bluuebunny/crossref_metadata_2025 huggingface dataset:
Influence of birth size on body composition in early adulthood: the programming factors for growth and metabolism (PROGRAM)‐study
Authors: Leunissen R. W. J. , Stijnen T. , Hokken‐Koelega A. C. S.
Published: August 2008

Background/Objectives  Several studies have investigated the relationship of birth size with fat mass and lean body mass (LBM), but the findings differed greatly due to different ways of measuring FM and LBM, different study populations and age groups. We hypothesized that birth size has no influence on adult body composition, whereas weight gain during childhood has.

Methods  In the programming factors for growth and metabolism (PROGRAM)‐study, a cohort of 312 young adults, aged 18–24 years, FM and LBM were determined by dual energy X‐ray absorptiometry (DXA). Subsequently, differences in FM and LBM were analysed in four subgroups, young adults either born small for gestational age with short stature (SGA‐S) or with catch‐up growth (SGA‐CU), or born appropriate for gestational age (AGA) with idiopathic short stature (ISS) or with normal stature (controls).

Results  Age, gender, adult height SDS and adult weight SDS were significant positive determinants of FM and LBM, whereas weight gain during childhood was positively significant for FM and negatively for LBM. Birth weight SDS tended to be significant and birth length SDS was not. Weight gain during childhood was positively correlated with waist : hip ratio and trunk fat : total fat ratio. SGA‐CU subjects had significantly higher FM and significantly lower LBM than controls.

Conclusion  Weight gain during childhood is an important determinant of body composition in young adulthood, whereas birth size is less important. In clinical practice, too much weight gain in childhood should be prevented as it results in a relatively high fat mass, especially in children with catch‐up growth in weight, like SGA‐CU subjects.
Spinal volumetric trabecular bone mass in acromegalic patients: a longitudinal study
Authors: Battista Claudia , Chiodini Iacopo , Muscarella Silvana , Guglielmi Giuseppe , Mascia Maria Lucia , Carnevale Vincenzo , Scillitani Alfredo
Published: August 2008

Objective  Data on trabecular bone mass in acromegaly are controversial. All the studies are cross‐sectional and bone mineral density (BMD) has been evaluated largely by dual X‐ray absorptiometry (DXA), which is influenced by bone enlargement. In this study we assessed in acromegalic patients the effects overtime of GH excess on trabecular bone mass measured by single‐energy quantitative computed tomography (QCT) which is not influenced by bone size.

Design  Longitudinal retrospective study.

Patients  A total of 46 acromegalic patients followed‐up for 48 months (median), subdivided into four groups: group A (eugonadal patients with active disease: n = 13), group B (hypogonadal patients with active disease; n = 9), group C (eugonadal patients with controlled disease; n = 10), group D (hypogonadal patients with controlled disease; n = 14).

Measurements  Serum GH and IGF‐I levels, spinal trabecular BMD, and vertebral fractures were evaluated in all patients. BMD variations were reported as change (Δ) in Z‐values (Z‐QCT) measured at baseline and end of follow‐up per year (Δ Z‐QCT).

Results  Δ Z‐QCT was greater in group A vs. group B and D (P =0·002 and P = 0·0001, respectively) and in group C vs. group D (P =0·009). Multivariate regression analysis showed that hypogonadal status (β = –0·69; P = 0·001) and baseline duration of hypogonadism (β = 0·44; P = 0·02) but not baseline duration of acromegaly, length of follow‐up and disease activity, were significantly associated with Δ Z‐QCT.

Conclusions  This longitudinal study suggests that the effect of chronic GH excess on spinal trabecular bone mass seems to be anabolic in active eugonadal patients but not in hypogonadal ones.
Relationships between vascular resistance and energy deficiency, nutritional status and oxidative stress in oestrogen deficient physically active women
Authors: O'Donnell Emma , Harvey Paula J. , De Souza Mary Jane
Published: August 2008

Objective  Oestrogen deficiency contributes to altered cardiovascular function in premenopausal amenorrheic physically active women. We investigated whether other energy deficiency‐associated factors might also be associated with altered cardiovascular function in these women.

Design  A prospective observational study was completed at a research facility at the University of Toronto.

Participants  Thirty‐two healthy premenopausal women (18–35 years old) were studied; 9 sedentary and ovulatory; 14 physically active and ovulatory; and 8 physically active and amenorrheic.

Measurements  We measured calf vascular resistance, resting heart rate, dietary energy intake, resting energy expenditure and serum measures of homocysteine, high‐sensitivity C‐reactive protein, oxidized low‐density lipoproteins, total T3, ghrelin, leptin and insulin.

Results  Groups were similar (P > 0·05) in age (25·1 ± 0·8 years; mean ± SEM), weight (57·3 ± 1·1 kg), and BMI (21·4 ± 0·3 kg/m2). Resting vascular resistance and ghrelin were highest (P < 0·05, main effect), and total T3 and energy expenditure adjusted for fat free mass lowest (P < 0·05, main effect) in oestrogen deficient women. Using pooled data for stepwise multiple regression modelling: ghrelin and resting energy expenditure adjusted for fat free mass were associated with resting vascular resistance (R2 = 0·398, P = 0·018); adjusted dietary energy intake was associated with peak‐ischaemic vascular resistance (R2 = 0·231, P = 0·015). Adjusted resting energy expenditure (r = 0·624, P < 0·001) and total T3 correlated (r = 0·427, P = 0·019) with resting heart rate. Homocysteine, high‐sensitivity C‐reactive protein and oxidized low‐density lipoproteins were similar (P > 0·05, main effect) among the groups, and were unrelated to cardiovascular measures.

