Spare non-occupational HIV post-exposure prophylaxis by active contacting and testing of the source person.

OBJECTIVE: HIV-1 post-exposure prophylaxis (PEP) is frequently prescribed after exposure to source persons with an undetermined HIV serostatus. To reduce unnecessary use of PEP, we implemented a policy including active contacting of source persons and the availability of free, anonymous HIV testing ('PEP policy'). METHODS: All consultations for potential non-occupational HIV exposures i.e. outside the medical environment) were prospectively recorded. The impact of the PEP policy on PEP prescription and costs was analysed and modelled. RESULTS: Among 146 putative exposures, 47 involved a source person already known to be HIV positive and 23 had no indication for PEP. The remaining 76 exposures involved a source person of unknown HIV serostatus. Of 33 (43.4%) exposures for which the source person could be contacted and tested, PEP was avoided in 24 (72.7%), initiated and discontinued in seven (21.2%), and prescribed and completed in two (6.1%). In contrast, of 43 (56.6%) exposures for which the source person could not be tested, PEP was prescribed in 35 (81.4%), P < 0.001. Upon modelling, the PEP policy allowed a 31% reduction of cost for management of exposures to source persons of unknown HIV serostatus. The policy was cost-saving for HIV prevalence of up to 70% in the source population. The availability of all the source persons for testing would have reduced cost by 64%. CONCLUSION: In the management of non-occupational HIV exposures, active contacting and free, anonymous testing of source persons proved feasible. This policy resulted in a decrease in prescription of PEP, proved to be cost-saving, and presumably helped to avoid unnecessary toxicity and psychological stress.

To say or not to say: a qualitative study on the disclosure of their condition by human immunodeficiency virus-positive adolescents.

PURPOSE: Human immunodeficiency virus (HIV)-positive adolescents face a number of challenges in dealing with their disease, treatment, and developmental tasks. This qualitative study describes some of the reasons why, and the extent to which, adolescents may or may not disclose their condition to others. METHODS: A semistructured interview lasting 40-110 minutes was conducted with each of 29 adolescents 12-20 years old, 22 female and seven male) living in Switzerland. Interviews were tape recorded and transcribed verbatim. The analysis of the content of interviews allowed us to identify salient topics (e.g., disclosure), which were then explored in detail. RESULTS: Of 29 participants, eight had not disclosed their condition to anyone outside the family, 19 had disclosed it to good friends, and 16 had disclosed it to some teachers. Four participants had engaged in public disclosure, and six of 10 sexually active teenagers disclosed their status to their partners. The attitudes toward disclosure among younger adolescents were mostly related to those of the parents, particularly the mother. Older adolescents, engaged in their search for autonomy, tended to decide independently what to say and to whom. Although foster/adoptive parents would often encourage disclosure, biological parents, especially HIV-positive mothers, insisted on not disclosing the adolescent's status for fear of stigma. CONCLUSION: The health care team should systematically address the issue of disclosure with the adolescent and his family (or foster parents), the aim being to balance the right of the adolescent and that adolescent's family to maintain privacy against the concerns of sexual partners, as well as the adolescent's interest in divulging HIV status to relatives, school staff, and friends.

Melanin-based coloration covaries with ovary size in an age-specific manner in the barn owl.

While the adaptive function of black eumelanin-based coloration is relatively well known, the function of reddish-brown pheomelanin-based coloration is still unclear. Only a few studies have shown or suggested that the degree of reddish-brownness is associated with predator-prey relationships, reproductive parameters, growth rate and immunity. To gain insight into the physiological correlates of melanin-based coloration, I collected barn owl (Tyto alba) cadavers and examined the covariation between this colour trait and ovary size, an organ that increases in size before reproduction. A relationship is expected because melanin-based coloration often co-varies with sexual activity. The results showed that reddish-brown juveniles had larger ovaries than whiter juveniles particularly in individuals in poor condition and outside the breeding season, while in birds older than 2 years lightly coloured females had larger ovaries than reddish-brown conspecifics. As barn owls become less reddish-brown between the first and second year of age, the present study suggests that reddish-brown pheomelanic and whitish colorations are associated with juvenile- and adult-specific adaptations, respectively.

