Structural basis for efficient phosphorylation of 3′-azidothymidine monophosphate by Escherichia coli thymidylate kinase

The crystal structures of Escherichia coli thymidylate kinase (TmpK) in complex with P1-(5′-adenosyl)-P5-(5′-thymidyl)pentaphosphate and P1-(5′-adenosyl)P5-[5′-(3′-azido-3′-deoxythymidine)] pentaphosphate have been solved to 2.0-Å and 2.2-Å resolution, respectively. The overall structure of the bacterial TmpK is very similar to that of yeast TmpK. In contrast to the human and yeast TmpKs, which phosphorylate 3′-azido-3′-deoxythymidine 5′-monophosphate (AZT-MP) at a 200-fold reduced turnover number (kcat) in comparison to the physiological substrate dTMP, reduction of kcat is only 2-fold for the bacterial enzyme. The different kinetic properties toward AZT-MP between the eukaryotic TmpKs and E. coli TmpK can be rationalized by the different ways in which these enzymes stabilize the presumed transition state and the different manner in which a carboxylic acid side chain in the P loop interacts with the deoxyribose of the monophosphate. Yeast TmpK interacts with the 3′-hydroxyl of dTMP through Asp-14 of the P loop in a bidentate manner: binding of AZT-MP results in a shift of the P loop to accommodate the larger substituent. In E. coli TmpK, the corresponding residue is Glu-12, and it interacts in a side-on fashion with the 3′-hydroxyl of dTMP. This different mode of interaction between the P loop carboxylic acid with the 3′ substituent of the monophosphate deoxyribose allows the accommodation of an azido group in the case of the E. coli enzyme without significant P loop movement. In addition, although the yeast enzyme uses Arg-15 (a glycine in E. coli) to stabilize the transition state, E. coli seems to use Arg-153 from a region termed Lid instead. Thus, the binding of AZT-MP to the yeast TmpK results in the shift of a catalytic residue, which is not the case for the bacterial kinase.

Explaining the moon illusion

An old explanation of the moon illusion holds that various cues place the horizon moon at an effectively greater distance than the elevated moon. Although both moons have the same angular size, the horizon moon must be perceived as larger. More recent explanations hold that differences in accommodation or other factors cause the elevated moon to appear smaller. As a result of this illusory difference in size, the elevated moon appears to be more distant than the horizon moon. These two explanations, both based on the geometry of stereopsis, lead to two diametrically opposed hypotheses. That is, a depth interval at a long distance is associated with a smaller binocular disparity, whereas an equal depth interval at a smaller distance is associated with a larger disparity. We conducted experiments involving artificial moons and confirmed the hypothesis that the horizon moon is at a greater perceptual distance. Moreover, when a moon of constant angular size was moved closer it was also perceived as growing smaller, which is consistent with the older explanation. Although Emmert's law does not predict the size–distance relationship over long distances, we conclude that the horizon moon is perceived as larger because the perceptual system treats it as though it is much farther away. Finally, we observe that recent explanations substitute perceived size for angular size as a cue to distance. Thus, they imply that perceptions cause perceptions.

Statistical modeling of large microarray data sets to identify stimulus-response profiles

A statistical modeling approach is proposed for use in searching large microarray data sets for genes that have a transcriptional response to a stimulus. The approach is unrestricted with respect to the timing, magnitude or duration of the response, or the overall abundance of the transcript. The statistical model makes an accommodation for systematic heterogeneity in expression levels. Corresponding data analyses provide gene-specific information, and the approach provides a means for evaluating the statistical significance of such information. To illustrate this strategy we have derived a model to depict the profile expected for a periodically transcribed gene and used it to look for budding yeast transcripts that adhere to this profile. Using objective criteria, this method identifies 81% of the known periodic transcripts and 1,088 genes, which show significant periodicity in at least one of the three data sets analyzed. However, only one-quarter of these genes show significant oscillations in at least two data sets and can be classified as periodic with high confidence. The method provides estimates of the mean activation and deactivation times, induced and basal expression levels, and statistical measures of the precision of these estimates for each periodic transcript.

