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Background: Currently, the potential benefits of additional resection after positive proximal intraoperative frozen sections (IFS) in perihilar cholangiocarcinoma (pCCA) on residual disease and oncological outcome remain uncertain. Therefore, the aim of this study is to investigate the number of R0 resections after additional resection of a positive proximal IFS and the influence of additional resections on overall survival (OS) in patients with pCCA.Materials and methods: A retrospective, multicenter, matched case-control study was performed, including patients undergoing resection for pCCA between 2000 and 2019 at three tertiary centers. Primary outcome was the number of achieved ‘additional’ R0 resections. Secondary outcomes were OS, recurrence, severe morbidity and mortality.Results: Forty-four out of 328 patients undergoing resection for pCCA had a positive proximal IFS. An additional resection was performed in 35 out of 44 (79.5%) patients, which was negative in 24 (68.6%) patients. Nevertheless, seven out of these 24 patients were eventually classified as R1 resection due to other positive resection margins. Therefore, 17 (48.6%) patients could be classified as “true” R0 resection after additional resection. Ninety-day mortality after R1 resections was high (25%) and strongly influenced OS. After correction for 90-day mortality, median OS after negative additional resection was 33 months (95%CI:29.5–36.5) compared to 30 months (95%CI:24.4–35.6) after initial R1 (P = 0.875) and 46 months (95%CI:32.7–59.3) after initial R0 (P = 0.348).Conclusion: There were only 17 patients (out of a total of 328 patients) that potentially benefitted from routine IFS. Additional resection for a positive IFS leading to R0 resection was not associated with improved long-term survival.

Galacto-oligosaccharides (GOS) are non-digestible oligosaccharides characterized by a mix of structures that vary in their degree of polymerization (DP) and glycosidic linkage between the galactose moieties or between galactose and glucose. They have enjoyed extensive scientific scrutiny, and their health-promoting effects are supported by a large number of scientific and clinical studies. A variety of GOS-associated health-promoting effects have been reported, such as growth promotion of beneficial bacteria, in particular bifidobacteria and lactobacilli, inhibition of pathogen adhesion and improvement of gut barrier function. GOS have attracted significant interest from food industries for their versatility as a bioactive ingredient and in particular as a functional component of infant formulations. These oligosaccharides are produced in a kinetically-controlled reaction involving lactose transgalactosylation, being catalyzed by particular β-galactosidases of bacterial or fungal origin. Despite the well-established technology applied for GOS production, this process may still meet with technological challenges when employed at an industrial scale. The current review will cover relevant scientific literature on the beneficial physiological properties of GOS as a prebiotic for the infant gut microbiota, details of GOS structures, the associated reaction mechanism of β-galactosidase, and its (large-scale) production.

A 35-year old dockworker sustained a pelvic injury when he was caught by a large loading clamshell grab. Primary survey revealed an open book pelvic fracture with soft tissue defects of the left thigh and groin. CT scanning of the thorax and abdomen did not reveal significant additional injuries. Partly due to patient’s haemodynamical instability, osteosynthesis of the pelvic fracture was performed immediately after resuscitation, whereby the severely contaminated wound of the thigh was debrided and irrigated. The following days, progressive facial subcutaneous emphysema developed, but patient remained clinically stable. Several specialists were consulted, but did not find a cause. At day 7, a second surgery was planned to treat a pelvic surgical wound infection. Unexpectedly, we found faecal contamination in the pelvic surgical wound. The consulted gastro/intestinal-surgeon performed a laparoscopic colostomy for a rectal laceration. Awareness for bowel injuries with open pelvic fracture should be high, also when subcutaneous emphysema is found remotely.

Many β-galactosidase enzymes convert lactose into a mixture of galacto-oligosaccharides (GOS) when incubated under the right conditions. Recently, the composition of commercial Vivinal GOS produced by Bacillus circulans β-galactosidase was studied in much detail in another study by van Leeuwen et al. As a spin-off of this study, we used the developed analytical strategy for the evaluation of 6 anonymous commercial GOS products, in comparison with Vivinal GOS. These GOS products were first subjected to HPLC-SEC, calibrated HPAEC-PAD profiling (glucose units in relation to a malto-oligosaccharide ladder), and 1D (1)H NMR spectroscopy. For a more detailed analysis and support of the conclusions based on the initial analysis, the GOS products were separated into DP-pure subpools on Bio-Gel P-2 (MALDI-TOF-MS analysis), which were subjected to calibrated HPAEC-PAD profiling and (1)H NMR analysis. Unidentified peaks from different GOS products, not present in Vivinal GOS, were isolated for detailed structural characterization. In this way, the differences between the various GOS products in terms of DP distribution and type of glycosidic linkages were established. A total of 13 new GOS structures were characterized, adding structural-reporter-group signals and HPAEC-PAD based glucose unit G.U. values to the analytical toolbox. The newly characterized products enhance the quality of the database with GOS structures up to DP4. The combined data provide a firm basis for the rapid profiling of the GOS products of microbial β-galactosidase enzymes.

