Secondary prevention in the clinical management of patients with cardiovascular diseases. Core components, standards and outcome measures for referral and delivery.

Despite major improvements in diagnostics and interventional therapies, cardiovascular diseases remain a major health care and socio-economic burden both in western and developing countries, in which this burden is increasing in close correlation to economic growth. Health authorities and the general population have started to recognize that the fight against these diseases can only be won if their burden is faced by increasing our investment on interventions in lifestyle changes and prevention. There is an overwhelming evidence of the efficacy of secondary prevention initiatives including cardiac rehabilitation in terms of reduction in morbidity and mortality. However, secondary prevention is still too poorly implemented in clinical practice, often only on selected populations and over a limited period of time. The development of systematic and full comprehensive preventive programmes is warranted, integrated in the organization of national health systems. Furthermore, systematic monitoring of the process of delivery and outcomes is a necessity. Cardiology and secondary prevention, including cardiac rehabilitation, have evolved almost independently of each other and although each makes a unique contribution it is now time to join forces under the banner of preventive cardiology and create a comprehensive model that optimizes long term outcomes for patients and reduces the future burden on health care services. These are the aims that the Cardiac Rehabilitation Section of the European Association for Cardiovascular Prevention & Rehabilitation has foreseen to promote secondary preventive cardiology in clinical practice.

A Framework for Stakeholder Management and Corporate Culture

Purpose: This paper investigates the link between two knowledge areas that have not been previously linked conceptually; stakeholder management and corporate culture. Focussing on the UK Construction Industry, the research study demonstrates mutual dependency of each of these areas on the other and establishes a theoretical framework with real potential to impact positively upon industry.

Design/methodology/approach: The study utilises both qualitative and quantitative data collection and then analysis to produce results contributing to the final framework. Semi-structured interviews were used and analysed through a cognitive mapping procedure. The result of this stage, set in the context of previous research, facilitated a questionnaire to be developed which helped gather quantitative values from a larger sample to enhance the final framework.

Findings: The data suggests that stakeholder management and corporate culture are key areas of an organisation’s success, and that this importance will only grow in future. A clearly identifiable relationship was established between the two theoretical areas and a framework developed and quantified.

Originality/value: It is evident that change is needed within the UK Construction Industry. Companies must employ ethical and social stakeholder management and manage their corporate culture like any other aspect of their business. Successfully doing this will lead to more successful projects, better reputation and survival. The findings of this project begin to show how change may occur and how companies might intentionally deploy advantageous configurations of corporate culture and stakeholder management.

Exploring statistical and population aspects of network complexity

The characterization and the definition of the complexity of objects is an important but very difficult problem that attracted much interest in many different fields. In this paper we introduce a new measure, called network diversity score (NDS), which allows us to quantify structural properties of networks. We demonstrate numerically that our diversity score is capable of distinguishing ordered, random and complex networks from each other and, hence, allowing us to categorize networks with respect to their structural complexity. We study 16 additional network complexity measures and find that none of these measures has similar good categorization capabilities. In contrast to many other measures suggested so far aiming for a characterization of the structural complexity of networks, our score is different for a variety of reasons. First, our score is multiplicatively composed of four individual scores, each assessing different structural properties of a network. That means our composite score reflects the structural diversity of a network. Second, our score is defined for a population of networks instead of individual networks. We will show that this removes an unwanted ambiguity, inherently present in measures that are based on single networks. In order to apply our measure practically, we provide a statistical estimator for the diversity score, which is based on a finite number of samples.

ISOLATION, LOCALIZATION, AND CARDIOVASCULAR ACTIVITY OF TACHYKININS FROM THE STOMACH OF THE BOWFIN AMIA-CALVA

The bowfin is an extant representative of an ancient group of ray-finned fish with evolutionary connections to modern teleosts. A peptide with substance P-like immunoreactivity was isolated from an extract of bowfin stomach and its primary structure was established as Ser-Lys-Ser-His-Gln-Phe-Tyr-Gly-Leu-Met-NH2. This amino acid sequence resembles mammalian substance P only in the COOH-terminal region of the peptide. A second tachykinin with neurokinin A-like immunoreactivity isolated from the extract comprises 23 amino acid residues and shows limited structural similarity to mammalian neuropeptide-gamma. A randomly distributed population of cells in the gastric glands of the bowfin were immunostained with an antiserum raised against substance P, but no immunopositive structures were identified in the surface epithelium, lamina propria, or the nerve plexuses of the submucosa. Bolus injections of synthetic bowfin substance P (0.1-10 nmol/kg) into the bulbus arteriosus of unanesthetized bowfin resulted in a significant and dose-dependent rise in vascular resistance and arterial blood pressure (P < 0.01) and a fall in cardiac output (P < 0.05) without change in heart rate. After 5-10 min, arterial pressure and vascular resistance returned to preinjection levels, but cardiac output significantly (P < 0.05) increased over baseline values. The response to the peptide was unaffected by pretreatment of the animals with phentolamine. The study has shown that the stomach of the bowfin synthesizes tachykinins with novel structural features that display cardiovascular activity in this species.

