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Re-interpreting anaerobic metabolism: an argument for the application of both anaerobic glycolysis and excess post-exercise oxygen comsumption (EPOC) as independent sources of energy expenditure.

Due to current technical difficulties and changing cellular conditions, the measurement of anaerobic and recovery energy expenditure remains elusive. During rest and low-intensity steady-state exercise, indirect calorimetric measurements successfully represent energy expenditure. The same steady-state O2 uptake methods are often used to describe the O2 deficit and excess post-oxygen consumption (EPOC): 1 l O2 = 5 kcal = 20.9 kJ. However, an O2 deficit plus exercise O2 uptake measurement ignores energy expenditure during recovery, and an exercise O2 uptake plus EPOC measurement misrepresents anaerobic energy expenditure. An alternative solution has not yet been proposed. Anaerobic glycolysis and mitochondrial respiration are construed here as a symbiotic union of metabolic pathways, each contributing independently to energy expenditure and heat production. Care must be taken when using O2 uptake alone to quantify energy expenditure because various high-intensity exercise models reveal that O2 uptake can lag behind estimated energy demands or exceed them. The independent bioenergetics behind anaerobic glycolysis and mitochondrial respiration can acknowledge these discrepancies. Anaerobic glycolysis is an additive component to an exercise O2 uptake measurement. Moreover, it is the assumptions behind steady-state O2 uptake that do not permit proper interpretation of energy expenditure during EPOC; 1 l O2 not = 20.9 kJ. Using both the O2 deficit and a modified EPOC for interpretation, rather than one or the other, leads to a better method of quantifying energy expenditure for higher intensity exercise and recovery.

Anaerobiosis↗

Telephotoscreening to detect retinopathy of prematurity: preliminary study of the optimum time to employ digital fundus camera imaging to detect ROP.

PURPOSE: Labor-intensive screening of infants in the neonatal intensive care units is the only way presently to detect retinopathy of prematurity (ROP). Our purpose is to determine if RetCam 120 images (Massie Research Laboratories, Inc, Dublin, Calif), acquired by a neonatal nurse, can be used to screen for ROP by performing 2 screening sessions, at 32 to 34 weeks' (examination 1) and 38 to 40 weeks' (examination 2) postconceptional age. METHODS: RetCam examinations were performed by a nurse on infants at examination 1 and examination 2 intervals. At the same time, an examination was performed by an experienced ophthalmologist. Masked readers evaluated the digital images for the presence of ROP and, if ROP was present, estimated the risk of that eye progressing to prethreshold or threshold disease. The data were compared to the eye's clinical course. RESULTS: A total of 46 eyes were assessed at examination 1 and 50 eyes at examination 2 from July 1, 1999, to December 15, 1999. For detecting ROP, the sensitivity and specificity were 46% and 100% for examination 1 and 76% and 100% for examination 2. Sensitivity and specificity of predicting prethreshold was 64% and 97%, respectively, for examination 1 and 2. Sensitivity for predicting ROP threshold at examination 1 was 0% (only 1 photo was available for grading of sensitivity) and specificity for predicting ROP threshold at examination 1 was 95%. At examination 2, sensitivity and specificity were 100%. CONCLUSION: The RetCam examination had insufficient sensitivity to be recommended as a substitute for indirect ophthalmoscopy in screening for ROP. Reasons for low sensitivity are the technical limitation of the camera design itself, which creates difficulty in photographing the peripheral retina in small eyes, and the need for a lid speculum better adapted to the contact camera optical system design. Both of these issues are being addressed as part of an ongoing project to study the feasibility of employing telemetry of digital fundus images from remote, underserved neonatal intensive care units to ophthalmologists capable of diagnosing ROP.

Diagnostic Techniques, Ophthalmological↗

Recent and future evolutions in NeuroSPECT with particular emphasis on the synergistic use and fusion of imaging modalities.

