Constraints on Cosmic Strings Using Data from the Third Advanced LIGO-Virgo Observing Run

We search for gravitational-wave signals produced by cosmic strings in the Advanced LIGO and Virgo full O3 dataset. Search results are presented for gravitational waves produced by cosmic string loop features such as cusps, kinks, and, for the first time, kink-kink collisions. A template-based search for short-duration transient signals does not yield a detection. We also use the stochastic gravitational-wave background energy density upper limits derived from the O3 data to constrain the cosmic string tension Gμ as a function of the number of kinks, or the number of cusps, for two cosmic string loop distribution models. Additionally, we develop and test a third model that interpolates between these two models. Our results improve upon the previous LIGO-Virgo constraints on Gμ by 1 to 2 orders of magnitude depending on the model that is tested. In particular, for the one-loop distribution model, we set the most competitive constraints to date: Gμ≲4×10^{-15}. In the case of cosmic strings formed at the end of inflation in the context of grand unified theories, these results challenge simple inflationary models.

Constraints on Cosmic Strings Using Data from the Third Advanced LIGO-Virgo Observing Run

We search for gravitational-wave signals produced by cosmic strings in the Advanced LIGO and Virgo full O3 dataset. Search results are presented for gravitational waves produced by cosmic string loop features such as cusps, kinks, and, for the first time, kink-kink collisions. A template-based search for short-duration transient signals does not yield a detection. We also use the stochastic gravitational-wave background energy density upper limits derived from the O3 data to constrain the cosmic string tension Gμ as a function of the number of kinks, or the number of cusps, for two cosmic string loop distribution models. Additionally, we develop and test a third model that interpolates between these two models. Our results improve upon the previous LIGO-Virgo constraints on Gμ by 1 to 2 orders of magnitude depending on the model that is tested. In particular, for the one-loop distribution model, we set the most competitive constraints to date: Gμ≲4×10^{-15}. In the case of cosmic strings formed at the end of inflation in the context of grand unified theories, these results challenge simple inflationary models.

GW190521: A Binary Black Hole Merger with a Total Mass of 150 M_{⊙}

On May 21, 2019 at 03:02:29 UTC Advanced LIGO and Advanced Virgo observed a short duration gravitational-wave signal, GW190521, with a three-detector network signal-to-noise ratio of 14.7, and an estimated false-alarm rate of 1 in 4900 yr using a search sensitive to generic transients. If GW190521 is from a quasicircular binary inspiral, then the detected signal is consistent with the merger of two black holes with masses of 85_{-14}^{+21}  M_{⊙} and 66_{-18}^{+17}  M_{⊙} (90% credible intervals). We infer that the primary black hole mass lies within the gap produced by (pulsational) pair-instability supernova processes, with only a 0.32% probability of being below 65  M_{⊙}. We calculate the mass of the remnant to be 142_{-16}^{+28}  M_{⊙}, which can be considered an intermediate mass black hole (IMBH). The luminosity distance of the source is 5.3_{-2.6}^{+2.4}  Gpc, corresponding to a redshift of 0.82_{-0.34}^{+0.28}. The inferred rate of mergers similar to GW190521 is 0.13_{-0.11}^{+0.30}  Gpc^{-3} yr^{-1}.

Prospects for observing and localizing gravitational-wave transients with Advanced LIGO, Advanced Virgo and KAGRA

We present our current best estimate of the plausible observing scenarios for the Advanced LIGO, Advanced Virgo and KAGRA gravitational-wave detectors over the next several years, with the intention of providing information to facilitate planning for multi-messenger astronomy with gravitational waves. We estimate the sensitivity of the network to transient gravitational-wave signals for the third (O3), fourth (O4) and fifth observing (O5) runs, including the planned upgrades of the Advanced LIGO and Advanced Virgo detectors. We study the capability of the network to determine the sky location of the source for gravitational-wave signals from the inspiral of binary systems of compact objects, that is binary neutron star, neutron star-black hole, and binary black hole systems. The ability to localize the sources is given as a sky-area probability, luminosity distance, and comoving volume. The median sky localization area (90% credible region) is expected to be a few hundreds of square degrees for all types of binary systems during O3 with the Advanced LIGO and Virgo (HLV) network. The median sky localization area will improve to a few tens of square degrees during O4 with the Advanced LIGO, Virgo, and KAGRA (HLVK) network. During O3, the median localization volume (90% credible region) is expected to be on the order of 10 5 , 10 6 , 10 7 Mpc 3 for binary neutron star, neutron star-black hole, and binary black hole systems, respectively. The localization volume in O4 is expected to be about a factor two smaller than in O3. We predict a detection count of 1 - 1 + 12 ( 10 - 10 + 52 ) for binary neutron star mergers, of 0 - 0 + 19 ( 1 - 1 + 91 ) for neutron star-black hole mergers, and 17 - 11 + 22 ( 79 - 44 + 89 ) for binary black hole mergers in a one-calendar-year observing run of the HLV network during O3 (HLVK network during O4). We evaluate sensitivity and localization expectations for unmodeled signal searches, including the search for intermediate mass black hole binary mergers.

Search for Subsolar Mass Ultracompact Binaries in Advanced LIGO's Second Observing Run

We present a search for subsolar mass ultracompact objects in data obtained during Advanced LIGO's second observing run. In contrast to a previous search of Advanced LIGO data from the first observing run, this search includes the effects of component spin on the gravitational waveform. We identify no viable gravitational-wave candidates consistent with subsolar mass ultracompact binaries with at least one component between 0.2  M_{⊙}-1.0  M_{⊙}. We use the null result to constrain the binary merger rate of (0.2  M_{⊙}, 0.2  M_{⊙}) binaries to be less than 3.7×10^{5}  Gpc^{-3} yr^{-1} and the binary merger rate of (1.0  M_{⊙}, 1.0  M_{⊙}) binaries to be less than 5.2×10^{3}  Gpc^{-3} yr^{-1}. Subsolar mass ultracompact objects are not expected to form via known stellar evolution channels, though it has been suggested that primordial density fluctuations or particle dark matter with cooling mechanisms and/or nuclear interactions could form black holes with subsolar masses. Assuming a particular primordial black hole (PBH) formation model, we constrain a population of merging 0.2  M_{⊙} black holes to account for less than 16% of the dark matter density and a population of merging 1.0  M_{⊙} black holes to account for less than 2% of the dark matter density. We discuss how constraints on the merger rate and dark matter fraction may be extended to arbitrary black hole population models that predict subsolar mass binaries.

