Effect of regular physical training on age-associated alteration of body composition in men

Body composition changes with increasing age in men, in that lean body mass decreases whereas fat mass increases. Whether this altered body composition is related to decreasing physical activity or to the known age-associated decrease in growth hormone secretion is uncertain. To address this question, three groups of healthy men (n = 14 in each group), matched for weight, height and body mass index, were investigated using dual-energy X-ray absorptiometry, indirect calorimetry and estimate of daily growth hormone secretion [i.e. plasma insulin-like growth factor I (IGF-I-) levels]. Group 1 comprised young untrained subjects aged 31.0 +/- 2.1 years (mean +/- SEM) taking no regular physical exercise; group 2 consisted of old untrained men aged 68.6 +/- 1.2 years; and group 3 consisted of healthy old men aged 67.4 +/- 1.2 years undergoing regular physical training for more than 10 years with a training distance of at least 30 km per week. Subjects in group 3 had for the past three years taken part in the 'Grand Prix of Berne', a 16.5-km race run at a speed of 4.7 +/- 0.6 min km-1 (most recent race). Fat mass was more than 4 kg higher in old untrained men (P < 0.01, ANOVA) than in the other groups (young untrained men, 12.0 +/- 0.9 kg; old untrained men, 16.1 +/- 1.0 kg; old trained men, 11.0 +/- 0.8 kg), whereas body fat distribution (i.e. the ratio of upper to lower body fat mass) was similar between the three groups. The lean mass of old untrained men was more than 3.5 kg lower (P < 0.02, ANOVA) than in the other two groups (young untrained men, 56.4 +/- 1.0 kg; old untrained men, 52.4 +/- 1.0 kg; old trained men, 56.0 +/- 1.0 kg), mostly because of a loss of skeletal muscle mass in the arms and legs (young untrained men, 24.0 +/- 0.5 kg; old untrained men 20.8 +/- 0.5 kg; old trained men, 23.6 +/- 0.7 kg; P < 0.01, ANOVA). Resting metabolic rate per kilogram lean mass decreased with increasing age independently of physical activity (r = -0.42, P < 0.005). Fuel metabolism was determined by indirect calorimetry at rest. Protein oxidation was similar in the three groups. Old untrained men had higher (P < 0.001) carbohydrate oxidation (young untrained men, 13.2 +/- 1.0 kcal kg-1 lean mass; old untrained men, 15.2 +/- 1.3 kcal Kg-1; old trained men, 7.8 +/- 0.8 kcal kg-1), but lower (P < 0.05, ANOVA) fat oxidation (young untrained men, 10.1 +/- 1.2 kcal kg-1 lean mass; old untrained men, 6.5 +/- 1.0 kcal kg-1; old trained men, 13.7 +/- 1.0 kcal kg-1) than the other two groups. Mean plasma IGF-I level in old trained men was higher than in old untrained men (P < 0.05), but was still lower than that observed in young untrained men (P < 0.005) (young untrained men, 236 +/- 24 ng mL-1; old untrained men, 119 +/- 13 ng mL-1; old trained men, 166 +/- 14 ng mL-1). In summary, regular physical training in older men seems to prevent the changes in body composition and fuel metabolism normally associated with ageing. Whether regular physical training in formerly untrained old subjects would result in similar changes awaits further study.

