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Assessing changes in functional exercise capacity is highly relevant in the treatment of people with Chronic Obstructive Pulmonary Disease (COPD), as lung function is often static. In Denmark, most people with COPD are followed in general practice where traditional functional tests, like six-minute walk test, require too much time and space. Therefore, there is an urgent need for a quick functional exercise capacity test that can be performed in a limited setting, such as general practice. This study aimed to identify a quick test to measure functional exercise capacity in people with COPD and identify which factors could affect the implementation of such a test in general practice. A mixed method feasibility study composed of a literature review and qualitative interviews was used. Quick functional tests for people with COPD were identified and evaluated through the COSMIN methodology. For the interviews, 64 general practices were included, and 50 staff members and 14 general practitioners (GPs) participated in the interviews. Responses were categorized and thematically analyzed. The 1 min sit-to-stand-test (1 M STST) was found suitable for a general practice setting. The COSMIN methodology rated it “sufficient” in reliability (ICC 0.90–0.99), measurement error (MID 2.5–3), construct validity and responsiveness (AUC 0.72), and found a moderate to strong correlation in criterion validity (r = 0.4–0.75). Several GPs wished for a quick functional test and emphasized evidence, information, and limitations as essential when deciding on implementation. Other factors identified included time, other tests, and economy. 1 M STST is a valid test to assess functional exercise capacity in people with COPD. The test is quick and can easily be performed in a standard consultation, and several GPs wished for such a test. [ABSTRACT FROM AUTHOR]

Purpose of Review : We reviewed reasons for the high cardiovascular risk (CVD) of patients with chronic kidney disease (CKD), and explored alternatives to treatment of traditional risk factors to reduce CVD in CKD. Recent Findings: Besides traditional risk factors, patients with CKD are exposed to uremic toxins of two kinds: systemically derived toxins include asymmetric dimethylarginine (ADMA), total homocysteine (tHcy), thiocyanate, tumor necrosis factor alpha, and interleukin 6. Gut-derived uremic toxins (GDUT), products of the intestinal microbiome, include hippuric acid, indoxyl sulfate, p-cresyl sulfate, p-cresyl glucuronide, phenylacetylglutamine, and trimethylamine N-oxide (TMAO). Cyanocobalamin is toxic in patients with CKD. Approaches to reducing plasma levels of these uremic toxins would include diet to reduce GDUT, kidney transplantation, more intensive dialysis, and vitamin therapy to lower tHcy with methylcobalamin rather than cyanocobalamin. Summary: The high CVD risk in CKD requires consideration of therapies beyond treatment of traditional risk factors. [ABSTRACT FROM AUTHOR]

Purpose of Review: To assess the validity of the belief that anticoagulation is not beneficial in patients with embolic stroke of unknown source (ESUS), and to asssess the benefits and safety of direct-acting oral anticoagulants (DOACs). Recent Findings: The failure of randomized trials to show benefit of anticoagulation in ESUS is probably due to misclassification of large artery atherosclerosis (LAA) as ESUS, as defined by a stenosis ≥ 50%. There are important differences among DOACs. There are a number of problems with dabigatran, and rivaroxaban and edoxaban are not suitable for once-daily dosing. Recent evidence from real-world practice indicates that apixaban is more effective and safer than rivaroxaban. Summary: Plaque burden should be included in the definition of LAA. Patients in whom a cardioembolic source is strongly suspected should be anticoagulated; antiplatelet agents are not significantly safer than DOACs, and are not effective in cardioembolic stroke. [ABSTRACT FROM AUTHOR]

