Association between a Frailty Index from Common Laboratory Values and Vital Signs (FI-LAB) and Hospital and Post-Hospital Outcomes in Veterans with COVID-19 Infection.

OBJECTIVES: Determine the association of higher FI-LAB scores, derived from common laboratory values and vital signs, with hospital and post-hospital outcomes in Veterans hospitalized with COVID-19 infection. DESIGN, SETTING, AND PARTICIPANTS: A retrospective, multicenter, cohort study of 7 Veterans Health Administration (VHA) medical centers in Florida and Puerto Rico. Patients aged 18 years and older hospitalized with COVID-19 and followed for up to 1 year post discharge or until death. Clinical Frailty Measure: FI-LAB. MAIN OUTCOMES AND MEASURES: Hospital and post-hospital outcomes. RESULTS: Of the 671 eligible patients, 615 (91.5%) patients were included (mean [SD] age, 66.1 [14.8] years; 577 men [93.8%]; median stay, 8 days [IQR:3-15]. There were sixty-one in-hospital deaths. Veterans in the moderate and high FI-LAB groups had a higher proportion of inpatient mortality (13.3% and 20.6%, respectively) than the low group (4.1%), p <0.001. Moderate and high FI-LAB scores were associated with greater inpatient mortality when compared to the low group, OR:3.22 (95%CI:1.59-6.54), p=.001 and 6.05 (95%CI:2.48-14.74), p<0.001, respectively. Compared with low FI-LAB scores, moderate and high scores were also associated with prolonged length of stay, intensive care unit (ICU) admission, and transfer. CONCLUSIONS AND RELEVANCE: In this study of patients admitted to 7 VHA Hospitals during the first surge of the pandemic, higher FI-LAB scores were associated with higher in-hospital mortality and other in-hospital outcomes; FI-LAB can serve as a validated, rapid, feasible, and objective frailty tool in hospitalized adults with COVID-19 that can aid clinical care.

Tetraploidy enhances the ability to exclude chloride from leaves in carrizo citrange seedlings.

Tetraploid citrus seedlings are more tolerant to salt stress than diploid genotypes. To provide insight into the causes of differences in salt tolerance due to ploidy and thus to better understand Cl- exclusion mechanisms in citrus, diploid and tetraploid seedlings of Carrizo citrange (CC) were grown at 0 (control) and 40mM NaCl (salt-treated) medium for 20 days. Chloride uptake and root-to-shoot translocation rates were on average 1.4-fold higher in diploid than in tetraploid salt-treated plants, which resulted in a greater (1.6-fold) Cl- build up in the leaves of the former. Root hydraulic conductance and leaf transpiration rate were 58% and 17% lower, respectively, in tetraploid than in diploid control plants. Differences remained after salt treatment which reduced these parameters by 30-40% in both genotypes. Morphology of the root system was significantly influenced by ploidy. Tetraploid roots were less branched and with lower number of root tips than those of diploid plants. The cross-section diameter and area were lower in the diploid, and consequently specific root length was higher (1.7-fold) than in tetraploid plants. The exodermis in sections close to the root apex was broader and with higher deposition of suberin in cell walls in the tetraploid than in the diploid genotype. Net CO2 assimilation rate in tetraploid salt-treated seedlings was 1.5-fold higher than in diploid salt-treated plants, likely due to the loss of photosynthetic capacity of diploid plants induced by Cl- toxicity. Leaf damage was much higher, in terms of burnt area and defoliation, in diploid than in tetraploid salt-treated plants (8- and 6-fold, respectively). Salt treatment significantly reduced (37%) the dry weight of the diploid plants, but did not affect the tetraploids. In conclusion, tetraploid CC plants appear more tolerant to salinization and this effect seems mainly due to differences in morphological and histological traits of roots affecting hydraulic conductance and transpiration rate. These results may suggest that tetraploid CC used as rootstock could improve salt tolerance in citrus trees.

Cryptic extended brood care in the facultatively eusocial sweat bee Megalopta genalis.

