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At the start of the 20th century, cesarean section (CS) was uncommon in obstetrics. By the end of the century, CS rates had increased dramatically worldwide. Although the explanation for the increase is multifactorial, a major driver in the ongoing escalation is the increase in women who are delivered by repeat CS. This is due, in part, to the fact that there has been a sharp fall in vaginal birth after CS (VBAC) rates as fewer women are offered a trial of labor after CS (TOLAC), due principally to fears of a catastrophic intrapartum uterine rupture. This paper reviewed international VBAC policies and trends. A number of themes emerged. The risk of intrapartum rupture and its associated complications is low and may sometimes be overestimated. Individual maternity hospitals in both developed and developing countries are inadequately resourced to safely supervise a TOLAC. Efforts to mitigate the risks of TOLAC by careful patient selection and good clinical practices may be underutilized. Given the serious short‐term and long‐term consequences of rising CS rates for women and for maternity services generally, a review of TOLAC policies worldwide should be prioritized and consideration given to convening a Global Consensus Development Conference on Delivery after CS. Synopsis: The dramatic fall in trial of labor after cesarean section rates globally may reflect overestimation of risks and underestimation of benefits associated with vaginal birth. [ABSTRACT FROM AUTHOR]

CrystalExplorer is a native cross‐platform program supported on Windows, MacOS and Linux with the primary function of visualization and investigation of molecular crystal structures, especially through the decorated Hirshfeld surface and its corresponding two‐dimensional fingerprint, and through the visualization of void spaces in the crystal via isosurfaces of the promolecule electron density. Over the past decade, significant changes and enhancements have been incorporated into the program, such as the capacity to accurately and quickly calculate and visualize quantitative intermolecular interactions and, perhaps most importantly, the ability to interface with the Gaussian and NWChem programs to calculate quantum‐mechanical properties of molecules. The current version, CrystalExplorer21, incorporates these and other changes, and the software can be downloaded and used free of charge for academic research. [ABSTRACT FROM AUTHOR]

The article examines how the U.S. Civil War and Reconstruction impacted political reform in Great Britain during the 1860s. It discusses liberalism in British politics, perceived messages about liberty, self-determination, and constitutional government sent from the U.S. to Great Britain, and radicalism in Great Britain. The article also discusses reaction to the U.S. Emancipation Proclamation issued by then-U.S. president Abraham Lincoln and economic conditions in Bradford, Yorkshire.

Background: Gait impairments following anterior cruciate ligament reconstruction (ACLR) may contribute to reinjury or future osteoarthritis development. Recently, plantar cutaneous sensation deficits have been reported post-ACLR. These sensory deficits may influence gait and represent a mechanism through which to improve gait.Research Question: Can established sensory interventions change sensation and gait in patients after ACLR and compared to healthy adults?Methods: Twenty-two adults (n = 11 post-ACLR, age:20.5 ± 1.9years, body mass index[BMI]:24.5 ± 3.6 kg/m2; n = 11 healthy, age:20.7 ± 1.4years, BMI:23.3 ± 2.7 kg/m2) completed two sessions separated by 48 h. Gait and plantar cutaneous sensation were assessed pre- and post-intervention (massage or textured insoles). Gait analysis was completed using 3D motion capture at 1.4 m/s ± 5% and standard inverse dynamics analysis. Plantar cutaneous sensation was assessed using Semmes Weinstein Monofilaments with a 4-2-1 stepping algorithm at the plantar aspect of the first metatarsal head, base of the fifth metatarsal, and lateral and medial malleoli. Plantar massage was a 5-minute massage to both feet. Textured insoles (coarse grit sandpaper) were worn while walking. Biomechanical data were assessed via mixed-models, repeated measures ANOVAs and 90 % confidence intervals. Wilcoxon Signed Rank tests and Mann-Whitney U tests evaluated plantar cutaneous sensation within and between groups, respectively.Results: Knee adduction moment was lower in the ACLR versus the contralateral limb pre-massage. The vGRF was lower during the first half of stance but greater during the second half of stance in the ACLR versus the control group post-massage. Massage improved ACLR limb sensation over the first metatarsal head (P = 0.042) and medial malleolus (P = 0.027). Textured insole application improved ACLR limb sensation over the first (P = 0.043) and fifth (P = 0.027) metatarsals and medial malleolus (P = 0.028).Significance: Plantar massage and textured insoles improved plantar cutaneous sensation in the ACLR limb. Neither intervention influenced gait. Improving plantar sensation may be beneficial for patients after ACLR; however, sensory interventions to improve gait are necessary. [ABSTRACT FROM AUTHOR]

British responses to the American Civil War were not straightforward, though the relevant historiography has tended to concentrate on a number of now quite familiar explanations. The reasons why British people took sides – if they did (for some did not) – are usually thought to have been shaped by the slavery question and concomitant thinking about race, labour systems, and the nature of work; by direct economic interest – cotton, grain, investments, and the potential for future commerce; by political ideas, relating especially to democracy, national self-determination, federalism, and republics; and by geostrategic concerns about how best to preserve Britain's global role and imperial power. These were all important, but so was a relatively neglected set of influences on British opinion that arose from cultural and social determinants. This article suggests that many British people supported the Confederacy because they saw the American South as fundamentally unlike the North and, what is more, as recognizably 'English'. The words and deeds of a prominent pro-Southerner, A.J. Beresford Hope, are used to elucidate this motivation for taking sides. Scholars have not previously investigated Hope's activism or the cultural and social case for the Confederacy in much detail. [ABSTRACT FROM AUTHOR]

This study examines the degree to which hotel owners influence the operation of their hotels in both single- and multiple-agency scenarios. Key findings from a survey of 499 general managers are that: (1) owners influence financial property-level decisions to a greater extent than operational property-level decisions; (2) owners of independently operated hotels are more involved in such decisions than are owners of hotels operated by a management company; and (3) asset managers assist owners in achieving greater involvement. The findings provide empirical evidence about how principals can mitigate the agency problem in multiple-principal scenarios through client and behavior-based methods. [ABSTRACT FROM AUTHOR]

Historians have used a number of political, social, and other factors to explain the controversy surrounding elementary education in Victorian Britain. This article underscores the importance of religious motivations. The Act of 1870 – a significant extension of state responsibility – did not end debates about the purpose of education and the pros and cons of government involvement and religious instruction. Prominent among voluntaryists and anti-secularists was A. J. Beresford Hope, whose position offers useful insights into the educational agencies of the Church and the manner in which churchmen responded to new circumstances. This article explains Hope's attitude and uses it to explore some of the causes and consequences of the Act of 1870. What type of schooling best suited the British people? Should it have a basis in something other than religion? How could the Church and its supporters meet the challenges posed by education reform? [ABSTRACT FROM AUTHOR]