UROTENSIN II FROM THE RIVER LAMPREY (LAMPETRA-FLUVIATILIS), THE SEA LAMPREY (PETROMYZON-MARINUS), AND THE PADDLEFISH (POLYODON SPATHULA)

Urotensin II was isolated from extracts of the whole brain of the river lamprey (Lampetra fluviatilis) and the sea lamprey (Petromyzon marinus). The primary structure of the peptide from both species is the same (Asn-Asn-Phe-Ser-Asp-Cys-Phe-Trp-Lys-Tyr-Cys-Val) and this amino acid sequence is identical to that of urotensin II from the dogfish and skate. Consistent with previous morphological studies indicating that the Agnatha lack a caudal neurosecretory system, urotensin II was not detected in an extract of P. marinus spinal cord. The data suggest that the urotensin II may have functioned in the earliest vertebrates as a neurotransmitter/neuromodulator in the central nervous system rather than as a neurohormone of the caudal neurosecretory system. Urotensin II was also isolated from an extract of the spinal cord of a chondrostean fish, the paddlefish (Polyodon spathula). The primary structure of the paddlefish urotensin II (Gly-Ser-Thr-Ser-Glu-Cys-Phe-Trp-Lys-Tyr-Cys-Val) is the same as that of another chondrostean, the sturgeon (Acipenser ruthenus). The study provides further evidence for a widespread distribution of urotensin II in vertebrate species and suggests that the primary structure of the peptide is better conserved in these phylogenetically ancient fish than in teleosts. (C) 1995 Academic Press, Inc.

‘Symposium: New Technologies, European Law and Citizens’

This special issue seeks to draw attention to the relations between new technologies and European law (encompassing EU law and the law of the Council of Europe and its institutions), and some of the implications for citizens.

ARTICLE: Property and the Definition of Slavery

Currently there is no clear understanding of the meaning of ‘slavery’ in modern international law. While generally it is accepted that the
authoritative definition of slavery is provided by Article 1 of the Slavery Convention 1926, in recent times slavery has been understood in such a wide variety of ways that effectively it is a meaningless term. This paper reflects on this interpretation problem and aims to redress this balance by reclaiming the core meaning of the legal definition. It applies property law perspectives to explain the conception of ownership invoked by Article 1, to argue that it remains relevant and to explore how it might be applied in identifying modern cases of slavery.

Postconditioning for salvage of ischemic skeletal muscle from reperfusion injury:efficacy and mechanism

We tested our hypothesis that postischemic conditioning (PostC) is effective in salvage of ischemic skeletal muscle from reperfusion injury and the mechanism involves inhibition of opening of the mitochondrial permeability transition pore (mPTP). In bilateral 8x13 cm pig latissimus dorsi muscle flaps subjected to 4 h ischemia, muscle infarction increased from 22+/-4 to 41+/-1% between 2 and 24 h reperfusion and remained unchanged at 48 (38+/-6%) and 72 (40+/-1%) h reperfusion (P

Inducing late phase of infarct protection in skeletal muscle by remote preconditioning:efficacy and mechanism

We have previously demonstrated that remote ischemic preconditioning (IPC) by instigation of three cycles of 10-min occlusion/reperfusion in a hindlimb of the pig elicits an early phase of infarct protection in local and distant skeletal muscles subjected to 4 h of ischemia immediately after remote IPC. The aim of this project was to test our hypothesis that hindlimb remote IPC also induces a late phase of infarct protection in skeletal muscle and that K(ATP) channels play a pivotal role in the trigger and mediator mechanisms. We observed that pig bilateral latissimus dorsi (LD) muscle flaps sustained 46 +/- 2% infarction when subjected to 4 h of ischemia/48 h of reperfusion. The late phase of infarct protection appeared at 24 h and lasted up to 72 h after hindlimb remote IPC. The LD muscle infarction was reduced to 28 +/- 3, 26 +/- 1, 23 +/- 2, 24 +/- 2 and 24 +/- 4% at 24, 28, 36, 48 and 72 h after remote IPC, respectively (P <0.05; n = 8). In subsequent studies, hindlimb remote IPC or intravenous injection of the sarcolemmal K(ATP) (sK(ATP)) channel opener P-1075 (2 microg/kg) at 24 h before 4 h of sustained ischemia (i.e., late preconditioning) reduced muscle infarction from 43 +/- 4% (ischemic control) to 24 +/- 2 and 19 +/- 3%, respectively (P <0.05, n = 8). Intravenous injection of the sK(ATP) channel inhibitor HMR 1098 (6 mg/kg) or the nonspecific K(ATP) channel inhibitor glibenclamide (Glib; 1 mg/kg) at 10 min before remote IPC completely blocked the infarct- protective effect of remote IPC in LD muscle flaps subjected to 4 h of sustained ischemia at 24 h after remote IPC. Intravenous bolus injection of the mitochondrial K(ATP) (mK(ATP)) channel inhibitor 5-hydroxydecanoate (5-HD; 5 mg/kg) immediately before remote IPC and 30-min intravenous infusion of 5-HD (5 mg/kg) during remote IPC did not affect the infarct-protective effect of remote IPC in LD muscle flaps. However, intravenous Glib or 5-HD, but not HMR 1098, given 24 h after remote IPC completely blocked the late infarct-protective effect of remote IPC in LD muscle flaps. None of these drug treatments affected the infarct size of control LD muscle flaps. The late phase of infarct protection was associated with a higher (P <0.05) muscle content of ATP at the end of 4 h of ischemia and 1.5 h of reperfusion and a lower (P <0.05) neutrophilic activity at the end of 1.5 h of reperfusion compared with the time-matched control. In conclusion, these findings support our hypothesis that hindlimb remote IPC induces an uninterrupted long (48 h) late phase of infarct protection, and sK(ATP) and mK(ATP) channels play a central role in the trigger and mediator mechanism, respectively.

