Rare earth elements and yttrium as tracers of waste/rock-groundwater interactions

Increasing concentrations of Rare Earth Elements (REE) plus yttrium (REY) are entering the environment due to human activities. The similar chemical behaviour across the whole REY, i.e. the lanthanide series (lanthanum to lutetium) and yttrium, allows their use as tracers, fingerprinting rock-forming processes and fluid-rock interactions in earth science systems. However, their use in fingerprinting waste and particularly low-level radioactive waste has not received much attention, despite the direct use of REE in the nuclear industry and the traditional use of REE as proxies to understand the environmental mobility of the actinide series (actinium to lawrencium). The highly instrumented low-level radioactive waste site at Little Forest (Australia) allows a detailed REY study, investigating interactions with local strata, neighbouring waste forms and shallow groundwater flows. Groundwater samples and solids from cored materials were recovered from 2007 to 2012 from the study site and regional baseline sites in the same geological materials. The REY in water samples were analysed by automated chelation pre-concentration (SeaFast, ESI) followed by ICP-MS determination, while solid samples were analysed using Neutron Activation Analysis (NAA) and X-ray fluorescence scanning (ITRAX). Solid rocks showed no REY departed from typical Upper Crust compositions in either Little Forest or regional background sites. Shallow groundwater from ~4-5 m, at or slightly below waste trench levels, showed water-waste interaction as a marked enrichment, relative to shale-normalised patterns, in samarium, europium and gadolinium, with depleted yttrium. Leachate samples from the neighbouring urban landfill show different REY normalised patterns. REY distribution changes with depth through increased interaction with shales and sandstones. Variations in pH and redox conditions lead to widespread precipitation of Fe-hydroxides, which scavenge REY with differential uptake by precipitating solids, resulting in increases in Y and higher Y/Ho ratio in the groundwater along the flow path. Our study revealed that the Little Forest low-level radioactive waste has a REY fingerprint different to that of groundwater in surrounding land uses. REY can be used to fingerprint diverse waste sources, assess the mobility of lanthanides inferring the mobility of selected actinides, and to trace the fate of REY during groundwater recharge. The approach presented can refine source allocation and trace pollutant mobility in current and legacy urban, mixed and radioactive waste sites around the world.

Isotopic evidence for nitrate sources and controls on denitrification in groundwater beneath an irrigated agricultural district

The application of N fertilisers to enhance crop yield is common throughout the world. Many crops have historically been, or are still, fertilised with N in excess of the crop requirements. A portion of the excess N is transported into underlying aquifers in the form of NO₃^-, which is potentially discharged to surface waters. Denitrification can reduce the severity of NO₃^- export from groundwater. We sought to understand the occurrence and hydrogeochemical controls on denitrification in NO₃^--rich aquifers beneath the Emerald Irrigation Area (EIA), Queensland, Australia, a region of extensive cotton and cereal production. Multiple stable isotope (in H₂O, NO₃^-, DIC, DOC and SO₄^2-) and radioactive isotope (³H and ³⁶Cl) tracers were used to develop a conceptual N process model. Fertiliser-derived N is likely incorporated and retained in the soil organic N pool prior to its mineralisation, nitrification, and migration into aquifers. This process, alongside the near absence of other anthropogenic N sources, results in a homogenised groundwater NO₃^- isotopic signature that allows for denitrification trends to be distinguished. Regional-scale denitrification manifests as groundwater becomes increasingly anaerobic during flow from an upgradient basalt aquifer to a downgradient alluvial aquifer. Dilution and denitrification occurs in localised electron donor-rich suboxic hyporheic zones beneath leaking irrigation channels. Using approximated isotope enrichment factors, estimates of regional-scale NO₃^- removal ranges from 22 to 93% (average: 63%), and from 57 to 91% (average: 79%) beneath leaking irrigation channels. In the predominantly oxic upgradient basalt aquifer, raised groundwater tables create pathways for NO₃^- to be transported to adjacent surface waters. In the alluvial aquifer, the transfer of NO₃^- is limited both physically (through groundwater-surface water disconnection) and chemically (through denitrification). These observations underscore the need to understand regional- and local-scale hydrogeological processes when assessing the impacts of groundwater NO₃^- on adjacent and end of system ecosystems.

