bluuebunny/crossref_metadata_2025 huggingface dataset:
Drought in a Bornean everwet rain forest
Authors: Potts Matthew D.
Published: May 2003

1 In 1998, the forests of Lambir Hills National Park experienced a severe drought. Between late January and mid‐April, less than one‐fifth of the normal expected rainfall was received. To investigate the effects of the drought, survival among 6993 trees (≥ 1 cm d.b.h.) in the drought period (1997–98) was compared with survival among 7270 trees in the same area before the drought (1993–97).

2 Mortality rates for the pre‐drought and drought periods were calculated using maximum likelihood techniques. Forest wide mortality rates during the drought were 7.63% year−1 as compared to 2.40% year−1 during the pre‐drought period. Logistic regression was used to investigate habitat effects. During the pre‐drought period, soil type was the most important predictor of tree survival, while during the drought period, slope was the most important.

3 The mortality rate of large (≥ 10 cm d.b.h.) rare trees (< 2 individuals ≥ 1 cm d.b.h. ha−1) did not differ between pre‐drought and drought periods, while that of large common trees (> 35 individuals ≥ 1 cm d.b.h. ha−1) increased 6.5 fold in response to the drought suggesting a possible compensatory mechanism maintaining the persistence of rare species. Mortality of large common and rare species however, did not differ significantly during the drought due to small sample sizes.

4 The results of a comparative analysis of the impacts of droughts in four tropical forest sites provide evidence in support of the Intermediate Disturbance hypothesis.
Transition probabilities from pollination to establishment in a rare dioecious shrub species (Rhamnus ludovici‐salvatoris) in two habitats
Authors: Traveset A. , Gulias J. , Riera N. , Mus M.
Published: May 2003

1 We elucidated the critical life stages and processes in the recruitment of Rhamnus ludovici‐salvatoris, a dioecious shrub endemic to the Balearic Islands (western Mediterranean), populations of which have been shrinking in recent decades. We evaluated transition probabilities between all stages involved in regeneration from pollination to seedling recruitment, in order to determine the overall probability of an ovule in a flower becoming an established individual in a population.

2 We compared populations in an oak (Quercus ilex) forest and in a more disturbed habitat (an abandoned field). We studied seed rain and probabilities of predation, germination and survival in the main microhabitats within each community.

3 High levels of seed predation after dispersal and unfavourable conditions (water deficit) during germination and recruitment periods were the most critical factors limiting population growth in both habitats.

4 The greater fecundity of shrubs in the abandoned field did not compensate for the lower probability of ovules recruiting new individuals in that habitat compared to the forest.

5 Spatial patterns of recruitment in this species cannot be predicted from seed dispersal patterns produced by frugivorous birds. In both habitats, but especially in the forest, there was strong spatial discordance between seed rain (most seeds were deposited under conspecifics) and seedling establishment. In the forest, most established Rhamnus are found under oaks, whereas in the abandoned field, saplings and juveniles are more equally distributed across different microhabitats.

6 This empirical study supports the idea that habitat disturbance, in general, may considerably alter the patterns of plant recruitment. For endemic species with restricted and rather small populations, the loss of natural habitat is likely to be detrimental for species’ persistence, as recruitment in disturbed sites is greatly reduced.
Forecasting plant migration rates: managing uncertainty for risk assessment
Authors: Higgins S. I. , Clark J. S. , Nathan R. , Hovestadt T. , Schurr F. , Fragoso J. M. V. , Aguiar M. R. , Ribbens E. , Lavorel S.
Published: May 2003

Anthropogenic changes in the global climate are shifting the potential ranges of many plant species.

Changing climates will allow some species the opportunity to expand their range, others may experience a contraction in their potential range, while the current and future ranges of some species may not overlap. Our capacity to generalize about the threat these range shifts pose to plant diversity is limited by many sources of uncertainty.

In this paper we summarize sources of uncertainty for migration forecasts and suggest a research protocol for making forecasts in the context of uncertainty.
Spatial ecology of a small desert shrub on adjacent geological substrates
Authors: Schenk H. Jochen , Holzapfel Claus , Hamilton Jason G. , Mahall Bruce E.
Published: May 2003

1 Spatial pattern analyses were used to generate hypotheses about the processes that shape the structure of a plant community in the Mojave Desert of North America, with a focus on the semi‐shrubAmbrosia dumosa. We analysed spatial distributions and sizes of this species relative to other semi‐shrubs, shrubs and annuals, and the relationships between spatial patterns and abiotic and biotic habitat characteristics.

2 The analyses were based on maps of sample plots placed along a transect spanning two adjacent geological substrates: aeolian sand and gravelly, sandy to loamy alluvium. Of these two substrates, sand supported higher total biomasses ofAmbrosiaand of all woody perennials, while alluvium supported on average higher biomasses of winter annuals.

3 Annuals and seedlings ofAmbrosiawere much more strongly aggregated withAmbrosiacanopies on sand than on alluvium, suggesting that these small plants were more strongly facilitated byAmbrosiaon sand than on alluvium.

4 Ambrosiasemi‐shrubs were spatially segregated on sand but aggregated on alluvium, and the degree of segregation on sand increased with the total above‐ground biomass ofAmbrosiaper unit area, indicating that negative interactions betweenAmbrosiaplants were stronger in more productive habitats. Canopy sizes ofAmbrosiain all mapped plots increased with distance to the nearest conspecific neighbour, which suggests that neighbour interactions negatively affected plant sizes.

