bluuebunny/crossref_metadata_2025 huggingface dataset:
Multiscale topoedaphic heterogeneity increases resilience and resistance of a dominant grassland species to extreme drought and climate change
Authors: GODFREE ROBERT , LEPSCHI BRENDAN , RESIDE APRIL , BOLGER TERRY , ROBERTSON BRUCE , MARSHALL DAVID , CARNEGIE MALCOLM
Published: July 2010

It is argued that the inclusion of spatially heterogeneous environments in biodiversity reserves will be an effective means of encouraging ecosystem resilience and plant community conservation under climate change. However, the resilience and resistance of plant populations to global change, the specific life‐history traits involved and the spatial scale at which environmentally driven demographic variation is expressed remains largely unknown for most plant groups. Here we address these questions by reporting an empirical investigation into the impacts of an unprecedented 3‐year drought on the demography, population growth rates (λ) and biogeographical distribution of core populations of the perennial grassland species Austrostipa aristiglumis in semiarid Australia. We use life‐history analysis and periodic matrix population models to specifically test the hypothesis that patch‐ and habitat‐scale variation in vital life‐history parameters result in spatial differences in the resilience and resistance of A. aristiglumis populations to extreme drought. We show that the development of critical soil water deficits during drought resulted in collapse of adult A. aristiglumis populations (λ≪1), rapid interhabitat phytosociological change and overall contraction towards mesic refugia where populations were both more resistant and resilient to perturbation. Population models, combined with climatic niche analysis, suggest that, even in core areas, a significant reduction in size and habitat range of A. aristiglumis populations is likely under climate change expected this century. Remarkably, however, we show that even minor topographic variation (0.2–3 m) can generate significant variation in demographic parameters that confer population‐level resilience and resistance to drought. Our findings support the hypothesis that extreme climatic events have the capacity to induce rapid, landscape‐level shifts in core plant populations, but that the protection of topographically heterogeneous environments, even at small spatial scales, may play a key role in conserving biodiversity under climate change in the coming century.
Ecological and environmental footprint of 50 years of agricultural expansion in Argentina
Authors: VIGLIZZO ERNESTO F. , FRANK FEDERICO C. , CARREÑO LORENA V. , JOBBÁGY ESTEBAN G. , PEREYRA HERNÁN , CLATT JONATHAN , PINCÉN DANIEL , RICARD M. FLORENCIA
Published: July 2010

Agriculture expanded during the last 50 years from the Pampas to NW Argentina at the expense of natural forests and rangelands. In parallel, productivity was boosted through the increasing application of external inputs, modern technology and management practices. This study evaluated the impact of agricultural expansion between 1960 and 2005 by assessing the implications of land use, technology and management changes on (i) carbon (C), nitrogen (N) and phosphorous (P) stocks in soil and biomass, (ii) energy, C, N, P and water fluxes and (iii) water pollution, soil erosion, habitat intervention and greenhouse gas (GHG) emissions (impacts). Based on different data sources, these issues were assessed over∼1.5 million km2(63% of Argentina), involving 399 political districts during three representative periods: 1956–1960, 1986–1990 and 2001–2005. The ecological and environmental performance of 1197 farming system types was evaluated through theAgroEcoIndexmodel, which quantified the stocks, fluxes and impacts mentioned above. Cultivation of natural ecosystems and farming intensification caused a noticeable increase of productivity, a strengthening of energy flux, an opening of matter cycles (C, N, P) and a negative impact on habitats and GHGs emission. However, due to the improved tillage practices and the application of less aggressive pesticides, erosion and pollution risk are today lower than those of the mid‐20th century. The consistency of some assumptions and results were checked through uncertainty analysis. Comparing our results with international figures, some impacts (e.g. soil erosion, nutrient balance, energy use) were less significant than those recorded in intensive‐farming countries like China, Japan, New Zealand, USA, or those of Western Europe, showing that farmers in Argentina developed the capacity to produce under relatively low‐input/low‐impact schemes during the last decades. [Correction added after online publication 4 October 2010: In the first sentence of the Abstract, NE was corrected to NW.]
Effect of plant spacing and nitrogen fertilizer levels on the growth, dry‐matter yield and nutritive quality of Columbus grass (Sorghum almum stapf) in southwest Nigeria
Authors: Olanite J. A. , Anele U. Y. , Arigbede O. M. , Jolaosho A. O. , Onifade O. S.
Published: July 2010

