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Vitamin K1 (VitK1) and Vitamin K2 (VitK2), two important naturally occurring micronutrients in the VitK family, found, respectively, in green leafy plants and algae (VitK1) and animal and fermented foods (VitK2). The present review explores the multiple biological functions of VitK2 from recently published in vitro and in vivo studies, including promotion of osteogenesis, prevention of calcification, relief of menopausal symptoms, enhancement of mitochondrial energy release, hepato-and neuro-protective effects, and possible use in treatment of coronavirus disease. The mechanisms of action associated with these biological effects are also explored. Overall, the findings presented here suggest that VitK, especially VitK2, is an important nutrient family for the normal functioning of human health. It acts on almost all major body systems and directly or indirectly participates in and regulates hundreds of physiological or pathological processes. However, as biological and clinical data are still inconsistent and conflicting, more in-depth investigations are warranted to elucidate its potential as a therapeutic strategy to prevent and treat a range of disease conditions.

OBJECTIVES: As people with HIV (PWH) age, the prevalence of frailty increases. Rapid screening tests to identify frailty within HIV outpatient settings are required to identify at-risk individuals. We undertook a service evaluation to assess three short frailty assessments in PWH. METHODS: We assessed two objective [gait speed (GS), timed-up-and-go test (TUGT)] and one subjective [the self-reported health questionnaire (SRH)] frailty screening tools in PWH aged > 40 years attending a single HIV outpatient department. Factors associated with positive frailty screening tests (defined as GS

This study presents (1) the temporal variations and trends of monthly and daily temperature and precipitation extremes in Alaska, and (2) the synoptic-scale circulation patterns associated with these extremes. The analysis is based on daily station observations of maximum temperature, minimum temperature and precipitation from 1948–2012 as well as monthly average temperatures and precipitation from 1920–2012 from 13 Alaska climate divisions. The frequencies of daily and monthly temperature extremes show variability and trends over the past 50–90 years consistent with a warming climate in Alaska. This warming is superimposed on low-frequency variability attributed to the Pacific Decadal Oscillation. Unlike the temperature extremes, occurrences of heavy-precipitation extremes do not display a coherent signal through time. The changes do not appear to be linked with an overall increase in the variance of temperature or precipitation. Composite analysis of sea level pressure (SLP) anomalies associated with a representative sample of different daily and monthly temperature extremes across Alaska shows that temperature and moisture advection, subject to topographic and coastal influences, is a key driver of these events. Composite SLP fields for daily and monthly extremes are similar, especially in winter, indicating that monthly extremes represent the recurrence of daily extreme patterns during those extreme months. The SLP anomalies were also often reduced in magnitude in the summer events compared with winter, consistent with the lower variance of temperature and SLP during summer.

High-resolution maps of potential frozen ground distribution in South America have been produced for the present day (0 ka) and the Last Glacial Maximum (21 ka). Surface air temperature outputs from global climate models (GCMs) of the recent Paleoclimate Model Intercomparison Project were used for the reconstructions, and then downscaled from regional to local scales, with the help of a 1 arc-minute digital elevation model. Their validity was examined using fieldwork-based evidence and knowledge. The downscaled map for the present day successfully reproduces the presence of permafrost in the Andes, a task at which original coarse-resolution GCM output maps failed. The map also shows close correspondence with instrumental observations. Similarly, the downscaled distribution of 21 ka frozen ground shows overall consistency with geomorphological and/or palaeoenvironmental reconstructions. Areal coverage of potential permafrost for all of South America is estimated at 139 000 km2 for today and 435 000 km2 for 21 ka, mostly along the Andean mountain ranges. Regional inspections, however, show divergence from field-observed features, attributed to microclimatic effects and past permafrost conditions. For southern Patagonia, and especially the eastern lowlands, the diagnosed lower limit for permafrost is about 1000 m asl, whereas field evidence at lower altitudes indicates the presence of either permafrost or deep seasonal frost. Copyright © 2015 John Wiley & Sons, Ltd.

