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Alternative widely available, inexpensive agents for pleurodesis.

PURPOSE OF REVIEW: Pleurodesis is the one of the best options for the management of symptomatic patients with malignant pleural effusion, recurrent benign pleural effusion, and recurrent pneumothorax. Although talc, parenteral tetracycline derivatives, and bleomycin are the most commonly used agents for pleurodesis, parenteral tetracycline derivatives are not available worldwide, bleomycin is expensive, and concerns about the side effects of talc are growing. The purpose of this review is to provide information about other widely available agents for pleurodesis. RECENT FINDINGS: It has recently been shown that oral tetracycline/doxycycline is as effective and safe as parenteral doxycycline in producing pleurodesis in rabbits. SUMMARY: Oral forms of tetracycline derivatives, quinacrine, silver nitrate, iodopovidone, and other talc preparations such as facial talc can be used to create pleurodesis when commonly used agents are not available.

Animals↗

Interaction effect between phosphorus and zinc on their availability in soil in relation to their contents in stevia (Stevia rebaudiana).

A greenhouse experiment was conducted at the Indian Institute of Horticultural Research (IIHR), Bangalore to study the interaction effect between phosphorus and zinc on their availability in soil in relation to their contents in stevia (Stevia rebaudiana). The results show that the amount of available P and Zn content in soil has been found to increase initially and, thereafter, the amount of the same decreased with the progress of plant growth up to 60 days irrespective of treatments. The amount of P and Zn in soils showed an increase with their separate applications either as soil or foliar spray while that of the same value significantly decreased both in soils and plants due to their combined applications, suggesting a mutual antagonistic effect between Zn and P affecting each other's availability in soil and content in the stevia plant.

Drug Interactions↗

Isoprene Emission from Velvet Bean Leaves (Interactions among Nitrogen Availability, Growth Photon Flux Density, and Leaf Development).

Although isoprene synthesis is closely coupled to photosynthesis, both via ATP requirements and carbon substrate availability, control of isoprene emission is not always closely linked to photosynthetic processes. In this study we grew velvet bean (Mucuna sp.) under different levels of photon flux density (PFD) and nitrogen availability in an effort to understand better the degree to which these two processes are linked. As has been observed in past studies, we found that during early leaf ontogeny the onset of positive rates of net photosynthesis precedes that of isoprene emission by 3 to 4 d. Other studies have shown that this lag is correlated with the induction of isoprene synthase activity, indicating that overall control of the process is under control of that enzyme. During leaf senescence, photosynthesis rate and isoprene emission rate declined in parallel, suggesting similar controls over the two processes. This coordinated decline was accelerated when plants were grown with high PFD and high nitrogen availability. The latter effect included declines in the photon yield of photosynthesis, suggesting that an unexplained stress arose during growth under these conditions, triggering a premature decline in photosynthesis and isoprene emission rate. In mature leaves, growth PFD and nitrogen nutrition affected photosynthesis and isoprene emission in qualitatively similar, but quantitatively different, ways. This resulted in a significant shift in the percentage of fixed carbon that was re-emitted as isoprene. In the case of increasing growth PFD, isoprene emission rate was more strongly affected than photosynthesis rate, and more carbon was lost as isoprene. In the case of increasing nitrogen, photosynthesis rate increased more than isoprene emission rate, and leaves containing high amounts of nitrogen lost a lower percentage of their assimilated carbon as isoprene. Taken together, our results demonstrate that, although the general correlation between isoprene emission rate and photosynthesis rate is consistently expressed, there is evidence that both processes are capable of independent responses to plant growth environment.

Journal Article↗

Correlation between Oxygen Availability, Energy Charge, and Protein Synthesis in Squash Cotyledons Isolated from Germinating Seeds.

The influence of O(2) availability on the rate of protein synthesis, the levels of RNA and of adenylates, and the value of the energy charge in squash (Cucurbita maxima) cotyledons isolated from seeds germinated for 15 or 28 hours at different O(2) concentration (3% or 20% O(2)) has been investigated.The rate of protein synthesis is five times lower in cotyledons maintained in 3% O(2) than in those maintained in 20% O(2). Also net RNA synthesis is almost blocked in 3% O(2), while in 20% O(2) it proceeds almost linearly for 48 hours.The different RNA contents cannot explain the different rates of protein synthesis.The results of shift experiments (cotyledons shifted from 20% to 3% O(2) or vice versa) show that the rate of protein synthesis is strictly correlated with actual O(2) availability and is largely independent of the one in the previous period. O(2) controls the development of the adenylate pool and particularly the increase of ATP level. Thus, both the adenylate pool and the values of the energy charge ratio are lower in cotyledons grown in 3% than in 20% O(2).The shifts of O(2) availability induce rapid changes of ATP, ADP, and AMP levels and thus of the values of the energy charge, which are about 0.7 at 3% O(2) and higher than 0.8 at 20% O(2), independent of previous O(2) availability.The rate of protein synthesis appears to be largely independent of the levels of the single nucleotides and better correlated to the energy charge values.

