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Rong-Hua Zheng,1,2 Xiao-Jie Bai,1 Wei-Wei Zhang,1 Jing Wang,1 Feng Bai,1 Cai-Ping Yan,1 Erskine A James,3 Himangshu S Bose,4 Ning-Ping Wang,1,4 Zhi-Qing Zhao1,41Department of Physiology, Shanxi Medical University, Taiyuan, Shanxi, People’s Republic of China; 2Department of Medicine, Linfen Vocational and Technical College, Linfen, Shanxi, People’s Republic of China; 3Department of Internal Medicine, Navicent Health, Macon, GA, USA; 4Basic Biomedical Sciences, Mercer University School of Medicine, Savannah, GA, USAObjective: Angiotensin II (Ang II) is known to contribute to the pathogenesis of heart failure by eliciting cardiac remodeling and dysfunction. The glucagon-like peptide-1 (GLP-1) has been shown to exert cardioprotective effects in animals and patients. This study investigates whether GLP-1 receptor agonist liraglutide inhibits abdominal aortic constriction (AAC)-induced cardiac fibrosis and dysfunction through blocking Ang II type 1 receptor (AT1R) signaling.Methods: Sprague-Dawley rats were subjected to sham operation and abdominal aortic banding procedure for 16 weeks. In treated rats, liraglutide (0.3 mg/kg) was subcutaneously injected twice daily or telmisartan (10 mg/kg/day), the AT1R blocker, was administered by gastric gavage.Results: Relative to the animals with AAC, liraglutide reduced protein level of the AT1R and upregulated the AT2R, as evidenced by reduced ratio of AT1R/AT2R (0.59±0.04 vs. 0.91±0.06, p

Wei-Wei Zhang,1,2 Feng Bai,1 Jin Wang,1 Rong-Hua Zheng,1 Li-Wang Yang,1 Erskine A James,3 Zhi-Qing Zhao1,4 1Department of Physiology, Shanxi Medical University, 2Department of Anesthesiology, Shanxi Provincial People’s Hospital, Taiyuan, Shanxi, China; 3Department of Internal Medicine, Navicent Health, Macon, 4Department of Basic Biomedical Sciences, Mercer University School of Medicine, Savannah, GA, USA Abstract: Angiotensin II (Ang II) is known to be involved in the progression of ventricular dysfunction and heart failure by eliciting cardiac fibrosis. The purpose of this study was to demonstrate whether treatment with an antioxidant compound, edaravone, reduces cardiac fibrosis and improves ventricular function by inhibiting Ang II AT1 receptor. The study was conducted in a rat model of transverse aortic constriction (TAC). In control, rats were subjected to 8 weeks of TAC. In treated rats, edaravone (10 mg/kg/day) or Ang II AT1 receptor blocker, telmisartan (10 mg/kg/day) was administered by intraperitoneal injection or gastric gavage, respectively, during TAC. Relative to the animals with TAC, edaravone reduced myocardial malonaldehyde level and increased superoxide dismutase activity. Protein level of the AT1 receptor was reduced and the AT2 receptor was upregulated, as evidenced by the reduced ratio of AT1 over AT2 receptor (0.57±0.2 vs 3.16±0.39, p

We report the case of a 44-year-old woman who suffered gastric perforation after receiving bag-valve-mask (BVM) ventilation in the setting of alcohol intoxication. She had a markedly distended abdomen and cold, dusky lower extremities upon arrival to the emergency department. Imaging revealed a large volume intra-abdominal accumulation of air with compression of the aorta. Needle decompression relieved symptoms of lower extremity arterial insufficiency. However, the patient quickly decompensated and subsequent exploratory laparotomy confirmed gastric rupture. A subtotal gastrectomy was performed but the patient ultimately passed on post-operative day two due to multi-organ dysfunction. Although BVM ventilation is commonplace in both the hospital and field, there is a lack of awareness of the serious complications of abdominal air accumulation due to their rareness in the adult population. Checking for abdominal distention during resuscitation ought to be routine in all patients. Signs of arterial insufficiency accompanying abdominal distention, once confirmed by diagnostic imaging that shows extensive pneumoperitoneum, are indicators of having reached a life-threatening level of air accumulation, calling for immediate needle decompression and exploratory laparotomy.

