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Aims: We examined the longitudinal associations of sedentary time (ST), light physical activity (LPA), and moderate‐to‐vigorous PA (MVPA) from childhood with carotid‐femoral pulse wave velocity (cfPWV), a measure of arterial stiffness and carotid intima‐media thickness (cIMT). Methods: We studied 1339 children, aged 11 years from Avon Longitudinal Study of Parents and Children, UK, followed up for 13 years. Accelerometer‐based ST, LPA, and MVPA were assessed at ages 11, 15, and 24 years clinic visits. cfPWV and cIMT were measured with Vicorder and ultrasound, respectively, at ages 17 and 24 years. Results: Among 1339 [56.4% female] participants, mean ST increased from ages 11 through 24 years, while mean LPA and MVPA decreased. Persistently high ST tertile from childhood was associated with increased cfPWV progression, effect estimate 0.047 m/s; [(95% CI 0.005 to 0.090); p = 0.030], but not cIMT progression. Persistently high LPA tertile category was associated with decreased cfPWV progression in males −0.022 m/s; [(−0.028 to −0.017); p < 0.001] and females −0.027 m/s; [(−0.044 to −0.010); p < 0.001]. Cumulative LPA exposure decreased the odds of progressively worsening cfPWV [Odds ratio 0.994 (0.994–0.995); p < 0.0001] and cIMT. Persistent exposure to ≥60 min/day of MVPA was paradoxically associated with increased cfPWV progression in males 0.053 m/s; [(0.030 to 0.077); p < 0.001] and females 0.012 m/s; [(0.002 to 0.022); p = 0.016]. Persistent exposure to ≥60 min/day of MVPA was inversely associated with cIMT progression in females −0.017 mm; [(−0.026 to −0.009); p < 0.001]. Conclusion: LPA >3 h/day from childhood may attenuate progressively worsening vascular damage associated with increased ST in youth. [ABSTRACT FROM AUTHOR]

Purpose: To compare the strength of associations between different indices of cardiorespiratory fitness (CRF) and brain health outcomes in children with overweight/obesity. Methods: Participants were 100 children aged 8–11 years. CRF was assessed using treadmill exercise test (peak oxygen uptake [V̇O2peak], treadmill time, and V̇O2 at ventilatory threshold) and 20‐metre shuttle run test (20mSRT, laps, running speed, estimated V̇O2peak using the equations by Léger et al., Mahar et al., and Matsuzaka et al.). Intelligence, executive functions, and academic performance were assessed using validated methods. Total gray matter and hippocampal volumes were assessed using structural MRI. Results: V̇O2peak/body mass (β = 0.18, 95% CI = 0.01–0.35) and treadmill time (β = 0.18–0.21, 95% CI = 0.01–0.39) were positively associated with gray matter volume. 20mSRT laps were positively associated with executive functions (β = 0.255, 95% CI = 0.089–0.421) and academic performance (β = 0.199–0.255, 95% CI = 0.006–0.421), and the running speed was positively associated with executive functions (β = 0.203, 95% CI = 0.039–0.367). Estimated V̇O2peak/Léger et al. was positively associated with intelligence, executive functions, academic performance, and gray matter volume (β = 0.205–0.282, 95% CI = 0.013–0.500). Estimated V̇O2peak/Mahar et al. and V̇O2peak/Matsuzaka et al. (speed) were positively associated with executive functions (β = 0.204–0.256, 95% CI = 0.031–0.436). Conclusion: Although V̇O2peak is considered the gold standard indicator of CRF in children, peak performance (laps or running speed) and estimated V̇O2peak/Léger et al. derived from 20mSRT had stronger and more consistent associations with brain health outcomes than other indices of CRF in children with overweight/obesity. [ABSTRACT FROM AUTHOR]

Aim: In 2024, cargo vessels must meet the International Maritime Organization's global ballast water discharge standards (IMO D‐2) that limit the concentration of living organisms. D‐2 focuses on reducing invasion risk by reducing 'community propagule pressure (CPP)', though it does not consider colonization pressure (CP). Location: Global. Methods: We modelled risk differences in IMO D‐2‐compliant discharges (10 ind. m−3) for communities that had inverse patterns of CP and species' individual propagule pressures (IPP). Secondly, we determined the effect on risk of varying CPP and CP. As part of this, we tested whether the IMO D‐2 standard for zooplankton‐sized organisms of <10 individuals m−3 was an optimal choice. Risk was defined as probability of at least one species invading using four risk–release models. Results: Risk differed strongly at the D‐2 limit based on community composition. At low CPP (<25 ind. m−3), risk was strongly affected by CP for hyperbolic and linear risk–release models and weakly for exponential and logistic models, while CPP affected only the former two model types. Across a much wider range of CPP values, risk was affected by CP, CPP and by their interaction for all models. Main Conclusion: The IMO D‐2 standard for zooplankton‐sized organisms requires very low CPP and even lower IPPs in mixed‐species releases, which will impede successful colonization. Species‐abundance theory predicts that discharges meeting the D‐2 standard (low CPP) will also have low CP. Much more empirical data are required to determine whether vessels can consistently reduce CP as it lowers CPP in order to meet these requirements. [ABSTRACT FROM AUTHOR]

Purpose: Hospitals with lower fixed‐to‐total‐cost ratios may be better positioned to remain financially viable when reducing service volumes required by many value‐based payment systems. We assessed whether hospitals in rural areas have higher fixed‐to‐total‐cost ratios, which would tend to create a systematic disadvantage in such an environment. Methods: Our observational study used a mixed‐effects, repeated‐measures model to analyze Medicare Hospital Cost Report Information System data for 2011‐2020. We included all 4,953 nonfederal, short‐term acute hospitals in the United States that are present in these years. After estimating the relationship between volume (measured in adjusted patient days) and patient‐care costs in a model that controlled for a small number of hospital characteristics, we calculated fixed‐to‐total‐cost ratios based on our model's estimates. Findings: We found that nonmetropolitan hospitals tend to have higher average fixed‐to‐total‐cost ratios (0.85‐0.95) than metropolitan hospitals (0.73‐0.78). Moreover, the degree of rurality matters; hospitals in micropolitan counties have lower ratios (0.85‐0.87) than hospitals in noncore counties (0.91‐0.95). While the Critical Access Hospital (CAH) designation is associated with higher average fixed‐to‐total‐cost ratios, high fixed‐to‐total‐cost ratios are not exclusive to CAHs. Conclusions: Overall, these results suggest that hospital payment policy and payment model development should consider hospital fixed‐to‐total‐cost ratios particularly in settings where economies of scale are unattainable, and where the hospital provides a sense of security to the community it serves. [ABSTRACT FROM AUTHOR]

Dynamic cerebral autoregulation (dCA) describes the regulation of cerebral blood flow (CBF) in response to fluctuations in systemic blood pressure (BP). Heavy resistance exercise is known to induce large transient elevations in BP, which are translated into perturbations of CBF, and may alter dCA in the immediate aftermath. This study aimed to better quantify the time course of any acute alterations in dCA after resistance exercise. Following familiarisation to all procedures, 22 (14 male) healthy young adults (22 ± 2 years) completed an experimental trial and resting control trial, in a counterbalanced order. Repeated squat‐stand manoeuvres (SSM) at 0.05 and 0.10 Hz were used to quantify dCA before, and 10 and 45 min after four sets of ten repetition back squats at 70% of one repetition maximum, or time matched seated rest (control). Diastolic, mean and systolic dCA were quantified by transfer function analysis of BP (finger plethysmography) and middle cerebral artery blood velocity (transcranial Doppler ultrasound). Mean gain (p = 0.02; d = 0.36) systolic gain (p = 0.01; d = 0.55), mean normalised gain (p = 0.02; d = 0.28) and systolic normalised gain (p = 0.01; d = 0.67) were significantly elevated above baseline during 0.10 Hz SSM 10‐min post resistance exercise. This alteration was not present 45 min post‐exercise, and dCA indices were never altered during SSM at 0.05 Hz. dCA metrics were acutely altered 10 min post resistance exercise at the 0.10 Hz frequency only, which indicate changes in the sympathetic regulation of CBF. These alterations recovered 45 min post‐exercise. [ABSTRACT FROM AUTHOR]

