Procedure for human saphenous veins ex vivo perfusion and external reinforcement.

The mainstay of contemporary therapies for extensive occlusive arterial disease is venous bypass graft. However, its durability is threatened by intimal hyperplasia (IH) that eventually leads to vessel occlusion and graft failure. Mechanical forces, particularly low shear stress and high wall tension, are thought to initiate and to sustain these cellular and molecular changes, but their exact contribution remains to be unraveled. To selectively evaluate the role of pressure and shear stress on the biology of IH, an ex vivo perfusion system (EVPS) was created to perfuse segments of human saphenous veins under arterial regimen (high shear stress and high pressure). Further technical innovations allowed the simultaneous perfusion of two segments from the same vein, one reinforced with an external mesh. Veins were harvested using a no-touch technique and immediately transferred to the laboratory for assembly in the EVPS. One segment of the freshly isolated vein was not perfused (control, day 0). The two others segments were perfused for up to 7 days, one being completely sheltered with a 4 mm (diameter) external mesh. The pressure, flow velocity, and pulse rate were continuously monitored and adjusted to mimic the hemodynamic conditions prevailing in the femoral artery. Upon completion of the perfusion, veins were dismounted and used for histological and molecular analysis. Under ex vivo conditions, high pressure perfusion (arterial, mean = 100 mm Hg) is sufficient to generate IH and remodeling of human veins. These alterations are reduced in the presence of an external polyester mesh.

Joint Official Positions of the International Society for Clinical Densitometry and International Osteoporosis Foundation on FRAX(®). Executive Summary of the 2010 Position Development Conference on Interpretation and use of FRAX® in clinical practice.

The International Society for Clinical Densitometry (ISCD) and the International Osteoporosis Foundation (IOF) convened the FRAX(®) Position Development Conference (PDC) in Bucharest, Romania, on November 14, 2010, following a two-day joint meeting of the ISCD and IOF on the "Interpretation and Use of FRAX(®) in Clinical Practice." These three days of critical discussion and debate, led by a panel of international experts from the ISCD, IOF and dedicated task forces, have clarified a number of important issues pertaining to the interpretation and implementation of FRAX(®) in clinical practice. The Official Positions resulting from the PDC are intended to enhance the quality and clinical utility of fracture risk assessment worldwide. Since the field of skeletal assessment is still evolving rapidly, some clinically important issues addressed at the PDCs are not associated with robust medical evidence. Accordingly, some Official Positions are based largely on expert opinion. Despite limitations inherent in such a process, the ISCD and IOF believe it is important to provide clinicians and technologists with the best distillation of current knowledge in the discipline of bone densitometry and provide an important focus for the scientific community to consider. This report describes the methodology and results of the ISCD-IOF PDC dedicated to FRAX(®).

Characterising avian haemosporidian communities : ecological factors, parasite persistence and co-infection

