Anti-cholinergic load, health care utilization, and survival in people with advanced cancer: a pilot study.

INTRODUCTION: Anti-cholinergic medications have been associated with increased risks of cognitive impairment, premature mortality and increased risk of hospitalisation. Anti-cholinergic load associated with medication increases as death approaches in those with advanced cancer, yet little is known about associated adverse outcomes in this setting. METHODS: A substudy of 112 participants in a randomised control trial who had cancer and an Australia modified Karnofsky Performance Scale (AKPS) score (AKPS) of 60 or above, explored survival and health service utilisation; with anti-cholinergic load calculated using the Clinician Rated Anti-cholinergic Scale (modified version) longitudinally to death. A standardised starting point for prospectively calculating survival was an AKPS of 60 or above. RESULTS: Baseline entry to the sub-study was a mean 62 +/- 81 days (median 37, range 1-588) days before death (survival), with mean of 4.8 (median 3, SD 4.18, range 1 - 24) study assessments in this time period. Participants spent 22% of time as an inpatient. There was no significant association between anti-cholinergic score and time spent as an inpatient (adjusted for survival time) (p = 0.94); or survival time. DISCUSSION: No association between anti-cholinergic load and survival or time spent as an inpatient was seen. Future studies need to include cognitively impaired populations where the risks of symptomatic deterioration may be more substantial.

Genetic evaluation of a proposed introduction: the case of the greater prairie chicken and the extinct heath hen.

Population introduction is an important tool for ecosystem restoration. However, before introductions should be conducted, it is important to evaluate the genetic, phenotypic and ecological suitability of possible replacement populations. Careful genetic analysis is particularly important if it is suspected that the extirpated population was unique or genetically divergent. On the island of Martha's Vineyard, Massachusetts, the introduction of greater prairie chickens (Tympanuchus cupido pinnatus) to replace the extinct heath hen (T. cupido cupido) is being considered as part of an ecosystem restoration project. Martha's Vineyard was home to the last remaining heath hen population until its extinction in 1932. We conducted this study to aid in determining the suitability of greater prairie chickens as a possible replacement for the heath hen. We examined mitochondrial control region sequences from extant populations of all prairie grouse species (Tympanuchus) and from museum skin heath hen specimens. Our data suggest that the Martha's Vineyard heath hen population represents a divergent mitochondrial lineage. This result is attributable either to a long period of geographical isolation from other prairie grouse populations or to a population bottleneck resulting from human disturbance. The mtDNA diagnosability of the heath hen contrasts with the network of mtDNA haplotypes of other prairie grouse (T. cupido attwateri, T. pallidicinctus and T. phasianellus), which do not form distinguishable mtDNA groupings. Our findings suggest that the Martha's Vineyard heath hen was more genetically isolated than are current populations of prairie grouse and place the emphasis for future research on examining prairie grouse adaptations to different habitat types to assess ecological exchangeability between heath hens and greater prairie chickens.

The Role of mRNA Translation in the Regulation of Ribosome Trafficking to the Endoplasmic Reticulum

The goal of this research is to identify the trafficking patterns that direct ribosomes to the endoplasmic reticulum (ER). It is widely believed that the SRP pathway is the only mechanism that cells use to localize mRNA and ribosomes to the ER, but this has been found not to be a sufficient explanation for the patterns of RNA localization in cells, namely that non-signal sequence-containing mRNA are translated on the ER and that ribosomes retain their membrane association after translation termination. First, a summary of the history of the field is presented to provide context for the key, unanswered questions in the field. Then, experiments employing [32Pi] pulse-chase labeling of HeLa cells over a time course to follow nascent ribosome trafficking are presented. The purpose of the cell labeling was to track rRNA processing and assembly into nascent ribosomes, followed by their export into the cytoplasm and recruitment into active polysomes. A detergent-based cell fractionation procedure was also utilized to separate the cytosol and ER compartments in order to observe ribosomes on their path as they exit the nucleus and either localize to the ER or cytosolic cellular compartment. Through this method, it was seen that ribosomes appear in both compartments at the same time, suggesting a mechanism may be occurring in addition to SRP-dependent ribosome trafficking. This research provides an understanding toward a mechanism that is not currently known, but will one day more fully explain the patterns of ribosomal localization.

SAFE: A Declarative Trust-Agile System with Linked Credentials

Secure Access For Everyone (SAFE), is an integrated system for managing trust

using a logic-based declarative language. Logical trust systems authorize each

request by constructing a proof from a context---a set of authenticated logic

statements representing credentials and policies issued by various principals

in a networked system. A key barrier to practical use of logical trust systems

is the problem of managing proof contexts: identifying, validating, and

assembling the credentials and policies that are relevant to each trust

decision.

SAFE addresses this challenge by (i) proposing a distributed authenticated data

repository for storing the credentials and policies; (ii) introducing a

programmable credential discovery and assembly layer that generates the

appropriate tailored context for a given request. The authenticated data

repository is built upon a scalable key-value store with its contents named by

secure identifiers and certified by the issuing principal. The SAFE language

provides scripting primitives to generate and organize logic sets representing

credentials and policies, materialize the logic sets as certificates, and link

them to reflect delegation patterns in the application. The authorizer fetches

the logic sets on demand, then validates and caches them locally for further

use. Upon each request, the authorizer constructs the tailored proof context

and provides it to the SAFE inference for certified validation.

Delegation-driven credential linking with certified data distribution provides

flexible and dynamic policy control enabling security and trust infrastructure

to be agile, while addressing the perennial problems related to today's

certificate infrastructure: automated credential discovery, scalable

revocation, and issuing credentials without relying on centralized authority.

We envision SAFE as a new foundation for building secure network systems. We

used SAFE to build secure services based on case studies drawn from practice:

(i) a secure name service resolver similar to DNS that resolves a name across

multi-domain federated systems; (ii) a secure proxy shim to delegate access

control decisions in a key-value store; (iii) an authorization module for a

networked infrastructure-as-a-service system with a federated trust structure

(NSF GENI initiative); and (iv) a secure cooperative data analytics service

that adheres to individual secrecy constraints while disclosing the data. We

present empirical evaluation based on these case studies and demonstrate that

SAFE supports a wide range of applications with low overhead.