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ObjectiveCT quantification of aortic valve calcification (CT-AVC) is useful in the assessment of aortic stenosis severity. Our objective was to assess its ability to track aortic stenosis progression compared with echocardiography.MethodsSubjects were recruited in two cohorts: (1) a reproducibility cohortwhere patients underwent repeat CT-AVC or echocardiography within 4 weeks and (2) a disease progression cohortwhere patients underwent annual CT-AVC and/or echocardiography. Cohen’s d-statistic (d) was computed from the ratio of annualised progression and measurement repeatability and used to estimate group sizes required to detect annualised changes in CT-AVC and echocardiography.ResultsA total of 33 (age 71±8) and 81 participants (age 72±8) were recruited to the reproducibility and progression cohorts, respectively. Ten CT scans (16%) were excluded from the progression cohort due to non-diagnostic image quality. Scan-rescan reproducibility was excellent for CT-AVC (limits of agreement −12% to 10 %, intraclass correlation (ICC) 0.99), peak velocity (−7% to +17%; ICC 0.92) mean gradient (−25% to 27%, ICC 0.96) and dimensionless index (−11% to +15%; ICC 0.98). Repeat measurements of aortic valve area (AVA) were less reliable (−44% to +28%, ICC 0.85).CT-AVC progressed by 152 (65–375) AU/year. For echocardiography, the median annual change in peak velocity was 0.1 (0.0–0.3) m/s/year, mean gradient 2 (0–4) mm Hg/year and AVA −0.1 (−0.2–0.0) cm2/year. Cohen’s d-statistic was more than double for CT-AVC (d=3.12) than each echocardiographic measure (peak velocity d=0.71 ; mean gradient d=0.66; AVA d=0.59, dimensionless index d=1.41).ConclusionCT-AVC is reproducible and demonstrates larger increases over time normalised to measurement repeatability compared with echocardiographic measures.

ObjectiveFirst-phase ejection fraction (EF1) is a novel measure of early left ventricular systolic dysfunction. We investigated determinants of EF1 and its prognostic value in aortic stenosis.MethodsEF1 was measured retrospectively in participants of an echocardiography/cardiovascular magnetic resonance cohort study which recruited patients with aortic stenosis (peak aortic velocity of ≥2 m/s) between 2012 and 2014. Linear regression models were constructed to examine variables associated with EF1. Cox proportional hazards were used to determine the prognostic power of EF1 for aortic valve replacement (AVR, performed as part of clinical care in accordance with international guidelines) or death.ResultsTotal follow-up of the 149 participants (69.8% male, 70 (65–76) years, mean gradient 33 (21–42) mm Hg) was 238 029 person-days. Sixty-seven participants (45%) had a low baseline EF1 (<25%) despite normal ejection fraction (67% (62%–71%)). Patients with low EF1 had more severe aortic stenosis (mean gradient 39 (34–45) mm Hg vs 24 (16–35) mm Hg, p<0.001) and more myocardial fibrosis (indexed extracellular volume (iECV) (24.2 (19.6–28.7) mL/m2vs 20.6 (16.8–24.3) mL/m2, p=0.002; late gadolinium enhancement (LGE) prevalence 52% vs 20%, p<0.001). Zva, iECV and infarct LGE were independent predictors of EF1. EF1 improved post-AVR (n=57 with post-AVR EF1 available, baseline 16 (12–24) vs follow-up 27% (22%–31%); p<0.001). Low baseline EF1 was an independent predictor of AVR/death (HR 5.6, 95% CI 3.4 to 9.4), driven by AVR.ConclusionEF1 quantifies early, potentially reversible systolic dysfunction in aortic stenosis, is associated with global afterload and myocardial fibrosis, and is an independent predictor of AVR.

