Extension of lymphocyte viability for radiation biodosimetry: Potential implications for radiological/nuclear mass casualty incidents

Dicentric chromosome assay (DCA) is routinely used for estimating the absorbed radiation dose in exposed humans. Optimal lymphocyte viability is crucial for reliable dose estimation and most cytogenetic laboratories prefer the receipt of blood samples within 24 to 36 hours after collection. Delays in the shipment/receipt of samples can occur sometimes under certain unforeseen circumstances: (1) Adverse weather conditions, (2) distant location of blood collection sites, and (3) shipping and handling of a large number of samples after radiological/nuclear mass casualty incident(s). To circumvent some of these limitations, we evaluated the suitability of ex vivo irradiated blood samples stored in the presence of phytohemagglutinin (PHA) for 7 days at ambient temperature (22-24°C) for radiation biodosimetry. Blood samples stored in the presence of PHA for up to 7 days showed a higher mitotic index than blood samples stored without PHA. To verify the use of stored blood samples for DCA, frequencies of X-rays induced dicentric chromosomes were analyzed in the blood samples that were cultured either 24 hours after exposure or 7 days later after storage. Our results indicate that storage of ex vivo irradiated blood samples in the presence of PHA at ambient temperature was found optimal for DCA and that the radiation doses estimated by dicentric chromosome frequencies were grossly similar between the fresh and stored blood samples. Our study suggests that reliable and accurate biodosimetry results can be obtained for triage using blood samples stored for up to a week at ambient temperature in the presence of PHA.     

Positive-pressure ventilation equipment for mass casualty respiratory failure

In the event of an influenza pandemic, patients with severe acute respiratory failure (ARF) due to influenza will require positive-pressure ventilation (PPV) in order to survive. In countries with widely available critical care services, PPV is delivered almost exclusively through use of full-feature mechanical ventilators in intensive care units (ICUs) or specialized hospital wards. But the supply of these ventilators is limited even during the normal course of hospital functioning. Purchasing and maintaining additional full-feature mechanical ventilators to be held in reserve and used only during mass casualty events is too expensive to allow the stockpiling of such equipment. Consequently, planning and preparedness efforts to respond to a severe influenza pandemic have stimulated consideration of limited-feature, less-expensive ventilation devices to augment traditional PPV capacity. This article offers guidance to authorities charged with preparing for mass casualty PPV in deciding which PPV equipment would be adequate for ventilating patients for days, weeks, or even months during a medical catastrophe.     

Cryolumpectomy for breast cancer: an experimental study

The effects of cryosurgical procedures and surgical excision in preventing the local recurrence of mammary adenocarcinoma were studied in BALB/cfC3H mice carrying syngeneic, virus-induced mammary adenocarcinomas transplanted into the fourth mammary fat pad. In this report we present evidence demonstrating that cryosurgical procedures involving multiple freeze-thaw cycles followed by tumor excision markedly reduce the local recurrence rate of mouse mammary cancer. Surgical resection without cryotreatment resulted in an 80% local recurrence rate; in contrast, cryotreatment consisting of three freeze-thaw cycles before excision prevented local tumor recurrence in 70% of the animals. The use of cryotherapy and local excision (cryolumpectomy) in the treatment of human breast cancer is discussed.     

Citizen participation in patient prioritization policy decisions: an empirical and experimental study on patients' characteristics

Health systems worldwide are grappling with the need to control costs to maintain system viability. With the combination of worsening economic conditions, an aging population and reductions in tax revenues, the pressures to make structural changes are expected to continue growing. Common cost control mechanisms, e.g. curtailment of patient access and treatment prioritization, are likely to be adversely viewed by citizens. It seems therefore wise to include them in the decision making processes that lead up to policy changes. In the context of a multilevel iterative mixed-method design a quantitative survey representative of the German population (N = 2031) was conducted to probe the acceptance of priority setting in medicine and to explore the practicability of direct public involvement. Here we focus on preferences for patients' characteristics (medical aspects, lifestyle and socio-economic status) as possible criteria for prioritizing medical services. A questionnaire with closed response options was fielded to gain insight into attitudes toward broad prioritization criteria of patient groups. Furthermore, a discrete choice experiment was used as a rigorous approach to investigate citizens' preferences toward specific criteria level in context of other criteria. Both the questionnaire and the discrete choice experiment were performed with the same sample. The citizens' own health and social situation are included as explanatory variables. Data were evaluated using corresponding analysis, contingency analysis, logistic regression and a multinomial exploded logit model. The results show that some medical criteria are highly accepted for prioritizing patients whereas socio-economic criteria are rejected.     

