Mean Increment Research Articles

Trier social stress test in Indian adolescents.

To test the Trier Social Stress Test for children (TSST-C) in a cohort of Indian adolescents. Cohort study. Holdsworth Memorial Hospital, Mysore, India. Adolescent children (N=273, 134 males; mean age 13.6 yrs) selected from an ongoing birth cohort; 269 completed the test. Performance of 5-minutes each of public- speaking and mental arithmetic tasks in front of two unfamiliar 'evaluators'. Salivary cortisol concentrations were measured at baseline and at regular intervals after the TSST-C. Continuous measurements of heart rate, finger blood pressure, stroke volume, cardiac output and systemic vascular resistance were carried out before, during and for 10 minutes after the TSST-C using a finger cuff. Cortisol concentrations [mean increment (SD): 6.1 (6.9) ng/mL], heart rate [4.6 (10.1) bpm], systolic [24.2 (11.6) mmHg] and diastolic blood pressure [16.5 (7.3) mmHg], cardiac output [0.6 (0.7) L/min], stroke volume [4.0 (5.6) mL] and systemic vascular resistance [225 (282) dyn.s/cm5] increased significantly (P<0.001) from baseline after inducing stress. The TSST-C produces stress responses in Indian adolescents of a sufficient magnitude to be a useful tool for examining stress physiology and its relationships to disease outcomes in this population.

ESTIMATION OF WOOD PRODUCTION SPATIAL DISTRIBUTION IN THE HIGH FOREST ON IGMAN MOUNTAIN

UDK: 630*52/*56:528.8(234.422 Igman)&#x0D; Information about quantitative and qualitative forest attributes are the base for successful forest planning and management. Forest inventories collect number of data used for different estimations from large (management unit level) to small (forest stand) scales. Then, control sampling has to be done in order to confirm regularity of terrestrial work. Such sample becomes data source too. Recent approach for forest characterization includes all available information as sources for additional non-standard insight. Here were used available data about wood volume and increment from control sample for high forest on mountain Igman. Also, recent Landsat TM image from vegetation period was available and used in this research. Here is applied k nearest neighbor’s estimation method. Five nearest neighbors and Euclidian distance is chosen for estimation and mapping. Biases for all forest attributes were non-significant. Obtain results show non significant differences between means and observed and estimated distributions of wood volume and increment. It is estimated higher mean wood volume and increment of broadleaves while means for conifers and totals are lower. That higher wood volume and increment is estimated in all diameter classes for broadleaves while lower quantities are estimated for conifers. Spatial mapping presents distribution of wood volume and increment respecting variability of vegetation in high forest on Igman.

European beech grows better and is less drought sensitive in mixed than in pure stands: tree neighbourhood effects on radial increment

Tree neighbourhood can affect the radial increment of Fagus sylvatica and its sensitivity to environmental fluctuation, which partly depends on soil clay content and species identity of the neighbours. In a temperate deciduous forest, we analysed the tree ring chronologies of 152 Fagus sylvatica L. target trees from tree neighbourhoods varying in species composition and tree diversity. We hypothesised that the species identity of the neighbour trees influences radial stem increment and environmental sensitivity of growth of the target trees. Further, we postulated that the effect was stronger under low abiotic stress as expressed by soil clay content and that beech individuals could have a higher wood production in mixed than in monospecific stands. We measured radial increment and analysed the growth response to, and recovery from, selected stress events. Fagus trees in a neighbourhood with more than 30 % of the canopy’s ‘influence sphere’ occupied by allospecific trees had a higher mean stem increment, a lower increment sensitivity to environmental fluctuation and a smaller growth depression after the 1976 drought than beech trees surrounded by conspecific trees. We found that the neighbours’ identity can influence beech growth: positive effects on mean increment and a reduced sensitivity were found for Tilia, Fraxinus and Acer neighbourhoods, but not for Quercus neighbourhoods. The growth-promoting effect was significant on clay-poorer soil, but not on clay-richer soil. Tree species diversity in the neighbourhood tended to correlate positively with mean stem growth and negatively with the sensitivity to environmental fluctuation. We conclude that the neighbourhood of a tree can influence its mean stem increment and growth sensitivity to environmental fluctuation in temperate mixed forests with the effect partly depending on the neighbours’ species identity.

