An online survey capturing the views of stakeholders on primary school food systems across the four UK nations

BACKGROUND

In 2020, the Generating Excellent Nutrition in UK Schools (GENIUS) Network was established to develop an understanding of the school food system across the four UK nations. This study explores stakeholders' views (headteachers, teachers, parents and pupils) on what works well, the challenges, and what an ideal primary school food system includes.

METHODS

An online 'School Food Survey' was created in Qualtrics XM including closed and open-ended questions about the primary school food system. The Qualtrics link was distributed to stakeholders with an interest in school food through key contacts and networks across the four UK nations (21st June to 21st July and September 2021). Responses from the open-ended questions were exported from Qualtrics into Excel and analysed using SPSS. Aspects of qualitative content analysis were applied to summarise, code and quantify responses. Identified codes were entered by stakeholder, for example, parents and their response to the question into a Matrix table to allow identification of categories, themes and interpretation.

RESULTS

A total of 509 participants completed the survey: most participants were from Scotland (n = 281; 55%) and England (n = 213; 42%) and were parents (n = 394). There were some consistent views across stakeholder responses, for example, the range of healthy options, costs, and portion sizes offered to pupils. Parents views varied, with some expressing the range of healthy options worked well and others reporting too many unhealthy choices. The cost of school food and school food funding presented challenges for both parents and schools. For parents, an ideal school food system would include a wide variety of fresh healthy food choices that were made on site, use quality produce, be inclusive for all cultures and diets, and provide food portion sizes appropriate for pupils ages.

CONCLUSIONS

The findings iterate the diversity and some inconsistencies between stakeholders, emphasising the complexity and competing tensions school food systems encounter. Parental involvement and consideration of school-level and national factors are important when identifying challenges, what works well and describing an ideal primary school food system.

Regulatory mechanisms to create healthier environments: planning appeals and hot food takeaways in England

AIMS

To explore existing regulatory mechanisms to restrict hot food takeaway (HFT) outlets through further understanding processes at local and national levels.

METHODS

The Planning Appeals Portal was utilised to identify recent HFT appeal cases across England between December 2016 and March 2020. Eight case study sites were identified using a purposive sampling technique and interviews carried out with 12 professionals involved in planning and health to explore perceptions of and including factors that may impact on the HFT appeal process. Additionally, documents applicable to each case were analysed and a survey completed by seven Local Authority (LA) health professionals. To confirm findings, interpretation meetings were conducted with participants and a wider group of planning and public health professionals, including a representative from the Planning Inspectorate.

RESULTS

Eight case study sites were identified, and 12 interviews conducted. Participants perceived that LAs would be better able to work on HFT appeal cases if professionals had a good understanding of the planning process/the application of local planning policy and supplementary planning documents; adequate time and capacity to deal with appeals cases; access to accurate, robust, and up to date information; support and commitment from elected members and senior management; good lines of communication with local groups/communities interested in the appeal; information and resources that are accessible and easy to interpret across professional groups.

CONCLUSIONS

Communication across professional groups appeared to be a key factor in successfully defending decisions. Understanding the impact of takeaway outlets on health and communities in the long term was also important. To create a more robust appeals case and facilitate responsiveness, professionals involved in an appeal should know where to locate current records and statistical data. The enthusiasm of staff and support from senior management/elected officials will play a significant role in driving these agendas forward.

Childhood-Onset Lupus Nephritis in the Childhood Arthritis and Rheumatology Research Alliance Registry: Short-Term Kidney Status and Variation in Care

OBJECTIVE

The goal was to characterize short-term kidney status and describe variation in early care utilization in a multicenter cohort of patients with childhood-onset systemic lupus erythematosus (cSLE) and nephritis.

METHODS

We analyzed previously collected prospective data from North American patients with cSLE with kidney biopsy-proven nephritis enrolled in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry from March 2017 through December 2019. We determined the proportion of patients with abnormal kidney status at the most recent registry visit and applied generalized linear mixed models to identify associated factors. We also calculated frequency of medication use, both during induction and ever recorded.

