Search

In this article, we explore how women in different social classes had differential access to resources and services to enhance their 'wellness'-resulting in classed roles in alcohol consumption. We analyse data from a qualitative study on alcohol by midlife women in South Australia and employ the analogy of a 'toolkit' in order to understand the structural patterning of 'wellness tools'. Bourdieu's relational model of class guides our exploration of women's inequitable opportunities for wellness. Higher social class women had 'choices' facilitated by bulging wellness toolkits, such as yoga, exercise and healthy eating regimens-alcohol consumption was not essential to promoting 'wellness' and did not have an important place in their toolkits. Middle-class women had less well-stocked toolkits and consumed alcohol in a 'compensation approach' with other wellness tools. Alcohol consumption received positive recognition and was a legitimised form of enjoyment, fun and socialising, which needed counterbalancing with healthy activities. Working-class women had sparse toolkits-other than alcohol-which was a tool for dealing with life's difficulties. Their focus was less on 'promoting wellness' and more on 'managing challenging circumstances'. Our social class-based analysis is nestled within the sociology of consumption and sociological critiques of the wellness industry.

Objective Decision-making around tracheostomy placement and chronic respiratory support in children is complicated. Families often seek support and advice from outside the medical care team, including from social media. We undertook this study to characterize the content and nature of online resources created and managed primarily by caregivers of children living with tracheostomy and chronic mechanical ventilation. Design/setting We used a "grey literature" search methodology to identify internet resources created by caregivers of children with tracheostomy. We included only publicly available, nonindustry associated, English language, North American websites updated at least once in 2019. We then applied inductive content analysis to establish central themes, patterns and associations. Measurements/main results We identified six blogs/forums that met our search criteria. We identified four main themes: (1) Uncertainty, (2) Lived experience-wants, needs, and emotions, (3) Seeking context and meaning, and (4) Advice/information sharing/support. Two patterns of coping were identified on the basis of the relationships between codes. The "Acceptance pathway" is associated with a sense of self-actualization, mastery, satisfaction, return to normalcy, and ultimately acceptance. The "Resignation pathway" is associated with a sense of lack of control, frustration, burnout and stress, persistent lack of normalcy, and resignation to the tracheostomy as a negative but necessary outcome. Conclusion Caregivers often come to see themselves as experts in the care of children with tracheostomy, though many still express ambivalence about their knowledge and skills. Those early in the experience express a desire for community and can potentially benefit from online resources.

Our recent genomic studies identified a complex kidney‐specific enhancer module located within the introns of adjacent Mettl1 (M1) and Mettl21b (M21) genes that mediate basal and PTH induction of Cyp27b1, as well as suppression by FGF23 and 1,25‐dihydroxyvitamin D3 [1,25(OH)2D3]. The tissue specificity for this regulatory module appears to be localized exclusively to renal proximal tubules. Gross deletion of these segments in mice has severe consequences on skeletal health, and directly affects Cyp27b1 expression in the kidney. Deletion of both the M1 and M21 submodules together almost completely eliminates basal Cyp27b1 expression in the kidney, creating a renal specific pseudo‐null mouse, resulting in a systemic and skeletal phenotype similar to that of the Cyp27b1‐KO mouse caused by high levels of both 25‐hydroxyvitamin D3 [25(OH)D3] and PTH and depletion of 1,25(OH)2D3. Cyp24a1 levels in the double KO mouse also decrease because of compensatory downregulation of the gene by elevated PTH and reduced FGF23 that is mediated by an intergenic module located downstream of the Cyp24a1 gene. Outside of the kidney in nonrenal target cells (NRTCs), expression of Cyp27b1 in these mutant mice was unaffected. Dietary normalization of calcium, phosphate, PTH, and FGF23 rescues the aberrant phenotype of this mouse and normalizes the skeleton. In addition, both the high levels of 25(OH)D3 were reduced and the low levels of 1,25(OH)2D3 were fully eliminated in these mutant mice as a result of the rescue‐induced normalization of renal Cyp24a1. Thus, these hormone‐regulated enhancers for both Cyp27b1 and Cyp24a1 in the kidney are responsible for the circulating levels of 1,25(OH)2D3 in the blood. The retention of Cyp27b1 and Cyp24a1 expression in NRTCs of these endocrine 1,25(OH)2D3‐deficient mice suggests that this Cyp27b1 pseudo‐null mouse will provide a model for the future exploration of the role of NRTC‐produced 1,25(OH)2D3 in the hormone's diverse noncalcemic actions in both health and disease. © 2020 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.

Fibroblast growth factor 23 (FGF23) production is regulated by both calciotropic hormones and inflammation. Consistent with this, elevated FGF23 levels are associated with inflammatory markers as well as parathyroid hormone (PTH) in various disease states, including chronic kidney disease (CKD). However, the molecular mechanisms underpinning Fgf23 transcription in response to these regulators are largely unknown. We therefore utilized chromatin immunoprecipitation followed by DNA sequencing (ChIP-seq) data from an osteocyte cell line to identify potential regulatory regions of the Fgf23 gene. Based on ChIP-seq analysis of enhancer-associated histone modifications, including H3K4 methylation and H3K9 acetylation, we discovered several potential enhancers for Fgf23, one of which was located 16kb upstream of the gene's transcriptional start site. Deletion of this putative enhancer from the mouse genome using CRISPR-Cas9 technology led to lower bone, thymus, and spleen expression of Fgf23 mRNA without altering circulating levels of the intact hormone, although as previously reported, only bone displayed significant basal expression. Nevertheless, lack of the -16kb enhancer blunted FGF23 upregulation in a tissue-specific manner by the acute inflammatory inducers lipopolysaccharide (LPS), interleukin-1-beta (IL-1β), and tumor necrosis factor-alpha (TNFα) in bone, non-osseous tissues, and in circulation. Lack of the -16kb enhancer also inhibited PTH-induced bone Fgf23 mRNA. Moreover, the absence of this Fgf23 enhancer in an oxalate diet-induced murine CKD model prevented the early onset induction of osseous, renal, and thymic Fgf23 mRNA levels and led to a significant blunting of elevated circulating intact FGF23 levels. These results suggest that -16kb enhancer mediates the induction of Fgf23 by inflammation and PTH and facilitates the increase in FGF23 expression in a murine model of CKD. As exemplified herein, these Fgf23 enhancer-deleted mice will provide a unique model in which to study the role of FGF23 expression in inflammatory diseases.

