Have patients with esophagitis got an increased risk of adenocarcinoma?:Results from a population-based study

To examine an increased risk of esophageal adenocarcinoma is restricted to patients who develop Barrett's esophagus or whether esophagitis per se is a risk factor for adenocarcinoma.

Forecasting invasions: resource use by mussels informs invasion patterns along the South African coast

Invasive species are often more able to rapidly and efficiently utilise resources than natives, and comparing per capita resource use at different resource densities among invaders and trophically analogous natives could allow for reliable predictions of invasiveness. In South Africa, invasion by the Mediterranean mussel Mytilus galloprovincialis has transformed wave-exposed shores, negatively affecting native mussel species. Currently, South Africa is experiencing a second mussel invasion with the recent detection of the South American Semimytilus algosus. We tested per capita uptake of an algal resource by invading M. galloprovincialis, S. algosus, and the native Aulacomya atra at different algal concentrations and temperatures, representing the west and south coasts of South Africa, to examine whether their per capita resource use could be a predictor of their spread and subsequent invasiveness. Regardless of temperature, M. galloprovincialis was the most efficient consumer, significantly reducing algal cells compared to the other species when the resource was presented in both low and high starting densities. Furthermore, these findings aligned with a greater biomass of M. galloprovincialis on the shore in comparison with the other species. Resource use by the new invader S. algosus was dependent on the density of resource and, although this species was efficient at low algal concentrations at cooler temperatures, this pattern broke down at higher algal densities. This was once more reflected in lower biomass in surveys of this species along the cool west coast. We therefore forecast that S. algosus will be become established along the south coast; however, we also predict that M. galloprovincialis will maintain dominance on these shores.

Directional performance in motion transparency

Motion transparency provides a challenging test case for our understanding of how visual motion, and other attributes, are computed and represented in the brain. However, previous studies of visual transparency have used subjective criteria which do not confirm the existence of independent representations of the superimposed motions. We have developed measures of performance in motion transparency that require observers to extract information about two motions jointly, and therefore test the information that is simultaneously represented for each motion. Observers judged whether two motions were at 90 to one another; the base direction was randomized so that neither motion taken alone was informative. The precision of performance was determined by the standard deviations (S.D.s) of probit functions fitted to the data. Observers also made judgments of orthogonal directions between a single motion stream and a line, for one of two transparent motions against a line and for two spatially segregated motions. The data show that direction judgments with transparency can be made with comparable accuracy to segregated (non-transparent) conditions, supporting the idea that transparency involves the equivalent representation of two global motions in the same region. The precision of this joint direction judgment is, however, 2–3 times poorer than that for a single motion stream. The precision in directional judgment for a single stream is reduced only by a factor of about 1.5 by superimposing a second stream. The major effect in performance, therefore, appears to be associated with the need to compute and compare two global representations of motion, rather than with interference between the dot streams per se. Experiment 2tested the transparency of motions separated by a range of angles from 5 to 180 by requiring subjects to set a line matching the perceived direction of each motion. The S.D.s of these settings demonstrated that directions of transparent motions were represented independently for separations over 20. Increasing dot speeds from 1 to 10 deg/s improved directional performance but had no effect on transparency perception. Transparency was also unaffected by variations of density between 0.1 and 19 dots/deg2

Mis-measure of animal contests.

Contests between rivals placing similar value on the resource at stake are commonly won by the rival having greater 'resource holding potential' (RHP). Mutual assessment of RHP difference between rivals is usually expected as an economical means of resolution; weaker rivals can retreat when they detect their relative inferiority, thereby avoiding costly, futile persistence. Models of contest resolution that entail retreat decisions based on estimates of RHP difference predict that contest duration diminishes as RHP difference between rivals increases because the asymmetry is more readily detected. This prediction appears to have been fulfilled in contests of diverse taxa, generating widespread support for assessment of RHP differences in contests. But few studies have considered alternatives in which each rival simply persists in accord with its own RHP ('own RHP-dependent persistence'). In contests decided by own RHP-dependent persistence, in which costs accrue only through each rival's own actions, weaker rivals retreat first because they are inherently less persistent, and contest duration depends primarily on the weaker (losing) rival's RHP rather than RHP difference between the rivals. We show here that the analyses most commonly used to detect effects of RHP difference cannot discriminate between these alternatives. Because RHP difference between rivals tends to be correlated with RHP of the weaker rival in a pair, a negative relation between RHP difference and contest duration may be generated even when decisions of retreat are not based on estimated RHP difference. Many studies purporting to show a negative relation between RHP difference and contest duration may actually reflect an incidental association between weaker rival RHP and RHP difference. We suggest statistical and experimental approaches that may help to discriminate between effects of weaker rival RHP and true effects of RHP difference. We also discuss whether 'true' negative effects of RHP difference on contest duration always reflect retreat decisions based on estimated RHP differences. Copyright 2003 Published by Elsevier Science Ltd on behalf of The Association for the Study of Animal Behaviour.

