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People with disabilities (PWD) commonly experience difficulties in accessing their environments, which can lead to restricted participation in outdoor leisure-time physical activity. Participating in outdoor leisure-time physical activity (OLTPA) provides health and social benefits to PWD and benefits to the communities in which they live.

L’utilisation des technologies de l’information et de la communication (TIC) a connu une expansion importante dans les systèmes de santé de plusieurs pays. Cette étude visait à décrire les perceptions des agents de santé relatives à l’implantation et l’utilisation de la télésanté, de même que la satisfaction et la motivation dans le cadre de leur travail en zones rurales au Mali.

Les écrits sur les défis posés par l’usage de la télésanté mettent souvent en évidence les difficultés rencontrées pour son implantation, déploiement et la pérennité de son utilisation. La lenteur de la progression de l’utilisation des TIC dans le domaine de la santé est souvent dénoncée. Pourtant des progrès sont réalisés. Sur quoi reposent-ils ?

Background: In Canada, 7% of children are born preterm between 29 and 36 weeks gestational age (GA). Electroencephalography (EEG) provides a bedside evaluation of brain activity, yet the clinical significance of several EEG patterns requires further study. The goal of this study is to determine the EEG features at term equivalent age (TEA) that correlate with neurodevelopmental evaluation at TEA in infants born between 29-36 weeks GA. Methods: Prospective cohort study of preterm infants born 29-36 weeks GA with 1 hour EEG recording at TEA. EEG discontinuity index (proportion <25mcV amplitude) and spectral power densities were calculated as well as the mean and maximum values of interburst intervals. At TEA, neurodevelopment was evaluated using the General Movement Optimality Score (GMOS). Linear regression analyses were used to evaluate the association between EEG features and neurodevelopmental assessment. Results: Eighty-two children (median GA 33.6 weeks) were included (47 males). Median GMOS was 29.0 (IQR 24.3-35.0). A greater EEG discontinuity index was associated with reduced GMOS (B -6.85; 95% CI -12.13,-1.57; p=0.012). Conclusions: At TEA, a greater EEG discontinuity index was associated with a more abnormal neurodevelopmental assessment. Ongoing longitudinal neurodevelopmental assessments are needed to better evaluate the prognostic potential of TEA EEG.

The current study presents an effective and selective multifunctional nanoparticle used to deliver antiatherogenic therapeutics to inflamed pro-atherogenic regions without off-target changes in gene expression or particle-induced toxicities. MicroRNAs (miRNAs) regulate gene expression, playing a critical role in biology and disease including atherosclerosis. While anti-miRNA are emerging as therapeutics, numerous challenges remain due to their potential off-target effects, and therefore the development of carriers for selective delivery to diseased sites is important. Yet, co-optimization of multifunctional nanoparticles with high loading efficiency, a hidden cationic domain to facilitate lysosomal escape and a dense, stable incorporation of targeting moieties is challenging. Here, we create coated, cationic lipoparticles (CCLs), containing anti-miR-712 (∼1400 molecules, >95% loading efficiency) within the core and with a neutral coating, decorated with 5 mol % of peptide (VHPK) to target vascular cell adhesion molecule 1 (VCAM1). Optical imaging validated disease-specific accumulation as anti-miR-712 was efficiently delivered to inflamed mouse aortic endothelial cells in vitroand in vivo. As with the naked anti-miR-712, the delivery of VHPK-CCL-anti-miR-712 effectively downregulated the d-flowinduced expression of miR-712 and also rescued the expression of its target genes tissue inhibitor of metalloproteinase 3 (TIMP3) and reversion-inducing-cysteine-rich protein with kazal motifs (RECK) in the endothelium, resulting in inhibition of metalloproteinase activity. Moreover, an 80% lower dose of VHPK-CCL-anti-miR-712 (1 mg/kg dose given twice a week), as compared with naked anti-miR-712, prevented atheroma formation in a mouse model of atherosclerosis. While delivery of naked anti-miR-712 alters expression in multiple organs, miR-712 expression in nontargeted organs was unchanged following VHPK-CCL-anti-miR-712 delivery.

