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Objectives: The objectives of this study were to: (1) understand the personal impact of workplace violence (WPV) on staff within a large multistate emergency medical services (EMS) agency, (2) describe the impact of WPV on subsequent patient interactions, examining how experiences of violence affect the quality of care provided by EMS clinicians, (3) examine the influence of WPV on perceived workplace safety among prehospital personnel and its correlation with retention in the EMS field, and (4) solicit recommendations from staff for the prevention and mitigation of WPV in the future., Methods: We conducted virtual focus groups and individual interviews with 22 prehospital personnel using a descriptive qualitative design within a large multistate Midwest EMS agency between 4/5/2023-6/20/2023. Data were analyzed using Thematic Analysis to identify common perceptions among and across participants., Results: Major themes of personal impact; impact on patient interactions; influence of WPV on career longevity/sustainability; and relationship between EMS culture and WPV were identified. Overall, participants shared the perception that WPV is "part of the job", and that verbal abuse was so common that they hadn't previously considered it as violence. Participants provided several examples of WPV and described how these experiences impacted them personally (e.g., hypervigilance) and impacted their subsequent interaction with patients (e.g., quicker to use restraints, loss of empathy). Participants shared the perception that EMS is no longer valued or respected by patients or communities. Several voiced concerns for the next generation of colleagues and nearly all participants reported the need for education and training in situational awareness, de-escalation, and self-defense tactics. Participants referenced desire for more coordination and communication with law enforcement, change in culture of abuse from patients without repercussions, and improved agency mental health support and peer support/mentoring following a violent event. Despite experiences with WPV, the majority reported plans to remain in EMS., Conclusions: Emergency Medical Services personnel are commonly traumatized by violence in their work and nonphysical violence is underappreciated. Despite its impact on staff and subsequent patient interactions, most participants reported plans to remain within EMS. Multi-faceted system-focused efforts are needed to shift toward and support a zero-tolerance culture for WPV.

Changes in the environment or novel procedures can result in altered cow behavior during data collection; training is often recommended to ensure accurate data is being recorded. Currently, little is known regarding the habituation of dairy cows during methane emission testing with the GreenFeed emission monitoring system (C-Lock Inc., Rapid City, SD), or how behavior relates to enteric methane emission measurements. Methane emissions were estimated from a total of 202 Holstein dairy cows (120-150 d in milk) housed in tiestalls as part of a larger project. Cows were tested on d 0 (training day) and d 1-5 (test day) for approximately 10 min, during which behavior was recorded by a trained observer. While cows spent more time with their head outside of the machine on the training day (d 0) than during the test days (d 1-5), the opposite pattern was observed for the number of leg movements. No differences in estimated methane production were found over the different days, though it was negatively correlated with both behaviors. These results highlight the importance of habituation of dairy cows to the GreenFeed system for methane measurements to minimize changes to cow behavior under tiestall conditions, whereas the methane emissions themselves are less affected. However, further research is needed to determine the impact of cow behavior on the reliability and repeatability of methane emission measurements as it may introduce bias in genetic evaluations for methane efficiency., (© 2023.)

Pragmatic trials aim to generate timely evidence while ensuring feasibility, minimizing practice burden, and maintaining real-world conditions. We conducted rapid-cycle qualitative research in the preimplementation period of a trial evaluating a community paramedic program to shorten and prevent hospitalizations. Between December 2021 and March 2022, interviews ( n = 30) and presentations/discussions ( n = 17) were conducted with clinical and administrative stakeholders. Two investigators analyzed interview and presentation data to identify potential trial challenges, and team reflections were used to develop responsive strategies. Solutions were implemented prior to the commencement of trial enrollment and were aimed at bolstering feasibility and building ongoing practice feedback loops., Competing Interests: In the last 36 months, Dr McCoy has received support from NIDDK, PCORI, and AARP®. She also serves as a consultant to Emmi® (Wolters Kluwer) on developing patient education materials related to prediabetes and diabetes. All other authors declare no conflicts., (© The Author(s) 2023.)

