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There is increasing evidence that early liver transplantation (eLT), performed within standardized protocols can improve survival in severe alcoholic hepatitis (sAH). The aim of the study was to assess outcomes after eLT for sAH in four Italian LT centers and to compare them with non-responders to medical therapy excluded from eLT. Patients admitted for sAH (2013–2019), according to NIAAA criteria, were included. Patients not responding to medical therapy were placed on the waiting list for eLT after a strict selection. Histological features of explanted livers were evaluated. Posttransplant survival and alcohol relapse were evaluated. Ninety-three patients with severe AH were evaluated (65.6% male, median [IQR] age: 47 [42–56] years). Forty-five of 93 patients received corticosteroids, 52 of 93 were non-responders and among these, 20 patients were waitlisted. Sixteen patients underwent LT. Overall, 6-, 12-, and 24-month survival rates were 100% significantly higher compared with non-responders to medical therapy who were denied LT (45%, 45%, and 36%; p&nbsp

Objective:To determine the impact of a healthy food and drink policy on hospital staff and visitors’ food purchasing behaviours, and their awareness and support for the changes introduced.Design:Two repeated cross-sectional surveys, consisting of intercept interviews and observations of food items purchased, were conducted before (March–July 2018) and after (April–June 2019) the target date for implementation of thirteen food and drink practices (31 December 2018). Food purchases were coded as ‘Everyday’ (healthy) or ‘Occasional’ (unhealthy).Setting:Ten randomly selected New South Wales public hospitals, collection sites including hospital entrances and thirteen hospital cafés/cafeterias.Participants:Surveys were completed by 4808 hospital staff and visitors (response rate 85 %). The majority were female (63 %), spoke English at home (85 %) and just over half had completed tertiary education (55 %).Results:Significant increases from before to after the implementation target date were found for policy awareness (23 to 42 %; P < 0·0001) and support (89 to 92 %; P = 0·01). The proportion of ‘Everyday’ food purchases increased, but not significantly (56 to 59 %; P = 0·22); with significant heterogeneity between outlets (P = 0·0008). Overall, younger, non-tertiary-educated adults, visitors and those that spoke English at home were significantly less likely to purchase ‘Everyday’ food items. Support was also significantly lower in males.Conclusions:The findings provide evidence of strong policy support, an increasing awareness of related changes and a trend towards increased ‘Everyday’ food purchasing. Given the relatively early phase of policy implementation, and the complexity of individual food purchasing decisions, longer-term follow-up of purchasing behaviour is recommended following ongoing implementation efforts.

Background:The development of alcoholic cardiomyopathy (ACM) is related to chronic excessive alcohol use. However, features of early-stage ACM are still unclear. We assessed echocardiographic characteristics of patients with alcohol dependence (DSM-IV criteria) during a six-month treatment period. Methods:Active drinking patients, heavy alcohol users, without heart disease, referred to our Alcohol Addiction Unit were enrolled in the study. After signing informed consent, patients started outpatient treatment program. Echocardiography was performed at enrollment, then three and six months afterwards, by cardiologists blinded to drinking status. Results:Forty-three patients (36 males, 7 females) were enrolled. At six months, 20 patients (46.5%) reduced alcohol consumption below heavy drinking levels. Although within normal range, baseline mean IVS thickness and mean LVDD were significantly higher (p < 0.001) and mean EF significantly reduced (p = 0.009), as compared to age-matched mean references. Mean E/A ratio, DcT and LA diameter were significantly different (p < 0.001) from mean references, but within normal range. Baseline mean E/e' ratio was significantly higher than the mean reference (p < 0.001) and out of the normal range. A significant correlation between the number of drinks per drinking days in the 7 days before baseline assessment and E/e' ratio was observed (p = 0.028). After six months, a trend-level reduction of mean E/e' ratio (p = 0.051) was found in the whole sample; this reduction was statistically significant (p = 0.041) among patients reducing drinking, compared to baseline. Conclusions:Altered E/e' ratio may characterize early-ACM before the occurrence of relevant echocardiographic alterations. The reduction of alcohol consumption could restore this alteration after six months.

This study utilised a cross-sectional survey of 369 participants in 77 countries to examine 15 possible risk and protective factors pertaining to the mental health of aid workers—many of which have not been assessed before—in the categories of job context, working conditions, and demographics. Risk factors associated with job context include emergency postings and being an international worker. No significant differences were found between humanitarian and development workers and none between organisation type; the number of past traumas was not associated with negative mental health outcomes. Protective factors with regard to working conditions include higher income, long-term contracts, previous psychosocial training, and voluntary postings. With respect to demographics, protective factors include older age, more work experience, and greater religiosity and spirituality, while female gender was a risk factor. Ultimately, this study provides a more nuanced understanding of the aid worker sector, which can inform the development of more targeted mental health support.

Aim People experiencing homelessness are often excluded from treatment programs for alcohol use disorder (AUD). The goal of this study was to describe the impact of a multidisciplinary treatment program on alcohol consumption and social reintegration in individuals with AUD experiencing homelessness. Methods Thirty-one individuals with AUD experiencing homelessness were admitted to an inpatient unit for 5–6 days for clinical evaluation and to treat potential alcohol withdrawal syndrome. A group of volunteers, in collaboration with the Community of Sant’Egidio, provided social support aimed to reintegrate patients. After inpatient discharge, all patients were followed as outpatients. Alcohol intake (number drinks/day), craving and clinical evaluation were assessed at each outpatient visit. Biological markers of alcohol use were evaluated at enrollment (T0), at 6 months (T1) and 12 months (T2). Results Compared with T0, patients at T1 showed a significant reduction in alcohol consumption [10 (3–24) vs 2 (0–10); P = 0.015] and in γ-glutamyl-transpeptidase [187 (78–365) vs 98 (74–254); P = 0.0021]. The reduction in alcohol intake was more pronounced in patients with any housing condition [10 (3–20) vs 1 (0–8); P = 0.008]. Similarly, compared with T0, patients at T2 showed significant reduction in alcohol consumption [10 (3–24) vs 0 (0–15); P = 0.001], more pronounced in patients with any housing condition [10 (3–20) vs 0 (0–2); P = 0.006]. Moreover, at T2 patients showed a significant reduction in γ-glutamyl-transpeptidase [187 (78–365) vs 97 (74–189); P = 0.002] and in mean cell volume [100.2 (95–103.6) vs 98.3 (95–102); P = 0.042]. Conclusion Patients experiencing homelessness may benefit from a multidisciplinary treatment program for AUD. Strategies able to facilitate and support their social reintegration and housing can improve treatment outcomes.

