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[External ventricular support in primary cardiogenic shock].

Primary cardiogenic shock is a common condition with a high mortality rate. In this indication, mechanical assist plays an important part and has improved a lot over the last decade. The authors report their experience with the same assist device in patients with primary cardiogenic shock. Nineteen patients (9 dilated cardiomyopathies, 7 myocardial infarctions, 2 myocardities, 1 undetermined) were treated with an external mechanical ventricular assist device (Thoratec, Berkeley, U.S.). Fourteen patients received a biventricular assist and 5 had a uni-left ventricular assist device. Four of the 19 patients were completely weaned off their ventricular assist after 13, 27, 36 and 94 days, respectively. Ten patients underwent transplantation after an average of 43 days (range 8-95 days). Of the 19 patients, 7 had a portable console allowing autonomous ambulation. Five patients died under mechanical assistance (26.9%) and 3 patients died after transplantation. Three patients required temporary haemodialysis; 4 suffered embolic complications; 4 had mediastinal haemorrhages; 4 had bleeding from other sites, and 6 suffered from late tamponnade. Fourteen patients had at least one infectious episode. The authors conclude that, in patients referred for severe primary cardiogenic shock, the implantation of an external biventricular assist is a reliable option, allowing sequential weaning or being a bridge to transplantation in non-dependent patients, providing they are severely selected.

Adolescent↗

Why don't we have enough cornea donors? A literature review and survey.

BACKGROUND: Organ donation provides a second chance for those who have experienced severe disease or injury. Unfortunately there is a huge discrepancy between the supply and demand of transplantable organs, despite the existence of sufficient numbers of potential donors. Through a review of the literature and a survey of optometry students, this article provides insight into the reasons for the shortage of corneal donors and how more corneal donors might be obtained. METHOD: A survey of 200 optometry students at the University California, Berkeley, School of Optometry was conducted to augment the literature review. Seventy-six students (38% of those surveyed) completed the survey process. RESULTS: Results of the survey indicated that 64.5% of who responded were willing to donate body organs, while 31.6% were not. Of those not willing to donate organs, 11.8% cited religious reasons. Other personal reasons included: fear (4%), respect for the human body (7.9%), and parental disapproval (6.4%). Only 46.1% of respondents had donation stickers on their driver's licenses. CONCLUSION: The literature review and survey indicate that age, religion, culture, personality characteristics, views on death and mortality, body image, and humanitarian concerns are among the many factors that influence people's opinion concerning organ donations. Education of the public and health care professionals' awareness of the importance of obtaining corneas for donation is crucial to end the shortage of organ donors.

Cornea↗

Mean arterial pressure, pregnancy-induced hypertension, and preeclampsia: evaluation as independent risk factors and as surrogates for high maternal serum alpha-fetoprotein in estimating breast cancer risk.

Data from a nested case-control study were analyzed to examine high mean arterial pressure (MAP), hypertension of pregnancy, and preeclampsia as independent predictors and as surrogate markers for elevated alpha-fetoprotein (AFP) levels in evaluating breast cancer risk. Cases (n = 205) were identified by the California Cancer Registry from a cohort of pregnant women who were part of the Kaiser Health Plan and took part in the Child Health and Development Studies initiated by the University of California, Berkeley, from June 1959 to September 1966. Controls (n = 337) were selected by randomized recruitment from the same cohort probability matched to cases by distribution of birth dates of cases. High MAP was associated with breast cancer risk and is different across quartile of age at first full-term pregnancy as is high AFP. Odds ratios (OR) across quartiles for MAP were 0.24 [95% confidence interval (CI), 0.08-0.71], 0.84 (95% CI, 0.39-1.66), 1.00 (referent), and 2.50 (95% CI, 1.21-5.13), and for AFP were 0.34 (95% CI, 0.13-0.93), 0.77 (95% CI, 0.36-1.67), 1.00 (referent), and 2.38 (95% CI, 1.13-5.00). Neither diagnosed preeclampsia nor hypertension of pregnancy showed any association with breast cancer risk. When both high AFP and high MAP were entered into the same analysis, neither changed the OR for the other more than 8%. Additionally, AFP level was not a linear function of MAP. Although the pattern of ORs across quartiles of age at first full-term pregnancy was similar for the two variables, it cannot be concluded that high MAP is an adequate surrogate for high levels of maternal serum AFP, but rather represents some related process that is in and of itself a risk factor for breast cancer.

