Clinical findings for the first 1000 Gulf war veterans in the Ministry of Defence’s medical assessment programme

ObjectiveTo review the clinical findings in the first 1000 veterans seen in the Ministry of Defence’s Gulf war medical assessment programme to examine whether there was a particular illness related to service in the Gulf.DesignCase series of 1000 veterans who presented to the programme between 11 October 1993 and 24 February 1997.SubjectsGulf war veterans.Results588 (59%) veterans had more than one diagnosed condition, 387 (39%) had at least one condition for which no firm somatic or psychological diagnosis could be given, and in 90 (9%) veterans no other main diagnosis was made. Conditions characterised by fatigue were found in 239 (24%) of patients. At least 190 (19%) patients had a psychiatric condition, which in over half was due to post-traumatic stress disorder. Musculoskeletal disorders and respiratory conditions were also found to be relatively common (in 182 (18%) and 155 (16%) patients respectively).ConclusionMany Gulf war veterans had a wide variety of symptoms. This initial review shows no evidence of a single illness, psychological or physical, to explain the pattern of symptoms seen in veterans in the assessment programme. As the veterans assessed by the programme were all self selected, the prevalence of illness in Gulf war veterans cannot be determined from this study. Furthermore, it is not known whether the veterans in this study were representative of sick veterans as a group.

Key messages

• Many Gulf war veterans present with a wide variety of symptoms
• No single cause has been found to explain these symptoms
• From a clinical standpoint the variety and multiplicity of symptoms makes it unlikely that any single cause will be found to underlie Gulf war illness
• Some of the illnesses may be an example of a postwar syndrome

     

Role of vaccinations as risk factors for ill health in veterans of the Gulf war: cross sectional study

ObjectivesTo explore the relation between ill health after the Gulf war and vaccines received before or during the conflict. To test the hypothesis that such ill health is limited to military personnel who received multiple vaccines during deployment and that pesticide use modifies any effect.DesignCross sectional study of Gulf war veterans followed for six to eight years after deployment.Setting UK armed forces.ParticipantsMilitary personnel who served in the Gulf and who still had their vaccine records.Results The response rate for the original survey was 70.4% (n=3284). Of these, 28% (923) had vaccine records. Receipt of multiple vaccines before deployment was associated with only one of the six health outcomes (post-traumatic stress reaction). By contrast five of the six outcomes (all but post-traumatic stress reaction) were associated with multiple vaccines received during deployment. The strongest association was for the multisymptom illness (odds ratio 5.0; 95% confidence interval 2.5 to 9.8).ConclusionAmong veterans of the Gulf war there is a specific relation between multiple vaccinations given during deployment and later ill health. Multiple vaccinations in themselves do not seem to be harmful but combined with the “stress” of deployment they may be associated with adverse health outcomes. These results imply that every effort should be made to maintain routine vaccines during peacetime.     

The Sino-Vietnamese Agreement on Maritime Boundary Delimitation in the Gulf of Tonkin

This article addresses the recently ratified Sino-Vietnamese Boundary Delimitation Agreement in the Gulf of Tonkin and its implications for bilateral cooperation and development of friendly and neighboring relations between China and Vietnam. As the first maritime boundary line for China, the delimitation in the Gulf of Tonkin is indicative of China's positive attitude towards the resolution of other maritime issues with Vietnam and other neighboring countries.     

中国北部湾光裸方格星虫可培养微生物的分离鉴定及其活性代谢物产生菌筛选

【目的】本研究从北部湾海域光裸方格星虫(Sipunculus nudus)肠道中分离鉴定可培养微生物,并对筛选菌株的代谢物活性进行研究,为后续开发和利用光裸方格星虫肠道微生物代谢产物提供理论支持。【方法】通过微生物培养、菌株分离纯化和16S rRNA基因序列分析,分析鉴定湛江、北海、防城港三地光裸方格星虫肠道可培养微生物;采用透明圈法、可见分光光度法、平板打孔法等对产胞外活性代谢物的菌株进行筛选和活性分析。【结果】中国北部湾不同海域光裸方格星虫肠道可培养微生物包括弧菌属(Vibrio)、希瓦氏菌属(Shewanella)、假交替单胞菌属(Pseudoalteromonas)、发光杆菌属(Photobacterium)和芽孢杆菌属(Bacillus)等12个细菌属。弧菌属(Vibrio)是3个地区样本共有的优势菌群。具有产胞外水解蛋白酶、壳聚糖酶、多糖以及抑菌活性等能力的菌株主要来自假交替单胞菌属(Pseudoalteromonas)、发光杆菌属(Photobacterium)和芽孢杆菌属(Bacillus)。【结论】中国北部湾不同海域光裸方格星虫肠道可培养微生物在属的种类上存在显著性差异,且光裸方格星虫肠道菌株具有产生多种胞外活性代谢物的能力,是一种良好的海洋活性代谢物来源。     