Calcium regulation of a slow post-spike hyperpolarization in vagal afferent neurons

Activation of distinct classes of potassium channels can dramatically affect the frequency and the pattern of neuronal firing. In a subpopulation of vagal afferent neurons (nodose ganglion neurons), the pattern of impulse activity is effectively modulated by a Ca2+-dependent K+ current. This current produces a post-spike hyperpolarization (AHPslow) that plays a critical role in the regulation of membrane excitability and is responsible for spike-frequency accommodation in these neurons. Inhibition of the AHPslow by a number of endogenous autacoids (e.g., histamine, serotonin, prostanoids, and bradykinin) results in an increase in the firing frequency of vagal afferent neurons from <0.1 to >10 Hz. After a single action potential, the AHPslow in nodose neurons displays a slow rise time to peak (0.3–0.5 s) and a long duration (3–15 s). The slow kinetics of the AHPslow are due, in part, to Ca2+ discharge from an intracellular Ca2+-induced Ca2+ release (CICR) pool. Action potential-evoked Ca2+ influx via either L or N type Ca2+ channels triggers CICR. Surprisingly, although L type channels generate 60% of action potential-induced CICR, only Ca2+ influx through N type Ca2+ channels can trigger the CICR-dependent AHPslow. These observations suggest that a close physical proximity exists between endoplasmic reticulum ryanodine receptors and plasma membrane N type Ca2+ channels and AHPslow potassium channels. Such an anatomical relation might be particularly beneficial for modulation of spike-frequency adaptation in vagal afferent neurons.

cAMP-dependent, long-lasting inhibition of a K+ current in mammalian neurons.

We report the long-term modulation of K+ channels by cAMP in cultured murine colliculi neurons. A short (1-2 s) application of 8-Br-cAMP induced a long-lasting broadening of the action potential, a loss of after-hyperpolarization, and a reduction in spike accommodation. In agreement with these changes, 8-Br-cAMP produced a long-lasting (2 hr) inhibition of a K+ current. These effects were also observed after a short activation of the pituitary adenylyl cyclase-activating polypeptide, beta-adrenergic, and 5-hydroxytryptamine type 4 (5-HT4) receptors, all known to increase cAMP. A transient activation of the cAMP-dependent protein kinase and a long-lasting inhibition of phosphatases (up to 2 hr) were detected. The blockade of the K+ current resulting from a brief application of 8-Br-cAMP or 5-hydroxytryptamine was prolonged from 2 to 4 hr when protein-serine/threonine phosphatases 1 and 2A were inhibited with 10 nM okadaic acid. The critical steps following the cAMP-dependent protein kinase activation and resulting in a long-term blockade of phosphatases are discussed in this report.

Promotion of purine nucleotide binding to thymidylate synthase by a potent folate analogue inhibitor, 1843U89.

A folate analogue, 1843U89 (U89), with potential as a chemotherapeutic agent due to its potent and specific inhibition of thymidylate synthase (TS; EC 2.1.1.45), greatly enhances not only the binding of 5-fluoro-2'-deoxyuridine 5'-monophosphate (FdUMP) and dUMP to Escherichia coli TS but also that of dGMP, GMP, dIMP, and IMP. Guanine nucleotide binding was first detected by CD analysis, which revealed a unique spectrum for the TS-dGMP-U89 ternary complex. The quantitative binding of dGMP relative to GMP, FdUMP, and dUMP was determined in the presence and absence of U89 by ultrafiltration analysis, which revealed that although the binding of GMP and dGMP could not be detected in the absence of U89 both were bound in its presence. The Kd for dGMP was about the same as that for dUMP and FdUMP, with binding of the latter two nucleotides being increased by two orders of magnitude by U89. An explanation for the binding of dGMP was provided by x-ray diffraction studies that revealed an extensive stacking interaction between the guanine of dGMP and the benzoquinazoline ring of U89 and hydrogen bonds similar to those involved in dUMP binding. In addition, binding energy was provided through a water molecule that formed hydrogen bonds to both N7 of dGMP and the hydroxyl of Tyr-94. Accommodation of the larger dGMP molecule was accomplished through a distortion of the active site and a shift of the deoxyribose moiety to a new position. These rearrangements also enabled the binding of GMP to occur by creating a pocket for the ribose 2' hydroxyl group, overcoming the normal TS discrimination against nucleotides containing the 2' hydroxyl.

