Six-Minute Walk Test: Reference Values and Prediction Equation in Healthy Boys Aged 5 to12 Years

OBJECTIVE

This study aimed to (1) generate normative data in healthy boys aged 5–12 years for the six-minute walk test (6MWT), an outcome measure currently used in clinical trials in Duchenne muscular dystrophy (DMD), (2) to describe the relation with anthropometric variables and myometry, and (3) to compare our data with published equations.

METHODS

The 6MWT was conducted in 442 boys according to a standardized protocol, as currently used in clinical trials in DMD. Maximal voluntary isometric contractions for knee flexion and extension were recorded with a hand-held myometer.

RESULTS

The 6MWD increased significantly with age, from 478.0±44.1 m at age 5, to 650.0±76.8 m at age 12, with the steepest increase between 5 and 8 years. Age- and height related percentile curves of the 6MWD were developed. Correlations with anthropometric variables were fair to good (age r = 0.60, height r = 0.57, weight r = 0.44). Myometric variables (knee flexors and extensors) showed correlations of 0.46 and 0.50 respectively. When dividing into two age categories (5–8 years, 9–12 years), these magnitudes of correlations only applied to the younger age group. Additionally, predicted values were calculated according to available reference equations (Geiger and Ben Saad), indicating an overestimation by those equations. Finally, the Geiger equation was refitted to our population.

CONCLUSION

The percentile curves according to age and height provide a useful tool in the assessment of ambulatory capacity in boys aged 5 to 12 years. Significant correlations with anthropometric variables and myometry were only found in the 5–8 years age group. The Geiger prediction equation, currently used to assess ambulatory capacity in DMD was refitted to obtain a more accurate prediction model based on a large sample with a homogenous distribution across the age categories 5 to 12 years and applying the methodology as currently used in clinical trials in DMD.     

The Contribution of Emotional Partners to Sexual Risk Taking and Violence among Female Sex Workers in Mombasa,Kenya: A Cohort Study

Objectives

To assess sexual risk-taking of female sex workers (FSWs) with emotional partners (boyfriends and husbands), compared to regular and casual clients. Experiences of violence and the degree of relationship control that FSWs have with emotional partners are also described.

Design

Cohort study with quarterly follow-up visit over 12-months.

Methods

Four hundred HIV-uninfected FSWs older than 16 years were recruited from their homes and guesthouses in Mombasa, Kenya. A structured questionnaire assessed participant characteristics and study outcomes at each visit, and women received risk-reduction counselling, male and female condoms, and HIV testing.

Results

Four or more unprotected sex acts in the past week were reported by 21.3% of women during sex with emotional partners, compared to 5.8% with regular and 4.8% with casual clients (P<0.001). Total number of unprotected sex acts per week was 5–6-fold higher with emotional partners (603 acts with 259 partners) than with regular or casual clients (125 acts with 456, and 98 acts with 632 clients, respectively; P<0.001). Mostly, perceptions of “trust” underscored unprotected sex with emotional partners. Low control over these relationships, common to many women (36.9%), was linked with higher partner numbers, inconsistent condom use, and being physically forced to have sex by their emotional partners. Half experienced sexual or physical violence in the past year, similarly associated with partner numbers and inconsistent condom use.

Conclusions

High-risk sexual behaviour, low control and frequent violence in relationships with emotional partners heighten FSWs'' vulnerability and high HIV risk, requiring targeted interventions that also encompass emotional partners.     

Prevalence and correlates of poor sleep quality and daytime sleepiness in Belgian truck drivers

Sleepiness and sleep complaints are common among professional drivers. Sleepiness is a considerable problem not only because it affects the drivers' well-being, but also because of the consequences for performance and safety. Assessment of the (self-reported) prevalence and research into the risk factors are thus an important health issue and are also indispensable to prevent productivity loss and work-related accidents and injuries. Therefore, the aim of this study was to describe sleeping, driving, and health characteristics of Belgian truck drivers and to determine occupational and individual factors associated with poor sleep quality and daytime sleepiness. Cross-sectional data were collected using a self-administered questionnaire that included the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and Berlin Questionnaire (BQ). The mean (SD) age of the 476 studied truck drivers was 42.7 (10.2) yrs and the mean (SD) body mass index was 27.3 (5.1) kg/m(2). Approximately 47% declared that they drove >50 h/wk and found their work schedule unrealistic. The mean (SD) PSQI score was 4.45 (2.7); poor quality of sleep (PSQI >5) was found in 27.2%. The mean (SD) ESS score was 6.79 (4.17); 18% had a score >10. The BQ indicated that 21.5% had a higher risk on obstructive sleep apnea. In multiple logistic regression analysis, low educational level (odds ratio [OR] 1.86), current smoking (OR 1.75), unrealistic work schedule (OR 1.75), and risk for obstructive sleep apnea (OR 2.97) were found to be independent correlates of daytime sleepiness. Poor sleep quality was significantly associated with poor self-perceived health (OR 1.95), unrealistic work schedule (OR 2.85), low job satisfaction (OR 1.91), and less driving experience (OR 1.73). These results show that poor sleep quality and daytime sleepiness were prevalent in Belgian truck drivers. Taking into account that several significant correlates with respect to these sleep problems were identified both at the individual and the occupational level, comprehensive countermeasures to improve working conditions and organization are needed, as well as health promotion interventions, to ensure the safety and well-being of truck drivers.     

