"INTERMED": a method to assess health service needs. I. Development and reliability.

The purpose of this paper is to describe the development and to test the reliability of a new method called INTERMED, for health service needs assessment. The INTERMED integrates the biopsychosocial aspects of disease and the relationship between patient and health care system in a comprehensive scheme and reflects an operationalized conceptual approach to case mix or case complexity. The method is developed to enhance interdisciplinary communication between (para-) medical specialists and to provide a method to describe case complexity for clinical, scientific, and educational purposes. First, a feasibility study (N = 21 patients) was conducted which included double scoring and discussion of the results. This led to a version of the instrument on which two interrater reliability studies were performed. In study 1, the INTERMED was double scored for 14 patients admitted to an internal ward by a psychiatrist and an internist on the basis of a joint interview conducted by both. In study 2, on the basis of medical charts, two clinicians separately double scored the INTERMED in 16 patients referred to the outpatient psychiatric consultation service. Averaged over both studies, in 94.2% of all ratings there was no important difference between the raters (more than 1 point difference). As a research interview, it takes about 20 minutes; as part of the whole process of history taking it takes about 15 minutes. In both studies, improvements were suggested by the results. Analyses of study 1 revealed that on most items there was considerable agreement; some items were improved. Also, the reference point for the prognoses was changed so that it reflected both short- and long-term prognoses. Analyses of study 2 showed that in this setting, less agreement between the raters was obtained due to the fact that the raters were less experienced and the scoring procedure was more susceptible to differences. Some improvements--mainly of the anchor points--were specified which may further enhance interrater reliability. The INTERMED proves to be a reliable method for classifying patients' care needs, especially when used by experienced raters scoring by patient interview. It can be a useful tool in assessing patients' care needs, as well as the level of needed adjustment between general and mental health service delivery. The INTERMED is easily applicable in the clinical setting at low time-costs.

Alcohol consumption and incidence of type 2 diabetes. Results from the CoLaus study.

BACKGROUND AND AIMS: Moderate alcohol consumption has been shown to decrease the risk of type 2 diabetes (T2DM), but whether this association is also valid for impaired fasting glucose (IFG) is less well known. We aimed at assessing the impact of alcohol consumption and of type of alcoholic beverage on the incidence of T2DM and T2DM + IFG. METHODS AND RESULTS: As many as 4765 participants (2613 women, mean age 51.7 ± 10.5 years) without T2DM at baseline and followed for an average of 5.5 years. The association between alcohol consumption, type of alcoholic beverage and outcomes was assessed after adjustment for a validated T2DM risk score. During follow-up 284 participants developed T2DM and 643 developed IFG. On bivariate analysis, alcohol consumption was positively associated with the risk of developing T2DM or T2DM + IFG. Moderate (14-27 units/week) alcohol consumption tended to be associated with a lower risk of T2DM, but no protective effect was found for T2DM + IFG. Multivariable-adjusted odds ratio (OR) and (95% confidence interval) for T2DM: 0.89 (0.65-1.22), 0.66 (0.42-1.03) and 1.63 (0.93-2.84) for 1-13, 14-27 and 28 + units/week, respectively (p for quadratic trend < 0.005). For T2DM + IFG, the corresponding ORs were 1.09 (0.90-1.32), 1.33 (1.02-1.74) and 1.54 (0.99-2.39), respectively, p for trend = 0.03. No specific effect of alcoholic beverage (wine, beer or spirits) was found for T2DM or for T2DM + IFG. CONCLUSION: Moderate alcohol consumption is associated with a reduced risk of developing T2DM, but not of developing T2DM + IFG. No specific effect of type of alcoholic beverage was found.

