bluuebunny/crossref_metadata_2025 huggingface dataset:
A timing mechanism for stem cell maintenance and differentiation in the Arabidopsis floral meristem
Authors: Sun Bo , Xu Yifeng , Ng Kian-Hong , Ito Toshiro
Published: August 2009

Developmental regulation of the floral meristem ensures that plants of the same species have similarly sized flowers with a fixed number of floral organs. The maintenance of stem cells in the floral meristem is terminated after the production of a fixed number of floral organ primordia. Precise repression of the Arabidopsis thaliana homeobox gene WUSCHEL (WUS) by the floral homeotic protein AGAMOUS (AG) plays a major part in this process. Here we show that KNUCKLES (KNU) mediates the repression of WUS in floral meristem determinacy control. AG directly induces the transcription of KNU, which encodes a C2H2-type zinc finger protein with a conserved transcriptional repression motif. In turn, KNU represses WUS transcription to abolish stem cell activity. We also show that the timing of KNU induction is key in balancing proliferation and differentiation in flower development. Delayed KNU expression results in an indeterminate meristem, whereas ectopic KNU expression prematurely terminates the floral meristem. Furthermore, KNU induction by AG is preceded by changes in repressive histone modification at the KNU locus, which occurs in an AG-dependent manner. This study provides a mechanistic link between transcriptional feedback and epigenetic regulation in plant stem cell proliferation.
A terminator of floral stem cells: Figure 1.
Authors: Ming Feng , Ma Hong
Published: August 2009

Normal flower development requires the termination of stem cell activities in the floral meristem. The floral regulator AGAMOUS (AG) is necessary for this termination and represses the expression of the stem cell determinant WUSCHEL (WUS), but the repression mechanism was not clear. A recent study by Sun and colleagues (pp. 1791–1804) in this issue of Genes & Development has identified a direct target of AG, KNUCKLES (KNU), which encodes a transcriptional repressor of WUS, providing a key missing link in floral meristem determinacy.
Bar the windows: an optimized strategy to survive drought and salt adversities
Authors: Song Xian-Jun , Matsuoka Makoto
Published: August 2009

Hydrogen peroxide (H2O2) is a central modulator of stomatal closure. It remains unknown, however, how the upstream regulation of H2O2 homeostasis operates. In this issue of Genes & Development, Huang and colleagues (pp. 1805–1817) report that a novel C2H2-type transcription factor, drought and salt tolerance (DST), mediates H2O2-induced stomatal closure and abiotic stress tolerance.
The Red Flour Beetle, Tribolium castaneum (Coleoptera): A Model for Studies of Development and Pest Biology: Figure 1.
Authors: Brown Susan J. , Shippy Teresa D. , Miller Sherry , Bolognesi Renata , Beeman Richard W. , Lorenzen Marcé D. , Bucher Gregor , Wimmer Ernst A. , Klingler Martin
Published: August 2009

INTRODUCTION

Tribolium castaneum is a small, low-maintenance beetle that has emerged as a sophisticated model system for studying the evolution of development and that complements (in some cases, even rivals) Drosophila for functional genetic analysis of basic biological questions. Although Tribolium and Drosophila are both holometabolous insects, they differ fundamentally in larval and adult morphology. Even generally conserved developmental features, such as body segmentation, are achieved by quite different means. Thus, comparison of developmental mechanisms between these two insects can address many interesting questions concerning the evolution of morphology and other characters. Genetic tools available for Tribolium include genetic maps for visible and molecular markers, chromosomal rearrangements that enable lethal mutations to be balanced in true-breeding stocks, transposon-based transformation systems, a completed and annotated genome sequence, and systemic RNA interference (RNAi), which makes it possible to knock down any given gene and even particular splice variants in the offspring or in any tissue of the injected animal. Inactivating gene functions at various developmental stages provides new opportunities to investigate post-embryonic development, as well as larval and adult physiology, including hormonal control, host-parasite interactions, and pesticide resistance.
Ambystoma mexicanum, the Axolotl: A Versatile Amphibian Model for Regeneration, Development, and Evolution Studies
Authors: Voss S. Randal , Epperlein Hans H. , Tanaka Elly M.
Published: August 2009

INTRODUCTION

Adult salamanders are best known for their capacity to regenerate an astounding range of body structures including the whole limb and tail, the central nervous system, and tissues of the eye and heart. The axolotl (Ambystoma mexicanum) represents the salamander species that is most easily bred in the laboratory, and for which the most comprehensive genetic, genomic, and transgenesis tools have been developed. As such, it serves as an important vertebrate model for studying regeneration and tissue repair. Beyond regeneration, axolotls have a deep and rich history as primary amphibian models, especially in research areas concerning embryonic development--most notably the inductive mode of germ cell formation. The easily obtained oocytes, high quantities of embryos produced by each spawning, large size of the embryo, and ability to graft tissues from individual to individual at any stage without rejection make the axolotl an advantageous model system for the study of development, electrophysiology, and regeneration.
Concurrent In Situ Hybridization and Antibody Staining in Red Flour Beetle (Tribolium) Embryos
Authors: Shippy Teresa D. , Coleman Cassondra M. , Tomoyasu Yoshinori , Brown Susan J.
Published: August 2009

