Occupation and other risk factors for injury among enlisted U.S. Army Soldiers.

OBJECTIVE: To investigate injury risk associated with occupation and occupational physical demand levels among U.S. Army Soldiers. STUDY DESIGN: Retrospective cohort study. METHODS: Personal characteristics, physical fitness, military occupational specialty (MOS), and injury data were obtained by survey from Soldiers in an Army light infantry brigade (n = 2101). Odds ratios (OR) and 95% confidence intervals (95% CI) from a multivariate analysis assessing injury risk were calculated. RESULTS: Injury incidence for the prior 12 months was 43%. Physical fitness and behavioral factors associated with injury risk included age 21-29 (OR [age 21-29/age ≤ 20] = 1.37, 95% CI 1.00-1.90), BMI 27.5-29.9 (high-overweight) (OR high-overweight/normal = 1.62, 95% CI 1.20-2.18); BMI >29.9 (obese) (OR obese/normal = 1.73, 95% CI 1.23-2.44), cigarette smoking (OR Smoker/Nonsmoker = 1.34, 95% CI 1.11-1.63), and poor APFT two mile run performance (OR (Q4/Q1) = 1.61, 95% CI 1.19-2.19). Higher risk of injury was associated with some MOSs (OR (Chemical, Explosives & Ammunition/Infantry) = 2.82, 95% CI 1.19-6.68; OR (Armor/Infantry) = 1.53, 95% CI 1.13-2.07). CONCLUSION: This study identified a number of potentially modifiable risk factors for injuries including: maintenance of healthy weight, improved aerobic endurance, and reduction in smoking. Results also indicate certain Army occupations may be at higher risk of injury. Further investigation into reasons for their higher risk is warranted.

Generation of immunoglobulin light chain gene diversity in Raja erinacea is not associated with somatic rearrangement, an exception to a central paradigm of B cell immunity.

In all vertebrate species examined to date, rearrangement and somatic modification of gene segmental elements that encode portions of the antigen-combining sites of immunoglobulins are integral components of the generation of antibody diversity. In the phylogenetically primitive cartilaginous fishes, gene segments encoding immunoglobulin heavy and light chain loci are arranged in multiple clusters, in which segmental elements are separated by only 300-400 bp. In some cases, segmental elements are joined in the germline of nonlymphoid cells (joined genes). Both genomic library screening and direct amplification of genomic DNA have been used to characterize at least 89 different type I light chain gene clusters in the skate, Raja. Analyses of predicted nucleotide sequences and predicted peptide structures are consistent with the distribution of genes into different sequence groups. Predicted amino acid sequence differences are preferentially distributed in complementarity-determining versus framework regions, and replacement-type substitutions exceed neutral substitutions. When specific germline sequences are related to the sequences of individual cDNAs, it is apparent that the joined genes are expressed and are potentially somatically mutated. No evidence was found for the presence of any type I light chain gene in Raja that is not germline joined. The type I light chain gene clusters in Raja appear to represent a novel gene system in which combinatorial and junctional diversity are absent.

Striking differences in estimates of infant adiposity by new and old DXA software, PEAPOD and skin-folds at 2 weeks and 1 year of life.

BACKGROUND: Infant adiposity better predicts childhood obesity/metabolic risk than weight, but technical challenges fuel controversy over the accuracy of adiposity estimates. OBJECTIVE: We prospectively measured adiposity (%fat) in term newborns (NB) at 2 weeks (n = 41) and 1 year (n = 30). METHODS: %fat was measured by dual X-ray absorptiometry (DXA), PEAPOD and skin-folds (SF). DXAs were analyzed using Hologic Apex software 3.2(DXAv1) and a new version 5.5.2(DXAv2). RESULTS: NB %fat by DXAv2 was 55% higher than DXAv1 (14.2% vs. 9.1%), 45% higher than SF (9.8%), and 36% higher than PEAPOD (10.4%). Among NB, Pearson correlations were 0.73-0.89, but agreement (intra-class correlations) poor between DXAv2 and DXAv1 (0.527), SF (0.354) and PEAPOD (0.618). At 1 year, %fat by DXAv2 was 51% higher than DXAv1 (33.6% vs. 22.4%), and twice as high compared with SF (14.6%). Agreement was poor between DXAv2 and DXAv1 (0.204), and SF (0.038). The absolute increase in %fat from 2 weeks to 1 year was 19.7% (DXAv2), 13.6% (DXAv1) and only 4.8% by SF. CONCLUSION: Analysis of the same DXA scans using new software yielded considerably higher adiposity estimates at birth and 1 year compared with the previous version. Using different modalities to assess body composition longitudinally is problematic. Standardization is gravely needed to determine how early life exposures affect childhood obesity/metabolic risk.

