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Aim: To describe the process and outputs of a workshop convened to identify key priorities for future research in the area of remission of type 2 diabetes, and provide recommendations to researchers and research funders on how best to address them. With the ultimate aim of enabling the remission of type 2 diabetes to become a possibility for more people. Methods: A 1‐day research workshop was conducted, bringing together 31 researchers, people living with diabetes, healthcare professionals and members of staff from Diabetes UK to identify and prioritize recommendations for future research into remission of type 2 diabetes. Results: Workshop attendees identified 10 key themes for further research. Four of these themes were prioritized for further focus: (i) understanding how to personalize lifestyle approaches based on biology, patient choice and subtypes; (ii) understanding the biology of remission; (iii) understanding the most effective approaches to implementation of lifestyle interventions; and (iv) understanding the best approaches to combining therapies (gut hormones, other drugs, lifestyle approaches and bariatric surgery). Conclusions: This paper outlines recommendations to address the current gaps in knowledge related to remission of type 2 diabetes. What's new?: It is known that type 2 diabetes can be put into remission; however, standard clinical treatment of type 2 diabetes does not currently aim to put the condition into remission.This is the first time that researchers and healthcare professionals from a wide range of specialist areas have come together to identify research priorities to increase understanding of remission of type 2 diabetes.The paper sets out key recommendations for further research that is needed in order to make remission an achievable aim for more people with type 2 diabetes. [ABSTRACT FROM AUTHOR]

Aim: To develop a structured education programme for individuals with Type 1 diabetes who are engaging in regular exercise. Method: A multidisciplinary team of experts in supporting exercise and physical activity for people with Type 1 diabetes, alongside researchers with experience of developing self‐management education, developed an exercise programme using the Medical Research Council framework. The programme was informed by a review of the evidence relating to Type 1 diabetes and exercise, the behaviour change literature (including the behaviour change taxonomy), and qualitative interviews with stakeholders. The programme and supporting resources were refined using an iterative process of testing, delivery and collecting feedback from participants and the wider development team. Results: The outcome of the intervention development was the design of a feasible and acceptable intervention for people with Type 1 diabetes to support safe exercise. The pilot allowed refinement of the intervention prior to testing in a two‐site feasibility randomized controlled trial. Key findings from the pilot informed minor restructuring of the timetable (timings and order) and adaptation of supporting educational materials (participant handbook and teaching materials). Conclusion: The 'EXercise in people with Type One Diabetes' (EXTOD) education programme has been developed using robust methodology for the generation of educational interventions. It now needs testing in a randomized controlled trial. What's new?: Currently there is no dedicated structured education programme that supports the management of Type 1 diabetes for exercise.A self‐management education programme to support safe and effective exercise for people with Type 1 diabetes has been developed using the Medical Research Council framework.In the exercise programme we developed, participants were able to adjust their regimens and plan their exercise in a more structured way.The programme was delivered by trained healthcare professionals, meaning it can be embedded into the specialist care setting.If demonstrated to be effective, this programme could potentially expand currently available support for adults with Type 1 diabetes who wish to exercise. [ABSTRACT FROM AUTHOR]

Aim: To review evidence on whether diet and exercise should be used as an alternative to drug therapy for the management of type 2 diabetes or alongside. Method: We present a narrative review that draws on evidence from other systematic reviews and meta‐analyses, narrative reviews, trials and cohort studies. We focused mainly on glycaemic control rather than control of blood pressure or cholesterol. Results: Good‐quality dietary advice that results in weight loss of >5% and physical activity interventions of >150 min/week of moderate to vigorous physical activity, combined with resistance exercise, can produce improvements in HbA1c similar to those produced by the addition of glucose‐lowering drugs. These improvements can be seen at all stages of the disease. There are recognized interactions between glucose‐lowering drugs and physical activity which may not be synergistic, but these are not well understood, and it is not clear if they are considered in clinical practice. Studies that explicitly compare drugs with diet or physical activity or control for drug use found that lifestyle could delay or reduce medication use, but most people eventually needed to progress to drug treatment. There are few studies, however, that provide strategies for the long‐term maintenance of weight loss or physical activity. Conclusion: Diet and physical activity are of key importance in type 2 diabetes management, and attention to them improves glycaemic control and cardiovascular disease risk, but it is not yet known whether maintained lifestyle changes provide an alternative to drug therapy in the long term. What's new?: Interactions between physical activity and glucose‐lowering medications have been observed but are not well understood, and there is little research into the interactions between medication and overall diet patterns.Few interventions compare lifestyle with drug therapy or a control for medication use. At present available evidence indicates that most people will eventually need drug therapy in addition to lifestyle.There is little evidence for how best to support people in maintaining weight loss or physical activity for the long term. Improving maintenance strategies may help more people delay or prevent medication use. [ABSTRACT FROM AUTHOR]

