Stable C and N isotope concentration in several tissues of the loggerhead sea turtle Caretta caretta from the western Mediterranean and dietary implications

The isotopic concentrations of carapace scutes, skin, muscle and blood of loggerhead sea turtles (Caretta caretta) from the Balearic Archipelago were analysed to investigate the pattern of variation between tissues and to assess the position of this species in the trophic webs of the Algerian Basin. Skin showed higher δ13C values than muscle or carapace scutes and these showed higher values than blood. Conversely, muscle showed higher δ15N values than skin, skin showed higher values than blood and blood showed higher values than carapace scutes. Dead and live sea turtles from the same habitat did not differ in the concentration of stable isotopes. However, some of the tissues of the turtles caught in drifting longlines in the oceanic realm showed higher δ13C values than those from the turtles caught by hand or in trammel nets over the continental shelf, although they did not differ in the δ15N. Comparison of the concentration of stable isotopes in the turtles with that of other species from several areas of the Algerian Basin revealed that they consumed planktonic prey and that the trophic level of the sea turtles was higher than that of carnivorous cnidarians but lower than that of zooplanktophagous fish and crustaceans.

Auto-évaluation de la qualité d'un site Internet de pharmacie hospitalière

Introduction: L'unité d'Assistance Pharmaceutique de la Pharmacie des HUG fonctionne comme centre d'information sur les médicaments et gère des informations mises à disposition sur le web. Celles-ci sont destinées prioritairement au personnel soignant des HUG et accessibles sur le site intranet/Internet (http://www.hcuge.ch/Pharmacie), mis en service en 1998. L'objectif de ce travail était d'évaluer la qualité de l'information du site intranet/Internet et d'y apporter les améliorations nécessaires. Méthode: Le site intranet/Internet de la pharmacie des HUG a été évalué en automne 2004 à l'aide de 2 outils : NetScoring : grille d'évaluation de la qualité de l'information de santé sur Internet (http://www.chu-rouen.fr/netscoring/). Elle comporte 49 critères répartis en 8 catégories. Chaque critère est noté sur une échelle de 5 occurrences puis pondéré selon son importance (multiplication par 3 si le critère est essentiel, par 2 s'il est important ou par 1 s'il est mineur). Analyse AMDEC : méthode permettant de séquencer un processus et d'en Analyser les Modes de Défaillance, leur Effet et leur Criticité (Qual Saf Health Care 2005 :14(2);93-98). Un score est attribué à chaque mode de défaillance identifié en terme de fréquence, de sévérité et de détectabilité. La multiplication des 3 scores fournit un résultat global de criticité (indice de criticité IC, max. 810), permettant de hiérarchiser les risques. Résultats: Etat des lieux NetScoring : La qualité globale du site intranet/Internet était bonne (202 pts/312). Les points forts concernaient la pertinence et l'utilité du site, la qualité du contenu, du moteur de recherche et du design, la rapidité de chargement du site, la sélection des liens externes proposés et le respect du secret médical. Les faiblesses résidaient dans l'absence de politique de mise à jour régulière, d'annotation systématique de l'état d'actualisation des documents, d'un comité éditorial et scientifique, de mots-clés en anglais et d'une liste permettant l'identification des auteurs. Analyse AMDEC : Quatre catégories (création du document, conversion, structure du site et publication du document) et 19 modes de défaillances ont été caractérisés. Trois modes de défaillance étaient associés à un IC important: erreurs lors de la création d'un document (IC 256), information inadéquate car pratique non validée ou recommandation non généralisable (IC 147) et absence de relecture après la conversion du document en format publiable (ex : PDF) (IC 144). Mesures correctives: Une procédure standard (SOP) a été élaborée pour la gestion du site intranet/Internet. Le format standard des informations (initiales de l'auteur, dates de création et de mise à jour, logo de la pharmacie), la validation et la politique de mise à jour des documents ainsi que la procédure d'archivage y sont clairement définis. Une fiche de suivi accompagnant chaque document a été créée pour la traçabilité de toutes les modifications effectuées et la fréquence de révision à respecter. Discussion et conclusion Cette étude a permis de déterminer et de quantifier les points critiques à améliorer sur le site intranet/Internet de la Pharmacie des HUG. Les mesures correctives entreprises doivent permettre d'améliorer les principales faiblesses et défaillances mises en évidence. La mise en place d'un comité éditorial et scientifique devra être évaluée à l'avenir. Le NetScoring et l'analyse AMDEC sont des outils utiles pour l'évaluation et l'amélioration continue de la qualité d'un site Internet, sous réserve d'une interprétation critique des résultats obtenus avant la mise en place de mesures correctives. Malgré une approche totalement différente, ces outils ont permis de mettre en évidence des lacunes similaires.