Inhibitors of acyl-CoA:cholesterol O-acyltransferase. 17. Structure-activity relationships of several series of compounds derived from N-chlorosulfonyl isocyanate.

Several series of acyl-CoA:cholesterol O-acyltransferase inhibitors were prepared by the stepwise addition of nitrogen, oxygen, and sulfur nucleophiles to N-chlorosulfonyl isocyanate. The (aminosulfonyl)ureas 3-44 were the most potent inhibitors in vitro, with several compounds having IC50 values < 1 microM. Although the other series of compounds were not as potent in vitro, many compounds did display good in vivo activity in cholesterol-fed rats. Several of the oxysulfonyl carbamates (including CI-999, 115) showed excellent lipid-lowering activity in the chronic in vivo screen, demonstrating significant cholesterol lowering in a pre-established hypercholesterolemic state.

Heterocyclic amides: inhibitors of acyl-CoA:cholesterol O-acyl transferase with hypocholesterolemic activity in several species and antiatherosclerotic activity in the rabbit.

A series of heterocyclic amides were synthesized and evaluated as inhibitors of acyl-CoA: cholesterol O-acyltransferase (ACAT) in vitro and for cholesterol lowering in cholesterol-fed rats. Compounds were evaluated for cell-based macrophage ACAT inhibition, bioactivity, and adrenal toxicity. Candidates were selected for evaluation in cholesterol-fed dogs and, ultimately, the injured cholesterol-fed rabbit model of atherosclerosis. The heterocyclic amides potently inhibited rabbit liver ACAT (IC50's = 0.014-0.11 microM), and the majority of compounds significantly lowered plasma cholesterol (42-68%) in an acute cholesterol-fed rat model at 3 mg/kg. The most efficacious compounds in the rat were evaluated for bioactivity in vivo and arterial ACAT inhibition in a cell-based macrophage ACAT assay. Two highly bioactive analogs, (+/-)-2-(3-dodecylisoxazol-5-yl)-2-phenyl-N-(2,4,6-trimethoxypheny l) acetamide (13a) and (+/-)-2-(5-dodecylisoxazol-3-yl)-2-phenyl-N-(2,4,6-trimethoxypheny l) acetamide (16a), were selected for further study and were found to be nontoxic in a guinea pig model of adrenal toxicity. Compounds 13a and 16a lowered total cholesterol in the cholesterol-fed rat, rabbit, and dog models of pre-established hypercholesterolemia. Compound 13a in the injured cholesterol-fed rabbit model of atherosclerosis was effective in slowing the development of cholesteryl ester-rich thoracic aortic lesions, reducing lesion coverage by 53% at a dose of 1 mg/kg.

Differential effects of excitatory amino acid receptor antagonism in the ventral respiratory group.

This study tested the hypothesis that selective antagonism of excitatory amino acid (EAA) receptors within the ventral respiratory group (VRG) would induce changes in both respiratory rhythm and pattern. In the paralyzed, decerebrate, vagotomized and ventilated cat, baseline values for respiratory (Ttot), inspiratory (Ti), and expiratory (Te) durations and peak integrated phrenic nerve (integralPN) amplitude were established. Microinjection of the non-NMDA (N-methyl-d-aspartate) receptor antagonist NBQX (2, 3-dihydroxy-6-nitro-7-sulfamoyl-benzo(F)quinoxaline) into rostral/inspiratory-modulated (iVRG) or caudal/expiratory-modulated VRG elicited an immediate apnea. When PN activity resumed, Ttot was significantly decreased, and integralPN amplitude was attenuated. NMDA receptor antagonism with microinjections of AP5 (2-amino-5-phosphonopentanoic acid) into iVRG decreased Te for more than 30 min. NMDA receptor antagonism in inspiratory/expiratory-modulated VRG (level of obex, transitional VRG) yielded either apnea or a significant reduction in Ttot, Ti and integralPN amplitude. Our data suggest that endogenous EAA receptor-mediated neurotransmission throughout the VRG is active in the determination of both respiratory timing and pattern. Our data further suggest that tVRG serves a unique function within the respiratory network.

Evidence for medullary projections of the intercostal nerve-elicited inspiratory termination.

This study hypothesized that the ICN-elicited inspiratory termination reflex required synaptic activation in two distinct regions of the ventral respiratory group (VRG): (1) transitional (tVRG), and (2) pre-Bötzinger complex (pre-BötC). Data from adult cats indicate that axons of passage associated with the ICN-elicited termination reflex traverse tVRG, but that relevant synaptic processing does not occur in this region. Furthermore, data indicate that neither synaptic nor axonal transmission within the pre-BötC is required for the SLN- or ICN-elicited termination reflex.

Effect of a high-fat diet on the performance response to porcine somatotropin (PST) in finishing pigs.