Conclusion  Altered resting vascular resistance in premenopausal oestrogen deficient physically active amenorrheic women is not associated with vascular inflammation or oxidative stress, but rather with parameters that reflect metabolic allostasis and dietary intake, suggesting a potential role for chronic energy deficiency in vascular regulation.
Relationship between clinical features and gastric emptying disturbances in diabetes mellitus
Authors: Bharucha Adil E. , Camilleri Michael , Forstrom Lee A. , Zinsmeister Alan R.
Published: August 2008

Background and objectives  Gastric emptying (GE) may be delayed or rapid in diabetes mellitus. We sought to ascertain differences in risk factors or associated features (i.e. diabetic ‘phenotype’) among patients with diabetes who have rapid, slow or normal GE.

Methods  From a database of patients in whom gastrointestinal transit was assessed by scintigraphy, we compared the diabetic phenotype in diabetic patients with rapid, slow and normal GE.

Results  Of 129 patients, 55 (42%) had normal, 46 (36%) had delayed and 28 (22%) patients had rapid GE. In each GE category, there was an approximately equal number of type 1 and type 2 diabetes. In multivariable analyses, significant weight loss (OR, 2·81; 95% CI, 1·09–7·23) and neuropathy (OR, 3·60; 95% CI, 1·007–12·89) were the risk factors for delayed and rapid GE, respectively. Insulin therapy (OR, 0·08; 95% CI, 0·01–0·53) was associated with a lower risk of rapid compared to normal GE. However, other manifestations or characteristics of the diabetes ‘phenotype’ (i.e. type and duration of diabetes, glycosylated haemoglobin levels, and extraintestinal complications) were not useful for discriminating normal from delayed or rapid GE. At a specificity of 60%, clinical features were 73% sensitive for discriminating between normal and delayed GE and 80% sensitive for discriminating normal from rapid GE.

Conclusions  Diabetes is associated with slow and rapid GE. Because the diabetic phenotype is of limited utility for identifying disordered GE, GE should be assessed in patients with diabetes and gastrointestinal symptoms.
Lactic acid fermentation of anthocyanin‐rich sweet potato (Ipomoea batatas L.) into lacto‐juice
Authors: Panda Smita H. , Naskar Samir K. , Sivakumar Paramasivan Sethuraman , Ray Ramesh C.
Published: August 2008

Sweet potato (SP) is an important root crop grown all over the world and consumed as a vegetable, boiled, baked or often fermented into food and beverages. The grated SP roots [non‐ boiled and fully boiled (boiled in water at 100 °C for 15 min) were treated with 0.05% of commercial pectinase enzyme (Pectinex, Novoenzyme) in order to extract the juice. The fresh juice was inoculated with Lactobacillus plantarum MTCC 1407 culture at 28 ± 2 °C for 48 h to produce lacto‐juice (LJ). The anova analysis of analytical data revealed that there was significant effect of boiling conditions (fully boiled and non‐boiled) on pH [F (1, 4) = 220.5, P < 0.001), TA [F (1, 4) = 78.89, P < 0.01], starch [F (1, 4) = 26.63, P < 0.01), total sugar [F (1, 4) = 61.36, P < 0.01) and anthocyanin [F (1, 4) = 32.86, P < 0.01) but not on reducing sugar [F (1, 4) = 2.48, P = 0.19). Sensory evaluation rated the SP LJ acceptable based on texture, taste, aroma, flavour and after taste. LJ prepared from fully boiled roots with 10% cane sugar was most preferred by a consumer’s panelist based on Linear Discriminant Analysis. Principal component analyses (PCA) reduced the seven original analytical variables to three independent components (factors), which accounted for 99.9% of the total variations. Similarly, six original sensory variables were reduced to two independent components, which accounted for 65.7% of the total variations.
An immune‐complex glomerulonephritis of Chinook salmon, Oncorhynchus tshawytscha (Walbaum)
Authors: Lumsden J S , Russell S , Huber P , Wybourne B A , Ostland V E , Minamikawa M , Ferguson H W
Published: August 2008

Chinook salmon from New Zealand were shown to have a generalized membranous glomerulonephritis that was most severe in large fish. Marked thickening of the glomerular basement membrane was the most consistent lesion, with the presence of an electron‐dense deposit beneath the capillary endothelium. Severely affected glomeruli also had expansion of the mesangium and loss of capillaries, synechiae of the visceral and parietal epithelium and mild fibrosis of Bowman’s capsule. Chinook salmon from British Columbia, Canada with bacterial kidney disease caused by Renibacterium salmoninarum had similar histological lesions. They also had thickened glomerular basement membranes that were recognized by rabbit antiserum to rainbow trout immunoglobulin. This was true only when frozen sections of kidney were used and not formalin‐fixed tissue. An attempt to experimentally produce a glomerulopathy in rainbow trout by repeated immunization with killed R. salmoninarum was not successful. Case records from the Fish Pathology Laboratory at the University of Guelph over a 10‐year period revealed that a range of species were diagnosed with glomerulopathies similar to those seen in Chinook salmon. The majority of these cases were determined to have chronic inflammatory disease. This report has identified the presence of immunoglobulin within thickened basement membranes of Chinook salmon with glomerulonephritis and supports the existence of type III hypersensitivity in fish.
Immunization of rainbow trout, Oncorhynchus mykiss (Walbaum), with a low molecular mass fraction isolated from Flavobacterium psychrophilum
Authors: Högfors E , Pullinen K‐R , Madetoja J , Wiklund T
Published: August 2008

