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Although radiation dose escalation improves prostate cancer disease control, it can cause increased toxicity. Genitourinary (GU) symptoms after prostate radiation therapy affect patient health-related quality of life (QoL). We compared patient-reported GU QoL outcomes following 2 alternative urethral sparing stereotactic body radiation therapy regimens. Expanded Prostate Cancer Index Composite (EPIC)–26 GU scores were compared between 2 urethral sparing stereotactic body radiation therapy trials. The SPARK trial prescribed a "Monotherapy" dose of 36.25 Gy in 5 fractions to the prostate. The PROMETHEUS trial prescribed 2 phases: a 19- to 21-Gy in 2 fractions "Boost" to the prostate, followed by 46 Gy in 23 fractions or 36 Gy in 12 fractions. The biological effective dose (BED) for urethral toxicity was 123.9 Gy for Monotherapy and 155.8 to 171.2 Gy for Boost. Mixed effects logistic regression models were utilized to estimate the difference in the odds of a minimal clinically important change from baseline EPIC-26 GU score between regimens at each follow-up. 46 Monotherapy and 149 Boost patients completed baseline EPIC-26 scoring. Mean EPIC-26 GU scores revealed statistically superior urinary incontinence outcomes for Monotherapy at 12 months (mean difference, 6.9; 95% confidence interval [CI], 1.6-12.1; P =.01) and 36 months (mean difference, 9.6; 95% CI, 4.1-15.1; P <.01). Monotherapy also revealed superior mean urinary irritative/obstructive outcomes at 12 months (mean difference, 6.9; 95% CI, 2.0-12.9; P <.01) and 36 months (mean difference, 6.3; 95% CI, 1.9-10.8; P <.01). For both domains and at all time points, the absolute differences were <10%. There were no significant differences in the odds of reporting a minimal clinically important change between regimens at any time point. Even in the presence of urethral sparing, the higher BED delivered in the Boost schedule may have a small adverse effect on GU QoL compared with Monotherapy. However, this did not translate to statistically significant differences in minimal clinically important changes. Whether the higher BED of the boost arm offers an efficacy advantage is being investigated in the Trans Tasman Radiation Oncology Group 18.01 NINJA randomized trial. [ABSTRACT FROM AUTHOR]

The purpose of this case report is to describe the conservative chiropractic management of a patient with a suspected triangular fibrocartilage complex (TFCC) injury. A 36-year-old Brazilian Jiu-Jitsu black belt athlete sought care for left-sided diffuse ulnar pain (numeric pain scale 5/10) with a notable bump over the ulna and weakness when grappling. A working diagnosis of suspected TFCC injury was made. The patient was treated with forearm and grip strength exercises to rehabilitate the pain and strength loss. Following 6 visits and a home exercise program for 8 weeks, his numeric pain scale decreased to 0/10. In this case, it is evident that Triangular fibrocartilage complex injury was successfully treated conservatively without the need for surgical intervention or passive care modalities. [ABSTRACT FROM AUTHOR]

Urinary toxicity is common following pelvic radiotherapy and can have a substantial negative effect on survivorship. Due to its prevalence and the increasing number of related clinical trials, localised prostate cancer radiotherapy is a useful illustrative tool to explore urinary toxicity. A good understanding of the interplay between anatomy, radiation-sensitive cell populations, and treatment sequencing is necessary for optimal outcomes. Emerging evidence suggests that the prostatic urethra is a radiation-sensitive structure, not only for stricture development, but also chronic irritative symptoms. Tools now exist not only to identify the urethra, but also to direct radiation dose away from the urethra, with early data suggesting that this reduces moderate-to-severe late urinary toxicity. Coupled with new evidence supporting dominant nodule microboosting and ultrahypofractionation as emerging standards of care, urethral sparing radiotherapy is a powerful tool against radiation induced urinary toxicity while also maximising disease control. [ABSTRACT FROM AUTHOR]

