Living with personality disorder and seeking mental health treatment: patients and family members reflect on their experiences.
Despite effective treatments for personality disorders being developed, consumers and carers often report negative experiences of mental health services, including challenges accessing these treatments. This qualitative study used separate focus groups to compare the unique perspectives of consumer and carers, and to investigate how to improve services for individuals with personality disorders. Reflexive thematic analysis was used to analyze the data. Both consumers and carers (N = 15) discussed the value of providing appropriate information to consumers when they are diagnosed with personality disorder. Consumers and carers described the importance of creating a safe environment for consumers when they present to the emergency department. Both groups discussed experiencing positive and negative treatment from mental health professionals, and suggested that professionals should be trained to understand personality disorder. Limited accessibility and quality of services, and offering peer support to consumers were also described by consumers and carers. Consumers and carers also had perspectives which were unique to their group. Consumers identified the importance of psychological treatment, having a strong therapeutic relationship with a mental health professional, and the benefit of long term psychotherapy with the same professional. Broadening the scope of psychotherapies including creative, animal-assisted, and physical therapies was recommended by consumers. Carers described the importance of assessing for personality disorder and intervening early. Involvement in the assessment, diagnosis, and intervention process was important to carers. The desire to be recognized and supported by mental health professionals was discussed by carers. This research contributes to the concern that consumers with personality disorder and their carers experience stigma and low quality care within mental health services. In line with these findings, we recommend guidelines for health professionals who work with consumers with personality disorder.


Chlamydia pneumoniae--a new causative agent of reactive arthritis and undifferentiated oligoarthritis.
To examine whether reactive arthritis (ReA) known to occur after a urogenital infection with Chlamydia trachomatis can also follow an infection with Chlamydia pneumoniae, a recently described species of Chlamydiae that is a common cause of respiratory tract infections. Specific antibodies (microimmunofluorescence test) and lymphocyte proliferation to C trachomatis and C pneumoniae in paired samples of peripheral blood and synovial fluid were investigated in 70 patients with either reactive arthritis (ReA) or undifferentiated oligoarthritis (UOA). Five patients with acute ReA after an infection with C pneumoniae are reported. Three had a symptomatic preceding upper respiratory tract infection and two had no such symptoms. In all patients a C pneumoniae-specific lymphocyte proliferation in synovial fluid and a high specific antibody titre suggesting an acute infection was found. C pneumoniae needs to be considered a new important cause of reactive arthritis.


Capsaicin, Nociception and Pain.
Capsaicin, the pungent ingredient of the hot chili pepper, is known to act on the transient receptor potential cation channel vanilloid subfamily member 1 (TRPV1). TRPV1 is involved in somatic and visceral peripheral inflammation, in the modulation of nociceptive inputs to spinal cord and brain stem centers, as well as the integration of diverse painful stimuli. In this review, we first describe the chemical and pharmacological properties of capsaicin and its derivatives in relation to their analgesic properties. We then consider the biochemical and functional characteristics of TRPV1, focusing on its distribution and biological effects within the somatosensory and viscerosensory nociceptive systems. Finally, we discuss the use of capsaicin as an agonist of TRPV1 to model acute inflammation in slices and other ex vivo preparations.


Genetic abnormality of the visual pathways in a "white" tiger.
"White"tigers show an inherited reduction of pigment, produced by an autosomal recessive gene. The brain of one of these tigers shows an abnormality of the visual pathways similar to abnormalities that are associated with albinism in many other mammals. There is a close relationship between the reduced pigment formation, the pathway abnormality, and strabismus.


Drinking water application of Denagard® Tiamulin for control of Brachyspira pilosicoli infection of laying poultry.
Avian intestinal spirochaetosis (AIS) caused by Brachyspira spp., and notably Brachyspira pilosicoli, is common in layer flocks and reportedly of increasing incidence in broilers and broiler breeders. Disease manifests as diarrhoea, increased feed consumption, reduced growth rates and occasional mortality in broilers and these signs are shown in layers also associated with a delayed onset of lay, reduced egg weights, faecal staining of eggshells and non-productive ovaries. Treatment with Denagard® Tiamulin has been used to protect against B. pilosicoli colonisation, persistence and clinical presentation of AIS in commercial layers, but to date there has been no definitive study validating efficacy. Here, we used a poultry model of B. pilosicoli infection of layers to compare the impact of three doses of Denagard® Tiamulin. Four groups of thirty 17 week old commercial pre-lay birds were all challenged with B. pilosicoli strain B2904 with three oral doses two days apart. All birds were colonised within 2 days after the final oral challenge and mild onset of clinical signs were observed thereafter. A fifth group that was unchallenged and untreated was also included for comparison as healthy birds. Five days after the final oral Brachypira challenge three groups were given Denagard® Tiamulin in drinking water made up following the manufacturer's recommendations with doses verified as 58.7 ppm, 113 ppm and 225 ppm. Weight gain body condition and the level of diarrhoea of birds infected with B. pilosicoli were improved and shedding of the organism reduced significantly (p=0.001) following treatment with Denagard® Tiamulin irrespective of dose given. The level and duration of colonisation of organs of birds infected with B. pilosicoli was also reduced. Confirming previous findings we showed that the ileum, caeca, colon, and both liver and spleen were colonised and here we demonstrated that treatment with Denagard® Tiamulin resulted in significant reduction in the numbers of Brachyspira found in each of these sites and dramatic reduction in faecal shedding (p<0.001) to approaching zero as assessed by culture of cloacal swabs. Although the number of eggs produced per bird and the level of eggshell staining appeared unaffected, egg weights of treated birds were greater than those of untreated birds for a period of approximately two weeks following treatment. These data conclusively demonstrate the effectiveness of Denagard® Tiamulin in reducing B. pilosicoli infection in laying hens.


Novel, potent THC/anandamide (hybrid) analogs.
The structure-activity relationship (SAR) of the end pentyl chain in anandamide (AEA) has been established to be very similar to that of Delta(9)-tetrahydrocannabinol (Delta(9)-THC). In order to broaden our understanding of the structural similarities between AEA and THC, hybrid structures 1-3 were designed. In these hybrids the aromatic ring of THC-DMH was linked to the AEA moiety through an ether linkage with the oxygen of the phenol of THC. Hybrid 1 (O-2220) was found to have very high binding affinity to CB1 receptors (K(i)=8.5 nM), and it is interesting to note that the orientation of the side chain with respect to the oxygen in the phenol is the same as in THCs. To further explore the SAR in this series the terminal carbon of the side chain was modified by adding different substituents. Several such analogs were synthesized and tested for their CB1 and CB2 binding affinities and in vivo activity (tetrad tests). The details of the synthesis and the biological activity of these compounds are described.


Cardiorespiratory Fitness Among Individuals With Psoriasis in the General Population.
Psoriasis confers risk for cardiometabolic disorders. Cardiorespiratory fitness is inversely associated with risk of cardiometabolic disorders in other populations, but limited data have been published assessing cardiorespiratory fitness among individuals with psoriasis. This investigation aimed to: 1) assess cardiorespiratory fitness among individuals with psoriasis in the general population; and 2) compare levels to individuals without psoriasis. A secondary data analysis from the 2003-2004 National Health and Nutritional Examination Survey was performed. Cardiorespiratory fitness was assessed with a treadmill test, while measures of psoriasis severity included rating of psoriasis as a life problem and body surface area involvement. Twenty-six of 1093 participants reported a psoriasis diagnosis (population weighted prevalence 2.9%). Individuals with psoriasis had lower cardiorespiratory fitness compared with individuals without psoriasis (36.2 vs. 39.1 mL·kg-1·min-1, P = .009). No differences in self-reported or accelerometer physical activity were found by psoriasis diagnosis. Cardiorespiratory fitness was not significantly lower in those reporting high life impairment or body surface area involvement. Cardiorespiratory fitness may be lower in individuals with psoriasis and these differences may not be explained by self-reported disease severity measures or physical activity. Future studies should examine whether validated measures of psoriasis severity predict lower cardiorespiratory fitness.


[Response rates and non-response bias in a health-related mailed survey].
A health-related mailed survey was conducted to investigate the effect of follow-up mailings to response rates. In addition, the answer distributions among early and late respondents were compared to check non-response bias. Approximately 3,000 persons aged 40-64 were randomized into two groups; a questionnaire with four pages (twenty-two questions) was assigned to the first group, and a questionnaire with eight pages (thirty-five questions) to the second group. Both questionnaires contained questions of current health status, health-related practice, smoking status, etc. Follow-up mailings were sent twice to non-respondents. Response rates were increased from 38% to 62% by the first follow-up mail, and to 71% by the second follow-up mail. Although the length of the questionnaire did not affect response rates, response rates among the older subjects was higher than the younger subjects. Positive response to current smoking status was 10% lower among early respondents than late respondents, collected after the second follow-up mailing, and response to regular participation in physical/medical checkup was 15% higher among early respondents, whereas there were few differences for answers to other questions. Odds ratios between current health status and several health-related questions may not be biased by late response. However, increased response rates are needed to prevent non-response bias, because there were some differences in responses from follow-up mailings.


Mutation of a nuclear receptor gene, NR2E3, causes enhanced S cone syndrome, a disorder of retinal cell fate.
Hereditary human retinal degenerative diseases usually affect the mature photoreceptor topography by reducing the number of cells through apoptosis, resulting in loss of visual function. Only one inherited retinal disease, the enhanced S-cone syndrome (ESCS), manifests a gain in function of photoreceptors. ESCS is an autosomal recessive retinopathy in which patients have an increased sensitivity to blue light; perception of blue light is mediated by what is normally the least populous cone photoreceptor subtype, the S (short wavelength, blue) cones. People with ESCS also suffer visual loss, with night blindness occurring from early in life, varying degrees of L (long, red)- and M (middle, green)-cone vision, and retinal degeneration. The altered ratio of S- to L/M-cone photoreceptor sensitivity in ESCS may be due to abnormal cone cell fate determination during retinal development. In 94% of a cohort of ESCS probands we found mutations in NR2E3 (also known as PNR), which encodes a retinal nuclear receptor recently discovered to be a ligand-dependent transcription factor. Expression of NR2E3 was limited to the outer nuclear layer of the human retina. Our results suggest that NR2E3 has a role in determining photoreceptor phenotype during human retinogenesis.


