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Many of the 700,000 American military personnel deployed to the Persian Gulf region in 1990 and 1991 have since reported health symptoms of unknown etiology. This cluster of symptoms has been labeled Gulf War Illness and include chronic musculoskeletal pain, fatigue, headaches, memory and attention difficulties, gastrointestinal complaints, skin abnormalities, breathing problems, and mood and sleep problems [1,2]. There have been few high-quality intervention trials and no strong evidence to support available treatments [3]. Tai Chi is an ancient Chinese martial art with benefits that include enhancing physical and mental health and improving quality of life for those with chronic conditions.In this randomized controlled trial, GW Veterans are randomly assigned to either Tai Chi or a Wellness control condition, with both remotely delivered intervention groups meeting twice a week for 12 weeks. The primary aim is to examine if Tai Chi is associated with greater improvements in GWI symptoms in Veterans with GWI compared to a Wellness intervention. Participants will receive assessments at baseline, 12 weeks (post-intervention), and follow-up assessments 3- and 9-months post-intervention. The primary outcome measure is the Brief Pain Inventory that examines pain intensity and pain interference.This trial will produce valuable results that can have a meaningful impact on healthcare practices for GWI. If proven as a helpful treatment for individuals with GWI, it would support the implementation of remotely delivered Tai Chi classes that Veterans can access from their own homes.

There has been a call to identify populations who are at-risk for harassment. At our institution, participant-perpetrated harassment led to the development of an institution-wide program called Cultivating Respect in Research Environments (CuRRE). In this article, we describe the proactive and multipronged approach used to promote and implement the CuRRE program. We describe a policy created to set guidelines and expectations for research participants and discuss the educational and skills-based trainings delivered to principal investigators and research staff members. Research staff members completed anonymous surveys before and after the training. Over half of the attendees reported having been harassed by a participant/patient. Attendees responded favorably to the training; they felt more confident and better equipped to address participant-perpetrated harassment at the conclusion of the training. Given the dearth of literature in this area, we offer our experiences to encourage others to address this issue within their own research environment and institution.

Gulf War illness (GWI) is a chronic and multisymptom disorder affecting military veterans deployed to the 1991 Persian Gulf War. It is characterized by a range of acute and chronic symptoms, including but not limited to, fatigue, sleep disturbances, psychological problems, cognitive deficits, widespread pain, and respiratory and gastrointestinal difficulties. The prevalence of many of these chronic symptoms affecting Gulf War veterans occur at markedly elevated rates compared to nondeployed contemporary veterans. To date, no effective treatments for GWI have been identified. The overarching goal of this umbrella review was to critically evaluate the evidence for the potential of Tai Chi mind-body exercise to benefit and alleviate GWI symptomology. Based on the most prevalent GWI chronic symptoms and case definitions established by the Centers for Disease Control and Prevention and the Kansas Gulf War Veterans Health Initiative Program, we reviewed and summarized the evidence from 7 published systematic reviews and meta-analyses. Our findings suggest that Tai Chi may have the potential for distinct therapeutic benefits on the major prevalent symptoms of GWI. Future clinical trials are warranted to examine the feasibility, efficacy, durability and potential mechanisms of Tai Chi for improving health outcomes and relieving symptomology in GWI.

Background Afamelanotide (AFA) is a synthetic analogue of α-melanocyte-stimulating hormone that is approved for the treatment of patients affected by erythropoietic protoporphyria (EPP). AFA induces a “sun free” tanning and changes of acquired melanocytic nevi (AMN) that are generically described as “darkening”. Objectives To assess clinical and dermoscopic AMN changes during AFA treatment. Methods Adult EPP patients treated with two AFA implants 50 days apart were enrolled. They underwent a clinical and dermoscopic examination of all AMN at baseline (T0), and after 5 (T1) and 12 (T2) months from the first AFA implant. The general pattern, symmetry, number, and size of pigmented globules, morphology of the pigment network, and dermoscopic melanoma features were assessed. Results Fifteen patients were enrolled with 103 AMN. At T1 all reticular and 2-component AMN showed a focal network thickening that returned to baseline by T2. The increase of globules’ number was observed at T1 but not at T2. The difference in number was not influenced by patients’ age or phototype. Dermoscopic changes suggestive of malignancy were never seen. The development of new AMN was never registered. Conclusions AFA treatment induces reversible changes of AMN dermoscopic morphology without findings suggestive of malignant transformation and it does not stimulate the development of new AMN.

