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The purpose of this study was to determine the accuracy of the pedometer when walking, skipping, galloping, sliding, and hopping. One hundred-two college students were fitted with a pedometer (Walk4Life LS-7010) at mid-thigh on the right and left of the hip. Participants then performed the randomly assigned movements for the length (26 m) of a hardwood court playing surface, during which time the investigator tallied the steps with a hand counter. Each step with the lead foot elicited a tally on the counter. Participants were instructed to perform the movement at a brisk pace, to jump-stop at the end of the court, and to remain still until after the pedometer reading was recorded. Repeated measure ANOVAs using the Bonferroni technique were used to compare differences between pedometer counts and hand counts. Significant differences were evident between the hand tally counts and readings from the right and left pedometers during all five locomotor movements (P < .01). Mean error was lowest between the hand tally and the average of the right and left pedometers while walking (-1.35 +/- 1.60) and hopping (-2.94 +/- 2.33), and increased while sliding (-6.42 +/- 4.78), galloping (-8.22 +/- 4.63), and skipping (-8.30 +/- 4.45). Results indicate the pedometer may not consistently register the vertical force produced by the trail foot contact, the lead foot contact, or a combination of the two while skipping, galloping, and sliding. Though the pedometer is a valid instrument when estimating physical activity levels, caution is urged when interpreting movements other than walking. [ABSTRACT FROM AUTHOR]

This evaluation project used a triangulation of methods and data sources to link the expanded role nurse clinician (NC) to outcomes of costs, quality, and satisfaction in managed care. Results of patient surveys, case studies, cost-benefit analyses, interviews, focus groups, and HMO documents suggest that the impact of the role has benefit far beyond its costs. This article builds on an earlier article (Nursing Economic$, Vol. 17, No. 1). Part I reviewed literature on expanded role nursing in population management, and described the development of the NC role. In Part II, the NC expanded role is linked to organizational outcomes of costs, quality, and satisfaction. Results here could be used by managers and planners to provide rationale for implementing expanded nursing roles in managed care in order to improve ambulatory care processes, recruit and retain nurses, reduce costs, and increase patient and provider satisfaction. [ABSTRACT FROM AUTHOR]

New expanded roles in nursing are developing in response to the health system switch from private, episodic care of individuals to health maintenance organizations (HMO's) focusing on disease prevention and promotion of health for populations of persons with chronic illness. This evaluation project explored the role of the nurse clinician in population and case management at a large HMO in the Northwest United States. In Part I of this two-part series, a literature review, is presented on chronic illness, ambulatory nursing, expanded role nursing, and nursing in HMOs. The development of the expanded role nurse clinician at the managed care organization is also described. Results could be used by HMOs to attract and retain nurses, improve care processes, and decrease costs in ambulatory care. Part II of this series, to be published in the March/April 2000 issue of Nursing Economic, will document the impact of the nurse clinician role on costs, quality, and provider and patient satisfaction. [ABSTRACT FROM AUTHOR]

This study examined differences in consciousness indexes (perceived duration of time) at different levels of physical exertion within the framework of Newman's model of health and with emphasis on Prigogine's theory of dissipative structures. The sample consisted of 100 volunteers participating in regular aerobic exercise. Instruments included 817E Monarch Stationary Bicyles, 1800 Dynamap Automatic Blood Pressure/Pulse Monitors, the production method of time estimation, and the Perceived Exertion Scale. Repeated measures ANOVA revealed significant differences in consciousness indexes during exertion (p < .00001). Paired t-tests yielded significant differences between the resting consciousness index and consciousness indexes at preferred, increased, and decreased exertion levels (p = .000). Results indicate that the consciousness index decreased with physical exertion regardless of actual exertion level. In addition, changes in perceived exertion and in physiological parameters suggest a pattern of expanding consciousness that is consistent with the theoretical framework. [ABSTRACT FROM AUTHOR]

Newman's model of health as the expansion of consciousness and Prigogine's theory of dissipative structures provide the framework for the development of a model of consciousness as a dissipative structure. Relationships among Type A behavior, temporal orientation, and death anxiety are examined and explicated within the human field pattern of consciousness as a dissipative structure. Type A behavior, future orientation, and death anxiety are proposed as manifestations of consciousness with the potential to evolve to higher levels in accordance with Prigogine's theory. Preliminary research findings related to the model and suggestions for future research are also presented. [ABSTRACT FROM AUTHOR]

Objective: To characterize the extent of the impact of the COVID-19 pandemic on aspects of the anesthesia residency experience from the perspective of American College of Veterinary Anesthesia and Analgesia (ACVAA) mentors and trainees. This includes the residency interview process, didactic training and availability and variety of clinical cases for resident learning., Study Design: Cross-sectional, online, anonymous voluntary survey., Sample Population: A total of 58 respondents, representing 30 residency program mentors and 28 residents., Methods: Surveys were distributed by email to 94 residency program mentors and 70 residents, representing programs and residents registered with the ACVAA during the years of 2019-2021. Anonymous links to an online survey were provided via a link embedded in the email. Questions included perceived impacts (-5 to +5 scale) on didactic and clinical training, case distribution, workload, residency application and selection process, and mental health. Responses were summarized with descriptive statistics [median (IQR) or mean ± SD]., Results: The overall survey response rate was 31.9% (30/94) and 40.0% (28/70) for resident program mentors and residents, respectively. There was a negative perceived impact on overall residency training reported: -1.0 (IQR -2.0 to 0) for program mentors and -1.5 ± 1.5 for residents. The reported perceived impact of travel limitations on case log completion was -2.0 (IQR -4.0 to -1.0) for program mentors and -2.4 ± 2.0 for residents. Program mentors and residents had incongruent feelings on the impact of the pandemic on work hours, with residents reporting a perceived increase in work hours [+2.1 ± 2.1 versus 0 (IQR -1.0 to 0)]., Conclusions: Residency program mentors and residents generally agreed that the COVID-19 pandemic had negatively impacted multiple aspects of residency interview and training process. A broader, objective analysis of veterinary anesthesia training programs is required to fully elucidate the scale of the impact on veterinary anesthesia training., (Copyright © 2024 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved.)