Perceived connections between information and communication technology use and mental symptoms among young adults - a qualitative study.
Prospective associations have been found between high use of information and communication technology (ICT) and reported mental symptoms among young adult university students, but the causal mechanisms are unclear. Our aim was to explore possible explanations for associations between high ICT use and symptoms of depression, sleep disorders, and stress among young adults in order to propose a model of possible pathways to mental health effects that can be tested epidemiologically. We conducted a qualitative interview study with 16 women and 16 men (21-28 years), recruited from a cohort of university students on the basis of reporting high computer (n = 28) or mobile phone (n = 20) use at baseline and reporting mental symptoms at the one-year follow-up. Semi-structured interviews were performed, with open-ended questions about possible connections between the use of computers and mobile phones, and stress, depression, and sleep disturbances. The interview data were analyzed with qualitative content analysis and summarized in a model. Central factors appearing to explain high quantitative ICT use were personal dependency, and demands for achievement and availability originating from the domains of work, study, social life, and individual aspirations. Consequences included mental overload, neglect of other activities and personal needs, time pressure, role conflicts, guilt feelings, social isolation, physical symptoms, worry about electromagnetic radiation, and economic problems. Qualitative aspects (destructive communication and information) were also reported, with consequences including vulnerability, misunderstandings, altered values, and feelings of inadequacy. User problems were a source of frustration. Altered ICT use as an effect of mental symptoms was reported, as well as possible positive effects of ICT on mental health. The concepts and ideas of the young adults with high ICT use and mental symptoms generated a model of possible paths for associations between ICT exposure and mental symptoms. Demands for achievement and availability as well as personal dependency were major causes of high ICT exposure but also direct sources of stress and mental symptoms. The proposed model shows that factors in different domains may have an impact and should be considered in epidemiological and intervention studies.


Clinical presentation of rhabdoid tumors of the kidney.
We designed this study to differentiate the clinical presentation, particularly the incidence of hematuria, of a rhabdoid tumor of the kidney (RTK), a rare but highly malignant tumor, from a Wilms tumor. We reviewed patient flow charts from the National Wilms Tumor Study Group and queried participating hospitals to obtain additional information regarding presenting symptoms and laboratory data for fifty patients. Patient ages ranged from 2 days to 3.5 years with a mean of 11 months. We documented the presence of gross and microscopic hematuria, fever, and hypercalcemia. Whereas 75% of children with rhabdoid tumor of the kidney (RTK) had stage III (44%), IV (27%), or V (4%) tumors, 67% of children with Wilms tumors had stage I (41%) or II (26%) tumors. Either gross or microscopic hematuria was present in 84.4% (27/32) of the patients with RTK. Gross hematuria was present in 59% (22/37) of children with RTK compared with 18% previously reported with Wilms tumor. Microscopic hematuria was present in 76% (22/29) of children with RTK compared with 24% previously reported with Wilms tumor. Fever was found in 44% (16/36) of children with RTK, compared with 22% of children previously reported with Wilms tumor. Hypercalcemia was seen 26% (6/23) of children with RTK. Although diagnosis of any renal mass still must be confirmed with histopathologic features, a distinct clinical presentation with fever, hematuria, a young age, and high-tumor stage at presentation suggests the diagnosis of RTK.


Eugenics and American social history, 1880-1950.
Eugenics, the attempt to improve the human species socially through better breeding was a widespread and popular movement in the United States and Europe between 1910 and 1940. Eugenics was an attempt to use science (the newly discovered Mendelian laws of heredity) to solve social problems (crime, alcoholism, prostitution, rebelliousness), using trained experts. Eugenics gained much support from progressive reform thinkers, who sought to plan social development using expert knowledge in both the social and natural sciences. In eugenics, progressive reformers saw the opportunity to attack social problems efficiently by treating the cause (bad heredity) rather than the effect. Much of the impetus for social and economic reform came from class conflict in the period 1880-1930, resulting from industrialization, unemployment, working conditions, periodic depressions, and unionization. In response, the industrialist class adopted firmer measures of economic control (abandonment of laissez-faire principles), the principles of government regulation (interstate commerce, labor), and the cult of industrial efficiency. Eugenics was only one aspect of progressive reform, but as a scientific claim to explain the cause of social problems, it was a particularly powerful weapon in the arsenal of class conflict at the time.


[Evolution of the climate change concept and its impact in the public health of Peru].
The term "climate change" is not a new concept but its impact on public health is under constant review. We know that climate has already changed and will continue to change for centuries with the rise in average global temperature, and the associated rise in sea level. This fact makes mitigation efforts relevant only in the very long term and for generations of humans whose parents have not yet been born. When we talk about public health in the context of climate change, we are talking about adaptation. In the present, countries that are currently the most affected by climate change are precisely countries like Peru, without a significant carbon footprint at the global level but that are highly sensitive to the effects of climate. Without reliable climate projections, the health impact of climate change can be uncertain and complicated. Nevertheless, at the local level, every district can identify its vulnerabilities and define priorities to protect the health of its population. There are, and it can also be developed, environmental health indicators that can help monitor how well we are adapting and how prepared we are for changes in the climate. Adaptation to climate change implies improving living conditions, enhancing epidemiological surveillance systems and extending access to healthcare. The fight against the effects of climate change in public health is a fight against poverty and inequality, and that is nothing new in Peru.


Agent-Based Modeling of Day-to-Day Intimate Partner Violence.
The purpose of this study was to develop a mathematical model of mutual partner violence and assess impact of her controllable behaviors on reducing violence. An agent-based model was created of couples with history of violence based upon results of two multiple time series studies of partner violence. To explore factors that may alter model results, eight continuous variable parameters were created based upon significant (p=.05) but discrepant (opposite directions) results from previous studies. To assess the potential impact that random stress and her behavior (arguments, forgiveness, alcohol use, violence) could have on violence and stalking, the impact of variable parameter settings of these factors were also assessed. The model identified 18 unique patterns were observed, grouped into five general categories. Added random stress contributed to his violence in only two patterns. Although avoiding participation in arguments had no effect, her forgiveness and elimination of alcohol use often reduced her violence only. However, consistent violence or nonviolence on her part sometimes affected his violence and stalking. In conclusion, while increasing forgiveness and reducing alcohol intake could reduce her violence, they generally had little effect on his. However, if she eliminated her violence, it could eliminate his violence and stalking in some situations.


Bovine colostrum contains immunoglobulin G antibodies against intimin, EspA, and EspB and inhibits hemolytic activity mediated by the type three secretion system of attaching and effacing Escherichia coli.
Enterohemorrhagic Escherichia coli (EHEC) is the main cause of hemolytic-uremic syndrome, an endemic disease in Argentina which had an incidence in 2005 of 13.9 cases per 100,000 children younger than 5 years old. Cattle appear to be a major reservoir of EHEC, and a serological response to EHEC antigens has been demonstrated in natural and experimental infections. In the current study, antibodies against proteins implicated in EHEC's ability to form attaching and effacing lesions, some of which are exported to the host cell via a type three secretion system (TTSS), were identified in bovine colostrum by Western blot analysis. Twenty-seven (77.0%) of the 35 samples examined contained immunoglobulin G (IgG) antibodies against the three proteins assayed in this study: EspA, EspB, and the carboxy-terminal 280 amino acids of gamma-intimin, an intimin subtype associated mainly with O157:H7 and O145:H- serotypes. Every colostrum sample was able to inhibit, in a range between 45.9 and 96.7%, the TTSS-mediated hemolytic activity of attaching and effacing E. coli. The inhibitory effect was partially mediated by IgG and lactoferrin. In conclusion, we found that early colostrum from cows contains antibodies, lactoferrin, and other unidentified substances that impair TTSS function in attaching and effacing E. coli strains. Bovine colostrum might act by reducing EHEC colonization in newborn calves and could be used as a prophylactic measure to protect non-breast-fed children against EHEC infection in an area of endemicity.


Electrophysiological characterisation of motor and sensory tracts in patients with hereditary spastic paraplegia (HSP).
Hereditary spastic paraplegias (HSPs) are characterised by lower limb spasticity due to degeneration of the corticospinal tract. We set out for an electrophysiological characterisation of motor and sensory tracts in patients with HSP. We clinically and electrophysiologically examined a cohort of 128 patients with genetically confirmed or clinically probable HSP. Motor evoked potentials (MEPs) to arms and legs, somato-sensory evoked potentials of median and tibial nerves, and nerve conduction studies of tibial, ulnar, sural, and radial nerves were assessed. Whereas all patients showed clinical signs of spastic paraparesis, MEPs were normal in 27% of patients and revealed a broad spectrum with axonal or demyelinating features in the others. This heterogeneity can at least in part be explained by different underlying genotypes, hinting for distinct pathomechanisms in HSP subtypes. In the largest subgroup, SPG4, an axonal type of damage was evident. Comprehensive electrophysiological testing disclosed a more widespread affection of long fibre tracts involving peripheral nerves and the sensory system in 40%, respectively. Electrophysiological abnormalities correlated with the severity of clinical symptoms. Whereas HSP is primarily considered as an upper motoneuron disorder, our data suggest a more widespread affection of motor and sensory tracts in the central and peripheral nervous system as a common finding in HSP. The distribution patterns of electrophysiological abnormalities were associated with distinct HSP genotypes and could reflect different underlying pathomechanisms. Electrophysiological measures are independent of symptomatic treatment and may therefore serve as a reliable biomarker in upcoming HSP trials.


