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To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.addbeh.2006.11.021 Byline: George W. Joe, Patrick M. Flynn, Kirk M. Broome, D. Dwayne Simpson Keywords: Drug use expectations; Follow-up outcomes; Latent class analyses; Longitudinal assessments; Methadone drug use Abstract: Expectations about future behavior have been shown to have a positive relationship with subsequent behavior. For patients in drug treatment, recovery should manifest changes in drug use and in cognitive perceptions of being able to refrain from use. The present study identified latent patterns of the longitudinal relationship between drug use expectation and illegal drug use during treatment. Latent variable mixture modeling identified three patterns of change over successive 3-month intervals during treatment: Improvers (48%), Decliners (33%), and Continuing Users (19%). The sample consisted of 497 patients in community-based outpatient methadone treatment. The utility of the latent patterns was shown through their relationship to treatment engagement, where Continuing Users had lower counseling rapport and time in treatment. These latent patterns also differed on drug use measures at follow-up. Additional analyses of expectations with measures of opioid use, cocaine use, or criminality yielded similar latent patterns. Expectations about future drug use were found to be a useful measure of cognitive change corresponding to drug use change. Its potential as a brief treatment management tool is noted. Author Affiliation: Institute of Behavioral Research, Texas Christian University, TCU Box 298740, Fort Worth, TX 76129, United States Article Note: (footnote) [star] More information (including data collection instruments that can be downloaded without charge) is available on the Internet at www.ibr.tcu.edu, and electronic mail can be sent to ibr@tcu.edu.

Many patients with shoulder arthroplasty enjoy hobbies that require the use of firearms; however, there is a paucity of literature regarding firearm use after arthroplasty. The purpose of this study was to determine if patients can safely engage in shooting sports and/or hunting after shoulder replacement. Retrospective review identified 473 patients with anatomic or reverse shoulder arthroplasty with a minimum of 2-year follow-up. Patients were contacted to complete a survey to assess their participation in hunting and/or shooting sports: Type of firearm (shoulder-mounted or handgun), frequency of firearm use, purposes for which firearms were used (recreation, competition, hunting), pain level, limitations during firearm use, and shooting-related complications with the shoulder replacement. Medical records were reviewed to correlate any reported complications due to firearm use. Of the 473 patients identified, 245 (52%) completed the firearm survey; 61 (25%) resumed firearm use after surgery, 42 using shoulder-mounted firearms (27 on the operative extremity) and 53 using handguns. Recreational shooting (69%) and hunting (54%) were the primary reasons for firearm use. Eleven patients reported shooting over 500 rounds per year after surgery, with no increased limitations or pain with greater frequency of firearm use. Fifty-two patients reported no or mild pain when shooting, and 49 patients reported no limitations in their ability to shoot. There were no complications related to firearm use reported by patients or in the medical record. Patients can safely engage in the use of a variety of firearms after shoulder arthroplasty without pain or limitations or shooting-related arthroplasty complications. Level IV; Case Series [ABSTRACT FROM AUTHOR]

Eight ruminally-fistulated weathers were used to examine the temporal effects of afternoon (PM; 1600h) v. morning (AM; 0800 h) allocation of fresh spring herbage from a perennial ryegrass (Lolium perenne L.)-based pasture on fermentation and microbial community dynamics. Herbage chemical composition was minimally affected by time of allocation, but daily mean ammonia concentrations were greater for the PM group. The 24-h pattern of ruminal fermentation (i.e. time of sampling relative to time of allocation), however, varied considerably for all fermentation variables (P ⩽0.001). Most notably amongst ruminal fermentation characteristics, ammonia concentrations showed a substantial temporal variation; concentrations of ammonia were 1.7-, 2.0- and 2.2-fold greater in rumens of PM weathers at 4, 6 and 8h after allocation, respectively, compared with AM weathers. The relative abundances of archaeal and ciliate protozoal taxa were similar across allocation groups. In contrast, the relative abundances of members of the rumen bacterial community, like Prevotella 1 (P =0.04), Bacteroidales RF16 group (P =0.005) and Fibrobacter spp. (P =0.008) were greater for the AM group, whereas the relative abundance of Kandleria spp. was greater (P =0.04) for the PM group. Of these taxa, only Prevotella 1 (P =0.04) and Kandleria (P <0.001) showed a significant interaction between time of allocation and time of sampling relative to feed allocation. Relative abundances of Prevotella 1 were greater at 2h (P =0.05), 4h (P =0.003) and 6h (P =0.01) after AM allocation of new herbage, whereas relative abundances of Kandleria were greater at 2h (P =0.003) and 4h (P <0.001) after PM allocation. The early post-allocation rise in ammonia concentrations in PM rumens occurred simultaneously with sharp increases in the relative abundance of Kandleria spp. and with a decline in the relative abundance of Prevotella. All measures of fermentation and most microbial community composition data showed highly dynamic changes in concentrations and genus abundances, respectively, with substantial temporal changes occurring within the first 8h of allocating a new strip of herbage. The dynamic changes in the relative abundances of certain bacterial groups, in synchrony with a substantial diurnal variation in ammonia concentrations, has potential effects on the efficiency by which N is utilised by the grazing ruminant. [ABSTRACT FROM AUTHOR]