Extreme temperature and precipitation events in Alaska are examined in an ensemble of global climate models (GCMs) and an atmospheric reanalysis. Extreme monthly maximum and minimum temperature and the monthly maximum 5-day precipitation amount are evaluated for a 30-year historical period and two 30-year future time slices (2050s and 2080s). Although biases exist, models capture the spatial pattern and seasonality of the extremes depicted by the ERA-40 reanalysis. Discrepancies between station data (Anchorage, Fairbanks and Barrow) and GCMs/reanalysis are larger than the model-reanalysis differences, and are consistent with (1) surface elevation differences arising from the models' resolution and (2) gauge undercatch of precipitation in the station data. GCMs project future changes that are 2–4 times larger than the across-model standard deviations. The largest changes projected by the GCMs are significantly different from the historical mean at the 95% confidence level. Changes in extreme minimum temperature and extreme 5-day precipitation projections are larger than changes in means. The extreme minimum temperatures are projected to increase 2–3 times as much as the extreme maximum temperatures in all seasons except summer, with the largest increases of extreme minima in coastal regions. By the 2080s, the increases in all three extremes indices are twice as large in the Representative Concentration Pathway (RCP) 8.5 as in the RCP 4.5 scenario. The magnitude of the projected increase of maximum 5-day precipitation is largest in southern and inland areas, although the percentage increase is largest in the north. In the RCP 8.5 simulations, the inter-annual variability of extreme temperatures narrows by the end of the century, most notably in autumn. Record-breaking 5-day precipitation events become more common in the RCP 8.5 than in the RCP 4.5 scenario.

The Community Climate System Model, version 4 (CCSM4) is evaluated against reanalysis data for the late-twentieth century (1955–2005), with a focus on the ecologically and commercially important Bering Sea in the subarctic Pacific. Several atmospheric variables including surface-air temperature, sea level pressure, wind strength, and direction were evaluated due to their relevance to large marine ecosystems. Simulated spatial patterns of climatological surface-air temperature over the Bering Sea are generally well simulated despite some subregional biases as large as +3 °C during autumn and −5 °C during winter. Interannual variability of simulated surface-air temperature exceeds that of the reanalysis by a factor of nearly 1.5. Model simulations show an under-simulated Siberian high and a large northwest displacement of the Aleutian Low-pressure centre. Further, sea level pressure over the Bering Sea is under-simulated in winter and fall by more than 8 hPa, and over-simulated in summer by more than 5 hPa. Interannual variability in simulated sea level pressure is nearly twice as large as observed. In general, the CCSM4 shows an improved representation of both monthly mean surface-air temperature and sea level pressure over the subarctic Pacific relative to its predecessor, the CCSM3. Despite these advances, there is still a clear need for improvements in the model's representation of high-latitude atmospheric circulation in order to achieve proper atmospheric forcing of marine ecosystem models.

Although much remains to be learned about the Arctic and its component processes, many of the most urgent scientific, engineering, and social questions can only be approached through a broader system perspective. Here, we address interactions between components of the Arctic system and assess feedbacks and the extent to which feedbacks (1) are now underway in the Arctic and (2) will shape the future trajectory of the Arctic system. We examine interdependent connections among atmospheric processes, oceanic processes, sea-ice dynamics, marine and terrestrial ecosystems, land surface stocks of carbon and water, glaciers and ice caps, and the Greenland ice sheet. Our emphasis on the interactions between components, both historical and anticipated, is targeted on the feedbacks, pathways, and processes that link these different components of the Arctic system. We present evidence that the physical components of the Arctic climate system are currently in extreme states, and that there is no indication that the system will deviate from this anomalous trajectory in the foreseeable future. The feedback for which the evidence of ongoing changes is most compelling is the surface albedo-temperature feedback, which is amplifying temperature changes over land (primarily in spring) and ocean (primarily in autumn-winter). Other feedbacks likely to emerge are those in which key processes include surface fluxes of trace gases, changes in the distribution of vegetation, changes in surface soil moisture, changes in atmospheric water vapor arising from higher temperatures and greater areas of open ocean, impacts of Arctic freshwater fluxes on the meridional overturning circulation of the ocean, and changes in Arctic clouds resulting from changes in water vapor content.