New Findings: What is the central question of this study?What is the effect of 4 weeks of high‐intensity interval training (HIIT) and 2 weeks of detraining on vascular function and traditional cardiovascular disease (CVD) risk factors in male adolescents?What is the main finding and its importance?Four weeks of HIIT improved macrovascular function in adolescents. However, this training period did not measurably change microvascular function, body composition or blood biomarkers. Following 2 weeks of detraining, the improvement in flow‐mediated dilatation (FMD) was lost. This highlights the importance of the continuation of regular exercise for the primary prevention of CVD. High‐intensity interval training (HIIT) represents an effective method to improve cardiometabolic health in adolescents. This study aimed to investigate the effect of 4 weeks of HIIT followed by 2 weeks of detraining on vascular function and traditional cardiovascular disease (CVD) risk factors in adolescent boys. Nineteen male adolescents (13.3 ± 0.5 years) were randomly allocated to either a training (TRAIN, n = 10) or control (CON, n = 9) group. Participants in TRAIN completed 4 weeks of HIIT running with three sessions per week. Macro‐ (flow‐mediated dilatation, FMD) and microvascular (peak reactive hyperaemia, PRH) function, body composition (fat mass, fat free mass, body fat percentage) and blood biomarkers (glucose, insulin, total cholesterol, high‐ and low‐density lipoprotein, triacylglycerol) were assessed pre‐, 48 h post‐ and 2 weeks post‐training for TRAIN and at equivalent time points for CON. Following training, FMD was significantly greater in TRAIN compared to CON (9.88 ± 2.40% and 8.64 ± 2.70%, respectively; P = 0.036) but this difference was lost 2 weeks after training cessation (8.22 ± 2.47% and 8.61 ± 1.99%, respectively; P = 0.062). No differences were detected between groups for PRH (P = 0.821), body composition (all P > 0.14) or blood biomarkers (all P > 0.18). In conclusion, 4 weeks of HIIT improved macrovascular function; however, this training period did not measurably change microvascular function, body composition or blood biomarkers. The reversal of the FMD improvement 2 weeks post‐training highlights the importance of the continuation of regular exercise for the primary prevention of CVD. [ABSTRACT FROM AUTHOR]

Understanding racial disparities in cancer outcomes continues to be a challenge, with likely many factors at play, including socioeconomic factors and genetic polymorphisms impacting basic cellular and molecular functions. Additionally, it is possible that specific combinations of environment and genetics have specific impacts. T‐cell receptor (TCR) gene segment usage, HLA allele combinations have been associated with autoimmune and infectious disease courses, and more recently, TCR gene segment usage, HLA allele combinations have been associated with distinct survival outcomes in cancer as well. We examined several such, previously reported cancer‐related TCR gene segment usage, HLA allele combinations for evidence of racial disparities, with regard to the prevalence of the combination in different racial groups. Results indicated that TCR gene segment usage, potentially reflecting environmental factors related to previous pathogen exposure, in combination with certain HLA alleles or independently, may represent a novel explanation for racial disparities in cancer outcomes. Overall, at this point, a genetic connection to racial disparities in cancer outcomes is detectable but remains modest, suggesting that other factors, such as socioeconomic factors, remain as important considerations. [ABSTRACT FROM AUTHOR]

Considering physical activity (PA) volume and intensity may provide novel insights into the relationships of PA with bone, lean, and fat mass. This study aimed to assess the associations of PA volume, PA intensity distribution, including moderate‐to‐vigorous PA (MVPA) with total‐body‐less‐head bone mineral content (BMC), lean, and fat mass in children. A population sample of 290 Finnish children (158 females) aged 9–11 years from the Physical Activity and Nutrition in Children (PANIC) Study was studied. PA, including MVPA, was assessed with a combined heart rate and movement sensor, and the uniaxial acceleration was used to calculate average‐acceleration (a proxy metric for PA volume) and intensity‐gradient (reflective of PA intensity distribution). Linear regression analyzed the associations of PA volume, PA intensity and MVPA with BMC, lean mass, and fat mass assessed by dual‐energy X‐ray absorptiometry. PA volume was positively associated with BMC in females (unstandardised regression coefficient [ß] = 0.26) and males (ß = 0.47), and positively associated with lean (ß = 7.33) and negatively associated with fat mass in males (ß = −20.62). PA intensity was negatively associated with BMC in males (ß = −0.13). MVPA was positively associated with lean mass in females and males (ß = 0.007 to 0.012), and negatively associated with fat mass in females and males (ß = −0.030 to −0.029). PA volume may be important for improving BMC in females and males, and increasing lean and reducing fat mass in males, whereas MVPA may be important for favorable lean and fat outcomes in both sexes. [ABSTRACT FROM AUTHOR]

Ovarian cancer continues to present significant challenges for early detection and treatment, indicating a need for novel approaches to improve disease outcomes. In this report, we applied a previously described algorithm for detecting chemical complementarity between candidate cancer antigens and complementarity determining region‐3 (CDR3) amino acid sequences from tumor resident T‐cell receptors. Current literature indicates an association between high CDR3‐cancer antigen complementarity and improved survival outcomes. For example, high CDR3‐BRAF electrostatic complementarity is associated with a better melanoma outcome. However, such CDR3‐cancer antigen chemical complementarity in ovarian cancer was largely associated with worse outcomes. Specifically, high CDR3‐MAGEB4 and CDR3‐TDRD1 electrostatic complementarity was associated with lower ovarian cancer disease free survival (DFS). Additionally, high CDR3‐MAGEB4 and CDR3‐TDRD1 electrostatic complementarity was associated with decreased MAGEB4/TDRD1 gene expression and gene copy numbers, consistent with a selection against ovarian cancer cells expressing these antigens. However, when TDRD1 was split into fragments, high CDR3‐TDRD1 hydrophobicity complementarity, for a specific TDRD1 fragment, was associated with increased DFS and higher immune marker expression levels. This dichotomy highlights the myriad of opportunities to establish risk stratifications and to identify potential, actionable cancer antigens using immunogenomic parameters. [ABSTRACT FROM AUTHOR]

Caley Horan's I The Insurance Era i examines the marketing, investing and underwriting activities of select segments of the private insurance industry in the United States during the mid-decades of the 20th century. For example, certain forms of gender discrimination in insurance criticised by Horan and documented by Feminist activists in the 1970s and 1980s in fact often significantly benefitted women (with lower life and health insurance premiums), and this probably explains why the feminists lobbying for unisex insurance laws, or for the same rate and coverage for men and women, ultimately failed. If risks are heterogenous, it is of course possible for the insurer to try to do as Horan claims and charge an average pooling premium to all, and still break even, but this is unlikely to be sustainable as a competitive market equilibrium due to the profitable cream-skimming opportunities open to other insurers. [Extracted from the article]

Aim: To examine the effect of exercise training programs with aerobic components on C‐reactive protein, erythrocyte sedimentation rate and self‐assessed disease activity in people with ankylosing spondylitis compared to non‐aerobic rehabilitation. Methods: A systematic review was undertaken of PubMED, Cochrane Library, Embase and Web of Science databases. Articles evaluating the effect of exercise training programs with aerobic components on C‐reactive protein, erythrocyte sedimentation rate or Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) in adults (>17 years) with ankylosing spondylitis were included. Control groups were defined as non‐aerobic rehabilitation, including usual care or physiotherapy. Results: Thirteen articles met inclusion criteria for qualitative and meta‐analysis, involving 366 participants undertaking exercise and 361 controls. Exercise programs included modalities such as running, aerobic walking and swimming, and were between 3 weeks and 3 months in duration. Exercise programs significantly reduced C‐reactive protein (weighted mean difference [WMD]: −1.09; 95% CI: −2.08 to −0.10; P =.03; n = 5) and BASDAI (WMD: −0.78; 95% CI: −0.98 to −0.58; P <.001; n = 13) compared to non‐aerobic rehabilitation. BASDAI subgroup analysis revealed greater improvements compared to usual care than structured physiotherapy. Exercise programs did not reduce erythrocyte sedimentation rate (WMD: 0.16; 95% CI: −2.15 to 2.47; P =.89; n = 4). Conclusion: Exercise training programs with aerobic components reduced C‐reactive protein and improved self‐assessed disease activity in people with ankylosing spondylitis. Further research is required to investigate the effects of differing aerobic exercise modes, intensities and durations. [ABSTRACT FROM AUTHOR]

