Comparison of high sensitivity troponin T and I assays in the diagnosis of non-ST elevation acute myocardial infarction in emergency patients with chest pain

Objectives: Concentrations of troponin measured with high sensitivity troponin assays are raised in a number of emergency department (ED) patients; however many are not diagnosed with acute myocardial infarction (AMI). Clinical comparisons between the early use (2 h after presentation) of high sensitivity cardiac troponin T (hs-cTnT) and I (hs-cTnI) assays for the diagnosis of AMI have not been reported. Design and methods: Early (0 h and 2 h) hs-cTnT and hs-cTnI assay results in 1571 ED patients with potential acute coronary syndrome (ACS) without ST elevation on electrocardiograph (ECG) were evaluated. The primary outcome was diagnosis of index MI adjudicated by cardiologists using the local cTnI assay results taken ≥6 h after presentation, ECGs and clinical information. Stored samples were later analysed with hs-cTnT and hs-cTnI assays. Results: The ROC analysis for AMI (204 patients; 13.0%) for hs-cTnT and hs-cTnI after 2 h was 0.95 (95% CI: 0.94–0.97) and 0.98 (95% CI: 0.97–0.99) respectively. The sensitivity, specificity, PLR, and NLR of hs-cTnT and hs-cTnI for AMI after 2 h were 94.1% (95% CI: 90.0–96.6) and 95.6% (95% CI: 91.8–97.7), 79.0% (95% CI: 76.8–81.1) and 92.5% (95% CI: 90.9–93.7), 4.48 (95% CI: 4.02–5.00) and 12.86 (95% CI: 10.51–15.31), and 0.07 (95% CI: 0.04–0.13) and 0.05 (95% CI:0.03–0.09) respectively. Conclusions: Exclusion of AMI 2 h after presentation in emergency patients with possible ACS can be achieved using hs-cTnT or hs-cTnI assays. Significant differences in specificity of these assays are relevant and if using the hs-cTnT assay, further clinical assessment in a larger proportion of patients would be required.

The limit to wheat water-use efficiency in eastern Australia. I. Gradients in the radiation environment and atmospheric demand

In the wheatbelt of eastern Australia, rainfall shifts from winter dominated in the south (South Australia, Victoria) to summer dominated in the north (northern New South Wales, southern Queensland). The seasonality of rainfall, together with frost risk, drives the choice of cultivar and sowing date, resulting in a flowering time between October in the south and August in the north. In eastern Australia, crops are therefore exposed to contrasting climatic conditions during the critical period around flowering, which may affect yield potential, and the efficiency in the use of water (WUE) and radiation (RUE). In this work we analysed empirical and simulated data, to identify key climatic drivers of potential water- and radiation-use efficiency, derive a simple climatic index of environmental potentiality, and provide an example of how a simple climatic index could be used to quantify the spatial and temporal variability in resource-use efficiency and potential yield in eastern Australia. Around anthesis, from Horsham to Emerald, median vapour pressure deficit (VPD) increased from 0.92 to 1.28 kPa, average temperature increased from 12.9 to 15.2°C, and the fraction of diffuse radiation (FDR) decreased from 0.61 to 0.41. These spatial gradients in climatic drivers accounted for significant gradients in modelled efficiencies: median transpiration WUE (WUEB/T) increased southwards at a rate of 2.6% per degree latitude and median RUE increased southwards at a rate of 1.1% per degree latitude. Modelled and empirical data confirmed previously established relationships between WUEB/T and VPD, and between RUE and photosynthetically active radiation (PAR) and FDR. Our analysis also revealed a non-causal inverse relationship between VPD and radiation-use efficiency, and a previously unnoticed causal positive relationship between FDR and water-use efficiency. Grain yield (range 1-7 t/ha) measured in field experiments across South Australia, New South Wales, and Queensland (n = 55) was unrelated to the photothermal quotient (Pq = PAR/T) around anthesis, but was significantly associated (r2 = 0.41, P < 0.0001) with newly developed climatic index: a normalised photothermal quotient (NPq = Pq . FDR/VPD). This highlights the importance of diffuse radiation and vapour pressure deficit as sources of variation in yield in eastern Australia. Specific experiments designed to uncouple VPD and FDR and more mechanistic crop models might be required to further disentangle the relationships between efficiencies and climate drivers.

