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After five positive randomized controlled trials showed benefit of mechanical thrombectomy in the management of acute ischemic stroke with emergent large-vessel occlusion, a multi-society meeting was organized during the 17th Congress of the World Federation of Interventional and Therapeutic Neuroradiology in October 2017 in Budapest, Hungary. This multi-society meeting was dedicated to establish standards of practice in acute ischemic stroke intervention aiming for a consensus on the minimum requirements for centers providing such treatment. In an ideal situation, all patients would be treated at a center offering a full spectrum of neuroendovascular care (a level 1 center). However, for geographical reasons, some patients are unable to reach such a center in a reasonable period of time. With this in mind, the group paid special attention to define recommendations on the prerequisites of organizing stroke centers providing medical thrombectomy for acute ischemic stroke, but not for other neurovascular diseases (level 2 centers). Finally, some centers will have a stroke unit and offer intravenous thrombolysis, but not any endovascular stroke therapy (level 3 centers). Together, these level 1, 2, and 3 centers form a complete stroke system of care. The multi-society group provides recommendations and a framework for the development of medical thrombectomy services worldwide.
Little is known about the combined use of benzodiazepines and antidepressants in older psychiatric patients. This study examined the prescription pattern of concurrent benzodiazepines in older adults treated with antidepressants in Asia, and explored its demographic and clinical correlates.
The data of 955 older adults with any type of psychiatric disorders were extracted from the database of the Research on Asian Psychotropic Prescription Patterns for Antidepressants (REAP-AD) project. Demographic and clinical characteristics were recorded using a standardized protocol and data collection procedure. Both univariate and multiple logistic regression analyses were performed.
The proportion of benzodiazepine and antidepressant combination in this cohort was 44.3%. Multiple logistic regression analysis revealed that higher doses of antidepressants, younger age (<65 years), inpatients, public hospital, major comorbid medical conditions, antidepressant types, and country/territory were significantly associated with more frequent co-prescription of benzodiazepines and antidepressants.
Nearly, half of the older adults treated with antidepressants in Asia are prescribed concurrent benzodiazepines. Given the potentially adverse effects of benzodiazepines, the rationale of benzodiazepines and antidepressants co-prescription needs to be revisited.
Transparent conducting thin-films of SnO2: F were grown on preheated glass, Al2O3 coated glass, and quartz substrates by Streaming Process for Electrodeless Electrochemical Deposition (SPEED). Stannic chloride (SnCl4) and ammonium fluoride (NH4F) dissolved in a mixture of deionized water and organic solvents were used as precursors. The preheated substrate temperature was varied between 440 and 500 °C. High quality SnO2:F films were grown at all the substrate temperatures studied. The resulting typical film thickness was 250 nm. X-ray diffraction shows that the grown films are polycrystalline SnO2 with a tetragonal crystal structure. The average optical transmission of the films was around 93% throughout the wavelength range 400 to 1000 nm. The lowest electrical resistivity achieved was 6 × 10-4 Ω-cm. The Hall measurements showed that the film is an n-type semiconductor, with carrier mobility of 8.3 cm2/V-s, and carrier concentration of 1 × 1021 cm-3. The direct bandgap was determined to be 4.0 eV from the transmittance spectrum.
There is evidence that epigenetic changes occur early in breast carcinogenesis. We hypothesized that early-life exposures associated with breast cancer would be associated with epigenetic alterations in breast tumors. In particular, we examined DNA methylation patterns in breast tumors in association with several early-life exposures in a population-based case–control study. Promoter methylation of E-cadherin, p16 and RAR-β2 genes was assessed in archived tumor blocks from 803 cases with real-time methylation-specific PCR. Unconditional logistic regression was used for case–case comparisons of those with and without promoter methylation. We found no differences in the prevalence of DNA methylation of the individual genes by age at menarche, age at first live birth and weight at age 20. In case–case comparisons of premenopausal breast cancer, lower birth weight was associated with increased likelihood of E-cadherin promoter methylation (OR = 2.79, 95% CI, 1.15–6.82, for ⩽2.5 v. 2.6–2.9 kg); higher adult height with RAR-β2 methylation (OR = 3.34, 95% CI, 1.19–9.39, for ⩾1.65 v. <1.60 m); and not having been breastfed with p16 methylation (OR = 2.75, 95% CI, 1.14–6.62). Among postmenopausal breast cancers, birth order was associated with increased likelihood of p16 promoter methylation. Being other than first in the birth order was inversely associated with likelihood of ⩾1 of the three genes being methylated for premenopausal breast cancers, but positively associated with methylation in postmenopausal women. These results suggest that there may be alterations in methylation associated with early-life exposures that persist into adulthood and affect breast cancer risk.
