Declines in TBT contamination in Irish coastal waters 1987-2011, using the dogwhelk (Nucella lapillus) as a biological indicator.

Using the vas deferens sequence index (VDSI) and relative penis size index (RPSI) in dogwhelks (Nucella lapillus), imposex levels were assessed at 63 sites within 11 sea inlets during 2010/2011 and compared these with levels gathered since 1987. Sterile females (VDS>5.0) were found at 14 of the 63 sites and 47 sites (75%) met the EcoQO (VDSI<2.0). The absence of imposex in 'control' areas on the west coast is due to the lack of vessel paint applications or net dips with TBT being used as an active anti-fouling ingredient. A significant decline was observed following 2005 when comparing VDSI levels which is consistent with the decline of TBT usage. Current levels are consistent with an overall improvement towards achieving Good Environmental Status according to the requirements under the Marine Strategy Framework Directive.

Biomarkers: are realism and control mutually exclusive in integrated pollution assessment?

The conventional view of pollution monitoring is that any choice is a trade-off between realism and precision, as the control over confounding variables decreases with the increasing degree of organization of the test system. Dublin Bay is subject to considerable anthropogenic pressures and there have been many attempts to quantify the status of the system at organizational levels from DNA strand breaks (Comet) to the system itself (Ecological Network analysis, ENA). Using Dublin Bay as an example, the data show there was considerable variability at all levels of organization. At intracellular level, Lysosome Membrane Stability (LMS, assessed by Neutral Red Retention, NRR) varied almost 4-fold with season and individual condition, while the community level AZTI Marine biotic Index (AMBI) had a similar range within a single, supposedly homogeneous, site. Overall, there was no evidence that biomarkers of the lower levels of organisation reduced the variability of the measure, despite the extra control over influencing variables, nor was there any evidence that variability was additive at higher levels of organisation. This poses problems for management, especially given the fixed limits of Ecological Quality Standards (EQSs). Clearly while the integrated approach to pollution monitoring does offer the potential to link effects across the organizational range, it should also be possible to improve their capability by widening the database for reference values, particularly at the higher level of organization, and by process models, including the confounding variables found in the field, for those at lower level.

Application of congener based multi-matrix profiling techniques to identify potential PCDD/F sources in environmental samples from the Burrishoole Catchment in the West of Ireland.

Homologue and congener profiles of PCDD/Fs in eels, passive sampler and sediment extracts from the Burrishoole, a rural upland catchment on the western Irish seaboard were compared with potential PCDD sources. ΣPCDD/F levels in eels ranged from 2.9 to 25.9 pg g(-1) wet weight, which are elevated compared to other Irish locations. The OCDD congener dominated the pattern of ΣPCDD/Fs in all matrices from Burrishoole. Passive samplers were successfully deployed to identify for the first time the presence in the water column of PCDD/Fs and dimethoxylated octachlorodiphenyl ether (diMeOoctaCDE), impurities found in pentachlorophenol (PCP) production. Principal component analysis (PCA) identified similarities between PCDD/F profiles in technical PCP mixtures and environmental samples from the Burrishoole region. Results strongly suggest residual PCDD contamination associated with historic local use of a dioxin contaminated product in the catchment area, with pentachlorophenol a strong candidate.

Assessment of biomarkers in Mytilus edulis to determine good environmental status for implementation of MSFD in Ireland.

Candidate OSPAR/ICES recommended biomarkers at the level of the individual in Mytilus edulis for determination of good environmental status for MSFD were evaluated against contaminant levels at sites around Ireland. The sites chosen ranged from moderate to low pollution levels, but the actual ranking of the sites varied according to the contaminant levels present. At the most contaminated site, Cork, 4 out of 16 contaminants exceeded the EAC, while at Shannon, no EACs were exceeded. The SOS assay suggested that Cork was the healthiest site with a LT50 of 17.6 days, while SOS for Shannon was 15.6 days. Likewise, condition factors varied among sites and did not always correspond to contaminant-based status. There may be uncertainty in assigning status around the not good:good boundary. This raises potential difficulties not only in the biomarker/contaminant load relationship but also in the reliability of the biomarkers themselves and hence barriers meeting compliance levels.

