Cytochrome P450 and ABCB1 genetics: association with quetiapine and norquetiapine plasma and cerebrospinal fluid concentrations and with clinical response in patients suffering from schizophrenia. A pilot study.

Variability in response to atypical antipsychotic drugs is due to genetic and environmental factors. Cytochrome P450 (CYP) isoforms are implicated in the metabolism of drugs, while the P-glycoprotein transporter (P-gp), encoded by the ABCB1 gene, may influence both the blood and brain drug concentrations. This study aimed to identify the possible associations of CYP and ABCB1 genetic polymorphisms with quetiapine and norquetiapine plasma and cerebrospinal fluid (CSF) concentrations and with response to treatment. Twenty-two patients with schizophrenia receiving 600 mg of quetiapine daily were genotyped for four CYP isoforms and ABCB1 polymorphisms. Quetiapine and norquetiapine peak plasma and CSF concentrations were measured after 4 weeks of treatment. Stepwise multiple regression analysis revealed that ABCB1 3435C > T (rs1045642), 2677G > T (rs2032582) and 1236C > T (rs1128503) polymorphisms predicted plasma quetiapine concentrations, explaining 41% of the variability (p = 0.001). Furthermore, the ABCB1 polymorphisms predicted 48% (p = 0.024) of the variability of the Δ PANSS total score, with the non-carriers of the 3435TT showing higher changes in the score. These results suggest that ABCB1 genetic polymorphisms may be a predictive marker of quetiapine treatment in schizophrenia.

Influence of weather, rank, and home advantage on football outcomes in the gulf region.

PURPOSE: The objective of this study was to investigate the effects of weather, rank, and home advantage on international football match results and scores in the Gulf Cooperation Council (GCC) region. METHODS: Football matches (n = 2008) in six GCC countries were analyzed. To determine the weather influence on the likelihood of favorable outcome and goal difference, generalized linear model with a logit link function and multiple regression analysis were performed. RESULTS: In the GCC region, home teams tend to have greater likelihood of a favorable outcome (P < 0.001) and higher goal difference (P < 0.001). Temperature difference was identified as a significant explanatory variable when used independently (P < 0.001) or after adjustment for home advantage and team ranking (P < 0.001). The likelihood of favorable outcome for GCC teams increases by 3% for every 1-unit increase in temperature difference. After inclusion of interaction with opposition, this advantage remains significant only when playing against non-GCC opponents. While home advantage increased the odds of favorable outcome (P < 0.001) and goal difference (P < 0.001) after inclusion of interaction term, the likelihood of favorable outcome for a GCC team decreased (P < 0.001) when playing against a stronger opponent. Finally, the temperature and wet bulb globe temperature approximation were found as better indicators of the effect of environmental conditions than absolute and relative humidity or heat index on match outcomes. CONCLUSIONS: In GCC region, higher temperature increased the likelihood of a favorable outcome when playing against non-GCC teams. However, international ranking should be considered because an opponent with a higher rank reduced, but did not eliminate, the likelihood of a favorable outcome.

Boron adsorption in soils from the State of São Paulo, Brazil

Boron adsorption was studied in five representative soils (Rhodic Hapludox, Arenic Paleudalf and three Typic Hapludox) from the State of São Paulo, Brazil. Adsorption was higher in the clayey Oxisols, followed by the Alfisol and the coarser Oxisols. Calcium carbonate promoted an increase in the amount of adsorbed boron in all soils, with the most pronounced effect in the coarser-textured Oxisols. High correlation coefficients were found between adsorbed boron and clay and amorphous aluminum oxide contents and specific surface area (r = 0.79, 0.76 and 0.73, respectively, p < 0.01). Clay content, free aluminum oxide, and hot CaCl2 (0.01 mol L-1)-extracted boron explained 93% of the variation of adsorbed boron. Langmuir and Freundlich isotherms fitted well to the adsorbed data, and highest values for maximum boron adsorption were found in clayey soils, which were significantly correlated with contents of total, free and amorphous iron and aluminum oxides, as well with the physical attributes. Ninety four percent of the variation in the maximum adsorption could be related to the free iron content.

Parents living with HIV in a high-income country: do patients need specific support?