Anthropogenic disturbances, including extraction of natural resources and development of alternative energy, are reducing and fragmenting habitat for wildlife across the globe. Effects of those disturbances have been explored by studying populations that migrate through oil and gas fields or alternative energy facilities. Extraction of minerals, including precious metals and lithium, is increasing rapidly in remote areas, which results in dramatically altered landscapes in areas of resident populations of wildlife. Our goal was to examine how a resident population of American pronghorn (Antilocapra americana) in the Great Basin ecosystem selected resources near a large-scale disturbance year around. We investigated how individuals selected resources around a large, open-pit gold mine. We classified levels of disturbance associated with the mine, and used a random forest model to select ecological covariates associated with habitat selection by pronghorn. We used resource selection functions to examine how disturbances affected habitat selection by pronghorn both annually and seasonally. Pronghorn strongly avoided areas of high disturbance, which included open pits, heap leach fields, rock disposal areas, and a tram. Pronghorn selected areas near roads, although selection was strongest about 2 km away. We observed relatively broad variation among individuals in selection of resources, and how they responded to the mine. The Great Basin is a mineral-rich area that continues to be exploited for natural resources, especially minerals. Sagebrush-dependent species, including pronghorn, that rely on this critical habitat were directly affected by that transformation of the landscape, which is likely to increase with expansion of the mine. As extraction of minerals from remote landscapes around the world continues to fragment habitats for wildlife, increasing our understanding of impacts of those changes on behaviors of wildlife before populations decline, may assist in the mitigation and minimization of negative impacts on mineral-rich landscapes and on wildlife populations., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier B.V.)

Objective: This retrospective study aimed to measure rabbit laryngotracheal dimensions at different locations on computed tomography (CT), assess the relationship of these measurements with rabbit body weight, determine the most common narrowest measurement and assess its relationship with endotracheal tube (ETT) size and body weight., Animals: 66 adult domestic rabbits (Oryctolagus cuniculus) of different breeds and body weights., Procedures: CT laryngotracheal luminal height, width, and cross-sectional area measurements were made at the rostral thyroid cartilage at the level of the arytenoids, caudal thyroid cartilage/rostral cricoid cartilage, caudal cricoid cartilage/cranial trachea, and trachea at the level of the fifth cervical vertebra., Results: The data for every measurement of luminal airway dimensions revealed robust positive associations with body weight (P < .001). The narrowest laryngotracheal measurement was the width at the level of the caudal thyroid cartilage/rostral cricoid cartilage, and the smallest cross-sectional area was at the rostral thyroid cartilage at the level of the arytenoids. There was a strong association between body weight and the likelihood of appropriate ETT fit. To have at least an 80% chance of appropriate ETT fit with a 2.0, 2.5, and 3.0 mm ETT, the rabbits' weight predicted by the model (lower 95% confidence limit) were at least 2.99 (2.72) kg, 5.24 (4.65) kg, and 5.80 (5.21) kg, respectively., Clinical Relevance: The laryngotracheal lumen was narrowest at the level of the caudal thyroid cartilage in rabbits, which indicates this location may be the limiting factor in determining ETT size in rabbits.

Publication bias and the decreased publication of trials with negative or non-significant results is a well-recognized problem in human and veterinary medical publications. These biases may present an incomplete picture of evidence-based clinical care and negatively impact medical practices. The purpose of this study was to utilize a novel sentiment analysis tool as a quantitative measure for assessing clinical trial reporting trends in human and veterinary medical literature. Abstracts from 177,617 clinical trials in human medical journals and 8684 in veterinary medical journals published in the PubMed database from 1995 to 2020. Abstracts were analyzed using the GAN-BioBERT sentiment classifier for both general trends and percentage of neutral/negative publications. Sentiment was defined on a - 1 (highly negative) to 1 (highly positive) scale. Human-based clinical trial publications were less likely to feature positive findings (OR 0.87, P < 0.001) and more likely to include neutral findings (OR 1.18, P < 0.001) relative to veterinary clinical trials. No difference was found in reporting of negative sentiment trials (OR 1.007, P = 0.83). In both groups, the published sentiment of clinical trials increased over time. Using sentiment analysis to evaluate large publication datasets and compare publication trends within and between groups, this study is significant in its detection of significant publication differences between human and veterinary medicine clinical trials and a continued unbalanced positive sentiment in the published literature. The implications of this unbiased reporting have important clinical and research implications that require consideration., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Objectives: To describe an ultrasound-guided rectus sheath (RS) block technique in calves with injections of methylene blue and assess the extent of injectate spread and nerve staining in calf cadavers., Study Design: Prospective, experimental, blinded cadaveric study., Animals: A total of 16 calf cadavers weighing 30.7 ± 7.1 kg., Methods: Using an ultrasound-guided, in-plane technique, each cadaver was injected with both a low (LV; 0.25 mL kg -1 ) and high (HV; 0.5 mL kg -1 ) volume of methylene blue dye. Volumes were randomly assigned to the left or right hemiabdomen. Ultrasound imaging was scored based on landmarks and needle visualization, and duration to perform injections were assessed. Dissections were performed immediately after injections. Staining of ventral branches of spinal nerves and the extent of dye spread were recorded by an anatomist unaware of treatment allocation., Results: The number of nerves stained in treatments LV and HV were 2.3 ± 1.7 and 4.4 ± 1.3, respectively (p = 0.0001). Branches of thoracic nerves T7-13 and lumbar nerves L1-2 were completely stained 6.3%, 6.3%, 31.3%, 62.5%, 56.3%, 37.5%, 31.3%, 6.3% and 0%, respectively, in treatment LV and 0%, 12.5%, 50%, 93.8%, 100%, 93.8%, 62.5%, 25% and 6.3%, respectively, in treatment HV. Ultrasound imaging was scored excellent in most cadavers and needle visualization deemed excellent in all injections. The mean duration to perform RS injections in both treatments was 2 (range, 1-6) minutes., Conclusions and Clinical Relevance: Nerve staining results from treatment HV suggest that this RS injection technique could be clinically useful in ventral midline surgical procedures, including umbilical procedures, in calves. This study supports future clinical trials in calves., (Copyright © 2021 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved.)

