bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spatial genetic structure and clonal diversity of Anemone nemorosa in late successional deciduous woodlands of Central Europe
Authors: Stehlik Ivana , Holderegger Rolf 
Published: March 2003

Summary 1 We tested whether established populations in similar environmental conditions exhibit similar or varying spatial genetic structures by comparing populations of the long‐lived species Anemone nemorosa from a number of late successional deciduous woodlands in Central Europe. We discuss the ways in which genetic structure may have been shaped by clonal growth and sexual reproduction. 2 A standardized sampling strategy was used to collect 30 ramets from each of 20 populations. Genotypes of the samples were determined by allozyme electrophoresis and analysed assuming that A. nemorosa shows tetraploid‐tetrasomic inheritance. 3 Genetic variation and clonal diversity were high compared with other clonal species. Most (95%) of the sampled ramets had unique multilocus genotypes with only 22 examples occurring more than once. Differences between observed and expected heterozygosities within populations were generally small to moderate. Fixation indices (mean of over 14 loci) in the populations ranged between 0.08 and 0.56 (grand mean = 0.21) confirming reports that the breeding system in A. nemorosa is predominantly outcrossing or mixed‐mating. 4 Limited historic gene flow among populations (Nm = 0.62) was reflected by high population differentiation (GST = 0.29), low genetic identities among populations and a non‐significant correlation between these identities and geographical distances. 5 Spatial autocorrelation (Moran’s I) showed no significant differences in genetic structures between populations under similar environmental conditions. Samples taken less than 0.5 m apart were genetically more closely related than to more distant samples, but similarity of genotypes decreased only slightly with further increase in distance. 6 The high levels of genetic variation found in populations of A. nemorosa are probably due to repeated seedling recruitment and the outcrossing or mixed‐mating breeding system, whereas vegetative propagation and short‐distance seed dispersal may contribute to the positive genetic autocorrelation observed at a small spatial scale.
Geographical variation in seed production, predation and abortion in Juniperus communis throughout its range in Europe
Authors: García Daniel , Zamora Regino , Gómez José M. , Jordano Pedro , Hódar José A. 
Published: March 2003

Summary 1 The geographical variation of seed production, predation and abortion was analysed in Juniperus communis for 31 populations in seven distinct regions throughout the species’ distribution range in Europe, including both the northern and southern boundaries. 2 The number of seeds per cone and the number of filled seeds per cone varied significantly between geographical regions and among populations within regions. Populations from the Mediterranean mountains (south‐east Spain) showed the highest values in the number of seeds per cone but the lowest values in the number of filled seeds per cone. 3 Losses due to predispersal seed predation varied significantly among populations within a region but not between regions, suggesting that predation incidence depends on local‐scale factors. Seed abortion rates were higher in southern Iberian populations than in the other regions, and varied significantly among populations and regions. As a result of predation and abortion, seed production was lowest in the Iberian regions. 4 Seed abortion showed a significant quadratic relationship with latitude, with higher values of abortion at either end of the gradient, but particularly at the southern limit. 5 The production of filled seeds declined gradually towards both northern and southern distribution limits. In the Mediterranean mountains (southern limit), low seed production coincided with a marked limitation placed upon natural regeneration by summer drought, leading to a demographic bottleneck in populations. Although seed abortion levels were relatively high in the subarctic tundra (northern limit) populations, they were free from predispersal seed predators, suggesting that population viability here may be under less pressure.
Seven characteristics of medical evidence
Authors: Upshur Ross E. G. 
Published: March 2003

AbstractThis paper outlines seven essential characteristics of medical evidence and describes the implications of these for both the theory of evidence‐based medicine and clinical practice. The seven characteristics are: (1) Provisional; (2) Defeasible; (3) Emergent; (4) Incomplete; (5) Constrained; (6) Collective and (7) Asymmetric. It is argued that the epistemological theory that best fits medical evidence is that of fallibilism.
Shared decision making observed in clinical practice: visual displays of communication sequence and patterns
Authors: Elwyn Glyn , Edwards Adrian , Wensing Michel , Hibbs Richard , Wilkinson Clare , Grol Richard 
Published: March 2003

