Predicting the Influence of Streamflow on Migration and Spawning of a Threatened Diadromous Fish, the Australian Grayling Prototroctes Maraena.

The development of effective strategies to restore the biological functioning of aquatic ecosystems with altered flow regimes requires a detailed understanding of flow-ecology requirements, which is unfortunately lacking in many cases. By understanding the flow conditions required to initiate critical life history events such as migration and spawning, it is possible to mitigate the threats posed by regulated river flow by providing targeted environmental flow releases from impoundments. In this study, we examined the influence of hydrological variables (e.g., flow magnitude), temporal variables (e.g., day of year) and spatial variables (e.g., longitudinal position of fish) on two key life history events (migration to spawning grounds and spawning activity) for a threatened diadromous fish (Australian grayling Prototroctes maraena) using data collected from 2008 to 2015 in the Bunyip-Tarago river system in Victoria. Our analyses revealed that flow changes act as a cue to downstream migration, but movement responses differed spatially: fish in the upper catchment showed a more specific requirement for rising discharge to initiate migration than fish in the lower catchment. Egg concentrations peaked in May when weekly flows increased relative to the median flow during a given spawning period. This information has recently been incorporated into the development of targeted environmental flows to facilitate migration and spawning by Australian grayling in the Bunyip-Tarago river system and other coastal systems in Victoria.

No gender-specific differences in mechanical efficiency during arm or leg exercise relative to ventilatory threshold.

The purpose of this study was to determine economy and mechanical efficiency in men and women during both arm cranking (AC) and leg cycling (LC) at 70%, 85%, 100%, and 115% of mode-specific ventilatory threshold (T(vent)). Recreationally active men (n=9) and women (n=9) with similar values for %VO2peak at T(vent) served as subjects. All subjects performed 5 min of exercise at each intensity of 70%, 85%, 100%, and 115% of T(vent) for both AC and LC. Economy was expressed as W/L/min. Gross efficiency (GE) was determined as the ratio of work accomplished to total energy expended (%). Delta efficiency (DE) was determined as the ratio of delta work accomplished to delta energy expended (%). Economy and efficiency during LC were greater than during AC in men and women. During AC or LC exercise, no sex differences were found in either economy (P=0.93 for AC, 0.98 for LC), GE (P=0.88 for AC, 0.75 for LC), or DE (P=0.57 for AC, 0.51 for LC). These findings indicate that men and women show similar economy and efficiency during both AC and LC exercise when subjects have similar %VO2peak at Tvent.

The addition of fenugreek extract (Trigonella foenum-graecum) to glucose feeding increases muscle glycogen resynthesis after exercise.

The purpose of this study was to determine the effects of ingesting an oral supplement containing 4-Hydroxyisoleucine (4-OH-Ile, isolated from fenugreek seeds [Trigonella foenum-graecum]) with a glucose beverage on rates of post-exercise muscle glycogen resynthesis in trained male cyclists. Following an overnight fast (12 hr), subjects completed a 90-minute glycogen depletion ride after which a muscle biopsy was obtained from the vastus lateralis. Immediately and 2 hours after the muscle biopsy, subjects ingested either an oral dose of dextrose (Glu) (1.8 g.kg BW(-1)) or 4-OH-Ile supplement (Glu+4-OH-Ile, including 2.0 mg.kg(-1) 4-OH-Ile with the same oral dose of dextrose) with a second muscle biopsy 4 hours after exercise. Post exercise muscle glycogen concentration was similar for both trials. Overall, there was a significant increase in glucose and insulin concentrations from time 0 throughout the majority of the 4-hour recovery period, with no significant differences between the two trials at any time point. Although muscle glycogen concentration significantly increased from immediately post exercise to 4 hr of recovery for both trials, the net rate of muscle glycogen resynthesis was 63% greater during Glu+4-OH-Ile (10.6+/-3.3 vs. 6.5+/-2.6 g.kg wet wt.(-1).hr.(-1) for the Glu+4-OH-Ile and Glu trials, respectively). These data demonstrate that when the fenugreek extract supplement (4-OH-Ile) is added to a high oral dose of dextrose, rates of post-exercise glycogen resynthesis are enhanced above dextrose alone.

