Invasion and spread of alien species can drive ecosystem changes, such as, the dynamics of infectious diseases. The non-native, marine gastropod Crepidula fornicata has become established across European coastlines over the last century, but there remains little insight into its disease carrying capacity and potential role as a source/sink of parasites. To address this knowledge gap, we surveyed limpets from two sites in South Wales, UK for signatures of disease/pathology using polymerase chain reaction-based methods (haemolymph) and histology (solid tissue). We encountered trematode-like parasites in ~1% individuals (5 out of 462). Three limpets displayed gross damage in the gonad, i.e. castration, and encysted metacercariae were found in the muscle of two other individuals. On the basis of 28S rDNA and internal transcribed spacer 2 genomic targets, we identified the gonad-infecting trematodes as members of the family Microphallidae – putative novel species related to the genus Longiductotrema. Earlier reports suggest that C. fornicata is not a host for trematode parasites in either its native or alien range but may act as a sink due to its filter feeding lifestyle. We provide clear evidence that C. fornicata is parasitized by at least one trematode species at two sites in Wales, UK, and likely act as a spillback or accidental host among native littorinids.

This study provides a morphological and phylogenetic characterization of two novel species of the order Haplosporida (Haplosporidium carcini n. sp., and H. cranc n. sp.) infecting the common shore crab Carcinus maenas collected at one location in Swansea Bay, South Wales, UK. Both parasites were observed in the haemolymph, gills and hepatopancreas. The prevalence of clinical infections (i.e. parasites seen directly in fresh haemolymph preparations) was low, at ~1%, whereas subclinical levels, detected by polymerase chain reaction, were slightly higher at ~2%. Although no spores were found in any of the infected crabs examined histologically (n = 334), the morphology of monokaryotic and dikaryotic unicellular stages of the parasites enabled differentiation between the two new species. Phylogenetic analyses of the new species based on the small subunit (SSU) rDNA gene placed H. cranc in a clade of otherwise uncharacterized environmental sequences from marine samples, and H. carcini in a clade with other crustacean-associated lineages.

The low-frequency unsteadiness in the direct numerical simulation of a Mach 2.9 shock wave/turbulent boundary layer interaction with mean flow separation is analysed using dynamic mode decomposition (DMD). The analysis is applied both to three-dimensional and spanwise-averaged snapshots of the flow. The observed low-frequency DMD modes all share a common structure, characterized by perturbations along the shock, together with streamwise-elongated regions of low and high momentum that originate at the shock foot and extend into the downstream flow. A linear superposition of these modes, with dynamics governed by their corresponding DMD eigenvalues, accurately captures the unsteadiness of the shock. In addition, DMD analysis shows that the downstream regions of low and high momentum are unsteady and that their unsteadiness is linked to the unsteadiness of the shock. The observed flow structures in the downstream flow are reminiscent of Görtler-like vortices that are present in this type of flow due to an underlying centrifugal instability, suggesting a possible physical mechanism for the low-frequency unsteadiness in shock wave/turbulent boundary layer interactions.

Extended abstract of a paper presented at Microscopy and Microanalysis 2011 in Nashville, Tennessee, USA, August 7–August 11, 2011.

Acute mastoiditis, a destructive bacterial infection of the mastoid bone and air cell system, is relatively uncommon today but remains a potentially serious condition. There is a lack of information in the literature regarding the long term otological problems that children may face following an episode of this condition.

Methicillin resistant Staphylococcus aureus (MRSA) has become a prevalent nosocomial pathogen worldwide. The objectives of this study were to assess the morbidity and cost associated with the treatment of head and neck cancer patients who become colonized or infected with MRSA following major surgical procedures.

We present a retrospective review of patients who underwent major surgery for head and neck cancer over a one year period and who then became MRSA positive in the post-operative period.

MRSA affected 25/55 (45 per cent) patients who underwent major head and neck procedures during the period studied. The mean time of diagnosis was 13 days post-surgery. Morbidity included cellulitis, osteomyelitis and MRSA pneumonia. Thirteen of the patients who became MRSA positive (52 per cent of the MRSA group) required further surgery including plate removal, new flap formation and wound debridement as a result of the infection. Average in-hospital stay was almost three times more prolonged for patients who became MRSA positive compared to those who did not have MRSA. The costs of the first hospital stay were over three times more in the MRSA-positive group of patients. Antibiotic costs were increased by £2470 per patient because of MRSA.

The extra stay in hospital, together with extra days in intensive care, extra medical and nursing care and additional costly antibiotic treatment, led to major cost implications and loss of health service resources in the unit.

MRSA infection is a serious cause of morbidity in any surgical group of patients and this study focuses on the consequences for treatment of head and neck cancer patients in particular.

We describe a case of a quadriplegic brain-damaged man with severe upper airway obstruction. A diagnosis of tardive dystonia affecting the vocal folds was made and confirmed by flexible nasopharyngoscopy. Emergency tracheotomy was required. The tardive movement disorder resolved with discontinuation of thioridazine. This case serves to heighten awareness of potentially serious airway complications associated with the use of anti-psychotics and anti-emetics particularly in those with organic brain disease.

Laryngeal cleft anomalies are rare congenital defects of the posterior laryngotracheal wall that usually present with a history of recurrent respiratory tract infections during the early neonatal period. Presentation of type I clefts can be subtle and subsequently can result in late diagnosis or indeed failure to present. We report on the case of a type I laryngeal cleft presenting with a history of recurrent lower respiratory tract infections and severe gastro-oesphageal reflux disease, at 19 years of age. This is the oldest documented initial presentation of a congenital laryngeal cleft, and emphasizes the importance of maintaining a suspicion of the diagnosis into early adulthood. We further highlight the role of gastro-oesophageal reflux disease in the presentation of laryngeal clefts.