A dosimetric study of radionuclide therapy for bone marrow ablation

In a phase I clinical trial, six multiple myeloma patients, who were non-responsive to conventional therapy and were scheduled for bone marrow transplantation, received Holmium-166 ($\sp{166}$Ho) labeled to a bone seeking agent, DOTMP (1,4,7,10-tetraazacyclododecane-1,4,7,10-tetramethylene-phosphonic acid), for the purpose of bone marrow ablation. The specific aims of my research within this protocol were to evaluate the toxicity and efficacy of $\sp{166}$Ho DOTMP by quantifying the in vivo pharmacokinetics and radiation dosimetry, and by correlating these results to the biologic response observed. The reproducibility of pharmacokinetics from multiple injections of $\sp{166}$Ho DOTMP administered to these myeloma patients was demonstrated from both blood and whole body retention. The skeletal concentration of $\sp{166}$Ho DOTMP was heterogenous in all six patients: high in the ribs, pelvis, and lumbar vertebrae regions, and relatively low in the femurs, arms, and head.^ A novel technique was developed to calculate the radiation dose to the bone marrow in each skeletal ROI, and was applied to all six $\sp{166}$Ho DOTMP patients. Radiation dose estimates for the bone marrow calculated using the standard MIRD "S" factors were compared with the average values derived from the heterogenous distribution of activity in the skeleton (i.e., the regional technique). The results from the two techniques were significantly different; the average of the dose estimates from the regional technique were typically 30% greater. Furthermore, the regional technique provided a range of radiation doses for the entire marrow volume, while the MIRD "S" factors only provided a single value. Dose volume histogram analysis of data from the regional technique indicated a range of dose estimates that varied by a factor of 10 between the high dose and low dose regions. Finally, the observed clinical response of cells and abnormal proteins measured in bone marrow aspirates and peripheral blood samples were compared with radiation dose estimates for the bone marrow calculated from the standard and regional technique. The results showed the regional technique values correlated more closely to several clinical response parameters. (Abstract shortened by UMI.) ^

Sample size in orthodontic randomized controlled trials: are numbers justified?

Sample size calculations are advocated by the Consolidated Standards of Reporting Trials (CONSORT) group to justify sample sizes in randomized controlled trials (RCTs). This study aimed to analyse the reporting of sample size calculations in trials published as RCTs in orthodontic speciality journals. The performance of sample size calculations was assessed and calculations verified where possible. Related aspects, including number of authors; parallel, split-mouth, or other design; single- or multi-centre study; region of publication; type of data analysis (intention-to-treat or per-protocol basis); and number of participants recruited and lost to follow-up, were considered. Of 139 RCTs identified, complete sample size calculations were reported in 41 studies (29.5 per cent). Parallel designs were typically adopted (n = 113; 81 per cent), with 80 per cent (n = 111) involving two arms and 16 per cent having three arms. Data analysis was conducted on an intention-to-treat (ITT) basis in a small minority of studies (n = 18; 13 per cent). According to the calculations presented, overall, a median of 46 participants were required to demonstrate sufficient power to highlight meaningful differences (typically at a power of 80 per cent). The median number of participants recruited was 60, with a median of 4 participants being lost to follow-up. Our finding indicates good agreement between projected numbers required and those verified (median discrepancy: 5.3 per cent), although only a minority of trials (29.5 per cent) could be examined. Although sample size calculations are often reported in trials published as RCTs in orthodontic speciality journals, presentation is suboptimal and in need of significant improvement.

Acupuncture-induced changes of pressure pain threshold are mediated by segmental inhibition-a randomized controlled trial

Our aim was to distinguish between spinal and supraspinal mechanisms in the intact nervous system by comparing homosegmental and heterosegmental effects of electroacupuncture (EA) and manual acupuncture (MA) on sensory perception in healthy volunteers by means of quantitative sensory testing. Seventy-two healthy volunteers were randomly assigned to receive either MA or EA at SP 6, SP 9, GB 39, and ST 36 at the left leg or relaxed for 30 minutes (control group [CG]). Blinded examiners assessed 13 sensory modalities (thermal and mechanical detection and pain thresholds) at the upper arms and lower legs before and after intervention by means of a standardized quantitative sensory testing battery. Change scores of all 13 sensory thresholds were compared between groups. The main outcome measure was the change score of the pressure pain threshold (PPT). There were no baseline differences between groups. Pressure pain threshold change scores at the lower left leg, in the same segment as the needling site, differed significantly (P = 0.008) between the EA (median: 103.01 kPa) and CG groups (median: 0.00 kPa) but not between the MA (median: 0.00 kPa) and CG groups. No further significant change score differences were found between one of the acupuncture groups and the CG. The PPT can be changed by EA. The PPT increase was confined to the segment of needling, which indicates that it is mainly mediated by segmental inhibition in the spinal cord. This underscores the importance of segmental needling and electrical stimulation in clinical practice.