Les parasites jouent un rôle clef dans l'évolution des comportements et des traits d'histoire de vie de leurs hôtes. Le parasitisme s'avère parfois dévastateur à l'échelle de population d'hôtes, et peut également altérer certains traits associés à la valeur sélective d'un individu infecté, tels que son succès reproducteur ou encore son taux de mortalité. La coévolution hôte/parasite, qui représente l'une des forces sélectives les plus puissantes dans l'évolution des organismes, peut également conduire les partenaires de l'association parasitaire à s'adapter localement à des environnements hétérogènes. Cette thèse porte sur l'étude de parasites aviaires, du genre Plasmodium, Haemopro- teus et Leucocytozoon (Haemosporidae), naturellement associés à différentes populations de mésanges charbonnières (Parus major) et d'hirondelles des fenêtres (Delichon ur- bicum). Dans un premier temps, nous avons cherché à déterminer comment se distribuent ces parasites au sein de différentes populations hôtes et si ces communautés de parasites sont structurées. Par la suite, la principale question à laquelle nous voulions répondre était de savoir comment ces parasites, et notamment après coexistence de plusieurs lignées génétiques d'Haemosporidae au sein dun même-individu (i.e. co-infection), affectent la physiologie et le succès de reproducteur des hôtes. Nos résultats suggèrent que la distribution des Haemosporidae est principalement gouvernée par la présence d'insectes vecteurs et que la persistance de l'infection chez les hôtes varie en fonction du genre d'Haemosporidae (Chapitre 1-2). Par ailleurs, nous avons trouvé que des lignées de parasite génétiquement distinctes peuvent avoir des effets contrastés sur leurs hôtes. Par exemple, les hôtes exhibent des différences de parasitémie marquées en fonction des lignées de parasites responsable de l'infection. De plus, le succès reproducteur ainsi que la charge parasitaire des mésanges infectées par Plasmodium ou Haemoproteus n'étaient pas affecté par l'infection simultanée avec Leucocytozoon (Chapitre 2-3). Dans le Chapitre 4, j'ai examiné la capacité immunitaire de mésanges charbonnières infectées par des hémosporidies. Les résultats n'ont pas été concluant, et je suggère fortement une réévaluation de ceux-ci dans de futures études. Les mésanges charbonnières ne semblent pas signaler leur statut infectieux par la coloration de leur plumage (Chapitre 5); toutefois, la coloration noire des plumes reflète l'état de stress oxydatif des mésanges, qui dépend lui-même de l'infection parasitaire. La coloration verte pourrait également indiquer la qualité des soins paxentaux délivrés par les mésanges adultes femelles à leurs petits, comme le suggère la corrélation que nous avons observée entre la masse des jeunes d'une nichée et la coloration de leur mère. Les hirondelles capturées en Algérie souffrent plus de l'infection que celles échantillon¬nées en Europe (Chapitre 6). Les similitudes observées entre les communautés de par¬asites affectant les populations européennes et celles des populations nord-africaines suggèrent que la transmission des parasites a lieu lors de la migration vers le sud. A l'instar de nos observations sur les mésanges dans les chapitres 2 et 3, les hirondelles co-infectées ne montrent pas d'altérations de leur condition physique. Cette thèse démontre qu'il existe, au sein des populations de mésanges charbonnières, des interactions antagonistes entre, d'une part, les parasites et leurs hôtes et d'autre part, entre différent parasites. Le résultat de ces interactions antagonistes varie en fonction des espèces et de la zone géographique considérée. Nous avons démontré que les interactions ne suivent pas toujours la théorie, puisque la coevolution qui, en suivant le concept de la virulence, devrait augmenter la charge parasitaire et diminuer la condition physique des hôtes, ne montre pourtant pas d'impact négatif sur les populations de mésanges. Nous pouvons maintenant concentrer nos efforts à la caractérisation des interactions antagonistes. De plus, grâce aux avancées des méthodes moléculaires, nous pouvons suivre et étudier en détails comment ces interactions se manifestent et quels sont leurs effets sur la condition physique des hôtes. - Parasites are key in shaping various behavioural and life-history traits of their hosts. The influence of parasitism on host populations varies from slight to devastating and might influence such parameters as mortality rates or reproductive success. Host-parasite coevolution is one of the most powerful selective forces in evolution and can lead to local adaptation of parasites and hosts in spatially structured environments. In this thesis, I studied haemosporidian parasites in different populations of great tits (Parus major) and house martins (Delichon urbicum). Firstly, I wanted to determine how parasites are distributed and if parasite communities are structured. The main question I wanted to address hereafter was how parasites, and specifically infection with multiple genera of parasites (i.e. co-infection) influenced host physiology and reproductive success. I found that parasite distribution is environmentally driven and could therefore be closely linked to vector prevalence; and that the stability of parasite infection over time is genus-dependent (Chapter 1 - 2). I further found that different haemosporidian lineages might interact differently with their hosts as parasitaemia was strongly lineage-specific and that the presence of Leucocytozoon parasites showed no correlation to Plasmodium or Haemoproteus parasitaemia, nor to great tit reproductive success (Chapter 2-3). In Chapter 4 I examined immune capacity of haemosporidian-infected great tits. The results proved inconclusive, and I strongly suggest re-evaluation hereof in future work. Great tits do not appear to signal parasite infection through plumage colouration (Chapter 5); however, infection did have a link to oxidative stress resistance which is strongly signalled through the black breast stripe, with darker males being more resistant and darker females less resistant. Females might incur different costs associated with darker stripes. This would allow reversal of signaling function. Green colouration could also serve as a cue for female provisioning quality as indicated by the strong correlation between colouration and chick body mass. Breeding house martins caught in Algeria suffer greater haemosporidian infection than European populations (Chapter 6). Similar parasite communities in European and North-African populations suggest transmission of parasites may occur during southward migration. Similarly to what was observed in great tits in Chapter 2 and 3, no relationship was found between parasite co-infection and Swiss house martin body condition. This thesis demonstrates that host-parasite and inter-parasite antagonistic interac¬tions exist in great tit populations. How these interactions play out is species dependent and varies geographically. I have demonstrated that interactions do not always follow the theory, as co-infection - which under the concept of virulence should increase parasitaemia and decrease body condition - showed no negative impact on great tit populations. We can now concentrate our efforts on characterising these antagonistic interactions, and with the advance in molecular methods, track and investigate how these interactions play out and what the effect on host fitness is.

Sex-specific estimates of dispersal show female philopatry and male dispersal in a promiscuous amphibian, the alpine salamander (Salamandra atra).

