bluuebunny/crossref_metadata_2025 huggingface dataset:
Artificial waterway design affects fish assemblages in urban estuaries
Authors: Waltham N. J. , Connolly R. M.
Published: August 2010

Fishes were collected from residential canal estates leading directly off natural estuaries and artificial lakes with control tidal exchange in south‐east Queensland, Australia, to test the model that the difference in artificial waterway design affects fish assemblages. A total of 17 779 fish representing 52 species was caught, including 23 species of economic importance (45% of the catch). Total fish abundance and species richness differed little among sites within or between the two artificial habitats (canals and lakes) in either of the seasons sampled (winter and spring). Multivariate analysis showed, however, that assemblages differed among sites within the same artificial habitat. The differences were best explained by the distance sites were from open water, while salinity, water temperature and dissolved oxygen explained little of the variability. Most species were found in canals and lakes, but there were enough differences in composition between the habitats to detect a difference in both seasons (significant ANOSIM tests). Salinity was lower in lakes because of the tidal restrictions, and while this was only weakly correlated with differences in fish assemblages, it had the most explanatory power of any environmental variable. New recruits arrived later in lakes than canals, perhaps because of the barriers to tidal flow. A survey the following year showed that differences among individual lakes were consistent through time, offering insights into the influence of different tidal barriers on fish assemblages. The design change from canals to lakes has a minor influence on fish assemblages and alters the timing of recruitment.
Zenopsis conchifera (Lowe, 1852) (Pisces, Actinopterygii, Zeidae): a new alien fish in the Mediterranean Sea
Authors: Ragonese S. , Giusto G. B.
Published: August 2010

The first documented occurrence of a silvery John dory, Zenopsis conchifera, in the Mediterranean Sea is reported. A female (645 mm total length, 3296 g body mass) of Z. conchifera was caught in July 2006 by a commercial bottom trawler off the northern Tunisian coast (central Mediterranean Sea).
A hydro‐mechanical approach to the scaling of swimming performance in the sand flathead Platycephalus bassensis Cuvier: effects of changes in morphological features based on fish size
Authors: Yanase K. , Arimoto T.
Published: August 2010

The swimming performance of Platycephalus bassensis at steady speed was assessed with an emphasis on hydrodynamics. The minimum swimming speed to maintain hydrostatic equilibrium for P. bassensis of 0·271 m total length (LT) was calculated to be 1·06 LT s−1. At this speed, the required lift to support the mass of the fish was equivalent to 6·6% of the fish mass; 82·7% of which was created by the body as a hydrofoil, and the rest of which was created by the pelvic fins as hydrofoils. The minimum swimming speed decreased with the LT of the fish and ranged from 1·15 LT s−1 for a fish of 0·209 m to 0·89 LT s−1 for a fish of 0·407 m. The forward movement per tail‐beat cycle (i.e. stride length) was described with an equation including quantities of morphological and hydro‐mechanical relevance. This equation explained that stride length was increased by the effect of turbulence characterized by the Reynolds number and demonstrated the morphological and hydro‐mechanical functional design of the fish for maximizing thrust and minimizing drag. The larger span of the caudal fin and caudal tail‐beat amplitude was associated with larger stride length, whereas greater frictional drag was associated with smaller stride length.
A critical review of the discovery and application of a migratory pheromone in an invasive fish, the sea lamprey Petromyzon marinus L.
Authors: Sorensen P. W. , Hoye T. R.
Published: August 2010

The sea lamprey Petromyzon marinus, an ancient and parasitic agnathan fish native to the North Atlantic, invaded the Laurentian Great Lakes approximately a century ago triggering its fisheries to collapse. Presently, this species is held in check through a toxicant‐based control programme directed by a bi‐national treaty organization that seeks to develop a more broadly based integrated pest management (IPM) strategy. After a long and difficult search, the most active components of a migratory pheromone for the sea lamprey were identified and synthesized. This pheromone has remarkable potency and considerable potential to enhance various control strategies that fall within an IPM scheme. The pheromone is comprised of a mixture of at least three sulphated steroids: petromyzonamine disulphate (PADS), petromyzosterol disulphate (PSDS) and petromyzonol sulphate (PS). A steroidal sex pheromone appears to have similar promise. These discoveries, which are prompting development of the first pheromonally guided pest management programme for an invasive fish, have revealed significant scientific and policy challenges. Among the former are the needs to acquire long‐term and significant support for the science, to synthesize sufficient quantities of cues, and to deploy and measure pheromonal components in natural waters. Among the latter are the needs to regulate this new type of ‘pesticide’, protect these technologies from exploitation and promote future research on this and other invasive fish species. Lessons from these experiences may be applicable to the study of other invasive fishes.
Introduction, establishment and effects of non‐native salmonids: considering the risk of rainbow trout invasion in the United Kingdom*
Authors: Fausch K. D.
Published: August 2010

