The social behaviour and ecology of Indri Indri

A period of 15 months was spent studying the behaviour and ecology of Indri indri in the eastern rain-forest of Madagascar. Two groups were habituated to the observer and followed every six weeks for a complete year. Quantitatives sampling techniques were developed which allowed several animals' behaviour to be simultaneously recorded. Surveys were conducted in three areas of different botanical and topographical structure and censuses performed both at the beginning and end of the study. Some behavioural properties of a population of Indri were investigated in one study site by collecting data on vocal interactions between approximately 40 groups. The maintenance activities of the species are described and assessed. Seasonal and individual variation in behaviour are compared both in the groups studied and with other species. Social behaviour is analysed (1) by measures of animal interaction and (2) in terms of the inter-dependence of some individuals' behaviour with others. Measures of spacing and feeding are shown to be suitable to this approach. Evidence for the territoriality of the species is presented and its adaptive qualities considered. The roles of territory definition, declaration and occupation are contrasted and compared. The development of behaviour in infant and juvenile Indri is examined in terms of individual and social adaptations. Some facets of ecological and social differentiation with Indri society are proposed

Evaluation of Direct Immunofluorescence Test with PCR for Detection of Novel Influenza A (H1N1) Virus during 2009 Pandemic

During the 2009 novel influenza (H1N1) pandemic, the sensitivity of direct immunofluorescence assay (DFA) for H1N1 infection was 62% (266/429) of that of the polymerase chain reaction (PCR) test. The sensitivity of the DFA differed significantly with the age of patients: the sensitivity was the highest (71.8%) for patients aged <10 years and the lowest for patients aged ≥30 years. The sensitivity of DFA in patients aged ≥30 years was 40.7%. Furthermore, the sensitivity (67.3%, 171/254) of DFA was higher for patients who had a high temperature at admission. An increase in the incidence of H1N1 infection did not influence the sensitivity of DFA (62.1% vs. 62%; p=0.984) test, but resulted in a decrease in the negative predictive value, from 92.4% (700/757) to 69.6% (247/355). PCR may be useful as the initial test for diagnosing H1N1 infection in patients aged ≥30 years with a normal temperature at presentation

Excision of a Nasal Dermoid Sinus Cyst via Open Rhinoplasty Approach and Primary Reconstruction Using Tutoplast-Processed Fascia Lata

Nasal dermoid sinus cysts are the most common congenital midline nasal lesion, accounting for 1% to 3% of all dermoid cysts, and 4% to 12% of all head and neck dermoids. Selection of the appropriate reconstruction technique, after dermoid resection, is important for treatment. Here we describe the successful management of a case with a nasal dermoid sinus cyst using an open rhinoplasty approach, and primary reconstruction using Tutoplast-processed fascia lata and crushed septal cartilage

Parity-Violating Excitation of the \Delta(1232): Hadron Structure and New Physics

We consider prospects for studying the parity-violating (PV) electroweak excitation of the \Delta(1232) resonance with polarized electron scattering. Given present knowledge of Standard Model parameters, such PV experiments could allow a determination of the N -> \Delta electroweak helicity amplitudes. We discuss the experimental feasibility and theoretical interpretability of such a determination as well as the prospective implications for hadron structure theory. We also analyze the extent to which a PV N -> \Delta measurement could constrain various extensions of the Standard Model.Comment: 43 pages, RevTex, 8 PS figures, uses epsf.sty, rotate.sty, version to appear in Nucl. Phys. A, main points emphasized, some typos correcte

An integrated atom-photon junction

Photonic chips that integrate guides, switches, gratings and other components, process vast amounts of information rapidly on a single device. A new branch of this technology becomes possible if the light is coupled to cold atoms in a junction of small enough cross section, so that small numbers of photons interact appreciably with the atoms. Cold atoms are among the most sensitive of metrological tools and their quantum nature also provides a basis for new information processing methods. Here we demonstrate a photonic chip which provides multiple microscopic junctions between atoms and photons. We use the absorption of light at a junction to reveal the presence of one atom on average. Conversely, we use the atoms to probe the intensity and polarisation of the light. Our device paves the way for a new type of chip with interconnected circuits of atoms and photons.Comment: 5 pages, 4 figure. Submitted to Nature Photonic

