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Significant Proportion (significant + proportion)
Selected AbstractsFurther survey of Australian ophthalmologist's diabetic retinopathy management: did practice adhere to National Health and Medical Research Council guidelines?CLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 6 2010Joshua Yuen MPH Abstract Background:, To compare the self-reported management of diabetic retinopathy by Australian ophthalmologists with the 1997 National Health and Medical Research Council (NHMRC) guidelines. Methods:, Self-reported cross-sectional survey of patterns of practice. Questionnaires were sent to all Australian ophthalmologists, comprising questions regarding professional details, diabetic retinopathy screening attitudes/practices and specific hypothetical management scenarios. Data were analysed using Chi-squared and adjusted logistic regression. Result:, 480 of the 751 (64%) eligible Australian ophthalmologists participated. The majority (80%, n = 376) reported they consistently reviewed patient's glycaemic control, but only 55% and 41% regularly reviewed blood pressure and serum cholesterol control, respectively. Ophthalmologists generally adhered to NHMRC-recommended screening intervals, although only 38% agreed with the guidelines relating to screening of pre-pubertal diabetic patients. Fluorescein angiogram was used more than recommended, especially for mild non-proliferative diabetic retinopathy where 45% of respondents used this investigation. Practice duration >15 years was associated with more regular fluorescein angiogram use (OR = 3.74; 95% CI: 2.53,5.53, P < 0.001). In the clinical scenarios where clinically significant macular oedema was concurrently present with cataract or proliferative diabetic retinopathy, >26% referred to retinal subspecialists for management; 85% of the remaining ophthalmologists performed macular laser first. Respondents with practice duration >15 years were 7.8 times (P = 0.001) more likely to perform cataract surgery first. Conclusion:, Diabetic retinopathy management guidelines were generally well followed by Australian ophthalmologists. However, areas of practice variation existed including frequent use of fluorescein angiogram. Significant proportion of practitioners referred diabetic patients to retinal subspecialists, who were more likely to adhere to guideline recommendations. Ophthalmologists with greater experience (>15 years) were more likely to employ practices differing from NHMRC recommendations. [source] Prevalence of allergy-related symptoms in Singaporean children in the second year of lifePEDIATRIC ALLERGY AND IMMUNOLOGY, Issue 2 2005Teng Nging Tan This study describes the cross-sectional prevalence of symptoms associated with eczema (chronic itchy rash), asthma (wheeze), and allergic rhinitis (rhinoconjunctivitis) in 1026 subjects between 18.5 and 23 months old (median age is 21 months) in Singapore. The first 2 yr cumulative prevalence of chronic itchy rash, wheeze, and rhinoconjunctivitis were 22.1% (n = 227), 22.9% (n = 235), and 8.4% (n = 86) respectively. In total, 42.2% (414 of 979) reported ever having any of these symptoms. Eczema, although prevalent, was diagnosed only in 34.4% (n = 78) of children with chronic itchy rash. Children with this eczematous rash were also more prone to wheeze (cOR = 2.0, 95% CI: 1.2,3.0) and rhinoconjunctivitis (cOR = 2.0, 95% CI: 1.4,2.8). Similarly, subjects who reported rhinoconjunctivitis and chronic itchy rash were 2.4 times (95% CI: 1.6,3.6) and 1.4 times (95% CI: 1.0,2.0) more at risk of wheezing respectively. Family history of allergy was a significant risk factor for chronic itchy rash (aOR = 1.8, 95% CI: 1.3,2.4) and wheeze (aOR = 1.7, 95% CI: 1.3,2.4). Thus, symptoms related to allergy were already prevalent during the second year of life. Significant proportions of these symptoms are likely to be due to true atopy as strong relationship with familial history and comorbidity with other potential allergic symptoms were observed. [source] Reed-Sternberg cells in atypical primary EBV infectionACTA PAEDIATRICA, Issue 2 2001M Bitsori The presence of Epstein-Barr virus (EBV) in the Hodgkin's/Reed-Sternberg (HRS) cells of a significant proportion of cases of Hodgkin's lymphoma (HL) is a matter of consideration when a case of presumptive HL has to be differentiated from infectious mononucleosis (IM). A 15-y-old boy was admitted with a presumptive diagnosis of extranodal HL, based on the biopsy of a painless ulcer on the right mandibular alveolar crest. Histologic examination of the lesion was consistent with mixed cellularity HL. The patient additionally presented with hepatosplenomegaly and regional lymphadenopathy. Serology for EBV was indicative of acute infection. Histological examination of regional lymphoid tissue was consistent with immunologic activation due to primary EBV infection. The patient was left untreated, under close observation. All clinical findings resolved within 3 mo and EBV viral capsid antigen (VCA) IgM antibodies converted to negative after 6 mo. A 3-y follow-up period was uneventful. [source] Understanding the Causes of Disease in European Freshwater CrayfishCONSERVATION BIOLOGY, Issue 6 2004BRETT F. EDGERTON Aphanomyces astaci; bioseguridad; epizootia; langostinos de agua dulce; patología de langostinos; peste de langostinos Abstract:,Native European freshwater crayfish (Astacida, Decapoda) are under severe pressure from habitat alteration, the introduction of nonindigenous species, and epizootic disease. Crayfish plague, an acute disease of freshwater crayfish caused by the fungus-like agent Aphanomyces astaci, was introduced into Europe in the mid-nineteenth century and is responsible for ongoing widespread epizootic mortality in native European populations. We reviewed recent developments and current practices in the field of crayfish pathology. The severity of crayfish plague has resulted in an overemphasis on it. Diagnostic methods for detecting fungi and fungal-like agents, and sometimes culturing them, are frequently the sole techniques used to investigate disease outbreaks in European freshwater crayfish. Consequently, the causes of a significant proportion of outbreaks are undetermined. Pathogen groups well known for causing disease in other crustaceans, such as viruses and rickettsia-like organisms, are poorly understood or unknown in European freshwater crayfish. Moreover, the pathogenic significance of some long-known pathogens of European freshwater crayfish remains obscure. For effective management of this culturally significant and threatened resource, there is an urgent need for researchers, diagnosticians, and resource managers to address the issue of disease in European freshwater crayfish from a broader perspective than has been applied previously. Resumen:,Los