A Tributação Pessoal dos Rendimentos Familiares em Cabo Verde – Estudo do Caso São Vicente

A transição para o modo de tributação único, a nível de rendimentos, constituiu uma modificação profunda na base de incidência e nas regras de determinação da matéria colectável dos impostos sobre os rendimentos, de forma a exprimir uma nova relação contribuinte – fisco, baseada numa maior transparência e simplificação dos procedimentos por parte da Administração Fiscal, mas também duma maior responsabilização dos contribuintes pelos seus comportamentos e declarações. Este trabalho teve como propósito estudar a forma como os rendimentos familiares são tributados, nomeadamente, a incidência na tributação de sujeitos passivos singulares, referindo assim o periodo da tributação, os métodos utilizados na determinação da matéria colectável e as taxas aplicadas. Para tanto, foram reunidos estudos teóricos e práticos a nível da tributação dos rendimentos de pessoas singulares, nomeadamente os principios e as regras praticados. Foi feito um estudo de caso sobre apuramento de imposto dos contribuintes casados dois titulares, a partir de formulários modelos 6A da Repartição de Finanças São Vicente, e o objecto desse estudo foi separar os rendimentos desses contribuintes e fazer o apuramento do respectivo imposto em separado. Os resultados do estudo apontam uma vantagem bastante satisfatória para os contribuintes no que diz respeito ao apuramento do imposto em separado. The transition to the unique taxation method, in the level of incomes, is a deep modification in the incidence base and in the determination rules of the basis of tax assessments of income taxes, in a way to express a new taxpayer – Exchequer relationship, based on a greater transparency and simplification of the procedures by Fiscal Administration, and a bigger responsabilization of taxpayers for their behaviours and declarations as well. The aim of this survey was to study how household incomes are taxed, namely: the incidence in the taxation of passive single persons, referring, thus, the taxation period, the methods used to determinate the basis of tax assessments and the applied taxes. For that, theoretical and practical studies were collected in the level of single persons incomes taxation, namely the principles and rules practised. A case study about tax verification of married taxpayers two holders was made, from São Vicente Financial Department’s 6A model forms, and the aim of this study was to separate the incomes of these taxpayers and make the verification of the respective tax separately. The results of this study points out a very satisfying advantage to taxpayers regarding the tax verification separately.

A community survey of sun exposure, sunburn and sun protection.

AIM: To describe outdoor activities, sun protection behaviours and the experience of sunburn in a sample of New Zealanders during summer weekends of 1994. METHODS: 1243 respondents to a telephone survey provided information regarding their outdoor activities for the 5 hour period around midday of the previous Saturday and Sunday. The sample was drawn from those aged 15 to 65 years in the five centres of Auckland, Hamilton, Wellington, Christchurch and Dunedin. Respondents provided information on sun exposure, sunburn, sun protection and beliefs about tanning, as well as background demographic information, skin type and previous experience of sunburn. RESULTS: 12% of the sample (or 17% of all those outdoors) reported being sunburned on the preceding weekend, and those sunburned tended to be men, and to be under age 35 years. The face, neck and limbs were the areas most frequently reported as burned. Sporting activities and beach or water activities were associated with the highest number of episodes of burning. Overall 38% of those outside reported wearing a hat and 32% reported the use of a sunscreen. Positive attitudes to tanning were quite common and probably present the main target for change in the community. CONCLUSION: On any sunny weekend in summer about three-quarters of adult New Zealanders will be out in the sun for relatively long periods of time, and many will get sunburned. The reduction of such harmful sun exposures remains an important public health goal.

Increasing prevalence of obesity in the Seychelles and association with socioeconomic status

Objective: We assessed the 15-year trends in the distribution of body mass index (BMI) categories in the Seychelles (Indian Ocean, African Region) and the relationship with sex, age and socio-economic status (SES). Methods: We conducted three population-based examination surveys in 1989 (n=1,081; participation rate: 86.4%), in 1994 (n=1,067; 87.0%), and in 2004 (n=1,255; 80.2%). Occupation was categorized as "laborer", "intermediate" or "professional". Results are adjusted to the population of 2002. Results: Between 1989 and 2004, mean BMI increased markedly in all sex and age categories (overall: ∼0.15 kg/m2/calendar year). The prevalence of overweight and obesity combined ("excess weight", BMI ≥25 kg/m2) increased from 29% to 52% in men and from 50% to 67% in women. The prevalence of obesity (BMI ≥30 kg/m2) increased from 4% to 15% in men and from 23% to 34% in women. Mean BMI - respectively the prevalence of excess weight- was lower in laborers than professionals in men but higher in laborers that professionals in women and this pattern was similar in the three surveys. Odds ratios for excess weight in professionals vs. laborers were 2.10 (95% CI: 1.94-2.17) in men and 0.51 (0.48-0.53) in women, adjusting for calendar year and participants' age and smoking habits. Conclusion: The prevalence of overweight/obesity increased markedly during a 15- year period. Similar increase of BMI over time in all age and sex categories suggests common environment obesogenic factors. The association between SES and excess weight was in opposite directions in men and women. The study emphasizes the need for prevention measures in all sex, age and SES groups, and suggests that they should be tailored according to sex and SES categories.

