Models of intellectual disability: towards a perspective of (poss)ability.

BACKGROUND: The social and medical models of disability configure the relationship between disability and impairment differently. Neither of these models has provided a comprehensive theoretical or practical basis for talking about intellectual disability (ID). Models that emphasise the interactive nature of disability appear to be more promising. This study explores the ways in which models of disability are reflected in disability discourse in an empirical discourse analysis conducted in the Eastern Cape Province of South Africa. METHODS: Q methodology was used in this study as a discourse analysis tool. Adults with ID, parents of children with ID and professionals who work with people with ID completed a sorting task where they stated the degree to which they agreed or disagreed with statements that are made about people with ID. This exercise resulted in a pattern of responses for each participant, termed a Q sort and these were used as data in a factor analysis using dedicated Q method software. A second order factor analysis was then performed on the resulting factors. RESULTS: Four discourses were identified: the Social Model/Human Rights Discourse, the Medical Model/Professional Religious Discourse, the Community Model/Community Religious Discourse and the Interactive Discourse. Except for the last one, each of these discourses adopts a model of disability with a static view of impairment as fixed. The Interactive Discourse appears to be related to dynamic, environmental conceptions of disability where competence is built through social interaction. CONCLUSIONS: A theory of (poss)ability is proposed and some of its concerns are suggested. This perspective views impairment as an interaction between individuals and their environment and postulates that competence is a function of context, rather than a property of the individual.

Obstructive sleep apnoea and perioperative complications in bariatric patients.

BACKGROUND: The objective of this study was to determine the relationship between perioperative complications and the severity of obstructive sleep apnoea (OSA) in patients undergoing bariatric surgery who had undergone preoperative polysomnography (PSG). METHODS: The records of 797 patients, age >18 yr, who underwent bariatric operations (442 open and 355 laparoscopic procedures) at Mayo Clinic and were assessed before operation by PSG, were reviewed retrospectively. OSA was quantified using the apnoea-hypopnoea index (AHI) as none (≤ 4), mild (5-15), moderate (16-30), and severe (≥ 31). Pulmonary, surgical, and 'other' complications within the first 30 postoperative days were analysed according to OSA severity. Logistic regression was used to assess the multivariable association of OSA, age, sex, BMI, and surgical approach with postoperative complications. RESULTS: Most patients with OSA (93%) received perioperative positive airway pressure therapy, and all patients were closely monitored after operation with pulse oximetry on either regular nursing floors or in intensive or intermediate care units. At least one postoperative complication occurred in 259 patients (33%). In a multivariable model, the overall complication rate was increased with open procedures compared with laparoscopic. In addition, increased BMI and age were associated with increased likelihood of pulmonary and other complications. Complication rates were not associated with OSA severity. CONCLUSIONS: In obese patients evaluated before operation by PSG before bariatric surgery and managed accordingly, the severity of OSA, as assessed by the AHI, was not associated with the rate of perioperative complications. These results cannot determine whether unrecognized and untreated OSA increases risk.

Biogeochemistry. Sulfate reducers--dominant players in a low-oxygen world?

Sulfate reducing bacteria can adapt to extreme physical and chemical conditions and play an important role in global geochemical cycles, but their role in the formation of ore deposits has remained controversial. Strong support for such a role is provided by Labrenz et al., who have discovered sulfate-reducing bacteria that can tolerate low levels of oxygen and can precipitate zinc sulfide minerals. The results may have implications for bioremediation and may provide clues to processes that may have been more widespread in the geologic past.

Mass mortality and its environmental and evolutionary consequences.

The latest Mesozoic and earliest Tertiary sediments at Deep Sea Drilling Project site 524 provide an amplified record of environmental and biostratographic changes at the end of Cretaceous. Closely spaced samples, representing time intervals as short as 10(2) or 10(3) years, were analyzed for their bulk carbonate and trace-metal compositions, and for oxygen and carbon isotopic compositions. The data indicate that at the end of Cretaceous, when a high proportion of the ocean's planktic organisms were eliminated, an associated reduction in productivity led to a partial transfer of dissolved carbon dioxide from the oceans to the atmosphere. This resulted in a large increase of the atmospheric carbon dioxide during the next 50,000 years, which is believed to have caused a temperature rise revealed by the oxygen-isotope data. The lowermost Tertiary sediments at site 524 include fossils with Cretaceous affinities, which may include both reworked individuals and some forms that survived for a while after the catastrophe. Our data indicate that many of the Cretaceous pelagic organisms became extinct over a period of a few tens of thousands of years, and do not contradict the scenario of cometary impact as a cause of mass mortality in the oceans, as suggested by an iridium anomaly at the Cretaceous-Tertiary boundary.

