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The physiological demands of weight-pulling dogs have yet to be investigated. Two groups of competitive weight-pulling dogs both underwent two identical pull series 3 h apart. The control group (n 8) was compared with a group fed a rapidly digestible carbohydrate and protein supplement after the first pull series (n 9). Blood was drawn before and after each pull series as well as at 15 and 30 min after the first pull series finished. Biochemistry values remained unremarkable throughout the study in both groups regardless of supplementation or exercise over time. Lactic acid showed mild significant increases post-exercise (2·1 (sd 1·2) mmol/l) compared with baseline (1·4 (sd 0·3) mmol/l; P = 0·03) after the initial pull series. When examining the effects of time there was a significant increase in insulin from baseline (median of 10·8 (range 6·8–17·4) μIU/ml) compared with 30 min after supplementation (17·0 (range 8·1–33·0) μIU/ml) and at 3 h after supplementation (19·2 (range 9·7–53·4) μIU/ml). In the treatment group there was also a time effect, with glucagon being elevated from baseline (median of 100 (range 79–115) pg/ml) compared with 30 min after supplementation (114 (range 90–183) pg/ml) and after the second pull series (131 (range 107–152) pg/ml). Evaluation of each dog's ability to pull the same or greater amount of weight on the second pull series revealed no significant differences. In conclusion, weight-pulling dogs have mild elevations in lactate reflecting little anaerobic metabolism compared with other canine sprinting athletes; hormonal changes associated with carbohydrate absorption are reflected within the treatment group, and supplementation had no effect on performance.
People who have schizophrenia die earlier from somatic diseases than do people in the general population, but information about cardiovascular deaths in people who have schizophrenia is limited. We analysed mortality in all age groups of people with schizophrenia by specific cardiovascular diseases (CVDs), focusing on five CVD diagnoses: coronary heart disease, acute myocardial infarction, cerebrovascular disease, heart failure and cardiac arrhythmias. We also compared hospital admissions for CVDs in people who had schizophrenia with hospital admissions for CVDs in the general population.
This national register study of 10 631 817 people in Sweden included 46 911 people who were admitted to the hospital for schizophrenia between 1 January 1987 and 31 December 2010. Information from national registers was used to identify people who had schizophrenia and obtain data about mortality, causes of death, medical diagnoses and hospitalisations.
CVDs were the leading cause of death in people who had schizophrenia (5245 deaths), and CVDs caused more excess deaths than suicide. The mean age of CVD death was 10 years lower for people who had schizophrenia (70.5 years) than the general population (80.7 years). The mortality rate ratio (MRR) for CVDs in all people who had schizophrenia was 2.80 (95% confidence interval (CI) 2.73–2.88). In people aged 15–59 years who had schizophrenia, the MRR for CVDs was 6.16 (95% CI 5.79–6.54). In all people who had schizophrenia, the MRR for coronary heart disease was 2.83 (95% CI 2.73–2.94); acute myocardial infarction, 2.62 (95% CI 2.49–2.75); cerebrovascular disease, 2.4 (95% CI 2.25–2.55); heart failure, 3.25 (95% CI 2.94–3.6); and cardiac arrhythmias, 2.06 (95% CI 1.75–2.43). Hospital admissions for coronary heart disease were less frequent in people who had schizophrenia than in the general population (admission rate ratio, 0.88 (95% CI 0.83–0.94). In all age groups, survival after hospital admission for CVD was lower in people who had schizophrenia than in the general population.
People who had schizophrenia died 10 years earlier from CVDs than did people in the general population. For all five CVD diagnoses, mortality risk was higher for those with schizophrenia than those in the general population. Survival after hospitalisation for CVDs in people who had schizophrenia was comparable with that of people in the general population who were several decades older.
This collective case study examined how and why specific organizational decision-making processes transpired at 2 large suburban county health departments in lower New York State during their response to Hurricane Sandy in 2012. The study also examined the relationships that the agencies developed with other emerging and established organizations within their respective health systems.
In investigating these themes, the authors conducted in-depth, one-on-one interviews with 30 senior-level public health staff and first responders; reviewed documentation; and moderated 2 focus group discussions with 17 participants.
Although a natural hazard such as a hurricane was not an unexpected event for these health departments, they nevertheless confronted a number of unforeseen challenges during the response phase: prolonged loss of power and fuel, limited situational awareness of the depth and breadth of the storm’s impact among disaster-exposed populations, and coordination problems with a number of organizations that emerged in response to the disaster.