DI-084 Acenocoumarol drug interactions in hospitalised patients

BackgroundAcenocoumarol interacts with widely-used drugs. In many cases, the result is an increase in the International Normalised Ratio (INR) which can have a significant clinical effect on patients.PurposeTo determine the...

Phenology of Annulus Formation in Walleye and Smallmouth Bass Otoliths

Walleye Sander vitreus and smallmouth bass Micropterus dolomieu were sampled monthly (May-October) from Lake Sharpe, South Dakota during 2006 and 2007 to estimate the timing of otolith annulus formation and to evaluate the influence of fish age, sex, and sample location (walleye only) on the timing and detection of annulus formation. Tim- ing of annulus formation was evaluated using marginal increment analysis. Walleye samples were stratified by age, sex, and sample location (i.e., upper and lower Lake Sharpe) and smallmouth bass samples were stratified by age and sex. Monthly mean marginal increment measurements for both species generally increased from May to June, declined in July, and slowly increased from August to October. Although monthly differences in marginal increment measurements across analysis strata were rarely consistent, July generally had the lowest mean marginal increment across species and strata, suggesting that annulus formation in walleye and smallmouth bass in Lake Sharpe likely occurs in July. The lack of dif- ferences in timing of annulus formation across species-specific strata was surprising given the well-known influences of age, sex, and water temperature on somatic growth. Nonetheless, results will aid managers in improving the accuracy of age estimates.

Estudo da Prevalência de Anomalias Cromossómicas em Abortamentos Espontâneos ou Mortes Fetais

Spontaneous abortion is one of the most frequent problems of pregnancy, estimated to affect, at least, one in every four women who tries to conceive. The main purpose of this work was to study the prevalence of chromosomal abnormalities in gestational losses, evaluating their relation with maternal age, gestational age and previous abortion history. Retrospective study of 401 pregnancy loss cases that have gone through cytogenetic and anatomopathologic analysis between January 2008 and June 2012, in Centro Hospitalar de S. João, Oporto. Of the 401 cases sent to cytogenetic study, it was possible to obtain information about the chromosomal complement in 333 cases, of which 72.7% showed normal karyotype, and 27.3% abnormal karyotype. Aneuploidies represented 92.3% of the identified chromosomopathies, with trisomies being the most frequent, related with an advanced maternal age and an early gestational age. There was no agreement between the results of the cytogenetic and the anatomopathologic analysis. The prevalence of chromosomal abnormalities, during the first trimester, is similar between sporadic and recurrent miscarriages. With increased maternal age, trisomies, the most frequent type of aneuploidy, are more likely to occur, with a mean increment in probability of 7.4% per year. A significant karyotype-pathological correlation was not established. Maternal contamination is the main obstacle to the accurate determination of the prevalence of chromosomal abnormalities. The molecular cytogenetic techniques already available can overcome the limitations of the conventional technique.

Azospirillum Inoculation Alters Nitrate Reductase Activity and Nitrogen Uptake in Wheat Plant under Water Deficit Conditions