5 Ambrosiaplants on sand were spatially aggregated withAcamptopappus sphaerocephalussemi‐shrubs, suggesting that at least one of these species may benefit from the association.Ambrosiaplants were spatially segregated fromLarrea tridentatashrubs on both substrates, possibly due to negative effects ofLarrearoots onAmbrosiaroots reported in previous studies.

6 Subtle differences in substrate characteristics were correlated with strong differences in the spatial distribution ofAmbrosiaplants relative to their neighbours, which suggests that edaphic conditions may affect the spatial structure of the community by modifying complex positive and negative interactions between neighbouring plants.
Molecular characterization of the fish‐pathogenic fungus Aphanomyces invadans
Authors: Lilley J H , Hart D , Panyawachira V , Kanchanakhan S , Chinabut S , Söderhäll K , Cerenius L
Published: May 2003

Aphanomyces invadans (Saprolegniaceae) is a peronosporomycete fungus associated with the serious fish disease, epizootic ulcerative syndrome (EUS), also known as mycotic granulomatosis. In this study, interspecific relationships were examined between A. invadans isolates and other aquatic animal pathogenic Saprolegniaceae, and saprophytic Saprolegniaceae from EUS‐affected areas. Restriction fragment length polymorphisms and sequences of ribosomal DNA confirmed that A. invadans is distinct from all other species studied. A sequence from the internal transcribed spacer region ITS1, unique to A. invadans, was used to design primers for a PCR‐based diagnostic test. Intraspecific relationships were also examined by random amplification of polymorphic DNA using 20 isolates of A. invadans from six countries. The isolates showed a high degree of genetic homogeneity using 14 random ten‐mer primers. This provides evidence that the fungus has spread across Asia in one relatively rapid episode, which is consistent with reports of outbreaks of EUS. Physiological distinctions between A. invadans and other Aphanomyces species based on a data set of 16 growth parameters showed remarkable taxonomic congruence with the molecular phylogeny.
Uptake of erythromycin by first‐feeding sockeye salmon, Oncorhynchus nerka (Walbaum), fed live or freeze‐dried enriched adult Artemia or medicated pellets
Authors: Cook M A , Rust M B , Massee K , Majack T , Peterson M E
Published: May 2003

The potential to use adult Artemia to deliver erythromycin to first‐feeding sockeye salmon, Oncorhynchus nerka (Walbaum), was investigated in three trials. In the first trial, first‐feeding sockeye were fed live erythromycin enriched adult Artemia or pellets containing equal amounts of erythromycin for 35 days. At the end of the trial, tissue erythromycin concentration of the fish fed the live Artemia was significantly greater (P < 0.05, 25.52 ± 1.29 μg mL−1; mean ± SEM), than the tissue concentration of the fish fed the pellets (0.72 ± 0.01 μg mL−1). In the second trial, first‐feeding sockeye were fed either live or freeze‐dried bioencapsulated erythromycin (adult Artemia) or pellets containing erythromycin daily for 21 days. Mean daily erythromycin concentration in fish fed the freeze‐dried Artemia, live Artemia, or pellets did not differ significantly. In the third trial, apparent erythromycin digestibility was determined. Significantly more (P < 0.05) erythromycin was retained by juvenile sockeye fed freeze‐dried bioencapsulated erythromycin (98.3 ± 1.0%) compared with medicated pellets (89.2 ± 1.7%). Uptake of bioencapsulated erythromycin from adult Artemia (live or freeze‐dried) appears to be greater than uptake from pellets. Freeze‐dried and live Artemia were equally effective at delivery suggesting enriched freeze‐dried adult Artemia could be produced into a highly palatable, consistent, off‐the‐shelf product.
Isolation of a highly pathogenic Vibrio pelagius strain associated with mass mortalities of turbot, Scophthalmus maximus (L.), larvae
Authors: Villamil L , Figueras A , Toranzo A E , Planas M , Novoa B
Published: May 2003

A bacterial strain, characterized as Vibrio pelagius (Hq 222), was isolated from a turbot, Scophthalmus maximus (L.), larvae mass mortality in a commercial fish farm in Spain. Turbot larvae, post‐larvae (0.2 g) and juveniles (5 and 15 g) were experimentally infected. The bacterium appeared to be very virulent for larvae and post‐larvae, LD50 being <5 bacteria mL−1 for larvae 1 week post‐infection and 3.9 × 105 bacteria mL−1 in post‐larvae at day 12 post‐infection. The bacterial strain was recovered in pure culture from the internal organs of infected fish. Histological lesions in post‐larvae exhibited swelling and necrosis of gill secondary lamellae, sloughing of intestinal mucosa and necrosis of haematopoietic tissue in the kidney. Vibrio pelagius (Hq 222) was able to grow in sterile sea water when incubated at room temperature or at 15 °C. Vibrio pelagius (Hq 222) was more adherent to the turbot cell lines TV‐1 and TF than Escherichia coli. In both cell lines, the number of adhered bacteria increased with incubation time.
Protective effect of cutaneous antibody produced by channel catfish, Ictalurus punctatus (Rafinesque), immune to Ichthyophthirius multifiliis Fouquet on cohabited non‐immune catfish
Authors: Xu D‐H , Klesius P H
Published: May 2003

