bluuebunny/crossref_metadata_2025 huggingface dataset:
Coping with stress
Authors: Bartram David , Gardner Dianne
Published: October 2010

DAVID Bartram and Dianne Gardner give an overview of various approaches to coping in stressful situations, and describe a framework of practical and straightforward steps to assist effective coping.
Handling large animals safely on‐farm
Authors: Phippen Martyn
Published: October 2010

HANDLING large animals like cattle is not without its risks, but these can usually be minimised by taking sensible precautions. The Health and Safety Executive (HSE) provides general advice on such procedures, but farm conditions are sometimes far from ideal, and it can be difficult for new graduates in particular to know how to proceed. Here, Martyn Phippens makes some suggestions on how to avoid getting hurt. In a box on page 285, Alastair Mitchell discusses guidance available from the HSE.
Common peripheral nerve disorders in the horse
Authors: Hahn Caroline
Published: October 2010

WITH rare exceptions, horses are largely unaffected by the plethora of developmental, degenerative and metabolic axonopathies and myelinopathies that perplex neurologists in human and small animal medicine. Nevertheless, selected equine peripheral nerve syndromes are not uncommon. A detailed neurological examination is an absolute prerequisite to localising peripheral neuropathies and determining the underlying aetiology of these syndromes. This article describes disorders affecting cranial and other peripheral nerves in the horse, and discusses the diagnosis, treatment and prognosis for each condition.
Mammary tumours in dogs and cats
Authors: Murphy Sue
Published: October 2010

COMPANION animal mammary gland neoplasias are common conditions seen in general practice. Most can be managed by surgical resection and there is usually no need for referral. The majority of mammary tumours in bitches are benign, while those in cats tend to be malignant and the prognosis is consequently guarded in this species. Overall, mammary tumours are less common in cats than dogs, which is probably related to the fact that most cats are neutered at a young age. Although general features such as the lesion being well circumscribed, slow growing and not fixed to underlying tissues suggest a lesion is benign, surgical biopsy should be conducted to definitively determine whether a mass is benign or malignant. This article describes canine and feline mammary tumours, highlighting the risk factors, diagnosis, treatment and prognosis.
Pelvic limb ataxia in the older dog
Authors: Bruto Cherubini Giunio , Lowrie Mark , Anderson James
Published: October 2010

ATAXIA is a common clinical sign in the older canine patient and can occur acutely or insidiously, pursuing a waxing and waning or progressive course. Although the prognosis may be guarded or unfavourable due to the underlying aetiology, age alone should not determine the outcome. The range of potential causes is extensive and, therefore, diagnosis requires a systematic approach, including thorough history taking and an accurate clinical and neurological examination. This should guide the practitioner to the most likely disease processes involved in a given case and suggest a potential prognosis for each. This article discusses the relevant physiology and neuroanatomy underpinning the interpretation of the neurological examination and reviews the major conditions associated with non‐painful ataxia in the older dog, focusing primarily on the assessment and non‐painful causes of pelvic limb ataxia. An article in the next issue will consider conditions associated with painful ataxia in older dogs.
Everyday ethics
Authors: Neale Madeleine
Published: October 2010

THIS series gives readers the opportunity to consider and contribute to the discussion of some of the ethical dilemmas that can arise in veterinary practice. Each month, a case scenario is presented, followed by discussion of some of the issues involved. In addition, a possible way forward is suggested; however, there is rarely a cut‐and‐dried answer in such cases, and readers may wish to suggest an alternative approach. This month's dilemma, entitled ‘Substandard stockmanship’, is presented and discussed by Madeleine Neale. Readers with comments to contribute are invited to send them as soon as possible, so that they can be considered for publication in the next issue. Discussion of the dilemma ‘A patient abroad’, which was published in the June issue of In Practice, appears on page 417.

The series is being coordinated by Siobhan Mullan, of the University of Bristol. It is hoped it will provide a framework that will help practices find solutions when facing similar dilemmas.
Pelvic limb ataxia in the older dog 2. Painful conditions
Authors: Cherubini Giunio Bruto , Lowrie Mark , Anderson James
Published: October 2010

PAIN can be a defining feature in older dogs presenting with pelvic limb ataxia. Dogs manifest pain through behavioural changes (eg, inappetence, lethargy, vocalisation, aggression or a reluctance to move) and physiological alterations (eg, tachycardia, tachypnoea, mydriasis or hypertension). The presence or absence of pain can be of clinical importance in refining the differential diagnosis. This article reviews the major conditions associated with painful ataxia in the older dog. An article in the last issue (In Practice, July/August 2008, volume 30, pp 386–391) discussed patient assessment and described conditions associated with non‐painful ataxia.
Field anaesthesia in camelids
Authors: Bradbury Leah
Published: October 2010

SOUTH American camelids, such as llamas and alpacas, can be challenging to manage in the field. Not only are these animals unusual, they can also be very valuable. Although different anatomically, camelids can be considered simply as small ruminants, such as goats and sheep, as they experience similar problems under general anaesthesia (eg, regurgitation, profuse salivation and hypoventilation). This article provides some basic guidelines for field anaesthesia of camelids for routine procedures, such as castration, skin biopsies or abdominal ultrasound.
Everyday ethics
Authors: Swan Pippa
Published: October 2010

