Search

Item does not contain fulltext BACKGROUND: Pregnancy-related venous thromboembolism is a leading cause of maternal morbidity and mortality, and thromboprophylaxis is indicated in pregnant and post-partum women with a history of venous thromboembolism. The optimal dose of low-molecular-weight heparin to prevent recurrent venous thromboembolism in pregnancy and the post-partum period is uncertain. METHODS: In this open-label, randomised, controlled trial (Highlow), pregnant women with a history of venous thromboembolism were recruited from 70 hospitals in nine countries (the Netherlands, France, Ireland, Belgium, Norway, Denmark, Canada, the USA, and Russia). Women were eligible if they were aged 18 years or older with a history of objectively confirmed venous thromboembolism, and with a gestational age of 14 weeks or less. Eligible women were randomly assigned (1:1), before 14 weeks of gestational age, using a web-based system and permuted block randomisation (block size of six), stratified by centre, to either weight-adjusted intermediate-dose or fixed low-dose low-molecular-weight heparin subcutaneously once daily until 6 weeks post partum. The primary efficacy outcome was objectively confirmed venous thromboembolism (ie, deep-vein thrombosis, pulmonary embolism, or unusual site venous thrombosis), as determined by an independent central adjudication committee, in the intention-to-treat (ITT) population (ie, all women randomly assigned to treatment). The primary safety outcome was major bleeding which included antepartum, early post-partum (within 24 h after delivery), and late post-partum major bleeding (24 h or longer after delivery until 6 weeks post partum), assessed in all women who received at least one dose of assigned treatment and had a known end of treatment date. This study is registered with ClinicalTrials.gov, NCT01828697, and is now complete. FINDINGS: Between April 24, 2013, and Oct 31, 2020, 1339 pregnant women were screened for eligibility, of whom 1110 were randomly assigned to weight-adjusted intermediate-dose (n=555) or fixed low-dose (n=555) low-molecular-weight heparin (ITT population). Venous thromboembolism occurred in 11 (2%) of 555 women in the weight-adjusted intermediate-dose group and in 16 (3%) of 555 in the fixed low-dose group (relative risk [RR] 0·69 [95% CI 0·32-1·47]; p=0·33). Venous thromboembolism occurred antepartum in five (1%) women in the intermediate-dose group and in five (1%) women in the low-dose group, and post partum in six (1%) women and 11 (2%) women. On-treatment major bleeding in the safety population (N=1045) occurred in 23 (4%) of 520 women in the intermediate-dose group and in 20 (4%) of 525 in the low-dose group (RR 1·16 [95% CI 0·65-2·09]). INTERPRETATION: In women with a history of venous thromboembolism, weight-adjusted intermediate-dose low-molecular-weight heparin during the combined antepartum and post-partum periods was not associated with a lower risk of recurrence than fixed low-dose low-molecular-weight heparin. These results indicate that low-dose low-molecular-weight heparin for thromboprophylaxis during pregnancy is the appropriate dose for the prevention of pregnancy-related recurrent venous thromboembolism. FUNDING: French Ministry of Health, Health Research Board Ireland, GSK/Aspen, and Pfizer.

Dynamic interactions between humans and water have produced unanticipated feedbacks, leading to unsustainability. Current water management practices are unable to capture the relevant spatial and temporal detail of the processes that drive the coupled human-water system. Whereas natural and socioeconomic processes occur slowly, local communities and individuals rapidly respond to ensure supply-demand balance. In this context, agricultural human-water systems stand out, as roughly 70% of global water demand is for agricultural uses. Additionally, interactions between humans and agricultural water systems involve many actors and occur at multiple spatial and temporal scales. For example, farmers are influenced by risk perceptions, and decisions made at the farm level influence regional hydrologic and socioeconomic systems, such as degradation and depletion of water sources as well as prices of crops. Regional behaviors, in turn, affect national and international dynamics associated with crop production and trade of associated investments. On the other hand, global and national priorities can also percolate down to the regional and local levels, influencing farmer decision-making through policies and programs supporting production of certain crops and local investments. Over the last decade, relevant phenomena in the coupled agricultural human-water systems have been described, as the irrigation efficiency paradox, reservoir effect, and river basin closure. Along with the globalization in the food market, attempts have been taken to developing and applying benchmarks for water-efficient food production, focusing on water productivities, water footprints and yield gaps for agricultural products. Furthermore, significant advancements have been achieved by incorporating social dimensions of agricultural human-water systems behavior. Fusion of quantitative datasets via observations, remote sensing retrieval, and physically-based models has been explored. Advancements have also been made to capture qualitative or relatively intangible concepts of community values, norms, and behaviors, by interacting with stakeholders, identifying the most important elements of their environments, and incorporating these insights into socio-hydrological models. Based on what has been done during the IAHS Panta Rhei decade and what we have learned, and despite recent efforts towards a more comprehensive understanding of the effects of human interventions in agricultural systems, several challenges persist, of which we highlight: 1) Identification of the cross-scale causal effect on agricultural water uses; 2) Quantification of human behavior uncertainties shaped by social norms and cultural values; 3) Development of a high spatial and temporal resolution global dataset.

