Evaluating the impact of caribou habitat restoration on predator and prey movement.

Fragmentation of the boreal forest by linear features, including seismic lines, has destabilized predator-prey dynamics, resulting in the decline of woodland caribou (Rangifer tarandus caribou) populations. Restoration of human-altered habitat has therefore been identified as a critical management tool for achieving self-sustaining woodland caribou populations. However, only recently has testing of the response of caribou and other wildlife to restoration activities been conducted. Early work has centered around assessing changes in wildlife use of restored seismic lines. We evaluated whether restoration reduces the movement rates of predators and their associated prey, which is expected to decrease predator hunting efficiency and ultimately reduce caribou mortality. We developed a new method for using cameras to measure fine-scale movement by measuring speed as animals traveled between cameras in an array. We used our method to quantify speed of caribou, moose (Alces alces), bears (Ursus americanus), and wolves (Canis lupus) on treated (restored) and untreated seismic lines. Restoration treatments reduced travel speeds along seismic lines of wolves by 1.38 km/h, bears by 0.55 km/h, and caribou by 1.57 km/h, but did not reduce moose travel speeds. Reduced predator and caribou speeds on treated seismic lines are predicted to decrease encounter rates between predators and caribou and thus lower caribou kill rates. However, further work is needed to determine whether reduced movement rates result in reduced encounter rates with prey, and ultimately reduced caribou mortality.

La fragmentación del bosque boreal causado por los accidentes lineales, incluyendo a las líneas sísmicas, ha desestabilizado las dinámicas depredador-presa, lo que resulta en la declinación de las poblaciones de caribú (Rangifer tarandus caribou). Por esto, la restauración del hábitat con alteraciones antropogénicas ha sido identificada como una herramienta fundamental de gestión para obtener poblaciones autosuficientes de esta especie. Sin embargo, no es hasta hace poco que se ha analizado la respuesta del caribú y otras especies a las actividades de restauración; los primeros trabajos se centraban en analizar los cambios en el uso que les daban las especies a las líneas sísmicas restauradas. Evaluamos si la restauración reduce las tasas de movimiento de los depredadores y sus presas asociadas, las cuales se esperan disminuyan la eficiencia de caza de los depredadores y por último reduzcan la mortalidad del caribú. Desarrollamos un nuevo método para usar las cámaras para medir el movimiento detallado mediante la medición de la velocidad con la que los animales se trasladan a lo largo de una serie de cámaras. Usamos nuestro método para cuantificar la velocidad del caribú, alces (Alces alces), osos (Ursus americanus) y lobos (Canis lupus) en líneas sísmicas tratadas (restauradas) y no tratadas. Los tratamientos de restauración redujeron la velocidad de movimiento de los lobos (reducción de 1.38 km/hora), osos (0.55 km/hora) y caribú (1.57 km/hora), pero no afectaron la velocidad de movimiento de los alces. Se pronostica que la reducción en la velocidad de movimiento sobre las líneas sísmicas disminuye la proporción de encuentros entre el caribú y sus depredadores y, por lo tanto, reduce la proporción de muertes del caribú. Sin embargo, se necesita un análisis más profundo para determinar si la tasa reducida de movimiento resulta en una tasa reducida de encuentros con depredadores y si, por último, esto reduce la mortalidad del caribú.

Ultrabrief Right Unilateral Electroconvulsive Therapy for the Treatment of the Neuropsychiatric Symptoms of Dementia with Lewy Bodies.

