Coronary artery bypass grafting: how much does it cost?

OBJECTIVE: To calculate the cost of coronary artery bypass grafting (CABG) and to compare it with the costs determined in two previous Canadian studies. DESIGN: Retrospective cost-analysis study. SETTING: A tertiary care referral hospital. PATIENTS: Fifty patients who had undergone successful triple and quadruple CABG between Jan. 3 and 30, 1989. MAIN RESULTS: The cost of CABG per patient varied from $10,982 to $33,676 (mean $14,328) (in 1988 Canadian dollars). The cost tended to increase with age and number of vessels grafted. Compared with the patients in the two previous Canadian studies our patients were older, had more vessels grafted and cost more to treat, even after the total hospital costs were adjusted for inflation. CONCLUSIONS: The population undergoing CABG is changing: it is older and has more diseased vessels. These changes have had a significant impact on the cost of CABG. Further study is required to determine the outcome and benefit of CABG in this group of patients.     

Macromastia: how much of it is fat?

A total of 25 patients who underwent bilateral breast reduction were included in this study. Each patient's age, weight, height, and amount of breast tissue removed from each breast were recorded. The body mass index was calculated for each patient. On the day of the operation, tissue samples (two each) were taken from the central, lateral, and preaxillary areas of the breast. One of the samples was weighed, placed in a closed glass container, and heated for 10 minutes in a microwave oven at full power. The liquid fat was separated from the solid residue, and the percentage of fat was calculated. The other sample from each area was examined grossly, and representative sections, corresponding to the distribution of fat and connective tissue, were submitted for evaluation. In these samples, the percentage of fat, gland, and connective tissue was estimated using low-magnification light microscopy. In this group of patients (who had an average age of 34 years and who were significantly overweight as determined by a mean body mass index of 28), it was found (using the microwave method) that there was a mean fat percentage of 61 percent in the central breast area, 74 percent in the lateral breast area, and 73 percent in the preaxillary area. Upon microscopic examination, the pathologist reported that fat accounted for 64 percent of the central breast area, 92 percent of the lateral breast area, and 94 percent of the preaxillary area. On average, the central breast area in macromastia patients had only seven percent gland and 29 percent connective tissue. The lateral and preaxillary areas of the breast had one to three percent gland and five percent connective tissue. The two methods had a significant (p < 0.05) positive correlation in the central breast area, but in the lateral and preaxillary regions, the correlation was poor. In the microscopic examination, there was a tendency to overestimate the amount of fat. Both methods of evaluation used in the study concur that the enlarged breast of macromastia consists primarily of fat and that the glandular element is rather small.     

Amazon vegetation: how much don’t we know and how much does it matter?

In spite of the existence of a vast body of information on the plant diversity of the Amazon, there remain significant obstacles to informed decision-making and management for conservation. Species distributions are poorly understood and the relationships between diversity and composition of vegetation, ecosystem services and resilience to climatic fluctuations are insufficiently clear. The geographic distribution of phylogenetic diversity in relation to current protected areas is unexplored and very little is known about intraspecific genetic variability and its practical significance. Interpretation of vegetation differentiation and distribution remains relatively simplistic; there are still large parts of the basin for which few or no botanical data exist, and many rare and sparsely distributed species remain undiscovered. Improved understanding of the ecological roles, dynamics and associations of the species of greatest importance for the maintenance of sustainable livelihoods and ecosystem services, habitat restoration and adaptation to climate change is a high priority. In many cases these are common and widespread species. Some of these issues are explored by looking at the Cristalino region in northern Mato Grosso as a case-study. Effective integration, quality assessment, synthesis and application of existing data on the plant diversity of the Amazon will help to address these issues. However, more targeted information is needed from the ground. Future prioritisation of research effort will require a careful and pragmatic balance between the ‘traditional’ focus on rare and endemic species and species-rich communities, and the growing need to understand the key ‘framework’ elements that will determine the future of the Amazon environment. Similar situations are faced elsewhere in the tropics: for botanical research institutes in the 21st century this demands an urgent re-evaluation of core activities and concerted engagement with the issues and challenges facing conservation in a context of rampant population growth, climate change and environmental destruction.     

Impact factor in cytopathology journals: what does it reflect and how much does it matter?

