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Children may develop changes in their behaviour following general anaesthesia. Some examples of negative behaviour include temper tantrums and nightmares, as well as sleep and eating disorders. The aim of this study was to determine whether dexmedetomidine reduces the incidence of negative behaviour change after anaesthesia for day case surgery in children aged two to seven years. Children were randomly allocated to one of three groups: a premedication group received 2 mg.kg-1 intranasal dexmedetomidine; an intra-operative group received 1 mg.kg-1 intravenous dexmedetomidine; and a control group. The primary outcome was the incidence of negative behaviour on postoperative day 3 using the Post-Hospitalisation Behaviour Questionnaire for Ambulatory Surgery (PHBQ-AS) and the Strength and Difficulties Questionnaire (SDQ). Secondary outcomes included: the incidence of negative behaviour on postoperative days 14 and 28; anxiety at induction; emergence delirium; pain; length of recovery and hospital stay; and any adverse events. The data for 247 patients were analysed. Negative behaviour change on postoperative day 3 was similar between all three groups when measured with the PHBQ-AS (47%, 44% and 51% respectively; adjusted p=0.99) and the SDQ (median scores 7.5, 6.0 and 8.0 respectively; adjusted p=0.99). The incidence of negative behaviour in the group who received dexmedetomidine intra-operatively was less at postoperative day 28 (15% compared with 36% in the dexmedetomidine premedication group and 41% in the control group, p<0.001). We conclude that dexmedetomidine does not reduce the incidence of negative behaviour on postoperative day 3 in two to seven-year olds having day case procedures. [ABSTRACT FROM AUTHOR]

Aim: There is significant international variation in the use of neoadjuvant radiation prior to total mesorectal excision. The MERCURY group advocate selective neoadjuvant chemoradiotherapy (CRT). We have performed a retrospective, single‐centre study of patients treated with CRT, where only the circumferential resection margin is threatened, with the aim of identifying whether a more selective approach to CRT provides acceptable local relapse rates (LRRs). Method: All consecutive patients who underwent radical surgery for rectal adenocarcinoma over a 5‐year period (2007–2012) in the Oxford University Trust were considered. Electronic hospital systems were reviewed to obtain patient and tumour demographics, treatment and follow‐up information. All patients were classified into risk categories according to National Institute for Health and Care Excellence guidance. Data were analysed using Microsoft Excel and R. Results: Two hundred and seventy‐two patients were identified: 123, 89 and 60 in the high‐, intermediate‐ and low‐risk categories, respectively. Seventy‐nine per cent of those in the high‐risk group, 6% in the intermediate and 5% in the low‐risk group underwent CRT. The overall 5‐year LRR and distant recurrence rate (DRR) were 5.2% and 17.8%, respectively. The 5‐year LRR for those who went straight to surgery was 2.0% and for those who had neoadjuvant CRT it was 7.4%. The DRR for these two groups was 8.5% and 18.9%, respectively. Conclusion: Our series demonstrates that the use of CRT only in margin‐threatening tumours, results in an exceptionally low LRR for those without margin‐threatening disease. In routine clinical care, this strategy can minimize the significant morbidity of multimodal treatment and allow earlier introduction of systemic therapy to minimize distant recurrence. [ABSTRACT FROM AUTHOR]

Aim Outcomes following treatment for low rectal cancer still remain inferior to those for upper rectal cancer. A clear definition of 'low' rectal cancer is lacking and consensus is more likely using a definition based on MRI criteria. This study aimed to determine disease presentation and treatment outcome of low rectal cancer based on a strict anatomical definition. Method A low rectal cancer was defined as one with a lower border below the pelvic attachment of the levator muscles on sagittal MRI. One hundred and eighty consecutive patients with tumours defined by this criterion between 2006 and 2011 were identified from a prospectively managed departmental database. Results One hundred and eighteen patients (66%) underwent curative resection and 12 (7%) palliative resection. Eleven patients (6%) were entered into a 'watch and wait' (W&W) protocol; 10 others (5%) were not fit to undergo any operation. Some 26 patients (14%) had nonresectable local or metastatic disease. An R0 resection was the most important factor influencing survival after curative surgery. R+ resections occurred in 12% of non-abdominoperineal excisions, 11% of abdominoperineal excisions and 47% of extended resections. Overall survival was similar in the curative resections compared with the W&W patients. In 23 of the 96 (24%) treated with neoadjuvant chemoradiotherapy there was a persistent clinical or a pathological complete response. Conclusion In curative resections, a clear margin is the most important determinant of survival. In 24% of the patients treated with neoadjuvant chemoradiotherapy, surgery could potentially have been avoided. There is scope for improvement in the treatment of locally advanced rectal cancers. [ABSTRACT FROM AUTHOR]

