Lipid-lowering therapy following major cardiac events: progress and deficits

Objective: To assess hospital prescribing of lipid-lowering agents in a tertiary hospital, and examine continuation of, or changes to, such therapy in the 6-18 months following discharge. Design: Retrospective data extraction from the hospital records of patients admitted from October 1998 to April 1999. These patients and their general practitioners were then contacted to obtain information about ongoing management after discharge. Setting: Tertiary public hospital and community. Participants: 352 patients admitted to hospital with acute myocardial infarction or unstable angina, and their GPs. Main outcome measures: Percentage of eligible patients discharged on lipid-lowering therapy and percentage of patients continuing or starting such therapy 6-18 months after discharge. Results: 10% of inpatients with acute coronary syndromes did not have lipid-level estimations performed or arranged during admission. Documentation of lipid levels in discharge summaries was poor. Eighteen per cent of patients with a total serum cholesterol level greater than 5.5 mmol/L did not receive a discharge prescription for a cholesterol-lowering agent. Compliance with treatment on follow-up was 88% in the group discharged on treatment. However, at follow-up, 70% of patients discharged without therapy had not been commenced on lipid-lowering treatment by their GPs. Conclusions: Prescribing of lipid-lowering therapy for secondary prevention following acute coronary syndromes remains suboptimal. Commencing treatment in hospital is likely to result in continuing therapy in the community. Better communication of lipid-level results, treatment and treatment aims between hospitals and GPs might encourage optimal treatment practices.

Hyaline tissue of thermally unaltered conodont elements and the enamel of vertebrates

Comparison of the ultrastructure of the hyaline tissue of conodont elements and the enamel of vertebrates provides little support for a close phylogenetic relationship between conodonts and vertebrates. Transmission and scanning electron microscopy shows that the mineralised component of the hyaline tissue of Panderodus and of Cordylodus elements consists of large, flat, oblong crystals, arranged in layers that run parallel to the long axis of the conodont. Enamel in the dentition of a living vertebrate, the lungfish Neoceratodus forsteri, has crystals of calcium hydroxyapatite, arranged in layers, and extending in groups from the dentine-enamel junction; the crystals are slender, elongate spicules perpendicular to the surface of the tooth plate, Similar crystal arrangements to those of lungfish are found in other vertebrates, but none resembles the organisation of the hyaline tissue of conodont elements, The crystals of hydroxyapatite in conodont hyaline tissue are exceptionally large, perpendicular or parallel to the surface of the element, with no trace of prisms, unlike the protoprismatic radial crystallite enamel of fish teeth and scales, or the highly organised prismatic enamel of mammals.

Growth and hard tissue remodelling in the dentition of the Australian lungfish, Neoceratodus forsteri (Osteichthyes: Dipnoi)

The extant lungfish, including three genera, the Australian, South American and African lungfishes, retain a dentition that appeared first in the Devonian, in some of the oldest members of this group. The dentition consists of permanent tooth plates with persistent cusps that appear early in development of the fish. The cusps, separate early in development, form ridges that are arranged in a radiating pattern, and fusion of the cusps to each other and to the underlying jaw bone produces a tooth plate. The lungfish dentition is based on a template of mantle dentine that surrounds bone trabeculae enclosed in the tooth plate. The mantle layer is covered by enamel. In most derived dipnoans, this framework encloses two further forms of dentine, known as interdenteonal and circumdenteonal dentines. The tooth plates grow in area and in depth without evidence of macroscopic resorption of dentines or of enamel. Increase in size and changes in shape of lungfish tooth plates is actually achieved by a process involving microscopic remodelling of the bone contained within the margin of each tooth plate, and the later addition of new dentines and enamel within and around the bone. This is accomplished without creating weakness in the structural integrity of the tooth plate and bone complex, and proceeds in line with growth and remodelling of the jaw bones attached to the tooth plates.

