Significant variance in genetic diversity among populations of Schistosoma haematobium detected using microsatellite DNA loci from a genome-wide database.
Urogenital schistosomiasis caused by Schistosoma haematobium is widely distributed across Africa and is increasingly being targeted for control. Genome sequences and population genetic parameters can give insight into the potential for population- or species-level drug resistance. Microsatellite DNA loci are genetic markers in wide use by Schistosoma researchers, but there are few primers available for S. haematobium. We sequenced 1,058,114 random DNA fragments from clonal cercariae collected from a snail infected with a single Schistosoma haematobium miracidium. We assembled and aligned the S. haematobium sequences to the genomes of S. mansoni and S. japonicum, identifying microsatellite DNA loci across all three species and designing primers to amplify the loci in S. haematobium. To validate our primers, we screened 32 randomly selected primer pairs with population samples of S. haematobium. We designed >13,790 primer pairs to amplify unique microsatellite loci in S. haematobium, (available at http://www.cebio.org/projetos/schistosoma-haematobium-genome). The three Schistosoma genomes contained similar overall frequencies of microsatellites, but the frequency and length distributions of specific motifs differed among species. We identified 15 primer pairs that amplified consistently and were easily scored. We genotyped these 15 loci in S. haematobium individuals from six locations: Zanzibar had the highest levels of diversity; Malawi, Mauritius, Nigeria, and Senegal were nearly as diverse; but the sample from South Africa was much less diverse. About half of the primers in the database of Schistosoma haematobium microsatellite DNA loci should yield amplifiable and easily scored polymorphic markers, thus providing thousands of potential markers. Sequence conservation among S. haematobium, S. japonicum, and S. mansoni is relatively high, thus it should now be possible to identify markers that are universal among Schistosoma species (i.e., using DNA sequences conserved among species), as well as other markers that are specific to species or species-groups (i.e., using DNA sequences that differ among species). Full genome-sequencing of additional species and specimens of S. haematobium, S. japonicum, and S. mansoni is desirable to better characterize differences within and among these species, to develop additional genetic markers, and to examine genes as well as conserved non-coding elements associated with drug resistance.


When is the Fukui Function Not Normalized? The Danger of Inconsistent Energy Interpolation Models in Density Functional Theory.
When one defines the energy of a molecule with a noninteger number of electrons by interpolation of the energy values for integer-charged states, the interpolated electron density, Fukui function, and higher-order derivatives of the density are generally not normalized correctly. The necessary and sufficient condition for consistent energy interpolation models is that the corresponding interpolated electron density is correctly normalized to the number of electrons. A necessary, but not sufficient, condition for correct normalization is that the energy interpolant be a linear function of the reference energies. Consistent with this general rule, polynomial interpolation models and, in particular, the quadratic E vs N model popularized by Parr and Pearson, do give normalized densities and density derivatives. Interestingly, an interpolation model based on the square root of the electron number also satisfies the normalization constraints. We also derive consistent least-norm interpolation models. In contrast to these models, the popular rational and exponential forms for E vs N do not give normalized electron densities and density derivatives.


Costs of migratory decisions: A comparison across eight white stork populations.
Annual migratory movements can range from a few tens to thousands of kilometers, creating unique energetic requirements for each specific species and journey. Even within the same species, migration costs can vary largely because of flexible, opportunistic life history strategies. We uncover the large extent of variation in the lifetime migratory decisions of young white storks originating from eight populations. Not only did juvenile storks differ in their geographically distinct wintering locations, their diverse migration patterns also affected the amount of energy individuals invested for locomotion during the first months of their life. Overwintering in areas with higher human population reduced the stork's overall energy expenditure because of shorter daily foraging trips, closer wintering grounds, or a complete suppression of migration. Because migrants can change ecological processes in several distinct communities simultaneously, understanding their life history decisions helps not only to protect migratory species but also to conserve stable ecosystems.


Defining the sources of low-flow phosphorus transfers in complex catchments.
Nutrient transfers from the land to rivers have the potential to cause persistent eutrophic impacts at low flows even though the transfers may constitute a minor percentage of total annual fluxes. In rural catchments, the contribution from agricultural soils during storm events can be particularly large and untangling the relative contributions from multiple sources that vary in time and space is especially problematic. In this study, the potential for domestic septic tank system pollution during low flows was investigated in 3 small catchments (3 to 5 km(2)) using an integrated series of methods. These included septic system surveys, continuous (10 min) total phosphorus (TP) monitoring at the outlet of each catchment, repeated low-flow water quality surveys in sub-catchments upstream of the catchment outlets and single day river-walk water quality surveys. A series of faecal matter and grey-water fingerprinting techniques were also employed. These included determining sterol ratios in stream sediments, monitoring the presence of proteins, E. coli and enterococci bacterial signatures and boron. The total density and density of poorly maintained septic systems mirrored the magnitude of frequent TP concentrations in the catchments although this relationship was less apparent in the nested sub-catchments. The exception was possibly related to the simple hydraulics in one particular catchment and indicated temporary effluent attenuation in the other catchments. Repeated low-flow and river-walk water quality surveys highlighted discrete areas and reaches where stepped changes in nutrient concentration occurred. Bio-chemical fingerprinting showed that between 7% and 27% of sediments were contaminated with human faecal material and correlation matrices indicated that, at least during low flows, P fractions were positively correlated with some markers of faecal and grey-water contamination.


Antagonistic effects of dexamethasone and retinoic acid on rat lung morphogenesis.
We have reported that dexamethasone (DEX) treatment of early embryonic rat lungs in culture induced features of both distorted and accelerated maturation. In this report, we investigated the effects of retinoids on normal and DEX-induced lung development in vitro. Lung maturation was assessed by examining the morphology and the expression of genes related to epithelial differentiation (surfactant proteins, SP-A, SP-B and SP-C and Clara cell protein, CC10) and growth [keratinocyte growth factor (KGF) and hepatocyte growth factor (HGF)]. We cultured d 14 and 15 fetal rat lungs in the presence of DEX (1-1000 nM) and/or all-trans-retinoic acid (RA) (10(-7)-10(-5) M) for 4 d. RA at 10(-6) and 10(-5) M inhibited branching and dilated the distal tubules, and at 10(-5) M caused dilatation of the proximal tubules destined to form the trachea and the main bronchi. The adverse effects of DEX, such as distorted branching, tubular dilatation, and suppression of both lung growth and epithelial cell proliferation, were all prevented by RA. In addition, RA inhibited several features of DEX-induced accelerated maturation, such as: 1) the increased levels of SP-A, SP-B, and CC10 mRNAs; 2) the attenuation of mesenchymal tissue; and 3) the mature distribution of cells expressing SP-C mRNA. In contrast, RA potentiated the increase of KGF and decrease of HGF transcripts induced by DEX. In conclusion, the study shows antagonism by RA of DEX-induced effects on lung morphology and gene expression. We postulate that normal lung development requires a balanced action of endogenous retinoids and glucocorticoids.


Clinical evaluation of different posterior resin composite materials: a 7-year report.
The aim of this study was to investigate the clinical performance of 120 posterior composite restorations placed in 38 patients after a period of 7 years. Eighty-eight Class I and 32 Class II restorations were made (93 molars and 27 premolars) using three different resin composite materials: Z100, Clearfil Ray-Posterior, and Prisma TPH. The restorations were evaluated using Ryge's criteria for color match, marginal discoloration, marginal adaptation, secondary caries, surface texture, and anatomic form at baseline, 1,2, 5, and 7 years. Photographs and radiographs were taken at each recall period. At 7-year recalls, 70 restorations were available for examination. Four restorations had failed due to secondary caries. Saliva sampling was performed to determine the level of mutans streptococci and lactobacilli for the four failed restorations at the last recall. No statistically significant differences were found among the materials in regard to color match, anatomic form, and secondary caries. Clearfil Ray-Posterior had statistically significantly rougher surface texture than the surrounding enamel compared to the other resin composites. Z100 showed more cavosurface margin discoloration after 5 years than the other two resin composites. All materials had slight marginal adaptation problems at the 7-year recall. There was no apparent relationship between the levels of mutans streptococci and lactobacilli in saliva and the failed restorations. The three posterior composites tested had acceptable clinical performance after 7 years.


GanedenBC30 cell wall and metabolites: anti-inflammatory and immune modulating effects in vitro.
This study was performed to evaluate anti-inflammatory and immune modulating properties of the probiotic, spore-forming bacterial strain: Bacillus coagulans: GBI-30, (PTA-6086, GanedenBC30TM). In addition, cell wall and metabolite fractions were assayed separately to address whether biological effects were due to cell wall components only, or whether secreted compounds from live bacteria had additional biological properties. The spores were heat-activated, and bacterial cultures were grown. The culture supernatant was harvested as a source of metabolites (MTB), and the bacteria were used to isolate cell wall fragments (CW). Both of these fractions were compared in a series of in vitro assays. Both MTB and CW inhibited spontaneous and oxidative stress-induced ROS formation in human PMN cells and increased the phagocytic activity of PMN cells in response to bacteria-like carboxylated fluorospheres. Both fractions supported random PMN and f-MLP-directed PMN cell migration, indicating a support of immune surveillance and antibacterial defense mechanisms. In contrast, low doses of both fractions inhibited PMN cell migration towards the inflammatory mediators IL-8 and LTB4. The anti-inflammatory activity was strongest for CW, where the PMN migration towards IL-8 was inhibited down to dilutions of 1010.Both MTB and CW induced the expression of the CD69 activation marker on human CD3- CD56+ NK cells, and enhanced the expression of CD107a when exposed to K562 tumor cells in vitro.The fractions directly modulated cytokine production, inducing production of the Th2 cytokines IL-4, IL-6, and IL-10, and inhibiting production of IL-2.Both fractions further modulated mitogen-induced cytokine production in the following manner: Both fractions enhanced the PHA-induced production of IL-6 and reduced the PHA-induced production of TNF-alpha. Both fractions enhanced the PWM-induced production of TNF-alpha and IFN-gamma. In addition, MTB also enhanced both the PHA- and the PWM-induced expression of IL-10. The data suggest that consumption of GanedenBC30TM may introduce both cell wall components and metabolites that modulate inflammatory processes in the gut. Both the cell wall and the supernatant possess strong immune modulating properties in vitro. The anti-inflammatory effects, combined with direct induction of IL-10, are of interest with respect to possible treatment of inflammatory bowel diseases as well as in support of a healthy immune system.


