bluuebunny/crossref_metadata_2025 huggingface dataset:
Nutritional condition of Anguilla anguilla starved at various salinities during the elver phase
Authors: Rodríguez A. , Gisbert E. , Castelló‐Orvay F.
Published: August 2005

The effects of food deprivation and environmental salinity (<1, 10 and 20) on survival, fish morphology, organization of the digestive system and body lipid reserves in European eel Anguilla anguilla during the transition from glass eel to elver, were evaluated. Fasted elvers kept in fresh water were able to withstand starvation for >60 days, while those in brackish environments (salinity 10 and 20) reached the level of irreversible starvation at 37 and 35 days, respectively. The high level of lipid reserves contained in liver inclusions and the abdominal cavity (perivisceral deposits) in elvers might explain their long resistance to starvation and differences in fasting tolerance under different salinities. Fasting resulted in a significant reduction of the elvers’ condition factor and body depth. There were severe histopathological changes in the digestive system and musculature, such as the alteration of the liver organization, and hepatic glycogen and lipid content, shrinkage of enterocytes and reduction of their height, pancreas degeneration, autolysis of the oesophageal and intestinal mucosa and disarrangement of myofibrils and degeneration of trunk musculature. Degeneration of the oesophageal and intestinal mucosa as a consequence of fasting might have impaired digestive and osmoregulatory functions in feed‐deprived fish, directly affecting the tolerance to starvation and survival. Length of food deprivation was associated with a significant increase in mortality, coefficient of variation, cannibalism and point of no return at high salinities. Mortality was dependent on food deprivation and salinity concentrations. Environmental salinity directly influenced the ability of elvers to withstand starvation; once glass eels metamorphosed into elvers, they tolerated starvation better in fresh water than in brackish environments.
Responsible estuarine finfish stock enhancement: an Australian perspective
Authors: Taylor M. D. , Palmer P. J. , Fielder D. S. , Suthers I. M.
Published: August 2005

The responsible approach to marine stock enhancement is a set of principles aimed at maximising the success and benefits of artificially re‐stocking depleted fisheries. The benefits of such an approach are evident in the 400% increase in survival of stocked striped mullet in Hawaii through refinement of release techniques, however financially or temporally constrained stocking programs in Australia have not adhered to all principles. A pragmatic approach to address these principles is proposed, using international examples and Australian marine finfish pilot stockings of barramundi, mulloway, sand whiting, dusky flathead and black bream. Biological ranking of candidate species by estuarine residency, a low natural‐mortality to growth ratio, a large L∞ and comparison by recreational value and available rearing technologies, show that mulloway, barramundi and sea mullet are ideal species for stocking in Australia. Australian intermittently closed opening landlocked lagoons and recreational fishing havens, especially near cities, provide experimental opportunities to apply this approach and stock suitable species through small‐scale pilot experiments. This would allow evaluation of production and carrying capacity, and density dependent processes with respect to optimal stocking strategies unconfounded by emigration and commercial fishing practices. Twenty per cent of Australians fish each year, and harvest approximately 27 000 t of finfish. Stocking recreationally important species in Australia should give a greater financial benefit, which is spread across a larger cross‐section of the community, compared to stocking to enhance commercial fisheries. The pragmatic application of the responsible approach, and stocking of fast growing estuarine residents into recreational fishing havens would enhance the benefit from marine stocking.
A cluster‐based decision support system for estimating earthquake damage and casualties
Authors: Aleskerov Fuad , Say Arzu Iseri , Toker Aysegül , Akin H. Levent , Altay Gülay
Published: August 2005

This paper describes a Decision Support System for Disaster Management (DSS‐DM) to aid operational and strategic planning and policymaking for disaster mitigation and preparedness in a less‐developed infrastructural context. Such contexts require a more flexible and robust system for fast prediction of damage and losses. The proposed system is specifically designed for earthquake scenarios, estimating the extent of human losses and injuries, as well as the need for temporary shelters. The DSS‐DM uses a scenario approach to calculate the aforementioned parameters at the district and sub‐district level at different earthquake intensities. The following system modules have been created: clusters (buildings) with respect to use; buildings with respect to construction typology; and estimations of damage to clusters, human losses and injuries, and the need for shelters. The paper not only examines the components of the DSS‐DM, but also looks at its application in Besiktas municipality in the city of Istanbul, Turkey.
Amotosalen photochemical inactivation of severe acute respiratory syndrome coronavirus in human platelet concentrates
Authors: Pinna D. , Sampson‐Johannes A. , Clementi M. , Poli G. , Rossini S. , Lin L. , Vicenzi E.
Published: August 2005

summary.  A novel human coronavirus causing severe acute respiratory syndrome (SARS) emerged in epidemic form in early 2003 in China and spread worldwide in a few months. Every newly emerging human pathogen is of concern for the safety of the blood supply during and after an epidemic crisis. For this purpose, we have evaluated the inactivation of SARS‐coronavirus (CoV) in platelet concentrates using an approved pathogen inactivation device, the INTERCEPT Blood System. Apheresis platelet concentrates (APCs) were inoculated with approximately 106 pfu mL−1 of either Urbani or HSR1 isolates of SARS‐CoV. The inoculated units were mixed with 150 µm amotosalen and illuminated with 3 J cm−2 UV‐A light. The viral titres were determined by plaque formation in Vero E6 cells. Mixing SARS‐CoV with APC in the absence of any treatment decreased viral infectivity by approximately 0·5–1 log10. Following photochemical treatment, SARS‐CoV was consistently inactivated to the limit of detection in seven independent APC units. No infectious virus was detected after treatment when up to one‐third of the APC unit was assayed, demonstrating a mean log10‐reduction of >6·2. Potent inactivation of SARS‐CoV therefore extends the capability of the INTERCEPT Blood System in inactivating a broad spectrum of human pathogens including recently emerging respiratory viruses.
Whole blood versus red cells and plasma for exchange transfusion in ABO haemolytic disease
Authors: Yigit S. , Gursoy T. , Kanra T. , Aydin M. , Erdem G. , Tekinalp G. , Yurdakok M.
Published: August 2005