The alluvial aquifer system of the Indo-Gangetic Basin (IGB) is one of the world’s most important freshwater resources, sustaining humans and river ecosystems. Understanding groundwater recharge processes and connections to meteoric and surface water is necessary for effective water resource management for human and wider ecological requirements. Parts of the mid-Gangetic Basin, across eastern Uttar Pradesh and Bihar, are characterised by stable long-term groundwater levels, high annual rainfall, and limited historical groundwater use compared to parts of Northwest India for example. In this paper we use a combination of environmental tracers and hydrograph observations to characterise sources of recharge and groundwater-surface water interaction using a transect approach across the catchment of the River Gandak, a major barrage-regulated tributary of the River Ganga. Stable isotope results show that the dominant source of groundwater recharge, in the shallow (0–40 m bgl) Holocene and underlying Pleistocene aquifer system (>40 m bgl), is local rainfall. The shallow Holocene aquifer is also supplemented by local recharge from river and canal seepage and irrigation return flow in the upper and mid parts of the catchment. These observations are corroborated by evidence from detailed groundwater hydrographs and salinity observations, indicating localised canal, river and lake connectivity to groundwater. In the middle and lower catchment, river discharge is dominated by groundwater baseflow during the peak dry season when barrage gates are closed, which contributes to ecological flows for endangered river dolphins and gharial crocodiles. Groundwater residence time tracers indicate active modern recharge in the shallow alluvial aquifer system across the catchment. In the shallow Holocene aquifer elevated arsenic (As), iron (Fe), and manganese (Mn) exceeded WHO drinking water guidelines in a minority of sites, and uranium (U) and fluoride (F) concentrations approach but do not exceed the WHO guideline values. These observations varied across the catchment with higher As, Fe and Mn in the upper and mid catchments and higher U in the lower catchment. Groundwater salinity was typically between 500 and 1000 μS/cm, and isolated higher salinity was due to recharge from flood-plain wetlands and lakes impacted by evaporation. At present, the Gandak catchment has relatively high rainfall and low abstraction, which maintains stable groundwater levels and thus baseflow to the river in the dry season. Potential future threats to groundwater resources, and therefore river ecology due to the sensitivity to changes in baseflow in the catchment, would likely be driven by reductions in local monsoon rainfall, changes in water management practices and increased groundwater use.

Understanding water user behavior and its potential outcomes is important for the development of suitable water resource management options. Computational models are commonly used to assist water resource management decision making; however, while natural processes are increasingly well modeled, the inclusion of human behavior has lagged behind. Improved representation of irrigation water user behavior within models can provide more accurate and relevant information for irrigation management in the agricultural sector. This paper outlines a model that conceptualizes and proceduralizes observed farmer irrigation practices, highlighting impacts and interactions between the environment and behavior. It is developed using a bottom‐up approach, informed through field experience and farmer interaction in the state of Uttar Pradesh, northern India. Observed processes and dynamics were translated into parsimonious algorithms, which represent field conditions and provide a tool for policy analysis and water management. The modeling framework is applied to four districts in Uttar Pradesh and used to evaluate the potential impact of changes in climate and irrigation behavior on water resources and farmer livelihood. Results suggest changes in water user behavior could have a greater impact on water resources, crop yields, and farmer income than changes in future climate. In addition, increased abstraction may be sustainable but its viability varies across the study region. By simulating the feedbacks and interactions between the behavior of water users, irrigation officials and agricultural practices, this work highlights the importance of directly including water user behavior in policy making and operational tools to achieve water and livelihood security.

