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Purpose: The study purpose was to describe trends in the size and demographics of the population of transgender Medicare beneficiaries identified using International Classification of Dise...

Summary Background & aims Nutritional deficiency and inflammation may impact CD4+ T cell recovery during combination antiretroviral therapy (cART), particularly in resource-limited settings where malnutrition is prevalent. The aim of this study was to investigate the relationship of micronutrient and inflammation biomarkers to CD4 recovery after cART initiation. Methods We conducted a secondary analysis of a random sub-cohort sample (n = 270) from a multinational randomized trial of cART regimen efficacy among 1571 cART-naive adults. We measured pre-cART serum levels of micronutrients (Vitamin A, B6, B12, D, total carotenoids, selenium, and iron) and inflammation (C-reactive protein, soluble CD14 (sCD14), IFNγ, TNFα, Interleukin-6, and C-X-C motif chemokine 10 (CXCL10/IP10), EndoCab (IgM)) biomarkers. Biomarker status (i.e. micronutrient deficiency vs. sufficiency and elevated vs. low inflammation) was defined using established cutoffs or quartiles. Mixed-effects linear regression models were used to determine the association of baseline (pre-cART) concentrations of individual biomarkers with CD4 recovery through 96 weeks post-cART initiation. Results In models adjusting for time-dependent viral load and baseline CD4 count, age, sex, body mass index, country, treatment regimen, anemia and hypoalbuminemia status, pre-cART vitamin D deficiency was associated with lower CD4 recovery (−14.9 cells/mm3, 95% CI: −27.9, −1.8) compared to sufficiency. In contrast, baseline selenium deficiency (20.8 cells/mm3, 95% CI: 3.3, 38.3), vitamin A deficiency (35.9 cells/mm3, 95% CI: 17.6, 54.3) and high sCD14 (23.4 cells/mm3, 95% CI: 8.9, 37.8) were associated with higher CD4 recovery compared to sufficient/low inflammation status. Conclusions In summary, baseline vitamin D deficiency was associated with diminished CD4 recovery after cART initiation; impaired CD4 recovery may contribute to the poor clinical outcomes recently observed in individuals with vitamin D deficiency. Vitamin A, selenium and sCD14 were associated with CD4 recovery but future studies are needed to further explore these relationships.

A measurement of the double-polarization observable E for the reaction $$\gamma p\rightarrow \pi ^0 p$$ γ p → π 0 p is reported. The data were taken with the CBELSA/TAPS experiment at the ELSA facility in Bonn using the Bonn frozen-spin butanol (C$$_4$$ 4 H$$_9$$ 9 OH) target, which provided longitudinally-polarized protons. Circularly-polarized photons were produced via bremsstrahlung of longitudinally-polarized electrons. The data cover the photon energy range from $$E_\gamma =600$$ E γ = 600 to 2310 MeV and nearly the complete angular range. The results are compared to and have been included in recent partial wave analyses.

A measurement of the double-polarization observable E for the reaction \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\gamma p\rightarrow \pi ^0 p$$\end{document}γp→π0p is reported. The data were taken with the CBELSA/TAPS experiment at the ELSA facility in Bonn using the Bonn frozen-spin butanol (C\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$_4$$\end{document}4H\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$_9$$\end{document}9OH) target, which provided longitudinally-polarized protons. Circularly-polarized photons were produced via bremsstrahlung of longitudinally-polarized electrons. The data cover the photon energy range from \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$E_\gamma =600$$\end{document}Eγ=600 to 2310 MeV and nearly the complete angular range. The results are compared to and have been included in recent partial wave analyses.

BackgroundDeciphering the monogenetic causes of neurodevelopmental disorders (NDD) is an important milestone to offer personalized care. But the plausibility of reported candidate genes in exome studies often remains unclear, which slows down progress in the field.MethodsWe performed exome sequencing (ES) in 198 cases of NDD. Cases that remained unresolved (n=135) were re-investigated in a research setting. We established a candidate scoring system (CaSc) based on 12 different parameters reflecting variant and gene attributes as well as current literature to rank and prioritize candidate genes.ResultsIn this cohort, we identified 158 candidate variants in 148 genes with CaSc ranging from 2 to 11.7. Only considering the top 15% of candidates, 14 genes were already published or funneled into promising validation studies.ConclusionsWe promote that in an approach of case by case re-evaluation of primarily negative ES, systematic and standardized scoring of candidate genes can and should be applied. This simple framework enables better comparison, prioritization, and communication of candidate genes within the scientific community. This would represent an enormous benefit if applied to the tens of thousands of negative ES performed in routine diagnostics worldwide and speed up deciphering the monogenetic causes of NDD.

The polarization observables T , E , P , H , and G in photoproduction of η mesons off protons are measured for photon energies from threshold to W = 2400 MeV (T), 2280 MeV (E), 1620 MeV ( P , H ), or 1820 MeV (G), covering nearly the full solid angle. The data are compared to predictions from the SAID, MAID, JuBo, and BnGa partial-wave analyses. A refit within the BnGa approach including further data yields precise branching ratios for the Nη decay of nucleon resonances. A Nη-branching ratio of 0.33 ± 0.04 for N ( 1650 ) 1 / 2 − is found, which reduces the large and controversially discussed Nη-branching ratio difference of the two lowest mass J P = 1 / 2 − -resonances significantly.

