Search

Objective: Insomnia, characterized by difficulty falling and staying asleep, is a common and debilitating symptom of posttraumatic stress disorder (PTSD) that is resistant to first-line, trauma-focused therapies. Previous research has found that sleep-directed hypnosis improves subjective sleep quality, particularly sleep onset latency, in women with PTSD. However, it cannot be assumed that improvements in subjective sleep reports correspond with objectively measured sleep improvements, because research has indicated a lack of agreement across these measures. The current study examined the effects of sleep-directed hypnosis plus cognitive processing therapy (hypCPT) on objective indices of sleep quality measured with actigraphy. Method: Forty-five women with PTSD were randomized to receive sleep-directed hypCPT or sleep and psychiatric symptom monitoring plus CPT (ssmCPT). Pre- and posttreatment, participants completed 1 week of daily actigraphy assessments of nocturnal sleep onset latency, waking after sleep onset, and total sleep time. Results: Overall improvement in objective sleep indices was not observed. Despite this, at posttreatment, treatment completers receiving hypCPT took significantly less time to fall asleep than did women receiving ssmCPT. Conclusions: More research is needed to understand and reduce the discrepancy between subjectively and objectively assessed sleep impairments in PTSD. Nevertheless, results indicate that adding sleep-directed hypnosis to trauma-focused therapy may be of some use for individuals with PTSD-related insomnia. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

In laboratory medicine, reference intervals (RIs) are key decision support tools used to guide the clinical interpretation of numerical test results. Best practice suggests each laboratory establishes RIs in the local population prior to introducing an assay into routine clinical practice. The aim of this study was to define RIs for frequently requested biochemical/haematological parameters in a healthy adult Irish Caucasian population. A cross-sectional study of non-pregnant apparently healthy volunteers was conducted. Baseline demographics, anthropometric and laboratory measurements were recorded. In total, 37 commonly requested biochemical (serum, n = 26) and haematological (venous blood, n = 11) ISO15189:2012 accredited tests were analysed, using the Roche Cobas® Sebia Capillarys 3 Tera and Siemens Advia® 2120i platforms following standard operating procedures. RIs were defined according to the International Federation of Clinical Chemistry (IFCC) recommended method. Of 208 apparently healthy volunteers, 76 failed to meet the study inclusion criteria. The reference population comprised of 132 participants (males: n = 65, 49.2%) with a median age of 29.7 (18.1–62.2) years. RIs for the majority of biochemical/haematological parameters were broadly in accord with those provided by Pathology Harmony (UK)/Irish RI Harmonisation Project and the manufacturer Roche Diagnostics. However, the established RI defined for HbA1c: 27–37 mmol/mol was markedly different from that quoted nationally, HbA1c: 20–42 mmol/mol. Normative biological intervals established in a healthy adult Irish population for 37 commonly requested biochemical/haematological parameters will be a valuable aid to result interpretation in clinical laboratories after appropriate verification in accordance with ISO 15189: 2012.

The utility of sheer volumes of very high spatial resolution (VHSR) commercial imagery in mapping the Arctic region is new and actively evolving. Commercial satellite sensors typically record image data in low-resolution multispectral (MS) and high-resolution panchromatic (PAN) mode. Spatial resolution is needed to accurately describe feature shapes and textural patterns, such as ice-wedge polygons (IWPs) that are rapidly transforming surface features due to degrading permafrost, while spectral resolution allows capturing of land-use and land-cover types. Data fusion, the process of combining PAN and MS images with complementary characteristics often serves as an integral component of remote sensing mapping workflows. The fusion process generates spectral and spatial artifacts that may affect the classification accuracies of subsequent automated image analysis algorithms, such as deep learning (DL) convolutional neural nets (CNN). We employed a detailed multidimensional assessment to understand the performances of an array of eight application-oriented data fusion algorithms when applied to VHSR image scenes for DLCNN-based mapping of ice-wedge polygons. Our findings revealed the scene dependency of data fusion algorithms and emphasized the need for careful selection of the proper algorithm. Results suggested that the fusion algorithms that preserve spatial character of original PAN imagery favor the DLCNN model performances. The choice of fusion approach needs to be considered of equal importance to the required training dataset for successful applications using DLCNN on VHRS imagery in order to enable an accurate mapping effort of permafrost thaw across the Arctic region.

Background and aims There is limited information on reference values for lipids and lipoproteins in an Irish population. In this observational study, we have described the distributions of lipids in a large Irish cohort. Methods Over 110,000 lipid profiles were selected from a database of almost 1.5 million consecutive lipid profiles performed in the Clinical Biochemistry Laboratory in University Hospital Galway between 2004 and 2017 to best represent the Irish population. Age- and sex-related reference intervals for both sexes for total cholesterol, triglycerides, HDL cholesterol and LDL cholesterol, from the age of ten to greater than 90 years, were determined. Two methods for estimating LDL cholesterol were also compared. Results Sex-related differences in lipid distributions arise before the age of 20 years and are life-long. In both sexes total and LDL cholesterol levels gradually increased towards middle age with a decrease towards old age. Levels tended to be higher in males than in females up to mid-life at which stage they cross over with females having on average higher levels. The median of the triglyceride distributions show similar age- and sex-related changes to total cholesterol, but the distributions show a very marked positive skew that is particularly obvious in middle aged males. HDL cholesterol distributions change little throughout life with males having lower levels than females. Changing from the Friedewald formula to that proposed by Martin would impact the management of some patients with dyslipidaemia. Conclusions This study provides lipid reference values for clinical biochemistry laboratories and clinicians working in Ireland. It is informative for public health initiatives wishing to target dyslipidaemia as a modifiable risk for cardiovascular disease and for investigators researching geographical and temporal variances in lipid parameters.

