bluuebunny/crossref_metadata_2025 huggingface dataset:
Measuring nurse attitudes towards deliberate self‐harm: the Self‐Harm Antipathy Scale (SHAS)
Authors: PATTERSON P. , WHITTINGTON R. , BOGG J.
Published: July 2007

Most mental health nurses engage at some point with clients who harm themselves and these nurses often experience strong negative emotional reactions. Prolonged engagement with relapsing clients can lead to antipathy, and ‘malignant alienation’. The study reported here has the aim of developing a brief, robust instrument for assessing nurse attitudes in this area. The Self‐Harm Antipathy Scale, developed here on a sample of 153 healthcare professionals, has 30 attitudinal items with six factors. It has acceptable face validity, good internal consistency and some evidence of good test–retest reliability. It discriminates effectively between criterion groups. Overall this is evidence for the complexity of nurses' responses to this client group but such complex attitudes can still be assessed using a relatively brief structured instrument.
Job satisfaction in psychiatric nursing
Authors: WARD M. , COWMAN S.
Published: July 2007

In recent years, mental health services across Europe have undergone major organizational change with a move from institutional to community care. In such a context, the impact of change on the job satisfaction of psychiatric nurses has received little attention in the literature. This paper reports on the job satisfaction of psychiatric nurses and data were collected in 2003. The population of qualified psychiatric nurses (n = 800) working in a defined geographical health board area was surveyed. Methodological triangulation with a between‐methods approach was used in the study. Data were collected on job satisfaction using a questionnaire adopted from the Occupational Stress Indicator. A response rate of 346 (43%) was obtained. Focus groups were used to collect qualitative data. Factors influencing levels of job satisfaction predominantly related to the nurses work location. Other factors influencing job satisfaction included choice of work location, work routine, off duty/staff allocation arrangements, teamwork and working environment. The results of the study highlight to employers of psychiatric nurses the importance of work location, including the value of facilitating staff with choices in their working environment, which may influence the recruitment and retention of nurses in mental health services.
Multidisciplinary consensus of best practice for pro re nata (PRN) psychotropic medications within acute mental health settings: a Delphi study
Authors: BAKER J. A. , LOVELL K. , HARRIS N. , CAMPBELL M.
Published: July 2007

There is a limited evidence base for the use of pro re nata (PRN) ‘as required’ psychotropic medication within acute mental health settings. This study aimed to explore expert opinion concerning issues and best practice for the prescribing and administration of psychotropic PRN medications within acute inpatient mental health settings. Eighteen experts participated in three Delphi rounds of a modified Delphi panel to establish consensus. A total of 271 items were initially generated from four questions. As a result of the consensus process the number of items retained reduced to 78, then 34 items and finally 13 items. Clinicians' practice could be informed by the 13 recommendations established by the Delphi panel. Further research is required to establish the clinical effectiveness of these recommendations.
Phylogeography and population structure of the Yunnan snub‐nosed monkey (Rhinopithecus bieti) inferred from mitochondrial control region DNA sequence analysis
Authors: LIU ZHIJIN , REN BAOPING , WEI FUWEN , LONG YONGCHENG , HAO YANLI , LI MING
Published: July 2007

Rhinopithecus bieti, the Yunnan snub‐nosed monkey, is the nonhuman primate with the highest altitudinal distribution and is also one of the 25 most globally endangered primate species. Currently, R. bieti is found in forests between 3000 and 4500 m above sea level, within a narrow area on the Tibetan Plateau between the Yangtze and Mekong rivers, where it is suffering from loss of habitat and shrinking population size (~1500). To assess the genetic diversity within this species, its population structure and to infer its evolutionary history, we sequenced 401 bp of the hypervariable I (HVI) segment from the mitochondrial DNA control region (CR) for 157 individuals from 11 remnant patches throughout the fragmented distribution area. Fifty‐two variable sites were observed and 30 haplotypes were defined. Compared with other primate species, R. bieti cannot be regarded as a taxon with low genetic diversity. Phylogenetic analysis partitioned haplotypes into two divergent haplogroups (A and B). Haplotypes from the two mitochondrial clades were found to be mixed in some patches although the distribution of haplotypes displayed local homogeneity, implying a strong population structure within R. bieti. Analysis of molecular variance detected significant differences among the different geographical regions, suggesting that R. bieti should be separated into three management units (MUs) for conservation. Based on our results, it can be hypothesized that the genetic history of R. bieti includes an initial, presumably allopatric divergence between clades A and B 1.0–0.7 million years ago (Ma), which might have been caused by the Late Cenozoic uplift of the Tibetan Plateau, secondary contact after this divergence as a result of a population expansion 0.16–0.05 Ma, and population reduction and habitat fragmentation in the very recent past.
Genetic variation and population structure in black‐grass (Alopecurus myosuroides Huds.), a successful, herbicide‐resistant, annual grass weed of winter cereal fields
Authors: MENCHARI Y. , DÉLYE C. , LE CORRE V.
Published: July 2007

