Late-night salivary cortisol and cortisone should be the initial screening test for Cushing's syndrome.

Endogenous Cushing's syndrome (CS) poses considerable diagnostic challenges. Although late-night salivary cortisol (LNSC) is recommended as a first-line screening investigation, it remains the least widely used test in many countries. The combined measurement of LNSC and late-night salivary cortisone (LNS cortisone) has shown to further improve diagnostic accuracy.

Forensic Mental Health Care Staff Experiences of Providing Palliative Care: A Qualitative Descriptive Case Study Approach.

Background: There is a steady increase in the number of people dying within the walls of forensic institutions across the world. This escalation is, to a large extent, because of an aging population. There is a need to explore how palliative care can be delivered in these settings where, historically, security has been the main focus.

Making research real: Innovative approaches for graduate level nursing research.

Background: Engaging graduate students in the research process is often challenging. Making research real requires more innovation than lecture alone.

Purpose: This project is a new curricular approach to Nursing Research, where graduate students collectively engage in the entire research process, from project conception through dissemination.

Simulation-Based Interprofessional Education: A Nursing and Social Work Collaboration.

Background: Contemporary teaching and learning pedagogy commands interprofessional collaboration among allied professions such as nursing and social work, two professions that have a natural inclination to partner in the workforce.

Method: Nursing and social work students participated in a structured simulated learning experience where they demonstrated their respective professional practice skills in a supported learning environment while working collaboratively to assess one of two patient types: high-fidelity or simulated.

Results: Both groups expressed initial worry during prebriefing but articulated their appreciation for and usefulness of working with the other profession.

Integrating Video Simulation Scenarios Into Online Nursing Instruction.

Background: As nursing programs continue to expand online, innovative pedagogies that support online teaching and learning practices grounded in theoretical constructs are needed.

Method: Video simulation scenarios and VoiceThread technology were used to create a model of online instruction that promotes active student participation and aligns with course objectives and content. Kolb's experiential learning theory serves as the framework for this project.

Evaluation and refinement of the environmental stress index for different climatic conditions.

The purpose of this study was to evaluate the recently constructed environmental stress index (ESI) for a large database comprising various climatic conditions. Data analysis of measurements from 19 locations revealed a high correlation between ESI and the wet bulb globe temperature (WBGT) index for each database. Validity from statistical analysis, including optimization procedures, slightly changed the ESI constants as follows: ESI = 0.

Impairment of the blood-nerve and blood-brain barriers in apolipoprotein e knockout mice.

Apolipoprotein E (apoE) is well characterized as a plasma lipoprotein involved in lipid and cholesterol metabolism. Recent studies implicating apoE in Alzheimer's disease and successful recovery from neurological injury have stimulated much interest in the functions of apoE within the brain. To explore the functions of apoE within the nervous system, we examined apoE knockout (KO) mice.

Apolipoprotein E modulates glial activation and the endogenous central nervous system inflammatory response.

Apolipoprotein E (apoE) is a 299 amino acid protein that is associated with risk of developing Alzheimer's Disease (AD) and outcome after acute brain injury. To investigate the possibility that apoE modulates glial activation we studied the effect of endogenous apoE on inflammatory gene regulation in vitro and in vivo. Our results indicate that apoE downregulates CNS production of TNFalpha, Il-1beta, and Il-6 mRNA following stimulation with lipopolysaccharide (LPS).

Cross validation of USARIEM heat strain prediction models. U.S. ARMY Research Institute of Environmental Medicine.

Hypothesis: This study was a cross validation of three heat strain prediction models developed at the U.S. Army Research Institute of Environmental Medicine: the ARIEM, HSDA, and ARIEM-EXP models ability to predict core temperature.

Modeling analysis of women litter bearers during heat stress.

Background: The majority of military physiological studies have been conducted on men. Consequently most physiological modeling is based on male performance. This study obtained data on women performing military tasks under hot-dry field conditions.

Peripheral sensory nerve defects in apolipoprotein E knockout mice.

Apolipoprotein E (apoE), a plasma lipoprotein involved in lipid metabolism, is also proposed to have important functions within the central and peripheral nervous systems. To investigate the function of apoE in the peripheral nervous system, we examined the structure of sciatic nerves in apoE-deficient (apoE KO) mice. In the normal peripheral nervous system, apoE is produced by nonmyelinating Schwann cells, suggesting a role for apoE in the support of unmyelinated thermal and nociceptive sensory afferents.

Endogenous apolipoprotein E suppresses LPS-stimulated microglial nitric oxide production.

The human apolipoprotein (apo) E4 isoform is associated with an increased risk for Alzheimer's disease (AD) and poor prognosis after acute CNS injury. Addition of human apoE inhibits murine microglial activation in culture, suggesting that microglia might be an important physiological target of apoE. In the present study, we examined the role of endogenous murine apoE in modulating microglial nitric oxide (NO) production following lipopolysaccharide (LPS) stimulation.

Apolipoprotein E binds to and potentiates the biological activity of ciliary neurotrophic factor.