ObjectivesIntraplaque angiogenesis and inflammation are key promoters of atherosclerosis and are mediated by the alpha-V beta-3 (αvβ3) integrin pathway. We investigated the applicability of the αvβ3-integrin receptor-selective positron emission tomography (PET) radiotracer 18F-fluciclatide in assessing human aortic atherosclerosis.MethodsVascular 18F-fluciclatide binding was evaluated using ex vivo analysis of carotid endarterectomy samples with autoradiography and immunohistochemistry, and in vivo kinetic modelling following radiotracer administration. Forty-six subjects with a spectrum of atherosclerotic disease categorised as stable (n=27) or unstable (n=19; recent myocardial infarction) underwent PET and CT imaging of the thorax after administration of 229 (IQR 217–237) MBq 18F-fluciclatide. Thoracic aortic 18F-fluciclatide uptake was quantified on fused PET-CT images and corrected for blood-pool activity using the maximum tissue-to-background ratio (TBRmax). Aortic atherosclerotic burden was quantified by CT wall thickness, plaque volume and calcium scoring.Results18F-Fluciclatide uptake co-localised with regions of increased αvβ3integrin expression, and markers of inflammation and angiogenesis. 18F-Fluciclatide vascular uptake was confirmed in vivo using kinetic modelling, and on static imaging correlated with measures of aortic atherosclerotic burden: wall thickness (r=0.57, p=0.001), total plaque volume (r=0.56, p=0.001) and aortic CT calcium score (r=0.37, p=0.01). Patients with recent myocardial infarction had greater aortic 18F-fluciclatide uptake than those with stable disease (TBRmax1.29 vs 1.21, p=0.02).ConclusionsIn vivo expression of αvβ3integrin in human aortic atheroma is associated with plaque burden and is increased in patients with recent myocardial infarction. Quantification of αvβ3integrin expression with 18F-fluciclatide PET has potential to assess plaque vulnerability and disease activity in atherosclerosis.

Natural mechanisms in the ocean, both physical and biological, concentrate carbon in the deep ocean, resulting in lower atmospheric carbon dioxide. The signals of these carbon pumps overlap to create the observed carbon distribution in the ocean, making the individual impact of each pump difficult to disentangle. Noble gases have the potential to directly quantify the physical carbon solubility pump and to indirectly improve estimates of the biological organic carbon pump. Noble gases are biologically inert, can be precisely measured, and span a range of physical properties. We present dissolved neon, argon, and krypton data spanning the Atlantic, Southern, Pacific, and Arctic Oceans. Comparisons between deep-ocean observations and models of varying complexity enable the rates of processes that control the carbon solubility pump to be quantified and thus provide an important metric for ocean model skill. Noble gases also provide a powerful means of assessing air–sea gas exchange parameterizations.

The Greenland Ice Sheet is losing mass at an accelerating pace, increasing its contribution to the freshwater input into the Nordic Seas and the subpolar North Atlantic. It has been proposed that this increased freshwater may impact the Atlantic Meridional Overturning Circulation by affecting the stratification of the convective regions of the North Atlantic and Nordic Seas. Observations of the transformation and pathways of meltwater from the Greenland Ice Sheet on the continental shelf and in the gyre interior, however, are lacking. Here, we report on noble gas derived observations of submarine meltwater distribution and transports in the East and West Greenland Current Systems of southern Greenland and around Cape Farewell. In southeast Greenland, submarine meltwater is concentrated in the East Greenland Coastal Current core with maximum concentrations of 0.8%, thus significantly diluted relative to fjord observations. It is found in water with density ranges from 1,024 to 1027.2 kg m−3and salinity from 30.6 to 34, which extends as deep as 250 m and as far offshore as 60 km on the Greenland shelf. Submarine meltwater transport on the shelf averages 5.0 ± 1.6 mSv which, if representative of the mean annual transport, represents 60%–80% of the total solid ice discharge from East Greenland and suggests relatively little offshore export of meltwater east and upstream of Cape Farewell. The location of the meltwater transport maximum shifts toward the shelfbreak around Cape Farewell, positioning the meltwater for offshore flux in regions of known cross‐shelf exchange along the West Greenland coast. The Greenland Ice Sheet is losing a lot of ice very quickly and this is causing more lightweight freshwater to flow into the North Atlantic Ocean. This extra freshwater could possibly influence the way that the surface and interior of the ocean interact, impacting global ocean currents. We do not have enough information about how the ice that is melting from Greenland is affecting the ocean, in part because we do not have many tools to observe where the meltwater goes. In this work, we made measurements with the best tools available to follow the ice melted from marine terminating glaciers as it travels around Greenland. We were able to make some of the most comprehensive direct measurements of the oceanic pathways of glacial meltwater in coastal Greenland. We found that the freshwater from Greenlandic glacier's submarine melted ice is not very concentrated when it gets to the ocean, but it does go deep and, at first, not too far away from the shore. The Greenland meltwater stays close to shore along the east coast up to Cape Farewell. However, meltwater moves farther from shore after that and may mix out into the open ocean from there. Direct measurements of the pathways and fluxes of glacial meltwater in coastal GreenlandLittle offshore export of meltwater east and upstream of Cape FarewellMeltwater moves offshore toward shelfbreak around Cape Farewell Direct measurements of the pathways and fluxes of glacial meltwater in coastal Greenland Little offshore export of meltwater east and upstream of Cape Farewell Meltwater moves offshore toward shelfbreak around Cape Farewell