langostinos nativos de Europa (Astacida, Decapada) están bajo severa presión por alteración del hábitat, la introducción de especies no nativas y una enfermedad epizoótica. La peste de langostinos, una enfermedad aguda de langostinos de agua dulce producida por el agente micoide Aphanomyces astaci, fue introducida a Europa a mediados del siglo diecinueve y es responsable de la actual mortalidad epizoótica de poblaciones Europeas nativas. Revisamos acontecimientos recientes y prácticas actuales en el campo de la patología de langostinos. La severidad de la peste de langostinos ha resultado en un excesivo énfasis en ella. Los métodos para diagnosticar, y algunas veces cultivar, hongos y agentes micoides frecuentemente son la única técnica empleada al investigar brotes de la enfermedad en langostinos de agua dulce en Europa. Consecuentemente, no están determinadas las causas de una proporción significativa de los brotes. Grupos patógenos, como virus y organismos similares a rickettsias, bien conocidos por producir enfermedades en otros crustáceos son poco o nada conocidos en langostinos de agua dulce de Europa. Más aún, el significado patogénico de algunos patógenos de langostinos de agua dulce de Europa largamente conocidos es oscuro. Para el manejo efectivo de este recurso culturalmente significativo y amenazado es urgente la necesidad de investigadores, diagnosticadores y gestores de recursos para atender el asunto de la enfermedad en langostinos de agua dulce europeos desde una perspectiva más amplia que la previamente aplicada. [source] Significance of Specimen Databases from Taxonomic Revisions for Estimating and Mapping the Global Species Diversity of Invertebrates and Repatriating Reliable Specimen DataCONSERVATION BIOLOGY, Issue 2 2004RUDOLF MEIER More specifically, we demonstrate for a specimen database assembled during a revision of the robber-fly genus Euscelidia (Asilidae, Diptera) how nonparametric species richness estimators (Chao1, incidence-based coverage estimator, second-order jackknife) can be used to (1) estimate global species diversity, (2) direct future collecting to areas that are undersampled and/or likely to be rich in new species, and (3) assess whether the plant-based global biodiversity hotspots of Myers et al. (2000) contain a significant proportion of invertebrates. During the revision of Euscelidia, the number of known species more than doubled, but estimation of species richness revealed that the true diversity of the genus was likely twice as high. The same techniques applied to subsamples of the data indicated that much of the unknown diversity will be found in the Oriental region. Assessing the validity of biodiversity hotspots for invertebrates is a formidable challenge because it is difficult to decide whether species are hotspot endemics, and lists of observed species dramatically underestimate true diversity. Lastly, conservation biologists need a specimen database analogous to GenBank for collecting specimen records. Such a database has a three-fold advantage over information obtained from digitized museum collections: (1) it is shown for Euscelidia that a large proportion of unrevised museum specimens are misidentified; (2) only the specimen lists in revisionary studies cover a wide variety of private and public collections; and (3) obtaining specimen records from revisions is cost-effective. Resumen:,Sostuvimos que los millones de registros de especimenes publicados en miles de revisiones taxonómicas en décadas anteriores son una fuente de información costo-efectiva de importancia crítica para la incorporación de invertebrados en decisiones de investigación y conservación. Más específicamente, para una base de datos de especimenes de moscas del género Euscelidia (Asilidae, Diptera) demostramos como se pueden utilizar estimadores no paramétricos de riqueza de especies (Chao 1, estimador de cobertura basado en incidencia, navaja de segundo orden) para (1) estimar la diversidad global de especies, (2) dirigir colecciones futuras a áreas que están sub-muestreadas y/o probablemente tengan especies nuevas y (3) evaluar si los sitios globales de importancia para la biodiversidad basados en plantas de Myers et al. (2000) contienen una proporción significativa de invertebrados. Durante la revisión de Euscelidia el número de especies conocidas fue más del doble, pero la estimación de riqueza de especies reveló que la diversidad real del género probablemente también era el doble. Las mismas técnicas aplicadas a las sub-muestras de datos indicaron que gran parte de la diversidad no conocida se encontrará en la Región Oriental. La evaluación de la validez de sitios de importancia para la biodiversidad de invertebrados es un reto formidable porque es difícil decidir si las especies son endémicas de esos sitios y si las listas de especies observadas subestiman dramáticamente la diversidad real. Finalmente, los biólogos de la conservación requieren de una base de datos de especimenes análoga a GenBank, para obtener registros de especimenes. Dicha base de datos tiene una triple ventaja sobre la información obtenida de colecciones de museos digitalizadas. (1) Se muestra para Euscelidia que una gran proporción de especimenes de museo no revisados están mal identificados. (2) Sólo las listas de especimenes en estudios de revisión cubren una amplia variedad de colecciones privadas y públicas. (3) La obtención de registros en revisiones es costo-efectiva. [source] Fragrance contact allergic patients: strategies for use of cosmetic products and perceived impact on life situationCONTACT DERMATITIS, Issue 6 2009Susan Hovmand Lysdal Background: Fragrance ingredients are a common cause of contact allergy. Very little is known about these patients' strategies to manage their disease and the effect on their daily lives. Objectives: To investigate if patients with diagnosed fragrance contact allergy used scented products, how they identified tolerated products, and if fragrance allergy affected their daily living. Method: One hundred and forty-seven patients diagnosed with fragrance contact allergy in a 20-month period were included and received a postal questionnaire concerning the subjects of the study. One hundred and seventeen (79.6%) replied. Results: In total, 53/117 (45.3%) responded that they had found some scented products that they could tolerate. Thirty-seven (31.6%) had not tried to find any scented products and 26 (22%) had tried but could not find any. The methods most often used were trying different products and reading the ingredient label. Of the total respondents, 17.1% reported sick-leave due to fragrance allergy and 45.3% found that fragrance allergy significantly affected their daily living. Conclusion: Many patients with fragrance contact allergy succeeded in finding some scented products, which they could