisture storage. The subsoil physical differences between native and tropical grass pastures are not well understood. This observational study compared root abundance, soil structure and soil physical parameters (dispersion, bulk density, porosity and pore distribution) in sodic texture contrast soils under native and adjacent, well established and fertilised tropical pastures in a 14-year chronosequence. The physical differences observed may have contributed to improved soil water storage reported by other authors. Fourteen years after establishment, mean root abundance was significantly lower in soils under native pasture and greater in the tropical grass pasture system with 4600 and 8400 m of roots m -3respectively. Dispersion values were high in native pastures but soils under tropical pastures had to be physically worked to cause dispersion. Bulk density under native pasture was significantly higher than in tropical grass pastures by 0.08 g cm -3 at 0-10 cm and by 0.2 g cm -3 in the upper B horizons. Total soil porosity of topsoils and upper B horizons was consequently lower in native than in tropical grass pasture. Tropical grass pasture upper B horizons had a three-fold greater macroporosity (pores > 30 -m), than under native pastures. This is equivalent to significantly greater potential water flow through stable macropores in dense sodic B horizons in tropical pastures. These findings indicate that pasture system selection and management positively affects deep soil structural properties which promote pasture productivity. The study contributes to a better understanding of mechanisms of published deeper water storage in tropical grass pasture systems on these normally low production soils.

Purpose Patients presenting to emergency departments (EDs) following head injury often undergo computed tomography (CT) of the head to exclude traumatic brain injury. In many cases, this does not show the maxillofacial skeleton. A proportion of these patients also sustain facial fractures, and when fractures involve the orbits, CT imaging is useful in diagnosis and management; obtaining a second scan may cause delay, incur greater cost, and increase radiation dose. The aim of this preliminary study was to examine the value of signs and symptoms of orbital fractures in predicting a fracture on CT. Methods The clinical records of 47 patients who underwent CT of the face following facial trauma were retrospectively examined for the presence of signs and symptoms of orbital fractures. Sensitivity, specificity, negative predictive value (NPV) and positive predictive values (PPV) were then calculated for each sign and symptom for the presence of an orbital fracture on CT. We also described a clinical decision instrument and examined the predictive values of this. Results Change in the position of the globe, reduced visual acuity, subconjunctival haemorrhage and change in sensation in the maxillary division of the trigeminal nerve were the most specific signs and symptoms for orbital fracture. Our clinical decision instrument had 80.0% sensitivity, 75.0% specificity, 90.3% PPV and 56.3% NPV for predicting the presence of an orbital fracture on CT in this population. Conclusions Our results demonstrate that signs and symptoms of orbital fractures may be useful for predicting these injuries, and a decision instrument could be used in the ED to identify patients likely to benefit from extending the radiation field to include the orbits where CT of the head is already planned. This work is however exploratory; and further prospective validation is required before a robust instrument can be recommended for clinical use.

The cost of the NHS, wastage within it and how much trusts have overspent is a national obsession. Despite these widespread opinions, the costs of individual treatments and impacts of non-attendance appear to be little understood. There is a paucity of literature with regards to patients’ awareness of costs associated with services provided by the NHS. The authors aim to ascertain whether patients are aware of the costs associated with care services provided, and if these data could aid educating patients on NHS costs to reduce missed appointments. A questionnaire was randomly distributed to new and review patients in our Oral and Maxillofacial outpatient and emergency departments from November-December 2017 asking them to estimate the cost of common services they may encounter, such as an outpatient appointment, an orthopantomogram (OPT), a CT head, and a full blood count test (FBC). The results demonstrate that 81% of patients surveyed underestimated the cost of their new patient appointment, with 34% underestimating the cost of their review appointment. The cost of an overnight stay in hospital was underestimated by 65% of patients, with 89% of patients underestimating the cost of an hours’s operating. The costs of a full blood count, an OPT and a CT head have been mostly overestimated by 89%, 77%, and 54% of patients respectively. The results show there is a wide variation in patients’ estimates of costs, with over 50% of patients overestimating the costs of investigations but underestimating the cost of their appointment/A&E attendance.