Journal Article↗

The relationship between parental physical availability and child sexual, physical and emotional abuse: a study among a sample of university students in South Africa.

The relationship between perceived parental physical availability and child sexual, physical and emotional abuse was investigated. The sample comprised 722 undergraduate students of psychology at the University of the North, South Africa. Participants filled in a retrospective self-rated questionnaire in a classroom setting. The questionnaire asked about perceived parental physical availability during childhood, and childhood sexual, physical and emotional abuse. Logistic regression analysis showed that, among all the participants, the factors "the participant not living with the natural (biological) mother until he or she was at least 16 years old" and "have ever had a stepfather or adoptive father until he or she was at least 16 years old" predicted child sexual abuse; and "have ever had a stepfather or adoptive father until he or she was at least 16 years old" predicted child emotional abuse. None of the other aspects of parental availability considered predicted child physical abuse. Mental health and social workers, educators and law enforcement agencies dealing with prevention and protection against child abuse should take note of the above identified predictors while designing programs for the eradication of child sexual, physical and emotional abuse.

Adolescent↗

The quantitative measurement of organizational culture in health care: a review of the available instruments.

OBJECTIVE: To review the quantitative instruments available to health service researchers who want to measure culture and cultural change. DATA SOURCES: A literature search was conducted using Medline, Cinahl, Helmis, Psychlit, Dhdata, and the database of the King's Fund in London for articles published up to June 2001, using the phrase "organizational culture." In addition, all citations and the gray literature were reviewed and advice was sought from experts in the field to identify instruments not found on the electronic databases. The search focused on instruments used to quantify culture with a track record, or potential for use, in health care settings. DATA EXTRACTION: For each instrument we examined the cultural dimensions addressed, the number of items for each questionnaire, the measurement scale adopted, examples of studies that had used the tool, the scientific properties of the instrument, and its strengths and limitations. PRINCIPAL FINDINGS: Thirteen instruments were found that satisfied our inclusion criteria, of which nine have a track record in studies involving health care organizations. The instruments varied considerably in terms of their grounding in theory, format, length, scope, and scientific properties. CONCLUSIONS: A range of instruments with differing characteristics are available to researchers interested in organizational culture, all of which have limitations in terms of their scope, ease of use, or scientific properties. The choice of instrument should be determined by how organizational culture is conceptualized by the research team, the purpose of the investigation, intended use of the results, and availability of resources.

Health Services Research↗

Establishing a baseline for the monitoring of medicines availability for children in the UK: 1998-2002.

AIM: To determine changes in the availability, in terms of licensing and formulations, of medicines for children in the UK between 1998 and 2002. METHODS: Using the Association of British Pharmaceutical Industry (ABPI) Compendium of Data Sheets and Summaries of Product Characteristics (SPC) 1998 and the Medicines Compendium 2002, licensed medicines available in the UK in the calendar years 1998 and 2002 were examined. RESULTS: In 1998, 61% of chemical entities/fixed-dose combinations were licensed in some form for children compared with 64% in 2002. Of the chemical entities/fixed-dose combinations with oral formulations, 250 (33%) in 1998 had an oral formulation suitable for use by children and in 2002 there were 284 (34%). Of the 129 new chemical entities registered in the UK between 1998 and 2002, only 30 (23%) were licensed for under the age of 12 years and 19 (15%) for the neonatal age group. A total of 480 medicines licensed for children were withdrawn from marketing but only cisapride and primidone had no generic or therapeutic alternatives. CONCLUSION: Although there was improvement in the availability of medicines for children in the UK over the 5-year period (1998-2002), considerable inequities still existed between children and adults.

Child↗

Regulatory networks affected by iron availability in Candida albicans.

