Energy metabolism during the postexercise recovery in man.

In order to explore the magnitude and duration of the long-term residual effect of physical exercise, a mixed meal (55% CHO, 27% fat and 18% protein) was given to 10 young male volunteers on two occasions: after a 4-h resting period, and on the next day, 30 min after completion of a 3-h exercise at 50% VO2max. Energy expenditure and substrate utilization were determined by indirect calorimetry for 17 h after meal ingestion. The fuel mix oxidized after the meal was characterized by a greater contribution of lipid oxidation to total energy expenditure when the meal was ingested during the post-exercise period as compared with the meal ingested without previous exercise. During the night following the exercise, the stimulation of energy expenditure observed during the early recovery period gradually faded out. However, resting energy expenditure measured the next morning was significantly higher (+4.7%) than that measured without previous exercise. It is concluded that intense exercise stimulates both energy expenditure and lipid oxidation for a prolonged period.

Individual differences in control of language interference in late bilinguals are mainly related to general executive abilities

Background: Recent research based on comparisons between bilinguals and monolinguals postulates that bilingualism enhances cognitive control functions, because the parallel activation of languages necessitates control of interference. In a novel approach we investigated two groups of bilinguals, distinguished by their susceptibility to cross-language interference, asking whether bilinguals with strong language control abilities ('non-switchers") have an advantage in executive functions (inhibition of irrelevant information, problem solving, planning efficiency, generative fluency and self-monitoring) compared to those bilinguals showing weaker language control abilities ('switchers"). Methods: 29 late bilinguals (21 women) were evaluated using various cognitive control neuropsychological tests [e.g., Tower of Hanoi, Ruff Figural Fluency Task, Divided Attention, Go/noGo] tapping executive functions as well as four subtests of the Wechsler Adult Intelligence Scale. The analysis involved t-tests (two independent samples). Non-switchers (n = 16) were distinguished from switchers (n = 13) by their performance observed in a bilingual picture-naming task. Results: The non-switcher group demonstrated a better performance on the Tower of Hanoi and Ruff Figural Fluency task, faster reaction time in a Go/noGo and Divided Attention task, and produced significantly fewer errors in the Tower of Hanoi, Go/noGo, and Divided Attention tasks when compared to the switchers. Non-switchers performed significantly better on two verbal subtests of the Wechsler Adult Intelligence Scale (Information and Similarity), but not on the Performance subtests (Picture Completion, Block Design). Conclusions: The present results suggest that bilinguals with stronger language control have indeed a cognitive advantage in the administered tests involving executive functions, in particular inhibition, self-monitoring, problem solving, and generative fluency, and in two of the intelligence tests. What remains unclear is the direction of the relationship between executive functions and language control abilities.

Evolution of Gait Performance and Fear of Falling after a 10-Week Program of Exercise Training in Community Dwelling Older People

A pilot study was conducted to determine the effect of a 10-week, low intensity, exercise training program on fear of falling and gait in fifty (mean age 78.1 years, 79% women) community-dwelling volunteers. Fear of falling (measured by falls self-efficacy) and gait performance were assessed at baseline and one week after program completion. At follow-up, participants modestly improved their falls self-efficacy and gait speed. To investigate whether this effect differed according to participants' fear of falling, secondary analyses stratified by subject's baseline falls efficacy were performed. Subjects with lower than average falls efficacy improved significantly their falls efficacy and gait performance, while no significant change occurred in the others. Small but significant improvements occurred after this pilot training program, particularly in subjects with low baseline falls efficacy. These results suggest that measures of falls efficacy might be useful for better targeting individuals most likely to benefit from similar training programs.

Synthetic calibrators for the analysis of total metanephrines in urine: revisiting the conditions of hydrolysis.