Objective: To describe the technique for performing an ultrasound-guided pecto-intercostal fascial (PIF) block and compare two volumes of injectate in canine cadavers., Study Design: Prospective experimental cadaveric study., Animals: A total of 11 canine cadavers (11.8 ± 1.9 kg)., Methods: Parasternal ultrasound-guided injections were performed within the PIF plane, between the deep pectoral and external intercostal muscles, at the intercostal space between ribs four and five. Each hemithorax was injected with 0.25 mL kg -1 (treatment low volume, LV) or 0.5 mL kg -1 (treatment high volume, HV) of 1% methylene blue dye. Treatments were randomly assigned to either right or left hemithorax, with each cadaver injected with both treatments, for a total of 22 injections. Anatomical dissections were performed to determine staining of ventral cutaneous branches of intercostal nerves, surrounding nerves and musculature and spread of injectate. The presence or absence of intrathoracic puncture was also noted., Results: The PIF plane was identified and injected in each hemithorax. No significant differences between treatments LV and HV were found for number of ventral cutaneous nerve branches stained or any other analyzed variable. The ventral cutaneous branches of intercostal nerves (T3-T8) were variably stained, and the most commonly stained nerves were T5 (6 and 10), T6 (8 and 9) and T7 (2 and 7) in treatments LV and HV, respectively. Staining outside the immediate parasternal region was noted in both treatments, with greater spread away from the parasternal region in treatment HV. No intrathoracic staining was found., Conclusions and Clinical Relevance: Ultrasound-guided PIF injections resulted in staining of ventral cutaneous branches and parasternal musculature; however, the spread observed was inadequate to provide effective analgesia to the sternum. In vivo studies are warranted to investigate this regional anesthetic technique in veterinary patients., (Copyright © 2022 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved.)

Objectives: To describe the ultrasound-guided rectus sheath block technique and the anatomical spread of two volumes of methylene blue injection in dog cadavers., Study Design: Blinded, prospective, experimental cadaveric study., Animals: A total of eight dog cadavers weighing 8.9 ± 1.6 kg., Methods: Ultrasound-guided rectus sheath injections were performed bilaterally 1 cm cranial to the umbilicus using 0.25 mL kg -1 (low volume; LV) and 0.50 mL kg -1 (high volume; HV) of 0.5% methylene blue dye. A total of 16 hemiabdomens were injected. The ultrasound image quality of the muscular and fascial plane landmarks and needle visualization were scored using a standardized scale. Cadavers were dissected to determine the distribution of the dye and to assess staining of ventral branches of the spinal nerves., Results: Fewer ventral spinal nerve branches were stained in the LV group than in the HV group, at 2.00 ± 0 and 2.90 ± 0.83, respectively (p < 0.01). Ventral branches of thoracic (T) and lumbar (L) spinal nerves (T10, T11, T12, T13 and L1) were stained 25%, 100%, 75%, 25% and 0% of the time in LV group and 12.5%, 87.5%, 100.0%, 75.0% and 13.0% in HV group. A lesser extent of cranial-caudal dye distribution was observed in the LV group than in the HV group (7.1 ± 1.8 cm and 9.2 ± 1.8 cm, respectively; p = 0.03). There was no significant difference in medial-lateral spread of dye, number of test doses or ultrasound image quality scores between groups., Conclusions and Clinical Relevance: The results of this study suggest that, on an anatomical basis, this easily performed block has the potential to provide effective abdominal wall analgesia for the ventral midline. This study supports the potential of the rectus sheath block for abdominal procedures, and further investigations on its clinical efficacy are warranted., (Copyright © 2019 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved.)

Objectives: To describe a technique to perform an ultrasound-guided erector spinae plane (ESP) block and determine the distribution and potential complications after injection of two volumes of methylene blue in dog cadavers., Study Design: Prospective experimental cadaveric study., Animals: A total of eight dog cadavers weighing 9.3 ± 1.9 kg., Methods: Ultrasound-guided injections dorsal to the transverse process and ventral to the erector spinae muscles aimed at the fifth thoracic transverse process were performed bilaterally in each dog using 0.5 and 1.0 mL kg -1 dye solution [low volume (LV) and high volume (HV) treatments, respectively]. Treatments were randomly assigned to the right or left side of each dog, resulting in a total of 16 injections. Anatomical dissections determined dye spread characteristics, including epaxial muscles spread, staining of spinal nerves, dorsal rami, ventral rami (intercostal nerves) and sympathetic trunk spread. Staining indicating potential complications (epidural, mediastinal and intrapleural spread) was recorded., Results: There was complete staining of at least one dorsal ramus following all injections. A more extensive spread was observed along the muscles in the HV compared with LV (p = 0.036). No significant difference between multisegmental dorsal rami spread (six out of eight injections in each treatment) was noted. Out of 16 injections, one in LV treatment resulted in multisegmental spinal nerve staining and one in HV treatment resulted in ventral ramus (intercostal nerve) staining. Use of anatomic landmarks resulted in inaccurate identification of the fifth transverse process in at least six out of 16 injections (38%). No sympathetic trunk, epidural, mediastinal or intrapleural staining was observed., Conclusions and Clinical Relevance: Ultrasound-guided ESP injections resulted in extensive staining along the epaxial muscles, as well as staining of the dorsal rami in all dogs. The incidence of dorsal rami mutisegmental spread was the same in both treatments., (Copyright © 2019 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved.)