Introduction: Quality of Life (QoL) is an important consideration in patients with abdominal wall hernia (AWH). What matters to patients and their everyday experience living with AWH may depend on a variety of personal, psychological, social and environmental factors. At present, no study has addressed what is important to this particular group of patients by asking the patients themselves. This study aims to determine QoL from the patient's perspective by examining the lived experience in this patient population., Methods: We interviewed 15 patients with AWH until thematic saturation. The patients were purposively sampled from AWH clinic between February 2020 and June 2020 using topic guides and interview schedules. Verbatim interview transcripts were coded and analysed using NVivo12 software and Interpretative Phenomenological Analysis (IPA). We adhered to consolidated criteria for reporting qualitative research (COREQ)., Results: Fifteen participants (8 men and 7 women) of age range 36-85 years, median 65 years, covering all Ventral Hernia Working Group (VHWG) grades. Five superordinate themes were identified each with several subordinate themes, as follows: (1) body image (subthemes-'changes to perceptions of self' and 'fears concerning perceptions of others'). (2) Mental health (subthemes-'emotional responses', 'disruptions to previously solid aspects of identity', 'developing coping strategies'). (3) Symptoms (subthemes-'managing pain', 'freedom of movement', 'restriction and adaptation of function'). (4) Interpersonal relationships (subthemes-'difficulties socially connecting' and 'changes in sexual relations'). (5) Employment (subthemes-'financial pressure', 'return to work issues' and 'costs to family')., Conclusion: This is the first phenomenological qualitative study in the field of AWH and presents a rich account of what is important to these patients in terms of QoL. Developed from the patients' own words, the themes are interrelated and should shape our understanding of patients with AWH. This study provides qualitative examples of each theme. This study has identified new themes (body image, interpersonal relationships and employment) that are not incorporated in existing AWH-specific QoL instruments. This is important for surgeons because the study suggests that we are currently not capturing all data relevant to QoL in this specific patient group with current tools. The wider impact of this would be to help counsel patients and support them more holistically through the disease process and it's management. Further research is needed to generate a standardised AWH QoL instrument which incorporates bio-psycho-emotional-social themes important to patients, as identified by patients., (© 2022. Crown.)

A subcommittee of the Hawaii Governor's Joint Task Force on Rat Lungworm Disease developed preliminary guidelines for the diagnosis and treatment of neuroangiostrongyliasis (NAS) in 2018 (Guidelines, 2018). This paper reviews the main points of those guidelines and provides updates in areas where our understanding of the disease has increased. The diagnosis of NAS is described, including confirmation of infection by real-time polymerase chain reaction (RTi-PCR) to detect parasite DNA in the central nervous system (CNS). The treatment literature is reviewed with recommendations for the use of corticosteroids and the anthelminthic drug albendazole. Long-term sequelae of NAS are discussed and recommendations for future research are proposed.

This study examined whether daily variations in levels of mothers' work, home, and relationship stress were related to collaborative and oppositional qualities of mother-child conflict interactions across 1 week. Mothers reported on 1 specific conflict interaction with their 5- to 8-year-old child and their work, home, and relationship stress through online surveys each day for 7 consecutive days. Diary data from 142 mothers were analyzed in 6 multilevel models, each including within- and between-family levels of a stressor predicting collaborative or oppositional conflict qualities. Results suggested that families in the sample differed from each other, and also varied during the week, in collaborative and oppositional conflict qualities as well as stress in all 3 domains. Mothers reported a greater degree of oppositional conflict qualities on days characterized by higher perceptions of home chaos. Additionally, mothers who reported higher average levels of negativity in romantic relationships endorsed oppositional conflict qualities to a greater extent than mothers with lower relationship negativity. Two multilevel models including all 3 stressors in relation to collaborative and oppositional conflict revealed that for mothers managing multiple roles, average romantic relationship stress was the most important unique contributor to mother-child conflict qualities and daily relationship stress was particularly influential among mothers with sons compared to those with daughters. Results support the spillover hypothesis of stress within the family system and are discussed in terms of mothers' coping mechanisms and emotional engagement. (PsycINFO Database Record, ((c) 2017 APA, all rights reserved).)