Background: We assessed secular trends in the burden of ischaemic heart disease (IHD), stroke, and dementia in the Organization for Economic Co-operation and Development (OECD) countries. Methods: Using the Global Burden of Disease (GBD) Study 2017, we compared sex-specific and age-standardized rates of disability-adjusted life years (DALY); mortality, incidence, and prevalence of IHD and stroke; and dementia per 100,000 people, in the world, OECD countries, and Canada. Results: From 1990 to 2017, the crude incidence number of IHD, stroke, and dementia increased 52%, 76%, and 113%, respectively. Likewise, the prevalence of IHD (75%), stroke (95%), and dementia (119%) increased worldwide. In addition during the study period, the crude global number of deaths of IHD increased 52%, stroke by 41%, and dementia by 146% (9, 6, and 3 million deaths in 2017, respectively). Despite an increase in the crude number of these diseases, the global age-standardized incidence rate of IHD, stroke, and dementia decreased by −27%, − 11%, and − 5%, respectively. Moreover, there was a decline in their age-standardized DALY rates (− 1.17%, − 1.32%, and − 0.23% per year, respectively) and death rates (− 1.29%, − 1.46%, and − 0.17% per year, respectively), with sharper downward trends in Canada and OECD countries. Almost all trends flattened during the last decade. Conclusions: From 1990 to 2017, the age-standardized burden of IHD, stroke, and dementia decreased, more prominently in OECD countries than the world. However, their rising crude numbers mainly due to population growth and ageing require urgent identification of reversible risk and protective factors. [ABSTRACT FROM AUTHOR]

Background/objectives: The progression of carotid-plaque volume in patients with type 2 diabetes is common. Previous observational studies showed an association between moderate alcohol and reduced risk of coronary disease. We examined whether consuming moderate wine affects the progression of carotid atherosclerosis.Subjects/methods: In the CASCADE (CArdiovaSCulAr Diabetes and Ethanol), a 2-year randomized controlled trial, we randomized abstainers with type 2 diabetes were to drink 150 ml of either red wine, white wine, or water, provided for 2 years. In addition, groups were guided to maintain a Mediterranean diet. We followed 2-year changes in carotid total plaque volume (carotid-TPV) and carotid vessel wall volume (carotid-VWV), using three-dimensional ultrasound.Results: Carotid images were available from 174 of the 224 CASCADE participants (67% men; age = 59 yr; HbA1C = 6.8%). Forty-five percent had detectable plaque at baseline. After 2 years, no significant progression in carotid-TPV was observed (water, -1.4 (17.0) mm3, CI (-2.7, 5.5), white-wine, -1.2 (16.9) mm3, CI (-3.8, 6.2), red wine, -1.3 (17.6) mm3, CI (-3.4, 6.0; p = 0.9 between groups)). In post hoc analysis, we divided the 78 participants with detectable baseline carotid plaque into tertiles. Those with the higher baseline plaque burden, whom were assigned to drink wine, reduced their plaque volume significantly after 2 years, as compared to baseline. Two-year reductions in Apo(B)/Apo(A) ratio(s) were independently associated with regression in carotid-TPV (β = 0.4; p < 0.001). Two-year decreases in systolic blood pressure were independently associated with regression in carotid-VWV (β = 0.2; p = 0.005).Conclusions: No progression in carotid-TPV was observed. In subgroup analyses, those with the greatest plaque burden assigned to drink wine may have had a small regression of plaque burden. [ABSTRACT FROM AUTHOR]

Patients with asymptomatic carotid stenosis all warrant intensive medical therapy; they are at a higher risk of myocardial infarction than of stroke. With modern intensive medical therapy, the annual risk of ipsilateral is now ∼0.5 %. Justifying carotid intervention on the basis of the results of historic trials with a medical arm, extrapolated to modern trials with lower interventional risks but no medical arm is not legitimate. Most patients (∼90 %) with asymptomatic carotid stenosis would be better served by intensive medical therapy than by either stenting or endarterectomy. The few (∼10 %) who could benefit from intervention can be identified by microemboli on transcranial Doppler and other methods in development. Routine stenting of asymptomatic carotid stenosis, because it is more likely to harm than help the patient, may be considered unethical. [ABSTRACT FROM AUTHOR]

