Low income, community poverty and risk of end stage renal disease

BACKGROUND: The risk of end stage renal disease (ESRD) is increased among individuals with low income and in low income communities. However, few studies have examined the relation of both individual and community socioeconomic status (SES) with incident ESRD. METHODS: Among 23,314 U.S. adults in the population-based Reasons for Geographic and Racial Differences in Stroke study, we assessed participant differences across geospatially-linked categories of county poverty [outlier poverty, extremely high poverty, very high poverty, high poverty, neither (reference), high affluence and outlier affluence]. Multivariable Cox proportional hazards models were used to examine associations of annual household income and geospatially-linked county poverty measures with incident ESRD, while accounting for death as a competing event using the Fine and Gray method. RESULTS: There were 158 ESRD cases during follow-up. Incident ESRD rates were 178.8 per 100,000 person-years (105 py) in high poverty outlier counties and were 76.3 /105 py in affluent outlier counties, p trend&#8201;=&#8201;0.06. In unadjusted competing risk models, persons residing in high poverty outlier counties had higher incidence of ESRD (which was not statistically significant) when compared to those persons residing in counties with neither high poverty nor affluence [hazard ratio (HR) 1.54, 95% Confidence Interval (CI) 0.75-3.20]. This association was markedly attenuated following adjustment for socio-demographic factors (age, sex, race, education, and income); HR 0.96, 95% CI 0.46-2.00. However, in the same adjusted model, income was independently associated with risk of ESRD [HR 3.75, 95% CI 1.62-8.64, comparing the&#8201;<&#8201;$20,000 income group to the&#8201;>&#8201;$75,000 group]. There were no statistically significant associations of county measures of poverty with incident ESRD, and no evidence of effect modification. CONCLUSIONS: In contrast to annual family income, geospatially-linked measures of county poverty have little relation with risk of ESRD. Efforts to mitigate socioeconomic disparities in kidney disease may be best appropriated at the individual level.

Skeletal muscle mitochondria in the elderly: effects of physical fitness and exercise training.

Context: Sarcopenia is thought to be associated with mitochondrial (M) loss. It is unclear whether the decrease in M content is consequent to aging per se or to decreased physical activity. Objectives: To examine the influence of fitness on M content and function, and to assess whether exercise could improve M function in older adults. Design and subjects: Three distinct studies were conducted: 1) a cross-sectional observation comparing M content and fitness in a large heterogeneous cohort of older adults; 2) a case-control study comparing chronically endurance-trained older adults (A) and sedentary (S) subjects matched for age and gender; 3) a 4-month exercise intervention in S. Setting: University-based clinical research center Outcomes: M volume density (Mv) was assessed by electron microscopy from vastus lateralis biopsies, electron transport chain proteins (ETC) by western blotting, mRNAs for transcription factors involved in M biogenesis by qRT-PCR and in-vivo oxidative capacity (ATPmax) by (31)P-MR spectroscopy. Peak oxygen uptake (VO2peak) was measured by GXT. Results: VO2peak was strongly correlated with Mv in eighty 60-80 yo adults. Comparison of A vs. S revealed differences in Mv, ATPmax and some ETC complexes. Finally, exercise intervention confirmed that S are able to recover Mv, ATPmax and specific transcription factors. Conclusions: These data suggest that 1) aging per se is not the primary culprit leading to M dysfunction, 2) an aerobic exercise program, even at an older age, can ameliorate the loss in skeletal muscle M content and may prevent aging muscle comorbidities and 3) the improvement of M function is all about content.

Land-use systems affect Archaeal community structure and functional diversity in western Amazon soils

The study of the ecology of soil microbial communities at relevant spatial scales is primordial in the wide Amazon region due to the current land use changes. In this study, the diversity of the Archaea domain (community structure) and ammonia-oxidizing Archaea (richness and community composition) were investigated using molecular biology-based techniques in different land-use systems in western Amazonia, Brazil. Soil samples were collected in two periods with high precipitation (March 2008 and January 2009) from Inceptisols under primary tropical rainforest, secondary forest (5-20 year old), agricultural systems of indigenous people and cattle pasture. Denaturing gradient gel electrophoresis of polymerase chain reaction-amplified DNA (PCR-DGGE) using the 16S rRNA gene as a biomarker showed that archaeal community structures in crops and pasture soils are different from those in primary forest soil, which is more similar to the community structure in secondary forest soil. Sequence analysis of excised DGGE bands indicated the presence of crenarchaeal and euryarchaeal organisms. Based on clone library analysis of the gene coding the subunit of the enzyme ammonia monooxygenase (amoA) of Archaea (306 sequences), the Shannon-Wiener function and Simpson's index showed a greater ammonia-oxidizing archaeal diversity in primary forest soils (H' = 2.1486; D = 0.1366), followed by a lower diversity in soils under pasture (H' = 1.9629; D = 0.1715), crops (H' = 1.4613; D = 0.3309) and secondary forest (H' = 0.8633; D = 0.5405). All cloned inserts were similar to the Crenarchaeota amoA gene clones (identity > 95 %) previously found in soils and sediments and distributed primarily in three major phylogenetic clusters. The findings indicate that agricultural systems of indigenous people and cattle pasture affect the archaeal community structure and diversity of ammonia-oxidizing Archaea in western Amazon soils.