CpG-based immunotherapy impairs antitumor activity of BRAF inhibitors in a B-cell-dependent manner.

Combining immunotherapy with targeted therapy has increasingly become an appealing therapeutic paradigm for cancer treatment due to its great potential for generating durable and synergistic antitumor response. In this study, however, we unexpectedly found that two types of CpG-based tumor peptide vaccine treatments consistently negated the antitumor activity of a selective BRAF inhibitor in tumors with BRAF mutation rather than showing a synergistic antitumor effect. Our further studies demonstrated that CpG alone was sufficient to dampen BRAF inhibitor-induced antitumor responses, suggesting that the impaired antitumor activity of the BRAF inhibitor observed in mice receiving CpG-based peptide vaccine is mainly dependent upon the use of CpG. Mechanistically, CpG increased the number of circulating B cells, which produced elevated amounts of tumor necrosis factor-α (TNFα) that contributed to the increased tumor resistance to BRAF inhibitors. More importantly, B-cell depletion or TNFα neutralization can restore the antitumor effect of BRAF inhibition in mice receiving CpG treatment, indicating that TNFα-secreting B cells play an indispensable role in BRAF inhibitor resistance induced by CpG. Taken together, our results strongly suggest that precautions must be implemented when designing combinatorial approaches for cancer treatment, because distinct regimens, despite their respective therapeutic benefit as monotherapy, may together provide antagonistic clinical outcomes.

The effect of sequence variations and structure on the cytolytic activity of melittin peptides.

The importance of various amino acid residues in melittin for cytolytic function against mammalian cells was assessed by use of a monoclonal antibody to the C-terminal region, synthesis of peptide analogues and chemical modification of specific residues. A monoclonal anti-melittin antibody directed to the basic C-terminal region inhibited cytolytic activity. Consistent with this, deletion of one of the two Lys Arg sequences at the C terminal end of the peptide reduced cytolysis 8-fold, although significant activity was still present. A similar reduction in activity was also found with a synthetic analogue which had the reverse sequence to melittin. In contrast, when the last 6 residues of the C-terminal region were transferred to the N-terminus, a peptide with markedly reduced activity was obtained. Chemical modification of lysine and arginine residues of melittin indicated that lysine was only minimally important for functional activity compared with arginine which was essential. In particular, our results demonstrate that substitution of serine for lysine 7 has no significant effect on the activity of the peptide and suggest that this residue is important only in maintaining the amphipathic helix of the peptide.

The release of a compound-chromosome stock in a vineyard cellar population of Drosophila melanogaster.

The prospect of autocidal insect control was investigated in a cellar population of D. melanogaster using a compound-chromosome stock. The released stock was synthesized by irradiating virgin female progeny derived from the cellar and crossing to a second-chromosome compound laboratory stock. Incorporation of an appropriate genetic background into the compound stock was tested in laboratory studies. Larval development to adult emergence and adult survival studies indicated the compound release stock to be relatively similar to the wild population, while behavioral tests detected no mating isolation between wild or compound genotypes. An unstable equilibrium point of compound frequency 0.7 was observed in population cage experiments with the two genotypes. Adults were released into the cellar at a 50:1 ratio in favor of the compound. Five hundred newly hatched compound-chromosome larvae were also released. Adult, larval and pupal samples were regularly made. The compound stock successfully bred in the cellar maintaining an adult frequency of at least 90% for 108 days after the release. The rapid decline in compound frequency after this period is thought to be due to the migration of inseminated wild-type females from wine storage areas adjacent to the cellar. The results indicate that a compound stock may limit the rate of population expansion in an area and may be a useful mechanism of autocidal control. It cannot be overemphasized that the probability of a successful release will be related to the level of understanding of the adaptive strategy of the population into which the release is made.

Gene flow and selection in a natural population of Drosophila melanogaster.