L’abilità di perspective taking : un training per bambini in età prescolare in differenti contesti

Elemento centrale della presente tesi dottorale è il costrutto di perspective taking, definibile come l’abilità, emergente nei bambini intorno a 4-5 anni, di assumere la prospettiva altrui secondo tre differenti dimensioni: emotiva, cognitiva e percettiva (Bonino, Lo Coco, Tani, 1998; Moll e Meltzoff, 2011). Dalla letteratura emerge come il perspective taking, in quanto abilità di comprensione sociale, rivesta un ruolo adattivo e sia fondamentale per lo sviluppo, non solo intellettivo, ma anche per la formazione di adeguate capacità relazionali e sociali (Jenkins e Astington, 2000; Weil et al., 2011). Sulla base di tali considerazioni, alcuni ricercatori si sono interrogati sulla possibilità di insegnare questa abilità, elaborando specifiche e differenti procedure di intervento finalizzate ad incrementare l’abilità di perspective taking sia in bambini a sviluppo normativo (Cigala e Mori, 2015), sia in gruppi di bambini a sviluppo atipico (Fisher e Happé, 2005; Heagle e Rehfeldt, 2006; Paynter e Peterson, 2012). A partire da una prospettiva teorica socio-costruzionista, secondo cui l’acquisizione del perspective taking si configura come un’impresa di co-costruzione continua, all’interno di interazioni quotidiane con figure significative per il bambino, si è deciso di analizzare il perspective taking non solo in relazione a variabili individuali (genere, età del bambino, regolazione emotiva, abilità sociali) ma anche e soprattutto a variabili contestuali quali le caratteristiche del contesto familiare (caratteristiche disposizionali e stili genitoriali di socializzazione emotiva, presenza di fratelli). Sono stati in particolare indagati un contesto familiare normativo ed uno caratterizzato da maltrattamento psicologico, contrassegnato dalla reiterazione di comportamenti inadeguati (critiche svalutanti, denigrazione, umiliazione, minacce verbali, indifferenza) nei confronti del minore, che convogliano sul bambino l’idea di non essere amato e di avere poco valore. Con i termini “a sviluppo tipico” si intendono i bambini per i quali non sussista una diagnosi clinica e con quelli di “famiglie normative” ci si riferisce a nuclei per i quali non ci siano state segnalazioni da parte dei Servizi Educativi e Sociali di riferimento, indipendentemente dalle caratteristiche della composizione del nucleo familiare (nucleare, estesa, multipla, ricostituita o ricomposta). Tale studio rientra in un ampio progetto di ricerca e formazione che ha coinvolto più di 250 prescolari frequentanti 8 scuole dell’infanzia e 15 comunità terapeutiche e di accoglienza mamma-bambino, situate in differenti province del Nord Italia. Il gruppo dei partecipanti alla ricerca si è composto di 256 bambini in età prescolare, compresa quindi tra 3 e 5 anni (M=54,39; DS=5,705): 128 maschi (M=54,08; DS=5,551) e 128 femmine (M=54,70; DS=5,860). In particolare, 213 bambini appartenevano a famiglie normative e 43 a nuclei familiari caratterizzati dalla presenza di maltrattamento psicologico. Oltre ai bambini, la ricerca ha previsto il coinvolgimento di 155 coppie di genitori, 43 madri ospitate in comunità, 18 insegnanti e 30 operatori. Obiettivo centrale è stato l’indagine della possibilità di poter promuovere il perspective taking in bambini di età prescolare a sviluppo tipico appartenenti a due differenti tipologie di contesto familiare (normativo e psicologicamente maltrattante), attraverso l’applicazione