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Magnetic resonance imaging (MRI) is used for preoperative evaluation, high-risk screening, and other select indications for breast cancer. However, the interpretation of breast MR images in pregnant and lactating women is complicated by physiologic changes of the breast that may result in marked background enhancement. Breast MRI with contrast administration is contraindicated in pregnancy. Restriction spectrum imaging (RSI) is an advanced diffusion-weighted (DW)-MRI method that theoretically reflects signal from cells with high nuclear-to-cytoplasm ratio without gadolinium-based contrast. This report describes a case in which RSI notably increased tumor conspicuity in a lactating woman, compared to contrast-enhanced (CE)-MRI and conventional DW-MRI.

Both rabies and snakebite primarily affect underserved and impoverished communities globally, with an estimated 200,000 people dying from these diseases annually, and the greatest burden being in Africa and Asia. Both diseases have been neglected and have thus been denied appropriate prioritization, support, and interventions, and face many of the challenges common to all neglected tropical diseases (NTDs). In line with the call for integrated approaches between NTDs in the recent NTD Roadmap, we sought to build upon previous conceptualizations for an integrated approach by identifying the commonalities between snakebite and rabies to explore the feasibility of an integrated approach. While multiple areas for potential integration are identified, we highlight the potential pitfalls to integrating rabies and snakebite programs, considering the nuances that make each disease and its intervention program unique. We conclude that health system strengthening, and capacity building should be the focus of any integrated approach among NTDs, and that by strengthening overall health systems, both rabies and snakebite can advocate for further support from governments and stakeholders.

SUMMARY Bacteria adapt to dynamic changes in the host during chronic and recurrent infections. Bacterial microevolution is one type of adaptation that imparts a selective advantage. We hypothesize that recurrent episodes of disease promote microevolution through genetic mutations that modulate disease severity. We use a pre-clinical model of otitis media (OM) to determine the potential role for microevolution of nontypeable Haemophilus influenzae (NTHI) during sequential episodes of disease. Whole genome sequencing reveals microevolution of hemoglobin binding and lipooligosaccharide (LOS) biosynthesis genes, suggesting that adaptation of these systems is critical for infection. These OM-adapted strains promote increased biofilm formation, inflammation, stromal fibrosis, and an increased propensity to form intracellular bacterial communities (IBCs). Remarkably, IBCs remain for at least one month following clinical resolution of infection, suggesting an intracellular reservoir as a nidus for recurrent OM. Additional approaches for therapeutic design tailored to combat this burdensome disease will arise from these studies., Graphical Abstract, In Brief Harrison et al. develop a sequential model of otitis media (OM) to investigate microevolution through genetic mutations that modulate disease severity. OM-adapted strains promote increased biofilm, inflammation, stromal fibrosis, and intracellular bacterial community (IBC) development. IBCs remain one month following clinical resolution of infection, suggesting a nidus for recurrent OM.

Signal transducer and activator of transcription 3 (Stat3) is a member of the Stat family of proteins involved in signaling in many different cell types, including osteocytes. Osteocytes are considered major mechanosensing cells in bone due to their intricate dendritic networks able to sense changes in physical force and to orchestrate the response of osteoclasts and osteoblasts. We examined the role of Stat3 in osteocytes by generating mice lacking Stat3 in these cells using the Dmp-1(8kb)-Cre promoter (Stat3cKO mice). Compared to age-matched littermate controls, Stat3cKO mice of either sex (18 weeks old) exhibit reduced bone formation indices, decreased osteoblasts and increased osteoclasts, and altered material properties, without detectable changes in bone mineral density (BMD) or content of either trabecular or cortical bone. In addition, Stat3cKO mice of either sex show significantly decreased load-induced bone formation. Furthermore, pharmacologic inhibition of Stat3 in osteocytes in vitro with WP1066 blocked the increase in cytosolic calcium induced by ATP, a mediator of the cellular responses to sheer stress. WP1066 also increased reactive oxygen species (ROS) production in cultured MLO-Y4 osteocytes. These data demonstrate that Stat3 is a critical mediator of mechanical signals received by osteocytes and suggest that osteocytic Stat3 is a potential therapeutic target to stimulate bone anabolism., Highlights • Specific knockout of Stat3 in osteocytes suppresses loading induced bone formation • Stat3 deficiency in osteocytes decreases the material properties of femur • Stat3 inhibitor causes Reactive Oxidative Species (ROS) accumulation in MLO-Y4 osteocytes • Stat3 inhibitor blocked ATP-induced intracellular calcium influx into MLO-Y4 osteocytes

