Norepinephrine infusion with and without alpha-adrenergic blockade by phentolamine increases salivary alpha amylase in healthy men

BACKGROUND: Mental stress reliably induces increases in salivary alpha amylase (sAA), a suggested surrogate marker for sympathetic nervous system (SNS) reactivity. While stress-induced sAA increases correlate with norepinephrine (NE) secretion, a potential mediating role of noradrenergic mechanisms remains unclear. In this study, we investigated for the first time in humans whether a NE-stress-reactivity mimicking NE-infusion with and without alpha-adrenergic blockade by phentolamine would induce changes in sAA. METHODS: In a single-blind placebo-controlled within-subjects design, 21 healthy men (29-66 years) took part in three different experimental trials varying in terms of substance infusion with a 1-min first infusion followed by a 15-min second infusion: saline-infusion (trial-1), NE-infusion (5 μg/min) without alpha-adrenergic blockade (trial-2), and with phentolamine-induced non-selective blockade of alpha1- and alpha2-adrenergic receptors (trial-3). Saliva samples were collected immediately before, during, and several times after substance infusion in addition to blood pressure and heart rate readings. RESULTS: Experimental trials significantly differed in sAA reactivity to substance-infusion (p=.001) with higher sAA reactivity following NE-infusion with (trial-3; p=.001) and without alpha-adrenergic-blockade (trial-2; p=.004) as compared to placebo-infusion (trial-1); sAA infusion reactivity did not differ between trial-2 and trial-3 (p=.29). Effective phentolamine application was verified by blood pressure and heart rate infusion reactivity. Salivary cortisol was not affected by NE, either with or without alpha-adrenergic-blockade. CONCLUSIONS: We found that NE-infusion stimulates sAA secretion, regardless of co-administered non-selective alpha-adrenergic blockade by phentolamine, suggesting that the mechanism underlying stress-induced sAA increases may involve NE.

Glycemic Variability Is Associated with Frequency of Blood Glucose Testing and Bolus: Post Hoc Analysis Results from the ProAct Study

ntroduction: The ProAct study has shown that a pump switch to the Accu-Chek® Combo system (Roche Diagnostics Deutschland GmbH, Mannheim, Germany) in type 1 diabetes patients results in stable glycemic control with significant improvements in glycated hemoglobin (HbA1c) in patients with unsatisfactory baseline HbA1c and shorter pump usage time. Patients and Methods: In this post hoc analysis of the ProAct database, we investigated the glycemic control and glycemic variability at baseline by determination of several established parameters and scores (HbA1c, hypoglycemia frequency, J-score, Hypoglycemia and Hyperglycemia Indexes, and Index of Glycemic Control) in participants with different daily bolus and blood glucose measurement frequencies (less than four day, four or five per day, and more than five per day, in both cases). The data were derived from up to 299 patients (172 females, 127 males; age [mean±SD], 39.4±15.2 years; pump treatment duration, 7.0±5.2 years). Results: Participants with frequent glucose readings had better glycemic control than those with few readings (more than five readings per day vs. less than four readings per day: HbA1c, 7.2±1.1% vs. 8.0±0.9%; mean daily blood glucose, 151±22 mg/dL vs. 176±30 mg/dL; percentage of readings per month >300 mg/dL, 10±4% vs. 14±5%; percentage of readings in target range [80-180 mg/dL], 59% vs. 48% [P<0.05 in all cases]) and had a lower glycemic variability (J-score, 49±13 vs. 71±25 [P<0.05]; Hyperglycemia Index, 0.9±0.5 vs. 1.9±1.2 [P<0.05]; Index of Glycemic Control, 1.9±0.8 vs. 3.1±1.6 [P<0.05]; Hypoglycemia Index, 0.9±0.8 vs. 1.2±1.3 [not significant]). Frequent self-monitoring of blood glucose was associated with a higher number of bolus applications (6.1±2.2 boluses/day vs. 4.5±2.0 boluses/day [P<0.05]). Therefore, a similar but less pronounced effect on glycemic variability in favor of more daily bolus applications was observed (more than five vs. less than four bolues per day: J-score, 57±17 vs. 63±25 [not significant]; Hypoglycemia Index, 1.0±1.0 vs. 1.5±1.4 [P<0.05]; Hyperglycemia Index, 1.3±0.6 vs. 1.6±1.1 [not significant]; Index of Glycemic Control, 2.3±1.1 vs. 3.1±1.7 [P<0.05]). Conclusions: Pump users who perform frequent daily glucose readings have a better glycemic control with lower glycemic variability.

