Achievement of Target Gain Larger than Unity in an Inertial Fusion Experiment

On December 5, 2022, an indirect drive fusion implosion on the National Ignition Facility (NIF) achieved a target gain G_{target} of 1.5. This is the first laboratory demonstration of exceeding "scientific breakeven" (or G_{target}>1) where 2.05 MJ of 351 nm laser light produced 3.1 MJ of total fusion yield, a result which significantly exceeds the Lawson criterion for fusion ignition as reported in a previous NIF implosion [H. Abu-Shawareb et al. (Indirect Drive ICF Collaboration), Phys. Rev. Lett. 129, 075001 (2022)PRLTAO0031-900710.1103/PhysRevLett.129.075001]. This achievement is the culmination of more than five decades of research and gives proof that laboratory fusion, based on fundamental physics principles, is possible. This Letter reports on the target, laser, design, and experimental advancements that led to this result.

Thinking in Terms of Change over Time: Opportunities and Challenges of Using System Dynamics Models

Understanding the world around us is a growing necessity for the whole public, as citizens are required to make informed decisions in their everyday lives about complex issues. Systems thinking (ST) is a promising approach for developing solutions to various problems that society faces and has been acknowledged as a crosscutting concept that should be integrated across educational science disciplines. However, studies show that engaging students in ST is challenging, especially concerning aspects like change over time and feedback. Using computational system models and a system dynamics approach can support students in overcoming these challenges when making sense of complex phenomena. In this paper, we describe an empirical study that examines how 10th grade students engage in aspects of ST through computational system modeling as part of a Next Generation Science Standards-aligned project-based learning unit on chemical kinetics. We show students' increased capacity to explain the underlying mechanism of the phenomenon in terms of change over time that goes beyond linear causal relationships. However, student models and their accompanying explanations were limited in scope as students did not address feedback mechanisms as part of their modeling and explanations. In addition, we describe specific challenges students encountered when evaluating and revising models. In particular, we show epistemological barriers to fruitful use of real-world data for model revision. Our findings provide insights into the opportunities of a system dynamics approach and the challenges that remain in supporting students to make sense of complex phenomena and nonlinear mechanisms.

Lawson Criterion for Ignition Exceeded in an Inertial Fusion Experiment

For more than half a century, researchers around the world have been engaged in attempts to achieve fusion ignition as a proof of principle of various fusion concepts. Following the Lawson criterion, an ignited plasma is one where the fusion heating power is high enough to overcome all the physical processes that cool the fusion plasma, creating a positive thermodynamic feedback loop with rapidly increasing temperature. In inertially confined fusion, ignition is a state where the fusion plasma can begin "burn propagation" into surrounding cold fuel, enabling the possibility of high energy gain. While "scientific breakeven" (i.e., unity target gain) has not yet been achieved (here target gain is 0.72, 1.37 MJ of fusion for 1.92 MJ of laser energy), this Letter reports the first controlled fusion experiment, using laser indirect drive, on the National Ignition Facility to produce capsule gain (here 5.8) and reach ignition by nine different formulations of the Lawson criterion.

Promoting computational thinking through project-based learning

This paper introduces project-based learning (PBL) features for developing technological, curricular, and pedagogical supports to engage students in computational thinking (CT) through modeling. CT is recognized as the collection of approaches that  involve people in computational problem solving. CT supports students in deconstructing and reformulating a phenomenon such that it can be resolved using an information-processing agent (human or machine) to reach a scientifically appropriate explanation of a phenomenon. PBL allows students to learn by doing, to apply ideas, figure out how phenomena occur and solve challenging, compelling and complex problems. In doing so, students  take part in authentic science practices similar to those of professionals in science or engineering, such as computational thinking. This paper includes 1) CT and its associated aspects, 2) The foundation of PBL, 3) PBL design features to support CT through modeling, and 4) a curriculum example and associated student models to illustrate how particular design features can be used for developing high school physical science materials, such as an evaporative cooling unit to promote the teaching and learning of CT.

Molecular detection of Streptococcus equi subspecies equi in face flies (Musca autumnalis) collected during a strangles outbreak on a Thoroughbred farm

The objective of this study was to detect Streptococcus equi subspecies equi (S. equi) (Lactobacillales: Streptococcaceae) using quantitative polymerase chain reaction (qPCR) in flies collected from a farm with a documented outbreak of strangles. A total of 1856 face flies [Musca autumnalis (Diptera: Muscidae)] were collected using conventional fly traps. The flies were processed for nucleic acid purification and tested for the presence of S. equi by qPCR. A total of 10/1856 flies (0.54%) tested qPCR-positive for S. equi. The results may implicate the presence of face flies as a risk factor for the transmission of S. equi and highlight the need to institute proper husbandry measures, biosecurity protocols and fly control in order to reduce the potential for infection in at-risk horses.

Constraints on cosmic strings from the LIGO-Virgo gravitational-wave detectors

Cosmic strings can give rise to a large variety of interesting astrophysical phenomena. Among them, powerful bursts of gravitational waves (GWs) produced by cusps are a promising observational signature. In this Letter we present a search for GWs from cosmic string cusps in data collected by the LIGO and Virgo gravitational wave detectors between 2005 and 2010, with over 625 days of live time. We find no evidence of GW signals from cosmic strings. From this result, we derive new constraints on cosmic string parameters, which complement and improve existing limits from previous searches for a stochastic background of GWs from cosmic microwave background measurements and pulsar timing data. In particular, if the size of loops is given by the gravitational backreaction scale, we place upper limits on the string tension Gμ below 10(-8) in some regions of the cosmic string parameter space.

Thyroid hormone signaling and homeostasis during aging

Studies in humans and in animal models show negative correlations between thyroid hormone (TH) levels and longevity. TH signaling is implicated in maintaining and integrating metabolic homeostasis at multiple levels, notably centrally in the hypothalamus but also in peripheral tissues. The question is thus raised of how TH signaling is modulated during aging in different tissues. Classically, TH actions on mitochondria and heat production are obvious candidates to link negative effects of TH to aging. Mitochondrial effects of excess TH include reactive oxygen species and DNA damage, 2 factors often considered as aging accelerators. Inversely, caloric restriction, which can retard aging from nematodes to primates, causes a rapid reduction of circulating TH, reducing metabolism in birds and mammals. However, many other factors could link TH to aging, and it is these potentially subtler and less explored areas that are highlighted here. For example, effects of TH on membrane composition, inflammatory responses, stem cell renewal and synchronization of physiological responses to light could each contribute to TH regulation of maintenance of homeostasis during aging. We propose the hypothesis that constraints on TH signaling at certain life stages, notably during maturity, are advantageous for optimal aging.