A comprehensive review of MR imaging changes following radiosurgery to 500 brain metastases.

BACKGROUND AND PURPOSE: Stereotactic radiosurgery is known to control 85%-95% of intracranial metastatic lesions during a median survival of 6-8 months. However, with the advent of newer systemic cancer therapies, survival is improving; this change mandates a longitudinal quantitative analysis of the radiographic response of brain metastases to radiosurgery. MATERIALS AND METHODS: MR imaging of 516 metastases in 120 patients treated with GK-SRS from June 2006 to December 2009 was retrospectively reviewed. Lesion volume at initial treatment and each follow-up was calculated by using the following formula: length × width × height / 2. Volume changes were correlated with patient demographics, histopathology, and radiation treatment variables. RESULTS: Thirty-two percent of lesions increased in volume following radiosurgery. Clinically, this translated into 54% of patients having ≥1 of their lesions increase in size. This increase begins at 6 weeks and can last beyond 15 months' post-SRS. Male sex (P = .002), mean voxel dose <37 Gy (P = .009), and initial treatment volume >500 mm(3) (P < .001) are associated with posttreatment increases in tumor size. Median survival following radiosurgery was 9.5 months for patients with all lesions exhibiting stable/decreased volumes, >18.4 months for patients with all lesions exhibiting increased volumes, and 16.4 months for patients with mixed lesional responses. CONCLUSIONS: Most metastatic lesions are stable or smaller in size during the first 36 months post-SRS. However, a transient increase in volume is seen in approximately one-third of lesions. Sex, treatment dose, initial lesion size, and histopathology all correlate with variations in lesion volume post-SRS. The longer the patient survives, the more likely an increase in lesion size will be seen on follow-up imaging.

Evaluation of tumour promoting potency of fish borne toxaphene residues, as compared to technical toxaphene and UV-irradiated toxaphene.

In this study the potential impact of food chain-based biotransformation and physico-chemical weathering of toxaphene on its tumour promoting potential was investigated in vitro and in vivo. Human exposure to toxaphene is mainly through consumption of contaminated fish, therefore fish-borne residues of toxaphene (cod liver extract, CLE) were prepared by exposing cod to technical toxaphene (TT) for 63 days. UV-irradiated toxaphene (uvT) was included to represent a physico-chemical weathered toxaphene mixture. In vitro, TT, uvT and CLE all showed a dose- and time-dependent inhibition of gap junctional intercellular communication (GJIC) with a relative potency of CLE>TT=uvT. Tumour promoting potency was further studied in vivo in a medium term two-stage initiation/promotion bioassay in female Sprague-Dawley rats, using an increase in altered hepatic foci positive for glutathione-S-transferase-P (AHF-GST-P) as read out. No increase in AHF-GST-P occurred following exposure to either TT, uvT, or CLE, except for the positive control group (2,3,7,8-TCDD). Based on this study the no observed adverse effect level (NOAEL) for tumour promoting potency is at least 12.5mg/kg/week, or higher for CLE. Considering current human exposure levels in Europe it is doubtful that consumption of fish at current levels of toxaphene contamination give rise to human health risk.

Evaluation of the effect of shape on a contemporary CAD system.