Amenity and ecological management: A framework for policy and practice

Amenity is a term that has re‐emerged within both public policy and environmental management organisations in response to an increasing emphasis on the human benefits derived from ecosystems. However, practical implementation of amenity management has been difficult due to a lack of definitional clarity within operational and academic literature. This article discusses the need for definitional clarity and understanding of the component elements of amenity that are integral to ecological management and reviews the literature on the perceptions and definitions of amenity in varied contexts. This study argues that positive perceptions of amenity benefits of a place are influenced by both physical elements such as sight, sound and smell and social elements such as age, education and cultural values. These elements should be considered by management agencies in a structured manner in order for the full potential of amenity to be realised. We present a conceptual framework to provide definitional clarity to the concept of amenity and highlight the interactions among its constituent elements. For the management of human‐dominated landscapes, considering the relationship between amenity and biodiversity may improve the integration of ecological and social goals.     

A nationwide school fruit and vegetable policy and childhood and adolescent overweight: A quasi-natural experimental study

BackgroundSchool free fruit and vegetable (FFV) policies are used to promote healthy dietary habits and tackle obesity; however, our understanding of their effects on weight outcomes is limited. We assess the effect of a nationwide FFV policy on childhood and adolescent weight status and explore heterogeneity by sex and socioeconomic position.Methods and findingsThis study used a quasi-natural experimental design. Between 2007 and 2014, Norwegian combined schools (grades 1–10, age 6 to 16 years) were obligated to provide FFVs while elementary schools (grades 1–7) were not. We used 4 nationwide studies (n = 11,215 children) from the Norwegian Growth Cohort with longitudinal or cross-sectional anthropometric data up to age 8.5 and 13 years to capture variation in FFV exposure. Outcomes were body mass index standard deviation score (BMI_SDS), overweight and obesity (OW/OB), waist circumference (WC), and weight to height ratio (WtHR) at age 8.5 years, and BMI_SDS and OW/OB at age 13 years. Analyses included longitudinal models of the pre- and post-exposure trajectories to estimate the policy effect. The participation rate in each cohort was >80%, and in most analyses <4% were excluded due to missing data. Estimates were adjusted for region, population density, and parental education. In pooled models additionally adjusted for pre-exposure BMI_SDS, there was little evidence of any benefit or unintended consequence from 1–2.5 years of exposure to the FFV policy on BMI_SDS, OW/OB, WC, or WtHR in either sex. For example, boys exposed to the FFV policy had a 0.05 higher BMI_SDS (95% CI: −0.04, 0.14), a 1.20-fold higher odds of OW/OB (95% CI: 0.86, 1.66) and a 0.3 cm bigger WC (95% CI: −0.3, 0.8); while exposed girls had a 0.04 higher BMI_SDS (95% CI: −0.04, 0.13), a 1.03 fold higher odds of OW/OB (95% CI: 0.75, 1.39), and a 0-cm difference in WC (95% CI: −0.6, 0.6). There was evidence of heterogeneity in the policy effect estimates at 8.5 years across cohorts and socioeconomic position; however, these results were inconsistent with other comparisons. Analysis at age 13 years, after 4 years of policy exposure, also showed little evidence of an effect on BMI_SDS or OW/OB. The main limitations of this study are the potential for residual confounding and exposure misclassification, despite efforts to minimize their impact on conclusions.ConclusionsIn this study we observed little evidence that the Norwegian nationwide FFV policy had any notable beneficial effect or unintended consequence on weight status among Norwegian children and adolescents.

Bente Øvrebø and colleagues assess whether a nationwide free school fruit and vegetable policy was associated with weight outcomes in children and early adolescents in Norway.     

An experimental study of mass diffusion and reaction rate in an anaerobic biofilm

An experimental reactor consisting of two chambers, separated by a porous ceramic immobilization matrix, was constructed to measure the effective diffusivity of different compounds and the consumption rates of acetate in developing biofilms. In initial experiments, effective diffusivities for acetate, propionate, isopropanol, and lithium salt through the ceramic immobilization matrix in the absence of biofilm were determined to be 40% to 50% less than in water at infinite dilution. The effective diffusivity of the lithium salt was similar to that of acetate. The effective diffusivity of the lithium salt through biofilms of thickness in the range of 200 to 1200 mum was essentially constant with a value of approximately 7% of that in water at infinite dilution. Acetate consumption in the biofilm was linearly proportional to biofilm thickness up to a biofilm depth of 800 mum. Deviation from linearity appeared in biofilm thicknesses greater than 800 mum. Results of these experiments support previous reports that immobilized cell reactors have significantly higher bioconversion rates than suspended cell systems.     