Computational correction of spatially variant optical aberrations in 3D single-molecule localization microscopy

3D single-molecule localization microscopy relies on fitting the shape of point-spread-functions (PSFs) recorded on a wide-field detector. However, optical aberrations distort those shapes, which compromises the accuracy and precision of single-molecule localization microscopy. Here, we employ a computational phase retrieval based on a vectorial PSF model to quantify the spatial variance of optical aberrations in a two-channel ultrawide-field single-molecule localization microscope. The use of a spatially variant PSF model enables accurate and precise emitter localization in x-, y- and z-directions throughout the entire field of view.

Anal condyloma: a comparison between HIV positive and negative patients

HIV positive and negative patients with anal condylomata were compared to determine an association with squamous cell neoplasia, its disease progression, and response to treatment. From 1992 to 2003, 61 patients were diagnosed with anal condylomata by anal biopsy. Thirty-four patients were HIV+ and 27 patients were considered HIV-. Upon retrospective chart review, details on disease progression, development of malignancy, and subsequent treatment were collected. Sixty-one per cent of HIV+ patients had a neoplastic process in contrast to 25 per cent of HIV- patients (P = 0.005). Five patients demonstrated disease progression, of which four were HIV+. Three HIV+ patients were treated for invasive carcinoma with excision and standard chemoradiation therapy. Two patients with T3 lesions developed recurrence and died. Eighteen HIV+ patients had noninvasive carcinoma and were treated with local excision without recurrence at mean follow-up of 28 months. HIV+ patients were shown to have more condylomata harboring squamous cell neoplasia than HIV- patients. Noninvasive carcinoma can be treated effectively with local excision, independent of HIV status; however, long-term follow-up is needed. Chemoradiation therapy in patients who are relatively healthy and have stage I disease may be successful. The role for chemoradiation in AIDS patients with stage III disease remains unclear.

Cytokines and the pathogenesis of nosocomial pneumonia

BACKGROUND

Nosocomial pneumonia (NP) in injured patients is a significant clinical problem. We hypothesize that the pathogenesis of NP in injured patients involves an imbalanced cytokine response within the alveolar airspace that may inhibit effector cell function.

METHODS

Proinflammatory (IL-8) and anti-inflammatory (IL-10) levels were measured in bronchoalveolar lavage (BAL) fluid from multitrauma patients on admission, 24, 48, and 72 hours post-injury and following lipopolysaccharide (LPS) induction of alveolar cells. Patients were compared based on IL-8 levels and the development of NP.

RESULTS

A high level of IL-8 on admission was associated with the development of NP. In addition, levels of IL-8 were significantly greater in NP-positive patients at all time points. The IL-10 levels decreased from admission values in NP-negative patients but increased in NP-positive patients. Furthermore, a high level of IL-10 ( > 120 pg/mL) at 72 hours post-injury was associated with the development of NP. Alveolar cells from NP-positive patients produced significantly more IL-10 in response to LPS than cells from NP-negative patients.

CONCLUSIONS

The pathogenesis of NP in injured patients involves an early and severe IL-8 process within the lung followed by an exaggerated IL-10 response that may inhibit effector cell function.

Optical pattern recognition by use of a segmented semiconductor optical amplifier

A technique for high-speed, all-optical pattern recognition based on cross correlation in a segmented semiconductor optical amplifier (SSOA) is presented. A counterpropagating pump-probe setup is used to perform cross correlation of the spatial gain-loss pattern in the SSOA with the optical data pattern (pump), and the result is read out with a counterpropagating probe. Cross correlation of 4-bit patterns at 85 Gbits/s is experimentally demonstrated. Simulations show reasonable agreement with experimental measurements and are used to address scalability to higher bit rates and longer data patterns.

Surveillance of antibiotic resistance in invasive isolates of Neisseria meningitidis in Australia 1994-1999

A total of 1434 strains of Neisseria meningitidis isolated from cases of invasive meningococcal disease (IMD) in Australia between 1994 and 1999 were examined by standard methods for susceptibility to antibiotics used for treatment and prophylaxis. The proportion of isolates fully susceptible to penicillin decreased from 45% in 1994 to 26% in 1999 (P<0.001). All the other isolates were less sensitive to penicillin except for two meningococci with a penicillin MIC of 1 mg/l. The geometric mean penicillin MIC increased from 0.045 to 0.065 mg/l from 1994 to 1999. There was no significant difference in the geometric mean penicillin MICs of serogroup B and serogroup C meningococci. Penicillin susceptibility was significantly associated with a poorer outcome. Isolates from survivors of IMD had a higher geometric mean penicillin MIC (0.06 mg/l) than those from fatal cases (0.048 mg/l) (P< 0.001). This suggests that factors other than the decrease in susceptibility to penicillin observed were more relevant to outcome in IMD. All isolates were fully susceptible to ceftriaxone. Rifampicin resistance was infrequent (eight isolates in 6 years) and sporadic. A single isolate had decreased quinolone susceptibility. Despite the significant shift in susceptibility to penicillin recorded, this group of antibiotics remains a suitable treatment for IMD in Australia.

Direct detection of ultrafast thermal transients by use of a chirped, supercontinuum white-light pulse

An experimental technique is demonstrated that permits direct optical measurement of ultrafast material transients during a single excitation-relaxation cycle. Reflection of a linearly chirped, supercontinuum optical pulse from a gold film with changing surface temperature induced by an ultrafast pump pulse allows the thermal transients to be encoded onto the spectrum of the probe pulse. Calibrating the chirp of the probe pulse and the wavelength sensitivity of the sample permits mapping of the measured transient into the time domain. Measurements are completed over the course of 100 ps with subpicosecond time resolution. Results obtained with this technique are compared with similar measurements obtained with conventional pump-probe correlation techniques.

Contribution of dietary protein to sulfide production in the large intestine: an in vitro and a controlled feeding study in humans

BACKGROUND

Hydrogen sulfide is a luminally acting, bacterially derived cell poison that has been implicated in ulcerative colitis. Sulfide generation in the colon is probably driven by dietary components such as sulfur-containing amino acids (SAAs) and inorganic sulfur (eg, sulfite).

OBJECTIVE

We assessed the contribution of SAAs from meat to sulfide production by intestinal bacteria with use of both a model culture system in vitro and an in vivo human feeding study.

