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Biophysical characterization of lithostathine. Evidences for a polymeric structure at physiological pH and a proteolysis mechanism leading to the formation of fibrils.

Lithostathine is a calcium carbonate crystal habit modifier. It is found precipitated under the form of fibrils in chronic calcifying pancreatitis or Alzheimer's disease. In order to gain better insight into the nature and the formation of fibrils, we have expressed and purified recombinant lithostathine. Analytical ultracentrifugation and quasi-elastic light scattering techniques were used to demonstrate that lithostathine remains essentially monomeric at acidic pH while it aggregates at physiological pH. Analysis of these aggregates by electron microscopy showed an apparently unorganized structure of numerous monomers which tend to precipitate forming regular unbranched fibrils. Aggregated forms seem to occur prior to the apparition of fibrils. In addition, we have demonstrated that these fibrils resulted from a proteolysis mechanism due to a specific cleavage of the Arg(11)-Ile(12) peptide bond. It is deduced that the NH(2)-terminal undecapeptide of lithostathine normally impedes fiber formation but not aggregation. A theoretical model explaining the formation of amyloid plaques in neurodegenerative diseases or stones in lithiasis starting from lithostathine is described. Therefore we propose that lithostathine, whose major function is unknown, defines a new class of molecules which is activated by proteolysis and is not involved in cytoskeleton nor intermediate filament functions.

Alzheimer Disease↗

[The health gap in Mexico, measured through child mortality].

OBJECTIVE: To estimate the health gap in Mexico, as evidenced by the difference between the observed 1998 mortality rate and the estimated rate and the estimated rate for the same year according to social and economic indicators, with rates from other countries. MATERIAL AND METHODS: An econometric model was developed, using the 1998 child mortality rate (CMR) as the dependent variable, and macro-social and economic indicators as independent variables. The model included 70 countries for which complete data were available. RESULTS: The proposed model explained over 90% of the variability in CMR among countries. The expected CMR for Mexico was 22% lower that the observed rate, which represented nearly 20,000 excess deaths. CONCLUSIONS: After adjusting for differences in productivity, distribution of wealth, and investment in human capital, the excess child mortality rate suggested efficiency problems in the Mexican health system, at least in relation to services intended to reduce child mortality. The English version of this paper is available at: http://www.insp.mx/salud/index.html.

Delivery of Health Care↗

Relationship between patient variables and plasma clozapine concentrations: a dosing nomogram.

BACKGROUND: Previous work has suggested factors such as gender, smoking behavior, dose, and age affect the amount of drug a patient requires to achieve a desired plasma concentration of clozapine. Plasma clozapine concentrations ranging from 350 to 504 ng/mL in treatment-refractory schizophrenics and schizoaffective patients produce response rates ranging approximately 55-80%. Without the aid of clozapine plasma concentration monitoring, 3-6 months are recommended for a therapeutic clozapine trial. Data suggest that the lag time to response can be reduced by administering a dose that produces a therapeutic clozapine concentration. METHODS: To generate a clozapine dosing nomogram to predict clozapine steady-state plasma concentrations, a cohort of 71 patients was collected via retrospective chart review and/or patient interview. Clozapine steady-state plasma concentrations and demographic variables were obtained. Multiple-linear regression was utilized to examine the relationship between the plasma clozapine concentration and the independent variables. RESULTS: The dosing model that optimally predicted steady-state clozapine plasma concentrations included the variables dose (mg/day), smoking (yes = 0 and no = 1), gender, and a dose-gender interaction variable. The model explained 47% of the variance in the clozapine concentrations (F = 14.42, p < .001, r2 = .47). Two equations, one for male subjects, i.e., clozapine (ng/mL) = 111 (smoke) + 0.464 (dose) + 145, and one for female subjects, i.e., clozapine (ng/mL) = 111 (smoke) + 1.590 (dose)-149, were derived to predict clozapine steady-state plasma concentrations to serve as a clozapine dosing guide for clinicians. CONCLUSIONS: A clozapine dosing nomogram was constructed as a clinical aid to facilitate clozapine dosing.

Adult↗

An explanatory model of older persons' use of dental services. Implications for health policy.