Despite major advances in the last century, particularly in high resource settings, maternal sepsis remains a common and potentially preventable cause of direct maternal death globally. A barrier to further progress has been the lack of consensus on the definition of maternal sepsis. Publications from two recent multidisciplinary consensus conferences, one on sepsis in the non-pregnant adult and the other on sepsis in the pregnant woman, concluded that the criteria for diagnosing sepsis should be clinically-based, applicable at the bedside, and should not be laboratory-based. Informed by reviews of the evidence, in 2017 WHO published a new definition of maternal sepsis based on the presence of suspected or confirmed infection. It also announced a Global Maternal and Neonatal Sepsis Initiative to identify the diagnostic criteria for the early identification, epidemiology, and disease classification of maternal sepsis. Standardizing the criteria for maternal sepsis optimizes clinical audit and research. It may facilitate the evaluation of the role of different clinical parameters and biomarkers in the diagnosis, earlier recognition and management of maternal infection and sepsis. Further work is required to develop an international consensus on the criteria for diagnosing maternal sepsis and any associated organ dysfunction. [ABSTRACT FROM AUTHOR]

Background: Maternal nutrition may influence intrauterine fetal development. To date, the relationship between contemporary European dietary guidelines and fetal growth has not been examined.Aims: To develop a novel Periconceptual Nutrition Score (PENS) to assess maternal dietary quality in early pregnancy and examine its relationship with fetal growth.Study Design: Women were recruited conveniently at their first clinic visit and completed a supervised four day retrospective diet history. The PENS was developed using European Food Safety Authority recommended dietary intakes for pregnancy. The relationship between PENS and fetal growth was examined.Subjects: Women with a singleton pregnancy.Outcome Measures: Birthweight, small for gestational age (SGA), neonatal head circumference.Results and Conclusions: Of the 202 women, the mean age was 32.2 ± 5.0 years and 44.6% were nulliparas. The mean PENS was 9.4 ± 3.1. On multivariable regression, there was a positive relationship between the PENS and birthweight (beta = 45.3, 95%CI 14.8-75.9, P = 0.002) and neonatal head circumference (beta = 0.12, 95%CI 0.01-0.23, P = 0.03). Compared with the lowest PENS quartile, the mean birthweight was increased in the highest quartile (Mean difference 328 g, P = 0.02). The incidence of SGA was 16.4% (n = 10/61) in the lowest PENS quartile compared to 6.5% (n = 9/139) in the top three quartiles (P = 0.03). Thus, higher maternal dietary quality was associated with increased intrauterine fetal growth. The PENS is potentially useful in identifying those women before or during pregnancy who may benefit from dietary interventions that may optimise fetal growth. It may also be useful in tracking maternal dietary quality during pregnancy. [ABSTRACT FROM AUTHOR]

Although electrical activation of the carotid sinus baroreflex (baroreflex activation therapy) is being explored as a device therapy for resistant hypertension, possible effects on baroreflex dynamic characteristics of interaction between electrical stimulation and pressure inputs are not fully elucidated. To examine whether the electrical stimulation of the baroreceptor afferent nerve impedes normal short-term arterial pressure (AP) regulation mediated by the stimulated nerve, we electrically stimulated the right aortic depressor nerve (ADN) while estimating the baroreflex dynamic characteristics by imposing pressure inputs to the isolated baroreceptor region of the right ADN in nine anesthetized rats. A Gaussian white noise signal with a mean of 120 mmHg and standard deviation of 20 mmHg was used for the pressure perturbation. A tonic ADN stimulation (2 or 5 Hz, 10 V, 0.1-ms pulse width) decreased mean sympathetic nerve activity (367.0 ± 70.9 vs. 247.3 ± 47.2 arbitrary units, P < 0.01) and mean AP (98.4 ± 7.8 vs. 89.2 ± 4.5 mmHg, P < 0.01) during dynamic pressure perturbation. The ADN stimulation did not affect the slope of dynamic gain in the neural arc transfer function from pressure perturbation to sympathetic nerve activity (16.9 ± 1.0 vs. 14.7 ± 1.6 dB/decade, not significant). These results indicate that electrical stimulation of the baroreceptor afferent nerve does not significantly impede the dynamic characteristics of the arterial baroreflex concomitantly mediated by the stimulated nerve. Short-term AP regulation by the arterial baroreflex may be preserved during the baroreflex activation therapy. [ABSTRACT FROM AUTHOR]

This article focuses on some of the religious factors that shaped the pro-Southern lobby in Britain during the American Civil War and Reconstruction. British opinion cannot be explained only in terms of class and party. In exploring other determinants, the ideas and activities of wealthy High Churchman and Conservative politician Beresford Hope offer promising avenues of inquiry, for Hope saw in the American Union, and Southern secession, a religious dimension, represented most clearly in the Episcopal Church. To the more familiar (to historians) reasons why the South gained support in Britain--relating to economic and political interests--Hope added a deeper commitment arising from a sense of cultural affinity (the "Englishness" of the South) and from religious conviction (to him the Church, and indeed Christianity, seemed stronger in the South than in the North). This indicates a belief that Britain and the South were bound together by common Christian civilization. [ABSTRACT FROM AUTHOR]

Recent clinical trials in patients with drug-resistant hypertension indicate that electrical activation of the carotid sinus baroreflex can reduce arterial pressure (AP) for more than a year. To examine whether the electrical stimulation from one baroreflex system impedes normal short-term AP regulation via another unstimulated baroreflex system, we electrically stimulated the left aortic depressor nerve (ADN) while estimating the dynamic characteristics of the carotid sinus baroreflex in anesthetized normotensive Wistar-Kyoto (WKY; n = 8) rats and spontaneously hypertensive rats (SHR; n = 7). Isolated carotid sinus regions were perturbed for 20 min using a Gaussian white noise signal with a mean of 120 mmHg for WKY and 160 mmHg for SHR. Tonic ADN stimulation (2 Hz, 10 V, and 0.1-ms pulse width) decreased mean sympathetic nerve activity (73.4 ± 14.0 vs. 51.6 ± 11.3 arbitrary units in WKY, P = 0.012; and 248.7 ± 33.9 vs. 181.1 ± 16.6 arbitrary units in SHR, P = 0.018) and mean AP (90.8 ± 6.6 vs. 81.2 ± 5.4 mmHg in WKY, P = 0.004; and 128.6 ± 9.8 vs. 114.7 ± 10.3 mmHg in SHR, P = 0.009). The slope of dynamic gain in the neural arc transfer function from carotid sinus pressure to sympathetic nerve activity was not different between trials with and without the ADN stimulation (12.55 ± 0.93 vs. 13.03 ± 1.28 dB/decade in WKY, P = 0.542; and 17.37 ± 1.01 vs. 17.47 ± 1.64 dB/decade in SHR, P = 0.946). These results indicate that the tonic ADN stimulation does not significantly modify the dynamic characteristics of the carotid sinus baroreflex. [ABSTRACT FROM AUTHOR]

