Primary prevention with the ICD in clinical practice: not as straightforward as the guidelines suggest?

At first sight, guidelines for implantation of an implantable cardioverter defibrillator (ICD) for primary prevention of sudden cardiac death in patients with left ventricular systolic dysfunction seem unambiguous. There are clear cut-off values for ejection fraction, and functional class. However, determination of the ejection fraction itself is not unambiguous, and other risk factors for sudden death that may have a profound effect on risk are not used for decision-making. Furthermore, to obtain a clinically significant impact on survival, expected longevity is important as it can greatly compromise the benefit in elderly patients but underestimate the long-term potential of ICD therapy in younger patients. (Neth Heart J 2009; 17:107–10.)     

Changes in body temperature in king penguins at sea: the result of fine adjustments in peripheral heat loss?

To investigate thermoregulatory adjustments at sea, body temperatures (the pectoral muscle and the brood patch) and diving behavior were monitored during a foraging trip of several days at sea in six breeding king penguins Aptenodytes patagonicus. During inactive phases at sea (water temperature: 4-7 degrees C), all tissues measured were maintained at normothermic temperatures. The brood patch temperature was maintained at the same values as those measured when brooding on shore (38 degrees C). This high temperature difference causes a significant loss of heat. We hypothesize that high-energy expenditure associated with elevated peripheral temperature when resting at sea is the thermoregulatory cost that a postabsorptive penguin has to face for the restoration of its subcutaneous body fat. During diving, mean pectoral temperature was 37.6 +/- 1.6 degrees C. While being almost normothermic on average, the temperature of the pectoral muscle was still significantly lower than during inactivity in five out of the six birds and underwent temperature drops of up to 5.5 degrees C. Mean brood patch temperature was 29.6 +/- 2.5 degrees C during diving, and temperature decreases of up to 21.6 degrees C were recorded. Interestingly, we observed episodes of brood patch warming during the descent to depth, suggesting that, in some cases, king penguins may perform active thermolysis using the brood patch. It is hypothesized that functional pectoral temperature may be regulated through peripheral adjustments in blood perfusion. These two paradoxical features, i.e., lower temperature of deep tissues during activity and normothermic peripheral tissues while inactive, may highlight the key to the energetics of this diving endotherm while foraging at sea.     

Bioerosion caused by the sea urchin Diadema Mexicanum (Echinodermata: Echinoidea) at Bahías de Huatulco, Western Mexico

Mexican Pacific sea urchin studies have been focused mainly on species distribution, ecology and fisheries. Reef degradation by sea urchin bioerosion has not been studied previously en these reefs. We investigate the importance of Diadema mexicanum as a bioerosive agent of coral carbonate at Bahias de Huatulco, and the relative magnitude of coral accretion and bioerosion. At each of five localities in Bahias de Huatulco, sea urchin density, feeding and mechanical (spine) erosion was determined for three size class intervals. In general, D. mexicanum do not exert any significant role on coral reef community structure (live coral, dead coral or algal coverage) at the Huatulco area, probably because they are generally small (2.9-4 cm test size) and few in number (1.0-6.8 ind.m-2). Mean bioerosion rates are consistent with those measured for other diadematoids, as well as other urchin species in various eastern Pacific localities. However, the degree of bioerosive impact depends on species, test size, and population density of urchins. Coral carbonate removal by D. mexicanum erosion varies from 0.17 to 3.28 kgCaCO3m(-2)yr(-1). This represents a carbonate loss of < 5% of the annual coral carbonate production at Jicaral Chachacual, San Agustín and Isla Cacaluta, but 16 and 27% at Isla Montosa and La Entrega. On balance, coral accretion exceeds sea urchin erosion at all sites examined at Huatulco. At Bahias de Huatulco coral reef communities are actively growing, though in the coming years, it might be necessary to investigate the local effects of the interaction among erosion, and environmental and human induced perturbations.     

Blades,bladelets and flakes: A case of variability in tool design at the dawn of the Middle–Upper Palaeolithic transition in Italy

Neanderthals left diverse sets of cultural evidence just before the Middle–Upper Palaeolithic transition in Europe. Within this evidence, the production of lithic implements plays a key role in detecting possible affiliations (or lack thereof) with the techno-complexes that occurred during the few millennia before the large-scale spread of the Proto-Aurignacian. This crucial phase has also been recorded in the North of Italy, where around 44–45 ky cal BP, the last Neanderthals were still using the Levallois knapping technique, in common with the technology adopted at several sites in the central Mediterranean region. A similar picture is seen at the Grotta di Fumane, which provides the evidence presented in this paper. The production technology employed produced different levels of variability with respect to the production of blades, sometimes pointed, and the use of recurrent centripetal flaking at the end of the reduction sequence, in addition to bladelet and Discoidal volumetric structures. This variability does not outweigh the dominant tendency towards the use of elongated Levallois blanks and other by-products for shaping into basic retouched tools such as simple or convergent scrapers and points. A break from this apparently well-rooted use of the unipolar Levallois method is recorded in the Uluzzian where, instead, flakes and cores were made using the centripetal modality.     

