Species and regional variations in the effectiveness of antivenom against the in Vitro neurotoxicity of death adder (Acanthophis) venoms

Although viperlike in appearance and habit, death adders belong to the Elapidae family of snakes. Systemic envenomation represents a serious medical problem with antivenom, which is raised against Acanthophis antarcticus venom, representing the primary treatment. This study focused on the major Acanthophis variants from Australia and islands in the Indo-Pacific region. Venoms were profiled using liquid chromatography-mass spectrometry, and analyzed for in vitro neurotoxicity (0.3-10 mug/ml), as well as the effectiveness of antivenom. (1-5 units/ml; 10 min prior to the addition of 10 mug/ml venom). The following death adder venoms were examined: A. antarcticus (from separate populations in New South Wales, Queensland, South Australia, and Western Australia), A. hawkei, A. praelongus, A. pyrrhus, A. rugosus, A. wellsi, and venom from an unnamed species from the Indonesian island of Seram. All venoms abolished indirect twitches of the chick isolated biventer cervicis nerve-muscle preparation in a dose-dependent manner. In addition, all venoms blocked responses to exogenous acetylcholine (1 m-M) and carbachol (20 muM), but not KCl (40 mM), suggesting postsynaptic neurotoxicity. Death adder antivenom (1 unit/ml) prevented the neurotoxic effects of A. pyrrhus, A. praelongus, and A. hawkei venoms, although it was markedly less effective against venoms from A. antarcticus (NSW, SA, WA), A. rugosus, A. wellsi, and A. sp. Scram. However, at 5 units/ml, antivenom was effective against all venoms tested. Death adder venoms, including those from A. antarcticus geographic variants, differed not only in their venom composition but also in their neurotoxic activity and susceptibility to antivenom. For the first time toxicological aspects of A. hawkei, A. wellsi, A. rugosus, and A. sp. Seram venoms were studied. (C) 2001 Academic Press.

Variations régionales du recours aux soins: quelques problèmes méthodologiques. [Regional variations in health services: various methodological problems].

Many studies show strong variation of health consumption between regions, suggesting that theses variations are related to the uncertainty of medical practice or to other factors related to health services or patients attitude. However the statistical interpretation of these variations is far from easy: apart from usual and specific information bias, there are statistical problems when observing incidence of events like health care consumption: it is in fact a rare event, which is observed within small population, and among regions with unequal number of person. Therefore, most of the variation reported might be well explained by a purely statistical phenomenon. This paper presents some aspects of this variability for three common indicators of variation, and suggest the use of ad hoc simulation to get statistical criteria.

Regional variations in ABC transporter expression along the mouse intestinal tract.

The ATP-binding cassette (ABC) family of proteins comprise a group of membrane transporters involved in the transport of a wide variety of compounds, such as xenobiotics, vitamins, lipids, amino acids, and carbohydrates. Determining their regional expression patterns along the intestinal tract will further characterize their transport functions in the gut. The mRNA expression levels of murine ABC transporters in the duodenum, jejunum, ileum, and colon were examined using the Affymetrix MuU74v2 GeneChip set. Eight ABC transporters (Abcb2, Abcb3, Abcb9, Abcc3, Abcc6, Abcd1, Abcg5, and Abcg8) displayed significant differential gene expression along the intestinal tract, as determined by two statistical models (a global error assessment model and a classic ANOVA, both with a P < 0.01). Concordance with semiquantitative real-time PCR was high. Analyzing the promoters of the differentially expressed ABC transporters did not identify common transcriptional motifs between family members or with other genes; however, the expression profile for Abcb9 was highly correlated with fibulin-1, and both genes share a common complex promoter model involving the NFkappaB, zinc binding protein factor (ZBPF), GC-box factors SP1/GC (SP1F), and early growth response factor (EGRF) transcription binding motifs. The cellular location of another of the differentially expressed ABC transporters, Abcc3, was examined by immunohistochemistry. Staining revealed that the protein is consistently expressed in the basolateral compartment of enterocytes along the anterior-posterior axis of the intestine. Furthermore, the intensity of the staining pattern is concordant with the expression profile. This agrees with previous findings in which the mRNA, protein, and transport function of Abcc3 were increased in the rat distal intestine. These data reveal regional differences in gene expression profiles along the intestinal tract and demonstrate that a complete understanding of intestinal ABC transporter function can only be achieved by examining the physiologically distinct regions of the gut.

