Essential role of myosin light chain kinase in the mechanism for MgATP-dependent priming of exocytosis in adrenal chromaffin cells.
Ca(2+)-induced exocytosis in chromaffin cells now seems to consist of at least two distinct steps:MgATP-dependent Ca(2+)-dependent priming of the secretory apparatus, and Ca(2+)-dependent MgATP-independent step that triggers exocytosis (Bittner and Holz, 1992). Recently we found that a specific inhibitor of myosin light chain kinase (MLCK), wortmannin, inhibits Ca(2+)-induced catecholamine release from digitonin-permeabilized chromaffin cells, suggesting an implication of MLCK in the mechanisms of Ca(2+)-induced exocytosis (Imaizumi et al., 1992b). To elucidate further the implication of MLCK in the mechanism of exocytosis, we studied the effects of wortmannin and a peptide inhibitor (SM-1) corresponding to the pseudosubstrate domain of MLCK on MgATP-dependent and MgATP-independent release in digitonin-permeabilized chromaffin cells. Ca(2+)-induced exocytosis from the permeabilized cells in the presence of MgATP was inhibited by both SM-1 and wortmannin. Inhibitory effect of wortmannin on the rate of release induced by 10 microM Ca2+ in the presence of MgATP was much prominent in the later phase (1-10 min), although the initial rate was also decreased. SM-1 strongly inhibited ATP-dependent release without affecting Ca(2+)-dependent ATP-independent release at all. In addition, priming effect of MgATP that underlies Ca(2+)-dependent ATP-independent release was remarkably reduced by both wortmannin and SM-1. These results suggest that MLCK plays an essential role in ATP-dependent priming of Ca(2+)-induced exocytosis in chromaffin cells.


Digital video analysis of health professionals' interactions with an electronic whiteboard: a longitudinal, naturalistic study of changes to user interactions.
As hospital departments continue to introduce electronic whiteboards in real clinical settings a range of human factor issues have emerged and it has become clear that there is a need for improved methods for designing and testing these systems. In this study, we employed a longitudinal and naturalistic method in the usability evaluation of an electronic whiteboard system. The goal of the evaluation was to explore the extent to which usability issues experienced by users change as they gain more experience with the system. In addition, the paper explores the use of a new approach to collection and analysis of continuous digital video recordings of naturalistic "live" user interactions. The method developed and employed in the study included recording the users' interactions with system during actual use using screen-capturing software and analyzing these recordings for usability issues. In this paper we describe and discuss both the method and the results of the evaluation. We found that the electronic whiteboard system contains system-related usability issues that did not change over time as the clinicians collectively gained more experience with the system. Furthermore, we also found user-related issues that seemed to change as the users gained more experience and we discuss the underlying reasons for these changes. We also found that the method used in the study has certain advantages over traditional usability evaluation methods, including the ability to collect analyze live user data over time. However, challenges and drawbacks to using the method (including the time taken for analysis and logistical issues in doing live recordings) should be considered before utilizing a similar approach. In conclusion we summarize our findings and call for an increased focus on longitudinal and naturalistic evaluations of health information systems and encourage others to apply and refine the method utilized in this study.


Enhanced surveillance of hepatitis B infection in inner-western Sydney.
We developed an enhanced surveillance system for hepatitis B to improve the detection of newly acquired cases and to collect epidemiological data. The study was undertaken from February to June (inclusive) 2005 at the Sydney South West Area Health Service Eastern Zone Public Health Unit. A letter was sent to treating doctors on receipt of a notification, requesting additional information on cases. Cases identified by the treating doctors as newly acquired were followed up by telephone. There were 295 notifications of hepatitis B in the period, of which three were newly acquired infections. Only one of these three cases was identified through enhanced surveillance. Information on ethnicity was obtained. This enhanced surveillance system is of limited value as an ongoing process. We recommend that it be undertaken periodically to monitor the epidemiology of the disease.


Barriers to access of healthcare services by the immigrant population in Scandinavia: a scoping review protocol.
Access to healthcare services for legal immigrants in Scandinavia is part of the policy agenda of the various governments as they strive to provide equal healthcare services to its citizens. Legal immigrants have the same rights as natives; however, studies have shown that there are inequalities in access to healthcare services between legal immigrants and natives. The extent of access depends on several factors, including organisational, social, financial and cultural factors. The lack of these factors acts as a barrier to access of healthcare services. The aim of this review is to map and report the evidence available on the barriers to access of healthcare services by legal immigrants in Scandinavia. We will adopt the six-stage framework developed by Arksey and O'Malley: (1) identifying the research question(s); (2) searching for relevant studies; (3) selecting studies; (4) charting the data; (5) collating, summarising and reporting the results; (6) conducting consultation exercises refined by Levac et al and the Joanna Briggs Institute. The search strategy for this scoping review will involve electronic databases including Ovid Medline, PsycINFO, Ovid EMBASE, PubMed and Google Scholar, in addition to grey literature from websites of relevant organisations. Data will be extracted and charted by two independent reviewers. A narrative summary of the findings will be presented. This is a review of the literature and all data will be obtained from publicly available materials; therefore, ethics approval is not required. The findings from this study will be disseminated as publications in peer-reviewed journals, at relevant national and international conferences, and as presentations to the health authorities in several municipalities in the Trøndelag region of Norway.


Antagonistic effects of an alternative splice variant of human IL-4, IL-4delta2, on IL-4 activities in human monocytes and B cells.
IL-4 is a pleiotropic cytokine which exerts its actions on various lineages of hematopoietic and nonhematopoietic cells. This cytokine is one of the central regulators of immunity in health and disease states. An alternative splice variant, in which the second of four exons is omitted, has been recently described and designated as IL-4delta2. The variant has been previously described as a potential naturally occurring antagonist of human IL-4 (hIL-4)-stimulated T cell proliferation. In this study, we investigated the effects of recombinant human (rh) IL-4delta2 on monocytes and B cells. In monocytes, rhIL-4delta2 blocked inhibitory action of hIL-4 on LPS-induced cyclooxygenase-2 expression and subsequent prostaglandin E2 secretion. In B cells, rhIL-4delta2 was an antagonist of the hIL-4-induced synthesis of IgE and expression of CD23. Our results broaden the spectrum of hIL-4-antagonistic activities of rhIL-4delta2, thus creating the background for the potential use of rhIL-4delta2 as a therapeutic anti-hIL-4 agent.


A kinetic study in adults with food hypersensitivity assessed as eosinophil activation in fecal samples.
Immune-mediated food hypersensitivity affecting the gut is difficult to evaluate, and objective tools to diagnose local gastrointestinal (GI) inflammatory reactions are lacking. To determine whether allergic manifestations in adults with a history of food-related GI symptoms could be assessed in feces during symptomatic and non-symptomatic periods, using the surrogate markers, eosinophil cationic protein (ECP), eosinophil protein X (EPX) and myeloperoxidase (MPO). Thirteen subjects with food hypersensitivity-related GI symptoms, confirmed by a positive double-blind placebo-controlled food challenge (DBPCFC), were subjected to an open kinetic food challenge design for 6 weeks. Symptoms were recorded and scored during the 3-week study period and stool samples were obtained every day. The surrogate markers ECP, EPX and MPO were measured in the supernatants from feces samples. A significant increase in abdominal pain, distension and flatulence was observed during challenge, with a gradual decrease during elimination diet. Both between days and subjects, EPX levels were more frequently increased compared to ECP and MPO. Individuals with a history of a short duration of symptoms had significantly higher mean levels of EPX and MPO than those with a longer duration of symptoms. An overall increase in levels of eosinophil markers, in particular EPX, was observed in feces from patients with food-related GI symptoms. However, rather than being a tool to differentiate symptomatic from non-symptomatic periods, EPX might be used for detecting an ongoing clinical or subclinical chronic inflammation, that may have an impact on the patient's clinical course of GI symptoms.


Contextual novelty modulates the neural dynamics of reward anticipation.
We investigated how rapidly the reward-predicting properties of visual cues are signaled in the human brain and the extent these reward prediction signals are contextually modifiable. In a magnetoencephalography study, we presented participants with fractal visual cues that predicted monetary rewards with different probabilities. These cues were presented in the temporal context of a preceding novel or familiar image of a natural scene. Starting at ∼100 ms after cue onset, reward probability was signaled in the event-related fields (ERFs) over temporo-occipital sensors and in the power of theta (5-8 Hz) and beta (20-30 Hz) band oscillations over frontal sensors. While theta decreased with reward probability beta power showed the opposite effect. Thus, in humans anticipatory reward responses are generated rapidly, within 100 ms after the onset of reward-predicting cues, which is similar to the timing established in non-human primates. Contextual novelty enhanced the reward anticipation responses in both ERFs and in beta oscillations starting at ∼100 ms after cue onset. This very early context effect is compatible with a physiological model that invokes the mediation of a hippocampal-VTA loop according to which novelty modulates neural response properties within the reward circuitry. We conclude that the neural processing of cues that predict future rewards is temporally highly efficient and contextually modifiable.


Short communication: Ovine leukocyte telomere length is associated with variation in the cortisol response to systemic bacterial endotoxin challenge.
Stress has been associated with biological aging and numerous age-related diseases. This may be due, in part, to accelerated shortening of telomeres, which are critical genomic structures that cap and protect chromosomal ends. Dysfunction of the hypothalamic-pituitary-adrenal axis may indirectly contribute to telomere shortening if an animal reacts too strongly or weakly to a stressor, leading to accelerated biological aging. In this study, outbred Rideau-Arcott sheep were stress challenged with Escherichia coli endotoxin and classified as high, middle, or low cortisol responders to investigate a potential relationship between cortisol response and age, and telomere length. In the present study, no association was found between age and telomere length. The study, however, revealed shorter telomeres in high and low cortisol responders compared with the middle cortisol responders, which suggests that health and longevity may be compromised in extreme high- and low-stress-responding sheep.