Objectives Mycophenolate mofetil (MMF) and azathioprine (AZA) are immunomodulatory treatments in interstitial lung disease (ILD). This systematic review aimed to evaluate the efficacy of MMF or AZA on pulmonary function in ILD.Design Population included any ILD diagnosis, intervention included MMF or AZA treatment, outcome was delta change from baseline in per cent predicted forced vital capacity (%FVC) and gas transfer (diffusion lung capacity of carbon monoxide, %DLco). The primary endpoint compared outcomes relative to placebo comparator, the secondary endpoint assessed outcomes in treated groups only.Eligibility criteria Randomised controlled trials (RCTs) and prospective observational studies were included. No language restrictions were applied. Retrospective studies and studies with high-dose concomitant steroids were excluded.Data synthesis The systematic search was performed on 9 May. Meta-analyses according to drug and outcome were specified with random effects, I2 evaluated heterogeneity and Grading of Recommendations, Assessment, Development and Evaluation evaluated certainty of evidence. Primary endpoint analysis was restricted to RCT design, secondary endpoint included subgroup analysis according to prospective observational or RCT design.Results A total of 2831 publications were screened, 12 were suitable for quantitative synthesis. Three MMF RCTs were included with no significant effect on the primary endpoints (%FVC 2.94, 95% CI −4.00 to 9.88, I2=79.3%; %DLco −2.03, 95% CI −4.38 to 0.32, I2=0.0%). An overall 2.03% change from baseline in %FVC (95% CI 0.65 to 3.42, I2=0.0%) was observed in MMF, and RCT subgroup summary estimated a 4.42% change from baseline in %DLCO (95% CI 2.05 to 6.79, I2=0.0%). AZA studies were limited. All estimates were considered very low certainty evidence.Conclusions There were limited RCTs of MMF or AZA and their benefit in ILD was of very low certainty. MMF may support preservation of pulmonary function, yet confidence in the effect was weak. To support high certainty evidence, RCTs should be designed to directly assess MMF efficacy in ILD.PROSPERO registration number CRD42023423223.

Abstract While residual insecticide applications have the potential to decrease pathogen transmission by reducing the density of vectors and shifting the age structure of the adult mosquito population towards younger stages of development, this double entomological impact has not been documented for Aedes aegypti. Aedes collected from households enrolled in a cluster-randomized trial evaluating the epidemiological impact of targeted indoor residual spraying (TIRS) in Merida, Mexico, were dissected and their age structure characterized by the Polovodova combined with Christopher’s ovariole growth methods. In total, 813 females were dissected to characterize age structure at 1, 3, 6, and 9 months post-TIRS. Significant differences in the proportion of nulliparous Ae. aegypti females between the treatment groups was found at one-month post-TIRS (control: 35% vs. intervention: 59%), three months (20% vs. 49%) but not at six or nine months post-TIRS. TIRS significantly shiftted Ae. aegypti age structure towards younger stages and led to a non-linear reduction in survivorship compared to the control arm. Reduced survivorship also reduced the number of arbovirus transmitting females (those who survived the extrinsic incubation period). Our findings provide strong evidence of the full entomological impact of TIRS, with important implications for quantifying the epidemiological impact of vector control methods.