LC2, the Chlamydomonas Homologue of the t Complex-encoded Protein Tctex2, Is Essential for Outer Dynein Arm Assembly

Tctex2 is thought to be one of the distorter genes of the mouse t haplotype. This complex greatly biases the segregation of the chromosome that carries it such that in heterozygous +/t males, the t haplotype is transmitted to >95% of the offspring, a phenomenon known as transmission ratio distortion. The LC2 outer dynein arm light chain of Chlamydomonas reinhardtii is a homologue of the mouse protein Tctex2. We have identified Chlamydomonas insertional mutants with deletions in the gene encoding LC2 and demonstrate that the LC2 gene is the same as the ODA12 gene, the product of which had not been identified previously. Complete deletion of the LC2/ODA12 gene causes loss of all outer arms and a slow jerky swimming phenotype. Transformation of the deletion mutant with the cloned LC2/ODA12 gene restores the outer arms and rescues the motility phenotype. Therefore, LC2 is required for outer arm assembly. The fact that LC2 is an essential subunit of flagellar outer dynein arms allows us to propose a detailed mechanism whereby transmission ratio distortion is explained by the differential binding of mutant (t haplotype encoded) and wild-type dyneins to the axonemal microtubules of t-bearing or wild-type sperm, with resulting differences in their motility.

A maximum likelihood algorithm for genome mapping of cytogenetic loci from meiotic configuration data.

Frequencies of meiotic configurations in cytogenetic stocks are dependent on chiasma frequencies in segments defined by centromeres, breakpoints, and telomeres. The expectation maximization algorithm is proposed as a general method to perform maximum likelihood estimations of the chiasma frequencies in the intervals between such locations. The estimates can be translated via mapping functions into genetic maps of cytogenetic landmarks. One set of observational data was analyzed to exemplify application of these methods, results of which were largely concordant with other comparable data. The method was also tested by Monte Carlo simulation of frequencies of meiotic configurations from a monotelodisomic translocation heterozygote, assuming six different sample sizes. The estimate averages were always close to the values given initially to the parameters. The maximum likelihood estimation procedures can be extended readily to other kinds of cytogenetic stocks and allow the pooling of diverse cytogenetic data to collectively estimate lengths of segments, arms, and chromosomes.

