bluuebunny/crossref_metadata_2025 huggingface dataset:
Suicide prevention in New Zealand
Authors: Beautrais Annette , Larkin Gregory Luke
Published: January 2012

Suicide rates and suicide prevention emerged as important fi n de siècle social issues in New Zealand in the 1990s; they continue to be focal policy and public health concerns in New Zealand today and for the foreseeable future. This attention has been stimulated by two lines of evidence. First, international comparisons suggest that New Zealand has one of the highest rates of youth (15–24 age group) suicide in the developed world. Comparisons between countries of the Organization for Economic Co-operation and Development (OECD) consistently show New Zealand to share top ranking with Finland and Ireland (Ministry of Health 2006a) for male youth suicide rates, but New Zealand’s high rates of female youth suicide are without peer. Secondly, suicide rates increased markedly among young New Zealanders from the mid-1980s to the mid-1990s, garnering national attention, yet fuelling public misperception that youth suicides account for most suicides in the country. Indeed, these data led the New Zealand government’s early suicide prevention efforts to target youth explicitly. Forgotten, however, is the plight of those at highest risk: adults in later life. The reality is that youth suicides account for only 20 per cent of all suicides in New Zealand every year. Suicides in adult males account for half of all suicides, and the changing, ageing, population demographics suggest that numbers and rates of suicide in older adults will significantly increase in the next decade. If the suicide toll is to be meaningfully reduced, recognition of the epidemiologic facts and a corresponding alignment of resources are needed to adequately address suicide risk across the lifespan.
Suicide prevention in Finland
Authors: Lönnqvist Jouko
Published: January 2012

Finland, with a population of 5.5 million people, forms a culturally homogeneous, well-educated and well-functioning modern Western society. The Finnish health care system is mainly public, and financed by taxes collected both by the state and the municipalities.

Suicide has been one of the leading causes of death for decades. Suicide mortality has had a general increasing trend from the early 1920s to the peak of suicide rate, 30 per 100,000, in 1990. Since then, however, the suicide rate has been decreasing, and was 18 per 100,000 in 2005.
Suicide prevention in Germany
Authors: Etzersdorfer Elmar
Published: January 2012

The suicide rate in Germany is around the European average; nevertheless, in Germany the third highest absolute number of suicides is committed in Europe (after France and Poland). In 2005, there were 10.260 suicides (7.523 males and 2.737 females; 18.7 and 6.5/100.000, respectively). There are marked regional differences that have been observed for many years, and the suicides reflect a Hungarian pattern (increasing rates with increasing age).

There are many initiatives, as well as institutions, all over the country, which cover a broad spectrum ranging from telephone services and crisis intervention centres to inpatient facilities. I will, therefore, focus on the most important and influential activity of the last years, i.e. the implementation of a national suicide prevention programme (NaSPro, Nationales Suizidpraventionsprogramm).
Suicide prevention in Israel
Authors: Apter Alan , Bursztein Cendrine
Published: January 2012

In Israel, approximately 400–500 people commit suicide each year. In 2000, the Ministry of Health reported an incidence of 8.7 per 100,000 in individuals aged 15 years or more (Ministry of Health 2005). By gender, the rate was four times higher in men (14.2 per 100,000) than women (3.7 per 100,000). In 2002, the average annual number of emergency department visits for suicide attempts was 3600 (Ministry of Health 2005). More than one-third of these registered suicide attempts were committed by youth in the 15–24 age group. The figures for attempted suicide, however, may be grossly underestimated, given the known bias associated with reports from emergency room facilities.

Although Israel has been slow to recognize the value of a national suicide prevention programme compared to many countries in Europe, North America, and Oceania (Australia and New Zealand), recent developments are encouraging. Several governmental and non-governmental initiatives have been instituted by the Inter- Ministerial Committee for Suicide Prevention, Path to Life, a parent–professional alliance, and the Ministries of Health, Welfare and Education. Together, these are expected to lead to a concerted unified nationwide effort to build a national suicide prevention plan.

Even though Israel has not yet adopted an official suicide prevention plan, the Israel Defence Force (IDF) has taken a significant step toward this goal. These activities will be described below.
Suicide prevention in Scotland
Authors: Gordon Jacki , Henderson Gregor
Published: January 2012

Choose Life (Scottish Executive 2002)—Scotland’s 10-year suicide prevention strategy and action plan—was launched in December 2002 in direct response to national and local concerns over the increasing suicide rate at that time: while female rates had remained fairly stable over the preceding 30 years, male suicides had more than doubled (Platt et al. 2006).

By international standards, the suicide rate in Scotland is not exceptionally high (European age standardized rate of 15.1 per 100,000 over 2004–2006; population 5.12 million), but it is about twice as high as that for England and Wales (Platt et al. 2006).
Suicide prevention in Argentina
Authors: Martínez Carlos
Published: January 2012

The year 2007 will perhaps be a particularly meaningful year in the history of Argentina, because of the newly born Suicidology Discipline. The National Suicidology Congress has commemorated the 40 years of Centro de Asistencia al Suicida de Buenos Aires (Buenos Aires Suicide Prevention Centre), which runs the oldest telephone helpline in the country, the creation of the Suicidology Section in the Argentinian Psychiatric Association, and the discussion about creating a Professorship in Suicidology at Universidad de Palermo, Buenos Aires.