Water deficit stress usually diminishes nitrogen uptake by plants. There are evidences that some nitrogen fixing bacteria can alleviate this stress by supplying nitrogen and improving its metabolism in plants. Four Azospirillum strains, A. lipoferum AC45-II, A. brasilense AC46-I, A. irakense AC49-VII and A. irakense AC51-VI were tested for nitrate reductase activity (NRA). In a pot culture experiment using a sandy loam soil, wheat plants ( Triticum aestivum L. cv. Sardari) were inoculated with these bacterial strains and three ranges of soil water potential (W1: -10 to -20, W2: -40 to -50 and W3: -65 to -75 kPa) were applied to the pots. All strains were positive in NRA test and the highest (7.63mg NO 2 -N.L -1 .48h -1 ) was recorded for AC49-VII and the least (0.23mg NO 2 -N.L -1 .48h -1 ) was belong to AC51-VI. Leaf and root NRA, root and shoot nitrogen concentrations, and dry weights of root and shoot decreased by increasing water deficit stress. All four bacterial strains caused a significant enhancement in root NRA and in each water deficit level, the higher root NRA was recorded in AC46-I and AC49-VII inoculated plants. The highest leaf NRA was achieved by AC49-VII. The mean increment of root NRA by bacterial strains was 171% compared to the non-bacterial plants. Moreover, at the highest level of water deficit stress, the highest dry weight and nitrogen concentration in root and shoot were obtained by AC46-I and AC49-VII treatments.

Occupational exposure to airborne lead in Brazilian police officers

Shooting with lead-containing ammunition in indoor firing ranges is a known source of lead exposure in adults. Police officers may be at risk of lead intoxication when regular training shooting exercises are yearly mandatory to law enforcement officers. Effects on health must be documented, even when low-level elemental (inorganic) lead exposure is detected. Forty police officers (nineteen cadets and twenty-one instructors) responded to a questionnaire about health, shooting habits, and potential lead exposure before a training curse. Blood samples were collected and analyzed for blood lead level (BLL) before and after a three days training curse. The mean BLL for the instructors' group was 5.5 μg/dL ± 0.6. The mean BLL for the cadets' group before the training was 3.3 μg/dL ± 0.15 and after the training the main BLL was 18.2 μg/d L± 1.5. Samples were analyzed by Inductively Coupled Plasma Mass Spectrometer (ICP-MS). All the participants in the training curse had significantly increased BLL (mean increment about 15 μg/dL) after the three days indoor shooting season. In conclusion, occupational lead exposure in indoor firing ranges is a source of lead exposure in Brazilian police officers, and appears to be a health risk, especially when heavy weapons with lead-containing ammunition are used in indoor environments during the firing training seasons.

Production of Douglas-Fir in the Czech Republic based on national forest inventory data

This article summarizes basic estimates of productivity and trend analysis of one of the principal introduced forest tree species in the Czech Republic, i.e. Douglas-fir (Pseudotsuga menziesii [Mirbel] Franco). As a comparison, we also examine grand fir (Abies grandis [D. Don] Lindl), northern red oak (Quercus rubra L. syn. Quercus borealis Michx.) and black locust (Robinia pseudoacacia L). This paper presents estimates of forest land area, standing volume, annual and total increments, distribution of age classes, average ages and site indexes for the period 1979&amp;ndash;2010. All data were obtained from the national forest inventory of the Czech Republic. Korf&amp;rsquo;s growth function was used for the assessment of current and mean annual increments (CAI, MAI) of Douglas-fir compared to other tree species. Our results suggest a decline in the annual area afforested by Douglas-fir, as influenced by the State administration management choices, a low rate of an increase in the forest land area, increasing average age of the forests. On the other hand, we observed a dramatic increase in the standing volume as well as high annual increments in volume. Douglas-fir is the most productive major tree species in the Czech Republic and there is a great potential to expand its use throughout the country.

