Search

There is an increasing expectation on the private sector to address biodiversity impacts and contribute towards global conservation goals. Appropriate evidence use can help businesses avoid biodiversity losses and realise gains, reduce ineffective or suboptimal action, whilst minimising biodiversity‐related risks and securing opportunities from engaging with biodiversity. We review the status of evidence‐based action in the private sector, where previous studies have identified concerning trends, and explore the barriers that may currently be hindering practice. To learn from this, and improve the status quo, we propose a set of principles for evidence‐based biodiversity impact mitigation. We outline tools and resources that can help businesses move towards evidence‐based practice and achieve each of these principles. Meeting these principles would improve the biodiversity outcomes from businesses' biodiversity related actions. However, for business action to contribute more fully to global conservation goals, broader political and socio‐economic issues also need addressing. [ABSTRACT FROM AUTHOR]

Many rural areas experience population stagnation or decline from out‐migration with corresponding economic downturns. This is the case for the Northern Territory in Australia, a vast and sparsely populated jurisdiction. Its government has long sought to encourage stronger population growth but its population is young and highly transient, leading to high staff turn‐overs and challenges for industries and government to attract families and skilled workers. Place‐based factors such as job opportunities, access to essential services or environmental amenities influence satisfaction and migration decisions. The aim of this study was to understand why people might stay or move away through analysing responses to two open‐text questions on the best and worst aspect of living in the Northern Territory. Over 3500 valid responses were analysed using machine learning‐based unsupervised topic modelling which uncovered latent clusters. Forty‐four percent of positive aspects were clustered into lifestyle factors, while negative aspects clustered around high living costs and crime. Some aspects, such as the weather and distance to other places were discussed as both positive and negative aspects. Topics discussed by respondents could be directly related to their intention to leave the Northern Territory, and also to specific individual's demographic characteristics providing insights for policies focused on attracting and retaining population. The use of unsupervised text mining in population research is rare and this study verifies its use to deliver objective and nuanced results generated from a large qualitative data set. [ABSTRACT FROM AUTHOR]

He published over 200 peer-reviewed papers, and his research contributed conceptually to ecology, marine biology, environmental sciences, fisheries ecology, restoration ecology, and conservation biology. Pete was an exceptionally creative and productive scientist, who made key contributions to many aspects, or subdisciplines, in ecology and marine science. Introduction: Honoring the contribution of Charles H. Peterson (1946-2020) to the field of marine ecology Pete examined how habitat created by seagrass beds, salt marshes, oyster reefs, beaches, deep-sea hydrothermal vent organisms, and Antarctic crustaceans influences marine communities and produces ecosystem services. [Extracted from the article]

The loss of functional and accreting coral reefs reduces coastal protection and resilience for tropical coastlines. Coral restoration has potential for recovering healthy reefs that can mitigate risks from coastal hazards and increase sustainability. However, scaling up restoration to the large extent needed for coastal protection requires integrated application of principles from coastal engineering, hydrodynamics, and ecology across multiple spatial scales, as well as filling missing knowledge gaps across disciplines. This synthesis aims to identify how scientific understanding of multidisciplinary processes at interconnected scales can advance coral reef restoration. The work is placed within the context of a decision support framework to evaluate the design and effectiveness of coral restoration for coastal resilience. Successfully linking multidisciplinary science with restoration practice will ensure that future large‐scale coral reef restorations maximize protection for at‐risk coastal communities. [ABSTRACT FROM AUTHOR]

The conservation benefits of marine reserves are well established but their contribution to adjacent fisheries via spillover is less certain and context‐dependent. Theoretical predictions do not always match empirical evidence from individual reserves, so carefully designed studies are essential for accurately assessing spillover and its contribution to fisheries. Biomass buildup within reserves, and spillover from reserve borders, also usually takes time to develop. In 2003, a network of no‐take marine reserves was established in the Northern Channel Islands (NCI) of southern California (CA) to conserve biodiversity and to eventually enhance local fisheries through spillover of larvae, juveniles, and adults. The reserve network impacted the local CA spiny lobster (Panulirus interruptus) fishery by removing about 20% of fishing grounds in the NCI. In 2008, a collaborative fisheries research effort detected substantial lobster population increases within reserves, and an indication of the possible spillover of adult lobsters across reserve borders. To estimate whether and how much populations within reserves, and spillover from reserves, have increased through time, we repeated the sampling program 10 years later in 2018 at two of the three original reserves. Scientific trapping was conducted prior to the fishing season along a spatial gradient beginning deep within the reserves to reference sites located outside (≥2 km) of reserve borders. Results showed that legal‐sized lobster abundance in traps (catch per unit effort) increased by 125%–465% deep inside reserves, and by 223%–331% at sites near to reserve borders, and by nearly 400% just outside of reserve borders over the 10‐year period, thus indicating a substantial increase in spillover across reserve borders. A similar pattern was observed in lobster biomass caught in traps at the two reserves. This study demonstrates how spillover scales with biomass buildup and that collaborative fisheries research can be used to assess the efficacy of marine reserves as fishery management tools worldwide. [ABSTRACT FROM AUTHOR]

Coastal marine habitats continue to be degraded, thereby compelling large‐scale restoration in many parts of the world. Whether restored habitats function similarly to natural habitats and fully recover lost ecosystem services is unclear. In estuaries, oyster reefs have been degraded by multiple anthropogenic activities including destructive fishing practices and reduced water quality, motivating restoration to maintain oyster fisheries and other ecosystem services, often at relatively high cost. We compared fish and invertebrate communities on recently restored (0–1 year post‐restoration), older restored (3–4 years post‐restoration), and natural oyster reefs to determine if and when restored reefs support functionally similar faunal communities. To test the influence of landscape setting on the faunal communities, the restored and natural reefs, as well as a control without reef present, were distributed among three landscapes (on the edge of salt marsh away from seagrass [salt marsh landscape], on mudflats [mudflat landscape], and near to seagrass and salt marsh [seagrass landscape]). Oyster density and biomass were greatest on restored reef habitat, as were those of non‐oyster bivalve species. Total abundance of invertebrates was much greater on oyster reefs than in control plots, regardless of reef or landscape type, yet were frequently highest on older restored reefs. Meanwhile, juvenile fish densities were greatest on natural reefs, at intermediate densities on older restored reefs, and least abundant on controls. When comparing the effects of reef age and landscape setting, juvenile fish densities were greatest on younger reefs within the mudflat landscape. Collectively, these results indicate that oyster reefs harbor higher densities of resident invertebrate prey, which may explain why reef habitat is also important for juvenile fish. Laboratory and field experiments supported the notion that gag grouper (a predatory demersal fish) forage more effectively on oyster reefs than on unstructured mud bottom, whereas our experiments suggest that flounders that utilize oyster reefs likely forage on adjacent mud bottom. Because landscape setting influenced fish and invertebrate communities on restored reefs, the ecological consequences of landscape setting should be incorporated into restoration decision making and site selection to enhance the recovery of ecosystem goods and services. [ABSTRACT FROM AUTHOR]

