Effect of Cholecalciferol as Adjunctive Therapy With Insulin on Protective Immunologic Profile and Decline of Residual beta-Cell Function in New-Onset Type 1 Diabetes Mellitus

Objective: To evaluate the effect of vitamin D-3 on cytokine levels, regulatory T cells, and residual beta-cell function decline when cholecalciferol (vitamin D-3 administered therapeutically) is given as adjunctive therapy with insulin in new-onset type 1 diabetes mellitus (T1DM). Design and Setting: An 18-month (March 10, 2006, to October 28, 2010) randomized, double-blind, placebo-controlled trial was conducted at the Diabetes Center of Sao Paulo Federal University, Sao Paulo, Brazil. Participants: Thirty-eight patients with new-onset T1DM with fasting serum C-peptide levels greater than or equal to 0.6 ng/mL were randomly assigned to receive daily oral therapy of cholecalciferol, 2000 IU, or placebo. Main Outcome Measure: Levels of proinflammatory and anti-inflammatory cytokines, chemokines, regulatory T cells, hemoglobin A(1c), and C-peptide; body mass index; and insulin daily dose. Results: Mean (SD) chemokine ligand 2 (monocyte chemoattractant protein 1) levels were significantly higher (184.6 [101.1] vs 121.4 [55.8] pg/mL) at 12 months, as well as the increase in regulatory T-cell percentage (4.55%[1.5%] vs 3.34%[1.8%]) with cholecalciferol vs placebo. The cumulative incidence of progression to undetectable (<= 0.1 ng/mL) fasting C-peptide reached 18.7% in the cholecalciferol group and 62.5% in the placebo group; stimulated C-peptide reached 6.2% in the cholecalciferol group and 37.5% in the placebo group at 18 months. Body mass index, hemoglobin A(1c) level, and insulin requirements were similar between the 2 groups. Conclusions: Cholecalciferol used as adjunctive therapy with insulin is safe and associated with a protective immunologic effect and slow decline of residual beta-cell function in patients with new-onset T1DM. Cholecalciferol may be an interesting adjuvant in T1DM prevention trials.

J/psi production as a function of charged particle multiplicity in pp collisions at root s=7 TeV

The ALICE Collaboration reports the measurement of the relative J/psi yield as a function of charged particle pseudorapidity density dN(ch)/d eta in pp collisions at root s = 7 TeV at the LHC. J/psi particles are detected for p(t) > 0, in the rapidity interval vertical bar y vertical bar < 0.9 via decay into e(+)e(-), and in the interval 2.5 < y < 4.0 via decay into mu(+)/mu(-) pairs. An approximately linear increase of the J/psi yields normalized to their event average (dN(J/psi)/dy)/(dN(J/psi)/dy) with (dN(ch)/c eta)/(dN(ch)/d eta) is observed in both rapidity ranges, where dN(ch)/d eta is measured within vertical bar eta vertical bar < 1 and p(t) > 0. In the highest multiplicity interval with (dN(ch)/d eta)(bin)) = 24.1, corresponding to four times the minimum bias multiplicity density, an enhancement relative to the minimum bias J/psi yield by a factor of about 5 at 2.5 < y <4 (8 at vertical bar y vertical bar < 0.9) is observed. (C) 2012 CERN. Published by Elsevier B.V. All rights reserved.

Spatial analysis of leprosy incidence and associated socioeconomic factors

OBJECTIVE: To identify clusters of the major occurrences of leprosy and their associated socioeconomic and demographic factors. METHODS: Cases of leprosy that occurred between 1998 and 2007 in Sao Jose do Rio Preto (southeastern Brazil) were geocodified and the incidence rates were calculated by census tract. A socioeconomic classification score was obtained using principal component analysis of socioeconomic variables. Thematic maps to visualize the spatial distribution of the incidence of leprosy with respect to socioeconomic levels and demographic density were constructed using geostatistics. RESULTS: While the incidence rate for the entire city was 10.4 cases per 100,000 inhabitants annually between 1998 and 2007, the incidence rates of individual census tracts were heterogeneous, with values that ranged from 0 to 26.9 cases per 100,000 inhabitants per year. Areas with a high leprosy incidence were associated with lower socioeconomic levels. There were identified clusters of leprosy cases, however there was no association between disease incidence and demographic density. There was a disparity between the places where the majority of ill people lived and the location of healthcare services. CONCLUSIONS: The spatial analysis techniques utilized identified the poorer neighborhoods of the city as the areas with the highest risk for the disease. These data show that health departments must prioritize politico-administrative policies to minimize the effects of social inequality and improve the standards of living, hygiene, and education of the population in order to reduce the incidence of leprosy.

