Exercise-associated glucose metabolism in individuals with type 1 diabetes mellitus.

PURPOSE OF REVIEW The primary focus of this review is threefold: first, to summarize available knowledge on exercise-associated glucose metabolism in individuals with type 1 diabetes mellitus (T1DM); second, to elucidate physiological mechanisms predisposing to glycemic variations in patients in T1DM; and third, to describe novel approaches derived from physiological perceptions applicable to stabilize exercise-related glycemia in individuals with T1DM. RECENT FINDINGS Recent studies corroborate the concept that despite partial differences in counter-regulatory mechanisms individuals with T1DM do not fundamentally differ in their glucose response to exercise when compared with healthy individuals if studies are performed under standardized conditions with insulin and glucose levels held close to physiological ranges. Novel approaches derived from a better understanding of exercise-associated glucose metabolism (e.g., the concept of intermittent high-intensity exercise) may provide alternative ways to master the challenges imposed by exercise to individuals with T1DM. SUMMARY Exercise still imposes high demands on patients with T1DM and increases risks for hypoglycemia and hyperglycemia. Deeper insight into the associated metabolic pathways has revealed novel options to stabilize exercise-associated glucose levels in these patients.

Probing the moduli dependence of refined topological amplitudes

With the aim of providing a worldsheet description of the refined topological string, we continue the study of a particular class of higher derivative couplings Fg,n in the type II string effective action compactified on a Calabi–Yau threefold. We analyse first order differential equations in the anti-holomorphic moduli of the theory, which relate the Fg,n to other component couplings. From the point of view of the topological theory, these equations describe the contribution of non-physical states to twisted correlation functions and encode an obstruction for interpreting the Fg,n as the free energy of the refined topological string theory. We investigate possibilities of lifting this obstruction by formulating conditions on the moduli dependence under which the differential equations simplify and take the form of generalised holomorphic anomaly equations. We further test this approach against explicit calculations in the dual heterotic theory.

Accelerated magnetic resonance diffusion tensor imaging of the median nerve using simultaneous multi-slice echo planar imaging with blipped CAIPIRINHA.

PURPOSE To investigate the feasibility of MR diffusion tensor imaging (DTI) of the median nerve using simultaneous multi-slice echo planar imaging (EPI) with blipped CAIPIRINHA. MATERIALS AND METHODS After federal ethics board approval, MR imaging of the median nerves of eight healthy volunteers (mean age, 29.4 years; range, 25-32) was performed at 3 T using a 16-channel hand/wrist coil. An EPI sequence (b-value, 1,000 s/mm(2); 20 gradient directions) was acquired without acceleration as well as with twofold and threefold slice acceleration. Fractional anisotropy (FA), mean diffusivity (MD) and quality of nerve tractography (number of tracks, average track length, track homogeneity, anatomical accuracy) were compared between the acquisitions using multivariate ANOVA and the Kruskal-Wallis test. RESULTS Acquisition time was 6:08 min for standard DTI, 3:38 min for twofold and 2:31 min for threefold acceleration. No differences were found regarding FA (standard DTI: 0.620 ± 0.058; twofold acceleration: 0.642 ± 0.058; threefold acceleration: 0.644 ± 0.061; p ≥ 0.217) and MD (standard DTI: 1.076 ± 0.080 mm(2)/s; twofold acceleration: 1.016 ± 0.123 mm(2)/s; threefold acceleration: 0.979 ± 0.153 mm(2)/s; p ≥ 0.074). Twofold acceleration yielded similar tractography quality compared to standard DTI (p > 0.05). With threefold acceleration, however, average track length and track homogeneity decreased (p = 0.004-0.021). CONCLUSION Accelerated DTI of the median nerve is feasible. Twofold acceleration yields similar results to standard DTI. KEY POINTS • Standard DTI of the median nerve is limited by its long acquisition time. • Simultaneous multi-slice acquisition is a new technique for accelerated DTI. • Accelerated DTI of the median nerve yields similar results to standard DTI.

