Search

Purpose: Electric bikes (EB) are a form of active transportation with demonstrated health benefits. The purpose of this study was to determine the influence of riding an EB for one week on indices of cardiometabolic health in middle-aged adults. Methods: Adults (n = 22; age = 57.1 ± 11.3 year; BMI = 27.7 ± 4.9) participated in a 2 week study. During Week 1, participants were instructed to continue regular activities. Starting Week 2 participants were provided an EB to ride at least 3 days for a minimum of 30 min·day−1. Physical activity (PA) and glucose were measured continuously. Body composition, blood lipids, glucose, insulin, hemoglobin A1c (HbA1c), plasma endothelin-1 (ET-1), and carotid-femoral pulse wave velocity (cf-PWV) were measured on days 1 and 14.Data and Statistical analyses or Statistics. Each participant served as their own control. Paired t-tests compared dependent variables between week 1 (without EB) and week 2 (with EB). Results: When provided an EB for one week, moderate to vigorous PA increased by 6–9 min·day−1 (P < 0.05) and sedentary time decreased by ~ 77 min·day−1 (P < 0.05). Data from 24 h continuous glucose monitoring showed the percentage of time in healthy range (70–120 mg·dl−1 glucose) increased (P < 0.05) from week 1 to week 2. Compared to day 1, cf-PWV was lower at day 14 (P < 0.05) following one week of riding an EB. Conclusion: Moderately-active, middleaged adults showed improved continuous glucose regulation and lower central arterial stiffness following one week of riding an EB. [ABSTRACT FROM AUTHOR]

Background: Macrosomia in the absence of diabetes can be associated with increased neonatal and maternal morbidity. Management is usually undertaken on a case-by-case basis. Aims: In order to inform local practice, this study aimed to evaluate the outcomes of the management of non-diabetic macrosomia in an Irish tertiary center. Methods: A retrospective observational study was performed on all women with estimated fetal weight over 4000 g after 37 weeks' gestation. Maternal demographics and obstetric and neonatal outcomes were recorded using the hospital information system. Women with diabetes, previous caesarean section, non-cephalic presentation, or any other complicating condition were excluded. Women were divided into two groups: Active management: Elective delivery for macrosomia—between 38 + 0 and 40 + 6 weeks' gestation Expectant management: with induction of labour offered after 41 weeks' gestation Results: There were 397 women included, 188 with active and 209 with expectant management. There was no difference in adverse neonatal outcomes, major maternal morbidity, or mode of delivery, after exclusion of pre-labor caesarean section. Women with expectant management were more likely to go into spontaneous labor (46.9 vs 1.6%, p < 0.001) and to have a favorable cervix at the onset of induction of labor if nulliparous (86.1 vs 70.0%, p = 0.021), but have higher rates of episiotomy (28.6 vs 18.2%, p = 0.021). With active management, nulliparas with an unfavorable cervix had increased risk of anal sphincter injury (6.5 vs 0.0%, p = 0.007) and postpartum hemorrhage (59.0 vs 35.5%, p = 0.003). Conclusions: Overall, there was no difference in major maternal or neonatal outcomes between management options for fetal macrosomia. However, inducing nulliparas with an unfavorable cervix for non-diabetic macrosomia was associated with obstetric anal sphincter injury and postpartum hemorrhage. [ABSTRACT FROM AUTHOR]

Sediments from a small lake, Loch Beag, in Barrees, Beara peninsula, south-western Ireland, provide a record of vegetation history that spans most of the Lateglacial and Holocene (14–0.43 ka). The detailed part of the record relates to the Holocene, which is the focus of this paper. The investigations carried out include pollen and macrofossil analyses, loss-on-ignition measurements and 14C dating. As well as providing records for tree and shrub taxa, and especially Pinus, Quercus, Ulmus, Fraxinus and Taxus, other taxa mainly with Atlantic and/or Lusitanian distributions are also considered. These include Arbutus unedo (strawberry tree) and fern species such as Osmunda regalis, and the filmy ferns Hymenophyllum tunbrigense, H. wilsonii and Trichomanes speciosum (Killarney fern). Detailed records for a suite of bog/heath taxa, including ericoid species (Erica tetralix and E. cinerea), Narthecium ossifragum, Hypericum elodes and Myrica gale, are presented. The results of 14C dating of bog-pines from western Ireland are summarised. Results of other investigations, including key Holocene pollen diagrams, and charcoal and fossil-wood records from archaeological excavations that relate mainly to the Bronze Age in the wider west Cork/Kerry region, are reviewed. Vegetation dynamics, human impact and plant biogeography are discussed in the light of the considerable data now available for the region. [ABSTRACT FROM AUTHOR]

