No study has ever explored the prevalence and correlates of video game playing among children in the Islamic Republic of Iran. This study describes patterns and correlates of excessive video game use in a random sample of middle-school students in Iran. Specifically, we examine the relationship between video game playing and psychological well-being, aggressive behaviors, and adolescents' perceived threat of video-computer game playing.This cross-sectional study was performed with a random sample of 444 adolescents recruited from eight middle schools. A self-administered, anonymous questionnaire covered socio-demographics, video gaming behaviors, mental health status, self-reported aggressive behaviors, and perceived side effects of video game playing.Overall, participants spent an average of 6.3 hours per week playing video games. Moreover, 47% of participants reported that they had played one or more intensely violent games. Non-gamers reported suffering poorer mental health compared to excessive gamers. Both non-gamers and excessive gamers overall reported suffering poorer mental health compared to low or moderate players. Participants who initiated gaming at younger ages were more likely to score poorer in mental health measures. Participants' self-reported aggressive behaviors were associated with length of gaming. Boys, but not girls, who reported playing video games excessively showed more aggressive behaviors. A multiple binary logistic regression shows that when controlling for other variables, older students, those who perceived less serious side effects of video gaming, and those who have personal computers, were more likely to report that they had played video games excessively.Our data show a curvilinear relationship between video game playing and mental health outcomes, with "moderate" gamers faring best and "excessive" gamers showing mild increases in problematic behaviors. Interestingly, "non-gamers" clearly show the worst outcomes. Therefore, both children and parents of non-game players should be updated about the positive impact of moderate video gaming. Educational interventions should also be designed to educate adolescents and their parents of the possible harmful impact of excessive video game playing on their health and psychosocial functioning. Playing video games is now a major leisurely pursuit among children in many parts of the world -12. OverRegardless, evidence suggests that the prevalence of video games, especially violent video games, among adolescents from low- and middle-income countries is increasing dramatically and requires additional investigation to evaluate the connection between violent video games and aggressive behaviors. Lack or insufficient reinforcement of copyright protections and the selling of rated video games to children in these countries have intensified public concerns on the possible negative impact of violent video games on aggressive cognitions, attitudes, behaviors, academic performance, and the psychological well-being of children. This study describes patterns and correlates of excessive video game use in a random sample of middle-school boys and girls in the Islamic Republic of Iran. Specifically, we examine the relationship between video game playing and psychological well-being, aggressive behaviors, and adolescents' perceived threat of video-computer game playing. To the best of our knowledge, no study has ever explored the prevalence and correlates of video games among children in Iran. The impact of violent video games on the attitudes, behaviors, and mental health of the youth in Middle-Eastern countries may be intensified or indeed suppressed by several ongoing violent conflicts in the region. Similar to the rest of Middle-Eastern countries, Iranians have constantly been exposed to well-publicized, broadcasted, excessive violence in the region, including an eight-year Iran-Iraq war, the first Persian Gulf war (Iraq vs. Kuwait and US-collection), the U.S. occupation of Afghanistan and Iraq following the tragedy of 9-11, almost 50 years of on-going Palestinian-Israeli conflict, as well as almost daily suicide and/or car bombings etc. by individuals in this region. Iran is the most populated country in the Middle East with a population of over 70 million. More than two-thirds of its population is under the age of 30 ,20.This cross-sectional study was performed with a random sample of eight schools selected from all 26 middle schools in the city of Hamadan, which is located in central Iran, with a population of over 500,000 people . Almost This survey was self-administered in the absence of the instructor and collected by research associates of this project who were unaffiliated with the schools during regular classroom hours. To increase the validity of the responses, efforts were made to guarantee complete anonymity. Students were given a brief introduction and were asked not to write their name or any other identifiable information anywhere on the survey. The survey was conducted from February to March 2008. This study was conducted with approval from Hamadan University's Institutional Review Board. Informed assent and consent were obtained from participants and their parents/guardians. The survey instrument was pilot tested with 20 students and modified accordingly. The questionnaire was administered in Farsi, the official language of Iranian schools. Regardless of ethnicity or background, all Iranian students speak and write Farsi.In addition to demographic characteristics, survey instruments included several items that were specifically designed to capture the amount of time students spend playing video games during weekdays and weekends. Commitments to video game use, the average and longest duration of play, and the type of video games were assessed.The validated 28-item Farsi version of the General Health Questionnaire (GHQ-28)  was usedThe Orpinas' aggression scale was used to measure aggressive behaviors of students . The scaA 5-item rating scale was used to gauge student beliefs on the side effects of playing excessive video games. The following are examples of the 5-item rating scale: "I believe that excessively playing video games has negative affects on educational performance;" and "I believe that obesity could be a side effect of excessively playing video games." Each of these items was measured on an ordinal 5-point Likert-type scale . Higher scores on the scale indicated a greater perceived threat of video-computer games. The internal consistency reliability of this scale was examined using Cronbach's coefficient alpha (α = 0.72).Based on previous content analyses of popular video games among Iranian children, video games that were reported to be played by participants were categorized into two major groups: violent and non-violent games. Additionally, one of the co-authors of this study personally examined the content of each game to verify whether games are correctly categorized.Descriptive statistics were calculated to identify the distribution and frequency of all items which were subsequently used to construct the independent scales and indices for examination. In the bivariate analysis, chi-square tests were performed to measure the association between independent and outcome variables. A series of logistic regression and descriptive analyses was computed. Interrelationships between independent variables were examined to assess potential multicolinearity between independent variables. All statistical analyses were performed using the statistical software package SPSS .Of 477 adolescents who were selected to participate in this study, 444 students (93%) completed the survey. Less than 7% of students refused to participate in the study or did not complete the survey. Since the survey was anonymous, we were unable to record and compare the non-responders n = 31) with participants. Table  with parDead or Alive, Def Jam, Doom, Driver, Mortal Kombat, Grand Theft Auto, Resident Evil, and Prince of Persia.More than 57% of children reported that they had a computer or game console in their bedroom. Both girls and boys spent an average of 6.3, and 6.2 hours per week playing video gaming, respectively. Moreover, 47% of participants reported that they had played one or more intensely violent games including: The bivariate correlates of video gaming are reported in Table Participants' aggressive behaviors were associated with length of gaming; those who admitted playing longer, scored higher on the Orpinas' aggression scale . Further analysis shows that none of the 11 items of this scale were associated with length of time playing video games. However, boys who reported playing video games excessively - more than 7 hours per week - scored higher on: 1) fighting back; 2) name-calling; 3) teasing; and 4) threatening to hurt or hit items. None of the aggressive behaviors scale's items were associated with excessive playing among girls.Table 2 indicates that this set of variables/subscales explain over 14% of the variance in the dependent variable. Age, personal computer ownership, and perceived side effects of playing video games each showed independent impact on the outcome variables. This finding indicates that, controlling for all other variables, older students , students who perceived less serious side effects for playing video games , and those who have personal computers  were more likely to report that they had played video games excessively. No significant independent relationship between parental demographic characteristics and excessive video gaming was detected.The multiple binary logistic regression technique was employed to examine independent correlates of excessive video game playing. Independent variables included in the equation are reported in Table This cross-sectional study was performed to describe patterns and correlates of video game use in a random sample of middle-school students (aged 12 - 15) in the Islamic Republic of Iran. Similar to American teens , our datAdditionally, more than 15% of participants spend more than 10 hours per week playing video games. The stereotype that only boys play video games is far from true in Iran, as girls constitute a larger percentage of total video gamers: 92% of boys play video games, as do 96% of girls. While almost all girls and boys play video games, boys typically play games with greater duration than girls per setting; 11% and 6% of boys and girls spend more than 4 hours per setting, respectively. One out of two adolescents surveyed in this study reported that they had played one or more intensely violent games.One aspect of the results that warrants further discussion is the impact of the non-gaming and excessive video game playing on mental health status. Importantly, non-gamers and excessive gamers overall reported suffering poorer mental health compared to moderate players. As indicated in Table However, their surveys also documented statistically significant relationships between violent game play and some common childhood problems among boys but not girls. Boys who extensively played any Mature-rated game had twice the risk of certain aggressive behaviors and school problems compared to boys who played games with lower age ratings. Indeed,Another component of the results that requires further attention has to do with the detected impact of the perceived side-effects of video game playing on excessive game playing. The multiple binary logistic regression shows that