Public papers of the Presidents of the United States.

"Containing the public messages, speeches, and statements of the President", <1956-1992>.

Nonbreeding Eastern Curlews Numenius madagascariensis Do Not Increase the Rate of Intake or Digestive Efficiency before Long-Distance Migration because of an Apparent Digestive Constraint

The possibility of premigratory modulation in gastric digestive performance was investigated in a long-distance migrant, the eastern curlew (Numenius madagascariensis), in eastern Australia. The rate of intake in the curlews was limited by the rate of digestion but not by food availability. It was hypothesized that before migration, eastern curlews would meet the increased energy demand by increasing energy consumption. It was predicted that (1) an increase in the rate of intake and the corresponding rate of gastric throughput would occur or (2) the gastric digestive efficiency would increase between the mid-nonbreeding and premigratory periods. Neither crude intake rate (the rate of intake calculated including inactive pauses; 0.22 g DM [grams dry mass] or 3.09 kJ min(-1)) nor the rate of gastric throughput (0.15 g DM or 2.85 kJ min(-1)) changed over time. Gastric digestive efficiency did not improve between the periods (91%) nor did the estimated overall energy assimilation efficiency (63% and 58%, respectively). It was concluded that the crustacean-dominated diet of the birds is processed at its highest rate and efficiency throughout a season. It appears that without a qualitative shift in diet, no increase in intake rate is possible. Accepting these findings at their face value poses the question of how and over what time period the eastern curlews store the nutrients necessary for the ensuing long, northward nonstop flight.

Violence against young Australian women and association with reproductive events: a cross-sectional analysis of a national population sample

Objective: This study aimed to investigate associations between violence and younger women's reproductive events using Survey 1 (1996) data of the Younger cohort of the Australian Longitudinal Study of Women's Health (ALSWH). Methods: Multinomial regression, using composite variables for both violence and reproductive events, adjusting for socioeconomic variables and weighted for rural and remote areas. Results: 23.8% of 14,784 women aged 18 to 23 years reported violence; 12.6% reported non-partner violence in the previous year; and 11.2% reported ever having had a violent relationship with a partner. Of the latter group, 43% (4.8% overall) also reported violence in the past year. Compared with women reporting no violence, women reporting partner but not recent violence (OR 2.55, 95% Cl 2.10-3.09) or partner and recent violence (OR 3.96, 95% Cl 3.18-4.93) were significantly more likely to have had one or more pregnancies. Conversely, having had a pregnancy (2,561) was associated with an 80% increase in prevalence of any violence and a 230% increase in partner violence. Among women who had a pregnancy, having had a miscarriage or termination was associated with violence. Partner and recent violence is strongly associated with having had a miscarriage, whether alone (OR = 2.85, 95% Cl 1.74-4.66), with a termination (OR = 4.60, 2.26-9.35), or with birth, miscarriage and a termination (OR 4.12, 1.89-9.00). Conclusions and implications: Violence among young women of childbearing age is a factor for which doctors should be vigilant, well-trained and supported to identify and manage effectively.

Genomewide linkage study in 1,176 affected sister pair families identifies a significant susceptibility locus for endometriosis on chromosome 10q26

Endometriosis is a common gynecological disease that affects up to 10% of women in their reproductive years. It causes pelvic pain, severe dysmenorrhea, and subfertility. The disease is defined as the presence of tissue resembling endometrium in sites outside the uterus. Its cause remains uncertain despite 150 years of hypothesis-driven research, and thus the therapeutic options are limited. Disease predisposition is inherited as a complex genetic trait, which provides an alternative route to understanding the disease. We seek to identify susceptibility loci, using a positional-cloning approach that starts with linkage analysis to identify genomic regions likely to harbor these genes. We conducted a linkage study of 1,176 families ( 931 from an Australian group and 245 from a U. K. group), each with at least two members-mainly affected sister pairs-with surgically diagnosed disease. We have identified a region of significant linkage on chromosome 10q26 ( maximum LOD score [MLS] of 3.09; genomewide P = .047) and another region of suggestive linkage on chromosome 20p13 MLS p 2.09). Minor peaks with MLS > 1.0) were found on chromosomes 2, 6, 7, 8, 12, 14, 15, and 17. This is the first report of linkage to a major locus for endometriosis. The findings will facilitate discovery of novel positional genetic variants that influence the risk of developing this debilitating disease. Greater understanding of the aberrant cellular and molecular mechanisms involved in the etiology and pathophysiology of endometriosis should lead to better diagnostic methods and targeted treatments.

