Phonological processing skills in speech and language impaired children.
Phonological processing has been shown by many researchers to be strongly related to the acquisition of reading and spelling skills. Children with speech and language impairment appear to be at increased risk for phonological processing problems and hence literary difficulties. However, not all children with speech and language impairment experience difficulties: the literature is not clear as to which groups of speech and language impaired children are most severely affected nor which aspects of phonological processing are most likely to be impaired. Rigorous subject selection was employed to compare the performance of four groups of 20 children, aged approximately 6 years: speech-impaired (Speech); language-impaired (Language); speech and language impaired (Mixed); and children with normally developing language (Normal), by use of a battery of phonological processing tasks. The results supported the research that has shown speech and language impaired children to have weaker phonological processing skills than the general population. All the subjects in this sample appeared to be at risk: the Mixed children demonstrated the most difficulty, followed by the Language group, with the Normal group performing the best. Whilst the Speech group as a whole performed significantly more poorly than the Normal group, it consisted of two levels of performance which, on post hoc analysis were shown to relate to the pattern of speech impairment exhibited by the child.


Clinicopathological characteristics and treatment strategies for patients with low-grade endometrial stromal sarcoma.
To investigate and evaluate the clinicopathological characteristics and treatment strategies for patients with low-grade endometrial stromal sarcoma (LG-ESS).The medical records of LG-ESS patients who were treated at 2 cancer referral centers from January 2005 to December 2015 were retrospectively reviewed.Twenty patients with LG-ESS met the inclusion criteria and were included in this analysis. Hysterectomy with bilateral salpingo-oophorectomy was the mainstay of surgery. Lymphadenectomy was performed in 12 (60%) cases, and no positive nodes were identified. CD10 was the most commonly used immunohistochemistry marker, followed by smooth muscle actin (SMA), estrogen receptor (ER), desmin, progesterone receptor (PR), and S-100; the positivity rates of these markers were 88.2%, 66.7%, 75.0%, 16.7%, 88.9%, and 0, respectively. Postoperative chemotherapy, radiotherapy, and hormonal treatment were provided alone or in combination in 10 (50%) patients, 4 (20%) patients, and 1 (5%) patient, respectively. One patient developed lung metastasis at initial diagnosis, and 2 (10%) patients had recurrence with distant metastasis. They all underwent complete or incomplete resection followed by hormonal treatment. The overall survival time of these patients was 66, 89, and 109 months at last contact, respectively. The 5-year and 10-year disease-free survival rates for the entire cohort were 90% and 72%, respectively. No patients died of the disease.CD10/SMA/ER/PR in combination with desmin/S-100 might improve the diagnostic accuracy. Surgical resection is the foremost treatment for LG-ESS patients with recurrence or distant metastasis. Hormonal treatment may be beneficial for unresectable or residual tumors.


Agranulocytosis associated with dipyrone (metamizol).
Reported estimates of the risk of agranulocytosis associated with metamizol have varied by several orders of magnitude. We assessed this association in a large database for the surveillance of blood dyscrasias. Since 1980, all laboratory units of haematology in a defined area (3.3-4.1x10(6) inhabitants) contribute to the ascertainment of all cases of agranulocytosis meeting strict diagnostic criteria. These cases of patients with agranulocytosis and sex-, age-, hospital- and date-matched controls were interviewed using a structured questionnaire about previous drug exposures, and relative risks were calculated for several categories of exposure to metamizol. After a total follow-up of 78.73x10(6) person-years, 273 community cases of agranulocytosis had been found--of which 96 were excluded for various reasons and 177 were included in the case-control analysis--and were compared with 586 matched controls. Thirty cases of agranulocytosis (16.9%) and nine controls (1.5%) had been exposed to metamizol during the week before the index day. The adjusted relative risk was 25.8 [95% confidence interval (CI), 8.4-79.1], and the attributable incidence was 0.56 (0.4-0.8) cases per million inhabitants and per year. The risk disappeared after more than 10 days since the last dose of metamizol, and it increased with duration of use. Those with agranulocytosis exposed to metamizol had taken the drug for longer periods than the exposed controls. Compared with the cases recently reported from Sweden, the duration of use of metamizol by our exposed cases was substantially shorter, and the use of concomitant medications potentially causing agranulocytosis was lower. In our milieu, agranulocytosis attributable to metamizol is rare. Geographical disparities in its risk estimate can be partly explained by differences in its patterns of use, in terms of dose, duration and concomitant medications.


[State of the kinin system in burn shock and early toxemia].
State of kinin system was studied in blood serum of patients with burns of II, III, IIIb and IV degrees during shock and early toxemia. Content or activity of main components of kinin system (kininogen, kallikreinogen, kallikrein, kininase I (carboxypeptidase N)) were repeatedly estimated at 4-6 hrs intervals; BAEE-esterase and antitryptic activities were also studied within 48-72 hrs after the trauma. At the same period plasminogen and plasmin were estimated in 8 patients. The activation of kinin system in burn shock was demonstrated: content of kininogen was decreased on 30-50% (independently on alteration of total protein in blood serum), the kininase activity was decreased, appearance of free kallikrein was observed and content of kallikreinogen was distinctly lowered already within 10-24 hrs after the trauma. Within 24 hrs after the burn the total decrease of kininogen in circulation accounted for 50-70% of the theoretical content. Fibrinolytic system was also activated during the burn shock. Increase in the antitryptic activity within 30-40 hrs after the trauma, which was previously established, is corroborated; the effect correlated with development of burn intoxication. The data obtained suggest that massive production of free kinins occur apparently within 24-48 hrs after burn.


A miniaturized continuous dielectrophoretic cell sorter and its applications.
There is great interest in highly sensitive separation methods capable of quickly isolating a particular cell type within a single manipulation step prior to their analysis. We present a cell sorting device based on the opposition of dielectrophoretic forces that discriminates between cell types according to their dielectric properties, such as the membrane permittivity and the cytoplasm conductivity. The forces are generated by an array of electrodes located in both sidewalls of a main flow channel. Cells with different dielectric responses perceive different force magnitudes and are, therefore, continuously focused to different equilibrium positions in the flow channel, thus avoiding the need of a specific cell labeling as discriminating factor. We relate the cells' dielectric response to their output position in the downstream channel. Using this microfluidic platform that integrates a method of continuous-flow cell separation based on multiple frequency dielectrophoresis, we succeeded in sorting viable from nonviable yeast with nearly 100% purity. The method also allowed to increase the infection rate of a cell culture up to 50% of parasitemia percentage, which facilitates the study of the parasite cycle. Finally, we prove the versatility of our device by synchronizing a yeast cell culture at a particular phase of the cell cycle avoiding the use of metabolic agents interfering with the cells' physiology.


Women's enlightenment and early antenatal care initiation are determining factors for the use of eight or more antenatal visits in Benin: further analysis of the Demographic and Health Survey.
Within the continuum of reproductive health care, antenatal care (ANC) provides a platform for vital health care functions, such as disease prevention, health promotion, screening, and diagnosis. It has been widely confirmed that by implementing appropriate evidence-based practices, ANC can save lives. Previous studies investigated the utilization of ANC based on the four visits model. The new guidelines set by the World Health Organization 2016 recommended increasing contacts with health providers from four to eight contacts. The present study aims to determine the frequency, determinants, and socioeconomic inequalities of ANC utilization based on the eight or more contacts in Benin. This will provide information for policy makers to improve ANC utilization. We used a population-based cross-sectional data from Benin Demographic and Health Survey (BDHS)-2017-2018. The outcome variable considered for this study was coverage of ≥ 8 ANC contacts. About 1094 women of reproductive age who became pregnant after the new guideline of ≥ 8 ANC contacts was endorsed were included in this study. The determinants for ≥ 8 ANC contacts were measured using multivariable logistic regression. Concentration (Conc.) Index and Lorenz curves were used to estimate the socioeconomic inequalities of ≥ 8 ANC contacts. The level of significance was set at P < 0.05. The coverage of ≥ 8 ANC contacts was 8.0%; 95%CI 6.5%, 9.7%. The results of timing of antenatal care initiation showed that women who had late booking (after 1st trimester) had 97% reduction in ≥ 8 ANC contacts compared with women who initiated ANC contacts within the first trimester (adjusted odds ratio (AOR) = 0.03; 95% CI 0.00, 0.21). In addition, women with medium or high enlightenment were 4.55 and 5.49 as more likely to have ≥ 8 ANC contacts, compared with women having low enlightenment (AOR = 4.55; 95% CI 1.41, 14.69 and AOR = 5.49; 95% CI 1.77, 17.00, respectively). Conc. Index for the household wealth-related factor was 0.33; p < 0.001 for urban women and 0.37; p < 0.001 for the total sample. Similarly, Conc. Index for maternal education was 0.18; p = 0.006 for urban women and 0.21; p < 0.001 for the total sample. Secondary analysis of the BDHS showed low coverage of ≥ 8 ANC contacts in Benin. In addition, women's enlightenment, early ANC initiation, and socioeconomic inequalities determined the coverage of ≥ 8 ANC contacts. The findings bring to limelight the need to enhance women's enlightenment through formal education, exposure to mass media, and other channels of behavior change communication. Health care programs which encourage early antenatal care initiation should be designed or strengthened to enhance the coverage of ANC contacts in Benin.


Spatial and Cross-Sectoral Transfer of Air Pollutant Emissions from the Fleet Electrification in China by 2030.
Fleet electrification shifts emission sources from the tailpipe to electricity generation and automotive supply chains subsequently, with emission transfer among regions. Such a spatial and cross-sectoral transfer of air pollutant emissions might embody uncertain environmental benefits spatially, which has not been comprehensively quantified, mainly due to the complexity of manufacturing processes of electric vehicle (EV) components (e.g., battery). We developed a hybrid life cycle assessment by combining inventory data of major processes and cross-sectoral input-output information and identified how China's EV deployment would influence the spatial redistribution of air pollutant emissions currently (2017) and in the future (2030). The results indicate that fleet electrification could readily reduce life cycle nitrogen oxides (NOx) and nonmethane volatile organic compound (NMVOC) emissions by 12-93%, and the reductions are estimated to be concentrated in major cities and urban agglomerations. However, increased demand for electricity and power battery production could increase PM2.5 and SO2 emissions in 17-55% of grids under all the scenarios, which emerge in coal-rich (e.g., Inner Mongolia, Shanxi) and industrial (e.g., Shandong, Henan, Jiangsu) provinces. By tracing the upstream, 31-55% of vehicle-cycle emissions are from deep supply chains but exhibit diverse sources. It suggests the necessity to relieve emissions leakage of fleet electrification by synchronizing effective environmental management across multiple sectors through EV supply chains.