controlling for all other variables, those who perceived less serious side effects for playing video games were more likely to report that they had played video games excessively. This important finding may have extensive policy implication. Educational motivational interventions should be designed to educate adolescents of the possible harmful impact of excessive video game playing on their health and psychosocial functioning.Our findings suggest that playing video games may have different social implications for girls than for boys. Our data shows that boys, but not girls, who admitted playing video games excessively showed more aggressive behaviors. However, recent data show that moderate gaming among young men may provide a healthy source of socialization, relaxation, and coping . In addiIt is important to inform parents that while moderate video game use may be a positive experience, excessive use may cause problems. However, both children and parents of non-players should be updated about the positive impact of moderate video gaming. Similarly, comprehensive actions are needed in order to diminish excessive time spent playing video games, particularly mature-rated games, among adolescents in general and boys in particular. Finally, strategies are needed to encourage making pro-social video games more attractive and accessible to children, particularly male adolescents who play video games excessively.The authors declare that they have no competing interests.All authors read and approved the final manuscript. H.A. conceived of the study and participated in the design, data collection and analysis as well as MS preparation. M.B. participated in the data analysis and MS preparation. A.F. participated in the design and data collection. B.M. participated in the design data collectionThe pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2458/10/286/prepub


Psychometric properties of a new scale that measures motivations towards alcohol use were examined using a sample of 412 male alcohol users in Sri Lanka aged 16–30 years. In addition, associations between drinking motives and drinking frequency were explored. Confirmatory factor analysis showed that a 3-factor model consisting of the factors personal enjoyment, tension reduction, and social pressure fit the data well. Overall, tension-reduction motivation was found to be prominent in the context of young males’ drinking behavior in Sri Lanka. Associations between stress and alcohol use among young males warrant further investigations. This is partly due to the widespread production of illegal liquor in a country where no records of the quantity and sale of illegal liquor are kept . AnotherThe reasons and motives for drinking alcohol are closely associated to the drinking patterns and consequences of alcohol use ,10. DiffResearchers have identified a number of domains of drinking motives ,10, and To date and to our knowledge, no studies have been conducted on the motivation toward alcohol use among people in Sri Lanka. This study’s purpose was to test the 3-factor structure of a scale developed to measure drinking motives and to examine the relationships between drinking motives and drinking patterns in a sample of males aged 16–30 years in Sri Lanka. It was hypothesized that the drinking motives scale consist of three factors: personal enjoyment, social pressure, and tension reduction. It was also hypothesized that drinking motives were related to drinking frequency.2.A cross-sectional survey design was used. An anonymous, self-administered questionnaire was employed to collect data. Boards for the protection of human subjects from universities in both the United States and Sri Lanka approved the study protocol.2.1.Purposive sampling method was used to select sample subjects. Efforts were made to obtain an equal number of adolescents (16–19 years of age) and young adults (20–30 years of age) for the sample, so that the sample would represent the young males in the study population. Men aged 16–30 years, who were in the streets, universities and other educational institutes, in work places, or at homes during the survey period and who identified themselves as either occasional or regular drinkers, were invited to participate in the survey after explaining to them briefly the purpose of the survey and the anonymous nature of the data collection method. Those who agreed to participate in the study were surveyed using the questionnaire.The survey was conducted in two settings: urban and semi-urban. Three medical undergraduate students were recruited and trained as data collectors. The people in the area respect and have a high confidence in those working or studying in the medical field, thus recruitment of medical students as data collectors increased the response rate. Only about 5% of the subjects who were asked to participate refused to do so. Data were collected for a period of two weeks in January 2007 and a total of 448 subjects participated in the study.2.2.I use alcohol followed by four response categories: daily, 2–3 times a week, 2–3 times a month, and 2–3 times a year. A literature survey was done and expert opinions were sought to identify motives towards alcohol use in young people in Sri Lanka [I use alcohol because it helps me to forget my worries, were included in the new scale. New culturally-appropriate items, such as I drink alcohol because it will enhance my creative ability and I drink alcohol because it helps me to control others, were added to the new scale. The new scale varies from the contemporary drinking motive scales that have been developed and used in the West.The survey instrument consisted of several variables: age, drinking frequency, and 20 questions on drinking motives. Drinking frequency of the participants was obtained using the item ri Lanka ,16–19. TI drink alcohol because I like the taste was a PE item, and I drink alcohol because it is customary for men on special occasions was a SP item. There were four response categories for each of these 20 items which were scored as follows: to a greater extent equals 3; to some extent equals 2; to little extent equals 1; and not relevant equals 0. The internal consistencies of the three factors using Cronbach’s alpha methods were as follows: alphaPE = 0.48; alphaTR = 0.74; and alphaSP = 0.62. To assess the impact of each factor on drinking habits, each item in each of the three subscales were added up to obtain 3 subscale scores.A jury of experts consisting of a psychiatrist, two social scientists, and a psychologist examined the items for content validity. Based on their evaluation, the final scale of motive towards alcohol use was constructed using 20 rating items . Forty-eight participants (11.7%) were married. Of the total, 102 (24.8%) had a job at the time of the survey and the others were either students or unemployed. Nine participants (2.2%) were daily users, 33 (8%) use alcohol 2–3 times a week, 76 (18.4%) 2–3 times a month and the remaining 294 (71.4%) 2–3 times a year. Means, standard deviations, and correlations among subscales and total scale are provided in After cleaning and consistency checking, analysis was done using 412 sample subjects. The age of the participants ranged from 16–30 years (p < 0.01). The strongest association was found between tension reduction and total score, and a relatively weaker association was found between personal enjoyment and social pressure.Correlations among subscales and total scale ranged from 0.28 to 0.90  = 323.16; χ2/df ratio = 1.93:1; CFI = 0.98; and the RMSEA = 0.048 [The 3-factor structure of the scale 01 level . Loading3.2.To test the second hypothesis, associations between the 3 motivational factors and drinking frequency were examined using multiple regression. This analytical method was chosen so that the effects of the drinking motive dimensions could be mutually adjusted. The results are presented in As can be seen from the individual beta weights, only tension reduction predicts drinking frequency. Thus, it is reasonable to infer that young males in Sri Lanka are less likely to be motivated to use alcohol because of its enhancement effect or because of the social pressure exerted by peer or social groups to use alcohol.4.The present study aimed to develop and test a 3-factor measurement of drinking motives. It also explored whether drinking motives were related to young males’ drinking frequency and, if so, which drinking motives were. As expected, according to CFA, the 3-factor model on drinking motives  complemented the data on this sample of male alcohol users aged 16–30 in southern Sri Lanka. Although similar instruments used in western countries ,16,18,19Results of the study suggest that drinking to reduce tension seemed to be the most emphatic motive of alcohol use in this sample of young males. Stress, suicidal ideation, and suicide rates among young Sri Lankan people are ranked among the highest in the World ,25, and In studies conducted in other countries, social motives were found to be associated with moderate alcohol use, and personal enjoyment (enhancement) motives with heavy drinking ,16,26. IThe cross-sectional design does not allow for any inference of a cause-effect relationship. Thus, relationships between motives and drinking patterns are better tested with longitudinal data. The use of purposive, non-probability sampling procedure may have limited the generalizability of the findings. However, it should be noted that in countries like Sri Lanka, where alcohol use is considered as “anti-social” behavior, especially by young people, refusing to participate and underreporting drinking behaviors would become major threats to selecting a representative sample if we were to select a random sample from households. Although self-report measures would raise questions of reliability and validity, the use of medical undergraduates in data collection and collecting data in non-threatening atmospheres, such as on the streets in most occasions, reduced this problem tremendously. It is also likely that some items in the scale may have related to more than one motivational factor, and items not included in this scale do have an impact on drinking motives. Further, alcohol habits should ideally be investigated using the type, quantity, and frequency of use. Future research needs to address these methodological and measurement issues.5.The study advocates a 3-factor structure for a scale of motivations towards alcohol use, the scale developed and used for this study. However, the scale needs to be validated using a larger representative sample. Tension-reduction motivations seemed to be the most important social-cognitive factor in young Sri Lankan males’ drinking behavior. These findings have several implications for public health research and interventions. There is need for a continued focus on individual tension-reduction reasons for drinking in adolescents and young adults in substance use prevention programs. Alcohol motives are likely to have been shaped by other indirect and distal forces such as availability and the media. For example, television scenes that glamorize its use or incorporate strong symbolic meaning, such as rebellion against prejudice, while featuring alcohol may cause young people to initiate and continue drinking. Research that offers a better understanding of psycho-social and environmental factors associated with alcohol use behavior among the younger population in Sri Lanka is urgently needed.