A high-resolution map of potential frozen ground distribution in NE Asia (90–150°E, 25–60°N) at the period of the Last Permafrost Maximum (LPM, c. 21 000 years ago) was dually reconstructed by means of a statistical classification using air freezing and thawing indices and a topographical downscaling using a digital relief model (ETOPO1). Background LPM climate data were derived from global climate model simulations of the Paleoclimate Model Intercomparison Project, Phase II (PMIP2). The reconstructed LPM map shows the southward shift of the southern limit of climate-driven permafrost by 400–1500 km, with the greatest advance in the western sector (90–110°E), encompassing an area from central Siberia to most of the Altai area. The advance of environmentally conditional permafrost and seasonally frozen ground was greatest in the eastern sector (110–150°E), with an average shift of about 450 km. The descent of the lower limit of LPM alpine permafrost was in the range of 400–800 m. A comparison of the reconstructed map with published literature shows that this method, simplistically constructed yet effectively recognizing seasonality, continentality and topography, captures local features better than more elaborate methods. The sensitivity examination of a constant atmospheric lapse rate shows that altitudes of 2000–5000 m a.s.l. were most sensitive, though with only a limited effect on overall LPM distribution.

The National Disability Insurance Scheme (NDIS) has been called ‘the most fundamental social policy reform since the introduction of Medicare’. In this article, we document the chronology of the insurance and actuarial developments leading up to the NDIS. We describe the critical components of the ‘insurance model’ in this context and how these apply in a human services framework like disability and potentially other areas. We then briefly document the Productivity Commission's vision for the NDIS, including the potential economic benefits. Finally, we present some commentary on the current status of the NDIS's implementation and risks which may threaten its success.

Infrastructure - broadly defined to include road and rail networks, telecommunications, electricity and other utilities - offers both direct and indirect benefits to economic growth. The direct effects include employment and contracts for local firms, while its role as an enabling technology means that a multiplier effect is provided for the economy as a whole. Infrastructure also has a role to play in promoting the efficiency of governance and social cohesion. The relative importance of these factors varies according to the specific conditions applying within a geographical location. The Burmese capital, Naypyidaw, for example, has a symbolic status as the seat of postcolonial Burmese power, while also offering a strategic location from which to govern the country. The role of infrastructure in this case is to promote efficiency of rule and create a network in which the city can form a node connected with economically important locations. In Phnom Penh and Vientiane, by contrast, infrastructure is being used to both promote economic activities and link up with cross-border markets. In all cases, albeit in different ways, capital cities are being repositioned within actual and emerging power networks in order to control and take advantage of processes of international capital accumulation.

The overall purpose of these guidelines is to provide guidance on best clinical practice in the treatment and management of adults with HIV infection with antiretroviral therapy (ART). The scope includes: (i) guidance on the initiation of ART in those previously naive to therapy; (ii)support of patients on treatment; (iii) management of patients experiencing virological failure; and (iv) recommendations in specific patient populations where other factors need to be taken into consideration. The guidelines are aimed at clinical professionals directly involved with and responsible for the care of adults with HIV infection and at community advocates responsible for promoting the best interests and care of HIV-positive adults. They should be read in conjunction with other published BHIVA guidelines.

After the 1997 financial crisis, many retrenched workers preferred not to return to provincial homes but remained in Bangkok to establish informal retail businesses in branded and other consumer products. In contrast to traditional street vendors, who specialized in food items primarily catering for low-income customers, and focused on high volume, these ‘new generation’ street vendors also adopted more formal business practices. Given their greater sophistication and better education, we hypothesized that they would be more organized advocates of vendors' rights and thus more prone to conflicts with municipal authorities. Based on interviews, however, we found that new generation vendors are adaptive to location and business strategy, and prefer a low profile in dealing with officialdom. By contrast, traditional vendors remained more tied to particular spaces, are more likely to stand up for their rights to use public space and, because they expect more from government, are more prone to conflicts with municipal authorities. Our findings relate to ongoing discussion on the rights and needs of street vendors to access urban public space and the responsibilities of authorities to meet and provide for these informal sector livelihoods that make up a significant share of the national economy in Thailand, as elsewhere in the global South.

