Acute Hand Injury in Surfing: A Case Report.

Hand injuries from surfing tend to be severe and require medical attention. Follow-up of a surfing injury is difficult because many patients are visiting and go home after treatment. We report a case of a surfing hand injury sustained abroad, which was treated upon the patient's return, allowing for follow-up. The mechanism of injury was traction and torsion from the surfboard leash while surfing. The patient was initially treated for nailbed injury but presented later back home after persistent pain, for which an unstable distal phalanx fracture in their right ring finger was found by x-ray. This was surgically reduced with K-wire insertion and nailbed repair. Postoperatively, the injured finger was kept in a splint, and the patient had physiotherapy. Pain was significantly reduced, and the patient regained sufficient function. Considering a fracture as a differential for finger injury caused by the surfboard leash may prevent management delays. Injury may be prevented through education and redesign of the surfboard leash.

Use of a behavioural response method to assess the risk of collision between migrating humpback whales and vessels.

With the substantial increase in many large whale populations, paired with the rise in global shipping and recreational vessel activity, it is not surprising that negative interactions between whales and vessels are increasing. Here, the collision risk between migrating groups of humpback whales (Megaptera novaeangliae) and vessels was assessed by determining if changes in their movement trajectories in response to an oncoming vessel translated to vessel avoidance. It was assumed groups would implement an escape response strategy, using cues such as the vessel speed, trajectory, proximity, and received level of noise to inform their response magnitude. However, many groups were unresponsive to an approaching vessel such that the vessel had to take evasive action. This study shows that humpback whales are not likely to take sufficient avoidance action when there is a potential for a vessel and whale to collide. Therefore, when developing a risk management strategy, mitigation measures that reduce the encounter rate between whales and vessels are likely to be the most effective.

A novel RT-qPCR health assay reveals differential expression of stress and immunoregulatory genes between the seasonal migrations of humpback whales (Megaptera novaeangliae).

Health information is essential for the conservation management of whale species. However, assessing the health of free-ranging whales is challenging as samples are primarily limited to skin and blubber tissue. Reverse transcription quantitative polymerase chain reaction (RT-qPCR) offers a method to measure health from blubber RNA, providing insights into energetic status, stress and immune activity. To identify changes in health, natural differences in baseline gene expression linked to an individual's sex, reproductive status and life-history stage must first be quantified. This study aimed to establish baseline gene expression indices of health in migrating humpback whales (Megaptera novaeangliae). To do this, we developed an assay to quantify seven health-related gene transcripts (Leptin, Leptin Receptor, Adiponectin, Aryl Hydrocarbon Receptor, Tumour Necrosis Factor-α, Interleukin-6, Heat Shock Protein-70) and used Bayesian mixed effect models to assess differential baseline expression based on sex, lactation status and migration stage (northbound to and southbound from the annual breeding grounds). Results showed no significant contribution of sex to differential baseline expression. However, lactating individuals exhibited downregulated AhR and HSP-70 compared to non-lactating conspecifics. Additionally, southbound individuals demonstrated significantly upregulated HSP-70 and downregulated TNF-alpha, suggesting a relationship between these inflammation-linked transcripts and migratory fasting. Our results suggest that baseline differences due to migratory stage and lactation status should be considered in health applications of this assay. Future monitoring efforts can use our baseline measurements to better understand how gene expression is tied to population-level impacts, such as reduced prey availability or migratory stressors.

The Hand and Wrist: AntImicrobials and Infection (HAWAII) trial.

BACKGROUND: Hand trauma, comprising injuries to both the hand and wrist, affects over five million people per year in the NHS, resulting in 250 000 operations each year. Surgical site infection (SSI) following hand trauma surgery leads to significant morbidity. Triclosan-coated sutures may reduce SSI in major abdominal surgery but have never been tested in hand trauma. Feasibility needs to be ascertained before a definitive trial can be delivered in hand trauma. METHODS: A multicentre feasibility RCT of antimicrobial sutures versus standard sutures involving adults undergoing surgery for hand trauma to evaluate feasibility for a definitive trial. Secondary objectives were incidence of SSI in both groups, hand function measured with patient-reported outcome measures, health-related quality of life and change in employment. Randomization was performed on a 1:1 basis, stratified by age of the patient and whether the injury was open or closed, using a secure, centralized, online randomization service. Participants were blinded to allocation. RESULTS: 116 participants were recruited and randomized (60 intervention, 56 control). Of 227 screened, most were eligible (89.5 per cent), and most who were approached agreed to be included in the study (84.7 per cent). Retention was low: 57.5 per cent at 30 days, 52 per cent at 90 days and 45.1 per cent at 6 months. Incidence of SSI was >20 per cent in both groups. Hand function deteriorated after injury but recovered to near pre-injury levels during the study period. CONCLUSIONS: Risk of SSI after hand trauma is high. A definitive RCT of antimicrobial sutures in hand trauma surgery is feasible, if retention is improved. TRIAL REGISTRATION: ISRCTN10771059.

