2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease

The recommendations listed in this document are, whenever possible, evidence based. An extensive evidence review was conducted as the document was compiled through December 2008. Repeated literature searches were performed by the guideline development staff and writing committee members as new issues were considered. New clinical trials published in peer-reviewed journals and articles through December 2011 were also reviewed and incorporated when relevant. Furthermore, because of the extended development time period for this guideline, peer review comments indicated that the sections focused on imaging technologies required additional updating, which occurred during 2011. Therefore, the evidence review for the imaging sections includes published literature through December 2011

EFFECTS OF EXPERIMENTALLY INCREASED TESTOSTERONE ON MOVEMENT AND THE EFFECTS OF SEX AND AGE ON RELATIVE CORTICAL VOLUMES IN THE NORTHERN PACIFIC RATTLESNAKE (CROTALUS O. OREGANUS)

ABSTRACT Effects of Experimentally Increased Testosterone on Movement and the Effects of Sex and Age on Relative Cortical Volumes in the Northern Pacific Rattlesnake (Crotalus o. oreganus) Julius A. Frazier Hormones have been shown to play a crucial role in vertebrate reproductive behaviors. Androgens such as testosterone (T) stimulate male sexual behaviors such as mate-searching. Increases in movement and sex differences in navigational demands associated with increased movement are positively related to the volumes of cortical brain regions associated with navigational ability. In mammals and birds, the development and morphology of the hippocampal region, a structure within the forebrain, has been shown to play an important role in spatial learning, memory, and navigational ability. The medial cortex (MC), dorsal cortex (DC) and lateral cortex (LC) of non-avian reptiles are putative homologues to the avian hippocampus. This study sought to investigate the role of T in movement patterns displayed by free-ranging Northern Pacific Rattlesnakes (Crotalus o. oreganus) by utilizing a combined observational and experimental approach. Twenty two adult male rattlesnakes were radio-tracked for four months. At the time of radio-transmitter implantation, twelve of the 22 snakes were randomly selected to receive testosterone implants (T-implanted group) and the remaining 10 snakes received blank implants (control group). We also quantified changes in concentrations of corticosterone (CORT) because CORT can suppress the gonadal axis, thereby functioning to inhibit gonadal hormone release and suppressing the stimulatory effects of T. In order to monitor plasma hormone concentrations over time, we collected blood samples at three times intervals throughout the study. Within the control group, T concentration was significantly positively correlated with several of our movement parameters. Conversely, within the T-implanted group, T concentration was not correlated with any of the movement parameters. Additionally, we sought to investigate whether the difference in spatial ecology and associated navigational demands between the sexes is reflected in the relative volume of the MC, DC, and LC, and if sex differences in the relative volume of cortices are present from birth or develop later in life. For comparisons of adult DC, MC, and LC between the sexes, thirteen adult C. o. oreganus (6 females and 7 males) were collected in early May. In addition, two pregnant females were collected in early August of 2009 and held in the laboratory until parturition. A total of ten neonates (5 females and 5 males) were produced from the two litters. No sex differences in relative DC, MC, or LC were detected in adult or in neonatal rattlesnakes. Overall telencephalon volume was affected by sex in adult rattlesnakes (males larger) but not in neonates. By utilizing a combined descriptive and experimental approach, we have shown that naturally occurring elevations in T are positively associated with certain measures of movement and home range size. Failure of exogenous T in eliciting increases in movement suggests a steroid binding protein or T receptor saturation point. We show a non-significant trend in support of a complex relationship between the gonadal and adrenal systems, with experimentally increased T concentrations associated with a small increase in CORT. Finally, we suggest that changes in cortical volumes of C. o. oreganus are seasonal and occur over a relatively short time period. Results of this study highlight the need for further investigation into the timing and seasonality of volumetric changes in cortical volumes of reptiles, the mechanisms behind such changes, and further investigation into the neurological morphology of neonatal reptiles

Experimentally Altered Navigational Demands Induce Changes in the Cortical Forebrain of Free-Ranging Northern Pacific Rattlesnakes \u3cem\u3e(Crotalus o. oreganus)\u3c/em\u3e

The hippocampus of birds and mammals plays a crucial role in spatial memory and navigation. The hippocampus exhibits plasticity in adulthood in response to diverse environmental factors associated with spatial demands placed on an animal. The medial and dorsal cortices of the telencephalon of squamate reptiles have been implicated as functional homologues to the hippocampus. This study sought to experimentally manipulate the navigational demands placed on free-ranging northern Pacific rattlesnakes (Crotalus o. oreganus) to provide direct evidence of the relationship between spatial demands and neuroplasticity in the cortical telencephalon of the squamate brain. Adult male rattlesnakes were radio-tracked for 2 months, during which time 1 of 3 treatments was imposed weekly, namely 225-meter translocation in a random direction, 225-meter walk and release at that day’s capture site (handling control) or undisturbed (control). Snakes were then sacrificed and the brains were removed and processed for histological analysis of cortical features. The activity range was larger in the translocated (Tr) group compared to the handled (Hd) and undisturbed control (Cn) groups when measured via 95% minimum convex polygon (MCP). At the 100% MCP level, Tr snakes had larger activity ranges than the Cn snakes only. The volume of the medial cortex (MC) was larger in the Tr group compared to the Cn group. The MC of Hd snakes was not significantly different from that of either of the other groups. No differences in dorsal cortex (DC) or lateral cortex volumes were detected among the groups. Numbers of 5-bromo-2′-deoxyuridine (BrdU)-labeled cells in the MC and DC 3 weeks after BrdU injection were not affected by treatment. This study establishes a causal relationship between navigational demands and greater MC volume in a free-ranging reptile

Tiger Woods and the New Racial Order

There is no more serviceable celebrity than Tiger Woods. He is a colour- free emblem of a new America in which racism is dead and there are no barriers to progress for any member of its citizenry – a new racial order. His success obscures the grimmer reality of contemporary America. This article examines Woods, less as a person, more as a commodity of immense utility: something that effectively advertises a society that has long struggled with the issue of racism, but has finally won. Woods functions as ambulant publicity: he studiously avoids engaging with any political or remotely sensitive issue and refuses to align him- self with any particular ethnic group. In a sense, he is what one writer has called ‘a new kind of white person’. On the evidence presented here, Woods effectively invites consumers not to challenge racism directly, but to buy commodities that externalize success and in this way avoid confronting the racism that continues to bedevil most of America’s black population