The general shape, function and development of vertebrae tend to be highly conserved among mammals (Vaughan, 1970; Simmons and Geisler, 1998; Hildebrand and Goslow, 2001; Buchholtz, 2007), where the vertebral column is divided into five distinct regions: cervical, thoracic, lumbar, sacral and caudal. Typical mammalian vertebrae consist of a centrum, a neural arch and two pairs of zygopophyses. On the centrum, a pair of dorsally directed pedicles fuse with the lamina to form the neural arch for protection of the spinal cord. An intervertebral disc separates each centrum; it facilitates multiaxial motion and acts as a cushion between adjacent centra (Hildebrand and Goslow, 2001). Although individual vertebrae separated by intervertebral discs typically remain distinctly separate bones throughout life, vertebral bodies may fuse into multibone units.
Characteristic fusions of vertebrae are well known in turtles and birds, but also occur to varying degrees in some mammals. Fusion of three or more vertebrae into a sacrum that articulates to the ilium is a primitive characteristic in mammals; its loss is considered a derived trait (e.g., Flower, 1885; Vaughan, 1970) and is usually seen only in obligate aquatic mammals. In contrast to the loss of sacral fusion, the cervical vertebrae of many cetaceans are cranio-caudally compressed and often fuse into units of two to seven vertebrae, presumably to provide rigidity of the neck (Flower, 1885). In addition, some rodents, such as jerboas (Dipus sagitta), have fused cervical vertebrae. Jerboas use ricochetal locomotion (using only the hind feet for forward propulsion) and fused cervical vertebrae may provide increased surface area for muscle attachment and vertebral column strength to avoid whiplash injury (Hatt, 1932).
Walnuts contain a number of potentially neuroprotective compounds like vitamin E, folate, melatonin, several antioxidative polyphenols and significant amounts of n-3 α-linolenic fatty acid. The present study sought to determine the effect of walnuts on verbal and non-verbal reasoning, memory and mood. A total of sixty-four college students were randomly assigned to two treatment sequences in a crossover fashion: walnuts–placebo or placebo–walnuts. Baseline data were collected for non-verbal reasoning, verbal reasoning, memory and mood states. Data were collected again after 8 weeks of intervention. After 6 weeks of washout, the intervention groups followed the diets in reverse order. Data were collected once more at the end of the 8-week intervention period. No significant increases were detected for mood, non-verbal reasoning or memory on the walnut-supplemented diet. However, inferential verbal reasoning increased significantly by 11·2 %, indicating a medium effect size (P = 0·009; d = 0·567). In young, healthy, normal adults, walnuts do not appear to improve memory, mood or non-verbal reasoning abilities. However, walnuts may have the ability to increase inferential reasoning.
We studied concerns about cognitive health among ethnically diverse groups of older adults. The study was grounded in theories of health behaviour and the representation of health and illness. We conducted 42 focus groups (N=396, ages 50+) in four languages, with African Americans, American Indians, Chinese Americans, Latinos, Whites other than Latinos (hereafter, Whites) and Vietnamese Americans, in nine United States locations. Participants discussed concerns about keeping their memory or ability to think as they age. Audio recordings were transcribed verbatim. Constant comparison methods identified themes. In findings, all ethnic groups expressed concern and fear about memory loss, losing independence, and becoming ‘a burden’. Knowing someone with Alzheimer's disease increased concern. American Indians, Chinese Americans, Latinos and Vietnamese Americans expected memory loss. American Indians, Chinese Americans and Vietnamese Americans were concerned about stigma associated with Alzheimer's disease. Only African Americans, Chinese and Whites expressed concern about genetic risks. Only African Americans and Whites expressed concern about behaviour changes. Although we asked participants for their thoughts about their ability to think as they age, they focused almost exclusively on memory. This suggests that health education promoting cognitive health should focus on memory, but should also educate the public about the importance of maintaining all aspects of cognitive health.
To investigate the mode of transmission of and assess control measures for an outbreak of carbapenem-resistant (multidrug-resistant) Acinetobacter baumannii infection involving 6 premature infants.
An outbreak investigation based on medical record review was performed for each neonate during the outbreak (from November 2008 through January 2009) in conjunction with an infection control investigation.
A 36-bed, level 3 neonatal intensive care unit in a university-affiliated teaching hospital in Detroit, Michigan.