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jfineco.2004.06.017 Byline: Jacob Boudoukh (a)(c), Matthew Richardson (b)(c), YuQing (Jeff) Shen (d), Robert F. Whitelaw (b)(c) Keywords: Market efficiency; Excess volatility; State dependence; Nonlinearity Abstract: The behavioral finance literature cites the frozen concentrated orange juice (FCOJ) futures market as a prominent example of the failure of prices to reflect fundamentals. In contrast, we show that when theory clearly identifies the fundamental, e.g., at temperatures close to or below freezing, a close link exists between FCOJ prices and that fundamental. Using a simple, theoretically motivated, nonlinear, state dependent model, we can explain approximately 50% of the return variation on days with freezing temperatures. Moreover, while these observations represent less than 4.5% of the winter sample, they account for two-thirds of the entire winter return variability. Author Affiliation: (a) The Caesarea Center, Arison School of Business, IDC, Herzliya, Israel (b) Stern School of Business, New York University, New York, NY 10012, USA (c) National Bureau of Economic Research, Cambridge, MA 02138, USA (d) Barclays Global Investors, 45 Fremont Street, San Francisco, CA 94105, USA Article History: Received 16 June 2003; Revised 3 May 2004; Accepted 3 June 2004 Article Note: (footnote) [star] We would like to thank an anonymous referee, Kent Daniel (the discussant at the NBER), Rob Engle, Murray Frank, Owen Lamont, Tom Miller (the discussant at the WFA), Richard Roll, Bill Silber, Jeff Wurgler and seminar participants at the Federal Reserve Board of Governors, Princeton University, Rice University, Tel-Aviv University, UCLA, UBC, the NBER summer institute, the Western Finance Association meetings, University of Rochester, and New York University for their valuable comments.

The two necessary conditions for behavioral finance that explains financial asset prices are examined. The empirical results of the analysis on put-call parity no-arbitrage relation in the options market in the context of short sales restrictions are presented.

Stock prices in a domestic market are the result of a rational analysis of financial information and their incorporation into the price determination mechanism. This conclusion is derived from an analysis of Nikkei index-based derivative securities in the US and a comparison between the former and those that are traded overnight in Japan. Such perceived linkage belies the validity of theories that expound on the irrationality of stock market behavior.

A closed-form European option pricing formula for cross-rate call and put warrants is examined. The issue of volatility estimation is addressed. The study revealed a notable difference between the pricing and hedging of US cross-currency warrants. The analysis is applied to the prices of the New York Stock Exchange trade US yen/deutsche mark cross-currency warrant issued by AT&T Capital Corp.

Tests of inequality restrictions implied by conditional asset pricing models have been implemented and validated. The dynamic capital asset pricing model assumes that the ex ante risk premium is always positive such that the expected return on a market portfolio should always exceed the risk-free rate. However, it has been shown that the ex ante premium is negative in some states particularly those with higher T-bill rates and when the term structure has a downward slope.

The purpose of this case report is to describe the diagnosis and management of an adult patient presenting with a rarely reported avulsion fracture of the medial epicondyle of the humerus. A 27-year-old female sought care following an injury sustained when the elbow gave out on an attempted back flip. The clinical assessment found an indication of elbow fracture with a diagnosis of medial epicondyle avulsion fracture made on radiographic examination. Following in-house imaging, the patient was referred for an orthopedic consultation. An MRI was ordered and revealed numerous internal joint derangements. The orthopedist prescribed a hinged brace and followed up in 4 weeks. Physical therapy was ordered by the surgeon with follow-up again in 4 more weeks. Medial epicondyle avulsion fractures are extremely rare in adults, and in this case, were accompanied by extensive internal joint derangements in the elbow. Chiropractors should be able to diagnose this condition from x-ray and can be of assistance with rehabilitation therapies. [ABSTRACT FROM AUTHOR]

