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Background There are limited longitudinal data evaluating outcomes in idiopathic intracranial hypertension (IIH). We aimed to evaluate the long-term outcomes in a real-world cohort of patients with IIH and sought to establish the prognostic factors. Methods A longitudinal prospective cohort study was conducted over 9 years (2012–2021). Data included demographics and disease status. All consenting patients with IIH were recruited. Visual outcomes included visual acuity, Humphrey visual field and optical coherence tomography (OCT) imaging measurements. Headache frequency, severity, and impact were noted. We analysed the key variables impacting visual and headache outcomes. Results The cohort contained 490 patients with a confirmed IIH diagnosis. 98% were female with a mean body mass index (BMI) of 38 kg/m2. Those with the highest OCT retinal nerve fibre layer had the worst visual outcomes. We noted a delayed decline, in the visual field and OCT ganglion cell layer after 12 months. In the medically managed cohort (n = 426), we found that disease duration and change in BMI had the greatest influence on visual outcomes. There was a high burden of headache, with a daily headache at presentation and prior migraine history influencing long-term headache prognosis. Conclusions There is a delayed decline in visual outcomes in those with the most severe papilloedema. Disease duration and change in BMI were the key visual prognostic factors, therefore those with the more acute disease may require closer monitoring. Improving prognosis in IIH should focus on the potentially modifiable factor of weight management.

In this study the taxonomic status of three species of freshwater asellid isopod crustaceans, Lirceus hargeri, Lirceus usdagalun, and Lirceus culveri is evaluated using a large-scale RNA-seq data set. Whether each are distinct species, or whether they may be morphological variants of the same species is of particular importance for L. usdagalun, an endangered species, and L. culveri, a species of concern, since synonymy of the two could result in significantly reduced protections for the two taxa. RNA-seq was conducted on pooled individuals from each of two populations of L. usdagalun and L. hargeri, and one population of L. culveri. A single transcriptome was assembled de novo from the reads from all five populations, blasted against the NCBI non-redundant protein database, and sequence analysis was conducted on ≥ 13,468 highly expressed transcripts with significant blastx hits (E

Perfectionism is multidimensional and includes perfectionistic striving (ceaseless pursuit of very high performance standards) and perfectionistic concerns (excessive self-criticism over one’s inability to live up to unrealistically high expectations). Previous studies generally suggest that both perfectionistic striving and perfectionistic concerns are highly related to emotions; however, little research has been conducted on how perfectionism and its distinct components relate to key academic emotions such as hope towards one’s test performance. This study aimed to examine the relationship between perfectionism and test-related hope, and the mediating role of self-compassion. A sample of Chinese primary students (N = 1051) were recruited to complete measures of perfectionism, self-compassion and test-related hope. Structural equation modeling showed that perfectionistic striving was associated with higher test-related hope, and perfectionistic concerns with lower test-related hope. Partial mediation effects of self-compassion on the relationship between dimensions of perfectionism and test-related hope were also found. The findings contribute to our understanding of how perfectionism is related to emotion constructs in competitive contexts. Implications pertaining to future directions in research and practice will be discussed.

The present study investigates characteristics of treatment seeking problem gamblers with adult ADHD (n = 39) and those without ADHD (n = 87). Patients completed self-report questionnaires about gambling behaviors, impulsivity (UPPS-P), substance abuse (AUDIT/DAST), emotional dysregulation (PHQ-4), illegal activities, and gambling consequences. Each patient received a structured diagnostic interview (MINI) to assess for psychopathology, adult ADHD (ACDS), and gambling disorder (NODS). Results revealed that problem gamblers with adult ADHD encounter unique challenges above those common among problem gamblers including more problems with alcohol/drug abuse and higher levels of impulsivity. Earlier age for first gambling activities, onset of gambling problems, and higher severity of gambling problems was found among gamblers with ADHD. Gamblers with ADHD pawned more items to obtain money for gambling, were more likely to have debt, had significantly higher rates of bankruptcy and domestic violence arising from conflict with family members about their gambling. Interestingly, groups did not differ significantly on their time spent gambling prior to treatment, their win-to-loss ratio, and a number of other gambling-related consequences. These findings are discussed with their clinical ramifications for treatment.