The number of HIV-infected persons with children and caregiving duties is likely to increase. From this statement, the present study was designed to establish how HIV infected caregivers organise their parenting routines and to determine their support needs. A further aim was to ascertain caregivers' perception of conspicuous behaviours displayed by their children. Finally, it sought to determine the extent to which the caregivers' assessment of their parenting activity is influenced by the required support and their children's perceived conspicuous behaviours. The study design was observational and cross-sectional. Sampling was based on the 7 HIV Outpatient Clinics associated with the national population-based Swiss HIV Cohort Study. It focused on persons living with HIV who are responsible for raising children below the age of 18. A total of 520 caregivers were approached and 261 participated. An anonymous, standardised, self-administered questionnaire was used for data collection. The data were analysed using descriptive statistical procedures and backward elimination multiple regression analysis. The 261 respondents cared for 406 children and adolescents under 18 years of age; the median age was 10 years. The caregivers' material resources were low. 70% had a net family income in a range below the median of Swiss net family income and 30% were dependent on welfare assistance. 73% were undergoing treatment with 86% reporting no physical impairments. The proportion of single caregivers was 34%. 92% of the children were living with their HIV infected caregivers. 80% of the children attended an institution such as a school or kindergarten during the day. 89% of the caregivers had access to social networks providing support. Nevertheless, caregivers required additional support in performing their parenting duties and indicated a need for assistance on the material level, in connection with legal problems and with participation in the labour market. 46% of the caregivers had observed one or more conspicuous behaviours displayed by their children, which indicates a challenging situation. However, most of these caregivers assessed their parenting activity very favourably. Backward elimination multiple regression analysis indicated that a smaller number of support needs, younger age of the eldest child and fewer physical impairments on the part of the caregiver enhance the caregivers' assessment of their parenting activity. Physicians should speak to caregivers living with HIV about their parenting responsibilities and provide the necessary scope for this subject in their consultation sessions. Physicians are in a position to draw their patients' attention to the services available to them.

Effects of enteral carbohydrates on de novo lipogenesis in critically ill patients.

BACKGROUND: Conversion of glucose into lipid (de novo lipogenesis; DNL) is a possible fate of carbohydrate administered during nutritional support. It cannot be detected by conventional methods such as indirect calorimetry if it does not exceed lipid oxidation. OBJECTIVE: The objective was to evaluate the effects of carbohydrate administered as part of continuous enteral nutrition in critically ill patients. DESIGN: This was a prospective, open study including 25 patients nonconsecutively admitted to a medicosurgical intensive care unit. Glucose metabolism and hepatic DNL were measured in the fasting state or after 3 d of continuous isoenergetic enteral feeding providing 28%, 53%, or 75% carbohydrate. RESULTS: DNL increased with increasing carbohydrate intake (f1.gif" BORDER="0"> +/- SEM: 7.5 +/- 1.2% with 28% carbohydrate, 9.2 +/- 1.5% with 53% carbohydrate, and 19.4 +/- 3.8% with 75% carbohydrate) and was nearly zero in a group of patients who had fasted for an average of 28 h (1.0 +/- 0.2%). In multiple regression analysis, DNL was correlated with carbohydrate intake, but not with body weight or plasma insulin concentrations. Endogenous glucose production, assessed with a dual-isotope technique, was not significantly different between the 3 groups of patients (13.7-15.3 micromol * kg(-1) * min(-1)), indicating impaired suppression by carbohydrate feeding. Gluconeogenesis was measured with [(13)C]bicarbonate, and increased as the carbohydrate intake increased (from 2.1 +/- 0.5 micromol * kg(-1) * min(-1) with 28% carbohydrate intake to 3.7 +/- 0.3 micromol * kg(-1) * min(-1) with 75% carbohydrate intake, P: < 0. 05). CONCLUSION: Carbohydrate feeding fails to suppress endogenous glucose production and gluconeogenesis, but stimulates DNL in critically ill patients.

Selection of the most informative morphoagronomic descriptors for cassava germplasm

The objective of this work was to select the most informative morphoagronomic descriptors for cassava (Manihot esculenta) germplasm and to evaluate the ability of different methods to select the descriptors. Ninety-five accessions were characterized using 51 morphoagronomic descriptors. Data were subjected to a multiple correspondence analysis (MCA), whose information was used in the following four methods of descriptor selection: reverse order of the descriptor for the pth factorial axis of the MCA (Jolliffe); sequential, multiple correspondence analysis (SMCA); mean of the contribution orders of the descriptor in the first three factorial axes (C3PA); and C3PA method weighted by the respective eigenvalues of the full analysis (C3PAWeig). The correlations between the dissimilarity matrix with all descriptors and the most informative descriptors were high and significant (0.75, 0.77, 0.83, and 0.84 for C3PAWeig, C3PA, SMCA, and Jolliffe, respectively). The less informative descriptors were discarded, considering those common among the selection methods and relevant for the breeding interests. Therefore, 32 morphoagronomic descriptors with correlation between the dissimilarity matrices (r=0.81) were selected, due to their high capacity to discriminate cassava germplasm and to their ability to maintain some preliminary agronomic traits, useful for the initial characterization of the germplasm.

