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BACKGROUND: Persistent postural-perceptual dizziness (PPPD) is a chronic balance disorder, which is characterised by subjective unsteadiness or dizziness that is worse on standing and with visual stimulation. The condition was only recently defined and therefore the prevalence is currently unknown. However, it is likely to include a considerable number of people with chronic balance problems. The symptoms can be debilitating and have a profound impact on quality of life. At present, little is known about the optimal way to treat this condition. A variety of medications may be used, as well as other treatments, such as vestibular rehabilitation. OBJECTIVES: To assess the benefits and harms of non-pharmacological interventions for persistent postural-perceptual dizziness (PPPD). SEARCH METHODS: The Cochrane ENT Information Specialist searched the Cochrane ENT Register; Central Register of Controlled Trials (CENTRAL); Ovid MEDLINE; Ovid Embase; Web of Science; ClinicalTrials.gov; ICTRP and additional sources for published and unpublished trials. The date of the search was 21 November 2022.SELECTION CRITERIA: We included randomised controlled trials (RCTs) and quasi-RCTs in adults with PPPD, which compared any non-pharmacological intervention with either placebo or no treatment. We excluded studies that did not use the Bárány Society criteria to diagnose PPPD, and studies that followed up participants for less than three months. DATA COLLECTION AND ANALYSIS: We used standard Cochrane methods. Our primary outcomes were: 1) improvement in vestibular symptoms (assessed as a dichotomous outcome - improved or not improved), 2) change in vestibular symptoms (assessed as a continuous outcome, with a score on a numerical scale) and 3) serious adverse events. Our secondary outcomes were: 4) disease-specific health-related quality of life, 5) generic health-related quality of life and 6) other adverse effects. We considered outcomes reported at three time points: 3 to < 6 months, 6 to ≤ 12 months and > 12 months. We planned to use GRADE to assess the certainty of evidence for each outcome. MAIN RESULTS: Few randomised controlled trials have been conducted to assess the efficacy of different treatments for PPPD compared to no treatment (or placebo). Of the few studies we identified, only one followed up participants for at least three months, therefore most were not eligible for inclusion in this review. We identified one study from South Korea that compared the use of transcranial direct current stimulation to a sham procedure in 24 people with PPPD. This is a technique that involves electrical stimulation of the brain with a weak current, through electrodes that are placed onto the scalp. This study provided some information on the occurrence of adverse effects, and also on disease-specific quality of life at three months of follow-up. The other outcomes of interest in this review were not assessed. As this is a single, small study we cannot draw any meaningful conclusions from the numeric results. AUTHORS' CONCLUSIONS: Further work is necessary to determine whether any non-pharmacological interventions may be effective for the treatment of PPPD and to assess whether they are associated with any potential harms. As this is a chronic disease, future trials should follow up participants for a sufficient period of time to assess whether there is a persisting impact on the severity of the disease, rather than only observing short-term effects.

NEW FINDINGS What is the central question of this study? Is the estrous cycle affected during disuse atrophies and if so, how do estrous cycle changes relate to musculoskeletal outcomes? What is the main finding and its importance? Rodent estrous cycles are altered during disuse atrophy, which corresponds to musculoskeletal outcomes. However, the estrous cycle does not appear changed in Lewis Lung Carcinoma, which corresponded to no differences in muscle size compared to healthy controls. These findings suggest a relationship between estrous cycle and muscle size during atrophic pathologies. ABSTRACT Hyperglycemia can cause disruptions in vascular function, whereas exercise has been shown to restore vascular function. The primary aim of this study is to investigate the effect of performing whole-body resistance exercise, 30-min before, immediately following, or 30- or 60-min after a high carbohydrate meal, on endothelial function, measured by flow-mediated dilation (FMD). Healthy adults will be recruited to this randomized crossover trial to compare the postprandial glycaemic and vascular responses to four different exercise timing conditions and a control: i) C- control, high carbohydrate meal/no exercise, ii) 30Pre- 30 min of resistance exercises (~30% of 1RM [Repetition Maximum]), 30 min before a high carbohydrate meal, iii) IP- 30 min of resistance exercises (~30% of 1RM), immediately following a high carbohydrate meal, iv) 30Post- 30 min of resistance exercises, 30 min after a high carbohydrate meal and v) 60Post- 30 min of resistance exercises, 60 min after a high carbohydrate meal. Measures of metabolic and vascular function will be assessed at baseline and for two hours following the carbohydrate-based breakfast meal.