No interactions between previously associated 2-hour glucose gene variants and physical activity or BMI on 2-hour glucose levels.

Gene-lifestyle interactions have been suggested to contribute to the development of type 2 diabetes. Glucose levels 2 h after a standard 75-g glucose challenge are used to diagnose diabetes and are associated with both genetic and lifestyle factors. However, whether these factors interact to determine 2-h glucose levels is unknown. We meta-analyzed single nucleotide polymorphism (SNP) × BMI and SNP × physical activity (PA) interaction regression models for five SNPs previously associated with 2-h glucose levels from up to 22 studies comprising 54,884 individuals without diabetes. PA levels were dichotomized, with individuals below the first quintile classified as inactive (20%) and the remainder as active (80%). BMI was considered a continuous trait. Inactive individuals had higher 2-h glucose levels than active individuals (β = 0.22 mmol/L [95% CI 0.13-0.31], P = 1.63 × 10(-6)). All SNPs were associated with 2-h glucose (β = 0.06-0.12 mmol/allele, P ≤ 1.53 × 10(-7)), but no significant interactions were found with PA (P > 0.18) or BMI (P ≥ 0.04). In this large study of gene-lifestyle interaction, we observed no interactions between genetic and lifestyle factors, both of which were associated with 2-h glucose. It is perhaps unlikely that top loci from genome-wide association studies will exhibit strong subgroup-specific effects, and may not, therefore, make the best candidates for the study of interactions.

Tissue-based immune monitoring I: tumor core needle biopsies allow in-depth interrogation of the tumor microenvironment.

We sought to assess the feasibility and reproducibility of performing tissue-based immune characterization of the tumor microenvironment using CT-compatible needle biopsy material. Three independent biopsies were obtained intraoperatively from one metastatic epithelial ovarian cancer lesion of 7 consecutive patients undergoing surgical cytoreduction using a 16-gauge core biopsy needle. Core specimens were snap-frozen and subjected to immunohistochemistry (IHC) against human CD3, CD4, CD8, and FoxP3. A portion of the cores was used to isolate RNA for 1) real-time quantitative (q)PCR for CD3, CD4, CD8, FoxP3, IL-10 and TGF-beta, 2) multiplexed PCR-based T cell receptor (TCR) CDR3 Vβ region spectratyping, and 3) gene expression profiling. Pearson's correlations were examined for immunohistochemistry and PCR gene expression, as well as for gene expression array data obtained from different tumor biopsies. Needle biopsy yielded sufficient tissue for all assays in all patients. IHC was highly reproducible and informative. Significant correlations were seen between the frequency of CD3+, CD8+ and FoxP3+ T cells by IHC with CD3ε, CD8A, and FoxP3 gene expression, respectively, by qPCR (r=0.61, 0.86, and 0.89; all p< 0.05). CDR3 spectratyping was feasible and highly reproducible in each tumor, and indicated a restricted repertoire for specific TCR Vβ chains in tumor-infiltrating T cells. Microarray gene expression revealed strong correlation between different biopsies collected from the same tumor. Our results demonstrate a feasible and reproducible method of immune monitoring using CT-compatible needle biopsies from tumor tissue, thereby paving the way for sophisticated translational studies during tumor biological therapy.

Prévention de la malaria pour les séjours de tongue durée [Malaria prevention for long-term travelers]

The risk of malaria increases with the duration of stay. Long-term travelers need to know the risk of malaria and the effective measures to reduce this risk: personal protective measures against mosquito bites and chemoprophylaxis. The use of insecticide-impregnated mosquito nets and window screens should be emphasized. When chemoprophylaxis is indicated it should be prescribed at least for the first 3 to 6 months. Then, alternative strategies can be discussed with the traveler: continuous chemoprophylaxis, seasonal chemoprophylaxis and/or standby emergency treatment.

Study of OSEM with different subsets in grating-based X-ray differential phase-contrast imaging.

