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This study examines ten years of financial and production data of 249 farm businesses operating in southwestern Australia. It also identifies the behavioural characteristics of the farm operators through a comprehensive socio-managerial survey of each farm business. The study area has a Mediterranean climate, where three quarters of the rainfall is received during the growing season from April and October. Growers have learned to produce 2 tonnes per hectare of wheat on less than 200 ml of growing season rainfall. Australia is the driest continent in the world and is renowned for its climate variability. In addition, evidence is emerging that its southern parts, like south-western Australia, are experiencing a warming, drying trend in their climate. Average annual rainfall over the last thirty years in the study area has declined and average minimum and maximum temperatures have risen. Moreover, in the last ten years a number of droughts have occurred. This multidisciplinary study examines the business performance of 249 farms from 2002 to 2011 and identifies the strategies farm managers have adopted to adapt to a drying, warming environment. Farms are categorised according to their performance. Their characteristics are compared and contrasted. We find many significant differences between farm performance categories and the adaptation strategies used by the farmers in each category. There are also different socio-managerial and behavioural characteristics between the groups of farmers identified.

This report describes the demonstration of technologies and procedures developed during April 2002 and May 2004 under the Joint Rapid Airfield Construction (JRAC) Program. The demonstration took place at Sicily Landing Zone (LZ) at Fort Bragg, NC, in July of 2004. The objective of the exercise was to demonstrate the procedures and technologies developed under the JRAC Program by rapidly building two parking aprons capable of supporting C-130 transport aircraft taxiing and parking operations. The exercise was conducted under continuous 24-hr operations to simulate a real-world rapid construction environment. Apron 1 (north apron) was constructed using two technologies, one-half being ACE™ Matting and the other half being a cement-polymer stabilized soil surface. Apron 2 (south apron) was constructed solely of a fiber-cement-stabilized soil system. Both aprons were treated with a polymer emulsion surface application to form a sealed surface against abrasion and water infiltration. The entire construction of both aprons required 76 hr, with Apron 1 finished in 48 hr. The construction of Apron 1 was validated by operation of a C-130 aircraft approximately 31 hr after completion with success and high praises from the aircraft flight crew on the stability and surface of the apron, as well as its dust-abating characteristics.

Introduction: Identifying biomarkers of breast cancer risk among young women would have value in developing effective screening and prevention strategies at early ages. We have proposed that DNA methylation analysis of breast milk may provide breast cancer risk information among young women, and could possibly provide etiologic clues related to the higher rates of early onset cancers among African American as compared with White women in the US. Objective: The purpose of this project was to identify associations between genome-wide DNA methylation levels in breast milk and race adjusted for other breast cancer risk factors. Study Population: Cancer-free, lactating U.S. Black (n=57) and White (n=82) women, ages 19 to 44, provided frozen breast milk samples, as well as demographic, behavioral, and reproductive data, to the Breastmilk Laboratory at University of Massachusetts Amherst. Women were uniparous and did not have a personal history of breast cancer at the time of milk donation. Methods: DNA was extracted from breast milk samples using the phenol-chloroform method. Genome-wide methylation analysis was performed on breast milk samples using the Infinium HumanMethylation450 BeadChip. Probes with 50% or more missing data, cross-reactive probes, as well as probes with minor allelic frequency greater than 0.05 in European- or African-Americans were removed, leaving 379,042 CpG sites for analysis. Multivariate generalized linear regression models were used to examine associations between race and other breast cancer risk factors and methylation beta values, adjusting for potential confounding factors. P-values less than 1E-7 were considered statistically significant. Results: Black women in this study were more likely to be never smokers, to not have used over-the-counter pain medication in the past week, and to breastfeed longer. After adjustment by age, BMI, smoking status, and batch number, race was significantly associated with differential methylation at 1143 CpG sites, including 1024 at which Black women demonstrated increased methylation levels. Additionally, breastfeeding duration was associated with 269 CpG sites, with 268 showing a significant inverse relationship with methylation. Methylation sites significantly associated with Black race and lactation duration were located within tumor suppressor and promoter genes as well as in genes implicated in obesity and diabetes. Conclusion: This preliminarily analysis of DNA methylation in breast milk suggests that Black women have increased methylation and longer breastfeeding is associated with reduced methylation. Further research to understand how etiologic factors related to breast cancer may alter DNA methylation patterns in normal breast may lead to improved understanding of breast cancer risk at a young age and potentially causes of racial disparities in breast cancer incidence between White and Black women. Citation Format: Davis Lynn BC, Bodelon C, Pfeiffer RM, Yang HP, Yang H, Lee M, Laird PW, Campan M, Weisenberger DJ, Murphy J, Sherman ME, Browne EP, Anderton DL, Arcaro KF, Gierach GL. Differences in genome-wide DNA methylation levels in breast milk by race and lactation duration [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P6-10-07.

BackgroundPrior candidate gene studies have shown tumor suppressor DNA methylation in breast milk related with history of breast biopsy, an established risk factor for breast cancer. To further establish the utility of breast milk as a tissue-specific biospecimen for investigations of breast carcinogenesis we measured genome-wide DNA methylation in breast milk from women with and without a diagnosis of breast cancer in two independent cohorts.MethodsDNA methylation was assessed using Illumina HumanMethylation450k in 87 breast milk samples. After quality control, 368,171 autosomal CpG loci were analyzed. Cell type proportion estimates from RefFreeCellMix were calculated and adjusted for in this Epigenome Wide Association Study using linear mixed effects models adjusted for history of breast biopsy, age, time of delivery, cell type proportion estimates, array chip, and subject as random effect.ResultsEpigenome-wide analyses identified 58 differentially methylated CpG sites associated with a breast cancer diagnosis in the prospectively collected milk samples from the breast that would develop cancer compared with women without a diagnosis of breast cancer (q-value < 0.05). Nearly all CpG sites associated with a breast cancer diagnosis were hypomethylated in cases compared with controls, and were enriched for CpG islands. In addition, inferred repeat element methylation was lower in breast milk DNA from cases compared to controls, and cases exhibited increased estimated epigenetic mitotic tick rate as well as DNA methylation age compared with controls.ConclusionBreast milk has utility as a biospecimen for prospective assessment of disease risk, for understanding the underlying molecular basis of breast cancer risk factors, and improving primary and secondary prevention of breast cancer.