tolerate, e.g. by use of ingredient labelling, but a significant proportion had continued skin problems. Almost half of the patients perceived that fragrance allergy significantly affected their daily lives. [source] The Efficacy of Curettage in Delineating Margins of Basal Cell Carcinoma Before Mohs Micrographic SurgeryDERMATOLOGIC SURGERY, Issue 9 2003Désirée Ratner MD Background. Curettage may be helpful as a preliminary step to outline the gross subclinical extensions of high-risk basal cell carcinomas (BCCs) before the first stage of Mohs micrographic surgery. Although many Mohs surgeons use curettage in the Mohs surgical setting, no prospective studies have as yet been performed that demonstrate the efficacy of curettage in delineating tumor margins before Mohs surgery. Objective. To document the efficacy of curettage in delineating BCC margins before Mohs micrographic surgery. Methods. This was a prospective evaluation of 599 patients with biopsy-proven BCCs treated with Mohs surgery. The preoperative dimensions of each tumor, the curetted dimensions before the first surgical stage, the proposed excisional margins before each surgical stage, and the final defect dimensions after each surgical stage were measured. The maximum curetted margin around each tumor was calculated and compared with typical Mohs excisional margins of 1, 2, 3, and 4 mm. A hypothetical 1-, 2-, 3-, or 4-mm excisional margin was added to the preoperative X and Y dimensions of each tumor, and the actual final defect sizes were compared with the hypothetical final defect sizes to determine whether an additional surgical stage would have been needed had curettage not been performed. The amount of tissue stretch occurring after specimen removal was calculated to determine whether tissue stretch falsely elevated the number of instances in which an additional surgical stage would have been needed had curettage not been performed. Results. The curetted margin around the observed extent of each tumor exceeded 1 mm in 87.6% of cases, 2 mm in 47.1% of cases, 3 mm in 19.7% of cases, and 4 mm in 5.7% of cases. The mean curetted margin was 1.7 mm. Taking a 1-mm margin in the first stage of Mohs surgery without first performing curettage would have necessitated an extra surgical stage in 99.2% of cases, whereas taking a 2-, 3-, or 4-mm margin would have necessitated an extra surgical stage in 93.0%, 88.1%, and 49.4% of cases, respectively. After calculating and eliminating the effects of tissue stretch, it was found that a 1-mm excisional margin taken in the first stage of Mohs surgery without first performing curettage would have necessitated an extra surgical stage in 99.0% of the cases. Taking a 2-, 3-, or 4-mm margin would have necessitated an extra surgical stage in 87.5%, 57.9%, and 29.5% of cases, respectively. Conclusion. Careful debulking and palpation with the curette significantly reduce the number of Mohs surgical stages required for BCC clearance. Even after taking the effects of tissue stretch into consideration, a significant proportion of tumors would still require an additional stage for tumor clearance without aggressive presurgical curettage. [source] Sub-threshold manic symptoms in recurrent major depressive disorder are a marker for poor outcomeACTA PSYCHIATRICA SCANDINAVICA, Issue 4 2009D. J. Smith Objective:, A small but significant proportion of patients with major depressive disorder (MDD) report mild manic symptoms which are below the diagnostic threshold for a hypomanic episode. Method:, We tested for an association between sub-threshold manic symptoms and clinical outcome in almost 600 patients with recurrent MDD who also had no known family history of bipolar disorder. Results:, 9.6% of this large sample had a life-time history of sub-threshold manic symptoms. These patients were significantly more likely to have a history of poor response to antidepressants (OR 2.84; 95% CI 1.23,6.56; P < 0.02) and more likely to have experienced psychosis (OR 2.07; 95% CI 1.05,4.09; P < 0.04). They had also experienced more depressive episodes on average (P = 0.006) and were more likely to have been admitted to hospital (P < 0.03). Conclusion:, Sub-threshold manic symptoms in patients with recurrent MDD may be a useful clinical marker for poor response to antidepressants and a more morbid long-term clinical course. [source] Genome-wide identification of female-enriched genes in zebrafishDEVELOPMENTAL DYNAMICS, Issue 1 2005Chaoming Wen Abstract Characteristic differences in morphology, physiology, and behavior between a male and female are correlated to the differential selection of sex-dependent transcriptomes. By using a cDNA array carrying ,9,000 zebrafish unique genes, we identified a group of genes whose expression are enriched in the female fish. A subset of these genes have been confirmed and further grouped as egg-enriched genes, as both somatic- and egg-enriched genes or as somatic-enriched genes by means of RNA gel blot hybridization. Most importantly, a significant proportion of these genes are either functionally unknown or are novel genes. Thus, future studies of this group of genes will help us greatly to understand more about sex-determination and sex-related physiology and behavior. In addition, comparison of zebrafish female-enriched genes with that in Drosophila, we found that only germline genes are shared between vertebrate and invertebrate, suggesting that the process of oogenesis is highly conserved during the evolution. Developmental Dynamics 232:171,179, 2005. © 2004 Wiley-Liss, Inc. [source] Assessing diabetic control , reliability of methods available in resource poor settingsDIABETIC MEDICINE, Issue 3 2002A. P. Rotchford Abstract Aims and methods To examine the reliability of random venous or capillary blood glucose testing, random urine glucose testing, and a current symptom history in predicting a high HbA1c in Type 2 diabetic patients taking oral hypoglycaemic agents in a poorly controlled rural African population. Results For a cut-off point for HbA1c of , 8%, for random venous plasma glucose of , 14 mmol/L (present in 47.2% of subjects), specificity was 97.1% (95% CI 85.1,99.9), sensitivity 56.8% (48.8,64.5) and positive predictive value (PPV) 98.9% (94.2,99.9). HbA1c, 8% is predicted by a random capillary blood glucose of 17 mmol/L (present in 28.4% of subjects) with specificity 100% (90.0,100.0), PPV 100% (93.7,100.0) and sensitivity of 34.3% (27.2,42.1). HbA1c, 8% is predicted by the presence of heavy glycosuria (, 55 mmol/L) (present in 35.6%) with specificity 94.1% (80.3,99.3), sensitivity of 41.9% (34.1,49.9) and PPV 97.1% (89.9,99.6). Polyuria/nocturia (present in 31.3%) was the only symptom found to be associated with poor control, with a specificity for predicting HbA1c of , 8% of 81.5% (61.9,93.7), PPV 89.1% (76.4,96.4) and