For many long‐lived taxa, such as trees and corals, older, and larger individuals often have the lowest mortality and highest fecundity. However, climate change‐driven disturbances such as droughts and heatwaves may fundamentally alter typical size‐dependent patterns of mortality and reproduction in these important foundation taxa. Working in Moorea, French Polynesia, we investigated how a marine heatwave in 2019, one of the most intense marine heatwaves at our sites over the past 30 years, drove patterns of coral bleaching and mortality. The marine heatwave drove island‐wide mass coral bleaching that killed up to 76% and 65% of the largest individuals of the two dominant coral genera, Pocillopora and Acropora, respectively. Colonies of Pocillopora and Acropora ≥30 cm diameter were ~3.5× and ~1.3×, respectively, more likely to die than colonies <30‐cm diameter. Typically, annual mortality in these corals is concentrated on the smallest size classes. Yet, this heatwave dramatically reshaped this pattern, with heat stress disproportionately killing larger coral colonies and equalizing annual mortality rates across the size spectrum. This shift in the size‐mortality relationship reduced the overall fecundity of these genera by >60% because big corals are disproportionately important for reproduction on reefs. Additionally, the survivorship of microscopic coral recruits, critical for the recovery of corals following disturbances, declined to 2%, over an order of magnitude lower compared to a year without elevated thermal stress, where 33% of coral recruits survived. While other research has shown that larger corals can bleach more frequently than smaller corals, we show the severe impact this phenomenon can have at the reef‐wide scale. As marine heatwaves become more frequent and intense, disproportionate mortality of the largest, most fecund corals and near‐complete loss of entire cohorts of newly‐settled coral recruits will likely reduce the recovery capacity of these iconic ecosystems. [ABSTRACT FROM AUTHOR]

A concise and stereoselective total synthesis of the clinically relevant tricyclic prostaglandin D2 metabolite (tricyclic‐PGDM) methyl ester in racemic form was accomplished in eight steps from a readily available known cyclopentene‐diol derivative. The synthesis features a nickel‐catalyzed Ueno–Stork‐type dicarbofunctionalization to generate two consecutive stereocenters, a palladium‐catalyzed carbonylative spirolactonization to build the core oxaspirolactone, and a Z‐selective cross‐metathesis to introduce the (Z)‐3‐butenoate side chain, a group challenging to introduce through traditional Wittig protocols and troublesome for the two previous total syntheses. A general Z‐selective cross‐metathesis protocol to construct (Z)‐β,γ‐unsaturated esters was also developed that has broad functional group tolerance and high stereoselectivity. Additionally, our synthesis already accumulated 75 mg of valuable material for an 18O‐tricyclic‐PGDM‐based assay used in clinical settings for inflammation. [ABSTRACT FROM AUTHOR]

Renesas Electronics Corporation is a major global semiconductor supplier headquartered in Japan. It was formed in the early 2000s through the mergers of the semiconductor divisions of Hitachi, Mitsubishi, and NEC Corporation, each of which had a nearly 40‐year history. It is one of the world's leading suppliers of microcontroller devices, the brains of everything electronic and unique to each supplier, such that a redesign of the end‐system is needed to accommodate a change in microcontroller suppliers. Companies representing hundreds of billions of dollars of manufacturing revenue depended on a stable supply of microcontrollers from Renesas. This case‐based research analyzes how an ethical decision‐making framework helped Renesas survive the 2011 Great Japan Earthquake, which damaged Renesas's flagship factory and significantly reduced its production capacity, threatening to roil the global electronics industry. Because of this ethical framework, the company emerged stronger than before after an existential crisis. [ABSTRACT FROM AUTHOR]

A long‐held paradigm is that water depth has a strong influence on coral performance mainly due to the rapid attenuation of light. Yet, many factors influence coral performance across reefscapes, including corallivory. How coral demographic performance changes with water depth and the intensity of corallivory has not been tested but is intriguing because fish abundance and community composition change substantially with water depth. We tested the independent and interactive effects of water depth and corallivory on the growth rates of a reef‐building coral, Acropora hyacinthus common throughout the Indo‐Pacific. Our study was conducted on the fore reef of Mo'orea, French Polynesia, where shallower coral populations have recovered more quickly than deeper populations after a major disturbance that culminated in 2010. Contrary to predictions of the light‐attenuation paradigm, water depth (5 vs. 10 vs. 17 m) did not influence coral growth, regardless from what depth corals were collected. However, the effects of corallivory varied by depth as coral predators significantly reduced the growth rates of A. hyacinthus at 5 and 10 m depth, where the abundance of corallivores and rates of corallivory were greatest. There were no effects of predation on coral growth rates at 17 m, where the intensity of corallivory was lowest. Our results imply that corallivory is not a dominant factor establishing the distribution of A. hyacinthus corals across water depth. Instead, we found that partial predation may limit the potential for recovery of A. hyacinthus in relatively shallow water, where this coral is most abundant. As the frequency and intensity of disturbances impacting coral reef ecosystems increase with climate change and other anthropogenic factors, chronic predation on corals by corallivorous fish may play an increasingly important role in coral community recovery. [ABSTRACT FROM AUTHOR]

Sea‐level rise is predicted to cause major damage to tropical coastlines. While coral reefs can act as natural barriers for ocean waves, their protection hinges on the ability of scleractinian corals to produce enough calcium carbonate (CaCO3) to keep up with rising sea levels. As a consequence of intensifying disturbances, coral communities are changing rapidly, potentially reducing community‐level CaCO3 production. By combining colony‐level physiology and long‐term monitoring data, we show that reefs recovering from major disturbances can produce 40% more CaCO3 than currently estimated due to the disproportionate contribution of juvenile corals. However, the buffering effect of highly productive juvenile corals is compromised by recruitment failures, which have been more frequently observed after large‐scale, repeated bleaching events. While the size structure of corals can bolster a critical ecological function on reefs, climate change impacts on recruitment may undermine this buffering effect, thus further compromising the persistence of reefs and their provision of important ecosystem services. [ABSTRACT FROM AUTHOR]

Predicting whether, how, and to what degree communities recover from disturbance remain major challenges in ecology. To predict recovery of coral communities we applied field survey data of early recovery dynamics to a multi‐species integral projection model that captured key demographic processes driving coral population trajectories, notably density‐dependent larval recruitment. After testing model predictions against field observations, we updated the model to generate projections of future coral communities. Our results indicated that communities distributed across an island landscape followed different recovery trajectories but would reassemble to pre‐disturbed levels of coral abundance, composition, and size, thus demonstrating persistence in the provision of reef habitat and other ecosystem services. Our study indicates that coral community dynamics are predictable when accounting for the interplay between species life‐history, environmental conditions, and density‐dependence. We provide a quantitative framework for evaluating the ecological processes underlying community trajectory and characteristics important to ecosystem functioning. [ABSTRACT FROM AUTHOR]