di uno specifico percorso di training di natura “ecologica” all’interno della scuola dell’infanzia e della comunità, assimilabile a quelli di tipo evidence based. In particolare è stata prevista una procedura quasi sperimentale di tipo pre-test, training, post-test e follow-up. Dopo una preliminare valutazione dello sviluppo del perspective taking nelle sue tre componenti, in bambini appartenenti ad entrambi i contesti, si è voluto verificare l’esistenza di eventuali relazioni tra questa abilità ed alcune capacità socio-emotive dei bambini, con particolare riferimento alla disposizione prosociale, rilevate nel contesto scolastico attraverso differenti metodologie (osservazioni dirette non partecipanti, questionari self report compilati dalle insegnanti). Inoltre, data l’importanza del contesto familiare per lo sviluppo di tale abilità, la ricerca ha avuto lo scopo di verificare l’esistenza di eventuali relazioni tra le abilità di perspective taking mostrate dai bambini e gli stili di socializzazione emotiva delle figure familiari, caratteristiche di entrambi i contesti (maltrattante e non maltrattante). È stato inoltre previsto uno studio di confronto tra i due campioni rispetto alle dimensioni indagate. I risultati ottenuti sono stati particolarmente interessanti. Innanzitutto, le esperienze di training hanno determinato, in entrambi i contesti, miglioramenti nell’abilità dei prescolari di mettersi nei panni altrui. Tale training ha inoltre dimostrato effetti positivi sulla competenza sociale dei bambini, che, a seguito del percorso, hanno manifestato un incremento dei comportamenti prosociali ed una diminuzione di quelli aggressivi. Per lo studio in contesto normativo, è stato inoltre dimostrato un mantenimento delle abilità acquisite a seguito del training attraverso un follow-up a distanza di 4 mesi dal termine dell’intervento. Il positivo esito di tale percorso sembra quindi rappresentare un’importante risorsa per i prescolari, soprattutto in caso di situazioni in cui l’abilità di perspective taking risulti deficitaria. Il confronto dei due gruppi a seguito del training ha evidenziato come non siano emerse differenze significative, rispetto al perspective taking, ad eccezione della dimensione emotiva, in cui le prestazioni dei prescolari maltrattati sono risultate inferiori, come già evidenziato prima del training. Tali risultati non giungono però inaspettati, poiché, sebbene il percorso abbia agito significativamente sull’abilità di comprensione delle emozioni altrui di questi bambini, non si configura come sufficiente a ristrutturare così profondamente le problematiche presentate. Interessanti sono stati altresì i risultati ottenuti dall’analisi degli stili di socializzazione emotiva, dei genitori (madri e padri) dei prescolari non maltrattati e delle mamme dei bambini residenti in comunità. In particolare è emerso come, stili accettanti e di tipo coaching nei confronti delle emozioni negative dei bambini, siano positivamente correlati con il perspective taking dei figli, e come all’opposto, stili rifiutanti rispetto alle espressioni emotive negative dei propri bambini, mostrino correlazioni negative con le abilità di perspective taking dei figli. Oltre ad interessi di ordine teorico e metodologico, è possibile quindi affermare come, il presente lavoro di tesi, sia stato guidato da fini applicativi, affinché la ricerca scientifica possa tradursi in pratiche educative quotidiane da applicare ai contesti di vita significativi per i bambini.