The impact of aquaculture on the genetics and distribution of the onuphid annelid Diopatra biscayensis

AimEvolutionary history of natural populations can be confounded by human intervention such as the case of decorator worm species Diopatra (Onuphidae), which have a history of being transported through anthropogenic activities. Because they build tubes and act as ecosystem engineers, they can have a large impact on the overall ecosystem in which they occur. One conspicuous member, Diopatra biscayensis, which was only described in 2012, has a fragmented distribution that includes the Bay of Biscay and the Normanno‐Breton Gulf in the English Channel. This study explores the origin of these worms in the Normanno‐Breton region, which has been debated to either be the result of a historic range contraction from a relic continuous population or a more recent introduction.LocationNortheastern Atlantic, the Bay of Biscay, and the Normanno‐Breton Gulf.MethodsWe utilized a RAD‐tag‐based SNP approach to create a reduced genomic data set to recover fine‐scale population structure and infer which hypothesis best describes the D. biscayensis biogeographic distribution. The reduced genomic data set was used to calculate standard genetic diversities and genetic differentiation statistics, and utilized various clustering analyses, including PCAs, DAPC, and admixture.ResultsClustering analyses were consistent with D. biscayensis as a single population spanning the Bay of Biscay to the Normanno‐Breton Gulf in the English Channel, although unexpected genetic substructure was recovered from Arcachon Bay, in the middle of its geographic range. Consistent with a hypothesized introduction, the isolated Sainte‐Anne locality in the Normanno‐Breton Gulf was recovered to be a subset of the diversity found in the rest of the Bay of Biscay.Main conclusionsThese results are congruent with previous simulations that did not support connectivity from the Bay of Biscay to the Normanno‐Breton Gulf by natural dispersal. These genomic findings, with support from previous climatic studies, further support the hypothesis that D. biscayensis phylogeographic connectivity is the result of introductions, likely through the regions’ rich shellfish aquaculture, and not of a historically held range contraction.     

Modeling the potential distribution of the predator of honey bees,Palarus latifrons,in the Arabian deserts using Maxent and GIS

ObjectivesThe species Palarus latifrons (bee pirates) has been recorded in Saudi Arabia as an invasive species. This pest can destroy honey bee colonies under certain conditions. The origin of this species in Africa and it has a good ability to adapt to desert conditions. Studies on this species are very few but its current distribution in the Arabian deserts is mainly in the Arabian Gulf countries. This study presents maps for the possible expansion of this species to invade other desert areas in the Arabian countries’ under current and near-future conditions (2030).MethodsThis pest is a solitary insect with high activity during summer. It is hypothesized that summer conditions and especially temperature are the limiting factor for its distribution in the deserts. The analysis depended on generating maps based on temperatures during summer and based on two bioclimatic factors. Maxent and the geographical information system (GIS) were used to perform the analysis.Results and conclusionsAll maps showed the high ability of this pest to spread in the Gulf countries. In North Africa: south Egypt and Libya, and some parts of Algeria showed suitability for Palarus. The invasion of this pest towards North Africa can happen mostly due to trading activities with Gulf countries especially materials containing soil. Continues monitoring for the activity of Palarus in the risk areas is highly advised.     

Two new Marina (Leguminosae) from the southern Baja California peninsula, Mexico

Marina victoriae andM. brevis are newly described species from the southern Baja California peninsula, Mexico. The former is a perennial herb locally abundant in the eroded hillsides at the foothills of Sierra de la Victoria, where an oak woodland and a dry tropical forest meet. The latter is an elusive ephemeral inhabiting a narrow strip of land between the mangroves and the desert scrub on an island in the Gulf of California. These two new species belong to the seriesChrysorrhizae, a group native to the Gulf of California basin.     