Second, do less harm: The state of states' medical error reporting programs

Statement of the problem and public health significance. Hospitals were designed to be a safe haven and respite from disease and illness. However, a large body of evidence points to preventable errors in hospitals as the eighth leading cause of death among Americans. Twelve percent of Americans, or over 33.8 million people, are hospitalized each year. This population represents a significant portion of at risk citizens exposed to hospital medical errors. Since the number of annual deaths due to hospital medical errors is estimated to exceed 44,000, the magnitude of this tragedy makes it a significant public health problem. ^ Specific aims. The specific aims of this study were threefold. First, this study aimed to analyze the state of the states' mandatory hospital medical error reporting six years after the release of the influential IOM report, "To Err is Human." The second aim was to identify barriers to reporting of medical errors by hospital personnel. The third aim was to identify hospital safety measures implemented to reduce medical errors and enhance patient safety. ^ Methods. A descriptive, longitudinal, retrospective design was used to address the first stated objective. The study data came from the twenty-one states with mandatory hospital reporting programs which report aggregate hospital error data that is accessible to the public by way of states' websites. The data analysis included calculations of expected number of medical errors for each state according to IOM rates. Where possible, a comparison was made between state reported data and the calculated IOM expected number of errors. A literature review was performed to achieve the second study aim, identifying barriers to reporting medical errors. The final aim was accomplished by telephone interviews of principal patient safety/quality officers from five Texas hospitals with more than 700 beds. ^ Results. The state medical error data suggests vast underreporting of hospital medical errors to the states. The telephone interviews suggest that hospitals are working at reducing medical errors and creating safer environments for patients. The literature review suggests the underreporting of medical errors at the state level stems from underreporting of errors at the delivery level. ^

A systematic review of the methods used to assess race and racial disparities in uterine fibroid research

Context: Black women are reported to have a higher prevalence of uterine fibroids, and a threefold higher incidence rate and relative risk for clinical uterine fibroid development as compared to women of other races. Uterine fibroid research has reported that black women experience greater uterine fibroid morbidity and disproportionate uterine fibroid disease burden. With increased interest in understanding uterine fibroid development, and race being a critical component of uterine fibroid assessment, it is imperative that the methods used to determine the race of research participants is defined and the operational definition of the use of race as a variable is reported for methodological guidance, and to enable the research community to compare statistical data and replicate studies. ^ Objectives: To systematically review and evaluate the methods used to assess race and racial disparities in uterine fibroid research. ^ Data Sources: Databases searched for this review include: OVID Medline, NML PubMed, Ebscohost Cumulative Index to Nursing and Allied Health Plus with Full Text, and Elsevier Scopus. ^ Review Methods: Articles published in English were retrieved from data sources between January 2011 and March 2011. Broad search terms, uterine fibroids and race, were employed to retrieve a comprehensive list of citations for review screening. The initial database yield included 947 articles, after duplicate extraction 485 articles remained. In addition, 771 bibliographic citations were reviewed to identify additional articles not found through the primary database search, of which 17 new articles were included. In the first screening, 502 titles and abstracts were screened against eligibility questions to determine citations of exclusion and to retrieve full text articles for review. In the second screening, 197 full texted articles were screened against eligibility questions to determine whether or not they met full inclusion/exclusion criteria. ^ Results: 100 articles met inclusion criteria and were used in the results of this systematic review. The evidence suggested that black women have a higher prevalence of uterine fibroids when compared to white women. None of the 14 studies reporting data on prevalence reported an operational definition or conceptual framework for the use of race. There were a limited number of studies reporting on the prevalence of risk factors among racial subgroups. Of the 3 studies, 2 studies reported prevalence of risk factors lower for black women than other races, which was contrary to hypothesis. And, of the three studies reporting on prevalence of risk factors among racial subgroups, none of them reported a conceptual framework for the use of race. ^ Conclusion: In the 100 uterine fibroid studies included in this review over half, 66%, reported a specific objective to assess and recruit study participants based upon their race and/or ethnicity, but most, 51%, failed to report a method of determining the actual race of the participants, and far fewer, 4% (only four South American studies), reported a conceptual framework and/or operational definition of race as a variable. However, most, 95%, of all studies reported race-based health outcomes. The inadequate methodological guidance on the use of race in uterine fibroid studies, purporting to assess race and racial disparities, may be a primary reason that uterine fibroid research continues to report racial disparities, but fails to understand the high prevalence and increased exposures among African-American women. A standardized method of assessing race throughout uterine fibroid research would appear to be helpful in elucidating what race is actually measuring, and the risk of exposures for that measurement. ^

Identificación de localidades en el partido de General Pueyrredón a partir de la Implementación de Tecnologías de Información Geográfica (TIGS)