O cuidado no espaço de intermedicalidade em uma aldeia indígena

O objetivo deste estudo foi interpretar a realidade social e política, na qual se estabelece o cuidado intercultural vivenciado por indivíduos na zona de intermedicalidade de uma aldeia, partindo da perspectiva dos usuários indígenas e dos profissionais de saúde ameríndios e não-indígenas. As bases teóricas que ancoraram a coleta e análise interpretativa dos dados incluíram: a Etnografia, Antropologia Interpretativa, Modelos explanatórios e abordagem cultural safety. Mediante aprovação do Comitê Nacional de Ética em Pesquisa, procedeu-se trabalho de campo na Terra Indígena Buriti, localizada nos munícipios Sidrolândia e Dois Irmãos do Buriti, Mato Grosso do Sul, Brasil. Realizou-se observação participante nas unidades de saúde e no cotidiano das famílias nas aldeias, bem como no Pólo de Sidrolândia. Realizaram-se entrevistas semiestruturadas com 16 indígenas usuários do serviço, 12 profissionais de saúde terenas e seis trabalhadores de saúde não-indígenas. A análise dos dados, simultânea à coleta, ocorreu na perspectiva da Hermenêutica Dialética por meio da análise temática. Os preceitos éticos foram seguidos. Neste estudo, identificaram-se dois temas: 1) \"Doença é pior que a morte: explicações sobre o processo de adoecimento\" retrata como o processo saúde-doença é interpretado pelos participantes. Saúde, para os terenas, é um aspecto primordial na vida deles. O processo de adoecer envolve a perda e/ou a redução da disposição física, psíquica e espiritual para desenvolver atividades cotidianas. Espiritualidade, higiene, alimentação e a questão da posse de terra impactam o processo de adoecimento terena. 2) \"A intermedicalidade do sistema de cuidado em saúde terena\" que retrata os significados atribuídos pelos participantes à coexistência e intercomunicações (intermedicalidade) entre as formas de cuidados em saúde terena: medicina terena, espiritualidade, modo de vida e o serviço oficial de atenção à saúde (sistema Pólo/Posto). O sistema de cuidado dos terenas revela o processo de indigenização dos serviços de saúde. A medicina terena é entendida sob dois âmbitos: um centralizado no conhecimento tradicional indígena, que inclui uso de ervas, atividades de parteiras e de \"puxadores de pernas\"; e outro nos aspectos místicos e sobrenaturais para sua execução: rezas e prática da pajelança, com destaque para redução do número de pajés. A espiritualidade como opção terapêutica é representada pela fé do terena em Deus, concretizada pela oração. O modo de vida do terena engloba principalmente dois aspectos: centralidade na família e o cuidado com higiene individual e ambiental. O sistema Polo/Posto é procurado pelo terena conforme a cartela de serviços ofertada pelas unidades e segundo suas necessidades peculiares, os casos que o terena \"não consegue resolver\". Neste âmbito de cuidado, há a produção de encontros do cuidado pautados pelo vínculo, confiança, diálogo e agir dos profissionais culturalmente sensível. Há, também, desencontros do cuidado favorecidos por prioridades estabelecidas em metas, atendimento queixa-conduta e precária infraestrutura. Observou-se um processo maciço do uso de medicação. Os aspectos identificados nos relatos dos participantes sobre o sistema de cuidado terena são atravessados pela historicidade do povo terena, questão da posse de terra, medicalização da sociedade, higienismo, integração entre corpo, cosmos e terra, espiritualidade com diversidade religiosa, cultura terena centrada na família, atividades programáticas de saúde na atenção básica, biomedicina, transporte precário e baixa resolutividade. Diabetes e hipertensão arterial foram as doenças registradas pelo Pólo e significadas pelos participantes como as principais enfermidades da população. Há a coexistência de medicinas híbridas em todos âmbitos de cuidado em saúde terena. É importante que a intermedicalidade ocorra nos espaços do sistema Pólo/Posto sem sobreposição do saber médico e/ou da lógica institucional à sabedoria terena

How should the EU respond to Russia's war in Ukraine? CEPS Commentary, 3 September 2014

President Putin has chosen to escalate the conflict in south-eastern Ukraine, thereby ignoring both the sanctions and the diplomatic advances of the EU and its partners in response to Russia’s belligerence towards its neighbour over the last six months. Ahead of the NATO Summit in Wales on September 4-5, calls are growing for EU member states to provide arms and more intelligence to Ukraine’s beleaguered army. But it is far from certain that the EU will summon up the collective courage to do so. Beyond sanctions, what other options does the EU have to alter the Kremlin’s calculus?

O controlo interno e a implementação de auditorias online no Safex em contexto de e-governance: Tecnologias, desafios e oportunidades

