Physical and biological development of a newly breached managed realignment site, Humber estuary, UK

As part of the Humber flood defence upgrade works (Urgent works) undertaken by the Environment Agency, the Paull Holme Strays site was identified as one of twelve potential managed realignment sites within the Humber catchment. The site was breached in September 2003, creating 80 hectares of new intertidal habitat. Initial accretion monitoring commenced in December 2003 with annual surveys of invertebrate colonisation commencing in October 2004. The present study gives details of the physical development of the newly created mudflat within the site, together with invertebrate colonisation and benthic community change over time. Comparisons between the newly created habitat and the existing mudflat outside the old sea wall are made. The macrofaunal communities found within the area as a whole are considered to be characteristic of the area with low species diversity, high abundance and small body size. The community within the managed realignment site is still in an early successional stage with low abundance and diversity in comparison with other sites within this part of the Humber. However the community biomass increased considerably between 2004 and 2005. Colonisation within the managed realignment site is still primarily concentrated in the areas around the two breach sites and is thought to be restricted in other areas due to infrequent tidal inundation.

Thrombosis in myeloproliferative disorders: prevalence, prognostic factors, and the role of leukocytes and JAK2V617F

An underlying myeloproliferative disorder (MPD), especially polycythemia vera (PV) or essential thrombocythemia (ET), is a risk factor for thrombosis. Considering large selected studies, prevalence rates for major thrombosis, at time of diagnosis, range from approximately 34 to 39% for PV and 10 to 29% for ET; the corresponding figures for thrombosis at follow-up are approximately 8 to 19% for PV and 8 to 31% for ET. In all instances, arterial events were more frequent than venous events. In both PV and ET, advanced age and history of thrombosis are independent predictors of recurrent thrombosis. In addition, leukocytosis, but not thrombocytosis, has been identified as a potential risk factor for thrombosis in both diseases. The particular observation is consistent with the laboratory demonstration, in these disorders, of increased number of activated granulocytes and granulocyte-platelet aggregates, upregulation of platelet P-selectin and tissue factor expression by granulocytes, and the antithrombotic value of hydroxyurea therapy. Most recently, a JAK2 gain-of-function mutation ( JAK2V617F) was described in virtually all patients with PV and approximately 50% of those with ET. Whether the presence of this specific mutation or its allele burden modifies the risk of thrombosis in patients with MPDs currently is under investigation.

Public attitudes in New Zealand towards the use of animals for research, testing and teaching purposes

AIM

To investigate the awareness of and interest in the use of animals for research, testing and teaching (RTT) purposes, the levels of support and attitudes towards this use of animals, and the awareness of and opinions on regulations governing it within the public in New Zealand.

METHODS

An independent telephone survey was used to collect information including demographics, awareness and interest in the use of animals for RTT, attitudes towards the use of animals for RTT, and awareness of the regulation of the use of animals in RTT and the degree of confidence held in such regulation.

RESULTS

Data were obtained from 750 respondents throughout New Zealand. The rim-weighting efficiency figure was 90%, indicating that the sample collected closely matched the population demographics for New Zealand. Overall, 33% of respondents expressed an interest in the issue generally, 39% were interested in the area of animals used for research and testing purposes, and 21% for teaching purposes. A majority of respondents agreed that the use of animals for teaching (72%) and research and testing (68%) purposes was acceptable as long as there was no unnecessary suffering by the animals. Respondents felt animal research was most justified for research into life-threatening and debilitating diseases, and least justified for safety-testing of cosmetics and household chemicals. Only 8% of respondents knew a fair amount (or more) about the legislation pertaining to the use of animals in RTT.

CONCLUSIONS

The majority of New Zealanders were neither interested nor concerned about the use of animals in RTT. The largest proportion of respondents fell into a category of accepting this use of animals with conditions such as where there is no unnecessary suffering by the animals or where the research is for a serious disease. However, the responses also indicated that attitudes towards the use of animals in RTT as a general issue may change when that use is given a specific context.

CLINICAL RELEVANCE

The understanding of public opinion with regard to the use of animals in RTT is an important tool for New Zealand Veterinary Association nominees on animal ethics committees (AECs), for these veterinarians, as well as acting as assessors of the welfare of the animals involved, are also independent of the institutions using animals, so that, along with the other 'external' members, they provide a societal perspective to the deliberations of AECs.