It has been shown in this study that {CisPt@[n]CD} complexes formed from the anti-cancer drug cisplatin (CisPt) and cyclodextrins ([n]CD) can be a source of Pt based free radicals such as (H3N)2PtCl· and (H3N)2Pt·· species in water within a radiation environment which can produce hydrated electrons. Encapsulating CisPt within the [n]CD host takes advantage of the previously described drug delivery and reduced side effect advantages of CDs. Based on quantum mechanical modelling and literature results from other studies, it is predicted that {CisPt@[γ]CD} and the analogous 2-hydroxypropyl[β]cyclodextrin (HPBCD) complex {CisPt@HPBCD} may interact with serum albumin and engage in an enhanced permeation and retention mechanism in solid tumours, offering further synergistic advantages for radiation-{CisPt@[γ]CD} or -{CisPt@HPBCD} regimens over that of the conventional radiation-CisPt regimens in current use in anti-cancer chemoradiotherapies. Comparisons and possible advantages are made with the previously documented chemoradiosensitizing properties of the analogous cucurbit[7]uril based{CisPt@[7]CB} complex with the {CisPt@[γ]CD} and {CisPt@HPBCD} complexes suggest that all three complexes may have different and tailorable anti-tumour uses for a range of different chemotherapeutic environments or protocols.

Effective conservation and management of biodiversity is limited by a lack of critical knowledge on species’ distributions and abundances. This problem is particularly exacerbated for species living in habitats that are exceptionally difficult to access or survey, such as groundwater habitats. Environmental DNA (eDNA) represents a rapid, noninvasive, and potentially cost-effective new tool for detection and monitoring of biodiversity that occur in such habitats. In this study, we investigated the utility of eDNA in detecting the federally endangered Hay’s Spring Amphipod Stygobromus hayi and a co-occurring common congener S. tenuis potomacus from unique groundwater-associated habitats—hypotelminorheic seepage springs—in the Washington, DC metro area. We developed taxon-specific primers and probes for each species to amplify Stygobromus DNA using qPCR. In silico and in vitro validation demonstrated specificity of each designed assay. Assays were then used to screen water samples collected from ten seepage springs. Stygobromus hayi was detected at four seepage springs, including one potential new locality, while S. t. potomacus was detected at four springs, two of which were new localities. This study is the first to our knowledge to successfully employ an eDNA approach to detect rare or threatened invertebrates from subterranean ecosystems. Our study highlights challenges of employing an eDNA approach for the detection and monitoring of invertebrates in groundwater habitats that are difficult to study, including accounting for PCR inhibition and the potential for cryptic genetic diversity.

It has been shown in this study that the {CisPt@CB[7]} complex can be a source of Pt based free radicals such as (H3N)2PtCl· and (H3N)2Pt·· species in water within a radiation environment which can produce hydrated electrons. Encapsulating CisPt within the CB[7] host takes advantage of the previously described drug delivery and reduced side effect advantages of CBs. Based on quantum mechanical modelling and literature results, it is predicted that {CisPt@CB[7]} may interact with cellular macromolecules and engage in an enhanced permeation and retention mechanism in solid tumours, offering further synergistic advantages for a radiation-{CisPt@CB[7]} regimen over that of the conventional radiation-CisPt regimens in current use in anti-cancer chemoradiotherapies.

Gambling problems are associated with a wide range of serious negative personal, social, health, and mental health consequences and are an important public health concern. Some data suggest that gambling problems may be more prevalent among Hispanics, but few studies have been conducted in this community. The aim of the current study was to gather community-based, gambling-related data in order to increase understanding of gambling problems and their treatment in the Hispanic community. We conducted a mixed-methods study of gambling behavior and attitudes towards gambling, those with gambling problems, and professional treatment for gambling problems in a publicly funded health center serving a primarily Hispanic clientele. Study participants included clinic staff and clinic patients. All participants completed a brief, self-report survey; however, staff participated in a focus group on gambling issues and patients were interviewed individually about gambling issues. Nearly 80 % of patients had gambled in the past month, as compared to about 36 % of clinic staff. Survey data showed that patients had many risk factors for gambling problems. Focus group and interview information indicated that most viewed gambling problems as a form of addiction, the elderly were seen as being at increased risk for gambling problems, and gambling outings represented one of the few recreational opportunities in the region. The majority of both staff and patients believed that there was a need for gambling-related treatment services in the county; however, a notable minority of patients said that they would first seek help from a trusted relative or family member. Possible avenues to increase awareness of, screening for, and treatment for gambling problems may include collaborations with publicly funded health care centers and the training of promotoras to serve as an interface between health services and the community.

