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Aglaia fellii W.E.Cooper & Joyce (Meliaceae) is described from restricted areas of rainforest on Cape York Peninsula, Queensland, Australia. Given the unusual morphological features of the species, including solitary flowers and fruits, a molecular phylogenetic analysis was conducted to confirm its placement within Aglaia prior to formal description. All Australian Aglaia species and eight Australian representatives of closely allied Meliaceae genera were sampled, and 353 nuclear loci were sequenced. Maximum likelihood analysis of these loci retrieved A. fellii as nested within Aglaia, most closely related to A. cooperae and A. monticola. This validates its assignment to Aglaia, making it the only Aglaia species with mostly solitary flowers (rarely 3- or 4-flowered) and solitary fruits. A full taxonomic description of Aglaia fellii and notes on its habitat are provided.

Purpose At least five years of adjuvant endocrine therapy (ET) is recommended for patients with hormone receptor-positive invasive breast cancer to reduce cancer recurrence risk. Up to half of patients prematurely discontinue ET, often due to musculoskeletal pain. Nociplastic pain is abnormal central nervous system pain processing without evidence of tissue or neuronal damage. This study aimed to evaluate the relationship between baseline nociplastic pain and ET discontinuation. Methods This was a retrospective, single center, cohort study. Included patients were female, had stage 0-III invasive breast cancer, did not receive neoadjuvant therapy, and completed quality of life questionnaires prior to breast surgery, including Fibromyalgia Survey for nociplastic pain. Clinical data including duration of ET were abstracted from the medical record. Patient characteristics were analyzed with t-tests and chi-squared tests, as appropriate. Univariate and multivariable regressions were performed with Cox proportional hazard models. Results 681 patients diagnosed between 2012–2019 met inclusion criteria; 480 initiated ET and were included in the analysis. Of these 480 patients, 203 (42.3%) prematurely discontinued initial ET therapy. On univariate analysis, tamoxifen use (hazard ratio [HR] 0.70, p = 0.021) and premenopausal status (HR 0.73, p = 0.04) were inversely associated with ET discontinuation, while Fibromyalgia Score was positively associated (HR 1.04, p = 0.043). On multivariable analysis, baseline Fibromyalgia Score remained associated with ET discontinuation. Conclusion Nociplastic pain present prior to surgery was associated with premature ET discontinuation. Fibromyalgia Score screening may be useful for evaluating ET discontinuation risk. Treatments targeting nociplastic pain may be more effective for treating ET-emergent pain.

Narragansett Bay, the largest estuary in the northeastern U.S., is a heavily urbanized watershed impacted by deposition and runoff. Nutrient budgets and local policy rely on deposition data from a 1990 study that did not include any direct observations of dry deposition of gaseous ammonia (NH3) and particulate ammonium (NH4+) due to uncertainties in their flux direction and measurement difficulty. Recent precipitation measurements show that wet deposition of NH4+ to the Bay has increased by a factor of 6 over the past three decades, leading to a 2.5-fold increase in wet nitrogen (N) deposition. The documented increase in wet deposition of NH4+ concurrent with managed nutrient reductions in urbanized estuaries has potentially increased the impacts of atmospheric N deposition, including the dry deposition of NH3 and NH4+. However, a scarcity of measurements hinders our interpretation of this important N source. For the first time over Narragansett Bay, and to our knowledge over open water, dry (particulate and gas phase) deposition of total NHx (NHx = NH3 + NH4+) and bidirectional NH3 flux was quantified using a relaxed eddy accumulation sampling technique. We find that total N entering the Bay from the atmosphere has doubled since 1990. Dry deposition of NHx comprises 9.6% of total N deposition. During the fall season, the dominant flux direction for NH3 is upward, which also has implications for urban air quality. We estimate that NH3 emitted from the Bay to the atmosphere makes up to 10% of the local NH3 emission budget.