A comparison of Kodak Ultraspeed and Ektaspeed Plus dental X-ray films for the detection of dental caries

Background: Using the fastest dental X-ray film available is an easy way of reducing exposure to ionizing radiation. However, the diagnostic ability of fast films for the detection of proximal surface caries must be demonstrated before these films will become universally accepted. Methods: Extracted premolar and molar teeth were arranged to simulate a bitewing examination and radiographed using Ultraspeed and Ektaspeed Plus dental X-ray films. Three different exposure times were used for each film type. Six general dentists were used to determine the presence and depth of the decay in the proximal surfaces of the teeth radiographed. The actual extent of the decay in the teeth was determined by sectioning the teeth and examining them under a microscope. Results: There was no significant difference between the two films for the mean correct diagnosis. However, there was a significant difference between the means for the three exposure times used for Ultraspeed film. The practitioners used were not consistent in their ability to make a correct diagnosis, or for the film for which they got the highest correct diagnosis. Conclusions: Ektaspeed Plus dental X-ray film is just as reliable as Ultraspeed dental X-ray film for the detection of proximal surface decay. The effect of underexposure was significant for Ultraspeed, but not for Ektaspeed Plus. Patient exposure can be reduced significantly with no loss of diagnostic ability by changing from Ultraspeed X-ray film to Ektaspeed Plus X-ray film.

Testicular myxosporidiasis in anurans, with a description of Myxobolus fallax n. sp.

During studies of amphibian sperm cryopreservation, a new species of myxosporidean parasite (Myxozoa, Myxosporae) was observed in the testes of the Australian dwarf green tree frog Litoria fallax (Peters). Myxosporidiasis was found to have no affect on L. fallax body condition or sperm numbers. Myxobolus spores from L. fallax are morphologically distinct from Myxobolus hylae spores (infecting the sympatric Litoria aurea Lesson) and the three previously named (exotic to Australia) Myxobolus species found in anurans. Myxobolus fallax n. sp. is characterised by: pseudocyst white, spherical to ovoid, 141 x74 to 438 x337 mum in diameter (mature); plasmodium with spores loosely arranged within interior. Spores ovoid 13.4 +/- 0.5 (12.6-14.6) mum length, 9.5 +/- 0.4 (8.3-10.6) mum width, 6.8 +/- 0.4 (6.5-7.6) mum depth, 1.4 +/- 0.1 (1.3-1.6) length/width; polar capsules broadly pyriform and equal in size 4.2 +/- 0.3 (3.3-4.7) mum length, 2.4 +/- 0.2 (2.1-2.8) mum width; filament coils 7-8, wound tightly and perpendicular to the longitudinal axis of the capsule; polar filament 34 +/- 7.0 (18-50) mum length; intercapsular appendix and sutural ridge folds absent; and iodinophilous vacuole and mucous envelope lacking. In addition to this new species, data from archival samples of M. hylae are provided which show two morphologically distinct spore types. Both appeared rarely in the same pseudocysts and we cautiously retain the single species.

Two-dimensional balanced sampling plans excluding contiguous units

A balanced sampling plan excluding contiguous units (or BSEC for short) was first introduced by Hedayat, Rao and Stufken in 1988. These designs can be used for survey sampling when the units are arranged in one-dimensional ordering and the contiguous units in this ordering provide similar information. In this paper, we generalize the concept of a BSEC to the two-dimensional situation and give constructions of two-dimensional BSECs with block size 3. The existence problem is completely solved in the case where lambda = 1.

Empirical evidence for ultrametric structure in multi-layer perceptron error surfaces

Combinatorial optimization problems share an interesting property with spin glass systems in that their state spaces can exhibit ultrametric structure. We use sampling methods to analyse the error surfaces of feedforward multi-layer perceptron neural networks learning encoder problems. The third order statistics of these points of attraction are examined and found to be arranged in a highly ultrametric way. This is a unique result for a finite, continuous parameter space. The implications of this result are discussed.