Introducing an inquiry-based experiment-integrated science game for elementary students: the shadow races game

Abstract

This article introduces a science game which can be used for innovative teaching and as an assessment tool. The Shadow Races Game is designed for first and second grade students to learn the phenomenon of shadow through inquiry-based activities and questions that require the children to apply inferences from those activities. In this amusing board game, students will discover the relationship between light, objects and shadows using familiar objects.     

A numerical and experimental study of mass transfer in the artificial kidney

To develop a more efficient and optimal artificial kidney, many experimental approaches have been used to study mass transfer inside, outside, and cross hollow fiber membranes with different kinds of membranes, solutes, and flow rates as parameters. However, these experimental approaches are expensive and time consuming. Numerical calculation and computer simulation is an effective way to study mass transfer in the artificial kidney, which can save substantial time and reduce experimental cost. This paper presents a new model to simulate mass transfer in artificial kidney by coupling together shell-side, lumen-side, and transmembrane flows. Darcy's equations were employed to simulate shell-side flow, Navier-Stokes equations were employed to simulate lumen-side flow, and Kedem-Katchalsky equations were used to compute transmembrane flow. Numerical results agreed well with experimental results within 10% error. Numerical results showed the nonuniform distribution of flow and solute concentration in shell-side flow due to the entry/exit effect and Darcy permeability. In the shell side, the axial velocity in the periphery is higher than that in the center. This numerical model presented a clear insight view of mass transfer in an artificial kidney and may be used to help design an optimal artificial kidney and its operation conditions to improve hemodialysis.     

Why not lie? Costs enforce honesty in an experimental signalling game

Communication depends on reliability. Yet, the existence of stable honest signalling presents an evolutionary puzzle. Why should animals signal honestly in the face of a conflict of interest? While students of animal signalling have offered several theoretical answers to this puzzle, the most widely studied model, commonly called the ‘handicap principle’, postulates that the costs of signals stabilize honesty. This model is the motivating force behind an enormous research enterprise that explores signal costs—whether they are physiological, immunological, neural, developmental or caloric. While there can be no question that many signals are costly, we lack definitive experimental evidence demonstrating that costs stabilize honesty. This study presents a laboratory signalling game using blue jays (Cyanocitta cristata) that provides, to our knowledge, the first experimental evidence showing honesty persists when costs are high and disappears when costs are low.     

Critical issues in preparing for a mass casualty event: highlights from a new community planning guide

To assist community planners in allocating scarce resources in a mass casualty event, the Department of Health and Human Services' Agency for Healthcare Research and Quality (AHRQ) and the Office of the Assistant Secretary for Preparedness and Response collaborated with leading experts on a series of issue papers on preparedness and response. These papers were presented at an expert meeting in Washington, DC, in June 2006. The papers, revised based on meeting discussions, have been published by AHRQ as Mass Medical Care with Scarce Resources: A Community Planning Guide.     

Deliberate self-poisoning: a study in London casualty departments.

During a prospective study of the whole spectrum of drug-related problems treated in one month by 62 casualty departments in the Greater London area, 949 cases of deliberate self-poisoning were identified. Nearly three-quarters of the patients were under the age of 40 years and in all age groups women outnumbered men. Psychoactive drugs of some sort were used in 673 incidents (71%) and ordinary analgesics and other drugs were used in 252 (27%). The incidence of polydrug overdose (423; 45%) was much higher than that found in other studies. In at least 256 incidents (27%) there was a history of repeated overdose in the previous 12 months. Comparison with other studies showed a steady decline in the use of barbiturates in deliberate self-poisoning but an increase in the use of non-barbiturate hypnotics, minor tranquilisers, and antidepressants.     