AbstractThe aim of the study was to examine the communication strategies of general practitioners attempting to involve patients in treatment or management decisions. This empirical data was then compared with theoretical ‘competences’ derived for ‘shared decision making’. The subjects were four general practitioners, who taped conducted consultations with the specific intent of involving patients in the decision‐making process. The consultations were transcribed, coded into skill categorizations and presented as visual display using a specifically devised sequential banding method. The empirical data from these purposively selected consultation from clinicians who are experienced in shared decision making did not match suggested theoretical frameworks. The views of patients about treatment possibilities and their preferred role in decision making were not explored. The interactions were initiated by a problem‐defining phase, statements of ‘equipoise’ consistently appeared and the portrayal of option information was often intermingled with opportunities to allow patients to question and reflect. A decision‐making stage occurred consistently after approximately 80% of the total consultation duration and arrangements were consistently made for follow‐up and review. Eight of the 10 consultations took more than 11 min – these specific consultations were characterized by significant proportions of time provided for information exchange and patient interaction. The results demonstrate that some theoretical competences are not distinguishable in practice and other stages, not previously described, such as the ‘portrayal of equipoise’, are observed. The suggested ideal of a shared decision‐making interaction will either require more time than currently allocated, or alternative strategies to enable information exchange outside the consultation.
An explanatory model of medical practice variation: a physician resource demand perspective
Authors: Long Michael J. 
Published: March 2003

AbstractPractice style variation, or variation in the manner in which physicians treat patients with a similar disease condition, has been the focus of attention for many years. The research agenda is further intensified by the unrealistic assumption that by reducing variation, quality will be improved, costs will be reduced, or both. There is a wealth of literature that identifies differences in health care use of many kinds, in apparently similar communities. Attempts have been made by many scholars to identify the determinants of variation in terms of differences in the population characteristics (e.g. age, sex, insurance, etc.) and geographical characteristics (e.g. distance to provider, number of physicians, number of hospital beds, etc.). When significant differences in use rates prevail after controlling for differences in population characteristics, it is often attributed to ‘uncertainty’, or the fact that there is no consensus on what constitutes the optimum treatment process. It is suggested by this literature that the greatest variation can be found in the circumstances where there is the most ‘uncertainty’. In this work, a physician resource demand model is proposed in which it is suggested that, during the diagnosis and treatment process, physicians demand resources consistent with the clinical needs of the patients, modified by the intervening forces under which they practice. These intervening forces, or constraints, are categorized as patient agency constraints, organizational constraints and environmental constraints, which are characterized as ‘induced variation’. It is suggested that when all of the variables that constitute these constraints are identified, the remaining variance represents ‘innate variance’, or practice style differences. It is further suggested that the more completely this model is specified, the more likely area differences will be attenuated and the smaller will be the residual variance.
Clinical and economic outcomes of pneumonia in children: a longitudinal observational study in an Italian paediatric hospital
Authors: Ciommo V. Di , Russo P. , Attanasio E. , Liso G. Di , Graziani C. , Caprino L. 
Published: March 2003