Fish which survive a sublethal ichthyophthiriasis acquire protective immunity against Ichthyophthirius multifiliis Fouquet (Ich). This study evaluated the protective effect of cutaneous antibody secreted by channel catfish, Ictalurus punctatus (Rafinesque), immune to Ich on cohabited non‐immune catfish. Non‐immune and immune fish controls were separately maintained and infected with theronts. The Ich infection was assessed by scoring 0, <50, 50–100, and >100 trophonts fish−1 at 5 days post‐infection. The results of infection showed that cohabited fish at the ratio of 15 non‐immune to two immune fish had <50 trophonts fish−1. Eighty per cent of the cohabited fish at the ratio of 10 non‐immune to two immune fish showed 0 or <50 trophonts fish−1. The 76% of control non‐immune fish had more than 100 trophonts fish−1. The control immune fish had 0 trophonts fish−1. Anti‐Ich antibody was detected using enzyme‐linked immunosorbent assay in water samples taken from tanks containing immune fish after the water samples were concentrated 40‐fold. The study suggests that immune fish cohabited with non‐immune fish may protect non‐immune fish against Ich infection.
A transformation vector for the production of marker‐free transgenic plants containing a single copy transgene at high frequency
Authors: Sugita Koichi , Kasahara Takehide , Matsunaga Etsuko , Ebinuma Hiroyasu
Published: May 2003

We represent here the GST‐MAT vector system. The R recombinase gene of the site‐specific recombination system R/RS from Zygosaccharomyces rouxii was fused to the chemical inducible promoter of the glutathione‐S‐transferase (GST‐II‐27) gene from Zea mays. Upon excision, the isopentenyltransferase (ipt) gene that is used as a selectable marker gene is removed. When the cauliflower mosaic virus 35S promoter (CaMV 35S) was used to express R recombinase, 67% of the marker‐free transgenic plants had more than three transgene copies. Because the CaMV 35S promoter transiently and efficiently excised the ipt gene before callus and adventitious bud formation, the frequency of emergence of the ipt‐shooty explants with a single T‐DNA copy might be reduced. In this study we show that the GST‐MAT vector efficiently produced transgenic ipt‐shooty explants from 37 (88%) out of 42 differentiated adventitious buds and marker‐free transgenic plants containing the GUS gene from five (14%) out of 37 ipt‐shooty lines. Furthermore, the GST‐MAT vector also induced two marker‐free transgenic plants without the production of ipt‐shooty intermediates. Southern blot analysis showed that six (86%) out of seven marker‐free transgenic plants had a single GUS gene. This result suggests that the GST‐MAT vector is useful to generate high frequency, marker‐free transgenic plants containing a single transgene.
Modulation by phytochrome of the blue light‐induced extracellular acidification by leaf epidermal cells of pea (Pisum sativum L.): a kinetic analysis
Authors: Elzenga J. Theo M. , Staal Marten , Prins Hidde B. A.
Published: May 2003

Blue light induces extracellular acidification, a prerequisite of cell expansion, in epidermis cells of young pea leaves, by stimulation of the proton pumping‐ATPase activity in the plasma membrane. A transient acidification, reaching a maximum 2.5–5 min after the start of the pulse, could be induced by pulses as short as 30 msec. A pulse of more than 3000 μmol m−2 saturated this response. Responsiveness to a second light pulse was recovered with a time constant of about 7 min. The fluence rate‐dependent lag time and sigmoidal increase of the acidification suggested the involvement of several reactions between light perception and activation of the ATPase. In wild‐type pea plants, the fluence response relation for short light pulses was biphasic, with a component that saturates at low fluence and one that saturates at high fluence. The phytochrome‐deficient mutant pcd2 showed a selective loss of the high‐fluence component, suggesting that the high‐fluence component is phytochrome‐dependent and the low‐fluence component is phytochrome‐independent. Treatment with the calmodulin inhibitor W7 also led to the elimination of the phytochrome‐dependent high‐fluence component. Simple models adapted from the one used to simulate blue light‐induced guard cell opening failed to explain one or more elements of the experimental data. The hypothesis that phytochrome and a blue light receptor interact in a short‐term photoresponse is endorsed by model calculations based upon a three‐step signal transduction cascade, of which one component can be modulated by phytochrome.
Transformation of Arabidopsis with the codA gene for choline oxidase enhances freezing tolerance of plants
Authors: Sakamoto Atsushi , Valverde Roberto , Alia  , Chen Tony H. H. , Murata Norio
Published: May 2003

Arabidopsis thaliana was transformed with the codA gene from Arthrobacter globiformis, which encodes choline oxidase, the enzyme that synthesizes glycinebetaine from choline. The transformation enabled the plants to accumulate glycinebetaine in chloroplasts, and significantly enhanced the freezing tolerance of plants. Furthermore, the photosynthetic machinery of transformed plants was more tolerant to freezing stress than that of wild‐type plants. Exogenous application of glycinebetaine also increased the freezing tolerance of wild‐type plants, suggesting that the presence of glycinebetaine in transformed plants had enhanced their ability to tolerate freezing stress. Northern blotting analysis revealed that the enhancement of freezing tolerance was not related to the expression of four cold‐regulated genes. These results suggest that engineering of the biosynthesis of glycinebetaine by transformation with the codA gene might be an effective method for enhancing the freezing tolerance of plants.
Expression of Brassica juncea 3‐hydroxy‐3‐methylglutaryl CoA synthase is developmentally regulated and stress‐responsive
Authors: Alex Deepa , Bach Thomas J. , Chye Mee‐Len
Published: May 2003