Investigation of Sidewall Recombination in GaN Using a Quantum Well Probe

In this study, we use a quantum well (QW) probe structure to explore the size dependent effects of sidewall recombination in GaN. Mesas 0.8-7 μm in width with pitches of 4 μm, 8 μm, and 12 μm were etched into the QW probe structure, exposing the QW at the sidewalls. Several etch conditions were investigated. Room temperature photoluminescence (PL) measurements, using a He-Cd laser as an excitation source and laser spot size of approximately 230 μm, were taken before and after the mesas were etched. The effects of sidewall formation were quantified by comparing the maximum PL intensity of the QW before and after etch. Higher remaining PL intensity was observed for etch conditions which used both Ar ions and Cl2 gas instead of only Ar ions. The fraction of remaining PL decreased with decreasing mesa width, however the remaining PL intensity was relatively large even for small features. The preliminary data suggested that GaN is relatively insensitive to sidewall damage.

The evolution of the pathway and its role in improving patient care

OBJECTIVES

Redesign in healthcare has increased the focus on the needs of the patient. The redesign process typically involves a review of current practice using the patient pathway before considering possible improvements. The patient pathway can serve various roles, and it may be mapped in different ways using a variety of media. This paper reviews the evolution of the patient pathway comparing the merits of different media.

METHODS

Simple approaches to mapping pathways can be most useful. However, experience in the redesign of Unscheduled Care in NHS Fife suggests that computer-based, hierarchical pathway models using stylised icons offer many advantages.

RESULTS AND CONCLUSIONS

Such approaches can increase the effectiveness of pathways in the redesign process, providing both the detail and the system view in an accessible graphical form. This enhanced capability helps staff analyse current practice and visualise and assess redesign options. In addition, the pathway can fulfil new roles as a training tool and an effective basis for organising knowledge about patient care.

Differential changes in brain-derived neurotrophic factor and extracellular signal-regulated kinase in rat primary afferent pathways with colitis

Brain-derived neurotrophic factor (BDNF) has been postulated to participate in inflammation-induced visceral hypersensitivity by modulating the sensitivity of visceral afferents through the activation of intracellular signalling pathways such as the extracellular signal-regulated kinase (ERK) pathway. In the current study, we assessed the expression levels of BDNF and phospho-ERK in lumbosacral dorsal root ganglia (DRG) and spinal cord before and during tri-nitrobenzene sulfonic acid (TNBS)-induced colitis in rats with real-time PCR, ELISA, western blot and immunohistochemical techniques. BDNF mRNA and protein levels were increased in L1 and S1 but not L6 DRG when compared with control (L1: two- to five-fold increases, P < 0.05; S1: two- to three-fold increases, P < 0.05); however, BDNF protein but not mRNA level was increased in L1 and S1 spinal cord when compared with control. In parallel, TNBS colitis significantly induced phospho-ERK1/2 expression in L1 (four- to five-fold, P < 0.05) and S1 (two- to three-fold, P < 0.05) but not in L6 spinal cord levels. Immunohistochemistry results showed that the increase in phospho-ERK1/2 expression occurred at the region of the superficial dorsal horn and grey commisure of the spinal cord. In contrast, there was no change in phospho-ERK5 in any level of the spinal cord examined during colitis. The regional and time-specific changes in the levels of BDNF mRNA, protein and phospho-ERK with colitis may be a result of increased transcription of BDNF in DRG and anterograde transport of BDNF from DRG to spinal cord where it activates intracellular signalling molecules such as ERK1/2.

Epitaxially-grown Ge/Si avalanche photodiodes for 1.3 microm light detection

We designed and fabricated Ge/Si avalanche photodiodes grown on silicon substrates. The mesa-type photodiodes exhibit a responsivity at 1310 nm of 0.54 A/W, a breakdown voltage thermal coefficient of 0.05%/ degrees C, a 3 dB-bandwidth of 10 GHz. The gain-bandwidth product was measured as 153 GHz. The effective k value extracted from the excess noise factor was 0.1.

A surreptitious sinister sarcoma

Angiosarcoma is an exceedingly rare endothelial-derived sarcoma that, when seen, usually presents as an expanding bruise-like patch or violaceous papule/nodule on the head of an elderly patient. Herein, we present the histologic features of an unusual case that defied initial diagnosis.

An evaluation of the use of remotely sensed parameters for prediction of incidence and risk associated with Vibrio parahaemolyticus in Gulf Coast oysters (Crassostrea virginica)

The U.S. Food and Drug Administration recently published a Vibrio parahaemolyticus risk assessment for consumption of raw oysters that predicts V. parahaemolyticus densities at harvest based on water temperature. We retrospectively compared archived remotely sensed measurements (sea surface temperature, chlorophyll, and turbidity) with previously published data from an environmental study of V. parahaemolyticus in Alabama oysters to assess the utility of the former data for predicting V. parahaemolyticus densities in oysters. Remotely sensed sea surface temperature correlated well with previous in situ measurements (R(2) = 0.86) of bottom water temperature, supporting the notion that remotely sensed sea surface temperature data are a sufficiently accurate substitute for direct measurement. Turbidity and chlorophyll levels were not determined in the previous study, but in comparison with the V. parahaemolyticus data, remotely sensed values for these parameters may explain some of the variation in V. parahaemolyticus levels. More accurate determination of these effects and the temporal and spatial variability of these parameters may further improve the accuracy of prediction models. To illustrate the utility of remotely sensed data as a basis for risk management, predictions based on the U.S. Food and Drug Administration V. parahaemolyticus risk assessment model were integrated with remotely sensed sea surface temperature data to display graphically variations in V. parahaemolyticus density in oysters associated with spatial variations in water temperature. We believe images such as these could be posted in near real time, and that the availability of such information in a user-friendly format could be the basis for timely and informed risk management decisions.

