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Poised for contagion: evolutionary origins of the infectious abilities of invertebrate retroviruses.

Phylogenetic analyses suggest that long-terminal repeat (LTR) bearing retrotransposable elements can acquire additional open-reading frames that can enable them to mediate infection. Whereas this process is best documented in the origin of the vertebrate retroviruses and their acquisition of an envelope (env) gene, similar independent events may have occurred in insects, nematodes, and plants. The origins of env-like genes are unclear, and are often masked by the antiquity of the original acquisitions and by their rapid rate of evolution. In this report, we present evidence that in three other possible transitions of LTR retrotransposons to retroviruses, an envelope-like gene was acquired from a viral source. First, the gypsy and related LTR retrotransposable elements (the insect errantiviruses) have acquired their envelope-like gene from a class of insect baculoviruses (double-stranded DNA viruses with no RNA stage). Second, the Cer retroviruses in the Caenorhabditis elegans genome acquired their envelope gene from a Phleboviral (single ambisense-stranded RNA viruses) source. Third, the Tas retroviral envelope (Ascaris lumricoides) may have been obtained from Herpesviridae (double-stranded DNA viruses, no RNA stage). These represent the only cases in which the env gene of a retrovirus has been traced back to its original source. This has implications for the evolutionary history of retroviruses as well as for the potential ability of all LTR-retrotransposable elements to become infectious agents.

Amino Acid Sequence↗

Language plus for international graduate students in nursing.

PURPOSE: To provide information about an English-language support program that focuses on the needs of international graduate nursing students. The growing presence of these students coincides with the increasing numbers of universities committed to world health. Crucial social and language competence affect the success and progress of international students in graduate nursing programs. DESIGN: Reviewed literature was 1980 to 1998, in nursing and applied linguistic research including second-language acquisition, phonology, discourse analysis, and language pragmatics to identify social and language phenomena. FINDINGS: Investigators suggest essential elements such as conventions of academic writing, reading comprehension, vocabulary, and pronunciation skills be included in the supportive Language Plus program. CONCLUSIONS: Ongoing development of the Language Plus program can promote collaboration between nurses and linguists and increase the success of international graduate nursing students.

Communication Barriers↗

MRI of acute myocarditis: a comprehensive approach based on various imaging sequences.

STUDY OBJECTIVES: To explore the diagnostic performance of MRI for the diagnosis of acute myocarditis, using a comprehensive imaging approach. DESIGN AND SETTINGS: Twenty patients with myocarditis and 7 age-matched and gender-matched control subjects underwent comprehensive MRI. Magnetic resonance (MR) examinations included axial T2-weighted sequences, precontrast and postcontrast ECG-gated T1-weighted sequences in axial and short heart axis, cine-MRI, and serial dynamic turbo fast low-angle shot (turboFLASH) acquisitions in the short axis following Gd injection for a period of 2 min. Precontrast and postcontrast images were postprocessed using subtraction. Two observers read all images qualitatively and quantitatively. Myocardial enhancement was compared between patients and control subjects. PATIENTS: Myocardial involvement was focal in 6 patients examined within 1 week from clinical onset, and diffuse in the remaining 14 patients examined later. RESULTS: Qualitatively, contrast-enhanced T1-weighted subtracted images had 100% sensitivity and specificity for myocardial involvement. Postcontrast T1-weighted images were able to discriminate the early phase (nodular enhancement) from the later phase of myocarditis (diffuse enhancement). Quantitatively, myocardial enhancement was 56% +/- 3.2% in patients, vs 29% +/- 3.1% in control subjects using T1-weighted MRI (p < 0.0001). Serial turboFLASH images displayed greater myocardial enhancement between 25 s and 120 s in patients than in control subjects (p < 0.0001); however, there was marked enhancement of skeletal muscles in both early and late stages of myocarditis compared to control subjects (p < 0.0001). CONCLUSION: On the basis of subtracted cardiac-gated T1-weighted images and serial postinjection turboFLASH images, our study shows that myocarditis is largely, at least in the early stages, a focal process in the myocardium. It also provides evidence of transient skeletal muscle involvement, which may actually be useful for diagnosis.

