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Rayleigh wave ellipticity measurements from seismic ambient noise recorded on the Greenland Ice Sheet (GrIS) show complex and anomalous behavior at wave periods sensitive to ice (T < 3–4 s). To understand these complex observations, we compare them with synthetic ellipticity measurements obtained from synthetic ambient noise computed for various seismic velocity and attenuation models, including surface wave overtone effects. We find that in dry snow conditions within the interior of the GrIS, to first order the anomalous ellipticity observations can be explained by ice models associated with the accumulation and densification of snow into firn. We also show that the distribution of ellipticity measurements is strongly sensitive to seismic attenuation and the thermal structure of the ice. Our results suggest that Rayleigh wave ellipticity is well suited for monitoring changes in firn properties and thermal composition of the Greenland and Antarctic ice sheets in a changing climate. Plain Language Summary: Surface meltwater is increasingly being routed and distributed through the Greenland Ice Sheet (GrIS) changing the mechanical and thermal properties of the ice and resulting in accelerated ice flow. Here we observe complex and anomalous Rayleigh wave ellipticity measurements at periods sensitive to the ice structure. We compare our observations with ellipticity measurements made on simulated seismic noise for various seismic velocity and attenuation models. We demonstrate that in the interior of the GrIS the ellipticity is sensitive to the accumulation and densification of snow as it compacts into glacier ice. The variation in the measurements is strongly sensitive to the thermal structure of the ice sheet which we estimate to be warmer than about −10°. These results demonstrate that Rayleigh wave ellipticity is well suited for monitoring changes in firn properties and thermal composition of the Greenland and Antarctic ice sheets in a changing climate. Key Points: Densification of snow into firn has a first order effect on ellipticity measurements at periods sensitive to the iceThe distribution of ellipticity measurements is sensitive to the thermal composition of the iceEllipticity is a promising method for long term monitoring of ice properties and thickness beneath the seismic station [ABSTRACT FROM AUTHOR]

Objectives: To explore the impact of COVID‐19 on the management and outcomes of acute paediatric mastoiditis across the UK. Design: National retrospective and prospective audit. Setting: 48 UK secondary care ENT departments. Participants: Consecutive children aged 18 years or under, referred to ENT with a clinical diagnosis of mastoiditis. Main outcome measures: Cases were divided into Period 1 (01/11/19‐15/03/20), before the UK population were instructed to reduce social contact, and Period 2 (16/03/20‐30/04/21), following this. Periods 1 and 2 were compared for population variables, management and outcomes. Secondary analyses compared outcomes by primary treatment (medical/needle aspiration/surgical). Results: 286 cases met criteria (median 4 per site, range 0–24). 9.4 cases were recorded per week in period 1 versus 2.0 in period 2, with no winter increase in cases in December 2020‐Febraury 2021. Patient age differed between periods 1 and 2 (3.2 vs 4.7 years respectively, p < 0.001). 85% of children in period 2 were tested for COVID‐19 with a single positive test. In period, 2 cases associated with P. aeruginosa significantly increased. 48.6% of children were scanned in period 1 vs 41.1% in period 2. Surgical management was used more frequently in period 1 (43.0% vs 24.3%, p = 0.001). Treatment success was high, with failure of initial management in 6.3%, and 30‐day re‐admission for recurrence in 2.1%. The adverse event rate (15.7% overall) did not vary by treatment modality or between periods 1& 2. Conclusion: The COVID‐19 pandemic led to a significant change in the presentation and case mix of acute paediatric mastoiditis in the UK. [ABSTRACT FROM AUTHOR]

Climate change and a long legacy of fire suppression are leading to an increased prevalence of 'mega‐disturbances' such as drought and wildfire in terrestrial ecosystems. Evidence for the immediate effects of these novel disturbances on wildlife is accumulating, but little information exists on longer term impacts to species and ecosystems. We studied the occurrence dynamics of an iconic old‐forest species, the spotted owl (Strix occidentalis), on a long‐term study area in the Sierra Nevada, CA, USA from 1989 to 2020 to evaluate their multi‐scale population response following a 2014 megafire (the 'King' Fire) that affected a portion of our study area. We found that extensive severe fire within spotted owl sites resulted in both immediate site abandonment and prolonged lack of re‐colonization by owls six years post‐fire. Sites that experienced high pyrodiversity – a mosaic of burn severities – were more likely to persist after the fire, but this effect was only apparent at finer spatial scales. A potentially confounding factor, post‐fire salvage logging, did not explain variability in the probability of either owls persisting at sites or sites becoming re‐colonized; effects could be attributed only to severe fire extent and pyrodiversity. Our study demonstrates the prolonged effects of severe fire on the occupancy of this forest‐dependent species, suggesting that forest restoration that reduces megafires could benefit spotted owls. Our work emphasizes that long‐term monitoring can offer surprising learning opportunities and provide unparalleled value for understanding and addressing emerging environmental concerns. [ABSTRACT FROM AUTHOR]

Aim: To investigate the incretin axis in people with cystic fibrosis. Methods: Adults with cystic fibrosis‐related diabetes, cystic fibrosis without diabetes, and controls (adults without cystic fibrosis and without diabetes) underwent an oral glucose tolerance test and then a closely matched isoglycaemic i.v. glucose infusion. On each occasion, glucose, insulin, C‐peptide, total and active glucagon‐like peptide‐1 and gastric inhibitory polypeptide responses were recorded and incremental areas under curves were calculated for 60 and 240 min. Results: Five adults with cystic fibrosis‐related diabetes, six with cystic fibrosis without diabetes and six controls, matched for age and BMI, completed the study. Glucose during oral glucose tolerance test closely matched those during isoglycaemic i.v. glucose infusion. The calculated incretin effect was similar in the control group and the cystic fibrosis without diabetes group (28% and 29%, respectively), but was lost in the cystic fibrosis‐related diabetes group (cystic fibrosis‐related diabetes vs control group: –6% vs 28%; p=0.03). No hyposecretion of glucagon‐like peptide‐1 or gastric inhibitory polypeptide was observed; conversely, 60‐min incremental area under the curve for total glucagon‐like peptide‐1 was significantly higher in the cystic fibrosis‐related diabetes group than in the control group [1070.4 (254.7) vs 694.97 (308.1); p=0.03] Conclusions: The incretin effect was lost in cystic fibrosis‐related diabetes despite adequate secretion of the incretin hormones. These data support the concept that reduced incretin hormone insulinotropic activity contributes significantly to postprandial hyperglycaemia in cystic fibrosis‐related diabetes. What's new?: This study is the first to measure the incretin effect in people with cystic fibrosis (CF).The incretin effect is lost in people with cystic fibrosis‐related diabetes (CFRD) despite adequate secretion of glucagon‐like peptide‐1 and gastric inhibitory polypeptide.In people with CF but not diabetes, the incretin effect is similar to that in people without CF.These data suggest the lack of incretin effect contributes to postprandial hyperglycaemia, a hallmark of CFRD, most likely as a consequence of reduced β‐cell mass. [ABSTRACT FROM AUTHOR]