Societal Impact Statement Climate change is dramatically restructuring agriculture and damaging crops, food security, and human health, especially in deserts. To radically redesign food systems to buffer against climatic disruptions, we focus on agroecological function, human health, and community well‐being. Using arid North America (“Aridamerica”) as a laboratory for the future, we employed 18 criteria to select 17 desert plant genera with high potential as food crops. When integrated into perennial polycultures modeled after arid ecosystems and traditional knowledge, desert plants can stabilize yields, produce disease‐preventing foods, and generate rural livelihoods. We envision food systems that can reduce disparities while enhancing resilience in a hotter, drier world. Summary Climate disruptions and water scarcity are threatening food security and human well‐being. We provide a framework for selecting a more diverse set of arid‐adapted food crops to reduce food system vulnerabilities to climate change, climate‐related illness, and economic disparities in arid lands. We constructed a list of candidate crops based on the diets of the Comcaac, O'odham, and Pima Bajo peoples of the Sonoran Desert. Representative genera were then screened for traits related to agroecological functionality, human health, community well‐being, and agronomic suitability. Of the 154 species (86 genera) used by these Sonoran Desert Indigenous cultures, 101 species (80 genera) were more broadly used in Aridamerica, suggesting wide acceptability and value of desert plants for arid‐adapted agriculture in North America. We highlight 17 genera with high potential to simultaneously improve agricultural resilience, human health, and community prosperity in the face of climate change, over a third of which are water‐use efficient crassulacean acid metabolism (CAM) succulents. Assembling these candidate crops into perennial polycultures coupled with solar energy and rainwater harvesting systems can maximize yield reliability while minimizing fossil fuel, agrichemical, and surface and groundwater use. Now is the time to invest in desert‐adapted farming and food systems, with climate change already accelerating damages to agricultural landscapes. Biomimicry and traditional knowledge can aid in designing co‐located food, water, and energy provisioning systems adapted to arid climates and scarce resources that improve agroecological and human health. Adopting such designs will require transdisciplinary integration of plant, environmental, social, and health sciences.

Background: This is an update of the Cochrane review ‘Memory rehabilitation for people with multiple sclerosis’ (first published in the Cochrane Library 14 March 2012, Issue 3). Impairments in cognitive function, particularly memory, are common in people with multiple sclerosis (MS) and can potentially affect their ability to complete functional activities. There is evidence from single-case or small group studies that memory rehabilitation can be beneficial for people with MS, but findings from randomised controlled trials (RCTs) and systematic reviews have been inconclusive. Objectives: To determine whether people with MS who received memory rehabilitation showed: 1. better outcomes in their memory functions compared to those given no treatment or receiving a placebo control; and 2. better functional abilities, in terms of activities of daily living, mood, and quality of life, than those who received no treatment or a placebo. Search methods: We searched the Trials Specialised Register of the Cochrane Multiple Sclerosis and Rare Diseases of the CNS Group (2 June 2015) and the following electronic databases: The NIHR Clinical Research Network Portfolio database (NIHR CRN) (from 2010 to June 2015), The Allied and Complementary Medicine Database (AMED) (2010 to June 2015), British Nursing Index (BNI) (2010 to June 2015), PsycINFO (2011 to June 2015), and CAB Abstracts (2010 to June 2015). Start dates for the electronic databases coincided with the last search for the previous review. We handsearched relevant journals and reference lists. Selection criteria: We selected RCTs or quasi-randomised trials ofmemory rehabilitation or cognitive rehabilitation for people with MS in which a memory rehabilitation treatment group was compared to a control group. Selection was conducted independently first and then confirmed through group discussion. We excluded studies that included participants whose memory deficits were the result of conditions other than MS unless we could identify a subgroup of participants with MS with separate results. Data collection and analysis: Three review authors were involved in this update in terms of study selection, quality assessment, and data extraction. We contacted investigators of primary studies for further information where required. We conducted data analysis and synthesis in accordance with the Cochrane Handbook for Systematic Reviews ofInterventions (Higgins 2011). We performed a ’best evidence’ synthesis based on the methodological quality of the primary studies included. Main results: We added seven studies during this update, bringing the total to 15 studies, involving 989 participants. The interventions involved various memory retraining techniques, such as computerised programmes and training on internal and external memory aids. Control groups varied in format from assessment-only groups, discussion and games, non-specific cognitive retraining, and attention or visuospatial training. The risk of bias of the included studies was generally low, but we found eight studies to have high risk of bias related to certain aspects of their methodology. We found significant effect of intervention on objective assessments of memory in both the immediate and long-term follow-ups: standardised mean difference (SMD) 0.23 (95% confidence interval (CI) 0.05 to 0.41) and SMD 0.26 (95% CI 0.03 to 0.49), respectively. We also found significant effect of intervention for quality of life in the immediate follow-up (SMD 0.23 (95% CI 0.05 to 0.41)). These findings showed that the intervention group performed significantly better than the control group. We also found a significant difference for activities of daily living (ADL) in the long-term follow-up (SMD -0.33 (95% CI -0.63 to -0.03)), showing that the control groups had significantly less difficulty completing ADLs than the intervention groups. We found no significant effects, either immediate or long-term, on subjective reports of memory problems (SMD 0.04 (95% CI -0.19 to 0.27) and SMD 0.04 (95% CI -0.19 to 0.27)); on mood (SMD 0.02 (95% CI -0.16 to 0.20) and SMD -0.01 (95% CI -0.21 to 0.20)); and on immediate follow-up for ADL (SMD -0.13 (95% CI -0.60 to 0.33)) and in the long term for quality of life (SMD 0.16 (95% CI -0.03 to 0.36)). We could not complete a sensitivity analysis of intention-to-treat in comparison with per-protocol analysis, due to insufficient information from the included papers. However, a sensitivity analysis of high- versus low-risk studies suggested that while quality of the trials did not affect most outcomes, differences were seen in the objective memory outcomes (both at immediate and long term) and quality of life (immediate) outcome, with studies with higher risk of bias inflating the overall effect size estimates for these outcomes, and the test of overall effect changing from being statistically significant to not significant when studies at high risk of bias were excluded. This suggests that lower-quality studies may have positively influenced the outcomes. Authors’ conclusions: There is some evidence to support the effectiveness of memory rehabilitation on memory function, as well as on quality of life. However, the evidence is limited and does not extend to subjective reports of memory functioning or mood. Furthermore, the objective measures used are not ecologically valid measures, and thus potentially limit generalisability of these findings into daily life. Further robust RCTs of high methodological quality and better quality of reporting, using ecologically valid outcome assessments, are still needed.