B. AbdullGaffar
Impact factor in cytopathology journals: what does it reflect and how much does it matter? Objective: To study the trends of impact factor (IF) in four cytopathology journals. To investigate the factors that might influence IF in cytopathology literature and whether IF has any impact on cytopathology practice. Methods: The IFs of four cytopathology journals were searched from 2005 to 2009. The IFs and their relationships with the types and number of publications, publishers, the official societies, readership, the quality of their contents, the topics covered and the levels of evidence were compared. Results: Cancer Cytopathology (CC) had the highest IF. Acta Cytologica (AC) had the lowest IF, which appeared to be in decline. Cytopathology (C) and Diagnostic Cytopathology (DC) had a slow but steady increase in their IF. Components that might influence these differences could include the category and the society of the journal, targeted readers and certain types of publications. Publishers, the number of publications, the types of topics covered and the levels of evidence probably have no major effect on IF. Conclusions: IF has its own benefits and original applications. IF is a quantitative measure that does not reflect the levels of evidence in cytopathology journals. IF should not be abandoned because it might encourage competition between cytopathology journals, but it should not dictate their contents.     

The evolution of noncoding DNA: how much junk, how much func?

Comparative sequence analysis on a genomic scale has opened the door for the systematic analysis of cis-acting regulatory DNA. It is now possible to begin to answer basic questions such as, how much meaningful noncoding sequence is in the genome? How strong is natural selection on functional noncoding sequences in different species? Two recent articles have capitalized on the comparative genomic approach in an attempt to answer these questions with surprising results.     

Integration of omics data: how well does it work for bacteria?

In the current omics era, innovative high-throughput technologies allow measuring temporal and conditional changes at various cellular levels. Although individual analysis of each of these omics data undoubtedly results into interesting findings, it is only by integrating them that gaining a global insight into cellular behaviour can be aimed at. A systems approach thus is predicated on data integration. However, because of the complexity of biological systems and the specificities of the data-generating technologies (noisiness, heterogeneity, etc.), integrating omics data in an attempt to reconstruct signalling networks is not trivial. Developing its methodologies constitutes a major research challenge. Besides for their intrinsic value towards health care, environment and industry, prokaryotes are ideal model systems to further develop these methods because of their lower regulatory complexity compared with eukaryotes, and the ease with which they can be manipulated. Several successful examples outlined in this review already show the potential of the systems approach for both fundamental and industrial applications, which would be time-consuming or impossible to develop solely through traditional reductionist approaches.     

Hematopoiesis: how does it happen?

Hematopoiesis entails the generation of stem cells, the proliferation and maintenance of multipotential progenitors, and lineage commitment and maturation. During the past year, critical components of these steps have been defined. Notable are gene-targeting experiments in mice in which one or more hematopoietic lineages have been shown to be ablated upon inactivation of several nuclear regulatory proteins (GATA-2, Tal-1/SCL, Rbtn2/LMO2, PU.1, Ikaros, E2A, and Pax-5), and experiments that establish GATA-1 as a factor capable of programming at least three lineages (erythroid, thrombocytic, and eosinophilic) from a transformed avian progenitor cell.     

The small nuclear GTPase Ran: How much does it run?

Ran is one of the most abundant and best conserved of the small GTP binding and hydrolyzing proteins of eukaryotes. It is located predominantly in cell nuclei. Ran is a member of the Ras family of GTPases, which includes the Ras and Ras-like proteins that regulate cell growth and division, the Rho and Rac proteins that regulate cytoskeletal organization and the Rab proteins that regulate vesicular sorting. Ran differs most obviously from other members of the Ras family in both its nuclear localization, and its lack of sites required for post-translational lipid modification. Ran is, however, similar to other Ras family members in requiring a specific guanine nucleotide exchange factor (GEF) and a specific GTPase activating protein (GAP) as stimulators of overall GTPase activity. In this review, the multiple cellular functions of Ran are evaluated with respect to its known biochemistry and molecular interactions.     

Screening for hypercholesterolemia among Canadians: how much will it cost?