Regional variations of deformation mechanisms in the Lorrain Quartzite near Whitefish Falls, Ontario, Canada /

The quartzite microfabric found in the Lorrain Formation was studied across the La Cloche syncline, along a regional north-south transect along highway 6, near Whitefish Falls, Ontario. The complete stratigraphic sequence across the syncline is preserved, and is present on each fold limb. The lithostratigraphic units with the smallest grains size and lowest mica content are located close to the core of the fold, while coarser grained mica and feldspar rich units are situated at the northern and southern most extent of the transect. Deformation mechanisms vary with lithology and with position across the fold. Pressure solution appears to be the dominant deformation mechanism in the feldspathic, micaceous and ferruginous units. In the finer grained, mica poor white medium grained and cherty sandstone units, grain boundary migration (GBM) characteristics show dominance over those of pressure solution and show high amounts of fracturing which cut migrated boundaries and therefore post date GBM. All samples across the fold display a preferred orientation of quartz c-axes. The senses of asymmetry of fabrics are found to be similar across the syncline, with the exception of the ferruginous sandstone unit. Formation of these similar fabrics synmietries can not be the result of strain related to first order folding. The mica content appears to be related to the percentage of quartz lost due to pressure solution as a result of strain; the more mica present, the less quartz was lost. Calculations based on the shape of initial grains suggest that conservatively 30% of the quartz volume has been dissolved out of the Lorrain quartzite, and potentially migrated hundreds of meters to other members of the Huronian Supergroup as there was no meso or macroscopic evidence observed in outcrop.

Regional Variations in Political Ideology in Canada

Il est reconnu que les résultats électoraux au Canada varient grandement selon la région. Afin de trouver des explications à ce phénomène, il convient d’étudier comment les grandes régions du Canada se distinguent les unes des autres sur le plan politique. La présente recherche amorce cette étude sous l’angle de l’idéologie. Elle tente de déterminer en quoi l’idéologie politique diffère d’une région à l’autre du pays. Elle s’appuie sur les données des études électorales canadiennes de 2008. On a recours à des questions évaluant les préférences des répondants par rapport à plusieurs enjeux politiques pour répondre à la question de recherche. On conduit en premier lieu une analyse factorielle, qui identifie six facteurs qui ont structuré l’opinion publique lors de l’élection de 2008. Ensuite, des tests T sont conduits pour vérifier si les moyennes de ces facteurs idéologiques sont statistiquement différentes d’une région à l’autre. Les résultats montrent que les différences régionales sont souvent significatives et suivent les hypothèses. Toutefois, les résultats touchant à la privatisation de la santé ainsi qu’au Manitoba et à la Saskatchewan vont à l’encontre des attentes.

Social and regional variations in health status and health behaviours among Swiss young adults

OBJECTIVE To provide nationwide data on health status and health behaviours among young adults in Switzerland, and to illustrate social and regional variations. METHODS Data came from the Swiss Federal Surveys of Adolescents, conducted in 2010/11. The sample consisted of 32,424 young men and 1,467 young women. We used logistic regression models to examine patterns of social inequality for three measures of health status and three measures of health behaviour. RESULTS Among men, lower self-rated health, overweight and lower physical fitness levels were associated with lower educational and fewer financial resources. Patterns were similar among young women. Unfavourable self-rated health (odds ratio [OR]: men 0.83, women 0.75) and overweight (OR: men 0.84, women 0.85; p >0.05) were less common in the French- than in the German-language region. Low physical fitness was more common in the French- than in the German-language region. In both sexes, daily smoking was associated with fewer educational resources, and physical inactivity was associated with lower educational and fewer financial resources. Males from the Italian-language region were three times more likely to be physically inactive than their German-speaking counterparts (OR 2.95). Risk drinking was more widespread among males in the French- than in the German-speaking language region (OR 1.47). CONCLUSIONS Striking social and moderate regional differences exist in health status and health behaviours among young Swiss males and females. The current findings offer new empirical evidence on social determinants of health in Switzerland and suggest education, material resources and regional conditions to be addressed in public health practice and in more focused future research.

