Inclusion of Veterinary Services in national emergency management plans.

With human population growth, rapid urbanisation, increasing globalisation, and climate change, the interdependency of human health and animal health is mounting. Therefore, the importance of national emergency management plans (NEMPs) for the mitigation of, and preparedness for, all hazards, including disease epidemics, both zoonotic and zootic, is ever increasing. The authors decided to take a One Health approach by assessing the inclusion of Veterinary Services and animal health in NEMPs, based on geographical region, the date of the NEMP, national income status, and the proportion of the agricultural sector in national gross domestic product (GDP). To carry out the assessment, the authors analysed the publicly available NEMPs of 86 Members of the World Organisation for Animal Health. Of the 86 NEMPs reviewed, only a third expressly mentioned Veterinary Services, almost 60% mentioned zoonotic and/or zootic diseases, and about two-thirds mentioned animals to some extent. The highest correlating factor to the inclusion of animal health in NEMPs was the level of the agricultural sector's contributions to the national GDP. Fisheries and aquaculture were not a major consideration in any of the reviewed NEMPs, especially not in relation to diseases. Based on region, Latin America and the Caribbean exhibited the lowest inclusion rate of animal health in NEMPs. The results demonstrate that the omission of animal health is still a problem. A multi-disciplinary approach that includes veterinary medicine as well as human medicine is vital in the construction and/or revision of NEMPs. Future studies should consider whether or not there is a connection between countries' veterinary capacities and the inclusion of Veterinary Services in their NEMPs and whether or not they have the infrastructure and human resources to put into operation the roles of Veterinary Services as identified in their NEMPs.

La croissance démographique humaine, l'urbanisation accélérée, la mondialisation accrue et le changement climatique sont autant de facteurs qui intensifient l'interdépendance de la santé humaine et de la santé animale. De ce fait, les plans nationaux de gestion des urgences jouent un rôle de plus en plus important pour atténuer les dangers, quels qu'ils soient, et pour se préparer à leur survenue, y compris les dangers liés aux épidémies zoonotiques ou zootiques. Les auteurs ont entrepris d'évaluer le niveau d'intégration des Services vétérinaires et de la santé animale dans les plans nationaux de gestion des urgences dans une perspective Une seule santé, en se basant sur les critères suivants : la région géographique, la date du plan national de gestion des urgences, le niveau de revenu du pays et la part du secteur agricole dans le produit intérieur brut (PIB). Pour les besoins de cette évaluation, les auteurs ont analysé les plans nationaux de gestion des urgences publiés par 86 Membres de l'Organisation mondiale de la santé animale. Parmi ces 86 plans nationaux, un tiers seulement mentionnait expressément les Services vétérinaires, près de 60 % mentionnaient les maladies zoonotiques ou les épizooties et environ deux tiers prenaient en compte les animaux pour une raison ou pour une autre. Le facteur présentant la corrélation la plus élevée avec la prise en compte de la santé animale dans les plans nationaux de gestion des urgences était le niveau de contribution du secteur agricole dans le PIB national. Aucun des plans nationaux de gestion des urgences examinés ne prenait en compte la pêche et l'aquaculture en tant qu'aspect important, en particulier en lien avec des maladies. À l'échelle régionale, c'est en Amérique latine et aux Caraïbes que l'intégration de la santé animale dans les plans nationaux de gestion des urgences était la plus faible. Ces résultats montrent que le problème de l'omission de la santé animale est toujours d'actualité. Il est d'une importance capitale qu'une approche pluridisciplinaire intégrant la médecine vétérinaire et la médecine humaine soit adoptée lors de la conception et/ou de la révision des plans nationaux de gestion des urgences. Il conviendrait que de nouvelles études déterminent à l'avenir s'il existe ou non un lien entre les capacités vétérinaires des pays et la prise en compte des Services vétérinaires dans les plans nationaux de gestion des urgences, et si les pays disposent ou non des infrastructures et des ressources humaines permettant à leurs Services vétérinaires de mener à bien les interventions prévues dans les plans nationaux de gestion des urgences.