An important aspect of daily life is the ability to infer information about the contents of other people's minds, such as what they can see and what they know, in order to engage in successful interactions. This is referred to as possession of a "Theory of Mind" (ToM). Past research has shown that adults with Autistic Spectrum Disorders (ASD) often show deficits in social communication abilities, although can successfully pass tests of explicit ToM. The current study utilized a computerized false-belief task to explore subtle differences (i.e., measuring response times and accuracy rates) in how efficiently ToM capacities-specifically, belief-attribution-are utilized in adults with and without ASD. In the task, participants were asked to attribute a belief-state to either themselves or another person, following establishment of a true or false-belief scenario. Results revealed comparable patterns of ToM engagement across individuals with and without ASD, with faster and more accurate responses to "Self" versus "Other" oriented questions, and slower response times when shifting between the "Self" and "Other" perspective compared to when maintaining a perspective. However, autistic individuals showed a particular deficit in correctly identifying a belief-state in false-belief trials, in which two contrasting belief-states had to be held in mind, suggesting more difficulty disengaging from current, reality based belief-states than neuro-typical individuals. Autism Res 2018, 11: 1542-1553. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: To successfully communicate, we have to think about what other people do/do not know; this is called having a "Theory of Mind." This study looked at how well people use their Theory of Mind when thinking about the contents of people's minds. Results showed that people with autism had difficulties considering more than one mental state at a time, suggesting they may have more trouble in stopping themselves thinking about what is happening in reality than people without autism.

Context Sudaxine is a novel respiratory stimulant that increases ventilatory drive via NO+ -thiolate signaling and is under development for reversal of opioid-induced respiratory depression and other critical care indications. Objective This study investigates the pharmacokinetic characteristics after intravenous administration of Sudaxine by using a simple liquid chromatography-tandem mass spectrometry (LC-MS/MS) method. Materials and methods A sensitive LC-MS/MS method was validated to determine the concentration of Sudaxine in beagle dog plasma after intravenous administration of Sudaxine at (3, 10, 30, and 100 mg/kg). Blood samples (1 mL) were collected at designated time points and SDX concentration was measured for pharmacokinetic study. Results The calibration curve was linear within the range of 50-5,000 ng/mL with the lower limit of quantification at 50 ng/mL. The CTmax for all doses was reached at 10 minutes (Tmax ). Over the dose range studied, average concentration - time curves and systemic exposure (CTmax and AUC0-t ) increased to Sudaxine dose. The terminal half-life of Sudaxine in dogs ranged from 10 to 30 minutes and about 17.3 ± 1.0% of Sudaxine was protein-bound in dog plasma. Discussion and conclusions We developed a novel LC-MS/MS method of Sudaxine detection and quantification and determined its pharmacokinetic profiles after intravenous administration in canine subjects. Sudaxine followed first-order kinetics with rapid dose-dependent clearance rates and short half-life making it an ideal candidate for use in a critical care setting with intramuscular or IV administration.