Comparison of girth materials, girth tensions and their effects on performance in racehorses

OBJECTIVE

To compare the effect of girth materials and commonly used girth tensions on athletic performance of race-horses and to test the length tension properties of commercially available girths.

PROCEDURE

Seven horses were exercised at speeds to produce 95% of maximal heart rates on 15 occasions using a randomised block design, and girthed with 5 different girths at 3 nominal tensions of 6, 12 or 18 kg. The girths used were a standard elastic race girth, an 'American' elastic race girth, an elastic race girth twice the normal width, a standard canvas race girth and a canvas race girth at twice the normal width. Tension in the girth was recorded continuously using an in-line load cell connected to a physiograph. Horses ran to fatigue on a treadmill inclined at 10% slope. Tensions were measured at peak inhalation (T/inh) and exhalation (T/exh), recorded at rest (rest) and during exercise (ex). An analysis of variance was used to compare the mean run to fatigue times (RTFT) between girth types and tensions, multiple pair-wise comparisons were then carried out using Tukey's test where significant differences were found. The length-tension relationships of five commercially available girths for training and racing of Thoroughbred racehorses were studied by the application of standardized weights in series to multiple samples of each type of girth. Measurements were taken in a controlled environment and analysis of variance was used to compare the means for length-tension of each girth type.

RESULTS

The elastic and the 'American' elastic girths produced significantly longer RTFT when compared to the standard canvas girth (P = 0.01 and P = 0.001 respectively). Also girths tensioned at Texhrest 6 kg and Texhrest 12 kg produced significantly longer RTFT than when girthed at Texhrest 18 kg (P = 0.03 and P = 0.08 respectively). There were significant differences between the commercially available girth types at each tension (P < 0.05), but differences were not significant between girths of the same type. Girths with an elastic component reached their peak for maximum extension at 14.5 kg and thereafter their extension declined.

CONCLUSION

The type of girth and the tension at which it is applied affects athletic performance. Lower girth tensions and the use of elastic materials in the girth would appear to optimise performance. However according to this study and our previous study, none of the commercially available girths studied would adequately protect against the potentially detrimental effects of overtightening on athletic performance.

Interaction of saddle girth construction and tension on respiratory mechanics and gas exchange during supramaximal treadmill exercise in horses

OBJECTIVE

To determine the effect of girth construction and tension on respiratory mechanics and gas exchange during supramaximal treadmill exercise in horses.

METHODS

Six healthy detrained Thoroughbred horses were exercised on a treadmill inclined at 10% at 110% VO2max. Horses were instrumented for respiratory mechanics and gas exchange studies, and data were recorded during incremental exercise tests. The animals were exercised for 2 min at 40% VO2max, and samples and measurements were collected at 1 min 45 sec. After 2 min, speed was increased to that estimated at 110% VO2max and data was collected at 45 sec, 90 sec and every 30 sec thereafter at this speed until the horses fatigued. Horses were run on three occasions with the same racing saddle and saddle packing but using two different girths, either an elastic girth (EG) or a standard canvas girth (SCG) which is nonelastic. A run with 5 kg tension applied to a standard canvas girth was the control for each horse, with additional runs at 15 kg using either the standard canvas girth or using the elastic girth. The runs were randomised and tensions applied were measured at end exhalation whilst at rest.

RESULTS

Increasing girth tension was not associated with changes in respiratory mechanical or gas exchange properties. Although girths tightened to 15 kg tension had short run to fatigue times this was not found to be significantly different to girths set at 5 kg resting tension. Girth tensions declined at end exhalation in horses nearing fatigue.

CONCLUSIONS

Loss in performance associated with high girth tensions is not due to alteration of respiratory mechanics. Loss in performance may be related to inspiratory muscles working at suboptimal lengths due to thoracic compression or compression of musculature around the chest. However, these changes are not reflected in altered respiratory mechanical or gas exchange properties measured during tidal breathing during supramaximal exercise. Other factors may hasten the onset of fatigue when horses exercise with tight girths and further studies are required to determine why excessively tight girths affect performance.

Real-time PCR quantification of Vibrio parahaemolyticus in oysters using an alternative matrix

This study examined the relationship between levels of total Vibrio parahaemolyticus found in oyster tissues and mantle fluid with the goal of using mantle fluid as a template matrix in a new quantitative real-time PCR assay targeting the thermolabile hemolysin (tlh) gene for the enumeration of total V. parahaemolyticus in oysters. Oysters were collected near Mobile Bay, Ala., in June, July, and September and tested immediately after collection and storage at 26 degrees C for 24 h. Initial experiments using DNA colony hybridization targeting tlh demonstrated that natural V. parahaemolyticus levels in the mantle fluid of individual oysters were strongly correlated (r = 0.85, P < 0.05) with the levels found in their tissues. When known quantities of cultured V. parahaemolyticus cells were added to real-time PCR reactions that contained mantle fluid and oyster tissue matrices separately pooled from multiple oysters, a strong linear correlation was observed between the real-time PCR cycle threshold and the log concentration of cells inoculated into each PCR reaction (mantle fluid: r = 0.98, P < 0.05; and oyster: r = 0.99, P < 0.05). However, the mantle fluid exhibited less inhibition of the PCR amplification than the homogenized oyster tissue. Analysis of natural V. parahaemolyticus populations in mantle fluids using both colony hybridization and real-time PCR demonstrated a significant (P < 0.05) but reduced correlation (r = -0.48) between the two methods. Reductions in the efficiency of the real-time PCR that resulted from low population densities of V. parahaemolyticus and PCR inhibitors present in the mantle fluid of some oysters (with significant oyster-to-oyster variation) contributed to the reduction in correlation between the methods that was observed when testing natural V. parahaemolyticus populations. The V. parahaemolyticus-specific real-time PCR assay used for this study could estimate elevated V. parahaemolyticus levels in oyster mantle fluid within 1 h from sampling time.