Recent and future evolutions in neuroSPECT apply to radiopharmaceuticals techniques and the synergistic use of different imaging modalities in the work-up of neurological disorders. The introduction of Technetium labelled perfusion tracers, which could pass the intact blood-brain barrier, together with the implementation of the tomographic principle, by making the conventional gamma camera rotating, enabled estimation of regional cerebral blood flow and indirectly of local brain metabolism. In addition at present Thallium-201 and Tc-99m sestaMIBI allow functional detection of viable tumor tissue, without interference from previous surgery or radiotherapy as seen using CT-scan or MRI. In neurology this has led to the recognition of SPECT by the American Academy of Neurology (Therapeutics and technology subcommittee) as an established or promising tool in major neurological disorders such as dementia, stroke and epilepsy, while other domains such as brain oncology are considered investigational. With regard to radiopharmaceuticals, recent evolutions mainly include the development of mostly Iodine-123 labelled receptor ligands, some of which are already commercially available. For instrumentation advances consist e.g. of multidetector systems equipped with fanbeam collimators, attenuation and scatter correction or coincidence detection. Given the present role for nuclear neurology it may be expected that these additional radiopharmaceutical and technical innovations will continue to stimulate the development of SPECT of the brain. The synergistic use of several imaging techniques such as CT, (functional) MRI, source imaging, SPECT and PET represents a multimodal holistic approach to probe cerebral functions for research and clinical purposes. Clinical indications, in which this synergistic use is illustrated include e.g. support of the clinical diagnosis of dementia of the Alzheimer type, presurgical ictal detection of seizure focus, detection of acute ischemia and differential diagnosis between radiation necrosis and brain tumor recurrence. The synergistic use of imaging modalities, optimally applied using image fusion, allows to overcome the intrinsic limitations and to enhance the specific advantages of the different approaches as it leads to increased precision and accuracy, as well for spatial anatomofunctional correlation as for quantification.

Alzheimer Disease↗

Evaluating the adequacy of maximum contaminant levels as health-protective cleanup goals: an analysis based on Monte Carlo techniques.

At many sites in the United States, health-based remediation goals for contaminated groundwater have been set at levels far below USEPA's drinking water standards (i.e., maximum contaminant levels or MCLs). This is due to the fact that, while the USEPA must often consider technical and economic factors (e.g., cost of compliance, risk/benefit analysis) when setting MCLs for public water systems, cleanup goals for contaminated groundwater are often based solely on conservative "point" estimates of exposure. One of the more recent refinements in the risk assessment process is the use of ranges of exposure estimates or "probability density functions" (PDFs), rather than fixed point estimates, to estimate exposure and chemical uptake. This approach provides a more thorough description of the range of potential risks, rather than a single "worst-case" value, and allows one to understand the conservatism inherent in assessments based on regulatory default parameters. This paper uses a number of PDFs and the Monte Carlo technique to assess whether the USEPA's MCLs for drinking water are sufficiently low to protect persons exposed to these levels. A case study involving daily exposure to tapwater containing MCL concentrations of tetrachloroethylene, chloroform, bromoform, and vinyl chloride is presented. Several direct and indirect exposure pathways are evaluated, including inhalation and dermal contact while showering, direct ingestion, and inhalation of emissions from household fixtures and appliances. PDFs for each exposure factor are based on the most recent and applicable data available. Our analysis indicates that the estimated increased cancer risks at the 50th and 95th percentile of exposure are within the range of increased cancer risks typically considered acceptable at Superfund sites (10(-4)-10(-6)). These results suggest that, at least for some chemicals, groundwater need not be cleaned-up to concentrations less than drinking water standards (i.e., MCLs) to protect human health.

Air Pollutants↗

Population growth impacts of zero net international migration.

"In a country such as the United States, the contribution of net international migration to overall population change overshadows the contribution of natural increase.... Some analysts have assumed that if the same number of people leave and enter the country each year, then the effect of net international migration will be zero. This article examines that assumption and shows that it is fallacious. Examining the direct, indirect, total, and negative demographic impacts of zero net international migration through simulations with demographic data, we demonstrate that zero net international migration is not the same and therefore does not have the same demographic results and implications as zero international migration. We conclude that zero net international migration should not be confused with zero international migration."

