Search

Background: Co-curricular (CoC) activity tracking and assessment are required by the Accreditation Council for Pharmacy Education (ACPE) 2016 Standards. The purpose of this manuscript is to evaluate the student-perceived impact of the type of CoC activity chosen. Methods: First-year (P1) through third-year (P3) students in a 4-year Doctor of Pharmacy programme were required to complete two Professional Development Unit (PDUs) activities each semester and two Self-Selected Activities (SSAs) longitudinally through each academic year. PDUs include passive attendance at practitioner presentations, whereas SSAs require more active engagement, such as membership in professional organisations. Students completed surveys for each CoC activity. Survey responses for spring 2020, fall 2020, and spring 2021 were collected through ExamSoft and analysed with PowerBI (2021) and IntellectusStatisticsTM (2019). Results: Students reported positive perceptions for both PDUs and SSAs in the areas of being “different from prior experiences”, “complimenting the curriculum”, “increased my understanding of the profession”, and being of “high quality”. Professional organisation activities were the most commonly selected SSA. Those activities with lower perceived benefit were less clearly aligned with the professional role of a pharmacist, such as intramural sports. Conclusion: Overall, most CoC activities that closely aligned with the profession of pharmacy were perceived to complement the curriculum and enhance students’ understanding of the field. Students reported perceived value in both active and passive CoC activities.

Background: Studies evaluating the dietary intake of Australian Football League Women’s (AFLW) athletes are few and limited to the preseason. This prospective observational study aims to evaluate seasonal changes in dietary intake and health parameters of professional AFLW athletes. Methodology: Dietary intake (3-day weighed food records), body composition (bioelectrical impedance analysis, skinfolds), physical performance (global positioning system, GPS), and iron status (fasted blood sample) were assessed in 19 athletes (24 ± 5 years, 170 ± 6 cm, 22.8 ± 2.1 kg/m2) at three timepoints: start of preseason, end of preseason, and end of competition season. Sociodemographic information, sports nutrition knowledge (SNK), and risk of low energy availability (LEA) questionnaires were completed at the start of preseason. Results: Mean daily energy and carbohydrate (CHO) intakes were lower than recommendations across all seasons (p 80% of players did not meet minimum recommendations at each timepoint (all, p 21 km/h) efforts significantly increased across preseason and decreased during competition (all, p

Pain associated with severe burn injury is one of the most intense and clinically challenging to manage, as the metabolic imbalances associated with the inflammation caused by the injury and treatment interventions (e.g., dressing changes and debridement, excision, and grafting) can further worsen the pain. In the pharmacologic management of a complex, hospitalized patient with burn injuries, opioid therapy remains an efficacious mainstay of treatment. However, the complex nature of pain, injury characteristics, and common demographics after burn injury place patients at high risk of opioid-related adverse events. Thus, guidelines recommend that decisions about choice of opioid be based on physiology, pharmacology, and physician experience, in addition to individualizing initial treatment with subsequent continual adjustments throughout care. Although substantial progress has been made in pain management strategies with utilization of nonopioid medications and nonpharmacologic adjuncts to opioid pharmacotherapy, there is still a need to evaluate new therapies, as an optimal regimen still lacks significant evidential support. Herein, we review the actions of opioids at the cellular level, contributing to both nociception and opioid-related adverse events. We also discuss the most recently approved intravenously administered opioid, oliceridine, developed utilizing biased ligand technology, including a summary of its clinical efficacy and safety in the management of severe acute pain. While oliceridine has been evaluated for the management of moderate-to-severe acute pain, the large phase 3 studies did not include patients with burn injuries. However, potential implications and future study direction for pain associated with burn injury are discussed.

The presence of a small amount of oligomer can induce ordering and crystallization of the parent conducting polymer, resulting in highly conductive, compositionally homogeneous crystals with defined molecular weights.

The growing population of survivors of childhood brain tumors present the challenge of long-term quality of survival. The domains most affected by tumor and treatment are those implicated in development of typical intellectual functions: attention, working memory, and processing speed, with consequent effects upon function and quality of life. In this paper we present service evaluation data on the 12-month effect upon processing speed, visual and auditory attentional domains in 29 patients receiving methylphenidate aged 5-16 years (Mean=10.6).Patients received immediate-release methylphenidate and were converted to modified-release as appropriate. Mean optimal dose of immediate-release methylphenidate was 0.34 mg/kg per dose (range 0.2-0.67).Patients showed a significant positive impact of methylphenidate on attention in all tests of selective visual attention from the Test of Everyday Attention for Children 2. A significant improvement was also shown on response time. Significant change was not found on psychometric measures of sustained auditory or visual attention, or selective auditory attention. Ratings of Health-Related Quality of Life showed a positive benefit of methylphenidate at 12 months. Side effects were minimal and not statistically significant.Survivors of childhood brain tumor with attentional and processing speed deficit show clinical benefit from methylphenidate.

