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Use of experimental cats and dogs in veterinary heartworm preclinical drug research is increasing. As a potential alternative primaryin vivoheartworm preventative drug screen, we assessed lymphopenic mice with ablation of the interleukin-2/7 common gamma chain (γc) as susceptible to the larval development phase ofD. immitis. Non-obese diabetic (NOD) Severe Combined ImmunoDeficient (SCID)γc-/-(NSG / NXG) mice consistently yielded viableD. immitislarvae at 2-4 weeks post-infection across multiple experiments, different batches of infectious larvae inoculates, different isolates ofD. immitisand at independent laboratories. Mice did not display any overt clinical signs associated with infection up to 4 weeks. Developing larvae were found in subcutaneous and muscle fascia tissues, the natural site of this stage of heartworm in dogs. Larvae retrieved from NSG / NXG mice were mid-L4 stage of development. Compared with 14-dayin vitropropagated larvae,in vivoderived L4 were significantly larger and contained expandedWolbachiaendobacteria titres, determined by QPCR and Fluorescentin situHybridisation (FISH). We established anex vivo6-day L4 paralytic screening system against nematodicidal agents (moxidectin, levamisole) which highlighted discrepancies in relative drug sensitivities in comparison within vitroreared L4D. immitis.We demonstrated effective depletion ofWolbachiaby 70-90% inD. immitisL4 following 2-7 day oralin vivoexposures of NSG / NXG infected mice with doxycycline or the rapid-acting investigational anti-Wolbachiadrug, AWZ1066S. We validated the NSG / NXG mouse model as a filaricide drug screen byin vivotreatments with single injections of moxidectin, which mediated 60-88% reduction in L4 larvae at 14-28 days. Future adoption of the mouse model as a first-line efficacy screen will benefit end-user laboratories conducting research and development of novel heartworm preventatives via increased access, rapid turnaround and reduced costs whilst simultaneously decreasing need for experimental cat or dog use.

The steam turbine is used as the prime mover for driving equipment such as blowers, pumps and compressors, but its predominant use is to drive alternators and generators for the production of electricity.

Background: Normal subjects frequently experience troublesome respiratory symptoms when acclimatised to altitude. Bronchial hyperresponsiveness (BHR) and full and partial flow-volume loops were measured before and after ascent to 5000 m altitude to determine if there are changes in resting bronchial tone and BHR that might explain the symptoms. Methods: BHR to histamine was measured using a turbine spirometer to record partial and full flow-volume curves and expressed as log dose slopes. Twenty one subjects were tested at sea level and after acclimatisation at 5000 m altitude. Results: No significant change in log dose slope measurements of forced expiratory volume in 1 second occurred after acclimatisation, and the maximal expiratory flow with 30% of forced vital capacity remaining (MEF30%) rose on the full loop and fell on the partial loop. Their ratio (full divided by partial) rose on average by 0.28 (95% confidence limits 0.14 to 0.42) from the mean (SD) sea level value of 0.87 (0.20). Conclusions: There is no increase in BHR in normal subjects acclimatised to altitude but an increase in resting bronchial tone occurs that could be released by deep inspiration. This may be the result of increased cholinergic tone.

As survival of preterm infants improves, the long-term care of consequent ophthalmic problems is an expanding field. Preterm birth can inflict a host of challenges on the developing ocular system, resulting in the visual manifestations of varied significance and pathological scope. The ophthalmic condition most commonly associated with preterm birth is retinopathy of prematurity, which has the potential to result in devastating vision loss. However, the visual compromise from increased incidence of refractive errors, strabismus, and cerebral vision impairment has significant impact on visual function, which also has influence on other developmental aspects including psychological and educational. In this review, the normal ocular development is discussed, aiming to exemplify the impact of early exteriorisation on one of the more naive organs of prematurity. This is then related to the incidence and visual consequences of many types of deficit, including refractive error, strabismus, and loss of visual function in preterm populations, with comparisons to term infant studies. Often these conditions are linked with causal and resultant factors being impossible to segregate, but the common factor of increased rates of all types of ophthalmic deficits demonstrates that children born prematurely are indeed premature for life.

