How many, how old, how soon?

This article highlights the population projections for the UK to 2066 and their health implications. The changes in the demographic age structure of human populations have dual implications. Although they represent accomplishments in social and health development considering the fact that more individuals are able to live until old age, these changes also bring new demands that affect all aspects of society, including employment, taxation, pension, education, and health. Age specific population projections presented were obtained from the Office for National Statistics. It is projected that the total number of people aged 60 years and older will rise from 12 million in 2001 to 18.6 million in 2031 and the number of individuals suffering with chronic diseases and disabilities will see a three-fold increase. Although these projections rely on assumptions and are subject to some changes, it is made clear that the proportion of the population aged 65 and above will continue to increase substantially over the next decades. These population trends will have a large impact on the health and health care needs of the population. Thus, there is a need to develop and plan institutions and policies that address the demands of the aging population. Understanding and identification of the causes and prevention of conditions that could result to serious disabilities must be a high priority.     

Rewardlessness in orchids: how frequent and how rewardless?

About one‐third of orchid species are thought to offer no floral reward and therefore attract pollinators through deception. Statements of this idea are common in the botanical literature, but the empirical basis of the estimate is rarely mentioned. We traced citation pathways for the one‐third estimate in a sample of the literature and found that the paths lead to empirical foundations that are surprisingly narrow. Moreover, recent measurements have detected minute quantities of sugar available to insect visitors in some orchids thought to be rewardless, raising the possibility of a pollination strategy that is largely deceitful but different to absolute rewardlessness. The orchids are a well‐studied group and there is no doubt that rewardlessness is common in the family. However, greater empirical effort is needed to verify rewardlessness in orchids and to explore geographic and environmental variation in the proportion of rewardless species.     

Sampling of cardiovascular data; how often and how much?

Long-term measurement of cardiovascular variables by telemetry in laboratory animals has become indispensable in recent years. However, limited battery life and management of large volumes of recorded data are major drawbacks. These limitations can often be overcome by intermittent sampling of data. The question is, how much data does one need to collect to accurately reflect the underlying average value? To investigate this, 24-h continuous recordings of rabbit heart rate, arterial pressure, and integrated renal sympathetic nerve activity (RSNA) were resampled using a variety of protocols that differed with respect to the number of individual sampling periods used and the total amount of time that was sampled. The absolute percentage errors of estimates of the daily mean, standard deviation, and interquartile range were calculated for each sampling protocol. A similar analysis was repeated using arterial pressure data from rats. The results show that the number of sampling periods spread throughout the day had more effect than the total amount of data recorded. For example, just 2 h of total sampling time spread over 12 evenly spaced 10-min periods gave estimates of the daily mean of blood pressure and heart rate with <1% error and RSNA with <3% error. We show that accurate estimates of the daily mean of arterial pressure, heart rate, and RSNA can all be made using scheduled recording, and we recommend recording a minimum of 2 h/day spread over a number of periods throughout the day.     

Treatment of craniomaxillofacial fibrous dysplasia: how early and how extensive?

Twenty-eight craniomaxillofacial fibrous dysplasia patients were treated as early as the symptoms occurred. The principles of surgical treatment were based on the zones of involvement: total excision of dysplastic bone of fronto-orbital, zygoma, and upper maxillary origin (zone 1) and bone reconstruction primarily; conservative excision on hair-bearing skull (zone 2), central cranial base (zone 3), and tooth-bearing bones (zone 4); and optic canal decompression on patients with orbital dysplasia and decreasing visual acuity. Patients were followed for 1 to 11 years (average 5.3 years). No recurrence or invasion of the fibrous dysplasia into the grafted bone was seen. One patient had orthognathic maxillary osteotomy on the reconstructed maxilla 6 years after initial reconstruction. Five of 19 patients with alveolar dysplasia had a recurrence and were reshaped. One patient had mandibular sagittal osteotomies to set back the prognathic, fibrous dysplasic mandible after three attempts at conservative shaving. Another patient with mandibular fibrous dysplasia had recurrence with pain and a hemimandibulectomy with successful immediate free vascularized iliac bone graft reconstruction.     

DNA microarrays in the clinic: how soon,how extensively?

Although DNA microarrays are now widely used in research settings, they have been slow to penetrate clinical practice in spite of their apparent advantages. This is due to the very different requirements for a clinical test in contrast to a research tool, and to a strict necessity for demonstrated clinical utility. There is a clear differentiation between two types of DNA array tests: "genomic" diagnostics, developed to ascertain the presence or absence of mutations, deletions or duplications, and for which clinical evidence is already established, and tests using expression profiling for prognosis or predictive purposes, in which case the clinical correlate must be proven. Most array diagnostics currently used belong, understandably, to the "genomic" variety. It is to be expected that future improvements in tailored technology, as well as a logical trend towards measuring an ever-increasing number of parameters, will ensure an important diagnostic role for DNA arrays in the coming decade.     

Oxygen uptake in heart failure: how much,how fast?

Patients with chronic heart failure (CHF) have limited exercise capacity. Exercise intolerance in CHF is associated with increased mortality; 1 moreover, several studies suggest that interventions that increase exercise capacity in CHF improve prognosis. 2–4 Therefore, as Kemps and colleagues state in this issue of the Netherlands Heart Journal, 5 exercise testing is an important tool for evaluating and monitoring heart failure.     

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.     

Calcium - how and why?

Calcium is among the most commonly used ions, in a multitude of biological functions, so much so that it is impossible to imagine life without calcium. In this article I have attempted to address the question as to how calcium has achieved this status with a brief mention of the history of calcium research in biology. It appears that during the origin and early evolution of life the Ca²⁺ ion was given a unique opportunity to be used in several biological processes because of its unusual physical and chemical properties.     

Transdifferentiation: why and how?

Cell therapy is based on the replacement of damaged cells in order to restore injured tissues. The first consideration is that an abundant source of cells is needed; second, these cells should be immunologically compatible with the guest and third, there should be no real threat of these cells undergoing malignant transformation in the future. Given these requirements, already differentiated adult cells or adult stem cells obtained from the body of the patient appear to be the ideal candidates to meet all of these demands. The utilization of somatic cells also avoids numerous ethical and political drawbacks and concerns. Transdifferentiation is the phenomenon by which an adult differentiated cell switches to another differentiated cell. This paper reviews the importance of transdifferentiation, discussing the cells that are suitable for this process and the methods currently employed to induce the change in cell type.     

Parasitic worms: how many really?

Accumulation curves are useful tools to estimate species diversity. Here we argue that they can also be used in the study of global parasite species richness. Although this basic idea is not completely new, our approach differs from the previous ones as it treats each host species as an independent sample. We show that randomly resampling host–parasite records from the existing databases makes it possible to empirically model the relationship between the number of investigated host species, and the corresponding number of parasite species retrieved from those hosts. This method was tested on 21 inclusive lists of parasitic worms occurring on vertebrate hosts. All of the obtained models conform well to a power law curve. These curves were then used to estimate global parasite species richness. Results obtained with the new method suggest that current predictions are likely to severely overestimate parasite diversity.