Graphene-enhanced infrared near-field microscopy.
Graphene is a promising two-dimensional platform for widespread nanophotonic applications. Recent theories have predicted that graphene can also enhance evanescent fields for subdiffraction-limited imaging. Here, for the first time we experimentally demonstrate that monolayer graphene offers a 7-fold enhancement of evanescent information, improving conventional infrared near-field microscopy to resolve buried structures at a 500 nm depth with λ/11-resolution.


The influence of memory load upon delay-interval activity in a working-memory task: an event-related functional MRI study.
We conducted two fMRI studies to investigate the sensitivity of delay-period activity to changes in memory load during a delayed-recognition task for faces. In Experiment 1, each trial began with the presentation of a memory array consisting of one, two, or three faces that lasted for 3 sec. A 15-sec delay period followed during which no stimuli were present. The delay interval concluded with a one-face probe to which subjects made a button press response indicating whether this face was part of the memory array. Experiment 2 was similar in design except that the delay period was lengthened to 24 sec, and the memory array consisted of only one or three faces. We hypothesized that memory maintenance processes that spanned the delay interval would be revealed by their sensitivity to memory load. Long delay intervals were employed to temporally dissociate phasic activity engendered by the memory array from sustained activity reflecting maintenance. Regions of interest (ROIs) were defined anatomically for the superior frontal gyri (SFG), middle frontal gyri (MFG), and inferior frontal gyri (IFG), intraparietal sulci (IPS), and fusiform gyri (FFG) on a subject-by-subject basis. The mean time course of activity was determined for all voxels within these regions and for that subset of voxels within each ROI that correlated significantly with an empirically determined reference waveform. In both experiments, memory load significantly influenced activation 6--9 sec following the onset of the memory array with larger amplitude responses for higher load levels. Responses were greatest within MFG, IPS, and FFG. In both experiments, however, these load-sensitive differences declined over successive time intervals and were no longer significant at the end of the delay interval. Although insensitive to our load manipulation, sustained activation was present at the conclusion of the delay interval within MFG and other prefrontal regions. IPS delay activity returned to prestimulus baseline levels prior to the end of the delay period in Experiment 2, but not in Experiment 1. Within FFG, delay activity returned to prestimulus baseline levels prior to the conclusion of the delay interval in both experiments. Thus, while phasic processes engendered by the memory array were strongly affected by memory load, no evidence for load-sensitive delay-spanning maintenance processes was obtained.


Managing chronic pain in elderly patients requires a CHANGE of approach.
In many countries, the number of elderly people has increased rapidly in recent years and this is expected to continue; it has been predicted that almost a quarter of the population in the European Union will be over 65 years of age in 2035. Many elderly people suffer from chronic pain but it is regularly under-treated, partly because managing these patients is often complex. This paper outlines the extent of untreated pain in this population and the consequent reduction in quality of life, before articulating the reasons why it is poorly or inaccurately diagnosed. These include the patient's unwillingness to complain, atypical pain presentations, multiple morbidities and cognitive decline. Successful pain management depends upon accurate diagnosis, which is based upon a complete history and thorough physical examination, as well as an assessment of psychosocial functioning. Poor physician/patient communication can be improved by using standardized instruments to establish individual treatment targets and measure progress towards them. User-friendly observational instruments may be valuable for patients with dementia. In line with the widely accepted biopsychosocial model of pain, a multidisciplinary approach to pain management is recommended, with pharmacotherapy, psychological support, physical rehabilitation and interventional procedures available if required. Declining organ function and other physiological changes require lower initial doses of analgesics and less frequent dosing intervals, and the physician must be aware of all medications that the patient is taking, in order to avoid drug/drug interactions. Non-adherence to treatment is common, and various strategies can be employed to improve it; involving the elderly patient's caregivers and family, using medication systems such as pill-boxes, or even sending text messages. In the long term, the teaching of pain medicine needs to be improved--particularly in the use of opioids--both at undergraduate level and after qualification.


Malaria prevalence and mosquito net coverage in Oromia and SNNPR regions of Ethiopia.
Malaria transmission in Ethiopia is unstable and seasonal, with the majority of the country's population living in malaria-prone areas. Results from DHS 2005 indicate that the coverage of key malaria interventions was low. The government of Ethiopia has set the national goal of full population coverage with a mean of 2 long-lasting insecticidal nets (LLINs) per household through distribution of about 20 million LLIN by the end of 2007. The aim of this study was to generate baseline information on malaria parasite prevalence and coverage of key malaria control interventions in Oromia and SNNPR and to relate the prevalence survey findings to routine surveillance data just before further mass distribution of LLINs. A 64 cluster malaria survey was conducted in January 2007 using a multi-stage cluster random sampling design. Using Malaria Indicator Survey Household Questionnaire modified for the local conditions as well as peripheral blood microscopy and rapid diagnostic tests, the survey assessed net ownership and use and malaria parasite prevalence in Oromia and SNNPR regions of Ethiopia. Routine surveillance data on malaria for the survey time period was obtained for comparison with prevalence survey results. Overall, 47.5% (95% confidence interval (CI) 33.5-61.9%) of households had at least one net, and 35.1% (95% CI 23.1-49.4%) had at least one LLIN. There was no difference in net ownership or net utilization between the regions. Malaria parasite prevalence was 2.4% (95% CI 1.6-3.5%) overall, but differed markedly between the two regions: Oromia, 0.9% (95% CI 0.5-1.6); SNNPR, 5.4% (95% CI 3.4-8.5), p < 0.001. This difference between the two regions was also reflected in the routine surveillance data. Household net ownership exhibited nearly ten-fold increase compared to the results of Demographic and Health Survey 2005 when fewer than 5% of households in these two regions owned any nets. The results of the survey as well as the routine surveillance data demonstrated that malaria continues to be a significant public health challenge in these regions-and more prevalent in SNNPR than in Oromia.


Acalabrutinib monotherapy in patients with chronic lymphocytic leukemia who are intolerant to ibrutinib.
The Bruton tyrosine kinase (BTK) inhibitor ibrutinib improves patient outcomes in chronic lymphocytic leukemia (CLL); however, some patients experience adverse events (AEs) leading to discontinuation. Acalabrutinib is a potent, covalent BTK inhibitor with greater selectivity than ibrutinib. We evaluated the safety and efficacy of 100 mg of acalabrutinib twice daily or 200 mg once daily in patients with CLL who discontinued ibrutinib because of intolerance as determined by the investigators. Among 33 treated patients (61% men; median age, 64 years; range, 50-82 years), median duration of prior ibrutinib treatment was 11.6 months (range, 1-62 months); median time from ibrutinib discontinuation to acalabrutinib start was 47 days (range, 3-331 days). After a median of 19.0 months (range, 0.2-30.6 months), 23 patients remained on acalabrutinib; 10 had discontinued (progressive disease, n = 4; AEs, n = 3). No acalabrutinib dose reductions occurred. During acalabrutinib treatment, the most frequent AEs included diarrhea (58%), headache (39%), and cough (33%). Grade 3/4 AEs occurred in 58%, most commonly neutropenia (12%) and thrombocytopenia (9%). Of 61 ibrutinib-related AEs associated with intolerance, 72% did not recur and 13% recurred at a lower grade with acalabrutinib. Overall response rate was 76%, including 1 complete and 19 partial responses and 5 partial responses with lymphocytosis. Among 25 responders, median duration of response was not reached. Median progression-free survival (PFS) was not reached; 1-year PFS was 83.4% (95% confidence interval, 64.5%-92.7%). Acalabrutinib was well tolerated with a high response rate in patients who were previously intolerant to ibrutinib. This trial was registered at www.clinicaltrials.gov as #NCT02029443.


Health characteristics of the American Indian or Alaska Native adult population: United States, 2004-2008.
This report compares national estimates for selected health status indicators, health behaviors, health care utilization, health conditions, immunizations, and human immunodeficiency virus (HIV) testing status for American Indian or Alaska Native (AIAN) adults with those for white, black, Asian, and Hispanic adults aged 18 years and over. The estimates in this report were derived from the Family Core and the Sample Adult core components of the 2004-2008 National Health Interview Surveys, conducted by the Centers for Disease Control and Prevention's National Center for Health Statistics. Estimates were generated and compared using the SUDAAN statistical package to account for the complex sample design. In general, compared with other groups, non-Hispanic AIAN adults' are more likely to have poorer health, unmet medical needs due to cost, diabetes, trouble hearing, activity limitations, and to have experienced feelings of psychological distress in the past 30 days. Non-Hispanic AIAN adults are more likely to be current smokers and current drinkers compared with other adults. The non-Hispanic AIAN community faces many health challenges as reflected in their higher rates of risky health behaviors, poorer health status and health conditions, and lower utilization of health services.


Investigation of the potassium fluoride post deposition treatment on the CIGSe/CdS interface using hard X-ray photoemission spectroscopy - a comparative study.
The impact of the potassium fluoride post deposition treatment on CIGSe chalcopyrite absorbers is investigated by means of depth resolved hard X-ray photoemission spectroscopy of the near surface region. Two similar, slightly Cu-poor CIGSe absorbers were used with one being treated by potassium fluoride prior to the chemical bath deposition of an ultrathin CdS layer. The thickness of the CdS layer was chosen to be in the range of about 10 nm in order to allow the investigation of the CIGSe/CdS interface by the application of hard X-rays, increasing the information depth up to 30 nm. Besides strong intermixing on both samples, an increased Cu depletion of the KF treated absorber was observed in combination with an increased accumulation of Cd and S. In addition, a general shift of about 0.15 eV to higher binding energies of the CIGSe valence band at the absorber surface as well as the CIGSe and CdS related core levels was measured on the KF treated sample. This phenomenon is attributed to the impact of additional cadmium which acts as donor and releases further electrons into the conduction band of the absorber. Finally, the electrons accumulate at the CdS surface after having passed the interface region. This additional surface charge leads to a pronounced shift in the photoemission spectra as observed on the KF treated CIGSe absorber compared to the non-treated absorber.