One hundred sixty pigs were used in a 2 x 2 factorial design to compare the performance response to daily injection of porcine somatotropin (PST); (0 or 2 mg/d) in animals fed a 14% CP corn-soy diet (control, C) to those fed a diet with 10% added fat (F) and calorie:protein and lysine:protein ratios similar to that of the C diet. Treatments, assigned randomly to 20 pens (n = 5/treatment) of eight pigs each, were initiated at 90 kg body weight and continued for 28 d. Responses to PST and dietary fat were typical. These include improved gain and feed efficiency and decreased feed intake. The effects of dietary fat on intake and efficiency were accounted for largely by the difference in energy density of these diets. Across diets, PST treatment resulted in a 13% improvement in ADG (P less than .001), a 13% decrease in feed intake (P less than .0001) and a 22% improvement in efficiency (P less than .0001). Of particular interest were the additive (PST x diet interaction, P less than .2) effects of PST and dietary fat on gain in these animals. Pigs treated with PST that were fed the F diet had greater rates of gain than did PST-treated pigs fed the C diet (P less than .05). Treatment with PST increased ADG by 9% in pigs consuming the C diet vs 16% in pigs fed the F diet. Similarly, dietary fat resulted in 4 and 11% increases in ADG in pigs treated with 0 or 2 mg of PST/d.(ABSTRACT TRUNCATED AT 250 WORDS)

Screening for Chlamydia trachomatis in college women on routine gynecological exams.

Chlamydia trachomatis infection poses a serious threat to sexually active college women. Past research has demonstrated the difficulty of predicting infection on the basis of symptoms or physical exam. Recent studies highlight the prevalence of asymptomatic chlamydia infections. This study presents the results of screening 2,303 women for chlamydia infection on routine annual gynecological examinations at a college health center during a 22-month period. A prevalence of 6% was found. The study also assessed the differences between the 140 women identified as chlamydia positive and a control sample of 140 women who were chlamydia negative. The authors compared groups for signs and symptoms that might predict infection, but found no useful predictors. In fact, 79% of the patients who tested positive had no symptoms, and 58% of these had no signs, symptoms, or concurrent infections. Routine screening of women on annual gynecological exam is necessary to bring the chlamydia epidemic under control, the authors conclude.

The pressure toward enactment and the hatred of reality.

The pressure toward enactment is investigated in terms of the threats that primitive, pre-thinking states of mind exert on attempts to know and understand. Clinical material and a review of the literature suggest that when the analyst confronts (by thinking) rather than complies (by action) with the hidden demands of omnipotence, he or she triggers and is then subject to the pre-thinking mental realm of concrete sensory bombardment, which can penetrate and obliterate his or her separately thinking mind. One important pressure driving the analyst toward enactment derives from a defensive response aimed at avoiding the threat of such concrete projections.

Sources of coming out self-efficacy for lesbians.

The empirical literature on disclosing a lesbian sexual orientation has explored the circumstantial and demographic variables related to this act. This exploratory study utilized self-efficacy theory (Bandura, 1986) to investigate the extent to which each of the four sources of efficacy information (e.g., performance accomplishments, vicarious experience, verbal persuasion, or emotional arousal) contributed to the coming out self-efficacy of lesbians, that is, the sense of confidence possessed by a lesbian to disclose her sexual orientation to others. Anonymous survey packets were completed by 134 lesbians. Results of regression analyses indicated that emotional arousal was the most potent predictor of coming out self-efficacy. Verbal persuasion and vicarious experience also were significant. The most theoretically salient source of self-efficacy information, performance accomplishments (Bandura, 1986), was not a significant predictor of coming out self-efficacy. Further, significant correlations were found between coming out self-efficacy and outness and life-style satisfaction, which were also significantly correlated to measures of psychological adjustment.

Rapid separation and quantitation of combined neutral and polar lipid classes by high-performance liquid chromatography and evaporative light-scattering mass detection.

Modifications are described for an innovative and widely used high-performance liquid chromatography technique that resolves a very broad spectrum of lipids for quantitation by evaporative light-scattering detection. Substitution of acetone for 2-propanol in a portion of the solvent gradient program yields consistent resolution of diacylglycerol and cholesterol without sacrificing baseline resolution of the remaining major lipid classes. Moreover, previously noted instabilities in triacylglycerol retention time are eliminated. The introduction of acetone also enables a 20% reduction in flow-rate without an increase in total run time. As a further modification of the mobile phase composition, acetic acid and ethanolamine are substituted for the serine-ethylamine combination that was originally shown to improve column performance. The combination of acetic acid and ethanolamine yields the same result but the increased volatility of these solutes over serine results in decreased baseline noise. Finally, 1,2-hexadecanediol is introduced as an internal standard that is well suited for this method. The chromatographic performance obtained with these modifications is demonstrated in compositional analyses of lipid extracts from rat liver, heart, kidney and brain.