Relationship and transaction lending in a crisis

We study how relationship lending and transaction lending varyover the business cycle. We develop a model in which relationshipbanks gather information on their borrowers, which allows them toprovide loans for profitable firms during a crisis. Due to the servicesthey provide, operating costs of relationship-banks are higher thanthose of transaction-banks. In our model, where relationship-bankscompete with transaction-banks, a key result is that relationship-banks charge a higher intermediation spread in normal times, butoffer continuation-lending at more favorable terms than transactionbanks to profitable firms in a crisis. Using detailed credit registerinformation for Italian banks before and after the Lehman Brothers'default, we are able to study how relationship and transaction-banksresponded to the crisis and we test existing theories of relationshipbanking. Our empirical analysis confirms the basic prediction of themodel that relationship banks charged a higher spread before the crisis, offered more favorable continuation-lending terms in response tothe crisis, and suffered fewer defaults, thus confirming the informational advantage of relationship banking.

Hemoglobin concentration and cerebral metabolism in patients with aneurysmal subarachnoid hemorrhage.

BACKGROUND AND PURPOSE: The optimal hemoglobin (Hgb) target after aneurysmal subarachnoid hemorrhage is not precisely known. We sought to examine the threshold of Hgb concentration associated with an increased risk of cerebral metabolic dysfunction in patients with poor-grade subarachnoid hemorrhage. METHODS: Twenty consecutive patients with poor-grade subarachnoid hemorrhage who underwent multimodality neuromonitoring (intracranial pressure, brain tissue oxygen tension, cerebral microdialysis) were studied prospectively. Brain tissue oxygen tension and extracellular lactate/pyruvate ratio were used as markers of cerebral metabolic dysfunction and the relationship between Hgb concentrations and the incidence of brain hypoxia (defined by a brain tissue oxygen tension <20 mm Hg) and cell energy dysfunction (defined by a lactate/pyruvate ratio >40) was analyzed. RESULTS: Compared with higher Hgb concentrations, a Hgb concentration <9 g/dL was associated with lower brain tissue oxygen tension (27.2 [interquartile range, 21.2 to 33.1] versus 19.9 [interquartile range, 7.1 to 33.1] mm Hg, P=0.02), higher lactate/pyruvate ratio (29 [interquartile range, 25 to 38] versus 36 [interquartile range, 26 to 59], P=0.16), and an increased incidence of brain hypoxia (21% versus 52%, P<0.01) and cell energy dysfunction (23% versus 43%, P=0.03). On multivariable analysis, a Hgb concentration <9 g/dL was associated with a higher risk of brain hypoxia (OR, 7.92; 95% CI, 2.32 to 27.09; P<0.01) and cell energy dysfunction (OR, 4.24; 95% CI, 1.33 to 13.55; P=0.02) after adjusting for cerebral perfusion pressure, central venous pressure, PaO(2)/FIO(2) ratio, and symptomatic vasospasm. CONCLUSIONS: A Hgb concentration <9 g/dL is associated with an increased incidence of brain hypoxia and cell energy dysfunction in patients with poor-grade subarachnoid hemorrhage.