Cybersecurity risk management is the foundation of business and organizational decisions involving digital technology. Various models have been proposed and are in use, but these apply to current technologies and use cases, and none are sufficient to evaluate new technologies. This paper builds upon prior work using CVSS to quantify potential security threats for which information is limited. That prior work merges CVSS data with MITRE’s Common Attack Pattern Enumeration and Classification (CAPEC™) tools to inform a new technology risk scoring system in a Bayesian Belief Network (BBN). This work extends this risk model to incorporate CWSS data to better reflect the environments’ weaknesses that may apply to new technologies. This approach enables a more accurate and trustworthy way of quantitatively estimating risk as a function of the Base Finding Subscore and Attack Surface Subscore for weaknesses most relevant to businesses, missions, and deployed technologies.

Cybersecurity risk management often uses experience-based data to quantify the potential risks of new security technologies based on their exploitability and impact. However, use of such data may be limited and is rarely reusable because it often contains confidential information. This paper proposes a new approach using the Department of Homeland Security’s public National Vulnerability Database (NVD) for information on known vulnerabilities, and MITRE’s public Common Attack Pattern Enumeration and Classification (CAPEC™) tools as the basis of a risk scoring system.

Background Health services researchers have studied how care from oncologists impacts treatment and outcomes for cancer patients. These studies frequently identify physician specialty using files from the Center for Medicare and Medicaid Services (CMS) or the American Medical Association (AMA). The completeness of the CMS data resources, individually or combined, to identify oncologists is unknown. This study assessed the sensitivity of CMS data to capture oncologists included in the AMA Physician Masterfile. Methods Oncologists were identified from three CMS data resources: physician claims, the National Plan and Provider Enumeration System Registry, and the Medicare Data on Provider Practice and Specialty file. CMS files and AMA data were linked using a unique physician identifier. Sensitivity to identify any oncologists, radiation oncologists (ROs), surgical oncologists (SOs), and medical oncologists (MOs) was calculated for individual and combined CMS files. For oncologists in the AMA data not identified as oncologists in the CMS data, their CMS specialty was assessed. Results Individual CMS files each captured approximately 83% of the 17 934 oncologists in the AMA Masterfile; combined CMS files captured 90.4%. By specialty, combined CMS data captured 98.2% of ROs, 89.3% of MOs, and 70.1% of SOs. For ROs and SOs in the AMA data not identified as oncologists in the CMS data, their CMS specialty was usually similar to the AMA subspecialty; ROs were radiologists and SOs were surgeons. Conclusion Using combined files from CMS identified most ROs and MOs found in the AMA, but not most SOs. Determining whether to use the AMA data or CMS files for a particular research project will depend on the specific research question and the type of oncologist included in the study.

Many health services researchers are interested in assessing long term, individual physician treatment patterns, particularly for cancer care. In 2007, Medicare changed the physician identifier used on billed services from the Unique Physician Identification Number (UPIN) to the National Provider Identifier (NPI), precluding the ability to use Medicare claims data to evaluate individual physician treatment patterns across this transition period.Using the 2007-2008 carrier (physician) claims from the linked Surveillance, Epidemiology and End Results (SEER) cancer registry-Medicare data and Medicare's NPI and UPIN Directories, we created a crosswalk that paired physician NPIs included in SEER-Medicare data with UPINs. We evaluated the ability to identify an NPI-UPIN match by physician sex and specialty.We identified 470,313 unique NPIs in the 2007-2008 SEER-Medicare carrier claims and found a UPIN match for 90.1% of these NPIs (n=423,842) based on 3 approaches: (1) NPI and UPIN coreported on the SEER-Medicare claims; (2) UPINs reported on the NPI Directory; or (3) a name match between the NPI and UPIN Directories. A total of 46.6% (n=219,315) of NPIs matched to the same UPIN across all 3 approaches, 34.1% (n=160,277) agreed across 2 approaches, and 9.4% (n=44,250) had a match identified by 1 approach only. NPIs were paired to UPINs less frequently for women and primary care physicians compared with other specialists.National Cancer Institute has created a crosswalk resource available to researchers that links NPIs and UPINs based on the SEER-Medicare data. In addition, the documented process could be used to create other NPI-UPIN crosswalks using data beyond SEER-Medicare.

