Glutamate decarboxylase (GAD) autoantibody epitope shift during the first year of type 1 diabetes.

Autoantibodies in Type 1 diabetes patients may differentiate between glutamate decarboxylase (GAD65) cloned from human, mouse and rat with a significant better binding to the human antigen. A subgroup of 15% (27/183) patients showed significantly better binding to rodent than to human GAD65. The aim of this study was to determine whether the autoantibody specificity would remain anti-rodent during longitudinal follow-up for one year. We observed 1) that the average slope of the difference between human and mouse GAD65 autoantibodies binding increased between onset and after one year, which demonstrates reduced binding to rodent GAD65 and 2) that, in a group followed every third month, 9/11 (80%) children with rodent specific GAD65 autoantibodies at onset converted within one year to preference against human GAD65. This shift in preference was confirmed by significantly lower EC50 values in the initially anti-rodent GAD65 autoantibodies compared to samples taken one year after clinical diagnosis as determined in displacement studies with unlabeled human GAD65. We speculate that the evolution of GAD65 autoantibodies in Type 1 diabetes includes reactivity to a non-human GAD65 N-terminal end conformation. Progression towards Type 1 diabetes is, however, associated with a maturation of the immune response towards human GAD65 autoreactivity.     

Circadian rhythms of physiological functions in men and women as related to shift work

Operators of both sexes employed in the pulp industry were examined during a triple-shift cycle of shift work. Changes in the body temperature, heart rate, blood pressure, and sensorimotor coordination parameters were used as indicators of the circadian rhythms of their physiological functions. Sex-related differences were found with respect to a number of parameters (the muscular strength, critical flicker frequency, duration of the performance of a coordination test and coordination index, blood pressure and autonomic index, and physical general condition and mood scores). Fatigue in this type of operator activity was efficiently detected by the general condition, activity, mood (WAM) test score (especially in women), the number of errors in the test for sensorimotor coordination, and the coordination index.     

Perceptions of family medicine and career choice among first year medical students: a cross-sectional survey in a Turkish medical school

Public attitudes to family medicine in Turkey have lagged behind its rapid academic development. The effect of undergraduate training in primary care on medical students' attitudes to family medicine has not been assessed. Objectives of this study were to assess the attitudes of first year medical students at Uludag University School of Medicine in Bursa, Turkey to family medicine and to determine their career aspirations. The study was a survey of the first year medical class in 2003-2004. The response rate was 95% (248/261 students). Students were positive about their choice of medicine as a career but had negative opinions of general practice. Female students were more positive in this respect. Initial preference was for specialization in fields other than general practice with little knowledge of the academic specialty of family medicine. Greater undergraduate exposure to family medicine is needed in order to increase knowledge of the field and influence student career choices.     

Day-night pattern in accidental exposures to blood-borne pathogens among medical students and residents

The purpose of this study was to determine whether the occurrence of accidental blood-borne pathogen exposure incidents in medical students and residents in training varies during the 24 h. A retrospective review of reported exposures was conducted in a large urban teaching institution--the University of Texas Health Science Center in Houston--between November 1993 and July 1998. Professional level (year of student or level of resident), time of exposure, means/route of exposure (needle stick, laceration, or splash), and type of medical service were recorded. Analysis of the clock time of the 745 reported blood-borne pathogen exposures showed they occurred more frequently during the day than night. Over the nearly 5-year span, 531 incidents took place between 06:00 and 17:59 in comparison to only 214 between 18:00 and 05:59. To account for the day-night difference in medical student and resident hospital staffing, the data were reexpressed as exposure rates, that is, in terms of the number of events per hour per 1000 medical students and residents. Based on the total number of reported exposures over the almost 5-year span of data collection, the average rate was 40 accidents per hour per 1000 doctors in training during the 12 h daytime span (6:00-17:59). It was 50% greater at night (18:00-05:59), with 60 incidents per hour per 1000 doctors in training. The day-night difference in rate of exposures was statistically significant (p < .04). The relative risk ratio for residents and students when working during the day shift compared to working the night shift was 0.67. This means that doctors in training are at a 1.50 higher risk of sustaining a blood-borne pathogen exposure when working nights than when working days.     

Individual differences in the cortisol-awakening response during the first two years of shift work: A longitudinal study in novice police officers

Cortisol acts as a critical biological intermediary through which chronic stressors like shift work impact upon multiple physiological, neuro-endocrine and hormonal functions. Therefore, the cortisol awakening response (CAR) is suggested as a prime index of shift work tolerance. Repeated assessments of the CAR (calculated as MnInc) in a group of 25 young novice police officers showed that in the interval between about 4 and 14 months after transitioning from regular day work to rotating shift work, mean values began to rise from baseline to significantly higher levels at about 14 months after they commenced shift work. Visual inspection of the individual trends revealed that a subgroup of 10 subjects followed a monotonically rising trend, whereas another 14 subjects, after an initial rise from about 4–14 months, reverted to a smaller, baseline level cortisol response at about 20 months after the start of shift work. If the initial increase in the cortisol response marks the development of a chronic stress response, the subsequent reversal to baseline levels in the subgroup of 14 participants might be indicative of a process of recovery, possibly the development of shift work tolerance.     