THIS series gives readers the opportunity to consider and contribute to discussion of some of the ethical dilemmas that can arise in veterinary practice. Each month, a case scenario is presented, followed by discussion of some of the issues involved. In addition, a possible way forward is suggested; however, there is rarely a cut‐and‐dried answer in such cases, and readers may wish to suggest an alternative approach. This month's dilemma, entitled ‘Ex‐client with an emergency’, is presented and discussed by Pippa Swan. Readers with comments to contribute are invited to send them as soon as possible, so that they can be considered for publication in the next issue. Discussion of the dilemma ‘Substandard stockmanship’, which was published in the July/August issue of In Practice, appears on page 477. The series is being coordinated by Siobhan Mullan, of the University of Bristol. It is hoped it will provide a framework that will help practices find solutions when facing similar dilemmas.
Nutrition of the periparturient dairy cow
Authors: O'Boyle Nial
Published: October 2010

FROM a physiological standpoint, the transition period ‐ that is, the last three weeks before and the first three weeks after parturition ‐ is a pivotal time in a dairy cow's lactation. Despite a strong industry and research focus in this area over the past 20 years, approximately half of all high‐yielding dairy cows fail to make the transition without some form of periparturient disease. This is a sobering statistic, which is unique among mammalian species. This article reviews the conjecture behind the failings of the transition period in cows and examines some new nutritional approaches being investigated to reduce the levels of disease in these animals.
Options for inhalation anaesthesia
Authors: Clarke Kathy
Published: October 2010

HALOTHANE was first introduced into veterinary anaesthesia in the late 1950s by Dr Leslie Hall at Cambridge. Its use has been responsible for enabling many of the advances seen in veterinary surgery over the past 50 years, particularly in horses, for which at the time no suitable method of long duration anaesthesia existed. However, halothane is no longer available in the UK and has been superseded by isoflurane, sevoflurane and desflurane, all of which are commonly used in humans. This article discusses the differences between these agents, and highlights the relative advantages and disadvantages of each.
Applying evidence‐based veterinary medicine
Authors: Everitt Sally
Published: October 2010

VETS are increasingly being encouraged to ensure that their practice is evidence‐based, partly due to changing attitudes to the professions and increased requirements for public accountability. Practice should also be evaluated regularly, in the light of new research, to ensure that the best care is being provided. Sally Everitt looks at some of the options for integrating the tenets of evidencebased medicine into veterinary practice, and identifies some of the challenges.
Does your advertising work?
Authors: Page Gillian
Published: October 2010

ADVERTISING your practice is essential in an increasingly competitive environment, but there are a number of factors that must be considered first to ensure that it is money well spent. Here, Gillian Page suggests how to create effective advertising to raise the profile of your practice and bring in new clients. In a box on page 34, Tim Harrison describes the positive impact that sports sponsorship has had for his practice.
Using PEST analysis to improve business performance
Authors: Carruthers Harvey
Published: October 2010

THE acronym PEST aims to make us look at political, economic, social and technological pressures for change when assessing the business environment. Here, Harvey Carruthers discusses some of the factors that might need to be considered when applying the PEST model to veterinary practice.
Dental disease in pet rabbits 3. Jaw abscesses
Authors: Harcourt‐Brown Frances
Published: October 2010

Jaw abscesses are a common problem in pet rabbits and are usually caused by underlying dental disease. Although they are not straightforward to treat, many cases are curable. This article discusses the causes of jaw abscesses, outlines some prognostic indicators and describes an approach to successful treatment. Normal dentition, pathogenesis and aetiology of dental disease in rabbits were reviewed in Part 1 of this series of articles (In Practice, volume 31, pp 370–379), while diagnosis and treatment were considered in Part 2 (In Practice, volume 31, pp 432–445).
Gastric dilation‐volvulus syndrome in dogs 1. Pathophysiology, diagnosis and stabilisation
Authors: Tivers Mickey , Brockman Dan
Published: October 2010

GASTRIC dilation‐volvulus syndrome (GDVs) comprises acute gastric dilation (GD), acute gastric dilation‐volvulus (GDV) and chronic gastric volvulus. This article, the first of two reviewing the management of GDVs in dogs, discusses the pathogenesis, pathophysiology, diagnosis and stabilisation of GDV. An article in the next issue will describe surgical and postoperative
Ultrasonographic examination of the painful equine eye
Authors: Hughes Kristopher
Published: October 2010

ULTRASONOGRAPHY is a non‐invasive diagnostic procedure that can be used to examine the equine optic globe, orbit and periocular tissues. In particular, ultrasonographic examination can provide valuable information that cannot be obtained by direct visualisation or the use of other diagnostic techniques when periocular swelling or opacity of the ocular media is present. Ultrasonography is also useful for assessing globe size and position. Given the location of the eye, the procedure is usually simple to perform and a systematic examination can be undertaken quickly, producing good‐quality images. However, an understanding of the normal sonographic appearance of the ocular and orbital tissues is of paramount importance to facilitate image interpretation. Painful conditions of the equine eye are encountered commonly in veterinary practice and ocular ultrasonography can be performed without the need for specialist equipment in a field or hospital setting, and findings can facilitate selection of appropriate treatment and allow meaningful prognostication. This article describes how to carry out ocular ultrasonography and discusses image interpretation, with particular reference to horses presenting with ocular pain.
Canine hypothyroidism: diagnosis and therapy
Authors: Graham Peter
Published: October 2010

