Visualizing changes in physical activity behavioral patterns after redesigning urban infrastructure

The aim of this study was to explore effects of a major urban reconstruction on physical activity (PA) behavior by comparing PA intensity hotspots before and after the tunneling of a highway with a new infrastructure prioritized for walking and cycling. In total, 126 individuals participated before and after the tunneling. GPS loggers and accelerometers were used to assess location and PA levels. A geographic information system (GIS) was used to perform optimized hotspot analyses on PA data, both on transport and stationary data points. The results showed several changes in PA hotspots on trip data, even if total PA levels did not change. At follow-up, PA intensity hotspots were more connected, with the new infrastructure as a central connection. This was true for higher and lower educated individuals. Therefore, if changes in the built environment do not result in changes on population-level outcomes, this does not imply that they have no impact on behavior.     

茯苓多糖对ApoE-/-AS小鼠肝脏脂质沉积及胆固醇逆向转运相关蛋白表达的影响＊

目的 探讨茯苓多糖对载脂蛋白E基因敲除（ApoE^-/-）动脉粥样硬化（Atherosclerosis，AS）小鼠肝脏脂质沉积及胆固醇逆向转运的影响。方法 采用随机数字表法将30只ApoE^-/-小鼠随机分为模型组、茯苓多糖组、辛伐他汀组，每组10只，10只C57BL/6J小鼠作为正常组。正常组给予基础饲料喂饲，其余小鼠给予高脂饲料喂饲12周。茯苓多糖组以0.2 g/kg/d灌胃，辛伐他汀组以2.275 mg/kg/天灌胃，正常组和模型组给予等体积生理盐水灌胃，共干预4周。全自动生化分析仪检测小鼠血清三酰甘油（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）水平，苏木素-伊红（HE）染色观察小鼠肝脏病理形态学变化，油红O染色观察小鼠肝脏脂质沉积情况，ELISA检测各组小鼠血清载脂蛋白A1 （ApoA1）、对氧磷酶-1（PON1）含量，Real-time RT-qPCR法及Western Blot法检测肝脏胆固醇酯转运蛋白（CETP）、磷脂转运蛋白（PLTP）、卵磷脂胆固醇酰基转移酶（LCAT）mRNA及蛋白表达。结果 与正常组比较，模型组小鼠血清TG、TC、LDL-C含量均明显上升，HDL-C含量明显下降（P<0.01），肝细胞脂肪变性明显，肝脏脂质沉积明显，小鼠血清ApoA1、PON1含量均明显下降（P<0.01），小鼠肝脏CETP、PLTP mRNA及蛋白表达明显上升，LCAT mRNA及蛋白表达明显下降（P<0.01）。与模型组相比，茯苓多糖组血清TG、TC、LDL-C含量均显著下降（P<0.01），HDL-C含量呈上升趋势（P>0.05），肝细胞脂肪变性、脂质沉积程度均有所减轻，茯苓多糖组ApoA1含量明显上升（P<0.01），PON1含量呈上升趋势（P>0.05），茯苓多糖组CETP、PLTP mRNA及蛋白表达有所下降，LCAT mRNA及蛋白表达有所上升（P<0.05，P<0.01）。结论 茯苓多糖可能通过调控血脂水平与胆固醇逆向转运过程，改善ApoE^-/- AS小鼠肝脏脂质沉积，进而发挥防治AS作用。     

Germline variant burden in multidrug resistance transporters is a therapy-specific predictor of survival in breast cancer patients

Multidrug resistance due to facilitated drug efflux mediated by ATP-binding cassette (ABC) transporters is a main cause for failure of cancer therapy. Genetic polymorphisms in ABC genes affect the disposition of chemotherapeutics and constitute important biomarkers for therapeutic response and toxicity. Here we correlated germline variability in ABC transporters with disease-specific survival (DSS) in 960 breast cancer (BRCA), 314 clear cell renal cell carcinoma and 325 hepatocellular carcinoma patients. We find that variant burden in ABCC1 is a strong predictor of DSS in BRCA patients, whereas candidate polymorphisms are not associated with DSS. This association is highly drug-specific for subgroups treated with the MRP1 substrates cyclophosphamide (log-rank p = 0.0011) and doxorubicin (log-rank p = 0.0088) independent of age and tumor stage, whereas no association was found in individuals treated with tamoxifen (log-rank p = 0.13). Structural mapping of significant variants revealed multiple variants at residues involved in protein stability, cofactor stabilization or substrate binding. Our results demonstrate that BRCA patients with high variant burden in ABCC1 are less prone to respond appropriately to pharmacological therapy with MRP1 substrates, thus incentivizing the consideration of genomic germline data for precision cancer medicine.     

Violence et institution militaire

ObjectivesThis work consists in a study of the links between the concept of violence and military environment where its problematic is particularly acute. Violence is at the heart of the profession of arms, which conveys a transgression, the prohibition of murder, which itself is at the foundation of the organization of our society.MethodsThe soldier occupies a position of exception by this possibility of giving death, which finds its legitimacy in a regulated use of the force, while responding to very precise conditions of use of the weapons. The power granted to the soldier is none the less marked up, presupposing a regulated use of the armed force, which implies its control, but commits jointly the possible overflow of these conditions of employment; sometimes there is an insidious sliding, much more obvious elsewhere, towards a deregulated violence, attesting a loss of control of the force. These specific coordinates of emergence of violence are here detailed, to specify the springs and the repercussions, beyond contextual considerations.ResultsTwo expressions in mirror of violence have been pinpointed in order to be clarified. The one which refers to a controlled and framed violence, then lever and driving force of the war action, and the other consisting of a out of frame violence, in connection with a use against the use of force; we did the hypothesis that this deregulated violence is the expression of a point of impossibility for the subject, a form of impasse both in his own psychic functioning and in his relationship to the group.ConclusionsThe military environment, which is itself violence holder, is structured in such a way that it can frame and control the intrinsic violence to warlike action. But as soon as the violence comes to express itself out of frame, it is outside the precise and regulated context of the use of the armed force, it becomes destructive, hindering the work of symbolization of the psyche, to lead to breaking the links of the subject with himself and with his group.     

