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Background and purpose P2Y12 receptor antagonists reduce platelet aggregation and the incidence of arterial thrombosis. Adenosine signalling in platelets directly affects cyclic nucleotide tone, which we have shown to have a synergistic relationship with P2Y12 inhibition. Several studies suggest that ticagrelor inhibits erythrocyte uptake of adenosine and that this could also contribute to its antiplatelet effects. We therefore examined the effects on platelet activation of adenosine signalling activators in combination with the P2Y12 receptor antagonists ticagrelor and prasugrel. Experimental approach Human washed platelets, platelet-rich plasma and whole blood were used to test the interactions between ticagrelor or prasugrel and adenosine or 5'-N-ethylcarboxamidoadenosine (NECA). Platelet reactivity to thrombin, protease-activated receptor 1 (PAR-1) activation or collagen was assessed by a combination of 96-well plate aggregometry, light transmission aggregometry, whole blood aggregometry, ATP release assay and levels of cAMP. Key results The inhibitory effects of ticagrelor and prasugrel on platelet aggregation and ATP release were enhanced in the presence of adenosine or NECA. Isobolographic analysis indicated a powerful synergy between P2Y12 receptor inhibition and adenosine signalling activators. Increased levels of cAMP in platelets were also observed. In all cases, ticagrelor showed similar synergistic effects on platelet inhibition as prasugrel in the presence of adenosine or NECA. Conclusion and implications These results indicate that P2Y12 antagonists have a synergistic relationship with adenosine signalling and that their efficacy may depend partly upon the presence of endogenous adenosine. This effect was common for prasugrel and ticagrelor despite reports of differences in their effects upon adenosine reuptake.

Heparin-induced thrombocytopenia (HIT) presents a unique challenge in patients requiring orthotopic heart transplantation (OHT). We sought to pool the existing evidence in a systematic review.Electronic search was performed to identify all relevant studies on OHT in patients with HIT. Patient-level data for 33 patients from 21 studies were extracted for statistical analysis.Median patient age was 51 [IQR 41, 55] years, with 75.8% (25/33) males. All patients had a clinical diagnosis of HIT, and anti-PF4/Heparin antibodies were positive in 87.9% (29/33). Median lowest reported platelet count was 46 × 10Heparin use during OHT may be associated with less adverse effects compared to use of other anticoagulants with no difference in 30-day mortality.

High dietary salt (NaCl) intake is a global health concern which leads to various chronic diseases; hence, the reduction of salt content in foods has been a high demand in the food industry. Inhomogeneous salt distribution is a promising strategy for salt reduction. This study investigated the effect of inhomogeneous salt distribution using salt edible coating on the physiochemical and sensory attributes of beef frankfurter sausages. Results demonstrated that this method significantly reduced the salt content in frankfurter sausages by 60–81% without affecting the consumers’ perception of saltiness intensity. Among the coated samples, 7.5% and 10% salt coating samples showed the best performance on the product quality. However, the problems associated with high cooking loss and hard texture of the salt-coated sausages need to be further addressed. This research has potentially developed a new method for manufacture of salt-reduced food.

This study explored effects of different cooking methods, pork fat addition and food additives on physicochemical and nutritional attributes of beef meatballs fortified, or not, with 3% sugarcane fibre. TPA hardness of meatballs with fibre, cooked in boiling water, was lower compared to oven-baked and pan-fried (47.11, 56.24 and 59.22 N, respectively). Hardness also decreased with increasing fat content (5%, 10%, 15% and 20% fat; 62.07, 56.96, 54.02 and 45.51 N, respectively). Tetrasodium pyrophosphate and sodium tripolyphosphate provided similar results for all parameters except ash content where cooked meatballs with the latter were higher (1.98% and 2.22%, respectively). Cooking loss of 20% fat meatballs with fibre was lower (17.14%) compared to without fibre (20.28%). Loss of nutrients after cooking was lower for oven-baked compared to boiling. Using different ingredients to manipulate quality traits of meatballs is an alternative to manufacture suitable products for different market requirements, for example for elderly consumers.