Copyright 2017 by The American Council on Consumer Interests. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for self-archiving. This author accepted manuscript is made available following 24 month embargo from date of publication (Sept 2017) in accordance with the publisher’s archiving policy

Introduction Central venous catheters (CVC) increase risks associated with hemodialysis (HD), but may be necessary until an arteriovenous fistula (AVF) or graft (AVG) is achieved. The impact of vascular imaging on achievement of working AVF and AVG has not been firmly established. Methods Retrospective cohort of patients initiating HD with CVC in 2010–2011, classified by exposure to venography or Doppler vein mapping, and followed through December 31, 2012. Standard and time-dependent Cox models were used to determine hazard ratios (HRs) of death, working AVF, and any AVF or AVG. Logistic regression was used to assess the association of preoperative imaging with successful AVF or AVG among 18,883 individuals who had surgery. Models were adjusted for clinical and demographic factors. Findings Among 33,918 patients followed for a median of 404 days, 39.1% had imaging and 55.7% had surgery. Working AVF or AVG were achieved in 40.6%; 46.2% died. Compared to nonimaged patients, imaged patients were more likely to achieve working AVF (HR = 1.45 [95% confidence interval [CI] 1.36, 1.55], P 0.001), and less likely to die (HR = 0.88 [0.83-0.94], P

Introduction: Microbiological culture of dialysis water and fluid is a routine safety measure. In the United States (U.S.), laboratories perform these cultures on trypticase soy agar at 35–37°C for 48 h (TSA-48h), not on the tryptone glucose extract agar or Reasoner's 2A agar at 17–23°C for 7 days (TGEA-7d and R2A-7d, respectively) recommended by international standards. We compared culture methods to identify samples exceeding the accepted action level of 50 CFU/mL. Methods: Dialysis water and fluid samples collected from 41 U.S. dialysis programs between 2011 and 2014 were cultured at two U.S. laboratories. Each sample was cultured using (1) either TGEA-7d or R2A-7d and (2) TSA-48h. We compared proportions exceeding the action level by different methods and test characteristics of TSA-48h to those of TGEA-7d and R2A-7d. Findings: The proportion of water samples yielding colony counts ≥50 CFU/mL by TGEA-7d was significantly different from the proportion by TSA-48h (P = 0.001; difference in proportion 4.3% [95%CI 1.3–7.3%]). The proportions of dialysis fluid samples ≥50 CFU/mL by TGEA-7d and TSA-48h were not significantly different; there were no significant differences for comparisons of R2A-7d to TSA-48h. Discussion: In dialysis fluid, TSA-48h was comparable to TGEA-7d and R2A-7d in identifying samples as having bacterial counts ≥50 CFU/mL. In dialysis water, TSA-48h was comparable to R2A-7d in identifying samples ≥50 CFU/mL, but TGEA-7d did yield significantly more results above 50 CFU/mL. Nonetheless, the negative predictive value of a TSA-48h result of

Objective Minority candidates for office must overcome numerous hurdles in order to win elective office, with one such hurdle being the racial resentment of voters. This article tests the impact racial resentment has on white support for a minority candidate in relation to a similar white candidate. Method This article employs a natural experiment provided by the 2014 South Carolina Senate elections. Examining these elections, this article examines what impact a voter's racial resentment has on his or her support for the two candidates. Results The results show that voters who score highly on the racial resentment scale are just as likely to support a minority Republican as they are to support a white Republican. Conclusion These findings indicate that racial resentment scores may not adequately measure a person's true feelings on race, particularly when the minority candidate is a Republican.

The Perceived Susceptibility to Sport Injury (PSSI) scale is a measure that has recently surfaced in the sport injury literature. The factor structure of the PSSI scale has not been subjected to a rigorous factor analysis; thus, the factorial validity of the measure in athlete populations is unknown. To establish the validity of the PSSI scale in sports medicine research, the purpose of this study was to examine the factor structure and measurement invariance across gender of the PSSI scale. Male and female intercollegiate athletes (N = 217) completed the PSSI scale during the off-season. The factor structure was analyzed using confirmatory factor analysis (CFA) procedures and maximum likelihood estimation. The measurement invariance analysis was conducted via comparisons of fit indices within a series of hierarchically constrained models. Results of the CFA yielded a very good fit of the measurement model: χ2 (2) = 4.535, P = 0.104; RMSEA = 0.076; SRMR = 0.018; CFI = 0.995; NNFI = 0.985. Results of the measurement invariance analysis demonstrated strict invariance across gender, and no significant latent mean differences emerged between men and women. Study results support the factorial validity of the PSSI scale for use in future sports medicine research.