Neuronal accumulation of alpha- and beta-synucleins in the brain of a GM2 gangliosidosis mouse model.
Sandhoff disease (SD) is a heritable lysosomal storage disease resulting from impaired degradation of GM2 ganglioside. The hallmark pathology of the SD model mouse brain is GM2 ganglioside accumulation in neurons. In the present study, we immunohistochemically investigated the neuronal pathology in SD mouse brains, and demonstrated neuronal accumulation of alpha- and beta-synucleins in addition to GM2 ganglioside. Synuclein-positive neurons were extensively observed throughout SD mouse brains, although the distribution of beta-synuclein was less extensive than that of alpha-synuclein. Synuclein-positive neurons were negative to ubiquitin and PHF-tau. These findings suggest that neuronal synucleins may accumulate secondarily to GM2 ganglioside in SD mouse brains, and that neuronal accumulation of synucleins may be more critical than that of GM2 ganglioside for SD mice.


Effects of protein and energy supplementation on growth, forage intake, forage digestion and nitrogen balance in meat goat kids.
The objective of this study was to further the understanding of the effects of dietary protein and energy supplements on growth, performance, feed intake and grass forage digestibility in growing meat goat wethers. In Experiment 1, an 18% CP complete goat pellet was offered alone (control diet, C) or added (+), or not, as supplement to three grass hays (coastal bermudagrass, CB; Tifton 85 bermudagrass, T; and sorghum-Sudan grass hay, SS), to Boer-cross wethers (n = 72). The resulting seven diets were offered ad libitum. In Experiment 2, four wether goats in metabolism crates were used in a 4 × 4 Latin square design and fed a SS basal diet ad libitum with treatments consisting of no supplement, supplemental urea (200 mg/kg BW daily), supplemental dextrose (0.2% BW daily), or urea + dextrose (200 mg/kg BW daily and 0.2% BW daily, respectively). In Experiment 1, average daily gain (ADG) were -3.8, -5.0 and -6.6 g/day for goats consuming CB, T and SS, respectively, and 69.2, 61.6 and 58.1 g/day for supplemented CB (CB+), T (T+) and SS (SS+), respectively, as compared to 245.8 g/day for ad libitum access to C. Supplementation in Experiment 1 increased (P < 0.01) ADG for all hays when compared to hay-only diets. In Experiment 2, protein and energy supplementation increased (P < 0.01) nitrogen retention but did not impact diet digestibility. The beneficial effects of supplements in Experiment 1 and the increase in nitrogen retention in Experiment 2 cannot be explained by improvements in ruminal fiber utilization, but could be due to post-ruminal nutrient supply and/or increased ruminal microbial protein synthesis.


Cell surface thrombospondin is functionally essential for vascular smooth muscle cell proliferation.
Thrombospondin (TS) is an extracellular glycoprotein whose synthesis and secretion by vascular smooth muscle cells (SMC) is regulated by platelet-derived growth factor. We have used a panel of five monoclonal antibodies against TS to determine an essential role for thrombospondin in the proliferation of cultured rat aortic SMC. All five monoclonal antibodies inhibited SMC growth in 3-d and extended cell number assays; the growth inhibition was specific for anti-TS IgG. The effects of one antibody (D4.6) were examined in detail and were found to be reversable and dose dependent. Cells treated with D4.6 at 50 micrograms/ml (which resulted in a greater than 60% reduction in cell number at day 8) were morphologically identical to control cells. D4.6-treated SMC were analyzed by flow cytofluorimetry and were found to be arrested in the G1 phase of the cell cycle. To determine a possible cellular site of action of TS in cell growth, SMC were examined by immunofluorescence using a polyclonal antibody against TS. TS was observed diffusely bound to the cell surface of serum- or platelet-derived growth factor-treated cells. The binding of TS to SMC was abolished in the presence of heparin, which prevents the binding of TS to cell surfaces and inhibits the growth of SMC. Monoclonal antibody D4.6, like heparin, largely abolished cell surface staining of TS but had no detectable effect on the cellular distribution of fibronectin. These results were corroborated by metabolic labeling experiments. We conclude that cell surface-associated TS is functionally essential for the proliferation of vascular SMC, and that this requirement is temporally located in the G1 phase of the cell cycle. Agents that perturb the interaction of TS with the SMC surface, such as heparin, may inhibit SMC proliferation in this manner.


The social determinants of health for people with type 1 diabetes that progress to end-stage renal disease.
Self-management of type 1 diabetes over a lifetime is complex and challenging even in the best of circumstances, and the social environment can be a powerful determinant of health behaviours and outcomes. The aim of this study was to identify how social determinants of health can impact on the capacity of young people to manage their glycaemic control. The findings emerged from a constructivist grounded theory approach through an in-depth examination of life course events that were recounted through qualitative interviews. The rich descriptive detail obtained from this enquiry locates common experiences and the context in which concordance with therapies occurs and health behaviours develop. This qualitative study of young people with type 1 diabetes who have developed end-stage renal disease demonstrates that there are many factors beyond individual control that can contribute to health outcomes. The social determinants of childhood environment, education, socio-economic status, gender and the culture of public health can contribute to disengagement from treatment regimens and the health-care system and to the development of microvascular complications at a comparatively young age. These findings challenge the assumptions of health-care practitioners about individual responsibility and highlight the importance of considering how social determinants can shape lives, behaviours and health.


Regional Variation in the Predictive Validity of Self-Rated Health for Mortality.
Self-rated health (SRH) is a commonly used measure for assessing general health in surveys in the United States. However, individuals from different parts of the United States may vary in how they assess their health. Geographic differences in health care access and in the prevalence of illnesses may make it difficult to discern true regional differences in health when using SRH as a health measure. In this article, we use data from the 1986 and 1989-2006 National Health Interview Survey Linked Mortality Files and estimate Cox regression models to examine whether the relationship between SRH and five-year all-cause mortality differs by Census region. Contrary to hypotheses, there is no evidence of regional variation in the predictive validity of SRH for mortality. At all levels of SRH, and for both non-Hispanic white and non-Hispanic black respondents, SRH is equally and strongly associated with five-year mortality across regions. Our results suggest that differences in SRH across regions are not solely due to differences in how respondents assess their health across regions, but reflect true differences in health. Future research can, therefore, employ this common measure to investigate the geographic patterning of health in the United States.


Medical Care or Disciplinary Discourses? Preventive Measures against the Black Death in Late Medieval Paris: A Brief Review.
This paper examined the political and social implications of the Compendium de epidemia prescription written by the Masters of the Faculty of Medicine of the University of Paris in the mid-14th century during the Black Death. This study aimed to examine how the effects of power as a discourse owned by medical knowledge are revealed. This paper outlines the composition of the contents based on the 1888 edition edited and translated by Émile H. Rébouis and notes the features of the prescription examined by the existing study of medical history rather than the causes of diseases. Compendium de epidemia seems to have been written primarily for the royal family and nobles who ordered them when looking at prescription-related technologies. At the same time, under the influence of Islamic-Arabic academia, it clearly distinguishes the world of faith and the world of academia (intelligence), explaining the pathogenesis and infection pathways based on causality. The onset substrate is due to heat and humidity, and the prescription is to prevent the two from overdoing in the body. In particular, issues related to heat are criticized in connection with the value of life of knight-noblesse. This is in response to political criticism of the ineffectual French royal family and nobility at the beginning of the Hundred Years' War and shows why this tract sets the utilitas publica at the forefront as an important purpose. The conclusion has shown how medical knowledge produced on the Black Death pandemic how they function as discourses that have a sort of power effect on the value of life of knight-noblesse. It is necessary to conduct if these phenomena can be found in other contemporary medical writings.


Giant cell granuloma of the facial bones.
Giant cell granuloma of the facial bones is a benign, reparative metabolic lesion that usually presents as a painful, expansile mass of the mandible. However, 1 of our patients had the extremely rare findings of multiple other facial bone involvement. In this series of 3 patients followed for > 6 years, the combination of biopsy and clinical presentation provided a stereotypical pattern that enabled an accurate diagnosis in all cases. Our patients were treated successfully with aggressive, but not radical, therapy, excisional curettage, and cauterization of remaining bone. Satisfactory reconstruction and stabilization of the mandible and maxilla were achieved with split rib grafts. The rib graft reconstruction and new bone formation provided excellent contour at 6 years in our adult patients and resulted in normal mandibular growth in the child we treated and followed for 12 years.


First-Trimester Detection of Surface Abnormalities: A Comparison of 2- and 3-Dimensional Ultrasound and 3-Dimensional Virtual Reality Ultrasound.
The aim was to determine the diagnostic performance of 3-dimensional virtual reality ultrasound (3D_VR_US) and conventional 2- and 3-dimensional ultrasound (2D/3D_US) for first-trimester detection of structural abnormalities. Forty-eight first trimester cases (gold standard available, 22 normal, 26 abnormal) were evaluated offline using both techniques by 5 experienced, blinded sonographers. In each case, we analyzed whether each organ category was correctly indicated as normal or abnormal and whether the specific diagnosis was correctly made. Sensitivity in terms of normal or abnormal was comparable for both techniques (P = .24). The general sensitivity for specific diagnoses was 62.6% using 3D_VR_US and 52.2% using 2D/3D_US (P = .075). The 3D_VR_US more often correctly diagnosed skeleton/limb malformations (36.7% vs 10%; P = .013). Mean evaluation time in 3D_VR_US was 4:24 minutes and in 2D/3D_US 2:53 minutes (P < .001). General diagnostic performance of 3D_VR_US and 2D/3D_US apparently is comparable. Malformations of skeleton and limbs are more often detected using 3D_VR_US. Evaluation time is longer in 3D_VR_US.


