Dead-reckoning elucidates fine-scale habitat use by European badgers Meles meles

Background

Recent developments in both hardware and software of animal-borne data loggers now enable large amounts of data to be collected on both animal movement and behaviour. In particular, the combined use of tri-axial accelerometers, tri-axial magnetometers and GPS loggers enables animal tracks to be elucidated using a procedure of 'dead-reckoning'. Although this approach was first suggested 30 years ago by Wilson et al. (1991), surprisingly few measurements have been made in free-ranging terrestrial animals. The current study examines movements, interactions with habitat features, and home-ranges calculated from just GPS data and also from dead-reckoned data in a model terrestrial mammal, the European badger (Meles meles).

Methods

Research was undertaken in farmland in Northern Ireland. Two badgers (one male, one female) were live-trapped and fitted with a GPS logger, a tri-axial accelerometer, and a tri-axial magnetometer. Thereafter, the badgers' movement paths over 2 weeks were elucidated using just GPS data and GPS-enabled dead-reckoned data, respectively.

Results

Badgers travelled further using data from dead-reckoned calculations than using the data from only GPS data. Whilst once-hourly GPS data could only be represented by straight-line movements between sequential points, the sub-second resolution dead-reckoned tracks were more tortuous. Although there were no differences in Minimum Convex Polygon determinations between GPS- and dead-reckoned data, Kernel Utilisation Distribution determinations of home-range size were larger using the former method. This was because dead-reckoned data more accurately described the particular parts of landscape constituting most-visited core areas, effectively narrowing the calculation of habitat use. Finally, the dead-reckoned data showed badgers spent more time near to field margins and hedges than simple GPS data would suggest.

Conclusion

Significant differences emerge when analyses of habitat use and movements are compared between calculations made using just GPS data or GPS-enabled dead-reckoned data. In particular, use of dead-reckoned data showed that animals moved 2.2 times farther, had better-defined use of the habitat (revealing clear core areas), and made more use of certain habitats (field margins, hedges). Use of dead-reckoning to provide detailed accounts of animal movement and highlight the minutiae of interactions with the environment should be considered an important technique in the ecologist's toolkit.

Activity of loggerhead turtles during the U-shaped dive: insights using angular velocity metrics

Understanding the behavioural ecology of endangered taxa can inform conservation strategies. The activity budgets of the loggerhead turtle Caretta caretta are still poorly understood because many tracking methods show only horizontal displacement and ignore dives and associated behaviours. However, time-depth recorders have enabled researchers to identify flat, U-shaped dives (or type 1a dives) and these are conventionally labelled as resting dives on the seabed because they involve no vertical displacement of the animal. Video- and acceleration-based studies have demonstrated this is not always true. Focusing on sea turtles nesting on the Cabo Verde archipelago, we describe a new metric derived from magnetometer data, absolute angular velocity, that integrates indices of angular rotation in the horizontal plane to infer activity. Using this metric, we evaluated the variation in putative resting behaviours during the bottom phase of type 1a dives for 5 individuals over 13 to 17 d at sea during a single inter-nesting interval (over 75 turtle d in total). We defined absolute resting within the bottom phase of type 1a dives as periods with no discernible acceleration or angular movement. Whilst absolute resting constituted a significant proportion of each turtle’s time budget for this 1a dive type, turtles allocated 16-38% of their bottom time to activity, with many dives being episodic, comprised of intermittent bouts of rest and rotational activity. This implies that previously considered resting behaviours are complex and need to be accounted for in energy budgets, particularly since energy budgets may impact conservation strategies.

The importance of sample size in marine megafauna tagging studies

Telemetry is a key, widely used tool to understand marine megafauna distribution, habitat use, behavior, and physiology; however, a critical question remains: "How many animals should be tracked to acquire meaningful data sets?" This question has wide-ranging implications including considerations of statistical power, animal ethics, logistics, and cost. While power analyses can inform sample sizes needed for statistical significance, they require some initial data inputs that are often unavailable. To inform the planning of telemetry and biologging studies of marine megafauna where few or no data are available or where resources are limited, we reviewed the types of information that have been obtained in previously published studies using different sample sizes. We considered sample sizes from one to >100 individuals and synthesized empirical findings, detailing the information that can be gathered with increasing sample sizes. We complement this review with simulations, using real data, to show the impact of sample size when trying to address various research questions in movement ecology of marine megafauna. We also highlight the value of collaborative, synthetic studies to enhance sample sizes and broaden the range, scale, and scope of questions that can be answered.