summary.  Records of 381 neonates who underwent exchange transfusion (ET) due to ABO haemolytic disease at the Division of Neonatology of Hacettepe University, Ankara, Turkey, between January 1977 and December 2003 were reviewed. Records were kept for the type of blood used in ET, the number of ETs for each infant, adverse event attributable to ET and bilirubin levels before, and 4 and 8 h after each ET. Of 381 infants, 300 were transfused with whole blood, whereas 81 infants were transfused with O red cells suspended in A or B plasma. The re‐exchange rate was higher in the whole blood group, compared with the erythrocyte and plasma group. Use of erythrocyte and plasma provided 30% reduction in the number of ETs per patient. Eight hours after the first ET, mean bilirubin levels were 84% of the pre‐exchange values in the whole blood group and 73% of the pre‐exchange values in the erythrocyte and plasma group (P = 0·001). As the use of O group red cells re‐suspended in AB plasma decreased the re‐exchange risk compared with O group whole blood, we suggest the use of O red cells re‐suspended in AB plasma for the ET in cases of ABO haemolytic disease.
The effect of continuous‐flow automated plateletpheresis on fibrinolytic activity of donor plasma
Authors: Radziwon P. , Boczkowska‐Radziwon B. , Lipska A. , Smoktunowicz M. , Kloczko J.
Published: August 2005

summary.  Blood circulating in extracorporeal circuit of the apheresis sets has a contact with an artificial surface. The data on the influence of plateletpheresis on fibrinolytic activity are very limited and difficult to interpret. The aim of our study was to estimate the effect of plateletpheresis on the activation of fibrinolysis. Plateletpheresis was performed in 17 healthy blood donors using continuous‐flow cell separator COM.TEC (Fresenius, Bad Homburg, Germany). Before and after plateletpheresis, blood samples were taken and markers of fibrinolysis (PAP, t‐PA, PAI‐1) as well as factor XII activity have been measured. We observed statistically significant decrease in t‐PA and factor XII activities after plateletpheresis. There were no significant changes in concentrations of t‐PA, PAI‐1 and PAP as well as PAI‐1 activity after plateletpheresis. Plateletpheresis performed by COM.TEC cell separator has very little, if any, effect on the activation of fibrinolysis. The mechanism of the inhibition of t‐PA activity needs further investigations.
The genetic and phenotypic basis of blood group A subtypes in Koreans
Authors: Cho D. , Shin M. G. , Yazer M. H. , Kee S. J. , Shin J. H. , Suh S. P. , Jeon M. J. , Song J. W. , Ki C. S. , Ryang D. W.
Published: August 2005

summary.  A serological and genetic study of Korean blood donors with phenotypic group A subtypes was performed. There were 176 donors with phenotypic A subtypes identified. Exons 6 and 7 from 57 representative donors were sequenced. The Avar allele (784 G > A) was cloned and sequenced, and a family study demonstrating its inheritance and unusual serological characteristics was performed. The A102 allele was the most frequently identified allele in phenotypically A2 (58%, 11/19) and A2B (68%, 17/25) donors. Anti‐A1 was rarely present amongst A2 and A2B donors. The family study revealed that the Avar allele was expressed as phenotype AweakB in Avar/B heterozygote members, but as phenotype O in Avar/O heterozygotes. The most frequent allele in Korean donors with the A2 phenotype differs from its Caucasian counterpart, as does the frequency of anti‐A1. The Avar allele demonstrates allelic enhancement in Avar/B heterozygotes.
Differences in Our Sensory Worlds
Authors: Bartoshuk Linda M. , Fast Katharine , Snyder Derek J.
Published: August 2005

People use intensity descriptors to compare sensory differences: “This tastes strong to me; is it strong to you?” These comparisons are deceptive because they assume that intensity descriptors like strong denote the same absolute perceived intensities to everyone. This assumption is false. Visual-analogue and category scales are labeled with intensity descriptors, and whenever there are systematic differences across groups in the absolute perceived intensity denoted by these descriptors, across-group comparisons will be invalid. We have explored this problem using studies of taste perception. When intensity descriptors are falsely assumed to have universal meaning, real differences can be blunted, abolished, or reversed. One solution to this problem is to express sensations of interest relative to an unrelated standard; any variation in this standard will be equivalent across groups, allowing valid group comparisons. The importance of detecting and correcting these measurement errors is not limited to sensory comparisons, but applies to hedonic comparisons as well.
At the Intersection of Emotion and Cognition
Authors: Carstensen Laura L. , Mikels Joseph A.
Published: August 2005

Divergent trajectories characterize the aging mind: Processing capacity declines, while judgment, knowledge, and emotion regulation are relatively spared. We maintain that these different developmental trajectories have implications for emotion–cognition interactions. Following an overview of our theoretical position, we review empirical studies indicating that (a) older adults evidence superior cognitive performance for emotional relative to non-emotional information, (b) age differences are most evident when the emotional content is positively as opposed to negatively valenced, and (c) differences can be accounted for by changes in motivation posited in socioemotional selectivity theory.
Relational Reasoning in a Neurally Plausible Cognitive Architecture
Authors: Hummel John E. , Holyoak Keith J.
Published: August 2005