Host specificity among Ancyrocephalinae (Monogenoidea) of Nebraska sunfish.
This study addressed the problem of local patterns of host specificity among Ancyrocephalinae (Monogenoidea) on bass and sunfish species, when the hosts occur in different species combinations in separate ponds. One hundred fifty-three fish of the Centrarchidae, from 4 study sites in Nebraska, were collected. Host species included bluegill (Lepomis macrochirus), green sunfish (L. cyanellus), largemouth bass (Micropterus salmoides), black crappie (Pomoxis nigromaculatus), white crappie (P. annularis), and rock bass (Ambloplites rupestris). These fish occurred in different species combinations, depending on the pond sampled. Results indicated that several centrarchid species could inhabit the same pond and yet support distinct monogene communities. Clavunculus bursatus, Onchocleidus helicis, O. principalis, and Syncleithrum fusiformis were found only on largemouth bass, regardless of what other centrarchids were present in a particular pond. Haplocleidus dispar occurred on green sunfish, bluegill, largemouth bass, and black crappie, and H. furcatus occurred on both bluegill and largemouth bass. Onchocleidus cyanellus and O. ferox were found on both bluegill and green sunfish. Rock bass were present in only 1 of the 4 ponds, but were not infected with any monogenes, even though co-occurring centrarchids were often heavily infected. Largemouth bass had the most diverse ancyrocephaline communities. The degree of parasite host specificity among these monogenes was inversely related to the diversity of host species present in a particular pond. In general, the parasites were more host specific than might be inferred from the literature; parasite species did not necessarily colonize supposedly receptive host species even when the latter were present, and host relatedness was the major factor in determining whether host species shared a common parasite species.


DeconMSn: a software tool for accurate parent ion monoisotopic mass determination for tandem mass spectra.
DeconMSn accurately determines the monoisotopic mass and charge state of parent ions from high-resolution tandem mass spectrometry data, offering significant improvement for LTQ_FT and LTQ_Orbitrap instruments over the commercially delivered Thermo Fisher Scientific's extract_msn tool. Optimal parent ion mass tolerance values can be determined using accurate mass information, thus improving peptide identifications for high-mass measurement accuracy experiments. For low-resolution data from LCQ and LTQ instruments, DeconMSn incorporates a support-vector-machine-based charge detection algorithm that identifies the most likely charge of a parent species through peak characteristics of its fragmentation pattern. http://ncrr.pnl.gov/software/ or http://www.proteomicsresource.org/.


Reactivity of the human thioltransferase (glutaredoxin) C7S, C25S, C78S, C82S mutant and NMR solution structure of its glutathionyl mixed disulfide intermediate reflect catalytic specificity.
Human thioltransferase (TTase) is a 12 kDa thiol-disulfide oxidoreductase that appears to play a critical role in maintaining the redox environment of the cell. TTase acts as a potent and specific reducing agent for protein-S-S-glutathione mixed disulfides (protein-SSG) likely formed during oxidative stress or as redox intermediates in signal transduction pathways. Accordingly, the catalytic cycle of thioltransferase itself involves a covalent glutathionyl enzyme disulfide intermediate (TTase-C22-SSG). To understand the molecular basis of TTase specificity for the glutathione moiety, we engineered a quadruple Cys to Ser mutant of human TTase (C7S, C25S, C78S, and C82S) which retains only the active site cysteine residue (C22), and we solved its high-resolution NMR solution structure in the mixed disulfide intermediate with glutathione (QM-TTase-SSG). This mutant which cannot form a C22-S-S-C25 intramolecular disulfide displays the same catalytic efficiency (Vmax/KM) and specificity for glutathionyl mixed disulfide substrates as wild-type TTase, indicating that the Cys-25-SH moiety is not required for catalysis or glutathionyl specificity. The structure of human thioltransferase is characterized by a thioredoxin-like fold which comprises a four-stranded central beta-sheet flanked on each side by alpha-helices. The disulfide-adducted glutathione in the TTase-SSG complex has an extended conformation and is localized in a cleft near the protein surface encompassing the residues from helices-alpha2,alpha3, the active site loop, and the loop connecting helix-alpha3 and strand-beta3. Numerous van der Waals and electrostatic interactions between the protein and the glutathione moiety are identified as contributing to stabilization of the complex and confering the substrate specificity. Comparison of the human thioltransferase with other thiol-disulfide oxidoreductases reveals structural and functional differences.


Ear oximetry: accuracy and practicability in the assessment of arterial oxygenation.
The accuracy of three ear oximeters (Waters XP-350, Waters 0-1100, Hewlett-Packard 47201A) was evaluated on 52 subjects during acute progressive and steady-state hypoxia. Ear oximeter readings were compared with measured arterial saturation (SAO2) in arterial or "arterialized" capillary blood samples. Hewlett-Packard (HP) 47201A ear oximeter readings most closely approximated measured Sao2 (y=0.99x - 1.52, r=0.97), although both the HP 47201A and Waters 0-1100 oximeters provided similarly accurate estimates of SAO2 once the characteristics of the individual oximeters were known (standard error of estimate; 2.52 and 2.98 per cent SAO2, respectively). The HP 47201A ear oximeter was relatively insensitive to changes in ear-piece position and differences in skin pigmentation, and offered the added advantages of comfort, simplicity of operation, and stability of characteristics.


A cross-sectional survey of potential factors, motivations, and barriers influencing research participation and retention among people who use drugs in the rural USA.
Despite high morbidity and mortality among people who use drugs (PWUD) in rural America, most research is conducted within urban areas. Our objective was to describe influencing factors, motivations, and barriers to research participation and retention among rural PWUD. We recruited 255 eligible participants from community outreach and community-based, epidemiologic research cohorts from April to July 2019 to participate in a cross-sectional survey. Eligible participants reported opioid or injection drug use to get high within 30 days and resided in high-needs rural counties in Oregon, Kentucky, and Ohio. We aggregated response rankings to identify salient influences, motivations, and barriers. We estimated prevalence ratios to assess for gender, preferred drug use, and geographic differences using log-binomial models. Most participants were male (55%) and preferred methamphetamine (36%) over heroin (35%). Participants reported confidentiality, amount of financial compensation, and time required as primary influential factors for research participation. Primary motivations for participation include financial compensation, free HIV/HCV testing, and contribution to research. Changed or false participant contact information and transportation are principal barriers to retention. Respondents who prefer methamphetamines over heroin reported being influenced by the purpose and use of their information (PR = 1.12; 95% CI: 1.00, 1.26). Females and Oregonians (versus Appalachians) reported knowing and wanting to help the research team as participation motivation (PR = 1.57; 95% CI: 1.09, 2.26 and PR = 2.12; 95% CI: 1.51, 2.99). Beyond financial compensation, researchers should emphasize confidentiality, offer testing and linkage with care, use several contact methods, aid transportation, and accommodate demographic differences to improve research participation and retention among rural PWUD.


Preparation of stable silica surfaces for surface forces measurement.
A surface forces apparatus (SFA) measures the forces between two surfaces as a function of the surface separation distance. It is regarded as an essential tool for studying the interactions between two surfaces. However, sample surfaces used for the conventional SFA measurements have been mostly limited to thin (ca. 2-3 μm) micas, which are coated with silver layers (ca. 50 nm) on their back, due to the requirement of the distance determination by transmission mode optical interferometry called FECO (fringes of equal chromatic order). The FECO method has the advantage of determining the absolute distance, so it should be important to increase the availability of samples other than mica, which is chemically nonreactive and also requires significant efforts for cleaving. Recently, silica sheets have been occasionally used in place of mica, which increases the possibility of surface modification. However, in this case, the silver layer side of the sheet is glued on a cylindrical quartz disc using epoxy resin, which is not stable in organic solvents and can be easily swollen or dissolved. The preparation of substrates more stable under severe conditions, such as in organic solvents, is necessary for extending application of the measurement. In this study, we report an easy method for preparing stable silica layers of ca. 2 μm in thickness deposited on gold layers (41 nm)/silica discs by sputtering, then annealed to enhance the stability. The obtained silica layers were stable and showed no swelling in organic solvents such as ethanol and toluene.


Image Sensor Noise Parameter Estimation by Variance Stabilization and Normality Assessment.
High-quality image denoising requires taking into account the dependence of the noise distribution on the original image. The parameters of this dependence are often unknown and we propose a new method to estimate them here. Using an optimization procedure, we find a variance-stabilizing transformation, which transforms the input image into an image with signal-independent noise. Principal component analysis of blocks of the transformed image allows estimation of the variance of the signal-independent noise so that the parameters of the original noise model can be computed. The image blocks for processing are selected in such a way that they have low stochastic texture strength but preserve the noise distribution. The algorithm does not require the original image to have homogeneous areas and can accurately process images with regular textures. It has high computational efficiency and smaller maximum estimation error compared with the state of the art. Our experiments have also shown that denoising with the noise parameters estimated by this method leads to the same results as denoising with the true noise parameters.


SDF-1 responsiveness does not correlate with CXCR4 expression levels of developing human bone marrow B cells.
Chemokines and their receptors are broadly expressed in different tissues and are involved in diverse biologic processes. Gene inactivation studies have shown that both stromal cell derived factor-1 (SDF-1) and chemokine receptor 4 (CXCR4) are essential for B lymphopoiesis. However, it is not yet clear by which mechanisms B lymphopoiesis is affected. In the present study, we have examined CXCR4 expression and function on primary B cells representing sequential stages of development (eg, pro-B, pre-B, immature, and mature B cells) in fetal and adult bone marrow. The expression of CXCR4 was observed to be sinusoidal. Expression was highest on pre-B cells, decreased as cells developed into immature B cells, and then increased again upon transition to the mature B-cell stage. The corresponding ligand SDF-1 was shown to trigger vigorous cell signaling and migration responses, which are restricted to early lineage B cells. The responsiveness to SDF-1 was markedly decreased for immature and mature B cells despite relatively high levels of CXCR4 expression. Thus, the diminished responsiveness to SDF-1 by more mature B cells was determined to be disproportionate to the level of CXCR4 expression. These findings raise the possibility that CXCR4 function is differentially controlled during B lymphopoiesis and may be relevant to the compartmentalization of B-cell precursors in the bone marrow.