A field experiment was conducted in 2006 and 2007 to determine the agronomic performance and nutritive value of Sorghum almum for introduction in the derived savannah area of Nigeria. The experiment was arranged in a 2 × 4 factorial design with 2 plant spacings (0·5 × 0·5 m and 1·0 × 1·0 m) and 4 nitrogen (N) fertilizer levels (0, 60, 120 and 180 kg N ha−1). Plant height, tiller number, leaf proportion, biomass yield and nutritive value of the herbage were evaluated as part of the search for alternatives (especially drought tolerant) to local forages for dry season feeding of ruminants. Herbage yield data were tested for linear, quadratic and cubic trends to identify the optimal fertilizer levels for both spacings. Spacing × N interactions (P < 0·05) were observed for plant height and tiller number in both years. Agronomic performance was marginally better in 2007 compared with 2006. The maximum dry‐matter (DM) yield of 3500 and 3740 kg ha−1 for the more dense row spacing (0·5 × 0·5 m) was achieved at N fertilizer levels of 144 and 149 kg N ha−1 for 2006 and 2007 respectively. For the less dense (1·0 × 1·0 m) row spacing, the maximum DM yield of 3020 and 3240 kg ha−1 was achieved at 51 and 97 kg N ha−1 for 2006 and 2007 respectively. The crude protein content of the grass ranged from 61 to 89 g kg−1 DM, while the neutral detergent fibre (NDF) content ranged from 700 to 734 g kg−1 DM. The ability of S. almum to persist into the second year in this region is seen as a promising index as persistence is one of the characteristics of a good forage plant. Considering the exorbitant price of N fertilizer, less dense row spacing with N fertilizer rate in the range of 50–100 kg N ha−1 is hereby recommended for this region.
Apexogenesis of a symptomatic molar with calcium enriched mixture
Authors: Nosrat A. , Asgary S.
Published: July 2010

Nosrat A, Asgary S. Apexogenesis of a symptomatic molar with calcium enriched mixture. International Endodontic Journal, 43, 940–944, 2010.

Aim  This article describes the apexogenesis of a mandibular right second molar in a 12‐year‐old girl who was referred with a history of lingering pain and pain on chewing.

Summary  Clinical and radiographic examinations revealed extensive coronal caries and immature roots. Treatment was performed under rubber dam isolation and included caries removal followed by pulp exposure and access cavity preparation. Pulpotomy was completed, and the remaining radicular pulp was capped with calcium enriched mixture (CEM) cement (BioniqueDent, Tehran, Iran). Clinical and radiographic examinations at 3, 6, and 12 months revealed the tooth was functional with no clinical signs or symptoms of pulpal disease. The final examination confirmed complete root development as well as formation of a calcified bridge beneath the CEM cement.

Key learning point 

 Pulpotomy with a CEM cement allowed root development to continue.
Temperature Profiles within a Double‐pipe Heat Exchanger with Countercurrent Turbulent Flow of Newtonian Fluids: Derivation, Validation, and Application to Food Processing
Authors: Uzzan M. , Leinen K.M. , Labuza T.P.
Published: July 2010

ABSTRACT: Pasteurization or sterilization of food and bioproducts is mostly performed using heat exchangers in countercurrent flow. The lack of appropriate analytic solutions for temperature profiles in the heating and cooling sections of such processes is most likely the main reason for the traditional cautious approach of disregarding the contribution of these stages in the total thermal history calculation. This approach leads to excessive thermal abuse of the product. The current manuscript describes the derivation and validation of an analytic solution for the temperature profiles within a double‐pipe heat exchanger with countercurrent turbulent flow of Newtonian fluids, at any possible flow rate and not necessarily assuming an isothermal heating medium or coolant. The presented solution is based on application of the “heat exchanger effectiveness” concept in a partial heat exchanger, and can be easily solved and plotted using a spreadsheet. An interactive ExcelTM workbook was developed for fast prediction of temperature profiles and used in a simulated case study to demonstrate the influence of operating conditions on the temperature profile and thermal history of a pasteurized liquid product.
Changes in pollinator fauna cause spatial variation in pollen limitation
Authors: Gómez José M. , Abdelaziz Mohamed , Lorite Juan , Jesús Muñoz‐Pajares A. , Perfectti Francisco
Published: July 2010

1. Pollen limitation may be a consequence of changes in pollinator abundance, diversity and identity. However, no empirical evidence exists concerning the consequences that the spatial variation in pollinator fauna has on pollen limitation intensity and plant reproduction. In this study, we test the effect that changes in flower‐visitor abundance, diversity and identity exert on the occurrence and strength of pollen limitation by experimentally quantifying pollen limitation in eight populations ofErysimum mediohispanicum, a pollination‐generalist plant native to the Iberian Peninsula.

2. Pollen limitation was accounted for by using a comprehensive estimator, the net reproductive rate (R0). Nevertheless, we also determined which components of plant reproduction, from ovule fertilization to seedling survival, were more intensely pollen‐limited. Finally, we explored whether the spatial variation in pollen limitation intensity was related to among‐population changes in flower‐visitor abundance, diversity and identity.

3. The whole reproductive cycle ofE. mediohispanicumwas pollen‐limited, although pollen limitation occurred more strongly during the ovule fertilization and seed‐production phases than during fruit ripening or seedling emergence and establishment.

4. There was a significant among‐population difference in pollen limitation intensity. Pollen limitation strength was associated with variations in flower‐visitor diversity, and identity. Populations with lower flower‐visitor diversity and with many low‐efficiency pollinators (i.e. beetles) showed stronger pollen limitation.

5. Synthesis. Our study shows that the intensity of pollen limitation at the population level may depend on several characteristics of the assemblage of flower‐visiting insects, such as their abundance, diversity and identity. Our results suggest that any impoverishment of pollinator diversity or any alteration in the specific composition of the pollinator assemblage may exacerbate pollen limitation.
Intraspecific aggregation does not increase species richness in dune grasslands
Authors: Damgaard Christian
Published: July 2010

1. One of the possible mechanisms to maintain a high number of species in a plant community is that intraspecific aggregation due to limited dispersal reduces the importance of interspecific competition.

