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PubMed2003

Landscape mapping of the Russian Black Sea coast.

The purpose of this investigation is to study structure, evolution and present ecological state of background and anthropogenically modified landscapes of the Abrau Peninsula. This region has been recommended as one of the main conservation sites on the Russian Black Sea coast due to its relatively low anthropogenic transformation and its historical importance. The ecological situation is aggravated today by the construction of a pipe-line and oil terminal near Novorossiysk and by an increase in unregulated recreation activity within the peninsula's narrow coastal zone. A special landscape-ecological map has been compiled for the model area. All ecosystems shown on the map can be grouped into four main categories based on changes of landscape structure resulting from direct impact of human activity and indirect impact mainly from chemical pollution. Ecosystems exhibiting a high degree of transformation are more typical for regions characterized by settlements, vineyards and the coastal recreation zone. Ecosystems with moderate changes also exist in the coastal area, including, for example, some unique ecosystems with pine-tree forests, pistachio-juniper and juniper open-lands. Nearly 50% of pine-tree (Pinus pithyusa) forests are in the fourth and fifth stages of recreation degradation. Some protection measures are suggested to maintain biodiversity and sustainable development of these coastal landscapes and to improve their current condition.

Agriculture↗
PubMed2000

The stage-structured predator-prey model and optimal harvesting policy.

In this paper, we establish a mathematical model of two species with stage structure and the relation of predator-prey, to obtain the necessary and sufficient condition for the permanence of two species and the extinction of one species or two species. We also obtain the optimal harvesting policy and the threshold of the harvesting for sustainable development.

Alligators and Crocodiles↗
PubMed1997

Pregnancy and multiple sclerosis.

In this review, we summarize the available information on the short- and long-term effects of pregnancy on the course of multiple sclerosis (MS). Published studies that used established criteria for the diagnosis of MS were given more weight than studies in which the criteria for diagnosis were unstated or unclear. Population-based studies were emphasized more than clinic-based studies, unless the clinic base was well defined and thought to be reasonably representative of the MS population in the geographic area. For completeness, small studies were also included but weighted accordingly in our overall conclusions. Methodologic limitations and biases inherent in the study methods are discussed. We conclude that patients with relapsing MS have an increased risk of relapse during the initial 6-month postpartum period. This increased risk does not seem to have a detrimental effect on the rate of developing sustained disability. In fact, a full-term pregnancy may increase the time interval to reaching a common disability endpoint-walking with the aid of a cane or crutch--or to having a secondarily progressive course. Evidence indicates that pregnancy may alter T-lymphocyte functions and cause clinically relevant consequences. The specific biochemical mechanisms responsible for these observations, however, remain undefined. Because of limitations of current knowledge, our conclusions are tentative at best. The data are most applicable to patients with relapsing-remitting MS in its early stages. MS is an unpredictable disease and is only one of many factors that patients must consider when a pregnancy is contemplated.

Acute Disease↗
PubMed2000

Protecting environmental quality and human health: strategies for harmonisation.

In September 1999 the MRC Institute for Environment and Health hosted a multidisciplinary seminar on the harmonisation of strategies to protect environmental quality and human health. The objectives of the meeting were to share information about ways in which the protection of the environment and human health can be harmonised, and, by bringing together an audience representing a range of disciplines, interests and sectors, to explore how these may be integrated to inform policy, decision-making and the management of risks. Key conclusions from the seminar focused on the importance of sustainable development, harmonising risk assessment and the role of stakeholder involvement. The necessary move from an expert-based to a dialogue-based process will require concerted efforts on the part of scientists, policy-makers, regulators, industry and the public.

Environmental Pollution↗
PubMed2000

Risk factors for arrhythmia and sudden cardiac death late after repair of tetralogy of Fallot: a multicentre study.

