Diets containing the highest levels of dairy products are associated with greater eutrophication potential but higher nutrient intakes and lower financial cost in the United Kingdom.

PURPOSE: Previously, the nutritional contribution, environmental and financial costs of dairy products have been examined independently. Our aim was to determine the nutritional adequacy, financial cost and environmental impact of UK diets according to dairy content. METHODS: In this cross-sectional study of adults (19-64 years) from the UK National Diet and Nutrition Survey years 1-4 (n = 1655), dietary intakes assessed from 4-day estimated food diaries were organized into quartiles (Q) total grams of dairy (milk, cheese, yogurt, dairy desserts) and analyzed using ANCOVA controlling for age, sex and energy intake with Bonferroni post hoc test for nutritional adequacy, Alternative Healthy Eating Index (AHEI-2010), environmental impact [greenhouse gas emissions (GHGE), eutrophication and acidification potentials], financial cost, markers of health and cardio-metabolic diseases. RESULTS: Nutritional adequacy, particularly for protein, calcium and iodine (+ 18 g, + 533 mg, + 95 g, respectively, all P < 0.0001) and AHEI-2010 (P < 0.0001) were significantly higher and systolic BP (- 2 mmHg, P = 0.019) was significantly lower for the higher-dairy diets (Q4, 274-1429 g/day dairy), compared with diets containing lower dairy (Q1, 0-96 g/day dairy). Diets in Q4 had lower financial cost (- 19%, P < 0.0001) and the greatest eutrophication potential, compared with Q1 (+ 29%, P < 0.0001). Yet the environmental (GHGE) and financial costs per unit nutrient (riboflavin, zinc, iodine, magnesium, calcium, potassium) were lower in Q4 than Q1 (all P < 0.0001). CONCLUSION: Diets with the highest dairy content had higher nutrient composition, better diet quality, were associated with lower BP and financial cost, but with higher eutrophication potential. Robust environmental data for many of food groups are limited and this needs an urgent addressing. TRIAL REGISTRATION: This trial was registered on clinicaltrials.gov as NCT03407248.

Assessing current genetic status of the Hainan gibbon using historical and demographic baselines: implications for conservation management of species of extreme rarity.

Evidence-based conservation planning is crucial for informing management decisions for species of extreme rarity, but collection of robust data on genetic status or other parameters can be extremely challenging for such species. The Hainan gibbon, possibly the world's rarest mammal, consists of a single population of ~25 individuals restricted to one protected area on Hainan Island, China, and has persisted for over 30 years at exceptionally low population size. Analysis of genotypes at 11 microsatellite loci from faecal samples for 36% of the current global population and tissue samples from 62% of existing historical museum specimens demonstrates limited current genetic diversity (Na = 2.27, Ar = 2.24, He  = 0.43); diversity has declined since the 19th century and even further within the last 30 years, representing declines of ~30% from historical levels (Na = 3.36, Ar = 3.29, He  = 0.63). Significant differentiation is seen between current and historical samples (FST  = 0.156, P = 0.0315), and the current population exhibits extremely small Ne (current Ne  = 2.16). There is evidence for both a recent population bottleneck and an earlier bottleneck, with population size already reasonably low by the late 19th century (historical Ne  = 1162.96). Individuals in the current population are related at the level of half- to full-siblings between social groups, and full-siblings or parent-offspring within a social group, suggesting that inbreeding is likely to increase in the future. The species' current reduced genetic diversity must be considered during conservation planning, particularly for expectations of likely population recovery, indicating that intensive, carefully planned management is essential.

The Effect of Rotational Disorder on the Microwave Transmission of Checkerboard Metal Square Arrays.

The effect of rotational disorder on the microwave transmission through thin metallic checkerboard arrays has been experimentally studied. Broad resonant features below the onset of diffraction, attributed to electromagnetic radiation coupling through the structure via the evanescent fields of bound surface waves, are found to be strongly dependent on the electrical connectivity of the surface. By applying rotational disorder to the elements comprising the arrays, with the lattice constant and element size unchanged, the electrical connectivity of the structure can be controlled whilst maintaining periodicity. The results show that rotational disorder can significantly affect transmission only when it changes the structure's connectivity. When the initial structure is just above the connectivity threshold (where the metallic occupancy is 50%), increasing disorder causes the resonant features in transmission to invert as the structure switches from a predominantly connected array to a disconnected array. When approximately half of the connections are broken, the resonant features are suppressed, with scattering loss shown to dramatically increase to as much as 40% of the incident power over a broad frequency range. The result is a thin, highly effective scatterer of microwaves.

