Monomorphic Ventricular Arrhythmias in Athletes.

Ventricular arrhythmias are challenging to manage in athletes with concern for an elevated risk of sudden cardiac death (SCD) during sports competition. Monomorphic ventricular arrhythmias (MMVA), while often benign in athletes with a structurally normal heart, are also associated with a unique subset of idiopathic and malignant substrates that must be clearly defined. A comprehensive evaluation for structural and/or electrical heart disease is required in order to exclude cardiac conditions that increase risk of SCD with exercise, such as hypertrophic cardiomyopathy and arrhythmogenic right ventricular cardiomyopathy. Unique issues for physicians who manage this population include navigating athletes through the decision of whether they can safely continue their chosen sport. In the absence of structural heart disease, therapies such as radiofrequency catheter ablation are very effective for certain arrhythmias and may allow for return to competitive sports participation. In this comprehensive review, we summarise the recommendations for evaluating and managing athletes with MMVA

Creating Modern Community Conservation Organizations and Institutions to Effect Successful Forest Conservation Change

Despite increased investment, current conservation strategies have failed to stop environmental degradation and loss of biodiversity of the earth’s ecosystems with consequent climate change. Community Conservation’s (CC) 30 years of experience has produced a successful, cost-effective, field-tested flexible formula to catalyze communities to stop deforestation and biodiversity loss. Our method focuses on four concepts: 1) catalyzing projects, leaving ownership to on-site community-based organizations (CBOs) or local nongovernmental organizations (NGOs); 2) encouraging creation of CBOs; 3) helping build complex federations or networks for a stronger community voice; and 4) creating conservation contagion for regional change. Based on trust, we initially make the community aware of their special forests and wildlife and ask their help in protecting them. Then we help them create CBOs and build federations of conservation activists to strengthen and empower them to manage their projects and their natural resources. By bringing community members to interact together from within a large region, we strive to create conservation contagion. Case histories from Assam, India; northern Peru; the Huon Peninsula in Papua New Guinea; Madagascar; Belize; and Wisconsin, USA demonstrate successes based on the formation of CBOs and community federations, allowing communities to play a powerful role in protecting and restoring forests

Dynamics of allosteric transitions in GroEL

The chaperonin GroEL-GroES, a machine which helps some proteins to fold, cycles through a number of allosteric states, the $T$ state, with high affinity for substrate proteins (SPs), the ATP-bound $R$ state, and the $R^{\prime\prime}$ ($GroEL-ADP-GroES$) complex. Structures are known for each of these states. Here, we use a self-organized polymer (SOP) model for the GroEL allosteric states and a general structure-based technique to simulate the dynamics of allosteric transitions in two subunits of GroEL and the heptamer. The $T \to R$ transition, in which the apical domains undergo counter-clockwise motion, is mediated by a multiple salt-bridge switch mechanism, in which a series of salt-bridges break and form. The initial event in the $R \to R^{\prime\prime}$ transition, during which GroEL rotates clockwise, involves a spectacular outside-in movement of helices K and L that results in K80-D359 salt-bridge formation. In both the transitions there is considerable heterogeneity in the transition pathways. The transition state ensembles (TSEs) connecting the $T$, $R$, and $R^{\prime\prime}$ states are broad with the the TSE for the $T \to R$ transition being more plastic than the $R\to R^{\prime\prime}$ TSE. The results suggest that GroEL functions as a force-transmitting device in which forces of about (5-30) pN may act on the SP during the reaction cycle.Comment: 32 pages, 10 figures (Longer version than the one published

What should deflationism be when it grows up?

http://philpapers.org/rec/HORWSDI argue that a popular brand of deflationism about truth, disquotationalism, does not adequately account for some central varieties of truth ascription. For example, given Boyle's Law is ''The product of pressure and volume is exactly a constant for an ideal gas'', disquotationalism does not explain why the blind ascription ''Boyle's Law is true'' implies that the product of pressure and volume is exactly a constant for an ideal gas, and given Washington said only ''Birds sing'', disquotationalism does not explain why the existentially quantified ascription ''Something Washington said is true'' implies that birds sing. Thus disquotationalism fails to account for all the facts about truth.This project was supported by a grant from the University of Missouri Research Board

Mortality and incidence of second cancers following treatment for testicular cancer

We studied 5555 seminoma patients and 3733 patients with nonseminomatous testicular cancers diagnosed in Southeast England between 1960 and 2004. For both groups survival improved over time: 10-year relative survival increased from 78% in 1960–1969 to 99% in 1990–2004 for seminomas, and from 55 to 95% for nonseminomas. In the early period mortality was still significantly increased more than 15 years after diagnosis in both groups, whereas in more recent periods the excess deaths mainly occurred in the first 5 years after diagnosis. For seminomas, there was a significant excess of cancers of the colon (standardised incidence ratio (SIR) 2.36; 95% confidence interval (CI) 1.13–4.35), soft tissue (SIR 13.64; CI 1.65–49.28) and bladder (SIR 4.28; CI 2.28–7.31) in the long term (20+ years after diagnosis), of pancreatic cancer in both the medium (10–19 years) (SIR 2.91; CI 1.26–5.73) and long term (SIR 5.48; CI 2.37–10.80), of leukaemia in both the short (0–9 years) (SIR 3.01; CI 1.44–5.54) and long term (SIR 4.48; CI 1.64–9.75), and of testis cancer in both the short (SIR 6.69; CI 4.28–9.95) and medium term (SIR 3.96; CI 1.08–10.14). For nonseminomas, significant excesses were found in the long term for cancers of the stomach (SIR 5.13; CI 1.40–13.13), rectum (SIR 4.49; CI 1.22–11.51) and pancreas (SIR 10.17: CI 3.73–22.13), and for testis cancer in the medium term (SIR 5.94; CI 2.18–12.93). Leukaemia was significantly increased in the short term (SIR 6.78; CI 2.93–13.36). The better survival observed is largely attributable to improved treatment, and the trend in reducing the toxicity of therapy should continue to reduce future health risks in testicular cancer survivors