Objective: Little is understood about the anxiety experienced by cancer patients undergoing radiotherapy or investigative imaging. Our aim was to identify sources of anxiety, the points along the cancer journey where anxiety occurred and methods to alleviate it. Methods: Six focus groups were conducted with cancer patients (n = 17), caregivers (n = 3) and healthcare practitioners (HCPs; n = 10) in the radiotherapy department. Patients described specific elements in the care pathway which induced anxiety, while HCPs focused on their perception of the patient experience. Thematic analysis was used to analyse data. Results: Three broad themes emerged: The Environment, The Individual and The Unknown. The physical environment of the hospital, inside the scanner for example, emerged as a key source of anxiety. The impact of cancer on patients' individual lives was significant, with many feeling isolated. The majority of participants described anxiety associated with the unknown. HCPs reported difficulty in identifying the anxious patient. Conclusions: Anxiety is experienced throughout the cancer pathway. Common sources include the physical environment and the uncertainty associated with having cancer. Identifying both anxiety-inducing factors, and the anxious patients themselves, is crucial to enable targeted interventions to alleviate anxiety.

Introduction: Anticoagulation (AC) with warfarin or direct oral anticoagulants (DOAC) is the core of VTE treatment. Due to lower risk of VTE recurrence, American College of Chest Physicians (ACCP) recommends three months AC in patients with provoked VTE and without other indication for long-term AC. We aimed to assess how closely “real world” practice followed guideline recommendations. Hypothesis: We hypothesize most patients taking warfarin or DOAC for provoked VTE receive no more than three months AC. Patients who get prolonged AC are more likely to be taking DOAC than warfarin. Methods: We identified patients who initiated warfarin or DOAC from a six center AC clinic registry between 2008-20. Provoked VTE was defined as VTE after a transient risk factor: surgery, lower extremity cast/immobilization, childbirth, or OCPs. AC duration was categorized as 120 days. Appropriate treatment window was defined as 80-120 days to adjust for variability in clinic scheduling. Median AC length for DOAC vs. warfarin was compared with a two-sample test. Prevalence of extended AC was compared using chi-square test. Variables increasing risk of extended AC were analyzed with logistic regression, adjusted for baseline demographic and clinical characteristics. Results: At six centers, we identified 488 patients with provoked VTE on warfarin and 302 on DOAC. Average AC length was 137 days for warfarin and 180 days for DOAC (p120 days of AC (p120 days AC include recurrent VTE (OR 2.11; CI 1.34,3.32), prior MI (OR 4.09; CI 1.37,12.2), and DOAC use (OR 2.34; CI 1.69, 3.23) (Figure 1). Conclusions: In this multi-center analysis, most patients receive AC longer than guideline-recommended. DOAC use, recurrent VTE, and prior MI are associated with prolonged AC. Understanding the relationship between prior MI and AC duration in provoked VTE warrants future investigation.

Concentrations and the stable isotopic composition of bulk aerosol nitrate (NO3-) were quantified from two fall GEOTRACES cruises: 1) Alaska–Tahiti (GP...

As targeted therapies help patients with advanced cancer live longer, interventions for management of axial spine pain will become more common. Unfortunately, the indications for and safety of these procedures have been relatively unexplored compared with non-cancer adults. This review focuses on the following aspects of axial spine pain management in patients with vertebral metastatic disease: (1) pathophysiology and symptoms of cancer- and non-cancer-related spine pain; (2) safety and efficacy of non-interventional rehabilitation approaches to treat this pain; (3) considerations for interventional pain approaches to acute and chronic pain in patients with vertebral metastatic disease. This review also summarizes gaps in the literature and describes specific cases in which the described interventions have been applied.