Patients with laryngeal lesions were observed and the lesions were recorded with anelectronic videoendoscope system using the PENTAX EPM-3300 video processor and thePENTAX VNL-1330 endoscope portion. The electronic videoendoscope system differsfrom the conventional fiberoptic endoscope connected to a video camera in that a smallmonochrome charge-coupled device (CCD) chip is built in the tip of the endoscope portion.The PENTAX VNL-1330 rhinolarynx endoscope portion has a tip and insertion tube ofapproximately 4mm in outer diameter to allow its introduction through the nasal passagesinto the larynx. The dynamic color images provided by this system were superior to thoseobtained by a conventional rhinolarynx flexible fiberscope connected to a video camera inboth quality and resolution of detail. This system should be useful in diagnosing laryngeallesions.


Alcohol consumption is pervasive in the United States, and extent of alcohol consumption for the growing US Hispanic population needs further study. We examined the association between language chosen for a national health survey and alcohol use among Hispanic adults.2 analyses and logistic regression models.Hispanic participants aged 18 years and older  from the 2005 Behavioral Risk Factor Surveillance System were stratified by choice of language  for completing the survey. Differences for these 2 groups in current alcohol use, heavy alcohol use, and binge drinking were determined by using χP < .001), heavy drinking (P < .001), and binge drinking (P = .002) were significantly higher among participants who chose to complete the survey in English than among those who elected to complete the survey in Spanish. After controlling for demographic characteristics, associations between language choice and drinking behaviors were found to be greatest among women. Compared with women who chose to complete the survey in Spanish, women who chose to complete the survey in English were more than twice as likely to report current drinking , heavy drinking , and binge drinking .In bivariate associations, current drinking (This study suggests that language choice when completing a health survey is a predictor of high levels of alcohol use among Hispanic adults in the United States and that differences in drinking behaviors based on language choice for a survey are more profound among women. Over the past 20 to 30 years, major demographic shifts in ethnic composition have occurred in the United States, particularly among the Hispanic population. From 1970 to 2000, the Hispanic population grew in the United States from 4.7% to 12.5%  survey. The BRFSS is an ongoing, state-based, random-digit–dialed, land-line telephone survey of adults aged 18 years or older that collects information on health risk behaviors, preventive health practices, and access to and use of health care services primarily related to chronic conditions. The data collected in the BRFSS are weighted to provide national estimates. In 2005, a total of 356,212 respondents participated in the survey. The median response rate for this survey was 51.1%, and the median cooperation rate, defined as the proportion of people interviewed of all eligible people who were actually contacted, was 75.1% .The sample for this study was limited to participants who identified themselves as Hispanic and who resided in 1 of the 50 US states or the District of Columbia. The sample size for our analysis was 20,234, which represented approximately 28 million people in the United States. The sample was stratified by language preference of the survey respondents; group assignment was determined by whether the survey was conducted in Spanish  or English . Demographic characteristics examined for each group were age, sex, marital status, number of adults in the household, education level, employment status, and region of the country in which the participant lived.Three measures of alcohol use were determined for this sample: current drinking, heavy drinking, and binge drinking. Current drinking was determined by the question, "During the past 30 days, have you had at least 1 drink of any alcoholic beverage, such as beer, wine, a malt beverage, or liquor?" People who responded no were not asked the subsequent questions on heavy drinking and binge drinking; thus, heavy drinking and binge drinking were assessed only among current drinkers. Heavy drinking was defined as having more than 2 drinks per day for men and more than 1 drink per day for women and was determined by the question, "One drink is equivalent to a 12-ounce beer, a 4-ounce glass of wine, or a drink with 1 shot of liquor. On the days when you drank, during the past 30 days, about how many drinks did you drink on the average?" . Binge dThe sample was described by providing estimates of the different demographic characteristics  by language of the survey. Bivariate analyses were performed on the 3 alcohol measures between participants who chose to complete the survey in English and those who chose Spanish. Chi-square tests were used to analyze the independent association of alcohol consumption with language preference. Significance was set at α = .05. Separate logistic regression models were performed to examine the association between the 3 alcohol measures and language preference, while controlling for demographic variables. Both bivariate and multivariate analyses were conducted for the entire sample, as well as stratified by sex because of findings from previous research suggesting that the effects of acculturation on drinking patterns differ for men and women ,32. All Participants who chose complete the survey in English and in Spanish were similar in terms of age and sex . For botCompared with participants who were interviewed in Spanish, a smaller proportion of participants interviewed in English reported that they were married or part of a couple . ParticiP < .001). Participants interviewed in English had a larger proportion of participants who were heavy drinkers (P < .001) and a larger proportion of participants who were binge drinkers (P = .002) compared with participants interviewed in Spanish.Statistically significant differences existed between the groups for the 3 alcohol consumption measures in bivariate relationships . Among pP < .001). Among women, those who chose to be interviewed in English rather than Spanish also had a significantly greater proportion of respondents indicating that they had used alcohol within the past 30 days . For heavy and binge drinking, however, the differences between participants who chose to be interviewed in English and those who chose Spanish were significant only among the women. Among women, 4.2% of those interviewed in English reported heavy drinking compared with only 0.8% of those interviewed in Spanish (P < .001). Similarly, 8.6% of women interviewed in English reported binge drinking compared with 2.8% of women interviewed in Spanish (P < .001).Similar outcomes were found when focusing the analyses on men  and women  separately . Among mThe logistic regression model for the combined sample of men and women demonstrated that, after controlling for demographic factors, participants who chose to complete the survey in English rather than Spanish were significantly more likely to have consumed alcohol within the past 30 days. Participants interviewed in English were nearly twice as likely to have engaged in heavy drinking and 40% more likely to participate in binge drinking compared with those interviewed in Spanish .Similar results were found when examining outcomes for men and women separately. Both men and women interviewed in English were significantly more likely than those interviewed in Spanish to report current, heavy, and binge drinking. Of participants who chose to be interviewed in English, odd ratios (ORs) among Hispanic women were larger than those for Hispanic men .The prevalence estimates and adjusted ORs for current, heavy, and binge drinking were higher among Hispanics who chose to complete the BRFSS in English than those who chose to complete the survey in Spanish. These results held true for both men and women separately, although the differences were particularly striking among women. To our knowledge, these are the most recent, nationally representative data stratified by language of survey on drinking patterns among Hispanics in the United States, and the results suggest that preferred language of survey administration is predictive of alcohol use in this population.The finding that English-speaking Hispanic women were more likely to drink than were English-speaking Hispanic men confirms previous research on acculturation and substance abuse . AlcoholVariations in drinking patterns among the heterogeneous Hispanic populations in the United States have been attributed to sex , countryr = 0.8) between the 1-item question on language preference for the survey and a validated instrument used to measure acculturation  are associated with drinking behaviors and how such associations change with different alcohol-related behaviors cross-sectionally and over time.One practical implication of our study is the need to create materials in Spanish to reduce or prevent alcohol misuse. Alcohol industry representatives, noting the increasing number of Hispanics in the United States, have targeted this population . AlcoholIn our review of the literature, we found no studies that addressed preventing Hispanic women from adopting US alcohol use patterns during the acculturation process. Our study and others  suggest Our study had some limitations that should be considered. First, the BRFSS is a land-line telephone survey, and not all people in the United States possess land-line telephones. A report from the US Census Bureau indicated that Hispanic households have a slightly lower rate of land-line telephone coverage than do white households . This siDespite these limitations, our analyses suggest that language of preference for survey interviews is associated with alcohol use among Hispanics in the United States. As previous work has suggested, language preference alone may be used as a reasonable proxy measure of acculturation. Future studies should consider language preference and its association with other health behaviors among Hispanics in the United States.