Investigating the relationship between energy expenditure, walking speed and angle of turning in humans

Recent studies have suggested that changing direction is associated with significant additional energy expenditure. A failure to account for this additional energy expenditure of turning has significant implications in the design and interpretation of health interventions. The purpose of this study was therefore to investigate the influence of walking speed and angle, and their interaction, on energy expenditure in 20 healthy adults (7 female; 28±7 yrs). On two separate days, participants completed a turning protocol at one of 16 speed- (2.5, 3.5, 4.5, 5.5 km∙h^-1) and angle (0, 45, 90, 180°) combinations, involving three minute bouts of walking, interspersed by three minutes seated rest. Each condition involved 5 m of straight walking before turning through the pre-determined angle with the speed dictated by a digital, auditory metronome. Tri-axial accelerometry and magnetometry were measured at 60 Hz, in addition to gas exchange on a breath-by-breath basis. Mixed models revealed a significant main effect for speed (F = 121.609, P < 0.001) and angle (F = 19.186, P < 0.001) on oxygen uptake (V˙O2) and a significant interaction between these parameters (F = 4.433, P < 0.001). Specifically, as speed increased, V˙O2 increased but significant increases in V˙O2 relative to straight line walking were only observed for 90° and 180° turns at the two highest speeds (4.5 and 5.5 km∙hr^-1). These findings therefore highlight the importance of accounting for the quantity and magnitude of turns completed when estimating energy expenditure and have significant implications within both sport and health contexts.

Recent advances in telemetry for estimating the energy metabolism of wild fishes

Metabolic rate is a critical factor in animal biology and ecology, providing an objective measure that can be used in attributing a cost to different activities and to assessing what animals do against some optimal behaviour. Ideally, metabolic rate would be estimated directly by measuring heat output but, until recently, this has not been easily tractable with fishes so instead metabolic rate is usually estimated using indirect methods. In the laboratory, oxygen consumption rate is the indirect method most frequently used for estimating metabolic rate, but technical requirements preclude the measurement of either heat output or oxygen consumption rate in free-ranging fishes. There are other field methods for estimating metabolic rate that can be used with mammals and birds but, again, these cannot be used with fishes. Here, the use of electronic devices that record body acceleration in three dimensions (accelerometry) is considered. Accelerometry is a comparatively new telemetric method for assessing energy metabolism in animals. Correlations between dynamic body acceleration (DBA) and oxygen consumption rate demonstrate that this will be a useful proxy for estimating activity-specific energy expenditure from fishes in mesocosm or field studies over extended periods where other methods (e.g. oxygen consumption rate) are not feasible. DBA therefore has potential as a valuable tool for attributing cost to different activities. This could help in gaining a full picture of how fishes make energy-based trade-offs between different levels of activity when faced with conflicting or competing demands arising from increased and combined environmental stressors.

Relationships between oxygen uptake, dynamic body acceleration and heart rate in humans

AIM

Accurate estimation of energy expenditure (EE) is important in human and animal behavior analysis. Rate of oxygen consumption (VO2) reflects EE during aerobic metabolism but is not always convenient. Alternative methods include heart rate (HR) and overall dynamic body acceleration (ODBA). A favorable ODBA-VO2 relationship was recently reported but the strength of association between VO2, ODBA, HR and its variability (HRV) is less clear.

METHOD

Fifteen young (23±4 years) healthy males of similar aerobic fitness (maximal oxygen uptake, VO2max=49.7±8.5 mL·kg(-1)·min(-1)) carried out progressive maximal exercise. ODBA, HRV and V̇O2 were recorded continuously. Relationships between ODBA, HRV and V̇O2 were explored using regression methods.

RESULTS

VO2 was strongly related to ODBA and RR during walking (R=0.45,0.30; P<5x10(-5)) and running (R=0.60,0.38; P<5x10(-5)). HRV was related to VO2 during walking only (R=0.11-0.26; 0.005<P<5x10(-5)). A strong ODBA-RR relationship during walking (R=0.45; P<5x10(-5)) was diminished during running (R=0.25; P<5x10(-5)).

CONCLUSION

ODBA is a stronger proxy for EE than RR or HRV, especially during running gaits. HRV is weakly related to EE and cannot be recommended for its estimation. ODBA and RR are relatively easily measured but careful attention to gait is imperative as it changes these relationships markedly.

Step by step: reconstruction of terrestrial animal movement paths by dead-reckoning

BACKGROUND

Research on wild animal ecology is increasingly employing GPS telemetry in order to determine animal movement. However, GPS systems record position intermittently, providing no information on latent position or track tortuosity. High frequency GPS have high power requirements, which necessitates large batteries (often effectively precluding their use on small animals) or reduced deployment duration. Dead-reckoning is an alternative approach which has the potential to 'fill in the gaps' between less resolute forms of telemetry without incurring the power costs. However, although this method has been used in aquatic environments, no explicit demonstration of terrestrial dead-reckoning has been presented.

RESULTS

We perform a simple validation experiment to assess the rate of error accumulation in terrestrial dead-reckoning. In addition, examples of successful implementation of dead-reckoning are given using data from the domestic dog Canus lupus, horse Equus ferus, cow Bos taurus and wild badger Meles meles.

CONCLUSIONS

This study documents how terrestrial dead-reckoning can be undertaken, describing derivation of heading from tri-axial accelerometer and tri-axial magnetometer data, correction for hard and soft iron distortions on the magnetometer output, and presenting a novel correction procedure to marry dead-reckoned paths to ground-truthed positions. This study is the first explicit demonstration of terrestrial dead-reckoning, which provides a workable method of deriving the paths of animals on a step-by-step scale. The wider implications of this method for the understanding of animal movement ecology are discussed.