Background: Early school start times may curtail children's sleep and inadvertently promote sleep restriction. The current study examines the potential implications for early school start times for behavioral problems in public elementary schools (student ages 5-12 years) in Kentucky., Method: School start times were obtained from school Web sites or by calling school offices; behavioral and disciplinary problems, along with demographic information about schools, were obtained from the Kentucky Department of Education. Estimated associations controlled for teacher/student ratio, racial composition, school rank, enrollment, and Appalachian location., Results: Associations between early school start time and greater behavioral problems (harassment, in-school removals, suspensions, and expulsions) were observed, although some of these associations were found only for schools serving the non-Appalachian region., Conclusions: Findings support the growing body of research showing that early school start times may contribute to student problems, and extend this research through a large-scale examination of elementary schools, behavioral outcomes, and potential moderators of risk., (Copyright © 2017 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.)

Background: In much of the Western hemisphere, mortality from traumatic acute extradural hematomas (AEDH) has been drastically brought down toward 0%. This is still not the case however in most developing countries., Case Description: This report represents a tragi-comic tale of two cases of traumatic AEDH managed by an academic neurosurgeon in a neurosurgically ill-resourced private health facility during a nationwide industrial strike action preventing clinical-surgical care in the principal author's University Teaching Hospital. A young man presented with altered consciousness, Glasgow Coma Score (GCS) 14/15, following a road accident. The cranial computed tomography (CT) scan was obtained only 9 h after its request, long after the man had actually deteriorated to GCS 7/15 with pupillary changes. The neurosurgeon, summoned from the nearby University Teaching Hospital for the operative care of this man, arrived on-site and was about moving the patient into the operative room when he took the final breaths and died, all within 2 h of the belated neuroimaging. This scenario repeated itself in the same health facility just 24 h later with another young man who presented GCS 7/15 and another identical CT evidence of traumatic AEDH. With more financially able relations, the diagnostic/surgical care of this second patient was much more prompt. He made a very brisk recovery from neurosurgical operative intervention. He is alive and well, 5-month postoperative., Conclusions: In most low-resourced health systems of the developing countries, a significant proportion of potentially salvageable cases of AEDH still perish from this disease condition.

Introduction: The normal haemoglobin is an efficient transporter of oxygen to the tissues and carbondioxide from tissues to the lungs for elimination. Various abnormal haemoglobin variants including, the sickle cell diseases, have been described with varying sickling tendencies., Aims: This study aimed to determine the haemoglobin variants among voluntary blood donors in Jos., Method: Records of the age, sex, Haemoglobin level, and the haemoglobin genotype of all voluntary blood donors who donated blood at the National Blood Transfusion Service Centre, Jos, Nigeria between January 2011 and April 2012; and their haemoglobin levels and protein electrophoresis determined, were reviewed., Results: A total of 937 blood donors, 658 (70.23%) males and 279 (29.79%) females, mean age 32.4 years, donated blood voluntarily, their haemoglobin electrophoretic patterns determined by alkaline cellulose acetate electrophoresis. Donor blood haemoglobin levels were determined by automation. Haemoglobin protein electrophoretic patterns identified among our donors were 77.70% AA, 21.88% AS, 0.22% SC, 0.11% AC and 0.11% SS. Mean haemoglobin levels of the donors according to their haemoglobin proteins electrophoretic patterns were, 150.4 +/- 12.5 gms/l for AA, 151.9 +/- 13.8 gms/l for AS and 131.1 +/- 5.0 gms/l for haemoglobin SC., Conclusion: Determination of haemoglobin protein electrophoretic patterns of blood unit for transfusion could enhance selective blood issuing based on recipient's haemoglobin type.

Hypertension is a prominent underlying factor in the genesis of cardiovascular-related morbidity and mortality. A major impediment to the investigation into the causes of the disease is the paucity of naturally occurring animal models of the disease. There is evidence that some species of New World primates spontaneously become hypertensive. We used chronically implanted pressure transducers to assess normally occurring blood pressure and heart rate levels at rest and during routine laboratory procedures in a group of one of these New World primates (Aotus sp.). Resting mean arterial pressure ranged from 72 to 130 mmHg. Three animals were judged to have resting mean arterial pressure levels in the hypertensive range (> or =110 mmHg). In all of the animals, pressor responses to routine laboratory events were exaggerated (average highest mean pressure during 1 min from any session was 97-196 mmHg). Subsequently, the region of the perifornical/lateral hypothalamus known to produce elevated blood pressure and heart rate responses to electrical stimulation was removed, and the blood pressure responses to the laboratory routines were significantly decreased and, in some cases, eliminated. Control lesions in nearby tissue had no effect on these responses. This region may play a critical role in initiating or exacerbating cardiovascular responses that contribute to the development of essential hypertension.

