bluuebunny/crossref_metadata_2025 huggingface dataset:
Drug Burden Index and physical function in older Australian men
Authors: Gnjidic Danijela , Cumming Robert G. , Le Couteur David G. , Handelsman David J. , Naganathan Vasi , Abernethy Darrell R. , Hilmer Sarah N.
Published: March 2009

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT

• Inappropriate medication use is common among the elderly.

• Use of medications with anticholinergic and sedative properties is associated with functional impairments in older people.

• Exposure to anticholinergic and sedative medications, measured with Drug Burden Index that includes the principles of dose–response and maximal effect, was associated with impairment in physical and cognitive function in two studies of older people in the USA.

WHAT THIS STUDY ADDS

• We evaluated Drug Burden Index in an Australian population of community‐dwelling older men, The Concord Health and Ageing in Men Project that enrolled a random sample of community‐dwelling men aged ≥70 years living in Sydney, Australia.

• In this population, increasing Drug Burden Index was associated with objective impairments of physical performance and functional status.

• The Drug Burden Index has broad applicability regardless of healthcare system, prescribing practices, gender or country.

AIMS

This study evaluated the associations of physical performance and functional status measures with the Drug Burden Index in older Australian men. The Drug Burden Index is a measure of total exposure to anticholinergic and sedative medications that incorporates the principles of dose–response and maximal effect.

METHODS

A cross‐sectional survey was performed on community‐dwelling older men enrolled in The Concord Health and Ageing in Men Project, Sydney, Australia. Outcomes included chair stands, walking speed over 6 m, 20‐cm narrow walk speed, balance, grip strength and Instrumental Activities of Daily Living score (IADLs).

RESULTS

The study population consisted of 1705 men (age 76.9 ± 5.5 years). Of the 1527 (90%) participants who reported taking medications, 21% were exposed to anticholinergic and 13% to sedative drugs. The average Drug Burden Index in the study population was 0.18 ± 0.35. After adjusting for confounders (sociodemographics, comorbidities, cognitive impairment, depression), Drug Burden Index was associated with slower walking speed (P < 0.05), slower narrow walk speed (P < 0.05), balance difficulty (P < 0.01), grip weakness (P < 0.01) and poorer performance on IADLs (P < 0.05). Associations with physical performance and function were stronger for the sedative than for the anticholinergic component of the Drug Burden Index.

CONCLUSIONS

Higher Drug Burden Index is associated with poorer physical performance and functional status in community‐dwelling older Australian men. The Drug Burden Index has broad applicability as a tool for assessing the impact of medications on functions that determine independence in older people.
Involvement of T helper type 17 and regulatory T cell activity in Citrobacter rodentium invasion and inflammatory damage
Authors: Symonds E L , Riedel C U , O'Mahony D , Lapthorne S , O'Mahony L , Shanahan F
Published: March 2009

Citrobacter rodentium is a murine pathogen that transiently colonizes the lumen of the large intestine. C. rodentium induces colitis, but the relative importance and temporal induction of the T helper type 17 (Th17) and regulatory T cell (Treg) pathways in protection from the infection and inflammation have not been assessed. Our aim was to investigate the key immunological signalling events associated with successful clearance of C. rodentium. Mice were challenged with luminescent-tagged C. rodentium and killed at days 3 (early infection), 10 (peak infection) and 21 (late infection) post-infection. Bioluminescent imaging and bacterial culture determined levels of C. rodentium. Distal colon mRNA expression of interleukin (IL)-17, IL-6, IL-1β, tumour necrosis factor (TNF)-α, forkhead box P3 (FoxP3) and ghrelin were assessed using real-time polymerase chain reaction. Results were compared with age-matched non-infected mice. Low levels of C. rodentium were found at day 3, high levels at day 10, with clearance from the majority of the mice by day 21. In the distal colon, there was up-regulation of TNF-α and FoxP3 throughout the study and increases in IL-6 and IL-17 during the peak and late stages of infection. Ghrelin expression was increased at the peak and late stages of infection. This study has characterized changes to the T helper cell pathways, following the course of C. rodentium infection in mice. There were significant immunological changes, with up-regulation of the Th17 and Treg pathways in the distal colon and an increase in ghrelin expression compared with non-infected control mice. These changes may play a role in the pathology and clearance of C. rodentium.
Amelioration of hepatic fibrosis via Padma Hepaten is associated with altered natural killer T lymphocytes
Authors: Ginsburg I , Koren E , Horani A , Mahamid M , Doron S , Muhanna N , Amer J , Safadi R
Published: March 2009