Crocidura cossyrensis Contoli, 1989 (Mammalia, Soridiae): karyotype, biochemical genetics and hybridization experiments

Crocidura cossyrensis Contoli, 1989 (Mammalia, Soricidae): karyotype, biochemical genetics and hybridization experiments. - The shrew Crocidura cossyrensis Contoli, 1989 from Pantelleria (I), a Mediterranean island 100 km south of Sicily and 70 km west from Tunisia, was investigated in order to understand its origin and its relationship with C. russula from Tunisia, Morocco and Switzerland. With the exception of a single heterozygote centric fusion, C. cossyrensis had a karyotype identical with that of C russula from Tunisia (2N = 42, NF = 70 to 72), but it differed from C russula from Morocco and Switzerland (2N = 42, NF = 60). The former have 5-6 pairs of chromosomes with small arms that are acrocentric in the latter. Genetic comparisons with allozyme data revealed small genetic distance (0.04) between C cossyrensis and C russula from Tunisia. In contrast, this eastern clade (Tunisia and Pantelleria) is separated from the western clade (Switzerland and Morocco) by a genetic distance of 0.14. A hybridization experiment between shrews from Pantelleria and Switzerland lead rapidly to an F1 generation. From 12 F1 hybrids that were backcrossed, females reproduced normally, but none of the males did so. Concluding from the results, C. cossyrensis from Pantelleria and C. russula cf. agilis from Tunisia belong to the same taxon that may have reached the differentiation of a biological species within the C. russula group. More geographic samples are needed to determine the definitive taxonomic positions of these shrews.

FAM161A, associated with autosomal recessive retinitis pigmentosa,localizes at the level of the photoreceptor cilium and interacts with proteins involved in ciliopathies

Purpose: We have previously demonstrated that mutations in the FAM161A gene, encoding a protein with unknown function and no similarities with other characterized sequences, cause autosomal recessive retinitis pigmentosa (RP). The purpose of this work is to investigate the functional role of FAM161A within the retina and its relationship with other proteins involved in RP. Methods: The subcellular localization of FAM161A in the retina was assessed by immunohistochemistry of retinal sections and dissociated photoreceptors from mice, which were stained using antibodies against FAM161A and antibodies against cilium markers. The function of FAM161A was further assessed in ciliated mammalian cell lines by expression of recombinant FAM161A with various fusion tags. The binary interaction between FAM161A and a collection of ciliary and ciliopathy-associated proteins was analyzed using a yeast two-hybrid assay. The results obtained with this technique were validated using independent protein-protein interaction assays (GST-pull downs, co-transfection and co-immunoprecipitation). Results: Native FAM161A localized at the connecting cilium of photoreceptor cells, as demonstrated by immunofluorescence in both dissociated photoreceptors and retinal sections of mice. More specifically, co-staining with markers for ciliary sub-structures (RPGRIP1L, Centrin, RP1, GT335) demonstrated that FAM161A decorated the basal body and the very apical part of the connecting cilium. Upon overexpression in ciliated cultured mammalian cells, FAM161A localized to the ciliary basal body. Yeast two-hybrid analysis of the binary interaction of FAM161A and an array of ciliary proteins revealed the direct interaction of FAM161A with three proteins of which the cognate genes are mutated in retinal ciliopathies. The confirmation of these interactions using different biochemical assays is currently in progress. Conclusions: FAM161A is a ciliary basal body protein of the photoreceptor connecting cilium, rendering the associated RP as a novel retinal ciliopathy. The confined expression of FAM161A in the retina and the direct interaction of FAM161A with other retinal ciliopathy-associated proteins may explain the retinal phenotype of this specific subset of mechanistically and phenotypically connected retinal disorders.

Plaque characteristics and arterial remodeling in coronary and peripheral arterial systems.

