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Biopharmaceutical product and process development do not yet take advantage of predictive computational modeling to nearly the degree seen in industries based on smaller molecules. To assess and advance progress in this area, spirited coopetition (mutually beneficial collaboration between competitors) was successfully used to motivate industrial scientists to develop, share, and compare data and methods which would normally have remained confidential. The first "Highland Games" competition was held in conjunction with the October 2018 Recovery of Biological Products Conference in Ashville, NC, with the goal of benchmarking and assessment of the ability to predict development-related properties of six antibodies from their amino acid sequences alone. Predictions included purification-influencing properties such as isoelectric point and protein A elution pH, and biophysical properties such as stability and viscosity at very high concentrations. Essential contributions were made by a large variety of individuals, including companies which consented to provide antibody amino acid sequences and test materials, volunteers who undertook the preparation and experimental characterization of these materials, and prediction teams who attempted to predict antibody properties from sequence alone. Best practices were identified and shared, and areas in which the community excels at making predictions were identified, as well as areas presenting opportunities for considerable improvement. Predictions of isoelectric point and protein A elution pH were especially good with all-prediction average errors of 0.2 and 1.6 pH unit, respectively, while predictions of some other properties were notably less good. This manuscript presents the events, methods, and results of the competition, and can serve as a tutorial and as a reference for in-house benchmarking by others. Organizations vary in their policies concerning disclosure of methods, but most managements were very cooperative with the Highland Games exercise, and considerable insight into common and best practices is available from the contributed methods. The accumulated data set will serve as a benchmarking tool for further development of in silico prediction tools.

Research shows that collaborative work promotes student learning and improves social skills, but teachers are still exploring how to best support problem-solving in a small group context, p...

The question of what constitutes a well-rounded Christian education invokes energetic discussion and diversity of opinions. What is often lacking is an analysis of how students are equipped to navigate what is arguably the greatest blessing or challenge they will ever face—pregnancy. Recent surveys of Australian students in Grades 10–12 showed around half are sexually active and, therefore, face a real risk of unintended pregnancy. At the same time, Australia has some of the most liberal abortion laws in the world. The topics of pregnancy, parenting and abortion are not generally included in the Christian studies curriculum, but societal messages in mainstream media are relentless. Most students will leave Christian schools without having had the opportunity to think deeply and critically about the issues of pregnancy and abortion. This chapter presents a mixed-method case study outlining the inception, development, implementation and outcomes of a youth education program titled Perspectives, which engages students in respectful, in-depth conversations about these issues. This program has been developed by a local Brisbane pregnancy support centre, Priceless House (Priceless Life Ltd.). Perspectives has been piloted and run for 5 years in two Christian co-educational schools with Grade 10–12 students.

Introduction Sarcopenia is a progressive loss in muscle mass, strength and function, the adverse consequences of which are severe, affecting quality of life and placing an increasing burden on social and healthcare systems. Vitamin D status is known to be associated with markers of sarcopenia, namely muscle mass, strength and function. Also, resistance exercise training (RET) is currently the only proven intervention to treat sarcopenia. However, very little data exist on the influence of combining the two interventions of vitamin D supplementation and resistance exercise training, although a recent systematic review provides tentative support for the current study’s hypothesis that the combined intervention may further improve musculoskeletal function above exercise training alone. The aim of the present study is to determine whether vitamin D3 supplementation is any more effective in improving musculoskeletal function when combined with RET compared with exercise training alone in older adults. Methods and analysis This double-blinded randomised placebo-controlled trial will recruit a target of 127 eligible men and women aged ≥65 years living independently or in sheltered housing within the Birmingham area to two groups: (1) 6 months RET and placebo or (2) 6 months RET and 800 IU/d vitamin D3. Measures of muscle power (Nottingham Power Rig), body composition (dual energy X-ray absorptiometry), muscle function (short physical performance battery, timed up and go), falls and fractures as events will be assessed. Assessments will take place at baseline and postintervention, with intermittent monitoring of bone turnover, calcium and vitamin D. The primary outcome will be lower limb extensor power output. Analyses of within-group changes and between-group differences in outcome measures are planned. Ethics and dissemination The EXVITD study has ethical approval granted by the Black Country National Health Service Research Ethics Committee (14/WM/1220). Results of this trial will be submitted for publication in peer-reviewed journals and presented at conferences. The study is being conducted according to the principles of the Declaration of Helsinki. Trial registration number NCT02467153; Post-results.