A management policy for sika deer based on sex-specific hunting

We consider here a management policy for a sika deer (Cervus nippon) population in the eastern part of Hokkaido. Deer populations are characterized by a large intrinsic rate of population increase, no significant density effects on population growth before population crash, and a relatively simple life history. Our goals of management for the deer population are (1) to avoid irruption with severe damage to agriculture and forestry, (2) to avoid the risk of extinction of the deer population, and (3) to maintain a sustainable yield of deer. To make a robust program on the basis of uncertain information about the deer population, we consider three levels of relative population size and four levels of hunting pressures. We also take into consideration a critical level for extinction, an optimal level, and an irruption level. The hunting pressure for females is set to increase with the population size. We also recommend catching males if the population size is between the critical and optimal levels and catching females and males if the population size is larger than the optimal level. We must avoid cases of irruption or threatened population under various sets of uncertain parameter values. The simulation results suggest that management based on sex-specific hunting is effective to diminish the annual variation in hunting yield. Received: April 8, 1998 / Accepted: December 25, 1998     

The temporalis myo-osseous flap: an experimental study

The present paper investigates the anatomy and vascularization of the temporalis myo-osseous flap. This is a calvarial bone flap that employs temporalis muscle and its distal pericranial extension as a pedicle. In six human cadavers the flap was raised as an island on the anterior deep temporal artery after transecting the zygomatic arch and coronoid process. Maximal mobilization was thus obtained, allowing rotation of the flap into the mouth for intraoral reconstruction. The arc of rotation and potential surgical applications were noted. A comparative study of the temporalis myo-osseous flap and free calvarial bone graft was then conducted in a rabbit model. Vascularization of the calvarial bone flap was confirmed by technetium scintigraphy performed on the first postoperative day. The uptake of fluorochrome labels immediately after transfer verified the adequacy of the periosteal circulation in maintaining viability and new osteoid formation throughout the full thickness of calvarial bone. The transplantation of free calvarial bone grafts was followed by necrosis of most cellular elements. This was demonstrated by an absence of fluorochrome uptake up to 19 days postoperatively and a predominance of empty lacunae and nonviable marrow.     

Competition for pulsed resources: an experimental study of establishment and coexistence for an arid-land grass

In arid environments, episodically-pulsed resources are important components of annual water and nutrient supply for plants. This study set out to test whether seedlings have an increased capacity for using pulsed resources, which might then improve establishment when in competition with older individuals. A second aim was to determine whether there is a trade-off in competitive strategies when resources are supplied continuously at low concentrations, or as pulses with pronounced inter-pulse periods. A glasshouse experiment used a target-neighbour design of size-asymmetric competition, with juveniles of Panicum antidotale (blue panicgrass) introduced into contrasting densities of adult plants. Stable isotopes of nitrogen were used for measuring plant resource uptake from pulses, and tolerance to inter-pulse conditions was assessed as the mean residence time (MRT) of nitrogen. A higher root/shoot ratio and finer root system enhanced the capacity of juveniles to use resources when pulsed, rather than when continuously supplied. Higher resource uptake during pulses improved the establishment of juvenile Panicum in mixed cultures with older individuals. However, a trade-off was observed in plant strategies, with juveniles showing a lower MRT for nitrogen, which suggested reduced tolerance to resource deficit during inter-pulse periods. Under field conditions, higher utilization of pulsed resources would lead to the improved seedling establishment of Panicum adjacent to “nurse” plants, whereas mature plants with well-developed roots, exploiting a greater soil volume, maintain more constant resource uptake and retention during inter-pulse periods.     

Interlaboratory comparison of the dicentric chromosome assay for radiation biodosimetry in mass casualty events

This interlaboratory comparison validates the dicentric chromosome assay for assessing radiation dose in mass casualty accidents and identifies the advantages and limitations of an international biodosimetry network. The assay's validity and accuracy were determined among five laboratories following the International Organization for Standardization guidelines. Blood samples irradiated at the Armed Forces Radiobiology Research Institute were shipped to all laboratories, which constructed individual radiation calibration curves and assessed the dose to dose-blinded samples. Each laboratory constructed a dose-effect calibration curve for the yield of dicentrics for (60)Co gamma rays in the 0 to 5-Gy range, using the maximum likelihood linear-quadratic model, Y = c + alphaD + betaD(2). For all laboratories, the estimated coefficients of the fitted curves were within the 99.7% confidence intervals (CIs), but the observed dicentric yields differed. When each laboratory assessed radiation doses to four dose-blinded blood samples by comparing the observed dicentric yield with the laboratory's own calibration curve, the estimates were accurate in all laboratories at all doses. For all laboratories, actual doses were within the 99.75% CI for the assessed dose. Across the dose range, the error in the estimated doses, compared to the physical doses, ranged from 15% underestimation to 15% overestimation.