Acute Disease↗

Parafoveal processing of words and saccade computation during eye fixations in reading.

Studied parafoveal word processing during eye fixations in reading to answer two questions: (a) Is the processing of parafoveally available words limited to the identification of beginning letters? (b) Does the parafoveal processing of words affect the following interword saccade? Reading afforded either no parafoveal preview, preview of beginning trigrams, preview of ending trigrams, or preview of the whole parafoveal word. Previews were controlled by replacing original letters either with X's or dissimilar letters. Preview benefits were larger for the whole word previews than for beginning or ending trigram previews. X-masks yielded preview benefits from intact beginning and ending trigrams but dissimilar letter masks yielded benefits from beginning trigrams only. Saccades were larger for whole word previews than for no previews. These results support Logogen-type models of word recognition and a model of saccade computation that posits a time-locked functional relation between the acquisition of parafoveal word information and the positioning of each fixation.

Attention↗

Effect of breath-holding on pulsatile ocular blood flow measurement in normal subjects.

BACKGROUND: The Valsalva maneuver is known to affect intraocular pressure (IOP). Simple breath-holding may cause IOP elevation. A recent study demonstrated a decrease in pulsatile ocular blood flow (POBF) during forcible exhalation. This study investigated whether breath-holding could affect POBF measurement. METHODS: Thirty-eight healthy young adults were recruited. Their POBF's were measured with an ocular blood flow pneumatonometer. The first set of measurements was made using normal measurement protocol. Three consecutive readings were obtained, and the mean was used for analysis. The second set of measurements was taken after 5-min rest, and the subjects were required to hold their breath during the acquisition period. RESULTS: As previously reported, POBF reduced with increasing myopia. There was no significant change in IOP, pulse rate, POBF, and pulse amplitude between normal protocol and breath-holding condition. POBF and pulse amplitude demonstrated a greater variation, shown by coefficient of variation, when subjects held their breath. CONCLUSIONS: This study found a greater variation in consecutive POBF measurements during breath-holding condition. There was no significant difference in either POBF or pulse amplitude during breath-holding session, probably because of the use of three consecutive measurements, and averaged results were generated from them. It is advised to measure the POBF by taking consecutive readings, and subjects should not hold their breath.

Adult↗

The use of digital imaging and communications in medicine (DICOM) in the integration of imaging into the electronic patient record at the Department of Veterans Affairs.

The US Department of Veterans Affairs (VA) is using the Digital Imaging and Communications in Medicine (DICOM) standard to integrate image data objects from multiple systems for use across the health care enterprise. DICOM uses a structured representation of image data and a communication mechanism that allows the VA to easily acquire images from multiple sources and store them directly into the online patient record. The VA can obtain both radiology and nonradiology images using DICOM, and can display them on low-cost clinician's color workstations throughout the medical center. High-resolution gray-scale diagnostic-quality multimonitor workstations with specialized viewing software can be used for reading radiology images. The VA's DICOM capabilities can interface six different commercial picture archiving and communication systems (PACS) and more than 20 different image acquisition modalities. The VA is advancing its use of DICOM beyond radiology. New color imaging applications for gastrointestinal endoscopy and ophthalmology using DICOM are under development. These are the first DICOM offerings for the vendors, who are planning to support the recently passed DICOM Visible Light and Structured Reporting service classes. Implementing these in VistA is a challenge because of the different workflow and software support for these disciplines within the VA hospital information system (HIS) environment.

Computer Communication Networks↗

Analysis of failure of voice production by a sound-producing voice prosthesis.