Gp74 a membrane glycoprotein of the cis-Golgi network that cycles through the endoplasmic reticulum and intermediate compartment

A monoclonal antibody CC92 (IgM), raised against a fraction of rat liver enriched in Golgi membranes, recognizes a novel Endo H-resistant 74-kD membrane glycoprotein (gp74). The bulk of gp74 is confined to the cis-Golgi network (CGN). Outside the Golgi gp74 is found in tubulovesicular structures and ER foci. In cells incubated at 37 degrees C the majority of gp74 is segregated from the intermediate compartment (IC) marker p58. However, in cells treated with organelle perturbants such as low temperature, BFA, and [AIF4]- the patterns of the two proteins become indistinguishable. Both proteins are retained in the Golgi complex at 20 degrees C and in the IC at 15 degrees C. Incubation of cells with BFA results in relocation of gp74 to p58 positive IC elements. [AIF4]- induces the redistribution of gp74 from the Golgi to p58-positive vesicles and does not retard the translocation of gp74 to IC elements in cells treated with BFA. Disruption of microtubules by nocodazol results in the rapid disappearance of the Golgi elements stained by gp74 and redistribution of the protein into vesicle-like structures. The responses of gp74 to cell perturbants are in sharp contrast with those of cis/middle and trans-Golgi resident proteins whose location is not affected by low temperatures or [AIF4]-, are translocated to the ER upon addition of BFA, and stay in slow disintegrating Golgi elements in cells treated with nocodazol. The results suggest that gp74 is an itinerant protein that resides most of the time in the CGN and cycles through the ER/IC following the pathway used by p58.

Alcohol consumption in late adolescence and early adulthood - where is the problem?

Risky single-occasion drinking (RSOD) is more common in late adolescence and early adulthood (approximately between the ages of 16 and 30) than in any other period in life. This is also the age when young people in Switzerland and many other European countries are legally allowed to buy and drink alcohol, but they usually do not yet have adult responsibilities. This paper reviews evidence from the international literature and provides examples of studies conducted in Switzerland demonstrating that (a) RSOD is by far most prevalent on Saturday evenings followed by Friday evenings, usually because young people go out and do not have any work or study responsibilities the next day; (b) RSOD results from drinking in private before going out ("predrinking") and accelerating the pace of drinking (i.e. increasing the number of drinks consumed per hour); (c) RSOD is often not accidental but purposeful,. to seek excitement, to have fun and to feel the effects of alcohol; (d) RSOD occurs predominantly outside the home, mostly in bars, pubs, discos or at special events and festivals; (e) RSOD often results in intended and unintended injuries and other acute consequences, which are leading risk factors for mortality and morbidity in this age group. Effective prevention strategies should include attempts to reduce opportunities to engage in heavy drinking as well as strategies to reduce its harmful consequences.

Report to the Governor and General Assembly on the Status of Out-of School Arts Programming for Youth, December 2006

In the 2006 Iowa General Assembly, House File 2797 called for a study on the status of afterschool arts programs and appropriated $5,000 for the study. In accordance with the legislation, the Iowa Arts Council, who received the charge, contracted with the Iowa Afterschool Alliance to form a Resource Group of out-of-school arts providers and experts to develop and oversee the study, review its results, and make recommendations for the expansion of arts programs that operate outside the normal school day. As a part of its charge in HF 2797, the Iowa Arts Council also documented a sampling of out-of-school arts programs statewide. Five are featured in this report.

The caveolin-binding motif of the pathogen-related yeast protein Pry1, a member of the CAP protein superfamily, is required for in vivo export of cholesteryl acetate.

Proteins belonging to the CAP superfamily are present in all kingdoms of life and have been implicated in different physiological processes. Their molecular mode of action, however, is poorly understood. Saccharomyces cerevisiae expresses three members of this superfamily, pathogen-related yeast (Pry)1, -2, and -3. We have recently shown that Pry function is required for the secretion of cholesteryl acetate and that Pry proteins bind cholesterol and cholesteryl acetate, suggesting that CAP superfamily members may generally act to bind sterols or related small hydrophobic compounds. Here, we analyzed the mode of sterol binding by Pry1. Computational modeling indicates that ligand binding could occur through displacement of a relatively poorly conserved flexible loop, which in some CAP family members displays homology to the caveolin-binding motif. Point mutations within this motif abrogated export of cholesteryl acetate but did not affect binding of cholesterol. Mutations of residues located outside the caveolin-binding motif, or mutations in highly conserved putative catalytic residues had no effect on export of cholesteryl acetate or on lipid binding. These results indicate that the caveolin-binding motif of Pry1, and possibly of other CAP family members, is crucial for selective lipid binding and that lipid binding may occur through displacement of the loop containing this motif.