Objectives Current British HIV Association (BHIVA) guidelines recommend that all patients with a CD4 count

OBJECTIVE We investigated whether adverse responses to highly active antiretroviral therapy (HAART) associated with late HIV presentation are secondary to low CD4 cell count per se or other confounding factors. METHODS A longitudinal analysis of the UK Collaborative HIV Cohort (CHIC) Study of individuals starting HAART in 1998-2007 was carried out, comparing late presenters (presenting/starting HAART at a CD4 count 350 cells/μL; starting HAART at a CD4 count 350 cells/μL; starting HAART at a CD4 count of 200-350 cells/μL) as a comparator. Virological, immunological and clinical (new AIDS event/death) outcomes at 48 and 96 weeks were analysed, with the analysis being limited to those remaining on HAART for>3 months. RESULTS A total of 4978 of 9095 individuals starting first-line HAART with HIV RNA>500 HIV-1 RNA copies/mL were included in the analysis: 2741 late presenters, 947 late starters and 1290 ideal starters. Late presenters were more commonly female, heterosexual and Black African. Most started nonnucleoside reverse transcriptase inhibitors (NNRTIs); 48-week virological suppression was similar in late presenters and starters (and marginally lower than in ideal starters); by week 96 differences were reduced and nonsignificant. The median CD4 cell count increase in late presenters was significantly lower than that in late starters (weeks 48 and 96). During year 1, new clinical events were more frequent for late presenters [odds ratio (OR) 2.04; 95% confidence interval (CI) 1.19-3.51; P=0.01]; by year 2, event rates were similar in all groups. CONCLUSION Amongst patients who initiate, and remain on, HAART, late presentation is associated with lower rates of virological suppression, blunted CD4 cell count increases and more clinical events compared with late starters in year 1, but similar clinical and immunological outcomes by year 2 to those of both late and ideal starters. Differences between late presenters and late starters suggest that factors other than CD4 cell count alone may be driving adverse treatment outcomes in late-presenting individuals.

We examined the prevalence of hepatitis C virus (HCV) infection among HIV-positive individuals in the UK, trends in HCV testing and the impact of HCV on HIV treatment outcomes. Trends over time in HCV prevalence were calculated using each patient's most recent HCV status at the end of each calendar year. Logistic regression was used to identify factors associated with having a HCV antibody test, and Cox regression was used to determine whether HCV status was associated with the time to experiencing an immunological response to highly active antiretroviral treatment (HAART), time to virological response and viral rebound. Of the 31,765 HIV-positive individuals seen for care between January 1996 and September 2007, 20,365 (64.1%) individuals were tested for HCV, and 1807 (8.9%) had detectable HCV antibody. The proportion of patients in follow-up ever tested for HCV increased over time, from 782/8505 (9.2%) in 1996 to 14,280/17,872 (79.9%) in 2007. Nine thousand six hundred and sixty-nine individuals started HAART for the first time in or after January 2000, of whom, 396 (4.1%) were HCV positive. Presence of HCV infection did not affect initial virological response, virological rebound or immunological response. The cumulative prevalence of HCV in the UK CHIC Study is 8.9%. Despite UK guidelines, over 20% of HIV-positive individuals have not had their HCV status determined by 2007. HCV infection had no impact on HIV virological outcomes or immunological response to HIV treatment. The long-term impact on morbidity and mortality remain to be determined.

Fire is a common disturbance in the North American boreal forest that influences ecosystem structure and function. The temporal and spatial dynamics of fire are likely to be altered as climate continues to change. In this study, we ask the question: how will area burned in boreal North America by wildfire respond to future changes in climate? To evaluate this question, we developed temporally and spatially explicit relationships between air temperature and fuel moisture codes derived from the Canadian Fire Weather Index System to estimate annual area burned at 2.5° (latitude x longitude) resolution using a Multivariate Adaptive Regression Spline (MARS) approach across Alaska and Canada. Burned area was substantially more predictable in the western portion of boreal North America than in eastern Canada. Burned area was also not very predictable in areas of substantial topographic relief and in areas along the transition between boreal forest and tundra. At the scale of Alaska and western Canada, the empirical fire models explain on the order of 82% of the variation in annual area burned for the period 1960-2002. July temperature was the most frequently occurring predictor across all models, but the fuel moisture codes for the months June through August (as a group) entered the models as the most important predictors of annual area burned. To predict changes in the temporal and spatial dynamics of fire under future climate, the empirical fire models used output from the Canadian Climate Center CGCM2 global climate model to predict annual area burned through the year 2100 across Alaska and western Canada. Relative to 1991-2000, the results suggest that average area burned per decade will double by 2041-2050 and will increase on the order of 3.5-5.5 times by the last decade of the 21st century. To improve the ability to better predict wildfire across Alaska and Canada, future research should focus on incorporating additional effects of long-term and successional vegetation changes on area burned to account more fully for interactions among fire, climate, and vegetation dynamics.