O presente Relatório Detalhado de Atividade Profissional é apresentado no âmbito da obtenção do Grau de Mestre dos Oficiais do Exército licenciados pré-Bolonha pela Academia Militar na Área específica de Administração Militar. A sua redação e estruturação tem por base o definido na NEP 520 e NEP 517/1ª da AM, para esta tipologia de trabalhos, tendo o autor, optado por desenvolver um tema no âmbito da sua atividade profissional, considerado como pioneiro e inovador. O Tenente-Coronel de Administração Militar do Exército Português, Luís Miguel Gonçalves, nasceu a 25 de Novembro de 1971. Do seu percurso académico e formativo, consta frequência pré-Universitária, em estabelecimento militar de ensino, no Instituto Militar dos Pupilos do Exército, na área de Contabilidade e Administração; a Licenciatura em Ciências Militares, na especialidade de Administração Militar, pela Academia Militar, em 1995, com a Classificação final de 13,58 valores; o tirocínio para Oficiais de Administração Militar, com a nota final de 15,38 valores; o Curso de Operações Irregulares, tendo obtido a classificação de 17,67 valores; o Curso de Promoção a Capitão, com 16,63 valores; e o Curso de Promoção a Oficial Superior do Instituto de Altos Estudos Militares, com a classificação final de 14,50 valores. No âmbito da formação de pós-graduação, tem averbado créditos no módulo de Metodologia de Investigação Cientifica, pela Academia Militar, no Ano Letivo 2013/14, com a classificação final de 16,00 valores. Para além destes, o Environmental Course For Portugal – NATO School/ SHAPE; formação em Gestão de Projetos/ Exército - Microsoft Enterprise Project Management; o Curso de Formação Pedagógica Inicial de Formadores do Instituto de Emprego e Formação Profissional, com Homologação das Competências Pedagógicas; e vários certificados de formações no âmbito da Contabilidade, Administração, Finanças Públicas e Auditorias Financeiras, atribuídas pela Direção de Finanças do Exército e pelo Instituto de Gestão e Administração Pública do Porto. Ao longo dos 25 anos de serviço prestado ao Exército Português, como Oficial de Administração Militar, desempenhou diversos cargos e funções de Comando e Chefia, em várias UEO, nas áreas setoriais e funcionais, da formação, da instrução, da componente operacional, da logística, do pessoal, das finanças públicas, das inspeções e auditorias, da gestão e da Administração Militar. Atualmente o Tenente-Coronel Miguel Gonçalves, desempenha as Funções de Comandante de Batalhão na Escola dos Serviços. Para além dos cargos e funções averbadas no seu Curriculum Vitae detalhado, constituiu em 1996 o Núcleo Logístico de Projeção, Implantação, Acompanhamento e Ajuda Técnica no âmbito do emprego dos meios táticos e operacionais da Área de Responsabilidade FND/ IFOR na Bósnia-Herzegovina (Jugoslávia). Tem publicado na Revista da Administração Militar, vários artigos no âmbito da logística operacional, na função de combate Apoio de Serviços. Na área da formação, foi orientador e supervisor de vários trabalhos, individuais e de grupo aos cursos de promoção a capitão; e constitui-se como elemento primariamente responsável pelo planeamento e implementação dos primeiros cursos no Exército, com formação certificado pela Agência Nacional para a Qualificação e Ensino Profissional, I.P., do Sistema Nacional de Qualificações, certificação inserida no Catálogo Nacional de Qualificações. Na área Inspetiva, integrou várias equipas de Inspeção-Geral do Exército, como inspetor responsável pelas áreas de Logística e Finanças, bem como as de Inspetor, para a área dos recursos humanos – Despesas com Pessoal, nas equipas de inspeção do Comando do Pessoal do Exército. No desempenho das funções de Auditor Financeiro do Centro de Finanças do Comando do Pessoal, realizou diversas auditorias financeiras às UEO do Comando do Pessoal, na sua dependência, tendo desenvolvido e implementado um sistema pioneiro e inovador de monitorização e controlo interno, de auditorias “Online” com análise e reporte mensal, às contas das UEO do Comando do Pessoal, tendo em vista a validação das Demonstrações Financeiras para a Conta de Gerência Anual do Exército. A escolha do tema, “O Controlo Interno e a implementação de Auditorias Online no SAFEx em contexto de e-Governance: Tecnologias, desafios e oportunidades” surge na sequência da implementação destes procedimentos pelo autor, numa altura em que o Exército entrava em operativo com o Sistema Integrado de Gestão (SIG/DN), tendo sido à data reconhecido publicamente pelo TGEN Comandante do Pessoal do Exército, como sendo um procedimento inovador, com notáveis vantagens para a eficiência e eficácia do sistema administrativo-financeiro do Comando do Pessoal e consequentemente do Exército.

Fortegnelse over en fortrinlig samling vaaben fra det 16 og 17 aarhundrede og for en stor deel hidrörende fra den berömte Dresdenervaabensamling ... oldsager af vaaben og redskaber ... som ved auction bortsælges Tirsdagen den 18. mai.