Mechanisms of interaction between oxygen and granulocytes in hyperoxic lung injury.
Hyperoxia and infused granulocytes act synergistically in producing a nonhydrostatic high-permeability lung edema in the isolated perfused rabbit lung within 4 h, which is substantially greater than that seen with hyperoxia alone. We hypothesized that the interaction between hyperoxia and granulocytes was principally due to a direct effect of hyperoxia on the lung itself. Isolated perfused rabbit lungs that were preexposed to 2 h of hyperoxia (95% O2-5% CO2) prior to the infusion of unstimulated granulocytes (under normoxic conditions) developed significant nonhydrostatic lung edema (P = 0.008) within 2 h when compared with lungs that were preexposed to normoxia (15% O2-5% CO2) prior to granulocyte perfusion. The edema in the hyperoxic-preexposed lungs was accompanied by significant increases in bronchoalveolar lavage (BAL) protein, BAL granulocytes, BAL thromboxane and prostacyclin levels, perfusate chemotactic activity, and lung lipid peroxidation. These findings suggest that the synergistic interaction between hyperoxia and granulocytes in producing acute lung injury involves a primary effect of hyperoxia on the lung itself.


Expanded health data from the new birth certificate, 2005.
This report presents data for 2005 on checkbox items exclusive to the 2003 U.S. Standard Certificate of Live Birth. Information is shown for checkboxes in the following categories: Risk factors in this pregnancy, Obstetric procedures, Characteristics of labor and delivery, Method of delivery, Abnormal conditions of the newborn, and Congenital anomalies of the newborn. These categories are included on both the 1989 and the 2003 U.S. Standard Certificate of Live Birth; however, many of the specific checkbox items were modified, or are new to the 2003 certificate. Data on selected new checkbox items are presented in this report. Descriptive tabulations are presented on births occurring in 2005 to residents of the 12 states (Florida, Idaho, Kansas, Kentucky, Nebraska, New Hampshire, New York (excluding New York City), Pennsylvania, South Carolina, Tennessee, Texas, and Washington), which implemented the 2003 U.S. Standard Certificate of Live Birth as of January 1, 2005. There were 1,268,502 births to residents of the 12-state area in 2005 (31 percent of all U.S. births). Gestational and prepregnancy diabetes were reported at rates of 39.3 and 6.9 per 1,000. Infants of women with diabetes, especially prepregnancy diabetes, were more likely to be high birthweight and to be admitted to a neonatal intensive care unit (NICU) than infants of women without diabetes. The rate of cervical cerclage was 3.7 per 1,000; this procedure was used more frequently in twin and higher order births than in singleton births. Almost all attempts at forceps or vacuum delivery (almost 99 percent) were successful. Almost one-third of all women who had a cesarean delivery had attempted a trial of labor. Antibiotics were given to 17 percent of women during labor. Steroids (glucocorticoids) for fetal lung maturation were received prior to delivery by 1 percent of all mothers. Surfactant replacement therapy was received by newborns at a rate of 3.7 per 1,000; rates were higher for infants delivered very preterm (less than 32 weeks of gestation). Large differences by race and Hispanic origin were seen for the receipt of steroids and for surfactant replacement therapy. More than 6 percent of all infants were admitted to a NICU. Nearly one-half of all singleton infants admitted to a NICU were delivered at term. Cyanotic congenital heart disease (56.9 per 100,000 infants) and hypospadias (126.2 per 100,000 male births only) were among the most frequently reported congenital anomalies.


The paradox of self-rated health following joint replacement surgery.
Self-rated health is a commonly used patient-reported outcome, but its responsiveness to is not well documented. We examined the ability of self-rated health to capture health changes attributable to a highly effective surgical intervention. Prospective study of patients with severe osteoarthritis of the hip (N = 990) or knee (N = 907) who underwent total hip replacement (THA) or total knee replacement (TKA). Self-rated health was assessed pre-operatively and 1 year after surgery on a scale between "excellent" and "poor," along with other health items (other 11 items of the SF12 questionnaire) and multi-item Pain and Function scales. On average, self-rated health was unchanged by surgery. In both THA and TKA cohorts, of 10 patients, 6 rated their health the same after surgery as before, 2 gave a higher rating, and 2 gave a lower rating. In contrast, major improvements were observed for all other SF12 items, and for the Pain and Function scales, in both cohorts of patients. Nevertheless, both before and after surgery, self-rated health was associated with the other SF12 items and with Pain and Function scores. These associations were stronger after surgery than before. Self-rated health was not responsive to major improvements in health, documented by other instruments, attributable to joint replacement surgery. However, self-rated health was even more strongly associated with concurrent assessments of more specific health problems after surgery than before. Caution is advised in interpreting changes in self-rated health following health-altering interventions.


Single dose oral ibuprofen and diclofenac for postoperative pain.
Ibuprofen and diclofenac are two widely used non-steroidal anti-inflammatory (NSAID) analgesics. It is therefore important to know which drug should be recommended for postoperative pain relief. This review seeks to compare the relative efficacy of the two drugs, and also considers the issues of safety and cost. To assess the analgesic efficacy of ibuprofen and diclofenac in single oral doses for moderate to severe postoperative pain. Randomised trials were identified by searching Medline (1966 to December 1996), Embase (1980 to January 1997), the Cochrane Library (Issue 3 1996), Biological Abstracts (January 1985 to December 1996) and the Oxford Pain Relief Database (1950 to 1994). Date of the most recent searches: July 1998. The inclusion criteria used were: full journal publication, postoperative pain, postoperative oral administration, adult patients, baseline pain of moderate to severe intensity, double-blind design, and random allocation to treatment groups which compared either ibuprofen or diclofenac with placebo. Data were extracted by two independent reviewers, and trials were quality scored. Summed pain relief or pain intensity difference over four to six hours was extracted, and converted into dichotomous information yielding the number of patients with at least 50% pain relief. This was then used to calculate the relative benefit and the number-needed-to-treat (NNT) for one patient to achieve at least 50% pain relief. Thirty-four trials compared ibuprofen and placebo (3,591 patients), six compared diclofenac with placebo (840 patients) and there were two direct comparisons of diclofenac 50 mg and ibuprofen 400 mg (130 patients). In postoperative pain the NNTs for ibuprofen 200 mg were 3.3 (95% confidence interval 2.8 to 4.0) compared with placebo, for ibuprofen 400 mg 2.7 (2.5 to 3.0), for ibuprofen 600 mg 2.4 (1.9 to 3.3), for diclofenac 50 mg 2.3 (2.0 to 2.7) and for diclofenac 100 mg 1.8 (1.5 to 2.1). Direct comparisons of diclofenac 50 mg with ibuprofen 400 mg showed no significant difference between the two. Both drugs work well. Choosing between them is an issue of dose, safety and cost.


Age-related differences in cancer relative survival in the United States: A SEER-18 analysis.
Cancer survival has improved since the 1990s, but to different extents across age groups, with a disadvantage for older adults. We aimed to quantify age-related differences in relative survival (RS-1-year and 1-year conditioning on surviving 1 year) for 10 common cancer types by stage at diagnosis. We used data from 18 United States Surveillance Epidemiology and End Results cancer registries and included cancers diagnosed in 2012 to 2016 followed until December 31, 2017. We estimated absolute differences in RS between the 50 to 64 age group and the 75 to 84 age group. The smallest differences were observed for prostate and breast cancers (1.8%-points [95% confidence interval (CI): 1.5-2.1] and 1.9%-points [95% CI: 1.5-2.3], respectively). The largest was for ovarian cancer (27%-points, 95% CI: 24-29). For other cancers, differences ranged between 7 (95% CI: 5-9, esophagus) and 18%-points (95% CI: 17-19, pancreas). Except for pancreatic cancer, cancer type and stage combinations with very high (>95%) or very low (<40%) 1-year RS tended to have smaller age-related differences in survival than those with mid-range prognoses. Age-related differences in 1-year survival conditioning on having survived 1-year were small for most cancer and stage combinations. The broad variation in survival differences by age across cancer types and stages, especially in the first year, age-related differences in survival are likely influenced by amenability to treatment. Future work to measure the extent of age-related differences that are avoidable, and identify how to narrow the survival gap, may have most benefit by prioritizing cancers with relatively large age-related differences in survival (eg, stomach, esophagus, liver and pancreas).


Dissemination of scientific software with Galaxy ToolShed.
The proliferation of web-based integrative analysis frameworks has enabled users to perform complex analyses directly through the web. Unfortunately, it also revoked the freedom to easily select the most appropriate tools. To address this, we have developed Galaxy ToolShed.


The PRECISE (PREgnancy Care Integrating translational Science, Everywhere) Network's first protocol: deep phenotyping in three sub-Saharan African countries.
The PRECISE (PREgnancy Care Integrating translational Science, Everywhere) Network is a new and broadly-based group of research scientists and health advocates based in the UK, Africa and North America. This paper describes the protocol that underpins the clinical research activity of the Network, so that the investigators, and broader global health community, can have access to 'deep phenotyping' (social determinants of health, demographic and clinical parameters, placental biology and agnostic discovery biology) of women as they advance through pregnancy to the end of the puerperium, whether those pregnancies have normal outcomes or are complicated by one/more of the placental disorders of pregnancy (pregnancy hypertension, fetal growth restriction and stillbirth). Our clinical sites are in The Gambia (Farafenni), Kenya (Kilifi County), and Mozambique (Maputo Province). In each country, 50 non-pregnant women of reproductive age will be recruited each month for 1 year, to provide a final national sample size of 600; these women will provide culturally-, ethnically-, seasonally- and spatially-relevant control data with which to compare women with normal and complicated pregnancies. Between the three countries we will recruit ≈10,000 unselected pregnant women over 2 years. An estimated 1500 women will experience one/more placental complications over the same epoch. Importantly, as we will have accurate gestational age dating using the TraCer device, we will be able to discriminate between fetal growth restriction and preterm birth. Recruitment and follow-up will be primarily facility-based and will include women booking for antenatal care, subsequent visits in the third trimester, at time-of-disease, when relevant, during/immediately after birth and 6 weeks after birth. To accelerate progress towards the women's and children's health-relevant Sustainable Development Goals, we need to understand how a variety of social, chronic disease, biomarker and pregnancy-specific determinants health interact to result in either a resilient or a compromised pregnancy for either mother or fetus/newborn, or both. This protocol has been designed to create such a depth of understanding. We are seeking funding to maintain the cohort to better understand the implications of pregnancy complications for both maternal and child health.