Abstract: Cutting height is an important factor controlling the yield and persistence of grass swards harvested for conserved feed. The objective of this experiment was to determine the effect of four cutting heights (5, 10, 15 and 20 cm) on the yield, composition and productivity based on deviation from a size/density compensation line for swards of orchardgrass (Dactylis glomerata L.) and an orchardgrass/alfalfa (Medicago sativa L.) mixture harvested nine times over three growing seasons. Yield was greatest for the 5 cm cutting height through the course of the experiment but ground cover of orchardgrass declined. Prior to the final harvest, tiller weight and density were determined. The 10‐, 15‐ and 20‐cm treatments fell on an apparent size/density compensation line with slope ‐1·779 (R2 = ·99; p = ·008) while the 5‐cm treatment fell considerably below that line indicating a reduction in productivity or relative persistence. Harvest at 10 cm appears to optimize yield while maintaining stand productivity in infrequently harvested orchardgrass swards. [ABSTRACT FROM AUTHOR]

Osteoarthritis is the leading musculoskeletal cause of disability in the Western society. Despite this, it is still difficult to gain a precise definition of what osteoarthritis actually is. The methods used for the study are narrative review and viewpoint focussing on the knee. It is well known that there is a modest correlation between X-ray changes and pain. Improvements in imaging have shown that osteoarthritis should be regarded as an umbrella term for a number of pathophysiological processes leading to pain and/or cartilage loss. If these are inside the joint (such as bone marrow lesions, cartilage defects or meniscal tear) then they can be considered osteoarthritis, while those outside the joint (such as obesity, weak muscles and vitamin D deficiency) could be considered the osteoarthritis syndrome. These improvements in basic science are leading to lesion-specific therapies indicating the importance of trying to pinpoint causes of pain in the individual. [ABSTRACT FROM AUTHOR]

Pasture herbage is a major source of minerals for livestock in pasture-based production systems. Herbage mineral concentrations vary throughout the growing season, whereas mineral supplementation to livestock is often constant. The study objectives were to analyse the seasonal variation in herbage mineral concentrations in tall fescue [ Schedonorus phoenix (Scop.) Holub]-based pasture with regard to beef cattle mineral requirements and to create a statistical model to predict variation in herbage mineral concentrations across the growing season. Pasture herbage was analysed from 12 grazing systems in Virginia to determine its mineral concentration from April to October of 2008-2012. The pasture herbage, grown without fertilization, contained adequate macronutrient concentrations to meet the requirements of dry beef cows through the growing season and the requirements of lactating beef cows in April. Phosphorus supplementation appeared to be unnecessary for dry beef cows given adequate concentrations in pasture herbage. A model using month of harvest, soil moisture and relative humidity explained 75% of the variation in an aggregated mineral factor. The 90% prediction intervals indicated that N, P, K, S and Cu concentrations could be predicted within 1·35, 0·08, 0·80 and 0·07% and 3·83 mg kg−1 respectively. Prediction of herbage mineral concentrations could help to improve livestock health, reduce costs to producers and limit nutrient losses to the environment. [ABSTRACT FROM AUTHOR]

The Pre‐Industrial climate model simulation is intended as an equilibrium control experiment that uses constant external forcing, yet in the Coupled Model Intercomparison Project Phase 6 (CMIP6) model HadGEM3‐GC31‐LL a distinct change in climate state occurs around year 500 of the 2000 year simulation. The global mean near surface air temperature increases by almost 0.5 K associated with a reduction in southern hemisphere sea ice area of almost 20%. Here we show this step change in the state of the climate to be a consequence of the onset of deep convection in the Weddell and Ross Sea gyres. The delayed onset of convection in the gyres is a consequence of a positive, downward, top‐of‐atmosphere radiative balance, and continual ocean heat up‐take during the model spin‐up and the initial pre‐industrial control simulation. Consequently, model spin‐up strategy should be revised to initialize pre‐industrial simulations that are in energy balance. Plain Language Summary: The Pre‐industrial control simulation of climate models is a reference for climate change simulations. Consequently it should simulate a stable climate. However, if the model is not in radiative equilibrium, the ocean continually accumulates heat, becoming unstable at high latitudes and generating large climate fluctuations. This results in a control simulation that is not a steady state. Consequently the methodologies used to initialize and formulate climate models should be revised to ensure a steady state is achieved. Key Points: The long timescales associated with deep ocean heat uptake suggests simulations may not be equilibriated before forcing is perturbedSouthern Ocean venting of heat reduces sea ice cover and increases global mean temperature, leading to a warmer climate stateNet top‐of‐atmosphere energy imbalance can have implications for the methodologies used for climate model spin‐up [ABSTRACT FROM AUTHOR]

The article presents a case study of a woman of 45 years with acute myeloid leukaemia (AML) blasts and poor karyotype. Topics discussed include her treatment using daunorubicin, reappearance of blasts in peripheral blood after completion of chemotherapy and increase in neutrophil count after granulocyte infusions. Other topics include information that higher amount of lymphocytes are present in buffy coat granulocytes and use of non-engrafting allogeneic cells in granulocyte infusion.

Background Post-operative recurrence of Crohn's disease is an important management challenge, with 2-year recurrence rates defined by clinical, endoscopic and radiological parameters of up to 77%, 64% and 49%. Clinical and severe endoscopic recurrence vary widely in controlled trials from 13% to 36% and 22% to 56% with thiopurine treatment or 0% and 9% with infliximab treatment respectively at 1 year. Aims To provide a review of the evidence for thiopurine or anti- TNF use in post-operative Crohn's disease, and to assess the ability to identify those patients at highest risk of recurrent disease. Methods A literature search was undertaken using Medline, Embase and Cochrane databases to identify studies using search terms 'thiopurine', 'azathioprine', 'mercaptopurine', 'Infliximab', 'adalimumab', 'Anti- TNF', 'Crohn's disease', 'post-operative' and 'recurrence'. Results Trials to examine this important area have proved difficult to execute, with recruitment and retention of patients posing major challenges to randomised clinical trials. There have been four RCTs of 433 patients of thiopurine therapy (with three meta-analyses of these data), and one of anti- TNF therapy involving 24 patients. Overall the efficacy data for thiopurine use in this setting are inconclusive, and other than smoking, there are no consistent predictors of post-operative relapse. Conclusions At present, evidence for routine use of thiopurine treatment in post-operative Crohn's disease is heterogeneous and unconvincing. Stratification by risk of relapse emerges as a key challenge in post-operative management that needs to be addressed, using clinical parameters and emerging biomarkers. The evidence for prophylactic anti- TNF use is limited though promising, with its routine use guided by early assessment of relapse. [ABSTRACT FROM AUTHOR]