Background: Maternity care in hospitals in the Republic of Ireland is funded by a hybrid of public finance and private health insurance. Aims: The aim of this longitudinal observational study was to investigate the annual trends in maternity care from 2009 to 2017 during and after the Great Economic Recession. Methods: All women who delivered a singleton baby weighing ≥ 500 g during the 9 years (2009–2017) were included. Detailed clinical and sociodemographic details were computerised at the first antenatal visit by a trained midwife. Women who delivered their first baby during the study were analysed longitudinally if they delivered again during the 9 years. Results: The mean age of the 73,266 women was 31.3 ± 5.6 years, 40.1% were nulliparas, and 70.3% were Irish-born. Overall, 75.2% opted for the public, 10.8% for the semi-private, and 14.0% for the private package of maternity care. Over the 9 years, the number of women choosing private and semi-private care decreased by 21.6% and 35.3%, respectively, whereas the number of women using public care increased by 12.3%. Most women opted for the same package of care in subsequent pregnancies. Conclusions: Ireland's recent economic recession was accompanied by an overall decrease in the number of women choosing private maternity care after 2009. Furthermore, economic recovery with increasing female employment after 2012 was not associated with a recovery in demand for private care. These findings have important implications for healthcare policies and for the future organisation and funding of our maternity services. [ABSTRACT FROM AUTHOR]

Galvanic exchange involving dissolution of iron and the simultaneous growth of platinum onto 316 L stainless steel was investigated for specimens manufactured by 3D-printing, and the behavior was compared to conventional stainless steel. Novel phenomena associated with the 3D-printed steel, but not conventional steel, reacting in three distinct phases were observed: first, with low platinum loading, a bright etching pattern linked to the laser-manufacturing process is revealed at the steel surface; second, a nanostructured pore pattern with platinum nano-deposits forms; and third, a darker platinum film coating of typically 500-nm thickness forms and then peels off the steel surface with further platinum growth underneath. Unlike the conventional steel (and mainly due to residual porosity), 3D-printed steel supports well-adhered platinum films for potential application in electrocatalysis, as demonstrated for alkaline methanol oxidation.ᅟ [ABSTRACT FROM AUTHOR]

This study explored the utility and performance of chironomid (Diptera: Chironomidae) autecology in the investigation of prehistoric farming impacts on freshwater lake systems. Chironomid subfossils, lake sediment geochemistry (δC, δN and C:N), pollen and macroscopic charcoal analyses were used in a comparative limnological assessment of three archaeologically rich study sites in northwest Ireland. At all three study sites, pastoral farming and its associated nutrient inputs, as represented by non-arboreal pollen indicative of grassland/pasture (NAPp) and lake sediment geochemistry, are concomitant with increases in eutrophic chironomid taxa. Redundancy analysis (RDA) and partial RDAs established that δN and NAPp were controlling factors of chironomid community compositional change during the Neolithic (4000-2500 BC) and Bronze Age (2500-600 BC). Bronze Age farming had a considerably greater impact on the lake systems than Neolithic farming, as indicated by a higher proportion of eutrophic taxa and increases in δN, C:N and δC values, consistent with increased erosion and agricultural inputs. Findings emphasise the importance of identifying the natural, pre-impacted state of a lake system to determine the extent of agricultural impact accurately. The timing and magnitude of change show that Neolithic and Bronze Age farming exhibited a strong control over chironomid communities at all three sites. [ABSTRACT FROM AUTHOR]

A detailed, AMS C-dated, pollen record from Cooney Lough, a small lake in Co. Sligo, western Ireland, is presented. Fluctuations in the pollen curves, indicative of changes in pollen productivity and shifts in woodland composition, suggest that the period spanned by the record (9.4-6 ka) was characterised by considerable climate instability. In all, five climate anomalies are recognised (CA-1 to CA-5). The most pronounced anomaly, CA-3, is dated to 8.45-8.2 ka, with the high point of that anomaly (CA-3b) centred on 8.2 ka and lasting about a century. On the basis of age, and also intensity and structure, CA-3b is equated with the 8.2 ka event as recorded in many proxies and especially the Greenland ice-core δO records. Key features of the event as recorded in the lake sediments include increased representation of Betula and Pinus (birch and pine; both widely recognised as cold tolerant trees) and a decline in Corylus and also Quercus (hazel and oak; both thermophilous). The anomalies CA-1 and CA-2 precede the 8.2 ka event, the former corresponding probably to the 9.2 ka event and the latter more pronounced, centred on ca. 8.8 ka and with a duration of approximately 100 years. The CA-4 event, at ca. 7.5 ka, is relatively minor as regards intensity while CA-5, which began at ca. 7.1 ka, initiated what seems to be a more long-lasting shift towards cooler conditions. The relationship of these developments to the arrival and expansion of alder ( Alnus), a key feature of the Boreal/Atlantic transition in European, including Irish pollen records is also discussed. [ABSTRACT FROM AUTHOR]

