Diverging strategies to planning an ecologically coherent network of MPAs in the North Sea: the roles of advocacy, evidence and pragmatism in the face of uncertainty.

The North Sea is one of the most economically important seas in the world due to productive fisheries, extensive oil and gas fields, busy shipping routes, marine renewable energy development and recreational activity. Unsurprisingly, therefore, the use of marine protected areas (here defined widely to include fisheries closed areas and no-take marine reserves) in its management has generated considerable controversy-particularly with regards to the design of a regional ecologically coherent MPA network to meet international obligations. Drawing on three MPA processes currently occurring in the UK North Sea, we examine the real-world problems that make the designation of MPA networks challenging.

Choroidal neovascularization secondary to sorsby fundus dystrophy treated with intravitreal bevacizumab.

Purpose: To report a case of extrafoveal choroidal neovascularization secondary to Sorsby fundus dystrophy that maintained 20/20 visual acuity over 14 months with intravitreal bevacizumab therapy.

Methods: Interventional case report of as-needed treatment with intravitreal bevacizumab of a 38-year-old lady with choroidal neovascularization from Sorsby fundus dystrophy.

Results: Three injections of intravitreal bevacizumab were given over 14.

Review article: Crisis resource management in emergency medicine.

Effective team management is a core element of expert practice in emergency medicine. Thus far, training in emergency medicine has focussed predominantly on proficiency in medical and technical skills, with emergency physicians acquiring these 'non-technical' skills in an ad hoc manner or by trial and error with varying levels of success. This paper describes a set of behaviours that, when practised in conjunction with medical and technical expertise, can reduce the incidence of clinical error and contribute to effective teamwork and the smooth running of an ED.

Pilot randomized trial of a nanopulse retinal laser versus conventional photocoagulation for the treatment of diabetic macular oedema.

Background:   To assess the efficacy of a new nanopulse laser, retinal regeneration therapy for the treatment of diabetic macular oedema.

Design:   Randomized, non-inferiority, trial.

Participants:   20 eyes of 17 subjects in the retinal regeneration therapy group and 18 eyes of 14 subjects in the conventional group were analysed.

Bilateral simultaneous acute angle closure glaucoma precipitated by non-prescription cold and flu medication.

We present a case of a 63-year-old woman who presented to an ED with bifrontal headache, nausea and vomiting and reduced visual acuity. Examination revealed bilateral elevated intraocular pressures, corneal haze, shallow anterior chambers and poorly reactive, mid-dilated pupils. Diagnosis was made of simultaneous bilateral acute angle closure glaucoma.

Reducing discards of fish at sea: a review of European pilot projects.

This paper is about improving the viability of discard-reduction pilot projects. One way to address the problem of wasteful discarding of fish at sea is to initiate pilot projects to trial potential solutions, such as selective gear, area closures, discard bans and data enhancement, which could subsequently be adopted by the fishing industry, either voluntarily or through regulation. However, such pilot projects are often difficult both to set up and to sustain through to completion and implementation.

Species-specific kinetics and zonation of hepatic DNA synthesis induced by ligands of PPARalpha.

Peroxisome proliferator-activated receptor alpha (PPARalpha) ligands evoke a profound mitogenic response in rodent liver, and the aim of this study was to characterize the kinetics of induction of DNA synthesis. The CAR ligand, 1,4-bis[2-(3,5-dichoropyridyloxy)]benzene, caused induction of hepatocyte DNA synthesis within 48 h in 129S4/SvJae mice, but the potent PPARalpha ligand, ciprofibrate, induced hepatocyte DNA synthesis only after 3 or 4 days dosing; higher or lower doses did not hasten the DNA synthesis response. This contrasted with the rapid induction (24 h) reported by Styles et al.

Clinical comparison of the Icare tonometer and Goldmann applanation tonometry.

Purpose: To compare a new method of intraocular pressure (IOP) measurement, using the Icare tonometer, with Goldmann applanation tonometry (GAT).

Patients And Methods: Two observers obtained IOP readings in 292 eyes (143 right and 149 left) of 153 subjects, using the Icare without topical anesthetic. A GAT reading was subsequently obtained by a consultant ophthalmologist, without the knowledge of the Icare readings.

Review of mannequin-based high-fidelity simulation in emergency medicine.

The spectrum of uses of high-fidelity simulation in emergency medicine has increased in the past 10 years and ranges from teaching isolated skills to improving complex team behaviours in critical situations. This review will describe these published uses and explore the evidence supporting the use of high-fidelity simulation, as well as the future directions and difficulties of using this technology in our specialty.

Both PPARgamma and PPARdelta influence sulindac sulfide-mediated p21WAF1/CIP1 upregulation in a human prostate epithelial cell line.

Nonsteroidal anti-inflammatory drugs (NSAIDs) including sulindac sulfide are known to exert cancer chemopreventative activity in a range of cell lines. This activity has been shown to involve the upregulation of the cyclin-dependent kinase inhibitor p21WAF1/CIP1. It is also known that NSAIDs can act as peroxisome proliferator-activated receptor (PPAR) agonists and antagonists.

Peroxisome proliferator activated receptor alpha regulates a male-specific cytochrome P450 in mouse liver.

We set out to find if the strain-specific, male-specific hepatic expression of Cyp4a protein in mouse was due to expression of Cyp4a12 and to understand the genetic basis for reported differences in expression. 12-Lauric acid hydroxylase (LAH) activity was found to show higher levels in male ddY, but not C57Bl/6, mouse liver microsomes. The expression of Cyp4a12 mRNA was studied using RNAase protection assays in male and female liver and kidney of nine mouse strains.

Self-inflicted blindness and Brown-Séquard syndrome.

A 30-year-old paranoid schizophrenic man suffered a psychotic episode while flying on an airplane, locked himself in the bathroom, detached the temples of his sunglasses, and stabbed them deeply into both medial orbits. He then secured one temple into the door hinge and rammed the back of his neck repeatedly against it. The injuries caused no light perception from optic nerve trauma and a Brown-Séquard hemitransection of the spinal cord.

The effects of haloalkene cysteine conjugates on cytosolic free calcium levels in LLC-PK(1) cells--studies utilising digital imaging fluorescence microscopy.

The aim of this study was to examine the effect of haloalkene S-cysteine conjugates on cytosolic free Ca(2+) levels in renal epithelial cells using digital imaging fluorescence microscopy (DIFM). S-(1,2,3,4,4-pentachloro-1,3,-butadienyl)-L-cysteine (PCBC) and S-(1,2-dichlorovinyl)-L-cysteine (DCVC) were both cytotoxic to LLC-PK(1) cells in culture. Prior treatment of the cells with aminooxyacetic acid (AOAA), an inhibitor of the enzyme cysteine conjugate beta-lyase, afforded complete protection against the toxicity at concentrations of PCBC up to 100 microM and DCVC up to 500 microM.