Background Approximately 1 billion people worldwide have Vitamin D deficiency. The aim of this study was to compare Vitamin D status and serum 25-hydroxyvitamin D (25(OH)D) concentrations among adults sampled in the community, in outpatient clinics, as hospital inpatients and in nursing homes in the West of Ireland. The secondary aim was to determine the associations between length of hospital stay (inpatients) at the time of serum 25(OH)D sampling and Vitamin D status. Methods A cross-sectional study was carried out. Patients who had serum 25(OH)D analysis carried out in Galway University Hospitals (January 2011–December 2015) were identified following interrogation of the electronic laboratory data system. Baseline demographics, location, and date of sample collection were recorded. Vitamin D deficiency was defined as a serum 25(OH)D concentration Results In total, 24,302 patient samples were eligible for inclusion: community 15,319; outpatient clinics 6,371; inpatients 2,339; and nursing home residents 273. Vitamin D deficiency was more common in nursing home residents than inpatients, or those sampled in outpatient clinics or in the community (42% vs 37% vs 17% vs 13%; p < .001). Inpatients sampled further into their hospital stay (≥3 days) had greater Vitamin D deficiency than inpatients sampled on 0–2 days (p = .007). Season (p < .001), sex (p < .001), and age (p < .001) were associated with 25(OH)D concentrations. Vitamin D deficiency was more common in Winter/Spring, in males, and in those aged ≥80 years. Conclusions Nursing home residents and inpatients are at the highest risk for Vitamin D deficiency. Season, sex, age, and day of hospital stay on which serum 25(OH)D concentrations were sampled were associated with Vitamin D status.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies are an excellent indicator of past COVID-19 infection. As the COVID-19 pandemic progresses, retained sensitivity over time is an important quality in an antibody assay that is to be used for the purpose of population seroprevalence studies. We compared 5,788 health care worker (HCW) serum samples by using two serological assays (Abbott SARS-CoV-2 anti-nucleocapsid immunoglobulin G (IgG) and Roche anti-SARS-CoV-2 anti-nucleocapsid total antibody) and a subset of samples (all Abbott assay positive or grayzone, n = 485) on Wantai SARS-CoV-2 anti-spike antibody enzyme-linked immunosorbent assay (ELISA). For 367 samples from HCW with a previous PCR-confirmed SARS-CoV-2 infection, we correlated the timing of infection with assay results. Overall, seroprevalence was 4.2% on Abbott and 9.5% on Roche. Of those with previously confirmed infection, 41% (150/367) and 95% (348/367) tested positive on Abbott and Roche, respectively. At 21 weeks (150 days) after confirmed infection, positivity on Abbott started to decline. Roche positivity was retained for the entire study period (33 weeks). Factors associated (P ≤ 0.050) with Abbott seronegativity in those with previous PCR-confirmed infection included sex (odds ratio [OR], 0.30 male ; 95% confidence interval [CI], 0.15 to 0.60), symptom severity (OR 0.19 severe symptoms; 95% CI, 0.05 to 0.61), ethnicity (OR, 0.28 Asian ethnicity; 95% CI, 0.12 to 0.60), and time since PCR diagnosis (OR, 2.06 for infection 6 months previously; 95% CI, 1.01 to 4.30). Wantai detected all previously confirmed infections. In our population, Roche detected antibodies up to at least 7 months after natural infection with SARS-CoV-2. This finding indicates that the Roche total antibody assay is better suited than Abbott IgG assay to population-based studies. Wantai demonstrated high sensitivity, but sample selection was biased. The relationship between serological response and functional immunity to SARS-CoV-2 infection needs to be delineated. IMPORTANCE As the COVID-19 pandemic progresses, retained sensitivity over time is an important quality in an antibody assay that is to be used for the purpose of population seroprevalence studies. There is a relative paucity of published literature in this field to help guide public health specialists when planning seroprevalence studies. In this study, we compared results of 5,788 health care worker blood samples tested by using two assays (Roche and Elecsys, anti-nucleocapsid antibody) and by testing a subset on a third assay (Wantai enzyme-linked immunosorbent assay [ELISA] anti-spike antibody). We found significant differences in the performance of these assays, especially with distance in time from PCR-confirmed COVID-19 infection, and we feel these results may significantly impact the choice of assay for others conducting similar studies.

Atypical femur fractures (AFFs) are well‐established serious complication of long‐term bisphosphonate and denosumab therapy in patients with osteopenia or osteoporosis. To elucidate underlying mechanism(s) for the development of AFF, we performed a nested case‐control study to investigate bone tissue nanomechanical properties and prevailing bone microstructure and tissue‐level remodeling status as assessed by bone histomorphometry. We hypothesized that there would be differences in nanomechanical properties between patients with and without AFF and that bone microstructure and remodeling would be related to nanomechanical properties. Thirty‐two full‐thickness transiliac bone biopsies were obtained from age‐ and sex‐matched patients on long‐term bisphosphonate therapy with (n = 16) and without an AFF (n = 16). Standard histomorphometric measurements were made in each sample on three different bone envelopes (cancellous, intracortical, and endosteal). Iliac bone wall thickness was significantly lower on all three bone surfaces in patients with AFF than in those without AFF. Surface‐based bone formation rate was suppressed similarly in both groups in comparison to healthy premenopausal and postmenopausal women, with no significant difference between the two groups. Nanoindentation was used to assess material properties of cortical and cancellous bone separately. Elastic modulus was higher in cortical than in cancellous bone in patients with AFF as well as compared to the elastic modulus of cortical bone from non‐AFF patients. However, the elastic modulus of the cancellous bone was not different between AFF and non‐AFF groups or between cortical and cancellous bone of non‐AFF patients. Resistance to plastic deformation was decreased in cortical bone in both AFF and non‐AFF groups compared to cancellous bone, but to a greater extent in AFF patients. We conclude that long‐term bisphosphonate therapy is associated with prolonged suppression of bone turnover resulting in altered cortical remodeling and tissue nanomechanical properties leading to AFF. © 2021 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.

Dynamic Nuclear Polarization Simulation Optimized with a Unified Propagator (DNPSOUP) is an open-source numerical software program that models spin dynamics for dynamic nuclear polarization (DNP). The software package utilizes a direct numerical approach using the inhomogeneous master equation to treat the time evolution of spin density operator under coherent Hamiltonians and stochastic relaxation effects. Here we present the details of the theory behind the software, starting from the master equation, and arriving at characteristic operators for any section of density operator time-evolution. We then provide an overview of the DNPSOUP software architecture. The efficacy of the program is demonstrated by simulating DNP field profiles on small spin systems exploiting both continuous wave and time-domain DNP mechanisms. Examples include Zeeman field profiles for the solid effect, Overhauser effect, and cross effect, and microwave field profiles for NOVEL, off-resonance NOVEL, the integrated solid effect, the stretched solid effect, and TOP-DNP. The software should facilitate a better understanding of the DNP process, aid in the design of optimized DNP polarizing agents, and allow us to examine new pulsed DNP methods at conditions that are not currently experimentally accessible, especially at high magnetic fields with high-power microwave pulses.