Large-scale serological screening for cytomegalovirus antibodies in homosexual males by enzyme-linked immunosorbent assay.
We compared an enzyme-linked immunosorbent assay (ELISA) with complement fixation and radioimmunoassay in determining the presence of immunoglobulin antibodies to cytomegalovirus. Of an initial 93 serum samples tested, the correlation between ELISA and radioimmunoassay was 98.9% and that between ELISA and complement fixation was 96.1%. ELISA was used to screen 1,123 homosexual men in San Francisco. Of 479 men attending a homosexual health fair, 35 (7%) lacked cytomegalovirus antibodies by ELISA. Only 15 (2%) of 644 homosexual men attending a municipal sexually transmitted disease clinic were found to be seronegative. All but one of the seronegatives detected by ELISA were also seronegative by radioimmunoassay and complement fixation. We conclude that ELISA can be used to reliably perform large-scale screening for the presence of immunoglobulin G antibodies to cytomegalovirus.


3D Bioprinting of Diatom-Laden Living Materials for Water Quality Assessment.
Diatoms have long been used as living biological indicators for the assessment of water quality in lakes and rivers worldwide. While this approach benefits from the great diversity of these unicellular algae, established protocols are time-consuming and require specialized equipment. Here, this work 3D prints diatom-laden hydrogels that can be used as a simple multiplex bio-indicator for water assessment. The hydrogel-based living materials are created with the help of a desktop extrusion-based printer using a suspension of diatoms, cellulose nanocrystals (CNC) and alginate as bio-ink constituents. Rheology and mechanical tests are employed to establish optimum bio-ink formulations, whereas cell culture experiments are utilized to evaluate the proliferation of the entrapped diatoms in the presence of selected water contaminants. Bioprinting of diatom-laden hydrogels is shown to be an enticing approach to generate living materials that can serve as low-cost bio-indicators for water quality assessment.


A preliminary investigation of pelvic obliquity patterns during gait in persons with transtibial and transfemoral amputation.
Differences in pelvic obliquity between small groups of persons with unilateral lower limb amputation and subjects without amputation were analyzed. Kinematic walking data were collected as six males with transtibial amputation and three males with transfemoral amputation walked over a range of speeds. The pelvic obliquity patterns and amplitudes from the groups with amputation were compared to normal data. Results showed that smaller peak-to-peak amplitudes of pelvic obliquity were associated with higher amputation levels. Pelvic drop during early prosthetic-limb stance tended to be smaller than during early sound-limb stance. Most of the subjects with amputation exhibited an obliquity pattern in which the hip on the prosthetic side was raised above the stance-side hip during prosthetic swing phase, indicative of a compensatory action known as hip-hiking. The subjects with transfemoral amputation exhibited this hip-hiking pattern during sound-limb swing phase as well. Results from this study suggest that further investigation is required to determine those limitations of current prosthetic technology that adversely affect pelvic obliquity in the gait of persons with amputation, and to determine if significant benefit can be realized by restoring a normal pattern of pelvic obliquity to the gait of persons with amputation.


Individual axon morphology and thalamocortical topography in developing rat somatosensory cortex.
The morphology of individual thalamocortical axons in developing rat primary somatosensory cortex was studied using lipophilic tracers. Anterograde labeling with lipophilic dyes demonstrated a topographical organization of thalamocortical projections exiting the thalamus as early as embryonic day (E) 16; retrograde labeling studies demonstrated topography of these projections as they reached the cortex as early as E18. At E17, axons course tangentially within the intermediate zone and turn or branch near the deepest layer of cortex (layer VIb), suggesting the presence of guidance cues in this region. Axons appear to grow and branch progressively within layers VIb and VIa during the following days; axons in the intermediate zone may give rise to radially directed branches. Individual axons appear to grow steadily and progressively into the cortex, with the leading front of axons at the transition zone between the cortical plate (CP) and the differentiating cortical layers. At birth (P0), thalamocortical axons extend radially through layers VIa and V and emit branches within these layers; some axons reach the CP. By P1, layer IV has begun to differentiate and axons begin to form a few simple branches in the vicinity of the layer IV cells. Over the ensuing week, axons generate more branches within layer IV, but the tangential extent of individual axon arbors does not exceed the width of a barrel. By P7, individual axons overlap within barrel clusters, and individual axons span the width of a cluster. These observations indicate that thalamic afferents develop by progressive growth of arbors that remain spatially restricted, rather than by overbranching and retracting arbors.


Circulating Ly-6C+ myeloid precursors migrate to the CNS and play a pathogenic role during autoimmune demyelinating disease.
Mature myeloid cells (macrophages and CD11b(+) dendritic cells) form a prominent component of neuroinflammatory infiltrates in multiple sclerosis and experimental autoimmune encephalomyelitis (EAE). The mechanism by which these cells are replenished during relapsing and chronic neuroinflammation is poorly understood. Here we demonstrate that CD11b(+)CD62L(+)Ly6C(hi) monocytes with colony-forming potential are mobilized into the bloodstream by a granulocyte-macrophage colony-stimulating factor-dependent pathway immediately before EAE relapses. Circulating Ly6C(hi) monocytes traffic across the blood-brain barrier, up-regulate proinflammatory molecules, and differentiate into central nervous system dendritic cells and macrophages. Enrichment of Ly6C(hi) monocytes in the circulating pool is associated with an earlier onset and increased severity of clinical EAE. Our studies indicate that granulocyte-macrophage colony-stimulating factor-driven release of Ly6C(hi) precursors from the bone marrow prevents exhaustion of central nervous system myeloid populations during relapsing or chronic autoimmune demyelination, suggesting a novel pathway for therapeutic targeting.


Heterogeneity in the distribution of genetically modified and conventional oilseed rape within fields and seed lots.
The implementation of co-existence in the commercialisation of GM crops requires GM and non-GM products to be segregated in production and supply. However, maintaining segregation in oilseed rape will be made difficult by the highly persistent nature of this species. An understanding of its population dynamics is needed to predict persistence and develop potential strategies for control, while to ensure segregation is being achieved, the production of GM oilseed rape must be accompanied by the monitoring of GM levels in crop or seed populations. Heterogeneity in the spatial distribution of oilseed rape has the potential to affect both control and monitoring and, although a universal phenomenon in arable weeds and harvested seed lots, spatial heterogeneity in oilseed rape populations remains to be demonstrated and quantified. Here we investigate the distribution of crop and volunteer populations in a commercial field before and during the cultivation of the first conventional oilseed rape (winter) crop since the cultivation of a GM glufosinate-tolerant oilseed rape crop (spring) three years previously. GM presence was detected by ELISA for the PAT protein in each of three morphologically distinguishable phenotypes: autumn germinating crop-type plants (3% GM), autumn-germinating 'regrowths' (72% GM) and spring germinating 'small-type' plants (17% GM). Statistical models (Poisson log-normal and binomial logit-normal) were used to describe the spatial distribution of these populations at multiple spatial scales in the field and of GM presence in the harvested seed lot. Heterogeneity was a consistent feature in the distribution of GM and conventional oilseed rape. Large trends across the field (50 x 400 m) and seed lot (4 x 1.5 x 1.5 m) were observed in addition to small-scale heterogeneity, less than 20 m in the field and 20 cm in the seed lot. The heterogeneity was greater for the 'regrowth' and 'small' phenotypes, which were likely to be volunteers and included most of the GM plants detected, than for the largely non-GM 'crop' phenotype. The implications of the volunteer heterogeneity for field management and GM-sampling are discussed.


Thermoinhibition uncovers a role for strigolactones in Arabidopsis seed germination.
Strigolactones are host factors that stimulate seed germination of parasitic plant species such as Striga and Orobanche. This hormone is also important in shoot branching architecture and photomorphogenic development. Strigolactone biosynthetic and signaling mutants in model systems, unlike parasitic plants, only show seed germination phenotypes under limited growth condition. To understand the roles of strigolactones in seed germination, it is necessary to develop a tractable experimental system using model plants such as Arabidopsis. Here, we report that thermoinhibition, which involves exposing seeds to high temperatures, uncovers a clear role for strigolactones in promoting Arabidopsis seed germination. Both strigolactone biosynthetic and signaling mutants showed increased sensitivity to seed thermoinhibition. The synthetic strigolactone GR24 rescued germination of thermoinbibited biosynthetic mutant seeds but not a signaling mutant. Hormone analysis revealed that strigolactones alleviate thermoinhibition by modulating levels of the two plant hormones, GA and ABA. We also showed that GR24 was able to counteract secondary dormancy in Arabidopsis ecotype Columbia (Col) and Cape Verde island (Cvi). Systematic hormone analysis of germinating Striga helmonthica seeds suggested a common mechanism between the parasitic and non-parasitic seeds with respect to how hormones regulate germination. Thus, our simple assay system using Arabidopsis thermoinhibition allows comparisons to determine similarities and differences between parasitic plants and model experimental systems for the use of strigolactones.


[The genetic sequelae of irradiation in mammals (a review of the literature)].
The problem of hereditary effects of mammal exposure to ionizing radiation has a 95-year history but to date, no simple final solution has been available. Many papers on this problem specify the dependence of the hereditary effects on dose rate, regime, physical nature of radiation exposure, type, line and age of mammals that were studied. Over many years it was studied mainly as an aspect of hereditary radiation effects in progeny of one irradiated and the second non-irradiated parents. Recently due to the large-scale expansion of ionizing irradiation, it has turned out urgent to study hereditary radiation effects in progeny of both irradiated parents. However, the original studies on this problem are not numerous, and in the summarized articles, the problem practically had no specified presentation.