L'arr��t cardiaque: quelle r��alit�� et quelle formation pour le praticien [Heart arrest: which reality and which training for the practitioner?]

Sudden death related to out-of hospital cardiac arrest is an important cause of mortality, which is mainly caused by ventricular fibrillation, a potentially reversible condition. The prognosis of out-of-hospital cardiac arrest remains dismal despite well developed emergency medical services. Witnessed arrest, ventricular fibrillation as the initial arrhythmia, cardiopulmonary resuscitation and early defibrillation are systematically associated with better survival. Key interventions must therefore be enforced to improve survival from out-of-hospital cardiac, introducing the concept of a "chain of survivals". The aim of the present article, which is illustrated by local results, is to review this important public health issue, to emphasize the role of the general practitioner in the chain of survival, and to promote education and training of basic and advanced life support.

Sequentially aerated membrane biofilm reactors for autotrophic nitrogen removal: microbial community composition and dynamics

Membrane-aerated biofilm reactors performing autotrophic nitrogen removal can be successfully applied to treat concentrated nitrogen streams. However, their process performance is seriously hampered by the growth of nitrite oxidizing bacteria (NOB). In this work we document how sequential aeration can bring the rapid and long-term suppression of NOB and the onset of the activity of anaerobic ammonium oxidizing bacteria (AnAOB). Real-time quantitative polymerase chain reaction analyses confirmed that such shift in performance was mirrored by a change in population densities, with a very drastic reduction of the NOB���Nitrospira and Nitrobacter and a 10-fold increase in AnAOB numbers. The study of biofilm sections with relevant 16S rRNA fluorescent probes revealed strongly stratified biofilm structures fostering aerobic ammonium oxidizing bacteria (AOB) in biofilm areas close to the membrane surface (rich in oxygen) and AnAOB in regions neighbouring the liquid phase. Both communities were separated by a transition region potentially populated by denitrifying heterotrophic bacteria. AOB and AnAOB bacterial groups were more abundant and diverse than NOB, and dominated by the r-strategists Nitrosomonas europaea and Ca. Brocadia anammoxidans, respectively. Taken together, the present work presents tools to better engineer, monitor and control the microbial communities that support robust, sustainable and efficient nitrogen removal

Community structure and water quality in Mediterranean streams of a Natural Park (Sant Lloren�� del Munt, NE Spain)

Se estudian las comunidades de macroinvertebrados de los r��os del Parque Natural de Sant Lloren�� del Munt i la Serra de l'Obac (Barcelona, NE Espa��a) y su relaci��n con las condiciones de flujo de los r��os. Hasta 78 localidades se visitaron en dos ocasiones (invierno y verano de 1996) y en 26 de ellas se tomaron muestras de macroinvertebrados. Mientras en invierno el 63 % de los kil��metros investigados ten��a flujo continuo y menos del 1% estaba seco, en verano solo el 26% ten��a flujo continuo, un 20% estaba totalmente seco y el resto presentaba pozas en su lecho. A pesar de ello el n��mero de familias de macroinvertebrados fue de 54 en invierno y 94 en verano, siendo dominantes en este ��ltimo caso los heter��pteros, cole��pteros, odonatos y d��pteros, mientras que en invierno los tric��pteros y plec��pteros eran m��s diversos. En general, la comunidad present�� una estrategia tr��fica recolectora aunque la proporci��n de los ramoneadores y depredadores aument�� en verano. El estudio de las comunidades mediante el an��lisis de su abundancia en los dos per��odos, mostr�� que las variables temporales (flujo, temperatura) o las relacionadas con el incremento de la producci��n primaria (ox��geno, pH) explicaban la mayor parte de la variabilidad con los elementos mas re��filos propios de invierno y los len��ticos de verano, mientras que otros factores fisicoqu��micos no eran relevantes. Calculado el ��ndice biol��gico BMWP' se demostr�� que los valores en verano eran superiores o similares a los de invierno lo que se explica por la mayor diversidad aunque la calificaci��n individual de cada una de las familias encontradas en verano fuera menor que las halladas en invierno.

Short-term HIIT and Fatmax training increase aerobic and metabolic fitness in men with class II and III obesity.

