COVID-19 opens the door for right iliac fossa pain treatment pathway.

INTRODUCTION: The COVID-19 pandemic has increased the risks of surgery and management of common surgical conditions has changed, with greater reliance on imaging and conservative management. The negative appendectomy rate (NAR) in the UK has previously remained high. The aim of this study was to quantify pandemic-related changes in the management of patients with suspected appendicitis, including the NAR. METHODS: A retrospective study was performed at a single high volume centre of consecutive patients aged over five years presenting to general surgery with right iliac fossa pain in two study periods: for two months before lockdown and for four months after lockdown. Pregnant patients and those with previous appendectomy, including right colonic resection, were excluded. Demographic, clinical, imaging and histological data were captured, and risk scores were calculated, stratifying patients into higher and lower risk groups. Data were analysed by age, sex and risk subgroups. RESULTS: The mean number of daily referrals with right iliac fossa pain or suspected appendicitis reduced significantly between the study periods, from 2.92 before lockdown to 2.07 after lockdown (p<0.001). Preoperative computed tomography (CT) rates increased significantly from 22.9% to 37.2% (p=0.002). The NAR did not change significantly between study periods (25.5% prior to lockdown, 11.1% following lockdown, p=0.159). Twelve (75%) out of sixteen negative appendectomies were observed in higher risk patients aged 16-45 years who did not undergo preoperative CT. The NAR in patients undergoing CT was 0%. CONCLUSIONS: Greater use of preoperative CT should be considered in risk stratified patients in order to reduce the NAR.

The impact of different Hormonal Growth Promotants (HGP) on desmin degradation and collagen content of various muscles from pasture and feedlot finished steer carcasses.

The impacts of several hormonal growth promotants (HGP) on Warner-Bratzler Shear Force (WBSF), desmin degradation ratio (DDR) and collagen content (COLL) were assessed. Treatments within feedlot and pasture finished steer carcasses (n = 60, n = 40, respectively) were control (CON-100-F and CON-400-P), oestradiol HGPs (OES-100-F and OES-400-P) and trenbolone acetate/oestradiol HGPs (TBA+OES-100-F only). The longissimus lumborum (LL), gluteus medius (GM), infraspinatus (IS), semitendinosus (ST,) and the LL and biceps femoris (BF) were collected from feedlot and pasture finished steers, respectively. All muscles were aged between 3 and 35 days. The LL from TBA+OES-100-F carcasses had increased WBSF and decreased DDR, which varied in magnitude with ageing (P < 0.05). The GM from OES-100-F steers also had lower DDR (P < 0.05). The feedlot HGP treatments had no impact on the WBSF of the IS, ST or GM and no impact on COLL in the LL. The OES-400-P had no impact on WBSF, DDRor COLL for both muscles (P > 0.05).

Does a single adjustment in the meat standards Australia beef grading model cater for different hormonal growth promotant formulations?

This paper investigated whether a single Hormonal Growth Promotant (HGP) adjustment in the Meat Standards Australia (MSA) beef grading model adequately predicted consumer eating quality of beef from cattle treated with different HGP formulations. This paper used consumer sensory data from two experiments. In experiment one, a total of 300 steers were allocated to three treatments; control (CON-100-F), 100 day oestradiol only HGP (OES-100-F), or a combination of trenbolone acetate and oestradiol HGP (TBA+OES-100-F) and finished in a feedlot for 73 days. In experiment two, a total of 200 steers were allocated either control or 400 day oestradiol only HGP treatments and finished on pasture for 389 days. Steers were slaughtered by finishing regime and carcass traits recorded. The anterior and posterior portions of the m. longissimus lumborum (LL-A and LL-P, respectively) and m. gluteus medius (GM) were collected and aged for five or 35 days. Grilled meat samples were scored for tenderness, juiciness, liking of flavour and overall acceptability using untrained consumers. Sensory scores were weighted by 0.3. 0.1, 0.3 and 0.3, respectively and summed to calculate a meat quality (MQ4) score. Residual MQ4 scores were calculated (observed MQ4 minus the predicted MQ4 score). The MSA model accounts for varied impacts of different HGPs on eating quality through a single HGP adjustment, and indirect impacts on carcass traits. For the majority of the HGP treatment samples, the residual MQ4 scores were not different to zero (5/18), or were positive i.e. the MSA model under-predicted these samples (11/18). Under-prediction was predominately for 35 day aged (7/9) and GM HGP treatment samples (6/6) and was considered low, with the majority less than ±5 MQ4 units. Under-prediction could be considered as advantageous through providing an additional safeguard to protect the interests of the consumers, rather than if the model had over-predicted and resulted in a more negative eating quality experience than expected. Some over-prediction was observed in the CON-100-F and TBA+OES-100-F treatment samples, which may be due to factors such as genetic variation and/or production environment. Minimal bias was observed when residual MQ4 was regressed against predicted MQ4 for the range of feeding regimes, muscles, ageing periods and treatment groups. This study showed that a single HGP adjustment in the MSA beef grading model, combined with the indirect effects of the different HGP formulations on carcass traits, provided a reasonable prediction of meat eating quality for different HGP formulations.