A marked genetic differentiation to the presence of alcohol in the environment has been shown to occur between inside cellar and adjacent outside sections of a vineyard population of D. melanogaster (McKenzie and Parsons 1974). Estimates of migration during the vintage period suggest considerable movement occurs from outside into the cellar and that the most tolerant genotypes are the most successful migrants. A quantitative model of this system suggests that the selection intensity may not be a limiting factor in maintaining the differentiation. It also suggests that gene flow must be restricted between sections of the population at all but vintage periods if this differentiation is to persist.

Diazinon resistance, fluctuating asymmetry and fitness in the Australian sheep blowfly, lucilia cuprina.

Genetic evidence suggests that the evolution of resistance to the insecticide diazinon in Lucilia cuprina initially produced an increase in asymmetry. At that time resistant flies were presumed to be at a selective disadvantage in the absence of diazinon. Subsequent evolution in natural populations selected modifiers to ameliorate these effects. The fitness and fluctuating asymmetry levels of resistant flies are currently similar to those of susceptibles. Previous genetic analyses have shown the fitness modifier to co-segregate with the region of chromosome III marked by the white eyes, w, locus, unlinked to the diazinon resistance locus, Rop-1, on chromosome IV. This study maps the asymmetry modifier to the same region, shows, as in the case of the fitness modifier, its effect to be dominant and presents data consistent with the fitness/asymmetry modifier being the same gene (gene complex). These results suggest changes in fluctuating asymmetry reflect changes in fitness.

Microdifferentiation in a natural population of Drosophila melanogaster to alcohol in the environment.

Strains of D. melanogaster derived from a vineyard population were more resistant to alcohol in the environment than strains from a population derived from an area removed from the vineyard. Within the vineyard population those strains most closely associated with alcohol in the environment in the cellar were more resistant than those collected outside the cellar. There was evidence of gene flow between the inside and outside cellar components of this population, but microdifferentiation had occurred within the cellar in spite of this. The adaptation appears to be independent of the ADH system and involves both additive and dominance genetic effects. D. simulans, a species not found in the cellar and susceptible to the presence of alcohol, showed no differentiation between vineyard and removed populations.

Environmental and genetic effects on the asymmetry phenotype: Diazinon resistance in the Australian sheep blowfly, Lucilia cuprina.

The asymmetry phenotype of diazinon-resistant flies lacking a fitness/asymmetry Modifier (+/+; R/-) was dominant and independent of developmental temperature, larval density and diazinon concentration. Asymmetry score, pooled over three bristle characters, was approximately 50% greater for these phenotypes than for those of modified genotypes (M/+; +/+) and unmodified susceptibles (+/+; S/S) reared under standard laboratory conditions. Modified and susceptible phenotypes showed increased asymmetry score for temperatures and larval densities above and below standard rearing conditions; a positive correlation was observed between diazinon concentration and asymmetry score. Single and multiple environmental stresses resulted in similar scores that approached, but never exceeded, those of unmodified resistant phenotypes. Irrespective of the developmental conditions anti-symmetry and fluctuating asymmetry were typically observed for each bristle character of unmodified resistant and the modified and susceptible phenotypes, respectively. Thus while similar asymmetry scores could arise from genetic or environmental effects, asymmetry pattern was genetically based. Population cage analyses at different temperatures and larval densities showed a negative association between mean asymmetry and relative fitness.

Polygenic and single gene responses to selection for resistance to diazinon in Lucilia cuprina.

Following mutagenesis with ethyl methanesulfonate, selection in a susceptible strain with a concentration of the insecticide diazinon (0.0004%, w/v) above that required to kill 100% of the susceptible strain, the LC100 of that strain, resulted in a single gene response. The resultant four mutant resistant strains have equivalent physiological, genetical and biochemical profiles to a diazinon-resistant strain derived from a natural population and homozygous for the Rop-1 allele. Modification of the microsomal esterase E3 is responsible for resistance in each case. The Rop-1 locus maps approximately 4.4 map units proximal to bu on chromosome IV. Selection within the susceptible distribution, at a concentration of diazinon [0.0001% (w/v)] less than the LC100, resulted in a similar phenotypic response irrespective of whether the base population had been mutagenized. The responses were polygenically based, unique to each selection line and independent of Rop-1. The relevance of the results to selection for insecticide resistance in laboratory and natural populations is discussed.

Scalloped wings is the Lucilia cuprina Notch homologue and a candidate for the modifier of fitness and asymmetry of diazinon resistance.