Host susceptibility to periodontitis: mapping murine genomic regions.

Host susceptibility to periodontal infection is controlled by genetic factors. As a step toward identifying and cloning these factors, we generated an A/J x BALB/cJ F2 mouse resource population. A genome-wide search for Quantitative Trait Loci (QTL) associated with periodontitis was performed. We aimed to quantify the phenotypic response of the progenies to periodontitis by microCT analysis, to perform a genome-wide search for QTL associated with periodontitis, and, finally, to suggest candidate genes for periodontitis. We were able to produce 408 F2 mice. All mice were co-infected with Porphyromonas gingivalis and Fusobacterium nucleatum bacteria. Six weeks following infection, alveolar bone loss was quantified by computerized tomography (microCT) technology. We found normal distribution of the phenotype, with 2 highly significant QTL on chromosomes 5 and 3. A third significant QTL was found on chromosome 1. Candidate genes were suggested, such as Toll-like receptors (TLR) 1 and 6, chemokines, and bone-remodeling genes (enamelin, ameloblastin, and amelotin). This report shows that periodontitis in mice is a polygenic trait with highly significant mapped QTL.

Mastectomy and reconstruction in stage IV breast cancer: a survey of UK breast and plastic surgeons.

The number of women with stage IV disease who have breast reconstruction is small. The primary aim of this study was to examine opinions as to the appropriateness of breast reconstruction in this group. The Association of Breast Surgeons (ABS) and the British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS) were invited to take part in an online survey. Of the respondents, 78.7% would operate on the primary tumour. Plastic surgeons showed a propensity for immediate reconstruction compared to their breast surgery colleagues, and 26.3% of breast surgeons would not offer reconstruction at all. Immediate latissimus dorsi (LD) flap and implant were the favoured method in early stage disease with delayed LD and implant the most popular option for stage IV disease. As survival figures continue to improve, the number of patients requesting reconstruction is likely to increase. Further debate will be necessary in anticipation of future service development.

Small flake, big problem: an unreported cause of extensor pollicis longus tendon rupture.

Fracture of the base of the third metacarpal with associated avulsion of the extensor carpi radialis brevis tendon is a rare injury. We report such a fracture and the unusual resulting complication of division of the extensor pollicis longus tendon by the avulsed bony fragment. Careful monitoring using lateral radiographs is needed to make the diagnosis and displacement of the avulsed fragment warrants open reduction and internal fixation.

Analysis of the rainbow trout solute carrier 11 family reveals iron import < or = pH 7.4 and a functional isoform lacking transmembrane domains 11 and 12.

A Xenopus oocyte heterologous expression system was used to characterise iron transport properties of two members of the solute carrier 11 (slc11) protein family isolated from rainbow trout gills. One cDNA clone differed from the trout Slc11alpha containing an additional 52bp in the exon between transmembrane domains (TM) 10 and 11. The 52bp contained a stop codon, resulting in a novel isoform lacking the last two TM (termed slc11gamma). Slc11gamma and another isoform slc11beta, import Fe(2+) at external pHs < or = to 7.4. Trout slc11beta Fe(2+) import was more sensitive to inhibition by divalent metals. The novel vertebrate slc11gamma isoform functions without TM11 and 12.

Forgotten digital tourniquet: salvage of an ischaemic finger by application of medicinal leeches.

Individual finger tourniquets are appropriate to the management of a wide range of conditions presenting to an accident and emergency department. They are simpler and more comfortable to use than upper arm pneumatic tourniquets and commercially available digital tourniquets are not readily available in the accident and emergency unit. However, if a finger tourniquet is overlooked, ischaemia of the digit results, and gangrene may follow if the problem is not defused early enough, leading to potential disaster. We present one case where a digit was salvaged after 4 days of tourniquet application, using medicinal leeches.

The rapid identification of human influenza neuraminidase N1 and N2 subtypes by ELISA.

An ELISA assay was developed to allow the rapid and accurate identification of human influenza A N1 and N2 neuraminidases. Initial testing using a fetuin pre-coating of wells correctly identified 81.7% of the neuraminidase type from a series of human A(H1N1), A(H1N2) and A(H3N2) viruses. This result could be improved to detect the neuraminidase subtype of almost all human influenza A viruses from a large panel of viruses isolated from 2000 to 2005, if the fetuin pre-coating was removed and the viruses were coated directly onto wells. This method is simple, rapid and can be used to screen large numbers of currently circulating human influenza A viruses for their neurraminidase subtype and is a good alternative to RT-PCR.

