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To review evidence regarding the impact of physical activity interventions for preventing and managing type 2 diabetes in Aboriginal and Torres Strait Islander Australians. We searched for published reports of physical activity interventions for preventing and managing type 2 diabetes in Indigenous adults (18 years or older). There were no exclusion criteria regarding study type or duration, frequency, length, or intensity of physical activity, except that short term interventions were excluded. We assessed the quality of each study using the Joanna Briggs Institute (JBI) critical appraisal tools and the ethical and methodological quality of studies from an Indigenous Australian perspective with the Centre of Research Excellence in Aboriginal Chronic Disease Knowledge Translation and Exchange (CREATE) Critical Appraisal Tool. MEDLINE; Scopus, Embase (Elsevier); Cumulative Index to Nursing and Allied Health Literature (CINAHL), Sports Discus, PsycINFO (EBSCO); Informit Complete; ProQuest Dissertations and Theses, and ProQuest Health and Medicine; each from their inception to 30 October 2022. The database searches identified 703 potentially relevant records; after removing duplicates and initial screening, the full text of 27 articles was assessed for eligibility. Nine studies met our inclusion criteria: two randomised controlled trials, five cohort studies, one quasi‐experimental study, and one repeated cross‐sectional study. Eight studies were rated as being of low or medium quality (median JBI score, 54%; interquartile range [IQR], 36–64%); seven studies were rated as being of low to medium ethical and methodological quality from the Indigenous perspective (median CREATE score, 50%; IQR, 36–64%). Six studies reported changes in glycated haemoglobin (HbA1c) levels, of which two (both cohort studies) reported significantly lower mean HbA1clevels after the intervention, but only one publication provided detailed results. No randomised controlled trials that investigated the effect of a combination of physical activity and dietary change for Indigenous Australians diagnosed with type 2 diabetes were identified. Differences in study design, outcome variables, and the small number of studies precluded meta‐analysis. Quality research into the impact of physical activity interventions on type 2 diabetes in Indigenous people is sparse. To improve research translation, studies that involve Indigenous community members at all levels of the research process are needed. PROSPERO CRD42021247496 (prospective).

The New York Police Department and the New York Nightlife Association have formulated a set of best practices to improve the safety of nightlife establishments. These measures concern the conduct and disposition of employees, age verification for guests, club policies, and other security issues.

The New York Police Department's (NYPDs) ways in terminating graffiti vandalism, a serious quality-of-life crime, are presented. The various steps involved can be easily followed and can be used by any law enforcement agency.

OBJECTIVE--To examine the effects of hormone replacement therapy (HRT) on lipid metabolism, glycemic control, total body and central abdominal fat, blood pressure (BP), and arterial pulse wave velocity (APWV) in [...]

Fearing crime, or becoming one of its victims, is to lose a fair measure of freedom in a democratic society. And, my premise is that we have gotten far too [...]

BackgroundIn general, academic but not community endoscopists have demonstrated adequate endoscopic differentiation accuracy to make the ‘resect and discard’ paradigm for diminutive colorectal polyps workable. Computer analysis of video could potentially eliminate the obstacle of interobserver variability in endoscopic polyp interpretation and enable widespread acceptance of ‘resect and discard’.Study design and methodsWe developed an artificial intelligence (AI) model for real-time assessment of endoscopic video images of colorectal polyps. A deep convolutional neural network model was used. Only narrow band imaging video frames were used, split equally between relevant multiclasses. Unaltered videos from routine exams not specifically designed or adapted for AI classification were used to train and validate the model. The model was tested on a separate series of 125 videos of consecutively encountered diminutive polyps that were proven to be adenomas or hyperplastic polyps.ResultsThe AI model works with a confidence mechanism and did not generate sufficient confidence to predict the histology of 19 polyps in the test set, representing 15% of the polyps. For the remaining 106 diminutive polyps, the accuracy of the model was 94% (95% CI 86% to 97%), the sensitivity for identification of adenomas was 98% (95% CI 92% to 100%), specificity was 83% (95% CI 67% to 93%), negative predictive value 97% and positive predictive value 90%.ConclusionsAn AI model trained on endoscopic video can differentiate diminutive adenomas from hyperplastic polyps with high accuracy. Additional study of this programme in a live patient clinical trial setting to address resect and discard is planned.

Presents a speech given by the commissioner of the United States Customs Service to The Sixteenth International Symposium on Economic Crime, dealing with the issue of combatting global money laundering.