The ACA a Decade In: Resilience, Impact, and Vulnerabilities

A decade after its enactment, the Affordable Care Act remains both politically viable and consequential, despite Republican efforts to end it. The law's impact on insurance coverage is substantial but remains distant from universal coverage, while its contributions to cost control are at best limited. National public opinion data collected by the author in 2018 reveal both strengths and vulnerabilities in the act.

The challenge of herbicide resistance around the world: a current summary

Herbicide-resistant weeds have been observed since the early years of synthetic herbicide development in the 1950s and 1960s. Since that time there has been a consistent increase in the number of cases of herbicide resistance and the impact of herbicide-resistant weeds. Although the nature of crop production varies widely around the world, herbicides have become a primary tool for weed control in most areas. Dependence on herbicides continues to increase as global populations migrate away from rural areas to cities and the agricultural labor force declines. This increased use of herbicides and the concurrent selection pressure have resulted in a rise in cases of multiple resistance, leaving some farmers with few or no herbicide options for certain weed infestations. Global population and economic forces drive many farmer choices regarding crop production and weed control. The challenge is how to insert best management practices into the decision-making process while addressing various economic and regulatory needs. This review endeavors to provide a current overview of herbicide resistance challenges in the major crop production areas of the world and discusses some research initiatives designed to address portions of the problem. © 2017 Society of Chemical Industry.

Biokinetic Analysis and Metabolic Fate of 2,4-D in 2,4-D-Resistant Soybean (Glycine max)

The Enlist weed control system allows the use of 2,4-D in soybean but slight necrosis in treated leaves may be observed in the field. The objectives of this research were to measure and compare uptake, translocation, and metabolism of 2,4-D in Enlist (E, resistant) and non-AAD-12 transformed (NT, sensitive) soybeans. The adjuvant from the Enlist Duo herbicide formulation (ADJ) increased 2,4-D uptake (36%) and displayed the fastest rate of uptake (U50= 0.2 h) among treatments. E soybean demonstrated a faster rate of 2,4-D metabolism (M50= 0.2 h) compared to NT soybean, but glyphosate did not affect 2,4-D metabolism. Metabolites of 2,4-D in E soybean were qualitatively different than NT. Applying 2,4-D-ethylhexyl ester instead of 2,4-D choline (a quaternary ammonium salt) eliminated visual injury to E soybean, likely due to the time required for initial de-esterification and bioactivation. Excessive 2,4-D acid concentrations in E soybean resulting from ADJ-increased uptake may significantly contribute to foliar injury.

Abstract P2-05-06: Analytical and clinical validation of a fully automated tissue-based quantitative assay (MetaSite Breast™) to detect the likelihood of distant metastasis in hormone receptor (HR)-positive, HER2-negative early stage breast cancer (ESBC)

Background: MetaSite Breast™ is a validated assay to predict risk of distant breast cancer metastasis in patients with HR+/HER2- ESBC. The assay measures the number of MetaSites defined as tumor microanatomic structures composed of MENA protein expressing tumor cells in contact with CD31+ endothelial cells and CD68+ macrophages. Previous studies have demonstrated that an increased number of these microanatomic structures is associated with distant metastasis (DM) in HR+/HER2- ESBC independent of clinicopathologic features. Analytical validation of MetaSite Breast™ demonstrated precision of 97-99% (repeat image analysis of the same slide) and performance of 91-96% (staining and image analysis of serial tumor sections). We sought to further understand the importance of the MetaSite in predicting distant breast cancer metastasis utilizing a fully automated prognostic assay in an independent large patient cohort.