El crecimiento demográfico, la rápida urbanización, la creciente mundialización y el cambio climático son otros tantos factores que traen consigo una dependencia recíproca cada vez más acusada entre la salud humana y la sanidad animal. De ahí la creciente importancia que van adquiriendo los planes nacionales de gestión de emergencias destinados a prepararse para todo tipo de peligros, incluidas las enfermedades epidémicas, tanto zoonóticas como epizoóticas, y, llegado el caso, a mitigar sus consecuencias. Los autores, partiendo de las premisas de Una sola salud, decidieron evaluar la integración de los Servicios Veterinarios y la sanidad animal en los planes nacionales de gestión de emergencias, utilizando como criterios de evaluación la región geográfica, la fecha del plan nacional en cuestión, el nivel de renta del país y el porcentaje del producto interno bruto (PIB) que representa el sector agrícola. Para llevar a cabo la evaluación los autores analizaron los planes nacionales de gestión de emergencias que están a disposición pública de 86 Miembros de la Organización Mundial de Sanidad Animal. De esos 86 planes nacionales examinados, solo en un tercio se mencionaban explícitamente los Servicios Veterinarios, en casi un 60% se aludía a enfermedades zoonóticas y/o epizoóticas y en cerca de dos tercios se hablaba en alguna medida de los animales. El factor que mayor correlación presentaba con la integración de la sanidad animal en los planes nacionales de gestión de emergencias era la aportación del sector agrícola al PIB. En ninguno de los planes examinados ocupaban un lugar relevante ni la pesca ni la acuicultura, especialmente en relación con las enfermedades. Por regiones, América Latina y el Caribe presentaba el menor porcentaje de integración de la sanidad animal en los planes nacionales de gestión de emergencias. Los resultados demuestran que la omisión de la sanidad animal sigue suponiendo un problema. A la hora de elaborar o revisar los planes nacionales de gestión de emergencias es crucial hacerlo desde planteamientos multidisciplinares que incluyan tanto la medicina veterinaria como la humana. En estudios ulteriores convendría determinar si existe una correlación entre la capacidad veterinaria de los países y la integración de los Servicios Veterinarios en su plan nacional de gestión de emergencias y si los países disponen de la infraestructura y el personal requeridos para que los Servicios Veterinarios cumplan las funciones que se les asignan en el plan nacional de gestión de emergencias.

Urinary Markers of Fibrosis and Risk of Cardiovascular Events and Death in Kidney Transplant Recipients: The FAVORIT Trial.

Cardiovascular risk remains high in kidney transplant recipients (KTRs) despite improved kidney function after transplant. Urinary markers of kidney fibrosis and injury may help to reveal mechanisms of this risk. In a case-cohort study among stable KTRs who participated in the FAVORIT trial, we measured four urinary proteins known to correlate with kidney tubulointerstitial fibrosis on biopsy (urine alpha 1 microglobulin [α1m], monocyte chemoattractant protein-1 [MCP-1], procollagen type I [PINP] and type III [PIIINP] N-terminal amino peptide) and evaluated associations with cardiovascular disease (CVD) events (n = 300) and death (n = 371). In adjusted models, higher urine α1m (hazard ratio [HR] per doubling of biomarker 1.40 [95% confidence interval [CI] 1.21, 1.62]), MCP-1 (HR 1.18 [1.03, 1.36]), and PINP (HR 1.13 [95% CI 1.03, 1.23]) were associated with CVD events. These three markers were also associated with death (HR per doubling α1m 1.51 [95% CI 1.32, 1.72]; MCP-1 1.31 [95% CI 1.13, 1.51]; PINP 1.11 [95% CI 1.03, 1.20]). Higher concentrations of urine α1m, MCP-1, and PINP may identify KTRs at higher risk for CVD events and death. These markers may identify a systemic process of fibrosis involving both the kidney and cardiovascular system, and give new insights into mechanisms linking the kidney with CVD.

The metabolic syndrome and diabetes mellitus as predictors of thoracic aortic calcification as detected by non-contrast computed tomography in the Multi-Ethnic Study of Atherosclerosis.