Salmonids like rainbow trout Oncorhynchus mykiss, brook trout Salvelinus fontinalis and brown trout Salmo trutta are potent invaders in various regions throughout the world, but non‐native rainbow trout have become established in only a few locations in the U.K. to date. Salmonid invasions in other regions are often driven by repeated authorized introductions of large numbers of fish, escapees from fish culture and illegal introductions by anglers. Their spread can be rapid within catchments via long‐distance movements. Currently, large numbers of all‐female diploid rainbow trout are released in the U.K., the eggs of which could be fertilized by relatively few mature males, thereby increasing the risk of invasion. If reproducing fish began to spread, especially by anadromy, then eradication could be difficult due to angler interest and logistical constraints. Establishment of non‐native salmonids can be limited by abiotic factors such as flow and temperature regimes, and biotic resistance from competition, predation and parasites or diseases, which often affect early life stages most strongly. Moreover, these factors can also interact with the zoogeography and evolutionary history of the native and introduced salmonids to make explanation and prediction complex. Although flow and temperature regimes in the U.K. are broadly suitable for rainbow trout, and biotic resistance by brown trout has been overcome in other regions, resistance from native diseases and angling mortality appear to be plausible hypotheses for lack of rainbow trout invasion in the U.K. Invading salmonids can have both direct effects on native salmonids and other fishes via biotic interactions, and indirect effects by fragmenting their habitat and isolating native populations. In addition, invaders can have indirect effects on entire aquatic food webs (e.g. invertebrates and algae) that cascade throughout ecosystems, or even cross boundaries into adjacent ecosystems. Evidence from other regions indicates that rainbow trout could have negative effects on brown trout or Atlantic salmon Salmo salar in U.K. waters, but this probably depends on the context set by other factors. Overall, primary factors to consider in any risk analysis of rainbow trout invasion in the U.K. include the decline of native salmonid populations due to degradation or overexploitation, the evolutionary history of newly introduced rainbow trout stocks, local or global influences that change aquatic environments and reduce biotic resistance by native parasites or diseases, and rapid evolution of local adaptations by new or marginally established populations of rainbow trout that makes them more invasive.
Population genetics of invasive common carp Cyprinus carpio L. in coastal drainages in eastern Australia
Authors: Haynes G. D. , Gilligan D. M. , Grewe P. , Moran C. , Nicholas F. W.
Published: August 2010

The common carp Cyprinus carpio introduced in two drainages in eastern Australia are largely descended from European common carp, and in a third drainage they descend largely from East Asian common carp. The partial genetic differentiation among the species in those drainages is consistent with their origins.
Long‐term prognosis for transplant‐free survivors of paracetamol‐induced acute liver failure
Authors: Jepsen P. , Schmidt L. E. , Larsen F. S. , Vilstrup H.
Published: August 2010

Aliment Pharmacol Ther 2010; 32: 894–900

Background  The prognosis for transplant‐free survivors of paracetamol‐induced acute liver failure remains unknown.

Aim  To examine whether paracetamol‐induced acute liver failure increases long‐term mortality.

Methods  We followed up all transplant‐free survivors of paracetamol‐induced acute liver injury, hospitalized in a Danish national referral centre during 1984–2004. We compared age‐specific mortality rates from 1 year post‐discharge through 2008 between those in whom the liver injury led to an acute liver failure and those in whom it did not.

Results  We included 641 patients. On average, age‐specific mortality rates were slightly higher for the 101 patients whose paracetamol‐induced liver injury had caused an acute liver failure (adjusted mortality rate ratio = 1.70, 95% CI 1.02–2.85), but the association was age‐dependent, and no survivors of acute liver failure died of liver disease, whereas suicides were frequent in both groups. These observations speak against long‐term effects of acute liver failure. More likely, the elevated mortality rate ratio resulted from incomplete adjustment for the greater prevalence of substance abuse among survivors of acute liver failure.

Conclusions  Paracetamol‐induced acute liver failure did not affect long‐term mortality. Clinical follow‐up may be justified by the cause of the liver failure, but not by the liver failure itself.
Kava, the anxiolytic herb: back to basics to prevent liver injury?
Authors: Teschke Rolf , Sarris Jerome , Glass Xaver , Schulze Johannes
Published: August 2010

The use of the anxiolytic herb kava has caused toxic liver injury in Western countries and economic problems in South Pacific Islands due to tthe regulatory ban on kava. This analysis shows poor quality of kava raw material as a cause for its toxicity and suggests preventative measures by going back to the traditional use of kava for the sake of the patients and the South Pacific economy.
Navigations between regulations and gut instinct: the unveiling of collective memory in decision‐making processes where teenagers are placed in residential care
Authors: Forkby Torbjörn , Höjer Staffan
Published: August 2010

The decision to take a young person away from his or her family into out‐of‐home care and treatment is the most drastic intervention within the statutory powers bestowed upon social services. The results of reports on the quality of residential treatment reveal that state supervision has not proven to be a good substitute for parental care. In this paper we analyse the decision‐making process when young persons are placed in residential care. Focus groups and individual interviews with different stakeholders were conducted. The results show that the placements are a collective process involving negotiations between the different parties with a coordinating social worker in the middle, with the aim to bring something to build hope on in often desperate situations, regardless of the specific treatment method used. To inform the process, the social workers draw on a ‘collective memory’ shared among colleagues in the department. Important signs of quality of a residential unit were the relational and collaborative competence from the staff. The inclination to use soft, diffuse information in decision‐making shows a striking lack of evidence upon which social workers can build well‐informed and knowledge‐based decisions.
The relationship between reduced testosterone, stimulated growth hormone secretion and increased carotid intima‐media thickness in obese men
Authors: Makimura Hideo , Stanley Takara L. , Sun Noelle , Connelly Jean M. , Hemphill Linda C. , Grinspoon Steven K.
Published: August 2010

Objective  Obesity is associated with reduced testosterone and growth hormone (GH). However, the interrelationship between these axes and their independent contributions to cardiovascular risk is unknown. The objectives of this study were to determine (1) the association between testosterone and GH in obesity, (2) whether excess adiposity mediates this association and (3) the relative contribution of reduced testosterone and GH to increased carotid intima‐media thickness (cIMT) in obesity.

