Global maps of soil temperature

Research in global change ecology relies heavily on global climatic grids derived from estimates of air temperature in open areas at around 2 m above the ground. These climatic grids do not reflect conditions below vegetation canopies and near the ground surface, where critical ecosystem functions occur and most terrestrial species reside. Here, we provide global maps of soil temperature and bioclimatic variables at a 1-km2 resolution for 0-5 and 5-15 cm soil depth. These maps were created by calculating the difference (i.e. offset) between in situ soil temperature measurements, based on time series from over 1200 1-km2 pixels (summarized from 8519 unique temperature sensors) across all the world's major terrestrial biomes, and coarse-grained air temperature estimates from ERA5-Land (an atmospheric reanalysis by the European Centre for Medium-Range Weather Forecasts). We show that mean annual soil temperature differs markedly from the corresponding gridded air temperature, by up to 10°C (mean = 3.0 ± 2.1°C), with substantial variation across biomes and seasons. Over the year, soils in cold and/or dry biomes are substantially warmer (+3.6 ± 2.3°C) than gridded air temperature, whereas soils in warm and humid environments are on average slightly cooler (-0.7 ± 2.3°C). The observed substantial and biome-specific offsets emphasize that the projected impacts of climate and climate change on near-surface biodiversity and ecosystem functioning are inaccurately assessed when air rather than soil temperature is used, especially in cold environments. The global soil-related bioclimatic variables provided here are an important step forward for any application in ecology and related disciplines. Nevertheless, we highlight the need to fill remaining geographic gaps by collecting more in situ measurements of microclimate conditions to further enhance the spatiotemporal resolution of global soil temperature products for ecological applications.

Think globally, measure locally: The MIREN standardized protocol for monitoring plant species distributions along elevation gradients

Climate change and other global change drivers threaten plant diversity in mountains worldwide. A widely documented response to such environmental modifications is for plant species to change their elevational ranges. Range shifts are often idiosyncratic and difficult to generalize, partly due to variation in sampling methods. There is thus a need for a standardized monitoring strategy that can be applied across mountain regions to assess distribution changes and community turnover of native and non‐native plant species over space and time. Here, we present a conceptually intuitive and standardized protocol developed by the Mountain Invasion Research Network (MIREN) to systematically quantify global patterns of native and non‐native species distributions along elevation gradients and shifts arising from interactive effects of climate change and human disturbance. Usually repeated every five years, surveys consist of 20 sample sites located at equal elevation increments along three replicate roads per sampling region. At each site, three plots extend from the side of a mountain road into surrounding natural vegetation. The protocol has been successfully used in 18 regions worldwide from 2007 to present. Analyses of one point in time already generated some salient results, and revealed region‐specific elevational patterns of native plant species richness, but a globally consistent elevational decline in non‐native species richness. Non‐native plants were also more abundant directly adjacent to road edges, suggesting that disturbed roadsides serve as a vector for invasions into mountains. From the upcoming analyses of time series, even more exciting results can be expected, especially about range shifts. Implementing the protocol in more mountain regions globally would help to generate a more complete picture of how global change alters species distributions. This would inform conservation policy in mountain ecosystems, where some conservation policies remain poorly implemented.

Baseline brain function in the preadolescents of the ABCD Study

The Adolescent Brain Cognitive Development (ABCD) Study® is a 10-year longitudinal study of children recruited at ages 9 and 10. A battery of neuroimaging tasks are administered biennially to track neurodevelopment and identify individual differences in brain function. This study reports activation patterns from functional MRI (fMRI) tasks completed at baseline, which were designed to measure cognitive impulse control with a stop signal task (SST; N = 5,547), reward anticipation and receipt with a monetary incentive delay (MID) task (N = 6,657) and working memory and emotion reactivity with an emotional N-back (EN-back) task (N = 6,009). Further, we report the spatial reproducibility of activation patterns by assessing between-group vertex/voxelwise correlations of blood oxygen level-dependent (BOLD) activation. Analyses reveal robust brain activations that are consistent with the published literature, vary across fMRI tasks/contrasts and slightly correlate with individual behavioral performance on the tasks. These results establish the preadolescent brain function baseline, guide interpretation of cross-sectional analyses and will enable the investigation of longitudinal changes during adolescent development.

Quantifying acceptable artefact ranges for dermatologic classification algorithms

Background

Many classifiers have been developed that can distinguish different types of skin lesions (e.g., benign nevi, melanoma) with varying degrees of success.^1–5 However, even successfully trained classifiers may perform poorly on images that include artefacts. While problems created by hair and ink markings have been published, quantitative measurements of blur, colour and lighting variations on classification accuracy has not yet been reported to our knowledge.