OBJECTIVES: Dementia with Lewy bodies (DLB) is a debilitating disorder associated with a number of distressing neuropsychiatric symptoms. There is currently limited guidance regarding the most effective strategies of managing these symptoms, and both pharmacologic and nonpharmacologic strategies are often used. Electroconvulsive therapy (ECT) has been reported as a potential nonpharmacologic method to alleviate some of these debilitating neuropsychiatric symptoms. However, there remains a paucity of evidence in current literature. This report aims to add to existing literature regarding ECT in DLB by highlighting successful treatment in seven cases. METHODS: Our study is a retrospective case series of 7 patients with DLB who received treatment with ultrabrief (UB) right unilateral (RUL) ECT for the treatment of agitation and depressive symptoms. Participants included patients with a diagnosis of DLB who were admitted to Emory University Hospital at Wesley Woods from 2011 to 2020 presenting with agitation and/or depressive symptoms after failing pharmacologic intervention. Patients underwent UB RUL ECT administered by a board-certified psychiatrist. After treatment, Pittsburg Agitation Scale and Clinical Global Impression-Improvement scales were recorded as measures of agitation and clinical improvement, respectively. RESULTS: All 7 patients responded to UB RUL ECT with marked improvement in their presenting symptoms of agitation and/or depression without significant adverse effects from treatment. CONCLUSIONS: Ultrabrief RUL ECT seems to be a safe and effective treatment of the agitative and depressive features of DLB.

Corridors or risk? Movement along, and use of, linear features varies predictably among large mammal predator and prey species.

Space-use behaviour reflects trade-offs in meeting ecological needs and can have consequences for individual survival and population demographics. The mechanisms underlying space use can be understood by simultaneously evaluating habitat selection and movement patterns, and fine-resolution locational data are increasing our ability to do so. We use high-resolution location data and an integrated step-selection analysis to evaluate caribou, moose, bear, and wolf habitat selection and movement behaviour in response to anthropogenic habitat modification, though caribou data were limited. Space-use response to anthropogenic linear features (LFs) by predators and prey is hypothesized to increase predator hunting efficiency and is thus believed to be a leading factor in woodland caribou declines in western Canada. We found that all species moved faster while on LFs. Wolves and bears were also attracted towards LFs, whereas prey species avoided them. Predators and prey responded less strongly and consistently to natural features such as streams, rivers and lakeshores. These findings are consistent with the hypothesis that LFs facilitate predator movement and increase hunting efficiency, while prey perceive such features as risky. Understanding the behavioural mechanisms underlying space-use patterns is important in understanding how future land-use may impact predator-prey interactions. Explicitly linking behaviour to fitness and demography will be important to fully understand the implications of management strategies.

Challenges in Treating Cardiovascular Disease: Restricting Sodium and Managing Hyperkalemia.

High sodium intake, whether via diet or drugs, augments cardiorenal risk. Regardless of its source, high sodium intake can both lead to hypertension and reduce the efficacy of renin-angiotensin-aldosterone system inhibitors, which are currently guideline-recommended treatments for hypertension, chronic kidney disease, and heart failure. Reducing sodium intake is therefore recommended to reduce the risk of adverse cardiorenal outcomes. An inverse relationship exists between sodium and potassium, with foods high in sodium being lower in potassium. Diets high in potassium have been associated with reducing hypertension and heart failure; however, optimal renin-angiotensin-aldosterone system inhibitor dosing is often limited by hyperkalemia, which can lead to life-threatening cardiac arrhythmias and increased mortality. Potassium binders are effective at reducing potassium levels. Although some use sodium as the potassium exchange ion, thus increasing sodium intake, a new potassium binder uses another exchange ion and therefore does not increase sodium intake. When treatment options require agents that may precipitate hyperkalemia, particularly in patients at high cardiorenal risk, drugs that do not add to the sodium load may be preferred. A literature search was conducted using PubMed; search terms included potassium, sodium, hyperkalemia, potassium binders, and the literature search focused on manuscripts published more recently since 2000.

Duplex Doppler Imaging of Dialysis Fistulae and Grafts.

Arteriovenous fistulae and grafts for hemodialysis access are a lifeline in patients with end-stage renal disease. A significant cause of morbidity and mortality in this population is dialysis access dysfunction. Duplex ultrasound imaging is an excellent modality to evaluate arteriovenous fistulae and grafts, the 2 main types of long-term hemodialysis access. This review provides a detailed Doppler ultrasound protocol for evaluation of fistulae or grafts to familiarize imagers with their normal appearance, highlighting common dialysis access complications.

MR Imaging of the Triangular Fibrocartilage Complex.