BACKGROUND: Analysis of cytokines and growth factors in human milk offers a noninvasive approach for studying the microenvironment of the postpartum breast, which may better reflect tissue levels than testing blood samples. Given that Black women have a higher incidence of early onset breast cancers than White women, we hypothesized that milk of the former contains higher levels of pro-inflammatory cytokines, adipokines, and growth factors. METHODS: Participants included 130 Black and 162 White women without a history of a breast biopsy who completed a health assessment questionnaire and donated milk for research. Concentrations of 15 analytes in milk were examined using two multiplex and 4 single-analyte electrochemiluminescent sandwich assays to measure pro-inflammatory cytokines, angiogenesis factors, and adipokines. Mixed-effects ordinal logistic regression was used to identify determinants of analyte levels and to compare results by race, with adjustment for confounders. Factor analysis was used to examine covariation among analytes. RESULTS: Thirteen of 15 analytes were detected in ≥25% of the human milk specimens. In multivariable models, elevated BMI was significantly associated with increased concentrations of 5 cytokines: IL-1β, bFGF, FASL, EGF, and leptin (all p-trend < 0.05). Black women had significantly higher levels of leptin and IL-1β, controlling for BMI. Factor analysis of analyte levels identified two factors related to inflammation and growth factor pathways CONCLUSION: This exploratory study demonstrated the feasibility of measuring pro-inflammatory cytokines, adipokines and angiogenesis factors in human milk, and revealed higher levels of some pro-inflammatory factors, as well as increased leptin levels, among Black as compared with White women.

This paper examines the mechanical response of precast panel pavement repair joints under static aircraft loadings using the finite-element method. Three-dimensional finite-element models were developed using the Abaqus software code, and their results were compared to and validated against results of full-scale field tests and theoretical calculations. Unlike previous pavement repair modelling efforts for precast panels and dowel retrofitting studies, all parts of the repair joint were modelled, including the dowels, dowel slot material, parent concrete, precast panel and pavement sublayers. Results show that high stress concentrations occur in the dowel slot material and that the current panel design is likely to be improved by modifying the dowel diameter.

This article explores the social interactions of immigration, occupation, and wealth in two urban industrial cities of nineteenth-century New England that were largely built upon, and shaped by, immigration: the very rapidly growing factory town of Holyoke, Massachusetts, and a more mixed-market and steadily growing nearby community of Northampton, Massachusetts. Both communities were emergent, rapidly industrializing, inland cities, providing a quite distinct immigration context than large established cities of the East Coast. Both were destinations for the same general ethnic immigration waves over the late nineteenth century, but with very different, and differently impacted, social spaces into which immigrants arrived. Contrasting and considering both these emergent cities allows us to ascertain the extent to which the occupational distribution and accumulation of wealth by immigrant groups supports the broad pattern of nineteenth-century assimilation, and reveals ways in which other migration processes may have been at odds, or intertwined, with the long-term historical assimilation of immigrants in such communities. Our findings support a traditional assimilationist perspective in emergent urban-industrial centers. However, they also reveal the role of universal immiseration in an industrial city dual-labor market in facilitating or forcing assimilation, the temporal advantages for ethnic groups of arriving early in growing settlements, and the more individualistic nature of economic enclaves in gaining advantages over time that did not manifest across broad immigrant or occupational groups.

TGF-β plays a dual role in breast carcinogenesis, acting at early stages as tumor-suppressors and later as tumor-promoters. TGF-β isoforms are expressed in breast tissues and secreted in milk, suggesting that analysis of levels in milk might be informative for breast cancer risk. Accordingly, we assessed TGF-β2 levels in milk from women who had undergone a breast biopsy and related the concentrations to diagnosis. Milk donated by women who had undergone or were scheduled for a breast biopsy was shipped on ice for processing and testing. Breast cancer risk factors were obtained through a self-administered questionnaire, and biopsy diagnoses were extracted from pathology reports. TGF-β2 levels in milk, assessed as absolute levels and in relation to total protein, were analyzed in bilateral samples donated by 182 women. Linear regression was used to estimate relationships of log-transformed TGF-β2 levels and TGF-β2/ total protein ratios to biopsy category. Milk TGF-β2 levels from biopsied and non-biopsied breasts within women were highly correlated (r 2 = 0.77). Higher mean TGF-β2 milk levels (based on average of bilateral samples) were marginally associated with more severe breast pathological diagnosis, after adjusting for duration of nursing current child (adjusted p trend = 0.07). Our exploratory analysis suggests a borderline significant association between higher mean TGF-β2 levels in breast milk and more severe pathologic diagnoses. Further analysis of TGF-β signaling in milk may increase understanding of postpartum remodeling and advance efforts to analyze milk as a means of assessing risk of breast pathology.

Background Diets rich in fruits and vegetables (F/V) can reduce the inflammatory profile of circulating cytokines and potentially decrease the risk of breast cancer. However, the extent to which a diet rich in F/V alters cytokine levels in breast tissue remains largely unknown. Breast milk provides a means of assessing concentrations of secreted cytokines in the breast microenvironment and is a potential tool for studying the effects of diet on inflammation in breast tissue and breast cancer risk. Objective The aim of this pilot randomized trial was to test the feasibility of increasing F/V intake in breastfeeding women and of measuring changes in markers of inflammation in breast milk. Design and intervention Participants randomized to the intervention (n=5) were provided weekly boxes of F/V, along with dietary counseling, to increase consumption of F/V to 8 to 10 daily servings for 12 consecutive weeks. Controls (n=5) were directed to the US Department of Agriculture’s “ChooseMyPlate” diet for pregnancy and breastfeeding. Participants/setting Ten breastfeeding women consuming fewer than five servings of F/V per day, as estimated by the National Institutes of Health “All-Day” Fruit and Vegetable Screener (F/V Screener), were recruited through flyers and a lactation consultant between February and May 2016 in the Western Massachusetts area. Main outcome measures Baseline demographic and F/V intake data were collected during enrollment. At week 1 and week 13 (final) home visits, participants provided milk samples and anthropometric measurements were recorded. Participants completed F/V screeners at baseline and at study end. Adiponectin, leptin, C-reactive protein, and 11 additional cytokines were measured in breast milk collected at weeks 1 and 13. Statistical analyses F/V consumption at baseline and after the final visit, and between controls and intervention groups, was compared with dependent and independent t tests, respectively. Differences between cytokine levels at weeks 1 and 13 were assessed with a mixed-effects repeated-measures model. Results All women in the intervention increased F/V intake and were consuming more servings than controls by week 13; daily serving of F/V at baseline and final visit: controls=1.6 and 2.0, diet=2.6 and 9.9. Most cytokines were detected in the majority of milk samples: 12 were detected in 90% to 100% of samples, one was detected in 75% of samples, and one was detected in 7.5% of samples; coefficients of variation were below 14% for 11 of the cytokines. Conclusions These preliminary findings indicate that it is feasible to significantly increase F/V intake in breastfeeding women and provide support for conducting a larger diet intervention study in breastfeeding women, in which longer-term benefits of the intervention are assessed.