Objective: To study the educational value to medical students of a labour ward rotation.Design: Qualitative research study was performed in two tertiary level obstetric hospitals attached to a large medical school in Dublin. Medical students attending a six-week rotation in Obstetrics and Gynaecology in University College Dublin were invited to participate. As part of this rotation, students spend one week as part of the clinical team working on the labour ward. Focus groups were held in order to identify common themes and experiences of medical students during this labour ward week. Grounded theory with thematic analysis was used. The main outcome measures were the educational experience and value of a labour ward rotation to medical students.Results: Five distinct themes developed from the focus groups of 19 students. A high value was placed on patient centred bedside teaching. Midwives were identified as excellent teachers and facilitators of learning. There was a clear sense of teamwork and belonging by the students. However, students reported frustration with unclear learning objectives. Students identified extra pre-learning with pre-specified learning aims before the labour ward week as being important.Conclusion: Bedside teaching was highly valued as it advanced student's knowledge of obstetrics theory and improved communication skills. In general, medical students reported a positive experience from working in the labour word but there is scope for improvement. [ABSTRACT FROM AUTHOR]

Objective: To describe the findings of a national inquiry into cases of misdiagnosis of miscarriage in the Republic of Ireland and to report the results of implementation of the findings of the inquiry, including investment in new equipment and training, new national guidelines, and rigorous annual audit of early pregnancy units.Design: Narrative description of the inquiry and its findings and results of a subsequent audit.Setting: Not applicable.Patient(s): Women with problems of bleeding and/or pain in early pregnancy who were erroneously diagnosed as having a nonviable intrauterine pregnancy.Intervention(s): After two cases of misdiagnosis of miscarriage that were widely reported in the Republic of Ireland in June 2010, a Miscarriage Misdiagnosis Review Team was commissioned by the Irish Health Service Executive (HSE) to undertake a national review of other possible cases of misdiagnosis of miscarriage. The Review Team made a series of recommendations that were subsequently implemented in full. The results of the implementation of the findings of the Review Team have been the subject of three annual audits across the country.Main Outcome Measure(s): The main outcome measure was the occurrence of misdiagnosis of miscarriage in the Republic of Ireland before and after implementation of the findings of the Review Team.Result(s): Twenty-four confirmed cases of misdiagnosis of miscarriage were identified, mostly occurring between 2005 and 2010. Analysis led to a series of recommendations by the Review Team, which were implemented in full by the HSE. Over € 3 million was provided to fund implementation; 26 high-quality gynecological ultrasound machines were purchased to reequip 19 units involved in provision of care to women with suspected miscarriage. There was further allocation of resources for new equipment and improvement in the management and staffing of early pregnancy units across Ireland, with each center now having a dedicated and properly staffed Early Pregnancy Assessment Unit. A national training program in the management of early pregnancy problems has been implemented, along with regular national meetings to discuss early pregnancy problems. National clinical guidelines on the diagnosis and management of miscarriage for implementation have been distributed to all hospitals.Conclusion(s): No cases of miscarriage misdiagnosis were identified in any of the three annual audits, suggesting that implementation of the findings of the review has been successful. We believe that this is the first report of national change in practice leading to improvement in clinical outcomes in the management of suspected miscarriage. [ABSTRACT FROM AUTHOR]

We assessed the impact of differing physical activity levels throughout the lifespan, using a musculoskeletal injury model, on the age-related changes in left ventricular (LV) parameters in active mice. Forty male mice (CBA/J) were randomly placed into one of three running wheel groups (transected CFL group, transected ATFL/CFL group, SHAM group) or a SHAM Sedentary group (SHAMSED). Before surgery and every 6 weeks after surgery, LV parameters were measured under 2.5 % isoflurane inhalation. Group effects for daily distance run was significantly greater for the SHAM and lesser for the ATLF/CFL mice (p = 0.013) with distance run decreasing with age for all mice (p < 0.0001). Beginning at 6 months of age, interaction (group × age) was noted with LV posterior wall thickness-to-radius ratios (h/r) where h/r increased with age in the ATFL/CFL and SHAMSED mice while the SHAM and CFL mice exhibited decreased h/r with age (p = 0.0002). Passive filling velocity (E wave) was significantly greater in the SHAM mice and lowest for the ATFL/CFL and SHAMSED mice (p < 0.0001) beginning at 9 months of age. Active filling velocity (A wave) was not different between groups (p = 0.10). Passive-to-active filling velocity ratio (E/A ratio) was different between groups (p < 0.0001), with higher ratios for the SHAM mice and lower ratios for the ATFL/CFL and SHAMSED mice in response to physical activity beginning at 9 months of age. Passive-to-active filling velocity ratio decreased with age (p < 0.0001). Regular physical activity throughout the lifespan improved LV structure, passive filling velocity, and E/A ratio by 6 to 9 months of age and attenuated any negative alterations throughout the second half of life. The diastolic filling differences were found to be significantly related to the amount of activity performed by 9 months and at the end of the lifespan. [ABSTRACT FROM AUTHOR]

Victorian attitudes to the past were varied and in some cases irreconcilable. Newer standards of expertise and objectivity coexisted with older approaches, and the idea that history should be used for present purposes remained intact. Throughout the Victorian age there were circumstances in which history was a polemical tool, designed to give one set of interpretations or values or policies an advantage over its rivals. This article explores the work of a relatively neglected figure in Victorian historiography – the reform-minded historian and lawyer Andrew Bisset (1803–1891) – whose primary goal was to illustrate and advance what he called ‘the principle of representation’. He discussed people and events of the past to this end, offending reviewers along the way because of his obvious political agenda, but also developing a rigorous source-based style, usefully evaluating for his readers the work of Macaulay, Carlyle, and others, and helping to shape Victorian opinion about, in particular, the political and religious crises of seventeenth-century Britain. Like others, Bisset believed that the disputes of that period had relevance to the public controversies of his own day. This article is designed to contribute to ongoing debates about the Victorians’ relationship with the past. [ABSTRACT FROM PUBLISHER]

The aim of the study was to identify the contribution of myelinated (A-fiber) and unmyelinated (Cfiber) baroreceptor central pathways to the baroreflex control of sympathetic nerve activity (SNA) and arterial pressure (AP) in anesthetized Wistar-Kyoto (WKY; n 8) and spontaneously hypertensive rats (SHR; n 8). The left aortic depressor nerve (ADN) was electrically stimulated with two types of binary white noise signals designed to preferentially activate A-fibers (A-BRx protocol) or C-fibers (C-BRx protocol). In WKY, the central arc transfer function from ADN stimulation to SNA estimated by A-BRx showed strong derivative characteristics with the slope of dynamic gain between 0.1 and 1 Hz (Gslope) of 14.63 ± 0.89 dB/decade. In contrast, the central arc transfer function estimated by C-BRx exhibited nonderivative characteristics with Gslope of 0.64 ± 1.13 dB/decade. This indicates that A-fibers are important for rapid baroreflex regulation, whereas C-fibers are likely important for more sustained regulation of SNA and AP. In SHR, the central arc transfer function estimated by A-BRx showed higher Gslope (18.46 ± 0.75 dB/decade, P < 0.01) and that estimated by C-BRx showed higher Gslope (8.62 ± 0.64 dB/decade, P < 0.001) with significantly lower dynamic gain at 0.01 Hz (6.29 ± 0.48 vs. 2.80 ± 0.36%/Hz, P < 0.001) compared with WKY. In conclusion, the dynamic characteristics of the A-fiber central pathway are enhanced in the high-modulation frequency range (0.1-1 Hz) and those of the C-fiber central pathway are attenuated in the lowmodulation frequency range (0.01- 0.1 Hz) in SHR. [ABSTRACT FROM AUTHOR]

