Separate and combined effects of boat noise and a live crab predator on mussel valve gape behavior.

Noisy human activities at sea are changing the acoustic environment, which has been shown to affect marine mammals and fishes. Invertebrates, such as bivalves, have so far received limited attention despite their important role in the marine ecosystem. Several studies have examined the impact of sound on anti-predator behavior using simulated predators, but studies using live predators are scarce. In the current study, we examined the separate and combined effects of boat sound playback and predator cues of shore crabs (Carcinus maenas) on the behavior of mussels (Mytilus spp.). We examined the behavior of the mussels using a valve gape monitor and scored the behavior from the crabs in one of two types of predator test conditions from video footage to control for effects from potential, sound-induced variation in crab behavior. We found that mussels closed their valve gape during boat noise and with a crab in their tank, but also that the stimulus combination did not add up to an even smaller valve gape. The sound treatment did not affect the stimulus crabs, but the behavior of the crabs did affect the valve gape of the mussels. Future research is needed to examine whether these results stand in situ and whether valve closure due to sound has fitness consequences for mussels. The effects on the well-being of individual mussels from anthropogenic noise may be relevant for population dynamics in the context of pressure from other stressors, their role as an ecosystem engineer, and in the context of aquaculture.

Evaluation of medication-related problems in liver transplant recipients with and without an outpatient medication consultation by a clinical pharmacist: a cohort study.

BACKGROUND: Transplant recipients undergo significant changes in their medication regimen during follow-up and are at an increased risk for medication-related problems (MRPs). AIM: This study aimed to compare the prevalence and types of MRPs and interventions in liver transplant recipients with and without an outpatient medication consultation by a clinical pharmacist as well as the satisfaction with information about medicines and medication adherence. METHOD: We performed a single-center, observational cohort study. A retro- and prospective cohort were used and subdivided in a group that did and did not receive a medication consultation. The prevalence and types of MRPs and interventions were identified and categorized. The satisfaction parameters were evaluated using validated questionnaires. RESULTS: Included were 291 patients. In total, 368 MRPs were identified in 197 patients in the non-medication consultation cohort (median 1; range 1-3 per patient) and 248 MRPs in 94 patients in the medication consultation cohort (median 2; range 1-4 per patient). In the medication consultation cohort, significantly fewer MRPs as unnecessary drugs (17.3% versus 58.7%, p < 0.001), suboptimal therapy (2.4% versus 9.5%, p < 0.001), untreated indication (2.8% versus 6.8%, p = 0.040) and underdosed drugs (0.4% versus 6.3%, p < 0.001) were identified. In the non-medication consultation cohort significantly more patients used unnecessary drugs (72.1% versus 39.4%, p < 0.001) compared to the medication consultation cohort. Patients in both cohorts are satisfied with the information about medicines and reported a high medication adherence. CONCLUSION: Patients in the medication consultation cohort had significantly fewer MRPs and used significantly less unnecessary drugs. Including a clinical pharmacist to the post-transplant care has an added value.

The quality of informed consent obtained for orthopedic surgeries-elective versus trauma: A prospective interview-based study.

BACKGROUND: Orthopedic surgeons routinely obtain informed consent prior to surgery. Legally adequate informed consent necessitates a thorough discussion of treatment options and risks and proper documentation. However, the quality of informed consent in orthopedic trauma patients is an under-researched area. PURPOSE: To assess the quality of the informed consent process in trauma compared with elective orthopedic patients and to assess patients' emotional state at the time of signing consent form. METHODS: Sixty-two consecutive patients undergoing either elective total joint arthroplasty ( N = 32) or orthopedic trauma surgery ( N = 30) were included. The data were collected through personal interviews using a proposed informed consent score. The interviews were held after obtaining the informed consent and before the index procedure. Patients were asked to describe their diagnosis, the surgical procedure, its' benefits, and risks as well as alternative treatments. RESULTS: Mean age differed significantly between elective and trauma group patients (66.1 vs. 51.6, respectively, p < 0.01), while gender and education level were comparable ( p = 0.075, p = 0.55, respectively). The quality of consent was significantly better for patients with post-high-school education compared to elementary education level (consent score: 16.9 ± 4.1 vs. 12.2 ± 5.5, p = 0.021). Patients in the elective group showed an overall higher quality of consent, as reflected by a mean score of 17.03 ± 4.2 versus a mean score of only 13.73 ± 4.7 in the trauma group ( p = 0.005, 95% CI: 1.02-5.57). Specifically, trauma patients demonstrated a lower comprehension of the diagnosis, the benefits of surgical treatment, the possible complications, and the expected postoperative course. CONCLUSION: Patients undergoing trauma surgery are significantly more likely to have an inadequate understanding of the proposed treatment. These findings raise questions concerning the validity of consent from trauma patients.