The development and ultimate approval of tecovirimat for the antiviral treatment of smallpox, a disease that has been eradicated from the world for nearly 40 years, required a unique regulatory approach based on the US Food and Drug Administration's Animal Rule. We summarise the regulatory pathway and describe the challenges involved. [ABSTRACT FROM AUTHOR]

Background: Clostridium difficile infection (CDI) is the leading cause of antibiotic-associated diarrhoea with peak incidence in late winter or early autumn. Although CDI is commonly associated with hospitals, community transmission is important.Aim: To explore potential drivers of CDI seasonality and the effect of community-based interventions to reduce transmission.Methods: A mechanistic compartmental model of C. difficile transmission in a hospital and surrounding community was used to determine the effect of reducing transmission or antibiotic prescriptions in these settings. The model was extended to allow for seasonal antibiotic prescriptions and seasonal transmission.Findings: Modelling antibiotic seasonality reproduced the seasonality of CDI, including approximate magnitude (13.9-15.1% above annual mean) and timing of peaks (0.7-1.0 months after peak antibiotics). Halving seasonal excess prescriptions reduced the incidence of CDI by 6-18%. Seasonal transmission produced larger seasonal peaks in the prevalence of community colonization (14.8-22.1% above mean) than seasonal antibiotic prescriptions (0.2-1.7% above mean). Reducing transmission from symptomatic or hospitalized patients had little effect on community-acquired CDI, but reducing transmission in the community by ≥7% or transmission from infants by ≥30% eliminated the pathogen. Reducing antibiotic prescription rates led to approximately proportional reductions in infections, but limited reductions in the prevalence of colonization.Conclusion: Seasonal variation in antibiotic prescription rates can account for the observed magnitude and timing of C. difficile seasonality. Even complete prevention of transmission from hospitalized patients or symptomatic patients cannot eliminate the pathogen, but interventions to reduce transmission from community residents or infants could have a large impact on both hospital- and community-acquired infections. [ABSTRACT FROM AUTHOR]

Background Postoperative pain control, short-term and long-term narcotic consumption, complication rates, and costs of indwelling interscalene catheter (ISC) were compared with a liposomal bupivacaine (LBC) mixture in patients undergoing primary total elbow arthroplasty. Methods Forty-four consecutive patients were identified, the first 28 with an ISC and the later 16 with intraoperative LBC injection that also included ketorolac and 0.5% bupivacaine. Medical records were reviewed for visual analog scale scores for pain, oral morphine equivalent (OME) use, complications, and facility charges. Results Average visual analog scale scores at 24 hours, 2 weeks, 6 weeks, and 12 weeks were not significantly different. Mean OME use was significantly greater in the LBC group at 24 hours but less at 12 weeks, although this difference was not statistically significant. Twelve anesthetic-related complications occurred in the ISC group (1 major and 11 minor); 10 patients (36%) had at least 1 complication. The major complication was respiratory failure requiring emergent tracheostomy. Minor complications included leaking pump/catheters, catheters inadvertently pulled out early, global hand paresthesias, forearm paresthesias, and pain at the catheter site. There were no anesthetic-related complications in the LBC group. The average charge for the LBC mixture was $327.10; charges for ISC, including equipment and anesthesia fees, were $1472.42. Conclusions An LBC mixture provides similar pain relief with fewer complications at a lower cost than indwelling ISC after total elbow arthroplasty. Although the OME use in the LBC group was almost double that of the ISC group at 24 hours, there was no difference at later time points. [ABSTRACT FROM AUTHOR]

Background: Clostridium difficile infections occur frequently among hospitalized patients, with some infections acquired in hospital and others in the community. International guidelines classify cases as hospital-acquired if symptom onset occurs more than two days after admission. This classification informs surveillance and infection control, but has not been verified by empirical or modelling studies.Aim: To assess current classification of C. difficile acquisition using a simulation model as a reference standard.Methods: C. difficile transmission was simulated in a range of hospital scenarios. The sensitivity, specificity and precision of classifications that use cut-offs ranging from 0.25 h to 40 days were calculated. The optimal cut-off that correctly estimated the proportion of cases that were hospital acquired and the balanced cut-off that had equal sensitivity and specificity were identified.Findings: The recommended two-day cut-off overestimated the incidence of hospital-acquired cases in all scenarios and by >100% in the base scenario. The two-day cut-off had good sensitivity (96%) but poor specificity (48%) and precision (52%) to identify cases acquired during the current hospitalization. A five-day cut-off was balanced, and a six-day cut-off was optimal in the base scenario. The optimal and balanced cut-offs were more than two days for nearly all scenarios considered (ranges: four to nine days and two to eight days, respectively).Conclusion: Current guidelines for classifying C. difficile infections overestimate the proportion of cases acquired in hospital in all model scenarios. To reduce misclassification bias, an infection should be classified as being acquired prior to admission if symptoms begin within five days of admission. [ABSTRACT FROM AUTHOR]

