Biphasic burrowing in Atlantic hagfish (Myxine limosa)

Myxine limosa is a burrowing species of hagfish that occurs in the western north Atlantic in areas with muddy substrate and at depths generally greater than 100 meters. Burrowing of M. limosa has been observed from submersibles, but little is known about the behavior of these animals within the substrate or the biomechanical mechanisms involved. Here we investigated burrowing in M. limosa by observing individuals as they burrowed through transparent gelatin. A photoelastic setup using crossed polarizers allowed us to visualize stress development in the gelatin as the hagfish moved through it. We found that M. limosa created U-shaped burrows in gelatin using a stereotyped, two-phase burrowing behavior. In the first ("Thrash") phase, hagfish drove their head and their anterior body into the substrate using vigorous sinusoidal swimming movements, with their head moving side-to-side. In the second ("Wriggle") phase, swimming movements ceased, with propulsion coming exclusively from the anterior, submerged portion of body. The Wriggle phase involved side-to-side head movements and movements of the submerged part of the body that resembled the "internal concertina" strategy used by caecilians and uropeltid snakes. The entire burrowing process took on average 7.6 minutes to complete and ended with the hagfish's head protruding from the substrate and the rest of its body generally concealed. Understanding the burrowing activities of hagfishes could lead to improved understanding of sediment turnover in marine benthic habitats, new insights into the reproductive behavior of hagfishes, or even inspiration for the design of burrowing robots.

Evidence-based medicine meets democracy: the role of evidence-based public health guidelines in local government

Background

In 2013, many public health functions transferred from the National Health Service to local government in England. From 2006 NICE had produced public health guidelines based on the principles of evidence-based medicine. This study explores how the guidelines were received in the new environment in local government and related issues raised relating to the use of evidence in local authoritites.

Methods

In depth, interviews with 31 elected members and officers, including Directors of Public Health, from four very different local government organizations (‘local authorities’).

Results

Participants reported that (i) there were tensions between evidence-based, and political decision-making; (ii) there were differences in views about what constituted ‘good’ evidence and (iii) that organizational life is an important mediator in the way evidence is used.

Conclusions

Democratic political decision-making does not necessarily naturally align with decision-making based on evidence from the international scientific literature, and local knowledge and local evidence are very important in the ways that public health decisions are made.

From the National Health Service to local government: perceptions of public health transition in England

OBJECTIVES

In England, in 2013, responsibility for some public health (PH) functions transferred from the National Health Service (NHS) to local government. This moved PH from a health-focussed into a broader and more politically oriented context. This article reports on the perceptions of those involved in this transition about how the PH function was changing as it transited to local government.

STUDY DESIGN

This is a cross-sectional interview study.

METHODS

The study included semi-structured interviews with 31 local government councillors, directors and deputy directors of PH, PH team members and members of clinical commissioning groups. Interviews and data analysis were informed by a theoretical framework, COM-B and an inductive and deductive approach was taken to identify relevant themes.

RESULTS

There was a mixed picture of perceived gains and losses for PH. The transition from NHS to local government was seen by some as a 'homecoming', providing the opportunity for PH to have further reach through influence and collaboration with departments like housing, transport and planning. The opportunity to promote evidence-based practice across local government was also seen as a positive aspect of the transition. However, professional roles of PH and individual PH practitioners were perceived to have less influence and autonomy than in the NHS, with some uncertainty about roles within local government. PH practitioners perceived the need to develop other skills to fulfil their roles in local government. Shorter timescales for action and pressure for faster responses were reported to be the reason for less emphasis on using PH evidence to inform policy and decision-making than hitherto in the NHS.

CONCLUSION

This study illustrates a variety of consequences of transitioning from NHS to local government. There were perceived benefits afforded by proximity to related local government departments but at the costs of reduction in status for PH practitioners and working to a timescale which in some cases reduced drawing on scientific evidence.

P5-16-02: The Impact of Educational Materials on Compliance and Persistence with Adjuvant Aromatase Inhibitors: 2 Year Follow-Up and Final Results from the CARIATIDE Study

Rationale Understanding and effectively addressing the factors that affect patient compliance with adjuvant aromatase inhibitors (AI) is required in order for patients to obtain maximum benefit from treatment. The CARIATIDE study sought to determine whether the provision of educational materials (EM) could improve compliance and persistence with adjuvant AI. At 1-y follow-up (FU), there was no improvement in overall compliance with AI therapy, compliance with initial AI or persistence rates when EM were provided. Final results from the 2-y FU are presented here.