Arterial baroreceptors can be divided into two categories dependent on whether their axons are myelinated (A-fiber) or unmyelinated (C-fiber). We investigated the effect of periaxonal resiniferatoxin (RTX), a blocker of C-fiber baroreceptor activity, on the open-loop static characteristics of the arterial baroreflex. The baroreceptor region of the right aortic depressor nerve was isolated, and intra-baroreceptor region pressure (BRP) was changed from 60 to 180 mm Hg in 10 anesthetized Sprague–Dawley rats. Open-loop static characteristics of the neural arc from BRP to efferent sympathetic nerve activity (SNA), peripheral arc from SNA to arterial pressure (AP), and total reflex arc from BRP to AP were estimated. Although blocking C-fiber activity with RTX resulted in a lower response range (33.7 ± 4.6% and 49.4 ± 4.8%, P < 0.01) and higher minimum SNA (78.0 ± 4.7% and 53.6 ± 5.0%, P < 0.001) of the steady-state neural arc, the peak SNA response to BRP was greater at a BRP of 160 mm Hg (− 37.87 ± 5.83% and − 26.28 ± 4.90%, P = 0.01). RTX also resulted in a lower response range (27.8 ± 5.0 mm Hg and 40.9 ± 5.2 mm Hg, P < 0.01) and higher minimum AP (92.4 ± 4.7 mm Hg and 79.1 ± 4.9 mm Hg, P < 0.001) of the total reflex arc. Despite these changes, the maximum slope of the neural arc and the maximum gain of the total reflex arc did not differ significantly after RTX. These data suggest that A-fiber baroreceptors can regulate AP and maintain the maximum gain when systemic AP is around the normal operating range. In contrast, C-fiber baroreceptors are critically important for reductions in SNA and AP when systemic AP is raised above the normal operating range. [ABSTRACT FROM AUTHOR]

Alemtuzumab, a monoclonal antibody directed against human CD52, is used in the treatment of MS. To characterize the impact of anti-CD52 administration, a monoclonal antibody to mouse CD52 (anti-muCD52) was generated and evaluated in EAE mouse models of MS. A single course of anti-muCD52 provided a therapeutic benefit accompanied by a reduction in the frequency of autoreactive T lymphocytes and production of pro-inflammatory cytokines. Examination of the CNS revealed a decrease in infiltrating lymphocytes, demyelination and axonal loss. Electrophysiological assessment showed preservation of axonal conductance in the spinal cord. These findings suggest that anti-CD52 therapy may help preserve CNS integrity. [ABSTRACT FROM AUTHOR]

Context: Ankle sprains are the most common orthopaedic pathologic condition, and more concerning is the high percentage of persons who develop chronic ankle instability (CAI). Researchers have reported that patients with CAI are restricted occupationally, have more functional limitations, and have a poorer health-related quality of life. We do not know if these limitations decrease physical activity levels. Objective: To assess total weekly steps taken between persons with CAI and persons with healthy ankles. Design: Case-control study. Setting: University research laboratory. Patients or Other Participants: A total of 20 participants with unilateral CAI (9 men, 11 women; age ¼ 21.2 6 1.9 years, height = 174.3 ± 6.9 cm, mass = 71.9 ± 11.7 kg) and 20 healthy participants (9 men, 11 women; age=20.4 ± 2.1 years, height = 172.1 ± 5.5 cm, mass = 73.1 ± 13.4 kg) volunteered. Main Outcome Measure(s): We provided all participants with a pedometer and instructed them to wear it every day for 7 days and to complete a daily step log. They also completed the Foot and Ankle Ability Measure (FAAM), the FAAM Sport version, and the International Physical Activity Questionnaire. A 2-way analysis of variance (group╳ sex) was used to determine if differences existed in the total number of weekly steps, ankle laxity, and answers on the International Physical Activity Questionnaire between groups and between sexes. Results: We found no group3sex interaction for step count (F range = 0.439-2.108, P = .08). A main effect for group was observed (F1,38 = 10.45, P = .04). The CAI group took fewer steps than the healthy group (P = .04). The average daily step count was 6694.47 ± 1603.35 for the CAI group and 8831.01 ± 1290.01 for the healthy group. The CAI group also scored lower on the FAAM (P = .01) and the FAAM Sport version (P = .01). Conclusions: The decreased step count that the participants with CAI demonstrated is concerning. This decreased physical activity may be secondary to the functional limitations reported. If this decrease in physical activity level continues for an extended period, CAI may potentially be a substantial health risk if not treated appropriately. [ABSTRACT FROM AUTHOR]

We present an approach to understanding crystal packing via‘energy frameworks’, that combines efficient calculation of accurate intermolecular interaction energies with a novel graphical representation of their magnitude. In this manner intriguing questions, such as why some crystals bend with an applied force while others break, and why one polymorph of a drug exhibits exceptional tabletability compared to others, can be addressed in terms of the anisotropy of the topology of pairwise intermolecular interaction energies. This approach is applied to a sample of organic molecular crystals with known bending, shearing and brittle behaviour, to illustrate its use in rationalising their mechanical behaviour at a molecular level. [ABSTRACT FROM AUTHOR]

Aims: This study aims to identify the contribution of myelinated (A-fiber) and unmyelinated (C-fiber) baroreceptor central pathways to the baroreflex control of sympathetic nerve activity and arterial pressure. Main methods: Two binary white noise stimulation protocols were used to electrically stimulate the aortic depressor nerve and activate reflex responses from either A-fiber (3V, 20–100Hz) or C-fiber (20V, 0–10Hz) baroreceptor in anesthetized Sprague-Dawley rats (n =10). Transfer function analysis was performed between stimulation and sympathetic nerve activity (central arc), sympathetic nerve activity and arterial pressure (peripheral arc), and stimulation and arterial pressure (Stim-AP arc). Key findings: The central arc transfer function from nerve stimulation to splanchnic sympathetic nerve activity displayed derivative characteristics for both stimulation protocols. However, the modeled steady-state gain (0.28±0.04 vs. 4.01±0.2%·Hz−1, P <0.001) and coherence at 0.01Hz (0.44±0.05 vs. 0.81±0.03, P <0.05) were significantly lower for A-fiber stimulation compared with C-fiber stimulation. The slope of the dynamic gain was higher for A-fiber stimulation (14.82±1.02 vs. 7.21±0.79dB·decade−1, P <0.001). The steady-state gain of the Stim-AP arc was also significantly lower for A-fiber stimulation compared with C-fiber stimulation (0.23±0.05 vs. 3.05±0.31mmHg·Hz−1, P <0.001). Significance: These data indicate that the A-fiber central pathway contributes to high frequency arterial pressure regulation and the C-fiber central pathway provides more sustained changes in sympathetic nerve activity and arterial pressure. A sustained reduction in arterial pressure from electrical stimulation of arterial baroreceptor afferents is likely mediated through the C-fiber central pathway. [ABSTRACT FROM AUTHOR]