Chronic stress resulting from prolonged exposure to negative life events increases the risk of mood and anxiety disorders. Although chronic stress can change gene expression relevant for behavior, molecular regulators of this change have not been fully determined. One process that could play a role is DNA methylation, an epigenetic process whereby a methyl group is added onto nucleotides, predominantly cytosine in the CpG context, and which can be induced by chronic stress. It is unknown to what extent chronic social defeat, a model of human social stress, influences DNA methylation patterns across the genome. Our study addressed this question by using a targeted-capture approach called Methyl-Seq to investigate DNA methylation patterns of the dentate gyrus at putative regulatory regions across the mouse genome from mice exposed to 14 days of social defeat. Findings were replicated in independent cohorts by bisulfite-pyrosequencing. Two differentially methylated regions (DMRs) were identified. One DMR was located at intron 9 of Drosha, and it showed reduced methylation in stressed mice. This observation replicated in one of two independent cohorts. A second DMR was identified at an intergenic region of chromosome X, and methylation in this region was increased in stressed mice. This methylation difference replicated in two independent cohorts and in Major Depressive Disorder (MDD) postmortem brains. These results highlight a region not previously known to be differentially methylated by chronic social defeat stress and which may be involved in MDD.

Quasi-free photoproduction of $ \eta{^\prime}$ -mesons off nucleons bound in the deuteron has been measured with the combined Crystal Barrel - TAPS detector. The experiment was done at a tagged photon beam of the ELSA electron accelerator in Bonn for incident photon energies from the production threshold up to 2.5GeV. The $ \eta{^\prime}$ -mesons have been detected in coincidence with recoil protons and recoil neutrons. The quasi-free proton data are in good agreement with the results for free protons, indicating that nuclear effects have no significant impact. The coincidence with recoil neutrons provides the first data for the $ \gamma$ n $ \rightarrow$ n $ \eta{^\prime}$ reaction. In addition, also first estimates for coherent $ \eta{^\prime}$ -production off the deuteron have been obtained. In agreement with model predictions, the total cross-section for this channel is found to be very small, at most at the level of a few nb. The data are compared to model calculations taking into account contributions from nucleon resonances and t -channel exchanges

Photoproduction of $\eta$ mesons off $^{12}$C, $^{40}$Ca, $^{93}$Nb, and $^{nat}$Pb nuclei has been measured with a tagged photon beam with energies between 0.6 and 2.2 GeV. The experiment was performed at the Bonn ELSA accelerator with the combined setup of the Crystal Barrel and TAPS calorimeters. It aimed at the in-medium properties of the S$_{11}$(1535) nucleon resonance and the study of the absorption properties of nuclear matter for $\eta$ mesons. Careful consideration was given to contributions from $\eta\pi$ final states and secondary production mechanisms of $\eta$-mesons e.g. from inelastic $\pi N$ reactions of intermediate pions. The analysis of the mass number scaling shows that the nuclear absorption cross section $\sigma_{N\eta}$ for $\eta$ mesons is constant over a wide range of the $\eta$ momentum. The comparison of the excitation functions to data off the deuteron and to calculations in the framework of a BUU-model show no unexplained in-medium modifications of the S$_{11}$(1535)., Comment: Accepted for publication in Eur. Phys. J. A

Data on the health and well-being of the transgender population are limited. However, using claims data we can identify transgender Medicare beneficiaries (TMBs) with high confidence. We seek to describe the TMB population and provide comparisons of chronic disease burden between TMBs and cisgender Medicare beneficiaries (CMBs), thus laying a foundation for national level TMB health disparity research.Using a previously validated claims algorithm based on ICD-9-CM codes relating to transsexualism and gender identity disorder, we identified a cohort of TMBs using Medicare Fee-for-Service (FFS) claims data. We then describe the demographic characteristics and chronic disease burden of TMBs (N = 7454) and CMBs (N = 39,136,229).Compared to CMBs, a greater observed proportion of TMBs are young (under age 65) and Black, although these differences vary by entitlement. Regardless of entitlement, TMBs have more chronic conditions than CMBs, and more TMBs have been diagnosed with asthma, autism spectrum disorder, chronic obstructive pulmonary disease, depression, hepatitis, HIV, schizophrenia, and substance use disorders. TMBs also have higher observed rates of potentially disabling mental health and neurological/chronic pain conditions, as well as obesity and other liver conditions (nonhepatitis), compared to CMBs.This is the first systematic look at chronic disease burden in the transgender population using Medicare FFS claims data. We found that TMBs experience multiple chronic conditions at higher rates than CMBs, regardless of Medicare entitlement. TMBs under age 65 show an already heavy chronic disease burden which will only be exacerbated with age.