AIMS: The metabolic syndrome (MetS) is a clustering of low levels of HDL cholesterol, hyperglycaemia, high waist circumference, hypertension and elevated triglycerides, and is associated with cardiovascular disease. Calcified atherosclerotic plaque in the thoracic aorta (TAC), measured by non-contrast cardiac computed tomography (CT) scans, is a marker for atherosclerosis and relates to mortality. We sought to evaluate the independent association of MetS and TAC on cardiac CT scans. METHODS: We examined the relation of the MetS, and each of its components, to the prevalence of TAC, measured from 2000 to 2002 in 6778 white, Chinese, African-American and Hispanic participants in the Multi-Ethnic Study of Atherosclerosis (MESA). RESULTS: Adjusting for age, gender, race, smoking, LDL cholesterol and lipid-lowering medications, relative risks and 95% confidence intervals (CI) for a TAC score > 0 were: 1.19 (95% CI 1.11 to 1.28) for participants with MetS, 1.34 (95% CI 1.21 to 1.49) for those with diabetes and MetS, and 1.33 (95% CI 1.11, 1.58) for those with diabetes and no MetS compared with participants who were free of the MetS and diabetes. Associations were found for most of the components of the MetS with TAC. CONCLUSIONS: We conclude that in adults without known heart disease, the MetS, most of its components and diabetes are associated with a higher prevalence of calcified atherosclerotic plaque in the thoracic arteries in a multi-ethnic population of men and women.

Prognostic value of the trichorhinophalangeal syndrome-1 (TRPS-1), a GATA family transcription factor, in early-stage breast cancer.

BACKGROUND: TRPS-1 is a new GATA transcription factor that is differentially expressed in breast cancer (BC) where it been found recently to regulate epithelial-to-mesenchymal transition (EMT). PATIENTS AND METHODS: We carried out a quantitative immunohistochemistry (qIHC) analysis of TRPS-1 expression in 341 primary-stage I-III BC samples in relation to patient clinical characteristics as well as its prognostic value, especially in an estrogen receptor-positive (ER+) subgroup. RESULTS: Higher TRPS-1 expression was significantly associated with a number of clinical and pathological characteristics as well as with improved overall survival (OS) and disease-free survival (DFS). Among stage I/II ER+ BC patients who received endocrine therapy alone, those with high TRPS-1 expression had significantly longer OS and DFS. There was also a strong association between TRPS-1 levels and the EMT marker E-cadherin in the ER+ invasive ductal carcinoma cases. Analysis of gene expression data on a panel of BC lines found that TRPS-1 expression was low or absent in BC lines having enriched mesenchymal features. CONCLUSIONS: Our data indicated that TRPS-1 is an independent prognostic marker in early-stage BC and a new EMT marker that can distinguish patients with ER+ BC who will respond longer to adjuvant endocrine therapy.

Increased incidence of herpes zoster among patients with systemic lupus erythematosus.

Herpes zoster (HZ) is the painful reactivation of latent varicella zoster virus infection. The incidence of HZ may be increased in some autoimmune diseases, including systemic lupus erythematosus (SLE). We examined the incidence and risk factors for HZ in a prospective cohort of patients with physician-diagnosed SLE compared to those diagnosed with non-inflammatory musculoskeletal conditions (MSK). After excluding participants with a history of prior HZ at enrollment, we followed 1485 SLE patients and 2775 MSK with semi-annual mailed questionnaires for incident HZ between 2001 and 2010. Age-adjusted incidences were calculated for each group and Cox proportional hazard models were used to identify predictors of HZ. Zostavax® vaccination rates were compared between groups. Participants had a mean age of 60 years at enrollment, with 13.9 years of disease. SLE patients had more HZ at all ages, with an age-adjusted incidence of 12.0/1000 person-years compared to MSK (8.7/1000 person-years) and a hazard ratio of 1.7 (95% CI 1.08-2.71) for SLE. Increasing age and reduced functional status were independent predictors of HZ. In SLE, prednisone and mycophenolate mofetil use conferred additional risk. SLE had the lowest HZ vaccination rates among age-eligible subjects.

Gastroschisis ultrasound bowel characteristics demonstrate minimal impact on perinatal outcomes.