BACKGROUND: Few studies have examined plaque characteristics among multiple arterial beds in vivo. The purpose of this study was to compare the plaque morphology and arterial remodeling between coronary and peripheral arteries using gray-scale and radiofrequency intravascular ultrasound (IVUS) at clinical presentation. METHODS AND RESULTS: IVUS imaging was performed in 68 patients with coronary and 93 with peripheral artery lesions (29 carotid, 50 renal, and 14 iliac arteries). Plaques were classified as fibroatheroma (VH-FA) (further subclassified as thin-capped [VH-TCFA] and thick-capped [VH-ThCFA]), fibrocalcific plaque (VH-FC) and pathological intimal thickening (VH-PIT). Plaque rupture (13% of coronary, 7% of carotid, 6% of renal, and 7% of iliac arteries; P = NS) and VH-TCFA (37% of coronary, 24% of carotid, 16% of renal, and 7% of iliac arteries; P = 0.02) were observed in all arteries. Compared with coronary arteries, VH-FA was less frequently observed in renal (P < 0.001) and iliac arteries (P < 0.006). Lesions with positive remodeling demonstrated more characteristics of VH-FA in coronary (84% vs. 25%, P < 0.001), carotid (72% vs. 20%, P = 0.001), and renal arteries (42% vs. 4%, P = 0.001) compared with those with intermediate/negative remodeling. There was positive relationship between remodeling index and percent necrotic area in all four arteries. CONCLUSIONS: Atherosclerotic plaque phenotypes were heterogeneous among four different arteries; renal and iliac arteries had more stable phenotypes compared with coronary artery. In contrast, the associations of remodeling pattern with plaque phenotype and composition were similar among the various arterial beds.

Cooperation between the transcription factors p63 and IRF6 is essential to prevent cleft palate in mice.

Cleft palate is a common congenital disorder that affects up to 1 in 2,500 live human births and results in considerable morbidity to affected individuals and their families. The etiology of cleft palate is complex, with both genetic and environmental factors implicated. Mutations in the transcription factor-encoding genes p63 and interferon regulatory factor 6 (IRF6) have individually been identified as causes of cleft palate; however, a relationship between the key transcription factors p63 and IRF6 has not been determined. Here, we used both mouse models and human primary keratinocytes from patients with cleft palate to demonstrate that IRF6 and p63 interact epistatically during development of the secondary palate. Mice simultaneously carrying a heterozygous deletion of p63 and the Irf6 knockin mutation R84C, which causes cleft palate in humans, displayed ectodermal abnormalities that led to cleft palate. Furthermore, we showed that p63 transactivated IRF6 by binding to an upstream enhancer element; genetic variation within this enhancer element is associated with increased susceptibility to cleft lip. Our findings therefore identify p63 as a key regulatory molecule during palate development and provide a mechanism for the cooperative role of p63 and IRF6 in orofacial development in mice and humans.

Plumage ornaments, bacterial colonisation and signalling in european starling, "Sturnus vulgaris"