Hepatic fibrosis is the end-stage consequence of chronic liver disease, affecting many people worldwide. Unlike the anti-fibrotic effect of natural killer (NK) cells, CD8 and NK T subsets are considered as profibrogenic subsets. Padma Hepaten is a multi-compound herbal preparation derived from Tibetan medicine and has proven efficacy in some clinical trials and tests at the cellular level. In this study, we evaluate the immune efficacy of Padma Hepaten administered intraperitoneally (i.p.) and/or orally in a mice model of hepatic fibrosis. Hepatic fibrosis was induced by 6 weeks of biweekly i.p. carbon tetrachloride (CCl4) injections in male C57Bl6 mice. There were four groups, including naive mice, non-treated fibrotic mice and fibrotic mice treated by Padma Hepaten at weeks 5–6 of fibrosis induction either orally or by i.p. injections. Padma Hepaten was prepared at 10 mg/ml in saline and 250 µl (2·5 mg) were administered four times per week. After week 6, animals were killed. To isolate a Padma Hepaten-associated effect on lymphocytes, splenocytes were harvested from either naive or Padma Hepaten-treated non-fibrotic donors. Isolated splenocytes were therefore reconstituted into two groups of irradiated recipients. Recipients were then administered the same CCl4 regimen. Hepatic fibrosis was determined by sirius red staining of liver sections and by assessment of alpha smooth muscle actin expression compared with β-actin (both by mRNA as well as the protein liver extract western blotting). Hepatic fibrosis and alanine aminotransferase serum levels were decreased significantly in both Padma Hepaten-treated groups compared with the non-treated fibrotic group. Padma Hepaten treatment was associated with attenuation of lymphocyte subsets in both treated groups. Using a chemiluminescence technique to assess total anti-oxidant capacities (TAC), it was found that both the plasmas and livers of mice treated by CCl4 had significantly higher TAC compared with controls. However, the levels of TAC in animals treated either by CCl4 alone or CCl4 with Padma Hepaten were similar. Adoptive transfer of Padma Hepaten-treated lymphocytes was associated with fibrosis amelioration compared with recipients with naive lymphocytes. CCl4 generates higher levels of anti-oxidant capacities, probably as a response to oxidative stress. Padma Hepaten administration attenuated hepatic fibrogenesis significantly, accompanied by attenuation of lymphocyte but not anti-oxidant capacities.
Gonadal dysfunction in male cancer patients before cytotoxic treatment
Authors: van Casteren Niels J. , Boellaard Willem P. A. , Romijn Johannes C. , Dohle Gert R.
Published: March 2009

Male patients diagnosed with cancer are often referred for semen cryopreservation before gonadotoxic treatment but often have low semen quality. The aim of this study was to evaluate which type of cancer affects gonadal function and proposes a risk factor for low pre‐treatment semen quality. Between January 1983 and August 2006, 764 male cancer patients were referred for semen cryopreservation prior to chemotherapy and radiotherapy. We compared semen characteristics and reproductive hormones between different groups of cancer patients. In addition, we evaluated the role of tumour markers in patients with testicular germ‐cell tumours (TGCT) on fertility. Abnormal semen parameters were found in 489 men (64%) before cancer treatment. Patients with TGCT and extragonadal germ‐cell tumours had significantly lower sperm concentrations and inhibin B levels than all other patient groups. No semen could be banked in 93 patients (12.2%). Eight hundred and thirty‐nine of 927 (90%) produced semen samples were adequate for cryopreservation. Inhibin B in all groups showed to be the best predictor of semen quality. Although pre‐treatment raised tumour markers were associated with a decrease in inhibin B and increased follicle stimulating hormone, both predictive for low semen quality; no direct linear association could be found between raised beta‐HCG, alfa‐fetoprotein and semen quality. Only 1/3 of cancer patients had normal semen parameters prior to cancer treatment. Patients with TGCT and extragonadal GCT have the highest risk for impaired semen quality and gonadal dysfunction at the time of semen cryopreservation.
A hierarchical Bayesian approach to multi‐state mark–recapture: simulations and applications
Authors: Calvert Anna M. , Bonner Simon J. , Jonsen Ian D. , Flemming Joanna Mills , Walde Sandra J. , Taylor Philip D.
Published: March 2009

Mark–recapture models are valuable for assessing diverse demographic and behavioural parameters, yet the precision of traditional estimates is often constrained by sparse empirical data. Bayesian inference explicitly recognizes estimation uncertainty, and hierarchical Bayes has proven particularly useful for dealing with sparseness by combining information across data sets.

We developed a general hierarchical Bayesian multi‐state mark–recapture model, tested its performance on simulated data sets and applied it to real ecological data on stopovers by migratory birds.

Our hierarchical model performed well in terms of both precision and accuracy of parameters when tested with simulated data of varying quality (sample size, capture and survivorship probabilities). It also provided more precise and accurate parameter estimates than a non‐hierarchical model when data were sparse.

A specific version of the model, designed for estimation of daily transience and departure of migratory birds at a mid‐route stopover, was applied to 11 years of autumn migration data from Atlantic Canada. Hierarchical estimates of departure and transience were more precise than those derived from parallel non‐hierarchical and frequentist methods, and indicated that inter‐annual variability in parameters suggested by these other methods was largely due to sampling error.

Synthesis and applications. Estimates of demographic parameters, often derived from mark–recapture studies, provide the basis for evaluating the status of species at risk, for developing conservation and management strategies and for evaluating the results of current protocols. The hierarchical Bayesian multi‐state mark–recapture model presented here permits partitioning of complex parameter variation across space or time, and the simultaneous analysis of multiple data sets results in a marked increase in the precision of estimates derived from sparse capture data. Its structural flexibility should make it a valuable tool for conservation ecologists and wildlife managers.
Quantifying historical changes in habitat availability for endangered species: use of pixel‐ and object‐based remote sensing
Authors: Pringle Robert M. , Syfert Mindy , Webb Jonathan K. , Shine Richard
Published: March 2009

Establishing medium‐ to long‐term trends in habitat availability for endangered species is important for determining the causes of historical population declines and for designing effective management plans. For some animal species, relative habitat availability can be estimated using time series of aerial photographs, but the limited information in old black‐and‐white images makes it challenging to estimate accurately at large spatial scales.