With increasing numbers of people keeping their teeth into their later years, regular dental care should be a health behavior practiced by all older persons. National surveys show, however, that older people use dental services at a much lower rate than other age groups. Even when low-cost dental services are provided, a significant number of eligible elderly do not seek dental care. A survey was conducted among 116 elderly utilizers of low-cost dental services and 142 comparable elderly who had not sought care in 3 or more years. Andersen and Newman's (1973) model was expanded in include attitudes as predisposing factors. The revised model explained 32% of variance in dental utilization; perceived need and two components of attitudes were among the eight significant variables. A follow-up of nonutilizers 6 months later revealed that 27.4% had subsequently sought dental care. The best predictors of the decision to seek care were attitudinal variables, accounting for 21% of the variance. Implications for planning dental services for low-income elderly, developing health education programs, and policies are discussed.

Aged↗

Linking economic activities to the distribution of exotic plants.

The human enterprise is flooding Earth's ecosystems with exotic species. Human population size is often correlated with species introductions, whereas more proximate mechanisms, such as economic activities, are frequently overlooked. Here we present a hypothesis that links ecology and economics to provide a causal framework for the distribution of exotic plants in the United States. We test two competing hypotheses (the population-only and population-economic models) using a national data set of exotic plants, employing a statistical framework to simultaneously model direct and indirect effects of human population and ecological and economic variables. The population-only model included direct effects of human population and ecological factors as predictors of exotics. In contrast, the population-economic model included the direct effects of economic and ecological factors and the indirect effects of human population as predictors of exotics. The explicit addition of economic activity in the population-economic model provided a better explanation for the distribution of exotics than did the population-only model. The population-economic model explained 75% of the variation in the number of exotic plants in the 50 states and provided a good description of the observed number of exotic plants in the Canadian provinces and in other nations in 85% of the cases. A specific economic activity, real estate gross state product, had the strongest positive effect on the number of exotics. The strong influence of economics on exotics demonstrates that economics matter for resolving the exotic-species problem because the underlying causes, and some of the solutions, may lie in human-economic behaviors.

Ecosystem↗

Normative beliefs of health behavior professionals regarding the psychosocial and environmental factors that influence health behavior change related to smoking cessation, regular exercise, and weight loss.

PURPOSE: To examine the degree of consensus among health behavior change professionals regarding the personal and environmental factors they believe most strongly influence health behavior decisions related to smoking cessation, regular exercise, and weight loss. DESIGN: A factorial survey design was implemented. This method combines the positive elements from simple sample surveys and factorial experiment designs. A total of 44 independent psychosocial and environmental variables are used to randomly construct vignettes, or short stories, to collect dependent variable data. SUBJECTS: A probability sample of 311 health behavior change professionals was selected from the Society for Public Health Education, Inc., the Society of Behavioral Medicine, and faculty from the 1986 Harvard University Symposium on Health Promotion in the Work Place. MEASURES: Judgment ratings on the probability that the person described in each vignette would initiate the behavior in question. RESULTS: Multivariate analysis indicates that the multidimensional model explained approximately one half of the variance in the judgments across the three health behaviors (smoking cessation, R2 = .52; weight loss, R2 = .49; and regular exercise, R2 = .49). CONCLUSIONS: These data suggest a high degree of consensus among the sample regarding the personal and environmental factors that influence health behavior judgments. Here, the subjects perceive both behavioral intentions and self-efficacy as the most powerful determinants of judgments to initiate weight loss, regular exercise, and smoking cessation.

Attitude of Health Personnel↗

Effects of external trunk loads on lumbar spine stability.

Stability of the lumbar spine is an important factor in determining spinal response to sudden loading. Using two different methods, this study evaluated how various trunk load magnitudes and directions affect lumbar spine stability. The first method was a quick release procedure in which effective trunk stiffness and stability were calculated from trunk kinematic response to a resisted-force release. The second method combined trunk muscle EMG data with a biomechanical model to calculate lumbar spine stability. Twelve subjects were tested in trunk flexion, extension, and lateral bending under nine permutations of vertical and horizontal trunk loading. The vertical load values were set at 0, 20, and 40% of the subject's body weight (BW). The horizontal loads were 0, 10, and 20% of BW. Effective spine stability as obtained from quick release experimentation increased significantly (p<0.01) with increased vertical and horizontal loading. It ranged from 785 (S.D.=580) Nm/rad under no-load conditions to 2200 (S.D.=1015) Nm/rad when the maximum horizontal and vertical loads were applied to the trunk simultaneously. Stability of the lumbar spine achieved prior to force release and estimated from the biomechanical model explained approximately 50% of variance in the effective spine stability obtained from quick release trials in extension and lateral bending (0.53<R(2)<0.63). There was no such correlation in flexion trials. It was concluded that lumbar spine stability increased with increased trunk load magnitude to the extent that this load brought about an increase in trunk muscle activation. Indirectly, our data suggest that muscle reflex response to sudden loading can augment the lumbar spine stability level achieved immediately prior to the sudden loading event.