El partido de General Pueyrredón es una unidad administrativa de fuerte tradición urbana, encabezada por la ciudad de Mar del Plata. No obstante, debe indicarse que hacia 1980 otros centros poblados del partido comenzaron a mostrar signos positivos en su dinámica demográfica. El reconocimiento de localidades dentro de una unidad civil de tercer rango, como son los partidos o departamentos, presupone un nivel de complejidad vinculado con aspectos teóricos, socio-culturales y metodológicos, por cuanto existen diversas elaboraciones referidas a la definición de localidades. Así, el aporte del presente trabajo consiste en aunar criterios, evidenciar la dinámica de las categorizaciones y remarcar la importancia de conocer directamente el territorio para mejorar las tipologías. El objetivo del trabajo es identificar las localidades del Partido de General Pueyrredón mediante el uso de TIGs como herramienta con potencialidad para el análisis de los procesos socioterritoriales

Identificación de localidades en el partido de General Pueyrredón a partir de la Implementación de Tecnologías de Información Geográfica (TIGS)

El partido de General Pueyrredón es una unidad administrativa de fuerte tradición urbana, encabezada por la ciudad de Mar del Plata. No obstante, debe indicarse que hacia 1980 otros centros poblados del partido comenzaron a mostrar signos positivos en su dinámica demográfica. El reconocimiento de localidades dentro de una unidad civil de tercer rango, como son los partidos o departamentos, presupone un nivel de complejidad vinculado con aspectos teóricos, socio-culturales y metodológicos, por cuanto existen diversas elaboraciones referidas a la definición de localidades. Así, el aporte del presente trabajo consiste en aunar criterios, evidenciar la dinámica de las categorizaciones y remarcar la importancia de conocer directamente el territorio para mejorar las tipologías. El objetivo del trabajo es identificar las localidades del Partido de General Pueyrredón mediante el uso de TIGs como herramienta con potencialidad para el análisis de los procesos socioterritoriales

Identificación de localidades en el partido de General Pueyrredón a partir de la Implementación de Tecnologías de Información Geográfica (TIGS)

El partido de General Pueyrredón es una unidad administrativa de fuerte tradición urbana, encabezada por la ciudad de Mar del Plata. No obstante, debe indicarse que hacia 1980 otros centros poblados del partido comenzaron a mostrar signos positivos en su dinámica demográfica. El reconocimiento de localidades dentro de una unidad civil de tercer rango, como son los partidos o departamentos, presupone un nivel de complejidad vinculado con aspectos teóricos, socio-culturales y metodológicos, por cuanto existen diversas elaboraciones referidas a la definición de localidades. Así, el aporte del presente trabajo consiste en aunar criterios, evidenciar la dinámica de las categorizaciones y remarcar la importancia de conocer directamente el territorio para mejorar las tipologías. El objetivo del trabajo es identificar las localidades del Partido de General Pueyrredón mediante el uso de TIGs como herramienta con potencialidad para el análisis de los procesos socioterritoriales

Bacterial activity in sediments of the deep Arabian Sea

In the Arabian Sea, productivity in the surface waters and particle flux to the deep sea are controlled by monsoonal winds. The flux maxima during the South-West (June-September) and the North-East Monsoon (December-March) are some of the highest particle fluxes recorded with deep-sea sediment traps in the open ocean. Benthic microbial biomass and activities in surface sediments were measured for the first time in March 1995 subsequent to the NE-monsoon and in October 1995 subsequent to the SW-monsoon. These measurements were repeated in April/May 1997 and February/March 1998, at a total of six stations from 1920 to 4420 m water depth. This paper presents a summary on the regional and temporal variability of microbial biomass, production, enzyme activity, degradation of 14C-labeled Synechococcus material as well as sulfate reduction in the northern, western, eastern, central and southern Arabian deep sea. We found a substantial regional variation in microbial biomass and activity, with highest values in the western Arabian Sea (station WAST), decreasing approximately threefold to the south (station SAST). Benthic microbial biomass and activity during the NE-monsoon was as high or higher than subsequent to the SW-monsoon, indicating a very rapid turnover of POC in the surface sediments. This variation in the biomass and activity of the microbial assemblages in the Arabian deep sea can largely be explained by the regional and temporal variation in POC flux. Compared to other abyssal regions, the substantially higher benthic microbial biomasses and activities in the Arabian Sea reflect the extremely high productivity of this tropical basin.

