An extendable optical fibre probe survey meter for naturally occurring radioactive material (NORM) and other weak emitters

We have developed a radioluminescence-based survey meter for use in industries in which there is involvement in naturally occurring radioactive material (NORM), also in support of those needing to detect other weak emitters of radiation. The functionality of the system confronts particular shortcomings of the handheld survey meters that are currently being made use of. The device couples a LYSO:Ce scintillator with a photodetector via a polymer optical fibre waveguide, allowing for "intrinsically safe" inspection within pipework, separators, valves and other such component pieces. The small-diameter optical fibre probe is electrically passive, immune to electromagnetic interference, and chemically inert. The readout circuit is entirely incorporated within a handheld casing housing a silicon photomultiplier (SiPM) detection circuit and a microprocessor circuit connected to an LCD display. A 15 m long flexible PMMA optical fibre waveguide is butt coupled to an ABS plastic probe that retains the LYSO:Ce scintillator. Initial tests have included the use of lab-based mixed gamma-ray sources, measurements being made in concert with a reference conventional GM survey-meter. Characterization, via NORM sources at a decontamination facility, has shown useful sensitivity, covering the dose-rate range 0.10- to 28 µSv h^-1 (R-squared 0.966), extending to 80 µSv/h as demonstrated in use of a Cs-137 source. The system is shown to provide an effective tool for detection of radioactivity within hard to access locations, in particular for sources emitting at low radiation levels, down to values that approach background.

Impacts of supplemental Ginkgo biloba oil on broilers' growth, blood indices, intestinal and hepatic morphology and expression of growth-related genes

The current work examined the impact of Ginkgo biloba oil (GBO) on growth performance, some biochemical parameters, intestinal and hepatic morphology, economic efficiency and expression of some growth-related genes in broiler chickens. A total of 135 chicks (Cobb 500) were allotted into three groups with 3 replications (15 birds/replicate). The experimental groups included: G1 (control), G2 and G3 were supplemented with GBO in the drinking water (0.25 and 0.5 cm/L), respectively. The GBO was added to the drinking water only for 3 successive weeks. Compared to the other groups, supplementation with 0.25 cm/L GBO significantly (P ≤ 0.05) increased final body weight, overall weight gain, feed intake and water consumption. When 0.25 cm GBO/L was added, that group significantly differed in intestinal villus length (P ≤ 0.05). Birds received 0.25 cm GBO/L had significantly greater blood total albumin and total protein concentrations (P ≤ 0.05), while birds given 0.5 cm GBO/L had higher serum cholesterol and LDL concentrations (P ≤ 0.05). The cost parameters were significantly higher (P ≤ 0.05) in the 0.25 cm GBO/L supplemented group, which exhibited higher total return and net profit. The addition of 0.25 cm GBO/L resulted in higher expression of antioxidant enzymes and insulin-like growth factor while inhibiting the expression of Myostatin in muscles (P < 0.05) compared to the control and those received 0.5 cm GBO/L. In conclusion, broiler chickens that received 0.25 cm GBO/L for 3 consecutive days per week had better performance, intestinal morphology, profitability, and antioxidant status than the control birds.

Serum Level of Inhibin B and Kisspeptin, as well as Their Correlation with Biochemical Factors in Obese Adult Patients

Obesity is one of the most important global health problems causing serious health risks and early death in human. It is also associated with disturbance of homeostasis of hormones and immunological biochemical factors inside the human body. This study aimed to evaluate the serum level of inhibin B and kisspeptin among Iraqi obese adult people and other biochemical parameters correlated with obesity. Inhibin B and levels of kisspeptin were evaluated in the samples of serum from 40 Iraqi obese adult patients and 30 healthy non-obese individuals. A significant decrease (P<0.0001) was observed in the kisspeptin level in both males and females, compared to the control group. Moreover, inhibin B decreased significantly in obese females only (P<0.001), while there was no differences between males and the control group in this regard. Finally, body mass index, serum glutamic pyruvic transaminase (SGPT), and leptin showed negative correlation with kisspeptin (0.01, 0.5, and 0.01), respectively. However, a positive association was observed with the level of Ca in the serum. On the other hand, inhibin B confirmed a positive correlation with SGPT. The present study revealed a significant increase in inhibin B and kisspeptin, with SGPT and Ca in the serum of obese patients, which could lead to complications and health problems among these patients.

Impacts of tea tree or lemongrass essential oils supplementation on growth, immunity, carcass traits, and blood biochemical parameters of broilers reared under different stocking densities

The effects of tea tree essential oil (TTEO) and lemongrass essential oil (LGEO) with different stocking densities on the growth performance, biochemical markers, antioxidants, and immunity state of broiler chickens were studied.  Birds were housed at stocking densities of 25, 30, 35, and 40 kg/m². The treatments were, basal diet without any supplementation, the second and third groups were supplemented with 300 mg TTEO/kg feed, and 300 mg LGEO/kg feed, respectively. Results revealed that increasing stocking density from 25 to 40 kg/m² significantly reduced body weight and daily weight gain at different ages. The phagocytic index and activity were significantly higher under the lower stocking density (25 kg/m²). Serum amyloid A (SAA), serum or liver transferrin (TRF), or C-reactive protein (CRP) were significant decreased when decreasing stocking density. Increasing stocking density from 25 to 40 kg/m² resulted in a significant increase in the serum urea, creatinine, uric acid, lactate dehydrogenase (LDH), alanine aminotransferase (ALT), aspartate aminotransferase (AST), malondialdehyde (MDA), and catalase (CAT) levels. However, there was a significant reduction in antioxidant enzyme activity, including glutathione peroxidase (GPx) and superoxide dismutase (SOD), as stocking density increased. The supplementation of TTEO produced significantly higher body weight and daily weight gain followed by LGEO. Additionally, the mortality rates were reduced in TTEO (27.4%) and LGEO (25%) groups. TTEO or LGEO supplementation significantly improved meat constituents and cellular immunity and reduced serum total lipids, serum and meat cholesterol, and triglycerides, SAA, TRF, and CRP. For all these measured parameters, superior results were obtained when TTEO was used compared to LGEO. TTEO or LGEO supplementation also significantly reduced serum urea, creatinine, uric acid, and the enzymatic activities of LDH, ALT, AST, MDA, and CAT (but not GPx and SOD) in comparison to the control treatment. Overall, our results showed the superiority of TTEO over LGEO as a feed supplement in broiler diets. In conclusion, TTEO treatment offers a better solution for raising broiler chickens in high stocking density.

Development of a core outcome set for cutaneous squamous cell carcinoma trials: identification of core domains and outcomes

BACKGROUND

The lack of uniformity in the outcomes reported in clinical studies of the treatment of cutaneous squamous cell carcinoma (cSCC) complicates efforts to compare treatment effectiveness across trials.

OBJECTIVES

To develop a core outcome set (COS), a minimum set of agreed-upon outcomes to be measured in all clinical trials of a given disease or outcome, for the treatment of cSCC.