6568 Background: Treatment with AI therapy for at least five years is recommended to reduce risk of cancer recurrence in postmenopausal women with hormone-positive breast cancer, but up to 50% prematurely discontinue their AI. Prior studies have demonstrated higher rates of nonadherence in older patients. Higher rates of comorbidities are also present in older patients, many of which require treatment with prescription medications. However, in prior studies, the impact of polypharmacy on AI persistence in older women has been variable. We evaluated the relationship between use of prescription and over-the-counter (OTC) medications and AI discontinuation in older women in a randomized controlled trial of AI therapy. Methods: In the Exemestane and Letrozole Pharmacogenetics (ELPh) trial, postmenopausal women with stage 0-III hormone-positive breast cancer were randomized to receive exemestane or letrozole and followed for two years. Prescription medication and OTC supplement usage was prospectively collected. Only enrolled participants at least 65 years of age were included in this analysis. Univariate and multivariable Cox proportional hazards models evaluated the association between baseline prescription medications, OTC medications, initial assigned AI medication, and time to discontinuation of initial AI. Results: 131 women at least 65 years old with baseline medication and OTC supplement information were identified. The average age was 70.4 (SD 5). 58 participants (44%) were randomized to exemestane and 73 (56%) to letrozole. 21% had previously received tamoxifen and 18% received taxane-based chemotherapy. The average number of prescription medications at AI initiation was 4.95, and 127 patients reported taking at least one. The average number of OTC medications was 3.23, and 107 patients reported taking at least one. There was no difference in number of prescription medications or OTC medications by study arm. As previously reported, exemestane was associated with premature discontinuation (HR 1.92 [95%CI 1.06-3.50], p = 0.032). Controlling for AI, the risk of discontinuation decreased by 12% for every additional prescription medication (HR 0.88 [95%CI 0.78-0.99], p = 0.038). OTC medication use was not significantly associated with AI duration. Conclusions: Increased prescription medication usage at AI initiation was associated with decreased risk of premature discontinuation of AI. Further research is needed to evaluate this interaction and identify characteristics that impact AI persistence in older women with breast cancer. Clinical trial information: NCT00228956.

Background: Isocitrate dehydrogenase-1 (IDH1) mutation is now an established early event in gliomagenesis. The ability to detect this mutation by several techniques including immunohistochemistry makes it a significant marker for diagnosing and prognosticating gliomas. This study was done to assess the expression of mutant IDH1 in different grades of gliomas and evaluate its utility in differentiating reactive gliosis from glioma and defining surgical margins of these tumors in the operative specimens. Materials and Methods: A total of fifty cases including equal number of Grade I, II, III, and IV gliomas and gliosis were included in the study. Formalin-fixed, paraffin-embedded tissue sections from these lesions were immunostained with IDH1 and Ki-67 antibody, and percentage of tumor cells that stained positive with these markers was assessed. Results: Grades II, III, and IV showed consistent immunopositivity for IDH1. No immunostaining was noted in Grade I glioma and gliosis. Mean Ki-67 labeling index correlated with grades of gliomas with low activity in Grade I and high activity in Grade IV. Individual tumor cells infiltrating into adjacent normal brain parenchyma also stained positive with IDH1 antibody. Conclusion: Immunostaining for IDH1 mutation can be utilized as a reliable marker in the precise diagnosis of diffuse gliomas and also in objective assessment of surgical margins to differentiate gliomas from gliosis.

Bilateral cricoarytenoid joint (CAJ) fixation is a rare rheumatologic disorder manifesting with hoarseness, dysphagia, and progressive dyspnea. It is a well-described manifestation of rheumatoid arthritis (RA), ankylosing spondylitis, and vasculitic airway disease such as granulomatosis with polyangiitis, but never with psoriatic arthritis (PsA)1,2. A 71-year-old man with psoriasis vulgaris and large and small joint pain developed progressive dyspnea, stridor, and hoarseness. Flexible laryngoscopy revealed bilateral vocal cord …

12068 Background: Aromatase inhibitors (AI) are recommended for at least five years to reduce risk of breast cancer recurrence in postmenopausal women with hormone receptor-positive disease. Despite the potential benefit, up to 50% of patients discontinue AI early, primarily because of musculoskeletal side effects. Some patients, including those with fibromyalgia and other chronic pain conditions, have preexisting pain that arises from altered nociception without clear evidence of tissue or peripheral nerve damage, called nociplastic or centralized pain. We hypothesized that preexisting nociplastic pain is associated with early discontinuation of AI therapy due to toxicity. Methods: Patients diagnosed with breast cancer between 2012-19 and who enrolled in the Michigan Genomics Initiative (MGI) were identified. Patients who were female, had hormone receptor-positive breast cancer, had not received neoadjuvant therapy, and who initiated adjuvant AI therapy were included in the analysis. Prior to breast cancer surgery patients completed surveys about pain in the affected breast and overall worst pain (Brief Pain Inventory [BPI]), nociplastic pain (2011 Fibromyalgia Survey [FS], which assesses widespread pain plus somatic symptom severity), and anxiety (PROMIS Anxiety 4a v.1). Demographics, cancer characteristics, and treatment history, including date and reason for discontinuation of AI therapy, were abstracted from the medical record. Patients were censored at date of last oncology follow-up. Univariate and multivariable analyses were conducted to assess relationship between age, BMI, surgical site pain, overall worst pain, FS score, anxiety, and time to discontinuation of initial AI medication. Results: Of 207 analyzed patients, the average age was 61 years, average BMI was 30.3 kg/m2, 181 (87%) were postmenopausal at the time of breast cancer diagnosis, and 31% received chemotherapy. The majority were prescribed anastrozole (n=196); 6 took letrozole and 5 took exemestane. Average scores prior to surgery were 1.5/10 for worst pain, 0.2/10 for surgical site pain, 4.2/31 for FS score, and 54.1/100 for anxiety. On univariate analysis, only use of exemestane (HR 5.55, p