1. Climate change has been inducing range shifts for many species as they follow their suitable climate space and further shifts are projected. Whether species will be able to colonize regions where climate conditions become suitable, so-called 'new climate space', depends on species traits and habitat fragmentation. 2. By combining bioclimate envelope models with dispersal models, we identified areas where the spatial cohesion of the ecosystem pattern is expected to be insufficient to allow colonization of new climate space. 3. For each of three ecosystem types, three species were selected that showed a shift in suitable climate space and differed in habitat fragmentation sensitivity. 4. For the 2020 and 2050 time slices, the amount of climatically suitable habitat in northwest Europe diminished for all studied species. Additionally, significant portions of new suitable habitat could not be colonized because of isolation. Together, this will result in a decline in the amount of suitable habitat protected in Natura 2000 sites. 5. We develop several adaptation strategies to combat this problem: (i) link isolated habitat that is within a new suitable climate zone to the nearest climate-proof network; (ii) increase colonizing capacity in the overlap zone, the part of a network that remains suitable in successive time frames; (iii) optimize sustainable networks in climate refugia, the part of a species' range where the climate remains stable. 6. Synthesis and applications. Following the method described in this study, we can identify those sites across Europe where ecosystem patterns are not cohesive enough to accommodate species' responses to climate change. The best locations for climate corridors where improving connectivity is most urgent and potential gain is highest can then be pinpointed.

Cardiac remodelling is commonly defined as a physiological or pathological state that may occur after conditions such as myocardial infarction, pressure overload, idiopathic dilated cardiomyopathy or volume overload. When training excessively, the heart develops several myocardial adaptations causing a physiological state of cardiac remodelling. These morphological changes depend on the kind of training and are clinically characterised by modifications in cardiac size and shape due to increased load. Several studies have investigated morphological differences in the athlete's heart between athletes performing strength training and athletes performing endurance training. Endurance training is associated with an increased cardiac output and volume load on the left and right ventricles, causing the endurance-trained heart to generate a mild to moderate dilatation of the left ventricle combined with a mild to moderate increase in left ventricular wall thickness. Strength training is characterised by an elevation of both systolic and diastolic blood pressure. This pressure overload causes an increase in left ventricular wall thickness. This may or may not be accompanied by a slight raise in the left ventricular volume. However, the development of an endurancetrained heart and a strength-trained heart should not be considered an absolute concept. Both forms of training cause specific morphological changes in the heart, dependent on the type of sport. (Neth Heart J 2008;16:129-33.). AD - Department of Cardiology, Maastricht University Hospital, Maastricht, the Netherlands.

Soy-derived proteins (soy protein isolate, glycinin, and ß-conglycinin) and bovine whey-derived proteins (whey protein isolate, ¿-lactalbumin, ß-lactoglobulin) were hydrolyzed using subtilisin Carlsberg, chymotrypsin, trypsin, bromelain, and papain. The (in)solubility of the hydrolysates obtained was studied as a function of pH. At neutral pH, all soy-derived protein hydrolysates, particularly those from glycinin, obtained by hydrolysis with subtilisin Carlsberg, chymotrypsin, bromelain, and papain showed a stronger aggregation compared to the non-hydrolyzed ones. This increase in aggregation was not observed upon hydrolysis by trypsin. None of the whey-derived protein hydrolysates exhibited an increase in aggregation at neutral pH. The high abundance of theoretical cleavage sites in the hydrophobic regions of glycinin probably explains the stronger exposure of hydrophobic groups than for the other proteins, which is suggested to be the driving force in the aggregate formation. Keywords: Aggregation; Peptides; Soy protein; Whey protein

Background: Creatine supplementation is popular among tennis players but it is not clear whether it actually enhances tennis performance. Objectives: To examine the effects of creatine supplementation on tennis specific performance indices. Methods: In a randomised, double blind design, 36 competitive male tennis players (24 creatine, mean (SD) age, 22.5 (4.9) years; 12 placebo, 22.8 (4.8) years) were tested at baseline, after six days of creatine loading, and after a maintenance phase of four weeks (14 creatine, 10 placebo). Serving velocity (10 serves), forehand and backhand velocity (three series of 5×8 strokes), arm and leg strength (bench press and leg press), and intermittent running speed (three series of five 20 metre sprints) were measured. Results: Compared with placebo, neither six days nor five weeks of creatine supplementation had a significant effect on serving velocity (creatine: +2 km/h; placebo: +2 km/h, p = 0.90); forehand velocity (creatine: +4 km/h; placebo: +4 km/h, p = 0.80), or backhand velocity (creatine: +3 km/h; placebo: +1 km/h, p = 0.38). There was also no significant effect of creatine supplementation on repetitive sprint power after 5, 10, and 20 metres, (creatine 20 m: −0.03 m/s; placebo 20 m: +0.01 m/s, p = 0.18), or in the strength of the upper and lower extremities. Conclusions: Creatine supplementation is not effective in improving selected factors of tennis specific performance and should not be recommended to tennis players.