Australia's most endangered snake, the broad‐headed snake Hoplocephalus bungaroides, requires unshaded, exfoliated sandstone rocks for shelter. Using digitized aerial photographs of four sites from 1941 and 1971, and a Quickbird satellite image from 2006, we estimated the trend in habitat availability for a well‐studied population of H. bungaroides in New South Wales. We did this using both traditional, pixel‐based classifications and a more recently developed object‐based approach.

Both classification methods revealed substantial, monotonic decreases (by 24–77%) in the percentage cover of bare rock from 1941 to 2006 at all sites, with concomitant (although non‐monotonic) net increases in percentage tree‐canopy cover of 3–70%. The cover of herbaceous and low‐shrub vegetation appeared variable and was poorly resolved in the classifications.

Both classification methods yielded adequate (> 70%) accuracy for most images, but the object‐based classifications were consistently more accurate than the pixel‐based classifications and performed better when analysing images (from 1971) with comparatively low resolution.

 Synthesis and applications. Our study indicates that habitat availability for broad‐headed snakes has decreased considerably over 65 years due to increased shading from vegetation, and that object‐based image analysis is a promising tool for assessing habitat trends using historical photographs. Multiple studies have reported woody‐vegetation increases over multi‐decadal time‐scales in Australia and elsewhere, but few have tied these trends to habitat availability for animal species of concern. The phenomenon we document may therefore be quite widespread, and advances in remote sensing (including applications and refinements of the methods presented here) will be invaluable for revealing these trends and designing ameliorative management strategies. Management plans to conserve broad‐headed snakes and similarly threatened species should include either controlled burns or regular targeted removal of vegetation, preferably after a rigorous comparison of the relative economic and biological costs and benefits of each.
Phenotypic, serological and genetic characterization of Flavobacterium psychrophilum strains isolated from salmonids in Chile
Authors: Valdebenito S , Avendaño‐Herrera R
Published: March 2009

Characterization of 20 Flavobacterium psychrophilum strains isolated from farmed Atlantic salmon and rainbow trout in Chile was done using phenotypic, antigenic and genetic techniques. Experimental infections were also performed to assess the virulence of two representative isolates and of the type strain. Biochemical and physiological analyses showed that Chilean F. psychrophilum strains, regardless of the host species, constitute a phenotypically very homogeneous group matching with previous descriptions of this pathogen. However, serological assays indicated the existence of antigenic heterogeneity with four patterns of serological reactions. The first group contained most (14 of 20) of the F. psychrophilum isolates showing cross‐reaction with the antisera obtained against Atlantic salmon and rainbow trout isolates. Group 2 corresponded to four other rainbow trout isolates (1658, 1731, 1762 and 29009) that did not agglutinate with anti‐1150 serum. Two minor serological groups were identified for the remaining isolates (Groups 3 and 4). Marked homogeneity was also revealed by genetic studies including 16S rRNA alleles, random amplified polymorphic DNA and REP‐PCR showing that a major genetic group of F. psychrophilum may be dominant in disease outbreaks in farms. Restriction fragment length polymorphism of PCR analysis showed that gyrase genotypes B‐S or B‐R were found in Chilean isolates from rainbow trout and Atlantic salmon, whereas genotype A was not found. Virulence assays using Atlantic salmon indicated no relationship between the degree of pathogenicity and the host origin of the F. psychrophilum strains.
Genetic characterization of Streptococcus phocae strains isolated from Atlantic salmon, Salmo salar L., in Chile
Authors: Valdés I , Jaureguiberry B , Romalde J L , Toranzo A E , Magariños B , Avendaño‐Herrera R
Published: March 2009

Streptococcus phocae is a beta‐haemolytic bacterium frequently involved in disease outbreaks in seals causing pneumonia or respiratory infection. Since 1999, this pathogen has been isolated from diseased Atlantic salmon, Salmo salar, causing serious economic losses in the salmon industry in Chile. In this study, we used different molecular typing methods, such as pulsed‐field gel electrophoresis (PFGE), randomly amplified polymorphic DNA (RAPD), enterobacterial repetitive intergenic consensus sequence PCR (ERIC‐PCR), repetitive extragenic palindromic PCR (REP‐PCR) and restriction of 16S–23S rDNA intergenic spacer regions to evaluate the genetic diversity in S. phocae. Thirty‐four strains isolated in different years were analysed. The S. phocae type strain ATCC 51973T was included for comparative purposes. The results demonstrated genetic homogeneity within the S. phocae strains isolated in Chile over several years, suggesting the existence of clonal relationships among S. phocae isolated from Atlantic salmon. The type strain ATCC 51973T presented a different genetic pattern with the PFGE, RAPD, ERIC‐PCR and REP‐PCR methods. However, the fingerprint patterns of two seal isolates were distinct from those of the type strain.
Better adherence to antihypertensive agents and risk reduction of chronic heart failure
Authors: Perreault S. , Dragomir A. , White M. , Lalonde L. , Blais L. , Bérard A.
Published: March 2009

Aims.  Antihypertensive (AH) agents have been shown to reduce the risk of major cardiovascular events including chronic heart failure (CHF). However, the impact of changes in patterns of AH agents use on CHF is unknown. Our objective was to estimate to which different patterns of AH agent use is associated with the occurrence of CHF in a population‐based study.