Highlights • Reviewing photographs helped identify dogs seen on both survey days. • Improved dog identification lead to a higher population estimate. • Vaccination coverage did not vary between field-surveyor and photo-reviewer populations. • Improved dog identification allowed for vaccination mark loss estimates, showing likely higher coverage., Background Enumerating dog populations is essential to plan and evaluate rabies vaccination campaigns. To estimate vaccination coverage and dog population size in a Haitian commune, 15 sight-resight counts were conducted over two days following a government-sponsored vaccination campaign. Methods Dogs received temporary laminated collars and livestock wax marks on the head and sides at the time of rabies vaccination. After the vaccination campaign, pairs of surveyors walked pre-defined routes through targeted neighborhoods, photographing and recording characteristics and location of each dog seen on a standardized data sheet. On the second survey day, surveyors retraced the prior day’s track, followed the same procedure, and indicated in addition whether they believed the dogs were resighted from the prior day. After completion of the field survey, two independent evaluators reviewed photographs and characteristics of each dog to assess which had vaccination marks and which were resighted. Surveyor and photo-reviewer sight-resight decisions were compared using Cohen’s kappa, and population estimates were compared using Lincoln-Petersen 95% confidence intervals. Results Field-surveyors identified dogs consistent with the photograph evaluations in 629 out of 800 instances (78.6%, Cohen’s kappa of 0.12). Despite this inconsistency, the population estimates resulting from the field and final determinations were not significantly different at 1,789 (95% CI 1,677 to 1,901) and 1,978 (95% CI 1,839 to 2,118). Vaccination coverage was also the same at 55% and 56%; however, an observed vaccination mark loss of 13.8% suggests that the true coverage may have been closer to 64%. Conclusion Using photos improved dog identification during the sight-resight study, leading to a higher population estimate. Despite using a 2-mark system to temporarily identify vaccinated dogs, a significant proportion had lost all identifying marks by the second day of field surveys. Efforts to estimate vaccination coverage using sight-resight surveys should consider improvement of marking techniques or better accounting for potential loss of marks in their free-roaming dog vaccination coverage assessments.

As with all structures, whether man made or naturally occurring, the mechanical properties of bone are governed by physical principles. However, bone has the biological ability to change and adapt to its environment, not only to more efficiently bear the loads imparted on it but also to repair damage induced by loading and disease. It would be an impractical and impossible task to fit all of the information needed to understand bone mechanics into one short chapter in a textbook. This chapter is meant to provide an overview of the most pertinent information required to grasp the basics of bone mechanics and those factors that contribute most to bone mechanical properties; it should be accessible to individuals across medical, engineering, and basic science disciplines. For additional information, please see the references noted in the “Suggested Readings” section.

The objective of this chapter is to describe the current landscape in health disparities science in the United States. After providing a brief overview of health disparities, we summarized the available influential published studies on inadequate sleep duration, poor sleep quality, and a group of commonly reported sleep disorders including insomnia, Obstructive Sleep Apnea, Narcolepsy, Restless Leg Syndrome and Periodic Limb Movement. Overall, despite the heterogeneity in methodology measures and study population, black men and women report the shortest objective sleep duration relative to their white counterparts; while specific Hispanic subgroups may have been particularly at high risk for sleep disordered breathing. Several critical gaps remain with respect to other racial/ethnic groups and sexual minorities. Overall, we underlined the complex relationship between SES measures and perceived sleep health that may vary by racial/ethnic background. Finally, after exploring the potential influence on sleep health among minorities of acculturation, discrimination, worry and risk perception, and sleep opportunity, we later identified gaps in the literature and provided suggestions for future inquiry, including importance of personalized efficacious treatments adapted to the needs of vulnerable populations, and inclusion of sexual minorities.