Magnetic Resonance Imaging (MRI) is well‐suited for imaging peripheral blood flow due to its non‐invasive nature and excellent spatial resolution. Although MRI is routinely used in adults to assess physiological changes in chronic diseases, there are currently no MRI‐based data quantifying arterial flow in pediatric or adolescent populations during exercise. Therefore the current research sought to document femoral arterial blood flow at rest and following exercise in a pediatric‐adolescent population using phase contrast MRI, and to present test‐retest reliability data for this method. Ten healthy children and adolescents (4 male; mean age 14.8 ± 2.4 years) completed bloodwork and resting and exercise MRI. Baseline images consisted of PC‐MRI of the femoral artery at rest and following a 5 × 30 s of in‐magnet exercise. To evaluate test‐retest reliability, five participants returned for repeat testing. All participants successfully completed exercise testing in the MRI. Baseline flow demonstrated excellent reliability (ICC = 0.93, p = 0.006), and peak exercise and delta rest‐peak flow demonstrated good reliability (peak exercise ICC = 0.89, p = 0.002, delta rest‐peak ICC = 0.87, p = 0.003) between‐visits. All three flow measurements demonstrated excellent reliability when assessed with coefficients of variance (CV's) (rest: CV = 6.2%; peak exercise: CV = 7.3%; delta rest‐peak: CV = 7.1%). The mean bias was small for femoral arterial flow. There was no significant mean bias between femoral artery flow visits 1 and 2 at peak exercise. There were no correlations between age or height and any of the flow measurements. There were no significant differences between male and female participants for any of the flow measurements. The current study determined that peripheral arterial blood flow in children and adolescents can be evaluated using non‐invasive phase contrast MRI. The MRI‐based techniques that were used in the current study for measuring arterial flow in pediatric and adolescent patients demonstrated acceptable test‐retest reliability both at rest and immediately post‐exercise. [ABSTRACT FROM AUTHOR]

New Findings: What is the central question of the study?What is the reliability of middle cerebral artery velocity cerebrovascular reactivity (CVR) when using traditional and novel outcomes, as measured by transcranial Doppler?What is the main finding and its importance?Traditional CVR approaches presented acceptable reproducibility but should be expressed as an absolute CVR. Large within‐ and between‐individual differences in the middle cerebral artery velocity response profile support using a dynamic peak, rather than a set time point, for the most reliable interpretation. The study highlights the utility of novel kinetic CVR outcomes, but due to increased variability in time‐based metrics, this analysis requires larger sample sizes than traditional methods. Cerebrovascular reactivity (CVR) of middle cerebral artery velocity (MCAv) to CO2 is a common method to assess cerebrovascular function. Yet, the approaches used to calculate CVR outcomes vary. The aim of this study was to explore the within‐ and between‐day reliability of traditional CVR outcomes. The second aim was to explore the reliability of novel kinetic‐based analyses. Healthy adults (n = 10, 22.3 ± 3.4 years) completed assessments of CVR over 4 min using a fixed fraction of inspired CO2 (6%). This was repeated across four separate visits (between‐day), and on one visit measures were repeated 2.5 h later (within‐day). No mean biases were present between assessments for traditional CVR metrics, expressed as absolute (cm/s/mmHg) or relative (%/mmHg) outcomes (minute 3, minute 4, peak 1 s, peak 30 s) (between‐day: P > 0.14, ηp2 < 0.20; within‐day: P > 0.22, d > 0.27). Absolute, rather than relative, CVR yielded the most reproducible parameters (coefficient of variation: 8.1–13.2% vs. 14–83%, respectively). There were significant differences between CVR outcomes (P < 0.001, ηp2 > 0.89) dependent on the time point used to determine CVR, as a steady state MCAv response was rarely observed. Furthermore, the MCAv response was not reproducible within an individual (κ = 0.15, P = 0.09). No mean differences were present for novel kinetic outcomes (amplitude, time‐delay, time constant) (between‐day: P > 0.05, d < 0.33; within‐day: P > 0.38, d < 0.25). The results support the need for standardisation and indicate CVR should be defined as a dynamic peak, rather than a set time point for increased reliability. For novel kinetic outcomes variability was greater (CV: 8.7–120.9%) due to the nature of time‐based metrics. [ABSTRACT FROM AUTHOR]

Background: Factors known to be associated with outcome of acquired myasthenia gravis (MG) in dogs are limited. Hypothesis/Objectives: Of dogs with MG, advancing age and comorbid neoplasia are associated with poor long‐term prognosis and low rates of remission. Animals: Ninety‐four client‐owned dogs with MG diagnosed by acetylcholine receptor antibody (AChR Ab) assay between 2001 and 2019 from a university clinic and 3 private clinics in the United States. Methods: Cases were retrospectively evaluated and data were collected to determine clinical signs, treatment, and response to therapy defined by means of a clinical scoring rubric. Immunological remission was defined as a return of the AChR Ab concentration to <0.6 nmol/L. Multivariable binary logistic regression analysis was used to identify clinical criteria predicting remission. Results: An anticholinesterase drug was used to treat 90/94 (96%) dogs, which in 63/94 (67%) was the sole treatment; other drugs included immune modulators. Clinical remission (lack of clinical signs ≥4 weeks after treatment cessation) was observed in 29 (31% [95% confidence interval (CI): 22.4‐40.8%]) dogs, clinical response (lack of clinical signs on treatment) in 14 (15% [95% CI: 9.0‐23.6%]) dogs, clinical improvement (on treatment) in 24 (26% [95% CI: 17.8‐35.2%]) dogs, and no clinical improvement in 27 (29% [95% CI: 20.5‐38.6%]) dogs. Immunological remission was observed in 27/46 (59%) dogs, with clinical remission in all 27. Younger age (P =.04) and comorbid endocrine disease (P =.04) were associated with clinical remission. Initial AChR Ab concentration (P =.02) and regurgitation (P =.04) were negatively associated with clinical remission. Conclusions and Clinical Importance: Clinical remission in MG is less likely in older dogs and dogs presenting with regurgitation or high initial AChR Ab concentration, but more likely in younger dogs and dogs with comorbid endocrine disease. [ABSTRACT FROM AUTHOR]

Aim: Golden mussel Limnoperna fortunei is an invasive bivalve in many freshwater ecosystems in Asia and South America. Cold winter temperatures are expected to restrict its spread to high‐latitude areas. Cold tolerance and potential distribution of this species remain largely unstudied because the most extensively studied populations occur in tropical and sub‐tropical areas. We sought to investigate cold tolerance of golden mussels and to model their potential distribution at higher latitudes. Location: China, Global. Methods: We investigated overwintering survival of caged golden mussels in a reservoir located at the northern invasion front in north China. We then determined the lowest water temperature at which mussel filtering occurred in laboratory. Finally, we modelled relative environmental suitability globally based on Maximum Entropy using the species' most updated occurrence records. Results: Golden mussels in a northern invasion front reservoir could survive over a course of 6 days at <1°C, or 41 days at <2°C, or 108 days at <5°C, with 27% survival overall. Caged mussels were inaccessible to local predators and reproduced, with the subsequent population size increasing in early summer by ~280%, representing a potential source population. Laboratory tests demonstrated that the lowest water temperature at which mussels could filter water was 5.5°C, and 50% of individuals became active when temperature rose to 7.5–8.0°C. Species distribution modelling illustrated a potential distribution of golden mussels at higher latitude than presently found. Models that considered updated high‐latitude occurrence records predicted a significantly larger suitable area than currently exists, including near the lower Laurentian Great Lakes. Main conclusions: Our findings suggest enhanced cold tolerance of golden mussels and wider potential distribution than currently exists. We emphasize the importance of examining samples from invasion fronts when developing distribution predictions for spreading invasive species. [ABSTRACT FROM AUTHOR]