Alemtuzumab is a humanized monoclonal antibody specific for the CD52 protein present at high levels on the surface of B and T lymphocytes. In clinical trials, alemtuzumab has shown a clinical benefit superior to that of interferon-β in relapsing-remitting multiple sclerosis patients. Treatment with alemtuzumab leads to the depletion of circulating lymphocytes followed by a repopulation process characterized by alterations in the number, proportions and properties of lymphocyte subsets. Of particular interest, an increase in the percentage of T cells with a regulatory phenotype (Treg cells) has been observed in multiple sclerosis patients after alemtuzumab. Since Treg cells play an important role in the control of autoimmune responses, the effect of alemtuzumab on Treg cells was further studied in vitro. Alemtuzumab effectively mediated complement-dependent cytolysis of human T lymphocytes and the remaining population was enriched in T cells with a regulatory phenotype. The alemtuzumab-exposed T cells displayed functional regulatory characteristics including anergy to stimulation with allogeneic dendritic cells and ability to suppress the allogeneic response of autologous T cells. Consistent with the observed increase in Treg cell frequency, the CD25hi T-cell population was necessary for the suppressive activity of alemtuzumab-exposed T cells. The mechanism of this suppression was found to be dependent on both cell-cell contact and interleukin-2 consumption. These findings suggest that an alemtuzumab-mediated increase in the proportion of Treg cells may play a role in promoting the long-term efficacy of alemtuzumab in patients with multiple sclerosis. [ABSTRACT FROM AUTHOR]

The understanding of lithium-ion migration through the bulk crystal structure is crucial in the search for novel battery materials with improved properties for lithium-ion conduction. In this paper, procrystal calculations are introduced as a fast, intuitive way of mapping possible migration pathways, and the method is applied to a broad range of lithium-containing materials, including the well-known battery cathode materials LiCoO2, LiMn2O4, and LiFePO4. The outcome is compared with both experimental and theoretical studies, as well as the bond valence site energy approach, and the results show that the method is not only a strong, qualitative visualization tool, but also provides a quantitative measure of electron-density thresholds for migration, which are correlated with theoretically obtained activation energies. In the future, the method may be used to guide experimental and theoretical research towards materials with potentially high ionic conductivity, reducing the time spent investigating nonpromising materials with advanced theoretical methods. [ABSTRACT FROM AUTHOR]

PURPOSE: The purpose of this study was to investigate the age-related changes in diastolic filling parameters in the aging hearts of active C57Bl/6J mice throughout the life span to indicate optimal age periods for improvements in resting diastolic parameters. METHODS: Fourteen C57Bl/6J mice (seven males and seven females) were individually housed at 8 wk of age in cages with a running wheel, magnetic sensor, and digital odometer. Duration, distance, and running velocity were recorded daily. Fourteen additional mice C57Bl/6J mice (seven males and seven females) were placed in individual cages without running wheels at 8 wk of age. Pulsed-wave Doppler transmitral inflow recordings with a SONOS 5500 ultrasound and 15-6L ultrasound probe were used to image the left ventricle every 4 wk throughout the life span. RESULTS: Peak E wave filling velocities were significantly greater by the start of the second quarter of the life span in the mice with access to running wheels (P < 0.0001). Peak E wave velocities improved in both groups during the first half of the life span (P < 0.0001) and declined throughout the second half of the life span (P < 0.0001). Early-to-late (E:A) filling ratio was significantly greater for the physically active mice by the start of the second quarter of the life span (P < 0.0001) and continued throughout most of the remainder of the life span (P < 0.0001). No differences were observed between the two groups of mice with peak A wave filling velocities (P > 0.05). Similar findings were observed when corrected for resting heart rate. CONCLUSIONS: Lifelong physical activity resulted in greater diastolic filling parameters by the second quarter of the life span, highlighting the clinical importance of regular aerobic activity in young adulthood as a mechanism for improved left ventricular performance with aging. [ABSTRACT FROM AUTHOR]

America's self-perception has long been influenced by the opinions of America held by foreigners. Admiration for the United States was strong among British radicals in the early and mid-nineteenth century, but there was an alternative position, one that was negative toward America. While some historians have assumed that respect for the United States was a dominant fixture in British radicalism, others have shown that disinterest, or equivocation, or even hostility, was more prevalent. This article explores some of the reasons behind anti-Americanism. Special attention is given to economic matters, slavery, and foreign policy from the late 1820s to the early 1860s, and to the writings and speeches of the radical M.P. and political economist Thomas Perronet Thompson (1783–1869). Thompson's thoughts and activities repay consideration because they point to the range of responses – some of which have been underestimated by historians – that the United States could evoke. [ABSTRACT FROM PUBLISHER]

Abstract: Alemtuzumab is a monoclonal antibody against the CD52 antigen present at high levels on the surface of lymphocytes. While treatment of multiple sclerosis patients with alemtuzumab results in marked depletion of lymphocytes from the circulation, it has not been associated with a high incidence of serious infections. In a human CD52 transgenic mouse, alemtuzumab treatment showed minimal impact on the number and function of innate immune cells. A transient decrease in primary adaptive immune responses was observed post-alemtuzumab but there was little effect on memory responses. These results potentially help explain the level of immunocompetence observed in alemtuzumab-treated MS patients. [Copyright &y& Elsevier]

The article focuses on how Irish Chartist leader James Bronterre O'Brien used the ideologies of French revolutionary politician Maximilian Robespierre in an attempt to reform democracy in Great Britain throughout the early 1800s. The author compares the political and social issues taking place in Britain to those that had started the French Revolution. He discusses O'Brien's role in the history of Chartism, explores how he sought to end aristocratic tyranny, and analyzes the impact of the British parliamentary act known as the 1832 Reform Act on democratic suffrage.