Objectives: Numerous scales assessing the aesthetics of cleft lip repair exist. Most, including the Asher-McDade scale, use frontal and lateral views, while neglecting a basal view. We believe this view is important for properly assessing the aesthetics of repair. In this study, we evaluate the basal view in comparison to the Asher-McDade scale.Methods: This scale was based on progressive columellar shortening and alar flaring/slumping. A panel of 4 plastic surgeons applied the basal and Asher-McDade scales to pictures of patients with repaired unilateral cleft lip in 56 multiethnic participants aged 5 years to 18 years; images were scored from 1 to 5 (best). Statistical analysis was done via Spearman correlation.Results: Scores from plastic surgeons correlated strongly for each view. There was moderate correlation for the basal view with both nasal form and deviation scores (P< .05). As expected, there were no strong correlations between the basal view and vermillion border or profile.Discussion: The Asher-McDade scale has been used to evaluate cleft lift repairs but is limited due to its subjective nature. The basal view scale grades these repairs by using a scale of progressive columellar shortening and alar flaring/slumping, which provides an opportunity for quantification and standardization. Our results show that the basal view correlates with the Asher-McDade scale among raters, thus providing an objective and validated measure of cleft lip repair.

Presents a speech, `Toward a New Intolerance,' by the police commissioner of New York City, delivered to the Second Annual FBI National Symposium on Addressing Violent Crime through Community Involvement in Quantico, Virginia on February 16, 1993, dealing with the issues of gun control and community policing.

Recordings of pressure in the brachial or peripheral arteries fail to disclose the marked increase in systolic pressure that occurs in the proximal aorta and central arteries with increasing age and with hypertension. This systolic pressure boost is caused by wave reflection returning from the periphery of the body while the ventricle is still contracting. Such early wave reflection is caused in turn by increased pulse-wave velocity, attributable to stiffening of the aorta and major conduit arteries. Drugs have little effect on arterial stiffening, whereas wave reflection can be markedly reduced by agents that dilate peripheral arteries. Such reduction in wave reflection causes substantial decrease of systolic pressure in central arteries. Because of differential timing of wave reflection, however, such reduction is not apparent from pressure recordings taken in the brachial or other peripheral arteries. The sphygmomanometer, therefore, fails to show the favorable effects of reduced wave reflection in the proximal aorta and central arteries. Noninvasive tonometric pressure wave recordings can supplement the sphygmomanometer to assess the magnitude of beneficial effect.

The article discusses the lessons learned by the New York Police Department (NYPD) during the past 10 years after the September 11 terrorist attacks in 2001 or 9/11 attack. It states that the attack is international and it involves informal networks of aspiring radicals and an organized entities with funds. It notes the effort of the police to develop their own counterterrorism bureau and hire civilian intelligence analysts to help minimize the threats faced by the people in the state.

Fas is a transmembrane receptor that can induce apoptosis after cross-linking with either agonistic antibodies or with Fas ligand (FasL). Although originally described as an important regulator of peripheral immune homeostasis, accumulating evidence suggests that the Fas/FasL system plays an important role in tumour development. In addition to its proapoptotic functions, accumulating evidence demonstrates that Fas can activate numerous nonapoptotic signalling pathways, and that activation of these pathways can result in increased tumourigenicity and metastasis. This review summarises the current understanding of the Fas/FasL system in tumorigenesis and discusses attempts to utilise the Fas/FasL system in the treatment of cancer.

Assembly of muscle sarcomeres is a complex dynamic process and involves a large number of proteins. A growing number of these have regulatory functions and are transiently present in the myofibril. We show here that the novel tubulin-associated RING/B-box protein MURF2 associates transiently with microtubules, myosin and titin during sarcomere assembly. During sarcomere assembly, MURF2 first associates with microtubules at the exclusion of tyrosinated tubulin. Then, MURF2-labelled microtubules associate transiently with sarcomeric myosin and later with A-band titin when non-striated myofibrils differentiate into mature sarcomeres. Finally, MURF2 labelled microtubules disappear from the sarcomere after the incorporation of myosin filaments and the elongation of titin. This suggests that the incorporation of myosin into nascent sarcomeres and the elongation of titin require an active,microtubule-dependent transport process and that MURF2-associated microtubules play a role in the alignment and extension of nascent sarcomeres. MURF2 is expressed in at least four isoforms, of which a 27 kDa isoform is cardiac specific. A C-terminal isoform is generated by alternative reading frame use,a novelty in muscle proteins. In mature cardiac sarcomeres, endogenous MURF2 can associate with the M-band, and is translocated to the nucleus. MURF2 can therefore act as a transient adaptor between microtubules, titin and nascent myosin filaments, as well as being involved in signalling from the sarcomere to the nucleus.