Adherence to combination antiretroviral therapies in HIV patients of low health literacy.
To test the significance of health literacy relative to other predictors of adherence to treatment for HIV and AIDS. Community sample of HIV-seropositive men (n = 138) and women (n = 44) currently taking a triple-drug combination of antiretroviral therapies for HIV infection; 60% were ethnic minorities, and 73% had been diagnosed with AIDS. An adapted form of the Test of Health Literacy in Adults (TOFHLA), a comprehensive health and treatment interview that included 2-day recall of treatment adherence and reasons for nonadherence, and measures of substance abuse, social support, emotional distress, and attitudes toward primary care providers. Multiple logistic regression showed that education and health literacy were significant and independent predictors of 2-day treatment adherence after controlling for age, ethnicity, income, HIV symptoms, substance abuse, social support, emotional distress, and attitudes toward primary care providers. Persons of low literacy were more likely to miss treatment doses because of confusion, depression, and desire to cleanse their body than were participants with higher health literacy. Interventions are needed to help persons of low literacy adhere to antiretroviral therapies.


Dietary fatty acid content regulates wound repair and the pathogenesis of osteoarthritis following joint injury.
The mechanisms linking obesity and osteoarthritis (OA) are not fully understood and have been generally attributed to increased weight, rather than metabolic or inflammatory factors. Here, we examined the influence of fatty acids, adipokines, and body weight on OA following joint injury in an obese mouse model. Mice were fed high-fat diets rich in various fatty acids (FA) including saturated FAs (SFAs), ω-6 polyunsaturated FAs (PUFAs), and ω-3 PUFAs. OA was induced by destabilising the medial meniscus. Wound healing was evaluated using an ear punch. OA, synovitis and wound healing were determined histologically, while bone changes were measured using microCT. Activity levels and serum cytokines were measured at various time-points. Multivariate models were performed to elucidate the associations of dietary, metabolic and mechanical factors with OA and wound healing. Using weight-matched mice and multivariate models, we found that OA was significantly associated with dietary fatty acid content and serum adipokine levels, but not with body weight. Furthermore, spontaneous activity of the mice was independent of OA development. Small amounts of ω-3 PUFAs (8% by kcal) in a high-fat diet were sufficient to mitigate injury-induced OA, decreasing leptin and resistin levels. ω-3 PUFAs significantly enhanced wound repair, SFAs or ω-6 PUFAs independently increased OA severity, heterotopic ossification and scar tissue formation. Our results indicate that with obesity, dietary FA content regulates wound healing and OA severity following joint injury, independent of body weight, supporting the need for further studies of dietary FA supplements as a potential therapeutic approach for OA.


Specific deletion of NaV1.1 sodium channels in inhibitory interneurons causes seizures and premature death in a mouse model of Dravet syndrome.
Heterozygous loss-of-function mutations in the brain sodium channel Na(V)1.1 cause Dravet syndrome (DS), a pharmacoresistant infantile-onset epilepsy syndrome with comorbidities of cognitive impairment and premature death. Previous studies using a mouse model of DS revealed reduced sodium currents and impaired excitability in GABAergic interneurons in the hippocampus, leading to the hypothesis that impaired excitability of GABAergic inhibitory neurons is the cause of epilepsy and premature death in DS. However, other classes of GABAergic interneurons are less impaired, so the direct cause of hyperexcitability, epilepsy, and premature death has remained unresolved. We generated a floxed Scn1a mouse line and used the Cre-Lox method driven by an enhancer from the Dlx1,2 locus for conditional deletion of Scn1a in forebrain GABAergic neurons. Immunocytochemical studies demonstrated selective loss of Na(V)1.1 channels in GABAergic interneurons in cerebral cortex and hippocampus. Mice with this deletion died prematurely following generalized tonic-clonic seizures, and they were equally susceptible to thermal induction of seizures as mice with global deletion of Scn1a. Evidently, loss of Na(V)1.1 channels in forebrain GABAergic neurons is both necessary and sufficient to cause epilepsy and premature death in DS.


An analysis of the relationship between metastases and cachexia in lung cancer patients.
Weight loss and hematogenous metastases are poor prognosis factors in lung cancer patients that can but do not necessarily co-occur. We retrospectively investigated the clinical association between cachexia, tumor characteristics (such as metastatic burden and mutational status), and treatment in lung cancer patients. The medical records of 394 lung cancer patients from two institutions (Columbia University, USA and Tohoku University, Japan) were reviewed. Information collected included the presence of cachexia, histologic subtype, tumor stage, number of metastases, mutation status, treatment, and survival. Descriptive statistics were performed. Only stage IV patients exhibited >5% weight loss (0.8%, 2.2%, 3.6%, and 5.1%, for stages I to IV; P = 0.0001). Patients with metastases developed cachexia more often than patients without metastases independent of treatment (6.0% and 7.1% weight loss in patients with metastases vs. 2.5% and 2.0% in patients without metastases, before [P = 0.0001] and after [P < 0.0001] treatment, respectively). The change in number of metastatic sites over time correlated with increasing weight loss (5.2%, 10.6%, 13.4%, and 13.4%, for an increase of 0, 1, 2, and ≥3 metastatic sites, from initial diagnosis to the endpoint; P < 0.0001). Patients with cachexia had worse survival than patients without cachexia (hazard ratio, 2.94; 95% confidence interval, 2.08-4.16; P < 0.0001). Tumors with mutated KRAS were associated with an increased risk of weight loss (11.4% weight loss in patients with mutated KRAS vs. 6.0% in patients with wild-type KRAS; P = 0.0011). Our findings suggest that the capabilities of lung cancer to metastasize and cause cachexia might be linked intrinsically and are independent of treatments administered. KRAS-mutated tumors were more commonly associated with cachexia.


Ex Vivo Administration of Mesenchymal Stromal Cells in Kidney Grafts Against Ischemia-reperfusion Injury-Effective Delivery Without Kidney Function Improvement Posttransplant.
Mesenchymal stromal cell (MSC) therapy may improve renal function after ischemia-reperfusion injury in transplantation. Ex vivo renal intraarterial administration is a targeted delivery method, avoiding the lung vasculature, a known barrier for cellular therapies. In a randomized and blinded study, we tested the feasibility and effectiveness of MSC therapy in a donation after circulatory death autotransplantation model to improve posttransplant kidney function, using an ex vivo MSC delivery method similar to the clinical standard procedure of pretransplant cold graft flush. Kidneys exposed to 75 minutes of warm ischemia and 16 hours of static cold storage were intraarterially infused ex vivo with 10 million male porcine MSCs (Tx-MSC, n = 8) or vehicle (Tx-control, n = 8). Afterwards, the kidneys were autotransplanted after contralateral nephrectomy. Biopsies an hour after reperfusion confirmed the presence of MSCs in the renal cortex. Animals were observed for 14 days. Postoperatively, peak plasma creatinine was 1230 and 1274 µmol/L (Tx-controls versus Tx-MSC, P = 0.69). During follow-up, no significant differences over time were detected between groups regarding plasma creatinine, plasma neutrophil gelatinase-associated lipocalin, or urine neutrophil gelatinase-associated lipocalin/creatinine ratio. At day 14, measured glomerular filtration rates were 40 and 44 mL/min, P = 0.66. Renal collagen content and fibrosis-related mRNA expression were increased in both groups but without significant differences between the groups. We demonstrated intraarterial MSC infusion to transplant kidneys as a safe and effective method to deliver MSCs to the graft. However, we could not detect any positive effects of this cell treatment within 14 days of observation.


Midpalmar accurate incision for carpal tunnel release.
Carpal tunnel syndrome is the most common entrapment neuropathy in humans today. For patients in whom conservative treatment fails, surgical decompression is indicated. Among the various surgical techniques currently in use, endoscopic techniques are becoming increasingly popular. Due to the rapid postoperative recovery shown after endoscopic operations, midpalmar accurate incision for carpal tunnel release is a comparative alternative. From February 1998 through January 2003, 84 patients had undergone 96 midpalmar carpal tunnel releases with accurate skin incisions under regional block or general mask anesthesia. The postoperative evaluations were performed via subjective assessment with a standardized telephone interview over an average follow-up period of 22.4 months. The average operation time was 16 minutes (range, 5 to 40 minutes). A total of 87 hands (91%) had excellent or good recovery in terms of symptom relief (improvement of 70% or greater). The incidence of postoperative sensory morbidity, i.e., pillar pain or scar tenderness, was 7% (7 hands). The motor functional morbidity of a persistent subjective decrease in grip strength was noted in 8% (8 hands), and the mean period for returning to work was 4.5 weeks. In addition, no operation-induced neurovascular or tendinous injury occurred in any patient. The outcomes were similar to those of endoscopic carpal tunnel release. Based on these results, midpalmar carpal tunnel release with accurate location of skin incision is as effective as any other surgical procedures for carpal tunnel release. Furthermore, it is also a safe and simple procedure.


[Functional capacity, socioeconomic conditions and of health of elderly assisted by Family Health teams in Goiania (GO, Brazil)].
The population ageing is a challenge for health professionals. This study seek to evaluate the functional capacity and to identify the factors associated to the dependence for the activities of daily life (ADL) and activities instrumental of daily life (AIDL), and also to describe the socioeconomic, demographic and health profile of the elderly. A transverse study was carried out with seniors assisted by Family Health teams of the District East Sanitary of Goiania (GO). A questionnaire was applied to obtain socioeconomic and demographic date, factors related to the health and scales of the functional evaluation. For analyses it was used Square-Qui Test considering the level of significance of 5%. The sample was composed by 388 elderly, 57.5% with age varying from 60 to 69 years, 58.5% female, 39.7% illiterate, 77.3% with income ≤ 2 minimum wages and 70.9% bearers of chronic diseases. It was verified that 34.8% needed help in one or more ADL and 60.6% in AIDL. The factors more frequently associated at dependence in both activities were: balance and mobility debilitated, depression, cognitive deficit and age ≥ 80 years. These results denote that the elderly are living aging characterized by comorbidities and dependence to accomplish daily activities.