Development of paper based electrodes: From air-breathing to paintable enzymatic cathodes

This work presents the results from the development of bio-cathodes for the application on paper-based biofuel cells. Our main goal here is to demonstrate the possibility of using different designs of air-breathing bio-cathodes and ink-based bio-cathodes for this new type of paper based electrochemical cell. The electrochemical performance for the bio-electrocatalytic oxygen reduction reaction was studied by using open circuit voltage and amperometry measurements, as well as polarization curves to probe the four-electron reduction reaction of ambient oxygen catalyzed by bilirubin oxidase (BOx). The electrochemical measurements showed that all procedures allowed the direct electron transfer from the active site of the bilirubin oxidase to the electrode surface with a limiting current density of almost 500 mu A cm(-2) for an air-breathing BOx cathode and 150 mu A cm(-2) for an ink based BOx cathode. Under a load of 300 mV a stable current density was obtained for 12 h of continuous operation. (C) 2012 Elsevier Ltd. All rights reserved.

Survey of Bancroftian filariasis infection in humans and Culex mosquitoes in the western Brazilian Amazon region: implications for transmission and control

Introduction: The aim of this work was to identify possible lymphatic filariasis foci in the western Brazilian Amazonian that could be established from the reports of Rachou in the 1950s. The study was conducted in three cities of the western Brazilian Amazon region - Porto Velho and Guajará-Mirim (State of Rondônia) and Humaitá (State of Amazonas). Methods: For human infection evaluation thick blood smear stained with Giemsa was used to analyze samples collected from 10pm to 1am. Polymerase chain reaction (PCR) was used to examine mosquito vectors for the presence of Wuchereria bancrofti DNA. Humans were randomly sampled from night schools students and from inhabitants in neighborhoods lacking sanitation. Mosquitoes were collected from residences only. Results: A total 2,709 night students enrolled in the Program for Education of Young Adults (EJA), and 935 people registered in the residences near the schools were examined, being 641 from Porto Velho, 214 from Guajará-Mirim and 80 from Humaitá. No individual examined was positive for the presence of microfilariae in the blood stream. A total of 7,860 female Culex quinquefasciatus specimens examined were negative by PCR. Conclusions: This survey including human and mosquito examinations indicates that the western Amazon region of Brazil is not a focus of Bancroftian filariasis infection or transmission. Therefore, there is no need to be included in the Brazilian lymphatic filariasis control program.

A feasibility study for the provision of electronic healthcare tools and services in areas of Greece, Cyprus and Italy

Background Through this paper, we present the initial steps for the creation of an integrated platform for the provision of a series of eHealth tools and services to both citizens and travelers in isolated areas of thesoutheast Mediterranean, and on board ships travelling across it. The platform was created through an INTERREG IIIB ARCHIMED project called INTERMED. Methods The support of primary healthcare, home care and the continuous education of physicians are the three major issues that the proposed platform is trying to facilitate. The proposed system is based on state-of-the-art telemedicine systems and is able to provide the following healthcare services: i) Telecollaboration and teleconsultation services between remotely located healthcare providers, ii) telemedicine services in emergencies, iii) home telecare services for "at risk" citizens such as the elderly and patients with chronic diseases, and iv) eLearning services for the continuous training through seminars of both healthcare personnel (physicians, nurses etc) and persons supporting "at risk" citizens. These systems support data transmission over simple phone lines, internet connections, integrated services digital network/digital subscriber lines, satellite links, mobile networks (GPRS/3G), and wireless local area networks. The data corresponds, among others, to voice, vital biosignals, still medical images, video, and data used by eLearning applications. The proposed platform comprises several systems, each supporting different services. These were integrated using a common data storage and exchange scheme in order to achieve system interoperability in terms of software, language and national characteristics. Results The platform has been installed and evaluated in different rural and urban sites in Greece, Cyprus and Italy. The evaluation was mainly related to technical issues and user satisfaction. The selected sites are, among others, rural health centers, ambulances, homes of "at-risk" citizens, and a ferry. Conclusions The results proved the functionality and utilization of the platform in various rural places in Greece, Cyprus and Italy. However, further actions are needed to enable the local healthcare systems and the different population groups to be familiarized with, and use in their everyday lives, mature technological solutions for the provision of healthcare services.