Methods: We conducted a nested case-control study within a cohort of 3,760 patients diagnosed between 1980 and 2000 with invasive breast cancer from the Kaiser Permanente Northwest health care system. Cases (n=259) were women who developed a subsequent distant metastasis; controls, selected using incidence density sampling, were matched closely to cases (1:1) on age at and calendar year of primary diagnosis. Of the 481 patient tumor samples evaluated in this study, 57% were HR+/HER2-, 19% were triple negative (TN), and 15% were HER2+ disease. Multivariate models were adjusted for clinical factors including: lymph node status, tumor size, tumor grade, and HRT; as well as matching variables: age and year of diagnosis. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression.

Results: In the HR+/HER2- group, MetaSite Score (MS) ranged from 0-357 and the mean was 44.6. MS was a significant predictor of DM (P=0.039) in patients with HR+/HER2- disease. Cut-points based on tertiles of MS in all 259 controls defined intermediate (13-41) and high (>41) risk groups that were significantly associated with risk of DM versus the low risk group (OR=2.24; 95%CI=1.23-4.13, P=0.009) and (OR=2.94; 95%CI=1.62-5.41, P=0.0005), respectively. Univariate estimates of absolute risk of DM with cutoffs based on 90% sensitivity and specificity were 9.4% for the low risk group (MS<7), 14.1% for the intermediate (MS=7-91), and 23.4% for the high (MS>91). When adjusted for clinical factors, estimates of absolute risk of DM were 6.6%, 14.1%, and 33.0% for the low, intermediate, and high risk groups, respectively. A binary cut-point for the high risk group was determined (MS>14) and was significant with a 2-fold higher risk of DM versus the low risk group and adjusted for clinical covariates (P=0.036). MS was not positively associated with DM in TN or HER2+ disease.

Conclusions: MetaSite Breast™ significantly predicted the risk of distant breast cancer metastasis in ESBC patients with HR+/HER2-disease, independent of classical clinicopathologic features.

Citation Format: Donovan MJ, Jones JG, Entenberg DR, Condeelis JS, D'alfonso TM, Gustavson M, Molinaro A, Oktay MH, Xue X, Sparano JA, Peterson MA, Podznyakova O, Rohan TE, Shuber AP, Gertler FB, Ly A, Divelbiss ME, Hamilton DA. Analytical and clinical validation of a fully automated tissue-based quantitative assay (MetaSite Breast™) to detect the likelihood of distant metastasis in hormone receptor (HR)-positive, HER2-negative early stage breast cancer (ESBC) [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P2-05-06.

Caring for the Uninsured with Prostate Cancer: A Comparison of Four Policy Alternatives in California

The IMPACT Program seeks to improve access to prostate cancer care for low-income, uninsured men. The objective of the current study was to compare the cost-effectiveness of four policy alternatives in treating this population. We analyzed the cost-effectiveness of four policy alternatives for providing care to low-income, uninsured men with prostate cancer: (1) IMPACT as originally envisioned, (2) a version of IMPACT with reduced physician fees, (3) a hypothetical Medicaid prostate cancer treatment program, and (4) the existing county safety net. We calculated cost-effectiveness based on incremental cost-effectiveness ratios (ICERs) with the formula ICER = (Cost(alternative strategy) - Cost(baseline strategy)) / (QALY(alternative strategy) - QALY(baseline strategy)). We measured outcomes as quality-adjusted life years (QALYs). "Best-case" scenarios assumed timely access to care in 50% of cases in the county system and 70% of cases in any system that reimbursed providers at Medicaid fee-for-service rates. "Worst-case" scenarios assumed timely access in 35 and 50% of corresponding cases. In fiscal year 2004-2005, IMPACT allocated 11% of total expenditures to administrative functions and 23% to fixed clinical costs, with an overall budget of $5.9 million. The ICERs ($/QALY) assuming "best-case" scenarios for original IMPACT, modified IMPACT, and a hypothetical Medicaid program were $32,091; $64,663; and $10,376; respectively. ICERs assuming "worst-case" scenarios were $27,189; $84,236; and $10,714; respectively. County safety net was used as a baseline. In conclusion, IMPACT provides underserved Californians with prostate cancer care and value-added services with only 11% of funds allocated to administrative fixed costs. Both the original IMPACT program and the hypothetical Medicaid prostate cancer program were cost-effective compared to the county safety net, while the reduced-fees version of IMPACT was not.