MR imaging has emerged as the mainstay in imaging internal derangement of the soft tissues of the musculoskeletal system largely because of superior contrast resolution. The complex geometry and diminutive size of the triangular fibrocartilage complex (TFCC) and its constituent structures can make optimal imaging of the TFCC challenging; therefore, production of clinically useful images requires careful optimization of image acquisition parameters. This article provides a foundation for advanced TFCC imaging including factors to optimize magnetic resonance images, arthrography, detailed anatomy, and classification of injury. In addition, clinical presentations and treatments for TFCC injury are briefly considered.

Endovascular repair of thoracic aortic aneurysms.

Degenerative aneurysms of the thoracic aorta are increasing in prevalence; open repair of descending thoracic aortic aneurysms is associated with high rates of morbidity and mortality. Repair of isolated descending thoracic aortic aneurysms using stent grafts was introduced in 1995, and in an anatomically suitable subgroup of patients with thoracic aortic aneurysm, repair with endovascular stent graft provides favorable outcomes, with decreased perioperative morbidity and mortality relative to open repair. The cornerstones of successful thoracic endovascular aneurysm repair are appropriate patient selection, thorough preprocedural planning, and cautious procedural execution, the elements of which are discussed here.

Predictors of Emergency Preparedness and Compliance.

BACKGROUND:: In response to the evolving nature of potential disasters, both human made and natural, this research identifies predictors of individual emergency preparedness and compliance with government requests. METHODS:: A survey of a nationally representative sample of US adults (1629 respondents) revealed which emergency supplies and plans they had in place; their perceived level of preparedness and that of their local health care system; the likelihood of 7 terrorist and 4 naturally occurring events, whether they would evacuate their home; shelter in place at home and work; be quarantined, vaccinated, or take medication; and whether they believed that these actions would increase their chances for survival. RESULTS:: Having supplies was predicted by being male, older, wealthier, and white, living in the western United States, and being exposed to national news. Having plans was related to living in the western United States, having children, and being exposed to national news. Compliance was associated with being female and ill. Holding demographic factors constant, preparedness and compliance with government requests were associated with the perceived likelihood of a natural but not a terrorist event, the perceived efficacy of requested actions, and belief in one's local health care system. CONCLUSIONS:: A focus on natural as opposed to terrorist events and people's perceived efficacy of emergency actions and local health care systems may increase their preparedness and compliance with government requests.

A template approach for detecting fractures in adults sustaining low-energy ankle trauma.

Low-energy trauma such as sprains account for 75% of injuries to the ankle; therefore, ankle pain is one of the most common problems encountered by emergency physicians. A close inspection of the radiographs is often required for diagnosis and this depends on the knowledge of high-risk areas since proper treatment relies on the accuracy of the initial diagnosis. In this article, we will present a template that has helped to increase the accuracy for detecting subtle avulsion fractures, chip fractures, and osteochondral fractures of the hind foot in adults sustaining low-energy ankle injuries. By utilizing this search strategy and understanding where the potential sites for fractures exist, the detection of these subtle fractures can be maximized.

Does entertainment-education work with Latinos in the United States? Identification and the effects of a telenovela breast cancer storyline.

This article examines the proposition that a popular form of entertainment, the telenovela, can educate Spanish-speaking viewers in the United States if accurate health information is presented in a dramatic, narrative format. Health professionals consulted on a breast cancer storyline in a Spanish-language telenovela, Ladrón de Corazones, and the impact on viewers' knowledge and behavioral intentions were assessed using three methods. First, an analysis of call attempts to 1-800-4-CANCER demonstrated a significant increase in calls when a PSA featuring the number aired during the program. Second, a nationwide telephone survey indicated that viewers, especially those who identify with Spanish-language television characters, gained specific knowledge from viewing the story and that male viewers were significantly more likely to recommend that women have a mammogram. Third, these trends were confirmed and further explored using focus groups of Ladrón viewers. Implications for educating viewers using dramatic serials in the United States are discussed.

Proliferation dynamics in cultured skin fibroblasts from Down syndrome subjects.