Black‐grass (Alopecurus myosuroides) is an allogamous grass weed common in cereal fields of northern Europe, which developed resistance to a widely used family of herbicides, the ACCase‐inhibiting herbicides. Resistance is caused by mutations at the ACCase gene and other, metabolism‐based, mechanisms. We investigated the genetic structure of 36 populations of black‐grass collected in one region of France (Côte d’Or), using 116 amplified fragment length polymorphism (AFLP) loci and sequence data at the ACCase gene. The samples were characterized for their level of herbicide resistance and genotyped for seven known ACCase mutations conferring resistance. All samples contained herbicide‐resistant plants, and 19 contained ACCase mutations. The genetic diversity at AFLP loci was high (HT = 0.246), while differentiation among samples was low (FST = 0.023) and no isolation by distance was detected. Genetic diversity within samples did not vary with the frequency of herbicide resistance. A Bayesian algorithm was used to infer population structure. The two genetic clusters inferred were not associated with any geographical structure or with herbicide resistance. A high haplotype diversity (Hd = 0.873) and low differentiation (GST = 0.056) were observed at ACCase. However, haplotype diversity within samples decreased with the frequency of ACCase‐based resistance. We suggest that the genetic structure of black‐grass is affected by its recent expansion as a weed. Our data demonstrate that the strong selection imposed by herbicides did not modify the genome‐wide genetic structure of an allogamous weed that probably has large effective population sizes. Our study gives keys to a better understanding of the evolution of successful, noxious weeds in modern agriculture.
Phylogeography of the olive sea snake, Aipysurus laevis (Hydrophiinae) indicates Pleistocene range expansion around northern Australia but low contemporary gene flow
Authors: LUKOSCHEK V. , WAYCOTT M. , MARSH H.
Published: July 2007

Pleistocene sea‐level fluctuations profoundly changed landmass configurations around northern Australia. The cyclic emergence of the Torres Strait land bridge and concomitant shifts in the distribution of shallow‐water marine habitats repeatedly sundered east and west coast populations. These biogeographical perturbations invoke three possible scenarios regarding the directions of interglacial range expansion: west to east, east to west, or bidirectional. We evaluated these scenarios for the olive sea snake, Aipysurus laevis, by exploring its genetic structure around northern Australia based on 354 individuals from 14 locations in three regions (Western Australia, WA; Gulf of Carpentaria, GoC; Great Barrier Reef, GBR). A 726‐bp fragment of the mitochondrial DNA ND4 region revealed 41 variable sites and 38 haplotypes, with no shared haplotypes among the three regions. Population genetic structure was strong overall, φST = 0.78, P < 0.001, and coalescent analyses revealed no migration between regions. Genetic diversity was low in the GBR and GoC and the genetic signatures of these regions indicated range or population expansions consistent with their recent marine transgressions around 7000 years ago. By contrast, genetic diversity on most WA reefs was higher and there were no signals of recent expansion events on these reefs. Phylogenetic analyses indicated that GBR and GoC haplotypes were derived from WA haplotypes; however, statistical parsimony suggested that recent range expansion in the GBR‐GoC probably occurred from east coast populations, possibly in the Coral Sea. Levels of contemporary female‐mediated gene flow varied within regions and reflected potential connectivity among populations afforded by the different regional habitat types.
Mediterranean populations of the lesser white‐toothed shrew (Crocidura suaveolensgroup): an unexpected puzzle of Pleistocene survivors and prehistoric introductions
Authors: DUBEY S. , COSSON J‐F. , MAGNANOU E. , VOHRALÍK V. , BENDA P. , FRYNTA D. , HUTTERER R. , VOGEL V. , VOGEL P.
Published: July 2007

An earlier study revealed the strong phylogeographical structure of the lesser white‐toothed shrew (Crocidura suaveolensgroup) within the northern Palaearctic. Here, we aim to reconstruct the colonization history of Mediterranean islands and to clarify the biogeography and phylogeographical relationships of the poorly documented Middle East region with the northern Palaearctic. We performed analyses on 998‐bp‐long haplotypes of the mitochondrial cytochromebgene of 143 samples collected around the Mediterranean basin, including islands and the Middle East. The analyses suggest that the Cypriot shrew belongs to the rare group of relict insular Pleistocene mammal taxa that have survived to the present day. In contrast, the Cretan, Corsican and Menorcan populations were independently introduced from the Middle East during the Holocene. The phylogeographical structure of this temperate Palaearctic species within the Middle East appears to be complex and rich in diversity, probably reflecting fragmentation of the area by numerous mountain chains. Four deeply divergent clades of theC. suaveolensgroup occur in the area, meaning that a hypothetical contact zone remains to be located in central western Iran.
Captive breeding and the reintroduction of Mexican and red wolves
Authors: HEDRICK P. W. , FREDRICKSON R. J.
Published: July 2007

Mexican and red wolves were both faced with extinction in the wild until captive populations were established more than two decades ago. These captive populations have been successfully managed genetically to minimize mean kinship and retain genetic variation. Descendants of these animals were subsequently used to start reintroduced populations, which now number about 40–50 Mexican wolves in Arizona and New Mexico and about 100 red wolves in North Carolina. The original captive Mexican wolf population was descended from three founders. Merging this lineage with two other captive lineages, each with two founders, has been successfully carried out in the captive population and is in progress in the reintroduced population. This effort has resulted in increased fitness of cross‐lineage wolves, or genetic rescue, in both the captive and reintroduced populations. A number of coyote‐red wolf hybrid litters were observed in the late 1990s in the reintroduced red wolf population. Intensive identification and management efforts appear to have resulted in the elimination of this threat. However, population reintroductions of both Mexican and red wolves appear to have reached numbers well below the generally recommended number for recovery and there is no current effort to re‐establish other populations.
Contrasting patterns of mitochondrial and microsatellite genetic structure among Western European populations of tawny owls (Strix aluco)
Authors: BRITO PATRÍCIA H.
Published: July 2007

