Studies on the development of the upper air passages

In this paper the writer proposes to give an account of the development of the nose, mouth, and pharynx. The methods of research employed in this piece of work have been mainly the use of wax plate reconstructions, while some embryos have been examined by the microscope alone. However, as the number of human embryos available was very limited, one has had to fall back on the literature for descriptions of some of the stages. It has been found necessary for the sake of clearness to repeat some of the facts occasionally.(1) The tongue is developed from three roots, vi+ tuberculum impar, lateral tongue rudiments and copulei The tuberculum impar is itself mainly derive4 from the first pair of arches, and ultimately forms triangular area on the dorsum of the tongue in front of the foramen caecum. The lateral tongue rudiments grow up from the anterior edges of the first arches and enclose the tip of the tuberculum impar betweén them. The tip and sides of the tongue are formed by the lateral tongue rudiments. The copula is a swell - ong caused by the union of the second arches in the middle line. It along with the parts of the second arches immediately lateral to it form the tongue root, i.e, the portion between the foramen caecum and the epiglottis.In this way the whole of the tongue in front of the foramen caecum is derived from the first arch, while behind the foramen caecum it is derived from the second arch.(2) The epiglottis is developed from the third arches and the arytenoid tubercles from the fourth and fifth arches.('3) The palatal processes, from which most of the permanent palate develops, are derived partly from the maxillary processes but also to a large extent directly from the mandibular arch.(4) The middle ear and. Eustachian tube are level oiled from the dorsal extensions of the first. and second visceral pouches. Thus elements of the first, second and third arches enter into the composition of its walls.(5) The faucial tonsil is developed from the remains of the second and appears a considerable time before the pharyngeal tonsil.(6) Median diverticula in the posterior pharyngeal wall near the mouth of the oesophagus are a common occurrence in the pig and may also occur in the human embryo. Their position is pretty constant in the pig, viz. between the third. and fourth visceral pouches. They are situated in a position in which malignant disease is very liable to occur and where the so called. "pressure pouches" are not uncommon. These facts are sufficient to suggest that there may be an embryological element in the - causation of the pharyngo-oesophageal diverticula met with occasionally in the adult

Radiation Tolerance of Fully-Depleted P-Channel CCDs Designed for the SNAP Satellite

Thick, fully depleted p-channel charge-coupled devices (CCDs) have been developed at the Lawrence Berkeley National Laboratory (LBNL). These CCDs have several advantages over conventional thin, n-channel CCDs, including enhanced quantum efficiency and reduced fringing at near-infrared wavelengths and improved radiation tolerance. Here we report results from the irradiation of CCDs with 12.5 and 55 MeV protons at the LBNL 88-Inch Cyclotron and with 0.1-1 MeV electrons at the LBNL Co60 source. These studies indicate that the LBNL CCDs perform well after irradiation, even in the parameters in which significant degradation is observed in other CCDs: charge transfer efficiency, dark current, and isolated hot pixels. Modeling the radiation exposure over a six-year mission lifetime with no annealing, we expect an increase in dark current of 20 e/pixel/hr, and a degradation of charge transfer efficiency in the parallel direction of 3e-6 and 1e-6 in the serial direction. The dark current is observed to improve with an annealing cycle, while the parallel CTE is relatively unaffected and the serial CTE is somewhat degraded. As expected, the radiation tolerance of the p-channel LBNL CCDs is significantly improved over the conventional n-channel CCDs that are currently employed in space-based telescopes such as the Hubble Space Telescope.Comment: 11 pages, 10 figures, submitted to IEEE Transaction

A comparative study of Australian and New Zealand male and female nurses’ health: a sex comparison and gender analysis

The aim of this research was to compare the health and lifestyle behaviors between male and female nursing professionals. Biological, workplace, and lifestyle factors as well as health behaviors and outcomes are reported as different between male and female nurses. Although male nurses show distinct health-related patterns and experience health disparities at work, few studies have investigated health differences by sex in a large cohort group of nursing professionals. This observation study of Australian and New Zealand nurses and midwives drew data from an eCohort survey. A cohort of 342 females was generated by SPSS randomization (total N=3625), to compare against 342 participating males. Measures for comparison include health markers and behaviors, cognitive well-being, workplace and leisure-time vitality, and functional capacity. Findings suggest that male nurses had a higher BMI, sat for longer, slept for less time, and were more likely to be a smoker than their female nurse counterparts. Men were more likely to report restrictions in bending, bathing, and dressing. In relation to disease, male nurses reported greater rates of respiratory disease and cardiovascular disease,including a three times greater incidence of myocardial infarction, and were more likely to have metabolic problems. In contrast, however, male nurses were more likely to report feeling calm and peaceful with less worries about their health. Important for nurse workforce administrators concerned about the well-being of their staff, the current study reveals significant sex differences and supports the need for gender-sensitive approaches to aid the well-being of male nurses