BACKGROUND: Bowel dilation and bowel wall thickness are common prenatal ultrasound measurements for fetuses with gastroschisis. Data regarding antenatal sonographic bowel findings and postnatal outcomes are conflicting. Our objective was to evaluate the impact of in utero bowel measurements on perinatal outcomes in gastroschisis pregnancies. METHODS: Retrospective cohort study of 116 pregnancies complicated by gastroschisis between 2011 and 2020. We reviewed ultrasounds documenting fetal bowel measurements. To evaluate the association of these measurements with antepartum and delivery outcomes, we ran logistic and linear models using generalized estimating equations. RESULTS: Eleven perinatal outcomes reached statistical significance, although with minimal clinical impact given small magnitude of effect. Intra-abdominal bowel dilation was associated with a 0.5 week decrease in delivery gestational age (GA) (95% CI -0.07, -0.03) and a 6.93 g increase in birth weight (95% CI 1.54, 28.73). Intra-abdominal bowel wall thickness was associated with later GA of non-stress test (NST) start of 0.22 weeks (95% CI 0.07, 0.37), increased delivery GA of 0.08 weeks (95% CI 0.02, 0.15), 0.006 decrease in umbilical artery (UA) pH (95% CI -0.009, -0.003), 0.26 increase in UA base deficit (95% CI 0.09, 0.43), and decreased odds of cesarean delivery (OR = 0.83, 95% CI 0.70, 0.99). Extra-abdominal bowel wall thickness was associated with a 0.1 increase in UA base deficit (95% CI 0.02, 0.19) and a 0.05 increase in 5-min APGAR score (95% CI 0.01, 0.09). Stomach cross-section was associated with a 0.01 week decrease in delivery GA (95% CI -0.02, -0.001) and increased odds of receiving betamethasone (OR = 1.02, 95% CI 1.01, 1.04). CONCLUSIONS: In utero bowel characteristics reached statistical significance for several outcomes, but with minimal meaningful clinical differences in outcomes.

Effects of anodal transcranial direct current stimulation over the leg motor area on lumbar spinal network excitability in healthy subjects.

In recent years, two techniques have become available for the non-invasive stimulation of human motor cortex: transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS). The effects of TMS and tDCS when applied over motor cortex should be considered with regard not only to cortical circuits but also to spinal motor circuits. The different modes of action and specificity of TMS and tDCS suggest that their effects on spinal network excitability may be different from that in the cortex. Until now, the effects of tDCS on lumbar spinal network excitability have never been studied. In this series of experiments, on healthy subjects, we studied the effects of anodal tDCS over the lower limb motor cortex on (i) reciprocal Ia inhibition projecting from the tibialis anterior muscle (TA) to the soleus (SOL), (ii) presynaptic inhibition of SOL Ia terminals, (iii) homonymous SOL recurrent inhibition, and (iv) SOL H-reflex recruitment curves. The results show that anodal tDCS decreases reciprocal Ia inhibition, increases recurrent inhibition and induces no modification of presynaptic inhibition of SOL Ia terminals and of SOL-H reflex recruitment curves. Our results indicate therefore that the effects of tDCS are the opposite of those previously described for TMS on spinal network excitability. They also indicate that anodal tDCS induces effects on spinal network excitability similar to those observed during co-contraction suggesting that anodal tDCS activates descending corticospinal projections mainly involved in co-contractions.

Impact of precision grip tasks on cervical spinal network excitability in humans.

Motor skill acquisition in the lower limb may induce modifications of spinal network excitability. We hypothesized that short-term motor adaptation in precision grip tasks would also induce modifications of cervical spinal network excitability. In a first series of experiments, we studied the impact of two different precision grip force control tasks (a visuomotor force-tracking task and a control force task without visual feedback) on cervical spinal network excitability in healthy subjects. We separately tested the efficacy of two key components of the spinal circuitry: (i) presynaptic inhibition on flexor carpi radialis (FCR) Ia terminals, and (ii) disynaptic inhibition directed from extensor carpi radialis (ECR) to FCR. We found that disynaptic inhibition decreased temporarily after both force control tasks, independently of the presence of visual feedback. In contrast, the amount of presynaptic inhibition on FCR Ia terminals decreased only after the visuomotor force tracking task. This temporary decrease was correlated with improved tracking accuracy during the task (i.e. short-term motor adaptation). A second series of experiments confirmed these results and showed that the visuomotor force-tracking task resulted also in an increase of the Hmax/Mmax ratio and the slope of the ascending part of the H-reflex recruitment curve. In order to address the role of presynaptic inhibition in the motor adaptation process, we conducted a third series of experiments during which presynaptic inhibition was recorded before and after two consecutive sessions of visuomotor force tracking. The results showed that (i) improved tracking accuracy occurred during both sessions, and (ii) presynaptic inhibition decreased only after the first session of visuomotor force tracking. Taken together, these results suggest thus that the nature of the motor task performed has a specific impact on the excitability of these cervical spinal circuits. These findings also suggest that early motor adaptation is associated with a modulation of presynaptic Ia inhibition in the upper limb.