Human mental representations are both flexible and structured—properties that, together, present challenging design requirements for a model of human thinking. The Learning and Inference with Schemas and Analogies (LISA) model of analogical reasoning aims to achieve these properties within a neural network. The model represents both relations and objects as patterns of activation distributed over semantic units, integrating these representations into propositional structures using synchrony of firing. The resulting propositional structures serve as a natural basis for memory retrieval, analogical mapping, analogical inference, and schema induction. The model also provides an a priori account of the limitations of human working memory and can simulate the effects of various kinds of brain damage on thinking.
Paternal Behavior and Offspring Aggression
Authors: Marler Catherine , Trainor Brian C. , Davis Ellen
Published: August 2005

Aggression can have a critical impact on the functioning of societies. Some aspects of aggression have received considerable attention, such as links between parenting behavior and offspring aggression in humans. Although acknowledged as being important to the understanding of human aggression, animal aggression has been relatively unstudied. Recent mammalian animal research is emerging that addresses issues relevant to the study of parenting and aggression. This has been accomplished primarily by focusing on nontraditional mammalian model systems. We integrate human and nonhuman animal studies to (a) further elucidate the potential impact that the behaviors of fathers have on offspring aggression, (b) study the influence of paternal behavior on the behavior of offspring and transfer of aggression across generations, and (c) explore neural and physiological underpinnings for variation in paternal behavior and aggression.
The Interplay Between Genotypes and Family Relationships
Authors: Reiss David
Published: August 2005

Children's genotypes and their social relationships are correlated throughout their development. Heritable characteristics of children evoke strong and specific responses from their parents; frequently, these same heritable characteristics also influence the children's adjustment. Moreover, parental heritable traits that influence their parenting are also transmitted to children and influence their children's adjustment. Thus, genetically influenced evocative processes from children and parental-transmission mechanisms influence the covariances between measures of family relationships and child development. These findings suggest new targets for preventing adverse development: altering parental responses to heritable characteristics of children and influencing the genetically influenced ontogeny of parenting.
The Phylogenetic Roots of Language
Authors: Zuberbühler Klaus
Published: August 2005

The anatomy of the nonhuman primate vocal tract is not fundamentally different from the human one. Notwithstanding, nonhuman primates are remarkably unskillful at controlling vocal production and at combining basic call units into more complex strings. Instead, their vocal behavior is linked to specific psychological states, which are evoked by events in their social or physical environment. Humans are the only primates that have evolved the ability to produce elaborate and willfully controlled vocal signals, although this may have been a fairly recent invention. Despite their expressive limitations, nonhuman primates have demonstrated a surprising degree of cognitive complexity when responding to other individuals' vocalizations, suggesting that, as recipients, crucial linguistic abilities are part of primate cognition. Pivotal aspects of language comprehension, particularly the ability to process semantic content, may thus be part of our primate heritage. The strongest evidence currently comes from Old World monkeys, but recent work indicates that these capacities may also be present in our closest relatives, the chimpanzees.
Education for outreach: development of an inter‐professional MSc in critical care
Authors: Fulbrook Paul , Cockerell Janet
Published: August 2005

This article describes the development of a new multi‐professional Master's degree programme, which is aimed at supporting the education of practitioners in meeting the needs of Level 1 critically ill patients. The main drivers that influenced its development were Comprehensive Critical Care (Department of Health, 2000a) and the National Health Service Modernisation Agency for Critical Care. The programme was aimed primarily at junior doctors, senior ward nurses, senior physiotherapists and members of Outreach teams. The programme was designed to maximize work‐based learning and is framed around two clinically focused units. The programme is informed by principles of quality improvement and aims to prepare practitioners to meet the needs of Level 1 patients ‘at the point of need’.
Nurse‐led elective cardioversion: an evidence‐based practice review
Authors: Smallwood Andrew
Published: August 2005

By posing a clinical practice question, this article aims to document and explore the published evidence base supporting nurse‐led cardioversion. A literature review was undertaken to determine the best evidence for practice. Five articles and two conference abstracts describing practice were found to be pertinent to the question. Description of the methodology used was a weakness of all the articles studied, with only one article purported to be framed as a research study. The remainder describe a planned change in nursing practice to encompass the delivery of a service previously, organizationally viewed as, physician led. Evaluations of practice were descriptive and supported by audit data in most articles, however, appropriate evidential comparisons were not offered. These articles were critically appraised in relation to safety and efficacy. Whilst the evidence may be seen to be limited and weak, it does add credence to the notion that a nurse with a suitable experiential background and knowledge base can make a significant contribution to the care of this group of patients. It is clearly evident that further developments in practice should be framed within a research context to support and strengthen the evidence base. Four prominent themes emerged from the review, ‘change milieu’, ‘reshaping boundaries’, ‘nurse‐led’, ‘efficacy of practice’, which are modelled into a conceptual framework. Nursing roles are expanding within the cardiological setting, affording practitioners unprecedented practice opportunities within a supportive organizational framework, however, these roles must be subject to appropriate evaluation in order to continue informing a robust evidence base.
An evaluation of the impact of the ventilator care bundle
Authors: Crunden Eddie , Boyce Carolyn , Woodman Helen , Bray Barbara
Published: August 2005

