A comparison of dermal toxicity models; assessing suitability for safe(r)-by-design decision-making and for screening nanomaterial hazards

The objective of Safe-by-Design (SbD) is to support the development of safer products and production processes, and enable safe use throughout a materials' life cycle; an intervention at an early stage of innovation can greatly benefit industry by reducing costs associated with the development of products later found to elicit harmful effects. Early hazard screening can support this process, and is needed for all of the expected nanomaterial exposure routes, including inhalation, ingestion and dermal. In this study, we compare in vitro and ex vivo cell models that represent dermal exposures (including HaCaT cells, primary keratinocytes, and reconstructed human epidermis (RhE)), and when possible consider these in the context of regulatory accepted OECD TG for in vitro dermal irritation. Various benchmark nanomaterials were used to assess markers of cell stress in each cell model. In addition, we evaluated different dosing strategies that have been used when applying the OECD TG for dermal irritation in assessment of nanomaterials, and how inconsistencies in the approach used can have considerable impact of the conclusions made. Although we could not demonstrate alignment of all models used, there was an indication that the simpler in vitro cell model aligned more closely with RhE tissue than ex vivo primary keratinocytes, supporting the use of HaCaT cells for screening of dermal toxicity of nanomaterials and in early-stage SbD decision-making.

Pre-validation of a reporter gene assay for oxidative stress for the rapid screening of nanobiomaterials

Engineered nanomaterials have been found to induce oxidative stress. Cellular oxidative stress, in turn, can result in the induction of antioxidant and detoxification enzymes which are controlled by the nuclear erythroid 2-related factor 2 (NRF2) transcription factor. Here, we present the results of a pre-validation study which was conducted within the frame of BIORIMA (“biomaterial risk management”) an EU-funded research and innovation project. For this we used an NRF2 specific chemically activated luciferase expression reporter gene assay derived from the human U2OS osteosarcoma cell line to screen for the induction of the NRF2 mediated gene expression following exposure to biomedically relevant nanobiomaterials. Specifically, we investigated Fe₃O₄-PEG-PLGA nanomaterials while Ag and TiO₂ “benchmark” nanomaterials from the Joint Research Center were used as reference materials. The viability of the cells was determined by using the Alamar blue assay. We performed an interlaboratory study involving seven different laboratories to assess the applicability of the NRF2 reporter gene assay for the screening of nanobiomaterials. The latter work was preceded by online tutorials to ensure that the procedures were harmonized across the different participating laboratories. Fe₃O₄-PEG-PLGA nanomaterials were found to induce very limited NRF2 mediated gene expression, whereas exposure to Ag nanomaterials induced NRF2 mediated gene expression. TiO₂ nanomaterials did not induce NRF2 mediated gene expression. The variability in the results obtained by the participating laboratories was small with mean intra-laboratory standard deviation of 0.16 and mean inter laboratory standard deviation of 0.28 across all NRF2 reporter gene assay results. We conclude that the NRF2 reporter gene assay is a suitable assay for the screening of nanobiomaterial-induced oxidative stress responses.

Changes of physico-chemical properties of nano-biomaterials by digestion fluids affect the physiological properties of epithelial intestinal cells and barrier models

Background

The widespread use of nano-biomaterials (NBMs) has increased the chance of human exposure. Although ingestion is one of the major routes of exposure to NBMs, it is not thoroughly studied to date. NBMs are expected to be dramatically modified following the transit into the oral-gastric-intestinal (OGI) tract. How these transformations affect their interaction with intestinal cells is still poorly understood. NBMs of different chemical nature—lipid-surfactant nanoparticles (LSNPs), carbon nanoparticles (CNPs), surface modified Fe₃O₄ nanoparticles (FNPs) and hydroxyapatite nanoparticles (HNPs)—were treated in a simulated human digestive system (SHDS) and then characterised. The biological effects of SHDS-treated and untreated NBMs were evaluated on primary (HCoEpiC) and immortalised (Caco-2, HCT116) epithelial intestinal cells and on an intestinal barrier model.

