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PubMed1995

Frequency of Travel of Adults Infected with HIV.

Background: Little is known about the frequency and pattern of travel in the HIV-infected population. Method: A test questionnaire administered to patients cared for at a public hospital HIV clinic examined the frequency, destinations, and motivations for travel of persons with HIV disease. Results: Of 89 persons surveyed, 46% had traveled within the preceding 2 years within the United States for a minimum of 1 week, or to a foreign destination. Forty patients (45%) had traveled to a mean of 3.4 destinations within the United States for an average trip duration of 16 days. In addition, 18 patients (20%) had traveled to at least one foreign country for an average of 20 days. Of the 25 foreign destinations that were specified, 15 (60%) were in lesser developed countries. Patients stated that they undertook 30% of their trips because they thought it was their last chance to travel. At the time of completion of the survey, the majority of those patients who had traveled were severely immunosuppressed (median CD4+ count, 120/mm3). Conclusions: These data provide information by which the clinician can anticipate the health care needs of patients who travel and develop appropriate travel medicine guidelines. (J Travel Med 2:85-88, 1995)

Journal Article↗
PubMed1997

Cryopreservation of equine embryos with glycerol plus sucrose and glycerol plus 1,2-propanediol.

Six or 7-day-old equine embryos were divided into 4 groups; Group 1, n = 15, Day 7 embryos destined for immediate transfer; Group 2, n = 15, Day 6 embryos destined for deep-freezing with glycerol plus sucrose as cryoprotectant; Group 3, n = 10, Day 6 embryos destined for deep-freezing with glycerol plus 1,2-propanediol as cryoprotectant and Group 4, n = 3, fresh embryos destined for ultrastructural analysis. All the frozen/thawed embryos were transferred to recipient mares, except 3 embryos in Group 3 that were subjected to ultrastructural analysis. After thawing the cryoprotectants were removed by successive dilutions in PBS + 15% v:v fetal calf serum (FCS) containing decreasing concentrations of the cryoprotectants. Pregnancy was diagnosed ultrasonographically in 53.3%, 13.3% and 0% of the mares in Groups 1, 2 and 3 respectively. Ultrastructural analysis showed differences between frozen/thawed and fresh embryos. In the former, embryonic cells were deformed and showed dilation of the intercellular and perivitelline spaces, a decrease of desmosome number in the junctional complexes, few microvilli on the apical surface of the trophectoderm and an almost total absence of pinocytotic vesicles. Most of the mitochondria showed regions containing dilation and irregularities on the cristae, which appeared electron-dense. The results obtained with Groups 2 and 3 embryos showed that the cryoprotectants employed were not effective in protecting the embryos against damage during freezing and thawing. Indeed, the ultrastructural changes observed in the Group 3 embryos explained the absence of any established pregnancies in this group of mares.

Animals↗
PubMed1997

Further validation of the Elderly Mobility Scale for measurement of mobility of hospitalized elderly people.

OBJECTIVE: To further assess the validity and inter-rater reliability of the Elderly Mobility Scale (EMS). Also whether the scale reflects elderly people's perceptions regarding their mobility, and whether it can predict discharge destination, or likelihood of falling. DESIGN: Questionnaire-based study completed on admission and weekly after this on all patients referred to physiotherapy for mobility problems over the course of one month. SETTING: Care of the elderly wards in the Bristol General Hospital. SUBJECTS: Sixty-six patients (ages 66-69 years, 66% female) were included in the validity study. Nineteen patients (ages 71-95 years, 47% female) were included in the inter-rater reliability study. INTERVENTIONS: EMS, Barthel and patients' perceptions of mobility were tested with routine physiotherapy treatment carried out as necessary. MAIN OUTCOME MEASURES: Concurrent validity was assessed by correlating EMS scores with Barthel scores using Spearman's test. Inter-rater reliability was also tested using a Spearman's correlation. EMS scores of patients were also evaluated in conjunction with whether or not they fell and their destination on discharge. RESULTS: A significant correlation between EMS and Barthel scores indicated concurrent validity. Inter-rater reliability was demonstrated on 19 patients with a significant correlation between scores. No predictive validity could be ascribed to EMS in terms of discharge destination or likelihood of falling. Results do indicate a possible predictive validity of the functional reach component of the EMS regarding the risk of future falls. CONCLUSIONS: The EMS was found to be a valid scale with good inter-rater reliability that could be readily applied during daily clinical work. However, it was found to have no predictive validity in terms of falling or discharge destination.