Design  Fifty obese men were studied with GH‐releasing hormone–arginine testing, and morning free testosterone (FT) was measured by equilibrium dialysis. Metabolic, anthropometric and cardiovascular risk indices, including cIMT were measured. Twenty‐six normal weight men served as controls.

Results  Obese subjects demonstrated lower mean (±SEM) peak stimulated GH (5·9 ± 0·6 vs 36·4 ± 3·9 μg/l; P < 0·0001) and FT (0·41 ± 0·03 vs 0·56 ± 0·03 nmol/l; P = 0·0005) compared to controls. GH was significantly associated with FT (r = +0·44; P < 0·0001) and both were inversely related to visceral adipose tissue (VAT) (GH: r = −0·65; P < 0·0001; FT: r = −0·51; P < 0·0001). In multivariate regression analysis controlling for VAT, FT was no longer related to GH. Both GH and FT were associated with cIMT in univariate analysis. However, in multivariate modelling including traditional cardiovascular risk markers, GH (β = 0·003; P = 0·04) but not FT (P = 0·35) was associated with cIMT.

Conclusions  These results demonstrate a strong relationship between FT and GH in obesity and suggest that this relationship is more a function of excess adiposity rather than a direct relationship. While reduced FT and GH are both related to increased cIMT, the relationship with reduced GH remains significant controlling for reduced FT and traditional cardiovascular disease risk markers.
The importance of the fallow period for N2O and CH4 fluxes and nitrate leaching in a Mediterranean irrigated agroecosystem
Authors: Sanchez‐Martin L. , Sanz‐Cobena A. , Meijide A. , Quemada M. , Vallejo A.
Published: August 2010

The aim of this study was to evaluate the pattern of nitrous oxide (N2O) and methane (CH4) fluxes, and leaching losses of nitrate (NO3−) and dissolved organic C (DOC), during a fallow–onion crop–fallow cycle in a Mediterranean area. The importance of the fallow (intercrop) period and the type of fertilizer were also evaluated. Goat and chicken manure (M) from an organic farm, digested pig slurry (DPS) and urea (U) were applied at a rate of 110 kg N ha−1 and compared with a zero N treatment (Control). The crop period contributed more than each fallow period to the total N2O emission (ranging from 70 to 85% of the total emission, depending on the treatment). The variability of rainfall during fallow periods affected N2O emissions, with the highest fluxes observed in the second fallow, which was the wetter. Negative net fluxes of N2O (0 to −0.4 mg N2O‐N m−2 day−1) were mainly observed during the irrigation period and in fallow periods. The type of fertilizer had no effect on N2O fluxes, but influenced the CH4 oxidation. The largest CH4 emission was from the manure treatment (2.4 mg CH4‐C m−2 day−1) during the irrigation period. The lowest NO3− but highest DOC leaching rates were measured during the second fallow period from the manure treated plots (0.2 kg NO3−‐N ha−1 and 3.9 kg C ha−1), which also had the highest drainage. The use of OM, therefore, seems to be a suitable method to reduce the environmental impacts associated with N leaching as well as increase the potential to denitrify NO3− in groundwater.
The effect of seasonal variation in abiotic factors on fish community structure in temporary and permanent pools in a tropical wetland
Authors: ESCALERA‐VÁZQUEZ LUIS H. , ZAMBRANO LUIS
Published: August 2010

1. Fish community structure depends on biotic interactions and abiotic variables. Abiotic variables appear to gain importance in highly variable freshwater systems, such as tropical wetlands where a marked seasonal hydroperiod (dry and wet seasons) modifies water quality and quantity, differentially affecting fish survival and, consequently, modifying species richness and abundance.

2. We evaluated the relationship between abiotic variables and fish community structure in variable (temporary) and stable (permanent) pools that were interconnected in a tropical wetland with marked annual dry and wet seasons.

3. All fish species were able to occupy any of the studied pools, but our results showed distinctive fish community structures in permanent and temporary pools. Community structure was related to temperature, depth, pH and macrophyte coverage. Total fish abundance in the wetland was negatively related to water depth and positively related to macrophyte coverage.

4. Null models of co‐occurrence indicated a non‐random pattern at the wetland scale and a random pattern within groups of pools with similar characteristics, suggesting that fish communities are structured according to habitat features. We conclude that seasonal abiotic variation and habitat characteristics in this highly variable pristine wetland play major roles in structuring fish communities.
Biomechanical behaviour of a fractured maxillary incisor restored with direct composite resin only or with different post systems
Authors: Garbin C. A. , Spazzin A. O. , Meira‐Júnior A. D. , Loretto S. C. , Lyra A. M. V. C. , Braz R.
Published: August 2010

Garbin CA, Spazzin AO, Meira‐Júnior AD, Loretto SC, Lyra AMVC, Braz R. Biomechanical behaviour of a fractured maxillary incisor restored with direct composite resin only or with different post systems. International Endodontic Journal.

Aim  To compare stress distribution between a fractured maxillary central incisor restored with direct composite resin only (CR) or associated with different post materials, using finite element analysis.

Methodology  A three‐dimensional model of a sound maxillary central incisor and supporting structures was constructed, using data from the dental literature. Changes were made in the crown region to create a tooth with a restored crown fracture. A composite resin restoration only and restorations associated with different tapered post systems (glass fibre, carbon fibre, titanium and zirconia ceramic) were also evaluated, resulting in six experimental models. A static chewing pressure of 2.16 N mm−2 was applied to two areas of the palatal surface of the tooth. Stress distribution was analysed under a general condition and in the structures of the models separately.