Method and results.  A cohort of 82 320 patients was reconstructed using the Régie de l’assurance maladie du Québec’s databases. Patients were eligible if they were between 45 to 85 years of age, had no indication of cardiovascular disease and were newly treated with AH therapy between 1999 and 2004. A nested case–control design was used to study the occurrence of CHF. Every case of CHF was matched for age and duration of follow‐up to a maximum of 15 randomly selected controls. Adherence level was reported as a medication possession ratio. Conditional logistic regression models were used to estimate the rate ratio (RR) of CHF adjusting for different covariables. The mean patient age was 65 years, 37% were male, 8% had diabetes, 19% had dyslipidaemia and mean time of follow‐up at 2.7 years. High adherence level (95%) to AH therapy compared with lower adherence level (60%) was associated with an additional reduction of CHF events (RR: 0.89; 0.80–0.99). Risk factors for CHF were being on social assistance, diabetes, dyslipidaemia, higher chronic disease score and developing a cardiovascular condition during follow‐up.

Conclusion.  Our study suggests that a better adherence is associated with a significant risk reduction of CHF. Adherence to AH therapy needs to be improved to optimize benefits.
Escherichia coli DnaA forms helical structures along the longitudinal cell axis distinct from MreB filaments
Authors: Boeneman Kelly , Fossum Solveig , Yang Yanhua , Fingland Nicholas , Skarstad Kirsten , Crooke Elliott
Published: March 2009

DnaA initiates chromosomal replication in Escherichia coli at a well‐regulated time in the cell cycle. To determine how the spatial distribution of DnaA is related to the location of chromosomal replication and other cell cycle events, the localization of DnaA in living cells was visualized by confocal fluorescence microscopy. The gfp gene was randomly inserted into a dnaA‐bearing plasmid via in vitro transposition to create a library that included internally GFP‐tagged DnaA proteins. The library was screened for the ability to rescue dnaAts mutants, and a candidate gfp–dnaA was used to replace the dnaA gene of wild‐type cells. The resulting cells produce close to physiological levels of GFP–DnaA from the endogenous promoter as their only source of DnaA and somewhat under‐initiate replication with moderate asynchrony. Visualization of GFP‐tagged DnaA in living cells revealed that DnaA adopts a helical pattern that spirals along the long axis of the cell, a pattern also seen in wild‐type cells by immunofluorescence with affinity purified anti‐DnaA antibody. Although the DnaA helices closely resemble the helices of the actin analogue MreB, co‐visualization of GFP‐tagged DnaA and RFP‐tagged MreB demonstrates that DnaA and MreB adopt discrete helical structures along the length of the longitudinal cell axis.
Trichomonas vaginalis: metronidazole and other nitroimidazole drugs are reduced by the flavin enzyme thioredoxin reductase and disrupt the cellular redox system. Implications for nitroimidazole toxicity and resistance
Authors: Leitsch David , Kolarich Daniel , Binder Marina , Stadlmann Johannes , Altmann Friedrich , Duchêne Michael
Published: March 2009

Infections with the microaerophilic parasiteTrichomonas vaginalisare treated with the 5‐nitroimidazole drug metronidazole, which is also in use againstEntamoeba histolytica,Giardia intestinalisand microaerophilic/anaerobic bacteria. Here we report that inT. vaginalisthe flavin enzyme thioredoxin reductase displays nitroreductase activity with nitroimidazoles, including metronidazole, and with the nitrofuran drug furazolidone. Reactive metabolites of metronidazole and other nitroimidazoles form covalent adducts with several proteins that are known or assumed to be associated with thioredoxin‐mediated redox regulation, including thioredoxin reductase itself, ribonucleotide reductase, thioredoxin peroxidase and cytosolic malate dehydrogenase. Disulphide reducing activity of thioredoxin reductase was greatly diminished in extracts of metronidazole‐treated cells and intracellular non‐protein thiol levels were sharply decreased. We generated a highly metronidazole‐resistant cell line that displayed only minimal thioredoxin reductase activity, not due to diminished expression of the enzyme but due to the lack of its FAD cofactor. Reduction of free flavins, readily observed in metronidazole‐susceptible cells, was also absent in the resistant cells. On the other hand, iron‐depletedT. vaginaliscells, expressing only minimal amounts of PFOR and hydrogenosomal malate dehydrogenase, remained fully susceptible to metronidazole. Thus, taken together, our data suggest a flavin‐based mechanism of metronidazole activation and thereby challenge the current model of hydrogenosomal activation of nitroimidazole drugs.
GSK962040: a small molecule, selective motilin receptor agonist, effective as a stimulant of human and rabbit gastrointestinal motility
Authors: Sanger G. J. , Westaway S. M. , Barnes A. A. , Macpherson D. T. , Muir A. I. , Jarvie E. M. , Bolton V. N. , Cellek S. , Näslund E. , Hellström P. M. , Borman R. A. , Unsworth W. P. , Matthews K. L. , Lee K.
Published: March 2009