METHODS

One hundred and nine outcomes were identified via a systematic literature review and interviews with 28 stakeholders. After consolidation of this long list, 55 candidate outcomes were rated by 19 physician and 10 patient stakeholders, in two rounds of Delphi exercises. Outcomes scored 'critically important' (score of 7, 8 or 9) by ≥ 70% of patients and ≥ 70% of physicians were provisionally included. At the consensus meeting, after discussion and voting of 44 international experts and patients, the provisional list was reduced to a final core set, for which consensus was achieved among all meeting participants.

RESULTS

A core set of seven outcomes was finalized at the consensus meeting: (i) serious or persistent adverse events, (ii) patient-reported quality of life, (iii) complete response, (iv) partial response, (v) recurrence-free survival, (vi) progression-free survival and (vii) disease-specific survival.

CONCLUSIONS

In order to increase the comparability of results across trials and to reduce selective reporting bias, cSCC researchers should consider reporting these core outcomes. Further work needs to be performed to identify the measures that should be reported for each of these outcomes.

Assessment of vaccination with gamma radiationattenuated infective Toxocara canis eggs on murine toxocariasis

Toxocara canis is a major parasite that infects many animals with high risk of human infections. This study aims at assessing the immunization with gamma radiationattenuated infective stage on rats challenged with non-irradiated dose. Level of vaccine protection was evaluated in liver and lung regarding parasitological, histopathological, biochemical and molecular parameters. Fifty rats were enrolled in three groups: group A (10 rats) as normal control; group B (20 rats) subdivided into subgroup B1 (infected control) and subgroup B2 infected then challenged after 14 days with the same dose of infection (challenged infected control); and group C (20 rats) subdivided into subgroup C1 vaccinated with a dose of 800 gray (Gy) gamma-radiated infective eggs (vaccine control) and subgroup C2 vaccinated then challenged on 14^th day with same number of infective eggs (vaccinated-challenged). Tissues were stained with Haematoxylin and Eosin (H and E) for histopathological studies. Biochemical studies through detection of nitric oxide (NO) and Caspase-3 were conducted. Extent of DNA damage by Comet assay was assessed. Vaccinated-challenged subgroup revealed a marked reduction in larvae in tissues with mild associated histological changes. In addition there was accompanied reduction of NO, Casepase-3 level and DNA damage compared to the control infected group. It could be concluded that vaccination of rats with a dose of 800Gy gamma radiation-attenuated infective stage improves immune response to challenge infection and drastically reduces the morbidity currently seen.

Graviola (Annona muricata) attenuates behavioural alterations and testicular oxidative stress induced by streptozotocin in diabetic rats

Oxidative stresses intensify the progression of diabetes-related behavioural changes and testicular injuries. Graviola (Annona muricata), a small tree of the Annonaceae family, has been investigated for its protective effects against diabetic complications, oxidative stress, and neuropathies. This study was planned to investigate the effects of graviola on behavioural alterations and testicular oxidative status of streptozotocin (STZ; 65 mg/kg)-induced diabetic rats. Forty adult male Wistar rats were equally allocated into four groups: control (received normal saline 8 ml/kg orally once daily), diabetic (received normal saline orally once daily), graviola (GR; received 100 mg/kg/day; orally once daily), and diabetic with graviola (Diabetic+GR; received 100 mg/kg/day; once daily). Behavioural functions were assessed using standard behavioural paradigms. Also, oxidative statuses of testis were evaluated. Results of behavioural observations showed that diabetes induced depression-like behaviours, reduction of exploratory and locomotor activities, decreased memory performance, and increased stress-linked behaviours. These variations in diabetic rats were happened due to oxidative stress. Interestingly, treatment of diabetic rats with graviola for four weeks alleviated all behavioural changes due to diabetes. Also, rats in graviola-treated groups had greater testicular testosterone and estradiol levels compared with diabetic rats due to significant rise in testicular acetyl-CoA acetyltransferase 2 expression. In the same context, graviola enhanced the antioxidant status of testicular tissues by significantly restoring the testicular glutathione and total superoxide dismutase that fell during diabetes. In addition, Graviola significantly decreased the expression of apoptotic (Bax) and inflammatory (interleukin-1β) testicular genes. In conclusion, these data propose that both the hypoglycemic and antioxidative potential of graviola are possible mechanisms that improve behavioural alterations and protect testis in diabetic animals. Concomitantly, further clinical studies in human are required to validate the current study.

Effect of dietary polyphenol-rich grape seed on growth performance, antioxidant capacity and ileal microflora in broiler chicks

In this study, we examined the effect of dietary supplementation with grape seed (GS) on the performance, carcass traits, plasma biochemistry, antioxidant status and ileal microflora in broilers. Experiment diets included a control diet (without additive) and three levels of GS powder (10, 20 and 40 g/kg of diet). Each diet was fed to a total of 300 one-day-old Cobb-500 chicks for 42 days. The addition of 20 g/kg of GS to the basal diet increased final body weight and body weight gain, improved the feed conversion ratio and did not affect feed intake. Dietary 20 g GS significantly increased (p < .05) the percentage of carcass yield %, dressing % and gizzard. However, the addition of 40 g/kg of GS significantly reduced the percentage of abdominal fat in the birds. Diets supplemented with GS showed the lowest content of ether extract compared with the control group (p < .05). The physical characteristics of meat and the chemical composition of DM, CP and ash were not significantly influenced by treatments. In the GS groups, plasma protein, albumin, globulin, aspartate aminotransferase and alanine aminotransferase concentrations showed no significant change compared with the control group. Broilers fed a diet supplemented with GS had lower levels of plasma glucose, total lipids, triglycerides and cholesterol compared with the control birds (p < .05). The addition of 40 g of GS significantly (p < .05) enhanced the activity of reduced glutathione, catalase, superoxide dismutase, glutathione peroxidase and GST, and correlated with significantly decreased thiobarbituric acid-reactive substances levels compared with the control group. The value of ileal pH was not significantly affected by the GS levels. Broilers fed diets supplemented with GS had lower ileal Streptococcus spp. and Escherichia coli populations but higher Lactobacillus spp. populations (p < .05). No adverse effects on birds' health were detected due to the use of GS. Thus, GS could be recommended as an herbal supplement in the diet of broiler chickens to improve performance, reduce blood lipids, enhance antioxidant capacity and decrease detrimental bacteria in the ileum.

Effect of in ovo injection of threonine on immunoglobulin A gene expression in the intestine of Japanese quail at hatch

The objective of this study was to investigate the effect of in ovo injection of threonine (THR) on immunoglobulin A (IgA) gene expression of Japanese quail on hatch day. A total of 540 Japanese quail eggs were assigned into nine groups of 60 each and were set in a single-stage incubator. Treatments were as follows: non-injected (control), two diluent levels (0.05 or 0.1 ml saline), two sites of injection (in or under the air sac) and with or without nutrients (0.5 mg/ml THR). Eggs were injected on d 11 of incubation. On hatch day, after euthanizing hatched quail chicks, the intestine was removed and the jejunum was separated. The relative mRNA expression of jejunal IgA increased (p < 0.05) by the injection of 0.05 ml THR under the air sac when compared to the control group or other treatments of injection. Compared to the control group, no differences were imputable to treatments of 0.1-ml injections on IgA gene expression. Differences with other injected groups were not significant. It was concluded that injection of 0.05 ml saline containing 0.5 mg THR/ml under the air sac can improve jejunal IgA mRNA expression in newly hatched Japanese quail chicks.

