Oportunidades Program Participation and Body Mass Index, Blood Pressure, and Self-Reported Health in Mexican Adults

IntroductionGovernments around the world are seeking to address the increasing prevalence of obesity and hypertension. Our objective was to evaluate the effect of an incentive-based development program (Oportunidades, formerly Progresa) on body mass index (BMI), blood pressure, and self-reported health.MethodsAn intervention group of low-income (below the 20th percentile nationally), rural, Mexican adults (aged 30-65 years) (n = 5280) received program benefits (cash transfers contingent on positive changes in health behavior such as regular health checkups) for 3.5 to 5.0 years. They were compared with a newly recruited control group of adults (n = 1063) who had not yet begun receiving benefits. Analyses were adjusted for almost 50 social and economic covariates.ResultsAge- and sex-adjusted BMI was lower in adults from intervention communities than in those from control communities (26.57 kg/m(2) vs 27.16 kg/m(2), P < .001), as was the prevalence of obesity (20.28% vs 25.31%, P < .001) and overweight (59.24% vs 63.04%, P = .03); these results were attenuated after covariates were included. Adults in intervention communities had a lower combined prevalence of uncontrolled hypertension (33.80% vs 34.52%, P = .008) when adjusting for all covariates. Mean systolic (beta = -2.60, P < .001) and diastolic (beta = -2.84, P < .001) blood pressures were significantly lower in the intervention communities after all covariates were included, and self-reported health outcomes were better.ConclusionParticipation in Oportunidades, a large-scale cash-transfer program, was associated with lower prevalence of obesity and hypertension and better self-reported health in adults in rural Mexico

Ena/VASP function in retinal axons is required for terminal arborization but not pathway navigation

The Enabled/vasodilator-stimulated phosphoprotein (Ena/VASP) family of proteins is required for filopodia formation in growth cones and plays a crucial role in guidance cue-induced remodeling of the actin cytoskeleton. In vivo studies with pharmacological inhibitors of actin polymerization have previously provided evidence for the view that filopodia are needed for growth cone navigation in the developing visual pathway. Here we have re-examined this issue using an alternative strategy to generate growth cones without filopodia in vivo by artificially targeting Xena/XVASP (Xenopus homologs of Ena/VASP) proteins to mitochondria in retinal ganglion cells (RGCs). We used the specific binding of the EVH1 domain of the Ena/VASP family of proteins with the ligand motif FP4 to sequester the protein at the mitochondria surface. RGCs with reduced function of Xena/XVASP proteins extended fewer axons out of the eye and possessed dynamic lamellipodial growth cones missing filopodia that advanced slowly in the optic tract. Surprisingly, despite lacking filopodia, the axons navigated along the optic pathway without obvious guidance errors, indicating that the Xena/XVASP family of proteins and filopodial protrusions are non-essential for pathfinding in retinal axons. However, depletion of Xena/XVASP proteins severely impaired the ability of growth cones to form branches within the optic tectum, suggesting that this protein family, and probably filopodia, plays a key role in establishing terminal arborizations

Local Nodes in Global Networks: The Geography of Knowledge Flows in Biotechnology Innovation

The literature on innovation and interactive learning has tended to emphasize the importance of local networks, inter-firm collaboration and knowledge flows as the principal source of technological dynamism. More recently, however, this view has come to be challenged by other perspectives that argue for the importance of non-local knowledge flows. According to this alternative approach, truly dynamic economic regions are characterized both by dense local social interaction and knowledge circulation, as well as strong inter-regional and international connections to outside knowledge sources and partners. This paper offers an empirical examination of these issues by examining the geography of knowledge flows associated with innovation in biotechnology. We begin by reviewing the growing literature on the nature and geography of innovation in biotechnology research and the commercialization process. Then, focusing on the Canadian biotech industry, we examine the determinants of innovation (measured through patenting activity), paying particular attention to internal resources and capabilities of the firm, as well as local and global flows of knowledge and capital. Our study is based on the analysis of Statistics Canada’s 1999 Survey of Biotechnology Use and Development, which covers 358 core biotechnology firms. Our findings highlight the importance of in-house technological capability and absorptive capacity as determinants of successful innovation in biotechnology firms. Furthermore, our results document the precise ways in which knowledge circulates, in both embodied and disembodied forms, both locally and globally. We also highlight the role of formal intellectual property transactions (domestic and international) in promoting knowledge flows. Although we document the importance of global networks in our findings, our results also reveal the value of local networks and specific forms of embedding. Local relational linkages are especially important when raising capital—and the expertise that comes with it—to support innovation. Nevertheless, our empirical results raise some troubling questions about the alleged pre-eminence of the local in fostering innovation