Adult↗

The relationship between health-state utilities and the SF-12 in a general population.

It would be a major advance if quality-of-life instruments could be translated into health-state utilities. The aim with this study was to investigate the relationship between the SF-12 and health-state utilities, based on responses to a postal questionnaire sent to a random sample of 8,000 inhabitants, aged 20-84 years, in the general population. The questionnaire included the SF-12, a rating-scale (RS) question, and a time-tradeoff (TTO) question; the response rate was 68%. Age, gender, and the 12 items of the SF-12 were used as explanatory variables in a linear regression analysis of the health-state utilities. The regression models explained about 50% of the variance in the RS answers and about 25% of the variance in the TTO answers. Most of the SF-12 items were related to the health-state utilities in the expected ways, with especially strong results for the RS method. The results suggest that the SF-12 can be converted to health-state utilities, but that further work is needed to reliably estimate the conversion function.

Activities of Daily Living↗

Factors associated with oral health-related quality of life in institutionalized elderly.

OBJECTIVE: The aim of this study was to investigate factors associated with the oral health-related quality of life (OHRQoL) of institutionalized elderly in Germany. MATERIAL AND METHODS: One-hundred-and-fifty-eight subjects from old people's homes were selected (mean 82.8 years). OHRQoL was measured using the Oral Health Impact Profile (OHIP). Denture characteristics (kind and age of denture, retention of removable denture, number of teeth in static occlusion) and general issues (age, gender, education level, and general pain status) were assessed. All factors were subjected to bivariate testing for their effects on the OHIP summary score (OHIP-SC) and to multivariate testing in subjects with removable dentures (n = 128); a linear regression model with backward elimination was used, with OHIP-SC as the dependent variable. RESULTS: In the context of other studies, a median OHIP-SC of 29 indicated highly impaired OHRQoL. According to the bivariate analysis, retention, age of denture, number of teeth in static occlusion, general pain status, and education all exhibited significant influence on OHIP-SC. In the final linear regression model, general pain status, education level, and retention of denture remained at a statistically significant level. The model explained 34% (R2 = 0.34) of the variance of the OHIP-SC. The kind of denture had no significant impact on OHIP-SC. CONCLUSIONS: In contrast to other groups, the kind of denture exhibited little impact on OHIP-SC for this highly specific collective. However, there were functional aspects of dentures which seemed to be important. Non-dental factors had a striking effect on OHRQoL.

Aged↗

Aerobiology of Artemisia airborne pollen in Murcia (SE Spain) and its relationship with weather variables: annual and intradiurnal variations for three different species. Wind vectors as a tool in determining pollen origin.

Detailed results from a 2-year survey of airborne pollen concentrations of Artemisia in Murcia are presented. Three consecutive pollen seasons of Artemisia occurring each year, related to three different species (A. campestris, A. herba-alba and A. barrelieri), were observed. A winter blooming of Artemisia could explain the incidence of subsequent pollinosis in the Murcia area. With regard to meteorological parameters, mathematical analyses showed relationships between daily pollen concentrations of Artemisia in summer-autumn and precipitations that occurred 6-8 weeks before. The cumulative percentage of insolation from 1 March seemed to be related to blooming onsets. Once pollination has begun, meteorological factors do not seem to influence pollen concentrations significantly. Intradiurnal patterns of pollen concentrations were similar for late summer and winter species (A. campestris and A. barrelieri). During autumn blooming (A. herba-alba), the intradiurnal pattern was particularly erratic. Theoretical values of wind run were obtained for each pollen season by the graphical sum of hourly wind vectors. When theoretical wind run was mapped onto the vegetation pattern, supposed pollen source locations were obtained for each hour. By comparing supposed hourly pollen origins with the intradiurnal patterns of pollen concentrations, it can be seen that this simple model explains variations in mean pollen concentrations throughout the day.

Allergens↗

Model-based relationship between physicochemical properties and inhibitory potency of alkylating 2-furylethylenes on yeast glycolysis.