Effect of testosterone and endurance training on glycogen metabolism in skeletal muscle of chronic hyperglycaemic female rats.van Breda E, Keizer H, Kuipers H, Kranenburg G.Nutrition and Toxicology Research Institute Maastricht (NUTRIM), Maastricht University, Maastricht, The Netherlands. vanbreda@bw.unimaas.nlOBJECTIVES: To investigate in glycolytic and oxidative muscles of trained (nine weeks) and untrained hyperglycaemic female rats the effect of hyperandrogenicity and/or endurance training on energy metabolic properties. METHODS: Glycogen content and activity of muscle enzymes with regulatory functions in glycogen synthesis were examined. RESULTS: Testosterone treatment increased glycogen content of extensor digitorum longus (EDL) and soleus muscles of hyperglycaemic sedentary (18% and 84% respectively) and hyperglycaemic trained (7% and 16% respectively) rats. In both types of muscle of the hyperglycaemic testosterone treated exercised subgroup, less depletion of glycogen was found than in the untreated group (38% and 87% for EDL and soleus respectively). CONCLUSIONS: The mechanisms by which training and/or hyperandrogenism alone or in combination elicits their specific effects are complex. Differences in sex, surgery, levels of hormones administered, and exercise model used may be the main reasons for the observed discrepancies. Conclusions from the results: (a) hyperandrogenism is not a primary cause of the development of insulin resistance; (b) glycogen content of slow and fast twitch muscle is increased by training through increased glycogen synthase activity. The most plausible explanation for differences between different muscle fibre types is the different levels of expression of androgen receptors in these fibres. Hyperandrogenicity therefore acts on energy metabolic variables of hyperglycaemic animals by different mechanisms in glycolytic and oxidative muscle fibres

Objectives—(a) To investigate the effects of reduced training on physical condition and performance in well trained cyclists; (b) to study whether an intermittent exercise programme would maintain physiological training adaptations more effectively than a continuous exercise programme during a period of reduced training.Methods—Twelve male cyclists participated in a 21 day training programme and were divided into two training groups. One group (age 25.3 (7) years; weight 73.3 (5.7) kg; Vo2max58.6 (4.5) ml/kg/min; means (SD)) underwent a continuous endurance exercise training programme (CT) whereas the second group (age 22.8 (3.5) years; weight 74.1 (7.0) kg; Vo2max59.7 (6.7) ml/kg/min) followed an intermittent endurance exercise training programme (IT). During this reduced training period, both groups trained for two hours a day, three days a week.Results—Neither group showed changes in maximal workload (Wmax) (4.6 (0.5)v4.8 (0.5) W/kg and 4.6 (0.5)v4.7 (0.6) W/kg for the CT and IT group respectively) and Vo2max(58.6 (4.5)v60.1 (5.8) ml/kg/min and 59.7 (6.7)v58.8 (7.5) ml/kg/min for the CT and IT group respectively). During the submaximal steady state exercise test, substrate use and heart rate remained unchanged after reduced training.Conclusions—These results indicate that well trained cyclists who reduce training intensity and volume for 21 days can maintain physiological adaptations, as measured during submaximal and maximal exercise. An intermittent training regimen has no advantage over a continuous training regimen during a detraining period.

General principles of milieu therapy together with a general psychodynamic frame of reference were felt to have become inadequate in providing an adequate and coherent treatment program in an inpatient psychotherapeutic setting. Both Transference Focused Psychotherapy (TFP) and Mentalization Based Treatment (MBT) are individual psychotherapy models developed for use in outpatient practice. Theoretically, both models could be adjusted for use in an inpatient setting. However, despite their common psychodynamic roots they differ fundamentally on some theoretical and practical issues.To reorganize the inpatient group psychotherapeutic program using TFP as the frame of reference supported with principles from MBT to provide strong guidelines for the multidisciplinary treatment.We describe the basic principles and procedures of both psychotherapy models and their modifications to adjust these models for inpatient group psychotherapy.From both a theoretical and a pragmatic point of view the TFP and MBT models complement each other extremely well. The modified TFP model seemed to work well in an inpatient psychotherapy setting. With the help of the detailed frame of reference, the working methods of the various disciplines could be better aligned and coordinated so that they bolster each other. The use of video registration, common practice in TFP treatments, made a major contribution to this process.Working with the TFP model enriched with MBT principles was successful in optimizing the treatment program.