Reliability of methods used for the risk assessment of mixture of micropollutants in aquatic enviromments : from theoretical concepts to field observations

Ces dernières années, de nombreuses recherches ont mis en évidence les effets toxiques des micropolluants organiques pour les espèces de nos lacs et rivières. Cependant, la plupart de ces études se sont focalisées sur la toxicité des substances individuelles, alors que les organismes sont exposés tous les jours à des milliers de substances en mélange. Or les effets de ces cocktails ne sont pas négligeables. Cette thèse de doctorat s'est ainsi intéressée aux modèles permettant de prédire le risque environnemental de ces cocktails pour le milieu aquatique. Le principal objectif a été d'évaluer le risque écologique des mélanges de substances chimiques mesurées dans le Léman, mais aussi d'apporter un regard critique sur les méthodologies utilisées afin de proposer certaines adaptations pour une meilleure estimation du risque. Dans la première partie de ce travail, le risque des mélanges de pesticides et médicaments pour le Rhône et pour le Léman a été établi en utilisant des approches envisagées notamment dans la législation européenne. Il s'agit d'approches de « screening », c'est-à-dire permettant une évaluation générale du risque des mélanges. Une telle approche permet de mettre en évidence les substances les plus problématiques, c'est-à-dire contribuant le plus à la toxicité du mélange. Dans notre cas, il s'agit essentiellement de 4 pesticides. L'étude met également en évidence que toutes les substances, même en trace infime, contribuent à l'effet du mélange. Cette constatation a des implications en terme de gestion de l'environnement. En effet, ceci implique qu'il faut réduire toutes les sources de polluants, et pas seulement les plus problématiques. Mais l'approche proposée présente également un biais important au niveau conceptuel, ce qui rend son utilisation discutable, en dehors d'un screening, et nécessiterait une adaptation au niveau des facteurs de sécurité employés. Dans une deuxième partie, l'étude s'est portée sur l'utilisation des modèles de mélanges dans le calcul de risque environnemental. En effet, les modèles de mélanges ont été développés et validés espèce par espèce, et non pour une évaluation sur l'écosystème en entier. Leur utilisation devrait donc passer par un calcul par espèce, ce qui est rarement fait dû au manque de données écotoxicologiques à disposition. Le but a été donc de comparer, avec des valeurs générées aléatoirement, le calcul de risque effectué selon une méthode rigoureuse, espèce par espèce, avec celui effectué classiquement où les modèles sont appliqués sur l'ensemble de la communauté sans tenir compte des variations inter-espèces. Les résultats sont dans la majorité des cas similaires, ce qui valide l'approche utilisée traditionnellement. En revanche, ce travail a permis de déterminer certains cas où l'application classique peut conduire à une sous- ou sur-estimation du risque. Enfin, une dernière partie de cette thèse s'est intéressée à l'influence que les cocktails de micropolluants ont pu avoir sur les communautés in situ. Pour ce faire, une approche en deux temps a été adoptée. Tout d'abord la toxicité de quatorze herbicides détectés dans le Léman a été déterminée. Sur la période étudiée, de 2004 à 2009, cette toxicité due aux herbicides a diminué, passant de 4% d'espèces affectées à moins de 1%. Ensuite, la question était de savoir si cette diminution de toxicité avait un impact sur le développement de certaines espèces au sein de la communauté des algues. Pour ce faire, l'utilisation statistique a permis d'isoler d'autres facteurs pouvant avoir une influence sur la flore, comme la température de l'eau ou la présence de phosphates, et ainsi de constater quelles espèces se sont révélées avoir été influencées, positivement ou négativement, par la diminution de la toxicité dans le lac au fil du temps. Fait intéressant, une partie d'entre-elles avait déjà montré des comportements similaires dans des études en mésocosmes. En conclusion, ce travail montre qu'il existe des modèles robustes pour prédire le risque des mélanges de micropolluants sur les espèces aquatiques, et qu'ils peuvent être utilisés pour expliquer le rôle des substances dans le fonctionnement des écosystèmes. Toutefois, ces modèles ont bien sûr des limites et des hypothèses sous-jacentes qu'il est important de