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An experimental flow facility for sustaining a column of nearly isotropic turbulence in air has been developed. Four arrays of synthetic jet actuators are arranged along the walls of a vertical tower, producing a homogeneous region spanning 13 integral length scales in the vertical direction. The isotropy, homogeneity, and various turbulence properties are quantified using optical measurement techniques. At the highest jet power setting, a root-mean-square velocity of 0.73 m/s and a Reynolds number R e λ of 240 are attained. Although the mean flows are not negligible, their contribution to the turbulence kinetic energy production is insignificant, given the small magnitude of the measured Reynolds stress. The flow exhibits a high degree of isotropy when comparing the longitudinal autocorrelation functions, although some anisotropy is observed in the large scales according to the rms velocity ratio, which ranges from 0.90 to 1.33 over the measured regions. Despite these deviations from ideal isotropic turbulence, the experimental design is well-suited for the study of inertial particle agglomeration during gravitational settling. [ABSTRACT FROM AUTHOR]

Summary: A 15‐year‐old Thoroughbred gelding showjumper presented with colic after a history of chronic mild, intermittent colic. He was refractory to medical management. At surgery, he was found to have a 15‐cm intramural mass in the distal jejunum, approximately 3 m orad to the ileum. Histopathology post‐operatively revealed a leiomyoma. Leiomyomas in horses are rare. They have been reported most commonly in the reproductive tract, with other rare reports in the oesophagus and omentum. To the knowledge of the authors, there are no reports of identification and treatment of non‐strangulating obstruction of the jejunum caused by a leiomyoma. The horse recovered from his surgery and went on to compete at the same level of showjumping as previous to the surgery with no further episodes of colic. Based on this report, leiomyoma should be a differential for small intestinal obstruction in the future. [ABSTRACT FROM AUTHOR]

Biological reference materials (RMs) are essential for quality assurance, traceability of measurement results and for method validation. When addressing new measurement questions or emerging regulatory issues, rigorous large-scale CRM production may not be time efficient or economically practical using current production methods. By amending a relatively small matrix batch with a compound(s) of interest at the homogenization step, the National Institute of Standards and Technology (NIST) can create a custom material on an "as-needed" basis and circumvent the time delay inherent in large-batch production, thereby generating a fit-for-purpose, rapid-response RM. Here, Coho salmon (Oncorhynchus kisutch) was cryohomogenized and spiked with an aquaculture antibiotic and antibiotic metabolite. The resultant material was analyzed using liquid chromatography-high resolution tandem mass spectrometry (LC-HRMS/MS) to determine the effectiveness of the amendment technique in a fresh-frozen matrix by assessing homogeneity and accuracy to the target concentration (e.g. mass fraction). Target mass fractions were achieved for both spike components, with RSDs below 5% in replicate measurements of each compound (n = 8). The stability of the spiked compounds was assessed one year post-production and mass fractions were stable, within 1–6% of the initial measurement results, indicating minimal change to the amended analyte concentrations over time. The results support this method as a promising new technique for custom, small-batch RM generation. [ABSTRACT FROM AUTHOR]

Supplemental digital content is available in the text. Objective: Evidence is limited regarding clinical factors associated with ambulation status over the lifespan of individuals with myelomeningocele. We used longitudinal data from the National Spina Bifida Patient Registry to model population-level variation in ambulation over time and hypothesized that effects of clinical factors associated with ambulation would vary by age and motor level. Design: A population-averaged generalized estimating equation was used to estimate the probability of independent ambulation. Model predictors included time (age), race, ethnicity, sex, insurance, and interactions between time, motor level, and the number of orthopedic, noncerebral shunt neurosurgeries, and cerebral shunt neurosurgeries. Results: The study cohort included 5371 participants with myelomeningocele. A change from sacral to low-lumbar motor level initially reduced the odds of independent ambulation (OR = 0.24, 95% CI = 0.15–0.38) but became insignificant with increasing age. Surgery count was associated with decreased odds of independent ambulation (orthopedic: OR = 0.65, 95% CI = 0.50–0.85; noncerebral shunt neurosurgery: OR = 0.65, 95% CI = 0.51–0.84; cerebral shunt: OR = 0.90, 95% CI = 0.83–0.98), with increasing effects seen at lower motor levels. Conclusions: Our findings suggest that effects of several commonly accepted predictors of ambulation status vary with time. As the myelomeningocele population ages, it becomes increasingly important that study design account for this time-varying nature of clinical reality. To Claim CME Credits: Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME Objectives: Upon completion of this article, the reader should be able to: (1) Describe general trends in ambulation status by age in the myelomeningocele population; (2) Recognize the nuances of cause and effect underlying the relationship between surgical intervention and ambulation status; (3) Explain why variation of clinical effect over time within myelomeningocele population matters. Level: Advanced Accreditation: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s) ™. Physicians should only claim credit commensurate with the extent of their participation in the activity. [ABSTRACT FROM AUTHOR]

Three-dimensional (3D), three-component time-averaged velocity fields have been measured within a low-speed centrifugal fan with forward curved (FC) blades. The model investigated is representative of fans commonly used in automotive applications. The flow was analyzed at two Reynolds numbers for the same ratio of blade rotational speed to outlet flow velocity. The flow patterns inside the volute were found to have weak sensitivity to Reynolds number. A pair of counter-rotating vortices evolves circumferentially within the volute with positive and negative helicity in the upper and lower regions, respectively. Measurements have been further extended to capture phase-resolved flow features by synchronizing the data acquisition with the blade passing frequency. The mean flow field through each blade passage is presented including the jet-wake structure extending from the blade and the separation zone on the suction side of the blade leading edge. [ABSTRACT FROM AUTHOR]

The historical trend in the axial dipole is sufficient to reverse the field in less than 2 kyr. Assessing the prospect of an imminent polarity reversal depends on the probability of sustaining the historical trend for long enough to produce a reversal. We use a stochastic model to predict the variability of trends for arbitrary time windows. Our predictions agree well with the trends computed from paleomagnetic models. Applying these predictions to the historical record shows that the current trend is likely due to natural variability. Furthermore, an extrapolation of the current trend for the next 1 to 2 kyr is highly unlikely. Instead, we compute the trend and time window needed to reverse the field with a specified probability. We find that the dipole could reverse in the next 20 kyr with a probability of 2%. Key Points: Statistics of dipole trends depend on the length of the time windowA stochastic model reproduces the statistics of paleomagnetic trendsSustaining the historical trend to produce a polarity transition is unlikely [ABSTRACT FROM AUTHOR]