East Asian Young and Older Adult Perceptions of Emotional Faces From an Age- and Sex-Fair East Asian Facial Expression Database.
There is increasing interest in clarifying how different face emotion expressions are perceived by people from different cultures, of different ages and sex. However, scant availability of well-controlled emotional face stimuli from non-Western populations limit the evaluation of cultural differences in face emotion perception and how this might be modulated by age and sex differences. We present a database of East Asian face expression stimuli, enacted by young and older, male and female, Taiwanese using the Facial Action Coding System (FACS). Combined with a prior database, this present database consists of 90 identities with happy, sad, angry, fearful, disgusted, surprised and neutral expressions amounting to 628 photographs. Twenty young and 24 older East Asian raters scored the photographs for intensities of multiple-dimensions of emotions and induced affect. Multivariate analyses characterized the dimensionality of perceived emotions and quantified effects of age and sex. We also applied commercial software to extract computer-based metrics of emotions in photographs. Taiwanese raters perceived happy faces as one category, sad, angry, and disgusted expressions as one category, and fearful and surprised expressions as one category. Younger females were more sensitive to face emotions than younger males. Whereas, older males showed reduced face emotion sensitivity, older female sensitivity was similar or accentuated relative to young females. Commercial software dissociated six emotions according to the FACS demonstrating that defining visual features were present. Our findings show that East Asians perceive a different dimensionality of emotions than Western-based definitions in face recognition software, regardless of age and sex. Critically, stimuli with detailed cultural norms are indispensable in interpreting neural and behavioral responses involving human facial expression processing. To this end, we add to the tools, which are available upon request, for conducting such research.


Cloche is a bHLH-PAS transcription factor that drives haemato-vascular specification.
Vascular and haematopoietic cells organize into specialized tissues during early embryogenesis to supply essential nutrients to all organs and thus play critical roles in development and disease. At the top of the haemato-vascular specification cascade lies cloche, a gene that when mutated in zebrafish leads to the striking phenotype of loss of most endothelial and haematopoietic cells and a significant increase in cardiomyocyte numbers. Although this mutant has been analysed extensively to investigate mesoderm diversification and differentiation and continues to be broadly used as a unique avascular model, the isolation of the cloche gene has been challenging due to its telomeric location. Here we used a deletion allele of cloche to identify several new cloche candidate genes within this genomic region, and systematically genome-edited each candidate. Through this comprehensive interrogation, we succeeded in isolating the cloche gene and discovered that it encodes a PAS-domain-containing bHLH transcription factor, and that it is expressed in a highly specific spatiotemporal pattern starting during late gastrulation. Gain-of-function experiments show that it can potently induce endothelial gene expression. Epistasis experiments reveal that it functions upstream of etv2 and tal1, the earliest expressed endothelial and haematopoietic transcription factor genes identified to date. A mammalian cloche orthologue can also rescue blood vessel formation in zebrafish cloche mutants, indicating a highly conserved role in vertebrate vasculogenesis and haematopoiesis. The identification of this master regulator of endothelial and haematopoietic fate enhances our understanding of early mesoderm diversification and may lead to improved protocols for the generation of endothelial and haematopoietic cells in vivo and in vitro.


Comparison of Nanostring nCounter® Data on FFPE Colon Cancer Samples and Affymetrix Microarray Data on Matched Frozen Tissues.
The prognosis of colorectal cancer (CRC) stage II and III patients remains a challenge due to the difficulties of finding robust biomarkers suitable for testing clinical samples. The majority of published gene signatures of CRC have been generated on fresh frozen colorectal tissues. Because collection of frozen tissue is not practical for routine surgical pathology practice, a clinical test that improves prognostic capabilities beyond standard pathological staging of colon cancer will need to be designed for formalin-fixed paraffin-embedded (FFPE) tissues. The NanoString nCounter® platform is a gene expression analysis tool developed for use with FFPE-derived samples. We designed a custom nCounter® codeset based on elements from multiple published fresh frozen tissue microarray-based prognostic gene signatures for colon cancer, and we used this platform to systematically compare gene expression data from FFPE with matched microarray array data from frozen tissues. Our results show moderate correlation of gene expression between two platforms and discovery of a small subset of genes as candidate biomarkers for colon cancer prognosis that are detectable and quantifiable in FFPE tissue sections.


Human resource development and capacity-building during China's rapid scale-up of methadone maintenance treatment services.
China's National Methadone Maintenance Treatment Programme (MMT) has expanded from eight clinics serving approximately 1000 clients to 738 clinics that have served more than 340 000 clients cumulatively in only 8 years. This has created an enormous demand for trained providers. Human resource development and capacity building efforts have been conducted in China's National MMT Programme to create a supply of providers trained in administering MMT for opioid dependence. From 2004 to 2007, China's National MMT Programme faced several problems: inappropriately low methadone doses, poor compliance, high concurrent drug use and high drop-out rates among clients, and little experience, little training and high turnover rates among providers. Training programmes for individual providers and their trainers were redeveloped and expanded in 2008. Although programme performance metrics show an increase in patients' annual mean duration in treatment (93 days in 2004 versus 238 days in 2011), the increase in their mean daily methadone dose (from 47.2 mg in 2004 to 58.6 mg in 2011) is modest. Some of the problems that can arise during the development, launch and scale-up of a major national public health effort, such as China's National MMT Programme, cannot be foreseen. Key to the programme's success so far have been the strong commitment on the part of China's government and the optimism and pragmatism of programme managers. Human resources development and capacity-building during scale-up have contributed to improved service quality in MMT treatment clinics and are critical to long-term success.


Natural zeolite clinoptilolite: new adjuvant in anticancer therapy.
Natural silicate materials, including zeolite clinoptilolite, have been shown to exhibit diverse biological activities and have been used successfully as a vaccine adjuvant and for the treatment of diarrhea. We report a novel use of finely ground clinoptilolite as a potential adjuvant in anticancer therapy. Clinoptilolite treatment of mice and dogs suffering from a variety of tumor types led to improvement in the overall health status, prolongation of life-span, and decrease in tumors size. Local application of clinoptilolite to skin cancers of dogs effectively reduced tumor formation and growth. In addition, toxicology studies on mice and rats demonstrated that the treatment does not have negative effects. In vitro tissue culture studies showed that finely ground clinoptilolite inhibits protein kinase B (c-Akt), induces expression of p21WAF1/CIP1 and p27KIP1 tumor suppressor proteins, and blocks cell growth in several cancer cell lines. These data indicate that clinoptilolite treatment might affect cancer growth by attenuating survival signals and inducing tumor suppressor genes in treated cells.


Cone-beam Computed Tomographic Usage: Survey of American Endodontists.
The aim of this study was to investigate the acceptance, accessibility, and usage of cone-beam computed tomographic (CBCT) imaging among American Association of Endodontists (AAE) members in the United States by means of an online survey. An invitation to participate in a Web-based survey was sent to 3,000 members of the AAE. The survey consisted of 19 questions on demographics, access to CBCT machines, frequency of use for particular applications, and reasons in case CBCT was not used. A total of 477 endodontists responded to the survey, representing a 15.9% response rate. Around 91.8% of endodontists used CBCT imaging in their practice. Around 86% of endodontists had access to CBCT in their office, while 14% referred their patients to an outside office. Cone-beam computed tomographic units used by endodontists were Carestream (59.6%), Morita (20.8%), and Sirona (5.7%). Around 81.1% of endodontists didn't think CBCT imaging has high risk of radiation exposure; however, 10% of their patients declined CBCT imaging due to both cost and radiation exposure. Around 92.7% requested the segmental view when asking for CBCT. Endodontists' opinion was that CBCT enhances diagnosis of odontogenic pathosis, anatomical structures, treatment of iatrogenic errors, and diagnosis of nonodontogenic pathosis by 96.4%, 96.3%, 92.2%, and 88%, respectively. Around 93% of endodontists agreed that they would not consider doing CBCT for pregnant women. Majority of endodontists (74.6%) use CBCT in their practice for surgery, followed by 60.2% in nonsurgical retreatment. While 59.1% use CBCT in initial nonsurgical treatment, 44% reported that they use CBCT in endodontic recall and 9.2% use CBCT for pediatric patients. CBCT technology is becoming the imaging modality of choice for nonsurgical retreatments and presurgical treatment planning. Endodontists deal with complex cases and thus the CBCT is a necessary tool that helps save a lot of time and effort during treatment procedures, looking for canals or determining why a previous treatment failed, and in providing the most comprehensive care. With the advancement in technology in the latest era, the three-dimensional CBCT imaging helped provide superior information over the two-dimensional periapical radiograph in making the correct diagnostic decision. This survey enlightened the usage of CBCT among endodontic practitioners in the United States. How to cite this article: Alzamzami ZT, Abulhamael AM, Talim DJ, et al. Cone-beam Computed Tomographic Usage: Survey of American Endodontists. J Contemp Dent Pract 2019;20(10):1132-1137.


Occipital gamma-aminobutyric acid and glutamate-glutamine alterations in major depressive disorder: An mrs study and meta-analysis.
The neurotransmitters GABA and glutamate have been suggested to play a role in Major Depressive Disorder (MDD) through an imbalance between cortical inhibition and excitation. This effect has been highlighted in higher brain areas, such as the prefrontal cortex, but has also been posited in basic sensory cortices. Based on this, magnetic resonance spectroscopy (MRS) was used to investigate potential changes to GABA+ and glutamate+glutamine (Glx) concentrations within the occipital cortex in MDD patients (n = 25) and healthy controls (n = 25). No difference in occipital GABA+ or Glx concentrations, nor in the GABA+/Glx ratio, was found between groups. An analysis of an extended MDD patient and unmatched control dataset (n = 90) found no correlation between metabolite concentrations and depressive symptoms. These results were integrated with prior studies through metabolite-specific meta-analyses, revealing no difference in occipital GABA and Glx concentrations between patients and controls. An effect of publication year on GABA group differences was found, suggesting that previously reported results may have been artifacts of measurement accuracy. Taken together, our results suggest that, contrary to some prior reports, MRS measurements of occipital GABA and Glx do not differ between MDD patients and controls.


Calculation of surface distortions of rotating mirrors and their effect on streak camera resolution.
The time resolution of streak cameras is limited by aberrations introduced by the rotating mirror. The effect of geometrical distortions of the mirror, rotating at maximum speed, may be minimized by appropriate choice of mirror material and cross section. The stresses in the rotating mirror and the distortions of its reflecting surface were calculated for various geometries of the mirror. By using a semianalytical point-match method, the same numerical scheme and the same formulas were applicable to all geometries. Sufficient data on the behavior of symmetric and partly symmetric cross sections have been obtained to permit optimization of the mirror design.