Utility of biological sensor tags in animal conservation

Electronic tags (both biotelemetry and biologging platforms) have informed conservation and resource management policy and practice by providing vital information on the spatial ecology of animals and their environments. However, the extent of the contribution of biological sensors (within electronic tags) that measure an animal's state (e.g., heart rate, body temperature, and details of locomotion and energetics) is less clear. A literature review revealed that, despite a growing number of commercially available state sensor tags and enormous application potential for such devices in animal biology, there are relatively few examples of their application to conservation. Existing applications fell under 4 main themes: quantifying disturbance (e.g., ecotourism, vehicular and aircraft traffic), examining the effects of environmental change (e.g., climate change), understanding the consequences of habitat use and selection, and estimating energy expenditure. We also identified several other ways in which sensor tags could benefit conservation, such as determining the potential efficacy of management interventions. With increasing sensor diversity of commercially available platforms, less invasive attachment techniques, smaller device sizes, and more researchers embracing such technology, we suggest that biological sensor tags be considered a part of the necessary toolbox for conservation. This approach can measure (in real time) the state of free-ranging animals and thus provide managers with objective, timely, relevant, and accurate data to inform policy and decision making.

Outbreak of abdominal distension and obstipation in a C57BL/6J experimental autoimmune encephalomyelitis study

Seventy-four 9-week old female C57BL/6J mice housed in a conventional facility were manipulated to induce experimental autoimmune encephalomyelitis, among which 26 developed clinical signs including lethargy, absence of defecation, and abdominal distension. By gross necropsy examination, there was distension of the cecum and colon with fecal impaction. By histologic examination, there was severe ulcerative and proliferative typhlocolitis. Fecal ELISA confirmed the presence of toxins A and B of Clostridium difficile. Alteration in immune status of the immunocompetent mice, due to stress caused by experimental manipulation or autoimmune disease, may have led to intestinal dysbiosis, followed by opportunistic infections resulting in C. difficile-associated disease. This report brings to light the occurrence of the disease in immunocompetent laboratory mice during experimental manipulations associated with alteration in immune status, and it discusses potential hazards associated with conventional housing within a hospital-associated research institute.

Assessing the validity of the accelerometry technique for estimating the energy expenditure of diving double-crested cormorants Phalacrocorax auritus

Over the past few years, acceleration-data loggers have been used to provide calibrated proxies of energy expenditure: the accelerometry technique. Relationships between rate of oxygen consumption and a derivation of acceleration data termed "overall dynamic body acceleration" (ODBA) have now been generated for a range of species, including birds, mammals, and amphibians. In this study, we examine the utility of the accelerometry technique for estimating the energy expended by double-crested cormorants Phalacrocorax auritus to undertake a dive cycle (i.e., a dive and the subsequent pause at the surface before another dive). The results show that ODBA does not calibrate with energy expenditure in diving cormorants, where energy expenditure is calculated from measures of oxygen uptake during surface periods between dives. The possible explanations include reasons why energy expenditure may not relate to ODBA but also reasons why oxygen uptake between dives may not accurately represent energy expenditure during a dive cycle.

Enteric Pathology and Salmonella-Induced Cell Death in Healthy and SIV-Infected Rhesus Macaques

The goal of this study was to morphologically characterize a ligated ileal loop model of Salmonella enterica serotype Typhimurium infection in rhesus macaques ( Macaca mulatta) and to verify the occurrence of Salmonella-induced cell death in vivo. Eight adult healthy male rhesus macaques were used for ligated ileal loop surgery. Four macaques had been intravenously inoculated with simian immunodeficiency virus (SIV) mac251. Ileal ligated loops were inoculated with wild-type (WT) S. Typhimurium strain IR715 (ATCC14028 nalr), an isogenic noninvasive mutant strain (ATCC14028 nalr Δ sipAΔ sopABDE2), or sterile Luria Bertani broth. Loops were surgically removed at 2, 5, and 8 hours post-inoculation (hpi). Intestinal samples were processed for histopathology, immunohistochemistry for detecting Salmonella, terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL), and transmission electron microscopy. Combined histopathology scores were similar between SIV-infected and control macaques. As expected, the invasion-deficient mutant was less pathogenic than WT S. Typhimurium. Neutrophil infiltrate in the intestinal mucosa correlated with bacterial loads ( r = 0.7148; P < .0001) and fluid accumulation ( r = 0.6019; P < .0001) in the lumen of the intestinal loops. Immunolabeled WT S. Typhimurium was observed in the epithelium and lamina propria at the tip of the villi at 2 hpi, progressing toward deeper lamina propria at 5–8 hpi. Most TUNEL-positive cells localized to the lamina propria, and some had morphological features of macrophages. Ultrastructurally, bacteria were observed intracellularly in the lamina propria as well as within apoptotic bodies. This study provides morphological evidence of Salmonella-induced cell death in vivo in a relevant nonhuman primate model.

