Bonamia exitiosa transmission among, and incidence in, Asian oyster Crassostrea ariakensis under warm euhaline conditions.

Previously reported in Australia, New Zealand, and more recently in Europe, the protistan parasite Bonamia exitiosa was also reported in the mid-Atlantic region of the USA after causing serious mortalities there in the Asian oyster Crassostrea ariakensis. At the time, this oyster was being considered for introduction, and the potential consequences of introducing this species were being assessed using field and laboratory studies. B. exitiosa emerged as the most serious disease threat for this oyster species, especially under warm euhaline conditions and for oysters <50 mm in size. To better evaluate how quickly this parasite may be able to spread among C. ariakensis, we investigated B. exitiosa transmission and incidence in C. ariakensis. During a first trial, potential direct transmission of B. exitiosa was evaluated by cohabitating infected C. ariakensis with uninfected C. ariakensis under in vivo quarantine conditions. In a second experiment, B. exitiosa incidence was estimated in situ by determining its prevalence in C. ariakensis deployed in an enzootic area after 4, 7, 14, 21 and 28 d of exposure. Results suggest that under warm euhaline conditions B. exitiosa can be transmitted among C. ariakensis without requiring any other parasite source and that parasite incidence may be at least as high as 40% after only 4 d exposure to an enzootic area. These results underscored the severity of the bonamiasis disease threat to C. ariakensis and provided further evidence that efforts to build an aquaculture industry based on C. ariakensis in the eastern USA might have been thwarted by parasitic disease.

Racial differences in cortical bone and their relationship to biochemical variables in Black and White children in the early stages of puberty.

UNLABELLED: Osteoporotic fracture rates differ according to race with Blacks having up to half the rate of Whites. The current study demonstrates that racial divergence in cortical bone properties develops in early childhood despite lower serum 25-hydroxyvitamin D in Blacks. INTRODUCTION: Racial differences in bone structure likely have roots in childhood as bone size develops predominantly during growth. This study aimed to compare cortical bone health within the tibial diaphysis of Black and White children in the early stages of puberty and explore the contributions of biochemical variables in explaining racial variation in cortical bone properties. METHODS: A cross-sectional study was performed comparing peripheral quantitative computed tomography-derived cortical bone measures of the tibial diaphysis and biochemical variables in 314 participants (n = 155 males; n = 164 Blacks) in the early stages of puberty. RESULTS: Blacks had greater cortical volumetric bone mineral density, mass, and size compared to Whites (all p < 0.01), contributing to Blacks having 17.0 % greater tibial strength (polar strength-strain index (SSIP)) (p < 0.001). Turnover markers indicated that Blacks had higher bone formation (osteocalcin (OC) and bone-specific alkaline phosphatase) and lower bone resorption (N-terminal telopeptide) than Whites (all p < 0.01). Blacks also had lower 25-hydroxyvitamin D (25(OH)D) and higher 1,25-dihydroxyvitamin D (1,25(OH)2D) and parathyroid hormone (PTH) (all p < 0.05). There were no correlations between tibial bone properties and 25(OH)D and PTH in Whites (all p ≥ 0.10); however, SSIP was negatively and positively correlated with 25(OH)D and PTH in Blacks, respectively (all p ≤ 0.02). Variation in bone cross-sectional area and SSIP attributable to race was partially explained by tibial length, 25(OH)D/PTH, and OC. CONCLUSIONS: Divergence in tibial cortical bone properties between Blacks and Whites is established by the early stages of puberty with the enhanced cortical bone properties in Black children possibly being explained by higher PTH and OC.

Stroke management: updated recommendations for treatment along the care continuum.

The Australian Clinical Guidelines for Stroke Management 2010 represents an update of the Clinical Guidelines for Stroke Rehabilitation and Recovery (2005) and the Clinical Guidelines for Acute Stroke Management (2007). For the first time, they cover the whole spectrum of stroke, from public awareness and prehospital response to stroke unit and stroke management strategies, acute treatment, secondary prevention, rehabilitation and community care. The guidelines also include recommendations on transient ischaemic attack. The most significant changes to previous guideline recommendations include the extension of the stroke thrombolysis window from 3 to 4.5 h and the change from positive to negative recommendations for the use of thigh-length antithrombotic stockings for deep venous thrombosis prevention and the routine use of prolonged positioning for contracture management.

Phase transitions in shear-induced segregation of granular materials.

We computationally study shear-induced segregation of different-sized particles in vertical chute flow. We find that, for low solid fractions, large particles segregate toward regions of low shear rates where the granular temperature (velocity variance) is low. As the solid fraction increases, this trend reverses, and large particles segregate toward regions of high shear rates and temperatures. We find that this is a global phenomenon: local segregation trends reverse at high system solid fractions even where local solid fractions are small. The reversal corresponds to the growth of a single enduring cluster of 30%-60% of the particles that we propose changes the segregation dynamics.

