The Frequency of Reevaluation or Peak Flow Meter Documentation in Acute Asthma Exacerbations in the Emergency Department: Are We Treating in Accordance with NIH/NAEPP Guidelines?

Objectives: To evaluate the frequency of peak expiratory flow rate (PEFR) measurement and clinical re-evaluation in the management of ED asthmatic patients. Methods: This was a retrospective chart review examining consecutive asthma patients who presented to the University of California Irvine ED between September 1, 2003 and December 31, 2003. Patients were excluded if they had a diagnosis of COPD, lung cancer, pneumonia, congestive heart failure, alpha 1 anti-trypsin deficiency or were under 5 years of age. Data collected included patient demographics, pulse oximetry reading(s), ED treatments rendered, and frequencies of PEFR measurement (pre and post therapy), of clinical re-evaluations in the ED, and of ED return visits. Results: Of the 122 ED visits from 111 patients, 11 (10%) patients returned during the 4 month study period, with 5 patients (4.5%) returning in less than 72 hours. Seven (6.0%) patients had PEFR done both pre and post treatment and 24 (20%) had one or more PEFR performed either before or after treatment. Only 61 (50%) of the visits had a documented clinical re-evaluation prior to disposition. Conclusions: Despite their documented role in asthma treatment algorithms, PEFR was performed infrequently and clinical re-evaluation was documented in only half of cases. Recommended algorithms for asthma management were not commonly followed in this academic ED

LP 133-373: A New Chromospherically Active Eclipsing dMe Binary with a Distant, Cool White Dwarf Companion

We report the discovery of the partially eclipsing binary LP 133-373. Nearly identical eclipses along with observed photometric colors and spectroscopy indicate that it is a pair of chromospherically active dM4 stars in a circular 1.6 day orbit. Light and velocity curve modeling to our differential photometry and velocity data show that each star has a mass and radius of 0:340 ± 0:014 MꙨ and 0:33 ± 0:02 RꙨ. The binary is itself part of a common proper motion pair with LP 133-374, a cool DC or possible DA white dwarf with a mass of 0.49Y0.82 MꙨ, which would make the system at least 3 Gyr old

Constrained sintering kinetics of 3YSZ films

3YSZ green layers approximately 10 μm thick were screen-printed onto 3YSZ substrates and their constrained sintering kinetics were measured at 1100–1350 °C using an optical dilatometer. The densification rates of the same powder in the form of pellets and free-standing films were also measured. The constrained densification rate was greatly retarded compared with the free densification rate at a given temperature and density. The retardation increased with increasing density and temperature and could not be properly accounted for by existing theories of constrained sintering. As a result the apparent activation energy is much lower for constrained sintering (135 ± 20 kJ mol−1) than for free sintering (660 ± 30 kJ mol−1). It is proposed that this is because the constrained microstructure exhibits larger and more widely separated pores at the higher temperatures

Stress induced by constrained sintering of 3YSZ films measured by substrate creep

3YSZ green layers approximately 10 μm thick were screen printed onto 3YSZ substrates up to 300 μm in thickness. The stress induced by constrained sintering of the film (between 1150° and 1350°C) was measured by monitoring the bending displacement of vertical strips of bilayers using a long-distance microscope. In order to deduce the stress it was first necessary to measure the creep properties of the substrates by monitoring the bending of horizontal beams under gravity. The creep strain rate of the 3YSZ substrates was linearly dependent on applied stress at the low stresses and strains involved in the present work. The creep viscosity appeared to increase with strain (time), which might be due to changes in grain-boundary composition, and had higher activation energy at temperatures above approximately 1250°C. The magnitudes of the creep viscosities are in reasonable agreement with other creep data in the literature for 3YSZ. The in-plane stress induced during constrained sintering of the 3YSZ films had a maximum value of approximately 3 MPa at 1200°C. This behavior is consistent with literature results reported for constrained sintering of bulk alumina. The stress induced by the constraint is of a similar order to the estimated sintering potential

The nature of the fungal cargo induces significantly different temporal programmes of macrophage phagocytosis

Acknowledgements We acknowledge Wellcome support of a Senior Investigator (101873/Z/13/Z), Collaborative (200208/A/15/Z) and Strategic Awards (097377/Z11/Z) and the MRC for a programme grant (MR/M026663/2) and the MRC Centre for Medical Mycology (MR/N006364/2). We thank Kevin Mackenzie for help with microscopy.Peer reviewedPublisher PD

Great Canadian Lagerstätten 3. Late Ordovician Konservat-Lagerstätten in Manitoba