Substrate utilization during arm and leg exercise relative to the ventilatory threshold in men.

BACKGROUND: The purpose of this study was to determine variations in substrate utilization in men during arm and leg exercise at 70 and 90% of mode specific ventilatory threshold (Tvent). METHODS: Ten males served as subjects. Limb total and muscle volumes were estimated in the right arm and leg with anthropometry. Ventilatory equivalence, excess CO2, and modified V-slope methods were used to determine Tvent. Subjects performed 15 min of exercise at 70 and 90%Tvent arm cranking (AC) exercise, and 70 and 90%Tvent leg cycling (LC) exercise. RESULTS: VO2, VE, and HR were higher during LC exercise at both intensities. However, arm and leg RPE were not different at 70 and 90%Tvent. There were no significant differences between modes at 70%Tvent in relative carbohydrate use (54.5+/-9.5 and 57.8+/-8.2% for AC and LC, respectively) and relative fat oxidation (45.5+/-9.5 and 42.2+/-8.2% for AC and LC, respectively). However, at 90%Tvent, relative carbohydrate oxidation was significantly higher during AC versus LC exercise (75.4+/-10.6 versus 68.6+/-9.0%, p<0.05). Energy expenditure (total kJ x min(-1) was significantly lower during AC exercise (14.5+/-2.9 and 18.4+/-3.4 for the 70 and 90%Tvent, respectively) versus LC exercise (27.1+/-3.3 and 34.8+/-4.1 for the 70 and 90%Tvent, respectively; p<0.05). CONCLUSIONS: These results indicate that substrate use during AC exercise is similar to LC exercise at 70%Tvent. However, as the exercise intensity increases, the smaller arm musculature becomes more dependent on carbohydrate utilization compared to the legs.

Variability in the response of HDL cholesterol to exercise training in the HERITAGE Family Study.

In the HERITAGE Family Study, 675 sedentary, healthy, white and black men and women, aged 17 to 65 years, performed 20 weeks of supervised cycle ergometer exercise at the same relative intensity and weekly volume. As a group, subjects had normal mean baseline lipid levels for North Americans with the exception of below average high density lipoprotein cholesterol (HDL-C) levels. A significant mean increase in plasma HDL-C of 3.6 % was observed; however, there was marked variability in responsiveness to training, ranging from a mean 9.3 % decrease in Quartile 1 of HDL-C response to a mean 18 % increase in Quartile 4 (P < 0.0001 by ANOVA). Parallel changes in HDL(2)-C and HDL(3)-C, apolipoprotein A-I levels, and lipoprotein lipase activity were noted across quartiles. The change in HDL-C across quartiles was inversely related to baseline HDL-C (p < 0.0001) and to changes with training in plasma triglycerides (p = 0.0007). No significant differences in HDL-C response were observed across quartiles by sex, race, age, or increase in VO(2)max with training; however, weak positive associations were observed with age-adjusted education level and with reduction in abdominal fat and increase in VO(2)max at the ventilatory threshold following training. Multivariate regression analysis including baseline variables and training responses only accounted for 15.5 % of the variability in the HDL-C response to training. Thus, marked variability was found in the HDL-C response to the same endurance exercise training stimulus with only a modest amount of the response predictable by identified nongenetic factors.

Validity and reliability of combining three methods to determine ventilatory threshold.