Au Québec, des services de télémédecine sont implantés pour assurer un accès plus équitable aux soins et services de santé pour la population, notamment dans les zones rurales. Toutefois, le défi qu’affronte la télémédecine est de réussir à intégrer le système de soins. Actuellement, une grande partie des projets peine à dépasser l’étape de projet pilote. L’une des explications de cette situation émanerait des nombreux questionnements d’ordres juridiques et légaux qui entourent encore la télémédecine à l’heure actuelle.

The 2-18Ffluoropropionic (2-18FFPA) acid is used as a prosthetic group for radiolabeling proteins and peptides for targeted imaging using positron emission tomography (PET). Radiolabeling of compounds with more than one acylable functional group can lead to complex mixtures of products; however, peptides can be labeled regioselectively on the solid phase. We investigated the use of a solid-phase approach for the preparation of 2-18Ffluoropropionyl peptides. 18FFPA was prepared and conjugated to the peptides attached to the solid phase support. The 18F-labeled peptides were obtained in 175 min with decay corrected yields of 10% (related to 18Ffluoride) and with a purity of 76−99% prior HPLC purification. The suitability of various coupling reagents and solid supports were tested for radiolabeling of several peptides of various lengths.

ABSTRACTMolecular methods for the rapid identification of methicillin-resistant Staphylococcus aureus(MRSA) are generally based on the detection of an S. aureus-specific gene target and the mecAgene. However, such methods cannot be applied for the direct detection of MRSA from nonsterile specimens such as nasal samples without the previous isolation, capture, or enrichment of MRSA because these samples often contain both coagulase-negative staphylococci (CoNS) and S. aureus, either of which can carry mecA.In this study, we describe a real-time multiplex PCR assay which allows the detection of MRSA directly from clinical specimens containing a mixture of staphylococci in <1 h. Five primers specific to the different staphylococcal cassette chromosome mec(SCCmec) right extremity sequences, including three new sequences, were used in combination with a primer and three molecular beacon probes specific to the S. aureuschromosomal orfXgene sequences located to the right of the SCCmecintegration site. Of the 1,657 MRSA isolates tested, 1,636 (98.7%) were detected with the PCR assay, whereas 26 of 569 (4.6%) methicillin-susceptible S. aureus(MSSA) strains were misidentified as MRSA. None of the 62 nonstaphylococcal bacterial species or the 212 methicillin-resistant or 74 methicillin-susceptible CoNS strains (MRCoNS and MSCoNS, respectively) were detected by the assay. The amplification of MRSA was not inhibited in the presence of high copy numbers of MSSA, MRCoNS, or MSCoNS. The analytical sensitivity of the PCR assay, as evaluated with MRSA-negative nasal specimens containing a mixture of MSSA, MRCoNS, and MSCoNS spiked with MRSA, was ~25 CFU per nasal sample. This real-time PCR assay represents a rapid and powerful method which can be used for the detection of MRSA directly from specimens containing a mixture of staphylococci.

Obesity is thought to have a genetic component with the estimates of heritability ranging from 0.25–0.40. As part of an ongoing study of obesity in the Old Order Amish, seven two- and three-generation families (157 individuals) were assessed for 21 traits related to obesity, including body mass index (BMI) and BMI-percentile (a standardized distribution of BMI adjusted for age and sex). Genotyping was performed using a panel of 384 short-tandem repeat markers. In this sample, the estimates of heritability ranged from 0.16–0.31 for BMI and from 0.40–0.52 for BMI-percentile. Model-independent linkage analysis identified candidate regions on chromosomes 1, 5, 7, 8, and 11. Given that several markers on 7q were significant for both BMI and BMI-percentile (P ≤ 0.001) and that the structural locus for leptin was located on 7q, this region was considered to be the primary candidate region. Subsequent typing of additional flanking markers on 7q corroborated the original findings. Tests of intrafamilial association for alleles at markers in this candidate region were significant at similar levels. Although there is some evidence for linkage and association in the region containing leptin, there appears to be stronger evidence for linkage (P ≤ 0.001) and association (P ≤ 0.00001) with BMI in a region 10–15 cM further downstream of leptin, flanked by markers D7S1804 and D7S3070 with peak values from D7S495–D7S1798. Evidence from linkage and association studies suggests that this region (D7S1804–D7S3070) may be responsible, at least in part, for variation in BMI and BMI-percentile in the Old Order Amish. Published 2003 Wiley-Liss, Inc.