Background and purpose The objective of this study was to assess the neurological manifestations in a series of consecutive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive patients, comparing their frequency with a population hospitalized in the same period for flu/respiratory symptoms, finally not related to SARS-CoV-2. Methods Patients with flu/respiratory symptoms admitted to Fondazione Policlinico Gemelli hospital from 14 March 2020 to 20 April 2020 were retrospectively enrolled. The frequency of neurological manifestations of patients with SARS-CoV-2 infection was compared with a control group. Results In all, 213 patients were found to be positive for SARS-CoV-2, after reverse transcriptase polymerase chain reaction on nasal or throat swabs, whilst 218 patients were found to be negative and were used as a control group. Regarding central nervous system manifestations, in SARS-CoV-2-positive patients a higher frequency of headache, hyposmia and encephalopathy always related to systemic conditions (fever or hypoxia) was observed. Furthermore, muscular involvement was more frequent in SARS-CoV-2 infection. Conclusions Patients with COVID-19 commonly have neurological manifestations but only hyposmia and muscle involvement seem more frequent compared with other flu diseases.

Binge drinking (BD) is a common pattern of alcohol consumption among adolescents. At present few data are available on the possible relationship between BD and alcohol use disorders (AUD) in adolescents. The aim of this study was to assess the prevalence of BD and relationship between BD behavior and AUD among adolescents. A total of 2704 students attending 10 purposively selected high schools from three Italian provinces were surveyed. Questionnaires regarding socio-demographic data, pattern and amount of alcohol intake, smoking habits, use of illicit drugs, and physical activity were administered. AUD and affective disorders were also evaluated. Alcohol intake was reported by 2126 participants; 1278 reported at least one episode BD in the last year and 715 in the last month. A diagnosis of AUD was made in 165 adolescents. The prevalence of AUD was higher in adolescents that reported BD behavior than in those that did not report BD (11.6% vs 0.9%, respectively; p 0.0001). Logistic regression showed a positive relationship between a diagnosis of AUD and BD behavior (OR 9.6; 95% CI 4.7-22·9; p 0.0001). In conclusion alcohol consumption with the pattern of BD among adolescents is highly related to development of AUD.

The genus Monastria Saussure, 1864 includes medium to large sized (40–55 mm) dark brown or black cockroaches found in the understory of the Neotropical Atlantic Forest from the Northeast of Brazil to Paraguay and Argentina. The genus shows evident sexual dimorphism: males are elongated with fully developed wings extending beyond the apex of cerci and females are oval and brachypterous. This study is a revision of the genus with redescription of the three already known species, Monastria biguttata (Thunberg, 1826), Monastria similis (Serville, 1838) and Monastria angulata Saussure, 1864, and description of five new ones, Monastria itubera sp. n. and Monastria itabuna sp. n. from state of Bahia, Monastria cabocla sp. n. from state of Sergipe, Monastria kaingangue sp. n. from state of Sao Paulo and Monastria sagittata sp. n. from state of Minas Gerais. The morphology of the genus and all species is described in details, including male genitalia. Based on this revision, we proposed a new combination for Hiereoblatta papillosa (Thunberg, 1826) comb. n. , excluding it from the genus Monastria . For the first time, the juvenile stages of Monastria are characterized and compared to other genera of Blaberinae of the Atlantic forest. Three determination keys are provided. The two first are aimed at identifying the adults and juvenile stages of the five genera of the Blaberinae radiation endemic to the Atlantic forest, respectively. The third concerns the identification of the species of the genus Monastria . A map indicating the localities where species were sampled is also provided.

Aim Alcoholic liver disease (ALD) is the most common liver disease in the Western World. Liver transplantation (LT) is the treatment for end-stage ALD. However, many transplant centers are still reluctant to transplant these patients because of the risk of alcohol relapse, recurrence of the primary liver disease and associated post-transplant complications. We examined survival rate, prevalence of primary liver disease recurrence, re-transplantation and post-transplant complications among transplanted patients for alcoholic cirrhosis compared with those transplanted for viral cirrhosis. Methods data about patients transplanted for alcoholic and viral cirrhosis at the Gemelli Hospital from January 1995 to April 2016 were retrospectively collected. Survival rate was evaluated according to the Kaplan-Meier method. Recurrence was defined as histological evidence of primary liver disease. Data on the onset of complication, causes of death and graft failure after liver transplant were analyzed. Results There was no statistically significant difference regarding survival rate between the two groups. Only patients transplanted for viral cirrhosis presented with primary liver disease recurrence. There was a higher rate of cancer development in patients transplanted for alcoholic cirrhosis. Cancer was the major cause of death in this population. Risk factors associated with the onset of cancer were a high MELD score at the transplant time and smoking after transplantation. Conclusion ALD is a good indication for LT. Patients transplanted for alcoholic cirrhosis should receive regular cancer screening and should be advised against smoking. Short summary No difference was found between patients transplanted for alcoholic cirrhosis and viral cirrhosis in term of survival rate. Only patients transplanted for viral cirrhosis presented primary liver disease recurrence. A higher rate of cancer development was found in patients transplanted for alcoholic cirrohosis. This complication was associated with post-trasplant smoking.