Post-whaling shift in mating tactics in male humpback whales.

Recent studies have shown behavioural plasticity in mating strategies can increase a population's ability to cope with anthropogenic impacts. The eastern Australian humpback whale population was whaled almost to extinction in the 1960s (~200 whales) and has recovered to pre-whaling numbers (>20,000 whales). Using an 18-year dataset, where the population increased from approximately 3,700 to 27,000 whales, we found that as male density increased over time, the use of mating tactics shifted towards more males engaging in non-singing physical competition over singing. Singing was the more successful tactic in earlier post-whaling years whereas non-singing behaviour was the more successful tactic in later years. Together, our study uncovers how changes in both local, and population-level male density resulted in a shift in the frequency, and fitness pay-off, of alternative mating tactics in a wild animal. This individual-level plasticity in male humpback whale mating tactics likely contributed to minimising their risk of extinction following a dramatic change in their social landscape due to whaling.

A mammalian messenger RNA sex determination method from humpback whale (Megaptera novaeangliae) blubber biopsies.

The large size of free-ranging mysticetes, such as humpback whales (Megaptera novaeangliae), make capture and release health assessments unfeasible for conservation research. However, individual energetic condition or reproductive health may be assessed from the gene expression of remotely biopsied tissue. To do this, researchers must reliably extract RNA and interpret gene expression measurements within the context of an individual's sex. Here, we outline an RNA extraction protocol from blubber tissue and describe a novel mammalian RNA sex determination method. Our method consists of a duplex reverse transcription-quantitative (real-time) polymerase chain reaction (RT-qPCR) with primer sets for a control gene (ACTB) and the X-chromosome inactivation gene (XIST). Products of each RT-qPCR had distinct melting temperature profiles based on the presence (female) or absence (male) of the XIST transcript. Using high-resolution melt analysis, reactions were sorted into one of two clusters (male/female) based on their melting profiles. We validated the XIST method by comparing results with a standard DNA-based method. With adequate quantities of RNA (minimum of approx. 9 ng µl-1), the XIST sex determination method shows 100% agreement with traditional DNA sex determination. Using the XIST method, future cetacean health studies can interpret gene expression within the context of an individual's sex, all from a single extraction.

A sampling, exposure and receptor framework for identifying factors that modulate behavioural responses to disturbance in cetaceans.

The assessment of behavioural disturbance in cetacean species (e.g. resulting from exposure to anthropogenic sources such as military sonar, seismic surveys, or pile driving) is important for effective conservation and management. Disturbance effects can be informed by Behavioural Response Studies (BRSs), involving either controlled exposure experiments (CEEs) where noise exposure conditions are presented deliberately to meet experimental objectives or in opportunistic contexts where ongoing activities are monitored in a strategic manner. In either context, animal-borne sensors or in situ observations can provide information on individual exposure and disturbance responses. The past 15 years of research have greatly expanded our understanding of behavioural responses to noise, including hundreds of experiments in nearly a dozen cetacean species. Many papers note limited sample sizes, required knowledge of baseline behaviour prior to exposure and the importance of contextual factors modulating behavioural responses, all of which in combination can lead to sampling biases, even for well-designed research programs. It is critical to understand these biases to robustly identify responses. This ensures outcomes of BRSs help inform predictions of how anthropogenic disturbance impacts individuals and populations. Our approach leverages concepts from the animal behaviour literature focused on helping to avoid sampling bias by considering what shapes an animal's response. These factors include social, experience, genetic and natural changes in responsiveness. We developed and applied a modified version of this framework to synthesise current knowledge on cetacean response in the context of effects observed across marine and terrestrial taxa. This new 'Sampling, Exposure, Receptor' framework (SERF) identifies 43 modulating factors, highlights potential biases, and assesses how these vary across selected focal species. In contrast to studies that identified variation in 'Exposure' factors as a key concern, our analysis indicated that factors relating to 'Sampling' (e.g. deploying tags on less evasive individuals, which biases selection of subjects), and 'Receptor' (e.g. health status or coping style) have the greatest potential for weakening the desired broad representativeness of BRSs. Our assessment also highlights how potential biases could be addressed with existing datasets or future developments.