Predictions of the MCMI-III personality disorders from NEO-PI-R domains and facets: Comparison between American and Spanish samples

Este estudio ex post facto analiza las relaciones entre las dimensiones y facetas del NEO-PI-R y los 14 trastornos de personalidad del MCMI-III en una muestra no clínica española (N = 674). Se exploran las diferencias y similitudes con los resul- tados de Dyce y O’Connor en una muestra americana con los mismos instrumentos. Como se esperaba, los análisis factoriales de facetas reteniendo cinco factores mostraron un modelo de relaciones muy similar entre ambas muestras, con un coeficiente de la congruencia total de 0,92, y coeficientes de congruencia de factor aceptables, salvo para el factor Apertura (0,68). En consonancia con las predicciones de Widiger y Widiger et al. los porcentajes de correlaciones significativas estaban alrededor de 60% en ambas muestras, y la mayoría coincidían. El análisis de regresión múltiple con dimensiones también reveló un gran parecido entre los resultados americanos y españoles, Neuroticismo fue el predictor más relacionado con los trastornos de personalidad. Se encontraron diferencias en las regresiones por facetas, aunque la varianza explicada fue prácticamente la misma que en las dimensiones. Se discute la validez transcultural y el valor predictivo del NEO-PI-R sobre los trastornos de personalidad del MCMI-III, junto con las ventajas relativas de las facetas sobre las dimensiones.

Factores de explotación asociados a la duración del anestro postparto en vacas nodrizas de razas Parda de Montaña y Pirenaica

Para determinar los factores de explotación relacionados con la reactivación ovárica postparto en vacas nodrizas se realizó un análisis global de una serie de indicadores productivos y la duración del anestro postparto (APP) de 549 vacas explotadas en condiciones extensivas. Debido a la naturaleza multifactorial del proceso en estudio se eligió la metodología estadística multivariante (Análisis Factorial de Correspondencias Múltiples y Análisis Cluster). La duración del APP estuvo asociada a cuatro factores que explicaron el 59% de la heterogeneidad inicial de la muestra y que se definieron como: «Alimentación preparto» (19% de la inercia), «Alimentación postparto-Edad» (16.4%), «Manejo del ternero» (13%) y «Dificultad al parto» (10.5%). Estos factores se introdujeron en un Análisis Cluster que identificó cinco grupos de vacas con características productivas y reproductivas diferentes, y que denominamos como: «Primíparas», «Acceso restringido», «Acceso Libre-Parda de Montaña», «Parto de otoño» y «Parto de primavera». La raza no estuvo relacionada con la duración del APP, aunque el análisis Cluster asoció los largos APP inducidos por la crianza libre con la raza Parda de Montaña. En la raza Parda de Montaña, la duración del APP fue mayor en primavera que en otoño debido a diferencias nutricionales más que a un efecto estacional en sí. El parto de otoño se adaptó mejor a las condiciones de montaña seca.

1D.03: Inactive matrix GLA protein is associated with renal resistive index in a population-based study

OBJECTIVE: Renal resistive index (RRI) varies directly with renal vascular stiffness and pulse pressure. RRI correlates positively with arteriolosclerosis in damaged kidneys and predicts progressive renal dysfunction. Matrix Gla-protein (MGP) is a vascular calcification inhibitor that needs vitamin K to be activated. Inactive MGP, known as desphospho-uncarboxylated MGP (dp-ucMGP), can be measured in plasma and has been associated with various cardiovascular (CV) markers, CV outcomes and mortality. In this study we hypothesize that increased RRI is associated with high levels of dp-ucMGP. DESIGN AND METHOD: We recruited participants via a multi-center family-based cross-sectional study in Switzerland exploring the role of genes and kidney hemodynamics in blood pressure regulation. Dp-ucMGP was quantified in plasma samples by sandwich ELISA. Renal doppler sonography was performed using a standardized protocol to measure RRIs on 3 segmental arteries in each kidney. The mean of the 6 measures was reported. Multiple regression analysis was performed to estimate associations between RRI and dp-ucMGP adjusting for sex, age, pulse pressure, mean pressure, renal function and other CV risk factors. RESULTS: We included 1035 participants in our analyses. Mean values were 0.64 ± 0.06 for RRI and 0.44 ± 0.21 (nmol/L) for dp-ucMGP. RRI was positively associated with dp-ucMGP both before and after adjustment for sex, age, body mass index, pulse pressure, mean pressure, heart rate, renal function, low and high density lipoprotein, smoking status, diabetes, blood pressure and cholesterol lowering drugs, and history of CV disease (P < 0.001). CONCLUSIONS: RRI is independently and positively associated with high levels of dp-ucMGP after adjustment for pulse pressure and common CV risk factors. Further studies are needed to determine if vitamin K supplementation can have a positive effect on renal vascular stiffness and kidney function.