Understanding the combined effects of multi-parasite infections on their hosts is necessary for documenting parasite impacts and is particularly important for developing effective management strategies for economically important organisms. The white shrimp Penaeus setiferus supports important recreational and commercial fisheries along the southeastern and Gulf coasts of the United States and occupies an important ecological niche in estuarine and offshore habitats throughout these regions. The goal of this study was to identify and assess ontogenetic and spatial variation in white shrimp parasite communities and their relation to shrimp health. We used a series of trawl surveys in tidal creek and open water habitats of an estuary in the southeastern USA to collect and identify parasites of white shrimp using morphological and DNA sequencing techniques. Parasite communities in white shrimp were composed of organisms belonging to 6 classes: Conoidasida (gregarines), Oligohymenophorea (apostome and sessilid ciliates), Microsporea (meiodihaplophasids), Chromadorea (rhabditids), Cestoda (cyclophyllideans, lecanocephalideans and trypanorhynchs) and Trematoda (plagiorchiids). Parasite communities differed significantly among white shrimp life stages and localities. Furthermore, the health condition known as black gill occurred in some shrimp and was significantly related to parasite community structure. Infection metrics for the apostome ciliate Hyalophysa lynni, the trypanorhynch larvae Prochristianella sp. and the rhabditid larvae Hysterothylacium sp. were significantly different between shrimp exhibiting and not exhibiting black gill. These results highlight the importance of understanding parasite communities and the potential interactive effects of multiple parasite infections on shrimp health.

The goal of the study was to identify secular trends in dental service delivery between dental therapists and dentists in the Yukon-Kuskokwim Delta region of Southwest Alaska, the first area of the United States to authorize dental therapy practice.Electronic health record transactions from the Yukon-Kuskokwim Health Corporation from 2006 through 2015 (n = 27,459) were analyzed. Five types of dental services were identified using Current Dental Terminology procedure codes: diagnostic, preventive, restorative, endodontic, and oral surgery. Main outcomes were percentages of services provided by dental therapists compared with dentists and population-level preventive oral health care.The overall number of diagnostic, preventive, and restorative services in the Yukon-Kuskokwim Delta increased. For diagnostic services, there was a 3.5% annual decrease observed for dentists and a 4.1% annual increase for dental therapists (P.001). Similar trends were observed for restorative services. For preventive services, there was no change for dentists (P = .89) and a 4.8% annual increase for dental therapists (P.001). Dental therapists were more likely than dentists to provide preventive care at the population level.Dental therapists have made substantial contributions to the delivery of dental services in Alaska Native communities, particularly for population-based preventive care.The study's findings indicate that there is a role for dental therapy practice in addressing poor access to oral health care in underserved communities.

The ice-covered Arctic Ocean constitutes a unique underwater acoustic waveguide; it is a half-channel, upward refracting environment possessing a rough upper boundary consisting of sea ice of varying thickness. The sea ice itself is an acoustic waveguide, capable of supporting the propagation of compressional and shear waves. In particular, the ice supports compressional wave resonances created by impulsive forces on the upper surface of the ice. During ICEX20 and ICEX22, observations were made of compressional wave resonances excited by hammer drops, as well as by near-impulsive signals generated from the compression of dry snow underfoot while walking on the ice. Results demonstrate that ice thickness can be inferred from compressional wave resonances in the sea ice waveguide using signals generated by walking on the snow-covered ice. Inferred ice thickness estimates were consistent with observations made by magnetic induction and physical measurements in holes drilled through the ice. Average first- and multi-year ice thicknesses were inferred to be 1.1–1.3 m and 2.4–2.5 m, respectively.

The laureates brought the conceptual features of quantum physics back to mainstream interest.