Amphibians display wide variations in life-history traits and life cycles that should prove useful to explore the evolution of sex-biased dispersal, but quantitative data on sex-specific dispersal patterns are scarce. Here, we focused on Salamandra atra, an endemic alpine species showing peculiar life-history traits. Strictly terrestrial and viviparous, the species has a promiscuous mating system, and females reproduce only every 3 to 4 years. In the present study, we provide quantitative estimates of asymmetries in male vs. female dispersal using both field-based (mark-recapture) and genetic approaches (detection of sex-biased dispersal and estimates of migration rates based on the contrast in genetic structure across sexes and age classes). Our results revealed a high level of gene flow among populations, which stems exclusively from male dispersal. We hypothesize that philopatric females benefit from being familiar with their natal area for the acquisition and defence of an appropriate shelter, while male dispersal has been secondarily favoured by inbreeding avoidance. Together with other studies on amphibians, our results indicate that a species' mating system alone is a poor predictor of sex-linked differences in dispersal, in particular for promiscuous species. Further studies should focus more directly on the proximate forces that favour or limit dispersal to refine our understanding of the evolution of sex-biased dispersal in animals.

Were Spanish migrants attracted by industrial agglomerations?: an analysis for the interwar years in the light of the new economic geography

In this paper we examine whether access to markets had a significant influence onmigration choices of Spanish internal migrants in the inter-war years. We perform astructural contrast of a New Economic Geography model that focus on the forwardlinkage that links workers location choice with the geography of industrial production,one of the centripetal forces that drive agglomeration in the NEG models. The resultshighlight the presence of this forward linkage in the Spanish economy of the inter-warperiod. That is, we prove the existence of a direct relation between workers¿ localizationdecisions and the market potential of the host regions. In addition, the direct estimationof the values associated with key parameters in the NEG model allows us to simulatethe migratory flows derived from different scenarios of the relative size of regions andthe distances between them. We show that in Spain the power of attraction of theagglomerations grew as they increased in size, but the high elasticity estimated for themigration costs reduced the intensity of the migratory flows. This could help to explainthe apparently low intensity of internal migrations in Spain until its upsurge during the1920s. This also explains the geography of migrations in Spain during this period,which hardly affected the regions furthest from the large industrial agglomerations (i.e.,regions such as Andalusia, Estremadura and Castile-La Mancha) but had an intenseeffect on the provinces nearest to the principal centres of industrial development.

Regional integration and specialisation patterns in Spain

The aim of this paper is to analyse how economic integration in Europe has affected industrial geographical concentration in Spain and explain what the driving forces behind industry location are. Firstly, we construct regional specialisation and geographical concentration indices for Spanish 50 provinces and 30 industrial sectors in 1979, 1986 and 1992. Secondly, we carry out an econometric analysis of the determinants of geographical concentration of industries. Our main conclusion is that there is no evidence of increasing specialisation in Spain between 1979 and 1992 and that the most important determinant of Spain¿s economic geography is scale economies. Furthermore, traditional trade theory has no effects in explaining the pattern of industrial concentration

Prothèses totales de genoux. Analyse clinique et numérique des micromouvements de l'implant tibial [Total knee prosthesis. Clinical and numerical study of micromovements of the tibial implant].

INTRODUCTION: The importance of the micromovements in the mechanism of aseptic loosening is clinically difficult to evaluate. To complete the analysis of a series of total knee arthroplasties (TKA), we used a tridimensional numerical model to study the micromovements of the tibial implant. MATERIAL AND METHODS: Fifty one patients (with 57 cemented Porous Coated Anatomic TKAs) were reviewed (mean follow-up 4.5 year). Radiolucency at the tibial bone-cement interface was sought on the AP radiographs and divided in 7 areas. The distribution of the radiolucency was then correlated with the axis of the lower limb as measured on the orthoradiograms. The tridimensional numerical model is based on the finite element method. It allowed the measurement of the cemented prosthetic tibial implant's displacements and the micromovements generated at bone-ciment interface. A total load (2000 Newton) was applied at first vertically and asymetrically on the tibial plateau, thereby simulating an axial deviation of the lower limbs. The vector's posterior inclination then permitted the addition of a tangential component to the axial load. This type of effort is generated by complex biomechanical phenomena such as knee flexion. RESULTS: 81 per cent of the 57 knees had a radiolucent line of at least 1 mm, at one or more of the tibial cement-epiphysis jonctional areas. The distribution of these lucent lines showed that they came out more frequently at the periphery of the implant. The lucent lines appeared most often under the unloaded margin of the tibial plateau, when axial deviation of lower limbs was present. Numerical simulations showed that asymetrical loading on the tibial plateau induced a subsidence of the loaded margin (0-100 microns) and lifting off at the opposite border (0-70 microns). The postero-anterior tangential component induced an anterior displacement of the tibial implant (160-220 microns), and horizontal micromovements with non homogenous distribution at the bone-ciment interface (28-54 microns). DISCUSSION: Comparison of clinical and numerical results showed a relation between the development of radiolucent lines and the unloading of the tibial implant's margin. The deleterious effect of lower limbs' axial deviation is thereby proven. The irregular distribution of lucent lines under the tibial plateau was similar of the micromovements' repartition at the bone-cement interface when tangential forces were present. A causative relation between the two phenomenaes could not however be established. Numerical simulation is a truly useful method of study; it permits to calculate micromovements which are relative, non homogenous and of very low amplitude. However, comparative clinical studies remain as essential to ensure the credibility of results.

