Child eating behaviors are consistently linked to intake across meals that vary in portion size.

Prior studies evaluating a single meal in children characterized an "obesogenic" style of eating marked by larger bites and faster eating. It is unclear if this style is consistent across portion sizes within children so we examined eating behaviors in 91 children (7-8 years, 45 F) without obesity (BMI<90th percentile). Children consumed 4 ad libitum meals in the laboratory consisting of chicken nuggets, macaroni, grapes, and broccoli that varied in portion size (100%, 133%, 166%, 200%) with a maximum of 30 min allotted per meal. Anthropometrics were assessed using age and sex adjusted body mass index (BMI) percentile and dual energy x-ray absorptiometry. Bites, sips, active eating time, and meal duration were coded from meal videos; bite size (kcal and g/bite), proportion of active eating (active eating time/meal duration), and eating rate (kcal and g/meal duration) were computed. Intraclass correlation coefficients (ICC) showed that most eating behaviors were moderately consistent across portions (>0.50). The consistency of associations between eating behaviors and total meal intake and adiposity were assessed with general linear models adjusted for food liking, pre-meal fullness, age, and sex. Across all portions, more bites, faster eating rate, and longer meal duration were associated with greater intake. While higher BMI percentile was associated with faster eating rates across all meals, greater fat mass index was only associated with faster eating at meals with portions typical for children (i.e., 100% and 133%). In a primarily healthy weight sample, an 'obesogenic' style of eating was a consistent predictor of greater intake across meals that varied in portion size. The consistent relationship of these behaviors with intake makes them promising targets to reduce overconsumption.

Switching between foods is reliably associated with intake across eating events in children.

Emerging evidence suggests switching between foods during an eating event is positively associated with intake. However, it is unclear whether switching is a stable behavior that predicts consumption across multiple eating events. The current study explored whether switching is consistent within children and reliably associated with intake across varied eating events. We analyzed data from 88 (45 F), 7-8-year-old children without obesity participating in a 7-visit prospective cohort study (ClinicalTrials.gov NCT03341247). Amount consumed and energy intake were measured at 4 separate meals of foods that varied by portion sizes served. Meals included macaroni and cheese, chicken nuggets, broccoli, and grapes (all 0.7-2.5 kcal/g). Children's intake was also assessed during 2 eating in the absence of hunger (EAH) paradigms separated by ≥ 1 year. The EAH paradigm included 9 sweet and savory snack foods (all 1.9-5.7 kcal/g). All eating events were video-recorded and switching was assessed by counting the number of times a child shifted between different food items. Results demonstrated that switching was reliably associated with intake at both the meals and the EAH paradigms (ps < 0.01). Specifically, at meals each additional switch was associated with 11.7 ± 1.3 kcal (7.7 ± 0.8 g) more consumed, and during EAH each additional switch was associated with 8.1 ± 2.1 kcal (2.1 ± 0.5 g) more consumed. Switching behavior was also moderately consistent across meals (ICC = 0.70) and EAH paradigms (ICC = 0.50). However, switching at meals was not related to switching at EAH paradigms. This study demonstrates the consistency of switching behavior and its reliable association with intake across eating events, highlighting its potential to contribute to chronic overconsumption and childhood obesity.

Sub-three-cycle pulses at 2 µm from a degenerate optical parametric amplifier.

In this work we present a compact two-stage optical parametric amplifier (OPA) pumped at degeneracy by the fundamental of a Yb:KGW laser system. The output pulses span from 1.7 to 2.5 µm (120-176 THz) and are compressed to a sub-20 fs duration. This parametric amplifier exploits the broad phase-matching bandwidth at the degeneracy point in bismuth triborate (BiBO) and periodically poled lithium tantalate (PPLT). The result drastically expands the availability of ultrashort pulses with few-microjoule energy from near-infrared (NIR) to even longer wavelengths in the mid-infrared (MIR) spectral region.

Calcified cartilage differs in patients with end-stage primary osteoarthritis and secondary osteoarthritis due to rheumatoid arthritis of the hip joint.