considérer lors de leur application. - Depuis plusieurs années, les risques que posent les micropolluants organiques pour le milieu aquatique préoccupent grandement les scientifiques ainsi que notre société. En effet, de nombreuses recherches ont mis en évidence les effets toxiques que peuvent avoir ces substances chimiques sur les espèces de nos lacs et rivières, quand elles se retrouvent exposées à des concentrations aiguës ou chroniques. Cependant, la plupart de ces études se sont focalisées sur la toxicité des substances individuelles, c'est à dire considérées séparément. Actuellement, il en est de même dans les procédures de régulation européennes, concernant la partie évaluation du risque pour l'environnement d'une substance. Or, les organismes sont exposés tous les jours à des milliers de substances en mélange, et les effets de ces "cocktails" ne sont pas négligeables. L'évaluation du risque écologique que pose ces mélanges de substances doit donc être abordé par de la manière la plus appropriée et la plus fiable possible. Dans la première partie de cette thèse, nous nous sommes intéressés aux méthodes actuellement envisagées à être intégrées dans les législations européennes pour l'évaluation du risque des mélanges pour le milieu aquatique. Ces méthodes sont basées sur le modèle d'addition des concentrations, avec l'utilisation des valeurs de concentrations des substances estimées sans effet dans le milieu (PNEC), ou à partir des valeurs des concentrations d'effet (CE50) sur certaines espèces d'un niveau trophique avec la prise en compte de facteurs de sécurité. Nous avons appliqué ces méthodes à deux cas spécifiques, le lac Léman et le Rhône situés en Suisse, et discuté les résultats de ces applications. Ces premières étapes d'évaluation ont montré que le risque des mélanges pour ces cas d'étude atteint rapidement une valeur au dessus d'un seuil critique. Cette valeur atteinte est généralement due à deux ou trois substances principales. Les procédures proposées permettent donc d'identifier les substances les plus problématiques pour lesquelles des mesures de gestion, telles que la réduction de leur entrée dans le milieu aquatique, devraient être envisagées. Cependant, nous avons également constaté que le niveau de risque associé à ces mélanges de substances n'est pas négligeable, même sans tenir compte de ces substances principales. En effet, l'accumulation des substances, même en traces infimes, atteint un seuil critique, ce qui devient plus difficile en terme de gestion du risque. En outre, nous avons souligné un manque de fiabilité dans ces procédures, qui peuvent conduire à des résultats contradictoires en terme de risque. Ceci est lié à l'incompatibilité des facteurs de sécurité utilisés dans les différentes méthodes. Dans la deuxième partie de la thèse, nous avons étudié la fiabilité de méthodes plus avancées dans la prédiction de l'effet des mélanges pour les communautés évoluant dans le système aquatique. Ces méthodes reposent sur le modèle d'addition des concentrations (CA) ou d'addition des réponses (RA) appliqués sur les courbes de distribution de la sensibilité des espèces (SSD) aux substances. En effet, les modèles de mélanges ont été développés et validés pour être appliqués espèce par espèce, et non pas sur plusieurs espèces agrégées simultanément dans les courbes SSD. Nous avons ainsi proposé une procédure plus rigoureuse, pour l'évaluation du risque d'un mélange, qui serait d'appliquer d'abord les modèles CA ou RA à chaque espèce séparément, et, dans une deuxième étape, combiner les résultats afin d'établir une courbe SSD du mélange. Malheureusement, cette méthode n'est pas applicable dans la plupart des cas, car elle nécessite trop de données généralement indisponibles. Par conséquent, nous avons comparé, avec des valeurs générées aléatoirement, le calcul de risque effectué selon cette méthode plus rigoureuse, avec celle effectuée traditionnellement, afin de caractériser la robustesse de cette approche qui consiste à appliquer les modèles de mélange sur les courbes SSD. Nos résultats ont montré que l'utilisation de CA directement sur les SSDs peut conduire à une sous-estimation de la concentration du mélange affectant 5 % ou 50% des espèces, en particulier lorsque les substances présentent un grand écart- type dans leur distribution de la sensibilité des espèces. L'application du modèle RA peut quant à lui conduire à une sur- ou sous-estimations, principalement