Abstract Animal behaviours or structures are used by senders as signals to try to increase their fitness by altering the behaviour of receivers. A large fraction of studies on sexual selection have focussed on male ornaments and have demonstrated that these ornaments signal the quality of their owner and are used by female for mate choice. Although females can also exhibit conspicuous traits, studies on female ornaments are markedly lacking. In chapter 1, we show that female starlings are showier on chest whiteness than males and that females' whiteness may potentially indicate female condition at the start of breeding and provide fitness advantages to breeding birds. Furthermore we point out that feather density and abrasion are important factors shaping the expression of chest whiteness. This suggests that further understanding of the evolution of chest whiteness in Starlings requires to examine the environmental and physiological factors that shape feather condition. Plumage may suffer from damage through abrasion and bacterial activity. In chapter 2, we focus on factors that influence feather-degrading bacterial communities. Within the hypothesis that parental care can be trade-off against the demands of self-maintenance, we show that a brood size manipulation modifies the structure of feather-degrading bacterial communities and the density of free- living bacteria. Thus we have pointed out a potentially poorly known cost of reproduction. In the same context of a trade-off between reproductive activities and individual self-maintenance, chapter 3 shows that at a proximate level in females but not in males, the individual variation in time and/or energy allocated in reproductive activities is associated with prolactin hormone levels. Our study provides evidence for the existence of a sex related difference in the relationship between brood size and prolactin levels. Birds have evolved sanitation behaviours and preen gland secretions to preserve the condition of their plumage. In chapter 4, we describe a method that allows to measure preen gland in situ. Then we use this method to characterize a number of phenotypic and ecological factors that explain variation in preen gland size in free-living individuals. In parent-offspring interactions, parents use offspring signals to provision their brood. In chapter 5, we demonstrate that nestling flanges and body skin reflect in the ultra-violet (UV) wavelengths ant that parents use this UV reflectance in food allocation decisions. Résumé Certains comportements et structures chez les animaux agissent, pour ceux qui les émettent, comme des signaux permettant d'augmenter leur fitness en altérant les comportements de ceux qui les perçoivent. Une grande partie des études sur la sélection sexuelle s'est focalisée sur les ornements mâles. Ces études ont démontré que ces ornements pouvaient signaler la qualité de celui qui les porte et influencer le choix des femelles. Bien que les femelles puissent aussi présenter des traits voyants, les études sur leurs ornements font défaut. Dans le chapitre 1 de ce travail, nous montrons que les étourneaux femelles sont plus voyantes que les mâles sur la base de la blancheur de la poitrine. De plus la blancheur des femelles peut signaler leur condition au début de la saison de reproduction et ainsi être corrélée avec leur fitness. Nous mettons aussi en évidence que la densité et l'abrasion des plumes sont des facteurs importants, contrôlant l'expression de la blancheur de la poitrine. Ceci suggère que des études futures pourraient examiner le rôle des facteurs environnementaux et physiologiques qui influencent la condition des plumes pour mieux comprendre l'évolution de la blancheur chez les étourneaux. Le plumage subit des dommages à travers l'abrasion et probablement aussi par l'activité de dégradation de bactéries. Dans le chapitre 2 de ce travail, nous nous intéressons aux facteurs qui influencent les communautés de bactéries dégradant les plumes. Nous basant sur l'hypothèse selon laquelle il existe un compromis entre les soins parentaux et la maintenance corporelle, nous montrons qu'une manipulation de la taille de nichée modifie la structure des communautés de bactéries dégradant les plumes ainsi que les densités de bactéries libres présentes sur le plumage. Ainsi nous mettons en évidence un coût encore peu connu des activités de reproduction. Dans le même contexte, nous montrons, dans le chapitre 3, que des variations individuelles dans l'énergie et/ou le temps alloué dans les activités de reproduction sont associés, chez les femelles, à un niveau proximal à l'hormone prolactine. Cette relation n'est pas présente chez les mâles. Cette étude montre que la relation entre la taille de nichée et les niveaux de prolactine diffère avec le sexe des individus. Les oiseaux utilisent des comportements de nettoyage associés aux sécrétions de la glande uropygiale afin de préserver la condition de leurs plumes. Dans le chapitre 4 de ce travail, nous décrivons une méthode qui permet de mesurer la taille de la glande in situ. Puis nous caractérisons certains facteurs écologiques et physiologiques qui expliquent les variations de la taille de la glande chez des individus capturés dans leur environnement. Les parents nourrissent leur progéniture en réponse à des signaux émis par ceux-ci. Dans le chapitre 5 de ce travail, nous démontrons que les commissures et la peau sur le corps des oisillons reflètent la lumière dans l'ultraviolet. Nous montrons que les parents utilisent cette réflexion dans l'ultraviolet lors de l'allocation de nourriture pour leurs jeunes.

Counselling overweight and obese patients in primary care: a prospective cohort study.

BACKGROUND: Primary care physicians are well positioned to provide counselling for overweight and obese patients, but no prospective study has assessed the effectiveness of this counselling in primary care. We aimed to evaluate weight reduction counselling by primary care physicians, and its relationship with weight change and patients' behaviour to control weight. DESIGN: A prospective cohort study. METHODS: We enrolled 523 consecutive overweight and obese patients from two Swiss academic primary care clinics. Physicians and patients were blinded to the study aims. We assessed the use of 10 predefined counselling strategies for weight reduction, and weight change and behaviour to control weight after 1 year. RESULTS: Sixty-five per cent of patients received some form of weight reduction counselling whereas 35% received no counselling. A total of 407 patients completed the 1-year follow-up. Those who received counselling lost on average (SD) 1.0 (5.0) kg after 1 year, whereas those who were not advised gained 0.3 (5.0) kg (P = 0.02). In multivariate analysis, each additional counselling strategy was associated with a mean weight loss of 0.2 kg (95% confidence interval 0.03-0.4, P = 0.02). Patients counselled by their physician had more favourable behaviour to control weight than those not counselled, such as setting a target weight (56 versus 36%) or visiting a dietician (23 versus 10%, both P < 0.001). CONCLUSIONS: Weight reduction counselling by primary care physicians is associated with a modest weight loss and favourable behaviour to control weight. However, many obese and overweight patients receive no advice on weight loss during primary care visits.