Methods This 2-y, global observational study (NCT00681122) randomized 2758 patients, across 18 countries, to Group A: Standard Therapy or Group B: Standard Therapy + EM. The EM were developed in collaboration with patient advocates, and consisted of a range of information on breast cancer-related topics. Compliance rate with adjuvant AI medication was the primary endpoint. Secondary endpoints included persistence rate after 1 and 2y, and reasons for, and time to, discontinuation of AI therapy. Compliance rate was defined as the proportion of patients being ‘compliant’ with the adjuvant AI medication; switching from AI therapy to tamoxifen would result in a non-compliance score at time of switching. For compliance with initial adjuvant AI medication, switching to another AI or hormone therapy would result in a non-compliance score. A patient was considered a ‘persistent’ user if they did not switch AI medication, AI medication was uninterrupted and there was no discontinuation of the AI medication during the second year. Patients’ compliance and behavior were evaluated using compliance questionnaires, EM feedback and validated questionnaires (EORTC IN-PATSAT32, GHQ-12, FACT-ES).

Results Of the 2758 patients randomized at study initiation, 2242 were available for analysis at 2-y FU. The results confirmed those obtained at 1-y FU. No statistically significant difference in compliance with AI therapy was observed between Group A and Group B (82% and 82%, respectively, p=0.9926). Compliance with initial AI was 81% in Group A and 80% in Group B (p=0.5541), with persistence rates of 90% and 88%, respectively (p=0.2425). Of the proportion of patients who had compliance data for both years (Group A n=1118; Group B n=1111) 72% were compliant for the whole 2-y FU period. Across the full 2-y FU, AI treatment discontinuation rates of 8% and 9% were observed in Group A and B, respectively, with discontinuation most frequently attributed to AI-related side effects. Analysis showed that no specific baseline demographic characteristics were associated with compliance behavior. Compliance rates differed widely between countries.

Conclusions At 2-y FU, EM were not found to improve overall patient compliance, compliance with initial AI, or persistence with therapy. In total, 72% of patients were compliant across the full 2-y FU. AI-related side effects remained the most frequent cause of AI treatment discontinuation across the full FU period. The 2-y CARIATIDE data confirm the 1-y findings.

Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P5-16-02.

A promoting early presentation intervention increases breast cancer awareness in older women after 2 years: a randomised controlled trial

Background:

We have developed the Promoting Early Presentation (PEP) Intervention to equip older women with the knowledge, skills, confidence and motivation to present promptly with breast symptoms, and thereby improve survival from breast cancer. The PEP Intervention consists of a 10-min interaction between a radiographer and an older woman, supported by a booklet. Our previous report showed that at 1 year, the PEP intervention increased the proportion who were breast cancer aware compared with usual care.

Methods:

We randomised 867 women aged 67–70 years attending for their final routine appointment on the National Health Service Breast Screening Programme to receive the PEP Intervention, a booklet alone or usual care. The primary outcome was breast cancer awareness measured using a validated questionnaire asking about knowledge of breast cancer symptoms, knowledge that the risk of breast cancer increases with age and breast checking behaviour.

Results:

At 2 years, the PEP Intervention increased the proportion who were breast cancer aware compared with usual care (21 vs 6% odds ratio 8.1, 95% confidence interval 2.7–25.0).

Conclusions:

The uniquely large and sustained effect of the PEP Intervention on breast cancer awareness increases the likelihood that a woman will present promptly should she develop breast cancer symptoms up to many years later.

Recruitment and consent of women with intellectual disabilities in a randomised control trial of a health promotion intervention

BACKGROUND

The need for evidence-based health promotion interventions for women with intellectual and developmental disabilities is critical. However, significant barriers impede them from participating in research, including those related to recruitment and obtaining informed consent.

METHODS

This study describes a procedure for the recruitment and consent of women with intellectual disabilities into a community-based, multi-site randomised controlled trial.

RESULTS

Of 269 women who participated in information sessions, 203 (75%) enrolled in the study. While women with and without legal guardians consented at the same approximate rates (83% and 85%, respectively), those with legal guardians enrolled at significantly lower rates (61%) because of lower rates (74%) of guardian consent.

CONCLUSIONS

It is possible to recruit community-dwelling women with intellectual disabilities into randomised controlled trials at relatively high participation rates. Recruiting women who have guardians poses additional challenges for researchers.