Asthma is a disease characterized by ventilation heterogeneity (VH). A number of studies have demonstrated that VH markers derived by using impulse oscillometry (IOS) or multiple-breath washout (MBW) are associated with key asthmatic patient–related outcome measures and airways hyperresponsiveness. However, the topographical mechanisms of VH in the lung remain poorly understood. We hypothesized that specific regionalization of topographical small-airway disease would best account for IOS- and MBW-measured indices in patients. We evaluated the results of paired expiratory/inspiratory computed tomography in a cohort of asthmatic (n = 41) and healthy (n = 11) volunteers to understand the determinants of clinical VH indices commonly reported by using IOS and MBW. Parametric response mapping (PRM) was used to calculate the functional small-airways disease marker PRMfSAD and Hounsfield unit (HU)–based density changes from total lung capacity to functional residual capacity (ΔHU); gradients of ΔHU in gravitationally perpendicular (parallel) inferior-superior (anterior-posterior) axes were quantified. The ΔHU gradient in the inferior-superior axis provided the highest level of discrimination of both acinar VH (measured by using phase 3 slope analysis of multiple-breath washout data) and resistance at 5 Hz minus resistance at 20 Hz measured by using impulse oscillometry (R5-R20) values. Patients with a high inferior-superior ΔHU gradient demonstrated evidence of reduced specific ventilation in the lower lobes of the lungs and high levels of PRMfSAD. A computational small-airway tree model confirmed that constriction of gravitationally dependent, lower-zone, small-airway branches would promote the largest increases in R5-R20 values. Ventilation gradients correlated with asthma control and quality of life but not with exacerbation frequency. Lower lobe–predominant small-airways disease is a major driver of clinically measured VH in adults with asthma. [ABSTRACT FROM AUTHOR]

Background Asthma is a complex chronic disease underpinned by pathological changes within the airway wall. How variations in structural airway pathology and cellular inflammation contribute to the expression and severity of asthma are poorly understood. Objectives Therefore we evaluated pathological heterogeneity using topological data analysis (TDA) with the aim of visualizing disease clusters and microclusters. Methods A discovery population of 202 adult patients (142 asthmatic patients and 60 healthy subjects) and an external replication population (59 patients with severe asthma) were evaluated. Pathology and gene expression were examined in bronchial biopsy samples. TDA was applied by using pathological variables alone to create pathology-driven visual networks. Results In the discovery cohort TDA identified 4 groups/networks with multiple microclusters/regions of interest that were masked by group-level statistics. Specifically, TDA group 1 consisted of a high proportion of healthy subjects, with a microcluster representing a topological continuum connecting healthy subjects to patients with mild-to-moderate asthma. Three additional TDA groups with moderate-to-severe asthma (Airway Smooth MuscleHigh, Reticular Basement MembraneHigh, and RemodelingLow groups) were identified and contained numerous microclusters with varying pathological and clinical features. Mutually exclusive T H 2 and T H 17 tissue gene expression signatures were identified in all pathological groups. Discovery and external replication applied to the severe asthma subgroup identified only highly similar "pathological data shapes" through analyses of persistent homology. Conclusions We have identified and replicated novel pathological phenotypes of asthma using TDA. Our methodology is applicable to other complex chronic diseases. Graphical abstract [ABSTRACT FROM AUTHOR]

This research examines the behaviour of cyclists in Dublin City with specific regard to red light running. A number of specific research questions are raised by this study. These questions address the impact of different infrastructure types on red light running, as well as the behavioural patterns and demographics of offending cyclists. Two data collection methods were used to gather information on cyclists in Dublin City – an observational survey and an online questionnaire. The observational surveys examined cyclist compliance with different traffic signal systems and the impact of on-road and off-road cycle infrastructure. An online questionnaire was used to get direct feedback from cyclists in Dublin City on the reasons (if any) they decide to commit infringement at traffic lights. With the recent growth of cycling in Dublin City (as well as many other international cities) it is vital to accommodate and manage this growing demand by ensuring the safety and road discipline of cyclists. The next few years will be crucial for the continued development of cycling in Dublin, particularly due to the increasing investment by transport planners in cycle infrastructure. It is therefore important to identify now the main factors which influence cyclist's decisions to break red lights in order to guide local traffic authorities in their efforts to reduce such transgressions. [ABSTRACT FROM AUTHOR]

