Native plants dominate understory vegetation following ponderosa pine forest restoration treatments

Dense ponderosa pine forests in the southwestern United States inhibit understory production and diversity and are susceptible to high-severity wildfire. Restoration treatments involving overstory thinning and prescribed burning are being implemented to increase understory productivity and diversity and to reduce the risk of severe wildfire. However, disturbances associated with treatments may favor invasion of nonnative species, and the severity of the disturbance may be related to the level of nonnative species establishment. We examined understory community composition, species richness, and plant cover responses to 3 stand-scale replicates of 4 different tree-thinning intensities. Restoration treatments altered the composition of the understory community regardless of thinning intensity. Understory richness and cover were highly variable among experimental blocks, but we observed strong trends of increasing richness and cover in the treated stands. Immediately following restoration treatments, nonnative species cover comprised 6% of the total cover where treatment-induced disturbances were the greatest. However, the initial increase in nonnative species did not persist and was reduced by half 6 years after treatment. Plant community composition was still in flux by the sixth year after treatment, indicating that continued monitoring is necessary for evaluating whether restoration targets are maintained over time

Priority setting for new technologies in medicine: A transdisciplinary study

BACKGROUND: Decision makers in health care organizations struggle with how to set priorities for new technologies in medicine. Traditional approaches to priority setting for new technologies in medicine are insufficient and there is no widely accepted model that can guide decision makers. DISCUSSION: Daniels and Sabin have developed an ethically based account about how priority setting decisions should be made. We have developed an empirically based account of how priority setting decisions are made. In this paper, we integrate these two accounts into a transdisciplinary model of priority setting for new technologies in medicine that is both ethically and empirically based. SUMMARY: We have developed a transdisciplinary model of priority setting that provides guidance to decision makers that they can operationalize to help address priority setting problems in their institution

Magnetic Resonance Imaging of the Cavernous Sinus 187

The magnetic resonance (MR) appearance of the cavernous sinus was studied by correlating the MR images of normal volunteers and cryomicrotomic sections from six cadavers. In addition, MR images of patients with parasellar masses were compared with corresponding intravenously enhanced computed tomographic (CT) scans. The MR appearance of the cranial nerves in the cavernous sinuses is demonstrated, as well as MR signs of a parasellar mass, including obliteration of intracavernous venous spaces, displacement of the intracavernous internal carotid artery, and bulging of the lateral wall of the cavernus sinus. MR proved to be more effective than CT in delineating the parts of the cavernous sinus. Magnetic resonance (MR) imaging has the potential to demonstrate the intracavernous segments of cranial nerves in contrast to the negligible signals of flowing blood. Our article describes the normal MR appearance of the cavernous sinuses and the MR signs of cavernous sinus lesions. Materials and Methods Six fresh frozen cadaver heads were embedded in styrofoam boxes with a solution of carboxymethyl cellulose gel. The orbitomeatal lines and sellae turcicae were identified with fluoroscopy. With a horizontally cutting heavy-duty sledge cryomicrotome (LKB 2250) and serial photography of the surfaces of the specimens (1), anatomic images of the cavernous sinuses were obtained in planes parallel or perpendicular to the orbitomeatal line. In the anatomic images, the intracavernous segments of cranial nerves III-VI and of the internal carotid arteries (ICAs) were identified using published anatomic, computed tomographic (CT), and MR literature (2-6). A group of seven normal volunteers and 15 patients were chosen for MR imaging. The patients included two with pituitary adenomas involving cavernous sinuses and one with a parasellar aneurysm . The diagnoses were verified with conventional clinical, CT , angiographic, and surgical (two cases) findings . The volunteers and patients were studied in prototype 1.3, 1.4, or 1.5 T General Electric MR scanners. Initially , a partial saturation (PS) sagittal image was used to determine locations for axial and coronal PS , inversion recovery (IR ), and spin-echo (SE) imaging . Sections parallel (axial plane) and/or perpendicular (coronal plane) to the orbitomeatal line were obtained

T cell repertoire to citrullinated self-peptides in healthy humans is not confined to the HLA-DR SE alleles; targeting of citrullinated self-peptides presented by HLA-DP4 for tumour therapy

Post-translational modifications are induced in stressed cells which cause them to be recognised by the immune system. One such modification is citrullination where the positive charged arginine is modified to a neutral citrulline. We demonstrate most healthy donors show an oligoclonal CD4 response in vitro to at least one citrullinated vimentin or enolase peptide. Unlike rheumatoid arthritis patients, these T cell responses were not restricted by HLA-DRB1 shared epitope (SE) alleles, suggesting they could be presented by other MHC-II alleles. As HLA-DP is less polymorphic than HLA-DR, we investigated whether the common allele, HLA-DP4 could present citrullinated epitopes. The modification of arginine to citrulline enhanced binding of the peptides to HLA-DP4 and induced high frequency CD4 responses in HLA-DP4 transgenic mouse models. Our previous studies have shown that tumours present citrullinated peptides restricted through HLA-DR4 which are good targets for anti-tumour immunity. In this study we show that citrullinated vimentin and enolase peptides also induced strong anti-tumour immunity (100% survival,

Maternal dental history, child's birth outcome and early cognitive development: Childhood outcomes