HYPOTHYROIDISM is a common endocrine disorder of dogs that may be both under‐ and overdiagnosed. The cost, ethical and medical consequences of unnecessary lifelong thyroid replacement therapy heightens a veterinary surgeon's responsibility to make confident diagnostic classifications of hypothyroidism or euthyroidism. Failure to recognise and treat hypothyroidism has a significant negative impact on a patient's quality of life. This article discusses the problems associated with diagnosing hypothyroidism in dogs, describes the various laboratory tests available for evaluating thyroid disease and dysfunction, including their respective advantages and disadvantages, and provides guidance on how the results obtained should be interpreted.
Problems of the postparturient ewe
Authors: Roger Paul
Published: October 2010

THE run up to lambing time is always fraught as ewes try to balance and partition nutrients and maintain the condition and growth of their lambs in utero, while developing mammary condition and starting to produce colostrum. But this period is only the start of the ewes' problems. The majority of ewe losses occur at this time, with an average annual loss of 5 per cent rising to 10 per cent in some situations, which can seriously affect farmers economically. This article discusses the problems experienced by ewes from parturition onwards, giving details of some specific diseases, and suggests treatments and possible measures to prevent losses.
Keeping computer systems safe
Authors: Fish
Published: October 2010

SAFEGUARDING computer systems requires constant diligence, but need not be as complicated as it sounds. In this article, Fish outlines the nature of the threats, and suggests simple, low‐cost ways of protecting computer systems against them.
Trading up with preventive health care
Authors: Goulding John
Published: October 2010

IN an article in last month's In Practice (February 2009, vol 31, pp 92‐93), John Goulding looked at some of the psychology involved in the buying decision and how, by understanding this, vets can improve the likelihood that their advice and recommendations will be followed. Here, he focuses on promoting the benefits of preventive health care and describes some of the initiatives he has implemented in his mixed practice.
Use of diagnostics for risk‐based control of paratuberculosis in dairy herds
Authors: Nielsen Søren Saxmose
Published: October 2010

INFECTIONS with Mycobacterium avium subspecies paratuberculosis (MAP) can cause significant economic losses in dairy herds. Control of paratuberculosis in dairy cattle requires changes in management procedures to break transmission routes, and primarily involves immediate removal of calves from their dam at birth, frequent cleaning of calving areas and separation of calves from cow manure. These measures can be time consuming to implement. Since only a proportion of the cows in a herd may be shedding MAP, control measures need only apply to infectious cows. However, continuous monitoring is required to detect newly infectious individuals in the herd. This article describes an approach to risk‐based control of paratuberculosis in dairy herds.
Decision making in the management cruciate disease in dogs
Authors: Corr Sandra
Published: October 2010

CRANIAL cruciate ligament rupture is one of the most common orthopaedic conditions seen in dogs. In addition to the obvious welfare considerations to the animal, the financial burden on pet owners can be considerable — an estimated US$1.32 billion was spent treating this condition in the USA in 2003. There are a number of surgical options available to manage cruciate disease and new procedures continue to be developed, all of which have advantages and disadvantages, with different reported success rates. The decision regarding the best procedure to employ for a particular case therefore remains a dilemma for many practitioners. This article reviews the current literature on cruciate disease and discusses how this might be applied by veterinary surgeons to provide evidence‐based recommendations to their clients.
Ultrasonography of the urogenital tract in dogs and cats
Authors: Webster Natalie
Published: October 2010

ULTRASONOGRAPHIC examination of the urogenital tract is a routine procedure in veterinary medicine. It may be performed in most patients without sedation and can give valuable anatomical and pathological information. Patient preparation, transducer selection and correct adjustment of the machine settings are vital in optimising an ultrasound examination. The patient's fur should be clipped, the skin cleaned and liberal amounts of acoustic gel applied to ensure good contact between the transducer and the patient. This article describes how to conduct an ultrasound examination of the different organs of the urogenital tract and, for each region, outlines normal and abnormal findings, with case examples.
Skin disease in rabbits
Authors: Sant Rachel , Rowland Mark
Published: October 2010

RABBITS are the third most commonly owned pet in the UK and skin disease represents a significant problem in this species. The general approach to skin disease in rabbits is similar to that in dogs and cats, and includes obtaining a full history and conducting a clinical examination, followed by a variety of diagnostic tests, depending on the clinical signs. This article describes the skin conditions frequently reported in pet rabbits and discusses how they may be diagnosed and managed.
Using audit to improve clinical effectiveness
Authors: Viner Bradley
Published: October 2010

CLINICAL audit is a useful method of measuring and improving clinical effectiveness. In 2005, Bradley Viner examined the process as part of his Masters degree course in veterinary general practice and shared some of his findings (In Practice, 2005, vol 27, pp 215‐218). He went on to research its application for his PhD, establishing an MSc group to assist with the process. Here, he provides an update gleaned from the results of his research and the work of the group.
Introduction to raptor management and husbandry
Authors: Stanford Michael
Published: October 2010