A novel neurological mechanism to explain the adverse effect of depression on coronary artery disease.
The strong antecedent effect of depression as a risk factor in the development of coronary artery disease (CAD) has been demonstrated in many robust epidemiological studies. However, the underlying causative mechanisms are incompletely understood: this hypothesis proposes one possibility. A variety of histological and radiological techniques have been used to demonstrate structural and functional abnormalities in the prefrontal cortex (PFC) of depressed subjects. In addition, this limbic region has been inextricably implicated in the modulation of autonomic tone. Cardio-specifically, stimulation of PFC has arrhythmogenic effects. Reciprocally, cardiac stress tests produce activation of this cortical region. These observations place PFC at the top of a hierarchical autonomic loop involved in sensing and modulating cardiac variables. Finally, the reduced heart rate variability, higher heart rates and elevated cerebrospinal fluid catecholamine levels in depressed patients, compared to non-depressed matched controls, suggest sympathetic overdrive in these patients. These observations lead the author to propose that a primary defect in the PFC of depressed subjects destabilises the autonomic neurocardiac axis, accounting for the proven adverse effect of depression on CAD. This novel neurological mechanism can help to develop other current theories and to design and trial future therapies to reduce the adverse effect of depression on coronary artery disease.


Aquifer Characterization Using Fiber Bragg Grating Multi-Level Monitoring System.
Groundwater responses measured from multiple wells at different depths are essential for delineating the aquifer heterogeneity using hydraulic tomography (HT). In general, conducting HT requires many wells because traditional well monitoring is usually partially open at a specific depth interval or is fully penetrating. Accordingly, conducting an HT survey is typically costly and time-consuming. To tackle these issues, a new multi-level monitoring system (MLMS) for the HT survey was developed using the fiber Bragg grating (FBG) technique. This FBG MLMS could collect the depth-discrete groundwater observations from a fully penetrated 2-inch well. Three field campaigns were conducted to validate the capability of the FBG MLMS for HT surveys. The results show that the accuracy and stability of this MLMS are reliable and that FBG MLMS is beneficial for conducting an HT survey. Specifically, compared to the traditional monitoring well in an injection event, this FBG MLMS can concurrently cause an increase in the number of cross-hole tests several times and collect many more head observations than the standard methods, resulting in the observed flow fields efficiently reaching ergodic conditions and effectively improving the accuracy of the estimated hydraulic heterogeneity. Therefore, the FBG MLMS could be an alternative MLMS for efficiently and economically conducting an HT survey.


Brain responses to auditory and visual stimulus offset: shared representations of temporal edges.
Edges are crucial for the formation of coherent objects from sequential sensory inputs within a single modality. Moreover, temporally coincident boundaries of perceptual objects across different sensory modalities facilitate crossmodal integration. Here, we used functional magnetic resonance imaging in order to examine the neural basis of temporal edge detection across modalities. Onsets of sensory inputs are not only related to the detection of an edge but also to the processing of novel sensory inputs. Thus, we used transitions from input to rest (offsets) as convenient stimuli for studying the neural underpinnings of visual and acoustic edge detection per se. We found, besides modality-specific patterns, shared visual and auditory offset-related activity in the superior temporal sulcus and insula of the right hemisphere. Our data suggest that right hemispheric regions known to be involved in multisensory processing are crucial for detection of edges in the temporal domain across both visual and auditory modalities. This operation is likely to facilitate cross-modal object feature binding based on temporal coincidence.


Activity of selected rostral and caudal hyoid muscles in clinically normal horses during strenuous exercise.
To determine the phase and quantitate the electromyographic (EMG) activity of the genioglossus, geniohyoideus, hyoepiglotticus, omohyoideus, sternohyoideus, sternothyroideus, and thyrohyoideus muscles of clinically normal horses during strenuous exercise. 7 clinically normal adult horses (2 Thoroughbreds and 5 Standardbreds). Bipolar electrodes were surgically implanted in the aforementioned muscles, and horses were subjected to an incremental exercise test on a high-speed treadmill. The EMG, heart rate, respiratory rate, and static pharyngeal airway pressures were measured during exercise. The EMG was measured as mean electrical activity (MEA). The MEA values for maximal exercise intensity (13 or 14 m/s) were expressed as a percentage of the MEA measured at an exercise intensity of 6 m/s. MEA was detected during expiration in the genioglossus, geniohyoideus, sternohyoideus, and thyrohyoideus muscles and during inspiration in the hyoepiglotticus and sternothyroideus muscles. Intensity of the MEA increased significantly with exercise intensity in the genioglossus, geniohyoideus, and hyoepiglotticus muscles. Intensity of the MEA increased significantly in relation to expiratory pharyngeal pressure in the geniohyoideus and hyoepiglotticus muscles. Once exercise intensity reached 6 m/s, no quantifiable additional increase in muscular activity was detected in the omohyoideus, sternohyoideus, sternothyroideus, and thyrohyoideus muscles. However, muscles that may affect the diameter of the oropharynx (genioglossus and geniohyoideus muscles) or rima glottis (hyoepiglotticus muscle) had activity correlated with the intensity of exercise or expiratory pharyngeal pressures. Activity of the muscles affecting the geometry of the oropharynx may be important in the pathophysiologic processes associated with nasopharyngeal patency.


Automated Diagnosis of Coronary Artery Disease: A Review and Workflow.
Coronary artery disease (CAD) is the most dangerous heart disease which may lead to sudden cardiac death. However, CAD diagnoses are quite expensive and time-consuming procedures which a patient need to go through. The aim of our paper is to present a unique review of state-of-the-art methods up to 2017 for automatic CAD classification. The protocol of review methods is identifying best methods and classifier for CAD identification. The study proposes two workflows based on two parameter sets for instances A and B. It is necessary to follow the proper procedure, for future evaluation process of automatic diagnosis of CAD. The initial two stages of the parameter set A workflow are preprocessing and feature extraction. Subsequently, stages (feature selection and classification) are same for both workflows. In literature, the SVM classifier represents a promising approach for CAD classification. Moreover, the limitation leads to extract proper features from noninvasive signals.


Overview of surface measurements and spatial characterization of submicrometer particulate matter during the DISCOVER-AQ 2013 campaign in Houston, TX.
The sources of submicrometer particulate matter (PM1) remain poorly characterized in the industrialized city of Houston, TX. A mobile sampling approach was used to characterize PM1 composition and concentration across Houston based on high-time-resolution measurements of nonrefractory PM1 and trace gases during the DISCOVER-AQ Texas 2013 campaign. Two pollution zones with marked differences in PM1 levels, character, and dynamics were established based on cluster analysis of organic aerosol mass loadings sampled at 16 sites. The highest PM1 mass concentrations (average 11.6 ± 5.7 µg/m3) were observed to the northwest of Houston (zone 1), dominated by secondary organic aerosol (SOA) mass likely driven by nighttime biogenic organonitrate formation. Zone 2, an industrial/urban area south/east of Houston, exhibited lower concentrations of PM1 (average 4.4 ± 3.3 µg/m3), significant organic aerosol (OA) aging, and evidence of primary sulfate emissions. Diurnal patterns and backward-trajectory analyses enable the classification of airmass clusters characterized by distinct PM sources: biogenic SOA, photochemical aged SOA, and primary sulfate emissions from the Houston Ship Channel. Principal component analysis (PCA) indicates that secondary biogenic organonitrates primarily related with monoterpenes are predominant in zone 1 (accounting for 34% of the variability in the data set). The relevance of photochemical processes and industrial and traffic emission sources in zone 2 also is highlighted by PCA, which identifies three factors related with these processes/sources (~50% of the aerosol/trace gas concentration variability). PCA reveals a relatively minor contribution of isoprene to SOA formation in zone 1 and the absence of isoprene-derived aerosol in zone 2. The relevance of industrial amine emissions and the likely contribution of chloride-displaced sea salt aerosol to the observed variability in pollution levels in zone 2 also are captured by PCA. This article describes an urban-scale mobile study to characterize spatial variations in submicrometer particulate matter (PM1) in greater Houston. The data set indicates substantial spatial variations in PM1 sources/chemistry and elucidates the importance of photochemistry and nighttime oxidant chemistry in producing secondary PM1. These results emphasize the potential benefits of effective control strategies throughout the region, not only to reduce primary emissions of PM1 from automobiles and industry but also to reduce the emissions of important secondary PM1 precursors, including sulfur oxides, nitrogen oxides, ammonia, and volatile organic compounds. Such efforts also could aid in efforts to reduce mixing ratios of ozone.


Anthropometric and body composition characteristics in pre- and postmenopausal Asian Indian women: Santiniketan women study.
The present cross-sectional study was aimed to investigate anthropometric and body composition characteristics in pre- and postmenopausal Asian Indian women. A total of 245 healthy women aged 25 to 65 years took part in the study. A random sampling procedure using a local voters' registration list was followed to select the participants. All participants belonged to the Bengalee population and were inhabitants of the Bolpur-Santiniketan area (lying in between 23 degrees 40' north latitude and 87degrees 43' east longitude) West Bengal, India. Before the actual commencement of the study, written information was communicated to select individuals, and an appointment was requested at their respective houses. Anthropometric measures, namely height, weight etc., were collected using standard techniques. Percentages of body fat (%BF) and body mass index (BMI) were measured using an Omron body fat analyser. All subjects were categorized into two groups: premenopausal (Group I; n = 145, mean age = 32.66 +/- 5.75 years) and postmenopausal (Group II; n = 100, mean age = 52.72 +/- 5.62 years). It was observed that 80.00% women were cohabited and 80.82% were housewife with 44.08% of them having an education up to secondary level. Furthermore, 62.45% subjects had monthly family expenditure of > or = 5000 Indian Rupees. One way ANOVA revealed that there was significant group difference for age, age at menarche, MWC, WHR, FM, FFM and %BF across the groups. Intercorrelation matrix (Pearson's correlation) showed that age had significantly positive association with MWC (p < 0.01), MHC (p < 0.05), WHR (p < 0.01), FM (p < 0.01), and %BF (p < 0.01), whereas FFM has had negative association with age. Most interestingly, it was observed that there was significant difference [chi2 (1) = 9.73] for central obesity status across the groups. It seems reasonable to argue that onset of menopause does play a vital role to alter body composition and in turn CVD risk factors.