Adolescent↗

From computing with numbers to computing with words. From manipulation of measurements to manipulation of perceptions.

Interest in issues relating to consciousness has grown markedly during the last several years. And yet, nobody can claim that consciousness is a well-understood concept that lends itself to precise analysis. It may be argued that, as a concept, consciousness is much too complex to fit into the conceptual structure of existing theories based on Aristotelian logic and probability theory. An approach suggested in this paper links consciousness to perceptions and perceptions to their descriptors in a natural language. In this way, those aspects of consciousness which relate to reasoning and concept formation are linked to what is referred to as the methodology of computing with words (CW). Computing, in its usual sense, is centered on manipulation of numbers and symbols. In contrast, computing with words, or CW for short, is a methodology in which the objects of computation are words and propositions drawn from a natural language (e.g., small, large, far, heavy, not very likely, the price of gas is low and declining, Berkeley is near San Francisco, it is very unlikely that there will be a significant increase in the price of oil in the near future, etc.). Computing with words is inspired by the remarkable human capability to perform a wide variety of physical and mental tasks without any measurements and any computations. Familiar examples of such tasks are parking a car, driving in heavy traffic, playing golf, riding a bicycle, understanding speech, and summarizing a story. Underlying this remarkable capability is the brain's crucial ability to manipulate perceptions--perceptions of distance, size, weight, color, speed, time, direction, force, number, truth, likelihood, and other characteristics of physical and mental objects. Manipulation of perceptions plays a key role in human recognition, decision and execution processes. As a methodology, computing with words provides a foundation for a computational theory of perceptions: a theory which may have an important bearing on how humans make--and machines might make--perception-based rational decisions in an environment of imprecision, uncertainty, and partial truth. A basic difference between perceptions and measurements is that, in general, measurements are crisp, whereas perceptions are fuzzy. One of the fundamental aims of science has been and continues to be that of progressing from perceptions to measurements. Pursuit of this aim has led to brilliant successes. We have sent men to the moon; we can build computers that are capable of performing billions of computations per second; we have constructed telescopes that can explore the far reaches of the universe; and we can date the age of rocks that are millions of years old. But alongside the brilliant successes stand conspicuous underachievements and outright failures. We cannot build robots that can move with the agility of animals or humans; we cannot automate driving in heavy traffic; we cannot translate from one language to another at the level of a human interpreter; we cannot create programs that can summarize non-trivial stories; our ability to model the behavior of economic systems leaves much to be desired; and we cannot build machines that can compete with children in the performance of a wide variety of physical and cognitive tasks. It may be argued that underlying the underachievements and failures is the unavailability of a methodology for reasoning and computing with perceptions rather than measurements. An outline of such a methodology--referred to as a computational theory of perceptions--is presented in this paper. The computational theory of perceptions (CTP) is based on the methodology of CW. In CTP, words play the role of labels of perceptions, and, more generally, perceptions are expressed as propositions in a natural language. CW-based techniques are employed to translate propositions expressed in a natural language into what is called the Generalized Constraint Language (GCL). In this language, the meaning of a proposition is expressed as a generalized constraint, X isr R, where X is the constrained variable, R is the constraining relation, and isr is a variable copula in which r is an indexing variable whose value defines the way in which R constrains X. Among the basic types of constraints are possibilistic, veristic, probabilistic, random set, Pawlak set, fuzzy graph, and usuality. The wide variety of constraints in GCL makes GCL a much more expressive language than the language of predicate logic. In CW, the initial and terminal data sets, IDS and TDS, are assumed to consist of propositions expressed in a natural language. These propositions are translated, respectively, into antecedent and consequent constraints. Consequent constraints are derived from antecedent constraints through the use of rules of constraint propagation. The principal constraint propagation rule is the generalized extension principle. (ABSTRACT TRUNCATED)

Consciousness↗

[A zoologist on a different path--Richard B. Goldschmidt (1878-1958) as sexuality researcher and his reception by the Third Reich].

