Defining the physical properties of corn grown under drought-stressed conditions and the associated energy and nutrient content for swine

Historically high temperatures and low rainfall during the 2012 growing season resulted in drought-stressed conditions in much of the U.S. corn belt. The objective of this experiment was to investigate the impact of these conditions on the composition and energy content in corn and determine if relationships exist among corn quality measurements, chemical composition, and digestibility of energy. Twenty-eight samples of corn from the 2012 drought-stressed crop (DS), plus 2 representative corn samples from the 2011 crop (CNTRL), were collected in Iowa and Illinois using yield as an initial screen for drought impact. Yields ranged from 2.5 to 14.8 t/ha. Each sample was graded by an official of the U.S. grain inspection agency and analyzed for 1,000 kernel weight, kernel density, ether extract, starch, GE, NDF, and CP content. Diets were formulated using each of the 30 corn samples and were fed at 2.6 times the estimated maintenance energy requirement according to the . Sixty individually housed barrows (PIC 359 × C29; 34.2 ± 0.2 kg initial BW) were randomly allotted in an incomplete crossover design to 30 diets across 4 periods. Diet and fecal samples were analyzed to determine DE values. Both ME and NE values were then calculated from DE values using methods developed by and , respectively. Mean DE, ME, and NE values between the CNTRL and DS were not different (3.72 vs. 3.68 Mcal/kg, respectively, 3.66 vs. 3.62 Mcal/kg, respectively, and 2.92 vs. 2.87 Mcal/kg, respectively; > 0.10). Comparing CNTRL with DS, there were no differences ( > 0.10) in ether extract (4.07 vs. 3.96%), CP (8.56 vs. 9.18%), or starch (70.5 vs. 69.5%). However, ADF and NDF were higher in the DS (2.23 and 8.19%, respectively) when compared with CNTRL (1.89 and 6.92%, respectively; < 0.001 and = 0.015, respectively). Small but significant correlations were observed between DE and NDF ( = -0.51, = 0.008), kernel density ( = 0.51, = 0.007), and percent damaged kernels ( = 0.41, = 0.031). No statistically significant correlations were observed between DE and starch or ADF content or between DE and test weight. We can conclude that corn grown in drought-stressed conditions has energy content similar to corn grown under more favorable conditions and, therefore, can be successfully used in swine diets. Furthermore, NDF proved to be superior to fat, starch, and ADF content in explaining the variation in corn energy content.

Can aerobic treadmill training reduce the effort of walking and fatigue in people with multiple sclerosis: a pilot study

Impaired mobility in multiple sclerosis (MS) is associated with high-energy costs and effort when walking, gait abnormalities, poor endurance and fatigue. This repeated measures trial with blinded assessments investigated the effect of treadmill walking at an aerobic training intensity in 16 adults with MS. The intervention consisted of 12 sessions of up to 30 minutes treadmill training (TT), at 55–85% of age-predicted maximum heart rate. The primary outcome measure was walking effort, measured by oxygen consumption (mL/kg per metre), during treadmill walking at comfortable walking speed (CWS). Associated changes in gait parameters using the ‘Gait-Rite’ mat, 10-m time and 2-minute distance, and Fatigue Severity Scale were examined. Following training, oxygen consumption decreased at rest (P = 0.008), CWS increased (P = 0.002), and 10-m times (P = 0.032) and walking endurance (P = 0.020) increased. At increased CWS, oxygen consumption decreased (P = 0.020), with a decreased time spent in stance in the weaker leg (P = 0.034), and a greater stride distance with the stronger leg (P = 0.044). Reported fatigue levels remained the same. Aerobic TT presents the opportunity to alter a motor skill and reduce the effort of walking, whilst addressing cardiovascular de-conditioning, thereby, potentially reducing effort and fatigue for some people with MS.

Surgical Pulmonary Embolectomy: Experience in a Series of 37 Consecutive Cases

BACKGROUND

Massive pulmonary embolism is a poorly tolerated condition. Treatment options in this condition include anticoagulation and primary reperfusion therapy - systemic thrombolysis, catheter based treatments or surgical embolectomy. There is little data on the relative efficacy of each treatment.

METHODS

The preoperative characteristics and outcomes of patients referred for surgical embolectomy between 2000-2014 was reviewed. Echocardiography was performed in the majority of patients before and after surgery.