Wide Variation in Adenoma Detection Rates at Screening Flexible Sigmoidoscopy

Background & Aims: Wide between-center variation in adenoma detection rates (ADRs) was observed in the U.K. Flexible Sigmoidoscopy Screening Trial (overall, 12.1%; range, 8.6%-15.9%; P <0.0001). The aim of this study was to determine whether the observed differences could be attributed to varying performance by endoscopists, to examine the effect of experience on performance, and to identify an attainable, standard ADR to which endoscopists could aspire. 

Methods: Thirteen medical endoscopists, one per trial center, each performed about 3000 examinations (200 per month) using the same equipment and protocol. Overall and monthly ADRs were compared using multivariable logistic regression. 

Results: Differences in ADRs were not explained by patient characteristics, incidence of colorectal cancer in the local population, or the endoscopists' medical specialty or previous experience. Average ADRs increased significantly with screening experience (up to 400 examinations). Endoscopists were classified as higher, intermediate, or lower adenoma detectors, and performance levels were maintained over time. Higher detectors had ADRs of 15% overall (men, 20%; women, 10%) and also detected more adenomas per case (higher/lower detectors, 21.7/10.4 adenomas per :100 examinations). 

Conclusions: The differences in ADRs were due to variation in performance of the endoscopists. Long-term follow-up will determine whether this variation is clinically important. We suggest that the standards in higher detecting centers should be achievable by all endoscopists screening unscreened populations aged older than 55 years. Endoscopists should aim to stay above the lower 95% confidence interval band for 200 examinations (10% overall; 5% in women, 15% in men).

Ischemic preconditioning before lower limb ischemia-reperfusion protects against acute lung injury

Objective: Prolonged limb ischemia followed by reperfusion (I/R) is associated with a systemic inflammatory response syndrome and remote acute lung injury. Ischemic preconditioning (IPC), achieved with repeated brief periods of I/R before the prolonged ischemic period, has been shown to protect skeletal muscle against ischemic injury. The aim of this study was to ascertain whether IPC of the limb before I/R injury also attenuates systemic inflammation and acute lung injury in a fully resuscitated porcine model of hind limb I/R. Methods: This prospective, randomized, controlled, experimental animal study was performed in a university-based animal research facility with 18 male Landrace pigs that weighed from 30 to 35 kg. Anesthetized ventilated swine were randomized (n = 6 per group) to three groups: sham-operated control group, I/R group (2 hours of bilateral hind limb ischemia and 2.5 hours of reperfusion), and IPC group (three cycles of 5 minutes of ischemia/5 minutes of reperfusion immediately preceding I/R). Plasma was separated and stored at -70° C for later determination of plasma tumor necrosis factor-a and interleukin-6 with bioassay as markers of systemic inflammation. Circulating phagocytic cell priming was assessed with a whole blood chemiluminescence assay. Lung tissue wet-to-dry weight ratio and myeloperoxidase concentration were markers of edema and neutrophil sequestration, respectively. The alveolar-arterial oxygen gradient and pulmonary artery pressure were indices of lung function. Results: In a porcine model, bilateral hind limb (I/R) injury significantly increased plasma interleukin-6 concentrations, circulating phagocytic cell priming, and pulmonary leukosequestration, edema, and impaired gas exchange. Conversely, pigs treated with IPC before the onset of the ischemic period had significantly reduced interleukin-6 levels, circulating phagocytic cell priming, and experienced significantly less pulmonary edema, leukosequestration, and respiratory failure. Conclusion: Lower limb IPC protects against systemic inflammation and acute lung injury in lower limb I/R injury.