Evaluation of New Cone-beam Computed Tomographic Criteria for Radiographic Healing Evaluation after Apical Surgery: Assessment of Repeatability and Reproducibility.

INTRODUCTION Conventional 2-dimensional radiography uses defined criteria for outcome assessment of apical surgery. However, these radiographic healing criteria are not applicable for 3-dimensional radiography. The present study evaluated the repeatability and reproducibility of new cone-beam computed tomographic (CBCT)-based healing criteria for the judgment of periapical healing 1 year after apical surgery. METHODS CBCT scans taken 1 year after apical surgery (61 roots of 54 teeth in 54 patients, mean age = 54.4 years) were evaluated by 3 blinded and calibrated observers using 4 different indices. Reformatted buccolingual CBCT sections through the longitudinal axis of the treated roots were analyzed. Radiographic healing was assessed at the resection plane (R index), within the apical area (A index), of the cortical plate (C index), and regarding a combined apical-cortical area (B index). All readings were performed twice to calculate the intraobserver agreement (repeatability). Second-time readings were used for analyzing the interobserver agreement (reproducibility). Various statistical tests (Cohen, kappa, Fisher, and Spearman) were performed to measure the intra- and interobserver concurrence, the variability of score ratios, and the correlation of indices. RESULTS For all indices, the rates of identical first- and second-time scores were always higher than 80% (intraobserver Cohen κ values ranging from 0.793 to 0.963). The B index (94.0%) showed the highest intraobserver agreement. Regarding interobserver agreement, the highest rate was found for the B index (72.1%). The Fleiss' κ values for R and B indices exhibited substantial agreement (0.626 and 0.717, respectively), whereas the values for A and C indices showed moderate agreement (0.561 and 0.573, respectively). The Spearman correlation coefficients for R, A, C, and B indices all exhibited a moderate to very strong correlation with the highest correlation found between C and B indices (rs = 0.8069). CONCLUSIONS All indices showed an excellent intraobserver agreement (repeatability). With regard to interobserver agreement (reproducibility), the B index (healing of apical and cortical defects combined) and the R index (healing on the resection plane) showed substantial congruence and thus are to be recommended in future studies when using buccolingual CBCT sections for radiographic outcome assessment of apical surgery.

COMPARISON OF MEASUREMENTS OF ABSORBED DOSE TO WATER USING A WATER CALORIMETER AND IONIZATION CHAMBERS FOR CLINICAL RADIOTHERAPY PHOTON AND ELECTRON BEAMS

With the development of the water calorimeter direct measurement of absorbed dose in water becomes possible. This could lead to the establishment of an absorbed dose rather than an exposure related standard for ionization chambers for high energy electrons and photons. In changing to an absorbed dose standard it is necessary to investigate the effect of different parameters, among which are the energy dependence, the air volume, wall thickness and material of the chamber. The effect of these parameters is experimentally studied and presented for several commercially available chambers and one experimental chamber, for photons up to 25 MV and electrons up to 20 MeV, using a water calorimeter as the absorbed dose standard and the most recent formalism to calculate the absorbed dose with ion chambers.^ For electron beams, the dose measured with the calorimeter was 1% lower than the dose calculated with the chambers, independent of beam energy and chamber.^ For photon beams, the absorbed dose measured with the calorimeter was 3.8% higher than the absorbed dose calculated from the chamber readings. Such differences were found to be chamber and energy independent.^ The results for the photons were found to be statistically different from the results with the electron beams. Such difference could not be attributed to a difference in the calorimeter response. ^

Relationships between soil nitrate desorbed from anion-exchange membranes, canopy reflectance and nitrate leaching losses from cool-season lawn turf.

Nutrient leaching studies are expensive and require expertise in water collection and analyses. Less expensive or easier methods that estimate leaching losses would be desirable. The objective of this study was to determine if anion-exchange membranes (AEMs) and reflectance meters could predict nitrate (NO3-N) leaching losses from a cool-season lawn turf. A two-year field study used an established 90% Kentucky bluegrass (Poa pratensis L.)-10% creeping red fescue (Festuca rubra L.) turf that received 0 to 98 kg N ha-1 month-1, from May through November. Soil monolith lysimeters collected leachate that was analyzed for NO3-N concentration. Soil NO3-N was estimated with AEMs. Spectral reflectance measurements of the turf were obtained with chlorophyll and chroma meters. No significant (p > 0.05) increase in percolate flow-weighted NO3-N concentration (FWC) or mass loss occurred when AEM desorbed soil NO3-N was below 0.84 µg cm-2 d-1. A linear increase in FWC and mass loss (p < 0.0001) occurred, however, when AEM soil NO3-N was above this value. The maximum contaminant level (MCL) for drinking water (10 mg L-1 NO3-N) was reached with an AEM soil NO3-N value of 1.6 µg cm-2 d-1. Maximum meter readings were obtained when AEM soil NO3 N reached or exceeded 2.3 µg cm-2 d-1. As chlorophyll index and hue angle (greenness) increased, there was an increased probability of exceeding the NO3-N MCL. These data suggest that AEMs and reflectance meters can serve as tools to predict NO3-N leaching losses from cool-season lawn turf, and to provide objective guides for N fertilization.