Discovery and structures of the cyclotides: novel macrocyclic peptides from plants

Circular disulfide-rich polypeptides were unknown a decade ago but over recent years a large family of such molecules has been discovered, which we now refer to as the cyclotides. They are typically about 30 amino acids in size, contain an N- to C-cyclised backbone and incorporate three disulfide bonds arranged in a cystine knot motif. In this motif, an embedded ring in the structure formed by two disulfide bonds and their connecting backbone segments is penetrated by the third disulfide bond. The combination of this knotted and strongly braced structure with a circular backbone renders the cyclotides impervious to enzymatic breakdown and makes them exceptionally stable. This article describes the discovery of the cyclotides in plants from the Rubiaceae and Violaceae families, their chemical synthesis, folding, structural characterisation, and biosynthetic origin. The cyclotides have a diverse range of biological applications, ranging from uterotonic action, to anti-HIV and neurotensin antagonism. Certain plants from which they are derived have a history of uses in native medicine, with activity being observed after oral ingestion of a tea made from the plants. This suggests the possibility that the cyclotides may be orally bioavailable. They therefore have a range of potential applications as a stable peptide framework.

Overlarge sets of 2-(11, 5, 2) designs and related configurations

We consider the construction of several configurations, including: • overlarge sets of 2-(11,5,2) designs, that is, partitions of the set of all 5-subsets of a 12-set into 72 2-(11,5,2) designs; • an indecomposable doubly overlarge set of 2-(11,5,2) designs, that is, a partition of two copies of the set of all 5-subsets of a 12-set into 144 2-(11,5,2) designs, such that the 144 designs can be arranged into a 12 × 12 square with interesting row and column properties; • a partition of the Steiner system S(5,6,12) into 12 disjoint 2-(11,6,3) designs arising from the diagonal of the square; • bidistant permutation arrays and generalized Room squares arising from the doubly overlarge set, and their relation to some new strongly regular graphs.

Influence of synthesis parameters on the formation of mesoporous SAPOs

The synthesis and characterization of high-quality mesoporous silicoaluminophosphates (SAPOs) with a hexagonally arranged pore structure and a good thermal stability are described. The influence of some important synthesis parameters including temperature, time, and Si content in the synthesis gel was examined. The local environments of Al, P, and Si were investigated using MAS NMR spectroscopy. The acidity of the mesoporous SAPOs was studied and compared with those of aluminosilicate MCM-41 and SAPO-5. Results show that both the synthesis temperature and time have a significant impact on the formation of mesoporous SAPOs, whereas the presence of Si in the synthesis gel has a direct influence on the structure type and the quality of the resulting mesoporous SAPO materials. High-quality mesoporous SAPOs can be synthesized from the synthesis gels with Si/Al ratio smaller than 0.5 in the presence of cationic surfactants in a weakly basic aqueous solution. The mesoporous SAPO materials show interesting acidity properties, possessing both strong and mild sites. (C) 2002 Elsevier Science Inc. All rights reserved.

General practitioner attitudes to case conferences: how can we increase participation and effectiveness?

Objectives: To identify general practitioners' views on the barriers to using case conferencing (as outlined in the Medical Benefits Schedule (MBS) Enhanced Primary Care package) and to develop a set of principles to encourage greater GP participation in case conferences. Design: Qualitative study, involving semistructured questions administered to focus groups of GPs, conducted between April and July 2001 as part of a broader study of case coordination in palliative care. Participants: 29 GPs from urban, regional, and rural areas of Queensland. Principal findings: Many of the GPs' work practices militated against participation in traditionally structured case conferences. GPs thought the range of MBS item numbers should be expanded to cover alternative methods of liaison (eg, phone consultations with other service providers). The onerous bureaucratic processes required to claim reimbursement were an additional disincentive. Conclusions: GPs would probably be more likely to participate in case conferences if they were initiated by specialist services and arranged more flexibly to suit GP work schedules.