PURPOSE This study aimed to quantify and compare conjunctival epithelial tumor necrosis factor (NF) α mRNA expression in Sjogren syndrome (SS), non-Sjogren syndrome aqueous-deficient dry eye (non-SS DE), and non-dry eye (NDE) control subjects. METHODS A total of 76 subjects were recruited for this study: 25 SS (confirmed via American-European Consensus Criteria 2002), 25 non-SS DE (confirmed by symptoms and Schirmer scores ≤ 10 mm), and 26 NDE. Superior and temporal bulbar conjunctival epithelial cells were collected via impression cytology. Epithelial RNA was extracted, and TNF-α mRNA expression was quantified by real-time quantitative polymerase chain reaction. RESULTS The expression of TNF-α mRNA was found to be significantly higher in the SS group (2.48 ± 1.79) compared to both non-SS DE (0.95 ± 1.18; p < 0.05) and NDE (0.84 ± 0.51; p < 0.05) groups. No difference in TNF-α mRNA expression was found between the non-SS DE and NDE groups (p = 0.67). CONCLUSIONS These results demonstrate that SS-associated aqueous-deficient dry eye is associated with a significant upregulation of conjunctival epithelial TNF-α mRNA relative to both non-SS DE and control groups. The degree to which TNF-α mRNA is upregulated in SS may contribute to the severe ocular surface damage observed in these patients.

The purpose of this study was to determine the effect of the covalent incorporation of hyaluronic acid (HA) into conventional hydrogel and hydrogels containing silicone as models for contact lens materials on the uptake and release of the fluoroquinolone antibiotic ciprofloxacin and the anti-inflammatory steroid dexamethasone phosphate. A 3 mg/mL ciprofloxacin solution (0.3% w/v) and a 1 mg/mL dexamethasone phosphate solution (0.1%) was prepared in borate buffered saline. Three hydrogel material samples (pHEMA; pHEMA TRIS; DMAA TRIS) were prepared with and without the covalent incorporation of HA of molecular weight (MW) 35 or 132 kDa. Hydrogel discs were punched from a sheet of material with a uniform diameter of 5 mm. Uptake kinetics were evaluated at room temperature by soaking the discs for 24 h. Release kinetics were evaluated by placing the drug-loaded discs in saline at 34 °C in a shaking water bath. At various time points over 6–7 days, aliquots of the release medium were assayed for drug amounts. The majority of the materials tested released sufficient drug to be clinically relevant in an ophthalmic application, reaching desired concentrations for antibiotic or anti-inflammatory activity in solution. Overall, the silicone-based hydrogels (pHEMA TRIS and DMAA TRIS), released lower amounts of drug than the conventional pHEMA material (p < 0.001). Materials with HA MW132 released more ciprofloxacin compared to materials with HA MW35 and lenses without HA (p < 0.02). Some HA-based materials were still releasing the drug after 6 days.