The TracerCAD system is one of the leading prosthetic CAD systems in the world and is increasingly used in clinics to replace traditional methods of residual limb shape capture. Accurate dimensional capture of the residuum is arguably the most important process in the production of a prosthetic socket. TracerCAD system accuracy has previously been tested on a cylindrical model but not a trans-tibial shape. Residual limbs are irregular in shape therefore it is important to assess if shape has an effect on the accuracy of data collected when using TracerCAD. The objective of this study is to investigate the accuracy of the TracerCAD system in measuring a model of a trans-tibial stump of known dimensions and volume. A model of a trans-tibial stump was produced and filled with plaster and measured using a data acquisition system with an accuracy of five micron (0.005 mm). The model was repeatedly traced using the TracerCAD system by an individual user. The mean value of measures taken by the dynamic indicator was calculated and compared to individual and mean values of TracerCAD measurement. Results showed that the TracerCAD measurement was not as consistent on the more complex trans-tibial model as for the cylindrical model.

Comparison of the results of four users of a contemporary CAD/CAM system.

The objective of this study was to investigate the variation of measurements recorded when four different users of the TracerCAD system trace a model of known dimensions and volume. This complements a previous study where the accuracy and consistency of a single user was measured. Landmarks were added to indicate proximal, distal, anterior, medial and lateral regions of a specially manufactured cylindrical nylon 6.6 model. Four circumferential lines were added at regular intervals along the length of the cylinder with a view to calculating diameters and volumes relative to these landmarks. The model was measured using a comparator with guaranteed accuracy to one hundredth of a millimetre, and was traced using the TracerCAD system by four different users. The difference in mean volume between measured results and TracerCAD scans of differing users ranged to -3%. Individual trace volumes varied by up to -7.85%. In all volumes measured, 11 out of 12 maximum volume percentage differences measured greater than 2%, and of these, seven results showed maximum volume percentage difference to measure greater than 4%.

Living with Marfan syndrome: coping with stigma.

Social stigmatization can disrupt the ability of individuals with genetic conditions to successfully adapt to their situation. We offer data on perceptions of stigma from a cross-sectional survey of 174 adults with Marfan syndrome by self-report. Fifty-six respondents (32%) reported feeling discriminated against or socially devalued because of having Marfan syndrome. Endorsement of discrimination was significantly correlated with having depressive symptoms, low self-esteem, the view Marfan syndrome has had significant negative consequences on one's life, striae, and perceptions of workplace discrimination. Nearly 30% of respondents reported withdrawing from social situations that they anticipated would lead to feeling stigmatized, and 25% reported electing to keep their condition secret in potentially stigmatizing situations. Over 50% of respondents reported educating others about Marfan syndrome as a means of coping with their feelings of stigma, and endorsement of education was correlated with viewing involvement in the National Marfan Foundation as important. Instances of workplace discrimination were perceived by 20% of respondents, and 23% reported that they remained in a dissatisfying job due to having Marfan syndrome. Genetics professionals should actively engage patients with Marfan syndrome in discussions about social stigmatization and encourage use of coping strategies aimed at enhancing quality of life.

Evaluation of a contemporary CAD/CAM system.

The objective of this study is to investigate the accuracy of the TracerCAD system in measuring a model of known dimensions and volumes. A cylindrical nylon 6.6 model was prepared. Landmarks were added to indicate proximal, distal, anterior, medial, and lateral. Four additional landmarks were added at regular intervals along the length of the cylinder with a view to calculating diameters and volumes relative to these landmarks. The model was measured using a comparator with a guaranteed accuracy of 0.01 mm and was traced using the TracerCAD system (Test 1). The test was repeated with the model rotated by 90 degrees (Test 2), to determine whether there were any effects related to the orientation of the model in relation to the transmitter. The difference in average volume between measured results and TracerCAD scans was between 0.20% and -1.96%. Individual trace volumes varied between -0.0085% and -4.50%. In all volumes measured in Tests 1 and 2, all maximum volume percentage differences measured greater than 3%.

Pilot study: data-capturing consistency of two trans-tibial casting concepts, using a manikin stump model: a comparison between the hands-on PTB and hands-off ICECAST compact concepts.