Oxygen free radicals in acute pancreatitis of the rat.
This study aimed to assess the role of oxygen free radicals in acute pancreatitis. Acute pancreatitis was induced in rats by infusion of the CCK-analogue cerulein (5 micrograms/kg per hour) for 30 minutes, 3.5 hours, and 12 hours. After the infusion, serum enzymes and conjugated tissue dienes and malondialdehyde were measured and tissue samples were subjected to electron and light microscopy. Electron microscopy after 30 minutes showed moderate intracellular alterations. After 3.5 hours of cerulein infusion interstitial oedema and intravascular margination of granulocytes in the pancreatic gland were seen. After 12 hours histological evaluation showed pronounced zymogen degranulation, extensive tissue necrosis, and migration of granulocytes into the tissue. Amylase and lipase activities increased 15 and 35-fold respectively during this time. After 30 minutes of cerulein infusion conjugated dienes and malondialdehyde increased, they reached their peak after 3.5 hours and decreased to normal values after 12 hours. Treatment with superoxide dismutase (100,000 U/kg/hour) and catalase (400,000 U/kg/hour) either before or after the start of the cerulein infusion prevented lipid peroxidation and reduced zymogen degranulation and tissue necrosis. Tissue oedema and inflammatory response, however, were not affected in any of the treated rats. Oxygen free radicals are instrumental in the development of acute pancreatitis. Even after its onset, scavenger treatment reduced the tissue damage normally observed.


Microarray estimation of genomic inter-strain variability in the genus Ectocarpus (Phaeophyceae).
Brown algae of the genus Ectocarpus exhibit high levels of genetic diversity and variability in morphological and physiological characteristics. With the establishment of E. siliculosus as a model and the availability of a complete genome sequence, it is now of interest to analyze variability among different species, ecotypes, and strains of the genus Ectocarpus both at the genome and the transcriptome level. We used an E. siliculosus gene expression microarray based on EST sequences from the genome-sequenced strain (reference strain) to carry out comparative genome hybridizations for five Ectocarpus strains: four E. siliculosus isolates (the male genome strain, a female strain used for outcrosses with the genome strain, a strain isolated from freshwater, and a highly copper-tolerant strain), as well as one strain of the sister species E. fasciculatus. Our results revealed significant genomic differences between ecotypes of the same species, and enable the selection of conserved probes for future microarray experiments with these strains. In the two closely related strains (a male and a female strain used for crosses), genomic differences were also detected, but concentrated in two smaller genomic regions, one of which corresponds to a viral insertion site. The high variability between strains supports the concept of E. siliculosus as a complex of cryptic species. Moreover, our data suggest that several parts of the Ectocarpus genome may have evolved at different rates: high variability was detected particularly in transposable elements and fucoxanthin chlorophyll a/c binding proteins.


Rate of clinically significant postoperative pancreatic fistula in pancreatic neuroendocrine tumors.
In 2005, the International Study Group of Pancreatic Fistula (ISGPF) developed a definition and grading system for postoperative pancreatic fistula (POPF). The authors sought to determine the rate of POPF after enucleation and/or resection of pancreatic neuroendocrine tumors (PNET) and to identify clinical, surgical, or pathologic factors associated with POPF. A retrospective analysis of pancreatic enucleations and resections performed from March 1998 to April 2010. We defined a clinically significant POPF as a grade B that required nonoperative intervention and grade C. One hundred twenty-two patients were identified; 62 patients had enucleations and 60 patients had resections of PNET. The rate of clinically significant POPF was 23.7 % (29/122). For pancreatic enucleation, the POPF rate was 27.4 % (17/62, 14 grade B, 3 grade C). The pancreatic resection group had a POPF rate of 20 % (12/60, 10 grade B, 2 grade C). This difference was not significant (p = 0.4). In univariate analyses, patients in the enucleation group with hereditary syndromes (p = 0.02) and non-insulinoma tumors (p = 0.02) had a higher POPF rate. Patients in the resection group with body mass index (BMI) > 25 (p < 0.01), multiple endocrine neoplasia type 1 (MEN-1; p < 0.01) and those who underwent simultaneous multiple procedures (p = 0.02) had a higher POPF rate. Multivariate analyses revealed that hereditary syndromes were able to predict POPF in the enucleation group, while having BMI > 25 and increasing lesion size were also associated with POPF in the group undergoing resection. We found a clinically significant POPF rate after surgery in PNET to be 23.7 % with no difference by the type of operation. Our POPF rate is comparable to that reported in the literature for pancreatic resection for other types of tumors. Certain inherited genetic diseases-von Hippel-Lindau disease (VHL) and MEN-1-were associated with higher POPF rates.


Impact of Exposure to Patient Death or Near Death on Compassion Fatigue in Pediatric Intensive Care Nurses.
Compassion fatigue affects up to 40% of health care professionals who work in intensive care settings. Frequent exposure to the death of patients, particularly children, may put nurses at risk for compassion fatigue, but the relation between these is unclear among those working in pediatric intensive care units. To examine the relationship between exposure to the death or near death of a pediatric patient and compassion fatigue, specifically the outcomes of compassion satisfaction, burnout, and secondary traumatic stress. Pediatric and neonatal intensive care nurses were surveyed about their exposure to patient death and near-death experiences. They were asked to respond to the Professional Quality of Life Scale, which has 3 subscales that measure compassion satisfaction, burnout, and secondary traumatic stress. Bivariate and multivariate linear regression modeling was used to identify correlates of these outcomes. Of the 65 respondents, 94% were female, 41% were aged 31 to 45 years, and 71% had a bachelor's degree. No significant relationship was found between nurses' experiences of patient death or near death and their compassion satisfaction, burnout, or secondary traumatic stress. Significant correlates of compassion satisfaction and burnout included educational level and an age-experience interaction. No relationship seems to exist between nurses' experiences of patient death or near death and their compassion satisfaction, burnout, or secondary traumatic stress. Further research is needed to evaluate the impact of educational attainment on nurse outcomes and determine how best to support nurses who are at risk for compassion fatigue.


Evidence that Maackia amurensis seed lectin (MASL) exerts pleiotropic actions on oral squamous cells with potential to inhibit SARS-CoV-2 infection and COVID-19 disease progression.
COVID-19 was declared an international public health emergency in January, and a pandemic in March of 2020. There are over 125 million confirmed COVID-19 cases that have caused over 2.7 million deaths worldwide as of March 2021. COVID-19 is caused by the SARS-CoV-2 virus. SARS-CoV-2 presents a surface "spike" protein that binds to the ACE2 receptor to infect host cells. In addition to the respiratory tract, SARS-Cov-2 can also infect cells of the oral mucosa, which also express the ACE2 receptor. The spike and ACE2 proteins are highly glycosylated with sialic acid modifications that direct viral-host interactions and infection. Maackia amurensis seed lectin (MASL) has a strong affinity for sialic acid modified proteins and can be used as an antiviral agent. Here, we report that MASL targets the ACE2 receptor, decreases ACE2 expression and glycosylation, suppresses binding of the SARS-CoV-2 spike protein, and decreases expression of inflammatory mediators by oral epithelial cells that cause ARDS in COVID-19 patients. In addition, we report that MASL also inhibits SARS-CoV-2 infection of kidney epithelial cells in culture. This work identifies MASL as an agent with potential to inhibit SARS-CoV-2 infection and COVID-19 related inflammatory syndromes.


A strategy for tuning achiral main-chain polymers into helical assemblies and chiral memory systems.
A general strategy to tune the achiral main chain polymers into helical nanoassemblies was proposed based on the co-gelation approach. As an example, two achiral main chain polymers, PCz8 and PSi8, were selected, and their co-assembly with an amphiphilic l- or d-glutamide gelator was investigated. Although the polymers could not form gels individually, they could form co-gels with the gelator and the resultant gels exhibited macroscopic supramolecular chirality, which could be confirmed by CD spectra and SEM observations. Moreover, the supramolecular chirality can be memorized even after the gelator molecules were removed. Remarkably, either the gelator-containing or gelator-free chiral polymer assemblies showed circularly polarized luminescence (CPL), which is usually inherent to intrinsic chiral polymers. It was suggested that during the co-gelation, the chirality of the gelator was transferred to and memorized by the achiral polymers. The approach seems to be general and we provided the first example to tune the achiral polymers into helical assemblies through the co-gelation.


Into the Evening: Complex Interactions in the Arabidopsis Circadian Clock.
In Arabidopsis thaliana an assembly of proteins named the evening complex (EC) has been established as an essential component of the circadian clock with conserved functions in regulating plant growth and development. Recent studies identifying EC-regulated genes and EC-interacting proteins have expanded our understanding of EC function. In this review we focus on new progress uncovering how the EC contributes to the circadian network through the integration of environmental inputs and the direct regulation of key clock genes. We also summarize new findings of how the EC directly regulates clock outputs, such as photoperiodic and thermoresponsive growth, and provide new perspectives on future experiments to address unsolved questions related to the EC.


ER tubules mark sites of mitochondrial division.
Mitochondrial structure and distribution are regulated by division and fusion events. Mitochondrial division is regulated by Dnm1/Drp1, a dynamin-related protein that forms helices around mitochondria to mediate fission. Little is known about what determines sites of mitochondrial fission within the mitochondrial network. The endoplasmic reticulum (ER) and mitochondria exhibit tightly coupled dynamics and have extensive contacts. We tested whether ER plays a role in mitochondrial division. We found that mitochondrial division occurred at positions where ER tubules contacted mitochondria and mediated constriction before Drp1 recruitment. Thus, ER tubules may play an active role in defining the position of mitochondrial division sites.


Function of microglia in organotypic slice cultures.
We have examined the functional characteristics of microglia in an environment where the cytoarchitecture of the brain is preserved. Using organotypic slice culture under serum-free conditions, microglia initially demonstrated a rounded morphology but after 10 days in vitro (DIV), microglia in the slice were highly branched. Stimulation of the microglia at 4 DIV with phorbol ester significantly increased the number of cells stained with nitroblue tetrazolium, an indicator of superoxide anion production, compared to non-stimulated conditions. At 10 DIV, superoxide anion production was significantly less than that seen at 4 DIV and no increase in production was seen with phorbol ester stimulation. Phagocytosis of fluorescent latex beads and chemotaxis of microglia in response to zymosan activated serum was also reduced at 10 DIV compared to 4 DIV. These experiments indicate that microglia at 4 DIV in tissue slice culture have functional characteristics that resemble microglia in primary culture. However, prolonged culture of the slices results in a return of the microglia to a ramified and functionally down-regulated state, reminiscent of an "in vivo"-like environment. The organotypic slice culture, thus, provides a useful model system to I examine the interactions of microglia with neurons and other glia in the normal and injured brain.


