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This article describes a program through which interactions every 2–3 weeks between patients and primary care clinicians (PCCs), with recommendations based on analysis of remote glucose monitoring by computerized insulin dose adjustment algorithms, significantly improved diabetes control. Insulin doses increased by 30% in the majority of patients. A sizeable minority (36%) had a decrease or no increase in insulin doses, but still showed an improvement in diabetes control. Frequent interactions allowed PCCs the opportunity to recognize and address medication nonadherence. [ABSTRACT FROM AUTHOR]

This article discusses the use of computerized insulin dose-adjustment algorithms (CIDAAs) in primary care settings to help manage insulin-requiring patients with diabetes. The study examined the real-world results of two primary care clinicians using CIDAAs in conjunction with continuous glucose monitoring (CGM) devices. The findings showed that the use of CIDAAs and CGM devices led to a decrease in estimated HbA1c levels and an increase in insulin doses, indicating improved glycemic control. The study suggests that this combination of technologies can effectively address the challenges faced by primary care clinicians in managing insulin therapy for their patients. [Extracted from the article]

Alcohol misuse affects 15 million people in the United States. Compared to White men, Latino men have disproportionately higher rates of both alcohol misuse and negative alcohol-related consequences (e.g. drunk driving, liver disease, alcohol dependence, HIV/AIDS). This cross sectional study examined how cultural stressors [immigration stress and negative context of reception (NCR)] coupled with traditional Latino male gender norms (machismo and caballerismo) influences alcohol use severity (AUS) among adult Latino immigrant men. Data for the present study was collected between 2017 and 2018 from 279 Cuban, Central American, and South American adult Latino men who immigrated to the US approximately 10 years prior. Results from hierarchical multiple regression analysis revealed higher levels of perceived NCR (β = 0.15, p =.01), and machismo (β = 0.16, p =.02) were associated with greater AUS. Significant interaction effects were found between both cultural stressors and machismo [immigration stress x machismo (β = 0.22, p <.001); NCR x machismo (β = 0.22, p <.001)] whereby higher levels of machismo strengthened the association between cultural stress and AUS. Findings from the present study can inform culturally appropriate interventions aimed at mitigating alcohol use among Latino immigrant men. [ABSTRACT FROM AUTHOR]

Lepton Flavour Violation (LFV) is New Physics that must occur, but is stringently constrained by experiments searching for μ ↔ e flavour change, such as μ → eγ, μ → e e ¯ e or μ → e conversion. However, in an Effective Field Theory(EFT) parametrisation, there are many more μ ↔ e operators than restrictive constraints, so determining operator coefficients from data is a remote dream. It is nonetheless interesting to learn about New Physics from data, so this manuscript introduces “observable-vectors” in the space of operator coefficients, which identify at any scale the combination of coefficients probed by the observable. These vectors have an overlap ≳ 10−3 with most of the coefficients, and are used to study whether μ → eγ, μ → e e ¯ e and μ → e conversion give complementary information about New Physics. The appendix gives updated sensitivities of these processes, (and a subset of τ → ℓ decays), to operator coefficients at the weak scale in the SMEFT and in the EFT below mW. [ABSTRACT FROM AUTHOR]

Introduction: Primary care physicians are often challenged to adjust insulin doses. To facilitate this process, we evaluated in a safety net clinic the work flow and glycemic effects of remote glucose monitoring utilizing Federal Drug Administration (FDA) cleared, Conformité Européenne (CE) registered software that contained computerized algorithms for insulin dose adjustments to help clinicians make dosing decisions for insulin-requiring patients. Methods: Patients taking insulin for at least 6 months with HbA1c levels of at least 8.0% measured glucose levels with a meter attached to their smartphones. Readings were automatically transmitted to a secure, Health Insurance Portability and Accountability Act (HIPAA)-approved server. Values were analyzed every 2–3 weeks and reports, including recommendations for insulin dose changes, were sent to a clinic nurse practitioner (NP) who modified or accepted the recommendations. A staff person contacted patients with the new doses determined by the NP. Results: Insulin regimens included basal alone (N = 11), basal/bolus (N = 14), and self-mixed/split (N = 3). Baseline HbA1 levels of 10.0% fell to 8.1% at 3 months (N = 28) and 7.6% at 6 months (N = 17) without any clinic visits for dose adjustments. There were 268 reports which allowed providers to see 268 other patients during these avoided clinic visits. The NP agreed with 82% of the recommendations. The total doses of insulin increased by 24%. No patient experienced severe hypoglycemia or visited an emergency department for hypoglycemia. Conclusion: Remote glucose monitoring utilizing computerized insulin dose adjustment algorithms saved time for both providers and patients while effectively improving glycemia. Funding: The Leonard M. Lipman Charitable Trust and Mellitus Health. [ABSTRACT FROM AUTHOR]

The article offers information on Stephen F. Austin Mexican school in New Braunfels, Texas along with an overview of New Braunfels and Comal County, and development of county's various schools. It mentions that the influx of immigrants profoundly impacted Texas schools. It mentions about former U.S. President Franklin D. Roosevelt's New Deal Programs including Civil Works Administration and the Works Progress Administration that played a role locally in education of Mexican American children.