With the advent of new oral anticoagulants, the place of warfarin for stroke prevention in patients with atrial fibrillation needs re-evaluation. Warfarin is difficult to use, because of large individual differences in response and metabolism, many significant interactions with drugs and foods, and fluctuations in vitamin K absorption. It requires frequent blood testing and dose adjustments, so with good reason patients and physicians are eager for the newer agents that are easier to use. However, the purchase price of the new anticoagulants is so high that warfarin will remain in widespread use. It is important therefore for physicians to know how to use it well. Anticoagulants work much better for stroke prevention in atrial fibrillation than do antiplatelet agents; physicians need to understand the concept of red thrombus (for which anticoagulants are required) versus white thrombus-platelet aggregates-which are the target of antiplatelet agents. Stroke from atrial fibrillation increases steeply with age, and the elderly benefit disproportionately from anticoagulation. It is still necessary for physicians to know how to use warfarin, and to use it better than it has been used in the past. [ABSTRACT FROM AUTHOR]

Fish welfare at harvest is easily compromised by poor choice of handling and slaughter methods, lack of attention to detail and by unnecessary adherence to fish farming traditions. The harvest process comprises fasting the fish to empty the gut, crowding the fish, gathering and moving the fish using brails, fish pumps, and sometimes also road or boat transport and finally stunning and killing the fish. The harvesting processes commonly used for bass, bream, carp, catfish, cod, eel, halibut, pangasius, salmon, tilapia, trout, tuna and turbot are outlined. These harvesting processes are discussed; the consequences for fish welfare identified and practical tests which can be made at the harvest site highlighted. Welfare at harvest for the majority of farmed fish species can be improved by adopting and adapting existing procedures already known to be beneficial for fish welfare through their use in other fish farming systems or with other species. It is seldom necessary to develop completely new concepts or methods. [ABSTRACT FROM AUTHOR]

Secondary stroke prevention can reduce the risk of recurrent stroke by approximately 90%. To achieve such a reduction, early implementation of preventative measures and administration of therapy appropriate to the underlying cause of the presenting transient ischemic attack or stroke are crucial. Smoking cessation and a Cretan Mediterranean diet are each more effective than any single medication in reducing the risk of recurrent stroke. Control of resistant hypertension can markedly reduce the risk of intracerebral hemorrhage and lacunar infarction but might require therapy that is specific to the underlying cause. New antiplatelet agents have been developed or are in development that might avoid the issues of resistance and drug interactions that prevail with established agents of this type. Furthermore, new anticoagulants in development offer promise of replacing warfarin, and devices to occlude the atrial appendage are on the horizon for patients with atrial fibrillation. Carotid endarterectomy is appropriate for severe symptomatic carotid stenosis, while stenting might be appropriate for symptomatic stenosis where the surgical risk is high. Most patients with asymptomatic stenosis, however, should be treated with medical therapy, unless indicators of high stroke risk are present. In this narrative Review, I discuss recent advances in secondary stroke prevention. [ABSTRACT FROM AUTHOR]

Objective:To undertake a 6-year longitudinal investigation of the relationship between the built environment (perceived and objectively measured) and change in body mass index (BMI). Specifically, this research examined whether change in BMI was predicted by objectively measured neighborhood walkability and socioeconomic status (SES), and perceived neighborhood characteristics (for example, crime, traffic and interesting things to look at) in addition to other factors such as age, gender, education, physical activity, fruit and vegetable consumption and smoking.Design:Longitudinal studySubjects:500 adults who provided complete data in 2002 and 2008 and who did not move over the course of the study (47.8% female; age in 2002: 18–90 years).Measurements:Telephone surveys in 2002 and 2008 measuring perceptions of their neighborhood environment and demographic factors. Objective measures of neighborhood characteristics were calculated using census data and geographical information systems in 2006.Results:Age, neighborhood SES and perceived traffic were significantly related to increased BMI over the 6 years. Younger participants and those in lower SES neighborhoods were more likely to have increased BMI. Agreement with the statement that traffic made it difficult to walk also predicted increased BMI.Conclusion:This study adds to the literature to show that BMI increased in low SES neighborhoods. Although more research is needed to fully understand how neighborhood SES contributes to obesity, it is without question that individuals in socially disadvantaged neighborhoods face more barriers to health than their wealthier counterparts. This study also calls into question the relationship between walkability and changes in BMI and emphasizes the necessity of longitudinal data rather than relying on cross-sectional research. [ABSTRACT FROM AUTHOR]