DESIGN

Five healthy men were housed in a metabolic suite and fed a sequence of 5 diets for 10 d each. Meat intake ranged from 0 g/d with a vegetarian diet to 600 g/d with a high-meat diet. Fecal sulfide and urinary sulfate were measured in samples collected on days 9 and 10 of each diet period. Additionally, 5 or 10 g bovine serum albumin or casein/L was added to batch cultures inoculated with feces from 4 healthy volunteers. Concentrations of sulfide, ammonia, and Lowry-reactive substances were measured over 48 h.

RESULTS

Mean (+/-SEM) fecal sulfide concentrations ranged from 0.22 +/- 0.02 mmol/kg with the 0-g/d diet to 3.38 +/- 0.31 mmol/kg with the 600-g/d diet and were significantly related to meat intake (P: < 0.001). Sulfide formation in fecal batch cultures supplemented with both bovine serum albumin and casein correlated with protein digestion, as measured by the disappearance of Lowry-reactive substances and the appearance of ammonia.

CONCLUSION

Dietary protein from meat is an important substrate for sulfide generation by bacteria in the human large intestine.

Measurements of nanometer scale interface diffusion between tungsten and niobium thin films using high frequency laser based ultrasound

This article presents the use of a quantitative analysis technique to describe time-resolved acoustic spectroscopy (high frequency laser based ultrasound) measurements of atomic diffusion on nanometer length scales occurring at the interface between sputter-deposited tungsten and niobium films. The extent of diffusion at the tungsten-niobium interface is determined by comparing experimental, simulated, and theoretical transfer functions between acoustic arrivals. The experimental and simulated transfer functions use the spectral content of successive reflected acoustic waves and the theoretical transfer function is based on the transfer matrix of an equivalent stratified interface region. This combination of theoretical, simulated, and experimental analyses makes it possible to separate signals with distinct differences between the as-deposited interface and those interfaces diffused to an experimentally determined 0.8-nm and 1.4-nm extent. Comparison of predicted and measured diffusion depths for this diffusion couple indicates that bulk diffusivities are not appropriate for describing nanometer scale interface diffusion.

A new method for the determination of sulphide in gastrointestinal contents and whole blood by microdistillation and ion chromatography

Hydrogen sulphide is produced in the human large intestine by the bacterial reduction of dietary inorganic sulphate and sulphite and by fermentation of sulphur amino acids. Sulphide may damage the colonic epithelium and has been implicated in the pathogenesis of ulcerative colitis. The accurate measurement of sulphide in biological samples, particularly in gut contents is difficult due to the volatile nature of the compound, and the viscosity and turbidity of the samples. Here we describe a method for the determination of sulphide in gut contents and whole blood which overcomes these problems. Initially, samples are treated with zinc acetate to trap sulphide. A microdistillation pretreatment is then used, which releases sulphide from its stable, stored state, coupled to ion chromatography with electrochemical detection. The limit of detection of the method was determined as 2.5 micromol/l, which enabled sulphide levels in gut contents and whole blood samples obtained from humans to be accurately determined. A preliminary investigation in healthy human subjects showed blood sulphide ranged from 10 to 100 micromol/l. Whole blood sulphide did not change significantly when increasing amounts of protein from meat were fed. However, faecal sulphide did show a significant increase from 164 to 754 nmol/g in four subjects fed diets which contained 60 and 420 g meat.

Oral transmission of human immunodeficiency virus by infected seminal fluid and milk: a novel mechanism

Salivary transmission by the 30 million human immunodeficiency virus (HIV) carriers is rare, despite kissing, aerosolization, and dental treatment. The main protective mechanism of saliva is reported to be inactivation of HIV-transmitting leukocytes by its unique hypotonicity; however, the successful oral transmission of HIV by seminal fluid and milk is unexplained. Whether seminal fluid and milk successfully transmit HIV orally by overcoming the recipient's salivary hypotonic inactivation of HIV-transmitting leukocytes was tested. Isotonic salt solution and normal donor samples of milk, colostrum, seminal fluid, and blood were studied for their ability to overcome the salivary hypotonic inactivation. All samples, in physiologic volumes, prevented the hypotonic saliva from inactivating HIV-transmitting leukocytes by providing solutes and retarding diffusion. This indicates that successful oral transmission of HIV by seminal fluid, milk, and colostrum may be due to their isotonicity, which overcomes hypotonic salivary inactivation of HIV-transmitting leukocytes.

Identification of patients at highest risk for ventilator-associated pneumonia in the surgical intensive care unit

Ventilator-acquired pneumonia (VAP) is a major problem for patients admitted to the surgical intensive care unit mechanically ventilated. Recently, we have identified both clinical and immunologic factors associated with the development of VAP. The clinical risk factors are associated with the severity of the injury and the length of mechanical ventilation. The immunologic risk factors are associated with the local lung inflammatory response that is unchecked and affects local cell function. The combination of the severity of injury, the length of mechanical ventilation, and the failure to "auto-regulate" the lung response places the host at risk of VAP. In the next millennium, if we are to make significant advances in the management of VAP, we will need to understand the pathophysiology of the disease process. Then we can develop preventive strategies that will reduce the morbidity and the associated cost of VAP.

The bottom line for prediction of residue solvent accessibility

A simple method of predicting residue solvent accessibilities in proteins is described, with the intention that it should be used as a baseline by which more sophisticated approaches to prediction can be judged. Comparison with existing methods of predicting residue burial reveals that their performance is often little better than that of the baseline method. The problem of comparing different prediction methods is shown to be complicated by the proliferation of different schemes for classifying residue burial.

Identification of regulators for Ypt1 GTPase nucleotide cycling

Small GTPases of the Ypt/Rab family are involved in the regulation of vesicular transport. Cycling between the GDP- and GTP-bound forms and the accessory proteins that regulate this cycling are thought to be crucial for Ypt/Rab function. Guanine nucleotide exchange factors (GEFs) stimulate both GDP loss and GTP uptake, and GTPase-activating proteins (GAPs) stimulate GTP hydrolysis. Little is known about GEFs and GAPs for Ypt/Rab proteins. In this article we report the identification and initial characterization of two factors that regulate nucleotide cycling by Ypt1p, which is essential for the first two steps of the yeast secretory pathway. The Ypt1p-GEF stimulates GDP release and GTP uptake at least 10-fold and is specific for Ypt1p. Partially purified Ypt1p-GEF can rescue the inhibition caused by the dominant-negative Ypt1p-D124N mutant of in vitro endoplasmic reticulum-to-Golgi transport. This mutant probably blocks transport by inhibiting the GEF, suggesting that we have identified the physiological GEF for Ypt1p. The Ypt1p-GAP stimulates GTP hydrolysis by Ypt1p up to 54-fold, has a higher affinity for the GTP-bound form of Ypt1p than for the GDP-bound form, and is specific to a subgroup of exocytic Ypt proteins. The Ypt1p-GAP activity is not affected by deletion of two genes that encode known Ypt GAPs, GYP7 and GYP1, nor is it influenced by mutations in SEC18, SEC17, or SEC22, genes whose products are involved in vesicle fusion. The GEF and GAP activities for Ypt1p localize to particulate cellular fractions. However, contrary to the predictions of current models, the GEF activity localizes to the fraction that functions as the acceptor in an endoplasmic reticulum-to-Golgi transport assay, whereas the GAP activity cofractionates with markers for the donor. On the basis of our current and previous results, we propose a new model for the role of Ypt/Rab nucleotide cycling and the factors that regulate this process.