New Findings: What is the central question of this study?What is the effect of high‐intensity and moderate‐intensity interval running on macro‐ and microvascular function in a fasted state and following a glucose challenge in adolescents?What is the main finding and its importance?Both macro‐ and microvascular function were improved after interval running independent of intensity. This finding shows that the intermittent exercise pattern and its associated effect on shear are important for vascular benefits. In adolescents, macrovascular function was enhanced after an acute glucose load. However, the effect of chronic glucose consumption on vascular function remains to be elucidated. Interventions targeting vascular function in youth are an important strategy for the primary prevention of cardiovascular diseases. This study examined, in adolescents, the effect of high‐intensity interval running (HIIR) and moderate‐intensity interval running (MIIR) on vascular function in a fasted state and postprandially after a glucose challenge. Fifteen adolescents (13 male, 13.9 ± 0.6 years) completed the following conditions on separate days in a counterbalanced order: (1) 8 × 1 min HIIR interspersed with 75 s recovery; (2) distance‐matched amount of 1 min MIIR interspersed with 75 s recovery; and (3) rest (CON). Macro‐ (flow‐mediated dilatation, FMD) and microvascular (peak reactive hyperaemia, PRH) function were assessed immediately before and 90 min after exercise/rest. Participants underwent an oral glucose tolerance test (OGTT) 2 h after exercise/rest before another assessment of vascular function 90 min after the OGTT. Following exercise, both HIIR and MIIR increased FMD (P = 0.02 and P = 0.03, respectively) and PRH (P = 0.04, and P = 0.01, respectively) with no change in CON (FMD: P = 0.51; PRH: P = 0.16) and no significant differences between exercise conditions. Following the OGTT, FMD increased in CON (P < 0.01) with no changes in HIIR and MIIR (both P > 0.59). There was no change in PRH after the OGTT (all P > 0.40). In conclusion, vascular function is improved after interval running independent of intensity in adolescents. Acute hyperglycaemia increased FMD, but prior exercise did not change vascular function after the OGTT in youth. [ABSTRACT FROM AUTHOR]

Purpose: Rural‐urban health disparities have received increasing scrutiny as rural individuals continue to have worse health outcomes. However, little is known about how insurance status contributes to urban‐rural disparities. This study characterizes how rural uninsured patients compare to the urban uninsured, determines whether rurality among the uninsured is associated with worse clinical outcomes, and examines how clinical outcomes based on rurality have changed over time. Methods: We conducted a retrospective cohort study of the 2012‐2016 National Inpatient Sample hospital discharge data including 1,478,613 uninsured patients, of which 233,816 were rural. Admissions were broken into 6 rurality categories. Logistic regression models were used to determine the independent association between rurality and hospital mortality. Findings: Demographic and clinical characteristics differed significantly between rural and urban uninsured patients: rural patients were more often white, lived in places with lower median household income, and were more often admitted electively and transferred. Rurality was associated with significantly higher in‐hospital mortality rates (1.44% vs 1.89%, OR 1.32, P <.001). This association strengthened after adjusting for medical comorbidities and hospital characteristics. Further, disparities between urban and rural mortality were found to be growing, with the gap almost doubling between 2012 and 2016. Conclusions: Rural and urban uninsured patients differed significantly, specifically in terms of race and median income. Among the uninsured, rurality was associated with higher in‐hospital mortality, and the gap between urban and rural in‐hospital mortality was widening. Our findings suggest the rural uninsured are a vulnerable population in need of informed, tailored policies to reduce these disparities. [ABSTRACT FROM AUTHOR]

Previously, master equation (ME) simulations using semiclassical transition state theory (SCTST) and high‐accuracy extrapolated ab initio thermochemistry (HEAT) predicted rate constants in excellent agreement with published experimental data over a wide range of pressure and temperatures ≳250 K, but the agreement was not as good at lower temperatures. Possible reasons for this reduced performance are investigated by (a) critically evaluating the published experimental data and by investigating; (b) three distinct ME treatments of angular momentum, including one that is exact at the zero‐ and infinite‐pressure limits; (c) a hindered‐rotor model for HOCO that implicitly includes the cis‐ and trans‐conformers; (d) possible empirical adjustments of the thermochemistry; (e) possible empirical adjustments to an imaginary frequency controlling tunneling; (f) including or neglecting the prereaction complex PRC1; and (g) its possible bimolecular reactions. Improvements include better approximations to factors in SCTST and using the Hill and van Vleck treatment of angular momentum coupling. Evaluation of literature data does not reveal any specific shortcomings, but the stated uncertainties may be underestimated. All ME treatments give excellent fits to experimental data at T ≥ 250 K, but the discrepancy at T < 250 K persists. Note that each ME model requires individual empirical energy transfer parameters. Thermochemical adjustments were unable to match the experimental H/D kinetic isotope effects. Adjusting an imaginary frequency can achieve good fits, but the adjustments are unacceptably large. Whether PRC1 and its possible bimolecular reactions are included had little effect. We conclude that none of the adjustments is an improvement over the unadjusted theory. Note that only one set of experimental data exists in the regime of the discrepancy with theory, and data for DO + CO are scanty. [ABSTRACT FROM AUTHOR]

Purpose: Cerebrovascular reactivity (CVR) is impaired in adolescents with cardiovascular disease risk factors. A breath-hold test is a noninvasive method of assessing CVR, yet there are no reliability data of this outcome in youth. This study aimed to assess the reliability of a breath-hold protocol to measure CVR in adolescents.Methods: Twenty-one 13 to 15 year old adolescents visited the laboratory on two separate occasions, to assess the within-test, within-day and between-day reliability of a breath-hold protocol, consisting of three breath-hold attempts. CVR was defined as the relative increase from baseline in middle cerebral artery mean blood velocity following a maximal breath-hold of up to 30 seconds, quantified via transcranial Doppler ultrasonography.Results: Mean breath-hold duration and CVR were never significantly correlated (r < .31, P > .08). The within-test coefficient of variation for CVR was 15.2%, with no significant differences across breath-holds (P = .88), so the three breath-hold attempts were averaged for subsequent analyses. The within- and between-day coefficients of variation for CVR were 10.8% and 15.3%, respectively.Conclusions: CVR assessed via a three breath-hold protocol can be reliably measured in adolescents, yielding similar within- and between-day reliability. Analyses revealed that breath-hold length and CVR were unrelated, indicating the commonly reported normalization of CVR to breath-hold duration (breath-hold index) may be unnecessary in youth. [ABSTRACT FROM AUTHOR]

Objective: To add to the evidence base on causal linkages between health insurance coverage and health status, controlling for sociodemographic factors, by analyzing longitudinal data. Data Source: Secondary data from the Panel Study of Income Dynamics (PSID), 2009‐17, which is a longitudinal, multigenerational study covering a wide array of socioeconomic topics that began in 1968 but has only recently begun collecting useful information on individual health insurance. Study Design: 2017 data on self‐reported health status, work limitations, and death were analyzed as outcomes based upon the degree of exposure to health insurance in 2011‐17. All variables were collected biannually for four years beginning in 2011. Having health insurance at each point in time was, in turn, modeled as a function of several sociodemographic factors. Data Extraction Methods: Data were downloaded using the crosswalk tool available at the PSID website. Because individual health insurance questions were only asked of heads and spouses in households beginning in 2011, we analyzed only these records. Principal Findings: Among respondents who were not in fair or poor health in 2009, each additional 2 years of subsequent reported insurance coverage reduced the chance of reporting fair or poor health in 2017 by 10 percent; however, this effect was not present for black respondents. Conclusions: Our results suggest that the effect of health insurance on health status may compound over time, although unevenly by race. Since people who report fair or poor health status represent the bulk of utilization and spending, our findings provide evidence in support of viewing coverage expansions as investments that will pay dividends in the form of lower utilization over time. More work is needed to produce detailed estimates of cost savings, which may in turn influence policy, as well as to understand and address the source of racial disparity. [ABSTRACT FROM AUTHOR]

