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The role of central orexin in the sympathetic control of interscapular brown adipose tissue (iBAT) thermogenesis has been established in rodents. Stimulatory doses of caffeine activate orexin positive neurons in the lateral hypothalamus, a region of the brain implicated in stimulating BAT thermogenesis. This study tests the hypothesis that central administration of caffeine is sufficient to activate BAT. Low doses of caffeine administered either systemically (intravenous [IV]; 10 mg/kg) and centrally (intracerebroventricular [ICV]; 5–10 μg) increases BAT thermogenesis, in anaesthetised (1.5 g/kg urethane, IV) free breathing male rats. Cardiovascular function was monitored via an indwelling intra-arterial cannula and exhibited no response to the caffeine. Core temperature did not significantly differ after administration of caffeine via either route of administration. Caffeine administered both IV and ICV increased neuronal activity, as measured by c-Fos-immunoreactivity within subregions of the hypothalamic area, previously implicated in regulating BAT thermogenesis. Significantly, there appears to be no neural anxiety response to the low dose of caffeine as indicated by no change in activity in the basolateral amygdala. Having measured the physiological correlate of thermogenesis (heat production) we have not measured indirect molecular correlates of BAT activation. Nevertheless, our results demonstrate that caffeine, at stimulatory doses, acting via the central nervous system can increase thermogenesis, without adverse cardio-dynamic impact.

ObjectiveTo explore women's lived experiences of a dehisced perineal wound following childbirth and how they felt participating in a pilot and feasibility randomised controlled trial (RCT).DesignA nested qualitative study using semistructured interviews, underpinned by descriptive phenomenology.Participants and settingA purposive sample of six women at 6–9 months postnatal who participated in the RCT were interviewed in their own homes.ResultsFollowing Giorgi's analytical framework the verbatim transcripts were analysed for key themes. Women's lived experiences revealed 4 emerging themes: (1) Physical impact, with sub-themes focusing upon avoiding infection, perineal pain and the impact of the wound dehiscence upon daily activities; (2) Psychosocial impact, with sub-themes of denial, sense of failure or self-blame, fear, isolation and altered body image; (3) Sexual impact; and (4) Satisfaction with wound healing. A fifth theme ‘participating in the RCT’ was ‘a priori’ with sub-themes centred upon understanding the randomisation process, completing the trial questionnaires, attending for hospital appointments and acceptability of the treatment options.ConclusionsTo the best of our knowledge, this is the first qualitative study to grant women the opportunity to voice their personal experiences of a dehisced perineal wound and their views on the management offered. The powerful testimonies presented disclose the extent of morbidity experienced while also revealing a strong preference for a treatment option.Trial registration numberISRCTN05754020; results.

Objective Centrally administered estrogen can increase sympathetic nerve activity to brown adipose tissue, resulting in thermogenesis. The central thermogenic effects of estrogen have not been investigated in males. Therefore, this study sought to investigate the effects of peripherally and centrally administered estrogen on thermogenesis, heart rate and mean arterial pressure in male rats. Thermogenesis was assessed by monitoring brown adipose tissue temperature. Results Peripherally administered estrogen elicited no significant effect on brown adipose tissue temperature, heart rate or mean arterial pressure. Centrally administered estrogen elicited a coincident increase in both brown adipose tissue and core temperature. Centrally administered estrogen also resulted in a decrease in mean arterial pressure but had no effect on heart rate. With the present data it is not possible to elucidate whether changes in temperature were the result of thermogenic or thermoregulatory mechanisms.