GTP hydrolysis is not important for Ypt1 GTPase function in vesicular transport

GTPases of the Ypt/Rab family play a key role in the regulation of vesicular transport. Their ability to cycle between the GTP- and the GDP-bound forms is thought to be crucial for their function. Conversion from the GTP- to the GDP-bound form is achieved by a weak endogenous GTPase activity, which can be stimulated by a GTPase-activating protein (GAP). Current models suggest that GTP hydrolysis and GAP activity are essential for vesicle fusion with the acceptor compartment or for timing membrane fusion. To test this idea, we inactivated the GTPase activity of Ypt1p by using the Q67L mutation, which targets a conserved residue that helps catalyze GTP hydrolysis in Ras. We demonstrate that the mutant Ypt1-Q67L protein is severely impaired in its ability to hydrolyze GTP both in the absence and in the presence of GAP and consequently is restricted mostly to the GTP-bound form. Surprisingly, a strain with ypt1-Q67L as the only YPT1 gene in the cell has no observable growth phenotypes at temperatures ranging from 14 to 37 degrees C. In addition, these mutant cells exhibit normal rates of secretion and normal membrane morphology as determined by electron microscopy. Furthermore, the ypt1-Q67L allele does not exhibit dominant phenotypes in cell growth and secretion when overexpressed. Together, these results lead us to suggest that, contrary to current models for Ypt/Rab function, GTP hydrolysis is not essential either for Ypt1p-mediated vesicular transport or as a timer to turn off Ypt1p-mediated membrane fusion but only for recycling of Ypt1p between compartments. Finally, the ypt1-Q67L allele, like the wild type, is inhibited by dominant nucleotide-free YPT1 mutations. Such mutations are thought to exert their dominant phenotype by sequestration of the guanine nucleotide exchange factor (GNEF). These results suggest that the function of Ypt1p in vesicular transport requires not only the GTP-bound form of the protein but also the interaction of Ypt1p with its GNEF.

Nutrient profiles in the everglades: examination along the eutrophication gradient

We examined the concentration profiles of nutrients in the surface water, soil and pore water along the eutrophication gradient of the Water Conservation Area-2A (WCA-2A) in the northern Everglades. Phosphorus levels in the surface waters contributed by the agricultural runoff showed an exponential decrease downstream of the inflow structures attaining background values of 7-12, 7-9 and 5-6 micrograms l-1 of TP, TDP and PO4-P, respectively, at distances of 8-10 km. The pore water PO4-P concentration in the oligotrophic areas ranged between 5 and 10 micrograms l-1. Molar ratios of dissolved inorganic N and P suggest a possible switch in nutrient limitation in the surface water from P in the oligotrophic areas to N in the eutrophic areas (DIN:DIP approximately 5). External nutrient loading has also contributed to a three- to four-fold increase in soil TP concentration and enhanced pore water PO4-P in the northern marshes. Unlike P, C and N concentration in the soils remained fairly uniform along the eutrophication gradient. 210Pb dating of soil cores suggests that the increase in soil P concentration (from < 500 to 1500 micrograms g-1) and P accumulation rate (from 0.06 to 0.46 g P m-2 per year) at the eutrophic site correlates with the installation of inflow structures in 1960-1963 through which agricultural drainage from the Hillsboro canal enters the marshes. Organic P makes up 70-90% of the total P in the soils as uptake by algae and macrophytes is the primary mechanism of P removal in these wetlands. Calcium supply from the underlying bedrock suggested from the surface and pore water chemical profiles has important consequences for P-cycling in the Everglades as Ca-bound P is the major form of inorganic P storage in the soils.

Prediction of Phase Behavior in Microemulsion Systems Using Artificial Neural Networks

Preliminary investigations have been conducted to assess the potential for using (back-propagation, feed-forward) artificial neural networks to predict the phase behavior of quaternary microemulsion-forming systems, with a view to employing this type of methodology in the evaluation of novel cosurfactants for the formulation of pharmaceutically acceptable drug-delivery systems. The data employed in training the neural networks related to microemulsion systems containing lecithin, isopropyl myristate, and water, together with different types of cosurfactants, including short- and medium-chain alcohols, amines, acids, and ethylene glycol monoalkyl ethers. Previously unpublished phase diagrams are presented for four systems involving the cosurfactants 2-methyl-2-butanol, 2-methyl-1-propanol, 2-methyl-1-butanol, and isopropanol, which, along with eight other published sets of data, are used to test the predictive ability of the trained networks. The pseudo-ternary phase diagrams for these systems are predicted using only four computed physicochemical properties for the cosurfactants involved. The artificial neural networks are shown to be highly successful in predicting phase behavior for these systems, achieving mean success rates of 96.7 and 91.6% for training and test data, respectively. The conclusion is reached that artificial neural networks can provide useful tools for the development of microemulsion-based drug-delivery systems.

Neural network computer simulation of medical aerosols

Preliminary investigations have been conducted to assess the potential for using artificial neural networks to simulate aerosol behaviour, with a view to employing this type of methodology in the evaluation and design of pulmonary drug-delivery systems. Details are presented of the general purpose software developed for these tasks; it implements a feed-forward back-propagation algorithm with weight decay and connection pruning, the user having complete run-time control of the network architecture and mode of training. A series of exploratory investigations is then reported in which different network structures and training strategies are assessed in terms of their ability to simulate known patterns of fluid flow in simple model systems. The first of these involves simulations of cellular automata-generated data for fluid flow through a partially obstructed two-dimensional pipe. The artificial neural networks are shown to be highly successful in simulating the behaviour of this simple linear system, but with important provisos relating to the information content of the training data and the criteria used to judge when the network is properly trained. A second set of investigations is then reported in which similar networks are used to simulate patterns of fluid flow through aerosol generation devices, using training data furnished through rigorous computational fluid dynamics modelling. These more complex three-dimensional systems are modelled with equal success. It is concluded that carefully tailored, well trained networks could provide valuable tools not just for predicting but also for analysing the spatial dynamics of pharmaceutical aerosols.