The Greenland Ice Sheet has been, and will continue, losing mass at an accelerating rate. The influence of this anomalous meltwater discharge on the regional and large‐scale ocean could be considerable but remains poorly understood. This uncertainty is in part a consequence of challenges in observing water mass transformation and meltwater spreading in coastal Greenland. Here we use tracer observations that enable unprecedented quantification of the export, mixing, and vertical distribution of meltwaters leaving one of Greenland's major glacial fjords. We find that the primarily subsurface meltwater input results in the upwelling of the deep fjord waters and an export of a meltwater/deepwater mixture that is 30 times larger than the initial meltwater release. Using these tracer data, the vertical structure of Greenland's summer meltwater export is defined for the first time showing that half the meltwater export occurs below 65 m. The Greenland Ice Sheet has been melting at an accelerating pace. As it melts, more and more freshwater drains into the Northern North Atlantic. This may have significant impacts on ocean circulation. In order to start to understand these impacts, we need better observations of the spreading of ice sheet meltwater around coastal Greenland. In this work we use noble gases as a natural “dye” that traces out the pathways of ice melt in coastal waters. These “dyes” give us a powerful tool to measure the size and location of ice melt export. This paper quantifies the flux of two types of meltwater in a major East Greenland fjord and shows that the meltwater is highly diluted by mixing with warm, salty waters from the deepest part of the fjord. Showing which ocean waters dilute the glacial melt is one step toward better representing these processes in numerical models. Direct observations of meltwater export from a major Greenland glacial fjord are reportedProperties of the exported meltwater mixture are dominated by entrainment and upwellingNoble gases reveal the vertical structure of Greenland meltwater forcing of the coastal ocean

ObjectivesMacrophages play a central role in the cellular inflammatory response to myocardial infarction (MI) and predict subsequent clinical outcomes. We aimed to assess temporal changes in cellular inflammation and tissue oedema in patients with acute MI using ultrasmallsuperparamagnetic particles of iron oxide (USPIO)-enhanced MRI.MethodsThirty-one patients were recruited following acute MI and followed up for 3 months with repeated T2 and USPIO-enhanced T2*-mapping MRI. Regions of interest were categorised into infarct, peri-infarct and remote myocardial zones, and compared with control tissues.ResultsFollowing a single dose, USPIO enhancement was detected in the myocardium until 24 hours (p<0.0001). Histology confirmed colocalisation of iron and macrophages within the infarcted, but not the non-infarcted, myocardium. Following repeated doses, USPIO uptake in the infarct zone peaked at days 2–3, and greater USPIO uptake was detected in the infarct zone compared with remote myocardium until days 10–16 (p<0.05). In contrast, T2-defined myocardial oedema peaked at days 3–9 and remained increased in the infarct zone throughout the 3-month follow-up period (p<0.01).ConclusionMyocardial macrophage activity can be detected using USPIO-enhanced MRI in the first 2 weeks following acute MI. This observed pattern of cellular inflammation is distinct, and provides complementary information to the more prolonged myocardial oedema detectable using T2 mapping. This imaging technique holds promise as a non-invasive method of assessing and monitoring myocardial cellular inflammation with potential application to diagnosis, risk stratification and assessment of novel anti-inflammatory therapeutic interventions.Trial registration numberTrial registration number: 14663. Registered on UK Clinical Research Network (http://public.ukcrn.org.uk) and also ClinicalTrials.gov(https://clinicaltrials.gov/ct2/show/NCT02319278?term=DECIFER&rank=2).

ObjectiveMaladaptive repair contributes towards the development of heart failure following myocardial infarction (MI). The αvβ3integrin receptor is a key mediator and determinant of cardiac repair. We aimed to establish whether αvβ3integrin expression determines myocardial recovery following MI.Methods18F-Fluciclatide (a novel αvβ3-selective radiotracer) positron emission tomography (PET) and CT imaging and gadolinium-enhanced MRI (CMR) were performed in 21 patients 2 weeks after ST-segment elevation MI (anterior, n=16; lateral, n=4; inferior, n=1). CMR was repeated 9 months after MI. 7 stable patients with chronic total occlusion (CTO) of a major coronary vessel and nine healthy volunteers underwent a single PET/CT and CMR.Results18F-Fluciclatide uptake was increased at sites of acute infarction compared with remote myocardium (tissue-to-background ratio (TBRmean) 1.34±0.22 vs 0.85±0.17; p<0.001) and myocardium of healthy volunteers (TBRmean1.34±0.22 vs 0.70±0.03; p<0.001). There was no 18F-fluciclatide uptake at sites of established prior infarction in patients with CTO, with activity similar to the myocardium of healthy volunteers (TBRmean0.71±0.06 vs 0.70±0.03, p=0.83). 18F-Fluciclatide uptake occurred at sites of regional wall hypokinesia (wall motion index≥1 vs 0; TBRmean0.93±0.31 vs 0.80±0.26 respectively, p<0.001) and subendocardial infarction. Importantly, although there was no correlation with infarct size (r=0.03, p=0.90) or inflammation (C reactive protein, r=−0.20, p=0.38), 18F-fluciclatide uptake was increased in segments displaying functional recovery (TBRmean0.95±0.33 vs 0.81±0.27, p=0.002) and associated with increase in probability of regional recovery.Conclusion18F-Fluciclatide uptake is increased at sites of recent MI acting as a biomarker of cardiac repair and predicting regions of recovery.Trial registration numberNCT01813045; Post-results.