Purpose. This study investigated the protein deposition that occurs on daily wear silicone hydrogel (SH) lenses, after 2 weeks of wear. Methods. A total of 40 subjects were divided into equal groups, based on their habitual SH contact lens [CIBA Vision O2OPTIX (O2); Johnson & Johnson ACUVUE ADVANCE with HYDRACLEAR (ADV); Bausch & Lomb PureVision (PV); CIBA Vision Night & Day (ND)]. A randomized, double-masked, cross-over study was conducted in which subjects wore either their habitual SH material or Johnson & Johnson ACUVUE OASYS with HYDRACLEAR PLUS (OAS) for 2 weeks. At the end of the 2-week period, lenses were collected for analysis of total protein, total lysozyme, and percent denatured lysozyme. Results. Total protein was greatest for PV (33 6 g/lens), with other lenses depositing 10 g/lens. The PV amount was greater than other materials (p 0.001), with no significant differences between the other three materials (p 0.05). Total lysozyme was also greatest for the PV lens (11 3 g/lens), with other lenses depositing 2 g/lens. The PV amount was greater than all other materials (p 0.001). ADV and OAS were greater than O2 (p 0.01) but were not different from each other (p 0.05). The percentage of lysozyme that was denatured was greatest for ND (90 8%) and lowest for PV (23 10%). The lysozyme extracted from ND and O2 lenses was significantly more denatured than that extracted from the other lens materials (p 0.001). There were no significant differences for lysozyme activity between ND and O2 (p 0.05) or between ADV, OAS, and PV (p 0.05). The amount of denatured lysozyme/lens was 3 g/lens for all materials. Lysozyme as a percentage of the total protein deposited ranged from 32 (PV) to 6% (O2). Conclusions. This study confirms that all SH lenses deposit low levels of protein, and that the amount and percentage of denatured lysozyme can vary, depending on the overall surface charge of the material and absence or type of surface treatment. (Optom Vis Sci 2009;86:1241–1249)

Cell lines can be useful experimental tools for studying marine fish, which are often difficult to routinely obtain and maintain in the laboratory. As few cell lines are available from coldwater marine fish, cultures were initiated from late gastrula embryos of haddock (Melanogrammus aeglefinus) in Leibovitz's L-15 with fetal bovine serum (FBS). From one culture, a cell line (HEW) emerged that has been grown for close to 100 population doublings, was heteroploid, and expressed telomerase activity, all of which suggest HEW is immortal. Growth occurred only if FBS was present and was optimal at 12 to 18 degrees C. Usually most cells had an epithelial-like morphology, but under some conditions, cells drew up into round central bodies from which radiated cytoplasmic extensions with multiple branches. These neural-like cells appeared within a few hours of cultures being placed at 28 degrees C or being switch to a simple salt solution (SSS). At 28 degrees C, cells died within 24 h. In SSS, HEW cells survived as a monolayer for at least 7 days. The sensitivity of HEW cells to morphological change and their capacity to withstand starvation should make them useful for investigating cellular responses to environmental stresses.

Purpose To report a case of an unusual adverse event subsequent to undertaking Conjunctival Impression Cytology (CIC). Methods CIC was undertaken on a 54-year-old healthy Caucasian female, using a 10 mm Millipore™ membrane on the bulbar conjunctiva. Prior to the CIC procedure, two drops of topical proparacaine (Alcaine ® ) were instilled and following the procedure two drops of artificial tears (GenTeal ® ) were administered. Results The subject reported excessive bulbar conjunctival hyperaemia in the left eye 5 min postprocedure, with no marked pain or discomfort. Slitlamp biomicroscopic evaluation revealed several “bubbles” or cystic formations trapped underneath the conjunctival tissue, in association with moderate to severe bulbar conjunctival redness. These cysts began to regress fairly rapidly and completely disappeared within 1 h. Conclusion CIC is a useful tool for studying the ocular surface; however, care should be taken while performing this mildly invasive procedure. This is the first report of bubble formation in the conjunctiva following CIC. Subjects should be advised about the short term redness and discomfort that could occur following CIC.

