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  • Instructor in the Department of Medicine

All undergraduate and postgraduate students from health (medicine generic 1mg doxazosin free shipping gastritis diet xone, biomedicine purchase doxazosin 1 mg with mastercard symptoms of gastritis back pain, nursing and nutrition) and non-health (computer science and information technology) programs who were present during the survey were included in the study cheap 2 mg doxazosin amex gastritis diet 22. Students who were absent due to purchase doxazosin 2 mg with amex gastritis diet íîâàÿ semester breaks or on medical leaves during the period of data collection were exempted from the study. The content validity of the study instrument was done by cross-checking and authentication from experts in the eld of study. Accordingly, the questionnaire was pre-tested on 20 students of 19–28 years old as part of a pilot study, and a few adjustments were made by changing the question wording. The validated questionnaire was made up of four parts: socio-demographic characteristics (gender, age, ethnicity, educational level, religion and faculty type). Those students with knowledge scores above the mean were categorized as having good knowledge, while those with knowledge scores below the mean were categorized as having poor knowledge. The responses were classi ed based on a 4-point Likert scale where 1, 2, 3 and 4 were used for “strongly disagree”, “disagree”, “agree” and “strongly agree”, respectively. The mean preventive score was obtained, and those students that had scores above the mean were categorized as having “acceptable preventive practice”, while those with scores lower than the mean were categorized as having “unacceptable preventive practice”. For the item “Do you abstain from sex”, it was interpreted as always abstaining from sex. In addition, students who answered “no” to this question were instructed to proceed further by answering the remaining items on preventive practices. Meanwhile, for the item “Do you have sex with only one partner for the past 12 months”, it was intended to examine whether the students had multiple sexual partners within that period. Sexually active was de ned as those who had sexual intercourse in the past three months or more [13]. Sexual abstinence was considered a student who has never had sexual intercourse with a partner in a lifetime. Logistic regression was used for the respective variables with signi cant associations. Demographic Data Seven hundred out of 748 students participated in this study, giving a response rate of 94%. The age group of the participants ranged from 17 to 30 years old with the mean age of 22. The participants within the age group of 17–23 years were the highest population involved (69. The socio-demographic characteristics of the participants are shown in the Supplementary Materials (Table S1). Interestingly, high percentages of students strongly agreed to seek treatment immediately if they (85. Strongly Disagree n Agree n Strongly Agree n Item Disagree n (%) (%) (%) (%) I feel condoms protect people against 70 (10. Students in the age group of 24–30 years old had a higher level of good knowledge compared to the younger age group (57. As expected, postgraduates had a higher level of good knowledge compared to undergraduates (58. The logistic regression analysis is shown in the Supplementary Materials (Table S3). In addition, there were no signi cant associations observed between the preventive practices and socio-demographic pro les and knowledge level (Supplementary Materials, Table S4). Associations between university students’ knowledge level and their socio demographic characteristics. Similar ndings were documented among youths (90%), as well as school pupils and university/college students (96%) by a few local studies [6,18]. In contrast, higher percentages of knowledge on syphilis (95%) and gonorrhea (83%) were reported among Chinese university students in Guangdong, China [23]. This could be explained by the greater awareness among their students as Guangdong was reported to have the highest morbidity from syphilis and gonorrhea in China. Public Health 2017, 14, 159 9 of 14 promotions on these diseases by the local authority. Chlamydia is commonly associated with gonorrhea, and in fact, a person with gonorrhea would require further tests and therapy for chlamydia, as reported by Lyss et al. Trichomoniasis, which is caused by a agellated protozoon, has been listed as the least known by the students in the present study. This notwithstanding, several studies have reported similar ndings among their students [20,22,23,25]. As expected, sexual intercourse was identi ed as the main route of transmission by most students (92. However, slightly higher knowledge was observed among our students for kissing as a route of transmission (47. To our surprise, sharing clothes and sharing food/drinks were mistakenly perceived as the modes of transmission by students in the present study. On the contrary, the misconception of monogamy as the preventive method was observed in 91. Similarly, most (80%) of our students in the present study also thought monogamy is protective, and 44. Similar percentages of knowledge on multiple sexual partners were reported in many studies [20,23], but a few reported slightly lower ones [8]. Consuming alcohol and drugs would impair one’s judgement on the risk of unprotected sexual behaviors [30,31]. A comparatively higher level of awareness (67%) on this matter was reported among high school students in Germany [22]. Gonococcal pharyngitis presents with sore throat following oral sex with an infected partner [33].