Robust crop resistance to broadleaf and grass herbicides provided by aryloxyalkanoate dioxygenase transgenes

Engineered glyphosate resistance is the most widely adopted genetically modified trait in agriculture, gaining widespread acceptance by providing a simple robust weed control system. However, extensive and sustained use of glyphosate as a sole weed control mechanism has led to field selection for glyphosate-resistant weeds and has induced significant population shifts to weeds with inherent tolerance to glyphosate. Additional weed control mechanisms that can complement glyphosate-resistant crops are, therefore, urgently needed. 2,4-dichlorophenoxyacetic acid (2,4-D) is an effective low-cost, broad-spectrum herbicide that controls many of the weeds developing resistance to glyphosate. We investigated the substrate preferences of bacterial aryloxyalkanoate dioxygenase enzymes (AADs) that can effectively degrade 2,4-D and have found that some members of this class can act on other widely used herbicides in addition to their activity on 2,4-D. AAD-1 cleaves the aryloxyphenoxypropionate family of grass-active herbicides, and AAD-12 acts on pyridyloxyacetate auxin herbicides such as triclopyr and fluroxypyr. Maize plants transformed with an AAD-1 gene showed robust crop resistance to aryloxyphenoxypropionate herbicides over four generations and were also not injured by 2,4-D applications at any growth stage. Arabidopsis plants expressing AAD-12 were resistant to 2,4-D as well as triclopyr and fluroxypyr, and transgenic soybean plants expressing AAD-12 maintained field resistance to 2,4-D over five generations. These results show that single AAD transgenes can provide simultaneous resistance to a broad repertoire of agronomically important classes of herbicides, including 2,4-D, with utility in both monocot and dicot crops. These transgenes can help preserve the productivity and environmental benefits of herbicide-resistant crops.

Lagrangian crumpling equations

A concise method for following the evolving geometry of a moving surface using Lagrangian coordinates is described. All computations can be done in the fixed geometry of the initial surface despite the evolving complexity of the moving surface. The method is applied to three problems in nonlinear elasticity: the bulging of a thin plate under pressure (the original motivation for Föppl-von Karman theory), the buckling of a spherical shell under pressure, and the phenomenon of capillary wrinkles induced by surface tension in a thin film. In this last problem the inclusion of a gravitational potential-energy term in the total energy improves the agreement with experiment.

Geometry of ciliary dynamics

Cilia are motile biological appendages that are driven to bend by internal shear stresses between tubulin filaments. A continuum model of ciliary material is constructed that incorporates the essential ciliary constraints: (i) one-dimensional inextensibility of filaments, (ii) three-dimensional incompressibility, and (iii) shear strain only longitudinally along filaments. It is shown that twist of filaments about each other is not an independent degree of freedom under ciliary constraints. The constraint on twist appears in the equations of motion for cilia as a term not previously recognized. As another application of the same geometrical idea, a general approach to the polymorphism of bacterial flagella is proposed.

Transient contrast encephalopathy after carotid artery stenting

PURPOSE

To report an unusual case of transient contrast encephalopathy arising after carotid artery stenting.