Objectives: To describe an ultrasound-guided thoracic paravertebral block and determine the distribution after injection of two volumes of methylene blue in dog cadavers., Study Design: Prospective experimental cadaveric study., Animals: Twelve dog cadavers weighing 11 ± 3 kg., Methods: Ultrasound-guided injections aimed at the fifth thoracic (T5) paravertebral space were performed in randomized order using 0.1 or 0.3 mL kg -1 dye solution (six dogs for each volume). Anatomic dissections determined dye spread characteristics, including the presence and degree of staining of spinal nerves, and the presence of intercostal and sympathetic trunk spread. Staining of mediastinum, epidural, intrapleural and contralateral thoracic paravertebral space was recorded., Results: There was no significant difference in dye distribution between groups. The use of anatomic landmarks resulted in the inaccurate identification of the T5 paravertebral space. The T4, T5 and T6 paravertebral spaces were injected in four, five and three of 12 dogs, respectively. Complete staining of the spinal nerve of the thoracic paravertebral space injected was observed in 11 of 12 dogs, and partial staining in one dog in the low-volume group. Multisegmental distribution was demonstrated with staining of contiguous spinal nerves in one dog in the high-volume group, and multiple segments of intercostal (three dogs) and sympathetic trunk (four dogs) spread in both groups. No mediastinal, epidural, intrapleural or contralateral thoracic paravertebral space staining was observed., Conclusions and Clinical Relevance: Ultrasound-guided injection at the thoracic paravertebral space resulted in staining of the spinal nerve in all dogs. However, T5 paravertebral space was not accurately identified using anatomic landmarks. Dye distribution was not significantly different between the two groups; therefore, the use of the lower-volume and multiple-site injections would be potentially necessary in clinical cases to achieve ipsilateral blockade of the thoracic wall., (Copyright © 2018 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved.)

The early steps of photosynthesis involve the photoexcitation of reaction centers (RCs) and light-harvesting (LH) units. Here, we show that the historically overlooked excitonic delocalization across RC and LH pigments results in a redistribution of absorption amplitudes that benefits the absorption cross section of the optical bands associated with the RC of several species. While we prove that this redistribution is robust to the microscopic details of the dephasing between these units in the purple bacterium Rhodospirillum rubrum, we are able to show that the redistribution witnesses a more fragile, but persistent, coherent population dynamics which directs excitations from the LH toward the RC units under incoherent illumination and physiological conditions. Even though the redirection does not seem to affect importantly the overall efficiency in photosynthesis, stochastic optimization allows us to delineate clear guidelines and develop simple analytic expressions in order to amplify the coherent redirection in artificial nanostructures.

The prospect of coherent dynamics and excitonic delocalization across several light-harvesting structures in photosynthetic membranes is of considerable interest, but challenging to explore experimentally. Here we demonstrate theoretically that the excitonic delocalization across extended domains involving several light-harvesting complexes can lead to unambiguous signatures in the optical response, specifically, linear absorption spectra. We characterize, under experimentally established conditions of molecular assembly and protein-induced inhomogeneities, the optical absorption in these arrays from polarized and unpolarized excitation, and demonstrate that it can be used as a diagnostic tool to determine the resonance coupling between iso-energetic light-harvesting structures. The knowledge of these couplings would then provide further insight into the dynamical properties of transfer, such as facilitating the accurate determination of Förster rates.

Oxidative damage to DNA and hole transport between nucleobases in oxidized DNA are important processes in lesion formation for which surprisingly poor thermodynamic data exist, the relative ease of oxidizing the four nucleobases being one such example. Theoretical simulations of radiation damage and charge transport in DNA depend on accurate values for vertical ionization energies (VIEs), reorganization energies, and standard reduction potentials. Liquid-jet photoelectron spectroscopy can be used to directly study the oxidation half-reaction. The VIEs of nucleic acid building blocks are measured in their native buffered aqueous environment. The experimental investigation of purine and pyrimidine nucleotides, nucleosides, pentose sugars, and inorganic phosphate demonstrates that photoelectron spectra of nucleotides arise as a spectral sum over their individual chemical components; that is, the electronic interactions between each component are effectively screened from one another by water. Electronic structure theory affords the assignment of the lowest energy photoelectron band in all investigated nucleosides and nucleotides to a single ionizing transition centered solely on the nucleobase. Thus, combining the measured VIEs with theoretically determined reorganization energies allows for the spectroscopic determination of the one-electron redox potentials that have been difficult to establish via electrochemistry.