Objectives

We created a system that measures the impact of various artefacts on machine learning accuracy. Our objectives were to (1) quantitatively identify the most egregious artefacts and (2) demonstrate how to assess a classification algorithm's accuracy when input images include artefacts.

Methods

We injected artefacts into dermatologic images using techniques that could be controlled with a single variable. This allows us to quantitatively evaluate the impact on the accuracy. We trained two convolutional neural networks on two different binary classification tasks and measured the impact on dermoscopy images over a range of parameter values. The area under the curve and specificity‐at‐a‐given‐sensitivity values were measured for each artefact induced at each parameter.

Results

General blur had the strongest negative effect on the melanoma versus other task. Conversely, shifting the hue towards blue had a more pronounced effect on the suspicious versus follow task.

Conclusions

Classifiers should either mitigate artefacts or detect them. Images should be excluded from diagnosis/recommendation when artefacts are present in amounts outside the machine perceived quality range. Failure to do so will reduce accuracy and impede approval from regulatory agencies.

SoilTemp: A global database of near-surface temperature

Current analyses and predictions of spatially explicit patterns and processes in ecology most often rely on climate data interpolated from standardized weather stations. This interpolated climate data represents long-term average thermal conditions at coarse spatial resolutions only. Hence, many climate-forcing factors that operate at fine spatiotemporal resolutions are overlooked. This is particularly important in relation to effects of observation height (e.g. vegetation, snow and soil characteristics) and in habitats varying in their exposure to radiation, moisture and wind (e.g. topography, radiative forcing or cold-air pooling). Since organisms living close to the ground relate more strongly to these microclimatic conditions than to free-air temperatures, microclimatic ground and near-surface data are needed to provide realistic forecasts of the fate of such organisms under anthropogenic climate change, as well as of the functioning of the ecosystems they live in. To fill this critical gap, we highlight a call for temperature time series submissions to SoilTemp, a geospatial database initiative compiling soil and near-surface temperature data from all over the world. Currently, this database contains time series from 7,538 temperature sensors from 51 countries across all key biomes. The database will pave the way toward an improved global understanding of microclimate and bridge the gap between the available climate data and the climate at fine spatiotemporal resolutions relevant to most organisms and ecosystem processes.

TEMPO® TVC for the Enumeration of Aerobic Mesophilic Flora in Foods: Collaborative Study

The automated system for enumeration of total viable count (TVC) in foods, TEMPO® TVC, uses a dehydrated culture medium and an enumeration card containing 48 wells across 3 different dilutions for the automatic determination of the most probable number (MPN). The alternative method was compared in a multilaboratory collaborative study to AOAC Method 966.23 for determination of aerobic plate count for nondairy products and the Standard Methods for the Examination of Dairy Products (SMEDP) Standard Plate Count for dairy products. Five food types, raw ground beef, raw ground chicken, cooked whitefish fillets, bagged lettuce, and milk, were analyzed for TVC by 14 collaborating laboratories throughout the United States and Canada. Three lots of naturally contaminated food products representing a wide range of counts were tested for each of the 5 food types. The study demonstrated that the overall repeatability, reproducibility, and mean log counts of the TEMPO TVC method were statistically comparable to those of the 2 standard methods at the 5 level.

Identical and Nonidentical Twins: Risk and Factors Involved in Development of Islet Autoimmunity and Type 1 Diabetes

OBJECTIVE

There are variable reports of risk of concordance for progression to islet autoantibodies and type 1 diabetes in identical twins after one twin is diagnosed. We examined development of positive autoantibodies and type 1 diabetes and the effects of genetic factors and common environment on autoantibody positivity in identical twins, nonidentical twins, and full siblings.

RESEARCH DESIGN AND METHODS

Subjects from the TrialNet Pathway to Prevention Study (N = 48,026) were screened from 2004 to 2015 for islet autoantibodies (GAD antibody [GADA], insulinoma-associated antigen 2 [IA-2A], and autoantibodies against insulin [IAA]). Of these subjects, 17,226 (157 identical twins, 283 nonidentical twins, and 16,786 full siblings) were followed for autoantibody positivity or type 1 diabetes for a median of 2.1 years.

RESULTS

At screening, identical twins were more likely to have positive GADA, IA-2A, and IAA than nonidentical twins or full siblings (all P < 0.0001). Younger age, male sex, and genetic factors were significant factors for expression of IA-2A, IAA, one or more positive autoantibodies, and two or more positive autoantibodies (all P ≤ 0.03). Initially autoantibody-positive identical twins had a 69% risk of diabetes by 3 years compared with 1.5% for initially autoantibody-negative identical twins. In nonidentical twins, type 1 diabetes risk by 3 years was 72% for initially multiple autoantibody-positive, 13% for single autoantibody-positive, and 0% for initially autoantibody-negative nonidentical twins. Full siblings had a 3-year type 1 diabetes risk of 47% for multiple autoantibody-positive, 12% for single autoantibody-positive, and 0.5% for initially autoantibody-negative subjects.

