Re: Walsh E. Re: Gestational Diabetes. What happens postpartum?
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Continuity of Patient Care↗
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Air pollution and climate gradients in western Oregon and Washington indicated by epiphytic macrolichens.
Human activity is changing air quality and climate in the US Pacific Northwest. In a first application of non-metric multidimensional scaling to a large-scale, framework dataset, we modeled lichen community response to air quality and climate gradients at 1416 forested 0.4 ha plots. Model development balanced polluted plots across elevation, forest type and precipitation ranges to isolate pollution response. Air and climate scores were fitted for remaining plots, classed by lichen bioeffects, and mapped. Projected 2040 temperatures would create climate zones with no current analogue. Worst air scores occurred in urban-industrial and agricultural valleys and represented 24% of the landscape. They were correlated with: absence of sensitive lichens, enhancement of nitrophilous lichens, mean wet deposition of ammonium >0.06 mg l(-1), lichen nitrogen and sulfur concentrations >0.6% and 0.07%, and SO(2) levels harmful to sensitive lichens. The model can detect changes in air quality and climate by scoring re-measurements.
Air Pollution↗
Equilibrium structures for butadiene and ethylene: compelling evidence for pi-electron delocalization in butadiene.
Equilibrium structures have been determined for s-trans-1,3-butadiene and ethylene after adjusting the rotational constants obtained from rotational spectroscopy by vibration-rotation constants calculated from the results of quantum chemical calculations. For butadiene, the formal C=C bond length is 1.338 A, and the formal C-C bond length is 1.454 A. For ethylene, the C=C bond length is 1.3305 A. These values appear to be good to 0.001 A. It is shown for the first time that pi-electron delocalization has the structural consequences of increasing the length of the formal double bond by 0.007 A and decreasing the length of the formal single bond by 0.016 A. Comparisons are made with structures computed with several quantum chemical models. The MP2/cc-pVTZ results agree best with the new re structure.
Butadienes↗
Detecting gene-gene interactions using affected sib pair analysis with covariates.
Interest has recently focussed on allowing for interactions between loci as a way to increase power to detect linkage. In this paper, a simplified logistic regression method was used to perform affected sib pair analyses allowing for the inclusion of data from other loci. A systematic search of two-locus disease models was carried out to determine the situations in which this was advantageous. If IBD information is available (e.g. from a genome scan), it is unlikely that allowing for interactions will give a large lod score in the absence of linkage evidence from sinlge-locus analysis. Furthermore, allowing for interactions rarely gave a significant increase in power to detect linkage over a single-locus analysis, except for heterogeneity models with low K(P). Conversely, the availability of disease-associated genotypes may greatly increase the power both to detect linkage to a second locus and interaction between the loci. These results indicate that when only IBD information is available, two-locus analysis of genome scan data should be restricted to regions giving peaks under single-locus analysis. If disease-associated genotypes are available, it may be worth re-analysing the whole genome.
Genetic Linkage↗
Formation of Kuiper-belt binaries by dynamical friction and three-body encounters.
The Kuiper belt is a disk of icy bodies that orbit the Sun beyond Neptune; the largest known members are Pluto and its companion Charon. A few per cent of Kuiper-belt bodies have recently been found to be binaries with wide separations and mass ratios of the order of unity. Collisions were too infrequent to account for the observed number of binaries, implying that these binaries formed through collisionless interactions mediated by gravity. These interactions are likely to have been most effective during the period of runaway accretion, early in the Solar System's history. Here we show that a transient binary forms when two large bodies penetrate one another's Hill sphere (the region where their mutual forces are larger than the tidal force of the Sun). The loss of energy needed to stabilize the binary orbit can then occur either through dynamical friction from surrounding small bodies, or through the gravitational scattering of a third large body. Our estimates slightly favour the former mechanism. We predict that five per cent of Kuiper-belt objects are binaries with apparent separations greater than 0.2 arcsec, and that most are in tighter binaries or systems of higher multiplicity.
Journal Article↗
Hypnosis in neuromuscular re-education.