A recent study of mitochondrial phylogeography of tawny owls (Strix aluco) in western Europe suggested that this species survived the Pleistocene glaciations in three allopatric refugia located in Iberia, Italy, and the Balkans, and the latter was likely the predominant source of postglacial colonization of northern Europe. New data from seven microsatellite loci from 184 individual owls distributed among 14 populations were used to assess the genetic congruence between nuclear and mitochondrial DNA (mtDNA) markers. Microsatellites corroborated the major phylogeographical conclusions reached on the basis of the mtDNA sequences, but also showed important differences leading to novel inferences. Microsatellites corroborated the three major refugia and supported the Balkan origin of northern populations. When corrected for differences in effective population size, microsatellites and mtDNA yielded generally congruent overall estimates of population structure ( = 0.12 vs. RST = 0.16); however, there was substantial heterogeneity in the RST among the seven nuclear loci that was not correlated with heterozygosity. Populations representing the Balkans postglacial expansion interact with populations from the other two refugia forming two clines near the Alps and the Pyrenees. In both cases, the apparent position of the contact zones differed substantially between markers due to the genetic composition of populations sampled in northern Italy and Madrid. Microsatellite data did not corroborate the lower genetic diversity of northern, recently populated regions as was found with mtDNA; this discrepancy was taken as evidence for a recent bottleneck recovery. Finally, this study suggests that congruence among genetic markers should be more likely in cases of range expansion into new areas than when populations interact across contact zones.
Population structure and species boundary delimitation of cryptic Dioryctria moths: an integrative approach
Authors: ROE AMANDA D. , SPERLING FELIX A. H.
Published: July 2007

Accurate delimitation of species boundaries is especially important in cryptic taxa where one or more character sources are uninformative or are in conflict. Rather than relying on a single marker to delimit species, integrative taxonomy uses multiple lines of evidence such as molecular, morphological, behavioural and geographic characters to test species limits. We examine the effectiveness of this approach by testing the delimitation of two cryptic Nearctic species of Dioryctria (Lepidoptera: Pyralidae) using three independent molecular markers [cytochrome c oxidase I (COI), second internal transcribed spacer unit (ITS2), and elongation factor 1α (EF1α)], forewing variation and larval host plant association. Although mitochondrial DNA (mtDNA) haplotypes do not form reciprocally monophyletic clades, restricted gene flow between COI haplotype groups, and concordance with ITS2 genotypes, forewing variation and host plant associations support delimitation of two Nearctic species: eastern Dioryctria reniculelloides and western Dioryctria pseudotsugella. Conversely, EF1α genotype variation was incongruent with the two previous markers. A case of discordance between COI and ITS2 was detected, suggesting either introgression due to hybridization or retained ancestral polymorphism due to incomplete coalescence. This study is consistent with other similar literature where molecular loci in closely related species progress from shared to fixed haplotypes/alleles, and from polyphyletic to reciprocally monophyletic relationships, although loci may vary in these characteristics despite maintenance of genomic integrity between distinct species. In particular, mtDNA in other studies generally showed a lower rate of fixation of differences than did X‐linked or autosomal loci, reinforcing the need to use an integrative approach for delimiting species.
Molecular ecological approaches to studying the evolutionary impact of selective harvesting in wildlife
Authors: COLTMAN DAVID W.
Published: July 2007

Harvesting of wildlife populations by humans is usually targeted by sex, age or phenotypic criteria, and is therefore selective. Selective harvesting has the potential to elicit a genetic response from the target populations in several ways. First, selective harvesting may affect population demographic structure (age structure, sex ratio), which in turn may have consequences for effective population size and hence genetic diversity. Second, wildlife‐harvesting regimes that use selective criteria based on phenotypic characteristics (e.g. minimum body size, horn length or antler size) have the potential to impose artificial selection on harvested populations. If there is heritable genetic variation for the target characteristic and harvesting occurs before the age of maturity, then an evolutionary response over time may ensue. Molecular ecological techniques offer ways to predict and detect genetic change in harvested populations, and therefore have great utility for effective wildlife management. Molecular markers can be used to assess the genetic structure of wildlife populations, and thereby assist in the prediction of genetic impacts by delineating evolutionarily meaningful management units. Genetic markers can be used for monitoring genetic diversity and changes in effective population size and breeding systems. Tracking evolutionary change at the phenotypic level in the wild through quantitative genetic analysis can be made possible by genetically determined pedigrees. Finally, advances in genome sequencing and bioinformatics offer the opportunity to study the molecular basis of phenotypic variation through trait mapping and candidate gene approaches. With this understanding, it could be possible to monitor the selective impacts of harvesting at a molecular level in the future. Effective wildlife management practice needs to consider more than the direct impact of harvesting on population dynamics. Programs that utilize molecular genetic tools will be better positioned to assess the long‐term evolutionary impact of artificial selection on the evolutionary trajectory and viability of harvested populations.
Genetic evidence supports song learning in the three‐wattled bellbirdProcnias tricarunculata(Cotingidae)
Authors: SARANATHAN VINODKUMAR , HAMILTON DEBORAH , POWELL GEORGE V. N. , KROODSMA DONALD E. , PRUM RICHARD O.
Published: July 2007