3‐Hydroxy‐3‐methylglutaryl‐coenzyme A synthase (HMGS) is an enzyme in mevalonate biosynthesis. In plants, investigations have focused on HMG CoA reductase (HMGR) and less is known of the preceding enzyme, HMGS. To understand the regulation of HMGS, we have isolated a Brassica juncea cDNA encoding HMGS, BjHMGS1, for use as a hybridization probe in Northern blot analyses. BjHMGS is expressed in all plant organs and shows developmental regulation in flower, seed and seedling, with highest expression in early development. In seedlings, expression is highest in young hypocotyls and is induced during the greening of etiolated cotyledons. BjHMGS is down‐regulated by abscisic acid, osmotic stress and dehydration, the effects of which arrested seedling growth. Thus BjHMGS expression shows correlation with rapid cell division and growth, like HMGR. This is not unexpected, as mevalonate is the precursor to many essential isoprenoid compounds, including sterols for membrane biogenesis. Wounding, methyl jasmonate or salicylic acid induce BjHMGS expression, suggesting that, like HMGR, HMGS is involved in defence. As in animals, coordinated regulation of HMGS with HMGR occurred in B. juncea upon germination and in response to salicylic acid. HMGS assays confirmed that Escherichia coli‐expressed recombinant BjHMGS1 shows HMGS activity that is inhibited by F244, a specific inhibitor of HMGS. Southern blot analysis revealed gene families encoding HMGS in Brassica species and a summation of homologous genes in the fusion amphidiploid genome of B. juncea, a bi‐parental species derived from diploids B. nigra and B. campestris.
The TATA motif, the CAA motif and the poly(T) transcription termination motif are all important for transcription re‐initiation on plant tRNA genes
Authors: Yukawa Yasushi , Sugita Mamoru , Choisne Nathalie , Small Ian , Sugiura Masahiro
Published: May 2003

The effect of alteration of 5′ and 3′ flanking sequences on the transcription of plant tRNA genes was analysed using an RNA polymerase III‐dependent in vitro transcription system derived from nuclei of cultured tobacco cells. A TATA‐like sequence and the CAA motif frequently observed upstream of plant tRNA genes, and the poly(T) stretch usually present downstream, were shown to be necessary for efficient re‐initiation of transcription. The CAA motif was shown to be a transcription initiation site. Introduction of the CAA and TATA‐like motifs into a gene naturally lacking them greatly enhanced transcription by promoting efficient re‐initiation.
Phytochromes confer the photoperiodic control of flowering in rice (a short‐day plant)
Authors: Izawa Takeshi , Oikawa Tetsuo , Tokutomi Satoru , Okuno Kazutoshi , Shimamoto Ko
Published: May 2003

The photoperiodic sensitivity 5 (se5) mutant of rice, a short‐day plant, has a very early flowering phenotype and is completely deficient in photoperiodic response. We have cloned the SE5 gene by candidate cloning and demonstrated that it encodes a putative heme oxygenase. Lack of responses of coleoptile elongation by light pulses and photoreversible phytochromes in crude extracts of se5 indicate that SE5 may function in phytochrome chromophore biosynthesis. Ectopic expression of SE5 cDNA by the CaMV 35S promoter restored the photoperiodic response in the se5 mutant. Our results indicate that phytochromes confer the photoperiodic control of flowering in rice. Comparison of se5 with hy1, a counterpart mutant of Arabidopsis, suggests distinct roles of phytochromes in the photoperiodic control of flowering in these two species.
Epistatic repression of PHANTASTICA and class 1 KNOTTED genes is uncoupled in tomato
Authors: Koltai Hinanit , Bird David McKenzie
Published: May 2003

Class 1 KNOTTED genes (KNOX) and PHANTASTICA (PHAN) are both central to meristem establishment and maintenance and, in maize and Antirrhinum, it has been proposed that PHAN acts as an epigenetic repressor of KNOX. In tomato, a distinct spatial distribution of Tkn2 KNOX transcripts compared to Antirrhinum and maize suggests either a different spatial distribution of tomato PHAN (Le‐phan) transcripts, or that PHAN alone is insufficient for KNOX repression in tomato. We established the pattern of Le‐phan expression, including a first demonstration of PHAN expression in healthy roots, and found Le‐phan and Tkn2 transcripts to be temporally and spatially coincidental, with PHAN exhibiting an expression pattern in tomato distinct from that in plants with simple leaves. Our results imply that the expression of Le‐phan is insufficient for the repression of Tkn2 in tomato and suggest an expanded role for either gene in the establishment of cell identity in plant development.
Expression patterns of genes encoding HD‐ZipIV homeo domain proteins define specific domains in maize embryos and meristems
Authors: Ingram Gwyneth C. , Boisnard‐Lorig Corinne , Dumas Christian , Rogowsky Peter M.
Published: May 2003