Background Because continued cigarette smoking after a cancer diagnosis is associated with detrimental outcomes, supporting cancer patients with smoking cessation is imperative. We evaluated the effect of the Smoking Cessation Program at the London Regional Cancer Program (lrcp) over a 2-year period. Methods The Smoking Cessation Program at the lrcp began in March 2014. New patients are screened for tobacco use. Tobacco users are counselled about the benefits of cessation and are offered referral to the program. If a patient accepts, a smoking cessation champion offers additional counselling. Follow-up is provided by interactive voice response (ivr) telephone system. Accrual data were collected monthly from January 2015 to December 2016 and were evaluated. Results During 2015-2016, 10,341 patients were screened for tobacco use, and 18% identified themselves as current or recent tobacco users. In 2015, 84% of tobacco users were offered referral, but only 13% accepted, and 3% enrolled in ivr follow-up. At the lrcp in 2016, 77% of tobacco users were offered referral to the program, but only 9% of smokers accepted, and only 2% enrolled in ivr follow-up. Conclusions The Smoking Cessation Program at the lrcp has had modest success, because multiple factors influence a patient's success with cessation. Limitations of the program include challenges in referral and counselling, limited access to nicotine replacement therapy (nrt), and minimal follow-up. To mitigate some of those challenges, a pilot project was launched in January 2017 in which patients receive free nrt and referral to the local health unit. [ABSTRACT FROM AUTHOR]

In this article, a complete analysis of the three muonic lepton-flavour violating processes μ → eγ, μ → 3 e and coherent nuclear μ → e conversion is performed in the framework of an effective theory with dimension six operators defined below the electroweak symmetry breaking scale m . The renormalisation-group evolution of the Wilson coefficients between m and the experimental scale is fully taken into account at the leading order in QCD and QED, and explicit analytic and numerical evolution matrices are given. As a result, muonic decay and conversion rates are interpreted as functions of the Wilson coefficients at any scale up to m . Taking the experimental limits on these processes as input, the phenomenology of the mixing effects is investigated. It is found that a considerable set of Wilson coefficients unbounded in the simplistic tree-level approach are instead severely constrained. In addition, correlations among operators are studied both in the light of current data and future experimental prospects. [ABSTRACT FROM AUTHOR]

The Youth Transition Project was designed to provide youth with mental health and addiction issues with individualized transitional care plans as they transition from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS). Over an 18-month period, a total of 127 (59.1%) youth were transitioned and seen by an AMHS provider, 41 (19.1%) remained on a waitlist for services and 47 (21.8%) canceled services. The average time to transition was 110 days (SD = 100). Youth exhibited a wide range of diagnoses; 100% of the population was identified as having serious psychiatric problems. Findings demonstrate that the Youth Transition Project has been successful in promoting continuity of care by transitioning youth seamlessly from youth to adult services. Inconsistencies in wait times and service delivery suggest that further model development is needed to enhance the long-term sustainability of the Youth Transition Project. [ABSTRACT FROM AUTHOR]

Three studies were conducted to determine the potential of experimental feed additives (EFAs), clays or non-digestible yeast oligosaccharides, to reduce milk aflatoxin (AFM1) concentrations in lactating Holstein cows consuming aflatoxin-contaminated diets. All studies included a pre-treatment period and a 2-week experimental period in a randomized block design. During the pre-treatment period, cows received a total mixed ration (TMR) with no aflatoxin contamination. During both experimental weeks, all cows were fed a TMR containing aflatoxin-contaminated corn. During experimental week 1, cows received no EFA's in the TMR, but EFA's were included in the TMR for the second experimental week. In studies 1 and 2, the experimental period consisted of 2 weeks each lasting 7 days with 12 cows per treatment. Aflatoxin M1 concentrations were analysed by HPLC for milk samples collected on days 5-7 and days 11-14. In various experiments, treatments included control (no EFA), 100 g/cow daily of experimental Lallemand® product, 10 g/cow daily of MTB-100®-2004, (Alltech, Inc.), 10 g/cow daily of MTB-100®-2006, (Alltech, Inc.), 10 g/cow daily of experimental Alltech® product (Alltech, Inc.) and 227 g/cow daily of Astra-Ben 20® (AB-20®; Prince Agri Products, Inc.). In study 3, the experimental period of 2 weeks each lasting 8 days and milk samples were collected from day 4 to 8 and day 11 to 16. Milk samples from study 3 were analysed for AFM1 concentrations by ELISA. For all experiments, changes in AFM1 concentrations because of the addition of EFA's were calculated. Four of the five EFAs tested in this study had no significant effect on AFM1 concentrations. However, the addition of AB-20® resulted in a significant decrease in AFM1 concentrations (60.4%). In summary, the addition of AB-20® to the diet of cattle appears to be effective for significantly reducing AFM1 concentrations in the milk of cows fed an aflatoxin-contaminated diet. [ABSTRACT FROM AUTHOR]