Abstract P1-10-03: CARIATIDE: The Impact of Educational Materials and Demographic Characteristics on Compliance with Adjuvant Aromatase Inhibitor Treatment

Background

Long-term use of adjuvant aromatase inhibitors (AI) can be associated with patient non-compliance, but the factors that impact this are currently unclear. A comprehensive understanding of the reasons behind non-compliance is important to inform the design of future interventions intending to improve patient compliance. Educational materials (EM) may improve patients’ treatment compliance, as may demographic characteristics such as country, post-operative chemotherapy, age and BMI. Methods

This 2 year, global observational study (NCT00681122) was designed to investigate whether EM could influence patients’ motivation and behavior, and improve treatment compliance with adjuvant AI treatment. Across 18 countries, 2758 patients were randomized 1:1 to Group A: Standard Therapy or Group B: Standard Therapy + EM. EM received by Group B consisted of a range of information on breast cancer related topics. The primary endpoint was compliance rate for the adjuvant AI medication. Secondary endpoints included persistence rate after 1 and 2 years, and reasons for and time to treatment discontinuation of AI. Compliance rate was defined as proportion of subjects being ‘compliant’ with regard to the adjuvant AI medication; switching from AI to tamoxifen would result in a non-compliance score at time of switching. For compliance to initial adjuvant AI medication, switching to another AI or hormone therapy would result in a non-compliance score. A subject was considered a ‘persistent’ user if, during the first year, they did not switch AI medication, AI medication was uninterrupted or there was no discontinuation of the AI medication. Patients’ compliance and behavior were assessed using validated questionnaires (EORTC-INPATSAT-32, GHQ-12, FACT-ES), specifically developed OPTIMA-X, compliance questionnaire and EM feedback in Group B. Results

Analysis of 1 year data did not demonstrate statistically significant differences between compliance rates for Groups A and B. Overall compliance was 81% and 82% for Groups A and B, respectively. Compliance with initial AI was reported as 75% for Group A and 77% for Group B, with persistence rates of 84% and 86%, respectively. EM only significantly improved overall compliance in Sweden/Finland (85% and 100%, Groups A and B respectively, p=0.0264, data combined). Demographic sub-group analysis at 1 year gave overall compliance rates of 83% for patients who received post-operative chemotherapy compared with 79% in patients who did not receive post-operative chemotherapy (p=0.0163). Age-group specific compliance for Groups A and B was 70% and 82% at <50y, 83% and 81% at 50-60y, 80% and 82% at 60-70y, and 81% and 82% at >70y, respectively. Compliance reported in Groups A and B for specific BMI groups was 79% and 81% at BMI <25; 82% and 83% at BMI 25-35, and 78% and 77% at BMI >35, respectively. Discussion

At 1 year, overall compliance, compliance to initial AI and persistence with therapy was not significantly different between treatment arms. Out of 18 countries, only Sweden/Finland demonstrated a significant improvement in compliance when EM were used. Post-operative chemotherapy was a predictor for patient compliance with AI, but age-group and BMI do not appear to be predictors.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P1-10-03.

Longitudinal predictors of psychological distress and self-esteem in people with ALS

OBJECTIVE

To identify predictors of psychological distress (measured by anxiety and depression) and low self-esteem and to determine whether these change over time in people with ALS.

METHOD

We interviewed 50 patients with ALS living with a spouse/partner; further interviews were held at median intervals of 6 and then 5 months. Although carers were interviewed, we report the patients' data. Patients completed measures about their social support and marital relationship; the functional impact of ALS; everyday cognitive, emotional, and behavioral changes; symptoms of anxiety and depression; and self-esteem. The ALS Severity Scale was also completed.

RESULTS

From the initial sample of 50, 26 patients were interviewed on all three occasions. At the first interview, negative social support and bulbar impairment were most predictive of psychological distress; pre-illness marital intimacy was the best predictor of patients' self-esteem. Over time, negative social support and pre-illness marital intimacy retained an ability to predict patients' affective state and self-esteem.

CONCLUSIONS

Social factors are important in determining longer-term psychological well-being in people with ALS who are in the relatively early stages of the disease.

Predictors of psychological distress in carers of people with amyotrophic lateral sclerosis: a longitudinal study

BACKGROUND

The majority of people providing informal care for people with amyotrophic lateral sclerosis (ALS) are spouses. This prospective study set out to examine changes in and predictors of psychological distress in spouse carers of people with ALS.

METHOD

Fifty spouse carers of people with ALS underwent an initial interview and at least 21 underwent two further interviews, at median intervals of approximately 5-6 months. They rated the functional impact of their partner's ALS on everyday activities and everyday cognitive, emotional and behavioural changes that might have occurred in the person with ALS. They also rated their own social support and marital relationship, and completed measures of mood, burden and strain. The ALS Severity Scale was also completed for their partner with ALS.

RESULTS

Over time, carers' psychological distress (a global measure combining mood, burden and strain) increased significantly. Initially carers' psychological distress was best predicted by the psychosocial impact of their spouse/partners' ALS, the extent to which their partner demonstrated emotional lability and how many other people were considered as dependents of the carer. Subsequently, carer distress was best predicted by an initial measure of negative social support and by their initial satisfaction with their social relationships.