Abstract Rationale, aims and objectives Antibiotic prescription for acute lower respiratory infections (ALRI) in hospitalized children can have a major impact on cure and costs. We performed a longitudinal study to explore the appropriateness of prescriptions, the predictors of therapeutic patterns, and the main outcomes: readmission, length of stay (LOS) and costs. Methods Ninety‐nine children who were inpatients of a paediatric hospital receiving antibiotic treatment for community acquired ALRI were consecutively enrolled. To calculate the costs of pneumonia treatment, we collected data on clinical presentation and resources consumption. We used multiple regression analysis to identify predictors of LOS and choice of therapy, and one‐way ANOVA to evaluate cost differences among treatment groups. Results Parenteral antibiotics were administered in 64.6% of cases, whereas 35.4% received oral antibiotic therapy by itself (OAT). Switch therapy (SWT) was performed in 43.4% of cases. The most frequently prescribed antibiotic for parenteral therapy was ceftriaxone (58.3%), and for oral therapy cefprozil (58.1%). The median LOS was 3 days and the cure rate 99% (95%CI: 97–100%). SWT and OAT were significantly associated with a shorter LOS. The clinical variables were not significantly associated with SWT or OAT. The average costs per patient in the management of pneumonia were _1435. SWT or OAT were associated with significant lower costs: _1487 per patient (95%CI: 1395–1580) and _1335 per patient (95%CI: 1233–1437), respectively. Conclusions The hospital management of paediatric pneumonia was more influenced by the early discharge policy than by clinical variables without under‐cure.
Fishing gear‐induced skin ulcerations in Baltic cod, Gadus morhua L.
Authors: Mellergaard S , Bagge O 
Published: March 2003

AbstractIn 1982 a high prevalence of skin ulcerations was observed in Baltic cod in the vicinity of the Danish island of Bornholm. In March the prevalence varied from 6 to 13%, and in May it had increased to between 26 and 48%. The ulcerations had a sequential development. The initial stage appeared as severe skin abrasions in the area from the pectoral fin posterior to the level of the anus. The skin abrasions developed into large spots of necrotic dermal tissue with a diameter of 2–5 cm. The central part of the necrotic area sloughed off exposing a large haemorrhagic ulcer. Characteristically, most of the ulcerations on the trunk occurred bilaterally. A common histopathological finding was coagulation necrosis of the muscular tissue. The ulcerated fish were mainly 24–28 cm in length. A correlation between high concentrations of cod around Bornholm, high fishing activity in the area, length of fish escaping from the nets, combined with bilateral occurrence of the ulcers, strongly indicates that the skin ulcers were induced by the fishing gear. Features of the pathology could be linked to the temporary retention of cod in trawl meshes.
Establishment of cell lines from a tropical grouper, Epinephelus awoara (Temminck & Schlegel), and their susceptibility to grouper irido‐ and nodaviruses
Authors: Lai Y‐S , John J A C , Lin C‐H , Guo I‐C , Chen S‐C , Fang K , Lin C‐H , Chang C‐Y 
Published: March 2003

AbstractFour tropical marine fish cell lines have been established from the eye, fin, heart and swim bladder of grouper, Epinephelus awoara (Temminck & Schlegel). Optimum media and temperature conditions for maximum growth were standardized. The eye and swim bladder cells were mostly epithelial, but the fin and heart cells were mostly fibroblastic. The viability of cells was 95% after 1 year of storage in liquid nitrogen (−196 °C). Besides these four cell lines, previously established grouper brain, kidney and liver cell lines were also used for a viral susceptibility study which showed that all the cell lines were sensitive to grouper iridovirus, whereas only brain, fin and liver cell lines were susceptible to the yellow grouper nervous necrosis virus (a nodavirus). Electron microscopy studies of the grouper irido‐ and nodaviruses in ultrathin sections of infected cells showed an abundance of viral particles in the cytoplasm of the virus‐infected cells indicating the effective replication of these two viruses. It is suggested that these cell lines can be used for the isolation of putative fish specific viruses and provide a valuable tool to study the mechanisms of host–pathogen interactions. Furthermore, these cell lines upon transfection, using pEGFP‐C1 and pEGFP‐aMT2.5 (ayu metallothionein promoter), produced significant fluorescent signals indicating their utility for exogenous studies.
Vibrio species isolated from diseased farmed sole, Solea senegalensis (Kaup), and evaluation of the potential virulence role of their extracellular products
Authors: Zorrilla I , Arijo S , Chabrillon M , Diaz P , Martinez‐Manzanares E , Balebona M C , Moriñigo M A 
Published: March 2003