Purpose: Seventeen thousand patients receive treatment with radical pelvic radiotherapy annually in the UK. Up to 50% develop significant gastrointestinal symptoms. The National Cancer Survivorship Initiative has identified access to specialist medical care for those with complications after cancer as one of their four key needs. We aimed to determine the current practice of British gastroenterologists with regards to chronic gastrointestinal symptoms after pelvic radiotherapy. Methods: A questionnaire was developed and sent up to a maximum of five times to all UK consultant gastroenterologists. Results: Eight hundred sixty-six gastroenterologists were approached and 165 (20%) responded. Sixty-one percent saw one to four patients annually with bowel symptoms after radiotherapy. Eighteen percent rate the current treatments as effective 'often' or 'most of the time'. Forty-seven percent of gastroenterologists consider themselves 'confident with basic cases', with 11% 'confident in all cases'. Fifty-nine percent thinks a gastroenterologist with a specialist interest should manage these patients. Although only 29% thinks a specific service is required for these patients, 34% rates the current service as inadequate. The ideal service was considered to be gastroenterology-led, multidisciplinary and regional. Low referral rates, poor evidence-base and poor funding are cited as reasons for the current patchy services. Conclusions: The low response rate contrasts with that from a parallel survey of clinical oncologists. This may reflect the opinion that radiation-induced bowel toxicity is not a significant issue, which may be because only a small proportion of patients are referred to gastroenterologists. The development of new, evidence-based gastroenterology-led services is considered the optimal way to meet the needs of these patients. [ABSTRACT FROM AUTHOR]

Summary At the same time as cell salvage was introduced into our institution for all patients undergoing cardiac surgery with cardiopulmonary bypass, we established a supporting programme of quality assurance to reassure clinicians regarding safety and efficacy. Data collected in patients operated on between 2001 and 2007 included pre- and post-wash heparin concentration, haemoglobin concentration and free haemoglobin concentration. Cell salvage was used in 6826 out of a total of 7243 patients (94%). Post-wash heparin concentration was consistently low (always < 0.4 IU.ml−1). There was a significant decrease in post-wash haemoglobin concentration in 2003 compared to 2001, from a median (IQR [range]) of 19.6 (16.7-22.2 [12.9-25.5]) g.dl−1 to 17.5 (13.6-20.8 [12.6-23.7]) g.dl−1 (p < 0.015). In addition, there was a significant increase in free plasma haemoglobin in 2006 compared to 2001, from 0.5 (0.3-0.8 [0.1-2.6]) g.l−1 to 0.8 (0.3-1.4 [0.3-5.2]) g.l−1 (p < 0.001). This programme led to the detection of a change in operator behaviour in 2003 and progressive machine deterioration resulting in appropriate fleet replacement in 2006. You can respond to this article at [ABSTRACT FROM AUTHOR]

A variety of information that relates to articles that appeared in the Fall/Winter 2009 issue of "The Volta Review" is presented.

Eighty lactating Holstein cows from 21 to 91 d in milk were fed a corn silage-based total mixed ration (TMR) formulated with the Met content limited (42 g/d) to investigate the impact of supplementing rumen-protected (RP) forms of Met, betaine, and choline on performance and metabolism. One of 4 supplements was blended into the TMR to produce 4 dietary treatments: 1) control, 2) 20 g/d of RP-Met, 3) 45 g/d of RP-betaine, and 4) 40 g/d of RP-choline. Calcium salts of fatty acids were used to protect both RP-betaine and RP-choline supplements. A similar amount of Ca salts of fatty acids was included in both control and RP-Met supplements to provide equal amounts of fat to all treatments. Overall, no differences in intake, milk yield, or milk composition were observed in primiparous cows. Average dry matter intake, body weight, and body condition score were not different among treatments in multiparous cows. Milk yield was higher in multiparous cows fed RP-choline compared with the other treatments. Multiparous cows fed RP-choline had higher milk protein yield than cows fed control or RP-betaine but was not different from cows fed RP-Met. Multiparous cows fed RP-choline had higher milk fat yield than cows fed RP-Met but was not different from cows fed control or RP-betaine. There were no beneficial effects of RP-betaine supplementation to a Met-limited TMR. [ABSTRACT FROM AUTHOR]