Predicting campylobacteriosis cases is a matter of considerable concern in New Zealand, after the number of the notified cases was the highest among the developed countries in 2006. Thus, there is a need to develop a model or a tool to predict accurately the number of campylobacteriosis cases as the Microbial Risk Assessment Model used to predict the number of campylobacteriosis cases failed to predict accurately the number of actual cases. We explore the appropriateness of classical time series modelling approaches for predicting campylobacteriosis. Finding the most appropriate time series model for New Zealand data has additional practical considerations given a possible structural change, that is, a specific and sudden change in response to the implemented interventions. A univariate methodological approach was used to predict monthly disease cases using New Zealand surveillance data of campylobacteriosis incidence from 1998 to 2009. The data from the years 1998 to 2008 were used to model the time series with the year 2009 held out of the data set for model validation. The best two models were then fitted to the full 1998-2009 data and used to predict for each month of 2010. The Holt-Winters (multiplicative) and ARIMA (additive) intervention models were considered the best models for predicting campylobacteriosis in New Zealand. It was noticed that the prediction by an additive ARIMA with intervention was slightly better than the prediction by a Holt-Winter multiplicative method for the annual total in year 2010, the former predicting only 23 cases less than the actual reported cases. It is confirmed that classical time series techniques such as ARIMA with intervention and Holt-Winters can provide a good prediction performance for campylobacteriosis risk in New Zealand. The results reported by this study are useful to the New Zealand Health and Safety Authority's efforts in addressing the problem of the campylobacteriosis epidemic. [ABSTRACT FROM AUTHOR]

The availability of a wide range of immunosuppressive therapies has revolutionized the management of patients who have undergone solid organ transplantation ( SOT). However, the cost of immunosuppressive drugs remains high. This situation has led to the development of generic equivalents, which are similar in quality, safety, and efficacy to their approved innovator drugs. There are data available for three generic brands, tacrolimus (Intas), tacrolimus (Phar OS), and tacrolimus (Sandoz). Bioequivalence has been demonstrated for generic tacrolimus (Sandoz) within a narrow therapeutic range to its innovator tacrolimus drug (Prograf) in both healthy volunteers and kidney transplant patients. Clinical experience with this generic tacrolimus formulation has also been established in both de novo and conversion patients who have undergone kidney and liver transplantation, as well as in conversion of other SOT patients, including lung and heart recipients. [ABSTRACT FROM AUTHOR]

Drunken lamb syndrome (DLS) is a fatal disease of unknown aetiology affecting young lambs. In 2011, a prospective on farm cohort study was carried out to investigate the epidemiology and pathophysiology of DLS. Ten cases from a cohort of 1635 crossbred and pure Welsh Mountain lambs were identified as having DLS on the basis of characteristic clinical signs. Renal histopathology demonstrated nephrosis in all 10 cases. Some cases also demonstrated concurrent intestinal pathology. The cases were significantly smaller than the cohort, nine out of the 10 were twins, and they all demonstrated a severe metabolic acidosis characterised by elevated D-lactate. This study demonstrates that D-lactate--probably initiated by the overgrowth of intestinal microorganisms--appears to be the cause of the metabolic acidosis seen in cases of DLS, and to be responsible for the clinical signs seen. It is unclear as to the significance of the nephrosis lesions, and the name 'Lamb Nephrosis' may be misleading. Treatment may be possible using solutions of sodium bicarbonate [ABSTRACT FROM AUTHOR]

Repetitive strain or 'overuse' is thought to be a major factor contributing to the development of tendinopathy. The aims of our study were to develop a novel cyclic loading system, and use it to investigate the effect of defined loading conditions on the mechanical properties and gene expression of isolated tendon fascicles. Tendon fascicles were dissected from bovine-foot extensors and subjected to cyclic tensile strain (1 Hz) at 30% or 60% of the strain at failure, for 0 h (control), 15 min, 30 min, 1 h, or 5 h. Post loading, a quasi-static test to failure assessed damage. Gene expression at a selected loading regime (1 h at 30% failure strain) was analyzed 6 h post loading by quantitative real-time polymerase chain reaction. Compared with unloaded controls, loading at 30% failure strain took 5 h to lead to a significant decrease in failure stress, whereas loading to 60% led to a significant reduction after 15 min. Loading for 1 h at 30% failure strain did not create significant structural damage, but increased Collagen-1-alpha-chain-1 and interleukin-6 ( IL6) expression, suggesting a role of IL6 in tendon adaptation to exercise. Correlating failure properties with fatigue damage provides a method by which changes in gene expression can be associated with different degrees of fatigue damage. [ABSTRACT FROM AUTHOR]

This study considers the feasibility of monitoring forces acting on a cutting machine tool using chromatically addressed optical fibre based photoelastic sensors. The approach offers a cost-effective and versatile method for avoiding susceptibility to electromagnetic interference, with potential for providing sufficient frequency response for high-speed machining and for accommodating noisy, wide band optical wavelength signals. Measurements of the static and dynamic characteristics of such systems are presented along with results for interrupted turning in a real robust machining environment. [ABSTRACT FROM AUTHOR]

We present a dichotomy, in terms of growth at infinity, of analytic functions definable in the real exponential field which take integer values at natural number inputs. Using a result concerning the density of rational points on curves definable in this structure, we show that if a definable, analytic function f: [0, ∞)k→ℝ is such that f(ℕk) ⊆ ℤ, then either sup|x̄|≤ r |f(x̄)| grows faster than exp(rδ), for some δ>0, or f is a polynomial over ℚ. [ABSTRACT FROM PUBLISHER]