Using the ARGUS detector at the e+e- storage ring DORIS II, we have searched for the real and imaginary part of the electric dipole formfactor d_tau of the tau lepton in the production of tau pairs at q^2=100 GeV^2. This is the first direct measurement of this CP violating formfactor. We applied the method of optimised observables which takes into account all available information on the observed tau decay products. No evidence for CP violation was found, and we derive the following results: Re(d_tau)=(1.6+-.9)*10^(-16) ecm and Im(d_tau)=(-0.2+-0.8)*10^(-16) ecm, where statistical and systematic errors have been combined., 8 pages, 5 figures (10 subfigures)

Using the ARGUS detector at the e+e− storage ring DORIS II at DESY, we have found evidence for the production of the excited charmed baryon state Λc(2593)+ in the channel Λc+π+π−. Its mass was determined to be (2594.6±0.9±0.4) MeV/c2, and the natural width measured to be Γ = (2.9−2.1−1.4+2.9+1.8) MeV. The production cross section times the branching ratios of σ(e+e− → Λc(2593)+X) × Br(Λc(2593)+ → Λc+π+π−) × Br(Λc+ → pK−π+) was measured to be (0.25−0.13+0.24 ±0.13) pb. The fractions of Λc(2593)+ decays proceeding through the Σc0π+ and Σc++π− channels were determined to be 0.29±0.10±0.11 and 0.37±0.12±0.13, respectively.

Using the ARGUS detector at the e+e− storage ring DORIS II at DESY, we have made two measurements of the mixing parameter χd using kaons as flavour tags. Using D∗+ K± correlations we found χd = 0.20 ± 0.13 ± 0.12 and from the study of (D∗+l−) K± correlations we obtained χd = 0.19 ± 0.07 ± 0.09. The branching ratio for B → D∗+ X has been updated: Br(B → D∗+ X) = (19.6 ± 1.9)%. We have also determined the average multiplicity of charged kaons in B0 decays to be 0.78 ± 0.08.

A maximum likelihood analysis of ARGUS data on two-photon production of π+π+π0π0π−π− is presented. A small fraction of events is due to the production of omega pairs. The γγ → ωω cross section has its maximum value close to threshold.

Using the ARGUS detector at the e + e − storage ring DORIS II, we have measured the semileptonic branching ratios of the D 0 meson to be Br ( D 0 → e + ν e X ) = (6.9 ± 0.3 ± 0.5) % and Br ( D 0 → μ + ν μ X ) = (6.0 ± 0.7 ± 1.2) %, and the semileptonic branching ratio of the charmed hadron mixture from e + e − annihilation around 10 GeV to be Br ( c → e + ν e X ) = (9.6 ± 0.4 ± 1.1) %.

The partial decay width into electrons, Γ ee , of the ϒ(1S) and ϒ(2S) resonances have been measured with the detector ARGUS at thee+e− storage ring DORISII of DESY. Applying the formula of Kuraev and Fadin for the radiative corrections we find: Γ ee (ϒ(1S))= (1.32±0.04±0.03) keV and Γ ee (ϒ(2S))=(0.52±0.03±0.01) keV. The total decay width of the ϒ(4S) resonance and its partial width into electrons have been determined as well. Fitting the data with a generalized Breit-Wigner function with an energy dependent decay width Γ(s) and a mass shift functionm(s), we obtain the following resonance parameters: Γ(M2)=(10.0±2.8±2.7) MeV, Γ ee =(0.28±0.05±0.01)keV andB ee =(2.77±0.50±0.49)·10−5. We argue that the disagrecment of this result with the world average originates from our more adequate parametrization of the observed ϒ(4S) resonance cross section.

Using the ARGUS detector at the DORIS II electron-positron storage ring at DESY, we have measured BR(D*+→D0π+)=(68.8±2.4±1.3)%, BR(D*+→D+π0)=(31.2±1.1±0.8)%, BR(D*+→D+γ)

Lepton spectra in τ decays have been studied with the ARGUS detector at thee+e− storage ring DORIS II at DESY using the “pseudo-rest-frame” technique. We have improved upper limits for two-body τ-decays into a lepton and an unobservable particle.

Using the ARGUS detector at the e+e - storage ring DORIS II at DESY, we have studied lepton energy spectra in ~- decays. We present a "pseudo-rest-frame" technique in which the second r in the event, decaying into a heavy hadronic system, is used as reference. This method allows for the first measurement of the Michel Parameter 7/in ~- decays. We also determine the Michel Parameter p in 7" --~ e~u decays with a precision comparable to the present world average. The measured values of the parameters p = 0.735 4- 0.036 4- 0.020 and r 1 = 0.03 4- 0.18 4- 0.12 are in good agreement with standard V-A coupling at the ~--~,-W vertex.