Objective Singleton infants with intrauterine growth restriction have an adaptive hormonal profile characterized by decreased levels of IGF-1, IGF-2, IGFBP-3 and insulin and elevated levels of IGFBP-1 and IGFBP-2. This study examined the association between cord serum levels of six growth factors and anthropometric features at birth in twins in order to determine the intrauterine growth factor interactions and to characterize the specific hormonal profile of small discordant twins. Design Prevalent case-control study. Patients Twenty pairs of discordant twins (5 monozygotic, 15 dizygotic) and 20 pairs of concordant twins (6 monozygotic, 14 dizygotic) matched for gestational age. Measurements Cord blood levels of IGF-1, IGF-2, IGFBP-1, IGFBP-3, insulin, leptin and anthropometric measurements at birth. Intra- and inter-pair differences and correlation coefficients were calculated, and the data were fitted to multivariate regression models. Results In both discordant and concordant groups, the smaller twins had a significantly lower level of IGF-1 ( P < 0·03) and significantly higher level of IGFBP-1 ( P < 0·02) than their larger cotwins. IGFBP-1 was inversely correlated with IGF-1 ( P < 0·05). Insulin levels were significantly higher in the smaller discordant than the smaller concordant twins ( P < 0·001) and in the larger discordant than the larger concordant twins ( P < 0·004). Among the monozygotic twins, the leptin level was significantly higher in the larger discordant than the larger concordant twins ( P < 0·025). Percentage birth weight discordancy was statistically correlated with twin-pair differences in IGF-1 and IGFBP-1. Conclusions Of the six factors studied, IGF-1 appears to be the main indicator of intrauterine growth. Twin discordancy may involve compensatory rather than adaptive mechanisms or a multihormone relative resistance syndrome. [ABSTRACT FROM AUTHOR]

The neuropeptide substance P (SP), encoded by the preprotachykinin-A (PPTA) gene, is expressed in the central and medial amygdaloid nucleus, where it plays a critical role in modulating fear and anxiety related behaviour. Determining the regulatory systems that support PPTA expression in the amygdala may provide important insights into the causes of depression and anxiety related disorders and will provide avenues for the development of novel therapies. In order to identify the tissue specific regulatory element responsible for supporting expression of the PPTA gene in the amygdala, we used long-range comparative genomics in combination with transgenic analysis and immunohistochemistry. By comparing human and chicken genomes, it was possible to detect and characterise a highly conserved long-range enhancer that supported tissue specific expression in SP expressing cells of the medial and central amygdaloid bodies (ECR1; 158.5 kb 5′ of human PPTA ORF). Further bioinformatic analysis using the TRANSFAC database indicated that the ECR1 element contained multiple and highly conserved consensus binding sequences of transcription factors (TFs) such as MEIS1. The results of immunohistochemical analysis of transgenic lines were consistent with the hypothesis that the MEIS1 TF interacts with and maintains ECR1 activity in the central amygdala in vivo. The discovery of ECR1 and the in vivo functional relationship with MEIS1 inferred by our studies suggests a mechanism to the regulatory systems that control PPTA expression in the amygdala. Uncovering these mechanisms may play an important role in the future development of tissue specific therapies for the treatment of anxiety and depression.Molecular Psychiatry (2006) 11, 410–421. doi:10.1038/sj.mp.4001787; published online 10 January 2006 [ABSTRACT FROM AUTHOR]

A series of workshops was run by two paediatric clinical psychologists for children's nurses in five London teaching hospitals. These were evaluated immediately after completion and indicated that nurses had found the workshops helpful. AIM: To determine whether the benefits described by attendees immediately after workshops were being realised in the clinical setting at three months. METHOD: A qualitative exploration of the current experiences of the nurses was conducted. Responses to open questions on evaluation forms were transcribed and analysed using a content analysis approach. FINDINGS: Participants identified that they benefited greatly from the workshops. Themes concerning the nature of benefits to emerge included: having greater awareness and understanding of the feelings and behaviours of others, feeling more confident at work and also finding it useful to hear about the experiences of others. CONCLUSION: Nurses value and benefit from psychologically oriented training workshops. Further research around the benefits perceived by patients and managers would add weight to this argument. [ABSTRACT FROM AUTHOR]

Manufacturing organizations worldwide are re-inventing their product development practices in an effort to satisfy changing customer requirements. In the context of these changes influencing the manufacturing community, there is a need to develop frameworks, architectures, and methods to facilitate the creation, implementation, and functioning of virtual enterprises (VEs). This paper presents an Internet-based framework, which supports distributed process planning activities in the context of a VE. Typically, in a VE, the enterprise partners are distributed, and possess diverse skills and heterogeneous software resources, which employ heterogeneous computing platforms. Using the developed approach, physically distributed product development partners can collaborate virtually via the Internet and integrate their life-cycle product development activities through seamless information exchange. In this framework, the distributed manufacturing resources communicate with each other via the Internet inter-ORB protocol (IIOP) using an object request broker (ORB) at each distributed site. [ABSTRACT FROM AUTHOR]