AbstractBacteria isolated from an outbreak with moderate mortalities in farmed sole, Solea senegalensis (Kaup), in the south of Spain were identified as Vibrio harveyi and V. parahaemolyticus. Only bacterial strains showing swarming were virulent in sole and caused mortalities in experimentally inoculated fish. However, the signs of the disease were only reproduced with V. harveyi. The intramuscular inoculation of the extracellular products (ECPs) of both species produced mortalities in inoculated fish and the appearance of surface ulcers in the case ofV. harveyi. However, the inoculation of sublethal doses of ECPs to fish showed a protective effect against V. harveyi.
Antagonistic activity of Aeromonas media strain A199 against Saprolegnia sp., an opportunistic pathogen of the eel, Anguilla australis Richardson
Authors: Lategan M J , Gibson L F 
Published: March 2003

AbstractA bacteriocin‐like inhibitory substance (BLIS) produced by Aeromonas media strain A199 inhibited the growth of Saprolegnia sp. in vitro, an opportunistic pathogen isolated from affected eels, Anguilla australis (Richardson). The presence of BLIS in solid media inhibited the growth of the vegetative state of the aquatic mould as well as the germination of cysts. Uninhibited growth was, however, observed in the presence of inactive BLIS, suggesting that the in vitro antagonism derived from the BLIS of A199. In four independent in vivo tank observations of fish affected with saprolegniosis, the daily addition of A199 to tank water contributed to the subsequent swift recovery of affected hosts from invasion by this opportunistic pathogen.
A survey of feeding practices in infants with phenylketonuria
Authors: Portnoi P. , MacDonald A. , Watling R. , Clarke B. J. , Barnes J. , Robertson L. , White F. , Jarvis C. , Laing S. , Weetch E. , Holliday K. , Francis D. , Netting M. , Wall C. 
Published: March 2003

Summary Background: Although the management of phenylketonuria (PKU) in infancy and early childhood is a critical part of the overall care of the disorder, there are few guidelines on infant feeding in this condition. This survey was undertaken to establish the practices of dietitians from major PKU centres in Australia and the UK. Methods: A postal questionnaire examining infant feeding practices was sent to dietitians at nine major PKU centres in the UK and four in Australia, with each dietitian describing the infant feeding process in their last five infants. A total of 63 infants were investigated. Results: A lower than expected incidence of infants with PKU were breast fed at the time of diagnosis: 28% of infants in the UK and 41% from Australia. Amino acid intake varied between 2.0 g kg−1 day−1 to 3.5 g kg−1 day−1 with 86% of dietitians calculating total amino acid intake derived from both protein substitute intake and normal infant formula. Amino acid intake was not calculated in breast‐fed infants. In breast‐fed infants, phenylalanine‐free protein substitute was always given before breast feeds. In bottle‐fed infants, normal infant formula was given before phenylalanine‐free protein substitute in 75% of infants. Solids were usually introduced between 3 and 6 months and phenylalanine‐free solids were given initially to the majority of infants. Most problems were seen when introducing a more concentrated phenylalanine‐free protein substitute to maintain the required amino acid intake in older infants. Age of introduction varied between 4 and 12 months and type of approach included concentrating infant protein substitutes, use of L‐amino acid protein substitutes only, or L‐amino acid protein substitutes with added carbohydrate, vitamins and minerals. Conclusions: There appeared to be no uniform policy of infant feeding in PKU and more work is needed correlating practices to develop national and even international protocols for management.
A10. Dietary intake and anthropometric indices of hip fracture patients: a case control study
Authors: Upton W. J. 
Published: March 2003