Passive Q switching of a solar-pumped Nd:YAG laser.
Passive Q switching is a preferable choice for switching the Q factor of a solar-pumped laser because it requires neither a driver nor an electrical power supply. The superior thermal characteristics and durability of Cr(4+):YAG single crystals as passive Q switches for lamp and diode-pumped high-power lasers has been demonstrated. Here we report on an average power of 37 W and a switching efficiency of 80% obtained by use of a solar-pumped Nd:YAG laser Q switched by a Cr(4+):YAG saturable absorber. Concentration of the pumping solar energy on the laser crystal was obtained with a three-stage concentrator, composed of 12 heliostats, a three-dimensional compound parabolic concentrator (CPC) and a two-dimensional CPC. The water-cooled passive Q switch also served as the laser rear mirror. Repetition rates of as much as 50 kHz, at pulse durations between 190 and 310 ns (FWHM) were achieved. From the experimental results, the saturated single-pass power absorption of the Cr(4+):YAG device was estimated as 3 ? 1%.


APC2 Cullin protein and APC11 RING protein comprise the minimal ubiquitin ligase module of the anaphase-promoting complex.
In mitosis, the anaphase-promoting complex (APC) regulates the onset of sister-chromatid separation and exit from mitosis by mediating the ubiquitination and degradation of the securin protein and mitotic cyclins. With the use of a baculoviral expression system, we have reconstituted the ubiquitin ligase activity of human APC. In combination with Ubc4 or UbcH10, a heterodimeric complex of APC2 and APC11 is sufficient to catalyze the ubiquitination of human securin and cyclin B1. However, the minimal APC2/11 ubiquitin ligase module does not possess substrate specificity, because it also ubiquitinates the destruction box deletion mutants of securin and cyclin B1. Both APC11 and UbcH10 bind to the C-terminal cullin homology domain of APC2, whereas Ubc4 interacts with APC11 directly. Zn(2+)-binding and mutagenesis experiments indicate that APC11 binds Zn(2+) at a 1:3 M ratio. Unlike the two Zn(2+) ions of the canonical RING-finger motif, the third Zn(2+) ion of APC11 is not essential for its ligase activity. Surprisingly, with Ubc4 as the E2 enzyme, Zn(2+) ions alone are sufficient to catalyze the ubiquitination of cyclin B1. Therefore, the Zn(2+) ions of the RING finger family of ubiquitin ligases may be directly involved in catalysis.


Hormone and fertility drug use and the risk of neuroblastoma: a report from the Children's Cancer Group and the Pediatric Oncology Group.
Previous epidemiologic studies have suggested an association between maternal sex hormone use during pregnancy, including infertility medication, and an increased risk of neuroblastoma in the offspring. The authors conducted a case-control interview study from 1992 to 1996 that included 504 children less than 19 years of age whose newly diagnosed neuroblastoma was identified by two national collaborative clinical trials groups in the United States and Canada, the Children's Cancer Group and the Pediatric Oncology Group. Controls, matched to cases on age, were identified by random digit dialing. No association was found for use of oral contraceptives before or during pregnancy (first trimester odds ratio (OR) = 1.0, 95% confidence interval (CI): 0.5, 2.1). The odds ratio was slightly elevated for history of infertility (OR = 1.4, 95% CI: 0.9, 2.1) and ever use of any infertility medication (OR = 1.2, 95% CI: 0.7, 2.2). Specifically, ever use of clomiphene was associated with a 1.6-fold increased risk (95% CI: 0.8, 3.0) but not periconceptionally or during the index pregnancy. A suggestive pattern was found for gender of the offspring, with an increased risk for males but not for females after exposure to oral contraceptives or clomiphene. This study did not find consistent and large increased risks for maternal use of hormones, but the suggestion of an association for male offspring requires further consideration.


Challenges in managing paediatric osteomyelitis in the developing world: analysis of cases presenting to a tertiary referral centre in Tanzania.
The literature on paediatric osteomyelitis in the developing world is scarce, and there have been calls for further characterisation of its epidemiology and the identification of factors that limit effective management in order to guide local service delivery. Our centre is a hospital serving a population of 11 million people in Tanzania. We identified patients <18 years admitted between 1 st January 2008 and 31 st December 2010 with a diagnosis of osteomyelitis through a search of admission logbooks. Patient notes were reviewed for information regarding the nature of the presentation, treatment given and outcome, with the primary outcome measure being recurrence of infection at follow-up. A total of 63 patients were identified, notes available for 55: 40 males and 15 females, mean age of 11 years. The most common sites were the tibia and femur with other sites including the skull, humerus and foot. At presentation, 8 cases were categorised as acute, 5 as acute with X-ray changes, 40 as chronic localised and 2 as chronic systemic.A total of 11 patients were treated with antibiotics only, 11 with incision and drainage and 30 with surgical debridement. Bacterial cultures were available in 11 cases. all Staphylococcus aureus tested were gentamicin-sensitive, but at least one patient had S. aureus resistant to cloxacillin, erythromycin, co-trimoxazole, tetracycline or a combination of these. Of 29 patients attending follow-up, 20 made a full recovery and 9 developed recurrence of infection. Eight out of nine with recurrence had time from symptom onset to presentation of >3 months. Twelve out of 13 with a time from symptom onset to presentation of <2 months did not develop recurrence. This is, to the best of our knowledge, the second largest study of paediatric osteomyelitis in the developing world. Major challenges facing this centre include a lack of availability of bacterial cultures and failure to attend follow-up. Delayed presentation of osteomyelitis to our centre is associated with recurrence of infection.


Smoking and Preterm Birth.
Premature birth is a significant global problem and the leading cause of newborn deaths. Tobacco smoking has been associated with premature birth for over 50 years. The mechanisms through which smoking exerts its effects on pregnancy outcomes remain unclear. In this review, we discuss rates of prematurity and smoking in pregnancy, the evidence of a causal relationship between tobacco and preterm birth, and proposed biochemical pathways through which the interaction is mediated. The suggested mechanisms include nicotine-induced vasoconstriction, carbon monoxide-induced fetal hypoxia, cadmium disruption of calcium signaling, altered steroid hormone production, disruption of prostaglandin synthesis, and changed responses to oxytocin. The relative importance of each of these pathways is yet to be ascertained. Further research is necessary to explore the mechanisms through which smoking exerts its effect on gestational length and the process of parturition. Moreover, the risks of nicotine replacement in pregnancy should be investigated further.


Perioperative complications and neurological outcomes of first and second craniotomies among patients enrolled in the Glioma Outcome Project.
In many new clinical trials of patients with malignant gliomas surgical intervention is incorporated as an integral part of tumor-directed interstitial therapies such as gene therapy, biodegradable wafer placement, and immunotherapy. Assessment of toxicity is a major component of evaluating these novel therapeutic interventions, but this must be done in light of known complication rates of craniotomy for tumor resection. Factors predicting neurological outcome would also be helpful for patient selection for surgically based clinical trials. The Glioma Outcome Project is a prospectively compiled database containing information on 788 patients with malignant gliomas that captured clinical practice patterns and patient outcomes. Patients in this series who underwent their first or second craniotomy were analyzed separately for presenting symptoms, tumor and patient characteristics, and perioperative complications. Preoperative and intraoperative factors possibly related to neurological outcome were evaluated. There were 408 patients who underwent first craniotomies (C1 group) and 91 patients who underwent second ones (C2 group). Both groups had similar patient and tumor characteristics except for their median age (55 years in the C1 group compared with 50 years in the C2 group; p = 0.006). Headache was more common at presentation in the C1 group, whereas papilledema and an altered level of consciousness were more common at presentation in patients undergoing second surgeries. Perioperative complications occurred in 24% of patients in the C1 group and 33% of patients in the C2 group (p = 0.1). Most patients were the same or better neurologically after surgery, but more patients in the C2 group (18%) displayed a worsened neurological status than those in the C1 group (8%; p = 0.007). The Karnofsky Performance Scale score and, in patients in the C2 group, tumor size were important neurological outcome predictors. Regional complications occurred at similar rates in both groups. Systemic infections occurred more frequently in the C2 group (4.4 compared with 0%; p < 0.0001) as did depression (20 compared with 11%; p = 0.02). The perioperative mortality rate was 1.5% for the C1 group and 2.2% for the C2 group (p = not significant). The median length of the hospital stay was 4 days in each group. Perioperative complications occur slightly more often following a second craniotomy for malignant glioma than after the first craniotomy. This should be considered when evaluating toxicities from intraoperative local therapies requiring craniotomy. Nevertheless, most patients are neurologically stable or improved after either their first or second craniotomy. This data set may serve as a benchmark for neurosurgeons and others in a discussion of operative risks in patients with malignant gliomas.


Alport syndrome: significance of gingival biopsy in the initial diagnosis and periodontal evaluation after renal transplantation.
Alport Syndrome (AS) is an important hereditary disorder affecting the glomerular basement membrane. Diagnosis of AS is based on the presence of hematuric nephropathy, renal failure, hearing loss, ocular abnormalities and changes in the glomerular basement membrane of the lamina densa. The aims of this case report were to show the changes in the gingival tissues in a patient with AS under therapy with cyclosporin-A after renal transplantation and to discuss the possible role of type IV collagen in gingival basal lamina as an alternative approach for the diagnosis of AS. A 20-year-old male patient with AS underwent periodontal therapy including a series of gingivectomy surgeries. Gingival samples obtained during the second surgery were examined histopathologically and by transmission electron microscopy for further pathological examination. Gingivectomy procedures have been performed every 6 months over the last 4 years. The excessive and fibrous gingival enlargements resulted in migration of the anterior teeth, but no alveolar bone loss occurred. This is the first report to demonstrate the possible changes in the gingival tissues caused by AS. It is suggested that gingival biopsy can be an initial diagnostic tool instead of renal or skin biopsies. Proper dental and periodontal care and regular visits to the dentist could provide limited gingival hyperplasia to patients with AS.