Summary: Chronic kidney disease is a leading cause of death and disability globally and impacts individuals of African ancestry (AFR) or with ancestry in the Americas (AMS) who are under-represented in genome-wide association studies (GWASs) of kidney function. To address this bias, we conducted a large meta-analysis of GWASs of estimated glomerular filtration rate (eGFR) in 145,732 AFR and AMS individuals. We identified 41 loci at genome-wide significance (p

Abstract In just over a decade, advances in genome-wide association studies (GWAS) have offered an approach to stratify individuals based on genetic risk for disease. Using recent Alzheimer's disease (AD) GWAS results as the base data, we determined each individual's polygenic risk score (PRS) in the UK Biobank dataset. Using individuals within the extreme risk distribution, we performed a GWAS that is agnostic of AD phenotype and is instead based on known genetic risk for disease. To interpret the functions of the new risk factors, we conducted phenotype analyses, including a phenome-wide association study. We identified 246 loci surpassing the significance threshold of which 229 were not reported in the base AD GWAS. These include loci that showed suggestive levels of association in the base GWAS and loci not previously suspected to be associated with AD. Among these, there are loci, such as IL34 and KANSL1, that have since been shown to be associated with AD in recent studies. We also show highly significant genetic correlations with multiple health-related outcomes that provide insights into prodromal symptoms and comorbidities. This is the first study to utilize PRS as a phenotype-agnostic group classification in AD genetic studies. We identify potential new loci for AD and detail phenotypic analysis of these PRS extremes.

Purpose The way coaching cues are worded can impact on the quality with which a subsequent motor skill is executed. However, there have been few investigations on the effect of coaching cues on basic motor skill performance in youths. Method Across several international locations, a series of experiments were undertaken to determine the effect of external coaching cues (EC), internal coaching cues (IC), analogies with a directional component (ADC) and neutral control cues on sprint time (20 m) and vertical jump height in youth performers. These data were combined using internal meta-analytical techniques to pool results across each test location. This approach was amalgamated with a repeated-measures analysis to determine if there were any differences between the ECs, ICs and ADCs within the different experiments. Results 173 participants took part. There were no differences between the neutral control and experimental cues in any of the internal meta-analyses except where the control was superior to the IC for vertical jump (d = -0.30, [-0.54, -0.05], p = 0.02). Just three of eleven repeated-measures analyses showed significant differences between the cues at each experimental location. Where significant differences were noted, the control cue was most effective with some limited evidence supporting the use of ADCs (d = 0.32 to 0.62). Conclusion These results suggest the type of cue or analogy provided to a youth performer has little subsequent effect on sprint or jump performance. Accordingly, coaches might take a more specific approach that is suited to the level or preferences of a particular individual.

Drug efflux through ABC transporters is a common mechanism leading to chemoresistance in cancer. Here, the authors show that mitochondrial respiration provides ATP to allow ABC transporters activity so mitochondrial respiration inhibition overcomes chemoresistance in preclinical cancer models.

Universities are increasingly prioritizing engagement and collaboration with their local communities. While such partnerships can be mutually beneficial, they can often perpetuate and exacerbate power differentials, particularly when the community partners belong to racially minoritized groups. This qualitative paper examines the founding of a community–university partnership between a Black, low-income community and a predominantly White university. Through the theoretical framework of aspirational capital, we find that valuing the experiences and aspirations of the community helped establish a more equitable partnership forged to support a community-led, culturally relevant after-school program. Centering the aspirations of Black community members and the epistemologies of the Black women on the program staff also served to acknowledge and address power imbalances at the founding stages of the partnership. Recognizing and valuing the aspirational capital of community members also positively impacted the university-based staff’s ability to function as boundary spanners between the university and community who could adequately articulate the desires and needs of program staff. We argue that by recognizing and valuing the aspirational capital already present in low-income Black communities, universities can create more equitable partnerships for positive social change.