CONCLUSIONS

Risk of type 1 diabetes at 3 years is high for initially multiple and single autoantibody-positive identical twins and multiple autoantibody-positive nonidentical twins. Genetic predisposition, age, and male sex are significant risk factors for development of positive autoantibodies in twins.

Evaluation of the prevalence of digital dermatitis and the effects on performance in beef feedlot cattle under organic trace mineral supplementation

Bovine digital dermatitis (DD) is a contagious and multifactorial disease that leads to painful, ulcerative lesions of the skin near the heel-horn border of the foot, most commonly in dairy cattle. With regard to beef cattle, the pathogenesis and etiology of DD has not been widely reported or studied over the past several decades. A longitudinal field trial in a commercial feedlot was conducted to compare prevalence and effects of DD in beef steers provided a diet supplemented with a novel formulation of inorganic and organic trace mineral sources (OTM diet) compared to a diet provided with similar levels of trace minerals solely from inorganic sources (CON diet). A secondary objective was to evaluate the prevalence of DD and the potential effects on growth performance and carcass yield and quality. One thousand seventy-seven steers were assigned to 1 of the 2 treatment groups (CON diet or OTM diet) based on location of their home pens which were situated in 1 of 2 barns. All pens in the B barn (group B) were assigned to the OTM diet, and all pens in the A barn (group A) were assigned to the CON diet. The study was conducted in 2 phases: adaptation phase (AP) comprising the initial 60 d of feeding CON and OTM diets and postadaptation phase (PAP) which lasted until cattle were sent to harvest. In the AP, pens in group B had a greater proportion of steers (54.03%) with DD lesions compared to pens in group A (26.72%). During the PAP, the relative risk of observing an increased DD prevalence was significantly ( < 0.05) higher in CON group compared to OTM group. Growth performance, final live weight, and hot carcass weight were negatively impacted when steers were observed to have active DD lesions (M2 lesions) compared to steers with no M2 lesions over the study period. For ADG, a calculated loss per steer of 0.08 kg/d from type I (no M2 lesions) to type II (one M2 lesion; SE = 0.028; = 0.003) and loss of 0.14 kg/d from type I to type III (multiple M2 lesions; SE = 0.038; = 0.0003) were observed. A significant BW loss of approximately 10.06 kg (SE = 4.18; = 0.022) and a mean reduction of 5.5 kg per steer in HCW (SE = 2.74; = 0.043) were also found between type I and type II steers.

Transcriptome analysis of Inbred Long Sleep and Inbred Short Sleep mice

Many studies have utilized the Inbred Long Sleep and Inbred Short Sleep mouse strains to model the genetic influence on initial sensitivity to ethanol. The mechanisms underlying this divergent phenotype are still not completely understood. In this study, we attempt to identify genes that are differentially expressed between these two strains and to identify baseline networks of co-expressed genes, which may provide insight regarding their phenotypic differences. We examined the whole brain and striatal transcriptomes of both strains, using next generation RNA sequencing techniques. Many genes were differentially expressed between strains, including several in chromosomal regions previously shown to influence initial sensitivity to ethanol. These results are in concordance with a similar sample of striatal transcriptomes measured using microarrays. In addition to the higher dynamic range, RNA-Seq is not hindered by high background noise or polymorphisms in probesets as with microarray technology, and we are able to analyze exome sequence of abundant genes. Furthermore, utilizing Weighted Gene Co-expression Network Analysis, we identified several modules of co-expressed genes corresponding to strain differences. Several candidate genes were identified, including protein phosphatase 1 regulatory unit 1b (Ppp1r1b), prodynorphin (Pdyn), proenkephalin (Penk), ras association (RalGDS/AF-6) domain family member 2 (Rassf2), myosin 1d (Myo1d) and transthyretin (Ttr). In addition, we propose a role for potassium channel activity as well as map kinase signaling in the observed phenotypic differences between the two strains.

Abstract P3-01-04: Differential Gene Expression Analysis among Post-Menopausal Caucasian Invasive Breast Cancer, Benign and Normal Subjects

Background: Breast Cancer (BC) is the second leading cause of cancer death among women in United States. There have been studies aiming to develop a blood-based BC detection assay, but most were focused on comparing blood samples between BC and normal subjects. Including benign disease patients in the study is critical in developing a BC detection assay. In addition, BC is a heterogeneous disease with distinct characteristics being associated with ethnicity and menopausal status. Thus we designed a study to analyze gene expression, in peripheral blood samples from invasive BC, benign disease and normal subjects, stratified by menopausal status and ethnicity. Here we report the results from Caucasian postmenopausal women.