The first measurements of the beam-target-helicity-asymmetries $E$ and $G$ in the photoproduction of $\omega$-mesons off protons at the CBELSA/TAPS experiment are reported. $E$ ($G$) was measured using circularly (linearly) polarised photons and a longitudinally polarised target. $E$ was measured over the photon energy range from close to threshold ($E_\gamma = 1108$~MeV) to $E_\gamma = 2300$~MeV and $G$ at a single energy interval of $1108 < E_\gamma, Comment: 6 pages, 6 figures

Photoproduction of two neutral pions off the proton is studied using linearly polarized photons, and the polarization observables I-s and I-c are measured for the first time. These two observables are unique to multi-meson final states; they characterize correlations between the linear photon polarization and the direction of outgoing single particles in photoproduction of three-body final states. The I-s and I-c distributions suggest that, in the 1.8 to 2.0 GeV mass region, the N(1520) 3/2(-)pi intermediate state is reached with reaction dynamics consistent with a dominant J(P) = 3/2(+) wave. These data are included in the Bonn-Gatchina (BnGa) partial wave analysis which is based on a large variety of data; the analysis confirms a significant contribution from the reaction chain gamma p -> N(1900)3/2(+) -> N(1520)3/2(-)pi(0) -> p pi(0)pi(0). (C) 2015 The Authors. Published by Elsevier B.V.

Cancer patients often present to the emergency department (ED) and hospital for symptom management, but many of these visits are avoidable and costly.We assessed the impact of 2 Health Care Innovation Awards that used an oncology medical home model [Community Oncology Medical Home (COME HOME)] or patient navigation model [Patient Care Connect Program (PCCP)] on utilization and spending.Participants in COME HOME and PCCP models were matched to similar comparators using propensity scores. We analyzed utilization and spending outcomes using Medicare fee-for-service claims with unadjusted and adjusted difference-in-differences models.In the adjusted models, both COME HOME and PCCP were associated with fewer ED visits than a comparison group (15 and 22 per 1000 patients/quarter, respectively; P0.01). In addition, COME HOME had lower spending ($675 per patient/quarter; P0.01), and PCCP had fewer hospitalizations (11 per 1000 patients/quarter; P0.05), relative to the comparison group. Among patients undergoing chemotherapy, fewer COME HOME and PCCP patients had ED visits (18 and 28 per 1000 patients/quarter, respectively; P0.01) and fewer PCCP patients had hospitalizations (13 per 1000 patients/quarter; P0.05), than comparison patients.The oncology medical home and patient navigator programs both showed reductions in spending or utilization. Adoption of such programs holds promise for improving cancer care.

Background and Objectives Care coordination and palliative care supports are associated with reduced anxiety, fewer hospital admissions, and improved quality of life for patients and their families. Early palliative care can result in savings in the end-of-life period, but there is limited evidence that larger-scale models can improve both utilization and the cost of care. Three models that received Health Care Innovation Awards from the Centers for Medicare & Medicaid Services aimed to improve quality of care and reduce cost through the use of innovative care coordination models. This study explores the total cost of care and selected utilization outcomes at the end-of-life for these innovative models, each of which enrolled adults with multiple chronic conditions and featured care coordination with advance care planning as a component of palliative care. These included a comprehensive at-home supportive care model for persons predicted to die within a year and two models offering advance care planning in nursing facilities and during care transitions. Research Design and Methods We used regression models to assess model impacts on costs and utilization for high-risk Medicare beneficiaries participating in the comprehensive supportive care model (N = 3,339) and the two care transition models (N = 587 and N = 277) who died during the study period (2013–2016), relative to a set of matched comparison patients. Results Comparing participants in each model who died during the study period to matched comparators, two of the three models were associated with significantly lower costs in the last 90 days of life ($2,122 and $4,606 per person), and the third model showed nonsignificant differences. Two of the three models encouraged early hospice entry in the last 30 days of life. For the comprehensive at-home supportive care model, we observed aggregate savings of nearly $19 million over the study period. One care transition model showed aggregate savings of over $500,000 during the same period. Potential drivers of these cost savings include improved patient safety, timeliness of care, and caregiver support. Discussion and Implications Two of the three models achieved significant lower Medicare costs than a comparison group and the same two models also sustained their models beyond the Centers for Medicare & Medicaid Services award period. These findings show promise for achieving palliative care goals as part of care coordination innovation.

Three models that received Health Care Innovation Awards from the Centers for Medicare and Medicaid Services (CMS) aimed to reduce the cost and use of health care services and improve the quality of care for Medicare beneficiaries with cancer. Each emphasized a different principle: the oncology medical home, patient navigation, or palliative care. Comparing participants in each model who died during the study period to matched comparators, we found that the oncology medical home and patient navigation models were associated with decreased costs in the last ninety days of life ($3,346 and $5,824 per person, respectively) and fewer hospitalizations in the last thirty days of life (fifty-seven and forty per 1,000 people, respectively). The patient navigation model was also associated with fewer emergency department visits in the last thirty days of life and increased hospice enrollment in the last two weeks of life. These promising results can inform new initiatives for cancer patients, such as the CMS Oncology Care Model.