Vocal learning is thought to have evolved in three clades of birds (parrots, hummingbirds, and oscine passerines), and three clades of mammals (whales, bats, and primates). Behavioural data indicate that, unlike other suboscine passerines, the three‐wattled bellbirdProcnias tricarunculata(Cotingidae) is capable of vocal learning.Procnias tricarunculatashows conspicuous vocal ontogeny, striking geographical variation in song, and rapid temporal change in song within a population. Deprivation studies of vocal development inP. tricarunculataare impractical. Here, we report evidence from mitochondrial DNA sequences and nuclear microsatellite loci that genetic variation within and among the four allopatric breeding populations ofP. tricarunculatais not congruent with variation in vocal behaviour. Sequences of the mitochondrial DNA control region document extensive haplotype sharing among localities and song types, and no phylogenetic resolution of geographical populations or behavioural groups. The vocally differentiated, allopatric breeding populations ofP. tricarunculataare only weakly genetically differentiated populations, and are not distinct taxa. Mitochondrial DNA and microsatellite variation show small (2.9% and 13.5%, respectively) but significant correlation with geographical distance, but no significant residual variation by song type. Estimates of the strength of selection that would be needed to maintain the observed geographical pattern in vocal differentiation if songs were genetically based are unreasonably high, further discrediting the hypothesis of a genetic origin of vocal variation. These data support a fourth, phylogenetically independent origin of avian vocal learning inProcnias. Geographical variations inP. tricarunculatavocal behaviour are likely culturally evolved dialects.
Rapid cold‐hardening of Drosophila melanogaster in a field setting
Authors: KELTY JONATHAN
Published: July 2007

Abstract Although laboratory studies demonstrate that cooling to ecologically relevant temperatures and/or at ecologically relevant rates induces rapid cold‐hardening (RCH) in a variety of insects, little is known of the induction of RCH in nature. In the present study, caged Drosophila melanogaster (1–2 days posteclosion) from a colony established with flies collected locally are placed in a field setting (i.e. in approximately 4‐cm deep leaf litter beneath an apple tree in Mount Pleasant, Michigan) during late afternoon (18.00 h EST; 05.00 h GMT). As the cage temperature falls from 22.1 ± 0.8 to 10.1 ± 0.1 °C between 18.00 and 06.00 h, the proportion of flies surviving a transfer to –6 °C for 1 h increases from 10.0 ± 6.2% to 68.1 ± 7.2%. When obtained from field cages, and then cooled from 23 °C at approximately 0.33 °C min−1, more female flies remain behaviourally responsive (clinging to surfaces, exhibiting an active righting response, and/or climbing) at temperatures of 8–12 °C (24.00 h samples) or 7–12 °C (06.00 h samples), than do those sampled from cages kept in an incubator (23 °C). Field cooling reduces chill coma temperature from 8.7 ± 0.2 °C at 06.00 h to 7.1 ± 0.2 °C at 24.00 h, and to 6.6 ± 0.2 °C at 06.00 h. These data demonstrate that, in a recently collected culture of D. melanogaster, natural changes in microenvironmental temperature induce RCH that can benefit the organism at temperatures encountered in nature.
Viral hepatitis infections among dialysis patients: Thailand registry report
Authors: THANACHARTWET VIPA , PHUMRATANAPRAPIN WEERAPONG , DESAKORN VARUNEE , SAHASSANANDA DUANGJAI , WATTANAGOON YUPAPORN , CHAIPRASERT AMNART , AIMPUN POTE , SUPAPORN THANOM
Published: July 2007

Background:  Patients on dialysis are at high risk of acquiring viral hepatitis infections. However, there were only few data from Thailand. The aim of the present study was to assess the prevalence, incidence and associated risk factors of viral hepatitis infections among dialysis patients.

Methods:  A retrospective study was conducted to evaluate 5179 medical records of dialysis patients from the Thailand Renal Replacement Therapy Registry.

Results:  In 2002, the seroprevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections were 6.3% (n = 2454) and 4.8% (n = 2167), respectively. HBV and HCV seroprevalence became 6.5% (n = 2585) and 4.3% (n = 2399) in 2003. The incidence of HBV and HCV infections were 1.5 and 2.4 cases per 1000 patient‐years, respectively. Logistic regression analysis showed that age and gender were significant risk factors for HBV infection, but not for HCV infection.

