Does the purchase of a mobility scooter alter physical activity levels in older adults?

Purpose: This cohort study investigated changes in physical activity, community mobility and social participation following the first-time purchase of a mobility scooter.Methods: A national sample of persons aged 65+ years was surveyed using customized semi-structured interviews that explored changes in physical activity via the International Physical Activity Questionnaire modified for the elderly, and community involvement. Participants were recruited at the point of purchase of their first mobility scooter, and interviewed at this time and again at 2 and 6 months post-purchase.Results: Eighteen participants (F = 10, M = 8) aged between 65 and 95 years were recruited. Physical activity levels remained unchanged in 12 participants, and declined by at least one category in five participants. All participants reported improvement to their self-perceived quality of life following acquisition of a mobility scooter. Participants did not access additional forms of physical activity, though nine reported increased social participation. At baseline, five participants stated that the scooter was used for journeys they formerly made by other motorized transport, and by the 6-month interview, this number had risen to 15 participants.Conclusions: It is unlikely that changes in physical activity were related to the ageing process given the relatively short time span of the study. Thus it can be inferred that participants viewed their mobility scooter as a vehicle for maintaining their lifestyle rather than as a means to seek out additional activities. Improvements to perceived quality of life may be attributed to continuing or furthering community and social engagement, and a sense of retained independence.Implications for rehabilitationAn awareness of possible changes in physical activity associated with the purchase of a mobility scooter is needed.The purchase of a mobility scooter provides a viable means of transport to facilitate access to physical activity situations.Over-reliance on a mobility scooter has the potential to decrease health-related physical activity.The development and dissemination of a targeted health message about maintaining (or improving) physical activity levels is warranted to increase the awareness in this growing group of new, and current, mobility scooter riders in an increasingly ageing population.

Influence of corn hybrid and processing method on nutrient digestibility, finishing performance, and carcass characteristics.

A finishing trial and a digestion trial were conducted to evaluate the effects of corn hybrid and processing method on nutrient digestibility, finishing performance, and carcass characteristics. A 2 x 5 factorial arrangement of treatments was used for both trials. Factors included 2 processing methods, dry-rolled (DRC) or high-moisture (HMC), and 5 commercially available corn hybrids. The finishing trial (Exp. 1) utilized 475 yearling steers (379 +/- 15 kg initial BW), stratified by BW into 2 blocks then assigned randomly to 1 of 60 pens (8 steers/pen). Treatments were assigned randomly to pens with 6 pens/treatment. Diets consisted of 67.5% corn (each hybrid processed as DRC or HMC), 20% wet corn gluten feed, 7.5% alfalfa hay, and 5% supplement. The digestion trial (Exp. 2) used 2 ruminally and duodenally fistulated Holstein steers (560 kg of BW) and the mobile bag technique. Bags were ruminally incubated for 22 h. For total tract digestibility, bags were subjected to a simulated abomasal pepsin digestion, inserted into the duodenum, and collected in the feces. No significant interactions between corn hybrid and processing method were observed in Exp. 1; therefore, only main effects are presented. Feeding HMC decreased (P < 0.01) DMI and increased (P < 0.01) G:F compared with cattle fed DRC. Hybrid tended to affect (P = 0.12) G:F, but did not affect (P > 0.36) any other variable. For Exp. 2, feeding HMC increased (P < 0.01) DM and starch digestibility compared with DRC, but to varying degrees depending on the hybrid. Correlating the results of the 2 trials across processing methods, strong relationships were observed between G:F and postruminal starch digestibility (r = 0.84) and total-tract starch digestibility (r = 0.73). When evaluated within processing method, these relationships weakened and were not significant. The results of these trials indicate that processing method had a larger effect on performance and digestibility than hybrid, and no interaction was observed between processing method and hybrid, suggesting hybrid effects were consistent across processing methods.

Thermal behavior of resistant starches RS 2, RS 3, and RS 4.

The thermal behaviors of 3 resistant starch types-RS 2, RS 3, and RS 4-were investigated. Samples were heated in excess water to specific temperatures, from 35 to 85 degrees C at 5 degrees C intervals, and freeze-dried. The treated samples were analyzed using SEM, DSC, XRD, and HPSEC to determine the structural changes at granular and molecular levels. Light microscopy was used to determine real-time thermal behavior of the starches. Although the resistant starches did not show significant morphological changes, as revealed by microscopy, they underwent internal structural changes at low temperatures before complete phase transitions occurred. The structural changes were less in RS 2 compared to the other 2 starches studied. The nongranular material of RS 3's crystallinity decreased gradually from 35 to 85 degrees C and showed microscopically visible changes at >80 degrees C. Cross-linking might have prevented RS 4 from becoming completely amorphous within the temperature range (35 to 85 degrees C) tested. The study indicated that the extent of structural changes depended on the treatment temperature and RS type.