Abstract: Aims: To identify early clinical predictors of depressive syndrome in people with Type 2 diabetes. Methods: Depressive syndrome was assessed in 325 individuals with Type 2 diabetes 15 years after a baseline assessment, which included information on antidepressant use and depressive symptoms obtained using a quality‐of‐life scale. Follow‐up current and lifetime depressive syndrome were assessed using the nine‐item Patient Health Questionnaire and the Brief Lifetime Depression Scale and taking account of antidepressant use. Analyses were conducted inclusive and exclusive of antidepressant use where Patient Health Questionnaire criteria were not met. Results: At baseline, the participants were aged 57.2±9.3 years and the median (interquartile range) diabetes duration was 2.2 (0.6–6.0) years. After a mean of 14.7±1.1 years’ follow‐up, 81 participants (24.9%) had depressive syndrome (14.8% defined by the Patient Health Questionnaire, 10.2% defined by antidepressants) and 31.4% reported lifetime depression, and in 10.2% of participants this preceded diabetes onset. With logistic regression (inclusive of antidepressants), follow‐up depressive syndrome was negatively associated with education level [odds ratio 0.39 (95% CI 0.20–0.75)] and antidepressant use [odds ratio 0.11 (95% CI 0.03–0.36)] and was positively associated with depression history before diabetes onset [odds ratio 2.79 (95% CI 1.24–6.27)]. In the model exclusive of antidepressants, depressive syndrome was positively associated with baseline depressive symptoms [odds ratio 2.57 (95% CI 1.32–5.03)] and antidepressant use [odds ratio 3.54 (95% CI 1.20–10.42)] and was negatively associated with education level [odds ratio 0.39 (95% CI 0.19–0.81)]. Conclusions: Risk factors for depressive syndrome can be identified early after the onset of Type 2 diabetes. The early presence of depressive symptoms or its treatment and/or history of depression are likely indicators of vulnerability. Early risk stratification for late depressive syndrome is feasible in people with Type 2 diabetes and could assist with depression treatment or prevention. [ABSTRACT FROM AUTHOR]

Aggregation of wetted particles in a turbulent flow is experimentally investigated. The particles settle through nearly isotropic turbulence inside a humid air chamber. The particles are pre-chilled so that wetting occurred even at sub-saturated humidity levels. Aggregates that fall out of the turbulent flow are physically sampled and their size distributions quantified to infer bulk sticking efficiencies at various humidity levels. Optical particle tracking techniques are used to detect individual time-resolved collision events, forming an independent measure of the sticking efficiency parameterized by a collision Stokes number. The two methods are contrasted and the limitations of each are discussed. The data are used to develop a new version of the early Costa sticking model, which is utilized by various volcanic ash transport codes. The key outcome of this work is a generalized Costa sticking model which incorporates the effect of the water film thickness coating the particles. • An experiment is developed to study aggregation of wetted particles in turbulence. • A PTV algorithm capable of detecting time-resolved collision events is demonstrated. • Sticking efficiencies are inferred by both physical sampling and optical detection. • A new sticking efficiency model is developed based on the experimental data. [ABSTRACT FROM AUTHOR]

The last decade has witnessed dramatic improvements in whole-genome sequencing capabilities coupled to drastically decreased costs, leading to an inundation of high-quality de novo genomes. For this reason, the continued development of genome quality metrics is imperative. Using the 2016 Atlantic bottlenose dolphin NCBI RefSeq annotation and mass spectrometry-based proteomic analysis of six tissues, we confirmed 10,402 proteins from 4711 protein groups, constituting nearly one-third of the possible predicted proteins. Since the identification of larger proteins with more identified peptides implies reduced database fragmentation and improved gene annotation accuracy, we propose the metric NP10, which attempts to capture this quality improvement. The NP10 metric is calculated by first stratifying proteomic results by identifying the top decile (or 10th 10-quantile) of identified proteins based on the number of peptides per protein and then returns the median molecular weight of the resulting proteins. When using the 2016 versus 2012 Tursiops truncatus genome annotation to search this proteomic data set, there was a 21% improvement in NP10. This metric was further demonstrated by using a publicly available proteomic data set to compare human genome annotations from 2004, 2013 and 2016, which showed a 33% improvement in NP10. These results demonstrate that proteomics may be a useful metrological tool to benchmark genome accuracy, though there is a need for reference proteomic datasets across species to facilitate the evaluation of new de novo and existing genome. [ABSTRACT FROM AUTHOR]

As columns age and differ between systems, retention times for comprehensive two-dimensional gas chromatography (GCxGC) may vary between runs. To properly analyze GCxGC chromatograms, it often is desirable to align the retention times of chromatographic features, such as analyte peaks, between chromatograms. Previous work by the authors has shown that global, low-degree polynomial transformation functions, namely affine, second-degree polynomial, and third-degree polynomial, are effective for aligning pairs of two-dimensional chromatograms acquired with dual second columns and detectors (GCX2GC). This work assesses the experimental performance of these global methods on more general GCxGC chromatogram pairs and compares their performance to that of a recent, robust, local alignment algorithm for GCxGC data [Gros et al. Anal. Chem. 2012, 84, 9033]. Measuring performance with the root-mean-square (RMS) residual differences in retention times for matched peaks suggests that global, low-degree polynomial transformations outperform the local algorithm given a sufficiently large set of alignment points, and are able to improve misalignment by over 95% based on a lower-bound benchmark of inherent variability. However, with small sets of alignment points, the local method demonstrated lower error rates (although with greater computational overhead). For GCxGC chromatogram pairs with only slight initial misalignment, none of the global or local methods performed well. In some cases with initial misalignment near the inherent variability of the system, these methods worsened alignment, suggesting that it may be better not to perform alignment in such cases. [ABSTRACT FROM AUTHOR]

Quality of life (QOL) has become an important focus of hernia repair outcomes. This study aims to identify factors which lead to ideal outcomes (asymptomatic and without recurrence) in large umbilical hernias (defect size ≥9 cm(2)). Review of the prospective International Hernia Mesh Registry was performed. The Carolinas Comfort Scale was used to measure QOL at 1-, 6-, and 12-month follow-up. Demographics, operative details, complications, and QOL data were evaluated using standard statistical methods. Forty-four large umbilical hernia repairs were analyzed. Demographics included: average age 53.6 ± 12.0 and body mass index 34.9 ± 7.2 kg/m(2). The mean defect size was 21.7 ± 16.9 cm(2), and 72.7 per cent were performed laparoscopically. Complications included hematoma (2.3%), seroma (12.6%), and recurrence (9.1%). Follow-up and ideal outcomes were one month = 28.2 per cent, six months = 42.9 per cent, one year = 55.6 per cent. All patients who remained symptomatic at one and two years were significantly symptomatic before surgery. Symptomatic preoperative activity limitation was a significant predictor of nonideal outcomes at one year (P = 0.02). Symptomatic preoperative pain was associated with nonideal outcomes at one year, though the difference was not statistically significant (P = 0.06). Operative technique, mesh choice, and fixation technique did not impact recurrence or QOL. Repair of umbilical hernia with defects ≥9 cm(2) had a surprising low rate of ideal outcomes (asymptomatic and no recurrence). All patients with nonideal long-term outcomes had preoperative pain and activity limitations. These data may suggest that umbilical hernia should be repaired when they are small and asymptomatic. [ABSTRACT FROM AUTHOR]