Room temperature ammonia sensing using tapered multimode fiber coated with polyaniline nanofibers

We demonstrate an ammonia sensor composed of a tapered multimode fiber coated with polyaniline nanofibers that operates at room temperature (26°C). The optical properties of the polyaniline layer changes when it is exposed to ammonia, leading to a change in the absorption of evanescent field. The fiber sensor was tested by exposing it to ammonia at different concentrations and the absorbance is measured using a spectrophotometer system. Measured response and recovery times are about 2.27 minutes and 9.73 minutes, respectively. The sensor sensitivity can be controlled by adjusting the tapered fiber diameter and the highest sensitivity is achieved when the diameter is reduced to 20 µm.

Photon irradiation response of photonic crystal fibres and flat fibres at radiation therapy doses

Radiation effects of photon irradiation in pure Photonic Crystal Fibres (PCF) and Flat fibres (FF) are still much less investigated in thermoluminescense dosimetry (TLD). We have reported the TL response of PCF and FF subjected to 6 MV photon irradiation. The proposed dosimeter shows good linearity at doses ranging from 1 to 4 Gy. The small size of these detectors points to its use as a dosimeter at megavoltage energies, where better tissue-equivalence and the Bragg-Gray cavity theory prevails.

Effect of simvastatin and naringenin coadministration on rat liver DNA fragmentation and cytochrome P450 activity: an in vivo and in vitro study

This study was designed to assess the effect of naringenin (NRG) on simvastatin (SV)-induced hepatic damage in rat and to investigate the effects of these drugs on cytochrome P450 (CYP) 2E1 and 3A1/2 isoforms in order to evaluate the possibility of their coadministration. Hepatic damage in rat was induced by SV (20 and 40 mg/kg/day, po for 30 days). The protective effect of NRG (50 mg/kg/day, po) was identified by estimating liver functions and oxidative stress markers such as lipid peroxidation, reduced glutathione, superoxide dismutase, glutathion s-transferase, and catalase as well as protein profile. DNA fragmentation and histopathological study were carried out to confirm the hepatic damage. An in vitro study was conducted to further evaluate the effect of SV and/or NRG administration on the activities of two microsomal CYP isoenzymes including CYP2E1 and CYP3A1/2. SV exerted an oxidative stress which may contribute to the hepatotoxicity. Administration of NRG in combination with SV significantly improved the liver functions, state of oxidative stress, protein profile, DNA fragmentation, and the histopathological changes. SV and/or NRG have a potential to inhibit CYP3A1/2 and CYP2E1. This study concluded that concurrent administration of NRG with SV provided a protection of liver tissue against the SV-induced hepatic damage. The inhibition of CYP2E1 and CYP3A1/2 by the SV and NRG should be taken into account in order to adjust doses to avoid interaction between SV and NRG and adverse effects of SV.

Effects of preservation methods on amino acids and 5'-nucleotides of Agaricus bisporus mushrooms

In this study, the proximate composition, free amino acids content and 5'-nucleotides in frozen, canned and salted Agaricus bisporus (A. bisporus) were investigated. We found that the three kinds of A. bisporus products were good sources of protein, with amount varying in the ranges of 16.54-24.35g/100g (dry weight). Freezing, canning and salting process, followed by 6months of storage led to a significant reduction in free amino acids, especially tyrosine, alanine, glutamine and cysteine. There were medium levels of MSG-like amino acids in frozen A. bisporus and canned A. bisporus, and low levels of MSG-like amino acids in salted A. bisporus. The mount of flavor 5'-nucleotides in frozen A. bisporus was higher than that of canned and salted A. bisporus. The present study thus suggests that freezing is beneficial for the preservation of A. bisporus.

Patterns of meningococcal infection in Sudan with emergence of Neisseria meningitidis serogroup W135

This study was conducted during the 2004-2006 epidemic of meningitis in Sudan to follow-up the frequency of disease outbreak or endemic waves and to evaluate the new quadrivalent vaccine for actual application. Samples were collected from Darfur, El Gedaref, Kassala and Khartoum States and transported to the National Health Central Laboratory in Khartoum. Of 196 patients with clinical symptoms and signs of meningitis, conventional culture identified Neisseria meningitidis in 37 (189%), confirmed by polymerase chain reaction. N. meningitidis type A was identified in 29 (78.4%) patients, type C in 3 (8.1%) and N. meningitidis W135 in 5 (15.5%). The serotyping and molecular diagnosis patterns of N. meningitidis showed the emergence of the new strain, W135, in 5 (15.5%). The patients from the borders of Sudan, 3 from the West Darfur, and 1 each from El Gedaref and Kassala. These could be related to the movement of pilgrims through the borders to Saudi Arabia in the Hajj season. Serious consideration may be needed for quadrivalent vaccination to prevent seasonal and Hajj season outbreaks.

Anatomical reconstruction of the lateral ligaments using Gracillis tendon in chronic ankle instability; a new technique

BACKGROUND

Many surgical technique have been described to assess the outcome of anatomical reconstruction of the lateral ligaments using Gracillis tendon. This technique aims to restore the stability of the ankle by reconstruction of the talofibular ligament (ATFL) and the calcaneofibular ligament (CFL) using the Gracillis tendon.

METHODS

From January 2004 to February 2008; inclusive, 16 patients; 11 male and 5 female, underwent an anatomic reconstruction of the lateral ankle ligament for chronic ankle instability. Their ages ranged from 18 to 29 giving a mean age of 25 years. Patients were then subjected to radiologic and clinical assessments for a period of at least 33.5 months. For pain scoring the Americans Orthopaedic Foot and Ankle Society (AOFAS) scores were used; whilst subjective symptom was evaluated using the Olerud and Molander ankle scoring system.

RESULTS

All patients returned for the final evaluation and subjective excellent or good results were recorded on self-assessment, pain scores, AOFAS and Karissons scores. Additionally Olerud and Molander ankle scoring was also done. During the final follow-up, the mean post-operative AOFAS score was 96 (range 80-100), the Visual analog score was 6 (range 0-4), Karissons score was 94.7 (range 80-100) and last but not least Olerud and Molander score was 87.5 (range 70-100). It was noted that the ankle range of motion was not affected by lateral ankle reconstruction. The talar tilt was reduced from a mean of 12-4° (p<0.0001) and the anterior drawer was reduced from a mean of 11-4mm (p<0.001) by the ankle ligament reconstruction.

