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Activity pacing (AP) is a concept that is central to many chronic pain theories and treatments, yet there remains confusion regarding its definition and effects.To review the current knowledge concerning AP and integrate this knowledge in a manner that allows for a clear definition and useful directions for future research.A narrative review of the major theoretical approaches to AP and of the empirical evidence regarding the effects of AP interventions, followed by an integrative discussion.The concept of AP is derived from 2 main traditions: operant and energy conservation. Although there are common elements across these traditions, significant conceptual and practical differences exist, which has led to confusion. Little empirical evidence exists concerning the efficacy of AP as a treatment for chronic pain.Future research on AP should be based on a clear theoretical foundation, consider the context in which the AP behavior occurs and the type of pacing problem ("underactivity" vs. "overactivity"), and should examine the impact of AP treatment on multiple clinical outcomes. We provide a provisional definition of AP and specific recommendations that we believe will move the field forward.

Systemic delivery of therapeutic agents remains ineffective against diffuse intrinsic pontine glioma (DIPG), possibly due to an intact blood-brain-barrier (BBB) and to dose-limiting toxicity of systemic chemotherapeutic agents. Convection-enhanced delivery (CED) into the brainstem may provide an effective local delivery alternative for DIPG patients.The aim of this study is to develop a method to perform CED into the murine brainstem and to test this method using the chemotherapeutic agent carmustine (BiCNU). To this end, a newly designed murine CED catheter was tested in vitro and in vivo. After determination of safety and distribution, mice bearing VUMC-DIPG-3 and E98FM-DIPG brainstem tumors were treated with carmustine dissolved in DW 5% or carmustine dissolved in 10% ethanol.Our results show that CED into the murine brainstem is feasible and well tolerated by mice with and without brainstem tumors. CED of carmustine dissolved in 5% DW increased median survival of mice with VUMC-DIPG-3 and E98FM-DIPG tumors with 35% and 25% respectively. Dissolving carmustine in 10% ethanol further improved survival to 45% in mice with E98FM-DIPG tumors.Since genetically engineered and primary DIPG models are currently only available in mice, murine CED studies have clear advantages over CED studies in other animals.CED in the murine brainstem can be performed safely, is well tolerated and can be used to study efficacy of chemotherapeutic agents orthotopically. These results set the foundation for more CED studies in murine DIPG models.

In this study, air concentrations of BaP in two different seasons (winter 2015 and summer 2016) and BaP levels in ground vegetation from Tarragona County were used as control simulations performed with the WRF-CHIMERE air quality modelling system, in order to reproduce the incidence of that hazardous chemical in air and soils. The CTM was validated for the present climatology, showing a good ability to represent air and soil concentrations of BaP over the target domain (petrochemical, chemical, urban and background sites), particularly in the winter. Then, the variation of the BaP concentrations in air and soils were simulated for the time series 1996-2015 and for the climate change scenario RCP8.5 (2031-2050). While an increase is projected for the levels in air, particularly in chemical and remote sites where the variation can go up to 10%, in terms of soil deposition the findings are the opposite, with an evident decrease in soil BaP concentrations, particularly for background sites. Finally, a potential health effect of BaP for the local population (lung cancer) was assessed. Although according to the projections the EU threshold for BaP atmospheric incidence (1 ng m-3) will not be reached by 2050, there will be an increase in the life-time risk of lung cancer, particularly in the most populated areas within the simulation domain.

Despite the well-established finding from questionnaire studies that positive expectancies are associated with drinking behavior, there is comparatively little known about the mechanisms through which they may affect drinking behavior. Incentive motivation models suggest that alcohol itself may alter the value of the expected outcomes of drinking. The current study was designed to examine the influence of low-dose alcohol on the activation of alcohol outcome expectancy value.Forty-eight hazardous drinkers (34 men) between the ages of 21 and 35 years were recruited from advertisements in local newspapers for a social drinking study. Participants, whose most frequently consumed beverage was beer, were administered a dose of either alcoholic (8.5%) beer, based on gender and weight to reach a blood alcohol concentration of 40 mg/dl, or an equivalent volume of placebo beer. Following an absorption phase, a computerized evaluative priming task was completed in which participants made a series of judgments about the value of positive and negative outcomes following either alcohol or neutral word primes.Those who consumed alcohol made faster evaluative responses to positive relative to negative outcomes, compared with individuals who consumed the placebo beverage.These findings suggest that moderate doses of alcohol may influence the incentive value of positive relative to negative outcome expectancies. It is suggested that these processes may play a role in patterns of hazardous alcohol use.