Evidence from a breast cancer hypofractionated schedule: late skin toxicity assessed by ultrasound

BackgroundFeasibility of whole breast hypofractionated radiotherapy schedules in breast conserving therapy is recognized however concerns remain about the role of the boost dose on the overall treatment’s potential toxicity. In this study we report on the possibility to quantitatively evaluate radiation induced toxicity in patients treated with an abbreviated course with major concern in the irradiated boost region.MethodsEighty-nine patients who underwent conservative surgery for early-stage breast cancer followed by adjuvant accelerated hypofractionated whole breast radiotherapy were included in this study to assess skin and subcutaneous tissue late toxicity by means of ultrasonographic quantitative examination. For each patient the skin thickness was measured at four positions: on the irradiated breast, in the boost region and in the corresponding positions in the contra-lateral not treated breast. All patients were scanned by the same radiologist to reduce potential inter-operator variability, the operator was blind to the scoring of the patient CTCv3 late toxicity as well as patient treatment characteristics. Ultrasound assessment and clinical evaluation were compared.ResultsThe median time between the end of adjuvant radiotherapy and ultrasound examination was 20.5 months. The measured mean skin thickness in the irradiated breast was 2.13 ± 0.72 mm while in the mirror region of the contra-lateral healthy breast was 1.61 ± 0.29 mm. The measured mean skin thickness in the irradiated boost region was 2.25 ± 0.79 mm versus 1.63 ± 0.33 mm in the corresponding region of contra-lateral healthy breast. The mean increment in skin thickness respect to the counterpart in the healthy breast was 0.52 ± 0.67 mm and 0.62 ± 0.74 mm for the breast and the boost region respectively. A significant direct correlation was found between the increment in skin thickness in the irradiated breast and in the boost region with fibrosis (G ≥ 1).ConclusionsIn this study results from a breast cancer hypofractionated schedule in terms of late skin toxicity are reported. In particular our study confirms that late cutaneous reactions can be reliably assed by ultrasonographic examination, also discriminating between regions irradiated at different doses, and that this instrumental evaluation is in agreement with clinical stated toxicity.

Safety and efficacy of total dose infusion of 1,020 mg of ferumoxytol administered over 15 min

For the majority of patients with iron deficiency anemia (IDA), a full course of intravenous (IV) iron is 1 g. Most IV irons require 5-10 administrations of 100-300 mg. We have successfully employed 1 g low molecular weight iron dextran over 1 hr. For further convenience for patients and physicians, we explored the administration of 1.02 g of ferumoxytol over 15 min instead of the approved 2 × 510 mg injections. Sixty patients with IDA, (hemoglobin <11 g/dL, transferrin saturation [TSAT] ≤20%, and ferritin <100 ng/mL) with an inadequate response or intolerance to oral iron, received 1020 mg ferumoxytol over 15 min. Vital signs were measured for 1 hr. Adverse events (AEs) were collected via telephone at 1, 2, and 7 days. Follow-up visits occurred at 4 and 8 weeks for efficacy assessments. The primary endpoint was safety and tolerability. Secondary efficacy endpoints included mean change in hemoglobin, TSAT, and red cell distribution width. No serious adverse events (SAEs) occurred. Fifty-eight patients received the planned dose. Twenty-six out of sixty (43.3%) patients reported AEs of which 13 were mild and transient during infusion. All resolved within minutes. Fourteen patients reported self-limited arthralgias, myalgias, and/or headache within 24-48 hr. At Baseline, the mean hemoglobin was 9.4 g/dL. The mean increments at Week 4 and 8 were 2.1 and 2.6 g/dL, respectively. Ferumoxytol, administered as 1.02 g infusion over 15 min was well tolerated with no SAEs and demonstrated excellent efficacy. If corroborated in future studies this represents an improved method of treating IDA.