ObjectiveTo establish the feasibility of conducting a definitive randomised controlled trial (RCT) comparing the effectiveness of resuturing versus expectant management for dehisced perineal wounds.DesignA multicentre pilot and feasibility RCT.SettingTen UK maternity units from July 2011 to July 2013.PopulationEligible women with a dehisced perineal wound within 2 weeks of childbirth.MethodsThe interventions were resuturing or expectancy. Randomisation was via web or telephone, stratified by participating centre. Blinding was not possible due to the nature of the interventions. Analysis was by intention-to-treat.OutcomeThe primary outcome measure was wound healing at 6–8 weeks.ResultsThe study revealed a number of feasibility issues, particularly strong patient and clinician preference for treatment options at recruiting centres and the timing of the primary outcome measure. Thirty-four women were randomised (17 in each arm). Data from 33 women were analysed on an intention-to-treat analysis to obtain preliminary estimates of effect size. There was a difference in wound healing at 2 weeks favouring resuturing (OR 20.00, 95% CI 2.04 to 196.37, p=0.004). However, by 6–8 weeks all but one wound in both groups had healed.ConclusionsPREVIEW revealed a number of feasibility issues, which impacted on recruitment rate. These will have to be taken into account in the design of any future definitive study. In this feasibility study, resuturing was associated with quicker wound healing and women reported higher satisfaction rates with the outcome at 3 months.Trial registration numberISRCTN05754020.

Tropical agro-forest landscapes are potentially valuable reserves of forest genetic resources for forestry and restoration of degraded forests. The Dipterocarpaceae is a dominant Southeast Asian family of tree species of global significance for the tropical timber industry. Very little information exists about how effective human modified landscapes are for conserving genetic diversity in dipterocarp species. This study provides a baseline for understanding how fragmented agro-forest landscapes in India sustain forest genetic resources in an endemic dipterocarp tree. We compare genetic diversity and fine-scale spatial genetic structure (FSGS) in the threatened tree species Vateria indica within an isolated and a continuous forest site in the Western Ghats, South India. We place these results in the context of dipterocarps from both the Seychelles and Borneo. Parentage analysis of 694 progeny using twelve nuclear microsatellite markers is applied to estimate pollen and seed dispersal. Using a nursery trial we evaluate effects of inbreeding on growth performance. Our results show that levels of FSGS, and gene dispersal are comparable between a small isolated and a large continuous site of V. indica. Realized long-distance pollen flow into the isolated patch appears to help maintaining genetic diversity. The nursery experiment suggests that selection favours outbred progeny. Individuals of V. indica in close proximity appear less related to each other than in another highly fragmented and endangered dipterocarp species from the Seychelles, but more related than in three dipterocarp species studied in continuous forest in Borneo. We discuss the wider implications of our findings in the context of conservation and restoration of dipterocarp forest genetic resources in fragmented populations.

The fine-scale spatial genetic structure (FSGS) of plant populations is strongly influenced by patterns of seed dispersal. An extreme case of limited dispersal is found in the charismatic yet endangered palm Lodoicea maldivica , which produces large fruits (up to 20 kg) dispersed only by gravity. To investigate patterns of seed dispersal and FSGS in natural populations we sampled 1252 individual adults and regenerating offspring across the species’ natural range in the Seychelles archipelago, and characterised their genotypes at 12 microsatellite loci. The average dispersal distance was 8.7 ± 0.7 m. Topography had a significant effect on seed dispersal, with plants on steep slopes exhibiting the longest distances. FSGS was intense, especially in younger cohorts. Contrary to what might be expected in a dioecious species, we found high levels of inbreeding, with most neighbouring pairs of male and female trees (≤10 m) being closely related. Nonetheless, levels of genetic diversity were relatively high and similar in the various sampling areas, although these differed in disturbance and habitat fragmentation. We discuss potential trade-offs associated with maternal resource provisioning of progeny, seed dispersal and inbreeding, and consider the implications of our findings for managing this globally significant flagship species.

When he saw the post on Hoy advertised, it seemed a good option for a man with a debilitating illness and a sense of adventure in equal measure. In August 2014 he was admitted to Aberdeen Royal Infirmary for the removal of a screw that had come loose in the metal scaffolding round his spine.