[Image: see text]

SARS-CoV-2 antibodies are an excellent indicator of past COVID-19 infection. As the COVID-19 pandemic progresses, retained sensitivity over time is an important quality in an antibody assay that is to be used for the purpose of population seroprevalence studies.We compared 5788 healthcare worker (HCW) serum samples on two serological assays (Abbott SARS-CoV-2 anti-nucleocapsid IgG and Roche Anti-SARS-CoV-2 anti-nucleocapsid Total Antibody) and a subset of samples (all Abbott assay positive or grayzone, n=485) on Wantai SARS-CoV-2 anti-spike Antibody ELISA. For 367 samples from HCW with previous PCR-confirmed SARS-CoV-2 infection we correlated the timing of infection with assay results.Overall seroprevalence was 4.2% on Abbott, 9.5% on Roche. Of those with previously confirmed infection, 41% (150/367) and 95% (348/367) tested positive on Abbott and Roche respectively. At 21 weeks (150 days) after confirmed infection, positivity on Abbott started to decline. Roche positivity was retained for the entire study period (33 weeks). Factors associated (P≤ 0.050) with Abbott seronegativity in those with previous PCR-confirmed infection included sex (male OR0.30;95%CI0.15-0.60), symptom severity (OR0.19 severe symptoms;95%CI0.05-0.61), ethnicity (OR0.28 Asian ethnicity;95%CI0.12-0.60) and time since PCR diagnosis (OR2.06 for infection 6 months previously;95%CI1.01-4.30. Wantai detected all previously confirmed infections.In our population, Roche detected antibodies up to at least seven months after natural infection with SARS-CoV-2. This may indicate that Roche is better suited than Abbott to population-based studies. Wantai demonstrated high sensitivity but sample selection was biased. The relationship between serological response and functional immunity to SARS-CoV-2 infection needs to be delineated.

Introduction This study aimed to determine the prevalence of diabetic kidney disease (DKD) and rapid renal function decline and to identify indices associated with this decline among adults attending a diabetes center in Northern Europe. Research design and methods This is a retrospective cohort study of 4606 patients who attended a diabetes center in Ireland between June 2012 and December 2016. Definition/staging of chronic kidney disease used the Kidney Disease: Improving Global Outcomes (KDIGO) 2012 classification based on data from the most recently attended appointment. Relevant longitudinal trends and variabilities were derived from serial records prior to index visit. Rapid renal function decline was defined based on per cent and absolute rates of estimated glomerular filtration rate (eGFR) change. Multiple linear regression was used to explore the relationships between explanatory variables and per cent eGFR change. Results 42.0% (total), 23.4% (type 1 diabetes), 47.9% (type 2 diabetes) and 32.6% (other diabetes) had DKD. Rapid decline based on per cent change was more frequent in type 2 than in type 1 diabetes (32.8% vs 14.0%, p

Introduction Coronavirus disease 2019 (COVID-19), is a respiratory illness caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The Clinical Blood Sciences Laboratory (CBSL) plays a key role in supporting the monitoring and management of patients with COVID-19 disease. Objective To provide a comprehensive CBSL testing protocol to support the medical management of SARS-CoV-2 infection. Methods Description of the biochemical, haematological and immunological tests that have a role in the assessment and monitoring of patients with COVID-19 infection. Results We provide a test menu for clinical laboratories to ensure the effective monitoring, management and prognostication of COVID-19 patients in hospital. Conclusion Given the rapidity with which patients with COVID-19 disease can deteriorate, we recommend regular testing with vigilance paid to the rate and trajectory of change in each of these parameters.

Purpose Hospital emergency medication kits (HEMKs) are used to provide certain critical medications in emergent situations, despite many technological advancements for patient safety and medication distribution. We sought to evaluate HEMK usage and analyze associated costs to identify and recommend process improvements. Methods Mayo Clinic in Rochester, MN, is a large multisite academic medical center with 2 hospital campuses and many ambulatory clinics. All documentation of the approximately 250 HEMKs in circulation was analyzed from January to November 2017. The primary outcome was HEMK use. Secondary outcomes included individual medication usage and associated costs. These data were then used to recommend process improvements. Results Of 880 HEMKs evaluated, 675 (76.7%) were used, resulting in expiration 23.3% of the time. A total of 1,024 emergency medications were used, most commonly for hypoglycemia. Many of these medications are also available in automated dispensing machines for patient care use. Cost analysis revealed an average annual cost of nearly $200,000 associated with HEMKs. The results of our analysis indicated little added benefit of HEMKs in the setting of automated dispensing machine optimization. Steps for HEMK retirement are described. Conclusion HEMKs offered little added benefit considering technological advancements that have been made in patient safety and medication distribution since their inception. Retirement of HEMKs is anticipated to increase pharmacy operational efficiency by using automated dispensing machine technology and appropriate emergency response protocols to ensure optimal patient care.

We report the design and experimental demonstration of a frequency tunable terahertz gyrotron at 527 GHz built for an 800-MHz dynamic nuclear polarization enhanced nuclear magnetic resonance (DNP-NMR) spectrometer. The gyrotron is designed at the second harmonic ( $\omega = {2}\omega _{c}$ ) of the electron cyclotron frequency. It produces up to 9.3-W continuous microwave (CW) power at 527.2-GHz frequency using a diode type electron gun operating at ${V} = {16.65}$ kV, ${I}_{b} = {110}$ mA in a TE11,2,1 mode, corresponding to an efficiency of ~0.5%. The gyrotron is tunable within ~0.4 GHz by combining voltage and magnetic field tuning. The gyrotron has an internal mode converter that produces a Gaussian-like beam that couples to the HE11 mode of an internal 12-mm i.d. corrugated waveguide periscope assembly leading up to the output window. An external corrugated waveguide transmission line system is built including a corrugated taper from 12- to 16-mm i.d. waveguide followed by 3 m of the 16-mm i.d. waveguide The microwave beam profile is measured using a pyroelectric camera showing ~84% HE11 mode content.

Vitamin D plays an important role in calcium homeostasis and is essential for normal bone growth and remodeling. Previous studies of acutely ill and institutionalized older women in Galway revealed that vitamin D insufficiency is extremely common. We aimed to evaluate age and gender-related rates of vitamin D insufficiency and deficiency in adult patients attending their General Practitioners in the same region.A retrospective cohort study.General practices in Galway, a city located on the west coast of Ireland, latitude 53.17 North.A total of 15,708 consecutive blood samples from adults attending their General Practitioners between January 2013 and December 2014 were sent to the Clinical Biochemistry Laboratory in the University Hospital Galway for vitamin D level testing. 73% were from women.Data were collected and grouped according to age, sex and season. Vitamin D levels (25OHD) were categorised into deficiency (25nmol/L), insufficiency (25-50nmol/L) and sufficiency (50nmol/L).Median and interquartile range were reported as vitamin D levels were not normally distributed. Descriptive statistics were performed using STATA/MP 13.1 for Mac.While vitamin D levels were sufficient in 56.4% (n=8,496), they were insufficient in 32.4% (n=4,891) and deficient in 11.2% (n=1,691). Of the deficient group, 19%( 325) had levels15nmol/L consistent with profound deficiency. Men were more likely than women to be deficient (12% (n=489) vs. 10.9% (n=1,202)) and insufficient (38.0% (n=1,550) vs. 30.4% (n=3,341)) (p0.01). Highest rates of deficiency were seen in those 81-97 years (19.4% (n=136)) and 18-40 years (13.8% (n=543)), the former group showing less seasonal variation.Overall prevalence of insufficiency is similar to those in national and European studies published recently. However, there is a high possibility that those most vulnerable to vitamin D deficiency were underrepresented in this cohort, when results from previous studies in the same region are considered. Further prospective studies are needed to guide treatment with supplementation of vitamin D for appropriate subgroups.