Public health staff had few plans or protocols to guide them and often found themselves improvising and problem-solving with new organizations in the context of an overburdened health care system (Disaster Med Public Health Preparedness. 2016;10:436–442).
Altered brain connectivity accompanies autism spectrum disorders (ASD), but the relationship between connectivity and intellectual abilities, which often differs within ASD, and between ASD and typically developing (TD) children, is not understood. Here, diffusion tensor imaging (DTI) was used to explore the relationship between white matter integrity and non-verbal intelligence quotients (IQ) in children with ASD and in age- and gender-matched TD children. Tract-based spatial statistical analyses (TBSS) of DTI fractional anisotropy (FA) revealed altered relationships between white matter and IQ. Different relationships were found using within-group analyses, where regions of significant (p < .05, corrected) correlations in ASD overlapped minimally with regions of FA-IQ correlations in TD subjects. An additional between-groups analysis revealed significant correlation differences in widespread cortical and subcortical areas. These preliminary findings suggest altered brain connectivity may underlie some differences in intellectual abilities of ASD, and should be investigated further in larger samples as a function of development. (JINS, 2013, 19, 1–6)
Global dissemination of imipenem-resistant (IR) clones of Acinetobacter baumannii–A. calcoaceticus complex (ABC) have been frequently reported but the molecular epidemiological features of IR-ABC in military treatment facilities (MTFs) have not been described. We characterized 46 IR-ABC strains from a dataset of 298 ABC isolates collected from US service members hospitalized in different US MTFs domestically and overseas during 2003–2008. All IR strains carried the blaOXA-51 gene and 40 also carried blaOXA-23 on plasmids and/or chromosome; one carried blaOXA-58 and four contained ISAbal located upstream of blaOXA-51. Strains tended to cluster by pulsed-field gel electrophoresis profiles in time and location. Strains from two major clusters were identified as international clone I by multilocus sequence typing.
The relative incidence of childhood-onset bipolar illness in the USA compared with that in Europe is controversial. We examined this issue in more than 500 out-patients (average age 42 years) with bipolar illness who reported age at onset of first episode, family history, and childhood physical or sexual abuse. Childhood or adolescent onset of bipolar illness was reported by 61% of those in the US cohort but by only 30% of those in The Netherlands or Germany. In the USA there was also twice the incidence of childhood adversity and genetic/familial risk for affective disorder. The findings deserve replication and further exploration.
We develop rapid chemical vapor sensors and micro gas chromatography (μGC) analyzers based on the optofluidic ring resonator (OFRR). An OFRR is a micro-sized thin-walled glass capillary; the circular cross-section of the capillary acts as an optical ring resonator while the whispering gallery modes or circulating waveguide modes (WGMs) supported by the ring resonator interact with the vapor samples passing through the capillary. The OFRR interior surface is coated with a vapor-sensitive polymer. The analyte and polymer interaction causes the polymer refractive index (RI) and the thickness to change, which is detected as a WGM spectral shift. Owing to the excellent fluidics, the OFRR vapor sensor exhibits sub-second detection and recovery time with a flow rate of 1 mL/min. On-column separation and detection in the OFRR based μGC system is also demonstrated, showing efficient separation of vapor mixtures and presenting highly reproducible retention time for the individual analyte. Compared to the conventional GC system, the OFRR μGC has the advantage of small size, rapid response, and high selectivity over a short length of column.
Few studies have examined the relative risks of switching into hypomania
or mania associated with second-generation antidepressant drugs in
To examine the relative acute effects of bupropion, sertraline and
venlafaxine as adjuncts to mood stabilisers.
In a 10-week trial, participants receiving out-patient treatment for
bipolar disorder (stratified for rapid cycling) were randomly treated
with a flexible dose of one of the antidepressants, or their respective
matching placebos, as adjuncts to mood stabilisers.
A total of 174 adults with bipolar disorder I, II or not otherwise
specified, currently in the depressed phase, were included. All three
antidepressants were associated with a similar range of acute response
(49–53%) and remission (34–41%). There was a significantly increased risk
of switches into hypomania or mania in participants treated with
venlafaxine compared with bupropion or sertraline.
More caution appears indicated in the use of venlafaxine rather than
bupropion or sertraline in the adjunctive treatment of bipolar
depression, especially if there is a prior history of rapid cycling.