These milestones were preceded by eight consecutive annual congresses organized by the Argentine Suicide Prevention Association from 1997 to 2004. In these congresses volunteers, therapists, teachers, students, civil servants, journalists, social workers, lawyers, researchers, survivors and those who have eventual interest in the subject participated.

This particular process of public awareness promoted the creation of the Expert Commission in the Health Department, in order to formulate the National Programme of Suicide Prevention. From 2008 to 2011, the work will focus on four main areas: collecting information, planning of preventive activities, training, and the evaluation of human resources available for suicide prevention. In 2005, the national suicide rate in Argentina was 8.2 per cent per 100,000 inhabitants, compared to 6 and 7 per cent per 100,000 inhabitants registered at the end of the twentieth century.
Suicide prevention in Chile
Authors: Ferrada-Noli Marcello , Alvarado Rubén , Florenzano Francisca
Published: January 2012

Although the epidemiology of suicide is known to be highly correlated with psychiatric factors and advances in mental health issues, the suicide rate in Chile had risen from 5.6 per 100,000 in 1990, to 10.3 in 2005: the suicide rate increased for men in the same period from 9.7 to 17.4, and for women from 1.6 to 3.4. This phenomenon has placed the country among the countries with the highest suicide figures in South America (Ministry of Health 2008; WHO 2008).
Suicide prevention in Uruguay
Authors: Pelaez Remigio Silvia
Published: January 2012

The suicide rate in Uruguay is very high in comparison with other Latin American countries, and ranks only second to Cuba (WHO 2000a, b). There are multiple reasons for this, however, the main ones concerning economic aspects are high unemployment rates, a poor economy (very low incomes and high debts), forced retirement, and the emigration of young people and professionals, etc. Other reasons include domestic violence, sexual abuse, alcoholism, isolation, and the insufficient treatment of psychiatric patients.
Risk assessment and analysis of outcomes
Authors: Ludman Peter F. , Routledge Helen
Published: January 2012

Patient outcomes following percutaneous coronary intervention (PCI) are predominantly determined by two factors: clinical presentation and comorbidities. For example, a patient presenting in cardiogenic shock has a predicted in-hospital mortality in excess of 50%, whereas the corresponding figure for uncomplicated non-ST elevation myocardial infarction (NSTEMI) is less than 1%. A third important factor is the quality of care provided to the patient. Quantification of the relative contribution of these three components to short- and long-term mortality and morbidity is required for several reasons: it informs both the patient and physician in deciding upon the optimal management strategy; it underpins appropriately informed consent; and, by recognizing modifiable elements in the treatment process, it can be used to drive improvements in healthcare delivery.
Routine management after percutaneous coronary intervention
Authors: Byrne Jonathan , Laarman GertJan , MacCarthy Philip
Published: January 2012

Following a technically successful procedure, it is the post-procedural care of the patient that will often dictate both short- and long-term outcomes. Post-procedural care involves close monitoring of the patient for early complications, which may be secondary to the procedure itself or the presenting complaint. Immediate complications following percutaneous coronary intervention (PCI) may occur due to bleeding, most commonly at the access site, or due to early cardiac complications, often related to technical issues during the procedure. Non-cardiac complications, such as the development of contrast nephropathy, will become apparent in the hours or days following the initial procedure. Prompt and accurate identification of post-procedural complications is essential if they are to be managed effectively, and identification of the ‘at risk’ patient may also facilitate early identification of problems when they do occur. Complication rates are higher in patients with acute coronary syndromes, often exacerbated by aggressive antithrombotic regimens, and also in older patients with comorbid conditions. The type of care and length of stay will also vary according to the clinical context and needs to be carefully considered once the PCI has been performed. Following discharge, the longer-term management of residual coronary disease and recurrent ischaemia along with appropriate secondary prevention may all affect longer-term outcome. This chapter will examine the issues surrounding the immediate and longer-term care of the patient following PCI.
The role of intravascular ultrasound in percutaneous coronary intervention
Authors: Otake Hiromasa , Honda Yasuhiro , Fitzgerald Peter J.
Published: January 2012

Contrast angiography has been used in routine clinical practice to evaluate coronary and peripheral artery disease. However, angiography provides only indirect information about the vessel wall structure, possibly misguiding operators in catheter-based interventions. In contrast, intravascular ultrasound (IVUS) has been the first widely-applied clinical imaging technology to directly visualize atherosclerosis and other pathologic conditions within the vessel wall. Its ability to image the entire arterial cross-section in real time offers better understanding of the process of atherosclerosis, as well as improvement of the precision of interventional procedures. This chapter reviews current clinical evidence established by IVUS technology, with an overview of basic image interpretation and IVUS-based assessment of coronary lesions.
Virtual histology intravascular ultrasound and optical coherence tomography in percutaneous coronary intervention
Authors: Bhindi Ravinay , Channon Keith M.
Published: January 2012

The inadequacies of angiography to identify and characterize coronary atherosclerosis were not fully appreciated until pathologic studies revealed that coronary atherosclerosis in patients with fatal myocardial infarction was typically diffuse and in many cases was accompanied by positive remodelling, without luminal stenosis. Pathologic studies also identified the critical pathophysiogical role of plaque rupture in coronary thrombosis, and the appreciation that plaque biology and composition, rather than luminal stenosis alone, were more critical determinants of plaque behaviour. Clinical and experimental studies have shown that the vulnerable plaque, prone to rupture, is characterized by a large lipid core rich in inflammatory cells, a thin fibrous cap, and by positive remodelling.

