Oral Challenge with Trimethoprim-Sulfamethoxazole in Patients with “Sulfa” Antibiotic Allergy

Letter to the Edito

The impact of Basic Fibroblast Growth Factor on Photoreceptor function and morphology

To assess the impact of basic fibroblast growth factor (bFGF) on photoreceptor function and morphology. METHODS: Impact was assessed in two models. In one, the endogenous expression of bFGF in photoreceptors was raised by sectioning one optic nerve of rats 3 to 4 weeks before study. In the other, bFGF was injected into the vitreous chamber in rats and cats. Retinal function was assessed from the electroretinogram (ERG), and retinal morphology was studied using DNA dyes, immunolabeling, and in situ hybridization. RESULTS: In both models of bFGF upregulation, the ERG b-wave was suppressed over a wide stimulus range and in light- and dark-adapted conditions. The a-wave was not suppressed by either procedure and at the brightest intensities was enhanced by both procedures. In nerve-sectioned eyes, outer retina appeared normal histologically, but levels of bFGF protein in the inner and outer nuclear layers were raised, whereas bFGF mRNA levels remained unchanged. In both models, levels of synaptophysin in the outer plexiform layer and of cytochrome oxidase in inner segments were raised in association with increases in bFGF protein levels. CONCLUSIONS: bFGF increased the ability of photoreceptors to respond to light but attenuated the transmission of this response to inner retinal cells, presumably by blocking the photoreceptor-bipolar synapse. If the expression of bFGF protein is upregulated in human photoreceptor dystrophies, it may contribute a reversible component to the loss of vision. The relationship between these actions of bFGF and its ability to protect photoreceptors from stress remains to be established

Dental Attendances to General Medical Practitioners in Wales: a 44 Year Analysis

One-third of the UK population is composed of problem-oriented dental attenders, seeking dental care only when they have acute dental pain or problems. Patients seek urgent dental care from a range of health care professionals, including general medical practitioners. This study aimed to identify trends in dental attendance at Welsh medical practices over a 44-y period, specifically in relation to dental policy change and factors associated with repeat attendance. A retrospective observational study was completed via the nationwide Secure Anonymised Information Linkage (SAIL) Databank of visits to general medical practice in Wales. Read codes associated with dental diagnoses were extracted for patients attending their general medical practitioner between 1974 and 2017. Data were analyzed with descriptive statistics and univariate and multivariable logistic regression. Over the 44-y period, there were 439,361 dental Read codes, accounting for 288,147 patient attendances. The overall attendance rate was 2.60 attendances per 1,000 patient-years (95% CI, 2.59 to 2.61). The attendance rate was negligible through 1987 but increased sharply to 5.0 per 1,000 patient-years in 2006 (95% CI, 4.94 to 5.09) before almost halving to 2.6 per 1,000 in 2017 (95% CI, 2.53 to 2.63) to a pattern that coincided with changes to National Health Service policies. Overall 26,312 patients were repeat attenders and were associated with living in an area classified as urban and deprived (odds ratio [OR], 1.22; 95% CI, 1.19 to 1.25; P < 0.0001) or rural (OR, 0.84; 95% CI, 0.83 to 0.85; P < 0.0001). Repeat attendance was associated with greater odds of having received an antibiotic prescription (OR, 2.53; 95% CI, 2.50 to 2.56; P < 0.0001) but lower odds of having been referred to another service (OR, 0.75; 95% CI, 0.70 to 0.81; P < 0.0001). Welsh patients’ reliance on medical care for dental problems was influenced by social deprivation and health policy. This indicates that future interventions to discourage dental attendance at medical practitioners should be targeted at those in the most deprived urban areas or rural areas. In addition, health policy may influence attendance rates positively and negatively and should be considered in the future when decisions related to policy change are made

Recovery of 150-250 MeV/nuc Cosmic Ray Helium Nuclei Intensities Between 2004-2010 Near the Earth, at Voyager 2 and Voyager 1 in the Heliosheath - A Two Zone Helioshpere