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The characteristics of delirium are rapid onset 2mg doxazosin free shipping gastritis vinegar, fluctuating course buy doxazosin 4mg line gastritis diet íó, and clouding of consciousness which becomes apparent in a reduced ability to effective 2mg doxazosin gastritis cystica profunda definition focus and shift attention purchase 1 mg doxazosin gastritis gurgling. Patients are usually disoriented: they may have vivid hallucinations, delusions, and agitation [9]. Dementia can be caused by a large number of diseases some of which affect only the brain while others affect the body as a whole. For the purposes of the present documentation we have classified these diseases into six main categories (neurodegenerative, infectious, traumatic, toxic, cerebro-vascular and metabolic). They are characterised by a progressive loss of nerve cells and synaptic connections. The second largest category of dementia causes comprises diseases of brain blood vessels. By reducing or cutting off blood supply they result in large or small infarcts as well as in demyelinisation of the fibers connecting nerve cells [18]. Compared to these two categories, traumatic, toxic, infectious, and metabolic causes of dementia are rare. Nevertheless these categories are important because in several of these diseases dementia may be reversible by adequate treatment [22]. As mentioned above, neuro-degenerative and small-vessel cerebro-vascular diseases which account for the majority of dementias are gradually progressive. Over extended periods of their course they are clinically silent because the brain can compensate a remarkable amount of pathology. Only when nerve cell and synaptic loss has reached a certain threshold symptoms become apparent. Initial symptoms consist in minor impairments of memory, attention, and executive functions, or in slight changes of personality, social conduct, and initiative. These symptom patterns represent a pre dementia stage of a number of diseases and are termed „mild cognitive impairment“ [14]. Different definitions of mild cognitive impairment have been proposed, some of which focus on memory impairment [15] while others are broader [4]. Follow-up studies have consistently demonstrated that patients with an amnestic type of mild cognitive impairment are likely to develop dementia at an annual rate of 12 to 15 % [12]. For the affected individual having dementia is associated with a progressive loss of abilities, personal autonomy, social roles and gratifications. Quality of life is further reduced by non-cognitive symptoms including depression, agitation, anxiety, delusions, illusionary misidentifications, and hallucinations. At later stages of dementia, physical symptoms such as epileptic seizures, difficulty swallowing, and gait disorder also occur. The management of dementia must therefore aim at maintaining cognition as well as 13 Alzheimer Europe Rare Forms of Dementia Project activities of daily living and physical well-being for as long as possible, and to minimise non-cognitive symptoms, combining pharmacological and non-pharmacological treatment strategies. For family members living with a demented person means a heavy and continuous burden which significantly increases the probability of psychological and physical morbidity [1]. The loss of a loved one, a change of roles and responsibilities, and withdrawal of relatives and friends all contribute to caregiver burden. Non-cognitive symptoms are more closely associated with caregiver distress than impairment of cognition or loss of activities of daily living [2]. Hence, providing advice and support to caregivers and improving their ability to cope with disease-related problems is another essential part of dementia management [19]. Brodaty H, Luscombe G (1998) Psychological morbidity in caregivers is associated with depression in patients with dementia. Variations in definitons and evolution of nondemented persons with cognitive impairment. Rockwood K, Bowler J, Erkinjuntti T, Hachinski V, Wallin A (1999) Subtypes of vascular dementia. This information is processed in the brain by nerve cells, analysed and integrated with our own information, our knowledge and our experience. The result of the integration generates an adapted response, an action if necessary, a storage in our memory if the information is interesting or important. All this work is performed by different specialised nerve cells, also known as neurons, that are gathered in specific neuronal populations that have different and specialised roles and location. Their function is to transport and to store the information (memory), or to trigger the activity of other cells (muscle fibers for example). The information is transported along neuronal extensions of nerve cells, called the axons. Information can jump and circulate to another neuron via a “synapse”, which is located at the end of the axon. The synapse bridges the gap between each neuron and allows the next neuron in the chain to be activated. All the information, received as micro-electric currents, is processed, analysed, integrated and then the resulting information is delivered to the appropriate neuron, via a synapse, for a specific task. For example, for vision, the eyes receive the visual information through numerous and specialised photoreceptors distributed on the retina. The visual information is then transported along axons, via a subset of neuronal population (colliculus), towards the occipital cortex. The information corresponding to the image is then transported to other brain areas to be analysed.