Matting systems are used for temporary applications on soft soils to reduce ground pressure exerted by aircraft, heavy equipment, vehicles, and construction material. They have been used for military airfields, construction platforms, and similar applications. Previous evaluation studies of matting systems have typically consisted of full-scale testing, with only a limited amount of numerical modeling found in the literature. This paper presents results of full-scale accelerated testing of 21 test sections encompassing five matting systems, five soil-support conditions, and two aircraft loadings. One of the soil-support conditions was instrumented and tested in conjunction with three matting systems and one aircraft loading. Three-dimensional finite-element modeling was performed on the instrumented sections using the measured test data for calibration. Good matches of measured soil stresses were obtained with the model for two of the mats, whereas the model underpredicted stresses in the third mat. Modeling of the type performed in this paper was capable of correctly ranking the performance of the matting systems modeled relative to the full-scale test results.

Background: Breast cancer risk increases during pregnancy and remains elevated for a number of years thereafter. Cancer-associated proteins that are secreted into breast milk may provide a means to detect cancer in the lactating breast or to assess future breast cancer risk. Objective: To determine whether proteins linked to breast cancer would be differentially expressed in matched (both breasts from each participant) human milk samples collected from women with unilateral breast cancer. Methods: Five cancer-associated proteins (basic fibroblast growth factor [bFGF], YKL-40, neutrophil gelatinase-associated lipocalin, and transforming growth factor β1 and β2) were analyzed in milk provided by 5 lactating women, 4 of whom were known to have cancer in 1 breast (and the opposite breast clinically disease free) at the time of milk collection and 1 who developed breast cancer 2 years after milk collection. Results: Expression was significantly higher for TGFβ2 ( P = .03) and bFGF ( P =.03) in the breasts with cancer. Conclusion: These proteins may play a role in assessing a woman’s risk of pregnancy-associated breast cancer. Because of variable protein concentration among patients and the limited sample size, the results are considered preliminary.

The focus of this work was to evaluate the use of commercially available matting systems to sustain C-130 and C-17 transport aircraft loads over soil bases having different California bearing ratio (CBR) ranges. Test sections were constructed using three range of CBR: high (CBR=40–50), medium (CBR=8–10), and low (CBR=5–6). Testing began with the C-130 load cart and six different matting systems. The C-130 was the lesser of the two aircraft loads examined and this initial testing was used as an "elimination round" for the various matting systems chosen. Matting systems deemed suitable for the C-130 were further tested under the C-17 load cart. Systems were evaluated based on logistical and assembly requirements, mat damage sustained during traffic, and accumulated deformation of the mats and soil during traffic. The latter are shown in line plots of passes versus plastic rut formation. Summary information on each matting system tested and the test sections themselves is presented. Conclusions on the matting systems tested and their application are discussed.

Purpose Poor living conditions are posited as an underlying cause of American Indian (AI) infant mortality, which is unusually high in the postneonatal period. We explore whether the effects of neighborhood poverty on AI infant death are identifiable by using observational data. Methods Vital records for infants born between 1990 and 1999 to AI women in a metropolitan area (n = 4751) are linked with tract-level poverty data. A counterfactual framework, an explicit causal contrast study design, and propensity score matching methods were used. For each comparison, we created exchangeable groups by matching infants with the same probability of exposure to poverty when one was exposed and the other was not. Results Our results suggest that neighborhood poverty has little effect on AI infant death outcomes. Importantly, the study design makes transparent the challenge of identifying appropriate analytic comparison groups in studies of neighborhood poverty and health. Conclusions Collecting additional data will likely not overcome the fact that AIs with a high probability of living in poverty rarely reside in low-poverty neighborhoods. Yet, some of them must if a meaningful counterfactual comparison is to be made and the effects of neighborhood poverty on AI infant death are to be identified.

In this study, we investigate the extent to which women and men differ in patterns of medication use, based on quantitative and qualitative data from a household survey in Western Massachusetts. Using a broad definition of medications, 96% of the sample reported taking one or more medications in the month preceding the survey (86% if vitamins, supplements, and alternative medications are excluded). Twenty-one percent of respondents reported taking five or more medications, and women were significantly more likely to report taking five or more medications in the month preceding the survey. For both sexes, analgesics and vitamins were the most commonly used medications, but women were more likely to report having taken hormones, supplements, and antihistamines. The likelihood of medicating reported health conditions did not differ by sex, but the frequency of reporting health conditions was higher among women, and the difference was significant for body aches and psychosomatic conditions. Analyses of qualitative data indicate that female networks of relatives and friends are an important source of advice on medications for both men and women. Responses to open-ended questions suggest that women's discourse about the effect of medications differs from men's in terms of the range and detail of descriptions of symptoms and side effects.

Historical mortality analysis is often confounded by changing disease environments, diagnostic criteria, and terminology. Recorded causes of death are shaped by these local and historical contexts. We analyze changing literal causes of death during the shift from miasmatic to germ theories of disease using death records from two Massachusetts towns for selected years spanning 1850 to 1912. This analysis demonstrates that (1) International Classification of Diseases (ICD) classifications are more stable, yet potentially less informative, than the literal causes recorded in death accounts, (2) recorded causes of death often include additional qualifications and elaborations beyond basic literal causes of death, and the use of such qualifiers rose dramatically during the late nineteenth century, (3) social biases are clearly evident in the extent to which causes of death were further described or qualified, and (4) the additional descriptive qualification of deaths during this period of often ambiguous historical causes of death can potentially aid in efforts to classify causes of death and derive robust estimates of cause-specific mortality trends.