Results  The maximum stresses were concentrated as follows: at the cemento‐enamel junction in the model with a sound maxillary central incisor, restored with CR and with a composite resin restoration associated with fibre posts; in the enamel at the post–enamel interface on the palatal surface of the model with a titanium post; and in the post of the model with zirconia ceramic post.

Conclusions  None of the restorations evaluated was able to recover the stress distribution of the sound tooth. The models restored with composite resin associated with a glass or carbon fibre post had similar stress distributions to that of the model restored with CR. The different post materials were shown to have a substantial influence on stress distribution, with less stress concentration when fibre posts were used.
Factors predicting blood pressure control in older Chinese immigrants to the United States of America
Authors: Li Wen‐Wen , Wallhagen Margaret I. , Froelicher Erika S.
Published: August 2010

li w.‐w., wallhagen m.i. & froelicher e.s. (2010) Factors predicting blood pressure control in older Chinese immigrants to the United States of America. Journal of Advanced Nursing 66(10), 2202–2212.

Aim.  This paper is a report of a study of the extent to which demographic characteristics, medication‐related factors, hypertension‐related knowledge and medication adherence predict systolic and diastolic blood pressure.

Background.  Little is known about predictors of hypertension control in Chinese elders.

Methods.  A longitudinal study with a 3‐month follow‐up was conducted with 90 Chinese immigrants to the United States of America aged ≥65 years and recruited from 2006 to 2007. The independent variables were measured at baseline. Blood pressure was measured at 3 months. Multiple linear regression analysis was used to evaluate the independent effects of seven variables on change in blood pressure at 3 months.

Results.  Participants ranged in age from 66 to 92 years (Mean 76·7, sd 6·6). The overall regression model for systolic blood pressure was statistically significant (R2 = 0·32, F = 4·37, P < 0·01). A higher number of prescribed oral medications (sr2 = 0·06, t = 2·42, P = 0·02) and lower medication adherence (sr2 = 0·07, t = −2·60, P = 0·01) were statistically significant determinants of an increased systolic blood pressure. The overall regression model for diastolic blood pressure was statistically significant (R2 = 0·21, F = 2·39, P = 0·03). Male gender (sr2 = 0·06, t = 2·26, P = 0·03) and lower medication adherence (sr2 = 0·11, t = −3·03, P < 0·01) were statistically significant determinants of an increased diastolic blood pressure.

Conclusion.  A greater number of prescribed medications and lower adherence predicted higher level of systolic blood pressure. Male gender and lower adherence were significantly associated with higher level of diastolic blood pressure. These predictors should be considered when designing interventions to help Chinese elders achieve better hypertension management.
Responses of stream macroinvertebrates and ecosystem function to conventional, integrated and organic farming
Authors: Magbanua Francis S. , Townsend Colin R. , Blackwell Grant L. , Phillips Ngaire , Matthaei Christoph D.
Published: August 2010

1. Organic farming practices can benefit a wide range of terrestrial biota in comparison to conventional farming but we do not know whether this benefit extends to streams flowing through farmed landscapes.

2. We measured the impacts of organic, integrated management and conventional farming on the taxonomic and trait composition of macroinvertebrate communities and on stream ecosystem functioning (algal accrual on tiles and leaf breakdown). Our study design included five replicates of each farming practice, arranged in blocks, in agricultural land dedicated to the farming of sheep and beef cattle on pasture in southern New Zealand. In each farm stream, we studied both upstream and downstream reaches within the farm’s boundaries.

3. The different farming practices were reflected in contrasting stream physicochemistry (total dissolved nitrogen, fine sediment on the bed and glyphosate concentrations in the bed sediment) and in differences in both the taxonomic organization and trait representation of stream invertebrate communities. Conventional farm streams showed the strongest negative responses, whilst the condition of organic and integrated farm streams was similar.

4. Invertebrate trait measures proved as effective as taxonomic measures in their response to agricultural intensity, whereas ecosystem function measures were least sensitive.

5. There were no overall physicochemical differences between upstream and downstream sites within the farms and few notable longitudinal patterns in ecological response variables.

6. Synthesis and applications. Conventional farming had the strongest adverse consequences for stream condition in our study. In contrast, an integrated management system (aimed at reducing pesticide use, increasing beneficial pest predators and encouraging environmentally responsible soil, water and energy management) proved at least as effective as organic farming and, together with organic farming, can be considered better practice.
Relationship between diabetes mellitus, hypertension and obesity, and health‐related quality of life in Gaziantep, a central south‐eastern city in Turkey
Authors: Ucan Ozlem , Ovayolu Nimet
Published: August 2010

Aims and objectives.  The main goal of nursing care should be to increase health‐related quality of life as well as improve the medical status of patients with chronic disease. For this reason, this study aims to evaluate and compare the health‐related quality of life of patients with diabetes mellitus, hypertension and obesity in Gaziantep, a south‐eastern city in Turkey.

Background.  Diabetes mellitus, hypertension and obesity are the most decisive factors in terms of adversely affecting health‐related quality of life.

Design.  A cross‐sectional, descriptive design was used.

Method.  In this study, the research population included a total of 1601 diabetes mellitus, hypertension and obesity patients. To evaluate health‐related quality of life of patients, Short Form‐36 (SF‐36) was used. Student’s t‐test, one‐way anova and chi‐square analyses were used for comparisons between groups.