Flavobacterium psychrophilum, the causative agent of rainbow trout fry syndrome has become a widespread fish pathogen in freshwater aquaculture worldwide. In this study, a low molecular mass fraction (P25‐33), with an approximate weight of 25–33 kDa, was identified among F. psychrophilum strains in an immunoblotting analysis with anti‐F. psychrophilum sera. The immunogenic efficacy of the isolated and extracted P25‐33 was investigated in two intraperitoneal immunization trials with rainbow trout, Oncorhynchus mykiss (Walbaum). The first trial included immunizations using P25‐33 with Freund’s complete adjuvant (FCA) and the second trial included immunizations using P25‐33, formalin‐inactivated whole and sonicated F. psychrophilum cell preparations without FCA. In both trials, antibody titres against F. psychrophilum were analysed with an enzyme‐linked immunosorbent assay and the efficacy of the immunizations was determined by a challenge with F. psychrophilum. The P25‐33 was shown to give rise to a protective immune response in rainbow trout after immunization with FCA, but not without FCA when a low concentration of P25‐33 was used. Instead formalin‐inactivated whole and sonicated cells of F. psychrophilum were able to protect the immunized fish more effectively when immunized without FCA. The results suggest that whole or sonicated F. psychrophilum cells could be better candidates for a cost‐effective water‐based injection vaccine than the immunogenic fraction.
Wildlife as reservoirs for parasites infecting commercial species: host specificity and a redescription of Kudoa amamiensis from teleost fish in Australia
Authors: Burger M A A , Barnes A C , Adlard R D
Published: August 2008

Parasites of the genus Kudoa (Phylum Myxozoa) have long been known to cause considerable losses to finfish aquaculture. One such parasite species, Kudoa amamiensis, causes unsightly white cysts in the skeletal muscle of yellowtail kingfish, Seriola quinqueradiata, in Japan rendering the fillets unmarketable. The authors who characterized K. amamiensis, Egusa & Nakajima, 1980, hypothesized that yellowtail kingfish, as non‐natives to the area, were accidental hosts of the parasite and that it normally infects native reef fish (damselfish, Family Pomacentridae). Since then, we have found parasites that are consistent with the description of K. amamiensis in two species of damselfish and one species of carangid fish in Australia, and it has been recorded previously in another species of reef‐associated fish. Our morphometric, histological and DNA results suggest that these specimens are K. amamiensis, and are new host records for that species. Furthermore, our observations show that reef fish may act as a reservoir of myxozoan infection for commercial species, and as such should be considered an infection pathway for species in aquaculture.
C‐Type Natriuretic Peptide is a Schwann Cell‐Derived Factor For Development and Function of Sensory Neurones
Authors: Kishimoto I. , Tokudome T. , Horio T. , Soeki T. , Chusho H. , Nakao K. , Kangawa K.
Published: August 2008

Cyclic GMP (cGMP) is known to play important roles for neuronal development and neurite pathfinding. However, the regulatory mechanism that governs the synthesis of cGMP in the nervous system is not well defined. In the present study, we examined the role of C‐type natriuretic peptide (CNP), which increases intracellular cGMP upon binding to its receptor, guanylyl cyclase (GC)‐B, in the peripheral nervous system. Immunohistochemistry revealed that CNP is demonstrated in Schwann cells, whereas GC‐B mRNA is highly expressed in dorsal root ganglion (DRG) neurones. In cultured DRG neurones, GC‐B was demonstrated in dendrites of TrkA‐positive cells, where it co‐exists with cGMP‐dependent protein kinase I (cGKI), the major intracellular mediator of cGMP actions. Addition of CNP in the culture medium increased the density of fine neurites, which was accompanied by the increase in phosphorylation of vasodilator‐stimulated phosphoprotein, a cGKI substrate. Furthermore, in mice deficient for the CNP gene (CNP‐KO), the numbers of TrkA‐positive DRG neurones were diminished. Likewise, there were much less cGKI‐positive neurones in DRG and cGKI‐positive fibres in the dorsal spinal cord of CNP‐KO than wild‐type mice. Finally, the bone deformity‐rescued CNP‐KO mice displayed a decreased response to formalin‐induced pain compared to wild‐type. Taken together, these results suggest that CNP is derived from Schwann cells and plays an important role for the development and function of nociceptive sensory neurones.
Sexually Dimorphic Distribution of sst2A Receptors on Growth Hormone‐Releasing Hormone Neurones in Mice: Modulation by Gonadal Steroids
Authors: Bouyer K. , Faivre‐Bauman A. , Robinson I. C. A. F. , Epelbaum J. , Loudes C.
Published: August 2008