Mass Loading Measurements in Amargosa Valley

This work will be conducted under Task DRI-FI-001, “Mass Loading Measurements in Amargosa Valley.” The objective of this task is to measure, with known accuracy, the levels of atmospheric mass loading (mass concentration of suspended particulates) accompanying soil surface disturbing activities in Amargosa Valley. Mass loading is used in the biosphere model to calculate inhalation exposure for the human receptor, the maximally reasonably exposed individual (RMEI). The mass loading currently used in the biosphere model is based on literature data from the analog sites rather than on site-specific conditions. This work is subject to the Nevada System of Higher Education (NSHE, previously UCCSN) QA program requirements

Diagnosis and treatment of thoracic aortic intramural hematoma

AbstractPurpose: This report reviews our recent experience with nine patients who had intramural hematoma of the thoracic aorta.Methods: This was a retrospective study of all patients who had intramural hematoma at our institution from 1989 to 1994. Patients who had identifiable intimal flap, tear, or penetrating aortic ulcer were excluded from the study.Results: Among these nine elderly patients (mean age, 76 years), the most common presentation was chest or back pain. Intramural hematoma was diagnosed by a variety of high-resolution imaging techniques. The descending thoracic aorta alone was involved in seven patients, whereas the ascending aorta was affected in the other two patients. One patient had evidence of an aneurysm (5.0 cm diameter) in the region of the hematoma. All patients were initially managed nonsurgically with blood pressure control. Both patients who had ascending aortic involvement had progression of aortic hematoma, which resulted in death in one case and in successful surgery in the other. Six of the seven patients who had descending aortic involvement alone were successfully managed without aortic surgery. The patient who had intramural hematoma and associated aortic aneurysm, however, had severe, recurrent pain and underwent successful aortic replacement. Another patient had recurrent pain associated with hypertension, but was successfully managed nonsurgically with antihypertensive therapy. All eight survivors are doing well at a median follow-up of 19 months.Conclusions: Intramural hematoma appears to be a distinct entity, although overlap with aortic dissection or penetrating aortic ulcer exists. Aggressive control of blood pressure with intensive care unit monitoring has been our initial management. Patients who have involvement of the descending thoracic aorta alone can frequently be managed without surgery in the absence of coexisting aneurysmal dilatation or disease progression. Our experience suggests that a more aggressive approach with early surgery is warranted in patients who have ascending aortic involvement or those who have coexisting aneurysm and intramural hematoma. (J Vasc Surg 1996;24;1022-9.

Intraoperative determinants of infrainguinal bypass graft patency: A prospective study