A number of interventions have been shown to improve the outcomes of patients who are invasively ventilated in intensive care units (ICUs). However, significant problems still exist in implementing research findings into clinical practice. The aim of this study was to assess whether the systematic and methodical implementation of evidence‐based interventions encapsulated in a care bundle influenced length of ventilation and ICU length of stay (LOS). A ventilator care bundle was introduced within a general ICU and evaluated 1 year later. The care bundle was composed of four protocols that consisted of prophylaxis against peptic ulceration, prophylaxis against deep vein thrombosis, daily cessation of sedation and elevation of the patient's head and chest to at least 30 degrees to the horizontal. Compliance with the bundle was assessed, as was ICU LOS, ICU mortality and ICU/high‐dependency unit patient throughput. Mean ICU LOS was reduced from 13·75 [standard deviation (SD) 19·11] days to 8·36 (SD 10·21) days (p < 0·05). Mean ventilator days were reduced from 10·8 (SD 15·58) days to 6·1 (SD 8·88) days. Unit patient throughput increased by 30·1% and the number of invasively ventilated patients increased by 39·5%. Care bundles encourage the consistent and systematic application of evidence‐based protocols used in particular treatment regimes. Since the introduction of the ventilator care bundle, length of ventilation and ICU LOS have reduced significantly.
Impact of the European Working Time Directive on the training of paediatric anaesthetists*
Authors: White M. L. , Walker I. A. , Jackson E. , Thomas M. L.
Published: August 2005

The European Working Time Directive and the New Deal have decreased the number of hours worked by anaesthetic trainees. We implemented the Working Time Directive in May 2004 and evaluated the effect of its implementation on training. During two 6‐month periods, one before and one after the change, we determined the number of operating lists undertaken by each Specialist Registrar in Anaesthesia. After implementation of the Working Time Directive, the mean number of lists performed by Specialist Registrars decreased from 24 to 21 lists per registrar per month, a 13% decrease. Exposure to subspecialty lists was the same in both periods, but this was at the expense of general lists and those in remote locations. We conclude that the Working Time Directive has had a measurable impact on the training of paediatric anaesthetists, but that the significance of this change for clinical practice has not yet been measured.
AIDS‐related lymphomas: from pathogenesis to pathology
Authors: Carbone Antonino , Gloghini Annunziata
Published: August 2005

Human immunodeficiency virus (HIV)‐associated lymphomas include: (1) lymphomas also occurring, although sporadically, in the absence of HIV infection. The vast majority of these lymphomas are high‐grade B‐cell lymphomas: Burkitt lymphoma (BL), diffuse large B‐cell lymphoma (DLBCL) with centroblastic (CB) features and DLBCL with immunoblastic (IBL) features; (2) unusual lymphomas occurring more specifically in HIV‐positive patients and include two rare entities, namely ‘primary effusion lymphoma’ (PEL) and ‘plasmablastic lymphoma’ of the oral cavity. The pathological heterogeneity of acquired immunodeficiency syndrome‐associated non‐Hodgkin's lymphomas (AIDS‐NHL) reflects the heterogeneity of their associated molecular lesions. In AIDS‐BL, the molecular lesions involve activation of cMYC, inactivation of P53, and infection with Epstein–Barr virus (EBV). AIDS‐IBL infected with EBV are characterised by frequent expression of latent membrane protein 1 – an EBV oncoprotein. The biological heterogeneity of AIDS‐NHL is highlighted by their histogenetic differences. Kaposi's sarcoma‐associated herpesvirus/human herpesvirus 8 (KSHV/HHV8)‐associated lymphomas, which often develop in persons with advanced AIDS, present predominantly as PEL. KSHV/HHV8 has also been recently detected in solid extracavitary‐based lymphomas. The KSHV/HHV8‐associated solid lymphomas are (1) unusual lymphomas that occur more specifically in HIV‐positive patients; (2) extracavitary and arise in nodal and/or extranodal sites; and (3) histologically, they usually display a PEL‐like morphology and plasma cell‐related phenotype.
Air travel and thrombosis
Authors: Chee Y.‐L. , Watson H. G.
Published: August 2005

The current literature suggests a weak association between long‐distance travel and the development of asymptomatic venous thromboembolism (VTE). Most of the data available relate to air travel and suggest that the risk is largely confined to asymptomatic calf vein thrombosis in passengers with additional risk factors for VTE, travelling for more than 8 h. The risk of both symptomatic and fatal pulmonary embolism (PE) is very small. The causal role of travel‐related factors (e.g. stasis, dehydration, cramped seats and hypobaric hypoxia) is not yet proved but, given the plausible risk‐free benefit, all passengers should be advised to maintain adequate hydration and exercise. There is currently no evidence for ‘routine’ thromboprophylaxis using stockings or drugs. In passengers with additional risk factors for VTE, thromboprophylaxis in the form of below‐knee graduated compression stockings (providing 15–30 mmHg at the ankle) and/or prophylactic dose low‐molecular‐weight heparin may be considered. The evidence does not support the use of aspirin, which is associated with a significant rate of adverse gastrointestinal effects.
Identification of ID‐1 as a potential target gene of MMSET in multiple myeloma
Authors: Hudlebusch Heidi Rye , Theilgaard‐Mönch Kim , Lodahl Marianne , Johnsen Hans Erik , Rasmussen Thomas
Published: August 2005