Using the detector ARGUS at the e+e− storage ring DORIS II at DESY, we have observed the decays Λc+ → Ξ−K+π+ and Λc+ → Ξ∗0K+ and obtained evidence for the decay Ξc0 → ΛKs0. All three of these decays are of interest as they provide information about W-exchange processes. The products of cross sections and branching ratios for Λc+ → Ξ−K+π+ and Λc+ → Ξ∗0K+ are (1.7±0.3±0.3) pb and (0.6±0.2±0.1) pb, respectively, which implies that (35±17) % of the Ξ−K+π+ final state is generated through a two-body decay via intermediate W-exchange. The product of production cross section and branching ratio for Ξc0 → Λ Ks0 is (2.1 ± 1.0 ± 0.6) pb.

Polarization in the exclusive decay B → J/ψK ∗ was measured using the ARGUS detector at the e+e− storage ring DORIS II. The ratio of the transverse to the total decay width was found to be ΓT/Γ = 0.03±0.16±0.15. This measurement demonstrates that the B 0 → J/ψK ∗0 decay channel can be effectively used for CP violation studies.

Using the ARGUS detector at the e+ e− storage ring DORIS II we have measured the absolute branching ratios of the D0 meson, Br(D0→K− π+)=(3.41±0.12±0.28)%, Br(D0→K− π+ π+ π−)=(6.80± 0.27±0.57)%, and Br (D 0 → K 0 π + π − )=(5.03±0.39±0.49)% .

Using the ARGUS detector at the DORIS II storage ring we have investigated the Lorentz structure of the electroweak interaction in semi-hadronic τ decays. Spin correlations in the process e + e − → τ + τ − → v τ π + π 0 v τ π − π 0 are exploited for a measurement of the normalized product of the vector ( g V ) and axial vector ( g A ) couplings of the τ lepton, γin AV = 2 Re {g A g V ∗ } (|g V | 2 ) . The correlations are sensitive to the product of the couplings in both τ decays: γ AV 2 = γ AV (τ − → ν τ W − ) AV = −h(v τ )h( v τ ) . The measured value, γ AV 2 = 1.044±0.057±0.060, determines the relative sign of the neutrino helicities. Assuming CP invariance, the absolute value | γ AV | = 1.022±0.028±0.030 was found to be incellent agreement with the Standard Model. The contribution of scalar ( g s ) or pseudoscalar ( g P ) couplings was also investigated. No evidence for a scalar-like coupling was found.

An analysis of the reaction yy ~ r/c was l~erformed in five different decay channels of the r/c: /~sK+~r ~, K+K-Tr+~ "- , 27r+21r -, ~b~b and 2K+2K -. A value Fry(r/c) = ( 11.3 + 4.2) keV was obtained for the radiative decay width by combining the results from the first four channels. Using our result on the two-photon width we also determined the branching ratio for the decay r/c --~ 2K+2K -.

Using the ARGUS detector at thee+e− storage ring DORIS II, we have studied Cabibbo-suppressedD0 decay modes resulting in theK+K−π+π− final state and two-bodyD0 decay modes with a ϕ meson in the final state. TheBR(D0→KS0KS0π+π− was measured for the first time. We also present a measurement of theD+→KS0KS0K+ branching ratio. The values are compared with other experimental results and model predictions.

We present the results of a partial reconstruction of the decay channel B − → D j (∗) π − performed using the ARGUS detector operating at the e+e− storage-ring DORIS II. In the context of this paper, D j (∗)0 is an L = 1 excited charm meson decaying to D ∗+ π − . The measured product of branching ratios is Br(B − → D 1 0 (2414)π − ) · Br Br(D 1 0 → D ∗+ π − ) = (0.17 ± 0.05 ± 0.04)% where the first error is statistical and statistical and the second systematic. No evidence for the decay B − → D 2 ∗0 (2459) π − ) · Br(D 2 ∗0 → D ∗+ π − ) at the 90% confidence level.