2. The hypothesis has been examined both theoretically and experimentally in the simplifying case of two species in a uniform abiotic environment, and there is a solid qualitative understanding that intraspecific aggregation reduces the importance of interspecific competition; however, there is considerable uncertainty as to the magnitude of this reduction in plant communities with many species in a heterogeneous environment and its effect on the number of coexisting species.

3. Here, the hypothesis was tested by comparing observed species richness at a site with a compound estimate of the intraspecific aggregation of all the species observed at the site, while taking the expected confounding effects of environmental spatial heterogeneity into account.

4. It is difficult to draw firm conclusions from the non‐significant statistical results found in this study, as a lack of significance does not necessarily rule out the presence of an effect. However, based on the observation that species richness was not correlated with the degree of intraspecific aggregation, it was concluded that there was no additional support for the hypothesis that reduced interspecific competition due to intraspecific aggregation is important for maintaining the relatively species‐rich flora in North‐European dune grassland.

5. Synthesis. It is important to test whether it is possible to generalize the expected effects of intraspecific aggregation from manipulated experiments using only a few plant species to natural plant communities with many species, and the approach taken in this paper is a practically manageable approach.
Evaluation of therapeutic control in a Pakistani population with hypertension
Authors: Saleheen Danish , Hashmi Saman K. , Zaidi Moazzam , Rasheed Asif , Murtaza Muhammed , Abbas Adil , Nasim Sana , Hameed Mustafa Qadir , Shuja Fahad , Sethi Muhammad Jawad , Hussain Imad , Shahid Kamran , Khalid Hamza , Ahmad Usman , Frossard Philippe M. , Ishaq Muhammad
Published: July 2010

Rationale, aims and objectives  Cardiovascular diseases (CVD) are increasing at an alarming rate in South Asia. High blood pressure is a modifiable risk factor for CVD. In this study, we evaluated the control of blood pressure and the prevalence of cardiovascular risk factors in patients with hypertension.

Method  A cross‐sectional study was conducted in 50 primary health care centres throughout Pakistan. Individuals with a documented history of hypertension, receiving pharmacological therapy, were enrolled and evaluated for the control of their blood pressure.

Results  The recommended therapeutic control of hypertension (systolic blood pressure <140 mmHg, diastolic blood pressure <90 mmHg) was seen in only 6.4% of the study participants. Values of both the mean systolic and diastolic blood pressures in all subjects were higher than the desired therapeutic levels (P < 0.001). There was a high prevalence in the study population of established but modifiable risk factors of CVD, such as smoking (30.5%), hypercholesterolemia (59.5%) and sedentary lifestyle (43.5%). Lack of therapeutic control of systolic blood pressure was found significantly associated with age, hypercholesterolemia and sedentary lifestyle (P < 0.05).

Conclusions  Patients being treated at primary health care centres in Pakistan have inadequate control of high blood pressure. Evidence‐based continuous education of primary health care physicians is a necessary intervention for optimizing treatment strategies and achieving better therapeutic control of hypertension in our population.
Complexity and the health care professions
Authors: Doll Jr William E. , Trueit Donna
Published: July 2010

The concept of complexity is a popular and contentious topic. Just what is complexity? What does it mean to ‘think complexly’? This paper addresses both of these issues. Complexity thinking is impossible to define with any precision as it deals not only with change, dynamic change, evergoing, but with transformative change. Definitions require stability, the very element complexity neither has nor aspires to have. Instead complexity asks us to see, to deal with a world in continual flux; but a world that does have patterns to it, patterns that bind and structure through their interplay. In short, complexity seeing/thinking asks us to envision our world and events within that world in terms, not of ‘things’ but of process. In so doing, we are moving from a science that studies particles to the new sciences of chaos and complexity that study the interactive relations between and among particles, events, happenings. After distinguishing the similarities and contrasts between chaos and complexity, and showing the characteristics of each, along with looking at systems closed and open, frames modern and post‐modern, this paper enumerates practical aspects of thinking complexly: accepting ambiguity, allowing humility to permeate one's being, and seeking out and utilizing difference and diversity. The health care profession by its very nature of dealing with that which is dynamically living deals with the complex daily. Its routines and rules, though, are too often caught in a modernist trap. This paper challenges all health care professionals to break free from that trap, and suggests ways to do so.
Albendazole sulphoxide kinetic disposition after treatment with different formulations in dogs
Authors: DIB A. , PALMA S. , SUÁREZ G. , FARÍAS C. , CABRERA P. , CASTRO S. , ALLEMANDI D. , MORENO L. , LANUSSE C. , SÁNCHEZ BRUNI S.
Published: July 2010

Dib, A., Palma, S., Suárez, G., Farías, C., Cabrera, P., Castro, S., Allemandi, D., Moreno, L., Lanusse, C., Sánchez Bruni, S. Albendazole sulphoxide kinetic disposition after treatment with different formulations in dogs. J. vet. Pharmacol. Therap.34, 136–141.