Army field surgical experience.

In the recent Falklands campaign four Army Field Surgical Teams were deployed in the two phases of the war. They functioned as Advanced Surgical Centres and operated on 233 casualties. There were 3 deaths. The patterns of wounding and the methods of casualty management are discussed and compared with other recent campaigns.

First and second line treatment--a retrospective view.

The case history of a single casualty is recorded. A critique of aspects of his treatment is presented. Some suggestions for modifying aspects of his treatment are considered. A factual account of the wounds received by a soldier during one of the land battles in the Falklands Campaign is presented together with an account of his initial (first and second line) and subsequent (third and fourth line) treatment. Comments and suggestions are offered on aspects of treatment given in the first and second line medical facilities as they existed during the Falklands Campaign.

Soldiers injured during the Falklands campaign 1982. Sepsis in soft tissue limb wounds.

The factors related to the development of sepsis in the soft tissue limb injuries sustained by soldiers during the Falkland Campaign have been assessed. Delay in surgery and delay in antibiotic administration are the most important factors, and where delay in surgery is inevitable, delay in antibiotic administration assumes an even greater importance.

Petrography of gypsum-bearing facies of the Codó Formation (Late Aptian), Northern Brazil.

An original and detailed study focusing the petrography of evaporites from the Late Aptian deposits exposed in the eastern and southern São Luís-Grajaú Basin is presented herein, with the attempt of distinguishing between primary and secondary evaporites, and reconstructing their post-depositional evolution. Seven evaporites phases were recognized: 1. chevron gypsum; 2. nodular to lensoidal gypsum or anhydrite; 3. fibrous to acicular gypsum; 4. mosaic gypsum; 5. brecciated gypsum or gypsarenite; 6. pseudo-nodular anhydrite or gypsum; and 7. rosettes of gypsum. The three first phases of gypsum display petrographic characteristics that conform to a primary nature. The fibrous to acicular and mosaic gypsum were formed by replacement of primary gypsum, but their origin took place during the eodiagenesis, still under influence of the depositional setting. These gypsum morphologies are closely related to the laminated evaporites, serving to demonstrate that their formation was related to replacements that did not affect the primary sedimentary structures. The pseudo-nodular anhydrite or gypsum seems to have originated by mobilization of sulfate-rich fluids during burial, probably related to halokinesis. The rosettes of gypsum, which intercept all the other gypsum varieties, represent the latest phase of evaporite formation in the study area, resulting from either intrastratal waters or surface waters during weathering.

Influence of corn hybrid traits on digestibility and the efficiency of gain in feedlot cattle.

Two experiments were conducted to determine the influence of chemical and physical corn kernel traits on digestibility and feedlot cattle performance. Seven commercially available corn hybrids representing a range in kernel traits were evaluated for a variety of chemical and physical traits that included test weight, 1,000-grain weight, kernel size, starch, CP, amylose, Stenvert Hardness tests (kernel hardness traits), tangential abrasive dehulling device loss, 12-h in vitro starch disappearance, and rate and extent of in situ DM disappearance. Differences among hybrids existed for all physical kernel traits measured. In Exp. 1, 224 steers in 28 pens were fed the same hybrids for 167 d in a completely randomized design. All diets were formulated to have 12.5% CP and contained 66% dry-rolled corn (DM basis). There were no differences (P >0.20) among corn hybrids for DMI, ADG, or carcass characteristics. However, efficiency of gain (G:F) was influenced by hybrid (P < 0.01) with a difference of 9.5% from the least to the most efficient. In Exp. 2, 7 ruminally cannulated heifers were used in a 7 x 7 Latin square design to determine the effects of these hybrids on nutrient digestibility, VFA concentrations, and ruminal pH. Total-tract OM and starch digestibilities were not different (P >0.15) among hybrids and averaged 77.9 and 95.1%, respectively. Differences (P < 0.05) among hybrids existed for ruminal propionate concentration and the acetate to propionate ratio. Kernel hardness traits correlated (P < 0.05) with G:F were 1,000-grain weight (r = -0.81), Stenvert time to grind (r = -0.83), and the proportion of Stenvert soft to coarse particle height (r = 0.83). Propionate concentration was not correlated (r = 0.45) with G:F but was correlated (P = 0.02) to the Stenvert time to grind (r = -0.83). Cattle fed dry-rolled corn hybrids with greater proportions of soft endosperm had greater concentrations of propionate and gained more efficiently than cattle fed hybrids with a harder endosperm. Selecting for these softer kernel traits may improve the efficiency of gain in feedlot cattle.

