Clostridium bolteae sp. nov., isolated from human sources

Seven obligately anaerobic, gram-positive, rod-shaped, spore-forming organisms isolated from human sources were characterized using phenotypic and molecular taxonomic methods. Comparative 16S rRNA gene sequencing showed that the strains were genetically highly related to each other (displaying >99% sequence similarity) and represent a previously unknown sub-line within the Clostridium coccoides rRNA group of organisms. Strains of the unidentified bacterium used carbohydrate as fermentable substrates, producing acetic acid and lactic acid as the major products of glucose metabolism. The closest described species to the novel bacterium corresponded to Clostridium clostridioforme, although a 16S rRNA sequence divergence of 3% demonstrated they represent different species. Genomic DNA-DNA pairing studies confirmed the separateness of the unknown species and Clostridium clostridioforme. Based on phenotypic and phylogenetic evidence, it is therefore proposed that the unknown bacterium, be classified as Clostridium bolteae sp. nov. The type strain of Clostridium bolteae is WAL 16351(T) (= ATCC(T) = BAA-613(T), CCUG(T) = 46953(T)).

Consistently inconsistent: commercially available starch-based Dysphagia products

Individuals with dysphagia may be prescribed thickened fluids to promote a safer and more successful swallow. Starch-based thickening agents are often employed; however, these exhibit great variation in consistency. The aim of this study was to compare viscosity and the rheological profile parameters complex (G*), viscous (G″), and elastic modulus (G′) over a range of physiological shear rates. UK commercially available dysphagia products at “custard” consistency were examined. Commercially available starch-based dysphagia products were prepared according to manufacturers’ instructions; the viscosity and rheological parameters were tested on a CVOR Rheometer. At a measured shear rate of 50 s−1, all products fell within the viscosity limits defined according to the National Dysphagia Diet Task Force guidelines. However, at lower shear rates, large variations in viscosity were observed. Rheological parameters G*, G′, and G″ also demonstrated considerable differences in both overall strength and rheological behavior between different batches of the same product and different product types. The large range in consistency and changes in the overall structure of the starch-based products over a range of physiological shear rates show that patients could be receiving fluids with very different characteristics from that advised. This could have detrimental effects on their ability to swallow.

Lack of association between central adiposity and lipaemia in UK Sikh men

OBJECTIVE: To determine whether the positive statistical associations between measures of total and regional adiposity and measures of glucose, insulin and triacylglycerol ( TAG) metabolism reported in Caucasian men, are also observed in UK Sikhs. DESIGN: A matched cross-sectional study in which each volunteer provided a blood sample after a 12-h overnight fast and had anthropometric measurements taken. SUBJECTS: A total of 55 healthy Caucasian and 55 healthy UK Sikh men were recruited. The Caucasian and Sikh men were matched for age ( 48.7 +/- 10.9 and 48.3 +/- 10.0 y, respectively) and body mass index (BMI) ( 26.1 +/- 2.8 and 26.3 +/- 3.2 kg/m(2), respectively). MEASUREMENTS: Anthropometric measurements were performed to assess total and regional fat depots. The concentrations of plasma total cholesterol, high-density cholesterol (HDL- C), low-density cholesterol (LDL-C) and small dense LDL (LDL3), TAG, glucose, fasting insulin (ins) and nonesterified fatty acids (NEFA) were analysed in fasted plasma. Surrogate measures of insulin resistance (HOMA-IR) and insulin sensitivity (RQUICKI) were calculated from insulin and glucose (HOMA-IR) and insulin, glucose and NEFA ( RQUICKI) measurements. RESULTS: The Sikh men had significantly higher body fat, with the sum of the four skinfold measurements (Ssk) ( P = 0.0001) and subscapular skinfold value (P = 0.009) higher compared with the Caucasian men. The Sikh volunteers also had characteristics of the metabolic syndrome: lower HDL-C (P = 0.07), higher TAG (P = 0.004), higher % LDL3 (P = 0.0001) and insulin resistance (P = 0.05). Both ethnic groups demonstrated positive correlations between insulin and waist circumference (Caucasian: r = 0.661, P = 0.0001; Sikh: r = 0.477, P = 0.0001). The Caucasian men also demonstrated significant positive correlations between central adiposity (r = 0.275, P = 0.04), other measures of adiposity (BMI and suprailiac skinfold) and plasma TAG, whereas the Sikh men showed no correlation for central adiposity (r = 0.019, ns) and TAG with a trend to a negative relationship between other measures ( Ssk and suprailiac) which reached near significance for subscapular skinfold and TAG (r = - 0.246, P = 0.007). The expected positive association between insulin and TAG was observed in the Caucasian men (r = 0.318, P = 0.04) but not in the Sikh men (r = 0.011, ns). CONCLUSIONS: In the Caucasian men, the expected positive association between plasma TAG and centralized body fat was observed. However, a lack of association between centralized, or any other measure of adiposity, and plasma TAG was observed in the matched Sikh men, although both ethnic groups showed the positive association between centralized body fat and insulin resistance, which was less strong for Sikhs. These findings in the Sikh men were not consistent with the hypothesis that there is a clear causal relationship between body fat and its distribution, insulin resistance, and lipid abnormalities associated with the metabolic syndrome, in this ethnic group.