Ethical concerns frequently arise in suicide prevention research regarding participant safety and confidentiality. Despite a substantial literature on managing and navigating ethical concerns in suicide research, little attention has been paid to the reporting of ethical procedures. Furthermore, standard procedures for reporting ethical risk management procedures have not been developed.A review of the current literature was performed to examine the current state of reporting of ethical procedures within suicide research. Articles published in 2020 (The majority of articles reported ethical review or approval (84.7%) and reported the use of an informed consent process (77.9%). Only 28.2% included risk mitigation procedures. Of those 29.7% of those articles reported conducting risk evaluation, 66.7% reported resource dissemination, and 51.4% reported an intervention.As empirical support for brief interventions accrues, suicide prevention researchers should consider establishing standards for the reporting of procedures to ensure the safety of participants with suicidal risk.HighlightsReporting suicide safety protocols helps ensure high ethical standards in research.Fewer than 1/3 of articles reviewed reported risk mitigation procedures in 2020.Standard procedures for reporting safety protocols in suicide research are needed.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has caused considerable morbidity and mortality worldwide. The protection provided by vaccines and booster doses offered a method of mitigating severe clinical outcomes and mortality. However, by the end of 2021, the global distribution of vaccines was highly heterogeneous, with some countries gaining over 90% coverage in adults, whereas others reached less than 2%. In this study, we used an age-structured model of SARS-CoV-2 dynamics, matched to national data from 152 countries in 2021, to investigate the global impact of different potential vaccine sharing protocols that attempted to address this inequity. We quantified the effects of implemented vaccine rollout strategies on the spread of SARS-CoV-2, the subsequent global burden of disease and the emergence of novel variants. We found that greater vaccine sharing would have lowered the total global burden of disease, and any associated increases in infections in previously vaccine-rich countries could have been mitigated by reduced relaxation of non-pharmaceutical interventions. Our results reinforce the health message, pertinent to future pandemics, that vaccine distribution proportional to wealth, rather than to need, may be detrimental to all.

Let $$\Gamma$$ Γ be an arithmetic subgroup of $${{\,\mathrm{SU}\,}}(d,1)$$ SU ( d , 1 ) with cusps, and let $$X_\Gamma$$ X Γ be the associated locally symmetric space. In this paper we investigate the pre-image of $$\Gamma$$ Γ in the covering groups of $${{\,\mathrm{SU}\,}}(d,1)$$ SU ( d , 1 ) . Let $$H^\bullet _!(X_\Gamma ,\mathbb {C})$$ H ! ∙ ( X Γ , C ) be the inner cohomology, i.e. the image in $$H^\bullet (X_\Gamma ,\mathbb {C})$$ H ∙ ( X Γ , C ) of the compactly supported cohomology. We prove that if the first inner cohomology group $$H^1_!(X_\Gamma ,\mathbb {C})$$ H ! 1 ( X Γ , C ) is non-zero then the pre-image of $$\Gamma$$ Γ in each connected cover of $${{\,\mathrm{SU}\,}}(d,1)$$ SU ( d , 1 ) is residually finite. At the end of the paper we give an example of an arithmetic subgroup $$\Gamma$$ Γ satisfying the criterion $$H^1_!(X_\Gamma ,\mathbb {C}) \ne 0$$ H ! 1 ( X Γ , C ) ≠ 0 .

In this case series, we present 5 cases of autoimmune rheumatic disease onset shortly after receiving mRNA vaccination against coronavirus disease 2019 (COVID-19).We identified 5 patients from Brooke Army Medical Center who developed new manifestations of rheumatic disease following the second dose of the Pfizer-BioNTech or Moderna COVID-19 vaccinations. All patients were initially seen in primary care and then referred to rheumatology for further evaluation and management. Clinical data were obtained through review of the electronic medical record.Three cases involve elderly women with insidious onset of symmetric wrist and hand polyarthritis with seropositivity for rheumatoid factor. One case involves an elderly woman with a subacute onset of lower extremity-predominant, symmetric polyarthritis. One case involves an elderly man with insidious onset of bilateral shoulder and hip stiffness and arthralgias in the setting of elevated erythrocyte sedimentation rate and a rapid response to glucocorticoid therapy.Whether there exists a causal or contributory relationship between COVID-19 mRNA vaccination and the development of autoimmune rheumatic disease remains to be determined. Ultimately, further research is needed to establish if there is a true connection between the two.