Accelerometry to Estimate Energy Expenditure during Activity: Best Practice with Data Loggers

Measurement of acceleration can be a proxy for energy expenditure during movement. The variable overall dynamic body acceleration (ODBA), used in recent studies, combines the dynamic elements of acceleration recorded in all three dimensions to measure acceleration and hence energy expenditure due to body movement. However, the simplicity of ODBA affords it limitations. Furthermore, while accelerometry data loggers enable measures to be stored, recording at high frequencies represents a limit to deployment periods as a result of logger memory and/or battery exhaustion. Using bantam chickens walking at different speeds in a respirometer while wearing an accelerometer logger, we investigated the best proxies for rate of oxygen consumption (Vo(2)) from a range of different models using acceleration. We also investigated the effects of sampling acceleration at different frequencies. The best predictor of Vo(2) was a multiple regression including individual measures of dynamic acceleration in each of the three dimensions. However, R(2) was relatively high for ODBA as well and also for certain measures of dynamic acceleration in single dimensions. The aforementioned are single variables, therefore easily derived onboard a data logger and from which a simple calibration equation can be derived. For calibrations of Vo(2) against ODBA, R(2) was consistent as sampling number decreased down to 600 samples of each acceleration channel per ODBA data point, beyond which R(2) tended to be considerably lower. In conclusion, data storage can be maximized when using acceleration as a proxy for Vo(2) by consideration of reductions in (1) number of axes measured and (2) sampling frequency.

Estimating energy expenditure of animals using the accelerometry technique: activity, inactivity and comparison with the heart-rate technique

Several methods have been used to estimate the energy expenditure of free-ranging animals. A relatively new technique uses measures of dynamic body acceleration as a calibrated proxy for energy expenditure and has proved an excellent predictor of energy expenditure in active animals. However, some animals can spend much of their time inactive and still expend energy at varying rates for a range of physiological processes. We tested the utility of dynamic body acceleration to estimate energy expenditure during a range of active (locomotion, eating) and inactive (digesting, thermoregulating) behaviours exhibited by domestic chickens. We also compared this technique with the more established heart-rate method for estimating energy expenditure. During activity, the error of estimation using body acceleration was very similar to that from the heart-rate method. Importantly, our results also showed that body acceleration can be used to estimate energy expenditure when birds are inactive. While the errors surrounding these estimates were greater than those during activity, and those made using the heart-rate method, they were less than those made using interspecific allometric equations. We highlight the importance of selecting a methodology that is appropriate for the life-history of the subject animal. We suggest that, to achieve the greatest possible accuracy and precision when estimating energy expenditure in free-ranging animals, the two techniques should be combined, and both heart rate (f(H)) and dynamic body acceleration could be included as covariates in predictive models. Alternatively, measures of acceleration can be used to ascertain which behaviour is being exhibited at each moment and hence which predictive model should be applied.

Temporal variation in cellular proliferation during recornification of mouse tail skin

The influence of the time of injury on subsequent epidermal regeneration is unknown. Epidermal cell proliferation of tail skin in C57BL/6J mice in response to tape stripping was followed for 7 days by radiolabelled thymidine incorporation and autoradiography. The homeostatic labelling index (LI) of the basal epidermis of unmanipulated, unwounded (control) animals was 7.6% and did not vary depending on the time of day. Tape stripping increased the LI of epidermal basal cells 110% above control values 24 h after injury. Labelling indexes of epidermal basal cells in the skin adjacent to the wounded area were 7.0%. Basal cell DNA synthesis stimulated by wounding exhibited a distinct temporal variation at 24 h postinjury, with tail skin wounded at 12.00 h found to be 275% greater than control values and elevated 78% from LIs recorded at any other time point. This temporal spike was due to the time of day at which wounding occurred rather than the time point when the LI was determined. Mice wounded at 12.00 h and terminated 27 h later (15.00 h) had LIs that were 52% greater than wounds created at 09.00 h and examined at 12.00 h the following day. Higher levels of DNA synthesis in tail skin injured at 12.00 h compared to wounding at 09.00 h was detected 12-48 h after injury. Furthermore, DNA synthesis in wounds created at 12.00 h returned to baseline levels 1-2 days earlier than tail skin wounded at 09.00 h. Investigation of other strains of mice detected differences in radiolabelling of epidermal basal cells 24 h after tape stripping at 12.00 h or 09.00 h in CD-1 and BALB/cJ mice, but not in the C3H/HeJ strain. These results indicate: (a) there is no diurnal variation in the LI of mouse tail skin under normal homeostatic conditions (b) tape stripping is a potent stimulator of basal cell turnover in the epidermis (c) the time of wounding determines the magnitude of the increase in the LI of basal cells following injury, and (d) the proliferative response to wounding of the tail is dependent on the strain of mouse.

