Attosecond-pump attosecond-probe x-ray spectroscopy of liquid water

Attosecond-pump/attosecond-probe experiments have long been sought as the most straightforward method for observing electron dynamics in real time. Although there has been much success with overlapped near-infrared femtosecond and extreme ultraviolet attosecond pulses combined with theory, true attosecond-pump/attosecond-probe experiments have been limited. We used a synchronized attosecond x-ray pulse pair from an x-ray free-electron laser to study the electronic response to valence ionization in liquid water through all x-ray attosecond transient absorption spectroscopy (AX-ATAS). Our analysis showed that the AX-ATAS response is confined to the subfemtosecond timescale, eliminating any hydrogen atom motion and demonstrating experimentally that the 1b1 splitting in the x-ray emission spectrum is related to dynamics and is not evidence of two structural motifs in ambient liquid water.

Difference in general practice telehealth utilisation associated with birth country during COVID-19 from two Australian states

Objective

Telehealth has been an integral part of ensuring continued general practice access during the COVID-19 pandemic. Whether telehealth was similarly adopted across different ethnic, cultural, and linguistic groups in Australia is unknown. In this study, we assessed how telehealth utilisation differed by birth country.

Methods

In this retrospective observational study, electronic health record data from 799 general practices across Victoria and New South Wales, Australia between March 2020 to November 2021 were extracted (12,403,592 encounters from 1,307,192 patients). Multivariate generalised estimating equation models were used to assess the likelihood of a telehealth consultation (against face-to-face consultation) by birth country (relative to Australia or New Zealand born patients), education index, and native language (English versus others).

Results

Patients born in Southeastern Asia (aOR: 0.54; 95% CI: 0.52-0.55), Eastern Asia (aOR: 0.63; 95% CI: 0.60-0.66), and India (aOR: 0.64; 95% CI: 0.63-0.66) had a lower likelihood of having a telehealth consultation compared to those born in Australia or New Zealand. Northern America, British Isles, and most European countries did not present with a statistically significant difference. Additionally, higher education levels (aOR: 1.34; 95% CI: 1.26-1.42) was associated with an increase in the likelihood of a telehealth consultation, while being from a non-English-speaking country was associated with a reduced likelihood (aOR: 0.83; 95% CI: 0.81-0.84).

Conclusions

This study provides evidence showing differences in telehealth use associated with birth country. Strategies to ensure continued healthcare access for patients, whose native language is not English, such as providing interpreter services for telehealth consultations, would be beneficial.

Perspectives

Understanding cultural and linguistic differences may reduce health disparities in telehealth access in Australia and could present an opportunity to promote healthcare access in diverse communities.

PSIX-18 Effect of chicory silage and se-yeast on peripartum ewes: Immune status via complete blood cell count

Immune status is critical for peripartum animals. Immune cells are highly affected by the oxidative status and level of Se. The use of forages with high content of antioxidants in combination with Se-yeast can improve the immune status in peripartum ruminants. The objective of this study was to test the possibility of improving the immune system of peripartum ewes by feeding a combination of chicory silage and Se-yeast. Approximately one month prior to lambing, 36 pregnant Polypay sheep were moved into single pens and randomly assigned to one of four groups to be fed either grass or chicory silage and supplemented or not with 3.6 mg Se/day (DiaMune, Diamond V). Blood was collected throughout the study to assess the complete blood count (VetScan HM5). Secondary compounds in silages were analyzed via LC-MS/MS. Data were analyzed using GLIMMIX (SAS) with day, silage type, Se and their interactions as fixed effects and ewe as random effect with significance declared at P≤0.05. Compared to grass silage, among measured secondary compounds only resveratrol was larger in chicory vs. grass. Total white blood cell count was larger in animals fed grass vs. chicory silage. Silage type and Se-yeast supplementation had little effects on the other measured parameters. The average hemoglobin inside red blood cells was larger in animals fed grass vs. chicory silage. Only tendencies (P between 0.08 and 0.09) were observed for the effects of Se supplementation, including increased hematocrit and number of circulating monocytes but, the latter, only in grass-fed ewes, and decreased red blood cell volume. Platelet size distribution tended (P=0.08) to increase in grass-fed ewes supplemented with Se but the opposite was observed in ewes fed chicory silage. Together, these data indicate a minimum-to-no effect of the type of silage or Se supplementation on complete blood cell count on peripartum ewes.

