What is the best size descriptor to use for pharmacokinetic studies in the obese?

The prevalence of obesity in the western world is dramatically rising, with many of these individuals requiring therapeutic intervention for a variety of disease states. Despite the growing prevalence of obesity there is a paucity of information describing how doses should be adjusted, or indeed whether they need to be adjusted, in the clinical setting. This review is aimed at identifying which descriptors of body size provide the most information about the relationship between dose and concentration in the obese. The size descriptors, weight, lean body weight, ideal body weight, body surface area, body mass index, fat-free mass, percent ideal body weight, adjusted body weight and predicted normal body weight were considered as potential size descriptors. We conducted an extensive review of the literature to identify studies that have assessed the quantitative relationship between the parameters clearance (CL) and volume of distribution (V) and these descriptors of body size. Surprisingly few studies have addressed the relationship between obesity and CL or V in a quantitative manner. Despite the lack of studies there were consistent findings: (i) most studies found total body weight to be the best descriptor of V. A further analysis of the studies that have addressed V found that total body weight or another descriptor that incorporated fat mass was the preferred descriptor for drugs that have high lipophilicity; (ii) in contrast, CL was best described by lean body mass and no apparent relationship between lipophilicity or clearance mechanism and preference for body size descriptor was found. In conclusion, no single descriptor described the influence of body size on both CL and V equally well. For drugs that are dosed chronically, and therefore CL is of primary concern, dosing for obese patients should not be based on their total weight. If a weight-based dose individualization is required then we would suggest that chronic drug dosing in the obese subject should be based on lean body weight, at least until a more robust size descriptor becomes available.

A standard weight descriptor for dose adjustment in the obese patient

Objective: To develop a standard weight descriptor that can be used for estimation of patient size for obese patients. Patients and methods: Data were available from 3849 patients: 2839 from oncology patients (index data set) and 1010 from general medical patients (validation data set). The patients had a wide range of age (16-100 years), weight (25-165kg) and body mass index (BMI) [12-52 kg/m(2)] in both data sets. From the normal-weight patients in the oncology data set, an equation for male and female patients was developed to predict their normal weight as the sum of the lean body mass and normal fat body mass. The equations were evaluated by predicting the weight of patients in the general medical data set who had a normal BMI (30 kg/m(2)).

Inflatable rescue boat-related injuries in Queensland surf lifesavers: The epidemiology - biomechanics interface

The objective was to describe the relationship between epidemiological and biomechanical factors in the causal pathway of inflatable rescue boat (IRB)-related injuries in Australian surf lifesavers; to develop epidemiological and biomechanical methodologies and measurement instruments that identify and measure the risk factors, for use in future epidemiological studies. Epidemiological and biomechanical models of injury causation were combined. Host, agent and environmental factors that influenced total available force for transfer to host were specified. Measurement instruments for each of the specified risk factors were developed. Instruments were piloted in a volunteer sample of surf lifesavers. Participant characteristics were recorded using demographic questionnaires; IRB operating techniques were recorded using a custom-made on-board camera (Grand RF-Guard) and images of operating techniques were coded by two independent observers. Ground reaction forces transmitted to the host through the lifesaver's feet at the time of wave impact were measured using a custom-built piezoelectric force platform. The demographic questionnaire was found practical; the on-board camera functioned successfully within the target environment. Agreement between independent coders of IRB operating technique images was significant (p < 0.001) with Kappa values ranging from 0.5 to 0.7. Biomechanical instruments performed successfully in the target environment. Peak biomechanical forces were 415.6N (left foot) and 252.9N (right foot). This study defines the relationship between epidemiological and biomechanical factors in modifying the risk of IRB-related injury in a population of surf lifesavers. Preliminary feasibility of combining epidemiological and biomechanical information has been demonstrated. Further testing of the proposed model and measurement instruments is required.