Inactive Matrix Gla-Protein is associated with arterial stiffness in an adult population-based study

Increased pulse wave velocity (PWV) is a marker of aortic stiffness and an independent predictor of mortality. Matrix Gla-protein (MGP) is a vascular calcification inhibitor that needs vitamin K to be activated. Inactive MGP, known as desphospho-uncarboxylated MGP (dp-ucMGP), can be measured in plasma and has been associated with various cardiovascular markers, cardiovascular outcomes, and mortality. In this study, we hypothesized that high levels of dp-ucMGP are associated with increased PWV. We recruited participants via a multicenter family-based cross-sectional study in Switzerland. Dp-ucMGP was quantified in plasma by sandwich ELISA. Aortic PWV was determined by applanation tonometry using carotid and femoral pulse waveforms. Multiple regression analysis was performed to estimate associations between PWV and dp-ucMGP adjusting for age, renal function, and other cardiovascular risk factors. We included 1001 participants in our analyses (475 men and 526 women). Mean values were 7.87±2.10 m/s for PWV and 0.43±0.20 nmol/L for dp-ucMGP. PWV was positively associated with dp-ucMGP both before and after adjustment for sex, age, body mass index, height, systolic and diastolic blood pressure (BP), heart rate, renal function, low- and high-density lipoprotein, glucose, smoking status, diabetes mellitus, BP and cholesterol lowering drugs, and history of cardiovascular disease (P≤0.01). In conclusion, high levels of dp-ucMGP are independently and positively associated with arterial stiffness after adjustment for common cardiovascular risk factors, renal function, and age. Experimental studies are needed to determine whether vitamin K supplementation slows arterial stiffening by increasing MGP carboxylation.

Une délicate rencontre entre savoirs autochtones "experts" : enjeux politiques interculturelles dans le domaine de la prévention de la violence à l'égard des femmes kichwa en Amazonie équatorienne

Cette thèse porte sur l'élaboration et la mise en pratique de politiques interculturelles dans le champ de la santé internationale, en se basant sur une ethnographie d'un programme de préven¬tion de la violence de genre dans le canton de Loreto, en Amazonie équatorienne, mis en place par la Croix-Rouge suisse et aujourd'hui géré de concert avec l'Etat équatorien et une organisation kichwa locale. Suivant une approche qui fait varier les échelles d'analyses pour articuler le niveau local, national et international, elle met en évidence les lieux d'intersection et les hiatus entre l'idéal d'interculturalité tel qu'il est conçu «par le haut» et les pratiques qui sont mises en oeuvre au quotidien par des professionnels de la santé et du développement métis équatoriens. Elle révèle ainsi qu'au-delà de l'idéal du respect des « différences culturelles autochtones » et de la symétrie entre les « cultures », les discours et les pratiques de ces professionnels consistent en une entreprise de normalisation et de moralisation des comportements des destinataires kichwa en matière de rapports de genre. Pour affiner ces analyses et dépasser une approche critique de la santé publique, cette thèse explore également les représentations et les pratiques des destinataires - femmes agents de santé et « bénéficiaires » kichwa du programme - en matière de violence et de rapports de genre. Elle montre ainsi que le transfert de normes et de valeurs via la santé publique fait l'objet de mul¬tiples processus d'appropriations, et explore les différentes d'interprétations, de négociations et d'instrumentalisations de la part des destinataires, tant au niveau individuel que collectif. -- Intercultural politics and the prevention of violence against kichwa women in the Ecuadorian Amazon This PhD thesis focuses on the development and application of intercultural policies in the field of international health. It is drawn on an ethnographic fieldwork conducted in canton Loreto, in the Ecuadorian Amazon, about a gender violence prevention program which was set up by the Swiss Red Cross and which is now managed in cooperation with the Ecuadorian State and a local kichwa organization. Following a multiple-scale analysis in order to articulate the local, national and international dynamics, it highlights the intersections and the gaps between, on the one hand, the the institutional prescriptions about the ideal of interculturality and on the other hand, the daily practices of Ecuadorian mestizo health and development profesionals. It reveals that beyond the ideal of respect for «indigenous cultural differences» and of symmetry between «cultures», the discourses and practices of these professionals consist of a normalizing and moralizing enter¬prise concerning the gendered and, more broadly, social behaviors of kichwa «beneficiaries». In order to refine the analysis and to go beyond a critical approach of public health, this thesis also explores the violence and gender relations representations and practices of kichwa women health workers and «beneficiaries», men and women. Thus it shows that the transfer of norms via public health is the subject of multiple processes of appropriation, interpretation, negotiation and instru¬mentalisation both on individual and collective levels by the «beneficiaries».