Vector-borne pathogens are responsible for serious emerging diseases and Rangelia vitalii, the etiologic agent of canine rangeliosis, is one of the most pathogenic tick-borne pathogens for dogs in South America. This protozoan is transmitted by the Amblyomma aureolatum tick bite and the clinical features associated to the disease are fever, hemolytic anemia, jaundice, hepatosplenomegaly and bleeding from natural orifices, mainly from the ear egde. The reports of canine rangeliosis in Argentina are scarce. In the present study we report the detection of Rangelia vitalii in a naturally infected dog from Gualeguay, Entre Ríos, Argentina with history of tick infestation and clinical signs compatible with rangeliosis. An initial blood sample was positive to piroplasmids by blood smear examination and the molecular amplification of a fragment of the 18SrRNA gene. Sequencing of the fragment confirmed the pathogen identity. After treatment with imidocarb dipropionate, the clinical signs remitted and the blood smear tested negative. Instituto de Biotecnología Fil: Borras, Pablo. Administración Nacional de Laboratorios e Institutos de Salud “Dr. Carlos G. Malbrán" (ANLIS). Centro Nacional de Diagnóstico e Investigación en Endemo Epidemias (CENDIE); Argentina Fil: Salvador, F. Laboratorio MF Salvador; Argentina Fil: Rinaldi, V. Laboratorio MF Salvador; Argentina Fil: Armitano, Rita Inés. Instituto Nacional de Enfermedades Infecciosas. Servicio Bacteriología Especial; Argentina Fil: Armitano, Rita Inés. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Biotecnología; Argentina Fil: Farber, Marisa Diana. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Biotecnología. Laboratorio de Hemoparásitos; Argentina. Fil: Farber, Marisa Diana. Administración Nacional de Laboratorios e Institutos de Salud “Dr. Carlos G. Malbrán" (ANLIS). INEI. Servicio Bacteriología Especial; Argentina Fil: Sanchez, R. ROSLAB Diagnostico Veterinario; Argentina Fil: Mori, L. Laboratorio MF Salvador; Argentina Fil: Guillemi, Eliana Carolina. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Biotecnología; Argentina Fil: Guillemi, Eliana Carolina. Administración Nacional de Laboratorios e Institutos de Salud “Dr. Carlos G. Malbrán" (ANLIS). INEI. Servicio Bacteriología Especial; Argentina

Brief Abstract: Small cell carcinoma of the urinary tract is an aggressive malignancy that comprises less than 1% of urinary bladder cancers. The renal pelvis and ureter, also lined by urothelium, are rare sites for small cell carcinoma. The diagnosis and staging of upper tract cancer are difficult due to the need for small, atraumatic instrument to access the upper tract. There are fewer than 40 reported cases of upper urinary tract small cell carcinoma. These include both pure and variant histologies. We present the management of a 72 year old male with small cell carcinoma of the upper urinary tract. Keywords: Small cell carcinoma, Neuroendocrine tumor, Renal pelvis and ureter cancer

Background Evaluations to determine one's readiness to initiate hormone therapy are often requested by endocrinologists or institutions who provide gender-affirming hormone therapy for transgender adults. Unfortunately, many mental health providers report unfamiliarity in working with gender-nonconforming individuals and with the needs of this population, and do not feel equipped to conduct these evaluations. Objectives The purpose of this paper is to introduce an instrument that can guide providers to conduct a hormone readiness evaluation that is consistent with the current best practices model of care put forth by the World Professional Association for Transgender Health Standards of Care. Methods Development of the Assessment of Readiness and Consent for Hormone Therapy (ARCH) was informed by published literature and consultation with subject matter experts. The tool has been revised through an iterative approach based on provider experience and client feedback. Results The ARCH has been used as part of a national training initiative in transgender healthcare and favorable feedback has been received. Providers have reported that using the ARCH has increased their confidence in their ability to provide sensitive care that is consistent with best practice recommendations. Conclusions Use of the ARCH has the potential to enhance care for a population that often encounters poor access to culturally competent providers and treatments. The focused nature of the interview helps providers support and advocate for their clients by providing and gathering information necessary to make meaningful recommendations that will help hormone treatment candidates enhance their gender related quality of life.

