Keel bone damage (KBD) in laying hens is an important welfare problem in both conventional and organic egg production systems. We aimed to identify possible risk factors for KBD in organic hens by analysing cross-sectional data of 107 flocks assessed in eight European countries. Due to partly missing data, the final multiple regression model was based on data from 50 flocks. Keel bone damage included fractures and/or deviations, and was recorded, alongside with other animal based measures, by palpation and visual inspection of at least 50 randomly collected hens per flock between 52 and 73 weeks of age. Management and housing data were obtained by interviews, inspection and by feed analysis. Keel bone damage flock prevalences ranged from 3% to 88%. Compiled on the basis of literature and practical experience, 26 potential associative factors of KBD went into an univariable selection by Spearman correlation analysis or Mann–Whitney U test (with P<0.1 level). The resulting nine factors were presented to stepwise forward linear regression modelling. Aviary v. floor systems, absence of natural daylight in the hen house, a higher proportion of underweight birds, as well as a higher laying performance were found to be significantly associated with a higher percentage of hens with KBD. The final model explained 32% of the variation in KBD between farms. The moderate explanatory value of the model underlines the multifactorial nature of KBD. Based on the results increased attention should be paid to an adequate housing design and lighting that allows the birds easy orientation and safe manoeuvring in the system. Furthermore, feeding management should aim at sufficient bird live weights that fulfil breeder weight standards. In order to achieve a better understanding of the relationships between laying performance, feed management and KBD further investigations are needed.

Introduction: Pulse check by manual palpation (MP) is an unreliable skill even in the hands of healthcare professionals. In the context of cardiac arrest, this may translate into inappropriate chest compressions when a pulse is present, or conversely omitting chest compressions when one is absent. To date, no study has assessed the utility of B-mode ultrasound (US) for the detection of a carotid pulse. The primary objective of this study is to assess the time required to detect a carotid pulse in live subjects using US compared to the standard MP method. Methods: This is a prospective randomized controlled cross-over non-inferiority trial. Health care professionals from various backgrounds were invited to participate. They attended a 15 minute focused US workshop on identification of the carotid pulse. Following a washout period, they were randomized to detect a pulse in live subjects either by MP first or by US first. Both pulse check methods were timed for each participant on 2 different subjects. The primary outcome measure was time to carotid pulse detection in seconds. Secondary outcome measures included comfort levels of carotid pulse detection measured on a 100mm visual analog scale (VAS), and rates of prolonged pulse checks (greater than 5 or 10 seconds) for each technique. Mean pulse detection times were compared using Students t-test. The study was powered to determine whether US was not slower than MP by greater than 2 seconds. Results: A total of 93 participants completed the study. Time to detect pulse was 4.2 (SD=3.4) seconds by US compared with 4.7 (SD=6.5) seconds by MP (P=0.43). Seventeen (18%) participants took >5 seconds to identify the carotid pulse using US compared to 19 (20%) by MP (P=0.74). Eight (9%) candidates took >10 seconds to identify the pulse using US compared to 9 (10%) by MP (P=0.81). Prior to training, participants had a higher comfort level using MP than US pulse checks (67 vs 26 mm, P<0.001). Following the study, participants reported higher comfort levels using US than MP (88 vs 78 mm, P<0.001). Conclusion: Carotid pulse detection in live subjects was not slower using US as compared to MP in this study. A brief teaching session was sufficient to improve confidence of carotid pulse identification even in those with little to no previous US training. The preliminary results from this study provide the groundwork for larger studies to evaluate this pulse check method for patients in actual cardiac arrest.

Hand stencils are an intriguing feature of prehistoric imagery in caves and rockshelters in several parts of the world, and the recent demonstration that the oldest of those in Western Europe date back to 37 000 years or earlier further enhances their significance. Their positioning within the painted caves of France and Spain is far from random, but responds to the shapes and fissures in the cave walls. Made under conditions of low and flickering light, the authors suggest that touch—‘palpation’—as much as vision, would have driven and directed the locations chosen for these stencils. Detailed study of the images in two Cantabrian caves also allows different individuals to be distinguished, most of whom appear to have been female. Finally, the project reveals deliberate associations between the stencils and features on the cave walls.

Before the advent of diagnostic imaging, palpation was one of the main methods of clinical investigation for the evaluation of tumours. Malignant tumours feel harder that benign ones and this physical property is related to their coefficient of elasticity. Direct comparison of tissue images before and after application of a force is too crude a measure of elasticity except at extremes of differences in elasticity. Analysis of the raw imaging data, which contains very much more information than can be displayed for visual perception, can detect very much smaller differences in elasticity.

The radio frequency data of returning ultrasound echoes contain much more data than appears in an ultrasound image. Comparison, of the datasets of uncompressed tissue with compressed tissue, of a region of interest allows production of a strain (elasticity) image of that same region of interest. Change in tissue which is not visible on B-mode (greyscale) imaging can now be detected with real time strain imaging which is beginning to be developed on commercial ultrasound equipment. The information obtained with strain/elasticity imaging is now showing potential in influencing management of patients with breast problems.

The reproductive biology and ecology of the European pond turtle Emys orbicularis is little known, and available information was previously mainly anecdotal. Morphological data on E. orbicularis are now well documented in most of the known distribution area. Body size in northern populations tends to be larger than in southern populations. There are also indications that clutch size may be larger in northern than in southern European pond turtle populations. Clutch size and reproductive status of a central Italy population were detected by radiography and palpation, respectively, and comparative data were obtained by direct count of intact nest eggs. Reproductive females averaged 13.9 cm and rarely exceeded 15.5 cm carapace length. They produced a clutch size of six, the same number found in intact nests. Nest egg-size averaged 32 mm in length. Egg number was positively associated with female body size, and especially with carapace height.

This prospective study compares the results of pre-operative clinical examination and simple ultrasound examination of the neck in 18 patients with proven head and neck primary tumours and palpable cervical lymphadenopathy, who then underwent 21 radical neck dissections. Neck palpation and ultrasound examination were compared with histological examination. Ultrasound did not add significantly to the information obtainable by simple neck palpation in this group of patients.