The noble gas signature of incoming Pacific Bottom Water (PBW), when compared to North Atlantic Deep Water, indicates the addition of 450 ± 70 GT a−1glacial melt water to form AABW and subsequently PBW. The downstream evolution of this signature between the southern (20°S to equator) and northern (25°–45°N) bottom waters indicates a decrease in sea level pressure around Antarctica over the past two millennia. Vertical profiles of noble gases in the deep Pacific show exponential relationships with depth with scale heights identical to temperature and salinity. Unlike the other noble gases, helium isotopes show evidence of mid‐depth injection of non‐atmospheric helium. Using observed deviations from exponential behavior, we quantify its magnitude and isotope ratio. There is a clear latitude trend in the isotope ratio of this added helium that decreases from a high exceeding 9 RA(atmospheric 3He/4He ratio) in the south to around 8 RAnear the equator. North of 30–40°N, it systematically decreases northward to a low of ∼2 RAnorth of 50°N. This decline results from a combination of northward decline in seafloor spreading, release of radiogenic helium from increased sediment thickness, and the possible emission of radiogenic helium through cold seeps along the Alaskan and North American margins. Finally, we derive an improved method of computing the excess helium isotope concentrations and that the distributions of bottom water 3HeXS/4HeXSare consistent with what is known about bottom water flow patterns and the input of low 3He/4He sedimentary helium. Dissolved noble gases, because they are inert and span a range of physical characteristics, uniquely record conditions at the sea surface when water masses are formed and sink from polar regions to fill the abyssal ocean. These signatures can be used not only to deduce past changes in sea level pressure and rates of glacial melting but also to disentangle air‐sea exchange and in situ physical processes that affect all gases from subsurface external sources that are unique for helium isotopes. The distribution of helium isotopes in the deep ocean can be used to constrain the patterns and magnitudes of hydrothermal sources at the sea floor as well as the input of sedimentary radiogenic helium and cold seeps to Pacific bottom water. We use these tools to study the various sources of helium isotopes in the abyssal Northeast Pacific. Noble gases constrain the rate of basal melting of Antarctic GlaciersNoble gases allow us to constrain the isotopic composition of helium being added to deep watersThe distribution of helium isotopes mirrors important geological and geophysical processes in the Pacific Noble gases constrain the rate of basal melting of Antarctic Glaciers Noble gases allow us to constrain the isotopic composition of helium being added to deep waters The distribution of helium isotopes mirrors important geological and geophysical processes in the Pacific

The distribution of noble gases and helium isotopes in the dense shelf waters of Antarctica reflects the boundary conditions near the ocean surface: air‐sea exchange, sea ice formation, and subsurface ice melt. We use a nonlinear least squares solution to determine the value of the recharge temperature and salinity, as well as the excess air injection and glacial meltwater content throughout the water column and in the precursor to Antarctic Bottom Water. The noble gas‐derived recharge temperature and salinity in the Weddell Gyre are −1.95°C and 34.95 psu near 5500 m; these cold, salty recharge values are a result of surface cooling as well as brine rejection during sea ice formation in Antarctic polynyas. In comparison, the global value for deep water recharge temperature is −0.44°C at 5500 m, which is 1.5°C warmer than the southern hemisphere deep water recharge temperature, reflecting a distinct contribution from the north Atlantic. The contrast between northern and southern hemisphere recharge properties highlights the impact of sea ice formation on setting the gas properties in southern sourced deep water. Below 1000 m, glacial meltwater averages 3.5‰ by volume and represents greater than 50% of the excess neon and argon found in the water column. These results indicate glacial melt has a nonnegligible impact on the atmospheric gas content of Antarctic Bottom Water. We adapt the noble gas paleothermometer to quantify recharge properties of the deep ocean, including sea ice and glacial meltwater fractionGlacial meltwater is responsible for a significant fraction of dissolved noble gases in deep waterBrine and gas rejection during sea ice formation alters the dissolved gas budget of deep water