en fonction de la pente des courbes dose- réponse de chaque espèce composant les SSDs. La sous-estimation avec RA devient potentiellement importante lorsque le rapport entre la EC50 et la EC10 de la courbe dose-réponse des espèces est plus petit que 100. Toutefois, la plupart des substances, selon des cas réels, présentent des données d' écotoxicité qui font que le risque du mélange calculé par la méthode des modèles appliqués directement sur les SSDs reste cohérent et surestimerait plutôt légèrement le risque. Ces résultats valident ainsi l'approche utilisée traditionnellement. Néanmoins, il faut garder à l'esprit cette source d'erreur lorsqu'on procède à une évaluation du risque d'un mélange avec cette méthode traditionnelle, en particulier quand les SSD présentent une distribution des données en dehors des limites déterminées dans cette étude. Enfin, dans la dernière partie de cette thèse, nous avons confronté des prédictions de l'effet de mélange avec des changements biologiques observés dans l'environnement. Dans cette étude, nous avons utilisé des données venant d'un suivi à long terme d'un grand lac européen, le lac Léman, ce qui offrait la possibilité d'évaluer dans quelle mesure la prédiction de la toxicité des mélanges d'herbicide expliquait les changements dans la composition de la communauté phytoplanctonique. Ceci à côté d'autres paramètres classiques de limnologie tels que les nutriments. Pour atteindre cet objectif, nous avons déterminé la toxicité des mélanges sur plusieurs années de 14 herbicides régulièrement détectés dans le lac, en utilisant les modèles CA et RA avec les courbes de distribution de la sensibilité des espèces. Un gradient temporel de toxicité décroissant a pu être constaté de 2004 à 2009. Une analyse de redondance et de redondance partielle, a montré que ce gradient explique une partie significative de la variation de la composition de la communauté phytoplanctonique, même après avoir enlevé l'effet de toutes les autres co-variables. De plus, certaines espèces révélées pour avoir été influencées, positivement ou négativement, par la diminution de la toxicité dans le lac au fil du temps, ont montré des comportements similaires dans des études en mésocosmes. On peut en conclure que la toxicité du mélange herbicide est l'un des paramètres clés pour expliquer les changements de phytoplancton dans le lac Léman. En conclusion, il existe diverses méthodes pour prédire le risque des mélanges de micropolluants sur les espèces aquatiques et celui-ci peut jouer un rôle dans le fonctionnement des écosystèmes. Toutefois, ces modèles ont bien sûr des limites et des hypothèses sous-jacentes qu'il est important de considérer lors de leur application, avant d'utiliser leurs résultats pour la gestion des risques environnementaux. - For several years now, the scientists as well as the society is concerned by the aquatic risk organic micropollutants may pose. Indeed, several researches have shown the toxic effects these substances may induce on organisms living in our lakes or rivers, especially when they are exposed to acute or chronic concentrations. However, most of the studies focused on the toxicity of single compounds, i.e. considered individually. The same also goes in the current European regulations concerning the risk assessment procedures for the environment of these substances. But aquatic organisms are typically exposed every day simultaneously to thousands of organic compounds. The toxic effects resulting of these "cocktails" cannot be neglected. The ecological risk assessment of mixtures of such compounds has therefore to be addressed by scientists in the most reliable and appropriate way. In the first part of this thesis, the procedures currently envisioned for the aquatic mixture risk assessment in European legislations are described. These methodologies are based on the mixture model of concentration addition and the use of the predicted no effect concentrations (PNEC) or effect concentrations (EC50) with assessment factors. These principal approaches were applied to two specific case studies, Lake Geneva and the River Rhône in Switzerland, including a discussion of the outcomes of such applications. These first level assessments showed that the mixture risks for these studied cases exceeded rapidly the critical value. This exceeding is generally due to two or three main substances. The proposed procedures allow therefore the