Environmental flows are now a standard part of sustainable water management globally but are only rarely implemented. One reason may be insufficient engagement of stakeholders and their priority outcomes in the environmental flow-setting process. A recent environmental flow assessment (EFA) in the Kilombero basin of the Rufiji River in Tanzania concentrated on a broad-based investigation of stakeholders' use and perceptions of the ecosystem services provided by the river as a framework for the assessment of flow regimes that would maintain them. The EFA process generally followed the Building Block Methodology but within an enhanced stakeholder engagement framework. Engagement began with the involvement of institutional stakeholders to explain the purpose of the EFA and to elicit their priority outcomes. Extensive interactions with direct-use stakeholders followed to investigate their uses of and priorities for the rivers. Results were used by the EFA specialist team in choosing flow indicators and defining measurable environmental objectives. The specialists then met to reach a consensus of the flow requirements. The EFA results were lastly reported back to stakeholders. During the Kilombero EFA, we learned that stakeholders at all levels have a good awareness of the natural services provided by a healthy river and can contribute to the setting of environmental objectives for the rivers and floodplain. These can be factored into the biophysical assessments of river flows required to maintain habitats, processes, water quality, and biodiversity. It is therefore important to allocate significant resources to stakeholder engagement. It now remains to be seen if enhanced stakeholder engagement, including the increased understanding and capacity built among all stakeholders, will increase support for the implementation of the recommended flows.

The effects of anthropogenic water use play a significant role in determining the hydrological cycle of north India. This paper explores anthropogenic impacts within the regions’ hydrological regime by explicitly including observed human water use behaviour, irrigation infrastructure and the natural environment in the CHANSE (Coupled Human And Natural Systems Environment) socio‐hydrological modelling framework. The model is constrained by observed qualitative and quantitative information collected in the study area, along with climate and socio‐economic variables from additional sources. Four separate scenarios, including business as usual (BAU, representing observed irrigation practices), groundwater irrigation only (where the influence of the canal network is removed), canal irrigation only (where all irrigation water is supplied by diverted surface water) and rainfed only (where all human interventions are removed) are used. Under BAU conditions the modelling framework closely matched observed groundwater levels. Following the removal of the canal network, which forces farmers to rely completely on groundwater for irrigation, water levels decrease, while under a canal only scenario flooding occurs. Under the rainfed only scenario, groundwater levels similar to current business as usual conditions are observed, despite much larger volumes of recharge and discharge entering and leaving the system under BAU practices. While groundwater abstraction alone may lead to aquifer depletion, the conjunctive use of surface and groundwater resources, which includes unintended contributions of canal leakage, create conditions similar to those where no human interventions are present. Here, the importance of suitable water management practices, in maintaining sustainable water resources, are shown. This may include augmenting groundwater resources through managed aquifer recharge and reducing the impacts on aquifer resources through occasional canal water use where possible. The importance of optimal water management practices that highlight trade‐offs between environmental impact and human wellbeing are shown, providing useful information for policy makers, water managers and users.