Understanding the biology of cancer is the key to understanding its behavior. Stage II colon cancers represent a unique treatment challenge for medical oncologists because they contain a very heterogeneous group of tumors with a wide range of recurrence risks after resection. Defining these differences in biology can help to explain differences in disease behavior. To this end, gene signatures have been developed to define various prognostic groups beyond the clinicopathologic features alone. Adjuvant chemotherapy for stage II colon cancers as a group has not shown survival advantage in clinical trials. Future research to develop gene signatures to predict a group that will benefit from adjuvant chemotherapy will be helpful in the clinical decision-making process. The purpose of this review is to present the prognostic gene signatures currently available for use, those in development, and their utility in stratifying recurrence risk in stage II colon cancer patients. [ABSTRACT FROM AUTHOR]

OBJECTIVES:Data on natural history following a sentinel attack of acute pancreatitis (AP) are limited. The objective of this study was to determine the risk of recurrent AP (RAP) and subsequent chronic pancreatitis (CP) diagnosis after the first attack of AP.METHODS:Using the Pennsylvania Health Care Cost Containment Council (PHC4) data set, we identified all unique White and Black Allegheny County residents who received a first-time primary inpatient discharge diagnosis of AP from 1996 through 2005. AP etiology was determined using associated diagnoses codes. We also checked whether any of these patients were readmitted for AP and/or received inpatient CP diagnosis until third quarter of 2007.RESULTS:In all, 7,456 unique residents (mean age 58±20 years, 45% male, 80% White) with incident AP admission were identified. Common etiologies included biliary (28%), alcohol (19%), and idiopathic (36%). Compared with other causes, alcoholic AP patients were significantly younger and more likely to be male and Black. Among survivors (98.1%) and those without pancreatic cancer, follow-up (median 40 months, interquartile range 18, 69) was available for 84% of patients. Readmission for primary or any AP was recorded for 22 and 29%; subsequent primary or any CP diagnosis was assigned to 6 and 12.8%, respectively. Significant independent predictors for RAP were alcohol etiology and tobacco abuse and for CP were RAP and tobacco abuse. RAP risk in biliary AP increased with the duration between AP and cholecystectomy.CONCLUSIONS:Readmissions following a sentinel attack of AP are common. Progression to CP is infrequent and usually occurs in the setting of RAP, alcohol, and smoking. Cholectstectomy should be considered as soon as feasible after an attack of biliary AP. Natural history of CP may be altered through early behavioral intervention. [ABSTRACT FROM AUTHOR]

Background: Postoperative outcomes of patients undergoing laparoscopic-assisted colectomy (LAC) have shown modest improvements in recovery but only minimal differences in quality of life (QOL) compared with open colectomy. We therefore sought to assess the effect of LAC on QOL in the short and long term, using individual item analysis of multi-item QOL assessments. Methods: QOL variables were analyzed in 449 randomized patients from the COST trial 93-46-53 (INT 0146). Both cross-sectional single-time and change from baseline assessments were run at day 2, week 2, month 2, and month 18 postoperatively in an intention-to-treat analysis using Wilcoxon rank-sum tests. Stepwise regression models were used to determine predictors of QOL. Results: Of 449 colon cancer patients, 230 underwent LAC and 219 underwent open colectomy. Subdomain analysis revealed a clinically moderate improvement from baseline for LAC in total QOL index at 18 months ( P = 0.02) as well as other small symptomatic improvements. Poor preoperative QOL as indicated by a rating scale of ≤ 50 was an independent predictor of poor QOL at 2 months postoperatively. QOL variables related to survival were baseline support ( P = 0.001) and baseline outlook ( P = 0.01). Conclusions: Eighteen months after surgery, any differences in quality of life between patients randomized to LAC or open colectomy favored LAC. However, the magnitude of the benefits was small. Patients with poor preoperative QOL appear to be at higher risk for difficult postoperative courses, and may be candidates for enhanced ancillary services to address their particular needs. [ABSTRACT FROM AUTHOR]