Quantification of lean bodyweight

Background: Lean bodyweight (LBW) has been recommended for scaling drug doses. However, the current methods for predicting LBW are inconsistent at extremes of size and could be misleading with respect to interpreting weight-based regimens. Objective: The objective of the present study was to develop a semi-mechanistic model to predict fat-free mass (FFM) from subject characteristics in a population that includes extremes of size. FFM is considered to closely approximate LBW. There are several reference methods for assessing FFM, whereas there are no reference standards for LBW. Patients and methods: A total of 373 patients (168 male, 205 female) were included in the study. These data arose from two populations. Population A (index dataset) contained anthropometric characteristics, FFM estimated by dual-energy x-ray absorptiometry (DXA - a reference method) and bioelectrical impedance analysis (BIA) data. Population B (test dataset) contained the same anthropometric measures and FFM data as population A, but excluded BIA data. The patients in population A had a wide range of age (18-82 years), bodyweight (40.7-216.5kg) and BMI values (17.1-69.9 kg/m(2)). Patients in population B had BMI values of 18.7-38.4 kg/m(2). A two-stage semi-mechanistic model to predict FFM was developed from the demographics from population A. For stage 1 a model was developed to predict impedance and for stage 2 a model that incorporated predicted impedance was used to predict FFM. These two models were combined to provide an overall model to predict FFM from patient characteristics. The developed model for FFM was externally evaluated by predicting into population B. Results: The semi-mechanistic model to predict impedance incorporated sex, height and bodyweight. The developed model provides a good predictor of impedance for both males and females (r(2) = 0.78, mean error [ME] = 2.30 x 10(-3), root mean square error [RMSE] = 51.56 [approximately 10% of mean]). The final model for FFM incorporated sex, height and bodyweight. The developed model for FFM provided good predictive performance for both males and females (r(2) = 0.93, ME = -0.77, RMSE = 3.33 [approximately 6% of mean]). In addition, the model accurately predicted the FFM of subjects in population B (r(2) = 0.85, ME -0.04, RMSE = 4.39 [approximately 7% of mean]). Conclusions: A semi-mechanistic model has been developed to predict FFM (and therefore LBW) from easily accessible patient characteristics. This model has been prospectively evaluated and shown to have good predictive performance.

Tourists and beach safety in Queensland, Australia

Surf Life Saving Queensland (SLSQ) is a leading authority on beach safety, providing patrol, education, and rescue services to both tourists and local residents along the coast of Queensland, Australia. SLSQ recognizes that tourists are a target group requiring special attention due to their unfamiliarity with ocean beaches and surfing activities, and in some cases having the additional challenge of poor swimming skills, language barriers, and disorientation in a foreign vacation environment. This article describes SLSQ initiatives to provide beach safety for tourists through a focus on service delivery and partnerships with the tourism industry and relevant government agencies. The positive involvement of SLSQ in tourism is a model for other coastal destinations, given that drowning is the second most frequent cause of injury death among international travelers.

Large scale experiments on gravel and mixed beaches: Experimental procedure, data documentation and initial results

This paper provides information on the experimental set-up, data collection methods and results to date for the project Large scale modelling of coarse grained beaches, undertaken at the Large Wave Channel (GWK) of FZK in Hannover by an international group of researchers in Spring 2002. The main objective of the experiments was to provide full scale measurements of cross-shore processes on gravel and mixed beaches for the verification and further development of cross-shore numerical models of gravel and mixed sediment beaches. Identical random and regular wave tests were undertaken for a gravel beach and a mixed sand/gravel beach set up in the flume. Measurements included profile development, water surface elevation along the flume, internal pressures in the swash zone, piezometric head levels within the beach, run-up, flow velocities in the surf-zone and sediment size distributions. The purpose of the paper is to present to the scientific community the experimental procedure, a summary of the data collected, some initial results, as well as a brief outline of the on-going research being carried out with the data by different research groups. The experimental data is available to all the scientific community following submission of a statement of objectives, specification of data requirements and an agreement to abide with the GWK and EU protocols. (C) 2005 Elsevier B.V. All rights reserved.