We present the first noble gas observations in a proglacial fjord in Greenland, providing an unprecedented view of surface and submarine melt pathways into the ocean. Using Optimum Multiparameter Analysis, noble gas concentrations remove large uncertainties inherent in previous studies of meltwater in Greenland fjords. We find glacially modified waters with submarine melt concentrations up to 0.66 ± 0.09% and runoff 3.9 ± 0.29%. Radiogenic enrichment of Helium enables identification of ice sheet near‐bed melt (0.48 ± 0.08%). We identify distinct regions of meltwater export reflecting heterogeneous melt processes: a surface layer of both runoff and submarine melt and an intermediate layer composed primarily of submarine melt. Intermediate ocean waters carry the majority of heat to the fjords' glaciers, and warmer deep waters are isolated from the ice edge. The average entrainment ratio implies that ocean water masses are upwelled at a rate 30 times the combined glacial meltwater volume flux. Noble gases make excellent tracers of meltwater in Greenlandic fjordsResolved glacially modified water distribution illuminates ice‐ocean interactionDifferent melt plume regimes are found in front of a glacier

18F-Sodium fluoride (18F-NaF) and 18F-fluorodeoxyglucose (18F-FDG) are promising novel biomarkers of disease activity in aortic stenosis. We compared 18F-NaF and 18F-FDG uptake with histological characterization of the aortic valve and assessed whether they predicted disease progression.

Low levels of the micronutrient iron limit primary production and nitrogen fixation in large areas of the global ocean. The location and magnitude of oceanic iron sources remain uncertain, however, owing to a scarcity of data, particularly in the deep ocean. Although deep-sea hydrothermal vents along fast-spreading ridges have been identified as important contributors to the oceanic iron inventory, slow-spreading ridges, which contribute more than half of the submarine ridge-crest environment, are assumed to be less significant and remain relatively unexplored. Here, we present measurements of dissolved iron and manganese concentrations along a full-depth section in the South Atlantic Ocean, running from offshore of Brazil to Namibia. We detect a large dissolved iron- and manganese-rich plume over the slow-spreading southern Mid-Atlantic Ridge. Using previously collected measurements of helium-3 concentrations—a tracer of hydrothermal activity—we calculate the ratio of dissolved iron to hydrothermal helium in the plume waters and find that it is 80-fold higher than that reported for plume waters emanating from faster-spreading ridges in the southeastern Pacific. Only the application of a higher ratio in global ocean model simulations yields iron fluxes from these slow-spreading submarine ridges that are in line with our observations. We suggest that global iron contributions from hydrothermal vents are significantly higher than previously thought, owing to a greater contribution from slow-spreading regions.

Background: Alcohol exposure during development has been shown to alter a variety of social behaviors in both humans and rodents. Sexual behavior in rodents has been well characterized and lends itself to a detailed investigation of the manner in which ethanol impacts this particular social behavior.

An analysis of the physical mechanisms contributing to the ventilation of the lower subtropical thermocline (26.5 < σθ< 27.3) of the North Atlantic is presented. Examination of the surface forcing suggests that this density range in the Atlantic should be strongly ventilated by flow from the surface winter mixed layer. In contrast to this expectation, the isopycnic distribution of tracers within the shielded thermocline fails to show evidence of net advective penetration of recently ventilated waters into the eastern North Atlantic. Instead, the presence of the Azores Current appears to block the net southward invasion of mass from the region of the isopycnal surface outcrops. Tracer properties of recently ventilated waters enter the gyre by diffusive exchange across the Azores Front. Evidence of this diffusive ventilation based on both steady-state and transient tracers is presented. Mean basin-scale property distributions on σθ 27.0 are diagnosed from an expanded high quality hydrographic database. The Montgomery streamfunction revels no evidence of pathways for direct geostrophic ventilation on this density horizon; low values of potential vorticity are confined to the region of formation north of the Azores Current.