The recovery of cosmic ray He nuclei of energy ~150-250 MeV/nuc in solar cycle #23 from 2004 to 2010 has been followed at the Earth using IMP and ACE data and at V2 between 74-92 AU and also at V1 beyond the heliospheric termination shock (91-113 AU). The correlation coefficient between the intensities at the Earth and at V1 during this time period is remarkable (0.921), after allowing for a ~0.9 year delay due to the solar wind propagation time from the Earth to the outer heliosphere. To describe the intensity changes and to predict the absolute intensities measured at all three locations we have used a simple spherically symmetric (no drift) two-zone heliospheric transport model with specific values for the diffusion coefficient in both the inner and outer zones. The diffusion coefficient in the outer zone, assumed to be the heliosheath from about 90 to 120 (130) AU, is determined to be ~5 times smaller than that in the inner zone out to 90 AU. This means the Heliosheath acts much like a diffusing barrier in this model. The absolute magnitude of the intensities and the intensity changes at V1 and the Earth are described to within a few percent by a diffusion coefficient that varies with time by a factor ~4 in the inner zone and only a factor of ~1.5 in the outer zone over the time period from 2004-2010. For V2 the observed intensities follow a curve that is as much as 25% higher than the calculated intensities at the V2 radius and at times the observed V2 intensities are equal to those at V1. At least one-half of the difference between the calculated and observed intensities between V1 and V2 can be explained if the heliosphere is squashed by ~10% in distance (non-spherical) so that the HTS location is closer to the Sun in the direction of V2 compared to V1.Comment: 13 Pages, 8 Figure

Technological Devices in the Archives: A Policy Analysis

Doing research in the archive is the cornerstone of humanities scholarship. Various archives institute policies regarding the use of technological devices, such as mobile phones, laptops, and cameras in their reading rooms. Such policies directly affect the scholars as the devices mediate the nature of their interaction with the source materials in terms of capturing, organizing, note taking, and record keeping for future use of found materials. In this paper, we present our analysis of the policies of thirty archives regarding the use of technology in their reading rooms. This policy analysis, along with data from interviews of scholars and archivists, is intended to serve as a basis for developing mobile applications for assisting scholars in their research activities. In this paper we introduce an early prototype of such a mobile application— AMTracker.Informatio

Waters of Hot Springs National Park, Arkansas: their nature and origin

The 47 hot springs of Hot Springs National Park, Arkansas, issue from the plunging crestline of a large overturned anticline, along the southern margin of the Ouachita anticlinorium, in the Zigzag Mountains. The combined flow of the hot springs ranges from 750,000 to 950,000 gallons per day (3.29 x 10/sup -2/ to 4.16 x 10/sup -2/ cubic meters per second). The radioactivity and chemical composition of the hot-water springs are similar to that of the cold-water springs and wells in the area. The tritium and carbon-14 analyses of the water indicate that the water is a mixture of a very small amount of water less than 20 years old and a preponderance of water about 4400 years old. The presence of radium and radon in the hot-springs waters has been established by analyses. Mathematical models were employed to test various conceptual models of the hot-springs flow system. The geochemical data, flow measurements, and geologic structure of the region support the concept that virtually all the hot-springs water is of local, meteoric origin. Recharge to the hot-springs artesian-flow system is by infiltration of rainfall in the outcrop areas of the Bigfork Chert and the Arkansas Novaculite. The water moves slowly to depth where it is heated by contact with rocks of high temperature. Highly permeable zones, related to jointing or faulting, collect the heated water in the aquifer and provide avenues for the water to travel rapidly to the surface

Dental Attendances to General Medical Practitioners in Wales: A 44 Year-Analysis

One-third of the UK population is composed of problem-oriented dental attenders, seeking dental care only when they have acute dental pain or problems. Patients seek urgent dental care from a range of health care professionals, including general medical practitioners. This study aimed to identify trends in dental attendance at Welsh medical practices over a 44-y period, specifically in relation to dental policy change and factors associated with repeat attendance. A retrospective observational study was completed via the nationwide Secure Anonymised Information Linkage (SAIL) Databank of visits to general medical practice in Wales. Read codes associated with dental diagnoses were extracted for patients attending their general medical practitioner between 1974 and 2017. Data were analyzed with descriptive statistics and univariate and multivariable logistic regression. Over the 44-y period, there were 439,361 dental Read codes, accounting for 288,147 patient attendances. The overall attendance rate was 2.60 attendances per 1,000 patient-years (95% CI, 2.59 to 2.61). The attendance rate was negligible through 1987 but increased sharply to 5.0 per 1,000 patient-years in 2006 (95% CI, 4.94 to 5.09) before almost halving to 2.6 per 1,000 in 2017 (95% CI, 2.53 to 2.63) to a pattern that coincided with changes to National Health Service policies. Overall 26,312 patients were repeat attenders and were associated with living in an area classified as urban and deprived (odds ratio [OR], 1.22; 95% CI, 1.19 to 1.25; P < 0.0001) or rural (OR, 0.84; 95% CI, 0.83 to 0.85; P < 0.0001). Repeat attendance was associated with greater odds of having received an antibiotic prescription (OR, 2.53; 95% CI, 2.50 to 2.56; P < 0.0001) but lower odds of having been referred to another service (OR, 0.75; 95% CI, 0.70 to 0.81; P < 0.0001). Welsh patients’ reliance on medical care for dental problems was influenced by social deprivation and health policy. This indicates that future interventions to discourage dental attendance at medical practitioners should be targeted at those in the most deprived urban areas or rural areas. In addition, health policy may influence attendance rates positively and negatively and should be considered in the future when decisions related to policy change are made