Background and purpose: Cognitive enhancers are commonly prescribed to people with Alzheimer's disease and related dementias to improve cognition and function. However, their effectiveness for individuals in the pre‐stages of dementia, particularly in functional motor outcomes, remains unknown. We aimed to determine the efficacy of donepezil, a cognitive enhancer that improves cholinergic neurotransmission, on gait performance in mild cognitive impairment (MCI). Methods: This was a double‐blind, placebo‐controlled trial including 60 older adults with MCI, randomized to receive donepezil (10 mg/daily, maximal dose) or placebo. Primary outcome was gait speed (cm/s) under single and three dual‐task conditions (counting backwards by 1 or 7 and naming animals) measured using an electronic walkway. Dual‐task gait cost (DTC), a valid measure of motor–cognitive interaction, was calculated as the percentage change between single (S) and dual‐task (D) gait speeds: [(S − D)/S] × 100. Secondary outcomes included attention, executive function, balance and falls. Results: After 6 months, the donepezil group experienced an improvement in dual‐task gait speed (range 4–11 cm/s), although this was not statistically significant. The donepezil group showed a significant reduction in DTC (improvement) by counting backwards by 1 and 7 compared with placebo (10.25% vs. 1.75%, P = 0.048; 21.38% vs. 14.64%, P = 0.037, intention‐to‐treat analysis). Per‐protocol analyses showed that all three DTCs improved in the donepezil group, along with a non‐significant reduction of rate of falls. Conclusions: Donepezil treatment improved dual‐task gait speed and DTC in elderly patients with MCI. Our results support the concept of reducing falls in MCI by targeting the motor–cognitive interface. [ABSTRACT FROM AUTHOR]

Predicting whether, how, and to what degree communities recover from disturbance remain major challenges in ecology. To predict recovery of coral communities we applied field survey data of early recovery dynamics to a multi‐species integral projection model that captured key demographic processes driving coral population trajectories, notably density‐dependent larval recruitment. After testing model predictions against field observations, we updated the model to generate projections of future coral communities. Our results indicated that communities distributed across an island landscape followed different recovery trajectories but would reassemble to pre‐disturbed levels of coral abundance, composition, and size, thus demonstrating persistence in the provision of reef habitat and other ecosystem services. Our study indicates that coral community dynamics are predictable when accounting for the interplay between species life‐history, environmental conditions, and density‐dependence. We provide a quantitative framework for evaluating the ecological processes underlying community trajectory and characteristics important to ecosystem functioning. [ABSTRACT FROM AUTHOR]

Abstract: Background: ASSURE‐CSU revealed differences in physician and patient reporting of angioedema. This post hoc analysis was conducted to evaluate the actual rate of angioedema in the study population and explore differences between patients with and without angioedema. Methods: This international observational study assessed 673 patients with inadequately controlled chronic spontaneous urticaria (CSU). Physicians abstracted angioedema data from medical records, which were compared with patient‐reported data. Patients in the Yes‐angioedema category had angioedema reported in the medical record and a patient‐reported source. For those in the No‐angioedema category, angioedema was reported in neither the medical record nor a patient‐reported source. Those in the Misaligned category had angioedema reported in only one source. Statistical comparisons between Yes‐angioedema and No‐angioedema categories were conducted for measures of CSU activity, health‐related quality of life (HRQoL), productivity and healthcare resource utilization (HCRU). Regression analyses explored the relationship between Dermatology Life Quality Index (DLQI) score and angioedema, adjusting for important covariates. Results: Among evaluable patients, 259 (40.3%), 173 (26.9%) and 211 (32.8%) were in the Yes‐angioedema, No‐angioedema and Misaligned category, respectively. CSU activity and impact on HRQoL, productivity, and HCRU was greater for Yes‐angioedema patients than No‐angioedema patients. After covariate adjustment, mean DLQI score was significantly higher (indicating worse HRQoL) for patients with angioedema versus no angioedema (9.88 vs 7.27, P < .001). The Misaligned category had similar results with Yes‐angioedema on all outcomes. Conclusions: Angioedema in CSU seems to be under‐reported but has significant negative impacts on HRQoL, daily activities, HCRU and work compared with no angioedema. [ABSTRACT FROM AUTHOR]

Objective: To perform a systematic review and meta‐analysis on the prevalence of transactive response DNA‐binding protein 43 (TDP‐43) proteinopathy in cognitively normal older adults. Methods: We systematically reviewed and performed a meta‐analysis on the prevalence of TDP‐43 proteinopathy in older adults with normal cognition, evaluated by the Mini‐Mental State Examination or the Clinical Dementia Rating. We estimated the overall prevalence of TDP‐43 using random‐effect models, and stratified by age, sex, sample size, study quality, antibody used to assess TDP‐43 aggregates, analysed brain regions, Braak stage, Consortium to Establish a Registry for Alzheimer's Disease score, hippocampal sclerosis and geographic location. Results: A total of 505 articles were identified in the systematic review, and 7 were included in the meta‐analysis with 1196 cognitively normal older adults. We found an overall prevalence of TDP‐43 proteinopathy of 24%. Prevalence of TDP‐43 proteinopathy varied widely across geographic location (North America: 37%, Asia: 29%, Europe: 14%, and Latin America: 11%). Estimated prevalence of TDP‐43 proteinopathy also varied according to study quality (quality score >7: 22% vs. quality score <7: 42%), antibody used to assess TDP‐43 proteinopathy (native: 18% vs. hyperphosphorylated: 24%) and presence of hippocampal sclerosis (without 24% vs. with hippocampal sclerosis: 48%). Other stratified analyses by age, sex, analysed brain regions, sample size and severity of AD neuropathology showed similar pooled TDP‐43 prevalence. Conclusions: Different methodology to access TDP‐43, and also differences in lifestyle and genetic factors across different populations could explain our results. Standardization of TDP‐43 measurement, and future studies about the impact of genetic and lifestyle characteristics on the development of neurodegenerative diseases are needed. [ABSTRACT FROM AUTHOR]

Aims KCNJ11-related diabetes is the most common form of permanent neonatal diabetes and has been associated with a spectrum of neurodevelopmental problems. We compared neurodevelopmental outcomes in patients with KCNJ11 mutations and their sibling controls. Methods Through our Monogenic Diabetes Registry (), we evaluated 23 patients with KCNJ11 mutations with ( n = 9) and without ( n = 14) global developmental delay successfully treated with sulfonylurea and 20 healthy sibling controls, using a battery of targeted neuropsychological and behavioural assessments with scaled scores that are comparable across a wide range of ages. Results Patients with KCNJ11-related diabetes without global developmental delay had significant differences compared with sibling controls on a range of assessments including IQ, measures of academic achievement and executive function. KCNJ11 patients with global delay exhibited significant differences in behavioural symptoms with a tendency to avoid social contact and displayed a reduced ability to adapt to new circumstances. Parents reported more immature behaviour, gross mood swings, bizarre thoughts, other unusual and severe behaviours, and there were also significant deficits in all subdomains of daily living skills. Conclusions This series represents the largest and most comprehensive study of neuropsychological and behavioural dysfunction of individuals with KCNJ11 diabetes and is the first to compare outcome with sibling controls. Our data demonstrate the variety of neurodevelopmental problems seen in those with KCNJ11 mutations, even in those without recognized global developmental delays. These data can be used to counsel families and guide structured neurodevelopmental assessments and treatments based on the initial genetic diagnosis in patients with neonatal diabetes. [ABSTRACT FROM AUTHOR]