Heavy alcohol consumption is widespread in Russia, but studying changes in drinking during the transition from Communism has been hampered previously by the lack of frequent data. This paper uses 1-2 yearly panel data, comparing consumption trends with the rapid concurrent changes in economic variables , and mortality.Data were from 9 rounds (1994-2004) of the 38-centre Russia Longitudinal Monitoring Survey. Respondents aged over 18 were included . Trends were measured in alcohol frequency, quantity per occasion (by beverage type) and 2 measures of potentially hazardous consumption: (i) frequent, heavy spirit drinking (≥80 g per occasion of vodka or samogon and >weekly) (ii) consuming samogon (cheap home-distilled spirit). Trends in consumption, mean household income and national mortality rates (in the same and subsequent 2 years) were compared. Finally, in a subsample of individual male respondents present in both the 1996 and 1998 rounds , determinants of changes in harmful consumption were studied using logistic regression.Frequent, heavy spirit drinking  was widespread amongst men (12-17%) throughout, especially in the middle aged and less educated; with the exception of a significant, temporary drop to 10% in 1998. From 1996-2000, samogon drinking more than doubled, from 6% to 16% of males; despite a decline, levels were significantly higher in 2004 than 1996 in both sexes. Amongst women, frequent heavy spirit drinking rose non-significantly to more than 1% during the study. Heavy frequent male drinking and mortality in the same year were correlated in lower educated males, but not in women. Individual logistic regression in a male subsample showed that between 1996 and1998, those who lost their employment were more likely to cease frequent, heavy drinking; however, men who commenced drinking samogon in 1998 were more likely to be rural residents, materially poor, very heavy drinkers or pessimistic about their finances. These changes were unexplained by losses to follow-up.Sudden economic decline in late 1990s Russia was associated with a sharp, temporary fall in heavy drinking, and a gradual and persistent increase in home distilled spirit consumption, with the latter more common amongst disadvantaged groups. The correlation between heavy drinking and national mortality in lower educated men is interesting, but the timing of RLMS surveys late in the calendar year, and the absence of any correlation between drinking and the subsequent year's mortality, makes these data hard to interpret. Potential study limitations include difficulty in measuring multiple beverages consumed per occasion, and not specifically recording "surrogate" (non-beverage) alcohols. Studying trends in alcohol consumption during the transition from Communism in Russia is potentially important in both adding to our understanding of the effects of rapid socioeconomic change on alcohol consumption, and seeing whether changes in harmful drinking were linked to the rapidly fluctuating death rates of that time.A consistent association between economic change and trends in alcohol consumption in transitional Russia has not so far been shown. Whilst the sharp decline in vodka sales during the 2008 "credit crunch" reached the popular press , previouIt is well known that heavy alcohol consumption, especially amongst men -7, is anIf alcohol were linked to the rapid changes in mortality, it would be reasonable to expect to see rapid changes in consumption, but it has not so far been shown that trends in alcohol consumption changed with death rates after 1991. Although population data from the mid-1980s at the time of Gorbachev's brief anti-alcohol campaign, showed declining consumption and rising life expectancy , the twoTwo repeat surveys of individual level drinking showed a steady rise in consumption; however these studies were not sufficiently frequent to identify whether there were any rapid changes comparable to the fluctuations in GDP and mortality. In Novosibirsk, heavy consumption amongst males rose substantially between 1984/5 and 1988/9 , but changed little between 1988/9 and 1994/5 ,17. FromImportantly, however, these studies did not account for the wide range of beverages consumed in Russia, especially two classes of non-purchased alcohols: first "samogon" (home-distilled spirit) ,20, and This paper has the advantage of using data collected every 1-2 years, from the Russia Longitudinal Monitoring Survey . The dat(i) During the years of the worst economic conditions, more people would consume cheaper beverages (ii) Fluctuations in potentially hazardous consumption  would be temporally associated with changes in national mortality rates.The data were from Phase 2 of the Russia Longitudinal Monitoring Survey (RLMS), a panel study of households, and individuals within them, collected over 9 rounds between 1994 and 2004 (no survey took place in 1997 or 1999). This dataset has been described extensively elsewhere  and is chttp://www.cpc.unc.edu/projects/rlms. The data were obtained from the study organisers at a time when they were freely available. Now, however, permission is required, and has been obtained.The overall response rate in the first round of Phase 2 (1994) was 84%, although in Moscow and St Petersburg it was approximately 67%. The investigators stated that the distribution of household size compared well to 1989 census data, as did sex, age and urban-rural distribution. As housRespondents were asked whether they had consumed alcohol within the last 30 days. For those who responded positively, there followed a single question on frequency. After this, respondents were asked which beverage they had consumed, and there was a question about typical quantity consumed per occasion for each beverage. This is effectively a modified version of the quantity-frequency approach,  and is sRespondents were asked whether they drank alcohol, and how frequently during the previous month. Frequency was initially divided into daily, 4-6 times a week, 2-3 times a week, once a week, 2-3 times a month, once in the last month and no alcohol in the last month. For some analyses it was collapsed into: none in the last month; between once in the last month and once a week; and more than once a week.Respondents were asked whether they had consumed beer, wine, fortified wine, vodka, home-distilled spirits ("samogon" in the Russian language questionnaire) in the last 30 days. They were also asked whether they had consumed any "other drinks", but this category was omitted from the analyses, since few people gave a positive answer (somewhat more women than men), and it was not possible to estimate the alcohol content, and was considered not to be useful, and unlikely to include "surrogate"(non-beverage) alcohols .For each beverage , respondents reported the quantity usually consumed per occasion in grams , which were converted into grams of pure alcohol using conversion factors based in part on concentrations stated on labels, but also on previous analyses of Russian drinks , as follQuantity was divided into 4 categories: very heavy episodic spirit consumption , heavy episodic spirit drinking (from 80 g up to 160 g of samogon or vodka per occasion), moderate consumption ; and no alcohol. .Two measures were developed to reflect potentially harmful consumption patterns.1) Frequent, heavy drinking, defined here as consuming at least 80 g spirits (vodka and/or samogon) per occasion, and drinking alcohol more than once a week. Frequent, heavy drinking is associated with increased mortality, particularly in Russia, ,25,26.2) Drinking samogon (any quantity). Samogon is a cheap non-purchased spirit, and whilst its health effects have not been studied, its drivers could be similar to the factors that drive the similarly inexpensive and potentially harmful surrogate alcohols.3 age bands were used: 18-39; 40-59; 60 and over. Education was divided into incomplete secondary or less; complete secondary ; and higher. Area of residence was divided into: metropolitan (Moscow or St Petersburg), urban (other); and rural, and was defined by the investigators during the sampling process. Marital status was divided into married/cohabiting, single, divorced or widowed. Household material goods  were combined into an asset score (0-5). Financial optimism was measured by asking "Do you think that in the next 12 months you and your family will live better than today, or worse?" .For later ecological comparisons, the following measures were used:Household income per person was calculated by dividing total household income (adjusted to the level of the 1994 rouble) by the square root of the number of occupants . The ageConsumption trends were studied separately by gender in respondents aged 18 and over  over the whole study (b) during 1996-2000 (when changes in consumption were significant). Correlation analyses also included lagged mortality (deaths over the subsequent 2 years), to test for a delayed effect of drinking on mortality.Preliminary analyses had shown that in men, frequent, heavy drinking declined, and samogon consumption rose significantly between 1996 and 1998 . To study the determinants of these changes amongst individual participants, multivariate logistic regression analyses were performed on a subsample of male participants present in both 1996 and 1998:(i) Commencing samogon consumption in 1998 (ii) Ceasing heavy frequent spirit consumption in 1998 .3 models were used, adjusted as follows: Model 1 - age; Model 2 - age, urban/rural, marital status; Model 3 - age, urban/rural, marital status, education, asset score.During the study period, frequent drinking rose in men, with more than weekly drinking rising from 17% to 21%. However, there was a significant decline in heavy male drinking: consuming ≥160 g per occasion declined from 22% to 12%. The proportion of frequent, heavy male drinkers did not change significantly between 1994 and 2004, with a steady 13-14% drinking more than weekly and consuming ≥80 g per occasion. In women, drinking more than weekly rose from 2% to 4%. The proportion of female heavy drinkers changed very little, with approximately 8% of women drinking ≥80 g per occasion throughout the study. Frequent, heavy drinking rose non-significantly amongst women to over 1%. Superimposed on these changes, in 1998 there was a transient decline in frequent drinking in both sexes, and in frequent, heavy drinking amongst men , and despite a decline after 2002, samogon drinking remained significantly more common than in 1994. Educational and urban-rural gradients in the prevalence of samogon consumption widened throughout the study  are shown in Table Men who stopped frequent, heavy drinking in 1998 were more likely to have been newly unemployed in that year, younger or living outside the main cities. In contrast, men who started to drink samogon in 1998 were significantly more likely to be older (over 60), pessimistic over family finances, secondary educated or less, very heavy drinkers (≥160 g and > wkly) or rural (vs urban) residents. However, metropolitan (vs urban) residents, men with fewer material assets or who became unemployed between 1996-8 were less likely to commence drinking samogon.The high levels of male alcohol consumption in RLMS were as expected, and broadly consistent with, and sometimes higher than in, other contemporaneous Russian studies ,7,30, alThese findings illustrate the complexity of the trends in alcohol consumption during the Russian transition. The rise in frequent drinking coincides with findings in Karelia  and suggAgain, the pattern of beverage consumption showed some similarities to another study. In 2003, 48% of men in RLMS had consumed purchased spirits, 48% beer and 8% wine within the previous month. Despite variations in question wording, consumption amongst the male controls in the Izhevsk study, the only suitable comparator, was of a similar