CONCLUSIONS

Despite the significant physical impairment associated with ALS, psychosocial factors appear important in determining short- and longer-term psychological well-being in carers of people with ALS and may help clinicians to predict which carers are likely to experience psychological difficulties as part of their caring role.

Patients' preference for administration of endocrine treatments by injection or tablets: results from a study of women with breast cancer

BACKGROUND

Endocrine therapies for advanced breast cancer include tablets and intramuscular injections. When treatments have similar efficacy and tolerability profiles, addressing preferences about routes of administration is important.

PATIENTS AND METHODS

Two hundred and eight women>2 years post-breast cancer diagnosis were interviewed about their preferences for daily tablets or monthly intramuscular injections. Health-care professionals treating the women estimated patients' preferences.

RESULTS

Sixty-three per cent of patients preferred tablets, 24.5% preferred the injection and 12.5% had no preference. The most cited reasons for tablet preference were convenience and dislike of needles; for injection preference, adherence and convenience. Variables associated with preferences were body mass index, educational level, attitudes towards injections and efficacy perceptions. Estimates about patients' preferences by health-care professionals varied widely. When asked to imagine scenarios where injections produced fewer hot flushes, or where two injections monthly improved efficacy, injection preference increased to 60.6% and 74.5%, respectively. Disturbingly, approximately 50% of patients admitted they sometimes forgot or chose not to take their current oral medication.

CONCLUSIONS

The majority of breast cancer patients preferred hormone therapy via daily tablets rather than monthly injections. Information about side-effects or improved efficacy altered these preferences. Adherence to treatment cannot be assumed; patients' preferences about drug administration may influence this.

Predictors of institutionalisation in people with dementia

OBJECTIVE

To identify what patient and carer characteristics influence transition into residential care for people with dementia.

METHOD

Longitudinal study of a cohort of people with dementia and their carers in contact with old age psychiatric services in south London.

RESULTS

100 people with dementia and their main family carer were recruited. At six month follow up 22 were in residential care, 63 in the community, 8 had died, and for 7 there were missing data. Between six and 12 months, 7 of the 63 in the community went into residential care, 4 died, and 12 were lost to follow up. The most striking finding is the 20-fold protective effect of having a co-resident carer (odds ratio 0.05, 95% confidence intervals 0.01 to 0.42, p=0.006). Higher ratings of behavioural problems in the person with dementia were also statistically significantly associated with transition into residential care as was the psychological domain of quality of life of the carer.

CONCLUSION

These findings powerfully illustrate the pivotal role carried out by carers of people with dementia; interventions directly targeted at helping them to maintain this role would be supported by these data. These data also suggest that strategies directed at improving carer quality of life and at the resolution of behavioural disorder in the person with dementia may also have particular value.

Health-related locus of control: does it change in motor neurone disease (MND)?

OBJECTIVES

Previous studies have attempted to describe locus of control beliefs in people with MND. This exploratory, longitudinal study set out to examine some of the possible correlations of health-related locus of control beliefs and the stability of these beliefs.

METHOD

32 people with Motor Neurone Disease completed the Multi-dimensional Health Locus of Control (MHLC) scale, initially on average 10.3 months after diagnosis, and again on average 16.4 months after diagnosis. Physical symptoms were assessed at both times.

RESULTS

Initially there were no correlations between MHLC beliefs or disease duration and physical symptomatology, although longer disease duration was associated with greater beliefs in the role of powerful others in health control. At the second assessment, belief in the role of powerful others controlling health had increased, with this increase relating significantly to a worsening in physical symptoms. At this second assessment, neither duration of symptoms nor time since diagnosis correlated with MHLC beliefs.

CONCLUSIONS

Whilst health locus of control beliefs do appear to change in MND, current findings suggest that this does not occur simply as a function of the passage of time. How symptoms change seems to be of particular importance when considering health locus of control beliefs in people with MND. Suggestions are made concerning other factors that might usefully be examined in future studies of this type.

Correlates of Quality of Life in people with motor neuron disease (MND)

OBJECTIVES

Previous work has not found correlations between standardized questionnaire measures of quality of life (QoL) and physical strength/functional ability in people with motor neuron disease (MND). Little is known about the relationship between ratings on an abbreviated self-generated measure of QoL, the Schedule for Evaluation of Individual Quality of Life-Direct Weighting (SEIQoL-DW), and measures of functional status such as the Sickness Impact Profile (SIP), although the former has been rated by people with MND as providing a more valid measure of their own QoL than the latter. The aim of this study was to examine whether self-generated ratings of QoL correlated with measures of physical impairment and self-reported functional status, psychological wellbeing and self-reported cognitive functioning, and with factors such as social support, which elsewhere has been reported to be a determinant of QoL in MND.