New Findings: What is the central question of this study?In this study, we investigated intracranial cerebrovascular and ventilatory reactivity to 6% CO2 in children and adults and explored dynamic ventilatory and cerebrovascular onset responses.What is the main finding and its importance?We showed that cerebrovascular reactivity was similar in children and adults, but the intracranial blood velocity onset response was markedly attenuated in children. Sex differences were apparent, with greater increases in intracranial blood velocity in females and lower ventilatory reactivity in adult females. Our study confirms the importance of investigating dynamic onset responses when assessing the influence of development on cerebrovascular regulation. The purpose of this study was to compare the integrated intracranial cerebrovascular reactivity (CVR) and hypercapnic ventilatory response between children and adults and to explore the dynamic response of the middle cerebral artery mean velocity (MCAV). Children (n = 20; 9.9 ± 0.7 years of age) and adults (n = 21; 24.4 ± 2.0 years of age) completed assessment of CVR over 240 s using a fixed fraction of inspired CO2 (0.06). Baseline MCAV was higher in the adult females compared with the males (P ≤ 0.05). The MCAV was greater in female children compared with male children (P ≤ 0.05) and in female adults compared with male adults (P ≤ 0.05) with hypercapnia. Relative CVR was similar in children and adults (3.71 ± 1.06 versus 4.12 ± 1.32% mmHg−1; P = 0.098), with absolute CVR being higher in adult females than males (3.27 ± 0.86 versus 2.53 ± 0.70 cm s−1 mmHg−1; P ≤ 0.001). Likewise, the hypercapnic ventilatory response did not differ between the children and adults (1.89 ± 1.00 versus 1.77 ± 1.34 l min−1 mmHg−1; P = 0.597), but was lower in adult females than males (1.815 ± 0.37 versus 2.33 ± 1.66 l min−1 mmHg−1; P ≤ 0.05). The heart rate response to hypercapnia was greater in children than in adults (P = 0.001). A monoexponential regression model was used to characterize the dynamic onset, consisting of a delay term, amplitude and time constant (τ). The results revealed that MCAV τ was faster in adults than in children (34 ± 18 versus 74 ± 28 s; P = 0.001). Our study provides new insight into the impact of age and sex on CVR and the dynamic response of the MCAV to hypercapnia. [ABSTRACT FROM AUTHOR]

New Findings: What is the central question of this study?Do the phase II parameters of pulmonary oxygen uptake (V̇O2) kinetics display linear, first‐order behaviour in association with alterations in skeletal muscle oxygenation during step cycling of different intensities or when exercise is initiated from an elevated work rate in youths.What is the main finding and its importance?Both linear and non‐linear features of phase II V̇O2 kinetics may be determined by alterations in the dynamic balance between microvascular O2 delivery and utilization in 11–15 year olds. The recruitment of higher‐order (i.e. type II) muscle fibres during 'work‐to‐work' cycling might be responsible for modulating V̇O2 kinetics with chronological age. This study investigated in 19 male youths (mean age: 13.6 ± 1.1 years, range: 11.7–15.7 years) the relationship between pulmonary oxygen uptake (V̇O2) and muscle deoxygenation kinetics during moderate‐ and very heavy‐intensity 'step' cycling initiated from unloaded pedalling (i.e. U → M and U → VH) and moderate to very heavy‐intensity step cycling (i.e. M → VH). Pulmonary V̇O2 was measured breath‐by‐breath along with the tissue oxygenation index (TOI) of the vastus lateralis using near‐infrared spectroscopy. There were no significant differences in the phase II time constant (τV̇O2p) between U → M and U → VH (23 ± 6 vs. 25 ± 7 s; P = 0.36); however, the τV̇O2p was slower during M → VH (42 ± 16 s) compared to other conditions (P < 0.001). Quadriceps TOI decreased with a faster (P < 0.01) mean response time (MRT; i.e. time delay + τ) during U → VH (14 ± 2 s) compared to U → M (22 ± 4 s) and M → VH (20 ± 6 s). The difference (Δ) between the τV̇O2p and MRT‐TOI was greater during U → VH compared to U → M (12 ± 7 vs. 2 ± 7 s, P < 0.001) and during M → VH (23 ± 15 s) compared to other conditions (P < 0.02), suggesting an increased proportional speeding of fractional O2 extraction. The slowing of the τV̇O2p during M → VH relative to U → M and U → VH correlated positively with chronological age (r = 0.68 and 0.57, respectively, P < 0.01). In youths, 'work‐to‐work' transitions slowed microvascular O2 delivery‐to‐O2 utilization with alterations in phase II V̇O2 dynamics accentuated between the ages of 11 and 15 years. [ABSTRACT FROM AUTHOR]

Purpose: Macrovascular endothelial function is commonly assessed using flow-mediated dilation (FMD) and is nitric oxide (NO) dependent. However, the vasoreactivity to low flow during the FMD protocol may complement FMD interpretation. This study aimed to investigate in adolescents: (1) the day-to-day reliability of low-flow-mediated constriction (L-FMC) and composite vessel reactivity (CVR); and (2) the relationship between L-FMC and FMD.Methods: A retrospective analysis of data on 27 adolescents (14.3 ± 0.6 year, 12 males) was performed. Participants had two repeat measures, on separate days, of macrovascular function using high-resolution ultrasound for assessment of L-FMC, FMD, and CVR.Results: On average, the L-FMC response was vasoconstriction on both days (-0.59 ± 2.22% and -0.16 ± 1.50%, respectively). In contrast, an inconsistent response to low flow (vasoconstriction, dilation, or no change) was observed on an individual level. Cohen's Kappa revealed poor agreement for classifying the L-FMC measurement between visits (k = 0.04, P > .05). Assessment of the actual vessel diameter was robust with a coefficient of variation of 1.7% (baseline and peak) and 2.7% (low-flow). The between-day correlation coefficient between measures was r = .18, r = .96 and r = .52 for L-FMC, FMD, and CVR, respectively. No significant correlation between FMD and L-FMC was observed for either visit (r = -.06 and r = -.07, respectively; P > .05).Conclusion: In adolescents, the low-flow vasoreactivity is inconsistent between days. Whereas the actual vessel diameter is reproducible, the measurement of L-FMC and CVR has poor between-day reliability compared to FMD. Finally, L-FMC, and FMD are not significantly correlated. [ABSTRACT FROM AUTHOR]

We aimed to develop cut‐points for directly measured peak oxygen uptake (V˙O2peak) to identify boys and girls at increased cardiometabolic risk using different scaling methods to control for body size and composition. Altogether 352 children (186 boys, 166 girls) aged 9‐11 years were included in the analyses. We measured V̇O2peak directly during a maximal cycle ergometer exercise test and lean body mass (LM) by bioelectrical impedance. We computed a sex‐ and age‐specific cardiometabolic risk score (CRS) by summing important cardiometabolic risk factors and defined increased cardiometabolic risk as >1 standard deviation above the mean of CRS. Receiver operating characteristics curves were used to detect V̇O2peak cut‐points for increased cardiometabolic risk. Boys with V̇O2peak <45.8 mL kg body mass (BM)−1 min−1 (95% confidence interval [CI] = 45.1 to 54.6, area under the curve [AUC] = 0.86, P < 0.001) and <63.2 mL kg LM−1 min−1 (95% CI =52.4 to 67.5, AUC = 0.65, P = 0.006) had an increased CRS. Girls with V̇O2peak <44.1 mL kg BM−1 min−1 (95% CI = 44.0 to 58.6, AUC = 0.67, P = 0.013) had an increased CRS. V̇O2peak scaled by BM−0.49 and LM−0.77 derived from log‐linear allometric modeling poorly predicted increased cardiometabolic risk in boys and girls. In conclusion, directly measured V˙O2peak <45.8 mL kg BM−1 min−1 among boys and <44.1 mL kg BM−1 min−1 among girls were cut‐points to identify those at increased cardiometabolic risk. Appropriately controlling for body size and composition reduced the ability of cardiorespiratory fitness to identify children at increased cardiometabolic risk. [ABSTRACT FROM AUTHOR]