The late Holocene environmental history of two karstic uplands in the Burren, western Ireland is reconstructed. The palaeoecological investigations focus on species-rich, upland plant communities of high biogeographic interest that include Sesleria-dominated grasslands and heath communities with Dryas octopetala, Arctostaphylos uva-ursi and Empetrum nigrum. Short monoliths taken from shallow peats were pollen analytically investigated. Particular attention was paid to non-pollen palynomorphs, and especially coprophilous fungal spores as indicators of environmental change and pastoral activity at local level. The exposed north-west Burren uplands carried Pinus sylvestris-dominated woodland during the mid and late Bronze Age. The demise of pine on these uplands at ca. 600 B.C. is ascribed to human impact. Evidence is presented for increased pastoral activity in the uplands from early medieval times (ca. sixth century A.D.) onwards. Farming, involving intensive grazing of the uplands, attained greatest intensity during the late 18th and early 19th century, and resulted in more or less total clearance of Corylus scrub which, prior to that, was common in both the upland and lowland Burren. The potential of non-pollen palynomorphs and especially the coprophilous fungal spore record for elucidating traditional Burren farming practices, including winterage (a type of transhumance), is highlighted. [ABSTRACT FROM AUTHOR]

We develop a method for multiscale estimation of pollutant concentrations, based on a nonparametric spatial statistical model. We apply this method to estimate nitrate concentrations in groundwater over the mid-Atlantic states, using measurements gathered during a period of 10 years. A map of the fine-scale estimated nitrate concentration is obtained, as well as maps of the estimated county-level average nitrate concentration and similar maps at the level of watersheds and other geographic regions. The fine-scale and coarse-scale estimates arise naturally from a single model, without refitting or ad hoc aggregation. As a result, the uncertainty associated with each estimate is available, without approximations relying on high spatial density of measurements or parametric distributional assumptions. Several risk measures are also obtained, including the probability of the pollutant concentration exceeding a particular threshold. These risk measures can be obtained at the fine scale, or at the level of counties or other regions. The nonparametric Bayesian statistical model allows for this flexibility in estimation while avoiding strong assumptions. This method can be applied directly to estimate ozone concentrations in air, pesticide concentrations in groundwater, or any other quantity that varies over a geographic region, based on approximate measurements at some locations and perhaps of associated covariates. An S-PLUS package with this capability is provided as supplemental material. [ABSTRACT FROM AUTHOR]

OBJECTIVES:Identification of patients at risk for severe disease early in the course of acute pancreatitis (AP) is an important step to guiding management and improving outcomes. A new prognostic scoring system, the bedside index for severity in AP (BISAP), has been proposed as an accurate method for early identification of patients at risk for in-hospital mortality. The aim of this study was to compare BISAP (blood urea nitrogen >25 mg/dl, impaired mental status, systemic inflammatory response syndrome (SIRS), age>60 years, and pleural effusions) with the “traditional” multifactorial scoring systems: Ranson's, Acute Physiology and Chronic Health Examination (APACHE)-II, and computed tomography severity index (CTSI) in predicting severity, pancreatic necrosis (PNec), and mortality in a prospective cohort of patients with AP.METHODS:Extensive demographic, radiographic, and laboratory data from consecutive patients with AP admitted or transferred to our institution was collected between June 2003 and September 2007. The BISAP and APACHE-II scores were calculated using data from the first 24 h from admission. Predictive accuracy of the scoring systems was measured by the area under the receiver-operating curve (AUC).RESULTS:There were 185 patients with AP (mean age 51.7, 51% males), of which 73% underwent contrast-enhanced CT scan. Forty patients developed organ failure and were classified as severe AP (SAP; 22%). Thirty-six developed PNec (19%), and 7 died (mortality 3.8%). The number of patients with a BISAP score of ≥3 was 26; Ranson's ≥3 was 47, APACHE-II ≥8 was 66, and CTSI ≥3 was 59. Of the seven patients that died, one had a BISAP score of 1, two had a score of 2, and four had a score of 3. AUCs for BISAP, Ranson's, APACHE-II, and CTSI in predicting SAP are 0.81 (confidence interval (CI) 0.74–0.87), 0.94 (CI 0.89–0.97), 0.78 (CI 0.71–0.84), and 0.84 (CI 0.76–0.89), respectively.CONCLUSIONS:We confirmed that the BISAP score is an accurate means for risk stratification in patients with AP. Its components are clinically relevant and easy to obtain. The prognostic accuracy of BISAP is similar to those of the other scoring systems. We conclude that simple scoring systems may have reached their maximal utility and novel models are needed to further improve predictive accuracy. [ABSTRACT FROM AUTHOR]