OBJECTIVE: To determine the cost of screening all Canadians aged 30 years or more without coronary heart disease (CHD) for hypercholesterolemia. DATA SOURCES: The expected results of initial screening of the serum cholesterol level were estimated on the basis of 1986 Canadian census data and the 1978 Canada Health Survey. The results of repeat testing were estimated on the basis of data from the Lipid Research Clinics Prevalence Study. Lipid profile results were extrapolated from tests at the Montreal General Hospital''s clinical chemistry laboratory. Laboratory costs and primary care practitioner costs were provided by the Canadian Society of Clinical Chemists and provincial fee schedules respectively. MAIN RESULTS: Among 12,479,356 Canadians free of CHD 48.7% would be identified as being at high risk, 4.8% would be identified as being at moderate risk, and 46.6% would be reassured that their lipid risk for CHD was low. The total cost of implementing the program in the first year would be $432 million to $561 million ($325 million for laboratory tests and $107 million to $236 million for visits to primary care practitioners). CONCLUSION: The substantial cost of implementing a nationwide screening program must be weighed against the expected benefits to ensure that the final result is both practical and economically feasible.     

Ring cleavage of sulfur heterocycles: how does it happen?

Sulfur heterocycles are common constituents ofpetroleum and liquids derived from coal, and they arefound in some secondary metabolites of microorganismsand plants. They exist primarily as saturated ringsand thiophenes. There are two major objectives drivinginvestigations of the microbial metabolism oforganosulfur compounds. One is the quest to develop aprocess for biodesulfurization of fossil fuels, andthe other is to understand the fates of organosulfurcompounds in petroleum- or creosote-contaminatedenvironments which is important in assessingbioremediation processes. For these processes to besuccessful, cleavage of different types of sulfurheterocyclic rings is paramount. This paper reviewsthe evidence for microbial ring cleavage of a varietyof organosulfur compounds and discusses the fewwell-studied cases which have shown that the C–S bondis most susceptible to breakage leading to disruptionof the ring. In most cases, the introduction of one ormore oxygen atom(s) onto the adjacent C atom and/oronto the S atom weakens the C–S bond, facilitating itscleavage. Although much is known about the thiophenering cleavage in dibenzothiophene, there is still agreat deal to be learned about the cleavage of othersulfur heterocycles.     

Ring cleavage of sulfur heterocycles: how does it happen?

Sulfur heterocycles are common constituents of petroleum and liquids derived from coal, and they are found in some secondary metabolites of microorganisms and plants. They exist primarily as saturated rings and thiophenes. There are two major objectives driving investigations of the microbial metabolism of organosulfur compounds. One is the quest to develop a process for biodesulfurization of fossil fuels, and the other is to understand the fates of organosulfur compounds in petroleum- or creosote-contaminated environments which is important in assessing bioremediation processes. For these processes to be successful, cleavage of different types of sulfur heterocyclic rings is paramount. This paper reviews the evidence for microbial ring cleavage of a variety of organosulfur compounds and discusses the few well-studied cases which have shown that the C-S bond is most susceptible to breakage leading to disruption of the ring. In most cases, the introduction of one or more oxygen atom(s) onto the adjacent C atom and/or onto the S atom weakens the C-S bond, facilitating its cleavage. Although much is known about the thiophene ring cleavage in dibenzothiophene, there is still a great deal to be learned about the cleavage of other sulfur heterocycles.     

Patterns of endemism in African birds: how much does taxonomy matter?

It has been suggested that the 'right' biogeographic patterns will only arise with a species concept reflecting the finest splitting of terminal phylogenetic branches. The significance of taxonomic resolution was assessed using distributional data for all resident African land-birds, held at the Zoological Museum of Copenhagen. The primary database (in a one-degree geographical grid) served as a template for creating two new databases: one, where the distributional records were allocated to species according to the 'Speciation Atlases' for African birds (Hall and Moreau 1970, Snow 1978) and two, according to the finest taxonomic splitting that has since then been suggested in the literature. With this spatial resolution, the species richness pattern is almost exactly the same whether old or new taxonomy is used. The endemism follows another pattern with marked local aggregates. The location of principal aggregates are quite robust to recent splitting, although a slightly more complex structure appears. Also some small new areas of endemism emerge, each with 2–3 narrow endemics. However, large portions of African savannah and lowland rainforest are still characterised by a total lack of narrow endemism. Based on the current understanding of diversification processes and adaptive re-distribution it is suggested that the uneven distribution of narrowly endemic and widespread species will persist even if it were possible, in the future, to define terminal taxa in a consistent way.     

The non‐existent aging program: how does it work?