New Findings: What is the topic of this review?Hypoglycaemia is a commonly cited barrier to exercise in type 1 diabetes mellitus (T1D). Knowledge of approaches to prevent or manage exercise‐induced hypoglycaemia can support patients to exercise and help clinicians to give advice. This review presents evidence‐based strategies to prevent exercise‐induced hypoglycaemia in T1D.What advances does it highlight?This review highlights approaches that can be used before, during and after exercise to mitigate the risk of hypoglycaemia. The approaches include the timing of exercise, the type of exercise, adjustments to insulin and carbohydrate, use of novel technology and education. Exercise is a key component for the management of type 1 diabetes mellitus (T1D) and is associated with reduced risk of cardiovascular disease, decreased daily insulin requirements and improved quality of life. Owing to these benefits, people with T1D are recommended to undertake regular physical activity, 150 min per week for adults and 60 min per day for children and adolescents. Despite the recommendations, many people do not meet these targets. One of the commonly cited barriers to exercise is fear of hypoglycaemia along with limited knowledge of effective preventative strategies. Hypoglycaemia can be difficult to predict, and symptoms are often masked during exercise or stress of competition. For athletes with T1D, hypoglycaemia can also limit sporting success. Hypoglycaemia before an event increases the risks of hypoglycaemia during competition and can reduce performance. To avoid hypoglycaemia, people with T1D may avoid exercise altogether or consume excessive amounts of carbohydrates, which mitigates many of the health benefits of exercise. Increased understanding of approaches to prevent or manage hypoglycaemia is therefore important to help increase levels of physical activity in people with T1D and to support athletes with T1D to compete at the highest level. This review outlines the prevalence of exercise‐related hypoglycaemia, its underlying physiology and the strategies that can be used to prevent and manage exercise‐induced hypoglycaemia in T1D. Our hope is that this knowledge will be used by people with T1D and their clinicians to find individual approaches to manage exercise‐related hypoglycaemia. [ABSTRACT FROM AUTHOR]

Aim Residual β-cell function is present at the time of diagnosis with Type 1 diabetes. Preserving this β-cell function reduces complications. We hypothesized that exercise preserves β-cell function in Type 1 diabetes and undertook a pilot trial to address the key uncertainties in designing a definitive trial to test this hypothesis. Methods A randomized controlled pilot trial in adults aged 16-60 years diagnosed with Type 1 diabetes within the previous 3 months was undertaken. Participants were assigned to control (usual care) or intervention (exercise consultation every month), in a 1 : 1 ratio for 12 months. The primary outcomes were recruitment rate, drop out, exercise adherence [weeks with ≥ 150 min of self-reported moderate to vigorous physical activity ( MVPA)], and exercise uptake in the control group. The secondary outcomes were differences in insulin sensitivity and rate of loss of β-cell function between intervention and control at 6 and 12 months. Results Of 507 individuals who were approached, 58 (28 control, 30 intervention) entered the study and 41 completed it. Participants were largely white European males, BMI 24.8 ± 3.8 kg/m2, HbA1c 75 ± 25 mmol/mol (9 ± 2%). Mean level of objectively measured MVPA increased in the intervention group (mean 243 to 273 min/week) and 61% of intervention participants reached the target of ≥ 150 min/week of self-reported MVPA on at least 42 weeks of the year. Physical activity levels fell slightly in the control group (mean 277 to 235 min of MVPA/week). There was exploratory evidence that intervention group became more insulin sensitive and required less insulin. However, the rate of loss of β-cell function appeared similar between the groups, although the change in insulin sensitivity may have affected this. Conclusion We show that it is possible to recruit and randomize people with newly diagnosed Type 1 diabetes to a trial of an exercise intervention, and increase and maintain their exercise levels for 12 months. Future trials need to incorporate measures of greater adherence to exercise training targets, and include more appropriate measures of β-cell function. (Clinical Trials Registry No; ISRCTN91388505) [ABSTRACT FROM AUTHOR]