We contrast recent climatic and environmental changes and their causes in the Arctic and the Antarctic. There are continuing increases in surface temperatures, losses of sea ice and tundra, and warming of permafrost over broad areas of the Arctic, while most of the major increase in Antarctic temperatures is on the Antarctic Peninsula associated with sea ice loss in the Bellingshausen-Amundsen Seas sector. While both natural atmospheric and oceanic variability, and changes in external forcing including increased greenhouse gas concentrations, must be considered in the quest for understanding such changes, the interactions and feedbacks between system components are particularly strong at high latitudes. For the 1950s to date in the Arctic and for 1957 to date in the Antarctic, positive trends in large-scale atmospheric circulation represented by the Arctic oscillation (AO) and Antarctic oscillations (AAO) and the Pacific North American (PNA) pattern contribute to the long-term temperature trends. However, continuing Arctic trends during the last decade of near neutral AO will require alternate explanations. The trend in the AAO since 1950 is larger than expected from natural variability and may be associated with the decrease in stratospheric ozone over Antarctic. The persistence shown in many Arctic and Antarctic Peninsula components of climate and their influence through possible feedback supports continuation of current trends over the next decade. One can expect large spatial and temporal differences, however, from the relative contributions of intrinsic variability, external forcing, and internal feedback/amplifications. It is particularly important to resolve regional feedback processes in future projections based on modeling scenarios.

Hydrate control is an integral part of any deep water development since hydrates exert a major impact on all aspects of systems design and operation. This paper identifies major challenges for hydrate research including high-pressure phase behavior, mixed electrolyte prediction, and kinetics. Operability issues related to deep water multiphase flowlines that ensure hydrate-free production and emerging technologies, such as low dosage inhibitors, are discussed.

Climate model output is used to analyze the behavior of extreme cold-air outbreaks (CAOs) under recent and future climatic conditions. The study uses daily output from seven GCMs run under late-twentieth century and projected twenty-first century radiative conditions (SRES A1B greenhouse gas emission scenario). We define a CAO as an occurrence of two or more consecutive days during which the local mean daily surface air temperature is at least two standard deviations below the local wintertime mean temperature. In agreement with observations, the models generally simulate modern CAOs most frequently over western North America and Europe and least commonly over the Arctic. These favored regions for CAOs are located downstream from preferred locations of atmospheric blocking. Future projections indicate that CAOs—defined with respect to late-twentieth century climatic conditions—will decline in frequency by 50 to 100% in most of the Northern Hemisphere during the twenty-first century. Certain regions, however, show relatively small changes and others actually experience more CAOs in the future, due to atmospheric circulation changes and internal variability that counter the thermodynamic tendency from greenhouse forcing. These areas generally experience greater near-surface wind flow from the north or the continent during the twenty-first century and/or are especially prone to atmospheric blocking events. Simulated reductions in CAOs are smallest in western North America, the North Atlantic, and in southern regions of Europe and Asia. The Eurasian pattern is driven by a strong tendency for the models to produce sea-level pressure (SLP) increases in the vicinity of the Mediterranean Sea (intermodel mean of 3 hPa), causing greater advection of continental air from northern and central Asia, while the muted change over western North America is due to enhanced ridging along the west coast and the increased frequency of blocking events. The North Atlantic response is consistent with a slowdown of the thermohaline circulation, which either damps the warming regionally or results in a cooler mean climate in the vicinity of Greenland. Copyright © 2006 Royal Meteorological Society.