Purpose To present a technique, which allows for the in vivo quantification of the spectral line broadening of the human lung in a single breathhold. The line broadening is an interesting parameter of the lung because it can provide information about important lung properties, namely: inflation and oxygen uptake. The proposed technique integrates the asymmetric spin-echo (ASE) approach, which is commonly used to quantify the line broadening, with a single shot turbo spin-echo pulse sequence with half-Fourier acquisition (HASTE), to reduce the acquisition times. Materials and Methods Imaging experiments were performed at 1.5 Tesla on 14 healthy volunteers, using a ASE-prepared HASTE sequence. The line broadening was quantified using a two-points method. Data were acquired at different breathing states: functional residual capacity (FRC) and total lung capacity (TLC), and with different breathing gases: room-air and pure-oxygen. Image acquisition was accomplished within a single breathhold of approximately 15 s duration. The violation of the Carr-Purcell-Meiboom-Gill conditions, deriving from inhomogeneities of the static magnetic field, was overcome by means of radiofrequency-phase cycling and generalized autocalibrating partially parallel acquisitions (GRAPPA) reconstruction. Results Significant increase of the line broadening was observed with both lung inflation and oxygen concentration (P

Aim This paper explores how food regulators respond to food incidents and the barriers and enablers associated with doing so. Methods Twenty-six semi-structured interviews lasting between 30 and 60 minutes were undertaken with Australian food regulators. Regulators worked across food policy development, implementation, enforcement and standards setting. These interviews ascertained food regulators' views on food safety and responses to real and hypothetical food incidents. Data were analysed using thematic analysis. Results Food regulators reported that working together with other food regulators is an important part of effective food regulation and response to food incidents. Strategies for working together included clarifying expectations and developing formal documents such as a memorandum of understanding. However, challenges in working together were reported, including different risk thresholds, different political agendas and a lack of clarity on regulators' roles. Conclusions A focus on partnerships and good communication between food regulators is likely to facilitate effective management of food incidents, and maximise the chances that food incidents do not lead to increased consumer morbidity and mortality as a result of a poor response to a food incident.

PURPOSE An algorithm is presented to enable cardiac and respiratory self-gating in combination with Inversion Recovery Look-Locker read-outs. METHODS A radial inversion recovery snapshot FLASH sequence was adapted for retrospective cardiac T1 measurements in mice. Cardiac and respiratory data were extracted from the k-space center of radial projections and an adapted method for retrospective cardiac synchronization is introduced. Electrocardiogram (ECG) data was acquired concurrently for validation of the proposed self-gating technique. T1 maps generated by the proposed technique were compared with maps reconstructed with the ECG reference. RESULTS Respiratory gating and cardiac trigger points could be obtained for the whole time course of the relaxation dynamic and correlate very well to the ECG signal. T1 maps reconstructed with the self-gating technique are in very good agreement with maps reconstructed with the external reference. CONCLUSION The proposed method extends "wireless" cardiac MRI to non-steady-state inversion recovery measurements. T1 maps were generated with a quality comparable to ECG based reconstructions. As the method does not rely on an ECG trigger signal it provides easier animal handling. Magn Reson Med 76:1887-1894, 2016. © 2016 International Society for Magnetic Resonance in Medicine.

This brief communication reports on the main findings and recommendations from the 2014 Science Forum organized by CropLife America. The aim of the Forum was to gain a better understanding of the current status of population models and how they could be used in ecological risk assessments for threatened and endangered species potentially exposed to pesticides in the United States. The Forum panelists' recommendations are intended to assist the relevant government agencies with implementation of population modeling in future endangered species risk assessments for pesticides. The Forum included keynote presentations that provided an overview of current practices, highlighted the findings of a recent National Academy of Sciences report and its implications, reviewed the main categories of existing population models and the types of risk expressions that can be produced as model outputs, and provided examples of how population models are currently being used in different legislative contexts. The panel concluded that models developed for listed species assessments should provide quantitative risk estimates, incorporate realistic variability in environmental and demographic factors, integrate complex patterns of exposure and effects, and use baseline conditions that include present factors that have caused the species to be listed (e.g., habitat loss, invasive species) or have resulted in positive management action. Furthermore, the panel advocates for the formation of a multipartite advisory committee to provide best available knowledge and guidance related to model implementation and use, to address such needs as more systematic collection, digitization, and dissemination of data for listed species; consideration of the newest developments in good modeling practice; comprehensive review of existing population models and their applicability for listed species assessments; and development of case studies using a few well-tested models for particular species to demonstrate proof of concept. To advance our common goals, the panel recommends the following as important areas for further research and development: quantitative analysis of the causes of species listings to guide model development; systematic assessment of the relative role of toxicity versus other factors in driving pesticide risk; additional study of how interactions between density dependence and pesticides influence risk; and development of pragmatic approaches to assessing indirect effects of pesticides on listed species. Integr Environ Assess Manag 2015;11:348–354. © 2015 SETAC

Coal-fly ash was released in unprecedented amounts (4.1 × 106 m3) into the Emory River from the Tennessee Valley Authority Kingston Fossil Plant on Watts Bar Reservoir in Tennessee. Tree swallows were exposed to ash-related constituents at the ash release via their diet of emergent aquatic insects, whose larval forms can accumulate constituents from submerged river sediments. Reproduction of tree swallow colonies was assessed over a 2-year period by evaluating whether 1) ash constituent concentrations were elevated in egg, eggshell, and nestling tissues at colonies near ash-impacted river reaches compared to reference colonies, 2) production of fledglings per nesting female was significantly lower in ash-impacted colonies versus reference colonies, and 3) ash constituent concentrations or diet concentrations were correlated with nest productivity measures (clutch size, hatching success, and nestling survival, and fledglings produced per nest). Of the 26 ash constituents evaluated, 4 (Se, Sr, Cu, and Hg) were significantly elevated in tissues potentially from the ash, and 3 (Se, Sr, and Cu) in tissues or in swallow diet items were weakly correlated to at least one nest-productivity measure or egg weight. Tree swallow hatching success was significantly reduced by 12%, but fledgling production per nest was unaffected due to larger clutch sizes in the impacted than reference colonies. Bioconcentration from the ash to insects in the diet to tree swallow eggs appears to be low. Overall, adverse impacts of the ash on tree swallow reproduction were not observed, but monitoring is continuing to further ensure Se from the residual ash does not adversely affect tree swallow reproduction over time. Integr Environ Assess Manag 2015;11:56–66. © 2014 SETAC