成都地区中老年居民血清尿酸相关危险因素分析

目的：分析成都地区中老年居民血清尿酸水平及其影响因素,为防治心脑血管事件提供策略支持。方法：利用2007代谢综合征研究调查资料（共1061人）,把人群依据血尿酸水平分为增高组（男性〉420umol/L,女性〉357umol/L）及正常组（男性≤420umol/L,女性≤357umol/L）,分析两组人群的多个代谢性指标的分布特征,并采用logistic回归分析寻找与尿酸相关的危险因素。结果：①两个分组间年龄、收缩压、男性比重、高血压家族史、人体质量指数、腰围、臀围、空腹血糖、肾功能等指标尿酸增高组明显高于尿酸正常组,舒张压则是尿酸增高组明显低于尿酸正常组。②血脂各成分中,总胆固醇、低密度脂蛋白水平尿酸增高组高于正常组,其余甘油三酯、高密度脂蛋白分组间无统计学差异。③尿酸增高组其代谢综合征、高血压、糖尿病、肥胖、腹型肥胖、血脂异常等患病率皆高于尿酸正常组,差异有统计学意义。④Logistic回归分析提示尿酸与你男性性别、年龄、收缩压、BMI、腰围、臀围、空腹血糖、肌酐、总胆固醇、低密度脂蛋白水平呈正相关,与女性性别及舒张压呈负相关。结论：成都地区尿酸与代谢性指标及肾功能相关指标关系密切,可能可以通过减少尿酸来减少心脑血管疾病、代谢性疾病及肾脏疾病的发生。     

Immunity to equine herpesvirus 1 infection in foals during the first year of life.

A band of 23 pregnant mares on a Thoroughbred breeding farm all had serum virus-neutralizing antibody titres to equine herpesvirus 1 (EHV-1). Antibody was not transferred to their foals in utero. All foals received antibody from colostrum and developed antibody titres similar to their dams. The serum virus-neutralizing antibody titres were observed in 10 of these foals for 1 year. Decay of passive immunity occurred at the rate of 3.25 two-fold dilutions in 100 days and reached zero at the mean time of 180 days. The foals were exposed to EHV-1 twice. Foals with a geometric mean titre of 1 : 25 experienced infection and a rise of titre, while those with a geometric mean titre of 1 : 76 resisted infection.     

Wood ontogeny during the first year of hybrid poplar development

During the first year of hybrid poplar development, we assessed radial growth dynamics quantified by the proportion of secondary xylem tissue within the stem area, the vessel area percentage, the content of both lignin and cellulose, the lignin monomeric composition, and the macromolecular properties of cellulose. The intraannual radial growth dynamics in the proportion of secondary xylem tissue was fitted by the Gompertz regression line whereas changes in the vessel area percentage were fitted maximally by a cubic regression line. Under constant temperature and photoperiod, this study revealed that nonlinear patterns of radial growth dynamics are the result of a developmental programme which drives cambial activity and ageing. The increased proportion of guaiacyl units found may be important for the greater stability of the lignin structure in the first year of hybrid poplar development. The tensile strength of juvenile wood was ensured by the trade-off between a slight increase in the degree of polymerization of cellulose and a slight decrease in the content of cellulose during ageing.     

Vocal-speech development of the child during the first year of life

The study aimed at investigation into the first step of language acquisition by Russian children and the imitation process as a possible mechanism of mastering the language through the sounds specific for their native language. On the basis of spectrographic, phonetic, and listener's analysis of the sounds infants, the beginning of shaping of the phonologic system in Russian language, was shown. It was shown that, during imitation of mother's voice, children acquire articulation skills and sound utterances approximating a phoneme category of the native language. The data obtained indicate that interaction between mother and child fulfills the function of learning transmitting a language data on the tongue trame.     

Implementing voluntary medical male circumcision for HIV prevention in Nyanza Province, Kenya: lessons learned during the first year

Background

In 2007, the World Health Organization endorsed male circumcision as an effective HIV prevention strategy. In 2008, the Government of Kenya (GoK) launched the national voluntary medical male circumcision (VMMC) program in Nyanza Province, the geographic home to the Luo, the largest non-circumcising ethnic group in Kenya. Currently, several other African countries are in the early stages of implementing this intervention.

Methods and Results

This paper uses data from a health facility needs assessment (n = 81 facilities) and a study to evaluate the implementation of VMMC services in 16 GoK facilities (n = 2,675 VMMC clients) to describe Kenya''s experience in implementing the national program. The needs assessment revealed that no health facility was prepared to offer the minimum package of services as outlined by the national guidelines, and partner organizations were called upon to fill this gap. The findings concerning human resource shortages facilitated the GoK''s decision to endorse trained nurses to provide VMMCs, enabling more facilities to offer the service. Findings from the evaluation study resulted in replacing voluntary counseling and testing (VCT) with provider-initiated testing and counseling (PITC) and subsequently doubling the proportion of VMMC clients tested for HIV.