Efficient computational methods for accurately predicting reduction potentials of organic molecules.
A simple computational approach for predicting ground-state reduction potentials based upon gas phase geometry optimizations at a moderate level of density functional theory followed by single-point energy calculations at higher levels of theory in the gas phase or with polarizable continuum solvent models is described. Energies of the gas phase optimized geometries of the S0 and one-electron-reduced D0 states of 35 planar aromatic organic molecules spanning three distinct families of organic photooxidants are computed in the gas phase as well as well in implicit solvent with IPCM and CPCM solvent models. Correlation of the D0 - S0 energy difference (essentially an electron affinity) with experimental reduction potentials from the literature (in acetonitrile vs SCE) within a single family, or across families when solvent models are used, yield correlations with r(2) values in excess of 0.97 and residuals of about 100 mV or less, without resorting to computationally expensive vibrational calculations or thermodynamic cycles.


Variability in 3' end of 16S rRNA sequence of Mycobacterium ulcerans is related to geographic origin of isolates.
Mycobacterium ulcerans causes extensive ulcers (Buruli ulcers) in the skin of humans. Analysis of the 3'-terminal region of the 16S rRNA gene sequence of 17 strains of M. ulcerans from Africa, the Americas, and Australia revealed three subgroups corresponding to the continent of origin, and some variable phenotypic characteristics. This sequence is useful for the rapid detection of M. ulcerans and discriminates M. marinum and M. shinshuense from M. ulcerans.


Solution-phase structural characterization of supramolecular assemblies by molecular diffraction.
Structures of four molecular squares based on rhenium coordination chemistry have been characterized in the solution phase using pair distribution function (PDF) analyses of wide-angle X-ray scattering measured to better than 1 A spatial resolution. In this report we have focused, in particular, on a comparison of structures for pyrazine- and bipyridine-edged squares measured in solution with structures determined for these molecules in the solid state using X-ray crystallography and models derived from geometry optimization and molecular dynamics simulations using a classical force field. The wide-angle scattering for these assemblies is dominated by pair correlations involving one or more rhenium atoms, with both edge and diagonal Re-Re interactions appearing prominently in PDF plots. The pyrazine square is characterized by a relatively rigid structure in solution, with PDF peak positions and linewidths corresponding closely to those calculated from crystal structure data. For the bipyridine-edged square, the experimental PDF peaks measured along the molecular sides match the positions and linewidths of the PDF peaks calculated from static models. In contrast, PDF peaks measured across the diagonal distances of the molecular square deviate significantly from those calculated from the static crystallographic and energy minimized models. The experimental data are instead indicative of configurational broadening of the diagonal distances. In this respect, molecular dynamics simulations point to the importance of butterfly type motions that modulate the Re-Re diagonal distance. Indeed, the experimental data are reasonably well fit by assuming a bimodal distribution of butterfly conformers differing by approximately 25 degrees in the Re-Re-Re-Re torsion angle. Additionally, the measurements provide evidence for solvent ordering by the supramolecular assemblies detected as regions of solvent association and exclusion.


Evolutionary History of Bioessential Elements Can Guide the Search for Life in the Universe.
Our understanding of life in the universe comes from one sample, life on Earth. Current and next-generation space missions will target exoplanets as well as planets and moons in our own solar system with the primary goal of detecting, interpreting and characterizing indications of possible biological activity. Thus, understanding life's fundamental characteristics is increasingly critical for detecting and interpreting potential biological signatures elsewhere in the universe. Astrobiologists have outlined the essential roles of carbon and water for life, but we have yet to decipher the rules governing the evolution of how living organisms use bioessential elements. Does the suite of life's essential chemical elements on Earth constitute only one possible evolutionary outcome? Are some elements so essential for biological functions that evolution will select for them despite low availability? How would this play out on other worlds that have different relative element abundances? When we look for life in the universe, or the conditions that could give rise to life, we must learn how to recognize it in extremely different chemical and environmental conditions from those on Earth. We argue that by exposing self-organizing biotic chemistries to different combinations of abiotic materials, and by mapping the evolutionary history of metalloenzyme biochemistry onto geological availabilities of metals, alternative element choices that are very different from life's present-day molecular structure might result. A greater understanding of the paleomolecular evolutionary history of life on Earth will create a predictive capacity for detecting and assessing life's existence on worlds where alternate evolutionary paths might have been taken.


Determination of the relationship between patient satisfaction and some global economic indicators using multidimensional scaling.
The importance of labor that contributes to the economy and economic power of the country is increasing recently. There is a strong link between health and economy. People are happier, more productive, and provide more contribution to the economy in communities of healthy individuals. In countries with strong economy, serious economic investments are made in the field of health to grow healthy individuals. The purpose of this study is to determine whether patient satisfaction in primary healthcare services is related to economic strength of countries. The data of European Patients Evaluate General/Family Practice (EUROPEP) scale from 2011 at 17 Organization for Economic Co-operation and Development (OECD) countries are used. The data were compiled from OECD reports and Republic of Turkey Ministry of Health Refik Saydam Hygiene Center Presidency School of Public Health patient satisfaction with primary healthcare services reports. 17 OECD member countries in 2011 health expenditure data, some health indicators, and patient satisfaction are determined to show how grouping in two-dimensional space with the multidimensional scaling. It was observed to vary by countries and groupings that they located in terms of all three criteria. In some countries' economic and health indicators, although quite high compared to the OECD average, citizen satisfaction of healthcare services was low. In some countries, although health expenditure and health indicators are far below the OECD average, citizens' satisfaction with health services has proved to be very high. Multidimensional scaling analysis findings reveal that countries have different positions and groups in terms of each three indicators. According to these results, it cannot be said that high expenditures in the field of health will affect patients satisfaction. Having a strong economy or spending too much money on health does not increase human satisfaction in health care. Effective expenditures on the field of health will increase healthcare service satisfaction. Policy-makers should consider international criteria and take the right steps according to citizens' expectation and satisfaction of healthcare service to implement effective spending.


Changes in Medical Therapy and Lifestyle After Anatomical or Functional Testing for Coronary Artery Disease.
Diagnostic testing in the care of patients newly presenting with symptoms suggestive of coronary artery disease may influence risk factor management, independent of test type or test results. However, little is known about changes in medications and lifestyle after anatomical or functional testing. We examined what factors influenced preventive medical therapy and lifestyle practices at 60 days among 10 003 symptomatic patients (53% women; mean age 61 years) randomly assigned to anatomical testing with coronary computed tomographic angiography or functional testing (NCT01174550). We also assessed the association of preventive changes with major cardiovascular events. There were no differences in medications/lifestyle at baseline. At 60 days, relative to baseline, the computed tomographic angiography strategy was associated with a higher proportion of patients newly initiating aspirin (11.8% versus 7.8%), statins (12.7% versus 6.2%), and β-blockers (8.1% versus 5.3%), compared to functional testing (P<0.0001 for each). No significant differences between computed tomographic angiography and functional testing strategies were observed for initiation of exercise, quitting smoking, or weight loss in overweight/obese patients, though overall prevalence of healthy eating was higher after computed tomographic angiography (P=0.002) while obese/overweight status was lower (P=0.040). Positive initial test results and revascularization demonstrated stronger associations with preventive medications and lifestyle than test type. Medication initiation was not associated with fewer cardiovascular events. Positive initial test results and revascularization are primary drivers of changes in preventive medical and lifestyle practices, with test type making secondary contributions. However, substantial opportunities exist to further reduce cardiovascular risk. URL: https://www.clinicaltrials.gov. Unique identifier: NCT01174550.


Relationship between exposure to extremely low-frequency electromagnetic fields and breast cancer risk: a meta-analysis.
To comprehensively analyze the relationship between human exposure to extremely low frequency electromagnetic fields (ELF-EMFs) and breast cancer and to discuss the potential risk of ELF-EMFs to human breast cancer. Sixteen research reports of case-control studies which were published from 2000 to 2007 were collected. The fixed effect model (FEM) or the random effect model (REM) was chosen to calculate total ORs depending on the outcomes of the test of homogeneity (Q test): the subgroup was analyzed with the menopause and the non-menopause. Sixteen research outcome was ORDL = 1.10, 95% CI = (1.01, 1.20), the OR(MH) of the non-menopause status group was 1.25, 95% CI = (1.05, 1.49), the OR(MH) of the menopause status group was OR(MH) = 1.04, 95% CI = (0.93, 1.18). The authors found that ELF-EMFs may be increase the risk of human breast cancer. The women's exposure to ELF-EMFs may be the risk factor of breast cancer when they are non-menopausal.


Restoration of TLR3-activated myeloid dendritic cell activity leads to improved natural killer cell function in chronic hepatitis B virus infection.
There is increasing evidence that the function of NK cells in patients with chronic hepatitis B (CHB) infection is impaired. The underlying mechanism for the impaired NK cell function is still unknown. Since myeloid dendritic cells (mDC) are potent inducers of NK cells, we investigated the functional interaction of mDC and NK cells in CHB and the influence of antiviral therapy. Blood BDCA1(+) mDC and NK cells were isolated from 16 healthy controls or 39 CHB patients at baseline and during 6 months of antiviral therapy. After activation of mDC with poly(I · C) and gamma interferon (IFN-γ), mDC were cocultured with NK cells. Phenotype and function were analyzed in detail by flow cytometry and enzyme-linked immunosorbent assay. Our findings demonstrate that on poly(I · C)/IFN-γ-stimulated mDC from CHB patients, the expression of costimulatory molecules was enhanced, while cytokine production was reduced. In cocultures of poly(I · C)/IFN-γ-stimulated mDC and NK cells obtained from CHB patients, reduced mDC-induced NK cell activation (i.e., CD69 expression) and IFN-γ production compared to those in healthy individuals was observed. Antiviral therapy normalized mDC activity, since decreased expression of CD80 and CD86 on DC and of HLA-E on NK cells was observed, while poly(I · C)/IFN-γ-induced cytokine production by mDC was enhanced. In parallel, successful antiviral therapy resulted in improved mDC-induced NK cell activation and IFN-γ production. These data demonstrate that CHB patients display a diminished functional interaction between poly(I · C)/IFN-γ activated mDC and NK cells due to impaired mDC function, which can be partially restored by antiviral therapy. Enhancing this reciprocal interaction could reinforce the innate and thus the adaptive T cell response, and this may be an important step in achieving effective antiviral immunity.