IntroductionSarcopenia is a progressive loss in muscle mass, strength and function, the adverse consequences of which are severe, affecting quality of life and placing an increasing burden on social and healthcare systems. Vitamin D status is known to be associated with markers of sarcopenia, namely muscle mass, strength and function. Also, resistance exercise training (RET) is currently the only proven intervention to treat sarcopenia. However, very little data exist on the influence of combining the two interventions of vitamin D supplementation and resistance exercise training, although a recent systematic review provides tentative support for the current study’s hypothesis that the combined intervention may further improve musculoskeletal function above exercise training alone. The aim of the present study is to determine whether vitamin D3supplementation is any more effective in improving musculoskeletal function when combined with RET compared with exercise training alone in older adults.Methods and analysisThis double-blinded randomised placebo-controlled trial will recruit a target of 127 eligible men and women aged ≥65 years living independently or in sheltered housing within the Birmingham area to two groups: (1) 6 months RET and placebo or (2) 6 months RET and 800 IU/d vitamin D3. Measures of muscle power (Nottingham Power Rig), body composition (dual energy X-ray absorptiometry), muscle function (short physical performance battery, timed up and go), falls and fractures as events will be assessed. Assessments will take place at baseline and postintervention, with intermittent monitoring of bone turnover, calcium and vitamin D. The primary outcome will be lower limb extensor power output. Analyses of within-group changes and between-group differences in outcome measures are planned.Ethics and disseminationThe EXVITD study has ethical approval granted by the Black Country National Health Service Research Ethics Committee (14/WM/1220). Results of this trial will be submitted for publication in peer-reviewed journals and presented at conferences. The study is being conducted according to the principles of the Declaration of Helsinki.Trial registration numberNCT02467153; Post-results.

The increasing prevalence of low pI non-mAb therapeutics as well as current challenges in mAb-aggregate separations and low recoveries motivate further development in the multimodal anion exchange (MM AEX) space. In this work, linear salt gradient experiments at pH 7 were used to evaluate the retention of model proteins (with pI from 3.4 to 6.8) in 17 novel MM AEX prototype systems. The ligands were organized into three series. Series 1 extended previous work in multimodal ligand design and included a hydroxyl variant and linker length variants. Series 2 and 3 investigated the nature of hydrophobicity in MM AEX systems by adding hydrophobic (series 2) or fluorine (series 3) substituents to a solvent exposed phenyl ring. Compared to the commercial resin Capto Adhere, the series 1 and 3 ligands exhibited weaker binding, while some of the series 2 aliphatic prototypes showed dramatically increased retention and unique selectivities. Within series 1, the model proteins eluted earlier in the gradient as the charge-hydrophobic group distance on the ligand was increased from 4.9 A to 8.5 A. For the aliphatic variants in series 2, proteins that eluted early in the salt gradient were not affected by the increase in ligand hydrophobicity, while the later eluting proteins bound stronger as the length of the aliphatic substituent increased. The series 3 variants indicated that phenyl ring fluorination created subtle changes in protein elution in these MM AEX systems. Retention data from the three series was used to generate a partial least squares QSAR model based on both protein and ligand descriptors which accurately predicted protein retention with a training R 2 of 0.81 and a test R 2 of 0.76. The retention characteristics of some prototypes such as the earlier elution and unique selectivities compared to Capto Adhere suggest that they could potentially provide unique selectivities and increased recovery for the downstream processing of both mAb and non-mAb biotherapeutics.