Background: Deliberate self-harm (DSH) is related to suicide and DSH repetition is common. DSH hospital presentations are often self-poisonings with medicinal agents. While older age and male sex are known risk factors for suicide, it is unclear how these factors are related to the nature and severity of medicinal self-poisoning (SP). Such knowledge can guide prevention strategies emphasizing detecting and treating mental illness and controlling access to means.Methods: Medicinal SP presentations by 18,383 residents of Ontario, Canada, aged 12 years and older, who presented to a hospital emergency department in that province between April 1, 2001-March 31, 2002 were characterized by the agents taken, identification of deliberate intent and medical severity.Results: We found distinct age-sex differences in the nature and severity of medicinal SP. In youths, aged 12-17, about 40% of presentations involved analgesics, typically not prescribed and most often the acetaminophen agent-group. Females aged 12-64 were identified as deliberate more often than their male counterparts and this pattern occurred in most agent-groups, even among those who took antidepressants. The acetaminophen agent-group was most consistently associated with medical severity and this effect was strongest among female youths. Although medicinal SP was less frequent in the elderly, these presentations tended to be more medically serious and less often identified deliberate.Conclusions: The high proportion of medicinal SP in youths involving agents typically not prescribed and the medical severity of the acetaminophen agent-group underscore how prevention strategies must extend beyond controlling access to antidepressants. Despite a higher risk for suicide, males and the elderly may not have their deliberate intent detected and therefore, may not receive appropriate treatment. The emergency department can serve as important link to mental health care and usage patterns can provide feedback about the need for system-level enhancements and DSH surveillance. [ABSTRACT FROM AUTHOR]

Quantitative measurements of carotid plaque burden are used to monitor patients and evaluate established interventions as well as new treatment options. Three-dimensional ultrasound (3D US) techniques were developed to noninvasively monitor the progression of carotid artery disease in both symptomatic and asymptomatic patients. Three-dimensional carotid US images were acquired and reconstructed, and methods for quantitative assessment were developed. The measurement of intima-media thickness (IMT) based on two-dimensional ultrasound (2D US) images was extended to a 3D vessel-wall-plus- plaque thickness (VWT), obtained by computing the distance between the carotid wall and lumen surfaces on a point-by-point basis. VWT measurements were superimposed on the arterial wall to produce 3D VWT maps. VWT changes were determined by comparing the 3D VWT maps obtained at two different time points. To facilitate the visualization and interpretation of the VWT and VWT-Change maps, a technique to flatten these maps was developed. Carotid remodeling involving changes in both arterial wall and plaque thickness was assessed with VWT maps obtained from in vivo 3D ultrasound images. 3D carotid ultrasound image evaluation with VWT mapping provides a feasible means for the analysis of plaque burden volumes and changes. [ABSTRACT FROM AUTHOR]