Is Allopreening a Stimulus-Driven Defense Against Ectoparasites?
Allopreening occurs when 1 bird preens another bird. The behavior is normally directed at the head and neck of the recipient, i.e., regions that the bird cannot self-preen. Studies of penguins, pigeons, and other groups of birds suggest that allopreening plays a role in the control of ectoparasites, such as ticks and feather lice. However, it is not known whether allopreening increases in response to increases in parasite load, or whether it is a programmed response that occurs independently of parasite load. We conducted a laboratory experiment using wild-caught rock pigeons (Columba livia) to test the relationship between ectoparasite load and allopreening rate. We added feather lice (Columbicola columbae) to captive pigeons and tested for changes in allopreening rates compared to control birds with no lice added. Allopreening rates did not change in response to the addition of lice. Interestingly, however, our data revealed a negative correlation between allopreening and self-preening rates.


Mental health trajectories from childhood to young adulthood affect the educational and employment status of young adults: results from the TRAILS study.
Young adults at work without basic educational level (BEL), and young adults in Neither Employment, Education nor Training (NEET) are at high risk of adverse employment outcomes. Evidence lacks on the impact of mental health problems during childhood, adolescence and young adulthood on employment outcomes of young adults. Therefore, the aims of this study were to (1) identify trajectories of mental health problems from childhood to young adulthood and (2) investigate the relation between these trajectories and the educational or employment status of young adults. Data were used from the Tracking Adolescents' Individual Lives Survey (TRAILS), a Dutch prospective cohort study with 9-year follow-up. Trajectories of mental health problems measured at ages 11, 13.5, 16 and 19 years were identified in 1711 young adults with latent class growth models. Young adults with high-stable trajectories of total problems, from childhood to young adulthood, were more likely to work without BEL or be in NEET at age 19, than to be at school or to work with BEL (28.0% vs 16.0%, p=0.01). The same was found for externalising problems (35.3% vs 23.2%, p=0.02). For internalising and attention problems, no statistically significant differences were found. Young adults with high-stable trajectories of mental health problems from age 11 to 19, were at risk of adverse employment outcomes. Interventions reducing mental health problems in childhood may improve the educational or employment status of young adults and their chances for successfully entering the labour market.


[The making of AIDS news].
This study is part of the overall research effort on the role of the media in making sense of events in late modernity. The main objective is to investigate the context in which news about AIDS is produced at the interface between norms for producing news (as expressed by professional journalists) and an analysis of news stories published in four mainstream Brazilian newspapers. The results are organized in three broad topics: (a) the construction of news about AIDS; (b) the visibility of AIDS news during the study period; and (c) factors that facilitate or hinder the production of AIDS news. Important factors include exclusiveness of the story and/or novelty of the content, the notion of hot (or cold) news, and the specific contents. The authors also emphasize the inevitable chance elements associated with organizational characteristics and daily journalism. They conclude by pointing to recent changes in both the shape of the AIDS epidemic and the communications dynamics resulting from recent developments in the electronic media.


Verbal Descriptions of Cue Direction Affect Object Desirability.
Approach-avoidance behaviors are observed across a broad range of species. For humans, we tend move toward things we like, and away from things we dislike. Previous research tested whether repeatedly shifting visuo-spatial attention toward an object in response to eye gaze cues can increase liking for that object. Here, we tested whether a gaze-liking effect can occur for verbal descriptions of looking behavior without shifts of attention. Also, we tested the gaze specificity hypothesis - that the liking effect is specific to gaze cues - by comparing the effect of different types of cue (pointing gestures and arrow cues). In Experiment 1, participants (N = 205) were split into 5 groups according to the type of cue that was described as directed either toward or away from an object. The results show that (1) attention is not necessary; the liking effect was recorded for verbal descriptions of looking, (2) the effect also occurs for descriptions of pointing and arrows, and (3) the liking effect is enhanced for gaze cues compared to arrows, consistent with the gaze specificity hypothesis. Results from a further experiment suggest that the effect is not due to demand compliance. We conclude that the gaze-liking effect occurs for verbal descriptions of eye gaze. Indeed, because our method bypasses altogether the use of visual cues, objects, and shifts in visual selective attention, our paradigm appears to be more sensitive at tapping into the fundamental approach-avoidance response that mediate the implicit liking effect. As such, it offers new opportunities for research investigations in the future.


Estimation of the magnitude of quadrupole relaxation enhancement in the context of magnetic resonance imaging contrast.
Magnetic Resonance Imaging (MRI) is one of the most powerful diagnostic tools providing maps of 1H relaxation times of human bodies. The method needs, however, a contrast mechanism to enlarge the difference in the relaxation times between healthy and pathological tissues. In this work, we discuss the potential of a novel contrast mechanism for MRI based on Quadrupole Relaxation Enhancement (QRE) and estimate the achievable value of QRE under the most favorable conditions. It has turned out that the theoretically possible enhancement factors are smaller than those of typical paramagnetic contrast agents, but in turn, the field-selectivity of QRE-based agents makes them extremely sensitive to subtle changes of the electric field gradient in the tissue. So far, QRE has been observed for solids (in most cases for 14N) as a result of very slow dynamics and anisotropic spin interactions, believed to be necessary for QRE to appear. We show the first evidence that QRE can be achieved in solutions of compounds containing a high spin nucleus (209Bi) as the quadrupole element. The finding of QRE in a liquid state is explained in terms of spin relaxation theory based on the stochastic Liouville equation. The results confirm the relaxation theory and motivate further exploration of the potential of QRE for MRI.


Assessment of noninvasive risk markers of subclinical atherosclerosis in premenopausal women with previous history of gestational diabetes mellitus.
Gestational diabetes mellitus (GDM) is state of carbohydrate intolerance detected first time during pregnancy. GDM represents a significant risk factor for the development of CVD in women. The degree to which women with histories of gestational diabetes are at risk for cardiovascular disease, beyond their predisposition to future diabetes, is still unclear. The aim of our study was to assess the presence of surrogate markers of subclinical atherosclerosis which can be present in them even without developing type 2 diabetes. In this descriptive cross-sectional hospital based study, 50 patients 20-45 yrs of age, premenopausal, at least 1 yr past her most recent pregnancy, and not more than 5 yr past her index pregnancy with GDM. These patients and controls who did not have GDM were assessed for carotid intima media thickness,endothelial dysfunction, epicardial fat thickness and other cardiovascular risk factors. Women with pGDM were found to have unfavourable cardiovascular risk parameters. They also demonstrated more frequent occurrence of metabolic syndrome(64% vs 10%) than control subjects. Individual components of MS increased with increasing BMI in both the groups. As far as markers of subclinical atherosclerosis were concerned women with pGDM had significantly higher CIMT, FMD and epicardial fat thickness than control group. Women with pGDM, even before development of diabetes have significant differences in CVD risk factors when compared to those who do not have such history. Postpartum screening for glucose intolerance and efforts to minimize modifiable cardiovascular risk factors, including hypertension, viscerall adiposity, and dyslipidemia should be the most effective measures for lowering of cardiovascular risk.


Atomic structures of RNA nanotubes and their comparison with DNA nanotubes.
We present a computational framework to model RNA based nanostructures and study their microscopic structures. We model hexagonal nanotubes made of 6 dsRNA (RNTs) connected by double crossover (DX) at different positions. Using several hundred nano-second (ns) long all-atom molecular dynamics simulations, we study the atomic structure, conformational change and elastic properties of RNTs in the presence of explicit water and ions. Based on several structural quantities such as root mean square deviation (RMSD) and root mean square fluctuation (RMSF), we find that the RNTs are almost as stable as DNA nanotubes (DNTs). Although the central portion of the RNTs maintain its cylindrical shape, both the terminal regions open up to give rise to a gating like behavior which can play a crucial role in drug delivery. From the bending angle distribution, we observe that the RNTs are more flexible than DNTs. The calculated persistence length of the RNTs is in the micron range which is an order of magnitude higher than that of a single dsRNA. The stretch modulus of the RNTs from the contour length distribution is in the range of 4-7 nN depending on the sequence. The calculated persistence length and stretch modulus are in the same range of values as in the case of DNTs. To understand the structural properties of RNTs at the individual base-pair level we have also calculated all the helicoidal parameters and analyzed the relative flexibility and rigidity of RNTs having a different sequence. These findings emphasized the fascinating properties of RNTs which will expedite further theoretical and experimental studies in this field.


Emulsion Polymerization with a Biosurfactant.
Emulsion polymerization of styrene was conducted using a biosurfactant (i.e., sodium surfactin, hereinafter called just "surfactin") having very low critical micelle concentration (CMC, 2.9 × 10-3 mmol/L) and biodegradability characteristics. The nucleation mechanism was investigated by comparing with a conventional surfactant (i.e., sodium dodecyl sulfate) system. Unlike the emulsion polymerization systems using conventional surfactants, nucleation mechanisms changed above CMC in the presence of a biosurfactant. At low concentrations of surfactin (above CMC), the polystyrene (PS) particles are likely generated via a soap-free emulsion polymerization mechanism. In contrast, at high surfactin concentrations, the PS particles would be synthesized by following a micellar nucleation mechanism. However, the slope (0.23) of the log Np versus log Cs plot (Np: number of particles; Cs: concentration of surfactin) did not obey the Smith-Ewart theory (0.6), this probably being produced by the high adsorbability of surfactin.


