Hip fracture in a developing country: a picture in need of change

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Nolan Pliny Jacobson Papers - Accession 24

The Nolan Pliny Jacobson Papers consist of biographical data, professional and personal correspondence, and other papers relating to Dr. Jacobson’s research; his relationship with other philosophers, and his interest in oriental religion, philosophy, and the effects of science on the culture of the modern world. Correspondents include Prince Sihanouk, Charles Morris, John and Roberta Dewey, Henry and Laura Weiman, Charles and Dorothy Hartshorne, Kenneth Inada, Haljme Nakamusa, T.I. Dow, Nyanaponika Mahathera, and many other distinguished philosophers of the Western World.

Spatial Management of Wildlife Disease

The spread of wildlife diseases is a major threat to livestock, human health, resource-based recreation, and biodiversity conservation (Cleaveland, Laurenson, and Taylor). The development of economically sound wildlife disease-management strategies requires an understanding of the links between ecological functions (e.g., disease transmission and wildlife dispersal) and economic choices, and the associated tradeoffs. Spatial linkages are particularly relevant. Yet while ecologists have long-argued that space is important (Hudson et al.), prior economic work has largely ignored spatial issues. For instance, Horan and Wolf analyzed a case study of bovine tuberculosis (bTB) in Michigan deer, a problem where the disease appears to be confined to a single, spatially confined, wildlife population—an island. But wildlife disease matters generally are not spatially confined. Barlow, in analyzing bTB in possums in New Zealand, accounted for immigration of susceptible possums into a disease reservoir. However, he modeled immigration as fixed and unaffected by management. Bicknell, Wilen, and Howitt, also focusing on possums in New Zealand, developed a model that incorporates simple density-dependent net migration. This allowed the authors to account for endogenous immigration when deriving optimal culling strategies.

Relationship Between BP (Baculovirus penaei) Energy Reserves in Larval and Postlarval Pacific White Shrimp Penaeus vannamei

The relationship between energy reserves of the penaeid shrimp Penaeus vannamei and Baculovirus penaei, or BP, were investigated in a series of experiments using mysis stage or early postlarval shrimp. Pre-exposure and post-exposure levels of protein and triacylgycerol (TAG) were determined. The effect of pre-exposure protein and TAG levels on susceptibility to BP infections was also investigated by starving a group of shrimp immediately prior to BP exposure. There was no consistent relationship between either pre-exposure or post-exposure protein levels and the percent of shrimp developing patent BP infections. There was, however, a significant positive correlation between TAG levels immediately prior to viral exposure and prevalence of infection 72 h later. Experimental reduction of TAG reserves prior to BP exposure delayed the development of a patent infection. In some, but not all, experiments there was a significant reduction in TAG levels of infected compared with uninfected shrimp 72 h post-exposure. The effect of patent BP infections on host TAG levels was subordinate to fluctuations in TAG content associated with the ontogeny of the hepatopancreas. Results of this study support histological observations that shrimp lipid levels can be altered by baculovirus infections. Furthermore, high levels of energy reserves in the form of TAG are associated with increased susceptibility to BP infection in larval and postlarval shrimp.

Eastern temperate North Pacific offshore killer whales (Orcinus orca): Occurrence, movements, and insights into feeding ecology

Beginning in the late 1980s, large groups of previously unidentified killer whales (Orcinus orca) were sighted off the west coast of Vancouver Island and in the Queen Charlotte Islands, British Columbia. Scientists working in this region produced two killer whale photo-identification catalogues that included both transient (mammal-eating) whales and 65 individual whales that investigators believed represented a distinct killer whale community (Ford et al. 1992, Heise et al. 1993). It was thought that these killer whales maintained a generally offshore distribution and were provisionally termed “offshores”; a term that has since been used as a population identifier for the eastern temperate North Pacific offshore killer whale population. Then in September 1992, 75 unidentified whales entered the Strait of Juan de Fuca just south and east of Victoria, British Columbia (Walters et al. 1992). Although most of these whales had not been seen before, two were matched to killer whales in the Queen Charlotte photo-identification catalogue (Ford et al. 1992, Heise et al. 1993) and were thus listed as “offshore” killer whales. During a similar time period, other large groups of killer whales, previously unidentified, were also being sighted off Alaska and California (Dahlheim et al. 1997; Nancy Black and Alisa Schulman- Janiger, unpublished data, respectively).