BACKGROUND: Ventricular arrhythmia and sudden cardiac death late after repair of tetralogy of Fallot are devastating complications in adult survivors of early surgery, but their prediction remains difficult. METHODS: We examined surgical, electrocardiographic, and late haemodynamic data, and their relation to clinical arrhythmia and sudden death occurring over 10 years, in a multicentre cohort of patients with repaired tetralogy, who were alive in 1985. RESULTS: Of 793 patients (mean age at repair 8.2 years [SD 8], mean time from repair 21.1 years [8.7]) who entered the study, 33 patients developed sustained monomorphic ventricular tachycardia, 16 died suddenly, and 29 had new-onset sustained atrial flutter or fibrillation. Electrocardiographic markers (QRS duration, QRS rate of change between 1985 and 1995) were significantly greater in the ventricular tachycardia and sudden-death groups. Older age at repair was associated with a higher risk of sudden death and atrial tachyarrhythmia. Pulmonary regurgitation was the main underlying haemodynamic lesion for patients with ventricular tachycardia and sudden death, whereas tricuspid regurgitation was for those with atrial flutter/fibrillation. Despite adverse haemodynamics, no patient who died suddenly had undergone late reoperation. CONCLUSION: Arrhythmia and sudden death are important late sequelae for patients after repair of tetralogy of Fallot. The electrophysiological and haemodynamic substrate of sudden death resembled that of sustained ventricular tachycardia, with pulmonary regurgitation being the predominant haemodynamic lesion. Preservation or restoration of pulmonary valve function may thus reduce the risk of sudden death. Furthermore, electrocardiographic markers can help to identify patients at risk.

Adult↗
PubMed2002

WHO: the casualties and compromises of renewal.

The World Health Organization is the leading international agency in health. WHO's reputation reached a peak in the 1970s with the then director-general Halfdan Mahler's advocacy of Health for All by the Year 2000 and the successful worldwide eradication of smallpox. The 1980s and 1990s saw WHO lose much of its authority. Too easily, the blame was put on one man-Mahler's successor, Hiroshi Nakajima. In 1998, Gro Harlem Brundtland, Figure 1 a former Prime Minister of Norway, took office and WHO began a period of major strategic and structural reform. Almost 4 years into her first term as director-general, I visited WHO's headquarters in Geneva to learn about Dr Brundtland's successes and failures. Figure 2 The ground rules of my visit were that I could talk with anybody and attend almost any meeting (budget discussions were excluded). I interviewed Dr Brundtland, executive directors, members of the staff association, and directors and project managers of programmes such as StopTB, Roll Back Malaria, HIV-AIDS, violence prevention, polio eradication, essential drugs and medicines, and sustainable development. At senior levels, WHO is confident and clear about its purpose-in a way that matches Mahler's vision and goes beyond it in results. Brundtland told me that her most important achievements were to have "strengthened the credibility of WHO" and to have "raised the awareness of health on to the political and global development agendas". But there is a troubling schism between the aspirations of its leadership and the realities faced by the organisation on the ground. Rapid change during the past 4 years has reinvigorated WHO's mandate, but poor management has created new tensions that the organisation's leadership seems unwilling to address.

Administrative Personnel↗
PubMed2004

Mortality trends and setbacks: global convergence or divergence?

Health trends over much of the past century have been generally, and notably, positive throughout the world. In several regions, however, life expectancy has declined over the past 1-2 decades. This trend suggests that the expectation that emerged in the 1960s and 1970s of worldwide gains and convergence in population health status is not guaranteed by a general deterministic process. National populations can now be clearly grouped into those that have achieved rapid gains in life expectancy; those whose gains are slower or are perhaps plateauing; and those in which the trends have reversed. Over the past two centuries, outside times of war and famine, such reversals have been rare. Exploration of these varied population health trends elucidates better the close relation between population health and the processes of economic, social, and technological change. Such analysis has shown that the health status of human populations should be a guiding criterion in the debate on sustainable development.

Age Factors↗
PubMed2004

Monitoring and management of mountain environment.

The monitoring of mountain environment gives necessary information for its control and effective management in view of its sustainable development. A system of complex monitoring of environment has been established, including physical, chemical, meteorological, hydrological, biological and sociological factors. Methods and observations have been developed and applied. Using a geographical information system, a database was created for Rila Mountain and a modern computer network connected to internet was established. As a direct consequence of the French-Bulgarian project OM2 (carried out in the period 1993-1998) a Basic Environmental Observatory (on the peak Moussala, 2925 m) was constructed and put in operation in attempt to control the large scale and long-term transportation of atmospheric pollutants.