INTRODUCTION

The red flour beetle, Tribolium castaneum, has emerged as an important model system for studying the evolution of development. Studies with Tribolium complement the vast amount of research done with Drosophila. Developmental features that are conserved between Drosophila and Tribolium, such as body segmentation, are achieved by quite different means, and thus comparison of developmental mechanisms between these two insects can address many interesting questions concerning the evolution of morphology and other characters. Most in situ and antibody staining protocols used for Tribolium have been adapted from Drosophila studies, and to date, few antibodies have been raised specifically against Tribolium antigens. Whole-mount in situ hybridization allows detection of mRNA expression patterns, while immunohistochemical staining detects protein expression patterns. This protocol allows both procedures to be performed concurrently in the same Tribolium embryo. Such double staining is particularly useful for comparing the expression pattern of a new gene to that of a known protein.
In Situ Hybridization of Large Milkweed Bug (Oncopeltus) Tissues
Authors: Liu Paul , Kaufman Thomas C.
Published: August 2009

INTRODUCTION

In this protocol, double-label in situ hybridization of large milkweed bug (Oncopeltus) embryos is performed using labeled probes. Dual antibody staining is followed by detection with two different chromagens.
Grafting Axolotl (Ambystoma mexicanum) Limb Skin and Cartilage from GFP+ Donors to Normal Hosts
Authors: Kragl Martin , Tanaka Elly M.
Published: August 2009

INTRODUCTION

A remarkable property of axolotls (Ambystoma mexicanum) is their amenability to grafting at any stage of the life cycle. In addition to the ease of transplantation in embryonic axolotls, the graftability of tissues extends to larval, juvenile, and adult tissues. Amazingly, there seems to be no rejection of tissue grafts from individual to individual. Grafting techniques have been important for studying tissue contributions to the blastema and other cellular aspects of blastema formation, growth, and patterning. This protocol describes grafting of axolotl limb skin and cartilage from green fluorescent protein (GFP)+ donors to normal hosts.
Axolotl (Ambystoma mexicanum) Limb and Tail Amputation
Authors: Kragl Martin , Tanaka Elly M.
Published: August 2009

INTRODUCTION

Appendage regeneration is a well-known and well-studied trait in salamanders including the axolotl (Ambystoma mexicanum). Depending on the size of the animal, functional regeneration of the limb or tail can occur within 3 wk (in 2-cm-long animals) to several months (in >10-cm-long animals). After appendage amputation, epithelial wound healing is followed by formation of a progenitor cell zone called the blastema that first undergoes expansion and then morphogenesis and differentiation to replace the appendage. To obtain reproducible, morphologically perfect regeneration, it is important to cut the appendage so that the wound site is evenly open over its surface. This allows cells from the basal layer of the surrounding epidermis to crawl over the cut end. This protocol describes limb amputation in 3- to 5-cm and 5- to 8-cm axolotls, as well as tail amputation in 3- to 8-cm axolotls.
Induction of Metamorphosis in Axolotls (Ambystoma mexicanum)
Authors: Page Robert B. , Voss S. Randal
Published: August 2009

INTRODUCTION

The Mexican axolotl (Ambystoma mexicanum) follows a very different pattern of development from other closely related tiger salamanders. Whereas many tiger salamanders undergo an obligatory metamorphosis, axolotls rarely if ever transform in the lab. As a consequence, axolotls retain larval features into adulthood and therefore require aquatic husbandry procedures throughout life. However, it is possible to induce metamorphosis in axolotls by simply adding thyroid hormone to the rearing water. If thyroid hormone is provided at an appropriate concentration and at a time during development that related tiger salamanders normally transform, healthy and robust terrestrial axolotls can be generated. The procedure is useful for studying molecular mechanisms of tissue-specific developmental programs that depend upon thyroid hormone. Also, because thyroid hormone brings about the maturation of tissues, the axolotl model can be used to study the molecular correlates of aging. Finally, the axolotl model can be used to study ecotoxicological factors that disrupt thyroid hormone signaling and tissue remodeling. The ability to precisely activate metamorphosis in the axolotl provides an advantage over anuran models that are always developing toward a metamorphic outcome. The protocol described here induces metamorphosis in axolotls using the less active form of thyroid hormone called T4 (tetraiodothyronine).
Dissection, Plating, and Maintenance of Cortical Astrocyte Cultures
Authors: Albuquerque Cristóvão , Joseph Donald J. , Choudhury Papiya , MacDermott Amy B.
Published: August 2009

INTRODUCTION

Survival of central nervous system neurons in culture is usually greatly improved if the neurons are plated on top of a layer of confluent astrocytes. Under these conditions, neurons attach more firmly and develop a more readily identifiable bidimensional neuritic tree than in culture conditions where primary cells are plated on top of collagen, laminin, or other cell-free substrates. Although dissociated cells from any central nervous system region will include astrocytes and other glia, these generally do not support the survival of the primary neurons as well as preplated astrocyte feeder layers. For example, plating dorsal root ganglion (DRG)/dorsal horn (DH) cocultures directly onto collagen or laminin results in a very low number of attached DH neurons, and those have stunted neurites. Furthermore, although a higher number of DRG neurons do attach without astrocytes, this attachment is weaker, as demonstrated by the tendency of those neurons (or at least their neurites) to blow off the coverslip when a local superfusion system is directed at them. Neonatal rat cortex provides abundant astrocytes that can be cultured readily. The protocol presented here selects for type I astrocytes that grow in a monolayer with contact inhibition.
A comparison of drug overdose deaths involving methadone and other opioid analgesics in West Virginia
Authors: Paulozzi Leonard J. , Logan Joseph E. , Hall Aron J. , McKinstry Edna , Kaplan James A. , Crosby Alexander E.
Published: August 2009

Aims  To describe all people dying from unintentional overdoses of methadone or other opioid analgesics (OOA) in West Virginia in 2006.