FALCONRY is defined as the pursuit of wild quarry in its natural environment using a trained bird of prey. There has been a dramatic upsurge of interest in this sport in the UK over the past 30 years, with raptors being kept for educational, demonstration or conservation purposes in private collections, and for vermin control on airfields and landfill sites, and in city centres and sports stadiums. A wealth of anecdotal and practical literature associated with the health of raptors has been published worldwide, and as the popularity of the sport has grown, veterinary input, including the emergence of scientific peer‐reviewed information, has dramatically increased. Falconers are potentially the most well‐informed clients seeking veterinary advice and consider their birds to be highly trained athletes. To gain their confidence, a clinician must endeavour to understand the complex bewildering language that surrounds the sport, as well as the management practices of the hobby. Once the principles of falconry are understood, veterinary work with raptors can be incredibly rewarding. This article provides an introduction to these birds, giving details of their husbandry and training, and describes how to perform a clinical examination.
Haematology and biochemistry in alpacas and llamas
Authors: Foster Aiden , Bidewell Cornelia , Barnett James , Sayers Robin
Published: October 2010

SOUTH American camelids – especially alpacas – are growing in numbers and popularity in the UK as sources of fibre. They are also kept for breeding and as pets. Previous studies of clinical biochemistry and haematology values have been reported from Australia, Germany, North America and Switzerland. The population sizes of some of these studies have been small, and the analytes determined have varied; in addition, there is an assumption that mean and reference interval values for llamas are equally valid for alpacas. However, differing management systems internationally may not allow easy comparison between these studies and clinical pathology values for camelids in the UK. This article provides haematological and biochemical parameters for alpacas and llamas using reference intervals derived from published literature and data drawn from animals of known health status sampled in the UK. It also highlights which parameters may be useful for assessing camelid health and disease status. However, the relationship between biochemical analytes, especially trace elements, and reproductive performance and various disease processes, including those affecting the central nervous system and the skin, have yet to be determined and require further investigation.
Seeing practice through clients' eyes
Authors: Tiffin Ross
Published: October 2010

WHILE clinical procedures are monitored closely for quality control, non‐clinical services that also contribute heavily towards client satisfaction are often neglected. Ross Tiffin suggests ways of putting yourself in the clients' shoes in order to provide the best possible service.
Evidence‐based veterinary medicine: new graduates' perspectives
Authors: Spoor Laura , Priestnall Simon , Claridge Jen , Dustan Ben , Reed Stephanie
Published: October 2010

IN October 2008, Sally Everitt looked at how evidence‐based medicine could be integrated into veterinary practice (In Practice, vol 30, pp 526‐528). Here, five veterinary graduates who have undertaken an intercalated degree comment on the use of evidence‐based medicine in veterinary practice.
Increasing client footfall
Authors: Lambert Alison
Published: October 2010

ANY successful business depends on keeping its customers happy, as well as bringing in new ones, and veterinary practices are no exception. However, says Alison Lambert, recruiting new clients is particularly important in the veterinary sector, where the market demographics mean that existing client numbers are naturally decreasing each year. Here, she suggests ways of ensuring that clients continue to visit the practice on a regular basis.
In the public eye: supervising at events
Authors: Jackson Rob
Published: October 2010

THERE exists outside of the usual veterinary workplace environments a whole world of fascinating opportunities for interactions between vets, animals, owners and spectators. It is perhaps the presence of this last party that provides the potential for the greatest challenge of veterinary work in the public eye. In this article, Rob Jackson outlines factors to consider when preparing for the role of supervising veterinary surgeon at public events.
Is best interests a relevant decision making standard for enrolling non-capacitated subjects into clinical research?
Authors: Berger Jeffrey T
Published: October 2010

The ‘best interests’ decision making standard is used in clinical care to make necessary health decisions for non-capacitated individuals for whom neither explicit nor inferred wishes are known. It has been also widely acknowledged as a basis for enrolling some non-capacitated adults into clinical research such as emergency, critical care, and dementia research. However, the best interests standard requires that choices provide the highest net benefit of available options, and clinical research rarely meets this criterion. In the context of modern norms of bioethics, the best interests standard rarely supports surrogate consent for research and should not be accepted as a routine provision.
Ethics in systematic reviews
Authors: Vergnes Jean-Noel , Marchal-Sixou Christine , Nabet Cathy , Maret Delphine , Hamel Olivier
Published: October 2010

Since its introduction by the Nuremberg Code and the Declaration of Helsinki, the place held by ethics in biomedical research has been continuously increasing in importance. The past 30 years have also seen exponential growth in the number of biomedical articles published. A systematic review of the literature is the scientific way of synthesising a plethora of information, by exhaustively searching out and objectively analysing the studies dealing with a given issue. However, the question of ethics in systematic reviews is rarely touched upon. This could lead to some drawbacks, as systematic reviews may contain studies with ethical insufficiencies, may be a possible way to publish unethical research and may also be prone to conflict of interest. Finally, informed consent given for an original study is not necessarily still valid at the systematic review level. There is no doubt that routine ethical assessment in systematic reviews would help to improve the ethical and methodological quality of studies in general. However, ethical issues change so much with time and location, and are so broad in scope and in context that it appears illusory to search for a universal, internationally accepted standard for ethical assessment in systematic reviews. Some simple suggestions could nevertheless be drawn from the present reflection and are discussed in the paper.
Medical surveillance programme for diisocyanate exposure
Authors: Labrecque Manon , Malo Jean-Luc , Alaoui Khadija M , Rabhi Khalil
Published: October 2010

Objectives

Surveillance programmes for occupational asthma should reduce the severity of asthma both at the time of diagnosis and after removal from exposure as well as costs related to functional impairment. The aim of this study was to compare the severity and cost of diisocyanate-induced occupational asthma in workers participating in a surveillance programme and in twice the number of workers diagnosed after being referred by their physician.

