Book review of Human Growth: Assessment and Interpretation. By Alex F. Roche and Shumei S. Sun. (Cambridge University Press,Cambridge, 2003). [pp. 311]. ISBN: 0 521 78245 7. US$95, £53.50.

Background: In many parts of the developing world, modernization has resulted in an increase in the prevalence of overweight and obesity and a subsequent rise in nutrition-related, non-communicable diseases such as cardiovascular disease and Type 2 diabetes.

Aim: The study examined the impact of socio-economic and lifestyle changes associated with modernization on the body size and shape of Balinese women.

Subjects and methods: Anthropometric data including weight, height, body mass index (BMI) and seven skinfolds were collected from 564 Balinese women, aged between 15 and 45 years. The relationship between the degree of ‘modernization’ (using such parameters as household wealth and education level) and body size and shape was analysed using multiple regression analysis, as was the effect of age, family size and breast-feeding.

Results: Using the WHO (WHO ) categories of BMI, 14% of Balinese women displayed Chronic Energy Deficiency (BMI<18.5?kg?m^?2), 7% were overweight (BMI?=?25.0–29.9?kg?m^?2) and less than 1% were obese (BMI?≥?30.0?kg?m^?2). Household wealth (p<0.0001) and education level (p<0.05) were significantly associated with fatness, while breast-feeding (p<0.05) was significantly associated with leanness. Fat distribution was largely independent of biological and socio-economic variables.

Conclusions: The trend toward increasing fatness associated with greater household wealth and higher education has important health implications for Balinese women as they continue their rapid transition from subsistence agriculture towards a more ‘western’ lifestyle.

Résumé. Arrière plan: Dans de nombreuses régions du globe, à la faveur du développement et de la modernisation, est apparue une prévalence du surpoids et de l’obésité ainsi qu’un accroissement corollaire de maladies non infectieuses telles que les maladies cardiovasculaires et le diabète de type 2.

But: L’étude examine l’impact des changements socioéconomiques et de style de vie associés à la modernisation, sur le format et la forme du corps des femmes balinaises.

Sujets et méthodes: Des données anthropométriques comprenant le poids, la stature, l’indice de masse corporelle (IMC) et sept plis cutanés, ont été collectées sur 564 femmes balinaises âgées de 15 à 45 ans. La relation entre le degré de ‘modernisation’ (au moyen de paramètres tels que l’aisance du foyer et le niveau éducatif) et la forme et le format corporel a été analysée, ainsi que les effets de l’âge, de la dimension de la famille et de l’allaitement maternel, au moyen de régressions multiples.

Résultats: Par rapport aux catégories d’IMC de l’OMS (1995), 14% des femmes balinaises présentent une déficience chronique d’énergie (IMC<18,5?kg?m^?2), 7% ont du surpoids (IMC?=?25,0–29,9?kg?m^?2) et moins de 1% sont obèses (IMC≥30,0?kg?m^?2). L’aisance du foyer (p<0,0001) et le niveau éducatif (p<0,05) sont associés significativement à l’adiposité tandis que l’allaitement maternel l’est avec la minceur. La distribution de l’adiposité est largement indépendante des variables biologiques et socioéconomiques.

Conclusion: La tendance en direction d’un accroissement de l’adiposité en association avec meilleure aisance domestique et meilleure éducation présente des implications importantes pour la santé des femmes balinaises, dans la mesure où elles poursuivent une rapide transition d’une agriculture de subsistance à un mode de vie plus ‘occidental’.

Zusammenfassung. Hintergrund: In vielen Entwicklungsländern hat die Modernisierung zu einem Anstieg der Prävalenz von Übergewicht und Adipositas geführt und in der Folge zu einem Anstieg ernährungsabhängiger nicht-übertragbarer Erkrankungen wie kardiovaskulärer Krankheiten und Typ2 Diabetes.

Ziel: Die Studie untersuchte die Bedeutung der mit der Modernisierung einhergehenden, sozio-ökonomischen Veränderungen und der Veränderungen des Lebensstils auf Körpermaße und Körperproportionen Balinesischer Frauen.