The magic of magic: The effect of magic tricks on subsequent engagement with lecture material.
Lecturers often present entertaining videos, or organize a variety of amusing demonstrations, to foster student engagement or to encourage critical analysis. Magic tricks, in particular, have been shown to activate neural circuits that underpin motivation or problem-solving and, therefore, could be beneficial during lectures. Nevertheless, we hypothesize that, unless the method that underpins these tricks is revealed, students may ruminate over possible explanations, distracting attention from the lecture material. To test these arguments, in this study, 224 participants watched a video of a magic performance, watched a video of a circus act, or watched no video at all. In half the participants who watched the magic performance, the secret that underpinned the trick was disclosed. Next, participants watched a psychology tutorial, before answering questions that assessed engagement, need for cognition, and comprehension of the material. If the secret was withheld, magic tricks diminished subsequent need for cognition but did not affect comprehension. Furthermore, magic tricks tended to diminish engagement with the subsequent tutorial. These effects, however, were small. Future research is warranted to ascertain whether information that is embedded within a magic trick, rather than presented after the trick, is more likely to be remembered or understood later. This research could clarify when performance can enhance or disrupt student engagement.


Epigenetically mediated pathogenic effects of phenanthrene on regulatory T cells.
Phenanthrene (Phe), a polycyclic aromatic hydrocarbon (PAH), is a major constituent of urban air pollution. There have been conflicting results regarding the role of other AhR ligands 2,3,7,8- tetrachlorodibenzo-p-dioxin (TCDD) and 6-formylindolo [3,2-b]carbazole (FICZ) in modifying regulatory T cell populations (Treg) or T helper (Th)17 differentiation, and the effects of Phe have been understudied. We hypothesized that different chemical entities of PAH induce Treg to become either Th2 or Th17 effector T cells through epigenetic modification of FOXP3. To determine specific effects on T cell populations by phenanthrene, primary human Treg were treated with Phe, TCDD, or FICZ and assessed for function, gene expression, and phenotype. Methylation of CpG sites within the FOXP3 locus reduced FOXP3 expression, leading to impaired Treg function and conversion of Treg into a CD4(+)CD25(lo) Th2 phenotype in Phe-treated cells. Conversely, TCDD treatment led to epigenetic modification of IL-17A and conversion of Treg to Th17 T cells. These findings present a mechanism by which exposure to AhR-ligands mediates human T cell responses and begins to elucidate the relationship between environmental exposures, immune modulation, and initiation of human disease.


Catalytic reactions of titanium alkoxides with Grignard reagents and imines: a mechanistic study.
The reactivity of Grignard reagents towards imines in the presence of catalytic and stoichiometric amounts of titanium alkoxides is reported. Alkylation, reduction, and coupling of imines take place. Whereas reductive coupling is the major reaction in stoichiometric reactions, alkylation is favored in catalytic reactions. Mechanistic studies clearly indicate that intermediates involved in the two reactions are different. Catalytic reactions involve a metal-alkyl complex. This has been confirmed by reactions of deuterium-labeled substrates and different alkylating agents. Under the stoichiometric conditions, however, titanium olefin complexes are formed through reductive elimination, probably through a multinuclear intermediate.


Seasonal and geographical impact on human resting periods.
We study the influence of seasonally and geographically related daily dynamics of daylight and ambient temperature on human resting or sleeping patterns using mobile phone data of a large number of individuals. We observe two daily inactivity periods in the people's aggregated mobile phone calling patterns and infer these to represent the resting times of the population. We find that the nocturnal resting period is strongly influenced by the length of daylight, and that its seasonal variation depends on the latitude, such that for people living in two different cities separated by eight latitudinal degrees, the difference in the resting periods of people between the summer and winter in southern cities is almost twice that in the northern cities. We also observe that the duration of the afternoon resting period is influenced by the temperature, and that there is a threshold from which this influence sets in. Finally, we observe that the yearly dynamics of the afternoon and nocturnal resting periods appear to be counterbalancing each other. This also lends support to the notion that the total daily resting time of people is more or less conserved across the year.


How Does Infection with Human Papillomavirus 16 and 18 Impact on DNA Damage and Repair in Cervical Cells and Peripheral Blood?
Human papillomavirus (HPV) infection is one of the most common sexually transmitted diseases worldwide and a prime cause of cervical cancer. The HPV DNA is detected in approximately 80-90% of all cervical cancers, with HPV 16 and 18 being the high risk conferring human carcinogens. DNA damage and diminished DNA repair mechanisms are potential biological surrogates of HPV infection that warrant further research in different tissues and populations. Notably, we do not know the extent to which the high risk HPV 16 and 18 differentially affect cervical cells versus other systems such as peripheral blood lymphocytes (PBLs). We evaluated DNA damage and repair in women who tested positive for HPV 16 or HPV 18 and healthy control women without HPV 16 or HPV 18 infection. We found that the DNA damage as measured by the Comet assay was markedly greater in cervical cells of women with HPV 16 (mean: 8.1 as% DNA in tail, 95% CI: 7.6-8.7) or HPV 18 infection (mean: 9.6, 95% CI: 8.9-10.2) than controls (mean: 6.7, 95% CI: 6.2-7.4) (p < 0.05). By contrast, in PBLs, we did not find a significant difference in DNA damage between women with HPV 16 or 18 infection versus controls, as measured by the Comet assay or the Conventional Chromosomal Aberration analysis (p > 0.05). We observed, however, the DNA repair capacity, as measured by the X-ray induced challenge (XRC) assay, was significantly impaired in PBLs from women with HPV 16 or 18 infection compared to controls (p < 0.05). This is the first comparative study, to the best of our knowledge, suggesting that the cervical swab cells might be better suited than peripheral lymphocytes as biosamples for detection of HPV 16 or 18 biological effects on DNA damage. In addition, these findings suggest that the Comet assay performed only in PBLs may potentially lead to false negative diagnosis of DNA damage. Taken together, these observations contribute to development of future diagnostic innovation and precision sampling strategies for robust detection of the biological effects of HPV 16 or 18 in women. We conclude by a brief discussion of implications for HPV clinical diagnostics and precision medicine innovation.


A prospective study of cognitive health in the elderly (Oregon Brain Aging Study): effects of family history and apolipoprotein E genotype.
The oldest old are the fastest-growing segment of our population and have the highest prevalence of dementia. Little is known about the genetics of cognitive health in the very old. The aim of this study was to determine whether the genetic risk factors for Alzheimer disease (AD)--namely, apolipoprotein E (APOE) epsilon4 allele and a family history of dementia-continue to be important factors in the cognitive health of the very old. Case-control studies suggest that the effect of genetic factors diminishes at age >75 years. The present prospective study provided evidence to the contrary. We studied 114 Caucasian subjects who were physically healthy and cognitively intact at age 75 years and who were followed, for an average of 4 years, with neurological, psychometric, and neuroimaging examinations. Excellent health at entry did not protect against cognitive decline. Incidence of cognitive decline rose sharply with age. epsilon4 and a family history of dementia (independent of epsilon4) were associated with an earlier age at onset of dementia. Subjects who had epsilon4 or a family history of dementia had a ninefold-higher age-specific risk for dementia than did those who had neither epsilon4 nor a family history of dementia. These observations suggest that the rate of cognitive decline increases with age and that APOE and other familial/genetic factors influence the onset age throughout life.


Benthic invertebrate and microbial biodiversity in sub-tropical urban rivers: Correlations with environmental variables and emerging chemicals.
Urban rivers often function as sinks for various contaminants potentially placing the benthic communities at risk of exposure. We performed a comprehensive biological survey of the benthic macroinvertebrate and bacterial community compositions in six rivers from the suburb to the central urban area of Guangzhou city (South China), and evaluated their correlations with emerging organic contaminants, heavy metals and nutrients. Overall, the benthic macroinvertebrate community shifted from molluscs to oligochaete from the suburban to the central urban rivers that receive treated and untreated sewage. An exception was the site in the Sha River where chironomids were most abundant. The differences in macroinvertebrate community assemblages were significantly associated with chromium, total phosphorus, galaxolide, triclosan and sand content in the sediment. There was no significant difference in benthic macroinvertebrate composition between the dry and wet season. As assessed by double constrained ordination, sexual reproduction was the only trait of benthic macroinvertebrates that showed a significant correlation with pollution variables, as it was significantly positively correlated with chromium and total phosphorus. This suggests that r-strategist occurs in polluted sampling sites. The benthic bacterial community composition showed a significant difference between seasons and among the Liuxi River, Zhujiang River and central urban rivers. The differences in community composition of the benthic bacteria were significantly correlated with galaxolide, total phosphorus, lead and triclosan. These results suggest that input of treated and untreated sewage significantly altered the benthic macroinvertebrate and bacterial community compositions in urban rivers.


Cellular dissection of malaria parasite invasion of human erythrocytes using viable Plasmodium knowlesi merozoites.
Plasmodium knowlesi, a zoonotic parasite causing severe-to-lethal malaria disease in humans, has only recently been adapted to continuous culture with human red blood cells (RBCs). In comparison with the most virulent human malaria, Plasmodium falciparum, there are, however, few cellular tools available to study its biology, in particular direct investigation of RBC invasion by blood-stage P. knowlesi merozoites. This leaves our current understanding of biological differences across pathogenic Plasmodium spp. incomplete. Here, we report a robust method for isolating viable and invasive P. knowlesi merozoites to high purity and yield. Using this approach, we present detailed comparative dissection of merozoite invasion (using a variety of microscopy platforms) and direct assessment of kinetic differences between knowlesi and falciparum merozoites. We go on to assess the inhibitory potential of molecules targeting discrete steps of invasion in either species via a quantitative invasion inhibition assay, identifying a class of polysulfonate polymer able to efficiently inhibit invasion in both, providing a foundation for pan-Plasmodium merozoite inhibitor development. Given the close evolutionary relationship between P. knowlesi and P. vivax, the second leading cause of malaria-related morbidity, this study paves the way for inter-specific dissection of invasion by all three major pathogenic malaria species.