Advances in machine learning (ML) techniques and computational capacity have yielded state‐of‐the‐art methodologies for processing, sorting, and analyzing large seismic data sets. In this study, we consider an application of ML for automatically identifying dominant types of impulsive seismicity contained in observations from a 34‐station broadband seismic array deployed on the Ross Ice Shelf (RIS), Antarctica from 2014 to 2017. The RIS seismic data contain signals and noise generated by many glaciological processes that are useful for monitoring the integrity and dynamics of ice shelves. Deep clustering was employed to efficiently investigate these signals. Deep clustering automatically groups signals into hypothetical classes without the need for manual labeling, allowing for the comparison of their signal characteristics and spatial and temporal distribution with potential source mechanisms. The method uses spectrograms as input and encodes their salient features into a lower‐dimensional latent representation using an autoencoder, a type of deep neural network. For comparison, two clustering methods are applied to the latent data: a Gaussian mixture model (GMM) and deep embedded clustering (DEC). Eight classes of dominant seismic signals were identified and compared with environmental data such as temperature, wind speed, tides, and sea ice concentration. The greatest seismicity levels occurred at the RIS front during the 2016 El Niño summer, and near grounding zones near the front throughout the deployment. We demonstrate the spatial and temporal association of certain classes of seismicity with seasonal changes at the RIS front, and with tidally driven seismicity at Roosevelt Island. We demonstrate the ability of a machine learning technique called deep clustering to automatically identify different types of seismic signals. A neural network encodes spectrograms into simplified representations. Application of a clustering algorithm separates the representations into distinct clusters of signal types. The deep clustering technique was applied to seismic data recorded by an extensive array of broadband seismometers deployed on the Ross Ice Shelf (RIS), Antarctica from 2014 to 2017. In addition to knowing when and where the RIS signals are detected, clustering enables users to determine the signal characteristics. Paired with environmental data, deep clustering can be used to identify whether certain environmental factors are associated with particular classes of seismicity. Deep clustering identified classes of seismic signals with similar spectral and temporal featuresDeep clustering can be adapted to various kinds of data sets, enabling rapid exploration of “big data” in seismologyPaired with environmental data, deep clustering could provide insights into the causes of seismicity Deep clustering identified classes of seismic signals with similar spectral and temporal features Deep clustering can be adapted to various kinds of data sets, enabling rapid exploration of “big data” in seismology Paired with environmental data, deep clustering could provide insights into the causes of seismicity

Research suggests that individuals with higher levels of self-efficacy and internal locus of control are more likely to engage in job search activities and persist for longer periods of time when faced with repeated failure when compared to individuals with low self-efficacy and external locus of control (Kulik and Rowland, J. Organization. Behav. 1989;10:361–367). This article will discuss how Bandura's (Psychol. Rev. 1977;84:191–214) self-efficacy theory and Rotter's (Psychol. Monogr.: Gen. Appl. 1966;80:1–27) locus of control theory can be applied to increase participation and persistence in job readiness training programs for people with disabilities. The authors will provide an overview of those theories and then use a case example to illustrate how they can be used in the job readiness process.

This was a parallel stratifiedstudy which examined the effect on gingival health of a new floss holder and applicator, designed to deliver a 25μl dose of 0.1% Chlorhexidine solution to each interdental embrasure during the flossing procedure. Fifty‐two patients with simple chronic gingivitis were stratified according to age, sex, and baseline interdental bleeding score and then assigned to one of three treatment groups. One of the following interdental cleaning agents was used once daily during a 2‐week period: conventional floss; a flossing device with Chlorhexidine; or a flossing device with placebo solution. Gingival health was assessed using the interdental bleeding index (IBI); i.e., the ratio of bleeding sites to the number of sites tested by stimulation with an interdental cleaner. The percentage reduction in bleeding amounted to 38.3% for conventional floss, 51.5% for the flossing device with Chlorhexidine, and 51.4% for the flossing device with placebo. The reductions in both flossing device groups were significantly greater than that of the conventional floss group as determined by one‐way ANOVA (F = 4.0; P= 0.024) and multiple range tests. There were no statistically significant differences between the two flossing device groups. There was no difference in patients' perception of ease of use of their respective materials; however, 72% of Chlorhexidine users and 94% of placebo users, but only 24% of conventional floss users, felt that their interdental cleaning regimens left their mouths feeling fresher. It is therefore postulated that the pleasant tasting spray may have been an important stimulus to extended use of the new device and may explain its greater effectiveness. J Periodontol 1992; 63:757–760.