Measurements were made in 29 adult baboons that were housed in social groups, allowing the occurrence of the full range of species-specific behavioral interactions. The cardiovascular variables measured included blood pressure, heart rate, renal blood flow, lower limb blood flow, and occasionally mesenteric blood flow. The data were telemetered from backpacks worn by the animals and were recorded in analogue form on a polygraph, digitally on a computer and were also recorded on the audio channels of videotape being made of the behavior and social interactions of the baboons. The video and the computer recordings were synchronized by a timing system that made it possible to relate the cardiovascular responses to the behavioral responses. A numerically based behavioral code was developed that allowed the categorization of the totality of the behavior, including postural and locomotor changes. Comparisons between baseline cardiovascular values and those occurring 1 s before the initiation of a movement or posture change gave no evidence of anticipatory cardiovascular responses unless the movement was associated with behavior that included emotional content. Hypothalamic perifornical lesions reduced or eliminated these anticipatory changes.

A remote-controlled device was developed for injection of fluids and collection of blood samples from freely moving, socially housed animals via an indwelling catheter. Samples are collected at times chosen by the investigator, and the animal is not aware that sampling is occurring. This technique allows measurement of plasma catecholamines and other substances that fluctuate rapidly, are affected by psychosocial stimuli, and are altered by capture and other stressful activities that often accompany sample collection. Rapid retrieval of samples is facilitated by remote-controlled injection of an anesthetic. The device has been used to collect blood from dominant and subordinate male baboons before and during events such as chases and presentation of food treats. Heart rate and blood pressure were measured via radio telemetry, and behavior was recorded on videotapes. This technique allowed construction of multifaceted physiological profiles of social roles and behaviors.

Heart rate, arterial blood pressure, and renal and mesenteric or femoral blood flow were telemetered from 11 Papio hamadryas in an untethered free-ranging situation. The animals' behavior was recorded on videotape, and the cardiovascular (CV) data were recorded on the audio channels of the tape. The behavior was coded, and the codes were linked to the CV data via a time-code generator and computer control. The CV data were digitized into 1-s intervals, and the static relations between CV measures and the postures/locomotions (P/Ls) associated with the behavior were analyzed. The total frequency distributions for heart rate, blood pressure, and renal conductance approximated Gaussian distributions, whereas femoral conductance was positively skewed. The distribution for renal conductance suggested that during normal waking conditions the kidney is not maximally dilated and may increase or decrease its blood flow. All distributions were highly influenced by the Sit category, which occupied 80% of the total time. The CV measures for all P/Ls had wide ranges, and the CV values associated with each P/L overlapped those for the other P/Ls. The heart rate and renal conductance associated with the various P/Ls showed the largest deviations from the grand means and therefore contributed the most to the ability to discriminate one P/L from another. Blood pressure varied little from one P/L to another. The patterns of CV variables served to distinguish particular P/Ls very effectively. The frequency distributions were separated best when they were parceled on the basis of the intensity of behavior associated with a particular P/L. These variations in intensity were the major cause of the overlaps in the frequency distributions associated with P/Ls.

We describe an integrated system to record physiological and behavioral variables from nonhuman primates in social groups. The system records data simultaneously from two animals in family groups of five. It synchronizes behavioral and physiological data within 16 ms, either on-line or from recordings. Behavioral data are entered by trained observers on-line or from videotape. Recordings of physiological data are produced on-line as stripchart records, tape recordings on the audio channels of video cassettes, and magnetic disk files. The physiological data include two arterial blood flows, arterial blood pressure and heart rate. The data are transmitted from freely behaving animals to a central site via radio telemetry. The infrared link controls the radio transmitter and physiological signal processing electronics, as well as two sources of drugs for each animal. All of the electronics are contained in a small, light backpack that can be worn by either male or female baboons.