Intravenous anesthetic delivery in reptiles can be challenging. Current injectable techniques have varied induction/recovery times and anesthetic quality. This study hypothesized that intracoelomic administration of a new anesthetic, fospropofol, in turtles would result in dose-dependent anesthesia and respiratory depression. A two-part prospective trial using adult red-eared slider turtles (Trachemys scripta elegans) weighing 764 +/- 17 g was conducted to determine an effective anesthetic dose and to evaluate the anesthetic quality, duration, and respiratory effects of an efficacious dose. In part 1, six turtles were randomly administered 25-mg/ kg (low-dose [LD]) and 50-mg/kg (high-dose [HD]) fospropofol in a crossover design. Respiratory rate, immobility, and muscle relaxation scores were evaluated for 180 min. In part 2, eight turtles were administered HD fospropofol. Immobility and muscle relaxation (front and hind limb) scores and time to endotracheal intubation/extubation were evaluated until scores returned to baseline. In part 1, the LD group had significantly lower immobility and muscle relaxation scores versus the HD group over time (both P < 0.05); scores were significantly elevated from baseline for 20-120 min and 15-180 min, respectively (all P < 0.05). Although not significantly different between groups (P > 0.05), respiratory rate was significantly decreased from baseline from 10 to 120 min (all P < 0.05). In part 2, HD fospropofol decreased respiratory rate from 21.5 +/- 2.9 breaths/min to 0.1 +/- 0.1 breaths/min, similar to the results in part 1. Maximal reductions in mobility and front and hind limb motor tone occurred at 39.0 +/- 4.1, 30.8 +/- 3.6, and 24.0 +/- 3.6 min, respectively. Intubation in 7/8 turtles occurred at 45.7 +/- 5.4 min and extubation at 147.0 +/- 23.2 min. However, 2/8 turtles showed prolonged anesthetic effects, requiring resuscitative efforts for recovery. Due to the unpredictable quality and duration of anesthesia with intracoelomic fospropofol, it should be used with caution for general anesthesia in red-eared sliders at the doses and administration route investigated.

Objective: To determine if the volume of injected local anesthetic solution affects cranial to caudal spread when performing ultrasound-guided transversus abdominis plane (TAP) blocks in dogs., Study Design: Prospective experimental study., Animals: Adult Beagle cadavers (n = 20), Methods: Bilateral TAP blocks using ultrasound guidance was performed in 20 Beagle cadavers (mean ± SD weight, 9.3 ± 1.4 kg) using a 1:1 solution of methylene blue/bupivacaine injected at volumes of 0.25, 0.5, 0.75, and 1.0 mL/kg. Cadavers were dissected to determine injectate spread within the transversus abdominis fascial plane., Results: The transversus abdominis fascial plane was adequately identified by ultrasonography, injected, and dissected in 38 beagle hemi-abdominal walls; injectate was not identified in 2 hemi-abdominal walls. Dermatomal spread (number of ventral nerve roots saturated by injected solution) was volume dependent (P = .026, Kruskal Wallis): 2.9 ± 0.74 nerve roots for 0.25 mL/kg; 3.4 ± 1.1 for 0.5 mL/kg; 4.0 ± 0.67 for 0.75 mL/kg; and 4.2 ± 1.2 for 1 mL/kg., Conclusion: In Beagle cadavers, the volume of injected local anesthetic solution significantly affects cranial to caudal spread within the TAP during ultrasound-guided TAP blocks. The volume of local anesthetic injected could potentially be used to augment the spread of analgesic coverage for a given surgical procedure in dogs., (© Copyright 2012 by The American College of Veterinary Surgeons.)

The purpose of this study was to evaluate the effectiveness of a novel fluorocarbon-based sevoflurane emulsion in dogs previously shown to produce short-term rodent anesthesia. On the basis of an unexpected allergic-type clinical reaction, we also tested the hypothesis that this type of formulation causes histamine release and complement activation. Physiological parameters, plasma histamine levels (radioimmunoassay), and complement activation (enzyme immunoassay) were quantified in response to emulsion components, including F13M5 (the emulsion's fluorocarbon-based polymer) and methoxy poly(ethylene glycol) 5000 (the polymer's hydrophilic block). Although the emulsion produced general anesthesia in dogs, they also experienced hypotension and clinical signs suggestive of an allergic-like response (i.e., vasodilation, urticaria, and pruritus upon recovery). Emulsions lacking sevoflurane failed to induce anesthesia but did elicit the allergic response. Plasma histamine levels were significantly increased following injection of micellar solutions of F13M5. Direct complement activation by the emulsion or its components was weak or absent. An allergic response leading to histamine release, likely initiated by the F13M5 component via an immunoglobulin pathway, is associated with an intravenous fluorocarbon-based emulsion of sevoflurane. Subsequently, its usefulness in medicine in its present formulation is limited., (Copyright © 2011 Wiley-Liss, Inc. and the American Pharmacists Association)

Objective: To describe the ultrasound-guided technique to the transversus abdominis plane (TAP) block in the dog and evaluate the spread of a local anesthetic/methylene blue solution., Study Design: Prospective experimental trial., Animals: Ten adult Beagle cadavers weighing 11.1 ± 1.1 kg (mean ± SD)., Methods: Transversus abdominis plane (TAP) blocks were performed bilaterally by a single trained individual on unpreserved cadaver dogs using 10 mL of methylene blue/bupivacaine solution per site. Dissection of the abdominal wall was performed within 15-55 minutes of block to determine distribution of injectate and nerve involvement in the transversus abdominis fascial plane., Results: The transversus abdominis fascial plane was adequately visualized via ultrasound and injected in twenty hemi-abdominal walls. Segmental branches of T11, T12, T13, L1, L2, and L3 were adequately stained in 20%, 60%, 100%, 100%, 90%, and 30% of injections, respectively., Conclusions and Clinical Relevance: This anatomical study suggests that the transversus abdominis plane (TAP) block would provide adequate regional anesthesia of the abdomen, potentially extending to the cranial and caudal limits of the abdomen. This supports the clinical potential of this block in veterinary medicine., (© 2011 The Authors. Veterinary Anaesthesia and Analgesia © 2011 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesiologists.)