CONCLUSION

Anatomical reconstruction of the lateral ligaments of chronic ankle instability using Gracillis tendon graft resulted in successful results, excellent ankle stability, significant reduction in pain and negligible loss of ankle and hind foot motion.

Socio-demographic and maternal factors in anaemia in pregnancy at booking in Kano, northern Nigeria

Anaemia in pregnancy still causes significant maternal morbidity and mortality in the developing countries including Nigeria. The burden and underlying factors are varied even within countries. We studied the prevalence of anaemia at booking and underlying factors in a teaching hospital in northern Nigeria. Using the capillary technique and blood film, the packed cell volume (PCV) and red cell morphology of 300 pregnant women was determined. Additional information was obtained on sociodemographic characteristics, obstetric and past medical history using an interviewer administered questionnaire. Of the 300 pregnant women studied, 51 (17%) [95% Confidence Interval (CI)=12.9%-21.7%] were anaemic. Specifically, 12.7% and 4.3% of the women had mild and moderate anaemia respectively. Blood film of 74.5%, 15.7% and 11.8% anaemic women showed normochromic normocytic, haemolytic and microcytic hypochromic pictures respectively. Low educational attainment [Adjusted Odds Ratio (AOR)=2.13], being single or divorced [AOR=2.02], high parity [AOR=2.06], late booking [AOR=2.71] and short intervals between pregnancies [AOR=2.37] were significant predictors of anaemia in pregnancy. The high prevalence of anaemia in pregnancy related to low educational and economic status especially among women with background obstetric risk factors calls for vigilance, sustained health education and chemoprophylaxis for pregnant women.

Bone mineral density in Egyptian adolescents and adults with short stature: results of a national survey

Little is known about bone mass acquisition among stunted adolescents who did not achieve their growth in height. A national survey was made of bone mineral density among stunted adolescents and adults. A multistage stratified random sample of 2500 families (8476 adolescents and their parents) was selected from 6 governorates in different geographical areas of Egypt. Clinical history, anthropometry and measurement of bone mineral density using dual energy X-ray absorptiometry was done. Mean T-scores were significantly lower among both adults and adolescents with short stature compared with those of normal height. The predictors of bone status among adolescent boys were age, body mass index (BMI), height attained (z-score) and maternal T-score and for girls were BMI, age at menarche, paternal T-score and z-score. Stunted adolescents suffered from low bone mass density and low stature adults suffered a high prevalence of osteoporosis.

Kinetic catalytic determination of trace levels of iodide based on the oxidation of basic dyes with hydrogen peroxide monitored potentiometrically using simple PVC electrodes

Four sensitive catalytic potentiometric methods have been developed for trace levels determination of iodide based on its catalytic effects on the oxidation of four dyes: viz. variamine blue (VB), rhodamine B (RB), methylene blue (MB) and malachite green (MG), with H(2)O(2) in H(3)PO(4) medium at 25±0.5°C. The catalyzed reaction rates were estimated potentiometrically by monitoring the potential of the corresponding dye-PVC ion selective electrodes. To select the optimized reaction conditions offering the highest sensitivity of the method, parallel studies were carried out on each dye catalyzed reaction including: the effect of reactant concentration, reaction medium and temperature. The working calibration curves were linear over the concentration range from 0.32 to 2.54 mg L(-1) iodide for VB method and from 3.2 to 12.7 mg L(-1) for other ones. The tolerance limits of more than 20 interfering species were listed indicating the high selectivity of the method. Trace iodide in edible salt and pharmaceutical samples was determined without the need for separation or preconcentration procedures.

The effect of replacing corn with glycerol on ruminal bacteria in continuous culture fermenters

The effects of substituting corn with glycerol on DNA concentration of selected ruminal bacteria were investigated using continuous fermenters. Four continuous culture fermenters were used in a 4 × 4 Latin Square design with four 10 days consecutive periods. Treatment diets (60:40 forage to concentrate) were fed at 45 g/day dry matter (DM) in three equal portions. Glycerol (0.995 g/g glycerol) was used to replace corn in a grain mix at proportions of 0% (T0; control), 15% (T15), 30% (T30) and 45% (T45). On day 10 of each period, samples were collected from each fermenter 3 h after the morning feeding and analysed for volatile fatty acid and bacterial DNA concentration. Glycerol substitution was related to significantly higher butyrate, valerate and isovalerate concentrations. Compared with the T0 diet, acetate concentration was significantly lower with the T30 and T45 diets whilst propionate concentration was higher only with the T45 diet. The DNA concentrations for Butyrivibrio fibrisolvens and Selenomonas ruminantium decreased with the T30 and T45 diets compared with the T0 diet. No differences in the DNA concentrations for Ruminococcus albus and Succinivibrio dextrinosolvens amongst diets were observed. The findings show that substituting 15% of the dietary corn with glycerol had no substantive effects on fermentation processing or ruminal bacteria. Higher substitution levels, however, may adversely affect ruminal bacteria and negatively impact acetate production.

miR-145-dependent targeting of junctional adhesion molecule A and modulation of fascin expression are associated with reduced breast cancer cell motility and invasiveness

Micro RNAs are small non-coding RNAs, which regulate fundamental cellular and developmental processes at the transcriptional and translational level. In breast cancer, miR-145 expression is downregulated compared with healthy control tissue. As several predicted targets of miR-145 potentially regulate cell motility, we aimed at investigating a potential role for miR-145 in breast cancer cell motility and invasiveness. Assisted by Affymetrix array technology, we demonstrate that overexpression of miR-145 in MDA-MB-231, MCF-7, MDA-MB-468 and SK-BR-3 breast cancer cells and in Ishikawa endometrial carcinoma cells leads to a downregulation of the cell-cell adhesion protein JAM-A and of the actin bundling protein fascin. Moreover, podocalyxin and Serpin E1 mRNA levels were downregulated, and gamma-actin, transgelin and MYL9 were upregulated upon miR-145 overexpression. These miR-145-dependent expression changes drastically decreased cancer cell motility, as revealed by time-lapse video microscopy, scratch wound closure assays and matrigel invasion assays. Immunofluorescence microscopy demonstrated restructuring of the actin cytoskeleton and a change in cell morphology by miR-145 overexpression, resulting in a more cortical actin distribution, and reduced actin stress fiber and filopodia formation. Nuclear rotation was observed in 10% of the pre-miR-145 transfected MDA-MB-231 cells, accompanied by a reduction of perinuclear actin. Luciferase activation assays confirmed direct miR-145-dependent regulation of the 3'UTR of JAM-A, whereas siRNA-mediated knockdown of JAM-A expression resulted in decreased motility and invasiveness of MDA-MB-231 and MCF-7 breast cancer cells. Our data identify JAM-A and fascin as novel targets of miR-145, firmly establishing a role for miR-145 in modulating breast cancer cell motility. Our data provide a rationale for future miR-145-targeted approaches of antimetastatic cancer therapy.