Activities of Daily Living↗
PubMedDate not supplied

Epidemiology of travel-related hospitalization.

BACKGROUND: Limited information exists on causes of hospitalization in patients returning from the tropics, and most is focused on febrile diseases. We evaluated all causes of post-travel hospitalization in a tertiary care hospital in Israel. METHOD: Demographics, diagnoses, and destinations of patients admitted between January 1999 and December 2003 with a history of recent travel were recorded. Demographics and destination of healthy travelers presenting to our pretravel clinic at the same period were recorded. RESULTS: Of 211 patients admitted, 71% were males, 8% were immigrants/foreign workers, and febrile diseases accounted for 77% of admissions. The most common diagnoses were malaria in 54 (26%), unidentified febrile disease in 34 (16%), and dengue fever in 27 (13%). New World cutaneous leishmaniasis was the most common cause of admission among nonfebrile patients (18 [9%]). Diarrheal diseases accounted for only 11% of admissions. Regarding destination, 101 (48%) patients had been to Asia, 71 (34%) to Africa, and 43 (20%) to the Americas. Of our healthy traveler population, 59% traveled to Asia, 20% to Africa, and 20% to the Americas. Travel to Africa carried the highest risk of being hospitalized (OR 1.85, 95% CI 1.16-2.97; p = .01). Most (59%) patients returning from Africa had malaria. The principal health problem originating in Asia was dengue fever (27%), and from Latin America, cutaneous leishmaniasis (48%). Males comprised 71% of the patients, and 59% of the healthy traveler population (p < .0001). Males were more likely to acquire malaria (OR 2.15, 95% CI 1.13-4.09; p = .02) and leishmaniasis (OR 3.41, 95% CI 0.97-11.89; p = .05). CONCLUSIONS: Febrile diseases were the most common cause for hospitalization, with malaria, unidentified febrile diseases, and dengue fever being the most common. Diseases were destination related; travel to Africa was associated with a higher rate of hospitalization. Malaria and cutaneous leishmaniasis had a substantially male predominance, probably due to risk-taking behavior.

Adult↗
PubMed1998

Comparison of 6- and 7-day physical therapy coverage on length of stay and discharge outcome for individuals with total hip and knee arthroplasty.

Providing physical therapy service on Sundays is a much debated topic among hospital administrators. The purpose of this study was to determine if 7 days per week of physical therapy coverage results in shorter lengths of stay and differing discharge status than 6 days per week. A total of 140 subjects with hip or knee arthroplasty participated; there were 80 in the 6-day groups and 60 in the 7-day groups. Data on postoperative length of stay, discharge destination, and discharge disposition were collected by retrospective medical record review. The Mann-Whitney U test was used to test for differences in length of stay data, and the chi-squared test was used to test for differences in discharge disposition and discharge destination. No significant differences in postoperative length of stay, discharge destination, nor discharge disposition existed between the 6- and 7-day physical therapy coverage hip or knee arthroplasty groups. However, the power of the statistical tests applied was low. This study provides no evidence that 7-day per week physical therapy results in shortened postoperative length of stay, differing discharge destination, nor differing discharge disposition for patients undergoing hip or knee arthroplasty.

Aged↗
PubMed2001

Active control of locomotion facilitates nonvisual navigation.

In some navigation tasks, participants are more accurate if they view the environment beforehand. To characterize the benefits associated with visual previews, 32 blindfolded participants were guided along simple paths and asked to walk unassisted to a specified destination (e.g., the origin). Paths were completed without vision, with or without a visual preview of the environment. Previews did not necessarily improve nonvisual navigation. When previewed landmarks stood near the origin or at off-path locations, they provided little benefit; by contrast, when they specified intermediate destinations (thereby increasing the degree of active control), performance was greatly enhanced. The results suggest that the benefit of a visual preview stems from the information it supplies for actively controlled locomotion. Accuracy in reaching the final destination, however, is strongly contingent upon the destination's location during the preview.