Distance software: design and analysis of distance sampling surveys for estimating population size

1. Distance sampling is a widely used technique for estimating the size or density of biological populations. Many distance sampling designs and most analyses use the software Distance. 2. We briefly review distance sampling and its assumptions, outline the history, structure and capabilities of Distance, and provide hints on its use. 3. Good survey design is a crucial prerequisite for obtaining reliable results. Distance has a survey design engine, with a built-in geographic information system, that allows properties of different proposed designs to be examined via simulation, and survey plans to be generated. 4. A first step in analysis of distance sampling data is modeling the probability of detection. Distance contains three increasingly sophisticated analysis engines for this: conventional distance sampling, which models detection probability as a function of distance from the transect and assumes all objects at zero distance are detected; multiple-covariate distance sampling, which allows covariates in addition to distance; and mark–recapture distance sampling, which relaxes the assumption of certain detection at zero distance. 5. All three engines allow estimation of density or abundance, stratified if required, with associated measures of precision calculated either analytically or via the bootstrap. 6. Advanced analysis topics covered include the use of multipliers to allow analysis of indirect surveys (such as dung or nest surveys), the density surface modeling analysis engine for spatial and habitat-modeling, and information about accessing the analysis engines directly from other software. 7. Synthesis and applications. Distance sampling is a key method for producing abundance and density estimates in challenging field conditions. The theory underlying the methods continues to expand to cope with realistic estimation situations. In step with theoretical developments, state-of- the-art software that implements these methods is described that makes the methods accessible to practicing ecologists.

A Tool Box Half Full: How Social Science can Help Solve Human–Wildlife Conflict

There is a growing recognition among wildlife managers that focusing management on wildlife often provides a temporary fix to human–wildlife conflicts, whereas changing human behavior can provide long-term solutions. Human dimensions research of wildlife conflicts frequently focuses on stakeholders’ characteristics, problem identification, and acceptability of management, and less frequently on human behavior and evaluation of management actions to change that behavior. Consequently, little information exists to assess overall success of management. We draw on our experience studying human–bear conflicts, and argue for more human dimensions studies that focus on change in human behavior to measure management success. We call for help from social scientists to conduct applied experiments utilizing two methods, direct observation and self-reported data, to measure change in behavior. We are optimistic these approaches will help fill the managers’ tool box and lead to better integration of human dimensions into human–wildlife conflict management.