Iron, an essential element for almost every organism, serves as a regulatory signal for the expression of virulence determinants in many prokaryotic and eukaryotic pathogens. Using a custom Affymetrix GeneChip representing the entire Candida albicans genome, we examined the changes in genome-wide gene expression in this opportunistic pathogen as a function of alterations in environmental concentrations of iron. A total of 526 open reading frame (ORF) transcripts are more highly expressed when the levels of available iron are low, while 626 ORF transcripts are more highly expressed in high-iron conditions. The transcripts dominantly affected by iron concentration range from those associated with cell-surface properties to others which affect mitochondrial function, iron transport and virulence-related secreted hydrolases. Moreover gene expression as assayed in DNA microarrays confirms and extends reports of alterations in cell-surface antigens and drug sensitivity correlated with iron availability. To understand how these genes and pathways might be regulated, we isolated a gene designated SFU1 that encodes a homologue of the Ustilago maydis URBS1, a transcriptional repressor of siderophore uptake/biosynthesis. Comparisons between wild-type and SFU1-null mutant strains revealed 139 potential target genes of Sfu1p; many of which are iron-responsive. Together, these results not only expand our understanding of global iron regulation in C. albicans, but also provide insights into the potential role of iron availability in C. albicans virulence.

Amino Acid Sequence↗

Impaired sucrose induction1 encodes a conserved plant-specific protein that couples carbohydrate availability to gene expression and plant growth.

To identify the molecular mechanisms underlying carbohydrate allocation to storage processes, we have isolated mutants in which the sugar induction of starch biosynthetic gene expression was impaired. Here we describe the IMPAIRED SUCROSE INDUCTION1 (ISI1) gene, which encodes a highly conserved plant-specific protein with structural similarities to Arm repeat proteins. ISI1 is predominantly expressed in the phloem of leaves following the sink-to-source transition during leaf development, but is also sugar-inducible in mesophyll cells. Soil-grown isi1 mutants show reduced plant growth and seed set compared to wild-type Arabidopsis. This growth reduction is not due to reduced carbohydrate availability or a defect in sucrose export from mature leaves, suggesting that isi1 mutant plants do not utilize available carbohydrate resources efficiently. ISI1 interacts synergistically with, but is genetically distinct from, the abscisic acid (ABA) signalling pathway controlling sugar responses via ABI4. Our data show that ISI1 couples the availability of carbohydrates to the control of sugar-responsive gene expression and plant growth.

Amino Acid Sequence↗

The cost and availability of devices for preventing childhood injuries.

Accidental injury is the major cause of death among Australian children. Many childhood injuries are preventable through the use of safety devices such as those recommended by the Child Accident Prevention Foundation of Australia (CAPFA). It has been suggested that poor availability and the high cost of obtaining and installing safety devices may contribute to their low rates of use among families with young children. This paper assesses the availability and cost of recommended safety devices in a medium sized city in Australia. Of the 17 devices recommended by the CAPFA only 10 were readily available in Newcastle. The cost of purchasing and installing all the devices recommended by CAPFA amounted to $1516, or 21.4% of the annual disposable income, after the purchase of necessities, of families with children and 75.5% of the annual disposable income, after purchase of necessities, of single parents. It is argued that the cost of safety devices may be prohibitively expensive, particularly for those most at risk of suffering from injury.

Accident Prevention↗

Evaluation of the implementation of the folate-neural tube defect health claim and its impact on the availability of folate-fortified food in Australia.

OBJECTIVE: To evaluate the implementation of the folate-neural tube defect (NTD) health claim and its impact on the availability of folate-fortified food in Australia. METHODS: During late 2005, a survey was conducted in 16 supermarkets across all Australian capital cities to identify the use of the folate-NTD health claim on the labels of the 128 food products listed in food standard 1.1A.2: 'Transitional standard--Health claims' and the number of products fortified with folic acid. RESULTS: Seventy-nine per cent of existing listed food products were found and two of these were implementing the folate-NTD health claim. Forty-four per cent of these listed products, previously fortified with folic acid, were no longer fortified. One hundred and seventeen generally available food products were fortified with folic acid, predominantly breakfast cereals (73%). Twenty-seven per cent of these folate-fortified products were listed in the transitional standard. CONCLUSIONS: The health claim was not used widely to inform women of child-bearing age of the importance of periconceptional folate intake. The increased availability of folate-fortified products generally has occurred independently of the health claim. Deficiencies in the verification system of the tested regulatory framework are identified. The voluntary regulatory provisions for both folate fortification and the use of the health claim diminished the States' influence over their implementation of public health tools.

Australia↗

Bicarbonate-induced alkalosis augments cellular acetyl group availability and isometric force during the rest-to-work transition in canine skeletal muscle.