The next revolution in biology is predicted to be in the integrative domain, and the need to involve physiologists in this kind of research has been recognized. This paper represents an approach to providing some of the tools required for dealing with integrative physiology at the behavioral level. Video tape recordings are made of the activities of a group of five baboons (Papio hamadryas) while simultaneous recordings of arterial blood pressure, heart rate, renal blood flow, and mesenteric or iliac blood flow are telemetered from two of the members of the group. The telemetered cardiovascular information is recorded on the two audio channels of the videotape. Subsequently the videotape is viewed, and a two-dimensional code is used to record the behavior of the two animals with the telemetry equipment. The first dimension of the code categorizes the behavior changes precisely regarding those aspects of behavior that are related to cardiovascular dynamics and does so with an accuracy of 16 ms. The second dimension codes relevant environmental changes. The paper describes the code and presents illustrations of how the code reflects the cardiovascular dynamics associated with the behavioral changes.

We did four experiments to determine whether the lateral hypothalamus-perifornical (LH/PF) region is the source of neuronal cell bodies responsible for producing the cardiovascular (CV) responses associated with emotion or the defense reaction. Of particular concern was whether the paraventricular nucleus (PVN) plays a role in the generation of these CV responses. Mapping the hypothalamus with electrical stimulation showed that the CV pattern of responses was never produced by stimulating the PVN and was invariably produced by stimulating the LH/PF region. Complete electrolytic destruction of the PVN and subsequent axonal degeneration did not change the CV pattern of responses elicited by LH/PF stimulation, whereas any encroachment of the lesion on the LH/PF region decreased the magnitude of the CV responses. Injection of the neuroexcitotoxin ibotenic acid (Ibo) into the PVN did not affect responses to LH/PF stimulation, whereas Ibo injection into the LH/PF region eliminated or severely attenuated the CV responses. Retrograde labeling of cells from the thoracic cord and the ventrolateral reticular formation revealed a scattered group of cells in the LH/PF region that may be the cells controlling the CV responses. These results point directly to the LH/PF region as the source of the cell bodies responsible for the autonomic responses associated with emotion or defense reactions.

Bilateral carotid occlusion was performed in seven baboons during dynamic leg exercise, static arm exercise, feeding, rest, and sleep. The baroreceptor reflex effects on blood pressure, heart rate and interval, renal blood flow, and terminal aortic blood flow were determined during each behavior. The carotid sinus baroreflex increase in blood pressure and heart rate was greatest during sleep and least during exercise. The hindlimb and renal vasomotor responses followed different patterns. The baroreceptor reflex sensitivity for renal vasoconstriction was greatest during rest and least during sleep. The reflex sensitivity in the hindlimb was unaltered by behavior. Thus behavior modifies baroreceptor reflex responses in the heart and peripheral circulation in different patterns.

Three to three and a half years after repair of monkey nerves, comparison of total myelinated nerves, electron microscopic sections, and nerve conduction velocities delineated no significant difference between nerves sutured in adult life and those sutured in infancy. Extrapolating these results to the human clinical situation, central nervous system adaption in young patients could explain the better clinical results.

Rhesus monkeys were trained in a discriminated conditioned emotional responses paradigm. The discriminated conditioned response (CR) complex consisted of bar-press suppression, increased terminal aortic blood flow, and increased arterial pressure. Bar-press suppression and blood flow responses were temporarily eliminated by single-stage bilateral prefrontal lobectomy but not by extensive posterior cortical ablation, 2-stage prefrontal lobe removal, or 3-stage prefrontal cortical surface ablation. The blood pressure CR was attenuated by almost every surgical operation. The changes in heart rate paralleled changes in general activity. These data indicate that the prefrontal lobes influence the conditioned suppression of ongoing rewarded behavior and the vascular responses accompanying the suppression. The time course for recovery of the somatic CR after lobectomy differed from those of the cardiovascular CRs.

Five chair-restrained baboons were trained with operant techniques and a food reward to perform dynamic leg exercise. Cardiac output and blood flows to most tissues were determined by radioactive microsphere distribution. After 2 min of exercise mean arterial blood pressure had increased by 11 +/- 3% (SE), heart rate by 34 +/- 7%, cardiac output by 50 +/- 12%, and O2 consumption by 157 +/- 17%. The blood flow to exercising leg muscle increased by 585 +/- 338% and to the myocardium by 35 +/- 19%. Blood flow to torso and limb skin fell by 38 +/- 4 and 38 +/- 6%, respectively, and similar reductions occurred in adipose tissue blood flow. Nonworking skeletal muscle blood flow decreased by 30 +/- 10%. Renal blood flow was lowered by 16 +/-2%. The lower visceral organs had more variable responses, but when grouped together total splanchnic blood flow fell by 21 +/- 9%. Blood flow to the brain was unchanged with exercise, whereas spinal cord perfusion increased 23 +/- 3%. Thus during short dynamic exercise baboons redistributed blood flow away from skin, fat, nonworking muscles, and visceral organs to supply the needs of exercising muscles. Our data suggest the baboon is a useful animal model for investigating vascular responses of tissues, such as torso skin, adipose, individual visceral organs, and the spinal cord, that cannot be examined in humans.