Background: Lesbian, gay, and bisexual youth face a disproportionate risk of suicidal ideation and attempt compared to heterosexual counterparts. Escalation from ideation to attempt can occur quickly, and youth who survive suicide attempts are likely to pursue subsequent, riskier attempts. This study examines the effects of bullying and sexual orientation on suicidal outcomes. Methods: Data came from the national, school-administered 2017 Youth Risk Behavior Survey (N = 14,765). Bivariate associations, binomial logistic regressions, and ordinal logistic regressions were performed. Results: Lesbian/gay, bisexual, and unsure youth reported greater odds of ideation and attempts compared to heterosexual youth. For ideation, increased effects were inconsistent across bullying types and significant interactions were found for bisexual youth who were bullied in school, and for lesbian/gay youth who were cyberbullied. Conclusion: These results underscore the need to understand bullying victimization for lesbian, gay, and bisexual youth. Awareness of increasing cyberbullying and creating school environments of no-bullying tolerance in the post-pandemic era are among the challenges ahead.

CRISPR/Cas9-based genome-editing therapies are poised to change the clinical outcome for many diseases with validated therapeutic targets awaiting an appropriate delivery system. Recent advances in lipid nanoparticle (LNP) technology make them an attractive platform for the delivery of various forms of CRISPR/Cas9, including the efficient and transient Cas9/gRNA ribonucleoprotein (RNP) complexes. In this study, we initially tested our novel LNP platform by delivering pre-complexed RNPs and template DNA to cultured mouse cortical neurons, and obtained successful ex vivo genome editing. We then directly injected LNP-packaged RNPs and DNA template into the mouse cornea to evaluate in vivo delivery. For the first time, we demonstrated wide-spread genome editing in the cornea using our LNP-RNPs. The ability of our LNPs to transfect the cornea highlights the potential of our novel delivery platform to be used in CRISPR/Cas9-based genome editing therapies of corneal diseases.

INTRODUCTION: Media guidelines for the responsible reporting of suicide are a recognized universal suicide prevention intervention. While implemented in numerous countries, including Australia, little is known about whether they are cost-effective. We aimed to determine the cost-effectiveness of Mindframe, the national initiative implementing media guidelines in Australia. METHOD: We conducted a modelled economic evaluation (5-year time-horizon) incorporating two types of economic analysis: (i) return-on-investment (ROI) comparing estimated cost savings from the intervention to the total intervention cost, and (ii) cost-effectiveness analysis comparing the net intervention costs to health outcomes: suicide deaths prevented and quality-adjusted life-years (QALYs). We also included uncertainty analyses to propagate parameter uncertainty and sensitivity analyses to test the robustness of the model outputs to changes in input parameters and assumptions. RESULTS: The estimated ROI ratio for the main analysis was 94:1 (95% uncertainty interval [UI]: 37 to 170). The intervention was associated with cost savings of A$596M (95% UI: A$228M to A$1,081M), 139 (95% UI: 55 to 252) suicides prevented and 107 (95% UI: 42 to 192) QALYs gained. The intervention was dominant, or cost-saving, compared with no intervention with results being robust to sensitivity analysis but varying based on the conservativeness of the parameters entered. CONCLUSION: Mindframe was found to be cost-saving, and therefore, worthy of investment and inclusion as part of national suicide prevention strategies. ispartof: SUICIDE AND LIFE-THREATENING BEHAVIOR vol:52 issue:5 pages:1048-1057 ispartof: location:England status: published

Vitamin D (25OHD) deficiency is associated with poor outcomes in intensive care populations. The primary objective of this 7-center study was to determine if 25OHD deficiency is associated with infectious outcomes in adult burn patients. Generalized linear mixed modeling was used to control for center effect, percent total body surface area burn (% TBSA), age, and presence of inhalation injury. A total of 1147 patients were initially included (admitted January 2016 through August 2019). After exclusions, 234 (56.8%) in the deficient (25OHD20 ng/mL) and 178 in the non-deficient group (25OHD ≥ 20 ng/mL) remained, surpassing a priori power requirements. The non-deficient group had their concentration drawn earlier (p 0.001), were more likely to be male (p = 0.006), Caucasian (p 0.001), have lower body mass index (p = 0.009), lower % TBSA (p = 0.002), and taking a 25OHD supplement prior to admission (p 0.001). Deficient patients were more likely to have an infectious outcome (52.1% vs 36.0%, p = 0.002), acute kidney injury with renal replacement therapy (p = 0.009), less ventilator free days in the first 28 days (p 0.001), and vasopressors (p = 0.01). After controlling for center, % TBSA, age, and inhalation injury the best model also included presence of deficiency (OR 2.425 [CI 1.206-4.876]), days until 25OHD supplement initiation (OR 1.139 [CI 1.035-1.252]), and choice of cholecalciferol over ergocalciferol (OR 2.112 [CI 1.151-3.877]). To the authors' knowledge, this is the first multicenter study to evaluate the relationship between 25OHD and infectious complications in burn patients.