Prior candidate gene studies have shown that methylation-induced silencing of tumor suppressor genes in breast milk is related with history of breast biopsy, an established risk factor for breast cancer. To further establish the utility of breast milk as a tissue-specific biospecimen for investigations of breast carcinogenesis we measured genome-wide DNA methylation in breast milk from women with and without a diagnosis of breast cancer. Breast milk provides a source of cells without invasive procedure that is available during a window of increased breast cancer risk. Actively lactating women were enrolled and consented through the University of Massachusetts Amherst breast milk study targeting high risk subjects. Participants completed a questionnaire to provide demographic and breast cancer risk factor data. Genome-wide DNA methylation levels were quantified using the Illumina 450K HumanMethylation array. Data was processed in R using RnBeads. Beta-values were normalized (FUNnorm), low quality probes were filtered and transformed to M-values. Linear mixed effects models were fit including a random effect for subject and adjusted for history of breast biopsy, age, body mass index, age of the baby, and estimated cell type proportions, an interaction term for time of diagnosis was included. DNA methylation in women with breast cancer (n=9), was compared with women without a history of breast cancer (n=22). Among women with a diagnosis of breast cancer there were two groups: those diagnosed within one year of donating breast milk, and those diagnosed more than one year before sample collection. Four women in the control and five women in the cancer group provided bilateral breast milk samples at recruitment and both samples were included in the analyses. CpGs with significant differential methylation were tested for enrichment in gene pathways using the KEGG database. We identified 215 differentially methylated CpG sites in women diagnosed within one year of sample donation compared with women without a diagnosis of breast cancer (Q Citation Format: Lucas A. Salas, Sara N. Lundgren, Eva P. Browne, Elizabeth C. Punska, Douglas L. Anderton, Kathleen F. Arcaro, Brock C. Christensen. Altered DNA methylation in breast milk from women with breast cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 4355. doi:10.1158/1538-7445.AM2017-4355

A finite-element analysis was conducted of flexible pavement test sections subjected to a moving aircraft tire. The test sections failed primarily as a result of shear in the base course. Excavation of the test sections at the end of the tests revealed that there was transverse shear flow of the base as a result of repetitive loading. Deflections at various depths were recorded with multidepth deflectometers. These deflections were used to calibrate the finite-element model. Subsequently, excellent agreement was obtained between measured and predicted time histories of deflections at the various depths. Also, excellent agreement was obtained between predicted and accumulated rutting. The analysis predicted that the shear stress in the base would equal the shear strength, which confirms the mode of failure observed in the test sections.

Erythropoietin enhances vascular responsiveness to norepinephrine in renal failure. The mechanism of hypertension induced by recombinant human erythropoietin (rHuEPO) is unclear but may include an increase in peripheral vascular resistance. We studied changes of arterial pressure and plasma endothelin in nine consecutive hemodialysis patients before, and 6 and 12 weeks after, starting rHuEPO. In six patients, changes in cardiac index (CI), stroke index (SI) and total peripheral resistance index (TPRI) were measured by bioimpedance, and forearm vascular responsiveness to intra-arterial norepinephrine (30 to 240 pmol/min) and endothelin-1 (5 pmol/min) were assessed. Six healthy age and sex matched subjects also underwent assessment of forearm vascular responsiveness to norepinephrine and endothelin-1. Treatment with rHuEPO significantly increased hemoglobin and mean arterial pressure (MAP). TPRI also increased by 35 ± 11%. Plasma endothelin, although elevated basally, remained unchanged. Intra-arterial infusion of norepinephrine caused a maximal increase in forearm vascular resistance (FVR) of 17 ± 9% before rHuEPO, significantly less than the 32 ± 5% increase in healthy control subjects (P = 0.04). The response increased to 65 ± 15% (P = 0.03) after 12 weeks rHuEPO treatment (P = 0.51 vs. controls). Endothelin-1 caused a maximal increase of FVR at 60 minutes of 45 ± 24% before rHuEPO, which was not significantly different from controls, and tended to decrease with rHuEPO therapy. The response to endothelin-1, but not norepinephrine, correlated inversely with MAP (r = -0.52; P = 0.03) and TPRI (r = -0.51; P = 0.04). In conclusion, these studies show that anemia in chronic renal failure is associated with depressed vascular responsiveness to norepinephrine which is restored by rHuEPO therapy. In contrast, vascular responses to endothelin-1 tend to reduce with rHuEPO therapy. The change in vascular responsiveness to norepinephrine may contribute to the increase in arterial pressure associated with rHuEPO therapy.

Background Paralemmin-1 is a phosphoprotein lipid-anchored to the cytoplasmic face of membranes where it functions in membrane dynamics, maintenance of cell shape, and process formation. Expression of paralemmin-1 and its major splice variant (Δ exon 8) as well as the extent of posttranslational modifications are tissue- and development-specific. Paralemmin-1 expression in normal breast and breast cancer tissue has not been described previously. Results Paralemmin-1 mRNA and protein expression was evaluated in ten breast cell lines, 26 primary tumors, and 10 reduction mammoplasty (RM) tissues using real time RT-PCR. Paralemmin-1 splice variants were assessed in tumor and RM tissues using a series of primers and RT-PCR. Paralemmin-1 protein expression was examined in cell lines using Western Blots and in 31 ductal carcinomas in situ, 65 infiltrating ductal carcinomas, and 40 RM tissues using immunohistochemistry. Paralemmin-1 mRNA levels were higher in breast cancers than in RM tissue and estrogen receptor (ER)-positive tumors had higher transcript levels than ER-negative tumors. The Δ exon 8 splice variant was detected more frequently in tumor than in RM tissues. Protein expression was consistent with mRNA results showing higher paralemmin-1 expression in ER-positive tumors. Conclusions The differential expression of paralemmin-1 in a subset of breast cancers suggests the existence of variation in membrane dynamics that may be exploited to improve diagnosis or provide a therapeutic target.