Results

The application of the in vitro SDHS modified the biocompatibility of NBMs on gastrointestinal cells. The differences between SHDS-treated and untreated NBMs could be attributed to the irreversible modification of the NBMs in the SHDS. Aggregation was detected for all NBMs regardless of their chemical nature, while pH- or enzyme-mediated partial degradation was detected for hydroxyapatite or polymer-coated iron oxide nanoparticles and lipid nanoparticles, respectively. The formation of a bio-corona, which contains proteases, was also demonstrated on all the analysed NBMs. In viability assays, undifferentiated primary cells were more sensitive than immortalised cells to digested NBMs, but neither pristine nor treated NBMs affected the intestinal barrier viability and permeability. SHDS-treated NBMs up-regulated the tight junction genes (claudin 3 and 5, occludin, zonula occludens 1) in intestinal barrier, with different patterns between each NBM, and increase the expression of both pro- and anti-inflammatory cytokines (IL-1β, TNF-α, IL-22, IL-10). Notably, none of these NBMs showed any significant genotoxic effect.

Conclusions

Overall, the results add a piece of evidence on the importance of applying validated in vitro SHDS models for the assessment of NBM intestinal toxicity/biocompatibility. We propose the association of chemical and microscopic characterization, SHDS and in vitro tests on both immortalised and primary cells as a robust screening pipeline useful to monitor the changes in the physico-chemical properties of ingested NBMs and their effects on intestinal cells.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12989-022-00491-w.

Xeroderma Pigmentosum C (XPC) Mutations in Primary Fibroblasts Impair Base Excision Repair Pathway and Increase Oxidative DNA Damage

Xeroderma Pigmentosum C (XPC) is a multi-functional protein that is involved not only in the repair of bulky lesions, post-irradiation, via nucleotide excision repair (NER) per se but also in oxidative DNA damage mending. Since base excision repair (BER) is the primary regulator of oxidative DNA damage, we characterized, post-Ultraviolet B-rays (UVB)-irradiation, the detailed effect of three different XPC mutations in primary fibroblasts derived from XP-C patients on mRNA, protein expression and activity of different BER factors. We found that XP-C fibroblasts are characterized by downregulated expression of different BER factors including OGG1, MYH, APE1, LIG3, XRCC1, and Polβ. Such a downregulation was also observed at OGG1, MYH, and APE1 protein levels. This was accompanied with an increase in DNA oxidative lesions, as evidenced by 8-oxoguanine levels, immediately post-UVB-irradiation. Unlike in normal control cells, these oxidative lesions persisted over time in XP-C cells having lower excision repair capacities. Taken together, our results indicated that an impaired BER pathway in XP-C fibroblasts leads to longer persistence and delayed repair of oxidative DNA damage. This might explain the diverse clinical phenotypes in XP-C patients suffering from cancer in both photo-protected and photo-exposed areas. Therapeutic strategies based on reinforcement of BER pathway might therefore represent an innovative path for limiting the drawbacks of NER-based diseases, as in XP-C case.

Affordability in individuals' healthcare decision making: A concept analysis

This concept analysis aims to define affordability within the context of healthcare decision making. Affordability is a complex concept that influences an individual's healthcare decision making. In the year's post-Affordable Care Act, the United States has seen an increase in insured individuals, but also an increase in underinsured healthcare consumers. Evidence for the concept attributes was found by searching the Cumulative Index of Nursing and Allied Health Literature, EconLit, Family & Society Studies Worldwide, Humanities Full Text, and PsychINFO databases. Literature was synthesized using the Walker and Avant approach. A new definition was derived with four defining attributes, as well as antecedents and consequences. Three cases are forwarded: the model, borderline, and contrary. In healthcare decision making, affordability is a subjective measure that individuals use in determining the ability to engage in a healthcare service or a durable good transaction. Affordability varies based on circumstances. The context of healthcare decision making of individuals stands in contrast to the decision-making in health systems and to decisions unrelated to one's health. Affordability is a determinant of an individual's ability to engage in a transaction. As such, nurses and policymakers should attempt to understand affordability from the patient's perspective.