Nutritional influence on epigenetics and effects on longevity.
This review synthesizes recently published information regarding nutrition and its impact upon epigenetically mediated mechanisms involved in longevity and aging. Recent studies enriched considerably our understanding of the relationship between aging and gene-nutrient interactions that continuously shape our phenotype. Epigenetic mechanisms play an important role in mediating between the nutrient inputs and the ensuing phenotypic changes throughout our entire life and seem to be responsible, in part, for the biological changes that occur during aging. Less is known about the epigenetic role that nutrients have in directly influencing longevity and aging. However, recent studies clearly indicated that because nutrition modulates epigenetic events associated with various diseases (e.g., cancer, obesity, and diabetes), there is at least an indirect epigenetic link between nutrition and longevity and, therefore, biologic plausibility to hypothesize the epigenetic role of nutrition in altering longevity. Apart from limited human studies, promising animal studies brought us much closer to understanding how nutrition could have such an impact upon longevity and aging. Complex epigenetic mechanisms are involved in aging and longevity, directly or indirectly via disease mechanisms. Nutrition has a strong impact upon epigenetic processes and, therefore, holds promise in having important roles in regulating longevity and aging.


Silver(I) complexes as precursors to produce silver nanowires: structure characterization, antimicrobial activity and cell viability.
In this contribution a simple method has been employed to synthesis silver nanowires by thermal decomposition of silver complexes. Nanowires are the product of possible chemical reduction of metallic silver residue that remains after the thermal degradation process. Silver(I) complexes of quinolone antibacterial drugs sparfloxacin [Ag(SPHX)2·NO3]·3H2O (1) and enrofloxacin [Ag(ENRX)2·NO3]·2H2O (2) have been prepared and structurally characterized. In the literature the carboxylate and the carbonyl oxygen atoms were the most predominant coordination sites used for quinolones. The resulted complexes presented the drugs as monodentate ligands; however sparfloxacin displayed different behaviour than enrofloxacin. Sparfloxacin coordinated through the nitrogen atom of the piperazine ring, while enrofloxacin coordinated through carboxylate oxygen. Antimicrobial and antifungal activities of the reported complexes are evaluated using a modified Kirby-Bauer disc diffusion and MIC methods. High significant antimicrobial activity is recorded especially against Escherichia coli and Aspergillus flavus. In vitro cytotoxicity of the complexes is measured using MTT assay. The analysis of the cell test showed that the selected complexes displayed no significant cytotoxic response which opens up opportunities for creating further advances in therapeutic challenges. The functional diversity of the prepared silver complexes as precursors of producing nanowires is a subject of high interest in the field of material science. The prepared complexes represent a unique capability when set in the context of biomaterials for therapeutic actions and material engineering. This work provides insight into the mutual amenability of the prepared complexes which can be used to influence both cell-biomaterials interactions and in technical research community.


Peer review of the pesticide risk assessment of the active substance Akanthomyces muscarius strain Ve6, formerly Lecanicillium muscarium strain Ve6.
The conclusions of the European Food Safety Authority (EFSA) following the peer review of the initial risk assessments carried out by the competent authorities of the rapporteur Member State, the Netherlands, and co-rapporteur Member State, France, for the pesticide active substance Akanthomyces muscarius strain Ve6 formerly Lecanicillium muscarium strain Ve6 are reported. The context of the peer review was that required by Commission Implementing Regulation (EU) No 844/2012 as amended by Commission Implementing Regulation (EU) No 2018/1659. The conclusions were reached on the basis of the evaluation of the representative uses of Akanthomyces muscarius strain Ve6 as an insecticide on fruiting vegetables of cucurbitaceae with edible and inedible peel, fruiting vegetables of solanaceae, strawberries, floriculture crops (except roses), cut roses and tree nursery. The reliable end points, appropriate for use in regulatory risk assessment, are presented. Missing information identified as being required by the regulatory framework is listed. Concerns are identified.


Pediatric ovarian malignancy presenting as ovarian torsion: incidence and relevance.
With ovarian torsion, concern for underlying malignancy in the enlarged ovary has previously driven surgeons to resection. Detorsion alone has been recommended to allow for resolution of edema of the ovary with follow-up ultrasound surveillance to evaluate for a persistent mass, yet is not routine practice. However, the incidence of malignancies presenting as ovarian torsion is not documented. Does the risk of an underlying malignancy justify salpingoophorectomy and decreased fertility? After institutional review board exemption (IRB#-022008-095), a 15(1/2)-year retrospective review was conducted to identify cases of operative ovarian torsion in our medical center. Tumors with neoplastic pathology (malignant and benign) were analyzed and compared with all reported cases in the literature. A total of 114 patients (mean +/- SEM age, 10 years, 2 days to 19 years +/- 0.53) with operatively proven ovarian torsion were identified. Four malignancies (3.5%) and 26 benign neoplasms (23%) were present in this age group. Malignancies consisted of serous borderline tumors (2), juvenile granulosa cell tumor (1), and dysgerminoma (1). All were stage I: the former were stage IA and cured with resection alone, and 1 was a stage IB dysgerminoma, which required chemotherapy. The literature yielded a total of 593 cases of operative ovarian torsion with 9 (1.5%) malignancies and 193 (33%) benign neoplasms. The malignancies were juvenile granulosa cell tumor (n = 4), dysgerminoma (n = 2), serous borderline tumors (n = 2), and 1 undifferentiated adenocarcinoma. By combining our series with 13 in the literature, a 1.8% malignancy rate occurred in 707 patients with ovarian torsion, markedly less than the reported malignancy rate of 10% in children with ovarian masses. Thus, neither a pathologic nor malignant lead point should be assumed in cases of torsion. In our series, which represents the largest series of torsion in the pediatric literature, all malignancies presented as stage I. These data further support the implementation of operative detorsion and close postoperative ovarian surveillance, with reoperation for persistent masses. Further study is needed to determine if delaying resection by weeks in those cases of persistent masses would result in tumor progression and thus change prognosis.


Local Pain Dynamics during Constant Exhaustive Exercise.
The purpose of this study was to delineate the topological dynamics of pain and discomfort during constant exercise performed until volitional exhaustion. Eleven physical education students were tested while cycling and running at a "hard" intensity level (e.g., corresponding to Borg's RPE (6-20) = 15). During the tests, participants reported their discomfort and pain on a body map every 15s. "Time on task" for each participant was divided into five equal non-overlapping temporal windows within which their ratings were considered for analysis. The analyses revealed that the number of body locations with perceived pain and discomfort increased throughout the five temporal windows until reaching the mean (± SE) values of 4.2 ± 0.7 and 4.1 ± 0.6 in cycling and running, respectively. The dominant locations included the quadriceps and hamstrings during cycling and quadriceps and chest during running. In conclusion, pain seemed to spread throughout the body during constant cycling and running performed up to volitional exhaustion with differences between cycling and running in the upper body but not in the lower body dynamics.


A comparative epidemiological study of hantavirus infection in Japan and Far East Russia.
Hantaviruses are causative agents of some severe human illnesses, including hemorrhagic fever with renal syndrome (HFRS) and hantavirus pulmonary syndrome (HPS). The viruses are maintained by rodent hosts, and humans acquire infection by inhaling virus-contaminated excreta from infected animals. To examine the epidemiology of hantavirus infections in Japan and Far East Russia, we conducted epidemiological surveys in these regions. In Japan, anti-hantavirus antibodies were found in four rodent species, Clethrionomys rufocanus, Rattus norvegicus, R. rattus, and Apodemus speciosus. Although no new HFRS cases have been officially reported over the past 20 years in Japan, one member of the Japan Ground Self-Defense Force did test positive for hantavirus antibody. Repeated surveys in Far East Russia have revealed that two distinct hantavirus types cause severe HFRS in this region. Hantavirus sequences identified from A. peninsulae, fetal HFRS cases in Vladivostok, and Amur virus are highly similar to each other (> 92% identity), but they are less similar (approximately 84% identity) to the prototypical Hantaan virus, which is carried by A. agrarius. Phylogenetic analysis also indicates that Amur and A. peninsulae-associated viruses are distinct from Hantaan virus, suggesting that A. peninsulae is the reservoir animal for Amur virus, which causes severe HFRS. From HFRS patients in the Khabarovsk region, we identified viruses with nucleotide sequences that are more similar to Far East virus (> 96%identity) than to the Hantaan (88-89% identity) or Amur (81-83% identity) viruses. Phylogenetic analysis also indicates that the viruses from Khabarovsk HFRS patients are closely related to the Far East virus, and distinct from Amur virus.


Low-cost multispectral vegetation imaging system for detecting leaking CO₂ gas.
As a component of a multisensor approach to monitoring carbon sequestration sites for possible leaks of the CO₂ gas from underground reservoirs, a low-cost multispectral imaging system has been developed for indirect detection of gas leaks through observations of the resulting stress in overlying vegetation. The imager employs front-end optics designed to provide a full 50° field of view with a small, low-cost CMOS detector, while still maintaining quasi-collimated light through the angle-dependent interference filters used to define the spectral bands. Red and near-infrared vegetation reflectances are used to compute the normalized difference vegetation index (NDVI) and spatial and temporal patterns are analyzed statistically to identify regions of anomalous stress, which are then flagged for closer inspection with in-situ CO₂ sensors. The system is entirely self-contained with an onboard compact computer and is housed in a weather-proof housing to enable extended outdoor deployment.