Results.  In total, 18·1% of patients had combined obesity, hypertension and diabetes mellitus; 16·1% had hypertension and diabetes mellitus. Approximately 16·1% had only hypertension; 15·4% had obesity and hypertension; 13·3% had diabetes mellitus; 12·7% had obesity and diabetes mellitus; and 8·4% had obesity. The health‐related quality of life physical component mean scores of patients with combined obesity and hypertension were lower than that of the other groups (p < 0·05). Health‐related quality of life physical component mean scores were determined as 34·5 (SD 0·4), and mental component mean scores were determined as 43·9 (SD 4·4). Health‐related quality of life physical component mean scores of moderately active patients were higher, while older age and lower educational and income levels had a negative effect on health‐related quality of life (p < 0·05).

Conclusion.  Diabetes, hypertension and obesity decrease patient health‐related quality of life while physical activity increases it. The coexistence of obesity and hypertension, in particular, has a more negative effect on health‐related quality of life.

Relevance to clinical practice.  Patients with hypertension, obesity and diabetes mellitus need professional support from nurse. Frequent health‐related quality of life evaluation and support is required for chronic patients, especially for those who are older, have lower educational and income levels and those with more than one chronic disease.
Exploratory cross‐sectional study of factors associated with pre‐hospital management of pain
Authors: Siriwardena A Niroshan , Shaw Deborah , Bouliotis George
Published: August 2010

Rationale, aims and objectives  Improving pain management is important in pre‐hospital settings. We aimed to investigate how pain was managed in pre‐hospital suspected acute myocardial infarction (AMI) or fracture and how this could be improved.

Method  We conducted a cross‐sectional study in Lincolnshire using recorded suspected AMI and fracture between April 2005 and March 2006. Outcomes included pain assessment, improvement in pain scores and administration of Entonox, opiates or GTN (in AMI).

Results  We accessed 3654 patients with suspected AMI or fracture. Pain was assessed in over three quarters of patients but analgesics administered in under two‐fifths. Assessment was more likely in patients with suspected AMI (OR 2.05, 95% CI [1.70, 2.47]), and who were alert (OR 3.55, 95% CI [2.32, 5.43]). Entonox was less likely to be administered for suspected AMI (OR 0.11, 95% CI [0.087, 0.15]) or by paramedic crews (OR 0.56, 95% CI [0.45, 0.68]) but more likely to be given when pain had been assessed (OR 3.54, 95% CI [2.77, 4.52]). Opiates were more likely to be prescribed for suspected AMI (OR 1.30, 95% CI [1.07, 1.57]), in alert patients (OR 1.35, 95% CI [0.71, 2.56]) assessed for pain (OR 2.20, 95% CI [1.73, 2.80]) by paramedic crews.

Conclusions  This exploratory study showed shortfalls in assessment and treatment of pain, but also demonstrated that assessment of pain was associated with more effective treatment. Further research is needed to understand barriers to pre‐hospital pain management and investigate mechanisms to overcome these.
Evaluation of email alerts in practice: Part 2 – validation of the information assessment method
Authors: Pluye Pierre , Grad Roland M. , Johnson‐Lafleur Janique , Bambrick Tara , Burnand Bernard , Mercer Jay , Marlow Bernard , Campbell Craig
Published: August 2010

Rationale and objective  The information assessment method (IAM) permits health professionals to systematically document the relevance, cognitive impact, use and health outcomes of information objects delivered by or retrieved from electronic knowledge resources. The companion review paper (Part 1) critically examined the literature, and proposed a ‘Push‐Pull‐Acquisition‐Cognition‐Application’ evaluation framework, which is operationalized by IAM. The purpose of the present paper (Part 2) is to examine the content validity of the IAM cognitive checklist when linked to email alerts.

Methods  A qualitative component of a mixed methods study was conducted with 46 doctors reading and rating research‐based synopses sent on email. The unit of analysis was a doctor's explanation of a rating of one item regarding one synopsis. Interviews with participants provided 253 units that were analysed to assess concordance with item definitions.

Results and conclusion  The content relevance of seven items was supported. For three items, revisions were needed. Interviews suggested one new item. This study has yielded a 2008 version of IAM.
Histopathological studies on Vibrio harveyi– infected tiger puffer, Takifugu rubripes (Temminck et Schlegel), cultured in Japan
Authors: Mohi M M , Kuratani M , Miyazaki T , Yoshida T
Published: August 2010

Vibrio harveyi infection occurred with a moderate mortality in tiger puffer, Takifugu rubripes (Temminck et Schlegel), in autumn 2007, at a mariculture farm in western Japan. The diseased fish showed nodular lesions in the branchial chamber and the inner surface of the operculum. Histopathologically, the lesions comprised granulation tissue containing many suppurative foci allowing propagation of the bacteria and granuloma encapsulating abscesses with a decrease in bacteria. The bacteria were disseminated in visceral organs including the spleen, kidney, liver, and myocardium, resulting in the formation of granulomatous lesions. Two groups of tiger puffer juveniles were artificially infected by an intramuscular injection with an isolate (1.0_108 CFU/fish). During the experimental period, 20% mortality occurred within 4–6 days post‐infection (d.p.i). The fish sampled on 4 d.p.i showed abscesses in the lateral musculature at the injection site. The fish sampled 5 d.p.i. displayed the production of granulation tissue containing many suppurative foci, which replaced the necrotic dermis and lateral musculature. Surviving fish (15 d.p.i.) had granulomatous lesions in the lateral musculature at the injection site. Pyogranulomatosis is pathognomonic in V. harveyi infection of tiger puffer.
Obesity worsens cardiovascular risk profiles independently of hyperinsulinaemia
Authors: BONORA E. , TARGHER G. , ZENERE M. B. , SAGGIANI F. , ALBERICHE M. P. , BRANZI P. , MUGGEO M.
Published: August 2010

Abstract. Bonora E, Targher G, Zenere MB, Saggiani F, Alberiche MP, Branzi P, Muggeo M. (University of Verona Medical School, Verona, Italy). Obesity worsens cardiovascular risk profiles independently of hyperinsulinaemia.