Design  We analyzed medical examiner data supplemented by data from the state prescription drug monitoring program. We compared people whose deaths involved methadone with those whose deaths involved OOA.

Findings  The methadone group included 87 decedents, and the OOA group included 163 decedents. Most were male. Decedents in the methadone group were significantly younger than those in the OOA group: more than a quarter were 18–24 years of age. For both groups, approximately 50% had a history of pain, and 80% had a history of substance abuse. There was no intergroup difference in the prevalence of benzodiazepines at post‐mortem. Methadone was significantly less likely to have ever been prescribed than OOA. Among those with prescriptions, the proportion prescribed within 30 days of death was significantly greater for methadone than for hydrocodone, but not for oxycodone. Ten (11.5%) of the methadone decedents were enrolled in an opiate treatment program (OTP) at the time of death.

Conclusions  The high prevalence of a substance abuse history and lack of prescriptions suggest that most of the deaths in both groups are related to substance abuse. There was no indication of a harmful effect from methadone's metabolic interaction with benzodiazepines, but provider or patient unfamiliarity with methadone may have been a risk factor. Prescribing methadone, especially to young males, requires extra care. Providers, OTPs and coroners/medical examiners should use state prescription drug monitoring programs to monitor the use of controlled substances by their patients.
Cognitive functioning in substance abuse and dependence: a population‐based study of young adults
Authors: Latvala Antti , Castaneda Anu E. , Perälä Jonna , Saarni Samuli I. , Aalto‐Setälä Terhi , Lönnqvist Jouko , Kaprio Jaakko , Suvisaari Jaana , Tuulio‐Henriksson Annamari
Published: August 2009

Aims  To investigate whether substance use disorders (SUDs) are associated with verbal intellectual ability, psychomotor processing speed, verbal and visual working memory, executive function and verbal learning in young adults, and to study the associations of SUD characteristics with cognitive performance.

Participants  A population‐based sample (n = 466) of young Finnish adults aged 21–35 years.

Measurements  Diagnostic assessment was based on all available information from a structured psychiatric interview (SCID‐I) and in‐ and out‐patient medical records. Established neuropsychological tests were used in the cognitive assessment. Confounding factors included in the analyses were comorbid psychiatric disorders and risk factors for SUDs, representing behavioural and affective factors, parental factors, early initiation of substance use and education‐related factors.

Findings  Adjusted for age and gender, life‐time DSM‐IV SUD was associated with poorer verbal intellectual ability, as measured with the Wechsler Adult Intelligence Scale–Revised (WAIS‐R) vocabulary subtest, and slower psychomotor processing, as measured with the WAIS‐R digit symbol subtest. Poorer verbal intellectual ability was accounted for by parental and own low basic education, whereas the association with slower psychomotor processing remained after adjustment for SUD risk factors. Poorer verbal intellectual ability was related to substance abuse rather than dependence. Other SUD characteristics were not associated with cognition.

Conclusions  Poorer verbal intellectual ability and less efficient psychomotor processing are associated with life‐time alcohol and other substance use disorders in young adulthood. Poorer verbal intellectual ability seems to be related to parental and own low basic education, whereas slower psychomotor processing is associated with SUD independently of risk factors.
Employment‐based abstinence reinforcement as a maintenance intervention for the treatment of cocaine dependence: a randomized controlled trial
Authors: DeFulio Anthony , Donlin Wendy D. , Wong Conrad J. , Silverman Kenneth
Published: August 2009

Context  Due to the chronic nature of cocaine dependence, long‐term maintenance treatments may be required to sustain abstinence. Abstinence reinforcement is among the most effective means of initiating cocaine abstinence. Practical and effective means of maintaining abstinence reinforcement programs over time are needed.

Objective  To determine whether employment‐based abstinence reinforcement can be an effective long‐term maintenance intervention for cocaine dependence.

Design  Participants (n = 128) were enrolled in a 6‐month job skills training and abstinence initiation program. Participants who initiated abstinence, attended regularly and developed needed job skills during the first 6 months were hired as operators in a data entry business and assigned randomly to an employment‐only (control, n = 24) or abstinence‐contingent employment (n = 27) group.

Setting  A non‐profit data entry business.

Participants  Unemployed welfare recipients who used cocaine persistently while enrolled in methadone treatment in Baltimore.

Intervention  Abstinence‐contingent employment participants received 1 year of employment‐based contingency management, in which access to employment was contingent upon provision of drug‐free urine samples under routine and then random drug testing. If a participant provided drug‐positive urine or failed to provide a mandatory sample, then that participant received a temporary reduction in pay and could not work until urinalysis confirmed recent abstinence.

Main outcome measure  Cocaine‐negative urine samples at monthly assessments across 1 year of employment.

Results  During the 1 year of employment, abstinence‐contingent employment participants provided significantly more cocaine‐negative urine samples than employment‐only participants [79.3% and 50.7%, respectively; P = 0.004, odds ratio (OR) = 3.73, 95% confidence interval (CI) = 1.60–8.69].