Regional variation in toxoplasmosis seronegativity in the São Paulo metropolitan region

Toxoplasmosis is a highly prevalent zoonotic human infection caused by the Apicomplexa protozoon Toxoplasma gondii. The acute disease is usually mild or asymptomatic, except for foetal infection transmitted by acutely infected pregnant women, which courses as a devastating disease. In order to determine possible regional variations in risk factors, we studied the frequency of seronegativity in areas of the São Paulo Metropolitan Region, comparing liters and age groups. The prevalence of seronegativity was determined retrospectively in 1286 pregnant women receiving prenatal care at public health services in four selected areas of the São Paulo Metropolitan Region of similar socioeconomic background. The São Paulo City area had the higher frequency of seronegativity (41.1%), followed by the Northwest (31.5%) and Southwest (29.9%) areas, with similar intermediate levels, and by the Northeast (22.5%) area with the lowest frequency (p<0.001). A rough estimate disclosed about 280 infected infants/year in the São Paulo Metropolitan Region. Serological titers analyzed by age group suggested a decline in antibody levels with age, as shown by a lower frequency of higher titers in older groups. Our study emphasizes the importance of determining the regional prevalence of toxoplasmosis for proper planning of public health prenatal care.

Regional and hemispheric determinants of language laterality: Implications for preoperative fMRI.

Language is typically a function of the left hemisphere but the right hemisphere is also essential in some healthy individuals and patients. This inter-subject variability necessitates the localization of language function, at the individual level, prior to neurosurgical intervention. Such assessments are typically made by comparing left and right hemisphere language function to determine "language lateralization" using clinical tests or fMRI. Here, we show that language function needs to be assessed at the region and hemisphere specific level, because laterality measures can be misleading. Using fMRI data from 82 healthy participants, we investigated the degree to which activation for a semantic word matching task was lateralized in 50 different brain regions and across the entire cortex. This revealed two novel findings. First, the degree to which language is lateralized across brain regions and between subjects was primarily driven by differences in right hemisphere activation rather than differences in left hemisphere activation. Second, we found that healthy subjects who have relatively high left lateralization in the angular gyrus also have relatively low left lateralization in the ventral precentral gyrus. These findings illustrate spatial heterogeneity in language lateralization that is lost when global laterality measures are considered. It is likely that the complex spatial variability we observed in healthy controls is more exaggerated in patients with brain damage. We therefore highlight the importance of investigating within hemisphere regional variations in fMRI activation, prior to neuro-surgical intervention, to determine how each hemisphere and each region contributes to language processing. Hum Brain Mapp, 2010. © 2010 Wiley-Liss, Inc.

Les variations géographiques de la mortalité par cancer au Québec en relation avec l’incidence et la létalité, 2000-2004

Le cancer occupe le premier rang parmi les causes de décès au Québec. Les taux de mortalité diffèrent cependant à travers les régions du Québec. En considérant les territoires des Centres de santé et de services sociaux (CSSS), ce mémoire propose dans un premier temps d’étudier la distribution des taux de mortalité pour les principaux sièges de cancer, d’identifier les régions où une différence significative du taux avec le reste du Québec est perceptible et d’approfondir des éléments impliqués dans la mortalité, soit l’incidence et la létalité. D’autre part, dans le but d’expliquer les variations des taux de mortalité, des variables socio-économiques liées aux territoires retenus serviront de variables explicatives au modèle de régression utilisé. Les résultats ont permis de constater que c’est pour le cancer du poumon que les écarts significatifs sont les plus nombreux. Quant au cancer colorectal, un seul territoire présentait un écart significatif. Pour ce qui est du cancer de la prostate et du sein, aucun écart n’est perceptible dans les taux de mortalité. Concernant la partie explicative de la mortalité, dans le cas du cancer du poumon, les taux d’incidence sont fortement corrélés aux taux de mortalité. On ne peut cependant faire le même constat pour les cancers colorectal, du sein et de la prostate. De plus, les variables socio-économiques considérées pour les territoires de CSSS ne permettaient pas d’arriver à un modèle explicatif convaincant. Ces résultats montrent la nécessité d’avoir des données longitudinales permettant de suivre les individus dès le moment où le diagnostic de cancer est établi afin d’être en mesure de mieux mesurer les liens entre l’incidence, la survie, le niveau socio-économique et la mortalité.