Summary: Improvements in the autonomic and vascular systems are implicated in cardiovascular disease risk reduction. Baroreflex sensitivity (BRS) is composed of vascular and autonomic components. This study aimed to investigate between‐ and within‐day reliability of BRS and its autonomic and vascular determinants in adolescents. Thirteen male adolescents (14·1 ± 0·5 y) participated in this study. For between‐day reliability, participants completed four experimental visits separated by a minimum of 48‐h. For within‐day reliability, participants repeated BRS assessments three times in the morning with one hour between the measures. BRS was evaluated using the cross‐spectral gain (LFgain) between blood pressure and heart rate interval. BRS was further divided into: 1) vascular component using arterial compliance (AC); and 2) autonomic component measured as LFgain divided by AC (LFgain/AC). LFgain, AC and LFgain/AC presented between‐day coefficient of variation (CV) of 20%, 17%, and 20%, respectively. Similarly, variables associated with blood pressure control, such as cardiac output, mean arterial pressure, heart rate and total peripheral resistance, presented CVs ranging from 6% to 15%. Within‐day reliability was poorer compared to between‐day for LFgain (25%), AC (25%), and LFgain/AC (31%), as well as all hemodynamic variables (CVs from 11% to 22%, except heart rate with presented CV of 6%). This study indicates suitable between‐ and within‐reliability of BRS and its autonomic and vascular determinants, as well as hemodynamic variables associated with BRS, in adolescents. [ABSTRACT FROM AUTHOR]

New Findings: What is the central question of this study? What are the autonomic and vascular components of the baroreflex during hypotension following different exercise intensities in adolescents? What is the main finding and its importance? Hypotension after high‐intensity exercise lasted 60 min, whereas following moderate‐intensity exercise, blood pressure was restored after 20 min. Stroke volume and peripheral resistance responses were different between intensities. Post both exercise intensities, baroreflex sensitivity was lowered mainly due to the autonomic component, which returned to baseline 60 min post‐exercise. The different haemodynamic stimuli indicate potential differences in cardiovascular health benefits of exercise intensity in healthy adolescents. Abstract: This work aimed to investigate the time course of changes in baroreflex sensitivity (BRS) and its vascular and autonomic components after different exercise intensities in adolescents. Thirteen male adolescents (age 13.9 ± 0.5 years) completed on separate days in a counterbalanced order (1) high‐intensity interval exercise (HIIE): 8 × 1 min running at 90% of maximal aerobic speed with 75 s of active recovery; (2) moderate‐intensity interval exercise (MIIE): 10–12 bouts of 1 min running at 90% of gas exchange threshold with 75 s of active recovery; and (3) resting as a control. Supine heart rate and blood pressure were monitored continuously at baseline, and 5 and 60 min following the conditions. A cross‐spectral method (low frequency gain; LFgain) was used to determine BRS gain. Arterial compliance (AC) was assessed as the BRS vascular component. LFgain/AC was used as the autonomic component. LFgain decreased 5 min post‐exercise bouts (HIIE P < 0.001; MIIE P = 0.002), but returned to baseline at 60 min post‐exercise. AC increased at 5 min post‐exercise for all conditions (P = 0.048), and returned to baseline at 60 min post‐exercise. LFgain/AC decreased 5 min post‐exercise bouts (HIIE P = 0.001; MIIE P = 0.004), but returned to baseline values at 60 min post‐exercise. Mean arterial pressure was lowered by both exercise intensities at 5 min post‐exercise, but remained decreased at 60 min post‐exercise following HIIE only. In conclusion, BRS decreases 5 min following exercise in adolescents independent of exercise intensity and is mainly driven by a lowered autonomic response. At 60 min post‐exercise, the ability of BRS to regulate blood pressure is restored after MIIE but not after HIIE, indicating exercise intensity‐dependent mechanisms. [ABSTRACT FROM AUTHOR]

Abstract: Advances in remote sensing, informatics, software, and microprocessors enable meter‐resolution two‐dimensional (2D) hydrodynamic models that produce nearly a census of ecohydraulic conditions over long river segments with 105 to 108 computational elements. It is difficult to test statistical and spatial model performance at such scope using fixed‐point velocity measurements, because field methods are so expensive, laborious, slow, and restricted by safety factors. This study evaluated low‐cost water surface particle tracking by kayak with real‐time kinematic GPS for 2D model validation using 7.2 km of the lower Yuba River in California. Observed flows were between 15 to 140 m3/s, which were in‐channel up to and including bankfull conditions. The coefficients of determination between 5,780 observations and 2D model predictions were 0.79 and 0.80 for velocity magnitude and direction, respectively. When surface speed was downscaled and compared to modelled depth‐averaged velocity, median unsigned difference was 15.5%. Standard hydrological model performance metrics affirmed satisfactory validation. Surface tracking provided the novel benefit of enabling validation of velocity direction, and that testing found satisfactory performance using all metrics. Having 10 to 1,000 times more data enables robust statistical testing and spatial analysis of both speed and direction, which outweighs the loss of depth‐averaged data. Both fixed‐point and kayak particle tracking methods are useful tools to help evaluate 2D model performance. [ABSTRACT FROM AUTHOR]

The ROR family of receptor tyrosine kinases, ROR1 and ROR2, is known to play an important role during skeletal muscle regeneration. ROR1 has a critical role in regulating satellite cell (SC) proliferation during muscle regeneration, and proinflammatory cytokines such as TNF‐α and IL‐1β can induce expression of ROR1 in myogenic cells via NF‐κB activation. While searching for ROR1‐interacting proteins in myogenic cells, we identified MuSK as a ROR1‐binding protein. MuSK interacts with and phosphorylates ROR1 at the cytoplasmic proline‐rich domain. ROR1 also interacts with the MuSK activator Dok‐7 independently of MuSK interaction. Collectively, our results identified ROR1 as a new interacting partner for MuSK and Dok‐7, which may have an important role in myogenic cell signaling. [ABSTRACT FROM AUTHOR]

This study aimed to examine adolescents’ acute cardiorespiratory and perceptual responses during high-intensity interval exercise (HIIE) and enjoyment responses following HIIE and work-matched continuous moderate intensity exercise (CMIE). Fifty-four 12- to 15-year olds (27 boys) completed 8 × 1-min cycling at 90% peak power with 75-s recovery (HIIE) and at 90% of the gas exchange threshold (CMIE). Absolute oxygen uptake (), percentage of maximal(%), heart rate (HR), percentage of maximal HR (%HRmax) and ratings of perceived exertion (RPE) were collected during HIIE. Enjoyment was measured using the physical activity enjoyment scale (PACES) following HIIE and CMIE. Boys elicited higher absoluteduring HIIE work (p < .01, effect size (ES) > 1.22) and recovery (p < .02, ES > 0.51) intervals but lower %during HIIE recovery intervals compared to girls (p < .01, ES > 0.67). No sex differences in HR and %HRmaxwere evident during HIIE and 48 participants attained ≥90% HRmax. Boys produced higher RPE at intervals 6 (p = .004, ES = 1.00) and 8 (p = .003, ES = 1.00) during HIIE. PACES was higher after HIIE compared with CMIE (p = .003, ES = 0.58). Items from PACES “I got something out of it”, “It’s very exciting” and “It gives me a strong feeling of success” were higher after HIIE (allp < .01, ES > 0.32). The items “I feel bored” and “It’s not at all interesting” were higher after CMIE (allp < .01, ES > 0.46). HIIE elicits a maximal cardiorespiratory response in most adolescents. Greater enjoyment after HIIE was due to elevated feelings of reward, excitement and success and may serve as a strategy to promote health in youth. [ABSTRACT FROM AUTHOR]