OBJECTIVES: Despite distinct aetiologies, the end-stages of primary osteoarthritis (OA) and secondary OA are described by common radiological features. However, the morphology of the bone-cartilage unit may differ depending on the pathogenesis. In this cross-sectional study, we aimed to investigate the histological differences in the bone-cartilage unit of the femoral head between patients with primary OA and secondary OA due to rheumatoid arthritis (RA). METHOD: Femoral heads were obtained from 12 patients with primary OA, six patients with secondary OA due to RA, and 12 control subjects. The femoral heads were investigated using stereological methods to ensure unbiased quantification. RESULTS: The volume (mean difference [95% confidence interval]) (2.1 [0.5;3.8] cm3, p = 0.016) and thickness (413 [78.9;747] µm, p = 0.029) of the articular cartilage and the thickness of the calcified cartilage (56.4 [0.4;113] µm, p = 0.017) were larger in patients with primary OA than in patients with secondary OA due to RA. Femoral head volume (1.2 [-3.6;6.1] cm3, p = 0.598), bone volume fraction (-1.1 [-2.8;5.1] cm3, p = 0.553), subchondral bone thickness (-2.5 [-212;207] µm, p = 0.980), and osteophyte area (25.3 [-53.6;104] cm2, p = 0.506) did not differ between patients. CONCLUSION: The thicker calcified cartilage in primary OA preceding the loss of articular cartilage can be attributed to endochondral ossification. Patients with secondary OA due to RA had severely thinner calcified cartilage as the pathogenesis is driven by inflammation and is characterized by a generalized and more severe loss of articular cartilage.

Comparison of High Throughput Sequencing to Standard Protocols for Virus Detection in Berry Crops.

We completed a comprehensive study comparing virus detection between high throughput sequencing (HTS) and standard protocols in 30 berry selections (12 Fragaria, 10 Vaccinium, and eight Rubus) with known virus profiles. The study examined temporal detection of viruses at four sampling times encompassing two growing seasons. Within the standard protocols, reverse transcription (RT) PCR proved better than biological indexing. Detection of known viruses by HTS and RT-PCR nearly mirrored each other. HTS provided superior detection compared with RT-PCR on a wide spectrum of variants and discovery of novel viruses. More importantly, in most cases in which the two protocols showed parallel virus detection, 11 viruses in 16 selections were not consistently detected by both methods at all sampling points. Based on these data, we propose a testing requirement of four sampling times over two growing seasons for berry and potentially other crops, to ensure that no virus remains undetected independent of titer, distribution, or other virus-virus or virus-host interactions.

Children's inhibitory control abilities in the presence of rewards are related to weight status and eating in the absence of hunger.

The Reflective-Impulsive Dual Processes Model suggests that overeating occurs when the temptation to consume food overrides inhibitory control processes. However, how rewards interact with inhibitory control and their relation to children's weight status and food intake is not understood. Here, 7-to-11-year-old children (n = 66; 32 overweight/obese) completed two versions (baseline [i.e., non-reward incentivized/control] and reward incentivized [food, money, no reward]) of a Go/Nogo task. Intake of palatable foods in the absence of hunger (i.e., eating in the absence of hunger-EAH) was measured following a standardized meal. A drift diffusion model was used to characterize children's performance parameters on the Go/Nogo. On the baseline Go/Nogo, children with higher weight status responded more cautiously, but on reward trials for food/money children were more cautions and made more false alarms relative to the no reward condition. Energy intake during EAH positively correlated with FA errors for food and money vs. no reward, but sex moderated this effect such that FA positively associated with EAH in girls but not boys. Independent of sex, FA for money vs. no reward and food vs. money were both positively associated with energy consumed during EAH. These results suggest that the presence of food and money rewards impair inhibitory control processing, especially in children with higher weight status. Further, increased inhibitory control impairment in response to food rewards, specifically, may be a risk factor for disinhibited eating in girls. Though preliminary, results may be useful in the development of targeted treatments to help moderate excess consumption in children.

Accessing distributions of exchange and dipolar couplings in stiff molecular rulers with Cu(II) centres.