Americas↗

DENSITY-GRADIENT PATTERNS OF STAPHYLOCOCCUS AUREUS CELLS AND CELL WALLS DURING GROWTH AND MECHANICAL DISRUPTION.

Huff, Eskin (National Institute of Allergy and Infectious Diseases, Bethesda, Md.), Harriet Oxley, and Carol S. Silverman. Density-gradient patterns of Staphylococcus aureus cells and cell walls during growth and mechanical disruption. J. Bacteriol. 88:1155-1162. 1964.-Procedures capable of rapid disruption of Staphylococcus aureus cells with optimal release of intact cell walls were investigated. This search was implemented by observation of the flotation patterns of cells and subcellular particulate matter after centrifugation in a cesium chloride density gradient. A quantitative evaluation of the light-scatter throughtout the gradient was achieved by transfer of the entire density gradient into an optical cell with wedge-shaped cross section. When this cell was photographed under indirect illumination, each band of light-scattering material appeared on the negative as a shaded curve, with an area proportional to amount of that material present. A series of photographs of known amounts of cells and cell walls was used to estimate the amounts of these materials in mixtures of the two occurring during mechanical disruption. With the methods employed, time studies established the optimal time for release of cell walls as 5 min in a Braun shaker. The use of sucrose gradients in the further purification of cell walls, and chemical analysis of the isolated walls, are described.

Bacteriological Techniques↗

World food resources and population: the narrowing margin.

This bulletin examines the narrowing margin between global food production and population growth. Between 1950 and 1971, world grain production nearly doubled and per capita production increased 31%. During the 1970s, gains in output barely kept pace with population growth, consumption/person declined in sub-Saharan Africa and parts of Asia, food prices were volatile, and over 100 food deficit countries came to depend on the exportable surplus of North America, now the only major grain exporting region. The world fish catch levelled off in the early 1970s and beef production, still dependent mainly on grassland grazing, levelled off in the mid-1970s. With little new land left to plow, satisfying increased food demand now depends on sharp increases in yields on existing crop land. Worldwide, this effort is hampered by loss of topsoil and irrigated land, conversion of cropland to nonfarm uses, rising energy costs, inefficient agrarian structures, particularly in the Soviet Union, the falling yield response to chemical fertilizers in agriculturally advanced countries, and the emerging competition between food and agriculturally based energy crops. Green Revolution successes in some developing countries deomonstrate that, given the right inputs, 3rd world farmers can increase crop yields dramatically. Feeding the world's poor also requires more equitable income and food distribution, including a reduction in the proportion of grain and fish consumed indirectly as livestock products by the affluent. Most important in meeting food needs on a finite planet is braking population growth. The author concludes that every effort should be made to stabilize world production at abour 6 billion by 2020, rather than 10.5 billion by 2110, as is now projected by the UN.

Agriculture↗

Estimation of fertility and mortality of the Kuwaiti population.

Indirect techniques are applied to estimate the current level of fertility and mortality among Kuwaiti nationals in Kuwait during 1980-85. The various methods discussed provide estimates in the vicinity of 45 per thousand for birth rate and 8 per thousand for death rate. While child spacing by birth order in Kuwait is about 2 years, the proportion of childlessness is very low (1%). As a consequence of lower mortality and stable high fertility, the Kuwaiti population remains young.

Adolescent↗

[Value of low ionic-strength salt solution in indirect antiglobulin tests with erhythrocytes].

A series of comparative investigations were carried out for estimation of the value of the indirect antiglobulin test (IAT) in the modification of Löw and Messeter in which a suspension of erythrocytes in low ionic-strength salt solution called by the authors LISS, is used for incubation of erythrocytes with tested serum, that is in phase I of this test. The results of these experiments demonstrated a significant superiority of this modification over the conventional techniques, particularly over the tile technique used generally in this country. The IAT-LISE method allows not only phase I to be reduced from 60 to 20 minutes, but increasing the intensity of the reaction it facilitates also detection of blood group antibodies and extends the range of their discovery, which is of particular importance in the compatibility tests before blood transfusion. These results were a basis for routine application of this method nad it was concluded that the IAT-LISS modification should be introduced widely in the Polish serological laboratories. Attention is called to a number of technical details important to obtain reproducible and une quivocal results.