62 Feeding Chicory-plantain Silage and Se-yeast to Lactating Ewes Subjected to Intramammary Infection: Effect on the Immune System

The objective was to test the effect on the immune status by feeding a combination of chicory-plantain and Se-yeast in lactating ewes subjected to intramammary infection (IMI) with 2×107CFU of Strep uberis in both glands. For the purpose we enrolled 28 Polypay lactating sheep from a prior study where they were randomly allocated to receive chicory (CS) or grass (GC) silage and either 3.6 mg of Se/day as Se-yeast (DiaMune, Diamond V) (Y) or isoenergetic-isonitrogenous alfalfa meal (C) for 2 months. For the present study, ewes were kept on the original dietary regiment except the CT group received a chicory-plantain silage(50% each). Blood was collected prior to and for 10 days after IMI for a complete blood count(VetScan HM5), leukocytes migration, and rectal temperature (RT). Data were analyzed using GLIMMIX (SAS)with time, silage type, and Se and their interactions as the fixed effects and ewe as random effect with significance declared at P ≤ 0.05. RT was lower in chicory vs. grass before IMI and Se limited the RT increase after IMI. Total WBC levels tended (P = 0.06) to increase in animals fed with Se after IMI, which was driven by a larger number of lymphocytes. Hematocrit, red blood cells, and hemoglobin were strongly decreased by IMI. The mean cell volume was overall larger in ewes fed with chicory-plantain silage while mean cell hemoglobin was larger in animal fed with grass silage. The platelet distribution width was affected by silage*Se interaction due to a positive effect by Se in grass-fed but negative in chicory-plantain-fed ewes. Migration of neutrophils was larger in animals fed with chicory-plantain before IMI but similar between groups after IMI. Overall, these findings indicate that Se supplementation can increase lymphocytes with no effect on neutrophils while activity of neutrophils is positively affected by feeding chicory-plantain silage.

Anticorrelated Contributions to Pre-edge Features of Aluminate Near-Edge X-ray Absorption Spectroscopy in Concentrated Electrolytes

Ion pairing within complex solutions and electrolytes is a difficult phenomenon to measure and investigate, yet it has significant impact upon macroscopic processes, such as crystal formation. Traditional methods of detecting and characterizing ion pairing are sensitive to contact ion pairs, may require minimum concentrations that limit applicability, and can have difficulty in characterizing solutions with many components. Because of its element specificity and sensitivity to local environment, X-ray absorption near edge structure (XANES) is a promising tool for investigating ion pairing in complex solutions. In concentrated sodium aluminate solutions, a shift in the pre-edge shoulder correlated to sodium concentration is observed, and the physical origins of that shift are investigated using energy specific time-dependent density functional theory of subensembles obtained from ab initio molecular dynamics. Two transitions are found to contribute to the pre-edge feature, yet they are anticorrelated with respect to the sodium···aluminate distance. Unexpectedly, this causes Al XANES to be an effective probe for longer-range ion interactions than the traditional counterparts of NMR or vibrational spectroscopies. Given the nature of the transitions involved, this observation may be extended to other systems where ion-ion interactions dominate; however, a complete understanding of the contributing transitions is necessary for accurate analysis of XANES pre-edge features in concentrated electrolytes.

A queueing system with non-recurrent input and batch servicing

We consider a queueing system in which arrivals occur at times , and after every kth arrival a servicing of k arrivals is begun. We assume that the number of servers is infinite. Initially, at t0= 0, the system is empty and the arrival process {tn} is about to start. The batch service times are independently and identically distributed with distribution function No assumption is made about the process {tn}.

Queues with moving average service times

A model for the service time structure in the single server queue is given embodying correlations between contiguous and near-contiguous service times. A number of results are derived in the case of Poisson arrivals both for equilibrium and the transient state. In particular, Kendall's (equilibrium) result P (a departure leaves the queue empty) = 1 — (mean service time)/(mean inter-arrival time) is found still to hold good. The effect of the correlation on the mean and variance of the equilibrium queue length distribution is examined in a simple case.