Enlarging vertebrobasilar nonsaccular intracranial aneurysms: frequency, predictors, and clinical outcome of growth.
Vertebrobasilar nonsaccular intracranial aneurysms (NIAs) are characterized by elongation, dilation, and tortuosity of the vertebrobasilar arteries. The goal of this study was to define the frequency, predictors, and clinical outcome of the enlargement of vertebrobasilar NIAs. Patients with vertebrobasilar fusiform or dolichoectatic aneurysms demonstrated on imaging studies between 1989 and 2001 were identified. In particular, patients who had undergone serial imaging were included in this study and their medical records were retrospectively reviewed. Prospective information was collected from medical records or death certificates when available. Both initial and serial imaging studies were reviewed. The authors defined NIA enlargement as a change in lesion diameter greater than 2 mm or noted on the neuroradiologist's report. A Cox proportional hazards regression was used to model time from diagnosis of the vertebrobasilar NIA to the first documented enlargement as a function of various predictors. The Kaplan-Meier method was used to study patient death as a function of aneurysm growth. Of the 159 patients with a diagnosis of vertebrobasilar NIA, 52 had undergone serial imaging studies including 25 patients with aneurysm enlargement. Lesion growth significantly correlated with symptomatic compression at the initial diagnosis (p = 0.0028), lesion type (p < 0.001), and the initial maximal lesion diameter (median 15 mm in patients whose aneurysm enlarged compared with median 8 mm in patients whose aneurysm did not enlarge; p < 0.001). The mortality rate was 5.7 times higher in patients with aneurysm growth than in those with no enlargement after adjustment for patient age (p = 0.002). Forty-eight percent of vertebrobasilar NIAs demonstrated on serial imaging enlarged, and this growth was associated with significant morbidity and death. Significant risk factors for aneurysm enlargement included symptomatic compression at the initial diagnosis, transitional or fusiform vertebrobasilar NIAs, and initial lesion diameter. Further studies are necessary to determine appropriate treatments of this disease entity once enlargement has been predicted or occurs.


The impact of fall risk assessment on nurse fears, patient falls, and functional ability in long-term care.
The purpose of this study was to determine whether providing fall risk information to long-term care (LTC) nurses affects restraint use, activities of daily living (ADL), falls, and nurse fears about patient falls. One-hundred and fifty LTC residents were randomized to a fall risk assessment intervention or care-as-usual group. Hypotheses were tested using analyses of variance and path analyses. Restraint use was associated with lower ADL scores. In the intervention group, there ceased to be significant relationships between nurse fears about falls and patient falls (after controlling for actual patient risk; post-intervention, nurse fears about falls were based on realistic appraisals), and between fears and restraints (i.e. unjustified nurse fears became less likely to lead to unjustified restraint use). No group differences in falls were identified. Despite a lack of group differences in falls, results show initial promise in potentially impacting resident care. Increasing intervention intensity may lead to fall reductions in future research. Given the high prevalence rates of falls in LTC and associated injuries, prevention programs are important. Nurse fears about patient falls may impact upon restraint use which, when excessive, can interfere with the patient's ability to perform ADL. Excessive restraint use, due to unjustified nurse fears, could also lead to falls. Providing accurate, concise information to nursing staff about patient fall risk may aid in reducing the association between unjustified nurse fears and the resulting restraint use that can have potential negative consequences.


Midterm experience with the endovascular treatment of isolated iliac aneurysms.
This report describes our 5-year experience with the endovascular repair of isolated iliac aneurysms and pseudoaneurysms. Between June 1993 and July 1998, 40 isolated iliac aneurysms and pseudoaneurysms were treated with endovascular grafts in 39 patients. Thirty-seven aneurysms were treated with endovascular grafts composed of polytetrafluoroethylene grafts and balloon expandable stents, and the other three underwent repair with a polycarbonate urethane endoluminal graft. All the patients underwent initially successful endovascular treatment of isolated iliac aneurysms and pseudoaneurysms and were followed from 1 to 51 months (mean, 18 months). The 4-year primary patency rate was 94.5% +/- 10%. The perioperative complications included one episode of distal embolization, an episode of colonic ischemia, five episodes of kinking or compression of the endovascular graft, and one early postoperative graft thrombosis. There was only one perioperative death in a patient whose aneurysm ruptured in the operating room just before endovascular repair. The median postoperative length of hospital stay was 3.0 +/- 1.3 days in this group of patients at moderate and high risk. The long-term complications included one graft thrombosis and two endoleaks. One small endoleak was followed until the patient died of unrelated causes, and the other one led to aneurysm rupture in the only patient temporarily lost to follow-up examination. This patient successfully underwent treatment in the standard open surgical fashion. To date, all the other aneurysms have remained stable or have decreased in size during the follow-up examinations with duplex or contrast-enhanced computed tomographic scans. Endovascular repair of iliac aneurysms and pseudoaneurysms is a safe and effective technique with good midterm results in patients at standard and high risk. These grafts are particularly beneficial for patients with medical, surgical, or anatomic contraindications for open surgical repair.


Management of extravasation injuries: a focused evaluation of noncytotoxic medications.
Extravasations are common manifestations of iatrogenic injury that occur in patients requiring intravenous delivery of known vesicants. These injuries can contribute substantially to patient morbidity, cost of therapy, and length of stay. Many different mechanisms are behind the tissue damage during extravasation injuries. In general, extravasations consist of four different subtypes of tissue injury: vasoconstriction, osmotic, pH related, and cytotoxic. Recognition of high-risk patients, appropriate cannulation technique, and monitoring of higher risk materials remain the standard of care for the prevention of extravasation injury. Prompt interdisciplinary action is often necessary for the treatment of extravasation injuries. Knowledge of the mechanism of extravasation-induced tissue injury, agents for reversal, and appropriate nonpharmacologic treatment methods is essential. The best therapeutic agent for treatment of vasopressor extravasation is intradermal phentolamine. Topical vasodilators and intradermal terbutaline may provide relief. Intradermal hyaluronidase has been effective for hyperosmotic extravasations, although its use largely depends on the risk of tissue injury and the severity of extravasation. Among the hyperosmotic agents, calcium extravasation is distinctive because it may present as an acute tissue injury or may possess delayed clinical manifestations. Extravasation of acidic or basic materials can produce significant tissue damage. Phenytoin is the prototypical basic drug that causes a clinical manifestation known as purple glove syndrome (PGS). This syndrome is largely managed through preventive and conservative treatment measures. Promethazine is acidic and can cause a devastating extravasation, particularly if administered inadvertently through the arteriolar route. Systemic heparin therapy remains the accepted treatment option for intraarteriolar administration of promethazine. Overall, the evidence for managing extravasations due to noncytotoxic medications is nonexistent or limited to case reports. More research is needed to improve knowledge of patient risk, prompt recognition of the extravasation, and time course for tissue injury, and to develop prevention and treatment strategies for extravasation injuries.


ASPIRE: A multi-site community-based participatory research project to increase understanding of the dynamics of violence against immigrant and refugee women in Australia.
One in three women around the world are or have been subjected to violence. This includes in Australia, where violence against women is an urgent public health and human rights issue. Immigrant and refugee women who have resettled in Australia are known to face barriers accessing services aimed at preventing and responding to family violence. However there is little evidence about the contexts, nature and dynamics of violence against immigrant and refugee women to inform appropriate responses to enhance their safety and well-being. The ASPIRE project will address this gap by identifying opportunities for the development of responsive local and community-based interventions for family violence against immigrant and refugee women, contributing to the currently limited Australian research in this area. This participatory research project will work with communities in eight geographic locations (two inner-city, three outer-suburban, and three regional) across two states (Victoria and Tasmania), to generate evidence about immigrant and refugee women's experiences in a range of settings. The project will engage stakeholders and communities through extensive consultation prior to data collection and by facilitating community members' participation in generating and analysing data. A mix of qualitative methods will be used to generate rich data about the family, cultural and place-based contexts that shape the prevalence and dynamics of violence against immigrant and refugee women; women's prevention and help-seeking efforts; and community attitudes about and responses to violence across a range of cultural groups. Methods include in-depth interviews with women who have experienced family violence, key informant interviews with local community service providers, focus group discussions with men and women from predominant cultural groups that have migrated to areas covered by the research sites, and Photovoice with community leaders. Bilingual health educators will contribute to development of the research approach, the collection and analysis of data, and the dissemination of findings. Findings from this two-year study will be disseminated to communities, service providers and policy-makers, providing evidence to inform culturally-appropriate prevention and support interventions, and building local communities' awareness and capacity to respond to violence against immigrant and refugee women.


Nitric oxide production during murine Lyme disease: lack of involvement in host resistance or pathology.
The murine model of Lyme disease was used to determine the role of inflammatory induced nitric oxide (NO) during infection by the spirochete Borrelia burgdorferi. The outer surface lipoproteins of B. burgdorferi are potent stimulators of inflammatory cytokines and NO production by cultured macrophages in vitro. The addition of NO to cultures of B. burgdorferi prevents growth, suggesting a protective role of NO for the infected host. NO is also a crucial effector in some models of arthritis. Therefore, the involvement of NO in controlling B. burgdorferi infection and its participation in pathological development of arthritis were investigated. Both mildly arthritic (BALB/c) and severely arthritic (C3H/HeJ) strains of mice systemically produced high levels of NO 1 week after infection with B. burgdorferi, as determined by urinary nitrate. NO production remained high throughout the infection in BALB/c mice, while in C3H/HeJ mice NO production returned rapidly to uninfected levels. The in vivo inhibitor of the NO synthase enzyme NG-L-monomethyl arginine (LMMA) was given to mice to investigate whether decreasing NO production would alter the course of disease. LMMA effectively blocked NO production in infected mice; however, there was no significant difference in arthritis development, spirochete infection of tissues, or production of specific antibody in LMMA-treated mice. These results indicate that B. burgdorferi is able to persist in the host even in the presence of high levels of NO. Furthermore, NO is not involved in the control of spirochete infection of tissues, nor is it involved in the development of arthritis. The potent activity of NO against intracellular pathogens and the in vivo resistance of B. burgdorferi to NO suggest that this organism is not located in an intracellular compartment during an essential portion of its infection of the mammalian host.