Barium titanate is a highly desired material for the development of advanced linear phase modulators due to the exceptionally large value of its electro-optic coefficient. While attempts have been made in the past to utilize this material property, the overall device performance has not been as sensitive as expected due to a number of special considerations that were not made as a result of the off-diagonal nature of barium titante's electro-optic coefficient. This work discusses these special considerations, presents an in-house characterization technique that is being developed specific to these off-diagonal coefficients, and demonstrates preliminary device designs for a high-performance barium titanate modulator.

Introduction Dyslipidemia is recognised as one of the most important modifiable risk factors for cardiovascular disease. The distribution of lipid parameters for certain populations, most notably in the United States, has been previously characterised in numerous studies, however there has never been a detailed evaluation of lipid distributions in an Irish cohort. Methods 110,620 serum lipid profile requests and result sets in an Irish population between 2004 and 2017 were analysed in relation to changes in age and sex-specific lipid distributions. This group was sub selected from a much larger database to include only first-time requests from primary care and taking precautions to have an untreated population. From this database we calculated age- and sex-related reference intervals for every 5 years of life from the age of 10 years to greater than 90 years for total cholesterol, triglycerides (TG), HDL cholesterol and LDL cholesterol (LDL-C). Results There are notable differences between the sexes and across different age groups in lipid profiles. Figure 1 shows the mean values for LDL-C for our population. The differences appear before the 20-year-old group and show that LDL-C levels rise at a younger age in men and peak at the ages of 40–50 years. In women peak values occur in the older age groups and women have higher mean values than men over the age of 50 years. Total cholesterol distributions follow a similar pattern to that of LDL-C. (Figure 2) The distribution of triglyceride levels for both males and females show a distinct positive skew from childhood through to old age. The positive skew is particularly marked in adult males up to the 60-year age group. In middle age median triglycerides are 0.5 mmol/l higher in males than females, with the sex difference widening to about 2.2 mmol/l amongst those individuals towards the 97.5 percentile of the distribution. Above 65 years triglyceride levels tend to fall or plateau in both sexes. Distributions in an Irish population are similar to international temporal and geographical comparisons, however the elderly Irish population tend to have lower total cholesterol levels than international comparators. Conclusions These distributions should be constructive in epidemiological and public health initiatives, providing data for temporal and geographical comparisons with other similar studies. For healthcare professionals advising individual patients it provides useful age-related reference intervals for the interpretation of significant dyslipidaemias.

STUDY OBJECTIVES: There is growing evidence to support sleep impairment as a core feature of posttraumatic stress disorder (PTSD). Sleep impairment in PTSD is associated with severe distress and poorer treatment outcomes. Therefore, specific attention to this symptom of PTSD is warranted and accurate assessment of sleep impairment is critical. The current study investigated the association between self-reported and objective assessment of sleep and sustained attention in women with PTSD. METHODS: Study participants include 50 treatment-seeking, female, interpersonal violence survivors who have PTSD. Nocturnal sleep duration was measured with self-report sleep diaries and objective actigraphy assessment over the course of 7 nights. Sustained attention during daytime was measured by the Psychomotor Vigilance Task (PVT). RESULTS: Results indicated that self-reported nocturnal sleep duration, but not objective or global sleep quality measures, best predicted attentional deficits as indicated by lapses and inverse reaction time on the PVT. Daily sleep diaries predicted 19% and 14% of the variance in attentional lapses and inverse reaction time, respectively. CONCLUSIONS: In a sample of women with PTSD, self-reported nocturnal sleep duration predicted deficits in sustained attention. Conversely, sleep duration as measured by actigraphy and global sleep quality, did not predict sustained attention. Findings suggest that assessing sleep impairment on a daily basis may provide clinically relevant information in evaluating daytime symptoms and provide guidance in targeting this particularly troublesome symptom in the treatment of PTSD. CITATION: Werner KB, Arditte Hall KA, Griffin MG, Galovski TE. Predicting attentional impairment in women with posttraumatic stress disorder using self-reported and objective measures of sleep. J Clin Sleep Med. 2019;15(9):1329–1336.

We describe the design and construction of a modular, triple-resonance, fully balanced, DNP-MAS probe based on transmission line technology and its integration into a 500 MHz/330 GHz DNP-NMR spectrometer. A novel quantitative probe design and characterization strategy is developed and employed to achieve optimal sensitivity, RF homogeneity and excellent isolation between channels. The resulting three channel HCN probe has a modular design with each individual, swappable module being equipped with connectorized, transmission line ports. This strategy permits attachment of a mating connector that facilitates accurate impedance measurements at these ports and allows characterization and adjustment (e.g. for balancing or tuning/matching) of each component individually. The RF performance of the probe is excellent; for example, the 13C channel attains a Rabi frequency of 280 kHz for a 3.2 mm rotor. In addition, a frequency tunable 330 GHz gyrotron operating at the second harmonic of the electron cyclotron frequency was developed for DNP applications. Careful alignment of the corrugated waveguide led to minimal loss of the microwave power, and an enhancement factor e = 180 was achieved for U-13C urea in the glassy matrix at 80 K. We demonstrated the operation of the system with acquisition of multidimensional spectra of cross-linked lysozyme crystals which are insoluble in glycerol-water mixtures used for DNP and samples of RNA.