Antifibrotic activity of an inhibitor of group IIA secretory phospholipase A(2) in young spontaneously hypertensive rats

The development of fibrosis in the chronically hypertensive heart is associated with infiltration of inflammatory cells and cardiac hypertrophy. In this study, an inhibitor of the proinflammatory enzyme, group IIA human secretory phospholipase A(2) (sPLA(2)-IIA), has been found to prevent collagen deposition as an important component of cardiovascular remodeling in a rat model of developing chronic hypertension. Daily treatment of young male spontaneously hypertensive rats (SHR) with an sPLA2-IIA inhibitor (KH064, 5-(4-benzyloxyphenyl)-4S-(phenyl-heptanoylamino)-pentanoic acid, 5 mg/kg/day p.o.) prevented increases in the content of perivascular,(SHR 20.6 +/- 0.9%, n = 5; SHR+KH064 14.0 +/- 1.2%, n = 5) and interstitial (SHR 7.9 +/- 0.3%, n = 6; SHR+KH064 5.4 +/- 0.7%, n = 6) collagen in the left ventricle of rat hearts, but did not affect numbers of infiltrating monocytes/macrophages, left ventricular hypertrophy (SHR 2.88 +/- 0.08, n = 12; SHR+KH064 3.09 +/- 0.08 mg/g body weight, n = 9), increased systolic blood pressure, or thoracic aortic responses. This selective antifibrotic activity suggests that sPLA2-IIA may have an important but specific role in cardiac fibrosis, and that its inhibitors could be useful in dissecting molecular pathways leading to fibrotic conditions.

Age-related macular degeneration and modification of systemic complement factor H production through liver transplantation

Purpose: To investigate whether modification of liver complement factor H (CFH) production, by alteration of liver CFH Y402H genotype through liver transplantation (LT), influences the development of age-related macular degeneration (AMD). Design: Multicenter, cross-sectional study. Participants: We recruited 223 Western European patients ≥55 years old who had undergone LT ≥5 years previously. Methods: We determined AMD status using a standard grading system. Recipient CFH Y402H genotype was obtained from DNA extracted from recipient blood samples. Donor CFH Y402H genotype was inferred from recipient plasma CFH Y402H protein allotype, measured using enzyme-linked immunosorbent assays. This approach was verified by genotyping donor tissue from a subgroup of patients. Systemic complement activity was ascertained by measuring levels of plasma complement proteins using an enzyme-linked immunosorbent assay, including substrates (C3, C4), activation products (C3a, C4a, and terminal complement complex), and regulators (total CFH, C1 inhibitor). Main Outcome Measures: We evaluated AMD status and recipient and donor CFH Y402H genotype. Results: In LT patients, AMD was associated with recipient CFH Y402H genotype (P = 0.036; odds ratio [OR], 1.6; 95% confidence interval [CI], 1.0-2.4) but not with donor CFH Y402H genotype (P = 0.626), after controlling for age, sex, smoking status, and body mass index. Recipient plasma CFH Y402H protein allotype predicted donor CFH Y402H genotype with 100% accuracy (n = 49). Plasma complement protein or activation product levels were similar in LT patients with and without AMD. Compared with previously reported prevalence figures (Rotterdam Study), LT patients demonstrated a high prevalence of both AMD (64.6% vs 37.1%; OR, 3.09; P<0.001) and the CFH Y402H sequence variation (41.9% vs 36.2%; OR, 1.27; P = 0.014). Conclusions: Presence of AMD is not associated with modification of hepatic CFH production. In addition, AMD is not associated with systemic complement activity in LT patients. These findings suggest that local intraocular complement activity is of greater importance in AMD pathogenesis. The high AMD prevalence observed in LT patients may be associated with the increased frequency of the CFH Y402H sequence variation. © 2013 by the American Academy of Ophthalmology Published by Elsevier Inc.