Specimens were obtained for surveillance cultures from all infants in the unit. In addition, geographic cohorting of affected infants and their nursing staff, contact isolation, re-emphasis of adherence to infection control practices, environmental cleaning, and use of educational modules were implemented to control the outbreak.
Six infants (age, 10-197 days) with multidrug-resistant A. baumannii infection were identified. All 6 infants were premature (gestational age, 23-30 weeks) and had extremely low birth weights (birth weight, 1000 g or less). Conditions included conjunctivitis (2 infants), pneumonia (4 infants), and bacteremia (1 infant). One infant died of causes not attributed to infection with the organism; the remaining 5 infants were discharged home. All surveillance cultures of unaffected infants yielded negative results.
The spread of multidrug-resistant A. baumannii infection was suspected to be due to staff members who spread the pathogen through close contact with infants. Clinical staff recognition of the importance of multidrug-resistant A. baumannii recovery from neonatal intensive care unit patients, geographic cohorting of infected patients, enhanced infection control practices, and staff education resulted in control of the spread of the organism.
This paper presents the results of atomic force microscope (AFM) measurements of the adhesion force between MDA-MB-231 breast cancer cells and anti-EphA2 antibody-coated AFM tips. As a control, the adhesive interactions are measured between Hs578Bst normal breast cells and anti-EphA2 antibody-coated AFM tips. The measurements show conclusively that the adhesive forces to breast cancer cells are over five times greater than those to normal breast cells. The increase is attributed largely to the interactions between anti-EphA2 antibody and over-expressed EphA2 receptors that are revealed by the staining of receptor-ligand interactions. The implications of the results are discussed for the localized targeting and treatment of cancer with antibody-conjugated nanoparticles.
In February 2007, the Health Council of Canada, in its third annual report, emphasized the need for pan-Canadian data on our health care system. To date, no studies have examined the strengths and weaknesses of emergency health services (EHS) administrative databases, as perceived by researchers. We undertook a qualitative study to determine, from a researcher's perspective, the strengths and weaknesses of EHS administrative databases. The study also elicited researchers' suggestions to improve these databases.
We conducted taped interviews with 4 Canadian health services researchers. The transcriptions were subsequently examined for common concepts, which were finalized after discussion with all the investigators.
Five common themes emerged from the interviews: clinical detail, data quality, data linkage, data use and population coverage. Data use and data linkages were considered strengths. Clinical detail, data quality and population coverage were considered weaknesses.
The 5 themes that emerged from this study all serve to reinforce the call from the Health Council of Canada for national data on emergency services, which could be readily captured through a national EHS administrative database. We feel that key stakeholders involved in emergency services across Canada should work together to develop a strategy to implement an accurate, clinically detailed, integrated and comprehensive national EHS database.
The paper presents the recent results of the spreading and traction of human osteosarcoma cells on soft polydimethylsiloxane (PDMS) microgrooved surfaces. The results show that the cell tractions resulted in significant deformation of the microgrooves. The tractions were calculated, and found to be in good agreement with the results from other studies. The results suggest that the cell spreading-induced soft substrate deformation needs to be considered in the design of implantable bioMEMS structures.
An essential feature of emotional states is their association with change in autonomic function. The importance of these changes lies in the fact that in many theoretical accounts of emotion the realization of autonomic states is a primary means through which feeling states are realized. The issue addressed in this chapter is how the brain generates and represents autonomic states of the organism and their importance in feeling states. A distinction will be drawn between brain systems that mediate relatively automatic responses to emotional stimuli and systems that are involved in what can be termed conscious feeling states. These distinctions will be illustrated by observations from functional neuroimaging and patients with focal brain lesions and pathology of the autonomic nervous system.
Despite the impact of William James at the end of the nineteenth century, for the best part of several decades in the middle of the twentieth century, neuroscientists treated “emotion” and “feeling” as interchangeable terms. This approach to the language of emotion, coupled with the behaviorist movement prevalent in twentieth century psychology, meant that the neuroscientific study of emotion was grossly neglected, often seen as conceptually ragged and its practitioners as pursuing “soft science” (Damasio, 1999; Damasio, 1994; Damasio, 1998; LeDoux, 1996; LeDoux, 2000). Recent efforts, however, have put the study of emotion center stage in understanding the workings of the brain, proposing roles in cognition (Zajonc, 1980), decision making (Damasio, 1994), perception (Anderson & Phelps, 2001), and even consciousness (Panksepp, 1998; Damasio, 1999).