RESULTS

We identified 222 patients with kidney biopsy-proven nephritis, with 64% class III/IV nephritis on initial biopsy. At the most recent registry visit at median (interquartile range) of 17 (8-29) months from initial kidney biopsy, 58 of 106 patients (55%) with available data had abnormal kidney status. This finding was associated with male sex (odds ratio [OR] 3.88, 95% confidence interval [95% CI] 1.21-12.46) and age at cSLE diagnosis (OR 1.23, 95% CI 1.01-1.49). Patients with class IV nephritis were more likely than class III to receive cyclophosphamide and rituximab during induction. There was substantial variation in mycophenolate, cyclophosphamide, and rituximab ever use patterns across rheumatology centers.

CONCLUSION

In this cohort with predominately class III/IV nephritis, male sex and older age at cSLE diagnosis were associated with abnormal short-term kidney status. We also observed substantial variation in contemporary medication use for pediatric lupus nephritis between pediatric rheumatology centers. Additional studies are needed to better understand the impact of this variation on long-term kidney outcomes.

Intraarticular steroids as DMARD-sparing agents for juvenile idiopathic arthritis flares: Analysis of the Childhood Arthritis and Rheumatology Research Alliance Registry

BACKGROUND

Children with juvenile idiopathic arthritis (JIA) who achieve a drug free remission often experience a flare of their disease requiring either intraarticular steroids (IAS) or systemic treatment with disease modifying anti-rheumatic drugs (DMARDs). IAS offer an opportunity to recapture disease control and avoid exposure to side effects from systemic immunosuppression. We examined a cohort of patients treated with IAS after drug free remission and report the probability of restarting systemic treatment within 12 months.

METHODS

We analyzed a cohort of patients from the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry who received IAS for a flare after a period of drug free remission. Historical factors and clinical characteristics and of the patients including data obtained at the time of treatment were analyzed.

RESULTS

We identified 46 patients who met the inclusion criteria. Of those with follow up data available 49% had restarted systemic treatment 6 months after IAS injection and 70% had restarted systemic treatment at 12 months. The proportion of patients with prior use of a biologic DMARD was the only factor that differed between patients who restarted systemic treatment those who did not, both at 6 months (79% vs 35%, p < 0.01) and 12 months (81% vs 33%, p < 0.05).

CONCLUSION

While IAS are an option for all patients who flare after drug free remission, it may not prevent the need to restart systemic treatment. Prior use of a biologic DMARD may predict lack of success for IAS. Those who previously received methotrexate only, on the other hand, are excellent candidates for IAS.

Social determinants of health influence disease activity and functional disability in Polyarticular Juvenile Idiopathic Arthritis

BACKGROUND

Social determinants of health (SDH) greatly influence outcomes during the first year of treatment in rheumatoid arthritis, a disease similar to polyarticular juvenile idiopathic arthritis (pJIA). We investigated the correlation of community poverty level and other SDH with the persistence of moderate to severe disease activity and functional disability over the first year of treatment in pJIA patients enrolled in the Childhood Arthritis and Rheumatology Research Alliance Registry.

METHODS

In this cohort study, unadjusted and adjusted generalized linear mixed effects models analyzed the effect of community poverty and other SDH on disease activity, using the clinical Juvenile Arthritis Disease Activity Score-10, and disability, using the Child Health Assessment Questionnaire, measured at baseline, 6, and 12 months.

RESULTS

One thousand six hundred eighty-four patients were identified. High community poverty (≥20% living below the federal poverty level) was associated with increased odds of functional disability (OR 1.82, 95% CI 1.28-2.60) but was not statistically significant after adjustment (aOR 1.23, 95% CI 0.81-1.86) and was not associated with increased disease activity. Non-white race/ethnicity was associated with higher disease activity (aOR 2.48, 95% CI: 1.41-4.36). Lower self-reported household income was associated with higher disease activity and persistent functional disability. Public insurance (aOR 1.56, 95% CI 1.06-2.29) and low family education (aOR 1.89, 95% CI 1.14-3.12) was associated with persistent functional disability.

CONCLUSION

High community poverty level was associated with persistent functional disability in unadjusted analysis but not with persistent moderate to high disease activity. Race/ethnicity and other SDH were associated with persistent disease activity and functional disability.