Growth of adolescents who were born at extremely low birth weight without major disability.

OBJECTIVE: To compare growth between adolescents who were born at extremely low birth weight (ELBW, /=2500 g). DESIGN/METHODS: Cross-sectional design. Fifty-three ELBW and 53 NBW adolescents without a major neurodevelopmental disability were matched by sex, race, age, and socioeconomic status. Anthropometrics (z scores), bone age, body composition (Lunar DPX-L densitometry), and sexual maturity were assessed. ELBW adolescents were classified as being born small for gestational age (SGA) or not (NSGA). RESULTS: Subjects were 58.5% female, 43.4% black, and 56.6% white. The mean birth weight for ELBW subjects was 849 g and 3355 g for NBW subjects. The mean age was 14.85 years. On average, ELBW adolescents were 4.8 cm shorter and 9.1 kg lighter than NBW adolescents. ELBW adolescents had lower mean z scores for height (P <.0001), weight (P <.0001), and head circumference (P <.0001) than NBW adolescents. ELBW/SGA subjects had lower mean z scores for height (P <.0001) and weight (P =.001) than NBW subjects. Head circumference z scores were lower for the ELBW/SGA group than the ELBW/NSGA group or the NBW group (P =. 003). Sexual maturity and relative body composition were similar between groups. Bone age, measured in SD units, was more advanced in the ELBW group (0.86 vs. 0.42, P =.039). CONCLUSIONS: ELBW adolescents who survive without a major neurodevelopmental disability attain lower growth measurements compared with NBW adolescents but have similar sexual maturation and relative body composition.

Synthesis and evaluation of diphenyl phosphonate esters as inhibitors of the trypsin-like granzymes A and K and mast cell tryptase.

Thirty-six new amino acid and peptidyl diphenyl phosphonate esters were synthesized and evaluated to identify potent and selective inhibitors for four trypsin-like proteases: lymphocyte granzymes A and K, human mast cell tryptase, and pancreatic trypsin. Among five Cbz derivatives of Lys and Arg homologues, Z-(4-AmPhe)P(OPh)2 is the most potent inhibitor for granzyme A, and Z-LysP(OPh)2 is the best inhibitor for granzyme K, mast tryptase, and trypsin. The amidino P1 residue D,L-(4-AmPhGly)P(OPh)2 was utilized in a series of compounds with several different N-protecting groups and systematic substitutions at P2 in Cbz-AA derivatives and at P3 in Cbz-AA-Ala derivatives. Generally, these phosphonates inhibit granzyme A and trypsin more potently than granzyme K and tryptase. The P2 Thr and Ala dipeptide phosphonates, Cbz-AA-(4-AmPhGly)P(OPh)2, are the most potent inhibitors for granzyme A, and Cbz-Thr-(4-AmPhGly)P(OPh)2 (kobs/[I] = 2220 M-1 s-1) was quite specific with much lower inhibition rates for granzyme K and trypsin (kobs/[I] = 3 and 97 M-1 s-1, respectively) and no inhibition with tryptase. The most effective inhibitor of granzyme A was Ph-SO2-Gly-Pro-(4-AmPhGly)P(OPh)2 with a second-order rate constant of 3650 M-1 s-1. The most potent inhibitor for granzyme K was 3, 3-diphenylpropanoyl-Pro-(4-AmPhGly)P(OPh)2 with a kobs/[I] = 1830 M-1 s-1; all other phosphonates inhibited granzyme K weakly (kobs/[I] < 60 M-1 s-1). Human mast cell tryptase was inhibited slowly by these phosphonates with Cbz-LysP(OPh)2 as the best inhibitor (kobs/[I] = 89 M-1 s-1). The overall results suggest that scaffolds of Phe-Thr-(4-AmPhe) and Phe-Pro-Lys will be useful to create selective phosphonate inhibitors for granzymes A and K, respectively, and that P4 substituents offer opportunities to further enhance selectivity and reactivity.

Purification and characterization of lymphocyte chymase I, a granzyme implicated in perforin-mediated lysis.