Deficient acquisition and consolidation: intertrial free recall performance in Alzheimer's disease and mild cognitive impairment

Previous research demonstrates that dementia of the Alzheimer type (DAT) is characterised by deficits of episodic memory, especially in the acquisition of new material. As well as this deficit in acquisition, some researchers have also argued for a deficit in consolidation in DAT. We examined acquisition and consolidation by measuring the intertrial gained and lost access in DAT, Mild Cognitive Impairment (MCI) and controls. We report findings from a study of clinical data based on assessment of patients using three free recall trials of a word list. We found that both DAT and MCI groups showed a deficit in acquisition and consolidation of items between trials relative to controls. Moreover, the DAT group was significantly impaired relative to the MCI group for both acquisition and consolidation. Correlations within each group showed that there were strong relationships between intertrial measures and standard measures of memory function. Importantly in no group was there a significant correlation between our measures of acquisition and consolidation: we argue that these measures reflect different underlying processes, and the failure to consolidate in DAT and MCI is not related to the deficit in acquisition. Finally, we showed strong correlations between our measure and dementia severity, suggesting that acquisition and consolidation both get worse as the dementia progresses.

Patients' understanding of risk associated with medication use: impact of European Commission guidelines and other risk scales

Patients want and need comprehensive and accurate information about their medicines so that they can participate in decisions about their healthcare: In particular, they require information about the likely risks and benefits that are associated with the different treatment options. However, to provide this information in a form that people can readily understand and use is a considerable challenge to healthcare professionals. One recent attempt to standardise the Language of risk has been to produce sets of verbal descriptors that correspond to specific probability ranges, such as those outlined in the European Commission (EC) Pharmaceutical Committee guidelines in 1998 for describing the incidence of adverse effects. This paper provides an overview of a number of studies involving members of the general public, patients, and hospital doctors, that evaluated the utility of the EC guideline descriptors (very common, common, uncommon, rare, very rare). In all studies it was found that people significantly over-estimated the likelihood of adverse effects occurring, given specific verbal descriptors. This in turn resulted in significantly higher ratings of their perceived risks to health and significantly lower ratings of their likelihood of taking the medicine. Such problems of interpretation are not restricted to the EC guideline descriptors. Similar levels of misinterpretation have also been demonstrated with two other recently advocated risk scales (Caiman's verbal descriptor scale and Barclay, Costigan and Davies' lottery scale). In conclusion, the challenge for risk communicators and for future research will be to produce a language of risk that is sufficiently flexible to take into account different perspectives, as well as changing circumstances and contexts of illness and its treatments. In the meantime, we urge the EC and other legislative bodies to stop recommending the use of specific verbal labels or phrases until there is a stronger evidence base to support their use.

Power properties if invariant tests for spatial autocorrelation in linear regression

This paper derives some exact power properties of tests for spatial autocorrelation in the context of a linear regression model. In particular, we characterize the circumstances in which the power vanishes as the autocorrelation increases, thus extending the work of Krämer (2005). More generally, the analysis in the paper sheds new light on how the power of tests for spatial autocorrelation is affected by the matrix of regressors and by the spatial structure. We mainly focus on the problem of residual spatial autocorrelation, in which case it is appropriate to restrict attention to the class of invariant tests, but we also consider the case when the autocorrelation is due to the presence of a spatially lagged dependent variable among the regressors. A numerical study aimed at assessing the practical relevance of the theoretical results is included

Al-Qaeda - terrorists, hypocrites, fundamentalists? The view from within

This article investigates the ideology of Al-Qaeda as perceived from within the network. Particular attention is paid to the ideological background of Al-Qaeda's intellectual leadership, its sociopolitical context and the nature of its recruits. The inner logic of the Al-Qaeda organisation advances an intellectual concept that is not based on the main schools of Islamic theology, but on a new ideological starting point that results from the application of Islamic principles to sociopolitical change. With its political goals reinforced by the teachings of the Quran, exemplified by the content and rhetoric of a recently discovered training manual, the organisation creates powerful imagery embedded in the collective consciousness of the Muslim community. Thus, the message provided by Al-Qaeda inspires its followers to commit violent acts of destruction while being fully convinced that they are fulfilling the ordained will of Allah.