Probanden und Methoden: Anthropometrische Daten einschließlich Gewicht, Höhe, Körpermasse-Index (body mass index, BMI) und sieben Hautfettfalten wurden bei 564 Balinesischen Frauen im Alter zwischen 15 und 45 Jahren erhoben. Die Beziehung zwischen dem Grad der ‘Modernisierung’ (unter Verwendung von Begriffen wie verfügbares Haushaltseinkommen und Schulbildung) und Körpermaßen und Körperproportionen wurde mittels multipler Regressionsanalysen hinsichtlich der Effekte von Alter, Familiengröße und Stillen untersucht.

Ergebnisse: Unter Verwendung der WHO-Kategorien () für BMI zeigten 14% der Balinesischen Frauen Zeichen eines chronischen kalorischen Defizits (BMI??2), 7% waren übergewichtig (BMI?=?25,0—29,9?kg?m^?2) und weniger als 1% waren adipös (BMI?≥?30,0?kg?m^?2). Verfügbares Haushaltseinkommen (p<0,0001) und Schulbildung (p<0,05) waren signifikant mit übergewicht, Stillen jedoch (p<0,05) signifikant mit Magerkeit korreliert. Die Fettverteilung war überwiegend unabhängig von den biologischen und sozio-ökonomischen Variablen.

Zusammenfassung: Der Trend zu zunehmendem Übergewicht, der mit größerem verfügbaren Haushaltseinkommen und besserer Schulbildung assoziiert ist, hat große gesundheitliche Bedeutung für Balinesischer Frauen, solange ihr rasanter Übergang von einer landwirtschaftlichen Subsistenzkultur zu einem mehr ‘westlichen’ Lebensstil anhält.

Resumen. Antecedentes: En muchos lugares del mundo en vías de desarrollo, la modernización ha producido un incremento de la prevalencia del sobrepeso y la obesidad así como del riesgo subsecuente de sufrir enfermedades no transmisibles relacionadas con la nutrición, como la enfermedad cardiovascular y la diabetes tipo 2.

Objetivo: El estudio examinó el impacto de los cambios socioeconómicos y del estilo de vida asociados con la modernización sobre el tamaño y la forma corporal de las mujeres balinesas.

Sujetos y Métodos: Se recogieron datos antropométricos que incluían el peso, la estatura y el índice de masa corporal (IMC) de 564 mujeres de Bali, con edades comprendidas entre los 15 y 45 años. La relación entre el grado de ‘modernización’ (utilizando parámetros como la salud familiar y el nivel de educación) y el tamaño y la forma del cuerpo se analizó mediante un análisis de regresión múltiple, que consideraba el efecto de la edad, el tamaño familiar y el amamantamiento.

Resultados: Según las categorías de la WHO () para el IMC, el 14% de las mujeres balinesas mostraron una Deficiencia Energética Crónica (IMC<18,5?kg?m^?2), el 7% presentaba sobrepeso (IMC?=?25,0–29,9?kg?m^?2) y menos del 1% eran obesas (IMC?≥?30,0?kg?m^?2). La salud familiar (p<0,0001) y el nivel de estudios (p<0,05) estaban significativamente asociados con la adiposidad (exceso de peso), mientras que el amamantamiento (p<0,05) estaba significativamente asociado con la delgadez. La distribución de grasa era muy independiente de las variables biológicas y socioeconómicas.

Conclusiones: La tendencia hacia un incremento de la adiposidad cuanto mejor es la salud familiar y mayor el nivel de educación tiene importantes implicaciones sanitarias para las mujeres balinesas, a medida que éstas continúan su rápida transición desde la agricultura de subsistencia hacia un estilo de vida más ‘occidentalizado’.     