To investigate the trunk strength of elite rowers and the impact of low back pain on these measures in order to determine if asymmetries or weakness were present.Twenty two elite rowers were recruited: 13 reported previous low back pain, five current low back pain, and the remainder had no history of low back pain. All subjects were scanned during simulated rowing in an interventional open magnetic resonance imaging scanner. In each simulated rowing position, axial scans were obtained at the level of the L4-5 and L5-S1 disc interspace to determine the cross sectional area of the posterior trunk muscles.Considerable differences were observed between the three groups of rowers. In contrast with expectations and previous literature, the trunk muscles of rowers with low back pain had significantly larger cross sectional areas (p0.001). No left/right asymmetries were observed and no differences between oarside and non-oarside in terms of muscle cross sectional area.These findings suggest that low back pain in rowers does not arise as a result of muscle weakness.

Many local agencies that provide services to the homeless have only limited data and resources to estimate the extent of need or the size of the local population at risk of requiring the services they provide. Methods exist, however, that are capable of providing reasonable estimates of underlying service populations with minimal record keeping. In this paper one group of such models, first‐capture models, is discussed as a resource‐efficient technique for estimating the underlying population consistently at risk ("residents") and those occasionally at risk ("transients") of requiring agency services.

Nearly all developed countries have experienced dramatic declines in the seasonality of demographic behavior over the last century. This article examines seasonal behavior in the population of Taiwan between 1906 and 1942, during Japanese colonial rule. First, we analyze seasonal demographic cycles and their ties to the cultural calendar and agriculture. Second, we compare seasonality in two regions (Xinzhu and Tainan) that experienced different agricultural development under the colonial regime. Findings demonstrate that demographic seasonality was less pronounced when urban development and colonial agricultural intensification produced more heterogeneous seasonal patterns of labor. We find that changes in agricultural organization, rather than purely a shift to nonagricultural production, may significantly reduce established seasonal timing of demographic behavior.

The U.S. military must have the ability to rapidly deploy troops and equipment anywhere in the world as part of a contingency operation. Recent military operations have highlighted the critical need for rapid repair procedures and materials for military use on substandard, in-theater airfields. The U.S. Army Engineer Research and Development Center is currently addressing these problems through a 6-year demonstration-based research and development program called JRAC (Joint Rapid Airfield Construction). This study involves the development of a method using rapid setting grouts and recycled concrete pavement (RCP) to repair portland cement concrete pavements. A laboratory study was conducted to evaluate material properties in order to gain an understanding of expected field performance. Eight full scale repairs were constructed using two rapid setting grouts, two types of equipment, and two concrete slabs. The repairs were successfully trafficked with simulated C-17 aircraft wheel loads to verify the structural capacity and, ultimately, the procedures.

This paper describes how the U.S. Army Engineer Research and Development Center (ERDC) initiated a new military research effort in 2001 known as the Joint Rapid Airfield Construction (JRAC) program. The JRAC program involves over twenty principal researchers from three ERDC laboratories, over thirty integrated research projects, scheduled research funds in excess of 20 million dollars, and two major field demonstrations during the seven-year research plan. The primary objective of this research program is to develop methodologies and materials for rapidly upgrading existing or constructing new contingency airfields with the lowest logistical footprint possible. The JRAC program is designed to meet this objective by; (1) integrating advanced terrain analysis technologies and performance prediction modeling to optimize contingency airfield site selection; (2) utilizing emerging commercial soil stabilization technologies to rapidly provide contingency airfield surfaces capable of sustaining mission operations; and (3) exploiting new construction technologies to enhance airfield construction productivity. It provides summaries of the background, current research efforts, and projected goals of the JRAC program. Discussions of "spin-off' technologies useful to civil airports and other construction industries are also presented. Since the JRAC program seeks to exploit new and emerging technologies within the private sector, it is hoped that this paper will generate critical exchanges of information and perhaps foster important industry and government partnerships in the near future.

Using a national survey of facilities governed by the Resource Conservation and Recovery Act (RCRA), we examine the sociospatial distribution of a much larger group of hazardous materials handlers than did previous environmental equity studies. Overall we find that RCRA-governed facilities are more likely to be sited in working-class neighborhoods with lower percentages of minority residents. We do not find evidence of stark environmental inequities. RCRA facilities, however, are close to neighborhoods with a higher percentage of minority residents. And in nonmetropolitan areas, they are slightly more likely to be located in neighborhoods with a higher percentage of black residents.

Data on the prevalence, magnitude and causes of blindness and severe visual impairment in children are needed for planning and evaluating preventive and curative services for children, and for planning special education and low vision services. Prevalence data can be obtained from a variety of different sources, each of which has limitations. The available data suggest that there may be a ten-fold difference in prevalence between the wealthiest countries of the world and the poorest, ranging from as low as 0.1/1000 children aged 0-15 years in the wealthiest countries to 1.1/1000 children in the poorest. In this paper, the available data are reviewed and the epidemiological methods and findings are discussed.

This article presents findtngs of the first national tract-level analysis of the distribution of residential characteristics, including the percentage of selected minorities and socioeconomically disadvan taged groups, in relation to uncontrolled toxic waste sites (i. e., CERCLIS and NPL sites). In contrast to prevailing notions, the authors find that uncontrolled toxic waste sites are not disproportionately located in minority neighborhoods or neighborhoods of soctoeconomtcally disadvantaged residents. However, multivariate analyses of site distribution and a hazard regression analysis of the site prioritization process suggest that communities with a higher percentage of Black residents are less likely to receive NPL (National Priorities List) designation, delaying potential remediation. Biases in the prioritization process are, however, substantively small.