Aim To assess the prospective association between objectively measured physical activity and kidney function over 4 years in people with Type 2 diabetes. Methods Individuals (120 women and 206 men) participating in the ADDITION-Plus trial underwent assessment of sedentary time ( SED-time), time spent in moderate-to-vigorous-intensity physical activity ( MVPA) and total physical activity energy expenditure ( PAEE) using a combined heart rate and movement sensor, and kidney function [estimated glomerular filtration rate ( eGFR), serum creatinine and urine albumin-to-creatinine ratio ( ACR)] at baseline and after 4 years of follow-up. Multivariate regression was used to quantify the association between change in SED-time, MVPA and PAEE and kidney measures at four-year follow-up, adjusting for change in current smoking status, waist circumference, HbA1c, systolic blood pressure, triglycerides and medication usage. Results Over 4 years, there was a decline in eGFR values from 87.3 to 81.7 ml/min/1.73m2 ( P < 0.001); the prevalence of reduced eGFR ( eGFR < 60 ml/min/1.73m2) increased from 6.1 to 13.2% ( P < 0.001). There were small increases in serum creatinine (median: 81-84 μmol/l, P < 0.001) and urine ACR (median: 0.9-1.0 mg/mmol, P = 0.005). Increases in SED-time were associated with increases in serum creatinine after adjustment for MVPA and cardiovascular risk factors (β = 0.013, 95% CI: 0.001, 0.03). Conversely, increases in PAEE were associated with reductions in serum creatinine (β = -0.001, 95% CI: -0.003, -0.0001). Conclusion Reducing time spent sedentary and increasing overall physical activity may offer intervention opportunities to improve kidney function among individuals with diabetes. (Trial Registry no. ISRCTN 99175498) [ABSTRACT FROM AUTHOR]

We may expect butterflies as ectotherms to have particularly active lifehistory stages that occur in the warmest and lightest times of the year; however, there are temperate species that are active when climatic conditions seem unfavourable and photoperiod short, such as the Taylor's checkerspot (Euphydryas editha taylori). For such species, studies suggest that even subtle changes to microclimate can potentially impact populations. Thus, understanding how in situ variations in microclimate influence the Taylor's checkerspot butterfly could provide much needed insights into more effective management. We conducted a series of surveys that explored (i) adult habitat use, (ii) final instar larval distribution and (iii) adult movement up to and across site boundaries at two sites in Oregon, USA, in 2010 and 2011. We found that in situ habitat use by the Taylor's checkerspot butterfly was strongly influenced by microclimate. Both adult activities and final instar larvae distribution were clustered within the warmest areas of the sites. Moreover, adults did not use up to 59% and larva up to 90% of their sites, despite vegetation structure and composition being uniform. More specifically, butterfly habitat use increased with increasing ground temperatures, and we found that areas with the highest ground temperatures were more exposed to direct sunlight. Similarly, we found that butterflies tended to only move through sunlit site boundaries. We conclude that the Taylor's checkerspot is sensitive to changes in its thermal environment at fine spatial scales. Our results highlight the importance of microclimate as an indicator of habitat quality, and establishing the thermal criteria in which species of concern exists may provide valuable insights into the implications of climate change. [ABSTRACT FROM AUTHOR]