While quantitative structure activity relationship (QSAR) models have been employed successfully for the prediction of small model protein chromatographic behavior, there have been few reports to date on the use of this methodology for larger, more complex proteins. Recently our group generated focused libraries of antibody Fab fragment variants with different combinations of surface hydrophobicities and electrostatic potentials, and demonstrated that the unique selectivities of multimodal resins can be exploited to separate these Fab variants. In this work, results from linear salt gradient experiments with these Fabs were employed to develop QSAR models for six chromatographic systems, including multimodal (Capto MMC, Nuvia cPrime, and two novel ligand prototypes), hydrophobic interaction chromatography (HIC; Capto Phenyl), and cation exchange (CEX; CM Sepharose FF) resins. The models utilized newly developed "local descriptors" to quantify changes around point mutations in the Fab libraries as well as novel cluster descriptors recently introduced by our group. Subsequent rounds of feature selection and linearized machine learning algorithms were used to generate robust, well-validated models with high training set correlations (R2 > 0.70) that were well suited for predicting elution salt concentrations in the various systems. The developed models then were used to predict the retention of a deamidated Fab and isotype variants, with varying success. The results represent the first successful utilization of QSAR for the prediction of chromatographic behavior of complex proteins such as Fab fragments in multimodal chromatographic systems. The framework presented here can be employed to facilitate process development for the purification of biological products from product-related impurities by in silico screening of resin alternatives. Biotechnol. Bioeng. 2017;114: 1231-1240. © 2016 Wiley Periodicals, Inc.

Decisions regarding the selection and implementation of management strategies that constrain fishing pressure can be among the most difficult choices that fisheries managers and stakeholders must make. These types of decisions often need to be confronted in a data-limited context, where few if any management measures are currently in place or fisheries are managed independent of adequate scientific advice. This situation can sometimes create a high risk of overfishing and potential loss of economic and social benefits. To address this situation, simple model-free indicator-based frameworks have the potential to be effective decision-making platforms for fisheries where quantitative estimates of biomass and fishing mortality based reference points are lacking. In this paper, a multi-indicator framework is developed that enables decision-makers to proceed with management decisions in data-limited situations. Model-free indicators are calculated using trends in observed data, rather than stock assessment derived estimates of biomass and fishing mortality. The framework developed is adaptive so that adjustments to catch or effort are recursive and can respond to changing environments, socioeconomic conditions, and fishing practices. Using stakeholder-defined objectives as a foundation, indicators and reference points of fishery performance are chosen that can be evaluated easily by undertaking analyses of available data. Indicators from multiple data streams are used so that uncertainty in one indicator can be hedged through careful interpretation and corroboration of information from alternative indicators. During the adaptive management cycle, managers and stakeholders evaluate each indicator against the associated reference points to determine performance measures, interpret the results using scientific and local knowledge, and adjust fishery management tactics accordingly using pre-defined harvest control rules. The framework facilitates the interpretation of situations in which performance measures suggest divergent stock abundance or productivity levels. A case study is presented on this framework's development for conch and lobster fisheries of Belize.

Background: Migration is a risk factor for psychoses but risks within the large South Asian communities of West Yorkshire are not known. Aim: To estimate the risk of psychosis in the Pakistani, Bangladeshi and Indian populations in West Yorkshire as compared with British White population. Method: We used data from Early Intervention for Psychosis services on 15–35 year-olds diagnosed with first episode psychosis in 2013–2015 and local census data to calculate risks. Results: Compared with the British White population, the Pakistani population had a significantly higher risk of first episode psychosis (RR 1.31, 95% CI 1.09, 1.58). The smaller Bangladeshi population showed a similar, but non-significant, trend (RR 1.50, 95% CI 0.89, 2.53). In contrast, the Indian population had a significantly lower risk (RR 0.51, 95% CI 0.33, 0.79). Conclusion: Variable risk of psychosis among south Asian ethnic groups in West Yorkshire needs further research.