Tendências e contratendências de mercantilização: as reformas dos sistemas de saúde alemão, francês e britânico

Ao longo dos últimos trinta anos, entre meados das décadas de 1980 e 2010, os sistemas de saúde da Alemanha, França e Reino Unido foram reformados, gerando uma crescente mercantilização no financiamento e na prestação de serviços. O trabalho analisa as raízes dessas mudanças, assim como identifica que a mercantilização não ocorreu nem mediante os mesmos mecanismos e nem com a mesma profundidade, havendo importante inércia institucional. As diferenças observadas atestam as especificidades de cada país, em termos de seu contexto econômico, de seus arranjos políticos, das características institucionais de cada sistema e das formas que assumiram os conflitos sociais (extra e intra sistema de saúde). Os sistemas de saúde alemão, francês e britânico, enquanto sistemas públicos de ampla cobertura e integralidade, são frutos do período após a Segunda Guerra Mundial. Um conjunto de fatores contribuiu para aquele momento histórico: os próprios impactos do conflito, que forjaram a ampliação na solidariedade nacional e a maior pressão por parte dos trabalhadores; a ascensão socialista na União Soviética; o maior apoio à ação e ao planejamento estatal; o forte crescimento econômico, fruto da emersão de um regime de acumulação fordista, pautado na expansão da produtividade. A acomodação do conflito capital-trabalho, neste contexto, ocorreu mediante a expansão dos salários reais e ao desenvolvimento do Estado de bem-estar social, ou seja, de políticas públicas voltadas à criação e/ou ampliação de uma rede de proteção social. No entanto, a crise econômica da década de 1970 corroeu a base de financiamento e gerou questionamentos sobre sua eficiência, em meio à transformação do regime de acumulação de fordista para financeirizado, levando à adoção de reformas constantes ao longo das décadas seguintes. Além disso, as transformações específicas do setor saúde complexificaram a situação, tendo em vista o crescente envelhecimento populacional, a demanda por cuidados mais amplos e complexos e, principalmente, os custos derivados da incorporação tecnológica. Este cenário impulsionou a implementação de uma série de alterações nesses sistemas de saúde, com destaque para a incorporação de mecanismos de mercado (como a precificação dos serviços prestados, a indução à concorrência entre prestadores de serviços), o crescimento da responsabilidade dos usuários pelo financiamento do sistema (como o aumento nos co-pagamentos e a redução na cobertura pública) e a ampliação da participação direta do setor privado na prestação dos serviços de saúde (realizando os serviços auxiliares, a gestão de hospitais públicos, comprando instituições estatais). No entanto, de forma simultânea, as reformas ampliaram o acesso e a regulamentação estatal, além da modificação na base de financiamento, principalmente na França. Isto significa que a mercantilização não foi o único direcionamento das reformas, em decorrência de dois fatores principais: a própria crise econômica expulsou parcela da população dos mecanismos pós-guerra de proteção à saúde, demandando reação estatal, e diferentes agentes sociais influenciaram nas mudanças, bloqueando ou ao menos limitando um direcionamento mercantil único.

Architecture of a Bench-Type Carbonate Lake Margin and Its Relation to Fluvially Dominated Deltas, Las Minas Basin, Upper Miocene, Spain

The Upper Miocene stratigraphic succession of the Las Minas Basin, located at the external zone of the Betic Chain in SE Spain, preserves several examples of lake carbonate bench deposits. Excellent exposures of the carbonate benches allow detailed observation of the architecture of these sediments and provide new insights for the ‘‘steep-gradient bench margin–low energy’’ model proposed by Platt and Wright (1991). The lake carbonate benches developed in close association with fluvially dominated shallow deltas that exhibit typical Gilbert-type profiles. The delta sequences comprise bottomset prodelta marl facies, distal to proximal foreset facies, deposited mainly in a delta-front environment, and topset facies, the latter reflecting both subaqueous delta-front and subaerial delta-plain environments. The development of the carbonate benches was constrained by the convexupward morphology of the deltaic deposits, which led to the available accommodation space for the growth of the steep-gradient platforms. The benches display a progradational pattern characterized by sigmoid-oblique internal geometries and offlap upper boundary relationships, which suggests that the carbonate benches developed under slow though continuous lake-level rise. Both the dimensions of the benches and the dominant carbonate components (i.e., encrusted charophyte stems and calcified cyanobaterial remains), allow comparisons with the progradational marl benches recognized in modern temperate hardwater lakes. Accordingly, the case study presented here provides a good ancient sedimentary analog for low-energy lake carbonate benches. Moreover, the evolutionary trend inferred from the fossil example offers new insights into the depositional conditions of this type of sediment and allows recognition of the transitional pattern from bench to ramp carbonate lake margins.

Contêineres metálicos para canteiros de obras: análise experimental de desempenho térmico e melhorias na transferência de calor pela envoltória.