BACKGROUND: The quantification of total (free+sulfated) metanephrines in urine is recommended to diagnose pheochromocytoma. Urinary metanephrines include metanephrine itself, normetanephrine and methoxytyramine, mainly in the form of sulfate conjugates (60-80%). Their determination requires the hydrolysis of the sulfate ester moiety to allow electrochemical oxidation of the phenolic group. Commercially available urine calibrators and controls contain essentially free, unhydrolysable metanephrines which are not representative of native urines. The lack of appropriate calibrators may lead to uncertainty regarding the completion of the hydrolysis of sulfated metanephrines, resulting in incorrect quantification. METHODS: We used chemically synthesized sulfated metanephrines to establish whether the procedure most frequently recommended for commercial kits (pH 1.0 for 30 min over a boiling water bath) ensures their complete hydrolysis. RESULTS: We found that sulfated metanephrines differ in their optimum pH to obtain complete hydrolysis. Highest yields and minimal variance were established for incubation at pH 0.7-0.9 during 20 min. CONCLUSION: Urinary pH should be carefully controlled to ensure an efficient and reproducible hydrolysis of sulfated metanephrines. Synthetic sulfated metanephrines represent the optimal material for calibrators and proficiency testing to improve inter-laboratory accuracy.

Efficacy, safety and tolerability of linezolid containing regimens in treating MDR-TB and XDR-TB: systematic review and meta-analysis.

Linezolid is used off-label to treat multidrug-resistant tuberculosis (MDR-TB) in absence of systematic evidence. We performed a systematic review and meta-analysis on efficacy, safety and tolerability of linezolid-containing regimes based on individual data analysis. 12 studies (11 countries from three continents) reporting complete information on safety, tolerability, efficacy of linezolid-containing regimes in treating MDR-TB cases were identified based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Meta-analysis was performed using the individual data of 121 patients with a definite treatment outcome (cure, completion, death or failure). Most MDR-TB cases achieved sputum smear (86 (92.5%) out of 93) and culture (100 (93.5%) out of 107) conversion after treatment with individualised regimens containing linezolid (median (inter-quartile range) times for smear and culture conversions were 43.5 (21-90) and 61 (29-119) days, respectively) and 99 (81.8%) out of 121 patients were successfully treated. No significant differences were detected in the subgroup efficacy analysis (daily linezolid dosage ≤600 mg versus >600 mg). Adverse events were observed in 63 (58.9%) out of 107 patients, of which 54 (68.4%) out of 79 were major adverse events that included anaemia (38.1%), peripheral neuropathy (47.1%), gastro-intestinal disorders (16.7%), optic neuritis (13.2%) and thrombocytopenia (11.8%). The proportion of adverse events was significantly higher when the linezolid daily dosage exceeded 600 mg. The study results suggest an excellent efficacy but also the necessity of caution in the prescription of linezolid.

Les représentations d'attachement du jeune enfant. Développement d'un système de codage pour les histoires à compléter

Les histoires d'attachement à compléter de Bretherton et Ridgeway (1990) constituent un moyen d'évaluer les narratifs d'enfants dès l'âge de 3 ans. Dans le présent article, nous présentons un Q-sort permettant de coder ces productions enfantines. Des scores à 4 dimensions d'attachement (sécurité, désactivation, hyperactivation, désorganisation) peuvent être obtenus grâce à une comparaison des réponses du sujet à celles de prototypes. Par ailleurs, une analyse en composantes principales a permis de définir 6 échelles, correspondant chacune à un aspect spécifique du jeu. Certains aspects des narratifs semblent influencés par le sexe et l'âge de l'enfant, mais non par son QI. Des exemples d'application du Q-sort sont présentés, notamment pour l'étude de la transmission intergénérationnelle des stratégies d'attachement ou pour l'étude de l'implication des représentations et des capacités narratives en matière de psychopathologie. Bretherton and Ridgeway's (1990) attachment story completion task allows for the assessment of child narratives as early as 3 years of age. In the present article, we present a Q-sort for the coding of these child productions. Scores on 4 attachment dimensions (security, deactivation, hyperactivation, disorganization) can be computed by comparing participants' responses to those of each prototype. Following a principal components analysis, 6 scales have been defined, each one corresponding to some specific aspects of child play. Certain aspects of child narratives seem to be influenced by gender and age, but not by IQ. Examples of possible applications of the Q-sort are presented, such as its use in the study of intergenerational transmission of attachment strategies or the study of the role of representations and narrative competence in psychopathology.