Abstract Since its emergence in late 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a pandemic with more than 55 million reported cases and 1.3 million estimated deaths worldwide. While epidemiological and clinical characteristics of COVID-19 have been reported, risk factors underlying the transition from mild to severe disease among patients remain poorly understood. In this retrospective study, we analysed data of 879 confirmed SARS-CoV-2 positive patients admitted to a two-site NHS Trust hospital in London, England, between January 1st and May 26th, 2020, with a majority of cases occurring in March and April. We extracted anonymised demographic data, physiological clinical variables and laboratory results from electronic healthcare records (EHR) and applied multivariate logistic regression, random forest and extreme gradient boosted trees. To evaluate the potential for early risk assessment, we used data available during patients’ initial presentation at the emergency department (ED) to predict deterioration to one of three clinical endpoints in the remainder of the hospital stay: admission to intensive care, need for invasive mechanical ventilation and in-hospital mortality. Based on the trained models, we extracted the most informative clinical features in determining these patient trajectories. Considering our inclusion criteria, we have identified 129 of 879 (15%) patients that required intensive care, 62 of 878 (7%) patients needing mechanical ventilation, and 193 of 619 (31%) cases of in-hospital mortality. Our models learned successfully from early clinical data and predicted clinical endpoints with high accuracy, the best model achieving area under the receiver operating characteristic (AUC-ROC) scores of 0.76 to 0.87 (F1 scores of 0.42–0.60). Younger patient age was associated with an increased risk of receiving intensive care and ventilation, but lower risk of mortality. Clinical indicators of a patient’s oxygen supply and selected laboratory results, such as blood lactate and creatinine levels, were most predictive of COVID-19 patient trajectories. Among COVID-19 patients machine learning can aid in the early identification of those with a poor prognosis, using EHR data collected during a patient’s first presentation at ED. Patient age and measures of oxygenation status during ED stay are primary indicators of poor patient outcomes.

In colorectal cancer (CRC), finding loci associated with risk may give insight into disease aetiology. Here, the authors report a genome-wide association analysis in Europeans of 34,627 CRC cases and 71,379 controls, and find 31 new risk loci and 17 new risk SNPs at previously reported loci.

Estimated glomerular filtration rate (eGFR) is a measure of kidney function used to define chronic kidney disease. Here, Morris et al. perform trans-ethnic genome-wide meta-analyses for eGFR in 312,468 individuals and identify novel loci and downstream putative causal genes.

Study region: : Western Tennessee, U.S.A. Study focus: : Recharge to aquifers that underlie loess and other fine-grained surficial deposits in western Tennessee as well as other areas is commonly impeded resulting in sensitivity in regard to sustainability of groundwater resources. This study investigates the role of preferential pathways of recharge to the regional Memphis aquifer in an area mantled by loess and fine-grained paleosols. New hydrological insights: : Data gathered through a vadose-zone chloride mass balance analysis and a year of monitoring physical hydrologic, water chemistry, and environmental and applied tracer data within an upland watershed in western Tennessee indicate that recharge to the Memphis aquifer is dominated by lateral recharge of infiltrated stream water sources rather than vertical infiltration through loess-covered uplands. The results from this research challenge prevailing models of recharge to the Memphis aquifer and aquifers mantled by loess or other fine-grained soils in other regions that envision vertical recharge through fine-grained soils to be the dominant recharge mechanism. Keywords: Groundwater, Loess, Aquifer, Vertical infiltration, Lateral recharge

Purpose: To describe the salvage radical prostatectomy (sRP) experience in patients presenting with recurrent, clinically localized prostate cancer after multiple failed local treatments. Materials and Methods: Among the 251 sRP performed during 2000–2016, 11 patients had failed multiple local therapies. We describe baseline clinical characteristics at primary cancer diagnosis and prior to sRP, surgical information, complications and oncological outcomes. Results: The mean±standard deviation age at sRP was 65±5 years and the median (interquartile range) serum prostate-specific antigen (PSA) level was 2 (1.3) ng/mL. The most common first and subsequent treatments were radiotherapy and cryotherapy, respectively, with median time of 24 months from the last local treatment. The median operative time was 180 minutes and median estimated blood loss was 750 mL. Five (45.5%) patients underwent additional procedures during sRP for pre-operative morbidity from prior treatments (rectourethral fistula, urethral stricture, incontinence). Post-operative complications requiring invasive intervention occurred in 7 (63.6%) patients. Over a median follow-up of 29 (12–96) months, 10 of the 11 men (90.9%) achieved an undetectable PSA in after sRP. Three of these men with an initially undetectable PSA level experienced biochemical recurrence; the remaining 7 are without evidence of disease. Overall, no local recurrence or systemic metastasis was identified at last follow-up. Conclusions: sRP is technically feasible and offers durable cancer control in patients with recurrent prostate cancer despite having undergone multiple prior attempts at cure. These patients experience higher rates of post-operative complications and such patients must be appropriately counseled regarding the potential risks and benefits.