sensitivity 30.6% (22.9,39.1). Conclusions Where resources are short, random glucose testing can be used to detect a significant proportion of those with the worst control with a high degree of specificity enabling primary care staff to modify treatment safely. Where facilities are limited capillary blood or urine testing with reagent strips, may be substituted for venous plasma testing in the laboratory. A symptom history was insufficient to replace biochemical testing, but where this is unavailable, urinary symptoms may be helpful. Diabet. Med. 19, 195,200 (2002) [source] ASC-US and high-risk HPV testing: Performance in daily clinical practiceDIAGNOSTIC CYTOPATHOLOGY, Issue 11 2006Suzanne M. Selvaggi M.D.Article first published online: 13 OCT 200 Abstract Data are beginning to accrue on high-risk HPV DNA testing in patients with ASC-US on cervical cytology. We report on our experience at the University of Wisconsin Hospital and Clinics. From February 2002 through December 31, 2005 (3 yr, 11 mo), the cytopathology laboratory processed 49,599 Pap Tests, of which 1,792 (3.6%) were diagnosed as ASC-US. Six hundred and seventy two (37.5%) of these cases were processed for high-risk HPV genotypes using the Digene Hybrid® Capture II method. Of these cases, 266 (39.6%) were positive for high-risk HPV genotypes, 11 (1.6%) were equivocal, and 395 (58.8%) were negative. Biopsy follow-up was available for 127 (47.7%) of the 266 cases, of which 66 (52%) were negative, 46 (36.2%) showed CIN I, 9 (7.1%) were CIN II, and 6 (4.7%) were CIN III. Of the remaining 139 (52.3%) cases, 86 (62%) had follow-up Pap Tests, of which 57 (66.3%) were negative, 15 (17.4%) were ASC-US, 12 (15%) were low-grade squamous intraepithelial lesions, and 2 (2.3%) were high-grade squamous intraepithelial lesions; 53 (38.1%) were lost to follow-up. In combination, 90 (42.25%) of the 213 cases with follow-up showed atypia or above after a diagnosis of ASC-US; of which 58 (64%) were low-grade lesions and 17 (19%) were high-grade lesions. Our laboratory's reported high-risk HPV positivity is comparable to recent reports in the literature on its use in daily clinical practice. In addition, cervical abnormalities were found in a significant proportion of the cases. Diagn. Cytopathol. 2006;34: 731,733. © 2006 Wiley-Liss, Inc. [source] Prediction of twelve-month service disengagement from an early intervention in psychosis serviceEARLY INTERVENTION IN PSYCHIATRY, Issue 3 2007Mark Turner Abstract Aim: The aim is to examine disengagement in an early psychosis treatment service and contrast clinical and demographic variables of patients who disengage against those who do not. Methods: Those with termination of treatment, despite therapeutic need within 12 months of entry (disengagers) (n = 57; 24.6%), were compared with those who remained in treatment at 12 months (n = 175) on a range of clinical and demographic variables collected at admission. After testing the difference between proportions, data analysis was conducted using methods of logistic regression. Results: Alcohol and/or cannabis abuse/dependence, initial diagnosisother than mood disorder, long duration of untreated psychosis, lower Positive and Negative Syndrome Scale total symptoms, and lower insight at referral accounted for 27% of variance in patient ,disengagement' within 12 months. Conclusion: A significant proportion of patients with first episode psychosis disengage from treatment within 12 months. Despite a number of factors being associated with disengagement, prediction using admission factors was poor. Early Intervention in Psychosis Services would benefit from increased attention to alcohol and drug problems, trying to reduce the duration of untreated psychosis, improving psychiatric symptoms and increasing insight in all patients to decrease service disengagement. [source] Insect community organisation in estuaries: the role of the physical environmentECOGRAPHY, Issue 3 2002D. Dudley Williams Insects are reportedly uncommon in marine habitats and, from a spatial/temporal intercomparison perspective, estuaries are among the least studied. We examined the natural variability seen among insect community organisation in estuaries on both sides of the North Atlantic, and evaluated the role of their physical environments. Community composition was found to be strongly influenced by three physical factors: estuary size, the degree of inundation by incoming tides, and substrate size/stability. Insects formed a significant proportion (17,54%, by numbers) of the benthic community of coarse-grained-substratum estuaries, and species richness increased with estuary size. Nymphs/larvae of mayflies, stoneflies, caddisflies, elmid beetles and chironomids dominated channel sites inundated by up to 25% of all incoming tides, but a gradual loss in species richness occurred downstream. However, even the most seaward sites supported high insect densities (up to 25,016 and 5433 m,2, supporting 26 and 4 species, at sites inundated by 75 and 100% of all incoming tides, respectively). Sites covered by tides for between 3 and 5 h twice daily were dominated by orthocladine chironomids, especially of the genus Orthocladius. Chironomid larvae contribute significantly to the diets of some coastal fish species, particularly juvenile flounder and sticklebacks. We present a schematic model summarising the relationships between estuary size, degree of inundation by salt water and insect community structure. [source] Growth-induced changes in the proteome of Helicobacter pyloriELECTROPHORESIS, Issue 5-6 2006Christina Uwins Abstract Helicobacter pylori is a major human pathogen that is responsible for a number of gastrointestinal infections. We have used 2-DE to characterise protein synthesis in bacteria grown either on solid agar-based media or in each of two broth culture media (Brucella and brain heart infusion (BHI) broth). Significant differences were observed in the proteomes of bacteria grown either on agar-based or in broth media. Major changes in protein abundance were identified using principal component analysis (PCA), which delineated the profiles derived for the three key growth conditions (i.e. agar plates, Brucella and BHI broth). Proteins detected across the gel series were identified by peptide mass mapping and Edman sequencing. A number of proteins associated with protein synthesis in general as well as specific amino acid synthesis were depressed in broth-grown bacteria compared to plate-grown bacteria. A similar reduction was also observed in the abundance of proteins involved in detoxification. Two of the most abundant spots, identified as UreB and GroEL, in plate-grown bacteria showed a >140-fold drop in abundance in bacteria grown in Brucella broth compared to bacteria grown on agar plates. Two protein spots induced in bacteria grown