Substantial reduction in caries from regular fluoride varnish application

The Cochrane Oral Health Group's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase, CINAHL, LILACS and BBO, ProQuest Dissertations and Theses, Web of Science Conference Proceedings and ClinicalTrials.gov databases were searched. Reference lists of identified articles were also scanned for relevant papers. Study authors were contacted for additional information. Randomised or quasi-randomised controlled trials using or indicating blind outcome assessment that compared fluoride varnish to placebo or no treatment for at least one year were included. Risk of bias assessment was undertaken. Study assessment and data extraction was carried out independently by at least two reviewers. The primary measure of effect was the prevented fraction, that is the difference in mean caries increments between the treatment and control groups expressed as a percentage of the mean increment in the control group. The caries increments nearest to three years were used from each included study. Random-effects meta-analyses were performed where data could be pooled. Potential sources of heterogeneity were examined in random-effects meta-regression analyses. Adverse effects information was collected from the included trials. Twenty-two trials (12,455 participants) were included. Thirteen trials were included in the permanent tooth surfaces meta-analysis, the pooled D(M)FS prevented fraction estimate comparing fluoride varnish with placebo or no treatment was 43% (95% confidence interval (CI) 30% to 57%; P < 0.0001). There was substantial heterogeneity, confirmed statistically (P < 0.0001; I(2) = 75%), however this body of evidence was assessed as of moderate quality. Ten trials contributed to the meta-analysis of primary teeth, the pooled d(e/m)fs prevented fraction estimate was 37% (95% CI 24% to 51%; P < 0.0001), there was some heterogeneity (P = 0.009; I(2) = 59%) this evidence was assessed as of moderate quality. No significant associations in either dentitions were found with baseline caries severity, background exposure to fluorides, application features such as prior prophylaxis, concentration of fluoride or frequency of application. There was little information concerning possible adverse effects or acceptability of treatment. The conclusions of this updated review remain the same as when it was first published. The review suggests a substantial caries inhibiting effect of fluoride varnish in both permanent and primary teeth; however the quality of the evidence was assessed as moderate, as it included mainly high risk of bias studies, with considerable heterogeneity.

A randomized controlled trial of peripheral blood mononuclear cell depletion in experimental human lung inflammation.

Depletion of monocytes reduces LPS-induced lung inflammation in mice, suggesting monocytes as potential therapeutic targets in acute lung injury. To investigate whether depletion of circulating blood monocytes has beneficial effects on markers of systemic and pulmonary inflammation in a human model of acute lung inflammation. A total of 30 healthy volunteers were enrolled in a randomized controlled trial. Volunteers inhaled LPS at baseline, and were randomized to receive active mononuclear cell depletion by leukapheresis, or sham leukapheresis, in a double-blind fashion (15 volunteers per group). Serial blood counts were measured, bronchoalveolar lavage (BAL) was performed at 9 hours, and [(18)F]fluorodeoxyglucose positron emission tomography at 24 hours. The primary endpoint was the increment in circulating neutrophils at 8 hours. As expected, inhalation of LPS induced neutrophilia and an up-regulation of inflammatory mediators in the blood and lungs of all volunteers. There was no significant difference between the depletion and sham groups in the mean increment in blood neutrophil count at 8 hours (6.16 × 10(9)/L and 6.15 × 10(9)/L, respectively; P = 1.00). Furthermore, there were no significant differences in BAL neutrophils or protein, positron emission tomography-derived measures of global lung inflammation, or cytokine levels in plasma or BAL supernatant between the study groups. No serious adverse events occurred, and no symptoms were significantly different between the groups. These findings do not support a role for circulating human monocytes in the early recruitment of neutrophils during LPS-mediated acute lung inflammation in humans.

Preventive effects of conservative treatment with short-term teriparatide on the progression of vertebral body collapse after osteoporotic vertebral compression fracture