Inhibitory effects of 35 2-furylethylenes, non-specific alkylating agents, on glycolysis in a respiratory mutant of Saccharomyces cerevisiae were correlated with their 1-octanol/water partition coefficients and the rate constants for reaction with 2-mercaptoacetic acid using physiologically based models. The simplest model explaining the data satisfactorily consists of two-step drug-receptor interaction involving reversible formation of a structurally non-specific non-covalent complex stabilized later covalently. The concentration of the free drug in the receptor surroundings was related to its initial concentration in external medium via a simple form of a disposition function constructed on the basis of time hierarchy of passive membrane transport, non-covalent binding to cell constituents and metabolic inactivation of the drug.

Alkylating Agents↗

Determinants of work satisfaction among Swedish dental hygienists.

This study examines factors that contribute to work satisfaction among Swedish dental hygienists. A questionnaire was used to collect data on health, demographics, work-history, work characteristics, work satisfaction and social support at work. The questionnaire was mailed to 471 hygienists; 77.3% responded. 70% of the hygienists are highly or very satisfied with their work tasks. Active leisure and working in large cities were significantly related to high work satisfaction. The best linear regression model explained 48% of the variance in work satisfaction. Thirty percent of the variance was explained by work tasks perceived to be skills developing. Skills development in the profession appears low (median = 44%). After controlling work factors, work satisfaction increased with growing skills development for all hygienists, even for those less satisfied with their work. The findings suggest that the opportunities for developing professional skills should increase to improve satisfaction among dental hygienists. Measures should also be taken to improve the work climate, work stimulation, and job variation as well as reduce the collegial pressure at work.

Adult↗

A note on migration with borrowing constraints.

"This note examines an important conflict between the theory and evidence on migration in LDCs. While the Harris-Todaro class of models explain the phenomenon of migration mainly by expected income differential between the economically advanced and the backward regions, the actual evidence in some cases suggests that migration could actually rise following a rise in income in backward areas. We resolve this puzzle by analysing migration in the context of the existence of imperfect credit markets in LDCs. We show that under certain plausible conditions, the rate of migration from the rural to the urban areas may actually rise when rural wages rise, as they ease the constraints on borrowing by potential migrants."

Demography↗

Relative validity of food intake estimates using a food frequency questionnaire is associated with sex, age, and other personal characteristics.

We investigated the validity of food intake estimates obtained by a self-administered FFQ relative to weighed food records (WFR) and the extent to which demographic, anthropometric, and social characteristics explain differences between these methods. A community-based sample of 96 Australian adults completed a FFQ and 12 d of WFR over 12 mo. The FFQ was adapted to the Australian setting from the questionnaire used in the US Nurses' Health Study. Spearman rank correlation coefficients ranged from 0.08 for "other vegetables" to 0.88 for tea. Exact agreement by quartiles of intake ranged from 27% (eggs) to 63% (tea). Differences between FFQ and WFR regressed on personal characteristics were significantly associated with at least 1 characteristic for 20 of the 37 foods. Sex was significantly associated with differences for 17 food groups, including 5 specific vegetable groups and 2 "total" fruit and vegetable groups. Use of dietary supplements and the presence of a medical condition were associated with differences for 5 foods; age, school leaving age, and occupation were associated with differences for 1-3 foods. BMI was not associated with differences for any foods. Regression models explained from 3% (whole-meal bread) to 37% (for all cereals and products) of variation in differences between methods. We conclude that the relative validity of intake estimates obtained by FFQ is different for men and women for a large number of foods. These results highlight the need for appropriate adjustment of diet-disease relations for factors affecting the validity of food intake estimates.

Adult↗

The quality of life of African American women with breast cancer.

The objectives of this study were to describe the quality of life of African American women with breast cancer and test a model of factors that may affect their quality of life. A stress-coping framework that included person (demographics, current concerns, and optimism), social resources (family functioning), and illness-related factors (symptom distress, medical characteristics), as well as appraisal of illness and quality of life, was used to guide this exploratory, cross-sectional study. Participants included 98 African American women who were approximately 4 years postdiagnosis. The women reported a fairly high quality of life, were generally optimistic, and had effective family functioning. Although symptom distress was generally low, a sizable number of women reported problems with energy loss, sleep disturbances, and pain. The model explained 75% of the variance in quality of life, with appraisal, family functioning, symptom distress, and recurrence status each explaining a significant amount of the variance. Current concerns had an indirect effect on quality of life that was mediated by appraisal. These findings underscore the importance of helping women foster a positive appraisal of their illness, manage current concerns, maintain family functioning, and reduce symptom distress, because each of these factors indirectly or directly affects their quality of life.