in broth culture were both identified as glyceraldehyde 3-phosphate dehydrogenase based on their N -terminal amino acid sequences derived by Edman degradation. The underlying causes of the changes in the proteins abundance were not clear, but it was likely that a significant proportion of the changes were due to the alkaline pH of the broth culture media. [source] Variability in agreement between physicians and nurses when measuring the Glasgow Coma Scale in the emergency department limits its clinical usefulnessEMERGENCY MEDICINE AUSTRALASIA, Issue 4 2006Anna Holdgate Abstract Objective:, To assess the interrater reliability of the Glasgow Coma Scale (GCS) between nurses and senior doctors in the ED. Methods:, This was a prospective observational study with a convenience sample of patients aged 18 or above who presented with a decreased level of consciousness to a tertiary hospital ED. A senior ED doctor (emergency physicians and trainees) and registered nurse each independently scored the patient's GCS in blinded fashion within 15 min of each other. The data were then analysed to determine interrater reliability using the weighted kappa statistic and the size and directions of differences between paired scores were examined. Results:, A total of 108 eligible patients were enrolled, with GCS scores ranging from 3 to 14. Interrater agreement was excellent (weighted kappa > 0.75) for verbal scores and total GCS scores, and intermediate (weighted kappa 0.4,0.75) for motor and eye scores. Total GCS scores differed by more than two points in 10 of the 108 patients. Interrater agreement did not vary substantially across the range of actual numeric GCS scores. Conclusions:, Although the level of agreement for GCS scores was generally high, a significant proportion of patients had GCS scores which differed by two or more points. This degree of disagreement indicates that clinical decisions should not be based solely on single GCS scores. [source] Factors influencing the effectiveness of an attracticide formulation against the Oriental fruit moth, Grapholita molestaENTOMOLOGIA EXPERIMENTALIS ET APPLICATA, Issue 2 2004Maya L. Evenden Abstract An attracticide formulation, LastCallÔOFM, was tested against the Oriental fruit moth Grapholita molesta (Busck) (Lepidoptera: Tortricidae) in replicated small plot field trials in apple, Malus domestica (Borkhausen), orchards in South-eastern Pennsylvania, USA. Attracticide treatments were applied using a calibrated hand pump, and treated plots were compared to similar untreated plots. Male moth activity was monitored using virgin female-baited traps, and the potential for reduction in mating activity was assessed using sentinel virgin females. A comparison of application rates showed that 1500 droplets per ha of the attracticide formulation was as effective as 3000 droplets per ha, and both application rates reduced captures in synthetic pheromone-baited traps for prolonged periods. Droplets placed either at high or low positions within the canopy significantly reduced trap capture and mating with sentinel females. In addition, the only sentinel females that mated in the treated plots were located in the untreated portion of the tree canopy. Mate finding behaviour was equally disrupted by formulations with and without insecticide. Therefore, under the test conditions, the mechanism by which the attracticide formulation worked was by disruption of male orientation, and not by the removal of males due to insecticide poisoning. Two field cage experiments tested the impact of population density on the competitiveness of the attracticide formulation compared to virgin females. A significant proportion of males were captured in female-baited traps at the highest female-to-droplet ratio tested. Equal proportions of males were captured in attracticide-baited traps at male moth densities of 10, 20, 40, and 80 males per cage. These results clarify some of the factors influencing the effectiveness and possible mechanisms of an attracticide management tactic against the Oriental fruit moth. [source] Comparative analysis of genome fragments of Acidobacteria from deep Mediterranean planktonENVIRONMENTAL MICROBIOLOGY, Issue 10 2008Achim Quaiser Summary Acidobacteria constitute a still poorly studied phylum that is well represented in soils. Recent studies suggest that members of this phylum may be also abundant in deep-sea plankton, but their relative abundance and ecological role in this ecosystem are completely unknown. A recent screening of three metagenomic deep-sea libraries of bathypelagic plankton from the South Atlantic (1000 m depth), the Adriatic (1000 m depth) and the Ionian (3000 m depth) seas in the Mediterranean revealed an unexpected relative proportion of acidobacterial fosmids, which affiliated to the Solibacterales (Group 3), to the Group 11 and, most frequently, to the Group 6 of this diverse phylum. Here, we present the comparative analysis of 11 acidobacterial genome fragments containing the rrn operon from these Mediterranean libraries. A highly conserved syntenic region spanning up to 30 kb and containing up to 25 open reading frames was shared by Group 6 Acidobacteria. Synteny was also partially conserved in distantly related acidobacterial genome fragments derived from a metagenomic soil library, indicating a remarkable conservation of this genomic region within these Acidobacteria. A search for Acidobacteria -specific hits in directly comparable, available fosmid-end sequences from soil and marine metagenomic libraries showed a significant increase of their relative proportion in plankton libraries as a function of increasing depth reaching, at high depth, levels nearly comparable to those of soil. Thus, our results suggest that Acidobacteria are abundant and represent a significant proportion of the microbial community in the deep-sea ecosystem. [source] The impact of a social network intervention on retention in Belgian therapeutic communities: a quasi-experimental studyADDICTION, Issue 7 2006Veerle Soyez ABSTRACT Background Although numerous studies recognize the importance of social network support in engaging substance abusers into treatment, there is only limited knowledge of the impact of network involvement and support during treatment. The primary objective of this research was to enhance retention in Therapeutic Community treatment utilizing a social network intervention. Aims The specific goals of this study were (1) to determine whether different pre-treatment factors predicted treatment retention in a Therapeutic Community; and (2) to determine whether participation of significant others in a social network intervention predicted treatment retention. Design, setting and participants Consecutive admissions to four long-term residential Therapeutic Communities were assessed at intake (n = 207); the