CASE REPORT

An 82-year-old right-handed man with a recent history of transient ischemic events was admitted to the hospital for evaluation of carotid artery disease. During cerebral angiography, which identified a 90% right internal carotid artery stenosis, the patient received 25 mL of an ionic, low-osmolar contrast agent (ioxaglate) in each carotid artery. The following day he underwent successful carotid stenting, during which 180 mL of ioxaglate were used. He developed rapidly worsening confusion and left hemiparesis on the table. Noncontrast computed tomography showed marked cortical enhancement and edema of the right cerebral hemisphere in the distribution of the right anterior and middle cerebral arteries. The patient improved rapidly and by day 2 was completely recovered; magnetic resonance imaging documented no cortical edema and normal sulci. One month after the procedure, he was well, with patent carotid arteries.

CONCLUSIONS

Transient neurotoxicity after carotid interventions must be differentiated from massive cerebral infarction and hyperperfusion syndrome, but the prognosis is excellent. However, subsequent contrast studies in a patient with this complication should be undertaken with extreme caution.

Effect of inhibition of MAO and COMT on intrarenal dopamine and serotonin and on renal function

The purpose of the present investigation was to study the effects of inhibition of monoamine oxidase (MAO) and/or catechol-O-methyltransferase (COMT), enzymes involved in the degradation of dopamine (DA) and serotonin (5-HT), on intrarenal DA and 5-HT, as reflected in the renal interstitial fluid (RIF) microdialysate and urine, and on renal function. Inhibition of MAO selectively increased RIF 5-HT from 3.16 +/- 0.38 to 8.03 +/- 1.83 pg/min (n = 7, P < 0.05), concomitant with decreases in mean arterial blood pressure and glomerular filtration rate (2.09 +/- 0. 18 to 1.57 +/- 0.22 ml/min, n = 7, P < 0.05). Inhibition of COMT significantly increased RIF DA (3.47 +/- 0.70 to 8.68 +/- 1.96 pg/min, n = 9, P < 0.05), urinary DA (2.00 +/- 0.16 to 2.76 +/- 0.26 ng/min, n = 9, P < 0.05), and absolute excretion of sodium (6.42 +/- 2.00 to 9.82 +/- 1.62 micromol/min, n = 10, P < 0.05). Combined inhibition of MAO and COMT significantly increased RIF DA, urinary DA, and urinary 5-HT, which was accompanied with increases in urine flow rate, and absolute (3.03 +/- 0.59 to 8.40 +/- 1.61 micromol/min, n = 9, P < 0.01) and fractional excretion of sodium. We conclude that inhibition of MAO selectively increases RIF 5-HT. COMT appears to be more important than MAO in the metabolism of intrarenal DA. Physiological increases in intrarenal DA/5-HT induced by inhibition of their degrading enzymes are accompanied with significant alterations of renal function.

Object memory effects on figure assignment: conscious object recognition is not necessary or sufficient

In three experiments we investigated whether conscious object recognition is necessary or sufficient for effects of object memories on figure assignment. In experiment 1, we examined a brain-damaged participant, AD, whose conscious object recognition is severely impaired. AD's responses about figure assignment do reveal effects from memories of object structure, indicating that conscious object recognition is not necessary for these effects, and identifying the figure-ground test employed here as a new implicit test of access to memories of object structure. In experiments 2 and 3, we tested a second brain-damaged participant, WG, for whom conscious object recognition was relatively spared. Nevertheless, effects from memories of object structure on figure assignment were not evident in WG's responses about figure assignment in experiment 2, indicating that conscious object recognition is not sufficient for effects of object memories on figure assignment. WG's performance sheds light on AD's performance, and has implications for the theoretical understanding of object memory effects on figure assignment.