Increasing blood bicarbonate content has long been cited as a potential mechanism to improve contractile function. We investigated whether sodium bicarbonate-induced metabolic alkalosis could positively affect force development during the rest-to-work transition in ischaemic skeletal muscle. Secondly, assuming it could, we investigated whether bicarbonate could augment acetyl group availability through the same equilibrium reaction as sodium acetate pre-treatment and whether this underpins, at least in part, its ergogenic effect. Multiple biopsy samples were obtained from the canine gracilis muscle during 5 min of electrically evoked ischaemic contraction, which enabled the determination of the time course of acetyl group accumulation, substrate utilisation, pyruvate dehydrogenase complex activation and tension development in animals treated with saline (control; n = 6) or sodium bicarbonate (n = 5). Treatment with bicarbonate elevated acetylcarnitine content above the control level at rest (P < 0.05), but at no time point during subsequent contraction. The pyruvate dehydrogenase complex was activated following 40 s of contraction in both groups, with no differences existing between treatments at any time point. The requirement for ATP re-synthesis from non-oxygen-dependent routes was no different between groups at any time point during contraction. No difference in peak twitch force production existed between groups. However, at 3 min of stimulation, tension development was better maintained in the bicarbonate group (P < 0.05), being approximately 20% greater than control following 5 min of contraction (P < 0.05). The results demonstrate, for the first time, that bicarbonate can augment acetyl group availability prior to contraction, independent of pyruvate dehydrogenase complex activation, but cannot influence the requirement for non-oxidative ATP re-synthesis during subsequent contraction. It would appear, therefore, that the bicarbonate-induced improvement in muscle tension development was probably mediated through the metabolic alkalosis and not via the increased availability of acetyl groups within the cell.

Acetylcarnitine↗

Short-term physiological and developmental responses to nitrogen availability in hybrid poplar.

Nitrogen fertilization induces dramatic changes in the growth and development of plants, including forest trees. In this study we examined short-term responses of hybrid poplar, Populus balsamifera ssp. trichocarpa x deltoides, to N fertilization. Glasshouse-grown saplings subjected to limiting, intermediate, and luxuriant levels of ammonium nitrate over a 28 d time course demonstrated rapid changes to whole-plant architecture and biomass accumulation. Nitrogen-associated shifts in allocation occurred in temporally distinct stages. Nitrogen availability modulated parameters that affect carbon gain, including light-saturated net photosynthesis and leaf area. These parameters were affected by N-induced changes to leaf maturation and senescence. Leaf area was also affected by N-induced sylleptic branch development. Genes encoding vegetative storage proteins and starch biosynthetic enzymes exhibited contrasting patterns of expression under differential N availability. A gene encoding a previously uncharacterized putative pectin methylesterase inhibitor displayed expression patterns comparable to the starch biosynthetic genes. The results of this study illustrate the phenotypic plasticity that P. balsamifera ssp. trichocarpa x deltoides exhibits in response to differential N availability.

Carbon↗

Should every unit have a 24-hour transvaginal ultrasound available?

The purpose of this debate is to argue the merits of whether the availability of 24-hour transvaginal ultrasound service in every unit will help predict and, subsequently, prevent preterm birth. Any new test introduced will need to fulfil certain criteria. It must be acceptable in terms of risk, cost and patient convenience. It must be an improvement over existing alternatives, and it must aid clinicians to improve care. While the 24-hour availability of transvaginal ultrasound to every maternity unit may be useful to research and teaching, there is, as yet, little evidence that a 24-hour transvaginal ultrasound service improves perinatal and maternal morbidity and mortality. Results from our own centre suggest that experienced clinicians can make an acceptable diagnosis of spontaneous preterm labour (PTL) using only history and digital examination. Based on these findings, the availability of 24-hour vaginal ultrasound in every unit cannot be justified for the diagnosis of spontaneous PTL.

Female↗

Evaluation of the effectiveness of a commercially available defined substrate medium and enumeration system for measuring Escherichia coli numbers in faeces and soil samples.

AIMS: To determine if a commercially available defined substrate medium and enumeration system could be utilized as an effective and accurate means of enumerating Escherichia coli in environmental samples containing faeces and soil. METHODS AND RESULTS: The samples tested were either inoculated with laboratory grown E. coli or natural E. coli populations in cow faeces. The number of E. coli recovered from faeces and soil samples using the defined substrate medium and enumeration system and a miniaturized MPN method (using traditional media) was compared by analysing the difference between the two methods in relation to the mean. For four of five groups of samples analysed there was no significant difference in the number of E. coli recovered by the two methods (P > 0.05). In one batch the difference was 0.30 log, which while being statistically significant (P < 0.01) was not considered to be biologically significant. CONCLUSION: The commercially available enumeration system was significantly more precise than the miniaturized MPN method (P < 0.001). SIGNIFICANCE AND IMPACT OF THE STUDY: We conclude that the commercially available defined substrate medium and enumeration system is a suitable method for the measurement of E. coli numbers in faeces and soil samples and should provide advantages of increased precision and a reduction in laboratory analysis time.