Thermal conduction and convection were examined as sources of error in thermographically measured SAR patterns of an interstitial microwave hyperthermia applicator. Measurements were performed in a layered block of muscle-equivalent phantom material using an infrared thermographic technique with varying heating duration. There was a 52.7% reduction in maximum SAR and 75.5% increase in 50% iso-SAR contour area for a 60-s heating duration relative to a 10-s heating duration. A finite element model of heat transfer in an homogeneous medium was used to model conductive and convective heat transfer during the thermographic measurement. Thermal conduction artefacts were found to significantly distort thermographically measured SAR patterns. Convective cooling, which occurs when phantom layers are exposed for thermal image acquisition, was found to significantly affect the magnitude, but not the spatial distribution, of thermographically measured SAR patterns. Results from this investigation suggest that the thermal diffusion artefacts can be minimized if the duration of the applied power pulse is restricted to 10 s or less. [ABSTRACT FROM AUTHOR]

This article is a review of the research findings on the subject of liquid ventilation and how it has shown to improve lung function in patients with respiratory distress syndrome. An overview of the physiology behind the success of liquid ventilation, including current research outcomes, is presented. The literature documenting research data was obtained through an internet search of articles published from 1962 to 2002. Respiratory distress syndrome is a potential complication for any patient that has suffered damage to the lungs. It continues to carry a significantly high mortality rate, in spite of multiple conventional treatments currently in use. The latest clinical research has led to the development of a new treatment for the syndrome called liquid ventilation, whereby chemicals called perfluorocarbons are used as a medium to transport vital respiratory gases into and out of the lungs. Research on animal and human subjects has shown that liquid ventilation therapy can improve lung function in certain patients with severe pulmonary dysfunction when conventional treatments have failed. [ABSTRACT FROM AUTHOR]

The purpose of this work was to measure the thermal conductivity of polyacrylamide (PAG) and compare it with previously reported values. Polyacrylamide phantoms play an important role in the development of hyperthermia and high-temperature thermal therapies based on electromagnetic (EM) radiation by providing a material that mimics the electrical and thermal properties of human tissue. The thermal properties of PAG have, up until now, not been thoroughly investigated and at least two significantly different values have been published. In this study, the thermal conductivity of polyacrylamide was measured from the steady state temperature drop across samples exposed to a known heat flux. The measured conductivity was 0.56 ± 0.047 W m -1 °C -1 . To validate the correct set of thermal properties for polyacrylamide, simple heating experiments were performed in a PAG phantom and then simulated using a finite element numerical model that incorporated the measured thermal conductivity along with literature values for specific heat and density. Temperature predictions from the model agreed with average temperatures measured in the phantom to within 1 SD of the measured temperatures. [ABSTRACT FROM AUTHOR]

Presents a study that determined the effects of crude protein and rumen undegradable protein combinations on milk production and nitrogen loss in feces and urine of dairy cows. Diets and cow management; Calculation of daily nitrogen excretion measures; Diet formulation comparison; Milk yield and composition.

Objective: The objective of this study was to document the prevalence of risk factors for cardiovascular disease among people with chronic mental illness. Method: A cross-sectional survey was conducted of 234 outpatients attending a community mental health clinic in the North-western Health Care Network in Melbourne, Australia. Prevalence of smoking, alcohol consumption, body mass index, hypertension, salt intake, exercise and history of hypercholesterolemia was assessed. Results: Compared with a community sample, the mentally ill had a higher prevalence of smoking, overweight and obesity, lack of moderate exercise, harmful levels of alcohol consumption and salt intake. No differences were found on hypertension. Men, but not women, with mental illness were less likely to undertake cholesterol screening. Conclusions: Psychiatric outpatients have a high prevalence of cardiovascular risk factors which may account for the higher rate of cardiovascular mortality among the mentally ill. Further research is needed to trial and evaluate interventions to effectively modify risk factors in this vulnerable population. [ABSTRACT FROM AUTHOR]

The integrated access to heterogeneous data sources is a major challenge for the biomedical community. Several solution strategies have been explored: link-driven federation of databases, view integration, and warehousing. In this paper we report on our experiences with two systems that were developed at the University of Pennsylvania: K2, a view integration implementation, and GUS, a data warehouse. Although the view integration and the warehouse approaches each have advantages, there is no clear "winner." Therefore, in selecting the best strategy for a particular application, users must consider the data characteristics, the performance guarantees required, and the programming resources available. Our experiences also point to some practical tips on how database updates should be published, and how XML can be used to facilitate the processing of updates in a warehousing environment. [ABSTRACT FROM AUTHOR]