We tested the impact of minimal therapist guidance with a workbook designed to aid in reducing or stopping gambling. Randomly assigned participants recruited from the community who met at least 2 DSM-IV criteria for pathological gambling received a workbook completed with therapist guidance (WB+G) or a workbook (WB only). Both groups met with a research assistant to monitor chapter completion and for data collection at each study visit. We examined the proportion of participants reporting any gambling, money spent gambling, and G-SAS scores during treatment, at the end of treatment, and at 1-year follow-up. Abstinence rates were higher among those in the WB+G condition, money spent gambling was lower for the WB only group during treatment, and both groups reported fewer G-SAS gambling symptoms at treatment completion and follow up. The workbook with guidance increased abstinence from gambling while in treatment and at follow-up more than the workbook alone.

Problem and pathological gamblers demonstrate high levels of depression, which may be related to coping styles, reactive emotional states, and/or genetics (Potenza et al., Arch Gen Psychiat 62(9):1015-1021, 2005; Getty et al., J Gambl Stud 16(4):377-391, 2000). Although depression impacts treatment outcomes (Morefield et al., Int J Men Healt Addict 12(3):367-379, 2013), research regarding depression among gamblers in residential treatment is particularly limited. This study attempts to address this deficit by examining the course of depressive symptoms among clients at a residential gambling program in the Western United States. Forty-four adults were administered a weekly measure of depression (Beck Depression Inventory-II, BDI-II) for eight consecutive weeks. Levels of depression were classified into three groups based on standard scoring criteria for the BDI-II: no/minimal, mild/moderate, and severe depression. Results from a mixed-model analysis indicated a main effect for group and time, as well as an interaction between group and time. Examination of the slopes for the rate of change for the three depression groups indicated no change in the non-depressed group and a decrease in depression scores over time for both the mild/moderate and severely depressed groups. The slopes for the two symptomatic depression groups were not significantly different, indicating a similar rate of change. We speculate that reductions in depression symptoms may be related to feelings of self-efficacy, environmental containment/stabilization, and therapeutic effects of treatment. These results help to illuminate the role of significant processes in residential treatment, including initial stabilization, insight, self-efficacy, and termination.

This study investigated three different types of gamblers (recreational, problem, and pathological gamblers) to determine differences in gambling motivations and recreational activity preferences among casino gamblers. We collected data from 600 gamblers recruited in an actual gambling environment inside a major casino in South Korea. Findings indicate that motivational factors of escape, sightseeing, and winning were significantly different among these three types of gamblers. When looking at motivations to visit the casino, pathological gamblers were more likely to be motivated by winning, whereas recreational gamblers were more likely to be motivated by scenery and culture in the surrounding casino area. Meanwhile, the problem gamblers fell between these two groups, indicating higher preferences for non-gambling activities than the pathological gamblers. As this study builds upon a foundational previous study by Lee et al. (Psychiatry Investig 6(3):141-149, 2009), the results of this new study were compared with those of the previous study to see if new developments within a resort-style casino contribute to changes in motivations and recreational activity preferences.

Contemporary American Indians and Alaska Natives (AIs/ANs) who live in urban areas today face the daunting task of navigating an urban landscape while maintaining the facets of their respective Native cultures. While AIs/ANs continue to grapple with the intergenerational trauma associated with forced assimilation, relocation movements, and boarding schools, these traumas have manifested themselves in elevated rates of psychopathology. AIs/ANs have elevated rates of domestic abuse, poverty, suicide, and substance misuse. Furthermore, AIs/ANs, like many other minority cultures often face discrimination in their everyday lives. In light of the aversive experiences they face, AI/AN people have followed the tenets of ritual and traditional healing to address imbalances in the body, mind, and spirit. For providers working with AI/AN clients, it is important to understand who is using traditional healing and why they are using alternative services. Secondary data analyses of survey data from 389 urban AIs/ANs were utilized in order to determine the relationship between experiences of discrimination and traditional healing use. Analyses indicated that experiences of discrimination in healthcare settings were significantly associated with participation in traditional healing. Analyses also indicated that nearly a quarter of the sample reported discrimination in a healthcare setting, roughly half of the sample had used traditional healing, and that the majority of those who had used traditional healing were women, and ages 35-44 (27%). This study calls attention to the socio-demographic factors implicated in traditional healing use by urban AI/AN people, in addition to the clinical and demographic characteristics of this sample.