Cenomanian benthic foraminifera of Demerara Rise

This study is based on Cenomanian sediments of Ocean Drilling Program (ODP) Sites 1258 and 1260 from Demerara Rise (Leg 207, western tropical Atlantic, off Suriname, ~1000 and ~500 m paleo-water depth, respectively). Studied sediments consist of laminated black shales with TOC values between 3 and 18% and include the Mid Cenomanian Event (MCE), a positive carbon isotope excursion predating the well-known Oceanic Anoxic Event 2 (OAE 2). Benthic foraminiferal assemblages of the continuously eutrophic environment at Demerara Rise are characterized by low diversities (<= 9 species per sample) and large fluctuations in abundances, indicating oxygen depletion and varying organic matter fluxes. Dominant species at both sites are Bolivina anambra, Gabonita levis, Gavelinella dakotensis, Neobulimina albertensis, Praebulimina prolixa, and Tappanina cf. laciniosa. Benthic foraminiferal assemblages across the MCE show a threefold pattern: (1) stable ecological conditions below the MCE interval indicated by relatively high oxygenation and fluctuating organic matter flux, (2) decreasing oxygenation and/or higher organic matter flux during the MCE with decreasing benthic foraminiferal numbers and diversities (Site 1258) and a dominance of opportunistic species (Site 1260), and (3) anoxic to slightly dysoxic bottom-water conditions above the MCE as indicated by very low diversities and abundances or even the absence of benthic foraminifera. Slightly dysoxic conditions prevailed until OAE 2 at Demerara Rise. A comparison with other Atlantic Ocean and Tethyan sections indicates that the MCE reflects a paleoceanographic turning point towards lower bottom-water oxygenation, at least in the proto-North Atlantic Ocean and in the Tethyan and Boreal Realms. This general trend towards lower oxygenation of bottom waters across the MCE is accompanied by ongoing climate warming in combination with rising sea-level and the development of vast shallow epicontinental seas during the Middle and Late Cenomanian. These changes are proposed to have favoured the formation of warm and saline waters that may have contributed to intermediate- and deep-water masses at least in the restricted proto-North Atlantic and Tethyan Ocean basins, poor oxygenation of the Late Cenomanian sediments, and the changes in benthic foraminiferal assemblages across the MCE.

High-resolution sedimentological and paleontological record of ODP Site 167-1019

Holocene and latest Pleistocene oceanographic conditions and the coastal climate of northern California have varied greatly, based upon high-resolution studies (ca. every 100 years) of diatoms, alkenones, pollen, CaCO3%, and total organic carbon at Ocean Drilling Program (ODP) Site 1019 (41.682°N, 124.930°W, 980 m water depth). Marine climate proxies (alkenone sea surface temperatures [SSTs] and CaCO3%) behaved remarkably like the Greenland Ice Sheet Project (GISP)-2 oxygen isotope record during the Bølling-Allerod, Younger Dryas (YD), and early part of the Holocene. During the YD, alkenone SSTs decreased by >3°C below mean Bølling-Allerod and Holocene SSTs. The early Holocene (ca. 11.6 to 8.2 ka) was a time of generally warm conditions and moderate CaCO3 content (generally >4%). The middle part of the Holocene (ca. 8.2 to 3.2 ka) was marked by alkenone SSTs that were consistently 1-2°C cooler than either the earlier or later parts of the Holocene, by greatly reduced numbers of the gyre-diatom Pseudoeunotia doliolus (<10%), and by a permanent drop in CaCO3% to <3%. Starting at ca. 5.2 ka, coastal redwood and alder began a steady rise, arguing for increasing effective moisture and the development of the north coast temperate rain forest. At ca. 3.2 ka, a permanent ca. 1°C increase in alkenone SST and a threefold increase in P. doliolus signaled a warming of fall and winter SSTs. Intensified (higher amplitude and more frequent) cycles of pine pollen alternating with increased alder and redwood pollen are evidence that rapid changes in effective moisture and seasonal temperature (enhanced El Niño-Southern Oscillation [ENSO] cycles) have characterized the Site 1019 record since about 3.5 ka.