Methods

Answers to a self-administered questionnaire led to possible referral for further assessment that included methacholine testing and specific inhalation challenges as the gold standard for confirming occupational asthma.

Results

Of the 2897 workers who participated, 182 (6.3%) had a positive questionnaire. 79/182 (43%) were referred for further medical assessment and 20 had confirmed occupational asthma by specific inhalation testing. At the time of diagnosis, the 20 screened subjects had a mean PC20of 3.35 mg/ml as compared to 1.50 mg/ml (p=0.05) in the 66 controls. Two years after diagnosis and removal from exposure, the 20 subjects screened had a mean PC20of 4.81 mg/ml compared to 1.67 mg/ml (p=0.03) in controls. Clinical remission occurred in 34% of the screened group compared to 16% of the control group (p=0.02). The median costs for functional impairment were $C11 900 in screened subjects and $C19 600 in controls (p=0.04).

Conclusions

Subjects with occupational asthma screened by a medical surveillance programme have a better outcome both at the time of diagnosis and 2 years after removal from exposure, with lower compensation costs compared to controls.
Traffic-related air pollution and incident asthma in a high-risk birth cohort
Authors: Carlsten Chris , Dybuncio Anne , Becker Allan , Chan-Yeung Moira , Brauer Michael
Published: October 2010

Objectives

The risk of incident asthma and bronchial hyper-reactivity associated with early life exposure to traffic-related air pollution has not been fully elucidated. We aimed to evaluate the hypothesis that the risk of new onset asthma is positively associated with early exposure to traffic-related air pollution in a well-characterised high-risk birth cohort.

Methods

Infants at high-risk for asthma were recruited for an intervention study. Birth year exposures to NO, NO2, black carbon and PM2.5were estimated by land use regression. At 7 years of age, asthma was assessed by a paediatric allergist and bronchial hyper-reactivity was measured by methacholine challenge. Associations between exposures and outcomes were analysed by stepwise multiple logistic regression, adjusted for potential confounding variables.

Results

Exposure estimates were available for 184 children; 23 were diagnosed with asthma and 68 with bronchial hyper-reactivity. The IQR (4.1 μg/m3) of birth year PM2.5was associated with a significantly increased risk of asthma (OR 3.1, 95% CI 1.3 to 7.4) and with a trend to increased risk of bronchial hyper-reactivity. Similar findings were noted in association with NO and NO2, while black carbon did not appear to confer increased risk.

Conclusion

Modest elevations in exposure to some traffic-related air pollutants during the year of birth are associated with new onset asthma assessed at age 7. That significant associations were revealed in spite of a limited sample size emphasises the strengths of a high-risk birth cohort model, along with individual air pollution exposure estimates and well-characterised data on covariates and outcomes.
Exposure to brominated trihalomethanes in drinking water and reproductive outcomes
Authors: Patelarou Evridiki , Kargaki Sophia , Stephanou Euripides G , Nieuwenhuijsen Mark , Sourtzi Panayota , Gracia Esther , Chatzi Leda , Koutis Anthonis , Kogevinas Manolis
Published: October 2010

Objectives

Exposure to disinfection by-products (DBPs) during pregnancy has been associated with adverse birth outcomes. We evaluated exposure to DBPs through ingestion, inhalation and dermal absorption among pregnant women in Crete, in relation to birth weight and gestational age.

Methods

The mother–child birth cohort in Crete (‘Rhea’ study) enrolled 1359 pregnant women at the third month of pregnancy (2007–2008), residents in the prefecture of Heraklion. Exposures were assessed through three questionnaires administered during pregnancy requesting extensive information on personal water-related habits. Tap water samples were collected in representative mother homes on the basis of detailed water distribution patterns, and were analysed for major DBPs including trihalomethanes (THMs). Logistic and linear regression models were applied.

Results

Pregnant women reported a high consumption of bottled water at home (76%) and work (96%). More than half the women (59%) washed dishes by hand, nearly all women (94%) took showers rather than baths (1%), and only 2% attended a swimming pool. THM levels were low (<20 μg/l) with a high proportion of brominated compounds. When using quantitative estimates of residential exposure, we found no association with low birth weight (LBW, OR 0.7, 95% CI 0.4 to 1.4), small for gestational age for weight (SGAweight, OR 1.1, 95% CI 0.6 to 2.2) and preterm delivery (OR 0.8, 95% CI 0.5 to 1.3). Similar results were observed when taking into account uptake of THMs through all exposure routes.