The development of novel intracoronary imaging techniques has enabled a greater appreciation of plaque composition in the pathogenesis of coronary artery disease in living patients. In particular, advances in intravascular ultrasound (IVUS) to provide ‘virtual histology’ of coronary plaque components, and optical coherence tomography (OCT) to define plaque composition in exquisite detail have provided new insights into the relationships between coronary plaque, the risk of clinical events, and the response of the vessel wall to percutaneous intervention.
Percutaneous coronary intervention in patients with impaired left ventricular function
Authors: Perera Divaka , Redwood Simon
Published: January 2012

Changes in left ventricular (LV) function are an early manifestation of the ischaemic cascade and often precede the well-recognized markers of ischaemia, such as ST segment changes or chest pain. Decreased ventricular compliance, diminished regional and global contractility, and elevated end-diastolic pressure occur within a few seconds of interruption of coronary blood flow by balloon occlusion, whereas recovery of these parameters can lag several minutes behind balloon deflation, restoration of blood flow, and resolution of electrocardiogram (ECG) changes. Prolonged postischaemic myocardial dysfunction, or stunning, can occur following recurrent ischaemia, which may persist for several hours or days even when blood flow is restored. The impact of transient or repetitive coronary occlusion on LV function is rarely of clinical consequence when percutaneous coronary intervention (PCI) is performed in patients with preserved ventricular function, but is potentially hazardous in those who have LV impairment at the outset, particularly when there is a large amount of myocardium at risk. These patients have attenuated haemodynamic reserve and may recover incompletely from post-ischaemic stunning, which increases the risk of entering a deteriorating spiral of decreasing cardiac output and worsening ischaemia that could culminate in cardiogenic shock or ventricular arrhythmias. Furthermore, patients with impaired LV function tend to be older and have more advanced comorbidities, which are independently associated with an adverse outcome following any form of revascularization.
Current status of GP IIb/IIIa inhibitors
Authors: Lockie Tim , Redwood Simon
Published: January 2012

The process of atheromatous plaque rupture is thought to underlie most acute coronary syndromes (ACS) and thus is a major cause of overall morbidity and mortality. As a result, the costs in terms of healthcare expenditure of the consequences of acute plaque rupture are considerable. The immediate and often catastrophic result of plaque rupture is intracoronary thrombosis resulting in vessel occlusion and myocardial infarction (MI). Over the last 20 years there has been a steady decline in the mortality rates from ACS that has resulted from the successful implementation of therapies to attenuate the effects of plaque rupture that include fibrinolysis, percutaneous revascularization, antithrombotic therapy, and plaque stabilization. Glycoprotein (GP) IIb/IIIa receptor inhibitors are agents that have been developed to block the final common pathway that results in platelet aggregation, and following plaque rupture is a key process in coronary thrombosis. Despite the improvement in outcomes from ACS, however, the mortality rate still remains high and there is a need for critical appraisal of the use of currently available agents as well as the need for ongoing research and development of new agents and clinical techniques to improve outcomes further.
Contrast-induced acute kidney injury
Authors: McCullough Peter A.
Published: January 2012

Contrast-induced acute kidney injury (AKI), previously known as contrast-induced nephropathy (CIN) is an important complication in the catheterization laboratory. The most commonly used definition in clinical trials was a rise in serum creatinine (Cr) of 44.2mmol/L (0.5mg/dL) or a 25% increase from the baseline value, assessed at 48h after the procedure. In 2007, the Acute Kidney Injury Network proposed the definition to a rise in serum Cr ≥26.5mmol/L (0.3mg/dL) or a 50% rise in Cr with oliguria which is compatible with previous definitions and is a new standard to follow. If there is a sustained reduction in estimated glomerular function (eGFR) from a baseline above 60 to a new baseline below 60mL/min/1.73m2 at 90 days after the procedure, then a definition of chronic kidney disease (CKD) (Stage 3) would be met as a late outcome of this complication.
Laser
Authors: O’Kane Peter , Redwood Simon
Published: January 2012

The first medical application of laser was reported by Dr Leon Goldman who, in 1962, reported the use of ruby and carbon dioxide (CO2) lasers in dermatology. In cardiovascular disease, early laser use was confined to cadaver vessels, animal models, and arteries located in freshly amputated limbs, until eventually work progressed to the use of laser energy to salvage an ischaemic limb in 1984. The concept of using laser to remove atherosclerotic material in coronary arteries developed as an alternative strategy to simply modifying the shape of an obstructed lumen as occurs with simple balloon angioplasty. Expectations grew that this new biomedical technology may overcome the low success rate and high complication rate of lesions considered non-ideal for balloon angioplasty. However, initial successful reports could not be replicated. Furthermore, underdeveloped catheter technology and limited appreciation of laser/tissue interactions meant that a cure for restenosis was not in fact discovered and laser coronary angioplasty became isolated to only a few centres in the world. However, more recently with advancement in both catheter technology and technique, excimer coronary laser angioplasty (ELCA) has been rediscovered for use in specific subsets of percutaneous coronary interventions (PCIs).