Tropical coral reef teleosts are exclusively ectotherms and their capacity for physical and physiological performance is therefore directly influenced by ambient temperature. This study examined the effect of increased water temperature to 3 °C above ambient on the swimming and metabolic performance of 10 species of damselfishes (Pomacentridae) representing evolutionary lineages from two subfamilies and four genera. Five distinct performance measures were tested: (a) maximum swimming speed ( Ucrit), (b) gait-transition speed (the speed at which they change from strictly pectoral to pectoral-and-caudal swimming, Up−c), (c) maximum aerobic metabolic rate (MO2−MAX), (d) resting metabolic rate (MO2−REST), and (e) aerobic scope (ratio of MO2−MAX to MO2−REST, ASC). Relative to the control (29 °C), increased temperature (32 °C) had a significant negative effect across all performance measures examined, with the magnitude of the effect varying greatly among closely related species and genera. Specifically, five species spanning three genera ( Dascyllus, Neopomacentrus and Pomacentrus) showed severe reductions in swimming performance with Ucrit reduced in these species by 21.3-27.9% and Up−c by 32.6-51.3%. Furthermore, five species spanning all four genera showed significant reductions in metabolic performance with aerobic scope reduced by 24.3-64.9%. Comparisons of remaining performance capacities with field conditions indicate that 32 °C water temperatures will leave multiple species with less swimming capacity than required to overcome the water flows commonly found in their respective coral reef habitats. Consequently, unless adaptation is possible, significant loss of species may occur if ocean warming of ≥3 °C arises. [ABSTRACT FROM AUTHOR]

UK national guidelines recommend the measurement of TSH receptor antibodies (TRAb) in certain clinical scenarios. A commercial third-generation TRAb autoantibody M22-biotin ELISA assay was introduced in May 2008 in our centre. To evaluate the diagnostic performance of a TRAb assay in a retrospective and subsequently a prospective cohort in a UK centre. A retrospective review of patients with thyroid disease followed by a prospective observational study in consecutive patients with newly found suppressed serum thyrotrophin (TSH). Medical records of 200 consecutive patients with thyroid disorders who had TRAb measured since the introduction of the assay. In a prospective study 44 patients with newly identified hyperthyroidism (TSH < 0·02 mIU/l) had sera assayed for TRAb prior to their clinic appointment at which a final diagnosis was sought. In the retrospective cohort, the manufacturer's cut-off point of TRAb ≥0·4 U/l resulted in a positive predictive value (PPV) of 95%, sensitivity 85%, specificity 94% and negative predictive value (NVP) 79% to diagnose Graves' disease using defined criteria. Receiver operating characteristic (ROC) analysis determined an optimal cut-off point of TRAb ≥3·5 U/l with a 100% specificity to exclude patients without Graves' disease at the cost though of a lower sensitivity (43%). In the prospective study, the sensitivity, PPV, specificity and NPV were all 96% using the ≥0·4 U/l cut-off. When combining hyperthyroid patients from both cohorts the assay sensitivity and specificity at ≥0·4 U/l cut-off were 95% and 92% respectively. A positive TRAb result increased the probability of Graves' disease for a particular patient by 25-35% and only six (2·5%) patients had a diagnosis of hyperthyroidism of uncertain aetiology after TRAb testing. The assay studied specifically identifies patients with Graves' disease. It is a reliable tool in the initial clinical assessment to determine the aetiology of hyperthyroidism and has the potential for cost-savings. [ABSTRACT FROM AUTHOR]

Background: Diabetes diagnosis is delayed 4–7 years and 50% are undiagnosed. Forty percent of hospitalized patients with any blood glucose level (BGL) ≥10 mmol/L have diabetes 3 months post-discharge, yet less than 5% are detected in hospital. We review identification of, and responses to, hyperglycaemia in inpatients at a teaching hospital. Methods: The world's largest retrospective review of medical records for inpatients with venous BGL ≥11.1 mmol/L without known diabetes over 12 months (2005–2006). The primary outcome was recognition of hyperglycaemia; secondary outcomes were treatment and documentation of follow up. Logistic regression was performed with variables including BGL, admitting team, length of stay and endocrine team review. Results: Of 10 973 people screened, 162 were eligible. The median age was 58 years and BGL 13.3 mmol/L, with increased mortality and length of stay. Hyperglycaemia was noted as definitely in 26%, maybe in 24% and definitely not in 50%. Forty percent of patients were treated in hospital and 19% on discharge. Follow up was documented for 24%. A higher BGL and review by the endocrine team were strongly associated with clinical recognition on uni- and multivariate analyses. However, where an endocrine review was sought for non-hyperglycaemia reasons, similar rates of non-recognition occurred. Conclusion: Despite evidence for improved inpatient outcomes when treated, and high short-term progression to frank diabetes, inpatient hyperglycaemia remains frequently missed. In-hospital recognition is cheap, and vital for the implementation of activities to improve outcomes and prevent progression and complications. Changes to systems for checking pathology results, medical officer education and inpatient screening guidelines are indicated. [ABSTRACT FROM AUTHOR]

Dessins d'enfants can be seen as bipartite graphs embedded in compact orientable surfaces. According to Grothendieck and others, a dessin uniquely determines a complex structure on the surface, even an algebraic structure as a projective algebraic curve defined over a number field. Combinatorial properties of the dessin should therefore determine the equations and also structural properties of the curve, such as the field of moduli or the field of definition. However, apart from a few series of examples, very few general results concerning such correspondences are known. As a step in this direction, we present a graph theoretic characterisation of certain quasiplatonic curves defined over cyclotomic fields, based on Wilson's operations on maps: these leave invariant the graph but change the cyclic ordering of edges around the vertices, therefore they change the embeddings, and hence the dessins, and hence the conformal and algebraic structure of the underlying curves. Under suitable assumptions, satisfied by many series of regular dessins, these changes coincide with the effect of Galois conjugation. This coincidence allows one to draw conclusions about Galois orbits and fields of definition of dessins. The possibilities afforded by these techniques, and their limitations, are illustrated by a new look at some known examples and a study of dessins based on the regular embeddings of complete graphs. [ABSTRACT FROM PUBLISHER]

Information about the topics discussed during the celebration of the Department of Health's National Breastfeeding Awareness Week (NBAW) on May 11, 2009 in London, England is presented. The event highlights the launch of the United Kingdom (UK)-World Health Organization (WHO) 0-4 years charts and focused on the discussion of how breastfeeding affects growth. It notes that the conference was hosted by Dr. Phil Hammond, a broadcaster and general practitioner (GP).