Air Pollutants↗
PubMed2001

From irreversibility to participation: towards a participatory foresight for the governance of collective environmental risks.

This paper presents a reflection on the introduction of methods and tools of "participative foresight" for scientific and technology policy as well as environmental policy fields. Future studies have recently made a comeback under the label of foresight. Future technology studies no longer claim to forecast the future, but are presented as a strategic tool for improving interaction between key actors and for anticipatory policy making. They can be defined as a "process by which one comes to a fuller understanding of the forces shaping the long term future which should be taken into account in policy formulation, planning and decision-making" [Foresight in Federal Government Policymaking, Futures Res. Quart. (1985) 29]. We discuss applications of this approach for perspectives on environmental policy and sustainable development. Foresight opens up the possibility of negotiating a new and more fruitful relationship or 'social contract' between science and technology, on the one hand, and society on the other. The focus has moved from merely scientific and industrial insights to social demand, thus emphasizing the importance of both the production and "supply" of innovation, and the "demand" as signaled in the views of citizens.

Decision Making↗
PubMed1999

Long-term effects of synaptic activation at low frequency on excitability of myenteric AH neurons.

Intracellular microelectrodes were used to record the effects of extended periods (1-30 min) of synaptic activation on AH neurons in the myenteric ganglia of the guinea-pig ileum. Low-frequency (1 Hz) stimulation gave rise to a slowly developing, sustained increase in excitability of the neurons associated with depolarization and increased input resistance. The increased excitability lasted for up to 3.5 h following the stimulus period. Successive stimulus trains (1-4 min) elicited successively greater increases in excitability. The neurons went through stages of excitation. Before stimulation, 500-ms depolarizing pulses evoked up to three action potentials (phasic response) and anode break action potentials were not observed. As excitability increased, more action potentials were evoked by depolarization (the responses became tonic), anode break action potentials were observed, prolonged after hyperpolarizing potentials that follow multiple action potentials were diminished and, with substantial depolarization of the neurons, invasion by antidromic action potentials was suppressed. It is concluded that a state of elevated excitability is induced in myenteric AH neurons by synaptic activation at low frequency and that changes in excitability can outlast stimulation by several hours.

Action Potentials↗
PubMed1985

Comparative study of encainide and disopyramide in chronic ventricular arrhythmias: a double-blind placebo-controlled crossover study.

Ten patients suffering from chronic premature ventricular complexes (greater than 60/h) were treated orally in a double-blind crossover study with encainide (50 mg three times a day) and disopyramide (200 mg three times a day), with five 7 day study periods: survey, placebo, encainide or disopyramide, washout placebo and disopyramide or encainide. At the end of each 7 day period, a 12 lead electrocardiogram, a 48 hour ambulatory electrocardiogram and a treadmill exercise test were performed. Blood levels of encainide and its metabolites and of disopyramide were measured at the end of each treatment (steady state). Drug efficacy was assessed by: 1) more than 80% reduction in the number of premature ventricular complexes per 24 hours, and 2) absence of ventricular tachycardia. Encainide was effective in four patients (complete suppression of premature ventricular complexes) and ineffective in five. One patient who showed a 92% reduction in the number of premature ventricular complexes developed sustained ventricular tachycardia after 24 hours of treatment. Disopyramide was effective in three patients (greater than 80% reduction in the number of premature ventricular complexes) and ineffective in seven patients. With encainide, the percent increase in PR, QRS and QT interval duration was, respectively: 32.7 (p less than 0.001), 30.8 (p less than 0.001) and 10.6% (p less than 0.01). With disopyramide this increase was not significant. Despite the variability of drug blood levels, a relation between blood levels and suppression of premature ventricular complexes on the 48 hour ambulatory electrocardiogram was found with encainide, but not with disopyramide.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗
PubMed2002

Policy initiatives to promote healthy aging.