Purpose: To verify the quality of pelvic lymph node dissection (PLND) performed at radical prostatectomy (RP) and its impact on nodal recurrence in patients undergoing salvage lymph node dissection (sLND). Materials and Methods: Retrospective review of 48 patients who underwent sLND for presumed nodal recurrence, to describe the PLND characteristics at RP and correlate the anatomical sites and number of suspicious nodes reported in radiological imaging and final pathology of sLND. Results: Overall, at RP, 8 (16.7%) did not undergo PLND, 32 (66.7%) and 8 (16.7%) received a “limited” (between external iliac vein and obturator nerve) and an “extended” (external iliac, hypogastric, and obturator) dissection, respectively. Median nodes removed during limited and extended dissection were 2 and 24, respectively. At sLND, the mean age was 61.3 years and median prostate specific antigen (PSA) was 1.07 ng/mL. Median nodes removed at sLND were 17 with a median of 2 positive nodes. Recurrent nodes were identified within the template of an extended PLND in 62.5%, 50.0% and 12.5% patients, respectively, following prior no, limited and extended dissection at RP. Recurrence outside the expected lymphatic drainage pathway was noted in 37.5% patients with prior extended dissection at RP. There was a correlation between imaging and pathology specimen in 83% for node location and 58.3% for number of anatomical sites involved. Conclusions: In prostate cancer patients undergoing sLND, most had inadequate PLND at the original RP. Pattern of nodal recurrence may be influenced by the prior dissection and pre sLND imaging appears to underestimate the nodal recurrence.

Ageing of the kidney is a multi-dimensional process that occurs simultaneously at the molecular, cellular, histological, anatomical and physiological level. Nephron number and renal cortical volume decline, renal tubules become atrophic and glomeruli become sclerotic with age. These structural changes are accompanied by a decline in glomerular filtration rate, decreased sodium reabsorption and potassium excretion, reduced urinary concentrating capacity and alterations in the endocrine activity of the kidney. However, the pace of progression of these changes is not identical in everyone - individuals of the same age and seemingly similar clinical profile often exhibit stark differences in the age-related decline in renal health. Thus, chronological age poorly reflects the time-dependent changes that occur in the kidney. An ideal measure of renal vitality is biological kidney age – a measure of the age-related changes in physiological function. Replacing chronological age with biological age could provide numerous clinical benefits including improved prognostic accuracy in renal transplantation, better stratification of risk and identification of those who are on a fast trajectory to an age-related drop in kidney health.

INTRODUCTION: Permanent pacemakers are capable of increasing heart rate in response to physical activity by a variety of sensors including accelerometers, piezoelectric crystals, or blended sensors. The impact of these different physiologic sensors on cardiovascular events and quality of life is not known. METHODS: Of 2,010 patients randomized in the Mode Selection Trial, 1,245 patients were selected with the most commonly used pacemakers with these three sensors. Clinical characteristics and quality of life were compared between groups at baseline, 3 months, and then yearly. RESULTS: There were 449 patients with an accelerometer sensor device, 682 with a piezoelectric sensor, and 114 with a blended sensor. The groups were similar in terms of age (mean 74 years), gender, and cardiac risk factors but differences existed in weight, heart rate, mitral regurgitation, revascularization history, and drug therapy. The median ventricular pacing frequency was 80% (25th, 75th percentiles 42, 97). After a median follow-up of 33.1 months, the risk of death, heart failure hospitalization, atrial fibrillation, and the combined endpoint of mortality and stroke was not significantly different between the sensor types, after adjustment for baseline differences. Quality of life analyses demonstrated that patients with blended sensors had significantly worse (P < 0.01) physical function than did patients with the other two sensor systems. Moreover, patients receiving blended sensors had the poorest absolute scores, without reaching statistical significance, on 9 of 13 quality of life measures after adjusting for differences in the groups. CONCLUSION: We found no significant differences among the three most utilized sensors in clinical endpoints. Those patients who received blended sensors had worse physical function quality of life scores. However, clinical selection of the most sophisticated sensor for the most ill patients cannot be excluded as an explanation of these results. [ABSTRACT FROM AUTHOR]