A randomized double-blind phase II study to evaluate same-day vs next-day administration of pegfilgrastim with carboplatin and docetaxel in patients with NSCLC

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Background: Combination therapy with carboplatin and docetaxel has demonstrated activity against non-small cell lung cancer (NSCLC), but is associated with at least a moderate risk of febrile neutropenia (FN). Though pegfilgrastim is given only once-per-cycle 24 hours after chemotherapy (CT), administering pegfilgrastim on the same day as CT would be convenient for patients (pts). Methods: Pts ≥18 years with previously untreated stage IIIB or IV NSCLC and ECOG ≤2 who were candidates for carboplatin AUC 6 and docetaxel 75 mg/m2 were randomized 1:1 to receive pegfilgrastim 6 mg within 4 hours or approximately 24 hours after CT. The primary endpoint was the duration of grade 4 neutropenia (DSN) in cycle 1. Same-day administration was considered noninferior to next-day if the upper 95% confidence interval (CI) limit for the difference in DSN between groups in cycle 1 was <2 days. Results: As planned, 90 pts were enrolled. 88 pts received blinded study drug. Pts in the same-day and next-day groups had comparable mean baseline ANC and similar proportions of pts completed the study (43% vs 45%). In cycle 1, only 5% of pts in both groups experienced grade 4 neutropenia; resulting in a mean DSN of 0 days. Similarly in cycle 4, 10% (lasting for 1 day only) and 0% of pts in the same-day and next-day groups experienced grade 4 neutropenia. No pts experienced FN during the study. 44% of pts in the same-day and 33% of pts in the next-day group experienced serious adverse events. Conclusions: In this study of lung cancer patients receiving carboplatin and docetaxel, use of pegfilgrastim from the first cycle was well-tolerated in both treatment groups. Although the incidence of grade 3/4 neutropenia was lower than previously reported for this regimen, DSN appeared to be similar for patients in the same-day and next-day groups. Additionally, few patients experienced reductions or delays in CT delivery.

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The clinical phenotype of wild-type, heterozygous, and homozygous JAK2V617F in polycythemia vera

BACKGROUND

Several studies have recently reported on the occurrence of a JAK2(V617F) mutation in myeloid cells from the majority of patients with polycythemia vera (PV). The clinical relevance of this novel observation currently is under study.

METHODS

In a single institutional study, mutation screening for JAK2(V617F) was performed in DNA derived from archived blood granulocytes from 63 consecutive patients with PV in whom current diagnostic criteria were strictly applied and the diagnosis confirmed by bone marrow histology.

RESULTS

The JAK2(V617F) mutant allele was detected in 58 of the 63 patients (92%) with 21% homozygosity. The clinical phenotype of the five patients with the wild-type allele was otherwise typical for the disease. A statistical comparison between JAK2(V617F) heterozygotes (n=45 patients) and homozygotes (n=13 patients) did not reveal any significant associations with regard to age, gender, leukocyte or platelet count at the time of diagnosis, duration of disease, or the incidences of thrombosis or bleeding. However, compared with their heterozygote counterparts, JAK2(V617F) homozygote patients displayed a significantly higher hemoglobin level at the time of diagnosis (P=0.001), an increased incidence of pruritus (69% vs. 38%; P=0.04), a higher rate of fibrotic transformation (23% vs. 2%; P=0.009), and higher PRV-1 transcript levels in their blood granulocytes (P=0.07).

CONCLUSIONS

The results of the current clinical study support previous laboratory observations that link JAK2(V617F) with the PV phenotype by demonstrating a mutant allele dose effect on erythrocytosis and clinical and laboratory features characteristic of PV.

Carotid artery occlusion in association with a retropharyngeal abscess

Deep neck space infections in children are not an uncommon presentation to an otolaryngologist and with appropriate antibiotic therapy, often in conjunction with surgical drainage, complications are rare. We report on a case of a 4-year boy who presented with a retropharyngeal abscess that was complicated by ipsilateral carotid artery and internal jugular vein compression. The patient was treated with intravenous broad-spectrum antibiotics and heparin. There were no subsequent neurological or vascular complications. An overview of the management of deep neck infections and their complications are discussed.