The ultradian pulsatile pattern of growth hormone (GH) secretion is markedly sexually dimorphic in rodents as in primates, but the neuroanatomical mechanisms of this phenomenon are not clear. In the arcuate nucleus of the hypothalamus, GH‐releasing hormone (GHRH) neurones receive somatostatinergic inputs through the sst2A receptor (sst2A‐R) and the percentage of GHRH neurones bearing sst2A‐R is higher in female than in male GHRH‐enhanced green fluorescent protein (eGFP) mice. In the present study, we hypothesised that sst2A‐R expression on GHRH neurones is modulated by gonadal steroids and constitutes a mechanism for sexually differentiated GH secretion. The distribution of sst2A‐R on GHRH neurones was evaluated by immunohistochemistry in adult GHRH‐eGFP mice gonadectomised and treated for 3 weeks with oestradiol or testosterone implants. In gonadectomised females supplemented with testosterone, sst2A‐R distribution on GHRH neurones was reduced to the level seen in intact males, whereas oestradiol implants were ineffective. Conversely, orchidectomy induced a female ‘sst2A phenotype’, which was reversed by testosterone supplementation. Changes in the hepatic expression of GH‐dependent genes for major urinary protein‐3 and the prolactin receptor reflected the altered steroid influence on GH pulsatile secretion. In the ventromedial‐arcuate region, GHRH and sst2‐R, as well as GHRH and somatostatin expression as measured by the real‐time polymerase chain reaction, were positively correlated in both sexes. By contrast, the positive correlation between ventromedial‐arcuate GHRH and periventricular somatostatin expression in males was reversed to a negative one in females. Moreover, the positive correlation between periventricular somatostatin and ventromedial‐arcuate sst2‐R expressions in males was lost in females. These results suggest that, in the adult mouse, testosterone is a major modulator of sst2A distribution on GHRH neurones. This marked sex difference in sst2A‐R distribution may constitute a key element in the genesis of the sexually differentiated pattern of GH secretion, possibly through testosterone‐modulated changes in somatostatin inputs from hypophysiotrophic periventricular neurones.
Photostimulated Expression of Type 2 Iodothyronine Deiodinase mRNA is Greatly Attenuated in the Rostral Tuberal Hypothalamus of the Photorefractory Turkey Hen
Authors: Steinman M. Q. , Dinius S. C. , Siopes T. D. , Millam J. R.
Published: August 2008

For many temperate‐zone avian species, termination of breeding occurs when individuals no longer respond to previously stimulatory day lengths, a condition called photorefractoriness. Long day lengths induce significantly greater expression of c‐fos and fos‐related antigens (FRAs) in the tuberal hypothalamus of the photosensitive hen than that of the photorefractory hen. The tuber is also a site of photoinducible glial expression of type 2 iodothyronine deiodinase (Dio2), which converts thyroxine into its active form, triiodothyronine (T3). T3 induces withdrawal of glial processes from gonadotrophin‐releasing hormone (GnRH) I nerve terminals, which is believed to permit the efficient release of GnRH I into the associated portal vasculature. Using a riboprobe, we tested whether long days induce Dio2 mRNA expression in the turkey tuber and, if so, whether this expression is reduced in photorefractory hens. Long days significantly induced rostral and caudal tuberal hypothalamic Dio2 expression in photosensitive hens. Photorefractory hens had reduced expression of Dio2 with most subjects expressing no detectable mRNA in the rostral tuber and variably attenuated amounts throughout the medial and caudal tuber. We also performed double‐label immunohistochemistry to identify co‐localisation between FRAs and glial fibrillary acidic protein, a glial marker. FRAs were present in the nuclei of a few astrocytes in the median eminence and infundibular nucleus of the tuber. The temporal and spatial coincidence between FRA and Dio2 expression, their mutual association with glia, and the attenuation of their response during photorefractoriness suggests that the two events are linked and that photorefractoriness involves a reduced capacity for photo‐inducible gene expression within glia of the tuberal hypothalamus.
Copeptin Immunoreactivity and Calcium Mobilisation in Hypothalamic Neurones of the Rat
Authors: Gao X. , Brailoiu G. C. , Brailoiu E. , Dun S. L. , Yang J. , Chang J. K. , Dun N. J.
Published: August 2008

Copeptin is cleaved from the C‐terminus of vasopressin (VP) prohormone. Immunohistochemical studies have revealed intense copeptin‐immunoreactivity (irCOPT) in neurones of the rat hypothalamic nuclei, including paraventricular, supraoptic, suprachiasmatic, periventricular, and accessory secretory. Varicose cell processes emanated from irCOPT neurones, some of which projected caudally and traversed the internal layer of the median eminence, and terminated in the posterior pituitary. Double‐labelling hypothalamic sections with copeptin antiserum and VP or oxytocin antiserum revealed an extensive overlapping of irCOPT and irVP neurones. The biological activity of human synthetic nonglycosylated copeptin or VP was evaluated in vivo and in vitro. Copeptin (1, 10, and 20 nmol/kg) injected i.v. caused no significant changes in the mean arterial pressure (MAP) and heart rate of urethane‐anaesthetised rats. VP (0.1 nmol/kg) increased MAP, which was accompanied by a small decrease of the heart rate. The ratiometric fluorescence method was employed to assess changes in intracellular Ca2+ concentrations [Ca2+]i which served as an index of the biological activity of peptides. VP (1 μm) markedly increased [Ca2+]i of rat hypothalamic neurones or vascular smooth muscle cells, whereas copeptin (100 nm to 1 μm) caused a low amplitude, sustained increase of [Ca2+]i in a population of hypothalamic neurones, but not in any of the vascular smooth muscle cells tested. The results obtained demonstrate that copeptin is expressed in VP neurones and that the peptide in the concentrations tested, although causing little or no detectable changes of blood pressure and heart rate in anaesthetised rats nor changes in [Ca2+]i of cultured aortic smooth muscle cells, increases [Ca2+]i in a small population (< 2%) of hypothalamic neurones tested, indicating that copeptin is biologically active in mammalian neurones.
RFamide‐Related Peptide and its Cognate Receptor in the Sheep: cDNA Cloning, mRNA Distribution in the Hypothalamus and the Effect of Photoperiod
Authors: Dardente H. , Birnie M. , Lincoln G. A. , Hazlerigg D. G.
Published: August 2008