Background Warfarin is an anticoagulant medication proven effective in the initial treatment and secondary prevention of venous thromboembolism. Anti-Xa direct oral anticoagulants are alternatives to warfarin; however there is limited data assessing satisfaction after switching from warfarin to an anti-Xa direct oral anticoagulant in patients for treatment of venous thromboembolism. Objectives To assess medication satisfaction in patients requiring anticoagulation for venous thromboembolism after conversion from warfarin to an anti-Xa direct oral anticoagulant. Methods A retrospective cohort study with prospective assessment of satisfaction and review of adverse events following anti-Xa direct oral anticoagulant replacement of warfarin for treatment of venous thromboembolism. Out of 165 patients who had switched from warfarin to rivaroxaban or apixaban from an outpatient haematology practice, 126 patients consented for a survey of patient’s relative satisfaction of anti-Xa direct oral anticoagulant therapy compared with previous warfarin therapy using the Anti-Clot Burden and Benefits Treatment Scale and SWAN Score. Results The mean Anti-Clot Burden and Benefits and SWAN Score was 93% (56/60) and 83% (24.8/30) respectively reflecting high satisfaction with anti-Xa direct oral anticoagulants. 120 patients stated preference for anti-Xa direct oral anticoagulants over warfarin. Leading perceptions driving this was the reduction in frequency of medical contact and fewer bleeding side effects. Thirteen patients (10.3%) experienced an adverse event after the anti-Xa direct oral anticoagulant switch (majority were non-major bleeding) but most remained on anti-Xa direct oral anticoagulant treatment after management options were implemented with continued high satisfaction scores. Conclusions Patient satisfaction with anti-Xa direct oral anticoagulant therapy for the treatment and prevention of venous thromboembolism after switching from warfarin in routine clinical practice appeared high. Improved patient convenience including reduced frequency of medical contact and fewer unpredictable side effects were perceived as significant advantages of anti-Xa direct oral anticoagulants compared to warfarin.

The present paper builds upon previous work on mAb domain contributions to multimodal (MM) chromatography by examining how pH can impact mAb surface properties and retention in these systems. Linear salt gradient experiments were carried out between pH 5-7 for several mAbs with different pI and surface hydrophobicities in four different MM CEX resins at two ligand densities. mAb retention showed an inverse, non-linear correlation with pH. Changing pH affected the elution order, creating unique windows of selectivity in each of the MM CEX resins. One mAb showed a pH-dependent spectrum of domain contributions, demonstrating that pH can be used to tune the relative importance of the (Fab)2 and Fc domains for some mAbs in MM systems. Positive, negative, and hydrophobic patches were calculated between pH 5-7 for the mAbs. Visualizing these patches on the protein surface demonstrated that each mAb showed a unique distribution of surface charge and hydrophobicity that changed with pH. The sum of patch areas was tracked across this pH range to quantitatively understand how pH impacted these important surface properties. The quantitative analysis then was narrowed to consider only patches in the CDR loops, which were hypothesized to be an important interaction site for some mAbs in these systems. Interestingly, differences in the titration of CDR loop patches for each mAb were shown to be a result of Histidine titrations and patches in this region were qualitatively correlated with experimental trends including the observed elution order reversals. These results indicate that pH potentially can be employed as a lever for the strategic design of multimodal steps to create flow through, bind and elute, or weak partitioning operations with important implications for the design of integrated and/or continuous downstream purification processes. Furthermore, the ability to tune domain contributions in MM separations using pH creates intriguing possibilities for current downstream challenges such as the removal of product-related impurities, as well as the purification of bispecific mAbs.

The recovery potential of endangered species is limited by the high prevalence of human-modified habitats, while effective in situ conservation strategies to identify and restore disturbed habitat within species ranges are lacking. Our goal was to determine the impact of human disturbance on the endangered endemic Barrens willow (Salix jejuna) to provide science-based protocols for future restoration of disturbed habitats; a key component of conservation and recovery plans for many rare plant species. Our study examined differences in substrate (e.g., % total plant cover, % species cover, substrate type) and vegetation in naturally- (via frost activity) vs human-disturbed limestone barrens (Newfoundland, Canada), across the entire species range of the endangered Barrens willow. There were distinct differences in substrate conditions and vegetation community structure between naturally- and human-disturbed limestone barrens habitat throughout the narrow range of this endemic willow. Human-disturbed sites are more homogeneous and differ significantly from the naturally-disturbed sites having a much coarser substrate (30% more gravel) with less fine grained sands, less exposed bedrock, decreased soil moisture, increased nitrogen content, and reduced phosphorus content. Substrate differences can inhibit return to the natural freeze-thaw disturbance regime of the limestone barrens, negatively affecting long-term persistence of this, and other rare plants. The structure of associated vegetation (specifically woody species presence) negatively affected willow abundance but was not linked to disturbance type. Human-disturbed sites are potential candidates for endangered plant recovery habitat if natural ecosystem processes, vegetation community structure, and habitat heterogeneity are restored, thereby supporting the establishment of long term viable populations.

