Cost-Effective Use of Silver Dressings for the Treatment of Hard-to-Heal Chronic Venous Leg Ulcers

Aim To estimate the cost-effectiveness of silver dressings using a health economic model based on time-to-wound-healing in hard-to-heal chronic venous leg ulcers (VLUs). Background Chronic venous ulceration affects 1–3% of the adult population and typically has a protracted course of healing, resulting in considerable costs to the healthcare system. The pathogenesis of VLUs includes excessive and prolonged inflammation which is often related to critical colonisation and early infection. The use of silver dressings to control this bioburden and improve wound healing rates remains controversial. Methods A decision tree was constructed to evaluate the cost-effectiveness of treatment with silver compared with non-silver dressings for four weeks in a primary care setting. The outcomes: ‘Healed ulcer’, ‘Healing ulcer’ or ‘No improvement’ were developed, reflecting the relative reduction in ulcer area from baseline to four weeks of treatment. A data set from a recent meta-analysis, based on four RCTs, was applied to the model. Results Treatment with silver dressings for an initial four weeks was found to give a total cost saving (£141.57) compared with treatment with non-silver dressings. In addition, patients treated with silver dressings had a faster wound closure compared with those who had been treated with non-silver dressings. Conclusion The use of silver dressings improves healing time and can lead to overall cost savings. These results can be used to guide healthcare decision makers in evaluating the economic aspects of treatment with silver dressings in hard-to-heal chronic VLUs

Odontocetes of the Southern Ocean sanctuary

Twenty-eight odontocete species were identified as occupying sub-Antarctic and Antarctic habitat covered by the 1994 IWC established Southern Ocean Sanctuary. Toothed whales evidently play an important part in the Antarctic polar ecosystem. Twenty-two species are autochthonous in showing a regular, apparently year-round, presence in the Sanctuary: Physeter macrocephalus, Kogia breviceps, Orcinus orca, Globicephala melas edwardii, Pseudorca crassidens, Lagenorhynchus cruciger, Lagenorhynchus obscurus, Lissodelphis peronii, Cephalorhynchus commersonii, Cephalorhynchus hectori, Tursiops truncatus, Delphinus delphis, Phocoena dioptrica, Hyperoodon planifrons, Berardius arnuxii, Ziphius cavirostris, Tasmacetus shepherdi, Mesoplodon layardii, Mesoplodon traversii, Mesoplodon grayi, Mesoplodon bowdoini and Mesoplodon hectori. Six species are considered vagrants into the Sanctuary: Kogia sima, Grampus griseus, Steno bredanensis, Mesoplodon peruvianus, Mesoplodon densirostris and Mesoplodon mirus. However, vagrant status of these three mesoplodonts is only provisionally assigned, considering that improved knowledge of diagnostic features of beaked whales should, as in recent years, continue to facilitate at sea identification. Two species are considered as having a ‘contiguous’ range (records less than 2° north of Sanctuary boundaries): Mesoplodon ginkgodens (at 39°S) and Mesoplodon mirus (at 38°24’S). The habitual southern range of at least four odontocetes extends significantly farther poleward than expected. G. melas edwardii is regularly encountered south of the Antarctic Polar Front, much like M. grayi which is known to reach the Ross Sea ice edge (ca. 67°S). Z. cavirostris and L. obscurus cross the Polar Front occasionally. The distribution of M. peruvianus and M. traversii and their relation to SST are unclear. Their southernmost records, 42°31’S and 44°17’S respectively, may either be extralimital or, more likely, reflect ordinary austral range. Temporally non-aligned distribution patterns of Hyperoodon planifrons in Antarctic and South African waters may suggest stock segregation

Using historical data to detect temporal changes in the abundances of intertidal species on Irish shores

An historical data set, collected in 1958 by Southward and Crisp, was used as a baseline for detecting change in the abundances of species in the rocky intertidal of Ireland. In 2003, the abundances of each of 27 species was assessed using the same methodologies (ACFOR [which stands for the categories: abundant, common, frequent, occasional and rare] abundance scales) at 63 shores examined in the historical study. Comparison of the ACFOR data over a 45-year period, between the historical survey and re-survey, showed statistically significant changes in the abundances of 12 of the 27 species examined. Two species (one classed as northern and one introduced) increased significantly in abundance while ten species (five classed as northern, one classed as southern and four broadly distributed) decreased in abundance. The possible reasons for the changes in species abundances were assessed not only in the context of anthropogenic effects, such as climate change and commercial exploitation, but also of operator error. The error or differences recorded among operators (i.e. research scientists) when assessing species abundance using ACFOR categories was quantified on four shores. Significant change detected in three of the 12 species fell within the margin of operator error. This effect of operator may have also contributed to the results of no change in the other 15 species between the two census periods. It was not possible to determine the effect of operator on our results, which can increase the occurrence of a false positive (Type 1) or of a false negative (Type 2) outcom

International Whaling Commission–Southern Ocean GLOBEC/CCAMLR collaboration. Scientific Committee document SC/55/E10, International Whaling Commission, May-June 2003, Berlin, Germany

Collaboration between the International Whaling Commission, and national programs conducting multidisciplinary ecosystem research in the Antarctic under Southern Ocean Global Ecosystem Dynamics (SO GLOBEC) program and the Commission for the Convention on Antarctic Marine Living Resources (CCAMLR) occurred during five research cruises between April 2002 and April 2003. Visual survey, passive acoustic and tissue biopsy work was conducted by IWC observers and collaborating passive acoustics scientists. Reported here are the preliminary results from these cruises: mapped distribution patterns of cetaceans from visual survey sighting data; individual photo identification records; species identification and positions of animals recorded on sonobuoys; and descriptions of environmental conditions observed or recorded as part of the multidisciplinary effort