Although age-adjusted cancer death rates have started to decline in the United States and other developed nations − thanks in large part to widespread screening programs that detect cancers at early, treatable stages − cancer in developing countries is on the rise. Ironically, rising life expectancy in those nations along with the adoption of ‘Western’ lifestyles will leave many more people vulnerable to cancer. Unfortunately, the early detection tools and treatment technology that have helped control cancer in wealthier lands are often not readily available in many other countries. Much of this increased cancer burden will take the form of cancers that affect women − not only breast, cervical, and other gynecologic cancers but colorectal cancer, lung cancer, and other malignancies related to tobacco. Physicians specializing in cancer care for women need to be alert to every opportunity to improve cancer screening and prevention among the growing, aging populations of less-developed countries. Less precise but less costly and more widely available screening techniques may save thousands more lives than the most sophisticated technology because low-cost programs can be applied widely instead of being reserved for a fortunate few. In addition, education and prevention efforts directed toward tobacco use need to be put in place to help stem an epidemic of tobacco-related cancers that has largely peaked in developed countries but looms ominously in the future of developing nations.

Tracheal intubating conditions were assessed in 112 children after induction of anaesthesia with propofol and remifentanil 1.0, 2.0 or 3.0 micro g.kg-1. Subjects in a control group were given propofol and mivacurium 0.2 mg.kg-1. Haemodynamic and respiratory parameters were recorded. Plasma catecholamine levels were measured in a subgroup of 40 children. Intubating conditions were acceptable in 14/28 (50%), 18/26 (69%) and 22/27 (82%) in those subjects given remifentanil 1.0, 2.0 or 3.0 micro g.kg-1, respectively, and in 27/28 (96%) of the control group. Intubating conditions in subjects given remifentanil 3.0 micro g.kg-1 were better than in those given remifentanil 1.0 micro g.kg-1 (p < 0.05). There were no significant differences in intubating conditions between those given remifentanil 3.0 micro g.kg-1 and the control group. Systolic blood pressure and heart rate increased in response to tracheal intubation in subjects given remifentanil 1.0 micro g.kg-1 and in the control group (p < 0.05). Time to resumption of spontaneous respiration was prolonged in subjects given remifentanil 3.0 micro g.kg-1 (p < 0.001). In conclusion, remifentanil 2 micro g.kg-1 provides acceptable intubating conditions and haemodynamic stability without prolonging the return of spontaneous respiration.

Aims and MethodWe describe activity and outcome concerning a consecutive series of older community patients referred to an outreach support team while waiting for acute psychiatric admission.ResultsForty patients on an admissions waiting list who were referred to the outreach support team were followed up. Each patient was reassessed for admission by the responsible medical officer when an in-patient bed became available. Thirty patients who would have been admitted (if a bed had been available at the time of the first assessment) remained at home and did not need hospitalisation.Clinical ImplicationsThis study suggests that intensive domiciliary support might offer an acceptable form of crisis intervention for older people with mental illness. Further research is needed before generalisation of these findings can be recommended.

We have developed a method for analytically solving the porous medium flow equation in many different geometries for horizontal (two-dimensional), homogeneous and isotropic aquifers containing impermeable boundaries and any number of pumping or injection wells located at arbitrary positions within the system. Solutions and results are presented for rectangular and circular aquifers but the method presented here is easily extendible to many geometries. Results are also presented for systems where constant head boundary conditions can be emulated internal to the aquifer boundary. Recommendations for extensions of the present work are briefly discussed. Copyright © 2003 John Wiley & Sons, Ltd.