Physiological Studies on Candida albicans

Candida albicans is a common opportunistic, dimorphic human fungal pathogen. One of its virulence factors is the morphological switch between yeasts and hyphal or pseudohyphal forms, which can invade tissues and cause damage. Our studies focus on factors regulating pseudohyphae and epigenetic modifications of C. albicans. Regulating factors of pseudohyphae are aromatic alcohols and high phosphate. At low concentrations, exogenous aromatic alcohols induced pseudohyphae, as did high phosphate. For addressing the pathways involved in inducing pseudohyphae by aromatic alcohols or high phosphate, we used mutants defective in cAMP dependent PKA pathway (efg1/efg1), MAP kinase pathway (cph1/cph1), or both (cph1/cph1/efg1/efg1). These mutants failed to produce either hyphae or pseudohyphae in the presence of aromatic alcohols; but high phosphate still stimulated pseudohyphae. Gcn4, a transcription activator of more than 500 amino acid related genes, is turned-on in response to amino acid starvation. The accumulation of aromatic alcohols sends nitrogen starvation signals, which inhibit eIF2B, which in turn derepresses Gcn4p. High phosphate also induces pseudohyphae by derepressing Gcn4p, although the pathways involved are still unknown. In sum, aromatic alcohols and high phosphate induce pseudohyphae by derepressing Gcn4. In this study we found a novel posttranslational histone modification in C. albicans, which is biotinylation. Western blot and Mass spectrometry techniques were used to find that Histones H2B and H4 were biotinylated at every condition tested such as yeast vs. hyphae, aerobic growth vs. anaerobic growth, rich medium vs. defined medium. In C. albicans lysines K8, K11 in histone H4 and lysines K17, K18, K31 in histone H2B are biotin attachment sites as found using mass spectrometry. Biotin was also found to enhance the germ tube formation of C. albicans. Germ tube formation assays with biotin-starved cells as inoculum showed low percent of germ tubes (1-5%). Addition of biotin to the media showed 100% germ tubes. Biotinylation of histones were not detected from biotin-starved cells. Appendix-A details work related to Farnesol quantification assays in several strains of C.albicans and Ceratocystis ulmi, and growth studies of class E VPS strains of Saccharomyces Cerevisiae. Adviser: Kenneth W. Nickerson

The People's Hour and the Social Gospel: George Howard Gibson's Gilded Age Search for an Organization of the Kingdom of God

Previous studies of the Social Gospel movement have acknowledged the fact that Social Gospelers were involved in multiple social reform movements during the Gilded Age and into the Progressive Era. However, most of these studies have failed to explain how the reform experiences of the Social Gospelers contributed to the development of the Social Gospel. The Social Gospelers’ ideas regarding the need to transform society and their strategies for doing so were largely a result of their personal experiences as reformers and their collaboration with other reformers. The knowledge and insight gained from interaction with a variety of reform methods played a vital role in the development of the ideology and theology of the Social Gospel. George Howard Gibson is exemplary of the connections between the Social Gospel movement and several other social reform movements of the time. He was involved in the Temperance movement, was a member of both the Prohibition Party and the People’s Party, and co-founded a Christian socialist cooperative colony. His writings illustrate the formation of his identity as a Social Gospeler as well as his attempts to find an organization through which to realize the kingdom of God on earth. Failure to achieve the changes he desired via prohibition encouraged him to broaden his reform goals. Like many Midwestern Social Gospelers Gibson believed he had found “God’s Party” in the People’s Party, but he rejected reform via the political system once the Populists restricted their attention to the silver issue and fused with the Democratic Party. Yet his involvement with the People’s Party demonstrates the attraction many Social Gospelers had to the reforms proposed in the Omaha Platform of 1892 as well as to the party’s use of revivalistic language and emphasis on producerism and brotherhood. Gibson’s experimentation with a variety of ways to achieve the kingdom of God on earth provides new insight into the experiences and contributions of lay Social Gospelers. Adviser: Kenneth J. Winkle

ANIMAL POPULATION ECOLOGY AND CONTROL FUNDAMENTALS

Expensive, extensive and apparently lethal control measures have been applied against many species of pest vertebrates and invertebrates for decades. In spite of this, few pests have been annihilated, and in many cases the stated goals have become progressively more modest, so that now we speak of saving foliage or a crop, rather than extermination. It is of interest to examine the reasons why animals are so difficult to exterminate, because this matter, of course, has implications for the type of control policy we pursue in the future. Also, it has implications for the problem of evaluating comparatively various resource management strategies. There are many biological mechanisms which could, in principle, enhance the performance of an animal population after control measures have been applied against it. These are of four main types: genetic, physiological, populationa1, and environmental. We are all familiar with the fact that in applying a control measure, we are, from the pest's point of view, applying intense selection pressure in favor of those individuals that may be preadapted to withstand the type of control being used. The well-known book by Brown (1958) documents, for invertebrates, a tremendous number of such cases. Presumably, vertebrates can show the same responses. Not quite so familiar is the evidence that sub-lethal doses of a lethal chemical may have a physiologically stimulating effect on population performance of the few individuals that happen to survive (Kuenen, 1958). With further research, we may find that this phenomenon occurs throughout the animal kingdom. Still less widely recognized is the fact that pest control elicits a populational homeostatic mechanism, as well as genetic and physiological homeostatic mechanisms. Many ecologists, such as Odum and Allee (1950, Slobodkin (1955), Klomp (1962) and the present author (1961, 1963) have pointed out that the curve for generation survival, or the curve for trend index as a function of last generations density is of great importance in population dynamics.