Meat color is important for consumer acceptability, with excessively dark meat often associated with consumer rejection. It is determined chromatically by pigment content (measured by hue and chroma) and achromatically by scattering of light by the microstructure (measured by lightness), the latter of which has received minimal research focus. This review discusses the individual components of the meat microstructure that cause differences in achromatic contributions to color. Differences in achromatic light scattering between light and dark extremes of meat color are most likely explained by structural attributes within the muscle cell. These differences are proposed to arise from variations in (a) transverse shrinkage of the structural lattice of the myofilaments, myofibrils, and muscles fibers, (b) longitudinal shrinkage of the sarcomere, and (c) different protein composition of the surrounding medium (sarcoplasm and extracellular space). These are discussed at a mechanistic level, in relation to six parameters of the muscle cell: (a) protein surface charge altering the myofilament spacing, (b) protein solubility, (c) sarcoplasmic protein binding to myofilaments and myofibrils, (d) integrity of the cytoskeleton and cell adhesion proteins, (e) sarcomere integrity and myofibrillar proteins, and (f) myosin denaturation and rigor bond modification. New data are presented to support the proposed role of structural elements in muscle causing achromatic light scattering and their contribution to the surface color of meat. In addition, the relationships between lightness and water holding capacity and pH are explored and the economic impact of dark meat for the meat industry is discussed.

Objectives This study examines the effect of crime‐specific fears (worry about crime and perceived risk of crime), violent victimization, and diffuse anxieties (belief in a dangerous world [BDW], general distrust, and belief in others’ violent intentions) on protective gun ownership and involvement in “active” gun behaviors (i.e., gun accessibility in the home and handgun carrying). Methods We use data on over 4,000 U.S. adults from the 2017 nationally representative Pew Research Center's American Trends Panel. Results Fear of crime and perceived risks are largely unrelated to gun ownership, yet violent victimization influences protective ownership, which in turn influences gun accessibility. Additionally, diffuse fears and anxieties also matter for protective ownership and accessibility, with some effects explained by political party affiliation. Broader, general distrust of others is associated with owners’ frequency of carrying their handgun outside of the home. Conclusion The results highlight the complexity of the fear‐guns link, with multiple dimensions of fear and experience at work.

3-Deoxyanthocyanidins are a rare type of anthocyanins that are present in mosses, ferns, and some flowering plants. They are water-soluble pigments and impart orange-red and blue-violet color to plants and play a role as phytoalexins against microbial infection and environmental stress. In contrast to anthocyanins, the lack of a hydroxyl group at the C-3 position confers unique chemical and biochemical properties. They are potent natural antioxidants with a number of potential health benefits including cancer prevention. 3-Deoxyanthocyanidin pigments have attracted much attention in the food industry as natural food colorants, mainly due to their higher stability during processing and handling conditions compared with anthocyanins. They are also photochromic compounds capable of causing a change in "perceived" color, when exposed to UV light, which can be used to design novel foods and beverages. Due to their interesting properties and potential industrial applications, great efforts have been made to synthesize these compounds. For biosynthesis, researchers have discovered the 3-deoxyanthocyanidin biosynthetic pathway and their biosynthetic genes. For chemical synthesis, advances have been made to synthesize the compounds in a simpler and more efficient way as well as looking for its novel derivative with enhanced coloration properties. This review summarizes the developments in the research on 3-deoxyanthocyanidin as a colorant, from natural sources to chemical syntheses and from health benefits to applications and future prospects, providing comprehensive insights into this group of interesting compounds.

The effects of incorporating lupin flour on the physicochemical and sensory characteristics of beef sausages were explored. Lupin (Lupinus angustifolius) flour was roasted, then hydrated to match the moisture content of beef meat. The beef sausage samples were manufactured for six treatments by replacing beef with hydrated lupin flour from 0% to 36% (w/w). Proximate analysis revealed that carbohydrate (dietary fibre) level was increased from 9.62% to 19.31%, whereas fat content was decreased from 11.62% to 7.91%. Inclusion of lupin flour increased the meat emulsion stability (fluid released decreased from 9.35% to 1.53%) and decreased cooking loss from 22.70% to 14.30%. Softer texture and greater adhesiveness were observed in lupin‐incorporated formulations. Sensory evaluation indicated no significant difference between control and 12% lupin‐enriched beef sausage formulation in appearance, aroma, flavour and overall liking, suggesting lupin flour can be added to beef sausage at this level without compromising consumer acceptance.