RESULTS

Thirty-seven patients underwent pulmonary embolectomy between 2000-2014. One patient died within 30 days, another before leaving hospital. All other patients were alive at the time of follow-up (survival 94.6% at median 36 months). Median ventilation time was 24hours. Median hospital length of stay was 10.5 days. There was echocardiographic evidence of severe right ventricular strain (increased size and decreased function) before surgery, which was significantly improved to within the normal range by discharge, and follow-up.

CONCLUSIONS

Surgical embolectomy is a safe procedure, with low mortality, improved postoperative right ventricular function and pulmonary pressure, and good long-term outcome. Early relief of a large proportion of the clot burden can be life-saving. There should be consideration for its use as an initial treatment strategy in patients with massive or submassive pulmonary embolus with a large burden of proximal clot. A multidisciplinary approach for the treatment of these patients is required.

The status of orofacial cleft care in Ghana

Orofacial Clefts (OFC) are common congenital facial anomalies. The study seeks to determine the status of care for OFC patients in Ghana. Currently, in addition to the Ministry of Health, there are six Non-Governmental Organizations, which are dedicated to the provision of logistics for the management of cleft patients. As it is possible there could be OFC endemic areas in Ghana, sensitization of the population of the condition and management of this anomaly should be promoted. Persons of OFCs are faced with known challenges, which result in negative self-image that affect their quality of life. Hence educating the general public, in particular pregnant women who access antenatal care in health facilities may reduce ill effects associated with the anomaly. Genetic studies of the anomaly should also be encouraged to help decrease the incidence.

Importance of Fungicide Seed Treatment and Environment on Seedling Diseases of Cotton

The importance of fungicide seed treatments on cotton was examined using a series of standardized fungicide trials from 1993 to 2004. Fungicide seed treatments increased stands over those from seed not treated with fungicides in 119 of 211 trials. Metalaxyl increased stands compared to nontreated seed in 40 of 119 trials having significant fungicide responses, demonstrating the importance of Pythium spp. on stand establishment. Similarly, PCNB seed treatment increased stands compared to nontreated seed for 44 of 119 trials with a significant response, indicating the importance of Rhizoctonia solani in stand losses. Benefits from the use of newer seed treatment chemistries, azoxystrobin and triazoles, were demonstrated by comparison with a historic standard seed treatment, carboxin + PCNB + metalaxyl. Little to no stand improvement was found when minimal soil temperatures averaged 25°C the first 3 days after planting. Stand losses due to seedling pathogens increased dramatically as minimal soil temperatures decreased to 12°C and rainfall increased. The importance of Pythium increased dramatically as minimal soil temperature decreased and rainfall increased, while the importance of R. solani was not affected greatly by planting environment. These multi-year data support the widespread use of seed treatment fungicides for the control of the seedling disease complex on cotton.

First Report of the Soybean Frogeye Leaf Spot Fungus (Cercospora sojina) Resistant to Quinone Outside Inhibitor Fungicides in North America