Chemicals or mutations that target mitochondrial translation can rescue the respiratory deficiency of yeast bcs1 mutants.

Bcs1p is a chaperone that is required for the incorporation of the Rieske subunit within complex III of the mitochondrial respiratory chain. Mutations in the human gene BCS1L (BCS1-like) are the most frequent nuclear mutations resulting in complex III-related pathologies. In yeast, the mimicking of some pathogenic mutations causes a respiratory deficiency. We have screened chemical libraries and found that two antibiotics, pentamidine and clarithromycin, can compensate two bcs1 point mutations in yeast, one of which is the equivalent of a mutation found in a human patient. As both antibiotics target the large mtrRNA of the mitoribosome, we focused our analysis on mitochondrial translation. We found that the absence of non-essential translation factors Rrf1 or Mif3, which act at the recycling/initiation steps, also compensates for the respiratory deficiency of yeast bcs1 mutations. At compensating concentrations, both antibiotics, as well as the absence of Rrf1, cause an imbalanced synthesis of respiratory subunits which impairs the assembly of the respiratory complexes and especially that of complex IV. Finally, we show that pentamidine also decreases the assembly of complex I in nematode mitochondria. It is well known that complexes III and IV exist within the mitochondrial inner membrane as supramolecular complexes III2/IV in yeast or I/III2/IV in higher eukaryotes. Therefore, we propose that the changes in mitochondrial translation caused by the drugs or by the absence of translation factors, can compensate for bcs1 mutations by modifying the equilibrium between illegitimate, and thus inactive, and active supercomplexes.

Fixation of an Akin osteotomy with a tension suture: our results.

An Akin osteotomy is a closing wedge varus osteotomy of the proximal phalanx, usually performed as part of a hallux valgus correction surgery to complement the metatarsal correction. Numerous fixation techniques have been described; most provide good and stable fixation, but involve permanent and sometimes protruding hardware. A retrospective cohort study has been carried out of 115 feet in 109 patients using a technique with an absorbable suture fixation of the medial cortex of the proximal phalanx while preserving the lateral cortex. All the osteotomies united completely with no loss of position. HV angles and IM angles were within acceptable parameters. In comparison to others methods, the technique presented in this study is technically simple, provides good results, requires no specialized instrumentation, is cost effective and has a very low complication rate.

Radiofrequency catheter ablation of ventricular tachycardia guided by intracardiac echocardiography.

AIMS: Ventricular tachycardia (VT) frequently has an anatomical substrate. Identification of areas prone to arrhythmogenicity facilitates radiofrequency catheter ablation (RFCA). Furthermore, direct monitoring of complications potentially increases safety of RFCA. The aim of this study was to evaluate the feasibility of guiding RFCA of VT with intracardiac echocardiography (ICE), in order to improve outcome and procedural safety. METHODS AND RESULTS: Eleven patients (age 59 +/- 15 years) with drug-refractory VT of various etiologies were studied. VT mapping and ablation were performed using standard techniques. ICE was performed with a multifrequency (5-10 MHz) phased-array transducer positioned in the right ventricle. Twenty different VTs were treated (CL 352 +/- 120 ms, 2.0 +/- 0.9 VT per patient). LV a- or dyskinesia was identified in all post-infarct patients. In patients with arrhythmogenic right ventricular dysplasia, right ventricular aneurysms and dyskinesia could be identified. In all patients catheter position and tip-tissue contact could easily be monitored with ICE. Procedural success (non-inducibility of hemodynamically stable VT) was achieved in all patients. Complications did not occur. CONCLUSION: ICE is feasible in guiding RFCA of VT of different etiologies. The use of ICE in adjunction with fluoroscopy and mapping procedures will facilitate treatment of VT and may contribute to the safety of the procedure.