Impressive developments in X-ray imaging are associated with X-ray phase contrast computed tomography based on grating interferometry, a technique that provides increased contrast compared with conventional absorption-based imaging. A new "single-step" method capable of separating phase information from other contributions has been recently proposed. This approach not only simplifies data-acquisition procedures, but, compared with the existing phase step approach, significantly reduces the dose delivered to a sample. However, the image reconstruction procedure is more demanding than for traditional methods and new algorithms have to be developed to take advantage of the "single-step" method. In the work discussed in this paper, a fast iterative image reconstruction method named OSEM (ordered subsets expectation maximization) was applied to experimental data to evaluate its performance and range of applicability. The OSEM algorithm with different subsets was also characterized by comparison of reconstruction image quality and convergence speed. Computer simulations and experimental results confirm the reliability of this new algorithm for phase-contrast computed tomography applications. Compared with the traditional filtered back projection algorithm, in particular in the presence of a noisy acquisition, it furnishes better images at a higher spatial resolution and with lower noise. We emphasize that the method is highly compatible with future X-ray phase contrast imaging clinical applications.

Towards a diffusion image processing validation and accuracy prediction framework

Validation is the main bottleneck preventing theadoption of many medical image processing algorithms inthe clinical practice. In the classical approach,a-posteriori analysis is performed based on someobjective metrics. In this work, a different approachbased on Petri Nets (PN) is proposed. The basic ideaconsists in predicting the accuracy that will result froma given processing based on the characterization of thesources of inaccuracy of the system. Here we propose aproof of concept in the scenario of a diffusion imaginganalysis pipeline. A PN is built after the detection ofthe possible sources of inaccuracy. By integrating thefirst qualitative insights based on the PN withquantitative measures, it is possible to optimize the PNitself, to predict the inaccuracy of the system in adifferent setting. Results show that the proposed modelprovides a good prediction performance and suggests theoptimal processing approach.

Body mass index and risk of head and neck cancer in a pooled analysis of case-control studies in the International Head and Neck Cancer Epidemiology (INHANCE) Consortium.

BACKGROUND: Head and neck cancer (HNC) risk is elevated among lean people and reduced among overweight or obese people in some studies; however, it is unknown whether these associations differ for certain subgroups or are influenced by residual confounding from the effects of alcohol and tobacco use or by other sources of biases. METHODS: We pooled data from 17 case-control studies including 12 716 cases and the 17 438 controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for associations between body mass index (BMI) at different ages and HNC risk, adjusted for age, sex, centre, race, education, tobacco smoking and alcohol consumption. RESULTS: Adjusted ORs (95% CIs) were elevated for people with BMI at reference (date of diagnosis for cases and date of selection for controls) 25.0-30.0 kg/m(2) (0.52, 0.44-0.60) and BMI >/=30 kg/m(2) (0.43, 0.33-0.57), compared with BMI >18.5-25.0 kg/m(2). These associations did not differ by age, sex, tumour site or control source. Although the increased risk among people with BMI 25 kg/m(2) was present only in smokers and drinkers. CONCLUSIONS: In our large pooled analysis, leanness was associated with increased HNC risk regardless of smoking and drinking status, although reverse causality cannot be excluded. The reduced risk among overweight or obese people may indicate body size is a modifier of the risk associated with smoking and drinking. Further clarification may be provided by analyses of prospective cohort and mechanistic studies.

Improvement of productivity and polysaccharide-protein complex in Agaricus blazei

The objective of this work was to assess the productivity and polysaccharide-protein complex content of Agaricus blazei on rice straw medium, in comparison to conventional sawdust, using four casing soils. The A. blazei strain used was BCRC36814T, purchased from the Food Industry Research and Development Institute, Hsin-Chu, Taiwan. The two media were evaluated as to A. blazei productivity, harvesting time, and production costs. The experimental design used was a randomized complete block, with four replicates. Three local casing soils - Typic Paleudult (CCe), Typic Udorthent (Tq) and Oxyaquic Paleudult (TSp) - were compared to imported peat soil (PS, Saprists, Histosols), used as the control. The productivity of A. blazei using Tq and TSp soil was significantly higher. The TSp casing treatment resulted in earlier harvest by at least 14 to 27 days, when compared to the other treatments. The polysaccharide content in CCe (13.2%) and Tq soils (13.2%) did not differ significantly from the PS (13.4%) and TSp (10.6%) treatments. Local casing soils decreased the production costs of A. blazei cultivation. Composted rice straw can substitute sawdust as the culture medium for A. blazei production with increased yield.