Cervical carcinoma affects around 3400 women in the UK each year and advanced disease is routinely treated with radiation. As part of a programme to establish rapid and convenient methods of predicting tumour and patient responses to radiotherapy, we have examined the relationship between the pre-treatment expression of the Ku components of the DNA damage recognition complex DNA-PK and patient survival in cervical carcinoma. Using immunohistochemistry of formalin-fixed sections of tumour biopsies, antibodies to Ku70 and Ku80 stained identical regions of tumour and there was a high degree of correlation between the mean number of cells stained positive for the two components in 77 tumours (r = 0.82, P<0.001). In 53 tumours there was a borderline significant correlation between measurements of tumour radiosensitivity (surviving fraction at 2 gray: SF2) and Ku70 expression (r = 0.26, P = 0.057) and no correlation for Ku80 (r = 0.18, P = 0.19). However, all tumours with a low number of Ku70 or Ku80 positive cells were radiosensitive. Furthermore, using log-rank analysis there was significantly higher survival in the patients whose tumours had a low Ku70 expression (P = 0.046). This difference was also reflected with Ku80, but did not reach statistical significance (P = 0.087). The study suggests that lack of Ku protein leads to radiosensitivity in some tumours and that other factors are responsible for radiosensitive tumours with high Ku expression. It is likely that the most accurate prediction of treatment outcome will lie in assessing the expression of several proteins involved in the recognition and repair of DNA damage, one of which will be Ku. [ABSTRACT FROM AUTHOR]

The early post-partum period is one of the few times of life stress for which health care professionals recommend alcohol consumption In this study, a group of nursing mothers who had delivered normal full-term, first-bom infants were examined during the 1-month period following childbirth. Data were collected on alcohol consumption patterns prior to and during pregnancy and following childbirth. Most women reported abstaining or decreasing consumption during pregnancy. Those who continued to drink during pregnancy reported drinking on social occasions, rather than when depressed or bored During the post-partum period, a number of women began drinking. By far the most common post-partum drinking situation was during or prior to breast feeding. Reportedly, many women were advised to drink by nurses and doctors in order to relax and to aid the letdown reflex. Several factors seem worth noting. First, professional advice may be based on misinformation Animal studies have suggested that alcohol inhibits the letdown reflex and may interfere with nursing Secondly, because alcohol has been shown to enter the milkstream, attention should be given to possible harmful effects of alcohol (on the newborn) during nursing. Nurses could easily incorporate up-to-date information into their nursing practice. [ABSTRACT FROM AUTHOR]

Nine patients with a lymphoproliferative disorder characterized by a persistent expansion of large granular lymphocytes (LGL) and an increased proportion of cells labelling with natural killer (NK) and T cell markers were identified. The six patients with an expansion of αβ CD3/TcR positive cells were shown to have rearranged T cell receptor (TcR) genes whereas three patients whose LGL lacked CD3/αβ TcR on the surface had no β TcR rearrangement detected. Eight of the nine patients were shown to exhibit non-MHC-restricted cytotoxic activity against K562; this activity was inhibited by CD45 and CD45-associated monoclonal antibodies known to inhibit normal non-MHC-restricted cytotoxicity but not specific MHC-restricted cytotoxic T cell activity. In contrast, the CD3 monoclonal antibody OKT3 did not inhibit but redirected LGL non-MHC-restricted cytotoxicity against K562. Following modulation of the CD3 molecule, the LGL were still capable of cytolysis of K562 targets, but additional OKT3 could no longer redirect cytoloysis. The data indicate that the CD3/TcR complex on the LGL clones in patients with large granular lymphoproliferative disease is not the receptor for antigen on K562 cells, although it retains functional capabilities. Thus the CD3/TcR positive subset appears to have bipotential cytotoxic characteristics involving additional unique receptors for non-MHC-restricted cytotoxicity. [ABSTRACT FROM AUTHOR]

Data of interest to biomedical researchers associated with the Human Genome Project (HGP) is stored all over the world in a number of different electronic data formats and accessible through a variety of interfaces and retrieval languages. These data sources include conventional relational databases with SQL interfaces, formatted text files on top of which indexing is provided for efficient retrieval (ASN.1-Entrez), and binary files that can be interpreted textually or graphically via special purpose interfaces (ACeDB). Researchers within the HGP want to combine data from these different data sources, add value through sophisticated data analysis techniques (such as the biosequence comparison software BLAST and FASTA), and view it using special purpose scientific visualization tools. However, currently there are no commercial tools for enabling such an integrated digital library, and a fundamental barrier to developing such tools appears to be one of language design and optimization: The data formats and software packages found throughout the HGP contain a number of data types not available in conventional databases, such as lists, variants and arrays; furthermore, these types may be deeply nested. We present in this paper a framework for providing read access to multiple data sources with complex structured data, and illustrate its use in an application called BioKleisli which accesses data sources critical to the HGP. The three primary components of this framework are: (1) a powerful language for querying and transforming complex structured data; (2) an extensible architecture for implementing the query primitives; and (3) optimization techniques that extend many known techniques to these more complex data types. [ABSTRACT FROM AUTHOR]