Method: Subjects were selected from the Clinical Breast Care Project (CBCP). Microarray data using Affymetrix GeneChip Human Genome U133 plus 2.0 arrays, of peripheral blood samples from pathologically confirmed invasive BC (n= 17) and benign patients (n= 17) were compared to those from normal subjects (n=17). All subjects were postmenopausal Caucasian women, matched for age. Using GenespringGX 11.0 software, the data were normalized, and QC on hybridization and internal controls were performed before filtering out probesets with the lowest 20% signal intensity in each array. Asymptotic t-test with FDR correction was used and significant pathways were obtained.

Results: Comparison of gene expression in invasive BC patients (mean±SD = 63.7±7.0 years old) vs. normal subjects (mean±SD = 63.2±7.4 years) identified 1102 significantly different genes, satisfying the thresholds of corrected p &lt; 0.05 and Fold Change (FC) &gt; 1.5. Of them, 1003 genes were up regulated and 99 genes were down regulated in BC patients. Comparison of gene expression in benign disease women (mean±SD = 61.4±10.4 years) vs. normal women showed 1320 significantly different genes (corrected p &lt; 0.05, FC &gt; 1.5), with 1121 genes being up regulated and 199 genes being down regulated in benign patients. Of the top 10 genes with highest FC values, 6 genes (MBNL1, FAR1, MDM4, ITGA4, RAB8B, and EXOC5) were common in both analyses and were up regulated. NOTCH pathway was up regulated in both benign (p=0.038) and invasive (p=0.042) groups. Similarly, IL-7 pathway was up regulated in both benign (p=0.047) and invasive (p=0.030) patients. TCR pathway (p=7.36E-04) was up regulated in benign group only. The benign vs. invasive BC subjects did not show significant differential gene expression.

Discussion: Our results provide a list of differentially expressed genes that are mostly up regulated in invasive and benign patients vs. normal subjects. NOTCH pathway is involved in cell-cell communication and angiogenesis. IL7 pathways play an important role in immune system response, cell proliferation and cell survival signaling. TCR pathway is highly significant only in benign patients and stimulation of TCR pathway induces a signaling cascade that ultimately results in activation of induced cell death. This activation could be early body response to prevent cancer development in benign subjects. When more microarray analyses are completed for this study, we hope to obtain a better understanding of the possibility of developing a blood-based BC detection assay.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P3-01-04.

Structures of proteins and cofactors: X-ray crystallography

Protein crystallography is the predominately used technique for the determination of the three-dimensional structures of proteins and other macromolecules. In this article, the methodology utilized for the measurement and analysis of the diffraction data from crystals is briefly reviewed. As examples of both the usefulness and difficulties of this technique, the determination of the structures of several photosynthetic pigment-protein complexes is described, namely, the reaction center from purple bacteria, photosystem I and photosystem II from cyanobacteria, the light-harvesting complex II from purple bacteria, and the FMO protein from green bacteria.

Speciation of polonium released from molten lead bismuth

The alpha-emitter 210Po is an activation product of liquid lead-bismuth, a low melting eutectic under investigation as a coolant of the next generation fast nuclear reactors. Experiments were performed to measure the gaseous polonium chemical species for assessing the radioactivity release from a Pb-Bi bath upon contact with a gas stream. The vapor pressure of lead polonide was measured over the 400-550°C temperature range and found to be in agreement with an existing correlation derived from data at higher temperatures. Also, it was experimentally confirmed that the presence of steam in the gas stream above the Pb-Bi melt substantially increases the amount of polonium released due to the formation of the volatile compound H2Po. The free-energy variation of the H2Po formation reaction was determined, permitting the calculation of the Po gas phase speciation under the experimental conditions.

Faecal contamination of drinking water sources of Dhaka city during the 2004 flood in Bangladesh and use of disinfectants for water treatment

AIMS

To describe the extent of faecal pollution and point of use water treatment strategy during and after the 2004 flood in Dhaka.

METHODS

A total of 300 water samples were collected from 20 different drinking water sources in Kamalapur, Dhaka city from August 2004 to January 2005. The level of faecal contamination was estimated using measurements of faecal indicator bacteria (total coliforms, faecal coliforms and faecal streptococci) and isolation of Vibrio cholerae was carried out following standard procedures. Total dissolved solids, dissolved oxygen, hardness, chloride and pH were also monitored. The efficacy of four disinfectants including Halotab, Zeoline-200, alum potash and bleaching powder were tested as point of use water treatment agents. The unacceptable level of contamination of total coliforms (TC), faecal coliforms (FC) and faecal streptococci (FS) ranged from 23.8% to 95.2%, 28.6% to 95.2% and 33.3% to 90.0%, respectively. The isolation rates of V. cholerae O1 and O139 were both 0.33%, and non-O1/non-O139 was 7.0%.