Comparison of conventional testing to polymerase chain reaction in detection of Trichomonas vaginalis in indigenous women living in remote areas

There are high rates of Trichomonas vaginalis in remote areas of Central Australia. Conventional tests for T. vaginalis have low sensitivity in this setting. Aims of the study were to estimate the prevalence of T. vaginalis, to assess the presence of clinical signs and symptoms, to compare a T. vaginalis polymerase chain reaction (PCR) test with conventional methods of diagnosis, and to compare the PCR from different samples, including self-collected swabs (SCS). Of 205 women recruited, the prevalence of T. vaginalis was 24%. The prevalence of T. vaginalis was higher in women under 25 years (33%), compared with those who were 25–34 years (26%) and those over 35 years (15%, P < 0.05). The sensitivity of T. vaginalis PCR detection from SCS (94%) was not statistically different from a practitioner-collected HVS (96%), but was superior to urine PCR (74%) and conventional methods. After multivariate analysis, those women with high pH were almost three times more likely to be positive for T. vaginalis (odds ratio = 2.71 with 95% confidence interval 1.06–6.93, P = 0.037). Superior assays such as PCR should be a diagnostic option to adequately screen and treat women with T. vaginalis, in order to reduce complications, including the increased risk of HIV transmission.

Osteosarcoma of the talus misdiagnosed as ankle arthritis: a case report

We present a 65-year-old man with osteosarcoma of the talus that was misdiagnosed as osteoarthritis. The patient eventually underwent below-knee amputation and adjuvant chemotherapy.

Redox cycling of Fe(II) and Fe(III) in magnetite by Fe-metabolizing bacteria

Microorganisms are a primary control on the redox-induced cycling of iron in the environment. Despite the ability of bacteria to grow using both Fe(II) and Fe(III) bound in solid-phase iron minerals, it is currently unknown whether changing environmental conditions enable the sharing of electrons in mixed-valent iron oxides between bacteria with different metabolisms. We show through magnetic and spectroscopic measurements that the phototrophic Fe(II)-oxidizing bacterium Rhodopseudomonas palustris TIE-1 oxidizes magnetite (Fe3O4) nanoparticles using light energy. This process is reversible in co-cultures by the anaerobic Fe(III)-reducing bacterium Geobacter sulfurreducens. These results demonstrate that Fe ions bound in the highly crystalline mineral magnetite are bioavailable as electron sinks and electron sources under varying environmental conditions, effectively rendering magnetite a naturally occurring battery.

Reporting Observational Studies of the Use of Information Technology in the Clinical Consultation

To develop a classification system to improve the reporting of observational studies of the use of information technology (IT) in clinical consultations.

Literature review, workshops, and development of a position statement. We grouped the important aspects for consistent reporting into a “faceted classification”; the components relevant to a particular study to be used independently.

The eightfacetsof ourclassification are: (1) Theoretical and methodological approach: e.g. dramaturgical, cognitive; (2) Data collection: Type and method of observation; (3) Room layout and environment: How this affects interaction between clinician, patient and computer. (4) Initiation and Interaction: Who starts the consultation, and how the participants interact; (5) Information and knowledge utilisation: What sources of information or decision support are used or provided; (6) Timing and type of consultation variables: Standard descriptors that can be used to allow comparison of duration and description of continuous activities (e.g. speech, eye contact) and episodic ones, such as prescribing; (7) Post-consultation impact measures: Satisfaction surveys and health economic assessment based on the perceived quality of the clinician-patient interaction; and (8) Data capture, storage, and export formats: How to archive and curate data to facilitate further analysis.

Adoption of this classification should make it easier to interpret research findings and facilitate the synthesis of evidence across studies. Those engaged in IT-consultation research shouldconsider adopting this reporting guide.

Reporting observational studies of the use of information technology in the clinical consultation. A position statement from the IMIA Primary Health Care Informatics Working Group (IMIA PCI WG)

OBJECTIVES

To develop a classification system to improve the reporting of observational studies of the use of information technology (IT) in clinical consultations.

METHODS

Literature review, workshops, and development of a position statement. We grouped the important aspects for consistent reporting into a "faceted classification"; the components relevant to a particular study to be used independently.