In addition to osteoblast lineage cells, the TNF-like factor receptor activator of NF-κB ligand (RANKL) is expressed in both B and T cells and may play a role in bone resorption. Rankl gene (Tnfsf11) expression in mouse T cells is mediated through multiple distal elements marked by increased transcription factor occupancy, histone tail acetylation, and RNA polymerase II recruitment. Little is known, however, of the regulation of human TNFSF11 in T cells. Accordingly, we examined the consequence of T cell activation on the expression of this factor both in Jurkat cells and in primary human T cells. We then explored the mechanism of this regulation by scanning over 400 kb of DNA surrounding the TNFSF11 locus for regulatory enhancers using ChIP-chip analysis. Histone H3/H4 acetylation enrichment identified putative regulatory regions located between -170 and -220 kb upstream of the human TNFSF11 TSS that we designated the human T cell control region (hTCCR). This region showed high sequence conservation with the mouse TCCR. Inhibition of MEK1/2 by U0126 resulted in decreased RANKL expression suggesting that stimulation through MEK1/2 was a prerequisite. ChIP-chip analysis also revealed that c-FOS was recruited to the hTCCR as well. Importantly, both the human TNFSF11 D5a/b (RLD5a/b) enhancer and segments of the hTCCR mediated robust inducible reporter activity following TCR activation. Finally, SNPs implicated in diseases characterized by dysregulated BMD co-localized to the hTCCR region. We conclude that the hTCCR region contains a cell-selective set of enhancers that plays an integral role in the transcriptional regulation of the TNFSF11 gene in human T cells.

Current scientific advances in metal and metalloid risk assessment were applied to evaluate risk to aquatic and riparian wildlife species potentially impacted by residual coal fly ash after cleanup of an unprecedented large ash release into an aquatic environment—the first assessment of its kind. Risk was evaluated using multiple lines of evidence (LOE), including 1) tissue-based risk assessment of inorganic concentrations in piscivorous and insectivorous bird eggs and raccoon organs, 2) deterministic and probabilistic diet-based risk estimates for 10 receptors species, 3) raccoon health metrics, and 4) tree swallow nest productivity measures. Innovative approaches included use of tissue-based toxicity reference values (TRVs), adjustment of bioavailability in the dietary uptake models (using sequential metal extractions in sediment), partitioning chemical species into uptake compartments (e.g., prey gut, nongut, sediment), incorporating uncertainty in both modeled dose and dietary TRVs, matching TRVs to chemical forms of constituents, and pairing these LOEs with reproductive success or health status of sensitive receptor species. The weight of evidence revealed that risk to wildlife from residual ash was low and that risk, though low, was most pronounced for insectivorous birds from exposure to Se and As. This information contributes to the debate surrounding coal combustion residue regulations prompted by this ash release. Because of the responsible party's proactive approach of applying state-of-the-art methods to assess risk using several LOEs that produced consistent results, and because of their inclusion of the regulating agencies in decisions at every step of the process, the risk assessment results were accepted, and an effective approach toward cleanup protective of the environment was quickly implemented. This study highlights the value of using multiple LOEs and the latest scientific advances to assist in timely decision making to obtain an effective remedy for an emergency spill. Integr Environ Assess Manag 2015;11:67–79. © 2014 SETAC

Purpose A method for the quantification of perfusion in murine myocardium is demonstrated. The method allows for the reconstruction of perfusion maps on arbitrary time points in the heart cycle while addressing problems that arise due to the irregular heart beat of mice. Methods A flow-sensitive alternating inversion recovery arterial spin labeling method using an untriggered FLASH-read out with random sampling is used. Look-Locker conditions are strictly maintained. No dummy pulses or mechanism to reduce deviation from Look-Locker conditions are needed. Electrocardiogram and respiratory data are recorded for retrospective gating and triggering. A model-based technique is used to reconstruct missing k-space data to cope with the undersampling inherent in retrospectively gated methods. Acquisition and reconstruction were validated numerically and in phantom measurements before in vivo experimentation. Results Quantitative perfusion maps were acquired within a single slice measurement time of 11 min. Perfusion values are in good accordance to literature values. Myocardial infarction could be clearly visualized and results were confirmed with histological results. Conclusion The proposed method is capable of producing quantitative perfusion maps on arbitrary positions in the heart cycle within a short measurement time. The method is robust against irregular breathing patterns and heart rate changes and can be implemented on all scanners. Magn Reson Med, 2014. © 2014 Wiley Periodicals, Inc.