Acyclic diastereoselection is achieved for the formation of thioaminyl acetals. The highly intramolecular stereocontrolled SN2 displacement of the thioaminyls allows for the formation of cyclic nucleoside derivatives. This versatile approach may provide easy access to a large variety of N-glycosides.

We have prepared four potentially lipophilic N-substituted hydroxypyridinones containing unsaturated hydrocarbon groups. The propyl vinyl ether derivative (3) has been characterized by an X-ray diffraction study. Complexes of the type cis-MoO2L2, where L represents the hydroxypyridinonato ligands, have also been prepared. The pyridinone ligands are bound to molybdenum in a cis bidentate fashion via the deprotonated hydroxy groups and the ketone moieties. Initial investigations into the hydroboration of the alkene groups in the pyridinone ligands and corresponding metal complexes is presented. Crystals of (3) are monoclinic, with a 10.466(1), b 13.388(1), c 15.386(2) Å, β 102.343(8)˚, Z 8, space group P21/n. Keywords. Molybdenum; pyridinones; hydroboration; boronic acids.

Indium-111 leukocyte scanning of the abdomen (IAS) was performed in 10 patients with ulcerative colitis and in 39 patients with Crohn's disease involving the small intestine (in 25 occasions) and/or the colon (17 cases). Radionuclide uptake by the gut was seen in 84 of the patients with active inflammation. We compared the extent of the disease displayed by IAS with the findings obtained by either radiological or endoscopic studies or at surgery. In two-thirds of the patients, the IAS gave an accurate evaluation of the extent of the disease (sensitivity 68). False-positive IASs were not seen in small bowel disease (specificity 100), but were observed on 4 occasions on the colon (specificity 86). The intensity of the radionuclide uptake could not be correlated with the clinical activity of the disease as evaluated by the Crohn's disease activity index. These results suggest that IAS is not superior to the standard procedures used to detect and localize inflammatory bowel disease and that IAS cannot replace these techniques. However, the simplicity of IAS and the complete lack of complications associated with its use render it useful in the evaluation of the extent and distribution of inflammation in some patients, mainly those with severe disease in whom standard diagnostic procedures would be contraindicated.

In the absence of biological markers, dementia classification remains complex both in terms of characterization as well as early detection of the presence or absence of dementing symptoms, particularly in diseases with possible secondary dementia. An empirical, statistical approach using neuropsychological measures was therefore developed to distinguish demented from non-demented patients and to identify differential patterns of cognitive dysfunction in neurodegenerative disease. Age-scaled neurobehavioral test results (Wechsler Adult Intelligence Scale—Revised and Wechsler Memory Scale) from Alzheimer's (AD) and Huntington's (HD) patients, matched for intellectual disability, as well as normal controls were used to derive a classification formula. Stepwise discriminant analysis accurately (99% correct) distinguished controls from demented patients, and separated the two patient groups (79% correct). Variables discriminating between HD and AD patient groups consisted of complex psychomotor tasks, visuospatial function, attention and memory. The reliability of the classification formula was demonstrated with a new, independent sample of AD and HD patients which yielded virtually identical results (classification accuracy for dementia: 96%; AD versus HD: 78%). To validate the formula, the discriminant function was applied to Parkinson's (PD) patients, 38% of whom were classified as demented. The validity of the classification was demonstrated by significant PD subgroup differences on measures of dementia not included in the discriminant function. Moreover, a majority of demented PD patients (65%) were classified as having an HD-like pattern of cognitive deficits, in line with previous reports of the subcortical nature of PD dementia. This approach may thus be useful in classifying presence or absence of dementia and in discriminating between dementia subtypes in cases of secondary or coincidental dementia.

To identify factors influencing willingness to participate (WTP) in clinical gerontologic research, a questionnaire containing descriptions of seven research projects with a corresponding set of questions about perceived intrusiveness (discomfort and inconvenience), stipend, and other incentive factors was sent to 1004 community-dwelling research subject registry members. There was an inverse relationship between perceived level of intrusiveness and WTP. The more intrusive the study, the greater the relative influence of a stipend on WTP. Male gender and a new experience with an opportunity to learn were independently related to WTP. Subject ratings of perceived intrusiveness for each study component were entered into a factor analysis to guide the development of a three- tier “Level of Intrusiveness” scale. Although prospective validation is necessary, the Level of Intrusiveness scale may be useful in predicting WTP, and determining when other incentives are needed to improve subject recruitment for clinical research.