RESULTS

The eight facets of our classification are: (1) Theoretical and methodological approach: e.g. dramaturgical, cognitive; (2) DATA COLLECTION: Type and method of observation; (3) Room layout and environment: How this affects interaction between clinician, patient and computer. (4) Initiation and Interaction: Who starts the consultation, and how the participants interact; (5) Information and knowledge utilisation: What sources of information or decision support are used or provided; (6) Timing and type of consultation variables: Standard descriptors that can be used to allow comparison of duration and description of continuous activities (e.g. speech, eye contact) and episodic ones, such as prescribing; (7) Post-consultation impact measures: Satisfaction surveys and health economic assessment based on the perceived quality of the clinician-patient interaction; and (8) Data capture, storage, and export formats: How to archive and curate data to facilitate further analysis.

CONCLUSIONS

Adoption of this classification should make it easier to interpret research findings and facilitate the synthesis of evidence across studies. Those engaged in IT-consultation research shouldconsider adopting this reporting guide.

Munchausen's syndrome by Google

A case is discussed of the use of medical images from the internet to support claims of injury. There were several inconsistencies in both history and examination even prior to the presentation of the specimen radiograph from the internet. Clinicians are advised to be vigilant, to question histories that do not match with examination findings, to ensure that all radiographs are adequately labelled with patient-specific information and to look for radiographic inconsistencies such as the presence or absence of accessory ossicles.

The misuse of 'no significant difference' in British orthopaedic literature

INTRODUCTION

Many studies published in medical journals do not consider the statistical power required to detect a meaningful difference between study groups. As a result, these studies are often underpowered: the sample size may not be large enough to pick up a statistically significant difference (or other effect of interest) of a given size between the study groups. Therefore, the conclusion that there is no statistically significant difference between groups cannot be made unless a study has been shown to have sufficient power. The aim of this study was to establish the prevalence of negative studies with inadequate statistical power in British journals to which orthopaedic surgeons regularly submit.

MATERIALS AND METHODS

We assessed all papers in the last consecutive six issues prior to the start of the study (April 2005) in The Journal of Bone and Joint Surgery (British), Injury, and Annals of the Royal College of Surgeons of England. We sought published evidence that a power analysis had been performed in association with the main hypothesis of the paper.

RESULTS

There were a total of 170 papers in which a statistical comparison of two or more groups was undertaken. Of these 170 papers, 49 (28.8%) stated as their primary conclusion that there was no statistically significant difference between the groups studied. Of these 49 papers, only 3 (6.1%) had performed a power analysis demonstrating adequate sample size.

CONCLUSIONS

These results demonstrate that the majority of negative studies in the British orthopaedic literature that we have looked at have not performed the statistical analysis necessary to reach their stated conclusions. In order to remedy this, we recommend that the journals sampled include the following guidance in their instructions to authors: the statement 'no statistically significant difference was found between study groups' should be accompanied by the results of a power analysis.

Quantification of t-tubule area and protein distribution in rat cardiac ventricular myocytes

The transverse (t-) tubules of cardiac ventricular myocytes are invaginations of the surface membrane that form a complex network within the cell. Many of the key proteins involved in excitation-contraction coupling appear to be located predominantly at the t-tubule membrane. Despite their importance, the fraction of cell membrane within the t-tubules remains unclear: measurement of cell capacitance following detubulation suggests approximately 32%, whereas optical measurements suggest up to approximately 65%. We have, therefore, investigated the factors that may account for this discrepancy. Calculation of the combinations of t-tubule radius, length and density that produce t-tubular membrane fractions of 32% or 56% suggest that the true fraction is at the upper end of this range. Assessment of detubulation using confocal and electron microscopy suggests that incomplete detubulation can account for some, but not all of the difference. High cholesterol, and a consequent decrease in specific capacitance, in the t-tubule membrane, may also cause the t-tubule fraction calculated from the loss of capacitance following detubulation to be underestimated. Correcting for both of these factors results in an estimate that is still lower than that obtained from optical measurements suggesting either that optical methods overestimate the fraction of membrane in the t-tubules, or that other, unknown, factors, reduce the apparent fraction obtained by detubulation. A biophysically realistic computer model of a rat ventricular myocyte, incorporating a t-tubule network, is used to assess the effect of the altered estimates of t-tubular membrane fraction on the calculated distribution of ion flux pathways.