Nanophthalmos is a rare, potentially devastating eye condition characterized by small eyes with relatively normal anatomy, a high hyperopic refractive error, and frequent association with angle closure glaucoma and vision loss. The condition constitutes the extreme of hyperopia or farsightedness, a common refractive error that is associated with strabismus and amblyopia in children. NNO1 was the first mapped nanophthalmos locus. We used combined pooled exome sequencing and strong linkage data in the large family used to map this locus to identify a canonical splice site alteration upstream of the last exon of the gene encoding myelin regulatory factor (MYRF c.3376-1G>A), a membrane bound transcription factor that undergoes autoproteolytic cleavage for nuclear localization. This variant produced a stable RNA transcript, leading to a frameshift mutation p.Gly1126Valfs*31 in the C-terminus of the protein. In addition, we identified an early truncating MYRF frameshift mutation, c.769dupC (p.S264QfsX74), in a patient with extreme axial hyperopia and syndromic features. Myrf conditional knockout mice (CKO) developed depigmentation of the retinal pigment epithelium (RPE) and retinal degeneration supporting a role of this gene in retinal and RPE development. Furthermore, we demonstrated the reduced expression of Tmem98, another known nanophthalmos gene, in Myrf CKO mice, and the physical interaction of MYRF with TMEM98. Our study establishes MYRF as a nanophthalmos gene and uncovers a new pathway for eye growth and development.

Aluminum (Al) toxicity imposes a significant limitation to crop production in South Western Australia. This paper examines the impact of surface-applied lime and gypsum on soil solution chemistry in the short term (1 year) and the long-term (10 years) in water limited environments. In the experiments, we measured soil solution chemistry using a paste extract on soil profile samples collected to a depth of 50 cm. We then used the chemical equilibrium model MINTEQ to predict the presence and relative concentrations of Al species that are toxic to root growth (Al associated with Al3+ and AlOH2 or Toxic-Al) and less non-toxic forms of Al bound with sulfate, other hydroxide species and organic matter. A feature of the soils used in the experiment is that they have a low capacity to adsorb sulfate. In the short term, despite the low amount of rainfall (279 mm), sulfate derived from the surface gypsum application is rapidly leached into the soil profile. There was no self-liming effect, as evidenced by there being no change in soil solution pH. The application of gypsum, in the short term, increased soil solution ionic strength by 524–681% in the 0–10 cm soil layer declining to 75–109% in the 30–40 cm soil layer due to an increase in soil solution sulfate and calcium concentrations. Calcium from the gypsum application displaces Al from the exchange sites to increase soil solution Al activity in the gypsum treatments by 155–233% in the short term and by 70–196% in the long term to a depth of 40 cm. However, there was no effect on Toxic-Al due to Al sulfate precipitation. In the long term, sulfate leaching from the soil profile results in a decline in soil solution ionic strength. Application of lime results in leaching of alkalinity into the soil profile leading to a decreased Toxic-Al to a depth of 30 cm in the long term, but it did not affect Toxic-Al in the short term. Combining an application of lime with gypsum had the same impact on soil solution properties as gypsum alone in the short term and as lime alone in the long term.