Requirement of nucleotide exchange factor for Ypt1 GTPase mediated protein transport

Small GTPases of the rab family are involved in the regulation of vesicular transport. It is believed that cycling between the GTP- and GDP-bound forms, and accessory factors regulating this cycling are crucial for rab function. However, an essential role for rab nucleotide exchange factors has not yet been demonstrated. In this report we show the requirement of nucleotide exchange factor activity for Ypt1 GTPase mediated protein transport. The Ypt1 protein, a member of the rab family, plays a role in targeting vesicles to the acceptor compartment and is essential for the first two steps of the yeast secretory pathway. We use two YPT1 dominant mutations that contain alterations in a highly conserved GTP-binding domain, N121I and D124N. YPT1-D124N is a novel mutation that encodes a protein with nucleotide specificity modified from guanine to xanthine. This provides a tool for the study of an individual rab GTPase in crude extracts: a xanthosine triphosphate (XTP)-dependent conditional dominant mutation. Both mutations confer growth inhibition and a block in protein secretion when expressed in vivo. The purified mutant proteins do not bind either GDP or GTP. Moreover, they completely inhibit the ability of the exchange factor to stimulate nucleotide exchange for wild type Ypt1 protein, and are potent inhibitors of ER to Golgi transport in vitro at the vesicle targeting step. The inhibitory effects of the Ypt1-D124N mutant protein on both nucleotide exchange activity and protein transport in vitro can be relieved by XTP, indicating that it is the nucleotide-free form of the mutant protein that is inhibitory. These results suggest that the dominant mutant proteins inhibit protein transport by sequestering the exchange factor from the wild type Ypt1 protein, and that this factor has an essential role in vesicular transport.

Extravascular extravasation of fluid as a complication of central venous lines in the neonate

The use of central venous lines in neonatal intensive care is widespread. We report a series of 11 infants in whom extravasation of fluid developed presumably as a result of the central line. There were six cases of pericardial effusion with a 67% mortality rate and five cases of pleural effusion with no mortality, for a total extravasation incidence of 1.1% for central lines placed during a 5-year period. The highest incidence of effusion occurred with polyethylene catheters, but all types of catheters resulted in effusion. This report emphasizes the serious morbidity and mortality of these complications of central venous lines.

Infants and young children with cystic fibrosis have high levels of serum sialyl Lewis(a) antigen

Previous studies suggest that serum levels of the mucin-associated sialyl Lewis(a) (Le(a)) antigen (NeuAC alpha 2-3 Gal beta 1-3 [Fuc alpha 1-4]GlcNAc beta 1...) correlate with the pulmonary status of cystic fibrosis (CF) patients who have Le(a) or Lewis(b) blood types and can form the antigen. However, there is little information on serum sialyl Le(a) antigen levels in CF patients or normal children younger than 9 y. We measured serum antigen levels using the MAb 19-9 in normal term neonates, CF infants and young children, and infants and children who had bronchopulmonary dysplasia or asthma. The mean serum sialyl Le(a) antigen level of the CF patients was 46.7 U/mL, significantly above (p < 0.01) the mean levels of the three other groups. The mean serum sialyl Le(a) levels of the three non-CF groups were not significantly different from one another or from published normal values. We conclude that serum sialyl Le(a) antigen levels are elevated early in CF, but are normal in asthma and bronchopulmonary dysplasia patients.

Acculturation and the initiation of breastfeeding

Despite the fact that breastfeeding is the most appropriate form of nutrition for the healthy term infant, the rate of initiation in the U.S. is declining. One demographic factor associated with this low rate is ethnicity and so in this study we measured acculturation (one aspect of ethnicity) into the U.S. and its relationship to the successful initiation of breastfeeding in a sample of women recruited approximately 2 months prenatally in a U.S.-Mexico border city. Interviews were administered in English or Spanish by bilingual interviewers prenatally (n = 906), natally (n = 788), and postnatally (n = 715). Acculturation (measured with a 20 item instrument) was strongly related to the intent to (p < 0.001) or the successful initiation of breastfeeding (p < 0.001). Marital status (p = 0.014) and education (p = 0.002) were related to breastfeeding prenatally and natally. Initiation of breastfeeding was highest among those women least acculturated (52.9%) and lowest in those most acculturated (36.1%) indicating an inhibiting effect of acculturation. To improve the rate of initiation of breastfeeding in the U.S. (a national health goal) intervention programs must consider cultural factors.

Peat Accretion and N, P, and Organic C Accumulation in Nutrient-Enriched and Unenriched Everglades Peatlands

Recent (1964-1989) rates of peat accretion and nitrogen (N), phosphorus (P), and organic carbon (C) accumulation were measured in Everglades soils to characterize the effects of altered hydroperiod and nutrient regimes on the nutrient storage capacity of the Everglades ecosystem. Peat accretion was related to hydroperiod and phosphorus loading. Accretion rates were highest in areas of extended hydroperiod (2.8-3.2 mm/yr) and/or phosphorus enrichment (4.0 mm/yr) and lowest in areas of reduced hydroperiod (1.6-2.0 mm/yr). Rates of accumulation of nitrogen were 3.8-ll.6 g°m^-2 °yr^-1 (X = 8.2 g°m^-2 ° yr^-1 ) and those of organic C were 54-161 g°m^-2 °yr^-1 (X = 104 g°m^-2 °yr^-1 ). Accumulation rates of N and organic C were primarily a function of peat accretion rates. Phosphorus accumulation was controlled by both peat accretion and increased soil P content. Soil P concentrations (1248 @m/g) in an area receiving N and P enriched agricultural runoff were 2-3 times higher than P levels at unenriched locations (432-764 mg/g). As a result, rates of P accumulation at this site (0.46 g°m^-2 °yr^-1 ) were 2-8 times greater compared to unenriched Everglades soils (0.06-0.23 g^. m^- 2^@ ?yr^-1 ). Inputs of P (0.53 g^. m^-2. yr^-1 ) and N (15.5 g^. m^-2 °yr^-1 ) to the nutrient-enriched area of Water Conservation Area (WCA) 2A (via rainfall and surface flow) were nine and twelve times higher than inputs to the unenriched part of WCA 2A. As a result, the efficiency of P removal was lower at the enriched site (87%) than at the unenriched location (100%). Nitrogen removal efficiencies also were lower in the enriched area (75%) as compared to the unenriched area, where N accumulation in peat was 290-450% of the input. The difference in N storage efficiencies between the two sites may reflect differences in N fixation and denitrification in nutrient-enriched and unenriched Everglades peatlands. Our findings suggest that nutrient-enriched agricultural drainage has contributed to increased rates of peat accretion and phosphorus accumulation in areas of the northern Everglades that have been receiving agricultural drainage for the past 25-30 yr. The affected area has functioned effectively as a phosphorus sink, primarily due to increased organic P storage. However, the effects of nutrient loading, especially P, on the long-term stability of the Everglades ecosystem and on the long-term P storage potential of Everglades peats are poorly understood and are currently under investigation.

