This paper reviews the biogeography of the Australian monsoon tropical biome to highlight general patterns in the distribution of a range of organisms and their environmental correlates and ...evolutionary history, as well as to identify knowledge gaps. Northern Australia, Australian Monsoon Tropics (AMT). The AMT is defined by areas that receive more than 85% of rainfall between November and April. Literature is summarized, including the origin of the monsoon climate, present-day environment, biota and habitat types, and phylogenetic and geographical relationships of selected organisms. Some species are widespread throughout the AMT while others are narrow-range endemics. Such contrasting distributions correspond to present-day climates, hydrologies (particularly floodplains), geological features (such as sandstone plateaux), fire regimes, and vegetation types (ranging from rain forest to savanna). Biogeographical and phylogenetic studies of terrestrial plants (e.g. eucalypts) and animals (vertebrates and invertebrates) suggest that distinct bioregions within the AMT reflect the aggregated effects of landscape and environmental history, although more research is required to determine and refine the boundaries of biogeographical zones within the AMT. Phylogenetic analyses of aquatic organisms (fishes and prawns) suggest histories of associations with drainage systems, dispersal barriers, links to New Guinea, and the existence of Lake Carpentaria, now submerged by the Gulf of Carpentaria. Complex adaptations to the landscape and climate in the AMT are illustrated by a number of species. The Australian monsoon is a component of a single global climate system, characterized by a dominant equator-spanning Hadley cell. Evidence of hot, seasonally moist climates dates back to the Late Eocene, implying that certain endemic elements of the AMT biota have a long history. Vicariant differentiation is inferred to have separated the Kimberley and Arnhem Land bioregions from Cape York Peninsula/northern Queensland. Such older patterns are overlaid by younger events, including dispersal from Southeast Asia, and range expansions and contractions. Future palaeoecological and phylogenetic investigations will illuminate the evolution of the AMT biome. Understanding the biogeography of the AMT is essential to provide a framework for ecological studies and the sustainable development of the region.
Introduction Solitary extramedullary plasmacytoma are rare, solid-mass tumours which appear immunophenotypically similar to multiple myeloma. The diagnosis and management of gastrointestinal ...plasmacytoma is complex and requires multidisciplinary input. This study presents a narrative review of intra-abdominal extramedullary plasmacytoma, illustrated with two case studies. Methods The PubMed database was searched without date restrictions for reports of intra-abdominal extramedullary plasmacytoma to synthesise a narrative review. Electronic records were reviewed at a high-volume, quaternary soft-tissue sarcoma centre to identify patients with histopathologically confirmed extramedullary plasmacytoma affecting the gastrointestinal tract. Results Gastrointestinal extramedullary plasmacytomas can present with mass effect or organ-specific dysfunction. Techniques for tissue diagnosis of extramedullary plasmacytoma vary dependent on location, with a formal diagnosis often being made from a resected specimen. Management can include surgery, radiotherapy, systemic chemotherapy or a combination. No high-quality evidence base exists to guide treatment. Two case studies of operated gastrointestinal extramedullary plasmacytoma are presented at different phases of disease progression, with a resultant impact on survival. Conclusion Intra-abdominal extramedullary plasmacytoma is a rare and heterogeneous condition that lacks consensus guidelines for diagnosis and management. Collaboration between international specialist centres will create better quality evidence for treatment of this cohort.
Adapting to the health effects of climate change is one of the key challenges facing public health this century. Our knowledge of progress on adaptation, however, remains in its infancy. Using the ...Fifth National Communications of Annex I parties to the UNFCCC, 1912 initiatives are systematically identified and analyzed. 80% of the actions identified consist of groundwork (i.e.preparatory) action, with only 20% constituting tangible adaptations. No health vulnerability was recognized by all 38 Annex I countries. Furthermore, while all initiatives affect at least one health vulnerability, only 15% had an explicit human health component. Consideration for the special needs of vulnerable groups is uneven and underdeveloped. Climate change is directly motivating 71% of groundwork actions, and 61% of adaptation initiatives are being mainstreamed into existing institutions or programs. We conclude that the adaptation responses to the health risks of climate change remain piecemeal. Policymakers in the health sector must engage with stakeholders to implement adaptation that considers how climate change will impact the health of each segment of the population, particularly within those groups already considered most vulnerable to poor health outcomes.
Excessive airway obstruction is the cause of symptoms and abnormal lung function in asthma. As airway smooth muscle (ASM) is the effecter controlling airway calibre, it is suspected that dysfunction ...of ASM contributes to the pathophysiology of asthma. However, the precise role of ASM in the series of events leading to asthmatic symptoms is not clear. It is not certain whether, in asthma, there is a change in the intrinsic properties of ASM, a change in the structure and mechanical properties of the noncontractile components of the airway wall, or a change in the interdependence of the airway wall with the surrounding lung parenchyma. All these potential changes could result from acute or chronic airway inflammation and associated tissue repair and remodelling. Anti-inflammatory therapy, however, does not "cure" asthma, and airway hyperresponsiveness can persist in asthmatics, even in the absence of airway inflammation. This is perhaps because the therapy does not directly address a fundamental abnormality of asthma, that of exaggerated airway narrowing due to excessive shortening of ASM. In the present study, a central role for airway smooth muscle in the pathogenesis of airway hyperresponsiveness in asthma is explored.