Arctic charr, a highly plastic salmonid that inhabits the circumpolar region, colonized its current environment after the last glaciation. Recent colonization limits the capacity of many techniques to define and characterize constituent populations. As a novel approach, we used the major histocompatibility (MH) class IIα gene polymorphism as a marker that would characterize the genetic divergence of global Arctic charr populations caused by drift and by local adaptation to pathogens. We were able to detect significant isolation of all the lineages previously defined by mitochondrial DNA sequencing and also isolation of some populations within those groups. We found that most of the polymorphism of the class IIα gene was distributed globally, which indicates ancestral selection; however, in most cases, distinctive allele frequencies and specific haplotypes distinguished each population suggesting that recent selection has also occurred. Although all studied populations showed similar MH class IIα polymorphisms, we also found variation in which particular amino acid positions were polymorphic and which were constant in the different populations studied. This variation provides a greater adaptive capacity for the MH class IIα receptors in Arctic charr and is yet another illustration of the extraordinary plasticity of the species. [ABSTRACT FROM AUTHOR]

Adjuvant chemotherapy with 5-fluorouracil modulated by folinic acid, combined with oxaliplatin, has now become an accepted standard of care for patients with stage III colon cancer. In contrast, the use of adjuvant therapy for stage II patients remains controversial, and the identification of reliable prognostic factors to aid therapeutic decision making is crucial. The authors critically review the results of clinical trials and meta-analyses investigating the value of adjuvant chemotherapy for stage II patients, emphasizing the heterogeneous nature of this population and the difficulty of performing clinical trials with sufficient power to reliably assess treatment efficacy. They also discuss the evidence concerning potential prognostic factors, particularly molecular markers. Available clinical trial data do not support the routine use of adjuvant chemotherapy for all stage II patients but suggest that it should be considered, particularly for certain high-risk patients. Recent guidelines advocate considering factors such as tumor differentiation, tumor perforation, number of lymph nodes examined, and T stage when assessing the likely benefit:risk ratio. Microsatellite instability and allelic imbalance seem to be strong predictors of good and poor prognosis, respectively, and in the near future, therapeutic decision-making models are likely to be further refined by the inclusion of such molecular markers. There is growing evidence that the prognosis of certain stage II patients with unfavorable prognostic factors can be improved by adjuvant chemotherapy, and increasingly refined tools are now available to define those most likely to benefit. Referral of stage II patients for individual assessment is strongly recommended. [ABSTRACT FROM AUTHOR]

Stable isotopes of carbon and nitrogen were used to examine differences in the feeding ecology of sympatric morphotypes of Arctic char, Salvelinus alpinus, from Gander Lake, Newfoundland. Morphotypes were differentiated on the basis of colour (pale and dark) and meristic characteristics. Significant differences in length, age and habitat depth were also noted, with the pale-form being smaller, younger and caught at greater average depths than the dark-form. Pale and dark morphotypes possessed significantly different carbon and nitrogen stable isotope signatures, with the dark-form being more δ13C enriched than the pale-form. Within each morphotype grouping distinctive isotopic signature differences related to diet (dark-form) and capture depth (pale-form) were also observed. Differences in the isotopic signatures within and among habitat groupings were induced by differences in feeding opportunities arising from differences in habitat use and feeding strategies and generally corroborated by stomach content analysis and an index of dietary overlap. Study results provide evidence for the contention that sympatric forms of Arctic char in Gander Lake occupy significantly different foraging niches within the lake. Results further suggest ecologically relevant separations within morphotype groupings result in lower resource competition. [ABSTRACT FROM AUTHOR]

Interrogations present several major challenges to persons with mental retardation (MR). Sixty adults with mild MR completed measures of Miranda comprehension and tendency to yield to leading questions. In addition, suggestibility was assessed based on whether participants revised answers to questions in response to unfriendly, friendly, or neutral feedback to original responses. Furthermore, we examined how expressed confidence in answers to repeated questions varied with the type of feedback received. Results revealed that participants demonstrated marked difficulties understanding their Miranda rights and greater likelihood of changing answers to questions for which they received friendly feedback than for questions for which they received unfriendly or neutral feedback. Most participants who received positive reinforcement for their answers on a second trial expressed confidence about improvement from trial 1 to trial 2, although accuracy did not improve. Implications of these results are reviewed. [ABSTRACT FROM AUTHOR]