Biotransformation of Food-Grade and Nanometric TiO2 in the Oral-Gastro-Intestinal Tract: Driving Forces and Effect on the Toxicity toward Intestinal Epithelial Cells

Background: Oral exposure to titanium dioxide (TiO₂) is common since it is widely used in food and pharmaceutical products. Concern on the safety of this substance has been recently raised, due to the presence of an ultrafine fraction in food-grade TiO₂. Discrepancy exists among data reported in in vitro and in vivo studies on intestinal acute/chronic toxicity of TiO₂. This might be due to the different biological identity of TiO₂ in traditional in vitro test by respect in vivo conditions. Methods: One food-grade TiO₂ and two nanometric TiO₂ samples were treated with a simulated human digestive dystem (SHDS) in order to investigate the bio-transformation occurring to the particles once ingested in term of size distribution (Dynamic Light Scattering—DLS-, Flow Particle Imaging, Asymmetric Flow Field Flow Fractionation-AF4-) and surface modification (Electrophoretic Light Scattering—ELS-, Electron Paramagnetic Resonance Spectroscopy—EPR-). The effect of SHDS on the cyto-, genotoxicity and potential to induce oxidative stress towards human colorectal carcinoma HCT116 cells was also assessed. Results: Aggregation as a consequence of the high ionic strength of the gastric and intestinal simulated fluids was observed, together with the formation of a partially irreversible bio-corona containing phosphate ions and proteins. Such bio-corona led to a partial masking of the TiO₂ particles surface and reactivity. Pristine and treated TiO₂ nanoparticles showed comparable acute toxicity and genotoxicity toward HCT116 cells, whereas a small decrease of the induction of oxidative stress after treatment was observed. Conclusions: Overall the results underline the importance of SHDS as a tool to improve the predictive power of in vitro tests towards intestinal nanomaterial toxicity.

Impairment of Base Excision Repair in Dermal Fibroblasts Isolated From Nevoid Basal Cell Carcinoma Patients

The nevoid basal cell carcinoma syndrome (NBCCS), also called Gorlin syndrome is an autosomal dominant disorder whose incidence is estimated at about 1 per 55,600–256,000 individuals. It is characterized by several developmental abnormalities and an increased predisposition to the development of basal cell carcinomas (BCCs). Cutaneous fibroblasts from Gorlin patients have been shown to exhibit an increased sensitivity to ionizing radiations. Mutations in the tumor suppressor gene PTCH1, which is part of the Sonic Hedgehog (SHH) signaling pathway, are responsible for these clinical manifestations. As several genetic mutations in the DNA repair genes are responsible of photo or radiosensitivity and high predisposition to cancers, we hypothesized that these effects in Gorlin syndrome might be due to a defect in the DNA damage response (DDR) and/or the DNA repair capacities. Therefore, the objective of this work was to investigate the sensitivity of skin fibroblasts from NBCCS patients to different DNA damaging agents and to determine the ability of these agents to modulate the DNA repair capacities. Gorlin fibroblasts showed high radiosensitivity and also less resistance to oxidative stress-inducing agents when compared to control fibroblasts obtained from healthy individuals. Gorlin fibroblasts harboring PTCH1 mutations were more sensitive to the exposure to ionizing radiation and to UVA. However, no difference in cell viability was shown after exposure to UVB or bleomycin. As BER is responsible for the repair of oxidative DNA damage, we decided to assess the BER pathway efficacy in Gorlin fibroblasts. Interestingly, a concomitant decrease of both BER gene expression and BER protein activity was observed in Gorlin fibroblasts when compared to control. Our results suggest that low levels of DNA repair within Gorlin cells may lead to an accumulation of oxidative DNA damage that could participate and partly explain the radiosensitivity and the BCC-prone phenotype in Gorlin syndrome.

Gadolinium-Based Nanoparticles Can Overcome the Radioresistance of Head and Neck Squamous Cell Carcinoma Through the Induction of Autophagy

Radiation therapy is a mainstay in the therapeutic management of Head and Neck Squamous Cell Carcinoma (HNSCC). Despite significant progress in this field, radioresistance still accounts for most treatment failures. Gadolinium-based nanoparticles (GBNs) have shown great promises as radiosensitizers but the underlying sensitizing mechanism is still largely unknown with regards to the disparities obtained in in vitro studies. In this study, we show that a new formulation of GBNs, AGuIX^®, can radiosensitize HNSCC after cell uptake and further accumulation in lysosomes. Although radiation alone triggered late apoptosis and mitochondrial impairment, the pre-treatment with GBNs led to complex DNA damage and a specific increase of autophagic cell death. In addition, a significant radio-enhancement effect was obtained after the pre-conditioning of cells with a glutathione inhibitor before GBNs treatment and radiation exposure. Overall, our results provide additional information on the radio-enhancing properties of GBNs in the management of radioresistant HNSCC.