Background Most hospitals in the United States are required to provide emergency care to all patients, regardless of insurance status. However, uninsured patients might be unable to access non-acute services, such as post-discharge inpatient care (PDIC). This could result in prolonged acute hospitalization. We tested the hypothesis that insurance status would be independently associated with both PDIC and length of stay (LOS). Methods An observational study was undertaken using the California State Inpatient Database (2007-2011), which captures 98% of patients admitted to hospital in California. All patients with a diagnosis of orthopedic lower limb trauma were identified using International Classification of Diseases, 9th Revision, Clinical Modification codes 820-828. Multivariable logistic and generalized linear regression models were used to adjust odds of PDIC and LOS for patient and hospital characteristics. Results There were 278,573 patients with orthopedic lower limb injuries, 160,828 (57.7%) of which received PDIC. Uninsured patients had lower odds of PDIC (adjusted odds ratio 0.20, 95% confidence interval 0.17-0.24) and significantly longer hospital LOS (predicted mean difference 1.06 [95% confidence interval 0.78-1.34] d) than those with private insurance. Conclusions Lack of health insurance is associated with reduced access to PDIC and prolonged hospital LOS. This potential barrier to hospital discharge could reduce the number of trauma beds available for acutely injured patients. [ABSTRACT FROM AUTHOR]

The article reports on the study that evaluates the impact of concurrent strength and aerobic endurance training on cardiovascular and cardiorespiratory adaptations in college athletes. The study shows that serial concurrent exercise reduces systolic and diastolic blood pressure and produces a trend toward reduced resting heart rate. It reveals that strength and endurance training are compatible for cardiovascular and cardiorespiratory adaptations.

The article reports on the study that evaluates the impact of concurrent strength (CS) and aerobic endurance (AE) training on muscles strength, body composition, and flexibility in female athletes. The study reveals that concurrent exercise (CE) increases lower and upper body muscle strength and trends toward greater lower-body muscle endurance, but reduces upper-body flexibility. It suggests that interference between CS and AE training supports prescription of CE under defined conditions.

We compared delayed-onset muscle soreness (DOMS) induced by anaerobic resistance exercises with and without aerobic cardioacceleration before each set, under the rationale that elevated heart rate (HR) may increase blood perfusion in muscles to limit eccentric contraction damage and/or speed muscle recovery. In two identical experiments (20 men, 28 women), well-conditioned athletes paired by similar physical condition were assigned randomly to experimental or control groups. HR (independent variable) was recorded with HR monitors. DOMS (dependent variable) was self-reported using Borg's Rating of Perceived Pain scale. After identical pretraining strength testing, mean DOMS in the experimental and control groups was indistinguishable (P ≥ 0.19) for musculature employed in eight resistance exercises in both genders, validating the dependent variable. Subjects then trained three times per week for 9 (men) to 11 (women) weeks in a progressive, whole-body, concurrent training protocol. Before each set of resistance exercises, experimental subjects cardioaccelerated briefly (mean HR during resistance training, 63.7% HR reserve), whereas control subjects rested briefly (mean HR, 33.5% HR reserve). Mean DOMS among all muscle groups and workouts was discernibly less in experimental than control groups in men (P = 0.0000019) and women (P = 0.0007); less for each muscle group used in nine resistance exercises in both genders, discernible (P < 0.025) in 15 of 18 comparisons; and less in every workout, discernible (P < 0.05) in 32% (men) and 55% (women) of workouts. Most effect sizes were moderate. In both genders, mean DOMS per workout disappeared by the fourth week of training in experimental but not control groups. Aerobic cardioacceleration immediately before each set of resistance exercises therefore rapidly eliminates DOMS during vigorous progressive resistance training in athletes. [ABSTRACT FROM AUTHOR]

In each sample run, comprehensive two-dimensional gas chromatography with dual secondary columns and detectors (GC x 2GC) provides complementary information in two chromatograms generated by its two detectors. For example, a flame ionization detector (FID) produces data that is especially effective for quantification and a mass spectrometer (MS) produces data that is especially useful for chemical-structure elucidation and compound identification. The greater information capacity of two detectors is most useful for difficult analyses, such as metabolomics, but using the joint information offered by the two complex two-dimensional chromatograms requires data fusion. In the case that the second columns are equivalent but flow conditions vary (e.g., related to the operative pressure of their different detectors), data fusion can be accomplished by aligning the chromatographic data and/or chromatographic features such as peaks and retention-time windows. Chromatographic alignment requires a mapping from the retention times of one chromatogram to the retention times of the other chromatogram. This paper considers general issues and experimental performance for global two-dimensional mapping functions to align pairs of GC x 2GC chromatograms. Experimental results for GC x 2GC with FID and MS for metabolomic analyses of human urine samples suggest that low-degree polynomial mapping functions out-perform affine transformation (as measured by root-mean-square residuals for matched peaks) and achieve performance near a lower-bound benchmark of inherent variability. Third-degree polynomials slightly out-performed second-degree polynomials in these results, but second-degree polynomials performed nearly as well and may be preferred for parametric and computational simplicity as well as robustness. [ABSTRACT FROM AUTHOR]

Type 1 diabetes is associated with increased suicide risk. Data for older diabetic individuals are inconsistent. In longitudinal data from 1413 adults recruited to the Fremantle Diabetes Study from 1993-1996 and 5660 matched non-diabetic residents, followed to end-2012, the age and sex-adjusted sub-hazard ratio (95% confidence interval) for suicide in diabetic versus non-diabetic individuals was 1.16 (0.38-3.51). Older Australians with diabetes are not at increased suicide risk. [ABSTRACT FROM AUTHOR]

Intelligent organisms face a variety of tasks requiring the acquisition of expertise within a specific domain, including the ability to discriminate between a large number of similar patterns. From an energy-efficiency perspective, effective discrimination requires a prudent allocation of neural resources with more frequent patterns and their variants being represented with greater precision. In this work, we demonstrate a biologically plausible means of constructing a single-layer neural network that adaptively (i.e., without supervision) meets this criterion. Specifically, the adaptive algorithm includes synaptogenesis, synaptic shedding, and bi-directional synaptic weight modification to produce a network with outputs (i.e. neural codes) that represent input patterns proportional to the frequency of related patterns. In addition to pattern frequency, the correlational structure of the input environment also affects allocation of neural resources. The combined synaptic modification mechanisms provide an explanation of neuron allocation in the case of self-taught experts. [ABSTRACT FROM AUTHOR]

