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Ind T.E.J.,Royal Marsden Hospital | Marshall C.,Royal Marsden Hospital | Hacking M.,Royal Marsden Hospital | Harris M.,Royal Marsden Hospital | And 5 more authors.
International Journal of Medical Robotics and Computer Assisted Surgery | Year: 2016

Background: We have assessed how the introduction of robotics in a publicly funded endometrial cancer service affects clinical and economic outcomes. Methods: The study included 196 women. Costs were divided into those for wards, high dependency, staffing, theatres, pharmacy, blood products, imaging, pathology and rehabilitation. Capital depreciation was included. Results: Prior to the introduction of robotics, 78/130 (60.0%) cases were performed open, compared to 17/66 (25.8%) afterwards (p<0.0001). The median operative time increased 37 min (95% CI 17-55 min; p=0.0002); the median blood loss was 55 ml lower (95% CI 0-150 ml; p = 0.0181); the stay was 2 days shorter (95% CI 1-3; p<0.0001). Complications reduced from 64/130 (49.2%) to 19/66 (28.8%) (p=0.0045). Costs reduced from £11 476 to £10 274 (p=0.0065). Conversions for 'straight stick' surgery were 18.2% (14/77) compared to 0.0% (0/24) for robotics (p=0.0164). Conclusions: Introducing robotics resulted in fewer laparotomies, shorter stays, fewer complications and lower costs. © 2015 The Authors. Source


Weise F.J.,N aAn Ku Se Research Programme | Weise F.J.,Manchester Metropolitan University | Lemeris J.R.,National Geographic Society | Munro S.J.,N aAn Ku Se Research Programme | And 4 more authors.
PeerJ | Year: 2015

Following dramatic range and population declines, the cheetah is Africa's most endangered large felid. In Namibia, private land managers still trap cheetahs but increasingly consider moving animals instead of killing them. Across Africa, managers have translocated perceived conflict carnivores for decades, but rarely evaluated their actions. We analyse the outcomes of 15 cheetah translocations (for 23 adults and 10 dependent offspring) into free-range environments in Namibia. We released cheetahs at an average distance of 419.6 km ± 216.1 km SD (range: 71-816 km) after captive periods ranging from 1-1,184 days (350.6 days ± 439.0 days SD). An individual's ability to survive the first year predominantly determined the overall translocation success of 40%. Post-release conflict and homing had less impact on success. Cheetah survival was lowest in the first three months after release. Human persecution (50% of deaths) and spotted hyaenas (29% of deaths) had the highest effect on survival. The degree of habituation to humans acquired during captivity significantly influenced chances of survival. Cheetahs surviving the initial post-release period (~90 days) often settled into ranges and females reproduced successfully. However, all individuals exhibited extensive movements, frequently roaming > 4,000 km2 in the first six months after release (with a maximum of 19,743 km2 in 112 days), resulting in low release site fidelity. Soft release and larger recipient area size did not improve site fidelity. Based on these outcomes, we evaluated which unfenced conservation areas in Namibia could potentially receive cheetahs. We found that there are currently few public and/or private reserves large enough to contain the movement profiles we observed in this study. This suggests that most translocations will result in cheetahs re-entering farmlands where they face a high risk of persecution. In conclusion, translocations into unconfined areas can successfully conserve individual cheetahs. Due to high mortality and unpredictable outcomes, however, conservation efforts need to focus on improving tolerance of cheetahs in commercial livestock and game farming areas in order to reduce the number of indiscriminately trapped animals. © 2015 Weise et al. Source


Moran-Gilad J.,Public Health Services | Moran-Gilad J.,Ben - Gurion University of the Negev | Mendelson E.,Central Virology Laboratory | Mendelson E.,Tel Aviv University | And 17 more authors.
Journal of Clinical Virology | Year: 2015

Background: Israel has used an inactivated polio vaccine (IPV)-only schedule since 2005 (95% coverage). Silent reintroduction of wild type poliovirus 1 (WPV1) into Israel in early 2013 was detected in Southern Israel via routine environmental surveillance without clinical cases. Objectives: To estimate the rate of WPV1 excretion by age and residence and inform decision-making regarding supplemental immunization with OPV. Study design: A convenience sample of Bedouin and Jewish residential areas in the epicenter of the incident, focusing on under 8 year-olds who not previously given OPV. Fecal samples were directly tested for WPV1 RNA using a novel qRT-PCR assay. Positive samples were confirmed by gold standard cell culture and subject to genotyping. Results: Overall, 2196 non-duplicate fecal samples were collected and analyzed. WPV1 was detected in 61 samples (2.8%), 55 of which (90.2%) were from Bedouins. WPV1 excretion rates were 5.4% among Bedouins and 0.6% among Jewish individuals. Respective age-specific rates among Bedouin and Jewish children were 4.9% and 0.2% for 0-2 years and 7.2% and 1.7% for 2-8 years. Molecular testing had 89.5% sensitivity (higher than culture) and 100% specificity. Conclusion: The rapid performance of a field study to evaluate WPV1 excretion unequivocally demonstrated substantial WPV1 infection rates among children under 8 years in Southern Israel, thus informing the decision to vaccinate this age group with bOPV and risk communication to both healthcare personnel and the public. Rapid development and implementation of molecular screening can thus underpin risk assessment and management in complex epidemiological situations. © 2015 Elsevier B.V. Source


Miller R.,Directorate | Owens S.J.,Directorate | Rorslett B.,Directorate
Optics and Laser Technology | Year: 2011

While there is a range of colours found in plants the predominant colour is green. Pigments in plants have several roles e.g. photosynthesis and signalling. If colour is to be used as a signal then it must stand out from green. However, one should be aware that there are also coloured compounds where we have not yet fully investigated the role of colour in their functions - they may have roles in, for example, defence or heat exchange. In this paper, we will describe the basic chemistry of the major pigments found in plants and especially floral pigments. We will then discuss their locations in parts of the flower (such as sepals, petals, pollen and nectar), the cells in which they are found and their sub-cellular locations. Floral pigments have a large role to play in pollination of flowers by animals. They can and are modified in many ways during the development of flowers in nature, for example, at emergence and post-pollination. There are a range of biochemical mechanisms of colour change both within flowers and in isolated pigments. Some of the factors influencing colour are temperature, co-pigments, pH, metals, sugars, anthocyanin stacking and cell shape. There is a renewed interest in analysing floral pigments and how they are modified partly because of advances in recombinant DNA technologies, but also because of pollinators and their significance to biodiversity and for evolutionary studies. There is continued strong interest from the horticultural industry for the introduction of new colours e.g. the blue rose and for the exploitation of natural dyes. Funding in this area may impact future research in a potentially beneficial way but it must not deflect us from science-based conservation. Copyright © 2009 Published by Elsevier Ltd. All rights reserved. Source

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