Acculturation and breastfeeding on the United States-Mexico border

Previous studies have demonstrated a strong association between breastfeeding incidence and ethnic background, indicating the presence of strong cultural influences on infant-feeding patterns within ethnic groups. This study analyzed the relationship of acculturation into the United States, one aspect of ethnicity, to the initiation of breastfeeding among a sample of 213 women recruited approximately 2 months prenatally in the United States-Mexico border city of Brownsville, Texas. An in-depth, structured interview was conducted at that time (n = 213), at the time of birth (n = 207), and 2 to 3 weeks postnatally (n = 206). In addition, male partners of the mothers were interviewed prenatally when available (n = 119). Acculturation scores and demographic characteristics were tested relative to breastfeeding initiation. The degree of acculturation, age, and marital status were associated significantly with breastfeeding initiation (with breastfeeding continued at 2 to 3 weeks postnatally), but occupational status, education, and income were not. Breastfeeding incidence was highest among older, married, or low-acculturated, Anglo mothers. These data suggest that women being assimilated into the United States are inhibited in the initiation of breastfeeding. These findings suggest that to be successful, intervention programs to increase breastfeeding incidence must consider the cultural adaptation of different groups as they meld with the larger population.

Contamination study of multiple-dose vials

OBJECTIVE

To document the number of opened, dated, and expired multiple-dose vials (MDVs) in patient-care areas and to determine what proportion of MDVs were contaminated with bacteria or cellular debris.

DESIGN

Every tenth opened MDV (69/656) identified on the wards was collected, ensuring representation from each nursing unit. Contents were examined for contamination.

SETTING

Medical-school-affiliated, tertiary care center.

MAIN OUTCOME MEASURES

(1) Visual inspection for debris, medication type, location, lot number, manufacturer's expiration date, and date of opening; (2) culture in solid and broth media for bacterial growth; and (3) staining and microscopic examination for cellular constituents.

RESULTS

No vials had been dated after opening and 4.6 percent were expired according to the manufacturer's expiration date. No bacterial contamination was evident; however, one vial was contaminated with red blood cells.

CONCLUSIONS

Transmission of infection via contaminated MDVs has been well documented and contamination with red blood cells raises concerns about potential for transmission of bloodborne pathogens. Recommendations include dating MDVs after opening, emphasizing the need for proper aseptic technique, and discarding MDVs on the manufacture's date of expiration.

Mycotic thromboaneurysmal disease of the abdominal aorta in preterm infants: its natural history and its management

Five infants with mycotic complications of umbilical artery catheterization were evaluated with abdominal ultrasound and followed serially to document their natural history. Methicillin-resistant Staphylococcus aureus was always the infecting organism. There were one female and four male infants and they weighed between 900 and 1,200 g at birth. While two of the catheters were positioned in the abdominal aorta, three were located above the diaphragm. The predominate signs and symptoms included: thrombocytopenia, unexplained anemia, renal failure, hypertension, and embolic phenomena to the toes. Real-time ultrasound always proved sufficient for diagnosis. Serial studies detected the initial aortic thrombosis in three patients and accurately documented its progression to aneurysmal disease over 10 days in one patient and 17 days in another. Three of the infants were diagnosed with aneurysms at their initial examination. Of the five patients, three were treated nonoperatively and died of complications of their aortic disease. One patient was discovered at operation to have necrotic ischemic intestine. Aortic repair was postponed and he died of septic complications. The remaining patient underwent a PTFE interposition graft and survived for 6 months, dying of pulmonary failure with autopsy confirmed graft patency.

Gentamicin population pharmacokinetic models for low birth weight infants using a new nonparametric method

Availability of personal computer programs for control of drug regimens has stimulated interest in modeling population pharmacokinetics. In this study, we found parameter values for gentamicin in two infant populations with low birth weights. The models were developed by use of a parametric (i.e., standard two-stage algorithm) and with a new nonparametric expected maximum algorithm. Data for the two populations (i.e., infants less than or equal to 31 weeks' and greater than 31 but less than or equal to 34 weeks' gestational age) were obtained from infants admitted to the University of Texas Medical Branch intensive care nursery between August 1, 1988, and July 31, 1989. The new nonparametric method was demonstrated to be not only the equal of the standard two-stage method for population modeling but better, especially in use of sparse data sets (e.g., single serum levels). It also obviates the need for selecting proper starting conditions for the least-squares fitting procedure used in the standard two-stage method.

Pyocin typing of Pseudomonas aeruginosa isolates from children with cystic fibrosis

Pyocin typing and serotyping of 433 strains of Pseudomonas aeruginosa from children with cystic fibrosis (CF) showed that pyocin type 9 was predominant, particularly in association with polyagglutinating serotype. The common pyocin groups, 1, 5 and 10, made up only 20% of these isolates in contrast to reported rates of up to 89% in other studies using non-CF strains. No strains of pyocin type 3 were found. Polyagglutinating strains made up 72% of strains from patients colonized with P. aeruginosa for more than 12 mths. Pyocin type 9 was associated with 93% of polyagglutinating strains. The parallel between pyocin type 9 and polyagglutinating serotype suggests that these may both be characteristics acquired by P. aeruginosa colonizing patients with CF. Because of confounding between duration of colonization and exposure to cross-infection, this study does not allow definition of the role of cross-infection in determining the characteristics of these strains in most patients. In siblings, however, evidence supports a role for cross-infection either between siblings or from a common source. In 6 pairs of siblings studied, each pair had at least 1 pyocin group in common concurrently, either at entry to the study or after an interval of several months. Identical and unusual pyocin groups were recognized in samples obtained on the same day from pairs of siblings. More studies are needed to compare results of pyocin typing with methods such as genome fingerprinting to characterize these strains and determine whether the observed distribution of pyocin groups in CF isolates is related to cross-infection or whether the combination of pyocin type 9 with polyagglutinating serotype is a characteristic of CF strains.