Developmental Pathways in Microcerotermes turneri (Termitidae: Termitinae): Biometric Descriptors of Worker Caste and Instar

The foraging process of location and exploitation of food in complex termite societies is in part reliant upon unequal division of specific tasks amongst its members (polyethism). To conduct studies assessing the role of individuals in foraging activities it is necessary to have descriptors of worker caste and instar. Here we provide biometric descriptors of specific caste and instar for worker caste and instars of Microcerotermes turneri (Froggatt) (Termitidae: Termitinae) for the worker castes (male and female) for the identification of individuals in laboratory assays applicable across multiple nests. The use of head width for determining sex of workers was successful across multiple nests. The length of the first three flagellum segments of the antenna and tibia three could be used to determine worker instar.

Long wave generation by the shoaling and breaking of transient wave groups on a beach

This paper presents new laboratory data on the generation of long waves by the shoaling and breaking of transient-focused short-wave groups. Direct offshore radiation of long waves from the breakpoint is shown experimentally for the first time. High spatial resolution enables identification of the relationship between the spatial gradients of the short-wave envelope and the long-wave surface. This relationship is consistent with radiation stress theory even well inside the surf zone and appears as a result of the strong nonlinear forcing associated with the transient group. In shallow water, the change in depth across the group leads to asymmetry in the forcing which generates significant dynamic setup in front of the group during shoaling. Strong amplification of the incident dynamic setup occurs after short-wave breaking. The data show the radiation of a transient long wave dominated by a pulse of positive elevation, preceded and followed by weaker trailing waves with negative elevation. The instantaneous cross-shore structure of the long wave shows the mechanics of the reflection process and the formation of a transient node in the inner surf zone. The wave run-up and relative amplitude of the radiated and incident long waves suggests significant modification of the incident bound wave in the inner surf zone and, the dominance of long waves generated by the breaking process. It is proposed that these conditions occur when the primary short waves and bound wave are not shallow water waves at the breakpoint. A simple criterion is given to determine these conditions, which generally occur for the important case of storm waves.

Taxonomy of Australian Funnel-web spiders using rp-HPLC/ESI-MS profiling techniques

The complex nature of venom from spider species offers a unique natural source of potential pharmacological tools and therapeutic leads. The increased interest in spider venom molecules requires reproducible and precise identification methods. The current taxonomy of the Australian Funnel-web spiders is incomplete, and therefore, accurate identification of these spiders is difficult. Here, we present a study of venom from numerous morphologically similar specimens of the Hadronyche infensa species group collected from a variety of geographic locations in southeast Queensland. Analysis of the crude venoms using online reversed-phase high performance liquid chromatography/electrospray ionisation mass spectrometry (rp-HPLC/ESI-MS) revealed that the venom profiles provide a useful means of specimen identification, from the species level to species variants. Tables defining the descriptor molecules for each group of specimens were constructed and provided a quick reference of the relationship between one specimen and another. The study revealed that the morphologically similar specimens from the southeast Queensland region are a number of different species/species variants. Furthermore, the study supports aspects of the current taxonomy with respect to the H. infensa species group. Analysis of Australian Funnel-web spider venom by rp-HPLC/ESI-MS provides a rapid and accurate method of species/species variant identification. (c) 2006 Elsevier Ltd. All rights reserved.

Testing the niche apportionment hypothesis with parasite communities: is random assortment always the rule?