Initiation and discontinuation of complementary therapy among cancer patients.
To identify the initiation or discontinuation of complementary therapy (CT) and determine the impact of sociodemographic and clinical factors on CT use among cancer patients. Eligible patients were age 20 or older; newly diagnosed with stomach, liver, or colorectal cancer; and started their initial treatment at the National Cancer Center, Korea, between April 1, 2001, and April 30, 2003. In total, 541 cancer patients were surveyed in face-to-face interviews at baseline, and telephone follow-up interviews were performed every 3 months for 3 years. A total of 281 patients commenced CT after diagnosis; 164 patients stopped using CT during the follow-up period. The overall cumulative probability of starting CT at 1, 2, and 3 years was 50%, 54%, and 55%, respectively. In a Cox multivariate analysis, stomach and liver cancer were associated with an increased probability of initiating CT compared with colorectal cancer. Patients who were classified as stage I, II, or III at diagnosis were associated with a decreased probability of discontinuing CT compared with stage IV. Most cancer patients started to use CT during the initial treatment period. Thus, physicians should communicate with cancer patients about CT at this phase. In particular, more attention should be paid to women and individuals with higher household incomes because these groups are more likely to start CT.


Associations between arterial stiffening and brain structure, perfusion, and cognition in the Whitehall II Imaging Sub-study: A retrospective cohort study.
Aortic stiffness is closely linked with cardiovascular diseases (CVDs), but recent studies suggest that it is also a risk factor for cognitive decline and dementia. However, the brain changes underlying this risk are unclear. We examined whether aortic stiffening during a 4-year follow-up in mid-to-late life was associated with brain structure and cognition in the Whitehall II Imaging Sub-study. The Whitehall II Imaging cohort is a randomly selected subset of the ongoing Whitehall II Study, for which participants have received clinical follow-ups for 30 years, across 12 phases. Aortic pulse wave velocity (PWV) was measured in 2007-2009 (Phase 9) and at a 4-year follow-up in 2012-2013 (Phase 11). Between 2012 and 2016 (Imaging Phase), participants received a multimodal 3T brain magnetic resonance imaging (MRI) scan and cognitive tests. Participants were selected if they had no clinical diagnosis of dementia and no gross brain structural abnormalities. Voxel-based analyses were used to assess grey matter (GM) volume, white matter (WM) microstructure (fractional anisotropy (FA) and diffusivity), white matter lesions (WMLs), and cerebral blood flow (CBF). Cognitive outcomes were performance on verbal memory, semantic fluency, working memory, and executive function tests. Of 542 participants, 444 (81.9%) were men. The mean (SD) age was 63.9 (5.2) years at the baseline Phase 9 examination, 68.0 (5.2) at Phase 11, and 69.8 (5.2) at the Imaging Phase. Voxel-based analysis revealed that faster rates of aortic stiffening in mid-to-late life were associated with poor WM microstructure, viz. lower FA, higher mean, and radial diffusivity (RD) in 23.9%, 11.8%, and 22.2% of WM tracts, respectively, including the corpus callosum, corona radiata, superior longitudinal fasciculus, and corticospinal tracts. Similar voxel-wise associations were also observed with follow-up aortic stiffness. Moreover, lower mean global FA was associated with faster rates of aortic stiffening (B = -5.65, 95% CI -9.75, -1.54, Bonferroni-corrected p < 0.0125) and higher follow-up aortic stiffness (B = -1.12, 95% CI -1.95, -0.29, Bonferroni-corrected p < 0.0125). In a subset of 112 participants who received arterial spin labelling scans, faster aortic stiffening was also related to lower cerebral perfusion in 18.4% of GM, with associations surviving Bonferroni corrections in the frontal (B = -10.85, 95% CI -17.91, -3.79, p < 0.0125) and parietal lobes (B = -12.75, 95% CI -21.58, -3.91, p < 0.0125). No associations with GM volume or WMLs were observed. Further, higher baseline aortic stiffness was associated with poor semantic fluency (B = -0.47, 95% CI -0.76 to -0.18, Bonferroni-corrected p < 0.007) and verbal learning outcomes (B = -0.36, 95% CI -0.60 to -0.12, Bonferroni-corrected p < 0.007). As with all observational studies, it was not possible to infer causal associations. The generalisability of the findings may be limited by the gender imbalance, high educational attainment, survival bias, and lack of ethnic and socioeconomic diversity in this cohort. Our findings indicate that faster rates of aortic stiffening in mid-to-late life were associated with poor brain WM microstructural integrity and reduced cerebral perfusion, likely due to increased transmission of pulsatile energy to the delicate cerebral microvasculature. Strategies to prevent arterial stiffening prior to this point may be required to offer cognitive benefit in older age. ClinicalTrials.gov NCT03335696.


Preventive service gains from first contact access in the primary care home.
The patient-centered medical home (PCMH) concept recently has garnered national attention as a means of improving the quality of primary care. Preventive services are one area in which the use of a PCMH is hoped to achieve gains, though there has been limited exploration of PCMH characteristics that can assist with practice redesign. The purpose of this study was to examine whether first-contact access characteristics of a medical home (eg, availability of appointments or advice by telephone) confer additional benefit in the receipt of preventive services for individuals who already have a longitudinal relationship with a primary care physician at a site of care. This was a secondary analysis examining data from 5507 insured adults with a usual physician who participated in the 2003 to 2006 round of the Wisconsin Longitudinal Study. Using logistic regression, we calculated the odds of receiving each preventive service, comparing individuals who had first-contact access with those without first-contact access. Eighteen percent of the sample received care with first-contact access. In multivariable analyses, after adjustment, individuals who had first-contact access had higher odds of having received a prostate examination (odds ratio [OR], 1.62; 95% CI, 1.20-2.18), a flu shot (OR, 1.36; 95% CI, 1.01-1.82), and a cholesterol test (OR, 1.36; 95% CI, 1.01-1.82) during the past year. There was no significant difference in receipt of mammograms (OR, 1.23; 95% CI, 0.94-1.61). In the primary care home, first-contact accessibility adds benefit, beyond continuity of care with a physician, in improving receipt of preventive services. Amid increasing primary care demands and finite resources available to translate the PCMH into clinic settings, there is a need for further studies of the interplay between specific PCMH principles and how they perform in practice.


Selective on site separation and detection of molecules in diluted solutions with super-hydrophobic clusters of plasmonic nanoparticles.
Super-hydrophobic surfaces are bio-inspired interfaces with a superficial texture that, in its most common evolution, is formed by a periodic lattice of silicon micro-pillars. Similar surfaces reveal superior properties compared to conventional flat surfaces, including very low friction coefficients. In this work, we modified meso-porous silicon micro-pillars to incorporate networks of metal nano-particles into the porous matrix. In doing so, we obtained a multifunctional-hierarchical system in which (i) at a larger micrometric scale, the super-hydrophobic pillars bring the molecules dissolved in an ultralow-concentration droplet to the active sites of the device, (ii) at an intermediate meso-scale, the meso-porous silicon film adsorbs the low molecular weight content of the solution and, (iii) at a smaller nanometric scale, the aggregates of silver nano-particles would measure the target molecules with unprecedented sensitivity. In the results, we demonstrated how this scheme can be utilized to isolate and detect small molecules in a diluted solution in very low abundance ranges. The presented platform, coupled to Raman or other spectroscopy techniques, is a realistic candidate for the protein expression profiling of biological fluids.


The salubrious effects of ascorbic acid on cyclophosphamide instigated lipid abnormalities in fibrosarcoma bearing rats.
The combined effect of cyclophosphamide and ascorbic acid on plasma lipids and lipoprotein profiles are important since, ascorbic acid encumbered the lipid abnormalities initiated by cyclophosphamide during cancer chemotherapy. Hence, the study was launched to appraise the salutary role of ascorbic acid in cyclophosphamide administered fibrosarcoma bearing rats. Fibrosarcoma cell line induced rats were treated with cyclophosphamide (10 mg/kg body weight) and ascorbic acid (200 mg/kg body weight) individually and in combination for 28 days. The concentration of plasma lipids and lipoprotein profiles were determined in control and experimental animals. The untreated, as well as cyclophosphamide administered fibrosarcoma bearing rats, divulged significantly increased levels of plasma total cholesterol, triglycerides, phospholipids, VLDL- and LDL-cholesterol, as compared with their respective control animals. In contrast, ester and HDL-cholesterol levels exhibited a marked decrease in these animals. Similar observations were also noticed in liver lipid values, as well. However, these lipid abnormalities were corrected by the co-administration of ascorbic acid. These results suggested, that some clinical entanglement of cyclophosphamide was refrained by co-administration of ascorbic acid in tumor stress condition.


Factors influencing referrals for ultrasound-diagnosed complications during prenatal care in five low and middle income countries.
Ultrasound during antenatal care (ANC) is proposed as a strategy for increasing hospital deliveries for complicated pregnancies and improving maternal, fetal, and neonatal outcomes. The First Look study was a cluster-randomized trial conducted in the Democratic Republic of Congo, Guatemala, Kenya, Pakistan and Zambia to evaluate the impact of ANC-ultrasound on these outcomes. An additional survey was conducted to identify factors influencing women with complicated pregnancies to attend referrals for additional care. Women who received referral due to ANC ultrasound findings participated in structured interviews to characterize their experiences. Cochran-Mantel-Haenszel statistics were used to examine differences between women who attended the referral and women who did not. Sonographers' exam findings were compared to referred women's recall. Among 700 referred women, 510 (71%) attended the referral. Among referred women, 97% received a referral card to present at the hospital, 91% were told where to go in the hospital, and 64% were told that the hospital was expecting them. The referred women who were told who to see at the hospital (88% vs 66%), where to go (94% vs 82%), or what should happen, were more likely to attend their referral (68% vs 56%). Barriers to attending referrals were cost, transportation, and distance. Barriers after reaching the hospital were substantial. These included not connecting with an appropriate provider, not knowing where to go, and being told to return later. These barriers at the hospital often led to an unsuccessful referral. Our study found that ultrasound screening at ANC alone does not adequately address barriers to referrals. Better communication between the sonographer and the patient increases the likelihood of a completed referral. These types of communication include describing the ultrasound findings, including the reason for the referral, to the mother and staff; providing a referral card; describing where to go in the hospital; and explaining the procedures at the hospital. Thus, there are three levels of communication that need to be addressed to increase completion of appropriate referrals-communication between the sonographer and the woman, the sonographer and the clinic staff, and the sonographer and the hospital. NCT01990625 .