Detection of Björk-Shiley convexo-concave heart valve outlet strut single leg separations: consensus image acquisition and interpretation using two different cineradiographic imaging technologies

BACKGROUND

Conventional cineradiology has been used clinically to detect partially broken outlet struts (single leg separations, SLSs) in normally functioning Björk-Shiley convexo-concave (C/C) heart valves. The value of radiographic screening has, however, been debated in the medical literature. This study uses the same radiographic technique in sheep implanted with known-status C/C valves in combination with a newly developed geometric image magnification radiography system. This study was designed to test whether sensitivity and specificity of radiographic screening of C/C valves in detecting SLSs could be improved through the combination of readers and imaging modalities.

METHODS

Twenty-one sheep with mitral C/C valves were studied on both systems. Five were used for extensive scanning training. When operators were expert on both systems, 16 blinded study valves (4 intact and 12 with outlet strut SLSs) were scanned twice on both systems, first on a modified conventional and then a prototype geometric image magnification (Feinfocus(TM)) cineradiographic system by two expert physicians working together.

RESULTS

Among the 32 scanned valves, the two combined expert physicians were required to evaluate 40 intact legs and 24 with an SLS. For all SLS valves, the conventional and Feinfocus systems separately detected 50 (12/24) and 54% (13/24), respectively. When the two systems were combined, the final consensus score was correct in 67% (16/24) of all SLS valves.

CONCLUSIONS

Combined modality, paired expert physicians detected 67% of all SLSs. The Feinfocus system might be best reserved for those patients in whom the Siemens screening study demonstrates in minimally suspicious (grade 2) or suspicious (grade 3) appearance of a C/C valve outlet strut leg.

The outcome of the functioning filter after subsequent cataract extraction

OBJECTIVE

To evaluate and compare the outcome of functioning filtration surgery followed by cataract surgery with posterior intraocular lens implantation by both phacoemulsification and extracapsular cataract extraction (ECCE) techniques in glaucomatous eyes.

PATIENTS AND METHODS

We retrospectively evaluated the clinical course of 77 eyes (68 patients) that after successful trabeculectomy, underwent cataract surgery by either phacoemulsification or ECCE techniques. We determined the frequency of partial and absolute failure following cataract surgery by either phacoemulsification or ECCE in eyes with functioning trabeculectomies. Partial failure of intraocular pressure (IOP), control after cataract extraction was defined as the need for an increased number of antiglaucoma medications or argon laser trabeculoplasty to maintain IOP < or =21mm Hg. Complete failure of IOP control after cataract surgery was defined as an IOP >21 mm Hg on at least two consecutive measurements one or more weeks apart or the performance of additional filtration surgery. Failure rates were calculated using the Kaplan-Meier actuarial method. Failure rates between phacoemulsification and ECCE subgroups were compared using the log rank test.

RESULTS

The probability of partial failure by the third postoperative year after cataract surgery was 39.5% in the phacoemulsification subgroup and 37.3% in the ECCE subgroup. This small difference is not statistically significant (P = 0.48). The probability of complete failure by the fourth postoperative year after cataract surgery was 12.0% in the phacoemulsification subgroup and 12.5% in the ECCE subgroup. This difference is also not statistically significant (P = 0.77). At the 6-month follow-up visit, visual acuity of both groups improved one or more lines in 87.0% of patients, and worsened one or more lines in 3.9% of patients. Sixty-one percent achieved visual acuity of 20/40 or better. The most frequent complication was posterior capsular opacification requiring laser capsulotomy that occurred in 31.2% of patients.

CONCLUSION

Cataract extraction by either phacoemulsification or ECCE following trabeculectomy surgery may be associated with a partial loss of the previously functioning filter and the need for more antiglaucoma medications to control IOP.

Endocarditis and meningitis caused by Streptococcus suis after cardiac surgery in a sheep

A female Dorset-cross sheep developed labored respirations and was anorexic, weak, ataxic and febrile (42.0 degrees C) 15 days after implantation of a cardiac device. Clinical pathologic evaluation identified a mild leukocytosis (11,800 cells/microl), neutrophilia (8,969 cells/microl), and hypokalemia (2.9 mmol/L). Despite intensive therapy, the animal was euthanized 7 days later. Necropsy of the sheep revealed meningitis and vegetative endocarditis associated with the cardiac device. Blood cultures collected antemortem and tissue cultures collected at necropsy yielded Streptococcus suis. Histopathology confirmed the diagnosis of bacterial valvular endocarditis and meningoencephalitis. A variety of environmental and host factors are proposed as contributing to the infection, and the zoonotic potential of S. suis is discussed.