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Hemiplegia↗
Incompetency--Massachusetts applies substituted judgment to probate court sterilization proceedings--In re Moe, 385 Mass. 555, 432 N.E.2d 712 (1982)
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Decision Making↗
High-dose immunosuppressive therapy and autologous progenitor cell transplantation for systemic sclerosis.
High-dose immunosuppressive therapy aimed at immunoablation, given together with autologous stem cell transplantation, has resulted in prolonged (>3 years) improvements of skin thickening and functional ability, together with a stabilization of pulmonary function in two-thirds of treated patients with severe systemic sclerosis. Transplant-related mortality occurred in 17% of the first cohort of 41 patients reported to the European Group for Blood and Marrow Transplantation, which included cases from the United States, but this figure has dropped to 8.7% in a recent retrospective analysis of 57 transplants performed in Europe. Similar outcomes were reported in multicentre studies from the United States of 19 patients, and from France of 12 patients, with improvements in skin scores and functional assessments, together with a stabilization of internal organ dysfunction. Based on the results of these phase I/II studies, multicentre prospective randomized trials are being planned or are in progress in Europe and the United States employing uniform patient entry criteria and outcome parameters. The aim of these studies is to compare the clinical benefits and safety of transplant regimens versus conventional chemotherapy in patients with severe systemic sclerosis who are at risk of life-threatening organ failure and premature mortality. Eligibility criteria include a diagnosis of diffuse systemic sclerosis of recent onset and major organ (heart, kidney, lungs) involvement according to predefined criteria. The prospective randomized trials address two issues related to the treatment of severe systemic sclerosis: is intensive immunosuppressive therapy superior to conventional therapy, and can self-tolerance be re-established?
Combined Modality Therapy↗
Effect of hydrophobic surfactant protein SP-C on binary phospholipid monolayers. Molecular machinery at the air/water interface.
Fluorescent and modified dark-field microscopies were used to investigate the phase behavior of physiologically relevant lipid/protein monomolecular films containing surfactant protein C(SP-C). Synthetic human SP-C(1-34) was labeled at its N-terminus using the fluorescent probe 6-(((4(4,4-difluoro-5-(2-thienyl)-4-bora-3a,4a-diaza-s-indacene-3-yl)phenoxy)acetyl)amino)hexanoic acid (BODIPY/TR-X). Using dual fluorescent labeling (lipid and protein) in the monolayers, we have correlated (at physiologically small concentrations of the protein) the lipid phase separation and protein distribution in situ. A comparison of the lipid and protein dye fluorescent micrographs indicates that SP-C(1-34) is preferentially associated with the disordered lipid phase. Three concepts arise from our results. (1) The presence of SP-C alone does not result in the complete dissolution of condensed phase domains in a fashion that we have previously reported for the entire hydrophobic surfactant protein (SP-B/C) fraction (Biophys. J. 77 (1999) 903). Rather, the use of relatively high amounts ( approximately 10 wt.%) of the labeled SP-C protein is needed to reproduce the fluorescence monolayer morphology previously observed for small concentrations ( approximately 1 wt.%) of the natural SP-B/C mixture. (2) Scattered light, dark-field microscopy performed using grazing angle laser illumination reveals the presence of surface-associated, three-dimensional (3D) structures of micrometer-sized dimensions when the labeled BODIPY/TR-X:SP-C(1-34) protein is included in the monolayer, as previously observed with the naturally isolated SP-B/C mixture. The 3D structures are associated exclusively with the presence of the SP-C protein in disordered monolayer phases. (3) To explain these results, we have derived a molecular model accounting for the structure and physico-chemical properties of the SP-C protein in terms of its energetics. The molecular events involved in the SP-C-mediated production of the 3D surface particles are explained using the analogy of a simple molecular machine, namely a loaded spring. This interpretation is supported by an energetic analysis that suggests the major factor contributing to the formation of the 3D particles is the energy liberated by re-expansion of the surrounding phospholipid film into the area vacated by the SP-C protein as it re-orients away from the surface.
Air↗
Prophylactic hyperbaric oxygen treatment and rat spinal cord re-irradiation.