Background: TGF-β isoforms play a dual role in breast carcinogenesis, acting at early stages as tumor-suppressors and later as tumor-promoters. TGF-β isoforms are expressed in breast tissues and secreted in milk, suggesting that analysis of levels in milk might have value for understanding the effect of pregnancy and lactation on breast carcinogenesis. Data suggest that TGF-β2 levels in milk are higher than TGF-β1, show heterogeneity among women, and may vary with psychosocial stress, maternal immunity, and length of nursing. We assessed whether TGF-β2 levels in milk from each breast were correlated with a history of prior breast biopsy (biopsied vs. not biopsied) and biopsy diagnosis. Methods: Fresh breast milk donated by lactating women who had either undergone or were scheduled for a breast biopsy was shipped on ice to a central laboratory. Breast cancer risk factors were obtained via questionnaire and biopsy diagnoses were extracted from pathology reports. Milk was processed to create cellular-enriched and cellular-depleted fractions and frozen at -20[≤]C prior to testing. TGF-β2 levels in milk were analyzed using the Quantikine Human TGF-β2 Immunoassay (R&D Systems DB250) and quantified using the Coomassie Plus (Bradford) Assay (Thermo Scientific) kits in bilateral samples donated by182 women, including duplicate samples from 1 woman (n= 366). We compared log transformed TGF-β2 (pg/ml) and TGF-β2/total protein ratio (pg/μg) levels for biopsied and non-biopsied breasts using t-tests and ordinary least squares regressions adjusted for confounders and clustering of observations by woman. Results: TGF-β2 levels ranged 0 - 68,070 pg/ml and total protein levels ranged 1,558- 36,198 μg/ml. The levels of TGF-β2 in the biopsied and non-biopsied breasts were correlated (r2 = 0.64), albeit not statistically significant. Controlling for mother's attained age, age at first birth, age of baby (surrogate for length of nursing), number of live births, time since breast biopsy, and race, did not alter the finding for TGF-β2 or the TGF-β2/total protein ratio. But, mean levels of TGF-β2 proteins were highest in milk among women with cancer (9971 pg/ml, n=16), followed by proliferative lesions with atypia (8842 pg/ml; n=4) biopsy diagnoses. TGF-β2 levels were lower among women with non-proliferative biopsy diagnoses (4131 pg/ml; n=292) as compared with those who had proliferative lesions with atypia or cancer (P Conclusion: More severe pathologic diagnoses were associated with higher mean TGF-β2 levels in breast milk, although levels of biopsied and non-biopsied breasts were correlated. These data suggest that higher TGF-β2 levels in milk are linked to higher breast cancer risk for a woman, but do not specifically indicate which breast is at risk. Citation Format: Hannah P. Yang, Mark E. Sherman, Sallie Smith Schneider, Christina M. Chisholm, Eva P. Browne, Sidra Mahmood, Sarah Lenington, Douglas L. Anderton, Kathleen A. Arcaro. Association of TGF-β2 levels in breast milk with breast biopsy diagnosis. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 117. doi:10.1158/1538-7445.AM2013-117

Effective renal plasma flow (ERPF) and glomerular filtration rate (GFR) were measured in 53 hypertensive patients (26 renally impaired, 27 with normal renal function) before and after treatment with sufficient bunazosin retard or prazosin to control their high blood pressure. After a 3-week placebo run-in period, patients were classified as normal (creatinine clearance80 ml/min) or renally impaired (20-55 ml/min), and randomly assigned to bunazosin retard or prazosin. There followed a dose titration (T) phase of 6-7 weeks, and a maintenance (M) phase of 4 weeks. Blood pressure was satisfactorily controlled (sitting diastolic pressureor = 90 mmHg or decreased byor = 10 mmHg) by both drugs in both groups. Bunazosin Retard was associated with increases in GFR and ERPF in both normal and renally impaired groups; the increases were statistically significant in the renally impaired group (n = 14). Prazosin was associated with small decreases in both measures in both groups. One patient died of myocardial infarction during the placebo run-in. There were no other serious adverse events. Four patients reported dizziness (2 with each drug). We conclude that with appropriate dose titration, bunazosin retard is well tolerated and preserves renal blood flow when used to treat hypertension in patients with renal insufficiency.

Breast cancer is the second most commonly diagnosed cancer among women, and is difficult to diagnose during pregnancy and lactation. Frequent methylation of the promoter region of key tumor suppressor genes occurs in the early etiology of breast cancer. We aimed to evaluate the feasibility of using DNA extracted from the epithelial cells exfoliated in breast milk as a biomarker for breast cancer risk. To date, studies of methylation patterns in breast epithelial cells from asymptomatic women have been limited to cells obtained from fine nipple aspirate and ductal lavage. Analysis of promoter hypermethylation in exfoliated epithelial cells isolated from breast milk provides a non-invasive opportunity to assess breast cancer risk. Breast milk samples from both the biopsied and non-biopsied breasts of women scheduled for or who had had a breast biopsy were collected and processed within 24 hours of expression. Epithelial enriched cell fractions were isolated via immunomagnetic separation and DNA subsequently isolated and bisulfite treated for RASSF1, GSTP1, and SFRP1 promoter methylation analysis via pyrosequencing. When available, pathology reports from each participant were also obtained to categorize the outcome of the biopsy. Over the past two years, we have collected breast milk samples from 230 women who were scheduled for or had a breast biopsy. Of those 230 participants, we obtained the biopsy reports from 85% of participants (196 biopsy reports). Using pyrosequencing, we analyzed 30 individual CpG sites on 3 genes (RASSF1, GSTP1 and SFRP1) in epithelial enriched cell fractions of the biopsied and non-biopsied breast. In women whose biopsy resulted in a non-proliferative lesion (n=104), there was no significant difference in the average epithelial DNA methylation of their biopsied breast compared to their non-biopsied breast for RASSF1 (p=0.15) and GSTP1 (p=0.92), but for SFRP1 the average methylation was significantly higher in the biopsied breast (p = 0.02). In women whose biopsy result revealed cancer (n=10), there was a significant increase in average RASSF1 methylation of their biopsied breast compared to their non-biopsied breast (p=0.05). This study is the first to collect breast milk and obtain epithelial cells and DNA from a population of women at increased risk of breast cancer. Utilizing this unique population, we have been able to assess promoter methylation in 3 genes known to be methylated in breast cancer. Long term follow-up is ongoing for women enrolled in this study to determine breast health outcomes. Knowledge of promoter methylation along with long term follow-up may help us to better assess individual breast cancer risk. Given the high percentage of women that give birth and therefore produce milk, if even for just a few days, a breast cancer risk screen based on epithelial cells in milk has the potential to affect a significant portion of all women. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr LB-443. doi:10.1158/1538-7445.AM2011-LB-443