CONCLUSION

Water collected during and after floods was contaminated with TC, FC, FS and V. cholerae. Although alum potash, bleaching powder, Halotab and Zeoline-200 were all effective general disinfectants, Halotab and Zeoline-200 were superior to bleaching powder and alum potash against FC.

SIGNIFICANCE AND IMPACT OF THE STUDY

During and after floods, point of use water treatment could reduce waterborne diseases among flood-affected people.

Normal acylcarnitine levels during confirmation of abnormal newborn screening in long-chain fatty acid oxidation defects

We report two infants identified by tandem mass spectrometry (MS/MS) of neonatal blood spot acylcarnitines and confirmed by molecular genetic analysis to have long-chain fatty acid oxidation defects. In both cases, acylcarnitine concentrations in confirmatory plasma samples were normal. None the less, molecular testing identified trifunctional protein (TFP) deficiency (McKusick 600890) and very long-chain acyl-CoA dehydrogenase (VLCAD) deficiency (McKusick 201475).

Identification of a missense mutation (G329A;Arg(110)--> GLN) in the human FUT7 gene

The human FUT7 gene codes for the alpha1,3-fucosyltransferase VII (Fuc-TVII), which is involved in the biosynthesis of the sialyl Lewis x (SLe(x)) epitope on human leukocytes. The FUT7 gene has so far been considered to be monomorphic. Neutrophils isolated from patients with ulcerative colitis were examined for apparent alterations in protein glycosylation patterns by Western blot analysis using monoclonal antibodies directed against SLe(x) and SLe(x)-related epitopes. One individual showed lower levels of SLe(x) expression and an elevated expression of CD65s compared to controls. The coding regions of the FUT7 gene from this individual were cloned, and a G329A point mutation (Arg(110) --> Gln) was found in one allele, whereas the other FUT7 allele was wild type. No Fuc-TVII enzyme activity was detected in COS-7 cells transiently transfected with the mutated FUT7 construct. The FUT7 Arg(110) is conserved in all previously cloned vertebrate alpha 1,3-fucosyltransferases. Polymerase chain reaction followed by restriction enzyme cleavage was used to screen 364 unselected Caucasians for the G329A mutation, and a frequency of < or =1% for this mutation was found (3 heterozygotes). Genetic characterization of the family members of one of the additional heterozygotes identified one individual carrying the G329A mutation in both FUT7 alleles. Peripheral blood neutrophils of this homozygously mutated individual showed a lowered expression of SLe(x) and an elevated expression of CD65s when analyzed by Western blot and flow cytometry. The homozygous individual was diagnosed with ulcer disease, non-insulin-dependent diabetes, osteoporosis, spondyloarthrosis, and Sjögren's syndrome but had no history of recurrent bacterial infections or leukocytosis.

Medical, personal, and occupational outcomes for work-related amputations in Minnesota

BACKGROUND

The Minnesota Sentinel Event Notification System for Occupational Risks (SENSOR) surveillance system has collected data on the medical, personal, and occupational outcomes associated with work-related amputations since 1992.

METHODS

SENSOR defined amputations as any finger amputation or the loss of any other body part; 832 workers were identified as having amputation injuries between 1994 and 1995 and 72% of these workers completed a telephone interview.

RESULTS

Twenty percent of those injured required overnight hospitalization. Ninety-one percent of the cases reported having missed work, with 56% reporting missing ten or more days. Individuals working on their usual jobs at the time of injury were more likely to report less serious medical and occupational outcomes.

CONCLUSIONS

Severe injuries were significantly associated with worse medical, personal, and occupational outcomes. Two groups of machines, material handling, and powered handtools were associated with a higher proportion of severe injuries.

Nature, incidence, and cause of work-related amputations in Minnesota

BACKGROUND

The Minnesota Sentinel Event Notification System for Occupational Risks (SENSOR) has collected data on the nature, incidence, and cause of work-related amputation injuries that have taken place since 1992.

METHODS

SENSOR defined an amputation as any finger amputation or the loss of any other body part; 832 workers were identified as having amputation injuries between 1994 and 1995 and 72% of these workers completed telephone interviews.

RESULTS

The amputation injury rate for Minnesota workers was 39 per 100,000 workers, with agriculture and manufacturing having the highest rates. Sixty-six percent of the injuries involved one finger; 14% involved two or more fingers. Persons working with machinery reported 73% of the injuries.

CONCLUSIONS

A closer examination of the incidence and causes for amputation injuries shows that these were not random events. Reliance on human reactions to prevent injury is inadequate; therefore, additional research needs to be conducted.