Objective: To investigate whether human obesity is characterized by a worse cardiovascular risk profile (than no obesity) even in the absence of hyperinsulinaemia.

Subjects and design: A total of 367 healthy subjects (247 nonobese and 120 obese) with normal glucose tolerance and without family history of diabetes mellitus.

Interventions: A 75‐g oral glucose tolerance test was performed in all participants.

Main outcome measures: Anthropometry, blood pressure, fasting plasma lipids and urate, plasma glucose and insulin concentrations at fasting, 1 h and 2 h after oral glucose load.

Results: In a multivariate linear regression analysis, body mass index was strongly related to all cardiovascular risk factors, independently of sex, age and plasma insulin. When risk factors were compared in 37 normoinsulinaemic obese subjects (plasma insulin within one standard deviation of the mean values observed in the 247 nonobese subjects), and in 37 sex‐ and age‐matched normoinsulinaemic nonobese subjects, we found that plasma glucose levels were similar in the two groups, whereas plasma triglyceride (1.50pL0.13 vs. 1.13pL0.08 mmol L‐1; mean pL SE). low‐density lipoprotein cholesterol (3.42pL0.25 vs. 2.77pL0.18 mmol L‐1) and urate (290pL12 vs. 255pL12 umol L‐1) levels were significantly higher, and plasma high‐density lipoprotein cholesterol concentrations were lower (1.27pL0.04 vs. 1.46pL0.06 mmol L‐1) in obese than in nonobese subjects with normal plasma insulin levels (P<0.01). Also systolic (132pL2 vs. 124pL2 mmHg) and diastolic (86pL1 vs. 81pL1 mmHg) blood pressure values were significantly higher in normoinsulinaemic obese subjects than in normoinsulinaemic nonobese individuals (P<0.001).

Conclusions: These results suggest that in human obesity a worse cardiovascular risk profile is found (than in the nonobese) independently of the presence of hyperinsulinaemia.
Schilling and protein‐bound cobalamin absorption tests are poor instruments for diagnosing cobalamin malabsorption
Authors: LINDGREN A. , BAGGE E. , CEDERBLAD Å. , NILSSON O. , PERSSON H. , KILANDER A. F.
Published: August 2010

Abstract. Lindgren A, Bagge E, Cederblad A, Nilsson 0, Persson H, Kilander AF (Boris Central Hospital, Sahlgrenska University Hospital, and Molndal Hospital, Sweden). Schilling and protein‐bound cobalamin absorption tests are poor instruments for diagnosing cobalamin malabsorption.

Objectives: To assess the advantage of a protein‐bound cobalamin absorption test (PBAT) over the Schilling test in patients with suspeded cobalamin (vitamin B12) malabsorption.

Design: Clinical study of consecutive patients referred from primary care units, medical and neurological clinics.

Setting: The catchment area of Sahlgrenska University Hospital, Goteborg. Subjects. Referred patients (n = 155) with suspected cobalamin deficiency and at least one serum cobalamin value < 200 pmol L‐l.

Interventions: All patients were investigated with upper gastrointestinal endoscopy with biopsies taken upper gastrointestinal endoscopy with biopsies taken methylmalonic acid (h4MA) and homocysteine (Hcy) were determined in all 109 patients not on cobalamin substitution. A dual isotope cobalamin absorption test was then performed with the concomitant administration of crystalline (Schilling) and proteinbound cobalamin (PBAT).

Main outcome measures: Number of patients with gastric body atrophy diagnosed with each absorption gastric body atrophy diagnosed with each absorption test and the relation between these results and functional cobalamin deficiency defined as elevated MMA and Hcy, that normalized after cobalamin substitution treatment.

Results: The majority of patients with abnormal absorption tests had already developed elevated MMA and/or Hcy. PBAT was more sensitive than the Schilling test in identifyiog patients with gastric body atrophy but the sensitivity was too low for clinical use. About f of the patients with gastric body atrophy and normal absorption tests had already developed elevated MMA and/or Hcy. PBAT was more sensitive than the Schilling test in identifyiog patients with gastric body atrophy but the sensitivity was too low for clinical use. About f of the patients with gastric body atrophy and normal absorption tests had elevated MMA and/or Hcy, indicating cobalamin deficiency.

Conclusion: PBAT may be somewhat more sensitive than the Schilling test but neither test is sensitive enough for diagnosing cobalamin malabsorption at an early stage.
Vascular function correlates with risk factors for cardiovascular disease in a healthy population of 35‐year‐old subjects
Authors: JENSEN‐URSTAD K. , JOHANSSON J. , JENSEN‐URSTAD M.
Published: August 2010

Abstract. Jensen‐Urstad K, Johansson J, Jensen‐Urstad M (Karolinska Institute at Sodersjukhuset, Research Centre of General Medicine, and Huddinge University Hospital, Stockholm, Sweden). Vascular function correlates with risk factors for cardiovascular disease in a healthy population of 35‐year‐old subjects.

Objective: To investigate whether, in a healthy, randomly selected population of 35‐year‐old menand women, there is a relation between vascular function and conventional risk factors for cardiovascular disease such as gender, smoking, elevated blood‐lipids, high blood pressure and heredity for cardiovascular disease, and to blood glucose.