Influence of water/alkoxide ratio in the synthesis of nanosized sol-gel titania on the release of phenytoin.

The sol-gel method was used to synthesize inorganic reservoirs with encapsulated antiepileptic drug phenytoin. The drug release profile was shown to depend on the morphology and surface properties of the matrix. A parameter of the synthesis such as water/alkoxide ratio r(w) was varied in order to investigate its influence on the matrix properties and as a result on the drug release profile. It was found that the specific surface area and crystallization degree decrease with an increase of r(w), whereas the hydroxyl group coverage increases with an increase of r(w). Drug release kinetics studies revealed that the initial release rate increases with an increase of water content in the reaction, whereas the long time release rate first slightly increases with an increase of water content from 4 to 8 and then decreases for r(w) = 16. The interplay of different parameters of the matrix is shown to be responsible for such a dependence and is discussed in the Article.

Glycosylated hemoglobin and the risk of death and cardiovascular mortality in the elderly.

BACKGROUND AND AIMS: Glycosylated hemoglobin (HbA(1c)) has been associated with incident cardiovascular disease (CVD), but the findings are inconsistent. We tested the hypothesis that HbA(1c) may be associated with an increased risk of death and cardiovascular mortality in older adults. METHODS AND RESULTS: We evaluated the association between HbA(1c) with all-cause and cardiovascular mortality in 810 participants without a history of diabetes in a sub-study of the Cardiovascular Health Study (CHS), a community cohort study of individuals > or =65 years of age. Glycosylated hemoglobin was measured at baseline and all-cause and cardiovascular mortality was assessed during the follow-up period. The relation between baseline HbA(1c) and death was evaluated with multivariate Cox proportional hazards regression models. After a median follow-up of 14.2 years, 416 deaths were observed. The crude incidence rates of all-cause mortality across HbA(1c) groups were: 4.4% per year, 4.3% per year and 4.6% per year for tertile 1 (< or =5.6%), tertile 2 (5.61-6.20%) and tertile 3 (> or =6.21%), respectively. In unadjusted and fully adjusted analyses, baseline HbA(1c) was not associated with all-cause mortality and cardiovascular mortality (hazard ratio: 1.16 [95% confidence interval 0.91-1.47] and hazard ratio: 1.31 [95% confidence interval 0.90-1.93], respectively for the highest HbA(1c) tertile compared with the lowest). CONCLUSION: These results suggest that HbA(1c) does not significantly predict all-cause and cardiovascular mortality in non-diabetic community-dwelling older adults.

Assessment of the reliability and validity of a novel point-of-care fibrinogen (F-Point) device against an industry standard at fibrinogen levels >2 g/L in non-haemorrhage scenarios.

INTRODUCTION: A diagnostic accuracy study assessing the reliability and validity of a novel plasma fibrinogen point-of-care (F-Point) device compared with the von Clauss method of assay. METHODS: Forty-one women presenting for elective caesarean delivery and 43 non-pregnant female patients presenting for elective gynaecological surgery were recruited to assess agreement at normal fibrinogen levels (elective gynaecological cohort) and high fibrinogen levels (elective caesarean section cohort). Validity was assessed by comparing the F-Point results with the gold standard of von Clauss fibrinogen assay performed on the ACL Top 500. Reliability (test-retest) and validity were assessed using the intraclass correlation to control for operator variance (two-way random absolute agreement method), presented as intra class correlation coefficients (ICCs) and 95% confidence interval, and Bland-Altman analysis, presented as mean bias and 95% limits of agreement and coefficient of variation (COV). RESULTS: The results demonstrated a high test-retest reliability demonstrated in the paired F-Point measurements with an intraclass correlation coefficient (ICC) of 0.95, a bias of 0 (-00.69 to 0.69) and a COV of 9%. Similarly, there was acceptable agreement demonstrated between F-Point and von Clauss assay with an ICC of 0.91, a bias of -0.1 (-0.96 to 0.75) and a COV of 11%. CONCLUSIONS: Our novel plasma fibrinogen point-of-care device has been shown to be reliable and valid when testing fibrinogen levels as low as 2 g/L. Future studies investigating the correlation at lower fibrinogen levels, for example during haemorrhage and in patients with coagulopathies, are required.