Quinone outside inhibitor (QoI; also known as strobilurin) fungicides sometimes are applied to soybean (Glycine max) fields to help manage frogeye leaf spot of soybean (caused by Cercospora sojina) in the United States. In August 2010, soybean leaflets exhibiting severe frogeye leaf spot symptoms were collected from a field in Lauderdale County, TN that had been treated twice with pyraclostrobin during that growing season. The field had been planted into soybean annually since at least 2008, and a QoI fungicide had been applied to the field in each of those years. Fifteen single-spore isolates of C. sojina were recovered from the affected soybean leaflets. These isolates were identified as C. sojina based on the observed symptoms on the soybean leaflets and the morphology and size of conidiophores and conidia (3). In addition, DNA was extracted from the cultures, PCR amplification of the small subunit rDNA and internal transcribed spacer (ITS) region was conducted (2), and the resulting PCR product was sequenced at the Keck Biotechnology Center at the University of Illinois, Urbana. The resulting nucleotide sequences were compared with sequences deposited in the nucleotide database ( http://www.ncbi.nlm.nih.gov ) and showed highest homology to sequences of C. sojina. The isolates were tested for their sensitivity to technical-grade formulations of the QoI fungicides azoxystrobin, pyraclostrobin, and trifloxystrobin with an in vitro conidial germination assay with fungicide + salicylhydroxamic acid (SHAM)-amended potato dextrose agar as described by Bradley and Pedersen (1). The effective concentration at which 50% conidial germination was inhibited (EC₅₀) was determined for all 15 C. sojina isolates, with mean values of 3.1644 (2.7826 to 4.5409), 0.3297 (0.2818 to 0.6404), and 0.8573 (0.3665 to 2.5119) μg/ml for azoxystrobin, pyraclostrobin, and trifloxystrobin, respectively. When compared with previously established mean EC₅₀ values of C. sojina baseline isolates (4), EC₅₀ values of the C. sojina isolates collected from the Lauderdale County, TN soybean field were approximately 249- to 7,144-fold greater than the EC₅₀ values of the baseline isolates. These results indicate that all isolates recovered from the Lauderdale County, TN soybean field were highly resistant to QoI fungicides. To our knowledge, this is the first report of QoI fungicide resistance occurring in C. sojina, and surveys for additional QoI fungicide-resistant C. sojina isolates are needed to determine their prevalence and geographic distribution. In light of these findings, soybean growers in Tennessee and adjacent states should consider utilizing alternative frogeye leaf spot management practices such as planting resistant cultivars, rotating to nonhost crops, and tilling affected soybean residue (3). References: (1) C. A. Bradley and D. K. Pedersen. Plant Dis. 95:189, 2011. (2) N. S. Lord et al. FEMS Microbiol. Ecol. 42:327, 2002. (3) D. V. Phillips. Page 20 in: Compendium of Soybean Diseases. 4th ed. G. L. Hartman et al., eds. The American Phytopathological Society, St. Paul, MN, 1999. (4) G. Zhang et al. Phytopathology (Abstr.) 100(suppl.):S145, 2010.

Perceived quality of maternal care in childhood and structure and function of mothers' brain

Animal studies indicate that early maternal care has long-term effects on brain areas related to social attachment and parenting, whereas neglectful mothering is linked with heightened stress reactivity in the hippocampus across the lifespan. The present study explores the possibility, using magnetic resonance imaging, that perceived quality of maternal care in childhood is associated with brain structure and functional responses to salient infant stimuli among human mothers in the first postpartum month. Mothers who reported higher maternal care in childhood showed larger grey matter volumes in the superior and middle frontal gyri, orbital gyrus, superior temporal gyrus and fusiform gyrus. In response to infant cries, these mothers exhibited higher activations in the middle frontal gyrus, superior temporal gyrus and fusiform gyrus, whereas mothers reporting lower maternal care showed increased hippocampal activations. These findings suggest that maternal care in childhood may be associated with anatomy and functions in brain regions implicated in appropriate responsivity to infant stimuli in human mothers.

Regulation of the synthesis of cyclic glucan in Xanthomonas campestris by a diffusible signal molecule

The rpf gene cluster of Xanthomonas campestris pv. campestris is involved in the co-ordinate positive regulation of the production of extracellular enzymes and the extracellular polysaccharide xanthan. Several of the rpf genes are involved in a regulatory system involving the small diffusible molecule DSF (for diffusible signal factor). Synthesis of DSF requires RpfF, and a two-component sensory transduction system involving RpfC has been implicated in the perception of the signal and signal transduction. Here we show that mutations in both rpfF and rpfC lead to reductions in the levels of cyclic glucan. The levels of cyclic glucan synthetase in membrane preparations from rpfF and rpfC mutants were, however, unaltered from the wild-type. Similar alterations in the level of cyclic glucan without changes in cyclic glucan synthetase activity were seen when wild-type bacteria were exposed to osmotic stress. These results extend the range of cellular functions subject to regulation by the rpf genes and DSF system.

Viability and stability of biological control agents on cotton and snap bean seeds

Cotton and snap bean were selected for a multi-year, multi-state regional (south-eastern USA) research project to evaluate the efficacy of both commercial and experimental bacterial and fungal biological control agents for the management of damping-off diseases. The goal for this portion of the project was to determine the viability and stability of biological agents after application to seed. The biological seed treatments used included: (1) Bacillaceae bacteria, (2) non-Bacillaceae bacteria, (3) the fungus Trichoderma and (4) the fungus Beauveria bassiana. Seed assays were conducted to evaluate the following application factors: short-term (< or = 3 months) stability after seed treatment; quality (i.e. isolate purity); compatibility with chemical pesticides and other biocontrol agents; application uniformity between years and plant species. For the bacterial treatments, the Bacillaceae genera (Bacillus and Paenibacillus) maintained the greatest population of bacteria per seed, the best viability over time and the best application uniformity across years and seed type. The non-Bacillaceae genera Burkholderia and Pseudomonas had the least viability and uniformity. Although Beauveria bassiana was only evaluated one year, the seed fungal populations were high and uniform. The seed fungal populations and uniformity for the Trichoderma isolates were more variable, except for the commercial product T-22. However, this product was contaminated with a Streptomyces isolate in both the years that it was evaluated. The study demonstrated that Bacillaceae can be mixed with Trichoderma isolates or with numerous pesticides to provide an integrated pest control/growth enhancement package.