An overwhelming array of policies and programs can be used to help older people (and future older people) maintain healthy lifestyles. How can clinicians help ensure that their patients take advantage of these opportunities? How can these broad-scope policies, educational and information initiatives, and direct service programs be turned into tools to help older people maximize health and independence? First, physicians do not need to do it all themselves. They need to know where to send their patients. For example, case managers in local aging service organizations and social workers, nurses, and discharge planners in hospitals can help connect elderly patients to appropriate benefits and services. Physicians play a critical role in creating a bridge between patients and the array of programs and information that can help them change their individual patterns of behavior. A serious lack of integration exists between what is known about healthy behaviors and lifestyles and what is really happening and available to older people today. From the earlier articles in this issue we know that much can be done to prevent many types of age-related disease and disability. This article provides examples of mechanisms that can be used to broadly disseminate knowledge about effective behavior and treatment changes and create mechanisms to turn this knowledge into real and widespread client-level, practice-level, health system, and community-wide interventions. Second, physicians need to understand that they are not merely subject to these policies and initiatives. They can help formulate and shape them. This political involvement includes active participation in policy initiatives of professional associations, involvement in research and demonstration activities, keeping informed about policy proposals at the federal and state levels, and helping advance ideas for improving health behaviors by speaking up and working toward change. These changes go beyond health initiatives to involve improving housing, nutrition, transportation, and other arenas that play a role in the health of communities and cities. According to the IOM, the most successful interventions are aimed at families, neighborhoods and communities. Interventions are also most likely to be successful when legislative, media, and marketing efforts support them [50]. These broader policies may actually have the most potential impact in terms of developing sustainable lifestyle changes that reach all Americans, especially those with the greatest health needs. Within the aging population, those with greatest health needs include members of minority groups, recent immigrants, and the old-old. These groups are often overlooked when designing and implementing health promotion programs. It is important, however, to remember, for patients and for ourselves, you are never too old to benefit from prevention.

Aged↗
PubMed2000

Anticonvulsant treatment of nerve agent seizures: anticholinergics versus diazepam in soman-intoxicated guinea pigs.

A total of eight anticholinergic drugs (aprophen, atropine, azaprophen, benactyzine, biperiden, procyclidine, scopolamine, trihexyphenidyl) were tested in parallel with diazepam for the ability to terminate seizure activity induced by the nerve agent soman. Guinea pigs, implanted with electrodes to record cortical electroencephalographic (EEG) activity, were pretreated with pyridostigmine Br (0.026 mg/kg, i.m.) and 30 min later challenged with 2 x LD50 soman (56 microg/kg, s.c.) followed 1 min later by treatment with atropine SO4 (2 mg/kg, i.m.) and pralidoxime chloride (2-PAM Cl; 25 mg/kg, i.m.). All guinea pigs developed sustained seizure activity following this treatment. Dose-effect curves were determined for the ability of each drug to terminate seizure activity when anticonvulsant treatment was given either 5 or 40 min after seizure onset. Body weight gain and recovery of behavioral performance of a previously trained one-way avoidance task were measured after exposure. With the exception of atropine, all anticholinergic drugs were effective at lower doses than diazepam in terminating seizures when given 5 min after seizure onset; benactyzine, procyclidine and aprophen terminated seizures most rapidly while scopolamine, trihexyphenidyl, biperiden, and diazepam were significantly slower. When given 40 min after seizure onset, diazepam was the most potent compound tested, followed by scopolamine, benactyzine and biperiden; atropine was not effective when tested 40 min after seizure onset. For diazepam, the time to terminate the seizure was the same whether it was given at the 5- or 40-min delay. In contrast, most anticholinergics were significantly slower in terminating seizure activity when

Animals↗
PubMed2004

Preparation and in vitro characterization of amifostine biodegradable microcapsules.

The purpose of this project was to develop sustained release microcapsules of amifostine. The microcapsules were prepared using solvent evaporation technique. The effect of several formulation variables on the characteristics of the microcapsules was studied. The formulation variables studied were drug loading, polymer (polylactide-co-glycolide) (PLGA) concentration, and the amount of gelatin in the initial aqueous phase. The drug loading was studied at three different levels (5, 10, and 25 mg); the PLGA concentration was studied at two levels (500 and 1000 mg); and the amount of gelatin used ranged from 2 to 14 mg. In general, the microcapsules were less than 155 microm in diameter with median size between 50 and 80 microm. While the use of higher amounts of PLGA significantly increased the median size of the microcapsules, using higher amounts of amifostine had no significant effect, irrespective of the amount of PLGA. The use of gelatin, within the range 2-14 mg, did not show any significant effect on the particle size distribution. Scanning electron microscopy (SEM) of the microcapsules revealed that all nine formulations yielded spherical particles. The use of 500 mg PLGA with 10 or 25 mg amifostine yielded microcapsules with porous surfaces. The surface pores, however, were not present in microcapsules prepared using 1000 mg PLGA. The efficiency of encapsulation decreased significantly from 63 to 24% when the amount of amifostine increased from 5 to 25 mg in the formulations using 500 mg PLGA. Similarly, the efficiency of encapsulation decreased from 87 to 23% when the amount of PLGA was doubled to 1000 mg. An increase in the amount of amifostine in the formulation using 500 mg PLGA also resulted in a significant increase in initial drug release (from 20 to 62%) within the first hour. These results were consistent with the porous morphology of these microcapsules. In general, all batches of microcapsules showed 24-96 h sustained drug release.