Development of a two-dimensional dynamic model of the foot-ankle system exposed to vibration.

Workers in mining, mills, construction and some types of manufacturing are exposed to vibration that enters the body through the feet. Exposure to foot-transmitted vibration (FTV) is associated with an increased risk of developing vibration-induced white foot (VIWFt). VIWFt is a vascular and neurological condition of the lower limb, leading to blanching in the toes and numbness and tingling in the feet, which can be disabling for the worker. This paper presents a two-dimensional dynamic model describing the response of the foot-ankle system to vibration using four segments and eight Kelvin-Voigt models. The parameters of the model have been obtained by minimizing the quadratic reconstruction error between the experimental and numerical curves of the transmissibility and the apparent mass of participants standing in a neutral position. The average transmissibility at five locations on the foot has been optimized by minimizing the difference between experimental data and the model prediction between 10 and 100 Hz. The same procedure has been repeated to fit the apparent mass measured at the driving point in a frequency range between 2 and 20 Hz. Monte Carlo simulations were used to assess how the variability of the mass, stiffness and damping matrices affect the overall data dispersion. Results showed that the 7°-of-freedom model correctly described the transmissibility: the average transmissibility modulus error was 0.1. The error increased when fitting the transmissibility and apparent mass curves: the average modulus error was 0.3. However, the obtained values were reasonable with respect to the average inter-participant variability experimentally estimated at 0.52 for the modulus. Study results can contribute to the development of materials and equipment to attenuate FTV and, consequently, lower the risk of developing VIWFt.

Impact of transcranial direct current stimulation on spinal network excitability in humans.

Transcranial direct current stimulation (tDCS) when applied over the motor cortex, modulates excitability dependent on the current polarity. The impact of this cortical modulation on spinal cord network excitability has rarely been studied. In this series of experiments, performed in healthy subjects, we show that anodal tDCS increases disynaptic inhibition directed from extensor carpi radialis (ECR) to flexor carpi radialis (FCR) with no modification of presynaptic inhibition of FCR Ia terminals and FCR H-reflex recruitment curves. We also show that cathodal tDCS does not modify spinal network excitability. Our results suggest that the increase of disynaptic inhibition observed during anodal tDCS relies on an increase of disynaptic interneuron excitability and that tDCS over the motor cortex in human subjects induces effects on spinal network excitability. Our results highlight the fact that the effects of tDCS should be considered in regard to spinal motor circuits and not only to cortical circuits.

Effects of galvanic mastoid stimulation in seated human subjects.

The vestibular responses evoked by transmastoid galvanic stimulation (GS) in the rectified soleus electromyogram (EMG) in freely standing human subjects disappear when seated. However, a GS-induced facilitation of the soleus monosynaptic (H and tendon jerk) reflex has been described in few experiments in subjects lying prone or seated. This study addresses the issue of whether this reflex facilitation while seated is of vestibulospinal origin. GS-induced responses in the soleus (modulation of the rectified ongoing EMG and of the monosynaptic reflexes) were compared in the same normal subjects while freely standing and sitting with back and head support. The polarity-dependent biphasic responses in the free-standing position were replaced by a non-polarity-dependent twofold facilitation while seated. The effects of GS were hardly detectable in the rectified ongoing voluntary EMG activity, weak for the H reflex, but large and constant for the tendon jerk. They were subject to habituation. Anesthesia of the skin beneath the GS electrodes markedly reduced the reflex facilitation, while a similar, although weaker, facilitation of the tendon jerk was observed when GS was replaced with purely cutaneous stimulation, a tap to the tendon of the sternomastoid muscle, or an auditory click. The stimulation polarity independence of the GS-induced reflex facilitation argues strongly against a vestibular response. However, the vestibular afferent volley, insufficient to produce a vestibular reflex response while seated, could summate with the GS-induced tactile or proprioceptive volley to produce a startle-like response responsible for the reflex facilitation.

High-temperature structural ceramics.

The unique properties of ceramics based on silicon carbide and silicon nitride make them prime candidates for use in advanced energy conversion systems. These compounds are the bases for broad families of engineering materials, whose properties are reviewed. The relationships between processing, microstructure, and properties are discussed. A review and assessment of recent progress in the use of these materials in high-temperature engineering systems, and vehicular engines in particular, is presented.