Induction of hydroxycinnamoyl-tyramine conjugates in pepper by Xanthomonas campestris, a plant defense response activated by hrp gene-dependent and hrp gene-independent mechanisms

Inoculation of pepper leaves, Capsicum annuum cv. Early Calwonder ECW 10R, with strains of Xanthomonas campestris led to an accumulation of the phenolic conjugates feruloyltyramine (FT) and p-coumaroyltyramine (CT) 24 h postinoculation in nonhost- and gene-for-gene-determined incompatible interactions with X. campestris pv. campestris and X. campestris pv. vesicatoria, respectively. In contrast, neither compound was detected in compatible interactions with X. campestris pv. vesicatoria. The accumulation of FT and CT was preceded by an increase in the extractable activity of tyrosine decarboxylase as well as increases in the transcription of genes encoding phenylalanine ammonia-lyase and tyramine hydroxycinnamoyl transferase. No such changes were detected in compatible interactions. Very rapid accumulation of FT and CT occurred (4 h postinoculation) in pepper in response to a X. campestris pv. campestris mutant carrying a deletion of the hrp gene cluster. In contrast, hrp mutants of X. campestris pv. vesicatoria failed to elicit the production of FT and CT. These observations suggest the existence of hrp gene-dependent and -independent activation mechanisms of a defense response involving hydroxycinnamoyltyramines.

Disruption of the helix-u-turn-helix motif of MutS protein: loss of subunit dimerization, mismatch binding and ATP hydrolysis

The DNA mismatch repair protein, MutS, is a dimeric protein that recognizes mismatched bases and has an intrinsic ATPase activity. Here, a series of Taq MutS proteins having C-terminal truncations in the vicinity of a highly conserved helix-u-turn-helix (HuH) motif are assessed for subunit oligomerization, ATPase activity and DNA mismatch binding. Those proteins containing an intact HuH region are dimers; those without the HuH region are predominantly monomers in solution. Steady-state kinetics of truncated but dimeric MutS proteins reveals only modest decreases in their ATPase activity compared to full-length protein. In contrast, disruption of the HuH region results in a greatly attenuated ATPase activity. In addition, only dimeric MutS proteins are proficient for mismatch binding. Finally, an analysis of the mismatch repair competency of truncated Escherichia coli MutS proteins in a rifampicin mutator assay confirms that the HuH region is critical for in vivo function. These findings indicate that dimerization is critical for both the ATPase and DNA mismatch binding activities of MutS, and corroborate several key features of the MutS structure recently deduced from X-ray crystallographic studies.

Low serum S100β protein levels following coronary artery surgery with or without cardiopulmonary bypass

BACKGROUND

S100beta protein has been used as a serum marker of brain injury during cardiac surgery. Previous studies may have been confounded by the re-transfusion of shed mediastinal blood, which has a high concentration of S100beta.

AIM

To examine serum S100beta levels in coronary artery surgery patients in whom re-transfusion of shed mediastinal blood was avoided, and to compare levels with and without cardiopulmonary bypass (CPB).

METHODS

Serum S100beta levels were measured preoperatively, pre-heparin, post-protamine and 24 h postoperatively in 31 patients undergoing elective coronary artery surgery with (n = 14) or without (n = 17) CPB. The postoperative values were compared to their preoperative controls using two-tailed paired t-tests.

RESULTS

There was a minor increase in serum S100beta post-protamine in the CPB group only (0.41 ng/mL; P < 0.01). All other levels in both groups were within normal limits.

CONCLUSIONS

Coronary artery surgery without CPB is not associated with an increase in serum S100beta. The observed increase in the CPB group was four- to ninefold lower than levels previously reported. A possible explanation for the lower level was the avoidance of retransfusing shed mediastinal blood. If elevated S100beta levels are thought to represent a cerebral insult caused by CPB, the magnitude of the insult might be less than previously assumed.