Analysis of the repeatability of tear break-up time measurement techniques on asymptomatic subjects before, during and after contact lens wear

This study assessed the repeatability of various methods of measuring tear break-up time (TBUT) with and without soft contact lenses (CLs). TBUT was measured on 22 subjects with the tearscope, videokeratoscope and slit-lamp before and after 30 min of soft CL wear, and immediately after CL removal. Slit-lamp corneal TBUT was measured with fluorescein and without fluorescein while wearing CLs. TBUT was measured three times on the right eye only, using each technique in randomised order. TBUT measurements on CLs were repeated a second day. TBUT measurements were highly variable under all conditions and our results indicated a lack of correlation between techniques. The videokeratoscope was the least repeatable; while the tearscope was the most repeatable technique.

The use of environmental integrative indicators to assess seabed disturbance in estuaries and coasts: Application to the Humber Estuary, UK

The coastal zone is subject to many and varied changes resulting from human activities and natural processes. Existing or emerging agreements and legislation acknowledge the relevance of indicators for monitoring these. In the UK, following a series of recent workshops, potential indicators of nearshore disturbance have been identified and grouped into three broad indices: 'Coastline Morphological Change', 'Resource Use Change' and 'Environmental Quality and its Perception'. The present study developed these indicators further and tested their use by applying them to 18 sections in the Humber Estuary, Eastern England. The results obtained reflect the current knowledge of the state of the Humber environment and show the potential of integrative indicators but indicate that further studies are required to assess the relative importance of the indicators and their value in reflecting the ability of the ecosystems to sustain natural habitats and populations at a good conservation status.

Protecting Young Workers in Agriculture: Participation in Tractor Certification Training

Tractor-related injuries among youth are an important public health problem. The major objectives of this study were to (1) provide a rigorous estimate of the number of youth operating tractors in Ohio and (2) assess the extent to which these youth are participating in federally mandated tractor safety training. A self-administered questionnaire was completed by approximately 4,000 students ages 14 or 15 years who were enrolled in a stratified cluster sample of 99 Ohio schools. Almost one-third of the youth (30%) reported having operated tractors, with 19% having operated a tractor on a farm not owned by a parent or guardian. More than half of the youth (52%) reported having operated a tractor and/or other hazardous machinery, with 25% having operated the machinery on a farm not owned or operated by a parent or guardian. Extrapolating from 4-H records and Ohio census data, fewer than 1% of the youth who are operating tractors or other hazardous machinery have participated in tractor certification training. Increasing participation in mandated training may be an important step in protecting the health of our nation's young agricultural workers.

Marine monitoring: Its shortcomings and mismatch with the EU Water Framework Directive's objectives

The main goal of the EU Water Framework Directive (WFD) is to achieve good ecological status across European surface waters by 2015 and as such, it offers the opportunity and thus the challenge to improve the protection of our coastal systems. It is the main example for Europe's increasing desire to conserve aquatic ecosystems. Ironically, since c. 1975 the increasing adoption of EU directives has been accompanied by a decreasing interest of, for example, the Dutch government to assess the quality of its coastal and marine ecosystems. The surveillance and monitoring started in NL in 1971 has declined since the 1980s resulting in a 35% reduction of sampling stations. Given this and interruptions the remaining data series is considered to be insufficient for purposes other than trend analysis and compliance. The Dutch marine managers have apparently chosen a minimal (cost-effective) approach despite the WFD implicitly requiring the incorporation of the system's 'ecological complexity' in indices used to evaluate the ecological status of highly variable systems such as transitional and coastal waters. These indices should include both the community structure and system functioning and to make this really cost-effective a new monitoring strategy is required with a tailor-made programme. Since the adoption of the WFD in 2000 and the launching of the European Marine Strategy in 2002 (and the recently proposed Marine Framework Directive) we suggest reviewing national monitoring programmes in order to integrate water quality monitoring and biological monitoring and change from 'station oriented monitoring' to 'basin or system oriented monitoring' in combination with specific 'cause-effect' studies for highly dynamic coastal systems. Progress will be made if the collected information is integrated and aggregated in valuable tools such as structure- and functioning-oriented computer simulation models and Decision Support Systems. The development of ecological indices integrating community structure and system functioning, such as in Ecological Network Analysis, are proposed to meet a cost-effective approach at the national level and full assessment of the ecosystem status at the EU level. The WFD offers the opportunity to re-consider and re-invest in environmental research and monitoring. Using examples from the Netherlands and, to a lesser extent, the United Kingdom, the present paper therefore reviews marine monitoring and marine environmental research in combination and in the light of such major policy initiatives such as the WFD.