• Strawberry fruit, a popular and high-value fruit, was tested in urban production. • Productivity and minerals varied among cultivars within a cropping system. • 'Portola' was among the best yielding cultivars in all systems. • The cropping system should be selected before the cultivar. Urban populations may struggle to access health-promoting fresh fruits and vegetables, and urban agriculture approaches are of increasing interest. In this study, we used five cropping systems for urban environments to produce strawberry fruit, a popular and high-value fruit. Two green roof systems, a hydroponic system, an aquaponic system, and a raised bed system were used to grow six strawberry cultivars: 'Albion,' 'Eversweet,' 'Monterey,' 'Portola,' 'San Andreas' and 'Seascape.' We measured total mass of fruit, marketable mass, size, percentage rotted fruit and mineral content. We found productivity and aspects of fruit quality to vary among cultivars within a cropping system and the best performers in one cropping system may not be the best in another. The most consistent result was that 'Portola' was among the best yielding cultivars in all systems, although 'Monterey' had reasonably good production in most systems, good berry size in the green roof pots and raised beds, and good mineral content in the aquaponic system. 'Monterey' and 'Portola' had higher amounts of calcium, silicon and sodium in the aquaponic system than other cultivars. 'San Andreas' had higher amounts of copper, potassium, phosphorus and silicon in the hydroponic system. 'Portola,' 'Seascape' and 'Eversweet' had higher amounts of copper and zinc in the green roof planters and 'Eversweet' also had higher amounts of zinc and calcium in the raised beds. Given the spatial and financial constraints in urban systems and the variability of performance among cultivars, the cropping system should be selected before the cultivar. [ABSTRACT FROM AUTHOR]

PURPOSE: To determine whether pretreatment (baseline) optical coherence tomography (OCT) features can be used as predictors of visual acuity outcome at 12 months in eyes with neovascular age-related macular degeneration treated with intravitreal ranibizumab and to assess whether baseline OCT features can predict a change in visual acuity from baseline to 12 months. DESIGN: Retrospective, observational study. METHODS: We retrospectively evaluated the serial cross-sectional images of the macula obtained using the Spectralis OCT (HRADOCT; Heidelberg Engineering) in 100 eyes of 94 patients attending a single center and undergoing treatment with intravitreal ranibizumab for neovascular age-related macular degeneration. The baseline OCT characteristics and visual acuity were correlated to the final visual acuity (Early Treatment Diabetic Retinopathy Study letters) and change in visual acuity after 12 months of monitoring and treatment. Univariate and multivariate analyses were carried out to correlate these morphologic features with the final visual acuity and the change in visual acuity. RESULTS: Intact ellipsoid zone (P = .0001) and external limiting membrane in the subfoveal area (P < .0001) at baseline were the only 2 independent good prognostic indicators of final visual acuity at 12months.However, none of the morphologic features at baseline could predict the change in visual acuity by 12 months. CONCLUSIONS: The results suggest that integrity of the outer retinal layers at baseline is crucial for determining final visual acuity at 12 months in eyes undergoing treatment with ranibizumab for neovascular age-related macular degeneration. [ABSTRACT FROM AUTHOR]

Abstract: Belanger HG, Vanderploeg RD, Soble JR, Richardson M, Groer S. Validity of the Veterans Health Administration''s traumatic brain injury screen. Objective: To compare the results of Veterans Affairs'' (VA''s) initial traumatic brain injury (TBI) Clinical Reminder Screen with the more extensive second-level Comprehensive TBI Evaluation in a national sample. Design: Criterion-standard. Setting: Veterans Health Administration system of polytrauma care. Participants: The data were from VA''s centralized database Patient Care Services on the TBI Clinical Reminder Screen and Comprehensive TBI Evaluation results of veterans (N=48,175). Interventions: None. Main Outcome Measures: Sensitivity, specificity, positive predictive value, and negative predictive value of the TBI Clinical Reminder Screen were calculated by using the Comprehensive TBI Evaluation findings as the comparative standard for TBI confirmation. Results: The TBI Clinical Reminder Screen has generally good sensitivity (.87–.90) but poor specificity (.13–.18). In addition, the TBI Clinical Reminder Screen, when compared with the Comprehensive TBI Evaluation by a clinician, has generally poor negative predictive power (.31–.49) in this sample. However, negative predictive power is good with an estimated Veterans Health Administration system-wide TBI prevalence rate of 15% (.89). Positive predictive power was acceptable (.77) in this sample. The screen performs comparably across patient demographic and symptom severity characteristics, as well as across level of polytrauma care. Systematic evaluations by clinicians primarily reveal mental health–perceived causes of ongoing symptoms. Conclusions: In summary, VA''s Clinical Reminder Screen, when evaluated against the follow-up Comprehensive TBI Evaluation, has good sensitivity but poor specificity. [Copyright &y& Elsevier]