DESIGN

The present cross-sectional study investigated between SEIQoL-DW ratings and SIP and the relationship ALS Severity Scale (ALSSS) scores, as well as with self-reported anxiety, depression, social support and everyday cognitive functioning in 31 people with MND.

RESULTS

Overall QoL ratings on the SEIQoL-DW failed to correlate with any of the ALSSS or SIP subscale scores. This was despite the fact that health was nominated as an important QoL-related category by 64.5% of the sample. QoL scores were, however, found to correlate positively with the existence of confiding and emotional support; they also correlated negatively with the presence of self-rated everyday cognitive difficulties but not with affective state.

CONCLUSIONS

Current findings support recent observations that individuals' ratings of their QoL cannot simply be equated with their physical impairment and functional limitations, and that support systems may be important. Cognitive functioning, known to be impaired in some people with MND, should also be considered when evaluating QoL.

Pituitary tumorigenesis and hPit-1 cells

Despite decades of clinical data verifying the success of therapeutic approaches to human pituitary tumors, a significant number of tumors progress and can be life-threatening. The development of better therapeutic strategies for pituitary tumors is complicated by the relative scarcity of human pituitary material for basic experimentation. Human pituitary tissue was used to derive cell cultures, and a cell line, hPIT-1. Molecular and functional analyses were used to further characterize the cells as human pituitary explants in vitro. Functional analyses of the cell cultures indicated that the cells were tumorigenic and of human folliculostellate origin. hPit-1 cells revealed numerous abnormalities of ploidy. Molecular analyses indicated the absence of expression of the following pituitary hormones or hormone subunits by this culture: growth hormone, prolactin, ACTH, FSHbeta, LHbeta, THbeta, and p-glycoprotein. By contrast, the cells expressed uniformly high levels of human follistatin mRNA. Finally, the cells are moderately tumorigenic in immune-deficient mice. Although the precise molecular genetic mechanisms for tumorigenesis in the established cell culture are unknown, the cells serve as a future resource in the study of pituitary tumor initiation, progression, and response to therapy.

Amplification of AML1 in childhood acute lymphoblastic leukemias

Amplification of AML1 has been confirmed by fluorescence in situ hybridization analysis in two cases of childhood acute lymphoblastic leukemia. It remains to be elucidated whether this amplification results in up-regulation of the normal AML1 gene product or a potentially mutant AML1 transcript.

Recovery of shrubland communities on abandoned farmland in southwestern Australia: soils, plants, birds and arthropods

Passive recovery of land formerly used for agricultural production may be an inexpensive and rapid method of ecosystem recovery, and may provide an alternative method to active revegetation. Passive recovery may also contribute to sustainable agriculture (soil salinity). For undisturbed and disturbed areas of the central wheatbelt of Western Australia, this paper reports the effects of farming history (clearing only, cultivation, duration of farming, and time since farming ceased) on the soil nutrient content, plant floristics (richness and composition) and structure, and the abundance, species richness and species composition of birds and arthropods. Only one site was cultivated for >6 years. We summarize as follows: (1) Previous clearing and cultivation has left no residual effects on the nitrogen or phosphorus content in the sandy soils. (2) There were no significant differences in terms of plant species richness but some differences in cover of woody plants, grass cover and plant species composition for farming history or time since farming ceased. (3) There were no significant differences in bird species richness but differences in species composition for time since farming ceased. (4) Arthropods showed few (and low) significant differences in their abundance, richness or species composition across different farming histories and time periods since farming ceased. Farming of these shrublands has left only minor changes in the composition and structure of the vegetation, and in the abundance, species richness and species composition of the passerine bird and arthropod assemblages. Abandoned parcels of land on the sandy soils which support shrubland may yield useful conservation benefits with relatively little input.

Characterization of a xenograft model of human ovarian carcinoma which produces intraperitoneal carcinomatosis and metastases in mice

A new xenograft model for human epithelial ovarian carcinoma, with extensive intraperitoneal (i.p.) carcinomatosis as the predominant disease manifestation, is described. Cells from the established NIH:OVCAR-5 cell line were injected i.p. into 6- to 8-week-old Swiss nude mice. Comparative analyses between cells cultured in vitro and tumor cells derived ex vivo were performed to assess histologic features, immunohistochemical cell markers, hormonal receptor expression, adhesion to extracellular matrix molecules and chromosomal constitution. Macroscopically, the extent of tumor development appeared to be site-dependent and tumor cell survival was dose-dependent. Advanced disease was characterized by extensive solid tumor burden and ascites with parenchymal invasion, lymphatic metastases and vascular dissemination. Individual tumor nodules exhibited developing neovasculature characterized by the absence of mature basement membrane. Despite some histologic loss of cellular differentiation in advanced disease, antigenic expression was preserved, distinguishing these cells as epithelial in origin. Karyotyping of tumor cells demonstrated multiple numeric and structural chromosomal abnormalities. Serum and ascites CA 125 levels were consistently elevated only in tumor-bearing mice. This new murine model closely resembles the aggressive disease process of human epithelial ovarian carcinoma, in which the efficacy of i.p. and systemic therapeutic modalities can be investigated.