As a result of different brood cell provisioning strategies, nest-making insects may differ in the extent to which adults regularly provide extended parental care to their brood beyond nest defense. Mass-provisioning species cache the entire food supply needed for larval development prior to the oviposition and typically seal the brood cell. It is usually assumed that there is no regular contact between the adult(s) and brood. Here, we show that the bee, Megalopta genalis, expresses a form of cryptic brood care, which would not be observed during normal development. Following experimental injections of different provisioning materials into brood cells, foundresses reopened manipulated cells and the brood were aborted in some cases, implying that the foundresses assessed conditions within the cells. In aborted cells, foundresses sometimes laid a second egg after first removing dead larvae, previously stored pollen and contaminants. Our results show that hygienic brood care can be cryptic and hence may be more widespread than previously believed, lending support to the hypothesis that extended parental care is a preadaptation toward eusociality.

Affective style and eating disorders: a field study.

Eating disorders (ED) are a heterogeneous group of problems related to restraint and/or overeating. It is proposed that individual differences in affective reactivity and moods (affective style) might be related to these behaviours. Variations in affective style are expressed by differing levels of sensitivity to the motivation systems of approach and avoidance. The present study tested whether a relation exists between ED and variations in the sensitivity of motivational systems as well as mood dispositions. A total of 2020 undergraduate students completed the Eating Disorder Diagnostic Scale (EDDS), the Behavioural Inhibition System and Behavioural Activation System Scales (BIS/BAS), and the Positive and Negative Affect Schedule (PANAS). The results showed a significant within- subject interaction of Alimentary group x Motivation (F=4.056; p<0.007). It was also observed that the Overeating group had lower levels of motivation asymmetry than the Normal (p<0.01) and Restrictive (p<0.005) groups and marginally lower levels than the Purgative group (p<0.07). The study results suggest mainly that the avoidance/inhibition motivational system is related to eating problems connected with overeating, including chronic alimentary restraint (chronic dieters). The theoretical and clinical implications of these findings are discussed.

[Endonasal tubes as cause of pressure ulcers in the critical patient]. / Sondas endonasales como causa de las úlceras por presión en el paciente crítico.

INTRODUCTION: One of the risks of using endonasal tubes (ET) is the appearance of pressure ulcers (PU). OBJECTIVE: To ascertain the proportion of patients with nasal PU, study the risk factors of appearance, and find predictive variables. MATERIAL AND METHODS: A six-month prospective, observational study of intensive care unit patients with ET. VARIABLES: Variable response: "the appearance of pu as a result of the use of ET". Explanatory variables: age, duration of stay, length of time with ET, gender, sedation, norepinephrine perfusion, mechanical ventilation, anemia, nutritional state. ANALYSIS: multivariate statistical techniques (multiple logistical regression). Statistics program g-stat 2.0. Significance level p < 0.05. RESULTS: Sample of 48 patients. Proportion of patients with PU: 29.2%. Those patients with PU had similar ages, duration of stay and longer length of time with ET. Results of the Logistic Regression model: only the variable "time with ET" was statistically significant (p = 0.03; odds ratio: 1.047). CONCLUSIONS: The length of time the patient is using an ET influences the appearance of nasal PU (risk increases 1.047 for each day with ET). None of the variables dealt with could be used as a predictive factor in the appearance of PU.

Estudio comparativo de estresores y apoyo psicosocial en adolescentes embarazadas en cinco ciudades de la República Mexicana / Comparative study of stressors and psychosocial support in pregnant adolescents in five cities of the Mexican Republique