Background: Various troponin I measurements (troponometrics) have been used as surrogate markers of patient outcome after coronary artery bypass grafting (CABG). Our aim was to define the postoperative troponometric best able to predict in-hospital and late mortality. Methods: In 440 patients (seen from January 2000 to September 2004) undergoing isolated on-pump CABG with standardized anesthesia, perfusion, cardioplegia, and postoperative care, we followed all-cause mortality (census June 2009, 100% complete). Subjects underwent troponin I (cardiac troponin I [cTnI]) estimation at baseline and 6, 12, 24, 48, and 72 hours postoperatively, and individual time-point cTnI (T6, T12, T24, T48, T72), peak cTnI (Cmax), increase in cTnI between 6 and 12 hours (T↑6-12) and 6 and 24 hours (T↑6-24), cumulative area under the curve cTnI (CAUC24, CAUC48, and CAUC72), and cTnI ≥ 13 ng · mL−1 at any time point were each analyzed using univariate and multivariable Cox models to identify the probability of in-hospital and late death. Logistic EuroSCOREs and calculated creatinine clearance (CrCl) were also included. The Akaike information criterion (AIC) was used to determine goodness of fit. Results: There were 62 of 440 deaths after a median (interquartile range) follow-up period of 7.0 (5.7 to 8.1) years. Univariate Cox analysis demonstrated T12, T24, T48, T72, T↑6-12, T↑6-24, standardized CAUC24, CAUC48, and CAUC72 each to be predictors of midterm mortality. On Cox multivariable analysis in models incorporating both logistic EuroSCOREs and CrCl, both T72 (hazard ratio [HR], 95% confidence interval [CI], 1.10 [1.06 to 1.14]; p < 0.001) and CAUC72 (1.45 [1.26 to 1.62], p < 0.001) were identified as independent predictors of mortality. Of these, CAUC72 was superior based on the lowest AIC. Conclusions: In myocardial protection studies, serial troponin I data should be collected until 72 hours postoperatively to calculate CAUC72, as this troponometric best predicts midterm mortality. [Copyright &y& Elsevier]

Purpose: To determine in a retrospective study the potential benefit on survival outcomes of radioembolization using yttrium-90 (90Y) resin microspheres in a cohort of patients presenting with chemotherapy-refractory liver metastases, primarily from colorectal cancer (CRC). Materials and Methods: Over 3 years, 249 patients were referred to the authors'' center to determine suitability for radioembolization as treatment for hepatic metastases. All patients were defined as salvage, having failed first-line and second-line chemotherapies. These patients were divided into group 1 (CRC) and group 2 (all other cancers, eg, breast, neuroendocrine) and assessed for overall survival (OS) as a whole and according to group. Results: Using 90Y resin microspheres, 208 patients were treated, undergoing 223 radioembolization treatments. The median OS was 8.3 months for the whole cohort, 7.9 months for group 1, and 8.7 months for group 2. At the 3-month follow-up, there was an overall adverse event rate of 9%. At the end of the data collection period, 62 patients were still alive. Conclusions: Radioembolization shows promise as an effective and safe treatment for patients with chemotherapy-refractory hepatic metastases providing an extension to survival in the salvage setting. [Copyright &y& Elsevier]

Objective: This case study presents the delayed diagnosis, surgical management, and postsurgical follow-up of an intra-articular osteoid osteoma of the left femoral neck in an 18-year-old male patient with special emphasis on discussing the confusing clinical and imaging characteristics of the lesion often associated with delayed diagnosis and increased morbidity. Clinical Features: The patient initially complained of left knee and hip pain at which time conventional radiographs were reported as normal. In magnetic resonance imaging studies, the diagnosis of intra-articular osteoid osteoma of the femoral neck was suggested; however, working diagnoses also included old posttraumatic injury, hip infection, juvenile chronic arthritis, and posttraumatic arthritis. The correct diagnosis was made 3 1 months after presentation based on computed tomography depiction of the lesion. Intervention and Outcome: Pain associated with the tumor was alleviated after surgical removal with minimal loss of motion and muscle atrophy 19 months after tumor excision. Conclusion: Clinicians and radiologists should be aware of the potentially confusing clinical and imaging findings associated with intra-articular osteoid osteoma of the hip. Early correlation between juvenile joint pain and imaging abnormalities as well as the use of thin slice computed tomography imaging could reduce the time to diagnose the lesion and prevent unnecessary morbidity. [ABSTRACT FROM AUTHOR]