There are many risk factors for Vitamin D deficiency. This study aimed to compare the Vitamin D status and serum 25(OH)D concentrations of adults living in an urban area to adults living in a rural area in the West of Ireland (latitude 53.27° North). A cross-sectional retrospective analysis of clinical records was performed. Following interrogation of the electronic laboratory information system, individuals who had serum 25(OH)D concentrations measured at Galway University Hospitals between January 2011 and December 2015 were identified. Clinical demographics, setting and date of sampling were recorded. In total, 17,590 patients (urban n = 4,824; rural n = 12,766) were eligible for inclusion. Serum 25(OH)D concentrations were lower among rural compared to urban dwellers irrespective of season (spring p < 0.001, summer p = 0.009, autumn p = 0.002, winter p < 0.001). There was a significant difference in Vitamin D status between urban and rural dwellers in three of the four seasons: spring- deficiency: 16%-v-23%, insufficiency: 39%-v-43%, sufficiency: 45%-v-35% (p < 0.001); autumn- deficiency: 11%-v-10%, insufficiency: 30%-v-35%, sufficiency: 59%-v-56% (p = 0.01); winter- deficiency: 23%-v-25%, insufficiency: 35%-v-42%, sufficiency: 41%-v-33% (p < 0.001). Serum 25(OH)D concentrations were higher and the prevalence of deficiency lower in urban/rural females compared to urban/rural males (p < 0.001). Serum 25(OH)D concentrations increased sequentially from the 18-39 year age group to the 60-69 year age group in both urban (p < 0.001) and rural (p < 0.001) dwellers and then decreased progressively as age increased to ≥90 years. The odds of Vitamin D deficiency increased with age, lower daily sunshine hours, male gender, rural address and season.

We report the results of a survey of criminology and criminal justice (CCJ) scholars asking their responses to the same questions posed annually to the general public in Gallup public opinion polls. We found CCJ scholars to be more likely to hold more liberal positions on these issues than the general public. The findings indicate a disconnect between popular crime and justice perspectives (and resultant crime policy formation) and the “experts” presumably best trained and informed on how to go about crime policy. We argue for a renewed discussion among CCJ scholars regarding the relevance and role of academic expertise in crime policy formation and offer suggestions for how CCJ scholars might “go public” in influencing policy decisions.

We investigate a new time domain approach to dynamic nuclear polarization (DNP), the frequency-swept integrated solid effect (FS-ISE), utilizing a high power, broadband 94 GHz (3.35 T) pulse EPR spectrometer. The bandwidth of the spectrometer enabled measurement of the DNP Zeeman frequency/field profile that revealed two dominant polarization mechanisms, the expected ISE, and a recently observed mechanism, the stretched solid effect (S(2)E). At 94 GHz, despite the limitations in the microwave chirp pulse length (10 μs) and the repetition rate (2 kHz), we obtained signal enhancements up to ~70 for the S(2)E and ~50 for the ISE. The results successfully demonstrate the viability of the FS-ISE and S(2)E DNP at a frequency 10 times higher than previous studies. Our results also suggest that these approaches are candidates for implementation at higher magnetic fields.

An 88-year-old female nursing home resident attended the endocrinology department for routine follow-up of primary hyperparathyroidism. Diagnosed 9 years earlier, she was deemed unsuitable for surgery and treated medically with cinacalcet, a calcimimetic that acts by allosteric activation of the calcium-sensing receptor reducing parathyroid hormone (PTH)6 secretion by the parathyroid gland (1). Several years before her current outpatient attendance, she was diagnosed with vitamin D deficiency (2) \[serum 25-hydroxyvitamin D (25(OH)D), 10.4 ng/mL (26 nmol/L)\] (Table 1). The Endocrine Society Clinical Practice Guideline for the management of vitamin D deficiency considers a 25(OH)D concentration of ≥30 ng/mL (≥75 nmol/L) optimal for bone health (2). Vitamin D supplementation was recommended. Cholecalciferol (vitamin D3) was prescribed (800 IU/day). At clinic, she was medically stable, well hydrated, and normotensive. Her estimated glomerular filtration rate (eGFR) was 30 mL/min/1.73 m2, indicative of impaired renal function. The eGFR estimation [calculated using the Chronic Kidney Disease–Epidemiology Collaboration (CKD-EPI) formula] met the National Kidney Foundation criteria for chronic kidney disease (CKD) stage 3b, or moderate to severe loss of kidney function (3). Measurement of ionized calcium is not routinely available in the outpatient setting and was not requested in this case. However, she was normocalcemic with an adjusted calcium of 9.3 mg/dL (2.33 mmol/L) [reference …

This article presents a framework for integrating a regional geographic information system (GIS)-based nitrogen dataset (Texas Anthropogenic Nitrogen Dataset, TX-ANB) and a GIS-based river routing model (Routing Application for Parallel computation of Discharge) to simulate steady-state riverine total nitrogen (TN) transport in river networks containing thousands of reaches. A two-year case study was conducted in the San Antonio and Guadalupe basins during dry and wet years (2008 and 2009, respectively). This article investigates TN export in urbanized (San Antonio) vs. rural (Guadalupe) drainage basins and considers the effect of reservoirs on TN transport. Simulated TN export values are within 10 percent of measured export values for selected stations in 2008 and 2009. Results show that in both years the San Antonio basin contributed a larger quantity than the Guadalupe basin of delivered TN to the coastal ocean. The San Antonio basin is affected by urban activities including point sources, associated with the city of San Antonio, in addition to greater agricultural activities. The Guadalupe basin lacks major metropolitan areas and is dominated by rangeland, rather than fertilized agricultural fields. Both basins delivered more TN to coastal waters in 2009 than in 2008. Furthermore, TN removal in the San Antonio and Guadalupe basins is inversely related to stream orders: the higher the order the more TN delivery (or the less TN removal).

A sample of 448 child abduction cases in which America's Missing: Broadcast Emergency Response (AMBER) Alert was issued was examined to determine the extent to which AMBER Alert is successful in rescuing abducted children, and whether the successes suggest ‘lifesaving’ rescues. We reached conclusions consistent with the scant available prior research on AMBER Alert: although over 25% of the Alerts facilitated the recovery of abducted child(ren) and are thus arguably ‘successful’ by that standard alone, there was little evidence AMBER Alerts ‘save lives.’ In fact, AMBER Alert success cases are in almost every measurable way identical to AMBER Alert cases in which the child(ren) were returned unharmed but the Alert had no direct role in that outcome: they typically involve abduction by family members and other (apparently) non-life-threatening abductors, and the vast majority of recovery times are over 3 h. The implications for the public discourse regarding AMBER Alert and directions for future research ar...

Thin film lithium niobate (TFLN™) electro-optic modulators have potential for superior gain, bandwidth, linearity and impedance matching relative to semiconductor technologies. This paper reports TFLN modulators with optical loss < 0.5 dB/cm, Vpi-length of 2.2 V-cm, and 67 GHz operation.