Abstract There is an urgent clinical need for a safe, efficacious stimulant of gastric emptying; current therapies include erythromycin (an antibiotic with additional properties which preclude chronic use) and metoclopramide (a 5‐hydroxytryptamine type 4 receptor agonist and an antagonist at brain D2receptors, associated with movement disorders). To move away from the complex motilide structure of erythromycin, a small molecule motilin receptor agonist, GSK962040, was identified and characterized. The compound was evaluated using recombinant human receptors, rabbit and human isolated stomach preparations known to respond to motilin andin vivo, by measuring its ability to increase defecation in conscious rabbits. At the human motilin receptor, the pEC50(the negative logarithm to base 10 of the EC50value, the concentration of agonist that produces 50% of the maximal response) values for GSK962040 and erythromycin as agonists were, respectively, 7.9 and 7.3; GSK962040 had no significant activity at a range of other receptors (including ghrelin), ion channels and enzymes. In rabbit gastric antrum, GSK962040 300 nmol L−1–10 μmol L−1caused a prolonged facilitation of the amplitude of cholinergically mediated contractions, to a maximum of 248 ± 47% at 3 μmol L−1. In human‐isolated stomach, GSK962040 10 μmol L−1, erythromycin 10 μmol L−1and [Nle13]‐motilin 100 nmol L−1, each caused muscle contraction of similar amplitude. In conscious rabbits, intravenous doses of 5 mg kg−1GSK962040 or 10 mg kg−1erythromycin significantly increased faecal output over a 2‐h period. Together, these data show that GSK962040, a non‐motilide structure, selectively activates the motilin receptor. Simplification of the structural requirements to activate this receptor greatly facilitates the design of potentially new medicines for gastroparesis.
Japanese herbal medicine in functional gastrointestinal disorders
Authors: Suzuki H. , Inadomi J. M. , Hibi T.
Published: March 2009

Abstract  Management of functional gastrointestinal disorders is hindered by both poor efficacy and adverse effects of traditional pharmacological therapy. Herbal medicine may be an attractive alternative based on the perception of its ‘natural’ approach and low risk of side effects; however, the lack of standardization of drug components has limited the ability to perform rigorous clinical studies in Western countries. Japanese herbal medicine (JHM) is a standardized form of herbal medicine with regards to the quality and quantities of ingredients. While extensively studied and widely used in Asia, there is a paucity of data upon which physicians in other parts of the world may draw conclusions regarding the effectiveness of herbal medicine for gastrointestinal disorders. The aim of this study was to summarize the most recent developments in JHM for treatment of functional gastrointestinal disorders. Animal and human studies were systematically reviewed to identify published data of JHM used for treatment of gastrointestinal disorders. The herbal components of JHM were examined. Results describing the physiological and clinical effects of JHM were abstracted, with an emphasis on functional gastrointestinal disorders. JHM are associated with a variety of beneficial physiological on the gastrointestinal system. Patient‐based clinical outcomes are improved in several conditions. Rikkunnshi‐to reduces symptoms and reverses physiological abnormalities associated with functional dyspepsia, while dai‐kenchu‐to improves symptoms of postoperative ileus and constipation in children. This updated summary of JHM in the field of gastrointestinal disorders illustrates the potential for herbal medication to serve a valuable role in the management of patients with functional gastrointestinal disorders.
The biogenic origin of needle fibre calcite
Authors: CAILLEAU GUILLAUME , VERRECCHIA ERIC P. , BRAISSANT OLIVIER , EMMANUEL LAURENT
Published: March 2009

Needle fibre calcite is one of the most ubiquitous habits of calcite in vadose environments (caves deposits, soil pores, etc.). Its origin, either through inorganic, indirect or direct biological processes, has long been debated. In this study, investigations at 11 sites in Europe, Africa and Central America support arguments for its biogenic origin. The wide range of needle morphologies is the result of a gradual evolution of the simplest type, a rod. This rod is the elementary brick which, by aggregation and welding, builds more complex needles. The absence of cross‐welded needles implies that they are welded in a mould, or under a longitudinal and unidirectional constraint, before being released inside the soil pores. The difference between the lengthening of the needles and the c axis can be explained by the existence of needles observed under a scanning electron microscope in organic sleeves, which can act as a mould during rod growth. Complex morphologies with epitaxial outgrowths on straight rods cannot have grown entirely inside organic microtubes; they must result from soil diagenesis after the release of straight rods in a soil‐free medium. Whisker crystals are interpreted as the result of growth and coalescence of euhedral crystals on a rod. Rhomb chains are considered to be the consequence of successive epitaxial growth steps on a needle during variations in growth conditions. Isotopic signatures for needle fibre calcite vary from −16·63‰ to +1·10‰ and from −8·63‰ to −2·25‰ for δ13C and δ18O, respectively. The absence of high δ18O values for needle fibre calcite precludes a purely physicochemical origin (evaporative) for this particular habit of calcite. As epitaxial growth cannot precipitate in the same conditions as initial needles, needle fibre calcite stable isotopic signatures should be used with caution as a proxy for palaeoenvironmental reconstructions. In addition, it is suggested that the term needle fibre calcite should be kept for the original biogenic form. The other habit should be referred to as epitaxial forms of needle fibre calcite.
Local adaptation of stress related traits in Drosophila buzzatii and Drosophila simulans in spite of high gene flow
Authors: SARUP P. , FRYDENBERG J. , LOESCHCKE V.
Published: March 2009