OBJECTIVES To describe serum C-reactive protein and S100A12 concentrations in dogs with hepatic disease and to determine whether there is a relationship between the concentration of either and the severity of hepatic necroinflammation. METHODS Serum C-reactive protein and S100A12 concentrations were measured in 46 dogs undergoing hepatic biopsy. Dogs were divided into three groups: congenital portosystemic shunts, chronic hepatitis and hepatic neoplasia. The histological severity of hepatic necroinflammation was scored. RESULTS C-reactive protein and S100A12 concentrations were greater than the upper limit of the reference intervals in 39 and 26% of dogs, respectively. There was no association of disease group with C-reactive protein (P=0·1733) or S100A12 (P=0·1513) concentrations. There was a positive correlation between serum C-reactive protein concentration and hepatic necroinflammatory activity (rs=0·428, P=0·006). CLINICAL SIGNIFICANCE Increased serum C-reactive protein and S100A12 concentrations were observed in a subpopulation of dogs with various types of hepatic diseases, suggesting acute-phase inflammation and activation of phagocytic cells, respectively. Dogs with higher hepatic necroinflammatory activity scores tended to have higher serum C-reactive protein concentrations. Further studies are needed to confirm this finding in a larger group of dogs. [ABSTRACT FROM AUTHOR]

The sex difference in marathon performance increases with finishing place and age of the runner but whether this occurs among swimmers is unknown. The purpose was to compare sex differences in swimming velocity across world record place (1st-10th), age group (25-89 years), and event distance. We also compared sex differences between freestyle swimming and marathon running. The world's top 10 swimming times of both sexes for World Championship freestyle stroke, backstroke, breaststroke, and butterfly events and the world's top 10 marathon times in 5-year age groups were obtained. Men were faster than women for freestyle (12.4 ± 4.2%), backstroke (12.8 ± 3.0%), and breaststroke (14.5 ± 3.2%), with the greatest sex differences for butterfly (16.7 ± 5.5%). The sex difference in swimming velocity increased across world record place for freestyle (P < 0.001), breaststroke, and butterfly for all age groups and distances (P < 0.001) because of a greater relative drop-off between first and 10th place for women. The sex difference in marathon running increased with the world record place and the sex difference for marathon running was greater than for swimming (P < 0.001). The sex difference in swimming increased with world record place and age, but was less than for marathon running. Collectively, these results suggest more depth in women's swimming than marathon running. [ABSTRACT FROM AUTHOR]

Background: A considerable amount of data and the CFR suggest that platelet concentrates (PCs) should be stored with continuous, gentle agitation before transfusion. However, there are only limited data concerning the mechanisms of platelet damage that may occur when agitation is interrupted, and there are no CFR guidelines concerning shipment between periods of storage.Study Design and Methods: PCs were prepared by the platelet-rich plasma method and stored for 5 days at 20 to 24 degrees C; agitation was interrupted for 1 to 3 days either by simply stopping the agitator or by placing the PCs in a stationary shipping container. Measurements of platelet metabolism and quality were made during storage and on Day 5.Results: With interruption on the agitator, the production of lactic acid was increased during the interruption in proportion to the number of platelets in the PC and the duration of the interruption. The pO(2) was increased during agitation interruption, which suggested a decline in oxygen utilization. With the use of the hypotonic shock response and the extent of shape change as reflections of platelet quality, there was no evidence of platelet damage unless the pH fell to or below 6.5. No PC reached this level after an interruption of agitation for only 1 day, irrespective of which day was chosen for interruption. PCs whose agitation was interrupted for 2 and 3 days were at risk of having a pH less than 6.5 if their contents were greater than 1.25 x 10(11) and 0.75 x 10(11) platelets, respectively. Interruption of agitation for 1 day in the shipping container produced results essentially identical to those produced by interruption on the agitator.Conclusion: Interruption of agitation of PCs for 1 day, either on the agitator or in the shipping container, produces no platelet damage measurable by these in vitro techniques. However, an interruption of agitation for 2 days can result in significant damage in some components. Further studies will be required to learn more about the mechanisms that lead to the metabolic changes described and to determine if the same generalizations apply to apheresis PCs and PCs prepared from pooled buffy coats. [ABSTRACT FROM AUTHOR]

Hydrodynamic conditions can influence the distribution and abundance of aquatic species in many ways, including directly through disturbance and resource delivery, and indirectly by altering environmental cues and species interactions. In coral reef ecosystems, corallivory is an important top-down control of coral populations, while water motion can enhance coral performance via autotrophic and/or heterotrophic pathways. Using a large-scale field assay in Mo'orea, French Polynesia, we measured the extent to which the growth of a branching acroporid coral is influenced by hydrodynamics that deliver nutrients and food to corals but also impede corallivory. We explored two hydrodynamic properties that characterized our study system, mean current velocity and current velocity fluctuation (a measure of waves and turbulence). In treatments where predators were excluded, coral skeletal growth was positively related to mean current velocity, whereas no effect of velocity fluctuations was detected. In the presence of predators, growth was positively related to velocity fluctuations, but no relationship with mean velocity was detected. The major effect of velocity fluctuations was to reduce the attack rate of corallivores by lowering both their per capita bite rate and local density. Corals thus benefited directly from increased currents, probably through enhanced autotrophy and/or heterotrophy, and indirectly from velocity fluctuations through reduced corallivory. Our data indicate that for the coral and locale we examined, the indirect hydrodynamic effect on coral performance via reduction in corallivory was substantial, increasing daily growth rate by 4%. Hydrodynamic enhancement of acroporid coral growth via simultaneous direct and indirect effects can be important for the persistence of coral reefs as well as their recovery following disturbance. [ABSTRACT FROM AUTHOR]

Environmental heterogeneity can promote the emergence of locally adapted phenotypes among subpopulations of a species, whereas gene flow can result in phenotypic and genotypic homogenization. For organisms like amphidromous fishes that change habitats during their life history, the balance between selection and migration can shift through ontogeny, making the likelihood of local adaptation difficult to predict. In Hawaiian waterfall-climbing gobies, it has been hypothesized that larval mixing during oceanic dispersal counters local adaptation to contrasting topographic features of streams, like slope gradient, that can select for predator avoidance or climbing ability in juvenile recruits. To test this hypothesis, we used morphological traits and neutral genetic markers to compare phenotypic and genotypic distributions in recruiting juveniles and adult subpopulations of the waterfall-climbing amphidromous goby, Sicyopterus stimpsoni, from the islands of Hawai'i and Kaua'i. We found that body shape is significantly different between adult subpopulations from streams with contrasting slopes and that trait divergence in recruiting juveniles tracked stream topography more so than morphological measures of adult subpopulation differentiation. Although no evidence of population genetic differentiation was observed among adult subpopulations, we observed low but significant levels of spatially and temporally variable genetic differentiation among juvenile cohorts, which correlated with morphological divergence. Such a pattern of genetic differentiation is consistent with chaotic genetic patchiness arising from variable sources of recruits to different streams. Thus, at least in S. stimpsoni, the combination of variation in settlement cohorts in space and time coupled with strong postsettlement selection on juveniles as they migrate upstream to adult habitats provides the opportunity for morphological adaptation to local stream environments despite high gene flow. [ABSTRACT FROM AUTHOR]