order: 24% drank spirits at least once a week, and 54% once a month or less; such figures were 48% and 30% for beer, and 7% and 33% for wine respectively . UnfortuRegarding the hypotheses at the start of this paper, there is some evidence to support the first, that more people would consume inexpensive spirits at a time of financial hardship. Two distinct changes in consumption in 1998 followed the "Rouble" economic crisis  two montThe marked temporary decline in frequent heavy drinking, similar to a fall in Taganrog between 1993/4 and 1998 , was cloIn contrast, a much wider range of factors were associated with starting to drink samogon in 1998 in men who were not doing so in 1996. The particularly high risk amongst the heaviest drinkers suggests that alcohol dependence (combined with affordability) was a likely precipitant, and the greater increase amongst rural residents could be related to easier access. For the materially poor, affordability was a factor, partly explaining the effect of low education. The independent effect of low optimism suggests that psychological influences may be important in drinking decisions, although more detailed research is clearly required. Those who started to drink appear to constitute a second and separate group, who were more multiply disadvantaged.The differences in trends between the 2 drinking patterns persisted. Whilst frequent, heavy drinking resumed in 2001, consumption of relatively inexpensive samogon and beer rose further, declining later and more gradually. This pattern suggests that the drivers of samogon consumption are not simply financial, although low cost is undoubtedly important ,35, samoThe second initial hypothesis appeared to be partly supported by the correlation between national mortality rates and rates of frequent, heavy drinking amongst the least educated men in the same year ,14,39, aApart from the trends, the overall levels of frequent, heavy consumption, were more common in two groups that experienced higher excess mortality during the transition. The first was the least educated ,14,41. TThis study showed two other important findings. First, the decline in heavy male alcohol consumption in Moscow and St Petersburg contributed to regional convergence, and could indicate a move amongst metropolitan residents towards more Western drinking patterns .Second, consumption trends differed by gender. Whilst female respondents drank less than men, it was notable that heavy, frequent drinking almost doubled in women, and samogon consumption increased more markedly. At the same time, however, a higher proportion of women drank wine, and this proportion rose. There appears to be a contrast between the majority of women who either do not drink, or who have more Western consumption patterns, and a small minority of hazardous women drinkers. Younger women drank more than their older counterparts, and interestingly, female smoking rates also rose most steeply in this age group , suggestSince a consistent temporal association between trends in mortality and alcohol consumption was not shown conclusively in all groups (bearing in mind the limitations of the data), it is possible that whilst alcohol may contribute to the excess mortality of the transition, the causes of excess deaths may have been multiple and complex. Other research has also shown rapid changes in economic, employment-related and psychological conditions ,46; an iSudden economic decline in late 1990s Russia was associated with a sharp, temporary fall in heavy drinking, especially amongst the newly unemployed and a gradual and persistent increase in home distilled spirit consumption, with the latter more common amongst disadvantaged groups. The correlation between heavy drinking and national mortality in lower educated men is interesting, but the timing of RLMS surveys late in the calendar year, and the absence of any correlation between drinking and the subsequent year's mortality, makes these data hard to interpret.The high prevalence of harmful drinking shown here highlights an urgent need for more effective alcohol policies in Russia, particularly to control widespread distillation and consumption of samogon, and to address public fears of counterfeit vodka poisoning . TaxatioThe first limitation in this study is the incomplete knowledge of the alcohol content of the beverages studied. Although the content of vodka and samogon was based on chemical analyses , the conSecond, episodic heavy drinking may have been underestimated, since quantity was measured by individual beverage, and could not capture combinations of drinks per occasion . FurtherThird, any unequally distributed losses to follow-up (including deaths) could affect the results, either because people with particular characteristics left more frequently, or because heavy drinkers did so. However, there are two reasons why this is unlikely to be the case. First, the panel age composition showed minor changes, confined to the youngest age groups, with a decrease of 4% in males and females aged 30-39, and a corresponding increase in 18-29 year olds, suggesting that any effect on the results would be small. Second, drinking pattern had little effect on leaving the study. In a subset of 6,000 men present in 1996, time in study did not differ significantly by drinking pattern . Furthermore, age adjusted logistic regression analyses indicated few differences in male drinkers leaving over the short term. Frequent heavy consumers in 1996 were no more likely to die or leave RLMS without explanation by 1998 than moderate drinkers, and whilst they were more likely to leave through household break-up [1.58 (1.08-2.25)], perhaps reflecting domestic strain , the absDespite some limitations, there are several reasons why the data can be reasonably used to assess trends. First, the determinants of reporting would not be expected to vary between years. Second, although it has been claimed that alcohol consumption in RLMS may underestimate total population drinking , perhapsIt should also be noted that whilst alcohol measures from this dataset have been studied previously ,55, the The author declares that they have no competing interests.At the time this research took place, FP was a Clinical Lecturer at the London School of Hygiene and Tropical Medicine.The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2458/10/691/prepub


Total restorative proctocolectomy with ileal pouch-anal anastomosis (RP/IPAA) has become the standard of care for the surgical treatment of ulcerative colitis. Despite its correlation with an excellent quality of life and favorable long-term outcomes, RP/IPAA has been associated with several complications. Prolapse of the ileoanal pouch is a rare and debilitating complication that should be considered in the differential diagnosis of pouch failure. Limited data exist regarding the prevalence and treatment of pouch prolapse. We present the case of a recurrent J-pouch prolapse treated with a novel minimally invasive “salvage” approach involving a robotic-assisted laparoscopic rectopexy with mesh. Surgical intervention is required in 30%–40% of patients with chronic ulcerative colitis (UC) . Total  to optimize her pelvic floor weakness. She was then scheduled for repair using a novel minimally invasive approach involving a robotic-assisted laparoscopic (RALS) rectopexy with mesh. The procedure and possible complications were described to the patient and informed consent was obtained.The procedure was performed by a board-certified colon and rectal surgeon (E.M.H.) using the da Vinci S-Type Surgical System . The patient was placed in a modified lithotomy position with 10 degrees of flexion at the hips. A total of five trocars were utilized—a 12-mm camera port, three 8-mm robotic ports and a 5-mm accessory port for the assistant. Laparoscopic exploration revealed multiple abdominal and pelvic adhesions as well as a benign cystic mass in the pelvis. Multiple intraloop small bowel adhesions required careful adhesiolysis to gain access to the pelvis. Extensive ovariolysis was required as both fallopian tubes and ovaries were densely adhered to the prolapsing segment of the pouch. In addition a deep and redundant enterocele was encountered. Ultimately, the presacral plane was entered and the mesentery of the J-pouch was dissected to the level of the levator ani. It was noted during dissection that the mesentery of the pouch was torsioned 180 degrees and adhered to the sac of the enterocele in the anterior plane. Once the pouch mesentery was completely mobilized and returned to anatomical position, a suture rectopexy fastening the mesentery to the presacral fascia was performed. A non-absorbable prolene mesh was used to reinforce the rectopexy see . Care waThe patient underwent robotic-assisted laparoscopic rectopexy without complication and did not require conversion to an open procedure. The robotic operative time was 128 minutes and the estimated blood loss was 200 mL. The patient had an expeditious recovery with return of bowel function, as evidenced by flatus, on postoperative day 2. At that point her diet was advanced, she was changed from intravenous to oral pain medication, and she was able to void following removal of her Foley catheter. She was discharged home on postoperative day 3. The patient presented to the office for postoperative evaluation at two weeks, six weeks, and three months following surgery. On two-week follow-up she continued to do well with no signs of complications. Repeat anal physiologic studies were performed six weeks following the procedure, and mean manometric pressures of the internal and external anal sphincters had improved to 45–65 mm Hg and 70–80 mm Hg, respectively. At three-month follow-up, she reported an overall excellent response with no further episodes of fecal incontinence or pouch prolapse.Restorative proctocolectomy with ileal pouch-anal anastomosis is an important treatment modality for patients suffering from refractory UC. Ileoanal pouch prolapse is a rarely reported complication following RP/IPAA. A review of the literature identified a total of 10 published reports of pouch prolapse in the adult population. Extent of prolapse varied from external mucosal or full-thickness prolapse –17 to inEhsan et al. estimated the prevalence of ileoanal pouch prolapse through a 2001 survey of the North American membership of the American Society of Colon and Rectal Surgeons . Of 23, We report a novel robotic-assisted surgical approach in the treatment of a patient who presented with a J-pouch prolapse that had failed a previous suture rectopexy repair at another institution. Robotic surgery is an innovative technique requiring a high degree of technical training to overcome several of the challenges of this approach, most notably the loss of tactile and tensile feedback. Furthermore, a learning curve is required to develop understanding of the spatial relationships of the external robotic arms to avoid clashing of the instruments and inadvertent injury to the tissues. We chose a robotic approach as this technology facilitates the freedom of movement of an open surgical procedure while maintaining a minimally invasive platform. This surgical system provides a three-dimensional field of view, 10-fold magnification, and camera stabilization , 23, whiWe describe the case of a recurrent prolapsed J-pouch treated through a novel RALS “salvage” procedure. Due to the numerous benefits offered by this innovative system, we have been performing robotic-assisted surgery specifically for various colorectal procedures in which pelvic dissection is necessary. With current levels of experience limited to familiarity from case reports, ileal pouch prolapse may be overlooked in the differential diagnosis of pouch dysfunction. Robotic-assisted laparoscopic rectopexy with mesh proved to be feasible and safe for the correction of J-pouch prolapse.