Interpretation of spring recession curves.

Recession curves contain information on storage properties and different types of media such as porous, fractured, cracked lithologies and karst. Recession curve analysis provides a function that quantitatively describes the temporal discharge decay and expresses the drained volume between specific time limits (Hall 1968). This analysis also allows estimating the hydrological significance of the discharge function parameters and the hydrological properties of the aquifer. In this study, we analyze data from perennial springs in the Judean Mountains and from others in the Galilee Mountains, northern Israel. All the springs drain perched carbonate aquifers. Eight of the studied springs discharge from a karst dolomite sequence, whereas one flows out from a fractured, slumped block of chalk. We show that all the recession curves can be well fitted by a function that consists of two exponential terms with exponential coefficients alpha1 and alpha2. These coefficients are approximately constant for each spring, reflecting the hydraulic conductivity of different media through which the ground water flows to the spring. The highest coefficient represents the fast flow, probably through cracks, or quickflow, whereas the lower one reflects the slow flow through the porous medium, or baseflow. The comparison of recession curves from different springs and different years leads to the conclusion that the main factors that affect the recession curve exponential coefficients are the aquifer lithology and the geometry of the water conduits therein. In normal years of rainy winter and dry summer, alpha1 is constant in time. However, when the dry period is longer than usual because of a dry winter, alpha1 slightly decreases with time.

The diffusion process of patient education in Dutch community pharmacy: an exploration.

Patient education activities in pharmacies are receiving much attention. These activities are relatively new and implementation requires individual and organisational change in pharmacies. The aim of this study is to identify barriers and facilitators to the implementation of patient education in community pharmacies and to classify these barriers and facilitators into the diffusion stages of Rogers' 'Innovations in Organisations' model [Rogers, EM. Diffusion of innovations. 4th ed. New York: The Free Press, 1995]. Six focus group interviews, three with pharmacists and three with pharmacy technicians (total n = 38) were carried out. The initiation phase has been dealt with by community pharmacies, whereas the implementation phase has not. The barriers and facilitators in the redefining/restructuring stage were mainly related to the organisation of patient education. In the clarifying and routinizing stages, barriers were related to repetition and knowledge transfer. The facilitators in these stages relate to performing and talking about patient education. Interventions for implementation of patient education should aim at these barriers and facilitating factors.

The reaction mechanism of nitrosothiols with copper(I).

Copper and other transition metal ions and their complexes are catalysts for the decomposition of nitrosothiols. In this way they catalyze the biological functions of nitrosothiols. The kinetics and mechanism of the reaction of two nitrosothiols, S-nitrosothiolactic acid and S-nitrosoglutathione (GSNO), with copper(I) are reported. The kinetics of the reaction of Cu(MeCN)+(n) (n=0-3) with the nitrosothiols were studied. The results indicate that Cu+(aq) is the active species in the GSNO system, with k(Cu+(aq)+GSNO)=(9.4 +/- 2.0) x 10(7) dm3 mol(-1) s(-1). The results also indicate that the Cu(MeCN)+(n) (n=0-3) complexes react with S-nitrosothiolactic acid. Transient species are formed in these processes. The results suggest that these species contain copper(I) and thiol. The results shed light on the catalytic role of copper complexes in the decomposition of S-nitrosothiols.

Generation of specific deoxynojirimycin-type inhibitors of the non-lysosomal glucosylceramidase.