Fisheries science often uses population models that assume no external recruitment, but nearshore marine populations harvested on small scales of <200 km often exhibit an unknown mix of self-recruitment and recruitment from external sources. Since empirical determination of self-recruitment vs. external recruitment is difficult, we used a modeling approach to examine the sensitivity of fishery management priorities to recruitment assumptions (self [closed], external [open]) in a local population of harvested giant clams (Tridacna maxima) on Mo'orea, French Polynesia. From 2006 to 2010, we measured growth, fecundity, recruitment, and survival (resulting from natural and fishing mortality). We used these data to parameterize both a closed (complete self-recruitment) and an open (no selfrecruitment) integral projection model (IPM), and then calculated elasticities of demographic rates (growth, survival, recruitment) to future population abundance in 20 years. The models' lowest projected abundance was 93.4% (95% CI, [86.5%, 101.8%]) of present abundance, if the local population is entirely open and the present level of fishing mortality persists. The population will exhibit self-sustaining dynamics (1 ≤ λ ≤ 1.07) as for a closed population if the ratio of self-recruits per gram of dry gonad is >0.775 (equivalent to 52.85% selfrecruitment under present conditions). Elasticity analysis of demographic parameters indicated that future abundance can most effectively be influenced by increasing survival of mid-sized clams (~80-120 mm) if the population is self-sustaining, and by increasing survival of juvenile clams (~40-70 mm) if the population is non-self-sustaining (as for an open population). Our results illustrate that management priorities can vary depending on the amount of self-recruitment in a local population. [ABSTRACT FROM AUTHOR]

No-take marine reserves show great promise as conservation tools, yet the integration of reserves into assessment models for data-limited fisheries management is just emerging. We develop a framework for integrating marine reserves into two data-limited assessment models: spawning potential ratio (SPR) and yield per recruit (YPR). We use Monte Carlo simulation to test the applicability of the framework to a sedentary species with a dispersive larval stage under process and observation uncertainties. The reserve-based approach increased estimates of spawning potential while reducing YPR and had a consistent estimation bias of less than 15%. Using the framework, we assessed a commercial fishery targeting grass rockfish ( Sebastes rastrelliger) in southern California, USA and found that inclusion of reserves reduced the probability of overfishing. The reserve-based assessment approach may create win-win policy solutions for conservation and fisheries objectives in many nearshore fisheries with well-enforced marine reserves that target sedentary species with a dispersive larval stage. [ABSTRACT FROM AUTHOR]

Aims To explore insulin sensitivity and insulin secretion in people with latent autoimmune diabetes in adulthood ( LADA) compared with that in people with Type 2 diabetes. Methods A total of 12 people with LADA, defined as glutamic acid decarboxylase ( GAD) antibody positivity and > 1 year of insulin independency (group A) were age-matched pairwise to people with Type 2 diabetes (group B) and to six people with Type 2 diabetes of similar age and BMI (group C). β-cell function (first-phase insulin secretion and assessment of insulin pulsatility), insulin sensitivity (hyperinsulinemic-euglycemic clamp) and metabolic response during a mixed meal were studied. Results Both first-phase insulin secretion and insulin release during the meal were greater ( P = 0.05 and P = 0.009, respectively) in Type 2 diabetes as compared with LADA; these differences were lost on adjustment for BMI (group C) and could be explained by BMI alone in a multivariate analysis. Neither insulin pulsatility, incretin secretion nor insulin sensitivity differed among the groups. Conclusions We found no evidence that LADA and Type 2 diabetes were distinct disease entities beyond the differences explained by BMI. [ABSTRACT FROM AUTHOR]

Sex-related differences in physiology and anatomy are responsible for profound differences in neuromuscular performance and fatigability between men and women. Women are usually less fatigable than men for similar intensity isometric fatiguing contractions. This sex difference in fatigability, however, is task specific because different neuromuscular sites will be stressed when the requirements of the task are altered, and the stress on these sites can differ for men and women. Task variables that can alter the sex difference in fatigability include the type, intensity and speed of contraction, the muscle group assessed and the environmental conditions. Physiological mechanisms that are responsible for sex-based differences in fatigability may include activation of the motor neurone pool from cortical and subcortical regions, synaptic inputs to the motor neurone pool via activation of metabolically sensitive small afferent fibres in the muscle, muscle perfusion and skeletal muscle metabolism and fibre type properties. Non-physiological factors such as the sex bias of studying more males than females in human and animal experiments can also mask a true understanding of the magnitude and mechanisms of sex-based differences in physiology and fatigability. Despite recent developments, there is a tremendous lack of understanding of sex differences in neuromuscular function and fatigability, the prevailing mechanisms and the functional consequences. This review emphasizes the need to understand sex-based differences in fatigability to shed light on the benefits and limitations that fatigability can exert for men and women during daily tasks, exercise performance, training and rehabilitation in both health and disease. [ABSTRACT FROM AUTHOR]

Aims The response to glucagon-like peptide 1 receptor agonist treatment may be influenced by endogenous β-cell function. We investigated whether urinary C-peptide creatinine ratio assessed before or during liraglutide treatment was associated with treatment response. Methods A single, outpatient urine sample for urinary C-peptide creatinine ratio was collected 2 h after the largest meal of the day among two separate groups: (1) subjects initiating liraglutide (0.6 → 1.2 mg daily) or (2) subjects already treated with liraglutide for 20-32 weeks. The associations between pretreatment and on-treatment urinary C-peptide creatinine ratio and HbA1c change at 32 weeks were assessed using univariate and multivariate analyses (the ratio was logarithm transformed for multivariate analyses). Changes in HbA1c according to pretreatment urinary C-peptide creatinine ratio quartiles are shown. Results One hundred and sixteen subjects (70 pretreatment, 46 on treatment) with Type 2 diabetes from 10 diabetes centres were studied. In univariate analyses, neither pretreatment nor on-treatment urinary C-peptide creatinine ratio correlated with HbA1c change (Spearman rank correlation coefficient, r = -0.17, P = 0.17 and r = -0.20, P = 0.19, respectively). In multi-linear regression analyses, entering baseline HbA1c and log urinary C-peptide creatinine ratio, pretreatment and on-treatment log urinary C-peptide creatinine ratio became significantly associated with HbA1c change ( P = 0.048 and P = 0.040, respectively). Mean ( sd) HbA1c changes from baseline in quartiles 1 to 4 of pretreatment urinary C-peptide creatinine ratio were -3 ± 17 mmol/mol (-0.3 ± 1.6%) ( P = 0.52), -12 ± 15 mmol/mol (-1.1 ± 1.4%) ( P = 0.003), -11 ± 13 mmol/mol (-1.0 ± 1.2%) ( P = 0.002) and -12±17 mmol/mol (-1.1±1.6%) ( P=0.016), respectively. Conclusions Postprandial urinary C-peptide creatinine ratios before and during liraglutide treatment were weakly associated with the glycaemic response to treatment. Low pretreatment urinary C-peptide creatinine ratio may be more useful than higher values by predicting poorer glycaemic response. [ABSTRACT FROM AUTHOR]