To examine the impact of a diabetes renal clinic (DRC) on renal functional and metabolic indices in adults who have diabetes mellitus (DM) and chronic kidney disease (CKD).All patients evaluated at a DRC in a single tertiary referral center from January 1, 2008, to December 31, 2012, were identified. Serial renal and metabolic indices from January 1, 2004, to December 31, 2014, were recorded, and trends over time were analyzed by linear mixed-effects models.A total of 200 patients who had DM and CKD were identified and subdivided into 3 categories based on presumptive CKD etiology: 43 (21.5%) with type 1 DM (T1D) only, 127 (63.5%) with type 2 DM (T2D) only, and 30 (15.0%) with DM and an additional CKD etiology. Average annual absolute (mL/min per body surface area per year) and percentage (%/year) changes, respectively, in Chronic Kidney Disease Epidemiology Collaboration estimated glomerular filtration rate before vs after first DRC attendance were: -1.59 vs -3.10 (P=.31) and -1.22 vs -9.39 (P=.06) for T1D; -5.64 vs -3.07 (P=.004) and -10.88 vs -9.94 (P=.70) for T2D; and -6.50 vs +0.91 (P

The superior thermal and optical properties of transparent polycrystalline ceramics make them attractive alternatives to glass-based materials for laser gain media. Fibers have other advantages of compactness, vibration-resistance, and reduced cooling requirements. Recently it was found that surface roughness caused by grain boundary grooving dominated optical scattering even though there were other scattering sources in the fiber. Therefore, a lot of effort went to fabrication of fibers with smooth surfaces. A mechanical polishing method for polycrystalline YAG fibers was developed. The fiber surface roughness was reduced, while maintaining a circular cross-section. Surface-polished 1.5% Ho-doped polycrystalline YAG fiber, 62 mm long with 31 μm diameter, was fabricated, and lasing was demonstrated from this fiber. Effects of surface-polishing on the surface roughness and scattering coefficient are presented, and lasing characteristics are discussed.

A polycrystalline 1.5% Ho: YAG fiber with a diameter of 31 µm was prepared. Surface roughness from grain boundary grooving was reduced by polishing, which decreased the fiber scattering coefficient from 76 msup-1/supto 35 msup-1/sup. Lasing tests were done on this fiber with a SF57 Schott glass cladding. Lasing was confirmed by spectrum narrowing with threshold pump power lower than 500 mW and a slope efficiency of 7%. To our knowledge, this is the first lasing demonstration from a small diameter polycrystalline ceramic fiber.

Empirical studies of judicial effects on the use of imprisonment have yet to estimate changes in these effects under more-structured sentencing schemes. Findings are presented from a multilevel analysis of whether the implementation of Ohio's presumptive guidelines in 1996 was effective for reducing inter-judge differences in the distribution of non-suspended prison sentences and in defendant-level effects on imprisonment. These data for seven urban courts provide a unique opportunity to estimate changes in judicial effects across sentencing regimes. Results suggest that Ohio's guidelines were successful for reducing judicial effects on sentencing based on judges' tenure on the bench, prosecutorial experience, and caseload composition.

Simulation results and experimental measurements are presented for ridge waveguide edge-emitting lasers with a palladium thin film integrated for hydrogen gas detection. The palladium film experiences a refractive index change when in contact with hydrogen, causing a shift in the laser's output power and wavelength. It is found that the sensitivity of the device can be controlled by altering the width of the ridge waveguide, and the response time can be controlled by regulating the operating temperature of the device.

Hyperglycaemia is common amongst hospitalised patients. Some of this is due to pre-existing diabetes (either previously diagnosed or not), but a proportion is due to stress hyperglycaemia, a transient state of high blood sugars related to the underlying illness. We aimed to estimate the prevalence of hyperglycaemia in an Irish hospital setting, including an assessment of what contribution is made by cases of stress hyperglycaemia. Over a 9-day period, all bedside glucometer-measured point of care blood glucoses performed in medical and surgical wards in University Hospital Galway were examined. Medical case notes and our diabetes computerised database were analysed to identify individuals with pre-existing diabetes. Glycosylated haemoglobin (HbA1c) was measured on the remainder of patients, to differentiate between pre-existing diabetes (HbA1c ≥ 48 mmol/mol) and stress hyperglycaemia (HbA1c

We present a new, efficient strategy for designing fully balanced transmission line RF circuits for solid state NMR probes based on back propagation of common impedance nodes (BPCIN). In this approach, the impedance node phenomenon is the sole means of achieving mutual RF isolation and balance in all RF channels. BPCIN is illustrated using a custom double resonance 3.2 mm MAS probe operating at 500 MHz ([superscript 1]H) and 125 MHz ([superscript 13]C). When fully optimized, the probe is capable of producing high homogeneity (810°/90° ratios of 86% and 89% for 1H and 13C, respectively) and high efficiency (γB[superscript 1] = 100 kHz for [superscript 1]H and [superscript 13]C at 70 W and 180 W of RF input, respectively; up to 360 kHz for [superscript 1]H). The probe’s performance is illustrated by 2D MAS correlation spectra of microcrystals of the tripeptide N-f-MLF-OH and hydrated amyloid fibrils of the protein PI3-SH3., National Institutes of Health (U.S.) (NIH Grant EB003151), National Institutes of Health (U.S.) (NIH grant EB002026), National Institutes of Health (U.S.) (NIH grant EB001960), National Institutes of Health (U.S.) (NIH grant EB001035)

Replacement, Reduction and Refinement, the ‘Three Rs’ of Russell & Burch, are accepted worldwide as fundamental to the ethics of animal experimentation. The production, care and use of genetically-altered animals can pose particular challenges to the implementation of the Three Rs,1 necessitating additional considerations by those responsible for overseeing the ethical use and appropriate care of animals involved in science. The International Council for Laboratory Animal Science brings representatives of the international laboratory animal science community together to recommend acceptance of guidance documents. The harmonization of guidance concerning genetically-altered animals was seen as a priority because of the increasing globalization of research involving these animals.

AimsExcessively acidic urine is the dominant factor in uric acid stone formation. Recent evidence implicating insulin resistance has revived interest in its causation. We reviewed data on uric acid stone formers attending a general stones clinic to find out whether this supports and adds to current concepts.MethodsA retrospective database study of 1504 stone formers investigated at the Southampton renal stones clinic from 1990 to March 2007. Uric acid stone formers and idiopathic calcium stone formers were compared using non-parametric tests.ResultsFifty-nine patients (3.9%; 43 men) had uric acid stones. In men the commonest associated conditions were diabetes (20%), gout (20%) and an ileostomy (15%); in women, diabetes (33%), urinary infections (27%) and hyperparathyroidism (20%). Most patients with diabetes (85% of men, 75% of women), however, produced calcium stones. Risk factors did not differ significantly between calcium and uric acid stone formers with diabetes, gout or ileostomies. The median urine pH of men with idiopathic calcium stones was 6.20, idiopathic uric acid stones 5.47, diabetes 5.68, gout 6.05, diabetes and gout 5.20 and ileostomy 5.10. Plasma urate was higher with gout and idiopathic uric acid stones. Urate excretion was increased in gout. Oxalate excretion was lower with idiopathic uric acid stones (new finding). Urine volume decreased and oxalate concentration increased with ileostomy.ConclusionsUric acid stones are increased in diabetes, but most patients with diabetes make calcium stones. Different mechanisms may explain low pH with diabetes, gout and idiopathic stones. Low oxalate excretion with idiopathic urate stones needs confirmation.