(Table A1) Species list of the high Antarctic Weddell Sea food web

Human-induced habitat destruction, overexploitation, introduction of alien species and climate change are causing species to go extinct at unprecedented rates, from local to global scales. There are growing concerns that these kinds of disturbances alter important functions of ecosystems. Our current understanding is that key parameters of a community (e.g. its functional diversity, species composition, and presence/absence of vulnerable species) reflect an ecological network's ability to resist or rebound from change in response to pressures and disturbances, such as species loss. If the food web structure is relatively simple, we can analyse the roles of different species interactions in determining how environmental impacts translate into species loss. However, when ecosystems harbour species-rich communities, as is the case in most natural systems, then the complex network of ecological interactions makes it a far more challenging task to perceive how species' functional roles influence the consequences of species loss. One approach to deal with such complexity is to focus on the functional traits of species in order to identify their respective roles: for instance, large species seem to be more susceptible to extinction than smaller species. Here, we introduce and analyse the marine food web from the high Antarctic Weddell Sea Shelf to illustrate the role of species traits in relation to network robustness of this complex food web. Our approach was threefold: firstly, we applied a new classification system to all species, grouping them by traits other than body size; secondly, we tested the relationship between body size and food web parameters within and across these groups and finally, we calculated food web robustness. We addressed questions regarding (i) patterns of species functional/trophic roles, (ii) relationships between species functional roles and body size and (iii) the role of species body size in terms of network robustness. Our results show that when analyzing relationships between trophic structure, body size and network structure, the diversity of predatory species types needs to be considered in future studies.

Turbidity measurements in 96-wells microplates to determine the densities of copiotrophic and oligotrophic bacteria with the Most-Probable-Number-method during POLARSTERN cruise ANT-XI/2

A new microtiter-plate dilution method was applied during the expedition ANTARKTIS-XI/2 with RV Polarstern to determine the distribution of copiotrophic and oligotrophic bacteria in the water columns at polar fronts. Twofold serial dilutions were performed with an eight-channel Electrapette in 96-wells plates by mixing 150 µl of seawater with 150 µl of copiotrophic or olitrophic Trypticase-Broth, three times per well. After incubation of about 6 month at 2 °C, turbidities were measured with an eight-channel photometer at 405 nm and combinations of positive test results for three consecutive dilutions chosen and compared with a Most Probable Number table, calculated for 8 replicates and twofold serial dilutions. Densities of 12 to 661 cells/ml for copiotrophs, and 1 to 39 cells/ml for oligotrophs were found. Colony Forming Units on copiotrophic Trypticase-Agar were between 6 and 847 cells/ml, which is in the same range as determined with the MPN method.

Seawater carbonate chemistry, nutrients and growth rate of coral (Acropora intermedia) and coral-reef seaweed (Lobophora papenfussii) during experiments, 2011

Space competition between corals and seaweeds is an important ecological process underlying coral-reef dynamics. Processes promoting seaweed growth and survival, such as herbivore overfishing and eutrophication, can lead to local reef degradation. Here, we present the case that increasing concentrations of atmospheric CO2 may be an additional process driving a shift from corals to seaweeds on reefs. Coral (Acropora intermedia) mortality in contact with a common coral-reef seaweed (Lobophora papenfussii) increased two- to threefold between background CO2 (400 ppm) and highest level projected for late 21st century (1140 ppm). The strong interaction between CO2 and seaweeds on coral mortality was most likely attributable to a chemical competitive mechanism, as control corals with algal mimics showed no mortality. Our results suggest that coral (Acropora) reefs may become increasingly susceptible to seaweed proliferation under ocean acidification, and processes regulating algal abundance (e.g. herbivory) will play an increasingly important role in maintaining coral abundance.

Have we been underestimating the effects of ocean acidification in zooplankton?

Understanding how copepods may respond to ocean acidification (OA) is critical for risk assessments of ocean ecology and biogeochemistry. The perception that copepods are insensitive to OA is largely based on experiments with adult females. Their apparent resilience to increased carbon dioxide (pCO2) concentrations has supported the view that copepods are 'winners' under OA. Here, we show that this conclusion is not robust, that sensitivity across different life stages is significantly misrepresented by studies solely using adult females. Stage-specific responses to pCO2 (385-6000 µatm) were studied across different life stages of a calanoid copepod, monitoring for lethal and sublethal responses. Mortality rates varied significantly across the different life stages, with nauplii showing the highest lethal effects; nauplii mortality rates increased threefold when pCO2 concentrations reached 1000 µatm (year 2100 scenario) with LC50 at 1084 µatm pCO2. In comparison, eggs, early copepodite stages, and adult males and females were not affected lethally until pCO2 concentrations >= 3000 µatm. Adverse effects on reproduction were found, with >35% decline in nauplii recruitment at 1000 µatm pCO2. This suppression of reproductive scope, coupled with the decreased survival of early stage progeny at this pCO2 concentration, has clear potential to damage population growth dynamics in this species. The disparity in responses seen across the different developmental stages emphasizes the need for a holistic life-cycle approach to make species-level projections to climate change. Significant misrepresentation and error propagation can develop from studies which attempt to project outcomes to future OA conditions solely based on single life history stage exposures.