A family of homeo box genes with cell layer‐specific expression patterns defining subdomains of the embryo and certain meristems has been isolated from maize. These genes encode proteins from the class of plant specific homeo domain‐leucine zipper (HD‐Zip) transcription factors containing the previously described ZmOCL1 protein, and have been designated ZmOCL2, ZmOCL3, ZmOCL4 and ZmOCL5. ZmOCL3, ZmOCL4 and ZmOCL5, like ZmOCL1, showed essentially L1 or epidermis‐specific expression. However, each gene was expressed in a distinct region of the embryonic protoderm during early development, with ZmOCL3 showing suspensor‐specific expression, ZmOCL4 transcripts being localized to the adaxial face of the embryo proper and ZmOCL5 showing a more abaxial expression pattern. All three genes were also expressed in vegetative, inflorescence and floral apices, although ZmOCL3 transcripts were excluded from meristems and very young organ primordia. In contrast, ZmOCL2 expression was entirely meristem‐specific and was excluded from the L1 layer, appearing instead to be largely restricted to a cell layer directly beneath the L1, especially in floral meristems. This expression pattern is unprecedented and may indicate that cell‐layer organization in maize meristems is more complex than that suggested by the classical L1/L2 (outer cell layer/inner cell mass) model. These differing expression patterns indicate that the members of the HD‐ZipIV family of maize may not only play roles in defining different regions of the epidermis during embryonic development, but could also be responsible for maintaining cell‐layer identity in meristematic regions.
Fusion genetic analysis of gibberellin signaling mutants
Authors: Raventos Dora , Meier Carsten , Jensen Ole Mattsson anders B. , Mundy John
Published: May 2003

A fusion genetic strategy was used to identify gibberellin (GA) signaling mutants in transgenic Arabidopsis expressing the β‐glucuronidase (GUS) and firefly luciferase (LUC) reporter genes under control of the GA‐responsive GASA1 promoter. Initial analyses determined the spatial and temporal patterns of reporter expression, and showed that reporter induction by GA was antagonized by ABA. γ‐Irradiated M2 progeny with altered reporter activities were identified by LUC bioimaging followed by GUS assays and northern hybridization of the endogenous GASA1 mRNA. Genetic analysis showed that three mutants, which overexpressed both reporters and endogenous GASA1, were caused by recessive (goe1 and goe2, for GASA over‐expressed) and semi‐dominant (goe3) mutations at different loci. These mutants are altered in their sensitivity to GA and the GA biosynthetic inhibitor paclobutrazol, and in the expression of several GA signaling related genes.
A survey of the decision‐making needs of Canadians faced with complex health decisions
Authors: O'Connor Annette M. , Drake Elizabeth R. , Wells George A. , Tugwell Peter , Laupacis Andreas , Elmslie Tom
Published: May 2003

Objective To describe the decision‐making needs of Canadians when faced with ‘complex’ health decisions characterized by balancing advantages against disadvantages. Although a national report emphasized that public confidence in the health‐care system depends on support for personal knowledge and decision‐making, there has been no systematic investigation of the Canadian population's decision‐making needs.

Design Cross‐sectional telephone survey using random digit dialling.

Participants National sample of 635 adults over 18 years of age, living in Canada.

Results Forty‐two percentage of eligible contacts participated. Sixty‐five percent of contacts reported making ‘complex’ health decisions, commonly about medical or surgical treatments or birth control, and more commonly by women and by married/separated individuals. Most respondents took an active role in their decisions, often sharing the process with their partner or family. Being younger was associated with a more independent role. Physicians were more often involved in the decisions of respondents with less education. Fifty‐nine percent of respondents experienced decisional conflict; more conflict was seen with those who were female and feeling uninformed about options, pressured to select one particular option, and unready or unskilled in decision‐making. Less decisional conflict was seen in those who reported birth control decisions and in those who were 70 years and older. Participants used several strategies when deliberating about choices including: information gathering, clarifying their values, and seeking support and information from others. Personal counselling and printed information materials were commonly preferred methods of learning about options. ‘Essential’ criteria for judging satisfactory decision‐making included: having sufficient knowledge about the options, outcomes, and probabilities; being clear about values; selecting and implementing a choice that agrees with personal values; and expressing satisfaction with the choice.

Conclusions Canadians, particularly women, face difficult decisions and need support and information from credible sources.
What factors are associated with a woman's decision to take hormone replacement therapy? Evaluated in the context of a decision aid
Authors: Clark Heather D. , O'Connor Annette M. , Graham Ian D. , Wells George A.
Published: May 2003

Objectives  To understand the factors associated with a post‐menopausal woman deciding to take hormone replacement therapy (HRT) after reviewing a decision aid (DA) and having a counselling visit with her physician as well as the factors associated with the act of taking HRT 2 months after the counselling interview.

Design  A secondary analysis of data collected for a randomized controlled trial evaluating two DAs.

Main outcome results  Although 28% of women were uncertain regarding their decision after the counselling interview, only 2.4% of women, at the assessment at 2 months, had not made a decision. The most significant factor associated with the decision to take HRT, after the physician visit, was the physician preference (OR: 62, 95% CI: 13.3, 289.7). Physician preference (OR: 78, 95% CI: 6.2, 975) remained the most significant factor for taking HRT 2 months after the counselling interview followed by low uncertainty about the decision (OR: 0.4, 95% CI: 0.2, 0.7).

