Reducing overuse of cervical cancer screening: A systematic review

Overuse of clinical preventive services increases healthcare costs and may deprive underserved patients of necessary care. Up to 45% of cervical cancer screening is overuse. We conducted a systematic review of correlates of overuse of cervical cancer screening and interventions to reduce overuse. The search identified 25 studies (20 observational; 5 intervention). Correlates varied by the type of overuse measured (i.e., too frequent, before/after recommended age to start or stop screening, after hysterectomy), the most common correlates of overuse related to patient age (n = 7), OBGYN practice or provider (n = 5), location (n = 4), and marital status (n = 4). Six observational studies reported a decrease in overuse over time. Screening overuse decreased in all intervention studies, which used before-after designs with no control or comparison groups. Observational studies suggest potential targets for de-escalating overuse. Randomized clinical trials are needed to establish best practices for reducing overuse

Irradiation effects test series, test IE-5. Test results report. [PWR]

Test IE-5, conducted in the Power Burst Facility at the Idaho National Engineering Laboratory, employed three 0.97-m long pressurized water reactor type fuel rods, fabricated from previously irradiated zircaloy-4 cladding and one similar rod fabricated from unirradiated cladding. The objectives of the test were to evaluate the influence of simulated fission products, cladding irradiation damage, and fuel rod internal pressure on pellet-cladding interaction during a power ramp and on fuel rod behavior during film boiling operation. The four rods were subjected to a preconditioning period, a power ramp to an average fuel rod peak power of 65 kW/m, and steady state operation for one hour at a coolant mass flux of 4880 kg/s-m/sup 2/ for each rod. After a flow reduction to 1800 kg/s-m/sup 2/, film boiling occurred on one rod. Additional flow reductions to 970 kg/s-m/sup 2/ produced film boiling on the three remaining fuel rods. Maximum time in film boiling was 80s. The rod having the highest initial internal pressure (8.3 MPa) failed 10s after the onset of film boiling. A second rod failed about 90s after reactor shutdown. The report contains a description of the experiment, the test conduct, test results, and results from the preliminary postirradiation examination. Calculations using a transient fuel rod behavior code are compared with the test results

The peptidergic control circuit for sighing.

Sighs are long, deep breaths expressing sadness, relief or exhaustion. Sighs also occur spontaneously every few minutes to reinflate alveoli, and sighing increases under hypoxia, stress, and certain psychiatric conditions. Here we use molecular, genetic, and pharmacologic approaches to identify a peptidergic sigh control circuit in murine brain. Small neural subpopulations in a key breathing control centre, the retrotrapezoid nucleus/parafacial respiratory group (RTN/pFRG), express bombesin-like neuropeptide genes neuromedin B (Nmb) or gastrin-releasing peptide (Grp). These project to the preBötzinger Complex (preBötC), the respiratory rhythm generator, which expresses NMB and GRP receptors in overlapping subsets of ~200 neurons. Introducing either neuropeptide into preBötC or onto preBötC slices, induced sighing or in vitro sigh activity, whereas elimination or inhibition of either receptor reduced basal sighing, and inhibition of both abolished it. Ablating receptor-expressing neurons eliminated basal and hypoxia-induced sighing, but left breathing otherwise intact initially. We propose that these overlapping peptidergic pathways comprise the core of a sigh control circuit that integrates physiological and perhaps emotional input to transform normal breaths into sighs

Breathing control center neurons that promote arousal in mice.

Slow, controlled breathing has been used for centuries to promote mental calming, and it is used clinically to suppress excessive arousal such as panic attacks. However, the physiological and neural basis of the relationship between breathing and higher-order brain activity is unknown. We found a neuronal subpopulation in the mouse preBötzinger complex (preBötC), the primary breathing rhythm generator, which regulates the balance between calm and arousal behaviors. Conditional, bilateral genetic ablation of the ~175 Cdh9/Dbx1 double-positive preBötC neurons in adult mice left breathing intact but increased calm behaviors and decreased time in aroused states. These neurons project to, synapse on, and positively regulate noradrenergic neurons in the locus coeruleus, a brain center implicated in attention, arousal, and panic that projects throughout the brain

Breathe out and learn : Expiration-contingent stimulus presentation facilitates associative learning in trace eyeblink conditioning

Rhythmic variation in heart rate and respiratory pattern are coupled in a way that optimizes the level of oxygen in the blood stream of the lungs and the body as well as saves energy in pulmonary gas exchange. It has been suggested that the cardiac cycle and respiratory pattern are coupled to neural oscillations of the brain. Yet, studies on how this rhythmic coupling is related to behavior are scarce. There is some evidence that, for example, the phase of respiration affects memory retrieval and the electrophysiological oscillatory state of the limbic system. It is also known that the phase of the cardiac cycle and hippocampal electrophysiological oscillations alone affect learning. Here, we studied whether the timing of training trials to different phases of respiration affects learning trace eyeblink conditioning in healthy adult humans. Trials consisting of a neutral conditioned stimulus (200‐ms tone) and a slightly aversive unconditioned stimulus (100‐ms air puff toward the eye), presented with a 600‐ms trace interval, were timed to either inspiration or expiration. A control group was trained regardless of respiratory phase. We found that, at the end of training, the rate of conditioned responses was higher in the group trained at expiration than it was in the other two groups. That is, brain state seems to fluctuate as a function of respiratory rhythm, and this fluctuation is also behaviorally relevant, exerting its effect on, at the least, a simple form of associative learning.peerReviewe

Racial Desegregation in Prisons

This article examines the history, law, and research on racial desegregation in American prisons. It focuses on the 2005 U.S. Supreme Court case of Johnson v. California, in which the Court held that prison administrators cannot racially segregate inmates unless under extraordinary circumstances to maintain the security of inmates, staff, and institutions. This article also examines evidence on attitudes and outcomes of racial desegregation in prisons. It ends with a discussion of racial desegregation mandates and policy change in prison organizations

The peptidergic control circuit for sighing

Sighs are long, deep breaths expressing sadness, relief, or exhaustion. Sighs also occur spontaneously every few minutes to reinflate alveoli, and sighing increases under hypoxia, stress, and certain psychiatric conditions. Here we use molecular, genetic, and pharmacologic approaches to identify a peptidergic sigh control circuit in murine brain. Small neural subpopulations in a key breathing control center (RTN/pFRG) express bombesin-like neuropeptide genes neuromedin B (Nmb) or gastrin releasing peptide (Grp). These project to the preBötzinger Complex (preBötC), the respiratory rhythm generator, which expresses NMB and GRP receptors in overlapping subsets of ~200 neurons. Introducing either neuropeptide into preBötC, or onto preBötC slices, induced sighing, whereas elimination or inhibition of either receptor reduced basal sighing and inhibition of both abolished it. Ablating receptor-expressing neurons eliminated basal and hypoxia-induced sighing, but left breathing otherwise intact initially. We propose these overlapping peptidergic pathways comprise the core of a sigh control circuit that integrates physiological and perhaps emotional input to transform normal breaths into sighs