One mechanism of killing by cytotoxic lymphocytes involves the exocytosis of specialized granules. The released granules contain perforin, which assembles into pores in the membranes of cells targeted for death. Serine proteases termed granzymes are present in the cytotoxic granules and include several chymases (with chymotrypsin-like specificity of cleavage). One chymase is selectively reactive with an inhibitor, Biotinyl-Aca-Aca-Phe-Leu-PheP(OPh)2, that blocks perforin lysis. We report the purification and characterization of this chymase, lymphocyte chymase I, from rat natural killer cell (RNK)-16 granules. Lymphocyte chymase I is 30 kDa with a pH 7.5 to 9 optimum and primary substrate preference for tryptophan, a preference distinct from rat mast cell chymases. This chymase also reacts with other selective serine protease inhibitors that block perforin pore formation. It elutes by Cu2+-immobilized metal affinity chromatography with other granzymes and has the N-terminal protein sequence conserved among granzymes. Chymase I reduces pore formation when preincubated with perforin at 37 degrees C. In contrast, addition of the chymase without preincubation had little effect on lysis. It should be noted that the perforin preparation contained sufficient residual chymase activity to support lysis. Thus, the reduction of lysis may represent an effect of excess prolytic chymase I or a means to limit perforin lysis of bystander cells. In contrast, other chymases and granzyme K were without effect when added to perforin during similar preincubation. Identification of the natural substrate of chymase I will help resolve how it regulates perforin-mediated pore formation.

Synthesis and kinetic studies of diphenyl 1-(N-peptidylamino)alkanephosphonate esters and their biotinylated derivatives as inhibitors of serine proteases and probes for lymphocyte granzymes.

Diphenyl 1-(N-peptidylamino)alkanephosphonate esters are highly reactive, specific, and aqueously stable irreversible inhibitors which can be used to probe the functions of many serine proteases, including the lymphocyte granzymes. We synthesized 16 peptide phosphonates with Ala, Met, Phe, or Val P1 amino acid residues, including two biotinylated derivatives for future functional and biochemical characterization of granzymes. The reactivity of the inhibitors was characterized with human leukocyte elastase (HLE), porcine pancreatic elastase (PPE), bovine chymotrypsin, and the granzymes of natural killer (NK) cells, which include a number of proteolytic activities (Asp-ase, Met-ase, etc.) that cleave peptide substrates with these residues in the P1 position. The reactivity and specificity of the phosphonates depended on the length and sequence of the peptidyl moiety and on the leaving group. Z-Ala-Ala-AlaP(OPh)2 was a good inhibitor of HLE and PPE (k(obsd)/[I] = 38 and 30 M(-1) s(-1), respectively) and had little reactivity with chymotrypsin. Z-Phe-Pro-Phe-P(OPh)2 was a good inhibitor of chymotrypsin (k(obsd)/[I] = 17,000 M(-1) s(-1)) and had little reactivity with the elastases. The leaving group of Z-MetP(OPh-4-Cl)2 made it a more effective chymotrypsin inhibitor than Z-MetP(OPh)2 (k(obsd)/[I] values of 142 and 30 M(-1) s(-1), respectively). With granzymes, the compounds reacted with a fraction of the Met-ase, chymase, and Ser-ase activities and lacked reactivity with Asp-ase and tryptase. Z-MetP(OPh-4-Cl)2 was an excellent inhibitor of Met-ase 1. Bi-Aca-Aca-Phe-Leu-PheP(OPh)2 appears to react specifically with one chymase while leaving other chymases untouched. Perforin-dependent lysis mediated by cytotoxic lymphocyte granules was inactivated by Z-Ala-Ala-AlaP(OPh)2, Z-MetP(OPh-4-Cl)2, Z-Leu-PheP(OPh)2, and Bi-Aca-Aca-Phe-Leu-PheP(OPh)2. The biochemical properties and biological efficacy of these inhibitors make them suitable for cellular and physiological studies of granzyme function.

A kinetic study of the hydrolysis of the N-tosylalanine ester of 3-hydroxy-5-phenylpyrrole and related compounds by human leukocyte elastase.

The tosylalanine ester of 3-hydroxy-5-phenylpyrrole (HOPPy) is localized on reagent strips (Ames LEUKOSTIX) and used diagnostically to test urine for the presence of human leukocyte elastase (HLE) as an indication of urinary tract infection. We have determined the kinetic constants for the HLE-catalyzed hydrolysis of this substrate and the related substrates Tos-Ala-ONp, Cbz-Ala-OPPy, and Cbz-Ala-ONp, in solution at three different pH values. In the reagent strip matrix, diazo coupling of 4-diazo-3-hydroxy-1-napthylsulfonate (HONapN+2) with the enzymatic hydrolysis product HOPPy generates a purple color. We have also studied the kinetics of the reaction of HOPPy with HONapN+2 and other related diazonium salts such as 4-diazo-3-hydroxy-7-nitro-1-napthylsulfonate, 4-diazo-3-hydroxy-1,7-napthyldisulfonate, and 2-methoxy-4-(N-morpholinyl)benzene diazonium chloride. Tos-Ala-OPPy is the most reactive substrate among the compounds examined and kinetic studies indicate that deacylation is rate-limiting for HLE hydrolysis. The presence of decanol accelerates the enzymatic hydrolysis of Tos-Ala-OPPy with a kcat/KM = 10(7) M-1 s-1, which is close to the diffusion-controlled limit. For the diazo coupling reaction, the rate is affected by the substituents on the naphthalene ring and by the buffer in which the reaction occurs. This research has elucidated some important mechanistic features for the reaction of these compounds and may lead to improved methods for the detection of leukocyte elastase.