Ambulatory blood pressure and physical activity in heart failure

Background. Ambulatory blood pressure (ABP) measurement is a means of monitoring cardiac function in a noninvasive way, but little is known about ABP in heart failure (HF) patients. Blood pressure (BP) declines during sleep as protection from consistent BP load, a phenomenon termed "dipping." The aims of this study were (1) to compare BP dipping and physical activity between two groups of HF patients with different functional statuses and (2) to determine whether the strength of the association between ambulatory BP and PA is different between these two different functional statuses of HF. ^ Methods. This observational study used repeated measures of ABP and PA over a 24-hour period to investigate the profiles of BP and PA in community-based individuals with HF. ABP was measured every 30 minutes by using a SpaceLabs 90207, and a Basic Motionlogger actigraph was used to measure PA minute by minute. Fifty-six participants completed both BP and physical activity for a 24-hour monitoring period. Functional status was based on New York Heart Association (NYHA) ratings. There were 27 patients with no limitation of PA (NYHA class I HF) and 29 with some limitation of PA but no discomfort at rest (NYHA class II or III HF). The sample consisted of 26 men and 30 women, aged 45 to 91 years (66.96 ± 12.35). ^ Results. Patients with NYHA class I HF had significantly greater dipping percent than those with NYHA class II/III HF after controlling their left ventricular ejection fraction (LVEF). In a mixed model analysis (PROC MIXED, SAS Institute, v 9.1), PA was significantly related to ambulatory systolic and diastolic BP and mean arterial pressure. The strength of the association between PA and ABP readings was not significantly different for the two groups of patients. ^ Conclusions. These preliminary findings demonstrate differences between NYHA class I and class II/III of HF in BP dipping status and ABP but not PA. Longitudinal research is recommended to improve understanding of the influence of disease progression on changes in 24-hour physical activity and BP profiles of this patient population. ^ Key Words. Ambulatory Blood Pressure; Blood Pressure Dipping; Heart Failure; Physical Activity. ^

A systematic review and meta-analysis of diabetes disease management programs

Context. Despite the rapid growth of disease management programs, there are still questions about their efficacy and effectiveness for improving patient outcomes and their ability to reduce costs associated with chronic disease. ^ Objective. To determine the effectiveness of disease management programs on improving the results of HbA1c tests, lipid profiles and systolic blood pressure (SBP) readings among diabetics. These three quantitative measures are widely accepted methods of determining the quality of a patient's diabetes management and the potential for future complications. ^ Data Sources. MEDLINE and CINAHL were searched from 1950 to June 2008 using MeSH terms designed to capture all relevant studies. Scopus pearling and hand searching were also done. Only English language articles were selected. ^ Study Selection. Titles and abstracts for the 2347 articles were screened against predetermined inclusion and exclusion criteria, yielding 217 articles for full screening. After full article screening, 29 studies were selected for inclusion in the review. ^ Data Extraction. From the selected studies, data extraction included sample size, mean change over baseline, and standard deviation for each control and experimental arm. ^ Results. The pooled results show a mean HbA1c reduction of 0.64%, 95% CI (-0.83 to -0.44), mean SBP reduction of 7.39 mmHg (95% CI to -11.58 to -3.2), mean total cholesterol reduction of 5.74 mg/dL (95% CI, -10.01 to -1.43), and mean LDL cholesterol reduction of 3.74 mg/dL (95% CI, -8.34 to 0.87). Results for HbA1c, SBP and total cholesterol were statistically significant, while the results for LDL cholesterol were not. ^ Conclusions. The findings suggest that disease management programs utilizing five hallmarks of care can be effective at improving intermediate outcomes among diabetics. However, given the significant heterogeneity present, there may be fundamental differences with respect to study-specific interventions and populations that render them inappropriate for meta-analysis. ^