During development of the sea urchin Strongylocentrotus purpuratus embryo, transcription of the Spec1 and actin CyIIIa genes is activated and the corresponding mRNAs accumulate specifically in ectoderm cells. We show that in gastrulae this tissue specificity of mRNA accumulation is regulated largely if not entirely at a posttranscriptional level. We used RNAase protection assays with intron and exon probes to measure the levels of nuclear precursors and mature message, respectively, in total RNA from embryo fractions enriched for ectoderm (Ect) or endoderm+mesenchyme (E/M) cells. These measurements demonstrate that E/M cells, which do not accumulate Spec1 and actin CyIIIa mRNAs, contain high levels of intron transcripts, indicating that cells of the E/M tissues transcribe these genes. At later stages, transcripts containing intron sequences are restricted to ectoderm cells. These results indicate that there is a transition from posttranscriptional to transcriptional regulation of tissue-specific mRNA accumulation during the gastrula stage. Measurements of transcription rate by nuclear run-on assays substantiate this conclusion for Spec1 and extend it to two other genes, SpEGFI and Spec2c, which also encode ectoderm-specific mRNAs. Posttranscriptional regulation was not observed for the SM50 gene whose mRNA accumulates only in primary mesenchyme cells, or for actin CyI which is expressed predominantly in E/M cells of gastrulae.

The purpose of this study was to examine different lifting conditions with combined flexion and twisting of the trunk relative to the pelvis full twist and halftwist techniques and to compare them to a situation using feet pivoting with minimization of trunk motions relative to the pelvis. Nine subjects with limited experience were tested with two force platforms and two 16mm cameras coupled with two mirrors dynamic threedimensional multisegment models were constructed and the net muscular moments as well as the angular velocities of the trunk relative to pelvis were determined about the three orthogonal orthopaedic axes of the trunk at L5S1 in flexionextension, lateral bending, and twisting. The results showed that pivoting required larger extension moments but considerably smaller twisting moments and that these moments were exerted from a safer trunk posture. Pivoting appears to be a good compromise to avoid or minimize complex trunk postures and loadings.

In cross-sectional analysis of 1,799 subjects of the Paquid Research Program, an epidemiological study on brain aging conducted in the Bordeaux area (France), we have studied the effects of age, gender, and education level on psychometric tests requiring visuo-spatial focused attention and psychomotor performance. Although previous studies suggest that normal aging produces no significant change in focused attention, we did observe lower attentional abilities and lower speed of execution with increasing age. Female gender and low education level were also related to poorer attention and psychomotor performance. As the effects of these individual factors are difficult to disentangle from each other on the small samples of subjects used in group studies, epidemiological surveys seem useful to provide a better understanding of the neuropsychology of aging.

Using data obtained during the baseline screening of the PAQUID cohort, an epidemiologic study on brain aging conducted in the Bordeaux area of France, we studied the relationship between lifetime occupation and memory performance in visual recognition (Benton Visual Retention Test; BVRT) and verbal induced recall (Wechsler Paired Associates Test; WPAT) in 2,720 elderly community residents. Occupational category was strongly correlated with poor memory performance for both the BVRT and the WPAT. Independent of the educational level, the risk of having poor memory performance was two to three times greater for farmers, domestic service employees, and blue-collar workers than for professionals/managerials. Occupational category should be taken into account in future cross-national studies on brain aging.

Two doses of halazepam, 20 and 40 mg, were compared to diazepam 5 mg and placebo in this double-blind, parallel experiment. The medications were administered thrice daily during the first 3 days, and twice daily during the following 11 days. Their effects were measured on the tandem walk and manual dexterity of 59 elderly female subjects. Most volunteers had some walking difficulty prior to the study and 21 suffered from some illness. With the higher dose of halazepam a statistically and clinically significant impairment of motor coordination was observed. Halazepam 40 mg, at the regimen above mentioned, should therefore not be used in elderly persons. This is substantiated by the results on all pertinent variables: tandem walk, manual dexterity, side effects and compliance to the drug regimen; indeed only 5 subjects out of 15 could tolerate halazepam 40 mg twice daily. With the manual dexterity test, significant effects of diazepam 5 mg and halazepam 20 mg were also observed. Furthermore, this test as well as the analysis of the side effects, shows that the lower dose of halazepam is well tolerated when compared to diazepam 5 mg.