Vestibular dysfunction is associated with visual short-term memory impairment; however, it remains unclear if this impairment arises as a direct result of the vestibular dysfunction or is a consequence of comorbid changes in mood, affect, fatigue, and/or sleep. To this end, we assessed the concurrence and interdependence of these comorbidities in 101 individuals recruited from a tertiary balance clinic with a neuro-otological diagnosis. Over fifty per cent of the sample showed reduced visuospatial short-term memory, 60% and 37% exceeded cut-off on the Beck Anxiety and Depression Inventories, respectively, 70% exceeded cut-off on the Fatigue Severity Scale, 44% reported daytime sleepiness on the Epworth Sleepiness Scale, and 78% scored above cut-off on the Pittsburgh Sleep Quality Index. The high concurrence of these symptoms gives reason to infer the existence of a vestibular cognitive affective syndrome. Structural equation modelling indicated that the significant statistical association between general unassisted posture (a marker of chronic vestibular dysfunction and strong predictor of falls risk) and short-term memory was not mediated by mood and wakefulness. Instead, the memory impairment related more directly to vestibular dysfunction. From a rehabilitation perspective, the implication is that if the vestibular disorder is treated successfully then the memory problem will likewise improve.

Soil N loss is a significant impediment to maximizing yield and profitability for farmers in Canada. Maintaining N in the stable and plant-available NH4 + form via use of nitrification inhibitors limits the potential for soil N losses from denitrification or leaching. Between 2013 and 2015, twenty-one research trials were established across the major cereal and oilseed growing regions of Canada to evaluate the efficacy of two commercially available formulated nitrapyrin products, eNtrenchTM and N-Serve, at stabilizing soil N in the NH4 + form and protecting against N loss. Urea, urea ammonium nitrate (UAN) or NH3 fertilizer treatments were banded in the fall or spring on fallow land, and the soil was sampled to a depth of 60 cm at multiple time intervals after application. Fall applications of nitrapyrin resulted in 21–63% more NH4N, and 10–19% more total mineral N, at spring sampling after soil thaw relative to non-stabilized fertilizer. Spring applications of nitrapyrin resulted in larger pools of NH4–N for at least 8 weeks after treatment, and they increased total mineral N by up to 25%, compared with non-stabilized treatments. Results suggest that eNtrench and N-Serve are useful tools for growers looking to protect their N investment, optimize crop yield potential, and enhance flexibility of their N application timing. N itrogen use efficiency (NUE) of major cereal and oilseed crops in Canada is generally less than 60% (Ma and Dwyer, 1998; Malhi and Nyborg, 1991; Malhi et al., 2001; Ma et al., 2006). Nitrogen loss is an important factor contributing to poor NUE (Malhi et al., 2001). Several studies have attempted to quantify N losses under Canadian growing conditions. Reported losses from studies using radiolabeled N were 15 to more than 50% from fall banded fertilizer applications, and slightly lower with spring banded applications, often in the range of 10–40% (Malhi and Nyborg, 1983, 1991; Aulakh and Rennie, 1984; Malhi et al., 1996; Jayasundara et al., 2007). Denitrification and immobilization are considered to be the dominant mechanisms driving N loss of soilplaced fertilizer in Western Canada (Malhi et al., 2001, and Published in Crop Forage Turfgrass Manage. Volume 2. doi:10.2134/cftm2016.03.0027 © 2016 American Society of Agronomy and Crop Science Society of America 5585 Guilford Rd., Madison, WI 53711 This is an open access article distributed under the CC BY-NC-ND license (http://creativecommons.org/ licenses/by-nc-nd/4.0/). Published August 11, 2016

Cholangiocytes form an intricate network of bile ducts to enable proper liver function; yet, recapitulating human stem cell differentiation to cholangiocytes in vitro requires Notch signaling and s ...

During solvent-based heavy-oil and bitumen recovery processes, viscosity reduction occurs through dilution of oil by mixing process. However, asphaltene precipitation may take place, eventually resulting in organic deposition (maltenes and asphaltenes) in the reservoir causing a reduction in permeability through pore plugging and unfavourable wettability reversal. In this paper, two identical porous media (unconsolidated glass bead packs) with significant contrast in wettability were used to investigate these phenomena. The oil-wet and water-wet glass bead models were exposed to constant rate solvent injection (propane, n-hexane, n-decane, and distillate hydrocarbon). The thickness of the multilayer organic deposition was determined using focused ion beam (FIB/SEM) and scanning electron microscope (SEM). Three points from the models were analyzed to determine the level of asphaltene deposition and oil trapping (maltenes) on the surface of the glass beads and pore spaces. The results showed that the asphaltene migrated through the glass bead pack model. As a consequence, asphaltene deposition was observed at the middle and bottom points of the vertically situated glass bead packs with an injection point at the top, in addition to accumulated oil trapping at the production (bottom) end. Moreover, elemental mapping from the organic deposition visualization was conducted using the energy dispersive X-ray (EDX) analysis. Heteroatom elements were found in the sample along with carbon and iron elements.