Photoproduction of $\eta$ mesons from neutrons} \abstract{Results from measurements of the photoproduction of $\eta$ mesons from quasifree protons and neutrons are summarized. The experiments were performed with the CBELSA/TAPS detector at the electron accelerator ELSA in Bonn using the $\eta\to3\pi^{0}\to6\gamma$ decay. A liquid deuterium target was used for the measurement of total cross sections and angular distributions. The results confirm earlier measurements from Bonn and the MAMI facility in Mainz about the existence of a narrow structure in the excitation function of $\gamma n\rightarrow n\eta$. The current angular distributions show a forward-backward asymmetry, which was previously not seen, but was predicted by model calculations including an additional narrow $P_{11}$ state. Furthermore, data obtained with a longitudinally polarized, deuterated butanol target and a circularly polarized photon beam were analyzed to determine the double polarization observable $E$. Both data sets together were also used to extract the helicity dependent cross sections $\sigma_{1/2}$ and $\sigma_{3/2}$. The narrow structure in the excitation function of $\gamma n\rightarrow n\eta$ appears associated with the helicity-1/2 component of the reaction.

The reaction γ p → K S 0 Σ + is studied in the photon energy range from threshold. Linearly polarised photon beams from coherent bremsstrahlung enabled the first measurement of photon beam asymmetries in this reaction up to E γ = 1650 MeV . In addition, the recoil hyperon polarisation was determined through the asymmetry in the weak decay Σ + → p π 0 up to E γ = 2250 MeV . The data are compared to partial wave analyses, and the possible impact on the interpretation of a recently observed prominent structure in the cross section near the K ⁎ thresholds is discussed.

In a search for $\omega$ mesic states, the production of $\omega$-mesons in coincidence with forward going protons has been studied in photon induced reactions on $^{12}$C for incident photon energies of 1250 - 3100 MeV. The $\pi^0 \gamma$ pairs from decays of bound or quasi-free $\omega$-mesons have been measured with the CBELSA/TAPS detector system in coincidence with protons registered in the MiniTAPS forward array. Structures in the total energy distribution of the $\pi^0 \gamma$ pairs, which would indicate the population and decay of bound $\omega~^{11}$B states, are not observed. The $\pi^0 \gamma$ cross section of 0.3 nb/MeV/sr observed in the bound state energy regime between -100 and 0 MeV may be accounted for by yield leaking into the bound state regime because of the large in-medium width of the $\omega$-meson. A comparison of the measured total energy distribution with calculations suggests the real part $V_0$ of the $\omega~^{11}$B potential to be small and only weakly attractive with $V_0(\rho=\rho_0) = -15\pm$ 35(stat) $\pm$20(syst) MeV in contrast to some theoretical predictions of attractive potentials with a depth of 100 - 150 MeV., Comment: 13 pages, 8 figures

Maternal high-fat (HF) diet has long-term consequences on the metabolic phenotype of the offspring. Here, we determined the effects of postweaning exercise in offspring of rat dams fed HF diet during gestation and lactation. Pregnant Sprague-Dawley rats were maintained on chow or HF diet throughout gestation and lactation. All pups were weaned onto chow diet on postnatal day (PND) 21. At 4 wk of age, male pups were given free access to running wheels (RW) or remained sedentary (SED) for 3 wk, after which all rats remained sedentary, resulting in four groups: CHOW-SED, CHOW-RW, HF-SED, and HF-RW. Male HF offspring gained more body weight by PND7 compared with CHOW pups and maintained this weight difference through the entire experiment. Three weeks of postweaning exercise did not affect body weight gain in either CHOW or HF offspring, but reduced adiposity in HF offspring. Plasma leptin was decreased at the end of the 3-wk running period in HF-RW rats but was not different from HF-SED 9 wk after the exercise period ended. At 14 wk of age, intracerebroventricular injection of leptin suppressed food intake in CHOW-SED, CHOW-RW, and HF-RW, while it did not affect food intake in HF-SED group. At death, HF-RW rats also had higher leptin-induced phospho-STAT3 level in the arcuate nucleus than HF-SED rats. Both maternal HF diet and postweaning exercise had effects on hypothalamic neuropeptide and receptor mRNA expression in adult offspring. Our data suggest that postweaning exercise improves central leptin sensitivity and signaling in this model.