Normal tissue injury may lead to severe, life threatening, late side effects after therapeutic use of irradiation. Neurological complications caused by radiation of the spinal cord are ascribed to progressive, irreversible damage to the vasculature. Hyperbaric oxygen (HBO) is known to induce angiogenesis in irradiated tissue and has been proven to reduce late radiation injury in several normal tissues when applied during the latent period before complications become manifest. In the present study: (1). the prophylactic potential of HBO; (2). optimal timing of HBO therapy after spinal cord irradiation, i.e. during the latent period; and (3). effect of HBO on the re-irradiation tolerance of the spinal cord were investigated. The rat cervical spinal cord was locally X-ray irradiated with ten fractions of 6.5 Gy in 11 days. Five treatment groups (n=10) included: irradiation alone and irradiation followed by 30 HBO treatments (100% oxygen at 240 kPa for 90 min) during latency, with HBO starting either immediately, 5, 10 or 15 weeks after the primary irradiation course. One year after the primary treatment, the same spinal cord volume was re-irradiated with 20 Gy single dose. During life span, the animals were observed on the incidence of myelitis and the duration of the latent period. The actuarial analysis revealed no significant difference in neurological complications free survival between the irradiation alone and the irradiation+HBO treatment groups. A tendency towards radiosensitization was found in the group in which the primary irradiation course was immediately followed by the HBO treatment course. The data show that HBO applied during the latent period of progressively developing irradiation damage to the spinal cord does not increase the re-irradiation tolerance of this tissue.
Animals↗
Moderate alcohol intake and motor vehicle crashes: the conflict between health advantage and at-risk use.
AIMS: To review the evidence on moderate alcohol intake and motor vehicle crash (MVC) risk, and discuss the possible public health tension in balancing risk reduction and increment with respect to moderate alcohol intake. METHOD: A Medline review was conducted on moderate alcohol intake, MVC, and cardiovascular disease (CVD) risks. RESULT: Moderate alcohol intake (24 g ethanol, two US standard drinks, or less a day) is associated with 20% reduction in risk of CVD. Public awareness of this may contribute to why rates of driving with blood alcohol content (BAC) <0.08 g/dl in the United States are static. Studies show 3- to 17-fold increased risk of a fatal MVC with BAC < 0.08 g/dl compared to sober drivers. The United States has 0.08 g/dl BAC laws, higher than that reached by a driver drinking two drinks per day or less. CONCLUSION: The public should be educated that although moderate alcohol drinking may not violate BAC laws, it still carries significant risk of MVC. Current BAC laws in some countries needs re-evaluation.
Accidents, Traffic↗
The past, present and future of genome-wide re-annotation.
Annotation, the process by which structural or functional information is inferred for genes or proteins, is crucial for obtaining value from genome sequences. We define the process of annotating a previously annotated genome sequence as 're-annotation', and examine the strengths and weaknesses of current manual and automatic genome-wide re-annotation approaches.
Computational Biology↗
The Saccharomyces cerevisiae recombination enhancer biases recombination during interchromosomal mating-type switching but not in interchromosomal homologous recombination.
Haploid Saccharomyces can change mating type through HO-endonuclease cleavage of an expressor locus, MAT, followed by gene conversion using one of two repository loci, HML or HMR, as donor. The mating type of a cell dictates which repository locus is used as donor, with a cells using HML and alpha cells using HMR. This preference is established in part by RE, a locus on the left arm of chromosome III that activates the surrounding region, including HML, for recombination in a cells, an activity suppressed by alpha 2 protein in alpha cells. We have examined the ability of RE to stimulate different forms of interchromosomal recombination. We found that RE exerted an effect on interchromosomal mating-type switching and on intrachromosomal homologous recombination but not on interchromosomal homologous recombination. Also, even in the absence of RE, MAT alpha still influenced donor preference in interchromosomal mating-type switching, supporting a role of alpha 2 in donor preference independent of RE. These results suggest a model in which RE affects competition between productive and nonproductive recombination outcomes. In interchromosome gene conversion, RE enhances both productive and nonproductive pathways, whereas in intrachromosomal gene conversion and mating-type switching, RE enhances only the productive pathway.