Ganglion cyst of the posterior cruciate ligament

A ganglion is a fluid cyst with a myxoid matrix that arises close to the tendons and joints. Its occurrence inside a joint is rare. Among the various pathological conditions producing impairment of the knee function, ganglia of the cruciate ligaments are quite rare. It may be painful or asymptomatic. Some patients may have a trauma history. Ganglia may mimic intra-articular lesions like tears of the anterior cruciate ligament (ACL) or meniscus. Ganglia, though commonly arise from the ACL, can also arise from other structures such as the posterior cruciate ligament (PCL) or meniscus. Ganglia are typically treated by arthroscopic excision and debridement. We report a case of ganglion of the PCL in a 28-year-old man; the lesion was incidentally discovered during ACL reconstruction with double bundle (Rigid fix technique). The patient underwent arthroscopic excision of the ganglion. At the end of 1-year follow-up the patient was pain free; a full range of motion of his right knee was restored, and he returned to his preinjury sport activity.

Solvatochromic, acid-base features and time effect of some azo dyes derived from 1,3-benzothiazol-2-ylacetonitrile: experimental and semiempirical investigations

The solvatochromism and other spectroscopic properties of seven azo dyes were studied, with a particular respect to the role of the solvent basicity, and interpreted with the aid of experimental findings and semiempirical data. The electronic absorption spectra of the dyes examined in different solvents combined with theoretical calculations showed that most of the investigated compounds coexist in the hydrazone and/or azo-enamine-common anion equilibrium or in the solely anionic form depending upon the nature of the solvent employed. These interesting features open up possibilities for the use of these compounds in analytical chemistry as acid-base indicators. Furthermore, both of intermolecular and intramolecular charge transfer equilibria have been reflected by experimental absorption spectra of compounds 4 and 5. The enthalpies of formation predicted at PM6 (COSMO) and PM6/CI (COSMO) for the ground (S(0)) and excited (S(1)) states, respectively have been successfully used for the explanation of the observed bathchromic shift in non-polar solvents. The effect of time on the longer wavelength visible band of compound 7 has been thoroughly investigated.

Pattern and severity of rheumatic valvular lesions in children in Khartoum, Sudan

We determined the pattern and severity of valvular involvement in 100 Sudanese patients with rheumatic heart disease (RHD) in 2 centres in Khartoum in 2003. All the patients underwent history taking, physical examination and Doppler echocardiography. The commonest lesions were mitral regurgitation (84%) and aortic regurgitation (40%). Mitral stenosis alone was uncommon (9%) which could be due to a low detection rate related to the slow stenotic process and the subtle early signs. This, together with the inconsistent history of rheumatic fever, may lead to an underestimate of the prevalence of RHD. There was a strong correlation between severity of the lesion and irregular prophylaxis (P < 0.001).

Disparities in joint replacement utilization: a quality of care issue

Although total joint replacement is an effective treatment option for end-stage lower extremity osteoarthritis, racial disparities in joint replacement utilization have been well documented. These disparities may be due in part to patient-level factors such as willingness to consider joint replacement and worse expectations of joint replacement outcomes. In addition, African-Americans may have worse outcomes after total joint replacement and are more likely to have surgery performed by surgeons with lower volumes or in hospitals with lower volumes. All of these issues may be considered concerns with the quality of care delivered to African-Americans with osteoarthritis.

Milk Conjugated Linoleic Acid Response to Fish Oil and Sunflower Oil Supplementation to Dairy Cows Managed Under Two Feeding Systems

Earlier research showed that conjugated linoleic acid (CLA) content in milk fat is highest when cows' diets are supplemented with a blend of fish oil (FO) and linoleic acid-rich oils. The objective of this study was to compare the effect of FO and sunflower oil (SFO) supplementation on milk cis-9, trans-11 CLA when dairy cows managed on pasture or in confinement. Fourteen Holstein cows were assigned into 2 treatment groups: cows grazed on alfalfa-grass pasture (PAS) or were fed corn silage-alfalfa hay mix ad libitum (LOT). Both groups were supplemented with a 8.2 kg/d grain supplement containing 640 g of FO and SFO (1:3 wt/ wt). Grain supplement was fed in 2 equal portions after each milking, for a period of 3 wk. Milk samples were collected during the last 3 d of the experimental period. Milk yield was greater with the LOT diet (23.1 kg/ d) compared with the PAS diet (19.4 kg/d). Milk fat percentages (2.51 and 2.95 for the LOT and PAS, respectively) and yields (0.57 and 0.51 kg/d) were similar for the 2 diets. Milk protein percentages were not affected by diets (3.34 and 3.35 for the LOT and PAS diets, respectively), but protein yields were lower for the PAS diet (0.61 kg/d) compared with the LOT diet (0.75 kg/ d). Treatment diets had no effect on milk trans C18:1 concentrations [10.64 and 9.82 g/100 g of total fatty acids (FA) for the LOT and PAS, respectively] or yields (60.65 and 64.01 g/d), but did affect isomers distributions. Concentration (g/100 g of total FA) of vaccenic acid was lower with the LOT diet (2.15) compared with the PAS diet (4.52), whereas concentration of trans-10 C18:1 was greater with the LOT diet (4.99) compared with the PAS diet (1.69). Milk cis-9, trans-11 CLA concentration was greater with the PAS diet (1.52) compared with the LOT diet (0.84). In conclusion, the increase in milk cis-9, trans-11 CLA content was greater when pasture-based diets were supplemented with FO and SFO. The lower cis-9, trans-11 CLA concentration in milk from the confinement-fed cows resulted from trans-10 C18:1 replacing vaccenic acid as the predominant trans C18:1 isomer.

Performance Assessment of Broiler Chickens Given Mushroom Extract Alone or in Combination with Probiotics

A study was conducted to evaluate the effect of combined Shiitake mushroom (Lentinus edodes) extract with probiotics (PrimaLac) on the growth and health of broiler chickens. In trial 1, 540 d-of-hatch chicks were randomly assigned to 6 treatment groups, replicated 3 times, with 15 males and 15 females per pen for 3 wk. Dietary probiotics and mushroom treatments were as follows: 1) control feed + ad libitum tap water; 2) control feed + skip-a-day mushroom water; 3) control feed + ad libitum mushroom water; 4) probiotic feed + ad libitum tap water; 5) probiotic feed + skip-a-day mushroom water; 6) probiotic feed + ad libitum mushroom water. Body weight gain, feed consumption and efficiency, mortality, bursa, liver, and spleen relative weights of chicks were taken. In trial 2, the performance of broilers 3 to 7 wk withdrawn from the mushroom extract was evaluated along with the comparative level of fecal biofidobacteria in the control and mushroom extract treatment (trt). Mortality, weight gain, feed consumption and efficiency, carcass yield, fat pads, bursa weights and fecal bifidobacteria were measured in trial 2. In trial 1, significant differences (P < 0.05) in female weight gain (trt 4-0.62 vs. trt 1-0.54 kg) and male spleen weights were observed. In trial 2, significant differences were observed in male weight gain (trt 2-2.40 vs. trt 4-1.12 kg), male and female fat pads, male bursa weights (trt 3-0.15 vs. trt 6-0.39), female carcass yield percentage (trt 1-77.8 vs. trt 4-66.4), and feed consumption and efficiency. Body weights were severely depressed in the male broilers receiving the probiotics feed in treatments 4, 5, and 6, but not in the female broilers. These results indicate that performance differences in gender occur with additives during different grow-out periods, and mushroom extract promotes bifidobacteria growth in broiler chickens after 4 wk of withdrawal. It appears that probiotics and mushroom extract offered no combination potential for weight gain, which was compromised in this study, but possible health-enhanced attributes.