With preliminary clinical trials completed for the treatment of antibiotic resistant infections using bacteriophages, there is a need to develop pharmaceutically acceptable formulations. ...Lyophilization is an established technique for the storage of bacteriophage, but there is little consensus regarding drying cycles, additives and moisture content specific to phage. Here, the addition of sucrose or poly(ethylene glycol) 6000 yielded stable freeze-dried cakes only from high concentrations (0.5
M and 5%, respectively), with addition of bacteriophage otherwise causing collapse. Gelatin, which is added to storage media (a solution of salts), played no role in maintaining bacteriophage stability following lyophilization. A secondary drying cycle was most important for maintaining bacteriophage activity. The addition of high concentrations of PEG 6000 or sucrose generally caused a more rapid fall in bacteriophage stability, over the first 7–14
d, but thereafter residual activities for all phage formulations converged. There was no distinct change in the glass transition temperatures (
T
g) measured for the formulations containing the same additive. Imaging of cakes containing fluorescently labeled bacteriophage did not show gross aggregation or phase separation of bacteriophage during lyophilization. However, the moisture content of the cake did correlate with lytic activity, irrespective of the formulation, with a 4–6% moisture content proving optimal. We propose that residual moisture is followed during lyophilization of bacteriophage from minimal concentrations of bulking agent.
Patients with suspected stroke first assessed by ambulance paramedics require early recognition to facilitate appropriate triage and early treatment. We determined paramedic's accuracy in detecting ...acute stroke signs by comparing agreement between neurological signs recorded in the Face Arm Speech Test (FAST), a stroke recognition instrument, by paramedics on the scene and by stroke physicians after admission.
Suspected stroke patients admitted by ambulance paramedics directly to an acute stroke unit through a rapid ambulance protocol were examined by a trainee stroke neurologist or admitting stroke physician over a 1-year period. Recorded neurological signs (facial weakness, arm weakness, speech disturbance) in confirmed acute stroke/transient ischemic attack (TIA) cases were compared between paramedics and the stroke neurologist/physician.
Ambulance crews referred 278 suspected stroke patients of whom 217 (78%) had confirmed stroke (n=189) or TIA (n=28); 95% were examined by the stroke neurologist (median 18 hours after paramedic assessment). Recorded signs and agreement between paramedics and stroke physicians in confirmed stroke group were: facial weakness, 68% versus 70% (kappa=0.49; 95% CI: 0.36 to 0.62); arm weakness, 96% versus 95% (kappa=0.77; 95% CI: 0.55 to 0.99); and speech disturbance, 79% versus 77% (kappa=0.69; 95% CI: 0.56 to 0.82). Interrater agreement was complete for arm weakness in 98% cases.
Recognition of neurological deficits by ambulance paramedics using FAST shows good agreement with physician assessment, even allowing for temporal evolution of deficits. The high prevalence and good agreement for arm weakness suggest that this sign may have the greatest usefulness for prehospital ambulance triage and paramedic-based neuroprotective trials.
Faecal calprotectin (f-Cp), a marker of intestinal inflammation, can be used to distinguish between functional and organic bowel disease. F-Cp, following extraction, is commonly quantified using ...enzyme-linked immunosorbent assays (ELISAs) but there are no data comparing the different f-Cp assays or sample extraction devices. We, therefore, evaluated and compared the performance of the Immunodiagnostik, Bühlmann and Eurospital f-Cp ELISA assays as well as the Roche, Immunodiagnostik and ScheBo Biotech commercial faecal extraction devices. We also briefly report results from a pilot f-Cp external quality assurance (EQA) scheme.
Imprecision, linearity, recovery, drift and limit of quantitation of the f-Cp assays were evaluated and between-assay variability assessed. The three commercial sample extraction devices were compared with the manual weighing method. Four faecal samples were distributed as part of a pilot EQA scheme to 15 laboratories using quantitative ELISA f-Cp assays.
The three f-Cp assays demonstrated adequate intra-/interbatch imprecision, linearity and recovery. The cross-comparison study and EQA data demonstrated that, for the same sample, the Bühlmann assay reports up to 3.8 times higher f-Cp concentrations than the Immunodiagnostik and Eurospital assays. On average, the commercial extraction devices led to a 7.8-28.1% under-recovery of f-Cp in comparison to the manual weighing method.