Photoperiodic responses enable animals to adapt their physiology to predictable patterns of seasonal environmental change. In mammals, this depends on pineal melatonin secretion and effects in the hypothalamus, but the cellular and molecular substrates of its action are poorly understood. The recent identification of a mammalian orthologue of the avian gonadotrophin‐inhibitory hormone gene has led to interest in its possible involvement in seasonal breeding. In long‐day breeding Syrian hamsters, hypothalamic RFamide‐related peptide (RFRP) expression is increased by exposure to long photoperiod. Because, opposite to hamsters, sheep are short‐day breeders, we predicted that a conserved role in mammalian reproductive activation would decrease RFRP expression in sheep under a long photoperiod. We cloned the ovine RFRP cDNA and examined its expression pattern in Soay sheep acclimated to a 16 : 8 h or 8 : 16 h light /dark cycle (LP and SP, respectively). RFRP was expressed widely in the sheep hypothalamus and increased modestly overall with exposure to LP. Interestingly, RFRP expression in the ependymal cells surrounding the base of the third ventricle was highly photoperiodic, with levels being undetectable in animals held on SP but consistently high under LP. These data are inconsistent with a conserved reproductive role for RFRP across mammals. Additionally, we cloned the ovine homologue of the cognate RFRP receptor, rfr‐2 (NPFF1) and found localised expression in the suprachiasmatic nuclei and in the pars tuberalis. Taken together, these data strengthen the emerging view that interplay between ependymal cells and the pars tuberalis might be important for the seasonal timing system.
Temporal and Site‐Specific Brain Alterations in CB1 Receptor Binding in High Fat Diet‐Induced Obesity in C57Bl/6 Mice
Authors: South T. , Huang X.‐F.
Published: August 2008

The cannabinoid CB1 receptor has been implicated in the regulation of appetite and the consumption of palatable foods. This experiment aimed to explore the involvement of the CB1 receptor in the early and late stages of high fat diet‐induced obesity in C57BL/6 mice. The C57Bl/6 mice were placed on a high fat (HF) or low fat/high carbohydrate (LF) diet for 3 or 20 weeks. Quantitative autoradiography revealed that binding of [3H] CP‐55,940 (CB1 receptor ligand) was elevated following 3 weeks of HF feeding in areas including the medial/ventral anterior olfactory nucleus (22.1%), agranular insular cortex (24.0%) and the hypothalamus (31.5%) compared to LF controls. This increased level of binding was correlated with an increase in plasma leptin in the hypothalamus, raising the possibility that this hormone may exert inhibitory control over endocannabinoid signalling at this stage of obesity. Mice fed a HF diet for 20 weeks were obese, hyperphagic and had decreased CB1 receptor binding levels in the substantia nigra (12.8%) and ventral tegmental area (17.1%) compared to LF controls. The low [3H] CP‐55,940 binding density seen in these reward‐related areas in the late stage of obesity may be indicative of increased endocannabinoid release due to the chronic HF diet consumption.
UK consensus statement on the content of communication curricula in undergraduate medical education
Authors: Von Fragstein Martin , Silverman Jonathan , Cushing Annie , Quilligan Sally , Salisbury Helen , Wiskin Connie ,   on behalf of the UK Council for Clinical Communication Skills Teaching in Undergraduate Medical Education
Published: August 2008

Context  The teaching and assessment of clinical communication have become central components of undergraduate medical education in the UK. This paper recommends the key content for an undergraduate communication curriculum. Designed by UK educationalists with UK schools in mind, the recommendations are equally applicable to communication curricula throughout the world.

Objectives  This paper is intended to assist curriculum planners in the design, implementation and review of medical communication curricula. The document will also be useful in the education of other health care professionals. Designed for undergraduate education, the consensus statement also provides a baseline for further professional development.

Methods  The consensus statement, based on strong theoretical and research evidence, was developed by an iterative process of discussion between communication skills leads from all 33 UK medical schools conducted under the auspices of the UK Council of Clinical Communication Skills Teaching in Undergraduate Medical Education.

Discussion  How this framework is used will inevitably be at the discretion of each medical school and its implementation will be determined by different course designs. Although we believe students should be exposed to all the areas described, it would be impractical to set inflexible competency levels as these may be attained at different stages which are highly school‐dependent. However, the framework will enable all schools to consider where different elements are addressed, where gaps exist and how to generate novel combinations of domains within the communication curriculum. It is hoped that this consensus statement will support the development and integration of teaching, learning and assessment of clinical communication.
Morphology and evolution of bars in a wandering gravel‐bed river; lower Fraser river, British Columbia, Canada
Authors: RICE STEPHEN P. , CHURCH MICHAEL , WOOLDRIDGE COLIN L. , HICKIN EDWARD J.
Published: August 2008

A hierarchical typology for the channels and bars within aggradational wandering gravel‐bed rivers is developed from an examination of a 50 km reach of lower Fraser River, British Columbia, Canada. Unit bars, built by stacking of gravelly bedload sheets, are the key dynamic element of the sediment transfer system, linking sediment transport during individual freshets to the creation, development and remoulding of compound bar platforms that have either a lateral or medial style. Primary and secondary unit bars are identified, respectively, as those that deliver sediment to compound bars from the principal channel and those that redistribute sediment across the compound bar via seasonal anabranches and smaller channels. The record of bar accretion evident in ground‐penetrating radar sequences is consistent with the long‐term development of bar complexes derived from historical aerial photographs. For two compound bars, inter‐annual changes associated with individual sediment transport episodes are measured using detailed topographic surveys and longer‐term changes are quantified using sediment budgets derived for individual bars from periodic channel surveys. Annual sediment turnover on the bars is comparable with the bed material transfer rate along the channel, indicating that relatively little bed material bypasses the bars. Bar construction and change are accomplished mainly by lateral accretion as the river has limited capacity to raise bed load onto higher surfaces. Styles of accretion and erosion and, therefore, the major bar form morphologies on Fraser River are familiar and consistent with those in gravelly braided channels but the wandering style does exhibit some distinctive features. For example, 65‐year histories reveal the potential for long sequences of uninterrupted accretion in relatively stable wandering rivers that are unlikely in braided rivers.
Non‐identical contributions of two membrane‐bound cpSRP components, cpFtsY and Alb3, to thylakoid biogenesis
Authors: Asakura Yukari , Kikuchi Shingo , Nakai Masato
Published: August 2008