Rheology of dense granular mixtures: boundary pressures.

Models for dense sheared granular materials indicate that their rheological properties depend on particle size, but the representative size for mixtures is not obvious. Here, we computationally study pressure on a boundary due to sheared granular mixtures to determine its dependence on particle size distribution. We find that the pressure does not depend monotonically on average particle size. Instead it has an additional dependence on a measure of the effective free volume per particle we adapt from an expression for packing of monosized particles near the jammed state.

Acute stroke and transient ischaemic attack management--time to act fast.

Stroke is Australia's second single greatest killer with 53 000 new events each year at a rate of 1 every 10 min. Stroke services should be organized to enable people to access proven therapies, such as stroke unit care and thrombolysis, to reduce the impact of stroke. Timely, efficient and coordinated care from ambulance services, emergency services and stroke services will maximize recovery and prevent costly complications and subsequent strokes. Efficient management of patients with transient ischaemic attack can produce significant reductions in subsequent stroke events and risk stratification using the ABCD2 tool can aid management decisions. Evidence for acute stroke care continues to evolve and it is crucial that health professionals are aware of, and implement, best practice clinical guidelines for stroke care.

Kinematics of densely flowing granular mixtures.

We measure the kinematics of segregating granular mixtures in dense free-surface boundary-layer flow in a rotated drum. We find that in a segregating mixture, the different components move with roughly the same velocities, except for a relatively small segregation velocity perpendicular to the direction of flow. On the other hand, the mean variance of the velocities--often associated with a granular temperature--may differ for the two components. In the majority of the high-density boundary layer, the difference is driven by relative particle size and may be understood considering a geometrically motivated model. In the low-density region at the top of the boundary layer, the difference is driven by relative particle mass, similar to observations in more energetic systems.

Shear-induced segregation of particles by material density.

Recently, shear rate gradients and associated gradients in velocity fluctuations (e.g., granular temperatures or kinetic stresses) have been shown to drive segregation of different-sized particles in a manner that reverses at relatively high solids fractions (〈f〉>0.50). Here we investigate these effects in mixtures of particles differing in material density through computational and theoretical studies of particles sheared in a vertical chute where we vary the solids fraction from 〈f〉=0.2 to 0.6. We find that in sparse flows, 〈f〉=0.2 to 0.4, the heavier (denser) particles segregate to lower shear rates similarly to the heavier (larger) particles in mixtures of particles differing only in size. However, there is no segregation reversal at high f in mixtures of particles differing in density. At all solids fractions, heavier (denser) particles segregate to regions of lower shear rates and lower granular temperatures, in contrast with segregation of different-sized particles at high f, where the heavier (larger) particles segregate to the region of higher shear rates. Kinetic theory predicts well the segregation for both types of systems at low f but breaks down at higher f's. Our recently proposed mixture theory for high f granular mixtures captures the segregation trends well via the independent partitioning of kinetic and contact stresses between the two species. In light of these results, we discuss possible directions forward for a model framework that encompasses segregation effects more broadly in these systems.

Immunohistochemical study of neuropeptides in vagal and glossopharyngeal afferent neurons in the rat.

The presence and distribution of multiple neuropeptides in vagal and glossopharyngeal afferent ganglia of the rat were studied using immunohistochemistry. Substance P-, calcitonin-gene related peptide-, cholecystokinin-, neurokinin A-, vasoactive intestinal polypeptide-, and somatostatin-immunoreactive neurons were detected in each visceral afferent ganglion. Neurotensin-immunoreactive cells were not observed. In the nodose ganglion (inferior ganglion of the vagus nerve) occasional immunoreactive cells were scattered throughout the main (caudal) portion of the ganglion with small clusters of cells seen in the rostral portion. The pattern of distribution of the various peptides in the nodose ganglion was similar, with the exception of vasoactive intestinal polypeptide-immunoreactive neurons which exhibited a more caudal distribution. The relative numbers of immunoreactive cells varied, with the greatest numbers being immunoreactive for substance P or vasoactive intestinal polypeptide, and the lowest numbers being immunoreactive for neurokinin A and somatostatin. A build-up of immunoreactivity for each of the peptides, except somatostatin and neurotensin, was detected in vagal nerve fibers of colchicine-injected ganglia. Numerous peptide-immunoreactive cells were also found in the petrosal (inferior ganglion of the glossopharyngeal nerve) and jugular (superior ganglion of the vagus nerve) ganglia. No specific intraganglionic distribution was noted although the relative numbers of cells which were immunoreactive for the different peptides varied considerably. Substance P and calcitonin-gene related peptide were found in large numbers of cells, cholecystokinin was seen in moderate numbers of cells, and neurokinin A, vasoactive intestinal polypeptide and somatostatin were seen in fewer cells. These data provide evidence for the presence and non-uniform distribution of multiple peptide neurotransmitters in vagal and glossopharyngeal afferent neurons. In general, relatively greater numbers of immunoreactive cells were located in the rostral compared with caudal nodose ganglion, and in the petrosal and jugular ganglia compared with the nodose ganglion. Thus, multiple neuropeptides may be involved as afferent neurotransmitters in the reflexes mediated by vagal and glossopharyngeal sensory nerves.