Conclusions  Employment‐based abstinence reinforcement that includes random drug testing is effective as a long‐term maintenance intervention, and is among the most promising treatments for drug dependence. Work‐places could serve as therapeutic agents in the treatment of drug dependence by arranging long‐term employment‐based contingency management programs.
Anxiety and depression among abstainers and low‐level alcohol consumers. The Nord‐Trøndelag Health Study
Authors: Skogen Jens Christoffer , Harvey Samuel B. , Henderson Max , Stordal Eystein , Mykletun Arnstein
Published: August 2009

Aims  The aim of this study was to examine the levels of anxiety and depression among individuals consuming low levels of alcohol.

Design  Prospective and cross‐sectional population‐based study.

Setting and participants  This study employed data from the Nord‐Trøndelag Health Survey (HUNT‐2, n = 38 930).

Measurements  Alcohol consumption was measured by self‐report of usual alcohol consumption during a 2‐week period. Low‐level alcohol consumption was defined as self‐reported abstainers and non‐abstainers currently consuming no alcohol. Anxiety and depression were measured using the Hospital Anxiety and Depression Rating Scale. Potential explanatory variables included somatic illness and symptoms, health‐related behaviour, socio‐economic status and social activity. In a subsample (n = 20 337), we also looked at the impact of previous heavy drinking among abstainers ('sick‐quitting').

Findings  A U‐shaped association between alcohol consumption and the risk of anxiety and depression was found. Abstention was related to increased odds for both case‐level anxiety [1.34, 95% confidence interval (CI) 1.19–1.52] and depression (1.52, 95% CI 1.30–1.77). This association was accounted for partly by adjustments for socio‐economic status, social network, somatic illness, age (depression only), gender (anxiety only) and ‘sick‐quitting’. We also identified significant differences between participants who label themselves as abstainers compared to those who report no usual alcohol consumption, but who do not label themselves as abstainers.

Conclusions  The risk of case‐level anxiety and depression is elevated in individuals with low alcohol consumption compared to those with moderate consumption. Individuals who label themselves as abstainers are at particularly increased risk. This increased risk cannot fully be explained by somatic illness, social activity or ‘sick‐quitting’.
The pathogenicity determinant of Citrus tristeza virus causing the seedling yellows syndrome maps at the 3′‐terminal region of the viral genome
Authors: ALBIACH‐MARTI MARIA R. , ROBERTSON CECILE , GOWDA SIDDARAME , TATINENI SATYANARAYANA , BELLIURE BELÉN , GARNSEY STEPHEN M. , FOLIMONOVA SVETLANA Y. , MORENO PEDRO , DAWSON WILLIAM O.
Published: August 2009

Citrus tristeza virus (CTV) (genus Closterovirus, family Closteroviridae) causes some of the more important viral diseases of citrus worldwide. The ability to map disease‐inducing determinants of CTV is needed to develop better diagnostic and disease control procedures. A distinctive phenotype of some isolates of CTV is the ability to induce seedling yellows (SY) in sour orange, lemon and grapefruit seedlings. In Florida, the decline isolate of CTV, T36, induces SY, whereas a widely distributed mild isolate, T30, does not. To delimit the viral sequences associated with the SY syndrome, we created a number of T36/T30 hybrids by substituting T30 sequences into different regions of the 3′ half of the genome of an infectious cDNA of T36. Eleven T36/T30 hybrids replicated in Nicotiana benthamiana protoplasts. Five of these hybrids formed viable virions that were mechanically transmitted to Citrus macrophylla, a permissive host for CTV. All induced systemic infections, similar to that of the parental T36 clone. Tissues from these C. macrophylla source plants were then used to graft inoculate sour orange and grapefruit seedlings. Inoculation with three of the T30/T36 hybrid constructs induced SY symptoms identical to those of T36; however, two hybrids with T30 substitutions in the p23‐3′ nontranslated region (NTR) (nucleotides 18 394–19 296) failed to induce SY. Sour orange seedlings infected with a recombinant non‐SY p23‐3′ NTR hybrid also remained symptomless when challenged with the parental virus (T36), demonstrating the potential feasibility of using engineered constructs of CTV to mitigate disease.
Usefulness of reagent strips for checking cure in spontaneous bacterial peritonitis after short‐course treatment
Authors: CASTELLOTE J. , GIRBAU A. , ARIZA X. , SALORD S. , VAZQUEZ X. , LOBATÓN T. , ROTA R. , XIOL X.
Published: August 2009

Background  The usefulness of reagent strips to check cure of spontaneous bacterial peritonitis have not been evaluated to date.

Aim  To assess the usefulness of ascitic fluid analysis by means of reagent strips to check cure after a 5‐day antibiotic course.

Methods  We prospectively included all cirrhotic patients diagnosed with spontaneous bacterial peritonitis. On day 5, conventional and reagent strip ascitic fluid analyses were performed.

Results  Fifty‐three episodes of spontaneous bacterial peritonitis in 51 cirrhotic patients were included. Five patients died before the fifth day and in two patients, the control paracentesis yielded no ascitic fluid. In nine out of 46 cases (19.6%), spontaneous bacterial peritonitis had not resolved by day 5. In 32 out of 33 cases in which the ascitic fluid polymorphonuclear count was <250/μL at day five, the reagent strips was negative. The negative predictive value of the reagent strip at fifth day was 97% and the LR− 0.13.