Polarization of the Λ daughter baryon from Λc+ → Λl+ vl decay has been measured for the first time using the ARGUS detector at the DORIS II ϵ+ϵ− storage ring. Expressed in terms of the Λc+ semileptonic asymmetry parameter the result is αΛc= −0.91±0.49 for events in the mass region 1.85

Creatine supplementation is popular among tennis players but it is not clear whether it actually enhances tennis performance.To examine the effects of creatine supplementation on tennis specific performance indices.In a randomised, double blind design, 36 competitive male tennis players (24 creatine, mean (SD) age, 22.5 (4.9) years; 12 placebo, 22.8 (4.8) years) were tested at baseline, after six days of creatine loading, and after a maintenance phase of four weeks (14 creatine, 10 placebo). Serving velocity (10 serves), forehand and backhand velocity (three series of 5x8 strokes), arm and leg strength (bench press and leg press), and intermittent running speed (three series of five 20 metre sprints) were measured.Compared with placebo, neither six days nor five weeks of creatine supplementation had a significant effect on serving velocity (creatine: +2 km/h; placebo: +2 km/h, p = 0.90); forehand velocity (creatine: +4 km/h; placebo: +4 km/h, p = 0.80), or backhand velocity (creatine: +3 km/h; placebo: +1 km/h, p = 0.38). There was also no significant effect of creatine supplementation on repetitive sprint power after 5, 10, and 20 metres, (creatine 20 m: -0.03 m/s; placebo 20 m: +0.01 m/s, p = 0.18), or in the strength of the upper and lower extremities.Creatine supplementation is not effective in improving selected factors of tennis specific performance and should not be recommended to tennis players.

OBJECTIVES: To identify educational needs of elite sportspeople with respect to the doping laws. METHODS: A questionnaire survey of 196 Olympic level sportspeople from the fields of athletics, cycling, rowing, and sailing. The questionnaire addressed the date and source of the last doping educational update, the usefulness of current resources, sources of help, and possible ways of improving the system. The questionnaire also sought to estimate the use of nutritional supplements in these sports. RESULTS: Seventy four (38%) athletes responded to the questionnaire. Over 90% of responders had received a doping educational update in the last six months, and most agreed with the statement "I have received the information I need to avoid getting into trouble with the doping laws". Despite this, more than half of responders agreed with the statements "I should receive reminders more often" and "The authorities should do more to educate sportspeople". In addition, there were four people who admitted taking a banned substance by accident. Forty one (55%) reported taking supplements. The team doctor was the most popular source if information on a substance or product was required, with 62% and 66% of subjects stating that they would contact their team doctor when based in the United Kingdom and abroad respectively. The UK Sports website was often suggested in relation to ways of improving knowledge. CONCLUSIONS: There is a need to alter the educational process, particularly with respect to contingency planning for minor illness. The use of internet based resources for up to date information about banned substances needs to be promoted, and access to the internet improved. The educational needs of team doctors with respect to the doping laws need to be assessed.

Objectives:To investigate the effects of two different regimens of androgenic-anabolic steroid (AAS) administration on serum lipid and lipoproteins, and recovery of these variables after drug cessation, as indicators of the risk for cardiovascular disease in healthy male strength athletes.Methods:In a non-blinded study (study 1) serum lipoproteins and lipids were assessed in 19 subjects who self administered AASs for eight or 14 weeks, and in 16 non-using volunteers. In a randomised double blind, placebo controlled design, the effects of intramuscular administration of nandrolone decanoate (200 mg/week) for eight weeks on the same variables in 16 bodybuilders were studied (study 2). Fasting serum concentrations of total cholesterol, triglycerides, HDL-cholesterol (HDL-C), HDL2-cholesterol (HDL2-C), HDL3-cholesterol (HDL3-C), apolipoprotein A1 (Apo-A1), apolipoprotein B (Apo-B), and lipoprotein (a) (Lp(a)) were determined.Results:In study 1 AAS administration led to decreases in serum concentrations of HDL-C (from 1.08 (0.30) to 0.43 (0.22) mmol/l), HDL2-C (from 0.21 (0.18) to 0.05 (0.03) mmol/l), HDL3-C (from 0.87 (0.24) to 0.40 (0.20) mmol/l, and Apo-A1 (from 1.41 (0.27) to 0.71 (0.34) g/l), whereas Apo-B increased from 0.96 (0.13) to 1.32 (0.28) g/l. Serum Lp(a) declined from 189 (315) to 32 (63) U/l. Total cholesterol and triglycerides did not change significantly. Alterations after eight and 14 weeks of AAS administration were comparable. No changes occurred in the controls. Six weeks after AAS cessation, serum HDL-C, HDL2-C, Apo-A1, Apo-B, and Lp(a) had still not returned to baseline concentrations. Administration of AAS for 14 weeks was associated with slower recovery to pretreatment concentrations than administration for eight weeks. In study 2, nandrolone decanoate did not influence serum triglycerides, total cholesterol, HDL-C, HDL2-C, HDL3-C, Apo-A1, and Apo-B concentrations after four and eight weeks of intervention, nor six weeks after withdrawal. However, Lp(a) concentrations decreased significantly from 103 (68) to 65 (44) U/l in the nandrolone decanoate group, and in the placebo group a smaller reduction from 245 (245) to 201 (194) U/l was observed. Six weeks after the intervention period, Lp(a) concentrations had returned to baseline values in both groups.Conclusions:Self administration of several AASs simultaneously for eight or 14 weeks produces comparable profound unfavourable effects on lipids and lipoproteins, leading to an increased atherogenic lipid profile, despite a beneficial effect on Lp(a) concentration. The changes persist after AAS withdrawal, and normalisation depends on the duration of the drug abuse. Eight weeks of administration of nandrolone decanoate does not affect lipid and lipoprotein concentrations, although it may selectively reduce Lp(a) concentrations. The effect of this on atherogenesis remains to be established.