identification of the most problematic substances for which management measures, such as a reduction of the entrance to the aquatic environment, should be envisioned. However, it was also showed that the risk levels associated with mixtures of compounds are not negligible, even without considering these main substances. Indeed, it is the sum of the substances that is problematic, which is more challenging in term of risk management. Moreover, a lack of reliability in the procedures was highlighted, which can lead to contradictory results in terms of risk. This result is linked to the inconsistency in the assessment factors applied in the different methods. In the second part of the thesis, the reliability of the more advanced procedures to predict the mixture effect to communities in the aquatic system were investigated. These established methodologies combine the model of concentration addition (CA) or response addition (RA) with species sensitivity distribution curves (SSD). Indeed, the mixture effect predictions were shown to be consistent only when the mixture models are applied on a single species, and not on several species simultaneously aggregated to SSDs. Hence, A more stringent procedure for mixture risk assessment is proposed, that would be to apply first the CA or RA models to each species separately and, in a second step, to combine the results to build an SSD for a mixture. Unfortunately, this methodology is not applicable in most cases, because it requires large data sets usually not available. Therefore, the differences between the two methodologies were studied with datasets created artificially to characterize the robustness of the traditional approach applying models on species sensitivity distribution. The results showed that the use of CA on SSD directly might lead to underestimations of the mixture concentration affecting 5% or 50% of species, especially when substances present a large standard deviation of the distribution from the sensitivity of the species. The application of RA can lead to over- or underestimates, depending mainly on the slope of the dose-response curves of the individual species. The potential underestimation with RA becomes important when the ratio between the EC50 and the EC10 for the dose-response curve of the species composing the SSD are smaller than 100. However, considering common real cases of ecotoxicity data for substances, the mixture risk calculated by the methodology applying mixture models directly on SSDs remains consistent and would rather slightly overestimate the risk. These results can be used as a theoretical validation of the currently applied methodology. Nevertheless, when assessing the risk of mixtures, one has to keep in mind this source of error with this classical methodology, especially when SSDs present a distribution of the data outside the range determined in this study Finally, in the last part of this thesis, we confronted the mixture effect predictions with biological changes observed in the environment. In this study, long-term monitoring of a European great lake, Lake Geneva, provides the opportunity to assess to what extent the predicted toxicity of herbicide mixtures explains the changes in the composition of the phytoplankton community next to other classical limnology parameters such as nutrients. To reach this goal, the gradient of the mixture toxicity of 14 herbicides regularly detected in the lake was calculated, using concentration addition and response addition models. A decreasing temporal gradient of toxicity was observed from 2004 to 2009. Redundancy analysis and partial redundancy analysis showed that this gradient explains a significant portion of the variation in phytoplankton community composition, even when having removed the effect of all other co-variables. Moreover, some species that were revealed to be influenced positively or negatively, by the decrease of toxicity in the lake over time, showed similar behaviors in mesocosms studies. It could be concluded that the herbicide mixture toxicity is one of the key parameters to explain phytoplankton changes in Lake Geneva. To conclude, different methods exist to predict the risk of mixture in the ecosystems. But their reliability varies depending on the underlying hypotheses. One should therefore carefully consider these hypotheses, as well as the limits of the approaches, before using the results for environmental risk management