Increased expression of the type I insulin-like growth factor receptor (IGF-1R) is associated with colon cancer, while the antioxidant N-acetyl-l-cysteine (NAC) is known to suppress colonic proliferation. We demonstrate that NAC down-regulates the expression of IGF-1R on three colorectal adenocarcinoma cell lines (HT29, SW480, and LoVo). NAC also abrogates the proliferative effect of IGF-I on HT29 cells. This indicates a novel mechanism for the therapeutic effects of NAC.

Inhaled nitric oxide is a potent and selective pulmonary vasodilator. However, when used in patients with congestive cardiac failure, the decrease in pulmonary vascular resistance is associated with an increase in pulmonary capillary wedge pressure (PCWP). This study examined load-independent indexes of left ventricular chamber function during inhaled nitric oxide in 10 patients with dilated cardiomyopathy (mean ejection fraction, 30.2 ± 7.8%, mean ± SD). Etiology of cardiomyopathy was idiopathic in six and ischemic in four. Pulmonary hemodynamics in seven patients revealed normal resting pulmonary vascular resistance. Chamber function was defined by recording pressure-volume loops at steady state and during inferior vena caval occlusion during inhalation of 20 ppm nitric oxide for 10 min. We found no effect of inhaled nitric oxide on steady-state left ventricular pressures, volumes, contractility (end-systolic elastance or preload recruitable stroke work), contraction duration, or active (τ, dP/dtmin) or passive (end-diastolic pressure-volume relation) diastolic function. Right heart filling pressures did not change. We therefore conclude that 20 ppm inhaled nitric oxide does not affect left ventricular chamber function in patients with controlled heart failure. Previously described elevations in PCWP during inhaled nitric oxide are most likely due to altered left ventricular loading conditions related to secondary pulmonary hypertension in severe heart failure.

To determine the detailed effects of hormone replacement therapy (HRT) on non-invasive haemodynamics, including an assessment of the effect on the pulsatile afterload assessed in terms of the augmentation index and pulse-wave velocity.

An unusual case of Coxiella burnetiinfection is described in which the patient presented with an “acute abdomen” and marked clinical icterus. This case emphasizes that Q‐fever may appear as acute hepatitis and illustrates its “characteristic” histopathological lesions which have been recognized only recently.

Systolic arterial pressure is an important risk factor for future cardiovascular morbidity and mortality.

Objectives. The aim of this study was to determine the relations between spontaneous echo contrast, left atrial appendage blood flow velocity and thromboembolism.

Abstract: Recent investigations have yielded new insights into the interaction of the left ventricle with the arterial system. These studies have employed a variety of coupling frameworks to quantify this interaction, and each makes several simplifying assumptions. In this article, we review these frameworks, their major findings, assumptions, and clinical applications, and examine future directions for this research.

Objectives. This study investigated the effect of age and gender on central arterial hemodynamic variables derived from noninvasive tonometric carotid pressure waveforms.

Objectives. This study determined the effects of inhaled nitric oxide (NO) on load-independent indexes of normal human left ventricular (LV) function.

Looks at the lessons learned from casualties of the Canadian military forces during the Battle at Dieppe in 1942. War with great casualties from 480 BC to 1876; Canadian casualty rate at Dieppe; Problems faced by the Canadian forces.

POISONING from camphor ingestion has been reported periodically for more than 140 years.1 Morbidity is significant, and 20 deaths have been reported.1,2 Camphor is listed in the Toxicology Rating System as "class 4, very toxic," with a probable human lethal dose in the range of 50 to 500 mg/kg.3 It is rapidly absorbed after oral ingestion,4 and there is no known antidote. Lipid hemodialysis has been the only reported technique for removal of absorbed camphor.5 In the course of treating a patient who had ingested camphorated oil, hemoperfusion through amberlite resin was used and shown to be a new, effective, and less cumbersome therapeutic modality.Report of a CaseA 37-year-old man came to the emergency department at 1:30 AM because of abdominal distress. A friend who accompanied him indicated that the patient had ingested part of the contents of a 120-ml bottle that contained

The article presents information on several objects found by brothers Trevor and Gary Bankhead while diving in the Wear river in Durham, England which are believed to belong to Michael Ramsey, a former bishop of Durham and archbishop of Canterbury, Kent.