Conclusion:  In Thailand, it was not uncommon for dialysis patients to acquire viral hepatitis infections. However, our prevalence is similar to reports from some other South‐East Asian countries.
Hereditary hypophosphatemias: New genes in the bone–kidney axis (Review Article)
Authors: NEGRI ARMANDO L
Published: July 2007

Hypophosphatemia due to isolated renal phosphate wasting is a genetically heterogeneous disease. Two new genes linked to two different forms of hereditary hypophosphatemias have recently been described. Autosomal recessive form of hypophosphatemic rickets was mapped to chromosome 4q21 and identified homozygous mutations in dentin matrix protein 1 (DMP1) gene, which encodes a non‐collagenous bone matrix protein. Intact plasma levels of the phosphaturic protein FGF23 (fibroblast growth factor 23) were clearly elevated in some of the affected individuals, providing a possible explanation for the phosphaturia and inappropriately normal 1,25(OH)2D levels, and suggesting that DMP1 may regulate FGF23 expression. Hereditary hypophosphatemic rickets with hypercalciuria is another rare disorder of autosomal recessive inheritance. Affected individuals present with hypercalciuria due to increased serum 1,25‐dihydroxyvitamin D levels and increased intestinal calcium absorption. The disease was mapped to a 1.6 Mbp region on chromosome 9q34, which contains SLC34A3, the gene encoding the renal sodium‐phosphate cotransporter NaPi‐IIc. This was the first demonstration that NaPi‐IIc has a key role in the regulation of phosphate homeostasis. Thus, DMP1 and NaPi‐IIc add two new members to the bone–kidney axis proposed since it was discovered that the first phosphatonin, FGF23, was of osteoblastic/osteocyte origin. This provides a mechanism for the skeleton to communicate with the kidney to coordinate the mineralization of extracelular matrix and the renal handling of phosphate.
GUIDELINES FOR THE MANAGEMENT OF HAEMODYNAMICALLY STABLE PATIENTS WITH STAB WOUNDS TO THE ANTERIOR ABDOMEN
Authors: Sugrue Michael , Balogh Zsolt , Lynch Joan , Bardsley Joel , Sisson Glenn , Weigelt John
Published: July 2007

Clinical practice guidelines have been shown to improve the delivery of care. Anterior abdominal stab wounds, although uncommon, pose a challenge in both rural and urban trauma care. A multidisciplinary working party was established to assist in the development of evidence‐based guidelines to answer three key clinical questions: (i) What is the ideal prehospital management of anterior abdominal stab wounds? (ii) What is the ideal management of anterior abdominal stab wounds in a rural or urban hospital without an on‐call surgeon? (iii) What is the ideal emergency management of stable patients with anterior abdominal stab wounds when surgical service is available? A systematic review, using Cochrane method, was undertaken. The data were graded by level of evidence as outlined by the Australian National Health and Medical Research Council. Stable patients with anterior abdominal stab wounds should be transported to the hospital without delay. Any interventions deemed necessary in prehospital care should be undertaken en route to hospital. In rural hospitals with no on‐call surgeon, local wound exploration (LWE) may be undertaken by a general practitioner if confident in this procedure. Otherwise or in the presence of obvious fascial penetration, such as evisceration, the patient should be transferred to the nearest main trauma service for further management. In urban hospitals the patient with omental or bowel evisceration or generalized peritonitis should undergo urgent exploratory laparotomy. Stable patients may be screened using LWE. Abdominal computed tomography scan and plain radiographs are not indicated. Obese and/or uncooperative patients require a general anaesthetic for laparoscopy. If there is fascial penetration on LWE or peritoneal penetration on laparoscopy, then an urgent laparotomy should be undertaken. The developed evidence‐based guidelines for stable patients with anterior abdominal stab wounds may help minimize unnecessary diagnostic tests and non‐therapeutic laparotomy rates.
EPIDEMIC OF STAB INJURIES: AN ALICE SPRINGS DILEMMA
Authors: Jacob Abraham O , Boseto Fred , Ollapallil Jacob
Published: July 2007

This study is unique in that it strives to unfold, perhaps for the first time, the problem of stab injuries and resultant significant mortality and morbidity within the Aboriginal population of Central Australia. Demographic features presented in the study are quite different from other published Australasian and overseas experiences. There were 1550 stab injury admissions to Alice Springs Hospital during a 7‐year period (July 1998 to June 2005). Thirty‐two patients were dead before arrival, and there were only three deaths in the hospital during the period of study. The most unique demographic feature was that 99.99% were Aborigines, 53% were women and the most common location of injury was in town camps and homes. The mean age of this population was 31 years, and the average length of stay in hospital was 3 days. The most common site of the stab injuries was the thigh with a total of 605 (38%). Stab injuries to the abdomen were significantly low with 68 (<1%). Twenty‐one per cent (332) presented 24 h to 10 days after stabbing. Another 21% (335) absconded before the completion of treatment. Of the victims, 31% (481) were under the influence of alcohol. Twenty per cent (311) of the patients presented with repeat stabbings during the study period. Traditional punishment is still practised in Central Australia and thus explains the high number of thigh injuries. A particular pattern of traditional stab injuries was also noted; medial thigh to kill, posterior thigh to permanently disable and lateral thigh to punish. Rampant alcoholism and social and family breakdown are thought to be significant contributors to the high incidence of violence in Alice Springs. There were only five firearm traumas during this period, two were self‐inflicted and three were accidental.
SIGNIFICANCE OF TUMOUR VOLUME MEASUREMENTS IN TONGUE CANCER: A NOVEL ROLE IN STAGING
Authors: Chew Min H. , Khoo James B. K. , Chong Vincent F. H. , Tai Bee C. , Soo Kee C. , Lim Dennis T. H.
Published: July 2007

Background: Tongue cancers are staged by the American Joint Committee on Cancer and the Union Internationale Contre le Cancer TNM staging systems. Cancer, however, evolves in a 3‐D plane. Hence, using the largest tumour diameter will not reflect total cancer volume. We aim to evaluate the use of tongue cancer tumour volume (Tv) as a prognostic predictor of disease recurrence and survival.