Regional Development in Kerala A Study of Malappuram District

The study makes an attempt to examine the inter regional variations in Kerala in economic development with respect to the important indicators of development over the period 1971 to 2001. The study takes districts as the unit of analysis because this is an attempt to find out the status of districts in Kerala.The study proved that there exists inter district disparities in economic development measured in terms of different indices used for analysis.. statistical estimation of variation proves that there is high degree of variation in industrial sector followed by social and economic infrastructure. The composite index of industrial development shows that the highest index is 1.395 which is five times greater than that of the lowest index 0.273. More or less the same pattern of differences are noticed in most of the indicators of the development. A ranking of the district on the basis of the overall development indicators shows that Malappuram is the least developed district in Kerala. In case of almost all indicators of development Malappuram is lagging behind all other districts.

Regional variation in cortical bone properties from broiler fowl - a first look

1. We used microhardness testing as a probe for fine-scale regional variation in the mechanical performance of bone and present data showing the extent of regional variation in the femora and humeri of 7-week-old broiler birds. 2. Ash content of dry bone was broadly correlated with microhardness, although there is some evidence that the relationship linking the two differs between the femur and the humerus. 3. Regional variations in the properties of bone from poultry are widely overlooked in the literature. Awareness of them is vital and existing measures of bone 'strength' may be misleading if local variation in properties is not taken into account when exploring the effects of nutrition and husbandry practices on bone mechanical performance.

Implications of regional fault distribution and kinematics for the uplift of rift flanks around the Rwenzori Mountains, Southwestern Uganda