[The influence of sociodemographic and familial factors on the therapeutic evolution of heroin addicts in a program of staged combined treatment].
In this study the authors evaluate the history of drug abuse, the familial and sociodemographic influence on the clinical evolution of 74 heroin-addicts, admitted sequentially to a therapeutic drug-free program named Sequential Combined Treatment (SCT), based on family and individual counselling, with a daily administration of naltrexone and with regular evaluation of drug abstinence, based on urinary analysis collected by family members. The enrollment rate recorded was 76%, and the participation rates during the course of the program were 88% after 3 months of administering the antagonist, 57% after 6 months, 47% after 9 months and 46% at the end of the 12th month. The results showed that age and previous scholarship levels, as well as parental or marital conflicts were significant predictors of over the subjects' total participation time in the program. The heroin-addicts with higher levels of scholarship or with drug abuse problems with other family members had more relapses during the treatment. No differences were found in the clinical variables of the therapeutic evolution among drug-addicts belonging to nuclear or enlarged family structures and single-parent or reconstructed family structures, which suggests that Sequential Combined Treatment (SCT) seems to have sufficiently similar results independently of the type of family structure to which they belong.


Spatial and temporal organization of ensemble representations for different odor classes in the moth antennal lobe.
In the insect antennal lobe, odor discrimination depends on the ability of the brain to read neural activity patterns across arrays of uniquely identifiable olfactory glomeruli. Less is understood about the complex temporal dynamics and interglomerular interactions that underlie these spatial patterns. Using neural-ensemble recording, we show that the evoked firing patterns within and between groups of glomeruli are odor dependent and organized in both space and time. Simultaneous recordings from up to 15 units per ensemble were obtained from four zones of glomerular neuropil in response to four classes of odorants: pheromones, monoterpenoids, aromatics, and aliphatics. Each odor class evoked a different pattern of excitation and inhibition across recording zones. The excitatory response field for each class was spatially defined, but inhibitory activity was spread across the antennal lobe, reflecting a center-surround organization. Some chemically related odorants were not easily distinguished by their spatial patterns, but each odorant evoked transient synchronous firing across a uniquely different subset of ensemble units. Examination of 535 cell pairs revealed a strong relationship between their recording positions, temporal correlations, and similarity of odor response profiles. These findings provide the first definitive support for a nested architecture in the insect olfactory system that uses both spatial and temporal coordination of firing to encode chemosensory signals. The spatial extent of the representation is defined by a stereotyped focus of glomerular activity for each odorant class, whereas the transient temporal correlations embedded within the ensemble provide a second coding dimension that can facilitate discrimination between chemically similar volatiles.


Malaria and the red cell.
Because of the breakdown of malaria control programs, the constant emergence of drug resistant parasites, and, possibly, climatic changes malaria poses a major problem for the developing countries. In addition, because of the speed of international travel it is being seen with increasing frequency as an imported disease in non-tropical countries. This update explores recent information about the pathophysiology of the disease, its protean hematological manifestations, and how carrier frequencies for the common hemoglobin disorders have been maintained by relative resistance to the malarial parasite. In Section I, Dr. Louis Miller and colleagues consider recent information about the pathophysiology of malarial infection, including new information about interactions between the malarial parasite and vascular endothelium. In Section II, Dr. David Roberts discusses what is known about the complex interactions between red cell production and destruction that characterize the anemia of malaria, one of the commonest causes of anemia in tropical countries. In Section III, Dr. David Weatherall reviews recent studies on how the high gene frequencies of the thalassemias and hemoglobin variants have been maintained by heterozygote advantage against malaria and how malaria has shaped the genetic structure of human populations.


Automated formal synthesis of provably safe digital controllers for continuous plants.
We present a sound and automated approach to synthesizing safe, digital controllers for physical plants represented as time-invariant models. Models are linear differential equations with inputs, evolving over a continuous state space. The synthesis precisely accounts for the effects of finite-precision arithmetic introduced by the controller. The approach uses counterexample-guided inductive synthesis: an inductive generalization phase produces a controller that is known to stabilize the model but that may not be safe for all initial conditions of the model. Safety is then verified via bounded model checking: if the verification step fails, a counterexample is provided to the inductive generalization, and the process further iterates until a safe controller is obtained. We demonstrate the practical value of this approach by automatically synthesizing safe controllers for physical plant models from the digital control literature.


Neural network output feedback control of robot formations.
In this paper, a combined kinematic/torque output feedback control law is developed for leader-follower-based formation control using backstepping to accommodate the dynamics of the robots and the formation in contrast with kinematic-based formation controllers. A neural network (NN) is introduced to approximate the dynamics of the follower and its leader using online weight tuning. Furthermore, a novel NN observer is designed to estimate the linear and angular velocities of both the follower robot and its leader. It is shown, by using the Lyapunov theory, that the errors for the entire formation are uniformly ultimately bounded while relaxing the separation principle. In addition, the stability of the formation in the presence of obstacles, is examined using Lyapunov methods, and by treating other robots in the formation as obstacles, collisions within the formation are prevented. Numerical results are provided to verify the theoretical conjectures.


Impact of two policy interventions on dietary diversity in Ecuador.
To differentiate the effects of food vouchers and training in health and nutrition on consumption and dietary diversity in Ecuador by using an experimental design. Interventions involved enrolling three groups of approximately 200 randomly selected households per group in three provinces in Ecuador. Power estimates and sample size were computed using the Optimal Design software, with a power of 80 %, at 5 % of significance and with a minimum detectable effect of 0·25 (sd). The first group was assigned to receive a monthly food voucher of $US 40. The second group was assigned to receive the same $US 40 voucher, plus training on health and nutrition issues. The third group served as the control. Weekly household values of food consumption were converted into energy intake per person per day. A simple proxy indicator was constructed for dietary diversity, based on the Food Consumption Score. Finally, an econometric model with three specifications was used for analysing the differential effect of the interventions. Three provinces in Ecuador, two from the Sierra region (Carchi and Chimborazo) and one from the Coastal region (Santa Elena). Members of 773 households randomly selected (n 4343). No significant impact on consumption for any of the interventions was found. However, there was evidence that voucher systems had a positive impact on dietary diversity. No differentiated effects were found for the training intervention. The most cost-effective intervention to improve dietary diversity in Ecuador is the use of vouchers to support family choice in food options.


A Systematic Review of the Economic Evaluation of Telemedicine in Japan.
There is no systematic review on economic evaluations of telemedicine in Japan, despite over 1000 trials implemented. Our systematic review aims to examine whether Japan's telemedicine is cost-saving or cost-effective, examine the methodological rigorousness of the economic evaluations, and discuss future studies needed to improve telemedicine's financial sustainability. We searched five databases, including two Japanese databases, to find peer-reviewed articles published between January 1, 2000 and December 31, 2014 in English and Japanese that performed economic evaluations of Japan's telemedicine programs. The methodological rigorousness of the economic analyses was assessed with a well-established checklist. We calculated the benefit-to-cost ratio (BCR) when a reviewed study reported related data but did not report the BCR. All cost values were adjusted to 2014 US dollars. Among the 17 articles identified, six studies reported on settings connecting physicians for specialist consultations, and eleven studies on settings connecting healthcare providers and patients at home. There are three cost-benefit analyses and three cost-minimization analyses. The remaining studies measured the benefit of telemedicine only, using medical expenditure saved or users' willingness-to-pay. There was substantial diversity in the methodological rigorousness. Studies on teledermatology and teleradiology indicated a favorable level of economic efficiency. Studies on telehomecare gave mixed results. One cost-benefit analysis on telehomecare indicated a low economic efficiency, partly due to public subsidy rules, e.g., a too short budget period. Overall, telemedicine programs in Japan were indicated to have a favorable level of economic efficiency. However, the scarcity of the economic literature indicates the need for further rigorous economic evaluation studies.


T2* measurements of 3-T MRI with ultrashort TEs: capabilities of pulmonary function assessment and clinical stage classification in smokers.
The purpose of this study was to determine the usefulness of MRI with ultrashort TEs on a 3-T system and of thin-section MDCT for pulmonary function assessment and clinical stage classification of chronic obstructive pulmonary disease (COPD) in smokers. Forty smokers (24 men and 16 women; mean age ± SD, 68.0 ± 9.3 years) underwent MRI with ultrashort TEs and thin-section MDCT. Pulmonary function testing was also performed to determine the following: the ratio of forced expiratory volume in 1 second to forced vital capacity (percentage predicted) (FEV(1/)FVC%), percentage predicted forced expiratory volume in 1 second (%FEV(1)), and percentage predicted diffusing capacity of lung for carbon monoxide corrected for alveolar volume (%DLCO/V(A)). All subjects were classified into one of four groups as follows: smokers without COPD, with mild COPD, with moderate COPD, and with severe or very severe COPD. T2(*) maps were expressed using proprietary software. Regional T2(*) values were determined by region of interest measurements and were averaged to determine a mean T2(*) value for each subject. CT-based functional lung volume and the ratio of the wall area to the total airway area were also determined. All indexes were statistically correlated with pulmonary function parameters. Then, all indexes were compared among all groups by means of Tukey's honest significance test. All indexes had significant correlation with FEV(1)/FVC%, %FEV(1), and % DLCO/V(A) (p < 0.05). All indexes except WA% of smokers without COPD and smokers with mild COPD differed significantly from those of smokers with moderate COPD and smokers with severe or very severe COPD (p < 0.05). Moreover, the mean T2(*) value of the moderate COPD group was significantly different from that of the severe or very severe COPD group (p < 0.05). MRI with ultrashort TEs is potentially as useful as quantitatively assessed MDCT for pulmonary function loss assessment and clinical stage classification of COPD in smokers.