Objective To assess the safety and efficacy of long-term use of long-acting GnRH agonist in women with chronic cyclical pelvic pain using immediate versus delayed add-back hormonal replacement therapy (HRT). Design A prospective randomised trial. Setting Reproductive and Developmental Medicine, Academic Unit, University Teaching Hospital and NHS Hospitals. Population Thirty-eight premenopausal women with chronic cyclical pelvic pain were recruited. Methods Women were given Zoladex 10.8 mg over 18 months and randomised to receive HRT (tibolone 2.5 mg) either immediately or after 6 months. Follow up was 12-month post-treatment. Main outcome measures Bone mineral density at 6 months, the end of treatment (18 months), and 12 months later, pain and quality of life. Results Women treated with immediate HRT add-back showed less bone mineral density loss at 6 months and less vasomotor symptoms compared with those who had delayed HRT add-back treatment. Long-term follow up showed both groups experienced equivalent bone mineral density loss. Pain and health-related quality-of-life assessment showed improvement in both groups but there was evidence of a return to baseline levels after ending treatment. Conclusion Long-term use of GnRH agonist plus immediate add-back HRT is a safe and acceptable approach to intractable cyclical pelvic pain. Given the delay in reactivation of the hypothalamo-pituitary-ovarian axis after long-term suppression, an intermittent dose regime with GnRH agonist might warrant investigation. [ABSTRACT FROM AUTHOR]

The reproductive potential of overwintering boll weevil, Anthonomus grandis grandis (Boheman), females collected from pheromone traps in September, November and January, fed for 1, 3, and 5 weeks on plant pollens, and then provided cotton squares, was determined in the laboratory at 27 ± 1°C, 65% RH, and a photoperiod 13 : 11 (L : D) h. Duration of pollen feeding by overwintering boll weevils did not significantly influence egg and feeding punctures, or puncture ratios (egg to total punctures) for any of the three months of parent weevil collections when provided cotton squares on a daily basis. However, punctures and puncture ratios are significantly different when comparing mean data between months of boll weevil collections. When boll weevils were provided with cotton squares daily, the pre-ovipositional periods of female parents captured in September, November and January were 5, 9 and 14 days, respectively. The rate of eggs by females was significantly lower during November and January than September. Female parents collected in September produced a significantly higher percentage of eggs yielding adult progeny than those collected in November and January. Life table parameters indicated that net reproductive rate ( Ro) of boll weevil females collected in September was 1.2-fold higher than those collected in November and 10.7-fold higher than those collected in January. Except for testes size, no differences in male reproductive parameters were observed during the cotton-free period compared with males captured during mid-cotton (June). The number of oocytes in the ovarioles and the number of oocytes containing yolk were significantly lower during September, November and January compared with June. The reproductive potential of overwintering boll weevil females collected in different months is an important consideration in determining the success of any control strategy. [ABSTRACT FROM AUTHOR]

The application of spatially explicit models of population dynamics to fisheries management and the design marine reserve network systems has been limited due to a lack of empirical estimates of larval dispersal. Here we compared assignment tests and parentage analysis for examining larval retention and connectivity under two different gene flow scenarios using panda clownfish ( Amphiprion polymnus) in Papua New Guinea. A metapopulation of panda clownfish in Bootless Bay with little or no genetic differentiation among five spatially discrete locations separated by 2–6 km provided the high gene flow scenario. The low gene flow scenario compared the Bootless Bay metapopulation with a genetically distinct population ( FST = 0.1) located at Schumann Island, New Britain, 1500 km to the northeast. We used assignment tests and parentage analysis based on microsatellite DNA data to identify natal origins of 177 juveniles in Bootless Bay and 73 juveniles at Schumann Island. At low rates of gene flow, assignment tests correctly classified juveniles to their source population. On the other hand, parentage analysis led to an overestimate of self-recruitment within the two populations due to the significant deviation from panmixia when both populations were pooled. At high gene flow (within Bootless Bay), assignment tests underestimated self-recruitment and connectivity among subpopulations, and grossly overestimated self-recruitment within the overall metapopulation. However, the assignment tests did identify immigrants from distant (genetically distinct) populations. Parentage analysis clearly provided the most accurate estimates of connectivity in situations of high gene flow. [ABSTRACT FROM AUTHOR]

This study examined the toxicological and physiological responses of a commercially important coral-reef grouper, Plectropomus leopardus (Serranidae), to injection of enriched stable-isotope barium chloride (BaCl2) solution. Thirty adult P. leopardus were subject to one of two 138BaCl2 injection treatment groups (corresponding to dosage rates of 2 and 4 mg 138Ba kg−1 body mass), and a control group in which fish were injected with 0·9% sodium chloride (NaCl) solution. Fish from each group were sampled at post-injection intervals of 48 h and 1, 3, 5 and 8 weeks, at which time blood and tissue samples were removed from each fish. Residual concentrations of Ba and 138Ba:137Ba ratios were measured in muscle, gonad, liver and bone tissues of each experimental fish. Elevated Ba concentrations were detected in all treatment fish tissue samples within 48 h post injection. Residual Ba concentrations decreased throughout the remainder of the 8 week experimental period in all tissues except bone. The BaCl2 injection had no significant effects on measured whole blood variables or on the plasma concentrations of steroid hormones. Enriched Ba stable isotopes can therefore be used at low dosages to mark larvae of commercially important marine fishes, without adverse effects on the health of the fishes or on humans who may consume them. [ABSTRACT FROM AUTHOR]

Sex-biased behaviours are expected to play an important role in partitioning genetic variance in animal populations. Comparing genetic structure at markers with different modes of inheritance provides a means of detecting these behaviours and their consequences for population genetic structure. In colonially breeding mammals, the common combination of female philopatry and male vagility can promote contrasting patterns of genetic differentiation between the sexes, both via their effects on recurrent gene flow and on colonization. We examined sex differences in gene flow and structure by comparing maternally inherited mitochondrial DNA (mtDNA) and biparentally inherited autosomal loci in the Formosan lesser horseshoe bat Rhinolophus monoceros. We found that genetic partitioning was higher at mtDNA than autosomal markers in both sexes, indicative of female-biased philopatry and male-biased dispersal. Across Taiwan, isolation-by-distance was detected for all sex/marker combinations but was steeper for mtDNA than for nuclear markers. We suggest that isolation-by-distance shown from mtDNA at large scales is likely to reflect the stepwise founding of new breeding colonies by females during colonization. In contrast, no isolation-by-distance was found at smaller distances of up to 100 km, indicating that gene flow and/or recent shared ancestry homogenises genetic structure among nearby sites. Our results highlight the value of an indirect genetic approach to understanding sex-biased behaviours and their consequences in a little-studied species. [ABSTRACT FROM AUTHOR]

The ATP-binding cassette A1 (ABCA1) protein regulates plasma high-density lipoprotein (HDL) levels. Mutations in ABCA1 can cause HDL deficiency and increase the risk of premature coronary artery disease. Single nucleotide polymorphisms (SNPs) in ABCA1 are associated with variation in plasma HDL levels. We investigated the prevalence of mutations and common SNPs in ABCA1 in 154 low-HDL individuals and 102 high-HDL individuals. Mutations were identified in five of the low-HDL subjects, three having novel variants (I659V, R2004K, and A2028V) and two with a previously identified variant (R1068H). Analysis of four SNPs in the ABCA1 gene promoter (C-564T, G-407C, G-278C, and C-14T) identified the C-14T SNP and the TCCT haplotype to be over-represented in low-HDL individuals. The R1587K SNP was over-represented in low-HDL individuals, and the V825I and I883M SNPs over-represented in high-HDL individuals. We conclude that sequence variation in ABCA1 contributes significantly to variation in HDL levels. [ABSTRACT FROM AUTHOR]