System architects traditionally use high-level models of component blocks to predict trends for various design metrics. However, with continually increasing design complexity and a confusing array of manufacturing choices, system-level design decisions cannot be made without considering physical-level details. This effect is more pronounced for 3-D integrated circuits (ICs) because it provides a plethora of physical-level design choices, such as the number of stacking layers and the type of 3-D bonding method, along with the choices provided by 2-D ICs. Thus, it is necessary for system-level flows to predict the complex interactions among system performance, power, temperature, floorplanning, process technology, computer architecture, and software/workloads. This is often called pathfinding. This paper presents a pathfinding flow that integrates SystemC transaction-level electrical and dynamic thermal simulations. The goal of this flow is to pass complex physical constraints to system architects in a convenient form. The applicability of the proposed flow is shown using an example stacking of two processor cores and L2 cache in two-tier 3-D stack. [ABSTRACT FROM AUTHOR]

Aims To determine the incidence and predictors of tendon ruptures requiring hospitalization of representative patients with Type 2 diabetes. Methods A total of 1296 patients from the longitudinal observational Fremantle Diabetes Study, Phase I, and 5159 de-identified age- and sex-matched control subjects without diabetes from the same urban area were studied. The patients' mean ( sd) age was 64.0 (11.3) years and 48.6% of them were male. Their median (interquartile range) diabetes duration was 4.0 (1.0-9.0) years. The main outcome assessed was any tendon rupture requiring hospitalization in the Fremantle Diabetes Study subjects and the matched control subjects. Independent predictors of spontaneous ruptures in the patients from the Fremantle Diabetes Study were assessed using Cox proportional hazards modelling. Results The incidence rate ratio for any tendon rupture requiring hospitalization in patients vs control subjects was 1.44 (95% CI 1.10-1.87; P = 0.005). Independent predictors of spontaneous ruptures in patients were BMI [hazard ratio 1.05 (95% CI 1.002-1.10] for 1 kg/m2 increase; P = 0.010] and alcohol consumption [hazard ratio 1.52 (95% CI 1.11-2.09) for √1 standard drink/day increase; P = 0.010]. Adjustment of the incidence rate ratio for overall rupture requiring hospitalization for these variables using the BMI and alcohol consumption data from the contemporary Australian general population suggested it could be as high as 1.84. Conclusions There is a greater risk of tendon rupture requiring hospitalization in people with Type 2 diabetes. Alcohol consumption and adiposity are potentially modifiable risk factors of spontaneous ruptures in patients with diabetes. [ABSTRACT FROM AUTHOR]

Radiochemical neutron activation analysis (RNAA) was used to measure arsenic at four levels in standard reference material (SRM) 955c Toxic Elements in Caprine Blood and at two levels in SRM 2668 Toxic Elements in Frozen Human Urine for the purpose of providing mass concentration values for certification. Samples were freeze-dried prior to analysis followed by neutron irradiation for 3 h at a fluence rate of 1 × 10cm s. After sample dissolution in perchloric and nitric acids, arsenic was separated from the matrix either by retention on hydrated manganese dioxide (urine) or by extraction into zinc diethyldithiocarbamate in chloroform (blood). As was quantified by gamma-ray spectroscopy. Differences in chemical yield and counting geometry between samples and standards were monitored by measuring the count rate of a As tracer added before sample dissolution. RNAA results were combined with inductively coupled plasma-mass spectrometry values from National Institute of Standards and Technology and collaborating laboratories to provide certified values of 10.81 ± 0.54 and 213.1 ± 0.73 μg/L for SRM 2668 Levels I and II, and certified values of 21.66 ± 0.73, 52.7 ± 1.1, and 78.8 ± 4.9 μg/L for SRM 955c Levels II-IV, respectively. Because of discrepancies between values obtained by different methods for SRM 955c Level I, an information value of <5 μg/L was assigned for this material. [ABSTRACT FROM AUTHOR]

New detrital zircon sensitive high-resolution ion microprobe (SHRIMP) geochronology and published framework geology of Neoproterozoic to Silurian strata are integrated to re-examine tectonic models of the Pearya terrane and the Franklinian margin at Ellesmere Island, Arctic Canada. Compared to Cambrian detrital zircon reference spectra, Neoproterozoic sandstones from the Pearya terrane contain Laurentian detrital zircon ages. In fact, they compare very well with Neoproterozoic strata of Greenland. Ultra mafic, tholeiitic, and andesitic basalts of the Maskell Inlet complex, inferred to have an age of ca. 481 Ma, predate the M'Clintock orogeny at ca. 475 Ma. Ordovician granitoid ages within the Pearya terrane span ca. 475-463 Ma. A K-Ar cooling age of 452 Ma records post-tectonic exhumation. Deposited at ca. 450 Ma, new data show that the Cape Discovery Formation contains mainly ca. 500-450 Ma detrital zircon ages, but also older ages of 660-620 Ma. Upper Ordovician sandstones indicate that the Pearya terrane platform continued to receive near-syndepositional zircon. The Pearya terrane platform was submerged at ca. 435 Ma and overlain by Silurian flysch fed by sources similar to detrital zircon within Proterozoic to Ordovician strata of the Pearya terrane. Ties between the Pearya terrane and the Franklinian shelf include: similar Proterozoic-Cambrian stratigraphy; detrital zircon ages from the Lower Cambrian Grantland Formation that appear to be a combination of recycled Marinoan strata of Pearya terrane and Franklinian shelf strata; and profound unconformities on the Franklinian shelf that correlate temporally to the M'Clintock orogeny. A pericratonic model is a straightforward solution to the tectonic history of the Pearya terrane and the Franklinian shelf. We hypothesize that the Pearya terrane was part of the Franklinian margin in the Neoproterozoic and that the intervening deep water basin, or Hazen Trough, originated as a failed rift. The Maskell Inlet complex records ca. 481 Ma volcanism as a response to mantle upwelling beneath a subducting slab, shortly before or as the continent-ocean transition zone of the Franklinian margin was overridden. Continued convergence and crustal thickening during arc-continent collision drove the M'Clintock orogeny at ca. 475 Ma and resulted in the unconformities on the Franklinian shelf. After arc-continent collision, magmatism between ca. 475 and 438 Ma was related to subduction on the outboard margin, and the Pearya terrane was overlain by a low-accommodation retroarc foreland basin. A subsequent collisional event led to progressive drowning of the Pearya terrane and Franklinian platforms between 435 and 425 Ma. Silurian flysch then blanketed the Pearya terrane and entered the axis of the foreland basin, which also received sediment from cratonic sources of the flexural basin margin. Limited deformation at northern Axel Heiberg Island was associated with a ca. 390 Ma granitoid within the Pearya terrane. After a Devonian pulse of subsidence, infilling of the basin to form the Devonian clastic wedge overlapped in age with small ca. 368 Ma granitic intrusions within the Pearya terrane and was followed by extensive foreland deformation of the Late Devonian--Mississippian Ellesmerian orogeny. [ABSTRACT FROM AUTHOR]