Methods: The study is a retrospective analysis of patients in Singapore General Hospital who underwent complete resection for histologically proven tongue carcinoma from 2000 to 2002. The Tv was measured on staging T2‐weighted magnetic resonance imaging datasets by semiautomated methods.

Results: Seventeen patients with a median follow‐up duration of 57.9 months were studied. A wide range of volumes was noted in each T stage. The median time to relapse was 8.6 months for those with Tv ≥ 13 cc but was not achieved for those with Tv < 13 cc. The hazard ratio comparing Tv ≥13 cc versus <13 cc is 9.02 (95% confidence interval (CI) 1.70–47.94,P = 0.014). Of the seven deaths reported, five patients had Tv ≥ 13 cc. The median overall survival was 15.8 months for those with Tv ≥ 13 cc but was not achieved for those with Tv < 13 cc. The hazards of death for Tv ≥ 13 cc was 3.91 times that of Tv < 13 cc (95%CI 0.86–17.86,P = 0.078).

Conclusion: Tongue cancer Tv measurement allows a more refined and accurate assessment of tumour status. This can be a possible prognostic indicator and be used in a novel staging method for the future.
INCIDENCE OF HETEROTOPIC OSSIFICATION AFTER HIP RESURFACING
Authors: Back Diane L. , Smith Jay D. , Dalziel Rodney E. , Young David A. , Shimmin Andrew
Published: July 2007

Background: Heterotopic ossification has been noted around total hip arthoplasty in numerous studies. With hip resurfacing growing in popularity, we have prospectively evaluated the incidence in a cohort undergoing hip resurfacing.

Methods: Two hundred and twenty consecutive hip‐resurfacing procedures were prospectively reviewed at a minimum of 2 years follow up to assess the incidence of heterotopic ossification and its effect on function and clinical outcome. We also reviewed the preoperative diagnosis, age, sex and previous surgery.

Results: The overall percentage of heterotopic ossification was 58.63%. The incidence of Brooker 1 was 37.27%, Brooker 2 was 13.18% and Brooker 3 was 8.18%. Male osteoarthritis had the highest incidence of heterotopic bone formation (HBF). Three men underwent excision of heterotopic bone, two for pain and stiffness and one for decreased range of movement. Both anteroposterior and lateral radiographs were reviewed for evidence of HBF. In all, 12.7% had no evidence of HBF in the first view but clearly had in the second view.

Conclusions: Overall, we found no evidence that HBF affected the clinical or functional outcome of the hip resurfacing at a mean of 3 years follow up. However, in light of the high incidence of HBF seen in a yet unproven long‐term prosthesis, we conclude that the Cochrane database recommendations with regard to prophylaxis should be implemented.
RANDOMIZED TRIAL COMPARING PANTOPRAZOLE INFUSION, BOLUS AND NO TREATMENT ON GASTRIC pH AND RECURRENT BLEEDING IN PEPTIC ULCERS
Authors: Hung Wai‐ka , Li Vicky K. M. , Chung Chi‐kin , Ying Marcus W. L. , Loo Ching‐kong , Liu Cecilia K. T. , Lam Billy Y. K. , Chan Miranda C. M.
Published: July 2007

Background:  To study the effects of pantoprazole on gastric pH and recurrent bleeding after endoscopic treatment for bleeding peptic ulcers.

Methods:  After endoscopic haemostasis, patients were randomly assigned to infusion group (pantoprazole 80 mg i.v. bolus followed by continuous infusion of 8 mg/h for 3 days), bolus group (pantoprazole 80 mg i.v. bolus followed by 40 mg i.v. bolus every 12 h for 3 days) and no‐treatment group (no acid suppression in the first 3 days). Gastric pH was monitored. Rebleeding rate within 30 days, the need for surgery, transfusion requirement, total hospital stay, mortality rate and gastric pH were compared.

Results:  One hundred and sixty‐eight patients were included, with 15 patients excluded from the analysis. There were 54 patients in the infusion group, 49 in the bolus group and 50 in the no‐treatment group. There was fewer rebleeding (3.7 vs 16.0%, P = 0.034), less operative intervention (0 vs 8.0%, P = 0.034) and shorter hospital stay (6.4 vs 8.2 days, P = 0.040) in the infusion group compared with that in no‐treatment group. When the bolus group was compared with no‐treatment group, there were fewer rebleed (4.1 vs 16.0%, P = 0.049) and less blood transfusion (1.5 vs 2.9 units, P = 0.007). There was no difference in mortality among the three groups. Patients who received either pantoprazole infusion or bolus had significantly higher mean pH and longer duration of pH above 6 compared with the no‐treatment group. There was no difference in the rebleeding rate, transfusion requirement, need for operation and hospital stay between the infusion and bolus groups. The mean pH and the duration of pH above 6 were also similar.

Conclusion:  Pantoprazole either as infusion or bolus decreased rebleeding after endoscopic treatment for bleeding peptic ulcer.
BLUNT CHEST TRAUMA IN CHILDHOOD
Authors: Inan Mustafa , Ayvaz Suleyman , Sut Necdet , Aksu Burhan , Basaran Umit N. , Ceylan Turan
Published: July 2007

Background:  Although thoracic injuries are uncommon in children, their rate of morbidity and mortality is high. The aim of this study was to evaluate the clinical features of children with blunt chest injury and to investigate the predictive accuracy of their paediatric trauma scores (PTS).