This chapter presents a series of treatment algorithms which may be used as a general guide in sequencing treatment so that patients who fail to respond to first-line conventional treatment may still achieve a substantial amelioration of depressive syndromes or recurrences. Depression in most treatment-resistant bipolar patients can usually be adequately treated. The authors have been able to model the loss of efficacy via tolerance to the anticonvulsants carbamazepine, lamotrigine, diazepam, and valproate in the model of amygdala-kindled seizures. The incidence of clinical tolerance development to lamotrigine in the affective disorders and dose regimens most likely to prevent this occurrence require further observation and study. With the availability of a large number of putative treatment agents within each class of drug for bipolar illness (mood stabilizers, antidepressants, and antimanics) appropriate sequencing and management of complex drug combinations may be fraught with difficulty, but at the same time potentially life-saving.
The Stanley Foundation Bipolar Network (SFBN) was created to address the paucity of help studies in bipolar illness.
To describe the rationale and methods of the SFBN.
The SFBN includes five core sites and a number of affiliated sites that have adopted consistent methodology for continuous longitudinal monitoring of patients. Open and controlled studies are performed as patients' symptomatology dictates.
The reliability of SFBN raters and the validity of the rating instruments have been established. More than 500 patients are in continuous daily longitudinal follow-up. More than 125 have been randomised to one of three of the newer antidepressants (bupropion, sertraline and venlafaxine) as adjuncts in a study of mood stabilisers and 93 to omega-3 fatty acids. A number of open clinical case series have been published.
Well-characterised patients are followed in a detailed continuous longitudinal fashion in both opportunistic case series and double-blind, randomised controlled trials with reliable and validated measures.
The Stanley Foundation Bipolar Network (SFBN) evaluates treatments, course and clinical and neurobiological markers of response in bipolar illness.
To give a preliminary summary of emerging findings in these areas.
Studies with established and potentially antimanic, antidepressant and mood-stabilising agents range from open case series to double-blind randomised clinical trials, and use the same core assessment methodology, thereby optimising the comparability of the outcomes. The National Institute of Mental Health Life Chart Method is the core instrument for retrospective and prospective longitudinal illness description.
The first groups of patients enrolled show a considerable degree of past and present symptomatology, psychiatric comorbidity and functional impairment. There are associations of both genetic and early environmental factors with more severe courses of illness. Open case series with add-on olanzapine, lamotrigine, gabapentin or topiramate show a differential spectrum of effectiveness in refractory patients.
The SFBN provides important new data for the understanding and treatment of bipolar disorder.
Silicon pressure sensors have historically been fabricating by bonding a glass wafer to a micro-machined silicon wafer. The sensor may be sealed as an absolute pressure sensor by using planar glass and can then be used for detection of barometric pressure changes.
It has generally been assumed that as long as the glass and silicon are reasonable clean, then the silicon-glass seal is good and the part becomes a reliable, stable sensor. This paper addresses a low-level drift that was identified in such an absolute pressure sensor. A Zero drift in the range of 0.1% FS was detectable under humidity stresses. The stress always caused drift in the same direction, indicating an effective increased pressure in the sealed cavity.
The impact of various cleaning processes in reducing drift are reported. The improved process assure reliable product for applications such as automotive and altimeter applications.
Background. Systematic and accurate depiction of a patient's course of illness is crucial for
assessing the efficacy of maintenance treatments for bipolar disorder. This need to rate the long-term prospective course of illness led to the development of the National Institute of Mental Health
prospective Life Chart Methodology (NIMH-LCMTM-p or LCM). The NIMH-LCMTM-p allows for
the daily assessment of mood and episode severity based on the degree of mood associated
functional impairment. We have previously presented preliminary evidence of the reliability and
validity of the LCM, and its utility in clinical trials. This study is a further and more extensive
validation of the clinician rated NIMH-LCMTM-p.
Methods. Subjects included 270 bipolar patients from the five sites participating in the Stanley
Foundation Bipolar Network. Daily prospective LCM ratings on the clinician form were initiated
upon entry, in addition to at least monthly ratings with the Inventory of Depressive
Symptomatology-clinician rated (IDS-C), the Young Mania Rating Scale (YMRS) and the Global
Assessment of Functioning (GAF). We correlated appropriate measures and time domains of the
LCM with the IDS-C, YMRS and GAF.
Results. Severity of depression on the LCM and on the IDS-C were highly correlated in 270 patients
(r = −0·785, P < 0·001). Similarly, a strong correlation was found between LCM mania and the
YMRS (r = 0·656, P < 0·001) and between the LCM average severity of illness and the GAF
(r = −0·732, P < 0·001).