Electrolyte measurements differ between point-of-care and reference analysers in dogs with hypoadrenocorticism

INTRODUCTION

Dogs treated for hypoadrenocorticism are monitored through analysis of their blood electrolytes. This is routinely performed with point-of-care analysers and doses of medications are adjusted based on the results.

OBJECTIVES

To investigate the performance of two point-of-care analysers (IDEXX Catalyst Dx and IDEXX VetStat) against a reference laboratory method for the measurement of blood sodium, potassium and chloride concentrations, as well as sodium: potassium ratios, in dogs diagnosed with and treated for hypoadrenocorticism.

METHODS

Forty-eight dogs were enrolled into a prospective cross-sectional study. Paired blood samples were taken and tested on two point-of-care analysers and at a reference laboratory. Statistical analysis was then performed with Bland-Altman analysis and Passing-Bablok regression. The clinical effects of inaccurate electrolyte analysis were investigated.

RESULTS

In total, 329 samples were tested on the Catalyst analyser, while another 72 samples were tested on the VetStat. Passing-Bablok regression identified both proportional and constant bias for some analytes. There was poor agreement between sodium and chloride concentrations on both analysers. Both analysers tended to give higher results than the reference method for all analytes, except for potassium when measured on the VetStat.

CLINICAL SIGNIFICANCE

There are inherent differences between the electrolyte concentrations measured by these two point-of-care analysers and reference laboratory methods in dogs with hypoadrenocorticism.

Hair nicotine concentration measurement in cats and its relationship to owner-reported environmental tobacco smoke exposure

OBJECTIVES

To investigate the association between hair nicotine concentration in cats and owner-reported exposure to environmental tobacco smoke.

MATERIALS AND METHODS

Owner questionnaires documented exposure. Nicotine was extracted from hair by sonification in methanol followed by hydrophilic interaction chromatography with mass spectrometry. Relationships between hair nicotine concentration and owner-reported exposure were examined using hypothesis-testing statistics and receiver operating characteristic curve analysis.

RESULTS

The hair nicotine concentration of reportedly exposed cats was significantly higher than unexposed cats and groups of cats with different levels of exposure had significantly different median hair nicotine concentrations corresponding to exposure. A hair nicotine concentration of 0·1 ng/mg had a specificity of 98% (95% confidence interval: 83 to 100) and a sensitivity of 69% (95% confidence interval: 54 to 84) for detecting environmental tobacco smoke exposure. Outdoors access, coat colour, urban or rural environment and length of time living with the owner were not obviously associated with hair nicotine concentration.

CLINICAL SIGNIFICANCE

Feline hair nicotine concentration appears strongly associated with owner-reported environmental tobacco smoke exposure. Feline hair nicotine concentration could therefore be used as a biomarker for tobacco smoke exposure, allowing future studies to assess whether exposed cats have an increased risk of specific diseases.

Nanoencapsulation of ABT-737 and camptothecin enhances their clinical potential through synergistic antitumor effects and reduction of systemic toxicity

The simultaneous delivery of multiple cancer drugs in combination therapies to achieve optimal therapeutic effects in patients can be challenging. This study investigated whether co-encapsulation of the BH3-mimetic ABT-737 and the topoisomerase I inhibitor camptothecin (CPT) in PEGylated polymeric nanoparticles (NPs) was a viable strategy for overcoming their clinical limitations and to deliver both compounds at optimal ratios. We found that thrombocytopenia induced by exposure to ABT-737 was diminished through its encapsulation in NPs. Similarly, CPT-associated leukopenia and gastrointestinal toxicity were reduced compared with the administration of free CPT. In addition to the reduction of dose-limiting side effects, the co-encapsulation of both anticancer compounds in a single NP produced synergistic induction of apoptosis in both in vitro and in vivo colorectal cancer models. This strategy may widen the therapeutic window of these and other drugs and may enhance the clinical efficacy of synergistic drug combinations.

Does higher diastolic augmentation predict clinical benefit from enhanced external counterpulsation?: Data from the International EECP Patient Registry (IEPR)

BACKGROUND

Enhanced external counterpulsation (EECP) has been demonstrated to be an effective treatment for stable angina in patients with coronary disease. The hemodynamic effects of EECP are maximized when the ratio of diastolic to systolic pressure area is in the range of 1.5 to 2.0.