Methods:  Between September 1996 and September 2006, children with blunt thoracic trauma were evaluated retrospectively. Clinical features and PTS of the patients were recorded.

Results:  There were 27 male and 17 female patients. The mean age was 7.1 ± 3.4 years, and the mean PTS was 7.6 ± 2.4. Nineteen cases were injuries caused by motor vehicle/pedestrian accidents, 11 motor vehicle accidents, 8 falls and 6 motor vehicle/bicycle or motorbike accidents. The following were noted: 28 pulmonary contusions, 12 pneumothoraxes, 10 haemothoraxes, 9 rib fractures, 7 haemopneumothoraxes, 5 clavicle fractures and 2 flail chests, 1 diaphragmatic rupture and 1 pneumatocele case. The cut‐off value of PTS to discriminate mortality was found to be ≤4, at which point sensitivity was 75.0% and specificity was 92.5%. Twenty‐seven patients were treated non‐operatively, 17 were treated with a tube thoracostomy and two were treated with a thoracotomy. Four patients who suffered head and abdominal injuries died (9.09%).

Conclusion:  Thoracic injuries in children expose a high mortality rate as a consequence of head or abdominal injuries. PTS may be helpful to identify mortality in children with blunt chest trauma. Blunt thoracic injuries in children can be treated with a non‐operative approach and a tube thoracostomy.
BLUNT CEREBROVASCULAR INJURY: AN EVALUATION FROM A MAJOR TRAUMA CENTRE
Authors: Risgaard Ole , Sugrue Michael , D’Amours Scott , Christey Grant , Smith Katherine , Caldwell Erica , Larivière Christian
Published: July 2007

Background:  Blunt cerebrovascular injury (BCVI), although uncommon, is associated with substantial morbidity and mortality and remains poorly understood. This study was conducted to determine the pattern and outcome of BCVI at a major trauma centre.

Methods:  A retrospective review of all trauma admissions between 1996 and 2004 at Liverpool Hospital, the major trauma service for south‐west Sydney, was undertaken using the hospital’s computerized trauma registry.

Results:  Fourteen of the 7788 (0.18%) admitted blunt trauma patients sustained BCVI. Blunt carotid injury occurred in 10 of 14 and blunt vertebral injury occurred in 4 of 14 patients. Road trauma accounted for 9 of 14 cases. The median time to diagnosis was 2 days (range 1–45 days). The stroke rate was 36%, and the overall mortality was 29%.

Conclusion:  This study identified BCVI as a relatively infrequent occurrence but with significant mortality and morbidity rates. Practice guidelines for both the screening and management of this patient group need to be developed and introduced in this major trauma centre.
TRAUMA CENTRE EXPERIENCE: FLAP RECONSTRUCTION OF TRAUMATIC LOWER LIMB INJURIES
Authors: Lo Cheng H. , Leung Michael , Baillieu Charles , Chong Elaine W. T. , Cleland Heather
Published: July 2007

Background:  Decision‐making in the management of combined major skeletal and soft tissue trauma to the lower limb is a complex process made more difficult by the uncertainty surrounding outcomes. The aim of this study was to review and present our experience with flap reconstruction of traumatic lower limb defects, with particular reference to in‐hospital complications and outcomes related to timing, choice of flap and pre‐existing complications.

Methods:  Retrospective review of all lower limb flap reconstructions carried out by the Plastic and Reconstructive Surgery Unit at the Alfred Hospital from 1 July 2001 to 20 October 2005 (51‐month period) was carried out.

Results:  Sixty‐four patients had 83 flap reconstructions (35 free and 48 local) of 70 separate lower limb injuries. Internal skeletal fixation was followed by earlier soft tissue coverage and lower deep metal infection rates. Twenty‐seven flaps (32.5%) developed soft tissue infections, and 16 fixation devices (25.8%) were complicated by deep metal infection. There were six (12.5%) local flap partial necrosis and four (11.4%) free flap failures. Limbs in which flaps were carried out after day 5 were more likely to develop deep metal infection (P = 0.04) and suffer free flap failure or local flap partial necrosis (P = 0.02). Three patients underwent secondary amputation during their initial admission.

Conclusions:  The current study presented our experience with flap reconstruction of complex lower limb injuries at a major trauma centre. Thorough wound debridement, internal fixation and early soft tissue coverage (within 5 days of injury) were associated with lower infection rates and optimal outcomes.
Modelling the vertical distribution of Prochlorococcus and Synechococcus in the North Pacific Subtropical Ocean
Authors: Rabouille Sophie , Edwards Christopher A. , Zehr Jonathan P.
Published: July 2007