Determining distributed exchange couplings is important for understanding the properties of synthetic magnetic molecules. Such distributions can be determined from pulsed dipolar spectroscopy (PDS) data, but this is challenging due to the similar influence of both exchange and dipolar couplings on such data. In this work we introduce two models that aim to identify these two contributions to the spin-spin couplings from frequency-domain PDS data of shape-persistent molecules having either two Cu(ii) ions, or a Cu(ii) ion and a nitroxide radical as the paramagnetic moieties. The first model assumes correlated Lorentzian or Gaussian exchange and dipole-dipole coupling distributions whose parameters are the model's unknowns. The second model relies on prior knowledge of the distance distribution and by performing Tikhonov regularization along the exchange coupling dimension yields the latter distribution model-free. Both models were able to differentiate between the absence and the presence of exchange interaction, to determine the coupling regime (ferro- or antiferromagnetic) and to estimate the distribution shape. In contrast, calculations within the exchange resilient model of the neural network analysis implemented in DeerAnalysis2018 were not able for our data to identify exchange couplings and return correct distance distributions. However, the generic model was able to identify and separate the strongly curved intermolecular background in the relaxation-induced dipolar modulation enhancement (RIDME) experiments. Our analysis revealed that in such systems exchange coupling may be present up to at least 3.3 nm in π-conjugated systems involving Cu(ii)-PyMTA, while it is negligible for distances r ≥ 4.5 nm between Cu(ii) ions and r ≥ 3.8 nm between a Cu(ii) ion and an unpaired electron of a nitroxide radical. Disruption of the π-conjugation between the ligand of the Cu(ii) complex and the nitroxide leads to negligible exchange coupling at distances r ≥ 2.6 nm in the corresponding [Cu(ii)-TAHA]-nitroxide ruler. Overall, for cases with known distance distributions, the presented analysis techniques allow to determine distributions of exchange couplings from PDS data.

Non-specific rheumatic manifestations in patients with Hashimoto's thyroiditis: a pilot cross-sectional study.

PURPOSE: Hashimoto's thyroiditis (HT) is often associated with rheumatic disorders (arthritis, etc.), but many HT patients report non-specific rheumatic signs and symptoms in the absence of clinically evident rheumatic diseases. Aim of this study was to evaluate the prevalence of non-specific rheumatic manifestations (RMs) in HT subjects without classified autoimmune comorbidities. METHODS: 500 HT patients (467 F, 33 M; median age 41 years, range 14-69) and 310 age- and sex-matched controls, consecutively referred to the Endocrine Unit of Messina University Hospital, were evaluated for non-specific RMs. None took L-thyroxine. EXCLUSION CRITERIA: autoimmune comorbidities, infectious, and/or inflammatory diseases, history of neoplasia, BMI > 30 kg/m2. RESULTS: In our HT cohort, 100 patients (20%) complained of one or more RMs, vs 21 controls (6.8%; P < 0.001). There were minimal differences between the manifestations recorded in the two groups, the most common being polyarthralgias and myalgias/fibromyalgia, but non-specific RMs occurred threefold more in HT patients. Comparing HT patients with RMs (96 F and 4 M) with those affected by HT alone, female sex was prevalent (F:M ratio 24:1 vs 5:1) with higher age at diagnosis (median 43 vs 37 years; P < 0.001). HT patients with RMs (62%) were mostly euthyroid (median TSH 2.0 µIU/L) and only 7% overtly hypothyroid, discouraging a possible causal relationship between thyroid dysfunction per se and RMs. CONCLUSIONS: A significant percentage of HT patients complains of non-specific rheumatic signs and symptoms, in the absence of other diagnosed systemic comorbidities and regardless of thyroid functional status, deserving careful evaluation and prolonged follow-up.

Local bone loss in patients with anti-citrullinated peptide antibody and arthralgia, evaluated with high-resolution peripheral quantitative computed tomography.