study comprised a mainly male (84.9%) sample of polydrug (41.1%) and opiate (20.8%) abusers, of whom 64.4% had ever injected drugs. Assessment involved the European version of the Addiction Severity Index (EuropASI), the Circumstances, Motivation, Readiness scales (CMR), the Dutch version of the family environment scale (GKS/FES) and an in-depth interview on social network structure and perceived social support. Network members of different cohorts were assigned to a social network intervention, which consisted of three elements (a video, participation at an induction day and participation in a discussion session). Findings Hierarchical regression analyses showed that client-perceived social support (F1,198 = 10.9, P = 0.001) and treatment motivation and readiness (F1,198 = 8.8; P = 0.003) explained a significant proportion of the variance in treatment retention (model fit: F7,197 = 4.4; P = 0.000). By including the variable ,significant others' participation in network intervention' (network involvement) in the model, the fit clearly improved (F1,197 = 6.2; P = 0.013). At the same time, the impact of perceived social support decreased (F1,197 = 2.9; P = 0.091). Conclusions Participation in the social network intervention was associated with improved treatment retention controlling for other client characteristics. This suggests that the intervention may be of benefit in the treatment of addicted individuals. [source] Emissions of greenhouse gases attributable to the activities of the land transport: modelling and analysis using I-CIR stochastic diffusion,the case of SpainENVIRONMETRICS, Issue 2 2008R. Gutiérrez Abstract In this study, carried out on the basis of the conclusions and methodological recommendations of the Fourth Assessment Report (2007) of the International Panel on Climate Change (IPCC), we consider the emissions of greenhouse gases (GHG), and particularly those of CO2, attributable to the activities of land transport, for all sectors of the economy, as these constitute a significant proportion of total GHG emissions. In particular, the case of Spain is an example of a worrying situation in this respect, both in itself and in the context of the European Union. To analyse the evolution, in this case, of such emissions, to enable medium-term forecasts to be made and to obtain a model that will enable us to analyse the effects of possible corrector mechanisms, we have statistically fitted a inverse Cox-Ingersoll-Ross (I-CIR) type nonlinear stochastic diffusion process, on the basis of the real data measured for the period 1990,2004, during which the Kyoto protocol has been applicable. We have studied the evolution of the trend of these emissions using estimated trend functions, for which purpose probabilistic complements such as trend functions and stationary distribution are incorporated, and a statistical methodology (estimation and asymptotic inference) for this diffusion, these tools being necessary for the application of the analytical methodology proposed. Copyright © 2007 John Wiley & Sons, Ltd. [source] Immediate antigen-specific effector functions byTCR-transgenic CD8+ NKT cellsEUROPEAN JOURNAL OF IMMUNOLOGY, Issue 3 2006Gerhard Wingender Abstract Only recently have natural antigens for CD1d-dependent, invariant V,14+ natural killer T (iNKT) cells been identified. Similar data for CD1d-independent and CD8+ NKT cell populations are still missing. Here, we show that the MHC class,I-restricted CD8+ TCR-transgenic mouse lines OT-I, P14 and H-Y contain a significant proportion of transgenic CD8+ NK1.1+ T,cells. In liver, most of NK1.1+ T,cells express CD8,, homodimers. Transgenic NKT cells did not bind invariant V,14-to-J,18 TCR rearrangement (V,14i)-specific CD1d/,-galactosylceramide tetramers and the frequency of iNKT cells was severely reduced. The activated cell surface phenotype and the distribution of transgenic NKT cells in vivo were similar to that reported for iNKT cells. The OT-I and P14 CD8+ NKT cells recognized their cognate antigen in the context of H2-Kb and produced cytokines shortly after TCR stimulation. Importantly, transgenic NKT cells exerted immediate antigen-specific cytotoxicity in vitro and in vivo. Our results demonstrate the presence of transgenic CD8+ NKT cells in MHC class,I-restricted TCR-transgenic animals, which are endowed with rapid antigen-specific effector functions. These data imply that experiments studying naive T,cell function in TCR-transgenic animals should be interpreted with caution, and that such animals could be utilized for studying CD8+ NKT cell function in an antigen-specific manner. [source] Demonstration of strong enterobacterial reactivity of CD4+CD25, T,cells from conventional and germ-free mice which is counter-regulated by CD4+CD25+ T,cellsEUROPEAN JOURNAL OF IMMUNOLOGY, Issue 3 2004Monika Gad Abstract Unfractionated CD4+ T,cells from the gut-associated lymphoid tissue (GALT) and peripheral lymph nodes are unresponsive when exposed to enterobacterial antigens in vitro. Under similar conditions, CD4+ T,cells depleted in vivo or in vitro of CD4+CD25+ T,cells proliferate extensively. The CD4+CD25, T,cell reactivity depends on MHC class,II presentation, specific TCR stimulation, CD4 ligation, and antigen processing by antigen-presenting cells. The CD4+CD25, T,cells respond to autologousand heterologous enterobacterial antigens, but not to antigens from the feces of germ-free mice. Surprisingly, CD4+CD25, T,cells obtained from the GALT of germ-free mice also proliferate when exposed to enterobacterial antigens, and adding back the conventional or germ-free CD4+CD25+ T,cells to the enteroantigen-stimulated CD4+CD25, T,cells abolishes proliferation. As judged from carboxyfluorescein diacetate succinimidyl ester-labeling experiments, 4,5% of the CD4+CD25, T,cells respond to enteroantigen. The data show for the first time that CD4+CD25, T,cells with reactivity towards the enterobacterial flora and regulatory CD4+CD25+ T,cells are present in both conventional and germ-free mice. The data suggest that a significant proportion of the peripheral pool of CD4+CD25, T,cells express anti-enterobacterial reactivity, which, due to the presence of regulatory CD4+CD25+ T,cells, is kept in a quiescent state. [source] Long-range oscillatory Ca2+ waves in rat spinal dorsal hornEUROPEAN JOURNAL OF NEUROSCIENCE, Issue 8 2005Ruth Ruscheweyh Abstract Synchronous activity of large populations of neurons shapes neuronal networks during development. However, re-emergence of such activity at later stages of development could severely disrupt the orderly processing of sensory information, e.g. in the spinal dorsal horn. We used Ca2+ imaging in spinal cord slices of neonatal and young rats to assess under which conditions synchronous activity occurs in dorsal horn. No spontaneous synchronous Ca2+ transients