The enteric bacterial pathogen Salmonella enterica serovar Typhimurium (S. Typhimurium), utilizes two type III secretion systems (T3SSs) to invade host cells, survive and replicate intracellularly. T3SS1 and its dedicated effector proteins are required for bacterial entry into non-phagocytic cells and establishment and trafficking of the nascent Salmonella-containing vacuole (SCV). Here we identify the first T3SS1 effector required to maintain the integrity of the nascent SCV as SopF. SopF associates with host cell membranes, either when translocated by bacteria or ectopically expressed. Recombinant SopF binds to multiple phosphoinositides in protein-lipid overlays, suggesting that it targets eukaryotic cell membranes via phospholipid interactions. In yeast, the subcellular localization of SopF is dependent on the activity of Mss4, a phosphatidylinositol 4-phosphate 5-kinase that generates PI(4,5)P2 from PI(4)P, indicating that membrane recruitment of SopF requires specific phospholipids. Ectopically expressed SopF partially colocalizes with specific phosphoinositide pools present on the plasma membrane in mammalian cells and with cytoskeletal-associated markers at the leading edge of cells. Translocated SopF concentrates on plasma membrane ruffles and around intracellular bacteria, presumably on the SCV. SopF is not required for bacterial invasion of non-phagocytic cells but is required for maintenance of the internalization vacuole membrane as infection with a S. Typhimurium ΔsopF mutant led to increased lysis of the SCV compared to wild type bacteria. Our structure-function analysis shows that the carboxy-terminal seven amino acids of SopF are essential for its membrane association in host cells and to promote SCV membrane stability. We also describe that SopF and another T3SS1 effector, SopB, act antagonistically to modulate nascent SCV membrane dynamics. In summary, our study highlights that a delicate balance of type III effector activities regulates the stability of the Salmonella internalization vacuole., Author summary Pathogenic bacteria that adopt an intracellular lifestyle must create a specialized niche that supports their replication while avoiding detection and killing by the host. The foodborne pathogen, S. Typhimurium, invades epithelial cells lining the intestine and establishes residence within a host-derived membrane-bound compartment called the Salmonella-containing vacuole (SCV). To create this intracellular niche, S. Typhimurium relies on two type III secretion systems (T3SS). These are specialized needle-like devices that inject bacterial effector proteins into host cells, and thereby manipulate host cell signalling and immune responses. T3SS1 delivers effectors that are required for early events in the infectious cycle. In this study we describe a new T3SS1 effector called SopF that is unique to Salmonella spp. We show that SopF associates with host cell membranes by binding to phosphoinositides, which are specialized lipids present in eukaryotic cellular membranes, and that SopF is required for maintaining the integrity of the nascent SCV membrane. Salmonella has therefore evolved to reside within a membrane-bound compartment by acquiring a unique type III effector whose actions promote vacuole stability.

Patients who request reduction of their prominent nose invariably have septal deviation and associated turbinate hypertrophy. Septal deviation is reported to occur in approximately 60% of people but the incidence appears to be much higher in people with a prominent nose. Perhaps the disturbance of the septum before birth results in overgrowth of the septum at puberty.

The most significant change in my understanding of the nasal anatomy relates to the elastic cuff. Initially I was setting the cuff back according to the calculated amount on the life-size profile photograph. Reviewing patients after one or more years and checking with the template showed a loss of tip projection when the dorsum had been reduced as in the case of a tension nose. Results improved when I avoided setting the elastic cuff posteriorly. Of course, that will not be the case for a non-tension nose that might have a projecting tip. Then the elastic cuff repositioning should follow the planned changes.

Jack Gunter described and illustrated a ligament connecting the columellar footplates to the septal cartilage. However, the great mobility of the columella relative to the septal cartilage convinced me that such a ligament did not exist. An elastic mucosal cuff is a better description of the connection between these structures.

Design evaluation is a complex and rich social practice that is organized and distinguished by its practical understandings, rules, general understandings and teleoaffective structures. This praxiographic study of a major National Health Service (NHS) hospital project uses practice theory to investigate the concept of design evaluation as ‘a practice’. By applying Theodore Schatzki’s site ontology, design evaluation practices are revealed to respond to dynamic teleoaffective structures that highlight the role of both practical intelligibility and the intertwined impact of external policy stipulations. Through this theoretical lens, fresh insight into the actuality of NHS hospital design evaluation praxis is provided that questions some of the axioms upon which such processes are assumed to operate. In particular, the appropriateness of the decontextualized and deterministic processes currently found in UK government design policy is questioned. It is posited that an approach to design evaluation grounded ...

Extracorporeal membrane oxygenation (ECMO) can be used as rescue intervention for cardiac and/or respiratory failure. High-risk adult patients with adult congenital heart disease (ACHD) may require pre- and post-operative ECMO support.Retrospective data collection within a five-year time period from 2011 to 2016, at a single-centre study at a tertiary university hospital and regional unit for ACHD. Patients with ACHD in cardiogenic shock or failure to be separated from cardio-pulmonary bypass (CPB) were included.Venoarterial (VA) ECMO.Three patients had Ebstein anomaly and one patient had a double-outlet right ventricle transposition type and severe atrioventricular valve insufficiency. Three male patients and one female patient were aged ranging from 19 to 52 years. All received VA ECMO, two each with central or peripheral cannulation. The mean duration of ECMO support was 7 days (range, 3-13 days) and bleeding complications were the main complications observed, with a range of 12 to 104 blood products used. One patient required renal replacement therapy for acute kidney injury and also had leg ischaemia.Two of four patients (50%) were successfully weaned off ECMO and survived to hospital discharge in this high-risk group of patients in severe heart failure. The patients are currently at 3 and 4 years follow-up, with improved mobility and exercise tolerance compared with pre-operatively.ECMO is a promising temporary rescue intervention for patients with ACHD and cardiogenic shock. The extracorporeal cardiac support is a useful bridge to recovery.