El embarazo en la adolescencia es un evento que en los últimos años se ha estudiado de manera prioritaria desde diferentes enfoques y perspectivas. El propósito de este estudio, fue generar información acerca de la percepción que tienen las adolescentes durante su embarazo, referente tanto a estresores como al apoyo psicosocial. Comparandose dos grupos de adolescentes embarazadas en cinco ciudades de la República Mexicana (Durango, Fresnillo, Zacatecas, Ciudad de México y Morelia). Uno de ellos formado por 114 casos de adolescentes con el diagnóstico de hipertensión inducida por el embarazo (HIE), y otro constituido por 223 cualificadas como "sanas" (grupo control); se establecieron comparaciones en lo referente a la percepción tanto de experiencias estresantes como de eventos gratificantes en relación a la red familiar y social. El trabajo aporta algunos elementos conceptuales que permiten describir, la percepción que tiene la adolescente embarazada de su entorno psicosocial identificando aspectos que tentativamente se proponen como factores que influyen en el desencadenamiento de problemas de salud

Pregnancy in the adolescente has beenstudied on a high-priority way from different approachesand perspectives in the last years. Theaim of this study, was to explore information onthe perception of the adolescents during her pregnancy,both referred to stressors and to psychosocialsupport. Two groups of pregnant adolescentsin five cities of the Mexican Republic (Durango,Fresnillo, Zacatecas, Morelia and Mexico City)were compared. One of them forrned by 114 adolescentcases with the diagnosis of pregnancy inducedhypertension (PIH), and other one constitutedby 223 qualified as "healthy" (controlgroup). Comparisons of stress fui experiences andgrateful events in relation to the familiar and socialnet were conducted. This work contributes todescribe several factors of the psychosocial environmentthat tentatively intluence the triggeringproblem ofhealth in the pregnant adolescent

Hipertensión inducida por el embarzo en adolescents: un studio multicéntrico / Pregnancy-induced hipertensión in young women: a multicenter study

Se evaluó la situación psicosocial percibida durante el proceso gestacional por dos grupos de adolescentes, un grupo se formó por 114 mujeres en quienes se estableció el diagnóstico de hipertensión inducida por el embarazo (HIE) y el otro por mujeres que fueron cualificadas como "sanas" (n=223). Fueron entrevistadas 337 mujeres adolescentes de las ciudades de Durango, Zacatecas, Fresnillo, Morelia y ciudad de México, que acudieron a instituciones hospitalarias de la Secretaría de Salud (SSA), y del Instituto Mexicano del Seguro Social (IMSS), de septiembre de 1998 a enero del 2000. Se aplicó a todas las participantes un cuestionario, para la identificación de estresores psicosociales y apoyo psicosocial. Se emplearon estadísticos descriptivos; X2 y estimación logarítmica media de razón de momios con IC. a 95%. Se observó una percepción más favorable de la situación psicosocial en las integrantes del grupo control. La situación psicosocial desfavorable identificada en el grupo de casos, sugiere su vinculación con los mecanismos biológicos responsables de la expresión de la HIE

To evaluate the psychosocial condition during pregnancy, as seen by two groups of young pregnant women from five cities in Mexico, women suffering from pregnancy-induced hypertension (PIH) were gathered into a group (n=l14). While women with a normal pregnancy formed another group (n=223). 337 young women from Durango, Zacatecas, Fresnillo, Morelia and Mexico City, were interviewed. They were submitted for obstetric care into hospitals belonging to the Mexican Ministry of Health (SSA) and the Mexican Social Security Institute (IMSS), between September 1998, and January 2000. All of the participating women answered a questionnaire, in order to identify psychosocial stressors and psychosocial support. Descriptive statistics, X2 and estimated mean log-odds ratio with 95% confidence intervals were used. A more favorable perception of psychosocial condition with figures statistically significative in the members of the control group were observed. The unfavorable psychosocial condition of the cases group, suggests its vinculation with the biologic process of the PIH

Acute immobilization stress induces clinical and neuroimmunological alterations in experimental murine cutaneous leishmaniasis.