New therapeutic strategies based on the search of alternative formulations of albendazole (ABZ) and albendazole sulphoxide (ABZSO) are under current development to optimize posology and antiparasite efficacy in dogs. In an incomplete block design, nine dogs were randomly divided into three groups (n = 6). Treatments were carried out in two phases as follows. Phase I: Group I (treatment A), animals received ABZ at 25 mg/kg of conventional formulation. Group II (treatment B), dogs received 25 mg/kg of a modified poloxamer‐ABZ formulation. Group III (treatment C), animals were treated with ABZSO in equimolar amount to ABZ doses. After 21 days of wash‐out period the experiment was repeated (Phase II). Blood samples were collected over 24 h and subsequently analysed by high performance liquid chromatography. ABZSO and ABZSO2 were the analytes recovered in plasma. Significant higher (P < 0.001) ABZSO area under the concentration–time curve (+500%) and Cmax (+487%) values were obtained for the treatment C in comparison with treatments A and B. However, no statistical differences on pharmacokinetic parameters were found between formulations A and B. In conclusion, the enhanced plasma concentration profile obtained for the ABZSO formulation used in treatment C may contribute to optimize the anthelmintic control in dogs.
Expression and distribution of antimicrobial peptides in the skin of healthy beagles
Authors: Santoro Domenico , Bunick David , Graves Thomas K. , Campbell Karen L.
Published: July 2010

Antimicrobial peptides (AMPs) are small proteins involved in defense against pathogenic organisms. Defensins and cathelicidin are the most frequently studied human AMPs. Our goals were to determine the distribution of AMPs and evaluate their mRNA expression in normal canine skin. Skin biopsies were taken from six healthy beagles. The relative transcript level of canine cathelicidin (cCath) and β‐defensin (cBD)‐1, cBD2 and cBD3 mRNA was quantified using quantitative real‐time polymerase chain reaction. Indirect immunofluorescence (IIF), using polyclonal antibodies against cBD2, cBD3 and cCath, was used to evaluate protein localization in the skin of healthy dogs. The Pfaffl method, using experimentally determined primer efficiencies of amplification, was used to determine the expression level of cCath, cBD1 and cDB3 relative to cDB2. The levels of cCath, cBD3 and cBD1 mRNA were 358, 296 and 177 times higher than those of cBD2, respectively. Using IIF, cBD2 and cBD3 protein fluorescence was detected in all layers of the epidermis, whereas cCath was detected predominantly in the stratum granulosum and corneum. In addition, antimicrobial peptide detection was limited to the infundibular portion of the pilosebaceous units. We have validated useful methods to evaluate AMPs in canine skin. Further studies are needed to compare AMP expression in healthy dogs with that of dogs with inflammatory skin conditions.
An outcome study on complications using routine ultrasound assistance for internal jugular vein cannulation
Authors: Lamperti M. , Cortellazzi P. , D’Onofrio G. , Subert M. , Falcone C. , Filippini G. , Caldiroli D.
Published: July 2010

Background:  Ultrasound guidance for central venous cannulation is advised by recent guidelines, but is not being applied in everyday practice. The purpose of this study was to determine the reduction in complications when applying an ultrasound locating device for internal jugular vein catheterization.

Methods:  An observational study was conducted from November 2004 to October 2005 in a tertiary neurosurgical hospital on 300 patients undergoing internal jugular vein cannulation using an ultrasound technique. Patients were not randomized and operators were trained using theoretical and practical courses. Prior to the study, the investigators, who were consultant anaesthesiologists, had to perform at least 20 successful supervised cannulations.

Results:  Cannulation was successful in all cases. The incidence of arterial puncture was 2.7%, and multiple venous punctures represented the main minor complication (14%). Bivariate analysis of the overall complications revealed no significant correlation with age group, American Society of Anesthesiologists' (ASA) classification, body mass index, or position and diameter of the vein.

Conclusions:  Ultrasound cannulation of the internal jugular vein minimized complications. These could be avoided when new ultrasound probes and specific needles are introduced.
The effects of activated protein C and prostacyclin on arterial oxygenation and protein leakage in the lung and the gut under endotoxaemia in the rat
Authors: DUBNIKS M. , GRÄNDE P.‐O.
Published: July 2010

Background:Based on the anti‐adhesive/anti‐aggregatory and permeability‐reducing properties of activated protein C (APC) and prostacyclin (PGI2), we analysed and compared these substances regarding their efficacy in counteracting transcapillary leakage of albumin in the lung and the gut, and in improving arterial oxygenation under a condition of inflammation.

Methods:The randomized and blinded study was performed on 31 adult male Sprague‐Dawley rats. Inflammation was induced by continuous infusion ofEscherichia coliendotoxin (lipopolysaccharide, LPS). Six hours after the start of the LPS infusion (240,000 U/kg/h), a simultaneous infusion of saline (control group) or 8 μg/kg/min of human recombinant APC or 2 ng/kg/min of PGI2was started and continued for 24 h (n=8 per group). The study also included a sham group. Transcapillary leakage of albumin was measured from the ratio between tissue radioactivity [counts per minute (cpm)/g tissue] and actual amount of radioactivity given (cpm/g body weight of125I‐albumin). Oxygenation was assessed from arterial and central venous blood samples.

Results:LPS induced albumin leakage in the gut and the lung, and impaired blood oxygenation. In the lung, the leakage was lower in the PGI2group than in the APC and the control groups (P<0.05). In the gut, it was lower in the APC and the PGI2groups than in the control group (P<0.05). Oxygenation was better in the APC and PGI2groups than in the control group.