Here we describe an experimental study of the mechanical properties of bacterial biofilms formed from the early dental plaque colonizer Streptococcus mutans. The S. mutans biofilms demonstrated the behavior of rheological fluids, with properties similar to those of organic polymers and other biological fluids. The time-dependent response of the biofilms was modeled on the basis of principles of viscoelasticity theory. The static and dynamic responses were defined in terms of the creep compliance, storage and loss moduli, and viscosity. The creep compliance and stress relaxation functions of S. mutans biofilms were characterized using the Burger model. Implications for developing more effective mechanical removal strategies of dental plaque biofilms are discussed.
Winston P. Smith, USDA Forest Service, Pacific Northwest Research Station, Forestry Sciences Laboratory, Juneau, Alaska 99801-8545, USA,
Robert G. Anthony, US Geological Survey, Oregon Cooperative Fish and Wildlife Research Unit, Oregon State University, 104 Nash Hall, Corvallis, Oregon 97331-3803, USA,
Jeffrey R. Waters, USDA Forest Service, Redwood Sciences Laboratory, 1700 Bayview Drive, Arcata, California 95519, USA,
Norris L. Dodd, Arizona Game and Fish Department, PO Box 2326, Pinetop, Arizona 85935-2326, USA,
Cynthia J. Zabel, USDA Forest Service, Redwood Sciences Laboratory, 1700 Bayview Drive, Arcata, California 95519, USA
Arboreal rodents were selected as a focal group because of their obvious association with forest canopies and relevance to forest management. The close association of arboreal rodents with trees predisposes them to being impacted by timber harvests (Carey 1989, Aubry et al. 2003, Hallett et al. 2003). Trees provide food, thermal and escape cover, shade, moisture and free water, and cavities that provide nest sites and safe refugia from avian and mammalian predators (Carey 1989, Carey et al. 1999, Aubry 2003). Carey (1989) characterized arboreal rodents according to their degree of dependence on trees for various activities and identified the following stand elements as important to their biology: large live trees, large snags, fallen trees, woody debris, multilayered canopy, overstory and understory diversity, and epiphytes. Additionally, he listed stand stability and landscape contiguity as important attributes with dense underbrush, streamsides, rock, and talus as special features (Carey 1989). More recent studies (e.g., Rosenberg and Anthony 1992, Waters and Zabel 1995, Smith and Nichols 2003) provide new information to examine the conclusions of Carey (1989), which serve as useful hypotheses regarding influences of forest management on arboreal rodent populations in western coniferous forests.
We selected species that are reputed late-seral forest habitat specialists or are known to be important prey for the northern spotted owl (Forsman et al. 2001, Hamer et al. 2001), the American marten (Buskirk and Ruggiero 1994, Ben-David et al. 1997), or the northern goshawk (Accipiter gentilis, Lewis 2001).
THEORETICAL AND EMPIRICAL EXTENSIONS
J. Frank Yates, Department of Psychology University of Michigan,
Ju-Whei Lee, Department of Psychology Chung Yuan University,
Winston R. Sieck, Department of Psychology University of Michigan,
Incheol Choi, Department of Psychology Seoul National University,
Paul C. Price, Department of Psychology California State University – Fresno
Frequency doubling a 140 × 110 mm 40 J sub-ps
1054 nm beam for laser matter interaction studies was investigated
at the Central Laser Facility, with efficiencies greater
than 60% being achieved. The conversion characteristics
(efficiency, beam quality, focusability, and pulse length)
for two large 157 mm diameter aperture high quality KDP
crystals of thickness 2 mm and 4 mm were studied. Using
a fundamental drive beam of two times diffraction limited
quality, focal spots of four times the diffraction limit
in the frequency doubled beam were achieved and beam degradation
effects shown to be minimal.
The technique of Chirped Pulse Amplification (CPA)
developed by Strickland and Mourou (1985) is now in common
use on many laser systems [see, for instance, the
review by Perry & Mourou (1994)] and has resulted
in massive increases in focused intensities. This paper
describes CPA implementation on the Vulcan laser system
which has generated multi-Joule sub-picosecond pulses whilst
maintaining beam quality to produce focused intensities
of 5 × 1019 Wcm−2.
Polar research teams often spend extended periods of time away from base stations, living and working in remote field camps of portable tents. This article reports results of a survey study conducted in 1996 of polar researchers from the United States. The study was about the design and use of portable field tents being deployed in polar areas with regard to safety, health, and well-being from the user's perspective. Preliminary analysis indicates that there existed a number of areas in design and use of the shelters that contributed to concerns of safety, health, and well-being among a considerable number of tent users. The article concludes with suggestions for designing and manufacturing portable field tents.