Objective To evaluate the signalment, clinical signs, treatment, and outcome of dogs with urethral prolapse and identify risk factors associated with prolapse or treatment. Study Design Retrospective case series. Animals Dogs (n = 48) with urethral prolapse. Methods Medical records (May 1995–June 2010) from 2 referral centers were reviewed. Retrieved data included signalment, clinical signs, laboratory findings, treatment, complications, results of long-term follow-up. Records from Veterinary Medical Data Base (VMDB) were evaluated to determine odds ratios. Results Odds ratio for urethral prolapse in English bulldogs compared to all breeds was 366.99 (95% CI: 265.83, 506.65). Of 48 affected dogs, 46 had either resection and anastomosis (43 dogs) or urethropexy (3 dogs). The most common early postoperative complication was hemorrhage (39%); postoperative hemorrhage was less common when a simple continuous pattern was used for resection and anastomosis. Prolapse recurred in 57% of dogs available for long-term follow-up; recurrence was less common in dogs that were administered postoperative butorphanol or acepromazine. Gender was not associated with urethral prolapse or postoperative complications. Conclusions Urethral prolapse occurs most commonly in English bulldogs. Postoperative hemorrhage and prolapse recurrence may be reduced with use of a simple continuous pattern for urethral anastomosis and by administration of postoperative sedation, respectively. Castration status did not appear to affect prolapse development or outcome.

Although it has been widely acknowledged that people living in poverty are underserved by mental health professionals, little is known about the experiences of psychotherapists who are currently working with poor clients. What can we learn from these clinicians that may help us more effectively prepare trainees for work in the context of poverty? This qualitative investigation analyzed narrative data from 10 therapists regarding their work with poor clients. Participants revealed perceptions of the challenging (and rewarding) nature of this work, the inadequacies of their training to meet these demands, and the damaging influence of social stigma within their clients' lives and presenting problems, as well as on clinicians' own occupational status.

Despite the high and increasing prevalence of poverty in the United States, psychologists and allied professionals have done little to develop mental health interventions that are tailored to the specific sociocultural experiences of low-income families. In this article, we describe the sociocultural stressors that accompany the material deprivations of poverty, and the mental health difficulties to which they often give rise. Next, we outline the psychosocial and class-related issues surrounding low-income adults' access to and use of mental health services and suggest a conceptual framework to guide the modification of mental health practice to better accommodate poor peoples' complex needs. This framework describes opportunities for practice modification at three levels of intervention, beginning at the individual level of traditional individual psychotherapy and subsequently targeting increasingly broad contextual elements of poverty.

An ideal domesticity of the mid-19th century advocated a role for white women in civilizing and defending the American family home from cultural incursions. Black (and other non-White, non-Anglo-Saxon Protestant) women, omitted from dominant representations of domesticity, provided their own literary interventions to appropriate and adapt the ideology. Short scenes of mundane domestic labor show authors reworking the relationship of domesticity to race and class. Textile work such as sewing (depicted in the works of Harriet Jacobs, Harriet Wilson, Fanny Fern, and Frances Ellen Watkins Harper) becomes the focal point for social change, enabling an appropriation of domesticity by individuals usually excluded. Current material culture studies investigate the interaction of human subjects and material objects in specific contexts that enact cultural meaning. Applying these studies to fictional and non-fictional narratives reveals how authors used their lived experiences with objects to query the racial and ethnic foundations of domestic womanhood in varied narrative contexts.