This chapter outlines the basic principles of ELCA and important practical aspects for using the device in contemporary PCI. A discussion of the current indications for clinical use follows and these are highlighted by clinical case examples.
Distal protection
Authors: van Gaal William J. , Banning Adrian P.
Published: January 2012

Percutaneous coronary intervention (PCI) aims to restore normal epicardial flow and improve microvascular perfusion to the vascular bed beyond the obstructive coronary stenosis. In the setting of elective PCI, the goal is to achieve this without injury to the distal myocardium, whilst in acute coronary syndromes, namely acute ST elevation myocardial infarction (STEMI), the goal is restore epicardial patency and microvascular perfusion as quickly as possible to limit the extent of irreversibly injured (necrotic) myocardium. The pathophysiology of distal injury in these clinical scenarios differs, and thus protection of the myocardium in the elective and acute setting requires different approaches.

The concept of distal protection was initially trialled during vein graft PCI. Vein grafts are large capacious conduits with large volumes of plaque. The concept that a basket placed downstream on the wire might catch plaque liberated during balloon expansion was the subject of a number of landmark studies proving in concept that this approach might be beneficial in these specific patients. A number of different devices have evolved and their use is considered routine in most centres when vein grafts are being treated.
Percutaneous device closure of atrial septal defect and patent foramen ovale
Authors: Calvert Patrick A. , Rana Bushra S. , Hildick-Smith David
Published: January 2012

Structural heart disease interventions look set to form an increasing proportion of the interventional cardiologist’s workload. Device closure of atrial septal connections, both patent foramen ovale (PFO) and atrial septal defect (ASD), are the most commonly performed adult structural interventional procedure in the United Kingdom, with 793 PFO and 573 ASD closure procedures performed in adults in 2007. Device closure of ASDs and PFOs are elegant procedures which combine technical and imaging skills with a detailed understanding of cardiac anatomy. More importantly, they also provide tangible clinical benefits to patients.
Alcohol septal ablation for obstructive hypertrophic cardiomyopathy
Authors: Knight Charles , Mohiddin Saidi A.
Published: January 2012

Hypertrophic cardiomyopathy (HCM) is a genetic disease occurring in approximately one in 500–1000 of the general population. HCM is often undiagnosed or misdiagnosed, and asymptomatic cases are often unrecognized. Asymmetric left ventricular (LV) hypertrophy (LVH) most often develops during the period of rapid body growth of adolescence, but it may be present in childhood or, rarely, before birth. Progressive LVH after age 20 is uncommon, but initial diagnosis even in old age is not. The hypertrophy predominantly involves the LV, and is often more marked than in any other cardiac disease. Hypertrophy may involve the right ventricle (RV), and an atrial myopathy may be progressive (left atrial enlargement [LA) and increased risks of atrial fibrillation [AF]). RV and LA involvement may be secondary to the LV disease, and/or a primary consequence of the basic molecular defect. The LVH represents hypertrophy and hyperplasia of several cell types, including cardiac myocytes, fibroblasts, and smooth muscle cells, along with excessive collagen and matrix deposition, and abnormalities of the microvasculature. The normal parallel arrangement of myocytes is often disturbed (fibre disarray).

Clinical practice addresses three needs: 1) assessing and treating the symptomatic patient; 2) assessing and addressing prognostic risks; and 3) genetic counselling, family screening, and mutation detection (genetic testing). Symptoms due to HCM will often have a striking variation in severity when patients may describe good and bad days, exacerbation of symptoms following large meals and an intolerance of dehydration or a hot climate. Chest pain, with a quality similar to angina pectoris but often developing at rest, dyspnoea, palpitations, dizziness, pre/syncope, and fatigue are the common complaints. Although the relief of LV outflow obstruction (LVOTO) by alcohol septal ablation (ASA) for the management of symptomatic HCM is the focus of this chapter, we will first describe some of the more important features of HCM in order that this procedure can be placed in the context of a complex cardiac condition.
Carotid artery stenting
Authors: Malik Iqbal
Published: January 2012