Breast cancers discovered during pregnancy or lactation (gestational) are known to be very aggressive and of poor prognosis. We have found a Mouse Mammary Tumor Virus (MMTV) like virus in human breast cancer, but not in adjacent normal tissue, indicating it exogenous origin. This virus, Human Mammary Tumor Virus (HMTV) recognized by its unique env sequence is present in 62% of gestational breast cancer, compared with 38% of sporadic breast cancers (Wang et al, 2003. Medical Oncology 20:233-236). The aggressive phenotype of gestational breast cancer was suggested to be due to the effect of hormones that stimulate cellular growth. HMTV- LTR contained sequences which are responsive to several hormones (glucocorticoid, estrogen, prolactin, and progesterone) and a transcription factor (TEF-1 family) (Wang et al, 2003. Medical Oncology 20:233-236). To find if HMTV is present in other tissues that respond to hormones, we have investigated the presence of HMTV sequences in two of these tissues. Endometrium is a classical example of such tissue. Endometrial cancers and normal endometrium were analyzed for HMTV env sequences. The results indicated that HMTV env sequences were present in 3.4% of the normal tissues and 37% of the tumors analyzed. Recently, it was reported that MMTV-like sequence was found in 10% of endometrial cancers (Johal et al. 2010, J. Med. Virology; 82: 1044-50). During lactation, the mammary gland experiences major metabolic changes due to hormonal stimulation. We have examined 88 normal milks and 63 milks from women, who have undergone biopsies. Whereas in the cells of normal milks 8% showed env sequences cells in the milk of the biopsied group showed that 23.8% contain HMTV sequences. These results confirmed electron microscope observations that a betaretrovirus was present in milk from healthy women and those with breast cancer (Moore et al. 1971, Nature 229: 611-615). Taken together, the results presented here suggest that tissues and tumors stimulated by hormones showed high prevalence of HMTV sequences. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 2302. doi:10.1158/1538-7445.AM2011-2302

Analysis of promoter methylation patterns in genes frequently downregulated in breast cancer may serve as an early indicator of breast cancer risk. To date, studies of methylation patterns in breast epithelial cells from asymptomatic women have been limited to cells obtained from fine nipple aspirate and ductal lavage. Analysis of promoter hypermethylation in exfoliated epithelial cells isolated from breast milk provides a non-invasive opportunity to assess breast cancer risk. Our preliminary data indicate that we can detect a cancer methylation phenotype in the milk of women at high risk. We propose that epithelial cells isolated from breast milk of lactating women scheduled to have a breast biopsy provide a resource for assessing early changes in DNA related to increased breast cancer risk. Two hundred and fifty breast milk samples from women who are scheduled to have, or have had a breast biopsy will be collected. Of these women, we expect that roughly ten percent will be diagnosed with breast cancer. Breast milk will be collected from both the biopsied and contralateral breast of each participant. To date, 153 participants have donated breast milk, yielding 300 breast milk samples with an average size of 50 ml (±30 ml) per breast. After collection, the epithelial enriched and epithelial depleted cells from each breast were isolated. Subsequent DNA isolation of both the epithelial enriched and depleted fraction of cells yielded an average of 372 ng (range 12-5000 ng) of high quality DNA. Using the DNA extracted from epithelial enriched and depleted fractions of cells isolated from breast milk, the promoter methylation level of 9 genes known to be methylated in breast cancer will be examined using pyrosequencing technology. We will assess the promoter methylation levels of: CDH1, DAP-K, ER-α, GSTP1, HIN1, P16, RAR-ß, RASSF1A, and SFRP1 in the epithelial enriched and depleted bisulfite treated DNA of each breast milk sample. Preliminary pyrosequencing assays conducted in our lab have shown that there is a difference in RASSF1A methylation levels between the epithelial enriched DNA from the cancerous breast compared to the epithelial depleted DNA from the non-cancerous breast of the same participant. Further methylation analysis may prove that breast milk can be used as non-invasive alternative to ductal lavage or fine needle aspirate, which may yield accurate breast cancer risk assessment. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 3764.

Fine-needle aspiration (FNA) is a well-recognized technique for sampling solid organs. It is used in renal transplantation to clarify the cause of a poorly functioning graft. Differential scoring techniques with respect to peripheral blood cell populations, and immunocyto-chemistry have been employed in this context. We describe the use of simple morphological criteria alone in renal transplant FNA. We compare these with needle biopsy and clinical parameters and show their value in the detection of active cellular rejection. Their limitations are discussed within the framework of other patterns of transplant pathology.

Ninety-four renal allograft recipients receiving cyclosporin A (CsA) immunosuppression for up to 4 years were examined for the presence of viral warts, keratoses, and skin cancers. They were compared with a group of 68 recipients on azathioprine who had been matched for duration of immunosuppression and other factors that might influence the occurrence of these lesions. No difference in prevalence of these tumours was found. Viral, bacterial, and fungal infections and other disorders of the skin related to immunosuppression were also noted. Apart from hypertrichosis, which occurred more frequently in the CsA group, no differences were observed. In view of the importance of duration of immunosuppression, the relative effects on the skin of the two drugs will not become apparent until CsA has been in general use for a much longer period of time. In the early stages, however, there appear to be no differences in the dermatological side-effects between CsA- and azathioprine-treated patients.

Summary— A group of 128 consecutive patients was identified on whom renal isotope studies had been performed during the first 2 months after renal transplantation and within 7 days of transplant biopsy. The prospective renogram and biopsy reports were reviewed and graded into 4 categories: severe rejection, predominant rejection, predominant acute tubular necrosis (ATN) and pure ATN. Two extreme patterns of renogram were identified: a sharp rise with a fast decline in the first min, attributed to ATN, and a slowly rising curve with no early peak occurring in severe rejection although not specific to this condition. There was a continuous intermediate spectrum. There was no inter-observer variation in gradings at the 2 ends of the spectrum. In the middle part the difference between 2 independent observers never exceeded more than 1 grade. There was good correlation between the biopsy and renogram gradings, with a discrepancy of more than 1 grade in only 5 patients; 2 of these, with severe rejection on the renogram, showed predominant ATN on biopsy, but the final clinical diagnosis was severe rejection (false positive biopsies). Two patients with biopsies showing severe rejection had a sharp initial up-slope in the renograms but a slower down-slope (over 4 min compared with 1 min in true ATN). With better definition of the criteria these renograms would not have been graded as ATN. There was 1 patient in whom no satisfactory explanation for the discrepancy was found (presumed false positive renogram). When properly defined criteria are used to interpret renograms, this simple test is at least as reliable as renal biopsy in differentiating ATN from rejection in the early post-transplant period, especially in the presence of anuria or severe oligurea.