Coagulase-negative staphylococci in very-low-birth-weight infants: inability of genetic markers to distinguish invasive strains from blood culture contaminants

Selected coagulase-negative staphylococci from the blood of very-low-birth-weight infants in the Neonatal Intensive Care Unit at the Royal Women's Hospital, Melbourne, collected over a 5-year period were examined. Isolates were classified as invasive or contaminants, speciated, typed by pulsed-field gel electrophoresis, and examined for biofilm genes (icaA, icaC, and icaD), adhesion genes (atlE, fbe), and the number of copies of IS256. Of the 24 isolates studied, there were 13 contaminants and 11 invasive isolates. The collection included 15 Staphylococcus epidermidis, eight Staphylococcus capitis, and one each of Staphylococcus warneri and Staphylococcus haemolyticus. Two small clusters of S. epidermidis that belonged to the same molecular type were identified. All S. capitis isolates belonged to the same molecular type or subtype, suggesting that a particular clone was circulating in the unit. There was no significant difference in the species found, the presence of icaA, icaC, icaD, atlE, or fbe, or the number of copies of IS256 between invasive isolates and contaminants. A series of nasal isolates from nonhospitalized adults differed from hospital isolates in the absence of IS256 and the low prevalence of icaC. There was no evidence of IS256-mediated insertion into ica genes as a mechanism of phase variation. These findings suggest that contaminants and invasive isolates derived from the same pool of hospital strains capable of causing sepsis in compromised hosts and that other mechanisms of phase variation exist, apart from IS256 insertion into ica genes.

Screening for intestinal parasites in recently arrived children from East Africa

BACKGROUND

Intestinal parasitic carriage is common in East African populations with a wide spectrum of clinical severity. There are scant data on the rates of carriage in East African immigrants to Australia. This study describes the prevalence of and risk factors for intestinal parasite carriage among children recently arrived from East African countries.

METHODS

Children aged 0-17 years, who attended an outpatient clinic, were born in East Africa and had immigrated since 1998 were eligible to participate. A single preserved stool specimen was collected for faecal microscopy, and blood tests were conducted for Strongyloides and Schistosoma serology, full blood examination and serum ferritin.

RESULTS

One hundred and thirty-five children (median age 8.1 years, range 1.0-17.5) participated, of whom 133 (99%) provided a stool specimen. Parasites were detected in 50% of samples, and 18% of children carried a possibly pathogenic species. No child was symptomatic at diagnosis. Positive or equivocal serology occurred in 11% of children for Strongyloides and 2% for Schistosoma. Anaemia and iron deficiency were detected in 16% of all children. Those carrying an intestinal parasite were older (mean age 9.8 vs 7.4 years, P= 0.002) and less likely to be anaemic (odds ratio 0.37, 95% confidence interval 0.14-0.96) than those who were not carriers.

CONCLUSIONS

Carriage of intestinal parasites is common among children from East Africa. Those carrying pathogenic organisms require treatment and follow up to ensure eradication. The results of this survey support the need for routine assessment of newly arrived immigrants from East Africa for intestinal parasites, anaemia and iron deficiency.

Australian doctors and their postgraduate qualifications

BACKGROUND

A key activity for doctors is lifelong learning. This may be as part of professional development, vocational registration, formal postgraduate study, e.g. university diplomas and degrees, or vocational training which leads to fellowship of a professional college. However, there are significant barriers of time and cost that prevent many doctors from participating in lifelong learning.

METHOD

We examined the range of basic and postgraduate qualifications held by a representative sample of 1198 doctors provided by the HIC of Australian doctors.

DISCUSSION

Significant numbers of general practitioners practise without a formal postgraduate qualification in general practice, unlike our specialist colleagues. However, postgraduate studies are undertaken in a variety of other formats and qualifications.

Anticoagulant therapy. Will computer use improve outcomes?