Soil acidity or aluminum (Al) toxicity is a major limitation to crop production. In this paper, we examine the effects of surface-applied lime and gypsum on soil profile chemical properties that affect Al toxicity in short-term (1 year), medium-term (2 years and 8 months) and long-term (10 years) experiments. Sulfate applied to the soil surface as gypsum was leached rapidly to a depth of 40 cm in the short-term despite relatively low amounts (279 mm) of rainfall. In the medium and long-term experiments, 28–54% of the sulfate applied as gypsum was retained in the 0–50 cm soil layer due to adsorption and precipitation reactions. The combined application of lime and gypsum increased soil calcium, to a depth of 30 cm in the short-term and to a depth of 50 cm in the medium and long-terms. Increases in soil sulfate and calcium were associated with greater electrical conductivity to a depth of 50 cm for all sampling times. Application of lime alone had no impact on soil Al, pH, and calcium in the soil layers below 10 cm in the short and medium terms. In the long-term, increasing the rate of lime application from 2 to 8 t L ha−1 increased soil pH in the 10–20 cm soil layer while soil Al decreased to a depth of 30 cm. The combined use of lime and gypsum decreased soil Al in the 30–50 cm soil layer in the medium-term and the 20–30 cm soil layer in the long-term which was more than when only lime was applied. Hence, we recommend the use of lime plus gypsum for treating soils with subsoil Al toxicity. Additionally, soil Al measurements are a more sensitive measurement of the impact of surface application lime and lime plus gypsum than soil pH.

Deforestation is a major threat to biodiversity, particularly within tropical forest habitats. Some of the fastest diminishing tropical forest habitats in the world occur in Indonesia, where fragmentation is severely impacting biodiversity, including on the island of Java, which holds many endemic species. Extreme fragmentation on the western part of the island, especially due to small-scale agriculture, impacts animal movement and increases mortality risk for mainly arboreal taxa. To mitigate this risk in an agroforest environment in Garut District, West Java, we installed 10 canopy bridges and monitored them through camera trapping between 2017 and 2019. Five of the monitored bridges were made of waterlines and five of rubber hose. We recorded Javan palm civets using the waterline bridges 938 times, while Javan slow lorises used the waterlines 1079 times and the rubber bridges 358 times. At least 19 other species used the bridges for crossing or perching. Our results demonstrate that relatively simple and cost-effective materials can be used to mitigate the effects of habitat fragmentation. We also recommend the use of camera traps to monitor the effectiveness of these interventions.

Surface (0–10 cm) and subsoil (soil layers below 10 cm) acidity and resulting aluminum (Al) toxicity reduce crop grain yields. In South Western Australia (SWA), these constraints affect 14.2 million hectares or 53% of the agricultural area. Both lime (L, CaCO3) and gypsum (G, CaSO4) application can decrease the toxic effect of Al, leading to an increase in crop grain yields. Within the region, it is unclear if G alone or the combined use of L and G has a role in alleviating soil acidity in SWA, due to low sulfate S (SO4–S) sorption properties of the soil. We present results from three experiments located in the eastern wheatbelt of SWA, which examined the short-term (ST, 2 growing seasons), medium-term (MT, 3 growing seasons), and long-term (LT, 7 growing seasons over 10 years) effects of L and G on grain yield and plant nutrient concentrations. Despite the rapid leaching of SO4–S and no self-liming impact, it was profitable to apply G, due to the significant ST grain yield responses. The grain yield response to G developed even following relatively dry years, but declined over time due to SO4–S leaching. At the LT experimental site had received no previous L application, whereas, at the ST and MT sites, L had been applied by the grower over the previous 5–10 years. For the LT site, the most profitable treatment for wheat (Triticum aestivum L.) grain yield, was the combined application of 4 t L ha−1 with 2 t G ha−1. At this site, the 0–10 cm soil pHCaCl2 was 4.6, and AlCaCl2 was greater than 2.5 mg kg−1 in the 10–30 cm soil layer. In contrast, at the ST and MT sites, the pHCaCl2 of 0–10 cm soil layer was ≥5.5; it was only profitable to apply G to the MT site where the soil compaction constraint had been removed by deep ripping. The use of L increases soil pHCaCl2, resulting in the improved availability of anions, phosphorus (P) in the LT and molybdenum (Mo) at all sampling times, but reduced availability of cations zinc (Zn) in the LT and manganese (Mn) at all sampling. The application of G reduced Mo concentrations, due to the high SO4–S content of the soil.