The objective of this study was to evaluate the respiratory effects of buprenorphine, butorphanol, midazolam, and their combinations in healthy conscious rabbits. Six adult female New Zealand white rabbits were anesthetized briefly with isoflurane by mask to allow placement of a catheter into the central ear artery. After a 60-min recovery period, a baseline arterial sample was obtained. Animals then were injected intramuscularly with either 0.9% NaCl (1 mL), buprenorphine (0.03 mg/kg), butorphanol (0.3 mg/kg), midazolam (2 mg/kg), buprenorphine + midazolam (0.03 mg/kg, 2 mg/kg), or butorphanol + midazolam (0.3 mg/kg, 2 mg/kg). Arterial blood gases were evaluated at 30, 60, 90, 120, 180, 240, and 360 min after drug administration. All drug treatments caused significant decreases in respiratory rate, compared with saline. Buprenorphine and the combinations of midazolam-butorphanol and midazolam-buprenorphine resulted in statistically significant decreases in pO(2). No significant changes in pCO(2) pressure were recorded for any treatment. Increases in blood pH were associated with administration of butorphanol, midazolam, and the combinations of midazolam-butorphanol and midazolam-buprenorphine. In light of these results, buprenorphine and the combinations of midazolam-buprenorphine and midazolam-butorphanol result in statistically significant hypoxemia in rabbits that breathe room air. The degree of hypoxemia is of questionable clinical importance in these healthy subjects. Hypoxemia resulting from these drug combinations may be amplified in rabbits with underlying pulmonary or systemic disease.

Objective: (1) To determine the interrater reliability and measurement error of an 11-step stair ascend/descend test (STTotal-11) and stair up (ascend) test (STUp-11); (2) to seek evidence for the STTotal-11 and STUp-11 as valid measures of physical function by determining if they relate to measures of physical function and do not relate to measures not of physical function; and (3) to explore if the STTotal-11 and STUp-11 scores relate to lower-extremity muscle weakness and knee range of motion (ROM) in subjects with total knee arthroplasty (TKA)., Design: Cross-sectional study., Setting: Academic center., Participants: Subjects (N=43, 30 women; mean age, 68+/-8y) with unilateral TKA., Interventions: Not applicable., Main Outcome Measures: STTotal-11 and STUp-11 were performed twice, and scores were compared with scores on 4 lower extremity performance-based tasks, 2 patient-reported questionnaires of physical function, 3 psychologic factors, knee ROM, and strength of quadriceps, hip extensors, and abductors., Results: Intraclass correlation coefficient was .94 for both the STTotal-11 and STUp-11, standard error of measurements were 1.14 seconds and .82 seconds, and minimum detectable change associated with 90% confidence interval was 2.6 seconds and 1.9 seconds, respectively. Correlations between stair tests and performance-based measures and knee and hip muscle strength ranged from Pearson correlation coefficient (r)=.40 to .78. STTotal-11 and STUp-11 had a small correlation with one of the patient-reported measures of physical function. Stair tests were not associated with psychologic factors and knee extension ROM and were associated with knee flexion ROM., Conclusions: STTotal-11 and STUp-11 have good interrater reliability and minimum detectable changes adequate for clinical use. The pattern of associations supports the validity of the stair tests in TKA., (Copyright 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.)

The transversus abdominis plane (TAP) block is an innovative regional anesthetic technique using local anesthetic that is gaining popularity in the analgesic management of human patients undergoing abdominal surgery. Needle placement in the TAP block is within the facial plane between the internal oblique and transversus abdominis muscles and involves the abdominal and thoracic nerves. Successful blockade generally involves spinal nerves T10-L1 and may induce sensory blockade as far cranially as T7, thus producing analgesia for abdominal surgery. Human studies suggest that this regional anesthetic technique may provide postoperative analgesia of the abdominal wall for up to 48 hr. Because of the extent and duration of sensory blockade, this novel technique with bupivacaine was used on a Canadian lynx (Lynx canadensis), possibly providing 8-10 hr ofintra- and postoperative analgesia concurrent to exploratory laparotomy for removal of a gastric foreign body.

Background: Serum protein electrophoresis (SPE) has emerged as a potentially valuable diagnostic tool in avian medicine; yet, there is limited information regarding SPE in cranes. Since 2000, 20 cases of unilateral periocular or facial soft tissue swelling, blepharitis, feather loss, and ocular or nasal discharge attributed to insect bite hypersensitivity were observed in cranes from a captive breeding center. SPE may be useful for evaluating these lesions., Objective: The aim of this study was to characterize the inflammatory response in cranes with hypersensitivity reactions using SPE., Methods: Serum samples from 7 cranes diagnosed with hypersensitivity reactions were submitted to a diagnostic laboratory for agarose gel electrophoresis. Results were compared to those in control serum samples obtained from the same cranes during routine physical examination, when they were clinically healthy., Results: Total protein and a- and g-globulin concentrations were significantly increased and albumin/globulin ratios were significantly decreased in serum samples from cranes with hypersensitivity lesions compared with control samples., Conclusions: Using SPE, we documented changes in protein fraction concentrations in cranes with clinical signs of hypersensitivity. The increase in alpha- and gamma-globulin concentrations suggested inflammation and antigenic stimulation, consistent with a Type I hypersensitivity reaction.