Background Low physical activity (PA) is associated with adverse health outcomes independent of airflow limitation in COPD. Self-reported assessments are often limited to global estimates of PA and may not be directly translatable to patients' goals and motivations. We developed a task-oriented PA checklist and examined its performance relative to pedometer-assessed daily step count in two COPD cohorts. Methods Task-oriented daily physical activity (DPA) was assessed in two COPD cohorts using either interviewer-administered recall questionnaire (DPA-R, Cohort 1, n = 109) or a self-administered diary-format daily checklist (DPA-C, Cohort 2, n = 175). Daily step count was measured in both cohorts using the Omron HJ-720 ITC pedometer. Univariate associations between individual DPA items and [a] cross-sectional and [b] longitudinal change (Cohort 1) in daily step count were assessed using a Pearson's correlation. Composite scores comprised of individual DPA items with univariate association p-values Results Tasks associated with average daily step count in both cohorts included putting on shoes, showering, washing hair, walking for exercise, the frequency of walks >10 min, and walking on an incline (Pearson's rho range = 0.14–0.43). A composite score of these 6 DPA items demonstrated significant associations with baseline average daily step count in both cohorts (ρ = 0.5 & 0.47, Cohorts 1 & 2, respectively) and longitudinal change in daily step count (ρ = 0.46, Cohort 1). Conclusions Self-reported task-oriented assessments complement direct monitoring and have potential clinical utility in exercise counseling to increase PA among COPD patients. Trial registration ClinicalTrials.gov NCT01772082.

The primary objective of this pilot study was to develop and implement a telephone intervention for veterans with diabetes and posttraumatic stress symptoms (PTSS). Additional objectives were to evaluate study feasibility and to conduct exploratory analyses of the influence of the intervention on diabetic self-care, quality of life, treatment adherence, and mental health functioning. Twenty-three veterans with PTSS and diabetes enrolled in the study and received an initial assessment interview and intervention session. Twenty participants completed the study protocol in its entirety and also received 7 weekly motivational telephone calls with a clinician and a final assessment. Results revealed high levels of compliance with telephone calls. Participants reported satisfaction with and benefit from the intervention that occurred during weekly telephone calls. Participants reported a statistically significant increase in exercise behaviors and healthy eating from pre- to postintervention. Results also revealed a decrease in psychological distress. Although these data are preliminary, they speak to the feasibility and benefits of a brief telephone intervention to address self-care behaviors critical to the management of diabetes for individuals with PTSS.

Physical activity (PA) is recommended in all patients with chronic obstructive pulmonary disease (COPD). Technology-based interventions can deliver effective, scalable behavior-change techniques; though feasibility and acceptability among older adults is not established. Veterans with COPD (N=112, aged 49-89 years, median=68) were randomized to a 12-week web-based and pedometer intervention or a pedometer alone (control). Across groups, there was no significant difference between middle-aged (

Kidney cancer is the ninth most common malignancy in the United States. Most kidney cancers are clear cell renal cell carcinoma (RCC) and arise as solid tumors from kidney parenchyma. In the setting of metastatic disease, a primary renal tumor is usually identified, and metastases are often to lung, bone, liver, and brain. Metastatic RCC without an identifiable solid kidney tumor is exceedingly rare. We report the case of a 52 year old male with a rare cutaneous RCC metastasis without an identifiable primary renal tumor. Keywords: Kidney cancer, Renal cell carcinoma

Background Although there are effective evidence-based treatments for posttraumatic stress disorder (PTSD), many individuals drop out or do not benefit from treatment. There is a need for new treatments, including approaches that are nontrauma focused. Objective The purpose of this program evaluation was to investigate the acceptability of a Wellness Group designed to promote healthy behaviors and adaptive coping when offered to veterans with PTSD. Methods Nine veterans in a PTSD outpatient clinic enrolled in a 12-week, 24-session Wellness Group. Acceptability of the intervention was evaluated with attendance data, questionnaires, and interviews. Results Group attendance rates were high and no participants dropped out of treatment. Treatment satisfaction was high and all veterans reported gains in at least 3 of the 8 Wellness domains covered. Interview data supported the findings that veterans had positive reactions to the group. Conclusion A Wellness approach may offer a low-cost alternative or supplementary treatment for veterans with PTSD that is highly acceptable and may improve health behaviors, quality of life, and coping skills.