Objective Breakthroughs in HIV treatment, especially combination antiretroviral therapy (ART), have massively reduced AIDS-associated mortality. However, ART administration amplifies the risk of non-AIDS defining illnesses including obesity, diabetes, and cardiovascular disease, collectively known as metabolic syndrome. Initial reports suggest that ART-associated risk of metabolic syndrome correlates with socioeconomic status, a multifaceted finding that encompasses income, race, education, and diet. Therefore, determination of causal relationships is extremely challenging due to the complex interplay between viral infection, ART, and the many environmental factors. Methods In the current study, we employed a mouse model to specifically examine interactions between ART and diet that impacts energy balance and glucose metabolism. Previous studies have shown that high-fat feeding induces persistent low-grade systemic and adipose tissue inflammation contributing to insulin resistance and metabolic dysregulation via adipose-infiltrating macrophages. Studies herein test the hypothesis that ART potentiates the inflammatory effects of a high-fat diet (HFD). C57Bl/6J mice on a HFD or standard chow containing ART or vehicle, were subjected to functional metabolic testing, RNA-sequencing of epididymal white adipose tissue (eWAT), and array-based kinomic analysis of eWAT-infiltrating macrophages. Results ART-treated mice on a HFD displayed increased fat mass accumulation, impaired glucose tolerance, and potentiated insulin resistance. Gene set enrichment and kinomic array analyses revealed a pro-inflammatory transcriptional signature depicting granulocyte migration and activation. Conclusion The current study reveals a HFD-ART interaction that increases inflammatory transcriptional pathways and impairs glucose metabolism, energy balance, and metabolic dysfunction. [ABSTRACT FROM AUTHOR]

A buildup of skeletal muscle plasma membrane (PM) cholesterol content in mice occurs within 1 week of a Western-style high-fat diet and causes insulin resistance. The mechanism driving this cholesterol accumulation and insulin resistance is not known. Promising cell data implicate that the hexosamine biosynthesis pathway (HBP) triggers a cholesterolgenic response via increasing the transcriptional activity of Sp1. In this study we aimed to determine whether increased HBP/Sp1 activity represented a preventable cause of insulin resistance. C57BL/6NJ mice were fed either a low-fat (LF, 10% kcal) or high-fat (HF, 45% kcal) diet for 1 week. During this 1-week diet the mice were treated daily with either saline or mithramycin-A (MTM), a specific Sp1/DNA-binding inhibitor. A series of metabolic and tissue analyses were then performed on these mice, as well as on mice with targeted skeletal muscle overexpression of the rate-limiting HBP enzyme glutamine-fructose-6-phosphate-amidotransferase (GFAT) that were maintained on a regular chow diet. Saline-treated mice fed this HF diet for 1 week did not have an increase in adiposity, lean mass, or body mass while displaying early insulin resistance. Consistent with an HBP/Sp1 cholesterolgenic response, Sp1 displayed increased O -GlcNAcylation and binding to the HMGCR promoter that increased HMGCR expression in skeletal muscle from saline-treated HF-fed mice. Skeletal muscle from these saline-treated HF-fed mice also showed a resultant elevation of PM cholesterol with an accompanying loss of cortical filamentous actin (F-actin) that is essential for insulin-stimulated glucose transport. Treating these mice daily with MTM during the 1-week HF diet fully prevented the diet-induced Sp1 cholesterolgenic response, loss of cortical F-actin, and development of insulin resistance. Similarly, increases in HMGCR expression and cholesterol were measured in muscle from GFAT transgenic mice compared to age- and weight-match wildtype littermate control mice. In the GFAT Tg mice we found that these increases were alleviated by MTM. These data identify increased HBP/Sp1 activity as an early mechanism of diet-induced insulin resistance. Therapies targeting this mechanism may decelerate T2D development. • Insulin sensitivity is impaired by excess skeletal muscle membrane cholesterol. • De novo cholesterol biosynthesis occurs early in the setting of high-fat feeding. • High-fat feeding triggers an HBP-mediated Sp1 cholesterolgenic response. • Sp1 inhibition prevents muscle membrane cholesterol buildup and insulin resistance. • Targeting the HBP/Sp1 response represents a novel approach to decelerate T2D. [ABSTRACT FROM AUTHOR]

In 1960, Dr Bayard Clarkson described a woman experiencing sporadic recurrent episodes of shock and anasarca. Plasma from an acute attack induced a shock-like syndrome when injected into rats. The enigmatic systemic capillary leak syndrome (SCLS) named for Dr Clarkson is characterized by transient and severe but reversible hemoconcentration and hypoalbuminemia caused by leakage of fluids and macromolecules into tissues. Although less than 500 cases of SCLS have been reported in the literature since 1960, the condition is probably underdiagnosed because of a lack of awareness and a high mortality without treatment. Allergists should be vigilant of this diagnosis because its presentation can resemble more common plasma leakage syndromes, including angioedema or systemic anaphylaxis. Although the precise molecular cause of SCLS remains unknown, substantial advances over the last 5 years have increased our understanding of SCLS pathogenesis. [ABSTRACT FROM AUTHOR]