Conclusion  Physician preference was the factor that was most associated with the woman's decision following counselling and 2 months later. Qualitative evaluation of the interview process involving the patient and physician would determine whether the patient and physician are reaching a shared decision or is the physician preference influencing the patient.
Patient participation in decision‐making on the introduction of home respiratory care: who does not participate?
Authors: Hämäläinen Päivi M. , Perälä Marja‐Leena , Poussa Tuija , Pelkonen Marjaana
Published: May 2003

Objectives  In this study we examined home respiratory patients' participation in decision‐making on whether to begin home respiratory care therapy, and this participation in decision‐making during the latest visit to the clinic.

Subjects and methods  The target population consisted of patients who were using home respiratory care devices and who were visiting the outpatient clinics. Postal questionnaires were sent to 4159 patients (40% of respiratory care device users in Finland). A total of 3336 answered (response rate 80%) and 3153 were eligible for analysis. Odds ratios, chi‐square tests, Mann–Whitney U‐test and stepwise logistic regression analysis were used in the data analyses.

Results  Patients who did not participate in decision‐making were more frequently older people, women and had lower income than the other patients. While these results parallel those of previous studies, in contrast we found more women with high education to be non‐participants. Non‐participants were not participating in decision‐making during their latest visit to the clinic in spite of the fact that they considered participation almost as important as did the other patients. Non‐participants were less satisfied with the quality of care given and felt that their life had improved less than did the other patients.

Conclusion  The ethical principle of equal opportunities to participate in care decisions was not applied among home respiratory care patients in this study. The results challenge health‐care professionals to notice inequalities and improve their practices. The results can be generalized to all home respiratory care patients in Finland.
Elaborating patient information with patients themselves: lessons from a cancer treatment focus group
Authors: Moumjid Nora , Morelle Magali , Carrère Marie‐Odile , Bachelot Thomas , Mignotte Hervé , Brémond Alain
Published: May 2003

Objective  To assess the significance of patients' input in the elaboration of a patient information booklet.

Design  Qualitative study based on focus group discussions.

Setting  Centre Léon Bérard, a comprehensive cancer centre in the Rhône‐Alpes region of France.

Participants  (1) A multidisciplinary working group (oncologists, health economists and one clinical psychologist) wrote up initial information documents concerning possible breast cancer treatments. (2) A focus group comprised of patients with a history of breast cancer and healthy volunteers discussed their reactions to these documents.

Main outcome measure  Analysis of the focus group's reactions according to key themes predetermined by the working group and related themes introduced by the focus group itself.

Results  The focus group proposed numerous, significant modifications to answer requests for additional information, clarification and better readability in the information booklets.

Discussion/Conclusions  This qualitative analysis showed a significant input of patients' perspective in the elaboration of patient information. It is also an additional support to the feasibility and appropriateness of the focus group technique. The next stage will be to test whether information documents produced here conform to the needs of patients currently undergoing treatment.
The use of willingness to pay to assess public preferences towards the fortification of foodstuffs with folic acid
Authors: Dixon Simon , Shackley Phil
Published: May 2003

Objectives To assess public attitudes towards the fortification of flour with folic acid, and quantify their intensity of preference towards the proposed policy.

Design Structured interviews describing the proposed policy of fortification followed by questions about the respondent's preferences towards fortification.

Setting and participants  A United Kingdom community sample of 76 people interviewed at home.

Main variables studied Direction of preference towards fortification, willingness to pay (WTP) for the preferred course of action, and the reasons behind their preferences.

Results  Responses showed that 51 (67%) were in favour of fortification, 15 (20%) were opposed, while the remaining 10 (13%) were either indifferent or were unsure. Those in favour of fortification tended to be younger and poorer than those opposed to it. Willingness to pay estimates show that those in favour of food fortification had more intense preferences, with mean and median WTP around twice as great. Reasons for being willing to pay were centred on the health benefits, with particular reference being made to the intervention saving lives and it being preventative. Those opposed tended to believe that there was insufficient evidence.

Conclusions The combination of a policy vote, WTP and qualitative data, allow us to assess the direction, intensity and motivations behind people's preferences. Further work needs to be undertaken to gather more robust estimates of public preferences for fortification, and to better understand attitudes towards public health interventions more generally.
Preliminary validation of the Satisfaction With Decision scale with depressed primary care patients
Authors: Wills Celia E. , Holmes‐Rovner Margaret
Published: May 2003

Objective To conduct a preliminary validation of the Satisfaction With Decision (SWD) scale with depressed primary care patients.

Design  Cross‐sectional observational pilot study using a postal survey.

Setting and participants  Depressed primary care patients (n = 97) who recently had made a new decision about antidepressant medication use completed surveys regarding their treatment decisions.

Main variables  Measures included patient‐reported satisfaction with decision, decisional conflict, knowledge about depression and treatment, decision involvement, pain and health status, antidepressant medication efficacy, and satisfaction with health services.

Results  The SWD scale had good internal consistency reliability (α = 0.85). Evidence for construct validity was confirmed via a hypothesized pattern of relationships between the SWD scale and other measures. Decision satisfaction was associated with several issues of relevance for designing patient‐centred decision support interventions: (1) knowledge about depression and treatment; (2) involvement in health‐related decisions; and (3) aiding evaluation of trade‐offs among pros and cons of treatment.