BACKGROUND

Anticoagulant therapy has been steadily increasing in clinical practice. With its narrow therapeutic range for efficacy and adverse events, this trend can lead to greater morbidity and mortality, making it an increasingly significant clinical, economic, medicolegal and public health issue.

OBJECTIVE

To examine issues and challenges arising from the increasing use of anticoagulants in general practice.

DISCUSSION

Adherence and regular monitoring by an effective multidisciplinary health care team is critical to optimise anticoagulant therapy. Clinicians, carers and patients need good information, training and support. Adherence to anticoagulation therapy is influenced by clinician interest, skills and involvement in shared decision making and risk counselling. Computerised decision support, based on relevant and comprehensive guidelines for anticoagulant therapy, can improve the way patients and clinicians manage anticoagulant therapy.

Pregnant women's perceptions of abuse

OBJECTIVE

To determine whether pregnant women's perceptions of abuse severity and danger, and their ability to control the abuse, are significantly correlated with the acts of abuse they experience, and to find out whether relationships exist among women's appraisals of abuse severity, danger, and their perceived ability to stop the abuse.

DESIGN

A correlational design was used to compare the abusive acts experienced by the women and their perceptions of that abuse.

SETTING

Nine prenatal clinics in urban areas of the northeastern United States.

PARTICIPANTS

Sixty-one ethnically diverse, pregnant abused women were interviewed.

MAIN OUTCOME MEASURE

Pearson's product-moment correlations were used to examine relationships between abusive experiences and women's perceptions of abuse.

RESULTS

Women's perceptions of abuse severity were modestly correlated with threatened (r = .25) and actual violence (r = .36). Perceptions of abuse severity and danger were correlated (r = .41).

CONCLUSIONS

Women's beliefs about abuse severity, danger, and their ability to control abuse cannot be fully comprehended by exploring the discrete acts they experience. Further research is needed to identify additional factors that influence those beliefs.

Mechanics of an educational exchange

Rural general practitioners occasionally exchange practices internationally. The process of exchanging is a complicated one, which involves multiple bureaucarcies. Exchanging is not for the anxious or impatient. We exchanged with a family physician in Canada and had to arrange registration, provider numbers and immigration for our Canadian colleague, as well as for ourselves in Canada. In addition, there are many personal details (cars, house, etc.) that must also be sorted out.

8-methyl-pyridoxatin: A novel N-hydroxy pyridone from fungus OS-F61800 that induces erythropoietin in human cells

In the course of screening for small-molecule modulators of erythropoietin gene expression, a novel N-hydroxy pyridone was isolated from a culture of OS-F61800. Its structure was elucidated by extensive 1H and 13C NMR spectroscopic and chemical studies. This compound induced erythropoietin gene expression fivefold at a concentration of 0.3 microM, which is about threefold greater potency than our previously identified erythropoietin inducers.

Epolones: novel sesquiterpene-tropolones from fungus OS-F69284 that induce erythropoietin in human cells

In the course of our screening for small molecule modulators of erythropoietin gene expression, two novel sesquiterpene tropolones and pycnidone were isolated from a culture of OS-F69284 (ATCC 74390). Their structures were elucidated by extensive 1H and 13C NMR spectroscopic studies and chemical reactions. These compounds induced erythropoietin gene expression 5-fold at a concentration of 1-1.6 microM.

Cell wall active antifungal compounds produced by the marine fungus hypoxylon oceanicum LL-15G256. I. Taxonomy and fermentation

The cell wall targeted antifungal activity of Hypoxylon oceanicum LL-15G256 extracts resulted from the production of novel lipodepsipeptides and previously reported macrocyclic polylactones. In an optimized medium, titers of the lipodepsipeptide and the polylactones reached approximately 200-400 mg/liter and 25-50 mg/liter, respectively. The optimum fermentation temperature for production of 15G256 gamma was 28 degrees C. Seawater appeared to have an inhibitory effect on metabolite accumulation at lower fermentation temperatures.