Background and Purpose: Oxidative stress may be involved in the development of abdominal aortic aneurysms (AAAs). Previous studies indicate that antioxidants protect against AAA formation during chronic angiotensin (Ang) II infusion in apolipoprotein E-deficient (ApoE(0)) mice. We here examine if these protective effects also occurred in aged ApoE(0) mice.Experimental Approach: Male ApoE(0) mice (50-60 weeks) were randomly divided into 4 groups: saline, Ang II (1000 ng kg(-1) min(-1) for 4 weeks), Ang II plus antioxidants (0.1% vitamin E in food plus 0.1% vitamin C in drinking water), and Ang II plus losartan (30 mg kg(-1) day(-1)).Key Results: Exogenous Ang II increased systolic blood pressure by 40 mmHg and resulted in the formation of pseudoaneurysms (rupture and extramural haematoma) in the abdominal aorta in 50% of animals. True aneurysmal dilatation was rarely observed. Antioxidants decreased systemic oxidative stress (plasma malondialdehyde), but had only minor effects on aortic rupture, relative to the complete prevention by losartan. Immunohistochemistry revealed strong matrix metalloproteinase-9 (MMP-9) expression in atherosclerotic plaques and at the sites of rupture. Antioxidants did not affect tumour necrosis factor-alpha-stimulated MMP-9 release from U937 cells. In addition, antioxidants had little effects on Ang II-induced renal dysfunction.Conclusions and Implications: In contrast to previous findings in younger mice, antioxidants had only minor effects on Ang II-induced aortic rupture in aged mice. Our results demonstrate that the pathological features of the aneurysmal remodelling induced by Ang II in old ApoE(0) mice are distinct from those of human AAA. [ABSTRACT FROM AUTHOR]

Currently, it is held by many that educational interventions are those most likely to make a significant difference to the prognosis and well-being of a child with an autistic spectrum disorder (ASD). Yet, decision making about educational interventions and provision in ASD is often based on beliefs, tradition and assumptions, rather than on empirical evidence. This can lead to inappropriate or ineffective provision and can cause confusion and conflict between and within professional groups and parents. Little rigorous research evidence exists to guide decisions for children with ASD. This is true for educational practice generally, and for children with other special educational needs. Practitioners and parents alike are keen for good information on how best to educate children with ASD. It was against this background that the Department for Education and Skills (DfES) and Department of Health (DoH) convened a working group of experienced practitioners and parents to produce the ‘Good Practice Guidance on ASDs’. This paper explores the need for the DfES/DoH Guidance, describes its structure and content and then suggests why research evidence is sparse and how future research might be enhanced to inform practice. [ABSTRACT FROM AUTHOR]

Objective To develop and evaluate a Web-based, electronic pelvic floor symptoms assessment questionnaire (e-PAQ) 1 for women. Design A cross-sectional study in primary and secondary care. Setting Two general practices, two community health clinics and a secondary care urogynaecology clinic. Sample A total of 432 women (204 in primary care and 228 in secondary care) were recruited between June 2003 and January 2004. Methods The e-PAQ was located on a workstation (computer, touchscreen and printer). Women completed the e-PAQ prior to their appointment. Untreated women in primary care were asked to return seven days later to complete the e-PAQ a second time (test–retest). Main outcome measures Factor analysis, reliability, validity, patient satisfaction, completion times and system costs. Results In secondary care, factor analysis identified 14 domains within the four dimensions (urinary, bowel, vaginal and sexual symptoms) with internal consistency (Cronbach's alpha) ≥ 0.7 in 11 of these. In primary care, alpha values were all ≥ 0.7 and test–retest analysis found acceptable intraclass correlations of 0.50−0.95 ( P < 0.001) for all domains. A measure of face validity and utility was gained using a nine-item questionnaire, which yielded strongly positive patient views on relevance and acceptability. Conclusions The e-PAQ offers a user-friendly clinical tool, which provides valid and reliable data. The system offers comprehensive symptoms and quality of life evaluation and may enhance the clinical episode as well as the quality of care for women with pelvic floor disorders. [ABSTRACT FROM AUTHOR]

From 2001 to 2003 we radio tracked 23 Pipistrellus pipistrellus and 23 Pipistrellus pygmaeus to investigate whether there are any differences in foraging behaviour between the two cryptic species during the summer, and to consider whether any differences between these species are important for their conservation planning. There were significant differences between the two species in relation to flying time, mean maximum distances travelled from the roost, numbers of foraging bouts made and span of home ranges. The results suggest that P. pipistrellus makes more flights to a greater number of foraging locations (and possibly) feeding habitats than P. pygmaeus, although these foraging areas are likely to be closer to the roosts. This behaviour is particularly marked during lactation. In contrast, P. pygmaeus spends less time flying, makes fewer foraging bouts but travels further distances, suggesting that this species is selecting specific foraging habitats. These differences in foraging behaviour support the hypothesis that these species occupy different ecological niches, and conservation planners should be aware of these differences when considering the requirements of pipistrelles in the UK. [ABSTRACT FROM AUTHOR]

This paper estimates the financial incentive to control paratuberculosis on dairy farms by establishing the level of expenditure that would minimise the total cost of the disease (output losses plus control expenditure). Given the late onset of the clinical signs and the lack of treatments, control was focused on minimising the financial impact of paratuberculosis by adjusting the dairy cow replacement policy. The optimum replacement policies for disease-free herds and infected herds were compared by using dynamic programming. At the standard settings, the disease justified adjusting the culling policy; under constant bioeconomic assumptions, it reduced the expected annuity from milk production under the optimal replacement policy by about 10 per cent (£27 per cow annually), a considerably lower figure than for other major endemic diseases that affect dairy cows in the UK. The effect was even less at lower milk prices, suggesting that there is at present little incentive for dairy farmers to put more resources into controlling the disease. However, the incentive could be increased if more information were available about how best to manage the disease under specific farm circumstances. Any effect that paratuberculosis may have on the future demand for milk and hence on milk prices would also be an important consideration. [ABSTRACT FROM AUTHOR]

The article focuses on how to effectively measure the health status of patients in urogynaecology. It was found that the most effective tool in determining health status is through use of self-completed questionnaires. Diagnosing incontinence purely in the basis of clinical criteria is often unsafe due to nonspecific and unreliable symptoms of the disease. Questionnaires, however, should not be used alone but in conjunction with other clinical measures.