Conclusions  The results of this pilot study show that the SWD scale appears to be a psychometrically sound and practical measure for research with this population. Additional research is needed on the theoretical nature of decision satisfaction and developing and testing patient‐centred decision support interventions for depression treatment.
Patient characteristics as predictors of primary health care preferences: a systematic literature analysis
Authors: Jung Hans Peter , Baerveldt Cor , Olesen Frede , Grol Richard , Wensing Michel
Published: May 2003

Objective

To identify associations between various cultural and demographic factors and patients’ primary health care preferences.

Search strategy Searches were performed in MEDLINE (1966–December 2000), PsycINFO (1977–May 2001) and Sociological Abstracts (1963–December 2000). Identified papers were checked for more papers.

Inclusion criteria Studies with a focus on primary health care or health care in general, asking patients about preferences with regard to health care, reporting quantitative results and examining the relations between specific patient characteristics and patient preferences.

Data extraction and synthesis Data were extracted from studies using a scoring form to register what methods were used, which patient characteristics were analysed and which patient characteristics significantly influenced patients’ preferences with regard to different aspects of health care (P < 0.05).

Main results A total of 145 studies were included with 2276 comparisons between subgroups of patients. Of all the comparisons, 607 (27%) showed a significant association between patient characteristics and preferences with regard to primary health care. Age and economic status significantly related to patient preferences in 38 and 33% of the comparisons, respectively. Education, health status, family situation, sex, and utilization of health care related significantly to patient preferences in less than 25% of the comparisons.

Conclusions This review of the literature showed patient characteristics to be an important determinant of preferences regarding many aspects of primary health care defined as general practice care or health care, in general. All of the patient characteristics examined here showed at least some significant associations with preferences for primary health care.
The Role of Decision Analysis in Transfusion Medicine
Authors: AuBuchon James P.
Published: May 2003

Transfusion medicine has become challenged by its own success. Within little more than two generations, diligent workers in this field have transformed blood conservation and transfusion techniques from a ‘cottage industry’ with unpredictable outcomes to a science that delivers components that are safe and efficacious and transfusion advice that is increasingly based on evidence rather than speculation.
Platelets Stored in a Glucose‐Free Additive Solution or in Autologous Plasma – An Ultrastructural and Morphometric Evaluation
Authors: Klinger Matthias H.F. , Josch Mirko , Klüter Harald
Published: May 2003

We evaluated a new glucose‐free citrate‐acetate‐NaCl platelet additive solution (PAS 2). In series I, platelet concentrates (PC) were prepared by apheresis and subsequently stored either in plasma (n =16) or in PAS 2 (n =15). In series II, PCs were prepared from pools of four buffy coats (BC) and stored in plasma (n =12) or in PAS 2 (n =11). By means of ultrastructural morphometry, the volume fractions of α‐granules, the open canalicular system (OCS) and the fraction of storage granules secreted into the OCS were analyzed during storage for up to 8 days. Additionally, we determined pH, glucose, lactate, pCO2, HCO3–, lactate dehydrogenase and platelet factor 4. Apheresis platelets stored in plasma showed no changes in their contents of α‐granules and in the fractions of the OCS. In contrast, apheresis platelets stored in PAS 2 displayed a decrease of their relative volume fraction of α‐granules from 9.1±1% on day 1 to 3.7±0.9% on day 5. The fraction of the OCS increased from 7.4±0.8% on day 1 to 17.1±1.4% on day 3. On day 8, 93±9% of all platelets were lysed. Levels of glucose were significantly lower in these preparations and after day 3 glucose consumption decreased to zero. Among PC derived from pooled BC, differences between storage in PAS 2 or plasma were less striking. Only the fraction of α‐granules secreted into the OCS was significantly greater in BC derived PC stored in PAS 2 on all days. These PCs stored in PAS 2 had a higher plasma carryover (30%) in comparison to apheresis PC stored in PAS 2 (10%). We conclude that plasma is superior to PAS 2 for storage of both apheresis and buffy coat platelets. For preservation of the structural integrity of platelets, the use of PAS 2 requires a minimum of 30% plasma carryover.
Testing Plasma Pools for Markers of Viral Contamination: The UK Experience
Authors: Ferguson Morag , Minor Philip D. , Garrett A. John , Page Mark , Thorpe Robin , Barrowcliffe Trevor
Published: May 2003

The transmission of viral infections through the use of products derived from blood has emphasised the need for adequate validation of the production process, testing of materials used in production and quality control tests on the final product. Since the late 1980s, as part of its batch release procedures, NIBSC has tested for markers of viral infectivity plasma pools used in production of blood products used in the UK. As a result of testing over 9,000 pools, NIBSC has identified 9 pools contaminated with HBsAg and 2 pools containing antibodies to HIV‐1. Since routine screening of plasma pools for anti‐HCV was introduced in 1993, 8 pools out of the 4,000 tested have been found to contain antibodies to HCV. In addition, the release of 12 batches of blood products was withheld and it is known that further batches of material produced from the positive pools were not submitted for batch release. Studies involving assays of dilutions of known positive plasma samples indicated that there is considerable variation in the endpoint dilutions of antigen or antibody detected by test kits from different manufacturers. The selection and validation of the kits used in such testing is therefore important. The usefulness of standardised low‐level external controls in assays of plasma pools for markers of viral infection is discussed.
More on False Thrombocytopenias: EDTA‐Dependent Pseudothrombocytopenia Associated with a Congenital Platelet Release Defect
Authors: Silvestri Federico , Masotti Adriana , Pradella Paola , Zaja Francesco , Barillari Giovanni , De Marco Luigi
Published: May 2003