OBJECTIVE: To investigate bone changes in the metacarpophalangeal (MCP) joints of anti-citrullinated peptide antibody (ACPA)-positive patients with arthralgia, but not arthritis, compared to healthy controls. METHOD: Using a cross-sectional study design, patients were recruited from hospitals and private care rheumatologists, and controls from a test subject website. All subjects underwent medical history interview, clinical examination, and biochemical screening including ACPA. Patients with positive ACPA, arthralgia, and no rheumatic disease were included. Controls without a history or signs of rheumatological disease or positive ACPA were included. A 2.7-cm-long region around the second and third MCP joints was evaluated using high-resolution peripheral quantitative computed tomography with a voxel size of 82 µm. RESULTS: Twenty-nine ACPA-positive patients and 29 healthy controls were evaluated. Trabecular volumetric bone mineral density and bone volume fraction did not differ between the groups. In addition, the cortical bone was not affected in patients, as we found no difference in average cortical thickness and cortical bone area between the groups. In contrast, the trabeculae were significantly (p < 0.05) thinner in both second and third MCP heads compared with controls, whereas trabecular number and trabecular separation did not differ between the groups. No erosions were demonstrated and the number of non-specific breaks did not differ between the groups. CONCLUSION: Trabecular bone changes were observed in ACPA-positive patients with arthralgia compared with healthy controls. The results may reflect inflammatory up-regulated trabecular bone resorption leading to early bone loss before the onset of clinical arthritis.

Effect of re-ensiling on the quality of sorghum silage.

The commercialization of silage in many countries, including Brazil, has increased in recent years. Re-ensiling of previously ensiled forage occurs when silage is relocated from one farm to another, where it will be compacted and sealed again. During this process, silage is exposed to oxygen before being ensiled, which may affect its quality. We exposed sorghum silage to air during the anaerobic storage phase to simulate the transportation of silages between farms. Experimental treatments included silage exposed to air for 0 or 12 h, with or without the use of an inoculant containing a mixture of Lactobacillus plantarum and the propionic bacteria Propionibacterium acidipropionici (1 × 106 cfu/g of forage; Biomax corn, Lallemand, Saint-Simon, France), totaling 4 treatments: conventional silage, conventional silage with inoculant use, re-ensilage after exposure to air, and re-ensilage after exposure to air with use of an inoculant. The sorghum was stored in experimental silos containing about 9.0 kg of fresh forage per replicate. Treatments were tested in a factorial 2 × 2 design with 5 replicates each. Chemical composition, in vitro dry matter digestibility, fermentative characteristics, losses (due to gas, effluents, and total dry matter), microorganism counts, and aerobic stability of sorghum silage were evaluated. Dry matter content of sorghum before ensiling was 273.12 g/kg. The 12-h re-ensiling process increased the effluent loss of the silage when compared with conventional silage (456.42 vs. 201.19 g/kg of FM, respectively). In addition, re-ensiled silages presented lower concentrations of lactic acid and higher concentrations of propionic acid than the silages that had not been opened during storage. The aerobic stability of silage was not affected by the re-ensiling process and the use of inoculant. The use of inoculant increased the pH and loss of dry matter of the silages (4.23 vs. 3.98 and 14.05 vs. 7.82%, respectively) and therefore did not provide any benefits in this study.

Ligand-dependent Hedgehog pathway activation in Rhabdomyosarcoma: the oncogenic role of the ligands.

BACKGROUND: Rhabdomyosarcoma (RMS) is the most common type of soft tissue sarcoma in children. The Hedgehog (HH) pathway is known to develop an oncogenic role in RMS. However, the molecular mechanism that drives activation of the pathway in RMS is not well understood. METHODS: The expression of HH ligands was studied by qPCR, western blot and immunohistochemistry. Functional and animal model studies were carried out with cells transduced with shRNAs against HH ligands or treated with HH-specific inhibitors (Vismodegib and MEDI-5304). Finally, the molecular characterisation of an off-target effect of Vismodegib was also made. RESULTS: The results showed a prominent expression of HH ligands supporting an autocrine ligand-dependent activation of the pathway. A comparison of pharmacologic Smoothened inhibition (Vismodegib) and HH ligand blocking (MEDI-5304) is also provided. Interestingly, a first description of pernicious off-target effect of Vismodegib is also reported. CONCLUSIONS: The clarification of the HH pathway activation mechanism in RMS opens a door for targeted therapies against HH ligands as a possible alternative in the future development of better treatment protocols. Moreover, the description of a pernicious off-target effect of Vismodegib, via unfolded protein response activation, may mechanistically explain its previously reported inefficiency in several ligand-dependent cancers.