Electrolytes in serum are important biomarkers for skeletal and cellular health. The levels of electrolytes are monitored by measuring the Ca, Mg, K, and Na in blood serum. Many reference methods have been developed for the determination of Ca, Mg, and K in clinical measurements; however, isotope dilution thermal ionization mass spectrometry (ID-TIMS) has traditionally been the primary reference method serving as an anchor for traceability and accuracy to these secondary reference methods. The sample matrix must be separated before ID-TIMS measurements, which is a slow and tedious process that hindered the adoption of the technique in routine clinical measurements. We have developed a fast and accurate method for the determination of Ca, Mg, and K in serum by taking advantage of the higher mass resolution capability of the modern sector field inductively coupled plasma mass spectrometry (SF-ICP-MS). Each serum sample was spiked with a mixture containing enriched Ca, Mg, and K, and the Ca:Ca, Mg:Mg, and K:K ratios were measured. The Ca and Mg ratios were measured in medium resolution mode (m/Δm ≈ 4 500), and the K ratio in high resolution mode (m/Δm ≈ 10 000). Residual ArH interference was still observed but the deleterious effects of the interference were minimized by measuring the sample at K > 100 ng g. The interferences of Sr at the two Ca isotopes were less than 0.25 % of the analyte signal, and they were corrected with the Sr intensity by using the Sr:Sr ratio. The sample preparation involved only simple dilutions, and the measurement using this sample preparation approach is known as dilution-and-shoot (DNS). The DNS approach was validated with samples prepared via the traditional acid digestion approach followed by ID-SF-ICP-MS measurement. DNS and digested samples of SRM 956c were measured with ID-SF-ICP-MS for quality assurance, and the results (mean ± expanded uncertainty in mg dL unit) for Ca (DNS = 10.14 ± 0.13, digested = 10.11 ± 0.10), Mg (DNS = 2.093 ± 0.008, digested = 2.098 ± 0.007), and K (DNS = 15.48 ± 0.11, digested = 15.50 ± 0.28) were in good agreement with the certified values (Ca = 10.17 ± 0.06, Mg = 2.084 ± 0.023, K = 15.55 ± 0.13). Major sources of uncertainty are sample measurement, spike calibration, and instrument factor including mass discrimination of the spectrometer and the detector deadtime. [ABSTRACT FROM AUTHOR]

Vitamin D-binding protein (VDBP), a serum transport protein for 25-hydroxyvitamin D [25(OH)D], has three common proteoforms which have co-localized amino acid variations and glycosylation. A monoclonal immunoassay was found to differentially detect VDBP proteoforms and methods using liquid chromatography-tandem mass spectrometry (LC-MS/MS) might be able to overcome this limitation. Previously developed multiple reaction monitoring LC-MS/MS methods for total VDBP quantification represent an opportunity to probe the potential effects of proteoforms on proteolysis, instrument response and quantification accuracy. VDBP was purified from homozygous human donors and quantified using proteolysis or acid hydrolysis and LC-MS/MS. An interlaboratory comparison was performed using pooled human plasma [Standard Reference Material® 1950 (SRM 1950) Metabolites in Frozen Human Plasma] and analyses with different LC-MS/MS methods in two laboratories. Several shared peptides from purified proteoforms were found to give reproducible concentrations [≤2.7% coefficient of variation (CV)] and linear instrument responses (R2≥0.9971) when added to human serum. Total VDBP concentrations from proteolysis or amino acid analysis (AAA) of purified proteoforms had ≤1.92% CV. SRM 1950, containing multiple proteoforms, quantified in two laboratories resulted in total VDBP concentrations with 7.05% CV. VDBP proteoforms were not found to cause bias during quantification by LC-MS/MS, thus demonstrating that a family of proteins can be accurately quantified using shared peptides. A reference value was assigned for total VDBP in SRM 1950, which may be used to standardize methods and improve the accuracy of VDBP quantification in research and clinical samples. [ABSTRACT FROM AUTHOR]

Background Asian migrants represent an expanding proportion of the Australian population and are from a region with an increasing diabetes burden. There are few data detailing the characteristics and outcome of type 2 diabetes in Asian Australians. Aims To determine whether the phenotype and prognosis of Asians with type 2 diabetes differ from those in Anglo- Celt ( AC) patients from the same Australian community. Methods We studied 44 Asian and 796 AC patients from the Fremantle Diabetes Study. Each had a detailed assessment between 1993 and 1996, and was invited to annual reviews for ≥5 years. Data linkage provided additional endpoints to end-2010. Cox proportional hazards modelling was used to determine predictors of cardiovascular disease ( CVD) death and all-cause mortality. Results The prevalence of type 2 diabetes in Asians and the general population in Fremantle was similar (1.5% vs 1.6%; P = 0.60). The Asian patients were younger, less obese and less likely to be hypertensive than the AC subjects, but they had a higher retinopathy prevalence (27.3% vs 13.5%; P = 0.023). During up to 18 years of follow up, 12 Asians and 428 AC patients died, 2 (16.7%) vs 205 (47.9%) from CVD ( P = 0.040). Asian ethnicity was independently protective against CVD death (hazard ratio 0.13 (95% confidence interval: 0.02-0.96); P = 0.046) but not all-cause mortality (hazard ratio 0.58 ( 95% confidence interval: 0.31-1.10); P = 0.10). Conclusions The phenotype of type 2 diabetes in a relatively small group of well-characterised Asian Australians differed from that in AC patients from the same urban community. Their favourable cardiovascular prognosis may reflect a healthy migrant effect. [ABSTRACT FROM AUTHOR]

The edge and scrape-off layer (SOL) region of a tokamak plasma is considered, with emphasis on sheared flow generation and the dynamics of blob-filaments. Both numerical simulations and experimental data analysis are employed. The simulations use the fluid-based two-dimensional (2D) curvature-interchange model embedded in the SOLT code. A blob-tracking algorithm based on 2D time-resolved images from the gas puff imaging diagnostic has also been developed and applied to NSTX, Alcator C-Mod and simulation data. The algorithm is able to track the blob motion and changes in blob structure, such as elliptical deformations, that can be affected by sheared flows. Results of seeded blob simulations and quasi-steady turbulence simulations are compared with the experimental data to determine the role of plasma parameters on the blob tracks and to evaluate the exchange of momentum between the blobs and flows. The simulations are shown to reproduce many qualitative and quantitative features of the data including size, scale-length and direction of perpendicular (approximately poloidal) flows, the inferred Reynolds acceleration and residual stress, poloidal reversal of blob tracks, and blob trapping and/or ejection. Mechanisms related to blob motion, SOL currents and radial inhomogeneity are shown to be sufficient to explain the presence or absence of mean and oscillating zonal sheared flows in selected shots. [ABSTRACT FROM AUTHOR]