Effect of temperature on intra- and interspecific crosses of diploid and tetraploid red clover, Trifolium pratense L.

Reciprocal intraspecific crosses of diploid and tetraploid Trifolium pratense L. and reciprocal interspecific crosses of 4N T. pratense and T. medium were attempted in conjunction with a 40 °C temperature treatment on the female parent. The temperature treatment was found to be of little benefit in interspecific and intraspecific hybridization attempts. No cytologically verified interspecific hybrids were found from either heat-treated or non-heat-treated crosses. Intraspecific crosses produced no viable triploid offspring. One seedling was found to possess 17 chromosomes but died before positive verifications could be made. However, several seedlings from male-sterile diploid × tetraploid crosses were found to possess 28 chromosomes. These resulting tetraploids were cross compatible with other tetraploids.

Vaccinia virus encodes an essential gene with strong homology to protein kinases.

The B1 gene of vaccinia virus encodes a 34-kDa protein which is essential for viral replication. Temperature-sensitive mutants bearing lesions in this gene arrest at the stage of DNA replication during nonpermissive infections. In this report, the sequence of the 34-kDa open reading frame is presented, and the mutations in two ts alleles are identified. Analysis of the deduced protein sequence reveals strong homology with catalytic domains of numerous protein kinases. The lesion in one of the mutants alters an invariant glycine residue within one such domain.

Evolution of antigen binding receptors.

This review addresses issues related to the evolution of the complex multigene families of antigen binding receptors that function in adaptive immunity. Advances in molecular genetic technology now permit the study of immunoglobulin (Ig) and T cell receptor (TCR) genes in many species that are not commonly studied yet represent critical branch points in vertebrate phylogeny. Both Ig and TCR genes have been defined in most of the major lineages of jawed vertebrates, including the cartilaginous fishes, which represent the most phylogenetically divergent jawed vertebrate group relative to the mammals. Ig genes in cartilaginous fish are encoded by multiple individual loci that each contain rearranging segmental elements and constant regions. In some loci, segmental elements are joined in the germline, i.e. they do not undergo genetic rearrangement. Other major differences in Ig gene organization and the mechanisms of somatic diversification have occurred throughout vertebrate evolution. However, relating these changes to adaptive immune function in lower vertebrates is challenging. TCR genes exhibit greater sequence diversity in individual segmental elements than is found in Ig genes but have undergone fewer changes in gene organization, isotype diversity, and mechanisms of diversification. As of yet, homologous forms of antigen binding receptors have not been identified in jawless vertebrates; however, acquisition of large amounts of structural data for the antigen binding receptors that are found in a variety of jawed vertebrates has defined shared characteristics that provide unique insight into the distant origins of the rearranging gene systems and their relationships to both adaptive and innate recognition processes.

Transcriptional regulation of lymphocyte lineage commitment.

The development of T cells and B cells from pluripotent hematopoietic precursors occurs through a stepwise narrowing of developmental potential that ends in lineage commitment. During this process, lineage-specific genes are activated asynchronously, and lineage-inappropriate genes, although initially expressed, are asynchronously turned off. These complex gene expression events are the outcome of the changes in expression of multiple transcription factors with partially overlapping roles in early lymphocyte and myeloid cell development. Key transcription factors promoting B-cell development and candidates for this role in T-cell development are discussed in terms of their possible modes of action in fate determination. We discuss how a robust, stable, cell-type-specific gene expression pattern may be established in part by the interplay between endogenous transcription factors and signals transduced by cytokine receptors, and in part by the network of effects of particular transcription factors on each other.

Homeless patients' experience of satisfaction with care.

This article explores homeless individuals' experiences of satisfaction with health care, and explores the interrelationship among experiences of being homeless, health perceptions of participants, and experiences of satisfaction with health care. It presents the findings of a phenomenological study that was conducted using participants selected from five sites in one southeastern state. Participant interviews were conducted at a nurse-managed primary health care clinic for homeless, at a night time soup-kitchen, and at three private, not-for-profit, homeless shelters in two different towns. The study was part of a larger study designed to develop and validate a reliable measure of client satisfaction with primary health care among homeless individuals. Face-to-face in-depth interviews with 17 homeless individuals were conducted, with the semistructured interview constituting the primary data source. Common themes were identified and the interrelationship of theme clusters was explored. Analysis of the data yielded five distinct themes that represent the lived experiences of satisfaction with health care. These themes were mediated and directly informed by five themes of homelessness and three themes of health identified in the shared experiences of the participants. The themes identified suggest that satisfaction with health care for homeless persons differs from currently identified dimensions of satisfaction with care, and that some aspects of homelessness are seen by participants as positive and health promoting.