With a view to better understanding the role of oxidant/antioxidant variables in proliferation dynamics of somatic cells, we explored the relationships among superoxide dismutase (SOD) activity, glutathione peroxidase (Gpx) activity, reactive oxygen intermediates (ROI), and indices of cellular proliferation and senescence in cultured fibroblasts from Down syndrome and normal donors. We found that Down syndrome cells had a significantly slower proliferative rate, but attain replicative senescence at similar population doubling (PD) as control cells. Irrespective of donor origin, the number of PD until replicative senescence was positively correlated with Gpx activity (r = 0.784, P = 0.007). In addition, the presence of exogenous catalase in the growth medium significantly extended the number of PD until replicative senescence (P = 0.011). The loss of telomere repeats per PD was not different between Down syndrome cells and controls. However, SOD activity was inversely correlated with the loss of telomere repeats per PD. Collectively, these findings suggest that replicative senescence ultimately relates to mechanisms downstream to SOD (i.e., Gpx and catalase) and confirmed previous observations about inverse relationships between SOD activity and telomere repeat loss per cellular replication.

Two gamma interferon-activated site-like elements in the human cytomegalovirus major immediate-early promoter/enhancer are important for viral replication.

Human cytomegalovirus (HCMV) infection directly initiates a signal transduction pathway that leads to activation of a large number of cellular interferon-stimulated genes (ISGs). Our previous studies demonstrated that two interferon response elements, the interferon-stimulated response element and gamma interferon-activated site (GAS), in the ISG promoters serve as HCMV response sites (VRS). Interestingly, two GAS-like VRS elements (VRS1) were also present in the HCMV major immediate-early promoter-enhancer (MIEP/E). In this study, the importance of these VRS elements in viral replication was investigated. We demonstrate that the expression of the major IE genes, IE1 and IE2, is interferon inducible. To understand the biological significance of this signal transduction pathway in HCMV major IE expression, the two VRS1 in the MIEP/E were mutated. Mutant HCMVs in which the VRS elements were deleted or that contained point mutations grew dramatically more slowly than wild-type virus at a low multiplicity of infection (MOI). Insertion of wild-type VRS1 into the mutant viral genome rescued the slow growth phenotype. Furthermore, the expression levels of major IE RNAs and proteins were greatly reduced during infection with the VRS mutants at a low MOI. HCMV microarray analysis indicated that infection of host cells with the VRS mutant virus resulted in a global reduction in the expression of viral genes. Collectively, these data demonstrate that the two VRS elements in the MIEP/E are necessary for efficient viral gene expression and replication. This study suggests that although the HCMV-initiated signal transduction pathway results in induction of cellular antiviral genes, it also functions to stimulate viral major IE gene expression. This might be a new viral strategy in which the pathway is used to regulate gene expression and play a role in reactivation.

Noise filtering and nonparametric analysis of microarray data underscores discriminating markers of oral, prostate, lung, ovarian and breast cancer.

BACKGROUND: A major goal of cancer research is to identify discrete biomarkers that specifically characterize a given malignancy. These markers are useful in diagnosis, may identify potential targets for drug development, and can aid in evaluating treatment efficacy and predicting patient outcome. Microarray technology has enabled marker discovery from human cells by permitting measurement of steady-state mRNA levels derived from thousands of genes. However many challenging and unresolved issues regarding the acquisition and analysis of microarray data remain, such as accounting for both experimental and biological noise, transcripts whose expression profiles are not normally distributed, guidelines for statistical assessment of false positive/negative rates and comparing data derived from different research groups. This study addresses these issues using Affymetrix HG-U95A and HG-U133 GeneChip data derived from different research groups. RESULTS: We present here a simple non parametric approach coupled with noise filtering to identify sets of genes differentially expressed between the normal and cancer states in oral, breast, lung, prostate and ovarian tumors. An important feature of this study is the ability to integrate data from different laboratories, improving the analytical power of the individual results. One of the most interesting findings is the down regulation of genes involved in tissue differentiation. CONCLUSIONS: This study presents the development and application of a noise model that suppresses noise, limits false positives in the results, and allows integration of results from individual studies derived from different research groups.

The seven deadly sins of yellow-page advertising...and why most health-care providers commit them!

Yellow-page advertising is thought to be necessary for many practices. Purchasing such advertising is a relatively complex and expensive undertaking. This article outlines some of the pitfalls managers should consider when making such purchases. They should not be left to a neophyte. They should be considered within the general context of the practice's ability to market to patients directly, and careful attention must be given to the type, pricing, and placement of the advertising.