The opioid growth factor, [Met5]-enkephalin, inhibits DNA synthesis during recornification of mouse tail skin

Opioid peptides serve as tonically active negative growth regulators in renewing and regenerating epithelia. To examine the involvement of opioids in renewal of the stratum corneum after tape stripping of tail skin, C57BL/6 J mice were given systemic injections of the potent opioid antagonist, naltrexone (NTX, 20 mg/kg i.p.) following injury. Blockade of opioid-receptor interaction by NTX for 4 h resulted in an elevation of 36-66% in basal cell DNA synthesis measured 24 h after injury. Injection of the endogenous opioid peptide, [Met5]-enkephalin (OGF, 10 mg/kg i.p.) 4 h before termination, suppressed radiolabelled thymidine incorporation in the basal cell layer by 37-46% at 24 h after wounding. The magnitude of the effects on DNA synthesis of OGF, but not NTX, depended on the timing of administration with respect to injury. OGF maximally depressed basal cell labelling (72%) when given 16 h after tape stripping. Concomitant administration of naloxone (10 mg/kg) with OGF blocked the inhibition of DNA synthesis; naloxone alone at the dosage utilized had no effect on cell labelling. Both OGF and its receptor, OGFr, were detected by immunocytochemistry in the basal and suprabasal cell layers, but not the cornified layer of tape stripped and uninjured tail skin. These results indicate: (a) a native opioid peptide and its receptor are expressed in epidermal cells of injured and uninjured mouse tail skin; (b) removal of the stratum corneum by tape stripping does not disrupt the function of the endogenous opioid growth system; (c) the proliferative response to wounding of the tail is tonically inhibited by the receptor-mediated action of an endogenous opioid peptide; and (d) DNA synthesis by basal cells can be elevated by disrupting opioid peptide receptor interactions.

Outcome of trabeculectomy with mitomycin-C in the iridocorneal endothelial syndrome

PURPOSE

Eyes with iridocorneal endothelial (ICE) syndrome have a high risk of failure in glaucoma filtering surgery failing. We investigated the efficacy of trabeculectomy with intraoperative mitomycin-C application in these patients.

DESIGN

Retrospective nonrandomized comparative trial with historical controls.

PARTICIPANTS AND CONTROLS

Ten patients with unilateral iridocorneal endothelial (ICE) syndrome were reviewed. Their intraocular pressures could not be controlled medically. In five eyes, this was the primary surgery performed. Five of the patients had undergone prior intraocular pressure-(IOP) lowering surgery that had failed at the time enrolled. Results were compared with previously published case series of similar patients treated with trabeculectomy alone or trabeculectomy and subconjunctival 5-fluorouracil injections.

INTERVENTION

Intervention consisted of trabeculectomy with a limbus-based conjunctival flap and mitomycin-C application. The dosage of mitomycin-C was 0.4 mg/ml for 1 to 4 minutes (mean, 1.9 min).

MAIN OUTCOME MEASURES

Adequate control of IOP (without medication lower than 21 mm Hg).

RESULTS

In eight eyes the IOP remained well controlled (mean IOP, 12.1 mm Hg) over the entire length of available of follow-up (mean, 14.9 months). Two eyes required implantation of an aqueous tube shunt at 4 and 11 months, respectively, after trabeculectomy with mitomycin-C. One eye experienced visual loss of 3 Snellen lines because of hypotony maculopathy.

CONCLUSIONS

Trabeculectomy with mitomycin-C application offers a reasonable intermediate-term success rate in ICE patients, who are otherwise at high risk for failure of filtering surgery.

Therapeutic substitution and therapeutic conservatism as cost-containment strategies in primary care: a study of fundholders and non-fundholders

BACKGROUND

General practice (GP) fundholders contained prescribing costs by restricting the rise in volume of prescribing and by increasing generic prescribing. It is uncertain whether they used more sophisticated approaches to medicine choice in attempts to contain costs.

AIM

To examine whether fundholding practices have adopted medicine-specific strategies to contain prescribing costs--i.e. switching to less expensive but equally effective medicines or resisting the uptake of newer more expensive medicines--by examination of the prescribing of ulcer-healing and antidepressant medicines in the period before and after practices became fundholders.

METHOD

Comparison of prescribing data of 52 fundholding practices before fundholding and after fundholding with that of matched non-fundholding practices. Measures examined were prescribing costs (net ingredient cost in each therapeutic area per ASTRO-pu); prescribing volume (defined daily doses per ASTRO-pu); the proportion of all ulcer-healing medicines prescribed as cimetidine, ranitidine, nizatidine, and as proton pump inhibitors; and the proportion of all antidepressant medicines prescribed as selective serotonin re-uptake inhibitors.

RESULTS

In comparison with non-fundholding practices, fundholders increasingly prescribed less expensive medicines (cimetidine and nizatidine) within the class of histamine2 receptor antagonists. However, fundholders adopted proton pump inhibitors or selective serotonin re-uptake inhibitors at the same rate as non-fundholders.

CONCLUSION

Fundholders have used therapeutic substitution with medicines of equal effectiveness to contain prescribing costs. There is no evidence that fundholders have been slower than non-fundholders to use newer, more expensive medicines.

Evaluation of a modified arrow-trerotola percutaneous thrombolytic device for treatment of acute pulmonary embolus in a canine model

PURPOSE

Massive pulmonary embolus (PE) is often rapidly fatal. Surgical thrombectomy has a mortality rate as high as 74%. Multiple percutaneous methods have been tested with limited success. The purpose of this study was to evaluate the Arrow-Trerotola percutaneous thrombolytic device (PTD) for (i) the ability to clear pulmonary embolus and (ii) the effect on normal pulmonary vasculature. These were tested in a canine model.