OBJECTIVE: To analyse the cause of failing voice production by a sound-producing voice prosthesis (SPVP). METHODS: The functioning of a prototype SPVP is described in a female laryngectomee before and after its sound-producing mechanism was impeded by tracheal phlegm. This assessment included: perceptual voice evaluation of read-aloud prose by an expert listener; inspection of the malfunctioning SPVP; and aero-acoustical in vivo registrations using a computer-based data acquisition system. RESULTS: Sound-producing voice prosthesis speech is higher pitched, stronger, contains less aperiodic noise and requires a lower airflow rate than the patient's regular tracheoesophageal (TE) shunt speech. Tracheal phlegm caused malfunction of the vibrating silicone lip of the SPVP by causing it to stick to its stainless steel container in an opened position, thereby reducing the SPVP to no more than a regular TE shunt valve from a functional point of view. Tracheal phonatory pressure and dynamic vocal intensity range were not affected by the functional status of the SPVP. CONCLUSIONS: To exploit the advantages an SPVP could offer female laryngectomees with an atonic or severely hypotonic pharyngoesophageal segment, the sound-producing mechanism of the SPVP needs to be less vulnerable to tracheal phlegm.

Aged, 80 and over↗

Micro-miniature autonomous optical sensor array for monitoring ions and metabolites 2: color responses to pH, K+ and glucose.

In Part 1 of this series (Anal. Sci., 2006, 22, 383), design, fabrication, and optical data acquisition of an array of tiny color changing capsules embedded in a cellulose acetate bar, called the "sliver sensor", have been described. Capsule colors are read by a CCD camera and translated into blue, red and green Kubelka-Munk variables for quantitative analysis. The respective concentrations are determined using prior calibration. The approach may be adapted to different non-biological analytical problems, as well as in vitro and in vivo applications. To demonstrate this adaptability to potential in vivo use as an example, sensitivity for each target ion was tuned to cover the respective interstitial levels by varying the relative amount of ionophore used in the corresponding microscopic beads. After optimizing the ratio of glucose oxidase (GOX)-containing beads relative to the coupled pH sensing beads and their composition, reversible color response to glucose was obtained in the entire clinically relevant glucose concentration range (10 to 600 mg/dL, 0.55 to 33 mM). Decoupling of pH and glucose sensing from possible variations in interstitial sodium level and buffer capacity is currently being optimized for future in vivo use. In vitro and non-biological applications are also being explored.

Biosensing Techniques↗

A fundus camera dedicated to the screening of diabetic retinopathy in the primary-care physician's office.

PURPOSE: To increase the number of diabetic patients being screened for retinopathy, an instrument, the DigiScope, was specifically designed to operate in primary-care physicians' offices. The DigiScope is described and its automated functions are evaluated. METHODS: The DigiScope consists of a semiautomated optical head to acquire fundus images, evaluate visual acuity, and transmit the data to a remote reading center through telephone lines. Normal volunteers and 17 consecutive diabetic patients visiting their primary-care physician were recruited, and nonophthalmic staff performed the acquisition session. RESULTS: The pupil center and working distance were set automatically. Centering was achieved within 750 microm in less than 500 ms. The fundus was successfully focused by an automated algorithm, and an imaging session covering 71 degrees of the posterior pole of both eyes lasted 5.6 +/- 2.4 minutes. It was found that a file-compression ratio of 12 did not degrade the clinical information and allowed data transfer in less than 6 minutes. A pilot study in normal eyes showed that the DigiScope images yielded the same amount of details as conventional color fundus photographs obtained by an expert photographer. CONCLUSIONS: The DigiScope fulfills the instrumental requirements for a practical and cost-effective tool to acquire data needed to identify diabetic patients who must be referred to an eye-care specialist. Widespread screening with the DigiScope may help reduce the risk of vision loss in an estimated 4 million individuals in the United States alone, who currently do not undergo an annual eye examination.

Diabetic Retinopathy↗

What happens to reading between first and third grade? Implications for students who use AAC.