A developmentally normal adolescent boy with a history of childhood absence epilepsy presented with recurrence of pyknolepsy after a seven-year period of remission. The characteristics of his EEG showed the same 3-Hz generalised spike-wave discharge as in his previous EEG in childhood. To our knowledge, this is the first case report describing recurrence of childhood absence epilepsy as pyknolepsy in an adolescent. [Published with video sequences].

This article compares three self-developed subject guides and one commercial online subject guide (LibGuides) to provide information to other institutions which have a plan or are in the process of developing a plan to implement similar services to support online, distance and traditional education. This is a comparison of the current subject guides in use by three separate academic institutions: Murray State University, North Carolina State University, and The Ohio State University. This paper examines the creation and use of dynamic subject guides as a result of collaboration among departments: reference, systems, and campus information technology, through an examination of related articles.

Embedded librarians are attempting assimilation into a new pedagogical collective outside the library, often with a mission to improve the quality of service to that collective. But like the Borg, embedded librarians may not be achieving the results they envision. This article documents the varied experiences of five reference librarians at Murray State University and the challenges faced in incorporating themselves within the fabric of their college. The examinations by each individual will include a brief history of their liaison position, challenges and obstacles encountered, and embedding methods utilized in an attempt to achieve successful assimilation.

Aims and methodA trust-wide survey of all in-patients to estimate the prevalence of likely deprivation of liberty and to investigate how two different approaches to measuring deprivation might affect the number identified.ResultsA notable difference in the results was detected when comparing the two methods. One survey method identified deprivation of liberty factors in 84% of informal incapacitous patients, whereas a different approach that weighed up the factors in accordance with the UK government's interpretation of the case law detected only 11% as potential cases.Clinical implicationsTo be usefully implemented, the deprivation of liberty safeguards require an accurate method of assessment in order to target those the process is designed to protect. This survey demonstrates the difficulties in defining deprivation of liberty and highlights the issue of how it is best measured.

Clear communication between primary and secondary care is essential to prevent prescribing errors, especially in the case of psychiatry where medication is frequently altered and prescribing may be the responsibility of either the GP or the specialist. Here, Dr Robinson describes an audit carried out at the local elderly day treatment service to examine the discrepancies between GPs' records of medication and those of the day service, and to investigate how improvements could be made. Copyright © 2008 Wiley Interface Ltd

This paper will briefly review the utilization of the paraprofessional in a community-based sex offender treatment programme in Merseyside, UK. The paraprofessionals are treated paedophiles in the role of treatment co-facilitators. Further thoughts on the role dynamic, training issues and supervision are discussed. This is an example of service-user involvement in practice.

Flow microcalorimetry has been used to probe acid-base interactions between five-membered-ring heterocyclics and thermally pre-treated, porous silica. The adsorbates (1-methylpyrrolidin-2-one, pyridine, pyrrolidine, pyrrole, 2-methylthiophene, 2-octyl-4-isothiazolin-3-one, 4,5-dichloro-2-octyl-4-isothiazolin-3-one and 2-cyclopentenone,) varied in basicity, polarity and π-character. The amounts of the adsorbates retained by the silica were determined, along with enthalpy of adsorption (ranging from −5.5 kJ mol−1 to −57.8 kJ mol−1) and enthalpy of desorption (ranging from 5.6 kJ mol−1 to 26.1 kJ mol−1). For the majority of the adsorbates the enthalpy of adsorption is consistent with hydrogen bonding to isolated silanols. Although increasing basicity enhanced the adsorption enthalpy and hence the strength of associations, desorption was inhibited when a carbonyl, or unsaturated carbonyl, group was adjacent to the active basic centre. Bulky electron-withdrawing agents (chlorine atoms) substituted at the double bond of the unsaturated carbonyl reduced the adsorption considerably. This was attributed to steric hinderance restricting the proximity of the basic groups with the active silanol sites.