Tietojärjestelmäinvestoinnin jälkitarkkailumalli

Tämän työn ensisijaisena tavoitteena oli kehittää tietojärjestelmähankkeiden investointiprosessia luomalla kohdeyritykseen yhtenäinen toimintatapa hankkeiden jälkitarkkailuun. Tavoiteltu muutos koskee järjestelmäinvestointien arviointiperusteita sekä niiden käyttöönoton jälkeistä seurantaa. Jälkitarkkailumalli on rakennettu tasapainotettujen mittaristojen viitekehyksestä mittaamalla onnistumista johdon, loppukäyttäjän sekä projektin näkökulmasta. Työn tuloksena on Excel -sovellus sekä toimintatapa sovelluksen käytölle. Esimerkki-investoinnista kerätyn kokemuksen perusteella malli tukee investointiin liittyvien sidosryhmien sitoutumista yhteisiin tavoitteisiin sekä selkeyttää roolijakoa IT - vetoisen projektiryhmän ja yrityksen liiketoiminnallisen johdon välillä. Lisäksi mallin koettiin tukevan käyttöönotetun järjestelmän tavoitelähtöistä johtamista. Käytön laajentuessa mallilla uskotaan olevan yksittäistenhankkeiden lisäksi positiivinen vaikutus myös yrityksen tietojärjestelmähankkeiden investointiprosessiin.

Investointiprosessin arviointi ja kehittäminen: tuotannollisten hankkeiden kannattavuus

Työn päätavoitteena on tutkia investointiprosessin toimivuutta. Työssä selvitetään, mitä lisätietoja päätöksentekijät tarvitsevat investointien valinnassa. Työssä tarkastellaan investointien kannattavuuden arviointia, projektien valintaa ja valintaan vaikuttavia tekijöitä. Myös investoinnin toteutuksen jälkeistä tarkkailua tutkitaan. Työ on tehty kohdeyrityksen eri tehtaiden investointikäytäntöjen yhdistämisen avuksi. Työssä tarkastellaan yrityksennykyisiä käytäntöjä ohjeiden, haastattelujen ja tapaustutkimuksen kautta. Tutkimuksen tuloksena selvisi, että investointien arviointikäytäntöjä olisi kehitettävä. Vain suurilta investointiprojekteilta vaaditaan tarkat suunnitelmat ja laskelmat. Nykyisen takaisinmaksuajan menetelmän rinnalle tulisi ottaa käyttöön rahan aika-arvon huomioon ottava menetelmä, kuten sisäisen koron menetelmä. Riskienhallinnassa olisi vielä otettava huomioon kustannuksiin ja markkinoiden muutosherkkyyteen liittyvät riskit. Kun suunnittelu saadaan kuntoon, seuraavana tärkeänä kehittämiskohteena olisi investoinnin jälkeisen tarkkailun lisääminen investointiprosessiin.

Riskianalyysistäohjeelliseen panostussuunnitelmaan

Nykytekniikalla kyetään tehokkaaseen ja turvalliseen työn toteuttamiseen. Suorituksen aikaansaanti edellyttää ympäristön kartoittamista niin, että urakoitsija tuntee ne seikat, jotka ovat tarpeen, jotta työ voidaan suorittaa vaurioittamatta olevia rakennuksia ja aiheuttamatta asukkaille vaaratilanteita. Riskianalyysi tuo esille ne seikat, jotka on syytä tietää työn laskenta- ja suoritustilanteessa. On tunnettava käytettävät räjähdysaineet ja mitä tapahtuu räjähdysprosessissa. Prosessin ideaalimallin (harmoninen värähtely) pohjalta on kehitetty teorioita, joiden avulla kyetään pitämään suorituksen aiheuttama tärinätaso sellaisena, ettei ympäristössä olevia entisiä rakennuksia vaurioiteta eikä teknisestä suorituksesta aiheudu vaaratilanteita ihmisille. Riskianalyysi- ja rakennuskatselmustietojen perusteella mitoitetaan käytettävä panos sellaiseksi, että asetetut turvallisuusvaateet tulevat täytetyiksi. Työn suorituksen onnistumiseksilaaditaan ohjeellinen panostussuunnitelma, jossa käytettävä panoskoko ilmoitetaan etäisyyden funktiona varottavasta kohteesta. Samassa esityksessä käy selville rakenteille sallittu tärinäaallon heilahdusnopeus mm/s:ssa. Muuttunut etäisyys ja se tosiasia, etteivät räjäytyskentät ole tärinätasoltaan identtisiä, vaikka etäisyys ja panoskoko ovat samat, tarvitsee muutostentekoa varten teoreettistasoisen esityksen tuekseen. Tuo tuki on ohjeellinen panostussuunnitelma. Muutosten perusteena ei ole mutu - menettely, vaan teoreettinen, yleisesti hyväksyttyihin menettelytapoihin perustuva malli.