Background Endothelium-derived prostacyclin and nitric oxide elevate platelet cyclic nucleotide levels and maintain quiescence. We previously demonstrated that a synergistic relationship exists between cyclic nucleotides and P2Y12 receptor inhibition. A number of clinically approved drug classes can modulate cyclic nucleotide tone in platelets including activators of NO-sensitive guanylyl cyclase (GC) and phosphodiesterase (PDE) inhibitors. However, the doses required to inhibit platelets produce numerous side effects including headache. Objective We investigated using GC-activators in combination with P2Y12 receptor antagonists as a way to selectively amplify the anti-thrombotic effect of both drugs. Methods In vitro light transmission aggregation and platelet adhesion under flow were performed on washed platelets and platelet rich plasma. Aggregation in whole blood and a ferric chloride-induced arterial thrombosis model were also performed. Results The GC-activator BAY-70 potentiated the action of the P2Y12 receptor inhibitor prasugrel active metabolite in aggregation and adhesion studies and was associated with raised intra-platelet cyclic nucleotide levels. Furthermore, mice administered sub-maximal doses of the GC activator cinaciguat together with the PDE inhibitor dipyridamole and prasugrel, showed significant inhibition of ex vivo platelet aggregation and significantly reduced in vivo arterial thrombosis in response to injury without alteration in basal carotid artery blood flow. Conclusions Using in vitro, ex vivo, and in vivo functional studies, we show that low dose GC activators synergize with P2Y12 inhibition to produce powerful anti-platelet effects without altering blood flow. Therefore, modulation of intra-platelet cyclic nucleotide levels alongside P2Y12 inhibition can provide a strong, focused anti-thrombotic regimen while minimizing vasodilator side effects.

Improving functional and eating qualities of processed meat products through incorporation of plant fibre is of interest to both consumers and food industry. This project investigated the physicochemical and sensory properties of chicken sausages with incorporation of up to 3% sugarcane fibre, a by‐product of sugarcane processing. Compared with no sugarcane fibre sample, the cooking yield of chicken sausage with 3% of fibre and 10% of water addition was increased from 94.20% to 97.52%, total phenolic content from 25.43 to 57.09 mg GAE/100 g and radical scavenging activity from 28.11% to 60.72%, whereas lipid oxidation of Thiobarbituric acid reactive substances value was decreased from 0.535 to 0.428 malondialdehyde mg kg−1. Moreover, consumer overall liking of chicken sausages was not affected by the incorporation of sugarcane fibre. This research suggested that incorporation of sugarcane fibre could improve eating quality and health benefits of the chicken sausage product, and add value to both the food and sugarcane industry.

Author(s): Ramos, AM; Wilson, AM; DeFlorio, MJ; Warner, MD; Barnes, E; Garreaud, R; Gorodetskaya, IV; Lavers, DA; Moore, B; Payne, A; Smallcomb, C; Sodemann, H; Wehner, M; Ralph, FM | Abstract: Atmospheric rivers (ARs) play a vital role in shaping the hydroclimate of many regions globally, and can substantially impact water resource management, emergency response planning, and other socioeconomic entities. The second International Atmospheric Rivers Conference took place at the Scripps Institution of Oceanography, University of California, San Diego, during 25–28 June, 2018, in La Jolla, California, USA. It was sponsored by the Center for Western Weather and Water Extremes (CW3E). A total of 120 people attended the Conference with 94 abstracts submitted and 30 participating students. In addition to the conference, the Student Forecasting Workshop was organised in the same week. During this workshop, students were exposed to AR forecasting tools, and learned examples of how these tools could be used to make decisions for various applications. The main goals of this conference were to bring together experts from across the fields of hydrology, atmospheric, oceanic, and polar sciences, as well as water management, civil engineering, and ecology to advance the state of AR science and to explore the future directions for the field. The conference was organised into traditional oral and poster presentations, along with panel discussions and Breakout Groups. This format allowed enhanced interaction between participants, driving progress within the scientific community and the enhanced communication of societal needs by various stakeholders. Several emerging topics of research were highlighted, including subseasonal-to-seasonal (S2S) prediction of ARs and an overview of the AR Reconnaissance campaign. In addition to providing a forum to disseminate and debate new results from scientific talks and posters, the conference was equally effective and useful in linking scientists to users and decision-makers that require improved knowledge on ARs to manage resources and prepare for hazards. The third International Atmospheric Rivers Conference will be held in Chile in 2020, and hosted by the University of Chile, Santiago.