At the beginning of 20th century, genetic research was carried out by many different branches of science. Biology, zoology, medicine, psychiatry, and psychology took part, so some results were a mixture of the involved sciences and not pure genetic. One researcher, who used his experiences from zoology to explain sexual orientation in the human race, was Richard B. Goldschmidt (1878-1958). He published several articles between 1916 and 1927 on this topic before he reconsidered his own theses. Greatest feedback he became during the Third Reich. Although being Jewish he became professor for life in autumn 1933. When he left Berlin for Berkeley in 1936, he began a new scientific career, leaving all old theories and ideologies behind. But his "Umwandlungsmännchen"-theory was restarted by some German psychiatrists to explain homosexuality. One of these men was Theo Lang (1898-1957), who was allowed to publish his articles in the USA and in Switzerland. Lang had been one of the founders of the association of Nazi doctors and was a member of the SA. Moreover, after 1945 during Denazification he was allowed to call for Richard Goldschmidt as witness for his own defence.

Animals↗

Nitrogen dynamics in controlled systems: meeting summary and conclusions.

This article summarizes the findings of a meeting held during September 1995, in Berkeley, CA. The purpose of the meeting was to provide NASA with a summary of the current data, theories, and hypotheses concerning the energetics, dynamics, and stability of nitrogen cycling in controlled systems. NASA's interest stems from the development of advanced life support systems that must recycle and/or regenerate all life support materials. Nitrogen is an important element in biological systems; it undergoes a variety of transformations during both biotic and abiotic processes and, hence, an understanding of its dynamic changes in a closed system is critical to the design of efficient and reliable life support systems. This article reviews the meeting goals and objectives, summarizes the findings of the participants, and outlines future research needs.

Carbon↗

State medicaid coverage for tobacco-dependence treatments--United States, 1998 and 2000.

The Guide to Community Preventive Services recommends reducing the cost of tobacco-dependence treatments because these interventions increase both the use of treatment by smokers during attempts to stop smoking and the number of smokers who actually stop. The Public Health Service (PHS) Clinical Practice Guideline supports insurance coverage for tobacco-dependence treatment (i.e., individual, group, and telephone counseling, and Food and Drug Administration-approved pharmacotherapy. One of the 2010 national health objectives is to provide coverage in the 50 states and District of Columbia (DC) for nicotine-dependence treatment by Medicaid (objective 27.8b). In 2000, approximately 32 million low-income persons in the United States received their health insurance coverage through the federal-state Medicaid program; approximately 11.5 million (36%) of these persons smoked (CDC, unpublished data, 2000). Medicaid recipients have approximately 50% greater smoking prevalence than the overall U.S. population. To assess the amount and type of coverage for tobacco dependence offered by Medicaid, the Center for Health and Public Policy Studies at the University of California, Berkeley, conducted state surveys in 1998 and 2000. In 1998, 24 states and DC offered some coverage for tobacco-dependence treatment; in 2000, nine started offering some coverage. In 1998 and 2000, one state offered coverage for all the counseling and pharmacotherapy treatments recommended by PHS. These findings indicate that states can reduce smoking prevalence among Medicaid recipients by implementing more extensive Medicaid coverage for treatment of tobacco dependence.

Bupropion↗

Predicting extended wear complications from overnight corneal swelling.