The progression of fractured vertebral collapse is not rare after a conservative treatment of vertebral compression fracture (VCF). Teriparatide has been shown to directly stimulate bone formation and improve bone density, but there is a lack of evidence regarding its use in fracture management. Conservative treatment with short-term teriparatide is effective for decreasing the progression of fractured vertebral body collapse. Few studies have reported on the prevention of collapsed vertebral body progression after osteoporotic VCF. Teriparatide rapidly enhances bone formation and increases bone strength. This study evaluated preventive effects of short-term teriparatide on the progression of vertebral body collapse after osteoporotic VCF. Radiographs of 68 women with single-level osteoporotic VCF at thoracolumbar junction (T11-L2) were reviewed. Among them, 32 patients were treated conservatively with teriparatide (minimum 3 months) (group I), and 36 were treated with antiresorptive (group II). We measured kyphosis and wedge angle of the fractured vertebral body, and ratios of anterior, middle, and posterior heights of the collapsed body to posterior height of a normal upper vertebra were determined. The degree of collapse progression was compared between two groups. The progression of fractured vertebral body collapse was shown in both groups, but the degree of progression was significantly lower in group I than in group II. At the last follow-up, mean increments of kyphosis and wedge angle were significantly lower in group I (4.0° ± 4.2° and 3.6° ± 3.6°) than in group II (6.8° ± 4.1° and 5.8° ± 3.5°) (p = 0.032 and p = 0.037). Decrement percentages of anterior and middle border height were significantly lower in group I (9.6 ± 10.3 and 7.4 ± 7.5 %) than in group II (18.1 ± 9.7 and 13.8 ± 12.2 %) (p = 0.001 and p = 0.025), but not in posterior height (p = 0.086). In female patients with single-level osteoporotic VCF at the thoracolumbar junction, short-term teriparatide treatment did not prevent but did decrease the progression of fractured vertebral body collapse.

Fluoride varnishes for preventing dental caries in children and adolescents.

Topically-applied fluoride varnishes have been used extensively as an operator-applied caries-preventive intervention for over three decades. This review updates the first Cochrane review of fluoride varnishes for preventing dental caries in children and adolescents, which was first published in 2002. To determine the effectiveness and safety of fluoride varnishes in preventing dental caries in children and adolescents, and to examine factors potentially modifying their effect. We searched the Cochrane Oral Health Group's Trials Register (to 13 May 2013), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2013, Issue 4), MEDLINE via OVID (1946 to 13 May 2013), EMBASE via OVID (1980 to 13 May 2013), CINAHL via EBSCO (1980 to 13 May 2013), LILACS and BBO via the BIREME Virtual Health Library (1980 to 13 May 2013), ProQuest Dissertations and Theses (1861 to 13 May 2013), and Web of Science Conference Proceedings (1945 to 13 May 2013). A search for ongoing trials was undertaken on ClinicalTrials.gov on 13 May 2013. There were no restrictions on language or date of publication in the search of the electronic databases. Randomised or quasi-randomised controlled trials with blind outcome assessment used or indicated, comparing topically-applied fluoride varnish with placebo or no treatment in children up to 16 years during at least one year. The main outcome was caries increment measured by the change in decayed, missing and filled tooth surfaces in both permanent (D(M)FS) and primary (d(e/m)fs) teeth. At least two review authors assessed all search results, extracted data and undertook risk of bias independently. Study authors were contacted for additional information. The primary measure of effect was the prevented fraction, that is the difference in mean caries increments between the treatment and control groups expressed as a percentage of the mean increment in the control group. The caries increments nearest to three years were used from each included study. Random-effects meta-analyses were performed where data could be pooled. Potential sources of heterogeneity were examined in random-effects meta-regression analyses. Adverse effects information was collected from the included trials. Twenty-two trials with 12,455 participants randomised (9595 used in analyses) were included. For the 13 that contributed data for the permanent tooth surfaces meta-analysis, the pooled D(M)FS prevented fraction estimate comparing fluoride varnish with placebo or no treatment was 43% (95% confidence interval (CI) 30% to 57%; P < 0.0001). There was substantial heterogeneity, confirmed statistically (P < 0.0001; I(2) = 75%), however this body of evidence was assessed as of moderate quality. The pooled d(e/m)fs prevented fraction estimate was 37% (95% CI 24% to 51%; P < 0.0001) for the 10 trials that contributed data for the primary tooth surfaces meta-analysis, also with some heterogeneity (P = 0.009; I(2) = 59%). Once again this body of evidence was assessed as of moderate quality. No significant association between estimates of D(M)FS or d(e/m)fs prevented fractions and the pre-specified factors of baseline caries severity, background exposure to fluorides, application features such as prior prophylaxis, concentration of fluoride, frequency of application were found. There was also no significant association between estimates of D(M)FS or d(e/m)fs prevented fractions and the post hoc factors: whether a placebo or no treatment control was used, length of follow-up, or whether individual or cluster randomisation was used, in the meta-regression models. A funnel plot of the trials in the main meta-analyses indicated no clear relationship between prevented fraction and study precision. In both methods, power is limited when few trials are included. There was little information concerning possible adverse effects or acceptability of treatment. The conclusions of this updated review remain the same as those when it was first published. The review suggests a substantial caries-inhibiting effect of fluoride varnish in both permanent and primary teeth, however the quality of the evidence was assessed as moderate, as it included mainly high risk of bias studies, with considerable heterogeneity.