Conclusions. These data further demonstrate the validity and potential utility of the NIMH-
LCMTM-p for the detailed daily longitudinal assessment of manic and depressive severity and
course, and response to treatment.
In this article, we present rationales for using complex combination therapy in treatment-refractory bipolar patients and discuss the agents available for use in this therapeutic approach. We review a case example of successful remission that was achievable only with complex combination therapy, and examine its theoretical implications. Practical approaches to devising the optimal complex combination treatment for individual patients are explained, and we look to the development of new methodologies and a more systematic database for decision making in the future.
Kindling involves repeated administration of brief high-frequency electrophysiological stimulation of the brain at initially subthreshold intensities that eventually evoke full-blown seizures. It has thus been used not only as a model of epileptogenesis, but of long-term neuronal memory. Quenching is a phenomenon that utilizes low-frequency stimulation for much longer periods of time (eg, 1 Hz for 15 minutes), and appears to exert preventive effects on the development of kindling and inhibit the manifestation of full-blown kindled seizures by markedly increasing the amygdala afterdischarge and seizure threshold. (See also “Kindling and Quenching: Conceptual Implications for rTMS,” by Weiss and Post, page 32). The parameters of kindling and quenching with intracerebral stimulation of the amygdala in vivo are highly similar to those achieved in vitro in hippocampai slice preparations for inducing long-term potentiation (LTP) and longterm depression (LTD), respectively. These neuroplastic changes are relatively long lasting and appear reversible at the level of synaptic function with either LTD or LTP capable of countering the effects of the other.
The recurrent affective disorders are discussed from the perspective of accumulating inherited and experiential effects on gene expression. Stress and episodes of affective illness are viewed as leaving biochemical and microstructural residues in the central nervous system (CNS) in relation to their patterning, severity, and recurrence. Comorbid factors such as substance abuse and developmental disturbances may also interact with these illness-related variables. In addition to the primary pathological processes, secondary adaptive changes can also be induced, which, in concert with pharmacological interventions, may be sufficient to counter episode occurrences and illness progression. We postulate that the balance of primary pathological and secondary adaptive changes at multiple levels of CNS regulation accounts for recurrence and cyclicity in the affective disorders. The importance of early, effective, long-term interventions in the recurrent affective disorders and the therapeutic potential of several new treatment modalities including repeated transcranial magnetic stimulation (rTMS) are discussed.
This work examines the adhesion of coatings derived from divinylsiloxane bisbenzocyclobutene, mixed stereo and positional isomers of 1,3-bis(2-bicyclo[4.2.0]octa-1,3,5-trien-3-ylethenyl)-1,1,3,3-tetramethyl disiloxane (CAS 117732–87–3), on oxidized silicon substrates treated with silane coupling agents.This material, commercially available as Cyclotene™ 3022, can be used in the construction of high performance electronic circuits, such as multichip modules. Silane coupling agents examined in this study were 3-aminopropyltriethoxysilane (CAS 01760-24-3)(APTES)(, vinyltriethoxysilane (CAS 00078–08–0)(VTES), and 3-methacryloxypropyl trimethoxysilane (CAS 02530–85–0) (MOP-TMS).
Measurement of the interfacial adhesion was performed using microindentation. Bond strengths obtained by this method exceed 200 MPa for the most effective coupling agents. However, these high bond strengths were not found to correlate with acceptable adhesive performance in all cases. In addition to the choice and preparation of the coupling agent, process related chemical exposure has been found to be a key element in the observed adhesive performance. The effect of the cure schedule for the thermoset coating has also been found to be a controlling factor. A short cycle test vehicle was developed consisting of a single 20 gIm polymer layer etched with anisotropic sidewalls. This test vehicle was used to evaluate the efficacy of the coupling agents during process exposures and subsequent thermal shock testing. A solution of MOP-TMS pre-hydrolyzed in methanol was found to produce the most reliable interface with high bond strength.
ABSTRACTPulsed laser deposition of compressed Si3N4 powder has been used to grow thin SiNx films on a variety of substrates at substrate temperatures ranging from room temperature to 350°C. Film composition was analyzed by Auger electron spectroscopy. The SiN0.33 films have a band gap of 5.60 eV as measured by UV absorption. The FT-IR spectrum shows an absorption characteristic of Si-N. The Si/N ratio in the deposited films corresponding to various substrate temperatures has also been determined.