The identification of membrane molecules expressed on subpopulations of B lymphocytes is of potential significance because these molecules may be candidates for regulating the activation, proliferation and differentiation of B cells. A new monoclonal antibody, CMRF-17, which reacts with a subpopulation of tonsil B lymphocytes has been produced. The antibody did not react with T lymphocytes in tonsil or peripheral blood nor most peripheral blood B lymphocytes but did label erythrocytes and some platelets. In tonsil, the germinal centre cells, cells in the interfollicular region and endothelial cells were positive, but mantle zone B cells were negative. Double labelling experiments showed that CMRF-17 reacted with activated tonsillar lymphocytes. The antigen recognized by CMRF-17 was heat stable, resistant to treatment with proteolytic enzymes and neuraminidase and was shown to be a carbohydrate determinant on one or more glycolipids. These characteristics of the antigen recognized by CMRF-17 and its pattern of reactivity distinguish this antibody from other monoclonal antibodies recognizing B-cell activation markers. It was notable that of the B-lymphoid malignancies tested to date, including those of probable follicular origin, few stained with CMRF-17. [ABSTRACT FROM AUTHOR]

Three monoclonal antibodies recognizing different epitopes of the leucocyte common molecule, CM RF-11 (against the restricted or B-220 leucocyte common molecule), CMRF-12 and CMRF-26 [each against a different epitope on the non-restricted or T200 leucocyte common (CD45) molecule], were tested for their effects on lymphocyte cytotoxicity. The individual monoclonal antibodies inhibited human natural killer cell-mediated cytolysis (NK-CMC) weakly, but a mixture of CMRF-11+12+26 antibodies inhibited cytolysis more consistently and to a greater extent. This mixture did not inhibit cytotoxic T lymphocytes derived from secondary mixed lymphocyte cultures. The CMRF-11+12+26 mix was shown to inhibit a post-conjugate formation stage of lysis at the effector cell level. Inhibition of NK-CMC of a wide range of target cells, including the T-cell lines Jurkat, HSB2 and Molt 4, was demonstrated. [ABSTRACT FROM AUTHOR]

Purpose: To examine whether in vitro measurements of normal and tumour cell radiosensitivity can be used as prognostic factors in clinical oncology. Materials and methods: Stage I-III cervix carcinoma patients were treated with radical radiotherapy with a minimum of 3 years' follow-up. Lymphocyte and tumour radiosensitivities were assayed using, respectively, a limiting dilution and soft agar clonogenic assay to obtain surviving fraction at 2 Gy (SF2). The results were related, in an actuarial analysis, to late morbidity assessed using the Franco-Italian glossary. Results: Patients with radiosensitive lymphocytes had a significantly increased risk of developing late complications (n 93, p 0.002). Increasing tumour radiosensitivity was associated with an increased risk of morbidity (n 113, p 0.032). A significant correlation was found between fibroblast and tumour cell radiosensitivity (r 0.57, p 0.03), but a weak inverse association was found between lymphocyte and tumour cell radiosensitivity (r 0.32, p 0.03). Patients with radiosensitive lymphocytes and tumour cells had higher levels of late complications than those whose cells were radioresistant. Conclusion: The work described highlights the importance of cellular radiosensitivity as a parameter determining the clinical response to radiotherapy. [ABSTRACT FROM AUTHOR]

While the mitochondrion has long fascinated biologists and the sheer diversity of druggable targets has made it attractive for potential drug development, there has been little success translatable to the clinic. Given the diversity of inborn errors of metabolism and mitochondrial diseases, mitochondrially mediated oxidative stress (myopathies, reperfusion injury, Parkinson's disease, ageing) and the consequences of disturbed energetics (circulatory shock, diabetes, cancer), the potential for meaningful gain with novel drugs targeting mitochondrial mechanisms is huge both in terms of patient quality of life and health care costs. In this themed issue of the British Journal of Pharmacology, we highlight the key directions of the contemporary advances in the field of mitochondrial biology, emerging drug targets and new molecules which are close to clinical application. Authors' contributions are diverse both in terms of species and organs in which the mitochondrially related studies are performed, and from the perspectives of mechanisms under study. Defined roles of mitochondria in disease are updated and previously unknown contributions to disease are described in terms of the interface between basic science and pathological relevance. Linked Articles This article is part of a themed issue on Mitochondrial Pharmacology: Energy, Injury & Beyond. To view the other articles in this issue visit [ABSTRACT FROM AUTHOR]