Postural changes in plasma renin activity were studied in three groups of age and duration-matched male diabetics (potent, impotent and with postural hypotension) and in non-diabetic control subjects. Those diabetic subjects with postural hypotension due to automatic neuropathy had no increase in plasma renin activity to the erect posture whereas both the potent and impotent groups had similar plasma renin activity responses to the control subjects. There was a significant inverse correlation between the rise in plasma renin activity on standing and the postural drop in blood pressure (r = 0.476, P less than 0.01) but no correlation with other tests of autonomic reflex function such as the Valsalva manoeuvre and blood pressure response to sustained handgrip. The results suggested that the lesion responsible for the postural hypotension is in the efferent sympathetic pathway. However, neuropathy per se did not wholly explain the decreased postural plasma renin activity response. Diabetic nephropathy, with involvement of cells of juxtaglomerular apparatus, may also be implicated.

Some 200 ML of water are reused tn Los Angeles and Orange counties each day for a variety of uses. Spurred by a statewide drought some two years ago, area water and wastewater utilities conducted the Orange and Los Angeles Counties Water Reuse Study, which revealed that long-term reuse potential for the region is 1150 ML/d. The study spawned a lo-year project plan that would expand reuse applications and make water reuse an official part of the California Water Plan.

We analyze a 140-year series of smallpox deaths in the Åland Islands, Finland. Vaccination, introduced in 1805, dramatically reduced the annual number of smallpox deaths. It also influenced the age distribution of smallpox deaths, changing smallpox from a childhood disease before 1805 to one which affected both adults and children after 1805. This appears to be due to the fact that Ålanders were usually vaccinated only once during childhood and often lost their immunity during adulthood. Spectral analysis of the prevaccination time series of smallpox deaths demonstrates a strong seven-year periodicity, reflecting the amount of time necessary to build up a cohort of nonimmune individuals. After the introduction of vaccination, the periodicity changes to eight years. The probability that a parish in Åland was affected by a smallpox epidemic is shown to be highly correlated with migration patterns and parish population sizes.

The direct relationship between fertility and fertility behavior of mothers and daughters was examined. It was hypothesized that the relative propensity to control family sizes in 1 generation is transmitted to the following generation and that transmission of fertility levels across generations is in part a result of the transmission of specific fertility-determining life-course behaviors across generations. The data were derived from the Mormon Historical Demography projects set of computerized family geneologies. To assess the importance of cohort effects the completed fertility of 1st daughters and last daughters was compared by mothers completed family size and mothers birth cohort. Daughters who were the last born tended to have lower fertility than 1st born daughters. For 1st born daughters a positive association between mothers and daughters family size was confirmed. The distribution of mothers and daughters relative to the median births for their respective cohorts was examined. Each woman was allocated to 1 of 3 groups: low -- completed fertility was 2 or more children less than the median for all women in the birth cohort; medium -- completed fertility was equal to + or - 1 child from the median for other women in the same birth cohort; and high -- completed fertility was 2 or more children greater than the median for all women in the birth cohort. It was expected that a greater proportion of daughters than mothers would have relatively low fertility. For the 1830-39 cohort only 15% of the mothers had relatively low fertility but 25% of their daughters did; for other mother cohorts the comparisons were 15:26 18:26 and 15:23. It also was expected that the daughters of low fertility mothers would be more likely to have relatively low fertility. For low fertility mothers in the 1830-39 cohort 33% of daughters had relatively low fertility; 24% fell in the relatively high fertility group. The expected difference was found for the 1840-49 cohort of mothers and for the 1860-69 cohort but not for the 1850-59 cohort. It also was expected that the daughters of relatively high fertility mothers would have relatively high fertility. 33% of daughters with high fertility mothers in the 1st cohort had relatively high fertility; only 23% had low fertility. This pattern was consistent for each of the other cohorts of mothers. Tabular and multivariate analyses supported the strong possibility that both fertility behavior and indirect associations regarding timing of fertility-related life course events were transmitted intergenerationally. Cohort-specific influences were substantial. The analyses confirmed both the hypothesized intergenerational fertility association and the hypothesized cohort-specific effects.

The successful use of diuretics depends upon a knowledge of their mode of action, their potency, and their side-effects. The four basic groups of diuretics which cover most situations are: (i) the thiazides, (ii) ethacrynic acid or frusemide, (iii) spironolactone or triamterene, (iv) mannitol.

The fall in blood base occurring after the administration of secretin and the aspiration of duodenal contents was assessed in normal patients and in patients with chronic pancreatitis. In contrast to normal patients, those with chronic pancreatitis showed only a small fall or no fall in blood base level. There was no correlation between the amount of bicarbonate as determined by aspiration and that calculated from the blood base change. In 3 normal patients the magnitude of the renal compensatory mechanism in the post-secretin hour was found to be insignificant.

In 30 patients with acute myocardial infarction complicated by either advanced atrioventricular or bundle branch block, pulmonary arterial wedge pressures were studied in relation to clinical and radiographic features of left ventricular failure, changes in central venous and pulmonary arterial pressures, and arterial hypoxemia. An increase in mean pulmonary arterial wedge pressure was poorly correlated with the presence of dyspnea, audible third or fourth heart sounds, or persistent basal rales; however, it was significantly related to radiographic evidence of pulmonary venous dilatation or edema, a systolic blood pressure of less than 100 mm Hg, gallop rhythm associated with tachycardia, and heart rate in patients with sinus rhythm and normal atrioventricular conduction. Increased mean right atrial pressure indicated increased mean pulmonary arterial wedge pressure in patients with isolated anterior infarction, but in several patients with isolated inferior infarction the level of right atrial pressure was disproportionately high. The pulmonary arterial diastolic pressure closely reflected the mean pulmonary arterial wedge pressure in the absence of obstructive airways disease or pulmonary embolism. The level of the arterial oxygen tension fell as the mean pulmonary arterial wedge pressure rose, but it was considerably reduced in some patients with only moderately increased pressures. However, the latter usually had radiographic evidence of pulmonary venous dilatation or edema, suggesting that the pressure had been elevated previously to higher levels.

The effect of ethamivan (vanillic acid diethylamide) on the ventilatory response to carbon dioxide has been investigated in healthy young adult males. Intravenous infusion of the drug at a rate of 9 mg/min causes respiratory stimulation depending in degree upon the prevailing alveolar CO(2) tension. When the latter is low stimulation by the drug is most marked and may largely support respiration below the CO(2) threshold. As alveolar Pco(2) increases, the effect of the drug disappears. These findings are discussed.