Objective Fibroblast activation protein (FAP) is a serine protease belonging to a S9B prolyl oligopeptidase subfamily. This enzyme has been implicated in cancer development and recently reported to regulate degradation of FGF21, a potent metabolic hormone. Using a known FAP inhibitor, talabostat (TB), we explored the impact of FAP inhibition on metabolic regulation in mice. Methods To address this question we evaluated the pharmacology of TB in various mouse models including those deficient in FGF21, GLP1 and GIP signaling. We also studied the ability of FAP to process FGF21 in vitro and TB to block FAP enzymatic activity. Results TB administration to diet-induced obese (DIO) animals led to profound decreases in body weight, reduced food consumption and adiposity, increased energy expenditure, improved glucose tolerance and insulin sensitivity, and lowered cholesterol levels. Total and intact plasma FGF21 were observed to be elevated in TB-treated DIO mice but not lean animals where the metabolic impact of TB was significantly attenuated. Furthermore, and in stark contrast to naïve DIO mice, the administration of TB to obese FGF21 knockout animals demonstrated no appreciable effect on body weight or any other measures of metabolism. In support of these results we observed no enzymatic degradation of human FGF21 at either end of the protein when FAP was inhibited in vitro by TB. Conclusions We conclude that pharmacological inhibition of FAP enhances levels of FGF21 in obese mice to provide robust metabolic benefits not observed in lean animals, thus validating this enzyme as a novel drug target for the treatment of obesity and diabetes. [ABSTRACT FROM AUTHOR]

Nickel superalloys with cubic L1 2 structured γ′ (Ni 3 (Al, Ti)) precipitates exhibit high strength at high temperatures and excellent corrosion resistance when exposed to water. Unlike prior studies on irradiation damage of other Ni-based superalloys, our study on Rene N4 involves much larger γ′ precipitates, ∼450 nm in size, a size regime where the irradiation-induced disordering and dissolution kinetics and the corresponding mechanical property evolution are unknown. We report that under heavy ion irradiation at room temperature, the submicron-sized γ′ precipitates were fully disordered at ∼0.3 dpa and only later partially dissolved after 75 dpa irradiation. Nanoindentation experiments indicate that the mechanical properties of the alloy change significantly, with a dramatic decrease in hardness, with irradiation dose. Three contributions to the change in hardness were examined: defect clusters, disordering and dissolution. The generation of defect clusters in the matrix and precipitates slightly increased the indentation hardness, while disordering of the submicron-sized γ′ precipitates resulted in a dramatic decrease in the total hardness, which decreased further during the early stages of the intermixing between γ′ precipitates and matrix (<18 dpa). Controlling the long-range-ordering and chemical intermixing can be used to tailor the mechanical properties of Ni-based superalloys under irradiation. [ABSTRACT FROM AUTHOR]

Background: The Systemic Capillary Leak Syndrome (SCLS) is a rare disorder of unknown etiology presenting as recurrent episodes of shock and peripheral edema due to leakage of fluid into soft tissues. Insights into SCLS pathogenesis are few due to the scarcity of cases, and the etiology of vascular barrier disruption in SCLS is unknown. Recent advances in cardiovascular magnetic resonance (CMR) allow for the quantitative assessment of the myocardial extracellular volume (ECV), which can be increased in conditions causing myocardial edema. We hypothesized that measurement of myocardial ECV may detect myocardial vascular leak in patients with SCLS. Methods: Fifty-six subjects underwent a standard CMR examination at the NIH Clinical Center from 2009 until 2014: 20 patients with acute intermittent SCLS, six subjects with chronic SCLS, and 30 unaffected controls. Standard volumetric measurements; late gadolinium enhancement imaging and pre- and post-contrast T1 mapping were performed. ECV was calculated by calibration of pre- and post-contrast T1 values with blood hematocrit. Results: Demographics and cardiac parameters were similar in both groups. There was no significant valvular disorder in either group. Subjects with chronic SCLS had higher pre-contrast myocardial T1 compared to healthy controls (T1: 1027 ±44 v. 971 ±41, respectively; p = 0.03) and higher myocardial ECV than patients with acute intermittent SCLS or controls: 33.8 ± 4.6, 26.9 ± 2.6, 26 ± 2.4, respectively; p = 0.007 v. acute intermittent; P = 0.0005 v. controls). When patients with chronic disease were analyzed together with five patients with acute intermittent disease who had just experienced an acute SCLS flare, ECV values were significantly higher than in subjects with acute intermittent SCLS in remission or age-matched controls and (31.2 ± 4.6 %, 26.5 ±2.7 %, 26 ± 2.4 %, respectively; p = 0.01 v. remission, p = 0.001 v. controls). By contrast, T1 values did not distinguish these three subgroups (1008 ± 40, 978 ± 40, 971 ± 41, respectively, p = 0.2, active v. remission; p = 0.06 active v. controls). Abundant myocardial edema without evidence of acute inflammation was detected in cardiac tissue postmortem in one patient. Conclusions: Patients with active SCLS have significantly higher myocardial ECV than age-matched controls or SCLS patients in remission, which correlated with histopathological findings in one patient. [ABSTRACT FROM AUTHOR]