Treadmill running and tibial loading are two common modalities used to assess the role of mechanical stimulation on the skeleton preclinically. The primary advantage of treadmill running is its physiological relevance. However, the applied load is complex and multiaxial, with observed results influenced by cardiovascular and musculoskeletal effects. In contrast, with tibial loading, a direct uniaxial load is applied to a single bone, providing the advantage of greater control but with less physiological relevance. Despite the importance and wide-spread use of both modalities, direct comparisons are lacking. In this study, we compared effects of targeted tibial loading, treadmill running, and their combination on cancellous and cortical architecture in a murine model. We show that tibial loading and treadmill running differentially improve bone mass, with tibial loading resulting in thicker trabeculae and increased cortical mass, and exercise resulting in greater number of trabeculae and no cortical mass-based effects. Combination of the modalities resulted in an additive response. These data suggest that tibial loading and exercise may improve mass differentially., Highlights • Tibial loading increased trabecular thickness while exercise increased number. • Combined effects of loading and exercise were additive in cancellous bone. • In cortical bone, loading increased cross-sectional area. • No mass-based effects were noted due to exercise.

Introduction Hypoparathyroidism in pregnancy is rare, but important, as it is associated with maternal morbidity and foetal loss. There are limited case reports and no established management guidelines. Optimal maintenance of calcium levels during pregnancy is required to minimise the risk of related complications. This study aims to identify causes and examine outcomes of hypoparathyroidism in pregnancy in a cohort of women delivering at a large referral centre. Design and method The Monash Health maternity service database captures pregnancy and birthing outcomes in over 9000 women each year. We audited this database between 2000 and 2014 to examine the clinical course, treatment and outcomes of pregnant women with hypoparathyroidism. Results We identified 10 pregnancies from 6 women with pre-existing hypoparathyroidism secondary to idiopathic hypoparathyroidism (n = 3), autosomal dominant branchial arch disorder with hypoparathyroidism (n = 3) and autosomal dominant hypocalcaemia (n = 1), surgery for thyroid cancer (n = 2) and Graves' disease (n = 1). Maternal calcium levels were monitored through pregnancy and management adjusted to maintain normocalcaemia. One woman was delivered by caesarean section at 34 weeks' gestation because of intrauterine growth restriction, and oligohydramnios complicated two other pregnancies. The postpartum period was complicated by severe hypercalcaemia in one woman and by symptomatic, labile serum calcium levels during lactation in another woman, requiring close monitoring over a 6 month period. Conclusion Although rare, hypoparathyroidism in pregnancy poses a management challenge for clinicians, and co-ordinated care is required by obstetricians and endocrinologists to ensure optimal outcomes for both mother and baby. Continued monitoring of maternal calcium levels during lactation and weaning is essential to avoid the potential complications of either hypercalcaemia or hypocalcaemia., Highlights • A review of 10 pregnancies with hypoparathyroidism presenting to a single centre • Causes of hypoparathyroidism includes idiopathic, congenital and post-thyroidectomy • Pre-existing hypoparathyroidism is associated with increased antenatal complications. • Monitor and maintain maternal corrected calcium levels in the low to mid-normal range • Dose reduction of calcitriol following delivery is needed to avoid hypercalcaemia.

Transition metal dichalcogenides (TMDs) are a class of layered materials of significant interest due to their scalability and thickness-dependent electrical and optical properties. The growth of these materials by molecular beam epitaxy has enabled high purity films and novel heterostructures. The weak van der Waals bonding between successive layers of these TMDs enables the growth of these heterostructures with minimal concern for lattice mismatch and the subsequent strain common in epitaxial growth. This field of “van der Waals epitaxy” has grown substantially in recent years primarily focusing on understanding the growth kinetics and materials physics of TMDs. In this chapter, we will discuss the fundamental nature of these materials, their nucleation and growth, optimal growth conditions, and the ability to form complex heterostructures with other layered materials with no misfit dislocations despite significant lattice mismatch.

The atmospheric general circulation connotes the motion of the atmosphere, as viewed from a global, long-term perspective. This term is usually applied to the seasonally-varying, climatological-mean circulation, including the statistical properties of the variability of the circulation on day-to-day, week-to-week, and month-to-month time scales, but it also encompasses year-to-year variability and long-term variations associated with climate change. A unifying concept in studies of the general circulation are the so-called balance requirements for the conservation of angular momentum, total energy, and the mass of water vapor and other trace substances. Also of interest are the processes that contribute to the generation and dissipation of the kinetic energy, the exchange of kinetic energy between the zonally averaged circulation and the longitudinally varying ‘eddies,’ the exchange of air between troposphere and stratosphere, and the long range transport of trace substances.