We present a new video-assisted minimally invasive technique for the treatment of pilonidal disease (E.P.Si.T: endoscopic pilonidal sinus treatment). Between March and November 2012, we operated on 11 patients suffering from pilonidal disease. Surgery is performed under local or spinal anesthesia using the Meinero fistuloscope. The external opening is excised and the fistuloscope is introduced through the small hole. Anatomy is identified, hair and debris are removed and the entire area is ablated under direct vision. There were no significant complications recorded in the patient cohort. The pain experienced during the postoperative period was minimal. At 1 month postoperatively, the external opening(s) were closed in all patients and there were no cases of recurrence at a median follow-up of 6 months. All patients were admitted and discharged on the same day as surgery and commenced work again after a mean time period of 4 days. Aesthetic results were excellent. The key feature of the E.P.Si.T. technique is direct vision, allowing a good definition of the involved area, removal of debris and cauterization of the inflamed tissue.

Objective To examine feasibility, qualitative feedback and satisfaction associated with a 4-session introduction to Tai Chi for veterans with post-traumatic stress symptoms. Design We observed and reported recruitment and retention rates, participant characteristics, adherence, and satisfaction across 2 cohorts. We also examined qualitative feedback provided by questionnaires, focus groups and individual interviews. Main outcome measures Rates of recruitment and retention, focus group and individual feedback interviews, self-reported satisfaction. Participants 17 veterans with post-traumatic stress symptoms. Results Almost 90% (17/19) of those eligible following the telephone screen enrolled in the programme. Three-quarters (76.4%) of the participants attended at least 3 of the 4 Tai Chi sessions. Qualitative data analysis revealed themes indicating favourable impressions of the Tai Chi sessions. In addition, participants reported feeling very engaged during the sessions, and found Tai Chi to be helpful for managing distressing symptoms (ie, intrusive thoughts, concentration difficulties, physiological arousal). Participants also reported high satisfaction: 93.8% endorsed being very or mostly satisfied with the programme. All participants (100%) indicated that they would like to participate in future Tai Chi programmes and would recommend it to a friend. Conclusions Tai Chi appears to be feasible and safe for veterans with symptoms of post-traumatic stress disorder (PTSD), is perceived to be beneficial and is associated with high rates of satisfaction. This study highlights the need for future investigation of Tai Chi as a novel intervention to address symptoms of PTSD.

Staged buccal mucosa graft urethroplasty has emerged as a reliable procedure for difficult anterior urethral strictures not amenable to one-stage graft or flap reconstruction. It has primarily been used for strictures and/or fistulae occurring after previous surgery for hypospadias or those related to lichen sclerosus (LS). Success rates in these patient populations have improved when compared to earlier techniques. However, prior studies have demonstrated a number of patients requiring more than two procedures to complete the reconstruction, as well as some who have been content with their voiding pattern after the first operation and therefore elected to forego second stage tubularization. In this setting, we have reviewed the surgical technique and summarized previously published work. There may be an opportunity to complete more of these repairs in two operations using additional oral mucosa at the time of tubularization.

“Health is the vital principle of bliss, and exercise, of health.” —James Thomson, 18th century Scottish poet Exercise is considered a crucial component of disease management for individuals with type 2 diabetes, and it is associated with extensive health and mental health benefits. Although the benefits of exercise are well established, most people with diabetes do not engage in physical activity in a regular and sustained manner. To address this, it is important to develop interventions that are easily and broadly accessible and that address specific barriers that prevent individuals with diabetes from participating in physical activity. Several investigations have examined the efficacy of using various forms of technology to deliver or enhance interventions designed to promote regular physical activity. The outcomes have been promising, providing support for continued exploration of telehealth interventions that promote physical activity in the diabetic population. This article provides an overview of telephone, Internet-based, and home-based monitoring interventions that promote physical activity, with a focus on those with diabetes. It also discusses the potential advantages of using telehealth interventions in this context.