Oyster-to-oyster variability in levels of Vibrio parahaemolyticus

This study examined the variability in the levels of total and pathogenic Vibrio parahaemolyticus in individual oysters. Twenty oysters were collected on three occasions (in June, July, and September 2001) from a site near Mobile Bay, Ala. Ten of these oysters were tested immediately, and 10 were tested after 24 h of storage at 26 degrees C. Levels of total and pathogenic V. parahaemolyticus were determined by alkaline phosphatase-labeled DNA probe procedures targeting the thermolabile hemolysin and thermostable direct hemolysin genes, respectively. Similar V. parahaemolyticus levels (200 to 2,000 CFU/g) were found in nearly 90% of the oysters (for all sampling occasions) prior to storage. The log-transformed densities (means +/- standard deviations) of V. parahaemolyticus in oysters immediately after harvest were 2.90 +/- 0.91, 2.88 +/- 0.36, and 2.47 +/- 0.26 log10 CFU/g for June, July, and September, respectively. After storage for 24 h at 26 degrees C, the mean V. parahaemolyticus densities increased approximately 13- to 26-fold. Before storage, pathogenic V. parahaemolyticus was detected in 40% (10 to 20 CFU/g) of the oysters collected in June and July but was not detected in any oysters collected in September. After storage, pathogenic V. parahaemolyticus was detected in some oysters at levels of > 100 CFU/g. These data should aid in the development of sampling protocols for oyster monitoring programs and in the determination of exposure distributions associated with raw oyster consumption.

Growth and survival of Vibrio parahaemolyticus in postharvest American oysters

Oysters at the retail stage of distribution generally contain greater densities of Vibrio parahaemolyticus than do oysters at harvest. The objective of this study was to determine the effects of postharvest storage at 26 and 3 degrees C on the growth and survival of naturally occurring V. parahaemolyticus in shellstock American oysters (Crassostrea virginica). Oysters were collected monthly from May 1998 through April 1999 from Mobile Bay, Alabama, and their V. parahaemolyticus densities were determined after 0, 5, 10, and 24 h of postharvest storage at 26 degrees C. After 24 h of storage at 26 degrees C, oysters were transferred to a refrigerator at 3 degrees C and analyzed 14 to 17 days later. V. parahaemolyticus numbers were determined by a direct plating method involving an alkaline-phosphatase-labeled DNA probe that targets the species-specific thermolabile hemolysin gene (tlh-AP) to identify suspect isolates. From April to December, when water temperatures at harvest were >20 degrees C, the geometric mean harvest density of V. parahaemolyticus was 130 CFU/g. When water temperatures were <20 degrees C, the geometric mean harvest density was 15 CFU/g. After harvest, V. parahaemolyticus multiplied rapidly in live oysters held at 26 degrees C, showing a 50-fold increase (1.7 log CFU/g) at 10 h and a 790-fold increase (2.9 log CFU/g) at 24 h (April through December). Average V. parahaemolyticus numbers showed a sixfold decrease (0.8 log CFU/g) after approximately 14 days of refrigeration. These results indicate that V. parahaemolyticus can grow rapidly in unrefrigerated oysters.

Organisational implications of concentration orthopaedic services

The re-organisation of the acute health services in 1999 is causing many acute trusts to consider the practical implications of concentrating services. This may be in terms of the complete merger of departments at different units or a less radical policy of the alternation of the responsibility for emergency receiving between units. The benefits may include the opportunity to improve the quality of care by providing more specialist services, more attractive working conditions with a larger pool of specialists providing the on-call rota and enhanced opportunity for training. Economic theory indicates that concentration should lead to economies of scale by greater sharing of fixed overhead costs, whilst statistical theory specifies that concentration should produce a relative decline in the variability of demand. This paper examines the effects of concentration on emergency admissions in an orthopaedic department by means of a series of simulation experiments. It examines the potential economies of scale for theatre utilisation and bed usage associated with increasing the volume of non-elective patients. As the volume of patients increases so the relative variability of demand decreases and the relative demand for emergency operating theatre time declines. Concentration could offer savings on theatre time allocated to trauma patients, but the impact on wards is less significant with concentration having a limited effect on the demand for beds.

Populations of Vibrio parahaemolyticus in retail oysters from Florida using two methods

Vibrio parahaemolyticus is a naturally occurring estuarine bacterium that is often associated with gastroenteritis in humans following consumption of raw molluscan shellfish. A number of studies have investigated the environmental distribution of V. parahaemolyticus, but little is known about the levels of this organism during distribution of oysters or at the point of consumption. Duplicate samples of shellstock oysters were collected monthly (September 1997 to May 1998) from the same four restaurants and three wholesale seafood markets in the Gainesville, Fla. area and analyzed for total V. parahaemolyticus densities using two methods: a standard MPN method (BAM-MPN) and a new direct plating procedure (direct-VPAP). Both methods employed an alkaline phosphatase-labeled DNA probe (VPAP) targeting the species-specific thermolabile hemolysin (tlh) gene to confirm suspect colonies as V. parahaemolyticus. The highest monthly geometric mean V. parahaemolyticus density was observed in October of 1997 (approximately 3,000/g) with similarly high values during September and November of 1997. From December 1997 to May 1998 mean densities were generally less than 100/g, falling to approximately 10/g in February and March. A strong correlation (r = 0.78) between the direct-VPAP and BAM-MPN methods for determining V. parahaemolyticus densities in market-level oysters was observed. The direct-VPAP method was more rapid and precise while the BAM-MPN was more sensitive and may better recover stressed cells. The utilization of the VPAP probe for identification of V. parahaemolyticus sharply reduced the labor for either method compared to biochemical identification techniques used in earlier V. parahaemolyticus surveys.

MSH-MLH complexes formed at a DNA mismatch are disrupted by the PCNA sliding clamp

In the yeast Saccharomyces cerevisiae, mismatch repair (MMR) is initiated by the binding of heterodimeric MutS homolog (MSH) complexes to mismatches that include single nucleotide and loop insertion/deletion mispairs. In in vitro experiments, the mismatch binding specificity of the MSH2-MSH6 heterodimer is eliminated if ATP is present. However, addition of the MutL homolog complex MLH1-PMS1 to binding reactions containing MSH2-MSH6, ATP, and mismatched substrate results in the formation of a stable ternary complex. The stability of this complex suggests that it represents an intermediate in MMR that is subsequently acted upon by other MMR factors. In support of this idea, we found that the replication processivity factor proliferating cell nuclear antigen (PCNA), which plays a critical role in MMR at step(s) prior to DNA resynthesis, disrupted preformed ternary complexes. These observations, in conjunction with experiments performed with streptavidin end-blocked mismatch substrates, suggested that PCNA interacts with an MSH-MLH complex formed on DNA mispairs.