Os contêineres metálicos foram desenvolvidos para a utilização no setor de logística e transporte, mas por sua escala adaptável à das edificações e pela mobilidade e praticidade de instalação, tiveram sua utilização apropriada também pelo setor da construção civil. Essas instalações possuem diversas qualidades ambientalmente amigáveis, mas seu aspecto térmico é extremamente insuficiente: sem isolamento térmico, demandam alta carga térmica de refrigeração e aquecimento, no verão e inverno, respectivamente e, consequentemente, um alto consumo energético. Tal característica foi crucial para que se determinassem como objetivos da presente pesquisa investigar o comportamento térmico dessas construções metálicas, avaliar seus parâmetros de desempenho, conforto e estresse térmicos, por meio de uma ampla coleta de dados experimentais. O experimento com duração de um ano - contou com três tipologias de contêiner em escala real, sendo o primeiro em aço Tipo X sem isolamento térmico, o segundo com um isolamento térmico para o fenômeno da condução e o terceiro com isolamento térmico para o fenômeno da radiação. Os diferentes tipos de tratamentos térmicos proporcionaram melhorias à envoltória dos contêineres, chegando a uma diferença nas temperaturas internas de até 9 °C. Constatou-se a extrema necessidade de adequação do tipo de isolamento térmico dos contêineres ao uso a que tais instalações se destinam escritório ou alojamento, no caso dos canteiros de obras para que as características da envoltória minimizem de fato a demanda ou mesmo atinjam a eliminação da necessidade de condicionamento artificial.

Struggling, Coping, And Thriving: Sense-Making In Stepfamily Couples' Narratives About Coparenting

The term coparenting implies a bioparental dyad that often excludes the stepparent's role in sharing parenting across joint-custody households. Focusing solely on this dyad also precludes gaining an understanding of how stepfamily couples manage together the communication and sharing of parental responsibilities with the parent(s) in the shared children's other home. In a departure from this bioparental dyad-focused approach, this study locates the stepfamily couple at the center of an inquiry into managing coparenting across households. This mixed methods design study included in-depth interviews of 32 stepfamily couples whose narratives about coparenting were analyzed using grounded theory methods. Forty-one percent of stepparents engage in direct coparenting communication, sometimes manifested as the coactive approach identified in this study. Stepfamily couples also involve the stepparent indirectly in coparenting communication, through the conferred and consultative approaches. As well, the couples' narratives about coparenting identify them as either united, where they share the experience, or divided, where coparenting is reserved exclusively for the bioparent to manage. The stepfamily couples' narratives about significant coparenting experiences revealed that they experience and make sense of coparenting as 1) struggling, 2) coping, or 3) thriving. No significant relationship was found between marital satisfaction and experiencing coparenting as strugglers, copers or thrivers. Grounded theory analysis of these narratives also reflects the four dichotomous dimensions of 1) regard-disregard, 2) decency-duplicity, 3) facilitation-interference, and 4) accommodation-inflexibility. Significant incidents located along these dimensions contribute to the stepfamily couples' identification as struggling, coping, or thriving in coparenting. Experiences on the extreme ends of the dichotomous dimensions generate positive and negative turning points for the coparenting interactions and relationships. As well, experiences on the negative end of the dimensional poles can present challenges for the stepfamily couples. Finally, a synthesis of the findings related to the dichotomous dimensions generates a theory of shared parenting values expectancy.

Symbol for a Community: The Dickens Opera House and Theaters of the American West

This paper reveals the importance of the Dickens Opera House to the local history of Longmont, Colorado. Through an exploration of pioneer history and of architectural patronage and audience accommodation, this paper illustrates how the Dickens Opera House participated in the construction of cultural identity and civic aspirations of the city of Longmont. Using the Tabor Opera House of Leadville and Wright Opera House of Ouray as framing examples to place the Dickens Opera House within its proper architectural and historical context, I approach the building’s inception, construction, and early years as a way to track the early civic identity of a community through a work of architecture. The Dickens Opera House provided a point for the citizens of Longmont to focus their hopes of success and respectability in a newly formed community. An opera house provided a high-class perception of a town that provided a projection of respectability. Such a construction was built from various sources – the architecture of the building, simply calling the building an ‘opera house’, furnishings in the latest fashions and equipment of the latest technology, and extravagant scenery and curtains. In addition to these outward projections, opera houses also provided a place for community events. It was the location in town that brought people together.

Do we really know the prevalence of accomodative and nonstrabismic binocular dysfunctions?