Conclusions

We found no evidence for an increased risk of LBW, SGA and preterm delivery at the relatively low level exposure to THMs and particularly brominated THMs in Cretan drinking water.
Cohort mortality study of workers at seven beryllium processing plants: update and associations with cumulative and maximum exposure
Authors: Schubauer-Berigan Mary K , Couch James R , Petersen Martin R , Carreón Tania , Jin Yan , Deddens James A
Published: October 2010

Objectives

To extend follow-up of cause-specific mortality in workers at seven beryllium processing plants and to estimate associations between mortality risk and beryllium exposure.

Methods

9199 workers were followed for mortality from 1940 through 2005. Standardised mortality ratios (SMRs) were estimated based on US population comparisons for lung, nervous system and urinary tract cancers, chronic obstructive pulmonary disease (COPD), chronic kidney disease, and categories containing chronic beryllium disease (CBD) and cor pulmonale. Associations with maximum and cumulative exposure were calculated for a subset of the workers.

Results

Overall mortality in the cohort compared with the US population was elevated for lung cancer (SMR 1.17; 95% CI 1.08 to 1.28), COPD (SMR 1.23; 95% CI 1.13 to 1.32), and the categories containing CBD (SMR 7.80; 95% CI 6.26 to 9.60) and cor pulmonale (SMR 1.17; 95% CI 1.08 to 1.26). Mortality rates for most diseases of interest increased with time-since-hire. For the category including CBD, rates were substantially elevated compared to the US population across all exposure groups. Workers whose maximum beryllium exposure was ≥10 μg/m3had higher rates of lung cancer, urinary tract cancer, COPD and the category containing cor pulmonale than workers with lower exposure. Significant positive trends with cumulative exposure were observed for nervous system cancers (p=0.0006) and, when short-term workers were excluded, lung cancer (p=0.01), urinary tract cancer (p=0.003) and COPD (p<0.0001).

Conclusion

These findings reaffirm that lung cancer and CBD, and suggest that COPD and nervous system and urinary tract cancers, are related to beryllium exposure. Cigarette smoking and exposure to other lung carcinogens are unlikely to explain these elevations.
Should glycated haemoglobin (HbA1c) be used to detect people with type 2 diabetes mellitus and impaired glucose regulation?
Authors: Mostafa Samiul A , Davies Melanie J , Srinivasan Balasubramanian Thiagarajan , Carey Marian E , Webb David , Khunti Kamlesh
Published: October 2010

There is a need to simplify screening tests for type 2 diabetes mellitus (T2DM) so patients can be identified earlier and more efficiently. Glycated haemoglobin (HbA1c) has been recommended by some international organisations as a diagnostic tool for detecting T2DM and impaired glucose regulation (IGR, also termed prediabetes and includes impaired fasting glucose and/or impaired glucose tolerance). The HbA1c cut-point of ≥6.5% (48 mmol/mol) has been selected as diagnostic for T2DM, while the cut-points for IGR are debated by the different international organisations: an International Expert Committee has suggested using HbA1c 6.0–6.4% (42–46 mmol/mol); however, the American Diabetes Association has recommended using HbA1c 5.7–6.4% (39–46 mmol/mol). Some countries will adopt a new method of reporting HbA1c values in millimoles per mole (mmol/mol). Use of HbA1c has some logistical advantages over using an oral glucose tolerance test (OGTT). As patients do not need to fast, appointments do not need to be limited to the morning. The HbA1c result reflects longer term glycaemia and is less affected by recent physical/emotional stress. However, there is some debate as to whether HbA1c should replace fasting plasma glucose or the OGTT. As the two tests detect different people, some individuals with diabetes detected on OGTT will no longer be classified as having T2DM using HbA1c ≥6.5% criteria. Furthermore, some medical conditions can result in HbA1c assay measurements not reflecting glycaemic control over the last 2–3 months; these include haematological disorders, renal failure, and chronic excess alcohol consumption.
Right ventricular myocardial infarction: pathophysiology, diagnosis, and management
Authors: Kakouros Nicholaos , Cokkinos Dennis V
Published: October 2010

Right ventricular (RV) ischaemia complicates up to 50% of inferior myocardial infarctions (MIs), though isolated RV myocardial infarction (RVMI) is extremely rare. Although the RV shows good long term recovery, in the short term RV involvement portends a worse prognosis to uncomplicated inferior MI, with haemodynamic and electrophysiologic complications increasing in-hospital morbidity and mortality. Acute RV shock has an equally high mortality to left ventricular (LV) shock. Identification of RV involvement, particularly in the setting of hypotension, can help anticipate and prevent complications and has important management implications which are distinct from the management of patients presenting with LV infarction. Reperfusion therapy, particularly by primary percutaneous coronary intervention, hastens and enhances RV functional recovery that occurs to near normality in most patients. The diagnostic methods for RVMI are discussed, including clinical, electrocardiographic, and various imaging modalities as well as the RV pathophysiology that underpins the specifics of RVMI management.
Relationship between the Chinese tobacco industry and academic institutions in China
Authors: Gan Quan , Glantz Stanton A
Published: October 2010

Objective

To investigate the relationship between the Chinese tobacco industry and academic institutions in China.