Maternal Hyperleptinemia Increases Arterial Stiffening and Alters Vasodilatoy Responses to Insulin in Adult Male Mice Offspring

Cardiovascular disease (CVD) is the number one cause of death in the U.S., and exposure to adverse maternal environments has been associated with the development of CVD including hypertension. Gestational diabetes mellitus (GDM) is an adverse maternal environment that has been associated with metabolic and CVD outcomes in the offspring. Key features of GDM and CVD are maternal hyperleptinemia and vascular disfunction/remodeling, respectively. Yet, there is limited information on the effects of maternal hyperleptinemia has on the function and structure of the offspring’s resistance vasculature. We hypothesize that alterations in offspring’s resistance artery structure and function underlie programming mechanisms for cardiovascular disease that are associated with maternal hyperleptinemia and GDM. To test this hypothesis, we used Leprdb/+ mice dams, which exhibit maternal hyperleptinemia and wildtype (WT) as controls. Vascular function was assessed in WT male offspring of control and hyperleptinemic dams at 31 weeks of age, after half the offspring had been fed a high fat diet (HFD) for 6 weeks. On a standard diet (SD), offspring of hyperleptinemic dams had mesenteric arteries with larger internal diameters than those of WT dams (258.36±14.99 vs 233.65±9.36 μm, p<0.05) indicative of outwardly remodeled, and enhanced maximal vasodilatory responses to insulin (39.97±6.71 vs 32.23±5.07 %, p<0.05). In offspring of WT, but not hyperleptinemic dams, HFD increased vessel wall cross-sectional area (18590.01±1251.16 vs 12807.20±1060.70 μm2, p<0.05), and enhanced the maximal vasodilatory response to acetylcholine (33.74±4.92 vs 21.86±2.73 %, p<0.05). HFD reduced the maximal response to insulin in offspring of hyperleptinemic dams compared to their WT and lean controls (21.88±3.80 vs 37.42±7.84 and 39.97±6.71 % respectively, p<0.05). Offspring of hyperleptinemic dams fed a HFD had increased elastic moduli normalized as a function of the percolation of the internal elastic lamina compared to their WT and lean controls (0.53±0.038 vs 0.34±0.023 and 0.38±0.032 ×106 dynes/cm2 respectively, p<0.05). Offspring of hyperleptinemic dams also had stiffer arteries at high pressure under both dietary conditions (2.36±0.35 vs 1.45±0.11 ×106 dynes/cm2, p<0.05). We conclude that when mice were fed a SD, maternal hyperleptinemia had beneficial effects to offspring’s vascular health, but did not protect offspring fed a HFD. Furthermore, maternal hyperleptinemia induced arterial stiffness in offspring regardless of diet. These results suggest that GDM programs offspring vascular function and structure through mechanisms that may be in part dependent on circulating maternal leptin levels and are differentially affected by postnatal developmental exposures

The challenges of implementing packaged hospital electronic prescribing and medicine administration systems in UK hospitals: premature purchase of immature solutions?

The UK National Health Service is making major efforts to implement Hospital Electronic Prescribing and Medicine Administration (HEPMA) to improve patient safety and quality of care. Substantial public investments have attracted a wide range of UK and overseas suppliers offering Commercial-Off –The-Shelf (COTS) solutions. A lack of (UK) implementation experience and weak supplier-user relationships are reflected in systems with limited configurability, poorly matched to the needs and practices of English hospitals. This situation echoes the history of comparable corporate information infrastructures - Enterprise Resource Planning systems - in the 1980s/1990s. UK government intervention prompted a similar swarming of immature, often unfinished, products into the market. This resulted, in both cases, in protracted and difficult implementation processes as vendors and adopters struggled to get the systems to work and match the circumstances of the adopting organisations. An analysis of the influence of the Installed Base on Information Infrastructures should explore how the evolution of COTS solutions is conditioned by the structure of adopter and vendor ‘communities’

Investigating and learning lessons from early experiences of implementing ePrescribing systems into NHS hospitals:a questionnaire study