Peripheral tolerance to developmentally regulated antigens is necessary to sustain tissue homeostasis. We have now devised an inducible and reversible system that allows interrogation of T-cell tolerance induction in endogenous naïve and memory CD8 T cells. Our data show that peripheral CD8 T-cell tolerance can be preserved through two distinct mechanisms, antigen addiction leading to anergy for naïve T cells and ignorance for memory T cells. Induction of antigen in dendritic cells resulted in substantial expansion and maintenance of endogenous antigen-specific CD8 T cells. The self-reactive cells initially exhibited effector activity but eventually became unresponsive. Upon antigen removal, the antigen-specific population waned, resulting in development of a self-specific memory subset that recalled to subsequent challenge. In striking contrast to naïve CD8 T cells, preexisting antigen-specific memory CD8 T cells failed to expand after antigen induction and essentially ignored the antigen despite widespread expression by dendritic cells. The inclusion of inflammatory signals partially overcame memory CD8 T-cell ignorance of self-antigen. Thus, peripheral CD8 T-cell tolerance for naïve CD8 T cells depended on the continuous presence of antigen, whereas memory CD8 T cells were prohibited from autoreactivity in the absence of inflammation. [ABSTRACT FROM AUTHOR]

This article explores the connections between Chartism, the most important popular reform mobilization in nineteenth-century Britain, and the United States of America, a source of hope and inspiration for many British radicals of the period, by focusing on the ideas and publications of James Bronterre O'Brien. The article explains why Chartists admired America's political system and social condition, why Britain seemed to them to be so flawed and corrupt in comparison, and how O'Brien - Chartism's 'schoolmaster'- used America in his political activities. Despite his key role in Chartism, especially in its early stages, O'Brien's reputation suffered thereafter, and among historians he has attracted only limited interest. His career merits another look. This article highlights in particular the ways in which he endorsed and increased the relevance of America to British radicals. [ABSTRACT FROM AUTHOR]

The relationship between physical activity levels and disease rates has become an important health-related concern in the developed world. Heart disease, certain cancers and obesity persist at epidemic rates in the US and Western Europe. Increased physical activity levels have been shown to reduce the occurrence of many chronic diseases leading to reductions in the burden on the healthcare system. Activity levels in humans are affected by many cultural and environmental factors; nevertheless, current research points to a strong biological input with potential genetic, neurological and endocrinological origins. Of unique interest, the sex hormones appear to have a very strong influence on activity levels. The current animal literature suggests that females tend to be more active than males due to biological pathways of estrogenic origin. The majority of human epidemiological and anthropological data, on the contrary, suggest women are less active than men in spite of this inherent activity-increasing mechanism. The purpose of this study is to review the current literature regarding the control of physical activity levels by the sex hormones in humans. Using the natural transitional phases of the aging endocrine system, natural periodicity of the menstrual cycle and pharmacological/hormone replacement therapy as variable experimental stages, some authors have been able to provide some information regarding the existence of an inherent activity-increasing mechanism in humans. In brief, activity levels during life stages prior to and after menopause do not significantly differ, despite the vast changes in sex hormone levels and function. Sex hormone differences throughout a regular menstrual cycle do not appear to influence activity levels in humans either; an effect that is pronounced in the female rodent. The use of hormone replacement therapies provides researchers with more systematic controls over hormone modulation in human subjects; however, this benefit comes with additional confounding variables, mostly due to disease or other states of malfunction. Despite the addition of these confounding factors, minor changes to the activity pattern have been observed in women, especially during the initial administration of the therapy. Observations are yet to be made in male subjects during replacement therapy. In general, some evidence exists suggesting that a biological mechanism extending from the sex hormones influences activity in humans. Unfortunately, despite a small number of investigative reports, the paucity of human research investigating how the sex hormones affect activity levels in humans prevents conclusive delineation of the mechanisms involved. Future research in this unique sub-field of endocrinology and exercise science utilizing more appropriate research protocols and effective techniques will provide definitive evidence of such mechanisms. [ABSTRACT FROM AUTHOR]

The article reports on research conducted to determine differences in physiologic responses and perceived discomfort during maximal and submaximal exercise with the elliptical cross-trainer (ECT) and the arc trainer, which undergoes an excursion of motion using an arc pathway. Researchers evaluated 18 subjects. They found that greater perceptions of discomfort were observed with ECT compared with ARC at similar submaximal exercise intensities.

Abstract: The participation of acetylcholine-activated potassium current (I K,ACh) and hyperpolarization-activated pacemaker current (I f) in vagal bradycardia were examined using vagally-innervated preparations of guinea-pig atria. Preparations were maintained in Krebs–Henseleit solution (36 °C). Before treatment, trains of vagal stimuli (10 s at 2, 5 and 10 Hz) produced graded bradycardias displaying rapid onset and offset. Tertiapin-Q (300 nM), which blocks I K,ACh, had no effect on baseline atrial rate. In tertiapin-Q, vagal bradycardia displayed a gradual onset and offset, with a peak response ~50% of that recorded in control conditions. Cumulative addition of 1 mM ZD7288 (blocker of I f) caused atrial rate to fall by ~60%, but had no further effect on the amplitude of the vagal bradycardia, while response onset and offset became slightly faster. From these observations, we argue that (i) vagal bradycardia was attributable primarily to activation of I K,ACh, (ii) vagal modulation of I f had a minor influence on the rate of onset and offset of bradycardia, and (iii) removal of the influence of I K,ACh unmasked a slow response, of undetermined origin, to vagal stimulation. In a separate set of experiments we compared the effects of 1 mM Ba2+ and 300 nM tertiapin-Q on vagal bradycardia. Ba2+ reduced baseline atrial rate and the response to vagal stimulation. Subsequent cumulative addition of tertiapin-Q had no additional effect on baseline atrial rate, but caused further reduction in the amplitude of vagal bradycardia, suggesting that 1 mM Ba2+ did not achieve a complete block of I K,ACh in this preparation. [Copyright &y& Elsevier]

Alemtuzumab is a humanized monoclonal antibody against CD52, an antigen found on the surface of normal and malignant lymphocytes. It is approved for the treatment of B-cell chronic lymphocytic leukaemia and is undergoing Phase III clinical trials for the treatment of multiple sclerosis. The exact mechanism by which alemtuzumab mediates its biological effects in vivo is not clearly defined and mechanism of action studies have been hampered by the lack of cross-reactivity between human and mouse CD52. To address this issue, a transgenic mouse expressing human CD52 (hCD52) was created. Transgenic mice did not display any phenotypic abnormalities and were able to mount normal immune responses. The tissue distribution of hCD52 and the level of expression by various immune cell populations were comparable to those seen in humans. Treatment with alemtuzumab replicated the transient increase in serum cytokines and depletion of peripheral blood lymphocytes observed in humans. Lymphocyte depletion was not as profound in lymphoid organs, providing a possible explanation for the relatively low incidence of infection in alemtuzumab-treated patients. Interestingly, both lymphocyte depletion and cytokine induction by alemtuzumab were largely independent of complement and appeared to be mediated by neutrophils and natural killer cells because removal of these populations with antibodies to Gr-1 or asialo-GM-1, respectively, strongly inhibited the activity of alemtuzumab whereas removal of complement by treatment with cobra venom factor had no impact. The hCD52 transgenic mouse appears to be a useful model and has provided evidence for the previously uncharacterized involvement of neutrophils in the activity of alemtuzumab. [ABSTRACT FROM AUTHOR]