Behavioral activation as a common mechanism of change across different orientations and disorders.
Behavioral activation is an effective treatment for depression, based on targeting deprivation of positive rewards. It becomes more and more evident that many forms of mental disorders and psychological suffering involve reduction of goal-driven and pleasant activities. This reduction leaves negative mental states free to take the center of consciousness, without being counterbalanced by positive feelings, memories, and experiences of agency, self-efficacy, competence, relaxation, energy, and satisfaction. Reduced activity can be found in disorders ranging from chronic pain to personality disorders and schizophrenia. We believed that the time was ripe to reason that behavioral activation, more than a treatment in itself, can be considered a fundamental mechanism of change in the psychotherapy for a wide range of dysfunctions, irrespective of the clinician's preferred orientation. In this special section, authors from diverse orientations describe how they integrate behavioral activation in their clinical practice, while providing rich and detailed clinical illustrations. We reflect that behavioral activation needs to be implemented in many forms of psychotherapy and for a wide range of disorders. Moreover, it has the potential to make treatment faster and maximize outcomes, as long as it is delivered under careful consideration of the therapy relationship. (PsycINFO Database Record


Microarray coupled with methyl-CpG targeted transcriptional activation (MeTA-array) identifies hypermethylated genes containing the stringent criteria of CpG islands at high frequency.
The identification of genes transcriptionally silenced by DNA hypermethylation is important in understanding the molecular basis of epigenetically regulated biological processes such as X chromosome inactivation, genomic imprinting and cancer development. Our previously developed methyl-CpG targeted transcriptional activation (MeTA) method reactivates epigenetically silenced genes by using a methyl-CpG binding domain from MBD2 with a transcriptional activation domain. We applied either MeTA or a conventional DNA demethylating agent, 5-aza-cytidine (Aza-CR), to human embryonic kidney cell line 293T and analyzed gene expression profiles by microarray: 138 and 202 genes that are upregulated 5-fold or more were identified by MeTA and Aza-CR, respectively. The top ten upregulated genes detected by MeTA were further analyzed. We found associations between expressional restorations by MeTA, methylation status and NFκB (AD)-MBD fusion protein bindings in CpG islands (CGIs) around the transcription start site of the genes. Importantly, MeTA can upregulate genes meeting the stringent criteria of CGIs defined by Takai and Jones at the promoter region at higher frequency: 109 of 138 (79.0%) genes in MeTA vs. 121 of 202 (59.9%) genes in Aza-CR. Interestingly, only 27 genes were upregulated by both methods; MeTA may identify methylated genes that show low levels of induction by the DNA demethylating agents; demethylating agents may also induce factors that help re-expression of genes that harbor less stringent or no CGIs. These results suggest that microarray coupled with MeTA (MeTA-array) is an efficient alternative way to identify transcriptionally silenced genes by DNA hypermethylation.


Cholesterol level regulates endosome motility via Rab proteins.
The role of cholesterol in the regulation of endosome motility was investigated by monitoring the intracellular trafficking of endocytosed folate receptors (FRs) labeled with fluorescent folate conjugates. Real-time fluorescence imaging of HeLa cells transfected with green fluorescent protein-tubulin revealed that FR-containing endosomes migrate along microtubules. Moreover, microinjection with antibodies that inhibit microtubule-associated motor proteins demonstrated that dynein and kinesin I participate in the delivery of FR-containing endosomes to the perinuclear area and plasma membrane, respectively. Further, single-particle tracking analysis revealed bidirectional motions of FR endosomes, mediated by dynein and kinesin motors associated with the same endosome. These experimental tools allowed us to use FR-containing endosomes to evaluate the impact of cholesterol on intracellular membrane trafficking. Lowering plasma membrane cholesterol by metabolic depletion or methyl-beta-cyclodextrin extraction was found to both increase FR-containing endosome motility and change endosome distribution from colocalization with Rab7 to colocalization with Rab4. These data provide evidence that cholesterol regulates intracellular membrane trafficking via modulation of the distribution of low molecular weight G-proteins that are adaptors for microtubule motors.


Computed tomographic-derived measurements of shunt fraction and hepatic perfusion in dogs with a single extrahepatic portosystemic shunt in a clinical setting.
To evaluate the clinical feasibility and usefulness of measuring shunt fraction (SF) and hepatic perfusion with CT in dogs with a single extrahepatic portosystemic shunt (EPSS). 36 client-owned dogs with EPSS. Dogs with EPSS referred for treatment between February 2016 and May 2017 were eligible for the clinical trial. Shunt type, SF, and hepatic perfusion were determined in each dog with a 320-row multidetector CT scanner, and surgical treatment was performed by a single veterinary surgeon. Differences in results between dogs grouped according to age (< 3 years vs ≥ 3 years), shunt type, and subgroups (eg, clinical signs and surgical procedure) were analyzed, and correlations between the SF and hepatic perfusion variables were evaluated. The median SF was higher in dogs < 3 years old (74.6%; n = 18) versus dogs ≥ 3 years old (35.1%; 18). Correlations were identified between SF and hepatic perfusion variables, and differences in results for SF and hepatic perfusion variables were detected between dogs grouped according to shunt type. Results indicated that CT-derived measurements of SF and hepatic perfusion variables in dogs with EPSS were feasible and could be useful (eg, estimating EPSS condition status and planning treatment) in clinical settings. In addition, our findings suggested that perfusion CT could be useful for distinguishing hemodynamic characteristics among different types of portosystemic shunts in dogs.


Antimicrobial resistance in the next 30 years, humankind, bugs and drugs: a visionary approach.
To describe the current standards of care and major recent advances with regard to antimicrobial resistance (AMR) and to give a prospective overview for the next 30 years in this field. Review of medical literature and expert opinion were used in the development of this review. There is undoubtedly a large clinical and public health burden associated with AMR in ICU, but it is challenging to quantify the associated excess morbidity and mortality. In the last decade, antibiotic stewardship and infection prevention and control have been unable to prevent the rapid spread of resistant Gram-negative bacteria (GNB), in particular carbapenem-resistant Pseudomonas aeruginosa (and other non-fermenting GNB), extended-spectrum β-lactamase (ESBL)-producing and carbapenem-resistant Enterobacteriaceae (CRE). The situation appears more optimistic currently for Gram-positive, where Staphylococcus aureus, and particularly methicillin-resistant S. aureus (MRSA), remains a cardinal cause of healthcare-associated infections worldwide. Recent advancements in laboratory techniques allow for a rapid identification of the infecting pathogen and antibiotic susceptibility testing. Their impact can be particularly relevant in settings with prevalence of MDR, since they may guide fine-tuning of empirically selected regimen, facilitate de-escalation of unnecessary antimicrobials, and support infection control decisions. Currently, antibiotics are the primary anti-infective solution for patients with known or suspected MDR bacteria in intensive care. Numerous incentives have been provided to encourage researchers to work on alternative strategies to reverse this trend and to provide a means to treat these pathogens. Although some promising antibiotics currently in phase 2 and 3 of development will soon be licensed and utilized in ICU, the continuous development of an alternative generation of compounds is extremely important. There are currently several promising avenues available to fight antibiotic resistance, such as faecal microbiota, and phage therapy.


Novel steroid receptor phyto-modulator compound a inhibits growth and survival of prostate cancer cells.
Androgen receptor (AR)- and glucocorticoid receptor (GR)- mediated signaling play opposite roles in prostate tumorigenesis: AR promotes prostate carcinoma (PC) development, whereas GR acts as a tumor suppressor. Compound A (CpdA) is a stable analogue of an aziridine precursor from the African shrub Salsola tuberculatiformis Botschantzev. It was shown recently that, in model cells, CpdA inhibits AR function and strongly enhances anti-inflammatory function of GR. We determined the effects of CpdA in prostate cells with different AR/GR status: (a) RWPE-1 cells (AR(low)/GR(low)), (b) PC3 and DU145 cells (GR(+)/AR(-)), (c) LNCaP cells (GR(-)/AR(+)), and (d) LNCaP-GR cells expressing both receptors. Similar to steroid hormones, CpdA induces nuclear translocation of both receptors in prostate cells. Despite this, CpdA inhibits DNA-binding and transactivation potential of AR. In addition, CpdA inhibits GR-mediated transactivation but induces GR transrepression via inhibition of several transcription factors, including nuclear factor-kappaB, AP-1, Ets-1, Elk-1, SRF, CRE/ATF, and NFATc. CpdA strongly decreases growth and induces caspase-dependent apoptosis in highly malignant PC3 and DU145 cells and in other AR/GR-expressing PC cells. The cytostatic effect of CpdA is receptor dependent: down-regulation of GR or AR expression drastically attenuates CpdA-induced PC cell growth inhibition. Finally, virtual docking analysis indicates that CpdA shares binding cavities in AR and GR ligand-binding domains with corresponding hormones and forms hydrogen bonds (H-bond) with the same amino acids that are involved in H-bond formation during steroid binding. Overall, our data suggest that CpdA is a unique dual-target steroid receptor modulator that has a high potential for PC therapy.


Ion-pair high-pressure liquid chromatography of cis-trans isomers of retinoic acid in tissues of vitamin A-sufficient rats.
Naturally occurring retinoids were separated by reversed-phase high-pressure liquid chromatography on an octadecylsilane column eluted with acetonitrile-potassium phosphate buffer (pH 7.2) mixtures. The order of elution from a mixture of 500 ng each of the following standards was 4-oxo retinoic acid (RA), retinyl phosphate (RP), 13-cis RA, all-trans RA, retinol, retinal, retinyl acetate, anhydroretinol, and retinyl palmitate. This method was employed to investigate the cis-trans isomerization of RA and its metabolism in vitamin A-sufficient male rats. Rats (200 g) were injected intraperitoneally with 50 muCi of either [10-3H]-all-trans RA (5.4 micrograms) or [11-3H]-13-cis RA (8.8 micrograms) and killed after 0.5 and 3 hr. Blood, liver, kidney, small intestines, and testes were removed and lyophilized. All-trans RA was converted at 0.5 hr after injection to 13-cis RA in all the tissues examined, with the exception of the small intestine; the conversion ranged from 2.4 to 6.9% of the total radioactivity. In addition, all-trans RA was converted to metabolites (17.5--47.7%) of greater polarity than 4-oxo RA. After 3 hr, most of the radioactivity (75--90%) was found in the highly polar metabolites. 13-cis RA was also partially isomerized to the all-trans RA and to the highly polar metabolites by 0.5 and 3 hr after injection. Appreciable radioactivity (10--41%) still resided in the 13-cis RA fraction after 3 hr. These results indicate that 13-cis RA is partially isomerized to all-trans RA and that all-trans RA is rapidly metabolized to highly polar compounds in tissues of vitamin A-sufficient rats.