Glucose-derived 3'-(carboxymethyl)-3'-deoxyribonucleosides and 2', 3'-lactones as synthetic precursors for amide-linked oligonucleotide analogues

Treatment of a 1,2-O-isopropylidene-3-ketopentofuranose derivative (obtained from D-glucose) with [(ethoxycarbonyl)methylene]triphenylphosphorane and catalytic hydrogenation of the resulting alkene gave stereodefined access to 3-(carboxymethyl)-3-deoxy-D-ribofuranose derivatives. Esters of 5-O-acetyl- or 5-azido-5-deoxy-3-(carboxymethyl)-D-ribofuranose were coupled with nucleobases to give branched-chain nucleoside derivatives. Ester saponification and protecting group manipulation provided 2'-O-(tert-butyldimethylsilyl) ethers of 5'-azido-5'-deoxy- or 5'-O-(dimethoxytrityl) derivatives of 3'-(carboxymethyl)-3'-deoxyribonucleosides that are effective precursors for synthesis of amide-linked oligoribonucleosides.

Multiplicative effects of intention on the perception of bistable apparent motion

When viewing ambiguous displays, observers can, via intentional efforts, affect which perceptual interpretation they perceive. Specifically, observers can increase the probability of seeing the desired percept. Little is known, however, about how intentional efforts interact with sensory inputs in exerting their effects on perception. In two experiments, the current study explored the possibility that intentional efforts might operate by multiplicatively enhancing the stimulus-based activation of the desired perceptual representation. Such a possibility is suggested by recent neurophysiological research on attention. In support of this idea, when we presented bistable apparent motion displays under stimulus conditions differentially favoring one motion percept over the other, observers' intentional efforts to see a particular motion were generally more effective under conditions in which stimulus factors favored the intended motion percept.

Opioid inhibition of formalin-induced changes in plasma extravasation and local blood flow in rats

Hindpaw injection of dilute formalin produces brief (Phase 1) and persistent (Phase 2) nociceptive responses in the rat. We recently showed that systemically-administered remifentanil during Phase 1 interacted with peripheral opioid receptors to delay the onset and termination of Phase 2 (Taylor et al., 1997b). To test the hypothesis that opioid inhibition of proinflammatory events during Phase 1 contributed to this delay, we evaluated the effects of remifentanil on the time course of formalin-induced inflammation. We found that formalin increased paw thickness (edema), plasma extravasation and local blood flow within minutes of its injection, i.e. during Phase 1. Each of these responses was blocked during remifentanil administration (30 microg/kg i.v. bolus, followed 90 s later with a 15 microg/kg/min infusion for 13.5 min), indicating that opioids inhibit Phase 1 inflammation. Opioid blockade of the blood flow response could be reversed with a peripherally-acting opioid antagonist, naloxone methiodide, indicating that remifentanil acted upon peripheral opioid receptors. Although the administration of remifentanil during Phase 1 did not reduce the magnitude of inflammatory responses during Phase 2, it did delay the onset and termination of edema during Phase 2. As this corresponds to the effects of remifentanil on nociceptive responses during Phase 2, we suggest that opioid analgesics act upon peripheral sites to inhibit inflammation during Phase 1, leading to a delay in the temporal profile of inflammatory (and likely nociceptive) responses during Phase 2.

Synthesis of amide-linked [(3')CH2CO-NH(5')] nucleoside analogues of small oligonucleotides

We report syntheses of new amide-linked (di-penta)nucleoside analogues of antisense oligonucleotide components. Solution-phase coupling of 3'-(carboxymethyl)-3'-deoxy- and 5'-amino-5'-deoxynucleoside derivatives provides amide dimers. Activated [3'-(carboxymethyl)-3'-deoxy] units with a 5'-azido-5'-deoxy function provide "masked" 5'-amino-5'-deoxy residues for chain extension, and a 5'-O-DMT-protected unit provides the 5'-terminus for attachment to a phosphodiester linkage.

Prospective, randomized trial of template-assisted versus undirected written recording of physician records in the emergency department

STUDY OBJECTIVE

To determine whether use of the T-System (Emergency Services Consultants, Irving, TX) template-generated medical documentation system (1) decreases physician evaluation time in the emergency department, (2) increases gross billing under the 1997 Health Care Financing Administration guidelines by minimizing downcoding caused by inadequate documentation, and (3) increases physician satisfaction with the documentation process, compared with the undirected written narrative format.