We addressed the question if local adaptation to a thermal gradient is possible in spite of a high gene flow among closely spaced populations of two species of Drosophila from the island of La Gomera (Canary Islands). Variation in multiple traits related to stress resistance in different life stages was measured in both species in flies collected from five localities at different altitudes and thereby with different climatic conditions. Based on microsatellite loci, the populations were not genetically differentiated. However, 18 of the 24 independent traits measured showed significant differentiation among populations of Drosophila buzzatii, but only nine of 25 for Drosophila simulans. This difference in the number of traits might reflect higher habitat specificity and thus higher potential for local adaptation of D. buzzatii than D. simulans. We found clinal variation, as some traits showed significant linear regressions on altitude, but more on altitude cubed.
The Price equation framework to study disease within‐host evolution
Authors: ALIZON S.
Published: March 2009

The evolution of infectious diseases is known to affect epidemiological dynamics, but, for some viruses and bacteria, this evolution also takes place inside a host during the course of an infection. I develop an original approach to study intrahost evolutionary dynamics of quantitative disease traits. This approach can be expressed mathematically using the ‘Price equation’ framework recently developed in evolutionary epidemiology. This framework combines population genetics and within‐host population dynamics models to identify trade‐offs that affect disease intrahost evolution and to predict short‐term evolutionary dynamics of life‐history traits. I show that this can be applied to study the evolution of viruses competing for host cells or to study the coevolution between parasites and the immune system of the host. This framework can also easily incorporate experimental data. Studying intrahost evolutionary dynamics provides insight at the within‐host level, because it allows us to better understand the course of chronic infections, and at the epidemiological level, because it helps to study multi‐scale evolutionary processes. This framework can be used to address important biological issues, from immune escape to disease evolutionary response to treatments.
Gender, socioeconomic status, need or access? Differences in statin prescribing across urban, rural and remote Australia
Authors: Stocks Nigel , Ryan Phil , Allan James , Williams Susan , Willson Kristyn
Published: March 2009

Objectives:  To assess differences in statin prescribing across Australia by geographic area.

Design, setting and participants:  A cross‐sectional study using Pharmaceutical Benefits Scheme data on statin prescribing by rurality, gender and patient postcode for the period May to December 2002. Participants were the Australian population, stratified by gender, quintile of index of relative socioeconomic disadvantage and rural, remote and metropolitan areas classification.

Results:  Statin prescribing (scripts per 1000 population per month) was higher in urban areas (women, 51.915; men, 51.892) than in rural (women, 48.311; men, 48.098) or remote (women, 39.679; men, 34.145) areas. In urban areas, weighted least squares regression analysis showed a significant negative linear association between statin prescribing and socioeconomic status for both women (weighted least squares slope, −3.358; standard error (SE) 0.057; P < 0.0001) and men (slope, −0.507; SE 0.056; P < 0.0001). A similar association occurred in rural areas: women (slope, −4.075; SE 0.122; P < 0.0001) and men (slope, −3.455; SE 0.117; P < 0.0001), but not in remote areas where there was a positive linear association (slope, 3.120; SE 0.451; P < 0.0001) and men (slope, 3.098; SE 0.346; P < 0.0001).

Conclusion:  Our results suggest differences in statin prescribing in Australia across geographic location, adjusting for age, gender and socioeconomic status.

Implications:  These findings suggest that health inequalities due to geography should be addressed.
Need for syphilis screening and counselling in HIV counselling and testing centres: A curtain raiser study from north India
Authors: Nag Vijaya Lakshmi , Dash Nihar Ranjan , Pathak Ashutosh , Agarwal Surendra Kumar
Published: March 2009

Background: Voluntary counselling and testing centres (VCTC) are important HIV screening points for the population with suspicion or apprehension for HIV, because of high‐risk exposures. Theoretically, these are also at the risk of having co‐infections, commonest being syphilis. The present short‐term study was aimed at knowing the sero‐reactivity of syphilis among a study cohort attending the VCTC in King George's Medical University, Lucknow, India.

Method: During a 2.5‐month period, 49 HIV‐positive and 171 HIV‐negative sera were tested for venereal disease research laboratory (VDRL). The positive sera were further tested for treponema pallidum haemagglutination (TPHA).

Result: Eleven (22.4%) HIV‐positive sera and 104 (60.8%) HIV‐negative sera were VDRL‐reactive (≥1:8 dilutions). Of these, TPHA was reactive in three (27.3%) and four (3.9%), respectively.