The effects of different bisphenol derivatives on oxidative stress, DNA damage and DNA repair in RWPE-1 cells: A comparative study

Bisphenol A (BPA) is a well-known endocrine disruptor and it is widely used mainly in the plastics industry. Due to recent reports on its possible impact on health (particularly on the male reproductive system), bisphenol F (BPF) and bisphenol S (BPS) are now being used as alternatives. In this study, RWPE-1 cells were used as a model to compare cytotoxicity, oxidative stress-causing potential and genotoxicity of these chemicals. In addition, the effects of the bisphenol derivatives were assessed on DNA repair proteins. RWPE-1 cells were incubated with BPA, BPF, and BPS at concentrations of 0-600 μM for 24 h. The inhibitory concentration 20 (IC₂₀ , concentration that causes 20% of cell viability loss) values for BPA, BPF, and BPS were 45, 65, and 108 μM, respectively. These results indicated that cytotoxicity potentials were ranked as BPA > BPF > BPS. We also found alterations in superoxide dismutase, glutathione peroxidase and glutathione reductase activities, and glutathione and total antioxidant capacity in all bisphenol-exposed groups. In the standard and modified Comet assay, BPS produced significantly higher levels of DNA damage vs the control. DNA repair proteins (OGG1, Ape-1, and MyH) involved in the base excision repair pathway, as well as p53 protein levels were down-regulated in all of the bisphenol-exposed groups. We found that the BPA alternatives were also cytotoxic and genotoxic, and changed the expressions of DNA repair enzymes. Therefore, further studies are needed to assess whether they can be used safely as alternatives to BPA or not.

Influence of the Core/Shell Structure of Indium Phosphide Based Quantum Dots on Their Photostability and Cytotoxicity

With the goal to improve their photostability, InP-based QDs are passivated with three types of inorganic shells, namely (i) a gradient ZnSe_xS_1−x shell, (ii) an additional ZnS shell on top of the gradient shell with two different thicknesses (core/shell/shell, CSS), (iii) an alumina coating on top of ZnS. All three systems have photoluminescence quantum yields (PLQY) > 50% and similar PL decay times (64–67 ns). To assess their photostability they are incorporated into a transparent poly (methyl methacrylate) (PMMA) matrix and exposed to continuous irradiation with simulated sunlight in a climate chamber. The alumina coated core/shell system exhibits the highest stability in terms of PLQY retention as well as the lowest shift of the PL maximum and lowest increase of the PL linewidth, followed by the CSS QDs and finally the gradient shell system. By means of XPS studies we identify the degradation of the ZnS outer layer and concomitant oxidation of the emissive InZnP core as the main origins of degradation in the gradient structure. These modifications do not occur in the case of the alumina-capped sample, which exhibits excellent chemical stability. The gradient shell and CSS systems could be transferred to the aqueous phase using surface ligand exchange with penicillamine. Cytotoxicity studies on human primary keratinocytes revealed that exposure for 24 h to 6.25–100 nM of QDs did not affect cell viability. However, a trend toward reduced cell proliferation is observed for higher concentrations of gradient shell and CSS QDs with a thin ZnS shell, while CSS QDs with a thicker ZnS shell do not exhibit any impact.