PURPOSE: To examine the hypothesis that the corneal overnight swelling response (ONSR) is a predictor of ocular complications in contact lens extended wear (EW). METHODS: The Berkeley Contact Lens Extended Wear Study (CLEWS) was a randomized, concurrently controlled clinical trial in which more than 200 subjects in EW with rigid gas-permeable (RGP) lenses were observed for 1 year. After adapting to EW, subjects were randomized to either medium or high oxygen-permeable (Dk) RGP lenses and underwent clinical assessments, keratometry, and corneal pachometry at 3-month intervals. RESULTS: The ONSR was directly related to lens Dk (P = 0.01) and exhibited substantial variability across subjects. The probability of remaining free of complications over time was not significantly lower for subjects with a mild ONSR compared with those with greater edema (P = 0.84). The risk of development of keratopathy was not significantly related to the ONSR (relative risk = 1.00). CONCLUSIONS: The corneal ONSR is not a good predictor of ocular complications in 1 year of RGP EW. Lenses that cause little or no corneal edema are not necessarily safer for overnight wear.

Circadian Rhythm↗

Physical and biological studies with protons and HZE particles in a NASA supported research center in radiation health.

NASA has established and supports a specialized center for research and training (NSCORT) to specifically address the potential deleterious effects of HZE particles on human health. The NSCORT in radiation health is a joint effort between Lawrence Berkeley National Laboratory (LBNL) and Colorado State University (CSU). The overall scope of research encompasses a broad range of subjects from microdosimetric studies to cellular and tissue responses to initial damage produced by highly energetic protons and heavy charged particles of the type found in galactic cosmic rays (GCR) spectrum. The objectives of the microdosimetry studies are to determine the response of Tissue Equivalent Proportional Counter (TEPC) to cosmic rays using ground based accelerators. This includes evaluation of energy loss due to the escape of high-energy delta rays and increased energy deposition due to the enhanced delta ray production in the wall of the detector. In this report major results are presented for 56Fe at 1000, 740, 600 and 400 MeV/nucleon. An assessment of DNA repair and early development of related chromosomal changes is extremely important to our overall understanding of enhanced biological effectiveness of high LET particle radiation. Results are presented with respect to the fidelity of the rejoining of double strand breaks and the implications of misrejoining. The relationship between molecular and cytogenetic measurements is presented by studying damage processing in highly heterochromatic supernumerary (correction of sypernumerary) X chromosomes and the active X-chromosome. One of the important consequences of cell's inability to handle DNA damage can be evaluated through mutation studies. Part of our goal is the assessment of potential radioprotectors to reduce the mutation yield following HZE exposures, and some promising results are presented on one compound. A second goal is the integration of DNA repair and mutation studies. Results are presented on a direct comparison of initial double strand breaks induction, the time course and fidelity of double strand break rejoining, cell killing and mutation induction in the same human model system. In order to understand the carcinogenic potential of protons and HZE particles, the role of damaged microenvironment in this process must be understood. In this project it has been postulated that radiation affects the microenvironment, which then modifies cell interactions in a manner conducive to neoplastic progression. Both TGF-beta and FGF-2 are important components of microenvironment. A recent result on the assessment of the role of FGF-2 and its cross-talk with TGF-beta as a function of radiation quality is presented. Theoretical modeling has so far played a central role in analyzing and integrating experimental data on repair and mutation studies and predicting new phenomena. The integrated NSCORT program also provides a broad training experience for students and postdoctoral fellows in space radiation health.

Animals↗

Response of cultured mammalian cells to accelerated krypton particles.

One of the more interesting observations made in early studies with heavy ions is that the cross-section of the radiosensitive area in mammalian cells increases with LET of HZE particles. It is not certain, however, whether this radiosensitive area is limited to the nuclear area of cells. The successful acceleration of krypton ions to 8.5 MeV/amu at the HILAC Lawrence Berkeley Laboratory, has provided an opportunity to gain more information on this question. Cultured human kidney cells (T-1), growing in exponential phase, were exposed to 3 MeV/amu krypton particles and their colony-forming ability studied. The survival curve was found to be exponential with a mean lethal dose D0=720 rad. A calculation of the cross-section of the radio-sensitive area from the data obtained gives a value of about 145 micrometers2. Present results suggest that the inactivation cross-section stays about the same for heavy ions that have LET greater than 20,000 MeV cm2 g-1, that the nucleus is the only sensitive site for high LET radiation and that a single hit of a heavy ion with very high LET in the nuclear region of the cell can lead to lethal effects. Such particles are therefore extremely dangerous to proliferating living cells.