The excitation function and momentum distribution of $\eta^\prime$ mesons have been measured in photon induced reactions on $^{12}{}$C in the energy range of 1250-2600 MeV. The experiment was performed with tagged photon beams from the ELSA electron accelerator using the Crystal Barrel and TAPS detectors. The data are compared to model calculations to extract information on the sign and magnitude of the real part of the $\eta^\prime$-nucleus potential. Within the model, the comparison indicates an attractive potential of -($37 \pm 10(stat)\pm10(syst)$) MeV depth at normal nuclear matter density. Since the modulus of this depth is larger than the modulus of the imaginary part of the $\eta^\prime$-nucleus potential of -($10\pm2.5$) MeV, determined by transparency ratio measurements, a search for resolved $\eta^\prime$-bound states appears promising., Comment: 13 pages, 6 figures

This paper reports on a measurement of the double-polarization observable G in $\pi^0$ photoproduction off the proton using the CBELSA/TAPS experiment at the ELSA accelerator in Bonn. The observable G is determined from reactions of linearly-polarized photons with longitudinally-polarized protons. The polarized photons are produced by bremsstrahlung off a properly oriented diamond radiator. A frozen spin butanol target provides the polarized protons. The data cover the photon energy range from 617 to 1325 MeV and a wide angular range. The experimental results for G are compared to predictions by the Bonn-Gatchina (BnGa), J\"ulich-Bonn (J\"uBo), MAID and SAID partial wave analyses. Implications of the new data for the pion photoproduction multipoles are discussed.

The γ + p → K 0 + Σ + photoproduction reaction is investigated in the energy region from threshold to E γ = 2250 MeV . The differential cross section exhibits increasing forward-peaking with energy, but only up to the K ⁎ threshold. Beyond, it suddenly returns to a flat distribution with the forward cross section dropping by a factor of four. In the total cross section a pronounced structure is observed between the K ⁎ Λ and K ⁎ Σ thresholds.

Glucocorticoids may play a significant role in the etiology of neuropsychiatric illnesses. Abnormalities in plasma cortisol levels, glucocorticoid sensitivity, and HPA-axis function often accompany clinical symptoms of stress-related illnesses such as PTSD and depression. Of particular interest are genetic association studies that link single nucleotide polymorphisms of HPA-axis genes with illnesses only in the context of an early-life trauma exposure such as child abuse. These studies suggest that dysregulation of HPA-axis function can have lasting repercussions in shaping mood and anxiety, long after termination of the traumatic experience. As persistent glucocorticoid-induced loss of DNA methylation in FK506 binding protein 5 (Fkbp5) was previously observed in the hippocampus and blood and in the neuronal cell line HT-22, we asked whether these epigenetic alterations occur in non-neuronal, HPA-axis relevant cells. We used the pituitary adenoma cell line AtT-20 to demonstrate that the intronic enhancer region of Fkbp5 undergoes loss of DNA methylation in response to dexamethasone treatment in a dose-dependent manner. We also focused on the mouse hippocampal dentate gyrus to test whether these changes would be enriched in a region implicated in the HPA-axis stress response, neurogenesis, and synaptic plasticity. We observed an increase in enrichment of DNA methylation loss in the dentate gyrus, as compared to whole hippocampal tissues that were similarly treated with glucocorticoids. We then asked whether DNA methyltransferase 1 (Dnmt1), a methyltransferase enzyme involved in maintaining DNA methylation following cell division, is involved in the observed epigenetic alterations. We found a dose-dependent decrease of Dnmt1 expression in the AtT-20 cells following dexamethasone treatment, and a similar decrease in corticosterone-treated mouse hippocampus. Taken together, we provide evidence that these glucocorticoid-induced epigenetic alterations have a broader validity in non-neuronal cells and that they may involve the DNA methylation machinery.

The photoproduction of η ′ -mesons off different nuclei has been measured with the CBELSA/TAPS detector system for incident photon energies between 1500–2200 MeV. The transparency ratio has been deduced and compared to theoretical calculations describing the propagation of η ′ -mesons in nuclei. The comparison indicates a width of the η ′ -meson of the order of Γ = 15 – 25 MeV at ρ = ρ 0 for an average momentum p η ′ = 1050 MeV / c , at which the η ′ -meson is produced in the nuclear rest frame. The inelastic η ′ N cross section is estimated to be 3–10 mb. Parameterizing the photoproduction cross section of η ′ -mesons by σ ( A ) = σ 0 A α , a value of α = 0.84 ± 0.03 has been deduced.

The photoproduction of 2π$^{0}$ mesons off protons was studied with the Crystal Barrel/TAPS experiment at the electron accelerator ELSA in Bonn. The energy of photons produced in a radiator was tagged in the energy range from 600 MeV to 2.5 GeV. Differential and total cross sections and pπ$^{0}$ π$^{0}$ Dalitz plots are presented. Part of the data was taken with a diamond radiator producing linearly polarized photons, and beam asymmetries were derived. Properties of nucleon and Δ resonances contributing to the pπ$^{0}$ π$^{0}$ final state were determined within the Bonn-Gatchina (BnGa) partial-wave analysis. The data presented here allow us to determine branching ratios of nucleon and Δ resonances for their decays into pπ$^{0}$ π$^{0}$ via several intermediate states. Most prominent are decays proceeding via Δ(1232)π, N(1440)1/2$^{+}$ π, N(1520)3/2$^{−}$ π, N(1680)5/2$^{+}$ π, but also pf$_{0}$(500), pf$_{0}$(980), and pf$_{2}$(1270) contribute to the reaction.