Alcohol Use Disorders (AUD) is a leading cause of mortality and morbidity worldwide. At present disulfiram, naltrexone and acamprosate are approved for the treatment of AUD in U.S. and Europe. Nalmefene is approved in Europe and sodium oxybate is approved in Italy and Austria only. Baclofen received a 'temporary recommendation for use' in France.The safety of the above mentioned medications on liver, digestive system, kidney function, nervous system, pregnancy and lactation and their possible side effects are described and discussed.Mechanism of action and metabolism of these drugs as well as patients' clinical characteristics can affect the safety of treatment. All approved medications are valid tools for the treatment of AUD in patients without advanced liver disease. For some drugs, attention should be paid to patients with renal failure and medications may be used with caution, adjusting the dosage according to kidney function. In patients with AUD and advanced liver disease, at present only baclofen has been formally tested in randomized controlled trials showing its safety in this population.

The treatment of alcohol use disorder (AUD) with sodium oxybate (SMO) or gamma-hydroxybutyric acid (GHB) was introduced in Italy and Austria more than 20 years and 15 years ago, respectively, and it is now widely employed to treat alcohol withdrawal syndrome (AWS) and to maintain alcohol abstinence. These indications derive from its similar structure to the inhibitory neurotransmitter γ-amino-butyric acid (GABA), exerting an ethanol-mimicking effect, because it binds to GABAB receptors. Craving for, and abuse of, SMO remain a controversial issue; even though these unfavorable effects are evident in poly-drug addicted patients and in those with psychiatric diagnosis of borderline personality disorder. In addition, despite cases of severe intoxication and deaths being widely documented when GHB is used as “street drug”; its clinical use remains safe. Thus, the aim of the present review is to examine the role of SMO in the treatment of AUD, its possible implications in reducing alcohol consumption, and cases of abuse, and severe intoxication due to SMO during its clinical use in the treatment of AUD.

Repetitive Transcranial Magnetic Stimulation (rTMS) of the dorsolateral prefrontal cortex may affect neuro-adaptations associated with alcohol use disorder (AUD), potentially influencing craving and alcohol intake. We investigated alcohol intake and dopamine transporter (DAT) availability by Single Photon Emission Computed Tomography (SPECT) in the striatum of AUD patients before and after deep rTMS. Fourteen patients underwent baseline clinical and SPECT assessment. Eleven out of fourteen patients were randomized into two groups for the REAL (n.5) or SHAM (n.6) treatment. Clinical and SPECT evaluations were then carried out after four weeks of rTMS sessions (T1). At baseline, AUD patients showed higher striatal DAT availability than healthy control subjects (HC). Patients receiving the REAL stimulation revealed a reduction in DAT availability at T1, whereas the SHAM-treated group did not. In addition, patients receiving the REAL stimulation had a decrease in alcohol intake. The results of this longitudinal pilot study may suggest a modulatory effect of deep rTMS on dopaminergic terminals and a potential clinical efficacy in reducing alcohol intake in AUD patients. Further investigations are required to confirm these preliminary data.

This paper reports on a case of massive hyperostotic alterations observed in the skeleton of an adult woman from the necropolis of Montescaglioso Belvedere (Basilicata, Southern Italy) attributed to the Enotrian culture and dated to the 6th century BC. Hyperostotic changes involve joints, the vertebral column, and the lower limbs. In particular, the large flowing ossification in both the thoracic (T6-T10) and lumbar (L2-L5) tracts, the sacralization of L5, accompanied by sacroiliac fusion on the left side, and the proliferative bone production on both the metaphyseal portion of the left tibia and the left third metatarsal are described. The vertebral antero-lateral ossification and the sacroiliac fusion support a diagnosis of diffuse idiopathic skeletal hyperostosis (DISH), while the flowing bone formation on the lower limbs supports a diagnosis of melorheostosis. The pathological conditions described here were already described in the literature, but this is the first reported case of the coexistence of DISH and the very rare melorheostosis. Furthermore, the skeleton from Montescaglioso Belvedere represents the first case of this disease described for ancient Europe, therefore adding a valuable contribution to the reconstruction of the antiquity and distribution of skeletal dysplasias.

Background— Inflammation has a pathogenetic role in acute myocardial infarction (MI). Pentraxin-3 (PTX3), a long pentraxin produced in response to inflammatory stimuli and highly expressed in the heart, was shown to peak in plasma ≈7 hours after MI. The aim of this study was to assess the prognostic value of PTX3 in MI compared with the best-known and clinically relevant biological markers. Methods and Results— In 724 patients with MI and ST elevation, PTX3, C-reactive protein (CRP), creatine kinase (CK), troponin T (TnT), and N-terminal pro-brain natriuretic peptide (NT-proBNP) were assayed at entry, a median of 3 hours, and the following morning, a median of 22 hours from symptom onset. With respect to outcome events occurring over 3 months after the index event, median PTX3 values were 7.08 ng/mL in event-free patients, 16.12 ng/mL in patients who died, 9.12 ng/mL in patients with nonfatal heart failure, and 6.88 ng/mL in patients with nonfatal residual ischemia (overall P 1 at entry (OR, 2.20; 95% CI, 1.14 to 4.25), and PTX3 (>10.73 ng/mL) (OR, 3.55; 95% CI, 1.43 to 8.83) independently predicted 3-month mortality. Biomarkers predicting the combined end point of death and heart failure in survivors were the highest tertile of PTX3 and of NT-proBNP and a CK ratio >6. Conclusions— In a representative contemporary sample of patients with MI with ST elevation, the acute-phase protein PTX3 but not the liver-derived short pentraxin CRP or other cardiac biomarkers (NT-proBNP, TnT, CK) predicted 3-month mortality after adjustment for major risk factors and other acute-phase prognostic markers.