Introduction Colorectal cancer (CRC) has the second highest cancer mortality rate in Australia. The Australian National Bowel Cancer Screening Program (NBCSP) aims to increase early detection of CRC by offering free Faecal Occult Blood Testing (FOBT), although uptake is low for culturally and linguistically diverse (CALD) groups. Aim of paper To present data on trust and mistrust in the NBCSP by population groups with low uptake and thus to highlight areas in need of policy change. Methods A qualitative study was undertaken in South Australia, involving interviews with 94 people from four CALD groups: Greek, Iranian, Anglo-Australian, and Indigenous peoples. Results Our study highlights the complexities of institutional trust, which involves considerations of trust at interpersonal, local and national levels. In addition, trust and mistrust was found in more abstract systems such as the medical knowledge of doctors to diagnose or treat cancer or the scientific procedures in laboratories to test the FOBTs. The object of institutional (mis)trust differed between cultural groups – AngloAustralian and Iranian groups indicated a high level of trust in the government, whereas Indigenous participants were much less trusting. Conclusion The level and nature of trust in the screening process varied between the CALD groups. Addressing program misconceptions, clarifying the FOBT capabilities and involving medical services in collecting and transporting the samples may increase trust in the NBCSP. However, broader and more enduring mistrust in services and institutions may need to be dealt with in order to increase trust and participation.

Summary Objective To determine the outcome of implanting fewer electrodes over the hemisphere with less supporting presurgical localizing data. Methods We retrospectively reviewed our epilepsy surgery database at Mayo Clinic, Rochester, Minnesota, between January 1, 1999, and December 31, 2011, to identify patients who had an asymmetric number of electrode contacts implanted in each hemisphere for seizure localization. We scored each presurgical noninvasive data point (0, 0.5, or 1) to predict the likelihood of identifying seizure onset in the hemisphere with fewer intracranial electrode contacts (HFEC). An aggregate score was obtained for each patient. Results Thirteen (37%) of 35 patients had HFEC-onset seizures on intracranial electroencephalography (iEEG). The following factors predicted HFEC-onset seizures: (1) temporal lobe epilepsy (p = 0.02); (2) interictal scalp electroencephalographic discharges at the HFEC (p = 0.04); and (3) both interictal and ictal scalp EEG discharges at the HFEC (p = 0.01). The median (range) aggregate score was 2 (1–3) for patients with HFEC-onset seizures recorded on iEEG and 1 (0–3) for patients without HFEC-onset seizures (p = 0.001). Using this scoring model, the odds ratio of identifying HFEC-onset seizures on iEEG was 6.4 for each one-point increment in the aggregate score. The area under the receiver operating characteristic curve for this model was 0.84, suggesting excellent ability of the aggregate score to discriminate between patients with and without HFEC-onset seizures on iEEG. Significance Implanting electrodes on the basis of limited supporting presurgical data may be useful in selected patients, especially those with temporal lobe epilepsy, interictal scalp discharges involving the HFEC, or both interictal and ictal scalp discharges involving the HFEC. In addition, our proposed scoring system may be helpful in selecting patients with complicated epilepsy for implantation of an asymmetric number of intracranial electrodes in the hemispheres.

The role of theory in qualitative health research is paramount for translation into practice and policy, since it moves beyond pure description of data, allowing interpretation of the social processes underpinning and potentially ‘explaining’ findings. However, the use of theory in empirical research proves challenging to undertake and subsequently articulate in theses and publications. This paper offers insight into how theory may be used in empirical research, drawing on both theory-driven and grounded theory approaches. The approach described assists researchers in bridging the central criticisms of these two methodological approaches. Furthermore, if offers researchers and students a step-by-step guide for integrating theory within and throughout the research process. Within our step-by-step guide, we provide examples from our own research that we hope will help readers to map the difficult terrain of using theory within and throughout their own research. Think of this paper as a guide to working with theory and research in an interconnected and interdependent way – a pluralistic approach for theory verification and generation.

Summary Objective Seizures are currently defined by their electrographic features. However, neuronal networks are intrinsically dependent on neurotransmitters of which little is known regarding their periictal dynamics. Evidence supports adenosine as having a prominent role in seizure termination, as its administration can terminate and reduce seizures in animal models. Furthermore, microdialysis studies in humans suggest that adenosine is elevated periictally, but the relationship to the seizure is obscured by its temporal measurement limitations. Because electrochemical techniques can provide vastly superior temporal resolution, we test the hypothesis that extracellular adenosine concentrations rise during seizure termination in an animal model and humans using electrochemistry. Methods White farm swine (n = 45) were used in an acute cortical model of epilepsy, and 10 human epilepsy patients were studied during intraoperative electrocorticography (ECoG). Wireless Instantaneous Neurotransmitter Concentration Sensor (WINCS)–based fast scan cyclic voltammetry (FSCV) and fixed potential amperometry were obtained utilizing an adenosine-specific triangular waveform or biosensors, respectively. Results Simultaneous ECoG and electrochemistry demonstrated an average adenosine increase of 260% compared to baseline, at 7.5 ± 16.9 s with amperometry (n = 75 events) and 2.6 ± 11.2 s with FSCV (n = 15 events) prior to electrographic seizure termination. In agreement with these animal data, adenosine elevation prior to seizure termination in a human patient utilizing FSCV was also seen. Significance Simultaneous ECoG and electrochemical recording supports the hypothesis that adenosine rises prior to seizure termination, suggesting that adenosine itself may be responsible for seizure termination. Future work using intraoperative WINCS–based FSCV recording may help to elucidate the precise relationship between adenosine and seizure termination.