Youth violent victimization (YVV) is a risk factor for precocious exits from adolescence via early coresidential union formation. It remains unclear, however, whether these early unions 1) are associated with intimate partner violence (IPV) victimization, 2) interrupt victim continuity or victim-offender overlap through protective and prosocial bonds, or 3) are inconsequential. By using data from the National Longitudinal Study of Adolescent to Adult Health (N = 11,928; 18-34 years of age), we examine competing hypotheses for the effect of early union timing among victims of youth violence (n = 2,479)-differentiating across victimization only, perpetration only, and mutually combative relationships and considering variation by gender. The results from multinomial logistic regression models indicate that YVV increases the risk of IPV victimization in first unions, regardless of union timing; the null effect of timing indicates that delaying union formation would not reduce youth victims' increased risk of continued victimization. Gender-stratified analyses reveal that earlier unions can protect women against IPV perpetration, but this is partly the result of an increased risk of IPV victimization. The findings suggest that YVV has significant transformative consequences, leading to subsequent victimization by coresidential partners, and this association might be exacerbated among female victims who form early unions. We conclude by discussing directions for future research.

Purpose Noninvasive imaging techniques that quantify renal tissue composition are needed to more accurately ascertain prognosis and monitor disease progression in polycystic kidney disease (PKD). Given the success of magnetization transfer (MT) imaging to characterize various tissue remodeling pathologies, it was tested on a murine model of autosomal dominant PKD. Methods C57Bl/6 Pkd1 R3277C mice at 9, 12, and 15 months were imaged with a 16.4T MR imaging system. Images were acquired without and with RF saturation in order to calculate MT ratio (MTR) maps. Following imaging, the mice were euthanized and kidney sections were analyzed for cystic and fibrotic indices, which were compared with statistical parameters of the MTR maps. Results The MTR-derived mean, median, 25th percentile, skewness, and kurtosis were all closely related to indices of renal pathology, including kidney weight/body weight, cystic index, and percent of remaining parenchyma. The correlation between MTR and histology-derived cystic and fibrotic changes was R2 = 0.84 and R2 = 0.70, respectively. Conclusion MT imaging provides a new, noninvasive means of measuring tissue remodeling PKD changes and may be better suited for characterizing renal impairment compared with conventional MR techniques. Magn Reson Med, 2015.

Social disorganization theory argues that racial/ethnic heterogeneity is a key neighborhood characteristic leading to social disorganization and, consequently, higher levels of crime. Heterogeneity’s effect is argued to be a result of its fragmentation of social ties along racial/ethnic lines, which creates racially homophilous social networks with few ties bridging racial/ethnic groups. Most studies of social ties in social disorganization models, however, have examined their quantity and left unaddressed the extent to which ties are within or across different racial groups. This study goes beyond previous studies by examining the effects of both racially homophilous and interracial friendship networks on informal social control. Using multilevel models and data from 66 neighborhoods with approximately 2,300 respondents, we found that heterogeneity actually increased the average percentage of residents with interracial friendship networks, but the percentage of residents with interracial networks decreased the likelihood of informal social control. In contrast, the percentage of residents with White racially homophilous networks increased the likelihood of informal social control. Examining the microcontext of individuals’ networks, however, we found residents with interracial ties reported higher likelihoods of informal social control and that this effect was enhanced in neighborhoods with higher percentages of non-White racially homophilous networks.

A proper soil raster unit resolution for grid sampling design is important to estimate the soil organic carbon (SOC) pool at certain map scales, which is related to the soil sampling density and the accuracy of the estimation. A series of raster soil unit data sets at varying resolutions were derived from different vector soil unit data sets at six map scales of 1:50,000, 1:200,000, 1:500,000, 1:1,000,000, 1:4,000,000, and 1:14,000,000 in the Tai-Lake region of China. Four indices—soil type number (STN) and area (AREA), average SOC density (ASOCD), and total SOC stocks (SOCS) of surface paddy soils—were attributed from all these vector and raster units data sets. Subjected to the four index values (IV) from parent vector unit data set, the relative variability (VIV, %) from raster unit data set was used to assess its accuracy and redundancy, which reflects uncertainty and workload of SOC estimation, respectively. Optimal raster unit resolutions were generated and suggested for each map scale’s SOC estimation, in which the soil raster unit data set can hold the same accuracy as its parent vector unit data set without any redundancy when VIV < 1% of all the four indices was assumed as criteria to the assessment. A relationship between map scale (1:x) of soil vector unit and its optimal grid resolution (y, km) was found to be: y = −8.03 × 10⁻⁶x² + 0.0256x- 0.087 (R² = 0.998, p < 0.05). The results may serve for soil unit conversion from vector to raster and soil grid sampling design at a certain map scale in the investigation of regional SOC pool.