Reversible inhibitors of penicillinases.
Reversible competitive inhibitors of a penicillinase, beta-lactamase 1 from Bacillus cereus, were studied. These represent the first inhibitors of a penicillinase that lack the beta-lactam ring. The products of the enzymic reaction, namely penicilloic acids, are inhibitors; their decarboxylation products, the penilloic acids, are also inhibitors, and have somewhat lower Ki values. Inhibitors have been prepared from benzylpenicillin, phenoxymethyl-penicillin, methicillin (2,6-dimethoxybenzamidopenicillanic acid) and 3-hydroxy-4-nitrobenzamidopenicillanic acid. Decarboxylation of the penicilloic acids from benzyl-penicillin, or from phenoxymethylpenicillin, leads to epimerization (at C-5) of the penilloic acid. Nuclear-magnetic resonance spectroscopy at a frequency of 270 MHz can distinguish the epimers. Other competitive inhibitors studied were boric acid, benzene boronic acid and m-aminobenzeneboronic acid. Boric acid itself was the best inhibitor of beta-lactamase I so far found.


"Surviving out of the Ashes" - An exploration of young adult service users' perspectives of mental health recovery.
WHAT IS KNOWN ON THE SUBJECT?: The conceptual components of mental health recovery have been proposed, however, the barriers to their sustainability within the context of internal and external stressors require further exploration. Within their emerging adult role, young people will experience the personal challenges that will directly impact their understanding of their recovery, which will be different from other age groups. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Findings revealed recovery is understood as an uncharted, timely and personal process of engaging and transcending pain. Perceived barriers to mental health recovery and the internal dynamics experienced within the process have been explored. Recovery in young adulthood involved the reclaiming of their active and purposeful life force. It acquires real-life relevance when applied to the social and cultural factors that provide meaning in life for young adults. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: This research will impact how mental health nurses understand the catalytic effects of personal, social and cultural meaning of suffering in young adults' actualization of mental health recovery. Findings have significance for practice as the process of mental health recovery must not be presented as a clinical pathway, but understood as a personalized strategy of individual wellness in young adulthood. INTRODUCTION: Within their emerging adult role, young people will embark on employment, form intimate relationships and live independently. This indicates that how recovery is experienced and actualized in young adulthood may be different from other age groups. To explore young adult service user's perspectives of mental health recovery in Northern Ireland. Semi-structured individual qualitative interviews were analysed using a Gadamerian-based hermeneutic method and interpreted using a novel theoretical framework. The sample comprised 25 participants with an average age of 28 years. Five key themes evolved: Services: A Losing Battle Straight Away; From your Foundations to a Step in the Dark; Let Go of the Pain not the Experience; Surviving Out of the Ashes Recovery; and Needs to be More than a Word. The main findings were that recovery involved the reclaiming of their active and purposeful life force. It is suggested that young adults have developed an explanatory model of "use that stuff you wanna bury" to transform an illness narrative to a wellness strategy. This research has implications for mental health nursing so the process of mental health recovery is not presented as a clinical pathway, but a personalized strategy of individual wellness.


Experiences with online consultation systems in primary care: case study of one early adopter site.
There is a strong policy drive towards implementing alternatives to face-to-face consultations in general practice to improve access, efficiency, and cost-effectiveness. These alternatives embrace novel technologies that are assumed to offer potential to improve care. To explore the introduction of one online consultation system (Tele-Doc) and how it shapes working practices. Mixed methods case study in an inner-city general practice. The study was conducted through interviews with IT developers, clinicians, and administrative staff, and scrutiny of documents, websites, and demonstrator versions of Tele-Doc, followed by thematic analysis and discourse analysis. Three interrelated themes were identified: online consultation systems as innovation, managing the 'messiness' of general practice consultations, and redistribution of the work of general practice. These themes raise timely questions about what it means to consult in contemporary general practice. Uptake of Tele-Doc by patients was low. Much of the work of the consultation was redistributed to patients and administrators, sometimes causing misunderstandings. The 'messiness' of consultations was hard to eliminate. In-house training focused on the technical application rather than associated transformations to practice work that were not anticipated. GPs welcomed varied modes of consulting, but the aspiration of improved efficiency was not realised in practice. Tele-Doc offers a new kind of consultation that is still being worked out in practice. It may offer convenience for patients with discrete, single problems, and a welcome variation to GPs' workload. Tele-Doc's potential for addressing more complex problems and achieving efficiency is less clear, and its adoption may involve unforeseeable consequences.


Single potassium channels blocked by lidocaine and quinidine in isolated turtle colon epithelial cells.
The patch-clamp technique for recording single-channel currents across cell membranes was applied to single turtle colon epithelial cells isolated with hyaluronidase. With electrodes fabricated from Corning #7052 glass, high-resistance seals were consistently formed to these cells. In on-cell patches with low K (2.5 mM) in the pipette and high K (114.5 mM) in the bath, outward K currents were recorded that had a slope conductance of 17 pS and a reversal potential greater than -70 mV. Currents through this K channel were blocked by lidocaine, quinidine, and barium. These agents also block a cell swelling-induced K conductance identified by macroscopic current measurements in the basolateral membranes of the intact colonic epithelium, suggesting that the 17 pS K channel identified by single-channel recording in isolated turtle colon cells may be responsible for this macroscopically defined K conductance.


Monitoring Wellness, Training Load, and Running Performance During a Major International Female Field Hockey Tournament.
McGuinness, McMahon, G, A, Malone, S, Kenna, D, Passmore, D, and Collins, K. Monitoring wellness, training load, and running performance during a major international female field hockey tournament. J Strength Cond Res 34(8): 2312-2320, 2020-The current observational study quantified players' activity profiles during a major international female field hockey tournament and determined whether an association exists between well-being measures and running performance within elite female hockey players. Elite female field hockey players (23 ± 3 years; 162.6 ± 13 cm; and 66 ± 6 kg) participated in the study. Participants running performance was monitored using global positioning system technology (S5; Catapult Innovations, Scoresby, Victoria, Australia), with daily well-being questionnaires used to quantify player responses during the tournament. Thresholds for the magnitude of the observed change for each variable were determined using the Hopkins Spreadsheets for analysis of controlled trials. Relative distance (m·min) was likely lower when compared with game 1 in game 7. Relative high speed (m·min >16 km·h) was likely lower in games 5, 6, and 7 when compared with game 1. Subjective load was very likely higher in game 2 and very likely lower in game 3 when compared with game 1. Mood and sleep quality were likely lower in game 1 when compared with game 4 and game 7. Muscle soreness was likely higher when compared with game 1 in game 7. During the tournament, it was observed that a decrease in players' daily well-being was accompanied by changes in running performance. Furthermore, changes to players' muscle soreness and sleep quality result in decreased players' high-speed running performance during match-play. Therefore, to prevent the observed effects, coaches should adopt strategies to enhance sleep quality and incorporate specific recovery modalities to reduce musculoskeletal soreness.


Comparing the epidemiology, clinical characteristics and prognostic factors of acute myeloid leukemia with and without acute promyelocytic leukemia.
Acute promyelocytic leukemia (APL) is a particularly aggressive subtype of acute myeloid leukemia (AML), with high rates of early death. It is important to examine how epidemiological characteristics, clinical and treatment factors, cytogenetic and genetic data affect survival and differ between APL and non-APL AML patients. We analyzed population data from the New York State Cancer Registry to characterize AML including APL incidence rates by demographics. APL incidence rates were higher among Hispanics than non-Hispanics [incidence rate ratio = 1.22; 95% confidence interval (CI) = 1.02-1.43]; and among foreign-born than USA-born persons. APL incidence rates increased more rapidly through 1995-2014 than non-APL AML; and its frequency increased faster among foreign-born persons. In a hospital cohort of 390 AML patients, the risk of death was significantly higher among APL patients with FLT3-internal tandem duplications than those without [hazard ratio (HR) = 11.74; 95% CI = 1.03-134.5]; and among APL patients with secondary versus de novo disease (HR = 17.32; 95% CI = 1.56-192.1). Among non-APL AML patients, risk of death was significantly associated with prior chemotherapy with antitubulin agents after adjusting for age, gender and ethnicity (adjusted HR = 3.30; 95% CI = 1.49-7.32); and separately with older age, unfavorable cytogenetics and complex karyotype. This study highlights FLT3-internal tandem duplications as a prognostic factor in APL and proposes consideration of prior antitubulin therapy as a prognostic factor in non-APL AML.


Issues in estimating the cost of innovative mental health programs.
This paper reviews problems encountered in estimating the unit cost of services provided by innovative mental health programs and illustrates methods for addressing these problems. Generally, the cost of a health care service is determined by identifying all resources used in its production and the cost of those resources. These costs are divided by appropriate workload measures to determine the cost per unit of service or per client. Issues that must be addressed include: 1) direct program costs; 2) indirect costs (including administration and capital costs); 3) program resources used to support research and other non-program activities; and 4) identification of "typical" workloads as the program is implemented. Application of these methods is illustrated with data from a multi-site study of intensive psychiatric community care conducted at nine Department of Veterans Affairs Medical Centers in the Northeast. A sensitivity analysis revealed that estimates of program costs vary by 59% over the entire program, and from 17%-168% at individual sites, depending on which cost estimation methods were included. The average cost of case management in this program varied considerably across sites, primarily reflecting differences in caseload size and staffing levels. Adjusting for inflation, the cost of this program falls below the cost of other published intensive community programs.


Syndesmotic ankle sprains in athletes.
Ankle sprains are among the most common athletic injuries and represent a significant source of persistent pain and disability. Despite the high incidence of ankle sprains in athletes, syndesmosis injuries have historically been underdiagnosed, and assessment in terms of severity and optimal treatment has not been determined. More recently, a heightened awareness in sports medicine has resulted in more frequent diagnoses of syndesmosis injuries. However, there is a low level of evidence and a paucity of literature on this topic compared with lateral ankle sprains. As a result, no clear guidelines are available to help the clinician assess the severity of injury, choose an imaging modality to visualize the injury, make a decision in terms of operative versus nonoperative treatment, or decide when the athlete may return to play. Increased knowledge and understanding of these injuries by clinicians and researchers are essential to improve the prevention, diagnosis, and treatment of this significant condition. This review will discuss the anatomy, mechanism of injury, diagnosis, and treatment of syndesmosis sprains of the ankle while identifying controversies in management and topics for future research.