OBJECTIVE: To compare the effects of two different 2-week-long training modalities [continuous at the intensity eliciting the maximal fat oxidation (Fatmax ) versus high-intensity interval training (HIIT)] in men with class II and III obesity. METHODS: Nineteen men with obesity (BMI&#8201;&#8805;&#8201;35 kg(.) m(-2) ) were assigned to Fatmax group (GFatmax ) or to HIIT group (GHIIT ). Both groups performed eight cycling sessions matched for mechanical work. Aerobic fitness and fat oxidation rates (FORs) during exercise were assessed prior and following the training. Blood samples were drawn to determine hormones and plasma metabolites levels. Insulin resistance was assessed by the homeostasis model assessment of insulin resistance (HOMA2-IR). RESULTS: Aerobic fitness and FORs during exercise were significantly increased in both groups after training (P&#8201;&#8804;&#8201;0.001). HOMA2-IR was significantly reduced only for GFatmax (P&#8201;&#8804;&#8201;0.001). Resting non-esterified fatty acids (NEFA) and insulin decreased significantly only in GFatmax (P&#8201;&#8804;&#8201;0.002). CONCLUSIONS: Two weeks of HIIT and Fatmax training are effective for the improvement of aerobic fitness and FORs during exercise in these classes of obesity. The decreased levels of resting NEFA only in GFatmax may be involved in the decreased insulin resistance only in this group.

A subalpine rangeland bird community before and after fire: prescribed burning in the Eastern Pyrenees

High mountain rangelands host important populations of threatened bird species, but can be affected by extensive changes in land use. I studied the breeding bird community of two shrubland plots at 1,850���2,100 m a.s.l. in the Pyrenees. Breeding territories were mapped for four years, before and after the prescribed burning, the aim of which was to increase the grazing value of the study area. The most abundant species (reaching ���3 breeding pairs/10 ha in at least one plot and one year) were Dunnock Prunella modularis, Dartford Warbler Sylvia undata, Stonechat Saxicola torquatus, Rock Bunting Emberiza cia and Ortolan Bunting E. hortulana. The open-shrubland plot contained a similar number of breeding species (10 vs.9), but a lower overall density (23 vs. 28 breeding pairs/10 ha) than the dense-shrubland plot. Most breeding species alsooccurred in winter. After fire, the number of bird species, overall density and conservation value (an index that takes into account all species��� densities and their categories of conservation concern in Europe) decreased, but tended to recover afterwards. These results may help understand the composition and dynamics of bird assemblages in managed mountain areas

Essays on Business and Leadership Ethics

As this is a dissertation, an academic thesis, it is important to define the objectives of my research, even if ex post facto, explicitly: - To define, develop and study the concept of business and leadership ethics. - To empirically study the phenomena associated with business and leadership from an ethical perspective. - To create a new framework for the development of responsible business. - To create an ���acid test��� for my body of works, i.e. a test and an evaluation on how well my research and ideas hold up under academic philosophical reflection. The utilitarian reasoning had the most support when the actors justified their actions regarding economic benefit. (=instrumental good). Duty and benefit were often mixed up in people���s speech. Their meaning contents were blurred and the argumentation lines created by the actors were broken. This can be interpreted in a way that supports Frankena���s mixed deontological philosophy as a frame of reference. Deontologica reasoning was used e.g. in describing the personnel management processes of a company. Virtue ethics is a favourable starting point for studying management and leadership ethics. All the actors studied could name virtues for their operations, towards which to aspire to. They also named professional practices already in use that they considered to be virtuous. Finally, I wish to state that normative ethics is an important branch of philosophical ethics, if also very important in applied ethics especially. From the normative standpoint, the results of this dissertation want to lead nations, communities and individuals towards the virtues of democratic leadership and sustainable economic development.

Changes in plant community diversity and composition across an edge between Araucaria forest and pasture in South Brazil

This work investigated how richness, abundance, composition and structure of woody and herbaceous vegetation were altered by the proximity of an edge between Araucaria forest and pasture in South Brazil. Herbaceous and woody species including seedlings were surveyed in 42 plots of 5 �� 5 m randomly placed at the following distances: 5 and 50 m from the edge into the pasture and 0, 25, 50, 100 and 250 m from the edge into the forest. There was a significant increase in vegetation cover, richness and abundance of woody species, woody seedlings and herbaceous plants at the edge (0 m). These variables, in general, decreased from 25 to 50 m from the edge into the forest in comparison to the forest interior. Few seedlings of woody plants were able to establish themselves in the pasture. There were continuous changes in species composition that occurred in the studied gradient due to the invasion of light-demanding species and the disappearance of some shade-tolerant species at the edge. In conclusion, the forest edge studied generated changes in the plant community that extended up to 50 m into the forest.