The Sisyphus Syndrome in Health Revisited

Health care may be similar to Sisyphus work: When the task is about to be completed, work has to start all over again. To see the analogy, consider an initial decision to allocate more resources to health. The likely consequence is an increased number of survivors, who will exert additional demand for health care. With more resources allocated to health, the cycle starts over again. The objective of this paper is to improve on earlier research that failed to find evidence of a Sisyphus syndrome in industrialized countries. This time, there are signs of such a cycle, which however seems to have faded away recentl

Expression of Atrophy mRNA Relates to Tendon Tear Size in Supraspinatus Muscle

Skeletal muscle atrophy and fatty infiltration develop after tendon tearing. The extent of atrophy serves as one prognostic factor for the outcome of surgical repair of rotator cuff tendon tears. We asked whether mRNA of genes involved in regulation of degradative processes leading to muscle atrophy, ie, FOXOs, MSTN, calpains, cathepsins, and transcripts of the ubiquitin-proteasome pathway, are overexpressed in the supraspinatus muscle in patients with and without rotator cuff tears. We evaluated biopsy specimens collected during surgery of 53 consecutive patients with different sizes of rotator cuff tendon tears and six without tears. The levels of corresponding gene transcripts in total RNA extracts were assessed by semiquantitative reverse transcriptase-polymerase chain reaction (RT-PCR) analysis. Supraspinatus muscle atrophy was assessed by MRI. The area of muscle tissue (or atrophy), decreased (increased) with increasing tendon tear size. The transcripts of CAPN1, UBE2B, and UBE3A were upregulated more than twofold in massive rotator cuff tears as opposed to smaller tears or patients without tears. These atrophy gene products may be involved in cellular processes that impair functional recovery of affected muscles after surgical rotator cuff repair. However, the damaging effects of gene products in their respective proteolytic processes on muscle structures and proteins remains to be investigate

Middle to Late Miocene Contractional Deformation in Costa Rica Triggered by Plate Geodynamics

Contractional deformation in Costa Rica is usually attributed to the subduction of the aseismic Cocos Ridge. In this work, we review the evidences for contraction in the middle to late Miocene, prior to the arrival of the Cocos Ridge at the Middle America Trench. We find that the Miocene phase of contractional deformation is found in all of Costa Rica, probably extending to Nicaragua as well. The widespread distribution of this event requires a regional or plate geodynamic trigger. We analyze the possible mechanisms that could produce the onset of contractional deformation, using the better known case of subduction orogeny, the Andes, as an analog. We propose that a change in the direction of the Cocos plate since ∼19 Ma led to a change from oblique to orthogonal convergence, producing contractional deformation of the upper plate.Fil: Mescua, Jose Francisco. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales. Provincia de Mendoza. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales. Universidad Nacional de Cuyo. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales; Argentina. Universidad Nacional de Cuyo. Facultad de Ciencias Exactas y Naturales; ArgentinaFil: Porras, Hernan. Observatorio Vulcanológico y Sismológico de Costa Rica; Costa RicaFil: Duran, Patrick. Universidad de Costa Rica; Costa RicaFil: Giambiagi, Laura Beatriz. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales. Provincia de Mendoza. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales. Universidad Nacional de Cuyo. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales; ArgentinaFil: de Moor, Maerten. Observatorio Vulcanológico y Sismológico de Costa Rica; Costa RicaFil: Cascante, Monserrat. Observatorio Vulcanológico y Sismológico de Costa Rica; Costa RicaFil: Salazar, Esteban. Servicio Nacional de Geología y Minería; ChileFil: Protti, Marino. Observatorio Vulcanológico y Sismológico de Costa Rica; Costa RicaFil: Poblete, Fernando. Universidad de O’Higgins; Chil

Turn-by-turn measurements of the energy spread at negative momentum compaction factor at KARA

The Karlsruhe Research Accelerator (KARA), the storage ring at KIT, allows short electron bunch operation with positive as well as negative momentum compaction factor. For both cases, the beam dynamics are studied. Using a line array camera KALYPSO (KArlsruhe Linear arraY detector for MHz rePetition rate SpectrOscopy), based on TI-LGAD, the horizontal intensity distribution of the emitted visible part of the synchrotron radiation is measured at a 5-degree port of a bending magnet on a turn-by-turn time scale. As the measurement is located at a dispersive section, the dynamics of the energy spread can be studied by measuring the horizontal bunch profile. The MHz acquisition rate and the low-light sensitivity of the line camera allow measurements at low bunch currents and the investigation of the microbunching instability. This contribution presents the results of the bunch profile measurements performed at positive and negative momentum compaction factor