Approaches to diagnostic magnetic resonance carotid angiography.
MR angiography (MRA) by the time-of-flight technique has been very successful in the carotid arteries as a result of relatively rapid flow velocities and the availability of high sensitivity neck coils. Two-dimensional or three-dimensional acquisition through the carotid bifurcation is an effective screening technique whose accuracy is very competitive with Doppler ultrasound and whose anatomic detail rivals that of conventional contrast angiography. As methods are perfected for visualizing the entire carotid from the aortic arch to the circle of Willis, MRA will replace contrast angiography for many diagnostic applications.


Global Foot-and-Mouth Disease Research Update and Gap Analysis: 7 - Pathogenesis and Molecular Biology.
We assessed research knowledge gaps in the fields of FMDV (foot-and-mouth disease virus) pathogenesis and molecular biology by performing a literature review (2011-15) and collecting research updates (2014) from 33 institutes from across the world. Findings were used to identify priority areas for future research. There have been important advances in FMDV pathogenesis; FMDV remains in lymph nodes of many recovered animals that otherwise do not appear persistently infected, even in species previously not associated with the carrier state. Whether virus retention helps maintain host immunity and/or virus survival is not known. Studies of FMDV pathogenesis in wildlife have provided insights into disease epidemiology, in endemic and epidemic settings. Many aspects of FMDV infection and virus entry remain unknown; however, at the cellular level, we know that expression level and availability of integrins (that permit viral entry), rate of clearance of infected cells and strength of anti-viral type I IFN (interferon) response are key determinants of tissue tropism. Extending findings to improved understanding of transmission requires a standardized approach and adoption of natural routes of infection during experimental study. There has been recognition of the importance of autophagosomes for FMDV entry into the cytoplasm following cell surface receptor binding, and that distinct internal cellular membranes are exploited for viral replication and immune evasion. New roles for viral proteins in blocking type I IFN production and downstream signalling have been identified facilitating research in anti-viral therapeutics. We know more about how infection affects cell protein expression, and research into molecular determinants of capsid stability has aided the development of stable vaccines. We have an expanding knowledge of viral and host molecular determinates of virulence and infectiousness, and of how phylogenetics may be used to estimate vaccine match and strain distribution. With ongoing advances, these areas could translate into significantly improved disease control.


Tart cherry anthocyanins suppress inflammation-induced pain behavior in rat.
The use of complementary and alternative medicine (CAM) has increased in the United States and more patients are seeking CAM therapies for control of pain. The present investigation tested the efficacy of orally administered anthocyanins extracted from tart cherries on inflammation-induced pain behavior in rats. Paw withdrawal latency to radiant heat and paw withdrawal threshold to von Frey probes were measured. The first set of experiments examined the effects of tart cherry anthocyanins (400 mg/kg) on the nociceptive behaviors and edema associated with inflammation induced by intraplantar injection of 1% carrageenan. These studies also included tests of motor coordination. The second set of experiments determined if tart cherry anthocyanins (15, 85, and 400 mg/kg) dose-dependently affected the inflammation induced by intraplantar injection of 25% complete Freund's adjuvant. We found that tart cherry extracts reduce inflammation-induced thermal hyperalgesia, mechanical hyperalgesia and paw edema. The suppression of thermal hyperalgesia was dose-dependent and the efficacy of highest dose (400 mg/kg) was similar to indomethacin (5 mg/kg). The highest dose anthocyanin (400 mg/kg) had no effects on motor function. These data suggest that tart cherry anthocyanins may have a beneficial role in the treatment of inflammatory pain. The antihyperalgesic effects may be related to the anti-inflammatory and antioxidant properties of anthocyanins. A better understanding of the modulatory role of dietary constituents and phytonutrients on pain will offer further therapeutic options for treating patients with persistent and chronic pain conditions.


Ebola epidemic of 2014-2015: unresolved ethical issues.
Some ethical aspects of the management of the Ebola epidemic in Guinea, Liberia and Sierra Leone which started in January 2014, have been questionable. First, as regards the prevention of the spread of the virus, the necessary epidemiological investigations on the origin of the infection were not carried out adequately and this did not help to curb the spread of the disease. A disparity has been observed between the western and African countries' access to the treatment of patients; this infringes on the principle of equality. This paper also focuses on how the Global Public Goods for Health principle was not fully respected in the management of the epidemic.


One mutation, two distinct disease variants: unravelling the impact of transthyretin amyloid fibril composition.
Although hereditary transthyretin (h-ATTR) amyloidosis is a monogenetic disease, a large variation in its phenotype has been observed. The common hypothesis of amyloid fibril formation involves dissociation of the transthyretin (TTR) tetramer into monomers that after misfolding reassemble into amyloid fibrils. This notion is partly challenged by the finding of two distinct types of amyloid fibrils. One of these, type A, consists of C-terminal ATTR fragments and full-length TTR, whereas the other, type B, consists only of full-length TTR. All organs of an individual patient contain ATTR deposits of either type A or type B fibrils, and the composition in each individual remains unchanged over time. The finding of two distinct types of ATTR fibrils suggests that there are at least two different pathways in operation for ATTR fibril formation. For the most common European mutation, TTR Val30Met, ATTR fibril composition is related to the outcome of liver transplantation, which is the first successful treatment for the disease, and the penetrance of the trait. In addition, the presence of C-terminal ATTR fragments has an impact on the affinity for various tracers used for noninvasive imaging of amyloid depositions such as 99 m-technetium-diphosphono-propanodicarboxylic acid scintigraphy and positron emission tomography utilizing Pittsburgh component B, and even for the gold standard diagnostic procedure, tissue biopsy stained by Congo red and examined under polarized light. The importance of amyloid fibril composition needs to be taken into consideration when designing clinical trials of treatment modalities, and also in the evaluation of diagnostic methods such as imaging techniques.


Exploiting the unusual effects of fluorine in methodology.
Fluorination of organic molecules significantly impacts the basic physicochemical properties of small and large biologically active molecules, agrichemicals, and materials. Thus, the development of synthetic reactions to access these substructures is important for many applied fields of chemistry. However, these fluorine-induced perturbations of chemical properties can inhibit standard chemical transformations, which provides unique challenges for synthetic organic chemists. In addition, the physicochemical properties imparted by fluorinated substituents can enable distinct reactivity patterns relative to non-fluorinated substrates, thus making synthetic organofluorine chemistry a fertile ground for developing new, exciting transformations. In this feature article, we detail our experiences in methodology, wherein fluorinated substrates have enabled unique reactivity patterns relative to non-fluorous substrates. Specifically, we highlight the non-standard chemo- and regio-selectivities imparted by fluorinated substrates on Pd-catalyzed coupling reactions, nucleophilic addition reactions of olefins, and Cu-catalyzed decarboxylative fluoroalkylation reactions.


Does sleep really influence face recognition memory?
Mounting evidence implicates sleep in the consolidation of various kinds of memories. We investigated the effect of sleep on memory for face identity, a declarative form of memory that is indispensable for nearly all social interaction. In the acquisition phase, observers viewed faces that they were required to remember over a variable retention period (0-36 hours). In the test phase, observers viewed intermixed old and new faces and judged seeing each before. Participants were classified according to acquisition and test times into seven groups. Memory strength (d') and response bias (c) were evaluated. Substantial time spent awake (12 hours or more) during the retention period impaired face recognition memory evaluated at test, whereas sleep per se during the retention period did little to enhance the memory. Wakefulness during retention also led to a tightening of the decision criterion. Our findings suggest that sleep passively and transiently shelters face recognition memory from waking interference (exposure) but does not actively aid in its long-term consolidation.


Open Source Brain: A Collaborative Resource for Visualizing, Analyzing, Simulating, and Developing Standardized Models of Neurons and Circuits.
Computational models are powerful tools for exploring the properties of complex biological systems. In neuroscience, data-driven models of neural circuits that span multiple scales are increasingly being used to understand brain function in health and disease. But their adoption and reuse has been limited by the specialist knowledge required to evaluate and use them. To address this, we have developed Open Source Brain, a platform for sharing, viewing, analyzing, and simulating standardized models from different brain regions and species. Model structure and parameters can be automatically visualized and their dynamical properties explored through browser-based simulations. Infrastructure and tools for collaborative interaction, development, and testing are also provided. We demonstrate how existing components can be reused by constructing new models of inhibition-stabilized cortical networks that match recent experimental results. These features of Open Source Brain improve the accessibility, transparency, and reproducibility of models and facilitate their reuse by the wider community.


Lung Cancer Surveillance After Definitive Curative-Intent Therapy: ASCO Guideline.
To provide evidence-based recommendations to practicing clinicians on radiographic imaging and biomarker surveillance strategies after definitive curative-intent therapy in patients with stage I-III non-small-cell lung cancer (NSCLC) and SCLC. ASCO convened an Expert Panel of medical oncology, thoracic surgery, radiation oncology, pulmonary, radiology, primary care, and advocacy experts to conduct a literature search, which included systematic reviews, meta-analyses, randomized controlled trials, and prospective and retrospective comparative observational studies published from 2000 through 2019. Outcomes of interest included survival, disease-free or recurrence-free survival, and quality of life. Expert Panel members used available evidence and informal consensus to develop evidence-based guideline recommendations. The literature search identified 14 relevant studies to inform the evidence base for this guideline. Patients should undergo surveillance imaging for recurrence every 6 months for 2 years and then annually for detection of new primary lung cancers. Chest computed tomography imaging is the optimal imaging modality for surveillance. Fluorodeoxyglucose positron emission tomography/computed tomography imaging should not be used as a surveillance tool. Surveillance imaging may not be offered to patients who are clinically unsuitable for or unwilling to accept further treatment. Age should not preclude surveillance imaging. Circulating biomarkers should not be used as a surveillance strategy for detection of recurrence. Brain magnetic resonance imaging should not be used for routine surveillance in stage I-III NSCLC but may be used every 3 months for the first year and every 6 months for the second year in patients with stage I-III small-cell lung cancer who have undergone curative-intent treatment.