Isolation and characterization of a novel simazine-degrading bacterium from agricultural soil of central Chile, Pseudomonas sp MHP41

s-Triazine herbicides are used extensively in South America in agriculture and forestry. In this study, a bacterium designated as strain MHP41, capable of degrading simazine and atrazine, was isolated from agricultural soil in the Quillota valley, central Chile. Strain MHP41 is able to grow in minimal medium, using simazine as the sole nitrogen source. In this medium, the bacterium exhibited a growth rate of mu = 0.10 h(-1), yielding a high biomass of 4.2 x 10(8) CFU mL(-1). Resting cells of strain MHP41 degrade more than 80% of simazine within 60 min. The atzA, atzB, atzC, atzD, atzE and atzF genes encoding the enzymes of the simazine upper and lower pathways were detected in strain MHP41. The motile Gram-negative bacterium was identified as a Pseudomonas sp., based on the Biolog microplate system and comparative sequence analyses of the 16S rRNA gene. Amplified ribosomal DNA restriction analysis allowed the differentiation of strain MHP41 from Pseudomonas sp. ADP. The comparative 16S rRNA gene sequence analyses suggested that strain MHP41 is closely related to Pseudomonas nitroreducens and Pseudomonas multiresinovorans. This is the first s-triazine-degrading bacterium isolated in South America. Strain MHP41 is a potential biocatalyst for the remediation of s-triazine-contaminated environments.

Cold War Politics in Britain and the Contested Legacy of the Spanish Civil War

This article offers a sustained examination of how the vicissitudes of the Cold War shaped changing interpretations of the Spanish Civil War in Britain. Considering the perspectives of participants and historians, it focuses on the diverse strands of the Left that frequently drew on the civil war to attack each other and to make wider arguments about the global Cold War. First, with the aim of criticizing Communist take-overs in Eastern Europe in the late 1940s, the article analyzes retrospective assaults on Communist party tactics and Soviet foreign policy in Spain. Second, in order to argue that the Soviet Union took a counter-revolutionary line after 1956, it investigates the re-emergence of debates over the Spanish revolution. Third, to express disapproval of the United States, it examines the increasing use of the civil war as an analogy in Cold War international affairs from the 1960s. Fourth, in support of non-Soviet Left-of-Centre collaboration, most notably Eurocommunism in the 1970s and opposition to Margaret Thatcher’s Conservative government in the 1980s, it considers the renewed emphasis on the popular front. The trajectories of these debates reveal that, over time, the weight of the Left’s criticism moved from the Soviet Union towards the United States.

Distribution and Translocation of Selenium from Soil to Grain and Its Speciation in Paddy Rice (Oryza sativa L.)

Selenium, an essential micronutrient for humans, is insufficient in dietary intake for millions of people worldwide. Rice as the most popular staple food in the world is one of the dominant selenium (Se) sources for people. The distribution and translocation of Se from soil to grain were investigated in a Se-rich environment in this study. The Se levels in soils ranged widely from 0.5 to 47.7 mg kg(-1). Selenium concentration in rice bran was 1.94 times higher than that in corresponding polished rice. The total Se concentrations in the rice fractions were in the following order: straw > bran > whole grain > polished rice > husk. Significant linear relationships between different rice fractions were observed with each other, and Se in the soil has a linear relationship with different rice fractions as well. Se concentration in rice can easily be predicted by soil Se concentrations or any rice fractions and vice versa according to their linear relationships. In all rice samples for Se speciation, SeMet was the major Se species, followed by MeSeCys and SeCys. The average percentage for SeMet (82.9%) and MeSeCys (6.2%) was similar in the range of total Se from 2.2 to 8.4 mg kg(-1) tested. The percentage of SeCys decreased from 6.3 to 2.8%, although its concentration elevated with the increase in total Se in rice. This could be due to the fact that SeCys is the precursor for the formation of other organic Se compounds. The information obtained may have considerable significance for assessing translocation and accumulation of Se in plant.