FRI0280 Cd4+cd25highfoxp3+ t regulatory cells as a biomarker of disease activity in systemic lupus erythematosus: a prospective study

BackgroundLow numbers of T regulatory cells (Tregs) in active systemic lupus erythematosus (SLE) are believed to reflect the breakdown of immune tolerance in disease pathogenesis. However, it is not clear...

Plasma total homocysteine is associated with abdominal aortic aneurysm and aortic diameter in older men

This study was conducted to determine whether plasma total homocysteine (tHcy) and the methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism are associated with abdominal aortic aneurysm (AAA) and aortic diameter. This was a cross-sectional study set in Western Australia of 4248 community-dwelling men aged 70 to 88 years. Infrarenal aortic diameter was measured using ultrasound scan, tHcy was measured by immunoassay, and MTHFR 677T polymorphism was detected by polymerase chain reaction. Adjusted multinomial logistic regression analysis showed the odds of having an AAA (aortic diameter ≥ 30 mm) for men with high tHcy (≥ 15 μmol/L) compared with those with normal tHcy (<15 μmol/L) was 1.45 (95% confidence interval [CI], 1.10-1.91). Every 5-μmol/L increment in tHcy was associated with 0.15-mm (95% CI, 0.01-0.28 mm) increase in mean aortic diameter. The tHcy concentration was higher in MTHFR TT homozygote individuals than in wild-type CC individuals. There was, however, no apparent association between MTHFR C677T polymorphism with AAA (TT vs CC genotype: odds ratio, 0.97; 95% CI, 0.72-1.31) or aortic diameter (TT vs CC genotype: mean increment of 0.01 mm; 95% CI, -0.63 to 0.65 mm). Elevated tHcy is associated with the presence of AAA in older men. There is also a positive dose-response relationship between tHcy and abdominal aortic diameter. Longitudinal studies and clinical trials of lowering tHcy are required to assess whether these relationships are causal.

Durable Efficacy and Safety of Raltegravir Versus Efavirenz When Combined With Tenofovir/Emtricitabine in Treatment-Naive HIV-1–Infected Patients