MATERIALS AND METHODS

Iatrogenic unilateral massive PEs were created in nine canines. These PEs were then treated with the PTD. The device was also activated in the normal pulmonary artery. Immediately after treatment, six animals were killed. Three animals were allowed to recover and underwent pulmonary arteriography 1 month later to evaluate pulmonary hypertension, stenosis, or occlusion; they were then killed. Autopsy specimens were evaluated for histologic evidence of acute or chronic vascular injury.

RESULTS

Acutely, the PTD effectively thrombolysed the PE in all animals. Histologically, there was moderate intimal injury, but no evidence of pulmonary artery disruption. There was one device failure. One month after treatment, there was no radiographic evidence of pulmonary stenosis at device activation sites, no pulmonary hypertension, and only mild histologic evidence of scar formation.

CONCLUSION

In preliminary animal testing, the PTD is safe and effective for treating large central pulmonary emboli. Human clinical trials are warranted.

Long-term outcome of aqueous shunt surgery in ten patients with iridocorneal endothelial syndrome

PURPOSE

To report the long-term outcome of ten patients with iridocorneal endothelial (ICE) syndrome who underwent aqueous shunt surgery for uncontrolled glaucoma.

DESIGN

Noncomparative, retrospective case series.

PARTICIPANTS

The authors reviewed charts of ten patients with ICE syndrome-related glaucoma who underwent aqueous shunt surgery at one institution between 1987 and 1996.

MAIN OUTCOME MEASURES

Intraocular pressure (IOP), number of glaucoma medications, and further surgical interventions were measured.

RESULTS

With a median follow-up of 55 months, four eyes had adequate IOP control (IOP <21 mm Hg) with one or two medications after the initial aqueous shunt surgery. An additional three eyes achieved adequate IOP control after one or more tube repositionings or revisions of the initial aqueous shunt. In this series, the aqueous shunt surgery most often failed because of blocking of the tube ostium by iris, ICE membrane, or membrane-induced tube migration.

CONCLUSION

Aqueous shunt surgery appears to be an effective method for IOP lowering in some eyes with ICE syndrome-related glaucoma when medical treatment or conventional filtration surgeries fail, but additional glaucoma procedures and/or aqueous shunt revisions and tube repositionings are not uncommon.

Reversal of optic disc cupping after glaucoma surgery analyzed with a scanning laser tomograph

OBJECTIVE

To detect and quantitate changes in optic nerve morphology after glaucoma surgery using the Heidelberg Retina Tomograph (HRT, Heidelberg Instruments, Heidelberg, Germany).

DESIGN

Nonconsecutive observational case series.

PARTICIPANTS AND INTERVENTION

The authors prospectively enrolled 21 adult patients undergoing incisional glaucoma surgery for progressive glaucoma damage. Quantitative analysis of the optic nerve head by scanning laser tomography and automated perimetry were performed before and after glaucoma surgery.

MAIN OUTCOME MEASURES

Changes in optic nerve parameters were subjected to linear regression analysis with respect to percent of postoperative reduction of intraocular pressure (IOP), as well as with respect to age, refraction, preoperative cup:disc ratio, and change in visual field parameters.

RESULTS

Seventeen patients had pre- and postoperative images suitable for analysis. Mean IOP at the time of image acquisition before surgery was 30.5+/-12 mm Hg, and after surgery 11.8+/-5.2 mm Hg (mean follow-up, 26+/-7 weeks). Eleven of 13 (85%) patients having IOP reduction of greater than 40% showed improvement in optic disc parameters. All four patients with less than 25% reduction in IOP showed worsening of most parameters. Changes in optic disc parameters were highly correlated with percent IOP reduction and with age. The parameters in which change most strongly correlated with percent change of IOP were cup area, rim area, cup:disc ratio, and mean cup depth (each, P<0.005). The age of the patient correlated highly with change in maximum cup depth (P<0.005). Refraction and clinically determined cup:disc ratio correlated poorly with changes in measured optic disc parameters. Clinical improvement in visual fields was correlated with the degree of improvement of cup:disc ratio (P = 0.025).

CONCLUSION

Most patients showing a 40% lowering of IOP after glaucoma surgery show improved optic nerve morphology as measured by the HRT. The amount of improvement correlated highly with the percent reduction of IOP.

Pseudocapsulorrhexis in a patient with iridocorneal endothelial syndrome

We describe a patient with Chandler's syndrome variant of the iridocorneal endothelial syndrome in whom ectopic Descemet's membrane was found intraoperatively on the anterior surface of the lens. Initially, the membrane was confused with the anterior lens capsule during extracapsular cataract extraction, leading to the performance of a pseudocapsulorrhexis. Electron microscopy disclosed that the epilenticular membrane was composed of multiple layers of abnormal basement membrane consistent with the iridocorneal endothelial syndrome.