Agricultural expansion has led to the widespread destruction of habitats and the creation of fragmented landscapes. Woodland has been severely affected by habitat loss; remaining woodland is often highly fragmented and degraded, immersed in an agricultural matrix. Woodland is one of the most important habitats for bats because it offers roosting and feeding opportunities for many species. A number of agri-environment schemes aim to increase the amount and quality of woodland on agricultural land; however, little is known about how woodland character relates to bat abundance/activity and recommendations for woodland creation and management for foraging bats are scarce. We studied temperate bat communities and examined bat foraging activity and relative abundance (and insect prey availability) in 34 woodland fragments in agricultural landscapes using two complementary methods (acoustic monitoring and trapping assisted by an acoustic lure). We evaluated the relative importance of woodland vegetation character, patch configuration and surrounding landscape in order to assess the importance of local- vs. landscape-scale woodland management to bat populations. Bat abundance and activity were influenced by both local and landscape-level attributes. At the local scale, woodland vegetation character appeared more important than patch configuration. High activity levels of aerial hawkers (e.g. Pipistrellus species) were related to low tree densities and an open understory, while gleaning species (e.g. Myotis bats) showed the opposite trend. Areas of cluttered vegetation were associated with high insect (mostly Diptera) abundance and could act as sources of prey for certain bat species. Bats' responses to the surrounding landscape depended on species mobility. For relatively low mobility species (e.g. Pipistrellus pygmaeus), local woodland character was more important than the landscape context, whereas the opposite was observed for higher mobility species (e.g. Pipistrellus pipistrellus and Myotis bats). Higher bat activity levels were observed in small and isolated woodland fragments, and in sparsely wooded landscapes. This may reflect a more intensive use of woodland in landscapes where this habitat is scarce, where woodland creation should be prioritised. Woodland management and creation schemes should encourage habitat heterogeneity to fulfil the requirements of different bat species. © 2013 Elsevier B.V.

Macadamia is a rainforest tree indigenous to Australia that is grown commercially for its edible nuts. This chapter discusses quality and the key preharvest and postharvest practices that impact on macadamia quality. The chapter first reviews botany, the macadamia industry, fruit development, and measures of quality, such as oil content, quality defects, appearance and rancidity. Preharvest impacts on quality such as cultivar, site, crop management and pests and diseases are considered. Key postharvest processes that are crucial for macadamia quality such as harvest methods, drying, postharvest handling and factory processing are also reviewed.

Publisher Summary This chapter focuses on some of the basic concepts and principles underlying atmospheric chemistry, as illustrated by the effects of both natural and anthropogenic trace constituents. It also focuses on gas-phase chemistry and atmospheric aerosols. Atmospheric chemistry studies were originally concerned with determining the major gases in the Earth's atmosphere. In the latter half of the past century, as air pollution became an increasing problem in many large cities, attention turned to identifying the sources, properties, and effects of the myriad of chemical species that exist in the natural and polluted atmosphere. Acid deposition led to the realization that chemical species emitted into the atmosphere can be transported over large distances and undergoes significant transformations as they move along their trajectories. In 1985, the identification of significant depletion of ozone in the Antarctic stratosphere focused attention on stratospheric chemistry and the susceptibility of the stratosphere to modification. More recently, studies of the effects of trace chemical constituents in the atmosphere on the climate of the Earth have moved to center stage.

Publisher Summary This chapter focuses on cloud microphysics studies. The chapter discusses the nucleation of cloud droplets from water vapor and the particles in the air. It focuses on the microstructures of warm clouds and the mechanisms by which cloud droplets grow to form raindrops. The chapter deals with ice particles in clouds and describes the various ways in which ice particles form and grow into solid precipitation particles. It discusses the artificial modification of clouds and attempts to deliberately modify precipitation. It also discusses cloud microphysical processes that are thought to be responsible for the electrification of thunderstorms. The chapter ends with the discussion on chemical processes within and around clouds, which play important roles in atmospheric chemistry, including the formation of acid rain.