Bone calcium balance is the net gain, loss, or equilibrium of calcium moving to and from bone, which reflects bone balance. There are currently no clinically available tools for measuring real-time bone balance. In this issue, Shroff et al. demonstrate the use of natural stable calcium isotope ratios as a novel biomarker of bone balance in children with chronic kidney disease on dialysis that is highly repeatable and associated with radiological and biochemical markers of bone metabolism.

The evolution of human cognitive function is reliant on complex social interactions which form the behavioural foundation of who we are. These social capacities are subject to dramatic change in disease and injury; yet their supporting neural substrates remain poorly understood. Hyperscanning employs functional neuroimaging to simultaneously assess brain activity in two individuals and offers the best means to understand the neural basis of social interaction. However, present technologies are limited, either by poor performance (low spatial/temporal precision) or an unnatural scanning environment (claustrophobic scanners, with interactions via video). Here, we describe hyperscanning using wearable magnetoencephalography (MEG) based on optically pumped magnetometers (OPMs). We demonstrate our approach by simultaneously measuring brain activity in two subjects undertaking two separate tasks—an interactive touching task and a ball game. Despite large and unpredictable subject motion, sensorimotor brain activity was delineated clearly, and the correlation of the envelope of neuronal oscillations between the two subjects was demonstrated. Our results show that unlike existing modalities, OPM-MEG combines high-fidelity data acquisition and a naturalistic setting and thus presents significant potential to investigate neural correlates of social interaction.

The objective of this study was to compare the pathogens and susceptibilities of the current automated, rule-based technology (RBT) antibiogram with one manually collected through chart review with additional rules applied. This study was a two-year, retrospective cohort study and included all bacterial cultures within the first 30 days from patients admitted to a single Burn Center. The current RBT antibiogram served as the control, and new antibiogram versions were created using additional rules and compared to the control. Six-hundred fifty-seven patients were admitted (61% excluded for lack of cultures). 59% had at least one hospital-acquired risk factor, with over one-third having recent illicit drug use and one-third having a recent hospitalization. Of the 410 cultures included, 57% were Gram-negative, and half were from wound infections. Sensitivities were significantly different when comparing the manual and the RBT version after including factors such as days since admission, presence of hospital-acquired risk factors, or previous antibiotic courses. Recommended empiric Gram-negative antibiotics changed from double coverage to a single β-lactam with >90% susceptibility. The susceptibilities between the first and subsequent courses were dramatically different. Before developing an antibiogram or interpreting the output, it is important to consider which automated criteria are utilized, especially for units with extended lengths of stay.

Neonates of hammerhead sharks (Sphyrnidae), Sphyrna lewini (Griffith and Smith, 1834), the sympatric cryptic species, Sphyrna gilberti Quattro et al., 2013, and their hybrids were captured in the western North Atlantic, along the coast of South Carolina, USA, between 2018 and 2019 and examined for gill monogenoids. Parasites were identified and redescribed from the gills of 79 neonates, and DNA sequences from partial fragments of the nuclear 28S ribosomal RNA (rDNA) and cytochrome c oxidase I mitochondrial DNA (COI) genes were generated to confirm species identifications. Three species of monogenoids from Hexabothriidae Price, 1942 and Monocotylidae Taschenberg, 1879 were determined and redescribed. Two species of Hexabothriidae, Erpocotyle microstoma (Brooks, 1934) and Erpocotyle sphyrnae (MacCallum, 1931), infecting both species of Sphyrna and hybrids; and 1 species of Monocotylidae, Loimosina wilsoni Manter, 1944, infecting only S. lewini and hybrids. Loimosina wilsoni 28S rDNA sequences matched those of Loimosina sp. from the southern coast of Brazil. Based on limited morphological analysis, Loimosina parawilsoni is likely a junior synonym of L. wilsoni. This is the first taxonomic study of monogenoids infecting S. gilberti and hybrids of S. gilberti and S. lewini.