Konservat-Lagerstätten, deposits in which soft-bodied or lightly sclerotized fossils are preserved, are very rare in Ordovician strata. Three significant sites are known from Upper Ordovician rocks in Manitoba: at Cat Head – McBeth Point, William Lake, and Airport Cove. These sites are in two distinct sedimentary basins: the former two are in the Williston Basin, while the latter is in the Hudson Bay Basin. All three sites contain marine fossils, but each has a different assemblage that contributes a distinct piece of the diversity picture. Important groups represented at one or more of the sites include seaweeds (algae), sponges, cnidarian medusae (jellyfish), conulariids, trilobites, eurypterids, xiphosurids (horseshoe crabs), and pycnogonids (‘sea spiders’). The different biotas reflect depositional conditions at each site. Many of the fossils are unknown elsewhere in the Ordovician at the family level or higher. The province of Manitoba therefore makes a significant contribution to knowledge of Late Ordovician biodiversity.SOMMAIRELes lagerstätten de conservation, ces sédiments contenant des fossiles d’organismes à corps mou ou légèrement sclérotisés particulièrement bien conservés, sont très rares dans les strates ordoviciennes.  Trois sites d’importance sont connus dans des roches de l'Ordovicien supérieur à Cat Head, Manitoba, soit McBeth Point, William Lake et  Airport Cove.  Ces sites sont situés dans deux bassins sédimentaires distincts : les deux premiers sont situés dans le bassin de Williston, tandis que le second est situé dans le bassin de la baie d'Hudson.  Les trois sites contiennent des fossiles marins, mais chacun présente un assemblage différent, chacun montrant une composante distincte de la diversité biologique d’alors.  Les groupes les plus importants représentés, dans un ou plusieurs de ces sites, sont les algues, les éponges, les cnidarian medusae (méduses), les conularides, les trilobites, les euryptérides, xiphosurides (limules) et pycnogonides.  Les différents biotopes reflètent les conditions de dépôt de chaque site.  Nombre de ces fossiles sont inconnus ailleurs dans l'Ordovicien, au niveau de la famille ou du taxon supérieur de la classification.  Ainsi, la province du Manitoba offre-t-elle une contribution importante à la connaissance de la biodiversité de l'Ordovicien supérieur

Bone morphogenetic protein-2 (BMP-2) and transforming growth factor-β1 (TGF-β1) alter connexin 43 phosphorylation in MC3T3-E1 Cells

BACKGROUND: Bone morphogenetic proteins (BMPs) and transforming growth factor-βs (TGF-βs) are important regulators of bone repair and regeneration. BMP-2 and TGF-β1 have been shown to inhibit gap junctional intercellular communication (GJIC) in MC3T3-E1 cells. Connexin 43 (Cx43) has been shown to mediate GJIC in osteoblasts and it is the predominant gap junctional protein expressed in these murine osteoblast-like cells. We examined the expression, phosphorylation, and subcellular localization of Cx43 after treatment with BMP-2 or TGF-β1 to investigate a possible mechanism for the inhibition of GJIC. RESULTS: Northern blot analysis revealed no detectable change in the expression of Cx43 mRNA. Western blot analysis demonstrated no significant change in the expression of total Cx43 protein. However, significantly higher ratios of unphosphorylated vs. phosphorylated forms of Cx43 were detected after BMP-2 or TGF-β1 treatment. Immunofluorescence and cell protein fractionation revealed no detectable change in the localization of Cx43 between the cytosol and plasma membrane. CONCLUSIONS: BMP-2 and TGF-β1 do not alter expression of Cx43 at the mRNA or protein level. BMP-2 and TGF-β1 may inhibit GJIC by decreasing the phosphorylated form of Cx43 in MC3T3-E1 cells

Exploring the literacy related behaviours and feelings of pupils eligible for free school meals in relation to their use of, and access to, school libraries

Although it has been argued that school libraries are important for supporting the reading engagement of pupils who receive free school meals, to date there has been little analysis of the extent to which use of school library spaces is related to these pupils' reading behaviors. We analyzed data from 6,264 UK children and young people entitled to FSM who completed the 2019 National Literacy Trust Annual Literacy Survey, to understand the extent to which these pupils' engagement with reading and writing is related to access to or use of their school library. We found their enjoyment of both reading and writing, their confidence in their own abilities, and the frequency with which they read or wrote for pleasure outside of school was significantly higher for those pupils eligible for FSM who used their school libraries relative to both those who did not, and those who had no school library. Consistent with this, children eligible for FSM who used their school library engaged with a greater diversity of reading material and writing than those who were not school library users. We argue that school library provision appears to be a significant resource in supporting low income children's engagement with self-motivated literacy practices