Summary Antithrombin inhibits VIIa when bound to cellular tissue factor in the presence of heparin. VIIa concentrations increase within the surgical field during cardiopulmonary bypass surgery but decrease when measured in the patient. Using a new ELISA (Stago, Reading, UK), we measured VIIa-antithrombin complexes in patients undergoing cardiopulmonary bypass to determine whether antithrombin plays a physiological role in VIIa inhibition during cardiac surgery. Samples were taken from 13 adult patients undergoing cardiac surgery with cardiopulmonary bypass at the following time points: presurgery, postheparin, 20 min intervals during cardiopulmonary bypass and postprotamine. The presurgery concentrations of VIIa-antithrombin complexes were median of 52.7pm, and these rose postheparin bolus to a median of 110pM that was maintained throughout cardiopulmonary bypass and postprotamine administration. There is an approximate twofold increase in measurable VIIa-antithrombin complexes in patients undergoing cardiac surgery, which is apparent after heparin administration. Antithrombin appears to play an active role in VIIa inhibition during cardiac surgery. [ABSTRACT FROM AUTHOR]

We report the application of a technique for performing opacity measurements on hot, dense plasmas. Plasmas were generated by using the x rays emitted from a laser-produced gold plasma to heat an aluminum sample. Observations were made using the technique of point projection spectroscopy. The distribution of ion stages observed is compared with predictions based on Saha distributions, at densities and temperatures deduced from hydrodynamic simulations. [ABSTRACT FROM AUTHOR]

Reperfusion of ischaemic cells causes intracellular Ca2+ oscillations as the sarcoplasmic reticulum (SR) takes up and releases Ca2+, leading to hypercontracture and cell death. In other systems, nicotinic acid adenine nucleotide phosphate (NAADP) acts as a second messenger to stimulate Ca2+ release from acidic intracellular Ca2+ stores, which in turn triggers Ca2+ release from the SR. We hypothesised that NAADP signalling is involved in the Ca2+ fluctuations that occur at reperfusion. We examined the effects of a novel NAADP inhibitor, Ned-19, on ischaemia-reperfusion injury in isolated adult rat ventricular cardiomyocytes (ARVC). The sensitivity of mitochondrial permeability transition pore (mPTP) was measured in ARVC using a laser-induced oxidative stress model. SR Ca2+ release was measured by treating cells loaded with fluorescent dye, fluo-4-AM, with caffeine. Cardioprotection was tested by exposing ARVC to metabolic ischaemia-reperfusion. Ned-19 was found to significantly delay the time to mPTP opening by 76%±16%, 55%±20%, 47%±19% and 44%±17% (all p<0.05) at concentrations of 100 α/4mol/l, 10 α/4mol/l, 1 α/4mol/l and 0.1 α/4mol/l, respectively, compared with the control group. Concentrations of Ned-19 at 100 α/4mol/l, 10 α/4mol/l and 1 α/4mol/l, but not 0.1 α/4mol/l, significantly inhibited caffeine-stimulated SR Ca2+ release (71.6%±2.0%, 34.2%±1.9%, 55.6%±5.5% and ∧14%±21%, respectively) indicating non-specific effects at higher concentrations. A low dose of 0.1 α/4mol/l Ned-19 increased the survival of cells following metabolic ischaemia-reperfusion to 46%±19% from 29% (control). In conclusion, we have shown the involvement of NAADP in SR Ca2+ release and mPTP opening, and that by inhibiting NAADP signalling at reperfusion with Ned-19, cardiomyocytes may be protected against ischaemia-reperfusion injury. [ABSTRACT FROM AUTHOR]

An abstract of the study "Heparin concentrations in neonates during cardiopulmonary bypass as measured by the activated clotting time and anti-Xa assay," by J. Keogh and colleagues is presented.

This article includes a case study of a pediatric patient who presented for elective correction of a speech impediment via a frenuloplasty. The patient's history and anesthetic course will be discussed prior to the deveopment of the episode of negative pressure pulmonary edema (NPPE). The events surrounding the development and diagnosis of NPPE will be presented, and the treatment modalities will be discussed. [ABSTRACT FROM AUTHOR]

The article discusses a study that compares insulin dose adjustment decisions in 20 simulated patients by nine primary care physicians (PCPs) and nine endocrinologists to the algorithms used in a diabetes program in a safety-net clinic. Topics covered include barriers to PCPs treating patients with insulin, reluctance on the part of PCPs in industrialized countries to start insulin, and an increase in communications with patients outside of office visits about their insulin therapy.