Direct noninvasive estimation of myocardial tricarboxylic acid cycle flux in vivo using hyperpolarized ¹³C magnetic resonance.
The heart relies on continuous energy production and imbalances herein impair cardiac function directly. The tricarboxylic acid (TCA) cycle is the primary means of energy generation in the healthy myocardium, but direct noninvasive quantification of metabolic fluxes is challenging due to the low concentration of most metabolites. Hyperpolarized (13)C magnetic resonance spectroscopy (MRS) provides the opportunity to measure cellular metabolism in real time in vivo. The aim of this work was to noninvasively measure myocardial TCA cycle flux (VTCA) in vivo within a single minute. Hyperpolarized [1-(13)C]acetate was administered at different concentrations in healthy rats. (13)C incorporation into [1-(13)C]acetylcarnitine and the TCA cycle intermediate [5-(13)C]citrate was dynamically detected in vivo with a time resolution of 3s. Different kinetic models were established and evaluated to determine the metabolic fluxes by simultaneously fitting the evolution of the (13)C labeling in acetate, acetylcarnitine, and citrate. VTCA was estimated to be 6.7±1.7 μmol·g(-1)·min(-1) (dry weight), and was best estimated with a model using only the labeling in citrate and acetylcarnitine, independent of the precursor. The TCA cycle rate was not linear with the citrate-to-acetate metabolite ratio, and could thus not be quantified using a ratiometric approach. The (13)C signal evolution of citrate, i.e. citrate formation was independent of the amount of injected acetate, while the (13)C signal evolution of acetylcarnitine revealed a dose dependency with the injected acetate. The (13)C labeling of citrate did not correlate to that of acetylcarnitine, leading to the hypothesis that acetylcarnitine formation is not an indication of mitochondrial TCA cycle activity in the heart. Hyperpolarized [1-(13)C]acetate is a metabolic probe independent of pyruvate dehydrogenase (PDH) activity. It allows the direct estimation of VTCA in vivo, which was shown to be neither dependent on the administered acetate dose nor on the (13)C labeling of acetylcarnitine. Dynamic (13)C MRS coupled to the injection of hyperpolarized [1-(13)C]acetate can enable the measurement of metabolic changes during impaired heart function.


Role of carotid endarterectomy in asymptomatic carotid stenosis. A Veterans Administration Cooperative Study.
A multi-centered cooperative study is being undertaken to determine the role of carotid endarterectomy in the treatment of asymptomatic carotid stenosis. The primary objective is to compare the incidence of transient ischemic attacks, stroke, and death in previously asymptomatic patients with arteriographically confirmed internal carotid stenoses (greater than or equal to 50%) randomly allocated to carotid endarterectomy and aspirin therapy versus aspirin therapy alone. Ten Veterans Administration Medical Centers (VAMC) in the United States are participating. The study will be conducted over a period of eight years. The first three years will be devoted to acquiring and randomizing patients, after which all patients will be followed clinically for a minimum of five years. It is anticipated that approximately 500 patients will be recruited into the study.


Sharpening stellar images.
Atmospherically induced phase perturbations have for years limited the resolution of large optical astronomical telescopes. A prototype telescope system with six movable elements has successfully corrected these phase perturbations. This use of real-time image sharpening has restored stellar images to the diffraction limit (in one dimension) for a 30-centimeter telescope. The double-star image presented indicates that the bulk of the atmospherically induced wave-front phase change occurred within 2 kilometers of the telescope. This implies that, at least for conditions similar to those of our measurement, real-time correction can be accomplished simultaneously for a region at least several arc seconds in angular size. With the present apparatus the technique should be practical for objects as dim as fifth magnitude, and with improvements the technique holds the promise of active image restoration for objects as dim as ninth magnitude.


Pharmacokinetics, distribution, metabolism, and excretion of deferasirox and its iron complex in rats.
Deferasirox (Exjade, ICL670, CGP72670) is an iron-chelating drug for p.o. treatment of transfusional iron overload in patients with beta-thalassemia or sickle cell disease. The pharmacokinetics and disposition of deferasirox were investigated in rats. The animals received single intravenous (10 mg/kg) or p.o. (10 or 100 mg/kg) doses of 14C-radiolabeled deferasirox. Biological samples were analyzed for radioactivity (liquid scintillation counting, quantitative whole-body autoradioluminography), for deferasirox and its iron complex [high-performance liquid chromatography (HPLC)/UV], and for metabolites (HPLC with radiodetection, liquid chromatography/mass spectrometry, 1H and 13C NMR, and two-dimensional NMR techniques). At least 75% of p.o.-dosed deferasirox was absorbed. The p.o. bioavailability was 26% at the 10 mg/kg dose and showed an overproportional increase at the 100 mg/kg dose, probably because of saturation of elimination processes. Deferasirox-related radioactivity was distributed mainly to blood, excretory organs, and gastrointestinal tract. Enterohepatic recirculation of deferasirox was observed. No retention occurred in any tissue. The placental barrier was passed to a low extent. Approximately 3% of the dose was transferred into the breast milk. Excretion of deferasirox and metabolites was rapid and complete within 7 days. Key clearance processes were hepatic metabolism and biliary elimination via multidrug resistance protein 2. Deferasirox, iron complex, and metabolites were excreted largely via bile and feces (total > or = 90%). Metabolism included glucuronidation at the carboxylate group (acyl glucuronide M3) and at phenolic hydroxy groups, as well as, to a lower degree, cytochrome P450-catalyzed hydroxylations. Two hydroxylated metabolites (M1 and M2) were administered to rats and were shown not to contribute substantially to iron elimination in vivo.


Life expectancy among elderly Brazilians in 2003 according to different levels of functional disability.
The aim of the present study was to estimate disability-free life expectancy for the Brazilian elderly in 2003, by gender and age, based on different concepts of functional disability. The Sullivan method is used to combine the period life tables from the Brazilian Institute of Geography and Statistics (IBGE, 2003) and the prevalence of functional disability according to the 2003 National Sample Household Survey (PNAD 2003). The main results of the study indicate that at age 60, Brazilian men can expect to live 19 years, 39% with mild, 21% with moderate, and 14% with severe functional disability, respectively. At the same age, Brazilian women can expect to live 22 years: 56% with mild, 32% with moderate, and 18% with severe functional disability.


Genetic composition of Brazilian population samples based on a set of twenty-eight ancestry informative SNPs.
Ancestry informative SNPs can be useful to estimate individual and population biogeographical ancestry. Brazilian population is characterized by a genetic background of three parental populations (European, African, and Brazilian Native Amerindians) with a wide degree and diverse patterns of admixture. In this work we analyzed the information content of 28 ancestry-informative SNPs into multiplexed panels using three parental population sources (African, Amerindian, and European) to infer the genetic admixture in an urban sample of the five Brazilian geopolitical regions. The SNPs assigned apart the parental populations from each other and thus can be applied for ancestry estimation in a three hybrid admixed population. Data was used to infer genetic ancestry in Brazilians with an admixture model. Pairwise estimates of F(st) among the five Brazilian geopolitical regions suggested little genetic differentiation only between the South and the remaining regions. Estimates of ancestry results are consistent with the heterogeneous genetic profile of Brazilian population, with a major contribution of European ancestry (0.771) followed by African (0.143) and Amerindian contributions (0.085). The described multiplexed SNP panels can be useful tool for bioanthropological studies but it can be mainly valuable to control for spurious results in genetic association studies in admixed populations.


Variations in the length of stay of intensive care unit nonsurvivors in three Scandinavian countries.
The length of stay (LOS) in intensive care unit (ICU) nonsurvivors is not often reported, but represents an important indicator of the use of resources. LOS in ICU nonsurvivors may also be a marker of cultural and organizational differences between units. In this study based on the national intensive care registries in Finland, Sweden, and Norway, we aimed to report intensive care mortality and to document resource use as measured by LOS in ICU nonsurvivors. Registry data from 53,305 ICU patients in 2006 were merged into a single database. ICU nonsurvivors were analyzed with regard to LOS within subgroups by univariate and multivariate analysis (Cox proportional hazards regression). Vital status at ICU discharge was available for 52,255 patients. Overall ICU mortality was 9.1%. Median LOS of the nonsurvivors was 1.3 days in Finland and Sweden, and 1.9 days in Norway. The shortest LOS of the nonsurvivors was found in patients older than 80 years, emergency medical admissions, and the patients with the highest severity of illness. Multivariate analysis confirmed the longer LOS in Norway when corrected for age group, admission category, sex, and type of hospital. LOS in nonsurvivors was found to be inversely related to the severity of illness, as measured by APACHE II and SAPS II. Despite cultural, religious, and educational similarities, significant variations occur in the LOS of ICU nonsurvivors among Finland, Norway, and Sweden. Overall, ICU mortality is low in the Scandinavian countries.


Osteopathic manipulative treatment for self-reported fatigue, stress, and depression in first-year osteopathic medical students.
During medical education, many students experience psychological distress, including symptoms such as fatigue, stress, and depression. To evaluate the effect of osteopathic manipulative treatment (OMT) on self-perceived fatigue, stress, and depression in first-year osteopathic medical students. This randomized controlled pilot study with repeated measures was conducted at the Lake Erie College of Osteopathic Medicine-Bradenton in Florida during the fall 2012 semester. First-year osteopathic medical students voluntarily enrolled in the study and were randomly assigned to directed OMT (D-OMT), nondirected OMT (ND-OMT), or control groups. The D-OMT and ND-OMT groups received treatment by osteopathic physicians weekly for 4 weeks. The control group received no treatment. All groups completed the Epworth Sleepiness Scale (ESS), the Self-Perceived Stress Scale (SPSS), and the Primary Care Evaluation of Mental Disorders Patient Health Questionnaire 9 (PHQ-9) depression scale before treatment (pretest), after 2 treatments (midtest), and after 4 treatments (posttest). All participants self-reported as white and single, with both sexes equally represented, and had an mean age of 24 years. Analysis of ESS scores revealed a statistically significant decrease in the D-OMT group from pretest and posttest scores and a statistically significant increase in the ND-OMT group from pretest to midtest but not from pretest to posttest scores. No statistically significant differences were noted in the control group scores on this measure. No statistically significant differences were seen in the SPSS or PHQ-9 scores from pretest to midtest or pretest to posttest in any of the 3 groups. The D-OMT regimen used in the current study produced a statistically significant decrease in self-perceived fatigue in first-year osteopathic medical students. Osteopathic manipulative treatment represents a potential modality to reduce self-perceived distress in medical students. Further research is warranted.