Allogenic Peripheral Blood Derived Mesenchymal Stem Cells (MSCs) Enhance Bone Regeneration in Rabbit Ulna Critical-Sized Bone Defect Model

Mesenchymal stem cells (MSCs) were demonstrated to exist within peripheral blood (PB) of several mammalian species including human, guinea pig, mice, rat, and rabbit. Whether or not the PB derived MSCs (PBMSCs) could enhance the regeneration of large bone defects have not been reported. In this study, rabbit MSCs were obtained from mononuclear cells (MNCs) cultures of both the PB and bone marrow (BM) origin. The number of PBMSCs was relatively lower, with the colony forming efficiency (CFE) ranging from 1.2-13 per million MNCs. Under specific inductive conditions, PBMSCs differentiated into osteoblasts, chondrocytes, and adipocytes, showing multi- differentiation ability similar to BMMSCs. Bilateral 20 mm critical-sized bone defects were created in the ulnae of twelve 6-month old New Zealand white rabbits. The defects were treated with allogenic PBMSCs/Skelite (porous calcium phosphate resorbable substitute), BMMSCs/Skelite, PBMNCs/Skelite, Skelite alone and left empty for 12 weeks. Bone regeneration was evaluated by serial radiography, peripheral quantitative computed tomography (pQCT), and histological examinations. The x-ray scores and the pQCT total bone mineral density in the PBMSCs/Skelite and BMMSCs/Skelite treated groups were significantly greater than those of the PBMNCs/Skelite and Skelite alone groups (p

Ovariole number - a predictor of differential reproductive success among worker subfamilies in queenless honeybee (Apis mellifera L.) colonies

A honeybee queen normally mates with 10-20 drones, and reproductive conflicts may arise among a colony's different worker patrilines, especially after a colony has lost its single queen and the workers commence egg laying. In this study, we employed microsatellite markers to study aspects of worker reproductive competition in two queenless Africanized honeybee colonies. First, we determined whether there was a bias among worker patrilines in their maternity of drones and, second, we asked whether this bias could be attributed to differences in the degree of ovary activation of workers. Third, we relate these behavioral and physiological factors to ontogenetic differences between workers with respect to ovariole number. Workers from each of three (colony A) and one (colony B) patrilineal genotypes represented less than 6% of the worker population, yet each produced at least 13% of the drones in a colony, and collectively they produced 73% of the drones. Workers representing these genotypes also had more developed follicles and a greater number of ovarioles per ovary. Across all workers, ovariole development and number were closely correlated. This suggests a strong effect of worker genotype on the development of the ovary already in the postembryonic stages and sets a precedent to adult fertility, so that

Energetics and litter size variation in domestic dog Canis familiaris breeds of two sizes

We measured resting metabolic rate (RMR), daily energy expenditure (DEE) and metabolisable energy intake (MEI) in two breeds of dog during peak lactation to test whether litter size differences were a likely consequence of allometric variation in energetics. RMR of Labrador retrievers (30 kg, n = 12) and miniature Schnauzers (6 kg, n = 4) averaged 3437 and 1062 kJ/day, respectively. DEE of Labradors (n = 6) and Schnauzers (n = 4) averaged 9808 and 2619 kJ/day, respectively. MEI of Labradors (n = 12) was 22448 kJ/day and of Schnauzers (a = 7) was 5382 kJ/day. DEE of Labrador pups (2.13 kg, n = 19) was 974 kJ/day and Schnauzers (0.89 kg, n = 7) were 490 kJ/day. Although Labradors had higher MEIs than Schnauzers during peak lactation, there was no difference in mass-specific energy expenditure between the two breeds. Hence, it is unlikely that litter size variation is a likely consequence of differences in maternal energy expenditure. Individual offspring were relatively more costly for mothers of the smaller breed to produce. Therefore, litter size variations were consistent with the expectation that smaller offspring should be more costly for mothers, but not that smaller mothers should per se invest more resources in reproduction. (C) 2001 Elsevier Science Inc. All rights reserved.