Stroke is the third leading cause of death in the developed world. Internal carotid artery (ICA) stenosis is a major correctable cause of ischaemic stroke, the risk being related to the degree of stenosis and the presence of recent symptoms. Carotid endarterectomy (CEA) has become the preferred method of treatment for patients with asymptomatic or symptomatic high-grade ICA stenosis, supplanting medical therapy alone. In coronary disease, the increasing use of percutaneous coronary intervention (PCI) has reduced the need for coronary artery bypass surgery (CABG). Unlike coronary stenting, where immediate relief of anginal symptoms can justify the procedure, carotid intervention is not usually done for haemodynamic or flow indications, but to reduce future emboli. For significant (greater than 50% angiographic) ICA stenosis, carotid artery stenting (CAS) is a reasonable alternative to CEA, but its true place is as yet undecided, and awaits the conclusion of several ongoing randomized trials.
First Report of Root Rot of Chicory Caused by Phytophthora cryptogea in Chile
Authors: Vargas M. , Loyola C. , Zapata N. , Rivera V. , Secor G. , Bolton M. , France A.
Published: January 2012

Chicory (Cichorium intybus L. var sativum Bisch.), a relatively new high-value crop in Chile, was introduced for commercial production of inulin. Inulins are polysaccharides extracted from chicory tap roots that are used in processed foods because of their beneficial gastrointestinal properties. Approximately 3,000 ha of chicory are grown for local processing in the BioBio Region near Chillan in south central Chile. Recently, a severe rot of 1 to 3% of mature roots in the field and after harvest has been observed in most fields, which caused yield and quality losses. Typical symptoms include a brown discoloration and a soft, watery decay of the root. Tissue pieces from symptomatic roots were placed on water agar and clarified V8 juice agar medium amended with antibiotics (1) for isolation of the causal pathogen. A Phytopthora sp. had been consistently isolated from root lesions, and axenic cultures were obtained using single-hypha transfers. The species was provisionally identified as Phytopthora cryptogea (Pethybridge and Lafferty, 1919) on the basis of morphological and cultural characteristics (1). Mycelia grew between 5 and 30°C with optimal growth at 20 to 25°C and no growth at 35°C. All isolates produced hyphal swellings and nonpapillate, persistent, internally proliferating, and ovoid to obpyriform sporangia with mean dimensions of 45 × 31 μm in sterile soil extract. The isolates were of A1 mating type because they produced oospores only when paired with reference isolates of P. cinnamomi A2 on clarified V8 juice agar amended with thiamine, tryptophan, and β-sitosterol (1) after 20 days at 20°C in the dark. On the basis of morphological and sequence data from cytochrome c oxidase subunit 1 and 2, internal transcribed spacer 2, and β-tubulin (GenBank Accession Nos. JQ037796 to JQ037798, respectively), the pathogen was identified as P. cryptogea. Pathogenicity tests were conducted using three isolates of P. cryptogea by placing a 7-mm-diameter disk from a 1-week-old V8 agar culture on 10 wounded and nonwounded healthy chicory roots (2). Control roots were mock inoculated with agar plugs. The inoculated roots were incubated at 20°C in a moist chamber. Root rot symptoms, identical to those observed both in field and storage, developed after 4 to 6 days only on wounded sites inoculated with the pathogen, and P. cryptogea was reisolated from these inoculated plants. Mock-inoculated roots remained healthy. This experiment was completed twice and similar results were obtained. To our knowledge, this is the first report of Phytophthora root rot of chicory caused by P. cryptogea in Chile.

References: (1) D. C. Erwin and O. K. Ribeiro. Phytophthora Diseases Worldwide. The American Phytopathological Society, St. Paul, MN, 1996. (2) M. E. Stanghellini and W. C. Kronland. Plant Dis. 66:262, 1982.
Testing for Plant-parasitic Nematodes that Feed on Corn in Iowa 2000-2010
Authors: Tylka Gregory L. , Sisson Adam J. , Jesse Laura C. , Kennicker John , Marett Christopher C.
Published: January 2012

The Iowa State University Plant and Insect Diagnostic Clinic analyzes soil and root samples for plant-parasitic nematodes. The results of samples associated with corn that were submitted from 2000 through 2010 were summarized. One or more genera of plant-parasitic nematodes were found in 92% of the samples. Spiral nematode and root-lesion nematode were most commonly found. Other nematodes recovered were dagger, lance, needle, pin, ring, and stunt nematodes. Nematodes recovered at damaging population densities were dagger, needle, ring, and spiral nematodes. An average of 15 samples were submitted per year from 2000 to 2004. Sample numbers increased nearly threefold since 2005, but overall sample numbers were low every year from 2000 through 2010. Samples were received from 53 of the 99 Iowa counties, and most samples were received in June and July, which is the recommended sampling time. Nematodes that have been associated with corn in Iowa in the past that were not recovered from the samples were sheath, sting, and stubby-root nematodes. The methods used to extract the nematodes from soil and roots and how the samples were handled during collection and processing may have affected the species and population densities recovered. Much more frequent and widespread sampling is needed in Iowa for plant-parasitic nematodes that feed on corn.