HIV/AIDS-Related Knowledge and Behaviors Among Most-at-Risk Populations in Vietnam.
The U.S. President's Emergency Plan for AIDS Relief (PEPFAR) has supported the Vietnamese Ministry of Health (MOH) in implementing behavior change strategies to slow the HIV epidemic. These programs target commercial sex workers (CSW), injection drug users (IDU), and men who have sex with men (MSM). Using data from a program evaluation to assess effectiveness of the PEPFAR intervention, we conducted a sub-analysis of HIV/AIDS knowledge, sexual behaviors, and injection drug risk behaviors among 2,199 Vietnamese respondents, including those reporting recent contact with an outreach worker and those who did not report contact. We found overall high levels of HIV/AIDS knowledge, low rates of needle sharing, and moderate to high rates of inconsistent condom use. Average knowledge scores of IDU were significantly higher than non-IDU for antiretroviral treatment knowledge, while MSM had significantly less knowledge of treatment compared to non-MSM. HIV/AIDS-related knowledge was not significantly associated with needle-sharing practices. Knowledge was modestly but significantly associated with more consistent use of condoms with primary and commercial sex partners, even after controlling for contact with an outreach worker. Contact with an outreach worker was also an independent predictor of more consistent condom use. Outreach programs appear to play a meaningful role in changing sexual behavior, though the effect of outreach on IDU risk behaviors was less clear. More research is needed to understand the relationship between outreach programs and skill development, motivation, and use of referral services by most-at-risk populations in Vietnam.


Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications: A Scientific Statement for Healthcare Professionals From the American Heart Association.
Infective endocarditis is a potentially lethal disease that has undergone major changes in both host and pathogen. The epidemiology of infective endocarditis has become more complex with today's myriad healthcare-associated factors that predispose to infection. Moreover, changes in pathogen prevalence, in particular a more common staphylococcal origin, have affected outcomes, which have not improved despite medical and surgical advances. This statement updates the 2005 iteration, both of which were developed by the American Heart Association under the auspices of the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease of the Young. It includes an evidence-based system for diagnostic and treatment recommendations used by the American College of Cardiology and the American Heart Association for treatment recommendations. Infective endocarditis is a complex disease, and patients with this disease generally require management by a team of physicians and allied health providers with a variety of areas of expertise. The recommendations provided in this document are intended to assist in the management of this uncommon but potentially deadly infection. The clinical variability and complexity in infective endocarditis, however, dictate that these recommendations be used to support and not supplant decisions in individual patient management.


Effects of In-Season Inertial Resistance Training With Eccentric Overload in a Sports Population at Risk for Patellar Tendinopathy.
Gual, G, Fort-Vanmeerhaeghe, A, Romero-Rodríguez, D, and Tesch, PA. Effects of in-season inertial resistance training with eccentric overload in a sports population at risk for patellar tendinopathy. J Strength Cond Res 30(7): 1834-1842, 2016-Volleyball and basketball players can be considered as a population at risk for patellar tendinopathy. Given the paradox that eccentric training elicits therapeutic benefits yet might provoke such injury, we investigated the influence of a weekly bout of inertial squat resistance exercise offering eccentric overload on lower limb muscle power and patellar tendon complaints. Players of 8 (4 basketball and 4 volleyball) teams (38 women and 43 men) were randomly assigned to either the intervention (IG) or control (CG) group. Although IG and CG maintained scheduled in-season training routines over 24 weeks, IG, in addition, performed 1 weekly session of eccentric overload by 4 sets of 8 repetitions of the squat using flywheel inertial resistance. Victorian Institute of Sports Assessment patellar tendinopathy questionnaire (VISA-p), vertical countermovement jump, and squat power, both concentric (Squat-Con) and eccentric (Squat-Ecc), tests were performed before (T1), during (T2), and after (T3) the 24 weeks of intervention. Neither group suffered from patellar tendinopathy during the study period. VISA-p displayed no differences across groups at any measurement period. Countermovement jump scores significantly (p ≤ 0.05) differed between groups in favor of the IG. Both Squat-Con and Squat-Ecc mean scores from the IG were significantly (p < 0.01) higher than the CG. Adding a weekly eccentric overload squat training bout to a regular basketball and volleyball exercise routine enhances lower limb muscle power without triggering patellar tendon complaints. Future studies, using the current exercise paradigm, aim to explore its efficacy to prevent or combat patellar tendinopathy in sports calling for frequent explosive jumps.


Chronic alcoholism-mediated impairment in the medulla oblongata: a mechanism of alcohol-related mortality in traumatic brain injury?
Alcohol-related traumatic brain injury (TBI) is a common condition in medical and forensic practice, and results in high prehospital mortality. We investigated the mechanism of chronic alcoholism-related mortality by examining the effects of alcohol on the synapses of the medulla oblongata in a rat model of TBI. Seventy adult male Sprague-Dawley rats were randomly assigned to either ethanol (EtOH) group, EtOH-TBI group, or control groups (water group, water-TBI group). To establish chronic alcoholism model, rats in the EtOH group were given EtOH twice daily (4 g/kg for 2 weeks and 6 g/kg for another 2 weeks). The rats also received a minor strike on the occipital tuberosity with an iron pendulum. Histopathologic and ultrastructure changes and the numerical density of the synapses in the medulla oblongata were examined. Expression of postsynaptic density-95 (PSD-95) in the medulla oblongata was measured by ELISA. Compared with rats in the control group, rats in the chronic alcoholism group showed: (1) minor axonal degeneration; (2) a significant decrease in the numerical density of synapses (p < 0.01); and (3) compensatory increase in PSD-95 expression (p < 0.01). Rats in the EtOH-TBI group showed: (1) high mortality (50%, p < 0.01); (2) inhibited respiration before death; (3) severe axonal injury; and (4) decrease in PSD-95 expression (p < 0.05). Chronic alcoholism induces significant synapse loss and axonal impairment in the medulla oblongata and renders the brain more susceptible to TBI. The combined effects of chronic alcoholism and TBI induce significant synapse and axon impairment and result in high mortality.


Perceived social support among HIV patients newly enrolled in care in rural Ethiopia.
Social support significantly enhances physical and mental health for persons with human immunodeficiency virus (HIV). We surveyed 142 rural Ethiopian HIV patients newly enrolled in care for perceived social support and factors associated with low support levels. Using the Social Provisions Scale (SPS), the mean summary score was 19.1 (possible scores = 0-48). On six SPS subscales, mean scores (possible scores = 0-8), were: Reliable Alliance (others can be counted on for tangible assistance) = 2.8, Attachment (emotional closeness providing sense of security) = 2.9, Reassurance of Worth (recognition of competence and value by others) = 3.2, Guidance (provision of advice or information by others) = 3.2, Social Integration (belonging to a group with similar interests and concerns) = 3.5, and Nurturance (belief that others rely on one for their well-being) = 3.6. In multivariate analysis, factors significantly associated with lower social support scores were: lower education level (did not complete primary school) (p = .019), lower total score on knowledge items about HIV care/treatment (p = .038), and greater number of external stigma experiences in past three months (p < .001); greater number of chronic disease symptoms was of borderline significance (p = .098). Among rural Ethiopian patients newly entering HIV care, we found moderate and varying levels of perceived social support, with lowest scores for subscales reflecting emotional closeness and reliance on others for tangible assistance. Given that patients who have recently learned their diagnosis and entered care may be an especially vulnerable group, programs to help identify and address social support needs can provide multiple benefits in facilitating the best possible physical, emotional and functional quality of life for people living with HIV.


Effect of knee joint angle on neuromuscular activation of the vastus intermedius muscle during isometric contraction.
The purpose of this study was to compare the relationship between surface electromyography (EMG) and knee joint angle of the vastus intermedius muscle (VI) with the synergistic muscles in the quadriceps femoris (QF) muscle group. Fourteen healthy men performed maximal voluntary contractions during isometric knee extension at four knee joint angles from 90°, 115°, 140°, and 165° (180° being full extension). During the contractions, surface EMG was recorded at four muscle components of the QF muscle group: the VI, vastus lateralis (VL), vastus medialis (VM), and rectus femoris (RF) muscles. The root mean square of the surface EMG at each knee joint angle was calculated and normalized by that at a knee joint angle of 90° for individual muscles. The normalized RMS of the VI muscle was significantly lower than those of the VL and RF muscles at the knee joint angles of 115° and 165° and those of the VL, VM, and RF muscles at the knee joint angle of 140° (P<0.05). The present results suggest that the neuromuscular activation of the VI muscle is regulated in a manner different from the alteration of the knee joint angle compared with other muscle components of the QF muscle group.


Socio-economic status, place of residence and dietary habits among the elderly: the Mediterranean islands study.
To investigate whether the socio-economic status (SES) of elderly eastern Mediterranean islanders is associated with their dietary habits, particularly with adherence to the traditional Mediterranean diet. Cross-sectional. Adherence to the Mediterranean diet was measured by the MedDietScore (range: 0-55), whereas SES was estimated using education and financial status. During 2005-2007, 300 men and women from Cyprus, 100 from Samothraki, 142 from Mitilini, 114 from Kefalonia, 131 from Crete, 150 from Lemnos, 150 from Corfu and 103 from Zakynthos (aged 65-100 years), free of known chronic diseases, participated in the survey. Multiple linear regression analysis revealed that belonging to the highest SES was associated with a higher MedDietScore (P < 0.01), after adjusting for potential sociodemographic, lifestyle, dietary and clinical confounders. A significant positive association was also found between MedDietScore and years of school (P = 0.004), as well as financial status (P = 0.001). Older Greek people of higher SES seem to follow a relatively healthier diet. Both education and income seem to play a role in this issue. Thus, public health policy makers should focus on people with low SES in order to improve their quality of diet and, consequently, their health status.