Psychosis is a debilitating mental health condition affecting approximately 4 persons per 1000. Cognitive behavioural therapy for psychosis (CBTp) has been shown to be an effective treatment for psychosis and is recommended by several national guidelines. CBTp does not work equally well with everyone, however, with some 50% of clients receiving little benefit. This review sets out to systematically assess the literature and methodological quality of a number of studies, which examine factors predicting successful outcome in CBTp. The databases CINAHL, Cochrane, EBSCO, EMBASE, ISI Web of Science, MEDLINE (Ovid), PsycARTICLES, PsycINFO, PubMed, and Scopus were electronically searched. English language articles in peer reviewed journals were reviewed. Search terms "psychosis", "psychotic disorder", "cognitive behavioural therapy", "cognitive therapy", "randomised controlled trial", "predictor", and "treatment outcome" in various combinations were used as needed. Only randomised controlled trials (RCTs) were included. Results suggest that female gender, older age, and higher clinical insight at baseline, each predicted better outcome in CBT interventions with psychotic patients, as did a shorter duration of the illness, and higher educational attainment. Several other factors, such as higher symptom severity at baseline, were suggestive of predictive capacity but further research to clarify was indicated. Providers of mental healthcare should consider these findings when offering CBTp. The onus is also on healthcare providers to better equip non-responders to CBTp. Further investigation into a limited number of predictive factors, with an agreed set of outcome measures, would allow future researchers more direct comparisons between studies.

In this work, the implementation of our recently proposed sequential Metropolis algorithm in the grand canonical ensemble, a case particularly relevant for continuum fluids, is considered. By performing Monte Carlo simulations for the two-dimensional lattice gas, it is shown that our algorithm converges faster than all known grand canonical algorithms that satisfy strict detailed balance. The main advantages of the new algorithm are its simplicity, generality, and the possibility of parallel implementation.

Strict detailed balance is essentially unnecessary for Markov chain Monte Carlo simulations to converge to the correct equilibrium distribution. Recently, we proposed a Monte Carlo algorithm based on sequential updating moves with partial randomness to guarantee correct sampling. The proposed algorithm only satisfies the weaker balance condition and converges faster than the Metropolis algorithm with strict detailed balance. In this work, we illustrate the efficiency of the algorithm for the two-dimensional lattice gas model in the grand canonical ensemble. Parallel implementation of the sequential algorithm on lattice systems indicates that parallel Monte Carlo simulations, if treated correctly, are not only as precise as serial implementation, but can also save significant computing time.

Flow patterns in the Great Fish River in the Eastern Cape province of South Africa have changed from being seasonal, with predictable no-flow periods during winter, to perennial following the completion of an inter-basin transfer scheme in 1977 to provide a regular supply of irrigation water. Simulium chutteri (Diptera: Simuliidae) consequently became a problem species of pestilential proportions, due to increased flow volumes and current velocities favouring this species. In this study, aquatic invertebrates were sampled from the stones-in-current biotope with a range of current velocities at three sites on the Great Fish River, with a particular focus on pool/rapid areas favouring S. chutteri. The main aim of this paper was to determine whether critical hydraulic thresholds, including current velocity, could be derived for this species. Knowledge of the hydraulic preferences of S. chutteri is a prerequisite for any integrated control programme which combines larvicidal control with flow manipulation. S. chutteri was found to favour the rapids biotope with current velocities in excess of 90 cms−1, with preferences for higher current velocities increasing with life cycle stage. Additional hydraulic variables, at the scale measured in this study, did not correlate with larval densities. There is potential for more effective long-term control of problem populations of larval blackfly in the Great Fish River through further research on the potential for using constructed in-stream vanes to reduce current velocities in rapids of the river at critical periods of the year (July–October), based on flow duration/current velocity relationships. Copyright © 2007 John Wiley & Sons, Ltd.