Perfil antropométrico de futebolistas da segunda divisão gaúcha

O objetivo deste estudo é descrever o perfil antropométrico e a composiçao corporal de jogadores de futebol da divisao de acesso profissional do Rio Grande do Sul. O perfil antropométrico apresenta informaçoes comparativas das características do grupo de jogadores e reflete, indiretamente, seu estado de treinamento. Foram avaliados 17 atletas, com idade média de 25,31 ± 6,26. Mediu-se 7 dobras para composiçao corporal e utilizou-se a Equaçao Jackson e Pollock (1978). Os valores médios obtidos foram: massa corporal 77,4 ± 9,52; altura 177,93 ± 6,88; percentual de gordura 9,69 ± 3,09; e densidade corporal 1,076853894 ± 0,007. Na literatura, os valores de percentuais de gordura em atletas de futebol da divisao de acesso, variam entre 6 a 12. No presente estudo, os valores encontram-se dentro da faixa relatada, nao havendo necessidade de controle dietético para a reduçao de gordura corporal ou treinamento específico para este fim. Este estudo tem a funçao de intervir e embasar o planejamento e a prática de treinamento

Perfil antropométrico de futebolistas da segunda divisão gaúcha

O objetivo deste estudo é descrever o perfil antropométrico e a composiçao corporal de jogadores de futebol da divisao de acesso profissional do Rio Grande do Sul. O perfil antropométrico apresenta informaçoes comparativas das características do grupo de jogadores e reflete, indiretamente, seu estado de treinamento. Foram avaliados 17 atletas, com idade média de 25,31 ± 6,26. Mediu-se 7 dobras para composiçao corporal e utilizou-se a Equaçao Jackson e Pollock (1978). Os valores médios obtidos foram: massa corporal 77,4 ± 9,52; altura 177,93 ± 6,88; percentual de gordura 9,69 ± 3,09; e densidade corporal 1,076853894 ± 0,007. Na literatura, os valores de percentuais de gordura em atletas de futebol da divisao de acesso, variam entre 6 a 12. No presente estudo, os valores encontram-se dentro da faixa relatada, nao havendo necessidade de controle dietético para a reduçao de gordura corporal ou treinamento específico para este fim. Este estudo tem a funçao de intervir e embasar o planejamento e a prática de treinamento

Perfil antropométrico de futebolistas da segunda divisão gaúcha

O objetivo deste estudo é descrever o perfil antropométrico e a composiçao corporal de jogadores de futebol da divisao de acesso profissional do Rio Grande do Sul. O perfil antropométrico apresenta informaçoes comparativas das características do grupo de jogadores e reflete, indiretamente, seu estado de treinamento. Foram avaliados 17 atletas, com idade média de 25,31 ± 6,26. Mediu-se 7 dobras para composiçao corporal e utilizou-se a Equaçao Jackson e Pollock (1978). Os valores médios obtidos foram: massa corporal 77,4 ± 9,52; altura 177,93 ± 6,88; percentual de gordura 9,69 ± 3,09; e densidade corporal 1,076853894 ± 0,007. Na literatura, os valores de percentuais de gordura em atletas de futebol da divisao de acesso, variam entre 6 a 12. No presente estudo, os valores encontram-se dentro da faixa relatada, nao havendo necessidade de controle dietético para a reduçao de gordura corporal ou treinamento específico para este fim. Este estudo tem a funçao de intervir e embasar o planejamento e a prática de treinamento

Impact of dental caries on quality of life of adolescents according to access to oral health services: a cross sectional study

Aim: This study presents the prevalence of dental caries and its relation to the quality of life of adolescents according to the access to dental health services. Methods: Two hundred and fifty-six adolescents between 15 and 19 years of age participated in the study; they were all enrolled in public schools in a countryside municipality of the São Paulo State. Data related to dental caries were evaluated by the DMFT Index, and OHIP-14 was used for evaluating the quality of life. Mann Whitney and Spearmann correlation tests were also used (p<0.05). Results: A DMFT of 3.09 (±3.30) was found with a higher prevalence among the adolescents who used public dental services (3.43±3.34) compared with those who used private services (2.94±3.28). A statistically significant relationship between the decay component of DMFT with physical pain (0.020), physical disability (0.002) and quality of life (0.017) was verified. Conclusions: A low prevalence of dental caries was observed, and it was higher in adolescents who used public oral health services rather than private ones, evidencing the low influence of oral health on the quality of life of the participants.

