37 research outputs found

    Patients with pelvic fractures due to falls: A paradigm that contributed to autopsy-based audit of trauma in Greece

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    Integrated stratigraphy and palaeoenvironment of the P/E boundary interval, Rakhi Nala section, Indus Basin (Pakistan)

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    Marine sedimentary section across the Paleocene/Eocene (P/E) boundary interval is preserved in the Dungan Formation (Lower Indus Basin), Pakistan. Four dinoflagellate zones in the P/E interval of the Rakhi Nala section (Lower Indus Basin) are identified and correlated. The quantitative analysis of the dinoflagellate cyst assemblages together with geochemical data are used to reconstruct the palaeoenvironment across the P/E interval. The dinocyst assemblages allow the local correlation of the Dungan Formation (part) of the Sulaiman Range with the Patala Formation (part) of the Upper Indus Basin and global correlation of the Zone Pak-DV with the Apectodinium acme Zone of the Northern and Southern hemispheres. The onset of the carbon isotopic excursion (CIE) associated with Paleocene Eocene Thermal Maximum (PETM) is used globally to identify the P/E boundary. The CIE for the total organic carbon (fine fraction) δ13CFF is of a magnitude of −1.7‰ is recorded for the first time in the Indus Basin. The Apectodinium acme precedes and straddles the onset of the CIE in the Indus Basin. This Apectodinium acme is also accompanied by a planktonic and benthonic foraminifera “barren zone.” The CIE in the Indus Basin, coupled with the changes in the dinocyst distribution and the benthonic and planktonic foraminifera assemblages, provides evidence of the changes associated with the PETM in this little-known part of the world. The benthonic foraminiferal assemblage indicates bathyal environment of deposition at the time of P/E boundary interval; the presence of dominantly open marine dinoflagellates and high planktonic foraminiferal ratio suggest that the water column at this site was well connected with the rest of the Tethys

    Endoscopic stenting for hilar cholangiocarcinoma: efficacy of unilateral and bilateral placement of plastic and metal stents in a retrospective review of 480 patients

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    <p>Abstract</p> <p>Background</p> <p>Endoscopic biliary drainage of hilar cholangiocarcinoma is controversial with respect to the optimal types of stents and the extent of drainage. This study evaluated endoscopic palliation in patients with hilar cholangiocarcinoma using self-expandable metallic stents (SEMS) and plastic stents (PS).We also compared unilateral and bilateral stent placement according to the Bismuth classification.</p> <p>Methods</p> <p>Data on 480 patients receiving endoscopic biliary drainage for hilar cholangiocarcinoma between September 1995 and December 2010 were retrospectively reviewed to evaluate the following outcome parameters: technical success (TS), functional success (FS), early and late complications, stent patency and survival. Patients were followed from stent insertion until death or stent occlusion. Patients were divided into 3 groups according to the Bismuth classification (Group 1, type I; Group 2, type II; Group 3, type > III).</p> <p>Results</p> <p>The initial stent insertion was successful in 450 (93.8%) patients. TS was achieved in 204 (88.3%) patients treated with PS and in 246 (98.8%) patients palliated with SEMS (p < 0.001). In the intention-to-treat (ITT) analysis, the FS in patients treated with SEMS (97.9%) was significantly higher than in patients treated with PS (84.8%) (p < 0.001). Late complications occurred in 115 (56.4%) patients treated with PS and 60 (24.4%) patients treated with SEMS (p < 0.001). The median duration of stent patency in weeks (w) were as follows: 20 w in patients palliated with PS and 27 w in patients treated with SEMS (p < 0.0001). In Group 2, the median duration of PS patency was 17 w and 18 w for unilateral and bilateral placement, respectively (p = 0.0004); the median duration of SEMS patency was 24 w and 29 w for unilateral and bilateral placement, respectively (p < 0.0001). Multivariate analysis using the Poisson regression showed that SEMS placement (B = 0.48; <it>P</it> < 0.01) and bilateral deployment (B = 0.24; <it>P</it> < 0.01) were the only independent prognostic factors associated with stent patency.</p> <p>Conclusions</p> <p>SEMS insertion for the palliation of hilar cholangiocarcinoma offers higher technical and clinical success rates in the ITT analysis as well as lower complication rates and a superior cumulative stent patency when compared with PS placement in all Bismuth classifications. The cumulative patency of bilateral SEMS or PS stents was significantly higher than that of unilateral SEMS or PS stents, with lower occlusion rates in Bismuth II patients.</p

    The impact of cognitive testing on the welfare of group housed primates

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    Providing cognitive challenges to zoo-housed animals may provide enriching effects and subsequently enhance their welfare. Primates may benefit most from such challenges as they often face complex problems in their natural environment and can be observed to seek problem solving opportunities in captivity. However, the extent to which welfare benefits can be achieved through programmes developed primarily for cognitive research is unknown. We tested the impact of voluntary participation cognitive testing on the welfare of a socially housed group of crested macaques (Macaca nigra) at the Macaque Study Centre (Marwell Zoo). First, we compared the rate of self-directed and social behaviours on testing and non-testing days, and between conditions within testing days. Minimal differences in behaviour were found when comparing testing and non-testing days, suggesting that there was no negative impact on welfare as a result of cognitive testing. Lipsmacking behaviours were found to increase and aggressive interaction was found to decrease in the group as a result of testing. Second, social network analysis was used to assess the effect of testing on associations and interactions between individuals. The social networks showed that testing subjects increased their association with others during testing days. One interpretation of this finding could be that providing socially housed primates with an opportunity for individuals to separate from the group for short periods could help mimic natural patterns of sub-group formation and reunion in captivity. The findings suggest, therefore, that the welfare of captive primates can be improved through the use of cognitive testing in zoo environments
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