A randomized controlled trial of tea tree oil (5%) body wash versus standard body wash to prevent colonization with methicillin-resistant Staphylococcus aureus (MRSA) in critically ill adults: research protocol

Background
Over the past ten years MRSA has become endemic in hospitals and is associated with increased healthcare costs. Critically ill patients are most at risk, in part because of the number of invasive therapies that they require in the intensive care unit (ICU). Washing with 5% tea tree oil (TTO) has been shown to be effective in removing MRSA on the skin. However, to date, no trials have evaluated the potential of TTO body wash to prevent MRSA colonization or infection. In addition, detecting MRSA by usual culture methods is slow. A faster method using a PCR assay has been developed in the laboratory, but requires evaluation in a large number of patients.

Methods/Design
This study protocol describes the design of a multicentre, phase II/III prospective open-label randomized controlled clinical trial to evaluate whether a concentration of 5% TTO is effective in preventing MRSA colonization in comparison with a standard body wash (Johnsons Baby Softwash) in the ICU. In addition we will evaluate the cost-effectiveness of TTO body wash and assess the effectiveness of the PCR assay in detecting MRSA in critically ill patients. On admission to intensive care, swabs from the nose and groin will be taken to screen for MRSA as per current practice. Patients will be randomly assigned to be washed with the standard body wash or TTO body wash. On discharge from the unit, swabs will be taken again to identify whether there is a difference in MRSA colonization between the two groups.

Discussion
If TTO body wash is found to be effective, widespread implementation of such a simple colonization prevention tool has the potential to impact on patient outcomes, healthcare resource use and patient confidence both nationally and internationally.

Trial Registration
[ISRCTN65190967]

Murder and the Ruthless Risk-Taker

The main focus of this article is the ways in which the problem of reckless murder is dealt with in the common law world. In a case of reckless murder it may not be possible to prove that the accused set out to kill or do serious injury; but the killing is nevertheless thought to merit classification as murder rather than manslaughter. This may be because the case is thought to be analytically indistinguishable from murder, or because the level of culpability demonstrated by the conduct in question is thought to deserve that stigma on other grounds. This article seeks, by reference to various common law systems, to analyse the different techniques used to classify the reckless killer as a murderer, and to compare their advantages and disadvantages in the light of the different rationales used to justify such a classification. The article concludes by arguing that the question whether reckless killers should be classified as murderers—and if so how—can only be decided by reference to broader conceptions of the nature of criminal culpability.

Inter- and intrapersonal processes underlying authoritarianism: The role of social conformity and personal need for structure

Several personality constructs have been theorised to underlie right-wing authoritarianism (RWA). In samples from New Zealand and Germany (Ns = 218, 259), we tested whether these constructs can account for specific variance in RWA. In both samples, social conformity and personal need for structure were independent predictors of RWA. In Sample 2, where also openness to experience was measured, social conformity and personal need for structure fully mediated the impact of the higher-order factor of openness on RWA. Our results contribute to the integration of current approaches to the personality basis of authoritarianism. and suggest that two distinct personality processes contribute to RWA: An interpersonal process related to social conformity and an intrapersonal process related to rigid cognitive style. Copyright (C) 2009 John Wiley & Sons, Ltd.

The police officer's terrorist dilemma: Trust resilience following fatal errors

Suicide attacks have raised the stakes for officers deciding whether or not to shoot a suspect ('Police Officer's Terrorist Dilemma'). Despite high-profile errors we know little about how trust in the police is affected by their response to the terrorist threat. Building on a conceptualisation of lay observers as intuitive signal detection theorists, a general population sample (N= 1153) were presented with scenarios manipulated in terms of suspect status (Armed/Unarmed), officer decision (Shoot/Not Shoot) and outcome severity (e.g. suspect armed with Bomb/Knife; police shoot suspect/ suspect plus child bystander). Supporting predictions, people showed higher trust in officers who made correct decisions. reflecting good discrimination ability and who decided to shoot, reflecting an 'appropriate' response bias given the relative costs and benefits. This latter effect was moderated by (a) outcome severity, suggesting it did not simply reflect a preference for a particular type of action, and (b) preferences for a tough stance towards terrorism indexed by Right-Wing Authoritarianism (RWA). Despite loss of civilian life, failure to prevent minor terror attacks resulted in no loss of trust amongst people low in RWA. whereas among people high in RWA trust was positive when police erroneously shot all unarmed suspect. Relations to alternative definitions of trust and procedural justice research are discussed. Copyright (C),. 2007 John Wiley & Sons, Ltd.