Peripheral muscle strength training in COPD: a systematic review.
Skeletal muscle weakness, and the associated impact on exercise tolerance, provides a strong theoretical rationale for strength training intervention for people with COPD. The purpose of this review was to examine systematically the current evidence for peripheral muscle strength training in people with COPD. Empirical trials and reviews relating to strength training in COPD were obtained by searching electronic databases and citation tracking, using the keywords of COPD with strength/resistance training and skeletal muscle. Two reviewers completed data extraction and quality assessment independently, using the PEDro (physiotherapy evidence database) scale and a checklist for review articles. Effect sizes and 95% confidence intervals were determined for empiric trials and metaanalysis used where appropriate. The search strategy yielded 13 articles (9 empirical trials and 4 reviews). Strength training was found to have strong evidence for improving upper body and leg strength. However, no strong evidence for strength training was found for other outcome measures. Further research is required to investigate the effects of strength training on functional activities, such as balance, upper limb function, self care, and participation in daily life.


Age-related striatal BOLD changes without changes in behavioral loss aversion.
Loss aversion (LA), the idea that negative valuations have a higher psychological impact than positive ones, is considered an important variable in consumer research. The literature on aging and behavior suggests older individuals may show more LA, although it is not clear if this is an effect of aging in general (as in the continuum from age 20 and 50 years), or of the state of older age (e.g., past age 65 years). We also have not yet identified the potential biological effects of aging on the neural processing of LA. In the current study we used a cohort of subjects with a 30 year range of ages, and performed whole brain functional MRI (fMRI) to examine the ventral striatum/nucleus accumbens (VS/NAc) response during a passive viewing of affective faces with model-based fMRI analysis incorporating behavioral data from a validated approach/avoidance task with the same stimuli. Our a priori focus on the VS/NAc was based on (1) the VS/NAc being a central region for reward/aversion processing; (2) its activation to both positive and negative stimuli; (3) its reported involvement with tracking LA. LA from approach/avoidance to affective faces showed excellent fidelity to published measures of LA. Imaging results were then compared to the behavioral measure of LA using the same affective faces. Although there was no relationship between age and LA, we observed increasing neural differential sensitivity (NDS) of the VS/NAc to avoidance responses (negative valuations) relative to approach responses (positive valuations) with increasing age. These findings suggest that a central region for reward/aversion processing changes with age, and may require more activation to produce the same LA behavior as in younger individuals, consistent with the idea of neural efficiency observed with high IQ individuals showing less brain activation to complete the same task.


Teicoplanin-resistant Staphylococcus aureus expresses a novel membrane protein and increases expression of penicillin-binding protein 2 complex.
In the recent clinical trials of teicoplanin therapy of endocarditis caused by Staphylococcus aureus, at least one instance of the emergence of teicoplanin-resistant strains during therapy has been reported (G.W. Kaatz, S. M. Seo, N. J. Dorman, and S. A. Lerner, J. Infect. Dis 162:103-108, 1990). We have confirmed, using conventional electrophoresis of EcoRI-digested chromosomal DNA and pulsed-field gel electrophoresis of SmaI-digested chromosomal DNA, that the resistant strain (12873) (MIC, 16 micrograms/ml) is genetically very similar to the susceptible parent (12871) (MIC, 4 micrograms/ml). Kaatz et al. were able to select spontaneous teicoplanin-resistant mutants (10(-9)), suggesting that a single gene might be involved. We have shown that the mutation is highly stable during growth in the absence of teicoplanin. Using Tn551, we have selected insertion mutants of 12873 that become teicoplanin susceptible. We have examined a number of aspects of cell wall physiology in strains 12871 and 12873 and the teicoplanin-susceptible Tn551 mutants of 12873. 12873 was more susceptible to lysostaphin lysis than 12871 and the susceptible Tn551 derivatives of 12873. Autolysis in phosphate buffer (pH 7.5) and cell wall turnover rates were similar in 12871 and 12873. An analysis of membrane proteins revealed the expression of a ca. 35-kDa protein and increased expression of both polypeptides of penicillin-binding protein (PBP) 2 (PBP2) in 12873 relative to 12871 and the Tn551 mutants of 12873. This increased expression was not related to PBP2', since both strains were susceptible to oxacillin in 2% NaCl (MIC, < or = 0.25 microgram/ml) and cellular DNA from neither strain hybridized with a specific mec gene probe. Two independent Tn551 inserts have been mapped to a ca. 117-kb SmaI fragment of the chromosome. These data suggest the possibility that the mutation resulting in resistance to teicoplanin involves the regulation of expression of both polypeptides of PBP2 and a 35-kDa membrane protein.


Thinking caps for everyone? The role of neuro-enhancement by non-invasive brain stimulation in neuroscience and beyond.
Neuro-enhancement by non-invasive brain stimulation (NIBS) has recently made considerable progress, triggering discussions regarding future applications to enhance human performance. We show that neuroscientific research does not aim at improving brain functions per se. Instead, neuro-enhancement is a research tool that has great potential to reveal the neural mechanisms underlying perception, cognition, and behavior. We provide instructive examples that showcase the relevance of neuro-enhancement by NIBS in neuroscience. Importantly, we argue that the scientific value of neuro-enhancement critically depends on our understanding of why enhancing effects occur. This is in contrast to applications of neuro-enhancement in other domains, where such knowledge may not be required. We conclude that neuro-enhancement as a therapeutic tool or in healthy people outside of neuroscience should be kept conceptually distinct, as these are separate domains with entirely different motives for enhancing human performance. Consequently, the underlying principles that justify the application of NIBS will be different in each domain and arguments for or against neuro-enhancement in one domain do not necessarily generalize to other domains.


CD56 expression predicts occurrence of CNS disease in acute lymphoblastic leukemia.
We examined the pre-treatment bone marrow samples from 200 consecutive adult patients with acute lymphoblastic leukemia (ALL) treated on various protocols at the University of Texas, M.D. Anderson Cancer Center between 1986 and 1998. Standard MFC techniques were used to determine CD56 expression on the leukemia blasts cells. The expression of CD56 was correlated with clinical characteristics at diagnosis, response to therapy, survival and disease-free survival. Blast expression of CD56 (> or = 20% of leukemic blasts) was seen in 16 (8%) of patients, with a median expression of 67% (range 20-99%). CD56 expression was associated with a higher incidence of central nervous system (CNS) disease at diagnosis (19% versus 4%; P=0.016). Incidence of CNS disease at any time was higher in patients with CD56+ disease (31% versus 14%; P=0.057). Among the 109 patients uniformly treated with the hyperCVAD regimen, CD56 expression was associated with a statistically significant higher incidence of CNS disease (33% versus 9%; P=0.026). CD56 expression in ALL is uncommon but may predict a higher risk for CNS disease. If these results are confirmed, CD56 expression could be used in combination with other high-risk features (e.g. lactate dehydrogenase (LDH), S-phase fraction, mature B-cell phenotype) to design a risk-oriented approach to CNS prophylaxis.


Unit Collective Medical Training in the 75th Ranger Regiment.
The 75th Ranger Regiment's success with eliminating preventable death on the battlefield is innate to the execution of a continuous operational readiness training cycle that integrates individual and unit collective medical training. This is a tactical solution to a tactical problem that is solved by the entire unit, not just by medics. When a casualty occurs, the unit must immediately respond as a team to extract, treat, and evacuate the casualty while simultaneously completing the tactical mission. All in the unit must maintain first responder medical skills and medics must be highly proficient. Leaders must be prepared to integrate casualty management into any phase of the mission. Leaders must understand that (1) the first casualty can be anyone; (2) the first responder to a casualty can be anyone; (3) medical personnel manage casualty care; and (4) leaders have ownership and responsibility for all aspects of the mission. Foundational to training is a command-directed casualty response system which serves as a forcing function to ensure proficiency and mastery of the basics. Four programs have been developed to train individual and collective tasks that sustain the Ranger casualty response system: (1) Ranger First Responder, (2) Advanced Ranger First Responder, (3) Ranger Medic Assessment and Validation, and (4) Casualty Response Training for Ranger Leaders. Unit collective medical training incorporates tactical leader actions to facilitate the principles of casualty care. Tactical leader actions are paramount to execute a casualty response battle drill efficiently and effectively. Successful execution of this battle drill relies on a command-directed casualty response system and mastery of the basics through rehearsals, repetition, and conditioning.


Management of rectal prolapse: the role of laparoscopic approaches.
Rectal prolapse is a lifestyle-altering disability which has been treated with over 100 surgical options. The specific goals of surgical management of full thickness rectal prolapse are to minimize the operative risk in this typically elderly population, eradicate the external prolapse of the rectum, improve continence, improve bowel function, and reduce the risk of recurrence. The theoretical advantages of a laparoscopic approach are to couple reductions in surgical morbidity and good post-operative outcome. Studies which compare the same laparoscopic and open surgical approach for rectal prolapse have demonstrated that laparoscopy confers benefits related to postoperative pain, length of hospital stay, and return of bowel function. Virtually every type of open transabdominal surgical approach to rectal prolapse has been laparoscopically accomplished. Current laparoscopic surgical techniques include suture rectopexy, stapled rectopexy, posterior mesh rectopexy with artificial material, and resection of the sigmoid colon with colorectal anastomosis, with or without rectopexy. The growing body of literature supports the concept that laparoscopic surgical techniques can safely provide the benefits of low recurrence rates and improved functional outcome for patients with full thickness rectal prolapse.


Soluble levels and endogenous vascular gene expression of KLOTHO are related to inflammation in human atherosclerotic disease.
Atherosclerosis is a chronic inflammatory disorder affecting the artery wall. Klotho, an anti-aging factor expressed in the vessel walls that participates in the maintenance of vascular homeostasis, can be down-regulated by inflammation. In this proof-of-concept work we seek to characterize the arterial KLOTHO expression in the vascular wall, as well as the serum concentration of this protein, in a group of patients with clinical atherosclerotic disease. In addition, we aim to analyze the relationship between Klotho and inflammation. Vascular samples were obtained from 27 patients with atherosclerotic disease under an elective vascular surgery procedure, and from 11 control subjects (cadaveric organ donation programme). qRT-PCR was performed to analyze the gene expression of KLOTHO, TNF-α, IL-6, and IL-10 Serum levels of soluble KLOTHO were measured by ELISA. As compared with control subjects, serum concentrations and vascular expression of Klotho were lower in patients with atherosclerotic vascular disease, whereas inflammatory status was significantly higher. There was a negative and significant correlation between inflammatory parameters and Klotho. After controlling for the effect of other variables, partial correlation showed a direct relationship between vascular KLOTHO gene expression and IL-10 mRNA levels, whereas there was a negative association with serum LDL concentrations and vascular TNF-α expression. Our study indicates an inverse interrelationship between inflammation and Klotho in atherosclerosis. Further studies are necessary to elucidate whether the inflammatory state causes Klotho deficiency or, on the contrary, reduction of Klotho could be responsible for greater inflammation, and finally, to investigate the potential clinical relevance of this association.