Expression of apolipoprotein E (apoE) and ciliary neurotrophic factor (CNTF), a pleiotropic neuron survival factor, increases in the CNS in response to injury. Although CNTF is believed to act as a survival factor after injury in the CNS, the functions of apoE in the CNS remain mainly unknown. Similarities between apoE and CNTF, including coinciding patterns of postinjury expression, extracellular localization, homologous tertiary structure, and ability to form homodimers led us to examine the possibility that apoE and CNTF directly associate and thereby facilitate the neurotrophic activity of CNTF.

Apolipoprotein E suppresses glial cell secretion of TNF alpha.

Apolipoprotein E (apoE) is a 299 amino acid protein with multiple biological functions. Initially described in the context of cholesterol metabolism, apoE also has immunomodulatory properties and recent evidence has implicated a role for apoE in neurological disease. One possibility is that apoE, which is the predominant apolipoprotein produced intra-axially, may modify the CNS response to acute and chronic injury.

Neurite outgrowth is enhanced by anti-idiotypic monoclonal antibodies to the ganglioside GM1.

Exogenously added gangliosides enhance sprouting, neurite outgrowth, and other neuronal activities; this effect may be initiated when a ganglioside binds to a membrane protein or when a ganglioside intercalates into the plasma membrane. To test whether binding to membrane proteins is sufficient for ganglioside-mediated activity, anti-idiotypic antibodies were generated that mimic the functional binding sites of the ganglioside GM1 as described by M. J.

Generating monoclonal antibodies to neuronal antigens.

Methods for generating monoclonal antibodies directed to the functional sites of neuronal antigens are reviewed. These methods include optimal antigen preparation and presentation as well as selective targeting and manipulation of the antigenic response. We describe our use of the immunosuppressant drug, cyclophosphamide, to produce a selective immune response to rare, poorly immunogenic, or actively suppressed antigens.

Anti-idiotypic monoclonal antibodies to GM1 identify ganglioside binding proteins.

Ganglioside stimulated neurite outgrowth may be due to ganglioside binding to membrane proteins or to intercalation into the membrane. To test that ganglioside binding proteins could be found on neuronal surfaces, anti-idiotypic ganglioside monoclonal antibodies (AIG mAbs) were generated to mimic the biological properties of the GM1 ganglioside. The AIG mAbs were identified by their ability to bind to a known GM1 binding protein, the beta-subunit of cholera toxin.

Glial growth factor 2, a soluble neuregulin, directly increases Schwann cell motility and indirectly promotes neurite outgrowth.

Schwann cells proliferate, migrate, and act as sources of neurotrophic support during development and regeneration of peripheral nerves. Recent studies have demonstrated that neuregulins, a family of growth factors secreted by developing motor and peripheral neurons, influence Schwann cell development. In this study, we use three distinct assays to show that glial growth factor 2 (GGF2), a secreted neuregulin, exerts multiple effects on mature Schwann cells in vitro.

Interaction of apolipoprotein E with laminin increases neuronal adhesion and alters neurite morphology.

The extracellular matrix protein laminin profoundly affects neuronal adhesion, spreading, differentiation, and growth by binding integrin-type cell surface receptors. Laminin binds other basement membrane components, including heparan sulfate proteoglycans. Apolipoprotein E (apoE) also binds basement membrane and heparan sulfate proteoglycans and colocalizes with s-laminin in the neuromuscular junction.

Neurotrophins affect the pattern of DRG neurite growth in a bioassay that presents a choice of CNS and PNS substrates.

Neurons can be categorized in terms of where their axons project: within the central nervous system, within the peripheral nervous system, or through both central and peripheral environments. Examples of these categories are cerebellar neurons, sympathetic neurons, and dorsal root ganglion (DRG) neurons, respectively. When explants containing one type of neuron were placed between cryosections of neonatal or adult sciatic nerve and neonatal spinal cord, the neurites exhibited a strong preference for the substrates that they would normally encounter in vivo: cerebellar neurites generally extended only on spinal cord, sympathetic neurites on sciatic nerve, and DRG neurites on both.

CD9 plays a role in Schwann cell migration in vitro.

To identify molecules that regulate Schwann cell migration, we have generated a panel of monoclonal antibodies against Schwann cell surface antigens that modulate Schwann cell migration in in vitro bioassays. One of these antibodies, SMRA1, recognizes a 26 kDa Schwann cell surface membrane protein identified here as CD9. SMRA1 enhances Schwann cell migration on two biologically relevant substrates: living axons of cultured dorsal root ganglion neurons, and cryostat sections of sciatic nerve.

Merosin promotes neurite growth and Schwann cell migration in vitro and nerve regeneration in vivo: evidence using an antibody to merosin, ARM-1.

Monoclonal antibodies that block the cellular function(s) of specific antigens can provide valuable probes for in vitro and in vivo bioassays. With the goal of understanding the molecular basis of neuron-Schwann cell interactions during development and regeneration, we have sought antibodies that interfere with the function of merosin, the predominant laminin isoform present in the Schwann cell basement membrane. To identify the biological functions of merosin in the peripheral nervous system, we studied Schwann cell migration and neurite outgrowth in vitro and nerve regeneration in vivo, in the presence and the absence of a monoclonal antibody that we believe binds to merosin, ARM-1 (Anti Rodent Merosin-1).