The purpose of the present study was to examine the relation between principal lifetime occupation and cognitive performance with the initial data collected (1988-1989) in a cohort of 3,777 community residents of the area of Bordeaux, France, aged 65 years and older. Subjects were considered as cognitively impaired if they scored under 24 on the French version of the mini-mental state examination. Cognitive impairment was found to vary significantly across the different occupational categories. Results of the logistic regression show that age, sex, and educational level are significantly related to cognitive impairment. Moreover, after controlling for these and other covariates, farmworkers (odds ratio (OR) = 6.1, 95% confidence interval (CI) 3.3-11.4), farm managers (OR = 2.9, 95% CI 1.6-5.1), domestic service employees (OR = 2.8, 95% CI 1.5-5.1), and blue-collar workers (OR = 2.5, 95% CI 1.4-4.4) had a higher risk of cognitive impairment than did subjects who had an intellectual occupation. Follow-up of the cohort will permit precise determination of the role of principal lifetime occupation in subsequent cognitive deterioration. Occupational status should be taken into consideration when studying brain aging.

In this double-blind study, the effects of diazepam (0.15 mg/kg intramuscularly for premedication and 0.3 mg/sec intravenously for induction) on memory were compared to those of standard premedication and induction agents, meperidine (1 mg/kg) and thiopentone (2.5 mg/sec). Forty patients (32 females and 8 males), in physical status I, undergoing minor elective operations, received an auditory stimulus immediately before induction of anaesthesia; stimulus recall as well as subjective side-effects were assessed the following day. The volunteers were randomly assigned to either of two groups, each receiving one of the premedicaments. The two groups were further subdivided into sub-groups corresponding to the induction agents and intubation.

Recent hyracoids and elephants share a taxeopode arrangement of tarsal and carpal bones, a condition in which bones are aligned with minimal interlocking between adjacent elements. Taxeopody has often been interpreted as a synapomorphy reflecting a close phyletic link between Hyracoidea and Proboscidea, but recently it has been suggested [Fischer, M. S. (1986) Cour. Forschungsinst. Senckenberg 84, 1-132] that hyracoid taxeopody is an independent acquisition resulting from selection favoring increased midcarpal and midtarsal rotation and that Hyracoidea is actually allied with Perissodactyla. As a test of this hypothesis, isolated carpal and tarsal bones of primitive Oligocene hyracoids from the Fayum, Egypt, have been examined to determine whether these indicate a taxeopode or diplarthral carpus and tarsus. Four complete astragali from the Fayum, representing at least three taxa, show a single, slightly convex articular surface on the head for articulation with the navicular and lack a facet for the cuboid. Two complete magna representing two species have a single proximal facet for articulation with the lunar, and they lack a facet for the scaphoid. Thus, both the carpus and tarsus of Fayum hyracoids are taxeopode. Taxeopody in hyracoids cannot be attributed to selection for carpal and tarsal rotation in climbers because the Oligocene, Miocene, and Recent species show great diversity in body size and probably locomotor specializations, despite relative uniformity of structure in the carpus and tarsus. The shared taxeopody of hyracoids and proboscideans, along with other osteological characters and similarities in hemoglobin, eye lens proteins, and other molecules, all suggest that Hyracoidea belongs within Paenungulata.