With more experience and better management, the incidence of complications like stone formation after continent urinary diversion is uncommon today. We report a case of large stone bulk in a patient who underwent this surgery 10 years back and who suggested the formation of stones in the pouch herself by sounding them. Proper counseling, regular pouch irrigation and follow-up are essential in any kind of diversion. Occasionally, urinary diversion is needed in cases of complex vesicovaginal fistula who have failed repeated repairs. We report one such case that underwent continent urinary diversion and reported 10 years later when she noticed a gritty sensation on passing catheter that was later found to be due to a large stone bulk in the pouch.A 20-year-old woman presented with vesicovaginal (VVF) and rectovaginal fistula (RVF) due to obstructed labor. She underwent a temporary transverse colostomy followed by two failed attempts of VVF repair. One year later, the RVF was repaired successfully by the vaginal route and a simultaneous continent cutaneous urinary diversion procedure (right colon pouch with Mitrofanoff continence mechanism) was performed. She was then lost to follow-up and could not come even for colostomy closure due to poor socioeconomic condition. She presented after 10 years when she noticed a gritty sensation while passing catheter for pouch emptying. On evaluation, she had normal renal functions, with serum creatinine of 1.0 mg%, while an intravenous urogram revealed a large pouch full of stones . In viewStone formation is a known complication of all reservoirs.–3 This pThis case demonstrates that if continent urinary diversion is planned, the patient should be counseled well about the need of regular self-catheterization, pouch irrigation and regular follow-up even if asymptomatic and may be advised to report any abnormal gritty sensation while draining the pouch by catheter. This grittiness may be experienced while passing the catheter or may even be experienced while withdrawing the catheter-sometimes better in the latter situation as the pouch becomes free of liquid urine and stones come close to each other and the catheter within the collapsing pouch. Although the stones were smooth surfaced, the passage or withdrawal of catheter through a significant stone burden can still produce gritty sensation to an intelligent patient.


Mycocepurus goeldii and M. smithii (Attini: Formicidae) were studied in an agroforest habitat near Manaus, Brazil during the excavation of 13 nests. Both species built their nests in two different ways. The first type possessed a “tree-like” architecture, in which a vertical tunnel led downwards and lateral tunnels branched off at 90° angles from the main tunnel, with a chamber at the end of each side branch. Alternatively, other nests displayed a “necklace-like” architecture, where the main tunnel also led down vertically, but entered each chamber from the top and exited it at the bottom, resulting in an architecture where chambers appeared like pearls on a necklace. The nest systems of M. goeldii and M. smithii consisted of 1–21 or 1–15 chambers, respectively. Of 199 excavated chambers, 57 % contained fungus-gardens. Chambers not containing fungus gardens were filled with organic matter from decaying fungus gardens or earthworm feces. Only M. smithii workers deposited loose soil in abandoned chambers during the construction of new nest chambers. Workers of M. smithii constructed significantly smaller chambers than those of M. goeldii. In both species, fungus garden-containing chambers were larger than non-garden chambers and were homogenously distributed in the soil between 17 cm and 105 cm depth. Neither fungus gardens nor abandoned chambers were encountered more frequently in deeper or shallower soil strata indicating that ants of both species did not abandon shallower versus deeper chambers, or move the colony to deeper soil layers with increasing colony age. Fungus gardens were suspended from the ceiling of the subterranean chambers and originated as small mycelial tufts. Through continual addition of organic debris, the tufts first grew vertically to strands before they expanded laterally until most of the chamber volume was filled with fungus garden curtains. New garden chambers were found at depths ranging from 17 to 83 cm, suggesting that new garden chambers were not constructed in deeper soil strata with increasing colony age. The size of M. goeldii and M. smithii colonies was dependent on their age. Worker counts varied between a few individuals in recently founded colonies and 1352 workers in an adult M. goeldii colony. The ratio of worker number per fungus garden chamber was higher in M. goeldii colonies than M. smithii colonies; the M. goeldii colonies were more populous. Both species were oligogynous with a maximum of four and three queens observed in a single chamber of M. goeldii and M. smithii, respectively. The reproductive status of each queen was unknown. In both species the ratio of brood to workers was approximately 2:3. Larvae and pupae were unequally distributed throughout the nest, but were only located in chambers containing a garden. Their location in the chamber was dependent upon the developmental state of the fungus garden.Nest architecture and demography of the non leaf-cutting fungus-growing ant species  Atta and Acromyrmex) grow their fungus gardens , rubber tree (Hevea brasiliensis), coconut palm (Cocos nucifera), urucum (Bixa orellana), peach palm (Bactris gasipaes), cupuaçu (Theobroma grandiflorum) and several citrus species . The understory was composed of kudzu , a species of Poaceae and three species of Melastomataceae. At Embrapa-Caldeirão, M. goeldii colonies were encountered in a manioc (Manihot esculenta) plantation, whereas M. smithii colonies were found at the edge of a secondary forest between herbaceous growths.Fieldwork was conducted from February to July 2003 at two experimental agricultural field sites of the Embrapa-Amazônia Ocidental (Empresa Brasileira de Pesquisa Agropecuária) near Manaus, Amazonas, Brazil. Nest excavations were made at the headquarters, north of the Rio Negro, located at kilometer 28 of Highway AM 010  and at the experimental site south of the Rio Negro, named Embrapa-Caldeirão . The field site at the Embrapa headquarters can best be described as an agroforestry system and is characterized by an assemblage of different fruit, nut and palm trees, including the Brazil-nut tree  with a very clayey texture. These soils are common in the Central Amazon and especially in this agricultural district  and average number of ants per chamber were collected by additional diggings, which did not follow the described protocol, and added to the results of the standardized excavations (n = 112).These additional data are from single-chamber nests or chambers, which could not be assigned to a nest system.Mycocepurus nest mounds consisted of fine grains of soil and had an irregular shape. Frequently, small pseudo-chambers of approximately 0.5 cm diameter were found at the base of the mound . In M. smithii nests abandoned fungus chambers were frequently filled with loose soil. This was never observed in M. goeldii nests.he mound , which wM. goeldii nest systems and nine M. smithii nest systems were carefully excavated, revealing two different types of nest architecture used by both species. The “tree-like” architecture  and M. smithii (n = 132) were excavated, of which 111 contained fungus and 88 did not  non-fungus chambers were completely empty and a single M. goeldii chamber was found to contain caterpillar feces, which serve as important fungus substrate in this species  were filled with a mixture of organic substance