Filtration procedures supplemented with mitomycin C in the management of childhood glaucoma

AIMS

To evaluate the outcome of filtering procedures supplemented with mitomycin C in children with glaucoma.

METHODS

All patients aged 17 or younger with glaucoma who underwent filtering surgery supplemented with mitomycin C at a tertiary care centre (n = 21) during a 5 year interval (1992 and 1996) were included. One eye for each patient was entered into the analysis. The postoperative intraocular pressure (IOP), use of antiglaucoma medications, clinical stability of glaucoma, complications, and visual acuity were retrospectively evaluated. Kaplan-Meier survival curves were used to estimate the probability of success.

RESULTS

At the time of surgery mean age was 5.7 (SD 5.0) years. The most common diagnoses were trabeculodysgenesis (n = 6) and aphakic glaucoma (n = 8). Mean IOP before surgery was 35.7 (10.5) mm Hg. Average length of follow up was 18.6 (14.7) months. The probability of having IOP less than 21 mm Hg with no antiglaucoma medications and with clinically stable glaucoma 1 year after surgery was 76.9% in phakic eyes (n = 13) and 0% in aphakic eyes (n = 8). A phakic patient with Sturge-Weber's syndrome had choroidal effusion after surgery that resolved spontaneously. In the aphakic group one patient had retinal detachment and another developed an encapsulated bleb. Visual acuity deteriorated in one patient.

CONCLUSION

A guarded filtration procedure with mitomycin C is relatively successful in phakic children with glaucoma, but unsuccessful in aphakic ones.

The association of some practice characteristics with antibiotic prescribing

BACKGROUND

Antibiotic prescribing in general practice is often considered inappropriate, and its volume excessive. Considerable variation in antibiotic prescribing volume and costs exists among practices.

OBJECTIVE

To investigate some factors behind the variation in antibiotic prescribing among general practices, by examining the contribution to this variation of the level of deprivation in the practice population, training status, partnership status, and fundholding status.

METHOD

Analysis of prescribing data (PACT) from 351 practices in the Mersey region for the year ending March 1991 and the year ending March 1994; prescribing data standardized for variation in practice population demography. Use of multiple linear regressions to investigate the variation among practices in standardized prescribing volume and standardized prescribing costs, in both years.

RESULTS

Level of deprivation, training status and partnership status contributed to the models explaining variation in prescribing volume. The same variables contributed to the model explaining variation in prescribing costs in the year ending March 1991. For the year ending March 1994, level of deprivation, training status, and fundholding status contributed to all models.

CONCLUSION

Higher levels of antibiotic prescribing occur in practices serving more deprived communities, in single-handed practices, and in non-training practices. These higher levels of prescribing may be due to higher levels of morbidity, but may also reflect the organization and attitudes of these practices.

CT bronchoscopy: optimization of imaging parameters

The authors evaluated the relative importance of the following scanning parameters at computed tomographic bronchoscopy in an anesthetized adult sheep's thorax: section thickness (2, 4, 8 mm), pitch (1.0, 1.5, 2.0), milliampere setting (100, 175, 250 mA), and overlap of reconstructed sections (0%, 25%, 50%, 75%). Five blinded readers ranked the images twice in comparison with photographs of the mounted specimen. Differences in image quality were significant (P < .001) with section thickness of 2 mm and a pitch of 1.0. The milliampere setting had only a minor effect on image quality, and a 50% overlap of reconstructed sections was best.

Radiative heat loss in gentoo penguin (Pygoscelis papua) adults and chicks and the importance of warm feet

Adult penguins and their chicks differ considerably in their apparent body insulation. The chicks are covered in down, whereas the adults have the short, hard body feathers characteristic of the family, so mechanisms of heat loss may vary considerably between the two groups. We examined radiative heat loss by measuring body surface temperatures of gentoo penguins (Pygoscelis papua) in Antarctica. At the time the birds were considered to be in their thermoneutral zone, and there was little or no wind. Measurements of infrared emission were made on breeding adults and in large downy, and thermally independent, chicks in relation to environmental temperature. All 28 external body surface sites measured were positively correlated with ambient temperature, although there was considerable intersite variability in the relationship between site temperature and ambient temperature. Foot temperature increased most rapidly per degree ambient temperature increase, followed by the flippers, followed by the trunk. This pattern was particularly pronounced in the chicks, indicating that the exceptional heat-loss capacities of the feet may counteract for the reduced capacity of the flippers. Net heat transfer by radiation was examined using Stefan-Boltzmann's law and preliminary data on the surface area of a gentoo penguin body. This showed that between ground temperatures of 5 degrees and 15 degrees C overall heat transfer remains essentially constant, although radiative heat loss from the trunk decreases, this being counteracted by increasing heat transfer from the flippers and feet. Over the same temperature range the specific radiation heat transfer of the feet increased approximately 100 times faster per degree ambient temperature increase than did that of the flippers. This and the bimodality in foot temperature found in the study birds even under constant ambient temperatures indicate that within the thermoneutral zone heat loss by radiation in gentoo penguins is primarily executed using the feet, through which the blood circulates in pulses.