Knowledge of digesta passage kinetics in ruminants is essential to predict nutrient supply to the animal in relation to optimal animal performance, environmental pollution and animal health. Fractional passage rates (FPR) of feed are widely used in modern feed evaluation systems and mechanistic rumen models, but data on nutrient-specific FPR are scarce. Such models generally rely on conventional external marker techniques, which do not always describe digesta passage kinetics in a satisfactory manner. Here the use of stable isotope-labelled dietary nutrients as a promising novel tool to assess nutrient-specific passage kinetics is discussed. Some major limitations of this technique include a potential marker migration, a poor isotope distribution in the labelled feed and a differential disappearance rate of isotopes upon microbial fermentation in non-steady state conditions. Such limitations can often be circumvented by using intrinsically stable isotope-labelled plant material. Data are limited but indicate that external particulate markers overestimate rumen FPR of plant fibre compared with the internal stable isotope markers. Stable isotopes undergo the same digestive mechanism as the labelled feed components and are thus of particular interest to specifically measure passage kinetics of digestible dietary nutrients.

Soil polygons are the preferred format for the modeling of denitrification-decomposition (DNDC) at regional scale because a large area of relatively homogeneous properties can be encompassed within a single boundary. Despite this, it is not yet fully understood how map scales of the soil polygons affect modeling. Six soil polygonal data sets were generated from soil vector maps at scales of 1:50,000∼1:14,000,000 to estimate CH₄ emissions from paddy soils in the Tai-Lake region of China using the DNDC model. The 1:50,000 scale data set (P005) was the most detailed and accurate soil database of the region. DNDC-simulated CH₄ concentrations from input of the other five data sets were compared with that obtained by input of the P005 data set using metrics with the following outcomes: (i) Relative variations (VIV, %) of three indices, paddy soil area (APS, ha), annual mean CH₄ emission (AME, Gg yr⁻¹), and emission rate (RGE, kg ha⁻¹ yr⁻¹), calculated for 1: 200,000 (P02) data were all 20%, the greatest equaling 138%. Accuracy and computational efficiency assessments of regional-scale DNDC modeling indicate that P02 scale input are preferred, those at scales of P4 and P14 are the source of unacceptable error, and even greater uncertainty exists when assessment units at scales of P05 and P1 are used. The results provide guidelines for modeling soil carbon–nitrogen cycle and climate change impacts in China. Further, they help build a global understanding concerning appropriate scale input data for carbon–nitrogen cycle modeling.

The U.S. government has the obligation of managing the high-level radioactive waste from its defense activities and also, under existing law, from civilian nuclear power generation. This obligation is not being met. The January 2012 Final Report from the Blue Ribbon Commission on America's Nuclear Future provides commendable guidance but little that is new. The author, who served on the federal Nuclear Waste Technical Review Board from 1989 to 1994 and subsequently on the Board on Radioactive Waste Management of the National Research Council from 1994 to 1999, provides a perspective both on the Commission's recommendations and a potential path toward progress in meeting the federal obligation. By analogy to Sisyphus of Greek mythology, our nation needs to find a way to roll the rock to the top of the hill and have it stay there, rather than continuing to roll back down again.

Objective: To explore service users and care providers' experiences of combined fetal medicine and specialist paediatric clinics. Method: A brief survey of service users and care providers at combined fetal medicine clinics, which bring together multiple specialists and expertise for the management of pregnancies complicated by fetal cardiac, renal, neurological or surgical abnormalities. Results: Two hundred and sixty-one patients and 22 health professionals participated. More than 85% of women rated the clinic highly, 61% reported that the service had changed how they viewed the abnormality, and 53% reported that they would welcome further visits to the combined clinic. The majority of health professionals reported that combined clinics improved the accuracy of parental counselling and enhanced communication between specialties involved in the management of complicated pregnancies. The clinics are generally regarded as being useful for the training of junior staff. Conclusion: A service model that combines fetal medicine and paediatric specialists in a single clinic can efficiently modify parental perspective on fetal anomalies and enhance professional communication and training. Condition-specific information leaflets could further enhance service quality. A larger study involving a socio-demographically stratified sample of service users is needed to provide more authoritative data. © 2012 John Wiley & Sons, Ltd.