Iowa Sex Offender Treatment and Supervision Task Force Report to the Iowa General Assembly, January 15, 2007

Over the last several years, lawmakers have been responding to several highly publicized child abduction, assault and murder cases. While such cases remain rare in Iowa, the public debates they have generated are having far-reaching effects. Policy makers are responsible for controlling the nature of such effects. Challenges they face stem from the need to avoid primarily politically-motivated responses and the desire to make informed decisions that recognize both the strengths and the limitations of the criminal justice system as a vehicle for promoting safe and healthy families and communities. Consensus was reached by the Task Force at its first meeting that one of its standing goals is to provide nonpartisan guidance to help avoid or fix problematic sex offense policies and practices. Setting this goal was a response to the concern over what can result from elected officials’ efforts to respond to the types of sex offender-related concerns that can easily become emotionally laden and politically charged due to the universally held abhorrence of sex crimes against children. The meetings of the Task Force and the various work groups it has formed have included some spirited and perhaps emotionally charged discussions, despite the above-stated ground rule. However, as is described in the report, the Task Force’s first set of recommendations and plans for further study were approved through consensus. It is hoped that in upcoming legislative deliberations, it will be remembered that the non-legislative members of the Task Force all agreed on the recommendations contained in this report. The topics discussed in this first report from the Task Force are limited to the study issues specifically named in H.F. 619, the Task Force’s enabling legislation. However, other topics of concern were discussed by the Task Force because of their immediacy or because of their possible relationships with one or more of the Task Force’s mandated study issues. For example, it has been reported by some probation/parole officers and others that the 2000 feet rule has had a negative influence on treatment participation and supervision compliance. While such concerns were noted, the Task Force did not take it upon itself to investigate them at this time and thus broaden the agenda it was given by the General Assembly last session. As a result, the recently reinstated 2000 feet rule, the new cohabitation/child endangerment law and other issues of interest to Task Force members but not within the scope of their charge are not discussed in the body of this report. An issue of perhaps the greatest interest to most Task Force members that was not a part of their charge was a belief in the benefit of viewing Iowa’s efforts to protect children from sex crimes with as comprehensive a platform as possible. It has been suggested that much more can be done to prevent child-victim sex crimes than would be accomplished by only concentrating on what to do with offenders after a crime has occurred. To prevent child victimization, H.F. 619 policy provisions rely largely on incapacitation and future deterrent effects of increased penalties, more restrictive supervision practices and greater public awareness of the risk presented by a segment of Iowa’s known sex offenders. For some offenders, these policies will no doubt prevent future sex crimes against children, and the Task Force has begun long-term studies to look for the desired results and for ways to improve such results through better supervision tools and more effective offender treatment. Unfortunately, much of the effects from the new policies may primarily influence persons who have already committed sex offenses against minors and who have already been caught doing so. Task Force members discussed the need for a range of preventive efforts and a need to think about sex crimes against children from other than just a “reaction- to-the-offender” perspective. While this topic is not addressed in the report that follows, it was suggested that some of the Task Force’s discussions could be briefly shared through these opening comments. Along with incapacitation and deterrence, comprehensive approaches to the prevention of child-victim sex crimes would also involve making sure parents have the tools they need to detect signs of adults with sex behavior problems, to help teach their children about warning signs and to find the support they need for healthy parenting. School, faithbased and other community organizations might benefit from stronger supports and better tools they can use to more effectively promote positive youth development and the learning of respect for others, respect for boundaries and healthy relationships. All of us who have children, or who live in communities where there are children, need to understand the limitations of our justice system and the importance of our own ability to play a role in preventing sexual abuse and protecting children from sex offenders, which are often the child’s own family members. Over 1,000 incidences of child sexual abuse are confirmed or founded each year in Iowa, and most such acts take place in the child’s home or the residence of the caretaker of the child. Efforts to prevent child sexual abuse and to provide for early interventions with children and families at risk could be strategically examined and strengthened. The Sex Offender Treatment and Supervision Task Force was established to provide assistance to the General Assembly. It will respond to legislative direction for adjusting its future plans as laid out in this report. Its plans could be adjusted to broaden or narrow its scope or to assign different priority levels of effort to its current areas of study. Also, further Task Force considerations of the recommendations it has already submitted could be called for. In the meantime, it is hoped that the information and recommendations submitted through this report prove helpful.