Chiral selective reactivity and redox chemistry of carbon nanotubes are two emerging fields of nanoscience. These areas hold strong promise for producing methods for isolating nanotubes into pure samples of a single electronic type, and for reversible doping of nanotubes for electronics applications. Here, we study the selective reactivity of single-walled carbon nanotubes with organic acceptor molecules. We observe spectral bleaching of the nanotube electronic transitions consistent with an electron-transfer reaction occurring from the nanotubes to the organic acceptors. The reaction kinetics are found to have a strong chiral dependence, with rates being slowest for large-bandgap species and increasing for smaller-bandgap nanotubes. The chiral-dependent kinetics can be tuned to effectively freeze the reacted spectra at a fixed chiral distribution. Such tunable redox chemistry may be important for future applications in reversible non-covalent modification of nanotube electronic properties and in chiral selective separations. [ABSTRACT FROM AUTHOR]

The U.S. Environmental Protections Agency's (U.S. EPA) Regional Vulnerability Assessment (ReVA) program has focused much of its research over the last five years on developing and evaluating integration methods for spatial data. An initial strategic priority was to use existing data from monitoring programs, model results, and other spatial data. Because most of these data were not collected with an intention of integrating into a regional assessment of conditions and vulnerabilities, issues exist that may preclude the use of some methods or require some sort of data preparation. Additionally, to support multi-criteria decision-making, methods need to be able to address a series of assessment questions that provide insights into where environmental risks are a priority. This paper provides an overview of twelve spatial integration methods that can be applied towards regional assessment, along with preliminary results as to how sensitive each method is to data issues that will likely be encountered with the use of existing data. [ABSTRACT FROM AUTHOR]

A new method has been developed to perform environmental assessment at regional scale. This involves a combination of a self-organizing map (SOM) neural network and principal component analysis (PCA). The method is capable of clustering ecosystems in terms of environmental conditions and suggesting relative cumulative environmental impacts of multiple factors across a large region. Using data on land-cover, population, roads, streams, air pollution, and topography of the Mid-Atlantic region, the method was able to indicate areas that are in relatively poor environmental condition or vulnerable to future deterioration. Combining the strengths of SOM with those of PCA, the method offers an easy and useful way to perform a regional environmental assessment. Compared with traditional clustering and ranking approaches, the described method has considerable advantages, such as providing a valuable means for visualizing complex multidimensional environmental data at multiple scales and offering a single assessment or ranking needed for a regional environmental assessment while still facilitating the opportunity for more detailed analyses. [ABSTRACT FROM AUTHOR]

Resident Arctic charr, Salvelinus alpinus, are widespread throughout the island of Newfoundland. This study examines aspects of the biology and spatial and temporal distributions of the charr of Gander Lake, the third largest in Newfoundland (surface area = 11 320 ha, maximum depth = 288 m, mean depth = 105.4 m). The deepest part of the lake is approximately 258 m below sea level. The lake is well oxygenated from the surface to the bottom during all seasons. Sampling was conducted with Lundgren multiple-mesh experimental gillnets and baited hooks. There appears to be two morphs present, based on colour (dark and pale) and certain meristic characteristics. Dark charr were caught mainly in benthic nets (at depths from 1 to 100 m inclusive) with only a few pelagic captures. Pale charr were caught only in benthic nets at depths between 20 and 100 m inclusive. The maximum depth sampled was 196 m, but there was no catch. There was a tendency for dark charr to be found in deeper, cooler water as the upper water column and inshore areas warmed during summer. There was no apparent trend in size of charr with depth sampled. Dark and pale charr both fed on benthic macroinvertebrates; sticklebacks were consumed only by dark charr and the importance of this prey item increased with size of predator. Zooplankton and surface food were not utilised by Gander Lake charr. Results of the study are compared with findings reported for other water bodies in Newfoundland and Labrador, North America, and Europe, particularly Loch Ness which has similarities in morphometry and trophic status to Gander Lake. [ABSTRACT FROM AUTHOR]