One ‘can hardly avoid controversy’ when discussing prose composition (Pearcy, 1998, 35); the very idea seems to evoke only the extremes from a Classicist. Some avidly argue against it, labelling it a ‘useless, archaic exercise’ (Ball and Ellsworth, 1992, p. 55), some vehemently defend it, calling it ‘an invaluable virtue in all areas of education’ (Butterfield, 2013, p. 8). Others believe there are more important arguments to be made about Classics, comparing the argument about prose composition to ‘litigating over property lines when the house is on fire’ (Jacoby, 1994, xii, cited in Pearcy, 1998, p. 37). Despite this view, the debate about prose composition has recently been reignited. The recent publication in Politeia (Butterfield, Anderson, Radice & Sullivan, 2013) demanded a new prose composition option for Latin GCSE in order to bring it in line with the current A Level system and for students to ‘obtain a higher level of linguistics familiarity and facility in Latin’ (2013, p. 8). The DfE (2014) has just published the guidelines to the reformed Latin GCSE, for first teaching in 2016, which does include recommendations for such an option.

Introduction. Hyponatremia complicates cirrhosis and predicts short term mortality, including adverse outcomes before and after liver transplantation.Material and methods. From April 1, 2008, through April 2, 2010, all adult candidates for primary liver transplantation with cirrhosis, listed in Region 11 with hyponatremia, were eligible for sodium (Na) exception.Results. Patients with serum sodium (SNa) less than 130 mg/dL, measured two weeks apart and within 30 days of Model for End Stage Liver Disease (MELD) exception request, were given preapproved Na exception. MELD Na was calculated [MELD + 1.59 (135-SNa/30 days)]. MELD Na was capped at 22, and subject to standard adult recertification schedule. On data end of follow-up, December 28, 2010, 15,285 potential U.S. liver recipients met the inclusion criteria of true MELD between 6 and 22. In Region 11, 1,198 of total eligible liver recipients were listed. Sixty-two (5.2%) patients were eligible for Na exception (MELD Na); 823 patients (68.7%) were listed with standard MELD (SMELD); and 313 patients (26.1%) received HCC MELD exception. Ninety percent of MELD Na patients and 97% of HCC MELD patients were transplanted at end of follow up, compared to 49% of Region 11 standard MELD and 40% of U.S.A. standard MELD (USA MELD) patients (p < 0.001); with comparable dropout rates (6.5, 1.6, 6.9, 9% respectively; p = 0.2). MELD Na, HCC MELD, Region 11 SMELD, and USA MELD post-transplant six-month actual patient survivals were similar (92.9, 92.8, 92.2, and 93.9 %, respectively).Conclusion. The Region 11 MELD Na exception prospective trial improved hyponatremic cirrhotic patient access to transplant equitably, and without compromising transplant efficacy.

PURPOSE: When faced with biochemical recurrence after definitive radiotherapy for prostate cancer, clinicians must determine whether the recurrence is local or systemic. Post radiotherapy prostate biopsies to detect persistent local disease are difficult to interpret histopathologically and are subject to sampling error. Our study examines outcomes for patients with a negative prostate biopsy performed for rising prostate-specific antigen (PSA) levels after prostate radiation. MATERIALS AND METHODS: We performed a retrospective review of 238 prostate cancer patients with a negative biopsy following definitive radiotherapy. Seventy-five of these patients had biochemical recurrence at the time of biopsy. A negative biopsy was defined as the absence of prostate cancer without radiation-treatment effect in the specimen. RESULTS: Patients underwent biopsy at a mean of 41 months after the completion of radiation. They had a mean PSA of 6. Patients were followed for an average of 63 months. Thirty-two patients (43%) developed metastasis, and 11 (15%) died of prostate cancer despite a negative post-radiation biopsy. Five of nine patients (56%) with sequential biopsies had a positive second biopsy. CONCLUSIONS: Patients with PSA recurrence and a negative post-radiation biopsy have a high chance of persistent local disease, progression, and death from prostate cancer. Furthermore, an initial negative biopsy does not rule-out local recurrence. Patients with biochemical recurrence after radiotherapy for prostate cancer need to be evaluated earlier for local recurrence.