Dormancy development in plants is synchronized with the cessation of environmental conditions that favour plant growth. The timing of this response is important in trees for growth and survival. Woody plants, such as dogwood (Cornus sericea L.) have evolved different ecotypes that are closely adapted to local climatic conditions, which are differentiated by irradiance, photoperiod and/or temperature. While short photoperiods are well known to play a key role in dormancy induction in northern ecotypes, low temperatures alone can by-pass the photoperiodic requirement. It is well established that the combination of low temperature and even low to moderate light intensities predispose plants to photoinhibition of photosynthesis. However, plants possess numerous photoprotective mechanisms to minimize photoinhibition including increased rates of photosynthesis as well as non-photochemical dissipation of excess excitation energy, a process involving xanthophyll cycle carotenoids. We used two ecotypes of dogwood, the northern ecotype of Northwest Territories (NWT 62° N latitude) and the southern Utah, U.S.A. (42° N latitude) ecotype, which exhibit differential responses to photoperiodic- and temperature-induced dormancy. These ecotypes were exposed to various combinations of photoperiod and low temperature treatments and monitored for photosynthetic and photoprotective processes as the plants entered dormancy. Our results demonstrate differential long- and short-term responses to photoinhibition at low temperatures between the two ecotypes. The northern ecotype was more tolerant to photoinhibition of photosynthesis than the southern ecotype potentially through a zeaxanthin-independent mechanism of photoprotection. Furthermore, anthocyanin accumulation may be involved in the LD-Cold treatment through putative sugar sensing mechanisms to trigger dormancy. [ABSTRACT FROM AUTHOR]

Background Although eosinophilic inflammation typifies allergic asthma, it is not a prerequisite for airway hyperresponsiveness (AHR), suggesting that underlying abnormalities in structural cells, such as airway smooth muscle (ASM), contribute to the asthmatic diathesis. Dysregulation of procontractile G protein-coupled receptor (GPCR) signaling in ASM could mediate enhanced contractility. Objective We explored the role of a regulator of procontractile GPCR signaling, regulator of G protein signaling 5 (RGS5), in unprovoked and allergen-induced AHR. Methods We evaluated GPCR-evoked Ca2+ signaling, precision-cut lung slice (PCLS) contraction, and lung inflammation in naive and Aspergillus fumigatus-challenged wild-type and Rgs5-/- mice. We analyzed lung resistance and dynamic compliance in live anesthetized mice using invasive plethysmography. Results Loss of RGS5 promoted constitutive AHR because of enhanced GPCR-induced Ca2+ mobilization in ASM. PCLSs from naive Rgs5-/- mice contracted maximally at baseline independently of allergen challenge. RGS5 deficiency had little effect on the parameters of allergic inflammation, including cell counts in bronchoalveolar lavage fluid, mucin production, ASM mass, and subepithelial collagen deposition. Unexpectedly, induced IL-13 and IL-33 levels were much lower in challenged lungs from Rgs5-/- mice relative to those seen in wild-type mice. Conclusion Loss of RGS5 confers spontaneous AHR in mice in the absence of allergic inflammation. Because it is selectively expressed in ASM within the lung and does not promote inflammation, RGS5 might be a therapeutic target for asthma. [ABSTRACT FROM AUTHOR]

Abstract: We study the use of Krylov subspace recycling for the solution of a sequence of slowly-changing families of linear systems, where each family consists of shifted linear systems that differ in the coefficient matrix only by multiples of the identity. Our aim is to explore the simultaneous solution of each family of shifted systems within the framework of subspace recycling, using one augmented subspace to extract candidate solutions for all the shifted systems. The ideal method would use the same augmented subspace for all systems and have fixed storage requirements, independent of the number of shifted systems per family. We show that a method satisfying both requirements cannot exist in this framework. As an alternative, we introduce two schemes. One constructs a separate deflation space for each shifted system but solves each family of shifted systems simultaneously. The other builds only one recycled subspace and constructs approximate corrections to the solutions of the shifted systems at each cycle of the iterative linear solver while only minimizing the base system residual. At convergence of the base system solution, we apply the method recursively to the remaining unconverged systems. We present numerical examples involving systems arising in lattice quantum chromodynamics. [Copyright &y& Elsevier]

Abstract: The objective of this study was to use an ecosystem process model, Biome-BGC, to explore the effects of different harvest scenarios on major components of the carbon budget of 205,000km2 of temperate forest in the Upper Midwest region of the U.S. We simulated seven harvest scenarios varying the (i) amount of harvest residue retained, (ii) total harvest area, and (iii) harvest type (clear-cut and selective) to assess the potential impacts on net biome production (NBP), net primary production (NPP), and total vegetation carbon. NBP was positive (C sink) in year 1 (2004) and generally decreased over the 50-year simulation period. More intensive management scenarios, those with a high percentage of clear-cut or a doubling of harvest area, decreased average NBP by a maximum of 58% and vegetation C by a maximum of 29% compared to the current harvest regime (base scenario), while less intensive harvest scenarios (low clear-cut or low area harvested) increased NBP. Yearly mean NPP changed less than 3% under the different scenarios. Vegetation carbon increased in all scenarios by at least 12%, except the two most intensive harvest scenarios, where vegetation carbon decreased by more than 8%. Varying the amount of harvest residue retention had a more profound effect on NBP than on vegetation C. Removing additional residue resulted in greater NBP over the 50-year period compared to the base simulation. Results from the seven model simulations suggest that managing for carbon storage and carbon sequestration are not mutually exclusive in Midwest forests. [Copyright &y& Elsevier]