Microwave photoconductivity and photodielectric measurements using a tuned microwave cavity method, operating in real time, were carried out for a series of commercial titanium dioxide (TiO 2 ) pigments. Changes in attenuation of microwave power and resonant frequency were shown to be sensitive to changes in particle size and composition. The data was interpreted by consideration of the relative contribution of excess carriers following saturation of traps during exposure, and the formation of long-lived states that persist during dark storage.

Testicular cancer is the most common cause of death for men aged 19–35 in North America. The mass print and other media are important sources of ‘information’ about a variety of treatment and health-related matters. This article explores the portrayal of testicular cancer in the mass print media from 1980–94. The analysis is both manifest and latent. The manifest analysis indicates the emphasis on early detection. The latent analysis indicates that the disease is described primarily through three different discourses: medical, machismo and social support. Stories of men with testicular cancer emphasize early detection and medical treatment; sports and competitiveness, sexuality, financial acumen, sexual and physical attractiveness and desirability, as well as war and battles; and the importance of social support.

Cognitive impairment is prevalent among cancer patients receiving palliative care. It affects both clinical management and research with these patients. Cognitive impairments can often be reversed by appropriate therapeutic intervention, but many cases of cognitive impairment among palliative care patients will remain undetected by clinical staff unless formal assessment is conducted. Selection of an appropriate method of assessment should be guided by the goal for which assessment is undertaken, the ways in which the special characteristics of palliative care patients constrain the gathering of information, the type of information and the scale of measurement required, the validity, reliability and standardisation of the tests available, and the significance attached to test outcomes.A wide variety of methods for assessing cognitive competence is available. They differ in the type of information provided, the scale of measurement, and the breadth of the skills assessed. Each is most suitable for ...

The effect of transition metal ion doping on the charge carrier dynamics in commercial TiO2 pigments has been investigated. The response to extended polychromatic irradiation was monitored by real-time measurements of microwave photoconductivity and photodielectric effects. In addition to intrinsic differences between the rutile and anatase polymorphs, shifts in the resonance frequency and quality factor of a tuned microwave cavity as a function of annealing, and foreign-ion incorporation provided a gauge of the influence of extrinsic trapping centres on photoactivity. Parallel luminescence studies revealed an extension in the lifetime of the emission band on doping, the energy associated with recombination being independent of the dopant ion. © 1998 Kluwer Academic Publishers

A novel analytical method is described which allows the charge-carrier dynamics taking place when titanium dioxide is subjected to ultrabandgap irradiation to be measured. Samples are exposed continuously to polychromatic light and photophysical processes monitored in real-time. The method relies on the perturbations that take place in the stored energy characteristics of a microwave cavity. In such a device, the electric and magnetic fields of the microwave energy reach a maximum when they are resonant with the cavity. Titanium dioxide powders held in the cavity, and simultaneously irradiated with visible light, produce free-carriers which reduce the stored energy density of the cavity. This results in a shift in the value of the resonant frequency and an attenuation of the microwave power, which are in proportion to the population of free-carriers produced in the sample. The frequency measurements are tempered by the presence of localised (trapped) carriers. Uncoupling the changes in power and frequency allows the dynamics of free and trapped carriers to be quantified. The results derived from this real-time method are consistent with those reported from time-resolved microwave conductivity (TRMC) measurements, which follow the decay of conductivity following a pulse of high intensity light. In addition, the real-time method follows the build-up of charge-carriers during irradiation as well as their decay immediately after irradiation. Data is presented for anatase, rutile and a sample of mixed morphology (75% anatase:25% rutile ). The influences of sample size, humidity, temperature, light-intensity and wavelength on the microwave response, are considered.

This paper addresses two issues: whether there is a developmental trend in suggestibility to misleading post-event information, and whether suggestibility can be reduced by use of part of the cognitive interview. Twenty participants from each of three age groups (four-to-five year olds, eight-to-nine year olds and adults) watched a filmed event, and half of the participants in each age group were subsequently asked to recall everything they had seen using a method derived from the cognitive interview procedure. Following this, all participants were asked questions about the filmed event, some of which incorporated misleading information. Twenty four hours later the witnesses were interviewed again, this time critical questions were included about the truth of the presuppositions introduced in the initial questionnaire. It was found that although the eight-to-nine year olds were more suggestible than adults, the apparent greater suggestibility of very young children (four-to-five years) could potentially be explained in terms of heightened compliance to the perceived demands of the interviewer. The 'be complete' part of the cognitive interview only produced an improvement in performance for the eight-to-nine year olds.