ABSTRACT Adolescence is a crucial period for bone development, and exercise can enhance bone acquisition during this period of life. However, it is not known how the different loading sports practiced can affect bone acquisition in adolescent male athletes. Therefore, the purpose of the present study was to determine the 1-year longitudinal bone acquisition among adolescent males involved in osteogenic (football) and non-osteogenic (swimming and cycling) sports and to compare with active controls. A total of 116 adolescent males aged 12 to 14 years at baseline were followed for 1 year: 37 swimmers, 37 footballers, 28 cyclists, and 14 active controls. Bone mineral content (BMC) was assessed using dual-energy X-ray absorptiometry (DXA); cross-sectional area (CSA), cross-sectional moment of inertia (CSMI), and section modulus (Z) at the femoral neck was assessed using hip structural analysis (HSA); and bone texture of the lumbar spine was assessed using trabecular bone score (TBS). Serum N-terminal propeptide of procollagen type I (PINP), isomer of the Carboxi-terminal telopeptide of type 1 collagen (CTX-I), total serum calcium, and 25 hydroxyvitamin D [25(OH)D] were analyzed. Footballers had significantly higher adjusted BMC at the lumbar spine (7.0%) and femoral neck (5.0%) compared with cyclists, and significantly greater BMC at the lumbar spine (6.9%) compared with swimmers. Footballers presented significantly greater TBS (4.3%) compared with swimmers, and greater CSMI (10.2%), CSA (7.1%), Z (8.9%) and TBS (4.2%) compared with cyclists. No differences were noted between cyclists and swimmers, both groups had similar bone acquisition compared with controls. PINP was significantly higher in footballers and controls compared with cyclists and swimmers (3.3% to 6.0%), and 25(OH)D was significantly higher in footballers and cyclists compared with swimmers and controls (9.9% to 13.1%). These findings suggest that bone acquisition is higher in adolescent male footballers compared with swimmers and cyclists at the femoral neck and lumbar spine sites of the skeleton. © 2017 American Society for Bone and Mineral Research. [ABSTRACT FROM AUTHOR]

Background Impairments in macrovascular, microvascular and autonomic function are present in asymptomatic youths with clustered cardiovascular disease risk factors. This study determines the within-day reliability and between-day reliability of a single protocol to non-invasively assess these outcomes in adolescents. Methods Forty 12- to 15-year-old adolescents (20 boys) visited the laboratory in a fasted state on two occasions, approximately 1 week apart. One hour after a standardized cereal breakfast, macrovascular function was determined via flow-mediated dilation ( FMD). Heart rate variability (root mean square of successive R-R intervals; RMSSD) was determined from the ECG-gated ultrasound images acquired during the FMD protocol prior to cuff occlusion. Microvascular function was simultaneously quantified as the peak ( PRH) and total ( TRH) hyperaemic response to occlusion in the cutaneous circulation of the forearm via laser Doppler imaging. To address within-day reliability, a subset of twenty adolescents (10 boys) repeated these measures 90 min afterwards on one occasion. Results The within-day typical error and between-day typical error expressed as a coefficient of variation of these outcomes are as follows: ratio-scaled FMD, 5·1% and 10·6%; allometrically scaled FMD, 4·4% and 9·4%; PRH, 11% and 13·3%; TRH, 29·9% and 23·1%; and RMSSD, 17·6% and 17·6%. The within- and between-day test-retest correlation coefficients for these outcomes were all significant ( r > 0·54 for all). Conclusion Macrovascular, microvascular and autonomic functions can be simultaneously and non-invasively determined in adolescents using a single protocol with an appropriate degree of reproducibility. Determining these outcomes may provide greater understanding of the progression of cardiovascular disease and aid early intervention. [ABSTRACT FROM AUTHOR]

Previous guidelines on consent for anaesthesia were issued by the Association of Anaesthetists of Great Britain and Ireland in 1999 and revised in 2006. The following guidelines have been produced in response to the changing ethical and legal background against which anaesthetists, and also intensivists and pain specialists, currently work, while retaining the key principles of respect for patients' autonomy and the need to provide adequate information. The main points of difference between the relevant legal frameworks in England and Wales and Scotland, Northern Ireland and the Republic of Ireland are also highlighted. [ABSTRACT FROM AUTHOR]

This study is the first to document suicidality among chronically homeless people with alcohol problems (N = 134) and examine its trajectory following exposure to immediate, permanent, low-barrier housing (i.e., Housing First). Suicidal ideation, intent, plans, and prior attempts were assessed at baseline and during a 2-year follow-up. Baseline suicidal ideation was over four times higher than in the general population. Two-year, within-subjects, longitudinal analyses indicated severity of suicidal ideation decreased by 43% from baseline to follow-up. Significant decreases were also found for intent and clinical significance of ideation. No participants died by suicide during the 2-year follow-up. [ABSTRACT FROM AUTHOR]

Cystic fibrosis ( CF) is a genetic condition affecting the respiratory and gastrointestinal systems, with patients experiencing problems maintaining weight, especially during rapid growth periods such as puberty. The aim of this case report was to monitor the effect of gastrostomy insertion and implementation of overnight supplemental feeding upon clinical outcomes, including body mass index ( BMI), lung function ( FEV1), and exercise-related variables (maximal oxygen uptake [ VO2max] and ventilatory efficiency [ VE/ VO2]) in an 11-year-old female with CF. Combined incremental and supramaximal exercise testing to exhaustion was performed at four time points: 3 months prior to the procedure (T1), 2 days prior to (T2), 4 months (T3), and 1 year following the procedure (T4). Improvements following gastrostomy insertion were observed at the 1 year follow-up with regards to BMI (+20%); whereas absolute VO2max remained stable and lung function fluctuated throughout the period of observation. Declines in function with regards to body weight relative VO2max (−16.3%) and oxygen uptake efficiency (+7.5%) were observed during this period. This case report is the first to consider exercise-related clinical outcomes in assessing the effect of implementing gastrostomy feeding in CF. The varied direction and magnitude of the associations between variables shows that further investigations are required. [ABSTRACT FROM AUTHOR]

Dasineura gannoni Kolesik sp. nov. is the first gall midge species known to feed on plants from the Hakea- Grevillea generic alliance. D. gannoni induces galls on swamp-loving Hakea microcarpa R. Br. and H. nodosa R. Br., flowering plant shrubs naturally occurring in south-east mainland Australia and Tasmania. The gall is a conspicuous red-coloured, multi-chambered, leaf swelling containing one, occasionally two, red larvae in each chamber. Pupation takes place in the soil. The new species was originally identified on H. microcarpa near Thredbo River in New South Wales. Later examination of herbarium vouchers found presence of galls of the new species on further specimens of H. microcarpa and another swamp-loving species H. nodosa. The geographical range of the new species extends over much of the combined distribution area of the two host plants on mainland Australia from far south-east Queensland through east New South Wales to Victoria and south-east South Australia. [ABSTRACT FROM AUTHOR]