Mode of access: Internet.

Handbuch der Provinz Hannover.

Bound in full calf, gilt with royal arms and insignia of the kings from George II to William IV on front and back covers, 1737-1803, 1821, 1823-1824, 1826-1827, 1830-1836.

Corografia portuguesa, e descripçam topografica do famoso reyno de Portugal : com as noticias das fundações das cidades, villas, & lugares, que contem : varões illustres, genealogias das familias nobres, fundações de conventos, catalogos dos bispos, antiguidades, maravilhas da natureza, edificios, & outras curiosas observaçoes /

Title-pages printed in red and black; woodcut title vignettes (coats of arms, and a printer's device); woodcut head- and tail-pieces, decorative initials.

Cromwell on foreign affairs, together with four essays on international matters,

Cromwell on foreign affairs.--Neutral trade in arms and ships.--Intervention among states.--The burning of Boer farms and the bombardment of coast towns.--The extent of territorial waters.--Nelson and the admiralty.

The effect of skin examination surveys on the incidence of basal cell carcinoma in a Queensland community sample: A 10-year longitudinal study

Skin cancers pose a significant public health problem in high-risk populations. We have prospectively monitored basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) incidence in a Queensland community over a 10-y period by recording newly treated lesions, supplemented by skin examination surveys. Age-standardized incidence rates of people with new histologically confirmed BCC were 2787 per 100,000 person-years at risk (pyar) among men and 1567 per 100,000 pyar among women, and corresponding tumor rates were 5821 per 100,000 pyar and 2733 per 100,000 pyar, respectively. Incidence rates for men with new SCC were 944 per 100,000 pyar and for women 675 per 100,000 pyar; tumor rates were 1754 per 100,000 pyar and 846 per 100,000 pyar, respectively. Incidence rates of BCC tumors but not SCC tumors varied noticeably according to method of surveillance, with BCC incidence rates based on skin examination surveys around three times higher than background treatment rates. This was mostly due to an increase in diagnosis of new BCC on sites other than the head and neck, arms, and hands associated with skin examination surveys and little to do with advancing the time of diagnosis of BCC on these sites as seen by a return to background rates following the examination surveys. We conclude that BCC that might otherwise go unreported are detected during skin examination surveys and thus that such skin cancer screening can influence the apparent burden of skin cancer.

Risk of serious NSAID-related gastrointestinal events during long-term exposure: a systematic review

Objective: Exposure to non-steroidal anti-inflammatory drugs (NSAIDs) is associated wit increased risk of serious gastrointestinal (GI) events compared with non-exposure. We investigated whether that risk is sustained over time. Data sources: Cochrane Controlled Trials Register (to 2002); MEDLINE, EMBASE, Derwent Drug File and Current Contents (1999-2002); manual searching of reviews (1999-2002). Study selection: From 479 search results reviewed and 221 articles retrieved, seven studies of patients exposed to prescription non-selective NSAIDs for more than 6 months and reporting time-dependent serious GI event rates were selected for quantitative data synthesis. These were stratified into two groups by study design. Data extraction: Incidence of GI events and number of patients at specific time points were extracted. Data synthesis: Meta-regression analyses were performed. Change in risk was evaluated by testing whether the slope of the regression line declined over time. Four randomised controlled trials (RCTs) provided evaluable data from five NSAID arms (aspirin, naproxen, two ibuprofen arms, and diclofenac). When the RCT data were combined, a small significant decline in annualised risk was seen: -0.005% (95% Cl, -0.008% to -0.001%) per month. Sensitivity analyses were conducted because there was disparity within the RCT data. The pooled estimate from three cohort studies showed no significant decline in annualised risk over periods up to 2 years: -0.003% (95% Cl, -0.008% to 0.003%) per month. Conclusions: Small decreases in risk over time were observed; these were of negligible clinical importance. For patients who need long-term (> 6 months) treatment, precautionary measures should be considered to reduce the net probability of serious GI events over the anticipated treatment duration. The effect of intermittent versus regular daily therapy on long-term risk needs further investigation.