Corn wet milling: separation chemistry and technology.

Corn wet milling is a complicated, large-scale, and efficient industrial process designed to separate the chemical components from corn kernels. The success of wet milling, in terms of maximum yields, is largely dependent on the success of the steeping process. Improper steeping, or steeping of corn kernels that have unusual physical or chemical structures, results in lost product and lower profits. Steeping processes, however, are still based largely on an art that was developed more than 100 years ago. In the next 20 years, major seed corn producers expect that the market for corn with unique starch characteristics and corn bred to produce speciality chemicals or have an altered composition will expand substantially. As the market increases for speciality corn, corn genetically bred with unique starch charcteristics or corn with altered chemical composition, a thorough scientific understanding of steeping chemistry and the entire wet milling process will become increasingly important.

Chymase-directed serine protease inhibitor that reacts with a single 30-kDa granzyme and blocks NK-mediated cytotoxicity.

Cytotoxic NK and T lymphocytes kill virally infected cells within minutes without causing damage to themselves or bystander cells. One mechanism of killing involves exocytosis of granules containing serine proteases and perforin. Serine protease inhibitors block killing of target cells mediated by the cytotoxic lymphocytes. There are at least five different serine protease activities in cytolytic granules. Ten different serine protease sequences have been identified with the use of cDNA-specific clones. It is not known whether only one or several of these serine proteases are essential for cytolytic activity. In this study we show that an irreversible serine protease inhibitor, biotinyl-Aca-Aca-Phe-Leu-PheP(OPh)2, selectively inhibits a chymotrypsin-like (chymase) serine protease activity of rat RNK-16 granule extracts. Under the same conditions, only one 30-kDa (reduced) band was detected on protein blots. Furthermore, only one of three chymase peaks separated by hydrophobic interaction chromatography was inhibited. When this granzyme was inhibited, granule-mediated lysis of erythrocytes was diminished. NK cell killing was completely blocked when biotinyl-Aca-Aca-Phe-Leu-PheP(OPh)2 was added to cytotoxicity assays at 200 microM with rat splenocytes as effectors. By confocal fluorescence microscopy, we show that this inhibitor localizes to distinct regions within RNK-16 cells and rat NK cells. Inhibitor treatment of intact cells inactivated the chymase activity and reduced lysis found in their dense organelles. Together these data indicate that biotinyl-Aca-Aca-Phe-Leu-PheP(OPh)2 inhibits a granule chymase that is essential to cytolytic activity of NK cells.

Practical applications of element-specific detection by inductively coupled plasma atomic emission spectroscopy and inductively coupled plasma mass spectrometry to ion chromatography of foods.

Three practical examples are presented to demonstrate the utility of element-selective detection for ion chromatography (IC). The determination of As species in a liquid health food supplement by IC with inductively coupled plasma atomic emission spectroscopy (IC-ICP-AES) is shown to confirm results obtained for total As. IC-ICP-AES is also used to investigate the identity of an unknown peak in a sample of shrimp commercially treated with tripolyphosphate. Finally, results are presented for the determination of residual bromate in baked goods by IC with inductively coupled plasma mass spectrometry detection.

Aggressive management of intra-arterial Temazepam injection.

Intravenous injection of the oral formulation of Temazepam is a common form of drug abuse. At the request of the Home Office, manufacturers have developed solid dose forms to replace the liquid filled capsules, but a number of cases of accidental intra-arterial injection of the new formulation have been reported, with varying management strategies advocated. A case is presented where prompt aggressive management using surgical and pharmacological measures resulted in complete limb salvage. Previous reported cases and management options are discussed.

Polyorchidism: functional classification and management strategy.

Polyorchidism is rare. We report a recent case and review the literature. A simple classification based on anatomic and functional arrangements of the testes and their drainage systems is described. Combining this classification with a knowledge of potential complications, we propose a management strategy.