"Virtual unwrapping" of a mummified hand

The purpose of this work is to demonstrate the feasibility of medical virtual reality technologies in the investigation of a mummified hand. The Ulster Museum obtained the mummy hand, which originated from Thebes, without any identifying information. The mummified hand was investigated using conventional X-ray and 3D multi-slice Computed Tomography (CT). Imaging revealed a range of fractures of the wrist, metacarpals and phalanges whilst 3D CT demonstrated internal structures using volume rendering. The absence of any features of bone healing at the fracture sites would imply that they occurred just prior to death or in the mummified state possibly during excavation. Conventional X-ray imaging indicated that the hand, although small, was likely to have originated from an adult. Medical imaging and virtual reality display will enable us to produce a rapid prototyped model using fused deposition technology. Therefore, further paleopathological research can be performed on the replica without the need to handle the original specimen.

Oscillations in NF-kappaB signaling control the dynamics of gene expression

Signaling by the transcription factor nuclear factor kappa B (NF-kappaB) involves its release from inhibitor kappa B (IkappaB) in the cytosol, followed by translocation into the nucleus. NF-kappaB regulation of IkappaBalpha transcription represents a delayed negative feedback loop that drives oscillations in NF-kappaB translocation. Single-cell time-lapse imaging and computational modeling of NF-kappaB (RelA) localization showed asynchronous oscillations following cell stimulation that decreased in frequency with increased IkappaBalpha transcription. Transcription of target genes depended on oscillation persistence, involving cycles of RelA phosphorylation and dephosphorylation. The functional consequences of NF-kappaB signaling may thus depend on number, period, and amplitude of oscillations.

Cardiac ECMO for biventricular hearts after paediatric open heart surgery

OBJECTIVE

To delineate predictors of hospital survival in a large series of children with biventricular physiology supported with extracorporeal membrane oxygenation (ECMO) after open heart surgery.

RESULTS

81 children were placed on ECMO after open heart surgery. 58% (47 of 81) were transferred directly from cardiopulmonary bypass to ECMO. Hospital survival was 49% (40 of 81) but there were seven late deaths among these survivors (18%). Factors that improved the odds of survival were initiation of ECMO in theatre (64% survival (30 of 47)) rather than the cardiac intensive care unit (29% survival (10 of 34)) and initiation of ECMO for reactive pulmonary hypertension. Important adverse factors for hospital survival were serious mechanical ECMO circuit problems, renal support, residual lesions, and duration of ECMO.

CONCLUSIONS

Hospital survival of children with biventricular physiology who require cardiac ECMO is similar to that found in series that include univentricular hearts, suggesting that successful cardiac ECMO is critically dependent on the identification of hearts with reversible ventricular dysfunction. In our experience of postoperative cardiac ECMO, the higher survival of patients cannulated in the operating room than in the cardiac intensive care unit is due to early effective support preventing prolonged hypoperfusion and the avoidance of a catastrophic cardiac arrest.

Anthropogenic regulation of the phosphorus balance in the Thau catchment-coastal lagoon system (Mediterraean Sea, France) over 24 years

In the Thau lagoon, despite there being no phosphate limitation policy, the annual mean phosphate concentrations decreased by 90% between 1971 and 1994. The present study indicates a relationship between the decrease of phosphate concentrations and changes in urban, industrial and agricultural activities within the catchment generating phosphorus (P) inputs; and shellfish farming leading to phosphorus storage and export. The relationship (tonnes of P) is: P-PO(4)(3-) in the lagoon waters=1.0124 anthropogenic phosphorus balance--47.62 (r(2) = 0.824, p < 0.000). As population growth is expected in coastal zones, sustainable development requires the need for addressing the role played by human activities and the multi-scale regulation of them. As an element of integrated coastal zone management, the present study provides a regional scale analysis of these aspects.