MiR-27b augments bone marrow progenitor cell survival via suppressing the mitochondrial apoptotic pathway in Type 2 diabetes.
Bone marrow-derived progenitor cells (BMPCs) are potential candidates for autologous cell therapy in tissue repair and regeneration because of their high angiogenic potential. However, increased progenitor cell apoptosis in diabetes directly limits their success in the clinic. MicroRNAs are endogenous noncoding RNAs that regulate gene expression at the posttranscriptional level, but their roles in BMPC-mediated angiogenesis are incompletely understood. In the present study, we tested the hypothesis that the proangiogenic miR-27b inhibits BMPC apoptosis in Type 2 diabetes. Bone marrow-derived EPCs from adult male Type 2 diabetic db/db mice and their normal littermates db/+ mice were used. MiR-27b expression (real-time PCR) in EPCs was decreased after 24 h of exposure to methylglyoxal (MGO) or oxidized low-density lipoprotein but not high glucose, advanced glycation end products, the reactive oxygen species generator LY83583, or H2O2 The increase in BMPC apoptosis in the diabetic mice was rescued following transfection with a miR-27b mimic, and the increased apoptosis induced by MGO was also rescued by the miR-27b mimic. p53 protein expression and the Bax/Bcl-2 ratio in EPCs (Western blot analyses) were significantly higher in db/db mice, both of which were suppressed by miR-27b. Furthermore, mitochondrial respiration, as measured by oxygen consumption rate, was enhanced by miR-27b in diabetic BMPCs, with concomitant decrease of mitochondrial Bax/Bcl-2 ratio. The 3' UTR binding assays revealed that both Bax, and its activator RUNX1, were direct targets of miR-27b, suggesting that miR-27b inhibits Bax expression in both direct and indirect manners. miR-27b prevents EPC apoptosis in Type 2 diabetic mice, at least in part, by suppressing p53 and the Bax/Bcl-2 ratio. These findings may provide a mechanistic basis for rescuing BMPC dysfunction in diabetes for successful autologous cell therapy.


Ultrastructure of Aplysia neurons having different degrees of light sensitivity.
The relationship between ultrastructure and photosensitivity of pigmented neurons of the abdominal ganglion of Aplysia californica was investigated using electron microscopy and electrophysiological methods. Four identified neurons of similar light microscopic appearance were examined; two are photoresponsive and two are not. Illumination hyperpolarizes both responsive neurons. One of them, R2, requires roughly 100 times greater light intensities than does the other, the ventral photoresponsive neuron (VPN), for similar responses. Two neurons lying adjacent to VPN and similar in appearance to VPN do not have measurable electrophysiological responses to even the highest light intensities. All four neurons contained lipochondria, pigmented organelles associated with the light response. Therefore the presence of these organelles is not the only requirement for light sensitivity in these neurons. Illumination appeared to increase the number of membranous lipochondria in both R2 and the ventral neurons, but only in R2 was this increase significant. Factors such as the concentration of lipochondria near the plasma membrane may affect quantitative aspects of the light response, but in the insensitive cells the lipochondria are apparently uncoupled from other factors required for the light response.


Ethanolic and aqueous extracts derived from Australian fungi inhibit cancer cell growth in vitro.
Fifteen Australian macrofungi were investigated for cytotoxic activity. Ethanol, cold and hot water extracts of each species were screened for cytotoxic activity against normal mouse fibroblast cells (NIH/3T3), healthy human epithelial kidney cells (HEK-293), four cancer cell lines, gastric adenocarcinoma cells (AGS), two mammary gland adenocarcinoma cells (MDA-MB-231, MCF7) and colorectal adenocarcinoma cells (HT-29) with a validated MTT assay. Most extracts derived from Omphalotus nidiformis, Cordyceps cranstounii and Cordyceps gunnii demonstrated significant cytotoxic activity toward a variety of cancer cell lines. In contrast only some extracts from Coprinus comatus, Cordyceps hawkesii, Hypholoma fasciculare, Lepista nuda, Leratiomyces ceres and Ophiocordyceps robertsii displayed significant cytotoxic activity, which was usually selective for only one or two cancer cell lines tested. The least cytotoxic species evaluated in this study were Agaricus bitorquis, Coprinopsis atrametaria, Psathyrella asperospora, Russula clelandii, Tricholoma sp. AU2 and Xerula mundroola.


An examination of the expected symptoms of postconcussion syndrome in a nonclinical sample.
This study examined the robustness of the postconcussion syndrome (PCS) expectation-as-etiology hypothesis using a variation on the typical study design and different symptom assessment methods. Participants were 51 university students with no history of brain injury or neurological disease. Participants reported expected PCS symptoms after being exposed to an established vignette in which they were asked to imagine that they had had a car accident (expectation condition). One week later, they reported their current symptoms (control condition). Symptoms were elicited in both test sessions using each of 3 methods administered in the following fixed order: an open-ended question (eg, how have you been feeling over the past couple of weeks?), prompted interview questions (eg, have you experienced any troubling physical symptoms over the past few weeks?), and checklist (the British Columbia Postconcussion Symptom Inventory). All 3 methods were administered in a paper-and-pencil format. Findings revealed that (a) when responding to structured interview questions or the checklist, participants expected more PCS symptoms from an imagined mild traumatic brain injury when compared with their baseline, (b) the expectation effect was not present when symptoms were elicited by an open-ended question, and (c) almost all participants (approximately 98% of those reporting expected symptoms) met a caseness criterion when symptoms were assessed using a checklist or structured interview. Contrary to predictions, personal knowledge of someone with mild traumatic brain injury did not alter PCS expectancies. The expectation-as-etiology hypothesis, which is one of several factors that has been associated with PCS, may be partly dependent on method of symptom assessment.


Swimming behavior and prey retention of the polychaete larvae Polydora ciliata (Johnston).
The behavior of the ubiquitous estuarine planktotrophic spionid polychaete larvae Polydora ciliata was studied. We describe ontogenetic changes in morphology, swimming speed and feeding rates and have developed a simple swimming model using low Reynolds number hydrodynamics. In the model we assumed that the ciliary swimming apparatus is primarily composed of the prototroch and secondarily by the telotroch. The model predicted swimming speeds and feeding rates that corresponded well with the measured speeds and rates. Applying empirical data to the model, we were able to explain the profound decrease in specific feeding rates and the observed increase in the difference between upward and downward swimming speeds with larval size. We estimated a critical larval length above which the buoyancy-corrected weight of the larva exceeds the propulsion force generated by the ciliary swimming apparatus and thus forces the larva to the bottom. This modeled critical larval length corresponded to approximately 1 mm, at which, according to the literature, competence for metamorphosis and no more length increase is observed. These findings may have general implications for all planktivorous polychaete larvae that feed without trailing threads. We observed bell shaped particle retention spectra with a minimum prey size of approximately 4 microm equivalent spherical diameter, and we found that an ontogenetic increase in maximum prey size add to a reduction in intra-specific food competition in the various larval stages. In a grazing experiment using natural seawater, ciliates were cleared approximately 50% more efficiently than similar sized dinoflagellates. The prey sizes retainable for P. ciliata larvae covers the microplankton fraction and includes non-motile as well as motile prey items, which is why the larvae are trophically positioned among the copepods and dinoflagellates. Not only do larval morphology and behavior govern larval feeding, prey behavior also influences the feeding efficiency of Polydora ciliata.


The role of radiation, with or without chemotherapy, in the management of NSCLC.
Lung cancer is the leading cause of cancer death in the United States. Surgery is the treatment of choice for early stage patients. Despite radical surgery, patients with early stage lung cancer remain at risk for recurrence. The role of adjuvant therapy remains to be clearly defined. Locally advanced non-small-cell lung cancer is too extensive for surgical resection, yet does not show evidence of metastatic disease. Historically, these patients were treated with radiation alone. More recent studies have provided the rationale for combining radiation with chemotherapy for patients with good performance status who have locally advanced disease. For patients with marginally resectable tumors, treatment is often given preoperatively (neoadjuvant) as a means of shrinking the tumor to make it resectable. In patients with clearly unresectable disease, radiation with chemotherapy has been established as better than either modality alone. Palliative radiation alone can be used for patients who cannot tolerate this aggressive approach. The optimal sequencing, as well as the best chemotherapeutic agent to use, remains under investigation. Some of the newer agents showing promise in the treatment of non-small-cell lung cancer include paclitaxel (Taxol) and carboplatin (Paraplatin). Other agents that are currently under investigation include topotecan, gemcitabine, and vinorelbine (Navelbine).


Flexible Job-Shop Rescheduling for New Job Insertion by Using Discrete Jaya Algorithm.
Rescheduling is a necessary procedure for a flexible job shop when newly arrived priority jobs must be inserted into an existing schedule. Instability measures the amount of change made to the existing schedule and is an important metrics to evaluate the quality of rescheduling solutions. This paper focuses on a flexible job-shop rescheduling problem (FJRP) for new job insertion. First, it formulates FJRP for new job insertion arising from pump remanufacturing. This paper deals with bi-objective FJRPs to minimize: 1) instability and 2) one of the following indices: a) makespan; b) total flow time; c) machine workload; and d) total machine workload. Next, it discretizes a novel and simple metaheuristic, named Jaya, resulting in DJaya and improves it to solve FJRP. Two simple heuristics are employed to initialize high-quality solutions. Finally, it proposes five objective-oriented local search operators and four ensembles of them to improve the performance of DJaya. Finally, it performs experiments on seven real-life cases with different scales from pump remanufacturing and compares DJaya with some state-of-the-art algorithms. The results show that DJaya is effective and efficient for solving the concerned FJRPs.