Conclusion: The result might suggest the need for routine screening and counselling for syphilis at VCTC. Studies from other centres on larger population are required.
Uterine preservation in a woman with spontaneous uterine rupture secondary to placenta percreta on the posterior wall: A case report
Authors: Wang Le‐Ming , Wang Peng‐Hui , Chen Chi‐long , Au Heng‐Kien , Yen Yuan‐Kuei , Liu Wei‐Min
Published: March 2009

Several cases in which uteruses have been preserved in women with placenta percreta have been reported. We herein report a 38‐year‐old woman with a history of previous cesarean section who was admitted with lower abdominal pain and vaginal bleeding at 31 weeks of gestation. An urgent exploratory laparotomy revealed active bleeding from the uterine rupture on the posterior uterine wall. A female infant weighing 1560 g, with Apgar scores of 1, 1, and 3 at 1, 5, and 10 min, respectively, was delivered, and the placenta was removed. We performed bilateral uterine vessel occlusion, followed by wedge resection of the ruptured uterine wall with the aid of an intrauterine muscle injection of 20 IU oxytocin, a local injection of diluted vasopressin (1:60) into the myometrium around and into the rupture site, and an intramuscular injection of 0.2 mg methylergonovine, primary repair of the defect, and an additional 24‐h postoperative oxytocin infusion (30 IU in 5% dextrose 500 mL) to preserve the uterus successfully. Although the overall blood loss was 3700 mL, no disseminated intravascular coagulopathy occurred after the patient had received adequate blood transfusion. The postoperative pathological diagnosis was placenta percreta with uterine rupture. The patient and her baby were discharged uneventfully. In some cases of spontaneous uterine rupture secondary to placenta percreta, we can preserve the uterus by performing bilateral uterine vessel occlusion and wedge resection of the ruptured uterine wall.
The role of ethnicity on pain perception in labor among parturients at the university college hospital Ibadan
Authors: Olayemi Oladapo , Morhason‐Bello Imran O. , Adedokun Babatunde O. , Ojengbede Oladosu A.
Published: March 2009

Aims:  In developing countries, the major mechanism by which parturients cope with labor pain is psychological. This study aims to assess the effect of ethnicity on the perception of pain by parturients in labor at the University College Hospital, Ibadan.

Materials and Methods:  The study was conducted between the 1 November 2006 and the 30 March 2007 at the University College Hospital Ibadan. The main outcome measure was pain perception assessed by the Box Numerical Scale (BNS). Univariate analysis was by t‐test for continuous variables and χ2 test for categorical variables. The multiple linear regression method was utilized for multivariate analysis. The level of statistical significance was set at P < 0.05.

Results:  The lowest adjusted mean BNS score was found in the Yoruba ethnic group: they had scores lower than the mean scores for the other ethnic groups (−0.636 [95% confidence interval (CI) −0.959, −0.313]). The presence of a doula also reduced the mean BNS scores significantly (−0.533 [95% CI −0.844, −0.222]. Increasing parity also reduced pain scores (−0.182 [95% CI −0.342, −0.022]). Increasing educational attainment increased pain scores in labor (0.189 [95% CI 0.017, 0.361]). The influence of increasing age was not statistically significant in this model.

In conclusion, ethnicity of the parturient relative to that of the predominant ethnicity in the place of birth has a significant effect on the perception of labor pain by the parturient. In our resource‐challenged environment, trained doulas may help make labor less painful for the parturient.
Lidocaine 10% spray reduces pain during hysterosalpingography: A randomized controlled trial
Authors: Karasahin Emre , Alanbay Ibrahim , Keskin Ugur , Gezginc Kazim , Baser Iskender
Published: March 2009

Aim:  The aim of this study was to evaluate whether the use of lidocaine 10% spray was effective in pain control during hysterosalpingography (HSG).

Methods:  A total of 81 patients were randomly assigned to three groups: Group 1, 10 mg lidocaine hydrochloride 10% spray; Group 2, 20 mg lidocaine hydrochloride 10% spray; and Group 3, Placebo. We used a standard 10 cm Visual Analog Scale for pain scoring. The ‘0 cm’ end corresponded to ‘no pain’, and the ‘10 cm’ end represented the ‘worst pain ever’. We asked the patients to mark their pre‐HSG pain expectancies initially, then to mark their pain during uterine traction after the tenaculum has been applied. Finally, they were asked to mark their pain during contrast medium injection.

Results:  In Group1, the mean anticipated pain (AP) score was 64.51 ± 12.62, the mean pain (MP) score during cervical traction with uterine tenaculum was 57.48 ± 11.32 (P: 0.011), and the MP score during contrast medium injection was 46.22 ± 13.00 (P: 0.005). In Group 2 the mean AP score was 66.44 ± 12.02, the MP score during cervical traction with uterine tenaculum was 48.03 ± 13.44 (P: 0.001), and the MP during contrast medium injection was 46.25 ± 11.57 (P: 0.001). In Group 3 the mean AP score was 61.8 ± 18.5, the MP score during cervical traction with uterine tenaculum was 59.5 (P: 0.07), and the MP during contrast medium injection was 57.5 ± 14.5) (P: 0.304).

Conclusion:  Topical lidocaine spray is a practical and effective analgesic for decreasing pain perception scores during the HSG procedure. A 10 mg dose is comparable to a 20 mg dose in pain reduction with less chance of side effects and better cost‐effectiveness.
Follow‐up assessment of excluded oocyte donor candidates
Authors: Zweifel Julianne E. , Biaggio Brittany , Schouweiler Calissa , Lindheim Steven R.
Published: March 2009

Aim:  In 2005 16,161 fresh and frozen egg donation embryo transfer cycles were performed in the USA. Use of egg donation continues to increase and, as such, the number of women who apply to be egg donors will also increase. Up to 44% of women who apply to be egg donors will ultimately be rejected. We suggest that women pursuing egg donation may not anticipate that they may be excluded from the program. Further, we suggest that many of them are unprepared to receive the information that they have been rejected from an egg donor program based on either medical or psychological grounds. In this brief report, we share our clinical experiences with women who were rejected from our egg donation program. We suggest that egg donation programs have an ethical obligation to follow up with women they have rejected from their program.