Detection of Supernova Neutrinos by Neutrino-Proton Elastic Scattering

We propose that neutrino-proton elastic scattering, $\nu + p \to \nu + p$, can be used for the detection of supernova neutrinos in scintillator detectors. Though the proton recoil kinetic energy spectrum is soft, with $T_p \simeq 2 E_\nu^2/M_p$, and the scintillation light output from slow, heavily ionizing protons is quenched, the yield above a realistic threshold is nearly as large as that from $\bar{\nu}_e + p \to e^+ + n$. In addition, the measured proton spectrum is related to the incident neutrino spectrum, which solves a long-standing problem of how to separately measure the total energy and temperature of $\nu_\mu$, $\nu_\tau$, $\bar{\nu}_\mu$, and $\bar{\nu}_\tau$. The ability to detect this signal would give detectors like KamLAND and Borexino a crucial and unique role in the quest to detect supernova neutrinos.Comment: 10 pages, 9 figures, revtex

Inhaled corticosteroids for bronchiectasis (review)

Background: Bronchiectasis is being increasingly diagnosed and recognised as an important contributor to chronic lung disease in both adults and children in high- and low-income countries. It is characterised by irreversible dilatation of airways and is generally associated with airway inflammation and chronic bacterial infection. Medical management largely aims to reduce morbidity by controlling the symptoms, reduce exacerbation frequency, improve quality of life and prevent the progression of bronchiectasis. This is an update of a review first published in 2000. Objectives: To evaluate the efficacy and safety of inhaled corticosteroids (ICS) in children and adults with stable state bronchiectasis, specifically to assess whether the use of ICS: (1) reduces the severity and frequency of acute respiratory exacerbations; or (2) affects long-term pulmonary function decline. Search methods: We searched the Cochrane Register of Controlled Trials (CENTRAL), the Cochrane Airways Group Register of trials, MEDLINE and Embase databases. We ran the latest literature search in June 2017. Selection criteria: All randomised controlled trials (RCTs) comparing ICS with a placebo or no medication. We included children and adults with clinical or radiographic evidence of bronchiectasis, but excluded people with cystic fibrosis. Data collection and analysis: We reviewed search results against predetermined criteria for inclusion. In this update, two independent review authors assessed methodological quality and risk of bias in trials using established criteria and extracted data using standard pro forma. We analysed treatment as 'treatment received' and performed sensitivity analyses. Main results: The review included seven studies, involving 380 adults. Of the 380 randomised participants, 348 completed the studies. Due to differences in outcomes reported among the seven studies, we could only perform limited meta-analysis for both the short-term ICS use (6 months or less) and the longer-term ICS use (> 6 months). During stable state in the short-term group (ICS for 6 months or less), based on the two studies from which data could be included, there were no significant differences from baseline values in the forced expiratory volume in the first second (FEV1) at the end of the study (mean difference (MD) -0.09, 95% confidence interval (CI) -0.26 to 0.09) and forced vital capacity (FVC) (MD 0.01 L, 95% CI -0.16 to 0.17) in adults on ICS (compared to no ICS). Similarly, we did not find any significant difference in the average exacerbation frequency (MD 0.09, 95% CI -0.61 to 0.79) or health-related quality of life (HRQoL) total scores in adults on ICS when compared with no ICS, though data available were limited. Based on a single non-placebo controlled study from which we could not extract clinical data, there was marginal, though statistically significant improvement in sputum volume and dyspnoea scores on ICS. The single study on long-term outcomes (over 6 months) that examined lung function and other clinical outcomes, showed no significant effect of ICS on any of the outcomes. We could not draw any conclusion on adverse effects due to limited available data. Despite the authors of all seven studies stating they were double-blind, we judged one study (in the short duration ICS) as having a high risk of bias based on blinding, attrition and reporting of outcomes. The GRADE quality of evidence was low for all outcomes (due to non-placebo controlled trial, indirectness and imprecision with small numbers of participants and studies). Authors' conclusions: This updated review indicates that there is insufficient evidence to support the routine use of ICS in adults with stable state bronchiectasis. Further, we cannot draw any conclusion for the use of ICS in adults during an acute exacerbation or in children (for any state), as there were no studies

Rfam: updates to the RNA families database

Rfam is a collection of RNA sequence families, represented by multiple sequence alignments and covariance models (CMs). The primary aim of Rfam is to annotate new members of known RNA families on nucleotide sequences, particularly complete genomes, using sensitive BLAST filters in combination with CMs. A minority of families with a very broad taxonomic range (e.g. tRNA and rRNA) provide the majority of the sequence annotations, whilst the majority of Rfam families (e.g. snoRNAs and miRNAs) have a limited taxonomic range and provide a limited number of annotations. Recent improvements to the website, methodologies and data used by Rfam are discussed. Rfam is freely available on the Web at http://rfam.sanger.ac.uk/and http://rfam.janelia.org/