The frequently detected t(4;14)(p16·3;q32) translocation in multiple myeloma (MM) results in a dysregulation of two potential oncogenes: multiple myeloma SET domain (MMSET) and fibroblast growth factor receptor 3 (FGFR3). As the expression of FGFR3 is undetectable in 30% of the t(4;14)+ MM patients, MMSET has been suggested to play an important role in the malignant transformation associated with the t(4;14) translocation. Screening with a real‐time polymerase chain reaction (PCR) found complex expression patterns of the MMSET transcripts in fluorescence‐activated cell sorted (FACS)‐purified plasma cells (PCs) from 15 t(4;14)+ MM patients. In addition, potential target genes of MMSET type I and II were identified, using microarray analyses of MMSET transfected cell lines. Subsequently, the expression of potential target genes was verified by real‐time PCR in FACS‐purified PCs from 15 t(4;14)+ and 22 t(4;14)− MM patients. We suggest that the inhibitor of differentiation 1 (ID‐1) is a target gene of MMSET, based on its upregulation in MMSET transfected cell lines and a significant association between the t(4;14) translocation and ID‐1 expression in MM patients (P = 0·002). As high levels of ID‐1 are associated with cancer, our findings indicate that MMSET promotes oncogenic transformation in t(4;14)+ MM patients by transcriptional activation of ID‐1 expression.
Acute myeloid leukaemia with FLT3 gene mutations of both internal tandem duplication and point mutation type
Authors: Chen Weina , Jones Dan , Jeffrey Medeiros L. , Luthra Rajyalashmi , Lin Pei
Published: August 2005

FLT3 gene mutations, either internal tandem duplication or point mutation type, are common in acute myeloid leukaemia (AML). We describe 21 AML cases with both types of gene mutations, so‐called dual mutations, representing approximately 1% of all cases. Most newly diagnosed AML with FLT3 dual mutations had monocytic differentiation and a normal karyotype. Over the disease course, changes in FLT3 mutation status were seen in 89% of cases, and were associated with cytogenetic changes. We conclude that FLT3 dual mutations occur rarely in AML, and appear to be related to clonal evolution.
Cyclophosphamide and antithymocyte globulin as a conditioning regimen for allogeneic marrow transplantation in patients with aplastic anaemia: a long‐term follow‐up
Authors: Kahl Christoph , Leisenring Wendy , Joachim Deeg H. , Chauncey Thomas R. , Flowers Mary E. D. , Martin Paul J. , Sanders Jean E. , Storb Rainer
Published: August 2005

A total of 81 severe aplastic anaemia patients, aged 2–63 years, received human leucocyte antigen‐matched related marrow grafts after cyclophosphamide + antithymocyte globulin followed by postgrafting methotrexate + ciclosporin. Median follow‐up was 9·2 years. Ninety‐six per cent of patients had sustained engraftment, 24% developed acute graft‐versus‐host disease (GVHD), grade II in all but two patients, and 26% developed chronic GVHD; all surviving patients eventually responded to immunosuppressive therapy. Six patients developed cancer: one fatal lymphoma and five carcinomas (all five patients are now free of cancer). Survival was 88%. The regimen appeared well tolerated and effective in heavily pretreated patients with aplastic anaemia.
Ligation of CD47 mediates phosphatidylserine expression on erythrocytes and a concomitant loss of viability in vitro
Authors: Head David J. , Lee Zoe E. , Swallah Muhammed M. , Avent Neil D.
Published: August 2005

CD47 ligation has been shown to induce phosphatidylserine (PS) expression as part of a death pathway in nucleated blood cells. Using Annexin V binding assays we showed that ligation of CD47 with the specific CD47‐binding peptide 41NK, anti‐CD47 monoclonal antibody, and its natural ligand thrombospondin‐1 also induced PS expression on enucleated erythrocytes. PS expression was associated with a concomitant loss of erythrocyte viability in vitro. Further characterisation of the CD47‐PS signalling pathway on erythrocytes may help develop clinical strategies to further preserve the life of blood donations and improve our understanding of certain types of haemolytic anaemias.
Premedication with acetaminophen or diphenhydramine for transfusion with leucoreduced blood products in children
Authors: Sanders Robert P. , Maddirala Sunil D. , Geiger Terrence L. , Pounds Stanley , Sandlund John T. , Ribeiro Raul C. , Pui Ching‐Hon , Howard Scott C.
Published: August 2005

Febrile non‐haemolytic or allergic reactions occur in 0·1–30% of transfusions; physicians often premedicate patients with acetaminophen or diphenhydramine to prevent these reactions. The effectiveness of this practice has not been demonstrated. In this retrospective review of all transfusions at our institution during 2002, 385 patients received 7900 evaluable leucoreduced, irradiated blood products (4280 single‐donor apheresis platelets and 3620 packed red blood cells). Febrile reactions occurred in 0·95% of 4108 transfusions with, and 0·53% of 3792 transfusions without, acetaminophen premedication. Allergic reactions occurred in 0·90% of 4315 transfusions with, and 0·56% of 3585 transfusions without, diphenhydramine premedication. In a multivariate analysis that adjusted for age, patient category, transfusion location, product, transfusion history, and reaction history, premedication with acetaminophen was associated with a statistically non‐significant increase in the odds of a febrile reaction (odds ratio 1·74; 95% confidence interval 0·71–4·23; P = 0·22), and diphenhydramine with a non‐significant increase in allergic reactions (odds ratio 1·74; 95% confidence interval 0·99–3·06; P = 0·054). Reactions occurred in only 1·3% of the 518 transfusions to patients with a history of two or more prior reactions. Febrile and allergic transfusion reactions were rare in paediatric patients transfused with leucoreduced, irradiated blood products, whether premedication was used or not.
Tracking and characterisation of transfused platelets by two colour, whole blood flow cytometry
Authors: Hughes Darren L. , Evans Gillian , Metcalfe Paul , Goodall Alison H. , Williamson Lorna M.
Published: August 2005