HYPOTHESIS

It is hypothesized that patients undergoing EECP who are able to achieve higher diastolic augmentation (DA) ratios may derive greater clinical benefit. This study examines the relationship between the DA ratio and clinical outcomes in patients undergoing EECP.

METHODS

We analyzed demographic, noninvasive hemodynamic, and clinical outcome data on 1,004 patients enrolled in the International EECP Patient Registry (IEPR) for treatment of chronic angina between January 1998 and August 1999. Blood pressure waveforms were recorded from finger plethysmography. Six-month clinical outcomes were obtained by telephone interview.

RESULTS

At the end of EECP treatment, 370 (37%) patients had a higher DA ratio (defined as > or = 1.5) and 634 (63%) had a lower DA ratio (defined as < 1.5). Factors associated with a lower DA ratio included age > or =65 years (p <0.001), female gender (p < 0.001), left ventricular ejection fraction < 35% (p < 0.05), hypertension (p < 0.01), prior coronary bypass surgery (p < 0.01), noncardiac vascular disease (p < 0.001), multivessel disease (p < 0.01), congestive heart failure (p < 0.01), current smoking (p < 0.01), unsuitability for further revascularization (p < 0.001), and higher baseline angina class (p < 0.001). There were no significant differences regarding diabetes mellitus, prior coronary angioplasty, prior myocardial infarction, or antianginal medication use between patients with higher or lower DA ratios. Based on a multiple logistic regression model, independent predictors of a DA ratio < 1.5 at the end of EECP included current smoking (odds ratio 3.3; 95% confidence intervals 2.0-5.4); multivessel disease (1.7; 1.3-2.3); female gender (2.2; 1.7-3.0); no prior EECP (1.9; 1.1-3.3); noncardiac vascular disease (2.3; 1.7-2.9); age > or = 65 years (1.7; 1.4-2.2), and patients not suitable for revascularization (1.6; 1.2-2.0). By the end of therapy, there were no significant differences in myocardial infarction, revascularization rates, or nitroglycerin use with respect to higher DA ratios. At 6-month follow-up, patients with higher DA had a trend toward a greater reduction in angina class compared with those with lower DA (p = 0.069). There was a significantly higher rate of unstable angina and congestive heart failure in the group not achieving higher augmentation (p < 0.05).

CONCLUSIONS

Patients who are younger, male, nonsmoking, and without multivessel coronary or noncardiac vascular disease are most likely to have higher DA with EECP. Patients with higher DA tended to have a greater reduction in angina class at 6-month follow-up compared with those with lower DA ratios. There is evidence that higher DA ratios are associated with improved short- or long-term clinical outcomes, suggesting that clinical benefit from EECP is associated with the magnitude of DA.

Fronto-limbic brain structures in suicidal and non-suicidal female patients with major depressive disorder

Our knowledge about the neurobiology of suicide is limited. It has been proposed that suicidal behavior generally requires biological abnormalities concomitant with the personality trait of impulsivity/aggression, besides an acute psychiatric illness or psychosocial stressor. We investigated fronto-limbic anatomical brain abnormalities in suicidal and non-suicidal adult female patients with unipolar depression. Our sample consisted of seven suicidal unipolar patients, 10 non-suicidal unipolar patients and 17 healthy female comparison subjects. The criterion for suicidality was one or more documented lifetime suicide attempts. A 1.5T GE Signa Imaging System running version Signa 5.4.3 software was used to acquire the magnetic resonance imaging images. All anatomical structures were measured blindly, with the subjects' identities and group assignments masked. We used analysis of covariance with age and intracranial volume as covariates and the Tukey-Kramer procedure to compare suicidal patients, non-suicidal patients and healthy comparison subjects. Suicidal patients had smaller right and left orbitofrontal cortex gray matter volumes compared with healthy comparison subjects. Suicidal patients had larger right amygdala volumes than non-suicidal patients. Abnormalities in the orbitofrontal cortex and amygdala in suicidal patients may impair decision-making and predispose these patients to act more impulsively and to attempt suicide.