Isolation and characterization of the fungal metabolite 3-O-methylviridicatin as an inhibitor of tumour necrosis factor alpha-induced human immunodeficiency virus replication

The cytokine tumour necrosis factor alpha (TNF-alpha) has been shown to play a role in human immunodeficiency virus (HIV) replication by activating transcription of the provirus in both T cells and macrophages. Therefore, agents that block TNF-alpha-induced HIV expression could have therapeutic value in the treatment of AIDS. We have sought to identify antiviral agents that block TNF-alpha induction of HIV LTR-directed transcription, using a cell-based, virus-free assay system in automated high-throughput screening. HeLa cells were transfected with an HIV LTR-luciferase reporter plasmid and a stable line was isolated in which TNF-alpha increased luciferase production by two- to threefold. This cell line was used to screen approximately 15,000 fungal extracts. An inhibitory activity specific for TNF-alpha-induced HIV LTR transcription was observed in culture OS-F67406. The active component was isolated and identified as a known metabolite, 3-O-methylviridicatin, by NMR and mass spectrometry. No biological activity has been associated with this compound previously. This compound blocks TNF-alpha activation of the HIV LTR in the HeLa-based system, with an IC50 of 5 microM, and inhibited virus production in the OM-10.1 cell line, a model of chronic infection responsive to induction by TNF-alpha, with an IC50 of 2.5 microM.

Destruxin-A4 chlorohydrin, a novel destruxin from fungus OS-F68576: isolation, structure determination, and biological activity as an inducer of erythropoietin

In the course of screening for small-molecule modulators of erythropoietin gene expression, five destruxins were isolated from the fungal culture of OS-F68576. The structures were elucidated by extensive 1H and 13C NMR spectroscopy and by hydrolytic modification. One compound (destruxin-A4 chlorohydrin, 1) is a novel destruxin. All these compounds induced erythropoietin gene expression 5-fold at concentration of 0.2-2 microM.

Effects of diethylamine/nitric oxide on blood perfusion and oxygenation in the R3230Ac mammary carcinoma

The effects of intravenous diethylamine/nitric oxide (DEA/NO), a short-acting nitric oxide (NO) donor, on systemic haemodynamics, muscle and tumour blood flow (MBF and TBF) and tumour oxygenation were examined in rats bearing subcutaneous R3230Ac carcinoma in the leg. The effects of DEA/NO on the diameters of tumour-feeding and normal arterioles were evaluated in window chambers with and without implanted tumours. DEA/NO reduced mean arterial pressure (MAP) when given at doses > or = 100 nmol kg(-1), with maximal suppression at 0.5-1 min followed by return to baseline within 20 min. DEA/NO did not affect MBF except at the highest doses (500 and 1000 nmol kg(-1)). In contrast, DEA/NO reduced TBF and constricted tumour arterioles at doses > or = 100 nmol kg(-1). Tumour arteriolar vasomotion occurred in more than half the animals during hypotension and with a significantly higher frequency than in normal granulating tissue at a dose of 500 nmol kg(-1). Normal arterioles rapidly and significantly vasodilated for about 3 min and then returned to baseline. The reductions in TBF and MAP were accompanied by synchronous reduction in tumour pO2. Our findings suggest that DEA/NO decreases TBF in two ways. In the window chamber model, vascular steal occurs as normal arterioles adjacent to tumour dilate more than tumour arterioles during the initial period of hypotension. In leg tumours, the predominant mechanism is attributable to reduced perfusion pressure induced by lowered MAP, which decreases flow to the tumour, probably because of relatively higher flow resistance. The vasoconstriction and vasomotion in tumour arterioles during DEA/NO-induced hypotension may reflect differences in regulatory metabolism of NO between neoplastic and normal arterioles. Thus, intravenous injection of a short-acting NO donor, DEA/NO, decreases MAP and heart rate, leading to subsequent decreases in tumour blood flow and oxygenation.