The polarization observable I^s, a feature exclusive to the acoplanar kinematics of multi-meson final states produced via linearly polarized photons, has been measured for the first time. Results for the reaction g p -> p pi0 eta are presented for incoming photon energies between 970 MeV and 1650 MeV along with the beam asymmetry I^c. The comparably large asymmetries demonstrate a high sensitivity of I^s to the dynamics of the reaction. Fits using Bonn-Gatchina partial wave analysis demonstrate that the new polarization observables carry significant information on the contributing partial waves., 11 pages, 6 figures, v2 to appear in Phys. Lett. B

Summa Health System Department of Pharmacy Services performs a workshop based competency program to assess the ability of our clinical staff pharmacists to perform both clinical and distributive functions that are required for practice in our institutions. One day each month is devoted to this program, which consists of several modules designed to measure, sharpen, and update skills. Pharmacists are scheduled to attend one of the sessions each year. The topics change yearly to include current issues in disease state management, patient safety, clinical skills, and pharmacy technology. Modules are led by clinical lead pharmacists and department management.

Within urban environments and other complex illumination conditions, tilted target surface or partial sky occlusions from nearby raised objects can have a significant impact on a target’s radiance observed from a spectral sensor. At the pixel level, these terms can be predicted and corrected for by modeling the impact collocated height data has on the scene radiometry. After properly accounting for these impacts, a Lambertian material’s retrieved spectral reflectivity should be the same at any location or orientation within the scene. This paper proposes a novel approach for using this constraint to iterate on atmospheric aerosol parameters until the difference of retrieved spectral reflectance of two pixels of the same material, but under different illumination conditions, is minimized.

The photoproduction of 2$\pi^0$ mesons off protons was studied with the Crystal Barrel/TAPS experiment at the electron accelerator ELSA in Bonn. The energy of photons produced in a radiator was tagged in the energy range from 600\,MeV to 2.5\,GeV. Differential and total cross sections and $p\pi^0\pi^0$ Dalitz plots are presented. Part of the data was taken with a diamond radiator producing linearly polarized photons, and beam asymmetries were derived. Properties of nucleon and $\Delta$ resonances contributing to the $p\pi^0\pi^0$ final state were determined within the BnGa partial wave analysis. The data presented here allow us to determine branching ratios of nucleon and $\Delta$ resonances for their decays into $p\pi^0\pi^0$ via several intermediate states. Most prominent are decays proceeding via $\Delta(1232)\pi$, $N(1440)1/2^+\pi$, $N(1520)3/2^-\pi$, $N(1680)5/2^+\pi$, but also $pf_0(500)$, $pf_0(980)$, and $pf_2(1270)$ contribute to the reaction.

The N pi(0)pi(0) decays of positive-parity N* and Delta* resonances at about 2 GeV are studied at ELSA by photoproduction of two neutral pions off protons. The data reveal clear evidence for several intermediate resonances: Delta(1232), N(1520)3/2(-), and N(1680)5/2(+), with spin parities J(P) = 3/2(+), 3/2(-), and 5/2(+). The partial wave analysis (within the Bonn-Gatchina approach) identifies N(1440)1/2(+) and the N(pi pi)s (wave) (abbreviated as N sigma here) as further isobars and assigns the final states to the formation of nucleon and Delta resonances and to nonresonant contributions. We observe the know Delta(1232)pi decays of Delta(1910)1/2(+), Delta(1920)3/2(+), Delta(1905)5/2(+), Delta(1950)7/2(+), and of the corresponding spin-parity series in the nucleon sector, N(1880)1/2(+), N(1900)3/2(+), N(2000)5/2(+), and N(1990)7/2(+). For the nucleon resonances, these decay modes are reported here for the first time. Further new decay modes proceed via N(1440)1/2(pi)(+), N(1520)3/2(pi)(-) , N(1680)5/2(pi)(+), and N sigma. The latter decay modes are observed in the decay of N* resonances and at most weakly in Delta(*) decays. It is argued that these decay modes provide evidence for a 3-quark nature of N* resonances rather than a quark-diquark structure.

Epigenetics may have an important role in mood stabilizer action. Valproic acid (VPA) is a histone deacetylase inhibitor, and lithium (Li) may have downstream epigenetic actions. To identify genes commonly affected by both mood stabilizers and to assess potential epigenetic mechanisms that may be involved in their mechanism of action, we administered Li (N=12), VPA (N=12), and normal chow (N=12) to Brown Norway rats for 30 days. Genomic DNA and mRNA were extracted from the hippocampus. We used the mRNA to perform gene expression analysis on Affymetrix microarray chips, and for genes commonly regulated by both Li and VPA, we validated expression levels using quantitative real-time PCR. To identify potential mechanisms underlying expression changes, genomic DNA was bisulfite treated for pyrosequencing of key CpG island ‘shores’ and promoter regions, and chromatin was prepared from both hippocampal tissue and a hippocampal-derived cell line to assess modifications of histones. For most genes, we found little evidence of DNA methylation changes in response to the medications. However, we detected histone H3 methylation and acetylation in the leptin receptor gene, Lepr, following treatment with both drugs. VPA-mediated effects on histones are well established, whereas the Li effects constitute a novel mechanism of transcriptional derepression for this drug. These data support several shared transcriptional targets of Li and VPA, and provide evidence suggesting leptin signaling as an epigenetic target of two mood stabilizers. Additional work could help clarify whether leptin signaling in the brain has a role in the therapeutic action of Li and VPA in bipolar disorder.