Purpose: To determine the scientific evidence about the prevalence of accommodative and nonstrabismic binocular anomalies. Methods: We carried out a systematic review of studies published between 1986 and 2009, analysing the MEDLINE, CINAHL, FRANCIS and PsycINFO databases. We considered admitting those papers related to prevalence in paediatric and adult populations. We identified 660 articles and 10 papers met the inclusion criteria. Results: There is a wide range of prevalence, particularly for accommodative insufficiency (2 %-61.7 %) and convergence insufficiency (2.25 %-33 %). More studies are available for children (7) compared with adults (3). Most of studies examine clinical population (5 studies) with 3 assessed at schools and 1 at University with samples that vary from 65 to 2048 patients. There is great variability regarding the number of diagnostic signs ranging from 1 to 5 clinical signs. We found a relation between the number of clinical signs used and prevalence values for convergence insufficiency although this relationship cannot be confirmed for other conditions. Conclusion: There is a lack of proper epidemiological studies about the prevalence of accommodative and nonstrabismic binocular anomalies. Studies reviewed examine consecutive or selected patients in clinical settings and schools but in any case they are randomized and representative of their populations with no data for general population. The wide discrepancies in prevalence figures are due to both sample population and the lack of uniformity in diagnostic criteria so that it makes difficult to compile results. Biases and limitations of reports determine that prevalence rates offered are only estimations from selected populations.

Elección de la duración del viaje vacacional: una aproximación con modelos de recuento

La duración del viaje vacacional es una decisión del turista con unas implicaciones fundamentales para las organizaciones turísticas, pero que ha recibido una escasa atención por la literatura. Además, los escasos estudios se han centrado en los destinos costeros, cuando el turismo de interior se está erigiendo como una alternativa importante en algunos países. El presente trabajo analiza los factores determinantes de la elección temporal del viaje turístico, distinguiendo el tipo de destino elegido -costa e interior-, y proponiendo varias hipótesis acerca de la influencia de las características de los individuos relacionadas con el destino, de las restricciones personales y de las características sociodemográficas. La metodología aplicada estima, como novedad en este tipo de decisiones, un Modelo Binomial Negativo Truncado que evita los sesgos de estimación de los modelos de regresión y el supuesto restrictivo de igualdad media-varianza del Modelo de Poisson. La aplicación empírica realizada en España sobre una muestra de 1.600 individuos permite concluir, por un lado, que el Modelo Binomial Negativo es más adecuado que el de Poisson para realizar este tipo de análisis. Por otro lado, las dimensiones determinantes de la duración del viaje vacacional son, para ambos destinos, el alojamiento en hotel y apartamento propio, las restricciones temporales, la edad del turista y la forma de organizar el viaje; mientras que el tamaño de la ciudad de residencia y el atributo “precios baratos” es un aspecto diferencial de la costa; y el alojamiento en apartamentos alquilados lo es de los destinos de interior.

Diagnostic validity of clinical signs associated with a large exophoria at near

Purpose. To analyze the diagnostic validity of accommodative and binocular tests in a sample of patients with a large near exophoria with moderate to severe symptoms. Methods. Two groups of patients between 19 and 35 years were recruited from a university clinic: 33 subjects with large exophoria at near vision and moderate or high visual discomfort and 33 patients with normal heterophoria and low visual discomfort. Visual discomfort was defined using the Conlon survey. A refractive exam and an exhaustive evaluation of accommodation and vergence were assessed. Diagnostic validity by means of receiver operator characteristic (ROC) curves, sensitivity (S), specificity (Sp), and positive and negative likelihood ratios (LR+, LR−) were assessed. This analysis was also carried out considering multiple tests as serial testing strategy. Results. ROC analysis showed the best diagnostic accuracy for receded near point of convergence (NPC) recovery (area = 0.929) and binocular accommodative facility (BAF) (area = 0.886). Using the cut-offs obtained with ROC analysis, the best diagnostic validity was obtained for the combination of NPC recovery and BAF (S  =  0.77, Sp = 1, LR+ = value tending to infinity, LR− = 0.23) and the combination of NPC break and recovery with BAF (S  =  0.73, Sp = 1, LR+ = tending to infinity, LR− = 0.27). Conclusions. NPC and BAF tests were the tests with the best diagnostic accuracy for subjects with large near exophoria and moderate to severe symptoms.