BACKGROUND: The skin is an important component of the neuroendocrine-immune axis. Several studies have shown that stress exacerbates skin disorders, affecting the function of sebaceous glands, keratinocytes, epidermal Langerhans cells and other cells, having an impact on the pathogenesis of many immunologically associated skin diseases. In American cutaneous leishmaniasis, we have shown the importance of the epidermis as a regulatory site, with the key participation of Langerhans cells. OBJECTIVES: To analyse the effect of acute immobilization stress on Langerhans cells, substance P (SP), calcitonin gene-related peptide (CGRP) and the natural course of infection in a murine model of cutaneous leishmaniasis. METHODS: BALB/c mice, susceptible to Leishmania infection, were placed under acute stress by immobilization (confinement) for 2 or 8 h before inoculation with L. mexicana (MHOM/BZ/82/BEL21). An avidin-biotin immunoperoxidase technique was used for cell and neuropeptide identification. RESULTS: The stressed animals became more susceptible to the parasite infection, which was manifested by acceleration and exacerbation of the lesions. In addition, the stressed animals showed morphological alterations (spherical bodies and shortened dendrites) and decreased numbers of epidermal Langerhans cells, when compared with control L. mexicana-infected mice. Mice stressed for 8 h showed greater and antidromic immunoreactivity to CGRP and SP at the time of infection. Moreover, the single inoculation of parasites caused a decrease of CGRP innervation. CONCLUSIONS: Acute immobilization stress induces an immunosuppressive state that further favours Leishmania invasion in susceptible animals.

Combined radiation and cytochrome CYP4B1/4-ipomeanol gene therapy using the EGR1 promoter.

BACKGROUND: Cytochrome p450 isozyme CYP4B1 converts the inert prodrug 4-ipomeanol (4-IM) into toxic alkylating metabolites. Induction of cytotoxicity by 4-IM combined with ionizing radiation (IR) in cells transfected with a fusion protein of rabbit cytochrome CYP4B1 under control of the radiation inducible EGR1 promoter was investigated. The capability of activated 4-IM to sensitize cells to IR was also assessed. MATERIALS AND METHODS: Survival fractions of cells, determined by MTT assays, stably transfected with EGR1-CYP4B1 were compared with that of cells transfected with a control plasmid after IR followed by 4-IM. Radiosensitization was tested by comparing clonogenic survival curves of cells transfected with the CYP4B1 cassette under a CMV promoter instead of EGR-1, irradiated with or without 4-IM. RESULTS: MTT assays for cytotoxicity indicated a decrease in relative survival fractions (survival with 4-IM/survival without 4-IM) of the EGR1-CYP4B1 transfected cells with increasing radiation dosage, but not of control cells. Clonogenic assays revealed decreased survival fractions with increasing radiation doses (CYP4B1 transfected and control cells) and 4-IM concentrations (CYP4B1 transfected cells), but showed no significant differences in slope of survival curves with 4-IM. CONCLUSION: The results indicate IR potentiates the cytotoxic activity of the EGR1-CYP4B1/4-IM transgene system, but activated 4-IM does not sensitize cells to IR. Thus, the EGR1-CYP4B1/4-IM system is a viable radiation-gene therapy system that may allow for improved spatial and temporal control of cytotoxicity by therapeutic radiation fields.

Diferencias en ansiedad estado-rasgo entre adolescentes con hipertension inducida por el embarazo y adolescentes embarazadas sanas / Differences in state-trait anxiety between adolescents with pregnancy induced hypertension and healthy pregnant adolescents

Se establecen y comparan los niveles de ansiedad percibidos por dos grupos de adolescentes, uno de ellos con el diagnóstico de hipertensión inducida por el embarazo (HIE), y el otro grupo conformado por adolescentes cualificadas como sanas. Es un estudio colaborativo de casos y controles, en el cual fueron escogidas 128 adolescentes embarazadas, que acudieron al servicio de gineco-obstetricia en hospitales de la Secretaría de Salud en las ciudades de Durango y México. El grupo de casos se integró por 46 adolescentes en quienes se estableció el diagnóstico de HIE por personal médico hospitalario, el grupo control se conformó por 82 adolescentes, que fueron cualificadas como sanas de acuerdo con criterios explícitos del estudio; tanto el grupo de casos como el de controles se integraron por adolescentes de ambas ciudades. Las participantes accedieron a responder el Inventario de Ansiedad EstadoRasgo (IDARE). Percepciones de ansiedad estado y rasgo difieren significativamente entre adolescentes con HIE y el grupo control. Los resultados muestran que el grupo de adolescentes con hipertensión inducida por el embarazo, presentan niveles de ansiedad significativamente más altos que el grupo control. (AU)

Identification of genotoxic stress in human cells by fluorescent monitoring of p53 expression.