were detected. However, increasing neuronal excitability by application of 4-aminopyridine after pretreatment of the slice with blockers of (RS)-alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA)/kainate, ,-aminobutyric acid (GABA)A and glycine receptors evoked repetitive Ca2+ waves in dorsal horn. These waves spread mediolaterally with a speed of 1.0 ± 0.1 mm/s and affected virtually every dorsal horn neuron. The Ca2+ waves were associated with large depolarizing shifts of the membrane potential of participating neurons and were most likely synaptically mediated because they were abolished by blockade of action potentials or N -methyl- d -aspartate (NMDA) receptors. They were most pronounced in the superficial dorsal horn and absent from the ventral horn. A significant proportion of the Ca2+ waves spread to the contralateral dorsal horn. This seemed to be enabled by disinhibition as primary afferent-induced dorsal horn excitation crossed the midline only when GABAA and glycine receptors were blocked. Interestingly, the Ca2+ waves occurred under conditions where AMPA/kainate receptors were blocked. Thus, superficial dorsal horn NMDA receptors are able to sustain synchronous neuronal excitation in the absence of functional AMPA/kainate receptors. [source] Selective GABAergic innervation of thalamic nuclei from zona incertaEUROPEAN JOURNAL OF NEUROSCIENCE, Issue 6 2002P. Barthó Abstract Thalamocortical circuits that govern cortical rhythms and ultimately effect sensory transmission consist of three major interconnected elements: excitatory thalamocortical and corticothalamic neurons and GABAergic cells in the reticular thalamic nucleus. Based on the present results, a fourth component has to be added to this scheme. GABAergic fibres from an extrareticular diencephalic source were found to selectively innervate relay cells located mainly in higher-order thalamic nuclei. The origin of this pathway was localized to zona incerta (ZI), known to receive collaterals from corticothalamic fibres. First-order nuclei were innervated only in zones showing a high density of calbindin-positive neurons. The large GABA-immunoreactive incertal terminals established multiple contacts preferentially on the proximal dendrites of relay cells via symmetrical synapses with multiple release sites. The distribution, ultrastructural characteristics and postsynaptic target selection of extrareticular terminals were similar to type II muscarinic acetylcholine receptor-positive boutons, which constituted up to 49% of all GABAergic terminals in the posterior nucleus. This suggests that a significant proportion of the GABAergic input into certain thalamic territories involved in higher-order functions may have extrareticular origin. Unlike the reticular nucleus, ZI receives peripheral and layer V cortical input but no thalamic feedback; it projects to brainstem centres and has extensive intranuclear recurrent collaterals. This indicates that ZI exerts a conceptually new type of inhibitory control over the thalamus. The proximally situated, multiple active zones of ZI terminals indicate a powerful influence on the firing properties of thalamic neurons, which is conveyed to multiple cortical areas via relay cells which have widespread projections to neocortex. [source] A randomized-response investigation of the education effect in attitudes towards foreignersEUROPEAN JOURNAL OF SOCIAL PSYCHOLOGY, Issue 6 2009Martin Ostapczuk While negative correlations have often been found between a respondent's education and his attitudes towards foreigners, the reasons for this education effect are still under debate. We examined the hypothesis that the highly educated may not be genuinely less xenophobic, but simply more prone to give socially desirable, xenophile answers in attitude questionnaires. We therefore compared the attitudes of respondents who were either questioned directly or using a cheating detection extension of the randomized-response technique (RRT). The latter is supposed to yield more honest answers to sensitive questions by experimentally offering the interviewee a higher degree of confidentiality. Under direct questioning conditions, we replicated the education effect; 75% of the highly educated expressed xenophile attitudes, as opposed to only 55% of the less educated. Under randomized-response conditions, we obtained significantly reduced estimates of 53% for the proportion of xenophiles among the highly educated, and 24% among the less educated, indicating a strong distortion of self-reported attitudes towards foreigners in both groups. However, a significant proportion of participants disobeyed the RRT instructions regardless of education. Because the education effect was found even after controlling for social desirability, it seems to be a genuine effect, rather than an artefact of a differential response bias. Copyright © 2008 John Wiley & Sons, Ltd. [source] Influence of former agricultural land use on net nitrate production in forest soilsEUROPEAN JOURNAL OF SOIL SCIENCE, Issue 3 2002J. H. Jussy Summary Except where nitrate is added to the soil artificially, nitrate is leached from forest soils only if it is produced. Although the factors influencing nitrification have been widely studied, nitrification activity still cannot be simply predicted from ecosystem characteristics. In France, about half of the present forest area was agricultural in 1850. Previous work suggested that former cultivation could be a major factor influencing nitrogen availability in forest soils. Using laboratory incubations, we compared the net production of ammonium and nitrate in soils from formerly manured lands planted with conifers 70,100 years ago with that in soils of surrounding ancient coniferous forests. Net nitrate production, available P content, and natural abundance of nitrogen 15, ,15N, were greater in soils from formerly manured plots than other land, whereas the C:N ratio of the soil was less. The difference in net nitrate production between previously manured sites and adjacent ancient forests was related to differences in ,15N values in the soil but not evidently to other soil properties. Because soil ,15N increases with the intensity of organic manuring, these results suggest that nitrification in forest soils depends on previous manurial practices under agriculture. In this context, the soil ,15N might be used as an indicator of both previous agricultural land use and potential nitrification. Because a significant proportion of West European forests grow on previously cultivated soils, past land use should be taken into account when evaluating the risks of nitrate leaching from forests. [source] Experimental analysis of the impact of peer-to-peer applications on traffic in commercial IP networksEUROPEAN TRANSACTIONS ON TELECOMMUNICATIONS, Issue 6 2004Nadia Ben