Survival of Mycobacterium avium subsp paratuberculosis in amitraz cattle dip fluid

OBJECTIVE

To determine the survival time of Mycobacterium avium subsp paratuberculosis in amitraz-based cattle dip fluid derived from an active dip site in northern New South Wales.

PROCEDURE

Following inoculation of triplicate 5 L containers with faeces (0.5 g/L) from a clinical case of bovine paratuberculosis, samples collected up to 8 weeks after inoculation were examined by conventional and radiometric culture. M a paratuberculosis colonies were enumerated on solid media.

RESULTS AND CONCLUSIONS

M a paratuberculosis survived in amitraz cattle dip fluid for up to 2 weeks, but not 3 weeks. Where 1% of solids in dip fluid is derived from a clinical case of paratuberculosis, dip fluid may contain viable M a paratuberculosis for at least 2 weeks. These findings have implications for the management of cattle dip sites.

Construct validity of Wechsler factor scores

The construct validity of the Verbal Comprehension. Perceptual Organization, and Freedom from Distractibility factor scores was examined in a sample of school-aged referred children. Examination of correlations between factor scores and neuropsychological and achievement tests generally supported the construct validity of the factors. The Verbal Comprehension factor was associated with verbal, quantitative, and concept-formation abilities. The Perceptual Organization factor was related to nonverbal concept formation, tactual performance, and visual attention. The Freedom from Distractibility factor demonstrated a complex pattern of correlations and appeared to reflect a range of abilities including quantitative, language, attentional, and concept formation.

Bias influencing maternal reports of child behaviour and emotional state

BACKGROUND

Previous research has indicated that there may be only a modest degree of agreement between different reporters of a child's behaviour (mental health). This raises the possibility that some descriptions of the child's behaviour may reflect the personal characteristics of the respondent. We examine two potential sources of bias that may influence reports of a child's behaviour/mental health. The first is the mental or emotional impairment of the respondent; the second concerns gender-related expectations of children.

METHODS

Mothers (and their children after the birth) were assessed at first clinic visit, 3-5 days after the birth, then 6 months, 5 years and 14 years after the birth. Some 70% of respondents giving birth remained in the study at the 14-year follow-up, leaving some 5277 cases for this analysis. At the 14-year follow-up, child behaviour (mental health) was assessed using the Child Behaviour Check List and the Youth Self Report. Maternal mental health was determined using the anxiety and depression subscales of the Delusions-Symptoms-States Inventory.

RESULTS

Mothers who were not emotionally impaired reported fewer child behaviour problems than did the children themselves. As the mother's current emotional impairment increased, so her reports of the child's behaviour problems increased, when compared with the child's own reports. Further, mothers attributed more internalising symptoms to female respondents, and more externalising symptoms to male respondents, than did the child respondents themselves.

CONCLUSIONS

Mothers differ systematically from their children when they are reporting their child's behaviour (mental health). The more emotionally impaired the mother, the greater the degree to which she imputes the child to have behaviour problems. Further, female children are attributed to have more internalising behaviours and male children externalising behaviours.

Pharmacological antagonism of the slow-activating delayed rectifying potassium channel (I(Ks)) has no effect on cochlear structure and function in vivo

The experimental class III antiarrhythmic drug, L-768673, prolongs the refractory period of cardiac myocytes by selectively blocking the slow-activating delayed rectifying potassium (I(Ks)) channel. The I(Ks) channel has also been identified in vestibular dark cells and in the marginal cells of the stria vascularis. In the stria vascularis, the I(Ks) channel plays an important role in cochlear homeostasis. Genetic null deletion of the I(Ks) channel in mice and man results in profound hearing loss and cochlear pathology. Therefore, the purpose of the present study was to investigate the effect of L-768673 on the auditory function and cochlear morphology in rats using auditory brainstem-evoked response and light microscopy. Auditory testing was performed one week prior to dosing, following 14 days of administration and 28 days after the completion of dosing. L-768673 (50 or 250 mg/kg/day for 14 days), had no significant effects on auditory function or cochlear morphology. The results of this study suggest that high doses of L-768673 are not toxic to the inner ear of adult rats treated for 14 consecutive days, and that the ototoxic potential of orally administered L-768673 and similar I(Ks)-selective compounds is unlikely at doses within the therapeutic range.