Biodiversity indicators in semi-arid, agricultural Western Australia

The predicted future loss of native Australian species of plants and animals, in part as a result of adverse land management strategies, has led to attempts to identify areas of high biotic richness (numbers of species). Bioindicators are measures of the physical environment, or of a subset of the plants or animals, that best predict biotic richness. Ideally, bioindicators should aim at predicting as large a component of the plant or animal fauna as is possible at minimum cost. For two contrasting vegetation types, we examined remnant area, vegetation structural diversity, species richness of plants, lizards and terrestrial arthropods, and the relative abundance of individual arthropod species, as indicators of faunal richness, using correlation, principal component regression and stepwise regression analyses. The study was carried out in gimlet Eucalyptus salubris woodlands (29 sites) and shrublands (27 sites) in semi-arid, agricultural Western Australia. Sites varied considerably in grazing history (woodland) and in farming history (shrubland). Fauna sampled were lizards (woodland), scorpions (woodland), isopods (woodland), cockroaches (woodland), termites (woodland, shrubland), earwigs (woodland), hemipterans (shrubland), beetles (woodland, shrubland), butterflies (shrubland) and ants (woodland, shrubland). None of the indicator variables in any analyses effectively predicted total faunal richness for either vegetation type (<35% of variation in total richness explained). In correlation analyses for woodlands, vegetation structural diversity and plant richness, but no fauna variable, explained a high percentage of the variation in the richness of lizards (56% explained by richness of native plants, +ve), scorpions (48%, richness of native plants, +ve), termites (55%, vegetation structural diversity, +ve) and beetles (59%, litter, –ve). The richness of the shrubland fauna was poorly predicted by all indicator variables (<25% explained). When using the total richness and abundance of ant functional groups, the abundance of a subset of species within ant functional groups, and of termite and beetle species, in principal component regressions, various ant functional groups explained 42% each of the richness of scorpions and beetles, and eight beetle species explained 50% of termite richness. When remnant area, vegetation structural diversity and the richness of native plants in woodland were tested in step-wise regressions as indicators of total faunal richness, remnant area was the only significant indicator variable, explaining 33% of total richness. The richness of native plants and vegetation structural diversity explained a total of 76% of the pooled richness of lizards + scorpions + termites. No significant indicator variable was found by regression procedures for total richness, or for a subset, of the shrubland fauna. We argue that differences in the predictive qualities of vegetation structure and plant richness between the vegetation types was due, in part, to differences in the spatial heterogeneity of biotic richness, and possibly the scale at which structure was measured. The use of structural diversity or plant richness as predictors of faunal richness for different woodland types, or those with different disturbance histories, or in different geographic or climatic regions, should not be adopted without verification of their efficiency at predicting the richness of the local fauna.

Health reform: what to expect from the coming debate. Interview by Jeannie Mankelker, Dan Wise, and Steven Findlay

Health care reform is in limbo as 1994 draws to a close. Last month's Republican sweep puts the issue in a starkly new political environment. The new Congressional leadership said last month it will put forth a reform plan in 1995. Also, the Clinton administration is working on a scaled-back proposal. To get an idea of what might happen next year, we invited 20 informed persons to give us their opinions and to tell us what action they'd prefer. Because of B&H's production schedule, the interviews took place before the election. We don't think that diminishes their insights and analyses.

Trisomy 5 and trisomy 7 are nonrandom aberrations in pigmented villonodular synovitis: confirmation of trisomy 7 in uncultured cells

Pigmented villonodular synovitis (PVNS) is a proliferative lesion of disputed genesis. Recently, we reported trisomy 7 in short-term cultures of 1 PVNS. In the present report, we describe another specimen of PVNS in which 9 of 26 (35 percent) metaphase cells demonstrated trisomy 7 when analyzed after 3-15 days of tissue culture. In situ hybridization analysis, with a biotinylated probe to chromosome 7 alpha-satellite DNA, revealed trisomy 7 in 53 of 200 uncultured cells from this PVNS sample. Our findings indicate that trisomy 7 is a nonrandom aberration that arises in vivo in PVNS.