Promoting law student well-being – A developing program and the use of animation

It is widely acknowledged that student mental well-being is a critical factor in the tertiary student learning experience and is important to student learning success. The issue of student mental well-being also has implications for effective student transition out of university and into the world of work. It is therefore vital that intentional strategies are adopted by universities both within the formal curriculum, and outside it, to promote student well-being. This paper describes the ongoing development of the ‘I Belong in the LLB’ program at the Queensland University of Technology Law School, and the use of animation to engage students with the importance of mental health.

The MBA-LBA I period in the Kourion region : new evidences from Erimi- Laonin tou Porakou (Lemesos, Cyprus)

The evidence from Erimi-Laonin tou Porakou within the Kouris valley settlement system can offer further new data to outline a picture of the development trends from MBA to LBA I periods in the Kourion region. As to this area, such a “transitional” phase could be particularly relevant to better understand the development process of the mature LBA II–III urban centers (in Alassa as well as the most recent discovered in Erimi-Pitharka). In 2008–2009 a focus investigation (an intensive survey, geoperspections and excavations) within the Kouris Valley Project has been addressed to the site of Erimi-Laonin tou Porakou, which lies on one of the highest hilltops facing southward the Kouris dam. The excavations evidenced a double circuit wall which surrounds the top mound and the lower terrace. The top mound (Area A) has been widely occupied by a complex workshop, directly linked with a storage area. The natural limestone bedrock has been worked out to arrange a system of carved deep basins connected each other by a series of flow channels. Southward from the workshop, a large storage area has been cleared, with a relevant assemblage of big pithoi and storage devices. The first lower terrace area (Area B) has been possibly occupied by a domestic quarter; a cemetery area (Area E) has been also evidenced outside the external circuit wall, where a series of five rock-cut tombs (Tombs 228– 232) with single chamber and small incoming dromoi has been excavated.

Major histocompatibility complex class I involvement in the rejection of allogeneic erythrocytes in rainbow trout (Oncorhynchus mykiss)

Major histocompatibility complex genes are thought to be involved in allogeneic graft rejection but not many reports are available on their functional analysis in fish. Analysis of available sequences of MHC genes suggests functions in antigen presentation similar to those found in higher vertebrates. In mammals, the MHC class I and class II molecules are major determinants of allogeneic graft rejection due to their polymorphism in conjunction with their antigen presenting function. In fish, MHC class H molecules are found to be involved in rejection of allogeneic scale grafts. The present study was designed to investigate the involvement of MHC class I molecules in allograft rejection. Erythrocytes were collected from donors of rainbow trout expressed different class MHC class I alleles, stained with two dyes, mixed and grafted to the recipients that were of the same sibling group as the donors. The grafts were rejected by allogeneic recipients and the MHC class I linkage group was the major determinant for the rejection.

Do EU direct payments to beef producers belong in the 'blue box'?

In the Uruguay Round Agreement on Agriculture, so-called 'blue box' support measures were exempted from reduction commitments, provided they were delivered under 'production-limiting' programs. Although classified as 'blue box', the EU system of direct payments (DP) to beef farmers imposes 'claim-limiting' restrictions rather than 'production-limiting' restrictions, allowing farmers to keep additional animals over and above the number upon which they are eligible to claim DP. The present paper provides empirical evidence that EU direct payments capitalise into the market prices of male calves and young steers in Ireland. It is also likely that DP capitalises into the prices of beef cows and heifers. Given this capitalisation process, some farmers can obtain 'capitalised' DP on animals produced over and above the 'claim-limiting' restrictions, by selling these animals through auction markets. Thus, 'capitalised' DP probably encourages production over and above the limiting measures.

Amazon fisheries. I. - Variations in the relative abundance of tambaqui ( Colossoma macropomum Cuvier, 1818) based on catch and effort data of the gill-net fisheries.