Adolescent↗
PubMed1998

Asylum applications in the European Union: patterns and trends and the effects of policy measures.

"Statistics on asylum applications have been used in a highly selective way in the debates on refugees and asylum policies in Western Europe, to justify restrictive measures. This paper provides a more systematic analysis of these statistics. It focuses on the pattern of origins and destinations for asylum seekers in the European Union in the period 1985-1994.... When the patterns of origin and destinations are compared for separate years, it becomes clear that the destinations of asylum movements have been constantly changing. Though some of the more remarkable shifts were clearly related to policy measures in the relevant countries, many measures produced only limited effects or failed to have any effect at all."

Demography↗
PubMed1994

The information effects of origin on migrants' job search behavior.

"Migrants are generally assumed to gather specific information about the destination primarily through physical contact, or through family, friends, and acquaintances. In this paper, I propose an additional source of information: similarities between origin and destination labor markets. Data from the 1983-1987 PSID [Panel Study of Income Dynamics] are used in a two-stage least squares model of postmove search duration in the U.S. Rural-to-urban migrants (except for rural Southerners) exhibit significantly lower search duration than other groups, controlling for productivity-related characteristics and postmove earnings. In addition, employment growth differences between origin and destination are found to be better predictors of search duration than are differences in average earnings."

Americas↗
PubMed1998

Environmental motivations for migration: population pressure, poverty, and deforestation in the Philippines.

"This paper uses a multinomial discrete choice model and data from the Philippines to examine migrant choice between alternative destinations. Travel costs and perceived opportunities at the upland frontier are more important than general (upland plus lowland) destination attributes that indicate more developed social infrastructure or greater expected welfare. For example, migration streams are larger to destinations where the public share of forestland and the road system are larger. These features also characterize regions of more rapid deforestation. Therefore, emigration policies must recognize their effects on deforestation at the frontier--and their anticipated indirect effects on downstream environments."

Asia↗
PubMed1997

Radiation-induced, lamina-specific deletion of neurons in the primate visual cortex.

To examine the early determinants of cortical cytoarchitecture, we deleted specific neuronal classes in the primate visual cortex by ionizing irradiation at selected prenatal stages. Multiple doses of X-rays were delivered to the macaque monkey brain between embryonic day (E) 80 and E90 to block the division of cells destined to populate the superficial cortical layers, between E70 and E79 to eliminate neurons destined for the middle layers; and between E33 and E40 to delete neurons destined for the lateral geniculate nucleus (LGN) that project to the cortex. All animals were killed after birth, and their brains were processed for histological and electron microscopic analyses. Cell density and number in the LGN and visual cortex were determined by using three-dimensional, computer-aided morphometry. In animals irradiated with low doses (total of approximately 200 cGy) during the genesis of the LGN but before the onset of corticogenesis (E33-40), the LGN was reduced in both volume and number of neurons. Area 17 in these animals displayed only slight changes in cortical thickness, cell density, and area-specific cytoarchitectonic features, whereas the total surface devoted to area 17 was significantly diminished. In contrast, animals irradiated with low doses during the period of corticogenesis, after the completion of the LGN genesis, showed no significant change in the volume of the LGN or in the number of its cells. Moreover, in these animals, the surface of area 17 was not significantly altered, although the cortical layers generated at the time of irradiation had a significantly lower density and total number of cells, whereas the layers generated before and after the period of irradiation were spared. In contrast, cases exposed to high doses of X-ray (total > 300 cGy) showed more severe effects, including all layers. However, layers normally generated during irradiation were depleted and consisted of cell-sparse strata populated by densely packed neuropil (axons, small dendrites, dendritic spines, and synaptic boutons). These cell-sparse strata were situated deeper in the early irradiated animals than in the later irradiated animals, and their laminar position changed abruptly at the area 17/18 border. These results show that low doses of irradiation in a slowly developing primate brain can be used effectively to eliminate targeted classes of neurons before they reach their final position, providing an opportunity to examine the role of cell-cell interactions in the formation of circuitry and the role of specific cell classes in cortical development.