Publisher Summary This chapter provides an overview of the optical properties, composition, and vertical structure of the Earth's atmosphere; the major wind systems; and the climatological-mean distribution of precipitation. The chapter introduces some of the terminology and conventions that will be used in performing calculations involving amounts of mass and rates of movement. The Earth's atmosphere is relatively transparent to incoming solar radiation and opaque to outgoing radiation emitted by the Earth's surface. The blocking of outgoing radiation by the atmosphere, popularly referred to as the “greenhouse effect,” keeps the surface of the Earth warmer than it would be in the absence of an atmosphere. Much of the absorption and reemission of outgoing radiation are due to air molecules, but cloud droplets also play a significant role. The radiation emitted to space by air molecules and cloud droplets provides a basis for remote sensing of the three-dimensional distribution of temperature and various atmospheric constituents using satellite borne sensors. The atmosphere is composed of a mixture of gases in different proportions, where fractional concentration by volume is the same as that based on numbers of molecules, or partial pressures exerted by the gases.

Publisher Summary Thermodynamics plays an important role in the quantitative understanding of atmospheric phenomena ranging from the smallest cloud microphysical processes to the general circulation of the atmosphere. This chapter introduces some fundamental ideas and relationships in thermodynamics and applies them to a number of simple, but important, atmospheric situations. The chapter deals with the ideal gas equation and its application to dry air, water vapor, and moist air. The chapter provides an important meteorological relationship, known as the hydrostatic equation. The chapter also focuses on the relationship between the mechanical work done by a system and the heat that the system receives, as expressed in the first law of thermodynamics. The chapter concludes with the details on the concept of the second law of thermodynamics and the concept of entropy.

Climate depends not only on atmospheric processes but also on physical, chemical, and biological processes involving other components of the Earth system. This chapter reviews the structure and behavior of those other components. The chapter shows how the cycling of water, carbon, and oxygen among the components of the Earth system has affected the evolution of the atmosphere. The chapter summarizes the history of climate over the lifetime of the Earth, with the emphasis on causal mechanisms. The chapter also discusses why Earth is so much more habitable than its neighbors in the solar system. Earth is the only planet in the solar system on which advanced life forms have evolved due to a very special combination of circumstances. The range of surface temperatures on Earth has allowed for the possibility of oceans that have remained unfrozen throughout most of Earth's history. The surface of Venus is far too hot to allow for the possibility of oceans. Furthermore, it appears that nearly all of the hydrogen atoms that presumably once resided in the atmosphere and crust of Venus in the form of water have escaped to space, leaving the planet virtually devoid of life-sustaining water. The surface of Mars is far too cold to allow water to exist in the liquid phase. The presence of geological features that resemble river valleys but are pockmarked by crater impacts suggests that oceans might have existed on the surface of Mars early in its history but were not sustainable. Earth is the only planet with an ozone layer, the heating of which produces the temperature maximum that defines the stratopause.

Publisher Summary This chapter introduces a framework for describing and interpreting the structure and evolution of large-scale atmospheric motions. It considers motions with horizontal scales of hundreds of kilometers or longer, vertical scales on the order of the depth of the troposphere, and timescales on the order of a day or longer. Motions on these scales are directly and strongly influenced by the Earth's rotation, they are in hydrostatic balance, and the vertical component of the three-dimensional velocity vector is more than three orders of smaller magnitude than the horizontal component but is nonetheless of critical importance. The chapter also introduces some concepts and definitions that are useful in characterizing horizontal flow patterns. It is followed by a more extensive review on the dynamics of large-scale horizontal motions on a rotating planet. The chapter further introduces the system of primitive equations, which is widely used for predicting how large-scale motions evolve with time. The chapter concludes with brief discussions on the atmospheric general circulation and numerical weather prediction.

Publisher Summary The term “climate” refers to the mean state of the atmosphere and related components of the Earth system and is also used in reference to atmospheric variability on timescales longer than the 2- to 3-week limit of most deterministic atmospheric predictability. The distinction between climate variability and climate change is largely semantic: if the variations of interest take place within some specified interval, they are referred to as the variability of the climate within that interval, whereas if the variations involve differences between two successive epochs, they are referred to as the “change in climate from one epoch to the next.” This chapter describes the present-day climate and the processes that shape it. The chapter discusses the nature and causes of climate variability on various timescales and relates it to the history of past climate. The chapter also discusses the climate sensitivity and climate feedbacks. It concludes by summarizing some of the scientific issues related to greenhouse warming.