Expression of human prostatic acid phosphatase gene is regulated by upstream negative and positive elements

Human prostatic acid phosphatase (PAcP) is a prostate epithelium-specific differentiation antigen. To understand the regulation of expression of the PAcP gene, we studied the cis-regulatory elements of its promoter. A DNA fragment from -2899 to +87 base pairs (bp) of PAcP gene was fused to the chloramphenicol acetyltransferase (CAT) reporter gene and introduced into PC-3 and LNCaP human prostate cancer cells. The expression of the CAT gene driven by the PAcP promoter was assessed in transient expression assays. Sequential 5' deletions of the promoter were constructed and analyzed to reveal the positive and the negative regulatory elements that are involved in regulating the transcription of the PAcP gene. Our data showed that the proximal sequence -1305/+87 bp directs a high level of the CAT activity in both cell lines. Deletion of the region from -1305 to -779 resulted in approximately a 10- and three-fold decrease of the PAcP promoter activity in PC-3 and LNCaP cells, respectively. Interestingly, an inverse correlation of the CAT activity with the cell growth was observed when the reporter gene was driven by the -1305/+87 fragment, but not by the -779/+87 fragment. Two regions of transcriptional suppression were identified and located in positions from -2899 to -2583, and from -2583 to -1305 bp. Furthermore, the activity of the core promoter region from -779 to +87 bp can be activated by a SV-40 enhancer. The results, thus, clearly demonstrate the presence of positive and negative cis-elements in the promoter region of the PAcP gene.

Experimental studies of extinction dynamics

Extinction of populations occurs naturally, but global extinction rates are accelerating, making understanding extinction a high priority for conservation. Extinction in experimental populations of brine shrimp (Artemia franciscana) was measured to assess hypothesized extinction processes. Greater initial population size, greater maximum population size supported by the environment, and lower variation in environmental conditions reduced the likelihood of extinction, as hypothesized. However, initial population size was less important, and maximum population size and environmental variation were more important than often hypothesized. Unexpectedly, deterministic oscillations in population size due to inherent nonlinear dynamics and overcrowding were as important or more important than hypothesized processes.

Perceived barriers to childhood immunization: a physician and parent survey in a southeastern urban/rural community

PURPOSE

To identify physicians' and parents' perceptions of barriers to completing the immunization process by age 24 months.

METHODS

A questionnaire hand-delivered to 110 physicians who treat children yielded a response rate of 83%. A telephone survey conducted with parents of a random sample of 2,100 children younger than three years of age selected from the county birth records yielded an adjusted response rate of 87%.

RESULTS

Physicians' response fell into two categories: those with more and less than 90% up-to-date immunizations. Those with less than 90% indicated that parental knowledge is the primary reason. Those with more than 90% reported telephone follow-up for missed appointments. The top three barriers reported by parents; (1) waiting time at the clinic (33%), (2) child too ill at time of appointment (21%), and (3) insurance does not cover immunizations (16%).

CONCLUSIONS

There is an opportunity for education intervention with physicians, policy makers, and parents in several key areas: (1) fact-based contraindications to immunizations, (2) effective means of follow-up, (3) accessibility to immunization for the under-insured, and (4) parental responsibility.

Mechanical load stimulates expression of novel genes in vivo and in vitro in avian flexor tendon cells

OBJECTIVE

Our experiments were designed to test the hypothesis that tendon cells might respond differently to applied strain in vitro than in vivo.

DESIGN

We tested cells in whole tendons from exercised chickens and from isolated surface (TSC) and internal tendon (TIF) in vitro that were subjected to mechanical strain. We hypothesized that tendon cells differentially express genes in response to mechanical loading in vivo and in vitro.

METHODS

We utilized an in-vivo exercise model in which chickens were run on a treadmill in an acute loading regime for 1 h 45 min with the balance of time at rest to 6 h total time. Gene expression was analyzed by a differential display technique. In addition, isolated avian flexor digitorum profundus TSC and TIF cells were subjected to cyclic stretching at 1 Hz, 5% average elongation for 6 h, +/- PDGF-BB, IGF-I, TGF-beta 1, PTH, estrogen, PGE2, or no drug and/or no load. mRNA was then collected and samples were subjected to differential display analysis.

CONCLUSIONS

Load with or without growth factor and hormone treatments induced expression of novel genes as well as some known genes that were novel to tendon cells. We conclude that the study of gene expression in mechanically loaded cells in vivo and in vitro will lead to the discovery of novel and important marker proteins that may yield clues to positive and negative cell strain responses that are protective under one set of conditions and destructive under another.

Asymmetric frontal brain activity, cortisol, and behavior associated with fearful temperament in rhesus monkeys

The authors examined the hypothesis that rhesus monkeys with extreme right frontal electroencephalographic activity would have higher cortisol levels and would be more fearful compared with monkeys with extreme left frontal activity. The authors first showed that individual differences in asymmetric frontal electrical activity are a stable characteristic. Next, the authors demonstrated that relative right asymmetric frontal activity and cortisol levels are correlated in animals 1 year of age. Additionally, extreme right frontal animals had elevated cortisol concentrations and more intense defensive responses. At 3 years of age, extreme right frontal animals continued to have elevated cortisol concentrations. These findings demonstrate important relations among extreme asymmetric frontal electrical activity, cortisol levels, and trait-like fear-related behaviors in young rhesus monkeys.