A role for DNA-PK in retroviral DNA integration.

Retroviral DNA integration is catalyzed by the viral protein integrase. Here, it is shown that DNA-dependent protein kinase (DNA-PK), a host cell protein, also participates in the reaction. DNA-PK-deficient murine scid cells infected with three different retroviruses showed a substantial reduction in retroviral DNA integration and died by apoptosis. Scid cell killing was not observed after infection with an integrase-defective virus, suggesting that abortive integration is the trigger for death in these DNA repair-deficient cells. These results suggest that the initial events in retroviral integration are detected as DNA damage by the host cell and that completion of the integration process requires the DNA-PK-mediated repair pathway.

Evoked release of norepinephrine and serotonin from brain slices: inhibitoon by lithium.

Slices of mammalian brain accumulate H(3)-norepinephrine and H(3)-serotonin when incubated in a physiologic medium containing these tritiated monoamines. When these tissues are subjected to mild electrical stimulation of short duration, which is associated with depolarization of nerve membranes, a striking increase in the rate of efflux of the exogenous labeled monoamines occurs. Stimulation-induced release of both labeled monoamines is diminished by the presence of lithium ions in the perfusing medium; related monovalent cations had no such effect. Evoked release from slices of brain from animals treated intraperitoneally with lithium chloride for 3 days was also reduced.

Anaesthetic management for caesarean section of a parturient with a known difficult airway and closed spinal dysraphism.

Many anaesthetists consider patients with existing neurological deficits, untreated spinal pathology or those having undergone major spinal intervention to be precluded from undergoing neuraxial anaesthesia. While this is partly rooted in fears of litigation there is also a lack of consensus of the best practice in the anaesthetic management of these patients. We present our management of a parturient who attended our institution, having a number of anaesthetic complexities including a known difficult airway, spinal fusion and persistent spinal cord tethering. She successfully underwent delivery under neuraxial blockade for the delivery of her fourth child. We believe that by undergoing a thorough multidisciplinary clinical evaluation, including the extensive use of neuroimaging and ultrasound, it may be possible to plan and perform safe neuraxial anaesthesia.

Bioethical Issues in Biostatistical Consulting Study: Additional Findings and Concerns.

OBJECTIVES: To determine the frequency and severity of 17 requests for inappropriate analysis and reporting of data that biostatisticians received from researchers in statistical consultations, as indirectly experienced (i.e., either heard about or observed being asked of other biostatisticians). METHODS: A randomly drawn sample of 522 members of the American Statistical Association who self-identified as consulting biostatisticians were selected to participate in an online survey with the Bioethical Issues in Biostatistical Consulting Questionnaire, specifically developed for this study. RESULTS: Of the 522 consulting biostatisticians contacted, 390 (74.7%) completed the survey. The top 4 most frequently reported indirectly experienced inappropriate requests rated as "high severity" by at least 50% of the respondents were as follows: 1) proposing a study with a flawed design, including insufficient power; 2) setting aside values when the outcome turns on a few outliers; 3) reporting results of data analysis from only subsets of the data; and 4) overstating the statistical findings well beyond what the data support so that readers are misled. CONCLUSIONS: This article is a follow-up report to our recently published article on 18 directly experienced inappropriate and/or unethical requests by biomedical researchers of their consulting biostatisticians. These additional survey findings from the Bioethical Issues in Biostatistical Consulting Questionnaire on 17 indirectly experienced inappropriate requests show the following: 1) the widespread nature of inappropriate, if not, frankly unethical requests made by biomedical researchers of their consulting biostatisticians and 2) the urgent need to develop and offer educational programs for biomedical researchers in training to correct these behaviors-be they intentional or accidental. This report speaks to the urgency for developing training programs for new and existing researchers to reduce the frequency of these inappropriate bioethical requests during biostatistical consultations. KNOWLEDGE TRANSFER STATEMENT: The findings from this U.S. national survey of biostatisticians on inappropriate requests for data analyses by biomedical researchers strongly suggest a need for remedial actions, including 1) new educational modules for in-development and currently employed biomedical researchers, 2) improved institutional environments by research universities and companies regarding job and publication pressures, and 3) inclusion of a collaborating biostatistician as a working research team member from the early planning stages of all biomedical studies.