resulting from the decaying fungus garden and soil and 29 (33 %) contained earthworm feces. In 13 (15 %) chambers,  species .M. goeldii nest system, including garden and non-garden chambers, was 12 about half of which contained fungus chambers  contained fungus garden. The average number of chambers per nest system was 7.1 and the average number of garden chambers was 3.4 .Mycocepurus workers plug tunnels coming from chambers with decaying or parasitized fungus garden with soil, the chamber was no longer connected to the main tunnel.The excavation of nest CR 7 revealed four chambers, three of them with a fungus garden . The lowM. smithii nest systems had significantly fewer fungus chambers per nest system than the four M. goeldii nests .The total numbers of garden versus non-garden chambers per nest system was not significantly different between species . The nine M. goeldii nests were measured, of which 45 (67 %) contained a fungus garden. In an excavation, chambers without a garden were found to occasionally contain a single ant. These chambers were therefore assumed to be connected to the nest system and were considered to be a part of it.A total of 67 chambers in M. goeldii nests had a significantly higher volume than non-fungus chambers  containing a fungus garden . The aveM. smithii nests did not differ significantly , indicating that M. smithii also does not preferably abandon shallower versus deeper chambers during the colony's lifecycle.The mean depth of garden chambers and non-garden chambers is shown in M. smithii than those of M. goeldii .In both species, the volume of chambers containing fungus was greater than the volume of non-fungus chambers. Both garden and non-garden chambers were significantly smaller in M. goeldii than in M. smithii  than those of M. smithii  and heavier . The volume of M. smithii fungus chambers were similar to those reported from Puerto Rico .Mycocepurus species studied, the fungus gardens were suspended from the chamber ceiling , but in general the number of individuals per nest chamber varied considerably (iderably .M. smithii nests are shown in M. smithii colony (CR 61) had a total of 163 workers, 38 larvae and 50 pupae located in 7 garden chambers .The total and average numbers of workers, gynes, larvae and pupae found in chambers . The gynM. goeldii colonies were more populous than M. smithii colonies. The average number of workers and brood were both significantly greater in M. goeldii chambers .Mycocepurus species. The comparative approach used systematic methods that contribute to a better understanding of the natural history of these poorly studied, debris collecting species of fungus-growing ants and will help to quantify the influence of non-leafcutting Attini on nutrient cycling processes. Some attine species cannot be classified as either debris collectors or herbivores, but are found at intermediate positions along this trophic continuum. Primarily debris collecting species were occasionally observed to cut flower petals  or circular craters (Mycetophylax emeryi) have not been observed in Mycocepurus. Therefore it is not possible to identify Mycocepurus nests based solely on the shape of the mound.The external appearance of attine nests is an important character, which differs between genera and, in some cases, enables identification to the genus level . In Mycococrypta . Unique M. goeldii and M. smithii nests did not adequately reflect the different volumes of each species' nests. While a significant difference in mound weight was not found, it appears that these two species have different nest construction behaviors. M. smithii seems to store part of the excavated soil in abandoned fungus chambers resulting in disproportionately smaller mounds while M. goeldii workers seem to bring excavated soil of new chambers nearly completely to the surface, resulting in much larger nest mounds than in M. smithii.The observed mound weights of M. smithii nests had one entrance with a single tunnel leading from the entrance to one or several nest chambers, which were either lined up directly along the main tunnel or connected to the main tunnel via lateral tunnels. This observation is consistent with those made by Fernández-Marín et al. , of M. obsoletus from Brazil and of two undescribed Mycocepurus species from Manaus, Brazil and Peru (Rabeling in preperation) also revealed a single entrance per colony.In contrast there is no doubt that all M. smithii and 21 for M. goeldii. In Puerto Rico, nests of reproductively active M. smithii colonies had 1–4 and non-reproductive colonies had 2–7 chambers  is currently studying the population biology of M. smithii in Latin America using molecular markers.The observation that three gynes were found in a single chamber is consistent with the idea that et al.'s  hypothesM. smithii and M. goeldii were suspended directly from the chamber ceiling. Cultivars of this type have also been observed in M. smithii and a new Mycocepurus species from Peru (Rabeling unpublished data). Fernández-Marín et al. , so that the shallower fungus chambers are in danger of flooding. Consequently, the garden chambers are not only maintaining a uniform microclimate for brood development  to 133 workers (A. dentigerum) per colony. A Myrmicocrypta buenzlii nest contained 1558 workers  are similar to those made by Fernández-Marín et al. . Even though it is not known whether n et al. , in whicM. goeldii were inhabited by significantly more workers than those of M. smithii. In addition to having more populous colonies, M. goeldii also had larger chambers and larger average worker body size. In both species, one individual was found on average per cubic centimeter of chamber volume.On average single chambers as well as whole nests of M. goeldii and M. smithii are necessary for understanding their biology and will help to investigate the hypothesis of asexuality in M. smithii. They are also critical for understanding the evolutionary origin of the symbiosis between attine ants, their basidiomycete fungi, and associated microorganisms. The phylogenetic relationships among the most plesiotypic attine genera are currently not well enough resolved to permit a meaningful discussion of what the ancestral nest architecture, fungus-garden organization or fungus cultivar species might have been. Nevertheless, these studies, once they are made possible by future phylogenetic analyses, will be interesting due to the diverse habits of plesiotypic attine species.Detailed data on nests and colony structure of Mycocepurus ants were observed in high nest densities at our study sites, and by collecting debris and growing fungus gardens in their subterranean chambers, these ants accumulate nutrients in low soil layers, which subsequently become available to higher plants after the chambers are abandoned by the colony. Based on the data presented here on nest density, number of chambers per nest and number of individuals per colony, we are currently working on a reliable statement about the enrichment effect of small fungus-gardening ants on soils, which may be especially important for the geo-chemically impoverished soils of Central Amazonia.The ecological impacts of debris-collecting attines have been largely neglected see . However


Trends in eye cancer mortality are presented for the USA and England and Wales during the period 1955-89. Mortality rates have fallen by 58% in the USA during this period. The fall in mortality is paralleled by an equal fall in incidence rates in the USA. In England and Wales, mortality rates and incidence rates have remained relatively constant during the last three decades. The explanation for these differences between the USA and England and Wales is unknown.