Background: Diabetes mellitus negates the premenopausal gender benefit with respect to coronary artery disease. Whether hormone replacement therapy (HRT) offers any cardiovascular advantage to diabetic postmenopausal women is not known. Diabetic subjects have increased vascular load and abnormal 24-h blood pressure (BP) profiles. Hormone replacement therapy has been shown to improve indexes of arterial load in nondiabetic postmenopausal women as well as to restore circadian variation in BP. This aim of this study, therefore, was to determine prospectively whether HRT improved arterial stiffness and 24-h ambulatory BP profile in diabetic postmenopausal women. Methods: Twelve diabetic postmenopausal women were studied. Six subjects were also hypertensive. Vascular load was characterized by carotid arterial pulse waveform analysis to calculate central augmentation index. All subjects also underwent 24-h BP monitoring. Subjects were studied before commencement of HRT and were then randomized to two groups. The first group was observed for 6 months and then given 2 months of estrogen alone, followed by 4 months of combination estrogen with progestin. The second group received the HRT regimen first, then were restudied after 6 months off HRT. Results: The HRT did not affect either clinic or ambulatory BP. There were no changes in indexes of vascular load or pulse pressure, an indirect measure of arterial stiffness. There was a low rate of circadian variation in 24-h BP at baseline (55%), which was unaltered by HRT. Conclusions: The HRT was well tolerated. Despite evidence for a beneficial effect of HRT on indexes of arterial load and ambulatory BP previously reported in normal subjects, we found no change in this cohort of diabetic postmenopausal women. Am J Hypertens 2001;14:699–703 © 2001 American Journal of Hypertension, Ltd.

Objectives: While women have lower rates of atherosclerotic disease than men, they are more likely to suffer cardiac failure following infarction or cardiac surgery, despite typically having a greater left ventricular (LV) ejection fraction. We hypothesised that gender differences in systolic chamber function and ventriculo-vascular coupling may contribute to these clinical findings. Methods: LV chamber function was determined in a cohort of 30 patients (16 women) aged 48–75 years with normal LV function using pressure-volume loops obtained by simultaneous conductance catheter volumetry and micromanometer pressure. End-systolic and end-diastolic pressure volume (ESPVR, EDPVR) and preload recruitable stroke work relations (PRSWR) were derived. Results were analysed according to gender, and the effects of body size and chamber dimensions were examined. Results: The groups were closely matched for age (60±6 vs. 60±8 years) and co-morbid conditions. Women had higher end-systolic blood pressure (139.7±21.1 vs. 123.6±12.6 mmHg, P = 0.001), and smaller LV cavity volume (end-diastolic volume 96.4±30.6 vs. 139±30.7 ml, P = 0.001). Women had significantly higher LV end-systolic elastance (Ees, 2.65±0.10 vs. 1.96±0.09 mmHg ml–1, P<0.002), arterial elastance (2.41±1.13 vs. 1.54±0.55 mmHg ml–1, P = 0.01) and lower passive LV diastolic compliance (slope EDPVR, 6.12±0.37 vs. 10.0±0.50 ml mmHg–1, P<0.001). While there was a strong relationship between end-systolic elastance and chamber volume (r = 0.69, P<0.001), gender differences in chamber function all persisted after indexing to body size. Higher LV systolic function in women was also shown in PRSWR analysis (slope, M_SW; 101.4±3.8 vs. 90.4±2.8 mmHg, P<0.05), which is independent of chamber size. After normalising volumes to resting diastolic volume, the greater systolic and diastolic elastance in women was accounted for. The ratio of end-systolic to arterial elastance, a measure of ventriculo-vascular coupling, was similar in women and men (1.19±0.40 vs. 1.54±0.30, respectively, P = 0.23). Conclusions: This study demonstrates greater systolic chamber function and lower diastolic compliance in women. Within the range of chamber dimensions seen in patients with normal LV function, a strong relationship was found between cardiac size and end-systolic elastance. While these differences were not accounted for by indexing to body size, the greater ventricular elastance in women was removed after normalising to chamber size. Despite differences in resting ventricular elastance, appropriate ventriculo-vascular coupling was maintained in both genders as the greater end-systolic elastance in women was matched by similarly elevated arterial elastance.