Neuroimaging and pediatrics.
The emphasis in understanding significant categories of pediatric brain and spinal cord lesions, such as brain neoplasms, white matter diseases, fetal abnormalities and lesions of the pituitary gland, is changing towards a clinical perspective with respect to modern imaging techniques. The initial experience with magnetic resonance imaging (MRI), Doppler sonography, computerized tomography (CT), and high-resolution ultrasound (US) is now being consolidated, compared and contrasted with each other and with the increasing clinical experience, particularly in diseases that are peculiar to childhood.


Effect of a combination of medium chain triglycerides, linoleic acid, soy lecithin and vitamins A and E on wound healing in rats.
The aim of the study was to determine the effect of a combination of medium chain triglycerides (caprylic, capric, caproic and lauric acids), linoleic acid (essential fatty acid), vitamins A and E and soy lecithin, through a morphometric study, on the wound healing kinetics of experimental cutaneous ulcers. A total of 45 male Wistar rats were used, in which a skin flap of total thickness with an area of 4 cm2 was removed. The animals were divided randomly into 3 groups of 15 rats each, Control, Reference and Test groups, which were treated topically with 0.9% NaCl, a preparation of clostebol combined with neomycin sulfate and the test formulation, respectively. The wound areas were measured by digital planimetry at days zero, 3, 7 and 12 postoperative. Based on the wound area, we determined the degree of tissue repair and mean rate of repair at different time intervals. At day 3, an expansion of the wound area was observed in the Reference group and slight contraction in the Control and Test groups. On the subsequent days, the healing process, according to the degree of repair, proceeded in a linear manner, such that, at day 12, the healed area reached 77.95% of the initial ulcerated region in the Control group, 78.40% in the Reference group and 83.49% in the Test group, showing no significant differences. The overall mean rate of repair was equally similar at 12 days of treatment: 25.79 mm2/dia in the Control group, 25.42 mm2/dia in the Reference group and 27.38 mm2/dia in the Test group. The test preparation, applied topically on the experimentally induced cutaneous ulcers in rats, did not accelerate the process of tissue repair by secondary union.


Singular efficacy of trimethylamine N-oxide to counter protein destabilization in ice.
This study reports the first quantitative estimate of the thermodynamic stability (Delta G degrees ) of a protein in low-temperature partly frozen aqueous solutions in the presence of the protective osmolytes trimethylamine N-oxide (TMAO), glycine betaine, and sarcosine. The method, based on guanidinium chloride denaturation of the azurin mutant C112S from Pseudomonas aeruginosa, distinguishes between the deleterious effects of subfreezing temperatures from those due specifically to the formation of a solid ice phase. The results point out that in the liquid state molar concentrations of these osmolytes stabilize significantly the native fold and that their effect is maintained on cooling to -15 degrees C. At this temperature, freezing of the solution in the absence of any additive causes a progressive destabilization of the protein, Delta G degrees decreasing up to 3-4 kcal/mol as the fraction of liquid water in equilibrium with ice ( V L) is reduced to less than 1%. The ability of the three osmolytes to prevent the decrease in protein stability at small V L varies significantly among them, ranging from the complete inertness of sarcosine to full protection by TMAO. The singular effectiveness of TMAO among the osmolytes tested until now is maintained high even at concentrations as low as 0.1 M when the additive stabilization of the protein in the liquid state is negligible. In all cases the reduction in Delta G degrees caused by the solidification of water correlates with the decrease in m-value entailing that protein-ice interactions generally conduct to partial unfolding of the native state. It is proposed that the remarkable effectiveness of TMAO to counter the ice perturbation is owed to binding of the osmolyte to ice, thereby inhibiting protein adsorption to the solid phase.


Should We Perform Early Cataract Surgery? A Patient Reported Outcome Study.
Current guidance states that access to cataract surgery should not be restricted by visual acuity (VA); nevertheless, 6/12 is used as a cut-off criterion in some health institutions. This study aims to determine the benefits of performing cataract surgery in patients with VA of 6/9 or better in both eyes; determine whether these benefits change over time; and compare the benefit observed between early first eye and second eye surgery. Fifty adults with VA at least 6/9 in the worst eye and no ocular comorbidity were recruited. The Visual Function Index (VF-14) and Impact of Visual Impairment (IVI) questionnaires were conducted pre-operatively, 4 months post-operatively, and 12 months post-operatively. The t-test or a non-parametric equivalent was used to compare averages between groups. The mean change in VF-14 from baseline to 4 months was 16.43 (95% CI 12.49-20.50, p < 0.001) and the median change in IVI was 6.5 (IQR 9.75, p < 0.001). There was no significant difference between 4-month and 12-month follow-up (p > 0.05). There was no significant difference in the change in visual function between the first and second eye surgery (p > 0.05). This study provides evidence that visual function improves after cataract surgery in patients with pre-operative VA of 6/9 or better. The improvement observed was clinically significant and unchanged a year after surgery. Visual function improved after second eye as much as after first eye surgery. Assessing patient reported visual function may give a more realistic indication of the benefit of early cataract surgery than relying on VA alone.


Interactions with compliant loads alter stretch reflex gains but not intermuscular coordination.
The human motor system regulates arm mechanics to produce stable postures during interactions with different physical environments. This occurs partly via involuntary mechanisms, including stretch reflexes. Previous single-joint studies demonstrated enhanced reflex sensitivity during interactions with compliant environments, suggesting reflex gain increases to enhance limb stability when that stability is not provided by the environment. This study examined whether similar changes in reflex gain are present throughout the limb following perturbations that simultaneously influence multiple joints. Furthermore, we investigated whether any observed modulation was accompanied by task-specific changes in reflex coordination across muscles, a question that cannot be addressed using single-joint perturbations. Reflexes were elicited during the maintenance of posture by perturbing the arm with a three degrees of freedom robot, configured to have isotropic stiffness of either 10 N/m (compliant) or 10 kN/m (stiff). Perturbation characteristics were matched in both environments. Reflex magnitude was quantified by the average rectified electromyogram, recorded from eight muscles crossing the elbow and shoulder. Reflex coordination was assessed using independent components analysis to compare reflex activation patterns during interactions with stiff and compliant environments. Stretch reflex sensitivity increased significantly in all muscles during interactions with the compliant environment and these changes were not due to changes in background muscle activity. However, there was no significant difference in the reflex coordination patterns observed during interactions with the stiff and compliant environments. These results suggest that reflex modulation occurred through altered use of fixed muscle coordination patterns rather than through a change in reflex coordination.


Quality of human-computer interaction--results of a national usability survey of hospital-IT in Germany.
Due to the increasing functionality of medical information systems, it is hard to imagine day to day work in hospitals without IT support. Therefore, the design of dialogues between humans and information systems is one of the most important issues to be addressed in health care. This survey presents an analysis of the current quality level of human-computer interaction of healthcare-IT in German hospitals, focused on the users' point of view. To evaluate the usability of clinical-IT according to the design principles of EN ISO 9241-10 the IsoMetrics Inventory, an assessment tool, was used. The focus of this paper has been put on suitability for task, training effort and conformity with user expectations, differentiated by information systems. Effectiveness has been evaluated with the focus on interoperability and functionality of different IT systems. 4521 persons from 371 hospitals visited the start page of the study, while 1003 persons from 158 hospitals completed the questionnaire. The results show relevant variations between different information systems. Specialised information systems with defined functionality received better assessments than clinical information systems in general. This could be attributed to the improved customisation of these specialised systems for specific working environments. The results can be used as reference data for evaluation and benchmarking of human computer engineering in clinical health IT context for future studies.


[Isolation of the theta-hemolysin of Cl. perfringens].
Teta-hemolysine was purified from Cl. perfringens strain BP6K 28 as follows: reprecipitation in the isoelectric point of the enzyme with 2 N H2SO4 containing 15% NaCl, DEAE cellulose chromatography, gel filtration on Sephadex G-100-G75 or Bio Gel P-60--P-100, rechromatography on DEAE-Sephadex A-50 and affinity chromatography. The biological activity of homogenous teta-hemolysine, estimated by complete hemolysis of human erythrocytes, exceeded 100, 000 theta E over mg protein but the enzyme was highly labile. Molecular weight of the enzyme was 53,000 daltons.


DNA vaccines for poultry: the jump from theory to practice.
DNA vaccines could offer a solution to a number of problems faced by the poultry industry; they are relatively easy to manufacture, stable, potentially easy to administer, can overcome neonatal tolerance and the deleterious effects of maternal antibody, and do not cause disease pathology. Combined with this, in ovo vaccination offers the advantage of reduced labor costs, mass administration and the induction of an earlier immune response. Together, this list of advantages is impressive. However, this combined technology is still in its infancy and requires many improvements. The potential of CpG motifs, DNA vaccines and in ovo vaccination, however, can be observed by the increasing number of recent reports investigating their application in challenge experiments. CpG motifs have been demonstrated to be stimulatory both in vitro and in vivo. In addition, DNA vaccines have been successfully delivered via the in ovo route, albeit not yet through the amniotic fluid. Lastly, a recent report has demonstrated that a DNA vaccine against infectious bronchitis virus administered via in ovo vaccination, followed by live virus boost, can slightly improve on the protective effect induced by the live virus alone. Therefore, DNA vaccination via the in ovo route is promising and offers potential as a poultry vaccine, however, efficacy needs to be improved and the costs of production reduced before it is likely to be beneficial to the poultry industry in the long term.


Scanning electron microscopy of dentition: methodology and ultrastructural morphology of tooth wear.
Scanning electron micrographs were taken of sets of human molars-those of paleo-Indians used in mastication of, ostensibly, a highly abrasive diet, and those of contemporary Americans. Different ultrastructural patterns of enamel wear were observed between the groups.