Conclusions  Almost 20% of episodes of spontaneous bacterial peritonitis do not resolve with a short‐course of antibiotic treatment. In view of the high negative predictive value and low likelihood ratio for a negative test, reagent strips analysis may be an alternative to conventional cytology if a 5‐day antibiotic therapy is planned.
Review article: chronic viral infection in the anti‐tumour necrosis factor therapy era in inflammatory bowel disease
Authors: SHALE M. J. , SEOW C. H. , COFFIN C. S. , KAPLAN G. G. , PANACCIONE R. , GHOSH S.
Published: August 2009

Background  Anti‐Tumour necrosis factor (TNF) therapy is now well established in the treatment of inflammatory bowel disease and the risk of opportunistic infection is recognized. However, specific considerations regarding screening, detection, prevention and treatment of chronic viral infections in the context of anti‐TNF therapy in inflammatory bowel disease are not widely adopted in practice.

Aim  To provide a detailed and comprehensive review of the relevance of chronic viral infections in the context of anti‐TNF therapy in inflammatory bowel disease.

Methods  Literature search was conducted using Medline, Pubmed and Embase using the terms viral infection, hepatitis, herpes, CMV, EBV, HPV, anti‐TNF, infliximab, adalimumab, certolizumab pegol and etanercept. Hepatitis B and C and HIV had the largest literature associated and these have been summarized in Tables.

Results  Particular risks are associated with the use of anti‐TNF drugs in patients with hepatitis B infection, in whom reactivation is common unless anti‐viral prophylaxis is used. Reactivation of herpes zoster is the most common viral problem associated with anti‐TNF treatment, and may be particularly severe. Primary varicella infection may present with atypical features in patients on anti‐TNF.

Conclusion  Appreciation of risks of chronic viral disease associated with anti‐TNF therapy may permit early recognition, prophylaxis and treatment.
A new, minimally invasive technique for measuring cardiac index: clinical comparison of continuous cardiac dynamic monitoring and pulmonary artery catheter methods
Authors: Berridge J. C. , Warring‐Davies K. , Bland J. M. , Quinn A. C.
Published: August 2009

To assess the utility of a relatively simple bedside method of estimating cardiac index during major surgery or in the intensive care unit, we conducted a prospective study in patients undergoing elective cardiac bypass surgery where a pulmonary artery catheter was inserted as part of routine monitoring. The cardiac index was estimated using standard techniques and compared with estimates from continuous cardiac dynamic monitoring using heartsmart® software. Two hundred and seventy sets of measurements were suitable for comparison. The mean bias (95% limits of agreement), for the pre‐bypass cardiac index was −0.09 (−1.26 to 1.08) l.min−1.m−2, and post‐bypass was 0.12 l.min−1.m−2 (−1.32 to 1.56). These results suggest that continuous cardiac dynamic monitoring using heartsmart® is sufficiently accurate for assessment of haemodynamic variables in critically ill patients, facilitating goal‐directed therapies.
Hypertonic saline in critical care: a review of the literature and guidelines for use in hypotensive states and raised intracranial pressure*
Authors: Strandvik G. F.
Published: August 2009

Hypertonic saline has been in clinical use for many decades. Its osmotic and volume‐expanding properties make it theoretically useful for a number of indications in critical care. This literature review evaluates the use of hypertonic saline in critical care. The putative mechanism of action is presented, followed by a narrative review of its clinical usefulness in critical care. The review was conducted using the Scottish Intercollegiate Guidelines Network method for the review of cohort studies, randomised‐controlled trials and meta‐analyses. The review focuses specifically on blood pressure restoration and outcome benefit in both haemorrhagic and non‐haemorrhagic shock, and the management of raised intracranial pressure. Issues of clinical improvement and outcome benefit are addressed. Hypertonic saline solutions are effective for blood pressure restoration in haemorrhagic, but not other, types of shock. There is no survival benefit with the use of hypertonic saline solutions in shock. Hypertonic saline solutions are effective at reducing intracranial pressure in conditions causing acute intracranial hypertension. There is no survival or outcome benefit with the use of hypertonic saline solutions for raised intracranial pressure. Recommendations for clinical use and future directions of clinical research are presented.
Inadvertent hypothermia and mortality in postoperative intensive care patients: retrospective audit of 5050 patients
Authors: Karalapillai D. , Story D. A. , Calzavacca P. , Licari E. , Liu Y. L. , Hart G. K.
Published: August 2009

We proposed that many Intensive Care Unit (ICU) patients would be hypothermic in the early postoperative period and that hypothermia would be associated with increased mortality. We retrospectively reviewed patients admitted to ICU after surgery. We recorded the lowest temperature in the first 24 h after surgery using tympanic membrane thermometers. We defined hypothermia as < 36 °C, and severe hypothermia as < 35 °C. We studied 5050 consecutive patients: 35% were hypothermic and 6% were severely hypothermic. In‐hospital mortality was 5.6% for normothermic patients, 8.9% for all hypothermic patients (p < 0.001), and 14.7% for severely hypothermic patients (p < 0.001). Hypothermia was associated with in‐hospital mortality: OR 1.83 for each degree Celsius (°C) decrease (95% CI: 1.2–2.60, p < 0.001). Given the evidence for improved outcome associated with active patient warming during surgery we suggest conducting prospective studies of active warming of patients admitted to ICU after surgery.
The effects of intrathecal levobupivacaine and bupivacaine in the elderly
Authors: Erdil F. , Bulut S. , Demirbilek S. , Gedik E. , Gulhas N. , Ersoy M. O.
Published: August 2009