Widespread reluctance to treat hypertension during acute stroke is based on historical accounts of unfavorable outcomes of treatment that were badly done: therapies that cannot be controlled, such as sublingual nifedipine, oral or intramuscular antihypertensive drugs may drop blood pressure precipitously, leading to worsening of ischemia. Case fatality in stroke obeys a U-shaped relationship: blood pressures that are either too low or too high are associated with worse outcomes both in ischemic stroke and in intracerebral hemorrhage. Very high blood pressures should be lowered in acute stroke, and there are some circumstances in which high blood pressure must be treated despite the presence of stroke. To avoid worsening of ischemia by reduction in cerebral blood flow, it is necessary to treat high blood pressure in acute stroke with drugs that can be controlled; this usually means giving drugs by intravenous infusion; however, there is recent evidence that transdermal administration of nitrates, which can be removed if pressure is too low, is a convenient alternative that does not reduce cerebral blood flow in acute stroke. [ABSTRACT FROM AUTHOR]

Patients at high risk of vascular events can reduce their risk by 75% to 80% through a combination of lifestyle changes and medical therapy. These include smoking cessation, a Mediterranean diet, daily exercise, maintaining a fit weight, moderate consumption of alcohol, effective control of blood pressure and diabetes, intensive treatment with lipid-lowering drugs and antiplatelet agents, and perhaps treatment with vitamins to lower homocysteine. Much of this is achieved primarily by the patient; physicians need to become better at assisting their patients in making lifestyle changes. Effective control of treatment-resistant hypertension can be improved by individualizing medical therapy to the underlying cause, based on measurement of plasma renin and aldosterone. Measurement of carotid plaque may be useful by providing feedback on the success of therapy. [ABSTRACT FROM AUTHOR]

The ab initio No-Core Shell Model (NCSM) adopts an intrinsic Hamiltonian for all nucleons in the nucleus. Realistic two-nucleon and tri-nucleon interactions are incorporated. From this Hamiltonian, an Hermitian effective Hamiltonian is derived for a finite basis space conserving all the symmetries of the initial Hamiltonian. The resulting finite sparse matrix problem is solved by diagonalization on parallel computers. Applications range from light nuclei to multiquark systems and, recently, to similar problems in quantum field theory. We present this approach with a sample of recent results. [ABSTRACT FROM AUTHOR]

OBJECTIVE:Research is limited concerning the moderating influence of weight status (ie normal, over, and obese) on the social ecological correlates of physical activity (PA) in adults. Therefore, the present study attempted to shed light on this issue.DESIGN:In 2001, a national cross-sectional mail out panel survey was conducted over a 3-month period in the United States.SUBJECTS:There were 1867 normal weight (ie body mass index (BMI)=20-24.99?kg/m2), 2145 overweight (ie BMI=25-29.99?kg/m2), and 1902 obese (ie BMI>30?kg/m2) adults.MEASURES:Various demographic measurements were taken in addition to social support (SS), self-efficacy (SE), access to facilities, and PA.RESULTS:Normal weight individuals engaged in significantly more PA than overweight individuals, who in turn engaged in significantly more PA than obese individuals F(2,5991)=55.51, P<0.01. Further regression analyses showed that higher SE, SS, the access to facilities in a neighborhood, and various interactions among these constructs were significantly and positively associated with PA. Interestingly, the strength of these relationships varied depending on weight status.CONCLUSION:Weight status needs to be taken into consideration when examining social ecological correlates of PA.International Journal of Obesity (2005) 29, 720-726. doi:10.1038/sj.ijo.0802927 Published online 29 March 2005 [ABSTRACT FROM AUTHOR]