Current Issues in the Diagnosis and Classification of Peripheral T-Cell Lymphomas

Mature T-cell and T/NK-cell neoplasms are both uncommon and heterogeneous, among the broad category of non-Hodgkin's lymphomas. Due to the lack of specific genetic alterations in the vast majority of cases, most currently defined entities show overlapping morphologic and immunophenotypic features and therefore pose a challenge to the diagnostic pathologist. The goal of the symposium is to address current criteria for the recognition of specific subtypes of T-cell lymphoma, and to highlight new data regarding emerging immunophenotypic or molecular markers. This activity has been designed to meet the needs of practicing pathologists, and residents and fellows enrolled in training programs in anatomic and clinical pathology. It should be a particular benefit to those with an interest in hematopathology. Upon completion of this activity, participants should be better able to: -To be able to state the basis for the classification of mature T-cell malignancies involving nodal and extranodal sites. -To recognize and accurately diagnose the various subtypes of nodal and extranodal peripheral T-cell lymphomas. -To utilize immunohistochemical and molecular tests to characterize atypical T-cell proliferations. -To recognize and accurately diagnose T-cell lymphoproliferative lesions involving the skin and gastrointestinal tract, and be able to provide guidance regarding their clinical aggressiveness and management -To be able to utilize flow cytometric data to identify diverse functional T-cell subsets.

Investigations of a thermosensitive gel to temporarily occlude crural arteries in femoro-distal bypass surgery.

OBJECTIVES: Long occlusions in calcified crural arteries are a major cause of endovascular technical failure in patients with critical limb ischaemia. Therefore, distal bypasses are mainly performed in patients with heavily calcified arteries and with consequently delicate clamping. A new reverse thermosensitive polymer (RTP) is an alternative option to occlude target vessels. The aim of the study is to report our technical experience with RTP and to assess its safety and efficiency to temporarily occlude small calcified arteries during anastomosis time. METHODS: Between July 2010 and December 2011, we used RTP to occlude crural arteries in 20 consecutive patients with 20 venous distal bypasses. We recorded several operative parameters, such as volume of injected RTP, duration of occlusion and anastomotic time. Quality of occlusion was subjectively evaluated. Routine on-table angiography was performed to search for plug emboli. Primary patency, limb salvage and survival rates were reported at 6 months. RESULTS: In all patients, crural artery occlusion was achieved with the RTP without the use of an adjunct occlusion device. Mean volume of RTP used was 0.3 ml proximally and 0.25 ml distally. Mean duration of occlusion was 14.4 ± 4.5 min, while completion of the distal anastomosis lasted 13.4 ± 4.3 min. Quality of occlusion was judged as excellent in eight cases and good in 12 cases. Residual plugs were observed in two patients and removed with an embolectomy catheter, before we amended the technique for dissolution of RTP. At 6 months, primary patency rate was 75% but limb salvage rate was 87.5%. The 30-day mortality rate was 10%. CONCLUSIONS: This study shows that RTP is safe when properly dissolved and effective to occlude small calcified arteries for completion of distal anastomosis.

Usefulness of betalactam therapy for community-acquired pneumonia in the era of drug-resistant Streptococcus pneumoniae: a randomized study of amoxicillin-clavulanate and ceftriaxone