Das Ziel dieser Arbeit bestand in der Untersuchung der Störungsverteilung und der Störungskinematik im Zusammenhang mit der Hebung der Riftschultern des Rwenzori Gebirges.rnDas Rwenzori Gebirge befindet sich im NNE-SSWbis N-S verlaufenden Albertine Rift, des nördlichsten Segments des westlichen Armes des Ostafrikanischen Grabensystems. Das Albertine Rift besteht aus Becken unterschiedlicher Höhe, die den Lake Albert, Lake Edward, Lake George und Lake Kivu enthalten. Der Rwenzori horst trennt die Becken des Lake Albert und des Lake Edward. Es erstreckt sich 120km in N-S Richtung, sowie 40-50km in E-W Richtung, der h¨ochste Punkt befindet sich 5111 ü. NN. Diese Studie untersucht einen Abschnitt des Rifts zwischen etwa 1°N und 0°30'S Breite sowie 29°30' und 30°30' östlicher Länge ersteckt. Auch die Feldarbeit konzentrierte sich auf dieses Gebiet.rnrnHauptzweck dieser Studie bestand darin, die folgende These auf ihre Richtigkeit zu überprüfen: ’Wenn es im Verlauf der Zeit tatsächlich zu wesentlichen Änderungen in der Störungskinematik kam, dann ist die starke Hebung der Riftflanken im Bereich der Rwenzoris nicht einfach durch Bewegung entlang der Graben-Hauptst¨orungen zu erklären. Vielmehr ist sie ein Resultat des Zusammenspiels mehrerer tektonische Prozesse, die das Spannungsfeld beeinflussen und dadurch Änderungen in der Kinematik hervorrufen.’ Dadurch konzentrierte sich die Studie in erster Linie auf die Störungsanalyse.rnrnDie Kenntnis regionaler Änderungen der Extensionsrichtung ist entscheidend für das Verständnis komplexer Riftsysteme wie dem Ostafrikanischen Graben. Daher bestand der Kern der Untersuchung in der Kartierung von Störungen und der Untersuchung der Störungskinematik. Die Aufnahme strukturgeologischer Daten konzentrierte sich auf die Ugandische Seite des Rifts, und Pal¨aospannungen wurden mit Hilfe von St¨orungsdaten durch Spannungsinversion rekonstruiert.rnDie unterschiedliche Orientierung spr¨oder Strukturen im Gelände, die geometrische Analyse der geologischen Strukturen sowie die Ergebnisse von Mikrostrukturen im Dünnschliff (Kapitel 4) weisen auf verschiedene Spannungsfelder hin, die auf mögliche Änderungen der Extensionsrichtung hinweisen. Die Resultate der Spannungsinversion sprechen für Ab-, Über- und Blattverschiebungen sowie für Schrägüberschiebungen (Kapitel 5). Aus der Orientierung der Abschiebungen gehen zwei verschiedene Extensionsrichtungen hervor: im Wesentlichen NW-SE Extension in fast allen Gebieten, sowie NNE-SSW Extension im östlichen Zentralbereich.rnAus der Analyse von Blattverschiebungen ergaben sich drei unterschiedliche Spannungszustände. Zum Einen NNW-SSE bis N-S Kompression in Verbindung mit ENE-WSW bzw E-W Extension wurde für die nördlichen und die zentralen Ruwenzoris ausgemacht. Ein zweiter Spannungszustand mit WNW-ESE Kompression/NNE-SSW Extension betraf die Zentralen Rwenzoris. Ein dritter Spannungszustand mit NNW-SSE Extension betraf den östlichen Zentralteil der Rwenzoris. Schrägüberschiebungen sind durch dazu schräge Achsen charakterisiert, die für N-S bis NNW-SSE Kompression sprechen und ausschließlich im östlichen Zentralabschnitt auftreten. Überschiebungen, die hauptsächlich in den zentralen und den östlichen Rwenzoris auftreten, sprechen für NE-SW orientierten σ2-Achsen und NW-SE Extension.rnrnEs konnten drei unterschiedliche Spannungseinflüsse identifiziert werden: auf die kollisionsbedingte Bildung eines Überschiebungssystem folgte intra-kratonische Kompression und schließlich extensionskontrollierte Riftbildung. Der Übergang zwischen den beiden letztgenannten Spannungszuständen erfolgte Schrittweise und erzeugte vermutlich lokal begrenzte Transpression und Transtension. Gegenw¨artig wird die Störungskinematik der Region durch ein tensiles Spannungsregime in NW-SE bis N-S Richtung bestimmt.rnrnLokale Spannungsvariationen werden dabei hauptsächlich durch die Interferenzrndes regionalen Spannungsfeldes mit lokalen Hauptst¨orungen verursacht. Weitere Faktoren die zu lokalen Veränderungen des Spannungsfeldes führen können sind unterschiedliche Hebungsgeschwindigkeiten, Blockrotation oder die Interaktion von Riftsegmenten. Um den Einfluß präexistenter Strukturen und anderer Bedingungen auf die Hebung der Rwenzoris zu ermitteln, wurde der Riftprozeß mit Hilfe eines analogen ’Sandbox’-Modells rekonstruiert (Kapitel 6). Da sich die Moho-Diskontinuität im Bereich des Arbeitsgebietes in einer Tiefe von 25 km befindet, aktive Störungen aber nur bis zu einer Tiefe von etwa 20 km beobachtet werden können (Koehn et al. 2008), wurden nur die oberen 25 km im Modell nachbebildet. Untersucht und mit Geländebeobachtungen verglichen wurden sowohl die Reihenfolge, in der Riftsegmente entstehen, als auch die Muster, die sich im Verlauf der Nukleierung und des Wachstums dieser Riftsegmente ausbilden. Das Hauptaugenmerk wurde auf die Entwicklung der beiden Subsegmente gelegt auf denen sich der Lake Albert bzw. der Lake Edward und der Lake George befinden, sowie auf das dazwischenliegende Rwenzori Gebirge. Das Ziel der Untersuchung bestand darin herauszufinden, in welcher Weise das südwärts propagierende Lake Albert-Subsegment mit dem sinistral versetzten nordwärts propagierenden Lake Edward/Lake George-Subsegment interagiert.rnrnVon besonderem Interesse war es, in welcherWeise die Strukturen innerhalb und außerhalb der Rwenzoris durch die Interaktion dieser Riftsegmente beeinflußt wurden. rnrnDrei verschiedene Versuchsreihen mit unterschiedlichen Randbedingungen wurden miteinander verglichen. Abhängig vom vorherrschenden Deformationstyp der Transferzone wurden die Reihen als ’Scherungs-dominiert’, ’Extensions-dominiert’ und als ’Rotations-dominiert’ charakterisiert. Die Beobachtung der 3-dimensionalen strukturellen Entwicklung der Riftsegmente wurde durch die Kombination von Modell-Aufsichten mit Profilschnitten ermöglicht. Von den drei genannten Versuchsreihen entwickelte die ’Rotationsdominierten’ Reihe einen rautenförmiger Block im Tranferbereich der beiden Riftsegmente, der sich um 5−20° im Uhrzeigersinn drehte. DieserWinkel liegt im Bereich des vermuteten Rotationswinkel des Rwenzori-Blocks (5°). Zusammengefasst untersuchen die Sandbox-Versuche den Einfluss präexistenter Strukturen und der Überlappung bzw. Überschneidung zweier interagierender Riftsegmente auf die Entwicklung des Riftsystems. Sie befassen sich darüber hinaus mit der Frage, welchen Einfluss Blockbildung und -rotation auf das lokale Stressfeld haben.