The insertion of light‐harvesting chlorophyll proteins (LHCPs) into the thylakoid membrane of the chloroplast is cpSRP‐dependent, and requires the stromal components cpSRP54 and cpSRP43, the membrane‐bound SRP receptor cpFtsY and the integral membrane protein Alb3. Previous studies demonstrated that the Arabidopsis mutant lacking both cpSRP54 and cpSRP43 had pale yellow leaves, but was viable, whereas the mutants lacking Alb3 exhibit an albino phenotype that is more severe and seedling lethality. We previously showed that a maize mutant lacking cpFtsY had a pale yellow–green phenotype and was seedling lethal. To compare the in vivo requirements of cpFtsY and Alb3 in thylakoid biogenesis in greater detail, we isolated Arabidopsis null mutants of cpftsY, and performed biochemical comparisons with the Arabidopsis alb3 mutant. Both cpftsY and alb3 null mutants were seedling lethal on a synthetic medium lacking sucrose, whereas on a medium supplemented with sucrose, they were able to grow to later developmental stages, but were mostly infertile. cpftsY mutant plants had yellow leaves in which the levels of LHCPs were reduced to 10–33% compared with wild type. In contrast, alb3 had yellowish white leaves, and the LHCP levels were less than or equal to 10% of those of wild type. Intriguingly, whereas accumulation of the Sec and Tat machineries were normal in both mutants, the Sec pathway substrate Cyt f was more severely decreased in the cpftsY mutant than in alb3, which may indicate a functional link between cpFtsY and Sec translocation machinery. These results suggest that cpFtsY and Alb3 have essentially similar, but slightly distinct, contributions to thylakoid biogenesis.
The CACTA transposon Bot1 played a major role in Brassica genome divergence and gene proliferation
Authors: Alix Karine , Joets Johann , Ryder Carol D. , Moore Jay , Barker Guy C. , Bailey John P. , King Graham J. , (Pat) Heslop‐Harrison John S.
Published: August 2008

We isolated and characterized a Brassica C genome‐specific CACTA element, which was designated Bot1 (Brassica oleracea transposon 1). After analysing phylogenetic relationships, copy numbers and sequence similarity of Bot1 and Bot1 analogues in B. oleracea (C genome) versus Brassica rapa (A genome), we concluded that Bot1 has encountered several rounds of amplification in the oleracea genome only, and has played a major role in the recent rapa and oleracea genome divergence. We performed in silico analyses of the genomic organization and internal structure of Bot1, and established which segment of Bot1 is C‐genome specific. Our work reports a fully characterized Brassica repetitive sequence that can distinguish the Brassica A and C chromosomes in the allotetraploid Brassica napus, by fluorescent in situ hybridization. We demonstrated that Bot1 carries a host S locus‐associated SLL3 gene copy. We speculate that Bot1 was involved in the proliferation of SLL3 around the Brassica genome. The present study reinforces the assumption that transposons are a major driver of genome and gene evolution in higher plants.
Microarray analysis of vegetative phase change in maize
Authors: Strable Josh , Borsuk Lisa , Nettleton Dan , Schnable Patrick S. , Irish Erin E.
Published: August 2008

Vegetative phase change is the developmental transition from the juvenile phase to the adult phase in which a plant becomes competent for sexual reproduction. The gain of ability to flower is often accompanied by changes in patterns of differentiation in newly forming vegetative organs. In maize, juvenile leaves differ from adult leaves in morphology, anatomy and cell wall composition. Whereas the normal sequence of juvenile followed by adult is repeated with every sexual generation, this sequence can be altered in maize by the isolation and culture of the shoot apex from an adult phase plant: an ‘adult’ meristem so treated reverts to forming juvenile vegetative organs. To begin to unravel the as‐yet poorly understood molecular mechanisms underlying phase change in maize, we compared gene expression in two juvenile sample types, leaf 4 and culture‐derived leaves 3 or 4, with an adult sample type (leaf 9) using cDNA microarrays. All samples were leaf primordia at plastochron 6. A gene was scored as ‘phase induced’ if it was up‐ or downregulated in both juvenile sample types, compared with the adult sample type, with at least a twofold change in gene expression at a P‐value of ≤0.005. Some 221 expressed sequence tags (ESTs) were upregulated in juveniles, and 28 ESTs were upregulated in adults. The largest class of juvenile‐induced genes was comprised of those involved in photosynthesis, suggesting that maize plants are primed for energy production early in vegetative growth by the developmental induction of photosynthetic genes.
The proteogenomic path towards biomarker discovery
Authors: Sigdel Tara K. , Sarwal Minnie M.
Published: August 2008