Losing the desire: selection can promote obligate asexuality.
Whilst parthenogenesis has evolved multiple times from sexual invertebrate and vertebrate lineages, the drivers and consequences of the sex-asex transition remain mostly uncertain. A model by Stouthamer et al. recently published in BMC Evolutionary Biology shows a pathway by which obligate asexuality could be selected for following endosymbiont infection. See research article http://www.biomedcentral.com/1471-2148/10/229.


Towards more Durable Electrochemical Capacitors by Elucidating the Ageing Mechanisms under Different Testing Procedures.
Electrical double-layer capacitors (EDLCs) commonly denoted supercapacitors are rechargeable energy storage devices with excellent power and energy delivery metrics intermediate to conventional capacitors and batteries. High-voltage aqueous electrolyte based EDLCs are particularly attractive due to their high-power capability, facile production, and environmental advantages. EDLCs should last for thousands of cycles and evaluation of future cell chemistries require long-term and costly galvanostatic cycling. Voltage holding tests have been proposed to shorten evaluation time by accelerating cell degradation processes. Whether voltage holding can replace cycling completely remains undemonstrated. In this work, a systematic investigation of the influence of testing procedure on cell performance is presented. The state-of-the-art post-mortem and operando experimental techniques are implemented to elucidate ageing mechanisms and kinetics inside EDLC cells under different testing procedures. Carbon corrosion occurring on the positively polarized electrode leads to the lower active surface area and higher oxygen content. On the contrary, an increase of surface area and micropore volume are observed on the negatively polarized electrode. Repeated galvanostatic cycles at U<1.6 V appears to facilitate the depletion of oxygen species on the positively polarized electrode in comparison with voltage holding, which indicates a more complex degradation mechanism during cycling. Caution is advised when comparing results from different test procedures.


Health expenditures by services and providers for 195 countries, 2000-2017.
National Health Accounts are a significant source of health expenditure data, designed to be comprehensive and comparable across countries. However, there is currently no single repository of this data and even when compiled major gaps persist. This research aims to provide policymakers and researchers with a single repository of available national health expenditures by healthcare functions (ie, services) and providers of such services. Leveraging these data within statistical methods, a complete set of detailed health expenditures is estimated. A methodical compilation and synthesis of all available national health expenditure reports including disaggregation by healthcare functions and providers was conducted. Using these data, a Bayesian multivariate regression analysis was implemented to estimate national-level health expenditures by the cross-classification of functions and providers for 195 countries, from 2000 to 2017. This research used 1662 country-years and 110 070 data points of health expenditures from existing National Health Accounts. The most detailed country-year had 52% of the categories of interest reported. Of all health functions, curative care and medical goods were estimated to make up 51.4% (uncertainty interval (UI) 33.2% to 59.4%) and 17.5% (UI 13.0% to 26.9%) of total global health expenditures in 2017, respectively. Three-quarters of the global health expenditures are allocated to three categories of providers: hospital providers (35.4%, UI 30.3% to 38.9%), providers of ambulatory care (25.5%, UI 21.1% to 28.8%) and retailers of medical goods (14.4%, UI 12.4% to 16.3%). As gross domestic product increases, countries spend more on long-term care and less on preventive care. Disaggregated estimates of health expenditures are often unavailable and unable to provide policymakers and researchers a holistic understanding of how expenditures are used. This research aggregates reported data and provides a complete time-series of estimates, with uncertainty, of health expenditures by health functions and providers between 2000 and 2017 for 195 countries.


Fine particulate matter concentrations in smoking households: just how much secondhand smoke do you breathe in if you live with a smoker who smokes indoors?
Using data on fine particulate matter less than 2.5 μm (PM2.5) concentrations in smoking and non-smoking homes in Scotland to estimate the mass of PM2.5 inhaled by different age groups. Data from four linked studies, with real-time measurements of PM2.5 in homes, were combined with data on typical breathing rates and time-activity patterns. Monte Carlo modelling was used to estimate daily PM2.5 intake, the percentage of total PM2.5 inhaled within the home environment and the percentage reduction in daily intake that could be achieved by switching to a smoke-free home. Median (IQR) PM2.5 concentrations from 93 smoking homes were 31 (10-111) μg/m(3) and 3 (2-6.5) μg/m(3) for the 17 non-smoking homes. Non-smokers living with smokers typically have average PM2.5 exposure levels more than three times higher than the WHO guidance for annual exposure to PM2.5 (10 μg/m(3)). Fine particulate pollution in Scottish homes where smoking is permitted is approximately 10 times higher than in non-smoking homes. Taken over a lifetime many non-smokers living with a smoker inhale a similar mass of PM2.5 as a non-smoker living in a heavily polluted city such as Beijing. Most non-smokers living in smoking households would experience reductions of over 70% in their daily inhaled PM2.5 intake if their home became smoke-free. The reduction is likely to be greatest for the very young and for older members of the population because they typically spend more time at home.


What does mental health have to do with well-being?
Positive mental health involves not the absence of mental disorder but rather the presence of certain mental goods. Institutions, practitioners, and theorists often identify positive mental health with well-being. There are strong reasons, however, to keep the concepts of well-being and positive mental health separate. Someone with high positive mental health can have low well-being, someone with high well-being can have low positive mental health, and well-being and positive mental health sometimes conflict. But, while positive mental health and well-being are not identical, there is an informative conceptual connection between them. Positive mental health usually contributes instrumentally to the living of a good human life, where a good human life includes (but is not limited to) well-being.


Perceived family history risk and symptomatic diagnosis of prostate cancer: the North Carolina Prostate Cancer Outcomes study.
Prostate cancer (PrCA) is the most common cancer and the second leading cause of cancer death among US men. African American (AA) men remain at significantly greater risk of PrCA diagnosis and mortality than other men. Many factors contribute to the experienced disparities. Guided by the Health Belief Model, the authors surveyed a population of AA and Caucasian men newly diagnosed with PrCA to describe racial differences in perceived risk of PrCA and to examine whether 1) perceived high risk predicts greater personal responsibility for prostate care; and 2) greater personal responsibility for prostate care predicts earlier, presymptomatic diagnosis. Multivariate general linear modeling was performed. The authors found that men with a PrCA family history appreciated their increased risk, but AA men with a family history were less likely to appreciate their increased risk. Nevertheless, neither reporting a PrCA family history nor perceived increased risk significantly predicted screening and preventive behaviors. Furthermore, higher physician trust predicted increased likelihood to have regular prostate exams and screening, indicating that the racial differences in seeking prostate care may be mediated through physician trust. Expressed personal responsibility for screening and more frequent preventive behaviors were associated with more frequent screening diagnoses, fewer symptomatic diagnoses, and less frequent advanced cancers. Together, these results indicate that appreciating greater risk for PrCA is not sufficient to ensure that men will intend, or be able, to act. Increased trust in physicians may be a useful, central marker that efforts to reduce disparities in access to medical care are succeeding.


Localization of specific binding sites for atrial natriuretic factor in the central nervous system of rat, guinea pig, cat and human.
Specific, high-affinity binding sites for atrial natriuretic factor (ANF) were identified and localized in the rat and guinea pig central nervous system (CNS), the cat brainstem, and the rat, guinea pig, cat and human spinal cord using quantitative autoradiographic techniques. The radioligands tested were rat 125I-ANF(1-28) in guinea pig, rat, cat and human tissues, human 125I-ANF in rat and human, and rat [3H]atriopeptin III in rat. All 3 radioligands labeled essentially the same structures in the brain and spinal cord of all species in which they were tested. In guinea pig very high concentrations of ANF binding sites were observed in the olfactory bulb, lateral olfactory tract and the granule cell layer of the cerebellum, high concentrations were observed in the fasciculus retroflexus, interpeduncular nucleus and subfornical organ. Moderate concentrations were observed in the nucleus accumbens, dorsomedial and suprachiasmatic hypothalamic nuclei, paraventricular thalamic nuclei, primary olfactory cortex and the subcommissural organ. High concentrations of ANF binding sites were also observed in the choroid plexus and the leptomeninges. Low concentrations were observed in the pineal gland. In the rat the same structures were labeled as in the guinea pig except that suprachiasmatic and dorsomedial hypothalamic nuclei, paraventricular thalamus and cerebellum were unlabeled. In the lower brainstem of the cat and all levels of the rat, guinea pig, cat and human spinal cord, the only site where specific binding was observed was in the pia/arachnoid. These findings suggest that ANF binding sites constitute several functional classes in the CNS as well as in a variety of other tissues. Outside the blood-brain barrier binding sites are prominent in glandular tissues implicated in the production of hormones involved in fluid and electrolyte balance, e.g. adrenal glomerulosa, neurohypophysis and subfornical organ, unstratified epithelia involved in ion gradient exchange, e.g. renal glomerulus, ciliary body, choroid plexus and pia mater; crossing the blood-brain barrier are sites in the anterior hypothalamus, e.g. organum vasculosum, regions of the brain parenchyma associated with angiotensin II binding sites, e.g. dorsomedial nucleus of hypothalamus, some of which may be occupied by brain rather than cardiac synthesized ANF, regions of brain lacking an obvious role in fluid and ion exchange or regulation, e.g. cerebellum, although association with K+,Na+-ATPase in guinea pig cerebellum may be a relevant clue and brain regions possibly implicated in an integrative and/or indirect regulatory role in fluid and electrolyte balance.(ABSTRACT TRUNCATED AT 400 WORDS)


Arabidopsis VILLIN1 generates actin filament cables that are resistant to depolymerization.
Dynamic cytoplasmic streaming, organelle positioning, and nuclear migration use molecular tracks generated from actin filaments arrayed into higher-order structures like actin cables and bundles. How these arrays are formed and stabilized against cellular depolymerizing forces remains an open question. Villin and fimbrin are the best characterized actin-filament bundling or cross-linking proteins in plants and each is encoded by a multigene family of five members in Arabidopsis thaliana. The related villins and gelsolins are conserved proteins that are constructed from a core of six homologous gelsolin domains. Gelsolin is a calcium-regulated actin filament severing, nucleating and barbed end capping factor. Villin has a seventh domain at its C terminus, the villin headpiece, which can bind to an actin filament, conferring the ability to crosslink or bundle actin filaments. Many, but not all, villins retain the ability to sever, nucleate, and cap filaments. Here we have identified a putative calcium-insensitive villin isoform through comparison of sequence alignments between human gelsolin and plant villins with x-ray crystallography data for vertebrate gelsolin. VILLIN1 (VLN1) has the least well-conserved type 1 and type 2 calcium binding sites among the Arabidopsis VILLIN isoforms. Recombinant VLN1 binds to actin filaments with high affinity (K(d) approximately 1 microM) and generates bundled filament networks; both properties are independent of the free Ca(2+) concentration. Unlike human plasma gelsolin, VLN1 does not nucleate the assembly of filaments from monomer, does not block the polymerization of profilin-actin onto barbed ends, and does not stimulate depolymerization or sever preexisting filaments. In kinetic assays with ADF/cofilin, villin appears to bind first to growing filaments and protects filaments against ADF-mediated depolymerization. We propose that VLN1 is a major regulator of the formation and stability of actin filament bundles in plant cells and that it functions to maintain the cable network even in the presence of stimuli that result in depolymerization of other actin arrays.