A simple model was developed to examine the vertical distribution of Prochlorococcus and Synechococcus ecotypes in the water column, based on their adaptation to light intensity. Model simulations were compared with a 14‐year time series of Prochlorococcus and Synechococcus cell abundances at Station ALOHA in the North Pacific Subtropical Gyre. Data were analysed to examine spatial and temporal patterns in abundances and their ranges of variability in the euphotic zone, the surface mixed layer and the layer in the euphotic zone but below the base of the mixed layer. Model simulations show that the apparent occupation of the whole euphotic zone by a genus can be the result of a co‐occurrence of different ecotypes that segregate vertically. The segregation of ecotypes can result simply from differences in light response. A sensitivity analysis of the model, performed on the parameter α (initial slope of the light‐response curve) and the DIN concentration in the upper water column, demonstrates that the model successfully reproduces the observed range of vertical distributions. Results support the idea that intermittent mixing events may have important ecological and geochemical impacts on the phytoplankton community at Station ALOHA.
Rare actinomycete bacteria from the shallow water sediments of the Trondheim fjord, Norway: isolation, diversity and biological activity
Authors: Bredholdt Harald , Galatenko Olga A. , Engelhardt Kerstin , Fjærvik Espen , Terekhova Larissa P. , Zotchev Sergey B.
Published: July 2007

Actinomycete bacteria produce a wide variety of secondary metabolites with diverse biological activities, some of which have been developed for human medicine. Rare actinomycetes are promising sources in search for new drugs, and their potential for producing biologically active molecules is poorly studied. In this work, we have investigated the diversity of actinomycetes in the shallow water sediments of the Trondheim fjord (Norway). Due to the use of different selective isolation methods, an unexpected variety of actinomycete genera was isolated. Although the predominant genera were clearly Streptomyces and Micromonospora, representatives of Actinocorallia, Actinomadura, Knoellia, Glycomyces, Nocardia, Nocardiopsis, Nonomuraea, Pseudonocardia, Rhodococcus and Streptosporangium genera were isolated as well. To our knowledge, this is the first report describing isolation of Knoellia and Glycomyces species from the marine environment. 35 selected actinomycete isolates were characterized by 16S rDNA sequencing, and were shown to represent strains from 11 different genera. In addition, these isolates were tested for antimicrobial activity and the presence of polyketide synthase and non‐ribosomal peptide synthetase genes. This study confirms the significant biodiversity of actinobacteria in the Norwegian marine habitats, and their potential for producing biologically active compounds.
Submersed macrophytes play a key role in structuring bacterioplankton community composition in the large, shallow, subtropical Taihu Lake, China
Authors: Wu Qinglong L. , Zwart Gabriel , Wu Jianfeng , Kamst‐van Agterveld Miranda P. , Liu Shuangjiang , Hahn Martin W.
Published: July 2007

Within‐lake horizontal heterogeneity of bacterioplankton community composition (BCC) was investigated in the large and shallow subtropical Taihu Lake (2338 km2, maximum depth < 3 m). Samples were collected at 17 sites along a trophic gradient ranging from mesotrophic to hypertrophic areas in August and September 2004. These sites cover two alternative stable states of shallow lakes, which are basically characterized by the dominance or the lack of submerged macrophytes. In the case of Taihu Lake, the macrophyte‐dominated state is characterized by clear water and immobilized sediment, and the state largely lacking macrophytes is characterized by the dominance of phytoplankton, frequent wind‐driven re‐suspension of sediments, and a high turbidity. Three different methods, i.e. denaturing gradient gel electrophoresis (DGGE), reverse line blot hybridization (RLB) with probes targeting 17 freshwater bacterial groups, and 16S rRNA gene cloning and sequencing, were used for analysis of BCC. The BCC varied strongly between the two alternative ecological states, but less pronounced between phytoplankton‐dominated sites even spanning chlorophyll a gradients from 16.5 (mesotrophic) to 229.8 μg l−1 (hypertrophic). The 16S rRNA gene library representing the turbid water state contained many sequences closely related to sequences previously obtained from soil or freshwater sediment samples. Furthermore, sequences representing two new lineages of freshwater Actinobacteria were obtained from the investigated samples. Comparative statistical analyses of BCC along the investigated ecological gradients revealed that the dominance of submersed macrophytes was the most influential factor on BCC, responsible for a major part of the observed within‐habitat heterogeneity of BCC in Taihu Lake.
Self‐produced extracellular stimuli modulate the Pseudomonas aeruginosa swarming motility behaviour
Authors: Tremblay Julien , Richardson Anne‐Pascale , Lépine François , Déziel Eric
Published: July 2007

Pseudomonas aeruginosa presents three types of motilities: swimming, twitching and swarming. The latter is characterized by rapid and coordinated group movement over a semisolid surface resulting from morphological differentiation and intercellular interactions. A striking feature of P. aeruginosa swarming motility is the formation of migrating tendrils producing colonies with complex fractal‐like patterns. Previous studies have shown that normal swarming motility is intimately related to the production of extracellular surface‐active molecules: rhamnolipids (RLs), composed of monorhamnolipids (mono‐RLs) and dirhamnolipids (di‐RLs), and 3‐(3‐hydroxyalkanoyloxy) alkanoic acids (HAAs). Here, we report that (i) di‐RLs attract active swarming cells while HAAs behave as strong repellents, (ii) di‐RLs promote and HAAs inhibit tendril formation and migration, (iii) di‐RLs and HAAs display different diffusion kinetics on a surface as di‐RLs spread faster than HAAs in agar, (iv) di‐RLs and HAAs have no effect on swimming cells, suggesting that swarming cells are different from swimming cells not only in morphology but also at the regulatory level and (v) mono‐RLs act as wetting agents. We propose a model explaining how HAAs and di‐RLs together modulate the behaviour of swarming migrating cells by acting as self‐produced negative and positive chemotactic‐like stimuli.