This study examined the relationships between jail incarceration during pregnancy and infant birth weight, preterm birth, and fetal growth restriction. We used multivariate regression analyses to compare outcomes for 496 births to women who were in jail for part of pregnancy with 4,960 Medicaid-funded births as matched community controls. After adjusting for potential confounding variables, the relationship between jail incarceration and birth outcomes was modified by maternal age. Relative to controls, women incarcerated during pregnancy had progressively higher odds of low birth weight and preterm birth through age 39 years; conversely, jail detainees older than 39 years were less likely than controls to experience low birth weight or preterm birth. For women in jail at all ages, postrelease maternity case management was associated with decreased odds of low birth weight, whereas prenatal care was associated with decreased odds of preterm birth. Local jails are important sites for public health intervention. Efforts to ensure that all pregnant women released from jail have access to enhanced prenatal health services may improve perinatal outcomes for this group of particularly vulnerable women and infants.

Few studies have examined health care access for the growing population of pregnant women who cycle in and out of urban jails. The present study compared use of Medicaid-funded perinatal services for births to women who were in jail during pregnancy and births to women who had been in jail, but not while pregnant. Jail contact during pregnancy increased the likelihood women would receive prenatal care (odds ratio [OR] = 5.95; 95% confidence interval [CI] 2.18-16.23) and maternity support services (OR = 1.80; 95% CI 1.12-2.88), but was associated with fewer total prenatal and support visits. Jail contact during a previous pregnancy was associated with fewer prenatal care visits, more support service visits, and longer time receiving case management. Jail settings can become a place of coordination between public health and criminal justice professionals to ensure that pregnant women receive essential services following release. Service coordination may increase women's engagement in health services during future pregnancies, with or without subsequent incarceration.

Background: Congestive heart failure (CHF) patients experience dyspnea on exertion and therefore have decreased exercise tolerance., Objective: This study explores the hypothesis that stable New York Heart Association (NYHA) class III CHF patients without a history of pulmonary disease exhibit airflow limitation with increasing exercise., Methods: We characterized flow limitations and breathing reserves at baseline, during exercise before anaerobic threshold (pre-AT), and after anaerobic threshold (post-AT) in CHF patients and normal subjects. Data were collected in the form of maximal flow volume loops and subsequent tidal flow volume loops at baseline and during exercise. Expiratory flow limitation was expressed as percent of tidal volume that corresponded with overlap of the tidal flow volume loops and maximal flow volume loops during expiration. The area directly between the maximum flow volume loops and the tidal flow volume loops during the expiratory phase is expressed as expiratory flow volume reserve (EFVR)., Results: CHF patients experienced expiratory flow limitation during exercise (pre-AT and post-AT) that was significantly increased compared to baseline and to normal subjects at similar exercise levels (CHF, baseline 8.5 +/- 7, pre-AT 37 +/- 10, post-AT 38 +/- 8%, n = 9, p < 0.05). Both CHF patients and normal subjects increased EFVR during exercise, but only the normal subjects increased EFVR to a significantly different value at post-AT exercise levels (normal subjects, 9.5 +/- 2, 11 +/- 2, 32 +/- 4%, n = 7, p < 0.05). Both CHF patients and normal subjects increased end inspiratory lung volume (EILV) during exercise, but only the normal subjects significantly increased EILV at post-AT exercise levels (normal subjects, 49 +/- 4, 55 +/- 5, 76 +/- 4%, p < 0.05). Inspiratory capacity (IC)/forced vital capacity (FVC) ratios were increased in CHF patients compared to normal subjects. However, IC/FVC values did not change during exercise in either group., Conclusions: CHF patients cannot utilize their full respiratory capacity during exercise secondary to expiratory flow limitation and an inability to increase EILV and EFVR., (Copyright 2003 S. Karger AG, Basel)

Background: The purpose of this investigation was to examine the effects of carbohydrate (CHO) supplementation on isokinetic leg extension/flexion exercise performance, blood glucose responses, blood free fatty acid (FFA) responses, and blood lactate (La) responses., Methods: Eight resistance trained males (mean+/-SEM, age: 23.7+/-1.3 yrs, height: 180.0+/-3.5 cm, bodymass: 94.9+/-4.9 kg) participated in a randomized, double blind protocol with testing sessions separated by 7-d. Subjects were given CHO or placebo (P) while performing 16 sets of 10 repetitions at 120 degrees x s(-1) on a Cybex isokinetic dynamometer. Performance variables measured were; total work (TW), average work (AW), peak torque (PT) and average torque (AT). Plasma glucose (PG), FFA, and La were measured prior to testing (PRE), after set 8 (MID), and 16 (POST)., Results: Results indicated that the CHO treatment elicited significantly (p<0.05) more TW (CHO: 41.1+/-3.9 kJ; P: 38.1+/-3.9 kJ) and AW (CHO: 2.6+/-0.2 kJ; P: 2.4+/-0.2 kJ). There were no differences (p<0.05) between treatments for PT of the hamstrings (CHO: 91.6+/-6.5 Nm; P: 87.4+/-8.5 Nm) and quadriceps (CHO: 129.7+/-9.5 Nm; P: 123.0+/-10.6 Nm). The AT of the hamstrings (CHO: 77.8+/-5.2 Nm; P: 75.7+/-8.7 Nm) and quadriceps (CHO: 116.9+/-8.9 Nm; P: 110.0+/-8.5 Nm) were not statistically different (p>0.05) between the treatments. PG was significantly higher at the POST blood draw in the CHO treatment. No significant differences (p>0.05) were observed between the treatments for FFA and La concentrations., Conclusions: The data from this investigation indicate that the use of CHO supplementation during isokinetic leg exercise allows for the performance of more work.