Animals↗
PubMed1998

Cell cycle length of olfactory bulb neuronal progenitors in the rostral migratory stream.

The anterior portion of the neonatal telencephalic subventricular zone (SVZa) contains proliferating cells that generate an immense number of neurons destined to become the granule and periglomerular cells of the olfactory bulb. In contrast to other immature neurons in the central nervous system, cells arising in the SVZa maintain the ability to divide as they traverse the rostral migratory stream to their final destinations despite expressing an antigenic marker of differentiated neurons (Menezes et al. [1995] Molec. Cell. Neurosci. 6:496-508). Because of their considerable proliferative capacities and unusual mitotic behavior, we decided to determine the cell cycle length of proliferating cells within the SVZa and within the migratory pathway used by SVZa-derived cells. Following the methodology of Nowakowski et al. [1989](J. Neurocytol. 18:311-318), postnatal day 2 rat pups were exposed to 5'-bromo-2'deoxyuridine (BrdU) for increasing periods of time before perfusion. By plotting the percentage of nuclei undergoing DNA synthesis in the SVZa at each time versus the BrdU labeling interval, we determined that approximately 15% of the SVZa population is actively dividing and that these cells have a cycle length of approximately 14 hr, significantly less than the 18.6 hr determined to be the cycle length of dividing cells in more posterior, glia-generating regions of the subventricular zone (Thomaidou et al. [1997] J. Neurosci. 17:1075-1085). The cycle length of cells dividing in the mid portion of the rostral migratory stream, however, is considerably longer: 17.3 hr. This may reflect the need for these cells to coordinate the processes of migration and division. Our studies also suggest that there may be regional differences in the types of descendants produced by the proliferating cells. Retroviral lineage tracing studies showed that those cells that divide within the rostral migratory stream, like proliferating cells within the SVZa, make cells destined for the olfactory bulb. Unlike the progenitors that divide within the SVZa and generate more granule cells than periglomerular cells, the proliferating cells within the migratory pathway generate more periglomerular cells than granule cells. Collectively the proliferating cells of the SVZa and migratory pathway produce a large number of olfactory bulb interneurons. Our work suggests that this may be achieved in part by the relatively rapid divisions of progenitor cells within the SVZa and in part by the ongoing division of migrating cells en route to the olfactory bulb.

Animals↗
PubMed1979

A multinational Andean genetic and health program. VIII. Lung function changes with migration between altitudes.

Studies of lung function in high altitude populations have suggested the influence of hypoxic environment on the development of this characteristic independent of confounding variables such as ethnicity and habitual exercise. However, often the effect of altitude on vital capacity is greater in children than adults, suggesting that more than developmental adaptation is operative. Also selective migration could account for the similarity of migrants and permanent residents at a destination altitude. To explore these problems we studied the lung function (FVC, FEV1, PFR) of 377 individuals who had migrated between altitudes in northern Chile. Migrant measurements were adjusted to those of permanent residents of appropriate age, sex and height at the altitudes of origin and destination. The measurements were then related to ethnicity (Spanish-Aymara ancestry), occupation and permanence, the latter combining information on both age at migration to and length of stay at a destination altitude. Upward migration was associated with increased chest depth, FVC and FEV1, but not height or other chest measurements. Downward migration had no significant effect. The flow-dependent test PFR was so sensitive to observer variability and occupation that it was difficult to establish its relationship to permanence. Unlike the body measurements, lung function measurements (especially PFR) tended to deviate from permanent controls at the origin altitude in a direction suggestive of selective migration, nor was permanence itself independent of ethnicity and occupation. Because of these difficulties the question of developmental adaptation in lung function may not be answerable in cross-sectional studies like the present and previous efforts, but rather in longitudinal investigations in which the control is the individual him/herself.

Adaptation, Physiological↗
PubMed1981

Efferent systems of the rabbit visual cortex: laminar distribution of the cells of origin, axonal conduction velocities, and identification of axonal branches.