The pitfalls of transthoracic echocardiography. A case of eustachian valve endocarditis

A case of infective endocarditis involving the vestigial eustachian valve is presented and the available English medical literature is reviewed. Only 5 prior cases have been reported: 4 of those required transesophageal echocardiography for diagnosis, and the other was found at autopsy. This clinical entity is routinely missed on transthoracic echocardiography. Injection drug use is a common predisposing factor, and Staphylococcus aureus is the most commonly identified organism. This report broadens the differential diagnosis of endovascular infections in injection drug users and highlights the importance of transesophageal echocardiography for diagnosis in selected patients.

Environmental investigations of Vibrio parahaemolyticus in oysters after outbreaks in Washington, Texas, and New York (1997 and 1998)

Total Vibrio parahaemolyticus densities and the occurrence of pathogenic strains in shellfish were determined following outbreaks in Washington, Texas, and New York. Recently developed nonradioactive DNA probes were utilized for the first time for direct enumeration of V. parahaemolyticus in environmental shellfish samples. V. parahaemolyticus was prevalent in oysters from Puget Sound, Wash.; Galveston Bay, Tex.; and Long Island Sound, N.Y., in the weeks following shellfish-associated outbreaks linked to these areas. However, only two samples (one each from Washington and Texas) were found to harbor total V. parahaemolyticus densities exceeding the level of concern of 10,000 g(-1). Pathogenic strains, defined as those hybridizing with tdh and/or trh probes, were detected in a few samples, mostly Puget Sound oysters, and at low densities (usually <10 g(-1)). Intensive sampling in Galveston Bay demonstrated relatively constant water temperature (27.8 to 31.7 degrees C) and V. parahaemolyticus levels (100 to 1,000 g(-1)) during the summer. Salinity varied from 14.9 to 29.3 ppt. A slight but significant (P < 0.05) negative correlation (-0.25) was observed between V. parahaemolyticus density and salinity. Based on our data, findings of more than 10,000 g(-1) total V. parahaemolyticus or >10 g(-1) tdh- and/or trh-positive V. parahaemolyticus in environmental oysters should be considered extraordinary.

Analysis of yeast MSH2-MSH6 suggests that the initiation of mismatch repair can be separated into discrete steps

The yeast MSH2-MSH6 complex is required to repair both base-pair and single base insertion/deletion mismatches. MSH2-MSH6 binds to mismatch substrates and displays an ATPase activity that is modulated by mispairs that are repaired in vivo. To understand early steps in mismatch repair, we analyzed mismatch repair (MMR) defective MSH2-msh6-F337A and MSH2-msh6-340 complexes that contained amino acid substitutions in the MSH6 mismatch recognition domain. While both heterodimers were defective in forming stable complexes with mismatch substrates, only MSH2-msh6-340 bound to homoduplex DNA with an affinity that was similar to that observed for MSH2-MSH6. Additional analyses suggested that stable binding to a mispair is not sufficient to initiate recruitment of downstream repair factors. Previously, we observed that MSH2-MSH6 forms a stable complex with a palindromic insertion mismatch that escapes correction by MMR in vivo. Here we show that this binding is not accompanied by either a modulation in MSH2-MSH6 ATPase activity or an ATP-dependent recruitment of the MLH1-PMS1 complex. Together, these observations suggest that early stages in MMR can be divided into distinct recognition, stable binding, and downstream factor recruitment steps.

Band-shaped and whorled microcystic dystrophy of the corneal epithelium

OBJECTIVE

To report the clinical, histopathologic, and electron microscopic features of band-shaped and whorled microcystic corneal epithelial dystrophy.

DESIGN

Two interventional case reports.

PARTICIPANTS

Two patients, two eyes.

INTERVENTION

The involved area of corneal epithelium was scraped from each cornea.

RESULTS

Histopathologic examination showed microscopic vacuoles in the epithelial cytoplasm in both cases. Electron microscopic examination revealed mainly empty cytoplasmic vacuoles with scant nonspecific osmophilic material. The process recurred clinically in one patient. Changes in corneal topography are documented in one patient.

CONCLUSION

Clinical findings and pathologic studies seem nearly identical to those in the original report. No pattern of systemic disorder or medication use was found. The cause of this condition remains unknown.

Gut focused behavioural treatment (biofeedback) for constipation and faecal incontinence in multiple sclerosis

OBJECTIVES

To determine whether gut focused behavioural treatment (biofeedback) is a useful therapy in multiple sclerosis patients referred for constipation, incontinence, or a combination of these symptoms. Most patients with multiple sclerosis complain of constipation, faecal incontinence, or a combination of the two. Patients rate these bowel symptoms as having a major impact on their life. Until now the management of these problems has been empirical, with a lack of evaluated therapeutic regimes.

METHODS

Thirteen patients (eight women, median age 38 years, median duration of multiple sclerosis 10 years) complaining of constipation, with or without faecal incontinence underwent a median of four sessions of behavioural treatment. Anorectal physiological tests were performed before therapy. Impairment and disability were rated with the Kurtzke score and the Cambridge multiple sclerosis basic score (CAMBS). Patients were contacted a median of 14 months after completion of treatment.

RESULTS

A beneficial effect was attributed to biofeedback in five patients. Mild to moderate disability, quiescent and non-relapsing disease, and absence of progression of multiple sclerosis over the year before biofeedback were predictive of symptom improvement. No physiological test predicted the response to therapy.

CONCLUSION

Biofeedback retraining is an effective treatment in some patients with multiple sclerosis complaining of constipation or faecal incontinence. A response is more likely in patients with limited disability and a non-progressive disease course.