Living with severe COPD. A qualitative exploration of the experience of patients in Leeds.

A sample of 37 patients with severe chronic obstructive pulmonary disease (COPD) drawn from a larger group of 64 patients being studied in a randomized trial of nebulizer versus high-dose inhaler therapy, and similar in age and gender mix, was interviewed in depth, with a view to illuminating standardized outcome measures and improving the understanding of these patients' needs. Three patients are described in detail. The interview material was analysed using non-computerized methods. Quality of life was seen as depending mainly on family relationships, opportunities afforded locally for neighbourliness and freedom from fear, mobility and independence in the activities of daily living, and the absence or successful mitigation of symptoms of concomitant disease. Disease-specific, symptom-oriented outcome measures may miss these. Additionally, the near and repeatedly threatening approach of death recommended extension of a palliative approach to endstage COPD.

Modes of granular segregation in a noncircular rotating cylinder.

Axial segregation is a well-known example of segregation of granular materials. However, at present, there is no conclusive explanation as to why it occurs. Most studies of axial segregation to date are based on cylinders with circular cross sections, and models focus on the character of the surface flow without accounting explicitly for the influence of any subsurface detail. The present experiments demonstrate that the cross section of the mixer has a significant influence on axial segregation and that subsurface dynamics are, in fact, important. Unlike circular mixers, in square mixers the subsurface segregation patterns change with filling level, as does the time dependence of axial segregation. Furthermore, when radial segregation patterns in noncircular mixers most closely resemble that observed for circular cylinders, the time dependence for axial band formation deviates the most. These results challenge segregation theories of axial segregation that ignore subsurface effects.

Spasticity measurement in stroke: a pilot study.

The ability to objectively measure spasticity, related to cerebral stroke, is important in the rehabilitation therapies since many therapeutic modalities have been developed over the years to reduce spasticity. The unproven clinical expectation is that function would be improved were spasticity to be reduced. Unfortunately, the ability to measure spasticity to conduct efficacy studies of spasticity-reducing therapies is not possible. This relates to the multi-variable nature of the spastic syndrome with the result that no clinical measurement technique has been proven to be sensitive, valid and reliable. Therefore, it is important to develop a research-oriented spasticity measurement system to meet this need. We describe the current development of such a system. Details of our pilot study of a reflex excitability technique, designed to measure certain components of cerebral spasticity, are presented. The technique combined biomechanical and electrophysiological measures to investigate a homogenous stroke sample (n = 6); it incorporated the H-reflex in soleus, during passive ankle movements, as a measure of faulty neural inhibition. This component significantly (p < .05) differentiated the stroke sample from a matched, healthy control group (n = 6). Evocation of a cutaneous reflex in soleus was a condition that was problematic and it had to be dropped from the protocol. Joint stiffness, which is thought to affect measures of spasticity during passive movement, did not contaminate the measures. Further research in this direction is required to delineate and measure other neural components of spasticity while taking into account related non-neural variables. The final objective in this line of research is to develop a valid, reliable and sensitive spasticity measurement system that could be used to judge the efficacy of physical neurorehabilitation treatments currently employed to reduce spasticity following stroke.

A reflex technique to measure presynaptic inhibition in cerebral stroke.

The purpose of this study was to evaluate the feasibility of reflex excitability measurement techniques in the partial measurement of spasticity related to cerebral stroke. Techniques involved the testing of the soleus H-reflex at specific ankle positions during passive dorsiflexing movements with and without background plantarflexing contractions; conditions attempted to simulate the terminal stance phase of gait. Testing of 12 stroke subjects, having cerebrovascular lesions related only to occlusion of the middle cerebral artery, demonstrated significantly (p < 0.01) less inhibition of the H-reflex during passive ankle dorsiflexion compared to 12 matched, healthy controls. However, evocation of the H-reflex during a low-level, voluntary plantarflexing contraction concomitant with passive dorsiflexion, did not reflect a statistical difference between the two groups. The two conditions were thought to each represent measures of faulty presynaptic inhibition as indicators of cerebral spasticity. A Chi-square calculation of sensitivity for the passive ankle movement without background plantarflexing contraction condition, was shown to significantly differentiate (p < 0.05) between the stroke and normal groups. A positive, but weak, correlation was found for stroke subjects between this reflex measure and the Ashworth clinical measure of spasticity (r = 0.49). Although stroke subjects exhibited increased joint stiffness when the full range of passive ankle dorsiflexion movement was considered, in comparison to the matched healthy control subjects, no significant increase in passive stiffness was found at the joint position of the reflex evocation. Size of the cerebral lesion, as determined from CT or MRI scan, was not related to the spasticity measures. Therefore, in a homogeneous stroke sample, a component of cerebral spasticity i.e., faculty Ia presynaptic inhibition, has been measured during a simulated functional movement in the lower extremity and was shown to differentiate this group from a matched, healthy, control sample. Joint stiffness did not contaminate the measures.