Polybrominated diphenyl ethers (PBDEs) have become widely distributed as environmental contaminants due to their use as flame retardants. Their structural similarity to other halogenated aromatic pollutants has led to speculation that they might share toxicological properties such as hepatic enzyme induction. In this work we synthesized a number of PBDE congeners, studied their affinity for rat hepatic Ah receptor through competitive binding assays, and determined their ability to induce hepatic cytochrome P-450 enzymes by means of EROD (ethoxyresorufin-O-deethylase) assays in human, rat, chick, and rainbow trout cells. Both pure PBDE congeners and commercial PBDE mixtures had Ah receptor binding affinities 10(-2)-10(-5) times that of 2,3,7,8-tetrachlorodibenzo-p-dioxin. In contrast with polychlorinated biphenyls, Ah receptor binding affinities of PBDEs could not be related to the planarity of the molecule, possibly because the large size of the bromine atoms expands the Ah receptor's binding site. EROD activities of the PBDE congeners followed a similar rank order in all cells. Some congeners, notably PBDE 85, did not follow the usual trend in which strength of Ah receptor binding affinity paralleled P-450 induction potency. Use of the gel retardation assay with a synthetic oligonucleotide indicated that in these cases the liganded Ah receptor failed to bind to the DNA recognition sequence.

Education in leadership principles is included in Master's Degree programs for nurse practitioners (NPs). NPs have an opportunity to be leaders in a variety of roles and to make major decisions within their profession and within the healthcare system. NPs' collaboration with nursing professionals, colleagues, and other healthcare professionals--including clients and families--demonstrate their expanded practice. The purpose of this study was to examine perceptions of leadership by Master's-prepared NPs and determine if they are providing leadership in practice. There has been minimal research to evaluate whether NPs graduating from Master's programs are effectively using leadership skills in their practice. Master's Degree education has a strong focus on leadership and, combined with the need for lower cost of healthcare, NPs have the potential to provide important leadership and cost savings to the healthcare delivery system.

There are wide differences in the approach of European states to the issue of drugs, with the liberal polices of the Netherlands at odds with neighbouring countries such as France and Germany. The lack of consensus, particularly in relation to ‘soft’ drugs such as cannabis, has been one factor that has acted as a limit on co‐operation among European states. Another is that the issue does not have the same dominant priority as it does for the United States. However, the process of European integration is putting pressure on those states which are members of the European Union to formulate a common approach on drugs and transnational crime, particularly with the steps being taken to remove the European Union's internal borders. The establishment of the European Monitoring Centre for Drugs and Drug Addiction illustrates another important trend in European drug policy, investment in data‐gathering on drug consumption.

Purpose: To investigate the potential relationship between subjective symptomatology, tear volume, and tear break up time with tear film lipocalin and lysozyme concentrations in a group of symptomatic dry-eyed postmenopausal (PM) women compared to age-matched controls. Methods: Eighty-five healthy PM females (>50 years of age) were categorized as mild or moderate dry eye (DE), or asymptomatic [non-dry eye (NDE)] based on their responses to the Ocular Surface Disease Index (OSDI) questionnaire. Non invasive tear breakup time (NITBUT) and tear secretion were measured. Tears were collected via capillary tube and an eye wash method. Tear lysozyme and lipocalin concentrations were determined via Western blotting. Results: Ocular Surface Disease Index responses revealed 16 mild DE, 30 moderate DE, and 39 NDE. The OSDI total score and sub scores for the DE groups were significantly greater than for the NDE group (p

To investigate the effect of protein, lipid, and lens material on the neutralization kinetics of one-step hydrogen peroxide disinfection systems.A UV-based assay was used to determine the rate of neutralization of three one-step hydrogen peroxide systems (CIBA Vision Clear Care; CIBA Vision AOSEPT; Abbott Medical Optics UltraCare). Protein (bovine serum albumin and lysozyme) and various lipids were added to the lens cases during the neutralization phase to determine whether they influenced the rate of neutralization. Finally, rates were determined when the cases contained a silicone hydrogel lens material (lotrafilcon A) or Food and Drug Administration group IV (etafilcon A) lenses.Neutralization for all three systems was complete within 90 minutes. The rate of neutralization for Clear Care and AOSEPT were not significantly different from each other (P=NS). UltraCare exhibited statistically higher levels of peroxide up to the 20-minute time point (P0.001) Protein, lipid, or lens material did not significantly affect the rate of neutralization for any regimen (P=NS).Tablet-based one-step disinfection systems neutralize at a slower rate than disc-based peroxide systems, but this difference is only significant during the first 20 minutes after the onset of neutralization. Neither lens deposition nor lens material plays a role in the speed of neutralization of peroxide-based systems.