Systematic Studies of the Micro-Bunching Instability at Very Low Bunch Charges

At KARA, the KArlsruhe Research Accelerator of the KIT synchrotron, the so called short bunch operation mode allows the reduction of the bunch length down to a few picoseconds. The micro- bunching instability resulting from the high degree of longitudinal compression leads to fluctuations in the emitted THz radiation, referred to as bursting. For extremely compressed bunches at KARA, bursting occurs not only in one but in two different bunch-current ranges that are separated by a stable region. This work presents measurements of the bursting behavior in both regimes. Good agreement is found between data and numerical solutions of the Vlasov-Fokker-Planck equation.Comment: 6 pages, 5 figures, to be submitte

Elimination of Schistosomiasis Transmission in Zanzibar: Baseline Findings before the Onset of a Randomized Intervention Trial.

Gaining and sustaining control of schistosomiasis and, whenever feasible, achieving local elimination are the year 2020 targets set by the World Health Organization. In Zanzibar, various institutions and stakeholders have joined forces to eliminate urogenital schistosomiasis within 5 years. We report baseline findings before the onset of a randomized intervention trial designed to assess the differential impact of community-based praziquantel administration, snail control, and behavior change interventions. In early 2012, a baseline parasitological survey was conducted in ∼20,000 people from 90 communities in Unguja and Pemba. Risk factors for schistosomiasis were assessed by administering a questionnaire to adults. In selected communities, local knowledge about schistosomiasis transmission and prevention was determined in focus group discussions and in-depths interviews. Intermediate host snails were collected and examined for shedding of cercariae. The baseline Schistosoma haematobium prevalence in school children and adults was 4.3% (range: 0-19.7%) and 2.7% (range: 0-26.5%) in Unguja, and 8.9% (range: 0-31.8%) and 5.5% (range: 0-23.4%) in Pemba, respectively. Heavy infections were detected in 15.1% and 35.6% of the positive school children in Unguja and Pemba, respectively. Males were at higher risk than females (odds ratio (OR): 1.45; 95% confidence interval (CI): 1.03-2.03). Decreasing adult age (OR: 1.04; CI: 1.02-1.06), being born in Pemba (OR: 1.48; CI: 1.02-2.13) or Tanzania (OR: 2.36; CI: 1.16-4.78), and use of freshwater (OR: 2.15; CI: 1.53-3.03) showed higher odds of infection. Community knowledge about schistosomiasis was low. Only few infected Bulinus snails were found. The relatively low S. haematobium prevalence in Zanzibar is a promising starting point for elimination. However, there is a need to improve community knowledge about disease transmission and prevention. Control measures tailored to the local context, placing particular attention to hot-spot areas, high-risk groups, and individuals, will be necessary if elimination is to be achieved

Tracking HCV protease population diversity during transmission and susceptibility of founder populations to antiviral therapy

Due to the highly restricted species-tropism of Hepatitis C virus (HCV) a limited number of animal models exist for pre-clinical evaluation of vaccines and antiviral compounds. The human-liver chimeric mouse model allows heterologous challenge with clinically relevant strains derived from patients. However, to date, the transmission and longitudinal evolution of founder viral populations in this model have not been characterized in-depth using state-of-the-art sequencing technologies. Focusing on NS3 protease encoding region of the viral genome, mutant spectra in a donor inoculum and individual recipient mice were determined via Illumina sequencing and compared, to determine the effects of transmission on founder viral population complexity. In all transmissions, a genetic bottleneck was observed, although diverse viral populations were transmitted in each case. A low frequency cloud of mutations ( 1% restricted to a subset of nucleotides. The population of SNVs >1% was reduced upon transmission while the low frequency SNV cloud remained stable. Fixation of multiple identical synonymous substitutions was apparent in independent transmissions, and no evidence for reversion of T-cell epitopes was observed. In addition, susceptibility of founder populations to antiviral therapy was assessed. Animals were treated with protease inhibitor (PI) monotherapy to track resistance associated substitution (RAS) emergence. Longitudinal analyses revealed a decline in population diversity under therapy, with no detectable RAS >1% prior to therapy commencement. Despite inoculation from a common source and identical therapeutic regimens, unique RAS emergence profiles were identified in different hosts prior to and during therapeutic failure, with complex mutational signatures at protease residues 155, 156 and 168 detected. Together these analyses track viral population complexity at high-resolution in the human-liver chimeric mouse model post-transmission and under therapeutic intervention, revealing novel insights into the evolutionary processes which shape viral protease population composition at various critical stages of the viral life-cycle