Generating information on the behaviours, characteristics and drivers of users, as well on the resource itself, is vital in developing sustainable and realistic water security options. In this paper we present a methodology for collecting qualitative and quantitative data on water use practices through semi-structured interviews. This approach facilitates the collection of detailed information on actors' decisions in a convenient and cost-effective manner. The interview is organised around a topic guide, which helps lead the conversation in a standardised way while allowing sufficient opportunity to identify relevant issues previously unknown to the researcher. In addition, semi-structured interviews can be used to obtain certain types of quantitative data. While not as accurate as direct measurements, it can provide useful information on local practices and farmers' insights. We present an application of the methodology on two districts in the State of Uttar Pradesh in North India. By means of 100 farmer interviews, information was collected on various aspects of irrigation practices, including irrigation water volumes, irrigation cost, water source and their spatial variability. A statistical analysis of the information, along with some data visualisation is also presented, which highlights a significant variation in irrigation practices both within and between the districts. Our application shows that semi-structured interviews are an effective and efficient method of collecting both qualitative and quantitative information for the assessment of drivers, behaviours and their outcomes in a data scarce region. The collection of this type of data could significantly improve insight on water resources, leading to more realistic management options and increased water security in the future.

The giant sable antelope (Hippotragus niger variani), unique to Angola, was feared extinct after almost three decades of civil war. Comparisons of mitochondrial DNA sequences derived from dung samples recently collected in the field and from old museum specimens of certain provenance provide the first documented evidence to date that this enigmatic antelope has survived. Its DNA-led rediscovery in the former combat zone was subsequently confirmed by photographic evidence. The Angolan isolate constitutes a distinct monophyletic group that shows a dramatic population decline from historic levels. It represents a diagnosable conservation unit which is characterised by unique cranial morphological features (Blaine 1922 1922:317–339), a highly restricted range, and the presence of fixed genetic differences in all of its common relatives.

In this article we review economy class syndrome or travellers' thrombosis as it should be more appropriately described. We review the evidence for and against the existence of this condition. Much of the evidence included in this article has been justifiably criticised but it is the best evidence available to date. We conclude that there is a probable link between thrombosis and long distance travel. However this association is confined to individuals with additional risk factors and fatal pulmonary embolus is very rare. The probable aetiology of this association is prolonged immobilisation in cramped conditions. Other factors are likely to play a minor role. When considering preventative measures, for the majority of individuals the risk is very small. Simple advise can be given with no requirement for additional intervention. Compression stockings should be considered for high-risk patients. In individuals planning prolonged travel with multiple risk factors for thrombosis low dose low molecular weight heparin should be considered. The criteria for defining risk groups remains unclear and we outline our recommendations. There is conflicting evidence with regard to the use of aspirin but considering the latest evidence we do not recommend it.

A multiresidue method for the analysis for five corticosteroids (dexamethasone, flumethasone, fluorometholone, beclomethasone and triamcinolone acetonide) in urine was developed and validated. The method permits quantification and confirmation of the analytes according to the proposed EU (SANCO 1085/2000) criteria for banned substances. The method involves an initial enzymatic hydrolysis step with subsequent clean-up using solid phase extraction (SPE). Extracts were analysed by liquid chromatography–tandem mass spectrometry (LC–MS) (atmospheric pressure chemical ionization (+) ion mode). Enzymatic hydrolysis conditions were examined using samples incurred with dexamethasone. The method was validated using bovine urine fortified at levels of 1, 2 and 5 ng ml−1. The mean recovery was >60% for all analytes. Within laboratory repeatability for the range of analytes lies between 2 and 17% and within laboratory reproducibility lies between 7 and 29%. Decision limits (2 ng ml−1) and detection capabilities (2–3 ng ml−1) have also been established for each analyte. Linearity (Rsq>0.99) was established for each analyte over the concentration range of 0–18 ng ml−1 (matrix equivalent). The method has also been validated as a confirmatory method for all analytes (except beclomethasone). Four identification points (one precursor ion and two product ions) and a minimum of one ion ratio was monitored for each compound. All measured ion ratios in the sample correspond to those of the standard analyte at comparable concentrations within established tolerances outlined by the proposed SANCO 1085/2000 criteria. The method has also been successfully evaluated using incurred urine.