The tumor suppressor protein p53 is induced upon DNA damage essentially by post-translational regulatory mechanisms, which lead to a substantial increase of p53 levels. To exploit this essential property of p53, we developed a novel reporter system for monitoring accumulation and subcellular translocation of p53 protein, which is able to function as a simple test for detecting mutagenic and genotoxic stress in human cells. For this purpose, we constructed a plasmid with a specific translational TP53::EGFP gene fusion and selected stable transfected clones in the human cell line HEK293, in which p53 is functionally stabilized due to the expression of the transgenic adenoviral E1A oncoproteins. HEK293-TP53::EGFP clones may be used as a living cell system for monitoring not only of the induction of p53 protein in the cell, but also of its subcellular localization. Using this human reporter cell system, we examined levels of p53 by fluorescence microscopy and by FACS analysis following treatment with several classes of genotoxic and carcinogenic compounds. All tested DNA damaging agents caused a significant increase of intracellular p53-EGFP levels in a concentration-dependent manner. On the other hand, non-genotoxic carcinogens and stress conditions that cannot damage DNA were not able to induce p53-EGFP accumulation. The induction effect caused by genotoxic stress was found to be dependent on the endogenous p53 status, because it was not observed in p53-deficient cell lines. This corroborates the notion that p53 may be used as an universal sensor for genotoxic stress and demonstrates the usefulness of HEK293-p53-EGFP cells as a reporter system for identification of mutagens and genotoxic carcinogens in human cells by means of visualizing and monitoring intracellular p53 levels and localization.

Initial experience with intraoperative magnetic resonance imaging in spine surgery.

STUDY DESIGN: A case series of 12 patients who underwent spine surgery in an intraoperative magnetic resonance imager (IMRI). OBJECTIVES: To determine the advantages, limitations, and potential applications to spine surgery of the IMRI. SUMMARY OF BACKGROUND DATA: Existing stereotactic navigational systems are limited because images are obtained before surgery and are not updated to reflect intraoperative changes. In addition, they necessitate manual registration of fiducial landmarks on the patient's anatomy by the surgeon to the previously obtained image data set, which is a potential source of error. The IMRI eliminates these difficulties by using intraoperative acquisition of MRI images for surgical navigation with the capacity for both image update and image-guided frameless stereotaxy. The IMRI is a novel cryogenless superconducting magnet with an open configuration that allows the surgeon full access to the patient during surgery and intraoperative imaging. METHODS: T1- and T2-weighted fast spin echo images were obtained for localization, after surgical exposure and after decompression during the course of 12 spine surgeries performed in the IMRI. RESULTS: The authors performed a series of 12 procedures in the IMRI that included three lumbar discectomies, three anterior cervical discectomies with allograft fusion, three cervical vertebrectomies with allograft fusion, two cervical foraminotomies, and one decompressive cervical laminectomy. The system provided rapid and accurate localization in all cases. The adequacy of decompression by MRI during surgery was confirmed in 10 of 12 cases. CONCLUSIONS: The IMRI provided accurate and rapid localization in all cases and confirmed the adequacy of decompression in the majority of cases. Future applications of the IMRI to spine surgery may include intraoperative guidance for resection of spine and spinal cord tumors and trajectory planning for spinal endoscopy or screw fixation.

Abdominal decompression plays a major role in early postparacentesis haemodynamic changes in cirrhotic patients with tense ascites.