Abstract: Purpose: Congenital obstructive uropathy (COU) is a leading cause of pediatric chronic kidney disease (CKD). Urinary tract infections (UTIs) pose a risk for ascending infections and CKD in patients with COU. We evaluated the impact of comorbid UTIs on hospital charges and length of stay (LOS) for pediatric COU discharges. Materials and methods: The study sample (n = 2832) was drawn from the 2003 and 2006 US Healthcare Cost and Utilization Project Kids’ Inpatient Database. Data were analyzed using logistic and linear regression. Results: Comorbid UTIs complicated 6.7% of COU discharges, and were most common in patients with posterior urethral valves (15.7% of discharges). Comorbid UTIs increased mean charges by $7910 (95% confidence interval (CI) $4770–$11,040; p < 0.001) and prolonged mean LOS by 2.66 days (95% CI 2.03–3.29; p < 0.001) compared to COU discharges without UTI. After controlling for LOS, charges for COU with a secondary diagnosis of UTI were no longer significantly higher. Mean charges in inflation-adjusted dollars increased by $2710, a 15.8% increase unexplained by covariate diagnoses and procedures. Conclusions: Comorbid UTIs contribute significantly to inpatient charges for COU, by prolonging LOS. [Copyright &y& Elsevier]

Abstract: This study investigates how average costs for an episode of care in outpatient drug-free (ODF) treatment relate to clinical intensity (length of stay and weekly counseling hours) and program structure (e.g., size, staffing), controlling for prices paid and selected clientele measures. Based on cost assessments from a naturalistic sample of 67 programs located across the United States (using the Treatment Cost Analysis Tool), robust regression techniques showed that programs having 10% longer treatment stays had episode costs 7% higher; those having 10% more weekly counseling hours per client had 4% higher episode costs. Other important factors included wages, amount of counselors'' time conducting sessions, and serving more clients referred from the criminal justice system. The study provides valuable information on treatment program features that relate to costs. Most importantly, cost differences associated with longer stays or more intensive counseling protocols appear modest and may be justified by improved client outcomes. [Copyright &y& Elsevier]

Abstract: Clostridium difficile is the most common and important cause of toxigenic colitis in the health care setting. Laboratory diagnostics have included bacterial culture with further identification of toxigenic stains, or more commonly, direct detection of preformed toxin in stool samples using biological or immunochemistry assays. Recently, molecular amplification assays for the direct detection of toxin-encoding genes have become available commercially. We prospectively evaluated 2 FDA-cleared molecular amplification tests, the Illumigene C. difficile and the ProGastro Cd PCR assay, for the direct detection of toxigenic C. difficile from fecal samples. Of 446 samples tested, 418 produced matching amplification results, 88 positive and 330 negative, and 13 resolved with repeat testing. Toxigenic culture and direct cytotoxin testing were used to resolve the remaining 15 discordant samples. Overall, each assay performed well and correctly identified 97% of positive samples. [Copyright &y& Elsevier]

Background: Diffuse myocardial fibrosis, and to a lesser extent global myocardial edema, are important processes in heart disease which are difficult to assess or quantify with cardiovascular magnetic resonance (CMR) using conventional late gadolinium enhancement (LGE) or T1-mapping. Measurement of the myocardial extracellular volume fraction (ECV) circumvents factors that confound T1-weighted images or T1-maps. We hypothesized that quantitative assessment of myocardial ECV would be clinically useful for detecting both focal and diffuse myocardial abnormalities in a variety of common and uncommon heart diseases. Methods: A total of 156 subjects were imaged including 62 with normal findings, 33 patients with chronic myocardial infarction (MI), 33 with hypertrophic cardiomyopathy (HCM), 15 with non-ischemic dilated cardiomyopathy (DCM), 7 with acute myocarditis, 4 with cardiac amyloidosis, and 2 with systemic capillary leak syndrome (SCLS). Motion corrected ECV maps were generated automatically from T1-maps acquired pre- and postcontrast calibrated by blood hematocrit. Abnormally-elevated ECV was defined as >2SD from the mean ECV in individuals with normal findings. In HCM the size of regions of LGE was quantified as the region >2 SD from remote. Results: Mean ECV of 62 normal individuals was 25.4 ± 2.5% (m ± SD), normal range 20.4%-30.4%. Mean ECV within the core of chronic myocardial infarctions (without MVO) (N = 33) measured 68.5 ± 8.6% (p < 0.001 vs normal). In HCM, the extent of abnormally elevated ECV correlated to the extent of LGE (r = 0.72, p < 0.001) but had a systematically greater extent by ECV (mean difference 19 ± 7% of slice). Abnormally elevated ECV was identified in 4 of 16 patients with non-ischemic DCM (38.1 ± 1.9% (p < 0.001 vs normal) and LGE in the same slice appeared "normal" in 2 of these 4 patients. Mean ECV values in other disease entities ranged 32-60% for cardiac amyloidosis (N = 4), 40-41% for systemic capillary leak syndrome (N = 2), and 39-56% within abnormal regions affected by myocarditis (N = 7). Conclusions: ECV mapping appears promising to complement LGE imaging in cases of more homogenously diffuse disease. The ability to display ECV maps in units that are physiologically intuitive and may be interpreted on an absolute scale offers the potential for detection of diffuse disease and measurement of the extent and severity of abnormal regions. [ABSTRACT FROM AUTHOR]