Key points Skeletal muscle calcium resequestration and performance is increased in male rats with induced diabetes; and whilst muscle calcium resequestration is important during exercise, it has not been investigated in human diabetes or compared between sexes., We show that Ca2+-ATPase activity and Ca2+ uptake are higher among people with type 1 diabetes (T1D) compared with matched non-diabetic controls (CON), but that performance during intense exercise was similar; Ca2+-ATPase activity and Ca2+ uptake are also higher among men than women., We show that Ca2+-ATPase activity is reduced during intense exercise in men but not women, and is reduced by high-intensity exercise training (HIET) in T1D and CON., Fatigue is commonly reported by people with diabetes, but our data show that muscle calcium resequestration and performance during intense exercise and after HIET is not impaired in T1D, and hence other physiological or psychological mechanisms for fatigue in diabetes must be sought., Sex influences muscle calcium regulation., Abstract Calcium cycling is integral to muscle performance during the rapid muscle contraction and relaxation of high-intensity exercise. Ca2+ handling is altered by diabetes mellitus, but has not previously been investigated in human skeletal muscle. We investigated effects of high-intensity exercise and sprint training on skeletal muscle Ca2+ regulation among men and women with type 1 diabetes (T1D, n = 8, 3F, 5M) and matched non-diabetic controls (CON, n = 8, 3F, 5M). Secondarily, we examined sex differences in Ca2+ regulation. Subjects undertook 7 weeks of three times-weekly cycle sprint training. Before and after training, performance was measured, and blood and muscle were sampled at rest and after high-intensity exercise. In T1D, higher Ca2+-ATPase activity (+28%) and Ca2+ uptake (+21%) than in CON were evident across both times and days ( P < 0.05), but performance was similar. In T1D, resting Ca2+-ATPase activity correlated with work performed until exhaustion ( r = 0.7, P < 0.01). Ca2+-ATPase activity, but not Ca2+ uptake, was lower (−24%, P < 0.05) among the women across both times and days. Intense exercise did not alter Ca2+-ATPase activity in T1D or CON. However, sex differences were evident: Ca2+-ATPase was reduced with exercise among men but increased among women across both days (time × sex interaction, P < 0.05). Sprint training reduced Ca2+-ATPase (−8%, P < 0.05), but not Ca2+ uptake, in T1D and CON. In summary, skeletal muscle Ca2+ resequestration capacity was increased in T1D, but performance was not greater than CON. Sprint training reduced Ca2+-ATPase in T1D and CON. Sex differences in Ca2+-ATPase activity were evident and may be linked with fibre type proportion differences. [ABSTRACT FROM AUTHOR]

Zinc oxide (ZnO) nanoparticles are being increasingly utilized in a variety of products and applications and are therefore commonly discharged into aquatic environments, increasing exposure and potentially impacting aquatic organisms. Zinc oxide nanoparticles can depress growth of some marine phytoplankton, and several examples of nanoparticle trophic transfer have been documented, although not within planktonic communities. The authors test whether feeding on ZnO-exposed phytoplankton could cause toxic effects in a widespread and ecologically important marine grazer, the copepod Acartia tonsa. The authors exposed the diatom Thalassiosira weissflogii to ZnO nanoparticles for 7 d and measured growth, zinc accumulation, and zinc distribution within the algal cells to elucidate bioavailability to grazing copepods. Thalassiosira weissflogii cultured with nano-ZnO were continuously fed to A. tonsa for 7 d, and reproduction and survival were quantified. A dose-dependent growth reduction was observed in T. weissflogii exposed to nano-ZnO, with a 20% effective concentration (EC20) of 70 µg/L Zn and a lowest observed effect concentration (LOEC) of 99 µg/L Zn. Zinc accumulation in the algae occurred dose-dependently over time, with the majority of the zinc partitioning into the cell wall fraction. Feeding on ZnO-exposed diatoms led to a decrease in copepod survival and reproduction. The EC20s corresponding to the dissolved zinc concentration in the T. weissflogii exposure media were 112 µg/L (13 µg/g dry wt) and 143 µg/L (16 µg/g dry wt), and the LOECs were 168 µg/L (17 µg/g dry wt) and 263 µg/L (21 µg/g dry wt) for copepod survival and reproduction, respectively. These results provide evidence of trophic transfer of metal contaminants associated with metal oxide nanomaterials within a marine plankton community, leading to a reduction in individual demographic performance of an important coastal marine grazer. Environ Toxicol Chem 2013;32:1264-1269. © 2013 SETAC [ABSTRACT FROM AUTHOR]

Epidemiological theory suggests that pathogens will not cause host extinctions because agents of disease should fade out when the host population is driven below a threshold density. Nevertheless, infectious diseases have threatened species with extinction on local scales by maintaining high incidence and the ability to spread efficiently even as host populations decline. Intertidal black abalone (Haliotis cracherodii), but not other abalone species, went extinct locally throughout much of southern California following the emergence of a Rickettsiales-like pathogen in the mid-1980s. The rickettsial disease, a condition known as withering syndrome (WS), and associated mortality occur at elevated water temperatures. We measured abalone body temperatures in the field and experimentally manipulated intertidal environmental conditions in the laboratory, testing the influence of mean temperature and daily temperature variability on key epizootiological processes of WS. Daily temperature variability increased the susceptibility of black abalone to infection, but disease expression occurred only at warm water temperatures and was independent of temperature variability. These results imply that high thermal variation of the marine intertidal zone allows the pathogen to readily infect black abalone, but infected individuals remain asymptomatic until water temperatures periodically exceed thresholds modulating WS. Mass mortalities can therefore occur before pathogen transmission is limited by density-dependent factors. [ABSTRACT FROM AUTHOR]

Diabet. Med. 29, 470-478 (2012) Abstract Aims Systemic concentrations of adhesion molecules and chemokines are associated with increased risk of cardiovascular complications. We compared these factors between patients with Type 2 diabetes vs. Type 1 diabetes or latent autoimmune diabetes in adults. Methods Serum concentrations of adhesion molecules sE-selectin, sICAM-1 and sVCAM-1, and chemokines CCL2, CCL3 and CCL4 were measured in 61 patients with latent autoimmune diabetes in adults, 90 with Type 1 diabetes, 465 with Type 2 diabetes and in 41 control subjects, using multiple regression models to adjust for possible confounders. Results Patients with Type 2 diabetes exhibited greater concentrations of adhesion molecules ( P < 0.02) than those with Type 1 diabetes, latent autoimmune diabetes in adults and control subjects. These differences persisted upon adjustments for age, sex, BMI, blood pressure and diabetes duration ( P < 0.04). Higher BMI positively correlated with concentrations of adhesion molecules in all subjects ( P < 0.0001). Concentrations of sE-selectin positively related to diastolic (β = 0.31) and systolic (β = 0.28) blood pressure in the adjusted model ( P < 0.04). Concentrations of the chemokines, CCL2 and CCL4, did not differ between groups, while CCL3 was higher in patients with latent autoimmune diabetes in adults and Type 1 diabetes than in those with Type 2 diabetes and control subjects ( P < 0.05). Conclusions Systemic concentrations of adhesion molecules, but not chemokines, relate to cardiovascular risk factors, but remain higher after adjustments in Type 2 diabetes, suggesting a diabetes-type specific effect without difference between latent autoimmune diabetes in adults and Type 1 diabetes, despite their dissimilar phenotype. [ABSTRACT FROM AUTHOR]

The article presents a study on the spiny lobster population and fishery responses to a marine reserve network at Santa Cruz and Santa Rosa Islands in California. The study highlights the application of collaborative fisheries research (CFR), trapping, and analysis of variance (ANOVA) to describe the lobster population and fishery responses. Results show that fish mortality and spillover affects fishery dynamics in islands.