The Scalloped wings (Scl) gene of the Australian sheep blowfly, Lucilia cuprina, is shown to be the homologue of the Drosophila melanogaster Notch gene by comparison at the DNA sequence and genetic levels. A L. cuprina genomic fragment, which shows strong identity with the Notch (N) gene at the molecular level, hybridizes to the location of the Scl gene on polytene chromosomes. The two genes are functionally homologous; the dominant and recessive Notch-like phenotypes produced by mutations in the Scl gene allow these alleles to be classed as N-like or Abruptex-like. The Scl gene is under investigation as a candidate for the fitness and asymmetry Modifier (M) of diazinon resistance. We show that M affects the penetrance of wing and bristle phenotypes associated with two Scl alleles in a manner consistent with the M being an allele of Scl. In addition, we report a phenotypic interaction between the diazinon-resistance mutation, Rop-1, and the same alleles of Scl. We propose that the product of Rop-1, an esterase, may be involved in cell adhesion in developmental processes involving the Scl gene product.

Methanogenesis produces strong 13C enrichment in stromatolites of Lagoa Salgada, Brazil: a modern analogue for Palaeo-/Neoproterozoic stromatolites?

Holocene stromatolites characterized by unusually positive inorganic δ(13) CPDB values (i.e. up to +16‰) are present in Lagoa Salgada, a seasonally brackish to hypersaline lagoon near Rio de Janeiro (Brazil). Such positive values cannot be explained by phototrophic fixation of CO2 alone, and they suggest that methanogenesis was a dominating process during the growth of the stromatolites. Indeed, up to 5 mm methane was measured in the porewater. The archaeal membrane lipid archaeol showing δ(13) C values between -15 and 0‰ suggests that archaea are present and producing methane in the modern lagoon sediment. Moreover, (13) C-depleted hopanoids diplopterol and 3ß-methylated C32 17ß(H),21ß(H)-hopanoic acid (both -40‰) are preserved in lagoon sediments and are most likely derived from aerobic methanotrophic bacteria thriving in the methane-enriched water column. Loss of isotopically light methane through the water column would explain the residual (13) C-enriched pool of dissolved inorganic carbon from where the carbonate constituting the stromatolites precipitated. The predominance of methanogenic archaea in the lagoon is most likely a result of sulphate limitation, suppressing the activity of sulphate-reducing bacteria under brackish conditions in a seasonally humid tropical environment. Indeed, sulphate-reduction activity is very low in the modern sediments. In absence of an efficient carbonate-inducing metabolic process, we propose that stromatolite formation in Lagoa Salgada was abiotically induced, while the (13) C-enriched organic and inorganic carbon pools are due to methanogenesis. Unusually, (13) C-enriched stromatolitic deposits also appear in the geological record of prolonged periods in the Palaeo- and Neoproterozoic. Lagoa Salgada represents a possible modern analogue to conditions that may have been widespread in the Proterozoic, at times when low sulphate concentrations in sea water allowed methanogens to prevail over sulphate-reducing bacteria.

Stress and asymmetry during arrested development of the Australian sheep blowfly.

The dieldrin and diazinon resistance systems of the Australian sheep blowfly (Lucilia cuprina) have been used previously to relate stress, departures from bilateral symmetry, developmental stability and relative fitness. These systems are now used to consider stress and asymmetry in a developmental context. Larval to adult development is shown to be significantly impaired after arrested development at 8 degrees C, however the asymmetry score of adults of a given genotype is similar after arrested or continuous development. Selection against dieldrin-resistant and unmodified diazinon-resistant genotypes occurs during arrested development because greater proportions of these genotypes pupae at 8 degrees C than do susceptible or modified diazinon-resistant genotypes. Pre-pupae of all genotypes complete development equally successfully when transferred from 8 degrees C to 27 degrees C. Adults fail to emerge when pupae formed at 8 degrees C undergo this temperature transition. Temperature-shift experiments show the asymmetry score is determined between pre-pupal and pupal stages of the life cycle. This stage occurs at 27 degrees C in arrested and continuously developing cultures providing an explanation for the independence of stress, selective mortality during developmental arrest and asymmetry score. The results emphasize the need for genetic, environmental and developmental data before an asymmetry phenotype can be directly related to developmental stability and relative fitness.

Fatal association between dieldrin-resistant and susceptible Australian sheep blowflies, Lucilia cuprina.