The intertidal black abalone Haliotis cracherodii has experienced mass mortalities along the coast of California, USA, since the mid-1980s. Mortality is due to infection by a pathogen that leads to a fatal wasting disease called 'withering syndrome', where the foot of the abalone atrophies until it can no longer adhere to the substratum. Massive die-offs due to withering syndrome were first noted on the Channel Islands in 1986, and by 1992 withering syndrome was observed near Point Conception on the mainland and was suspected to be spreading northward up the coast of California. The timing of the initial mass mortalities following the strong 1982 to 1983 El Nino and an isolated outbreak of withering syndrome in 1988 at Diablo Cove, north of Point Conception, following warm water dis- charge from a power plant, led to the hypothesis that the onset of mass mortalities due to withering syndrome may be triggered by elevated seawater temperatures. We surveyed black abalone popula- tions at 7 sites along the mainland coast of California (including 3 where withering syndrome was al- ready present) from 1992 to 2001, a period spanning 2 El Nino events, to determine whether (1) with- ering syndrome and associated declines of black abalone were spreading northward up the coast; and (2) these mass mortalities of black abalone could be related to elevated seawater temperatures during El Nino events. Mass mortalities of black abalone due to withering syndrome were observed at the 5 most southern sites (>90% decline in numbers in all size classes), but not at the 2 most northern sites, and there was a clear pattern of decline from south to north over time. Massive die-offs of abalone were not exclusively associated with times of elevated sea surface temperatures due to El Nino. Nev- ertheless, rapid declines of abalone at 2 sites coincided with the strong 1997 to 1998 El Nino, and de- clines during El Nino events were faster than those during non-El Nino years. Abalone at the 2 most northern sites, where only slight declines occurred during the 1997 to 1998 El Nino, may not have been infected by disease. It appears, therefore, that in the presence of the pathogen, warm water conditions associated with El Nino may accelerate the development of withering syndrome and the rate of decline of black abalone. Consequently, anthropogenic disturbances, such as discharges of heated water or global warming, may increase the incidence of this fatal disease.

Traditional British undergraduate medical education has evolved with the development of medicine as a profession. However, despite dramatic progress in the provision of healthcare, the medical curriculum has remained mostly unchanged until recently. Conventional medical courses rely on the teacher-centred didactic setting of a lecture theatre to transmit vast quantities of information. This one-way traffic of facts is divided initially into the preclinical basic sciences and later into the medical specialties, with relatively little horizontal or vertical integration. Much of the assessment of students relies on their reproducing information as accurately as possible. This traditional format has been widely criticised (Lowry, 1992).

A 63-year-old female developed respiratory failure and was admitted to the Intensive Care Unit for non-invasive ventilation, inotropic support and antibiotic therapy. The patient was initially stable but then suddenly deteriorated with acute pulmonary oedema requiring mechanical ventilation. An electrocardiogram showed an acute ST elevation myocardial infarction and the patient subsequently had an urgent coronary angiogram which revealed normal coronary arteries but apical ballooning characteristic of Takotsubo cardiomyopathy. A short review is provided of this relatively newly described heart syndrome which has the potential to present in numbers of intensive care patients. This case emphasises the importance of being aware of uncommon causes of acute ECG changes in the critically ill.

Many decompression computers developed for the SCUBA leisure market over the past five years have the facility to store profile information which can be interrogated through PC interfaces. This capability allows for a variety of dive parameters to be stored, and subsequently downloaded [I]. The Natural Environment Research Council (NERC) Cent re for Oiving at Ounstaffnage, has been using a number of models of decompression computers over the past two years. Their use has been as dive loggers, and examples of the parameter categories recorded, and at what level of precision, are presented here in brief. The NERC Centre also accommodates a hyperbaric treatment facility. The availability of the software and PC interfaces necessary to download from most models of dive computers, has allowed for the incorporation of actual recorded dive details within the treatment management process. The benefits of having that additional information, usually at the commencement of the treatment, are discussed below. lt is not intended here to give a detailed product guide of downloadable computers, and a systematic investigation of all types of computers has not been attempted. The purpose of this note is to summarise the uses of such computers to the diving at work and hyperbaric treatment communities. Use of decompression computers as dive profilers and electronic logbooks