Telepathology, the distant service component of digital pathology, is a growth industry. The word 'telepathology' was introduced into the English Language in 1986. Initially, two different, competing imaging modalities were used for telepathology. These were dynamic (real time) robotic telepathology and static image (store-and-forward) telepathology. In 1989, a hybrid dynamic robotic/static image telepathology system was developed in Norway. This hybrid imaging system bundled these two primary pathology imaging modalities into a single multi-modality pathology imaging system. Similar hybrid systems were subsequently developed and marketed in other countries as well. It is noteworthy that hybrid dynamic robotic/static image telepathology systems provided the infrastructure for the first truly sustainable telepathology services. Since then, impressive progress has been made in developing another telepathology technology, so-called 'virtual microscopy' telepathology (also called 'whole slide image' telepathology or ' WSI' telepathology). Over the past decade, WSI has appeared to be emerging as the preferred digital telepathology digital imaging modality. However, recently, there has been a re-emergence of interest in dynamic-robotic telepathology driven, in part, by concerns over the lack of a means for up-and-down focusing (i.e., Z-axis focusing) using early WSI processors. In 2010, the initial two U.S. patents for robotic telepathology (issued in 1993 and 1994) expired enabling many digital pathology equipment companies to incorporate dynamic-robotic telepathology modules into their WSI products for the first time. The dynamic-robotic telepathology module provided a solution to the up-and-down focusing issue. WSI and dynamic robotic telepathology are now, rapidly, being bundled into a new class of telepathology/digital pathology imaging system, the ' WSI-enhanced dynamic robotic telepathology system'. To date, six major WSI processor equipment companies have embraced the approach and developed WSI-enhanced dynamic-robotic digital telepathology systems, marketed under a variety of labels. Successful commercialization of such systems could help overcome the current resistance of some pathologists to incorporate digital pathology, and telepathology, into their routine and esoteric laboratory services. Also, WSI-enhanced dynamic robotic telepathology could be useful for providing general pathology and subspecialty pathology services to many of the world's underserved populations in the decades ahead. This could become an important enabler for the delivery of patient-centered healthcare in the future. [ABSTRACT FROM AUTHOR]

* Premise of the study: A past study based on morphological data alone showed that the means by which plants of the Australian genus Hakea reduce florivory is related to the evolution of bird pollination. For example, bird pollination was shown to have arisen only in insect-pollinated lineages that already produced greater amounts of floral cyanide, a feature that reduces florivory. We examine a central conclusion of that study, and a common assumption in the literature, that bird pollination arose in insect-pollinated lineages, rather than the reverse. * Methods: We combined morphological and DNA data to infer the phylogeny and age of the Australian genus Hakea, using 9.2 kilobases of plastid and nuclear DNA and 46 morphological characters from a taxonomically even sampling of 55 of the 149 species. * Key results : Hakea is rooted confidently in a position that has not been suggested before. The phylogeny implies that bird pollination is primitive in Hakea and that multiple shifts to insect pollination have occurred. The unexpectedly young age of Hakea (a crown age of ca. 10 Ma) makes it coincident with its primary bird pollinators (honeyeaters) throughout its history. * Conclusions: Our study demonstrates that Hakea is an exception to the more commonly described shift from insect to bird pollination. However, we note that only one previous phylogenetic study involved Australian plants and their honeyeater pollinators and that our finding might prove to be more common on that continent. [ABSTRACT FROM AUTHOR]

Temporal order memory (memory for stimulus order) is crucial for discrimination between familiar objects and depends upon a neural circuit involving the perirhinal cortex (PRH) and medial pre-frontal cortex. This study examined the role of glutamatergic and cholinergic neurotransmission in the encoding or retrieval of temporal order memory, using a task requiring the animals to discriminate between two familiar objects presented at different intervals. 6-Cyano-7-nitroquinoxaline (CNQX) (AMPA/kainate receptor antagonist), scopolamine (muscarinic receptor antagonist) or 2-amino-5-phosphonopentanoic acid (AP5) ( N-methyl-D-aspartate receptor antagonist) was administered before sample phase 2 (to be active during encoding) or before test (to be active during retrieval). Unilateral CNQX administration into the PRH and pre-limbic/infra-limbic cortices (PL/IL) in opposite hemispheres, i.e. to disrupt neurotransmission within the circuit, impaired encoding and retrieval. Administration of scopolamine or AP5 in the PRH-PL/IL circuit impaired encoding. Drug effects in each brain region were then investigated separately. Intra-PRH CNQX, scopolamine or AP5 disrupted encoding, such that the animals explored the recent object significantly more than the old object. In contrast, intra-PL/IL CNQX, scopolamine or AP5 impaired memory performance such that the animals spent an equal amount of time exploring the objects. CNQX but not AP5 or scopolamine impaired retrieval. Furthermore, CNQX impaired novel object preference when infused into the PRH but not PL/IL following a 3 h delay. Thus, encoding of temporal order memory is mediated by plastic processes involving N-methyl-D-aspartate and muscarinic receptors within the PRH-PL/IL circuit, but these two regions make qualitatively different cognitive contributions to the formation of this memory process. [ABSTRACT FROM AUTHOR]

While it is well established that CD8 [ABSTRACT FROM AUTHOR]

The aim of this investigation was to examine the adaptation of the muscle phosphates (e.g. phosphocreatine (PCr) and ADP) implicated in regulating oxidative phosphorylation, and oxygenation at the onset of high intensity exercise in children and adults. The hypotheses were threefold: primary PCr kinetics would be faster in children than adults; the amplitude of the PCr slow component would be attenuated in children; and the amplitude of the deoxyhaemoglobin/myoglobin (HHb) slow component would be reduced in children. Eleven children (5 girls, 6 boys, 13 ± 1 years) and 11 adults (5 women, 6 men, 24 ± 4 years) completed two to four constant work rate exercise tests within a 1.5 T MR scanner. Quadriceps muscle energetics during high intensity exercise were monitored using 31P-MRS. Muscle oxygenation was monitored using near-infrared spectroscopy. The time constant for the PCr response was not significantly different in boys (31 ± 10 s), girls (31 ± 10 s), men (44 ± 20 s) or women (29 ± 14 s, main effects: age, p = 0.37, sex, p = 0.25). The amplitude of the PCr slow component relative to end-exercise PCr was not significantly different between children (23 ± 23%) and adults (17 ± 13%, p = 0.47). End-exercise [PCr] was significantly lower, and [ADP] higher, in females (18 ± 4 mM and 53 ± 16 µM) than males (23 ± 4 mM, p = 0.02 and 37 ± 11 µM, p = 0.02), but did not differ with age ([PCr]: p = 0.96, [ADP]: p = 0.72). The mean response time for muscle tissue deoxygenation was significantly faster in children (22 ± 4 s) than adults (27 ± 7 s, p = 0.01). The results of this study show that the control of oxidative metabolism at the onset of high intensity exercise is adult-like in 13-year-old children, but that matching of oxygen delivery to extraction is more precise in adults. Copyright © 2010 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The Mental Health Surveillance Study (MHSS) is an ongoing initiative by the Substance Abuse and Mental Health Services Administration (SAMHSA) to monitor the prevalence of serious mental illness (SMI) among adults in the USA. In 2008, the MHSS used data from clinical interviews to calibrate mental health data from the National Survey on Drug Use and Health (NSDUH) for estimating the prevalence of SMI based on the full NSDUH sample. The clinical interview used was the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM-IV; SCID). NSDUH interviews were administered via audio computer-assisted self-interviewing (ACASI) to a nationally representative sample of the population aged 12 years or older. A total of 46 180 NSDUH interviews were completed with adults aged 18 years or older in 2008. The SCID was administered by mental health clinicians to a sub-sample of 1506 adults via telephone. This paper describes the MHSS calibration study procedures, including information on sample selection, instrumentation, follow-up, data quality protocols, and management of distressed respondents. Copyright © 2010 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The Mental Health Surveillance Study (MHSS) is an ongoing initiative by the Substance Abuse and Mental Health Services Administration to develop and implement methods for measuring the prevalence of serious mental illness (SMI) among adults in the USA. The 2008 MHSS used data from clinical interviews administered to a sub-sample of respondents to calibrate mental health screening scale data from the National Survey on Drug Use and Health (NSDUH) for estimating the prevalence of SMI in the full NSDUH sample. The mental health scales included the K6 screening scale of psychological distress (administered to all respondents) along with two measures of functional impairment (each administered to a random half-sample of respondents): the World Health Organization Disability Assessment Schedule (WHODAS) and the Sheehan Disability Scale (SDS). The Structured Clinical Interview for DSM-IV (SCID) was administered to a sub-sample of 1506 adult NSDUH respondents within 4 weeks of completing the NSDUH interview. Results indicate that while SMI prediction accuracy of the K6 is improved by adding either the WHODAS or the SDS to the prediction equation, the models with the WHODAS are more robust. The results of the calibration study and methods used to derive prevalence estimates of SMI are presented. Copyright © 2010 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]