Tensions used on girths on thoroughbred racehorses

OBJECTIVE

To determine commonly used girth tensions in Thoroughbred racehorses in the Melbourne metropolitan area.

DESIGN

A prospective industry survey.

METHODS

Strappers were instructed to tension girths, using the same saddle, under-saddle packing and girth, sufficiently to hold the saddle for racing. These tensions were continuously recorded by an in-line load cell in the girth. Seventeen strappers from five stables participated in the study, which was conducted on 91 horses.

RESULTS

Resting girth tensions varied considerably. The mean tension on inhalation was 13 +/- 0.4 kg. Male strappers recorded higher tensions than females for all indices measured. Age and girth size of the horse did not significantly influence results.

CONCLUSION

This study confirms that there is no standard for application of a girth and saddle in the Thoroughbred racing industry and the range of tensions applied was large. Strappers were unable to reliably apply the same tensions between horses. Values recorded at the extremes of the range seem inappropriate for racing conditions as low values would result in slippage of the saddle and higher values may result in girth galls and possible reduction in athletic performance. Further work is necessary to determine the point at which girth tension affects performance.

An outbreak of plague including cases with probable pneumonic infection, Ecuador, 1998

During February and March of 1998, 12 sudden deaths were reported among residents of a high-Andean community in Ecuador. All 12 fatalities were members of the same extended family and some had apparent exposure to sick guinea-pigs. Following an initial investigation by public health officials, an additional death was reported in a nearby community in April, also associated with exposure to sick guinea-pigs. Blood samples from humans, dogs, and a rodent were tested for antibody to the F1 antigen of Yersinia pestis by passive haemagglutination assay. Tissue from rodents was subjected to direct fluorescent antibody staining using fluorescein-labelled monoclonal antibody to Y. pestis F1 antigen. Formalin-fixed specimens from the 2 autopsies were evaluated using a 2-step alkaline phosphatase immunoassay with a monoclonal antibody to Y. pestis F1 antigen, and tissues that had not been embedded in paraffin were tested for the presence of DNA encoding the F1 structural antigen by polymerase chain reaction. Serological evaluation of close contacts of the fatalities revealed positive titres to F1 antigen of Y. pestis, the aetiological agent of plague, in 3 contacts from the first community and 1 from the second. Immunohistochemical staining of tissues collected from 2 of the fatalities provided evidence that both had pneumonic plague. Five of 14 dogs found in the communities were seropositive for plague antibody, providing evidence of a recent epizootic plague in the area.

Behavioural treatment (biofeedback) for constipation following hysterectomy

BACKGROUND

Constipation after hysterectomy has been postulated to be due to pelvic nerve damage, but there may be emotional or reversible physical factors of pathophysiological relevance. The aim of this study was to determine whether such constipation is responsive to behavioural treatment.

METHODS

Three groups of patients who had completed a course of biofeedback treatment were compared: women with no history of abdominal or pelvic surgery (n = 25), women for whom a hysterectomy had led to no change in bowel function (n = 27) and women who stated that their constipation was precipitated (n = 18) or severely worsened (n = 8) by hysterectomy. Pretreatment and post-treatment details about bowel function and symptoms were assessed using structured interview, and pretreatment whole-gut transit time and anorectal physiology testing were assessed for prognostic relevance.

RESULTS

Follow-up after completing treatment was a median of 28 (range 12-44) months. Forty-eight of 78 patients considered that their constipation had improved with treatment; the proportion in each group was similar (P = 0.73). Biofeedback reduced the need to strain, reduced abdominal pain, improved bowel frequency, and reduced laxative use to a similar degree in all three groups. Thirty-three of 53 patients with slow transit considered there was an improvement, compared with 15 of 22 with measured normal transit. Physiological testing did not predict outcome and did not differ between the three groups.

CONCLUSION

The majority of patients complaining of constipation induced or worsened by hysterectomy respond subjectively to behavioural treatment, in a similar proportion to those with idiopathic constipation. In contrast to the widely held view that nerve damage is responsible for symptoms, reversible factors are likely to be important in many patients.

Effects of an Intergenerational Choir for Community-Based Seniors and College Students on Age-Related Attitudes

The purpose of this study was to examine attitudes of college students and senior citizens towards each other by incorporating successful components of a senior citizens' music program into the "Adopt-A-Choir" program established in a university music education/therapy program. Data collection was accomplished using the Age Group Evaluation and Description Inventory (AGED), providing insight into attitudes classified in 4 domains/evaluative scales: Goodness, Positiveness, Vitality, and Maturity. Subjects ware members of the Senior Singers (n = 15, 15) and music education/therapy students enrolled in the Woman's Glee Club at a local university (n = 15, 12). Results of the pre/post AGED survey warn compared using the Wilcoxon Matched Pairs test, with means increasing significantly for the four domains (p <.02). Gains were greatest for the seniors, suggesting a stronger move from negative to positive attitudes. Though the gains were smaller with the university students, all changes were positive, with one exception: in the "vitality" domain, university student attitude ratings decreased on the continuum for "timid-assertive." Informal predictors further suggested the partnership between seniors and university students was enjoyed by both sets of participants.

Historical Genetics: The Parentage of Chardonnay, Gamay, and Other Wine Grapes of Northeastern France

The origins of the classic European wine grapes (Vitis vinifera) have been the subject of much speculation. In a search for parental relationships, microsatellite loci were analyzed in more than 300 grape cultivars. Sixteen wine grapes that have long been grown in northeastern France, including 'Chardonnay', 'Gamay noir', 'Aligoté', and 'Melon', have microsatellite genotypes consistent with their being the progeny of a single pair of parents, 'Pinot' and 'Gouais blanc', both of which were widespread in this region in the Middle Ages. Parentage analysis at 32 microsatellite loci provides statistical support for these relationships.