北部湾人群Dectin-1的基因多态性与马尔尼菲青霉菌病易感性的相关性研究

目的:探讨北部湾人群C型凝集素-1(Dectin-1)基因多态性与马尔尼菲青霉菌病易感性的相关性。方法:选取北部湾地区的马尔尼菲青霉菌(PM)病患者71例为病例组,另选北部湾地区的71例体检正常者为对照组,直接测序检测rs16910526、rs16910527位点的基因型及等位基因频率,并分析其与马尔尼菲青霉菌病易感性的相关性。结果:(1)对照组和病例组之间rs16910526有三种基因型GG、GT、TT,两组之间基因型和等位基因频率比较差异不显著(P0.05)。(2)对照组和病例组之间rs16910527有三种基因型AA、AC、CC,且病例组AC的基因型频率显著高于对照组(P0.05)。(3)局限性、播散性PM患者rs16910526、rs16910527基因型和等位基因频率比较差异不显著(P0.05)。(4)rs16910526、rs16910527的4种单倍型:GT、AC、AT、TT,位于同一连锁不平衡区域内,且对照组和病例组A/C的分布频率比较差异具有统计学意义(P0.05)。结论:北部湾人群Dectin-1的rs16910527位点与马尔尼菲青霉菌病易感性相关,且A/C能提高马尔尼菲青霉菌病的易感性。     

Evidence of predation on a young tuatara,Sphenodon punctatus,by kiore,Rattus exulans,on Lady Alice Island

Abstract

Wounds on a juvenile tuatara discovered dead on Lady Alice Island, Chickens group, Hauraki Gulf, appear to have been inflicted by kiore. Flesh was stripped from the right abdominal wall of the tuatara exposing its ribs and liver, and part of its tail and eight digits were missing.     

Dietary changes of Mediterranean Shags Phalacrocorax aristotelis desmarestii between the breeding and post-breeding seasons in the upper Adriatic Sea

Capsule?Shags move between breeding and non-breeding areas and this is associated with a significant change in diet.

Aims?To determine whether the diet of Shags nesting on islets off the Croatian coast is the same as their diet after the post-breeding move to the Gulf of Trieste.

Methods?Diet was determined by the analysis of 611 regurgitated food pellets.

Results?A total of 23 988 prey items were identified in the sample of pellets. Post-breeding Shags in the Gulf of Trieste focused on demersal and relatively immobile Gobiidae (81.5% by number, 87.1% by biomass). The most frequent prey species was Gobius niger (70.8% by number). In the breeding season at Oruda island, Croatia, the diet was more varied. Breeding Shags fed on bentho-pelagic, mobile prey such as Atherina boyeri (28.4% in frequency), Serranus hepatus (16.1%) and Crenilabrus tinca (12.0%), while Gobiidae had a dietary frequency of only 18.1%. With respect to biomass the most important prey were Crenilabrus tinca (19.0%) and Serranus hepatus (18.4%).

Conclusion?We suggest that the movement of Shags within the Adriatic Sea is driven by dietary requirements. Most previous studies of Shag diet have shown that Shags tend to have a more specialized diet during the breeding season, concentrating upon demersal prey species. However, we have found that birds breeding at the Croatian study colony show dietary diversity. We suggest that lack of dietary specialization is a facultative response to local prey abundance, and is probably the result of over-fishing of demersal species in the areas around the breeding locations in which the birds find suitable sites and are little disturbed by human activity. Shags may move immediately after breeding to the Gulf of Trieste because demersal species are likely to be more abundant there. As a consequence, the diet becomes more specialized and is then more similar to the diet of other populations of Shags.     