Regional structural characteristics of bovine periodontal ligament samples and their suitability for biomechanical tests

Mechanical testing of the periodontal ligament requires a practical experimental model. Bovine teeth are advantageous in terms of size and availability, but information is lacking as to the anatomy and histology of their periodontium. The aim of this study, therefore, was to characterize the anatomy and histology of the attachment apparatus in fully erupted bovine mandibular first molars. A total of 13 teeth were processed for the production of undecalcified ground sections and decalcified semi-thin sections, for NaOH maceration, and for polarized light microscopy. Histomorphometric measurements relevant to the mechanical behavior of the periodontal ligament included width, number, size and area fraction of blood vessels and fractal analysis of the two hard-soft tissue interfaces. The histological and histomorphometric analyses were performed at four different root depths and at six circumferential locations around the distal and mesial roots. The variety of techniques applied provided a comprehensive view of the tissue architecture of the bovine periodontal ligament. Marked regional variations were observed in width, surface geometry of the two bordering hard tissues (cementum and alveolar bone), structural organization of the principal periodontal ligament connective tissue fibers, size, number and numerical density of blood vessels in the periodontal ligament. No predictable pattern was observed, except for a statistically significant increase in the area fraction of blood vessels from apical to coronal. The periodontal ligament width was up to three times wider in bovine teeth than in human teeth. The fractal analyses were in agreement with the histological observations showing frequent signs of remodeling activity in the alveolar bone - a finding which may be related to the magnitude and direction of occlusal forces in ruminants. Although samples from the apical root portion are not suitable for biomechanical testing, all other levels in the buccal and lingual aspects of the mesial and distal roots may be considered. The bucco-mesial aspect of the distal root appears to be the most suitable location.

Trauma care capacity and performance in Texas: Regional comparisons

Objective. The study reviewed one year of Texas hospital discharge data and Trauma Registry data for the 22 trauma services regions in Texas to identify regional variations in capacity, process of care and clinical outcomes for trauma patients, and analyze the statistical associations among capacity, process of care, and outcomes. ^ Methods. Cross sectional study design covering one year of state-wide Texas data. Indicators of trauma capacity, trauma care processes, and clinical outcomes were defined and data were collected on each indicator. Descriptive analyses were conducted of regional variations in trauma capacity, process of care, and clinical outcomes at all trauma centers, at Level I and II trauma centers and at Level III and IV trauma centers. Multilevel regression models were performed to test the relations among trauma capacity, process of care, and outcome measures at all trauma centers, at Level I and II trauma centers and at Level III and IV trauma centers while controlling for confounders such as age, gender, race/ethnicity, injury severity, level of trauma centers and urbanization. ^ Results. Significant regional variation was found among the 22 trauma services regions across Texas in trauma capacity, process of care, and clinical outcomes. The regional trauma bed rate, the average staffed bed per 100,000 varied significantly by trauma service region. Pre-hospital trauma care processes were significantly variable by region---EMS time, transfer time, and triage. Clinical outcomes including mortality, hospital and intensive care unit length of stay, and hospital charges also varied significantly by region. In multilevel regression analysis, the average trauma bed rate was significantly related to trauma care processes including ambulance delivery time, transfer time, and triage after controlling for age, gender, race/ethnicity, injury severity, level of trauma centers, and urbanization at all trauma centers. Transfer time only among processes of care was significant with the average trauma bed rate by region at Level III and IV. Also trauma mortality only among outcomes measures was significantly associated with the average trauma bed rate by region at all trauma centers. Hospital charges only among outcomes measures were statistically related to trauma bed rate at Level I and II trauma centers. The effect of confounders on processes and outcomes such as age, gender, race/ethnicity, injury severity, and urbanization was found significantly variable by level of trauma centers. ^ Conclusions. Regional variation in trauma capacity, process, and outcomes in Texas was extensive. Trauma capacity, age, gender, race/ethnicity, injury severity, level of trauma centers and urbanization were significantly associated with trauma process and clinical outcomes depending on level of trauma centers. ^ Key words: regionalized trauma systems, trauma capacity, pre-hospital trauma care, process, trauma outcomes, trauma performance, evaluation measures, regional variations ^