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Oxidative damage in the liver induced by ischemia-reperfusion: Protection by melatonin generic doxazosin 4 mg free shipping gastritis diet virus. Further insights into the influence of L-cysteine on the oxidation chemistry of dopamine: Reaction pathways of potential relevance to generic 2mg doxazosin mastercard gastritis colitis Parkinson’s disease buy discount doxazosin 4mg online chronic gastritis definition. Antioxidant activity of tetrandrine and its inhibition of quartz-induced lipid peroxidation doxazosin 1 mg with visa gastritis glutamine. Nitric oxide-induced cytotoxicity attenuation by thiopentone sodium but not pentobarbitone sodium in primary brain cultures. Rapid, fully automated measurement of plasma homocyst(e)ine with the Abbott Imx analyzer. The simultaneous measurement of uric acid and ascorbic acid in the lateral ventricles of freely-moving rats by brain microdialysis and electrochemical detection. Antioxidant effects of aminosalicylates and potential new drugs for inflammatory bowel disease: Assessment in cell-free systems and inflamed human colorectal biopsies. Abnormality in translational regulation of catalase expression in disorders of peroxisomal biogenesis. Radioimmunoassay of pineal 5-methoxytryptophol in different species: Comparison with pineal melatonin content. Nitrosation of uric acid by peroxynitrite: Formation of a vasoactive nitric oxide donor. Pantothenic acid and its derivatives protect ehrlich ascites tumor cells against lipid peroxidation. Compartmentation of glutathione: Implications for the study of toxicity and disease. Heme oxygenase-1 is associated with the neurofibrillary pathology of Alzheimer’s disease. Simultaneous quantitation of oxidized and reduced glutathione in equine biological fluids by reversed-phase high-performance liquid chromatography using electrochemical detection. Reduced and oxidized glutathione in the substantia nigra of patients with Parkinson’s disease. Determination of glutathione, glutathione disulfide, ascorbic acid and dehydroascorbic acid in tissues by reversed-phase liquid chromatography with electrochemical detection. Protective effect of endogenous coenzyme Q on both lipid peroxidation and respiratory chain inactivation induced by adriamycin-iron complex. Reduced total antioxidant capacity predicts ischemia-reperfusion injury after femorodistal bypass. A prospective study of vitamin E supplementation and risk of coronary disease in women. Quantitative high-performance liquid chromatographic method for determining the isomer distribution of retinol (vitamin A1) and 3-dehydroretinol (vitamin A2) in fish oils. The interstitium of the arterial wall contains very large amounts of extracellular superoxide dismutase. Simultaneous measurement of seven carotenoids, retinol and alpha-tocopherol in serum by high-performance liquid chromatography. Antioxidant properties of conjugated bilirubin and biliverdin: Biologically relevant scavenging of hypochlorous acid. Comparative antioxidant activity of tocotrienols and other natural lipid-soluble antioxidants in a homogenous system, and in rat and human lipoproteins. Resveratrol inhibits cyclooxygenase-2 transcription and activity in phorbol ester-treated human mammary epithelial cells. Recovery time course of ventricular vulnerability after coronary reperfusion in relation to mitochondrial function in ischemic myocardium. Ascorbate does not act as a pro-oxidant towards lipids and proteins in human plasma exposed to redox-active transition metal ions and hydrogen peroxide. The influence of coenzyme Q10 on doxorubicin uptake and metabolism by mouse myocardial cells in culture. Reduction of ubiquinone in membrane lipids by rat liver cytosol and its improvement in the cellular defense system against lipid peroxidation. Simultaneous determination of -tocopherol and -tocopherolquinone by high-performance liquid chromatography and coulometric detection in the redox mode. Different mechanisms of thioredoxin in its reduced and oxidized forms in defense against hydrogen peroxide in E. Reduced nicotinamide adenine dinucleotide phosphate-dependent lipid peroxidation by beef-heart submitochondrial particles. Reduced coenzyme Q10 as an antioxidant of lipid peroxidation in bovine heart mitochondria. Enzymatic and molecular aspects of the antioxidant effect of menadione in hepatic microsomes. A novel melatonin metabolite, cyclic 3-hydroxymelatonin: A biomarker of in vivo hydroxyl radical generation. Determination of lipoic acid in human plasma by high-performance liquid chromatography with electrochemical detection. High-performance liquid chromatography method for determination of lipoic acid and dihydrolipoic acid in human plasma. Ferritin: Structure, gene regulation, and cellular function in animals, plants, and microorganisms. Induction of hepatic microsomal reduced nicotinamide adenine dinucleotide phosphate-dependent production of hydrogen peroxide by chronic prior treatment with ethanol. The metabolism of menadione (2 methyl-1,4-naphthoquinone) by isolated hepatocytes. Glutathione-dependent detoxification of alpha-oxoaldehydes by the glyoxalase system: Involvement in disease mechanisms and antiproliferative activity of glyoxalase I inhibitors.

