Chronic insomnia and daytime functioning: an ambulatory assessment

In this ambulatory study, the relation between daytime functioning and chronic insomnia was investigated. The study sample consisted of 39 chronic insomniacs and 20 healthy control participants. Performance (vigilance, working memory, motor control) and well-being (concentration, fatigue, mood, sleepiness) were assessed by means of a validated test battery, and intra-individual sleep variability was taken into account. Subjective well-being was found to be compromised in insomniacs as compared to control participants, but no differences in the level of performance were found. Evening cortisol levels did not indicate increased levels of arousal in the insomniacs. Although the absence of an effect of chronic insomnia on objectively measured performance may be due to experimental or statistical factors, this study hypothesizes that the insomniacs studied in the field may have been able to exert compensatory effort to overcome their self-perceived fatigue.     

Assessment of use of microsatellite polymorphism analysis for improving spatial distribution tracking of echinococcus multilocularis

Alveolar echinococcosis (AE)--caused by the cestode Echinococcus multilocularis--is a severe zoonotic disease found in temperate and arctic regions of the northern hemisphere. Even though the transmission patterns observed in different geographical areas are heterogeneous, the nuclear and mitochondrial targets usually used for the genotyping of E. multilocularis have shown only a marked genetic homogeneity in this species. We used microsatellite sequences, because of their high typing resolution, to explore the genetic diversity of E. multilocularis. Four microsatellite targets (EmsJ, EmsK, and EmsB, which were designed in our laboratory, and NAK1, selected from the literature) were tested on a panel of 76 E. multilocularis samples (larval and adult stages) obtained from Alaska, Canada, Europe, and Asia. Genetic diversity for each target was assessed by size polymorphism analysis. With the EmsJ and EmsK targets, two alleles were found for each locus, yielding two and three genotypes, respectively, discriminating European isolates from the other groups. With NAK1, five alleles were found, yielding seven genotypes, including those specific to Tibetan and Alaskan isolates. The EmsB target, a tandem repeated multilocus microsatellite, found 17 alleles showing a complex pattern. Hierarchical clustering analyses were performed with the EmsB findings, and 29 genotypes were identified. Due to its higher genetic polymorphism, EmsB exhibited a higher discriminatory power than the other targets. The complex EmsB pattern was able to discriminate isolates on a regional and sectoral level, while avoiding overdistinction. EmsB will be used to assess the putative emergence of E. multilocularis in Europe.     

Gene therapy to create biological pacemakers

Old age and a variety of cardiovascular disorders may disrupt normal sinus node function. Currently, this is successfully treated with electronic pacemakers, which, however, leave room for improvement. During the past decade, different strategies to initiate pacemaker function by gene therapy were developed. In the search for a biological pacemaker, various approaches were explored, including β₂-adrenergic receptor overexpression, down regulation of the inward rectifier current, and overexpression of the pacemaker current. The most recent advances include overexpression of bioengineered ion channels and genetically modified stem cells. This review considers the strengths and the weaknesses of the different approaches and discusses some of the different viral vectors currently used.     

Toll-like receptor 4 polymorphism associated with the response to whole-cell pertussis vaccination in children from the KOALA study

We examined the association between haplotype tagging single-nucleotide polymorphisms in TLR4 and the pertussis toxin-specific immunoglobulin G response after whole-cell pertussis (wP) vaccination in 515 1-year-old children from the KOALA study. A lower titer was associated with the minor allele of rs2770150, supporting a role for Toll-like receptor 4 in the antibody response to wP vaccination.     

Temperature and cardiovascular deaths in the US elderly: changes over time

BACKGROUND: Short-term changes in temperature have been associated with cardiovascular deaths. This study examines changes in this association over time among the US elderly. METHODS: Daily cardiovascular mortality counts from 107 cities in the US National Morbidity and Mortality Air Pollution Study were regressed against daily temperature using the case-crossover method. Estimates were averaged by time and season using a meta-analysis. RESULTS: In summer 1987 the average increase in cardiovascular deaths due to a 10 degrees F increase in temperature was 4.7%. By summer 2000, the risk with higher temperature had disappeared (-0.4%). In contrast, an increase in temperature in fall, winter and spring was associated with a decrease in deaths, and this decrease remained constant over time. CONCLUSIONS: Heat-related cardiovascular deaths in the elderly have declined over time, probably due to increased use of air conditioning, while increased risks with cold-related temperature persist.     

Mortality patterns among workers exposed to acrylamide: updated follow up

OBJECTIVE: The objective of this study was to update the mortality experience of a cohort of workers with and without potential exposure to acrylamide (AMD) at three U.S. plants (n = 8508) and one plant in The Netherlands (n = 344). METHODS: We computed standardized mortality ratios (SMRs) using national and local rates and modeled internal cohort rates to assess site-specific cancer risks by demographic and work history factors and several exposure indicators for AMD. RESULTS: For the 1925-2002 study period, we observed both deficit and excess overall mortality risks among the U.S. cohort for cancer sites implicated in experimental animal studies: brain and other central nervous system (SMR = 0.67, confidence interval [CI] = 0.40-1.05), thyroid gland (SMR = 1.38, CI = 0.28-4.02), testis and other male genital organs (SMR = 0.64, CI = 0.08-2.30); and for sites selected in earlier exploratory analyses of this cohort: respiratory system cancer (RSC) (SMR = 1.17, CI = 1.06-1.27), esophagus (SMR = 1.20, CI = 0.86-1.63), rectum (SMR = 1.25, CI = 0.84-1.78), pancreas (SMR = 0.94, CI = 0.70-1.22), and kidney (SMR = 1.01, CI = 0.66-1.46). Except for RSC, attributed earlier to muriatic acid exposure, none of the mortality excesses was statistically significant. In the Dutch cohort, we observed deficits in deaths for all sites of a priori interest. An updated analysis of our previous exploratory findings for pancreatic cancer in the U.S. cohort revealed much less evidence of a possible exposure-response relationship with AMD. CONCLUSION: AMD exposure at the levels present in our study sites was not associated with elevated cancer mortality risks.     

Comprehensive quality assessment of healthy school interventions

OBJECTIVES: The number of healthy school interventions of unknown quality overwhelms schools. Quality is a construct that is differently interpreted by teachers and health promoters. The schoolBeat checklist for quality assessment of healthy school interventions incorporates the quality perceptions of both professional groups. To support quality improvements - and thus effectiveness - in school health promotion, this study evaluates the schoolBeat checklist. METHODS: Twenty-nine healthy school interventions were assessed in the Netherlands, each by two health promoters and two teachers-individually and at a consensus meeting. Generalizability coefficients were calculated for the nine specific quality criteria. RESULTS: The mean consensus score differs from the mean average individual score for two out of nine criteria. To obtain a threshold Generalizability coefficient of 0.70, the number of assessors required per criterion ranges from 1.6 to 10.8, with an average of 4.7. CONCLUSION: Quality assessment procedures of healthy school interventions using the schoolBeat checklist require about four experienced assessors from each professional domain to facilitate reliable quality scores based on individual assessment only. Publicly available quality scores enable the inclusion of high quality interventions in school policies in order to increase the impact of school health.