The Impact of Global Alignment and Proportion Score and Bracing on Proximal Junctional Kyphosis in Adult Spinal Deformity.
Retrospective chart review. The goal of this study is to examine the relationship between global alignment and proportion (GAP) score and postoperative orthoses with likelihood of developing proximal junctional kyphosis (PJK). Patients who underwent thoracic or lumbar fusions of ≥4 levels for adult spinal deformity (ASD) with 1-year post-operative alignment x-rays were included. Chart review was conducted to determine spinopelvic alignment parameters, PJK, and reoperation. A total of 81 patients were included; baseline and 1-year postoperative alignment did not differ between patients with and without PJK. There was no PJK in 53.1%, 29.6% had PJK from 10-20°, and 17.3% had severe PJK over 20° (sPJK). At baseline, 80% of patients had severely disproportioned GAP, 13.75% moderate, 6.25% proportioned. GAP improved across the population, but improved GAP was not associated with sPJK. Greater correction of the upper instrumented vertebra to pelvic angle (UIV-PA) was associated with a larger PJK angle (PJKA) change (R = -0.28) as was the 1 year T1-upper instrumented vertebra (T1-UIV) angle (R = 0.30), both P < .05. GAP change was not correlated with PJKA change. Postoperative orthoses were used in 46% of patients and did not impact sPJK. There was no correlation between PJK and GAP or change in GAP. Greater correction of UIV-PA and larger postop T1-UIV was associated with greater PJKA change; suggesting that the greater alignment correction led to greater likelihood of failure. Postoperative orthoses had no impact on PJK.


Analyses of age, gender and other risk factors of erythropoietin resistance in pediatric and adult dialysis cohorts.
Previous studies often report lower responses to erythropoietin (EPO) therapy in pediatric patients on chronic dialysis than those of adults. Because of the greater capacity for hematopoiesis in the younger population, these studies may be confounded by poorly identified variables. Thus, we made parallel studies of pediatric and adult cohorts to explore the relationship between age, gender and other risk factors with EPO resistance. Thirty pediatric subjects (aged 8-20 years) and 66 adult subjects (aged 22-85 years) on chronic hemodialysis and EPO were enrolled. After stratification by 50th percentile of EPO response, the best predictive model was identified by backward elimination of the risk factors with the least contribution to the regression. Relationship between age, gender and EPO resistance was examined by analysis of covariance (ANCOVA). The most predictive model of EPO response for the pediatric cohort had, as the major variables, urea clearance x dialysis duration/total body water (Kt/V), urea reduction ratio (URR), intact parathyroid hormone (iPTH), blood loss, normalized protein catabolic rates (nPCR) and indices of malnutrition and inflammation, whereas adults had iron and folate deficiencies as the dominant variables. Although EPO resistance was more common in female subjects than in male subjects, relationship with neither age nor gender was significant. Furthermore, the prescription of a larger (initiating) EPO dose by pediatric physicians compared with adult nephrologists confounded the interaction between age and EPO resistance. In summary EPO resistance in the pediatric dialysis cohort was predicted by nutritional deficits, inflammation, poor dialysis, and hyperparathyroidism, while iron and folate deficits were the major determinants in adults. Although confounded by the pattern of EPO prescription, neither age nor gender was predictive of EPO resistance in the two study groups.


Tumor conference No. 13. Fatal amelanotic nodular melanoma in a 15-year old girl.
The patient was a 15-year-old girl who was found to have a amelanotic nodular melanoma on a leg. The local malignancy was widely excised and an elective lymph node dissection was performed. On microscopic examination of the removed inguinal lymph nodes, one showed metastatic involvement. She was free of obvious disease for slightly more than one year at which time a subcutaneous metastasis was found on the chest wall. Soon thereafter she suffered dissemination of malignant melanoma and, despite systemic chemotherapy, rapidly deteriorated and died of metastatic melanoma one year later. The salient features of this patient are: (1) the onset of malignant melanoma early in life (age 15); (2) the poorer prognosis of amelanotic melanoma; (3) the often hopeless situation once distant metastases appear.


An in vivo model for the assessment of acute fibrinolytic capacity of the endothelium.
The effects on blood flow and plasma fibrinolytic and coagulation parameters of intraarterial substance P, an endothelium dependent vasodilator, and sodium nitroprusside, a control endothelium independent vasodilator, were studied in the human forearm circulation. At subsystemic locally active doses, both substance P (2-8 pmol/min) and sodium nitroprusside (2-8 microg/min) caused dose-dependent vasodilatation (p <0.001 for both) without affecting plasma concentrations of PAI-1, von Willebrand factor antigen or factor VIII:C activity. Substance P caused local increases in t-PA antigen and activity (p <0.001) in the infused arm while sodium nitroprusside did not. At higher doses, substance P increased blood flow and t-PA concentrations in the noninfused arm. We conclude that brief, locally active and subsystemic infusions of intraarterial substance P cause a rapid and substantial local release of t-PA which appear to act via a flow and nitric oxide independent mechanism. This model should provide a useful and selective method of assessing the in vivo capacity of the forearm endothelium to release t-PA acutely.


Risk factors for Toxoplasma gondii infection in sheep and cattle from Fernando de Noronha Island, Brazil.
Toxoplasmosis is a zoonotic disease of global distribution that affects all warm-blooded animals. The purpose of this investigation was to determine the prevalence of T. gondii infection and identify the risk factors associated with its occurrence in domestic ruminants raised on the island of Fernando de Noronha, Brazil, and to confirm that cattle and sheep raised in Fernando de Noronha Island present statistically different T. gondii prevalence rates. Serum samples were collected from sheep (n=240) and cattle (n=140) for the detection of antibodies by indirect immunofluorescence. Samples were collected from all the animals on all the farms. Risk factors were analyzed by univariate analysis and logistic regression. The prevalence rate of positive sheep was 85.0% while that of cattle was 10.7%. A multivariate analysis revealed that the site of contact of sheep with felines was a risk factor. For cattle, the risk factors identified in this study were: extensive farming system, water source, more than three cats per farm, and the presence of rats in feed storage locations. The findings revealed a significant difference in the prevalence rates in sheep and cattle raised in this insular environment.


General choice of the regularization functional in regularized image restoration.
The determination of the regularization parameter is an important issue in regularized image restoration, since it controls the trade-off between fidelity to the data and smoothness of the solution. A number of approaches have been developed in determining this parameter. In this paper, a new paradigm is adopted, according to which the required prior information is extracted from the available data at the previous iteration step, i.e., the partially restored image at each step. We propose the use of a regularization functional instead of a constant regularization parameter. The properties such a regularization functional should satisfy are investigated, and two specific forms of it are proposed. An iterative algorithm is proposed for obtaining a restored image. The regularization functional is defined in terms of the restored image at each iteration step, therefore allowing for the simultaneous determination of its value and the restoration of the degraded image. Both proposed iteration adaptive regularization functionals are shown to result in a smoothing functional with a global minimum, so that its iterative optimization does not depend on the initial conditions. The convergence of the algorithm is established and experimental results are shown.


Electroporation of DNA, RNA, and morpholinos into zebrafish embryos.
The combination of accessible embryology and forward genetic techniques has made zebrafish a powerful model system for the study of vertebrate development. One limitation of genetic analysis is that the study of gene function is usually limited to the first developmental event affected by a gene. In vivo electroporation has recently matured as a method for studying gene function at different developmental time points and in specific regions of the organism. The focal application of current allows macromolecules to be efficiently introduced into a targeted region at any time in the life cycle. Here we describe a rapid protocol by which DNA, RNA and morpholinos can all be precisely electroporated into zebrafish in a temporally and spatially controlled manner. This versatile technique allows gene function to be determined by both gain and loss of function analyses in specific regions at specific times. This is the first report that describes the electroporation of three different molecules into embryonic and larval zebrafish cells.


Predatory lizards perceive plant-derived volatile odorants.
Many lizards are olfactory foragers and prey upon herbivorous arthropods, yet their responses to common herbivore-associated plant volatiles remain unknown. As such, their role in mediating plant indirect defenses also remains largely obscured. In this paper, we use a cotton-swab odor presentation assay to ask whether lizards respond to two arthropod-associated plant-derived volatile compounds: 2-(E)-hexenal and hexanoic acid. We studied the response of two lizard species, Sceloporus virgatusand Aspidoscelis exsanguis, because they differ substantially in their foraging behavior. We found that the actively foraging A. exsanguisresponded strongly to hexanoic acid, whereas the ambush foraging S. virgatus responded to 2-(E)-hexenal-an herbivore-associated plant volatile involved in indirect defense against herbivores. These findings indicate that S. virgatus may contribute to plant indirect defense and that a species' response to specific odorants is linked with foraging mode. Future studies can elucidate how lizards use various compounds to locate prey and how these responses impact plant-herbivore interactions.


Unraveling the Link between Catalytic Activity and Agglomeration State with Scanning Electrochemical Microscopy and Atomic Force Microscopy.
In this article, we set up a methodology to investigate the relationship between the catalytic activity and the agglomeration state of platinum group metal-free ORR catalysts. To this end, we have developed a statistical approach based on scanning electrochemical microscopy (SECM) and atomic force microscopy (AFM). Two catalysts are investigated at very low loadings in order to access their intrinsic activity. Differences in terms of dispersion, stability of the inks, and adherence on the substrate are observed, highlighting the importance of measuring the exact amount and agglomeration state of the materials under study. The agglomeration state of the deposits measured by AFM explains the differences in activity measured by SECM. The performances of the catalysts are compared, and the contributions of the intrinsic activity and the agglomeration state are identified. This work paves the way toward various applications ranging from the benchmarking of new catalysts to the optimization of an ink formulation, for ORR and beyond.


Wide. Fast. Deep: Recent Advances in Multiphoton Microscopy of In Vivo Neuronal Activity.
Multiphoton microscopy (MPM) has emerged as one of the most powerful and widespread technologies to monitor the activity of neuronal networks in awake, behaving animals over long periods of time. MPM development spanned across decades and crucially depended on the concurrent improvement of calcium indicators that report neuronal activity as well as surgical protocols, head fixation approaches, and innovations in optics and microscopy technology. Here we review the last decade of MPM development and highlight how in vivo imaging has matured and diversified, making it now possible to concurrently monitor thousands of neurons across connected brain areas or, alternatively, small local networks with sampling rates in the kilohertz range. This review includes different laser scanning approaches, such as multibeam technologies as well as recent developments to image deeper into neuronal tissues using new, long-wavelength laser sources. As future development will critically depend on our ability to resolve and discriminate individual neuronal spikes, we will also describe a simple framework that allows performing quantitative comparisons between the reviewed MPM instruments. Finally, we provide our own opinion on how the most recent MPM developments can be leveraged at scale to enable the next generation of discoveries in brain function.