BACKGROUND: Some cirrhotic patients with tense ascites who undergo paracentesis develop a circulatory dysfunction syndrome, manifested by an increase in plasma renin activity. Recently, a significant inverse correlation between postparacentesis changes in plasma renin activity and systemic vascular resistance has been demonstrated in these patients, suggesting that peripheral arterial vasodilatation could be responsible for this circulatory dysfunction, but the mechanisms by which tense ascites removal induces such changes are unknown AIM: To investigate the role of a decrease in intra-abdominal pressure (IAP) in the development of early postparacentesis haemodynamic changes METHODS: Eleven cirrhotic patients with tense ascites received a large volume paracentesis. A specially designed pneumatic girdle was used to compress the abdomen to avoid a decrease in IAP during ascites removal. Haemodynamic studies were performed before paracentesis, one hour after ascites flow stopped, and 30 minutes after pneumatic girdle deflation RESULTS: When IAP was maintained at its original level, no haemodynamic changes were observed, despite large volume paracentesis. However, a significant decrease in systemic vascular resistance was seen immediately after pneumatic girdle deflation CONCLUSIONS: Early haemodynamic changes after paracentesis are avoided if IAP is maintained at its original level. The abrupt decrease in IAP could be the trigger for the development of the initial haemodynamic changes that eventually produce postparacentesis circulatory dysfunction.

Knigth's Move in the Periodic Table, From Copper to Platinum, Novel Antitumor Mixed Chelate Copper Compounds, Casiopeinas, Evaluated by an in Vitro Human and Murine Cancer Cell Line Panel.

We synthesized a novel anticancer agents based on mixed chelate copper (II) complexes, named Casiopeínas((R)) has of general formula [Cu(N-N)(N-O)H(2)O]NO(3) (where, N-N = diimines as 1,10- phenanthroline, 2,2-bipyridine, or substituted and N-O=aminoeidate or [Cu(N-N)(O-O)H(2)O]NO(3) (where NN= diimines as 10-phenanthroline, 2,2-bipyridine or substituted Casiopeínas I, II, IV, V, VI, VII VIII and O-O=acetylacetonate, salicylaldehidate Casiopínas III). We evaluated the in vitro antitumor activity using a human cancer cell panel and some nurine cancer cells. Eleven Casiopeinas are evaluated in order to acquire some structure-activity correlations and some monodentated Casiopeinäs analogues; cisplatinum was used as control drug. The 50% growth inhibition observed is, in all cases reach with concentrations of Casiopeina's 10 or 100 times lower than cisplatinum. In a previous work we reported the induction of apoptosis by Casiopeina II. The results indicate that Casiopeinass are a promising new anticancer drug candidates to be developed further toward clinical trials.

[Psychosocial status of adolescents and pregnancy toxemia]. / Situación psicosocial de las adolescentes y toxemias del embarazo.

OBJECTIVE: To compare the perception of psychosocial conditions (during pregnancy) between two groups of adolescents; one group was integrated by young women diagnosed with pregnancy induced-hypertension and the other group by clinically healthy women. MATERIAL AND METHODS: A case-control study design where 39 cases and 88 controls were chosen from pregnant adolescents seeking care at the General Hospital of Durango City, México, from July 1996 to February 1997, and from September 1998 to January 1999. Participants agreed to answer a semi-structured questionnaire to collect data on psychosocial support; psychosocial source of stress; coping responses; intention, desire and acceptance of pregnancy; and attitude and quality of socialization during pregnancy. Data analysis consisted of descriptive statistics, chi 2 and odds ratios with 95% confidence intervals. RESULTS: The two groups' sociodemographic and gyneco-obstetric characteristics were similar. Perception of stressors was higher among cases; sources of support were greater among controls. Positive attitudes and satisfactory socialization during pregnancy were more frequently reported by controls, with statistically significant differences between groups. CONCLUSIONS: We found qualitative differences in the perception of psychosocial conditions among study participants, with statistically significant favorable perceptions among controls.

Helper virus-free herpes simplex virus type 1 amplicon vectors for granulocyte-macrophage colony-stimulating factor-enhanced vaccination therapy for experimental glioma.