Design: Basal brachial artery diameter was measured. Endothelial function was measured as flow mediated dilation (FMD) in response to reactive hyperaemia. The nonendothelial dependent dilation was measured after sublingual nitro‐glycerine (NTG).

Setting: A research centre of general medicine and a university hospital.

Subjects: One hundred men and 100 women all 35 years old, were invited by letter. Sixty‐six of the 92 men (72 %) living in the community and 74 of the 88 women (84%) participated.

Results: Gender had the largest innuence on FMD and NTG induced arterial dilation, probably reflecting NTG induced dilation is inversely related to basal vessel size (r = ‐0.55, P < 0.001 and r = ‐0.40, P < 0.001). In women basal vessel diameter was positively correlated to blood glucose (r = 0.35, P = 0.009) and BMI (r = 0.34, P = 0.012) and negatively correlated to HDL cholesterol (r = ‐0.43, P = 0.001). FMD and NTG induced arterial dilation correlated with a combined risk factor score (r = ‐0.32, P = 0.019 and r = ‐0.31, P = 0.024). The men with the highest risk factor scores had larger vessel size and higher blood flow at rest compared to men without risk factors (4.8 kO.6 mm, 240f 84 mL min‐‘ and4.0+0.8 111111,139 k 72 mL min‐’, respectively, P = 0.014 and P = 0.016). FMD or NTG induced dilation did not correlate to any of the risk factors in men.

Conclusions: There are correlations between vascular reactivity and risk factors for MD in women and correlations between vessel diameter and risk factors for MD in both men and women already in a healthy population 3 5‐year‐old subjects. Further studies are needed to determine if the vessel diameter in itself, in a healthy population, is a sign of attenuated endothelial function.
Cardiac tamponade preceding adrenal insufficiency ‐ an unusual presentation of Addisons's disease: a report of two cases.
Authors: TORFOSS D. , LIPPE E. VON DER , JACOBSEN D.
Published: August 2010

Abstract.Torfoss D, von der Lippe E, Jacobsen D (Ullevaal University Hospital, Oslo, Norway). Cardiac tamponade preceding adrenal insdciency ‐ an unusual presentation of Addison's disease: a report of two cases (Case report).

Two cases of young healthy males presenting with cardiac tamponade and developing clinical adrenal insufficiency within a few weeks are described. On presentation they had a brisk inflammatory response with complement activation. Both had signs of subclinical hepatitis, and both have later shown evidence of thyroid involvement. The possibility of a connection between pericarditis and adrenal insdciency is discussed.
Clinical stable systemic mastocytosis with interferon alpha 2b therapy.
Authors: HÜBNER C. , WEDDING U. , STRÄTER J. , LIMBERG B. , STREMMEL W.
Published: August 2010

Abstract. Hubner C, Wedding U, Strater J, Limberg B, Stremmel W (Universitat Heidelberg. Friedrich Schiller Universitat, Jena and Universit2t Ulm, Germany). Clinical stable systemic mastocytosis with interferon alpha‐2b therapy (Case report).

Systemic mastocytosis (SM) with progessive infiltration of various organs by mast cells is a rare disease with a mean survival of 2 years. So far there is no established therapy. We describe a patient with Stremmel W (Universitat Heidelberg. Friedrich progressive mastocytosis who had a clinical response to interferon alpha‐2b 3 times 5 Mio U sc three times a week. The response is stable 3 years after initiation of therapy and includes reduction of abdominal lymphadenopathy, ascites, decrease of serum and urinary histamine levels as well as pulmonary reticdonodular markings.
Hypocomplementaemia caused by C3 nephritic factors (C3 NeF): clinical findings and the coincidence of C3 NeF type II with anti‐C1q autoantibodies
Authors: SKATTUM L. , MARTENSSON U. , SJÖHOLM A. G.
Published: August 2010

Abstract. Skattum L, MBrtensson U, Sjoholm AG (Lund University, Lund, Sweden). Hypocomple‐mentaemia caused by C3 nephritic factors (C3 NeF): clinical findings and the coincidence of C3 NeF type I1 with anti‐Clq autoantibodies. 1 Intern Med 1997; 242: 455‐64.

Objectives: The main purposes were to document manifestations associated with prolonged or clinical ly unexplained C3 deficiency and to approximate how often hypocomplementaemia of this kind is caused by C3 nephritic factors (C3 NeF), i.e. autoantibodies to alternative pathway C3 convertases. We also wished to distinguish between C3 NeF types I and I1 and to assess coincident autoantibody responses to the collagen‐like region of Clq (ClqCLR).

Setting: The investigation was based on serum Samples referred to a specialized laboratory for complement analysis in the course of several years.

Subjects: Twenty‐five persons with C3 concentrations lower than 0.43 g L', a third of the normal, were included in the study.

Results: Analysis using three methods provided evidence of C3 NeF in 20 persons with equal frequencies of C3 NeF types I and 11. We also gave evidence of antibody specificity differences for the two types of C3 NeF. Six patients with C3 NeF type I1 showed antibodies to C1 qCLR. Membranoproliferative glomerulonephritis was the predominant diagnosis and two patients had partial lipodystrophy reflecting the wellknown association between these diseases and C3 NeF. Anaphylactoid purpura, systemic lupus erythematosus, and severe infection, mainly meningococcal disease, were also observed.

