Real-time superchannel transmission over 10,500 km submarine link at 4.66 b/s/Hz spectral efficiency.

We show real-time measurement of error-free superchannel transmission over more than 10,500 km of large-area fiber at a spectral efficiency of 4.66 b/s/Hz, utilizing subcarrier based signal processing optimized at 5.4 GBd.

Lineage-specific evolution of cnidarian Wnt ligands.

We have studied the evolution of Wnt genes in cnidarians and the expression pattern of all Wnt ligands in the hydrozoan Hydractinia echinata. Current views favor a scenario in which 12 Wnt sub-families were jointly inherited by cnidarians and bilaterians from their last common ancestor. Our phylogenetic analyses clustered all medusozoan genes in distinct, well-supported clades, but many orthologous relationships between medusozoan Wnts and anthozoan and bilaterian Wnt genes were poorly supported. Only seven anthozoan genes, Wnt2, Wnt4, Wnt5, Wnt6, Wnt 10, Wnt11, and Wnt16 were recovered with strong support with bilaterian genes and of those, only the Wnt2, Wnt5, Wnt11, and Wnt16 clades also included medusozoan genes. Although medusozoan Wnt8 genes clustered with anthozoan and bilaterian genes, this was not well supported. In situ hybridization studies revealed poor conservation of expression patterns of putative Wnt orthologs within Cnidaria. In polyps, only Wnt1, Wnt3, and Wnt7 were expressed at the same position in the studied cnidarian models Hydra, Hydractinia, and Nematostella. Different expression patterns are consistent with divergent functions. Our data do not fully support previous assertions regarding Wnt gene homology, and suggest a more complex history of Wnt family genes than previously suggested. This includes high rates of sequence divergence and lineage-specific duplications of Wnt genes within medusozoans, followed by functional divergence over evolutionary time scales.

High School Students' Perceptions of Traditional and Online Health and Physical Education Courses.

BACKGROUND: High school students have few physical education (PE) and health requirements for graduation. Twenty-first century students have choices to take their PE and health courses in the traditional face-to-face (F2F) setting or online through accredited virtual schools. The purpose of this inquiry was to examine differences in high school students' perceptions and experiences in traditional versus online PE and health-related courses. METHODS: This cross-sectional study utilized mixed methods through survey distribution. Participants included 506 students from traditional F2F high school health and PE classes and 355 students finishing an online course from an accredited online academy. RESULTS: The online education setting was found to be statistically significantly more favorable for students in terms of the feedback and responsiveness of the teacher, understanding and interest of the content and perceived positive health changes during the course. However, the qualitative findings on student perceptions were relatively consistent between both the online and F2F classes. CONCLUSIONS: The results indicate that students' positive perceptions in an online high school class may equal or surpass those in a traditional F2F format. Increasingly, youth are exhibiting enhanced capacity for online-based coursework. Physical education classes have traditionally been F2F, but warrant further consideration as an online platform.

American pain society recommendations for improving the quality of acute and cancer pain management: American Pain Society Quality of Care Task Force.

BACKGROUND: The American Pain Society (APS) set out to revise and expand its 1995 Quality Improvement Guidelines for the Treatment of Acute Pain and Cancer Pain and to facilitate improvements in the quality of pain management in all care settings. METHODS: Eleven multidisciplinary members of the APS with expertise in quality improvement or measurement participated in the update. Five experts from organizations that focus on health care quality reviewed the final recommendations. MEDLINE and Cumulative Index to Nursing and Allied Health Literature databases were searched (1994-2004) to identify articles on pain quality measurement and quality improvement published after the development of the 1995 guidelines. The APS task force revised and expanded recommendations on the basis of the systematic review of published studies. The more than 3000 members of the APS were invited to provide input, and the 5 experts provided additional comments. The task force synthesized reviewers' comments into the final set of recommendations. RESULTS: The recommendations specify that all care settings formulate structured, multilevel systems approaches (sensitive to the type of pain, population served, and setting of care) that ensure prompt recognition and treatment of pain, involvement of patients and families in the pain management plan, improved treatment patterns, regular reassessment and adjustment of the pain management plan as needed, and measurement of processes and outcomes of pain management. CONCLUSION: Efforts to improve the quality of pain management must move beyond assessment and communication of pain to implementation and evaluation of improvements in pain treatment that are timely, safe, evidence based, and multimodal.

Toward a practical instrument system for the automatic measurement of "up-time" in chronic pain patients.

A portable low-cost instrument system for reliable and automatic measurement of "up-time" in chronic pain patients was described. The system used a miniature electronic stopwatch/calculator to accumulate up-time. A mercury tilt switch mounted on the outer thigh was used to control time accumulation. Performance assessment showed excellent reliaility, as well as high concurrent validity (r = 0.999) for the system. Initial field testing with normal subjects and chronic pain patients indicated reliable and easy operation.

Cross-validation of the Back Pain Classification Scale with chronic, intractable pain patients.

The current study investigated the utility of the Back Pain Classification Scale with chronic, intractable low back pain and headache patients. Subjects consisted of 50 chronic low back pain and 50 chronic headache patients referred to a university based Pain Center for evaluation. Data indicated that subjects were a representative sample of severely intractable chronic pain patients typically referred for Pain Center evaluation and treatment. Each was administered the Back Pain Classification Scale as part of a thorough physical and psychological/behavioral evaluation. All subjects were classified by blind review of medical records into one of two categories: (1) presence of psychopathologically based pain complaint with little or no pathophysiological findings and (2) presence of pathophysiologically based pain complaints with little or no psychopathological findings. Subjects were also independently classified from blind review of their scores on the Back Pain Classification Scale into one of these two categories. Findings revealed that the Back Pain Classification Scale accurately predicted the actual classification of 80% of the low back pain patients (i.e., 30% above baseline prediction rate) and only 60% of the chronic headache patients (i.e., only equal to the baseline prediction rate). Furthermore, the scale was found to be most accurate in predicting low back pain patients with primary psychopathologically based pain. It was concluded that the Back Pain Classification Scale was an empirically valid instrument to use with chronic low back pain patients, but not with chronic headache patients. This lack of utility with chronic headache patients was also viewed as support for the construct validity of the scale. Wider use of the scale with chronic low back pain patients was suggested.

Moving beyond traditional UV-visible absorption detection: cavity ring-down spectroscopy for HPLC.

We describe the use of liquid-phase continuous-wave cavity ring-down spectroscopy for the detection of an HPLC separation. This technique builds on earlier work by Snyder and Zare using pulsed laser sources and improves upon commercially available UV-visible detectors by a factor of up to 50. The system employs a compact doubled-diode single-mode continuous-wave laser operating at 488 nm and a previously described Brewster's-angle flow cell. Ring-down time constants as long as 5.8 micros were observed with liquid samples in a 0.3-mm path length cell. The baseline noise during an HPLC separation was only 2 x 10(-7) absorbance units (AU) peak to peak, as compared to 1 x 10(-5) AU for a state-of-the-art commercial UV-visible detector.