Methods and Results:  This paper reports on the experiences of the excluded donors from our clinic and reveals that being excluded creates a negative emotional impact which can include disappointment, fear, anger, and sadness. For most excluded donors this reaction is short‐term but for some it is more long‐lasting and more seriously upsetting.

Conclusions:  The scope of this paper is limited in that it reports on clinical experiences rather than results of a controlled study. This paper suggests that researchers and clinicians have an ethical obligation to follow up with rejected donors to assess and address the emotional impact of being excluded from a donor program.
Toll‐like receptors and pregnancy: Trophoblast as modulators of the immune response
Authors: Koga Kaori , Aldo Paulomi B. , Mor Gil
Published: March 2009

During normal pregnancy, the decidua is populated by a variety of leucocytes; however, cells of the innate immune system seem to dominate this tissue. Their presence suggests that the innate immune system is not indifferent to the fetus and has been associated with a response of the maternal immune system to the ‘semi‐allograft’ fetus. New evidences, however, indicate that these immune cells are critical for decidual and trophoblast development rather than induction of tolerance. We hypothesized that during implantation, an inflammatory environment is necessary for the attachment and invasion of the blastocyst. The existence of an ‘inflammatory‐mediated embryo implantation’ condition is dependent on the proper ‘education’ of the innate immune system which we propose is mediated by the trophoblast. Here we postulate that trophoblast cells successfully orchestrate their inflammatory environment and regulate immune cells differentiation and activation through Toll‐like receptors (TLR). We will describe potential functions of TLR in trophoblast cells, their recognition and response to microorganisms, and their involvement in innate immunity.
Prospects for tropical forest biodiversity in a human‐modified world
Authors: Gardner Toby A. , Barlow Jos , Chazdon Robin , Ewers Robert M. , Harvey Celia A. , Peres Carlos A. , Sodhi Navjot S.
Published: March 2009

The future of tropical forest biodiversity depends more than ever on the effective management of human‐modified landscapes, presenting a daunting challenge to conservation practitioners and land use managers. We provide a critical synthesis of the scientific insights that guide our understanding of patterns and processes underpinning forest biodiversity in the human‐modified tropics, and present a conceptual framework that integrates a broad range of social and ecological factors that define and contextualize the possible future of tropical forest species. A growing body of research demonstrates that spatial and temporal patterns of biodiversity are the dynamic product of interacting historical and contemporary human and ecological processes. These processes vary radically in their relative importance within and among regions, and have effects that may take years to become fully manifest. Interpreting biodiversity research findings is frequently made difficult by constrained study designs, low congruence in species responses to disturbance, shifting baselines and an over‐dependence on comparative inferences from a small number of well studied localities. Spatial and temporal heterogeneity in the potential prospects for biodiversity conservation can be explained by regional differences in biotic vulnerability and anthropogenic legacies, an ever‐tighter coupling of human‐ecological systems and the influence of global environmental change. These differences provide both challenges and opportunities for biodiversity conservation. Building upon our synthesis we outline a simple adaptive‐landscape planning framework that can help guide a new research agenda to enhance biodiversity conservation prospects in the human‐modified tropics.
Functional and structural response of the methanogenic microbial community in rice field soil to temperature change
Authors: Conrad Ralf , Klose Melanie , Noll Matthias
Published: March 2009

The microbial community in anoxic rice field soil produces CH4 over a wide temperature range up to 55°C. However, at temperatures higher than about 40°C, the methanogenic path changes from CH4 production by hydrogenotrophic plus acetoclastic methanogenesis to exclusively hydrogenotrophic methanogenesis and simultaneously, the methanogenic community consisting of Methanosarcinaceae, Methanoseataceae, Methanomicrobiales, Methanobacteriales and Rice Cluster I (RC‐1) changes to almost complete dominance of RC‐1. We studied changes in structure and function of the methanogenic community with temperature to see whether microbial members of the community were lost or their function impaired by exposure to high temperature. We characterized the function of the community by the path of CH4 production measuring δ13C in CH4 and CO2 and calculating the apparent fractionation factor (αapp) and the structure of the community by analysis of the terminal restriction fragment length polymorphism (T‐RFLP) of the microbial 16S rRNA genes. Shift of the temperature from 45°C to 35°C resulted in a corresponding shift of function and structure, especially when some 35°C soil was added to the 45°C soil. The bacterial community (T‐RFLP patterns), which was much more diverse than the archaeal community, changed in a similar manner upon temperature shift. Incubation of a mixture of 35°C and 50°C pre‐incubated methanogenic rice field soil at different temperatures resulted in functionally and structurally well‐defined communities. Although function changed from a mixture of acetoclastic and hydrogenotrophic methanogenesis to exclusively hydrogenotrophic methanogenesis over a rather narrow temperature range of 42–46°C, each of these temperatures also resulted in only one characteristic function and structure. Our study showed that temperature conditions defined structure and function of the methanogenic microbial community.