Solution Structures of the cis- and trans-Pro30 Isomers of a Novel 38-Residue Toxin from the Venom of Hadronyche Infensa sp. that Contains a Cystine-Knot Motif within Its Four Disulfide Bonds

The primary sequence and three-dimensional structure of a novel peptide toxin isolated from the Australian funnel-web spider Hadronyche infensa sp. is reported. ACTX-HI:OB4219 contains 38 amino acids, including eight-cysteine residues that form four disulfide bonds. The connectivities of these disulfide bonds were previously unknown but have been unambiguously determined in this study. Three of these disulfide bonds are arranged in an inhibitor cystine-knot (ICK) motif, which is observed in a range of other disulfide-rich peptide toxins. The motif incorporates an embedded ring in the structure formed by two of the disulfides and their connecting backbone segments penetrated by a third disulfide bond. Using NMR spectroscopy, we determined that despite the isolation of a single native homologous product by RP-HPLC, ACTX-HI:OB4219 possesses two equally populated conformers in solution. These two conformers were determined to arise from cis/trans isomerization of the bond preceding Pro30. Full assignment of the NMR spectra for both conformers allowed for the calculation of their structures, revealing, the presence of a triple-stranded antiparallel sheet consistent with the inhibitor cystine-knot (ICK) motif.

An electromagnetic-field method modeling of a radial line planar antenna with coupling probes

This communications describes an electromagnetic model of a radial line planar antenna consisting of a radial guide with one central probe and many peripheral probes arranged in concentric circles feeding an array of antenna elements such as patches or wire curls. The model takes into account interactions between the coupling probes while assuming isolation of radiating elements. Based on this model, computer programs are developed to determine equivalent circuit parameters of the feed network and the radiation pattern of the radial line planar antenna. Comparisons are made between the present model and the two-probe model developed earlier by other researchers.

Trichostome ciliates from Australian marsupials. III. Megavestibulum gen. nov. (Litostomatea : Macropodiniidae)

A new macropodiniid ciliate genus, Megavestibulum, is described which is endocommensal in the stomach of macropodid marsupials. Two new species, M. morganorum and M. kuhri, are described from Macropus dorsalis and Wallabia, bicolor respectively. Megavestibulum is holotrichous, the somatic ciliation arranged into meridional, curving kineties between broad ridges. The interkinetal ridges are lined apically by thick-walled vacuoles similar to those lining the longitudinal grooves of Macropodinium. The conical vestibulum is apical and very large, occupying up to 1/3 of the cell volume. The vestibular lip appears closable and has a cleft which may allow distention of the vestibullum to ingest large food items. The vestibular ultrastructure is similar to that of Macropodinium including the presence of vestibular vacuoles and the hemispherical differentiation of the distribution of small nematodesmata. Many specimens contained ingested whole ciliates of the genera Amylovorax and Polycosta. The structure of the vestibulum suggests that Megavestibulum is adapted for life as an active predator of other stomach ciliates as well as sweeping in small particulates. The morphology of Megavestibulum suggests that it represents the plesiomorphic body plan within the family Macropodiniidae.

Trichostome ciliates from Australian marsupials. I. Bandia gen nov (Litostomatea : Amylovoracidae)

A new genus of amylovoracid ciliates, Bandia gen.nov., is described. They are endosymbiotic/endocommensal in the stomachs of macropodid marsupials. Six new species, B. beveridgei, B. equimontanensis, B. tammar, B. deveneyi, B. cribbi and B. smalesae, are described from Setonix brachyurus, Petrogale assimilis, Macropus eugenii, M. robustus, M. parryi and M. agilis respectively. The gross morphology of Bandia is similar to that of Bitricha, with holotrichous somatic ciliation in two fields, longitudinal dorsal and oblique ventral. The somatic kineties are arranged in groups between non-ciliated. major interkinetal ridges; the groups of kineties thus give the cell a banded appearance. Several species are bimorphic, one form holotrichous and the other with a glabrous right body groove which appears to be derived from an ingrowth of one of the major interkinetal ridges. The groove may function in attachment either in sequestration or conjugation. The ultrastructure of the somatic kineties and the oral structures is similar to that of Amylovorax. Bandia also has unique ultrastructural features associated with the major interkinetal ridges, right body groove and a karyophore. Morphological evolution within the Amylovoracidae may have proceeded from simple forms such as Amylovorax via a process of cellular torsion and/or oral migration to forms similar to Bitricha and by further torsion and cellular elaboration to Bandia.