Nonengagement in HIV care is a major clinical and public health challenge. To identify the risk factors and reasons, we performed (1) a retrospective study of patients admitted to the hospital with advanced HIV disease, (2) a prospective qualitative study, and (3) a population-based area-wide telephone interview. In the retrospective study, clinic care engagement was associated with age (43.9 ± 9.1 years vs 37.9 ± 7.2 years, P = .005) and improved from 23% to 44% ( P = .03) after hospitalization. Survival was higher (93% vs 73%, P = .03) among those who engaged in care. Twelve inpatients were interviewed in the qualitative study. Themes identified for nonengagement were social stigma, indifference, or lack of understanding of care needs/denial and life care issues. In the population-based study, 145 patients were interviewed. In all, 49 denied the need for HIV care and 28 denied their HIV status. Stigma, denial, and indifference or lack of understanding of need are significant barriers to care engagement.

We describe the design and implementation of the instrumentation required to perform DNP-NMR at higher field strengths than previously demonstrated, and report the first magic-angle spinning (MAS) DNP-NMR experiments performed at ¹H/e⁻ frequencies of 700 MHz/460 GHz. The extension of DNP-NMR to 16.4 T has required the development of probe technology, cryogenics, gyrotrons, and microwave transmission lines. The probe contains a 460 GHz microwave channel, with corrugated waveguide, tapers, and miter-bends that couple microwave power to the sample. Experimental efficiency is increased by a cryogenic exchange system for 3.2 mm rotors within the 89 mm bore. Sample temperatures ⩽85 K, resulting in improved DNP enhancements, are achieved by a novel heat exchanger design, stainless steel and brass vacuum jacketed transfer lines, and a bronze probe dewar. In addition, the heat exchanger is preceded with a nitrogen drying and generation system in series with a pre-cooling refrigerator. This reduces liquid nitrogen usage from >700 l per day to 7 days) cryogenic spinning without detrimental frost or ice formation. Initial enhancements, ε = −40, and a strong microwave power dependence suggests the possibility for considerable improvement. Finally, two-dimensional spectra of a model system demonstrate that the higher field provides excellent resolution, even in a glassy, cryoprotecting matrix., National Institutes of Health (U.S.) (EB002804), National Institutes of Health (U.S.) (EB003151), National Institutes of Health (U.S.) (EB002026), National Institutes of Health (U.S.) (EB001960), National Institutes of Health (U.S.) (EB001035), National Institutes of Health (U.S.) (EB001965), National Institutes of Health (U.S.) (EB004866)

We describe the design and implementation of a novel tunable 250 GHz gyrotron oscillator with >10 W output power over most of a 3 GHz band and >35 W peak power. The tuning bandwidth and power are sufficient to generate a >1 MHz nutation frequency across the entire nitroxide EPR lineshape for cross effect DNP, as well as to excite solid effect transitions utilizing other radicals, without the need for sweeping the NMR magnetic field. Substantially improved tunability is achieved by implementing a long (23 mm) interaction cavity that can excite higher order axial modes by changing either the magnetic field of the gyrotron or the cathode potential. This interaction cavity excites the rotating TE[subscript 5,2,q] mode, and an internal mode converter outputs a high-quality microwave beam with >94% Gaussian content. The gyrotron was integrated into a DNP spectrometer, resulting in a measured DNP enhancement of 54 on the membrane protein bacteriorhodopsin., National Institutes of Health (U.S.) (Grant EB002804), National Institutes of Health (U.S.) (Grant EB003151), National Institutes of Health (U.S.) (Grant EB002026), National Institutes of Health (U.S.) (Grant EB001960), National Institutes of Health (U.S.) (Grant EB001035), National Institutes of Health (U.S.) (Grant EB001965), National Institutes of Health (U.S.) (Grant EB004866), National Science Foundation (U.S.). Graduate Research Fellowship

A thin layer of palladium (Pd) was deposited on the surface of an etched air hole photonic crystal (PhC) vertical cavity surface emitting laser (VCSEL) to form a hydrogen gas (H2) sensor. H2 reacts with Pd, forming PdHx, which induces a shift in the complex refractive index. With Pd on its surface, the reflectivity of the top distributed Bragg reflector depends on the H2 concentration. We present device operation theory and experimental results showing a 60% output power increase and a 52 pm redshift of the lasing wavelength at 4% H2. Since the PhC VCSEL laser is single mode and the wavelength shift is comparable to the laser linewidth, the sensor can provide an accurate quantification of the H2 concentration over the range of 0-4% H2.

Polymorphic amplified typing sequences (PATS), a PCR-basedEscherichia coliO157:H7 (O157) strain typing system, targets insertions-deletions and single nucleotide polymorphisms atXbaI andAvrII restriction enzyme sites, respectively, and the virulence genes (stx1,stx2,eae,hlyA) in the O157 genome. In this study, the ability of PATS to discriminate O157 isolates associated with cattle was evaluated. An in-depth comparison of 25 bovine O157 isolates, from different geographic locations across Northwest United States, showed that about 85% of these isolates shared the same dendogram clade by PATS and pulsed-field gel electrophoresis (PFGE), irrespective of the restriction enzyme sites targeted. The Pearson’s correlation coefficient,r, calculated at about 0.4, 0.3, and 0.4 forXbaI-based,AvrII-based and combined-enzymes PATS and PFGE similarities, respectively, indicating that these profiles shared a good but not high correlation, an expected inference given that the two techniques discriminate differently. Isolates that grouped differently were better matched to their locations using PATS. Overall, PATS discriminated the bovine O157 isolates without interpretive biases or sophisticated analytical software, and effectively complemented while not duplicating PFGE. With its quick turnaround time, PATS has excellent potential as a convenient tool for early epidemiological or food safety investigations, enabling rapid notification/implementation of quarantine measures.