Significant correlation of Cd,Cu, Pb and Zn in sediments and oysters (Saccostrea cucullata) collected from Qeshm Island,Persian Gulf,Iran

Abstract

The relationships are evaluated between the heavy metal species in sediments and the accumulation by the soft tissues of Saccostrea cucullata collected from the northern and southern coasts of Qeshm Island, Persian Gulf. The sequential extraction technique was employed to fractionate the sediment into non resistant and resistant fractions. Data from sequential extractions indicated that the metals were mainly associated with the residual fraction at the north coast and with non residual fractions at the south coast. The results showed that the best correlations were observed between heavy metals concentrations in soft tissues and the fractions in the southern sediment. Note that the bioavailability of trace metals is influenced by the chemical characteristics and properties of the sediment. Therefore, the present results generally supported the use of soft tissues of S. cucullata as a more accurate biomonitoring organism for Cu, Pb and Cd in sediments from the southern coast of Qeshm Island, Persian Gulf.     

Identification of the highest potential human health and environmental hazard in contaminated sediment near the point sources in the northwest Persian Gulf

Abstract

The overall goal of this work was to determine the concentration levels and the potential ecological risks of 30 polycyclic aromatic hydrocarbons in the Persian Gulf sediments, Iran. The study also predicted the bioaccumulation of PAHs using the Monte Carlo simulation. For these goals, 68 surface sediment samples were collected from the Persian Gulf in January 2017. Then, the experiments were performed with Soxhlet system, chromatographic column and GC-MS instrument. According to the Canadian Sediment Quality Guidelines, 35.29% of sampling sites exhibited high potential adverse biological effects and 79.41% of samples have a low probability of toxicity. The mean bioaccumulated concentrations of carcinogenic PAHs in the Persian Gulf were predicted as 207.78?±?262.23, 116.06?±?146.47 and 69.26?±?87.41?ng g^–1 for mollusks, shrimps and crabs, respectively. The mean Toxic Equivalency and Mutagenic Equivalent Quotient for sediments was 702.06?±?1012.37 and 500.37?±?665.71?ng g^?1, respectively. The 95th percentile carcinogenic and non-carcinogenic risks calculated for children and adults were lower than the threshold values of 10^?6 and 1.0, respectively, revealing no potential health risk. The highest potential risks for toxicity were observed at sampling sites close to the Nowruz oil field and Mahshahr petrochemical economic zone based on the highest TEQcarc and MEQcarc values in this area.     

Recherches sur le genre Peyssonnelia (Rhodophyceae). X. Présence de Peyssonnelia codana (Rosenvinge) Denizot en Méditerranée

Abstract

Studies on the genus Peyssonnelia (Rhodophyceae). X. Presence of Peyssonnelia codana (Rosenvinge) Denizot in the Mediterranean.—Peyssonnelia codana (Rosenvinge) Denizot, previously known only from Denmark, is recorded from the vicinity of a thermal power plant outlet (Martigues-Ponteau, Gulf of Fos, France). Mediterranean specimens are described and new details about the morphology of sporangial and sexual nemathecia are given.     

Repeatability,reproducibility, and agreement of three computational methods to approximate the functional flexion-extension axis of the tibiofemoral joint using 3D bone models of the femur

Abstract

Background: Closely approximating the functional flexion-extension (FE) axis of the tibiofemoral joint in 3D models of the femur is important when computing joint motions which are physiologic. The objectives were to 1) develop methods to approximate the functional FE axis based on fitting circles, a tapered cylinder, and spheres to the posterior condyles, 2) determine the repeatability and reproducibility of each method, and 3) determine limits of agreement between pairs of axes.

Methods: For each method, the respective axis was determined in forty 3D bone models of the distal femur. Varus-valgus angles and internal-external axial angles were computed relative to standard planes.

Results: Repeatability and reproducibility were comparable for the tapered cylinder-based and sphere-based methods and better than that for the circle-based method. Limits of agreement were tightest when comparing the sphere-based and tapered cylinder-based axes. However, limits of agreement for the internal-external axial angle were wide at +3.6° to ?3.9° whereas limits of agreement were tighter at +1.4° to ?0.7° for the varus-valgus angle.

Conclusion: The tapered cylinder-based and sphere-based methods offer advantages of better repeatability and reproducibility over the circle-based method. However, the sphere-based and tapered cylinder-based axes are not interchangeable owing to wide limits of agreement for the internal-external axial angle. The tapered cylinder-based axis is preferred intuitively over the sphere-based axis because the spheres require fitting in both the sagittal and coronal planes whereas the tapered cylinder requires fitting in the sagittal plane only which is the plane of motion in flexion-extension.     