The British Association of Oral and Maxillofacial Surgeons (BAOMS) has been at the centre of the transition of our specialty in the UK from a branch of dentistry to one of the 10 UK surgical specialties. In this role it has, at different times, pushed boundaries against resistance from other specialties, and redirected the ambitions of the deputy chair of the Postgraduate Medical Education and Training Board (PMETB) review to produce recommendations that were exactly what OMFS needed. The editorial Our specialty. The future. Is the writing on the wall? is just the most recent iteration of half a century of internal debate. Whilst there are some issues with how the authors have presented recruitment data (their figures omit ST1 run-through and do not recognise that the same single, unfilled post may be present for two or more national selection rounds) their first paragraph A debate that we feel is long overdue presents the greatest concern. In this short communication, we illustrate that in the last 20 years the specialty has not been short of debate. In the absence of new and specific evidence that any other route forward would be supported by our national training committee (OMFS SAC), our regulator (GMC), the breadth of our specialty (including our current specialists and our current and future trainees) and, most importantly, would actually address our problems, we should avoid putting energy into an empty debate. Our focus should be on delivering the PMETB recommendations and inspiring our future trainees.

Facial asymmetry secondary to unilateral condylar hyperplasia can be a diagnostic challenge to oral and maxillofacial surgeons. Single positron emission computed tomography (SPECT) scans provide a useful adjunct. We report a brief summary of the evidence describing the effectiveness of different methods of analysing SPECT scans and compare it with the results of a 10-year study at Sunderland Royal Hospital. Overall, both the evidence base and our study strongly favour use of the condyle:condyle ratio over the condyle:reference bone ratio, suggesting that no further comparisons are needed.

The process of investigating spacecraft accidents rests on the lessons of more than 60 years of aircraft crash investigation. There was little need for such skills in the early years of US spaceflight. This changed dramatically in 1986 with the loss of the Space Shuttle Challenger and was perpetuated by the loss of Space Shuttle Columbia in 2003. There have been other fatal accidents involving spacecraft and many near misses. With plans that include continued manning of the International Space Station (ISS); multiple new vehicles; exploration of the moon, asteroids, and Mars; and a vigorous civilian presence in space, it is certain that there will be a need for such investigations in the future. Medical investigators, human factors specialists, and flight surgeons will have essential roles. Their activities will concern human factors, physiology, and the assessment of human survivability – all aimed at preventing future injury and death. The necessary “forensic analysis” will be difficult, both emotionally and physically, and will not always be appreciated, supported, or understood by those uninvolved with the process. Outcome conclusions must be “evidence based” and oriented toward gaining information that will contribute to answering specific questions relevant to future practices and designs.

This paper details the development of a novel method for increasing the operational bandwidth of piezocomposites without the need for lossy backing material, the aim being to increase fractional bandwith by geometrical design. Removing the need for lossy backing materials, should in turn increase the transmit efficiency in the desired direction of propagation. Finite element analysis has been employed to determine the mode of operation of the new piezocomposite devices and shows good correlation with that derived experimentally. Through a series of practical and analytical methods it has been shown that additional thickness mode resonances can be introduced into the structure by a simple machining process. The shaped composites described in this paper offer increased operational bandwidth. A simple example of a two step thickness design is described to validate and illustrate the principle. A more complex conical design is presented that illustrates a possible tenfold increase in bandwidth from 30kHz to 300kHz, operating in air without backing. An illustration of the applicability of this type of transducer technology for frequency agile guided mode non-destructive evaluation is then presented.

A training initiative in Europe opens doors for young scientists, promoting collaboration and broadening their skills with unique opportunities in atmospheric research.

This paper introduces a series of papers in the form of a special edition that reports phenotypic analyses done in parallel with genotypic analyses for the Australian Sheep Industry Cooperative Research Centre (Sheep CRC) using data generated from the information nucleus flock (INF). This has allowed new knowledge to be gained of the genetic, environment and management factors that impact on the carcase and eating quality, visual appeal, odour and health attributes of Australian lamb meat. The research described involved close collaboration with commercial partners across the supply chain in the sire breeding as well as the meat processing industries. This approach has enabled timely delivery and adoption of research results to industry in an unprecedented way and provides a good model for future research.