Accepted for publication 28 October 2011. Published 5 December 2011.
Adaptive signals in algal Rubisco reveal a history of ancient atmospheric carbon dioxide
Authors: Young J. N. , Rickaby R. E. M. , Kapralov M. V. , Filatov D. A.
Published: January 2012

Rubisco, the most abundant enzyme on the Earth and responsible for all photosynthetic carbon fixation, is often thought of as a highly conserved and sluggish enzyme. Yet, different algal Rubiscos demonstrate a range of kinetic properties hinting at a history of evolution and adaptation. Here, we show that algal Rubisco has indeed evolved adaptively during ancient and distinct geological periods. Using DNA sequences of extant marine algae of the red and Chromista lineage, we define positive selection within the large subunit of Rubisco, encoded by
rbcL
, to occur basal to the radiation of modern marine groups. This signal of positive selection appears to be responding to changing intracellular concentrations of carbon dioxide (CO
2
) triggered by physiological adaptations to declining atmospheric CO
2
. Within the ecologically important Haptophyta (including coccolithophores) and Bacillariophyta (diatoms), positive selection occurred consistently during periods of falling Phanerozoic CO
2
and suggests emergence of carbon-concentrating mechanisms. During the Proterozoic, a strong signal of positive selection after secondary endosymbiosis occurs at the origin of the Chromista lineage (approx. 1.1 Ga), with further positive selection events until 0.41 Ga, implying a significant and continuous decrease in atmospheric CO
2
encompassing the Cryogenian Snowball Earth events. We surmise that positive selection in Rubisco has been caused by declines in atmospheric CO
2
and hence acts as a proxy for ancient atmospheric CO
2
.
Evolutionary context for understanding and manipulating plant responses to past, present and future atmospheric [CO
2
]
Authors: Leakey Andrew D. B. , Lau Jennifer A.
Published: January 2012

Variation in atmospheric [CO
2
] is a prominent feature of the environmental history over which vascular plants have evolved. Periods of falling and low [CO
2
] in the palaeo-record appear to have created selective pressure for important adaptations in modern plants. Today, rising [CO
2
] is a key component of anthropogenic global environmental change that will impact plants and the ecosystem goods and services they deliver. Currently, there is limited evidence that natural plant populations have evolved in response to contemporary increases in [CO
2
] in ways that increase plant productivity or fitness, and no evidence for incidental breeding of crop varieties to achieve greater yield enhancement from rising [CO
2
]. Evolutionary responses to elevated [CO
2
] have been studied by applying selection in controlled environments, quantitative genetics and trait-based approaches. Findings to date suggest that adaptive changes in plant traits in response to future [CO
2
] will not be consistently observed across species or environments and will not be large in magnitude compared with physiological and ecological responses to future [CO
2
]. This lack of evidence for strong evolutionary effects of elevated [CO
2
] is surprising, given the large effects of elevated [CO
2
] on plant phenotypes. New studies under more stressful, complex environmental conditions associated with climate change may revise this view. Efforts are underway to engineer plants to: (i) overcome the limitations to photosynthesis from today's [CO
2
] and (ii) benefit maximally from future, greater [CO
2
]. Targets range in scale from manipulating the function of a single enzyme (e.g. Rubisco) to adding metabolic pathways from bacteria as well as engineering the structural and functional components necessary for C
4
photosynthesis into C
3
leaves. Successfully improving plant performance will depend on combining the knowledge of the evolutionary context, cellular basis and physiological integration of plant responses to varying [CO
2
].
Evaluating the effects of terrestrial ecosystems, climate and carbon dioxide on weathering over geological time: a global-scale process-based approach
Authors: Taylor Lyla L. , Banwart Steve A. , Valdes Paul J. , Leake Jonathan R. , Beerling David J.
Published: January 2012

Global weathering of calcium and magnesium silicate rocks provides the long-term sink for atmospheric carbon dioxide (CO
2
) on a timescale of millions of years by causing precipitation of calcium carbonates on the seafloor. Catchment-scale field studies consistently indicate that vegetation increases silicate rock weathering, but incorporating the effects of trees and fungal symbionts into geochemical carbon cycle models has relied upon simple empirical scaling functions. Here, we describe the development and application of a process-based approach to deriving quantitative estimates of weathering by plant roots, associated symbiotic mycorrhizal fungi and climate. Our approach accounts for the influence of terrestrial primary productivity via nutrient uptake on soil chemistry and mineral weathering, driven by simulations using a dynamic global vegetation model coupled to an ocean–atmosphere general circulation model of the Earth's climate. The strategy is successfully validated against observations of weathering in watersheds around the world, indicating that it may have some utility when extrapolated into the past. When applied to a suite of six global simulations from 215 to 50 Ma, we find significantly larger effects over the past 220 Myr relative to the present day. Vegetation and mycorrhizal fungi enhanced climate-driven weathering by a factor of up to 2. Overall, we demonstrate a more realistic process-based treatment of plant fungal–geosphere interactions at the global scale, which constitutes a first step towards developing ‘next-generation’ geochemical models.
Morphological evolution in land plants: new designs with old genes
Authors: Pires Nuno D. , Dolan Liam
Published: January 2012