Aims To determine if urine C-peptide/creatinine ratio is a useful tool for monitoring β-cell function in new-onset Type 1 diabetes. Methods Data were obtained from a prospective immunomodulation study in people with Type 1 diabetes ≤ 3 months from diagnosis, with a standard mixed-meal tolerance test and measurement of urine C-peptide/creatinine ratio carried out at 0, 3, 6, 9 and 12 months. The change in the insulin-dose-adjusted HbA1c level was also correlated with the change in serum/urine C-peptide level during the 12-month follow-up period. Results A significant reduction in urine C-peptide/creatinine ratio, measured after a mixed-meal, was reached at 9 months (−45.4%), whilst the reduction in stimulated serum C-peptide level reached significance after 3 months (−54.7%) in placebo-treated participants. Neither change in stimulated serum C-peptide nor change in urine C-peptide level correlated with each other, and nor did change in insulin-dose-adjusted HbA1c level in the first 6 months, but all measures correlated significantly in the second half of the 12-month follow-up period. Conclusion Mixed-meal-stimulated urine C-peptide/creatinine ratio was similar to, although less sensitive than, stimulated serum C-peptide level in monitoring β-cell function during the first year after diagnosis. Because the former is significantly less invasive, it warrants inclusion in further studies in Type 1 diabetes and may represent an attractive alternative outcome measure in cohort studies and in children. [ABSTRACT FROM AUTHOR]

Outcome reporting in bariatric surgery needs a core outcome set ( COS), an agreed minimum set of outcomes reported in all studies of a particular condition. The aim of this study was to summarize outcome reporting in bariatric surgery to inform the development of a COS. Outcomes reported in randomized controlled trials ( RCTs) and large non-randomized studies identified by a systematic review were listed verbatim and categorized into domains, scrutinizing the frequency of outcome reporting and uniformity of definitions. Ninety studies (39 RCTs) identified 1,088 separate outcomes, grouped into nine domains with most ( n = 920, 85%) reported only once. The largest outcome domain was 'surgical complications', and overall, 42% of outcomes corresponded to a theme of 'adverse events'. Only a quarter of outcomes were defined, and where provided definitions, which were often contradictory. Percentage of excess weight loss was the main study outcome in 49 studies, but nearly 40% of weight loss outcomes were heterogeneous, thus not comparable. Outcomes of diverse bariatric operations focus largely on adverse events. Reporting is inconsistent and ill-defined, limiting interpretation and comparison of published studies. Thus, we propose and are developing a COS for the surgical treatment of severe and complex obesity. [ABSTRACT FROM AUTHOR]

Previous research indicates that separate reinnervation of the anterior and posterior branches of the recurrent laryngeal nerve (RLN) can provide purposeful motion of the larynx, even after transplantation. This canine study was undertaken to better determine the results of RLN reinnervation after nerve transection distal to its bifurcation. This approximates ideal conditions for transplantation, because potential rejection and nerve branch mismatch are eliminated. Eight months after nerve repair, video, electromyographic, mechanical, and histologic data were collected on four canines. Results show return of appropriate motion without synkinesis, including purposeful abduction on endotracheal tube occlusion. Abductory function was weaker on the reinnervated side, but adduction was equal or stronger on the reinnervated vocal cord. These results indicate that this method of RLN reinnervation produces consistent, strong physiologic motion in the denervated larynx. [ABSTRACT FROM AUTHOR]