The Unintended Consequences of Requiring a Licence to Help

Comments that current proposals for licensure, accreditation, and 3rd-party reimbursement may have several unintended consequences. Until now discussion has focused on the effects of the proposed regulations on the development of psychology as a profession. Recent proposals, however, may have unexpected adverse consequences on 3 other areas as well: the education of professionals within psychology, the delivery of psychological and other helping services, and the self-definition of the consumer of psychological services. Any changes in licensure, accreditation, and reimbursement require compromises of concerns for the profession, for the consumer, and for psychologists' livelihood.

Talents in Migration Processes in the Conditions of the Czech Republic of the Nineties

The transformation of the 1990s has had a bearing on the academic and scientific world, as is becoming increasingly obvious with the changing numbers of foreign students wishing to study in the Czech Republic and of Czech students wishing to study abroad, the virtual collapse of doctoral studies, and the rapidly increasing age of Czech academics (placed at 48 by official sources and at rather more by this research). At the same time there is an apparent lack of interest in analysing and understanding these trends, which Mr. Cermak terms an ostrich policy, although his research showed that academics are in fact both aware and concerned about them. The mid-1990s migration of talent to and from R+D in the Czech Republic is also reflected in the number of talented Czech students studying abroad, who represent the largest and most interesting group of actual and potential migrants. Mr. Cermak's study took the form of a Delphi enquiry participated in by 44 specialists, including experts in the problems of higher education and science policy from the Presidium of the Higher Education Council (n = 23), members of the Council's Science and Research Commission (n = 14), former and current managers of higher education authorities (n = 4) and selected participants of the longitudinal talent research (n = 3). Questions considered included the influence of continuing talent migration from domestic R+D on the efficiency of domestic higher education, the diversification of forms of the brain drain and their impact on other processes in society, the possibility of positive influence on the brain drain processes to minimise the risks it presents, and the use of the knowledge obtained about the brain drain. The study revealed a clear drop of interest in brain drain problems in higher education in the mid-1990s, which is probably related to the collapsed of Czech R+D in the field of talent education. The effects on this segment of the labour market appeared earlier, with a major migration wave in 1991-1993 which significantly "cleared" the area of scientific talent. In addition, prospective talents from the ranks of younger students have not been integrated into domestic R+D, leading to the increasing average age of those working in this field. "Talent scouting" tended to be oriented towards much younger individuals, even in some cases towards undergraduate students. The R+D institutions deprived of human resources considered as basic in a functional R+D system have lost much of their dynamism and so no longer attract not only domestic talent but also talent from other regions. As a result the public, including the mass media and political structures, have stopped regarding the support of domestic science as a priority. This is clear both among the young people who are important for the future development of R+D (support for the education of talented children has dropped), from the drop in the prestige of this area as a profession among university students, and from the lack of explicit support for R+D by any of the political parties. On the basis of his findings Mr. Cermak concludes that there is no basis for the belief that the brain drain will represent a positive force in stimulating the development of the open society. Migration data shows that the outflow of talent from the Czech Republic far exceeds the inflow, and that the latter is largely short-term. Not only has the number of returning Czech professors dropped to half of its level at the beginning of the 1990s, but they also tend to take up only short-term contracts and retain their foreign positions. Recruitment of scientific talent from other countries, including the Slovak Republic, is limited. Furthermore internal contacts between those already involved in R+D have been badly hit by economic pressures and institutional co-operation has dropped to a minimum. There have been few moves to counteract this situation, the only notable one being the Program 250, launched in 1996 with government support to try and attract younger (i.e. under 40) talent into R+D. Its resources are however limited and its effects have not so far been evaluated. The deficit of academic and scientific talent in the Czech Republic is increasing and two major directions of academic work are emerging. Classic higher education science based on the teaching process is declining, largely due to economic factors, while there is an increasing emphasis on special; ad hoc projects which cannot be related directly to teaching but are often interesting to specialists outside the Czech Republic. This is shown clearly by the increase in publishing and in participation in domestic and foreign grant projects, which often serve to supplement the otherwise low salaries in the higher education sector. This tend was also accelerated by the collapse of applied R+D in individual sectors of the national economy and by substantial cutbacks in the Czech Academy of Sciences, which formerly fostered such research. Some part of the output of this research can be used in the education system and its financial contribution does significantly affect the stability of the present staff, but Mr. Cermak sees it as generally unfavourable for the development of talent education. In addition, it has led to a certain resignation on the question of integration into international structures, due to the emphasis on short-term targets, commercial advantages and individualism rather than team work. At the same time, he admits that these developments reflect those in other areas of the transformation in the Czech Republic.