The effects of exercise training on cell surface GLUT-4 in skeletal muscle of the obese (fa/fa) Zucker rat were investigated using the impermeant glucose transporter photoaffinity reagent 2-N-4-(1-azi-2,2,2-trifluoroethyl)-benzoyl-1,3-bis- (D-mannos-4-yloxy)-2-propylamine (ATB-BMPA). In the absence of insulin, 3-O-methyl-D-glucose transport activity was no different in either fast-twitch (epitrochlearis) or slow-twitch (soleus) muscles of trained and sedentary obese rats. Likewise, basal ATB-BMPA-labeled GLUT-4 was not altered in these muscles with training. In contrast, the trained group exhibited significantly greater insulin-stimulated (2 mU/ml) glucose transport activity in epitrochlearis muscles than the sedentary group (0.53 +/- 0.03 vs. 0.18 +/- 0.03 mumol.g-1 x 10 min-1 for trained and sedentary, respectively), which was paralleled by a significant enhancement of insulin-stimulated cell surface GLUT-4 (5.33 +/- 0.20 vs. 1.57 +/- 0.14 disintegrations.min-1.mg-1 for trained and sedentary, respectively). Exercise training, however, did not alter insulin-stimulated glucose transport activity or cell surface GLUT-4 in soleus muscles. Finally, exercise training did not alter the ability of muscle contraction to elevate glucose transport activity or cell surface GLUT-4 in either epitrochlearis or soleus muscles of the obese rat. These results indicate that training improves insulin-stimulated glucose transport in muscle of the obese Zucker rat by increasing GLUT-4 content and by altering the normal intracellular distribution of these transporters such that they are now capable of migrating to the cell surface in response to the insulin stimulus.

The aim of the present investigation was to determine whether the subcellular distribution and insulin-stimulated translocation of the GLUT4 isoform of the glucose transporter are affected when GLUT4 is overexpressed in mouse skeletal muscle, and if the overexpression of GLUT4 alters maximal insulin-stimulated glucose transport and metabolism. Rates of glucose transport and metabolism were assessed by hind-limb perfusion in GLUT4 transgenic (TG) mice and non-transgenic (NTG) controls. Glucose-transport activity was determined under basal (no insulin), submaximal (0.2 m-unit/ml) and maximal (10 m-units/ml) insulin conditions using a perfusate containing 8 mM 3-O-methyl-D-glucose. Glucose metabolism was quantified by perfusing the hind limbs for 25 min with a perfusate containing 8 mM glucose and 10 m-units/ml insulin. Under basal conditions, there was no difference in muscle glucose transport between TG (1.10 +/- 0.10 mumol/h per g; mean +/- S.E.M.) and NTG (0.93 +/- 0.16 mumol/h per g) mice. However, TG mice displayed significantly greater glucose-transport activity during submaximal (4.42 +/- 0.49 compared with 2.69 +/- 0.33 mumol/h per g) and maximal (11.68 +/- 1.13 compared with 7.53 +/- 0.80 mumol/h per g) insulin stimulation. Nevertheless, overexpression of the GLUT4 protein did not alter maximal rates of glucose metabolism. Membrane purification revealed that, under basal conditions, plasma-membrane (approximately 12-fold) and intracellular-membrane (approximately 4-fold) GLUT4 protein concentrations were greater in TG than NTG mice. Submaximal insulin stimulation did not increase plasma-membrane GLUT4 protein concentration whereas maximal insulin stimulation increased this protein in both NTG (4.1-fold) and TG (2.6-fold) mice. These results suggest that the increase in insulin-stimulated glucose transport following overexpression of the GLUT4 protein is limited by factors other than the plasma-membrane GLUT4 protein concentration. Furthermore, GLUT4 overexpression is not coupled to glucose-metabolic capacity.

To examine the prevalence, incidence and risk factors associated with visual hallucinations (VHs) amongst people suffering from Parkinson's disease (PD).We recruited 513 patients with PD from movement disorder and PD clinics within three sites in the UK. Patients were interviewed using a series of standardised clinical rating scales at baseline, 12, 24 and 36 months. Data relating to VHs were collected using the North-East Visual Hallucinations Interview. Prevalence rates for VHs at each assessment were recorded. Associations were determined using multiple regression analysis.Cross-sectional prevalence rates for VHs at baseline, 12, 24 and 36 months indicated VHs in approximately 50% of patients. A cumulative frequency of 82.7% of cases at the end of the study period exhibited VHs. The incidence rate for VHs was 457 cases per 1000 population. Longer disease duration, greater impairment in activities of daily living and higher rates of anxiety were most commonly associated with VHs. No factors predictive of VHs could be ascertained.When examined longitudinally, VHs affect more patients than is commonly assumed in cross-sectional prevalence studies. Clinicians should routinely screen for VHs throughout the disease course. Disease duration, impairment in activities of daily living and anxiety presented as co-morbidities associated with VHs in PD, and therefore those presenting with VHs should be screened for anxiety disorder and vice versa.