Objectives:To evaluate a number of currently available methods for intraoperative assessment of infrainguinal bypass grafts (IBG) in terms of detecting technical errors and predicting graft failure.Design:Prospective open clinical study.Methods:Forty-nine patients undergoing 54 consecutive IBG were studied. Intraoperatively, the following measurements were performed: distal pulse palpation (DPP), continuous wave Doppler (CWD), pulse volume recording (PVR), and ultrasonic volume flowmetry (UVF), followed by intraoperative angiography of the entire graft and runoff vessels. The outflow resistance was graded according to the guidelines of the Society for Vascular Surgery and International Society for Cardiovascular Surgery (SVS/ISCVS runoff score). Graft patency was determined noninvasively (PVR, colour Duplex) up to 12 months following surgery. Predictive values and likelihood ratios for the intraoperative tests in detecting a technical problem during the bypass procedure and in predicting early graft failure were calculated.Results:There were five immediate revisions for problems detected intraoperatively. Angiography did not identify any additional problems but assisted in the correct location of the problems detected by the other tests. DPP and CWD were highly significant indicators of the need for revision with likelihood ratios for a positive test of 14.7 (p < 0.01) and 12.3 (p < 0.01) respectively. PVR did not achieve statistical significance in this respect. None of the intraoperative tests was a statistically significant predictor of early graft failure. The SVS/ISCVS runoff score, on the other hand, predicted early failure with a PPV of 33% (likelihood ratio for a positive test of 4.9, p < 0.05). None of the grafts with a perfect SVS/ISCVS runoff score (n = 39) failed in the first postoperative month.Conclusions:Simple CWD insonation of graft and anastomoses is the best intraoperative indicator for technical inadequacies after IBG. Routine intraoperative angiography is not necessary and intraoperative anatomical imaging may be reserved for situations in which noninvasive documentation of technical success is absent. Contrary to the intraoperative haemodynamic test results, the SVS/ISCVS runoff score is a good predictor of early graft failure

Simultaneous aortic and renal artery reconstruction: Evolution of an eighteen-year experience

AbstractPurpose: We reviewed an 18-year experience with combined abdominal aortic and renal artery reconstruction (AOR) with a particular focus on patients' clinical risk profile and surgical results in contemporary practice as compared with earlier experience.Methods: One hundred seventy patients underwent AOR during the interval January 1, 1976 to June 30, 1994. To examine parameters representative of current practice, the cohort was divided into group I patients (n = 110) treated before 1990 and group II (n = 60) treated between 1990 and 1994. Median follow-up duration for the entire cohort was 8.4 ± 0.6 years. Renal artery reconstruction patency and patient survival rates were calculated by life-table methods. Logistic and Cox regression analysis were used to determine predictors of perioperative and long-term morbidity/mortality rates.Results: Although demographic features changed little over the review period, the detection (56% vs 73%, p = 0.03) and treatment with percutaneous transluminal coronary angioplasty/coronary artery bypass grafting (11% vs 40%, p = 0.0001) of associated coronary artery disease were more frequent in group II versus group I patients. Alternatively, renal insufficiency was more frequent in group I patients. The operative mortality rate for the entire cohort was 6.5% (group I = 9% vs group II = 2%, p = 0.06). Changing trends of surgical techniques over the review period included (group I vs II, respectively) increased use of bilateral simultaneous renal artery repair (12% vs 25%, p < 0.005) and transaortic endarterectomy as the renal artery reconstruction technique (3% vs 25%, p < 0.0001). Favorable response in blood pressure control was noted in 68% of group II patients. The cumulative 5-year survival rate for all patients was 75% with an initial serum creatinine of 2.0 mg/dl or greater being the only negative predictor of late survival after regression analysis.Conclusion: The current operative mortality rate for AOR is in the range anticipated for aortic surgery alone, and this appears to be related to improved detection and treatment of associated coronary artery disease and intervention before major deterioration in renal function. These findings coupled with currently available natural history data relative to renovascular disease justify an aggressive approach with AOR when significant renal artery stenosis is detected during evaluation of aortic disease. (J VASC SURG 1995;21:916-25.

Calculation of the positron bound state with the copper atom

A new relativistic method for calculation of positron binding to atoms is presented. The method combines a configuration interaction treatment of the valence electron and the positron with a many-body perturbation theory description of their interaction with the atomic core. We apply this method to positron binding by the copper atom and obtain the binding energy of 170 meV (+ - 10%). To check the accuracy of the method we use a similar approach to calculate the negative copper ion. The calculated electron affinity is 1.218 eV, in good agreement with the experimental value of 1.236 eV. The problem of convergence of positron-atom bound state calculations is investigated, and means to improve it are discussed. The relativistic character of the method and its satisfactory convergence make it a suitable tool for heavier atoms.Comment: 15 pages, 5 figures, RevTe