The present investigation aims to assess the changes in both social interaction and sex steroids excreted in feces of group-living Japanese macaques and rhesus monkeys. By comparing profiles of estrone conjugates (E1C) and pregnanediol-glucuronide (PdG) with the behavioral propensities of two closely related species living in similar environments, we could test the hypothesis that the social behavior of pregnant females shows significant hormonally mediated changes during the late prepartum and early postpartum period. We found a general tendency to withdraw from social life across pregnancy in both species. These behavioral changes were paralleled by endocrine profiles showing a slight prepartum increase in E1C during the last week in the rhesus group, whereas the increase was more marked and continuous in the Japanese macaque group. PdG increased slightly in rhesus macaques, whereas in Japanese macaques the fluctuations were not significant. Postpartum, both hormones dropped to low levels in both species, with no significant variation therein. Consequent to these changes, the E1C/PdG ratio increased significantly in late pregnancy only in the Japanese macaque group. Overall, these results show significant differences in the social behavior and endocrine profiles of two closely related species, thus complementing previous findings and indicating species-specific characteristics of the association between changes in affiliative behaviors and hormonal fluctuations. In particular, the shift between grooming performed and self-grooming, which showed the closest association with variations in the E1C/PdG ratio, could represent a reliable indicator of the change in the internal status of pregnant females, and is probably functional to infant survival.

Summary The aim of this work is to outline a general picture of life style and conditions of a population living in Magna Graecia between the 7th and the 4th c. BC by the study of human skeletal remains found in two necropoles from the Matera province, Timmari and Montescaglioso, neighbouring Metaponto, one of the main Ionian Greek colonies. The biological reconstruction was attempted by a holistic approach which foresees the use of anthropometric, anthroposcopic, palaeodemographic, palaeopathological data, the study of skeletal and dentoalveolar indicators of environmental stress and the integration with archaeological and historical information. Interpretation of the results was also based on comparisons with coeval sites from Central-Southern Italy, from Greece and with earlier and later sites from the same region. The two samples from Matera did not show appreciable differences with the other Southern Italian coeval series when compared on the basis of metric and morphometric traits. The comparison with Greek samples was hampered by the scarcity of pertinent data. A high level of muscular activity was observed in males and females, with males clearly more mobile than females. Sexual dimorphism and limb bone lateralisation were marked. Health conditions and nutritional status were good.

The ability to operate during the day and at night (i.e., cathemerality) is common among mammals but has rarely been identified in primates. Adaptive hypotheses assume that cathemerality represents a stable adaptation in primates, while nonadaptive hypotheses propose that it is the result of an evolutionary disequilibrium arising from human impacts on natural habitats. Madagascar offers a unique opportunity to study the evolution of activity patterns as there we find a monophyletic primate radiation that shows nocturnal, diurnal, and cathemeral patterns. However, when and why cathemeral activity evolved in lemurs is the subject of intense debate. Thus far, this activity pattern has been regularly observed in only three lemurid genera but the actual number of lemur species exhibiting this activity is as yet unknown. Here we show that the ring-tailed lemur, Lemur catta, a species previously considered to be diurnal, can in fact be cathemeral in the wild. In neighboring but distinct forest areas these lemurs exhibited either mainly diurnal or cathemeral activity. We found that, as in other cathemeral lemurs, activity was entrained by photoperiod and masked by nocturnal luminosity. Our results confirm the relationship between transitional eye anatomy and physiology and 24-h activity, thus supporting the adaptive scenario. Also, on the basis of the most recent strepsirrhine phylogenetic reconstruction, using parsimony criterion, our findings suggest pushing back the emergence of cathemerality to stem lemurids. Flexible activity over 24-h could thus have been one of the key adaptations of the early lemurid radiation possibly driven by Madagascar's island ecology. Am J Phys Anthropol, 2012. © 2012 Wiley Periodicals, Inc.

Primates deal with fluctuations of the thermal environment by both physiological and behavioral mechanisms of thermoregulation. In this article we focus on nonhibernating lemurs, which are hypometabolic and have to cope with a seasonal environment. Behavioral thermoregulation has received little attention compared with specific physiological adaptations to seasonality, i.e., hibernation and torpor, which characterize a number of lemurs. We investigated the role of seasonality and dietary-related factors in determining frequencies of resting, social and postural thermoregulation, and microhabitat selection in collared lemurs, Eulemur collaris. We observed two groups of collared lemurs over a 14-month period in the littoral forest of Sainte Luce, Southern Madagascar. Frequencies of total resting and time spent in huddling, prone, and curled postures were collected via 5-min instantaneous sampling. Microhabitat selection was evaluated as the proportion of time spent in the upper canopy as compared with other layers. Climatic variables were recorded by automatic data loggers, while dietary variables were derived from phenological data and nutritional analyses of the ingested food items. We weighted the combined effects of climatic and dietary variables on the different types of behavioral thermoregulation by means of canonical correlation analysis. The model with the strongest canonical correlation included a first root representing mainly feeding time, day length, and ambient temperature and a second root representing diet quality and height of feeding trees. The output indicated that collared lemurs adapt to thermal and dietary-related metabolic stress by adjusting resting time, social, and postural thermoregulation. Am J Phys Anthropol, 2011. © 2010 Wiley-Liss, Inc.