Objective: To report and describe the MR imaging features of eight new cases of this rare soft tissue sarcoma and correlate them with the clinical and histologic findings. DESIGN AND PATIENTS. Retrospective analysis was carried out for the MR imaging characteristics and histologic findings of eight patients with pathologically proven epithelioid sarcoma and the literature was reviewed. Findings were correlated in each case with the patient's clinical presentation and eventual outcome.Results: The patients, whose primary tumors ranged from 2.5 cm to 19 cm in maximum dimension, were 1 to 90 years of age. Tumors involved the extremities ( n=5), the scalp ( n=2) and the paraspinal muscles ( n=1). Five tumors presented as well-defined, frequently painful, deeply situated masses and three as subcutaneous nodules or cutaneous ulcers with no palpable mass. Four patients had associated regional lymphadenopathy and one had distant metastases at diagnosis. MR imaging showed tumor infiltration of adjacent tissues in seven patients. Signal characteristics reflected varying degrees of cellularity, and the presence of necrosis, hemorrhage, fibrosis, hyalinization and inflammation. Bone marrow involvement was demonstrated in one patient. Clinical outcomes were generally poor.Conclusions: Epithelioid sarcoma is an aggressive soft tissue sarcoma with a varied clinical presentation, growth pattern, MR signal characteristics and histologic picture. The tumor favors the distal extremities and is commonly infiltrative and accompanied by enlarged regional lymph nodes. This neoplasm may present as an intramuscular mass but should also be suspected in patients with ulcerating cutaneous nodules with or without regional lymphadenopathy. [ABSTRACT FROM AUTHOR]

Hypertension is often poorly controlled despite its importance and despite the availability of very effective treatments. Many factors contribute to poor control, including failure of patients to attend physicians, failure of physicians to detect and adequately treat hypertension to goal levels, and failure of patients to persist with prescribed therapy. An under-recognized problem is the failure, both in writing and in the application by third party payers, of consensus guidelines to recognize the important difference between efficacy in clinical trials and effectiveness in clinical practice. The issue of applicability of guidelines to actual practice was studied in the context of a Canadian Family Medicine teaching practice. At the time of the study, consensus guidelines for management of hypertension recommended that drug therapy be initiated with a β-blocker or diuretic, except for patients with complicated hypertension for whom these drug classes are relatively contraindicated. It was generally assumed that widespread use of other classes of drugs represented inappropriate and wasteful use of resources. By a retrospective chart audit, we determined the proportion of patients in a family practice for whom therapy with a β-blocker or diuretic was contraindicated, and examined the compliance of the physicians in the practice with guidelines. We found that about half of hypertensives had conditions for which recommended therapy is not a β -blocker or diuretic. Thus, failure of physicians to follow guidelines is apparently less inappropriate than is widely perceived. [ABSTRACT FROM AUTHOR]

Hypertension is a major risk factor for stroke disease. There is now some international agreement on what constitutes hypertension, and at what level of blood pressure treatment is required. Large randomised controlled trials demonstrate the benefit of reducing blood pressure for the primary and secondary prevention of stroke disease. Studies have also demonstrated the benefit of particular classes of antihypertensive agents in certain patient groups. Research is beginning to elucidate the problems of hypertension in the acute phase of ischaemic stroke and the therapeutic strategies that may be helpful. Given the significant impact of stroke disease on all health services, it remains an important priority to determine the best management of hypertension in stroke. [ABSTRACT FROM AUTHOR]

The expression of extA, an extensin gene from Brassica napus L. (oilseed rape) was examined in transgenic Nicotiana tabacum L. (tobacco) and untransformed Brassica juncea L. and B. napus tissues. Northern analysis showed that this gene maintained its normal pattern of expression when transferred to tobacco. In transgenic tobacco plants containing an extA promoter/β-glucuronidase coding sequence fusion, expression of extA was detected in the external and internal phloem of the main stem. High expression levels were seen in cortical parenchyma cells at the point where the axillary flowering branch joined the main stem. Expression was greatest in regions where the maximum tensile stress would seem to be exerted on the main stem by the weight of the axillary branch. It was confirmed that this expression pattern was due to tensile stress by using weights to induce expression of the fusion gene in axillary flowering stalks. In B. juncea pods, in-situ hybridisation studies showed that the extensin gene was strongly expressed in cells of the carpel walls within which considerable tensile stresses develop. [ABSTRACT FROM AUTHOR]