Breaking Point: Violence Against Long-Term Care Staff.
Direct resident care in long-term care facilities is carried out predominantly by personal support workers and registered practical nurses, the majority of whom are women. They experience physical, verbal, and sexual violence from residents on a regular basis. To explore this widespread problem, fifty-six staff in seven communities in Ontario, Canada, were consulted. They identified such immediate causes of violence as resident fear, confusion, and agitation and such underlying causes as task-driven organization of work, understaffing, inappropriate resident placement, and inadequate time for relational care. They saw violence as symptomatic of an institution that undervalues both its staff and residents. They described how violence affects their own health and well-being-causing injuries, unaddressed emotional trauma, job dissatisfaction, and burnout. They outlined barriers to preventing violence, such as insufficient training and resources, systemic underfunding, lack of recognition of the severity and ubiquity of the phenomenon, and limited public awareness.


Ingestion of cocoa ameliorates endothelial dysfunction in mesentery arterioles induced by high fat diet in rats: an in vivo intravital microscopy study.
Numerous clinical studies have reported that ingestion of cocoa has a therapeutic effect on hypertension. However, there is only limited information on the mechanism of ingestion of cocoa on arterioles, vessels that have a major role in determining blood pressure. In this study, we used intravital video-microscopy to evaluate the effect of cocoa consumption on the mesentery microcirculation of rats fed a high fat diet. The animals were allocated to 3 groups, and fed either a control diet, a high fat diet containing 15% lard, or the HFD with 2% cocoa (HFD-C) for 6 weeks. At the end of the experimental period, the mesentery was spread in a chamber, and the vessels were treated topically with phenylephrine, acetylcholine, or papaverine. The vascular responses to phenylephrine, acetylcholine-dependent vasodilatation and endothelium-independent vasodilatation were calculated by the diameter of the mesentery artery with each treatment. Topical treatment of mesenteric arterioles with acetylcholine caused a significantly greater response in the control compared with the HFD group. In the HFD-C group, acetylcholine-dependent vasodilatation was decreased marginally. Similarly, rats in the HFD group showed a significant reduction in vascular sensitivity to phenylephrine compared with the control group. However, there was no significant difference between the control and HFD-C groups. The induction of endothelial-independent artery dilation was reduced slightly in the HFD group. Our results suggest that one of the hypotensive mechanisms of cocoa is due to amelioration of endothelial dysfunction in arterioles induced by an inappropriate diet.


Effect of curcumin and curcumin copper complex (1:1) on radiation-induced changes of anti-oxidant enzymes levels in the livers of Swiss albino mice.
The effect of mononuclear copper (II) complex of curcumin in 1:1 stoichiometry (hereafter referred to as complex) administered 30 min before gamma-irradiation (4.5 Gy) on alterations in antioxidant and Thiobarbituric acid reactive substances (TBARS) levels in livers was studied in comparison to curcumin at a dose of 50 mg/kg. The different antioxidants like GSH, GST, catalase, SOD, TBARS and total thiols were estimated in the liver homogenates excised at different time intervals (1, 2 and 4 h) post irradiation using colorimetric methods. There was a radiation-induced decrease in the levels of all the studied enzymes at 1 h post irradiation, while an increase was observed at later time points. Both curcumin and complex treatment in sham-irradiated mice decreased the levels of GSH and total thiols, whereas there was an increase in the levels of catalase, GST and SOD compared to normal control. Under the influence of irradiation, both curcumin and complex treatment protected the decline in the levels of GSH, GST, SOD, catalase and total thiols, and inhibited radiation-induced lipid peroxidation. Further, the complex was found to be more effective in protecting the enzymes at 1 h post irradiation compared to curcumin treated group. This may be due to the higher rate constants of the complex compared to curcumin for their reactions with various free radicals.


Disruption of leptin receptor expression in the pancreas directly affects beta cell growth and function in mice.
Obesity is characterized by hyperinsulinemia, hyperleptinemia, and an increase in islet volume. While the mechanisms that hasten the onset of diabetes in obese individuals are not known, it is possible that the adipose-derived hormone leptin plays a role. In addition to its central actions, leptin exerts biological effects by acting in peripheral tissues including the endocrine pancreas. To explore the impact of disrupting leptin signaling in the pancreas on beta cell growth and/or function, we created pancreas-specific leptin receptor (ObR) KOs using mice expressing Cre recombinase under the control of the pancreatic and duodenal homeobox 1 (Pdx1) promoter. The KOs exhibited improved glucose tolerance due to enhanced early-phase insulin secretion, and a greater beta cell mass secondary to increased beta cell size and enhanced expression and phosphorylation of p70S6K. Similar effects on p70S6K were observed in MIN6 beta cells with knockdown of the ObR gene, suggesting crosstalk between leptin and insulin signaling pathways. Surprisingly, challenging the KOs with a high-fat diet led to attenuated acute insulin secretory response to glucose, poor compensatory islet growth, and glucose intolerance. Together, these data provide direct genetic evidence, from a unique mouse model lacking ObRs only in the pancreas, for a critical role for leptin signaling in islet biology and suggest that altered leptin action in islets is one factor that contributes to obesity-associated diabetes.


Adapting, piloting and evaluating complex public health interventions: lessons learned from the Nurse-Family Partnership in Canadian public health settings.
The Nurse-Family Partnership (NFP) is a home-visit program for young and first-time, socially and economically disadvantaged mothers. Evidence from three United States randomized controlled trials (RCTs) on the effectiveness of this intervention at improving pregnancy outcomes, improving child health and development, and increasing maternal economic self-sufficiency is robust. However, the effectiveness of the NFP in Canada, with its different health and social care context, needs to be determined. The purpose of this article is to describe the complex process for moving the NFP from the research arena to full implementation in Canada. This process of evaluation in Canada includes (1) adapting the intervention; (2) piloting the intervention in small-scale feasibility and acceptability studies; and (3) conducting an RCT and process evaluation through a study called the British Columbia Healthy Connections Project (BCHCP). This large-scale evaluation also creates an opportunity to expand the NFP evidence base by conducting an additional study to examine potential biological mechanisms linking intervention and behavioural outcomes in children. Adaptation of the NFP home-visit materials is a continuous process. A pilot project determined that it was feasible to enrol eligible women into the NFP. This pilot also determined that, in Canada, it was most appropriate for public health agencies to implement the NFP and for public health nurses to deliver the intervention. Finally, the pilot showed that this intensive home-visit program was acceptable to clients, their family members and health care providers. Through the BCHCP, the next steps - the RCT and process evaluation - are currently underway. The BCHCP will also set the foundation for long-term evaluation of key public health outcomes in a highly vulnerable population of families.


Tunable properties of PtxFe1-x electrocatalysts and their catalytic activity towards the oxygen reduction reaction.
We present the controlled synthesis of bimetallic Pt(x)Fe(1-x) nanoparticles with tunable physical properties and a study of their catalytic activity towards the oxygen reduction reaction (ORR). Composition-induced variations in alloying extent and Pt d-band vacancies in Pt-Fe/C catalysts are systematically investigated. Density functional theoretical calculations are performed in order to realize the electronic effect caused by alloying Pt with Fe. The DFT computational observations revealed that iron donates electrons to platinum, when the Fe 3d and Pt 5d orbitals undergo hybridization. The Pt(x)Fe(1-x) catalysts with various Pt-to-Fe atomic ratios are characterized by X-ray diffraction (XRD), transmission electron microscopy (TEM), cyclic voltammetry (CV), and X-ray absorption spectroscopy (XAS). TEM images indicate that the dispersion of the metal nanoparticles is uniform and the XAS technique provides significant insight on Pt d-band vacancies and the alloying extent of Pt and Fe in Pt(x)Fe(1-x) nanoparticles. Rotating-disk voltammetry of Pt(x)Fe(1-x) nanoparticle catalysts with various Pt : Fe atomic compositions (3 : 1, 1 : 1, and 1 : 3) revealed that the Pt(1)Fe(1)/C nanocatalyst showed a greater enhancement in ORR activity than platinum. The enhanced catalytic activity toward ORR is attributed to the higher alloying extent of platinum and iron as well as the promising electronic structure offered by the lower unfilled Pt d states in Pt(x)Fe(1-x) nanoparticles when compared to pure Pt.


A framework for resolving disagreement during end of life care in the critical care unit.
End-of-life decisions regarding the administration, withdrawal or withholding of life-sustaining therapy in the critical care setting can be challenging. Disagreements between health care providers and family members occur, especially when families believe strongly in preserving life, and physicians are resistant to providing medically "futile" care. Such disagreements can cause tension and moral distress among families and clinicians. To outline the roles and responsibilities of physicians, substitute decision makers, and the judicial system when decisions must be made on behalf of incapable persons, and to provide a framework for conflict resolution during end-of-life decision-making for physicians practicing in Canada. We used a case-based example to illustrate our objectives. We employed a comprehensive approach to understanding end-of-life decision making that included: 1) a search for relevant literature; 2) a review of provincial college policies; 3) a review of provincial legislation on consent; 4) a consultation with two bioethicists and 5) a consultation with two legal experts in health law. In Canada, laws about substitute decision-making for health care are primarily provincial or territorial. Thus, laws and policies from professional regulatory bodies on end-of-life care vary across the country. We tabulated the provincial college policies on end-of-life care and the provincial legislation on consent and advance directives, and constructed a 10-step approach to conflict resolution. Knowledge of underlying ethical principles, understanding of professional duties, and adoption of a process for mediation and conflict resolution are essential to ensuring that physicians and institutions act responsibly in maintaining a patients' best interests in the context of family-centred care.