Drosophila oogenesis is especially well suited for studying stem cell biology, cellular differentiation, and morphogenesis. The small modifier protein ubiquitin regulates many cellular pathways. Ubiquitin is conjugated to target proteins by a diverse class of enzymes called ubiquitin E3 ligases. Here we characterize the requirement of Cul-5, a key component of a subgroup of Cullin-RING-type ubiquitin E3 ligases, in Drosophila oogenesis. We find that reduced cul-5 activity causes the formation of aberrant follicles that are characterized by excess germ cells. We show that germ line cells overproliferate in cul-5 mutant females, causing the formation of abnormally large germ line cysts. Also, the follicular epithelium that normally encapsulates single germ line cysts develops aberrantly in cul-5 mutant, leading to defects in cyst formation. We additionally found that Cul-5 is required for germ cell maintenance, as germ cells are depleted in a substantial fraction of cul-5 mutant ovaries. All of these cul-5 phenotypes are strongly enhanced by reduced activity of gustavus (gus), which encodes a substrate receptor of Cul-5-based ubiquitin E3 ligases. Taken together, our results implicate Cul-5/Gus ubiquitin E3 ligases in ovarian tissue morphogenesis, germ cell proliferation and maintenance of the ovarian germ cell population. Ubiquitination is a particularly versatile post-translational modification that influences most, if not all, aspects of cellular biology CRLs are modular protein complexes that are formed on a characteristic scaffold subunit of the Cullin protein family Drosophila, certain genetic manipulations of cul-5 have been reported to affect epidermal patterning, synapse formation and sensory organ development Cullin-5 (Cul-5) has been most extensively studied in the context of viral infection Drosophila oogenesis provides an excellent model system to study different aspects of cellular biology, intercellular communication and tissue morphogenesis In region 2B of the germarium, each germ line cyst becomes encapsulated by a monolayered follicular epithelium of somatic origin cul-5 function leads to the formation of aberrantly formed follicles that are most frequently characterized by an excess of germ line cells. Their formation results both from germ cell overproliferation in the germarium, and improper clustering of germ cell cysts into inappropriately sized follicles. These phenotypes are drastically enhanced by sensitizing the cul-5 mutant background by reducing genetic dosage of the Cul-5 CRL receptor Gustavus (Gus) Here, we demonstrate that reduced cul-5 mutant ovarioles also display a partially penetrant germ cell depletion phenotype. Again, this phenotype is drastically enhanced by simultaneous reduction of the Cul-5 substrate receptor Gus. We therefore establish a novel functional link between a Cul-5 CRL and GSC maintenance or germ cell survival.Intriguingly, EY21463cul-5 P-element insertion EY21463cul-5 mutant females  we observed at least one but often several follicle(s) containing an excess number of germ line cells  ; Fig. 1.ne cells ; Table 1ell area ; Table 1We next decided to establish whether the penetrance of these phenotypes increased with the age of the flies . The abeEY21463cul-5 ovarioles that did not contain aberrant egg chambers, Orb accumulated in a pattern that was indistinguishable from wild type  characteristic of mitotic chromatin cul-5 mutant ovarioles. As expected, we observed small numbers of pH 3-positive germ cells only in regions 1 and 2A in wild type germaria, and never in germ cells in more distal regions of the ovariole (EY21463cul-5 germaria resembled wild type in this respect (not shown), but in some EY21463cul-5 germaria we observed large clusters of synchronously dividing cells  EY21463cul-5 follicles, aberrant or not, both staining patterns resembled wild type in that FasIII was enriched in an anterior and a posterior population of polar cells but downregulated in all other follicle cells, while EyA was detectable in its complementary pattern , or in f07073gus homozygotes that bear only one copy of EY21463cul-5  of empty germaria in f07073gus;EY21463cul-5 ovaries. This suggests that a Gus-containing Cul-5 CRL is involved in the maintenance of germ line cells in the ovariole.The substrate specificity receptor Gus has been co-crystallized with Vas ozygotes  or in gu5EY21463 . Howeverchambers , as comp ovaries , 2. We aDrosophila oogenesis. We find that reduced cul-5 activity predominantly causes formation of aberrant egg chambers that contain abnormal numbers of germ cells. Our data suggest that both abnormal proliferation of germ cell cysts as well as aberrant packaging of germ cell cysts into follicles contribute to this phenotype. Although few direct targets of Drosophila Cul-5 have been identified, it seems likely that Cul-5-containing CRLs would modify many proteins. Therefore, it would be unsurprising if several pathways acting in follicular morphogenesis were affected by reduced cul-5 function.We present evidence that Cul-5 is important for normal follicular development in egghead and brainiac, is required for normal egg chamber separation Aberrant egg chambers containing more or less than the normal complement of 16 germ line cells may arise for a number of different reasons Egfr mutant follicle cells fail to correctly migrate between individual cysts EGFR appears to affect migratory movements of early follicle cells to surround each germ line cyst, because EGFR is not the only signalling pathway implicated in follicle encapsulation. Mutations affecting Notch, Delta or the Notch modulator Fringe can cause formation of large compound egg chambers which contain several individual cysts, or can prevent the formation of stalk cells leading to fused egg chambers separated by a follicular epithelium but not a stalk cul-5 phenotype resemble the effects of mutations in the EGFR and Notch/Delta pathways, the germ cell overproliferation phenotype of cul-5 is not exhibited by mutants in these signaling pathways. Overexpression of Cyclin A, or mutations affecting the cyclin-dependent kinase inhibitor Dacapo or the E2 conjugating enzyme UbcD1 may cause one extra round of cyst divisions, leading to the production of follicles containing 32 germ cells n rule, and abnormal morphogenesis of the follicular epithelium does not appear to contribute to the generation of aberrant egg chambers in these cases. Mutations in encore also cause extra germ line cyst divisions, and encore egg chambers are occasionally split, leading to the formation of follicles with fewer than 16 germ line cells encore follicles do not specify an oocyte, unlike what we observed for cul-5. Encore has been shown to associate with Cul-1 CRLs and to regulate Cyclin E expression in the germarium While many aspects of the cul-5 mutants may be due to aberrant regulation of one or several regulators of cell proliferation. We never observed germ cell overproliferation in gus mutants (data not shown), however, since no null allele of gus is currently available we cannot distinguish whether the overproliferation phenotype occurs exclusively because of reduced Cul-5/Gus CRL activity or whether Cul-5 CRLs using substrate receptors other than Gus are involved in cell cycle regulation. It would be highly informative to generate and analyse null alleles for both gus and cul-5 to address this and other questions.Large scale yeast two hybrid screens cul-5 mutant ovarioles, which indicates either defects in GSC maintenance or induction of ectopic germ cell death. We occasionally observed germaria which were devoid of GSCs but still contained one or very few clusters of multicellular germ line cysts . This observation is consistent with the idea that GSCs may differentiate inappropriately in cul-5 mutants resulting in their loss, leading to the empty germaria phenotype. In contrast, we never observed obviously aberrant nuclear morphology in the germarial germ cell population by DAPI stainings. However, based on our data we cannot fully rule out that reduced germ cell or GSC survival causes or contributes to the germ line depletion phenotype in cul-5 mutant ovaries. Interestingly, this phenotype is strongly enhanced in gus; cul-5 double mutants, suggesting that Cul-5/Gus CRL act to prevent GSC differentiation or to ensure their survival. Existing gus mutations do not display such a phenotype (data not shown), therefore it remains possible that Cul-5 CRLs other than Gus are also involved in germ line maintenance.We observed germaria devoid of germ cells in Drosophila follicular morphogenesis, in the regulation of germ line cyst divisions and in germ line maintenance, and that some of these Cul-5 CRLs most likely include Gus. Our results suggest that Cul-5 regulates numerous targets relevant to these phenotypes. Identification of these Cul-5 targets will require further investigation using biochemical and proteomic approaches.We provide evidence that Cul-5 CRLs are involved in EY21463cul-5 and EY00051cul-5 alleles were obtained from the Bloomington Stock Center.The 0–24 h old flies were collected and fed on dry yeast for 24 h prior to dissection. To obtain aged specimens, 0–24 h old flies were collected and maintained on standard cornmeal-molasses food that was changed every 2–3 days. Ovaries were dissected into PBS, fixed in 4% formaldehyde in PBS for 5 minutes, rinsed 3x in PBST (PBS +0.3% Triton), washed extensively first in PBST, then in PBSTB (PBST +3% BSA) prior to incubation in primary antibodies diluted in PBSTB over night. Samples were then rinsed and washed extensively prior to overnight incubation in secondary antibodies diluted in PBSTB. Samples were then rinsed and washed in PBSTB, followed by 20 minutes incubation in 0.5 µg/ml DAPI in PBST. After one rinse in PSBT, samples were equilibrated in Slow Fade Antifade Reagent (1 part Antifade solution in 6 parts equilibrium buffer) before mounting. All steps were performed at room temperature, except for antibody incubations, which were done at 4°C. Rhodamine-Phalloidin incubation was performed together with the secondary antibodies when applicable.Primary antibodies used were: rabbit α-Vas (1∶2000), rabbit α-Aub (1∶2000), mouse α-Orb , mouse α-Bic-D , rabbit α-PH 3 , mouse α-adducin-related protein , mouse α-FasIII  and α-EyA . Secondary antibodies were AlexaFluor-488- and AlexaFluor-555-conjugated (Molecular Probes) and used at 1∶500.Samples were analysed either on a Leica DM6000B fluorescence microscope, a Zeiss LSM510meta confocal microscope, or a Leica DMI6000B spinning disc confocal microscope. Image acquisition was done with Volocity or LSM imaging software. For image analysis and figure preparation we used the LSM Image Browser, Volocity, ImageJ and Adobe Photoshop and Illustrator.