The quality of fit of a trans-tibial patellar tendon bearing (PTB) socket may be influenced by consistency in casting, rectification or alignment. For this study two distinctive different data-capturing concepts were tested in relation to prosthetist performance. The hands-on PTB and hands-off ICECAST compact concept were studied and compared for inter- and intra-prosthetist consistency using a specially designed manikin stump model. A purpose designed digitiser was used to scan a selected surface area of the produced models, 5 for each concept, 10 in total. The extent of casting consistency at each of 936 locations per plaster model was calculated and the level of consistency was quantified. This study has shown that by using the manikin model there is a clear indication that the investigated hands-off concept produces more consistent results than the hands-on concept.

Measurement of the consistency of patellar-tendon-bearing cast rectification.

The quality of fit of a trans-tibial patellar-tendon-bearing (PTB) socket may be influenced by consistency in casting, rectification or alignment. This paper quantifies, for the first time, the variations in the rectified casts between two experienced prosthetists and the variation between the rectified casts of each individual prosthetist. Prosthetists A and B observed the hand casting of a typical trans-tibial amputee. Each prosthetist was supplied with 5 previously measured duplicated plaster models. The two prosthetists rectified the supplied plaster models based on their own interpretation of basic rectification guidelines. Both prosthetists operated in isolation. The re-measured rectified plaster model data was compared with the unrectified data. The extent of rectification at each of 1800 locations per plaster model was calculated. In zones of major rectification, the mean difference between prosthetists was quantified as 2mm and the standard deviation (SD) about that mean was +/- 1mm for each prosthetist. The co-ordinates of the apex of the fibular head for the 10 modified casts indicated that the maximum variation was in the axial direction with a SD of 4.3mm for prosthetist A and a SD of 2.8mm for prosthetist B. The lengths of the 5 plaster models rectified by prosthetist A indicated a SD of 0.2mm whereas the lengths of the 5 plaster models rectified by prosthetist B indicated a SD of 2.9mm.

Genetic basis of transferase-deficient galactosaemia in Ireland and the population history of the Irish Travellers.

Transferase-deficient galactosaemia, resulting from deficient activity of galactose-1-phosphate uridyltransferase (GALT), is relatively common among the Travellers, an endogamous group of commercial/industrial nomads within the Irish population. This study has estimated the incidence of classical transferase-deficient galactosaemia in Ireland and determined the underlying GALT mutation spectrum in the Irish population and in the Traveller group. Based upon a survey of newborn screening records, the incidence of classical transferase-deficient galactosaemia was estimated to be 1 in 480 and 1 in 30,000 among the Traveller and non-Traveller communities respectively. Fifty-six classical galactosaemic patients were screened for mutation in the GALT locus by standard molecular methods. Q188R was the sole mutant allele among the Travellers and the majority mutant allele among the non-Travellers (89.1%). Of the five non-Q188R mutant alleles in the non-Traveller group, one was R333G and one F194L with three remaining uncharacterized. Anonymous population screening has shown the Q188R carrier frequency to be 0.092 or 1 in 11 among the Travellers as compared with 0.009 or 1 in 107 among the non-Travellers. The Q188R mutation was shown to be in linkage disequilibrium with a Sac I RFLP flanking exon 6 of the GALT gene. This represents the first molecular genetic description of classical transferase-deficient galactosaemia in Ireland and raises intriguing questions concerning the genetic history of the Irish Travellers.

Analysis of body-device interface forces in the sagittal plane for patients wearing ankle-foot orthoses.