医院信息系统:过去,现在,未来

长期以来,信息曾被视为一个不可避免的弊病,它存在着,但有时又使人不便得到,随着信息量的增大,信息就愈加难以组织。直到最近几年,信息才被视为一种资源,一种与医院或商业中的物资及资金同样重要的资源。用最简单的话来讲,健康护理人员应当利用所有的有用信息为其提供护理工作的行动方针,从而为病人提供最大的康复机会;数据处理专家应当使信息在健康护理人员需要时容易利用。这些就要依赖工程技术的进步来实现。     

Face ethnicity and measurement reliability affect face recognition performance in developmental prosopagnosia: Evidence from the Cambridge Face Memory Test–Australian

The Cambridge Face Memory Test (CFMT, Duchaine & Nakayama, 2006) provides a validated format for testing novel face learning and has been a crucial instrument in the diagnosis of developmental prosopagnosia. Yet, some individuals who report everyday face recognition symptoms consistent with prosopagnosia, and are impaired on famous face tasks, perform normally on the CFMT. Possible reasons include measurement error, CFMT assessment of memory only at short delays, and a face set whose ethnicity is matched to only some Caucasian groups. We develop the “CFMT-Australian” (CFMT-Aus), which complements the CFMT-original by using ethnicity better matched to a different European subpopulation. Results confirm reliability (.88) and validity (convergent, divergent using cars, inversion effects). We show that face ethnicity within a race has subtle but clear effects on face processing even in normal participants (includes cross-over interaction for face ethnicity by perceiver country of origin in distinctiveness ratings). We show that CFMT-Aus clarifies diagnosis of prosopagnosia in 6 previously ambiguous cases. In 3 cases, this appears due to the better ethnic match to prosopagnosics. We also show that face memory at short (<3-min), 20-min, and 24-hr delays taps overlapping processes in normal participants. There is some suggestion that a form of prosopagnosia may exist that is long delay only and/or reflects failure to benefit from face repetition.     

BAFF, APRIL, TWE-PRIL: who's who?

BAFF and APRIL are two members of the TNF superfamily that have co-stimulatory activity on B cells and contribute to autoimmunity. While BAFF is processed at the cell surface, APRIL is processed inside the cell by a furin-convertase and is able to perform its function only as a soluble factor. However, APRIL can be expressed as a cell surface fusion protein with TWEAK called TWE-PRIL. BAFF can also exist as a soluble molecule and can be detected in human serum. Whether the biological functions controlled by membrane-bound BAFF differ from those triggered by soluble BAFF is unclear. In addition to this complexity, DeltaBAFF, an alternative splice isoform of BAFF shows different properties. BAFF can also, in autoimmune disease form heterotrimers with APRIL but the control and function of these heterotrimers remain unclear. In order to understand the function of these molecules we need to elucidate the complexity of the various forms of these members of the TNF family.     

Transfusion de plaquettes : produits,indications, dose,seuil, efficacité

The quality of platelet concentrates had been greatly improved since the implementation of processing techniques based on the use of the buffy-coat in the years 1980. More recently, in the last 10 years, it is in the domain of safety that the greatest advances have been done, by the introduction of platelet additive solutions, on one hand, and by the progressive availability of pathogen reduction techniques, on the other hand. These developments in quality and safety of platelet components are important, as they lead to the conclusion that nowadays, apheresis platelet concentrates and pooled random donor platelet concentrates can be considered as equivalent, the only specific indication of the former being the care of HLA or HPA allo-immunized patients. This review covers the physiological basis of prophylactic and curative platelet transfusions, and the means to evaluate their efficacy. The main investigations that are necessary to perform in the event of an inefficient prophylactic transfusion are also mentioned. Platelet transfusion is an essential part of the transfusion support in case of central thrombocytopenia, and more indications in other medical and surgical situations are well defined. The vast majority of clinical situations in which platelet transfusions are indicated have been defined in the national guidelines published in 2003 by the AFSSAPS French authority, and are still fully valid today. Therefore, only some specific domains for which recent published data are questioning our present practices are discussed, such as the use of platelet concentrates in massive transfusion. Finally, three critical factors for establishing a coherent platelet transfusion strategy are developed: the transfusion trigger for prophylactic platelet transfusion, the platelet dose, and the impact of ABO compatibility between the product and the recipient.     

基因污染:无孔不入,防不胜防

用于动植物转基因的运载体DNA中含有一段作标志用的特殊基因棗抗菌素抗性基因。这种基因的危险性一直未被充分认识。芬兰的研究人员发现，基因工程食物中存在的抗菌素抗性基因能转移到人体肠道中的细菌内。虽然还没有人报道，这种食物在人体内能使肠道菌特别是致病菌对抗菌素产