We have used a photoaffinity label to quantify cell surface GLUT4 glucose transporters in isolated rat soleus muscles. In this system, insulin stimulated an 8.6-fold increase in 3-O-methylglucose glucose transport, while photolabelled GLUT4 increased 8-fold. These results demonstrate that the insulin-stimulated increase in glucose transport activity in skeletal muscle can be accounted for by an increase in surface-accessible GLUT4 content.

Patients who have chest pain occurring at rest are at a significant risk of myocardial infarction and or sudden death. Most trials enter patients with anginal rest pain after an initial screening period. Thus, the clinical efficacy of early thrombolytic treatment for patients with rest pain remains unproven. Eighty patients with chest pain at rest and with ECG changes of ST depression of at least 1 mm in any ECG lead, were randomized to alteplase 100 mg infused over 3 h, or placebo. Concomitantly, all patients received intravenous heparin and 300 mg of aspirin daily (unless contra-indicated). Seventy-four patients had coronary angiography (the majority within 72 h of admission) of which 73 were assessable. The patency of the ischaemia-related vessel was not significantly greater in the alteplase treated group (81% vs 78%, P = 0.82). The culprit lesion morphology tended to be more concentric in the alteplase treated group (84% vs 56%, P = 0.06) although alteplase treatment was not associated with a significant reduction in the severity of the culprit lesion stenosis. Intra-coronary thrombi were detected in 7% of patients (3% placebo, 11% alteplase, P = 0.35). The mean left ventricular ejection fraction or the alteplase-treated group was 49 +/- 3% and for the placebo-treated patients 56 +/- 3% (P = 0.05). There was no difference in the total in-hospital cardiac event rate i.e. cardiac death, myocardial infarction and coronary revascularization between patients receiving alteplase (10%, 63%, and 38%) and those receiving placebo (8%, 65%, and 30%) respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Background The islets of Langerhans are micro-organs rich in blood vessels. The process of islet isolation and culture disrupts the vasculature of the islets. The reestablishment of an appropriate microvascular supply is an essential prerequisite for long-term survival and function of islet grafts. In this study, we examined the effects on the process of neovascularization of coating the islets with fibrin. Methods Isolated human islets were stained using the dioctadecylindocarbocyanine (DII) dye. An aliquot of the human islets were embedded in 3-dimensional fibrin. Human islets (100 islets-equivalents) were transplanted into a mouse dorsal window model to evaluate angiogenesis over 17 days. Transplanted islets were divided into 2 groups: either free islets or islets coated with fibrin gel. Animals were imaged using intravital microscopy immediately and at 3, 4, 8, 11, and 17 days after surgery. The DII dye caused the islets to be fluorescent and visible using a rhodamine filter. Fluorescein isothiocyanate dextran was used to visualize vasculature structures surrounding the islets. Results Human islets coated with fibrin demonstrated an early appearance of a network of immature blood vessels that produced a significantly higher density/unit area for neovascularization by day 8 after transplantation. Conclusion Our preliminary data showed that fibrin played a role in early neovascularization and support to sustain development of new blood vessels. Fibrin formed a matrix that helped to maintain the 3-dimensional structure of, and therefore reducing the environmental stress on islets.