通鼻消涕颗粒对慢性鼻窦炎鼻黏膜功能的影响*

目的对医院制剂通鼻消涕颗粒对慢性鼻窦炎鼻黏膜功能是否有调控作用进行临床研究。方法 收集慢性鼻窦炎不伴鼻息肉患者，采用单盲方法随机将患者分为治疗组（通鼻消涕颗粒组）和对照组（克拉霉素片组）。分别给予口服通鼻消涕颗粒和克拉霉素片治疗4周，并对治疗前、治疗2周后、治疗4周后的患者进行糖精试验、鼻部症状VAS评分与鼻内镜Lund Kennedy评分。并采用t检验统计分析。比较服药前、服药后的评分变化。结果 VAS评分提示：治疗组中，治疗2周后、治疗4周后与治疗前相比差异均有统计学意义（P＜0.05），对照组在治疗后的各个阶段与治疗前相比均无明显差异（P＞0.05）。Lund Kennedy评分提示：治疗组在治疗2周后与治疗前无明显差异，但在治疗4周后有明显改善（P＜0.05），对照组则在治疗后各个阶段无明显变化（P＞0.05）。糖精试验提示2组在治疗后2周患者糖精清除时间差异无统计学意义（P＞0.05），但治疗组在治疗4周后患者糖精清除时间低于对照组（P＜0.05）。结论 通鼻消涕颗粒对慢性鼻窦炎的鼻黏膜形态与传输功能有明显改善作用，可以促进鼻黏膜纤毛功能的恢复，并优于克拉霉素片组，且无毒副作用，值得临床上推广应用。     

Patient Extrication Process for Urban Emergency Departments

ObjectivesThis project aimed to create and implement a safe and efficient role-based process to rapidly extricate traumatically injured persons transported to the emergency department via police transport or private vehicle.MethodsA simulation exercise was conducted with an interdisciplinary team of ED personnel, Philadelphia Police Department, and University of Pennsylvania police officers to identify the necessary steps to rapidly extricate traumatically injured individuals.ResultsThe simulation exercise identified several new processes needed to complete rapid extrications of traumatically injured individuals from private and police vehicles. These included a safe drop-off location, ED personnel role identification, proper personal protective equipment donning, 2 rapid extrication techniques, and a hard stop for weapon check by security before entering the emergency department.ConclusionsThrough simulation, the ED interdisciplinary team was able to develop a role-based safe and efficient rapid extrication process. Educating new ED personnel, security, and Pennsylvania police continues to facilitate ongoing safe rapid extrication practices in the emergency department.     

Feed or feed transport as a potential route for a porcine epidemic diarrhoea outbreak in a 10,000-sow breeding herd in Mexico

Porcine epidemic diarrhoea virus (PEDV) infects pigs of all ages causing vomiting and diarrhoea. PEDV is transmitted via the oral–faecal route, and a very low dose is enough to infect susceptible pigs, resulting in significant production losses. This short communication aims to describe the introduction of PEDV into a 10,000-sow farrow-to-wean farm located in northwest Mexico. Following the onset of clinical signs, an outbreak investigation was conducted to determine the most probable route of introduction. Based on data collected from interviews, construction of a timeline of events, and the detection of PEDV RNA in feed samples and samples collected from various surfaces of feed transport vehicles, it was concluded that the most probable route for PEDV incursion into this breeding herd was contaminated feed or a contaminated feed transport vehicle. This paper describes how feed or feed transport could serve as potential routes of PEDV infection to a farm and highlights the importance of establishing biosecurity programs to mitigate these risks.     

A comparative analysis of the impacts of objective versus subjective neighborhood environment on physical,mental, and social health

Research on the relationship between neighborhood context and health outcome has attracted notable attention. However, few studies examine and compare the associations between the objective and subjective neighborhood environment and different dimensions of health. To this end, high-resolution remote sensing images and points-of-interest (POIs) data collected in Guangzhou, China, are used together with questionnaire survey data to measure the objective and subjective characteristics of the neighborhood environment. The sample includes 1029 adults selected from 34 communities in Guangzhou, China. Hierarchical linear modeling is then employed to analyze the associations between the objective and subjective neighborhood environment and three dimensions of health (physical health, mental health, and social health), as well as compare the relative strengths of and moderating mechanisms between these associations. The results indicate that significant variations in health outcomes are observed among neighborhoods, which can be explained by both personal attributes and the neighborhood environment. Although objective and subjective measures of the neighborhood environment are both linked to the three dimensions of health, physical health and social health are influenced more by objective measures, while mental health is affected more by subjective measures. Further, subjective measures have positive moderating effects on the relationship between objective measures and mental health but do not have significant moderating effects on the relationships between objective measures and physical and social health.