PURPOSE: This research was undertaken to validate a combination of methodologies to determine ventilatory threshold (VT). METHODS: Three methods were used individually and then combined to determine VT as follows: 1) ventilatory equivalencies, 2) excess CO2 production, and 3) a modified V-slope method. Three groups of participants-endurance athletes (N = 132), healthy, aerobically active adults (N = 31), and healthy, sedentary/low-active adults (N = 22)-were independently evaluated for VT and compared with the criterion standard lactate threshold (LT) defined as the first rise in blood lactate with increasing intensity of exercise. RESULTS: VT and LT were significantly correlated using the combined VT method within each study group (r = 0.98, 0.97, and 0.95, respectively; P < 0.001). Mean VO2 values at VT and LT were not significantly different between the three groups (P > 0.20). The combined method improved the determination rate of VT and reduced the standard deviation of the LT - VT difference by 80-170% over the individual methods. During test-retest procedures VO2lt and VO2vt determined by the combined method met criteria demonstrating further reliability. CONCLUSION: The combined method to determine VT is valid and reliable across a wide fitness range in healthy individuals and improves the determination rate and accuracy of VT determination over the use of single methods.

Familial resemblance in ventilatory threshold: the HERITAGE Family Study.

PURPOSE: This study investigates the familial resemblance of VO2 at the ventilatory threshold (VO2vt) from 199 nuclear families (100 White and 99 Black) participating in the HERITAGE Family Study. METHODS: VO2vt (mL x min(-1)) was determined in the sedentary state and again after 20 wk of aerobic cycle ergometer exercise training in 339 individuals (131 parents and 228 of their offspring), aged between 17 and 65 yr. VO2vt was adjusted for weight, age, fat mass, and fat-free mass by using regression methods. RESULTS: There was evidence for significant familial resemblance in the sedentary state for VO2vt (maximal heritability = 58% in White and 54% in Black families) and VO2vt/VO2max (maximal heritability = 38% in White and 39% in Black families). Spouse, sibling, and parent-offspring relationships for VO2vt were significant at baseline, suggesting that both genetic and shared environmental factors may contribute to the familial resemblance in the sedentary state. There was a moderate familial component in the response of VO2vt to aerobic exercise training in Whites (22%) and a larger component in Blacks (51%). In Blacks, the familial effect for VO2vt/VO2max appeared to be accounted for by fat and fat-free mass. CONCLUSION: These results show a strong familial contribution to VO2vt in the sedentary state and to the response of VO2vt to aerobic exercise training.

Changes in ventilatory threshold with exercise training in a sedentary population: the HERITAGE Family Study.

UNLABELLED: The purpose of this study was to evaluate the effect of exercise training intensity relative to the ventilatory threshold (VT) on changes in work (watts) and VO2 at the ventilatory threshold and at maximal exercise in previously sedentary participants in the HERITAGE Family Study. We hypothesized that those who exercised below their VT would improve less in VO2 at the ventilatory threshold (VO2vt) and VO2max than those who trained at an intensity greater than their VT. Supervised cycle ergometer training was performed at the 4 participating clinical centers, 3 times a week for 20 weeks. Exercise training progressed from the HR corresponding to 55% VO2max for 30 minutes to the HR associated with 75% VO2max for 50 minutes for the final 6 weeks. VT was determined at baseline and after exercise training using standardized methods. 432 sedentary white and black men (n = 224) and women (n = 208), aged 17 to 65 years, were retrospectively divided into groups based on whether exercise training was initiated below, at, or above VT. RESULTS: 1) Training intensity (relative to VT) accounting for about 26% of the improvement in VO2vt (R2 = 0.26, p < 0.0001). 2) The absolute intensity of training in watts (W) accounted for approximately 56% of the training effect at VT (R2 = 0.56, p < 0.0001) with post-training watts at VT (VT(watts)) being not significantly different than W during training (p > 0.70). 3) Training intensity (relative to VT) had no effect on DeltaVO2max. These data clearly show that as a result of aerobic training both the VO2 and W associated with VT respond and become similar to the absolute intensity of sustained (3 x /week for 50 min) aerobic exercise training. Higher intensities of exercise, relative to VT, result in larger gains in VO2vt but not in VO2max.

Mutation analysis and embryonic expression of the HLXB9 Currarino syndrome gene.