Publisher Summary This chapter discusses a model of judgment maintenance and change, known as “activation/comparison model” that specifies the various processes that take place at the time of making a judgment on the basis of memory-based and online information. This model proposes that attitude maintenance and change depend on three processes: recalling a prior attitude, recalling or receiving other attitude-related information, and comparing the prior attitude with attitude-related information. The activation/comparison model assumes that all three processes can elicit attitude change and maintenance under different conditions. The chapter describes the nature and predicted effects of attitude activation and information comparison on attitude change and maintenance. When prior attitude accessibility elicits attitude maintenance in the absence of comparative processes, prior attitude accessibility accelerates comparison and changes when comparative cues are present. Comparative principles are identified and the implications of this model are discussed in relation to prior theorizing on change in attitudes and non-evaluative judgments.

Publisher Summary This chapter focuses on oncostatin M (OM). Human OM (hOM) is a single-chain polypeptide that was originally identified for its growth-inhibitory effects on human tumor cell lines and contrary growth stimulatory effects on several normal fibroblast lines. The hOM was isolated from media conditioned by phorbol 12-myristate 13-acetate (PMA)-treated human histiocytic lymphoma cells and from phytohemagglutinin (PHA)-activated human T lymphocytes. The hOM is structurally and functionally related to a family of hematopoietic and neurotropic cytokines whose members include leukemia inhibitory factor (LIF), interleukin-6 (IL-6), granulocyte colony-stimulating factor (G-CSF), ciliary neurotropic factor (CNTF), myelomonocytic growth factor (MGF), interleukin-II (IL-II), and cardiotrophin. The human, simian, and bovine genes for OM are approximately 5 kb in length. The human gene consists of three exons and two introns, and the exon/intron boundary sequences conform to the AT-GT rule for nucleotides flanking the eukaryotic exon boundaries. The hOM contains five cysteine residues, four of which form intramolecular disulfide bonds. Very few cell types have been shown to synthesize and secrete the hOM. U-937 histiocytic lymphoma cells do not constitutively express the hOM, but upon treatment with PMA these cells acquire many of the characteristics of macrophages and produce the hOM. Human macrophages, following stimulation with endotoxin, also secrete the hOM. The hOM acts on various cell types and elicits various diverse responses. The nature and magnitude of these responses are likely to be modulated by the cellular environment and the presence of other cytokines in vivo.

Publisher Summary This chapter examines the role of barotropic energy conversions in the general circulation. Baroclinic instability is the main source of transient variability in the general circulation. In the later stages of their life cycle, baroclinic waves feed energy into the time-mean zonally averaged flow and planetary-scale low-frequency transients by barotropic exchange processes. The evidence in favor of baroclinic instability/barotropic stability as a conceptual model for interpreting the energetics of large-scale atmospheric motion is based on theoretical analyses, modeling studies, and observational diagnostics. The interactions between the transient eddies and the longitudinally dependent time-mean flow are studied. It is found that the fastest-growing normal mode associated with barotropic instability resembles two observed teleconnection patterns. The normal modes associated with barotropic instability of the time-mean flow are characterized by much lower-frequency oscillatory components than those associated with baroclinic instability. It is observed that the low-frequency fluctuations apparently feed on the time-mean flow, and thereby serve to damp the longitudinally dependent, climatological-mean features at the jet-stream level.

Publisher Summary This chapter describes an experiment where messenger RNA (mRNA) was isolated from human peripheral blood lymphocytes stimulated with the mitogen Staphylococcal enterotoxin β. Sucrose-gradient centrifugation and acid-urea gel electrophoresis were used to fractionate mRNA. Following fractionation, mRNA was recovered and injected into Xenopus oocytes, and the translated fractions were assayed for antiviral activity in a cytopathic-effect inhibition assay. Two activity peaks were observed in the sucrose-gradient-fractionated RNA. One peak sedimented with a calculated size of 12S and contained 100–400 units/ml of antiviral activity per microgram of injected RNA. The other peak of activity sedimented as 16S in size and contained approximately half the activity of the slower sedimenting peak. Only one peak of activity was observed in the gel-fractionated mRNA. The size discrepancies among activity peaks observed on the sucrose gradients and acid-urea agarose gels may be the result of fractionation under conditions that do not totally denature the mRNA.