Blood Group Antigens↗

A hazard model analysis examining inferential evidence of migration from the Port-city of Viana do Castelo, Minho, 1834-1931.

"This paper is an attempt to analyse the determinants of out-migration of the elite from the Portuguese city of Viana do Castelo [from 1834-1931]. The data used are derived from a reconstruction of this electorate using record linkage methods. Indirect evidence of emigration is available from passport books, and evidence of death is available with cemetery lists. The paper discusses methodological issues in the estimation of hazard models of duration spent under observation in the elite. The analysis suggests that, while out-migration was not significantly dependent on age, or marital status, there were large occupational differentials, and significant period effects." (SUMMARY IN FRE)

Age Factors↗

The Bali Indirect Maternal Mortality Study.

The Bali Indirect Maternal Mortality Study (BIMMS) was conducted in Bali Province, Indonesia in 1991. The objective of the study was to evaluate the indirect sisterhood method for estimating maternal mortality, using a prospective (direct) community-based survey undertaken from 1980 to 1982 among women of reproductive age (Reproductive Age Mortality Survey, or RAMOS) as a comparison. The BIMMS maternal mortality ratio was 331 per 100,000 live births adjusted for 1982. This ratio is similar to the RAMOS one prior to its adjustment, of 359 per 100,000 live births. The sisterhood method was faster, cheaper, and appears to be as accurate as direct methods.

Adolescent↗

A procedure for RT-PCR amplification of mRNAs on histological specimens.

Detection in combination with localization of low copy gene expression can be difficult to achieve. The use of reverse transcription PCR on tissue sections with a fluorescent marker provides localization of mRNA expression on a cellular level, and when combined with confocal microscopy and image analysis it also allows for an estimate of the relative intensity of fluorescence. A good example of the application of this method is the localization of nerve growth factor (NGF) mRNA expression in the inner ear. NGF through indirect tests appears to be present in this system, yet NGF mRNA could not be localized with in situ hybridization using radiolabeled riboprobes. Using fluorescent in situ RT-PCR, we can easily detect the presence of NGF mRNA and localize it to specific cell types within the maturing inner ear.

Animals↗

Do undocumented migrants earn lower wages than legal immigrants? New evidence from Mexico.

"This article examines the extent to which undocumented status lowers wage rates among immigrants to the United States from four Mexican communities. Regression equations were estimated to determine the effect of legal status on wages independent of other demographic, social and economic variables, and special efforts were made to control for possible sample selection biases. Findings suggest that the data are relatively free from selectivity problems that have characterized earlier studies, and that legal status had no direct effect on wage rates earned by male migrants from the four communities. Legal status also had little effect on the kind of job that migrants take in the United States, but it does play an important indirect role in determining the length of time that migrants stay in that country. By reducing the duration of stay, illegal status lowers the amount of employer-specific capital accruing to undocumented migrants, and thereby lowers wage rates relative to legal migrants." Data are for 1982-1983.

Americas↗

[Verification of two methods of indirectly estimating mortality].

"This paper examines two methods of indirectly estimating mortality: the Bourgeois-Pichat method (estimation of life expectancy at birth), and the Bourbeau and Legare method.... This last method consists of estimating various past mortality measures, for a given population, by examining these same measures as they were observed in certain other populations, during the period in question." These methods are applied to Norwegian data for 1826-1976. The results are then compared with data observed during the same period. The findings are used to evaluate the two methods and assess their advantages and disadvantages. However, the emphasis is on the Bourbeau and Legare method. (summary in ENG, SPA)

Demography↗

Measuring the health status gap for American Indians/Alaska Natives: getting closer to the truth.