Summary Objective Patients with primary aldosteronism (PA) who are suitable for surgery should undergo adrenal computerised tomography (CT) and adrenal venous sampling (AVS). A retrospective study was performed of 100 patients with PA. We determined the optimal AVS lateralisation ratio for unilateral disease and reviewed adrenalectomy outcomes evaluating which characteristics predicted hypertension cure. Methods AVS was performed in 93 patients. Lateralisation criteria were assessed using ROC curve analysis. The outcome of adrenalectomy was reviewed in 39 patients and predictive factors for cure determined using univariate and multivariate analysis. Results Of previously published criteria, ROC curve analysis found a cortisol corrected aldosterone affected to unaffected (Aldo/Cort A:U) cut-off of 2·0 was the best predictor of adenoma identifying 80·4% of patients. A novel ratio calculated by dividing the affected to unaffected ratio by the unaffected to peripheral ratio [(Aldo/Cort A:U)/(Aldo/Cort U:IVC)] was successful in identifying 87·0% of patients. Cure rate for blood pressure after adrenalectomy was 38·5% with improvement in 59·0%. On univariate analysis, predictors of post-operative hypertension were increased weight, raised creatinine, left ventricular hypertrophy (LVH) and male sex. On multivariate analysis, male sex and higher pre-operative systolic blood pressure were predictive. Conclusions Patients with PA should have CT scanning and AVS. Aldo/Cort A:U >2·0 is the most accurate of previously published ratios in predicting unilateral disease. When patients were carefully selected for surgery, 97% had cure or improvement in blood pressure control. Further confirmatory work is required on a novel ratio which was even more predictive in our series. [ABSTRACT FROM AUTHOR]

The species composition of coral communities has shifted in many areas worldwide through the relative loss of important ecosystem engineers such as highly branched corals, which are integral in maintaining reef biodiversity. We assessed the degree to which the performance of recently recruited branching corals was influenced by corallivory, competition, sedimentation, and the interactions between these factors. We also explored whether the species-specific influence of these biotic and abiotic constraints helps to explain recent shifts in the coral community in lagoons of Moorea, French Polynesia. Population surveys revealed evidence of a community shift away from a historically acroporid-dominated community to a pocilloporid- and poritid-dominated community, but also showed that the distribution and abundance of coral taxa varied predictably with location in the lagoon. At the microhabitat scale, branching corals grew mainly on dead or partially dead massive Porites ("bommies"), promontories with enhanced current velocities and reduced sedimentation. A demographic study revealed that growth and survival of juvenile Pocillopora verrucosa and Acropora retusa, the two most common branching species of each taxon, were affected by predation and competition with vermetid gastropods. By 24 months of age, 20-60% of juvenile corals suffered partial predation by corallivorous fishes, and injured corals experienced reduced growth and survival. A field experiment confirmed that partial predation by corallivorous fishes is an important, but habitat-modulated, constraint for branching corals. Competition with vermetid gastropods reduced growth of both branching species but unexpectedly also provided an associational defense against corallivory. Overall, the impact of abiotic constraints was habitat-specific and similar for Acropora and Pocillopora, but biotic interactions, especially corallivory, had a greater negative effect on Acropora than Pocillopora, which may explain the local shift in coral community composition. [ABSTRACT FROM AUTHOR]

Ecosystem restoration often aims to recreate the physical habitat needed to support a particular life-stage of a focal species. For example, river channel reconstruction, a common restoration practice along the Pacific coast, is typically used to enhance spawning habitat for adult Chinook salmon, a species experiencing large population declines. These restoration efforts rarely consider, however, that altering spawning habitat could have indirect effects on other life-stages, such as juveniles, which might occur if, e.g. reconstruction alters the benthic food web. To determine how channel reconstruction impacts benthic macroinvertebrates, juvenile Chinook's primary prey, we conducted two studies at a restoration site in the Merced River, California. We asked (1) has gravel enhancement altered invertebrate assemblages in the restored reach compared with an unrestored reach? and, if so, (2) can shifts in the invertebrate community be explained by increased substrate mobility and by reduced heterogeneity that results from restoration? We show that invertebrate abundance and biomass were lower in the restored reach and that these changes were accompanied by a shift from dominance by filter-feeding caddisflies ( Hydropsyche) in the unrestored reach to grazing mayflies ( Baetis) in the restored reach. Using an in situ manipulation, we demonstrated that this trend was driven by increased substrate mobility that reduces the abundance of Hydropsyche and by decreased substrate heterogeneity that reduces the abundance of Baetis. Our studies suggest that geomorphic changes typical of reconstructed rivers can alter food webs in ways that may have important implications for supporting the focal species of restoration efforts. [ABSTRACT FROM AUTHOR]

Aims The aim of this study was to use general practice data to estimate the prevalence of diabetic nephropathy within the registered diabetes patients and examine variation in practice prevalence and management performance since introduction of this initiative. Methods Reported quality indicators from the Northern Ireland General Practice Quality and Outcomes Framework were analysed for diabetes and diabetic nephropathy prevalence and management in the period 2004-2008. Variation in prevalence at practice level was assessed using multiple linear regression adjusting for age, practice size, deprivation and glycaemic control. Results In 2006-2007, 57 454 (4.1%) adult diabetic patients were registered in the denominator population of 1.4 million comparedwith 51 923 (3.8%) in 2004-2005 (mean practice range 0.5-7.7%).Diabetic nephropathy prevalencewas 15.1 and 11.5%, respectively (8688 and 5955 patients). Documented diabetic nephropathy prevalence showed marked variation across practices (range 0-100%) and was significantly negatively correlatedwith diabetes list size, albumin creatinine ratio testing rates and renin-angiotensin-aldosterone system blockade use and positively correlated with exception reporting rates. Specifically, for every increase in 100 diabetic patients to a register, documented diabetic nephropathy prevalence reduced by 40% (P = 0.003). On the positive side, median albumin-creatinine ratio testing rates doubled to 82%compared with figures in the pre-Framework era. Conclusions Implementation of the Northern Ireland General Practice Quality and Outcomes Framework has positively benefitted testing for diabetic nephropathy and increased numbers of detected patients in a short space of time.Large variation in diabetic nephropathy prevalence remains and is associated with diabetes registry size, screening and treatment practices, suggesting that understanding this variation may help detect and better manage diabetic nephropathy. [ABSTRACT FROM AUTHOR]