Aim Assessing the influence of land cover in species distribution modelling is limited by the availability of fine-resolution land-cover data appropriate for most species responses. Remote-sensing technology offers great potential for predicting species distributions at large scales, but the cost and required expertise are prohibitive for many applications. We test the usefulness of freely available raw remote-sensing reflectance data in predicting species distributions of 40 commonly occurring bird species in western Oregon. Location Central Coast Range, Cascade and Klamath Mountains Oregon, USA. Methods Information on bird observations was collected from 4598 fixed-radius point counts. Reflectance data were obtained using 30-m resolution Landsat imagery summarized at scales of 150, 500, 1000 and 2000 m. We used boosted regression tree ( BRT) models to analyse relationships between distributions of birds and reflectance values and evaluated prediction performance of the models using area under the receiver operating characteristic curve ( AUC) values. Results Prediction success of models using all reflectance values was high (mean AUC = 0.79 ± 0.10 SD). Further, model performance using individual reflectance bands exceeded those that used only Normalized Difference Vegetation Index ( NDVI). The relative influence of band 4 predictors was highest, indicating the importance of variables associated with vegetation biomass and photosynthetic activity. Across spatial scales, the average influence of predictors at the 2000 m scale was greatest. Main Conclusions We demonstrate that unclassified remote-sensing imagery can be used to produce species distribution models with high prediction success. Our study is the first to identify general patterns in the usefulness of spectral reflectances for species distribution modelling of multiple species. We conclude that raw Landsat Thematic Mapper data will be particularly useful in species distribution models when high-resolution predictions are required, including habitat change detection studies, identification of fine-scale biodiversity hotspots and reserve design. [ABSTRACT FROM AUTHOR]

Habitat loss and fragmentation in forested landscapes often negatively affect animal abundance; however, whether these factors also affect fitness is not well known. We hypothesized that observed decreases in bird occurrence and abundance in landscapes with harvested forests are associated with reduced apparent survival of adults. We defined apparent survival as an estimate of survival that accounts for an imperfect resighting probability, but not permanent emigration (i.e., dispersal). We examined the association between spatially extensive habitat loss and apparent survival of males of 2 Neotropical migrant species, Blackburnian Warbler (Dendroica fusca ) and Black-Throated Green Warbler (D. virens ), over 7 years in the Greater Fundy Ecosystem, New Brunswick, Canada. We estimated apparent survival among and within breeding seasons. We quantified amount of habitat in the context of individual species. In this landscape, boundaries between land-cover types are gradual rather than clearly identifiable and abrupt. Estimated apparent within-season survival of both species decreased as a function of amount of habitat within a 2000-m radius; survival was approximately 12 times (95% CI 3.43-14) greater in landscapes with 85% habitat than in landscapes with 10% habitat. Apparent annual survival also decreased as a function of amount of habitat within a 100-m radius. Over the range of habitat amount, apparent annual survival decreased 15% (95% CI 7-29%) as the amount of habitat decreased. Our results suggest that reduced species occurrence in landscapes with low proportions of habitat is due partly to lower apparent survival at these sites. This mechanism operates both directly (i.e., via effects on mortality or dispersal during breeding) and possibly through indirect effects during the nonbreeding season. Habitat loss was associated not only with a lower number of individuals, but also with lower survival of those individuals. [ABSTRACT FROM AUTHOR]

The article presents a study on the implication of the decline in forest bird occurrence in early-seral broadleaf forest to bird population. The study used two avian point-count data from southwestern and northwestern Oregon that were gathered using fixed-radius point counts while gradient nearest neighbor (GNN) method was used to characterize the number of broadleaf cover. Results show that the viability of forest birds in Oregon is affected by broadleaf and early-seral broadleaf forest.

Background and Purpose: Increased glutamatergic innervation of the substantia nigra pars reticulata (SNpr) and pars compacta (SNpc) may contribute to the motor deficits and neurodegeneration, respectively, in Parkinson's disease (PD). This study aimed to establish whether activation of pre-synaptic group III metabotropic glutamate (mGlu) receptors reduced glutamate release in the SN, and provided symptomatic or neuroprotective relief in animal models of PD.Experimental Approach: Broad-spectrum group III mGlu receptor agonists, O-phospho-l-serine (l-SOP) and l-2-amino-4-phosphonobutyrate (l-AP4), were assessed for their ability to inhibit KCl-evoked [(3)H]-d-aspartate release in rat nigral prisms or inhibit KCl-evoked endogenous glutamate release in the SNpr in vivo using microdialysis. Reversal of akinesia in reserpine-treated rats was assessed following intranigral injection of l-SOP and l-AP4. Finally, the neuroprotective effect of 7 days' supra-nigral treatment with l-AP4 was examined in 6-hydroxydopamine (6-OHDA)-lesioned rats.Key Results: l-SOP and l-AP4 inhibited [(3)H]-d-aspartate release by 33 and 44% respectively. These effects were blocked by the selective group III mGlu antagonist (RS)-alpha-cyclopropyl-4-phosphonophenylglycine (CPPG). l-SOP also reduced glutamate release in the SNpr in vivo by 48%. Injection of l-SOP and l-AP4 into the SNpr reversed reserpine-induced akinesia. Following administration above the SNpc, l-AP4 provided neurochemical, histological and functional protection against 6-OHDA lesion of the nigrostriatal tract. Pretreatment with CPPG inhibited these effects.Conclusions and Implications: These findings highlight group III mGlu receptors in the SN as potential targets for providing both symptomatic and neuroprotective relief in PD, and indicate that inhibition of glutamate release in the SN may underlie these effects. [ABSTRACT FROM AUTHOR]