Anesthetic management in tetralogy of fallot with pulmonary atresia and major aortopulmonary collateral arteries in pediatric patients: One year experience.
Unlike the typical tetralogy of fallot (TOF), the presence of pulmonary atresia and major aortopulmonary collaterals is recognized as a rare but severe variant of TOF. The objective was to describe the perioperative anesthetic management of pediatric patients who underwent unifocalization procedure and to describe their postoperative morbidity and mortality. A retrospective observational study was conducted among pediatric patients who underwent unifocalization procedure at Prince Sultan Cardiac Center (PSCC) between October 2017 and October 2018. Unifocalization procedures were performed in a two-staged approach. Anesthetic management of both stages had similar concerns and challenges but with few peculiar issues. These included preoperative assessment, intraoperative management, vascular access, positioning, ventilation, optimizing hemodynamics, cardiopulmonary bypass monitoring, and postoperative management. A total of 19 unifocalization procedures were included. The average age was one year and 52.6% were females. Two patients (10.5%) arrived in theater already with intubated ventilation. Continuous mandatory ventilation was used in 11 (57.9%) patients while one-lung ventilation was used in the rest of patients. Approximately, 30% of patients encountered a stormy postoperative course, 52.6% underwent cardiopulmonary bypass with or without cross-clamping of the aorta, and 10.5% had reperfusion injury. Despite the major challenges of unifocalization, significantly low rates of morbidity and mortality were observed in our patients. A thorough familiarity of different airway and ventilation issues, besides meticulous hemodynamic and anesthetic management, is of paramount importance. The maintenance of hemodynamic stability, hemostasis, and proper ventilation is critical for the success of the operation.


Envelope protein glycosylation status influences mouse neuroinvasion phenotype of genetic lineage 1 West Nile virus strains.
The introduction of West Nile virus (WNV) into North America has been associated with relatively high rates of neurological disease and death in humans, birds, horses, and some other animals. Previous studies identified strains in both genetic lineage 1 and genetic lineage 2, including North American isolates of lineage 1, that were highly virulent in a mouse neuroinvasion model, while other strains were avirulent or significantly attenuated (D. W. C. Beasley, L. Li, M. T. Suderman, and A. D. T. Barrett, Virology 296:17-23, 2002). To begin to elucidate the basis for these differences, we compared a highly virulent New York 1999 (NY99) isolate with a related Old World lineage 1 strain, An4766 (ETH76a), which is attenuated for mouse neuroinvasion. Genomic sequencing of ETH76a revealed a relatively small number of nucleotide (5.1%) and amino acid (0.6%) differences compared with NY99. These differences were located throughout the genome and included five amino acid differences in the envelope protein gene. Substitution of premembrane and envelope genes of ETH76a into a NY99 infectious clone backbone yielded a virus with altered in vitro growth characteristics and a mouse virulence phenotype comparable to ETH76a. Further site-specific mutagenesis studies revealed that the altered phenotype was primarily mediated via loss of envelope protein glycosylation and that this was associated with altered stability of the virion at mildly acidic pH. Therefore, the enhanced virulence of North American WNV strains compared with other Old World lineage 1 strains is at least partly mediated by envelope protein glycosylation.


Lung ultrasound for the screening of interstitial lung disease in very early systemic sclerosis.
A high percentage of patients with systemic sclerosis (SSc) develop interstitial lung disease (ILD) during the course of the disease. Promising data have recently shown that lung ultrasound (LUS) is able to detect ILD by the evaluation of B-lines (previously called ultrasound lung comets), the sonographic marker of pulmonary interstitial syndrome. To evaluate whether LUS is reliable in the screening of ILD in patients with SSc. Fifty-eight consecutive patients with SSc (54 women, mean age 51±14 years) who underwent a high resolution CT (HRCT) scan of the chest were also evaluated by LUS for detection of B-lines. Of these, 32 patients (29 women, mean age 51±15 years) fulfilled the criteria for a diagnosis of very early SSc. At HRCT, ILD was detected in 88% of the SSc population and in 41% of the very early SSc population. A significant difference in the number of B-lines was found in patients with and without ILD on HRCT (57±53 vs 9±9; p<0.0001), with a concordance rate of 83%. All discordant cases were false positive at LUS, providing a sensitivity and negative predictive value of 100% in both SSc and very early SSc. ILD may be detected in patients with very early SSc. The presence of B-lines at LUS examination correlates with ILD at HRCT. LUS is very sensitive for detecting ILD even in patients with a diagnosis of very early SSc. The use of LUS as a screening tool for ILD may be feasible to guide further investigation with HRCT.


Improving Dignity of Care in Community-Dwelling Elderly Patients with Cognitive Decline and Their Caregivers. The Role of Dignity Therapy.
Demographic changes have placed age-related mental health disorders at the forefront of public health challenges over the next three decades worldwide. Within the context of cognitive impairment and neurocognitive disorders among elderly people, the fragmentation of the self is associated with existential suffering, loss of meaning and dignity for the patient, as well as with a significant burden for the caregiver. Psychosocial interventions are part of a person-centered approach to cognitive impairment (including early stage dementia and dementia). Dignity therapy (DT) is a therapeutic intervention that has been shown to be effective in reducing existential distress, mood, and anxiety symptoms and improving dignity in persons with cancer and other terminal conditions in palliative care settings. The aims of this paper were: (i) To briefly summarize key issues and challenges related to care in gerontology considering specifically frail elderly/elderly with cognitive decline and their caregivers; and (ii) to provide a narrative review of the recent knowledge and evidence on DT in the elderly population with cognitive impairment. We searched the electronic data base (CINAHL, SCOPUS, PSycInfo, and PubMed studies) for studies regarding the application of DT in the elderly. Additionally, given the caregiver's role as a custodian of diachronic unity of the cared-for and the need to help caregivers to cope with their own existential distress and anticipatory grief, we also propose a DT-dyadic approach addressing the needs of the family as a whole.


Characteristics of the Agfa-Gevaert Type 10E70 Holographic Film.
The major sensitometric properties of a new holographic film, Agfa-Gevaert type 10E70, have been measured. To facilitate comparison, the same properties have been measured for Kodak type 649-F emulsion. Both the density vs log exposure and time vs gamma curves have been plotted for both films. The relative ASA speed of the Agfa emulsion was also calculated. It was concluded that the relatively high speed and high contrast of this film make it an excellent recording material in holography and optical data processing.


Graft patency after open versus endoscopic saphenous vein harvest in coronary artery bypass grafting surgery: a systematic review and meta-analysis.
Saphenous vein grafts (SVG) are a commonly used conduit for coronary artery bypass graft (CABG) surgery and can be harvested by either an open or endoscopic technique. Our goal was to evaluate long-term angiographic and clinical outcomes of open compared to endoscopic SVG harvest for CABG. Electronic search was performed to identify all studies in the English literature that compared open and endoscopic SVG harvesting for CABG with at least one year of follow-up. The primary outcome was graft patency. Secondary outcomes included perioperative morbidity and mortality. Of 3,255 articles identified, a total of 11 studies were included for analysis. Of 18,131 patients, 10,873 (60%) patients underwent open SVG harvest and 7,258 (40%) patients underwent endoscopic SVG harvest. The mean age of patients was 65 years and 87% were male. The overall mean follow-up period was 2.6 years. During follow-up, patients who underwent open SVG harvest had superior graft patency per graft [open 82.3% vs. endoscopic 75.1%; OR: 0.61 (95% CI, 0.43-0.87); P=0.01], but higher rates of overall wound complications in the immediate post-operative period [open 3.3% vs. endoscopic 1.1%; OR: 0.02 (95% CI, 0.01-0.06); P<0.001]. Patients who underwent open SVG harvest had higher postoperative 30-day mortality [open 3.4% vs. endoscopic 2.1%; OR: 0.59 (95% CI, 0.37-0.94); P=0.03], but no significant difference in overall mortality [open 4.9% vs. endoscopic 4.9%; OR: 0.34 (95% CI, 0.50-1.27); P=0.34]. Patients who underwent an open SVG harvest technique had improved graft patency and comparable overall mortality to endoscopic SVG harvest at average follow-up time of 2.6 years. Patients with open SVG harvest had higher rates of early wound complications and postoperative 30-day mortality, however, there was no difference in overall mortality.