Long-term exposure of A549 cells to titanium dioxide nanoparticles induces DNA damage and sensitizes cells towards genotoxic agents

Titanium dioxide nanoparticles (TiO2-NPs) are one of the most produced NPs in the world. Their toxicity has been studied for a decade using acute exposure scenarios, i.e. high exposure concentrations and short exposure times. In the present study, we evaluated their genotoxic impact using long-term and low concentration exposure conditions. A549 alveolar epithelial cells were continuously exposed to 1-50 μg/mL TiO2-NPs, 86% anatase/14% rutile, 24 ± 6 nm average primary diameter, for up to two months. Their cytotoxicity, oxidative potential and intracellular accumulation were evaluated using MTT assay and reactive oxygen species measurement, transmission electron microscopy observation, micro-particle-induced X-ray emission and inductively-coupled plasma mass spectroscopy. Genotoxic impact was assessed using alkaline and Fpg-modified comet assay, immunostaining of 53BP1 foci and the cytokinesis-blocked micronucleus assay. Finally, we evaluated the impact of a subsequent exposure of these cells to the alkylating agent methyl methanesulfonate. We demonstrate that long-term exposure to TiO2-NPs does not affect cell viability but causes DNA damage, particularly oxidative damage to DNA and increased 53BP1 foci counts, correlated with increased intracellular accumulation of NPs. In addition, exposure over 2 months causes cellular responses suggestive of adaptation, characterized by decreased proliferation rate and stabilization of TiO2-NP intracellular accumulation, as well as sensitization to MMS. Taken together, these data underline the genotoxic impact and sensitization effect of long-term exposure of lung alveolar epithelial cells to low levels of TiO2-NPs.

In-cell click labelling of small molecules to determine subcellular localisation

Small molecule fluorometric boron dipyrromethene probes were developed to bind hepatitis C virus-encoded NS5A protein and aid subcellular distribution studies. These molecules did not co-locate with NS5A, therefore alternative 'silent' azide reporters were used to obtain a more relevant picture of their distribution. Following pre-incubation with replicon cells, click chemistry was used to append a fluorophore to the azide that confirmed the co-localisation of the small molecule with the NS5A protein, thus providing greater insight into the antiviral mode of action of this chemotype.

ELECTRONIC SUPPLEMENTARY MATERIAL

The online version of this article (doi:10.1007/s12154-010-0047-1) contains supplementary material, which is available to authorized users.

Sources of formaldehyde, other aldehydes and terpenes in a new manufactured house

Formaldehyde, less volatile aldehydes, and terpene hydrocarbons are generally the predominant air contaminants in new manufactured and site-built houses. This study was conducted to identify the major sources of these compounds in a typically constructed, new manufactured house and to evaluate several source reduction practices. Specimens of materials used within the house were collected. These were individually pre-conditioned for 19 +/- 4 days, and tested for emissions of formaldehyde and other target compounds using small-scale chambers. Several cabinetry materials, passage doors, and the plywood subfloor were the predominant sources of formaldehyde and other aldehydes. The plywood subfloor was the predominant terpene source. Whole-house emission rates for combined materials were predicted based on the emission factors and the corresponding material quantities. These predicted rates were compared with whole-house emission rates derived from measurements made at the house 3 months after its installation. For 10 of 14 target compounds including formaldehyde, the predicted and derived rates were within a factor of two. Four emission barriers applied to plywood were shown to reduce emission factors for formaldehyde, hexanal, and other aldehydes.

Volatile organic compound concentrations and emission rates in new manufactured and site-built houses

Concentrations of 54 volatile organic compounds (VOCs) and ventilation rates were measured in four new manufactured houses over 2-9.5 months following installation and in seven new site-built houses 1-2 months after completion. The houses were in four projects located in hot-humid and mixed-humid climates. They were finished and operational, but unoccupied. Ventilation rates ranged from 0.14-0.78 h-1. Several of the site-built houses had ventilation rates below the ASHRAE recommended value. In both manufactured and site-built houses, the predominant airborne compounds were alpha-pinene, formaldehyde, hexanal, and acetic acid. Formaldehyde concentrations were below or near 50 ppb with a geometric mean value for all houses of 40 ppb. Similarities in the types of VOCs and in VOC concentrations indicated that indoor air quality in the houses was impacted by the same or similar sources. Major identified sources included plywood flooring, latex paint and sheet vinyl flooring. One site-built house was operated at ventilation rates of 0.14 and 0.32 h-1. VOC emission rates calculated at the two conditions agreed within +/- 10% for the most volatile compounds. Generally, the ratios of emission rates at the low and high ventilation rates decreased with decreasing compound volatility. Changes in VOC emission rates in the manufactured houses over 2-9.5 months after installation varied by compound. Only several compounds showed a consistent decrease in emission rate over this period.