Post-traumatic stress disorder dimensions and asthma morbidity in World Trade Center rescue and recovery workers.

OBJECTIVE: Using data from a cohort of World Trade Center (WTC) rescue and recovery workers with asthma, we assessed whether meeting criteria for post-traumatic stress disorder (PTSD), sub-threshold PTSD, and for specific PTSD symptom dimensions are associated with increased asthma morbidity. METHODS: Participants underwent a Structured Clinical Interview for Diagnostic and Statistical Manual to assess the presence of PTSD following DSM-IV criteria during in-person interviews between December 2013 and April 2015. We defined sub-threshold PTSD as meeting criteria for two of three symptom dimensions: re-experiencing, avoidance, or hyper-arousal. Asthma control, acute asthma-related healthcare utilization, and asthma-related quality of life data were collected using validated scales. Unadjusted and multiple regression analyses were performed to assess the relationship between sub-threshold PTSD and PTSD symptom domains with asthma morbidity measures. RESULTS: Of the 181 WTC workers with asthma recruited into the study, 28% had PTSD and 25% had sub-threshold PTSD. Patients with PTSD showed worse asthma control, higher rates of inpatient healthcare utilization, and poorer asthma quality of life than those with sub-threshold or no PTSD. After adjusting for potential confounders, among patients not meeting the criteria for full PTSD, those presenting symptoms of re-experiencing exhibited poorer quality of life (p = 0.003). Avoidance was associated with increased acute healthcare use (p = 0.05). Sub-threshold PTSD was not associated with asthma morbidity (p > 0.05 for all comparisons). CONCLUSIONS: There may be benefit in assessing asthma control in patients with sub-threshold PTSD symptoms as well as those with full PTSD to more effectively identify ongoing asthma symptoms and target management strategies.

[Medicinal treatment of tricuspid valve regurgitation]. / Medikamentöse Therapie der Trikuspidalklappeninsuffizienz.

The vast majority of tricuspid valve regurgitations are of low degree without prognostic relevance in healthy individuals; however, morbidity and mortality increase with the degree of regurgitation, which can be secondary to either primary (structural) or secondary (functional) alterations of the valve. Due to the frequent lack of symptoms, echocardiographic examinations should be annually performed in patients with higher degree (at least moderate) tricuspid valve regurgitation, in particular in the presence of risk factors. Individual therapeutic management strategies should consider the etiology of the tricuspid valve regurgitation, the degree of regurgitation, the valve pathology and the risk-to-benefit ratio of the envisaged therapeutic procedure. Medicinal treatment options for tricuspid valve regurgitation are limited and generalized recommendations cannot be provided due to the lack of conclusive clinical trials. Symptomatic therapeutic measures encompass especially (loop) diuretics for the reduction of preload and afterload of the right ventricle. Pharmaceutical reduction of the heart rate should be avoided in patients with right heart insufficiency. While symptomatic therapeutic measures are often associated with only moderate effects, the most effective therapy of tricuspid valve regurgitation consists in the treatment of underlying illnesses, in most cases pulmonary hypertension due to pulmonary arterial hypertension (PAH), left heart disease or acute pulmonary embolism. Based on a number of published clinical studies and licensing of new drugs, treatment options for patients with PAH and heart failure with reduced ejection fraction (HFrEF) have substantially improved during the past years allowing for a differentiated, individualized management.

Reduced neural response to food cues following exercise is accompanied by decreased energy intake in obese adolescents.