Niche apportionment models have only been applied once to parasite communities. Only the random assortment model (RA), which indicates that species abundances are independent from each other and that interspecific competition is unimportant, provided a good fit to 3 out of 6 parasite communities investigated. The generality of this result needs to be validated, however. In this study we apply 5 niche apportionment models to the parasite communities of 14 fish species from the Great Barrier Reef. We determined which model fitted the data when using either numerical abundance or biomass as an estimate of parasite abundance, and whether the fit of niche apportionment models depends on how the parasite community is defined (e.g. ecto, endoparasites or all parasites considered together). The RA model provided a good fit for the whole community of parasites in 7 fish species when using biovolume (as a surrogate of biomass) as a measure of species abundance. The RA model also fitted observed data when ecto- and endoparasites were considered separately, using abundance or biovolume, but less frequently. Variation in fish sizes among species was not associated with the probability of a model fitting the data. Total numerical abundance and biovolume of parasites were not related across host species, suggesting that they capture different aspects of abundance. Biovolume is not only a better measurement to use with niche-orientated models, it should also be the preferred descriptor to analyse parasite community structure in other contexts. Most of the biological assumptions behind the RA model, i.e. randomness in apportioning niche space, lack of interspecific competition, independence of abundance among different species, and species with variable niches in changeable environments, are in accordance with some previous findings on parasite communities. Thus, parasite communities may generally be unsaturated with species, with empty niches, and interspecific interactions may generally be unimportant in determining parasite community structure.

Drifting blooms of the endemic filamentous brown alga Hincksia sordida at Noosa on the subtropical east Australian coast

Since 2002, the usually uncommon endemic filamentous brown alga Hincksia sordida (Harvey) Silva (Ectocarpales, Phaeophyta) has formed nuisance blooms annually during spring/early summer at Main Beach, Noosa on the subtropical east Australian coast. The Hincksia bloom coincides with the normally intensive recreational use of the popular bathing beach by the local population and tourists. The alga forms dense accumulations in the surf zone at Main Beach, giving the seawater a distinct brown coloration and deterring swimmers from entering the water. Decomposing algae stranded by receding tides emit a nauseating sulphurous stench which hangs over the beach. The stranded algal biomass is removed from the beach by bulldozers. During blooms, the usually crowded Main Beach is deserted, bathers preferring to use the many unaffected beaches on the Sunshine Coast to the south of Main Beach. The bloom worsens with north-easterly winds and is cleared from Noosa by south easterly winds, observations which have prompted the untenable proposal by local authorities that the bloom is forming offshore of Fraser Island in the South Pacific Ocean. The Noosa River estuarine system/Laguna Bay is the more probable source of the bloom and the nutrient inputs into this system must be substantial to generate the high bloom biomass. Current mitigation procedures of removing the blooming alga off the beach with bulldozers treat the symptom, not the cause and are proving ineffective. Environmental management must be based on science and the Noosa bloom would benefit greatly from the accurate ecological data on which to base management options. (c) 2006 Elsevier Ltd. All rights reserved.

Beach face and berm morphodynamics fronting a coastal lagoon

This study documents two different modes of berm development: (I) vertical growth at spring tides or following significant beach cut due to substantial swash overtopping, and (2) horizontal progradation at neap tides through the formation of a proto-berm located lower and further seaward of the principal berm. Concurrent high-frequency measurements of bed elevation and the associated wave runup distribution reveal the details of each of these berm growth modes. In mode I sediment is eroded from the inner surf and lower swash zone where swash interactions are prevalent. The net transport of this sediment is landward only, resulting in accretion onto the upper beach face and over the berm crest. The final outcome is a steepening of the beach face gradient, a change in the profile shape towards concave and rapid vertical and horizontal growth of the berm. In mode 2 sediment is eroded from the lower two-thirds of the active swash zone during the rising tide and is transported both landward and seaward. On the falling tide sediment is eroded from the inner surf and transported landward to backfill the zone eroded on the rising tide. The net result is relatively slow steepening of the beach face, a change of the profile shape towards convex, and horizontal progradation through the formation of a neap berm. The primary factor determining which mode of berm growth occurs is the presence or absence of swash overtopping at the time of sediment accumulation on the beach face. This depends on the current phase of the spring-neap tide cycle, the wave runup height (and indirectly offshore wave conditions) and the height of the pre-existing berm. A conceptual model for berm morphodynamics is presented, based on sediment transport shape functions measured during the two modes of berm growth. (c) 2006 Elsevier B.V. All rights reserved.