According to the United States Department of Agriculture (USDA) Economic Research Service (ERS), rural and frontier America consists of approximately 80% of the US landmass and is inhabited by 50 million people (http://www.ers.usda.gov). Rural America is increasingly more culturally diverse with approximately 20% of rural residents indicating their heritage as Hispanic, African American, Native America/Alaska Native, Asian, or multi-race.1 Although rich with diversity, rural and frontier areas often have limited economic resources. Rural regions report limited economic growth, lower median income, and higher rates of poverty than their urban counterparts. These economic disparities are even greater in rural areas with concentrations of racial and ethnic minorities.2 Given the unique and complex features of rural America, many challenges arise in the provision of effective and ethical health care.3 One major challenge is related to geographic and travel barriers that rural residents and health care providers encounter.4–6 Due to these geographic challenges, some rural residents make trade-offs between their safe travel in inclement weather and accessing health care in a timely manner. Rural residents incur more expense to travel to regional centers to receive care that may not exist in their local community. Additionally, due to distance and access restrictions, rural residents with a chronic illness may not receive updated information regarding new treatment strategies.6 Residents and providers have limited access to specialized providers, consultants (ie, cardiologists, oncologists, psychiatrists), and additional resources due to the rural geography.7–10 Additional impediments to effective and ethical rural health care come in many forms including economic disparities,11,12 navigating multiple relationships,3,7,13,14 cultural and communication differences,15–18 and regularly encountering ethical dilemmas.18–20 Adding to the complexity of rural practice, providers are often working in demanding environments, with heavy caseloads, high patient acuity, and limited time for vacations.12,13,21 Over the last decade, efforts have attempted to address these issues through the development of various rurally tailored education and training programs designed to prepare health care providers for service in rural communities.22,23 Although a worthy endeavor, these efforts have been marginal in their success due to the very challenges experienced by rural health care systems, including complications in recruitment, retention, and training of rural health care professionals.22,24 Rural providers confront challenges related to too few continuing education opportunities25 and insufficient supervision, training, and preparation for the uniqueness of providing care in rural and remote settings.13,26 The difficulty of practicing in rural settings with limited training opportunities, or being ill-prepared for rural practice at the onset, inhibits retention and recruitment of a rural workforce.27–29 These factors result in high rates of depression, burnout, and turnover among rural providers.30 To develop and maintain a rural workforce and to avoid the pitfalls experienced by many rural practitioners and residents, it is vital to adequately train and prepare providers interested in rural health care. The intersection of rural living and health care challenges can create barriers to care that health care providers may not be trained to navigate, resulting in burnout and high turnover. The purpose of this study is to enhance knowledge and understanding of the preparatory needs of professionals embarking on careers in rural health care settings. More specifically, this qualitative study provides a comprehensive analysis of what experienced rural health care providers wish they had known prior to embarking on their own careers. Through the exploration of experienced rural providers’ knowledge and lessons learned, the ultimate aim of the study is to help inform future practitioners, educators, and policy makers in training, recruiting, and maintaining a rural workforce across multiple health care domains. Findings such as these are crucial in the development and maintenance of a sustainable rural workforce.

Background and purpose: Gram-negative bacteria contain ligands for Toll-like receptor (TLR) 4 and nucleotide oligomerization domain (NOD) 1 receptors. Lipopolysaccharide (LPS) activates TLR4, while peptidoglycan products activate NOD1. Activation of NOD1 by the specific agonist FK565 results in a profound vascular dysfunction and experimental shock in vivo.

Objective To examine the results of health-related quality-of-life questionnaire scores from profoundly deaf children fitted with at least one cochlear implant (CI) and to compare their responses with those of normal-hearing mates of similar age and their parents. Study Design Cross-sectional study utilizing a generic quality-of-life questionnaire designed to be completed by both parents and children independently of each other. Setting Questionnaires completed at various summer camps designed for children with CIs in Texas and Colorado. Subjects and Methods Eighty-eight families from 16 states were divided into two subgroups by age of cochlear implantation: an eight- to 11-year-old group and a 12- to 16-year-old group. The KINDL-R Questionnaire for Measuring Health-Related Quality of Life in Children and Adolescents was distributed, and CI participants completed the questionnaire independently of their participating family member. Results CI users in both age groups scored similarly to their normal-hearing peers and their parents. Younger CI users scored their family domain lower compared with their normal-hearing peers. Teen CI users scored the school domain lower compared with their parents. Among CI participants, earlier implantation and longer CI use resulted in higher quality-of-life scores. Conclusion Children with CIs experience quality of life similar to that of normal-hearing peers. Parents are reliable reporters on the status of their child's overall quality of life.