Creation of consistent burn wounds: a rat model.
Burn infliction techniques are poorly described in rat models. An accurate study can only be achieved with wounds that are uniform in size and depth. We describe a simple reproducible method for creating consistent burn wounds in rats. Ten male Sprague-Dawley rats were anesthetized and dorsum shaved. A 100 g cylindrical stainless-steel rod (1 cm diameter) was heated to 100℃ in boiling water. Temperature was monitored using a thermocouple. We performed two consecutive toe-pinch tests on different limbs to assess the depth of sedation. Burn infliction was limited to the loin. The skin was pulled upwards, away from the underlying viscera, creating a flat surface. The rod rested on its own weight for 5, 10, and 20 seconds at three different sites on each rat. Wounds were evaluated for size, morphology and depth. Average wound size was 0.9957 cm(2) (standard deviation [SD] 0.1845) (n=30). Wounds created with duration of 5 seconds were pale, with an indistinct margin of erythema. Wounds of 10 and 20 seconds were well-defined, uniformly brown with a rim of erythema. Average depths of tissue damage were 1.30 mm (SD 0.424), 2.35 mm (SD 0.071), and 2.60 mm (SD 0.283) for duration of 5, 10, 20 seconds respectively. Burn duration of 5 seconds resulted in full-thickness damage. Burn duration of 10 seconds and 20 seconds resulted in full-thickness damage, involving subjacent skeletal muscle. This is a simple reproducible method for creating burn wounds consistent in size and depth in a rat burn model.


An update on the safety of ixazomib for the treatment of multiple myeloma.
Treatment options for multiple myeloma (MM) have rapidly expanded over the past few years with several newly approved drugs. While there is need to explore treatments that lead to longer responses and survival, special consideration should be given on reducing treatment burden, reducing toxicities, and improving quality of life. Ixazomib is the first oral proteasome inhibitor for the treatment of MM, combining clinical efficacy with a favorable safety profile. Here, we discuss the clinical efficacy and safety of ixazomib. Pharmacokinetic considerations, management of common toxicities, and the impact of the drug on the current and future treatment strategies are also discussed. Ixazomib is an effective and welltolerated MM drug. It is also being studied in combination with other newer agents. It does not have long-term cumulative toxicities, and the most adverse events are mild and manageable. These findings, along with the ease of oral administration, make it a possible option for long-term treatment approaches for MM patients, as well as in the frail/elderly patient population.


Detection of 2-hydroxy-fatty acids and 2-hydroxy-fatty acid-containing ceramides in a gliding marine bacterium Aureispira marina.
The cellular fatty acid composition of Aureispira marina IAM 15389T (JCM 23197T), a gliding bacterium isolated from the coastline of Thailand, was re-examined by using a standard MIDI method based on alkaline hydrolysis, and two other methods. The direct transesterification using 5% HCl/methanol or 4 M HCl hydrolysis followed by methyl esterification revealed that 2-hydroxy-15-methyl-hexadecanoic acid (2-OH-iso-C17:0) and 2-hydroxy-15-methyl-hexadecenoic acid (2-OH-iso-C17:1), which were not reported in a previous paper, were found to be major cellular fatty acids of this bacterium, and the amount of 2-OH-iso-C17:1 was even higher than that of arachidonic acid (C20:4), a characteristic polyunsaturated fatty acid present in this bacterium. These 2-hydroxy-fatty acids were contained in two cellular lipids that were relatively stable against alkaline hydrolysis. One of them was analyzed by mass spectrometry, 1H-nuclear magnetic resonance, and other chemical methods, and identified as a ceramide composed of 2-hydroxy-fatty acid and sphingosine of 19 carbons with three double bonds. A minor ceramide containing 18 carbon sphingosine with three double bonds was also detected.


Dynamic repair of acromio-clavicular dislocation.
Twenty patients with complete acromio-clavicular dislocation treated between 1967 and 1973 were reviewed with a follow-up time of from 1-6 years, the average being 3 years. They were treated by transposition of coraco-brachialia, short head of biceps and a third of pectoralis minor from their origin in the coracoid process to the clavicle together with repair of the acromio-clavicular joint. The results were evaluated according to pain, motion, deformity and x-rays with 90 per cent excellent results, 5 per cent fiar and 5 per cent poor. Discussion of the other types of treatment is presented.


Telephone call reminders and attendance in an adolescent clinic.
To determine the effect of a single telephone call reminder on appointment compliance among adolescents in an inner city, hospital-based clinic. A randomized clinical trial was conducted at the Adolescent Clinic, a part of the Ambulatory Pediatric Practice Clinic in Cleveland, Ohio, from December 1995 to November 1996. A total of 703 routine adolescent ambulatory appointments were randomized to receive either a single telephone call reminder 1 day before the appointment or to receive no reminder. A single telephone call attempt was directed primarily to the parent or guardian of the patient in the assignment group. If not available, the reminder message was left with the patient or other family member, or on the answering machine. The study variables selected included age, gender, appointment time, distance from clinic, and payment source, and for the intervention group, the recipient of the reminder telephone call. The outcome measure was the attendance rate. The intervention group (n = 347) and control group (n = 356) were well balanced for all study variables. The overall attendance rate was 49.8%. Only 204 (58.8%) of the 347 attempted intervention appointments were contacted successfully by telephone. In the attempted intervention analysis, the attendance rate of 55.6% in the intervention group (n = 347), regardless of whether subjects were successfully contacted by telephone, was 26.1% greater than the 44.1% attendance rate in the control group. In the completed intervention analysis, the attendance rate of 65.2% in the successfully contacted individuals within the intervention group (n = 204) was increased by 47.8% over that in the control group. In the univariate analysis, attendance for self-paying patients (25.4%) was worse than that for any group. In the logistic regression analysis, both the reminder telephone call intervention and the payment source were independent predictors of attendance. In the group that was called successfully (n = 204), there was no association between attendance and the recipient of the telephone call. Telephone reminders are a very effective method of increasing attendance in a hospital-based adolescent clinic. The reminder is a consistently effective intervention whether the message is delivered to the patient, to the parent or other family member, or to a telephone answering machine. Adolescent patients whose visits are not covered by Medicaid or commercial insurance are least likely to attend their clinic appointments, and a telephone call reminder has no effect on this pattern.


The influence of workplace injuries on work-family conflict: job and financial insecurity as mechanisms.
Research examining the outcomes of workplace injuries has focused on high costs to the organization. In this study, we utilize conservation of resources theory to develop and test a model that explains how and under what circumstances workplace injuries impact employees' perceptions of how their work interferes with their family. Results from 194 registered nurses (along with 85 of their spouses), using path analytic tests of moderated mediation, provide support for the prediction that the mediated effect of workplace injury severity on work-family conflict (through job and financial insecurity) is weaker when employees perceive high levels of supervisor support. We discuss the implications of these findings for the study of job and financial insecurity and work-family conflict. Limitations of this study and directions for future research are also presented.


[Elaboration and validation of the Depression Scale for the Elderly].
The objective of this study was to develop and validate the Depression Scale for the Elderly. An explanatory theoretical model was developed for depression, consisting of three categories: cognitive, affective, and somato-motor. The items elaborated thusly were submitted to semantic analysis and judges. The pilot instrument was applied to 340 subjects, 88% of whom were females, mostly with complete primary education (67.9%), and a mean age of 63.74 (SD = 6.87) years. The sample also responded to the Beck Depression Index (BDI). Validation of the scale was based on factor analyses (Principal Axis Factoring) and analysis of the items' internal consistency (Cronbach's alpha). Multiple regressions evaluated the predictive power of the factors in the depression scale for the elderly on the final BDI score. Scale validation demonstrated that the depression scale for the elderly is composed of two factors: cognitive-affective and somato-motor, which explain 53% of the BDI (convergent validity). One can thus state that the depression scale for the elderly consists of factors that assess different aspects of the depression construct (factor validity), which present internal consistency indices within the psychometric standards.


Bacteriuria and kidney damage.
Chronic pyelonephritis is a disease of childhood that is carried on into adult life. Children under the age of 4 in whom UTI, vesicoureteric reflux and pyelotubular backflow coexist appear to be particularly at risk of developing kidney damage. Attempts to prevent kidney damage in adults by detection and treatment of covert UTI are doomed to failure because persistent bacteriuria in the adult is a consequence of underlying abnormality of the urinary tract rather than its cause. Our main hope for the prevention of kidney damage associated with bacteriuria and reflux is to detect and treat these conditions at the earliest possible age. The controlled trials of the value of treatment of bacteriuria and vesicoureteric reflux in childhood that are in progress in various centers in the United Kingdom should be allowed to continue and medical opinion as to the value of such treatments should not be allowed to crystallize before the results of these trials are known.


Measurement models for ultrasonic nondestructive evaluation.
The article reviews ways to use the electromechanical reciprocity relation to construct theoretical models of measurement processes in ultrasonic nondestructive evaluation. This relationship is important because it connects the change in the voltages measured at the electrical terminal of the transducer to the perturbation in the mechanical wavefield caused by the change in the propagation environment. It does so by mixing an unperturbed reference wavefield with one containing the perturbed wavefield. Two problems of progressive difficulty are explored. We begin by investigating the imaging of a one-dimensional sinusoidal fluid-solid interface using a cylindrically focused beam and continue by developing a model of the imaging of the mechanical properties of a two-dimensional, thin solid film using a confocal arrangement of point-focused transducers. This last problem uses an approximation to the thin solid film, which reduces its mechanical response to one similar to that of a membrane. Integral relations are given that can be used to form integral equations or to generate asymptotic approximations to the particle displacements and stresses in the film.


[Evaluation of the short-form social support questionnaire (SOZU-K-22) in clinical and non-clinical samples].
Three versions (22-item, 10-item, and 7-item) of the social support questionnaire (F-SOZU) were psychometrically evaluated in two clinical and three non-clinical Austrian samples. The distribution of sum scores in all three versions was negatively skewed; means on the item-level were in the upper region of the five-point scale (M > 4.0) in all non-clinical samples. Internal consistency estimates were found to be satisfying for the total test scores (alpha > 0.85). The 10-item and the 7-item forms correlated highly with the 22-item form total score (r > 0.90). Principal components analysis supported a one dimensional solution in all forms. The discussion focuses on the problem of the highly skewed test scores. It is also argued that the use of the 7-item version might be preferable and more efficient if the researcher is only interested in obtaining a global score for perceived social support.