Subcutaneous fat measurements have been recently found to show sex differences in variability (dispersion dimorphism) in young adult samples from two extant unrelated European populations, with males more variable than females.This paper aims to investigate potential sex-by-age interaction and to verify its presence and possible different expression in various populations.Biceps, triceps, subscapular, suprailiac, abdominal, midthigh and calf skinfolds were analysed in two European samples from the Basque Country (4176 subjects, 8-50 years) and from Sardinia (2491 subjects, 14-100 years). Data on triceps and subscapular skinfolds in Non-Hispanic Whites (1799 subjects, 8-75 years), Mexican Americans (3133 subjects, 8-85 years), Other samples (1733 subjects, 8-70 years) from NHANES (2001-2002) were also included in the analysis. The significance of the difference between male and female coefficients of variation was performed by means of a suitable non-parametric bootstrap test.Skinfold coefficients of variation were greater in males than in females in 79.8% of comparisons with 27.2% significant differences. Dispersion dimorphism was particularly evident in peripheral subcutaneous fat depots. The results do not show appreciable variations across population samples and age classes.Skinfold dispersion dimorphism seems to exist throughout most of the life cycle, and be widespread in European and non-European human populations. It involves especially accumulation sites of the gynoid pattern known to be relevant in female reproduction. More 'standardized' fatty reserves in women might represent a selective advantage. On the other hand, skinfold dispersion dimorphism might also be related to cultural factors affecting the extent of female variability by means of enhanced environmental homogeneity.

This multicenter study examined the adherence of high-risk women to screening recommendations for breast and ovarian cancer following consultation at a familial cancer clinic (FCC). Self-report questionnaires assessing recall of screening advice, tests undertaken, risk perception, anxiety (Impact of Events Scale) and demographics were mailed to 396 consecutive eligible women who had attended one of six FCCs a median of 3.6 years prior. Family history, genetic test results and screening recommendations were abstracted from medical records. 182/266 (68.4%) women responded with 130 lost to follow-up. The proportions of women undertaking at least the recommended frequency of screening tests were: breast␣self examination (BSE) 50.4%, clinical breast examination (CBE) 66.0%, mammography 82.2%, transvaginal ultrasound (TVUS) 70.0%, CA125 84.0%. Factors associated with adherence to screening were: higher anxiety for BSE and CBE, being BRCA1/2 positive for CBE, older age, method of arrangement and having at least one affected first degree relative for mammography. Factors significantly associated with over-adherence were higher scores for anxiety for BSE and CBE and younger age (< 40 years) for TVUS. Between 41.3% (BSE) and 57.6% (CBE) of women incorrectly recalled their screening recommendations. A substantial minority of high-risk women do not adhere to screening advice. Strategies to improve the accuracy of recall of recommendations and the uptake of recommended screening are required.

Many reports have claimed that the duration of the swelling cycle in female bonobos (Pan paniscus) is longer than that of chimpanzees, and that the bonobo maximum swelling phase is markedly prolonged. Field data on intermenstrual intervals (IMIs) in female bonobos are limited and restricted to interswelling intervals (ISIs), which are assumed to reflect the IMI, though a direct comparison between the duration of ISIs and IMIs is still lacking. Reports on bonobo sexual activity as a function of the swelling phase are often contradictory. Moreover, the function of female homosexual interactions (genito-genital (GG) rubbing) is still debated. This study examines the reliability of the ISI as an approximation of the IMI, and the attractivity of female sexual swellings for other individuals. An analysis of 51 ISI-IMI pairs showed that ISIs are a fair representation of the reproductive cycle. The cycle length was 35.6±1.1 SE days relying on the ISI, whereas it was 35.0±1.1 SE days considering the IMI. This result is similar to the cycle length reported for chimpanzees. Female homosexual interactions and copulatory rates were higher during maximum tumescence, suggesting that the sexual swelling may be attractive for both males and other females. Furthermore, the GG-rubbing was performed free of a hierarchical postural imposition, and was not correlated with affinitive interactions. We suggest that GG-rubbing, which is generally the most frequent female sexual interaction, is a tool for social assessments among females. Am. J. Primatol. 67:333–347, 2006. © 2006 Wiley-Liss, Inc.

Empathy is a necessary prerequisite for the occurrence of consolation. The term "consolation" contains a hypothesis about function, which is distress alleviation. The present study aims to confirm the occurrence of consolation in captive chimpanzees via the post-conflict/matched-control method (PC-MC) and to suggest its possible roles. We collected 273 PC-MC pairs in the group of Pan troglodytes housed in the ZooParc de Beauval (France). We confirmed the presence of consolatory contacts (mean level of consolation, 49.5% +/- 22.3% SEM) in the colony. Consolation rates were significantly higher than reconciliation levels (mean level of reconciliation, 28.9% +/- 16.8% SEM). The level of consolation was greater in the absence of reconciliation than in the presence of it, suggesting that consolation might be an alternative behavior. As friendship and relatedness did not influence the occurrence of consolation, they did not seem to be the best prerequisites for this behavioral mechanism, at least in this chimpanzee colony. Affinitive contacts with third parties were significantly more frequent when the victim called attention to itself during severe aggressions by screaming. These high-pitched sounds seem to be useful in eliciting aid from conspecifics, as occurs in young humans. The occurrence of consolation reduced the likelihood of further attacks among group-members. From this perspective, both victims and consolers most likely gain potential advantages by interacting with each other when aggression is particularly severe, reconciliation is not immediate, and consequently social stress reaches high levels.