Adjusted mean catches which are calculated discounting the effect of average fishing effort increase the further the lake is from Manaus, Brazil. -from Author

Biological Background on Bottlenose Dolphins (<i>Tursiopsi> spp.) in the 'Live-Capture' Trade and Specifically on the Indo-Pacific Bottlenose Dolphin, <i>T. Aduncusi>

The most significant cetacean trade items until commercial whaling all but ceased in the 1990s (aside from scientific exchanges of tissues etc.) were meat and blubber from baleen whales for human consumption. Since then, live dolphins and 'small' whales for display (and to some extent for research, military use, and 'therapy') have become the most significant cetacean 'products' in international trade. Trade in live cetaceans is presently dominated by bottlenose dolphins (Tursiops spp.), beluga whales (Debhinapterns leucas) and to a lesser extent killer whales (Orcinus orca) (Fisher and Reeves 2005). In the past, most of the dolphins in trade were common bottlenose dolphins (Tursiops truncatus) originating in the United States, Mexico and the Black Sea, but since the 1980s the United States has essentially stopped its capture-for-export activities and in 2001Mexico implemented a moratorium on live-captures. The source countries for dolphins in trade are now geographically diverse, but Cuba and Japan are currently major source nations for common bottlenose dolphins. Russia is the only current source for belugas. Russia and Japan have become the main potential sources for killer whales since Iceland ceased exporting them in the 1980s or early 1990s.

Insulin-associated changes in carnitine palmitoyltransferase activity are mediated through the insulin-like growth factor I pathway in the cultured neonatal rat cardiac myocyte

The mitochondrial carnitine palmitoyltransferase (CPT) system is composed of two proteins, CPT-I and CPT-II, involved in the transport of fatty acids into the mitochondrial matrix to undergo $\beta$-oxidation. CPT-I is located outside the inner membrane and CPT-II is located on the inner aspect of the inner membrane. The CPT proteins are distinct with different molecular weights and activities. The malonyl-CoA sensitivity of CPT-I has been proposed as a regulatory step in $\beta$-oxidation. Using the neonatal rat cardiac myocyte, assays were designed to discriminate between these activities in situ using digitonin and Triton X-100. With this methodology, we are able to determine the involvement of the IGF-I pathway in the insulin-mediated increase in CPT activities. Concentrations of digitonin up to 25 $\mu$M fail to release citrate synthase from the mitochondrial matrix or alter the malonyl-CoA sensitivity of CPT-I. If the mitochondrial matrix was exposed, malonyl-CoA insensitive CPT-II would reduce malonyl-CoA sensitivity. In contrast to digitonin, Triton X-100 (0.15%) releases citrate synthase from the matrix and exposes CPT-II. CPT-II activity is confirmed by the absence of malonyl-CoA sensitivity. To examine the effects of various agents on the expression and/or activity of CPT, it is necessary to use serum-free medium to eliminate mitogenic effects of serum proteins. Comparison of different media to optimize CPT activity and cell viability resulted in the decision to use Dulbecco's Modified Eagle medium supplemented with transferrin. In three established models of cardiac hypertrophy using the neonatal rat cardiac myocyte there is a significant increase in CPT-I and CPT-II activity in the treated cells. Analogous to the situation seen in the hypertrophy model, insulin also significantly increases the activity of the mitochondrial proteins CPT-I, CPT-II and cytochrome oxidase with a coinciding increase the expression of CPT-II and cytochrome oxidase mRNA. The removal of serum increases the I$\sb{50}$ (concentration of inhibitor that halves enzyme activity) of CPT-I for malonyl-CoA by four-fold. Incubation with insulin returns I$\sb{50}$ values to serum levels. Incubation with insulin significantly increases malonyl-CoA and ATP levels in the cells with a resulting reduction in palmitate oxidation. Once malonyl-CoA inhibition of CPT-I is removed by permeabilizing the cells, insulin significantly increases the oxidation of palmitoyl-CoA in a manner which parallels the increase in CPT-I activity. Interestingly, CPT-II activity increases significantly only at the tissue culture concentration (1.7 $\mu$M) of insulin suggesting that the IGF-I pathway may be involved. Supporting a role for the IGF-I pathway in the insulin-induced increase in CPT activity is the significant increase in the synthesis of both cellular and mitochondrial proteins as well as increased synthesis of CPT-II. Consistent with an IGF-mediated pathway for the effect of insulin, IGF-I (10 ng/ml) significantly increases the activities of both CPT-I and -II. An IGF-I analogue which inhibits the autophosphorylation of the IGF-I receptor blunts the insulin-mediated increase in CPT-I and -II activity by greater than 70% and virtually eliminates the IGF-I response by greater than 90%. This is the first study to demonstrate the involvement of the IGF-I pathway in the regulation of mitochondrial protein expression, e.g. CPT. ^