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With the passage of time discount doxazosin 2mg mastercard gastritis antibiotics, agnosic defects merge into anterograde amnesia (failure to cheap doxazosin 1mg with amex gastritis or pancreatitis learn new information) generic doxazosin 2mg online gastritis what not to eat. The neuropsychological mechanisms underpinning these phenomena are often ill understood generic doxazosin 4 mg gastritis sintomas. Whether this is a perceptual de cit or a tactile agnosia (‘agraphognosia’) remains a subject of debate. Cross References Agnosia; Tactile agnosia Agraphia Agraphia or dysgraphia is a loss or disturbance of the ability to write or spell. Since writing depends not only on language function but also on motor, visuospatial, and kinaesthetic function, many factors may lead to dysfunction. Agraphias may be classi ed as follows: • Central, aphasic, or linguistic dysgraphias: these are usually associated with aphasia and alexia, and the de cits mirror those seen in the Broca/anterior/motor and Wernicke/posterior/sensory types of aphasia. From the linguistic viewpoint, two types of paragraphia may be distinguished as follows: Surface/lexical/semantic dysgraphia: misspelling of irregular words, producing phonologically plausible errors. Alzheimer’s disease, Pick’s disease; Deep/phonological dysgraphia: inability to spell unfamiliar words and non-words; semantic errors; seen with extensive left hemisphere damage. Recognized associations of akathisia include Parkinson’s disease and neu roleptic medication use (acute or tardive side effect), suggesting that dopamine depletion may contribute to the pathophysiology. Centrally acting -blockers such as propranolol may also be helpful, as may anticholinergic agents, amantadine, clonazepam, and clonidine. More usually in clinical practice there is a dif culty (reduction, delay), rather than com plete inability, in the initiation of voluntary movement, perhaps better termed bradykinesia, or reduced amplitude of movement or hypokinesia. These dif culties cannot be attributed to motor unit or pyramidal system dysfunction. Akinesia may coexist with any of the other clinical features of extrapyramidal system disease, particularly rigidity, but the presence of akinesia is regarded as an absolute requirement for the diagnosis of parkinsonism. Hemiakinesia may be a feature of motor neglect of one side of the body (possibly a motor equivalent of sensory extinction). Neurophysiologically, akinesia is associated with loss of dopamine projec tions from the substantia nigra to the putamen. Parkinson’s disease, progressive supranuclear palsy (Steele–Richardson–Olszewski syndrome), and multiple system atrophy (striatonigral degeneration); akinesia may occur in frontotemporal lobar degeneration syndromes, Alzheimer’s disease, and some prion diseases; • Hydrocephalus; • Neoplasia. However, many parkinsonian/akinetic-rigid syndromes show no or only partial response to these agents. Frontal release signs, such as grasping and sucking, may be present, as may double inconti nence, but there is a relative paucity of upper motor neurone signs affecting either side of the body, suggesting relatively preserved descending pathways. Akinetic mutism represents an extreme form of abulia, hence sometimes referred to as abulia major. Akinetic mutism from hypothalamic damage: successful treatment with dopamine agonists. This sta tokinetic dissociation may be known as Riddoch’s phenomenon; the syndrome may also be called cerebral visual motion blindness. Such cases, although excep tionally rare, suggest a distinct neuroanatomical substrate for movement vision, as do cases in which motion vision is selectively spared in a scotomatous area (Riddoch’s syndrome). Cross References Acalculia; Aphasia; Riddoch’s phenomenon Alalia Alalia is now an obsolete term, once used to describe a disorder of the mate rial transformation of ideas into sounds. Stendhal’s aphasic spells: the rst report of transient ischemic attacks followed by stroke. The word dyslexia, though in some ways equivalent, is often used to denote a range of disorders in people who fail to develop normal reading skills in childhood. Alexia may be categorized as: • Peripheral: A defect of perception or decoding the visual stimulus (written script); other language functions are often intact. Patients lose the ability to recognize written words quickly and easily; they seem unable to process all the elements of a written word in parallel. They can still access meaning but adopt a laborious letter-by-letter strategy for reading, with a marked word length effect. Pure alexia has been characterized by some authors as a limited form of associative visual agnosia or ventral simultanagnosia. Pure alexia is caused by damage to the left occipitotemporal junction, its afferents from early mesial visual areas, or its efferents to the medial temporal lobe. Global alexia usually occurs when there is additional damage to the splenium or white matter above the occipital horn of the lateral ventricle. Hemianopic alexia is usually associated with infarction in the territory of the posterior cerebral artery damaging geniculostriate bres or area V1 itself, but can be caused by any lesion outside the occipital lobe that causes a macular splitting homonymous eld