Beneficial bacterial strains on Agaricus blazei cultivation

The objective of this work was to evaluate the effects of six bacterial strains isolated from Agaricus blazei (ABM) on its cultivation. The six strains were characterized as to their effects on the productivity, polysaccharide-protein complex (PSPC), and polysaccharide contents of ABM cultured on sterilized casing soils. Three isolates enhanced ABM mycelium growth. Inoculation of Arthrobacter sp. or Exiguobacterium sp. on sterile peat casing soil resulted in 64% increase in ABM mushroom total fresh matter yield compared to the uninoculated control. Inoculation of Exiguobacterium sp., Microbacterium esteraromaticum or Pseudomonas resinovorans on sterilized loamy casing soil resulted in 62, 95, and 59% increase in ABM mushroom total fresh matter yield, respectively. The PSPC content in ABM increased 7 to 10% in casing soil inoculated with five of the six isolates compared to the uninoculated control. Exiguobacterium sp. inoculated on casing soil resulted in a mushroom-polysaccharide content 15% higher than the control. Moreover, inoculation of five of the six isolates on the casing soil reduced the harvesting time from 10 to 27 days. The evaluated beneficial microbes improve the yield, PSPC, and polysaccharide contents, besides reducing the harvesting time in ABM culture.

Cultivable mushroom growth-promoting bacteria and their impact on Agaricus blazei productivity

The objective of this work was to identify growth-promoting bacteria isolated from Agaricus blazei and to evaluate their effect on mushroom mycelial growth and productivity. A total of 56 A. blazei-associated bacterial isolates were obtained from casing soil and identified by 16S rRNA gene sequencing. Bacteria were evaluated as to phosphate-solubilization ability, nitrogen-fixation capability, and secretion of cellulase. Superior isolates were tested for their to effect on A. blazei productivity, micelial growth, and on the contents of the polysaccharide-protein complex and of N, P, K, Ca, and Mg. Bacterial isolates were identified as actinobacteria (60%), firmicutes (20%), and proteobacteria (20%). Among them, ten isolates had phosphate-solubilization ability, eight showed nitrogen-fixation capability, and 12 isolates promoted A. blazei mycelium growth. Bacterial inoculation reduces time till harvest in up to 26 days, increases fresh mushroom yield up to 215%, and increases total polysaccharide-protein complex content twofold when compared to the non-inoculated control. The actinobacteria group is the predominant A. blazei-associated phylum.

Suomalaisen musiikkiteollisuuden arvojärjestelmä

Työn tavoitteena on kuvailla suomalaisen musiikkiteollisuuden toimialan rakennetta määrittelemällä alan arvojärjestelmä. Ensin tutkitaan minkälainen kuvailutapa sopii musiikkiteollisuuden arvojärjestelmän esittämiseen. Toisena analysoidaan Suomen musiikkitoimialan nykytilannetta sekä kehitystä. Kolmantena tarkastellaan, millaisista toiminnoista musiikkiteollisuuden verkosto koostuu ja millainen se on toimintaympäristönä. Työssä esitetään toimialan arvonmuodostumisen mallintamiseen Parolinin (1999) arvojärjestelmän sekä arvoverkon käsitteet. Arvojärjestelmä koostuu tietyn tarjooman tuottamiseen tarvittavista toiminnoista sekä niiden välisistä suhteista. Tätä soveltaen kootaan musiikkiteollisuuden kulutustoimintojoukko, sekä näihin vastaavat tuotantotoiminnot, jotka edelleen jakaantuvat kolmeen perustoimintoon sekä joukkoon tukitoimintoja. Tämän pohjalta esitetään toimialan arvojärjestelmä, josta mallinnetaan tarkemmin tallenne- ja ohjelmatuotannon arvoverkot. Suomalaisen musiikkiteollisuuden tilaa ja ajankohtaisia suuntauksiaanalysoidaan arvoketjun toiminnoittain jäsenneltynä. Alan verkostoa toimintaympäristönä tarkastellaan rakenteellisesta näkökulmasta. Musiikkiteollisuus on vahvasti verkostomainen toimiala. Verkosto on epämuodollinen ja rakentuu toimijoidenvälisistä sosiaalisista suhteista.

In-hospital and 1-year mortality in patients undergoing early surgery for prosthetic valve endocarditis.