• Hibiscus sabdariffa is an important tropical crop and was tested in urban production. • Yield, pests, and nutrients are influenced by genotype and production system. • Local adaptation is most likely to lead to successful cultivation. • H. sabdariffa can be grown in temperate, urban systems. Urban agriculture is expanding but faces economic and environmental challenges. One way to mitigate the impact of climate change on food security in cities with a temperate climate is to grow crops adapted to the hotter temperatures expected by the middle of the twenty-first century. Hibiscus sabdariffa L., commonly called red sorrel or roselle, is a hardy shrub widely grown throughout tropical regions of the world that has high economic value as a food crop. Most studies on H. sabdariffa have been conducted in tropical areas and, to our knowledge, none compared genotypes, their nutrients, and suitability for urban production. Therefore, we grew seven genotypes of H. sabdariffa in three production systems (i.e., green roof, field row, high tunnel) in and near Washington, DC to: 1) determine differences in leaf and flower yield between genotypes and production systems; 2) determine nutritional differences of leaves between genotypes and production systems; and 3) determine susceptibility of genotypes to insect pests. Genotype PI 286316 produced copious flowers, especially in the high tunnel. Production of leaves was highest in the field row, despite this system being most frequently attacked by Popillia japonica Newman. PI 273388, PI 275414, and green hibiscus produced the highest mass of leaves. Most minerals were influenced by the production systems, but most notable is that genotypes differed in amounts of some nutrients regardless of the production system. The locally adapted green hibiscus, which was cultivated in the Washington, DC area for many years, produced a moderate number of flowers, was a top producer of leaves in all systems, was least attacked by P. japonica , and had higher levels of nutrients than some other genotypes. Overall, our work demonstrates that H. sabdariffa , a tropical plant, can be grown in temperate, urban systems. [ABSTRACT FROM AUTHOR]

Patients with asthma and chronic obstructive pulmonary disease (COPD) are susceptible to exacerbations, often caused by microbial pathogens. We hypothesised that intracellular Toll-like receptor (TLR) function in blood mononuclear cells (PBMCs) from these subjects would be impaired and that this impairment is related to exacerbation frequency. PBMCs stimulated with a TLR-9 agonist (but not TLR-3 or 7/8) produced significantly less IFN-α in asthma (26 [3-696]pg/ml) compared to control (943 [164-1651]) and COPD (597 [127-1186]) subjects (p=0.0019) but this was not related to the number of exacerbations per year in asthma or COPD. In COPD, IFN-α levels were related to KCO (% predicted) in COPD (r=-0.41, p=0.01). IFN-α was derived from plasmacytoid dendritic cells (pDCs) and their frequency was lower in asthma compared to control subjects (control 0.48% [0.33-0.64] versus asthma 0.29% [0.13-0.34], p=0.019) whereas pDC function per se was not significantly impaired between groups. The mechanism underlying reduced IFN-α production and the clinical consequences in severe asthma remains to be established. [ABSTRACT FROM AUTHOR]