Trauma to the perineum is a serious and frequent problem after childbirth, with about 350 000 women each year in the UK needing sutures for perineal injury after spontaneous vaginal delivery, and many millions more worldwide. We compared the continuous technique of perineal repair with the interrupted method, and the more rapidly absorbed polyglactin 910 suture material with the standard polyglactin 910 material. 1542 women who had a spontaneous vaginal delivery with a second-degree perineal tear or episiotomy were randomly allocated to either the continuous (n=771) or interrupted (771) suturing method, and to either the more rapidly absorbed polyglactin 910 suture material (772) or standard polyglactin 910 material (770). Primary outcomes were pain 10 days after delivery and superficial dyspareunia 3 months postpartum. Analysis was by intention to treat. At day 10, three women had dropped out of the study. Significantly fewer women reported pain at 10 days with the continuous technique than with the interrupted method (204/770 [26·5%] vs 338/769 [44·0%], odds ratio 0·47, 95% CI 0·38–0·58, p<0·0001). Occurrence of pain did not differ significantly between groups assigned the more rapidly absorbed material or standard material (256/769 [33·3%] vs 286/770 [37·1%], 0·84, 0·68–1·04, p=0·10). Women reported no difference in superficial dyspareunia at 3 months for the continuous vs the interrupted method (98/581 [16·9%] vs 102/593 [17·2%], 0·98, 0·72–1·33, p=0·88) or the more rapidly absorbed versus standard material (105/586 [17·9%] vs 95/588 [16·2%], 1·13, 0·84–1·54, p=0·42). Suture removal was done less with the more rapidly absorbed material than with standard suture material (22/769 [3%] vs 98/770 [13%], p<0·0001), and with the continuous versus interrupted method (24/770 [3%] vs 96/769 [12%], p<0·0001). A simple and widely practicable continuous repair technique can prevent one woman in six from having pain at 10 days. Also, the more rapidly absorbed polyglactin 910 material obviates need for suture removal up to 3 months postpartum for one in ten women sutured.

Arthropods vary more than 30-fold in segment number. The evolutionary origins of differences in segment number among species must ultimately lie in intraspecific variation. Yet paradoxically, in most groups of arthropods, the number of segments is fixed for each species and shows no intra- or interpopulation variation at all. Geophilomorph centipedes are an exception to this general rule, and exhibit intraspecific variation in segment number, with differences between individuals being determined during embryonic development and hence independent of population age structure. Significant differences in segment number between different geographical populations of the same species have been previously reported, but insufficient sampling has been conducted to reveal any particular geographical pattern. Here, we reveal a latitudinal cline in segment number in the geophilomorph species Strigamia maritima: segment number in British populations decreases with distance north. This is the first such cline to be reported for any centipede species; indeed as far as we are aware it is the first such cline reported for any arthropod species. In vertebrates, fish are known to exhibit a latitudinal cline in segment number, but interestingly, this is in the opposite direction; fish add segments with increasing latitude, centipedes subtract them.

Background Perineal trauma during childbirth affects millions of women worldwide every year. The aim of the Perineal Assessment and Repair Longitudinal Study (PEARLS) was to improve maternal clinical outcomes following childbirth through an enhanced cascaded multiprofessional training program to support implementation of evidence-based perineal management. Methods This was a pragmatic matched-pair cluster randomized controlled trial (RCT) that enrolled women (n = 3681) sustaining a second-degree perineal tear in one of 22 UK maternity units (clusters), organized in 11 matched pairs. Units in each matched pair were randomized to receive the training intervention either early (group A) or late (group B). Outcomes within each cluster were assessed prior to any training intervention (phase 1), and then after the training intervention was given to group A (phase 2) and group B (phase 3). Focusing on phase 2, the primary outcome was the percentage of women who had pain on sitting or walking at 10 to 12 days post-natal. Secondary outcomes included use of pain relief at 10 to 12 days post-natal, need for suture removal, uptake and duration of exclusive breastfeeding, and perineal wound infection. Practice-based measures included implementation of evidence into practice to promote effective clinical management of perineal trauma. Cluster-level paired t -tests were used to compare groups A and B. Results There was no significant difference between the clusters in phase 2 of the study in the average percentage of women reporting perineal pain on sitting and walking at 10 to 12 days (mean difference 0.7%; 95% CI −10.1% to 11.4%; P = 0.89). The intervention significantly improved overall use of evidence-based practice in the clinical management of perineal trauma. Following the training intervention, group A clusters had a significant reduction in mean percentages of women reporting perineal wound infections and of women needing sutures removed. Conclusion PEARLS is the first RCT to assess the effects of a ‘training package on implementation of evidence-based perineal trauma management. The intervention did not significantly improve the primary outcome but did significantly improve evidence-based practice and some of the relevant secondary clinical outcomes for women. Trial registrations ISRCTN28960026 NIHR UKCRN portfolio no: 4785.