BSTRACT: The interaction between probiotic ( Enterococcus spp., Lactobacillus spp., and Lactococcus spp.) and enteric ( Bacteroides spp., Escherichia coli, and Salmonella spp.) bacteria with respect to menaquinone production was examined. Menaquinones were measured in cell pellets by high-pressure liquid chromatography and the main homologues produced were MIK7-11. The growth of both Bacteroides and E. coli cultured with the 3 probiotics was significantly inhibited with concomitant reduction in menaquinone production. The vitamin K status of humans could be affected by consumption of probiotic dairy foods via the contribution made by gut microflora. [ABSTRACT FROM AUTHOR]

BSTRACT: Turnip greens, a Brassica, are characterized by a sulfurous aroma, pungent flavor, and a bitter taste due to isothiocyanates, degradation products of glucosinolates. This study examined the sensory characteristics and preference of turnip greens as affected by variety and maturity. A descriptive analysis panel characterized 16 aromas, flavors, and tastes. The intensity of mustard oil/mustard green aroma and flavor and bitterness was significantly affected ( P < 0.05) by variety. Mustard oil/mustard green aroma and flavor, bitterness, and bitter aftertaste increased significantly ( P < 0.05) with maturity. Seven Top was preferred significantly ( P < 0.05) less than the remaining varieties and as the greens matured, preference decreased. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to investigate the association of clinical risk factors and bone density with prevalent fractures in prepubertal children.Methods: Bone mineral density (BMD) in lumbar spine, femoral neck and total body bone was assessed by dual-energy X-ray absorptiometry. Clinical data on risk factors were collected by measurement and questionnaires.Results: Of 324 children, 32 (10%) had a prevalent fracture (upper limb 69%). Most fractures were due to low-energy falls at home (69%). Children with fractures were older (P = 0.04), had higher levels of sports participation (P = 0.03), lower levels of breastfeeding (P = 0.05) and tended towards higher usage of inhaled corticosteroids in the previous year (P = 0.05). However, both BMD and apparent BMD did not differ between those with and without prevalent fracture. No differences were observed in the proportion of maternal fractures, maternal smoking during pregnancy, asthma history and oral prednisolone in last year (all P > 0.05). A final model incorporating age, weight, height, breastfeeding history, sports participation and inhaled corticosteroid usage accounted for 10% of the variability in the odds of fracture (P = 0.03).Conclusion: These results suggest that BMD may be less important than clinical risk factors for total fracture risk in prepubertal children. However, sample size limitations mean that further investigation in larger populations with less heterogeneity in fracture types is warranted. [ABSTRACT FROM AUTHOR]

Objective: To document symptomatic fracture incidence in those aged under 50 years of age.Methods: Fractures were ascertained from X-ray reports containing the word 'fracture' from all radiology providers for the geographically defined population of southern Tasmania (n = 165 175) for the period 1 July 1997 to 30 June 1999.Results: In the 2-year study frame there were 2943 fractures in 164 730 person years in males and 1348 fractures in 165 620 person years in females. This represents a fracture incidence of 1787 per 100 000 person years in males and 819 per 100 000 person years in females. Peak fracture incidence was 10-14 years in females and 15-19 years in males although different fracture types had varying peak incidence suggesting different fracture-specific causes. The most common fractures were those of the hand (24%), forearm (17%), wrist (10%) and foot (9%). All fractures (including vertebral) were more common in males with relative risks ranging from 1.34 to 4.50. The estimated probability of at least one fracture between birth and 50 years of age was 59% for males and 34% for females.Conclusion: There are threefold as many fractures in this age group compared to those due to osteoporosis in the elderly in any given year. More research priority needs to be given to understanding the causes of these fractures so that preventive strategies can be formulated. [ABSTRACT FROM AUTHOR]

Discusses the value of the gum elastic bougie in difficult intubations. Guidelines from the manufacturer on the use of the bougie; Problem associated with a bougie at an unexpected difficult intubation that supports the manufacturer's recommendations.

1. Patterns of torpor, arousal and activity in free-living Greater Horseshoe Bats, Rhinolophus ferrumequinum (Schreber), were investigated during the hibernation period by using temperature-sensitive radio-transmitters. 2. Torpor bouts varied between 0·1 and 11·8 days, with individual means ranging from 1·3 to 7·4 days. Torpor bout duration decreased with increasing ambient temperature. 3. Activity duration varied from 37 min to 54 h 24 min, with individual means ranging from 2 : 29 to 8 : 58 h. Activity duration increased with ambient temperatures above approximately 10 °C. 4. Ten of 11 bats synchronized their arousals with dusk. The circadian rhythm of one bat showed a free-running pattern over a period of about 5 weeks. Arousals were more highly synchronized, and closer to dusk, in individuals with lower body condition. 5. That bats forage in mild weather is supported by the strong synchronization of arousals with dusk, especially in bats with low body condition. 6. Patterns of torpor and subsequent activity are consistent with predictions that torpor lasts until a critical metabolic or water imbalance is achieved. Because metabolism and water loss are temperature-dependent, torpor bout duration decreases with increasing temperature. The imbalance is corrected during subsequent activity, which is relatively constant in duration until a temperature threshold of 10 °C, above which increasing levels of foraging lead to longer activity bouts. [ABSTRACT FROM AUTHOR]

The structure of the tetragonal phase of the A-site-substituted perovskite sodium bismuth titanate, Na0.5Bi0.5TiO3, has been determined by neutron powder diffraction of 698 K. The structure was refined in space group P4bm with a (= b) = 5.5191 (1), c = 3.9085 (1) Å, V = 119.055 (5) ų, Z = 2 and Dx = 5.91 Mg m-3. The structure exhibits an unusual combination of in-phase (a0a0c-) tilts and antiparallel cation displacements along the polar c axis, which results in a new variant of the perovskite structure. [ABSTRACT FROM AUTHOR]

We investigated intraspecific differences in evening emergence time of northern bats Eptesicus nilssonii, greater horseshoe bats Rhinolophus ferrumequinum and lesser horseshoe bats R. hipposideros. Significant differences in emergence time were associated with presumed variation in predation risk, related to light intensity, and energetic benefits of early emergence, caused by differences in age, reproductive state (energetic demands), and body condition. Females of both species emerged progressively later as pregnancy advanced, perhaps because of decreased flight performance, and earlier as lactation proceeded, probably because of increased energy demands and low reserves. Bats under energetic stress, due to persistent low ambient temperatures during pregnancy, or when body reserves were low, emerged relatively early, and hence appeared to take higher risks, than other bats. Young bats emerged much later than the adults at first, but progressively earlier as their flight skills improved. Lesser horseshoe bats emerged later at exposed roost exits than in more protected situations. The results largely corroborate the hypothesis that emergence time, and therefore feeding performance, of insectivorous bats is constrained at bright light conditions, possibly by predation risk (from birds), and modified by energetic considerations. [ABSTRACT FROM AUTHOR]

