Introducing physician assistants into new roles: International experiences

Conference report: The development of physician assistants (PAs) is a phenomenon that has accelerated since the new century and many countries are involved (1). We report on countries that have recently introduced PAs to identify opportunities for improving the transition. The 35th Annual Physician Assistant Conference of the American Academy of Physician Assistant (AAPA) held in Philadelphia, US, May 26-31, 2007 was attended by almost 8,000 delegates including PAs, students, academics and policy makers. The main purposes of this conference were to promote professional development, develop ideas and provide education. It also featured an international forum focusing on global developments

Separate GABA Afferents to Dopamine Neurons Mediate Acute Action of Opioids, Development of Tolerance, and Expression of Withdrawal

SummaryGABA release from interneurons in VTA, projections from the nucleus accumbens (NAc), and rostromedial tegmental nucleus (RMTg) was selectively activated in rat brain slices. The inhibition induced by μ-opioid agonists was pathway dependent. Morphine induced a 46% inhibition of IPSCs evoked from the RMTg, 18% from NAc, and IPSCs evoked from VTA interneurons were almost insensitive (11% inhibition). In vivo morphine treatment resulted in tolerance to the inhibition of RMTg, but not local interneurons or NAc, inputs. One common sign of opioid withdrawal is an increase in adenosine-dependent inhibition. IPSCs evoked from the NAc were potently inhibited by activation of presynaptic adenosine receptors, whereas IPSCs evoked from RMTg were not changed. Blockade of adenosine receptors selectively increased IPSCs evoked from the NAc during morphine withdrawal. Thus, the acute action of opioids, the development of tolerance, and the expression of withdrawal are mediated by separate GABA afferents to dopamine neurons

Distinct regulation of dopamine D2S and D2L autoreceptor signaling by calcium

D2 autoreceptors regulate dopamine release throughout the brain. Two isoforms of the D2 receptor, D2S and D2L, are expressed in midbrain dopamine neurons. Differential roles of these isoforms as autoreceptors are poorly understood. By virally expressing the isoforms in dopamine neurons of D2 receptor knockout mice, this study assessed the calcium-dependence and drug-induced plasticity of D2S and D2L receptor-dependent G protein-coupled inwardly rectifying potassium (GIRK) currents. The results reveal that D2S, but not D2L receptors, exhibited calcium-dependent desensitization similar to that exhibited by endogenous autoreceptors. Two pathways of calcium signaling that regulated D2 autoreceptor-dependent GIRK signaling were identified, which distinctly affected desensitization and the magnitude of D2S and D2L receptor-dependent GIRK currents. Previous in vivo cocaine exposure removed calcium-dependent D2 autoreceptor desensitization in wild type, but not D2S-only mice. Thus, expression of D2S as the exclusive autoreceptor was insufficient for cocaine-induced plasticity, implying a functional role for the co-expression of D2S and D2L autoreceptors

Space radiation health research, 1991-1992

The present volume is a collection of 227 abstracts of radiation research sponsored by the NASA Space Radiation Health Program for the period 1991-1992. Each abstract has been categorized within one of three discipline areas: Physics, Biology and Risk Assessment. Topic areas within each discipline have been assigned as follows: Physics - Atomic Physics, Theory, Cosmic Ray and Astrophysics, Experimental, Environments and Environmental Models, Solar Activity and Prediction, Experiments, Radiation Transport and Shielding, Theory and Model Development, Experimental Studies, and Instrumentation. Biology - Biology, Molecular Biology, Cellular Radiation Biology, Transformation, Mutation, Lethality, Survival, DNA Damage and Repair, Tissue, Organs, and Organisms, In Vivo/In Vitro Systems, Carcinogenesis and Life Shortening, Cataractogenesis, Genetics/Developmental, Radioprotectants, Plants, and Other Effects. Risk Assessment - Risk Assessment, Radiation Health and Epidemiology, Space Flight Radiation Health Physics, Inter- and Intraspecies Extrapolation and Radiation Limits and Standards. Section I contains refereed journals; Section II contains reports/meetings. Keywords and author indices are provided. A collection of abstracts spanning the period 1986-1990 was previously issued as NASA Technical Memorandum 4270

New OH Zeeman measurements of magnetic field strengths in molecular clouds

We present the results of a new survey of 23 molecular clouds for the Zeeman effect in OH undertaken with the ATNF Parkes 64-m radio telescope and the NRAO Green Bank 43-m radio telescope. The Zeeman effect was clearly detected in the cloud associated with the HII region RCW 38, with a field strength of 38+/-3 micro-Gauss, and possibly detected in a cloud associated with the HII region RCW 57, with a field strength of -203+/-24 micro-Gauss. The remaining 21 measurements give formal upper limits to the magnetic field strength, with typical 1-sigma sensitivities <20 micro-Gauss. For 22 of the molecular clouds we are also able to determine thecolumn density of the gas in which we have made a sensitive search for the Zeeman effect. We combine these results with previous Zeeman studies of 29 molecular clouds, most of which were compiled by Crutcher (1999), for a comparsion of theoretical models with the data. This comparison implies that if the clouds can be modeled as initially spherical with uniform magnetic fields and densities that evolve to their final equilibrium state assuming flux-freezing then the typical cloud is magnetically supercritical, as was found by Crutcher (1999). If the clouds can be modeled as highly flattened sheets threaded by uniform perpendicular fields, then the typical cloud is approximately magnetically critical, in agreement with Shu et al. (1999), but only if the true values of the field for the non-detections are close to the 3-sigma upper limits. If instead these values are significantly lower (for example, similar to the 1-sigma limits), then the typical cloud is generally magnetically supercritical.Comment: 39 pages, 7 figures. Accepted for publication in Ap

