The critical view of safety in laparoscopic cholecystectomy: towards a national consensus.

Laparoscopic Cholecystectomy (LC) is one of the commonest operations performed by surgeons today. Despite the decreasing incidence of bile duct injury (BDI) since the introduction of LC, it still remains a major complication today1. The commonest cause of BDI is misidentification of the anatomy of Calot\u27s Triangle. A technique of identification of this anatomy, called the critical view of safety (CVS), was first described by Strasberg et al. in the mid-nineties and has been shown to significantly reduce the incidence of BDI1-3. Despite its success, it has failed to gain universal acceptance and the infundibular approach to dissection is still being taught today

Quality and safety of milk from farm to dairy product

End of Project ReportNeutrophils (PMN cells) constitute one of the main cell types in milk. Increased PMN level is an indication of mastitis. An ELISA method has been developed to determine PMN levels in milk. This may allow (in addition to somatic cell count [SCC]) selection of infected quarters at drying off, thereby allowing antibiotic therapy to be limited to those quarters. PMN counts may also be used to select milk for processing. Little information is available on the contribution of different somatic cells in milk to cheese-making efficiency. The overall objective of this study was to establish the influence of the quality of raw milk, as determined by somatic cell level and type, on milk biochemistry and cheese quality. The work firstly included modification to a method for an enzyme immunoassay, which could enumerate milk PMN. Subsequently, the impact of somatic cell and PMN content on biochemistry of individual udder quarter milks and simulated bulk cow milks, and quality of cheese manufactured from such milks was investigated. The somatic cell and PMN content of bulk herd milks was also investigated. The modification to the test of O’Sullivan et al (1992) allowed the accurate measurement of PMN levels in milk. The strong relationship or correlation between SCC and PMN of 92% in the individual quarter milks has confirmed previous preliminary data. This is important since PMN in conjunction with SCC may now provide a more reliable method of selecting milks for processing. The reduction in casein at elevated SCC and PMN levels may have resulted in the trend towards deteriorated milk coagulation properties. A very heterogeneous selection of proteolysis patterns was observed in the miniature cheeses. This substantial difference in proteolytic activity in milk from different quarters had not been observed previously. Enzymes associated with the cells in high SCC milk were retained in the cheese curd and thus, contributed to proteolysis during ripening. Addition of low volumes of high SCC milk had an obvious impact on proteolysis patterns and cheese ripening. However, such trends were generally less clear with increasing PMN milk than those observed for addition of high SCC milk. The poor correlation between SCC and PMN obtained in both cow and herd bulk milks, compared to the correlation in quarter milks was probably due to the mixing of high and low SCC milks from either quarters or cows. Thus, the true effect of PMN may not be observed in bulk herd milk but may still have an adverse effect on milk quality. Whether elevated bulk milk SCC and PMN level is due to milk from a smaller number of cows with extremely high SCC/PMN being included with milk from a predominantly healthy herd, or, to large numbers of cows with sub-clinical infections, probably contributes to variation in the effects of SCC/PMN on dairy products

Suppression of reactive oxygen species generation in heart mitochondria from anoxic turtles: the role of complex I S-nitrosation.

Freshwater turtles (Trachemys scripta) are among the very few vertebrates capable of tolerating severe hypoxia and re-oxygenation without suffering from damage to the heart. As myocardial ischemia and reperfusion causes a burst of mitochondrial reactive oxygen species (ROS) in mammals, the question arises as to whether, and if so how, this ROS burst is prevented in the turtle heart. We find that heart mitochondria isolated from turtles acclimated to anoxia produce less ROS than mitochondria from normoxic turtles when consuming succinate. As succinate accumulates in the hypoxic heart and is oxidized when oxygen returns, this suggests an adaptation to lessen ROS production. Specific S-nitrosation of complex I can lower ROS in mammals and here we show that turtle complex I activity and ROS production can also be strongly depressed in vitro by S-nitrosation. We detect in vivo endogenous S-nitrosated complex I in turtle heart mitochondria, but these levels are unaffected upon anoxia acclimation. Thus, while heart mitochondria from anoxia-acclimated turtles generate less ROS and have a lower aerobic capacity than those from normoxic turtles, this is not due to decreases in complex I activity or expression levels. Interestingly, in-gel activity staining reveals that most complex I of heart mitochondria from normoxic and anoxic turtles forms stable super-complexes with other respiratory enzymes and, in contrast to mammals, these are not disrupted by dodecyl maltoside. Taken together, these results show that although S-nitrosation of complex I is a potent mechanism to prevent ROS formation upon re-oxygenation after anoxia in vitro, this is not a major cause of the suppression of ROS production by anoxic turtle heart mitochondria

Transition from electron accumulation to depletion at InGaN surfaces

The composition dependence of the Fermi-level pinning at the oxidized (0001) surfaces of n-type InxGa1−xN films (0<=x<=1) is investigated using x-ray photoemission spectroscopy. The surface Fermi-level position varies from high above the conduction band minimum (CBM) at InN surfaces to significantly below the CBM at GaN surfaces, with the transition from electron accumulation to depletion occurring at approximately x=0.3. The results are consistent with the composition dependence of the band edges with respect to the charge neutrality level

SelfPub 2.0

The self-publishing revolution has created a drastic increase in the number or works being published in the social sciences and humanities. This windfall of content has created an abundance that can be overwhelming, but it ultimately presents an opportunity for libraries to develop deeper and more unique collections. The preconference at the 2013 Charleston Conference focused on several interrelated topics in the self-publishing world: navigating the abundance of self-published material, libraries’ adoption of the role of publisher, vendor perspectives on self-published content and plans for the future, issues in humanities and social science acquisitions of self-published works, and an agent’s perspective on how self-publishing fits into the traditional publishing world. Speakers include librarians, publishers, vendors, and academics involved with a number of projects and efforts to pioneer this emerging field

Getting shot of elves: healing, witchcraft and fairies in the Scottish witchcraft trials

This paper re-examines the evidence of the Scottish witchcraft trials for beliefs associated by scholars with "elf-shot." Some supposed evidence for elf-shot is dismissed, but other material illuminates the interplay between illness, healing and fairy-lore in early modern Scotland, and the relationship of these beliefs to witchcraft itself

Three-year Treatment Outcomes in the Ahmed Baerveldt Comparison Study

To compare three year outcomes and complications of the Ahmed FP7 Glaucoma Valve (AGV) and Baerveldt 101–350 Glaucoma Implant (BGI) for the treatment of refractory glaucoma