Although the language of social justice counseling theory has become more focused and explicit within the past decade, a dedication to the "dignity, diversity, and uniqueness" (Engels & Bradley, 2001, p. 101) of all people is fundamental to the heritage of the counseling profession. Crethar, Torres Rivera, and Nash (2008) noted that the counseling profession actually originated with concern for people affected by injustice. They defined social justice counseling as a multifaceted approach to counseling in which practitioners strive to simultaneously promote human development and the common good through addressing challenges related to both individual and distributive justice. Social justice counseling includes empowerment of the individual as well as active confrontation of injustice and inequality in society because they affect clientele as well as those in their systemic contexts. (Crethar et al., 2008, p. 270) In bringing this conceptualization to life, counselors have developed innovative interventions at many different levels of practice. Comstock et al. (2008) showed how relational--cultural theory provides a framework for socially just counseling through its elucidation of contextual, culture-based relational disconnections. Grounding their interventions in liberation psychology (Martin-Baro, 1998) and Freirean pedagogy (Freire, 1970), Duran, Firehammer, and Gonzalez (2008) connected community well-being with counseling practice among indigenous peoples. They explained that these socially just practices require that counselors become "enmeshed" in local culture in a way that creates what the authors called "epistemological hybridity"--a process of learning from community wisdom that promotes "liberation from orthodox professional Western practices as are commonly taught in most counselor education programs" (Duran et al., 2008, p. 292). Lee and Rodgers (2009) struck a similar chord as they encouraged counselors to move beyond "the passivity often inherent in counseling as 'the talking cure' to become active voices and conduits for social/political change" (p. 285). As with the other authors cited, Lee and Rodgers did not suggest that traditional individual counseling approaches are without utility; rather, counselors seeking to meet the needs of members of marginalized social groups should be ready to address issues beyond those that are individual and/or internal. Thus, counselors who can implement interventions that incorporate advocacy and social action will be in a better position to ensure that these clients can access the resources and services they need and to "address the significant social, cultural, and economic challenges that have the potential to negatively affect psychosocial development" (Lee & Rodgers, 2009, p. 284). Hipolito-Delgado and Lee (2007) further emphasized the importance of such advocacy and action for counselors working with marginalized youth, such as children of color and those in poor urban communities. These young people, they explained, experience oppression in mainstream institutions as part of their "daily routine ... [which] involves negotiating the hardships that are a product of a legacy of discrimination" (p. 327). Hipolito-Delgado and Lee suggested that counselors could support young people in addressing these barriers through the facilitation of development of critical consciousness and the promotion of community connection and social activism. The foregoing discussion points to the need for innovative practices that will allow youth counselors to move beyond conventional "talking cures," to connect adolescents to their communities, to facilitate social action and critical consciousness, and to promote the opportunity for professionals to learn from community wisdom in the process. In this article, we profile an example of a project, undertaken as part of a community-based organization's (CBO) after-school programming, that addresses all these aims. …

Background Respiratory syncytial virus (RSV) infections range from upper respiratory illness to severe lower respiratory disease. There is no universally accepted treatment for RSV in solid organ transplant (SOT) recipients. Methods Retrospective review of adult SOT patients with RSV infections, between January 2007 and December 2009, in a single transplant center was performed. Results During the 3-year period, a total of 24 adults developed RSV infection, including 12 (50%) SOT recipients (5 kidneys, 4 livers, and 3 lungs). Most cases were seen in 2009 during the influenza H1N1 pandemic, likely as a result of increased testing. In 83% of the cases, the diagnosis was based on RSV antigen detection, which was also used to follow subsequent shedding (mean duration: 20.6 days). Most of the cases presented with lower respiratory disease and required hospitalization. All the patients were on at least two classes of immunosuppressive drugs. We observed a lower lymphocyte count in patients with lower respiratory tract infection. Computed tomography was superior to chest x-ray in demonstrating pulmonary disease, with the most common findings being pulmonary nodules and ground-glass opacities. Novel radiographic findings were small cavities and pleural effusions. No co-infections were documented, and no mortality could be attributed to RSV. Inhaled or oral ribavirin was administered in 67% of the cases, with variations in the treatment regimens. Conclusion SOT recipients accounted for half of all adult cases of RSV at our institution. Type and length of treatment varied widely, and we cannot conclude that outcomes differed between treatments with oral or inhaled ribavirin. Current therapeutic management of RSV in SOT is empiric, and can be rather expensive and difficult, without clear evidence of effectiveness.

rowat a., smith l., graham c., lyle d., horsburgh d. & dennis m. (2011) A pilot study to assess if urine specific gravity and urine colour charts are useful indicators of dehydration in acute stroke patients. Journal of Advanced Nursing67(9), 1976–1983. Abstract Aim. The purpose of this pilot study was to examine whether urine specific gravity and urine colour could provide an early warning of dehydration in stroke patients compared with standard blood indicators of hydration status. Background. Dehydration after stroke has been associated with increased blood viscosity, venous thrombo-embolism and stroke mortality at 3-months. Earlier identification of dehydration might allow us to intervene to prevent significant dehydration developing or reduce its duration to improve patient outcomes. Methods. We recruited 20 stroke patients in 2007 and measured their urine specific gravity with urine test strips, a refractometer, and urine colour of specimens taken daily on 10 consecutive days and compared with the routine blood urea:creatinine ratios over the same period to look for trends and relationships over time. The agreement between the refractometer, test strips and urine colour were expressed as a percentage with 95% confidence intervals. Results. Nine (45%) of the 20 stroke patients had clinical signs of dehydration and had a significantly higher admission median urea:creatinine ratio (P = 0·02, Mann–Whitney U-test). There were no obvious relationships between urine specific gravity and urine colour with the urea:creatinine ratio. Of the 174 urine samples collected, the refractometer agreed with 70/174 (40%) urine test strip urine specific gravity and 117/174 (67%) urine colour measurements. Conclusions. Our results do not support the use of the urine test strip urine specific gravity as an early indicator of dehydration. Further research is required to develop a practical tool for the early detection of dehydration in stroke patients.