Subluxation of a vertebra secondary to an injury (ie, traumatic spondyloptosis) is most commonly seen in the lumbosacral joint. This extremely rare spinal destabilization is caused by congenital defects, degeneration, tumors, infection, or trauma and is accompanied by severe neurologic debilitation. The patient's neurological function can be preserved when surgical team members have knowledge of spinal injuries, surgical interventions, positioning and its implications, and an awareness of the risks to the patient. Appropriate interventions can decrease complications, operative revisions, length of stay, morbidity and mortality, and hospital costs. [ABSTRACT FROM AUTHOR]

Technological advances have changed how traditional surgical procedures are performed. New knowledge and surgical skills are required to effectively monitor the patient and manage fluids administered perioperatively.Today, selective fluids are used in a variety of surgical specialties. Complications of fluid therapy can occur that are intrinsic to each procedure within a specialty.This article provides perioperative nurses with the information needed to evaluate different fluid media and their applications and identify patient care considerations. Pos sible complications and important postanesthesia care concerns also are discussed. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a study to explore patients' experiences of primary angioplasty and assess their illness perceptions during early recovery. Background. Primary angioplasty is recognized as the gold standard treatment for patients with ST elevation myocardial infarction, yet little is known about patients' experiences of this treatment. Recent policy change has emphasized the need for clinical practice to be more patient-centred. One way to achieve this is to understand patients' experiences of treatment better. Method. A mixed methods exploratory study was carried out in 2006-2007 with a purposive sample of 29 patients. Data were collected 3-12 days after hospital discharge using (a) semi-structured interviews to explore participants' experiences and (b) The Illness Perception Questionnaire to evaluate illness perceptions. Interview data were analysed using the Framework approach. Questionnaire data were used to inform the qualitative findings. Findings. Participants were very positive about their treatment but experienced considerable emotional shock, which was exacerbated by the speed with which events occurred. Patients' experiences were characterized by a mismatch between their expectations and reality. Questionnaire data supported the notion that they experienced difficulty in 'making sense' of their condition in a coherent way. They tended to see their condition as 'acute' rather than 'chronic' and their treatment as curative. Conclusion. Patient education should include focused discussions addressing the 'mismatches' that may occur between their expectations and reality. In this way, a more coherent understanding can be promoted, with greater awareness of heart disease as a long-term condition requiring ongoing self-management. [ABSTRACT FROM AUTHOR]

Diseases gain identity from clinical phenotype as well as genetic and environmental aetiology. The definition of type 1 diabetes is clinically exclusive, comprising patients who are considered insulin dependent at diagnosis, whilst the definition of type 2 diabetes is inclusive, only excluding those who are initially insulin dependent. Ketosis-prone diabetes (KPD) and latent autoimmune diabetes in adults (LADA) are each exclusive forms of diabetes which are, at least initially, clinically distinct from type 2 diabetes and type 1 diabetes, and each have a different natural history from these major types of diabetes. KPD can be diagnosed unequivocally as diabetes presenting with the categorical clinical feature, ketoacidosis. In contrast, LADA can be diagnosed by the co-occurrence of three traits, not one of which is categorical or exclusive to the condition: adult-onset non-insulin-requiring diabetes, an islet autoantibody such as glutamic acid decarboxylase autoantibodies (GADA) or cytoplasmic islet cell autoantibodies (ICA), and no need for insulin treatment for several months post-diagnosis. But while some would split diabetes into distinct subtypes, there is a strong case that these subtypes form a continuum of varying severity of immune and metabolic dysfunction modified by genetic and non-genetic factors. This article discusses the nature of disease classification in general, and KPD and LADA in particular, emphasizing the potential value and pitfalls in classifying diabetes and suggesting a need for more research in this area. Copyright © 2008 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Aims To establish the safety in terms of insulin sensitivity of a low dose thiazide/ACE inhibitor combination. Methods We examined the effects on insulin sensitivity of captopril either alone or in combination with low-dose bendroflumethiazide (1.25 mg) in 15 hypertensive Type 2 diabetic patients. Insulin action was assessed using an isoglycaemic hyperinsulinaemic clamp in a double-blind, randomised, crossover study after a 6-week placebo run-in and following two 12-week treatment periods with captopril (C) (100 mg) alone or in combination with bendroflumethiazide (CB) (1.25 mg). Results Blood pressure was lower following CB compare to C (138/83 vs. 144/85 mmHg; P < 0.05) and both were lower than baseline (153/92 mmHg; P < 0.01). CB resulted in a significant increase in fasting plasma glucose compared to C (9.6 ± 2.6 vs. 8.5 ± 1.6 mmol/l; P < 0.05). Exogenous glucose infusion rates required to maintain isoglycaemia during hyperinsulinaemia were lower after CB compared to C (25.1 ± 13.3 vs. 34.2 ± 16.8 µmol/kg/min; P < 0.01) as were isotopically determined glucose utilisation rates (29.0 ± 12.4 vs. 36.6 ± 17.3 µmol/kg/min; P < 0.05). There was no significant difference in fasting endogenous glucose production between treatments (CB 9.3 ± 3.3 vs. C 8.6 ± 1.6 µmol/kg/min), nor between suppression following insulin (CB 4.0 ± 2.1 vs. C 4.3 ± 3.1 µmol/kg/min). Conclusions Combination of low-dose bendroflumethiazide with captopril lowered blood pressure but resulted in deleterious effects on insulin action compared to captopril alone. [ABSTRACT FROM AUTHOR]

Extent of shape change (ESC) and hypotonic shock response (HSR) have been widely used to characterize the in vitro function of platelets and have been shown to correlate with in vivo viability. These assays have been routinely performed using platelet-poor plasma (PPP) as the test sample diluent. Because of the increasing popularity of storing platelets in synthetic media, it is important to understand the effects of using these synthetic media as test diluents for ESC and HSR measurements. The objective of this study was to determine the effect of using platelet storage solutions vs. plasma for the in vitro testing of ESC and HSR. Six laboratories participated in this study. Platelets were prepared by apheresis, the platelet-rich plasma (PRP) method, or derived from buffy-coats. Each platelet preparation was divided, half being stored in plasma and the other half in storage solution. ESC and HSR testing were performed in duplicate on days 1 and 5, using each of three diluents: autologous plasma; fresh-frozen plasma; or storage solution. For both ESC and HSR, dilutions made in each of the three diluents yielded significantly different results. Dilutions made in storage solutions were more than 30% lower for ESC and HSR than those made in autologous plasma ( P < 0·0001). Dilutions made in thawed fresh-frozen plasma were more than 16% lower for ESC and HSR than those made in liquid autologous plasma ( P < 0·0005). ESC and HSR test results are significantly affected by the test diluent. Platelets should be diluted in plasma (preferably autologous) for the in vitro testing of ESC and HSR, regardless of the media in which they are stored. [ABSTRACT FROM AUTHOR]

Examines the structure and dynamics of natural communities from abiotic and biotic factors. Determination on the role of abiotic communities and biotic interactions in structuring deep-sea communities; Implication of predation structures communities at deep-sea hydrothermal vents; Effects of predation on benthic community.