Small cell lung cancer (SCLC) is characterized by morphologic, epigenetic and transcriptomic heterogeneity. Subtypes based upon predominant transcription factor expression have been defined that, in mouse models and cell lines, exhibit potential differential therapeutic vulnerabilities, with epigenetically distinct SCLC subtypes also described. The clinical relevance of these subtypes is unclear, due in part to challenges in obtaining tumor biopsies for reliable profiling. Here we describe a robust workflow for genome-wide DNA methylation profiling applied to both patient-derived models and to patients’ circulating cell-free DNA (cfDNA). Tumor-specific methylation patterns were readily detected in cfDNA samples from patients with SCLC and were correlated with survival outcomes. cfDNA methylation also discriminated between the transcription factor SCLC subtypes, a precedent for a liquid biopsy cfDNA-methylation approach to molecularly subtype SCLC. Our data reveal the potential clinical utility of cfDNA methylation profiling as a universally applicable liquid biopsy approach for the sensitive detection, monitoring and molecular subtyping of patients with SCLC.

Magnetoencephalography (MEG) measures human brain function via assessment of the magnetic fields generated by electrical activity in neurons. Despite providing high-quality spatiotemporal maps of electrophysiological activity, current MEG instrumentation is limited by cumbersome field sensing technologies, resulting in major barriers to utility. Here, we review a new generation of MEG technology that is beginning to lift many of these barriers. By exploiting quantum sensors, known as optically pumped magnetometers (OPMs), 'OPM-MEG' has the potential to dramatically outperform the current state of the art, promising enhanced data quality (better sensitivity and spatial resolution), adaptability to any head size/shape (from babies to adults), motion robustness (participants can move freely during scanning), and a less complex imaging platform (without reliance on cryogenics). We discuss the current state of this emerging technique and describe its far-reaching implications for neuroscience.

Grieving children are at risk for negative outcomes (American Academy of Child and Adolescent Psychiatry, 2020). This study described a collaboration between a community agency and a large school district to create and implement groups for grieving children. A preliminary evaluation of the effectiveness of these groups was conducted. Quantitative and qualitative data from 318 students, 59 group facilitators, and 59 school counselors indicated that the grief group was a promising intervention for diverse students with regard to enhancing awareness about grief, reducing isolation, providing a place to share feelings, and learning coping strategies after the death of a significant person. This research may inform the development, implementation, and evaluation of other important interventions established through community partnerships to prevent negative outcomes associated with unattended grief in childhood.

It is commonly believed that IL-12 produced by DCs in response to pathogens is the first signal that stimulates the production of IFN-γ by NK cells. However, IL-12 production by DCs in response to bacterial LPS depends on either engagement of CD40 by CD40L on activated T cells or IFN-γ from NK cells. This suggests that during the primary immune response, NK cells produce IFN-γ before IL-12 production by DCs. Here, using single-cell measurements, cell sorting and mouse lines deficient in IL-12, IL-23, type I IFN receptor and the IL-18 receptor, we show that a subset of BM-derived DCs characterized by low expression of MHC class II (MHCII

The oscillon is a highly localized dynamical phenomenon occurring in a thin horizontal layer of granular material, which rests on a rigid plate oscillating in the vertical direction. The geometry is axially symmetric and physically resembles a splash of liquid due to a falling drop, except that it continually perpetuates itself and does not generate a spreading wave, as is the case for a liquid splash. The oscillon moves from "peak" to "crater" and "crater" to "peak" such that the time from "peak" to "peak" or "crater" to "crater" is twice the period of the oscillating plate. The physics of granular phenomena is not properly understood, and there is no continuum mechanical theory of granular materials which is widely accepted as accurately describing their behaviour. Here for a free-flowing (cohesion-less) granular material, under axially symmetric conditions, we present a partial continuum mechanical analysis assuming the Coulomb-Mohr yield function and non-dilatant double-shearing theory. We examine small perturbations superimposed upon a purely vertical vibration, and make the assumption that throughout the motion, the lower surface of the layer remains in contact with the rigid metal plate. We show how the temporal dependence, which decouples from the spatial structure, is governed by Mathieu's equation for the physically relevant case of the rigid plate oscillating sinusoidally, and therefore stability is determined by certain key parameters. We explore a variety of possible forms for spatial dependence. The present axially symmetric analysis complements that presented by the authors for plane strain conditions, and we find, quite remarkably, that apart from constants, both flows are governed by similar fourth-order systems of ordinary differential equations. This means that for both plane strain and axially symmetry, analogous pattern forming conditions can operate. Refereed/Peer-reviewed