This article reports on the results of a qualitative study of Black faculty working in counseling and counseling psychology programs. This investigation involved the use of semistructured interviews to explore the racial microaggressions Black faculty members reportedly experienced in academia. Results of the analysis indicated that 7 primary microaggression themes were perceived by the participants, including alternating feelings of invisibility and hypervisibility, receiving inadequate mentoring, and difficulties determining whether discrimination was race or gender based.

As the counseling profession charts its future course, issues related to classism, ableism, and heterosexism remain fully incorporated within the multicultural/social justice curriculum. The authors define each of these forms of oppression, explicate their intersections with race, and summarize the resulting implications for counseling education and training.

BACKGROUND Proteins of the Bcl-2 family play a key role in the control of apoptosis and carry out both proapoptotic and antiapoptotic functions. However, with the exception of Bcl-2 itself, little is known about the expression of these potentially critical proteins in nonsmall cell lung carcinoma. METHODS Immunohistochemistry was used to study the expression of Bcl-2 and 6 other Bcl-2 family proteins in a pilot series of 41 archival nonsmall cell lung carcinoma specimens (19 adenocarcinomas and 22 squamous cell carcinomas). RESULTS Overexpression of the apoptosis inhibitors Bcl-2 and Bcl-XL was observed in 10 of 41 samples (24%) and in 11 of 41 samples (27%), respectively. Loss of expression of proapoptotic proteins was observed as follows: Bak, 24 of 41 samples (59%); Bad, 21 of 41 samples (51%); Bid, 20 of 41 samples (49%); Bax, 14 of 41 samples (34%); and Bim/Bod, 2 of 41 samples (5%). Statistically significant differences in expression between adenocarcinoma samples and squamous cell carcinoma samples were observed for Bcl-XL (overexpression in 11 of 19 adenocarcinomas [58%] vs. 0 of 22 squamous cell carcinomas [0%]; P < 0.001) and for Bad (loss of expression in 5 of 19 adenocarcinomas [26%] vs. 16 of 22 squamous cell carcinomas [73%]; P = 0.004). CONCLUSIONS Although this was only a pilot study, the results revealed significant differences in the expression of apoptosis-related proteins both between individual samples of nonsmall cell lung carcinoma and between the two main histologic subtypes. Such differences may play a role in the development of lung tumors; and, if it is found that these differences are of clinical importance, then it may be required to regard nonsmall cell lung carcinoma subtypes as separate entities rather than as one disease. Cancer 2005. © 2005 American Cancer Society.