The prognostic value of lymph node ratio in stage IIIC cervical cancer patients triaged to primary treatment by radical hysterectomy with systematic pelvic and para-aortic lymphadenectomy.
The aim of this study was to determine the prognostic value of lymph node ratio (LNR) in women with 2018 International Federation of Gynecology and Obstetrics stage IIIC cervical cancer. In this retrospective dual-institutional study, a total of 185 node-positive cervical cancer patients who had undergone radical hysterectomy with systematic pelvic and para-aortic lymphadenectomy were included. All of the patients received adjuvant chemoradiation after surgery. LNR was defined as the ratio of positive lymph nodes (LNs) to the total number of LNs removed. The patients were categorized into 2 groups according to LNR; LNR <0.05 and LNR ≥0.05. The prognostic value of LNR was evaluated with univariate log-rank tests and multivariate Cox regression models. A total of 138 patients (74.6%) had stage IIIC1 disease and 47 (25.4%) patients had stage IIIC2 disease. With a median follow-up period of 45.5 months (range 3-135 months), the 5-year disease-free survival (DFS) rate was 62.5% whereas the 5-year overall survival (OS) rate was 70.4% for the entire study population. The 5-year DFS rates for LNR <0.05 and LNR ≥0.05 were 78.2%, and 48.4%, respectively (p<0.001). Additionally, the 5-year OS rates for LNR <0.05 and LNR ≥0.05 were 80.6%, and 61.2%, respectively (p=0.007). On multivariate analysis, LNR ≥0.05 was associated with a worse DFS (hazard ratio [HR]=2.12; 95% confidence interval [CI]=1.15-3.90; p=0.015) and OS (HR=1.95; 95% CI=1.01-3.77; p=0.046) in women with stage IIIC cervical cancer. LNR ≥0.05 seems to be an independent prognostic factor for decreased DFS and OS in stage IIIC cervical carcinoma.


Early biofouling detection using fluorescence-based extracellular enzyme activity.
Membrane-based filtration technologies have seen rapid inclusion in a variety of industrial processes, especially production of drinking water by desalination. Biological fouling of membranes is a challenge that leads to increased costs from efficiency reductions, membrane damage and ultimately, membrane replacement over time. Such costs can be mitigated by monitoring and optimizing cleaning processes for better prognosis. Monitoring bacterial accumulation in situ can therefore advance understanding of cleaning efficiency. A fluorescence-based sensor for early biofouling detection capable of measuring extracellular enzyme activity was developed and tested in a lab-scale seawater reverse osmosis (SWRO) biofouling model for use in monitoring bacterial accumulation proximal to the surface of a membrane. We tracked bacterial biomass accumulation rapidly and non-invasively using exogenously applied fluorogen-substrates and corroborated with optical coherence tomography imaging of the membrane surface in real-time. The selected fluorogen and fluorogen-substrate were characterized and down selected by high throughput screening in vitro for compatibility in seawater and profiled over relevant Red Sea desalination parameters (pH and temperature). This approach demonstrates the practicality of prototyping an early-detection biofouling sensor in membrane based processes, such as seawater desalination, using extracellular enzyme activity as a measure of bacterial abundance.


Errors in medication history at hospital admission: prevalence and predicting factors.
An accurate medication list at hospital admission is essential for the evaluation and further treatment of patients. The objective of this study was to describe the frequency, type and predictors of errors in medication history, and to evaluate the extent to which standard care corrects these errors. A descriptive study was carried out in two medical wards in a Swedish hospital using Lund Integrated Medicines Management (LIMM)-based medication reconciliation. A clinical pharmacist identified each patient's most accurate pre-admission medication list by conducting a medication reconciliation process shortly after admission. This list was then compared with the patient's medication list in the hospital medical records. Addition or withdrawal of a drug or changes to the dose or dosage form in the hospital medication list were considered medication discrepancies. Medication discrepancies for which no clinical reason could be identified (unintentional changes) were considered medication history errors. The final study population comprised 670 of 818 eligible patients. At least one medication history error was identified by pharmacists conducting medication reconciliations for 313 of these patients (47%; 95% CI 43-51%). The most common medication error was an omitted drug, followed by a wrong dose. Multivariate logistic regression analysis showed that a higher number of drugs at admission (odds ratio [OR] per 1 drug increase = 1.10; 95% CI 1.06-1.14; p < 0.0001) and the patient living in their own home without any care services (OR = 1.58; 95% CI 1.02-2.45; p = 0.042) were predictors for medication history errors at admission. The results further indicated that standard care by non-pharmacist ward staff had partly corrected the errors in affected patients by four days after admission, but a considerable proportion of the errors made in the initial medication history at admission remained undetected by standard care (OR for medication errors detected by pharmacists' medication reconciliation carried out on days 4-11 compared to days 0-1 = 0.52; 95% CI 0.30-0.91; p=0.021). Clinical pharmacists conducting LIMM-based medication reconciliations have a high potential for correcting errors in medication history for all patients. In an older Swedish population, those prescribed many drugs seem to benefit most from admission medication reconciliation.


BMI-1 expression increases in oral leukoplakias and correlates with cell proliferation.
Oral leukoplakia (OL) is a white lesion of an indeterminate risk not related to any excluded (other) known diseases or disorders that carry no increased risk for cancer. Many biological markers have been used in an attempt to predict malignant transformation; however, no reliable markers have been established so far. Objective To evaluate cell proliferation and immortalization in OL, comparing non-dysplastic (Non-dys OL) and dysplastic OL (Dys OL). Methodology This is a cross-sectional observational study. Paraffin-embedded tissue blocks of 28 specimens of Non-dys OL, 33 of Dys OL, 9 of normal oral mucosa (NOM), 17 of inflammatory hyperplasia (IH), and 19 of oral squamous cell carcinomas (OSCC) were stained for Ki-67 and BMI-1 using immunohistochemistry. Results A gradual increase in BMI-1 and K-i67 expression was found in oral carcinogenesis. The immunolabeling for those markers was higher in OSCC when compared with the other groups (Kruskal-Wallis, p<0.05). Ki-67 expression percentage was higher in OL and in IH when compared with NOM (Kruskal-Wallis/Dunn, p<0.05). Increased expression of BMI-1 was also observed in OL when compared with NOM (Kruskal-Wallis/Dunn, p<0.05). No differences were observed in expression of both markers when non-dysplastic and dysplastic leukoplakias were compared. A significant positive correlation between Ki-67 and BMI-1 was found (Spearman correlation coefficient, R=0.26, p=0.01). High-grade epithelial dysplasia was associated with malignant transformation (Chi-squared, p=0.03). Conclusions These findings indicate that BMI-1 expression increases in early oral carcinogenesis and is possibly associated with the occurrence of dysplastic changes. Furthermore, our findings indicate that both Ki-67 and BMI-1 are directly correlated and play a role in initiation and progression of OSCC.


Selective inhibition by a class III antiarrhythmic agent, E-4031, of the negative chronotropic response to parasympathetic stimulation in anesthetized dogs.
To investigate the influence of a class III antiarrhythmic agent, E-4031, on the vagus control of the heart, we studied the effects of E-4031 on the chronotropic, dromotropic and inotropic responses to parasympathetic stimulation in the autonomically decentralized hearts of the open-chest, anesthetized dogs. E-4031 (0.01-3 mumol/kg i.v.) decreased heart rate dose-dependently without affecting atrioventricular (AV) conduction time, first derivative of "a" wave component of the right atrial pressure (RA dP/dt), maximum rate of the right ventricular pressure development (RV +dP/dt) and arterial blood pressure. When cervical vagus stimulation decreased the heart rate, RA dP/dt and RV +dP/dt and prolonged the AV conduction time, E-4031 antagonized the negative chronotropic response in a dose-dependent manner but affected neither dromotropic nor atrial inotropic responses. E-4031 at a high dose of 3 mumol/kg i.v. attenuated the ventricular inotropic response. ID50 for the chronotropism was 0.20 +/- 0.05 mumol/kg. Stimulation of the selective intracardiac parasympathetic nerves to the sinoatrial nodal area decreased the heart rate and RA dP/dt without a dromotropic response. E-4031 antagonized the negative chronotropic response to the stimulation but not the inotropic response. Stimulation of the selective intracardiac parasympathetic nerves to the AV nodal area prolonged the AV conduction time without a chronotropic response. E-4031 at a high dose of 3 mumol/kg i.v. attenuated the negative dromotropic response to the stimulation by 35 +/- 10%. These results suggest that E-4031 preferentially blocks the negative chronotropic response to vagus stimulation without significantly affecting other cardiac responses at a site distal to the muscarinic receptor in the heart in situ.