Changes in AMP deaminase activities in the hearts of diabetic rats

AMP deaminase from normal and diabetic rat hearts was separated on cellulose phosphate and quantitated by HPLC. From soluble fractions three different AMP deaminase activities, according to KCl elution from cellulose phosphate and percent of total activity were: 170 mM (85%), 250 mM (8%) and 330 mM (7%) KCl. The AMP deaminase activity which eluted with 170 mM KCl was resolved to two distinct peaks by HPLC anionic exchange. After 4 weeks of diabetes the heart enzyme profile change to: 170 mM (10%), 250 mM (75%) and 330 mM (15%). Once purified the four activities were kinetically distinct: 170 mM KCl cytosolic, AMP Km = 1.78, stimulated by ATP, GTP, NADP and strongly inhibited by NAD; 170 mM KCl mitochondria AMP Km = 17.9, stimulated by ATP, ADP; 250 mM KCl isozyme, AMP Km = 0.66, stimulated by ADP; and 330 mM KCl isozyme, AMP Km = 0.97, inhibited by ATP, NAD(P).

Loss of the Y chromosome in meningiomas. A molecular genetic approach

Loss of the Y chromosome in meningiomas from 17 male patients was examined by cytogenetic analysis and by Southern blot hybridization with a series of Y-specific DNA probes. Cytogenetic analysis revealed loss of the Y chromosome in seven of 17 (41%) of the tumors whereas Southern blot hybridization showed loss of Y-associated sequences in only three of 17 (18%). Although the incidence of Y-chromosome loss was less by Southern blot hybridization than by cytogenetic analysis, the finding that loss of Y is present in the original uncultured tumor specimen suggests that a gene or genes on the Y chromosome may play a role in growth control of meningioma cells, and loss of this gene may be associated with tumor progression. The difference in the incidence of Y loss between the two methods indicates that both methods should be used when examining chromosome losses.

[Polymorphism of restriction fragment length in the detection of the precise status of monosomy 21 in a deformed retarded girl]

The authors used genomic single copy DNA fragments cloned from chromosome 21 to study cytogenetic abnormalities in patients not easily defined by conventional cytogenetic means. Ten restriction fragment length polymorphisms (RLFP) detected by 8 independent probes were used to detect homologous sequences from chromosome 21 in genomic digests of DNA from one patient and her parents. The proband is a 3 1/2-year-old girl who was referred to us at 1 month of age because of hypertonia, hirsutism, flattened nasal bridge, antimongoloid slant of palpebral fissures, high arched palate and bilateral hip dysplasia. The karyotype of the proband was: 46, XX, -3, -21, + ? del (3) (3 pter----3q1:) +? (3qter----3q1:: 21q21----21 pter). GTG banding and the karyotype of her parents were normal (in peripheral blood and skin fibroblasts). She was re-examined by us every three months, because she showed physical and psychomotor retardation. We traced the inheritance of RFLPs from her parents, and familial molecular studies showed in contrast to the cytogenetic analysis that the patient is disomic for all regions of 21q tested by our collection of probes. The use of molecular technology has resulted in a more precise definition of 21 chromosome abnormalities and especially the "complete" monosomy 21 which is extremely rare in live born infants.

Molecular genetic approach to human meningioma: loss of genes on chromosome 22

A molecular genetic approach employing polymorphic DNA markers has been used to investigate the role of chromosomal aberrations in meningioma, one of the most common tumors of the human nervous system. Comparison of the alleles detected by DNA markers in tumor DNA versus DNA from normal tissue revealed chromosomal alterations present in primary surgical specimens. In agreement with cytogenetic studies of cultured meningiomas, the most frequent alteration detected was loss of heterozygosity on chromosome 22. Forty of 51 patients were constitutionally heterozygous for at least one chromosome 22 DNA marker. Seventeen of the 40 constitutionally heterozygotic patients (43%) displayed hemizygosity for the corresponding marker in their meningioma tumor tissues. Loss of heterozygosity was also detected at a significantly lower frequency for markers on several other autosomes. In view of the striking association between acoustic neuroma and meningioma in bilateral acoustic neurofibromatosis and the discovery that acoustic neuromas display specific loss of genes on chromosome 22, we propose that a common mechanism involving chromosome 22 is operative in the development of both tumor types. Fine-structure mapping to reveal partial deletions in meningiomas may provide the means to clone and characterize a gene (or genes) of importance for tumorigenesis in this and possibly other clinically associated tumors of the human nervous system.