Biglycan deficiency interferes with ovariectomy-induced bone loss.
Biglycan is a matrix proteoglycan with a possible role in bone turnover. In a 4-week study with sham-operated or OVX biglycan-deficient or wildtype mice, we show that biglycan-deficient mice are resistant to OVX-induced trabecular bone loss and that there is a gender difference in the response to biglycan deficiency. Biglycan (bgn) is a small extracellular matrix proteoglycan enriched in skeletal tissues, and biglycan-deficient male mice have decreased trabecular bone mass and bone strength. The purpose of this study was to investigate the bone phenotype of the biglycan-deficient female mice and to investigate the effect of estrogen depletion by ovariectomy (OVX). OVX or sham operations were performed on 21-week-old mice that were divided into four groups: wt sham (n = 7), wt OVX (n = 9), bgn-deficient sham (n = 10) and bgn-deficient OVX (n = 10). The mice were killed 4 weeks after surgery. Bone mass and bone turnover were analyzed by peripheral quantitative computed tomography (pQCT), biochemical markers, and histomorphometry. In contrast to the male mice, there were only few effects of bgn deficiency on bone metabolism in female mice, showing a clear gender difference. However, when stressed by OVX, the female bgn knockout (KO) mice were resistant to the OVX-induced trabecular bone loss. The wt mice showed a decrease in trabecular bone mineral density by pQCT measurements, a decrease in trabecular bone volume (BV/TV), and an increase in mineral apposition rate. In contrast, no significant changes were detected in bgn KO mice after OVX. In addition, analysis of the bone resorption marker deoxypyridinoline showed no significant increase in the bgn KO OVX mice compared with bgn KO sham mice. Measurements of serum osteoprotegerin (OPG) and RANKL revealed increased levels of OPG and decreased levels of RANKL in the bgn KO mice compared with wt mice. In conclusion, the bgn deficiency protects against increased trabecular bone turnover and bone loss in response to estrogen depletion, supporting the concept that bgn has dual roles in bone, where it may modulate both formation and resorption ultimately influencing the bone turnover process.


Minimum number of measurements for evaluating soursop (Annona muricata L.) yield.
Repeatability studies on fruit species are of great importance to identify the minimum number of measurements necessary to accurately select superior genotypes. This study aimed to identify the most efficient method to estimate the repeatability coefficient (r) and predict the minimum number of measurements needed for a more accurate evaluation of soursop (Annona muricata L.) genotypes based on fruit yield. Sixteen measurements of fruit yield from 71 soursop genotypes were carried out between 2000 and 2016. In order to estimate r with the best accuracy, four procedures were used: analysis of variance, principal component analysis based on the correlation matrix, principal component analysis based on the phenotypic variance and covariance matrix, and structural analysis based on the correlation matrix. The minimum number of measurements needed to predict the actual value of individuals was estimated. Principal component analysis using the phenotypic variance and covariance matrix provided the most accurate estimates of both r and the number of measurements required for accurate evaluation of fruit yield in soursop. Our results indicate that selection of soursop genotypes with high fruit yield can be performed based on the third and fourth measurements in the early years and/or based on the eighth and ninth measurements at more advanced stages.


The acquisition of skilled motor performance: fast and slow experience-driven changes in primary motor cortex.
Behavioral and neurophysiological studies suggest that skill learning can be mediated by discrete, experience-driven changes within specific neural representations subserving the performance of the trained task. We have shown that a few minutes of daily practice on a sequential finger opposition task induced large, incremental performance gains over a few weeks of training. These gains did not generalize to the contralateral hand nor to a matched sequence of identical component movements, suggesting that a lateralized representation of the learned sequence of movements evolved through practice. This interpretation was supported by functional MRI data showing that a more extensive representation of the trained sequence emerged in primary motor cortex after 3 weeks of training. The imaging data, however, also indicated important changes occurring in primary motor cortex during the initial scanning sessions, which we proposed may reflect the setting up of a task-specific motor processing routine. Here we provide behavioral and functional MRI data on experience-dependent changes induced by a limited amount of repetitions within the first imaging session. We show that this limited training experience can be sufficient to trigger performance gains that require time to become evident. We propose that skilled motor performance is acquired in several stages: "fast" learning, an initial, within-session improvement phase, followed by a period of consolidation of several hours duration, and then "slow" learning, consisting of delayed, incremental gains in performance emerging after continued practice. This time course may reflect basic mechanisms of neuronal plasticity in the adult brain that subserve the acquisition and retention of many different skills.


A mechanism of extreme growth and reliable signaling in sexually selected ornaments and weapons.
Many male animals wield ornaments or weapons of exaggerated proportions. We propose that increased cellular sensitivity to signaling through the insulin/insulin-like growth factor (IGF) pathway may be responsible for the extreme growth of these structures. We document how rhinoceros beetle horns, a sexually selected weapon, are more sensitive to nutrition and more responsive to perturbation of the insulin/IGF pathway than other body structures. We then illustrate how enhanced sensitivity to insulin/IGF signaling in a growing ornament or weapon would cause heightened condition sensitivity and increased variability in expression among individuals--critical properties of reliable signals of male quality. The possibility that reliable signaling arises as a by-product of the growth mechanism may explain why trait exaggeration has evolved so many different times in the context of sexual selection.


Technological properties and probiotic potential of Lactobacillus fermentum strains isolated from West African fermented millet dough.
Throughout Africa, food fermentations are still driven by indigenous microorganisms which influence the nutritional, organoleptic and safety of the final products. However, for improved safety, consistent quality and beneficial health effects, a trend has emerged which involves the isolation of indigenous strains from traditional fermented products to be used as functional starter cultures. These functional starter cultures possess inherent functional characteristics and can contribute to food quality and safety by offering one or more organoleptic, nutritional, technological or health advantage (probiotics). With the aim of selecting potential probiotic starter cultures, Lactobacillus fermentum strains isolated from fermented millet dough were investigated for technological properties and probiotic traits in-vitro. A total of 176 L. fermentum strains were assessed for technological properties including rate of acidification, exopolysaccharide production and amylase activity. Following this, 48 strains showing desirable technological properties were first screened for acid resistance. Sixteen acid resistant strains were assessed for additional probiotic properties including resistance to bile salts, bile salt hydrolysis, antimicrobial property, haemolysis and antibiotics resistance. L. fermentum strains clustered into 3 groups represented by 36 %, 47 % and 17 % as fast, medium and slow acidifiers respectively. About 8 %, 78 % and 14 % of the strains showed strong, weak and no exopolysaccharides production respectively. Amylase activity was generally weak or not detected. After exposure of 48 L. fermentum strains to pH 2.5 for 4 h, 16 strains were considered to be acid resistant. All 16 strains were resistant to bile salt. Four strains demonstrated bile salt hydrolysis. Antimicrobial activity was observed towards Listeria monocytogenes and Staphylococcus aureus but not E. coli and Salmonella enteritidis. Lactobacillus fermentum strains were generally susceptible to antibiotics except 6 strains which showed resistance towards streptomycin, gentamicin and kanamycin. In vitro determination of technological and probiotic properties have shown strain specific difference among L. fermentum strains isolated from fermented millet dough. Sixteen (16) L. fermentum strains have been shown to possess desirable technological and probiotic characteristics in vitro. These strains are therefore good candidates for further studies to elucidate their full potential and possible application as novel probiotic starter cultures.


Development of an ultrasonic airflow measurement device for ducted air.
In this study, an in-duct ultrasonic airflow measurement device has been designed, developed and tested. The airflow measurement results for a small range of airflow velocities and temperatures show that the accuracy was better than 3.5% root mean square (RMS) when it was tested within a round or square duct compared to the in-line Venturi tube airflow meter used for reference. This proof of concept device has provided evidence that with further development it could be a low-cost alternative to pressure differential devices such as the orifice plate airflow meter for monitoring energy efficiency performance and reliability of ventilation systems. The design uses a number of techniques and design choices to provide solutions to lower the implementation cost of the device compared to traditional airflow meters. The design choices that were found to work well are the single sided transducer arrangement for a "V" shaped reflective path and the use of square wave transmitter pulses ending with the necessary 180° phase changed pulse train to suppress transducer ringing. The device is also designed so that it does not have to rely on high-speed analogue to digital converters (ADC) and intensive digital signal processing, so could be implemented using voltage comparators and low-cost microcontrollers.


Transient congenital hypothyroidism caused by compound heterozygous mutations affecting the NADPH-oxidase domain of DUOX2.
Here, we describe three cases of loss-of-function mutations in the nicotinamide adenine dinucleotide phosphate (NADPH)-oxidase (NOX) domain of dual oxidase 2 (DUOX2) occurring along with concurrent missense mutations in thyroid peroxidase (TPO), leading to transient congenital hypothyroidism (CH). Three Japanese boys with nonconsanguineous parents were diagnosed with CH during their neonatal screenings. All patients presented with moderate-to-severe neonatal hypothyroidism and were diagnosed with transient CH after re-evaluation of thyroid function. Two siblings were compound heterozygous for p.[R1110Q]+[Y1180X] in DUOX2; one of them was also heterozygous for p.[R361L] in TPO. The third patient was compound heterozygous for p.[L1160del]+[R1334W] in DUOX2 and heterozygous for p.[P883S] in TPO. This is the first report of a de novo L1160del mutation affecting the DUOX2 gene and of the novel mutations Y1180X in DUOX2 and R361L in TPO. R1110Q and L1160del were found to reduce H2O2 production (5%-9%, p<0.01), while Y1180X, which introduces a premature stop codon, did not confer detectable H2O2 production (-0.7%±0.6%, p<0.01). Moreover, R1334W, a missense mutation possibly affecting electron transfer, led to reduced H2O2 production (24%±0.9%, p<0.01) in vitro, and R1110Q and R1334W resulted in reduced protein expression. Y1180X was detected in a 120 kDa truncated form, whereas L1160del expression was maintained. Further, R361L, a novel missense mutation in TPO, caused partial reduction in peroxidase activity (20.6%±0.8%, p=0.01), whereas P883S, a missense variant, increased it (133.7%±2.8%, p=0.02). The protein expression levels in the case of R361L and P883S were maintained. In conclusion, we provide clinical and in vitro demonstrations of different functional defects and phenotypic heterogeneity in the same thyroid hormonogenesis pathway.