Images pseudoplanaires issues des tomographies pulmonaires : étude de la reproductibilité de lecture et comparaison aux images planaires

PurposeDue to a long time of acquisition, performing during the same examination planar and pulmonary tomography is time expensive. Then, pseudoplanar images have been advocated to be used instead of planar images in the diagnosis of pulmonary embolism. We aim to compare both kinds of images in terms of probability and to assess intra- and inter-observer agreement.Materials and methodsThirty-four patients referred to our unit to diagnose or rule out pulmonary embolism, underwent a planar ventilation/perfusion (V/Q) lung scan and a V/Q lung SPECT. Using the SPECT projections, eight pseudoplanar images were created for each examination. Two experienced physicians read twice both sets of anonymous planar and pseudoplanar images. They checked the probability of pulmonary embolism using the modified PIOPED criteria but without the chest X-ray.ResultsFor both readers, intra-observer agreement for pseudoplanar images is good (κw = 0.69 and 0.78), and similar to the planar images agreement. Interobserver agreement (κw = 0.63) is also good. Both modalities show a good agreement in terms of probability of pulmonary embolism.ConclusionsWe showed that pseudoplanar pulmonary images have a good intra- and interobserver agreement. Furthermore, in our population, these images lead to the same results in terms of probability of pulmonary embolism as those obtained using the standard planar technique.     

Post-combat syndromes from the Boer war to the Gulf war: a cluster analysis of their nature and attribution

ObjectivesTo discover whether post-combat syndromes have existed after modern wars and what relation they bear to each other.DesignReview of medical and military records of servicemen and cluster analysis of symptoms.ResultsThree varieties of post-combat disorder were identified—a debility syndrome (associated with the 19th and early 20th centuries), somatic syndrome (related primarily to the first world war), and a neuropsychiatric syndrome (associated with the second world war and the Gulf conflict). The era in which the war occurred was overwhelmingly the best predictor of cluster membership.ConclusionsAll modern wars have been associated with a syndrome characterised by unexplained medical symptoms. The form that these assume, the terms used to describe them, and the explanations offered by servicemen and doctors seem to be influenced by advances in medical science, changes in the nature of warfare, and underlying cultural forces.

What is already known on this topic

Service in the Gulf war is associated with an increased rate of reported symptoms and worsening subjective healthPost-combat syndromes have been described after most modern conflicts from the US civil war onwards

What this study adds

There seems to be no single post-combat syndrome but a number of variations on a themeThe ever changing form of post-combat syndromes seems to be related to advances in medical understanding, the developing nature of warfare, and cultural undercurrentsBecause reported symptoms are subject to bias and changing emphasis related to advances in medical science or the discovery of new diseases, the characterisation of individual syndromes has to be treated with cautionAttributions by servicemen are generally consistent with symptom characteristics, though there seems to be a growing reluctance to consider the stress of military service as a cause     

Analysis of gene associated tandem repeat markers in Atlantic salmon (<Emphasis Type="Italic">Salmo salar L.</Emphasis>) populations: implications for restoration and conservation in the Baltic Sea

Patterns of genetic diversity and differentiation among five wild and four hatchery populations of Atlantic salmon in the Baltic Sea were assessed based on eight assumedly neutral microsatellite loci and six gene-associated markers, including four expressed sequence tag (EST) linked and two major histocompatibility complex (MHC) linked tandem repeat markers (micro- and mini-satellites). The coalescent simulations based on the method of Beaumont and Nichols (1996, Proc. R. Soc. Lond. Ser. B – Biol. Sci., 263, 1619–1626) indicated that two loci (MHCIIα and Ssa171, with the lowest and highest overall F_ST estimates, respectively) exhibited significant departures (P<0.05) from the neutral expectations. Another coalescent-based test for selective neutrality (Vitalis et al. 2001, Genetics, 158, 1811–1823) further supported the outlier status of the Ssa171 microsatellite locus but not of the MHCIIα linked minisatellite. In addition, actin related protein linked microsatellite locus was identified with this test as an outlier in six pairwise population comparisons. All genetic diversity estimates revealed more genetic variation in hatchery stocks than in the small wild salmon populations from the Gulf of Finland. However, the wild populations possessed alleles at gene-associated markers (e.g. MHCI and IGF) not found in the hatchery stocks, which together with moderate genetic differentiation and distinctive environmental conditions justifies the special conservation measures for the last remaining native salmon populations in the Gulf of Finland.     