While dominance relationships have been widely studied in chimpanzees, in bonobos, dominance style and linearity of hierarchy are still under debate. In fact, some authors stated that bonobo hierarchy is nonlinear/ill-defined, while others claimed that it is fairly linear. In this paper, we test the hypothesis that a shift in group composition determines changes in linearity of hierarchy. To test this hypothesis, we collected data on one of the largest captive groups in the world, in the Apenheul Primate Park (The Netherlands). We investigated the linearity of the hierarchy in two different periods, with a shifting group composition. We used the corrected Landau's index and David's scores to estimate which animals were most dominant. The major overall result of our study is that hierarchy is fairly nonlinear in this group: during the first study period (eight adults), the hierarchy was nonlinear, whereas during the second one (six adults), it failed to reach statistical linearity. We argue that the reduction of the number of adults is the principal factor affecting linearity. We also found that dominance interactions were evenly distributed across sex classes in both study periods. Furthermore, no correlation was observed between age/body weight and rank. As for the overall dominance relationship between males and females, our results suggest that there is no exclusive female dominance in the Apenheul group. The dominance style of bonobos may be loose and differentially expressed in diverse groups or in the same group, along with shifting conditions.

This multicentre study examined uptake of bilateral risk-reducing mastectomy (BRRM) and bilateral risk-reducing oophorectomy (BRRO) in women at increased risk for breast and/or ovarian cancer who had attended a familial cancer clinic (FCC) between January 1999 and June 2000. Eligible women (N=396), were mailed a questionnaire assessing: BRRM and BRRO details; risk perception; and anxiety. Family history, genetic testing and risk assessment were abstracted from medical records. Surgery was cross-tabulated with demographics, risk perception and anxiety with either Fisher's exact test or the exact form of the Mantel-Haenszel test (for ordinal factors) used to investigate for associations. Ordinal logistic regression was used with continuous-scale covariates. In total, 130 women were lost to follow-up leaving 266; of these 182 (68.4%) responded. Mean follow-up time was 3.73 years. The BRRM rate was 4.4%; with no difference found between moderate and high-risk groups. BRRM was associated with increasing numbers of affected relatives (P=0.025). BRRO was undertaken by 17.3%, more commonly in women older than 40 years of age (P=0.023) and with a BRCA1/2 mutation (P=0.017). Women who underwent BRRM (P=0.052) or BRRO (P0.001) had a lower post-procedure risk perception than those who did not. During the timeframe of this study, risk-reducing surgery was undertaken by a small percentage of Australian women at increased risk for breast and/or ovarian cancer who attended FCCs. Family cancer history and mutation status were associated with uptake.

The aim of this paper is to verify the existence of dispersion (or variability) dimorphism in several anthropometric traits, i.e., some skeletal, muscular, and adipose dimensions, and to provide an evaluation of this scarcely considered aspect of sex differences. This research focuses on two human samples from two different European regions, Sardinia (Italy) and the Basque Country (Spain). Twenty-three anthropometric measurements were taken. A first qualitative analysis was carried out comparing the profiles of the coefficients of variation of each variable in both sexes. Secondly, the equality of variability was verified with different tests. In the normal case, Student's t-test, as proposed by Sokal and Braumann ([1980] Syst. Zool. 29:50-63), was applied. In the more general case, it was necessary to resort to resampling techniques. A suitable bootstrap test was constructed and the results were compared, when possible, with those obtained by other methods. The measurements showed parallel trends in the two populations. In particular, subcutaneous skinfolds showed significant dispersion dimorphism, with the greatest coefficients of variation in men. We suggest that this result was linked to stronger canalization in female dimensions related to the reproductive function and influenced by sociocultural factors. We also suggest defining dispersion dimorphism, whose existence is confirmed by the results presented in this paper, as a descriptive pattern of phenotype variability in both sexes that can be specific of a given class of anthropometric traits.

Although reconciliation in bonobos (Pan paniscus) has previously been described, it has not been analyzed heretofore by the postconflict (PC) match-control (MC) method. Furthermore, although reconciliation has been investigated before in this species, consolation has not. In this study we analyzed agonistic and affiliative contacts in all sex-class combinations to clarify and reevaluate the occurrence of reconciliation in bonobos via the PC-MC method. We also investigated the occurrence of consolation by analyzing the victims' triadic contact tendency (TCT), the influence of the sex of victims, and the relative occurrence of consolation and reconciliation. We collected 167 pairs of PC-MC observations in a captive group of bonobos (in Apeldoorn, The Netherlands). The conciliatory tendency (CCT) we obtained was tendentially lower than the mean value previously found for Yerkes captive chimpanzees. Close relationships, which were present in all female-female (FF) and some male-female (MF) dyads, positively affected reconciliation rates. When only adult PC-MC pairs (157) were considered, the mean TCTs and CCTs did not differ significantly. When we focused on types of PC affiliative contact, in the case of consolation we found a striking preference for sociosexual patterns. As to the relative occurrence of consolation and reconciliation, the highest level of the former was found in the absence of the latter. When reconciliation took place, consolation generally preceded it, suggesting that consolation may be a substitutive behavior. Our findings suggest that even if reconciliation remains the best option, consolation may be an alternative substitute for reconciliation that is used to buffer the tension originating from an unresolved conflict. Reconciliation and consolation are complex phenomena that are probably related to the life history of a group. Given that few studies have been conducted on this subject, we can not at this time make any generalizations regarding conflict resolution in certain species by comparing results among studies.