Diabetes is a risk factor for dementia, but relatively little is known about the epidemiology of the association. A retrospective population study using Western Australian hospital inpatient, mental health outpatient, and death records was used to compare the age at index dementia record (proxy for onset age) and survival outcomes in dementia patients with and without preexisting diabetes (n = 25,006; diabetes, 17.3%). Inpatient records from 1970 determined diabetes history in this study population with incident dementia in years 1990–2005. Dementia onset and death occurred an average 2.2 years and 2.6 years earlier, respectively, in diabetic compared with nondiabetic patients. Age-specific mortality rates were increased in patients with diabetes. In an adjusted proportional hazard model, the death rate was increased with long-duration diabetes, particularly with early age onset dementia. In dementia diagnosed before age 65 years, those with a ≥15-year history of diabetes died almost twice as fast as those without diabetes (hazard ratio = 1.9, 95% confidence interval: 1.3, 2.9). These results suggest that, in patients with diabetes, dementia onset occurs on average 2 years early and survival outcomes are generally poorer. The effect of diabetes on onset, survival, and mortality is greatest when diabetes develops before middle age and after 15 years' diabetes duration. The impact of diabetes on dementia becomes progressively attenuated in older age groups. [ABSTRACT FROM PUBLISHER]

Radiologists frequently encounter studies demonstrating spinal instrumentation, either as part of the patient''s postoperative evaluation, or as incidental to a study performed for another purpose. It is important for the reporting radiologist to identify potential complications of commonly used spinal implants. Part 1 of this review examined both the surgical approaches used and the normal appearances of these spinal implants and bone grafting techniques. This second part of the review will focus on the multimodal imaging strategy adopted in the assessment of the instrumented spine and the demonstration of imaging findings of common postoperative complications. [Copyright &y& Elsevier]

The general radiologist frequently encounters studies demonstrating spinal instrumentation, either as part of the patient''s postoperative evaluation or as incidental to a study performed for another purpose. There are various surgical approaches and devices used in spinal surgery with an increased understanding of spinal and spinal implant biomechanics drives development of modern fixation devices. It is, therefore, important that the radiologist can recognize commonly used devices and identify their potential complications demonstrated on imaging. The aim of part 1 of this review is to familiarize the reader with terms used to describe surgical approaches to the spine, review the function and normal appearances of commonly used instrumentations, and understand the importance of the different fixation techniques. The second part of this review will concentrate on the roles that the different imaging techniques play in assessing the instrumented spine and the recognition of complications that can potentially occur. [Copyright &y& Elsevier]

Complex global business environments are associated with increasingly interconnected economies, societies, and governments. Moreover, the proliferation of discrete markets, categories of product offerings, and individualized customer segments motivates business leaders to drastically simplify their organizations to become more agile in exploiting this complexity. Incremental changes are no longer sufficient to remain viable in volatile and uncertain environments. Internal business processes must undergo radical simplifications that reduce cycle time (a measure of responsiveness), cost per transaction (a measure of efficiency), and the number of hand-offs (a measure of how often work is transferred to another organization or business process). IBM defines radical simplification as realizing reductions in these measures of 50% or greater. To achieve these goals, IBM executives identified the need for a consistent, carefully matched set of best-practice methods, techniques, and leading-edge software tools, including scenario-based guidance to enable leaders to radically simplify their businesses. This paper describes the resulting IBM Toolkit for Radical Simplification and includes project case studies to demonstrate how the toolkit is being applied to simplify business processes for increased speed, agility, and value. [ABSTRACT FROM AUTHOR]

Abstract: More than half of pygmy sperm whales (Kogia breviceps) that strand exhibit signs of cardiomyopathy (CMP). Many factors may contribute to the development of idiopathic CMP in K. breviceps, including genetics, infectious agents, contaminants, biotoxins, and dietary intake (e.g. selenium, mercury, and pro-oxidants). This study assessed trace elements in K. breviceps at various stages of CMP progression using fresh frozen liver and heart samples collected from individuals that stranded along US Atlantic and Gulf coasts between 1993 and 2007. Standard addition calibration and collision cell inductively coupled plasma mass spectrometry (ICP-MS) were employed for total Se analysis and pyrolysis atomic absorption (AA) was utilized for total Hg analysis to examine if the Se/Hg detoxification pathway inhibits the bioavailability of Se. Double spike speciated isotope dilution gas chromatography ICP-MS was utilized to measure methyl Hg and inorganic Hg. Immunoblot detection and colorimetric assays were used to assess protein oxidation status. Data collected on trace elements, selenoproteins, and oxidative status were evaluated in the context of animal life history and other complementary histological information to gain insight into the biochemical pathways contributing to the development of CMP in K. breviceps. Cardiomyopathy was only observed in adult pygmy sperm whales, predominantly in male animals. Both Hg:Se molar ratios and overall protein oxidation were greater in males than females and increased with progression of CMP. [Copyright &y& Elsevier]

The author argues why Pennsylvania State University former head football coach Joe Paterno and his wife Sue deserved better in the aftermath of the sex scandal involving former assistant football coach Jerry Sandusky. The decision of the university board of trustees to fire Paterno for failing to report the case resulted to a students' riot. The author points out that Paterno has committed no crimes in the eyes of the law.

In Cambrian time, Laurentia was bounded on all sides by passive margins, providing an opportunity to establish a "Cambrian baseline" of detrital zircon provenance for the craton during a relatively quiescent tectonic stage. U-Pb detrital zircon ages from laser ablation—multicollector—inductively coupled plasma—mass spectrometry (LA-MCICP-MS) and sensitive high-resolution ion microprobe (SHRIMP) analysis of seven Cambrian sandstone samples from northern Northwest Territories are consistent with generally local provenance. Samples from Mackenzie Mountains were most likely derived from the Proterozoic Mackenzie Mountains Supergroup and are dominated by detrital zircon ages of ca. 1020—1516 Ma, but also contain populations of ca. 1615--1692 Ma and ca. 2699--2752 Ma. Cambrian sandstones from south of Great Bear Lake have a complementary set of detrital zircon age populations dominated by ca. 1810--2010 Ma, with smaller relative probability peaks at 2100 Ma, 2300 Ma, and 2600 Ma, which are consistent with derivation from the Hottah terrane, Great Bear magmatic zone, and Slave craton. Comparison of the signatures from Mackenzie Mountains and Great Bear Lake south suggests that there were two distinct sources of detrital zircon available to the northern Northwest Territories during the Cambrian. Detrital zircon ages from Cambrian strata of Victoria Island appear to be a mixture of Shaler Supergroup, Slave craton—like, Taltson-Thelon orogen, and Wopmay orogen sources. Following the dichotomy of detrital zircon age spectra presented by Cambrian samples from Mackenzie Mountains and Great Bear Lake south allows subdivision of other published detrital zircon ages from across northern Laurentia into two groups: Laurentia Cambrian type 1 suite reflects the Archean cratons and Paleoproterozoic orogens of the Precambrian Shield. Laurentia Cambrian type 2 suite is dominated by Grenvillian and older ages (1000--1500 Ma) and includes relative probability peaks at 1600—1700 Ma and 2700--2750 Ma. We find, therefore, that this Cambrian baseline mirrors the Precambrian tectonic fabric of Laurentia from Archean cratonization and Paleoproterozoic through Mesoproterozoic orogenesis, culminating in assembly of the supercontinent Rodinia. Furthermore, the Neoproterozoic breakup of Rodinia and establishment of passive margins surrounding Laurentia provided little new zircon available to the Cambrian sedimentary system. The detrital zircon spectra for the Cambrian of northern Laurentia are intended to provide a reference to test the affinity of suspect terranes and potentially exotic detrital zircon within Paleozoic foreland basins. [ABSTRACT FROM AUTHOR]