Subcutaneous vaccination therapy with glioma cells, which are retrovirally transduced to secrete granulocyte-macrophage colony-stimulating factor (GM-CSF), has previously proven effective in C57BL/6 mice harboring intracerebral GL261 gliomas. However, clinical ex vivo gene therapy for human gliomas would be difficult, as transgene delivery via retroviral vectors occurs only in dividing cells and ex vivo glioma cells have a low growth fraction. To circumvent this problem, a helper virus-free herpes simplex virus type 1 (HSV-1) amplicon vector was used. When primary cultures of human glioblastoma cells were infected with HSV-1 amplicon vectors at an MOI of 1, more than 90% of both dividing and nondividing cells were transduced. When cells were infected with an amplicon vector, HSVGM, bearing the GM-CSF cDNA in the presence of Polybrene, GM-CSF secretion into the medium during the first 24 hr after infection was 1026 ng/10(6) cells, whereas mock-infected cells did not secrete detectable GM-CSF. Subcutaneous vaccination of C57BL/6 mice with 5 x 10(5) irradiated HSVGM-transduced GL261 cells 7 days prior to intracerebral implantation of 10(6) wild-type GL261 cells yielded 60% long-term survivors (>80 days), similar to the 50% long-term survivors obtained by vaccination with retrovirally GM-CSF-transduced GL261 cells. In contrast, animals vaccinated with the same number of nontranduced GL261 cells or with GL261 cells infected with helper virus-free packaged HSV-1 amplicon vectors carrying no transgene showed only 10% long-term survivors. In conclusion, helper virus-free HSV-1 amplicon vectors appear to be effective for cytokine-enhanced vaccination therapy of glioma, with the advantages that both dividing and nondividing tumor cells can be infected, no viral proteins are expressed, and these vectors are safe and compatible with clinical use.

Evolution of exon 1 of the dopamine D4 receptor (DRD4) gene in primates.

The dopamine D4 receptor (DRD4) gene exhibits a large amount of expressed polymorphism in humans. To understand the evolutionary history of the first exon of DRD4-which in humans contains a polymorphic 12bp tandem duplication, a polymorphic 13bp deletion, and other rare variants-we examined the homologous exon in thirteen other primate species. The great apes possess a variable number of tandem repeats in the same region as humans, both within and among species. In this sense, the 12bp tandem repeat of exon 1 is similar to the 48bp VNTR of exon 3 of DRD4, previously shown to be polymorphic in all primate species examined. The Old World monkeys show no variation in length, and a much higher conservation of amino acid sequence than great apes and humans. The New World monkeys show interspecific differences in length in the region of the 12bp polymorphism, but otherwise show the higher conservation seen in Old World monkeys. The different patterns of variation in monkeys compared to apes suggest strong purifying selective pressure on the exon in these monkeys, and somewhat different selection, possibly relaxed selection, in the apes.

Characterizing pharmacy part-time practice.

OBJECTIVES: (1) To characterize pharmacists who work part-time and compare them with pharmacists who work a secondary part-time job (moonlighters) with respect to their motivations for working in a part-time job, and (2) to identify the set of characteristics that best describes pharmacists engaged in each of the part-time work arrangements under study. DESIGN: A five-page questionnaire was mailed to 3,002 licensed pharmacists nationwide. Two follow-up surveys were sent to nonrespondents at the fifth and ninth weeks from the original mailout to ensure an adequate response rate. RESULTS: The net response rate was 57% (n = 1,637). Assessment of the sample did not detect any potential nonresponse bias. Sixty-eight percent of the respondents reported working full time, 13% were moonlighters, 14% were part-timers, and 5% were part-timers in more than one job. Reasons for working part-time were analyzed for the moonlighter and part-timer subsamples. A principal components analysis revealed that both groups have distinct motivations for selecting their chosen work arrangement. CONCLUSION: This study provides some insight into those factors affecting pharmacists' decisions to engage in two different types of part-time work. Since pharmacists' alternative work schedules can have repercussions on the quality of pharmacy being practiced, further research on pharmacists' work arrangement choices should provide useful information for work force-related endeavors.