Simple counting equipment and radioiodinated human serum albumin (131IHSA) were used to perform placental localization on 48 pregnant women with antepartum hemorrhage. The level of diagnostic accuracy of 85% compares favorably with more expensive methods. The false-negative diagnosis rate for the whole group was 4% and the false-positive diagnosis rate was 8%. The authors recommend this method of isotope placentography for developing countries because the cost of the equipment, including maintenance, and the isotopes is relatively small, and the radiation hazards are negligible.

The cardiovascular (CV) responses to an acute emotional situation in unanesthetized, chair-restrained baboons include elevations in heart rate, blood pressure, and terminal aortic flow and a complex biphasic reduction in renal flow. The same CV responses can be produced by stimulating an area in the hypothalamus. Furthermore, bilateral ablation of the hypothalamic area eliminates CV responses to the emotional behavior while responses to exercise, free feed, and lever press remain unaltered. This effect is not due to memory loss, loss of emotionality, or a general loss of CV regulatory capacity. Efferent projections of the hypothalamic site were traced by means of autoradiography and afferent sources were traced by horseradish peroxidase injections. Efferents include projections to amygdala, central gray, zona incerta, midline thalamic nuclei, dorsal midbrain tegmentum, the parabrachial region. Afferents were widely distributed and included inputs from the subiculum, amygdala, septal area, central gray, locus ceruleus, interpeduncular nucleus, and bilateral labeling in and around the dorsal motor nucleus of X and the nucleus ambiguus.

The Mesulam technique for horseradish peroxidase was used to study the subcortical afferent projections to a location in the hypothalamus that has been shown to control the complete cardiovascular (CV) response accompanying a specific emotional behavior. Major projections common to all baboons injected included the lateral septal nucleus; medial, cortical and basal amygdala; the anteroventral third ventricle area; the preoptic areas; the subiculum; the paraventricular nucleus of the thalamus; periventricular gray and the central gray of the midbrain; the midbrain tegmentum; locus ceruleus, parabrachial and raphe cells in the pons; and in the medulla, raphe nuclei, the nucleus of the solitary tract, in and around the dorsal motor nucleus of the vagus, and in the region of the nucleus ambiguus. Other projections in some but not all baboons included the subfornical organ and the midline and dorsomedial nuclei of the thalamus. The nucleus of the diagonal band of Broca was labeled to some degree with all injections but was most heavily labeled with the injection extending more laterally in the hypothalamus. These results fit well with physiological and behavioral studies dealing with neural control of emotional and CV responses and support the concept of an integrative area in the hypothalamus concerned specifically with the control of CV response accompanying emotion.

Thirteen infant and juvenile monkeys and baboons were studied in procedures designed to assess the functional characteristics of the upper airway, with special attention to the consequences of laryngeal nerve stimulation. In young animals, stimulation of the recurrent laryngeal nerve produced closure of the airway in sufficient degree and duration to cause death. Older juvenile monkeys were resistant to fatal laryngospasm induced by nerve stimulation. A variety of patterns of general autonomic response accompanied the airway changes. These results are consistent with (1) a laryngospasm hypothesis to account for certain terminal events in sudden infant death syndrome, and (2) prior observations of age-related general autonomic stability.

Blood pressure, heart rate, oxygen consumption, and blood flow to the renal and hind-limb vasculatures were measured in healthy, unanesthetized baboons (Papio cynocephalus) in a controlled environment. Appropriate behavioral techniques were applied to allow the reproducible elicitation of a conditional emotional response (CER). Section of renal nerves and autonomic pharmacologic interventions were used to determine the mechanisms for the cardiovascular responses accompanying the CER. The resistance changes in the renal and hind-limb vascular beds were generated by rapid, neurally mediated vasoconstriction of the renal vasculature and by a slower acting, circulating vasoactive agent, most probably epinephrine, which causes a delayed second constriction in the renal bed and a net dilation in the hind limbs.