Omega photoproduction off hydrogen and deuterium has been studied with the tagged photon beam of the ELSA accelerator in Bonn for photon energies up to 2.0 GeV. The omega meson has been identified via the omega -> pi(0) gamma -> gamma gamma gamma decay mode, using the combined setup of the Crystal Barrel/TAPS detector systems. Both inclusive and exclusive analyses have been carried out. Differential and total cross-sections have been derived for omega mesons produced off free protons and off protons and neutrons bound in deuterium. The cross-section for the production off the bound neutron is found to be a factor of a parts per thousand 1.3 larger than the one off the bound proton in the incident beam energy region 1.2 GeV

The Nπ^{0}π^{0} decays of positive-parity N^{*} and Δ^{*} resonances at about 2 GeV are studied at ELSA by photoproduction of two neutral pions off protons. The data reveal clear evidence for several intermediate resonances: Δ(1232), N(1520)3/2^{-}, and N(1680)5/2^{+}, with spin parities J^{P}=3/2^{+}, 3/2^{-}, and 5/2^{+}. The partial wave analysis (within the Bonn-Gatchina approach) identifies N(1440)1/2^{+} and the N(ππ)_{S wave} (abbreviated as Nσ here) as further isobars and assigns the final states to the formation of nucleon and Δ resonances and to nonresonant contributions. We observe the known Δ(1232)π decays of Δ(1910)1/2^{+}, Δ(1920)3/2^{+}, Δ(1905)5/2^{+}, Δ(1950)7/2^{+}, and of the corresponding spin-parity series in the nucleon sector, N(1880)1/2^{+}, N(1900)3/2^{+}, N(2000)5/2^{+}, and N(1990)7/2^{+}. For the nucleon resonances, these decay modes are reported here for the first time. Further new decay modes proceed via N(1440)1/2^{+}π, N(1520)3/2^{-}π, N(1680)5/2^{+}π, and Nσ. The latter decay modes are observed in the decay of N^{*} resonances and at most weakly in Δ^{*} decays. It is argued that these decay modes provide evidence for a 3-quark nature of N^{*} resonances rather than a quark-diquark structure.

Photoproduction off protons of the pπ 0 η three-body final state was studied with the Crystal Barrel/TAPS detector, at the electron stretcher accelerator ELSA in Bonn, for incident energies from the π 0 η production threshold up to 2.5 GeV. Differential cross sections and the total cross sections are presented. The use of linearly polarized photons gives access to the polarization observables Σ, I s , and I c , the latter two characterize beam asymmetries in case of three-body final states. Δ(1232)η, N(1535)1/2− π, and pa 0(980) are the dominant isobars contributing to the reaction. The partial wave analysis confirms the existence of some nucleon and Δ resonances, for which so far only fair evidence was reported. A large number of decay modes of known nucleon and Δ resonances is presented. It is shown that detailed investigations of decay branching ratios may provide a key to unravelling the structure of nucleon and Δ resonances.

The first measurement of the helicity dependence of the photoproduction cross section of single neutral pions off protons is reported for photon energies from 600 to 2300 MeV, covering nearly the full solid angle. The data are compared to predictions from the SAID, MAID, and BnGa partial wave analyses. Strikingly large differences between data and predictions are observed, which are traced to differences in the helicity amplitudes of well-known and established resonances. Precise values for the helicity amplitudes of several resonances are reported.

There is ample evidence that exposure to stress during gestation increases the risk of the offspring to develop mood disorders. Brain-derived neurotrophic factor (Bdnf) plays a critical role during neuronal development and is therefore a prime candidate to modulate neuronal signaling in adult offspring of rat dams that were stressed during gestation. In the current study, we tested the hypothesis that alterations in Bdnf expression in prenatally stressed (PNS) offspring are mediated by changes in DNA methylation in exons IV and VI of the Bdnf gene. We observed decreased Bdnf expression in the amygdala and hippocampus of prenatally stressed rats both at weaning and in adulthood. This decrease in Bdnf expression was accompanied by increased DNA methylation in Bdnf exon IV in the amygdala and hippocampus, suggesting that PNS-induced reduction in Bdnf expression may, at least in part, be mediated by increased DNA methylation of Bdnf exon IV. Expression of DNA methyltransferases (Dnmt) 1 and 3a was increased in PNS rats in the amygdala and hippocampus. Our data suggest that PNS induces decreases in Bdnf expression that may at least in part be mediated by increased DNA methylation of Bdnf exon IV.