Gender representation on journal editorial boards in the field of veterinary sciences.

Despite the increased entry of women into the veterinary profession over the past several decades, women remain substantially underrepresented in senior leadership positions. This may include editorial positions at veterinary sciences journals. This study examines the gender distribution of editorships of 143 journals from the Thomson Reuters Web of Knowledge Journal Citation Reports category of veterinary science. The gender analysis was performed by impact factor, editorial board role, country and publisher. Females were underrepresented in the group of managing editors (32.2% females vs 67.2% males), editors (34.5% females vs 65.1% males) and others (33.3% females vs. 65.4% males). The journal impact factor did not have a significant impact on the proportion of males versus females on the editorial board. The median publisher had 27.5% editorships belonging to women. North America Europe and Oceania showed the greatest representation of women on editorial boards. Our findings provide the first measure of gender distribution on editorial boards in the veterinary sciences and may stimulate a discussion on the current situation of women in academic positions and, in particular, on editorial boards. Further research should investigate the underlying causes contributing to this aspect of gender inequality and identify possible strategies to encourage a greater participation of women to editorial boards.

Song complexity is maintained during inter-population cultural transmission of humpback whale songs.

Among animal species, the songs of male humpback whales (Megaptera novaeangliae) are a rare example of social learning between entire populations. Understanding fine-scale similarity in song patterns and structural features will better clarify how accurately songs are learned during inter-population transmission. Here, six distinct song types (2009-2015) transmitted from the east Australian to New Caledonian populations were quantitatively analysed using fine-scale song features. Results found that New Caledonian whales learned each song type with high accuracy regardless of the pattern's complexity. However, there were rare instances of themes (stereotyped patterns of sound units) only sung by a single population. These occurred more often in progressively changing 'evolutionary' songs compared to rapidly changing 'revolutionary' songs. Our results suggest that populations do not need to reduce complexity to accurately learn song patterns. Populations may also incorporate changes and embellishments into songs in the form of themes which are suggested to be learnt as distinct segments. Maintaining complex song patterns with such accuracy suggests significant acoustic contact, supporting the hypothesis that song learning may occur on shared feeding grounds or migration routes. This study improves the understanding of inter-population mechanisms for large-scale cultural transmission in animals.

Humpback whale adult females and calves balance acoustic contact with vocal crypsis during periods of increased separation.

Acoustic communication is important for animals with dependent young, particularly when they are spatially separated. Maternal humpback whales (Megaptera novaeangliae) use acoustic calling to help minimize the risk of separation from their young calves during migration. These pairs also use acoustic crypsis to minimize detection by males. How they balance a restricted active space with the need to maintain acoustic contact during periods of separation is not yet understood. Here, we analyzed movement metrics of tagged adult female-calf pairs during migration to identify two behavioral states, "resting/milling" and "travelling." When travelling, these pairs dived synchronously and exhibited little to no spatial separation. Alternatively, adult females had significantly longer dive durations (p < .01) when resting, and while they spent prolonged times at depth, calves would surface several times independently. This demonstrated that these pairs are frequently separated during periods of rest. We then determined whether the call rates and acoustic levels of these pairs increased with more frequent separation, finding that both adult females and calves significantly increased their call rates, but not levels, when resting. We also found that adult female-calf pairs have a restricted active space, with less than 15% of calls estimated to be detectable beyond 2 km. However, as with call level, detection distance did not differ significantly between the two behavioral states. In summary, adult female-calf pairs maintain successful communication during periods of separation by calling more frequently rather than by producing louder calls. This strategy aids in maintaining acoustic contact while simultaneously limiting detectability by conspecifics.

Women Representation and Gender Equality in Different Academic Levels in Veterinary Science.

Women's participation and completion at veterinary schools has increased globally for the past few decades. However, increased female graduates have not translated into similar patterns of academic staffing. The gender distribution within each academic level at eight accredited veterinary faculties in Australia and New Zealand, 38 accredited faculties in the USA and Canada and 98 accredited faculties in Europe were analyzed. Women occupied 47.9%, 45.5% and 47.5% of the academic positions in Australia/New Zealand, the USA/Canada and Europe, respectively. Compared to their male counterparts, female academics were more likely to hold the lower ranked positions. The gender distribution is skewed toward men in the senior positions at or above associate professor level in all analyzed regions. The findings of this study confirm gender inequality in academic progression meaning there is a continued need to develop strategies to eliminate inequity in veterinary science faculties worldwide.

Fuzzy clustering as a tool to differentiate between discrete and graded call types.