Artificial Equations, Artificial Distinctions: Language that Poisons the Waters of Ethnic Relations

“It is my contention at this point that when race relations on campuses get better, it is in spite of, not because of, the proliferation of jargon-based rhetoric about diversity.”

Emtricitabine-Tenofovir Concentrations and Pre-Exposure Prophylaxis Efficacy in Men Who Have Sex with Men

Drug concentrations associated with protection from HIV-1 acquisition have not been determined. We evaluated drug concentrations among men who have sex with men in a substudy of the iPrEx trial (1). In this randomized placebo-controlled trial, daily oral doses of emtricitabine/tenofovir disoproxil fumarate were used as pre-exposure prophylaxis (PrEP) in men who have sex with men. Drug was detected less frequently in blood plasma and in viable cryopreserved peripheral blood mononuclear cells (PBMCs) in HIV-infected cases at the visit when HIV was first discovered compared with controls at the matched time point of the study (8% versus 44%; P < 0.001) and in the 90 days before that visit (11% versus 51%; P < 0.001). An intracellular concentration of the active form of tenofovir, tenofovir-diphosphate (TFV-DP), of 16 fmol per million PBMCs was associated with a 90% reduction in HIV acquisition relative to the placebo arm. Directly observed dosing in a separate study, the STRAND trial, yielded TFV-DP concentrations that, when analyzed according to the iPrEx model, corresponded to an HIV-1 risk reduction of 76% for two doses per week, 96% for four doses per week, and 99% for seven doses per week. Pro-phylactic benefits were observed over a range of doses and drug concentrations, suggesting ways to optimize PrEP regimens for this population.

A comparative study between crack analysis and a mechanical test for assessing the polymerization stress of restorative composites

Objectives. To verify the hypothesis that crack analysis and a mechanical test would rank a series of composites in a similar order with respect to polymerization stress. Also, both tests would show similar relationships between stress and composite elastic modulus and/or shrinkage. Methods. Soda-lime glass discs (2-mm thick) with a central perforation (3.5-mm diameter) received four Vickers indentations 500 mu m from the cavity margin. The indent cracks were measured (500x) prior and 10 min after the cavity was restored with one of six materials (Kalore/KL, Gradia/GR, Ice/IC, Wave/WV, Majesty Flow/MF, and Majesty Posterior/MP). Stresses at the indent site were calculated based on glass fracture toughness and increase in crack length. Stress at the bonded interface was calculated using the equation for an internally pressurized cylinder. The mechanical test used a universal testing machine and glass rods (5-mm diameter) as substrate. An extensometer monitored specimen height (2 mm). Nominal stress was calculated dividing the maximum shrinkage force by the specimen cross-sectional area. Composite elastic modulus was determined by nanoindentation and post-gel shrinkage was measured using strain gages. Data were subjected to one-way ANOVA/Tukey or Kruskal-Wallis/Mann-Whitney tests (alpha: 5%). Results. Both tests grouped the composites in three statistical subsets, with small differences in overlapping between the intermediate subset (MF, WV) and the highest (MP, IC) or the lowest stress materials (KL, GR). Higher stresses were developed by composites with high modulus and/or high shrinkage. Significance. Crack analysis demonstrated to be as effective as the mechanical test to rank composites regarding polymerization stress. (c) 2012 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Thrombin-Receptor Antagonist Vorapaxar in Acute Coronary Syndromes