Ideal Spin Filters: Theoretical Study of Electron Transmission Through Ordered and Disordered Interfaces Between Ferromagnetic Metals and Semiconductors

It is predicted that certain atomically ordered interfaces between some ferromagnetic metals (F) and semiconductors (S) should act as ideal spin filters that transmit electrons only from the majority spin bands or only from the minority spin bands of the F to the S at the Fermi energy, even for F with both majority and minority bands at the Fermi level. Criteria for determining which combinations of F, S and interface should be ideal spin filters are formulated. The criteria depend only on the bulk band structures of the S and F and on the translational symmetries of the S, F and interface. Several examples of systems that meet these criteria to a high degree of precision are identified. Disordered interfaces between F and S are also studied and it is found that intermixing between the S and F can result in interfaces with spin anti-filtering properties, the transmitted electrons being much less spin polarized than those in the ferromagnetic metal at the Fermi energy. A patent application based on this work has been commenced by Simon Fraser University.Comment: RevTeX, 12 pages, 5 figure

Shared Care, Elder and Family Member Skills Used to Manage Burden

Aim. The aim of this paper is to further develop the construct of Shared Care by comparing and contrasting it to related research, and to show how the construct can be used to guide research and practice. Background. While researchers have identified negative outcomes for family caregivers caused by providing care, less is known about positive aspects of family care for both members of a family dyad. Understanding family care relationships is important to nurses because family participation in the care of chronically ill elders is necessary to achieve optimal outcomes from nursing interventions. A previous naturalistic inquiry identified a new construct, Shared Care, which was used to describe a family care interaction that contributed to positive care outcomes. Methods. A literature review was carried out using the databases Medline, CINAHL, and Psych-info and the keywords home care, care receiver, disability, family, communication, decision-making and reciprocity. The results of the review were integrated to suggest how Shared Care could be used to study care difficulties and guide interventions. Results. The literature confirmed the importance of dyad relationships in family care. Shared Care extended previous conceptualizations of family care by capturing three critical components: communication, decision-making, and reciprocity. Shared Care provides a structure to expand the conceptualization of family care to include both members of a care dyad and account for positive and negative aspects of care. Conclusions. The extended view provided by the construct of Shared Care offers practitioners and scholars tools to use in the context of our ageing population to improve the effectiveness of family care relationships

Search for the decay K+→π+ννˉK^+\to \pi^+ \nu \bar\nu in the momentum region Pπ<195 MeV/cP_\pi < 195 {\rm ~MeV/c}

We have searched for the decay $K^+ \to \pi^+ \nu \bar\nu$ in the kinematic region with pion momentum below the $K^+ \to \pi^+ \pi^0$ peak. One event was observed, consistent with the background estimate of $0.73\pm 0.18$. This implies an upper limit on $B(K^+ \to \pi^+ \nu \bar\nu)< 4.2\times 10^{-9}$ (90% C.L.), consistent with the recently measured branching ratio of $(1.57^{+1.75}_{-0.82}) \times 10^{-10}$, obtained using the standard model spectrum and the kinematic region above the $K^+ \to \pi^+ \pi^0$ peak. The same data were used to search for $K^+ \to \pi^+ X^0$, where $X^0$ is a weakly interacting neutral particle or system of particles with $150 < M_{X^0} < 250 {\rm ~MeV/c^2}$.Comment: 4 pages, 2 figure