Cell Line↗

Effects of radiation upon the light-sensing elements of the retina as characterized by scanning electron microscopy.

A model system using Necturus maculosus, the common mudpuppy, was established for evaluating effects of radiation upon the light-sensing elements of the retina. Accelerated heavy ions of helium and neon from the Berkeley Bevalac were used. A number of criteria were chosen to characterize radiation damage by observing morphological changes with the scanning electron microscope. The studies indicated retina sensitivity to high-LET (neon) particles at radiation levels below 10 rads (7 particles per visual element) whereas no significant effects were seen from fast helium ions below 50 rads.

Animals↗

Biological effects due to single accelerated heavy particles and the problems of nervous system exposure in space.

The use of accelerated nitrogen and oxygen nuclei with 270 MeV nucleon-1 at the Berkeley Bevatron allowed a beginning to be made of systematic studies of the effects of heavy particles in multicellular organisms. Initial studies will be briefly reviewed. Individual nitrogen particles produced definite light flashes, streaks and interrupted streaks when they crossed light-sensitive parts of the human retina. The possible hazard from primary heavy galactic cosmic ray particles on long-term space flights are discussed, with special attention to the nervous system.

Animals↗

The structure of emotional expressivity: each emotion counts.

Several models of the dimensionality of emotional expressivity were examined in a multitrait-multimethod study. Targets and peer raters completed measures of the target's emotional expressivity (Berkeley Expressivity Questionnaire. BEQ; J. J. Gross & O. P. John, 1995; and a measure of emotion-specific expression) and the Big 5 personality dimensions. The results of structural equation modeling and analysis of variance revealed that an emotion-specific model was superior to models of valence-specific or unidimensional expressivity. The distinct emotions differed in their relations with the dimensions of the 5-factor model. These results were corroborated by self- and other reports. Finally, the degree of convergence between self- and other ratings differed between emotions, demonstrating the multidimensional character of emotional expressivity.

Adult↗

Clinical diagnosis and treatment of epidermal chytridiomycosis in African clawed frogs (Xenopus tropicalis).

An investigation was conducted to determine the cause of morbidity and mortality in a collection of 55 adult male Xenopus (Silurana) tropicalis at the University of California, Berkeley. More than 80% of affected frogs died during the epizootic. All frogs were anorectic and lethargic, had dark pigmentation and excess skin sloughing, and lacked a slime layer. Histologic examination revealed severe hyperplastic and spongiotic dermatitis associated with colonization of the stratum corneum by large numbers of zoosporangia diagnostic of Batrachochytrium dendrobatidis. Treatment with a commercial formalin/malachite green solution at a dilution of 0.007 ml/L of tank water for 24 h, repeated every other day for four treatments, eliminated the organism and was curative. These findings are indicative of epidermal chytridiomycosis as a primary cause of death in this collection of X. tropicalis.

Animal Husbandry↗

A dynamic mass budget for toxaphene in North America.

A continental-scale dynamic mass budget for toxaphene in North America is presented, based on available information on physicochemical properties, usage patterns, and reported environmental concentrations and using the Berkeley-Trent North American mass balance contaminant fate model (BETR North America). The model describes contaminant fate in 24 ecological regions of North America, including advective transport between regions in the atmosphere, freshwater, and near-shore coastal water. The dynamic mass budget accounts for environmental partitioning, transport, and degradation of the estimated 534 million kg of toxaphene that were used in North America as an insecticide and piscicide between 1945 and 2000. Satisfactory agreement exists between model results and current and historically reported concentrations of toxaphene in air, water, soil, and sediments throughout North America. An estimated 15 million kg of toxaphene are believed to remain in active circulation in the North American environment in the year 2000, with the majority in soils in the southern United States and Mexico, where historic usage was highest. Approximately 70% of total toxaphene deposition from the atmosphere to the Great Lakes is attributed to sources outside the Great Lakes Basin, and an estimated total of 3.9 million kg of toxaphene have been transported to this region from other parts of the continent. The toxaphene mass budget presented here is believed to be the first reported continental-scale multimedia mass budget for any contaminant.