BACKGROUND: Studies relating certain chemokine and chemokine receptor gene alleles with the outcome of HIV-1 infection have yielded inconsistent results. OBJECTIVE: To examine postulated associations of genetic alleles with HIV-1 disease progression. DESIGN: Meta-analysis of individual-patient data. SETTING: 19 prospective cohort studies and case-control studies from the United States, Europe, and Australia. PATIENTS: Patients with HIV-1 infection who were of European or African descent. MEASUREMENTS: Time to AIDS, death, and death after AIDS and HIV-1 RNA level at study entry or soon after seroconversion. Data were combined with fixed-effects and random-effects models. RESULTS: Both the CCR5-Delta32 and CCR2-64I alleles were associated with a decreased risk for progression to AIDS (relative hazard among seroconverters, 0.74 and 0.76, respectively; P = 0.01 for both), a decreased risk for death (relative hazard among seroconverters, 0.64 and 0.74; P < 0.05 for both), and lower HIV-1 RNA levels after seroconversion (difference, -0.18 log(10) copies/mL and -0.14 log(10) copies/mL; P < 0.05 for both). Having the CCR5-Delta32 or CCR2-64I allele had no clear protective effect on the risk for death after development of AIDS. The results were consistent between seroconverters and seroprevalent patients. In contrast, SDF-1 3'A homozygotes showed no decreased risk for AIDS (relative hazard for seroconverters and seroprevalent patients, 0.99 and 1.03, respectively), death (relative hazard, 0.97 and 1.00), or death after development of AIDS (relative hazard, 0.81 and 0.97; P > 0.5 for all). CONCLUSIONS: The CCR5-Delta32 and CCR2-64I alleles had a strong protective effect on progression of HIV-1 infection, but SDF-1 3'A homozygosity carried no such protection. Ann Intern Med

Using the ARGUS detector at the e+e− storage ring DORIS II at DESY, we have searched for decays b → sgluon through full reconstruction of a whole event. Two B B decays were found with one of B meson decaying into a final state without charmed particles. We also obtained an upper limit of Br(B+ → τ+ντ) of 1.04% at 90% CL.

Summary Numerous criteria for quantifying the intensity of field traffic are reviewed and consideration is given to their theoretical and practical relevance. Their selection and utilization depend largely upon the particular application. For general purposes, the product of load and loading time per unit area, the Field Load Index (FLI), is considered to be the most appropriate. Loading 1 ha with 1 bar during 1 s requires roughly 30 t h. From the comparison of the results of different methods of quantifying field traffic on the basis of the same dataset, it appeared that there is good agreement between FLI and other parameters, such as Traffic Intensity (TI) and Compaction Risk Factor (CRF). Higher mechanization levels are attended by lower average values of TI, CRF and FLI. Except for transport of harvest products and slurry, the weight of the power source is the first and often the main determinant for the total load. In turn, the weight of the power source is mainly dependent on the available power. The weight/power ratio for animal traction is 10-20 times higher than for tractors. For some important crops in highly mechanized farming, the time spent in the field by wheeled machinery presently ranges from 5 to 10 h ha -1 year -1 . In arable cropping the loading events can be categorized in four groups: (1) seedbed preparation and sowing (seedbed loading), (2) between sowing and harvest (rootbed loading), (3) during harvest (harvest loading), (4) tillage between harvest and the next seedbed preparation (post-harvest loading). Based on data from the U.S.A. and the Netherlands, it has been estimated that for an annual load of 40 t h ha -1 , 10% was exerted on the seedbed, 10% on the rootbed, 55% at harvest and 25% in post-harvest tillage. On grassland, the yearly loading by field traffic is usually somewhat lower, but here there is normally no loosening effect of tillage operations. Calculations about the theoretical position of wheelmarks made in the Netherlands, indicate that up to 50% of the field area may be loaded with >5 t h ha -1 for seedbed and rootbed loading together. Usually, the headlands are more frequently loaded than the field itself. For ploughing operations this may result in 3 times higher figures than for the field itself. The few data available suggest that the load distribution in the field may well be an important clue to understand crop responses to soil compaction.