Objectives: Discuss initial findings of a randomized clinical trial comparing the effects of telephone- based and face-to-face (f-to-f) cognitive-behavioral therapy (CBT) on changes in caregiver (CG) burden, assistance support, depression, and health status for African American (AA) CGs with depression. Design: Pilot study using a prepost, two-group design with 14 enrolled and randomized participants. Measures: Subjective Burden subscale of the Caregiver Appraisal Inventory, Assistance Support subscale of the Interpersonal Support Evaluation List, Physical Symptoms subscale of the Caregiver Health and Health Behavior Inventory and the Center for Epidemiologic Studies Depression Scale. Results: Prepost improvements were found on 11 completers across all measures for both telephone and f-to-f CBT. Moderate and similar effects sizes for CG subjective burden and assistance support were found for both the telephone and f-to-f groups. Effect sizes for physical symptoms and depression varied from low to moderate, respectively, with a trend toward smaller improvements in f-to-f CBT than in telephone CBT. Qualitative analysis highlighted CGs' perceptions of the active ingredients of treatment and provided indirect support for similar gains in emotional and psychosocial functioning across the two Treatment modalities. Conclusions: Both telephone-based and f-to-f CBT showed improvements in depression, subjective burden, and assistance support in dementia AA CGs. Replication with a larger sample size (N = 106) is currently in progress. Study limitations and future directions for research are also addressed. [ABSTRACT FROM AUTHOR]

The field of Synthetic Biology seeks to apply engineering principles to biology in order to produce novel biological systems. One approach to accomplish this goal is the genome-driven cell engineering approach, which searches for functioning minimal genomes in naturally occurring microorganisms, which can then be used as a template for future systems. Currently a prototypical minimal genome has not been discovered. This review analyzes the organisms Mycoplasma pneumoniae, Pelagibacter ubique, Vesicomyosocius okutanii and Prochlorococcus marinus as models of heterotrophic symbiont, heterotrophic free-living, autotrophic symbiont and autotrophic free-living organisms respectively and compares them to the current minimal cell model in order to determine which most closely resembles a true minimal genome. M. pneumoniae possesses a genome of 816 394 base pairs (bp) with 688 open reading frames (ORF) and a severely limited metabolism. Pelagibacter ubique possesses a 1 308 000 bp genome with 1354 ORF and has a fully functional metabolism but requires a reduced form of sulphur. Vesicomyosocius okutanii possesses a 1 020 000 bp genome with 975 ORF and is deficient in the production of threonine, isoleucine and ubiquinone. Prochlorococcus marinus possesses a 1 751 080 bp genome with 1884 ORF and has a complete metabolism with no deficiencies. The current minimal cell model requires a genome to be of limited size, culturalble and having minimal media requirements as such it is the conclusion of this review that P. marinus best fits this model. Further, future research should concentrate on genome reduction experiments using P. marinus and the search for additional minimal genomes should concentrate on autotrophic free-living organisms. [ABSTRACT FROM AUTHOR]

Background: The optimal approach to cytomegalovirus (CMV) prevention after lung transplantation is controversial. We recently completed a prospective, randomized, placebo-controlled study of CMV prevention in lung transplantation that demonstrated the short-term efficacy and safety of extending valganciclovir prophylaxis to 12 months vs 3 months of therapy. In the current analysis, we monitored a single-center subset of patients enrolled in the CMV prevention trial to determine if extended prophylaxis conferred a sustained long-term benefit and to assess its hematologic safety. Methods: The sub-analysis included 38 randomized patients from Duke University Medical Center. All patients underwent consistent serial serum CMV monitoring and surveillance bronchoscopies. CMV was defined by viremia (≥ 500 CMV DNA copies/ml) or pneumonitis. The safety assessment included a review of all complete blood counts obtained from transplant onward. Results: During a mean follow-up of 3.9 years in each group, extended-course compared with short-course prophylaxis provided a sustained protective benefit with a lifetime CMV incidence of 12% vs 55%, respectively (hazard ratio, 0.13; 95% confidence interval, 0.03–0.61; p = 0.009), an effect that persisted after adjustment for clinical risk factors. Patients in each group underwent a comparable number of peripheral blood draws and bronchoscopies. Post-transplant white blood cell, neutrophil, and platelet counts were similar between each treatment group during the course of follow-up. Conclusion: Extending valganciclovir prophylaxis to 12 months provides a durable long-term CMV protective benefit compared with short-course therapy, without increasing adverse hematologic effects. [ABSTRACT FROM AUTHOR]

Diabet. Med. 28, 1131-1135 (2011) Abstract Aim To assess the change in the cost of diabetes medication attributable to moderate weight loss in patients with Type 2 diabetes. Methods Longitudinal data collected annually from 590 patients participating in the observational, community-based Fremantle Diabetes Study were examined to determine whether moderate weight loss (≥ 5% of initial body weight) was independently associated with diabetes medication cost during 4 years' follow-up. Results Overall, the weight of the cohort decreased significantly during 4.3 ± 0.4 years' follow-up by 1.3 ± 6.2 kg (−1.4 ± 7.9% baseline body weight; trend P < 0.001). Moderate weight loss was achieved by 31%. HbA1c improved significantly in the group with moderate weight loss compared with the group without moderate weight loss [−4 ± 16 mmol/mol (−0.3 ± 1.5%) vs. 0 ± 17 mmol/mol (0.0 ± 1.5%), P = 0.015]. Mean (bias-corrected 95% confidence intervals) diabetes medication costs were $A820 ($A744−907) during follow-up. As the cost distribution was highly right-skewed and contained zeros, it was square root (√) transformed before multiple linear regression analysis. The most parsimonious model of baseline associates of √(diabetes medication cost) included glycaemic control, diabetes treatment, diabetes duration, BMI, systolic blood pressure, serum HDL cholesterol (negative), taking lipid-lowering medication and age (negative) (adjusted R2 = 73.6%). After adjusting for these variables, √(diabetes medication cost) was negatively associated with moderate weight loss ( P = 0.026). After entering average values for the cohort into the model, the cost of diabetes medications between baseline and fourth review for an average patient with no weight loss was $A752 compared with $A652 for a patient who attained moderate weight loss, a saving of $A100 (−13.3%). Discussion These data highlight the economic and clinical benefits of moderate weight loss in Type 2 diabetes. [ABSTRACT FROM AUTHOR]