An ankle-foot orthosis (AFO) is employed principally to treat musculoskeletal disorders of the ankle and/or subtalar joints although, occasionally, it may be prescribed to provide stance phase control of the knee. In order to function satisfactorily, an AFO must apply appropriate forces to the lower leg in a manner which does not cause local tissue damage or discomfort. Equally the leg will apply forces to the AFO which it must be capable of withstanding without breakage or loss of function. Thus it is useful to know where the body-device interface forces act during walking and to be able to estimate their magnitudes. This is not well understood and has not been satisfactorily documented. This paper explains the force actions between the AFO and the leg, in the sagittal plane, where there is absence of muscle power. Furthermore, it explores the possibility of estimating the magnitudes of these forces. It is found that the forces are greatest when orthotic assistance is needed to compensate for plantar flexor insufficiency in late stance phase. On the other hand, where the AFO is used to support the foot, in the absence of dorsiflexion power in swing phase, the forces are relatively small. Understanding these force levels is relevant to the design of the AFO in terms of choice and use of materials and components.

Environmental occurrence, analysis, and toxicology of toxaphene compounds.

Toxaphene production, in quantities similar to those of polychlorinated biphenyls, has resulted in high toxaphene levels in fish from the Great Lakes and in Arctic marine mammals (up to 10 and 16 microg g-1 lipid). Because of the large variabiliity in total toxaphene data, few reliable conclusions can be drawn about trends or geographic differences in toxaphene concentrations. New developments in mass spectrometric detection using either negative chemical ionization or electron impact modes as well as in multidimensional gas chromatography recently have led researchers to suggest congener-specific approaches. Recently, several nomenclature systems have been developed for toxaphene compounds. Although all systems have specific advantages and limitations, it is suggested that an international body such as the International Union of Pure and Applied Chemistry make an attempt to obtain uniformity in the literature. Toxicologic information on individual chlorobornanes is scarce, but some reports have recently appeared. Neurotoxic effects of toxaphene exposure such as those on behavior and learning have been reported. Technical toxaphene and some individual congeners were found to be weakly estrogenic in in vitro test systems; no evidence for endocrine effects in vivo has been reported. In vitro studies show technical toxaphene and toxaphene congeners to be mutagenic. However, in vivo studies have not shown genotoxicity; therefore, a nongenotoxic mechanism is proposed. Nevertheless, toxaphene is believed to present a potential carcinogenic risk to humans. Until now, only Germany has established a legal tolerance level for toxaphene--0.1 mg kg-1 wet weight for fish.

Early transfer to a rehabilitation hospital for infants with chronic bronchopulmonary dysplasia.

Shortly after being weaned off the respirator, 43 infants with severe chronic bronchopulmonary dysplasia (BPD) were transferred from an intensive-care nursery at a teaching hospital to an affiliated children's rehabilitation hospital in a program that included special staff instruction. Morbidity, measured by rate of transfer back to the acute-care hospital, was lower than in a comparison group of 15 infants treated for severe BPD during the previous two years. Average length of stay was significantly shortened and an average of $60,000 per patient was saved. Using a rehabilitation hospital as a step-down unit shifts the emphasis from acute needs to chronic and developmental needs and from intensive monitoring and nursing care to care given at home by parents with nursing assistance.

Postoperative heterotopic ossification in the child with cerebral palsy: three case reports.

Three children with cerebral palsy and mental retardation showed irritability after surgical procedures. They were subsequently diagnosed as having heterotopic ossification. Heterotopic ossification developed around the hip in all cases--two after bilateral adductor releases at the operative site and the third after spinal fusion at a site unrelated to the surgery.

The outcome of childhood suicidal behaviour.

A group of children under 16 years of age who were admitted to hospital after episodes of deliberate self-poisoning, were followed up after one year. Ninety of the original sample of 100 were traced, and interviewed. Almost half of the subjects were improved after one year but the remaining children continued disturbed. Improvement was most marked in relation to "school problems" and "running away from home". There was significant improvement for some children in their family relationships. Ten per cent of children had been involved in further self-poisoning during the follow-up period. Extended follow-up some seven years later traced 41 of the original subjects. The repetition rate for self-poisoning was 20% although the majority of these episode occurred within a year of the original self-poisoning. Overall, the situation of subjects was judged as improved by them and their families although significant psycho-social difficulties remained for some.