Evidence of reliability and validity of IPAQ for Mexican-American adults

Physical activity is a key component of life-style modification process which helps to reduce the risk of developing chronic diseases. It is important to have accurate estimates of physical activity to identify sedentary populations where interventions might be helpful. The International Physical Activity Questionnaire (IPAQ) short version has been used to estimate physical activity in diverse populations. However, there is little literature depicting the use of the IPAQ short version in Mexican America population. This study addressed the predictive validity and test-retest reliability of the IPAQ short version in Mexican American adults. The analysis was performed on 97 participants enrolled in the Cameron County Hispanic Cohort. Individuals selected in this study were 18 years of age or older. The predictive validity was evaluated by studying the relationship between physical activity and biomarkers known to be correlated with physical activity, namely, TNF-α, Adiponectin, and HDL. Multiple linear regression analysis was performed to delineate predictive validity. To assess test-retest reliability, two IPAQ-short last seven days questionnaires were interviewer administered to the participants on the same day, approximately two hours apart. Test-Retest reliability of IPAQ was estimated by performing intraclass correlations between the readings at two different time periods. The study showed that the IPAQ – short version used in the above study had acceptable test-retest reliability in the Mexican American population. This study showed that the IPAQ – short version did not have acceptable predictive validity when looking at physical activity and TNF-α, Adiponectin, and HDL in this sample.^

Spectral reflectance library of selected biotic and abiotic coral reef features in Glovers Reef, Belize

Underwater spectral reflectance was measured for selected biotic and abiotic coral reef features of Glovers Reef, Belize from March 6 - 10, 2005. Spectral reflectance's of 63 different benthic types were obtained in-situ. An Ocean Optics USB2000 spectrometer was deployed in an custom made underwater housing with a 0.5 m fiber-optic probe mounted next to an artificial light source. Spectral readings were collected with the probe (bear fibre) about 5 cm from the target to ensure that the target would fill the field of view of the fiber optic (FOV diameter ~4.4 cm), as well as to reduce the attenuating effect of the intermediate water (Roelfsema et al., 2006). Spectral readings included for one target included: 1 reading of the covered spectral fibre to correct for instrument noise, 1 reading of spectralon panel mounted on divers wrist to measure incident ambient light, and 8 readings of the target. Spectral reflectance was calculated for each target by first subtracting the instrument noise reading from each other reading. The corrected target readings were then divided by the corrected spectralon reading resulting in spectral reflectance of each target reading. An average target spectral reflectance was calculated by averaging the eight individual spectral reflectance's of the target. If an individual target spectral reflectance was visual considered an outlier, it was not included in the average spectral reflectance calculation. See Roelfsema at al. (2006) for additional info on the methodology of underwater spectra collection.

Processed data from CTD casts and fluorospectrometer measurements from the SONNE SO226/3 cruise track

The Sonne transit cruise SO226-3 DipFIP took place from March 4th (Wellington, New Zealand) to March 28th (Kaohsiung, Taiwan) in 2013. CTD data for 16 stations along the cruise track were recorded using the onboard a SEABIRD SBE 9 plus CTD down to depth of 800m. Obtained hydrographic data were binned to 1 m intervals with the available SBE software. Obvious outliers in the readings of the oxygen sensor close to the sea surface have been manually removed. Fluorospectrometer (bbe Moldaenke) pigment data measured for 24 depth intervals are available for 10 stations. Measurements were conducted in the shipboard laboratory on water samples from the CTD rosette. Data are averages of a least 30 readings per sample.

Spectral reflectance library of selected biotic and abiotic coral reef features in Heron Reef

Underwater spectral reflectance was measured for selected biotic and abiotic coral reef features of Heron Reef from June 25-30, 2006. Spectral reflectance's of 105 different benthic types were obtained in-situ. An Ocean Optics USB2000 spectrometer was deployed in an custom made underwater housing with a 0.5 m fiber-optic probe mounted next to an artificial light source. Spectral readings were collected with the probe(bear fibre) about 5 cm from the target to ensure that the target would fill the field of view of the fiber optic (FOV diameter ~4.4 cm), as well as to reduce the attenuating effect of the intermediate water (Roelfsema et al., 2006). Spectral readings included for one target included: 1 reading of the covered spectral fibre to correct for instrument noise, 1 reading of spectralon panel mounted on divers wrist to measure incident ambient light, and 8 readings of the target. Spectral reflectance was calculated for each target by first subtracting the instrument noise reading from each other reading. The corrected target readings were then divided by the corrected spectralon reading resulting in spectral reflectance of each target reading. An average target spectral reflectance was calculated by averaging the eight individual spectral reflectance's of the target. If an individual target spectral reflectance was visual considered an outlier, it was not included in the average spectral reflectance calculation. See Roelfsema at al. (2006) for additional info on the methodology of underwater spectra collection.