Aims To determine whether the reduction in urinary albumin excretion through renin-angiotensin-aldosterone system blockade found in intervention trials extends to community-based patients with Type 2 diabetes. Methods We analysed data from 302 participants in the longitudinal observational Fremantle Diabetes Study who commenced angiotensin-converting enzyme inhibitor or angiotensin receptor blocker therapy during follow-up andwho had an annual assessment on either side of this therapeutic change. Results At baseline, the patients had amean age of 63.8 years, a median diabetes duration of 4 years, amedianHbA1c of 7.6% (60 mmol /mol) and a geometricmean (sd range) urinary albumin: creatinine ratio of 3.3 mg /mmol (0.8-13.1 mg /mmol). The percentages with normo-, micro- and macro-albuminuria were 49.0, 38.4 and 12.6%, respectively. During 6.1 ± 1.7 years of follow-up, initiation of renin-angiotensin-aldosterone system blockade was associatedwith a larger geometricmean (sd range) absolute albumin: creatinine ratio reduction in the patients with macro albuminuria compared with those who had either normoor microalbuminuria [)40.9 ()825.7 to 159.9) mg/mmol) vs. 1.7 ()1.6 to 20.0) mg/mmol and )0.5 ()23.0 to 39.5) mg/mmol, respectively; P < 0.001]. These changes remained significant after adjustment for changes in blood pressure and other potentially confounding variables, including drug dose and angiotensin-converting enzyme genotype. The post-treatment median albumin: creatinine ratios were 35.4 and 27.4% lower than before treatment in those with micro- or macro albuminuria, respectively. Conclusions Usual-care initiation of renin-angiotensin-aldosterone system blockade confers a quantitatively similar renal benefit to that in intervention trials in Type 2 diabetes. [ABSTRACT FROM AUTHOR]

The article discusses data that do not support previous interpretations for multiple episodes of fluorapatite cementation in the Thelon Basin in Canada in spite of wide stratigraphic positions in style of occurrence. The Thelon Basin cement is reportedly younger than originally regarded, but older than the Athabasca Basin, that suggests two distinct fluid-flow histories. The article states that the production of fluorapatite cements in the basins is independent, but similar in conditions.

Objective: The purpose of this study was to investigate the efficacy and tolerance of an additional phosphate enema prior to non-laxative CT colonography (CTC). Methods: 71 patients (mean age 80 years, 28 male, 43 female) underwent non-laxative CTC following 4 oral doses of diluted 2% w/w barium sulphate. Patients were invited to self-administer a phosphate enema 2 h before CTC. An experienced observer graded the volume of retained stool (1 (nil) to 4 (>75% bowel circumference coated)), retained fluid ((1 (nil) to 4 (>50% circumference obscured)), retained stool tagging quality (1 (untagged) to 5 (⩾75% to 100%) tagged) and confidence a polyp ⩾6 mm could be excluded (yes/no) for each of six colonic segments. Tolerance of the enema was assessed via questionnaire. Data were analysed between those using and not using the enema by Mann-Whitney and Fisher's exact test. 18/71 patients declined the enema. Results: There was no reduction in residual stool volume with enema use compared with non-use either overall (mean score 2.6 vs 2.7, p=0.76) or in the left colon (mean 2.3 vs 2.4, p=0.47). Overall tagging quality was no different (mean score 4.4 vs 4.3, p=0.43). There was significantly more retained left colonic fluid post enema (mean score 1.9 vs 1.1, p<0.0001), and diagnostic confidence in excluding polyps was significantly reduced (exclusion not possible in 35% segments vs 21% without enema, p=0.006). Of 53 patients, 30 (56%) found the enema straightforward to use, but 4 (8%) found it unpleasant. [ABSTRACT FROM AUTHOR]

As little is known about the impact of type 2 diabetes amongst Australian youth despite international increases in childhood obesity, we aimed to identify and characterize people aged <25 years with type 2 diabetes in an urban community with 60 000 people aged 10-24 years. The estimated maximum prevalence (59/100 000 persons) was lower than US estimates but higher than in Asia and Europe. In eight patients assessed in detail, obesity and related comorbidities were common, and quality of life was low. [ABSTRACT FROM AUTHOR]

The oxidizing anticancer system of vitamin C and vitamin K3 (VC:VK3, producing hydrogen peroxide via Superoxide) was combined individually with melatonin, curcumin, quercetin, or cholecalciferol (VD3) to determine interactions. Substrates were LNCaP and PC-3 prostate cancer cell lines. Three of the tested antioxidants displayed differences in cell line cytotoxicity. Melatonin combined with VC:VK3 quenched the oxidizing effect, while VC:VK3 applied 24 hours after melatonin showed no quenching. With increasing curcumin concentrations, an apparent combined effect of VC:VK3 and curcumin occurred in LNCaP cells, but not PC-3 cells. Quercetin alone was cytotoxic on both cell lines, but demonstrated an additional 50-percent cytotoxicity on PC-3 cells when combined with VC:VK3. VD3 was effective against both cell lines, with more effect on PC-3. This effect was negated on LNCaP cells with the addition of VC:VK3. In conclusion, a natural antioxidant can enhance or decrease the cytotoxicity of an oxidizing anticancer system in vitro, but generalizations about antioxidants cannot be made. [ABSTRACT FROM AUTHOR]

Aim: To determine whether combination of metformin–sulphonylurea is associated with an increased risk of cardiovascular disease (CVD) and mortality in an urban community-based cohort of type 2 patients. Methods: We studied 1271 (98.2%) of 1294 type 2 participants in the observational Fremantle Diabetes Study (mean age 64.2 years, 48.8% males) who had detailed diabetes-specific therapy recorded at baseline and complete follow-up data. Mortality and hospital discharge data were collected over 13 174 patient-years (mean ± SD: 10.4 ± 3.9 years). Cox proportional hazards modelling was used to determine whether baseline diabetes treatments were independently associated with cardiovascular mortality, hospitalization for/death from CVD or all-cause mortality after adjustment for other explanatory variables. Results: During follow-up, 523 deaths occurred (41.1%) of which 269 (51.4%) were attributed to CVD. Hospitalization for CVD as principal diagnosis occurred at least once for 481 (37.8%) participants. In Kaplan–Meier analyses, there were significant differences in cardiovascular mortality, hospitalization for/death from CVD and all-cause mortality between diabetes therapy groups (p < 0.001). Compared with diet and metformin monotherapy, those treated with metformin–sulphonylurea had higher cardiovascular and all-cause mortality (p ≤ 0.024). Insulin users had significantly higher cardiovascular mortality, hospitalization for/death from CVD and all-cause mortality than those on combination therapy (p ≤ 0.016). After adjustment for significant variables in the most parsimonious models, diabetes treatment was not independently associated with any of the three study endpoints (p ≥ 0.49). Conclusions: Combination metformin–sulphonylurea appears as safe as other blood glucose-lowering therapies used for type 2 diabetes. [ABSTRACT FROM AUTHOR]