Patients with incompletely resected locally advanced and recurrent colon cancers have a dismal prognosis. Since 1981, 100 colon cancer patients have been treated with combination therapy including surgical resection, chemotherapy, and external plus intraoperative radiotherapy. A prospective computerized intraoperative radiation database identified patients for this retrospective review. Data collection included patient demographics, tumor and treatment variables, and morbidity, recurrence, and survival statistics. The mean age was 55.2 years. Follow-up was available for all patients. Fifty-nine patients have died. Median follow-up of survivors was 70.5 months. Twenty-five patients with locally advanced colon cancer had a median survival of 38.2 months and a 5-year survival of 49%. Eleven of these patients are still free of disease. Seventy-three patients treated for recurrent colon carcinoma had a median survival of 33.3 months from the time of recurrence, with a 5-year survival of 24.7%. Twenty-one are alive without evidence of recurrence. The 38 patients with recurrent disease whose disease was completely resected had a 37.4% 5-year survival. A multimodality approach using en-bloc surgical resection with radiotherapy and chemotherapy affords some patients with locally advanced and recurrent colon cancer a chance for long-term survival. [ABSTRACT FROM AUTHOR]

One of the challenges of interpreting a Quality-adjusted time without symptoms of disease and toxicity (Q-TWiST) analysis is examining the sensitivity of conclusions that may be drawn to varying values of the utility coefficients for days with toxicity and days after disease progression. We present a graphic that parsimoniously displays the impact on median Q-TWiST survival across treatment groups of varying values of the utility coefficients. The goal of the graphic is to present a concise Q-TWiST analysis. We use Zhao and Tsiatis (Biometrika 1997; 84(2): 339-348) to adjust for the bias in Kaplan-Meier (K-M) estimates. The graphic contains bounds that approximate points for which statistical significance would be achieved by comparing the median Q-TWiST survival between treatment alternatives for each value of the utility coefficients. The plot may be generalized to compare Q-TWiST means, medians or percentiles across treatment groups. We demonstrate the application of the Q-TWiST plot through a re-analysis of a randomized phase III North Central Cancer Treatment Group (NCCTG) clinical trial of recombinant Interferon-2alpha in patients with malignant melanoma. We explore alternative options to customize the graphic representation for other data sets drawn from several NCCTG clinical trials. [ABSTRACT FROM AUTHOR]

Abstract This article describes recent developments in remote patient self-management programmes for care management. An overview of current practices in disease management, care management and quality improvement is provided along with descriptions of enabling technologies including interactive voice response (IVR) and new patient communication and data capture systems. A new technology platform for disease management, case management and performance measurement - the Health Hero(R) online service - is presented and described. The Health Hero(R) platform features a patient information appliance (the Health Hero(R) Health Buddy(R) appliance), a central data centre, and an Internet-based service facilitating the daily activities of patient- and population-based care management, disease management and performance measurement. Results from preliminary field testing of the Health Hero(R) online service are presented. These results indicate that compliance (usage) with the Health Hero(R) online service is consistently above 90% and that patient satisfaction is high. Surveys conducted on the Health Hero(R) online service indicate the device is easy to set-up and use, and that the likelihood of patients' continuing to use the Health Hero(R) online service is high and increases with time (from 80 to 93% over 3 months). Remote patient care management systems, such as the Health Hero(R) Internet-based communications platform and some IVR systems, facilitate efficient monitoring of patients. They consequently provide a foundation for better outcomes and quality of lite for patients and reductions in the cost of healthcare delivery. [ABSTRACT FROM AUTHOR]

For the last 30 years, attempts have been made to discriminate among fish populations by using molecular markers. Although some techniques have proved successful in certain circumstances, the consistent trend to newer markers among fishery geneticists highlights the general lack of resolving power observed with older technologies. The last decade has seen the increasing use of satellite DNA in investigations of genetic variability and divergence. Applications to fish and fisheries-related issues initially concentrated on minisatellite single-locus probes. Although minisatellites have successfully addressed a number of fishery-related questions, this class of satellite DNA has not been widely adopted by fishery geneticists. Most of the current research effort is concentrated on another class of satellite DNA called microsatellites. The large interest in microsatellite loci is largely due to the very high levels of variability that have been observed and the ability to investigate this variation using PCR technology. The isolation and application of microsatellites to research fields as diverse as population genetics, parentage analyses and genome mapping are reviewed. Despite the undisputed advantages that the marker possesses, there are a number of potential problems associated with investigating variation at microsatellite loci. Statistical considerations (e.g. appropriate sample sizes, number of loci and the mutation model assumptions on which the estimate is based) have not been considered in detail yet and the problems are often exacerbated in fish species, as some species show very large numbers of alleles at microsatellite loci. These issues and others, e.g. null alleles, are reviewed and possible solutions are proposed [ABSTRACT FROM AUTHOR]