[Hepatic hamartoma in adults. Apropos of a case documented by MRI]

A mixed hamartoma of the liver in a 39 year old man is reported. Abdominal ultrasound revealed a 4 cm inhomogeneous echogenic mass with acoustic shadowing. MRI T1 weighted images showed a inhomogeneous low intensity mass with lower gadolinium enhancement than normal liver, a moderate low signal intensity on proton density weighted images, and heterogeneous isosignal intensity on T2 weighted images. Peripheric calcifications were found on pathologic examination.

Anatomical basis of a fascio-cutaneous pedicle flap based on the infero-lateral collateral artery of the leg

An anatomical study of 30 cases has been performed on the vascularisation of the distal third of the antero-lateral compartment of the leg, with particular reference to the relations of the infero-lateral collateral artery of the anterior tibial artery, the perforating branch of the peroneal artery, and the antero-lateral malleolar artery. A fascio-cutaneous pedicle flap based on the infero-lateral collateral artery is described noting that the superior, anterior, and posterior limits are similar to those of the lateral supramalleolar flap of Masquelet. The inferior limit of this new flap is 15 mm distal to the site of emergence of the perforating branch of the peroneal artery. The advantages of this flap are; a large surface area for cover, antegrade vascularisation, and no significant vascular sacrifice. The distal half of the calf can be covered both medially and posteriorly as well as the proximal half of the dorsum of the foot, the medial and lateral arch areas, the perimalleolar region, and the region behind the Achilles tendon. The flap requires the presence of the infero-lateral collateral artery of the tibialis anterior which can be confirmed either peroperatively or preoperatively by angiography.

[GUEPAR total trapeziometacarpal prosthesis in the treatment of arthritis of the thumb. 36 case reports]

The authors review a series of 36 total GUEPAR trapezometacarpal arthroplasties, performed between 1981 and 1990 in 32 patients, with a Dell stage III or IV carpometacarpal arthritis of the thumb (primary arthritis = 34 cases; secondary arthritis: 2 cases, 1 case of chondrocalcinosis, 1 case of osteochondromatosis). Scaphotrapezial arthritis present in 7 cases is not a contraindication to total arthroplasty. The mean follow-up period was 3 and a half years, with a range of 1 to 9 years. Functional results were considered to be good in 89%, without limitation of activity. X-ray study shows: 1) A radioclinical concordence in 64% of cases with good clinical and X-ray results, stable in the long term. 2) A radioclinical discordance in 22% of cases with good functional result but mobilisation of metacarpal stem. 3) Failure in 5 cases (14%) with unsealing and trapezial fracture. This radioclinical study yields two failure factors: preoperative destruction of trapezium in all the failures and these cases are now a contraindication to the prosthesis and inadaptation between stem arthroplasty and metacarpal cavity. This study supports total arthroplasty in trapezometacarpal arthritis of the thumb: III or IV Dell's stage, with preserved trapezium configuration.

Anatomical basis of neurotisation of the median nerve in the hand by the radial nerve

The sensory sequelae after lesions of the median nerve cause difficulties in treatment since few sensory transfers are available. Neurotisation of the median by sensory branches of the radial nerve have aroused little interest although they have already been used by some authors after anastomosis at the wrist or through the first or second interosseous spaces. Based on what was originally a purely anatomic study, our interest was directed to the possibilities of performing more distal neurotisation for the treatment of sensory disorders of limited extent. The chief object was to obtain faster sensory reinnervation. 30 hands were dissected and a radial branch was defined as suitable for neurotisation whose diameter approximated that of its palmar digital homolog. Only those findings constantly observed in analysis of the hands studied were taken into account. It is therefore possible to reliably define the type and site of the routes of approach as well as the sensory branches suitable for neurotisation.

[Bundled central medullary bone wiring. Method of choice in the treatment of fractures of the neck of the fifth metacarpal necessitating a reduction. 30 cases]

The authors present a short series of 30 displaced fractures of the neck of the fifth metacarpal. All fractures were treated by K-wire nailing according to the method described by Fourcher in 1976. The good results confirm the advantages of this technique, allowing early mobilization and rehabilitation. The poor results are due to faults in the use of the method, and the authors emphasize these technical errors.