Kinetics of the substitution of dehydroacetic acid in tris (dehydroacetato) Fe(III) complex by 8-hydroxyquinoline, di- and tetra-hydroxyquinone

The ligand substitution reactions of dehydroacetic acid (Hdha) in [Fe(dha)(3)] with second ligand such as 8-hydroxyquinoline (Hquin), 1,4-dihydroxyanthraquinone (H(2)dhaq) and 1,4,5,8-tetra-hydroxyanthraquinone (H(4)thaq) were investigated spectrophotometrically by in low polarity solvents like benzene, chloroform and dichloromethane. It is deduced that the substitution reaction takes place through one successive step. The reaction was performed at four different temperatures (5-25) degrees C, and it exhibits a first order dependence on the concentration of the starting complex. The observed rate constant depends on the concentration of both leaving and entering ligands. The evaluation of the kinetic data gives activation parameters which support an associative mechanism in the transition states and the higher rate of substitution of the dha in Fe(dha)(3) complex is due to entropy effect. The solid complexes were synthesized and characterized by elemental analysis, IR and UV-vis spectral techniques.

Vertical migration of 134Cs bearing soil particles in arid soils: implications for plutonium redistribution

Vertical migration of plutonium in soils at the Waste Isolation Pilot Plant (WIPP) and the Rocky Flats Environmental Technology Site (RFETS) was evaluated based on observed 134Cs migration in soil column experiments. After applying 134Cs-labeled soil particles to the surfaces of large, undisturbed soil cores collected from each site, resulting soil columns were subjected to experimental cycles of irrigation plus drying (treatment columns) or to cycles of irrigation only (control columns). Mean losses of 134Cs inventory from soil surfaces were 3.1 +/- 0.6% cycle(-1) and 0.7 +/- 0.6% cycle(-1) respectively for RFETS treatment and control columns. WIPP columns had mean respective losses of 1.3 +/- 1.2% cycle(-1) and 0.5 +/- 0.2% cycle(-1). Bulk transport of labeled soil particles through soil cracks was an important process in RFETS soils, accounting for 64-86% of total 134Cs migration. Colloidal transport processes governed migration in WIPP soils.

Measles vaccination in the presence of maternal antibodies primes for a balanced humoral and cellular response to revaccination

Early or low dose antigen exposure can prime the immune system for subsequent responses; the so-called "prime-boost" effect. In the context of a Sudanese measles vaccine trial, we assessed whether or not such early exposure could influence the response to revaccination. Children received either Connaught high titer vaccine (CN: n = 53; 10(4.7)pfu) or meningococcal A + C vaccine as a placebo (MEN: n = 58) at 5 months of age. At 9 months of age, all received standard titer Schwarz vaccine (SCH: 10(3.9)pfu). Neutralizing antibodies were measured before initial vaccination and at 9 months of age (plaque reduction neutralization assay (PRN)) and again at 5 years of age (syncytium inhibition assay (SIA)). Lymphoproliferative responses to measles virus (MV) antigens were evaluated at 5 years of age. Eleven of the 53 CN-SCH children (21%) had sub-protective neutralizing antibody titers prior to revaccination (log PRN 1.5 +/- 0.03 versus 2.9 +/- 0.07 in the remaining 42 children; P < 0.004). Maternal antibody titers at the time of initial vaccination in these 11 were high (PRN 2.44 +/- 0.12 versus 1.9 +/- 0.04; P < 0.0001). At 5 years of age, neutralizing antibodies were comparable in the 11 CN-SCH poor responders (log SIA 2.1 +/- 0.09), the remaining CN-SCH children (2.2 +/- 0.06) and the MEN-SCH group vaccinated only once at 9 months of age (2.25 +/- 0.06). In contrast, 7/11 of the CN-SCH poor responders (64%) had stimulation indices (SI) > 3 in response to MV antigens at 5 years of age (SI 3.1 +/- 0.6) compared with only 14% in the remaining children of the CN-SCH group (2.0 +/- 0.3; P = 0.05) and 8% in the MEN-SCH group (1.4 +/- 0.2; P < 0.0003). These data suggest that early measles vaccination in the presence of maternal antibodies can sometimes prime for a balanced humoral and cellular immune response to subsequent revaccination.

Surveillance of measles in the Sudan using filter paper blood samples

Dried blood spots collected on filter paper are considered potential clinical specimens for measles surveillance because of their ease of collection, storage, and transport. The usefulness of these samples for surveillance of measles was evaluated in a field setting. Blood spots were collected by finger-prick from 316 clinically diagnosed measles patients in suburban Khartoum, mostly within a week after onset of the rash. Samples were collected between October, 2000 and April, 2003, and stored at 4 degrees C. Measles virus-specific IgM antibodies were detected in 200 (63%) of the samples using an "in-house" IgM capture ELISA. For 201 samples reconstitution and IgM measurement was repeated 1 year after initial testing with essentially the same results, showing the stability of IgM in the filter paper under these conditions. In a limited number of samples (n = 38) measles virus-specific IgM was also tested with a commercial indirect IgM ELISA. Although the results of the two assays correlated well, the "in-house" IgM capture ELISA proved slightly more sensitive. Measles virus-specific reverse transcriptase polymerase chain reaction (RT-PCR) amplicons were obtained from 16 of 57 (28%) samples tested. Sequencing of the 3' 456 nucleotides of the nucleoprotein gene showed the continued endemic circulation of genotype B3 viruses identified previously in this region. Although problems related to limited sample quantities were encountered, the present study confirms the usefulness of dried blood spots for measles surveillance. The results also demonstrate that measles continues to be endemic in the Sudan.