Studies of Prevention, Treatment and Mechanisms of Heart Failure in the Aging Spontaneously Hypertensive Rat

The spontaneously hypertensive rat (SHR) is an animal model of genetic hypertension which develops heart failure with aging, similar to man. The consistent pattern of a long period of stable hypertrophy followed by a transition to failure provides a useful model to study mechanisms of heart failure with aging and test treatments at differing phases of the disease process. The transition from compensated hypertrophy to failure is accompanied by changes in cardiac function which are associated with altered active and passive mechanical properties of myocardial tissue; these events define the physiologic basis for cardiac decompensation. In examining the mechanism for myocardial tissue dysfunction, studies have demonstrated a central role for neurohormonal activation, and specifically the renin-angiotensin-aldosterone system. Pharmacologic attenuation of this system at differing points in the course of the process suggests that prevention but not reversal of myocardial tissue dysfunction is possible. The roles of the extracellular matrix, apoptosis, intracellular calcium, beta-adrenergic stimulation, microtubules, and oxygen supply-demand relationships in ultimately mediating myocardial tissue dysfunction are reviewed. Studies suggest that while considerable progress has been made in understanding and treating the transition to failure, our current state of knowledge is limited in scope and we are not yet able to define specific mechanisms responsible for tissue dysfunction. It will be necessary to integrate information on the roles of newly discovered, and as yet undiscovered, genes and pathways to provide a clearer understanding of maladaptive remodeling seen with heart failure. Understanding the mechanism for tissue dysfunction is likely to result in more effective treatments for the prevention and reversal of heart failure with aging. It is anticipated that the SHR model will assist us in reaching these important goals.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/45828/1/10741_2004_Article_391524.pd

Universality of Sypersymmetric Attractors

The macroscopic entropy-area formula for supersymmetric black holes in N=2,4,8 theories is found to be universal: in d=4 it is always given by the square of the largest of the central charges extremized in the moduli space. The proof of universality is based on the fact that the doubling of unbroken supersymmetry near the black hole horizon requires that all central charges other than Z=M vanish at the attractor point for N=4,8. The ADM mass at the extremum can be computed in terms of duality symmetric quartic invariants which are moduli independent. The extension of these results for d=5, N=1,2,4 is also reported. A duality symmetric expression for the energy of the ground state with spontaneous breaking of supersymmetry is provided by the power 1/2 (2/3) of the black hole area of the horizon in d=4 (d=5). It is suggested that the universal duality symmetric formula for the energy of the ground state in supersymmetric gravity is given by the modulus of the maximal central charge at the attractor point in any supersymmetric theory in any dimension.Comment: few misprints removed, version to appear in Phys. Rev. 20 pages, 1 figur

Design Considerations for Fire Safety

ERAF: 48415Papers presented at the Symposium on Design Considerations for Fire Safety at the Semiannual Meeting of The American Society of Heating, Refrigerating and Air-conditioning Engineer

Intimate Partner Violence and Abuse Against Men: Voices of Victimization Among Ex-Servicemen of the British Armed Forces

This study presents the personal testimonies of male British ex-Armed Forces personnel who have experienced violence and abuse victimization that was perpetrated by civilian female partners. In this research, we argue that to embark upon any understanding of the domestic lives of military personnel, an appreciation of the linkages to the cultural context of the military institution is necessary. Understanding the influence of the military institution beyond the military domain is crucial. We unveil the nature and character of the violence and abuse and how the servicemen negotiated their relationships. In doing so, we highlight the embodiment of military discipline, skills, and tactics in the home—not ones of violence which may be routinely linked to military masculinities; rather ones of restraint, tolerance, stoicism, and the reduction of a threat to inconsequential individual significance

Unique V3 Loop Sequence Derived from the R2 Strain of HIV-Type 1 Elicits Broad Neutralizing Antibodies

DNA vaccines expressing the envelope (Env) of the human immunodeficiency virus type 1 (HIV-1) have been relatively ineffective at generating high-titer, long-lasting, neutralizing antibodies. In this study, DNA vaccines were constructed to express the gp120 subunit of Env from the isolate HIV-1R2 using both wild-type and codon- ptimized gene sequences. Three copies of the murine C3d were added to the carboxyl terminus to enhance the immunogenicity of the expressed fusion protein. Mice (BALB/c) vaccinated with DNA plasmid expressing the gp120R2 using codon-optimized Env sequences elicited high-titer anti-Env antibodies regardless of conjugation to C3d. In contrast, only mice vaccinated with DNA using wild-type gp120R2 sequences fused to mC3d3, had detectable anti- Env antibodies. Interestingly, mice vaccinated with DNA expressing gp120R2 from codon-optimized sequences elicited antibodies that neutralized both homologous and heterologous HIV-1 isolates. To determine if the unique sequence found in the crown of the V3 loop of the EnvR2 was responsible for the elicitation of the cross-clade neutralizing antibodies, the codons encoding for the Pro-Met (amino acids 313–314) were introduced into the sequences encoding the gp120ADA (R5) or gp12089.6 (R5X4). Mice vaccinated with gp120ADA–mC3d3–DNA with the Pro–Met mutation had antibodies that neutralized HIV-1 infection, but not the gp12089.6–mC3d3–DNA. Therefore, the use of the unique sequences in the EnvR2 introduced into an R5 tropic envelope, in conjunction with C3d fusion, was effective at broadening the number of viruses that could be neutralized. However, the introduction of this same sequence into an R5X4-tropic envelope was ineffective in eliciting improved cross-clade neutralizing antibodies. Originally published AIDS Research and Human Retroviruses, Vol. 20, No. 11, Nov 200