Summary Aging and lifespan determination have been viewed, in the most well-accepted theories, as nonprogrammatic, and are thought to result from the evolutionary selection for early fitness at the expense of late survival. Here, recent data implicating potentially programmatic aspects of aging and lifespan determination are discussed, and analogies between programmed cell death and programmed organismal death are offered. It is hoped that the recognition of at least the possibility of a programmatic aspect, or aspects, to the determination of longevity and the process of aging will help to optimize our chances to identify appropriate therapeutic targets both for longevity enhancement and disease prevention.     

Treatment of COVID-19 with MSCs: how does it work?

Science China Life Sciences -     

The shape of life: how much is written in stone?

Considering the enormous diversity of living organisms, representing mostly untapped resources for studying ecological, ontogenetic and phylogenetic patterns and processes, why should evolutionary biologists concern themselves with the remains of animals and plants that died out tens or even hundreds of millions of years ago? The reason is that important new insights into some of the most vexing evolutionary questions are being revealed at the interfaces of palaeontology, developmental biology and molecular biology. Attempts to synthesise information from these disciplines, however, often encounter their greatest hurdles in considerations of the radiation of the Metazoa. Ongoing challenges relate to the origins of body plans, the relationships of the metazoan phyla and the timing of major evolutionary radiations. Palaeontology not only has its own unique contributions to the study of evolutionary processes, but provides a lynchpin for many of the emerging techniques.     

Plasticity in the timing of physiological development: physiological heterokairy--what is it, how frequent is it, and does it matter?

The study of developmental sequences of physiological traits could be an important way of placing comparative developmental physiology (CDP) within the research agenda being forged by work on developmental plasticity. Here we focus on the concept of heterokairy defined by Spicer & Burggren in 2003 as changes in the timing of physiological development in an individual. The role of this concept in the future of the CDP is discussed. First we provide an historical perspective of the ideas that have led to the investigation of sequences in CDP. This is followed by a re-examination and clarification of the definition of physiological heterokairy before empirical case studies that (explicitly or implicitly) demonstrate physiological heterokairy are reviewed. We suggest that physiological heterokairy can be demonstrated through a wide range of invertebrate and vertebrate examples. However, care must be taken when inferring that heterokairy as a pattern is always the result of heterokairic processes as there is evidence that physiological heterokairy could result from the altered timing of both homologous or analogous physiological mechanisms. We conclude by discussing the potential link between heterokairy and heterochrony and suggest that the investigation of this link should be a major goal for workers in both CDP and developmental plasticity.     

Expression of apo-aequorin during embryonic development; how much is needed for calcium imaging?

Aequorin is a bioluminescent calcium indicator consisting of a 21 kDa protein (apo-aequorin) that is covalently linked to a lipophilic cofactor (coelenterazine). The aequorin gene can be expressed in a variety of cell lines and tissues, allowing non-invasive calcium imaging of specific cell types. In the present paper, we describe the possibilities and limitations of calcium imaging with genetically introduced apo-aequorin during embryonic development. By injecting aequorin into sea urchin, Drosophila and zebrafish eggs, we found that higher aequorin concentrations are needed in smaller eggs. Our results suggest that for measuring resting levels of free cytosolic calcium, one needs aequorin concentrations of at least 40 μM in sea urchin eggs, 2 μM in Drosophila eggs, and only 0.11 μM in zebrafish eggs. A simple assay was used to determine the absolute concentrations of expressed apo-aequorin and the percentage of aequorin formation in vivo. The use of this assay is illustrated by expression of the aequorin gene in Drosophila oocytes. These oocytes form up to 1 μM apo-aequorin. In our hands, only 0.3% of this apo-aequorin combined with coelenterazine entering from the medium to form aequorin, which was not enough for calcium imaging of the oocytes, but did allow in vivo imaging of the ovaries. From these studies, we conclude that coelenterazine entry into the cell is the rate limiting step in aequorin formation. Based on the rate of coelenterazine uptake in Drosophila, we estimate that complete conversion of 1 μM apo-aequorin would take 50 days in zebrafish eggs, 19 days in Drosophila eggs, 7 days in sea urchin eggs or 18 h in a 10 gm tissue culture cell. Our results suggest that work based on genetically introduced apo-aequorin will be most successful when large amounts of small cells can be incubated in coelenterazine. During embryonic development this would involve introducing coelenterazine into the circulatory system of late stage embryos. Calcium imaging in early stage embryos may be best done by injecting aequorin, which circumvents the slow process of coelenterazine entry.