Conclusion:Our data suggest that both APC and low‐dose PGI2are beneficial in LPS‐induced inflammation in the rat, by reducing albumin leakage and improving blood oxygenation.
Light vs. heavy sedation during mechanical ventilation after oesophagectomy – a pilot experimental study focusing on memory
Authors: SAMUELSON K. A. M. , LUNDBERG D. , FRIDLUND B.
Published: July 2010

Background:To assess and compare the feasibility and stressful memories of light vs. heavy sedation during post‐operative mechanical ventilation.

Methods:Randomized clinical trial in one general intensive care unit (ICU) in a Swedish university hospital. Thirty‐six adults were randomly assigned to receive either light [Motor Activity Assessment Scale (MAAS) 3–4] or heavy (MAAS 1–2) sedation with continuous i.v. infusion of propofol during post‐operative invasive mechanical ventilation after oesophagectomy. The patients were interviewed at the general ward 5 days post‐ICU using the ICU Memory Tool and the ICU Stressful Experience Questionnaire, and 2 months post‐ICU using the Impact of Event Scale Revised. Patient data and hourly recorded MAAS values were collected after the interviews.

Results:Seventy‐four per cent of the 139 MAAS values in the light sedation group (n=18) and 79% of the 142 in the heavy sedation group (n=18) were within the targeted levels, and the median MAAS scores were 3.0 vs. 1.25, respectively. Intention‐to‐treat analyses showed no significant difference in the prevalence of stressful memories between groups, including endotracheal tube discomfort, presenting wide 95% confidence intervals for the difference in outcome estimates. Excluding the patients with a prolonged ICU stay (n=3), a higher prevalence of delusional memories was found in the heavy sedation group (31% vs. 0%,P=0.04).

Conclusions:This small randomized‐controlled pilot study suggests that a light sedation regimen during short‐term post‐operative mechanical ventilation after major surgery is feasible without increasing patient discomfort.
Development of the appendicularianOikopleura dioica: Culture, genome, and cell lineages
Authors: Nishida Hiroki
Published: July 2010

Appendicularians are planktonic tunicates (urochordates), and retain a swimming tadpole shape throughout their life. Together with ascidians, they are the closest relatives of the vertebrates.Oikopleura dioicais characterized by its simplified life habit and anatomical organization. It has a tiny genome, the smallest ever found in a chordate. Its life cycle is extremely short – about 5 days – and it can be maintained in the laboratory over many generations. Embryos and adults are transparent and consist of a small number of cells. The anatomy of juveniles and adults has been described in detail. Cleavage pattern, cell lineages, and morphogenetic movements during embryogenesis have also been comprehensively documented. A draft genome sequence is now available. These features make this organism a suitable experimental model animal in which genetic manipulations would be feasible, as inDrosophilaandCaenorhabditis elegans. In this review, I summarize a hundred years’ knowledge on the development throughout the life cycle of this organism.Oikopleurais an attractive organism for developmental and evolutionary studies of chordates. It offers considerable promise for future genetic approaches.
Assessment of heavy metals in sediments and aquatic organisms in West Lake (Ho Tay), Hanoi, Vietnam
Authors: Pham Nga Thi Thu , Pulkownik Alexandra , Buckney Rodney T.
Published: July 2010

West Lake (Ho Tay) is the largest freshlake in Hanoi, Vietnam. It has a surface area of ≈ 500 ha and a total volume of >107 m3, and is 1–3.5 m in depth. West Lake has been classified as needing protection because of its valuable freshwater genetic resources. Noting that it has been extensively affected by pollution, the objective of the present study was to examine the extent of heavy metal contamination of the sediments and commercially important biota in the lake. Heavy metal concentrations in the sediment from most of 24 samples in West Lake exceeded the Ontario Ministry of Environment Screening Level for chromium (Cr), copper (Cu), manganese (Mn), lead (Pb) and zinc (Zn) concentrations. Aquatic organisms from the lake also were found to be contaminated by heavy metals. The average Zn concentrations in snails and mussels tissues ranged between 174 and 415 µg g−1, and the Pb concentrations between 3.5 and 5.2 µg g−1. The Cu concentration in shrimp (52 µg g−1) and snail (189 µg g−1), and the Pb concentration in all fish species and shrimp from the lake (2.0–5.2 µg g−1) exceeded the Food Standard Australia‐New Zealand (FSANZ) health standards for human consumption. The Cd concentration in Cyprinus carpio also exceeded the FSANZ standard. The implications of these study findings for the effective management of the food and ecological resources of West Lake are discussed.
Relation of ankle‐brachial index to the rate of decline of residual renal function in peritoneal dialysis patients
Authors: LIU JIUNG‐HSIUN , WANG SHU‐MING , CHEN CHING‐CHU , HSIEH CHUNG‐LIN , LIN SHIH‐YI , CHOU CHE‐YI , LIU YAO‐LUNG , LIN HSIN‐HUNG , HUANG CHIU‐CHING
Published: July 2010

Aim:  The aim of this study was to determine whether ankle‐brachial index (ABI) predicts the rate of decline of residual renal function (RRF) in peritoneal dialysis (PD) patients. Previous studies demonstrated the importance of loss of RRF in predicting all‐cause risk and cardiovascular mortality in PD patients. It is also known that patients with a low ABI value have a greater risk for deteriorating renal function in the general population. The relationship between ABI and the declining rate of RRF in PD patients with an additional dialysis‐specific risk factor is uncertain.