The impact of physical activity on health-related fitness and quality of life for patients with head and neck cancer: a systematic review.
Patients with head and neck cancer often face a plethora of cancer and treatment-related side effects, negatively impacting their lean body mass, physical functioning, quality of life and fatigue management. Physical activity is a potential mediator of many of these side effects. This is the first systematic review reporting on head and neck cancer and physical activity literature. A literature search was conducted up to January 2015. Two reviewers independently identified articles using the outlined inclusion criteria, assessing the study methodology, risk of bias and extracting the necessary data from studies evaluating the impact of full-body physical activity on patients with head and neck cancer. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement was used to guide this review. We identified 16 articles published from 2003 to 2014, the majority of which were published within the past 5 years. Physical activity interventions were feasible, safe and beneficial in mediating cancer and treatment-related side effects. Specifically, patients experienced improvements in lean body mass, muscular strength, physical functioning, quality of life and fatigue management. Owing to significant study heterogeneity, data were not pooled. Reflecting the early state of the literature, included studies were found to vary greatly in design, quality and reporting characteristics. There is early evidence that supports the benefit of physical activity interventions for patients with head and neck cancer, both during and following treatment. Future research is necessary to determine the benefits of different physical activity interventions, and their impact on patients with different head and neck cancers.


Navigation in wood ants Formica japonica: context dependent use of landmarks.
Wood ants Formica japonica can steer their outbound (foraging) and inbound (homing) courses without using celestial compass information, by relying exclusively on landmark cues. This is shown by training ants to run back and forth between the nest and an artificial feeder, and later displacing the trained ants either from the nest (when starting their foraging runs: outbound full-vector ants) or from the feeder (when starting their home runs: inbound full-vector ants) to various nearby release sites. In addition, ants that have already completed their foraging and homing runs are displaced after arrival either at the feeder (outbound zero-vector ants) or at the nest (inbound zero-vector ants), respectively, to the very same release sites. Upon release, the full-vector ants steer their straight courses by referring to panoramic landmark cues, while the zero-vector ants presented with the very same visual scenery immediately search for local landmark cues defining their final goal. Hence, it depends on the context, in this case on the state of the forager's round-trip cycle, what visual cues are picked out from a given set of landmarks and used for navigation.


Comparisons of Resistance Training and "Cardio" Exercise Modalities as Countermeasures to Microgravity-Induced Physical Deconditioning: New Perspectives and Lessons Learned From Terrestrial Studies.
Prolonged periods in microgravity (μG) environments result in deconditioning of numerous physiological systems, particularly muscle at molecular, single fiber, and whole muscle levels. This deconditioning leads to loss of strength and cardiorespiratory fitness. Loading muscle produces mechanical tension with resultant mechanotransduction initiating molecular signaling that stimulates adaptations in muscle. Exercise can reverse deconditioning resultant from phases of detraining, de-loading, or immobilization. On Earth, applications of loading using exercise models are common, as well as in μG settings as countermeasures to deconditioning. The primary modalities include, but are not limited to, aerobic training (or "cardio") and resistance training, and have historically been dichotomized; the former primarily thought to improve cardiorespiratory fitness, and the latter primarily improving strength and muscle size. However, recent work questions this dichotomy, suggesting adaptations to loading through exercise are affected by intensity of effort independent of modality. Furthermore, similar adaptations may occur where sufficient intensity of effort is used. Traditional countermeasures for μG-induced deconditioning have focused upon engineering-based solutions to enable application of traditional models of exercise. Yet, contemporary developments in understanding of the applications, and subsequent adaptations, to exercise induced muscular loading in terrestrial settings have advanced such in recent years that it may be appropriate to revisit the evidence to inform how exercise can used in μG. With the planned decommissioning of the International Space Station as early as 2024 and future goals of manned moon and Mars missions, efficiency of resources must be prioritized. Engineering-based solutions to apply exercise modalities inevitably present issues relating to devices mass, size, energy use, heat production, and ultimately cost. It is necessary to identify exercise countermeasures to combat deconditioning while limiting these issues. As such, this brief narrative review considers recent developments in our understanding of skeletal muscle adaptation to loading through exercise from studies conducted in terrestrial settings, and their applications in μG environments. We consider the role of intensity of effort, comparisons of exercise modalities, the need for concurrent exercise approaches, and other issues often not considered in terrestrial exercise studies but are of concern in μG environments (i.e., O2 consumption, CO2 production, and energy costs of exercise).


The self-prescribed use of aromatherapy oils by pregnant women.
While some studies have reported effectiveness of aromatherapy oils use during labour there is no reported evidence of efficacy or risks of aromatherapy oils use for pregnancy-related symptoms or conditions. A number of aromatherapy oils are unsafe for use by pregnant women yet there is currently no research examining the prevalence and characteristics of women who use aromatherapy oils during pregnancy. To conduct an empirical study of the prevalence and characteristics of women who use aromatherapy oils during pregnancy. The research was conducted as part of the Australian Longitudinal Study on Women's Health (ALSWH), focusing on the nationally representative sample of Australian women aged 31-36 years. Data were collected via a cross-sectional questionnaire (n=8200) conducted in 2009. Self-prescribed aromatherapy oils were used by 15.2% of pregnant women. Pregnant women were 1.57 (95% CI: 1.01, 2.43) times more likely to self-prescribe use of aromatherapy oils if they have allergies or hayfever, and 2.26 (95% CI: 1.34, 3.79) times more likely to self-prescribe use of aromatherapy oils if they have a urinary tract infection (UTI). Our study highlights a considerable use of aromatherapy oils by pregnant women. There is a clear need for greater communication between practitioners and patients regarding the use of aromatherapy oils during pregnancy, as well a need for health care practitioners to be mindful that pregnant women in their care may be using aromatherapy oils, some of which may be unsafe.


Nurse Perceptions of Pain in Pediatric Traumatic Brain Injury: A Pilot Study.
Pain assessment in the pediatric population is challenging because of age, developmental stage, and patient cooperation. Cognitive impairment, impaired communication, and physical disability that may accompany traumatic brain injury (TBI) further complicate pain assessments. A pilot descriptive qualitative research study was conducted to investigate nurse perceptions of pain in pediatric patients diagnosed with TBI. Specifically, this study sought to answer the following questions: a) Is pain accurately assessed in this population? b) Is pain adequately treated in this population? and c) What obstacles exist, if any, to the assessment and treatment of pain? A convenience sample of three registered nurses employed in a pediatric neurosurgery setting participated in this study. Each nurse participated in one individual, semi-structured, face-to-face interview lasting approximately 30 minutes. Interviews were transcribed verbatim and analyzed for common themes. Common themes identified across all interviews were a) challenging assessments; b) limited, although effective, treatments; and c) communication as an area of opportunity for improvement. Implications for practice and policy include a need for more sensitive pain assessment tools to improve the objectivity and accuracy of pain assessment, clarification of care priorities and organization of care from clinical and management perspectives, and additional research in alternative pain treatments for this population. Findings from this study will guide the development of a larger, more comprehensive study, with the aim of improving practice and policy in pain management for this population.


International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: A 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases.
A Panel of International Experts was convened by the Infectious Diseases Society of America (IDSA) in collaboration with the European Society for Microbiology and Infectious Diseases (ESCMID) to update the 1999 Uncomplicated Urinary Tract Infection Guidelines by the IDSA. Co-sponsoring organizations include the American Congress of Obstetricians and Gynecologists, American Urological Association, Association of Medical Microbiology and Infectious Diseases-Canada, and the Society for Academic Emergency Medicine. The focus of this work is treatment of women with acute uncomplicated cystitis and pyelonephritis, diagnoses limited in these guidelines to premenopausal, non-pregnant women with no known urological abnormalities or co-morbidities. The issues of in vitro resistance prevalence and the ecological adverse effects of antimicrobial therapy (collateral damage) were considered as important factors in making optimal treatment choices and thus are reflected in the rankings of recommendations.


Inhibition of low-density lipoprotein oxidation by astaxanthin.
Marine animals produce astaxanthin which is a carotenoid and antioxidant. In this study we determined the in vitro and ex vivo effects of astaxanthin on LDL oxidation. The oxidation of LDL was measured in a 1 ml reaction system consisting of increasing concentrations of astaxanthin (12.5, 25.0, 50.0 microg/ml), 400 microM V-70 (2, 2'-azobis(4-methoxy-2, 4-dimethylvaleronitrile)), and LDL (70 microg/ml protein). Astaxanthin dose, dependently significantly prolonged the oxidation lag time (31.5, 45.4, 65.0 min) compared with the control (19.9 min). For the ex vivo study 24 volunteers (mean age 28.2 [SD 7.8] years) consumed astaxanthin at doses of 1.8, 3.6,14.4 and 21.6 mg per day for 14 days. No other changes were made in the diet. Fasting venous blood samples were taken at days 0, +14. LDL lag time was longer (5.0, 26.2, 42.3 and 30.7% respectively) compared with day 0 after consuming astaxanthin at doses of 1.8, 3.6,14.4 and 21.6 mg for 14 days compared with day 0, but there was no difference in oxidation of LDL between day 0 (lag time 59.9+/-7.2 min) and day 14 (57.2+/-6.0 min) in the control group. Our results provide evidence that consumption of marine animals producing astaxanthin inhibits LDL oxidation and possibly therefore contributes to the prevention of atherosclerosis.


Disease Activity and Conversion into Multiple Sclerosis after Optic Neuritis Is Treated with Erythropoietin.
Changes in cerebral lesion load by magnetic resonance imaging (MRI) in patients from a double-blind, placebo-controlled, phase II study on erythropoietin in clinically isolated optic neuritis (ClinicalTrials.gov, NCT00355095) were analyzed. Therefore, patients with acute optic neuritis were assigned to receive either 33,000 IU of recombinant human erythropoietin (IV) daily for three days, or a placebo, as an add-on to methylprednisolone. Of 35 patients, we investigated changes in cerebral lesion load in MRIs obtained at baseline and at weeks 4, 8, and 16. In 5 of the 35 patients, we found conversion into multiple sclerosis (MS) based on MRI progression only. These five patients had received the placebo. Another five patients showed MRI progression together with relapses. Three of these patients had received erythropoietin, and two the placebo. Yet, analyzing the change in absolute numbers of periventricular, juxtacortical, and infratentorial lesions including gadolinium-enhancing lesions, there were no significant differences between the groups. Although effective in terms of retinal nerve fiber layer protection, erythropoietin treatment of acute isolated optic neuritis did not influence further evolution of MRI lesions in the brain when comparing absolute numbers. However, early conversion from clinically isolated syndrome to MS assessed by MRI activity seemed to occur more frequently in the placebo-treated group.