Recent misconceptions about the "database search problem": a probabilistic analysis using Bayesian networks

This paper analyses and discusses arguments that emerge from a recent discussion about the proper assessment of the evidential value of correspondences observed between the characteristics of a crime stain and those of a sample from a suspect when (i) this latter individual is found as a result of a database search and (ii) remaining database members are excluded as potential sources (because of different analytical characteristics). Using a graphical probability approach (i.e., Bayesian networks), the paper here intends to clarify that there is no need to (i) introduce a correction factor equal to the size of the searched database (i.e., to reduce a likelihood ratio), nor to (ii) adopt a propositional level not directly related to the suspect matching the crime stain (i.e., a proposition of the kind 'some person in (outside) the database is the source of the crime stain' rather than 'the suspect (some other person) is the source of the crime stain'). The present research thus confirms existing literature on the topic that has repeatedly demonstrated that the latter two requirements (i) and (ii) should not be a cause of concern.

Effects of total fishing prohibition on the rocky fish assemblages of Medes Islands marine reserve (NW Mediterranean)

Visual scuba diving censuses were used to assess the effects of fishing prohibition on abundance and size structure of littoral fish populations by comparing the same benthic communities inside and outside the protected area of Medes Islands (NE Catalonia, Spain). The total number of species found was 43 in the reserve and 44 outside, but the mean value of species richness per sampling station was significantly higher in the protected area. However, diversity, heavily affected by the presence or absence of large schools of pelagic species, showed no significant differences between sites. The prohibition of fishing for 6 years is the first factor affecting the qualitative and quantitative structure of fish populations ('reserve effect'), and depth is the second factor. Thus, except in the cases of Serranus cabrilla and Mullus surmuletus, all other vulnerable species are highly sensitive to the protection measures. The size structure of all vulnerable species was found to be absolutely different at the reserve sites than in the unprotected zones, and the modal size classes of size frequency distributions were always higher in the reserve than outside. The reserve effect was significantly responsible of the differences observed in this change on size structure. Some highly vulnerable species, such as Epinephelus guaza and Sciaena umbra, have only been found in the protected area. Others, such as Sparus aurata, Diplodus cervinus and Dicentrarchus labrax, were much more frequent inside the reserve.

The future of patient safety: Surgical trainees accept virtual reality as a new training tool.

BACKGROUND: The use of virtual reality (VR) has gained increasing interest to acquire laparoscopic skills outside the operating theatre and thus increasing patients' safety. The aim of this study was to evaluate trainees' acceptance of VR for assessment and training during a skills course and at their institution. METHODS: All 735 surgical trainees of the International Gastrointestinal Surgery Workshop 2006-2008, held in Davos, Switzerland, were given a minimum of 45 minutes for VR training during the course. Participants' opinion on VR was analyzed with a standardized questionnaire. RESULTS: Fivehundred-twenty-seven participants (72%) from 28 countries attended the VR sessions and answered the questionnaires. The possibility of using VR at the course was estimated as excellent or good in 68%, useful in 21%, reasonable in 9% and unsuitable or useless in 2%. If such VR simulators were available at their institution, most course participants would train at least one hour per week (46%), two or more hours (42%) and only 12% wouldn't use VR. Similarly, 63% of the participants would accept to operate on patients only after VR training and 55% to have VR as part of their assessment. CONCLUSION: Residents accept and appreciate VR simulation for surgical assessment and training. The majority of the trainees are motivated to regularly spend time for VR training if accessible.

Residence time, expansion toward the equator in the invaded range and native range size matter to climatic niche shifts in non-native species

Aim Identifying climatic niche shifts and their drivers is important to accurately predict the risk of biological invasions. The niches of non-native plants and birds have recently been assessed in large-scale multi-species studies, but such large-scale tests are lacking for non-native reptiles and amphibians (herpetofauna). Furthermore, little is known about the factors contributing to niche shifts when they occur. Based on the occurrence of 71 reptile and amphibian species, we compared native and non-native realized niches in 101 invaded ranges at a worldwide scale and identified the factors that affect niche shifts. Location The world except the Antarctic. Methods We assessed climatic niche dynamics in a gridded environmental space allowing the quantification of niche overlap and expansion into climatic conditions not colonized by the species in their native range. We analyzed the factors affecting niche shifts using a model averaging approach based on generalized linear mixed-effects models. Results Approximately 57% of the invaded ranges (51% for amphibians and 61% for reptiles) showed niche shifts (≥10% expansion in the realized climatic niche). Island endemics, species introduced to Oceania and invaded ranges outside the native biogeographic realm showed a higher proportion of niche shifts. Niche shifts were more likely for species that had smaller native range sizes, were introduced earlier into a new range or invaded areas located at lower latitudes than the native range. Main conclusions The proportion of niche shifts for non-native herpetofauna was higher than those for Holarctic non-native plants and European non-native birds. The 'climate matching hypothesis' should be used with caution for species shifting their niche because it could underestimate the risk of their establishment.