The surgical management of 50 false aneurysms caused by transfemoral arterial catheterization was reviewed to document the incidence and effects of rupture before repair. Twelve false aneurysms ruptured, leading to shock in six patients, distal ischaemia in three and stroke in one. The mean(s.d.) time, from catheterization to rupture was 2.8(1.7) (range 1-6) days. Postoperative complications occurred in seven patients with ruptured and eight with non-ruptured aneurysms (P < 0.04). The mean(s.d.) age of patients with ruptured aneurysms was 67.2(6.3) (95 per cent confidence interval 63.5–70.8) years and those without 58.5(9.1) (95 per cent confidence interval 55.3–61.7) years (P < 0.008). On multiple regression analysis, age, peripheral vascular disease and raised plasma liver enzyme levels on admission were found to be significant independent predictive variables for rupture (all P < 0.05). It is recommended that patients with these risk factors undergo urgent operative correction of femoral false aneurysm.

Shielding the lens of the eye while treating orbital lymphoid tumors and achieving a relatively homogeneous dose can be a dosimetric challenge. There are many clinical cases of tumors close to one or both eyes, where it is desirable to spare the lens as much as possible. We will show isodose curves comparing direct anterior fields using various electron beam energies to a single 6 mv photon beam to a multifield combination. The presence of an eye shield in a photon beam may impair the dose distribution at the back of the eye to an undesirable degree. The strong in-depth dose drop-off in electrons and the ease with which the beam can be intercepted suggests that an electron beam with an eye shield may offer advantages. We designed a suspended movable lens shield .8 cm wide with a height of 4.5 cm made of cerrobend surrounded by a brass cylinder mounted to a thin plexiglass plate to insert into a Varian electron 6 x 6 cone. A 1.5 cm gap between block and eye surface was used. Verification of dose distribution under the lens shield was obtained by film dosimetry.

Field experiments were carried out to compare the littoral fate and ecological effects of chemically dispersed oil and nondispersed oil. The basic experimental design was a series of treatments applied to marked plots on rocky shores, a salt marsh, an intertidal sea-grass bed, and sand and mud flats. The treatments included a variety of oils and the dispersants BP 1100 WD, BP 1100X, Corexit 8667, and Corexit 7664, applied directly to the intertidal plots. Sediment hydrocarbon analysis indicated little long-term retention of applied oil (whether dispersanttreated or not) in the salt marsh mud and in muddy sand on a waterlogged intertidal flat. However, in the sea-grass bed sediments and in the fine sands on freely draining intertidal flats, dispersant-treated oil was, in some cases, retained at greater concentrations than untreated oil. The results are discussed with reference to the rocky shore Exposure Scale of Ballantine, to the shoreline Vulnerability Index of Gundlach and Hayes, and to factors such as the behavior of the water table, particle size, and depth of disturbance of sediments.

Photons are fundamental excitations of the electromagnetic field and can be captured in cavities. For a given cavity with a certain size, the fundamental mode has a fixed frequency {\it f} which gives the photons a specific "color". The cavity also has a typical lifetime $\tau$, which results in a finite linewidth $\delta${\it f}. If the size of the cavity is changed fast compared to $\tau$, and so that the frequency change $\Delta${\it f} $\gg \delta${\it f}, then it is possible to change the "color" of the captured photons. Here we demonstrate superconducting microwave cavities, with tunable effective lengths. The tuning is obtained by varying a Josephson inductance at one end of the cavity. We show data on four different samples and demonstrate tuning by several hundred linewidths in a time $\Delta t \ll \tau$. Working in the few photon limit, we show that photons stored in the cavity at one frequency will leak out from the cavity with the new frequency after the detuning. The characteristics of the measured devices make them suitable for different applications such as dynamic coupling of qubits and parametric amplification., Comment: 2nd International Workshop on Solid-State Quantum Computing, June 2008, Taipei, Taiwan

Objective: To determine whether cardiac monitoring is required in children sustaining electric shock at Australian household voltage. Methodology: Records of patients admitted via the Emergency Department of Princess Margaret Hospital for Children, Perth, Australia, for the period 1968–96 were retrospectively reviewed. The initial ECG findings of patients with an electric shock were recorded, and the development of any arrhythmia. Results: Forty-four patients were identified, 40 of whom had sustained a household electrical injury. One patient had an abnormal ECG on admission, none developed an arrhythmia and all survived. Conclusions: Routine cardiac monitoring is not required after exposure to Australian household electricity supply if the child is asymptomatic and has a normal ECG on presentation.