Fire is the keystone disturbance in the Alaskan boreal forest and is highly influenced by summer weather patterns. Records from the last 53 years reveal high vari- ability in the annual area burned in Alaska and corresponding high variability in weather occurring at multiple spatial and temporal scales. Here we use multiple linear regression (MLR) to systematically explore the relationships between weather variables and the annual area burned in Alaska. Variation in the seasonality of the atmospheric circulation-fire linkage is addressed through an evaluation of both the East Pacific teleconnection field and a Pacific Decadal Oscillation index keyed to an annual fire index. In the MLR, seven explanatory variables and an interaction term collectively explain 79% of the variability in the natural logarithm of the number of hectares burned annually by lightning-caused fires in Alaska from 1950 to 2003. Average June temperature alone explains one-third of the variability in the logarithm of annual area burned. The results of this work suggest that the Pacific Decadal Oscillation and the East Pacific teleconnection indices can be useful in determining a priori an estimate of the number of hectares that will burn in an upcoming season. This information also provides insight into the link between ocean-atmosphere interactions and the fire disturbance regime in Alaska.

Since the inception of the open-door policy, in 1978, China has acted as a magnet for firms wishing to locate there to gain access to the billion plus consumers. However, the scramble to establish a presence in the country has led firms to make a number of hasty decisions, to revise their plans, and in some cases, to withdraw from the market. Research in the PRC, primarily in Shanghai, among leading international consumer goods firms has revealed a variety of shortcomings in our practical understanding of the internationalization process and the theoretical underpinning of the market entry decisions that emerge. It has also yielded insights into how adaptation to the advancing PRC business environment may be successfully effected. © 2003 Wiley Periodicals, Inc.

The historical absence of formal political borders in the mainland Southeast Asian region, combined with the nature of the geography, mean that unofficial and illegal forms of crossborder movement and economic activities are pervasive and significant throughout the region. This is particularly true in Myanmar (formerly Burma), where pressure on international firms to comply with a boycott of the country, togeth-er with the covert activities of the government conspire to make border trade a viable form of international business. Although illegal trade such as smuggling is perhaps a universal feature of international economic activities, what is more interesting is the phenomenon of quasi-legal trade, which includes such activities as parallel importing and reimporting, and advertising by proxy. In many cases, there is evidence that multinational firms collude with distributors, quasi-legal importers, and government officials to enable the continuation of the marketing of their brands within a country in which this would otherwise be prohibited. This article reports on research conduct-ed in Myanmar during 1997 and 1998 concerning this issue. The study included a wide-ranging program of qualitative research with in-depth interviews of leading overseas executives, intermediaries, and government officials. This research in Myanmar is unique, and it was conducted under considerable difficulties and extreme need for security and provision of confidentiality. In describing the role of multinational companies and others in pursuing quasi-legal border trade, the article makes a significant contribution to the understanding of the business environment in Myanmar and, more generally, in Southeast Asia. The wider implications of this for international marketing are also described. � 2001 John Wiley & Sons, Inc.

Adhalin and alpha-dystroglycan are two components of a complex of proteins that, in conjunction with dystrophin, provide a link between the subsarcolemmal cytoskeleton and the basal lamina of the extracellular matrix of skeletal muscle. In the absence of dystrophin, in Duchenne muscular dystrophy (DMD) and the mdx mouse, levels of adhalin, alpha-dystroglycan and other components of the complex, are severely reduced, and it has been speculated that this might be an important factor in precipitating myofibre necrosis. However, there is, as yet, little information on how these proteins interact structurally or functionally. From biochemical data it might be predicted that adhalin and alpha-dystroglycan are positioned more peripherally in the muscle cell than dystrophin and more proximal than merosin. Using single and double immunogold labelling we here show that adhalin is localized to the plasma membrane with the majority of the gold probe particles situated on the membrane's outer face, while alpha-dystroglycan labelling is seen on material which projects from the outer face and which, in places, forms strands that stretch to the basal lamina. When double labelling of laminin and alpha-dystroglycan is carried out, laminin is localized to the proximal face of the basal lamina, facing the alpha-dystroglycan. In DMD the labelling of adhalin and alpha-dystroglycan is severely reduced quantitatively (although the vestige that remains is positioned normally) but merosin is expressed normally, showing that its incorporation is independent of that of dystrophin and its associated proteins.