Samantha B. Meyer, Loreen Mamerow, Julie Henderson, Anne W. Taylor, John Coveney and Paul R. Ward

Summary Purpose: Focal seizures are thought to reflect simultaneous activation of a large population of neurons within a discrete region of pathologic brain. Resective surgery targeting this focus is an effective treatment in carefully selected patients, but not all. Although in vivo recordings of single-neuron (i.e., “unit”) activity in patients with epilepsy have a long history, no studies have examined long-term firing rates leading into seizures and the spatial relationship of unit activity with respect to the seizure-onset zone. Methods: Microelectrode arrays recorded action potentials from neurons in mesial temporal structures (often including contralateral mesial temporal structures) in seven patients with mesial temporal lobe epilepsy. Key Findings: Only 7.6% of microelectrode recordings showed increased firing rates before seizure onset and only 32.4% of microelectrodes showed any seizure-related activity changes. Surprisingly, firing rates on the majority of microelectrodes (67.6%) did not change throughout the seizure, including some microelectrodes located within the seizure-onset zone. Furthermore, changes in firing rate before and at seizure onset were observed on microelectrodes located outside the seizure-onset zone and even in contralateral mesial temporal lobe. These early changes varied from seizure to seizure, demonstrating the heterogeneity of ensemble activity underlying the generation of focal seizures. Increased neuronal synchrony was primarily observed only following seizure onset. Significance: These results suggest that cellular correlates of seizure initiation and sustained ictal discharge in mesial temporal lobe epilepsy involve a small subset of the neurons within and outside the seizure-onset zone. These results further suggest that the “epileptic ensemble or network” responsible for seizure generation are more complex and heterogeneous than previously thought and that future studies may find mechanistic insights and therapeutic treatments outside the clinical seizure-onset zone.

RANKL is a stromal cell-derived tumor necrosis factor (TNF)-like factor that plays a primary role in osteoclast formation and function. Recent studies suggest that 1,25(OH)(2) D(3) induces Rankl expression via vitamin D receptor (VDR) interaction at several enhancers located up to 76 kb upstream of the gene's transcriptional start site (TSS). In the current studies, we explored these interactions further using ChIP-chip and RNA analysis. We confirm VDR and RXR binding to the five enhancers described previously and identify two additional sites, one located within the Rankl coding region. We also show that RNA polymerase II is recruited to these enhancers, most likely through transcription factors TBP, TFIIB, and TAF(II) 250. Interestingly, the recruitment of these factors leads to the production of RNA transcripts, although their role at present is unknown. We also discovered that histone H4 acetylation (H4ac) marks many upstream Rankl enhancers under basal conditions and that H4ac is increased upon 1,25(OH)(2) D(3) treatment. Surprisingly, the hormone also induces C/EBPβ binding across the Rankl locus. C/EBPβ binding correlates directly with increased H4ac activity following 1,25(OH)(2) D(3) treatment. Finally, elevated H4ac is restricted to an extended region located between two potential insulator sites occupied by CTCF and Rad21. These data suggest a mechanism whereby 1,25(OH)(2) D(3) functions via the VDR and C/EBPβ to upregulate Rankl expression.

Focal cortical epilepsy is currently most effectively studied in humans. However, improvement in cortical monitoring and investigational device development is limited by lack of an animal model mimicking human acute focal cortical epileptiform activity under epilepsy surgery conditions. Therefore, we assessed the swine model for translational epilepsy research. Swine were used due to their cost effectiveness, convoluted cortex, and comparative anatomy similar to humans. Focal subcortical injection of benzyl-penicillin produced clinical seizures correlating with epileptiform activity demonstrating temporal and spatial progression. Swine were evaluated under 5 different anesthesia regimens. Of the 5 regimens, conditions similar to human intraoperative anesthesia, including continuous fentanyl with low dose isoflorane, was the most effective for eliciting complex, epileptiform activity after benzyl-penicillin injection. The most complex epileptiform activity (spikes, and high frequency activity) was then repeated reliably in 9 animals, utilizing 14 swine total. There were 20.1 ± 10.8 (95% CI: 11.8–28.4) epileptiform events with greater than 3.5 hertz activity occurring per animal. Average duration of each event was 46.3 ± 15.6 (95% CI: 44.0 to 48.6) seconds, ranging from 20 to 100 seconds. In conclusion, the acute swine model of focal cortical epilepsy surgery provides an animal model mimicking human surgical conditions with a large brain, gyrated cortex, and is relatively cheap among animal models. Therefore, we feel this model provides a valuable, reliable, and novel platform for translational studies of implantable hardware for intracranial monitoring.

Combined visualizations of filamentous structures and surrounding volumetric objects are common in biological and medical applications. Often, the structures' spatial relationships remain unclear to the viewer. In this paper, we discuss and evaluate techniques to emphasize spatial relationships. We concentrate on the visualization of transparent objects and intersecting lines. Among various techniques, participants of an exploratory user study preferred coloring of lines, marking of line-surface intersections by glyphs, and the combination of both. These techniques were additionally evaluated in a confirmatory study in which participants were asked to judge whether a filament runs through a transparent structure. We found that the evaluated techniques significantly improve the participants' performance in terms of the number of correct responses and response time. The best performance was found for the combination of line coloring and intersection glyph display.

Although sliced by several strike slip faults, a large part of Central Iran remained aseismic during the period of time covered by the instrumental and historical seismic records. Stating the existence of earthquakes in the Holocene is therefore important for the assessment of the regional seismic hazard. A palaeoseismic study of the Deshir fault demonstrates that Central Iran hosted large earthquakes during latest Pleistocene and Holocene. The last event corresponds to 1 m-deep fissures, which sandy infilling yielded an optically stimulated luminescence (OSL) age of 2.8 ± 1.4 ka. At least two previous events, outlined by older fissures and/or colluvial wedges, have been recorded over the last 10–30 ka. The magnitudes are difficult to assess because the actual slips per event are unknown. The size of the fissures and the significant vertical displacement associated with a colluvial wedge are nevertheless compatible with M ≈ 7 events along a primary strike-slip surface break.