Objectives There is a lack of published data about the food intake of patients with type 2 diabetes and the changes that they make in response to patient-centred dietary advice. The present study describes the changes reported in response to a nonprescriptive dietary intervention based upon UK dietary guidelines. Methods Two hundred and sixty-two patients (87 women and 175 men) from the Early ACTivity in Diabetes (ACTID) trial who received the dietary intervention returned 4 days food diaries at baseline and 6 months. Nonparametric tests were used to examine changes in meal patterns, total energy intake and energy from food groups between baseline and 6 months. Results Mean (SD) number of reported meals day-1 was 3.0 (0.3) and mean (SD) number of snacks was 1.1 (0.6) at both baseline and 6 months for men and women. Men reported decreasing energy intake by a mean (SD) of 912 (1389) KJ/day [218 (332) kcal day-1] ( P < 0.001) and women by 515 (1130) KJ/day [123 (270) kcal day-1] ( P < 0.001). Men reported reducing energy from alcoholic drinks [−234 (527) KJ day-1; P < 0.001], white bread [−113 (402) KJ day-1; P = 0.001], biscuits [i.e. cookies −67 (205) KJ day-1; P < 0.001] and cakes [−50 (410) KJ day-1; P = 0.0012]. Women reported reducing energy from mixed main meals [−134 (456) KJ day-1; P = 0.036], pasta and rice [−79 (326) KJ day-1; P = 0.019], high-energy drinks [−59 (159) KJ day-1; P = 0.001] and white bread [−59 (368) KJ day-1; P = 0.042]. Conclusions Men and women in the Early ACTID study reported small changes in higher-energy and lower-fibre foods and drinks in response to patient-centred dietary advice. [ABSTRACT FROM AUTHOR]

At the same time as biophysical and omics approaches are drilling deeper into the molecular details of platelets and other blood cells, as well as their receptors and mechanisms of regulation, there is also an increasing awareness of the functional overlap between human vascular systems. Together, these studies are redefining the intricate networks linking haemostasis and thrombosis with inflammation, infectious disease, cancer/metastasis and other vascular pathophysiology. The focus of this state-ofthe- art review is some of the newer advances relevant to primary haemostasis. Of particular interest, platelet-specific primary adhesion-signalling receptors and associated activation pathways control platelet function in flowing blood and provide molecular links to other systems. Platelet glycoprotein (GP)Iba of the GPIb-IX-V complex and GPVI not only initiate platelet aggregation and thrombus formation by primary interactions with von Willebrand factor and collagen, respectively, but are also involved in coagulation, leucocyte engagement, bacterial or viral interactions, and are relevant as potential risk markers in a range of human diseases. Understanding these systems in unprecedented detail promises significant advances in evaluation of individual risk, in new diagnostic or therapeutic possibilities and in monitoring the response to drugs or other treatment. [ABSTRACT FROM AUTHOR]

Bariatric surgery is increasingly being used to treat severe obesity, but little is known about its impact on patient-reported outcomes ( PROs). For PRO data to influence practice, well-designed and reported studies are required. A systematic review identified prospective bariatric surgery studies that used validated PRO measures. Risk of bias in randomized controlled trials ( RCTs) was assessed, and papers were examined for reporting of (i) who completed PRO measures; (ii) missing PRO data and (iii) clinical interpretation of PRO data. Studies meeting all criteria were classified as robust. Eighty-six studies were identified. Of the eight RCTs, risk of bias was high in one and unclear in seven. Sixty-eight different PRO measures were identified, with the Short Form ( SF)-36 questionnaire most commonly used. Forty-one (48%) studies explicitly stated measures were completed by patients, 63 (73%) documented missing PRO data and 50 (58%) interpreted PRO data clinically. Twenty-six (30%) met all criteria. Although many bariatric surgery studies assess PROs, study design and reporting is often poor, limiting data interpretation and synthesis. Well-designed studies that include agreed PRO measures are needed with reporting to include integration with clinical outcomes to inform practice. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented regarding the M1761K mutation in the von Willebrand factor (VWF) A3 domain caused by impaired collagen binding and without platelet dysfunction.

During the 1990s, the Steller sea lion ( Eumetopias jubatus Schreber) Western Alaska stock (WS) suffered steep population decline while the Eastern Alaska stock (ES) steadily increased. One bottom-up forcing hypothesis explaining this decline predicted lactating adult female foraging behavior would be different between stocks. To investigate this effect, we monitored 11 ES females at two breeding rookeries using satellite dive recorders (SDR) during the early breeding seasons of 1992–1993, examined their behavior with respect to prey, physiological limitations, and habitat, and made limited comparisons to observations of WS female behavior reported in the literature. ES females were not operating at the extremes of ability, with most diving within the limits of aerobic metabolism, less than one-quarter of possible foraging time during trips spent submerged and most foraging trips requiring less than one-half the lipid store fasting ability of dependent pups. Thus, females may have some capacity to alter behavior to accommodate future changes in foraging conditions, but the extent of this plasticity is unknown. Because recent work suggests WS recovery is impeded by low natality, future studies should test differences between reproductive and non-reproductive mature females in order to properly assess the contribution of foraging ecology to SSL population dynamics. [ABSTRACT FROM AUTHOR]