Health-seeking behaviors of elderly Chinese Americans: shifts in expectations.

PURPOSE: This study reported a qualitative analysis of health-seeking behaviors of community-dwelling elderly Chinese Americans on the influences of family network, cultural values, and immigrant experience in their use of health resources. Barriers to health care, pathway of health care, and adaptation of health care by use of self-treatment and Eastern and Western medicines were also examined. DESIGN AND METHODS: The investigators used content analysis to obtain themes and key points of focus group interview data (N = 25) to explore the elderly participants' attitudes, values, and practices in their use of health resources. Survey questionnaires in Chinese were used to compile demographic data. RESULTS: Findings suggested a shift from traditional expectations of filial piety to more dependence on neighbors and friends, and a genuine adaptability to combining Eastern and Western health care modalities. Immigration was not proposed by these Chinese elders as an explanation of shifts in expectations for family support or values. IMPLICATIONS: This study has implications for research, service delivery, and policy making for health care of ethnic elderly persons, particularly in addressing structural and cultural issues in access and compliance.

Induction of in vitro reprogramming by Toll-like receptor (TLR)2 and TLR4 agonists in murine macrophages: effects of TLR "homotolerance" versus "heterotolerance" on NF-kappa B signaling pathway components.

In this study, tolerance induction by preexposure of murine macrophages to Toll-like receptor (TLR)2 and TLR4 agonists was revisited, focusing on the major signaling components associated with NF-kappaB activation. Pretreatment of macrophages with a pure TLR4 agonist (protein-free Escherichia coli (Ec) LPS) or with TLR2 agonists (Porphyromonas gingivalis LPS or synthetic lipoprotein Pam3Cys) led to suppression of TNF-alpha secretion, IL-1R-associated kinase-1, and IkappaB kinase (IKK) kinase activities, c-jun N-terminal kinase, and extracellular signal-regulated kinase phosphorylation, and to suppression of NF-kappaB DNA binding and transactivation upon challenge with the same agonist (TLR4 or TLR2 "homotolerance," respectively). Despite inhibited NF-kappaB DNA binding, increased levels of nuclear NF-kappaB were detected in agonist-pretreated macrophages. For all the intermediate signaling elements, heterotolerance was weaker than TLR4 or TLR2 homotolerance with the exception of IKK kinase activity. IKK kinase activity was unperturbed in heterotolerance. TNF-alpha secretion was also suppressed in P. gingivalis LPS-pretreated, Ec LPS-challenged cells, but not vice versa, while Pam3Cys and Ec LPS did not induce a state of cross-tolerance at the level of TNF-alpha. Experiments designed to elucidate novel mechanisms of NF-kappaB inhibition in tolerized cells revealed the potential contribution of IkappaBepsilon and IkappaBxi inhibitory proteins and the necessity of TLR4 engagement for induction of tolerance to Toll receptor-IL-1R domain-containing adapter protein/MyD88-adapter-like-dependent gene expression. Collectively, these data demonstrate that induction of homotolerance affects a broader spectrum of signaling components than in heterotolerance, with selective modulation of specific elements within the NF-kappaB signaling pathway.

Presence of pro-tobacco messages on the Web.

Ignored in the finalized Master Settlement Agreement (National Association of Attorneys General, 1998), the unmonitored, unregulated World Wide Web (Web) can operate as a major vehicle for delivering pro-tobacco messages, images, and products to millions of young consumers. A content analysis of 318 randomly sampled pro-tobacco Web sites revealed that tobacco has a pervasive presence on the Web, especially on e-commerce sites and sites featuring hobbies, recreation, and "fetishes." Products can be ordered online on nearly 50% of the sites, but only 23% of the sites included underage verification. Further, only 11% of these sites contain health warnings. Instead, pro-tobacco sites frequently associate smoking with "glamorous" and "alternative" lifestyles, and with images of young males and young (thin, attractive) females. Finally, many of the Web sites offered interactive site features that are potentially appealing to young Web users. Recommendations for future research and counterstrategies are discussed.