Summary Objective We sought to determine if higher resolution 3 Tesla (T) magnetic resonance imaging (MRI) with or without ovine corticotropin releasing hormone (o-CRH) stimulation would increase the sensitivity for detection of pituitary microadenomas in ACTH-dependent Cushing’s syndrome (CS). Design and patients We prospectively identified 23 patients over a 2-year period with clinical and biochemical evidence of ACTH-dependent CS with no lesion (n = 11) or equivocal lesion (n = 10) on 1·5T MRI. Subsequently, two additional MRIs were performed in random order: 3T nonstimulated MRI or 3T MRI with o-CRH in all patients. Three neuroradiologists reviewed all examinations in a randomized blinded fashion. Patients were divided into four groups, depending on the outcome of their evaluation and treatment for CS. Two patients had to be excluded, and so we report on 21 subjects. Measurements and results Both 3T MRI without (P

Partial seizure disorders account for the majority of epilepsy (Sander et al., 1990). In one tertiary center cohort of 2,200 patients, partial epilepsy was more than twice as common as symptomatic, cryptogenic, and idiopathic generalized epilepsies combined. Moreover, in that study, two-thirds of the partial seizure disorders localized to the temporal lobe (Semah et al., 1998). Unfortunately, despite optimal medical therapy, approximately 30% of patients continue to experience recurrent seizures (Sander et al., 1990 Wiebe, et al. 2001). In a recent well-designed trial studying patients who failed initial medication trials, seizure freedom was achieved in only 8% of patients with continued medical therapy compared to 58% of patients undergoing anterior temporal lobectomy (Wiebe, et al. 2001). However, physicians may be reluctant to consider surgery for temporal lobe epilepsy when structural neuroimaging appears normal. Temporal lobectomy has been shown to render about 80% of patients seizure-free in the setting of a magnetic resonance imaging (MRI)–apparent structural abnormality concordant to the seizure onset zone, such as mesial temporal sclerosis (MTS) (Cascino, 2004). On the other hand, patients with temporal lobe epilepsy and normal MRI have received less attention. In order to demonstrate the absence of a potentially epileptogenic structural lesion, it is critical that patients have high-resolution seizure protocol MRI with both T1- and T2-weighted images (Jack, 1996; Cascino, 2004). There are relatively few studies examining temporal lobectomy in patients with normal modern seizure protocol MRI. Existing research suggests significantly disparate rates of successful surgery in patients with nonlesional MRI, ranging from 18–63% of patients becoming seizure-free (Berkovic et al., 1995; Theodore et al., 1997; Sylaja et al., 2004; Cohen-Gadol et al., 2005; Jeha et al., 2006). Many of these studies were conducted during the 1980s and early 1990s (Berkovic et al., 1995; Radhakrishnan et al., 1998; McIntosh et al., 2004), prior to the widespread use of epilepsy neuroimaging protocols that are more sensitive for detecting MTS (Jack, 1996; Jack et al., 1996). Some of these studies used pathologic findings to categorize patients (McIntosh et al., 2004; Cohen-Gadol et al., 2006), information that is not available preoperatively for clinical prognostication. Other studies include heterogeneous patient populations and only small numbers of patients with nonlesional MRI (Holmes et al., 2000; Sylaja et al., 2004; Cohen-Gadol et al., 2005). Therefore, we sought to examine the efficacy of epilepsy surgery and noninvasive predictors of favorable outcome for patients with medically refractory temporal lobe epilepsy and a nonlesional high-resolution seizure protocol MRI.

This study examined the effects o/Adventure Based Counseling (i.e., a low-element challenge program) on the cohesion of a collegiate women's volleyball team. Results suggest post-intervention improvements in team cohesion. The support created in the challenge experience also transferred to the players helping one another to grieve the untimely loss o/ a teammate. ********** A sport team is a special type of group that shares a collective identity, a sense of shared purpose, structured patterns of interaction and communication, personal and task interdependence, and interpersonal attraction (Carron, 1988). Individuals who participate in sport range from children and adults who play in neighborhood leagues for recreation, socialization, and exercise to professional athletes who sign multimillion-dollar contracts. For athletes who participate in sport at the college level, high-stakes competition can result in the need to consistently achieve peak performance. Over the years, many sport experts and scientists have attempted to identify the qualities and characteristics that will assist athletes and teams to consistently perform at an optimal level. Sport teams are traditionally classified as being either interactive or coactive (Widmeyer & Williams, 1991). It is necessary for members of interactive teams (e.g., volleyball, ice and field hockey, football, soccer, basketball) to coordinate their efforts, but such coordination is not necessary for members of coactive teams (e.g., golf, singles tennis, diving, bowling), who participate simultaneously but independently on the same task. COHESION AND SPORT Cohesion can be defined as the sum of forces acting on group members that maintains their participation in the group, such as cooperation, helping each other, mutual psychological support, interpersonal attraction, commitment to the task, and group pride (Mullen & Cooper, 1994). Similarly, cohesion in sports is defined as the tendency for a group to stick together and remain united in the pursuit of its goals and objectives (Carron, 1982), and it is vital for successful team functioning and success (Cartwright, 1968; Hall, 1985; Meyers, 1962; Murray, 1981). Furthermore, cohesion has been divided into two types, task cohesion and social cohesion. Task cohesion can be defined as a general orientation toward achieving the group's goals and objectives. Social cohesion is the social aspect that can be seen as a general orientation toward developing and maintaining social relationships within the group (Carron, Widmeyer, & Brawley, 1985). Mullen and Cooper (1994) conducted a meta-analysis, which showed that the effect of cohesion on performance is an important contributor to effective group performance and due primarily to commitment to the task rather than interpersonal attraction or group pride. Recently, researchers have also shown that a positive relationship exists between team cohesion and team performance (Wellington & Faria, 1996) and team cohesion and individual satisfaction (Carron & Chelladurai, 1982). Being a member of a cohesive team has been identified as a factor related to whether or not Olympic athletes performed to meet, to exceed, or fail to meet expectations (Gould, Guinan, Greenleaf, Medberry, & Peterson, 1999). It has been suggested that there is a positive relationship between psychological advantages to participants and being a member of a highly cohesive team (Carron, Prapavessis, & Grove, 1994). Cohesion has been positively linked with psychological momentum (Eisler & Spink, 1998); exercise adherence in the sport setting, such as a spinning class (Spink, 1995; Spink & Carron, 1992); and decreased competitive state anxiety (Prapavessis & Carron, 1996). Also, an investigation examining the relationship of group cohesion to mood disturbance, stress, and athletic performance in a female collegiate basketball team indicated that participants perceiving high levels of task cohesion were found to be less depressed, less confused, and to demonstrate less total mood disturbance. …