STARTMRK, a phase III noninferiority trial of raltegravir-based versus efavirenz-based therapy in treatment-naive patients, remained blinded until its conclusion at 5 years. We now report the final study results. Previously untreated patients without baseline resistance to efavirenz, tenofovir, or emtricitabine were eligible for a randomized study of tenofovir/emtricitabine plus either raltegravir or efavirenz. Yearly analyses were planned, with primary and secondary end points stipulated at weeks 48 and 96, respectively. The primary efficacy outcome was the percentage of patients with viral RNA (vRNA) levels <50 copies per milliliter counting noncompleters as failures (NC=F). Changes from baseline CD4 count were computed using an observed-failure approach to missing data. No formal hypotheses were formulated for testing at week 240. Overall, 71 of 281 raltegravir recipients (25%) and 98 of 282 efavirenz recipients (35%) discontinued the study; discontinuations due to adverse events occurred in 14 (5%) and 28 (10%) patients in the respective groups. In the primary NC=F efficacy analysis at week 240, 198 of 279 (71.0%) raltegravir recipients and 171 of 279 (61.3%) efavirenz recipients had vRNA levels <50 copies per milliliter, yielding a treatment difference {Δ [95% confidence interval (CI)] = 9.5 (1.7 to 17.3)}. Generally comparable between-treatment differences were seen in both the protocol-stipulated sensitivity analyses and the prespecified subgroup analyses. The mean (95% CI) increments in baseline CD4 counts at week 240 were 374 and 312 cells per cubic millimeter in the raltegravir and efavirenz groups, respectively [Δ(95% CI) = 62 (22 to 102)]. Overall, significantly fewer raltegravir than efavirenz recipients experienced neuropsychiatric side effects (39.1% vs 64.2%, P < 0.001) or drug-related clinical adverse events (52.0% vs 80.1%, P < 0.001). In this exploratory analysis of combination therapy with tenofovir/emtricitabine in treatment-naive patients at week 240, vRNA suppression rates and increases in baseline CD4 counts were significantly higher in raltegravir than efavirenz recipients. Over the entire study, fewer patients experienced neuropsychiatric and drug-related adverse events in the raltegravir group than in the efavirenz group. Based on better virologic and immunologic outcomes after 240 weeks, raltegravir/tenofovir/emtricitabine seemed to have superior efficacy compared with efavirenz/tenofovir/emtricitabine.

Polysaccharide-based polyelectrolytes hollow microcapsules constructed by layer-by-layer technique

Two water-soluble polysaccharide derivatives, carboxymethylated and quarternized glucans (CMGP and QGP) were synthesized for the first time from water-insoluble polysaccharides (GP) extracted from Ganoderma lucidum. Hollow microspheres were constructed using electrostatic layer-by-layer (LbL) deposition of the CMGP and QGP polyelectrolytes onto colloidal ZnO particles followed by the core decomposition with an acid solution. The structures of the multilayered CMGP/QGP microspheres were investigated by transmission electron microscopy (TEM), zeta potential and dynamic light scattering (DLS). The results revealed that the multilayer thickness increased regularly from 48 to 145nm as the number of deposited CMGP/QGP layers was increased from two to seven, and the mean increment of thickness was ∼25nm per layer, reflecting the high regularity of the layer-by-layer assembly. This work provided an easy method to construct hollow microcapsules with biocompatibility and controlled dimensions.

Preliminary evaluations of FGOALS-g2 for decadal predictions

The Flexible Global Ocean-Atmosphere-Land System model, Grid-point Version 2 (FGOALS-g2) for decadal predictions, is evaluated preliminarily, based on sets of ensemble 10-year hindcasts that it has produced. The results show that the hindcasts were more accurate in decadal variability of SST and surface air temperature (SAT), particularly in that of Nino3.4 SST and China regional SAT, than the second sample of the historical runs for 20th-century climate (the control) by the same model. Both the control and the hindcasts represented the global warming well using the same external forcings, but the control overestimated the warming. The hindcasts produced the warming closer to the observations. Performance of FGOALS-g2 in hindcasts benefits from more realistic initial conditions provided by the initialization run and a smaller model bias resulting from the use of a dynamic bias correction scheme newly developed in this study. The initialization consists of a 61-year nudging-based assimilation cycle, which follows on the control run on 01 January 1945 with the incorporation of observation data of upper-ocean temperature and salinity at each integration step in the ocean component model, the LASG IAP Climate System Ocean Model, Version 2 (LICOM2). The dynamic bias correction is implemented at each step of LICOM2 during the hindcasts to reduce the systematic biases existing in upper-ocean temperature and salinity by incorporating multi-year monthly mean increments produced in the assimilation cycle. The effectiveness of the assimilation cycle and the role of the correction scheme were assessed prior to the hindcasts.