An influenza A(H3) reassortant was epidemic in Australia and New Zealand in 2003.

During 2003, Australia and New Zealand experienced substantial outbreaks of influenza. The strain responsible was an A(H3N2) influenza virus described as A/Fujian/411/2002-like, which had circulated as a minor variant in the previous Northern Hemisphere (NH) winter, mainly in Korea and Japan. Early in the year the isolates were very similar to those that had been previously isolated in the NH, however, a reassortant strain emerged early in the New Zealand winter, followed by the appearance of similar viruses in Australia and other regional areas. While the hemagglutinin HA1 sequence of these viruses demonstrated only minor differences from the A/Fujian/411/2002 reference strain, the neuraminidase gene was clearly different from that of other recently circulating H3 viruses and most closely matched an earlier reference strain A/Chile/6416/2001. Three internal genes (NS, NP, M) in the reassortant viruses were also more closely related to the A/Chile/6416/2001 lineage. This reassortant A(H3) virus predominated in Australia and New Zealand in 2003 was also seen in Brazil and Malaysia during 2003 and was widespread in the United States and Europe during their 2003-04 winter. Interestingly most of the strains of A(H3) that were isolated at the beginning of the 2004 winter in Australia, did not have this earlier A/Chile/6416/2001-like neuraminidase but had a neuraminidase that was similar to that of the reference strain A/Fujian/411/2002. This was suggestive of the re-introduction of influenza A(H3) from other countries, however, there was still low level circulation of the reassortant virus in 2004 with isolates detected in Australia and Singapore.

Mastectomy and reconstruction--an unusual solution to intractable breast pain.

Breast pain is a common complaint which usually subsides with simple reassurance or sometimes medication. This paper describes the case of a 41-year-old woman suffering from severe non-cyclical breast pain that had proved resistant to a battery of medical treatments. The pain was so disabling that it drove the patient to contemplate suicide. At the patient's request, a bilateral subcutaneous mastectomy with immediate implant reconstruction was performed, resulting in a complete resolution of the pain. Non-cyclical breast pain is less common than cyclical breast pain and tends to be more difficult to treat. This case suggests that mastectomy may be an appropriate option of last resort in the treatment of severe intractable breast pain.

Reassortants in recent human influenza A and B isolates from South East Asia and Oceania.

From 2000 to 2002, human influenza A and B viruses that were genetic reassortants of contemporary circulating human strains, were isolated in South East Asia and Oceania. Similar to reports from other regions, A(H1N2) isolates were found to be reassortants of circulating A(H3N2) viruses that had acquired only the haemagglutinin gene of an A(H1N1) virus. Some of these reassortants from Thailand and Singapore predate those previously recorded during the winter of 2001-2002 in Europe and the Middle East and may be precursors of these viruses. The B reassortants had a haemagglutinin similar to an earlier B strain, B/Shangdong/7/97 (B/Victoria/2/87-lineage) and a neuraminidase similar to the recently circulating B/Sichuan/379/99 virus (B/Yamagata/16/88-lineage). Despite the early occurrences of A(H1N2) reassortants and the extensive circulation of A(H1) viruses in South East Asia and Oceania during 2000-2001, these reassortant influenza A viruses have to date not been prominent unlike Europe and the Middle East where they were common in the 2001-2002 winter. In contrast the reassortant B viruses, which first emerged in this region in early 2002, rapidly became the predominant strains isolated from patients with influenza B in South East Asia and Oceania.

A method of indirect registration of the coordinates of condylar points with a six-degree-of-freedom jaw tracker.

Previous studies have indicated that the location of a condylar point can significantly influence its trajectory. The aim of this investigation was to develop a method of registering the location of radiographically defined condylar points in the coordinate system of a six-degree-of-freedom jaw-tracking device and to determine the accuracy of this method by using a perspex model in one experiment and a dry skull in another. A direct measurement ('the gold standard') of condylar point coordinates in the coordinate system of JAWS3D was done using a three-dimensional (3D) digitizer (MicroScribe-3DX). The indirect measurement used a distributed fiducial marker as the interface between the coordinate system of MicroScribe-3DX (which was used to register the fiducial marker and the JAWS3D coordinate system) and the coordinate system of the CT scans (used to define condyle anatomy and the relation with the fiducial marker). The coordinates of condylar points could then be calculated in the coordinate system of JAWS3D. The results showed that the indirect method could register condylar point coordinates on either side to an accuracy of approximately 0.5 mm.