1HR ON-CALL - Using Simulated ON-CALL to Underpin Experiential Learning in Final Year Medical Students.

A survey of Blackpool Foundation Year One (FY1) doctors found limited training about being on-call. We could not find any direct mention in Tomorrow's Doctors for preparing undergraduates for this.1 1Tomorrow's Doctors: Outcomes and standards for undergraduate medical education [Internet]. 1st ed. 2009 [cited 30 February 2015]. Available from: http://www.gmc-uk.org/Tomorrow_s_Doctors_1214.pdf_48905759.pdf Working out of hours, on-call and with a reduced workforce is a known area of anxiety among junior doctors. With few examples in literature,2 2Dickinson M, Pimblett M, Hanson J, Davis M. Reflecting reality: pager simulations in undergraduate education. The Clinical Teacher. 2014;11(6):421-424.,3 3Fisher J, Martin R, Tate D. Hands on + hands free: simulated on-call interaction. The Clinical Teacher. 2014;11(6):425-428. we developed a novel approach to aiding final-year medical students prepare for this. A simulated teaching programme allowed students to experience the pressures of working on-call. We hoped to imitate stressors within a safe environment. Students were each given a bleep for an hour. Supervisors role-playing a concerned nurse "bleeped" the students. Each task was held in a folder on different wards (no patient interaction or information was involved). They were relatively simple and designed to stimulate resourcefulness, communication and triage skills. Various resources were available including the number for the medical registrar, played by supervisors. The final station was always the unwell patient aimed at drawing the student immediately to this scenario. A facilitated feedback session explored students' positive and negative experiences, concerns and coping mechanisms. Over the three years of this running, results were resoundingly positive with students taking great confidence from the programme. During the open feedback session, students valued using open wards and having to navigate in an unfamiliar hospital as a realistic preparation for next year. Being on-call is an inevitable part of a junior doctor's work and we believe there is scope for better preparation within undergraduate training. We have developed an effective and sustainable simulation that has shown excellent results. Due to the positive reaction and low maintenance of the project, we aim to cement our teaching programme as a permanent feature for undergraduate students at Blackpool Victoria Hospital.

Patient and physician perceptions of lung cancer care in a multidisciplinary clinic model.

Background: Lung cancer (lc) is a complex disease requiring coordination of multiple health care professionals. A recently implemented lc multidisciplinary clinic (mdc) at Kingston Health Sciences Centre, an academic tertiary care hospital, improved timeliness of oncology assessment and treatment. This study describes patient, caregiver, and physician experiences in the mdc. Methods: We qualitatively studied patient, caregiver, and physician experiences in a traditional siloed care model and in the mdc model. We used purposive sampling to conduct semi-structured interviews with patients and caregivers who received care in one of the models and with physicians who worked in both models. Thematic design by open coding in the ATLAS.ti software application (ATLAS.ti Scientific Software Development, Berlin, Germany) was used to analyze the data. Results: Participation by 6 of 72 identified patients from the traditional model and 6 of 40 identified patients from the mdc model was obtained. Of 9 physicians who provided care in both models, 8 were interviewed (2 respirologists, 2 medical oncologists, 4 radiation oncologists). Four themes emerged: communication and collaboration, efficiency, quality of care, and effect on patient outcomes. Patients in both models had positive impressions of their care. Patients in the mdc frequently reported convenience and a positive effect of family presence at appointments. Physicians reported that the mdc improved communication and collegiality, clinic efficiency, patient outcomes and satisfaction, and consistency of information provided to patients. Physicians identified lack of clinic space as an area for mdc improvement. Conclusions: This qualitative study found that a lc mdc facilitated patient communication and physician collaboration, improved quality of care, and had a perceived positive effect on patient outcomes.