A mutation in the MSH6 subunit of the Saccharomyces cerevisiae MSH2-MSH6 complex disrupts mismatch recognition

In yeast, MSH2 interacts with MSH6 to repair base pair mismatches and single nucleotide insertion/deletion mismatches and with MSH3 to recognize small loop insertion/deletion mismatches. We identified a msh6 mutation (msh6-F337A) that when overexpressed in wild type strains conferred a defect in both MSH2-MSH6- and MSH2-MSH3-dependent mismatch repair pathways. Genetic analysis suggested that this phenotype was due to msh6-F337A sequestering MSH2 and preventing it from interacting with MSH3 and MSH6. In UV cross-linking, filter binding, and gel retardation assays, the MSH2-msh6-F337A complex displayed a mismatch recognition defect. These observations, in conjunction with ATPase and dissociation rate analysis, suggested that MSH2-msh6-F337A formed an unproductive complex that was unable to stably bind to mismatch DNA.

Neutron reflectivity studies of critical adsorption: the correspondence between a critical adsorption profile and specular neutron reflection

For interfacial order parameter profiles which decay as Az(-mu), such as the composition profile of the noncritical interface of a binary liquid mixture at a critical end point, there is a reported one-to-one correspondence between the profile and the reflectivity which can be described by an analytical theory [S. Dietrich and R. Schack, Phys. Rev. Lett. 58, 140 (1987)]. Evidence for mu=0.53+/-0.02 for adsorption at the hydrophilic silicon/liquid surface of the mixture (2-butoxyethanol+deuterium oxide) near its lower critical end point, determined from neutron reflectivity measurements, is presented. This value is in good agreement with the theoretical prediction of mu=0.516+/-0.004. Further examination of the data permits the determination of the asymptotic surface enrichment scaling factor amplitude P0 approximately 0.11, which is not in agreement with the theoretical value P(0) = 0.94+/-0.05 and values determined by other experimental methods.

Developing culturally sensitive HIV/AIDS and substance abuse prevention curricula for Native American youth

In 1990, researchers and health care professionals joined with members of several southwestern Native American communities to form an HIV/AIDS and substance abuse prevention partnership. Culturally sensitive approaches to theory-based interventions were developed into highly replicable, structured, school-based and community-based intervention programs. Process evaluations indicated high levels of program acceptance and fidelity. Outcome evaluations demonstrated significant positive preventive intervention effects among participants. This article reports how NAPPASA school prevention curricula were developed and discusses three critical processes in developing these successful curricula: 1) selection of integrative theory to address the multi-dimensional antecedents of HIV/AIDS and substance abuse among Native Americans, 2) use of ethnographic methodology to obtain intensive input from target groups and community members to ensure cultural and developmental sensitivity in the curriculum, and 3) use of process and outcome evaluations of pilot and field trials to develop an optimal curriculum.

The pharmacology of GR203040, a novel, potent and selective non-peptide tachykinin NK1 receptor antagonist

1. The in vitro and in vivo pharmacology of GR203040 ((2S, 3S)-2-methoxy-5-tetrazol-1-yl-benzyl-(2-phenyl-piperidin-3-y l)-amine), a novel, highly potent and selective non-peptide tachykinin NK1 receptor antagonist, was investigated in the present study. 2. GR203040 potently inhibited [3H]-substance P binding to human NK1 receptors expressed in Chinese hamster ovary (CHO) and U373 MG astrocytoma cells, and NK1 receptors in ferret and gerbil cortex (pKi values of 10.3, 10.5, 10.1 and 10.1 respectively). GR203040 had lower affinity at rat NK1 receptors (pKi = 8.6) and little affinity for human NK2 receptors (pKi < 5.0) in CHO cells and NK3 receptors in guinea-pig cortex (pKi < 6.0). With the exception of the histamine H1 receptor (pIC50 = 7.5). GR203040 had little affinity (pIC50 < 6.0) at all non-NK1 receptors and ion channels examined. Furthermore, GR203040 produced only weak inhibition of Na+ currents in SH-SY5Y neuroblastoma and superior cervical ganglion cells (pIC50 values < 4.0). GR203040 produced only weak antagonism of Ca(2+)-evoked contractions of rat isolated portal vein (pKn = 4.1). The enantiomer of GR203040, GR205608 (2R, 3R)-2-methoxy-5-tetrazol-1-yl-benzyl-(2-phenyl-piperidin-3-y l)-amine), had 10,000 fold lower affinity at the human NK1 receptor expressed in CHO cells (pKi = 6.3). 3. In gerbil ex vivo binding experiments, GR203040 produced a dose-dependent inhibition of the binding of [3H]-substance P to cerebral cortical membranes (ED50 = 15 micrograms kg-1 s.c. and 0.42 mg kg-1 p.o.). At 10 micrograms kg-1 s.c., the inhibition of [3H]-substance P binding was maintained for > 6 h. In the rat, GR203040 was less potent (ED50 = 15.4 mg kg-1 s.c.) probably reflecting, at least in part, its lower affinity at the rat NK1 receptor. 4. In guinea-pig isolated ileum and dog isolated middle cerebral and basilar arteries, GR203040 produced a rightward displacement of the concentration-effect curves to substance P methyl ester (SPOMe) with suppression of the maximum agonist response (apparent pKB values of 11.9, 11.2 and 11.1 respectively). 5. In anaesthetized rabbits, GR203040 antagonized reductions in carotid arterial vascular resistance evoked by SPOMe, injected via the lingual artery (DR10 (i.e. the dose producing a dose-ratio of 10) = 1.1 micrograms kg-1, i.v.). At a dose 20 fold greater than its DR10 value (i.e. 22 micrograms kg-1, i.v.), significant antagonism was evident more than 2 h after GR203040 administration. 6. In anaesthetized rats, GR203040 (3 and 10 mg kg-1, i.v.) produced a dose-dependent inhibition of plasma protein extravasation in dura mater, conjunctiva, eyelid and lip in response to electrical stimulation of the trigeminal ganglion. 7. It is concluded that GR203040 is one of the most potent and selective NK1 receptor antagonists yet described, and as such, has considerable potential as a pharmacological tool to characterize the physiological and pathological roles of substance P and NK1 receptors. GR203040 may also have potential as a novel therapeutic agent for the treatment of conditions such as migraine, emesis and pain.