METHODS

A prospective, randomized, unblinded, controlled, convenience trial of documentation with the T-System of ED templates versus undirected written documentation was conducted in the ED of a county-owned, university-affiliated hospital. All patients seen between the hours of 7 AM and 10 PM during a 16-day period were included. The intervention was varying the method of documentation of the emergency physician. Adequacy of randomization to the 2 documentation groups was assessed by comparing ED triage classification, patient disposition, level of training of the evaluating physician, and whether ED consultation with other services occurred. Outcome measurements included emergency physician total evaluation and treatment time, professional bill, and satisfaction, as evaluated by a questionnaire completed after the study period. The 2 documentation groups were compared by an intention-to-treat analysis and by Student's t test and the median test as appropriate.

RESULTS

A total of 1,228 patient encounters were included. Emergency physician total evaluation and treatment time with template-directed documentation was 4.6 minutes less than with undirected recording, a difference that was not significant (95% confidence interval [CI], -9.2 to 18.3). Gross billing was $29. 60 more per patient (95% CI, $22.20 to $37.00) with the T-System, as assessed by our hospital coders. This difference was caused by a mean.50 (95% CI,.39 to.60) higher level of evaluation and management coding. Physicians preferred the T-System (P <.0005).

CONCLUSION

Use of template-assisted documentation in the ED was associated with higher gross billing and physician satisfaction but no significant decrease in emergency physician total evaluation time.

Pituitary-adrenocortical responses to persistent noxious stimuli in the awake rat: endogenous corticosterone does not reduce nociception in the formalin test

Although glucocorticoids inhibit inflammation and are used to treat painful inflammatory rheumatic diseases, the contribution, if any, of endogenous pituitary-adrenocortical activity to the control of pain remains unclear. We report that injection of dilute formalin into the hindpaw not only evokes inflammation and pain-related behavior, but it also increases ACTH and corticosterone to a greater extent than restraint and saline injection alone. This difference was particularly robust during the final periods of pain-related behavior in the formalin test, when the ACTH and corticosterone (B) levels in the restraint/saline control group had returned to normal. These results indicate that formalin-evoked increases in ACTH and B reflect nociceptive input, rather than the stress associated with handling. To test the hypothesis that the formalin-induced increase in corticosterone reduces pain and inflammation, we next evaluated the effect of adrenalectomy (to prevent activation of glucocorticoid receptors) or high-dose dexamethasone (to saturate glucocorticoid receptors) on nociceptive processing in the formalin test. Neither adrenalectomy nor dexamethasone changed behavioral or cardiovascular nociceptive responses. Furthermore, the increases in blood pressure and heart rate produced by formalin may not be mediated by adrenomedullary catecholamine release. In addition, we conclude that the nociceptive component of the formalin stimulus is sufficient to activate the pituitary-adrenocortical system in the awake rat, but that the resulting release of corticosterone does not feed back and reduce nociceptive processing.

Age-related hemispheric asymmetry in object discrimination

Young and elderly observers judged whether two sequentially presented images in either the left or right visual field (LVF or RVF) were the same or different. The two objects depicted were always from the same entry-level category, but could differ only in viewpoint (a "same" trial--observers were instructed to ignore viewpoint changes) and/or in exemplar (a "different" trial). Young observers showed no difference in sensitivity across visual fields. Elderly observers were less sensitive overall than young observers, and were less sensitive to stimuli presented in the LVF-RH than in the RVF-LH. The results of this experiment support the hypothesis that one type of visual cognitive functioning declines with age faster in the right hemisphere than in the left hemisphere.