The objective of this study was to compare the block durations and haemodynamic effects associated with intrathecal levobupivacaine or bupivacaine in elderly patients undergoing transurethral prostate surgery. Eighty patients were prospectively randomised to receive plain 1.5 ml levobupivacaine 0.5% (group levobupivacaine) or 1.5 ml plain bupivacaine 0.5% (group bupivacaine) in combination with fentanyl 0.3 ml (15 μg) for spinal anaesthesia. The time to reach T10 and peak sensory block level, and to maximum motor block were significantly shorter in group bupivacaine compared to group levobupivacaine (p < 0.05). Peak sensory block level was also significantly higher in group bupivacaine. In group bupivacaine, mean arterial pressure was significantly lower than group levobupivacaine, starting from 10 min until 30 min after injection (p < 0.05). Hypotension and nausea were less common in group levobupivacaine than group bupivacaine (p < 0.05). Because of the better haemodynamic stability and fewer side‐effects associated with levobupivacaine, it may be preferred for spinal anaesthesia in elderly patients.
Radiological validation of tracheal tube insertion depth in out‐of‐hospital and in‐hospital emergency patients
Authors: Geisser W. , Maybauer D. M. , Wolff H. , Pfenninger E. , Maybauer M. O.
Published: August 2009

We performed a 5‐year, retrospective study using records of 1081 patients admitted to the trauma emergency room at a University Hospital to investigate the occurrence of tracheal tube malpositioning after emergency intubation in both the inpatient and outpatient settings, using chest radiographs and CT scans in the trauma emergency room. Prehospital patients and inpatients referred from peripheral hospitals were compared. This study showed that tracheal tube misplacements occur with an incidence of 18.2%, of which almost a third (5.7%) were placed in a main bronchus. We further show that tracheal intubation in emergency patients approximates the misplacement rates in the prehospital or in‐hospital settings. We speculate that the skill level of the operator may be critical in determining the success of tracheal intubation. Based on our findings, all efforts should be made to verify the tube position with immediate radiographic confirmation after admission to the emergency room.
Intensive insulin therapy decreases urinary MCP‐1 and ICAM‐1 excretions in incipient diabetic nephropathy
Authors: Ye S. D. , Zheng M. , Zhao L. L. , Qian Y. , Yao X. M. , Ren A. , Li S. M. , Jing C. Y.
Published: August 2009

Background  Nowadays, intensive insulin treatment has been widely used in type 2 diabetics who have poor control of blood glucose, to reduce the risk of chronic complications of diabetes. Recently, some scholars have paid more attention to the pivotal role of inflammation involved in type 2 diabetes and its complications. Monocyte chemoattractant protein‐1 (MCP‐1) and intercellular adhesion molecule‐1 (ICAM‐1), which are two important inflammatory chemokines, have been documented to participate in the onset and development of type 2 diabetes and its complications, such as diabetic nephropathy (DN).

Design  In the current study, we recruited 30 type 2 diabetics with microalbuminuria to be treated with multiple insulin injections daily for 2 weeks. Random spot urine samples (corrected for creatinine‐Cr) were collected for the examination of urinary MCP‐1, ICAM‐1 and albumin (Alb) levels before and after the intensive insulin therapy. Changes in their levels were observed to test the hypothesis that type 2 diabetes with microalbuminuria is associated with elevated urinary concentrations of MCP‐1 and ICAM‐1, and intensive insulin therapy can result in a decline of Alb by reducing the inflammatory reaction.

Results  The urinary MCP‐1/Cr and urinary ICAM‐1/Cr ratios in type 2 diabetic patients with microalbuminuria were much higher than those in normal controls, and intensive insulin treatment could decrease significantly the urinary MCP‐1/Cr, ICAM‐1/Cr and Alb/Cr ratios in type 2 diabetics with microalbuminuria.

Conclusion  Intensive insulin treatment may protect against renal injury in early DN by reducing the urinary MCP‐1 and ICAM‐1 excretions.
Fate of soil‐applied black carbon: downward migration, leaching and soil respiration
Authors: MAJOR JULIE , LEHMANN JOHANNES , RONDON MARCO , GOODALE CHRISTINE
Published: August 2009

Black carbon (BC) is an important pool of the global C cycle, because it cycles much more slowly than others and may even be managed for C sequestration. Using stable isotope techniques, we investigated the fate of BC applied to a savanna Oxisol in Colombia at rates of 0, 11.6, 23.2 and 116.1 t BC ha−1, as well as its effect on non‐BC soil organic C. During the rainy seasons of 2005 and 2006, soil respiration was measured using soda lime traps, particulate and dissolved organic C (POC and DOC) moving by saturated flow was sampled continuously at 0.15 and 0.3 m, and soil was sampled to 2.0 m. Black C was found below the application depth of 0–0.1 m in the 0.15–0.3 m depth interval, with migration rates of 52.4±14.5, 51.8±18.5 and 378.7±196.9 kg C ha−1 yr−1 (±SE) where 11.6, 23.2 and 116.1 t BC ha−1, respectively, had been applied. Over 2 years after application, 2.2% of BC applied at 23.2 t BC ha−1 was lost by respiration, and an even smaller fraction of 1% was mobilized by percolating water. Carbon from BC moved to a greater extent as DOC than POC. The largest flux of BC from the field (20–53% of applied BC) was not accounted for by our measurements and is assumed to have occurred by surface runoff during intense rain events. Black C caused a 189% increase in aboveground biomass production measured 5 months after application (2.4–4.5 t additional dry biomass ha−1 where BC was applied), and this resulted in greater amounts of non‐BC being respired, leached and found in soil for the duration of the experiment. These increases can be quantitatively explained by estimates of greater belowground net primary productivity with BC addition.
Effects of climate‐driven primary production change on marine food webs: implications for fisheries and conservation
Authors: BROWN C. J. , FULTON E. A. , HOBDAY A. J. , MATEAR R. J. , POSSINGHAM H. P. , BULMAN C. , CHRISTENSEN V. , FORREST R. E. , GEHRKE P. C. , GRIBBLE N. A. , GRIFFITHS S. P. , LOZANO‐MONTES H. , MARTIN J. M. , METCALF S. , OKEY T. A. , WATSON R. , RICHARDSON A. J.
Published: August 2009