The HLXB9 homeobox gene was recently identified as a locus for autosomal dominant Currarino syndrome, also known as hereditary sacral agenesis (HSA). This gene specifies a 403-amino acid protein containing a homeodomain preceded by a very highly conserved 82-amino acid domain of unknown function; the remainder of the protein is not well conserved. Here we report an extensive mutation survey that has identified mutations in the HLXB9 gene in 20 of 21 patients tested with familial Currarino syndrome. Mutations were also detected in two of seven sporadic Currarino syndrome patients; the remainder could be explained by undetected mosaicism for an HLXB9 mutation or by genetic heterogeneity in the sporadic patients. Of the mutations identified in the 22 index patients, 19 were intragenic and included 11 mutations that could lead to the introduction of a premature termination codon. The other eight mutations were missense mutations that were significantly clustered in the homeodomain, resulting, in each patient, in nonconservative substitution of a highly conserved amino acid. All of the intragenic mutations were associated with comparable phenotypes. The only genotype-phenotype correlation appeared to be the occurrence of developmental delay in the case of three patients with microdeletions. HLXB9 expression was analyzed during early human development in a period spanning Carnegie stages 12-21. Signal was detected in the basal plate of the spinal cord and hindbrain and in the pharynx, esophagus, stomach, and pancreas. Significant spatial and temporal expression differences were evident when compared with expression of the mouse Hlxb9 gene, which may partly explain the significant human-mouse differences in mutant phenotype.

Upper body power comparison between groups of cross-country skiers and runners.

The purpose of this study was to evaluate relationships between upper body power (UBP) and cross-country ski skating race velocity (R) in a cross sectional representation of cross-country skiers. Additionally, cross-country skiers' UBP was compared to UBP of distance runners. Participants (n = 195) were tested on a Street Arm Ergometer for UBP using a ramped maximal UBP test simulating a double poling motion. A strong relationship (r = 0.89) between UBP and RV in skiers was determined. High school skiers were separated into slow and fast groups based on reported RV; significant differences (p < 0.05) in both UBP was found to be an effective partial predictor of RV, independent of gender. Mean UBP for the cross-country runners was 46% of mean UBP for the cross-country skiers. With UBP contributing so much to performance in cross-country ski racing, it is recommended that cross-country skiers focus a large portion of their training on the specific development of that fitness component.

Responses to training in cross-country skiers.

PURPOSE: This study evaluated whether cross-country skiers who did not respond positively to a training program consisting of high volume and low intensity would improve if high-intensity training volume was doubled during a subsequent training year. METHODS: During the first year of the study, cross-country skiers (N = 14) were evaluated for VO2max, VO2threshold, lactate response, max arm power, and competitive results after a standard training program. During the second year, the athletes were divided into a control group (athletes who had responded well to the training) and a treatment group (athletes who had responded poorly to the training). The control group (N = 7) repeated the previous year's training program. The treatment group (N = 7) was given a modified training program which increased high-intensity training time as a percentage of total training from < 17% to > 35% and decreased low-intensity training volume 22%. RESULTS: The treatment group, using the high-intensity training program, demonstrated significantly improved VO2max, VO2threshold, max arm power, and competitive results (P < 0.05). CONCLUSIONS: Increased volume of high-intensity training may improve competitive results in cross-country skiers who fail to respond to increased volume of low-intensity training.

Prevalence of hypertension in a Mexican population according to the Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure.