A series of studies has demonstrated that the perifornical area of the hypothalamus ("acro-named" HACER, for Hypothalamic Area Controlling Emotional Responses) is responsible for producing the elevated blood pressure and other cardiovascular responses that accompany emotional behavior. The central neural structures providing afferents to the HACER are detailed, and the efferent outflow is analyzed to demonstrate how the HACER produces cardiovascular responses.

Coagulation of medial and lateral parts of the lateral hypothalamic area increases latency of responses and decreases respiration, arterial blood pressure and heart rate responses to stimulation of the hypothalamic ventromedial nucleus. Coagulation of the perifornical region of the lateral hypothalamus completely eliminates the above autonomic responses. A new rigid integration which is characterized with the increased number of correlated relations between separate components of somato-autonomic responses, was postulated after correlation analysis of somato-autonomic parameters during stimulation of hypothalamic ventromedial nucleus in animals with lateral hypothalamic lesions. The data suggest that somato-autonomic responses to stimulation of negative emotion sites of the hypothalamus are mediated by those brain structures which are under ascending excitatory influences of the lateral hypothalamus.

Twenty-three electromagnetic flow transducers with lumen diameters of 3.5-6.0 mm were implanted in rhesus monkeys and baboonss for 12 h to 120 days. Each flow transducer was calibrated 1) in vitro on dialysis tubing with saline before implantation, 2) in vivo the last day of the implant period, and 3) again in vitro after the flow transducer was recovered. Three other flow transducers were implanted on femoral arteries of baboon just central to an arteriovenous Silastic shunt, and were calibrated in vivo daily for 23-47 days. In vitro sensitivity was not affected by implant durations of up to 120 days. In vivo sensitivity fluctuated unpredictably for the first 3-4 wk of implant, after which it followed a systematic course that depended on the lumen size. In vivo sensitivity at any time during implant (after the initial period) could be accurately predicted by knowing either the in vitro sensitivity or the terminal in vivo sensitivity.

Arteriolar nephrosclerosis was observed at necropsy in 26 of 38 woolly monkeys (Lagothrix lagotricha). This lesion is the earliest histologic change associated with hypertension in humans. Seventeen of the monkeys had died of congestive heart failure, renal failure or acute cardiovascular accident, complications similar to those seen in human hypertension. All monkeys known to be over 4 years of age were affected. Direct blood pressure measurements in nine otherwise healthy woolly monkeys revealed systolic pressures of 194 +/- 20 mmHg. Our physiologic, clinical and pathologic studies suggest that woolly monkeys develop hypertension spontaneously and could be a useful model for the study of human hypertension.

Twelve chair-restrained baboons (Papio cynocephalus) were conditioned with operant techniques and a food reward to perform 4 min of dynamic leg exercise. During the last minute of exercise, blood flow through the left renal artery, measured by an electromagnetic flow transducer, was decreased 19 +/- 2% SEM with respect to the minute of rest preceding the exercise. This response occurred within 1.5 min, was maintained throughout the exercise, and recovered to control within 2 min. Mean arterial blood pressure rose 17 +/- 2%; renal vascular resistance, 46 +/- 6%; heart rate, 42 +/- 4%; and whole-body oxygen consumption, 233 +/- 19%. Behavioral situations simulating the arousal and feeding components of the exercise task, but not requiring muscular exertion, did not alter renal blood flow. In four animals, blood flow to the contralateral but surgically denervated kidney was measured; it increased transiently at the onset of exercise, but returned to control by the last minute of work. Thus, the baboon, like man, shows a decrease in renal blood flow during exercise. This response has a rapid onset and recovery and is primarily neurally mediated.

Flow transducers were surgically implanted on the terminal aorta of five monkeys. A classical conditioning procedure, in which a light preceded a brief shock, was superimposed upon a variable-interval schedule of food reinforcement for key pressing (three monkeys) and alternated with an avoidanceschedule of shock reinforcement for key pressing (two monkeys). Suppression of the rate of the response of key pressing and sizable increase in blood flow and heart rate during the light were obtained for all animals.