Background and Purpose.Job-related repetitive strain injuries (RSIs) are increasing, and current treatment strategies often fail to return injured people to work. This study documented the neural consequences of using two different movement strategies for active, repetitive hand closing and opening. Methods.Two owl monkeys were trained for 20 weeks to repetitively close a handpiece against an 80-g force (3–400 trials per day, training at 80%–90% accuracy). One monkey used a highly articulated hand-squeezing strategy, and the other monkey used a proximal arm-pulling strategy. Changes in motor performance were analyzed, and the electrophysiological maps of the hand representation on the trained primary sensory cortex (area 3b) were compared with those of untrained control animals and the untrained sides of the trained monkeys. Results.The monkey using the articulated hand-squeezing strategy showed motor deterioration and dedifferentiation of the normally sharply segregated areas of the hand representation in area 3b. Mild degradation of the hand representation was measured in the monkey using the proximal arm-pulling strategy, but there was no motor dysfunction. Conclusion and Discussion.Attended, highly articulated, repetitive finger squeezing degrades the hand representation and interferes with motor control. A proximal, more variable repetitive strategy minimized the sensory degradation and preserved motor control. Restoring the hand representation may be a critical part of treatment for patients with chronic RSI and focal hand dystonia.

Getting to grips with the technical difficulties of performance measurement should not blind us to the fact that political factors can be as important as technical ones in the management of organisations, particularly in the public sector. Government Departments carry out different tasks and work within different traditions. The combination of political and contingent factors should lead us to expect that performance measurement in government will be diverse in its operation.

There are many differences between state and local special education programs and the state-federal vocational rehabilitation (VR) program. The differences are highlighted through discussion of the history of the state-federal VR program, differing definitions of individuals with disabilities (used in VR and special education), operation of the VR program, and funding differences and resultant differences in evaluation standards between VR and special education programs. Recommendations are made to effect productive interaction between special education and state-federal VR agencies.

Successful implantation in children requires that provision be made for later head growth. The timing and magnitude of this growth was determined by measurements made from high-resolution computerized tomographic images of developing temporal bones. The temporal bone scans of 103 children of varying ages were studied. The development of the petrous and squamous portion of the temporal bone was at its greatest in the first 2 years of life. The order of magnitude of growth varied with the different axes measured.

Many factors may influence the actions and fates of anesthetic and anesthetic-related agents in ruminant animals. These considerations need to be taken into account when these drugs are employed clinically. Some of the major principles governing the disposition of CNS-active drugs are reviewed, with special emphasis on the uniqueness of ruminant animals. General pharmacokinetic considerations are also covered as a preamble to a commentary on the kir1etic characteristics of anesthetic and anesthetic-related agents that are commonly used in domesticated ruminants.

Pb, Sr and Nd isotope variations are correlated in diverse lavas erupted at small seamounts near the East Pacific Rise. Tholeiites are isotopically indistinguishable from MORB (206Pb/204Pb=18.1–18.5; 87Sr/86Sr=0.7023–0.7028; 143Nd/144Nd=0.51326-0.51308); associated alkali basalts always show more radiogenic Pb and Sr signatures (206Pb/204Pb=18.8–19.2; 87Sr/86Sr=0.7029–0.7031) and less radiogenic Nd (143Nd/144Nd=0.51289–0.51301). The isotopic variability covers ~80% of the variability for Pacific MORB, due to the presence of small-scale heterogeneity in the underlying mantle. Isotope compositions also correlate with trace element ratios such as La/Sm. Tholeiites at these seamounts have 3He/4He between 7.8–8.7 RA(RA= atmospheric ratio), also indistinguishable from MORB. He trapped in vesicles of alkali basalts, released by crushing in vacuo, has low 3He/4He (1.2–2.6 R)Ain conjunction with low helium concentrations ([He]<5×10-8 ccSTP/g). In many cases post-eruptive radiogenic ingrowth has produced He isotope disequilibrium between vesicles and glass in the alkali basalts; subatmospheric 3He/4He ratios characterize the He dissolved in the glass which is released by melting the crushed powders. The narrow range of 3He/4He in the vesicles of the alkali basalts suggests that low 3He/4He is a source characteristic, but given their low [He] and high (U + Th), pre-eruptive radiogenic ingrowth cannot be excluded as a cause for low inherited 3He/4He ratios. Pb, Sr and Nd isotope compositions in lavas erupted at Shimada Seamount, an isolated volcano on 20 m.y. old seafloor at 17°N, are distinctly different from other seamounts in the East Pacific (206Pb/204Pb=18.8–19.0, 87Sr/ 86Sr?0.7048 and 143Nd/144Nd?0.51266). Relatively high 207Pb/204Pb (15.6–15.7) indicates ancient (>2 Ga) isolation of the source from the depleted upper mantle, similar to Dupal components which are more prevalent in the southern hemisphere mantle. 3He/4He at Shimada Seamount is between 3.9–4.8 RA. Because the helium concentrations range up to 1.5×10-6, the low 3He/4He can not be due to radiogenic accumulation of 4He in the magma for reasonable volcanic evolution times. The low 3He/4He may be due to the presence of “enriched” domains within the lithosphere with high (U + Th)/He ratios, possibly formed during its accretion near the ridge. Alternatively, the low 3He/4He may be an inherent characteristic of an enriched component in the mantle beneath the East Pacific. Collectively, the He-Pb-Sr-Nd isotope systematics at East Pacific seamounts suggest that the range of isotope compositions present in the mantle is more readily sampled by seamount and island volcanism than by axial volcanism. Beneath thicker lithosphere away from the ridge axis, smaller degrees of melting in the source regions are less efficient in averaging the chemical characteristics of small-scale heterogeneities.