Bark beetles (Coleoptera: Curculionidae, Scolytinae) are commonly recognized as important tree mortality agents in coniferous forests of the western U.S.A. 2 High stand density is consistently associated with bark beetle infestations in western coniferous forests, and therefore thinning has long been advocated as a preventive measure to alleviate or reduce the amount of bark beetle-caused tree mortality. 3 The present study aimed to determine the effectiveness of thinning to reduce stand susceptibility to bark beetle infestations over a 10-year period in Pinus jeffreyi forests on the Tahoe National Forest, California, U.S.A. Four treatments were replicated three times within 1-ha square experimental plots. Treatments included thinning from below (i.e. initiating in the smallest diameter classes) to a residual target basal area (cross-sectional area of trees at 1.37 m in height) of: (i) 18.4 m 2 /ha (low density thin); (ii) 27.6 m 2 /ha (medium density thin); (iii) 41.3 m 2 /ha (high density thin); and (iv) no stand manipulation (untreated control). 4 Throughout the present study, 107 trees died as a result of bark beetle attacks. Of these, 71% (75 trees) were Abies concolor killed by Scolytus ventralis; 20.6% (22 trees) were Pinus ponderosa killed by Dendroctonus ponderosae; 4.7% (five trees) were P. jeffreyi killed by Dendroctonus jeffreyi ; 1.8% (two trees) were P. jeffreyi killed by Ips pini ; 0.9% (one tree) were P. jeffreyi killed by Orthotomicus (= Ips) latidens; 0.9% (one tree) were P. ponderosa killed by both Dendroctonus brevicomis and D. ponderosae; and 0.9% (one tree) were P. jeffreyi killed by unknown causes. 5 In the low density thin, no pines were killed by bark beetles during the 10-year period. Significantly fewer trees (per ha/year) were killed in the low density thin than the high density thin or untreated control. No significant treatment effect was observed for the percentage of trees (per year) killed by bark beetles.

The process of psychosocial evaluation for weight loss surgery (WLS) is one that goes beyond serving the function of information-gathering (Bauchowitz et al. in Surg Obes Relat Dis 3:554-558, 2007; Friedman et al. in Surg Obes Relat Dis 3:376-382, 2007; Lanyon and Maxwell in Obes Surg 17:321-328, 2007; Sogg and Mori in Obes Surg 14:370-380, 2004; Sogg and Mori in Surg Obes Relat Dis 4:455-463, 2008). This process offers myriad opportunities for delivering significant and powerful interventions that can enhance the patient's success in the WLS process. A discussion of the unique opportunities for psychosocial intervention afforded by the pre-surgical evaluation process is presented, using The Boston Interview for Bariatric Surgery (Sogg and Mori in Surg Obes Relat Dis 4:455-463, 2008) as the organizing framework.

Recruiting sufficient numbers of participants for physical activity trials for individuals with diabetes can be difficult because there are often many behavioral demands for participants, and inclusion and exclusion criteria can be extensive. This study examined the recruitment strategies used for a randomized, controlled trial designed to investigate the efficacy of an automated telephone intervention to promote physical activity in adults with type 2 diabetes in an urban Veterans Administration health care system. Traditional recruitment approaches of posting flyers and obtaining referrals from clinicians did not yield sufficient numbers of interested patients. Using the electronic medical record system to identify patients with uncontrolled diabetes allowed staff to send targeted mailings to participants, and 77% of participants were recruited using this method. The targeted mailing approach elicited a positive response rate of 12% (328 of 2,764 potential participants identified) and appeared to produce a more representative and appropriate sample than other recruitment methods used. Lessons learned in this study may be helpful to researchers in future trials who attempt to recruit participants with diabetes for physical activity protocols.

Identifying and treating depression has been a major focus in primary care over the last decade. Unfortunately, treatments have not been as successful as originally hoped. The current study investigated factors that may contribute to poor outcomes in a sample of VA primary care patients. Results indicate that 15.5% of the patients in this investigation had significant symptoms of depression. The vast majority (89.6%) of these patients also had significant symptoms of at least one additional comorbid psychiatric condition. Furthermore, an association between depression and unhealthy behaviors (smoking, not exercising) was demonstrated. Finally, sexual dysfunction and chronic pain were more frequently observed in individuals with depressive symptoms. These findings illustrate that depression is only one of many problems for most primary care patients identified with depression. A multidisciplinary team in primary care is recommended to provide a coordinated approach to the treatment of depression and its associated problems.