OBJECTIVES: We compared the historical method of calculating cancer incidence rates with 2 new methods to determine which approach optimally estimates the burden of cancer among the Northwest American Indian/Alaska Native (AIAN) population. METHODS: The first method replicates the traditional way of calculating race-specific rates, and the 2 new methods use probabilistic record linkages to ascertain cancer cases. We indirectly adjusted all rates to the standard 2000 US population. RESULTS: Whereas the historical cancer incidence rates for all races are more than double those for the AIAN population, this apparent gap is considerably narrower when the all-race rates are compared with AIAN-specific rates calculated with probabilistic linkage methods. Similarly, there is no meaningful difference in incidence rates for selected site- and gender-specific cancers between the AIAN population and all races combined, and, in fact, some of these rates may be higher among the AIAN population. CONCLUSIONS: Our results suggest that the burden of cancer among the AIAN population is considerably higher than was previously understood. We recommend that a standardized approach based on probabilistic linkage methods be adopted and that adequate financial and technical support be made available for conducting routine linkage studies throughout Indian communities.

Adult↗

A framework for estimating causes of death in Indonesia [causes of death in Indonesia].

A number of demographic techniques for the indirect estimation of trends in causes of death in Indonesia are proposed. These involve "the use of rates and proportions derived from other nations experiencing similar levels of mortality to that prevailing in Indonesia. Four sets of estimates were produced, the first based on a regression developed by Preston, the other three derived from national patterns of Mexico, the Philippines, and a composite group of countries. These were compared with available epidemiologic and clinical data from Indonesia to produce a final set of estimates which accord both with known Indonesian patterns and medical findings from other nations."

Asia↗

Heuristic overlap-exchange model of noble gas chemical shifts.

It is now generally recognized that overlap-exchange interactions are the primary cause of the medium-dependent magnetic shielding (chemical shift) in all noble gases except helium, although the attractive electrostatic-dispersion (van der Waals) interactions play an indirect role in determining the penetration of the interacting species into the repulsive overlap-exchange region. The short-range nature of these overlap-exchange interactions, combined with the fact that they often can be approximated by simple functions of the overlap of the wave functions of the interacting species, suggests a useful semiempirical model of these chemical shifts. In it the total shielding is the sum of shieldings due to pairwise interactions of the noble gas atom with the individual atoms of the medium, with the "atomic" shielding terms either estimated by simple functions of the atomic overlap integrals averaged over their Boltzmann-weighted separations, or determined by fits to experimental data in systems whose complexity makes the former procedure impractical. Results for (129)Xe chemical shifts in the noble gases and in a variety of molecular and condensed systems, including families of n-alkanes, straight-chain alcohols, and the endohedral compounds Xe@C(60) and Xe@C(70) are encouraging for the applicability of the model to systems of technical and biomedical interest.

Journal Article↗

Relationship between impact velocity and injuries in fatal pedestrian-car collisions.

The most common type of fatal pedestrian-car collision, i.e. a passenger car with a wedge or pontoon shaped front striking an erect adult with this front, was investigated. A reliable calculation of the impact velocity range by a technical expert and a comprehensive autopsy suitable for traffic accidents were performed in every case. A total of 47 fatalities form the material of this study and the impact velocities varied between 18 and 142 km/h. Primary and secondary injuries did not show a relationship to impact velocity. The occurrence of four types of indirect injuries revealed a clear relationship to impact velocity, i.e. spinal fractures, ruptures of the thoracic aorta, inguinal skin ruptures and dismemberment of the body. Important parameters such as the type of car, impact velocity range and indirect injuries are listed for each individual case. Because of the limited number of cases, the impact velocity ranges (3-30 km/h) instead of mean values were considered. A cautious interpretation of the data can be summarised in the following conclusions: If there is no spinal fracture, the velocity was below 70 km/h and probably below 50 km/h. Aortic and inguinal skin ruptures are always present if the velocity was above 100 km/h but never occurred below 50-60 km/h. If dismemberment occurs, the velocity was above 90 km/h. Consequently, an estimation of the impact velocity from the presence or absence of indirect injuries is possible in pedestrian-car collisions of the type examined. However, the selection criteria applied in this study and additional parameters influencing the collision dynamics have to be considered carefully.

Accidents, Traffic↗