Xerri, Christian, Michael M. Merzenich, Bret E. Peterson, and William Jenkins.Plasticity of primary somatosensory cortex paralleling sensorimotor skill recovery from stroke in adult monkeys. J. Neurophysiol.79: 2119–2148, 1998. Adult owl and squirrel monkeys were trained to master a small-object retrieval sensorimotor skill. Behavioral observations along with positive changes in the cortical area 3b representations of specific skin surfaces implicated specific glabrous finger inputs as important contributors to skill acquisition. The area 3b zones over which behaviorally important surfaces were represented were destroyed by microlesions, which resulted in a degradation of movements that had been developed in the earlier skill acquisition. Monkeys were then retrained at the same behavioral task. They could initially perform it reasonably well using the stereotyped movements that they had learned in prelesion training, although they acted as if key finger surfaces were insensate. However, monkeys soon initiated alternative strategies for small object retrieval that resulted in a performance drop. Over several- to many-week-long period, monkeys again used the fingers for object retrieval that had been used successfully before the lesion, and reacquired the sensorimotor skill. Detailed maps of the representations of the hands in SI somatosensory cortical fields 3b, 3a, and 1 were derived after postlesion functional recovery. Control maps were derived in the same hemispheres before lesions, and in opposite hemispheres. Among other findings, these studies revealed the following 1) there was a postlesion reemergence of the representation of the fingertips engaged in the behavior in novel locations in area 3b in two of five monkeys and a less substantial change in the representation of the hand in the intact parts of area 3b in three of five monkeys. 2) There was a striking emergence of a new representation of the cutaneous fingertips in area 3a in four of five monkeys, predominantly within zones that had formerly been excited only by proprioceptive inputs. This new cutaneous fingertip representation disproportionately represented behaviorally crucial fingertips. 3) There was an approximately two times enlargement of the representation of the fingers recorded in cortical area 1 in postlesion monkeys. The specific finger surfaces employed in small-object retrieval were differentially enlarged in representation. 4) Multiple-digit receptive fields were recorded at a majority of emergent, cutaneous area 3a sites in all monkeys and at a substantial number of area 1 sites in three of five postlesion monkeys. Such fields were uncommon in area 1 in control maps. 5) Single receptive fields and the component fields of multiple-digit fields in postlesion representations were within normal receptive field size ranges. 6) No significant changes were recorded in the SI hand representations in the opposite (untrained, intact) control hemisphere. These findings are consistent with “substitution” and “vicariation” (adaptive plasticity) models of recovery from brain damage and stroke.

Abstract: One of the fundamental goals of the modern field of neuroscience is to understand how neuronal activity gives rise to higher cortical function. However, to bridge the gap between neurobiology and behavior, we must understand higher cortical functions at the behavioral level at least as well as we have come to understand neurobiological processes at the cellular and molecular levels. This is certainly the case in the study of speech processing, where critical studies of behavioral dysfunction have provided key insights into the basic neurobiological mechanisms relevant to speech perception and production. Much of this progress derives from a detailed analysis of the sensory, perceptual, cognitive, and motor abilities of children who fail to acquire speech, language, and reading skills normally within the context of otherwise normal development. Current research now shows that a dysfunction in normal phonological processing, which is critical to the development of oral and written language, may derive, at least in part, from difficulties in perceiving and producing basic sensory-motor information in rapid succession – within tens of ms (see Tallal et al. 1993a for a review). There is now substantial evidence supporting the hypothesis that basic temporal integration processes play a fundamental role in establishing neural representations for the units of speech (phonemes), which must be segmented from the (continuous) speech stream and combined to form words, in order for the normal development of oral and written language to proceed. Results from magnetic resonance imaging (MRI) and positron emission tomography (PET) studies, as well as studies of behavioral performance in normal and language impaired children and adults, will be reviewed to support the view that the integration of rapidly changing successive acoustic events plays a primary role in phonological development and disorders. Finally, remediation studies based on this research, coupled with neuroplasticity research, will be presented.