The data from nine centres in Europe which had used the Geriatric Mental Scale (GMS) AGECAT were analysed to compare prevalence of diagnoses in subjects aged 65 years and over living in the community. Levels of depressive illness were: Iceland 8.8%, Liverpool 10.0%; Zaragoza 10.7%; Dublin 11.9%; Amsterdam 12.0%; Berlin 16.5%; London 17.3%; Verona 18.3% and Munich 23.6%. Taking all levels of depression, five high (Amsterdam, Berlin, Munich, London and Verona) and four low (Dublin, Iceland, Liverpool, Zaragoza) scoring centres were identified. Meta-analysis of all 13,808 subjects yielded a mean level of depression of 12.3% (95% CI 11.8-12.9), 14.1% for women (95% CI 13.5-14.8) and 8.6% for men (95% CI 7.9-9.3). Symptom levels varied between centres: 40% of the total study population in Amsterdam reported depressive mood against only 26% in Zaragoza. To incorporate studies from other centres using other methods for depression identification, the EURO-D scale was developed from 12 items of the GMS and validated against other scales and expert diagnosis. A two factor solution emerged, an 'affective suffering factor' and a 'motivation factor'. The EURO-D scale was applied to 14 population based surveys. Depression score tended to increase with age unlike levels of prevalence of depression. Large between centre differences were evident in levels of depression unexplained by age, gender or marital status. These data show that depressive illness defined as suitable for intervention is common among older people in Europe. Opportunities for effective treatment are almost certainly being lost. Levels of depressive symptoms vary significantly between high and low scoring centres, prompting the next phase of this study, an examination of risk factors in Europe.

We performed a novel phase sensitive microwave reflection experiment which directly probes the dynamics of the Josephson plasma resonance in both the linear and non-linear regime. When the junction was driven below the plasma frequency into the non-linear regime, we observed for the first time the transition between two different dynamical states predicted for non-linear systems. In our experiment, this transition appears as an abrupt change in the reflected signal phase at a critical excitation power., Comment: 4 Figures

We report on a simple 80‐μm‐diam Ni‐Si‐Ni back‐to‐back Schottky photodiode with a demonstrated vibration‐limited optical‐position sensitivity of

This review presents the findings of published research in the Reaching for Excellence in Adolescent Care and Health (REACH) Project on sexually transmitted infections (STIs) within the context of the project's scientific agenda. Methods employed in the study for specimen collection, management, and laboratory analysis are presented. This review presents published analyses of cross-sectional data; longitudinal analyses are underway. In addition, baseline prevalence data on selected STIs and sexual risk profiles of the subjects in REACH are presented. High STI rates were evident in both human immunodeficiency virus (HIV) infected and uninfected youth of both genders regardless of sexual orientation. High infection rates at baseline suggest that prevention-oriented programs for risk reduction among adolescents should focus on both HIV infected and at-risk, uninfected youth.

To evaluate hepatitis B (HBV) vaccine response rates in HIV infected and high-risk HIV uninfected youth and examine associations with responsiveness in the HIV infected group.Cohorts within the Reaching for Excellence in Adolescent Care and Health (REACH) study population were defined based on receipt of HBV vaccine both retrospectively and prospectively. Sero-responsiveness was determined by HBsAb measurements. Testing was done for HBsAg, HBsAb, and HBcAb. For HBsAb, a value of10 International Units per liter was considered a positive response, and the data were collected as either positive or negative from each of the reporting laboratories. Covariates of responsiveness were explored in univariate and multivariate models for each cohort.Sixty-one subjects had received a three-dose vaccination course at the time of entry into REACH. HIV uninfected subjects had significantly higher rates of response by serology compared with HIV infected subjects (70% vs. 41.1%; chi(2) = .05; RR = .586, 95% CI: .36-.96). By the time of an annual visit 43 subjects had received three vaccinations with at least one occurring in the study period. The rates of response were similar for the HIV infected and uninfected groups (37.1% vs. 37.5%) in this cohort. Univariate and multivariate analysis in the prospective HIV infected group (N = 35) found an association between elevated CD8(+)/CD38(+)/HLA-DR(+) T cells and lack of HBV vaccine responsiveness (6.7% vs. 60%; chi(2) = .03; RR = .12, 95% CI: .02- .55).The poor HBV vaccine response rate in the HIV uninfected high-risk adolescents was unexpected and suggests that HBV vaccination doses have not been optimized for older adolescents. This is the first report of decreased responsiveness in HIV infected subjects being associated with elevated CD8(+)/CD38(+)/HLA(-)DR(+) T cells and suggests that ongoing viral replication and concomitant immune system activation decreases the ability of the immune system in HIV infected subjects to respond to vaccination.