Purpose To investigate the expression of MUC16 protein in tears and conjunctival cell membranes and MUC16 mRNA in conjunctival cells of Sjogren’s syndrome (SS), keratoconjunctivitus sicca (KCS) and non-dry eyed (NDE) subjects. The relationship of tear flow and soluble MUC16 concentration was also measured. Methods Seventy-six subjects were recruited for this study: 25 SS (confirmed via American-European Consensus Criteria 2002), 25 KCS (confirmed by symptoms and Schirmer scores ≤10 mm) and 26 NDE. Tear flow was measured by the Schirmer test without anesthesia for 5 min. Tears were collected using an eye-wash technique. Protein and mRNA were isolated from conjunctival epithelial cells collected via impression cytology. Soluble and membrane bound MUC16 were quantified via western blotting and MUC16 mRNA was quantified by real time qPCR. Results The SS group demonstrated significantly higher concentrations of soluble MUC16 (7.28 [SS]±3.97 versus 3.35 [KCS]±4.54 [p=0.004] and versus 1.61 [NDE]±1.22 [p

PURPOSE To evaluate the concentration of tear lipocalin, lysozyme, and total protein in Sjogren's Syndrome (SS), non-Sjogren's keratoconjunctivitis sicca (KCS), and non-dry-eyed (NDE) individuals. METHODS Seventy-six subjects were recruited for this study: 25 SS subjects; 25 KCS subjects, and 26 NDE individuals. Symptoms were measured with a visual analogue scale. Tear flow was measured by the Schirmer I test without anesthesia. Tears were collected using an eye wash technique. Total tear protein was quantified using the DC Protein Assay Kit. Tear lipocalin and lysozyme were quantified via Western blotting performed on a Phast System. RESULTS By definition, the SS and KCS groups both had significantly lower mean Schirmer scores (5.12 +/- 5.96 mm and 7.84 +/- 7.35 mm) compared with the NDE group (23.83 +/- 7.85 mm; p < 0.0001). There was no difference in mean Schirmer scores between SS and KCS groups (p = 0.19). The tear film of the SS group was characterized by significantly reduced (p < 0.0001) total protein and lipocalin concentrations compared with both KCS and NDE groups. No difference between the KCS and NDE groups was found in total protein (p = 0.92) or lipocalin (p = 0.19) concentration. In contrast, the concentration of tear film lysozyme was found to be statistically similar in all three groups examined. No statistically significant correlation was found in any group between mean Schirmer values compared with total protein, lipocalin or lysozyme concentration. CONCLUSION Our data demonstrate a biochemical distinction between the Sjogren's group compared with both KCS and control groups, in that both tear lipocalin and total tear protein were significantly reduced. Although correlations were not found between protein measurements and tear flow, a combination of tests including Schirmer I and quantitation of tear film biomarkers may allow for the identification of SS patients without the need for invasive testing.

Purpose: To characterize clinical signs and symptoms in a group of post-menopausal (PM) females who present with and without symptoms of dry eye. Methods: Eighty-three healthy PM females were categorized as being symptomatic or asymptomatic of dry eye based on their response to the Allergan Ocular Surface Disease Index© (OSDI) questionnaire. Non-invasive tear breakup time (NITBUT) was evaluated using the ALCON Eyemap®. Tear volume was assessed using the phenol red thread (PRT) test and bulbar conjunctival hyperaemia was measured using objective and subjective methods. Results: The total OSDI score (TOS) and subscores for the non-dry eye (NDE; n = 39) and dry eye (DE; n = 44) groups were significantly different (TOS: NDE = 7.43 ± 7.71 vs DE = 24.87 ± 13.89; p