A review of the most recent 23 cases of benign intracranial hypertension (BIH), admitted to the War Memorial Children's Hospital in London, Ontario, provided a compendium of the clinical manifestations of this disorder in children and adolescents. Although CT scanning lets one feel more secure in making such a diagnosis, pitfalls still exist. The sex ratio was 11 males to 12 females. Age groupings were: 0-6 years (2 patients); 7-12 years (10); 13-17 years (11). No postviral etiologies were encountered in patients more than 13 years of age. In only 6 cases could no definite etiology be established. Of great importance was the recognition of the condition in 12 patients who did not have papilledema. Elevated intracranial pressure was proven in 8 of these by lumbar CSF pressure monitoring, in 1 by lumbar punctures and in 1 infant with split cranial sutures. Absence of papilledema was confirmed by ophthalmological examination. Transient visual obscurations were very common in this group. In 6 patients, persistent signs and symptoms in spite of vigorous drug therapy prompted lumboperitoneal shunting, with immediate relief of symptoms in all. In only 1 case has the diagnosis of BIH proven to be in error. A warning leak from an aneurysm caused papilledema and headache, and a normal CT scan supported the diagnosis until the patient had a major hemorrhage weeks later. BIH has a variety of causes in children and adolescents, and papilledema is not a prerequisite for diagnosis. [ABSTRACT FROM AUTHOR]

Endralazine, a novel vasodilator related to hydralazine, exhibits a longer half-life and is only minimally influenced by acetylator status. The antihypertensive action of once daily endralazine has been studied in 17 patients previously controlled with an antihypertensive regimen which included hydralazine and a beta-blocker. Hydralazine was discontinued but other medications were unchanged. Pre-study dosage of hydralazine ranged from 25 mg b.i.d. to 50 mg g.i.d., mean daily dose 126.5 mg. End-ralazine was started at a dose of 10 mg o.d. and increased by 10 mg to a maximum of 40 mg o.d. until seated DBP was controlled below 95 mmHg. All 17 patients completed the study. Seated BP significantly decreased from 147.5/99.7 to 133.8/83.9 and standing BP from 145.8/99.2 to 133.6/87.3 mmHg. Ten patients (59%) were successfully controlled with endralazine once daily but 7 patients required twice daily dosage schedules because of lack of BP control at 24 h after dosing or excessive hypotension shortly after dosing. Other adverse effects were headache, palpitations and fatigue. There was a statistically insignificant average weight gain of 1 kg but pedal edema was not observed. Endralazine is an effective antihypertensive agent with adverse symptoms similar to those experienced with hydralazine. [ABSTRACT FROM AUTHOR]

The largest class of de novo chromosomal rearrangements in Down syndrome are rea(21q21q). Classically, these rearrangements have been termed Robertsonian translocations, implying an attachment of two different chromosome 21 homologues. Additionally, a Robertsonian translocation between two chromosomes 21 cannot be distinguished from an isochromosome composed of genetically identical arms by cytogenetic analyses. Therefore, we have used molecular techniques to differentiate between true Robertsonian translocations and isochromosomes. Samples were obtained from 12 probands, ascertained for de novo rearrangements between homologous chromosomes 21 [11 rea(21q21q) and 1 rea (21;21)(q22;q22)], their parents ( n = 24) and available siblings ( n = 7). The parental origins of the de novo rearrangements were assigned using molecular and cytogenetic analyses. Although not statistically significant, there was a two-fold increase in the number of paternally derived de novo rearrangements ( n = 8) as compared with maternally derived rearrangements ( n = 4). To distinguish between rob(21q21q) and i(21q), we used restriction fragment length polymorphisms (RFLPs) spanning the length of chromosome 21. Using all informative and partially informative RFLPs, we used the method of maximum likelihood to assign the most likely rearrangement definition (i or rob) and parental origin in each family. The maximum likelihood estimates indicated that all rearrangements tested ( n = 8) were isochromosomes. C-banding revealed two centromeres in three cases indicating that a U-type exchange occurred between sister chromatids in these rearrangements. Our results suggest that the majority of de novo rea(21q21q) are isochromosomes derived from a single parental chromosome 21. [ABSTRACT FROM AUTHOR]