Perinatal lethality with kidney and pancreas defects in mice with a targetted Pkd1 mutation

PKD1 is the most common site for mutations in human autosomal dominant polycystic kidney disease (ADPKD). ADPKD is characterized by progressive replacement of kidney tissue by epithelial cysts and eventual renal failure. Hepatic and pancreatic cysts are also common. The PKD1 protein, polycystin, is a cell-surface protein of unknown function that is widely expressed in epithelia and in vascular smooth muscle and myocardium. None of the genetic forms of murine polycystic disease map to the murine Pkd1 locus. We introduced into mice by homologous recombination a Pkd1 truncation mutation, Pkd1-, that mimics a mutation found in ADPKD. Pkd1- heterozygotes have no discernible phenotype, whereas homozygotes die during the perinatal period with massively enlarged cystic kidneys, pancreatic ductal cysts and pulmonary hypoplasia. Renal cyst formation begins at embryonic day 15.5 (E15.5) in proximal tubules and progresses rapidly to replace the entire renal parenchyma. The timing of cyst formation indicates that full-length polycystin is required for normal morphogenesis during elongation and maturation of tubular structures in the kidney and pancreas.

Decision making errors in the use of interlocking tibial nails

Seventy-one fractures of the tibial shaft were treated with interlocking intramedullary nails. None of the fractures were treated with static locking of the intramedullary nails. These 71 fractures were studied to determine whether certain fracture patterns are prone to loss of alignment when static interlocking is not used. Loss of alignment was defined as shortening of 1 cm or more and/or change in angulation of at least 5 degrees. Loss of alignment occurred in eight of the 71 (11%) fractures. Shortening and/or angulation occurred in seven of 22 spiral and short oblique fractures, and in none of 27 transverse fracture patterns. It was concluded that the dynamically locked and nonlocked modes of intramedullary nailing should not be used in the stabilization of spiral and oblique fractures of the tibial shaft.

Bioavailability and efficacy of omeprazole given orally and by nasogastric tube

We compared the bioavailability and the efficacy of omeprazole provided either as encapsulated enteric-coated granules or as enteric-coated granules delivered via a nasogastric tube in 10 healthy subjects. Omeprazole reduced mean pentagastrin-stimulated peak gastric acid secretion by 85.5% +/- 23.7% when delivered orally and by 79.6% +/- 32.1% when delivered by nasogastric tube; the mean plasma omeprazole concentration area under the curve (AUC) was 2.02 +/- 0.79 after oral delivery and 1.74 +/- 1.89 after nasogastric tube delivery. There was no significant difference in these parameters between the two routes of administration, and there was excellent intrasubject correlating between oral and nasogastric percent acid suppression and AUC. There was a close correlation between AUC and percent acid suppression at AUC values below 0.6, and complete acid suppression at AUC values above 0.6, regardless of the delivery route. We conclude that omeprazole delivered as enteric-coated granules via nasogastric tube provides equal bioavailability and gastric acid suppression as omeprazole given orally in its proprietary formulation.

Comparing outcomes and charges for patients with acute myocardial infarction in three community hospitals: an approach for assessing "value"

OBJECTIVE

To assess the value of care (i.e. outcomes in relation to charges) for acute myocardial infarction (Acute MI) patients in three community hospitals after controlling for patient mix differences.

DESIGN

An observational study of a cohort of acute MI patients admitted to hospital for care were studied based on medical record review and on patient-completed questionnaires at 8 weeks post-discharge.

SETTING

Three community hospitals located in urban areas in the southeastern region of the United States.

PATIENTS

A consecutive sample of 133 non-transfer Acute MI patients were entered into the study based on EKG results, enzyme tests and chest pain characteristics. Hospital medical record and charge data were available on all patients and patient-reports on 86% of survivors.

MAIN OUTCOME MEASURES

Data were gathered on clinical outcomes (death, angina, dyspnea), functional outcomes (physical and psychosocial), satisfaction, and resource intensity (length of stay, total hospital charges, ancillary charges). Because of patient mix differences across hospitals, outcomes were adjusted for severity of Acute MI, comorbidity and demographics.