To compare tear osmolality and ferning patterns in postmenopausal women (PMW) with and without dry eye symptoms.Thirty-seven healthy PMW (50 years of age), not on hormone replacement therapy, were categorized as being symptomatic or asymptomatic of dry eye based on their responses to an Allergan "Single-Item Score Dry Eye Questionnaire" (SIDEQ). They subsequently completed the Allergan "Ocular Surface Disease Index" (OSDI) questionnaire. Tear samples were collected from participants to evaluate osmolality and ferning patterns. A novel freezing point depression osmometer (Advanced Instruments Inc., Model 3100 Tear Osmometer), was used to measure the osmolality of the tear film. The tear ferning test was performed and evaluated for the quality of ferning based on the Rolando grading system.SIDEQ responses revealed 21 symptomatic and 16 asymptomatic participants. The OSDI total score was 6.5 +/- 5.9 for the non-dry-eyed (NDE) group and 25.7 +/- 12.4 for the dry-eyed (DE) group. The subscores for the DE group were significantly greater than the NDE group (p0.001). Osmolality values in DE individuals were significantly different from NDE (328.1 +/- 20.8 vs. 315.1 +/- 11.3 mOsm/kg; p = 0.02). Fifty percent of the DE participants showed type II ferning patterns and 29% of the DE participants showed type III ferning patterns, whereas the NDE participants showed either type I (44%) or II (66%) ferning patterns. There was a significant difference between the DE and NDE participants for the ferning patterns (p = 0.019). There was no significant correlation between tear osmolality and tear ferning (DE: r = 0.12; p0.05, NDE: r = -0.17; p0.05).Osmolality in mild and moderately DE PMW is higher than in NDE PMW and tear ferning is a rapid, simple, noninvasive laboratory procedure that indicates altered tear quality in PMW with symptoms of dry eye.

In the present study, mating behavior was observed in female rats that were given the opportunity to mate with two males simultaneously. Three groups of females were tested: 1) sexually naive, naturally cycling rats in proestrous; 2) sexually naive, hormone-primed, ovariectomized (OVX) rats; and 3) hormone-primed, OVX rats tested 1 week after sexual receptivity testing. One male rat was determined to be the preferred male for each female, if she spent more time with him during a mating test. Independent of sexual experience, female rats were less likely to leave their preferred male than their non-preferred male following intromissions. However, when they left their preferred male, they returned to him faster than to their non-preferred male. This effect of preference was slightly more robust in the OVX rats. When female rats from Group 2 were tested with the same pair of males for 3 additional tests, each female's preference for a particular male was stable. That is, a female rat preferred the same male in approximately 3 out of the 4 tests, which is more likely than would be expected by chance. In a final experiment, pairs of male rats were tested with different females once weekly to determine if different females would prefer particular males consistently. Although no male rat was preferred by all females, females consistently preferred the same male from each pair during approximately 70% of the tests. In conclusion, female mate preference may have adaptive significance for the reproductive success of rats.

Acknowledgements-List of Contributors - List of Tables - List of Figures - Preface: Elizabeth Joyce and Carlos Malamud - Introduction: Fernando Cepeda Ulloa - PART 1: CONSUMPTION PATTERNS IN EUROPE AND LATIN AMERICA - Foreign Demand for Latin American Drugs: The USA and Europe Peter Reuter - Drug Consumption in Latin America Augusto Perez Gomez - PART 2: DRUGS IN LATIN AMERICA: THE PRODUCER COUNTRIES - The Drug Trade, Politics and the Economy: The Colombian Experience Jorge Orlando Melo - The Economic and Political Impact of the Drug Trade and Drug Control Policies in Bolivia Andy Atkins - The Drug Trade in Peru Roberto Lerner - The Political Repercussions of Drug Trafficking in Mexico Mar'a Cella Toro - PART 3: MONEY LAUNDERING AND INTERNATIONAL DRUG CONTROL - Offshore Banking in the Caribbean: The Panamanian Case Anthony P Malngot - Cocaine Trafficking and British Foreign Policy Elizabeth Joyce - Conclusions Elizabeth Joyce - Bibliography - Index

In 1985, the House of Commons Home Affairs Committee, in its interim report on the Misuse of Hard Drugs, described the prospect of Latin American cocaine exporters targeting the British market as “the most serious peacetime threat to our national well-being”.1 The seriousness of this assessment shows at least one group of British policy-makers conceiving of the problem in much the same security terms as their counterparts in the USA. The similarity to the US response is no coincidence. In 1985, Britain and its European neighbours were first becoming aware of a potential cocaine threat as a result of US warnings. Their perceptions of the production, trafficking and consumption of cocaine were almost entirely drawn from US experience. Given the lack of knowledge and experience of cocaine in Europe, the US view of the Andean countries as the root of the global drug problem became, in the late 1980s and early 1990s, the global view. More than ten years later, it is appropriate to ask whether this threat has been realised and, crucially, whether we would know if it had.