Informal social control is a central concept in the contemporary social disorganization literature, and much attention has been directed at examining community characteristics related to variation in the quantity of informal social control across communities. However, considerably less attention has been paid to variation in forms of informal social control. This study examines the extent to which neighborhood characteristics are related to residents’likelihood of using two different forms of informal social control: direct informal social control (i.e., through direct intervention) and indirect informal social control (i.e., through mobilizing formal authorities). Data for this study are based on surveys of residents in 66 neighborhoods. The analysis uses hierarchical modeling to examine whether neighborhood characteristics central to contemporary social disorganization theory have similar effects on these two forms of neighborhood social control. Findings indicate that social ties increase the likelihood of direct informal social control but not indirect informal social control, whereas social cohesion and trust decreases indirect informal social control but does not have a significant effect on direct informal social control. Faith in the police is not found to affect either form of informal social control. These findings are discussed in terms of current issues in contemporary social disorganization theory.

In this article, the authors describe the properties of the Comprehensive Trauma Inventory-104 (CTI-104), developed and designed empirically to improve assessment of traumatic war-related events. The mean number of events reported by 252 community dwelling Kurdish and Vietnamese refugees was 32 (SD = 27) out of the 104 items. Internal and test-retest reliability was excellent, and the validity of the CTI-104 as a measure of war trauma was supported by its high correlation with standard measures of known outcomes of trauma. The CTI-104 is reliable and valid, and assesses a broader range of traumatic war-related events in a broader range of refugees than currently available instruments.

Soil classification systems are not consistent among countries or organizations thereby hindering the communication and organizational functions they are intended to promote. The development of translations between systems will be critical for overcoming the gap in understanding that has resulted from the lack of a single internationally accepted classification system. This paper describes the application of a process that resulted in the translation of the Genetic Soil Classification of China (GSCC) to Soil Taxonomy (ST). A brief history of soil classification in China is also provided to familiarize readers with GSCC and its origins. Genetic Soil Classification of China is the attribute base for the recently assembled digital form of the 1:1 000 000 soil map of The People's Republic of China. The translation between GSCC and ST was based on profile, chemical, and physical descriptions of 2540 soil series. First, the 2540 soil series were classified to their equivalent soil order, suborder, great group, and subgroup according to ST and GSCC subgroup descriptors. Order names for both classification systems were then linked to corresponding map units in the 1:1 000 000 digital soil map of China using a geographic information system (GIS). Differences in classification criteria and in the number of orders of the two systems (there are more GSCC orders than ST orders) meant that each GSCC order could possibly be assigned to more than one ST order. To resolve the differences, the percent correspondence in area between orders was determined and used as the criterion for assigning GSCC orders to ST orders. Some percentages of correspondence were low so additional processing was used to improve the assignment process. The GSCC suborders were then matched with ST orders. When the area for each order was summarized, the percentage of correspondence increased except for two subgroups in the Ferrasols order.

Acetaminophen is one of the most commonly used drugs for the safe and effective treatment of pain and fever. Acetaminophen works by lowering cyclo-oxygenase products preferentially in the central nervous system, where oxidant stress is strictly limited. However, the precise mechanism of action for acetaminophen on cyclo-oxygenase activity is debated. Two theories prevail. First, it is suggested that acetaminophen selectively inhibits a distinct form of cyclo-oxygenase, cyclo-oxygenase-3. Second, it is suggested that acetaminophen has no affinity for the active site of cyclo-oxygenase but instead blocks activity by reducing the active oxidized form of cyclo-oxygenase to an inactive form. Here, we have used an in vitro model of cyclo-oxygenase-2 activity (A549 cells stimulated with IL-1beta) to show that acetaminophen is an effective inhibitor of cyclo-oxygenase activity in intact cells. However, acetaminophen, unlike nonsteroidal anti-inflammatory drugs (NSAIDs), cannot inhibit activity in broken cell preparations. The inhibitory effects of acetaminophen were abolished by increasing intracellular oxidation conditions with the cell-permeable hydroperoxide t-butylOOH. Similarly the inhibitory effects of the cyclo-oxygenase-2 selective inhibitor rofecoxib or the mixed cyclo-oxygenase-1/cyclo-oxygenase-2 inhibitors ibuprofen and naproxen were significant reduced by t-butylOOH. By contrast, the inhibitory effects of indomethacin or diclofenac, which also inhibit both cyclo-oxygenase-1 and cyclo-oxygenase-2, were unaffected by t-butylOOH. These observations dispel the notion that cyclo-oxygenase-3 is involved in the actions of acetaminophen and provide evidence that supports the theory that acetaminophen interferes with the oxidation state of cyclo-oxygease. Moreover, they suggest for the first time that the inhibitory effects of some NSAIDs, including the newly introduced cyclo-oxygenase-2 selective inhibitor rofecoxib, owe part of their inhibitory actions to effects on oxidation state of cyclo-oxygenase. Our data with t-butylOOH and NSAIDs illustrates an, as yet, undeveloped therapeutic window for the "cyclo-oxygenase inhibitor". Specifically, combining active site selectively with actions on enzyme oxidation state would allow for a broader range of tissue selective drugs.