BACKGROUND: Hypertension in Mexico represents a challenging public health problem. The National Survey on Chronic Diseases published in 1993 reported that hypertension affects more than 10 million Mexicans. No information has been published regarding the prevalence of hypertension in Mexico using the new diagnostic criteria established by the Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC VI). METHODS: The Mexico City Diabetes Study is a prospective study designed to estimate the prevalence and incidence of cardiovascular risk factors in a low-income area. The survey included 941 men and 1341 non-pregnant women aged 35-64 years. Blood pressure measurements were performed using a random zero sphygmomanometer. The diagnostic criteria for hypertension were those recommended by the JNC VI. RESULTS: The crude prevalence of hypertension was 17.2% and 18.1% in men and women, respectively. We found significant associations between hypertension and obesity, body fat distribution, very-low-density lipoprotein cholesterol, fasting and 2-h post-glucose in both sexes, and between hypertension and total cholesterol, low-density lipoprotein cholesterol and triglycerides levels in women. In 40% of hypertensive men and 23% of women, hypertension was undiagnosed and untreated. Of the previously diagnosed hypertensive individuals, 38% of men and 30% of women reported not taking antihypertensive medicine. The prevalence++ of associated risk factors in this population is 12.3% for tobacco consumption, 22.4% for diabetes, 49.8% for hypertriglyceridemia and 40.9% for hypercholesterolemia. CONCLUSIONS: Hypertension occurs in 18% of this population. There is a high prevalence of undiagnosed and untreated cases. Associated cardiovascular risk factors are highly prevalent.

Rapid rise in the incidence of type 2 diabetes from 1987 to 1996: results from the San Antonio Heart Study.

BACKGROUND: The prevalence of type 2 diabetes has increased in the early part of the 20th century, particularly in developing countries. There is now evidence that the prevalence also continues to increase in developed countries, including the United States. However, it is unknown whether this increase is due to a rise in the incidence of diabetes or to decreasing diabetic mortality or both. METHODS: Participants in the San Antonio Heart Study, who were nondiabetic at baseline and who returned for a 7- to 8-year follow-up examination, were examined for secular trends in the incidence of type 2 diabetes. Risk factors for diabetes, such as obesity, were also examined. Patients were enrolled in the San Antonio Heart Study from 1979 to 1988 and 7- to 8-year incidence of diabetes was determined from 1987 to 1996. RESULTS: A significant secular trend in the 7- to 8-year incidence of type 2 diabetes was observed in Mexican Americans (5.7% for participants enrolled in 1979 to 15.7% for participants enrolled in 1988). In non-Hispanic whites, the incidence increased from 2.6% for participants enrolled in 1980 to 9.4% for participants enrolled in 1988 (P = .07) . After adjusting for age and sex, the secular trend remained significant in Mexican Americans and borderline significant in non-Hispanic whites. This indicates that between 1987 and 1996 the 7- to 8-year incidence of type 2 diabetes approximately tripled in both ethnic groups. The overall secular trend also remained significant after adjusting for additional risk factors for diabetes, such as obesity. A rising secular trend in obesity was also observed. CONCLUSIONS: There has been a significant increasing secular trend in the incidence of type 2 diabetes in Mexican Americans and a borderline significant trend in non-Hispanic whites participating in the San Antonio Heart Study. Unlike other cardiovascular risk factors such as lipid levels, cigarette smoking, and blood pressure, which are either declining or under progressively better medical management and control, and unlike cardiovascular mortality, which is also declining, obesity and type 2 diabetes are exhibiting increasing trends. Thus, obesity and diabetes could easily become the preeminent US public health problem.

Continuing medical education versus clinic-based STD and HIV education interventions for primary care service providers: replication and extension.

An evaluation of a 2-day sexually transmitted disease (STD) and HIV and AIDS curriculum for primary care providers is presented which compares large scale continuing medical education (CME) conferences with smaller clinic workshop (CW) models with regard to short-term (2-month) and long-term (10-month) program effects on STD and HIV knowledge, attitudes toward risk assessment, and frequency of both STD diagnosis and STD and HIV risk counseling. Data from interventions held in San Antonio, Texas (328 CME; 95 CW) replicate and extend earlier findings from a preliminary intervention, indicating nonsignificant CME-CW differences and dramatic and long-lasting gains from baseline among those with lower knowledge and experience levels preintervention. Similar program effect magnitudes were found for attitude and practice dimensions at 2 months postintervention, with the strongest consistent short and long-term program effects observed for STD and HIV knowledge among service providers.

Reversion from type 2 diabetes to nondiabetic status. Influence of the 1997 American Diabetes Association criteria.