School-age students who use AAC need access to communication, reading, and writing tools that can support them to actively engage in literacy learning. They also require access to core literacy learning opportunities across grade levels that foster development of conventional literacy skills. The importance of the acquisition of conventional literacy skills for students who use AAC cannot be overemphasized. And yet, one of the critical challenges in supporting the literacy learning of students who use AAC has been a lack of knowledge about literacy curricula and supports to literacy learning for these students. Most students who use AAC do not become conventionally literate and few of those who do achieve literacy skills beyond the second grade level. This article will provide an overview of the most frequent reading instructional activities in first and third grade classrooms. To better understand the foundational experiences important to literacy learning, the results of a survey project that examined the reading activities of general education students and teachers during primary grade instruction are presented, and critical shifts in instruction that occurred between first and third grade are highlighted. The primary instructional focus of core reading activities is also examined, along with adaptations for students who use AAC.

Child↗

Improved contrast at 1.5 tesla using half-Fourier imaging: application to spin-echo and angiographic imaging.

Half-Fourier imaging is useful for reducing imaging time by requiring less than the usual number of phase-encoding steps. This increase in speed can be traded off for longer repeat times, TR, for improved contrast-to-noise in the same imaging time or to collect short asymmetric echoes. Consequently, it is shown to be especially useful for long TR spin-echo imaging where at 1.5 T a repeat time of 4 sec is recommended for a double-echo TE = 30/90 sequence or 3 sec for a double-echo TE = 15/90 sequence. Short TR FLASH imaging also benefits from a longer TR since there is more time to spoil the signal. In both cases, there is the advantage when a multislice acquisition mode is used that more slices (and hence, a larger volume) can be taken. Another application is to apply half-Fourier imaging in the read direction to avoid spin dephasing and motion artifacts. This is particularly useful in angiographic imaging where smaller pixel sizes and shorter echo times both reduce pixel dephasing. Again, even though taking less than the usual number of data points leads to a reduction in S/N, the improved signal and resolution for blood vessels can more than compensate this loss.

Adult↗

The development of a real-time biosensor for the detection of trace levels of trinitrotoluene (TNT) in aquatic environments.

This paper describes the development of a highly sensitive TNT immunosensor consisting of a highly specific monoclonal antibody coupled with a prototype fluorescence-based detector system (KinExA Inline Biosensor, Sapidyne Instrument Inc). The antibody developed possesses a high affinity for TNT (association constant, aK 8.2) with minimal cross reactivity with other compounds such as tetryl, 2,4-dinitrotoluene and 2-amino-4,6-dinitrotoluene. This system provides sample assessment within 160 s from source acquisition and possesses sensitivity for TNT of 0.05 microg/L in ground water. The sensor can be regenerated in 8 min, allows a minimum of 40 repeated readings, and has a standard error of 0.1-0.4% between repeat readings. The fluidics and software allow samples to be obtained from up to eight different sources allowing the user to examine the stratification of the pollutant in the water column. We believe that this immunosensor can be used to rapidly assess trace levels of TNT in environmental water samples.

Biosensing Techniques↗

Computer Aided Detection (CAD) for breast MRI.

Since 1999, there has been a 40 percent increase per year in the number of breast MR studies performed in the United States. In addition, over 1200 sites in the United States have purchased surface coils for use in breast MR. This number is expected to grow to over 2,000 coils by the end of 2007. It is well accepted that MR sensitivity for invasive breast cancers is near 100%, but as the use of breast MRI increases, radiologists interpreting breast MR are challenged to achieve high specificity while retaining high sensitivity. Reading the large number of acquired MR images in a reasonable amount of time also becomes more important as the number of studies increases. Breast MR acquisition and image interpretation techniques have been refined through clinical optimization. The number of images to interpret, however, has increased to several hundred per case. Computer Aided Detection (CAD) algorithms have allowed radiologists to regain efficiency while maintaining optimized acquisition techniques. The first CAD system for breast MR (CADstream by Confirma, Inc.) was launched in January 2003. The CAD installed base has since grown to over 150 systems in the US. The primary reason for this quick adoption of CAD for breast MR is that the CAD software enables readers to increase their efficiency while potentially improving their overall accuracy. The full benefits CAD for Breast MR are realized when the interpreting radiologist has a thorough understanding of the algorithms used, and the limitations of CAD.