The purpose of this paper is to introduce the Structured Interview for the Treatment of the Hepatitis C Virus (SIT-HCV). This comprehensive interview expands upon a standard psychiatric interview by including those medical, psychological, and behavioral factors that are essential to determining a patient’s psychological appropriateness for interferon therapy. A detailed description of the SIT-HCV is provided, highlighting its utility in developing recommendations that positively impact patients’ treatment outcomes. The advantages of the SIT-HCV will be presented, including a discussion on how this approach can ensure comprehensive assessment and facilitate research, training, and patient education.

Il villaggio di Fehwet è situato nella piccola oasi omonima, posta ca. 10 km a sud Ghat, in Libia sud-occidentale. Il sito archeologico è stato oggetto di scavo nel corso delle campagne 2002- 2006 della Missione Archeologica Italo-Libica diretta da Savino di Lernia e condotta da Sapienza Università di Roma e Dipartimento di Archeologia di Tripoli. La maggior parte dei reperti ha mostrato buono stato di conservazione. Dai dati raccolti emerge una larga predominanza di Tamarix (153 reperti-77%) che include T. tetragyna Ehrenb. (97 reperti), T. aphylla Karst. (26 reperti), e Tamarix sp. (30 reperti). Pure significativa è la presenza di Phoenix dactylifera L. (43 reperti - 22%), mentre rari sono Acacia sp. (1 reperto) e cf. Nerium oleander L. (1 reperto).

Despite the prevalence of psychiatric disorders in medical settings, mental health problems often go undetected and patients do not receive appropriate treatment. The main goal of this study is to provide additional information about the Beck Anxiety Inventory – Primary Care (BAI–PC), a brief instrument that screens for patients with anxiety. This study provides information on the performance of the BAI–PC as a screening instrument for depression and PTSD in addition to its original purpose as a screening instrument for anxiety. This efficient tool can identify patients who can benefit from effective psychological treatments and facilitate referrals to psychologists working in medical settings.

APENEXT is a new generation APE processor, optimized for LGT simulations. The project follows the basic ideas of previous APE machines and develops simple and cheap parallel systems with multi T-Flops processing power. This paper describes the main features of this new development., Comment: Lattice2001(plenary/machinestatus), 4 pages, 1 eps figure

Renal transplantation has profound improvements in mortality, morbidity, and overall quality of life compared to renal replacement therapy. This report aims to illustrate the use of ex-vivo partial nephrectomy in a patient with a renal angiomyolipoma prior to living donor transplantation. The surgical outcomes of the donor nephrectomy and recipient transplantation are reported with 2 years of follow-up. Both the donor and recipient are healthy and without any significant comorbidities. In conclusion, urologic techniques such as partial nephrectomy can be used to expand the living donor pool in carefully selected and well informed transplant recipients. Our experience demonstrated a safe and positive outcome for both the recipient and donor, and is consistent with other reported outcomes in the literature.

Vanilla ice cream with 8, 13 or 18% sucrose and 10, 14 or 18% butterfat was evaluated by descriptive analysis (DA) with 15 judges, instrumental texture measurements (ITM), and hedonic rating with 146 consumers. Increased sugar caused higher vanilla, almond, buttery, custard/eggy, sweetness, fatty, creamy, doughy and mouthcoating characteristics, and lower coolness, ice crystals, melt rate (ITM) and hardness (ITM). Increased fat caused higher buttery, custard/eggy and sweet flavor, fatty, creamy, doughy and mouthcoating texture, and lower color, ice crystals and melting rate (DA). Acceptability was positively related to the vanilla, creamy, fatty and milky characters, and negatively related to color, ice crystals and ITM hardness.