Although there is a substantial amount of research suggesting that higher levels of religiosity/spirituality (R/S) are associated with better treatment outcomes of substance-related disorders, no studies have explored this relationship at a faith-based residential treatment center. The objective of this prospective study is to explore the relationship between R/S, self-reported religious preference, and retention at a Jewish residential treatment center for substance-related disorders. Using the Daily Spiritual Experience Scale, R/S levels were assessed for 33 subjects at baseline, 1 month, 3 months, and 6 months. Results demonstrated a significant relationship between baseline R/S level and retention at 6 months, while R/S levels were unchanged during the course of treatment. Notably, no relationship was found between self-reported religious affiliation and retention. This study demonstrates that patients' R/S level, rather than religious affiliation, is a possible predictor for better outcome at faith-based residential centers for substance-related disorders.

This study explored the concept of school connectedness and the factors that may influence its development with a sample of Chinese adolescents. Six focus groups involving 52 high school students were conducted using a set of predetermined discussion topics. Results indicated that the students fully understood the notion of school connectedness and could identify a number of key influences affecting its development. These factors could be grouped under several domains including teacher care, peer relations, broader school relationships, school disciplinary policies and practices, activities within the school’s guidance and counseling program, and opportunities for talent development. The students were also able to suggest practical strategies that schools might introduce to enhance and strengthen students’ acquisition of connectedness to school. The implications from the findings are discussed with particular reference to implementing comprehensive school guidance and counseling program in Hong Kong.

Background Emerging data suggest that problem/pathological gambling may be highly prevalent among Asian-Pacific Islanders (APIs) and that can be a major concern to their communities. Methods This study surveyed problem/pathological gambling knowledge, attitudes, and perceived community impact of problem gambling among self-identified male and female APIs and non-APIs attending one of two API community events in Los Angeles County. Results Unexpectedly, our results indicated no effect for ethnicity with regards to ratings of problem/pathological gambling knowledge, community impact, or consequences. However, a gender effect with women reporting less problem/pathological-gambling-related knowledge than men, regardless of ethnicity was found. Over 40% of all respondents reported that problem/pathological gambling impacted their communities ‘a lot’, and the ratings for the impact of problem/pathological gambling was equal to ratings for other significant public health issues like diabetes, depression, drug abuse, and alcohol abuse. Discussion Based on these results, it is recommended that evidence-based legislation support the development of culturally-relevant prevention and intervention programs for problem/pathological gambling in Los Angeles County.

An increase in prevalence of problem gambling and gambling-related costs to the individual, family, and community are accompanying the spreading availability of venues in which to gamble. This highlights the need for effective educational programs, media campaigns, consumer protection, and public policy aimed at preventing increased incidence of problematic gambling behavior. This review explores prominent models of prevention including the risk and protective factors model, levels-of-prevention, and the public health perspective and illustrates each model's power to facilitate efforts toward preventing gambling problems. The current state of problem gambling prevention research and practice is delineated and future directions for policy are made. EDITORS' STRATEGIC IMPLICATIONS: Researchers and policymakers will benefit from the review and set of recommendations and also the detailed supplemental online content, in the form of six helpful Appendixes related to gambling prevention resources and materials.

Heart failure has emerged as one of the most important diseases of the past century. The understanding and treatment of heart failure has evolved significantly over the years. As we move further into the era of device therapy, attention has turned to the idea of sympathetic nervous system modulation through renal denervation to treat heart failure. In this review, we summarize the background research, denervation technique, and current studies on renal denervation for the treatment of heart failure. We also compare and contrast the work on carotid barostimulation.