Animals may communicate potential information to conspecifics using stereotyped "discrete" calls and variable "graded" calls. However, animal vocal research often centers on identifying the number of call types in a repertoire rather than quantifying the amount of gradation. Here, fuzzy clustering was applied to the social call repertoire of a species with a complex communication system, the humpback whale (Megaptera novaeangliae). Of 26 call types, 6 were classified as discrete, 7 as graded, and 13 as intermediate. These results indicate that humpback whales have a graded call repertoire, and fuzzy clustering may be a useful approach to investigate this variability.

Ships and air guns reduce social interactions in humpback whales at greater ranges than other behavioral impacts.

Understanding the interactions between human activity in the ocean and marine mammals is a fundamental step to developing responsible mitigation measures and informing policy. Here, the response of migrating humpback whales to vessels towing seismic air gun arrays (on or off) was quantified as a reduction in their likelihood of socially interacting (joining together). Groups were significantly less likely to participate in a joining interaction in the presence of a vessel, regardless of whether or not the air guns were active. This reduction was especially pronounced in groups within a social environment that favored joining, that is, when singing whales or other groups were nearby. Seismic survey mitigation practices are designed primarily to prevent damage to whales' hearing from close-by sources. Here, we found potentially detrimental behavioral changes at much greater ranges, and much lower received levels, than those used for current mitigation recommendations.

Blubber cortisol levels in humpback whales (Megaptera novaeangliae): A measure of physiological stress without effects from sampling.

Baleen whales are vulnerable to environmental impacts due to low fecundity, capital breeding strategies, and their reliance on a large amount of prey resources over large spatial scales. There has been growing interest in monitoring health and physiological stress in these species but, to date, few measures have been validated. The purpose of this study was to examine whether blubber cortisol could be used as a measure of physiological stress in humpback whales. Cortisol concentrations were initially compared between live, presumably 'healthy' whales (n = 187) and deceased whales (n = 35), which had died after stranding or entanglement, or washed ashore as a carcass. Deceased whales were found to have significantly higher cortisol levels (mean ± SD; 5.47 ± 4.52 ng/g) than live whales (0.51 ± 0.14 ng/g; p < 0.001), particularly for those animals that had experienced prolonged trauma (e.g. stranding) prior to death. Blubber cortisol levels in live whales were then examined for evidence of life history-related, seasonal, or sampling-related effects. Life history group and sampling-related factors, such as encounter time and the number of biopsy sampling attempts per animal, were found to be poor predictors of blubber cortisol levels in live whales. In contrast, blubber cortisol levels varied seasonally, with whales migrating north towards the breeding grounds in winter having significantly higher levels (0.54 ± 0.21 ng/g, p = 0.016) than those migrating south towards the feeding grounds in spring (0.48 ± 1.23 ng/g). These differences could be due to additional socio-physiological stress experienced by whales during peaks in breeding activity. Overall, blubber cortisol appears to be a suitable measure of chronic physiological stress in humpback whales.

The effects of vessel noise on the communication network of humpback whales.

Humpback whales rely on acoustic communication to mediate social interactions. The distance to which these social signals propagate from the signaller defines its communication space, and therefore communication network (number of potential receivers). As humpback whales migrate along populated coastlines, they are likely to encounter noise from vessel traffic which will mask their social signals. Since no empirical data exist on baleen whale hearing, the consequences of this are usually assumed, being the modelled reduction in their communication space. Here, the communication space and network of migrating humpback whales was compared in increasing wind-dominated and vessel-dominated noise. Behavioural data on their social interactions were then used to inform these models. In typical wind noise, a signaller's communication space was estimated to extend to 4 km, which agreed with the maximum separation distance between groups that socially interacted. An increase in vessel noise reduced the modelled communication area, along with a significant reduction in group social interactions, probably due to a reduction in their communication network. However, signal masking did not fully explain this change in social behaviour, implying there was also an additional effect of the physical presence of the vessel on signaller and receiver behaviour. Though these observed changes in communication space and social behaviour were likely to be short term and localized, an increase in vessel activity due to tourism and coastal population growth may cause more sustained changes along the humpback whale migration paths.

Network analysis reveals underlying syntactic features in a vocally learnt mammalian display, humpback whale song.