Cultural and Educational Society of Muslims "Narodna Uzdanica" /"National Hope"/ 1923-1941

Ibrahim Kemura. The Muslim Cultural-Educational Society Narodna uzdanica from 1923/4 to 1941 One of the features of the cultural history of the Bosniacs between the two world wars (1918-1941) was a cultural and educational society named Narodna uzdanica, which was a significant institutional and cultural-intellectual centre of the Bosniac people in Bosnia and Herzegovina. Narodna uzdanica expressed the aspirations and needs of the Bosniac citizens who were its main support and axis and was aimed at fulfilling their interests. This was reflected in an ideological-cultural orientation towards the West and the adoption of positive western achievements while at the same time stressing its Slavic origins and individuality, the education of young people and the formation of a European-type civic intelligentsia, adaptation to life in capitalist society, the development of modern trade and crafts, the emancipation of women, and cultural education based on European values. Thus conceived, the programme enjoyed the support of a wider circle of members, the reading public and the cultural consumers of those particular elements such as education and economic prosperity which it sought to achieve. The political involvement of Narodna uzdanica and its use as a platform for the leading Bosniac political party Jugoslovenska muslimanska organizacija (JMO - Yugoslav Muslim Organisation) which had founded the society, played a significant role in the socio-political life and development of Bosniacs. The opposition to the ruling regime, often expressed through close cooperation with similar Croat organisations and through the pro-Croat attitude of some of the society's leading figures, offered both the regime and Narodna uzdanica's political adversaries grounds for describing it as separatist and Croat and served as a pretext for repressive measures to hinder its normal operations. This research proved these accusations to be groundless, showing that the pro-Croat orientation was primarily political and cultural and that throughout its existence Narodna uzdanica was active in the cultural and educational renaissance of Bosniacs, helping to strengthen their national identity.

The Culture of the Deaf Community in the Czech Republic

Romana Mazerova. The Culture of the Deaf Community in the Czech Republic Mazerova set out to discover if the deaf community in the Czech Republic can be said to have its own culture and if so what this is. She began with a comprehensive survey of the history of the deaf from 1786 to the present day, identifying a major turning point in the exclusion of sign language from the education of the deaf around 1930, a move then reinforced in the communist period to the extent that teachers of the deaf had to sign a commitment not to use sign language in their lessons. She also noted the difference between so-called signed Czech, which is an exact translation of the spoken language, and Czech sign language, which has its own structure and even dialects. Following the historical research, Mazerova studied a range of Czech and foreign materials relating to the culture of the deaf, interviewed deaf people about their experiences in school, their participation in the activities of associations for the deaf, and their experiences as a deaf person in a hearing society (these interviews are recorded on video), and visited various associations, clubs and schools for the deaf throughout the country. She concluded that while deaf people share certain behaviours which are quite distinct from those of hearing Czechs, there is little sense of a community as such. The vast majority of deaf people were not born into the deaf community and while feel that they belong together, they do not identify themselves as part of a deaf community and do not work together as a community to achieve their goals.

[Castration of calves: a survey among Swiss suckler beef farmers]

In fall 2004, a survey of a representative sample of 1185 Swiss suckler beef farmers was carried out by questionnaire (return rate 51.9%). 32.7% of the respondents castrated their calves without the help of a veterinarian, 37.8% mandated a veterinarian to carry out the castrations and 29.4% did not castrate their bull calves at all. On average, 8 calves were castrated per farm and year at an average age of 7 days when the castration was carried out by a farmer or 34 days when the castration was carried out by a veterinarian. Almost all farmers castrated their calves with the rubber ring, and a majority considered no other method as feasible. 73.9% of the veterinarians used the Burdizzo technique, 14.9% applied rubber rings, and 11.2% performed a surgical procedure. 22.6% of the farmers and 85.4% of the veterinarians used sedation; local anaesthesia was performed in 32.1% of the castrations carried out by farmers and in 84.5% of the castrations carried out by veterinarians. 65.7% of the farmers were concerned by the change of the Swiss Animal Protection Ordinance (2001), when pain relief became mandatory. 47.6% of these farmers changed their castration routine: 53.1% now mandated a veterinarian, 33.0% used sedation or local anaesthesia and 8.9% abandoned castration of their calves. 59.8% of the farmers intended to participate in a future course for laymen, to study and train the technique of local anaesthesia for castration. Castration of their calves is for many suckler beef farmers an inevitable husbandry procedure. The political goal, that all calves shall be castrated with local anaesthesia can only be reached when livestock owners are informed about the distress caused by the castration and convinced of the benefit of the local anaesthesia.Veterinarians are important information carriers in this process. The implementation also produces work, be it the more complex castration procedure or the education of the farmers who want to carry out the local anaesthesia themselves.