The limits of social learning: translating analysis into action

In what respects does public-policy making reflect social learning, drawing lessons from previous experiences and from the experiences of governments in other settings? Starting with an examination of the effect of policy legacies on current policy making, I present a process model of social learning embedded within the larger policy-making process resting at the intersection of the nation's constitutional context, technological change, and political influences exogenous to social learning. The model first distinguishes between the structural and the social learning effects of policy legacies. I then conceptually divide social learning into separate streams of substantive learning and situational learning. The effect that each of these has on policy making depends on the relative position of three categories of participants in the policy-making process (experts, organized interests, and politicians), as well as on the scope of the policy issue being considered (ranging from routine change to major reform). This analysis, with reference to recent health care policy making, reveals the full extent to which social learning is often a decidedly political struggle over ideas and information in which advocates promote lessons that severe their specific interests within a given institutional context and political setting. I consider the implications of social learning for understanding likely policy responses to the rise of market forces in health care.

The differential contribution of capsaicin-sensitive afferents to behavioral and cardiovascular measures of brief and persistent nociception and to Fos expression in the formalin test

Intraplantar injection of dilute formalin evokes brief (Phase 1) and persistent (Phase 2) increases in primary afferent activity, pain behavior, and cardiovascular responses, and induces spinal cord Fos-like immunoreactivity (Fos-LI). Although previous studies demonstrated that the destruction of small diameter primary afferents with neonatal capsaicin treatment decrease formalin-evoked nociception, these studies only evaluated behavioral responses, and did not distinguish between Phase 1 and 2. To address these questions, we simultaneously evaluated formalin-evoked pain behavior (flinching of the afflicted paw), cardiovascular responses (heart rate and mean arterial pressure), and lumbar spinal cord Fos expression in control rats and in rats treated with capsaicin (100 mg/kg) one day postpartum. We found that neonatal capsaicin-treated rats, compared to controls, exhibited similar cardiovascular responses and slightly less flinching behavior during Phase 1. During Phase 2, however, capsaicin-treated rats exhibited 59% less flinching and 45% smaller heart rate responses. Also, in capsaicin-treated rats, we counted 59% fewer Fos-labeled neurons in the spinal cord. These results indicate that capsaicin-sensitive afferents contribute to formalin-evoked behavioral and cardiovascular responses and to spinal cord neuronal responses. The differential effect of neonatal capsaicin on nociception during Phase 1 and Phase 2 suggests that sensitization mechanisms during Phase 1 do not contribute to the magnitude of nociceptive responses during Phase 2.

Early nociceptive events influence the temporal profile, but not the magnitude, of the tonic response to subcutaneous formalin: effects with remifentanil

Injection of dilute formalin into the hindpaw produces brief (phase 1) and persistent (phase 2) nociceptive responses in the rat. We recently reported that ongoing peripheral nerve input is required for the expression of behavioral and cardiovascular responses during phase 2. Here we evaluated the contribution of central and peripheral sensitization mechanisms, generated during phase 1, to the magnitude and temporal profile of phase 2. During phase 1, we administered analgesic doses of an ultrashort-acting opioid, remifentanil (i.v. administration from 0-5 min after 5.0% formalin injection), or anesthetic concentrations of halothane (2.1%). Inhibition of phase 1 did not reduce the magnitude of flinching and cardiovascular responses during phase 2, but it did delay their onset and/or termination. Longer remifentanil infusions (0-15 or 0-30 min) produced even longer delays (up to 30 min) in the onset and termination of flinching during phase 2; however, when remifentanil was administered during the early part of phase 2 (15-30 or 15-45 min), it did not prolong the time to termination of phase 2. Continuous infusion (10 mg/kg/hr i.v.) of a peripherally acting opiate antagonist, naloxone methiodide, did not reduce the antinociception produced by remifentanil during phase 1 but almost completely reversed the delay in the onset and termination of phase 2. We conclude that central sensitization mechanisms during phase 1 do not influence the magnitude of phase 2. We also hypothesize that remifentanil interacts with peripheral opioid receptors to impede the formalin-evoked synthesis and/or release of proinflammatory compounds during phase 1 and thus delay phase 2.