Several attempts to model the entire plasma cross section have been reported in the last few years. Two possibilities are to either couple a core code to a scrape-off layer (SOL) code at a specified interface or to extend the computational region of an SOL-code all the way to the plasma centre. The most advanced global code is the code COCONUT which is based on the former principle and comprises the Monte-Carlo code NIMBUS, the 2D scrape-off layer code EDGE2D, the core transport code JETTO and the core impurity transport code SANCO. A main feature of COCONUT is its modular structure which ensures a high degree of flexibility and the capability to cover a large range of time-scales. The influence of the SOL on the core is lllustrated with a range of global simulations carried out with COCONUT. The simulations show that the primary effect of the SOL is the control of the particle sources and sinks with a secondary effect on plasma dilution, radiation and perhaps pedestal temperatures. [ABSTRACT FROM AUTHOR]

Prenatal dignosis was performed for 47 pregnancies with 1 in 4 risk of cystic fibrosis, including 7 cases analyzed with linked DNA markers, 16 cases analyzed by microvillar intestinal enzyme testing, and 24 cases where both methods of testing were attempted. DNA was obtained by chorionic villus sampling in 10 cases and by amniocentesis in 21 cases, and diagnosis was based on analysis with the tightly linked DNA markers D7S8 and met. DNA analysis using these probes was fully informative in 74.4% of 90 couples with 1 in 4 risk. In 18 cases where both DNA results and microvillar intestinal enzyme data were diagnostic, there was agreement regarding the predicted status of the fetus. No adequate diagnosis was achieved in two cases where both diagnostic tests were attempted. Ourcome is known for 24 pregnancies including 10 where DNA analysis was diagnostic, and no errors in diagnosis were detected. Prenatal diagnosis of cystic fibrosis using DNA markers is highly informative and accurate, but microvillar intestinal enzyme analysis remains a valuable part of a complete diagnostic program. [ABSTRACT FROM AUTHOR]

We present a model for cold dark matter based upon continuum bound states of the e e system. These continuum bound states, referred to as photonium states to distinguish them from the well-known bound states of positronium, are shown to have cross sections and lifetime properties consistent with abundant production in the early universe and survival to the present time. Thus photonium can easily account for more than 90% of the total mass of the universe. [ABSTRACT FROM AUTHOR]

Rooted leaves provide convenient material for investigating various physiological processes. Details are given for producing rooted leaves of species with tuberous roots, e.g. Sweet potato ( Ipomoea batatas) and Dahlia ( Dahlia variabilis) and species with tap roots, e.g. Sugar beet ( Beta vulgaris) and Runner bean ( Phaseolus coccineus). The storage root formed on a single sugar-beet leaf develops concentric cambia suggesting that their formation is not determined by particular leaves. [ABSTRACT FROM AUTHOR]

The article discusses research on identifying which patients with atherosclerosis are at higher risk of future cardiovascular events from carotid plaque composition. It references the study "Composition of Carotid Atherosclerotic Plaque Is Associated With Cardiovascular Outcome: A Prognostic Study," by W. E. Hellings et al. in a 2010 issue of the periodical "Circulation." It notes the development of approaches to identifying high-risk patients using noninvasive imaging of plaques. The study's limitation is also mentioned.

Stroke risk in patients with nonvalvular atrial fibrillation increases markedly with age. although anticoagulation is more effective than antiplatelet therapy in atrial fibrillation, it tends to be underutilized in the elderly. A study by van Walraven et al. examines the influence of age on stroke prevention therapy in atrial fibrillation. [ABSTRACT FROM AUTHOR]

Comments on the determination of Pseudo-hypertension in the elderly. Problems in the accurate measurement of blood pressure; Measurement of cuff diastolic pressure; Determination of intra-arterial pressure for the study.