[The influence of the socio-economic structure of the breeding farms of Franches-Montagnes horses on the conditions of husbandry]

The socio-economic structure of the breeding farms of Franches-Montagnes horses (FM) in Switzerland is evaluated on the basis of an investigation carried out in 2002 by the Swiss FM breeding federation. Questionnaires were sent to 3500 of its members and the results include data from 968 breeding enterprises, housing a total of 3965 FM. The quality of the husbandry of FM varies according to factors such as the altitude and the geographical situation of the farms and studs. Socio-economic parameters, such as the role of FM in the business, their use (breeding, driving, riding) and the age and level of professional education of the owners may also have an effect on standards of husbandry. The results show that the owners for whom FM represent a source of income more frequently keep their horses in standing stalls, but give them more time to exercise at liberty than the horses belonging to amateur breeders. Younger and better educated breeders are more likely to house their animals in groups.

Orofacial/cerebral injuries and the use of mouthguards by professional athletes in Switzerland

The objective of the present study was to measure the occurrence of orofacial and cerebral injuries in different sports and to survey the awareness of athletes and officials concerning the use of mouthguards during sport activities. Two hundred and sixty-seven professional athletes and 63 officials participating in soccer, handball, basketball and ice hockey were interviewed. The frequency of orofacial and cerebral trauma during sport practice was recorded and the reason for using and not using mouthguards was assessed. A great difference in orofacial and cerebral injuries was found when comparing the different kinds of sports and comparing athletes with or without mouthguards. 45% of the players had suffered injuries when not wearing mouthguards. Most injuries were found in ice hockey, (59%), whereas only 24% of the soccer players suffered injuries when not wearing mouthguards. Sixty-eight percentage of the players wearing mouthguards had never suffered any orofacial and cerebral injuries. Two hundred and twenty-four athletes (84%) did not use a mouthguard despite general acceptance by 150 athletes (56%). Although the awareness of mouthguards among officials was very high (59%), only 25% of them would support the funding of mouthguards and 5% would enforce regulations. Athletes as well as coaches should be informed about the high risk of oral injuries when performing contact sports. Doctors and dentists need to recommend a more intensive education of students in sports medicine and sports dentistry, and to increase their willingness to become a team dentist.

Further concerns about self-assessment: are medical students aware of their progress in clinical skills during clerkship

Background: Medical students do not accurately self-assess their competence. However, little is known about the awareness of change of competence over time. The aim of this study was to evaluate if students are aware of their progress. Summary of work: Twenty-two fourth year medical students had self- and expert-assessments of their clinical skills in musculoskeletal medicine in an OSCE like station (4 point Likert scale) at the beginning (t0) and end (t1) of their eight weeks clerkship in internal medicine. Thirteen students were assigned to the intervention of a 6x1 hour practical examination course; nine took part in the regular clinical clerkship activities only and served as controls. Summary of results/Conclusions: The intervention students significantly improved their skills (from 2.78 ± 0.36 to 3.30 ± 0.36, p<0.05) in contrast to the control students (from 3.11 ± 0.58 to 2.83 ± 0.49, n.s.). At t0, 19 students, at t1 21 out of 22 students underestimated their competence. Correlations between the change of self- and expert-assessment were r=0.43, p<0.05 (all), r=0.47, n.s. (control) and r=-0.12, n.s. (intervention), respectively. Take-home message: Medical students improving their clinical skills by an interactive course in addition to their regular clerkship activities are not aware of their progress

Interactive educational DVD on hoof protection, horseshoeing and diseases of the hoof

Good cooperation between farrier, veterinarian and horse owner is an important prerequisite for optimal support of the horse with regards to shoeing and hoof health. The introduction of a joint educational aid aims to improve the level of education of both veterinarians and farriers. The interactive, multimedia approach represents an innovative new dimension in instruction techniques, predominantly provided through images and videos. The contents of the new teaching aid will focus on detailed anatomy of the foot and distal limb, as well as currently accepted shoeing practices and techniques and pathologic conditions of the hoof and foot.