• The tympanic membrane is that closest place in the head, to which noninvasive electric stimulation can be applied. • Tympanic membrane electrode is four times more efficient than ear canal electrode and 10 times more than scalp electrodes in terms of electrically evoked auditory responses. • Tympanic membrane electric stimulation is more effective in tinnitus suppression than ear canal and scalp-based electric stimulation. While noninvasive brain stimulation is convenient and cost effective, its utility is limited by the substantial distance between scalp electrodes and their intended neural targets in the head. The tympanic membrane, or eardrum, is a thin flap of skin deep in an orifice of the head that may serve as a port for improved efficiency of noninvasive stimulation. Here we chose the cochlea as a target because it resides in the densest bone of the skull and is adjacent to many deep-brain-stimulation structures. We also tested the hypothesis that noninvasive electric stimulation of the cochlea may restore neural activities that are missing in acoustic stimulation. We placed an electrode in the ear canal or on the tympanic membrane in 25 human adults (10 females) and compared their stimulation efficiency by characterizing the electrically-evoked auditory sensation. Relative to ear canal stimulation, tympanic membrane stimulation was four times more likely to produce an auditory percept, required eight times lower electric current to reach the threshold and produced two-to-four times more linear suprathreshold responses. We further measured tinnitus suppression in 14 of the 25 subjects who had chronic tinnitus. Compared with ear canal stimulation, tympanic membrane stimulation doubled both the probability (22% vs. 55%) and the amount (−15% vs. −34%) of tinnitus suppression. These findings extended previous work comparing evoked perception and tinnitus suppression between electrodes placed in the ear canal and on the scalp. Together, the previous and present results suggest that the efficiency of conventional scalp-based noninvasive electric stimulation can be improved by at least one order of magnitude via tympanic membrane stimulation. This increased efficiency is most likely due to the shortened distance between the electrode placed on the tympanic membrane and the targeted cochlea. The present findings have implications for the management of tinnitus by offering a potential alternative to interventions using invasive electrical stimulation such as cochlear implantation, or other non-invasive transcranial electrical stimulation methods. [ABSTRACT FROM AUTHOR]

• NCI Thesaurus: Transient Abnormal Myelopoiesis Associated with Down Syndrome (C82339). • Disease Ontology: transient myeloproliferative syndrome (DOID:0060888). • MeSH:Transient Abnormal Myelopoiesis (MeSH Unique ID: C563551). • Oncotree: Transient Abnormal Myelopoiesis (TAM). [ABSTRACT FROM AUTHOR]

BACKGROUND: Previous non-stage-adjusted research described a lower use of breast-conserving surgery (BCS) for the treatment of breast cancer in the Veterans Health Administration (VHA) facilities than in the private sector. METHODS: We combined data from the VHA Centralized Cancer Registry with administrative datasets to describe surgical treatment for locoregional breast cancer in VHA facilities from 2000 to 2006. RESULTS: When considering only procedures performed in VHA facilities, BCS rates decreased from 50.5% (53/105) in 2000 to 42.3% (n = 58/137) in 2006; however, after accounting for procedures conducted in the private sector and paid for by the VHA, BCS rates approached those experienced in breast cancer patients cared for outside the VHA. CONCLUSIONS: Based solely on procedures performed in the VHA, rates of BCS use are much lower in the VHA than in the private sector. We were able to show similar rates of BCS use when we accounted for procedures paid for by the VHA but performed at an outside facility. Further exploration and prospective analyses to examine these findings are needed. [ABSTRACT FROM AUTHOR]

Objective: Murine embryonic stem cells can be differentiated into embryoid bodies (EBs), which serve as an in vitro model recapitulating many aspects of embryonic yolk sac hematopoiesis. Differentiation of embryonic stem cells deficient in either Gata-4 or Gata-6 results in EBs with disrupted visceral endoderm (VE). While lack of VE has detrimental effects on hematopoiesis in vivo, it is unclear whether lack of VE affects hematopoiesis in EBs. Therefore, we compared Gata-4 null (G4N) and Gata-6 null (G6N) EBs with wild-type EBs to assess their ability to commit to hematopoietic cells. Materials and Methods: EB VE formation was examined using cell-sorting techniques and analysis visceral endoderm gene expression. Hematopoietic progenitor potential of EBs cultured under various conditions was assessed using colony-forming assays. Results: Definitive erythroid, granulocyte-macrophage, and mixed colonies were significantly reduced in G4N and G6N EBs compared to wild-type EBs. Vascular endothelial growth factor (VEGF) expression and secretion were also reduced in both G4N and G6N EBs, consistent with VE serving as a site of VEGF production. Addition of exogenous VEGF165, to EB cultures completely rescued definitive colony-forming cells in G4N and G6N EBs. This rescue response could be blocked by addition of soluble Flk-1 Fc to EB cultures. Similarly, addition of exogenous Indian hedgehog to EB cultures also recovers the diminishment in definitive hematopoiesis in a reversible manner. Conclusion: These results suggest that the absence of VE in G4N and G6N EBs does not prevent emergence of definitive progenitors from EBs. However, the decreased level of VEGF and Indian hedgehog production in VE devoid G4N and G6N EBs attenuates definitive hematopoietic progenitor cell expansion. [Copyright &y& Elsevier]