Conclusions: The study group was probably fairly representative of C3 deficiency syndromes as encountered in clinical practice. The findings emphasize the heterogeneity of C3 NeF, and that acquired C3 deficiency syndromes caused by C3 NeF should perhaps be considered more often in diagnostic work.
Elevated apoptotic cell population in patients with chronic fatigue syndrome: the pivotal role of protein Kinase RNA
Authors: VOJDANI A. , GHONEUM M. , CHOPPA P. C. , MAGTOTO L. , LAPP C. W.
Published: August 2010

Abstract. Vojdani A, Ghoneum M, Choppa PC, Magtoto L, Lapp CW (Immunosciences Laboratory Inc., Beverly Hills, and Charles Drew University School of Medicine and Science, Los Angeles, California, and the Hunter‐Hopkins Centre, Charlotte, North Carolina, USA). Elevated apoptotic cell population in patients with chronic fatigue syn‐drome: the pivotal role of protein kinase RNA. J Intern Med 1997; 242: 465478.

Objectives: A prominent feature of chronic fatigue syndrome (CFS) is a disordered immune system. Recent evidence indicates that induction of apoptosis might be mediated in a dysregulated immune system by the upregulation of growth inhibitory cytokines. Therefore, the purpose of this study was to evaluate the apoptotic cell population, interferon‐alpha (IFN‐ a) and the IFN‐induced protein kinase RNA (PKR)gene transcripts in peripheral blood lymphocytes (PBL) of CFS individuals, as compared to healthy controls.

Subjects and methods: PBL were isolated from CFS (n = 29) and healthy control individuals (n = 15) and subjected to quantitative analysis of apoptotic cell population and cell cycle progression by flow cytometry. Quantitative competitive polymerase chain reaction (QIC PCR) and Western blot analysis were used to assess the levels of PKR mRNA and protein in control and CFS individuals. In addition, circulating IFNα was measured by ELISA assay.

Results: Increased apoptotic cell population was observed in CFS individuals, as compared to healthy controls (26.6 2 12.9% and 9.9 ? 4.2% respectively). The increased apoptotic subpopulation in CFS individuals was accompanied by an abnormal cell arrest in the S phase and the G2lM boundary of the cell cycle as compared to the control group (8.6 ‐I 1.2 to 22.8 2 2.4 and 3.6 5 0.82 to 24.3 ? 3.4, respectively). In addition, CFS individuals exhibited enhanced PKR mRNA and protein levels (mean basal level 3538 ? 1050 and 2.7 ‐+ 0.26, respectively) as compared to healthy controls (mean basal level 562 5 162 and 0.89 ‐I 0.18, respectively). In 50% of the CFS samples (n = 29) treated with 2‐aminopurine (2‐AP) (a potent inhibitor of PKR) the apoptotic population was reduced by more then 50%.

Conclusions: PKR‐mediated apoptosis in CFS individuals may contribute to the pathogenesis and the fatigue symptomatology associated with CFS.
Post‐transplant hyperlipidaemia: low‐dose lovastatin lowers atherogenic lipids with without plasma accumulation of lovastatin
Authors: GULLESTAD L. , NORDAL K. P. , FORFANG K. , IHLEN H. , HØSTMARK A. , BERG K. J. , CHENG H. , SCHWARTZ M. S. , GEIRAN O. , SIMONSEN S.
Published: August 2010

Abstract.Gullestad L, Nordal K, Forfang K, Ihlen H, Hostmark A, Berg KJ, Cheng H, Schwartz MS, Geiran 0, Simonsen S (Rikshospitalet University Hospital and University of Oslo, Oslo, Norway, and Merck Research Laboratories, West Point, PA, USA). Post‐transplant hyperlipidaemia: low‐dose lovastatin lowers atherogenic lipids without plasma ac‐cumulation of lovastatin. 1 Intern Med 1997; 242: 483‐490.

Objectives:The purpose of the present study was twofold. First, to determine the frequency of hyperlipidaemia after heart transplantation (Tx) in relation to values obtained before Tx. Secondly, to examine the effect of low‐dose lovastatin on possible antiatherogenic mechanisms and test the hypothesis that the side‐effects are dose‐dependent.

Subjects and design:Retrospective study of the frequency of hyperlipidaemia disturbances in heart transplant patients. In addition, in a prospective study, the safety and efficacy of incremental study, the safety and efficacy of incremental studied, with measurements of its plasma concentration in 24 cyclosporin A treated heart (n = 14) and kidney (n = 10) recipients with total cholesterol >7.5 mmol L‐I.

Results:Cholesterol increased markedly after heart transplantation from a pretransplant value of 5.3 (5.0.5.6) mmol L‐‘ to 6.7 (6.4.7.0) mmol L ‐’ after 1 year and then remained constant, but this increase was largely due to a ‘normalization’ since cholesterol decreased significantly during increasing heart failure before transplantation. Treatment with lovastatin decreased total cholesterol by 19% (P < 0.00l), primarily by an effect on IBL cholesterol. HDL cholesterol increased by 15% (P < 0.05), whereas triglycerides remained unchanged. Lovastatin also caused a significant reduction in apolipoprotein B of 16% and lipid peroxidation of 40%. whereas apolipoprotein A‐I, fibperoxidation of 40%. whereas apolipoprotein A‐I, fibcentration of lovastatin was significantly higher in transplant recipients compared with controls, but there was no accumulation during incremental dosing of lovastatin. The drug was well tolerated without significant symptoms or evidence of myopathy.

Conclusions:Hyperlipidaemia is common after cardiac transplantation. Treatment with low dose lovastatin is well tolerated and has a favourable effect on atherogenic lipids.