Methods

We searched online databases of journal articles published in both Chinese and English for academic institutions in China conducting research with or sponsored by Chinese tobacco companies. We also searched the websites of tobacco companies, their affiliated institutions and academic institutions for reports of collaborations.

Results

The Chinese tobacco industry, in addition to its own strong tobacco research capacity, maintains close ties with an extensive network of academic research institutions and universities to provide both research and training. The Chinese tobacco industry relies heavily upon academic researchers to advance its research agenda and such reliance has grown over time. Most research deals with farming, manufacturing and management issues, but research on ‘reduced harm’ and health effects has increased from 1% of projects in 1983–1987 to 4% in 2003–2007.

Conclusions

Chinese academic institutions should consider the fact that engagement with the tobacco industry, particularly on issues related to health or promotion of tobacco products, could damage their reputations, a concern that has led many leading Western universities to eschew relationships with the tobacco industry. To the extent that the Chinese tobacco industry's involvement in academic institutions affects tobacco control policy making; it violates Article 5.3 of Framework Convention on Tobacco Control, which China ratified in 2005.
Health consequences of pipe versus cigarette smoking
Authors: Tverdal Aage , Bjartveit Kjell
Published: October 2010

Objectives

To estimate the risk of dying from all causes and from specified smoking-related diseases in men who were exclusive daily pipe smokers at two consecutive examinations, and in men who switched from smoking cigarettes only to pipe only.

Design

A prospective cohort study.

Setting

Three counties in Norway.

Participants

16 932 men, aged 20–49, screened for cardiovascular disease risk factors in the mid-1970s, re-screened after 3–13 years, and followed throughout 2007.

Outcomes

Absolute mortality and relative risks adjusted for confounding variables, of dying from all causes and ischaemic heart disease, stroke, cardiovascular disease, lung cancer and other smoking-related cancer.

Results

Altogether, the men were observed for 403 327 years, and during the observation period, 4933 deaths occurred. With sustained never smokers as reference, the sustained smokers of a pipe only had adjusted relative risk (95% CI), of dying from any cause that was 1.99 (1.73 to 2.27). At comparable tobacco consumption, no significant difference in risk between pipe and cigarette smokers appeared. As to survival, no difference was found between sustained smokers of a pipe only and of cigarettes only. Men who switched from cigarettes only to pipe only had a risk which was not significantly different from the risk in sustained smokers of cigarettes only.

Conclusions

Between pipe and cigarette smokers, no or only minor differences were found in mortality from any cause and the specified smoking-related diseases. Pipe smoking is not safer than cigarette smoking.
A FAST VISUAL GREEDY SPARSE APPROXIMATION VIA IMPROVED LEARNED DICTIONARY
Authors: Yi Xueneng , Cao Hanqiang
Published: October 2010

Orthogonal Matching Pursuit (OMP) is an effective solution to sparse approximation based on redundant dictionary, but there are plenty of matrix-vector multiplications in order to seek for the most matching atom. This full search scheme can consume much CPU time, especially for high dimension data such as image. Although some existing schemes proposed some accelerating methods by exploiting the property of atoms in parametric dictionary, they cannot be extended to other dictionaries, especially learned dictionary. Considering statistical nature of atoms in learned dictionary, this paper proposes a novel method which utilizes modified K-mean algorithm to cluster all the atoms in the learned dictionary while sufficiently considering the inner product operation between every two atoms, determines the class in which the desired atom locates and finally find it in the class. Some analyses and experiments have shown the success of the method. In addition, this paper gives some empirical analysis of the effect of related parameters of indexed dictionary.
Detrital heavy minerals, white mica and zircon geochronology in the Ordovician South Mayo Trough, western Ireland: signatures of the Laurentian basement and the Grampian orogeny
Authors: Mange Maria , Idleman Bruce , Yin Qing-Zhu , Hidaka Hiroshi , Dewey John
Published: October 2010

The Ordovician strata of the South Mayo Trough in western Ireland were deposited as a conformable sequence, first in the forearc of a north-facing oceanic arc, then in a synorogenic basin above the arc–continent collisional Grampian orogen, then in an extensional hanging-wall basin above the exhuming Dalradian metamorphic complex and, finally, in an Andean-type margin successor basin. This depositional history, and its relationship to the Grampian orogeny, to the pre- and post-collision arcs, and to sources in the Laurentian foreland, is recorded in detrital heavy mineral suites, Ar/Ar ages of detrital white micas, and U–Pb ages of detrital zircons. Heavy minerals record the progressive extensional unroofing of an obducted ophiolite complex, then the rapid extensional unroofing of the Grampian Dalradian metamorphic complex. White mica ages give Neoproterozoic, Mesoproterozoic, and Neoarchaean ages in the lower part of the sequence then, at about 466 Ma, synchronously with the appearance of amphibolite-facies metamorphic detritus, a tightly unimodal Grampian metamorphic age. Zircons yield mainly Mesoproterozoic and Neoarchaean ages, indicating a Laurentian source, and a Grampian age of 460–468 Ma. Paralleling the appearance of Grampian-age micas, the colour of zircon changes from dominantly purple to dominantly colourless, reflecting the thermal annealing effect of metamorphism. However, the temperature of Grampian metamorphism was not high enough to reset the U–Pb isotopic systematics of detrital zircons.
Vestige of an Early Cambrian incipient oceanic crust incorporated in the Variscan orogen: Letovice Complex, Bohemian Massif
Authors: Soejono Igor , Žáčková Eliška , Janoušek Vojtĕch , Machek Matĕj , Košler Jan
Published: October 2010

