A survey of 557 GHz water vapor emission in the NGC 1333 molecular cloud

Using NASA\u27s Submillimeter Wave Astronomy Satellite (SWAS), we have examined the production of water in quiescent and shocked molecular gas through a survey of the 556.936 GHz 110-101 transition of ortho-H2O in the NGC 1333 molecular core. These observations reveal broad emission lines associated with the IRAS 2, IRAS 4, IRAS 7, and HH 7-11 outflows. Toward three positions we detect narrow (Δv ~ 2-3 km s-1) emission lines clearly associated with the ambient gas. The SWAS observations, with a resolution of ~4\u27, are supplemented with observations from the Infrared Space Observatory (ISO) and by an unbiased survey of a ~17\u27 × 15\u27 area, with ~50\u27\u27 resolution, in the low-J transitions of CO, 13CO, C18O, N2H+, CH3OH, and SiO. Using these combined data sets, with consistent assumptions, we find beam-averaged ortho-H2O abundances of greater than 10-6 relative to H2 for all four outflows. A comparison of SWAS and ISO water data is consistent with nondissociative shock models, provided the majority of the ortho-H2O (110-101) emission arises from cool postshock material with enhanced abundances. In the ambient gas the ortho-H2O abundance is found to lie between 0.1 × 10-7 and 1 × 10-7 relative to H2 and is enhanced when compared to cold prestellar molecular cores. A comparison of the water emission with tracers of dense condensations and shock chemistry finds no clear correlation. However, the water emission appears to be associated with the presence of luminous external heating sources that power the reflection nebula and the photodissociation region (PDR). Simple PDR models are capable of reproducing the water and high-J 13CO emission, suggesting that a PDR may account for the excitation of water in low-density undepleted gas, as suggested by Spaans & van Dishoeck

Cross-sectional evaluation of a longitudinal consultation skills course at a new UK medical school

Background: Good communication is a crucial element of good clinical care, and it is important to provide appropriate consultation skills teaching in undergraduate medical training to ensure that doctors have the necessary skills to communicate effectively with patients and other key stakeholders. This article aims to provide research evidence of the acceptability of a longitudinal consultation skills strand in an undergraduate medical course, as assessed by a cross-sectional evaluation of students' perceptions of their teaching and learning experiences. Methods: A structured questionnaire was used to collect student views. The questionnaire comprised two parts: 16 closed questions to evaluate content and process of teaching and 5 open-ended questions. Questionnaires were completed at the end of each consultation skills session across all year groups during the 2006-7 academic year (5 sessions in Year 1, 3 in Year 2, 3 in Year 3, 10 in Year 4 and 10 in Year 5). 2519 questionnaires were returned in total. Results: Students rated Tutor Facilitation most favourably, followed by Teaching, then Practice & Feedback, with suitability of the Rooms being most poorly rated. All years listed the following as important aspects they had learnt during the session: • how to structure the consultation • importance of patient-centredness • aspects of professionalism (including recognising own limits, being prepared, generally acting professionally). All years also noted that the sessions had increased their confidence, particularly through practice. Conclusions: Our results suggest that a longitudinal and integrated approach to teaching consultation skills using a well structured model such as Calgary-Cambridge, facilitates and consolidates learning of desired process skills, increases student confidence, encourages integration of process and content, and reinforces appreciation of patient-centredness and professionalism

Photodissociation and the Morphology of HI in Galaxies

Young massive stars produce Far-UV photons which dissociate the molecular gas on the surfaces of their parent molecular clouds. Of the many dissociation products which result from this ``back-reaction'', atomic hydrogen \HI is one of the easiest to observe through its radio 21-cm hyperfine line emission. In this paper I first review the physics of this process and describe a simplified model which has been developed to permit an approximate computation of the column density of photodissociated \HI which appears on the surfaces of molecular clouds. I then review several features of the \HI morphology of galaxies on a variety of length scales and describe how photodissociation might account for some of these observations. Finally, I discuss several consequences which follow if this view of the origin of HI in galaxies continues to be successful.Comment: 18 pages, 7 figures in 8 files, invited review paper for the conference "Penetrating Bars Through Masks of Cosmic Dust: The Hubble Tuning Fork Strikes a New Note", South Africa, June 2004. Proceedings to be published by Kluwer, eds. D.L. Block, K.C. Freeman, I. Puerari, R. Groess, & E.K. Bloc

Transforming growth factor and intercellular communication in tubular epithelial cells: a role in diabetic nephropathy.

Aims: Changes in cell-to-cell communication have been linked to several secondary complications of diabetes, including diabetic nephropathy. This study examines a role for glucose-evoked changes in the beta1 isoform of the pro-fibrotic cytokine transforming growth factor (TGFβ1), on connexin expression, gap-junction mediated intercellular communication and hemi-channel mediated ATP release from epithelial cells of the proximal tubule. Methods: Connexin-26 and connexin-43 expression was assessed by immunoblot analysis in human kidney (HK2) tubular epithelial cells treated with TGFβ1 (2-10ng/mL) for 48hrs. Whole cell paired-patch electrophysiology assessed junctional conductance between TGFβ1 treated HK2 cells. Hemi-channel opening was determined by carboxyfluorescein uptake, whilst bio-sensing was used to determine real-time ATP release. Results: Immunoblotting confirmed that TGFβ1 down-regulates connexin-26 to 72.7±13.3%, 71.6±4.8%, and 58.3±5.7% of control and connexin-43 to 61.2±10.4%, 49.5±6.1%, and 48.1±3.8% at 2, 4 and 10 ng/mL respectively. TGFβ1 significantly decreased junctional conductance at 48hrs (1.15±0.9nS compared to 4.5±1.3nS in control cells n=5; P<0.05), whilst carboxyfluorescein uptake increased 346±33% in TGFβ1-treated (10ng/mL) cells. A response inhibited by the hemi-channel blocker carbenoxolone (200µM, 30mins). Bio-sensing confirmed that increased channel opening was paralleled by elevated ATP release following 48hr TGFβ1 treatment (1.99±0.47µM compared to a control 0.29± 0.06µM, P<0.01, n=3). Conclusions: The current study suggests that acute 48hr application of the pro-fibrotic cytokine reduces connexin-mediated intercellular communication in proximal tubular epithelial cells in favour of hemi-channel mediated ATP release. The rise in intercellular ATP may contribute to tubular fibrosis in the diabetic kidney. Acknowledgement: This work is supported by Diabetes UK (BDA:11/0004215, BDA:16/0005427