BACKGROUND: Acute exercise has been found to favor a transient anorexigenic effect in obese adolescents. Although the role of some gastro-peptides has been suggested as an explanation for this observed reduced energy intake after exercise, it is unknown whether neural pathways involved in the regulation of food intake are modulated in youth. METHODS: Body composition (dual-energy X-ray absorptiometry) and aerobic capacities were assessed in 19 obese adolescent boys. Participants were randomized to remain at rest in a sitting position (CON condition) or to exercise 45 min at 65% of their maximal capacities (EX condition) by the end of the morning. An attentional computer task with electroencephalography recording was completed immediately after the exercise or sitting period to measure an event-related component (P3b) reflecting the level of cognitive engagement in the processing of food cues. A lunch test-meal was offered ad libitum and appetite feelings assessed at regular intervals using visual analog scales. RESULTS: The 45-min cycling exercise set at 65% VO2max induced a mean energy expenditure of 399±75 kcal. Both absolute (P<0.05) and relative (P<0.001) subsequent energy intake were significantly reduced after EX (1037±260 and 639±256 kcal, respectively) compared with CON (1116±243 and 1011±239 kcal, respectively). The energy ingested derived from each macronutrient and self-reported appetite remained unchanged. Although the amplitudes of the P3b component evoked by food and non-food visual stimuli were not significantly different during CON, the response to food cues was significantly reduced compared with non-food stimuli after exercise (P<0.01). DISCUSSION: An acute exercise favors decreased neural response to food cues compared with non-food ones in obese adolescents that may contribute to their subsequently reduced energy intake.

Brain regions implicated in inhibitory control and appetite regulation are activated in response to food portion size and energy density in children.

OBJECTIVE: Large portions of energy-dense foods drive energy intake but the brain mechanisms underlying this effect are not clear. Our main objective was to investigate brain function in response to food images varied by portion size (PS) and energy density (ED) in children using functional magnetic resonance imaging (fMRI). METHODS AND DESIGN: Blood-oxygen-level-dependent (BOLD) fMRI was completed in 36 children (ages 7-10 years) after a 2-h fast while viewing food images at two levels of PS (Large PS, Small PS) and two levels of ED (High ED, Low ED). Children rated perceived fullness pre- and post-fMRI, as well as liking of images on visual analog scales post-fMRI. Anthropometrics were completed 4 weeks before the fMRI. Large PS vs Small PS and High ED vs Low ED were compared with region-of-interest analyses using Brain Voyager v 2.8. RESULTS: Region-of-interest analyses revealed that activation in the right inferior frontal gyrus (P=0.03) was greater for Large PS vs Small PS. Activation was reduced for High ED vs Low ED in the left hypothalamus (P=0.03). Main effects were no longer significant after adjustment for pre-fMRI fullness and liking ratings (PS, P=0.92; ED, P=0.58). CONCLUSION: This is the first fMRI study to report increased activation to large portions in a brain region that is involved in inhibitory control. These findings may contribute to understanding why some children overeat when presented with large portions of palatable food.

Subchondral bone turnover, but not bone volume, is increased in early stage osteoarthritic lesions in the human hip joint.

OBJECTIVE: The pathogenesis of osteoarthritis (OA) is not fully understood, but bone changes are suggested to be important. Bone turnover and bone volume (BV) in human hip OA were investigated in relation to the overlying cartilage degeneration using design-based stereological estimators. MATERIALS AND METHODS: Femoral heads were obtained from 25 end-stage OA patients and 24 controls (CTL). Design-based stereological methods were used for sampling and quantification to obtain absolute estimates of volume and surface in the central trabecular and the subarticular bone region. The subarticular bone was further subdivided into regions according to the OARSI-score of the overlying articular cartilage in which erosion and osteoid surfaces were estimated. RESULTS: In the subarticular region, bone volume (BV/TV) was 15.0% higher in OA patients compared to CTL; The fraction of erosive (ES/BS) and osteoid surfaces (OS/BS) were 56.2% and 72.8% higher in OA compared to CTL. In subarticular regions with none to mild cartilage degeneration (OARSI grade 0-2), ES/BS and OS/BS were 48.6% and 59.9% higher in OA compared to CTL, whereas BV/TV did not differ between OA and CTL. CONCLUSION: In human end-stage hip OA, BV and bone turnover correlate with the degree of local cartilage degeneration. Subarticular bone sclerosis was only present in regions corresponding to end-stage OA. However, in regions with only none to mild cartilage degeneration the underlying bone had significantly higher turnover in OA patients compared to the control group, suggesting that high bone turnover may contribute to the early pathogenesis of OA.