The monitoring survey and health assessment for benthic community were carried out in Luhuitou fringing reef of Sanya, Hainan, China in 2002. Monitoring survey included manta tow, line intercept transect, video transect and digital photograph. The mean live coral cover was 23.40%. Comparison of used monitoring methods showed that video transect can replace line intercept transect, and 50 m transect is better than 20 m transect in uneven coral region. Survey data and comparison with previous research work showed that Luhuitou fringing reef has been damaged severely and has a general declining trend with live coral cover from about 85% in the 1960s down to 20% in 2004, but it still has quite high biodiversity and therefore has special protection value. Main factors of Luhuitou fringing reef declining were human activities including reef rock digging and curios collecting, destructive fishing, sediment and pollutant from coastal land, and recent marine aquaculture. Only strengthening integrated management can reach improvement and restoration of Luhuitou declining coral reef ecosystem.

The distribution, species, biomass, productivity of main seagrasses and their suffered main threats are introduced and discussed in this paper based on the field surveys in the offshore areas of Guangdong, Guangxi and Hainan provinces. The seagrass beds distributed mainly in Liusha Bay, Donghai Island and Hailing Island of Guangdong Province; Hepu and Pearl Bay of Guangxi Zhuang Autonomous Region; Li’an Bay, Xincun Bay, Longwan Bay and Sanya Bay of Hainan Province and so on. The total area of seagrass beds in the coastal sea of South China is about 2400 ha. There are about 8 species, such as Halophila ovalis, Halodule uninervis, Halophila beccarii, Zostera japonica, Enhalus acoroides, Thalassia hemperichii, Ruppia martime and Cymodocea rotundata. These seagrasses have high biomass and productivity. However, they are subjected to some threats resulting from artificial and natural factors, especially anthropogenic causes, such as culture of shrimps and fishes, shellfish collection, fishing by means of poisons, electric power and explosives as well as trawling, artificial pollution, dredging channels, and typhoons natural disaster.

Bupropion is an antidepressant with stimulant properties, which inhibits the reuptake of dopamine (DA) and norepinepherine, and is purported to enhance DA neurotransmission. Bupropion is considered an appealing candidate medication for the treatment of methamphetamine dependence. The current laboratory study was set forth to assess the impact of bupropion treatment on the subjective effects produced by methamphetamine in the laboratory. We also assessed the effects of bupropion treatment on craving elicited by exposure to videotaped methamphetamine cues. A total of 26 participants were enrolled and 20 completed the entire study (n=10 placebo and n=10 bupropion, parallel groups design). Bupropion treatment was associated with reduced ratings of 'any drug effect' (p

Methamphetamine dependence is a growing problem for which no medication treatments have proven effective. We evaluated bupropion, an antidepressant with beneficial effects for the treatment of nicotine dependence, in patients with methamphetamine dependence, to assess the safety and tolerability of methamphetamine administration during bupropion treatment. Twenty-six participants entered the study and 20 completed the protocol. Participants received intravenous methamphetamine (0, 15, and 30 mg) before and after randomization to twice-daily bupropion (150 mg SR) or matched placebo. Dependent measures included cardiovascular effects of methamphetamine, methamphetamine and amphetamine pharmacokinetics, and peak and trough plasma concentrations of bupropion and its metabolites. Bupropion treatment was well tolerated, with bupropion- and placebo-treated groups reporting similar rates of adverse events. Methamphetamine administration was associated with expected stimulant cardiovascular effects, and these were not accentuated by bupropion treatment. Instead, there was a trend for bupropion to reduce methamphetamine-associated increases in blood pressure and a statistically significant reduction in methamphetamine-associated increases in heart rate. Pharmacokinetic analysis revealed that bupropion treatment reduced the plasma clearance of methamphetamine and also reduced the appearance of amphetamine in the plasma. Methamphetamine administration did not alter the peak and trough plasma concentrations of bupropion or its metabolites. Methamphetamine administration was well tolerated during bupropion treatment. There was no evidence of additive cardiovascular effects when the drugs were coadministered. This study provides initial evidence for the safety of prescribing bupropion for the treatment of methamphetamine abuse and dependence. The impact of bupropion treatment in patients who abuse larger doses of methamphetamine remains undetermined.

Web-based e-commerce software is typically real-time, responsive, and distributed software that must meet high quality requirements. Moreover, because of its Internet-based operating environment, e-commerce software must deal with concurrency, synchronization, and non-deterministic issues (such as delays) primarily caused by the heavy usage load and underlying network conditions. In this paper, we introduce a generic, cost-effective approach to optimize requirements capture (and subsequent development and testing) with respect to functional coverage and customer perception of quality. This high-yield approach is presented and illustrated by application to an e-commerce online shopping system and used to explain the principles of use-case requirements captured in the unified modeling language.