A total of 30 human head-hair samples were analyzed for cocaine (COC), cocaethylene (CE), benzoylecgonine (BE), methylecgonine (EME), and norcocaine (NCOC) using a sensitive positive ion chemical ionization gas chromatography-tandem mass spectrometry (GC-MS-MS) method. All 30 hair samples had been previously submitted to the laboratory and had confirmed positive for cocaine. Hair samples (20 mg each) were cut into small segments (2–5 mm) and incubated overnight at 45° in 0.1 N HCl after the addition of 50 µL of an internal standard mix of COC-d3 (1.0 ng/mg), BE-d3 (0.5 ng/mg), EME-d3 (0.25 ng/mg), and NCOC-d3 (0.25 ng/mg). The samples were then extracted with Clean Screen® extraction columns from United Chemical Technologies, Inc. The final extract was evaporated to dryness and derivatized with 50 µL of 1,1,1,3,3,3-hexafluoro-2-propanol and 50 µL of trifluoroacetic anhydride at 90°C for 15 min. The derivatized samples were allowed to cool to room temperature, evaporated to dryness, and then reconstituted in 50 µL of ethyl acetate. Parent set masses (unbolded ions) and product ions were m/z 304 and m/z 182 and 82 (COC), m/z 307 and m/z 185 and 85 (COC-d3), m/z 318 and m/z 196 and 82 (CE), m/z 440 and m/z 318 and 105 (BE), m/z 443 and m/z 321 and 105 (BE-d3), m/z 296 and m/z 182, and 82 (EME), m/z 299 and m/z 185 and 85 (EME-d3), m/z 403 and m/z 386 and 105 (NCOC), m/z 406 and m/z 389 and 105 (NCOC-d3). Quantitation was accomplished by calculating the area ratio of the higher mass product ion (underlined ions) of analyte to the respective internal standard based on multilevel calibrations from 0.01 to 10.0 ng/mg. The GC-MS-MS method had a limit of detection of 0.01 ng/mg and a limit of quantitation of 0.05 ng/mg for all five analytes. COC, BE, and EME were detected in all 30 samples, and CE and NCOC were found in 19 and 29 samples, respectively. The average relative percentages of each metabolite normalized to the cocaine concentrations were 12.8%, 15.4%, 1.8%, and 2.5% for BE, CE, EME, and NCOC, respectively.

Inhaled nitric oxide allows selective pulmonary vasodilatation with rapidity of action. It is effective in the acute post-operative management of pulmonary hypertension in cardiac surgical patients and is also valuable in assessing the pulmonary vasodilator capacity in patients with chronic pulmonary hypertension. This review examines the current role of inhaled nitric oxide in cardiac medicine, discussing issues concerning its administration and toxicity, as well as a summary of clinical studies in cardiac patients. New roles, as a modifier of platelet and leukocyte function, post-thrombolysis and following lung transplantation are described. New agents and alternative therapies, which prolong pulmonary activity, are also discussed.

Proficiency testing in forensic toxicology is now in the initial stages of development; the time is right for forensic toxicologists to influence the form it takes. This paper discusses the benefits of proficiency testing to the practicing toxicologist, enumerates desirable features for such programs and considers the role of drug metabolites in proficiency testing.

A simple procedure for analysis of camphor in plasma samples by gas chromatography is presented here. Samples are extracted with hexane containing an internal standard (acetophenone) and, after centrifugation, the hexane layers are concentrated by evaporation, and a small aliquot is injected into the gas chromatograph. Quantitation is achieved by comparison of the peak height ratio of the samples with those of standard solutions. The method displays good sensitivity, linearity, and precision.

Human hair was collected from the occipital crown region of the head from several subjects; these hair samples were presumptively positive for amphetamines by a previously evaluated immunoassay. Hair was washed briefly with methanol to remove external contamination, then extracted with hot methanol for 2 h to recover the drugs. The extracts were evaporated to dryness, reconstituted in buffer, and analyzed using a new enzyme-linked immunosorbent assay (ELISA) technique adapted for the detection of amphetamines in hair. Gas chromatography-mass spectrometry was used as the reference technique. Cross-reactivity of several related compounds was evaluated by equating the inverse of the ligand concentration at 50% antibody binding to the affinity constant for each compound. The ratio of a compounds affinity constant to that for d-methamphetamine was used to derive percent crossreactivity. These experiments yielded values of 30.8% for d-amphetamine, 7.4% for l-methamphetamine, 4.3% for phentermine, 2.9% for l-amphetamine, and <1% for ephedrine, methylenedioxyamphetamine, and methylenedioxymethamphetamine. Cross-reactivity of unrelated compounds was found to be non-existent. The optimum cutoff concentration was determined by receiver operating characteristic curve analysis to be 300 pg/mg and the observed limit of detection was 60 pg/mg. Intra-assay precision at 300 pg/mg was 3.3% (coefficient of variation, CV), and the interassay CV was 10.5%. The sensitivity and specificity of the method were 83% and 92%, respectively.