OBJECTIVES: To assess the extent to which persons aged 70 and older undergoing hemodialysis (HD) had greater changes in health-related quality of life (HRQOL) over 3 years than younger patients undergoing HD. DESIGN: Longitudinal. SETTING: The Hemodialysis Study (HEMO Study) was a randomized, clinical trial of the effects of HD dose and membrane flux on mortality and morbidity in patients undergoing chronic dialysis. PARTICIPANTS: Secondary analysis of the HEMO Study. MEASUREMENTS: Participants completed the Index of Well-Being (IWB) and the Kidney Disease Quality of Life—Long Form (KDQOL-LF), which also includes the Medical Outcomes Study 36-item Short Form Questionnaire (SF-36) annually. Changes in subjects those aged 70 and older were compared with changes in subjects aged 55 to 69 and 18 to 54. RESULTS: At baseline, 1,813 (98%) of HEMO participants completed HRQOL surveys. Their mean age was 58, 56% were female, 64% were black, and mean duration of dialysis was 3.8 years. In subjects with HRQOL data at the first three annual assessments, there were no substantial mean declines in the SF-36 Physical or Mental Component Summary scales over 3 years. In models incorporating effects of attrition, the differences in average change over 3 years between patients undergoing HD aged 70 and older and the younger cohorts were small in magnitude. There were high rates of adverse HRQOL events in all age groups and significantly higher composite event rates of death or clinically significant decline in HRQOL over 3 years was found in subjects aged 70 and older. CONCLUSION: Although HRQOL was impaired in the population undergoing HD, HRQOL scores at baseline reflect a better-preserved multidimensional quality of life in respondents in the HEMO Study aged 70 and older than in younger patients undergoing HD. There was no substantial relationship between age and average decline in HRQOL score over 3 years in participants in the HEMO Study.

From 1987 to 1992, we evaluated a fish bypass system at Bonneville Dam Powerhouse 2 on the Columbia River. The survival of subyearling Chinook salmon Oncorhynchus tshawytscha released into the system ranged from 0.774 to 0.911 and was significantly lower than the survival of test fish released into turbines and the area immediately below the powerhouse where bypass system flow reentered the river. Yearling and subyearling Chinook salmon and yearling coho salmon O. kisutch released into the bypass system were injured or descaled. Also, levels of blood plasma cortisol and lactate were significantly higher in yearling and subyearling Chinook salmon that passed through the bypass system than in fish released directly into a net located over the bypass exit. This original system was then extensively modified using updated design criteria, and the site where juvenile fish reentered the river was relocated 2.8 km further downstream to reduce predation on bypassed fish by northern pikeminnow Ptychocheilu...

We employ a mail survey of private developers that uses conjoint choice experiments and Likert-scaled attitudinal questions to examine preferences for policy instruments and incentives intended to encourage brownfield cleanup and redevelopment. Our analysis suggests that developers judge public hearing requirements at brownfield redevelopments unattractive, but that they place a relatively high value on liability relief—from both cleanup costs and claims by third parties. Reimbursement of environmental assessment costs is not particularly attractive. We also find considerable heterogeneity among developers in the value they place on these incentives, depending on their experience with contaminated sites. © 2006 by the Association for Public Policy Analysis and Management

Purpose To develop an image fusion technique using elliptical centric contrast-enhanced (CE) MR angiography (MRA) and three-dimensional (3D) time-of-flight (TOF) acquisitions for radiosurgery treatment planning of arteriovenous malformations (AVMs). Materials and Methods CE and 3D-TOF MR angiograms with disparate in-plane fields of view (FOVs) were acquired, followed by k-space reformatting to provide equal voxel dimensions. Spatial domain addition was performed to provide a third, fused data volume. Spatial distortion was evaluated on an MRA phantom and provided slice-dependent and global distortion along the three physical dimensions of the MR scanner. In vivo validation was performed on 10 patients with intracranial AVMs prior to their conventional angiogram on the day of gamma knife radiosurgery. Results Spatial distortion in the phantom within a volume of 14 × 14 × 3.2 cm3 was less than ±1 mm (±1 standard deviation (SD)) for CE and 3D-TOF data sets. Fused data volumes were successfully generated for all 10 patients. Conclusion Image fusion can be used to obtain high-resolution CE-MRA images of intracranial AVMs while keeping the fiducial markers needed for gamma knife radiosurgery planning. The spatial fidelity of these data is within the tolerance acceptable for daily quality control (QC) purposes and gamma knife treatment planning. J. Magn. Reson. Imaging 2006. © 2006 Wiley-Liss, Inc.