Helical tomotherapy in the treatment of anal canal cancer: 3-year clinical experience

Objective: To report a single-center experience treating patients with squamous- cell carcinoma of the anal canal using helical Tomotherapy (HT) and concurrent chemotherapy (CT).Materials/Methods: From October 2007 to February 2011, 55 patients were treated with HT and concurrent CT (5-fluorouracil/capecitabin and mitomycin) for anal squamous-cell carcinoma. All patients underwent computed- tomography-based treatment planning, with pelvic and inguinal nodes receiving 36 Gy in 1.8 Gy/fraction. Following a planned 1-week break, primary tumor site and involved nodes were boosted to a total dose 59.4 Gy in 1.8 Gy/fraction. Dose-volume histograms of several organs at risk (OAR; bladder, small intestine, rectum, femoral heads, penile bulb, external genitalia) were assessed in terms of conformal avoidance. All toxicity was scored according to the CTCAE, v.3.0. HT plans and treatment were implemented using the Tomotherapy, Inc. software and hardware. For dosimetric comparisons, 3D RT and/or IMRT plans were also computed for some of the patients using the CMS planning system, for treatment with 6-18 MV photons and/or electrons with suitable energies from a Siemens Primus linear accelerator equipped with a multileaf collimator.Locoregional control and survival curves were compared with the log-rank test, and multivariate analysis by the Cox model.Results: With 360-degree-of-freedom beam projection, HT has an advantage over other RT techniques (3D or 5-field step-and-shot IMRT). There is significant improvement over 3D or 5-field IMRT plans in terms of dose conformity around the PTV, and dose gradients are steeper outside the target volume, resulting in reduced doses to OARs. Using HT, acute toxicity was acceptable, and seemed to be better than historical standards.Conclusions: Our results suggest that HT combined with concurrent CT for anal cancer is effective and tolerable. Compared to 3D RT or 5-field step-andshot IMRT, there is better conformity around the PTV, and better OAR sparing.

Who Cares? A comparison of informal and formal care provision in Spain, England and the USA

This paper investigates the prevalence of incapacity in performing daily activities and the associations between household composition and availability of family members and receipt of care among older adults with functioning problems in Spain, England and the United States of America (USA). We examine how living arrangements, marital status, child availability, limitations in functioning ability, age and gender affect the probability of receiving formal care and informal care from household members and from others in three countries with different family structures, living arrangements and policies supporting care of the incapacitated. Data sources include the 2006 Survey of Health, Ageing and Retirement in Europe for Spain, the third wave of the English Longitudinal Study of Ageing (2006), and the eighth wave of the USA Health and Retirement Study (2006). Logistic and multinomial logistic regressions are used to estimate the probability of receiving care and the sources of care among persons age 50 and older. The percentage of people with functional limitations receiving care is higher in Spain. More care comes from outside the household in the USA and England than in Spain. The use of formal care among the incapacitated is lowest in the USA and highest in Spain.

Characterization of HbpR binding by site-directed mutagenesis of its DNA-binding site and by deletion of the effector domain.

In the presence of 2-hydroxybiphenyl, the enhancer binding protein, HbpR, activates the sigma54-dependent P(hbpC) promoter and controls the initial steps of 2-hydroxybiphenyl degradation in Pseudomonas azelaica. In the activation process, an oligomeric HbpR complex of unknown subunit composition binds to an operator region containing two imperfect palindromic sequences. Here, the HbpR-DNA binding interactions were investigated by site-directed mutagenesis of the operator region and by DNA-binding assays using purified HbpR. Mutations that disrupted the twofold symmetry in the palindromes did not affect the binding affinity of HbpR, but various mutations along a 60 bp region, and also outside the direct palindromic sequences, decreased the binding affinity. Footprints of HbpR on mutant operator fragments showed that a partial loss of binding contacts occurs, suggesting that the binding of one HbpR 'protomer' in the oligomeric complex is impaired whilst leaving the other contacts intact. An HbpR variant, devoid of its N-terminal sensing A-domain, was unable to activate transcription from the hbpC promoter while maintaining protection of the operator DNA in footprints. Wild-type HbpR was unable to activate transcription from the hbpC promoter when delta A-HbpR was expressed in the same cell, suggesting the formation of (repressing) hetero-oligomers. This model implies that HbpR can self-associate on its operator DNA without effector recognition or ATP binding. Furthermore, our findings suggest that the N-terminal sensing domain of HbpR is needed to activate the central ATPase domain rather than to repress a constitutively active C domain, as is the case for the related regulatory protein XylR.