This article describes and elucidates the making of Manchester Chartism, with special reference to the Reform Crisis of 1830–32 and its role in highlighting and confirming divisions within and between groups of radicals. For all the importance of personalities, ideas, organisations and national as well as local reform issues, the history of Chartism in Manchester was shaped above all by the town's political configuration. Political and class identities became stronger in 1830–32. This, and subsequent differences of opinion on key questions, ensured that no inclusive reform alliance was possible in Manchester. After examining the Reform Crisis of 1830–32, tracing the separation of middle-class from working-class activists and exploring the internal schisms within plebeian and respectable middle-class campaigns, this article shows how the polarisation of the early 1830s continued into the Chartist period. Problems of contact, communication and sympathy between the different groups were never overcome, and Manchester Chartism would itself experience fragmentation and resistance, just as earlier popular mobilisations in the town had been divided and opposed. [ABSTRACT FROM AUTHOR]

The genomic locations and identities of the genes that regulate voluntary physical activity are presently unknown. The purpose of this study was to search for quantitative trait loci (QTL) that are linked with daily mouse running wheel distance, duration, and speed of exercise. F2 animals (n 310) derived from high active C57L/J and low active C3H/HeJ inbred strains were phenotyped for 21 days. After phenotyping, genotyping with a fully informative single-nucleotide polymorphism panel with an average intermarker interval of 13.7 cM was used. On all three activity indexes, sex and strain were significant factors, with the F2 animals similar to the high active C57L/J mice in both daily exercise distance and duration of exercise. In the F2 cohort, female mice ran significantly farther, longer, and faster than male mice. QTL analysis revealed no sex-specific QTL but at the 5% experimentwise significance level did identify one QTL for duration, one QTL for distance, and two QTL for speed. The QTL for duration (DUR13.1) and distance (DIST13.1) colocalized with the QTL for speed (SPD13.1). Each of these QTL accounted for 6% of the phenotypic variance, whereas SPD9.1 (chromosome 9, 7 cM) accounted for 11.3% of the phenotypic variation. DUR13.1, DIST13.1, SPD13.1, and SPD9.1 were subsequently replicated by haplotype association mapping. The results of this study suggest a genetic basis of voluntary activity in mice and provide a foundation for future candidate gene studies. [ABSTRACT FROM AUTHOR]

The article offers information on diagnostic criteria for gestational diabetes mellitus. Topics include examines that Special Editorial from the International Federation of Gynecology and Obstetrics (FIGO) on the diagnostic criteria suggested that the present cut-off value for the fasting plasma glucose (FPG) with a several gram oral glucose tolerance test (OGTT) can be increased.

This article re-examines the problem of radical disunity after 1832. The main focus is on radical attitudes towards the second Melbourne ministry (1835–41) and its handling of the Canadian rebellions of 1837. Even when the government's imperial difficulties created a suitable opportunity to rekindle their reform campaign, radical leaders failed to co-operate effectively and made little headway in mobilizing and harnessing popular support. This defeat can be profitably explored through the experiences of Thomas Perronet Thompson (1783–1869), who emerged as one of the most energetic and strident critics of British policy in Canada during and after the rebellions. Despite his best efforts, Thompson was unable to win over other radical leaders or to attract a large following, a failure that highlights the wider constraints faced by radicalism in this era. [ABSTRACT FROM AUTHOR]

While a good deal has been written about the contacts between British and continental reformers in 1848 and afterwards, the same cannot be said of the 1820s and 1830s. This article will investigate the involvement in European affairs of Thomas Perronet Thompson and John Bowring, two of the closest colleagues of the utilitarian philosopher Jeremy Bentham. This article has three main purposes: first, to establish the relevance to British radicalism of a European perspective, using Thompson and Bowring as exemplars who can be taken to represent one of the most important strands in the British radicalism of their day; secondly, to improve our understanding of reform agitation and ideologies in early nineteenth-century Britain and Europe; and, thirdly, in view of the customary focus of historians on 1848 and after, to begin to redress this imbalance in the historiography by drawing attention to the 1820s and 1830s. [ABSTRACT FROM AUTHOR]

The purpose of this article is to describe and explain one important component of mid-nineteenth century British opinion on war and peace. The main avenues of inquiry are provided by the principles of utilitarian philosopher Jeremy Bentham and, in particular, the ways in which these were employed, modified and in some respects abandoned by one of Bentham's followers, Thomas Perronet Thompson. The activities of Thompson during the 1840s and 1850s can be usefully explored alongside those of another Benthamite, John Bowring. Thompson and Bowring worked closely together on many issues. Their contribution to various organizations, debates and campaigns is analysed, and their outlook compared with that of other figures, notably Richard Cobden. Britain's suspicion of France and wars against Russia and China provides useful case studies, illustrating the clash of ideas and the priorities that shaped policy and discussion. Thompson stayed closer to the Benthamite foundation than did Bowring, and the activities of both men offer valuable insights into the internal divisions and external pressures that plagued movements for peace and reform. [ABSTRACT FROM AUTHOR]

Objective: To determine if the RhD status of the fetus can be detected in an unselected group of RhD-negative women with ongoing pregnancies booking for routine antenatal care. Material and methods: We obtained 2.5ml of whole blood from 202 unselected women with a normal ongoing pregnancy who booked for antenatal care before 20 weeks’ gestation. DNA was extracted and real time quantitative PCR performed. Primers and a specific probe were targeted at the Rhesus D gene. Results: Of 194 women, 31 were RhD-negative with no evidence of prior isoimmunisation. They delivered 17 RhD-positive and 14 RhD-negative babies. Of the 17 RhD-negative women carrying a RhD-positive fetus, the RhD gene was detected in the maternal blood in 14 (82%). There were no false positives. The quantity of RhD gene detected in the maternal blood of RhD-negative mothers ranged from 2×102 to 4×106 copies/ml of whole blood. Conclusion: Using real time quantitative PCR assays to amplify free fetal DNA in the maternal circulation, identification of RhD-positive fetuses in RhD-negative mothers is feasible when they book for antenatal care. Before such RhD genotyping can be introduced into clinical practice, however, further studies are required to show that false negative results can be eliminated and to show that this diagnostic test is reliable outside a research setting. [Copyright &y& Elsevier]

Deals with the establishment and early history of the 'Westminster Review,' a radical periodical of early nineteenth-century Great Britain. Spotlight on the role of Thomas Perronet Thompson; Examination of editorial processes; Defense of Bethamite utilitarianism; Demands for political reform; Championship of liberal economics; Conflict with 'Edinburgh Review.'