The recognition of the Reserve by the new South African Water Law poses new challenges for river scientists. The ecological water requirement or environmental flow is recognised by that part of the Reserve known as the ecological Reserve. If the ecological Reserve is to be implemented, it must first be defined and quantified for all river systems subject to water related developments. Standard procedures are being developed through the Resource Directed Measures (RDM) of the Department of Water Affairs and Forestry while monitoring the health of South Africa's rivers is taking place through the National River Health Programme (NRHP). Cost effective methods of developing spatial frameworks for both the RDM and NRHP are required. Concepts of longitudinal river zonation were developed by river ecologists in the 1960s and 1970s to assist in the classification of ecologically uniform stretches of rivers. This paper reviews the different zonation concepts and presents a geomorphological classification ...

SUMMARYThe immune response of PBMC to gliadin was investigated in patients with coeliac disease (CoD) by examining proliferation, MHC restriction and cytokine production. Gliadin induced low levels of proliferation in 63% of eight untreated patients, 32% of 28 treated patients and 35% of 31 healthy control subjects. In MHC restriction studies, the proliferative response to gliadin was inhibited (range 47–98% inhibition) in the presence of a MoAb to HLA-DR in each of three coeliac and three control donors studied. Using flow cytometry, increased expression of activation markers (HLA-DR and IL-2R) was demonstrated on gliadin-stimulated T cells from four of nine coeliac patients and three of seven healthy control donors. Cytokines were studied in culture supernatants using ELISA. Gliadin was a potent inducer of IL-6 and IL-10 in 100% of coeliac patients and controls, whereas IL-4 was not produced in either subject group. Gliadin induced IL-2 production in 40% of untreated patients, 42% of treated patients and 35% of healthy control donors. Interferon-gamma (IFN-γ) in gliadin-stimulated cultures was found only in coeliac patients, observed in 33% of untreated patients and 25% of treated patients. Spontaneous secretion of both IL-2 and IFN-γ was found more frequently in patients with untreated disease (87% of cases versus 21% of controls for IFN-γ and 40% versus 0% for IL-2). These results suggest, as manifest by IFN-γ production, that gliadin stimulates a Th1/Th0-like response in coeliac patients and a Th0-like response in healthy controls.

A supercritical fluid extraction procedure has been developed for the extraction of beta-agonists in bovine liver samples. The method is suitable for compounds of different beta-agonist classes: the substituted aniline-type compounds (e.g. clenbuterol) and the phenolic-type compounds (e.g. salbutamol), including conjugated forms of the latter. The developed procedure involves a combination of supercritical fluid extraction with enzyme immunoassay for the determination of clenbuterol and salbutamol residues at the low ppb level. Addition of methanol modifier and removal of sample moisture are necessary for the extraction of more polar analytes such as salbutamol. Method validation incorporating intra- and inter-assays was carried out on fortified liver tissue and showed good recovery and low variation (RSD15%). An enzyme hydrolysis procedure was incorporated into the method for the deconjugation of conjugated residues. The developed procedure was shown to be successful for the determination of both clenbuterol and salbutamol in incurred liver tissue.

The development of a supercritical fluid extraction procedure for the extraction of clenbuterol from bovine liver tissue is described. The procedure involves a combination of supercritical fluid extraction with enzyme immunoassay for the determination of clenbuterol residues at the low ppb level. Method validation incorporating inter- and intra-assays was carried out on fortified liver tissue and showed good recoveries and low variations (RSD

This paper describes a collaborative process of identifying and prioritising current and future water research questions from a wide range of water specialists within South Africa. Over 1 600 questions were collected, reduced in number and prioritised by specialists working in water research and practice. A total of 59 questions were finally proposed as an outcome of the study and are categorised under the themes of change, data, ecosystems, governance, innovation and resources. The questions range in scale, challenge and urgency, and are also aligned with prevailing paradigms in water research. The majority of the questions dealt with relatively short- to medium-term research requirements and most focused on immediate issues such as water supply, service delivery and technical solutions. Formulations of long-term research questions were sparse, partly because some of the principles and methods used in this study were difficult to apply in the South African context, and also because researchers are influenced by addressing what are believed to be the more immediate, short-term water-related challenges in South Africa. This is the first initiative of its kind to produce a comprehensive and inclusive list of research priorities for water in South Africa.Keywords: research, questions, collaboration, prioritisation, South Africa