Azzouna To evaluate the impact of peer-to-peer (P2P) applications on traffic in wide area networks, we analyze measurements from a high speed IP backbone link carrying TCP traffic towards several ADSL areas. The first observations are that the prevalent part of traffic is due to P2P applications (almost 80% of total traffic) and that the usage of network becomes symmetric in the sense that customers are not only clients but also servers. This latter point is observed by the significant proportion of long flows mainly composed of ACK segments. When analyzing the bit rate created by long flows, it turns out that the TCP connections due to P2P applications have a rather small bit rate and that there is no evidence for long range dependence. These facts are intimately related to the way P2P protocols are running. We separately analyze signaling traffic and data traffic. It turns out that by adopting a suitable level of aggregation, global traffic can be described by means of usual tele-traffic models based on M/G/, queues with Weibullian service times. Copyright © 2004 AEI [source] A TEST OF WORKER POLICING THEORY IN AN ADVANCED EUSOCIAL WASP, VESPULA RUFAEVOLUTION, Issue 6 2005T. Wenseleers Abstract Mutual policing is an important mechanism for maintaining social harmony in group-living organisms. In some ants, bees, and wasps, workers police male eggs laid by other workers in order to maintain the reproductive primacy of the queen. Kin selection theory predicts that multiple mating by the queen is one factor that can selectively favor worker policing. This is because when the queen is mated to multiple males, workers are more closely related to queen's sons than to the sons of other workers. Here we provide an additional test of worker policing theory in Vespinae wasps. We show that the yellowjacket Vespula rufa is characterized by low mating frequency, and that a significant percentage of the males are workers' sons. This supports theoretical predictions for paternities below 2, and contrasts with other Vespula species, in which paternities are higher and few or no adult males are worker produced, probably due to worker policing, which has been shown in one species, Vespula vulgaris. Behavioral observations support the hypothesis that V. rufa has much reduced worker policing compared to other Vespula. In addition, a significant proportion of worker-laid eggs were policed by the queen. [source] GENETIC VARIATION IN MALE EFFECTS ON FEMALE REPRODUCTION AND THE GENETIC COVARIANCE BETWEEN THE SEXESEVOLUTION, Issue 6 2003MARY ELLEN CZESAK Abstract., Males of many insect species increase the fecundity and/or egg size of their mates through the amount or composition of their nuptial gifts or ejaculate. The genetic bases of such male effects on fecundity or egg size are generally unknown, and thus their ability to evolve remains speculative. Likewise, the genetic relationship between male and female investment into reproduction in dioecious species, which is expected to be positive if effects on fecundity are controlled by at least some of the same genes in males and females, is also unknown. Males of the seed beetle Stator limbatus contribute large ejaculates to females during mating, and the amount of donated ejaculate is positively correlated with male body mass. Females mated to large males lay more eggs in their lifetime than females mated to small males. We describe an experiment in which we quantify genetic variation in the number of eggs sired by males (mated to a single female) and found that a significant proportion of the phenotypic variance in the number of eggs sired by males was explained by their genotype. Additionally, the number of eggs sired by a male was highly positively genetically correlated with his body mass. The between-sex genetic correlation, that is, the genetic correlation between the number of eggs sired by males and the number of eggs laid by females, was highly positive when eggs were laid on Acacia greggii seeds. This indicates that males that sire many eggs have sisters that lay many eggs. Thus, some of the genes that control male ejaculate size (or some other fecundity-enhancing factor) when expressed in males appear to control fecundity when expressed in females. We found no significant interaction between male and female genotype on fecundity. [source] Pharmacogenomics in dermatology: from susceptibility genes to personalized therapyEXPERIMENTAL DERMATOLOGY, Issue 4 2009Carlo Pincelli Abstract:, A significant proportion of patients with skin disease do not respond to treatment and adverse drug reactions are a common problem. Genetic factors are important determinants for both drug efficacy and toxicity. The fields of pharmacogenetics and pharmacogenomics examine inter-individual variations in the DNA sequence that are related to drug efficacy and toxicity. Here, we present pharmacogenomic data relevant to dermatology and explore the role of dermatologists in identifying patients who may respond to treatment or experience adverse drug reactions. [source] NEMO oligomerization in the dynamic assembly of the I,B kinase core complexFEBS JOURNAL, Issue 10 2007Elisabeth Fontan NF-,B essential modulator (NEMO) plays an essential role in the nuclear factor ,B (NF-,B) pathway as a modulator of the two other subunits of the I,B kinase (IKK) complex, i.e. the protein kinases, IKK, and IKK,. Previous reports all envision the IKK complex to be a static entity. Using glycerol-gradient ultracentrifugation, we observed stimulus-dependent dynamic IKK complex assembly. In wild-type fibroblasts, the kinases and a portion of cellular NEMO associate in a 350-kDa high-molecular-mass complex. In response to constitutive NF-,B stimulation by Tax, we observed NEMO recruitment and oligomerization to a shifted high-molecular-mass complex of 440 kDa which displayed increased IKK activity. This stimulus-dependent oligomerization of NEMO was also observed using fluorescence resonance energy transfer after a transient pulse with interleukin-1,. In addition, fully activated, dimeric kinases not bound to NEMO were detected in these Tax-activated fibroblasts. By glycerol gradient ultracentrifugation, we also showed that: (a) in fibroblasts deficient in IKK, and IKK,, NEMO predominantly exists as a monomer; (b) in NEMO-deficient fibroblasts, IKK, dimers are present that are less stable than IKK, dimers. Intriguingly, in resting Rat-1 fibroblasts, 160-kDa IKK,,NEMO and IKK,,NEMO heterocomplexes were observed as well as a significant proportion of NEMO monomer. These results suggest that most NEMO molecules do not form a tripartite IKK complex with an IKK,,IKK, heterodimer as previously reported in the literature but, instead, NEMO is able to form a complex with the monomeric forms of IKK, and IKK,. [source] | ||||||||||||||||||||||||||||||||||||||||||||||