Laboratories should be aware of the lack of the assay standardization, as demonstrated by the between-assay variability. A comparison between f-Cp concentrations reported by these assays and clinical markers of disease severity is required in order to determine their diagnostic accuracy. The EQA scheme represents the first available programme for f-Cp.
The issue of whether regular use of an inhaled β2-adrenergic agonist worsens airflow and clinical outcomes in asthma is controversial. Retrospective studies have suggested that adverse effects occur ...in patients with a genetic polymorphism that results in homozygosity for arginine (Arg/Arg), rather than glycine (Gly/Gly), at aminoacid residue 16 of the β2-adrenergic receptor. However, the existence of any genotype-dependent difference has not been tested in a prospective clinical trial.
Patients with mild asthma, not using a controller medication, were enrolled in pairs matched for forced expiratory volume in 1 s (FEV1) according to whether they had the Arg/Arg (n=37; four of 41 matches withdrew before randomisation) or Gly/Gly (n=41) genotype. Regularly scheduled treatment with albuterol or placebo was given in a masked, cross-over design, for 16-week periods. During the study, as-needed albuterol use was discontinued and ipratropium bromide was used as needed. Morning peak expiratory flow rate (PEFR) was the primary outcome variable. The primary comparisons were between treatment period for each genotype; the secondary outcome was a treatment by genotype effect. Analyses were by intention to treat.
During the run-in period, when albuterol use was kept to a minimum, patients with the Arg/Arg genotype had an increase in morning PEFR of 23 L/min (p=0·0162); the change in patients with the Gly/Gly genotype was not significant (2 L/min; p=0·8399). During randomised treatment, patients with the Gly/Gly genotype had an increase in morning PEFR during treatment with regularly scheduled albuterol compared with placebo (14 L/min 95% CI 3 to 25; p=0·0175). By contrast, patients with the Arg/Arg genotype had lower morning PEFR during treatment with albuterol than during the placebo period, when albuterol use was limited (–10 L/min –19 to –2; p=0·0209). The genotype-attributable treatment difference was therefore –24 L/min (–37 to –12; p=0·0003). There were similar genotype-specific effects in FEV1, symptoms, and use of supplementary reliever medication.
Genotype at the 16th aminoacid residue of the β2-adrenergic receptor affects the long-term response to albuterol use. Bronchodilator treatments avoiding albuterol may be appropriate for patients with the Arg/Arg genotype.
Context. The galaxy cluster XMMU J2235.3-2557 (hereafter XMM2235), spectroscopically confirmed at $z = 1.39$, is one of the most distant X-ray selected galaxy clusters. It has been at the center of a ...multi-wavelength observing campaign with ground and space facilities. Aims. We characterize the galaxy populations of passive members, the thermodynamical properties and metal abundance of the hot gas, and the total mass of the system using imaging data with HST/ACS (i775 and z850 bands) and VLT/ISAAC (J and KS bands), extensive spectroscopic data obtained with VLT/FORS2, and deep (196 ks) Chandra observations. Methods. Chandra data allow temperature and metallicity to be measured with good accuracy and the X-ray surface brightness profile to be traced out to 1´ (or 500 kpc), thus allowing the mass to be reliably estimated. Out of a total sample of 34 spectroscopically confirmed cluster members, we selected 16 passive galaxies (without detectable OII) within the central 2´ (or 1 Mpc) with ACS coverage, and inferred star formation histories for subsamples of galaxies inside and outside the core by modeling their spectro-photometric data with spectral synthesis models. Results. Chandra data show a regular elongated morphology, closely resembling the distribution of core galaxies, with a significant cool core. We measure a global X-ray temperature of kT = $8.6_{\rm -1.2}^{+1.3}$ keV (68% confidence), which we find to be robust against several systematics involved in the X-ray spectral analysis. By detecting the rest frame 6.7 keV Iron K line in the Chandra spectrum, we measure a metallicity Z = $0.26^{\rm +0.20}_{-0.16}$ $Z_\odot$. In the likely hypothesis of hydrostatic equilibrium, we obtain a total mass of $M_{\mathrm{tot}}$(<1 Mpc)= (5.9±1.3) $\times$ 1014 $M_\odot$. By modeling both the composite spectral energy distributions and spectra of the passive galaxies in and outside the core, we find a strong mean age radial gradient. Core galaxies, with stellar masses in excess of 1011 $ M_\odot$, appear to have formed at an earlier epoch with a relatively short star formation phase ($z = 5{-}6$), whereas passive galaxies outside the core show spectral signatures suggesting a prolonged star formation phase to redshifts as low as z ≈ 2. Conclusions. Overall, our analysis implies that XMM2235 is the hottest and most massive bona-fide cluster discovered to date at $z > 1$, with a baryonic content, both its galaxy population and intracluster gas, in a significantly advanced evolutionary stage at 1/3 of the current age of the Universe.
PDF