Adaptation, Psychological↗

Variation in continuous reaction norms: quantifying directions of biological interest.

Thermal performance curves are an example of continuous reaction norm curves of common shape. Three modes of variation in these curves--vertical shift, horizontal shift, and generalist-specialist trade-offs--are of special interest to evolutionary biologists. Since two of these modes are nonlinear, traditional methods such as principal components analysis fail to decompose the variation into biological modes and to quantify the variation associated with each mode. Here we present the results of a new method, template mode of variation (TMV), that decomposes the variation into predetermined modes of variation for a particular set of thermal performance curves. We illustrate the method using data on thermal sensitivity of growth rate in Pieris rapae caterpillars. The TMV model explains 67% of the variation in thermal performance curves among families; generalist-specialist trade-offs account for 38% of the total between-family variation. The TMV method implemented here is applicable to both differences in mean and patterns of variation, and it can be used with either phenotypic or quantitative genetic data for thermal performance curves or other continuous reaction norms that have a template shape with a single maximum. The TMV approach may also apply to growth trajectories, age-specific life-history traits, and other function-valued traits.

Animals↗

The molecular mechanism of multidrug resistance by the Q151M human immunodeficiency virus type 1 reverse transcriptase and its suppression using alpha-boranophosphate nucleotide analogues.

Nucleoside analogues are currently used to treat human immunodeficiency virus infections. The appearance of up to five substitutions (A62V, V75I, F77L, F116Y, and Q151M) in the viral reverse transcriptase promotes resistance to these drugs, and reduces efficiency of the antiretroviral chemotherapy. Using pre-steady state kinetics, we show that Q151M and A62V/V75I/F77L/F116Y/Q151M substitutions confer to reverse transcriptase (RT) the ability to discriminate an analogue relative to its natural counterpart, and have no effect on repair of the analogue-terminated DNA primer. Discrimination results from a selective decrease of the catalytic rate constant k(pol): 18-fold (from 7 to 0.3 s(-1)), 13-fold (from 1.9 to 0.14 s(-1)), and 12-fold (from 13 to 1 s(-1)) in the case of ddATP, ddCTP, and 3'-azido-3'-deoxythymidine 5'-triphosphate (AZTTP), respectively. The binding affinities of the triphosphate analogues for RT remain unchanged. Molecular modeling explains drug resistance by a selective loss of electrostatic interactions between the analogue and RT. Resistance was overcome using alpha-boranophosphate nucleotide analogues. Using A62V/V75I/F77L/F116Y/Q151M RT, k(pol) increases up to 70- and 13-fold using alpha-boranophosphate-ddATP and alpha-boranophosphate AZTTP, respectively. These results highlight the general capacity of such analogues to circumvent multidrug resistance when RT-mediated nucleotide resistance originates from the selective decrease of the catalytic rate constant k(pol).

Anti-HIV Agents↗

Basic counterpoint: mechanisms and pathways of gonadal steroid modulation of growth hormone secretion.

In spite of the different patterns of GH secretion observed in male and female rats, it can be argued that there are limited differences between the mechanism of action of androgens and estrogens as reported in the literature. However, we feel that it is possible to organize the available data into a unique physiological model explaining the sex-based differences in GH secretion in the rat. Thus, it can be proposed that the greater spontaneous GH peaks observed in the male with respect to the female rat may be due to an androgen-mediated enhancement of both GHRH secretion at the hypothalamic level and GH secretion at the pituitary level. The lower GH troughs observed in the male as compared to the female rat may be due to increased interpeak somatostatin secretion induced by the androgens with respect to the estrogens. It is likely that these high GH peaks and low GH troughs establish a recycling mechanism through established feedback mechanisms. That is, the high GH peak, induced by GHRH, stimulates somatostatin secretion such that a very low GH trough follows. In turn, this low GH trough, in the high somatostatin environment, establishes the correct neuroendocrine milieu for the next high GH peak, and so on. Additional studies will help clarify this model and hopefully provide a better understanding of the mechanisms regulating the interaction between gonadal steroids and GH.

Androgens↗