Epigenetic studies that utilize peripheral tissues to identify molecular substrates of neuropsychiatric disorders rely on the assumption that disease-relevant, cellular alterations that occur in the brain are mirrored and detectable in peripheral tissues such as blood. We sought to test this assumption by using a mouse model of Cushing's disease and asking whether epigenetic changes induced by glucocorticoids can be correlated between these tissue types.Mice were treated with different doses of glucocorticoids in their drinking water for four weeks to assess gene expression and DNA methylation (DNAm) changes in the stress response gene Fkbp5.Significant linear relationships were observed between DNAm and four-week mean plasma corticosterone levels for both blood (R(2)=0.68, P=7.1×10(-10)) and brain (R(2)=0.33, P=0.001). Further, degree of methylation change in blood correlated significantly with both methylation (R(2)=0.49, P=2.7×10(-5)) and expression (R(2)=0.43, P=3.5×10(-5)) changes in hippocampus, with the notable observation that methylation changes occurred at different intronic regions between blood and brain tissues.Although our findings are limited to several intronic CpGs in a single gene, our results demonstrate that DNA from blood can be used to assess dynamic, glucocorticoid-induced changes occurring in the brain. However, for such correlation analyses to be effective, tissue-specific locations of these epigenetic changes may need to be considered when investigating brain-relevant changes in peripheral tissues.

Background A German astronaut visited the MIR space station between 10 February and 2 March 1997. Together with his Russian colleagues, he conducted a series of scientific investigations before, during and after his stay aboard the MIR station. Research performed during this flight was part of a global space life sciences programme and focused on metabolic homeostasis, fluid balance, calcium homeostasis and cardiovascular regulatory mechanisms. The main goal of the scientific experiments was to use this mission as a milestone to establish international networks of scientific collaboration using space research as a tool for focused research in respective fields. Thus, in most cases the results obtained from the astronaut complemented a series of results obtained on ground and from other flights. In other cases, they extended previous results and opened new fields for future research. Participants Human space flight with astronauts serving as operators and at the same time as test subjects is very complex. Many people, including mission control, a science management team, medical operations, ethics committees and a medical board, participated to harmonize the different requirements, thus making a maximal scientific outcome possible. Conclusion In summary, this space mission may be seen as a model for focused long-term multidisciplinary international research, and demonstrates that space medicine is no longer adventure but science.

The measurement of the total forces acting on the surface of a wind tunnel model is still the most important wind tunnel measurement technology. Either the model is mounted by struts to a balance, which is located outside the test section (an `external balance'), or the balance is located inside the model and connects the model structure to the mounting sting, which in the case of aeroplane configurations protrudes from the rear fuselage (an `internal balance'). This review concerns internal balances only. The functional principle is described and some comments on the demand for high accuracy are given. The optimization of designs for strain gauge balances, the fabrication methods and the selection of materials are commented on. The calibration theory of multi-component balances is outlined and the calibration equipment is described. Examples for conventional manual calibration equipment and for an automatic calibration machine are given. Finally the specific design features of cryogenic balances and half model balances are given. This review presents the author's experiences and developments. Since there is hardly any general literature on the subject of strain gauge balances and since the balance engineers in the world have not that much contact with each other, there may be different points of view at other institutions.

In photoproduction experiments, a large number of final states yielding various resonance contributions are accessible. To extract resonance parameters via partial-wave analysis not only the measurement of differential cross-sections is necessary, but also the determination of polarization observables. At the electron accelerator ELSA (Bonn) the coherent bremsstrahlung method was used to generate a linearly polarized photon beam. Using the CBELSA/TAPS detector setup, the beam asymmetry Σ in the reaction γp → pπ 0 η was determined as a function of various masses and angles for photon energies between 970MeV and 1650MeV.

Today, it is generally considered as a fact that hydrogen will play a decisive role in a future energy system, when fossil fuels have become scarce and thus expensive and/or unsuitable because of ecological reasons. Moreover, it is likely that hydrogen will be applied first and mainly for transportation at least until an efficient storage of electricity on-board of vehicles is available. Based on the experience of the Industrial Gases Industry and of chemical process engineering, on space technology and new developments, different methods of hydrogen storage have been proposed and partly investigated in the past. An important result is that the most favorable type of fuel tank system depends on the kind of vehicle and the mode of its operation. The paper gives a review of on-board storage methods with examples of applications. Requirements for storage systems with respect to the various means of transportation are discussed, emphasizing ground transport by car and bus and mentioning aviation. Further development is necessary which has to be undertaken now as long as we are not under constraint regarding economy, safety and common acceptance. It is shown that the development of hydrogen technology can benefit the introduction of natural gas powered vehicles, in particular if it is stored as cryogenic liquid.

The first measurement of the helicity dependence of the photoproduction cross section of single neutral pions off protons is reported for photon energies from 600 to 2300 MeV, covering nearly the full solid angle. The data are compared to predictions from the SAID, MAID, and BnGa partial wave analyses. Strikingly large differences between data and predictions are observed, which are traced to differences in the helicity amplitudes of well-known and established resonances. Precise values for the helicity amplitudes of several resonances are reported.