The Letovice Complex, composed of metamorphosed enriched mid-ocean ridge basalts with trondhjemitic sheets, as well as gabbroic and ultrabasic bodies, is exposed within an important Variscan suture separating the Moldanubian Domain (to the west) from the Brunovistulicum (to the east) in the eastern part of the Bohemian Massif, Czech Republic. A polyphase tectonic evolution of the study area was connected with underthrusting and subsequent exhumation of the former oceanic realm, which resulted in three deformation phases (D
1
–D
3
). New U–Pb laser ablation inductively coupled plasma mass spectrometry dating of magmatic zircons from amphibolite and trondhjemite yielded statistically identical concordia ages of 530 ± 6 Ma and 529 ± 7 Ma (2σ), respectively. These are interpreted as dating intrusions of the Early Cambrian protoliths of the studied rocks. Based on this age as well as whole-rock geochemical and Nd isotopic data, the Letovice Complex is interpreted as a vestige of an incipient oceanic basin developing on attenuated crust. The most likely geotectonic setting was a post-Cadomian extensional regime at the northern margin of Gondwana that marked the onset of its break-up.

Supplementary material:

Photomicrographs of microstructures, sample locations, descriptions of analytical techniques, and selected electron microprobe analyses of the main rock-forming minerals are available at
http://www.geolsoc.org.uk/SUP18424
.
Pyritic and baritic burrows and microbial filaments in postglacial lacustrine clays in the northern Baltic Sea
Authors: Virtasalo Joonas J. , Löwemark Ludvig , Papunen Heikki , Kotilainen Aarno T. , Whitehouse Martin J.
Published: October 2010

Holocene postglacial lacustrine clays in the northern Baltic Sea were studied for ichnofossils, petrography, and microscale elemental and
34
S/
32
S composition to understand the impact of benthos-produced organic matrices on the early diagenesis of sediments. X-radiographs of these clays display intense burrow mottling with discrete
Palaeophycus
, ‘Mycellia' and rare
Arenicolites
. Small burrow-like and irregularly shaped concretions were separated from these clays. The burrow-like concretions are composed of framboidal pyrite and poorly crystalline FeS
2
cement. They formed within worm-produced burrows by the decomposition of mucous coatings on the burrow walls by sulphate reduction. δ
34
S
CDT
composition of the framboids indicates saline inflows from the North Sea as the sulphate source. The irregular concretions are microcrystalline pyritic masses that formed in pore spaces with less reactive organic compounds. Their δ
34
S
CDT
values reflect precipitation from the ambient porewater sulphate by sulphate reduction. The burrow-like and irregular concretions are microcrystalline barite in the lower parts of the clays. ‘Mycellia' are mineral-replaced filaments produced by large sulphur-oxidizing bacteria or mycelial fungi. They concentrate in monosulphide bands in the lower substrate levels, but are associated with organic patches upward. This study demonstrates that substantial amounts of pyrite formed within organic matrices close to the sediment–water interface. This differs from previous studies that proposed a deeper-burial origin and allochthonous sulphur source.

Supplementary material:

Sulphur isotope data are available at
http://www.geolsoc.org.uk/SUP18426
.
Testing rival tectonic uplift models for the Lechaion Gulf in the Gulf of Corinth rift
Authors: Turner J.A. , Leeder M.R. , Andrews J.E. , Rowe P.J. , Van Calsteren P. , Thomas L.
Published: October 2010

The Gulf of Corinth, central Greece, is a rapidly extending continental rift, the eastern part of which bifurcates into the active northern Alkyonides Gulf and the southern Lechaion Gulf. The Lechaion Gulf is considered an inactive relict of early rifting, yet the presence of late Quaternary shorelines is evidence of continuing uplift of the north, east and south margins of this basin. Models to explain uplift include uplift on the footwall of the southern Alkyonides Gulf fault system and the Xylocastro–Perachora faults or ‘regional' isostatic uplift independent of fault slip. These models are tested by comparing predicted spatial uplift trends with those observed. Uplift rates since Marine Isotope Stage 7 of 0.31 ± 0.04 mm a
−1
on the Lechaion Gulf north coast are explained as displacement on the footwall of active faults. However, the south coast uplift cannot be explained by footwall uplift and is evidence for isostatic uplift that probably affects the whole of the southern Gulf of Corinth rift. Isostatic uplift rates of 0.22 ± 0.01 mm a
−1
at the Corinth canal increase westward towards the mouth of the Lechaion Gulf where it meets the modern rift, the Gulf of Corinth.

Supplementary material:

Details of Holocene marine notches that identify raised shorelines from exposures on the southern Perachora peninsula between Heraion and Loutraki, and of the cumulative displacement of sequences by minor faults on the Isthmus, exposed in the Corinth canal walls, are available at
http://www.geolsoc.org.uk/SUP18429
.