defect. Neglect alexia is usually caused by occipitoparietal lesions, right-sided lesions causing left neglect alexia. Central (linguistic) alexias include • Alexia with aphasia: Patients with aphasia often have coexistent dif culties with reading (reading aloud and/or comprehending written text) and writing (alexia with agraphia, such patients may have a complete or partial Gerstmann -16 Alexithymia A syndrome, the so-called third alexia of Benson). The reading prob lem parallels the language problem; thus in Broca’s aphasia reading is laboured with particular problems in reading function words (of, at) and verb in ections (-ing, -ed); in Wernicke’s aphasia numerous paraphasic errors are made. From the linguistic viewpoint, different types of paralexia (substitution in reading) may be distinguished: • Surface dyslexia: Reading by sound: there are regularization errors with exception words. Cross References Acalculia; Achromatopsia; Agnosia; Agraphia; Aphasia; Broca’s aphasia; Gerstmann syndrome; Hemianopia; Macula sparing, Macula splitting; Neglect; Prosopagnosia; Saccades; Simultanagnosia; Visual agnosia; Visual eld defects; Wernicke’s aphasia Alexithymia Alexithymia is a reduced ability to identify and express ones feelings. It may be measured -17 A ‘Alice in Wonderland’ Syndrome using the Toronto Alexithymia Score. Some authors have subsequently interpreted these as somes thetic migrainous auras whereas others challenge this on chronological grounds, nding no evidence in Dodgson’s diaries for the onset of migraine until after he had written the Alice books. It was suggested that the grasp re ex and alien hand syndromes are not separate entities but part of the spectrum of frontal lobe dysfunction, the term ‘alien grasp re ex’ attempting to emphasize the overlap.

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Units or groups such as species cheap doxazosin 1 mg on line chronic gastritis forum, then order doxazosin 1mg free shipping gastritis in cats, may be established through individual or genic selection doxazosin 2mg lowest price gastritis diet çàêîí, yet persist or fail as a result of competition with other species­ hence purchase doxazosin 4 mg fast delivery gastritis diet èãðû, through a kind of group selection. Dawkins (19) has denied that diferential species extinction can properly be termed group selection because, as he puts it, species are not "replicators. But when a sexual population produces an asexual one-when a sexual individual asexually produces an ofspring capable of continuing to reproduce asexually-unless the asexual de­ scendants can revert more or less easily to sexuality, the asexual population is exactly like a second species, and the competition between sexuality and asexuality (that is, the question whether or not sexuality is maintained) is in some sense between the asexual genotype (throughout the asexual population except for muta­ tions) and the whole collection of recombining sexual genotypes. This is as clearly group selection as is competition between two distinct species. Part of the reason for considering the whole collection of genotypes in the sexual population in the above argument is that, in comparing sexual and asexual geno­ types as competitors, one cannot measure simply the collective value of a brood in the sexual line to determine the ftness of the parent. Also involved is how diferent is the average ftness of the brood members from the rest of the population-r, more specifcally, from that of potential mates. A set of ofspring enormously superior to the asexual genotype(s) might, on this account, be limited to producing a set of grandchildren inferior to the asexual genotype(s). This is a hazard of specialized sex (meaning loss of the ability to become quickly asexual when a superior genotype is produced, or when ftness is high and the environment is stable), and to some extent it binds together the members of a sexual population and gives special importance to the average ftness of sexual genotypes. The average ftness of genotyps in sexual ppulations, despite its wide use in ppulation genetics, actually has little signifcance, except in interspecifc competition that is defnitely leading to unilateral extinction, or when there are asexual genotypes with which to compete. If there are no asexual genotypes, then, unless ftness diferences involve some kind of "absolute" values. Ifthere are competing asexual genotypes, however, the fttest sexual genotypes will be hurt in their competition with the asexual genotypes by having only inferior genotypes with which to recombine. Ifphenotypes produced by superior genotypes are able to restrict their matings to other superior genotypes they need not be dragged down all the way by the average ftness of the entire sexual population. Selection of Asexual Genomes In the expanded view of "group" selection suggested here, the extreme example below the species level, as evidenced by integrity of groups, may be the populations of genes that make up secondarily asexual genotypes. Although they may not represent the easiest cases to review in causal historical terms, we can use them to consider conditions optimal to group selection, as well as to exemplify an extreme outcome of these conditions. First, it may be useful to justify considering genes in genotypes as groups in