Objective To describe the actual and potential geographic distributions of Ixodes cornuatus and I holocyclus in south-eastern Australia. Procedure Examination of ticks from museum collections and trapped animals were made. (Bioclimatic analysis BIOCLIM) was used to predict potential distributions. Results I holocyclus was collected from rodents ( Rattus fuscipes, R lutreolus, R rattus), wombats ( Vombatus ursinus), cats and dogs in Gippsland and I cornuatus was collected from rodents ( R fuscipes), wombats, cats and dogs in central Victoria. All life-cycle stages of both species were collected during the warmer months of the year. The known distribution of the two species was established from specimens in museum collections and suggested that a boundary between the two may exist in eastern Gippsland. BIOCLIM suggested that the area immediately to the east of Melbourne was climatically suitable for I holocyclus, although no endemic foci of infection are currently known from this region. The potential distribution of I cornuatus included east Gippsland and the Otway Ranges, areas in which the tick is not currently known to occur. Conclusions I holocyclus and I cornuatus have more restricted distributions than current collections suggest and therefore may have the possibility to extend their geographical ranges in the future. [ABSTRACT FROM AUTHOR]

The ability to discriminate and further quantify the proportion of donor and host cells is essential in hematopoietic stem cell transplant protocols. In human sex-mismatched transplants, this can be easily accomplished by the use of commercially available fluorescent in situ hybridization (FISH) probes. In many animal models, including non-human primates, this methodology is not possible due to the lack of commercially available FISH probes. In animal models, donor cell detection could be accomplished if there is a known species-specific sex determining region Y (SRY) (male) or other unique DNA sequence using either semiquantitative or quantitative real-time polymerase chain reaction (PCR). The use of real-time quantitative PCR has the obvious advantage of providing detailed enumeration of the percentage of donor cells present. We report the development of extremely sensitive primer and probe combinations for male (SRY) and major histocompatibility complex (MHC)-DQA sequences in the macaque and baboon non-human primate models. This assay has a sensitivity of a five-log range and can detect less than four target cells in the presence of 105 background cells (approximately 0.001%) and fetal DNA obtained from maternal serum from Macaca nemestrina. The SRY (male) primer and probe combination has similar sensitivity in Macaca fasicularis, Macaca mulatta, and Papio cynocephalus anubis. [ABSTRACT FROM AUTHOR]

To determine the prevalence of and assess risk factors associated with head lice infections (pediculosis) in children from government primary schools in Victoria, Australia.Between May and October 2001, children were selected by clustered random sampling of schools and classes, then examined for head lice using hair conditioner and a fine-toothed head lice comb. There were 1838 children screened from 16 primary schools. Risk factors evaluated included metropolitan or rural residence, school class, gender and hair length.Thirteen percent of children (239/1838) had an active infection (95% CI, 10.9−15.1) and 3.3% (61/1838) had an inactive infection (95% CI, 2.0−4.6). Prevalence of active pediculosis varied between schools from 0 to 28%. Our screening identified no more than one case per class in the majority of classes screened (58.5%). Females were 2.2 times more likely to have active infection than males (95% CI[1.7,2.9]) and there was no significant difference for the other risk factors investigated.Our study demonstrated the prevalence of head lice varied across Victoria and showed that risk factors commonly attributed to head lice infections did not hold true. Our findings support the premise that traditional ad hoc mass school-based screening may not be the best use of resources when controlling head lice. We suggest a more pragmatic community-based approach. [ABSTRACT FROM AUTHOR]

Discusses the results of a long-term study on the tropical iguanid lizard `Anolis limifrons' in central Panama. Materials and methods; Results; Discussion.