Adaptation planning in Alaska, as in other snowy parts of the world, will require snow projections, yet snow is a challenging variable to measure, simulate and downscale. Here we describe the construction and evaluation of 771-m-resolution gridded historical and statistically downscaled projections of snow/rain partitioning for the state of Alaska at decadal temporal resolution. The method developed here uses observational data to describe the relationship between average monthly temperature and the fraction of wet days in that month receiving snow, the snow-day fraction. Regionally and seasonally specific equations were developed to accommodate variability in synoptic scale climatology of rain and snow events. These equations were then applied to gridded decadal temperature data and projections. The gridded products provide a reasonable characterization of snow-day fraction throughout the state. However, there are local deviations from the regional relationships, particularly in the topographically complex areas ringing the Gulf of Alaska and Cook Inlet. When applied to questions about changing precipitation regimes in northern, western and south-eastern Alaska, these data demonstrate the potential for marked changes from snow-dominated to mixed precipitation regimes and also exhibit a wide range of potential future conditions. Copyright © 2013 John Wiley & Sons, Ltd.

The hot-gas thermal shock testing method consists of impinging a stream of high temperature air onto the center of a ceramic disk. This test is suitable for determining the relative resistance of ceramics to thermal shock involving fast heating from ambient with the principal heat transfer mode being convection. The feasibility of this testing method has been established using specimens of transparent La2O3-doped Y2O3. Thermal shock fracture appears to initiate from the backface of the disk. Thinner or toughened transparent Y2O3 results in a higher probability of survival for a given critical temperature difference in the test.

Renografin-76 (RG76) regularly depresses myocardial contractility during coronary angiography. Angiovist-370 (AV370) is a contrast medium similar to RG76 except the calcium sequestering agents sodium citrate and EDTA in RG76 have been replaced by calcium EDTA (an additive that does not bind additional calcium). To determine if the calcium sequestering agents contribute to the mechanical depression produced by ionic contrast media, this study compared the inotropic response of RG76 to that of AV370. Additionally, saline solutions containing sodium citrate + EDTA and calcium EDTA at concentrations found in the respective contrast media were also compared. In 10 open chest dogs the percent change and duration of the inotropic response following intracoronary injections of RG76 and AV370, as well as solutions of sodium citrate + EDTA and calcium EDTA were compared using Walton-Brodie strain gauges. Injections, 2 cc, of RG76 and AV370 produced a biphasic response characterized by an initial negative inotropic response followed by a more prolonged positive inotropic response. The magnitude (67 ± 3% vs 59 ± 2%; p 0.3). This positive response was not affected by b-adrenergic blockage with 0.2 mg/kg of timolol. Similarly, 4 cc of sodium citrate + EDTA produced a significantly greater magnitude (56 ± 5%) and longer (42 ± 7 sec) negative inotropic response than calcium EDTA (17 ± 2% and 15 ± 3 sec) or 0.9% saline (18 ± 8% and 13 ± 2 sec; p < 0.001). The results suggest that the calcium sequestering agents sodium citrate + EDTA produce significant negative inotropic effects contributing to the mechanical depression produced by RG76. However, the calcium binding additives are not solely responsible for the depression in contractility produced by ionic contrast media. Contrast media lacking calcium binding additives may be preferable for coronary angiography.

Salicylates have been shown to increase the serum creatinine and decrease the creatinine clearance in normal volunteers and patients with rheumatoid arthritis and systemic lupus erythmatosus. Our clinical impression is that patients on long term salicylate therapy do not have creatinine clearances or serum creatinines which differ from the norm. We decided to study the effect of a five-week period of salicylate therapy on the creatinine clearance and serum creatinine of normal volunteers.

Summary After vaginal hysterectomy patients were given intramuscular injectinons of Ubretid or of a placebo. No significant difference was found in the number of patients requiring catheterization or in the incidence of postoperative urinary tract infection in the treated and control groups.