Several efferent systems of visual area I in Dutch rabbits were studied with anatomical (horseradish peroxidase) and physiological (antidromic) methods. Anatomical studies provided information regarding the laminar origin of the projections to the contralateral hemisphere, visual area II, the dorsal lateral geniculate nucleus, and the superior colliculus. Physiological studies provided information regarding conduction velocities and multiple destinations of efferent axons. Both the callosal projection and the projection to V-II were shown to originate primarily in layer II-III. However, approximately 10-20% of the callosal projection and 20-40% of the projection to V-II originated in layers IV and V. In contrast, the projection to the dorsal lateral geniculate nucleus originated nearly exclusively in layer VI, while corticotectal neurons occurred primarily in layer V. A significant number of corticotectal neurons were, however, found in layer IV. Thus, the above efferent systems were found to differ in their principal laminar origin and in the diffuseness of that origin. The origins of corticocortical projections were considerably more diffuse than those of corticofugal projections. In addition to differences in laminar origin, efferent systems also differed significantly in the conduction velocities of their axons. The projection to visual area II and to the lateral geniculate nucleus consisted primarily of very slowly conducting axons, while the projection to the superior colliculus was fast conduction. The callosal projection consisted of both slow and fact conduction axons. Finally, the question of branching of V-I efferent axons was addressed. Although the laminar origin of the projections to the contralateral hemisphere and to visual area II overlapped considerably, none of these corticocortical axons could be shown to project to both locations or to a subcortical destination. In contrast, approximately one-third of corticotectal axons were shown to project a collateral into the thalamus. Although the destination of this collateral is unclear, it is medial to the lateral geniculate nucleus and may be the pulvinar.

Animals↗
PubMed1985

Neurogenesis of the cat's primary visual cortex.

The 3H-thymidine method of birth-dating was used to determine when the cells belonging to each of the principal cellular layers of the cat's primary visual cortex are generated. In order to detect systematic differences in the position of radioactively labeled cells following 3H-thymidine administration at different prenatal ages, a geometric method was devised to represent the distribution of labeled cells in the form of depth histograms. Results show that visual cortical neurogenesis occurs largely during the second half of gestation between embryonic day 31 (E31) and E57. Cells of layer 6 are generated early, between E31 and E38, whereas cells destined for successively more superficial layers are generated at progressively later times. Layer 4 cells, the principal targets of geniculocortical afferents, are generated between E37 and E44. In addition, a special population of cells embedded in the white matter below layer 6 was found to be produced throughout the week-long period immediately prior to the onset of layer 6 neurogenesis. Overall, this radial pattern of cortical neurogenesis closely resembles the inside-first, outside-last, spatiotemporal sequence of development described for the monkey's primary visual cortex (Rakic, '74). In addition to finding this pronounced gradient in the radial dimension, we were also able to detect a less pronounced gradient along the tangential dimension: neurons destined for any given layer in the anterior part of the cortex (inferior visual field representation) are generated slightly in advance of neurons destined for more posterior regions (superior visual field). However even our more quantitative histogram analysis failed to reveal a mediolateral (central to peripheral visual field) gradient within area 17. In the cat, layers 6, 5, and 4 each take about a week to be generated, although their total cell numbers and packing densities differ in the adult. About 2 weeks are required to produce the cells of layers 2 and 3 combined. Furthermore, we found that neurons belonging to different layers and different morphological classes can be generated simultaneously. This suggests that the identity of a cortical neuron is not solely a function of the time of neurogenesis.

Age Factors↗
PubMedDate not supplied

Using the Functional Independence Measure instrument to predict stroke rehabilitation outcomes.

The purpose of the study described in this article was to identify the factors that have an impact on stroke patients' discharge destination. Two hundred thirty-four stroke patients admitted to a rehabilitation facility over a 2-year period were examined. Functional Independence Measure (FIM) data were used to examine functional status, demographic characteristics, and the discharge destination of patients admitted to the facility's program. The relationship between patients' FIM scores at discharge and their discharge locations was analyzed using the chi-square statistic. The results showed that a discharge FIM score of 80 or above had a high specificity and sensitivity with patients' discharge to their homes. In addition, outliers were analyzed, and the results showed that family members of only 20% of the patients who were discharged to their homes were working, in contrast to 65% of the family members of patients who were discharged to a skilled nursing facility. The availability of a nonworking family member and the ability of a family to provide supervision and physical assistance were more likely to be factors related to discharge of patients to their homes. Ninety percent of the families of patients discharged to their homes were able to provide supervision and to provide physical assistance. Thus, both functional status and social factors, such as family availability and support, are critical elements in predicting the discharge destination of this patient population.