Desempenho produtivo de Pseudoplatystoma corruscans estocados em sistemas de criação: semi-intensivo (viveiro escavado) e intensivo (tanque-rede)

Objetivou-se comparar o desempenho produtivo e custos de produção de exemplares de pintado, Pseudoplatystoma corruscans, estocados em dois sistemas de criação: semi-intensivo (viveiro escavado, VE) e intensivo (tanque-rede, TR). Trezentos (300) peixes, com um ano de idade, foram estocados, sendo 150 em um VE (médias de peso e comprimento: 1,48±0,46kg e 57,31±6,42cm) e 150 divididos em três TR (médias de peso e comprimento: 1,27±0,34kg e 55,05±4,11cm). Foram alimentados com ração extrusada de 15mm (diâmetro) 40% PB e 3110kcal ED kg-1, ajustada mensalmente à quantidade de ração. Os parâmetros físico-químicos da água, observados durante o experimento, foram temperatura = 24,08°C±3,23; pH=6,89±0,39 e oxigênio dissolvido = 7,57±0,97mg L-1. Os reultados obtidos dos valores médios finais dos comprimentos (VE=74,07±4,34cm; TR=70,33±5,02cm) e pesos dos peixes (VE=3,41±0,58kg e TR=2,94±0,60kg) indicaram desempenho semelhante nos dois sistemas. As médias do fator de condição (0,09-0,036); ganho em peso diário (9,29g dia-1 - 8,95g dia-1); conversão alimentar (3,09-4,15); consumo total de ração (29,60g dia-1 - 74,16g dia-1); índice de crescimento (0,219-0,215) e sobrevivência (97,33-90,67%) para VE e TR, respectivamente. Houve interação significativa entre os sistemas de criação e mês (P<0,05). O quilo de peixe produzido foi de R$ 8,76 (US$ 2,85) e R$ 8,73 (US$ 2,33) para o VE e TR, respectivamente. Embora o VE tenha demonstrado melhor desenvolvimento durante o período e uma vantagem econômica, o índice de crescimento mostrou que ambos os sistemas tiveram desempenhos semelhantes.

Eventos cardiovasculares en el Lupus eritematoso sistémico. Estudio del registro español Relesser

Objetivos: (1) Estudiar la frecuencia de eventos cardiovasculares (CV) que presentaron los pacientes de una gran cohorte española de lupus eritematoso sistémico (LES) tras el diagnóstico de la enfermedad, y (2) investigar los principales factores de riesgo implicados en la aterosclerosis. Material y métodos: Estudio transversal retrospectivo basado en RELESSER, un registro multicéntrico, nacional de pacientes diagnosticados de LES. Pacientes: sujetos con diagnóstico de LES (criterios ACR 1997), atendidos en 45 servicios de Reumatología españoles. Variables: demográficas, clínicas, factores de riesgo tradicionales y eventos CV. La variable de desenlace fue evento CV que se definió por la presencia de al menos uno de los siguientes tras el diagnóstico de LES: 1) Enfermedad cardiaca isquémica (infarto agudo de miocardio y/o angina por clínica y/o electrocardiograma y/o enzimas y/o coronariografía), 2) accidente cerebrovascular (ACV) basado en un diagnóstico previo o por clínica y/o imagen; y 3) enfermedad arterial periférica por diagnóstico previo o por imagen. Los pacientes con eventos CV previos al diagnóstico de LES se excluyeron del análisis. Protocolo: la información fue recogida a partir de las historias clínicas usando un protocolo específico en una plataforma web y con previo entrenamiento de los investigadores. Análisis estadístico: Descriptivo y comparaciones entre grupos utilizando χ2, T-Student o U Mann-Whitney. Análisis de regresión logística múltiple para analizar los posibles factores de riesgo CV asociados a aterosclerosis. Resultados: Desde el año 2.011 al 2.012, 3.658 pacientes con LES fueron reclutados en RELESSER y solo 9 se excluyeron por insuficiente información sobre eventos CV. De los 3.649 restantes, 374 (10,9%) presentaron al menos un evento CV. Doscientos sesenta y nueve (7,4%) pacientes tuvieron 318 eventos CV tras el diagnóstico de LES. El 86,2% de esos pacientes eran mujeres, mediana [RIQ] de edad de 54,9 años [43,2 ̶ 66,1] y una duración del LES de 212.0 meses [120,8 ̶ 289,0]. La media (DE) de edad al cuando sufrieron el primer evento CV fue 48,6 (17,1) años. Los ACV (5,7%), fueron los eventos más frecuentes seguidos de la cardiopatía isquémica (3,8%) y la enfermedad arterial periférica (2,2%). El análisis multivariante mostró una fuerte asociación (OR [IC 95%]) entre los eventos CV y la edad (1,03 [1,02 ̶ 1,04]), la hipertensión arterial (1,71 [1,20 ̶ 2,44]), el tabaquismo (1,48 [1,06 ̶ 2,07]), la diabetes (2,2 [1,32 ̶ 3,74]), la dislipemia (2.18 [1,54 ̶ 3,09], el lupus neuropsiquiátrico (2,42 [1,56 ̶ 3,75]), la presencia de valvulopatía (2,44[1,34 ̶ 4,26]), serositis (1,54 [1,09 ̶ 2.18]), anticuerpos antifosfolípidos (1,57 [1,13 ̶ 2,17]), disminución del complemento (1,81 [1,12 ̶ 2,93]) y la toma de azatioprina (1,47 [1,04 ̶ 2,07]). Conclusiones: Los pacientes con LES presentan una alta prevalencia de enfermedad CV prematura que se asocia con factores de riesgo CV tradicionales y relacionados con el LES. Aunque se necesitan futuros estudios que lo comprueben, nuestro trabajo demuestra, por primera vez, una asociación entre la diabetes y los eventos CV en pacientes con LES.