This study assessed the ability of otolaryngologists to diagnose and grade reflux disease at rigid endoscopy. Twenty-one out of 25 senior otolaryngologists who were questioned by means of a telephone survey said that if they find evidence of reflux disease at rigid endoscopy of the oesophagus and larynx, their practice is to place the patient on a proton pump inhibitor for six weeks without requesting pH and manometry studies, and without referral to a gastroenterologist. Over a two year period, 21 patients were diagnosed as having reflux disease at rigid endoscopy. This was based on the finding of fluid and erythema in the aerodigestive tract and upper oesophagus. Subsequent oesophageal pH and manometry was performed. Nine out of 21 patients were confirmed as refluxers. This demonstrated an accuracy of less than 50 per cent when using these findings to diagnose gastro-oesophageal reflux at rigid endoscopy.

This present paper reviews the reliability and validity of visual analogue scales (VAS) in terms of (1) their ability to predict feeding behaviour, (2) their sensitivity to experimental manipulations, and (3) their reproducibility. VAS correlate with, but do not reliably predict, energy intake to the extent that they could be used as a proxy of energy intake. They do predict meal initiation in subjects eating their normal diets in their normal environment. Under laboratory conditions, subjectively rated motivation to eat using VAS is sensitive to experimental manipulations and has been found to be reproducible in relation to those experimental regimens. Other work has found them not to be reproducible in relation to repeated protocols. On balance, it would appear, in as much as it is possible to quantify, that VAS exhibit a good degree of within-subject reliability and validity in that they predict with reasonable certainty, meal initiation and amount eaten, and are sensitive to experimental manipulations. This reliability and validity appears more pronounced under the controlled (but more artificial) conditions of the laboratory where the signal: noise ratio in experiments appears to be elevated relative to real life. It appears that VAS are best used in within-subject, repeated-measures designs where the effect of different treatments can be compared under similar circumstances. They are best used in conjunction with other measures (e.g. feeding behaviour, changes in plasma metabolites) rather than as proxies for these variables. New hand-held electronic appetite rating systems (EARS) have been developed to increase reliability of data capture and decrease investigator workload. Recent studies have compared these with traditional pen and paper (P&P) VAS. The EARS have been found to be sensitive to experimental manipulations and reproducible relative to P&P. However, subjects appear to exhibit a significantly more constrained use of the scale when using the EARS relative to the P&P. For this reason it is recommended that the two techniques are not used interchangeably.

Following radiation treatment for carcinoma of the larynx it may be very difficult to differentiate between persistent or recurrent tumour and severe radiation effects particularly chondroradionecrosis. Despite repeated negative biopsy it may be necessary to perform total laryngectomy where the concern about persistent cancer remains and the larynx is non-functioning. We report nine cases presenting as chondroradionecrosis over a five-year period. Two patients settled on medical treatment. Of seven patients treated with laryngectomy the histology on two revealed residual or recurrent carcinoma.

We outline the dilemmas in diagnosis and propose management strategies to deal with this condition including recommendations for prevention and treatment.

The GALLEX collaboration aims at the detection of solar neutrinos in a radiochemical experiment employing 30 tons of Gallium in form of concentrated aqueous Gallium-chloride solution. The detector is primarily sensitive to the otherwise inaccessible pp-neutrinos. Details of the experiment have been repeatedly described before [1-7]. Here we report the present status of implementation in the Laboratori Nazionali del Gran Sasso (Italy). So far, 12.2 tons of Gallium are at hand. The present status of development allows to start the first full scale run at the time when 30 tons of Gallium become available. This date is expected to be January, 1990.

The simple story of the book of Ruth abounds in problems for which no final solution can ever be found, since the materials for their solution are denied us. On this village scene, so different in character from most of the scenes of those ungentle times, the curtain is half lifted. But only half. Naomi returns from her sojourn abroad, bringing her daughter-in-law with her, and Ruth goes out to glean in the harvest-field. Then unexpectedly we find Naomi possessed of land, and we are left to guess how it came into her possession, and what had happened to it during the years of her sojourn in Moab. We are not told the relationship of Boaz to Elimelech, or the relationship of the nearer kinsman; nor are we told why the hand of Ruth went with the property. That the story of Ruth's marriage must be linked with the question of levirate marriage is generally agreed, though this is clearly not strictly a case of levirate marriage, since Boaz is not a brother-in-law or levir. There are not wanting, indeed, those who draw a much sharper distinction between Ruth's marriage and levirate marriage, but to this we must return. Of levirate marriage in ancient Israel we know very little, and while the later scholasticism of the Talmud may preserve, some ancient traditions, it cannot be implicitly trusted to throw light on customs which were already obsolete when the book of Ruth was written, needing to be explained to the reader as customs that formerly held in Israel.

‘The central place in the field of Old Testament religion’ says Hertzberg ‘is undoubtedly occupied by the prophets. It is therefore little wonder that research and investigation has concentrated ever more directly on this point: What are the prophets, and what is their significance for the spiritual development of men?’ For a generation now the most keenly discussed question in this connection has been that of ‘ecstasy,’ and the extent to which the prophets were subject to abnormal experiences. It has been held that ‘ecstasy’ is of the esse of prophecy, and that it provided a criterion without which neither the prophet nor his audience would be satisfied. Yet at best the ‘ecstatic theory’ could tell us only the How? rather than the What? of prophecy.