We describe a flow cytometric technique to study transfused platelets in patients. By selecting donor/recipient pairs discrepant for HLA‐A2, transfused platelets were identified using anti‐HLA‐A2 with a detection limit of <5%, and accuracy within 4·3% of predicted (r2 > 0·96, P < 0·0001). In two of three episodes, transfused platelets were present in greater numbers than predicted from increment counts. Platelets with bound fibrinogen fell from 20·9 ± 23·6% of donor platelets pretransfusion to 1·7 ± 0·3% 1 h post‐transfusion, whereas P‐selectin‐positive platelets fell gradually, from 24·1 ± 6·7 to 7·3 ± 3·3% at 6 h. This method avoids radio or chemical labelling, and could be used to assess novel platelet preparations post‐transfusion.
Serum interleukin (IL)‐1, IL‐2, sIL‐2Ra, IL‐6 and thrombopoietin levels in patients with chronic myeloproliferative diseases
Authors: Panteli Katerina E. , Hatzimichael Eleftheria C. , Bouranta Paraskevi K. , Katsaraki Afroditi , Seferiadis Konstantinos , Stebbing Justin , Bourantas Konstantinos L.
Published: August 2005

A number of growth factors are involved in clonal haematopoietic expansion and their clinical significance in patients with chronic myeloproliferative diseases requires further evaluation. Using enzyme‐linked immunosorbent assays, we analysed serum levels of interleukin (IL)‐1a, IL‐1b, IL‐2, IL‐6, the soluble IL‐2 receptor alpha (sIL‐2Ra), and thrombopoietin (TPO), in 25 individuals with myelofibrosis with myeloid metaplasia (MMM), 40 with essential thrombocythaemia (ET), eight with polycythaemia vera (PV), 10 patients with chronic myeloid leukaemia (CML) and 27 normal controls. These were correlated with clinicopathological characteristics including overall survival, and histopathological bone marrow features, including angiogenesis. The serum derived from patients with MMM, ET, PV and CML contained significantly higher IL‐2 and sIL‐2Ra than healthy subjects, while IL‐6 levels were higher only in MMM and CML than controls. IL‐2, sIL‐2Ra and IL‐6 levels were raised during the transformation phase of CML, during progression of MMM to AML, and ET and PV to myelofibrosis (P < 0·001). There was a positive correlation between IL‐2, sIL‐2Ra, IL‐6 and angiogenesis in bone marrow samples. Cytokines may be useful markers for predicting clinical evolution, reflecting increased angiogenesis. This requires further evaluation to guide diagnostic and therapeutic options.
Superior mobilisation of haematopoietic progenitor cells with glycosylated G‐CSF in male but not female unrelated stem cell donors
Authors: Fischer Johannes C. , Frick Markus , Wassmuth Ralf , Platz Alexander , Punzel Michael , Wernet Peter
Published: August 2005

Granulocyte colony‐stimulating factor (G‐CSF) effectively mobilises haematopoietic stem cells to the peripheral blood. It is unclear whether the mobilisation of stem cells with lenograstim (glycosylated G‐CSF) or filgrastim (non‐glycosylated G‐CSF) leads to a higher cell number of collected engraft able progenitor cells. Thus, we investigated harvesting efficiency of the licensed G‐CSF preparations in mobilising peripheral stem cells in a randomised study. A total of 501 healthy unrelated donors, including 339 males and 162 females received either lenograstim (n = 261) or filgrastim (n = 240) at 10 μg/kg body weight (BW) per day. Aphaeresis was performed on day 5 and, if necessary, on day 6 of mobilisation. The number of CD34+ cells collected was 11·5% higher in the lenograstim group (7·19 × 106 vs. 6·44 × 106/kg BW donor; P < 0·03). Univariate variance analysis revealed that this effect was caused by male donors: more progenitors cells per kg BW of the donor (7·73 × 106 vs. 6·88 × 106; P < 0·017) and of the recipient (10·1 × 106 vs. 8·88 × 106, P < 0·029) could be harvested. There was no significant difference in the percentage of donors in whom a second aphaeresis was required (9·6% vs. 11·6%). Lenograstim mobilises progenitor cells into the peripheral blood more effectively in males than filgrastim.
Phosphoinositide 3‐kinase/Akt inhibition increases arsenic trioxide‐induced apoptosis of acute promyelocytic and T‐cell leukaemias
Authors: Tabellini Giovanna , Tazzari Pier Luigi , Bortul Roberta , Evangelisti Camilla , Billi Anna Maria , Grafone Tiziana , Martinelli Giovanni , Baccarani Michele , Martelli Alberto M.
Published: August 2005