Methods:  Seventy‐four PD patients with RRF of more than 1 mL/min per 1.73 m2 were analyzed. ABI was used as the surrogate measure of pre‐existing cardiovascular disease and atherosclerosis burden to further determine the outcome of RRF in this study. The slope of decline of RRF was used to determine the outcome.

Results:  Based on the multivariate analysis, only ABI (P < 0.001), diabetes (P = 0.02) and baseline RRF (P = 0.009) independently predicted a faster decline in RRF. A stepwise multiple linear regression analysis demonstrated that ABI was an independent predictor for the slope of decline of RRF (P < 0.001).

Conclusion:  A low ABI is an independent predictor of not only the known atherosclerotic events, but also of the rate of decline of RRF over time in PD patients.
Time and geographical variations in utilization of endocrine therapy for breast cancer in Australia
Authors: Vitry A. I. , Thai L. P. , Lu C. Y.
Published: July 2010

Background: Endocrine therapies, aromatase inhibitors and tamoxifen, are commonly used as an adjuvant treatment in women with breast cancer.

Aims: This study examined the trends in use of endocrine therapies in Australia between 1996 and 2008, including a comparison between Australian states.

Methods: Prescription and expenditure data for tamoxifen and aromatase inhibitors (1996–2008) were obtained from the Drug Utilisation Sub‐Committee. We converted prescription data to defined daily doses (DDD)/1000 population/day, the international unit of drug utilization. Utilization data in each state/territory (2003–2008) were adjusted for female population and age‐standardized incidence rates of breast cancer.

Results: Total utilization of endocrine therapies increased by 30% from 1.66 to 2.14 DDD/1000/day between 1996 and 2008. Over this period, there was a shift in use from tamoxifen to aromatase inhibitors which became the highest used products in 2008. Anastrozole was the most used aromatase inhibitor and its use increased markedly after being listed on Australia's national Pharmaceutical Benefits Scheme (PBS) for early breast cancer in 2005 (average increase of 0.14 DDD/1000/day per annum between 2005 and 2008). PBS expenditure for endocrine therapies increased by 265% from $16 million to $58 million between 1996 and 2008. Utilization of endocrine therapies was overall comparable between regions except that it was substantially lower in the Northern Territory.

Conclusions: Use of aromatase inhibitors has overtaken use of tamoxifen in 2008. Further real‐world effectiveness data are required to evaluate whether large associated increases in expenditures partly because of the higher costs of aromatase inhibitors are actually justified.
How reliable is eGFR when calculating drug dosage in acute medical admissions?
Authors: McNeill G. B. S. , Martin J. H.
Published: July 2010

Background: The Modification of Diet in Renal Disease‐derived estimation of glomerular filtration rate (eGFR) is used widely. Although validated in stable chronic kidney disease (CKD) outpatients, it is not known how it performs in those presenting with acute medical illness.

Aim: We aimed to compare eGFR with Cockroft Gault (CG) – the renal function assessment tool available prior to eGFR – to assess the difference in clinical outcome that would occur when one over another estimation is used in practice. In particular, we wished to assess whether use of eGFR would have resulted in a change of dose of commonly used acutely administered medications.

Methods: Acute medical admissions presenting to a tertiary hospital between August and December 2008 were included. Serum creatinine concentration, age, sex, height and weight were collected. Renal function was estimated by both estimates. Movement from CKD class 3 to 4 or 5 was measured – a clinically used cut‐off point for changes in management.

Results: A total of 54 patients was included. eGFR values were higher than those estimated by CG. Almost half of patients categorized as CKD stage 4–5 using CG were only categorized as CKD stage 3 using eGFR.

Conclusion: Although we did not use a gold standard estimation of GFR, this study shows that estimates of renal function vary in a clinically significant manner. As estimates of GFR are used to adjust drug dosages and to stratify for many other treatments, it is imperative that we find a method of estimating kidney function that is readily available, consistent and accurate.
Pituitary adenylyl cyclase‐activating polypeptide controls the proliferation of retinal progenitor cells through downregulation of cyclin D1
Authors: Njaine Brian , Martins Rodrigo A. P. , Santiago Marcelo F. , Linden Rafael , Silveira Mariana S.
Published: July 2010

During retinal development, cell proliferation and exit from the cell cycle must be precisely regulated to ensure the generation of the appropriate numbers and proportions of the various retinal cell types. Previously, we showed that pituitary adenylyl cyclase‐activating polypeptide (PACAP) exerts a neuroprotective effect in the developing retina of rats, through the cAMP–cAMP‐dependent protein kinase (protein kinase A) (PKA) pathway. Here, we show that PACAP also regulates the proliferation of retinal progenitor cells. PACAP, PACAP‐specific receptor (PAC1), and the receptors activated by both PACAP and vasoactive intestinal peptide (VIP), VPAC1 and VPAC2, are expressed during embryonic and postnatal development of the rat retina. Treatment of retinal explants with PACAP38 reduced the incorporation of [3H]thymidine as well as the number of 5‐bromo‐2′‐deoxyuridine‐positive and cyclin D1‐positive cells. Pharmacological experiments indicated that PACAP triggers this antiproliferative effect through the activation of both PAC1 and VPACs, and the cAMP–PKA pathway. In addition, PACAP receptor activation decreased both cyclin D1 mRNA and protein content. Altogether, the data support the hypothesis that PACAP is a cell‐extrinsic regulator with multiple roles during retinal development, including the regulation of proliferation in a subpopulation of retinal progenitor cells.
5‐HT1A and 5‐HT1B receptors differentially modulate rate and timing of auditory responses in the mouse inferior colliculus
Authors: Castellan Baldan Ramsey Lissandra , Sinha Shiva R. , Hurley Laura M.
Published: July 2010