Lymph node status as a guide to selection of available prognostic markers in breast cancer: the clinical practice of the future?

Prognosticators evaluating survival in breast cancer vary in significance in respect to lymph node status. Studies have shown e.g. that HER2/neu immunohistochemistry or HER2/neu gene amplification analysis do perform well as prognosticators in lymph node positive (LN +) patients but are less valuable in lymph node negative (LN -) patients. We collected data from different studies and tried to evaluate the relative significance of different prognosticators in LN+/LN- patient groups. In LN+ patients HER2/neu and E-cadherin immunohistochemistry were the statistically most significant prognosticators followed by proliferation associated features (mitotic counts by SMI (standardised mitotic index) or MAI (mitotic activity index), or S-phase fraction). Bcl-2 immunohistochemistry was also significant but p53 and cystatin A had no significance as prognosticators. In LN- patients proliferation associated prognosticators (SMI, MAI, Ki-67 index, PCNA immunohistochemistry, S-phase fraction) are especially valuable and also Cathepsin D, cystatin A, and p53 are significant, but HER2/neu or bcl-2, or E-cadherin less significant or without significance. We find that in studies evaluating single prognosticators one should distinguish between prognosticators suitable for LN+ and LN- patients. This will allow the choice of best prognosticators in evaluating the prospects of the patient. The distinction between LN+ and LN- patients in this respect may also be of special value in therapeutic decisions.     

What Should Be Held Steady in a Steady‐State Economy?: Interpreting Daly's Definition at the National Level

Within this article, I investigate a number of the conceptual issues that arise when attempting to translate Herman Daly's definition of a steady‐state economy (SSE) into a set of national biophysical indicators. Although Daly's definition gives a high‐level view of what would be held steady in an SSE, it also leaves many questions unanswered. How should stocks and flows be aggregated? What is the role of international trade? How should nonrenewable resources be treated? And where does natural capital fit in? To help answer these questions, I relate Daly's definition to key concepts and terminology from material and energy flow accounting. I explore topics such as aggregation, international trade, the relevance of throughput, and hidden flows. I conclude that a set of biophysical accounts for an SSE should include three types of indicators (stocks, flows, and scale), track how stocks and flows are changing over a 5‐ to 10‐year period, use aggregated data that measure the quantity of resource use (rather than its quality), measure both total and nonrenewable resource use, adopt a consumption‐based approach, include hidden flows, and exclude indicators that measure characteristics of the stock of natural capital (with the notable exception of indicators that measure the regenerative and assimilative capacities of ecosystems).     

Earlier onset of treatment or increment in LT4 dose in screened congenital hypothyroidism: which as the more important factor for IQ at 7 years?

OBJECTIVE: To determine between timing and LT4 dose which was the more important factor for IQ at 7 years in screened congenital hypothyroidism (CH). METHODS: 131 children with CH born from 1979 to 1994 and 30 controls were studied. Mean age at recall: 22.8+/-1.1 days. Mean initial LT4:5.6+/-0.1 microg/kg/day. RESULTS: Optimal global IQ (GIQ; 119+/-1.8) was obtained for a recall < or =15 days. Results for a recall after 3 weeks were lower (107.7 +/- 2.4). The IQ of infants treated before 21 days (117.1 +/-1.2) was identical to the IQ of those treated after this threshold was lower (108.6 +/- 1.7). No significant differences for GIQ were observed with various initial LT4. Infants treated with a dose of LT4 > or = 6 microg/kg/day had a higher performance IQ (117.3 +/-1.8 vs. 112.8+/- 1.2) compared with those treated with a dose < 6 microg/kg/day. The severity of CH and socio-economic levels were similar in all groups. CONCLUSION: In this study, timing appears to be more important factor for the intellectual outcome.     

Cavitation in plants at low temperature: is sap transport limited by the tensile strength of water as expected from Briggs' Z-tube experiment?

Xylem cavitation in plants is thought to be caused by a loss of adhesion at the conduit wall surface because a rupture in the body of the water column was implicitly ruled out by an experiment by Lyman J. Briggs with Z-tube capillaries. However, Briggs reported a drastic increase in cavitation pressure of water below 5 degrees C which, if it were also true in xylem conduits, would suggest that water transport in plants could be limited by water cohesion at low temperature. In this study we have repeated Briggs' experiment using stem segments. Xylem vulnerability curves were obtained with a centrifuge technique at 1, 25 and 50 degrees C on yew (Taxus baccata). Contrary to Briggs' finding, vulnerability to cavitation, measured as per cent loss conductance, did not increase sharply at 1 degrees C and was even less than at 25 degrees C and 50 degrees C. Moreover, the onset of cavitation in yew at 1 degrees C was measured at a much more negative pressure than Briggs' value. This points out an artefact in Brigg's experiment at low temperature possibly related to imperfections in the tube walls which act as cavitation nuclei.     