Empirical antibiotic therapy of community-acquired pneumonia (CAP) has been complicated by the worldwide emergence of penicillin resistance among Streptococcus pneumoniae. The impact of this resistance on the outcome of patients hospitalized for CAP, empirically treated with betalactams, has not been evaluated in a randomized study. We conducted a prospective, randomized trial to assess the efficacy of amoxicillin-clavulanate (2 g/200 mg/8 hr) and ceftriaxone (1 g/24 hr) in a cohort of patients hospitalized for moderate-to-severe CAP. Three-hundred seventy-eight patients were randomized to receive amoxicillin-clavulanate (184 patients) or ceftriaxone (194 patients). Efficacy was assessed on Day 2, after completion of therapy and at long term follow-up. There were no significant differences in outcomes between treatment groups, both in intention-to-treat and per-protocol analysis. Overall mortality was 10.3% for amoxicillin-clavulanate and 8.8% for ceftriaxone (NS). There were 116 evaluable patients with proven pneumococcal pneumonia. Rates of high-level penicillin resistance (MIC of penicillin ≥2 µg/mL) were similar in the two groups (8.2 and 10.2%). Clinical efficacy at the end of therapy was 90.6% for amoxicillin-clavulanate and 88.9% for ceftriaxone (95% C.I. of the difference: -9.3 to +12.7%). No differences in outcomes were attributable to differences in penicillin susceptibility of pneumococcal strains. Sequential i.v./oral amoxicillin-clavulanate and parenteral ceftriaxone were equally safe and effective for the empirical treatment of acute bacterial pneumonia, including penicillin and cephalosporin-resistant pneumococcal pneumonia. The use of appropriate betalactams in patients with penumococcal pneumonia and in the overall CAP population, is reliable at the current level of resistance

Can eukaryotic cells monitor the presence of unreplicated DNA?

Completion of DNA replication before mitosis is essential for genome stability and cell viability. Cellular controls called checkpoints act as surveillance mechanisms capable of detecting errors and blocking cell cycle progression to allow time for those errors to be corrected. An important question in the cell cycle field is whether eukaryotic cells possess mechanisms that monitor ongoing DNA replication and make sure that all chromosomes are fully replicated before entering mitosis, that is whether a replication-completion checkpoint exists. From recent studies with smc5–smc6 mutants it appears that yeast cells can enter anaphase without noticing that replication in the ribosomal DNA array was unfinished. smc5–smc6 mutants are proficient in all known cellular checkpoints, namely the S phase checkpoint, DNA-damage checkpoint, and spindle checkpoint, thus suggesting that none of these checkpoints can monitor the presence of unreplicated segments or the unhindered progression of forks in rDNA. Therefore, these results strongly suggest that normal yeast cells do not contain a DNA replication-completion checkpoint.

Efecto del fotoperiodo en la terminación de la diapausa de larvas de los taladros del maíz, Sesamia nonagrioides y Ostrinia nubilalis, desarrolladas en distintas variedades de maíz transgénico y sus isogénicas correspondientes

La creciente implantación de maíz transgénico en España está ocasionando cambios importantes en las poblaciones de taladros de maíz y en su ecofisiología, cambios que están por estudiar. En el evento de maíz transgénico Bt 176, hoy en día no autorizado, la concentración de proteína de Bacillus thuringiensis decrecía en el maíz senescente de forma que en otoño se podían encontrar en campos con este evento alguna larva de taladros. La implantación de maíz con el evento MON 810 sugirió la posibilidad de estudiar la posible supervivencia de larvas en maíz senescente y algunos aspectos de la diapausa de estas larvas. Para ello se infestaron 6 variedades de maíz, una con el evento Bt 176, dos con el evento MON 810 y las tres isogénicas correspondientes, con larvas neonatas de Sesamia nonagrioides (Lefébvre), confiando en una infestación natural de Ostrinia nubilalis (Hübner). Las larvas de S. nonagrioides recogidas en el evento Bt176 suponían el 14% del total de larvas de esta especie muestreadas, mientras que las de O. nubilalis recogidas en el maíz Bt suponían un 25% del total de esta especie. Sin embargo en las variedades con el evento MON 810 apenas se recogieron un 0,25% y un 1,9% de larvas de S. nonagrioides y O. nubilalis respectivamente. Las larvas recogidas en el evento Bt 176 no mostraron diferencias en su intensidad de diapausa con las recogidas en las isogénicas correspondientes. El efecto del fotoperiodo en la terminación de la diapausa fue diferente en ambas especies: mientras que el fotoperiodo largo aceleraba la terminación de diapausa en S. nonagrioides pero no en O. nubilalis pareciendo tener un efecto más pronunciado la oscuridad completa. El parasitismo por parte de Lydella thompsoni (Herting) fue del 5% para el total de larvas de O. nubilalis mientras que para el total de larvas de S. nonagrioides fue del 0,4% lo que indica la preferencia de esta taquínido por el pirálido.