The responsibility of the pharmaceutical industry.

The pharmaceutical industry plays an active role in policy surrounding the research, discovery and development of new medicines. Along with this commitment, the pharmaceutical industry must also take an active role in helping to ensure that appropriate patients receive access to state-of-the-art scientific advancements. The various players involved in drug development and introduction, including the pharmaceutical industry, clinicians, advocacy groups and regulatory bodies, need to work together to ensure patient access to quality care. While issues such as drug acquisition costs and marketing are often given a high profile, this may cloud perceptions of the industry's commitment to deliver important new medicines to the patients and healthcare systems that need them.

Evidence of red cell alignment in the magnetic field of an NMR spectrometer based on the diffusion tensor of water.

The alignment of human erythrocytes in aqueous suspensions in the magnetic field B(0) (called the z-direction) of an NMR spectrometer was shown by calculating the diffusion tensor for water in the sample. The diffusion was measured using a pulsed-field-gradient spin-echo NMR method. The extent of diffusion anisotropy for water was exemplified by the values of the apparent diffusion coefficients with erythrocytes of normal shape and volume: for a typical experiment the values for the x-, y-, and z-directions were (6.88 +/- 0.17) x 10(-10), (7.07 +/- 0.17) x 10(-10), and (10.20 +/- 0.17) x 10(-10) m(2) s(-1), respectively. Cells in hypo- and hyperosmotic media were also studied and they too showed the anisotropy of the apparent diffusion coefficients but the extents were different. A new method of data analysis was developed using the Standard Add-On Packages in a Mathematica program. The experimental findings support evidence of erythrocyte alignment that was previously obtained with a high-field-gradient q-space method.

Permeability coefficients from NMR q-space data: models with unevenly spaced semi-permeable parallel membranes.

The NMR "q-space" experiment conducted on water provides information on the sizes of repeated structures on the micrometer-length scale in heterogeneous samples, including cell suspensions or tissues. Under some circumstances these plots display coherence peaks, and it has been implied theoretically that the position of the peaks will vary with the rate of molecular exchange across the membranes. This has been demonstrated (qualitatively) with human erythrocytes in suspension. Thus, in the quest for a quantitative approach to the interpretation of such data, we address here the "inverse problem," namely the estimate of the permeability coefficient of membranes from q-space experiments. The present work describes theoretical predictions of q-space plots from molecules diffusing in a simple system of parallel semi-permeable membranes arranged with separations that alternate between two different values; this was designed to (loosely) mimic the intra- and extracellular compartments in a suspension of cells or a tissue. The development of the theory was facilitated by symbolic computation, and the analysis of synthetic data was shown to be achievable by the use of a three-layer back-propagation artificial neural network.

Analytical Solutions and Simulations for Spin-Echo Measurements of Diffusion of Spins in a Sphere with Surface and Bulk Relaxation

Nuclear spins (in molecules) are considered to be diffusing in a sphere in a linearly inhomogeneous magnetic field (field gradient) that is imposed during a spin-echo NMR experiment. Relaxation of magnetization both in the bulk medium and on the inner surface of the sphere is assumed to occur. Analytical solutions were obtained for the relevant modified diffusion (partial differential) equation by using separation of variables with a Green's function (propagator) and three different boundary conditions. Neuman [J. Chem. Phys. 60, 4508 (1974)] analyzed the same physical system, but with no relaxation, to obtain an expression that relates the NMR spin-echo signal intensity to the magnitude of the magnetic field gradient, the spin-echo time, and the intrinsic molecular diffusion coefficient. The present analysis was based on that originally used by Neuman and, like the latter, it employed the assumption of a Gaussian distribution of phases of the spin magnetizations. This assumption, while rendering a tractable solution, nevertheless limits its range of applicability; this aspect, and the convergence properties of the series solutions were investigated in conjunction with numerical simulations made with diffusion modeled as a three-dimensional random (Monte Carlo) walk. A novel prediction for spheres with finite surface relaxation and a given radius is the presence of two minima in a graph of the normalized spin-echo signal intensity versus the reciprocal of the diffusion coefficient.