Abstract:  The desire for biomarkers for diagnosis and prognosis of diseases has never been greater. With the availability of genome data and an increased availability of proteome data, the discovery of biomarkers has become increasingly feasible. However, the task is daunting and requires collaborations among researchers working in the fields of transplantation, immunology, genetics, molecular biology, biostatistics and bioinformatics. With the advancement of high throughput omic techniques such as genomics and proteomics (collectively known as proteogenomics), efforts have been made to develop diagnostic tools from new and to‐be discovered biomarkers. Yet biomarker validation, particularly in organ transplantation, remains challenging because of the lack of a true gold standard for diagnostic categories and analytical bottlenecks that face high‐throughput data deconvolution. Even though microarray technique is relatively mature, proteomics is still growing with regards to data normalization and analysis methods. Study design, sample selection and rigorous data analysis are the critical issues for biomarker discovery using high‐throughput proteogenomic technologies that combine the use and strengths of both genomics and proteomics. In this review, we look into the current status and latest developments in the field of biomarker discovery using genomics and proteomics related to organ transplantation, with an emphasis on the evolution of proteomic technologies.
MORGAGNI’S HERNIA: BELIEVING IS SEEING
Authors: McBride Craig A. , Beasley Spencer W.
Published: August 2008

The original description by Morgagni of the anterior diaphragmatic defect that bears his name implies a paramedian defect and this may be true when acquired in adulthood. In contrast, the anterior diaphragmatic defect that is observed in children is central rather than paramedian, as is often assumed. Its central retrosternal location has been confirmed by various methods, but is most clearly evident on laparoscopy.
ACINIC CELL CARCINOMA OF THE PAROTID GLAND: AUCKLAND EXPERIENCE AND LITERATURE REVIEW
Authors: Greig Samuel R. , Chaplin John M. , McIvor Nicholas P. , Izzard Mark E. , Taylor Graham , Wee Desmond
Published: August 2008

Acinic cell carcinoma is an uncommon malignancy of the salivary glands and as such it has been difficult to accurately delineate its natural history. The aim of this study is to assess the behaviour of acinic cell salivary cancer of the parotid gland presenting to a single head and neck surgical unit in Auckland. The study is a structured review of cases of acinic cell carcinoma of the parotid gland presenting from 2000 to 2006 to the Head and Neck Unit at Auckland Hospital, those identified from the pathology database and the Otobase head and neck database. Case records and pathology reports were reviewed. Fifteen patients were identified, 9 men and 6 women. The mean age was 67.2 years, with range 50–85 years. The mean follow up was 4.4 years and range 1.1–7 years. There was one case of local recurrence during study period and no deaths. Five of 15 patients received postoperative radiotherapy. Postoperative complications consisted of one wound haematoma and two cases of marginal mandibular weakness (one transient and one permanent). Current management strategies are obtaining appropriate rates of recurrence and postoperative complications within the Auckland population.
LAWN MOWER INJURIES IN CHILDREN: A 30‐YEAR EXPERIENCE
Authors: Nguyen Anh , Raymond Simon , Morgan Vanessa , Peters Julian , Macgill Kirstie , Johnstone Bruce
Published: August 2008

Background:  Lawn mowers cause severe injuries that are particularly devastating to children. This study analyses the patterns and trends in lawn mower injuries involving children referred to Victoria’s principal children’s hospital.

Methods:  A retrospective review of the patient medical records at the Royal Children’s Hospital (Melbourne) Victoria, Australia was carried out. The series included all patients admitted for lawn mower injury during the 30‐year period spanning 1975–2004.

Results:  Lawn mower injuries treated at Royal Children’s Hospital were severe and included partially amputated limbs. Overall, admissions for lawn mower injury generally decreased over time from n = 26 in the 1975–1979 interval to n = 14 in the 2000–2004 interval. However, the frequency of admission for injuries caused by ride‐on mowers contradicted the overall trend and generally increased over time from n = 5 in the 1975–1979 interval to n = 11 in the 2000–2004 interval. This is of particular concern. Ride‐on lawn mowers caused significantly more severe injuries requiring longer periods of admission and more operations during admission in comparison to standard mowers. Rural location at the time of injury was a risk factor associated with requiring longer periods of admission and more operations during admission. Children injured while operating mowers were generally older than children injured as bystanders.

Conclusion:  Lawn mower injuries are a significant cause of morbidity. These injuries are particularly devastating to children. The tragedy is keenly felt in the realization that these devastating injuries to children could all be prevented. Strategic preventative measures should be developed through partnership between the medical profession, the media, industry specialists and the wider community.
RETROSPECTIVE REVIEW OF STICKLER SYNDROME PATIENTS WITH CLEFT PALATE 1997‐2004
Authors: Lee Kai H. , Hayward Peter
Published: August 2008

Background:  Stickler syndrome is a rare autosomal dominant connective tissue disorder estimated to affect approximately 1/7500 newborns. It is diagnosed clinically and, at present, there is no consensus on a minimal clinical diagnostic criterion. The aim of this series was to evaluate the outcome of a group of cleft palate children with Stickler syndrome in a large tertiary children’s hospital in New South Wales.

Methods:  The International Classification of Diseases‐10 code for ‘other specified congenital malformations affecting facial appearance’ over past 8 years (1997–2004) and an internal database from the Cleft Clinic were used to search for patients. Patients were included if the diagnosis was confirmed by a clinical geneticist, an ophthalmologist and a paediatric plastic surgeon.

Results:  A total of nine patients were identified. All had cleft palate. Six patients had Pierre Robin Sequence. The most common non‐craniofacial manifestation was a refractive error, followed by musculoskeletal abnormalities and hearing impairment. Seven patients had some form of myopia bilaterally. Four patients had hearing impairment. Six patients had musculoskeletal abnormality.