Serotonin (5‐hydroxytryptamine; 5‐HT) is a physiological signal that translates both internal and external information about behavioral context into changes in sensory processing through a diverse array of receptors. The details of this process, particularly how receptors interact to shape sensory encoding, are poorly understood. In the inferior colliculus, a midbrain auditory nucleus, 5‐HT1A receptors have suppressive and 5‐HT1B receptors have facilitatory effects on evoked responses of neurons. We explored how these two receptor classes interact by testing three hypotheses: that they (i) affect separate neuron populations; (ii) affect different response properties; or (iii) have different endogenous patterns of activation. The first two hypotheses were tested by iontophoretic application of 5‐HT1A and 5‐HT1B receptor agonists individually and together to neuronsin vivo. 5‐HT1A and 5‐HT1B agonists affected overlapping populations of neurons. During co‐application, 5‐HT1A and 5‐HT1B agonists influenced spike rate and frequency bandwidth additively, with each moderating the effect of the other. In contrast, although both agonists individually influenced latencies and interspike intervals, the 5‐HT1A agonist dominated these measurements during co‐application. The third hypothesis was tested by applying antagonists of the 5‐HT1A and 5‐HT1B receptors. Blocking 5‐HT1B receptors was complementary to activation of the receptor, but blocking 5‐HT1A receptors was not, suggesting the endogenous activation of additional receptor types. These results suggest that cooperative interactions between 5‐HT1A and 5‐HT1B receptors shape auditory encoding in the inferior colliculus, and that the effects of neuromodulators within sensory systems may depend nonlinearly on the specific profile of receptors that are activated.
The comorbidity of tobacco smoking and gambling: A review of the literature
Authors: MCGRATH DANIEL S. , BARRETT SEAN P.
Published: July 2010

Issues. Evidence suggests that tobacco smoking and gambling frequently co‐occur. Although high rates of comorbid smoking and gambling have been documented in studies with clinical populations of pathological gamblers in treatment, in studies using samples drawn from the community, and in large‐epidemiological surveys, little empirical attention has been directed towards investigating the exact nature of this relationship. Approach. In this review, we stress the literature that has examined the epidemiology, aetiology and environmental factors implicated in comorbid smoking and gambling. Publications included in the review were identified through PsycInfo, PubMed and Medline searches. Key Findings. Although conclusive evidence is lacking, a growing body of literature suggests that smoking and gambling might share similar neurobiological, genetic and/or common environmental influences. Implications. Comorbid tobacco smoking and gambling are highly prevalent at the event and syndrome levels. However, research investigating how smoking might affect gambling or vice versa is currently lacking. Conclusion. More studies that examine the impact of this comorbidity on rates of tobacco dependence and problem gambling, as well as implications for treatment outcomes, are needed.[McGrath DS, Barrett SP. The comorbidity of tobacco smoking and gambling: A review of the literature. Drug Alcohol Rev 2009]
Tobacco education in dentistry and dental hygiene
Authors: GORDON JUDITH S. , ALBERT DAVID A. , CREWS KAREN M. , FRIED JACQUELYN
Published: July 2010

Introduction and Aims. Dentists and dental hygienists are in a unique position to motivate and assist their patients to quit smoking and using smokeless tobacco, and there is ample evidence that they can be effective. Tobacco plays a major role in the development and treatment of many oral diseases, and the repeated nature of dental treatment provides multiple opportunities for information, advice and brief counselling. However, dentists and dental hygienists in practice report lack of training in effective tobacco cessation skills as a significant barrier to incorporating these behaviours into routine care. Design and Methods. In this paper, we summarise the rationale for addressing tobacco use within dentistry and dental hygiene, review the extant policies regarding provision of tobacco‐related education, and make recommendations for the content and format of tobacco dependence treatment training in undergraduate curricula and continuing education courses. Results. Although worldwide dental education organisations have policies encouraging their members to provide tobacco cessation services to their patients, there are no national standards for tobacco cessation curriculum in US dental schools. In addition, tobacco cessation is not considered a clinical competency. Discussion and Conclusions. For dental professionals to systematically assist their patients to quit tobacco, changes must be made to the ways treatment of tobacco dependence is viewed within dentistry and taught at the undergraduate and post‐graduate levels. Until that time, the dental profession will continue to fall short of the Clinical Practice Guidelines and the policies set out by its professional organisations.[Gordon JS, Albert DA, Crews KM, Fried J. Tobacco education in dentistry and dental hygiene. Drug Alcohol Rev 2009;28:517–532]
Co‐occurring mental illness and substance use disorder among Australian prisoners
Authors: BUTLER TONY , INDIG DEVON , ALLNUTT STEPHEN , MAMOON HASSAN
Published: July 2010