Recent studies suggest that the prosurvival signal transduction pathway involving phosphoinositide 3‐kinase (PI3K)/Akt can confer an aggressive, apoptosis‐resistant phenotype to acute leukaemia cells. We have investigated the effect of modulating this signalling pathway on the sensitivity of leukaemic cell lines (NB‐4, CEM, Jurkat, MOLT‐4) and acute promyelocytic primary blasts to apoptosis induced by 1 μmol/l As2O3. Whereas parental NB‐4 cells did not display any phosphorylated (active) Akt, CEM, Jurkat and MOLT‐4 cells exhibited high levels of Akt activation. Consistently, treatment of NB‐4 cells with pharmacological inhibitors of the PI3K/Akt pathway (LY294002, wortmannin) did not increase sensitivity of these cells to arsenic trioxide (As2O3), whereas siRNA knock‐down of Akt enhanced As2O3‐induced apoptosis of CEM, Jurkat and MOLT‐4 cells. Overexpression of a constitutively active Akt cDNA rendered NB‐4 cells less susceptible to As2O3. Upon prolonged exposure to As2O3, we isolated a NB‐4 cell clone that was resistant to As2O3 and displayed high levels of active Akt. LY294002 treatment of acute promyelocytic primary blasts with elevated Akt phosphorylation levels resulted in an increased sensitivity to As2O3. These results may provide a rationale for the development of combined or sequential treatment with PI3K/Akt inhibitors to improve the efficacy of As2O3 on acute leukaemias and also to overcome As2O3 resistance.
Variables influencing Platelet Function Analyzer‐100TM closure times in healthy individuals
Authors: Haubelt Hannelore , Anders Christof , Vogt Anette , Hoerdt Petra , Seyfert Ulrich Theo , Hellstern Peter
Published: August 2005

We investigated the relationship between platelet function analyzer (PFA‐100TM) closure times (CT) and bleeding time (BT), platelet aggregation (PA) induced by ADP, arachidonic acid, and collagen, blood cell counts, and von Willebrand factor (VWF) in 120 well‐characterised healthy individuals. Pre‐analytical and analytical conditions were standardised comprehensively. In a substantial number of cases the differences between duplicate measurements exceeded 15%. The reference range (5th and 95th percentiles) for CT with the collagen/epinephrine (CEPI) and the collagen/ADP (CADP) cartridge was 93–223 s and 64–117 s respectively. Re‐examination of 11 individuals with CEPI‐CT above the 95th percentile revealed considerable batch‐to‐batch variation of CEPI‐CT. Males had significantly longer CADP than females (P = 0·002). CEPI and CADP‐CT measured pm were significantly longer than corresponding values determined am (P = 0·003 and P < 0·0001 respectively). Blood group O was associated with greater CEPI and CADP‐CT and lower VWF levels compared with non‐O blood groups (P = 0·008, P = 0·0003 and P < 0·0001 respectively). Linear regression analysis revealed association between CEPI‐CT, CADP‐CT and VWF (P < 0·0001), but no relationship was found between CT and BT or between CT and PA. We conclude that VWF plasma levels modulate PFA‐100TM CT to a greater extent than platelet function. Establishment of reliable reference ranges and careful standardisation of pre‐analytical and analytical conditions is a prerequisite for obtaining reliable PFA‐100TM results. Duplicate measurements are necessary.
Splenectomy for the treatment of thrombotic thrombocytopenic purpura
Authors: Kappers‐Klunne M. C. , Wijermans P. , Fijnheer R. , Croockewit A. J. , van der Holt B. , de Wolf J. T. M. , Löwenberg B. , Brand A.
Published: August 2005

Plasma exchange is the treatment of choice for patients with thrombotic thrombocytopenic purpura (TTP) and results in remission in >80% of the cases. Treatment of patients who are refractory to plasma therapy or have relapsing disease is difficult. Splenectomy has been a therapeutic option in these conditions but its value remains controversial. We report on a series of 33 patients with TTP who were splenectomised because they were plasma refractory (n = 9) or for relapsed disease (n = 24). Splenectomy generated prompt and unmaintained remissions in all except five patients, in whom remission was delayed (n = 4) or who died with progressive disease (n = 1). Four postoperative complications occurred: one pulmonary embolism and three surgical complications. Median follow‐up after splenectomy was 109 months (range 28–230 months). The overall postsplenectomy relapse rate was 0·09 relapses/patient‐year and the 10‐year relapse‐free survival (RFS) was 70% (95% CI 50–83%). In the patients with relapsing TTP, relapse rate fell from 0·74 relapses/patient‐year before splenectomy to 0·10 after splenectomy (P < 0·00001). Two patients died from first postsplenectomy relapse. Although these results are based on retrospective data and that the relapse rate may spontaneously decrease with time, we conclude that splenectomy, when performed during stable disease, has an acceptable safety profile and should be considered in cases of plasma refractoriness or relapsing TTP to reach durable remissions and to reduce or prevent future relapses.
Complimentary and alternative medicine use among patients starting warfarin
Authors: Ramsay Nadine A. , Kenny Martin W. , Davies Graham , Patel Jignesh P.
Published: August 2005

The use of complimentary and alternative medicines (CAM) among the UK population is on the increase. For patients requiring warfarin therapy, it is important to maintain an adequate and safe level of anticoagulation. As some forms of CAM can interact with warfarin, it is imperative that any patient considered for warfarin, is asked about their use of CAM. Our report describes the incidence and type of CAM usage among patients about to start or recently commenced on warfarin therapy attending our outpatient anticoagulant clinic. All patients attending clinic for the first time were seen by a pharmacist. A retrospective analysis of the pharmaceutical care plans for all patients seen during 2003 were analysed regarding the degree of CAM usage. Of 631 care plans reviewed, 170 (26·9%) patients were taking some form of CAM. Ninety‐nine (58% of all CAM users) were taking a CAM that could interact with warfarin; the commonest forms were cod‐liver oil capsules and garlic capsules. We conclude that many patients new to warfarin therapy were significant users of CAM, many of which had the potential to interact with warfarin. By taking a full drug history, potential CAM/warfarin interactions could be avoided.
Subclinical inflammation and soleus muscle intramyocellular lipids in healthy Asian Indian males
Authors: Sinha Sanjeev , Rathi Manish , Misra Anoop , Kumar Virendra , Kumar Mahesh , Jagannathan N. R. , Pandey Ravindra Mohan , Dwivedi Manjari , Luthra Kalpana
Published: August 2005

Objectives  The relationship between C‐reactive protein (CRP), a marker of subclinical inflammation, and intramyocellular lipid (IMCL) content, a novel correlate of insulin resistance, has not previously been investigated.