The prevalence and incidence of cytomegalovirus (CMV) infections were studied in a group of homosexual men. Of the 710 participants, 501 (70.6%) had complement fixing antibodies to CMV on entry to the study. During the follow up (maximum 23 months) 69 CMV infections were found: 50 primary infections among the 209 seronegative men (attack rate 27.3%), and 19 recurrent infections among the 501 seropositive men (attack rate 6.2%). The prevalence of antibody to CMV was correlated with four characteristics of the participants' lifestyles: duration of homosexual activity, number of different sexual partners, history of syphilis, and anal sexual contact. Among the seronegative men, the incidence of primary infection with CMV correlated with a history of syphilis and anal sexual contact. We conclude that infections with CMV are highly prevalent among homosexual men, and that anal sexual contact plays an important part in the transmission of this virus.

In pycnometer determinations of the pore volume of 2-5-mm air-dry aggregates from various soils of 1.5-2.5 and 2.6-3.5% organic-matter levels and various clay contents, the use of kerosene (S. & F. XVII [1897]) gave as good values as, and was more convenient than, the use of sand or mercury (the latter giving low porosities). The pore-space percentage of aggregates could be calculated from the water content at pF 2, when no air voids in the small aggregates are likely to occur and water between the aggregates is of no importance. Dry aggregates were only slightly denser in cores of light soils than under field conditions, and swelling was small; dry aggregates were very dense in heavy soils in which moisture content and density of aggregates appeared so closely related that it was difficult to distinguish between the effect of either on the strength of aggregates. Swelling properties and aggregate size are likely to be important factors in the structure of heavy soils. (Abstract retrieved from CAB Abstracts by CABI’s permission)

Moisture content at pF 2 decreases at high bulk densities when areation under wet conditions is top poor for plant growth, and increases if the soil contains a considerable amount of aggregates

The apparatus is a board 220 cm x 18 cm on the face of which thin rods 50 cm in length are placed at 10-cm intervals at right angles to the long edge. The board is supported vertically by legs and adjusted until its long edge is parallel to the soil surface. When released the rods slide down to touch the soil and their position is measured on a scale on the board. These data permit the determination of surface roughness of soil. Roughness after plowing generally increased with increasing clay content, and deep plowing increased roughness on a light soil. Roughness in spring depended mainly on roughness after autumn plowing. (Abstract retrieved from CAB Abstracts by CABI’s permission)

Highlights • Active site characteristics of the β-galactosidase enzyme of Bacillus circulans ATCC 31382. • Residues essential for catalysis were identified by structure-based alignments. • Mutational analysis identified two catalytic glutamate amino acid residues., The Bacillus circulans ATCC 31382 β-galactosidase (BgaD) is a retaining-type glycosidase of glycoside hydrolase family 2 (GH2). Its commercial enzyme preparation, Biolacta N5, is used for commercial-scale production of galacto-oligosaccharides (GOS). The BgaD active site and catalytic amino acid residues have not been studied. Using bioinformatic routines we identified two putative catalytic glutamates and two highly conserved active site histidines. The site-directed mutants E447N, E532Q, and H345F, H379F had lost (almost) all catalytic activity. This confirmed their essential role in catalysis, as general acid/base catalyst (E447) and nucleophile (E532), and as transition state stabilizers (H345, H379), respectively.

In a study of 689 male homosexuals 290 (42%) were found to have antibodies to hepatitis A virus. The 399 men who did not have antibodies were followed up for up to 690 days, and 35 cases of hepatitis A were detected. The attack rate at the end of the study was 14%. The incidence climbed steadily, indicating that the cases of hepatitis A did not occur in clusters. Statistical analysis showed that the prevalence of antibodies to hepatitis A virus was significantly correlated with the duration of homosexual activity (p less than 0.006), and this was independent of age. The incidence of hepatitis A was found to be correlated with the number of different sexual partners in the preceding six months. It is concluded that hepatitis A is a sexually transmitted disease among homosexual men in countries with a low rate of exposure to hepatitis A during childhood.

The mechanical properties of remoulded samples of eight soils from the IJsselmeer polders were investigated. The Atterberg (Plastic and Liquid) Limits were positively correlated with the soil clay content, but were not significantly correlated with the organic matter content. Artificial aggregates of the remoulded soil age-hardened when moist. The tensile strength of artificial aggregates was positively correlated with the soil clay content and negatively correlated with the porosity. Friability of the dried, remoulded soil was much lower than that of natural, undisturbed soil. Factors affecting the rates of wetting and drying of aggregates in the laboratory were examined in detail. Wetting resulted in mellowing (or softening) of artificial aggregates. Mellowing was investigated as a function of the potential of the source of water causing the wetting. Multiple wetting and drying cycles may result in increased mellowing or in no mellowing depending on the water potential. New terminology is introduced to facilitate discussion of these phenomena. (Abstract retrieved from CAB Abstracts by CABI’s permission)