Rehabilitation staff perspectives on training for problem-solving therapy for primary care in a low vision service

Vision rehabilitation staff were trained to deliver problem-solving therapy for primary care (PSTPC) over the telephone to adults with depressive symptoms and low vision. Training was a 2-day workshop, completion of training cases, and assessment of treatment fidelity. Staff perspectives of training and challenges in PST-PC delivery were explored. Telephone-administered semistructured interviews were conducted pre- and post-workshop and following PST-PC competency. In all, 14 staff (mean age = 47.64 years, SD = 12.68 years, 93% females) achieved competency and 6 withdrew. Results showed an increased understanding of PST-PC from pre- to post-workshop (Z = −2.71, p = .007) and pre-workshop to post-competency (Z = −3.09, p = .002). A high level of satisfaction with training was reported. Staff challenges included the clients’ ability to define problems and brainstorm solutions. Training enabled staff to competently deliver PST-PC and may serve as a model for integrating depression care into vision rehabilitation services recommended by international guidelines.

Clinical presentation, etiology, and outcome of infective endocarditis in the 21st century: the International Collaboration on Endocarditis-Prospective Cohort Study.

BACKGROUND: We sought to provide a contemporary picture of the presentation, etiology, and outcome of infective endocarditis (IE) in a large patient cohort from multiple locations worldwide. METHODS: Prospective cohort study of 2781 adults with definite IE who were admitted to 58 hospitals in 25 countries from June 1, 2000, through September 1, 2005. RESULTS: The median age of the cohort was 57.9 (interquartile range, 43.2-71.8) years, and 72.1% had native valve IE. Most patients (77.0%) presented early in the disease (<30 days) with few of the classic clinical hallmarks of IE. Recent health care exposure was found in one-quarter of patients. Staphylococcus aureus was the most common pathogen (31.2%). The mitral (41.1%) and aortic (37.6%) valves were infected most commonly. The following complications were common: stroke (16.9%), embolization other than stroke (22.6%), heart failure (32.3%), and intracardiac abscess (14.4%). Surgical therapy was common (48.2%), and in-hospital mortality remained high (17.7%). Prosthetic valve involvement (odds ratio, 1.47; 95% confidence interval, 1.13-1.90), increasing age (1.30; 1.17-1.46 per 10-year interval), pulmonary edema (1.79; 1.39-2.30), S aureus infection (1.54; 1.14-2.08), coagulase-negative staphylococcal infection (1.50; 1.07-2.10), mitral valve vegetation (1.34; 1.06-1.68), and paravalvular complications (2.25; 1.64-3.09) were associated with an increased risk of in-hospital death, whereas viridans streptococcal infection (0.52; 0.33-0.81) and surgery (0.61; 0.44-0.83) were associated with a decreased risk. CONCLUSIONS: In the early 21st century, IE is more often an acute disease, characterized by a high rate of S aureus infection. Mortality remains relatively high.