Animals↗

A mechanical study of ligature security of commercially available pre-tied ligatures versus hand tied ligatures for use in equine laparoscopy.

OBJECTIVE: To determine a hand-tied ligature knot configuration, suture size, and suture type that would be an acceptable substitute to commercially available ligature knots for use in equine laparoscopic surgery. STUDY DESIGN: Three-factor ANOVA with the fixed effects being suture type, suture size, and knot type. The dependent variable was ligature security (load to failure). METHODS: Commercially available Endoloop and 4 hand-tied slipknot ligatures were compared with a 4-layer square knot. The hand tied ligature knots tested were the 4S modified Roeder knot, the Brooks knot, the modified Roeder knot, and the Weston knot. Two suture sizes (0, 2) of each of 2 suture types (polydioxanone, polyglactin 910) were tested with each hand tied knot. Two types (polydioxanone, polyglactin 910) of size 0 Endoloop were tested. Twenty repetitions of each knot suture type were tested for force to yield on a materials testing machine. Statistical analysis consisted of a 3-way ANOVA with individual comparisons made using the Bonferroni method. Significance was P< or = .05. RESULTS: Only the 4S modified Roeder knot in 2 polydioxanone (103 N) was comparable with the breaking strength of the square knots (157 N). All other knot suture combinations tested were significantly weaker than the square knot (range, 2-18 N). CONCLUSION: For equine laparoscopy, a 2 polydioxanone 4S modified Roeder knot would be an acceptable alternative to the commercially available Endoloop. CLINICAL RELEVANCE: Laparoscopic slip knots are commonly used in equine laparoscopic surgery. Various knot configuration and suture size and type combinations will affect the security of the slip knot.

Analysis of Variance↗

Occurrence of hepatitis A virus genotype III in Germany requires the adaptation of commercially available diagnostic test systems.

BACKGROUND: A blood donation, obtained in 2003 in Germany during the preseroconversion diagnostic window period of a hepatitis A virus (HAV) infection, tested HAV-negative by commercially available HAV reverse transcription-polymerase chain reaction (RT-PCR) detection assays. STUDY DESIGN AND METHODS: The virus responsible for this infection was identified as HAV genotype IIIA by characterization of the nearly complete genome sequence. RESULTS: Thereby, this HAV variant, which was named strain HMH, was detected in Germany for the first time. Because the commercially available HAV RNA detection systems failed to detect this genotype, a real-time RT-PCR kit was developed that allows quantification and detection of all HAV genotypes. The first nearly full-length nucleotide sequence so far available for HAV genotype IIIA is also provided. CONCLUSION: This case demonstrates that owing to the genetic variability of HAV, constant monitoring and adaptation of the diagnostic nucleic acid assays are required to guarantee the safety of blood and blood products.

Alanine Transaminase↗

Regulation of local availability of active tissue-type plasminogen activator in vivo in man.

Free, biologically active tissue-type plasminogen activator (tPA) is the main initiator of intravascular fibrinolysis, but little is known about the regulation of active tPA on the organ level. The aim was to investigate if the local availability of active tPA on the organ level depends on the local release rate of tPA or the arterial input of tPA and plasminogen activator inhibitor type 1 (PAI-1). Also, we wanted to evaluate if plasma levels predict capacity for endothelial release of fibrinolytic proteins. Invasive perfused-forearm studies were performed in 96 healthy subjects. Local release rates of fibrinolytic proteins were assessed at baseline and during endothelial stimulation. Stimulation by methacholine and desmopressin induced a 6- and 12-fold increase in total tPA release rates, respectively. With increasing local release rates of tPA a gradually closer correlation emerged between the total tPA secretion and the forearm output of active tPA (from r = 0.102, ns to r = 0.85, P < 0.0001). Forearm availability of active tPA was not related to arterial input of either tPA or PAI-1. Release rates and plasma levels of tPA were not correlated. Baseline release rates of active tPA increased to noon. The major determinant for the local availability of active tPA is the capacity of the endothelium to release tPA rather than the arterial input of PAI-1 or tPA. Despite a molar excess of PAI-1, the majority of tPA released during stimulation does not undergo local inactivation. The capacity to release tPA locally cannot be predicted from its plasma concentration.

Adult↗