In November 2001, the Monterey Institute of International Studies convened a workshop on bioterrorism threat assessment and risk management. Risk assessment practitioners from various disciplines, but without specialized knowledge of terrorism, were brought together with security and intelligence threat analysts to stimulate an exchange that could be useful to both communities. This article, prepared by a subset of the participants, comments on the workshop's findings and their implications and makes three recommendations, two short term (use of threat assessment methodologies and vulnerability analysis) and one long term (application of quantitative risk assessment and modeling), regarding the practical application of risk assessment methods to bioterrorism issues.

Eight months after the Cerro Grande Fire, 78 evacuees seeking treatment for posttraumatic sleep disturbances were assessed for chronic nightmares, psychophysiological insomnia, and sleep-disordered breathing symptoms. Within this sample, 50% of participants were tested objectively for sleep-disordered breathing; 95% of those tested screened positive for sleep-disordered breathing. Multiple regression analyses demonstrated that these three sleep disorders accounted for 37% of the variance in posttraumatic stress symptoms, and each sleep disorder was significantly and independently associated with posttraumatic stress symptoms severity. The only systematic variable associated with posttraumatic stress symptoms of avoidance was sleep-disordered breathing. The findings suggest that three common sleep disorders relate to posttraumatic stress symptoms in a more complex manner than explained by the prevailing psychiatric paradigm, which conceptualizes sleep disturbances in PTSD merely as secondary symptoms of psychiatric distress.

The beneficial actions of nonsteroidal anti-inflammatory drugs (NSAIDs) have been linked to their ability to inhibit inducible COX-2 at sites of inflammation, and their side effects (e.g., gastric damage) to inhibition of constitutive COX-1. Selective inhibitors of COX-2, such as celecoxib, etoricoxib, lumiracoxib, rofecoxib, and valdecoxib have been developed and the greatest recent growth in our knowledge in this area has been come from the clinical use of these compounds. Although clinical data indicate that COX-2 selectivity is associated with a reduction in severe gastrointestinal events, they also reveal there are roles for constitutive COX-2 within tissues such as the brain, kidney, pancreas, intestine, and blood vessels. We now better understand the roles of COX-1 and COX-2 in functions as disparate as the perception of pain and the progression of cancers. Clinical use of COX-2-selective compounds has ignited strong debates regarding potential side effects, most notably those within the cardiovascular system such as myocardial infarctions, strokes, and elevation in blood pressure. This review will discuss how the latest studies help us understand the roles of COX-1 and COX-2 and what clinically proven benefits the newer generation of COX-2-selective inhibitors offer

Peroxisome proliferator-activated receptor (PPAR)gamma and inducible cyclooxygenase-2 (COX-2) are expressed in atherosclerotic lesions, particularly in the intimal monocytic and vascular smooth muscle cells. We have therefore studied the interaction between PPARgamma and inducible cyclo-oxygenase (COX-2) in rat aortic vascular smooth muscle cells (RASMC)s. The synthetic PPARgamma ligand rosiglitazone induced prostaglandin (PG) release from RASMCs, including that of PGD2, the precursor of the putative endogenous PPARgamma ligand 15-deoxy-Delta12,14-prostaglandin J2. Moreover, rosiglitazone both synergized with IL-1beta to further induce prostaglandin release and affected the expression of phospholipase A2 and COX-2. Rosiglitazone-induced prostaglandin release was inhibited by the PPARgamma partial agonist GW0072 and the PPARgamma antagonist GW9662. Rosiglitazone also induced RASMC apoptosis, an effect not explained as an autocrine effect of the induced-prostanoids, but on arachidonic acid release, as cell death was unaffected by either the nonselective COX inhibitor piroxicam or the selective COX-2 inhibitor DFP, but by inhibitors of either secretory or cytosolic phospholipase A2. In contrast, indomethacin, an alternative inhibitor of cyclooxygenase activity, inhibited both rosiglitazone-induced cell death, and rosiglitazone-induced PPAR reporter gene activation.