discussing "group" selection. Even genes at diferent loci, however, are potentially reproductively competing entities, at least historically, and in this sense genes in genomes may be viewed as parallels to individuals in populations. At infrequent intervals, the genes in sexual genomes disperse and recombine, forming new genomes in a fashion roughly parallel to the dispersal and recombination of individuals in species living in temporary habitats. The regularity and organization of the periodic recombinations of genes in genomes, and the complexity of genic cooperation between recombinations that produces the emergent populational efect that we call the phenotype, may at frst cause this comparison with individuals to seem bizarre. Unlike individuals in spe­ cies, genes in genomes (usually) cooperate without diferential reproduction and it is this cooperation that contributes to our view of an individual as a well-defned unit in the reproductive hierarchy. At any time, however, sexual genomes are susceptible to the appearance of genes or other units (here termed "outlaw" genes or units) that, because of recombination, may reproduce at some expense to the rest of the genome. There are obvious limits to the damage such elements can infict while still successfully spreading, but they can have important efects on individual reproduction. Unlike the populations of genes that make up sexual genotypes, those in com­ pletely asexual (apomictic) genotypes never recombine; hence, the genome is cer­ tainly the unit of selection. Changing any gene creates a new genotype, and the fate of every gene is inextricably linked to the fates of all other genes in its genotyp. The interests of the genes within an asexual genotype are evidently synonymous, meaning that they scarcely (if at all) compete with other gene in their own geno­ types; they compete only with those in other genotypes. In some sense, then, it can be seen that all units of higher levels in the hierarchy of organization of life are essentially aspects of the environments in which units at lower levels are selected. This "power of the collective" [Leigh (46, 47) called it a "parliament of the genes"] exists in any situation in which a large number of units, at any level in the hierarchy of life, share a similar interest contrary to that of a single unit or smaller group. For example, even though parents are generally more able to manipUlate their ofspring in their own interests than vice versa [(2), (68), p. Ofspring domination is probably most likely in cases in which the confict involves adult ofspring, no longer in any sense dependent on parental care; in such cases, typical of at least some hymenopteran interactions, the confict may be more appro­ priately viewed simply in terms of the relatedness of the interactants rather than as parent-ofspring confict. The allele, therefore, must not only overcome any suppressing efects by the parent, which may be quite powerful (2), but must also compete with its alteratives both in lines not containing it and in mixed broods. Support for the existence of selection against "outlaws" is provided by reports that, in some dipteran females, aberrant chromosomes are preferentially shunted into polar bodies during meiosis (15, 65). In humans, only one of the X chromo­ somes is active in somatic cells; if one X chromosome is damaged it generally becomes the deactivated member of the pair (26, 31, 34). Genes on the Y chromosome are particularly likely to be able to operate to their own advantage, contrary to the interests of other genes in their own genome (37). Because this chromosome occurs only in the heterogametic sex, and alone is passed intact through generations of descendants of that sex, the possibility exists for genes on it to mutate and cause their bearers to favor descendants carrying the mutation (4). Any efects of genes on any chromosome that increase the phenotypic distinc­ tiveness of the sexes would incidentally increase the potential for a Y mutant to produce this efect. Such a gene might cause its bearer to give more care to descen­ dants of the same sex, or to give care only to descendants of that sex; or it might cause the bearer to produce only ofspring of the same sex. Any such gene would be approximately three times a efective as similar genes on the other (X) sex chromosome, because each X chromosome spends approximately one third of its time in the heterogametic sex (37), and in humans even more so because of the recognizability of theY chromosome, given established cultural inheritance patters [e. If the above arguments about outlawry are correct, efects of genes on the Y chromosome might be expected to lead to a general suppression of their activity by modifers throughout the genome, thus contributing to the observed general inert­ ness of the Y chromosome. Hamilton (37) attributed this general inertness to the genomic response toY mutants when they cause either meiotic drive or diferential success of V-bearing sperm. To illustrate further the behavior of what we are calling "outlaw" genes and systems within the genome, we may consider the meiotic drive of sex chromosomes in Drosophila (29, 66), which causes biases in the representation of chromosomes among the gametes of an individual male.

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