Chromosomes, Fungal↗
Re: Depression, stroke diagnosis, and SSRI discontinuation syndrome.
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Aged↗
Rapid diagnosis of malaria by fluorescence microscopy.
The routine procedure for detection of blood stages of Plasmodium spp involves Giemsa staining of thin and thick blood smears. This procedure, although simple, is time consuming, and its interpretation is dependent upon the training and experience of the observer. New methods for malaria diagnosis still require considerable financial outlay for specialist equipment and re-training of staff In this article, Hiko Kawamoto and Peter Billingsley discuss an efficient method for the detection of malaria parasites using low-cost, paired filters adapted for standard light microscopes and acridine orange staining.
Journal Article↗
Efficacy of abduction bracing in the management of total hip arthroplasty dislocation.
A retrospective review of total hip arthroplasty (THA) dislocations was performed to determine the effectiveness of abduction bracing following closed reduction. Patients were grouped as a first-time dislocation (n = 91) or recurrent dislocation (n = 58) and whether or not they received an abduction brace; re-dislocation defined failure of treatment. The mean follow-up was 4.0 years in the first-time group and 3.7 years in the recurrent group. Among patients treated for first-time dislocations, 61% re-dislocated with a brace and 64% of nonbraced patients re-dislocated. In the recurrent group, 55% re-dislocated with a brace, whereas 56% re-dislocated without a brace. Chi-square analysis revealed that observed differences were not significant. There was no significant difference among groups with regards to age, sex, operative side, or significant surgical parameters. Abduction bracing following closed reduction of THA dislocation is ineffective in preventing re-dislocation.
Arthroplasty, Replacement, Hip↗
How important is the back reaction of electrons via the substrate in dye-sensitized nanocrystalline solar cells?
The role of the conducting glass substrate (fluorine-doped tin oxide, FTO) in the back reaction of electrons with tri-iodide ions in dye-sensitized nanocrystalline solar cells (DSCs) has been investigated using thin-layer electrochemical cells that are analogues of the DSCs. The rate of back reaction is dependent on the type of FTO and the thermal treatment. The results show that this back-reaction route cannot be neglected in DSCs, particularly at lower light intensities, where it is the dominant route for the back transfer of electrons to tri-iodide. This conclusion is confirmed by measurements of the intensity dependence of the photovoltages of DSCs with and without blocking layers. It follows that blocking layers should be used to prevent the back reaction in mechanistic studies in which the light intensity is varied over a wide range. Conclusions based on studies of the intensity dependence of the parameters of DSCs such as photovoltage and electron lifetime in cells without blocking layers, must be critically re-examined.
Journal Article↗
ICU incident reporting systems.
Intensive care is one of the largest and most expensive components of American health care. Studies suggest that errors and resulting adverse events are common in intensive care units (ICUs). The incidence may be as high as 2 errors per patient per day; 1 in 5 ICU patients may sustain a serious adverse event, and virtually all are exposed to serious risk for harm. Theories of error developed in aviation and other high-risk industries suggest that errors are likely to occur in all complex systems. Reporting of incidents, including both adverse events and near misses, is an essential component for improving safety. Voluntary, confidential reporting is likely to be more important than mandatory reporting. There have been a few efforts to apply such systems in medicine. In intensive care, the Australian Incident Monitoring System (AIMS)-ICU has been the most prominent. We have designed a Web-based ICU Safety Reporting System (ICUSRS). The goal is to identify high-risk situations and working conditions, to help change systems, and reduce the risk for error. The analysis and feedback of reports will inform the design of interventions to improve patient safety. The effort is aided substantially by collaboration with the 30 participating ICUs and important stakeholders including the Society of Critical Care Medicine, the American Society for Health-care Risk Management, the Food and Drug Administration Center for Devices and Radiological Health, the Foundation for Accountability, and the Leapfrog Group. A demonstration and evaluation of the system is underway, funded by the Agency for Healthcare Re-search and Quality.
Disclosure↗