Background: Traditionally considered a motor neuron–selective disorder, the clinical manifestations of ALS can include a frontotemporal dementia. Although the pathologic substrate of cognitive impairment remains to be defined, the presence of ubiquitin-immunoreactive (Ub+) intraneuronal inclusions in cortical regions has been suggested to constitute a pathologic marker of this process. Methods: The authors compared the neuropathological features of four cognitively impaired patients with ALS, four cognitively intact patients with ALS, and four neurologically normal patients. The extent and load of Ub+ neuronal inclusions, Ub+ dystrophic neurites, and superficial linear spongiosis (SLS) was determined among a number of cortical, hippocampal, and subcortical regions. Results: Although Ub+, alpha-synuclein-negative, and tau-negative neuronal inclusions were observed in both cognitively impaired and cognitively intact patients with ALS, their density and extent was greater among the former, with the difference greatest in the cingulate gyrus. Ub+ neurites were observed in a similar distribution. Only the presence of SLS, affecting the first and second cortical layers, reliably distinguished between the cognitively impaired and cognitively intact ALS subpopulations. In three of four cognitively impaired patients with ALS, SLS was associated with transcortical microglial activation, in the absence of detectable differences in astrocytosis, density of calbindin or parvalbumin neurons, or optical density of synaptophysin and SNAP-25. Conclusions: Although intraneuronal Ub+ inclusions and dystrophic neurites are observed in both ALS subpopulations, the presence of cognitive impairment was associated with a greater distribution and load of both neuropathologic features, suggesting a disease continuum. Moreover, cognitive impairment was uniformly associated with superficial linear spongiosis, a pathologic feature common to several forms of frontotemporal dementia.

Left ventricular hypertrophy is an independent cardiovascular risk factor. In hypertensives, the pattern of hypertrophy is influenced by central haemodynamic characteristics. Central haemodynamics may also determine physiological differences in left ventricular structure and predispose to particular responses of the left ventricle to pathological increases in load. M-mode echocardiography was used to measure left ventricular diastolic dimension and to estimate left ventricular mass index, relative wall thickness and stroke volume in 159 healthy volunteers aged between 19 and 74 years. Tonometric sphygmography was used to estimate augmentation index, central end-systolic and mean arterial blood pressure. Effective arterial elastance was calculated as the ratio of end-systolic pressure to stroke volume. Left ventricular mass index and relative wall thickness were adjusted for variation in age, sex and blood pressure before analyses. Left ventricular diastolic dimension exhibited significant inverse correlations with both effective arterial elastance (r=-0.72, P0.0001) and augmentation index (r=-0.23, P=0.004). Adjusted left ventricular mass index was inversely correlated with effective arterial elastance (r=-0.35, P0.0001), but no correlation was observed between left ventricular mass index and augmentation index (r=0.04). Adjusted relative wall thickness correlated with increasing effective arterial elastance (r=0.32, P0.0001) and augmentation index (r=0.18, P=0.02). Relative wall thickness (r=0.34, P0.0001), but not left ventricular mass index, correlated with age. Higher elastance and augmentation correlates with relatively smaller left ventricular cavity size but larger relative wall thickness. Age-related changes in left ventricular afterload may affect relative wall thickness more significantly than left ventricular mass index and may contribute to a particular change in left ventricular geometry with age.