Prenatal exposure to high levels of mercury, radiation, and inflammation have been associated with adverse reproductive outcomes such as increases in preterm delivery, low birthweight, and delayed neurodevelopment. Few data are available to evaluate the potential effects of prenatal low-level exposure to these factors as might occur during dental care. We evaluated maternal dental history prior to and during pregnancy in relation to birth outcomes and early communicative development among offspring in a large cohort (n=7375) of British children born in 1991–1992. Dental history was assessed by questionnaire. The child’s communicative development was assessed using the MacArthur Communicative Development Inventory at 15 months of age. Total mercury was measured in umbilical cord tissue for a subset of the children. Overall, dental care, including amalgam fillings, was not associated with birth outcomes or language development. Having x-rays taken during pregnancy was not associated with birthweight measured continuously (β=14.7, p=0.4), but was associated with slightly increased odds of having a term, low birthweight baby (OR 1.9, 95%CI 1.0–3.4). More detailed evaluation of the potential adverse effects of elective dental treatment during pregnancy, particularly dental x-rays, may be warranted

Murray Valley encephalitis virus surveillance and control initiatives in Australia.

Mechanisms for monitoring Murray Valley encephalitis (MVE) virus activity include surveillance of human cases, surveillance for activity in sentinel animals, monitoring of mosquito vectors and monitoring of weather conditions. The monitoring of human cases is only one possible trigger for public health action and the additional surveillance systems are used in concert to signal the risk of human disease, often before the appearance of human cases. Mosquito vector surveillance includes mosquito trapping for speciation and enumeration of mosquitoes to monitor population sizes and relative composition. Virus isolation from mosquitoes can also be undertaken. Monitoring of weather conditions and vector surveillance determines whether there is a potential for MVE activity to occur. Virus isolation from trapped mosquitoes is necessary to define whether MVE is actually present, but is difficult to deliver in a timely fashion in some jurisdictions. Monitoring of sentinel animals indicates whether MVE transmission to vertebrates is actually occurring. Meteorological surveillance can assist in the prediction of potential MVE virus activity by signalling conditions that have been associated with outbreaks of Murray Valley encephalitis in humans in the past. Predictive models of MVE virus activity for south-eastern Australia have been developed, but due to the infrequency of outbreaks, are yet to be demonstrated as useful for the forecasting of major outbreaks. Surveillance mechanisms vary across the jurisdictions. Surveillance of human disease occurs in all States and Territories by reporting of cases to health authorities. Sentinel flocks of chickens are maintained in 4 jurisdictions (Western Australia, the Northern Territory, Victoria and New South Wales) with collaborations between Western Australia and the Northern Territory. Mosquito monitoring complements the surveillance of sentinel animals in these jurisdictions. In addition, other mosquito monitoring programs exist in other States (including South Australia and Queensland). Public health control measures may include advice to the general public and mosquito management programs to reduce the numbers of both mosquito larvae and adult vectors. Strategic plans for public health action in the event of MVE virus activity are currently developed or being developed in New South Wales, the Northern Territory, South Australia, Western Australia and Victoria. A southern tri-State agreement exists between health departments of New South Wales, Victoria and South Australia and the Commonwealth Department of Health and Aged Care. All partners have agreed to co-operate and provide assistance in predicting and combatting outbreaks of mosquito-borne disease in south-eastern Australia. The newly formed National Arbovirus Advisory Committee is a working party providing advice to the Communicable Diseases Network Australia on arbovirus surveillance and control. Recommendations for further enhancement of national surveillance for Murray Valley encephalitis are described

Setting priorities in health care organizations: criteria, processes, and parameters of success

BACKGROUND: Hospitals and regional health authorities must set priorities in the face of resource constraints. Decision-makers seek practical ways to set priorities fairly in strategic planning, but find limited guidance from the literature. Very little has been reported from the perspective of Board members and senior managers about what criteria, processes and parameters of success they would use to set priorities fairly. DISCUSSION: We facilitated workshops for board members and senior leadership at three health care organizations to assist them in developing a strategy for fair priority setting. Workshop participants identified 8 priority setting criteria, 10 key priority setting process elements, and 6 parameters of success that they would use to set priorities in their organizations. Decision-makers in other organizations can draw lessons from these findings to enhance the fairness of their priority setting decision-making. SUMMARY: Lessons learned in three workshops fill an important gap in the literature about what criteria, processes, and parameters of success Board members and senior managers would use to set priorities fairly

Depressive Symptoms during Pregnancy and the Concentration of Fatty Acids in Breast Milk

The aim of the present study was to examine the association between depressive symptoms in pregnancy and the concentration of long-chain polyunsaturated fatty acids (LCPUFAs) in breast milk. Women (n =287) enrolled in the Pregnancy, Infection, and Nutrition Study completed the Center for Epidemiologic Studies Depression Scale in pregnancy (<20 and 24–29 weeks) and had LCPUFAs measured in breast milk (4 months postpartum). Multiple linear regression was used to examine associations between depressive symptoms and breast milk LCPUFAs. Increasing depressive symptoms at <20 weeks were associated with lower docosahexaenoic acid concentrations (adjusted β=−1.15, 95% confidence interval =−2.12, −0.19). No similar associations were observed with other fatty acids nor between symptoms at 24–29 weeks and LCPUFAs. Depressive symptoms, even in the subclinical range, early in pregnancy are inversely associated with breast milk docosahexaenoic acid. This may have implications for the timing of screening and interventions for perinatal depression and the nutritional value of breast milk

A prospective study of maternal anxiety, perceived stress, and depressive symptoms in relation to infant cognitive development

Our objective was to examine the associations between maternal psychological health (trait anxiety, perceived stress, depressive symptoms) during pregnancy or postpartum and infant visual, language, motor, and overall cognitive development