Photo-identification confirms that humpback whales (Megaptera novaeangliae) from eastern Australia migrate past New Zealand but indicates low levels of interchange with breeding grounds of Oceania

Recent photo-identification and genetic studies have identified at least five discrete breeding populations in Australia and Oceania: western Australia (D), eastern Australia (E (i)), New Caledonia (E (ii)), Tonga (E (iii)), French Polynesia and the Cook Islands (F). Also evident are low levels of intermingling among breeding populations consistent with the degree of genetic differentiation. Photo-identification has confirmed linkages between Area V feeding areas and eastern Australia breeding grounds and one genotype match has been reported between Area V feeding areas and Oceania breeding grounds. Recent abundance estimates show strong increases in the eastern Australian population, and some recovery in the New Caledonia and Tonga populations, but with little evidence of recovery at other known Oceania breeding grounds or New Zealand. Studies to date have provided no conclusive evidence of the migratory destination of humpback whales passing through New Zealand waters en route between Antarctic feeding areas and tropical breeding grounds. Photo-identification comparisons were undertaken between humpback whale fluke catalogues from eastern Australia (EA, 1315), Oceania east (OE, 513), Oceania west (OW, 166) and New Zealand (NZ, 13). Five matches were found between OE/OW, four matches between OW/EA and three matches between NZ/EA. The data are used to investigate and discuss the migratory destination and breeding ground migratory terchange of humpback whales travelling through New Zealand waters. The data confirm that humpback whales with site fidelity to eastern Australia migrate past New Zealand including through the Cook Strait and Foveaux Strait

Septic hip abscess due to Fusobacterium nucleatum and Actinomyces turicensis in an immunocompetent SARS-CoV-2 positive patient

A 42-year-old man was referred to the Department of Orthopedic Surgery with pain over his right greater trochanter and signs of systemic infection. CT showed an enhanced mass in his gluteus maximus as well as gas in the biceps femoris over the underlying hip joint. Tissue biopsy yielded Fusobacterium nucleatum and Actinomyces turicensis. The patient was successfully treated for 6 weeks with amoxicillin/clavulanic acid 875mg/125mg and metronidazole 500mg

Abundance and distribution of sperm whales in the Canary Islands : can sperm whales in the Archipelago sustain the current level of ship-strike mortalities?

Funding was provided through an agreement between the Canary Islands Government and the Spanish Ministries of the Environment and Defence. Additional survey effort on the Amanay, Banquete and Concepción seamounts was funded by the Fundación Biodiversidad-MAGRAMA via the LIFE-INDEMARES project.Sperm whales are present in the Canary Islands year-round, suggesting that the archipelago is an important area for this species in the North Atlantic. However, the area experiences one of the highest reported rates of sperm whale ship-strike in the world. Here we investigate if the number of sperm whales found in the archipelago can sustain the current rate of ship-strike mortality. The results of this study may also have implications for offshore areas where concentrations of sperm whales may coincide with high densities of ship traffic, but where ship-strikes may be undocumented. The absolute abundance of sperm whales in an area of 52933 km2, covering the territorial waters of the Canary Islands, was estimated from 2668 km of acoustic line-transect survey using Distance sampling analysis. Data on sperm whale diving and acoustic behaviour, obtained from bio-logging, were used to calculate g(0) = 0.92, this is less than one because of occasional extended periods when whales do not echolocate. This resulted in an absolute abundance estimate of 224 sperm whales (95% log-normal CI 120-418) within the survey area. The recruitment capability of this number of whales, some 2.5 whales per year, is likely to be exceeded by the current ship-strike mortality rate. Furthermore, we found areas of higher whale density within the archipelago, many coincident with those previously described, suggesting that these are important habitats for females and immature animals inhabiting the archipelago. Some of these areas are crossed by active shipping lanes increasing the risk of ship-strikes. Given the philopatry in female sperm whales, replacement of impacted whales might be limited. Therefore, the application of mitigation measures to reduce the ship-strike mortality rate seems essential for the conservation of sperm whales in the Canary Islands.Publisher PDFPeer reviewe

Sex stereotypes influence adults' perception of babies' cries

Background: Despite widespread evidence that gender stereotypes influence human parental behavior, their potential effects on adults’ perception of babies’ cries have been overlooked. In particular, whether adult listeners overgeneralize the sex dimorphism that characterizes the voice of adult speakers (men are lower-pitched than women) to their perception of babies’ cries has not been investigated. Methods: We used playback experiments combining natural and re-synthesised cries of 3 month-old babies to investigate whether the interindividual variation in the fundamental frequency (pitch) of cries affected adult listeners’ identification of the baby’s sex, their perception the baby’s femininity and masculinity, and whether these biases interacted with their perception of the level of discomfort expressed by the cry. Results: We show that low-pitched cries are more likely to be attributed to boys and high-pitched cries to girls, despite the absence of sex differences in pitch. Moreover, low-pitched boys are perceived as more masculine and high-pitched girls are perceived as more feminine. Finally, adult men rate relatively low-pitched cries as expressing more discomfort when presented as belonging to boys than to girls. Conclusion: Such biases in caregivers’ responses to babies’ cries may have implications on children’s immediate welfare and on the development of their gender identity