Conclusions

This paper outlines how certain challenges, like human resource shortages and low HIV test rates, were addressed through national policy changes, while other challenges, like large fluctuations in demand, were addressed locally. Currently, the program requires significant support from partner organizations, but a strategic plan is under development to continue to build capacity in GoK staff and facilities. Coordination between all parties was essential and was facilitated through the formation of national, provincial, and district VMMC task forces. The lessons learned from Kenya''s VMMC implementation experience are likely generalizable to other African countries.     

Formation of intestinal microflora in children during the first year of their life

In 525 young children the state of intestinal microbiocenosis was studied every month of the first year their life. The study revealed that the process of the microflora formation lasted throughout the first year of their life and was characterized by dysbiotic disturbances. During this period the aggravation of dysbiotic changes in the intestine of these children on months 3, 6-7 and 11-12 was of particular importance. The formation of stable dysbacteriosis led to a decrease in the immunological status of the child, which was manifested by the increased content of such microorganisms as hemolytic cocci, Proteus and a decrease in the quantitative level of bifidobacteria in the total intestinal microbiocenosis by the end of the first year of child's life.     

Temporal relationships among LH, estradiol, and follicle vascularization preceding the first compared with later ovulations during the year in mares

Diameter of the preovulatory follicle, plasma concentrations of LH and estradiol, and vascularization of the follicle wall, based on color-Doppler signals, were characterized in 40 pony mares for 6 days preceding ovulation (Days -6 to -1; preovulatory period). Comparisons between the preovulatory periods preceding the first compared with a later ovulation during the year were used to study the relationships between LH and estradiol and between vascularization and estradiol. Diameter of the preovulatory follicle was greater (P<0.02) and concentration of LH was less (P<0.02) during the first preovulatory period, whereas concentration of estradiol was not different between the first and second preovulatory periods. Vascularized area (cm(2)) of the follicle wall increased at a reduced rate during the first preovulatory period, as indicated by an interaction (P<0.03) between day and group. Vascularized area was similar between the preovulatory groups on Day -6, and a reduced rate of increase resulted in a lesser (P<0.001) area on Day -1 before the first ovulation (1.4+/-0.1cm(2)) than before a later ovulation (2.2+/-0.2 cm(2)). Results demonstrated that follicle vascularization and the LH surge were attenuated preceding the first ovulation of the year with no indication that estradiol was involved in the differences between the first and later ovulations.     

A neurophysiologic study of sleep in children during the first year of life]

Polygraphic investigation of day sleep has been carried out in thirty suckling infants (aged from 25 days to 12 months). EEG, OCG, SGR, respiration ECG, muscular activity, and in some infants, also rheographic parameters (REG and RG of the shin) have shown that already at an early nursing age, states of drowsiness, falling asleep, light and medium depth and deep slow sleep set in, as well as the so-called rapid sleep which occurs only after slow sleep. The denotation of the slow sleep stages is based on the classification by Loomis et al., though their electroenecepholographic expression in the infant is in many ways peculiar and undergoes certain dynamics during the first year of life. Peculiarities of the central area EEG have been exhibited in all the age groups, and it has been assumed that the central parts of the cortex of a suckling infant are a kind of "window" into the subcortical parts. While EEG, displaying new forms of activity at certain stages of sleep undergo distinct age changes, vegetative sleep manifestations display only some age depending quantitative differences. Thus, at the nursing age the mechanisms of electroencephalographic and vegetative sleep manifestations are of different degree of maturity: they possess a considerable autonomy, although they function in concord.     

Changes of adolescents' defence mechanisms during the first year of high school education

The goal of this study was to analyse the defence mechanism's changes during adolescent's adaptation to the new schooling terms at the first year in high school. Sample of 266 students, mean age 15, have been included in the research. Kellerman's Life Style Questionnaire (LSQ) was administred for measuring defence mechanisms at the beginning and at the end of the school year. Results show that regression and reactive formation are changing at most; regression raises (p < 0.005) while reactive formation decreases (p < 0.000). Boys used repression, while girls reactive formation more frequently in both measuring. Displacement was 'male" defence in the first measuring; but at repeated measuring this difference in sex vanished. The sources of anxiety can be found partly in new school environment and in adolescent's effort to "solve the problem" with sexual impulses and aggression using different sets of defences.     

Determinants of the clinical outcomes of gout during the first year of urate-lowering therapy

Clinical benefit early in urate-lowering treatment of gout is difficult to document. We examined data from 1,832 gouty subjects treated with either urate-lowering agents or placebo to identify determinants of gout flare incidence and tophus size during year 1 of treatment. Reductions from pretreatment serum urate levels influenced flare frequency and tophus size, but the effect of urate level on flare incidence was biphasic. Lower urate levels were associated with higher flare incidence early in treatment but lower incidence by one year. The complex relationship between urate-lowering and clinical outcome early in treatment has implications for both clinical and investigative approaches to urate-lowering management.