Breast Neoplasms↗

Multiple L1 progenitors in prosimian primates: phylogenetic evidence from ORF1 sequences.

One of the uncertainties regarding the evolution of L1 elements is whether there are numerous progenitor genes. We present phylogenetic evidence from ORF1 sequences of slow loris (Nycticebus coucang) and galago (Galago crassicaudatus) that there were at least two distinct progenitors, active at the same time, in the ancestor of this family of prosimian primates. A maximum parsimony analysis that included representative L1s from human, rabbit, and rodents, along with the prosimian sequences, revealed that one of the galago L1s (Gc11) grouped very strongly with the slow loris sequences. The remaining galago elements formed their own unique and strongly supported clade. An analysis of replacement and silent site changes for each link of the most parsimonious tree indicated that during the descent of the Gc11 sequence approximately two times more synonymous than nonsynonymous substitutions had occurred, implying that the Gc11 founder was functional for some time after the split of galago and slow loris. Strong purifying selection was also evident on the galago branch of the tree. These data indicate that there were two distinct and contemporaneous L1 progenitors in the lorisoid ancestor, evolving under purifying selection, that were retained as functional L1s in the galago lineage (and presumably also in the slow loris). The prosimian ORF1 sequences could be further subdivided into subfamilies. ORF1 sequences from both the galago and slow loris have a premature termination codon near the 3' end, not shared by the other mammalian sequences, that shortens the open reading frame by 288 bp. An analysis of synonymous and nonsynonymous substitutions for the 5' and 3' portions, that included intra- and inter-subfamily comparisons, as well as comparisons among the other mammalian sequences, suggested that this premature stop codon is a prosimian acquisition that has rendered the 3' portion of ORF1 in these primates noncoding.

Animals↗

Semantic processing of unattended text during selective reading: how the eyes see it.

Subjects were instructed to read and comprehend a target (attended) passage while eye movements were recorded. A second (unattended) passage was also present, with attended and unattended passages occupying alternating lines of text. Subsequent multiple-choice questions showed acquisition of semantic information from attended and unattended text. However, a detailed examination of eye-fixation records showed that readers occasionally fixated unattended text, indicating the presence of shifts of visual attention to unattended text. When fixations of unattended text were excluded, there was no longer any indication that readers obtained useful semantic information from unattended text.

Attention↗

Short breath-hold, volumetric coronary MR angiography employing steady-state free precession in conjunction with parallel imaging.

An ECG-gated, 3D steady-state free precession (SSFP) technique in conjunction with sensitivity encoding (SENSE)-based parallel imaging was implemented for short breath-hold, volumetric coronary MR angiograpy (CMRA). Two parallel imaging acquisition strategies (employing 1 R-R and 2 R-R intervals, respectively) were developed to achieve 1) very short breath-hold times (12 s for a heart rate of 60 bpm), and 2) small acquisition windows to minimize sensitivity to physiologic motion. Both strategies were examined in CMRA applications over a range of heart rates. A four-point scale blinded reading (with 4 indicating the most desirable features) revealed substantial image quality improvements for the accelerated data as compared to the nonaccelerated approach. The 1 R-R interval scheme yielded an image score of 3.39 +/- 0.60, and was found to be particularly suitable for low heart rates (P = 0.0008). The 2 R-R interval strategy yielded an image score of 3.35 +/- 0.64, and was more appropriate for higher heart rates (P = 0.03). The results demonstrate that 3D SSFP combined with parallel imaging is a versatile method for short breath-hold CMRA while maintaining high spatial resolution. This strategy permits imaging of the major coronary artery distributions in two to three breath-holds using targeted slabs, and offers the potential for single breath-hold, large-volume CMRA.

Adult↗