La poblacion de Merino australiano ha disminuido de forma significativa a lo largo de los ultimos 15 anos como respuesta a una bajada del precio de las prendas de lana, tanto en terminos absolutos como en lo relativo al precio de su carne. Durante el mismo periodo de tiempo, se ha presentado un sistema nacional de evaluacion genetica basado en los metodos BLUP, cuya aceptacion por parte de los criaderos va creciendo de forma progresiva. Los parametros geneticos estimados para la poblacion indican una importante diversidad genetica para todos los rasgos registrados, proporcionando una gran oportunidad para la mejora genetica. Mas recientemente, determinadas pruebas han puesto de manifiesto un progreso, cada vez mas rapido, con respecto a las caracteristicas del vellon, asi como a una serie de caracteristicas relacionadas con la adaptacion y la produccion de carne. La poblacion de Merino esta evolucionando hacia dos grandes grupos � uno centrado en la produccion de lana para ropa de alta calidad cuya seccion de fibra es inferior a las 19 micras y utilizadas en empresas con unos ingresos en la proporcion lana-carne a razon de 3 a 1 respectivamente, y otro mas centrado en la cria de un animal de doble proposito que produce una fibra de lana cuya seccion se encuentra entre 19 y 21 micras y utilizadas en empresas cuyos ingresos corresponden a la proporcion lana:carne a razon de 1.5 a 1:1 respectivamente. Detras de estas tendencias existe un creciente enfoque en las caracteristicas de adaptacion que incluyen una resistencia a parasitos, una menor necesidad de intervenciones por veterinarios, y un mayor crecimiento en edades tempranas, asi como un aumento de la fertilidad y de la capacidad maternal. Juntas, estas tendencias apuntan hacia un ganado ovino cuyos cuidados son cada vez mas sencillos, asi como a la explotacion de la diversidad genetica disponible para aumentar rapidamente la rentabilidad.

Coursework masters degrees in Australia have experienced rapid, decentralised growth since deregulation at the end of the 1980s. The result is an extraordinarily high level of diversity and some confusion as to standards, strategic positioning, purpose and educational approaches. Throughout this period of growth, a sense that large-scale (often distance-education based) collaboration between universities and with industry would be beneficial has not always led to successful outcomes. Using a new collaborative, industry-funded postgraduate coursework program as a case study, this paper describes the issues that decision-makers need to address and evaluates the challenges and benefits of the coursework masters in higher education. The outcomes of industry surveys, student interviews and action research suggest that postgraduate coursework can facilitate technology transfer and aid capacity building, through mechanisms similar to ‘mode 2’ research. With some additional systems to ensure sustainability and standards, this could position coursework masters to be uniquely valuable nationally.

Genetic parameters were estimated using uni- and bi-variate random regression models for weight, eye-muscle depth and fat depth measures between 60 and 360 days of age. Each trait was measured up to five times in 50-day intervals following weaning on approximately 4000 Australian Poll Dorset Sheep. The model accounted for rearing type, dam age, management group and age of recording. The model used for analysing weight included quadratic, orthogonal polynomials for direct genetic and environmental effects, a linear polynomial for maternal genetic effects and heterogeneous error variance across ages. The fat and muscle analysis used linear orthogonal polynomials for direct genetic and environmental effects and heterogeneous error variance. Throughout the 300-day trajectory heritability for weight traits ranged from 0·20 to 0·31, while heritability for fat depth ranged from 0·24 to 0·34 and heritability for eye-muscle depth ranged from 0·24 to 0·40. Genetic correlations between repeated measures of the same trait at different ages were positive and declined as the age interval increased, to minimum values of 0·60, 0·31 and 0·50 for weight, fat and muscle respectively between 60 and 360 days of age. Genetic correlations between weight and fat and weight and eye muscle were moderate to high (0·6 to 0·8) and positive but decreased slightly with age. The genetic correlations between fat and muscle were moderate to high (0·5 to 0·7) throughout the 300-day trajectory. In all cases, the estimates produced in this study were reasonably consistent with the limited number of studies that exist in the reported literature. This study demonstrated the relationships that exist between repeated measures of weight, fat and muscle measures over time, which is of interest to prime lamb producers looking to select for specific breeding objectives or market end points requiring precise weight, fat and muscle combinations at certain ages.

Random regression has been proposed as an accurate method for evaluation of growth data; however, this method has seldom been applied to data from an extensive industry where few records per animal exist. Consequently, field data containing weights of Poll Dorset sheep from 50 to 500 days of age were analysed fitting a random regression model. This model included quadratic, orthogonal polynomials for direct genetic and environmental effects and maternal environmental effects, a linear polynomial for maternal genetic effects and heterogeneous error variances. Direct heritability estimates increased steadily throughout time and were in agreement with literature estimates taken at specific ages. Some estimates for the highest ages with the least records tended to be overestimated, in particular heritability beyond 450 days. Research to solve this problem may require use of a function other than a polynomial. Variances due to maternal genetic effects were low throughout the trajectory. Covariances between weights of sheep for a considerable range of ages can be modelled adequately using random regression.