The analgesic property of the anesthetic gas N2O has long been known and used to treat pain in clinical medicine and dentistry. The present study was conducted to identify by subtype and possible location the brain opioid receptors that mediate N2O antinociception in rats. A 5-min exposure to 70% N2O consistently evoked an antinociceptive effect in the hot plate test. This drug effect was partly antagonized in dose-related fashion by i.c.v. pretreatment with naltrexone, D-Phe-Cys-Tyr-D-Trp-Orn-Thr-Pen-Thr-NH2 and beta-endorphin, which block multiple, mu and epsilon opioid receptors, respectively. However, the N2O-evoked antinociception was unaffected by i.c.v. pretreatment with either the delta opioid antagonist naltrindole or the kappa opioid antagonist nor-binaltorphimine. When D-Phe-Cys-Tyr-D-Trp-Orn-Thr-Pen-Thr-NH2 was administered intracerebrally directly into the periaqueductal gray, N2O antinociception was partly antagonized in a dose-dependent manner. The antinociceptive response to N2O was uninfluenced by beta-endorphin administered into the periaqueductal gray. The findings of these pharmacological antagonism studies are consistent with the hypothesis that exposure to N2O causes a neuronal release of beta-endorphin. These results indicate that supraspinal mu and epsilon opioid receptors mediate N2O antinociception in the rat hot plate paradigm and that one central site of such mu but not epsilon opioid receptors is the periaqueductal gray.

Administration of the anesthetic gas N2O evoked an antinociceptive effect in two rodent antinociception paradigms. In the mouse abdominal constriction test, pretreatment with the nitric oxide synthase (NOS) inhibitor L-NG-nitroarginine (L-NOARG) caused dose-related antagonism of the antinociceptive effect of N2O but not of either morphine or trans(+/-)-3,4-dichloro-N-methyl-N-[2-(1-pyrrolidinyl)cyclohexyl] benzeneacetamide methane sulfonate. This antinociceptive effect was also antagonized by systemic pretreatment with the NOS inhibitors L-NG-nitroarginine methyl ester (L-NAME) and L-NG-monomethylnitroarginine. The antagonism of N2O by L-NOARG and L-NAME was completely reversed by i.c.v. administration of L-arginine but not D-arginine. In the absence of NOS inhibition, N2O antinociception was potentiated by i.c.v. treatment with L-arginine but not D-arginine. The i.c.v. pretreatment with L-NAME also reduced N2O antinociception; this antagonism was also stereospecifically reversed by L-arginine. In the rat hot plate test, the antinociceptive response to 70% N2O was antagonized in dose-related manner by i.c.v. pretreatment with L-NOARG or L-NAME. N2O antinociception was restored by i.c.v. treatment with L-arginine but not D-arginine. However, neither L-arginine nor D-arginine alone affected N2O antinociception. These results implicate a key role for NO in the mediation of the antinociceptive effects of N2O in both mice and rats.

Tasks associated with patient handling may present nursing aides with some risk of injuring the lumbar spine. The purpose of this study was to estimate the forces at L5/S1 and to assess mechanical work and energy transfers in a task consisting of raising a patient (a 72·6thinsp; kg manikin) from a chair using three different methods: (A) with the hands; (B) with the forearms behind the patient's back at shoulder level; and (C) with a belt held at waist level. Six male subjects took part in the experiment. Spinal forces were estimated from a static and planar mathematical model used in conjunction with cinematography techniques, a force platform and EMG recordings. External forces and the internal forces (compression and shear at L5/S1) were determined from free-body diagrams and static equations. The model was analysed for its sensitivity in estimating patterns of EMG forces, intra-discal and musculo-ligamentous forces, intra-abdominal pressure and inertial forces. The model was found to discriminate between the relative demands imposed on the spine by the different lifting methods, but the absolute values of the forces remain uncertain because of the uncertainty residing in many of the model's hypotheses. The method requiring a belt to lift the patient was found to be considerably more strenuous for the spine and also to require a larger amount of work; it should therefore not be recommended as a task for nursing aides.

Handling patients in bed using a piqué (a waterproof padded sheet placed under the patient) is associated with a high incidence of risks for the spine with, in particular, the activity of pulling and turning the patient with the pique representing the highest risk. Fifteen female nursing aides were evaluated for compression and shear forces at the L5/S1 joint and for selected muscular activities in the trunk and shoulders. Films, force platforms and EMG recordings supplied the data; dynamic segmental analyses were performed to calculate reaction forces at L5/S1, and a planar single-muscle equivalent was used to estimate internal loads. Different execution parameters were examined including execution velocity, height of bed, direction of effort, leg position and knee support. A 'free' task, and a manual task not involving the pique, were also investigated. Recommendations are made for reducing spinal loading. The results also suggest that a change of direction in the trunk motion may present some risks when associated with handling of heavy loads. Furthermore transfer of problems from a particular joint to other joints is likely to occur.