Chlamydia pneumoniae, a respiratory pathogen, has been suggested as a risk factor for cardiovascular disease. Epidemiologic data are very controversial. Histopathologic and microbiologic studies have established an association between atherosclerosis and presence of C. pneumoniae, consistently finding C. pneumoniae DNA and antigens in atherosclerotic arteries. C. pneumoniae has been cultured from atherosclerotic arteries in several centers. An etiologic role for C. pneumoniae in initiation, acceleration of atherosclerosis, and/or acute ischemia remains debatable. In vitro studies have shown that C. pneumoniae can induce foam cell formation, low-density lipoprotein oxidation, and proinflammatory and procoagulant cytokine expression. Animal models of de novo initiation or enhancement of atherosclerosis have been developed. Preliminary trials of secondary prevention of coronary artery disease complications by antimicrobial agents show modest results. Better diagnostic tools, more diverse animal models, and clinical trials of primary prevention are needed. Meanwhile, results of ongoing large clinical trials on secondary prevention are eagerly awaited, but may not be definitive.

Transcription and pre-mRNA splicing are tightly coupled gene expression events in eukaryotic cells1,2. An interaction between the carboxy-terminal domain of the largest subunit of RNA polymerase (Pol) II and components of the splicing machinery is postulated to mediate this coupling3,4,5. Here, we show that splicing factors function directly to promote transcriptional elongation, demonstrating that transcription is more intimately coupled to splicing than previously thought. The spliceosomal U small nuclear ribonucleoproteins (snRNPs) interact with human transcription elongation factor TAT-SF1 (refs 6,7,8,9) and strongly stimulate polymerase elongation when directed to an intron-free human immunodeficiency virus-1 (HIV-1) template. This effect is likely to be mediated through the binding of TAT-SF1 to elongation factor P-TEFb10, a proposed component of the transcription elongation complex11,12. Inclusion of splicing signals in the nascent transcript further stimulates transcription, supporting the notion that the recruitment of U snRNPs near the elongating polymerase is important for transcription. Because the TAT-SF1–U snRNP complex also stimulates splicing in vitro, it may serve as a dual-function factor to couple transcription and splicing and to facilitate their reciprocal activation.

These experiments examined the hypothesis that isolation-rearing and strain influence hedonic mechanisms. In experiment 1, voluntary consumption of ethanol and water was monitored in the home cage of Fawn Hooded (FH) and Wistar rats. FH rats were found to consume more ethanol at low concentrations than Wistar rats, independent of rearing condition, and isolation-reared rats were found to consume more of high ethanol concentrations, independent of strain. In experiment 2, isolation-reared rats were found to consume more sucrose, independent of concentration, than socially reared rats. In experiment 3, Fawn Hooded rats were found to be more sensitive to low concentration solutions of saccharin, and to consume less of the high concentration solutions, while isolation-rearing was found to enhance consumption of high concentrations. Thus, hedonic processes are independently modulated by strain and rearing conditions, although the effects of isolation-rearing appear to be exacerbated in Fawn Hooded rats.

Voluntary ethanol (EtOH) consumption is increased by isolation-rearing in several rat strains. The following experiments examined the effects of isolation-rearing on basal and ethanol-stimulated behavior in Fawn Hooded rats, an alcohol-preferring rat strain, compared to Wistar rats. Locomotor activity and anxiety were examined under both conditions. Basal locomotor activity was higher in isolated subjects of both strains in low light conditions, but under bright light conditions, this difference was only observed in Wistar rats. Locomotor stimulant effects of EtOH were only observed in isolation-reared rats. In the elevated plus maze, Fawn Hooded rats were more anxious than Wistar rats under low light conditions, but under bright light conditions, Wistar socials were less anxious than all of the other groups. Administration of 1.5 mg/kg EtOH produced an anxiolytic response in the elevated plus maze under bright light conditions in Fawn Hooded rats, but to a lesser degree Wistar rats, particularly Wistar isolates. In conclusion, although both strain and isolation-rearing had effects on locomotion and anxiety as well as the stimulatory and anxiolytic effects of EtOH, these effects appeared to be independent.