Introduction and Aims. Estimate the prevalence of co‐occurring substance use disorder and mental illness in a sample of Australian prisoners, and describe patterns of co‐occurring substance use disorder and mental illness. Design and Methods. The sample comprised 1478 individuals (1208 men, 270 women) from two surveys of prisoners' mental health: the 2001 New South Wales Inmate Health Survey, and a consecutive sample of prison receptions. Individuals were drawn from all of the state's 29 prisons. Mental health and substance use disorders were assessed using the Composite International Diagnostic Interview. Results. The overall prevalence of any mental disorder was 42.7% and the prevalence of any substance use disorder was 55.3%. With the exception of alcohol use disorder, women had higher rates than men of mental illness and substance use disorders. The prevalence of a co‐occurring mental illness and substance use disorder in the past 12 months was 29% (46% among women vs. 25% among men). The association between cannabis use disorder and psychosis was significant for men only [odds ratio (OR) = 2.4]. Among women there was a significant association between affective disorder and co‐occurring alcohol use disorder (OR = 2.4), and stimulant use disorder (OR = 2.4). Discussion and Conclusion. The results highlight the high prevalence of co‐occurring substance use and mental illness among prisoners. These results indicate that mental health services in prisons need to be adequately resourced to address co‐occurring mental health and substance use problems, and these services need to be appropriately structured to effectively screen, manage and treat this group.[Butler T, Indig D, Allnutt S, Mamoon H. Co‐occurring mental illness and substance use disorder among Australian prisoners. Drug Alcohol Rev 2010]
Validation of a 28‐item version of the Systemic Clinical Outcome and Routine Evaluation in an Irish context: the SCORE‐28
Authors: Cahill Paul , O'Reilly Ken , Carr Alan , Dooley Barbara , Stratton Peter
Published: July 2010

This article describes the development, in an Irish context, of a three‐factor, twenty‐eight‐item version of the Systemic Clinical Outcome and Routine Evaluation (SCORE) questionnaire for assessing progress in family therapy. The forty‐ item version of the SCORE was administered to over 700 Irish participants including non‐clinical adolescents and young adults, families attending family therapy, and parents of young people with physical and intellectual disabilities and cystic fibrosis. For validation purposes, data were also collected using brief measures of family and personal adjustment. A twenty‐eight‐item version of the SCORE (the SCORE‐28) containing three factor scales that assess family strengths, difficulties and communication was identified through exploratory principal components analysis. Confirmatory factor analysis showed that the factor structure of the SCORE‐28 was stable. The SCORE‐28 and its three factor scales were shown to have excellent internal consistency reliability, satisfactory test‐retest reliability and construct validity. The SCORE‐28 scales correlated highly with the General Functioning Scale of the Family Assessment Device, and moderately with the Global Assessment of Relational Functioning Scale, the Kansas Marital and Parenting Satisfaction Scales, the Satisfaction with Life Scale, the Mental Health Inventory – 5, and the total problems scale of the Strengths and Difficulties Questionnaire. Correlational analyses also showed that the SCORE‐28 scales were not strongly associated with demographic characteristics or social desirability response set. The SCORE‐28 may routinely be administered to literate family members aged over 12 years before and after family therapy to evaluate therapy outcome.
Developing an indicator of family function and a practicable outcome measure for systemic family and couple therapy: the SCORE
Authors: Stratton Peter , Bland Julia , Janes Emma , Lask Judith
Published: July 2010

There is a need for a measure of outcome in systemic family and couples therapy (SFCT) that reflects current theory and practice. To meet the needs of SFCT practice the measure needs to use self‐report by family members, take a short time to complete and be easy to understand. The development of such a measure, called the SCORE, is reported in this article. Substantial piloting, consultation and review in terms of clinical judgement led to the construction of the SCORE 40 which has forty items about how the family functions, rated by family members over 11 years of age on a Likert scale, in addition to independent ratings of the family and its difficulties. The SCORE 40 is shown to be a viable instrument but is too substantial for everyday clinical use. In a research project to reduce and refine the measure and determine its psychometric properties the SCORE 40 was administered to 510 members of 228 families at the start of their first appointment for family therapy at clinics throughout the UK. The scale has good psychometric properties and could operate with either three or four dimensions. The analyses of these data, combined with data from a convenience sample of 126 non‐clinical families, allowed a reduction to fifteen items while retaining most of the information provided by the SCORE 40. This version is offered with three dimensions of: (1) Strengths and adaptability; (2) Overwhelmed by difficulties; and (3) Disrupted communication. It is hoped that the ready availability of the SCORE 15 will encourage routine evaluation of outcomes in clinics as well as the SCORE being used flexibly for both therapy and research.
‘Tell us what we need to know to do this!’ Preparing a path to safe uncertainty in assignment writing on a family therapy foundation course
Authors: Hopkins Clare , Reed Alex , MacKenzie Julie , Thomas Mair
Published: July 2010

This article describes a single session aimed at helping participants on a family therapy foundation course to move from a position of anxiety and discomfort about completing a written assignment to a position of safe uncertainty. Evaluation from the perspectives of course participants, course facilitators and assignment markers has shown participants engaging more enthusiastically with the writing of the assignment and expressing less anxiety about the process.