The colonization and radiation of multicellular plants on land that started over 470 Ma was one of the defining events in the history of this planet. For the first time, large amounts of primary productivity occurred on the continental surface, paving the way for the evolution of complex terrestrial ecosystems and altering global biogeochemical cycles; increased weathering of continental silicates and organic carbon burial resulted in a 90 per cent reduction in atmospheric carbon dioxide levels. The evolution of plants on land was itself characterized by a series of radical transformations of their body plans that included the formation of three-dimensional tissues,
de novo
evolution of a multicellular diploid sporophyte generation, evolution of multicellular meristems, and the development of specialized tissues and organ systems such as vasculature, roots, leaves, seeds and flowers. In this review, we discuss the evolution of the genes and developmental mechanisms that drove the explosion of plant morphologies on land. Recent studies indicate that many of the gene families which control development in extant plants were already present in the earliest land plants. This suggests that the evolution of novel morphologies was to a large degree driven by the reassembly and reuse of pre-existing genetic mechanisms.
Evolution of C
4
plants: a new hypothesis for an interaction of CO
2
and water relations mediated by plant hydraulics
Authors: Osborne Colin P. , Sack Lawren
Published: January 2012

C
4
photosynthesis has evolved more than 60 times as a carbon-concentrating mechanism to augment the ancestral C
3
photosynthetic pathway. The rate and the efficiency of photosynthesis are greater in the C
4
than C
3
type under atmospheric CO
2
depletion, high light and temperature, suggesting these factors as important selective agents. This hypothesis is consistent with comparative analyses of grasses, which indicate repeated evolutionary transitions from shaded forest to open habitats. However, such environmental transitions also impact strongly on plant–water relations. We hypothesize that excessive demand for water transport associated with low CO
2
, high light and temperature would have selected for C
4
photosynthesis not only to increase the efficiency and rate of photosynthesis, but also as a water-conserving mechanism. Our proposal is supported by evidence from the literature and physiological models. The C
4
pathway allows high rates of photosynthesis at low stomatal conductance, even given low atmospheric CO
2
. The resultant decrease in transpiration protects the hydraulic system, allowing stomata to remain open and photosynthesis to be sustained for longer under drying atmospheric and soil conditions. The evolution of C
4
photosynthesis therefore simultaneously improved plant carbon and water relations, conferring strong benefits as atmospheric CO
2
declined and ecological demand for water rose.
The cardioprotective association of average alcohol consumption and ischaemic heart disease: a systematic review and meta‐analysis
Authors: Roerecke Michael , Rehm Jürgen
Published: January 2012

Aims  Most, but not all, epidemiological studies suggest a cardioprotective association for low to moderate average alcohol consumption. The objective was to quantify the dose–response relationship between average alcohol consumption and ischaemic heart disease (IHD) stratified by sex and IHD end‐point (mortality versus morbidity).

Methods  A systematic search of published studies using electronic databases (1980–2010) identified 44 observational studies (case–control or cohort) reporting a relative risk measure for average alcohol intake in relation to IHD risk. Generalized least‐squares trend models were used to derive the best‐fitting dose–response curves in stratified continuous meta‐analyses. Categorical meta‐analyses were used to verify uncertainty for low to moderate levels of consumption in comparison to long‐term abstainers.

Results  The analyses used 38 627 IHD events (mortality or morbidity) among 957 684 participants. Differential risk curves were found by sex and end‐point. Although some form of a cardioprotective association was confirmed in all strata, substantial heterogeneity across studies remained unexplained and confidence intervals were relatively wide, in particular for average consumption of one to two drinks/day.

Conclusions  A cardioprotective association between alcohol use and ischaemic heart disease cannot be assumed for all drinkers, even at low levels of intake. More evidence on the overall benefit–risk ratio of average alcohol consumption in relation to ischaemic heart disease and other diseases is needed in order to inform the general public or physicians about safe or low‐risk drinking levels.
Randomised clinical trial: efficacy of Lactobacillus paracasei‐enriched artichokes in the treatment of patients with functional constipation – a double‐blind, controlled, crossover study
Authors: Riezzo G. , Orlando A. , D'Attoma B. , Guerra V. , Valerio F. , Lavermicocca P. , De Candia S.
Published: January 2012

Background

The role of probiotics in the management of constipation is uncertain.

Aims

To evaluate the effects of probiotic‐enriched artichokes on treatment preference, symptom profile and short‐chain fatty acid (SCFA) production in constipated subjects when compared with ordinary artichokes.

Methods

Twenty constipated patients (3M/17F; 38.8 ± 14.4 years) were studied using a double‐blind method and a computer‐generated randomisation list. Each patient consumed 180 g per day of ordinary artichokes or artichokes enriched with Lactobacillus paracasei IMPC 2.1 for 15 days (daily dose of 2 × 1010 CFU). Relief of symptoms was evaluated using a visual analogue scale. The stool consistency and symptom profile of patients were investigated using the Bristol stool form chart and the Gastrointestinal Symptom Rating Scale questionnaire (GSRS). SCFA production in faecal samples was evaluated using HPLC.