Resilience and unmet supportive care needs in patients with cancer during early treatment: A descriptive study.

PURPOSE: The concept of resilience is gaining increasing importance as a key component of supportive care but to date has rarely been addressed in studies with adult cancer patients. The purpose of our study was to describe resilience and its potential predictors and supportive care needs in cancer patients during early treatment and to explore associations between both concepts. METHODS: This descriptive study included adult cancer patients under treatment in ambulatory cancer services of a Swiss hospital. Subjects completed the 25-item Connor-Davidson-Resilience Scale and the 34-item Supportive Care Needs Survey. Descriptive, correlational and regression analysis were performed. RESULTS: 68 patients with cancer were included in the study. Compared to general population, resilience scores were significantly lower (74.4 ± 12.6 vs. 80.4 ± 12.8, p = .0002). Multiple regression analysis showed predictors ("age", "metastasis", "recurrence" and "living alone") of resilience (adjusted R2 = .19, p < .001). Highest unmet needs were observed in the domain of psychological needs. Lower resilience scores were significantly and strongly associated with higher levels of unmet psychological needs (Rho = -.68, p < .001), supportive care needs (Rho = -.49, p < .001) and information needs (Rho = -.42, p = .001). CONCLUSION: Ambulatory patients with higher levels of resilience express fewer unmet needs. Further work is needed to elucidate the mechanism of the observed relationships and if interventions facilitating resilience have a positive effect on unmet needs.

Measuring Brand Equity and Analyzing Its Relationship with Key Marketing Mix Elements

The aim of this paper is to analyze the effect of price and advertising on brand equity. The dimensionality of brand equity is thoroughly examined, and the effect price, price deals, perceived advertising spending and advertising appeal have on the dimensions of brand equity are analyzed using multiple regression analysis as well as other supporting analyses. Price and advertising are found to be of great importance to brand equity. Arguably the most influential finding is the strong positive effect low prices – an integral brand element – have on the case company brand equity, even though a negative effect was hypothesized based on prior research. The results also support separating advertising appeal from perceived advertising spending, as well as linking service quality as part of the overall perceived quality in the context of service-intensive firms.

Ohutlevytuotteen valmistuskustannusten määrittely suunnitteluvaiheessa

Diplomityössä kehitetään ABB Oy Drives:lle menetelmää, jolla voidaan ennustaa ohutlevyosien ja niistä koostuvien kokoonpanojen hintaa ilman tarkkaa valmistuksellista geometriatietoa. Työ on osa Tekesin rahoittamaa Piirre 2.0 -projektia. Työn teoriaosa määrittelee lyhyesti ohutlevytuotteet ja niiden valmistusmenetelmät. Laajemmassa teoriatarkastelussa ovat erilaiset ohutlevytuotteiden valmistuskustannusten ennustamismenetelmät regressioanalyysin käyttöön painottuen. Käytännön osiossa määritetään Finn-Power LP6 -levytyökeskuksen suorituskyky ja muodostetaan työaikalaskuri kerättyyn tietoon perustuen. Lisäksi muodostetaan regressioanalyysit kahden eri alihankkijan valmistamien ohutlevytuotteiden pohjalta. Regressiotekniikoiden avulla etsitään kustannuksiin voimakkaasti vaikuttavat parametrit ja muodostetaan laskukaava valmistuskustannusten ennustamiseen. Lopuksi vertaillaan teorian ja käytännön osien yhteensopivuutta ja etsitään syitä havaittuihin eroihin. Tutkimustulosten hyödyntämismahdollisuuksien ohella esitetään myös eräitä jatkokehitysehdotuksia.