In response to the General Medical Council's initiative to reform UK medical undergraduate education only a minority of medical schools have developed entirely novel curricula. Although the experiences gained by these schools in curriculum design and planning have not been recorded in the literature they are likely to be of interest to other medical schools still contemplating course revision. The medical school at the University of Liverpool recently launched an integrated problem-based course differing radically from its predecessor. The General Medical Council considered integration of contributing disciplines one of the most important aims of reform, yet courses that integrate independent component disciplines may be perceived by staff as threatening due to the loss of structure and disciplinary autonomy. Strategies for early course development must take account of these concerns as well as dealing with the identification of course content. A multidisciplinary consensus group process, designed to combat some of these problems, was employed to identify the learning objectives and core content for the new course. The purpose of this paper is to describe, first, the processes employed to identify the core palliative care component for a new PBL curriculum and secondly, how these objectives were integrated horizontally and vertically throughout all course elements. [ABSTRACT FROM AUTHOR]

(1) This paper presents information obtained on the prevalence and distribution of tuberculosis in badgers from four areas in south-west England. One hundred and thirty-six badgers, representing twenty-four social groups, were removed for post-mortem examination following outbreaks of tuberculosis in cattle. (2) Mean group size for each area varied little (4.8-7.6 individuals) but mean territory size varied considerably (22.0-74.7 ha). (3) The prevalence of tuberculosis varied greatly from 6.9% to 34.5% indicating spatial and/or temporal variations in prevalence in local populations. [ABSTRACT FROM AUTHOR]

This paper reviews empirical studies relating communities of coral-reef fishes to the characteristics of the underlying habitat, and the effects of habitat disturbance. Many contrasting patterns in the relationships between fish communities and coral cover, habitat heterogeneity or topographic complexity have been described, including strong effects of particular habitat characteristics (both positive and negative), as well as those finding weak or no relationships. In addition, a whole range of potential responses to different kinds of disturbance, including hurricane damage, crown-of-thorns (Acanthaster planci)outbreaks, and El Nino-associated coral and sea urchin die-offs, have been described. Few workers have attempted to test among alternative models about the importance of resource limitation or responses to disturbance, so critical hypotheses have not been tested. Potential generalizations may be obscured due to a number of problems faced whenmaking comparisons among existing studies. These include the enormous variation in the magnitude of changes to habitats observed, restrictive assumptions about the form of relationships between fish andhabitat variables, inadequate descriptions of habitat and fish community structure, a heavy reliance on `natural', pseudoreplicated experiments and a plethora of different numerical and analytical techniques. We conclude that the search for generalizations would be facilitated by a greater attention to theory and clearer statements of the hypotheses being tested. Evaluation of the general importance of fish-habitat interactions must await the application of common observationaland experimental methodologies to a wider range of fish taxa and locations. [ABSTRACT FROM AUTHOR]

Streptococcus gordonii glucosyltransferase polymerizes sucrose to form glucans, which confer a hard, sucrose-promoted phenotype (Spp+) to colonies on sucrose agar plates. The glucosyltransferase structural gene, gtfG, is positively regulated by the upstream determinant, rgg. Strain Challis undergoes a spontaneous, reversible phase variation between high (Spp+) and low (Spp-) levels of glucosyltransferase activity. Representative strains were examined to gain insights into the basis of glucosyltransferase phase variation. Western blots indicated that the level of glucosyltransferase activity was related to the amount of extracellular glucosyltransferase protein produced by Spp- and Spp+ strains. The nucleotide sequence of rgg and gtfG of the Spp- strain CH97 was found to be identical to that of the Spp+ parent, indicating that DNA differences in these regions are not the basis for glucosyltransferase phase variation. Indeed, 13C-NMR spectroscopy suggested that glucans synthesized by strain CH97 glucosyltransferase were similar to those synthesized by glucosyltransferase of the Spp+ parental strain, indicating a quantitative rather than qualitative change. However, one Spp- strain, CH1C1, had a point mutation in rgg; replacement of the parent rgg with the CH1C1 allele resulted in decreased levels of glucosyltransferase protein and activity. The results indicate that glucosyltransferase phase variation can occur in more than one way, and suggest that glucosyltransferase regulation may involve distally located regulatory gene(s) that affect rgg and/or gtfG expression. [ABSTRACT FROM AUTHOR]

The adhesion and accumulation of oral streptococci on saliva-coated hydroxyapatite was examined in strains representing species that appear in initial plaque (Streptococcus sanguise FCI and Streptococcus oralis C5) and in more mature plaque (Streptococcus gordonii G9B), Washed cells of strains FC1 and C5 did not attach better to saliva-coated hydroxyapatite than did strain G9B, suggesting that the degree of initial adhesiveness does not alone account for the temporal appearance of these bacteria in dental plaque. Growing cells of each strain were also examined for their ability to accumulate on saliva-coated hydroxyapatite. The addition of sucrose to the medium promoted the accumulation of strain G9B more than it promoted the accumulation of strains FCI and C5. Sucrose also enhanced the accumulation of adhesion-defective mutants of each strain to levels similar to those of the respective parent strains. These results suggest that sucrose-dependent accumulation may facilitate the colonization of the tooth surface by these species of oral streptococci when adhesion is limited by reduced bacterial adhesiveness or limited pellicle-binding sites. [ABSTRACT FROM AUTHOR]

Aim: People living with ulcerative colitis (UC) have two broad treatment avenues, namely medical or surgical therapy. The choice between these can depend on patient preference as well as the receipt of relevant information. The aim of this study was to define the informational needs of patients with UC. Method: A postal survey was designed to capture respondent demographics, treatment experienced within the previous 12 months and informational preferences by rating a long list of items. It was delivered through two hospitals that provide tertiary inflammatory bowel disease services. Descriptive analyses were performed to describe demographics and experiences. Principal component analysis was carried out using a varimax rotation to investigate informational needs. Results: A total of 101 responses were returned (20.1% response rate). The median age of respondents was 45 years and the median time since diagnosis was 10 years. Control preferences skewed towards shared (42.6%) or patient‐led but clinician‐informed (35.6%). Decision regret was low for the population (median 12.5/100, range 0–100). Key informational needs related to medical therapy were benefits and risks of long‐term therapy, burden of hospital attendance, reproductive health, need for steroid treatment and impact on personal life. For surgery, these were stoma information, effect on daily life, effect on sexual and reproductive health, risks and benefits and disruption of life due to surgery. Conclusion: This study has identified key areas for discussion when counselling patients about treatment decisions around medical therapy and surgery for UC. [ABSTRACT FROM AUTHOR]