Capturing the multiple contributions of the CNS role: a criterion-based evaluation tool.

The CNSs at a community hospital found that tools used to evaluate their performance did not reflect the wide variety of activities native to the CNS role within the institution. A six-member working group came to consensus on practice behaviors, and ordered them into a hierarchy of performance levels. The resulting role description and evaluation tool provides flexibility in application to unit-based, centralized, and specialty-based positions. The benefits of the new role description and evaluation tool to the organization and individual are multiple and serve to highlight the unique talents the role can bring to nursing.

EP studies: when they're called for, what they reveal.

Electrodes in the right atrium, across the tricuspid valve, and at the right ventricle's apex give inside information on electrical activity.

Rheology of dense granular mixtures: particle-size distributions, boundary conditions, and collisional time scales.

We computationally investigate the dependence of the rheology of dense sheared granular mixtures on their particle size distribution. We consider the simplest case of a binary mixture of two different sized particles where the fraction of large particles is varied from one simulation to the next while the total solid mass is kept constant. We find that the variation of the rheology with the particle size distribution depends on the boundary conditions. For example, under constant pressure conditions the effective friction coefficient µ(∗) (the ratio between shear and pressure stresses at the boundary) increases mildly with the average particle size. On the other hand, under constant volume conditions, µ(∗) has a nonmonotonic dependence on the average particle size that is related to the proximity of the system solid fraction to the maximum packing fraction. Somewhat surprisingly, then, µ(∗) scales with a dimensionless shear rate (a generalized inertial number) in the same way for either boundary condition. We show that, for our system of relatively hard spheres, these relationships are governed largely by the ratio between average collision times and mean-free-path times, also independent of boundary conditions.

Shear-driven segregation of dense granular mixtures in a split-bottom cell.

Shear-driven segregation of dense granular mixtures has been associated with a number of interesting pattern formation problems. We use experimental and computational split-bottom cells to isolate segregation effects associated with shear gradients from those associated with gravity. We find the effect of shear gradients much less dramatic than initial observations of segregation suggest. While a segregation pattern emerges in a circular split-bottom cell that appears coincident with the shear gradient, we find the pattern is orthogonal to the active segregation flux. We measure a toroidal convection roll that, in conjunction with gravity-driven segregation, is likely responsible for the dramatic horizontal segregation pattern. On the other hand, computational results from a parallel split-bottom cell indicate a subtle segregation flux associated with the shear gradient. The nature of the driving mechanism is unknown. A current predictive form of kinetic theory based on binary collisions dominating the particle dynamics predicts segregation in the opposite direction from observed trends. This indicates the direction of shear-driven segregation depends on the nature of the flow itself, collisional or frictional.

Collapse of a rectangular well in a quasi-two-dimensional granular bed.

We report on an experimental and numerical study of the collapse under gravity of a rectangular well in a quasi-two-dimensional granular bed. For comparison, we also perform experiments on the collapse of a single vertical step. Experiments are conducted in a vertical Hele-Shaw cell, which allows the flow to be recorded from the side using high-speed video. If the rectangular well is sufficiently narrow, the collapsing sidewalls collide at the center of the well and the dynamics of the collapse are dependant on the aspect ratio of the initial well. We follow the evolution of the free surface from the video images, and use particle image velocimetry to determine the subsurface velocity field. From these data, the potential and kinetic energy of the system are calculated. We observe two stages to the collapse flow: an initial gravity-dominated stage, during which the kinetic energy increases, and a later dissipation-dominated phase during which the kinetic energy decreases. We find that although both the width and depth of the depression that remains after the well has collapsed depend on the initial aspect ratio, the surface profiles are self-similar; that is, the shape of the final profile is independent of the aspect ratio of the initial well. We model the collapse of the well using a depth-averaged continuum model with basal friction and with a discrete element model. Both models give results which agree well with experiment. The discrete element model indicates that friction between the particles is the most important source of dissipation over the course of the collapse.