Reducing the level of nutrition of twin-bearing ewes during mid to late pregnancy produces leaner prime lambs at slaughter.

The Australian prime lamb industry is seeking to improve lean meat yield (LMY) as a means to increasing efficiency and profitability across the whole value chain. The LMY of prime lambs is affected by genetics and on-farm nutrition from birth to slaughter and is the total muscle weight relative to the total carcass weight. Under the production conditions of south eastern Australia, many ewe flocks experience a moderate reduction in nutrition in mid to late pregnancy due to a decrease in pasture availability and quality. Correcting nutritional deficits throughout gestation requires the feeding of supplements. This enables the pregnant ewe to meet condition score (CS) targets at lambing. However, limited resources on farm often mean it is difficult to effectively manage nutritional supplementation of the pregnant ewe flock. The impact of reduced ewe nutrition in mid to late pregnancy on the body composition of finishing lambs and subsequent carcass composition remains unknown. This study investigated the effect of moderately reducing ewe nutrition in mid to late gestation on the body composition of finishing lambs and carcass composition at slaughter on a commercial scale. Multiple born lambs to CS2.5 target ewes were lighter at birth and weaning, had lower feedlot entry and exit weights with lower pre-slaughter and carcass weights compared with CS3.0 and CS3.5 target ewes. These lambs also had significantly lower eye muscle and fat depth when measured by ultrasound prior to slaughter and carcass subcutaneous fat depth measured 110 mm from the spine along the 12th rib (GR 12th) and at the C-site (C-fat). Although carcasses were ~5% lighter, results showed that male progeny born to ewes with reduced nutrition from day 50 gestation to a target CS2.5 at lambing had a higher percentage of lean tissue mass as measured by dual energy X-ray absorptiometry and a lower percentage of fat during finishing and at slaughter, with the multiple born progeny from CS3.0 and CS3.5 target ewes being similar. These data suggest lambs produced from multiple bearing ewes that have had a moderate reduction in nutrition during pregnancy are less mature. This effect was also independent of lamb finishing system. The 5% reduction in carcass weight observed in this study would have commercially relevant consequences for prime lamb producers, despite a small gain in LMY.

The Meat Standards Australia Index indicates beef carcass quality.

A simple index that reflects the potential eating quality of beef carcasses is very important for producer feedback. The Meat Standards Australia (MSA) Index reflects variation in carcass quality due to factors that are influenced by producers (hot carcass weight, rib fat depth, hump height, marbling and ossification scores along with milk fed veal category, direct or saleyard consignment, hormonal growth promotant status and sex). In addition, processor impacts on meat quality are standardised so that the MSA Index could be compared across time, breed and geographical regions. Hence, the MSA Index was calculated using achilles hung carcasses, aged for 5 days postmortem. Muscle pH can be impacted by production, transport, lairage or processing factors, hence the MSA Index assumes a constant pH of 5.6 and loin temperature of 7oC for all carcasses. To quantify the cut weight distribution of the 39 MSA cuts in the carcass, 40 Angus steers were sourced from the low (n=13), high (n=15) and myostatin (n=12) muscling selection lines. The left side of each carcass was processed down to the 39 trimmed MSA cuts. There was no difference in MSA cut distribution between the low and high muscling lines (P>0.05), although there were differences with nine cuts from the myostatin line (P<0.05). There was no difference in the MSA Index calculated using actual muscle percentages and using the average from the low and high muscling lines (R 2=0.99). Different cooking methods impacted via a constant offset between eating quality and carcass input traits (R 2=1). The MSA Index calculated for the four most commercially important cuts was highly related to the index calculated using all 39 MSA cuts (R 2=0.98), whilst the accuracy was lower for an index calculated using the striploin (R 2=0.82). Therefore, the MSA Index was calculated as the sum of the 39 eating quality scores predicted at 5 days ageing, based on their most common cooking method, weighted by the proportions of the individual cut relative to total weight of all cuts. The MSA Index provides producers with a tool to assess the impact of management and genetic changes on the predicted eating quality of the carcass. The MSA Index could also be utilised for benchmarking and to track eating quality trends at farm, supply chain, regional, state or national levels.