Climate change is altering the rate and distribution of primary production in the world's oceans. Primary production is critical to maintaining biodiversity and supporting fishery catches, but predicting the response of populations to primary production change is complicated by predation and competition interactions. We simulated the effects of change in primary production on diverse marine ecosystems across a wide latitudinal range in Australia using the marine food web model Ecosim. We link models of primary production of lower trophic levels (phytoplankton and benthic producers) under climate change with Ecosim to predict changes in fishery catch, fishery value, biomass of animals of conservation interest, and indicators of community composition. Under a plausible climate change scenario, primary production will increase around Australia and generally this benefits fisheries catch and value and leads to increased biomass of threatened marine animals such as turtles and sharks. However, community composition is not strongly affected. Sensitivity analyses indicate overall positive linear responses of functional groups to primary production change. Responses are robust to the ecosystem type and the complexity of the model used. However, model formulations with more complex predation and competition interactions can reverse the expected responses for some species, resulting in catch declines for some fished species and localized declines of turtle and marine mammal populations under primary productivity increases. We conclude that climate‐driven primary production change needs to be considered by marine ecosystem managers and more specifically, that production increases can simultaneously benefit fisheries and conservation. Greater focus on incorporating predation and competition interactions into models will significantly improve the ability to identify species and industries most at risk from climate change.
Tree invasion in managed tropical forests facilitates endemic species
Authors: Fischer Leonie K. , Von Der Lippe Moritz , Kowarik Ingo
Published: August 2009

Aim  To determine whether different abundances of introduced species of Cinchona (Rubiaceae) affect species composition and facilitate species richness in managed tropical forests, to test whether any facilitative effects on understorey species depend on forest type, and to investigate whether facilitative effects can be attributed to the ‘substitutive facilitation model’.

Location  Makawao Forest Reserve on Maui, Hawai’i, USA.

Methods  Cinchona species (Cinchona pubescens and Cinchona calisaya) were mapped within various forest types. In three forest types (ageing Eucalyptus and Pinus plantations, and near‐natural Acacia koa forests), we analysed environmental parameters (e.g. canopy cover, litter cover, pH value and soil depth) and the species composition of Cinchona‐invaded and non‐invaded plots; data were compared based on Cinchona cover and forest types. Habitat modelling for several endemic species and tree ferns was carried out to test whether Cinchona cover is an important variable for the probability of occurrence of these endemics.

Results  Cinchona species have naturalized mainly in Eucalyptus and Pinus plantations and Acacia koa forests and here add an additional shrub layer. In contrast to other studies, we revealed facilitative effects of Cinchona on native species within all forest types. Species richness is about 20% higher in invaded plots than in non‐invaded plots, and these show a nearly 50% higher proportion of endemic species, including tree ferns. The proportion of endemics even increases with increasing Cinchona cover. For several endemics, Cinchona is found to be an important variable for the probability of occurrence, and the removal of Cinchona cover as an explanatory variable lowers the model fit. In addition to Cinchona, variables delineating vegetation structure and light availability have a strong effect on the model fit.

Main conclusions  In the structurally simplified Hawaiian forests studied, Cinchona facilitated endemic species in accordance with the ‘substitutive facilitation model’. This contrasts with the results of an earlier study in the naturally treeless Galápagos highlands, which revealed a sharp decrease in the abundance of endemics under Cinchona canopy. These results illustrate that, through the same structural change (addition of a vegetation layer), an invasive species may exert divergent effects across different ecosystem types. The facilitation of endemic understorey species by invasive tree species in managed forests leads to a dilemma in conservation but also to new perspectives for ecosystem restoration.
DSM‐III‐R and persons with dual diagnoses: conceptual issues and strategies for future research
Authors: Sturmey P.
Published: August 2009

Diagnosis of mental health needs in people with mental retardation using the DSM‐III‐R manual was critically reviewed. Conceptual issues included the interaction of different diagnosis categories; the cognitive and linguistic competencies often required for diagnosis; the potential mismatch between psychopathology in people with mental retardation and the DSM‐III‐R nosology; and issues relating to multi‐axial classification. Strategies identified to explore and resolve these issues include better documentation of the frequency and nature of these problems when using unmodified DSM‐III‐R criteria, better empirical piloting of modified diagnostic criteria with people with severe and profound mental retardation, and the use of social validity data to identify potential mismatches between psychopathology in people with mental retardation and DSM‐III‐R diagnoses.
The form and function of challenging behaviours
Authors: Emerson E. , Bromley J.
Published: August 2009