Background: It is not known whether exercise training can induce a reduction of blood pressure (BP) and a regression of left ventricular hypertrophy (LVH) in older hypertensive subjects. This study was designed to determine whether endurance exercise training, by lowering BP, can induce regression of LVH and left ventricular (LV) concentric remodeling in older hypertensive adults.Methods: We studied 11 older adults with mild to moderate hypertension (BP 152.0 +/- 2.5/91.3 +/- 1.5 mm Hg, mean +/- SE), 65.5 +/- 1.2 years old, who exercised for 6.8 +/- 3.8 months. Seven sedentary hypertensive (BP 153 +/- 3/89 +/- 2 mm Hg) subjects, 68.5 +/- 1 years old, served as controls. LV size and geometry and function were assessed with the use of two-dimensional echocardiography.Results: Exercise training increased aerobic power by 16% (p < .001), and it decreased systolic (p < .05) and diastolic (p < .05) BP, LV wall thickness (from 12.8 +/- 0.4 mm to 11.3 +/- 0.3 mm; p < .05), and the wall thickness-to-radius (h/r) ratio (from 0.48 +/- 0.02 to 0.41 +/- 0.01; p < .05). There were no significant changes in the controls. The changes in LV mass index (deltaLVMI) were different between the two groups. LV mass index decreased in the exercise group (deltaLVMI - 14.3 +/- 3.3 g) but not in the controls (deltaLVMI 1.4 +/- 4.1 g; p = .009). A multiple stepwise regression analysis showed that among clinical and physiological variables including changes in resting systolic BP, aerobic power, body mass index, and systolic BP during submaximal and maximal exercise, only the reduction in resting systolic BP correlated significantly with a regression of concentric remodeling (delta h/r ratio r = .80; p = .003). The other variables did not add to the ability of the model to predict changes in the h/r ratio.Conclusions: The data suggest that exercise training can reduce BP and induce partial regression of LVH and LV concentric remodeling in older adults with mild or moderate hypertension. [ABSTRACT FROM AUTHOR]

PURPOSE: Older adults are known to gain the benefits of improved cognition, reduced risk of falls, and decreased mortality when participating in regular physical activity. Nearly sixty percent of older adults suggest they are not involved with regular physical activity or exercise, but those who are regularly active participate in different structured and unstructured programming options. Our investigation studied the influence of different physical activity options on perceived quality of life, step counts, and sleep behaviors in the older adult population. METHODS: Forty-five older adult volunteers answered a questionnaire that asked "Do you exercise?" If answered "Yes", then participants were asked "Is it structured (SE-Structured Exercise) or independent (IE-Independent Exercise)?". If answered "No", then participants were asked "Do you lead an active lifestyle (AL-Active Lifestyle) or not (C-Control)?" Nine men and 36 women participated in the current study, with group mean ages (±SD) of SE: 73.9±6.6yrs (n=13), IE: 76.5±6.1yrs (n=13), AL: 79.9±9.6yrs (n=10), C: 69.8±5.8yrs (n=9). Perceived health status and sleep quality were assessed with the SF-36 & PSQI, respectively, while daily energy expenditure and sleep quality were measured through a wrist worn Fitbit Charge HR for seven days. RESULTS: Groups were similar in height and weight (p>0.05), but SE and C were found to be younger (p=0.02) than the IE and AL groups. No group differences were observed for energy expenditure, sleep quality, or sleep efficiency (p>0.05). Pain (p= 0.002) and physical functioning (p=0.01) were lesser in the AL group compared to the remaining groups. Perceived health (p= 0.07) and daily step count (p= 0.07) trended towards group differences but were not statistically significant. CONCLUSIONS: Physical functioning and daily pain were influenced by physical activity programming with older adults, yet daily step counts and energy expenditure was found to not be influenced by type of activity programming with older adults. [ABSTRACT FROM AUTHOR]

PURPOSE: To examine thickness of the anterior talofibular ligament (ATFL) and if that thickness relates to physical activity levels one year after an ankle sprain. METHODS: Twenty college students (8 males and 12 females, age=21.2 ± 2.4yr., mass=80.9±21.6kg, ht=173.3±10.6cm) with an acute LAS and 20 healthy matched controls (8 males and 12 females, age=21.9± 2.8yr., mass=79.1±20.2kg, ht=172.5±9.8cm) participated in the study. ATFL thickness was measured with a LOGIQ Book (GE Healthcare, Waukesha, WI) diagnostic ultrasound. The examiner orientated the probe to view the cross sectional view of the lateral malleolus and the lateral talar articular surface cartilage and the neck of the talus. Measurements of ATFL thickness were made using ImageJ software (National Institutes of Health, Bethesda, MD). Thickness of the ATFL was measured at the midpoint of the ligament between the attachments of the lateral malleolus and talus. The main outcome measures were the thickness of the ATFL (mm) at 3 days post LAS and 1 year post LAS, and physical activity levels as measured by the IPAQ and NASA physical activity scales. RESULTS: There was a significant relationship between ATFL thickness and both the IPAQ and NASA physical activity scales. As ligament thickness increased, "average time spent performing vigorous physical activity" significantly decreased (p=.04, r²=-.86) and "average time spent performing moderate physical activity" (p=.02, r²=-.84) one year after injury. Subjects with a LAS also had a significant relationship with time spent walking (p=.01, r²=-.92), and days per week where they pursued vigorous activity (p=.02, r²=-.81) or moderate activity (p=.04 r²=-.85) one year after their sprain. As ligament thickness increased, overall subjective physical activity scores significantly decreased. CONCLUSIONS: One year after a LAS subjects had a significant relationship with ATFL thickness and activity levels. The changes in ATFL morphology may lead to the decreased physical activity levels due to the feeling of the ankle being unstable. Future research needs to focus on early interventions to ensure proper ligament healing occurs to restore joint function after an ankle sprain. [ABSTRACT FROM AUTHOR]

Background: The age-associated impairment in left ventricular (LV) systolic function appears to be mostly detectable during exercise or sympathetic stimulation. We hypothesized that the decline in cardiac function could be unmasked by an acute increase in afterload induced by phenylephrine. We further sought to examine whether the deterioration in cardiac function is influenced by gender.Methods: We studied 17 young (20-31 years old) and 21 older healthy subjects (60-75 years old) who were given infusions of incremental doses of phenylephrine following cardiac muscarinic receptor blockade with atropine. Left ventricular systolic function was assessed with 2-D echocardiography.Results: The young subjects exhibited a paradoxical increase in heart rate in response to alpha-adrenergic stimulation, but the older subjects did not (p < .01). The increase in systolic blood pressure in response to phenylephrine was influenced by age and gender (i.e., greater in the younger men and older women), whereas the increase in diastolic blood pressure was greater in the younger than the older subjects of both sexes. The changes in LV end-diastolic diameter with phenylephrine were unaffected by age or gender. The slope of the systolic shortening-end systolic wall stress relationship was significantly steeper in the older subjects, suggesting a decline in the contractile response to an acute increase in afterload with aging.Conclusions: This study's findings suggest that age can significantly influence the cardiovascular responses to alpha-adrenergic stimulation and that phenylephrine, by acutely increasing afterload, is effective in unmasking the age-associated deterioration in left ventricular systolic function. Further, it appears that the increase in systolic blood pressure in response to an alpha-adrenergic challenge is significantly influenced not only by age but also by gender. [ABSTRACT FROM AUTHOR]

Seeks to re-balance the canon of anti-corn law leadership by examining the ideas of Thomas Perronet Thompson. Role in the work of the Anti-Corn Law League; Thompson's free trade principles; Personal leadership among anti-corn leaders; Links between the League and other phenomena as Chartism and the campaign for factory reform; Central importance of Thompson in the achievement of repeal.