广西北部湾茅尾海浮游真菌群落结构及其影响因子

浮游真菌在海洋食物网和生物地球化学循环中发挥着关键作用。【目的】为解析广西北部湾茅尾海不同季节浮游真菌群落结构及其关键环境影响因子，于2017年7月(夏季)、9月(秋季)、12月(冬季)和2018年3月(春季)期间在该海域设置7个站点，采集表层海水样品。【方法】利用内部转录间隔区(internal transcribed spacer, ITS)基因高通量测序技术，分析茅尾海浮游真菌群落结构与多样性。【结果】茅尾海海域浮游真菌隶属6个门、26个纲、71个目、167个科、282个属和374个种。主要浮游真菌类群为子囊菌门(Ascomycota, 82.14%)和担子菌门(Basidiomycota, 10.74%)，共占浮游真菌总丰度的92.88%。茅尾海浮游真菌群落Shannon指数和Simpson指数在春季最高，Chao1指数和丰富度(richness)指数在冬季最高。主坐标分析(principal coordinates analysis, PCoA)和相似性分析(analysis of similarities, ANOSIM)结果显示，不同季节浮游真菌群落的β多样性具有极显著差异(R=0.591 2, P<0.001)。通过随机森林模型分析(random forest modeling analysis, RF)，发现黄曲霉(Aspergillus flavus)、二色胶孔菌(Gloeoporus dichrous)、杂色曲霉(Aspergillus subversicolor)和微扁沃利雅炭皮菌(Whalleya microplaca)、翹鱗香菇(Lentinus squarrosulus)等20种海洋浮游真菌对环境变化敏感，可用于评估茅尾海富营养化状况。Spearman相关性分析表明，浮游真菌α多样性与海水pH、盐度和溶解氧(dissolved oxygen, DO)呈显著正相关关系(P<0.05)，与温度、叶绿素-a (chlorophyll a, Chl-a)以及总有机碳(total organic carbon, TOC)呈显著负相关关系(P<0.05)。方差分解分析(variance partitioning analysis, VPA)发现营养因子是浮游真菌群落结构的主要驱动因子。【结论】本研究可为揭示北部湾海洋浮游真菌多样性提供理论参考，并为茅尾海生态环境监测与资源利用提供科学依据。     

Interobserver And Intraobserver Agreement In Parathyroid Scintigraphy: How Can Parathyroid Scintigraphy Be Made More Reliable?

ObjectiveTo determine the intraobserver and interobserver agreement levels in the evaluation of technetium Tc 99m sestamibi parathyroid scintigraphic images.MethodsNinety-eight patients with hyperparathyroidism were included in the study, and their parathyroid images were evaluated by 4 experienced nuclear medicine observers. The 98 cases were evaluated twice by each observer within an interval of 2 weeks. The evaluations were performed directly on workstations with use of digital images. A questionnaire was completed by each observer. The presence of a lesion, the number and the localizations of the lesions, and whether the lesion was clear or doubtful were all evaluated. Cohen kappa statistics and total agreement percentages were calculated by using SPSS version 11.0 software.ResultsThe 4 observers performed 8 different evaluations and identified a minimum of 38 and a maximum of 43 cases with a parathyroid lesion (or lesions). Both the intraobserver and the interobserver agreements were “very good” for the presence of a parathyroid lesion. The intraobserver agreement was also “very good” and the interobserver agreement was “good” (for only 1 pair of observers) or “very good” for the evaluation of the number of parathyroid lesions. The intraobserver agreement was “very good” or “good” and the interobserver agreement was “good” for the lesion localization and for the presence of a doubtful lesion.ConclusionParathyroid scintigraphy seems to be an observer independent method in the detection of a parathyroid lesion, in the determination of the number of lesions, and in the localizations of the lesions. The measured high agreement between observers increases the reliability of parathyroid scintigraphy. (Endocr Pract. 2012;18: 538-548)