As evidence accumulates regarding the influence of hormones and stress-related conditions on maternal behavior, it becomes critical to better understand the relationship between physiological stress and the ability to cope with infants. Eight Japanese macaque females were observed 3 hr per week during the first 12 weeks after parturition; fecal samples were collected twice a week from each mother, starting 4 weeks before parturition and ending 4 weeks after parturition. Time spent in contact, maternal responsiveness, latency of response, and maternal rejection were measured and correlated with peripartum excreted cortisol and estradiol metabolite levels. Two indices of peripartum hormonal status were also tested against behavior: the postpartum stress index, and the postpartum cortisol/prepartum estradiol ratio (F/E). Postpartum cortisol levels showed a positive correlation with maternal rejection. The cortisol/estradiol ratio was positively correlated with rejection and latency of response, and negatively correlated with maternal responsiveness. Prepartum cortisol levels and the postpartum stress index did not correlate with any aspect of maternal behavior. Our findings suggest that hypothalamic-pituitary-adrenal (HPA) axis activity per se is not enough to predict the quality of interaction between mother and infant. Only when cortisol is high relative to estradiol could it be symptomatic of a possible negative feedback response involving stress, adrenal activity, and the ability of mothers to cope with the additional problems imposed by newborns.

This research assessed mother-infant relationships in rhesus and Japanese macaques living in analogous captive social groups, and monitored changes in the levels of excreted estrogen metabolites during the peripartum period. Each mother-infant pair was focally observed 3 h per week during the first 12 weeks of life of newborns. Fecal samples were collected twice a week from each mother, starting 4 weeks before delivery and ending 4 weeks after delivery. Infant-directed behaviors appeared to be consistently less protective/controlling and more rejecting in rhesus macaques than in Japanese macaques. Estrogen metabolite levels during the perinatal period were, on average, 3-fold higher in Japanese macaques and showed a sharp increase during the last weeks of pregnancy only in the Japanese macaque group. Considering the ecological and behavioral similarities between Japanese and rhesus macaques, the divergence between the two species in the onset and maintenance of maternal behavior was unexpected. This was possibly linked to the difference in the overall body size and life history, and to the striking divergence in estrogen metabolite variation during the peripartum period. Group size, social relationships, and average age of individuals in the two captive groups were not clearly involved in the recorded differences in maternal behavior.

In this study we report preliminary data on the consumption of tannin-rich plants by sifakas (Propithecus verreauxi verreauxi) living in the Kirindy forest, western Madagascar. Sifakas spent most of their time feeding on only a few plant species. The tannin intake during the period between the pregnancy and birth season was significantly higher in pregnant females or females with lactating infants than in non-reproductive females and males. These periparturient females secured a larger proportion of condensed tannins by short feeding bouts on plants not included in the group's limited preferred food species. The measured increase in tannin intake is puzzling in light of the fact that tannins are commonly known for their protein-binding properties. Since protein demands are highest in pregnant and lactating females, possible medicinal benefits of tannin ingestion are considered. Tannin consumption is associated with an increase in body weight and stimulation of milk secretion. Veterinarians administer tannins as an astringent, anti-hemorrhagic and anti-abortive. Their high potential as an alternative anthelminthic has also recently been recognized. Thus, when viewed as self-medicating behavior, controlled increase in tannin intake could have multiple prophylactic advantages for females during the periparturient period. The high selectivity in their plant choice, and the presence of unusual feeding habits by a particular group of individuals (females with infants) limited in time (birth season), suggests that an increase in tannin ingestion may be a self-medicating behavior with multiple directly adaptive benefits to female reproduction.

Objective: The purpose of this paper was to investigate factors associated with intrafamily violence toward children in Italy. Family structure and the characteristics of both caretakers and children were explored. Their association with the incidence of minor and severe violence was analyzed to test the hypothesis that child physical abuse is related to a combination of different factors involving the family as a whole. Method: This research was carried out by submitting an anonymous questionnaire to 2388 families residing in Tuscany, Italy. The form included two sections, one related to the family cultural substrate, and to potentially influential events affecting the family during the year 1998. The other one, taken from the conflict tactics (CT) scales, presented a hierarchy of possible responses to conflict. Results: Physical punishment appeared to be a general behavior in Italy, because the incidence of minor violence was 77%. The incidence of severe violence was about 8%. When considering family, caretaker, and child characteristics mostly associated with physical punishment in Italy, we found that families with a low income, where caretakers had health problems or were stressed, and with younger and more “problematic” children presented the highest risk of intrafamily violence during conflict resolution. Conclusions: The results point to the importance of a balance between potentiating and compensatory factors in complex and dynamic relationships among family members, to avoid strategy resolution of conflict ultimately leading to violence. Moreover, minor and severe violence appeared to be two related but different phenomena.

This work assessed the changes in both social interactions and estrogen metabolite excreted in feces in eight group-living Japanese macaques (Macaca fuscata). We tested the hypothesis that the social behavior of pregnant females shows significant changes during the late prepartum and early postpartum period. We also tested the hypothesis that the marked fluctuation in estrogen levels during the perinatal period is associated with the changes in social behavior. We found that pregnant females withdrew from the social life of their group in preparation for parturition and only slowly regained their normal social activity after delivery. These changes were correlated with the fluctuation in estrogen conjugate excreted in feces, giving further evidence that hormones can enhance responsiveness to the infant and may predict maternal competence in macaques. We also found that the high frequency of self-grooming by pregnant females during the perinatal period may be a functional way to improve the quality of care toward an infant by a simple shifting from the care for oneself to the care for the infant after parturition.

Several ecological and physiological factors have been suggested to structure circadian activity in cathemeral primates, i.e., those that are regularly active both day and night, but their relative importance remains controversial. We studied the nocturnal activity of a group of cathemeral redfronted lemurs (Eulemur fulvus rufus) in Kirindy Forest in Western Madagascar to examine its relationship with one environmental factor, ambient light levels, in detail. To this end, nightly travel distances and moon luminosity were determined between March and June 1996. During this transitional period between the wet and dry seasons these red-fronted lemurs were regularly active at night, and traveled significantly larger distances during full-moon nights compared to new-moon nights. The importance of ambient luminosity for nocturnal activity was highlighted by observations during a total lunar eclipse (i.e., during a full-moon night), which caused abrupt cessation of the animal's activity. Our results support the hypothesis that nocturnal activity of these cathemeral lemurs is regulated also by changes in ambient light levels.