Abstract: Accurate landscape-scale maps of forests and associated disturbances are critical to augment studies on biodiversity, ecosystem services, and the carbon cycle, especially in terms of understanding how the spatial and temporal complexities of damage sustained from disturbances influence forest structure and function. Vegetation change tracker (VCT) is a highly automated algorithm that exploits the spectral–temporal properties of summer Landsat time series stacks (LTSSs) to generate spatially explicit maps of forest and recent forest disturbances. VCT performs well in contiguous forest landscapes with closed or nearly closed canopies, but often incorrectly classifies large patches of land as forest or forest disturbance in the complex and spatially heterogeneous environments that typify fragmented forest landscapes. We introduce an improved version of VCT (dubbed VCTw) that incorporates a nonforest mask derived from snow-covered winter Landsat time series stacks (LTSSw) and compare it with VCT across nearly 25million ha of land in the Lake Superior (Canada, USA) and Lake Michigan (USA) drainage basins. Accuracy assessments relying on 87 primary sampling units (PSUs) and 2640 secondary sampling units (SSUs) indicated that VCT performed with an overall accuracy of 86.3%. For persisting forest, the commission error was 14.7% and the omission error was 4.3%. Commission and omission errors for the two forest disturbance classes fluctuated around 50%. VCTw produced a statistically significant increase in overall accuracy to 91.2% and denoted about 1.115million ha less forest (−.371million ha disturbed and −0.744million ha persisting). For persisting forest, the commission error decreased to 9.3% and the omission error was relatively unchanged at 5.0%. Commission errors decreased considerably to near 22% and omission errors remained near 50% in both forest disturbance classes. Dividing the assessments into three geographic strata demonstrated that the most dramatic improvement occurred across the southern half of the Lake Michigan basin, which contains a highly fragmented agricultural landscape and relatively sparse deciduous forest, although substantial improvements occurred in other geographic strata containing little agricultural land, abundant wetlands, and extensive coniferous forest. Unlike VCT, VCTw also generally corresponded well with field-based estimates of forest cover in each stratum. Snow-covered winter imagery appears to be a valuable resource for improving automated disturbance mapping accuracy. About 34% of the world''s forests receive sufficient snowfall to cover the ground and are potentially suitable for VCTw; other season-based techniques may be worth pursuing for the remaining 66%. [Copyright &y& Elsevier]

Abstract: The Pd/C-catalysed hydrogenolysis of in-situ and isolated lignins from Pinus radiata wood was investigated to gain a more complete understanding of the factors affecting yield and composition of the hydrogenolysis products. Such hydrogenolysis products could potentially be refined into aromatic feedstock chemicals providing sustainable alternatives to petroleum-derived phenols. Lignins were converted into solvent-soluble oils composed of monomeric, dimeric and oligomeric products in high yields, up to 89% of the original lignin. The main monomer products were dihydroconiferyl alcohol and 4-n-propyl guaiacol. Dimeric and oligomeric compounds constituted 75% of the hydrogenolysis oils and were mainly composed of dihydroconiferyl alcohol and 4-n-propyl guaiacol units linked by β-5, 5-5, 4-O-5 and β-1 linkages. Hydrogenolysis of steam exploded wood gave lower yields of lignin hydrogenolysis products compared to unmodified wood due to fewer reactive aryl-ether linkages in the lignin. [Copyright &y& Elsevier]

Abstract: Glucagon has long been known as a counter-regulatory hormone to insulin of fundamental importance to glucose homeostasis. Its prominent ability to stimulate glycogenolysis and gluconeogenesis, has historically cast this peptide as one hormone where the metabolic consequences of increasing blood glucose levels, especially in obesity, are viewed largely as being deleterious. This perspective may be changing in light of emerging data and reconsideration of historic studies, which suggest that glucagon has beneficial effects on body fat mass, food intake, and energy expenditure. In this review, we discuss the mechanisms of glucagon-mediated body weight regulation as well as possible novel therapeutic approaches in the treatment of obesity and glucose intolerance that may arise from these findings. The paper represents an invited review by a symposium, award winner or keynote speaker at the Society for the Study of Ingestive Behavior [SSIB] Annual Meeting in Portland, July 2009. [Copyright &y& Elsevier]

Abstract: Enzyme immunoassays are currently the most common tests used in the clinical laboratory for the detection of Clostridium difficile toxins; however, significant problems with their performance have recently been described. We prospectively reevaluated the Meridian Premier C. difficile toxin A/B assay with direct comparison to a 2-step algorithm that screened for C. difficile common antigen and compared cytotoxin and real-time polymerase chain reaction (PCR) as confirmatory procedures. The Premier assay lacked sufficient sensitivity, missing 25% of true-positive samples. PCR was the most sensitive method and the only procedure that allowed same day testing and reporting. [Copyright &y& Elsevier]

Abstract: Counselors are a critical component of substance abuse treatment programming, but their working experiences are not yet well understood. As treatment improvement efforts focus increasingly on these individuals, their perceptions of program leadership, emotional burnout, and job satisfaction and related attitudes take on greater significance. This study explores counselor views and the impact of organizational context using data from a nationwide set of 94 outpatient drug-free treatment programs in a hierarchical linear model analysis. Results show counselors hold generally positive opinions of program director leadership and job satisfaction and have low levels of burnout, but they also have important variations in their ratings. Higher counselor caseloads were related to poorer ratings, and leadership behaviors predicted both satisfaction and burnout. These findings add further evidence that treatment providers should also address the workplace environment for staff as part of quality improvement efforts. [Copyright &y& Elsevier]