Results

Eighty per cent of patients preferred probiotic‐enriched artichokes to ordinary ones (P = 0.011). Satisfactory relief of symptoms was significantly higher (P = 0.0014) during the probiotic‐enriched artichoke period. Bristol chart cluster scores were significantly higher (3.3 ± 1.2, 2.9 ± 1.3 2.2 ± 1.2, baseline, ordinary artichokes and probiotic‐enriched ones, respectively; P = 0.009) and GSRS constipation was significantly lower (13.9 ± 0.9, 10.2 ± 0.8, 8.3 ± 0.9; P = 0.032) in the probiotic group compared with the baseline. As for SCFA production, propionic acid was significantly higher (2.2 ± 1.4, 2.1 ± 1.53, 1.5 ± 1.2; P = 0.035) in the probiotic group compared with baseline.

Conclusion

This trial shows a positive effect on symptoms in constipated patients after intake of probiotic‐enriched artichokes (clinical trial NCT01212146).
Chronic lymphocytic leukaemia with 17p deletion: a retrospective analysis of prognostic factors and therapy results
Authors: Delgado Julio , Espinet Blanca , Oliveira Ana C. , Abrisqueta Pau , de la Serna Javier , Collado Rosa , Loscertales Javier , Lopez Montserrat , Hernandez‐Rivas Jose A. , Ferra Christelle , Ramirez Angel , Roncero Josep M. , Lopez Cristina , Aventin Anna , Puiggros Anna , Abella Eugenia , Carbonell Felix , Costa Dolors , Carrio Anna , Gonzalez Marcos ,   on behalf of the Grupo Español de Leucemia Linfatica Cronica (GELLC) y Grupo Español de Citogenetica Hematologica (GECGH)
Published: January 2012

Patients with chronic lymphocytic leukaemia (CLL) whose tumour cells harbour a 17p deletion (17p‐) are universally considered to have a poor prognosis. The deletion can be detected at diagnosis or during the evolution of the disease, particularly in patients who have received chemotherapy. We sought to evaluate the natural history of patients with 17p‐ CLL, identify predictive factors within this prognostic subgroup, and evaluate the results of different therapeutic approaches. Data from 294 patients with 17p‐ CLL followed up at 20 different institutions was retrospectively collected and analysed. Median age was 68 (range 27–98) years at the time of fluorescence in situ hybridization analysis. After 17p‐ documentation, 52% received treatment, achieving an overall response rate of 50%. Median overall survival was 41 months, and was significantly shorter in patients with elevated beta2‐microglobulin concentration (P < 0·001), B symptoms (P = 0·016), higher percentage of cells with deletion (P < 0·001), and acquired deletions (P = 0·012). These findings suggest that patients with 17p‐ CLL have a variable prognosis that can be refined using simple clinical and laboratory features, including 17p‐ clone size, beta2‐microglobulin concentration, presence of B symptoms and type of deletion (de novo versus acquired).
Prospects for primary stroke prevention in children with sickle cell anaemia
Authors: Jordan Lori C. , Casella James F. , DeBaun Michael R.
Published: January 2012

This review will focus on the strengths and limitations associated with the current standard of care for primary prevention of ischaemic strokes in children with sickle cell anaemia (SCA) ‐ transcranial Doppler ultrasound (TCD) screening followed by regular blood transfusion therapy when TCD measurement is above a threshold defined by a randomized clinical trial (RCT). The theoretical basis for potential alternative strategies for primary prevention of neurological injury in SCA is also discussed. These strategies will include, but will not be limited to: immunizations to prevent bacterial infections, particularly in low income countries; management of elevated blood pressure; and targeted strategies to increase baseline haemoglobin levels with therapies such as hyroxycarbamide or potentially definitive haematopoietic stem cell transplant.
Objective assessment of internal stress in children during dental treatment by analysis of autonomic nervous activity
Authors: UEHARA NAOKO , TAKAGI YUZO , MIWA ZENZO , SUGIMOTO KUMIKO
Published: January 2012

International Journal of Paediatric Dentistry 2012; 22: 331–341

Aims.  The aim of this study was to assess the internal stress of children during dental treatment based on autonomic nerve activity and facial muscle activity.

Methods.  We recorded the electrocardiogram of children during the treatment of composite resin restoration and analysed autonomic nerve activity by means of power spectral analysis of heart rate variability. Simultaneously, electromyography (EMG) activity of the corrugator muscle was recorded in children during dental treatment, and the relationship between sympathetic nerve activity and corrugator EMG activity was analysed.

Results.  In all subjects, the mean sympathetic nerve activity was significantly higher during oral examination and after treatment compared with pre‐treatment. Depending on the sympathetic nerve responses to the other treatment procedures, the subjects could be classified into two groups: the stress group and the nonstress group. Sympathetic nerve activity was significantly higher during infiltration anaesthesia and cavity preparation compared with pre‐treatment activity in the stress group, whereas it was consistently lower than the pre‐treatment levels during most treatment procedures in the nonstress group. The mean amplitudes of the averaged corrugator muscle EMG during dental treatment did not differ between the stress and nonstress groups.

Conclusion.  The present results suggest that the measurement of autonomic nervous activity, especially sympathetic nervous activity, is quite useful in assessing the internal stress of children, even when no expressed sign of unease are present during dental treatment.