OBJECTIVE: To determine the incidence and the rate of reversion of type 2 diabetes to a nondiabetic status in the 7- to 8-year follow-up of the San Antonio Heart Study, and to determine the influence of the recent 1997 American Diabetes Association (ADA) criteria for diabetes on these rates. Individuals who revert have been problematic for those developing criteria for the diagnosis of type 2 diabetes. Few studies have addressed this issue using 1979 National Diabetes Data Group/1980 World Health Organization (WHO) criteria. RESEARCH DESIGN AND METHODS: We studied 3,682 Mexican-American and non-Hispanic white men and nonpregnant women who completed both the baseline and follow-up examination of the San Antonio Heart Study. Incidence and reversion rates were calculated using both the 1980 WHO and the 1997 ADA criteria. Risk factors for reversion were identified, and the best fitting model using multiple logistic regression was determined using both the 1980 WHO and the 1997 ADA criteria. RESULTS: Using the 1997 ADA criteria, the age-adjusted incidences of type 2 diabetes for Mexican-American men and women were 10.8 and 12.2%, respectively. For non-Hispanic white men and women, the age-adjusted incidence rates were 5.5 and 5.1%, respectively. Similar age-adjusted incidences were recorded using the 1980 WHO criteria. The reversion rate for individuals with type 2 diabetes was 11.5% using the 1980 WHO criteria and 12.5% using the 1997 ADA criteria. These rates were not significantly different. Numerous risk factors for reversion were identified. The best fitting model, after controlling for age, sex, and ethnicity, included baseline 2-h glucose level, baseline HDL cholesterol, and previous diagnosis of diabetes. The models were the same for both the 1980 WHO and the 1997 ADA criteria. CONCLUSIONS: There was no significant difference in the incidence or the reversion rates for diabetic subjects using either 1980 WHO or 1997 ADA criteria. In addition, the risk factors for reversion were very similar using either set of criteria. The revision of the ADA criteria did not have a significant influence on reversion in this study.

Radiation exposure in the myelomeningocele population.

Radiation-induced carcinoma is known to occur with lower doses of radiation exposure than previously recognized. The myelomeningocele population, because of its complex medical problems, is exposed to relatively high doses of radiation from diagnostic radiographs performed throughout their lives. To quantify the amount of exposure, we have calculated the total lifetime radiographic exposure for patients in a myelomeningocele clinic. Out of a myelomeningocele clinic of 248 patients, 112 were identified who had been followed in the clinic since birth. A retrospective history of radiographic exposure was obtained for each patient by reviewing the hospital X-ray jackets. Using standard radiographic dose tables, calculations of total radiation exposure were performed for each patient. The total skin dose exposure ranged from 3.96 to 171.29 rad with a mean of 42.99 rad (SD 33.58). The total skin dose per year of life ranged from 0.79 to 37.81 rad/year of life with a mean of 6.38 rad/year of life (SD 5.72). The total red marrow dose ranged from 0.3 to 29.04 rad with a mean of 7.02 rad (SD 6.24). The total red marrow dose per year of life ranged from 0. 1 to 5.35 rad/year of life with a mean of 1.01 rad/year of life (SD 1.06). These data suggest that the radiation burden from diagnostic radiographs in the myelomeningocele population may ultimately contribute to carcinogenesis, mutagenesis and other radiation damage. Specific strategies for reducing the lifetime radiographic exposure in these patients are discussed in detail.

Laparoscopic surgery in a patient with a ventriculoperitoneal shunt: a new technique.

With advances in the treatment of hydrocephalus, patients with ventriculoperitoneal shunts (VPS) often have normal life expectancies. They are therefore more commonly requiring abdominal surgery. Laparoscopic surgery has become the favored technique for performing many of these operations. However, the presence of a VPS has been considered a contraindication or hazard in performing many of these laparoscopic operations. We present a case report of a laparoscopic Toupet fundoplication in a patient with a VPS and describe a technique for the successful management of the VPS throughout the procedure with no adverse sequelae.