Background There is concern regarding the increasing rates of fractures that are being attributed to osteoporosis. It is estimated that around 60 000 hip fractures occur annually in the U.K. The majority being in the elderly, resulting in considerable morbidity and mortality (
DoH, 1998). Investigations into the causes, prevention and treatment of fractures are therefore of both clinical and economic importance.Aim The aim of this study was to compare a group of elderly, fractured neck of femur patients (female, 60–102 years, n 64) with a group of healthy age‐matched controls (female, 63–90, n 45). Differences in their current dietary intake, intake in the recent and distant past, anthropometric indices lifestyle factors and food choice were all investigated.Methods Interviewer administered questionnaires were used to obtain the information necessary and three consecutive 24 h recalls determined current dietary intake (analysed using ’Dietplan’). Anthropometric indices examined included; weight, height, demispan, mindex, demiquet, body mass index (BMI), triceps skinfold thickness (TSF), mid upper arm circumference (MUAC), mid upper arm muscle circumference (MUAMC) and maximum calf circumference.Independent t‐tests and chi‐square were used to assess statistical significance.Results Current dietary intake data revealed that the control group consumed almost all nutrients in greater amounts. Energy, carbohydrate, protein, thiamine, pyridoxine, calcium, phosphate, magnesium, potassium, iron, selenium, iodine and fibre were all significantly greater in the control group (P = < 0.01). Although, neither the cases nor controls achieved 100% of the RNI for energy (mean values).There was also found to be a significant difference between the majority of the anthropometric indices measured. The controls were significantly heavier than the cases (P = 0.001) and had a greater mean mindex value (P = 0.001). Also, significantly lower TSF and MUAC values were seen in the cases (P = 0.005 and 0.001, respectively). All these results suggest that the fractured neck of femur patients were nutritionally compromised and would benefit from supplementation to aid recovery.Analysis of past calcium intake produced surprising results, in that a greater percentage of the cases than controls stated consuming a ’high’ calcium intake in both childhood and early adulthood. The effect of recall bias needs to be considered here. But, although these results contradict the majority of findings in this field, similar results have previously been found ( New et al., 1998
).Conclusions Various potential risk factors for hip fractures have been highlighted in this study (including; low body weight, low muscle mass and low activity level). Therefore, in conclusion, improved nutrition could help to prevent hip fracture occurrence and supplementation of the diet is an important part of the treatment for fractured neck of femur.
A12. The effect of nutrition intervention, using the Balance of Good Health Model, on the composition of the packed lunches of 10–11‐year‐old schoolchildren
Authors: Barton R. 
Published: March 2003

Background The decline in the nutritional standard of school meals equates closely with an overall decline in the quality of the diets of British children. Numerous studies have found children’s diets to be high in fat and sugar, and low in fibre, calcium and iron (
Department of Health, 1989,
Adamson et al., 1991
). A balanced diet is important in schoolchildren to promote good growth and development, to protect against short‐term illnesses and diseases such as dental caries and obesity, and to avoid manifestations of diseases in adult life such as coronary heart disease (CHD) and diabetes.Lunches eaten at school make an important contribution to a child’s daily energy and nutrient intake ( Ruxton et al., 1996
), and in recognition of this the government has proposed a set of new nutritional standards for school meals. However, an increasing number of children are consuming packed lunches, which are not addressed in the new proposals.Aim This study investigated whether an intervention based on a teaching session using the ’Balance of Good Health’ model would have an effect on the content of packed lunches eaten by 10–11‐year‐old schoolchildren. The study also looked at parents’ views on healthy eating for their children.Methods Twenty‐five children from a Primary school in Lincolnshire took part in the study. The contents of their lunch boxes were nutritionally analysed and scored against the Balance of Good Health model for three days in the preintervention week and for three days in the third week postintervention. Differences between weeks were statistically analysed using a paired t‐test. A questionnaire was administered to parents in order to discover their views on healthy eating and on the intervention.Results A significant difference (P = 0.05) in the carbohydrate content of the lunch boxes was observed postintervention. There was also a greater compliance with guidelines on fat, protein and riboflavin, although the change was not statistically significant. Consistent with results from previous studies; iron and calcium were found to be lower than the recommended amount. No significant difference was found when lunch boxes were scored against the Balance of Good Health.Conclusions All parents recognized the importance of healthy eating for their children but felt the largest barrier to changing children’s eating habits were the child’s likes and dislikes.The study highlights the need for more nutrition education both inside and outside the school.