(Table 1) Magnetic susceptibility readings in the western part of the Sør Rondane Montains

The Sør Rondane Mountains (SRM) in eastern Dronning Maud Land (DML) are located in an area, where two apparent Pan-African (650-520 Ma) orogenic mobile belts appear to intersect, the East African-Antarctic Orogen and the Kuunga Orogen. Hence, a better understanding of the tectonic structure of the Sør Rondane region is an important key for unravelling the complex geodynamic evolution of the eastern DML and adjacent regions of East Antarctica during the Late Neoproterozoic/Early Palaeozoic amalgamation of Gondwana. The SRM were recently (2011-2012) aerogeophysically investigated with a 5 km flight line spacing, covering a total area of ~140,000 km². The aeromagnetic data are correlated with ground-based magnetic susceptibility measurements and geological field data and allow to project tectonic terranes and individual structures into ice-covered areas. Magnetic anomalies and basement foliation trends are collinear in areas dominated by simple shear deformation, whereas an area of large-scale refolding correlates with a subdued small-scale broken magnetic anomaly pattern. The latter area can be regarded as a distinct tectonic domain, the central Sør Rondane corridor. It magnetically separates the SRM into an eastern, a central, and a western portion. This subdivision is presumably related to late Pan-African extensional tectonics and suggests that such a tectonic regime may play a larger role than previously assumed. Voluminous late Pan-African granitoids, which are mainly undeformed, correlate with positive magnetic anomalies between +30 and +80 nT, while a strong magnetic high (+680 nT) near the granitic intrusion at Dufekfjellet is caused by a highly magnetised enigmatic body. The recently discovered prominent magnetic anomaly province of southeastern DML continues into the southern part of the Sør Rondane region, where only a few outcrops are exposed. Findings at these westernmost nunataks of the SRM indicate that the subdued magnetic anomaly pattern of this southeastern DML province is most likely caused by the predominance of metasedimentary rocks of yet unknown age.

Abundance of mesozooplankton from the S-IT4 cruise in the Western Mediterranean Sea in March and April 2008

The "SESAME_IT4_ZooAbundance_0-50-100m_SZN" dataset contains data of mesozooplankton species composition and abundance (ind./m**3) from samples collected in the Western Mediterranean in the early spring of 2008 (20 March-5 April) during the SESAME-WP2 cruise IT4. Samples were collected by vertical tows with a closing WP2 net (56 cm diameter, 200 µm mesh size) in the following depth layers: 100-200 m, 50-100 m, 0-50 m. Sampling was always performed in light hours. A flowmeter was applied to the mouth of the net, however, due to its malfunctioning, the volume of filtered seawater was calculated by multiplying the the area by the height of the sampled layer from winch readings. After collection, each sample was split in two halves (1/2) after careful mixing with graduated beakers. Half sample was immediately fixed and preserved in a formaldehyde-seawater solution (4% final concentration) for species composition and abundance. The other half sample was kept fresh for biomass measurements (data already submitted to SESAME database in different files). Here, only the zooplankton abundance of samples in the upper layers 0-50 m and 50-100 m are presented. The abundance data of the samples in the layer 50-100 m will be submitted later in a separate file. The volume of filtered seawater was estimated by multiplying the the area by the height of the sampled layer from winch readings. Identification and counts of specimens were performed on aliquots (1/20-1/5) of the fixed sample or on the total sample (half of the original sample) by using a graduate large-bore pipette. Copepods were identified to the species level and separated into females, males and juveniles (copepodites). All other taxa were identified at the species level when possible, or at higher taxonomic levels. Taxonomic identification was done according to the most relevant and updated taxonomic literature. Total mesozooplankton abundance was computed as sum of all specific abundances determined as explained above.

High resolution in situ microsensor measurements of oxygen and temperature at a vesicomyid clam colony in the Japan Deep Sea Trench

Oxygen penetration depth and temperature at the rim of the clam colony was measured with a small deep-sea microprofiler module (Treude et al., 2009), carrying 3 oxygen Clark-type microelectrodes (Revsbech et al., 1980) and one temperature sensor (Pt100, UST Umweltsensorentechnik GmbH, Germany). High-resolution microprofiles across the sediment-water interface were measured with a vertical resolution of 100 µm on a total length of 15 cm. Oxygen electrodes had a linear response to the oxygen concentration in seawater and were calibrated in situ using constant readings in the bottom water (oxygen concentration determined by Winkler titration) and the anoxic parts of the sediment.