The impact of oestradiol only hormone growth promotants (HGPs) on the eating quality of pasture finished steer carcasses.

A total of 200 Bos indicus/Bos taurus cross steers were allocated to control (CON) and an oestradiol (OES) implant treatments and pasture finished for 389 days. Longissimus lumborum (LL) and gluteus medius (GM) samples were aged for 5 and 35 days. Live weight, carcass weight and ossification scores (P < 0.05) increased in OES relative to CON. The three-way interaction between treatment, days aged and muscle was significant (P < 0.05) for tenderness, overall liking and meat palatability, whereby the OES had lower scores relative to CON at 5 days in LL (P < 0.05), although the difference halved by 35 days. For the GM, OES scores at 5 days were lower than CON (P < 0.05), apart from like flavour, and differences reduced by 35 days. LL shear force was higher for OES at 5 days (P < 0.05), though not 35 days (P > 0.05), or the GM at 5 or 35 days (P > 0.05). OES samples had a higher calpastatin activity (P < 0.05) in the LL at 19 h post mortem.

A 3D imaging and visualization workflow, using confocal microscopy and advanced image processing for brachyuran crab larvae.

Confocal laser scanning microscopy is an excellent tool for nondestructive imaging of arthropods and can provide detailed information on morphology including fine surface detail. A methodology is presented here for the visualization by confocal microscopy of arthropods, using brachyuran crab zoeal stages as examples and postprocessing techniques derived from micro-CT protocols to improve the final images. This protocol is divided into description of the preprocessing steps (cleaning, staining, digesting and mounting), confocal laser scanning microscopy and data visualization using open-source, freeware programs ImageJ and Drishti. The advantages of using ImageJ to standardize stack data and Drishti for surface rendering are discussed. The methodology has been comprehensively tested using data acquired from all four brands of confocal microscope (Leica, Nikon, Olympus and Zeiss).

SEM-microphotogrammetry, a new take on an old method for generating high-resolution 3D models from SEM images.

The method we present here uses a scanning electron microscope programmed via macros to automatically capture dozens of images at suitable angles to generate accurate, detailed three-dimensional (3D) surface models with micron-scale resolution. We demonstrate that it is possible to use these Scanning Electron Microscope (SEM) images in conjunction with commercially available software originally developed for photogrammetry reconstructions from Digital Single Lens Reflex (DSLR) cameras and to reconstruct 3D models of the specimen. These 3D models can then be exported as polygon meshes and eventually 3D printed. This technique offers the potential to obtain data suitable to reconstruct very tiny features (e.g. diatoms, butterfly scales and mineral fabrics) at nanometre resolution. Ultimately, we foresee this as being a useful tool for better understanding spatial relationships at very high resolution. However, our motivation is also to use it to produce 3D models to be used in public outreach events and exhibitions, especially for the blind or partially sighted.

COMETARY SCIENCE. Thermal and mechanical properties of the near-surface layers of comet 67P/Churyumov-Gerasimenko.

Thermal and mechanical material properties determine comet evolution and even solar system formation because comets are considered remnant volatile-rich planetesimals. Using data from the Multipurpose Sensors for Surface and Sub-Surface Science (MUPUS) instrument package gathered at the Philae landing site Abydos on comet 67P/Churyumov-Gerasimenko, we found the diurnal temperature to vary between 90 and 130 K. The surface emissivity was 0.97, and the local thermal inertia was 85 ± 35 J m(-2) K(-1)s(-1/2). The MUPUS thermal probe did not fully penetrate the near-surface layers, suggesting a local resistance of the ground to penetration of >4 megapascals, equivalent to >2 megapascal uniaxial compressive strength. A sintered near-surface microporous dust-ice layer with a porosity of 30 to 65% is consistent with the data.

A macroalgal germling bioassay to assess biocide concentrations in marine waters.