Wheat yield and physical properties of a brown latosol under no-tillage in south-central Paraná

Soil management influences the chemical and physical properties of soil. Chemical conditions have been thoroughly studied, while the role of soil physical conditions regarding crop yield has been neglected. This study aimed to analyze the wheat yield and its relationship with physical properties of an Oxisol under no-tillage (NT). The study was carried out between 2010 and 2011, in Reserva do Iguaçu, State of Paraná, Brazil, on the Campo Bonito farm, after 25 years of NT management. Based on harvest maps of barley (2006), wheat (2007) and maize (2009) of a plot (150 ha), zones with higher and lower yield potential (Z1 and Z2, respectively) were identified. Sampling grids with 16 units (50 x 50 m) and three sampling points per unit were established. The wheat grain yield (GY) and water infiltration capacity (WIC) were evaluated in 2010. Soil samples with disturbed and undisturbed structure were collected from the 0.00-0.10 and 0.10-0.20 m layers. The former were used to determine soil organic carbon (Corg) levels and the latter to determine soil bulk density (BD), total porosity (TP), macroporosity (Mac), and microporosity (Mic). Soil penetration resistance (PR) and water content (SWC) were also evaluated. The wheat GY of the whole plot was close to the regional average and the yield between the zones differed significantly, i.e. 22 % higher in Z1 than in Z2. No significant variation in Mic was observed between zones, but Z1 had higher Corg levels, SWC, TP and Mac and lower BD than Z2 in both soil layers, as well as a lower PR than Z2 in the 0.00-0.10 m layer. Therefore, soil physical conditions were more restrictive in Z2, in agreement with wheat yield and zone yield potential defined a priori, based on the harvest maps. Soil WIC in Z1 was significantly higher (30 %) than in Z2, in agreement with the results of TP and Mac which were also higher in Z1 in both soil layers. The correlation analysis of data of the two layers showed a positive relationship between wheat GY and the soil properties TP, SWC and WIC.

Pulmonary and systemic vascular dysfunction in young offspring of mothers with preeclampsia.

BACKGROUND: Adverse events in utero may predispose to cardiovascular disease in adulthood. The underlying mechanisms are unknown. During preeclampsia, vasculotoxic factors are released into the maternal circulation by the diseased placenta. We speculated that these factors pass the placental barrier and leave a defect in the circulation of the offspring that predisposes to a pathological response later in life. The hypoxia associated with high-altitude exposure is expected to facilitate the detection of this problem. METHODS AND RESULTS: We assessed pulmonary artery pressure (by Doppler echocardiography) and flow-mediated dilation of the brachial artery in 48 offspring of women with preeclampsia and 90 offspring of women with normal pregnancies born and permanently living at the same high-altitude location (3600 m). Pulmonary artery pressure was roughly 30% higher (mean+/-SD, 32.1+/-5.6 versus 25.3+/-4.7 mm Hg; P<0.001) and flow-mediated dilation was 30% smaller (6.3+/-1.2% versus 8.3+/-1.4%; P<0.0001) in offspring of mothers with preeclampsia than in control subjects. A strong inverse relationship existed between flow-mediated dilation and pulmonary artery pressure (r=-0.61, P<0.001). The vascular dysfunction was related to preeclampsia itself because siblings of offspring of mothers with preeclampsia who were born after a normal pregnancy had normal vascular function. Augmented oxidative stress may represent an underlying mechanism because thiobarbituric acid-reactive substances plasma concentration was increased in offspring of mothers with preeclampsia. CONCLUSIONS: Preeclampsia leaves a persistent defect in the systemic and the pulmonary circulation of the offspring. This defect predisposes to exaggerated hypoxic pulmonary hypertension already during childhood and may contribute to premature cardiovascular disease in the systemic circulation later in life.