The existence of a non-lysosomal glucosylceramidase in human cells has been documented (van Weely, S., Brandsma, M., Strijland, A., Tager, J. M., and Aerts, J. M. F. G. (1993) Biochim. Biophys. Acta 1181, 55-62). Hypothetically, the activity of this enzyme, which is localized near the cell surface, may influence ceramide-mediated signaling processes. To obtain insight in the physiological importance of the non-lysosomal glucosylceramidase, the availability of specific inhibitors would be helpful. Here we report on the generation of hydrophobic deoxynojirimycin (DNM) derivatives that potently inhibit the enzyme. The inhibitors were designed on the basis of the known features of the non-lysosomal glucosylceramidase and consist of a DNM moiety, an N-alkyl spacer, and a large hydrophobic group that promotes insertion in membranes. In particular, N-(5-adamantane-1-yl-methoxy)pentyl)-DNM is a very powerful inhibitor of the non-lysosomal glucosylceramidase at nanomolar concentrations. At such concentrations, the lysosomal glucocerebrosidase and alpha-glucosidase, the glucosylceramide synthase, and the N-linked glycan-trimming alpha-glucosidases of the endoplasmic reticulum are not affected.

[0.15 mg clonidine as oral premedication in retrobulbar anesthesia]. / 0,15 mg Clonidin als orale Prämedikation bei Retrobulbäranästhesie.

BACKGROUND: In the present clinical study, oral premedication of 0.15 mg clonidine has been explored with view to anxiolytic effects and physiological stress parameters. METHODS: The study involved 44 patients of ASA-class I-III, all scheduled to undergo ophthalmological surgery under retrobulbar anesthesia (RBA). One hour before RBA 22 patients received 0.15 mg clonidine and 22 patients placebo p.o. The following parameters were assessed at different times perioperatively: oxygenation (SpO2), heart rate, blood pressure, intraocular pressure and anxiety. Anxiolysis was determined using the Erlanger Anxiety Scale. RESULTS: There were no significant differences among the groups in SpO2 and heart rate. Significantly decreased blood pressures were measured after clonidine premedication (p < 0.01). In contrast to clonidine after placebo the preoperative anxiety increased. Right before operation anxiety was decreased significantly (p < 0.01) by clonidine compared to placebo. CONCLUSIONS: In our opinion, oral clonidine (0.15 mg) is useful for premedication of surgery under RBA.

Paraneoplastic hypercalcemia associated with adenosquamous carcinoma of the endometrium.

Paraneoplastic hypercalcemia associated with adenosquamous carcinoma of the endometrium is described. This is the first reported case of a gynecologic cancer in which the paraneoplastic syndrome has been conclusively shown by immunohistochemical analysis to be due to ectopic parathormone.

Accumulation of mutagenic activity in bile fluid of river Rhine fish.

Considerable mutagenic activity can be detected in the bile of natural fish (bream Abramis brama) from the river Rhine. Like the river water, organic mutagens can be extracted from aqueous bile by adsorption on XAD-resins. The mutagenic activity of the fish bile in the Amestest resembles that of the river water with regard to strain specificity (TA 98 and TA 1538) and the effect of S-9 (enhancement). However, relative to the river water, the activity in the bile is at least 10(4)-fold higher. No mutagenic activity can be detected in the bile of bream from the river Meuse, which contains little activity in the water itself. Seasonal changes in the level of Rhine water mutagenicity roughly coincide with similar changes in the activity of bile from Rhine fish. Finally, additional mutagenic activity can be observed in the bile of Rhine fish after treatment with beta-glucuronidase.

Lack of an effect of melatonin on the basal and L-dopa stimulated growth hormone secretion in men.

The oral administration of melatonin to men has been reported to cause a rapid and significant elevation of serum GH, and to inhibit GH release after stimulation by L-Dopa. We studied the effect of melatonin i.v. on the basal and L-Dopa stimulated GH secretion in four young men. Each subject's control response to L-Dopa was first studied by an oral administration to 500 mg of L-Dopa under a placebo infusion and was followed 2 weeks later by a similar study under melatonin infusion, 2.1 mg/min (total dose of 500 mg). The infusion of melatonin was given for a 4-hour period, 2 hours before and 2 hours after the L-Dopa stimulation. Blood samples for GH were obtained at 30-min intervals. Basal values of serum GH did not rise under the melatonin infusion and peak GH values following L-Dopa stimulation during the control infusion and the melatonin infusion also did not differ (2 +/- 0.5 to 22 +/- 6 and 2 +/- 0.8 to 25 +/- 4 ng/ml respectively). Our data suggest that under an acute constant infusion melatonin does not stimulate GH secretion, nor does it interfere with the L-Dopa stimulated GH response in men.