Background: ePrescribing systems have significant potential to improve the safety and efficiency of healthcare, but they need to be carefully selected and implemented to maximise benefits. Implementations in English hospitals are in the early stages and there is a lack of standards guiding the procurement, functional specifications, and expected benefits. We sought to provide an updated overview of the current picture in relation to implementation of ePrescribing systems, explore existing strategies, and identify early lessons learned.Methods: a descriptive questionnaire-based study, which included closed and free text questions and involved both quantitative and qualitative analysis of the data generated.Results: we obtained responses from 85 of 108 NHS staff (78.7% response rate). At least 6% (n = 10) of the 168 English NHS Trusts have already implemented ePrescribing systems, 2% (n = 4) have no plans of implementing, and 34% (n = 55) are planning to implement with intended rapid implementation timelines driven by high expectations surrounding improved safety and efficiency of care. The majority are unclear as to which system to choose, but integration with existing systems and sophisticated decision support functionality are important decisive factors. Participants highlighted the need for increased guidance in relation to implementation strategy, system choice and standards, as well as the need for top-level management support to adequately resource the project. Although some early benefits were reported by hospitals that had already implemented, the hoped for benefits relating to improved efficiency and cost-savings remain elusive due to a lack of system maturity.Conclusions: whilst few have begun implementation, there is considerable interest in ePrescribing systems with ambitious timelines amongst those hospitals that are planning implementations. In order to ensure maximum chances of realising benefits, there is a need for increased guidance in relation to implementation strategy, system choice and standards, as well as increased financial resources to fund local activitie

Patient initiated outpatient follow up in rheumatoid arthritis:six year randomised controlled trial

Objectives To determine whether direct access to hospital review initiated by patients with rheumatoid arthritis would result in improved clinical and psychological outcome, reduced overall use of healthcare resources, and greater satisfaction with care than seen in patients receiving regular review initiated by a rheumatologist. Design Two year randomised controlled trial extended to six years. Setting Rheumatology outpatient department in teaching hospital. Participants 209 consecutive patients with rheumatoid arthritis for over two years; 68 (65%) in the direct access group and 52 (50%) in the control group completed the study (P = 0.04). Main outcome measures Clinical outcome: pain, disease activity, early morning stiffness, inflammatory indices, disability, grip strength, range of movement in joints, and bone erosion. Psychological status: anxiety, depression, helplessness, self efficacy, satisfaction, and confidence in the system. Number of visits to hospital physician and general practitioner for arthritis. Results Participants were well matched at baseline. After six years there was only one significant difference between the two groups for the 14 clinical outcomes measured (deterioration in range of movement in elbow was less in direct access patients). There were no significant differences between groups for median change in psychological status. Satisfaction and confidence in the system were significantly higher in the direct access group at two, four, and six years: confidence 9.8 v 8.4, 9.4 v 8.0, 8.7 v 6.9; satisfaction 9.3 v 8.3, 9.3 v 7.7, 8.9 v 7.1 (all P < 0.02). Patients in the direct access group had 38% fewer hospital appointments (median 8 v 13, P < 0.0001). Conclusions Over six years, patients with rheumatoid arthritis who initiated their reviews through direct access were clinically and psychologically at least as well as patients having traditional reviews initiated by a physician. They requested fewer appointments, found direct access more acceptable, and had more than a third fewer medical appointments. This radical responsive management could be tested in other chronic diseases

The Effect Of Breastfeeding On Child Development At 5 Years: A Cohort Study

Objective It is uncertain to what degree the relationship between breastfeeding and later cognitive development is a true biological effect, or is confounded by psychosocial factors. The study aim was to further investigate this relationship and the effect of duration of breast feeding on cognitive development. Methods A total of 3880 children were followed from birth. Breastfeeding duration was measured by questionnaire at 6 months of age and a Peabody Picture Vocabulary Test Revised (PPVT-R) was administered at 5 years. PPVT-R scores were adjusted for the effects of a large array of biological and psychosocial confounders. The relationship between breastfeeding and the mean PPVT-R scores were examined using analysis of variance and multiple linear regression. Results A strong positive relationship was demonstrated between breastfeeding and the PPVT-R scores with increasing scores with increased duration of breastfeeding. After adjusting for a wide range of biological and social factors, the adjusted mean for those breastfed for 6 months or more was 8.2 points higher for females and 5.8 points for males when compared to those never breastfed. Conclusion These findings suggest a significant benefit to child development is conferred by breastfeeding and is related independently to longer periods of breastfeeding