Counselors are often challenged to address issues of social justice in the counseling context, and they must be deliberate and innovative in their attempts to respond. Counselors will be required to relate social justice considerations to their practices and to the theoretical foundations of these practices; they must then operationalize an approach that suits their particular practice setting. The authors present the early results of their attempt to meet this challenge. ********** A social justice approach to counseling (or any other endeavor) is based on (a) the acknowledgment of broad, systematic societal inequities and oppression and (b) the assumption of the inevitable, if unintentional, location of every individual (and every professional field) within this system. In turn, this assumption then obliges responsible action that contributes to the elimination of systematic oppression in the forms of racism, sexism, heterosexism, classism, and other biases. This concept is closely related to multiculturalism, with its emphasis on cultural, racial, and ethnic issues, one of which is social injustice and oppression. It is easy to find examples of the increasing attention that is being given to social justice in counseling and psychology. Lorraine Bradley, during her term (1999-2000) as president of the American Counseling Association (ACA), chose social justice and advocacy as the thematic focus of her term (see Kiselica & Robinson, 2001). Bonnie Strickland, the recipient of an Award for Distinguished Contributions to Psychology from the American Psychological Association (APA), has commented extensively on the topic of psychology's unintentional support of patriarchal, Eurocentric, classist social norms (Strickland, 2000). According to Strickland, professionals in the mental health field have frequently reexamined and reevaluated their positions regarding these norms, yet additional reconsideration by psychologists and counselors of their most basic assumptions is still needed. We still consistently place the reason for the occurrence of psychopathology within the person. Thc anxiety, depression, and dissociative disorders which may be adaptive signals of stressful life conditions arc pathologized as the emotional weakness of the "mentally ill." ... We must expand our boundaries by remembering that our theories and methods were designed to he replaced. Today's notions ... will be as outmoded to the next generation as hysteria, the schizophrenogenie mother, and lobotomies are to us now. (Strickland, 2000, p. 336) Outside observers of the mental health field have come to similar conclusions. In his address to the APA's 2000 annual conference, the Reverend Jesse Jackson reminded psychologists of Dr. Martin Luther King's charge to professionals in the field 30 years earlier (King, 1968). Jackson explained King's view that the social sciences are instruments of change and that, to this end, psychologists and counselors should "question the precepts of society, and reject those that permit injustice to form and grow" (Jackson, 2000, p. 328). According to King, psychologists should not allow themselves to be comfortable members of an unjust status quo: "Even as you help people make terrible choices between one evil and another, you can reject the limitations imposed by those forced choices" (Jackson, 2000, p. 329). Members of professional associations such as the APA and the ACA are focusing their efforts on these goals. It is notable that the expressed goal of Counselors for Social Justice, an ACA division, is to promote individual and collective social responsibility and to encourage the eradication of oppressive systems of power and privilege. Related goals are contained in the mission statements of the ACA's Association for Multicultural Counseling and Development and of APA Divisions 17 (Society of Counseling Psychology) and 45 (Society for the Psychological Study of Ethnic Minority Issues), among others. …

Acoustic cell retention devices have provided a practical alternative for up to 50 L/day perfusion cultures but further scale-up has been limited. A novel temperature-controlled and larger-scale acoustic separator was evaluated at up to 400 L/day for a 10(7) CHO cell/mL perfusion culture using a 100-L bioreactor that produced up to 34 g/day recombinant protein. The increased active volume of this scaled-up separator was divided into four parallel compartments for improved fluid dynamics. Operational settings of the acoustic separator were optimized and the limits of robust operations explored. The performance was not influenced over wide ranges of duty cycle stop and run times. The maximum performance of 96% separation efficiency at 200 L/day was obtained by setting the separator temperature to 35.1 degrees C, the recirculation rate to three times the harvest rate, and the power to 90 W. While there was no detectable effect on culture viability, viable cells were selectively retained, especially at 50 L/day, where there was a 5-fold higher nonviable washout efficiency. Overall, the new temperature-controlled and scaled-up separator design performed reliably in a way similar to smaller-scale acoustic separators. These results provide strong support for the feasibility of much greater scale-up of acoustic separations.

Pretreatment and posttreatment MMPI scores of 821 patients who completed a chronic pain program were submitted to a multivariate analysis of variance, examining the effects of age, gender, and insurance sponsorship. With the exception of scale 9, all clinical scales were significantly lower at posttreatment. Only the sponsorship variable was found to be a moderator variable for these treatment effects, with decreases on scales 1, 2, 3, and 0 attenuated in subjects with Worker's Compensation sponsorship compared to other sponsorship. Suggestions for further multivariate research with this population are discussed. © 2002 Wiley Periodicals, Inc. J Clin Psychol 58: 827–832, 2002.

Osteopontin is a secreted glycoprotein with adhesive and migratory functions. Cellular interactions with osteopontin are mediated through integrin receptors which recognize the RGD domain. Recently, CD44, a non-integrin, multifunctional adhesion molecule was identified as an osteopontin receptor. CD44 is a ubiquitous surface molecule that exists as a number of different isoforms, generated by alternative splicing. To analyze which forms of CD44 mediate binding to osteopontin, we used the standard form of CD44 as CD44-human immunoglobulin fusion proteins and several splice variants in enzyme-linked immunosorbant assays. Multiple preparations of osteopontin were used including native osteopontin derived from smooth muscle cells, human urinary osteopontin, full-length recombinant osteopontin, and two recombinant osteopontin fragments expected to be formed following thrombin cleavage. Our data show that although the CD44-hIg fusion proteins could interact with hyaluronic acid as expected, there was no interaction between CD44H, CD44E, CD44v3,v8-v10, or CD44v3 with osteopontin. These studies suggest that CD44-osteopontin interactions may not be common in vivo and may be limited to a specific CD44 isoform(s), and/or a particular modified form of osteopontin. J. Cell. Biochem. 73:20–30, 1999. © 1999 Wiley-Liss, Inc.