Activities of Daily Living↗
PubMed2005

Air transportation of patients with end-stage liver disease to distant liver transplantation centers.

The Israeli population does not meet its transplantation organ needs. Therefore, liver transplantation (LTX) candidates are sometimes transported to centers abroad. We aimed to assess the demographic and clinical issues concerning this policy. Records of all candidates transported (2000-2004) were retrospectively reviewed. Data included etiology, disease severity, outcome, distances traveled and destinations, and medical complication arising en route. Forty-three candidates were transported overseas: 12 patients with fulminant hepatic failure (FHF) and 31 with cirrhosis. Average MELD score was 19.94, and the APACHE II score for patients with FHF was 20.5. Destinations included the United States, Colombia, Belgium, Germany, China, and Italy. Average distance traveled was 4,660 miles. Two patients were intubated and sedated during flight. All patients safely reached their destinations: 8 died prior to transplantation, 5 died after transplantation, 3 are awaiting transplantation, 3 recovered spontaneously, and the rest successfully underwent transplantation and returned home. In conclusion, our results suggest that long-distance transportation of patients awaiting liver transplantation is safe and technically feasible provided precaution measures are taken. Therefore, allocation regions may be broadened to include larger and more distant populations.

Academic Medical Centers↗
PubMed1999

Cold hardiness adaptations of codling moth, cydia pomonella

The cold hardiness adaptations of natural and laboratory reared populations of the codling moth, Cydia pomonella, were examined. Hemolymph, gut, and whole body supercooling points (SCPs), 24-h LT50s, polyhydroxy alcohol concentrations, hemolymph freezing points, and hemolymph melting points were determined. Nondiapausing codling moth larvae do not have appreciable levels of ice nucleators in the hemolymph or gut. Whole body supercooling points were higher than hemolymph supercooling points. For nondiapausing larvae, LT50s were significantly higher than both the whole body and the hemolymph supercooling points, indicating the presence of chill sensitivity. As the larvae left the food source and spun a cocoon, both hemolymph and whole body SCPs decreased. Diapause destined larvae had significantly lower hemolymph SCPs than nondiapausing larvae, but whole body SCPs were not significantly different from nondiapausing larvae of the same age. The LT50s of diapause destined and diapausing larvae were significantly lower than that of nondiapausing larvae. Codling moths are freezing intolerant, with LT50s close to the average whole body supercooling point in diapause destined and diapausing larvae. The overwintering, diapausing larvae effectively supercool to avoid lethal freezing by removal of ice nucleators from the gut and body without appreciable increase of antifreeze agents such as polyols or antifreeze proteins.

Journal Article↗
PubMed1995

Steering by echolocation: a paradigm of ecological acoustics.

1. Flights of three big brown bats (Eptesicus fuscus) landing on a hand and catching a suspended mealworm were video analysed. 2. Results were consistent with the bats using the same basic control procedure in the quite different approach tasks--namely keeping tau (r) = kr and tau (a)/tau (r) = k alpha r. Here r is the current distance to the destination; alpha is the angle between the current direction of the destination and the goal direction of final approach (beta min); tau (r) = r/r, tau (alpha) = alpha/alpha; and kr, k alpha r are constants. 3. The bats were each quite consistent on a particular task (hand or mealworm) in the values they used for the control parameters kr, k alpha r and beta min. However, different values were used in the two tasks, which reflected the different behaviour required at the destination. Flights to hand required twisting and landing upside down and approach angle beta min was closer to vertical and kr was smaller and corresponded to decelerating nearly to a stop. In contrast, the mealworms were caught in mid flight and approach angle beta min was shallower and speed of approach was about constant. 4. tau (r) might be registered acoustically by tau (echo-delay) or by tau (echo-intensity). tau (alpha) might be registered by the bat's directional hearing and gravity sense. 5. The bat's learned the tasks easily, suggesting that the control procedure they used in the experiments was part and parcel of the natural skills they had developed in the wild.

Acoustics↗