Mothers' mental illness and child behavior problems: cause-effect association or observation bias?

OBJECTIVE

A number of studies have consistently found that a mother's mental health (particularly her level of depression) is a strong predictor of mental health problems experienced by her child(ren). However, the validity of this finding is in doubt because the majority of these studies have relied on maternal reports as indicators of children's behavior.

METHOD

This prospective, longitudinal study examines data on the mental health of the mother from prior to the birth of her child to when the child reaches 14 years of age. Child behavior is measured at 14 years of age using reports from mother and child. Mother and child responses are compared to provide an indication of the possible magnitude of maternal observation bias in the reporting of child behavior problems.

RESULTS

Anxious and/or depressed mothers tend to report more cases of child behavior problems than do their mentally healthy counterparts or children themselves. Differences between mothers and youths in reporting behavior problems appear to be related to the mothers' mental health.

CONCLUSIONS

Current maternal mental health impairment appears to have a substantial effect on the reporting of child behavior problems by the mother, thereby raising questions about the validity of reports of child behavior by persons who are currently emotionally distressed.

Simulation of Horizontal Wells to Mitigate Miscible Solvent Gravity Override in the Virginia Hills Margin

Abstract

Significant incremental recovery can be obtained when vertical sweep is improved in the mature Phase I Miscible Flood area of the Virginia Hills Field. This study advances our knowledge of the gravity override processes operating in this complex carbonate reservoir. Furthermore it shows that horizontal injection wells improve sweep efficiency thereby alleviating the impact of solvent gravity override. As a result of this simulation, a successful horizontal injection well was drilled, with an actual 18 E3m3 incremental oil recovery to date and a predicted 65 E3m3 total incremental oil. The results of this study suggest redevelopment in mature EOR areas is expected to extend the life of the miscible flood and increase overall recovery.

Introduction

Miscible recovery in the Virginia Hills Field Hydrocarbon Miscible Flood (HCMF) project is significantly limited by poor vertical sweep of the solvent within individual layers of the reservoir. A vertically continuous interval within the reef margin (30 m thick) was investigated and shown to have a large bypassed tertiaryoil target. This study demonstrated that recovery could be significantly increased through the use of horizontal solvent injection wells.

To have confidence in the results of the study it was critical to utilize geological and production history data to address the interwell extent of significant heterogeneities. This required complete integration of geological and engineering staff in all phases of the study.

Background

Historical

The Virginia Hills Beaverhill Lake A Pool was discovered in 1957. The field (Figure 1) produces oil from a Mid-Upper Devonian limestone, stromatoporoid build-up.

The field was unitized in 1963 and a waterflood pressure maintenance scheme was implemented. In the late 1980s the patternswere normalized to inverted nine spots and in 1989 a tertiary horizontal hydrocarbon miscible flood project was initiated in the south half of the Pool.

The original oil in place (OOIP) for the pool has been calculated at 59.6 E6m3 by the operator. Cumulative oil production to the end of July 1996 was 22.9 E6m3, or 38.4﹪ of the OOIP. Current oil rates of 1,000 m3/d have fallen from peak rates of 4,400 m3/d. Field average water cut is greater than 90%. Within the EOR area, well spacing is 32 ha., approximately 400 m interwell distance.

Geological

The internal architecture of this limestone reservoir is multilayered and compartmentalized, due to several stages of carbonate accumulation. From the base up these stages are: S1 (equivalent to the regionally extensive Slave Point platform), S2A, S2, S3L, S3U, and S4, (herein called S-units) reaching a total maximum thickness of 150 m. A high energy windward margin exists along the eastern portion of the build-up with superior reservoir quality (an average range of.09 to.12 phi, and 20 to 120 mD permeability). For this study the S3L in the margin area of the build-up was investigated (Figure 1).

Solvent Gravity Override

Solvent gravity override (Figure 2) occurs when there is sufficient time for injected solvent to segregate prior to its withdrawal due to gravity differences and therefore a smaller miscible oil target is swept.