Roadside survey data have been used frequently to assess species occurrence and population trends and to establish conservation priorities. However, most studies using such data assume that samples are representative of either the amount of habitat or its rate of change at larger spatial scales. We tested both of these assumptions for the Breeding Bird Survey (BBS) from 1974 to 2001 in New Brunswick, Canada. Our study focused on mature forest--a cover type that we predicted would be characterized by rapid change due to human activities and that is of high ecological importance. We also sought to determine whether land cover changes adjacent to BBS routes were related to bird population trends detected in BBS data. Within all 3 time periods examined (1970s, 1980s, and 1990s), the amount of mature forest adjacent to BBS routes was significantly lower than in surrounding 18 blocks of latitude and longitude. This could be problematic for studies that use roadside data to compare the relative abundance of species. On average, mature forest declined at a rate of -1.5% per year over the 28-year study period. We detected no significant difference in the rate of change between degree blocks and BBS routes over this time span. However, in the 1970s and 1980s, mature forest declined more rapidly in degree blocks (-2.7%/yr) than adjacent to BBS routes (-0.5/yr). We also found that the BBS trend for a mature forest-associated species, blackburnian warbler (Dendroica fusca), was correlated with the trend in mature forest along BBS routes. This, combined with slower rates of mature forest change along routes in the 1970s and 1980s, suggests that BBS data may have underestimated population declines during this period. It is important that research be conducted to test for potential biases in roadside surveys caused by uneven rates of landscape change, particularly in regions characterized by rapid habitat alteration. [ABSTRACT FROM AUTHOR]

The contents of sodium, potassium, calcium, magnesium, phosphorus and ash in the blue tits, coal tits, goldcrests and the invertebrate canopy fauna in a plantation of S cots pine are given. The significance of the canopy animals in the nutrient cycle of woodlands is discussed. [ABSTRACT FROM AUTHOR]

Background: Primary sclerosing cholangitis (PSC) is closely associated with inflammatory bowel disease, particularly ulcerative colitis (UC), with an increased risk of biliary and colorectal malignancy. We sought to clarify the prevalence, characteristics and long-term outcome of sub-clinical PSC diagnosed by magnetic resonance cholangiogram (MRC) in patients with UC and normal liver biochemistry, with or without colorectal dysplasia (CRD)., Methods: In this prospective case-control study, 70 patients with UC and normal liver function (51 extensive UC, 19 CRD), 28 healthy volunteers (negative controls) and 28 patients with PSC and cholestasis (positive controls) underwent MRC and blood evaluation. MRC scans were interpreted blindly by two radiologists who graded individually, the scans as definitive for PSC, possible for PSC or normal. Clinical outcome was assessed by blood monitoring, abdominal imaging and endoscopic surveillance., Results: 7/51 (14%) with extensive UC and 4/19 (21%) with CRD had biliary abnormalities on MRC consistent with PSC. 7/11 (64%) with sub-clinical PSC had isolated intrahepatic duct involvement. Sub-clinical PSC was associated with advanced age (P = .04), non-smoking (P = .03), pANCA (P = .04), quiescent colitis (P = .02), absence of azathioprine (P = .04) and high-grade CRD (P = .03). Inter-observer (kappa = 0.88) and intra-observer (kappa = 0.96) agreement for MRC interpretation was high. No negative controls were assessed as definite PSC, 4/28 were considered on blinding as possible PSC. During follow-up of sub-clinical PSC (median 10.1(3.1-11.9) years), four patients developed abnormal liver biochemistry, two had radiological progression of PSC and seven developed malignancy, including two biliary and one colorectal carcinoma., Conclusions: Prevalence of sub-clinical PSC appears high in patients with extensive UC and normal liver biochemistry, with or without CRD. Disease progression and malignancy were identified on long-term follow-up. MRC should be considered for all patients with extensive UC or CRD to stratify surveillance., (© 2020 The Authors. Liver International published by John Wiley & Sons Ltd.)