This chapter is intended to provide practical advice for academic librarians with collection development responsibilities in the health sciences, including Nursing and Social Work. Highlighting the processes and procedures at the author’s institution, the chapter will focus on collection development responsibilities that are needed to support both undergraduate and graduate programs in several of the disciplines stated above.

The aim of this naturalistic survey was to measure the prevalence of metabolic syndrome by collating data on routine physical investigation in an acute psychiatric inpatient population. The size of this study is small, but the results offer some interesting and useful preliminary findings, pertinent to the provision of good physical health care to psychiatric inpatients and from which further research could develop.\ud Metabolic syndrome was found in more than a third (38%) of the population studied and was equally prevalent across a variety of psychiatric disorders. A higher trend was found in females than in males, but this figure did not reach statistical significance. Although small, the naturalistic setting of this survey demonstrates the ease with which metabolic syndrome can be opportunely excluded or identified in this vulnerable population, where physical healthcare is often problematic. With the increasing involvement of non-medically qualified practitioners in psychiatric care, simple techniques such as this hold a valuable place in holistic patient management.

Beginning with the launch of the European Columbus module planned for December 2007, we approach a transition in the assembly of the International Space Station (ISS) that is of great importance for the sciences. During the following 18 months, we will operate the first experiments in Columbus physical science resource facilities and also launch and commission the Japanese Kibo module. In addition, two Multi-purpose Logistics Module (MPLM) flights will deliver the U.S. Combustion Integrated Rack (CIR) and Fluids Integrated Rack (FIR) along with their first science experiments. These facilities provide significant new capabilities for basic and applied physical science research in microgravity. New life support technologies will come online throughout 2008, and we will reach the milestone of a 6-person crew planned for April 2009. A larger crew enables significant more scientific use of all the facilities for the life of ISS. Planning for the use of the International Space Station as a national laboratory is also maturing as we near the completion of assembly, enabling access to ISS as a research platform for other government agencies and the private sector. The latest updates on National Laboratory implementation will also be provided in this presentation. At the same time as these significant increases in scientific capability, there have been significant ongoing accomplishments in NASA's early ISS research both exploration related and fundamental research. These accomplishments will be reviewed in context as harbingers of the capabilities of the International Space Station when assembly is complete. The Vision for Space Exploration serves to focus NASA's applied investigations in the physical sciences. However, the broader capability of the space station as a National Laboratory and as a nexus for international collaboration will also influence the study of gravity-dependent processes by researchers around the world.

This report is a compilation and discussion of the findings from AFHS research related to the mortality, reproductive outcomes, and morbidity components of the AFHS. Subsequent to the protocol, published in 1982, the baseline physical examination was conducted in 1982, and follow-up examinations were performed in 1985, 1987, 1992, 1997, and 2002. Findings from technical reports such as the physical examinations, letters to the editor and journal articles published as of 30 September 2006 are described in the appropriate chapters of the report.

Purpose: To (1) characterize epidemiological trends in anterior permanent tooth trauma (2) examine the relationship of crown fractures and root fractures to determine if crown fractures are protective against root fractures (3) determine the diagnostic value of obtaining three periapical radiographic projections to assess potential root fractures. Methods: Two dentists served as expert examiners for the radiographic assessments. Kappa statistics, Pearson's Chi-Square tests and logistic regression analyses were employed. Results: The final sample included 185 teeth. Expert examiners detected: 22 root fractures, 10% of the teeth exhibited root fractures when no crown fractures was documented, and 14% of the teeth had both crown fractures and root fractures as separate entities. Conclusions: Crown fractures were not protective against root fractures. As radiographic projections increased, root fractures were identified more often. Our data support obtaining multiple radiographic projections at different vertical angulations to rule out root fractures in children and adolescents.

Although a familiar concept, clinical supervision has yet to be available to all nurses. This is often due to difficulties in implementation. Having recognised these problems, one acute paediatric ward introduced the role of clinical supervision facilitator. This enabled the introduction of a system of clinical supervision and ensured a sustained change in practice.