Adsorption of ethanol and water on calcite: dependence on surface geometry and effect on surface behavior.

Molecular dynamics (MD) simulations were used to explore adsorption on calcite, from a 1:1 mixture of ethanol and water, on planar {10.4} and stepped, i.e. vicinal, surfaces. Varying the surface geometry resulted in different adsorption patterns, which would directly influence the ability of ethanol to control calcite crystal growth, dissolution, and adsorption/desorption of other ions and molecules. Ethanol forms a well-ordered adsorbed layer on planar faces and on larger terraces, such as between steps and defects, providing little chance for water, with its weaker attachment, to displace it. However, on surfaces with steps, adsorption affinity depends on the length of the terraces between the steps. Long terraces allow ethanol to form a well-ordered, hydrophobic layer, but when step density is high, ethanol adsorption is less ordered, allowing water to associate at and near the steps and even displacing pre-existing ethanol. Water adsorbed at steps forms mass transport pathways between the bulk solution and the solid surface. Our simulations confirm the growth inhibiting properties of ethanol, also explaining how certain crystal faces are more stabilized because of their surface geometry. The -O(H) functional group on ethanol forms tight bonds with calcite; the nonpolar, -CH3 ends, which point away from the surface, create a hydrophobic layer that changes surface charge, thus wettability, and partly protects calcite from precipitation and dissolution. These tricks could easily be adopted by biomineralizing organisms, allowing them to turn on and off crystal growth. They undoubtedly also play a role in the wetting properties of mineral surfaces in commercial CaCO3 manufacture, oil production, and contamination remediation.

Cardiac troponin I for predicting right ventricular dysfunction and intermediate risk in patients with normotensive pulmonary embolism.

BACKGROUND: Right ventricular dysfunction (RVD) and cardiac troponin I (cTnI) are important tools for risk stratification in pulmonary embolism (PE). We investigate the association of RVD and cTnI in normotensive PE patients and calculate a cTnI cut-off level for predicting RVD and submassive PE. METHODS: Clinical, laboratory, radiological and echocardiagraphic data were analysed. Patients were categorised into groups with or without RVD and compared focussing on cTnI. Effectiveness of cTnI for predicting RVD and submassive PE was tested. RESULTS: One hundred twenty-nine normotensive PE patients, 71 with and 58 without RVD, were included. Patients with RVD were older (75.0 years (61.3/81.0) vs. 66.0 years (57.7/75.1), P = 0.019). cTnI (0.06 ng/ml (0.02/0.23) vs. 0.01 ng/ml (0.00/0.03), P < 0.0001) and D-dimer values (2.00 mg/l (1.08/4.05) vs. 1.23 mg/l (0.76/2.26), P = 0.016) were higher in PE with RVD. cTnI was associated with RVD (OR 3.95; 95 % CI 1.95-8.02, p = 0.00014). AUC for cTnI diagnosing RVD was 0.79, and for submassive PE0.87. Cut-off values for cTnI predicting RVD and submassive PE were 0.01 ng/ml, with a negative predictive value of 73 %. cTnI was positively correlated with age, D-dimer and creatinine. CONCLUSIONS: In normotensive PE patients, cTnI is helpful for risk stratification and excluding RVD. cTnI elevation is correlated with increasing age and reduced kidney function.

[Relevance of personal contextual factors of the ICF for use in practical social medicine and rehabilitation]. / Bedeutung der personbezogenen Faktoren der ICF für die Nutzung in der praktischen Sozialmedizin und Rehabilitation.

Personal contextual factors play an essential part in the model of the International Classification of Functioning, Disability and Health (ICF). The WHO has not yet classified personal factors for global use although they impact on the functioning of persons positively or negatively. In 2010, the ICF working group of the German Society of Social Medicine and Prevention (DGSMP) presented a proposal for the classification of personal factors into 72 categories previously arranged in 6 chapters. Now a positioning paper has been added in order to stimulate a discussion about the fourth component of the ICF, to contribute towards a broader and common understanding about the nature of personal factors and to incite a dialogue among all those involved in health care as well as those people with or with-out health problems in order to gain a comprehensive perspective about a person's condition.