IMPORTANCE: There are limited prospective, controlled data evaluating survival in patients receiving early surgery vs medical therapy for prosthetic valve endocarditis (PVE). OBJECTIVE: To determine the in-hospital and 1-year mortality in patients with PVE who undergo valve replacement during index hospitalization compared with patients who receive medical therapy alone, after controlling for survival and treatment selection bias. DESIGN, SETTING, AND PARTICIPANTS: Participants were enrolled between June 2000 and December 2006 in the International Collaboration on Endocarditis-Prospective Cohort Study (ICE-PCS), a prospective, multinational, observational cohort of patients with infective endocarditis. Patients hospitalized with definite right- or left-sided PVE were included in the analysis. We evaluated the effect of treatment assignment on mortality, after adjusting for biases using a Cox proportional hazards model that included inverse probability of treatment weighting and surgery as a time-dependent covariate. The cohort was stratified by probability (propensity) for surgery, and outcomes were compared between the treatment groups within each stratum. INTERVENTIONS: Valve replacement during index hospitalization (early surgery) vs medical therapy. MAIN OUTCOMES AND MEASURES: In-hospital and 1-year mortality. RESULTS: Of the 1025 patients with PVE, 490 patients (47.8%) underwent early surgery and 535 individuals (52.2%) received medical therapy alone. Compared with medical therapy, early surgery was associated with lower in-hospital mortality in the unadjusted analysis and after controlling for treatment selection bias (in-hospital mortality: hazard ratio [HR], 0.44 [95% CI, 0.38-0.52] and lower 1-year mortality: HR, 0.57 [95% CI, 0.49-0.67]). The lower mortality associated with surgery did not persist after adjustment for survivor bias (in-hospital mortality: HR, 0.90 [95% CI, 0.76-1.07] and 1-year mortality: HR, 1.04 [95% CI, 0.89-1.23]). Subgroup analysis indicated a lower in-hospital mortality with early surgery in the highest surgical propensity quintile (21.2% vs 37.5%; P = .03). At 1-year follow-up, the reduced mortality with surgery was observed in the fourth (24.8% vs 42.9%; P = .007) and fifth (27.9% vs 50.0%; P = .007) quintiles of surgical propensity. CONCLUSIONS AND RELEVANCE: Prosthetic valve endocarditis remains associated with a high 1-year mortality rate. After adjustment for differences in clinical characteristics and survival bias, early valve replacement was not associated with lower mortality compared with medical therapy in the overall cohort. Further studies are needed to define the effect and timing of surgery in patients with PVE who have indications for surgery.

FTO genetic variants, dietary intake and body mass index: insights from 177,330 individuals.

FTO is the strongest known genetic susceptibility locus for obesity. Experimental studies in animals suggest the potential roles of FTO in regulating food intake. The interactive relation among FTO variants, dietary intake and body mass index (BMI) is complex and results from previous often small-scale studies in humans are highly inconsistent. We performed large-scale analyses based on data from 177,330 adults (154 439 Whites, 5776 African Americans and 17 115 Asians) from 40 studies to examine: (i) the association between the FTO-rs9939609 variant (or a proxy single-nucleotide polymorphism) and total energy and macronutrient intake and (ii) the interaction between the FTO variant and dietary intake on BMI. The minor allele (A-allele) of the FTO-rs9939609 variant was associated with higher BMI in Whites (effect per allele = 0.34 [0.31, 0.37] kg/m(2), P = 1.9 × 10(-105)), and all participants (0.30 [0.30, 0.35] kg/m(2), P = 3.6 × 10(-107)). The BMI-increasing allele of the FTO variant showed a significant association with higher dietary protein intake (effect per allele = 0.08 [0.06, 0.10] %, P = 2.4 × 10(-16)), and relative weak associations with lower total energy intake (-6.4 [-10.1, -2.6] kcal/day, P = 0.001) and lower dietary carbohydrate intake (-0.07 [-0.11, -0.02] %, P = 0.004). The associations with protein (P = 7.5 × 10(-9)) and total energy (P = 0.002) were attenuated but remained significant after adjustment for BMI. We did not find significant interactions between the FTO variant and dietary intake of total energy, protein, carbohydrate or fat on BMI. Our findings suggest a positive association between the BMI-increasing allele of FTO variant and higher dietary protein intake and offer insight into potential link between FTO, dietary protein intake and adiposity.