A bioassay method using the early life stages (germlings) of macroalgae was developed to detect toxicity of anti-fouling paint biocides. A laboratory based bioassay using Ulva intestinalis and Fucus spiralis germlings was performed with 4 common anti-fouling biocides (tributyltin (TBT), Irgarol 1051, Diuron and zinc sulphate), over a range of environmentally relevant concentrations (0.0033-10 µg l(-1)). Comparison between the two species showed that germlings of U. intestinalis were better adapted for in-situ monitoring, as germlings of F. spiralis appeared to be too robust to display sufficient growth differences. The response of U. intestinalis germling growth appeared to reflect environmental biocide concentrations. Overall the developed method showed potential for the assessment of the sub-lethal effects of anti-fouling biocides on the early developmental stages of U. intestinalis.

Mineralization of Alvinella polychaete tubes at hydrothermal vents.

Alvinellid polychaete worms form multilayered organic tubes in the hottest and most rapidly growing areas of deep-sea hydrothermal vent chimneys. Over short periods of time, these tubes can become entirely mineralized within this environment. Documenting the nature of this process in terms of the stages of mineralization, as well as the mineral textures and end products that result, is essential for our understanding of the fossilization of polychaetes at hydrothermal vents. Here, we report in detail the full mineralization of Alvinella spp. tubes collected from the East Pacific Rise, determined through the use of a wide range of imaging and analytical techniques. We propose a new model for tube mineralization, whereby mineralization begins as templating of tube layer and sublayer surfaces and results in fully mineralized tubes comprised of multiple concentric, colloform, pyrite bands. Silica appeared to preserve organic tube layers in some samples. Fine-scale features such as protein fibres, extracellular polymeric substances and two types of filamentous microbial colonies were also found to be well preserved within a subset of the tubes. The fully mineralized Alvinella spp. tubes do not closely resemble known ancient hydrothermal vent tube fossils, corroborating molecular evidence suggesting that the alvinellids are a relatively recent polychaete lineage. We also compare pyrite and silica preservation of organic tissues within hydrothermal vents to soft tissue preservation in sediments and hot springs.

Carcase weight and dressing percentage are increased using Australian Sheep Breeding Values for increased weight and muscling and reduced fat depth.

Pre-slaughter live weight, dressing percentage, and hot standard carcase weight (HCWT) from the 2007, 2008, 2009 and 2010 birth-years of the Information Nucleus Flock Lambs (n=7325) were analysed using linear mixed effects models. Increasing the sire breeding value for post-weaning weight (PWWT), and c-site eye muscle depth (PEMD), and reducing the sire breeding value for fat depth (PFAT) all had positive impacts on HCWT. The magnitude of the PWWT effect was greater in pure bred Merinos compared to Maternal and Terminal sired progeny. The improved HCWT resulting from increased PEMD was entirely due to its impact on improving dressing percentage, given that it had no impact on pre-slaughter live weight. There were marked differences between sire types and dam breeds, with pure-bred Merinos having lower pre-slaughter weight, reduced dressing percentage, and lower HCWT than progeny from Terminal and Maternal sired lambs or progeny from Maternal (1st cross) dams.

You are in sync with me: neural correlates of interpersonal synchrony with a partner.

Interpersonal synchrony is characterized by a temporary alignment of periodic behaviors with another person. This process requires that at least one of the two individuals monitors and adjusts his/her movements to maintain alignment with the other individual (the referent). Interestingly, recent research on interpersonal synchrony has found that people who are motivated to befriend an unfamiliar social referent tend to automatically synchronize with their social referents, raising the possibility that synchrony may be employed as an affiliation tool. It is unknown, however, whether the opposite is true; that is, whether the person serving as the referent of interpersonal synchrony perceives synchrony with his/her partner or experiences affiliative feelings toward the partner. To address this question, we performed a series of studies on interpersonal synchrony with a total of 100 participants. In all studies, participants served as the referent with no requirement to monitor or align their behavior with their partners. Unbeknown to the participants, the timings of their "partner's" movements were actually determined by a computer program based on the participant's (i.e., referent's) behavior. Overall, our behavioral results showed that the referent of a synchrony task expressed greater perceived synchrony and greater social affiliation toward a synchronous partner (i.e., one displaying low mean asynchrony and/or a narrow asynchrony range) than with an asynchronous partner (i.e., one displaying high mean asynchrony and/or high asynchrony range). Our neuroimaging study extended these results by demonstrating involvement of brain areas implicated in social cognition, embodied cognition, self-other expansion, and action observation as correlates of interpersonal synchrony (vs. asynchrony). These findings have practical implications for social interaction and theoretical implications for understanding interpersonal synchrony and social coordination.