Vocal communication systems have a set of rules that govern the arrangement of acoustic signals, broadly defined as 'syntax'. However, there is a limited understanding of potentially shared or analogous rules across vocal displays in different taxa. Recent work on songbirds has investigated syntax using network-based modelling. This technique quantifies features such as connectivity (adjacent signals in a sequence) and recurring patterns. Here, we apply network-based modelling to the complex, hierarchically structured songs of humpback whales (Megaptera novaeangliae) from east Australia. Given the song's annual evolving pattern and the cultural conformity of males within a population, network modelling captured the patterns of multiple song types over 13 consecutive years. Song arrangements in each year displayed clear 'small-world' network structure, characterized by clusters of highly connected sounds. Transitions between these connected sounds further suggested a combination of both structural stability and variability. Small-world network structure within humpback songs may facilitate the characteristic and persistent vocal learning observed. Similar small-world structures and transition patterns are found in several birdsong displays, indicating common syntactic patterns among vocal learning in multiple taxa. Understanding the syntactic rules governing vocal displays in multiple, independently evolving lineages may indicate what rules or structural features are important to the evolution of complex communication, including human language.

Outcomes of surgical repair of a single digital nerve in adults.

Current standard management of a cut digital nerve is end-to-end microsurgical nerve coaptation where possible. A recent systematic review of adult digital nerve injuries that were either repaired or left unrepaired showed that the evidence for good nerve recovery or improved function following nerve repair is poor. In the 30 studies included, only 24% of repaired nerves regained sensory recovery close to or equivalent to estimated pre-injury levels. Neuroma rates were the same in those nerves repaired (4.6%) and those not repaired (5%). Questions under debate include proper assessment methods of outcomes, decision making for repair or no repair to different fingers or the thumb, levels of injury, age, and hand dominance. This review summarizes the major evidence available and debates the surgical dogma that surrounds this injury.

Outcome of surgical repair of adult digital nerve injury: a systematic review.

OBJECTIVES: A systematic review to assess the evidence supporting surgical repair of digital nerve injury versus no repair in adults in terms of clinical outcomes. DESIGN: A Preferred Reporting Items for Systematic Reviews and Meta-Analyses-compliant systematic review with methodology based on the Cochrane Handbook of Systematic Reviews of Interventions. DATA SOURCES: Databases included OvidMEDLINE, EMBASE, AMED, clinicaltrials.gov and the Cochrane Database of Systematic Reviews, searched from inception until 10 November 2018. ELIGIBILITY CRITERIA: Adult digital nerve injury in which either direct repair or no repair was undertaken and an outcome measure was recorded. DATA EXTRACTION AND SYNTHESIS: Study data extracted included demographics, injury type and extent, timing, treatment details, outcome data and time points, adverse outcomes, hand therapy and return to work. The National Institute of Health quality assessment tool for case series was used to assess risk of bias. RESULTS: Thirty studies were included. One compared surgical repair with non-repair. All studies were case series of between 15 and 110 nerve injuries, with heterogeneous patient, injury and treatment characteristics. Two studies detailed nerve repair without magnification. Static 2-point discrimination (s2PD) was the most commonly reported outcome measure. Return of protective sensation was achieved in most cases in the nerve repair and no nerve repair groups. Repair resulted in better s2PD than no repair, but <25% repaired nerves achieved normal levels. Adverse outcomes were similar between repair and no repair groups. CONCLUSIONS: Only level IV evidence is available to support surgical repair of digital nerves in adults. Return of normal sensibility is uncommon and almost all unrepaired nerves regained protective sensation by 6 months and all patients declined further surgery. There was no difference in adverse outcomes. There is currently a lack of high-quality evidence to support surgical repair of digital nerve injuries in adults and further research is needed. PROSPERO REGISTRATION NUMBER: CRD42017065092.

Source levels of humpback whales decrease with frequency suggesting an air-filled resonator is used in sound production.

Source level and frequency are important in determining how far an acoustic signal can travel. However, in some species these sound characteristics have been found to be biomechanically linked, and therefore cannot be modified independently to achieve optimal transmission. This study investigates the variability in source levels and their relationship with frequency in the songs of humpback whales (Megaptera novaeangliae). Songs were recorded off eastern Australia using a fixed hydrophone array deployed on the whales' migratory corridor. Singing whales were acoustically tracked. An empirical, frequency-dependent model was used to estimate transmission loss. Source levels and frequency were measured for 2408 song units from 19 singers. Source levels varied from 138 to 187 dB re 1 µPa at 1 m (root mean squared), while peak frequency ranged between 52 and 3877 Hz. Much of the variability in source levels was accounted for by differences between the unit types, with mean source levels for each unit type varying by up to 17 dB. Source levels were negatively correlated with peak frequency and decreased by 2.3 dB per octave. The negative correlation between source levels and frequency is consistent with the presence of an air-filled resonator in the whales' sound production system.