Drugs for preventing red blood cell dehydration in people with sickle cell disease.
Sickle cell disease is an inherited disorder of hemoglobin, resulting in abnormal red blood cells. These are rigid and may block blood vessels leading to acute painful crises and other complications. Recent research has focused on therapies to rehydrate the sickled cells by reducing the loss of water and ions from them. Little is known about the effectiveness and safety of such drugs. This is an updated version of a previously published review. To assess the relative risks and benefits of drugs to rehydrate sickled red blood cells. We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group's Haemoglobinopathies Trials Register. We also searched online trials registries for any ongoing trials (01 July 2018).Last search of the Group's Haemoglobinopathies Trials Register: 08 October 2018. Randomized or quasi-randomized controlled trials of drugs to rehydrate sickled red blood cells compared to placebo or an alternative treatment. Both authors independently selected studies for inclusion, assessed study quality and extracted data. Of the 51 studies identified, three met the inclusion criteria, including 524 people with sickle cell disease aged between 12 and 65 years of age. One study tested the effectiveness of zinc sulphate as compared to placebo and the remaining two assessed senicapoc versus placebo. No deaths were seen in any of the studies (low-quality evidence). The zinc sulphate study showed a significant reduction in painful crises (in a total of 145 participants) over one and a half years, mean difference -2.83 (95% confidence interval -3.51 to -2.15) (moderate-quality evidence). However, analysis was restricted due to limited statistical data. Changes to red blood cell parameters and blood counts were inconsistent (very low-quality evidence). No serious adverse events were noted in the study. The Phase II dose-finding study of senicapoc (a Gardos channel blocker) compared to placebo showed that the high dose senicapoc showed significant improvement in change in hemoglobin level, the number and proportion of dense red blood cells, red blood cell count and indices and hematocrit value (very low-quality evidence). The results with low-dose senicapoc were similar to the high-dose senicapoc group but of lesser magnitude. There was no difference in the frequency of painful crises between the three groups (low-quality evidence). A subsequent Phase III study of senicapoc was terminated early since there was no difference observed between the treatment and control groups in the primary end point of painful crises. While the results of zinc for reducing sickle-related crises are encouraging, larger and longer-term multicenter studies are needed to evaluate the effectiveness of this therapy for people with sickle cell disease.While the Phase II and the prematurely terminated phase III studies of senicapoc showed that the drug improved red blood cell survival (depending on dose), this did not lead to fewer painful crises.Given this is no longer an active area of research, this review will no longer be regularly updated.


Structural changes of the brain in rheumatoid arthritis.
To investigate whether structural changes are present in the cortical and subcortical gray matter of the brains of patients with rheumatoid arthritis (RA). We used two surface-based style morphometry analysis programs and a voxel-based style analysis program to compare high-resolution structural magnetic resonance imaging data obtained for 31 RA patients and 25 age- and sex-matched healthy control subjects. We observed an increase in gray matter content in the basal ganglia of RA patients, mainly in the nucleus accumbens and caudate nucleus. There were no differences in the cortical gray matter. Moreover, patients had a smaller intracranial volume. Our results suggest that RA is associated with changes in the subcortical gray matter rather than with cortical gray matter atrophy. Since the basal ganglia play an important role in motor control as well as in pain processing and in modulating behavior in response to aversive stimuli, we suggest that these changes may result from altered motor control or prolonged pain processing. The differences in brain volume may reflect either generalized atrophy or differences in brain development.


Monitoring the health-related labelling of foods and non-alcoholic beverages in retail settings.
Food labelling on food packaging has the potential to have both positive and negative effects on diets. Monitoring different aspects of food labelling would help to identify priority policy options to help people make healthier food choices. A taxonomy of the elements of health-related food labelling is proposed. A systematic review of studies that assessed the nature and extent of health-related food labelling has been conducted to identify approaches to monitoring food labelling. A step-wise approach has been developed for independently assessing the nature and extent of health-related food labelling in different countries and over time. Procedures for sampling the food supply, and collecting and analysing data are proposed, as well as quantifiable measurement indicators and benchmarks for health-related food labelling.


A single-item approach to screening elders for oral health assessment.
Oral health contributes significantly to overall health. Finding a single item that can be used by primary care providers to screen elders who are in need of oral care is important. The objective of this article was to evaluate usefulness of the item: "Do you have regular dental checkups?" as a means to decide whether an oral health assessment or further referral is indicated. Answering no is postulated as a positive predictor of poor oral health and need for care. This study was a secondary analysis of a nutritional survey of 240 community-dwelling elders. Examiner-rated Kayser-Jones Brief Oral Health Status Examination; self-reported General Oral Health Assessment Index; number of remaining teeth; and pattern of checkups (regular vs. irregular) were evaluated by a trained gerontological nurse practitioner during an in-home assessment. A dental visit within the past year for any reason was reported by 132 subjects (55.0%), but only 81 (33.8%) reported some sort of regular dental checkups. For dentate elders (n = 147), an irregular checkup was associated with lower educational level, Protestant faith, and Black race. People with irregular checkups scored significantly lower on all three oral indices. The negative predictive values and likelihood ratio negative values ranged 98.7-100.0% and 0.00-0.98, respectively, indicating that this item of interest is valid for ruling-out dentate subjects with good oral health. For edentulous elders (n = 93), the item was less effective. A single item, "Do you have regular dental checkups?" can be used effectively to rule out dentate elders with good oral health and identify those who are in need of further oral health assessment or referrals.


The inheritance of liability to epistaxis in the southern African Thoroughbred.
This study was carried out to estimate the heritability of liability to epistaxis in the southern African Thoroughbred population. Data of all horses that suffered epistaxis while racing in southern Africa and Mauritius from 1986 to 2002 and involving 1252 bleeders were analysed. Pedigree data covering the period 1960-1986 was used as required to calculate the incidence of bleeding amongst ancestors of the post-1986 era. Only pedigrees of horses that raced were included in this study as it was not possible to predict whether non-runners would have bled had they raced. Consequently all non-runners and also those that raced overseas in countries where bleeding occurrence was not recorded, were excluded. The heritability of liability method as described by Falconer (1989) was used to estimate the relative importance of heredity and environment. For the period investigated, the population incidence for epistaxis in southern African horses was 2.1%. The estimation of heritability of liability showed that 1st-degree relatives had a figure of 55.4%. Second-degree relatives had a heritability of 41.3% and 3rd-degree relatives came in at 30.4%. The heritability of liability shown in this study could be regarded as being at the lower end of the range but could be appreciably higher. The data depict horses that bled almost exclusively on race days, as only a small percentage (approximately 5%) was reported as having bled during exercise. Accordingly, the full extent of epistaxis amongst racing Thoroughbreds in southern Africa is difficult to gauge. It is clear that epistaxis in the racing Thoroughbred has a strong genetic basis. It is suggested that horses showing frankbleeding from the nostrils after racing or exercise be suspended, and not used for breeding purposes. This should result in relatively fast progress being made towards eradicating this costly scourge of the modern Thoroughbred racehorse.


Bloch Analysis of Photonic Lattices that Incorporate Vertical Cavity Surface-Emitting Laser Arrays.
We analyzed one-dimensional photonic lattices that incorporate mirror-modulated vertical cavity surface-emitting laser arrays utilizing the Bloch formalism. First, infinitely long arrays are considered. The in-phase mode (with a main central lobe at the far field) and antiphase mode (with two main symmetrically-located lobes at the far-field) are examined. A comparison of the modal losses of the in-phase and the antiphase modes, resulted in the discovery of regimes in which the in-phase mode is dominant. Considering lattices of finite length, we compared the results of the Bloch model to the exact solutions. It is shown that the boundary conditions in these lattices select a specific mode from the continuous spectrum in the infinite case. Consequently, the lattice's length affects the eigenmodes and the corresponding eigenvalues in a periodic manner.


The Consumption of Cannabis by Fibromyalgia Patients in Israel.
To report on the habits of cannabis consumption among fibromyalgia patients in Israel. An Internet-based questionnaire was posted to three large fibromyalgia Facebook groups in our country. The questionnaire was anonymous and included demographic, clinical, and cannabis-related questions, including acquisition of a license for medical cannabis (MC) method and amount of cannabis consumption; need to buy cannabis beyond the medical allowance; effect of cannabis on pain, sleep, depression, and anxiety; adverse effects of cannabis; feelings of dependence on cannabis or other meds; the involvement of family members; tendency to drive after using cannabis; and employment and social disability status. Of 2,705 people, 383 (14%) responded to the questionnaire, with a mean age of 42.2±14.2 years. Of the responders, 84% reported consuming cannabis, and 44% were licensed for MC. The mean amount per month of cannabis consumed was 31.4±16.3g, and 80% of cannabis consumers (CC) smoked pure cannabis or cannabis mixed with tobacco. Pain relief was reported by 94% of CC, while 93% reported improved sleep quality, 87% reported improvement in depression, and 62% reported improvement in anxiety. Of MC-licensed CC, 55% bought cannabis beyond the medical allowance on the black market. Adverse effects were reported by 12% of CC. Only 8% reported dependence on cannabis. Most CC (64%) worked either full- or part-time jobs, and 74% reported driving "as usual" under cannabis use. Cannabis consumption among fibromyalgia patients in our country is very common and is mostly not licensed. Nearly all CC reported favorable effects on pain and sleep, and few reported adverse effects or feeling of dependence on cannabis.


Passive Q-switching characteristics of Yb3+:Gd3Ga5O12 crystal.
The passively Q-switched laser characteristics of a quasi-three level Yb3+:Gd3Ga5O12 (Yb3+:GGG) crystal with Cr4+:YAG saturable absorbers are studied experimentally and theoretically. The pulse parameters under different experimental conditions are measured. Some characteristics different from those of a four-level system are found. In the theoretical aspect, taking into account the spatial distributions of the pump light and intracavity laser mode, the rate equations describing the single Q-switched pulse characteristics of a quasi-three-level system are obtained. The obtained theoretical results are in fair agreement with the experimental results. Some topics such as the influence of the pumping power, the selection of the pump beam size, the optimal combination of output coupler reflectivity and saturable absorber initial transmission, the influence of the excited absorption of the saturable absorber, are discussed.


Consistent verbal labels promote odor category learning.
Recent research shows that speakers of most languages find smells difficult to abstract and name. Can verbal labels enhance the human capacity to learn smell categories? Few studies have examined how verbal labeling might affect non-visual cognitive processes, and thus far very little is known about word-assisted odor category learning. To address these gaps, we tested whether different types of training change learning gains in odor categorization. After four intensive days of training to categorize odors that were co-presented with arbitrary verbal labels, people who learned odor categories with odor-label pairs that were more consistent were significantly more accurate than people with the same perceptual experience but who had odor-label pairs that were less consistent. Both groups' accuracy scores improved, but the learning curves differed. The context of consistent linguistic cuing supported an increase in correct responses from the third day of training. However, inconsistent linguistic cuing delayed the start of approximating to target odor categorization until after the fourth day. These results show that associations formed between odors and novel verbal labels facilitate the formation of odor categories. We interpret this as showing a causal link between language and olfactory perceptual processing in supporting categorization.