Translating science into the next generation meat quality program for Australian lamb.

This paper introduces a series of papers in the form of a special edition that reports phenotypic analyses done in parallel with genotypic analyses for the Australian Sheep Industry Cooperative Research Centre (Sheep CRC) using data generated from the information nucleus flock (INF). This has allowed new knowledge to be gained of the genetic, environment and management factors that impact on the carcase and eating quality, visual appeal, odour and health attributes of Australian lamb meat. The research described involved close collaboration with commercial partners across the supply chain in the sire breeding as well as the meat processing industries. This approach has enabled timely delivery and adoption of research results to industry in an unprecedented way and provides a good model for future research.

Effect of branched-chain fatty acids, 3-methylindole and 4-methylphenol on consumer sensory scores of grilled lamb meat.

Tenderness, flavour, overall liking and odour are important components of sheepmeat eating quality. Consumer assessment of these attributes has been made for carcasses from the Information Nucleus Flock (INF) of the Cooperative Research Centre for Sheep Industry Innovation. The concentrations of three branched chain fatty acids, 4-methyloctanoic (MOA), 4-ethyloctanoic (EOA) and 4-methylnonanoic acids (compounds related to 'mutton flavour' in cooked sheepmeat) and 3-methylindole and 4-methylphenol (compounds related to 'pastoral' flavour) were determined for 178 fat samples taken from INF carcasses. Statistical modelling revealed that both MOA and EOA impacted on the 'Like Smell' consumer sensory score of the cooked meat product (P<0.05), with increasing concentration causing lower consumer acceptance of the product. None of the compounds though had an effect on the liking of flavour. Obviously, reducing the effect of MOA and EOA on the odour of grilled lamb will improve consumer acceptance of the cooked product but other factors affecting the eating quality also need to be considered.

Associations of sire estimated breeding values and objective meat quality measurements with sensory scores in Australian lamb.

The impact of selecting for lean meat yield using breeding values for increased eye muscle depth (PEMD) and decreased fat depth (PFAT) on the consumer acceptance of lamb meat was evaluated. Consumer sensory scores (tenderness, juiciness, flavour, odour, overall liking) were obtained for the longissimus lumborum (loin) and semimembranosus (topside) muscles of 1471 lambs. On average loin samples were more acceptable for consumers. Sensory scores increased with higher IMF levels, with lower shear force levels, and when animals were younger and less muscular. Increasing PEMD decreased tenderness, overall liking and flavour scores in both muscles, and decreasing PFAT reduced tenderness within the loin samples only. This negative impact of PEMD and PFAT is not solely driven through the phenotypic impact of IMF and shear force on sensory scores. Our results confirm the growing concerns that selecting for lean meat yield would reduce consumer eating quality, and highlight that careful monitoring of selection programmes is needed to maintain lamb eating quality.

Intramuscular fat in the longissimus muscle is reduced in lambs from sires selected for leanness.

Selection for lean growth through Australian Sheep Breeding Values (ASBVs) for post weaning weight (PWWT), eye muscle depth (PEMD) and c-site fat depth (PFAT) raises concerns regarding declining intramuscular fat (IMF) levels. Reducing PFAT decreased IMF by 0.84% for Terminal sired lambs. PEMD decreased IMF by 0.18% across all sire types. Female lambs had higher IMF levels and this was unexplained by total carcass fatness. The negative phenotypic association between measures of muscling (shortloin muscle weight, eye muscle area) and IMF, and positive association between fatness and IMF, was consistent with other literature. Hot carcass weight increased IMF by 2.08% between 12 and 40 kg, reflective of development of IMF as lambs approach maturity. Selection objectives with low PFAT sires will reduce IMF, however the lower impact of PEMD and absence of a PWWT effect, will enable continued selection for lean growth without influencing IMF. Alternatively, the negative impact of PFAT could be off-set by inclusion of an IMF ASBV.