Familial premature ovarian failure due to an interstitial deletion of the long arm of the X chromosome

We describe a family in which four women had menstrual irregularities and a partial deletion of the long arm of the X chromosome (Xq). Three of the four women had premature ovarian failure (at the ages of 24 to 37 years). Chromosome-banding studies initially suggested that a terminal portion of Xq was deleted. However, DNA-hybridization studies showed that an interstitial portion of Xq was deleted and that the affected women had a 46,XX,del(X)(pter-q21.3::q27-qter) karyotype. These findings help clarify the role of Xq in ovarian function and indicate that the accurate description of such abnormalities requires a combination of cytogenetic and DNA-hybridization analysis.

Interstitial deletion and ring chromosome derived from 16q

An interstitial deletion of 16q was identified in an infant with failure to thrive, dysmorphic facies, and congenital heart defects. The mother of this infant had a similar deletion of 16q with ring formation of a fragment presumed to be derived from the deleted portion of 16q. We discuss these cases and compare them to other reports of 16q deletions.

Membrane-associated inhibitor of DNA synthesis in senescent human diploid fibroblasts: characterization and comparison to quiescent cell inhibitor

Cell membranes prepared from senescent human diploid fibroblasts (HDF) inhibited entry into S phase by 35% when added to the medium of replicating young HDF. This membrane-associated inhibitory activity was (i) sensitive to trypsin, heat, and periodate, which suggests that the inhibitor is a glycoprotein, and (ii) not able to inhibit DNA synthesis in simian virus 40-transformed HDF, which indicates that not all types of cells are sensitive to this inhibitor. Quiescent young HDF also have a surface membrane-associated inhibitor of DNA synthesis. A comparison of the senescent HDF and quiescent HDF inhibitor activities indicates that they may have the same chemical and physical nature and the same specific activity, but their regulation is different. The inhibitory activity of quiescent young HDF is abolished within 20 hr after refeeding with fresh serum-containing medium, whereas that of senescent HDF remains unchanged. Quiescent old HDF (two or three population doublings remaining) exhibit an intermediate response to serum with approximately two-thirds of the inhibitory activity abolished. The fraction of cells in S phase at 20-24 hr post-stimulation (37% in young HDF, 24% in old HDF, and 0% in senescent HDF) is inversely proportional to inhibitor levels. This suggests that inability to neutralize the inhibitory activity in response to serum stimulation could be involved in the inability of senescent HDF to enter S phase. Disappearance of the inhibitory activity from quiescent young HDF occurs late in G1 phase. Thus, the inhibitor may play a role in determining the length of the G0 to S phase transition in these cells.

Effect of hydroxyethyl starch (HES) in reducing parasite load in experimental visceral leishmaniasis

Leishmania donovani primarily infects phagocytic cells of the reticuloendothelial system. Hydroxyethyl starch (HES) has been shown to concentrate transiently in these organs. The effect of HES administration was assessed upon infection and also upon vaccination against this parasite. Animals received HES intraperitoneally thrice weekly, either alone (HES) or with a subcutaneous immunization protocol utilizing aluminum hydroxide and killed parasites (ALP-HES). Controls were untreated (NT) or received only the vaccination protocol (ALP). Results showed that animals treated with HES alone exhibited significantly fewer parasites as compared to untreated animals (p less than 0.001). The ALP animals also were protected against infection but demonstrated greater parasite burdens than HES animals. Immunized animals which also received HES demonstrated infection levels similar to those treated with HES alone, thus negating any synergistic effect. The reason for increased protection against L. donovani infection in animals treated with HES is not clear, but it may result from a transient increase in host resistance.

Quiescent human diploid fibroblasts. Common mechanism for inhibition of DNA replication in density-inhibited and serum-deprived cells

The mechanism for cessation of proliferation in density-inhibited quiescent human diploid fibroblasts (HDF) and serum-deprived quiescent HDF was compared in two ways. Density-inhibited HDF were fused to either replicating HDF or SV40-transformed HDF and DNA synthesis was measured in the resulting heterokaryons. DNA synthesis was inhibited in the replicating HDF nuclei in heterokaryons in a way that suggested that entry into S phase was blocked, but ongoing DNA synthesis was not inhibited. In contrast, DNA synthesis was induced in the quiescent nuclei in heterokaryons formed with SV40-transformed HDF. Previous experiments had shown that serum-deprived HDF also behave in this way in heterokaryons. To test this similarity further, we examined the inhibitory activity of cell membranes prepared from both types of quiescent HDF. We found that both types of quiescent HDF contain DNA synthesis-inhibitory activity that is (1) effective on replicating HDF; (2) ineffective on SV40-transformed HDF; (3) sensitive to heat and trypsin. Thus, these results support the hypothesis that both density-inhibited HDF and serum-deprived HDF share a common mechanism for arrest in G1 phase. They also suggest that a membrane-bound protein plays a role in the inhibition of DNA synthesis in quiescent HDF.