Teratogenic effects of the endothelin receptor antagonist L-753,037 in the rat

The studies presented in this paper were undertaken to investigate the effects of L-753,037, a balanced endothelin receptor antagonist with similar affinity for the ET(A) and ET(B) receptors (Ki = 0.03 to 0.12 nM and 0.1 to 3.33 nM, respectively), when administered to pregnant female rats by oral gavage, on the development, growth, maturation, and reproductive performance of the F1 generation. Following embryonic exposure to L-753,037, profound craniofacial, cardiovascular, and viscerocranial malformations were noted in the F1 generation. All of the affected organs are derived, in part, from cranial neural crest cells predominantly originating from the posterior midbrain through the hindbrain and destined for the pharyngeal arches. In contrast, cranial structures derived from the paraxial mesoderm (i.e., basisphenoid) were of normal shape and size. There were no apparent effects on enteric neural crest cell derivatives. Based on the phenotype of affected fetuses and their similarity to fetuses with gene knockouts of ET-1 or the ET(A) receptor, the observed alterations are considered to be a pharmacologically mediated class effect on cranial neural crest cells. The phenotype observed suggests that ET(A) receptor antagonism may have specific effects on cranial neural crest cell migration and/or proliferation.

The heart rate-corrected QT interval of conscious beagle dogs: a formula based on analysis of covariance

Three frequently used and cited formulas used to rate correct the QT interval (Bazett's, Fridericia's, and Van de Water's) were compared and ranked using a large population-based cohort of beagle dogs (99 males and 99 females). In addition, analysis of covariance was used to derive a flexible method to rate correct the QT.interval for heart rate. The method is flexible in that it utilizes pretest or control data to determine the degree of correction. In addition, it can also be used to evaluate whether treatment alters the association between heart rate and QT. Specifically, pretest QT (unadjusted) and heart rate data were used to estimate coefficients in the linear regression log(QT) = alpha + beta log(HR). The estimated slope (beta) from the pretest data was used to heart rate correct the QT interval in the formula log(QT)ca = log(QT) - beta *[log(HR - log(HRm)]. The term "log(HRm)" is included to standardize QTca to a reference value, either a fixed value or an average heart rate for the data set being analyzed. These formulas were retrospectively compared under a typical toxicity study paradigm with a class III antiarrhythmic agent (L-768,673) that selectively prolongs the QT interval by blocking the slow activating component of the delayed rectifying potassium channel (lks). Based on their ability to dissociate the effects of heart rate on the QT interval, the formulas received the following ranking: Covariate Adjustment (preferred) = Van De Water's > Fridericia's > Bazett's (not recommended). Analysis of covariance based on pretest or control data is preferred for moderate to large studies where there are adequate data for estimation of the slope parameter beta, the investigator does not have sufficient control over HR, or treatment alters the association between HR and the QT interval. Conversely, for smaller studies a fixed rate adjustment formula from the literature (such as Van de Water's or Fridericia's equations) may be preferable since the bias from using a fixed formula is likely to be smaller than the variance resulting from estimating beta from a small sample.

Cerebral laterality, repressive coping, autonomic arousal, and human bonding

Jim Henry wrote extensively about emotional expressive styles, such as alexithymia which is characterized by reduced awareness of one's own or others' feelings and emotions, and their relation to cerebral hemispheric asymmetries. The repressive coping style is a stable individual characteristic, which is marked by reduced and minimized reports of stress coupled with higher levels of autonomic, somatic, and behavioural responsivity. The apparent dissociation between subjective and physiological response may be associated with a functional disconnection between the two cerebral hemispheres and with greater cerebral lateralization. To test this hypothesis, we reexamined data from a study in which emotional and neutral slides were presented unilaterally to the left and right hemisphere. Exposure duration was 200 ms. Subjects were divided into four different coping styles based on their defensiveness and anxiety scores. Repressive copers were the only group to show a significant cardiac response (heart rate deceleration) to emotional material when it was presented to the right but not to the left hemisphere. These findings and the fact that repressive copers have a high need for social approval support Henry's views about the role of the right hemisphere in affiliation and human bonding.