BACKGROUND Vorapaxar is a new oral protease-activated receptor 1 (PAR-1) antagonist that inhibits thrombin-induced platelet activation. METHODS In this multinational, double-blind, randomized trial, we compared vorapaxar with placebo in 12,944 patients who had acute coronary syndromes without ST-segment elevation. The primary end point was a composite of death from cardiovascular causes, myocardial infarction, stroke, recurrent ischemia with rehospitalization, or urgent coronary revascularization. RESULTS Follow-up in the trial was terminated early after a safety review. After a median follow-up of 502 days (interquartile range, 349 to 667), the primary end point occurred in 1031 of 6473 patients receiving vorapaxar versus 1102 of 6471 patients receiving placebo (Kaplan-Meier 2-year rate, 18.5010 vs. 19.9%; hazard ratio, 0.92; 95% confidence interval [CI], 0.85 to 1.01; P=0.07). A composite of death from cardiovascular causes, myocardial infarction, or stroke occurred in 822 patients in the vorapaxar group versus 910 in the placebo group (14.7% and 16.4%, respectively; hazard ratio, 0.89; 95% CI, 0.81 to 0.98; P=0.02). Rates of moderate and severe bleeding were 7.2% in the vorapaxar group and 5.2% in the placebo group (hazard ratio, 1.35; 95% CI, 1.16 to 1.58; P<0.001). Intracranial hemorrhage rates were 1.1% and 0.2%, respectively (hazard ratio, 3.39; 95% CI, 1.78 to 6.45; P<0.001). Rates of nonhemorrhagic adverse events were similar in the two groups. CONCLUSIONS In patients with acute coronary syndromes, the addition of vorapaxar to standard therapy did not significantly reduce the primary composite end point but significantly increased the risk of major bleeding, including intracranial hemorrhage. (Funded by Merck; TRACER ClinicalTrials.gov number, NCT00527943.)

Prasugrel versus Clopidogrel for Acute Coronary Syndromes without Revascularization

Background The effect of intensified platelet inhibition for patients with unstable angina or myocardial infarction without ST-segment elevation who do not undergo revascularization has not been delineated. Methods In this double-blind, randomized trial, in a primary analysis involving 7243 patients under the age of 75 years receiving aspirin, we evaluated up to 30 months of treatment with prasugrel (10 mg daily) versus clopidogrel (75 mg daily). In a secondary analysis involving 2083 patients 75 years of age or older, we evaluated 5 mg of prasugrel versus 75 mg of clopidogrel. Results At a median follow-up of 17 months, the primary end point of death from cardiovascular causes, myocardial infarction, or stroke among patients under the age of 75 years occurred in 13.9% of the prasugrel group and 16.0% of the clopidogrel group (hazard ratio in the prasugrel group, 0.91; 95% confidence interval [CI], 0.79 to 1.05; P = 0.21). Similar results were observed in the overall population. The prespecified analysis of multiple recurrent ischemic events (all components of the primary end point) suggested a lower risk for prasugrel among patients under the age of 75 years (hazard ratio, 0.85; 95% CI, 0.72 to 1.00; P = 0.04). Rates of severe and intracranial bleeding were similar in the two groups in all age groups. There was no significant between-group difference in the frequency of nonhemorrhagic serious adverse events, except for a higher frequency of heart failure in the clopidogrel group. Conclusions Among patients with unstable angina or myocardial infarction without ST- segment elevation, prasugrel did not significantly reduce the frequency of the primary end point, as compared with clopidogrel, and similar risks of bleeding were observed. (Funded by Eli Lilly and Daiichi Sankyo; TRILOGY ACS ClinicalTrials.gov number, NCT00699998.)