Fusobacterium nucleatum has been implicated in the pathogenesis of periodontal diseases. Five subspecies have previously been proposed. The validity of these subdivisions was investigated using allozyme electrophoresis for 21 enzyme mobilities. The 18 F. nucleatum isolates tested had previously been subspeciated and included type strains as well as isolates from both oral and extraoral sites. The results showed 2 distinct genetic groups with fixed differences at 82.5% of the test loci, indicative of a species complex with a number of subspecies within each of the 2 groups. There was also evidence of a correlation between the 2 major groups of isolates and the site from which they were taken. It was concluded that there is a high degree of genetic heterogeneity within the species F. nucleatum and that its current subspeciation is of questionable validity. [ABSTRACT FROM AUTHOR]

SUMMARY A toddler temperament questionnaire was completed by the mothers of fifteen Down's syndrome children who had been assessed two years earlier with the Carey infant temperament questionnaire. The results suggest that infants who have been scored as showing signs of difficult temperament move towards the easier signs on the toddler scale. If these temperament questionnaires are biased by maternal perceptions, this move may reflect a reduced level of maternal anxiety. [ABSTRACT FROM AUTHOR]

SUMMARY The mothers of 25 Down's syndrome infants completed a questionnaire concerning the- child's behaviour in day-to-day situations in order to identify the temperamental characteristics of each infant. of these infants were identified as children with signs of difficult temperament and only two were found be easy children. in contrast to the amiable, mild stereotype for the syndrome. A comparison. Of the questionnaire characterstics with the mother's rating of her child's temperament shows that the mothers's impressions are more positive. This may be the result of lower expectations or social desirability but it is suggested that it can also be reflection of successful coping skills. [ABSTRACT FROM AUTHOR]

Examines the vocalization and looking behavior of Down's syndrome infants. Effect of contingent and non-contingent vocal stimulation on vocalization and looking behavior; Results indicating that looking behavior may be an important indication of competence in pre-linguistic social communication for developmentally delayed infants.

The analysis of fuel economy data results in estimates of the technology utilization by manufacturer and vehicle line. The analysis employs a hierarchical Bayesian regression model with random components representing vehicle lines and manufacturers. The model includes predictor variables which describe vehicle features, such as type of transmission, and vehicle line specific measurements, such as compression ratio. Non-informative priors with novel modifications are used and the Bayes estimates are obtained by use of Gibbs sampling. The results show there is substantial variability among manufacturers in efficiently utilizing technology for fuel economy. [ABSTRACT FROM AUTHOR]

The purpose of this research was to study the extent to which community nurses (CNs) were involved in health promotion activities and to investigate whether these activities were meeting the needs of their clients. A cross-sectional survey by multiple methods was designed and carried out in four district health authorities (DHAs) in one regional health authority in England. Two hundred and fifty-one (83-67%) completed questionnaires were returned by CNs working in primary health care (PHC). Sixty sessions with CNs were observed and 249 interviews were conducted with clients. Additionally, as part of the observation 155 clinical records were examined. CNs reported involvement in a wide range of opportunistic and organized health promotion activities. Lifestyle advice and ill-health prevention were most frequently used by all groups. Health visitors (HVs) were involved significantly more in group and community wide activities. District nurses (DNs) were mainly involved in opportunistic health promotion. Practice nurses (PNs) were found to be involved significantly more in health promotion activities organized on an individual basis. Observation revealed that opportunistic health promotion was carried out in almost half of the consultations observed, of which lifestyle advice was the most frequent. Records however showed that this information was rarely recorded. The clients of PNs were mostly aware of other health promotion activities available within the general practice, while almost half of the HVs' clients knew what other health promotion activities were available to them and few DNs' clients were aware of any. [ABSTRACT FROM AUTHOR]

Two successive grazing experiments were con- ducted over 12 weeks on perennial ryegrass pastures with 50 and 44 young cattle to study the effect of N fertilizer when applied at a daily rate of 1 or 3 kg N/ha. At each level of N two stocking rates differing by 20% were imposed. At the higher N level and stocking rate, three frequencies of grazing were imposed. At the stocking rates imposed N tended to reduce the daily liveweight gain per head, but increased the total liveweight gain per ha by from 0.79 to 1.58 kg/kg N. A 20% increase in stocking rate depressed gain per head in both years. In the first year it did not improve gain/ha, but in the second year gain/ha was increased by 12-17%. There was a tendency for performance per animal and per ha to increase as the grazing cycle was lengthened. In 1969 the highest yield in the whole season was 1880 grazing days and 1260 kg gain/ha. The overall response to N fertilizer was similar to that recorded in other reports, but it is possible that a lack of K had limited pasture growth. [ABSTRACT FROM AUTHOR]