A cross-validation of Paulson's discriminant function-derived scales for identifying "at risk" child-abusive parents

Paulson, Afifi, Chaleff, Liu, & Thomason (1975) developed a series of special subscales from the MMPI for identifying individuals who are at risk for child-abusive behavior. The initial results were highly encouraging, with the scales correctly identifying 93 to 100% of the subjects in their sample. Unfortunately, Paulson et al. (1975) failed to cross-validate their findings before publication. When the six scales were cross-validated on an independent sample from the population of child-abusing parents, significant shrinkage in the accuracy of prediction was found. The use of the special subscales for identifying "at risk" parents in prenatal clinics, pediatric clinics, pediatric clinics and mental health centers as originally suggested by Paulson and his colleagues is seriously questioned.

Developing an Elementary School CHD Prevention Program

In brief: Sixty-three students aged 7 to 12 years (32 boys, 31 girls) were assessed for coronary heart disease (CHD) risk factors, including family history of CHD, blood pressure, VO2 max, serum lipids, body composition, and history of diabetes mellitus and cigarette smoking. Forty-two percent of the children had one risk factor, and 12% and 3% had two and three risk factors, respectively. This information was used to encourage school administrators and faculty to modify the physical education program, teach health and fitness concepts in the classroom, and develop a rehabilitation program for children at risk.

Development of standards of performance by mentally retarded children

The ability of moderately mentally retarded children to set self-performance standards was investigated. We hypothesized that (a) subjects who received training based on the relational concept of "between" would be able to acquire and retain superior standard-setting performance compared to nontrained control subjects, and (b) those receiving this training would be able to generalize their superior standard-setting performance to a task involving more variable feedback as well as to a conceptually more abstract task. Results indicated that the subjects learned and retained concepts that allowed them to set appropriate or realistic self-performance standards. Further, retarded subjects were able to set appropriate standards when given less restricted feedback than was given during the initial training. On a more abstract picture-matching task, no significant differences were found between the two groups.

Malleability of preference for therapists' response style

Studies of clients' preferences, primarily descriptive in nature, are being reported at an increasing rate. The resources given to this sort of collecting and summarizing of clients' and nonclients' preferences are justified only if preference is an important variable to be reckoned with in group and individual psychotherapy. While a number, of authors have indeed postulated that clients' preferences constitute a critical variable in psychotherapy, not much experimental work has been done. To estimate the importance of clients' preferences for therapists' directiveness, the strength with which such preference is held was investigated. Sixty-six undergraduates were randomly assigned to six groups in a Solomon design. The four experimental groups were subsequently shown one of two taped demonstrations of high and low directive therapists' response styles, respectively. Posttests determined preference regarding therapists' directiveness. Results suggested preference was not impervious to shaping procedures and can be modified prior to therapy. It was hypothesized that if preference proved to be a such weakly held attitude, then it might well prove similarly weak in actual therapy.

The organization of a human milk bank in a North Q ueensland hospital

The development of a human milk bank with nursing mothers as donors of human milk is described. Breast milk is collected manually, and as aseptically as possible, by the mother in the privacy of her home, and the milk is transported frozen to the milk bank by a member of the Nursing Mothers' Association of Australia. A sample of expressed milk is also collected and sent to the Microbiology Department of the Australian Government Health Laboratory for bacteriological examination. The milk bank is suitably located in the paediatric ward of the Townsville General Hospital. Human milk which has been classed as bacteriologically safe is given untreated to hospitalized infants in preference to formula milk. The result is a human milk bank which is administered under medical and microbiological control.

Increased verbal interaction via group techniques with regressed schizophrenics

Verbal interaction on the tenth 50-min. session of remotivation therapy for 8 hospitalized male chronic schizophrenics ( Mage = 57.87) increased significantly over the level for 8 comparable schizophrenic patients who served as controls. Increased verbal interaction appeared on both a structured and an unstructured task. Although individual differences were marked, the efficacy of remotivation therapy with chronic schizophrenics is suggested.