The difference between male and female values of quantitative traits depends on the distribution of the variables within each sex, increasing with the rise in the difference between male and female average values and with the decrease of the dispersion of measurements in both sexes. This paper deals with the sensitivity of some widely used indices (relative difference between male and female mean values (MDI), Student's t, and the so-called Bennett-Chakraborty-Majumder D coefficient) with respect to intrasexual variability. The Kolmogorov-Smirnov distance (KS) is suggested here as a further index of dimorphism, although it is not usually utilized for this purpose. The theoretical approach is accompanied by the analysis of empirical data (metric variables obtained from a sample of present Sardinians) and by computer simulations under various assumptions. Indices based on the difference between male and female average values are not able to evaluate fully the various aspects of dimorphism. Student's t proved to be an adequate measure of whole sex differences, both in real and in simulated samples, as intrasexual variability is included in its formulation. The D index also proved to be a good measure of undivided sexual dimorphism, as it is the result of formal examination, and from application to empirical or to simulated cases. The Kolmogorov-Smirnov distance gave the best performance both in formal examination and in the whole simulation results, as it takes into account intrasexual variability, and is applicable to any kind of distribution. In simulated cases it was sensitive to variations of means and variances, and it was able to evaluate variance dimorphism. Since the last three indices measure the combined effect of size and variance dimorphism, the joint use of the MDI index is suggested in order to isolate the relative contribution of the difference between the means.

In 44 diabetic patients treated either with insulin or with oral antidiabetic agents, non-enzymatic glycosylation of serum proteins (GSP), expressed as nmol of 5-hydroxymethylfurfural/mg protein, showed higher values than those found in control subjects. In the diabetics GSP was more closely correlated to the degree of glycometabolic control during the 15 days preceding the assay, than to the glycosylated hemoglobin (HbAl). However, GSP values did not correlate significantly with fasting blood glucose levels. It may be concluded that GSP can be used as an index of the medium-term control of diabetes mellitus.

A new method is proposed for the determination of antistreptolysin O, based on the properties of streptolysin O. The reduced form of the toxin is hemolytic, whereas the oxidized form is not; this activity can be restored, however, by a reducing agent. Both forms maintain the capacity to bind specific antibodies. Unlike the classical method, the assay is performed on whole blood, using the patient's own erythrocytes as revealing agents. A procedure is proposed which limits the operation to a single dilution of a microvolume of blood (0.05 ml brought to 2 ml) and to the distribution of constant quantities in test tubes prefilled with different amounts of oxidized streptolysin O. After a few minutes, a reducing agent is added, and the reading is performed as in the classical technique after sedimentation of the erythrocytes. Correlation with the traditional method (r = 0.987) is evaluated on the basis of the results of samples from hospitalized patients.

A new radioimmunoassay (RIA) method is proposed, utilizing cellulose disks coated with a 125 I- Ag Ab complex as a single reagent. The labeled antigen is released into the incubation medium proportionally to the concentration of the corresponding antigen in the sample. The method is comparable to the classical RIA with regard to sensitivity, precision, and specificity, but it has the advantage of a wide range of nondependence on the sample volume and greater practicability (the analysis is performed using a single-step procedure). The assay of human chorionic somatomammotropin is adopted as a model.

Human chorionic somatomammotropin (HCS) is determined by an enzyme immunoassay where HCS competes with biotin-labeled HCS for insolubilized anti-HCS antibodies. Enzymelabeled avidin is then used to reveal the amount of bound HCS. The system proves to be sensitive (1 ng/ml of HCS can be detected) and results agree with radioimmunoassay determinations (correlation coefficient = 0.979). Kinetics of the avidin-biotin reaction and coating of polystyrene wells are also investigated.

A method is described for the quantitative assay of human prostatic acid phosphatase after its isolation from serum by a double antibody technique employing a specific rabbit antiserum and a goat anti-rabbit gammaglobulin serum. After centrifugation, the precipitate is analyzed for phosphatase activity using p-nitrophenylphosphate as substrate. The method allows a rapid, precise, specific and sensitive assay.

Chronic alcohol abuse represents a risk factor for oral diseases, in particular, oral cancer. Periodontal disease has been showed to be involved in the pathophysiology of cardiovascular and metabolic diseases, such as atherosclerosis and liver steatosis. The role of chronic alcohol consumption on periodontitis is still controversial. The aim of the study was to evaluate the effect of chronic alcohol abuse on oral health.Twenty-three alcohol use disorders (AUD) patients and twenty-three healthy social drinkers underwent an oral examination by trained oral clinicians in order to evaluate oral and dental health. A questionnaire assessing oral hygiene was administered together with the evaluation of DMFT (decayed, missing, filled teeth), SLI (Silness-Loë plaque index) and CPI (community periodontal index of treatment needs) scores.Alcoholic patients showed significantly lower oral hygiene scores compared to controls. Alcoholic patients showed significantly poorer scores at DMFT, SLI and CPI tests. Moreover, among alcoholics, smokers showed a significantly poorer oral health than non-smokers.Chronic alcohol abuse increases the risk of dental and periodontal diseases. Smoking represents a significant co-factor. The practice of basic oral hygiene and the access to professional dental care should be encouraged among AUD patients in order to reduce oral diseases.

The solubility of human pituitary growth hormone in ammonium sulfate solutions has been investigated and compared under similar conditions with that of three related proteins: ovine pituitary growth hormone, bovine pituitary growth hormone, and human chorionic somatomammotropin.