The tool-using behaviors of wild chimpanzees comprise the most impressive assemblages and flexible repertoires of nonhuman material culture. We expand knowledge of the breadth and complexity of tool use in this species by providing the first descriptions of the form and function of two distinct tool sets used by chimpanzees in preying upon termites within the forests of the Goualougo Triangle, Republic of Congo. Further, we report the first application of remote video monitoring technology to record wild chimpanzee tool-using behavior. Based on tool assemblages recovered at termite nests, we hypothesized that chimpanzees were regularly visiting two forms of termite nests and using specific tools to extract termite prey depending on the structure of the nest. Six months of continuous remote video monitoring at six termite nests confirmed that chimpanzees use a tool set to puncture and fish at subterranean termite nests and another tool set to perforate and fish at epigeal (aboveground) nests. Our findings of strict adherence to tool forms at different nest types, tool material selectivity, repeated visits to nests with reusable wood tool assemblages, and differences in material culture between communities have broad implications for our understanding of the ecological and cultural factors that shape hominoid tool use.

Background: Surgical mortality data are collected routinely in high-income countries, yet virtually no low-or middle-income countries have outcome surveillance in place. The aim was prospectively to collect worldwide mortality data following emergency abdominal surgery, comparing findings across countries with a low, middle or high Human Development Index (HDI).Methods: This was a prospective, multicentre, cohort study. Self-selected hospitals performing emergency surgery submitted prespecified data for consecutive patients from at least one 2-week interval during July to December 2014. Postoperative mortality was analysed by hierarchical multivariable logistic regression.

The endocrine function of the pars tuberalis of the pituitary gland has been an enigma for many years. Recent work suggests that one of its primary functions in seasonal mammals is to mediate photoperiodically regulated changes in prolactin secretion via an unidentified factor called tuberalin.

Paroxysmal nocturnal haemoglobinuria (PNH) cells are deficient in glycosylphosphatidylinositol (GPI) linked antigens due to a somatic mutation of the PIG-A gene in a haemopoietic stem cell. It appears that a PNH clone reaches detectable proportions only when there is selection in its favour. GPI-deficient T lymphocytes have been identified in patients treated with CAMPATH-1H, a monoclonal antibody against the GPI-linked CD52 molecule. CAMPATH-1H selects for cells that are deficient in CD52 (such as PNH-like cells) promoting the development of a PNH-like clone (analogous to PNH). We report that 10/15 patients with chronic lymphocytic leukaemia developed PNH-like lymphocytes after therapy with CAMPATH-1H. The remaining five patients developed no PNH-like cells at any stage, including one patient who received 12 weeks of therapy. The inactivating PIG-A mutation has been identified in one patient. This mutation was detectable by an extremely sensitive mutation-specific PCR-based analysis in the patient's mononuclear cells prior to CAMPATH-1H therapy. The frequency and phenotype of GPI-deficient lymphocytes after CAMPATH-1H and the detection of a PIG-A mutation in the lymphocytes prior to CAMPATH-1H therapy indicated that such mutations were present in a very small proportion of cells prior to selection in their favour by CAMPATH-1H. This suggests that a large proportion of individuals have cells with PIG-A mutations that are not detectable by flow cytometry and thus may have the potential to develop PNH.

HCy inhibited NO-mediated cavernosal smooth muscle relaxation, an effect that was potentiated by copper and reversed by superoxide dismutase or catalase. It is therefore proposed that the effect of HCy on cavernosal smooth muscle relaxation is mediated by an interaction between NO and superoxide anions. Moreover, HCy may constitute a new risk factor for angiopathic ED.

Our pilot data suggest that the simulator is a reliable assessment method for medical students' performance. Further work may justify the inclusion of the simulator as an evaluation and education tool and expanded to incorporate learning objectives of other medical disciplines.

The behavioural responses of captive possums (Trichosurus vulpecula) were observed during first encounters with non-toxic and toxic carrot and pellet baits used in pest control programmes. Possums confronted with new baits first used smell in a highly discriminating way, and then taste, which sometimes changed their initial response. Toxic carrot baits were rejected by 27.5% of possums, equally by smell and taste aversion, and toxic pellet baits by 34% of possums, mainly by taste aversion. Few (5-7%) rejected non-toxic baits. Such non-learned aversion mechanisms therefore have an important role in the feeding behaviour of possums. A range of flavours tested, using barley as a food base, showed that only orange-flavored barley was significantly preferred to non-flavoured barley; 19 flavours had no significant effect, and 19 others significantly reduced barley consumption. Orange and cinnamon, which was ranked fourth and repels some bird species, were tested as masks for 1080 baits. Both flavours effectively masked the aversive smell and taste of 1080. The levels of toxic flavoured bait rejection were low and did not differ from those of non-toxic (flavoured or non-flavoured) baits. Very few possums were observed vomiting, a behaviour in other species that may assist survival.

Objective  To examine the safety and efficacy of transurethral pharmacotherapy for erectile dysfunction, involving the use of a novel therapeutic system to administer alprostadil (prostaglandin E1) to the urethral mucosa in a double‐blind, randomized, parallel, placebo‐controlled study conducted in five countries in Europe. Patients and methods  In an outpatient setting, patients with primarily organic erectile dysfunction of at least 3 months’ duration were treated with transurethral alprostadil, in an open‐label, dose‐escalating study. Testing stopped when the dose provided an erection sufficient for intercourse, as assessed by the patient and the investigator. Patients who achieved a sufficient response were then randomized to either active medication at the selected dose or to placebo for use at home for 3 months. After each home administration, patients recorded in diaries whether or not sexual intercourse occurred and any adverse reactions to the drug. Results  A total of 249 patients were treated in an outpatient setting; of these patients, 159 (64%) achieved an erection sufficient for intercourse and were randomized (1:1) to either active medication or placebo for home treatment. Of the patients randomized to alprostadil for home treatment, 69% reported intercourse at least once, compared with 11% of patients randomized to placebo (P<0.001). The most common adverse reaction, urethral pain/burning, was reported by 7% of patients in the clinic. Most patients (83%) graded transurethral alprostadil as causing minimal or no discomfort in the clinic. No patient reported priapism or developed penile fibrosis. Conclusion  Alprostadil delivered transurethrally by this system was well tolerated and effective in treating erectile dysfunction.