Vulvovaginal candidiasis (VVC) is a frequent cause of morbidity in women of reproductive age. Most women will experience 1 or 2 episodes in their lifetime, but a smaller population develop chronic recurrent disease. There are few data on cost or pharmacoeconomic considerations in the management of this condition. The disease does not usually result in long term disability, loss of employment or death, but could affect a woman's work performance through irritability, frustration and unhappiness. This review attempts to estimate the least costly programme or regimen (as the efficacy of different regimens is similar) that would be applicable to patients, third-party payers and society. Nonprescription or over-the-counter (OTC) antifungal preparations could have an impact on overall cost in the management of VVC. In the management of infrequent acute VVC, an OTC preparation would be least costly to the healthcare system (provided that the diagnosis was correct). The strategies used to control symptoms in patients with chronic recurrent VVC should be based on the frequency of recurrent episodes. For patients with less than 12 episodes a year, empirical self-treatment at the onset of symptoms with an OTC agent (e.g. intravaginal clotrimazole 500mg) is less costly and preferable to patients than monthly prophylaxis. Patients with a greater frequency of recurrences may benefit from monthly, daily or twice weekly prophylaxis. At present, for very frequent recurrences, intravaginal clotrimazole 200mg twice weekly appears to be as effective as daily oral ketoconazole, and may be safer and less costly. However, because of the lack of prospective controlled studies, most of these recommendations are based on hypothetical reasonings. Furthermore, the disadvantages of OTC antifungals include the potential for overuse and inappropriate use, possibly resulting in the delayed diagnosis and treatment of other conditions. On balance, OTC preparations may provide patients with faster and more economical care, and improve healthcare delivery.

Data on number of subterranean crustaceans in river basins, in karst basins within a river basin, streams within a karst basin, riffles within a stream, and rocks within a riffle were analyzed with an emphasis on similarities at different geographic scales. Except at the smallest scale (individual rocks) the coefficient of variation of species number was roughly constant at 0.4, indicating some fractal properties of the variation. Using approximations for the log of the linear extent of each scale, species number increased linearly at a slope of 0.68 (P

Nypa fruticans Wurmb. dominated wetlands are commonly found where brackish waters overflow with the tides. This swamp palm is harvested for a variety of purposes, including roofing, construction materials and peels for rolling cigarettes from its leaves, and sugar syrup, an intoxicating juice, vinegar and alcohol from its floral and fruit stalk exudate. Extraction techniques are traditional, and current resource development strategies are non-existent in areas where nipa palms are being harvested. Maintenance of adequate supplies of the resource requires knowledge of demand on the resource and its renewability under natural and harvest regimes. To sustain production, indigenous populations follow conservation-oriented practices in husbanding the natural resource.

The relative efficacies of cilofungin, amphotericin B and fluconazole were compared in the treatment of systemic Candida albicans infection in neutropenic mice. Thirty-one day survival rates were lowest for cilofungin (14.6%), intermediate for amphotericin B (37.6%) and highest for fluconazole (50.5%). Residual tissue infection in surviving animals was observed with all agents, but was heaviest with fluconazole, especially in the kidneys.

Background Gammarus minus, a freshwater amphipod living in the cave and surface streams in the eastern USA, is a premier candidate for studying the evolution of troglomorphic traits such as pigmentation loss, elongated appendages, and reduced eyes. In G. minus, multiple pairs of genetically related, physically proximate cave and surface populations exist which exhibit a high degree of intraspecific morphological divergence. The morphology, ecology, and genetic structure of these sister populations are well characterized, yet the genetic basis of their morphological divergence remains unknown. Results We used degenerate PCR primers designed to amplify opsin genes within the subphylum Crustacea and discovered two distinct opsin paralogs (average inter-paralog protein divergence ≈ 20%) in the genome of three independently derived pairs of G. minus cave and surface populations. Both opsin paralogs were found to be related to other crustacean middle wavelength sensitive opsins. Low levels of nucleotide sequence variation (< 1% within populations) were detected in both opsin genes, regardless of habitat, and dN/dS ratios did not indicate a relaxation of functional constraint in the cave populations with reduced or absent eyes. Maximum likelihood analyses using codon-based models also did not detect a relaxation of functional constraint in the cave lineages. We quantified expression level of both opsin genes and found that the expression of both paralogs was significantly reduced in all three cave populations relative to their sister surface populations. Conclusions The concordantly lowered expression level of both opsin genes in cave populations of G. minus compared to sister surface populations, combined with evidence for persistent purifying selection in the cave populations, is consistent with an unspecified pleiotropic function of opsin proteins. Our results indicate that phototransduction proteins such as opsins may have retained their function in cave-adapted organisms because they may play a pleiotropic role in other important processes that are unrelated to vision.