Agriculture↗

Effects of heavy ions on bacteria.

Genetically well-known bacteria have been used to study efficiencies of heavy ions for mutation induction. For space experiments a technique of correlation of tracks of particles (in emulsion stacked on and between Petri dishes) with individual mutations, has been designed and checked in balloon flights. No clear cut results could be obtained without previous identification of genetic markers sensitive to irradiation by heavy ions. Accelerator experiments were performed at the Berkeley HILAC for systematic study. The results obtained on a strain of E. coli K12F- requiring threonine, leucine and arginine showed that the cell inactivation kinetics for gamma rays, helium, carbon and oxygen ions were almost identical (LD90 approaches 22krads) while argon was less effective (LD90 approaches 40 krads). Heavy ions up to oxygen were either equally or less efficient than gamma rays for induction of reverse mutations. Discrepancies between these findings and previous data on bacteria, yeast and Neurospora systems are discussed on the basis of radiosensitivity, ploidy, deletions, forward and reverse mutations.

Arginine↗

[World microbiological unification according to Woodrow Borah].

Now that developments in communication media are turning the world into a "global village" and there are risks of global epidemics due to infectious agents spread by possible terrorist attacks, this article aims to remind us of what happened in the "New World", where in the space of a few decades the indigenous civilizations disappeared. When, following the geographical discoveries of the 15th, 16th and 17th centuries, millions of people met European sailors, soldiers and traders, the outbreak of pathocenosis was destructive--the intensity of this effect was directly related to the degree of isolation of the indigenous populations colonised by the Europeans. The author of this article recalls the Woodrow Borah thesis. Borah, a former History Professor at Berkeley University, elaborated a theory according to which the microbiological unification of the world is the prime cause of the genocide of the indigenous population in America and Oceania. The author emphasises that the events following the discovery of the American continent are very similar to the plague epidemic which started in 1348 in Europe.

Global Health↗

State Medicaid coverage for tobacco-dependence treatments--United States, 1994-2001.

Tobacco use is the leading preventable cause of death in the United States. One of the national health objectives for 2010 is to increase insurance coverage of evidence-based treatment for nicotine dependence (i.e., total coverage of behavioral therapies and Food and Drug Administration [FDA]--approved pharmacotherapies) in Medicaid programs from 36 states to all states and the District of Columbia (DC) (objective 27.8). To increase both the use of treatment by smokers attempting to quit and the number of smokers who quit successfully, the Guide to Community Preventive Services recommends reducing the "out-of-pocket" cost of effective tobacco-dependence treatments (i.e., individual, group, and telephone counseling, and FDA--approved pharmacotherapies) for smokers. The 2000 Public Health Service (PHS) Clinical Practice Guideline supports expanded insurance coverage for tobacco-dependence treatments. In 2000, approximately 32 million low-income persons in the United States received their health insurance coverage through the federal-state Medicaid program; 11.5 million (36%) of these persons smoked (CDC, unpublished data, 2000). The amount and type of coverage for tobacco-dependence treatment offered by Medicaid has been reported for 1998 and 2000 from state surveys conducted by the Center for Health and Public Policy Studies (CHPPS) at the University of California, Berkeley. All states and DC were re-surveyed in 2001 about amount and type of coverage, and level of coverage since 1994. This report summarizes the results of the survey, which indicate that the number of Medicaid programs providing some coverage for tobacco-dependence counseling or medication increased from 34 in 2000 to 36 in 2001, but only one state offered coverage for all the counseling and pharmacotherapy treatments recommended by the 2000 PHS guideline. If the 2010 national health objective is to be achieved, Medicaid coverage for treatment of tobacco dependence should be increased dramatically.

Healthy People Programs↗