Method and design  We estimated IMCL content in soleus muscle in 30 healthy Asian Indian males using proton magnetic resonance spectroscopy (1H MRS), and correlated it with body mass index (BMI), measures of abdominal obesity, percentage of body fat (%BF), serum lipoproteins, fasting and post‐oral glucose load serum insulin levels and other surrogate markers of insulin resistance.

Results  Soleus muscle IMCL content was significantly correlated with age (ρ = 0·64, P < 0·001), BMI (ρ = 0·41, P < 0·05), %BF (ρ = 0·53, P ≤ 0·01), waist circumference (ρ = 0·45, P < 0·05) and waist‐to‐hip circumference ratio (ρ = 0·58, P < 0·01) but did not correlate significantly with insulin resistance measured by the homeostasis model assessment (HOMA‐IR) or CRP levels. CRP levels did not correlate with the HOMA‐IR value.

Conclusions  Soleus muscle IMCL content correlated significantly with measures of generalized and abdominal obesity but not with insulin sensitivity or CRP levels in healthy Asian Indian males. Studies are needed in other ethnic groups to corroborate these data.
Effects of spring acid episodes on macroinvertebrates revealed by population data and in situ toxicity tests
Authors: LEPORI F. , ORMEROD S. J.
Published: August 2005

1. While streams in Europe and North America are now recovering chemically from chronic acidification, severe episodic acidification continues to threaten sensitive biota. To appraise further the biological importance of episodic acidification, we surveyed the distribution of the mayfly Baetis alpinus in streams in the Southern Alps (Canton Ticino, Switzerland) in relation to runoff acidity during spring floods. Moreover, to improve mechanistic understanding, in situ toxicity assays were carried out on nymphal B. alpinus during low flows and spring floods, both in streams prone to acid episodes and in well‐buffered controls.

2. Streams surveyed for invertebrates represented three groups which contrasted in susceptibility to episodic acidity. Group one included streams that were acid (alkalinity <0) in spring; group two streams were susceptible to acid episodes because of low base‐flow alkalinity (<200 μeq L−1); and group three streams were well‐buffered and unlikely ever to be acid. The abundance of B. alpinus was similar among groups during stable flows in winter and summer, but was significantly lower in groups one and two following spring snowmelt.

3. During the bioassays, control streams remained circumneutral to alkaline (pH >6.4). By contrast, episodic streams were circumneutral at low flows, but became acid (pH 4.5–5.6 and total dissolved aluminium to 276 μg L−1) during intense spring snowmelt. After 15‐day exposures, nymphal B. alpinus survival in the circumneutral control streams exceeded 92% irrespective of flow. In the episodic streams, survival matched the controls during low flows, but declined significantly to 10–20% during acid episodes in spring. Shorter exposure (2–4 days) to pH 5.5–5.7 did not cause significant mortality either during the exposure or over the following 7 days, indicating that B. alpinus might recover from short acid episodes.

4. Our data suggest that the spring distribution of B. alpinus in acid sensitive parts of the Alps directly reflects the toxicity of acid runoff during snowmelt. Our study illustrates that even mild episodic acidification can have significant consequences in Alpine streams for one of the most important invertebrate indicators of acidity.
Impact of resuspended sediment on zooplankton feeding in Lake Waihola, New Zealand
Authors: LEVINE SUZANNE N. , ZEHRER REGLINDIS F. , BURNS CAROLYN W.
Published: August 2005

1. Wind‐induced sediment resuspension in shallow lakes affects many physical and biological processes, including food gathering by zooplankton. The effects of suspended sediment on clearance rate were determined for a dominant cladoceran, Daphnia carinata, and calanoid copepod, Boeckella hamata, in Lake Waihola, New Zealand.

2. Animals were incubated at multiple densities for 4 days in lake water containing different amounts of suspended lake sediment. Rates of harvest of major food organisms were determined for each sediment level (turbidity) from changes in net growth rate with grazer density.

3. Daphnia cleared all food organisms 7–40 μm in length at similar rates, but was less efficient in its removal of free bacteria, phytoplankton <7 μm, and large cyanobacterial filaments. Elevation of sediment turbidity from 2 to 10 nephelometric turbidity units (NTU) (63 mg DW L−1 added sediment) reduced Daphnia clearance of phytoplankton, heterotrophic flagellates and ciliates by 72–100%, and of amoebae and attached bacteria by 21–44%. Further inhibition occurred at higher turbidity.

4. Boeckella hamata removed microzooplankton primarily, rather than phytoplankton. The rate at which it cleared rotifers was reduced by 56% when turbidity was increased from 2.5 to 100 NTU.

5. In the absence of macrozooplankton, algal growth increased with sediment turbidity, suggesting that sediment also inhibits rotifer grazing.

6. As mid‐day turbidity in Lake Waihola is ≥10 NTU about 40% of the time, sediment resuspension may play a major role in moderating energy flow and structuring pelagic communities in this lake.