A novel phenomenon of interactions between genotypes of the dieldrin-resistance (Rdl) locus of the Australian sheep blowfly (Lucilia cuprina) is described. Susceptible adult flies exposed to dieldrin-resistant (Rdl/Rdl or Rdl/S) adults, raised from larvae grown on media containing sublethal concentrations of dieldrin, display mortality related to the concentration on which the resistant flies developed. The resistant flies excrete quantities of dieldrin that are toxic to susceptible flies. These observations provide an additional mechanism to those previously identified for the rapid evolution of resistance to dieldrin by L. cuprina.

Wings and bristles: character specificity of the asymmetry phenotype in insecticide-resistant strains of Lucilia cuprina.

We investigated the hypothesis that observed higher levels of asymmetry displayed by insecticide-resistance genotypes of Lucilia cuprina are restricted to bristle characters, due to the action of resistance genes in bristle cell development, rather than through the disruption of genomic coadaptation. We compared the level of asymmetry of three bristle characters and three wing characters in non-modified and modified-resistance genotypes. Consistent with previous studies, resistance genotypes displayed greater levels of bristle asymmetry than either susceptible or modified genotypes. However, there were no differences among genotypes for any of the wing characters. To confirm that this result is attributable to the action of the resistance and modifier genes themselves, we also examined the responses of both bristle and wing characters to the more general developmental stress of extreme temperature. Sub-optimal temperature was shown to increase both bristle and wing asymmetry, suggesting that there are no underlying differences between the two character types which could, of themselves, explain the differential response observed in the resistance genotypes.

Levamisole resistance in Trichostrongylus colubriformis: a sex-linked recessive character.

Reciprocal crosses between susceptible and levamisole resistant strains of Trichostrongylus colubriformis produced F1 offspring consistent with resistance being inherited as a sex-linked recessive character. The resistance status of the offspring of the backcrosses of the F1 to both parental strains supported this hypothesis. The results are consistent with resistance being controlled by a single gene, or a tightly linked group of genes, but indicate that other autosomal loci have minor effects. The results contrast with the reported observations that resistance to the benzimidazole anthelmintics is polygenic and autosomal. The results are discussed relative to a general evolutionary model for anthelmintic resistance which predicts that selection from the upper extreme of an anthelmintic tolerance distribution results in polygenicity.

Molecular characterization of the Notch homologue from the Australian sheep blowfly, Lucilia cuprina.

The Drosophila melanogaster Notch gene product as a receptor of intercellular signals and is central to cell fate specification. The Scalloped wings (Scl) gene is the homologue of Notch in the Australian sheep blowfly, Lucilia cuprina. An allele of Scl is thought to be involved in the modification of Darwinian fitness and bristle asymmetry in flies resistant to organophosphorous chemicals (OPs). As a first step towards the testing of this hypothesis we cloned and sequenced Scl. A full-length cDNA segment representing the mRNA of Scl is 8503 bp and encodes a protein of 2653 amino acids, which shares 73.6% identity with Notch. All functional motifs including EGF-like repeats, LNR repeats, cdc 10/ankyrin repeats, opa and PEST elements are present in the same order as in Notch and the sequence identities peak in these motifs. With respect to genomic structure, intron/exon boundaries are conserved but, in most cases, the Scl introns are larger. Sequence analysis of the upstream genomic region reveals that the gene has a TATA-less promoter. Consistent with a central role in embryogenesis and imaginal development, high levels of Scl expression were detected in the early embryonic and pupal stages.

Evaluation of the cleaning and disinfection efficacy of the DEKO-190; award-based automated washer/disinfector.

The DEKO-190 Washer-Disinfector combines both automatic washing and thermal disinfection functions and is designed for the decontamination of ward utensils (such as bedpans and urine bottles) and instruments used in minor surgery prior to sterilization. We undertook a microbiological evaluation of the disinfection efficacy of the machine, using its short wash plus disinfection programme and sealed suspensions of test organisms placed at various points within the instrument. Suspensions of Enterococcus faecalis and Poliovirus were totally inactivated, the counts of aerobic organisms within a stool specimen being reduced by a factor of 10(4)whilst spores of Clostridium perfringens were unaffected. The cleaning efficacy of the DEKO-190 was also evaluated under clinical conditions by visual inspection and was found to be satisfactory. Ward-based combined washer-disinfection machines, such as the DEKO-190, have the potential to improve the efficacy of cleaning protocols within healthcare institutions.