Conclusion:  There are few data in published work that follow patients with Stickler syndrome with initial cleft presentation. These patients can have potentially disabling consequences as a result of ophthalmological, musculoskeletal, auditory and cardiac problems. Early identification is crucial to allow referral to appropriate service.
ACUTE LAPAROSCOPIC CHOLECYSTECTOMY: PREFERRED TREATMENT FOR ACUTE BILIARY DISEASE*
Authors: Zargar‐Shoshtari Kamran , Short Heather , Poole Garth H. , Hill Andrew G.
Published: August 2008

Background:  Early laparoscopic cholecystectomy has been shown to be the treatment of choice for acute presentations of gallstone disease. However, currently this practice is not common in many centres. The aim of the study was to evaluate surgical management of patients presenting with acute symptomatic gallstone disease to Middlemore Hospital in 2005.

Methods:  A retrospective case review of acute presentations of symptomatic gallstone disease was carried out between 1 January and 31 December 2005.

Results:  Four hundred and two patients were included in the final analysis. Forty‐six of these patients were unfit for surgery, 26 were solely admitted to the emergency department without being referred to a surgical team and 25 declined surgery. Therefore, 305 patients (76%) were eligible for surgery at index admission (IA). Two hundred and four (67%) received surgery during IA with a median time to surgery of 3 days. From the 198th patient who did not have acute surgery at IA, 112 had delayed surgery. When comparing those with surgery at IA with those who did not receive surgery at IA, median length of stay for IA was significantly longer in acute surgical group (5 vs 3 P = 0.05); however, there was no significant difference in duration of total hospital stay (6 vs 6 P > 0.05). For those who had acute surgery the conversion rate was 3% (six) compared with 7% (seven) in delayed surgery group (P = 0.09).

Conclusion:  Acute surgery remains the treatment of choice for acute biliary disease. This approach requires a committed team approach but is safe and effective.
TOWARDS ESTABLISHING A NATIONAL COLORECTAL CANCER DATABASE: LESSONS LEARNT FROM BIO21 MOLECULAR MEDICINE INFORMATICS MODEL
Authors: Kosmider Suzanne , Jones Ian , Hibbert Marienne , Hunter Andrew , McLaughlin Steve , Johns Julie , Chapman Matthew , Gibbs Peter
Published: August 2008

Background:  Collecting data regarding treatment and outcomes of patients with cancer, for both audit and research purposes, is a common but challenging goal. Modern technology promises greater ease and sophistication for data collection, linkage and analysis, but many traditional challenges remain.

Method:  Here we relate our experience of an initiative aimed at multicentre colorectal cancer data collection, that is, in collaboration with the Colorectal Surgical Society Australia and New Zealand, moving towards a national initiative.

Results:  Initiated from a single site in Melbourne, using a range of data collection and linkage processes, and optimizing the use of modern technology, we have now implemented and sustained comprehensive and multidisciplinary data collection across multiple Victorian and interstate institutions. Specific challenges related to ethics and privacy, data accuracy and completeness and data ownership have been addressed and many lessons have been learnt. Multicentre audit and research queries can now be conducted with confidence that privacy, security and intellectual property issues are addressed. Research output, including many studies that were not previously possible, has informed a broad range of topics relevant to colorectal cancer.

Conclusion:  Multicentre and comprehensive data collection for colorectal cancer is achievable and sustainable and promises great benefit as an audit and research tool. Similar initiatives could be established for other tumour types.
Plasma nitric oxide, endothelin‐1, arginase and superoxide dismutase in pre‐eclamptic women
Authors: Bernardi Fabiana , Constantino Larissa , Machado Roberta , Petronilho Fabricia , Dal‐Pizzol Felipe
Published: August 2008

Aim:  The aim of this study was to determine several parameters of nitric oxide metabolism in pre‐eclamptic patients.

Methods:  We conducted a nested case‐control study at the Department of Obstetrics and Gynecology, São José Hospital, Brazil. Thirty‐five pre‐eclamptic and 35 normotensive pregnant women were included in the study. Pre‐eclampsia was diagnosed as an increase in diastolic blood pressure (BP) of 15 mm Hg and systolic BP of 30 mm Hg at two measurements at least 4 h apart, compared with BP obtained before 20 weeks of gestation, and proteinuria >0.3 g/24 h in the absence of urinary tract infection. Fasting peripheral venous blood samples were obtained during the antepartum period in pre‐eclamptic and control (matched for maternal age and gestational age) patients.

Results:  Plasma nitrite was significantly lower and plasma endothelin levels were significantly higher in pre‐eclamptic women than in normotensive pregnant women. Superoxide dismutase activity was decreased and arginase activity was significantly increased in pre‐eclamptic patients when compared to normotensive pregnant women.

Conclusions:  We suggested that in pre‐eclampsia excessive arginase and low superoxide dismutase activity leads to a decrease nitric oxide levels and oxidative stress, and this may promote microvascular oxidative damage and endothelial dysfunction.
Retiform pattern of Sertoli–Leydig cell tumor of the ovary in a 4‐year‐old girl
Authors: Kawatra Vibha , Mandal Shramana , Khurana Nita , Aggarwal Satish K.
Published: August 2008

Sertoli–Leydig cell tumors are rare sex cord‐stromal neoplasms that account for <0.2% of ovarian tumors. These tumors with a retiform pattern pose difficult diagnostic problems, with the majority being misinterpreted as serous papillary cystadenocarcinoma and endodermal sinus tumor. Retiform pattern Sertoli–Leydig cell tumor seen mostly in young patients is clinically malignant and has a worse prognosis, underlining the importance of recognition of this histopathologic entity. In the literature only two such cases have been described in patients under the age of 5 years; reported herein is the third case. Described here is a rare case of ovarian Sertoli–Leydig cell tumor with retiform pattern in a 4‐year‐old child without any endocrine manifestations.