Aspects of the topography and behavioural function underlying the challenging behaviours of all people with learning disabilities and challenging behaviour (n =70) in a defined geographical area were investigated. Results indicated that: (1) more severe challenging behaviours were shown by people with more severe disabilities; (2) a significant minority (44%) of people showed more than one form of challenging behaviour, this rising to 79% among people with more severe challenging behaviours; and (3) cross‐sectional analyses revealed specific clusters of problematic, aggressive and self‐injurious behaviours. Analysis of information derived from the Motivation Assessment Scale (MAS) indicated that (5) the most common funaions of challenging behaviours appeared to be ‘self‐stimulation’(for self‐injury, destructiveness and ‘other’ challenging behaviours) and securing the attention of carers (for aggressive behaviours). However, (6) parametric analyses failed to identify any consistent relationships between the form and function of an individual's challenging behaviour for aggressive, destructiveness and ‘other’ challenging behaviours, but (7) clients with self‐injurious behaviour were significantly more likely to score highly on the ‘self‐stimulation’ sub‐scale than other sub‐scales of the MAS. Finally, (8) significant consistency of behavioural functions across different forms of challenging behaviours shown by the same individual were found for the two combinations of aggressive‐destructive behaviours and self‐injury‐'other’ behaviours.
Cross‐national comparisons of ageing mothers of adults with intellectual disabilities
Authors: Seltzer M. M. , Krauss M. W. , Walsh P. , Conliffe C. , Larson B. , Birkbeck G. , Hong J. , Cchoi S.
Published: August 2009

Ageing (55 + years) mothers of adults with intellectual disabilities in the Republic of Ireland, Northern Ireland and the United States were compared with respect to three general issues. Firstly, to what extent do the adults in these three countries differ in their level of reliance on their mothers? Secondly, do the mothers differ in the extent to which they have made plans for the future care of their son or daughter with intellectual disabilities? Thirdly, do the mothers differ in physical, social and psychological well‐being? These cross‐national comparisons were undertaken to examine the extent to which lifelong caregiving has either a common influence on mothers across national boundaries, or, alternatively, whether the cultural context exerts a unique influence on mothers In each country. Findings suppxarted the latter explanation, even when background characteristics were statistically controlled.
Overweight and obesity amongst Down's syndrome adults
Authors: Prasher V. P.
Published: August 2009

Two hundred and one individuals with Down's syndrome were assessed for evidence of overweight and obesity. Thirty‐one per cent of males and 22% of females were overweight, while 48% males and 47% females were obese. Overweight and obesity was significantly associated with living in the family home compared to supervised community units or in hospital. No association with the degree of learning disability vras found.
Mortality in a hospitalized mentally handicapped population: a 10‐year survey
Authors: Puri B. K. , Lekh S. K. , Langa A. , Zaman R. , Singh I.
Published: August 2009

The mortality experiences of a hospitalized mentally handicapped population between 1981 and 1990 (inclusive) were examined. A continued trend for increasing longevity in both males and females was found, with mean ages at death now approaching those in the general population. The commonest cause of death was non‐tubercular respiratory infection, from which patients were particularly at risk during the months of December to February (inclusive). Patients diagnosed as suffering from psychoses other than schizophrenia and mood disorder had an increased mortality and should be thoroughly investigated for the presence of organic pathology. Epilepsy and Down's syndrome were associated with increased risk of earlier death, although in the case of Down's syndrome there has been a marked increase in longevity.
A lethal case of atlantoaxial dislocation in a 56‐year‐old woman with Down's syndrome
Authors: Saad K. F. G.
Published: August 2009

A case of fatal atlantoaxial dislocation is reported in a 56‐year‐old woman with Down's syndrome. The literature indicates such a case to be a rarity; however, this may be a result of the predominance of younger age samples. The implications of this are discussed.
Twenty‐five years' experience of prophylactic treatment in severe haemophilia A and B
Authors: NILSSON I. M. , BERNTORP E. , LÖFQVIST T. , PETTERSSON H.
Published: August 2009

In Sweden, prophylactic treatment of boys with severe haemophilia has been practised since 1958 in an attempt to convert the disease from a severe to a milder form. The present study population consisted of 60 severe haemophiliacs (52 A, 8 B), aged 3–32 years. Treatment is started when the boys are 1–2 years of age, the regimens used being 24–40 IU F VIII kg−1 three times weekly in haemophilia‐A cases (i.e. > 2000 IU kg−1 annually) and 25–40 IU F IX kg−1 twice weekly in haemophilia‐B cases. The orthopaedic and radiological joint scores (maximum scores of 90 and 78, respectively) are evaluated as recommended by the World Federation of Haemophilia. Of those subjects aged 3–17 years, 29 out of 35 individuals had joint scores of zero. The oldest group had only minor joint defects. The VIII:C and IX:C concentrations had usually not fallen below 1% of normal. All 60 patients are able to lead normal lives. In conclusion, it appears to be possible to prevent haemophilic arthropathy by giving effective continuous prophylaxis from an early age, and preventing the VIII:C or IX:C concentration from falling below 1% of normal.
Bilateral emphysematous pyelonephritis resolving to medical therapy
Authors: NAGAPPAN R. , KLETCHKO S.
Published: August 2009

We describe a case of bilateral emphysematous pyelonephritis, in a diabetic female, that responded to medical therapy alone. Her complete improvement is documented radiologically. Emphysematous pyelonephritis, as a cause of serious infection in diabetic patients, is briefly reviewed.