UV-inducible DNA exchange in hyperthermophilic archaea mediated by type IV pili

Archaea, like bacteria and eukaryotes, contain proteins involved in various mechanisms of DNA repair, highlighting the importance of these processes for all forms of life. Species of the order Sulfolobales of hyperthermophilic crenarchaeota are equipped with a strongly UV-inducible type IV pilus system that promotes cellular aggregation. Here we demonstrate by fluorescence in situ hybridization that cellular aggregates are formed based on a species-specific recognition process and that UV-induced cellular aggregation mediates chromosomal marker exchange with high frequency. Recombination rates exceeded those of uninduced cultures by up to three orders of magnitude. Knockout strains of Sulfolobus acidocaldarius incapable of pilus production could not self-aggregate, but were partners in mating experiments with wild-type strains indicating that one cellular partner can mediate the DNA transfer. Since pilus knockout strains showed decreased survival upon UV treatment, we conclude that the UV-inducible DNA transfer process and subsequent homologous recombination represents an important mechanism to maintain chromosome integrity in Sulfolobus. It might also contribute substantially to the frequent chromosomal DNA exchange and horizontal gene transfer in these archaea in their natural habitat.     

Polarization of PIN3-dependent auxin transport for hypocotyl gravitropic response in Arabidopsis thaliana

Gravitropism aligns plant growth with gravity. It involves gravity perception and the asymmetric distribution of the phytohormone auxin. Here we provide insights into the mechanism for hypocotyl gravitropic growth. We show that the Arabidopsis thaliana PIN3 auxin transporter is required for the asymmetric auxin distribution for the gravitropic response. Gravistimulation polarizes PIN3 to the bottom side of hypocotyl endodermal cells, which correlates with an increased auxin response at the lower hypocotyl side. Both PIN3 polarization and hypocotyl bending require the activity of the trafficking regulator GNOM and the protein kinase PINOID. Our data suggest that gravity-induced PIN3 polarization diverts the auxin flow to mediate the asymmetric distribution of auxin for gravitropic shoot bending.     

Use of benthic vs planktonic organic matter by sandy-beach organisms: A food tracing experiment with C labelled diatoms

Benthic diatoms are assumed to be of minor importance as food sources in sandy-beach food webs, since they are typically scarce in sandy-beach sediments; whereas organic matter derived from land and sea is known to be more important in sandy-beach food webs. In order to test if benthic and planktonic diatoms play a minor or major role, respectively, in sandy-beach food webs, a laboratory experiment was conducted. Labelled planktonic and benthic diatoms, enriched in the stable carbon ¹³C isotope, were offered as food sources to sandy-beach macrofauna and meiofauna communities. Uptake of both types of diatoms occurred with most of the species, but benthic diatoms were preferentially consumed by two macrofaunal species and all meiofaunal species. This result reveals the importance of benthic carbon sources in both macrofaunal and interstitial food webs, and suggests a link between both food webs through the common use of benthic diatoms.     

Effect of food preservation on the grazing behavior and on the gut flora of the harpacticoid copepod Paramphiascella fulvofasciata

Harpacticoids owe their ‘reputation’ as primary consumers in aquatic food webs to their substantial grazing on diatoms, thus assuring an efficient energy flow to higher trophic levels. Due to the complex feeding behavior of harpacticoids, the nature and dynamics of diatom-harpacticoid trophic interactions remain poorly understood. In addition, there is a growing interest from aquaculture industry in mass-culturing harpacticoids with algal foods but the labor costs of maintaining algal stock cultures are high. This study focuses on the palatability of preserved diatoms for copepods and considers the possible role of bacterially mediated effects on diatom food uptake.The grazing of Paramphiascella fulvofasciata on a preserved freeze-dried diatom diet was tested and compared to the grazing on fresh cells. P. fulvofasciata assimilated the preserved diet, but assimilation of fresh cells was higher. When both cell types were mixed, no selective feeding was observed. Community fingerprinting of the bacteria associated with diatoms and fecal pellets suggests that the copepod gut flora was modified depending on the food source. Furthermore, the results suggest that the egestion of gut bacteria enriches the microenvironment and this can have an additional influence on the feeding behavior of the copepod.Experimental research using preserved foods must take into account that copepod grazing assimilations of fresh foods are likely to be significantly higher. Yet, the stated high assimilation of the mixed diet, encourages further exploration of the application of preserved ‘balanced’ foods for harpacticoid mass-culturing.     

Dectin-1 interaction with tetraspanin CD37 inhibits IL-6 production

C-type lectins are pattern-recognition receptors important for pathogen binding and uptake by APCs. Evidence is accumulating that integration of incoming cellular signals in APCs is regulated by grouping of receptors and signaling molecules into organized membrane complexes, such as lipid rafts and tetraspanin microdomains. In this study, we demonstrate that C-type lectin dectin-1 functionally interacts with leukocyte-specific tetraspanin CD37. Dectin-1 and CD37 colocalize on the surface of human APCs. Importantly, macrophages of CD37-deficient (CD37(-/-)) mice express decreased dectin-1 membrane levels, due to increased dectin-1 internalization. Furthermore, transfection of CD37 into a macrophage cell line elevated endogenous dectin-1 surface expression. Although CD37 deficiency does not affect dectin-1-mediated phagocytosis, we observed a striking 10-fold increase of dectin-1-induced IL-6 production in CD37(-/-) macrophages compared with wild-type cells, despite reduced dectin-1 cell surface expression. Importantly, the observed increase in IL-6 production was specific for dectin-1, because signaling via other pattern-recognition receptors was unaffected in CD37(-/-) macrophages and because the dectin-1 ligand curdlan was used. Taken together, these findings show that tetraspanin CD37 is important for dectin-1 stabilization in APC membranes and controls dectin-1-mediated IL-6 production.