We report herein the case of a 54‐year‐old woman with a moderate bleeding tendency, diagnosed as an EDTA‐dependent pseudothrombocytopenia associated with a congenital platelet release defect. The patient, at the age of 12, had a misleading diagnosis of idiopathic thrombocytopenic purpura and all the recurrent bleeding problems she had during her life were referred to that disease. The recent correct diagnosis of a false thrombocytopenia stimulated further laboratory investigation on the cause of the patient's bleeding tendency with the consequent identification of a congenital platelet deficiency of the arachidonic acid pathway. This finding is of relevant importance for the management of the patient in case of elective surgery or hemorrhagic emergency.
A New Low‐Incidence Antigen in the Kell Blood Group System: VLAN (KEL25)
Authors: Jongerius J.M. , Daniels G.L. , Overbeeke M.A.M. , Petty A.C. , Reid M. , Oyen R. , Rijksen H. , van Leeuwen E.F.
Published: May 2003

A multilaboratory investigation has identified a new low‐incidence antigen ‘VLAN’ on the red cells of a blood donor. The VLAN antigen is destroyed by 2‐aminoethylisothiouronium bromide treatment of the donor's red cells suggesting an association with the Kell system. Monoclonal antibody‐specific immobilization of erythrocyte antigen analysis with anti‐VLAN and with several mouse monoclonal antibodies directed at epitopes on the Kell glycoprotein gave positive results, indicating that the VLAN antigen is located on the Kell glycoprotein. The VLAN red blood cells have the common Kell phenotype: KEL:–1,2,–3,4,5,–6,7,–10,11,12,13,14,–17,18,19,–21,22,–23,–24. Additional serologic data indicate that the VLAN antigen is not part of any other ISBT blood group system, collection or series. A family study showed that the VLAN antigen is inherited since the red cells of two sisters and one niece of the propositus are also VLAN+. The ISBT Working Party on Terminology for Red Cell Surface Antigens has assigned VLAN to the Kell blood group system as KEL25 (number for computer listings 006025).
First Case of HIV‐1 Group O Infection in Spain
Authors: Soriano V. , Gutiérrez M. , García‐Lerma G. , Aguilera O. , Mas A. , Bravo R. , Pérez‐Labad M. L. , Baquero M. , González‐Lahoz J.
Published: May 2003

A 34‐year‐old woman born in Bilbao, a northern city in Spain, was first seen at our institution in April 1995. She had maintained a monogamous sexual relation in the preceding 6 years with a 35‐year‐old male, and previously has sex only sporadically with two other persons. She as well as her three partners were Spanish‐born, and had neither a history of transfusions, nor of injecting drugs, nor were they homosexual.
Role of the Blood Transfusion Service in Tissue Banking
Authors: Warwick Ruth M. , Eastlund Ted , Fehily Deirdre
Published: May 2003

Tissue transplantation and banking are rapidly growing services throughout the world reflecting the widening availability of transplantable cadaver tissue and the mounting clinical indications particularly in orthopaedic, plastic and cardiovascular surgery. In the US tissue banking is more established, yet continues to show a rapid growth profile. In the UK it is currently organised in a variety of different ways and by a number of different organisations. The risks of disease transmission by tissue transplantation are similar to those for blood transfusion and the majority of tissues are grafted during procedures that are not life saving. The danger of disease transmission has resulted in the introduction of legislation in the US which allows the FDA to inspect tissue banks and to recall and destroy tissues. In the UK, there is currently no regulation or inspection of tissue banks to demonstrate that donor selection, tissue processing and tracking are conducted to acceptable standards. Blood transfusion services in the UK, US, New Zealand, Australia and possibly other countries have extended their roles to include organ and tissue donation to varying degrees, with the collection, processing and distribution of bone and tendon allografts most commonly undertaken. They have readily available special capabilities and experience with an established infrastructure, compliant with Good Manufacturing Practice, placing them in an ideal position to provide this service safely and cost‐effectively.
Influence of the Red Blood Cell Preparation Method on the Efficacy of a Leukocyte Reduction Filter
Authors: Alcorta I. , Pereira A. , Sanz C. , Terol M. J. , Ordinas A.
Published: May 2003

The performance of a leukocyte reduction bedside filter with different types of RBC concentrates was analyzed. Three types of RBCs were prepared: buffy‐coat‐depleted RBCs suspended in saline‐adenine‐glucose‐mannitol (SAGM)‐additive solution (BC‐RBCs; n = 20), RBCs suspended in SAGM‐additive solution without buffy coat removal (SAGM‐RBCs; n = 20), and RBCs drawn in CPDA‐1 conservative solution and processed for component preparation by the platelet‐rich plasma method (CPDA‐RBCs; n = 20). The units were filtered within 8 h of collection. One filter was used for every 2 units. High numbers of residual WBCs were found even in the units filtered first. Filtration of CPDA‐RBCs resulted in a higher residual WBC content than SAGM‐RBCs or BC‐RBCs (p = 0.0032 and p = 0.0002, respectively). The filter performance strikingly decreased when the WBC load per filter exceeded 4 × 109 or the platelet load was less than 100 × 109. We conclude that filter performance varies with the WBC and platelet content of the RBC concentrates. Under the experimental conditions assayed in this study CPDA‐RBCs are the least appropriate ones to be used for bedside leukocyte reduction.