Non-specific effects of the tachykinin NK1 receptor antagonist, CP-99,994, in antinociceptive tests in rat, mouse and gerbil

We have examined the antinociceptive activity of the potent and selective tachykinin NK1 receptor antagonist, CP-99,994, and its less active enantiomer, CP-100,263, in a variety of models in rat, mouse and gerbil. Administered systemically to gerbil or mouse CP-99,994 but not CP-100,263 stereo selectively inhibited a caudally directed biting and scratching elicited by intrathecal administration of the tachykinin NK1 receptor agonist, GR73632. In contrast, both CP-99,994 (ED50 = 3 (1-6) mumol.kg-1 s.c.) and CP-100,263 (4 (2-10)), were equipotent at inhibiting acetylcholine-induced abdominal constrictions in mice. Similarly, both enantiomers were also equipotent in reducing formalin-induced licking in gerbil (CP-99,994 (10.1 (5.7-18.6)), CP-100,263 (13.8 (7.8-27.1)) and rat (100 mumol.kg-1 s.c.). Finally, in the spinalised, anaesthetised rat, CP-99,994 dose-dependently and significantly inhibited the flexion reflex evoked by noxious pinch (5.0 (3.3-7.5) mumol.kg-1 i.v.), whereas the less active enantiomer, CP-100,263, was without significant effect when tested up to 30 mumol.kg-1. Our results demonstrate that in the spinal cord, CP-99,994 exhibits a tachykinin NK1 receptor mediated antinociceptive action.

The use of activated clotting times to monitor heparin therapy during and after interventional procedures

Use of the activated clotting time (ACT) was recommended in the mid 1970s to guide administration and reversal of heparin during cardiopulmonary bypass. As the applications of cardiopulmonary bypass spread, so too did the need for more efficient techniques to assess coagulation status. This led to the development of automated ACT measurements. Today, the importance of coagulation and anticoagulation has been further highlighted by recent advances in the field of interventional cardiology. More and more cardiologists are using in-laboratory bedside coagulation monitoring to assess heparin requirements during interventional procedures such as percutaneous transluminal coronary angioplasty (PTCA). This review focuses on the development of anticoagulation monitoring and provides historic information on the clinical use of heparin. The application of ACTs in the catheterization laboratory and in other clinical situations is discussed, along with alternative methods for bedside assessment of coagulation status. No definite guidelines have been established for ACT monitoring during invasive intravascular procedures; thus its role continues to be refined. In the meantime, the ACT appears to be an extremely useful method for monitoring heparin therapy and the adequacy of anticoagulation.

Risk assessment for aflatoxin: an evaluation based on the multistage model

Lifetime cancer potency of aflatoxin was assessed based on the Yeh et al. study from China in which both aflatoxin exposure and hepatitis B prevalence were measured. This study provides the best available information for estimating the carcinogenic risk posed by aflatoxin to the U.S. population. Cancer potency of aflatoxin was estimated using a biologically motivated risk assessment model. The best estimate of aflatoxin potency was 9 (mg/kg/day)-1 for individuals negative for hepatitis B and 230 (mg/kg/day)-1 for individuals positive for hepatitis B.

A double-blind, placebo-controlled trial of sustained-release diltiazem in patients with angina. Sustained-Release Diltiazem Study Group

The efficacy of a new sustained-release formulation of diltiazem was examined in a placebo-controlled, double-blind trial in patients with stable angina. Doses of 60 mg BID, 90 mg BID, 180 mg BID and 240 mg BID were compared with placebo in 208 patients at 3 hours and 12 hours after dosing. Diltiazem, in doses of 90 mg BID and 180 mg BID, was statistically superior to placebo with respect to increasing total exercise time. Treadmill exercise time at 3 hours postdose increased with placebo from 356.1 +/- 118.7 sec to 375.7 +/- 119.8 sec (NS); with 90 mg BID, 382.7 +/- 111.8 sec to 445.4 +/- 117.5 sec (P < 0.005); and with 180 mg BID, 386.8 +/- 145.9 sec to 467.2 +/- 166.2 sec (P < 0.0001). At 12 hours postdose, treadmill exercise time with placebo increased from 357.6 +/- 128.3 sec to 383.8 +/- 128.7 sec (NS); with 90 mg BID, 395.2 +/- 119.4 sec to 449.7 +/- 123.1 sec (P = 0.053); with 180 mg BID, 395.3 +/- 141.4 sec to 476.6 +/- 165.6 sec (P < 0.0001). Time to onset of angina was also increased by the 180-mg-BID dose both at 3 hours postdose (257.3 +/- 126.8 sec to 354.3 +/- 158.7 sec; P < 0.0001) and at 12 hours postdose (274.7 +/- 131.2 sec to 377.4 +/- 186.2 sec; P < 0.0001). Sustained-release diltiazem is effective and safe in treating patients with chronic stable angina.

Preoperative ultrasound and thallium-technetium subtraction scintigraphy in localizing parathyroid lesions in patients with hyperparathyroidism

Clinical and biochemical evaluation of patients with hypercalcemia are today extremely accurate in identifying those with primary hyperparathyroidism. Neck exploration by an experienced parathyroid surgeon is equally likely to identify correctly the diseased gland or glands. It has been suggested that recently devised localization techniques may allow the surgeon to limit the extent of the procedure to one side of the neck. The present retrospective study was undertaken to determine the reliability with which two such imaging procedures, ultrasonography (US) and thallium-technetium subtraction scanning (TTSS) localize these lesions by specific site or side. The identity of each patient undergoing parathyroidectomy at a metropolitan medical center was determined by review of the operating room log. From the records of each subject were noted the results of any imaging studies done, the location of lesions found at surgery, and the histologic diagnosis. Accuracy and positive predictive value of US and TTSS were then calculated on the basis of precise and lateralizing localization. Seventy-four patients underwent primary neck exploration during the study period. In 69 patients US, TTSS, or both were performed preoperatively, and among these, data were complete in 65. Ultrasound correctly localized the site of a lesion in 31 of 63 subjects, and TTSS in 25 of 45. Ultrasound correctly localized the side on which the lesion lay in 35 of 62 subjects, and TTSS in 27 of 45. In 29 of 42, one or both studies correctly identified the side on which the lesion lay. In only one of 13 subjects with hyperplasia were all four glands correctly identified as hyperplastic.(ABSTRACT TRUNCATED AT 250 WORDS)