RESULTS

There were important patient mix differences across hospitals. For example, Hospital C had more comorbidity than Hospital B (57.78% of Hospital C patients vs 15.00% of Hospital B patients were rated moderate or severe using a well tested index, p < 0.0001). After adjusting for patient mix differences, Hospital C scored significantly better on four of six outcome measures (i.e. angina, dyspnea, physical functioning, psychosocial functioning). For example, Hospital C's patients' mean scores on physical functioning at 8 week follow-up averaged 75.19 (on a 0-100 scale), while Hospital A's was 63.03 and Hospital B's was 48.57 (F-ratio = 4.95; p < 0.05). However, Hospital A scored significantly lower on all three resource intensity indicators (length of stay, ancillary charges, and total charges). For example, Hospital A's ancillary charges averaged $10,752 while Hospital B's and C's averaged $11,432 and $16,598 respectively. Between-hospital comparisons on adjusted mortality and satisfaction did not differ significantly.

CONCLUSION

The "value" profiles (i.e. outcomes related to charges) produced by these three hospitals were substantially different. Studies that simultaneously measure outcomes, costs, patient mix and processes have potential to: (a) enable clinical teams to improve the measurable value of clinical care; and (b) enable purchasers to better evaluate which providers to select as preferred sources of care.

Physiology of oropharyngeal swallow in the cat: a videofluoroscopic and electromyographic study

The majority of animal studies of deglutition have examined electrically stimulated swallows in sedated animals. This present investigation examined oropharyngeal and cervical esophageal swallow physiology in three awake normal domestic cats using concurrent electromyography (EMG) and videofluorography (VFG). Hooked wire electrodes were surgically implanted into six oropharyngeal muscles in each cat. During collection of VFG and EMG data, each cat ate barium-impregnated cat food while the fluorography tube focused on a lateral view of the oral cavity, pharynx, and cervical esophagus. A number of significant differences in the physiology of swallowing were found between the cat and human adult. The oral stage of swallow is much longer in the cat with bolus accumulation in the valleculae. Duration and components of the pharyngeal stage of swallow are much faster, and the pharyngeal stage occurs earlier in relation to bolus passage through the cricopharyngeus. In addition, the cat exhibits a marked superior constrictor bulge at the onset of the pharyngeal contractile wave and summation of the peristaltic waves in the esophagus, whereas the human adult does not. Feline swallow physiology is more similar to that of the human infant than that of human adults.

A randomized community trial of prepackaged and homemade oral rehydration therapies

OBJECTIVE

To compare the effectiveness of prepackaged oral rehydration solutions with homemade cereal-based oral rehydration therapy in the treatment of acute childhood diarrhea in children younger than 5 years.

BACKGROUND

In Ethiopia, approximately 40% of all mortality in children younger than 5 years, or over 200,000 annual deaths, is attributable to acute childhood diarrhea. Less than 15% of the episodes of acute childhood diarrhea are treated with oral rehydration solutions.

SUBJECTS

Two hundred ninety-one children younger than 5 years with acute childhood diarrhea.

METHODS

A randomized field trial comparing the effectiveness of an entirely homemade cereal-based oral rehydration therapy (HC-ORT, n = 103) with two alternative prepackaged salt solutions, a glucose-based oral rehydration solution (G-ORS, n = 98) and a cereal-based oral rehydration solution (C-ORS, n = 90), in the treatment of mild to moderate acute childhood diarrhea in children younger than 5 years.

RESULTS

Subjects in the HC-ORT group demonstrated equivalent or better weight gain than those in the C-ORS or G-ORS groups at 24, 48, 72, and 96 hours following the onset of treatment. The beneficial weight-gain effect of HC-ORT was most pronounced in infants younger than 12 months, following adjustment for demographic and baseline clinical characteristics. Compliance with ORT use through 96 hours was significantly better among caretakers of children receiving HC-ORT. Minor errors in the preparation of these oral rehydration regimens occurred more frequently among caretakers preparing either of the cereal-based ones.

CONCLUSIONS

That HC-ORT is an effective, culturally more acceptable alternative to G-ORS or C-ORS. The implementation of well-monitored, community-based HC-ORT programs in less developed countries is recommended.

The health consequences of intrauterine growth retardation in southwestern Ethiopia

Although over 90% of low birth weight deliveries occur in the developing world, knowledge of its occurrence and consequences are largely based on studies in developed populations. The aim of this investigation was to determine the health consequences of intrauterine growth retardation (IUGR) among an historical cohort of children delivered in a regional hospital located in southwestern Ethiopia. Following a census of all births over a three year period 116 full-term, IUGR and normal birth weight (NBW) matched pairs between 3 and 40 months of age were identified. IUGR children were found to be at elevated risk for moderate to severe malnutrition [relative risk (RR) = 2.26 (1.15,4.43)], frequent illnesses (RR = 1.29 (1.13, 1.46)), and current illness (RR 1.52 (1.10, 2.09)). Catch-up growth among IUGR children did not occur. A steady decline in the growth of NBW children resulted in similar anthropometric outcomes by 2 years of age between the two groups.