Physical activity (PA) is significantly reduced in persons with COPD. Assessing reasons why persons with COPD do not engage in PA can guide development of effective interventions to promote PA.We queried 102 participants with stable COPD about disease-related and general reasons why they do not walk more. The StepWatch Activity Monitor (Orthocare Innovations, Mountlake Terrace, WA, USA) assessed daily step count, a direct measure of PA. Regression models assessed daily step count by response categories, adjusting for age and FEV1 % predicted.Subjects had mean age 72 ± 8 years and mean FEV1 1.48 ± 0.55 L (52 ± 19% predicted). COPD-related worries of becoming short of breath (SOB), needing to use inhalers, or oxygen level becoming low were endorsed by 31, 14, and 12 subjects, respectively. Controlling for age and FEV1% predicted, those who worried about becoming SOB walked an average of 1,329 fewer steps per day than those who did not worry (p = 0.020). Those who worried about needing to use inhalers walked an average of 1,806 fewer steps per day than those who did not worry (p = 0.016). Subjects who were the most motivated and confident walked significantly more than those who were the least motivated and confident.Presence of COPD-related reasons and lower motivation and confidence are associated with lower daily step count. Management of dyspnea and education about medication use during exercise, and strategies to increase motivation and confidence could facilitate walking in COPD.

University students (73 men and 73 women) tasted and rated on a nine-point hedonic scale the texture and mouthfeel, flavor (taste and odor), and overall degree of liking for nine samples of vanilla ice cream varying in sugar (8.94 to 18.81%, wt/wt) and fat (8.73 to 19.30%, wt/wt) contents. Sugar consisted of 6% corn syrup solids [36 DE (dextrose equivalent)]; the balance was sucrose. Hedonic ratings differed significantly among samples, and the best-liked sample for texture and mouthfeel, flavor, and overall degree of liking contained 13.54% sugar and 14.99% fat. Men and women differed significantly in their liking of the flavor of the samples; men rated the flavor of the ice creams higher than did women. There was no gender difference for degree of liking of texture and mouthfeel or for overall degree of liking. Response surface methodology was used to relate hedonic ratings to sugar and fat percentages in the ice cream. Dome-shaped response surfaces were obtained for all three degree of liking parameters, and optimal sugar and fat, respectively, were 13.16% and 14.02% for degree of liking of texture and mouthfeel, 14.07% and 15.35% for degree of liking of flavor, and 14.30% and 14.77% for overall degree of liking. The response surfaces indicated that the level of sugar had a greater effect on all hedonic measures than did fat.

The role of TNF and its type 1 receptor (TNFR1) in the pathogenesis of collagen-induced arthritis (CIA) was investigated in mice using two approaches. First, DBA/1 mice were treated after immunization with type II collagen by injecting TNFR1-IgG1 fusion protein to neutralize systemic TNF. CIA was prevented when treatment was administered shortly before the onset of clinical disease, suggesting that TNF is a crucial mediator in the late initiation phase of the arthritic process. In a second approach, TNFR1-deficient mice, generated by gene targeting and crossed to DBA/1, were used. These mice developed CIA with a low incidence and in a milder form. However, once a joint was afflicted, the disease progressed in this joint to the same end stage as that in wild-type mice. These data suggest that TNFR1 is the main transducer of TNF proinflammatory effects establishing CIA, but the progression of arthritis to tissue destruction and ankylosis is independent of TNFR1.

Cytogenetic studies were performed on three species of eyelidless microteiids, Procellosaurinus erythrocerus, P. tetradactylus, and Vanzosaura rubricauda (Squamata, Gymnophthalmidae), all with a diploid number of 2n = 40. The specimens were collected in the palaeoquartenary dune fields of the middle Rio São Francisco in the State of Bahia, Brazil. Chromosomes from fibroblast cultures were studied after routine Giemsa staining, CBG- and RBG-banding, and Ag-NOR staining. Despite similarities in chromosome number and morphology, each species can be differentiated by the position and amount of C-heterochromatin. Our cytogenetic and DNA content data indicate that there are more similarities between the two species of Procellosaurinus than exist between either species and V. rubricauda, reinforcing the importance of banding techniques for the characterization of reptilian species.

During the past 15 years, major advances in molecular genetics have led to the identification of several primary immune deficiency (PID) genes. In many cases, unravelling the genetic defect has been essential to disclose the molecular and cellular pathophysiology of PID. However, for Wiskott–Aldrich syndrome (WAS), whose gene was identified in 1994 [1], we are still waiting for a comprehensive understanding of the mechanisms that lead to immune deficiency, thrombocytopenia and eczema.