The effect of temperature and strain-rate on the fracture behaviour during high strain-rate (∼ 103 sec−1) impact of two highly filled polymeric composite propellants (containing segmented polyurethanes based on hydroxy-term inated polybutadiene (HTPB) or glycidyl azide polymer (GAP) filled with ammonium perchlorate (AP) particles) and a plasticized thermoplastic (cast double base (CDB) nitrocellulose-nitroglycerine) propellant have been examined over a wide temperature range encompassing the ⋊ittle-ductile” transition. In the “elastic” region of the loaddisplacement curve, the yield stress and fracture toughness is highest for GAP/AP and lowest for HTPB/AP. In the “elastic” and post-yield “ductile” regions CDB is more fracture-resistant than GAP/AP and HTPB/AP over the temperature range −20 to 50° C, but below −40° C, where both CDB and GAP/AP are brittle, GAP/AP is more fracture-resistant than CDB (as observed in the “elastic” region). Although all the propellants are known to develop small cracks in the “elastic” and post-yield “ductile” regions of the load-displacement curve, the overall fracture behaviour is largely governed by viscoelastic properties (because the cracks close up in compression). The good mechanical properties of CDB, above the “brittle-ductile” transition temperature, can be attributed to the presence of a largeβ-transition loss peak. In the composites, the fracture behaviour is also influenced to a lesser extent by the degree of filler-binder interactions. Dynamic mechanical analysis indicates that GAP/AP has a slightly higher degree of filler-binder interactions than HTPB/AP. A temperature-strain rate reduction has been obtained for the yield stress and the composite curve can be expressed by the equation σy =K1 +K2 log (ĠeaT) whereK1 andK2 are constants andaT is a shift factor.K2 is a material constant which reflects the temperature and strain-rate sensitivity.

The effect of particle size and orientation on the inherent fracture toughness of a filled plasticized polymeric material has been determined by application of linear elastic fracture mechanics. Testing was caried out in a three-point bend mode under impact conditions. The material was a triple base gun propellant consisting of a matrix of nitrocellulose plasticized with nitroglycerine and filled with particles of nitroguanidine (NQ). The crystalline NQ was used in the “as-received” form of needles and in a “ground” state. The material containing as-received NQ consistently had a higher fracture toughness than the material with ground NQ, and the toughness was a maximum when the fillers were aligned perpendicularly to the fracture surface. The impact fracture toughness was found to be virtually independent of strain rate over the range from 3 to 90 sec−1.

The acceptance or rejection of leukemic cells by the host may be related to transplantation immunology. Viral infections of cells are known to alter the antigenic composition of cell membranes and lead to the development of new antigens, deletions with replacement by fetal forms, and/or partial development of specific antigens. Search for aberrant HL-A antigens in leukemias may lead to the discovery of tumor-specific antigens. HL-A phenotypes were determined by microcytotoxicity and absorption methods in 20 patients with acute lymphocytic leukemia (ALL) and 50 family members; 10 patients with chronic granulocytic leukemia; 20 patients with other lympho- and myelo-proliferative disorders and tumors. Seven of 16 ALL patients possessed one or two HL-A antigens not expected from family analysis. The aberrant HL-A specificities differed from patient to patient. Five of 16 ALL patients demonstrated three HL-A alleles per segregant group not found in family members. The gene frequency of HL-A7 in the ALL group was lower than expected (p < 0.01). There also appears to be a paucity of HL-A specificities at the locus of the second segregant group (5, 7, 8, 12) in ALL (p < 0.01). No relationship was found between certain HL-A genotypes and ALL. Malignant transformation of cells did lead to aberrant HL-A patterns. The discovery of HL-A specificities unique to the ALL patient through family analyses may form a basis for the development of immunotherapy.