Potential for Supernova Neutrino Detection in MiniBooNE

The MiniBooNE detector at Fermilab is designed to search for $\nu_\mu \to \nu_e$ oscillation appearance at $E_\nu \sim 1 {\rm GeV}$ and to make a decisive test of the LSND signal. The main detector (inside a veto shield) is a spherical volume containing 0.680 ktons of mineral oil. This inner volume, viewed by 1280 phototubes, is primarily a \v{C}erenkov medium, as the scintillation yield is low. The entire detector is under a 3 m earth overburden. Though the detector is not optimized for low-energy (tens of MeV) events, and the cosmic-ray muon rate is high (10 kHz), we show that MiniBooNE can function as a useful supernova neutrino detector. Simple trigger-level cuts can greatly reduce the backgrounds due to cosmic-ray muons. For a canonical Galactic supernova at 10 kpc, about 190 supernova $\bar{\nu}_e + p \to e^+ + n$ events would be detected. By adding MiniBooNE to the international network of supernova detectors, the possibility of a supernova being missed would be reduced. Additionally, the paths of the supernova neutrinos through Earth will be different for MiniBooNE and other detectors, thus allowing tests of matter-affected mixing effects on the neutrino signal.Comment: Added references, version to appear in PR

Health equity in the New Zealand health care system: a national survey

<p>Abstract</p> <p>Introduction</p> <p>In all countries people experience different social circumstances that result in avoidable differences in health. In New Zealand, Māori, Pacific peoples, and those with lower socioeconomic status experience higher levels of chronic illness, which is the leading cause of mortality, morbidity and inequitable health outcomes. Whilst the health system can enable a fairer distribution of good health, limited national data is available to measure health equity. Therefore, we sought to find out whether health services in New Zealand were equitable by measuring the level of development of components of chronic care management systems across district health boards. Variation in provision by geography, condition or ethnicity can be interpreted as inequitable.</p> <p>Methods</p> <p>A national survey of district health boards (DHBs) was undertaken on macro approaches to chronic condition management with detail on cardiovascular disease, chronic obstructive pulmonary disease, congestive heart failure, stroke and diabetes. Additional data from expert informant interviews on program reach and the cultural needs of Māori and Pacific peoples was sought. Survey data were analyzed on dimensions of health equity relevant to strategic planning and program delivery. Results are presented as descriptive statistics and free text. Interviews were transcribed and NVivo 8 software supported a general inductive approach to identify common themes.</p> <p>Results</p> <p>Survey responses were received from the majority of DHBs (15/21), some PHOs (21/84) and 31 expert informants. Measuring, monitoring and targeting equity is not systematically undertaken. The Health Equity Assessment Tool is used in strategic planning but not in decisions about implementing or monitoring disease programs. Variable implementation of evidence-based practices in disease management and multiple funding streams made program implementation difficult. Equity for Māori is embedded in policy, this is not so for other ethnic groups or by geography. Populations that conventional practitioners find hard to reach, despite recognized needs, are often underserved. Nurses and community health workers carried a disproportionate burden of care. Cultural and diversity training is not a condition of employment.</p> <p>Conclusions</p> <p>There is a struggle to put equity principles into practice, indicating will without enactment. Equity is not addressed systematically below strategic levels and equity does not shape funding decisions, program development, implementation and monitoring. Equity is not incentivized although examples of exceptional practice, driven by individuals, are evident across New Zealand.</p

DNM1 encephalopathy: A new disease of vesicle fission.

ObjectiveTo evaluate the phenotypic spectrum caused by mutations in dynamin 1 (DNM1), encoding the presynaptic protein DNM1, and to investigate possible genotype-phenotype correlations and predicted functional consequences based on structural modeling.MethodsWe reviewed phenotypic data of 21 patients (7 previously published) with DNM1 mutations. We compared mutation data to known functional data and undertook biomolecular modeling to assess the effect of the mutations on protein function.ResultsWe identified 19 patients with de novo mutations in DNM1 and a sibling pair who had an inherited mutation from a mosaic parent. Seven patients (33.3%) carried the recurrent p.Arg237Trp mutation. A common phenotype emerged that included severe to profound intellectual disability and muscular hypotonia in all patients and an epilepsy characterized by infantile spasms in 16 of 21 patients, frequently evolving into Lennox-Gastaut syndrome. Two patients had profound global developmental delay without seizures. In addition, we describe a single patient with normal development before the onset of a catastrophic epilepsy, consistent with febrile infection-related epilepsy syndrome at 4 years. All mutations cluster within the GTPase or middle domains, and structural modeling and existing functional data suggest a dominant-negative effect on DMN1 function.ConclusionsThe phenotypic spectrum of DNM1-related encephalopathy is relatively homogeneous, in contrast to many other genetic epilepsies. Up to one-third of patients carry the recurrent p.Arg237Trp variant, which is now one of the most common recurrent variants in epileptic encephalopathies identified to date. Given the predicted dominant-negative mechanism of this mutation, this variant presents a prime target for therapeutic intervention