Amifostine↗
PubMed2001

Research and clinical aspects of immunology in Africa.

There are few immunologists in Africa. Researchers predominantly study the immunology of infectious diseases (HIV, malaria and tuberculosis), HLA genotypes and cytokine secretion patterns. Lack of research funding is the problem; continued, equitable international collaboration is a short-term answer. Sustainable development will come when African countries find ways of training and retaining scientists who will produce research and diagnostic tests. The Internet should be utilized to improve communication and as a conduit for online, virtual immunology courses.

Africa↗
PubMed2002

A dynamic leaching method for the assessment of trace metals released from hydraulic binders.

With respect to sustainable development, the leachability of trace metal from solid materials in contact with water has focused much attention over the years. Portland cements produced in industrial kilns generally contain from 10 to 300 mg/kg of trace metals. The behaviour of these endogenous metals has been, in this regard, the target of different leaching studies. Many of these researches concluded that heavy metals release are lower than analytical detection limits. Although satisfying from an environmental point of view, it induces a lack in the knowledge about the trace metals behavior during the leaching of cement based material. Accordingly, we designed the CTG-LEACHCRETE device, a dynamic leaching system (modified Soxhlet type) that overcomes this difficulty and allows long term monitoring. The experimental procedure is presented and preliminary results are discussed.

Manufactured Materials↗
PubMed2002

High dose weekly oral prednisone improves strength in boys with Duchenne muscular dystrophy.

Daily prednisone improves strength in boys with Duchenne muscular dystrophy, but side effects are almost universal. We used a different dosing regimen of prednisone to determine if benefit to boys with Duchenne muscular dystrophy might be maintained with fewer side effects. Twice weekly oral prednisone was given each Friday and Saturday (5mg/kg/dose). This total dose is twice as high as the daily low dosage prednisone regimen (0.75 mg/kg/day). Twenty boys (8.0+/-1.2 years) were treated. Historical control groups included 18 untreated boys (6.1+/-1.6 years) and four boys (7.3+/-0.6 years) treated with daily prednisone. Strength (using a hand-held manometer and grip meter) and timed functional testing were measured. There was an improvement in upper extremity strength for 95% of boys (n=20) at 6 months using quantitative strength testing. Improvement in lower extremity strength occurred in all boys with antigravity quadriceps strength (17/17). The improvement (P=0.001 for proximal upper extremities; P=0.002 for grip; and P<0.0001 for proximal lower extremities) was significant compared to untreated boys. Sixteen boys were treated continuously for more than 12 months (22+/-1.5 months). Of these, 15 remained significantly stronger than prior to treatment and 8/16 showed additional gains in strength after six months of treatment. Six boys were on the weekly prednisolone 2 years or longer without interruption. All six had upper and lower extremity strength at follow-up that was as good or better than at baseline. Functional testing improved in boys less than 8 years without contractures. Three boys without antigravity quadriceps strength at the start of treatment lost the ability to walk unassisted within 6 months. Eight other boys lost the ability to ambulate unassisted between 12 and 24 months of treatment. In each, progressive contractures developed. Linear growth was maintained in all boys on weekly treatment. Obesity rates did not differ from untreated boys. Twice weekly prednisone improved strength over 6-12 months in the majority of boys, but did not slow contracture development. Sustained benefit beyond 12 months is possible with fewer side effects compared to daily prednisone.

Administration, Oral↗