Clonal diversity of Streptococcus mitis biovar 1 isolates from the oral cavity of human neonates

The clonal diversity of 101 isolates of the pioneer bacterium Streptococcus mitis biovar 1 obtained from the oral cavities of 40 human neonates 1 to 3 days, 2 weeks, and 1 month postpartum was examined by using rRNA gene restriction patterns. There was a high degree of genetic diversity, with the 101 isolates comprising 93 unique PvuII ribotypes. There were eight identical pairs of ribotype patterns, and seven of the eight pairs were obtained from individual neonates. Only one identical pair comprised isolates obtained from different neonates. In all but two cases, isolates with matching ribotypes were obtained at one visit. Two pairs of isolates with matching ribotype patterns were obtained from neonates on successive visits. The ribotype patterns of the isolates were examined by cluster analysis. The isolates forming each cluster were very similar, yet each cluster was well separated from its neighbors. When several isolates were obtained from individual neonates at a particular visit, in some instances they were contained in a single cluster, whereas in other cases each isolate was contained in a separate cluster. Isolates obtained from individual neonates on successive visits tended to be contained in different clusters. This high degree of diversity, which has been observed in other mucosal commensal bacteria, may serve as a mechanism for avoiding immune elimination of these bacteria.

Continuing medical education in marital and family therapy: a survey of South Australian psychiatrists

OBJECTIVE

South Australian psychiatrists were surveyed to determine their impressions of the usefulness of marital and family therapy (MFT) in the management of serious psychiatric conditions and to ascertain their previous experience with Continuing Medical Education (CME) about family therapy. It was expected that psychiatrists' preferences regarding CME would be related to their clinical experience of the usefulness of MFT.

METHOD

One hundred and twenty psychiatrists returned a questionnaire about their training, clinical and research interests, with ratings of the usefulness of MFT and CME preferences. This represented 65% of those eligible for the CME programme.

RESULTS

Thirteen percent of the respondents found MFT to be extremely useful and a further 47% found it moderately useful in their current practice. There was evidence of a possible training effect: respondents who had previous CME rated MFT as more useful, especially for mood disorders. Furthermore, the treatment of mood disorders seemed to have a particular relevance in family psychiatry, making a statistically unique contribution to ratings of MFT usefulness in the respondents' total practice. Sixty-nine percent of the respondents requested further CME in family therapy. This represented 45% of all South Australian psychiatrists. Respondents who rated MFT as more useful in practice were significantly more likely to be interested in CME.

CONCLUSIONS

There seems to be sufficient interest and clinical experience among psychiatrists for MFT to be included in CME courses. It is recommended that further training focus on major mental disorders, especially mood disorders and schizophrenia.

Adolescent suicide, depression and family dysfunction

This study investigated associations between adolescents' perceptions of their family dynamics (McMaster Family Assessment Device, FAD) and depression, suicide thoughts and attempts. High school students (mean age 15.2 years) completed self-report questionnaires including the Beck Depression Inventory (BDI), the FAD, questions about suicidal thoughts, plans and attempts, deliberate self harm, and selected life experiences. Univariate analysis showed that family dysfunction measured on the FAD is associated with thinking and planning suicide, deliberate self harm, suicide attempts, as well as severe depression (BDI > or = 22). Despite this, stepwise regression indicated that family dysfunction influences suicide behaviors indirectly through other variables such as depression. The FAD is recommended as a useful addition to questionnaires seeking to identify vulnerability to both depression and adolescent attempted suicide in early detection studies.

Identification of pioneer viridans streptococci in the oral cavity of human neonates

Three hundred and sixty-seven strains of pioneer streptococci isolated from the mouths of 40 healthy, full-term infants during the first month of life were examined by two taxonomic schemes that incorporated biochemical and physiological characteristics, IgA1 protease production and glycosidase activities. Streptococcus mitis biovar 1 and S. oralis comprised 55.0% of the pioneer streptococci isolated from neonates. S. salivarius constituted 25.3% of the isolates, while S. anginosus, S. mitis biovar 2, S. sanguis and S. gordonii accounted collectively for 11.4%. Difficulties in identifying streptococci were encountered and 8.4% of the 367 isolates could not be assigned to a recognised species.

RN to BS in Nursing: Historical Review Leads to Articulation Agreement

Historically, registered nurses who have graduated from associate degree or diploma programs and who wish to obtain a baccalaureate degree in nursing have been required to pass challenge examinations to obtain credit for their previous nursing knowledge. A review of this university's policy regarding challenge examinations convinced faculty to establish a transition course and to actively pursue articulation agreements with local community colleges. Through these agreements, RN students would be granted 29 credits and bypass the junior year. This article is written to encourage others to review their policies to facilitate educational mobility for the RN/BS student.