Waves on the surface of the Orion molecular cloud

Massive stars influence their parental molecular cloud, and it has long been suspected that the development of hydrodynamical instabilities can compress or fragment the cloud. Identifying such instabilities has proved difficult. It has been suggested that elongated structures (such as the `pillars of creation') and other shapes arise because of instabilities, but alternative explanations are available. One key signature of an instability is a wave-like structure in the gas, which has hitherto not been seen. Here we report the presence of `waves' at the surface of the Orion molecular cloud near where massive stars are forming. The waves seem to be a Kelvin-Helmholtz instability that arises during the expansion of the nebula as gas heated and ionized by massive stars is blown over pre-existing molecular gas.Comment: Preprint of publication in Natur

Bridging Time Scales in Cellular Decision Making with a Stochastic Bistable Switch

Cellular transformations which involve a significant phenotypical change of the cell's state use bistable biochemical switches as underlying decision systems. In this work, we aim at linking cellular decisions taking place on a time scale of years to decades with the biochemical dynamics in signal transduction and gene regulation, occuring on a time scale of minutes to hours. We show that a stochastic bistable switch forms a viable biochemical mechanism to implement decision processes on long time scales. As a case study, the mechanism is applied to model the initiation of follicle growth in mammalian ovaries, where the physiological time scale of follicle pool depletion is on the order of the organism's lifespan. We construct a simple mathematical model for this process based on experimental evidence for the involved genetic mechanisms. Despite the underlying stochasticity, the proposed mechanism turns out to yield reliable behavior in large populations of cells subject to the considered decision process. Our model explains how the physiological time constant may emerge from the intrinsic stochasticity of the underlying gene regulatory network. Apart from ovarian follicles, the proposed mechanism may also be of relevance for other physiological systems where cells take binary decisions over a long time scale.Comment: 14 pages, 4 figure

An international comparative study of blood pressure in populations of European vs. African descent

Background: The consistent finding of higher prevalence of hypertension in US blacks compared to whites has led to speculation that African-origin populations are particularly susceptible to this condition. Large surveys now provide new information on this issue. Methods: Using a standardized analysis strategy we examined prevalence estimates for 8 white and 3 black populations (N = 85,000 participants). Results: The range in hypertension prevalence was from 27 to 55% for whites and 14 to 44% for blacks. Conclusions: These data demonstrate that not only is there a wide variation in hypertension prevalence among both racial groups, the rates among blacks are not unusually high when viewed internationally. These data suggest that the impact of environmental factors among both populations may have been under-appreciated

Neoadjuvant endocrine therapy in primary breast cancer: indications and use as a research tool

Neoadjuvant endocrine therapy has been increasingly employed in clinical practice to improve surgical options for postmenopausal women with bulky hormone receptor-positive breast cancer. Recent studies indicate that tumour response in this setting may predict long-term outcome of patients on adjuvant endocrine therapy, which argues for its broader application in treating hormone receptor-positive disease. From the research perspective, neoadjuvant endocrine therapy provides a unique opportunity for studies of endocrine responsiveness and the development of novel therapeutic agents

Risk of death in the long QT syndrome when a sibling has died

BACKGROUND: Sudden death of a sibling is thought to be associated with greater risk of death in long QT syndrome (LQTS). However, there is no evidence of such an association. OBJECTIVE: This study sought to test the hypothesis that sudden death of a sibling is a risk factor for death or aborted cardiac arrest (ACA) in patients with LQTS. METHODS: We examined all probands and first-degree and second-degree relatives in the International Long QT Registry from birth to age 40 years with QTc >/= 0.45 s. Covariates included sibling death, QTc, gender by age, syncope, and implantable cardioverter-defibrillator (ICD) and beta-blocker treatment. End points were (1) severe events (ACA, LQTS-related death) and (2) any cardiac event (syncope, ACA, or LQTS-related death). RESULTS: Of 1915 subjects, 270 had a sibling who died. There were 213 severe events and 829 total cardiac events. More subjects with history of sibling death received beta-blocker therapy. Sibling death was not significantly associated with risk of ACA or LQTS-related death, but was associated with increased risk of syncope. QTc >/= 0.53 s (hazard ratio 2.5, P <.01), history of syncope (hazard ratio 6.1, P <.01), and gender were strongly associated with risk of ACA or LQTS-related death. CONCLUSION: Sudden death of a sibling prompted more aggressive treatment but did not predict risk of death or ACA, whereas QTc >/= 0.53 s, gender, and syncope predicted this risk. All subjects should receive appropriate beta-blocker therapy. The decision to implant an ICD should be based on an individual's own risk characteristics (QTc, gender, and history of syncope)