Measles virus protein-specific IgM, IgA, and IgG subclass responses during the acute and convalescent phase of infection

The availability of new generation serological assays allowed re-evaluation of the antibody response to measles virus. IgM, IgA, total IgG, and IgG subclass responses were studied to the three major immunogenic measles virus proteins: the fusion protein (F), haemagglutinin (H), and nucleoprotein (N). Plasma samples were obtained from clinically diagnosed measles cases (n = 146) in Khartoum (Sudan) within a week after onset of the rash. Convalescent phase samples were collected from 32 of 117 laboratory-confirmed measles cases at different time points after onset of rash. Glycoprotein-specific IgM, IgG, and IgA antibody levels correlated well to the N-specific response. For IgG and IgA, responses to F were higher than to H. IgA antibody levels were undetectable in about one third of the laboratory-confirmed cases during the acute phase, but positive in all patients tested 1-4 weeks after infection. IgM levels declined rapidly and were lost 3-6 months after infection. IgA levels declined slowly during the first year but did not return to background levels during the subsequent 2 years. IgG avidity maturation was detected during a 3-6 month period after infection. The predominant IgG subclasses during the acute phase were IgG(1) and IgG(3). The latter was lost in the convalescent phase, while the IgG(4) isotype showed a slight rise afterwards. Interestingly, acute phase IgG(3) and IgA responses were associated, and were only detected in samples with high IgG. This study provides a comprehensive perspective on the antibody response to wild-type measles virus infection.

Ion-selective electrode for the determination of prazosin in tablets

A poly (vinylchloride) (PVC) membrane electrode selective for prazosinium cation based on prazosinium-phosphotungstate (PZ)(3)PT ion-associate is prepared. The electrode exhibits a linear response with an approximate Nernstian slope over the range of 2.7 x 10(-6)-10(-2) M. Calibration graph slope of the electrode is 58 mV PZ(-1) concentration decade when preconditioned by soaking in distilled water for 1 h-20 days. The working pH of the electrode ranged from 1.5 to 6.4 and exhibits very good selectivity for the PZ with respect to a large number of inorganic cations and organic substances of biological importance. The standard additions method and potentiometric titration are used to determine the PZ in pure solution and in pharmaceutical preparations with satisfactory results.

Classification of perinatal death in a developing country

OBJECTIVES

To evaluate and compare the three most commonly used perinatal death classification systems: (1) the Nordic-Baltic; (2) the Aberdeen; and (3) the Wigglesworth, and assess their applicability in a developing country (Sudan) with a high perinatal mortality rate, and their justification for practical use in quality assurance and audit activities.

METHODS

At Omdurman Maternity Hospital (OMH), Khartoum, Sudan, 166 perinatal deaths were prospectively assessed during a 3-month period (May-August 2000) with a total of 2260 births. Narratives of 166 perinatal deaths were prepared for the purpose of audit. A panel of two Danish and one Sudanese obstetrician categorized the cases according to: (1) the Nordic-Baltic; (2) the Aberdeen; and (3) the Wigglesworth classification.

RESULTS

By all three classifications a similar fraction of cases (approx. 85%) were allocated to one category only, and in 15% of cases the assessors were in doubt into which of two categories the cases should be allocated. The necessary information is often not available, giving at least 40% classified as 'unknown' in the Aberdeen classification, whereas the Wigglesworth classification results in an even larger group of unspecified asphyxia.

CONCLUSION

Classification of perinatal deaths in developing countries is associated with problems regarding application, validity and usefulness. The Nordic-Baltic classification seems to be most suitable for appropriate stratification using routinely recorded variables and providing categories associated with specific levels of care.

Plutonium in Colorado residents: results of autopsy bone samples collected during 1975-1979

Concentrations of (239,240)Pu and the 240Pu/239Pu atom ratios were measured in rib samples from 55 non-occupationally exposed Colorado residents. Samples were collected at autopsy during 1975-1979 under an earlier study intended to compare plutonium levels in liver and lung of people who lived at various proximities to the Rocky Flats Environmental Technology Site (RFETS) near Denver. Overall, median (239,240)Pu concentrations from rib samples were 100, 80, and 57 microBq g(-1) ash weight for area locations A, B, and C, respectively. Area A encompassed subjects who lived within 25 km of RFETS, area B was between 25 and 50 km from RFETS, and area C included all of Colorado outside 50 km from the site and east of the continental divide. The corresponding median plutonium skeletal burdens estimated for these area locations were 146, 93, and 71 mBq, respectively. A statistically significant difference was noted only between plutonium concentrations in male rib samples and their skeletal burdens from area A compared to area C. However, based on a regression analysis of all study subjects, distance from RFETS was not statistically correlated to plutonium rib concentrations or skeletal burdens in this sample. Overall, median 240Pu/239Pu atom ratios were 0.20, 0.18, and 0.17 for areas A, B, and C, respectively. Although higher (239,240)Pu concentrations and skeletal burdens were indicated in area A males than area C males, we cannot conclude that RFETS releases may have caused this difference. The decreasing trends in the 240Pu/239Pu ratios with distance from RFETS are contrary with such a conclusion and strongly indicate that the material was primarily global fallout rather than weapons-grade plutonium that was processed at RFETS. Furthermore, there are other plausible explanations for the differences observed between area A and C residents. These include a decreasing trend in global fallout from the Rocky Mountain foothills eastward, smoking history differences, sample selection criteria, and possibly other unidentified factors. Nevertheless, estimated levels of total plutonium in this sample of Colorado residents were low and within the range of reported literature values for general, world-wide populations.

Genetic characterization of wild-type measles viruses circulating in suburban Khartoum, 1997-2000

Measles remains endemic in many East African countries, where it is often associated with high morbidity and mortality. We collected clinical specimens from Sudanese measles patients between July 1997 and July 2000. Sequencing of the 3' 456 nucleotides of the nucleoprotein gene from 33 measles virus (MV) isolates and 8 RNA samples extracted from clinical specimens demonstrated the presence of a single endemic MV strain with little sequence variation over time (overall nucleotide divergence of 0 to 1.3%). This was confirmed by sequencing of the complete H gene of two isolates from 1997 and two from 2000, in which the overall divergence ranged between 0 and 0.5%. Comparison with MV reference strains demonstrated that the viruses belonged to clade B, genotype B3, and were most closely related to a set of viruses recently isolated in Nigeria. Our study demonstrates a remarkable genetic stability of an endemically circulating MV strain.

Measles in suburban Khartoum: an epidemiological and clinical study

Clinical and epidemiological data were collected from 187 clinically diagnosed measles patients in Haj Yousif area, suburban Khartoum. Laboratory tests confirmed the diagnosis in 141 (75%) of the cases, but demonstrated that in 46 (25%) patients the clinical symptoms were not caused by an acute measles virus (MV) infection. According to their vaccination card, 59% of the laboratory-confirmed measles cases had been vaccinated for measles. Compared with non-measles rash disease cases, confirmed measles cases more often had severe illness (P < 0.0001), were dehydrated (P=0.01) at presentation and less likely to recover without complications [OR 0.19 (95% CI 0.09, 0.39)]. There was no difference in death rate (P=0.20). Underweight [weight-for-age Z score (WAZ) <or= -2 SD] was an independent predictor of recovery with complications [OR 0.4 (95% CI 0.2, 0.99)]. Severe measles cases (those who developed diarrhoea, pneumonia, otitis media, encephalitis or haemorrhagic rash) had similar vaccination rates and time intervals since vaccination as uncomplicated measles cases. Although severe measles had lower WAZ-scores (P=0.004), none of the nutritional parameters studied were predictive of outcome. Mortality was higher in the severe measles group [OR 8.8 (95% CI 1.7, 85.2)]. In 11 of 141 confirmed measles cases serological evidence of a recent infection with another virus was found, most commonly varicella zoster virus and dengue virus; spotted fever and rubella were among the most frequent diagnoses in 17 of 47 cases of the non-measles cases.