The design and the operation of a frequency-tunable continuous-wave (CW) 330-GHz gyrotron oscillator operating at the second harmonic of the electron cyclotron frequency are reported. The gyrotron has generated 18 W of power from a 10.1-kV 190-mA electron beam working in a TE-4,3 cylindrical mode, corresponding to an efficiency of 0.9%. The measured start oscillation current over a range of magnetic field values is in good agreement with theoretical start currents obtained from linear theory for successive high-order axial modes TE-4,3,q, where q = 1-6. Moreover, the observed frequency range in the start current measurement is in reasonable agreement with the frequency range obtained from numerical simulations. The minimum start current was measured to be 33 mA. A continuous tuning range of 1.2 GHz was experimentally observed via a combination of magnetic, voltage, and thermal tuning. The gyrotron output power and frequency stabilities were assessed to be ±0.4% and ±3 ppm, respectively, during a 110-h uninterrupted CW run. Evaluation of the gyrotron output microwave beam pattern using a pyroelectric camera indicated a Gaussian-like mode content of 92% with an ellipticity of 28%. The gyrotron will be used for 500-MHz nuclear magnetic resonance experiments with sensitivity enhanced by dynamic nuclear polarization.

Background and Objectives: Intravenous regional blocks (IVRBs) with ketorolac and lidocaine have been reported to be useful in the treatment of complex regional pain syndrome (CRPS). This is the first controlled prospective study of IVRB with lidocaine and ketorolac for treatment of pain and edema in CRPS of the lower extremity in adults. Methods: A prospective, randomized, double-blinded, crossover design was used. The primary outcome was overall pain numeric rating scale (NRS) at 1 week postinjection; secondary outcomes included pain with motion, allodynia, joint pain score, edema, range of ankle motion, skin temperature, and short-term pain relief. Ten of 12 adult patients diagnosed with unilateral lower extremity CRPS (type I) completed the study. Four IVRBs were performed 1 week apart in a random sequence with 50 mL lidocaine 0.5% and 0, 30, 60, and 120mg ketorolac. Results: Only 1 outcome achieved significant improvement; there was 1 day of significant pain reduction in the ketorolac groups (median NRS 6 to 4, P = 0.002). Overall pain NRS (10-point scale, mean±SE) at 1 week was 6.2 ± 0.53, 6.5 ± 0.89, 6.0 ± 0.88, 5.9 ±0.82, and 5.8 ±0.9 at baseline, 0, 30, 60, and 120mg, respectively (P=0.8). Pain with movement was 7.15 ± 0.69, 5.7 ± 1.07, 6.1 ± 0.86, 5.0 ±0.97, and 5.6 ± 0.86, (P = 0.059). Edema was not significantly reduced (2% reduction, P = 0.6). Conclusions: IVRB with ketorolac and lidocaine produced only short-term pain reduction in patients with CRPS involving the lower extremity after 4 serial injections in our study group. Prospective study is warranted, particularly in the pediatric population.

While clinical medicine is often well supported by health system information technology infrastructure, clinical research may need to create strategies to use clinical‐medicine informational technology tools. The authors describe a medication‐safety initiative that was carried out in a National Institutes of Health Clinical and Translational Science Award (CTSA)‐sponsored clinical research environment. A web based, medical informatics application was designed and implemented that allowed research groups to build protocol specific, electronic medication templates that were subsequently used to create participant‐specific medication order sets for conductance of clinical research activities in the CTSA‐sponsored clinical research environment. The medical informatics initiative eliminated typewritten or handwritten medication orders, created research protocol‐specific templates meeting institutional order‐writing requirements, and formalized a rigorous review and approval process. Enhancing safety in medication ordering and prescribing practices in a clinical research environment provided the background for multidisciplinary cooperation in medical informatics. Clin Trans Sci 2010; Volume 3: 312–315

The 12 papers in this special issue are grouped into three sections: 1) assessments of today's global routing system; 2) techniques to improve the performance of the existing routing system; and 3) new solutions that are designed to address the routing scalability problem by changing the basic model of the Internet routing architecture.

Implementing BGP route processing in an event-driven manner appears to be advantageous in terms of scalability. However, the inter-domain routing system as a whole would be overwhelmed without some type of rate limiting on BGP update streams. At first glace, an event-driven, pipelined route processing model does not seem to fit well with the traditional timer-based way of implementing BGP rate-limiting. In this paper we present a lazy event-driven BGP route processing pipeline that easily accommodates rate limiting.

The AMBER Alert system was designed to recover endangered missing children through the solicitation of citizen assistance via swift public announcements. Rigorous empirical support for AMBER Alert's effectiveness has been lacking, but since its inception program advocates and public safety officials have lauded the system's ability to “save lives”, often basing their optimism on AMBER Alert “success” stories. However, in this paper quantitative and qualitative analyses of 333 publicized and celebrated AMBER Alert “successes” suggest AMBER Alerts rarely result in the retrieval of abducted children from clearly “life-threatening” situations, and that most of the publicized successes involved relatively benign abductors and unthreatening circumstances. The routine conflation of such apparently mundane cases with rare dramatic successes by AMBER Alert advocates suggests popular portrayals of AMBER Alert are overly sanguine. The potentially negative effects of this and policy implications are discussed.

Increasing attention has been focused on diseases associated with ageing, as the mean age of the population in developed countries increases. Vitamin D and parathyroid hormone play key roles in calcium homeostasis, which is integral to skeletal health. To assess the vitamin D status of healthy, community dwelling, middle-aged and older females. General biochemistry and bone profiles, including ALP, PTH and 25(OH)D, were determined. Of 143 healthy white women receiving no supplementation or bone modifying treatments, 47% were vitamin D insufficient (

Dual-energy x-ray absorptiometry (DEXA) is now an established method of measuring bone mineral density (BMD) in humans. We have applied the technique to measuring BMD in the rat. The short-term precision of the technique was assessed by calculating the BMD coefficient of variation at the rat spine (1.20%), total femur (0.52%), proximal femur (1.16%), midfemur (1.00%), distal femur (0.96%), and proximal tibia (2.2%). The long-term precision of femoral measurements in rat cadavers over a 4 week period was 0.72% for the total femur and 1.2% for the distal femur. The accuracy of the technique was assessed by comparing DEXA-measured bone mineral content (BMC) in vitro and in vivo with ashed BMC. Results indicated a highly significant positive correlation between in vitro DEXA measurements and ash BMC (r = 0.99) and between in vivo DEXA measurements and ash BMC (r = 0.89). The ability of the technique to detect bone loss was assessed at the femoral site by comparing the BMD of ovariectomized (OVX) and sham-operated rats at baseline and at a 1 month follow-up. There was no significant difference in BMD between the groups at baseline. However, at 1 month follow-up the OVX group showed a significant (p < 0.001) decline in BMD at the distal femur (-8.6%) and in the total femur (-4.8%) compared with sham-operated rats. A comparison of retired breeder female rats with age-matched nulliparous rats indicated that the BMD of retired breeder rats was significantly lower than that of virgin females at all femoral sites (p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)