The purpose of this investigation was to examine white blood cell counts (WBC), immunoglobulin (IgA, IgG, IgM) levels, and T-cell proliferation following acute resistance training in 9 untrained (UT) and 6 trained (TR) women. Resistance training on 7 Universal machines at the subject's 10 repetition maximum (IORM) was performed at 89 +/- 5% for UT and 88 +/- 3% for TR. Blood was analyzed for WBCs and Ig levels pre-exercise, immediately postexercise, and 1.5, 3, and 24 hours postexercise. T-cell proliferation was determined pre-exercise and 3 hours postexercise through response to phytohemagglutanin (PHA). WBCs were significantly elevated in the UT subjects 1.5 and 3 hours postexercise compared with pre- and immediately postexercise; no differences (p < 0.05) were observed in TR subjects. No significant differences were found for Ig levels either between or within groups, although there was a trend for decreased IgG following exercise. T-cell proliferation was significantly decreased in the UT at 3 hours postexercise (0.27 +/- 0.06 units) compared with pre-exercise (0.41 +/- 0.06 units), whereas the proliferative response in TR was not significantly different from pre-exercise (0.48 +/- 0.04 units) to 3 hours postexercise (0.34 +/- 0.06 units). These data indicate that UT subjects experience an increase in WBC counts and a decrease in T-cell proliferative ability after acute resistance training, whereas TR subjects experience no significant change in these parameters.

Rather than a philosophy, pragmatism is a way of doing philosophy that has major implications for solving disputes involving nursing science, theory, and practice that may otherwise be interminable. Pragmatism weaves together theory and action so that one modifies the other continuously, but both maintain their mutual relevance. Pragmatism emphasizes pluralism and diversity, and depends on an ethical base for determination of what is reasonable. Recently repopularized by the philosopher Richard Rorty and others, pragmatic ideals seem inherent to nursing. We propose that a better understanding of the history and utility of pragmatism will enhance both clinically relevant nursing theory and theoretically relevant nursing practice.

In this study we tested the hypothesis that insulin may differentially affect isolated arterioles from red (RGM) and white gastrocnemius muscles (WGM) because of their differences in function and metabolic profile. We also determined whether the responses of these arterioles are endothelium dependent and mediated by either prostaglandins or nitric oxide (NO). Arterioles were isolated, pressurized to 85 mmHg, equilibrated in Krebs bicarbonate-buffered solution (pH 7.4) gassed with 10% O2 (5% CO2-85% N2), and studied in a no-flow state. Control diameters for first-order arterioles from RGM averaged 77 +/- 8 micrometers and from WGM averaged 77 +/- 5 micrometers. Cumulative dose-response curves to insulin (10 microU/ml, 100 microU/ml, 1 mU/ml, and 10 mU/ml) were obtained in arterioles before and after endothelium removal or administration of either indomethacin (Indo, 10(-5) M) or NG-nitro-L-arginine (L-NNA, 10(-4) M). Insulin evoked concentration-dependent increases in control diameter of intact RGM and WGM arterioles of 6-26% and 9-28%, respectively. Indo was without any effect on insulin-induced dilation in RGM and WGM arterioles. Insulin-evoked dilation in both RGM and WGM arterioles was completely inhibited and converted to vasoconstriction by endothelium removal and administration of L-NNA. These results indicate that in endothelium-intact arterioles from RGM and WGM, insulin evokes an endothelium-dependent dilation that is equivalent and mediated by NO. In contrast, in the absence of a functional endothelium, insulin evokes arteriolar constriction. The finding that insulin can constrict arterioles, at physiological concentrations, suggests that insulin may play a more significant role in the regulation of vascular tone and total peripheral resistance than previously appreciated.

Objective: To explore women's experience of bed rest in high risk pregnancy., Design: Naturalistic, qualitative. SAMPLE, SETTING: Twelve adult, pregnant women on prescribed bed rest of a minimum of 20 hours per day and for at least 3-weeks duration were interviewed in one Western state of the U.S.A. regarding their experiences., Findings: Three major themes were perceptions of high risk pregnancy, perceptions of bed rest, and the experience of time and restricted movement. The women described a high level of physical, emotional, familial, and economic hardship resulting from the bed-rest experience. Having adequate income, health insurance, and a supportive relative to take over household responsibilities were dimensions of successful maintenance of bed rest in the women., Conclusions: The routine obstetric procedure of bed-rest should be reevaluated in light of its lack of demonstrated effectiveness and potential to seriously harm women and their families., Clinical Implications: Women should be fully informed about controversies surrounding the efficacy of bed rest in pregnancy and encouraged to participate in decisions when complications occur regarding the prescription of prolonged bed rest.

Prolonged tissue ischemia and subsequent reperfusion results in significant tissue injury due to the ischemic-reperfusion (IR) syndrome. Ischemic preconditioning (IPC) or adenosine (ADO) pretreatment are known to protect IR injury in cardiac muscle. Our aim was to determine whether IPC or ADO pretreatment attenuates and protects against ischemic tissue reperfusion injury in skeletal muscle. Rats were anesthetized and global hindlimb ischemia was induced by 60 min of suprarenal aortic clamping followed by 30 min of reperfusion period. The degree of skeletal muscle dysfunction was determined by decreases in maximum contractile force, and adenosine triphosphate (ATP) and creatine phosphate (CP) levels of extensor digitorum longus (EDL) muscle. The distal tendon of the EDL was attached to a force transducer for maximum isometric force measurement. Samples were taken from the EDL for measurement of ATP and CP levels. The following were protective protocols prior to the IR challenge: (1) four consecutive 5-min periods of ischemia separated by 5-min reperfusion periods (PC/I) or (2) i.v. adenosine infusion (350 microg/kg/min x 10 min, PC/A). Our data suggest that pretreatment with brief periods of ischemia or systemic ADO infusion attenuates ischemic tissue reperfusion injury in skeletal muscle. [Table: see text]

Callus derived from avocado fruit pericarp grown in vitro for several generations developed roots with stele, endodermis, cortex, epidermis, and root cap. No correlation between environment and root production was demonstrated.