Nutritional stunting in Egypt: which nutrient is responsible?

We looked at the relationship between linear growth retardation and deficiencies of certain nutrients in Egyptian children. A group of 107 stunted children aged between 10 and 18 years were subjected to history-taking, physical examination and laboratory investigations. Selected cases were referred to radiology for assessment of bone age. Thirty-nine children were enrolled as controls. Serum haemoglobin, alpha-tocopherol, retinol and magnesium levels were significantly decreased in stunted children compared with the controls. Serum zinc levels were also lower in the stunted group but not significantly so. We conclude that several nutrient deficiencies occur simultaneously in stunted children and all of them may be responsible for stunting.

Impact of nutritional rehabilitation on enzymatic antioxidant levels in protein energy malnutrition

To assess the role of enzymatic antioxidants in the pathogenesis of protein energy malnutrition (PEM) and the effect of nutritional rehabilitation, we studied 30 infants with PEM (mean age 10.63 +/- 4.39 months: 10 marasmic; 8 with kwashiorkor; 12 with marasmic kwashiorkor) and 15 controls. All underwent clinical examination and laboratory investigations, including superoxide dismutase (SOD) and glutathione peroxidase (GPx) estimation before and after nutrition rehabilitation. SOD and GPx were significantly lower in all malnourished infants compared to controls, and significantly increased after nutritional rehabilitation. These significant correlations suggest that antioxidants could be introduced during PEM nutritional rehabilitation to decrease morbidity and mortality.

Job strain and self-reported health among working women and men: an analysis of the 1994/5 Canadian National Population Health Survey

This paper explores the associations, for working women and men, of high strain jobs with self-rated health in the 1994/95 Canadian National Population Health Survey (NPHS). NPHS data were obtained on men (n = 4230) and women (n = 4043), aged 18-64 who answered an abbreviated version oF the job content questionnaire (JCQ). Using the upper and lower tertiles of psychological demands and decision latitude as cut points we classified workers into high strain and other jobs. Self-rated health was the outcome. We used polytomous logistic regression analyses and controlled for potential personal and home confounders; two risk parameters were estimated: for the odds of reporting poor/fair and good health both vs. very good/excellent health. High strain work was reported by 11% of women and 9% of men. After adjusting for potential confounders, high job strain was consistently associated with worse self-rated health in both models for each gender.

Work correlates of back problems and activity restriction due to musculoskeletal disorders in the Canadian national population health survey (NPHS) 1994-5 data

OBJECTIVES

To describe the prevalence of musculoskeletal problems in the Canadian working population and to determine cross sectional associations between such problems and work factors, particularly job strain and physical demand variables.

METHODS

The Canadian 1994 national population health survey (NPHS) sampled 4230 working men and 4043 working women (ages 18-64) who answered an abbreviated version of the job content questionnaire. Workers were classified into four strain categories: high, passive, active, and low. Outcomes were restricted activity due to musculoskeletal disorders and the diagnosis of a back problem (both yes or no). Survey weights were incorporated to allow for different probabilities of selection. Logistic regression analyses were carried out separately for women and men, controlling for sociodemographic factors.

RESULTS

Prevalence of chronic back problems diagnosed by a health practitioner was 14.5% among men and 12.5% among women. Men had a 6.6% prevalence of restricted activity due to musculoskeletal disorders, whereas the corresponding figure for women was 5.3%. Women, but not men, in high strain jobs were more likely to report both back problems (odds ratio (OR) 1.60, 95% confidence interval (95% CI) 1.14 to 2.28) and restricted activity (OR 1.98, 95% CI 1.16 to 3.48) compared with those in low strain jobs. High physical exertion was an independent predictor of back problems in both sexes. For both men and women, low social support at work and high job insecurity were independent predictors of restricted activity due to musculoskeletal disorders. Conversely, chronic back problems contributed to explanation of high job strain among women (OR 1.76, 95% CI 1.30 to 2.39) and high physical exertion among men (OR 1.39, 95% CI 1.09 to 1.77), whereas restricted activity due to musculoskeletal disorders contributed to explanation of high job insecurity in both sexes.

CONCLUSIONS

Associations of interest between work stressors and musculoskeletal problems in this cross sectional study provide evidence for physical and psychosocial factors both affecting disability and being affected by disability in a working population.

Rheumatology patient and physician concordance with respect to important health and symptom status outcomes

OBJECTIVE

In chronic diseases such as arthritis, patients' priorities and values are of prime importance in the measurement of outcome. Relatively few indices take this into account. We sought to identify individual rheumatology patients' choices for important health and symptom status outcomes and assess physicians' ability to detect them.

METHODS

A cross-sectional, observational study design was used to examine rheumatology patients' choices for important health and symptom status outcomes. A descriptive summary of patients' choices of "most important" health and symptom status outcomes was compiled. The sensitivity and specificity of physicians' ability to detect their patients' choices for important health or symptom status outcomes were calculated.

RESULTS

The sample consisted of 79 rheumatology patients, 30 men and 49 women, with a mean age of 52.6 years. The feeling of being in control was the mental health outcome rated most important by the largest number of the patients (42%); cognitive function (making decisions, solving problems) (22%), feelings of being happy (18%), and feelings of being satisfied (16%) were also rated as being "most important" by many patients. Feelings of hope were rated "most important" by the fewest patients (2%). The physicians' sensitivity to detecting patients' choices of most important outcomes was highest for social functioning and lowest for mental functioning. The specificity to detect patients' choices of less important outcomes was highest for physical functioning and lowest for symptom status.

CONCLUSION

In this study involving 4 rheumatologists, patients were found to differ in their choices of important health and symptom status outcomes. Physicians often fail to identify these choices.

Variation in perceptions of treatment and self-care practices in elderly with osteoarthritis: a comparison between African American and white patients

OBJECTIVE

To compare elderly African American and white patients with osteoarthritis of the knee or hip with respect to their perceptions of the efficacy of traditional and complementary treatments and their self-care practices.

METHODS

An observational, cross-sectional study design using structured questionnaires was employed.

RESULTS

The sample consisted of 593 patients (44% African American and 56% white). The 2 groups were comparable with respect to age, disease severity or functional status, and comorbidities. African Americans were more likely than whites to report lower educational level and household income. African Americans were also more likely than whites to perceive various traditional and complementary care modalities as efficacious. However, they were less likely than whites to perceive joint replacement therapy as efficacious (odds ratio 0.52, 95% confidence interval 0.28-0.98). African American patients were more likely than white patients to rely on self-care measures for their arthritis.

CONCLUSION

African American and white patients with osteoarthritis of the knee or hip differ with respect to their perceptions of traditional and complementary treatments for arthritis and their self-care practices.