Longitudinal studies of virulence factors of Pseudomonas aeruginosa in cystic fibrosis

Among 111 strains of Pseudomonas aeruginosa from 49 children with cystic fibrosis, duration of colonization correlated with bacterial phenotype. We confirmed that P. aeruginosa from chronically colonized patients tended to be less motile, produce lower levels of protease and elastase, to be more sensitive to normal serum and to be polyagglutinating or untypable with standard antisera. We also showed that phospholipase and heat-stable hemolysin, concerned in metabolism of inorganic phosphate, and exotoxin A, were lower in these isolates. In longitudinal studies there was a decrease in virulence properties when isolates from the same patient were compared. No reversion from altered phenotype to 'wild-type' characteristics was found.

Breast-feeding initiation in a triethnic population

The influence of sociodemographic factors on the initiation of breast-feeding was evaluated in a triethnic population from Galveston, Tex. Breast-feeding rates were 44.3% among Anglo-Americans, 13.5% among blacks, and 26.6% among Mexican-Americans. Mexican ethnicity, education levels among Anglo-Americans, and marital status were associated with the initiation of breast-feeding. Odds ratios for breast-feeding were 1.94 (95% confidence interval, 1.10 to 3.43) times higher in Mexican-American compared with black women, and 1.94 (95% confidence interval, 1.34 to 2.83) times higher in married than unmarried women. Anglo-American ethnicity and education, as main effects, were not significantly associated with breast-feeding, but their interaction was. Among Anglo-American women (in comparison with black women), the odds ratios of breast-feeding increased with education level, ranging from 1.84 for those with less than an eighth grade education to 7.46 for those with some college. In contrast to recent findings suggesting that education was more important than ethnicity in predicting breast-feeding, the odds of breast-feeding among Anglo-American compared with black women depended on the level of maternal education, but the odds of breast-feeding for Mexican-American vs black women did not depend on education.

Serotype and serum sensitivity of Pseudomonas aeruginosa from children with cystic fibrosis: longitudinal studies and typing with monoclonal antibodies

Pseudomonas aeruginosa isolated from the respiratory tract of children with cystic fibrosis from Perth, Sydney or Brisbane, were serotyped with polyclonal antisera using the International Antigenic Serotyping System. Predominant strains were untypable among isolates from Brisbane (86% of 50 strains) and Sydney (60% of 50 strains) but 64% of the 408 isolates from Perth were polyagglutinating. The frequency distributions of typable strains showed differences from those reported in clinics in the northern hemisphere, but it appears that these local differences do not affect the emergence of strains with defective lipopolysaccharide antigens. Isolates from patients studied longitudinally showed correlation between duration of colonization, appearance of untypable or polyagglutinating strains and sensitivity to normal serum. Mucoid colonies were found more commonly from patients colonized for at least 12 months but, overall, there was no significant association between serotype and mucoid colonial morphology. Commercial monoclonal antibodies did not react with polyagglutinating or untypable strains and gave identical results to the polyvalent typing system with strains classified as typable.

Successful separation of a conjoined biliary tract in a set of omphalopagus twins

Omphalopagus twins were separated in the first 48 hours of life. Preoperative evaluation did not disclose either their conjoined intestines or their conjoined biliary tract; intraoperative evaluation, including an operative cholangiogram, was required to determine if separation was possible. The intestines were divided to give each infant an equal share, and an hepaticoenterostomy was constructed in each of the twins.

Assay and Electrophoresis of Superoxide Dismutase from Red Spruce (Picea rubens Sarg.), Loblolly Pine (Pinus taeda L.), and Scotch Pine (Pinus sylvestris L.) : A Method for Biomonitoring

This paper reports a method for extracting the antioxidant enzyme superoxide dismutase (SOD) from the needles of red spruce (Picea rubens Sarg.), loblolly pine (Pinus taeda L.), and scotch pine (Pinus sylvestris L.) with high efficiency and free from interfering compounds. The extraction employs phosphate buffer with polyvinylpolypyrrolidone and Triton X-100 followed by dialysis overnight. The isozymes of SOD in each species were separated electrophoretically and tested for their sensitivity to KCN and H(2)O(2). An isozyme resistant to these inhibitors was found in the spruce but not the pine needles. The isozymes from the spruce needles were examined for individual responses to aging and H(2)O(2) inhibition. Four of the five CuZn isozymes in spruce were found to have increased significantly but equally by October of their first year and two of those four isozymes were found to be more sensitive to H(2)O(2). The response of the SOD isozymes in loblolly pine seedlings to O(3) was also examined and the isozymes were found to be induced equally. Because the SOD activity in the young pine needles was too low to electrophorese, the SOD activity from the pines in the O(3) experiment had to be partially purified using CHCl(3) and ethanol, then concentrated.

Neonatal intensive care and pediatric rehabilitation: a joint program for care of chronically ill infants

A joint program involving a traditional neonatal intensive care unit and a pediatric rehabilitation unit was developed to care for the increasing number of infants with chronic illnesses requiring long-term specialized care. The program emphasizes provision of a more normal, age-appropriate environment, parent education, and opportunities for extended parent-child interaction.

Successful management of congenital tracheal stenosis in infancy

Seven infants with congenital tracheal stenosis were evaluated and treated to assess the efficacy of current techniques of management. All had multiple congenital anomalies in addition to tracheal stenosis. Notably, three infants had imperforate anus and three had vascular rings. Each infant presented early with respiratory distress. While bronchoscopy and/or bronchography were performed in some, the diagnosis could be made from high contrast x-rays of the chest in each instance. The complexity of the tracheal lesion(s) determined the operative approach. Complicating factors included tracheomalacia, multiple stenoses, pulmonary hypoplasia, and carinal involvement. The trachea was approached through an anterolateral thoracotomy in five cases and through the neck in one. Cardiopulmonary bypass was never required. Simple resection was possible only once. Four patients received costal cartilage grafts, and one graft was created from dura. Grafts varied from 2 1/2 to 6 cm in length and extended onto the bronchi in two cases. All patients with grafts were treated with postoperative endotracheal stents and ventilatory assistance and all were extubated successfully. One patient had trisomy 16p+ detected after successful extubation and died later. One patient was treated expectantly and died. While each case must be individualized, repair of complex tracheal stenosis often results in dramatic immediate improvement and long-term success.