Abstract: A Microsoft® Excel-based workbook designed for research analysts to use in a national study was retooled for treatment program directors and financial officers to allocate, analyze, and estimate outpatient treatment costs in the U.S. This instrument can also be used as a planning and management tool to optimize resources and forecast the impact of future changes in staffing, client flow, program design, and other resources. The Treatment Cost Analysis Tool (TCAT) automatically provides feedback and generates summaries and charts using comparative data from a national sample of non-methadone outpatient providers. TCAT is being used by program staff to capture and allocate both economic and accounting costs, and outpatient service costs are reported for a sample of 70 programs. Costs for an episode of treatment in regular, intensive, and mixed types of outpatient treatment were $882, $1310, and $1381 respectively (based on 20% trimmed means and 2006 dollars). An hour of counseling cost $64 in regular, $85 intensive, and $86 mixed. Group counseling hourly costs per client were $8, $11, and $10 respectively for regular, intensive, and mixed. Future directions include use of a web-based interview version, much like some of the commercially available tax preparation software tools, and extensions for use in other modalities of treatment. [Copyright &y& Elsevier]

Abstract: The regulators of G-protein signaling (RGS) proteins were initially characterized as inhibitors of signal transduction cascades initiated by G-protein-coupled receptors (GPCR) because of their ability to increase the intrinsic GTPase activity of heterotrimeric G proteins. This GTPase accelerating protein (GAP) activity enhances G protein deactivation and promotes desensitization. However, in addition to this signature trait, emerging data have revealed an expanding network of proteins, lipids, and ions that interact with RGS proteins and confer additional regulatory functions. This review highlights recent advances in our understanding of the physiological functions of one subfamily of RGS proteins with a high degree of homology (B/R4) gleaned from recent studies of knockout mice or cells with reduced RGS expression. We also discuss some of the newly appreciated interactions of RGS proteins with cellular factors that suggest RGS control of several components of G-protein-mediated pathways, as well as a diverse array of non-GPCR-mediated biological responses. [Copyright &y& Elsevier]

Abstract: Because work environment is central to understanding job performance, drug counselor perceptions of their programs and their skills were examined in relation to their attitudes about innovations training and its utilization. Latent profile analysis of measures on organizational climate and staff attributes for 1047 counselors from 345 programs defined three categories of counselors—labeled as isolated, integrated, and exceptional. All had generally positive views of their professional skills, although the isolated group scored lower on scales representing professional growth and influence on peers. They were less positive about the “climate” of programs in which they worked and were higher on stress. Program resources predicted the counselor groups, with the isolated having more limited resources. Counselor categorizations also differed in terms of workshop training experiences, with the isolated group of counselors reporting significantly less exposure, satisfaction, and program-wide use of workshop training. [Copyright &y& Elsevier]

Abstract: A key goal of drug abuse treatment providers is getting their clients to engage and participate in therapeutic activities as a first step toward deriving longer-term benefits. Much research had focused on personal characteristics that relate to client engagement; program characteristics have received less attention. This study explored client and program differences in engagement ratings using data from a nationwide set of 94 outpatient drug-free treatment programs in a hierarchical linear model analysis. The results show that elements of program context, including structural features (e.g., smaller size and Joint Commission on the Accreditation of Healthcare Organizations/Commission on Accreditation of Rehabilitation Facilities accreditation) and staff''s perceptions of personal efficacy, organizational climate, and communal workplace practices, relate to better overall client engagement. These findings add further evidence that treatment providers should also address the workplace environment for staff as part of quality improvement efforts. [Copyright &y& Elsevier]

An analytical model has been developed to describe Monte Carlo simulation results for the non-equilibrium incorporation of dopants during crystallization. These Monte Carlo simulation results, which are presented in the J. Crystal Growth, this issue. doi: 10.1016/j.jcrysgro.2004.07.074. as well as in earlier publications, have successfully reproduced experimental results on solute trapping. The analytical model presented here can also be used to describe extended solubility and other phenomena associated with rapid first-order phase transformations. The underlying physical picture, based on insights gained from Monte Carlo computer simulations, is that the interface can transfer, between species, the chemical potential differences which are driving the transformation. The analytical model starts with a set of rate equations, one for the crystallization of each component, based on standard reaction rate theory. The new equations describing growth reduce to the standard growth rate expression for a pure material and for growth near equilibrium, and they reduce to the usual quasi-equilibrium equations for alloy crystallization. They incorporate a transition from the independent crystallization of each component near equilibrium, which is governed by the differences in the individual chemical potentials between the two phases, to a cooperative growth mode far from equilibrium, which depends on the difference in free energy between the two phases of the alloy. The transition depends on a dimensionless parameter, β, which is the ratio of the distance an atom can diffuse to the distance the interface moves, during the time it takes an atom to join the crystal. This parameter embodies the relationship between the growth and diffusion parameters found in the Monte Carlo simulations (J. Crystal Growth, this issue. doi: 10.1016/j.jcrysgro.2004.07.074.), and was found earlier by Temkin (J. Crystal Growth 5 (1969) 193; Phys. Crystallogr 17 (1972) 405) in his analyses of alloy crystallization. The analytical model is compared with experimental results and, in the J. Crystal Growth, this issue. doi: 10.1016/j.jcrysgro.2004.07.074., with Monte Carlo computer simulations. This comparison requires a single fitting constant which also provides a reasonable fit to the available experimental data. [Copyright &y& Elsevier]