A radiocarbon-dated pollen profile provides the first evidence for the vegetation history of the north-west Burren, a karstic region in Co. Clare, western Ireland. The profile, which spans the period ca. 3200-0 B.P., shows that Corylus was the main woody species and that, apart from the later eighteenth and nineteenth centuries, when woody species were almost totally cleared, it constituted a more important element in the landscape than at present. The data indicate that small populations of Quercus, Fraxinus, Betula, Alnus and possibly Ulmus were also present until at least the mid seventeenth century. Exceptionally high values of Plantago lanceolata (mostly in excess of 20% total terrestrial pollen) suggest intensive pastoral farming over most of the period. Between A.D. 200-580, a lull in activity is recorded during which woody species and, in particular, hazel scrub regenerated. The separation of pollen of cereal origin from large cereal-type pollen produced by non-cultivated grasses proved particularly problematic. Reliance has therefore been placed on the weed pollen flora as a guide to arable activity. This flora indicates that arable farming was of some importance in the Burren from A.D. 1000 onwards. The implications of the various findings for the longer term history of the rarer elements of the Burren flora and the relationship between the pollen record and the archaeological and historical evidence for settlement and land use are discussed. [ABSTRACT FROM AUTHOR]

As human influences fragment native communities and ecosystems, remaining land must be better managed to conserve many elements of biodiversity. Much of this land is privately held, yet traditional private land-use management practices often further diminish biodiversity by promoting favored or edge-adapted species. Today, private land stewards are increasingly aware of and concerned about biodiversity, but little guidance exists for them to make land-use decisions incorporating principles and knowledge from conservation biology. Consequently, most management strategies are highly subjective. This article addresses that problem by introducing current conservation wisdom to management and use of private lands. The result is a model program for developing land management plans, with the goal of maintaining viable populations and natural distributions of native species and communities from a landscape perspective. The program establishes a protocol for classifying sites according to the importance of their species, communities, and other elements to global and regional biodiversity. These site classifications are based on the management objectives necessary to maintain important elements. Once managers classify a site, the program provides management standards, general stewardship principles, examples of land management strategies, and basic monitoring and evaluation procedures. [ABSTRACT FROM AUTHOR]

Purpose: To determine the maximum tolerable dose (MTD) and activity of levamisole administered concurrently with 5-fluorouracil (5-FU) in a standard 5-day course. To determine the pharmacokinetics of levamisole during the course of treatment.Patients and Methods: Levamisole was administered to 38 patients orally three times a day for 5 days concurrently with a course of 5-FU administered daily by rapid intravenous injection for 5 days. Toxicity was evaluated in 20 patients who received escalating doses of levamisole. The activity of the combination was evaluated in 18 patients who received levamisole at the MTD with 5-FU. The pharmacokinetics of levamisole were characterized in ten patients at the MTD level.Results: Intractable vomiting, confusion and vertigo were the major dose-limiting toxicities. The MTD of oral levamisole was 100 mg/m2 administered three times a day concurrently with 450 mg/m2 per day intravenous 5-FU for 5 consecutive days. Partial responses lasting 5 and 11 months were observed in 2/18 patients with measurable disease at the MTD. Peak plasma concentrations of 1 microg/ml (range 0.6-1.3 microg/ml) were achieved 90 min (range 60-360 min) after an oral dose of 100 mg/m2 levamisole with a 3.5-fold accumulation noted following 4 days of administration. Peak plasma concentrations of p-hydroxylevamisole were about 5% of parent drug. Little parent drug (2-5%) was detected in urine.Conclusions: Levamisole may be administered safely with 5-FU at doses which are up to four to five times greater than those presently given in conventional regimens. The recommended dose of levamisole combined with 5-FU for future research protocols is 75 mg/m2 t.i.d for 5 days. [ABSTRACT FROM AUTHOR]

A mutational analysis of the matrix metalloproteinase (MMP) gene family in human melanoma identified somatic mutations in 23% of melanomas. Five mutations in one of the most commonly mutated genes, MMP8, reduced MMP enzyme activity. Expression of wild-type but not mutant MMP8 in human melanoma cells inhibited growth on soft agar in vitro and tumor formation in vivo, suggesting that wild-type MMP-8 has the ability to inhibit melanoma progression. [ABSTRACT FROM AUTHOR]

A correction to the article "Natural History Following the First Attack of Acute Pancreatitis" that was published in a 2012 issue of the journal is presented.