‘The vain speculation disillusioned by the sense’: the Italian painter Agostino Scilla (1629–1700) called ‘The Discoloured’, and the correct interpretation of fossils as ‘lithified organisms’ that once lived in the sea

The search for the true nature and origin of fossils gave rise, starting about the beginning of the sixteenth century and throughout the seventeenth century, to a heated debate between the supporters of the inorganic nature of these objects and proponents of an interpretation of fossils as ex-vivi. Among the latter, a key figure is the Italian painter Agostino Scilla (1629–1700), who represents one of the first naturalists who was able to accumulate substantial evidence to support the interpretation of fossils as once-living marine organisms. The world view of Scilla and his real contribution to paleontology are here analysed and contextualised, taking into account the state of knowledge characterising the time of his activities. Scilla was not only a pioneer in the field of paleontology, but he prepared the groundwork for the achievement of milestone geological concepts such as actualism, taphonomy and recognition of internal and external moulds (in the instance of non-representation of original hard parts); Scilla deserves further recognition as one of the first to attempt sedimentological interpretation of rocky bodies observed directly in the field.     

Mercury levels assessment in hair of riverside inhabitants of the Tapajós River,Pará State,Amazon, Brazil: Fish consumption as a possible route of exposure

The study present evaluated the levels of mercury (Hg) and methylmercury (MeHg) in hair samples of people from Barreiras community, riverside inhabitants of the Tapajós River (Pará, Brazil), an area impacted by clandestine gold mining, as well as we analyzed the levels of Hg and Se (selenium) in nine fish species (carnivores and non-carnivorous) from the Tapajós River, which stand out as the main species consumed by riverside inhabitants, to evaluate a relationship between frequency of fish consumption and Hg concentration, and also to evaluate possible mechanisms of fish protection (or non-protection) to Hg exposure by Se. Furthermore we analyze the water quality to evaluate the environmental trophic state, fact responsible by creating conditions that can potentiate the effects of toxic mercury. Concentrations of Hg and MeHg were analyzed in hair samples of 141 volunteers in different age band. Of those, 84.40% of samples present values above the threshold for biological tolerance, which is 6.00 μg g⁻¹ of total Hg in hair. Total Hg, in men there was a variation of 2.07–24.93 μg g⁻¹, while for women the variation was 4.84–27.02 μg g⁻¹. Consequently, the level of MeHg in men presented a variation of 1.49–19.57 μg g⁻¹, with an average of 11.68 μg g⁻¹, while with women the variation was from 3.73 to 22.35 μg g⁻¹, with an average of 10.38 μg g⁻¹. In fish species, Hg concentrations in carnivorous species had an average of 0.66 μg g⁻¹, higher than that permitted by current legislation, ranging from 0.30 to 0.98 μg g⁻¹, while the non-carnivorous species have values below the recommended by the legislation averaging 0.09 μg g⁻¹, ranging between 0.02 and 0.44 μg g⁻¹. For Se in fish, show that among carnivores, the contents of Se ranged between 0.18 and 0.54 μg g⁻¹ with a mean of 0.34 μg g⁻¹, while for non-carnivores these values were of the order of 0.16–0.56 μg g⁻¹, with an average of 0.32 μg g⁻¹. In surface water quality variables at the sampling points all showed values in accordance with the range established by current legislation. In this regard, the results provided by this study, while not conclusive, are strong indicators that despite not having been shown the relationship between the concentration of mercury in hair and feeding habits along the Tapajós River basin communities showed that a plausible correlation exists between levels of mercury and selenium in fish. This fact may serve as a subsidy to research human health, because in the Amazon, there is still a lot to examine with regards to the full understanding of the Se cycle.     

A Peptide Bond from the Inter-lobe Segment in the Bilobal Lactoferrin Acts as a Preferred Site for Cleavage for Serine Proteases to Generate the Perfect C-lobe: Structure of the Pepsin Hydrolyzed Lactoferrin C-lobe at 2.28 Å Resolution

The Protein Journal - C-lobe represents the C-terminal half of lactoferrin which is a bilobal 80&nbsp;kDa iron binding glycoprotein. The two lobes are designated as N-lobe (Ser1-Glu333) and...     

Intercontinental comparison of phylogenetic relatedness in introduced plants at the transition from naturalization to invasion:A case study on the floras of South Africa and ChinaOA

Invasive species may pose significant threats to biodiversity and ecosystem structure and functioning.The number of introduced species that have become invasive is substantial and is rapidly increasing.Identifying potentially invasive species and preventing their expansion are of critical importance in invasion ecology.Phylogenetic relatedness between invasive and native species has been used in predicting invasion success.Previous studies on the phylogenetic relatedness of plants at the transit...