Abnormalities of the neonatal brain: MR imaging. Part II. Hypoxic-ischemic brain injury

Eighty-five infants, 82 of whom were 29-44 weeks postconceptional age, were imaged with a 0.6-T magnet. Eight infants had cerebral infarction. In premature neonates with very water, low-intensity white matter on T1-weighted images, ultrasound was better than both computed tomography and magnetic resonance (MR) imaging in depicting parenchymal changes of infarction or edema. However, after 37 weeks gestation, MR imaging was superior. Cerebral atrophy, present in seven infants, was consistent with subarachnoid space widths of 7 mm or more, or subarachnoid space widths of 5-6 mm with ventricular/brain ratios of 0.36 or greater. Delayed myelination was seen in a total of 18 infants with histories of hypoxic-ischemic insult. MR imaging shows promise in the neonatal period. It facilitates recognition of infarcts in full-term infants and may be used to predict abnormal neurologic outcome in infants who have initial delayed myelination.

Abnormalities of the neonatal brain: MR imaging. Part I. Intracranial hemorrhage

The authors prospectively evaluated 82 neonates, ranging in gestational age from 29 to 44 weeks postconception, with magnetic resonance (MR) imaging at 0.6 T. Twenty-two cases of hemorrhage in 15 infants were identified. Ultrasound (US) and computed tomography (CT) were superior to MR in the first few days after parenchymal hemorrhage, since at this time lesions were apparent on only T2-weighted images. After the first 3 days, MR was the single best modality because (a) hemorrhage on CT became imperceptible in the 2d week, whereas the high signal of hemorrhage on MR persisted for 2-11 weeks; (b) MR permitted rough dating of hemorrhage according to changes in signal intensity; and (c) MR was superior in identifying subdural or epidural hemorrhage. Because of the nonspecificity and restricted field of view of US and the inability of CT to depict hemorrhage after 7-10 days, the authors conclude that MR significantly improves the detection of intracranial hemorrhage in neonates.

Evaluation of hexosaminidase activity as a potential biochemical marker in serum for necrotizing enterocolitis

The presence of increased serum activity of the lysosomal hydrolase hexosaminidase has been suggested to be potentially useful in the diagnosis of neonatal necrotizing enterocolitis (NEC). In the present study, serum activity of hexosaminidase was measured in 19 neonates with NEC and compared to developmental patterns of enzyme activity determined in 61 neonates without NEC. Infants with NEC were studied at intervals starting at the onset of disease and continuing until 6 weeks after diagnosis. In normal infants, serum activity of hexosaminidase increases with increasing gestational and postnatal ages. However, infants with NEC had relatively lower serum hexosaminidase activity than these control infants of similar gestational and postnatal ages. Necrotizing enterocolitis is not associated with increased serum activity of hexosaminidase.

Piroxicam and 5'-hydroxypiroxicam kinetics following multiple dose administration of piroxicam

Piroxicam (20 mg once daily) was administered orally to six healthy young volunteers for 15 days. Trough steady-state levels of piroxicam and 5'-hydroxypiroxicam were 5.5 and 1.2 micrograms/ml, respectively. Piroxicam's plasma half-life (54.9 h) was significantly shorter than that of 5'-hydroxypiroxicam (70.5 h). Percent unbound piroxicam and 5'-hydroxypiroxicam in plasma at steady-state averaged 1.10 and 8.07 respectively. An average of 25.2% of the dose was recovered in urine as 5'-hydroxypiroxicam; approximately two-thirds (17.2%) in the form of the glucuronide conjugate. Average steady-state plasma levels (Css) of piroxicam (7.0 micrograms/ml) were significantly higher than predicted from a previously reported single dose study (5.3 micrograms/ml).

Developmental features of the neonatal brain: MR imaging. Part I. Gray-white matter differentiation and myelination

To establish the normal appearance of the neonatal brain, 51 neonates, 29-42 weeks postconception, underwent magnetic resonance (MR) imaging with a 0.6-T magnet in a prospective study. T1-weighted images were used to devise stages for the appearance of gray-white matter differentiation and extent of myelination. The results show that from 29 to 42 weeks postconception, changes in gray-white matter differentiation and myelination follow the stages in an orderly and predictable fashion. Changes in white matter intensity appear related to progressive decrease in brain water content. Myelination progresses cephalad from the brain stem at 29 weeks to reach the centrum semiovale by 42 weeks. Delayed myelination, defined as the absence of myelin in the corona radiata by 37 weeks, was seen in nine infants with complicated perinatal courses. Awareness of these developmental features should help to minimize misinterpretation of normal changes in the neonatal brain and lead to earlier detection of pathologic conditions, both with MR imaging and computed tomography.

Developmental features of the neonatal brain: MR imaging. Part II. Ventricular size and extracerebral space

Magnetic resonance (MR) imaging with a 0.6-T magnet was performed on 51 neonates, aged 29-42 weeks postconception. In 45 neonates, the ventricular/brain ratio (V/B) at the level of the frontal horns and midbody of the lateral ventricles ranged from 0.26 to 0.34. In six other infants a V/B of 0.36 or greater was associated with either cerebral atrophy or obstructive hydrocephalus. The width of the extracerebral space measured along specified points varied little in the neonatal period and ranged from 0 to 4 mm in 48 infants. Extracerebral space widths of 5-6 mm were seen in three other infants with severe asphyxia. Prominence of the subarachnoid space overlying the posterior parietal lobes is normal in neonates and should not be confused with cerebral atrophy. The authors conclude that V/B ratios of 0.26-0.34 and extracerebral space widths of 0-4 mm represent the normal range, and that neonates whose measurements exceed these values should be followed up.

Attitudes toward breastfeeding

To understand why some lower socioeconomic status mothers delivering at a state university hospital breastfeed, while others do not, 26 attitude items were administered in a survey of 358 mothers. A factor analysis of these items yielded four interpretable factors: benefits to infant, social inconvenience, personal inconvenience, and physical inconvenience-medical benefits to child. These factors were significantly related to breastfeeding within each level of ethnicity and marital status. The results imply that emphasizing the benefits for the infant, and providing strategies for minimizing personal inconveniences, should promote breastfeeding in these populations.