Stories play an exceptionally important role in how people assign value to a place. Taken together, all those stories essentially give a place an identity. The aim of placemaking is to ensure that the people using a place can appreciate that place. Placemaking approaches are focussed on strategic interventions in a place and aimed at changing the meaning and value of that place for local people, thus creating a qualitative place for enhanced storytelling. Using greenery is a common approach in place-making. Urban greenery has gone through a process of emancipation in the past 15 years. This emancipation has led to awareness that urban greenery is about more than just ecology and biodiversity, but also has social and economic consequences for a city’s fortunes. It is clear that green spaces do not stand alone: they are part of a complex urban system, and the use of green spaces in this complex system has immediate repercussions for how the city functions. With the changing role of green spaces within cities, the need to manage these spaces is emphasized. In this sense, the place-making approach, along with the storytelling approach could provide valuable insight on the planning and management of green spaces within the urban environment, with the aim to enhance quality of life by means of the social connection between people, the users of the space, and the qualitative place provided. This research illustrated that green space managers would need more social and organizational skills to manage modern urban green spaces in an attempt to create qualitative, usable spaces for citizens, spaces that are built upon stories and spaces that would further enable future stories of citizen life. The Story Behind the Place: Creating Urban Spaces That Enhance Quality of Life (PDF Download Available). Available from: https://www.researchgate.net/publication/271918395_The_Story_Behind_the_Place_Creating_Urban_Spaces_That_Enhance_Quality_of_Life [accessed Dec 21, 2015].

Species distribution models (SDMs) provide realistic scenarios to explain the influence of bioclimatic variables on plant pathogen distribution. Diplodia sapinea is most harmful to plantations of both exotic and native pine species in Italy, causing economic consequences expecially to edible seed production. In this study, we developed maximum entropy models for D. sapinea in Italy to reach the following goals: (i) to carry out the pathogen's first geographical distribution analysis in Italy and determine which ecogeographical variables (EGVs) may influence its outbreaks; (ii) to detect the effect of climate change on the potential occurrence of disease outbreaks by 2050 and 2070. We used Maxent ver. 3.4.0 to develop SDMs. We used six global climate models (BCC-CSM1-1, CCSM4, GISS-E2-R, MIROC5, HadGEM2-ES and MPI-ESM-LR) for two representative concentration pathways (4.5 and 8.5) and two time projections (2050 and 2070) to detect future climate projections of D. sapinea. The most important EGVs influencing outbreaks were land cover, altitude, mean temperature of driest and wettest quarter, precipitation of wettest quarter, precipitation seasonality and minimum temperature of coldest month. The distribution of D. sapinea mostly expanded in central and southern Italy and shifted in altitude upwards on average by ca. 93m a.s.l. Moreover the fungus expanded the range where disease outbreaks may be recorded in response to an increase in the mean temperature of wettest and driest quarter by ca. 1.9 C and 5.8 C, respectively in all climate change scenarios. Precipitation of wettest quarter did not differ between current and any of future models. Under different climate change scenarios D. sapinea's disease outbreaks will be likely to affect larger areas of pine forests in the country, probably causing heavy effects on the dynamics and evolution of these stands or perhaps constraining their survival.

The hollow-fibre oxygenator is a key component of any extracorporeal circuit used to provide cardiopulmonary bypass (CPB) during open-heart surgery. Since the oxygenator is placed downstream of the pump, the energy losses over it have a direct impact on the quality of pulsatile pressure and flow waveforms. The objective of this study was to describe the effects of hydrodynamic characteristics of the oxygenator on energy transfer during pulsatile, normothermic CPB. Twenty-three adult patients scheduled for coronary bypass surgery were divided randomly into two groups, using either an oxygenator (Group 1) with a relatively high-resistance and low-compliance (2079 ± 148 dyn.s.cm-5 and 0.00348 ± 0.00071 ml.mmHg-1, respectively) or an oxygenator (Group 2) with a relatively low-resistance and high-compliance (884 ± 464 dyn.s.cm-5 and 0.01325 ± 0.00161 ml .mmHg-1, respectively). During perfusion, pre- and post-oxygenator pressures, radial artery pressure, and blood flow were recorded simultaneously. A 32% decline of mean pressure was observed in Group 1 and a 16% decline in Group 2 (p<0.0001). Another decrease by approximately 73% in mean pressure in the rest of the perfusion system was noted in both groups. The mean radial artery pressure did not differ between the groups (74 ± 6 mmHg in Group 1 and 73 ± 6 mmHg in Group 2, p=0.608). Although lower total energy transfer indices were noticed through the low-resistance oxygenator (Group 2), both oxygenators showed a decrease of the generated pump oscillatory energy of approximately 50%. Despite the differences in resistance and compliance of the hollow-fibre oxygenators used, both oxygenators cause a comparable loss of generated oscillatory energy. Exclusion of the oxygenator downstream of the pulsatile pump would improve energy transfer during CPB.

China has achieved impressive rapid economic growth over the past 30 years but accompanied by significant extreme weather events and environmental changes caused by global change and overfast urbanization. Using the absolute hazards index (AHI), we assessed the spatial distribution patterns and related health effects of 4 major extreme natural disasters, including drought, floods (landslides, mudslides), hails, and typhoons from 2000 to 2011 at the provincial level in China. The results showed that (1) central and south China were the most affected by the 4 natural disasters, and north China suffered less; (2) the provinces with higher AHI suffered most from total death, missing people, collapse, and emergently relocated population; (3) the present health emergency response system to disasters in China mainly lacks a multidisciplinary approach. In the concluding section of this article, suggestions on preparedness and rapid response to extreme health events from environmental changes are proposed.