The research implications of the selection of a gestational age estimation method.
There are three primary methods of gestational age estimation: dating based on last menstrual period (LMP), ultrasound-based dating and neonatal estimates. We review the strengths and limitations of each method as well as their implications for research. Dating based on LMP is a simple, low-cost method of estimating gestational age. Limitations associated with the use of menstrual-based dating include reporting problems such as uncertainty regarding the LMP date, possibly due to bleeding not associated with menses, as well as concerns about the incidence of delayed ovulation, which can result in invalid estimates of gestation, even for women with certain LMP dates. Given that most women in the US have at least one ultrasound during pregnancy, it is becoming increasingly common for clinicians to verify menstrual dates using early ultrasound. To calculate gestational age with the use of ultrasound, fetal measurements are compared with a gestational age-specific reference. The primary limitation of this method is the fact that the gestational age estimates of symmetrically large or small fetuses will be biased. Further, given that ultrasound references were developed using pregnancies that were dated according to reliable LMP dates, they are potentially biased in the same direction as dates calculated according to LMP. Neonatal estimates of gestational age have been shown to be the least precise dating method. To highlight the research implications of the choice of a gestational dating method, we used data from the Routine Antenatal Diagnostic Imaging with Ultrasound Study to identify risk factors for post-term delivery. Risk factors for post-term delivery are shown to vary according to the choice of a gestational dating method, suggesting that some findings are an artefact of the choice of a method rather than evidence of causality.


Treatment Outcomes in Anxious Youth with and without Comorbid ADHD in the CAMS.
The purpose of this study is to examine the influence of Attention-Deficit/Hyperactivity Disorder (ADHD), independent of Oppositional Defiant Disorder (ODD), on acute treatment response, remission rates and maintenance of gains at 6-month follow-up in anxious youth (ages 7-17, 76% Caucasian, 52% female) who received cognitive-behavioral therapy (CBT) alone, pharmacotherapy alone, the combination of CBT and pharmacotherapy or placebo pill in the Child/Adolescent Multimodal Study. Treatment response was defined as independent evaluator rated meaningful improvement in anxiety. Remission was operationalized as the absence of targeted anxiety disorders. ADHD and ODD were examined as moderators of outcomes at a diagnostic level. In the CBT group only, an ADHD diagnosis predicted poorer immediate treatment response and remission rates. However, these associations were not obtained for the pharmacotherapy groups. Participants with comorbid ODD were not less likely to achieve acute treatment response and remission rates than their counterparts across treatment conditions. Due to small sample size of the comorbid subgroups, our analyses must be considered preliminary. Nevertheless, our initial findings suggest further exploration of the separate roles of ADHD and ODD are worth pursuing, as they may be differentially associated with treatment outcomes in anxious youth treated with CBT but not youth treated with pharmacotherapy. If confirmed, findings may indicate that anxious youth with comorbid ADHD are less likely to benefit from CBT strategies alone and raise the possibility that these youth need adjunctive pharmacotherapy or psychosocial interventions.


'Un chant d'appel amoureux': acoustic communication in moths
Tympanal sound receptors in moths evolved in response to selective pressures provided by echolocating insectivorous bats. The presence of these ultrasound detectors also set the stage for the later evolution of ultrasonic courtship signals in the tympanate moth families. Male moths have repeatedly exploited the bat-detection mechanisms in females for the purpose of finding, identifying and obtaining mates. Ultrasonic courtship has been described in several members of the moth families Arctiidae, Noctuidae and Pyralidae, and ultrasound is predicted to play a significant role in the courtship of other tympanate moths including the Sphingidae, Lymantriidae, Notodontidae and Geometridae. Ultrasonic signals are involved in species recognition, in male-male competition for mates and in female mate-choice systems. Pre-existing motor systems, including those involved in bat defence, have also been exploited for the purpose of generating high-frequency courtship signals. Sound production mechanisms in moths include thoracic tymbals, tegular tymbals, alar castanets and genital stridulatory organs. Thus, in both their sensory and motor aspects, the weapons of bat/moth warfare have frequently evolved into components of courtship systems.


Personality facets and all-cause mortality among Medicare patients aged 66 to 102 years: a follow-on study of Weiss and Costa (2005).
To investigate associations between personality facets and survival during an 8-year follow-up. In 597 Medicare recipients (age, 66-102 years) followed up for approximately 8 years, personality domains and facets were assessed using the Revised NEO Personality Inventory (NEO-PI-R). This study builds on a previous study which used proportional hazards regression to test whether the NEO-PI-R factor and selected facet scores were associated with mortality risk. That study revealed that the neuroticism facet impulsiveness, agreeableness facet straightforwardness, and conscientiousness facet self-discipline were related to lower risk during 4 years of follow-up. We extended the follow-up period by 4 years, examined all 30 facets, and used accelerated failure time modeling as an additional analytic approach. Unlike proportional hazards regression, accelerated failure time modeling permits inferences about the median survival length conferred by predictors. Each facet was tested in a model that included health-related covariates and NEO-PI-R factor scores for dimensions that did not include that facet. Over the 8-year follow-up period, impulsiveness was not significant, each standard deviation of straightforwardness was associated with an 11% increase in median survival time and, when dichotomized, higher self-discipline was associated with a 34% increase in median survival time. Each standard deviation of altruism, compliance, tender-mindedness, and openness to fantasy was associated with a 9% to 11% increase in median survival time. After extending the follow-up period from 4 to 8 years, self-discipline remained a powerful predictor of survival and facets associated with imagination, generosity, and higher-quality interpersonal interactions become increasingly important.


USE OF MALE METHODS OF CONTRACEPTION WORLDWIDE.
This article analyses male contraceptive use, both globally and for developing countries. Shares of all contraceptive use due to males are examined, in the context of female use and all use. Patterns according to wealth quintiles are analysed, as well as time trends and geographic variations. Data are drawn primarily from compilations by the UN Population Division and from the Demographic and Health Series and subjected to relatively simple statistical methods including correlation/regression applications. Contraceptive methods that men use directly, or that require their co-operation to use, including condoms, withdrawal, rhythm and male sterilization, account for one-quarter of all contraceptive use worldwide. This represents 13% of married/in-union women. Both the share and the prevalence of male methods vary widely by geography and by the four methods, as well as by quintile wealth groups. With greater wealth there is an unbroken rise for total use; among the male methods, the shares of condom use and rhythm rise by wealth quintiles, while the share of withdrawal drops. The share for male sterilization is highest in the lowest and highest wealth quintiles and dips for the middle quintiles. The overall time trend since the 1980s has been steady at one-quarter of all use involving men; moreover, the share is about the same at all levels of total use. The female-only methods continue to dominate: female sterilization, IUD, pill, injectable and implant, again with great diversity geographically. In surveys men report less total use but more condom use, while females report more injectable use. For the future the male share of one-quarter of use seems secure, with little prospect of an increase unless concerted programmatic efforts are made to expand access to male methods and promote their use as part of a broadened contraceptive method mix.


Optimised chronic infection models demonstrate that siderophore 'cheating' in Pseudomonas aeruginosa is context specific.
The potential for siderophore mutants of Pseudomonas aeruginosa to attenuate virulence during infection, and the possibility of exploiting this for clinical ends, have attracted much discussion. This has largely been based on the results of in vitro experiments conducted in iron-limited growth medium, in which siderophore mutants act as social 'cheats:' increasing in frequency at the expense of the wild type to result in low-productivity, low-virulence populations dominated by mutants. We show that insights from in vitro experiments cannot necessarily be transferred to infection contexts. First, most published experiments use an undefined siderophore mutant. Whole-genome sequencing of this strain revealed a range of mutations affecting phenotypes other than siderophore production. Second, iron-limited medium provides a very different environment from that encountered in chronic infections. We conducted cheating assays using defined siderophore deletion mutants, in conditions designed to model infected fluids and tissue in cystic fibrosis lung infection and non-healing wounds. Depending on the environment, siderophore loss led to cheating, simple fitness defects, or no fitness effect at all. Our results show that it is crucial to develop defined in vitro models in order to predict whether siderophores are social, cheatable and suitable for clinical exploitation in specific infection contexts.


Managing small-scale commercial fisheries for adaptive capacity: insights from dynamic social-ecological drivers of change in Monterey Bay.
Globally, small-scale fisheries are influenced by dynamic climate, governance, and market drivers, which present social and ecological challenges and opportunities. It is difficult to manage fisheries adaptively for fluctuating drivers, except to allow participants to shift effort among multiple fisheries. Adapting to changing conditions allows small-scale fishery participants to survive economic and environmental disturbances and benefit from optimal conditions. This study explores the relative influence of large-scale drivers on shifts in effort and outcomes among three closely linked fisheries in Monterey Bay since the Magnuson-Stevens Fisheries Conservation and Management Act of 1976. In this region, Pacific sardine (Sardinops sagax), northern anchovy (Engraulis mordax), and market squid (Loligo opalescens) fisheries comprise a tightly linked system where shifting focus among fisheries is a key element to adaptive capacity and reduced social and ecological vulnerability. Using a cluster analysis of landings, we identify four modes from 1974 to 2012 that are dominated (i.e., a given species accounting for the plurality of landings) by squid, sardine, anchovy, or lack any dominance, and seven points of transition among these periods. This approach enables us to determine which drivers are associated with each mode and each transition. Overall, we show that market and climate drivers are predominantly attributed to dominance transitions. Model selection of external drivers indicates that governance phases, reflected as perceived abundance, dictate long-term outcomes. Our findings suggest that globally, small-scale fishery managers should consider enabling shifts in effort among fisheries and retaining existing flexibility, as adaptive capacity is a critical determinant for social and ecological resilience.


Central tendency effects in time interval reproduction in autism.
Central tendency, the tendency of judgements of quantities (lengths, durations etc.) to gravitate towards their mean, is one of the most robust perceptual effects. A Bayesian account has recently suggested that central tendency reflects the integration of noisy sensory estimates with prior knowledge representations of a mean stimulus, serving to improve performance. The process is flexible, so prior knowledge is weighted more heavily when sensory estimates are imprecise, requiring more integration to reduce noise. In this study we measure central tendency in autism to evaluate a recent theoretical hypothesis suggesting that autistic perception relies less on prior knowledge representations than typical perception. If true, autistic children should show reduced central tendency than theoretically predicted from their temporal resolution. We tested autistic and age- and ability-matched typical children in two child-friendly tasks: (1) a time interval reproduction task, measuring central tendency in the temporal domain; and (2) a time discrimination task, assessing temporal resolution. Central tendency reduced with age in typical development, while temporal resolution improved. Autistic children performed far worse in temporal discrimination than the matched controls. Computational simulations suggested that central tendency was much less in autistic children than predicted by theoretical modelling, given their poor temporal resolution.