Lipopolysaccharides and plant responses to phytopathogenic bacteria

Abstract Treatment of the leaves of pepper (Capsicum annuum) cv. ECW10R with lipopolysaccharides (LPS) from both plant pathogenic and enteric bacteria alters several aspects of the plant response to subsequent inoculation with phytopathogenic xanthomonads. LPS pre-treatment prevents the hypersensitive reaction caused by strains of Xanthomonas campestris pv. vesicatoria carrying the avirulence gene avrBs1 (a gene-for-gene interaction) and by X. campestris pv. campestris (a non-host interaction). Associated with this effect are the earlier synthesis of feruloyl- and coumaroyl-tyramine, phenolic conjugates that are potentially antimicrobial, and alterations in the expression patterns of genes for some pathogenesis-related (PR) proteins. Similar effects on the timing of phenolic conjugate synthesis are also seen in the compatible interaction with X. campestris pv. vesicatoria, although the level of the response is lower. Recognition of LPS by plants may allow expression of resistance in the absence of catastrophic tissue damage. However phytopathogenic bacteria may have evolved mechanisms to suppress the effects of LPS (and of other non-specific bacterial elicitors) on plant cells.

The rhythm of relating in a paradigm of wholeness

The importance of relating to the rhythm of another person's interactive pattern is integral to helping people move through illness and disruptive events. At times of chaos, a person's rhythm may be irregular and difficult to sense, but transformation to higher levels of organization often occurs at far-from-equilibrium states. Nurses should develop a tolerance for ambiguity and uncertainty and "hang in there" with clients until a new rhythm emerges.

Protect the health of your health care worker

This article reviews the many health and safety risks that confront health care workers every day and lists the various regulations that administrators need to understand and implement to provide for the well-being of hospital employees. In an age of growing public awareness of health and safety issues and an increase in litigation covering such issues, this article demonstrates how crucial it is for administrators to take the offensive to ensure that their hospitals are in full compliance with all health and safety regulations. This article describes possible health hazards in various hospital departments, cites appropriate restrictions and guidelines, both governmental and JCAHO, and offers suggestions for remediation.

Drug therapy before coronary artery surgery: nitrates are independent predictors of mortality and beta-adrenergic blockers predict survival

We conducted this study to evaluate whether there is an association between preoperative drug therapy and in-hospital mortality in patients undergoing coronary artery graft surgery. We collected data on 1593 consecutive patients undergoing coronary artery surgery. The relative risk of in-hospital mortality was determined by logistic regression with in-hospital mortality as the dependent variable, and independent variables that included known risk factors and preoperative cardioactive or antithrombotic drug treatment, i.e., age; left ventricular function; left main coronary artery disease; urgent priority; gender; previous cardiac surgery; concurrent cardiovascular surgery; chronic lung disease; creatinine concentration; hemoglobin concentration; diabetes; hypertension; cerebrovascular disease; recent myocardial infarction; prior vascular surgery; number of arteries bypassed; and regular daily treatment with beta-blockers, aspirin within 5 days, calcium antagonists, angiotensin converting enzyme (ACE) inhibitors, digoxin, or warfarin. In-hospital mortality was 3.3%. The relative risk of in-hospital mortality (with 95% confidence intervals of the relative risk) associated with the following drug treatments was: nitrates 3.8 (1.5-9.6), beta-blockers 0.4 (0.2-0.8), aspirin within 5 days 1.0 (0.5-1.9), calcium antagonists 1.1 (0.6-2.1), ACE inhibitors 0.8 (0.4-1.5), digoxin 0.7 (0.2-1.8), and warfarin 0.3 (0.1-1.6). We conclude that in-hospital mortality is positively associated with preoperative nitrate therapy and negatively associated with beta-adrenergic blocker therapy. A significant association between in-hospital mortality and the preoperative use of calcium antagonists, ACE inhibitors, aspirin, digoxin, and warfarin was not confirmed.

IMPLICATIONS

We examined the association between common drug treatments for ischemic heart disease and short-term survival after cardiac surgery using a statistical method to adjust for patients' preoperative medical condition. Death after surgery was more likely after nitrate therapy and less likely after beta-blocker therapy.

Differential association of uracil DNA glycosylase with SIVSM Vpr and Vpx proteins

The HIV-1 Vpr protein is a virion-associated protein which has been shown to facilitate infection of nondividing macrophages and additionally to alter cell cycle and proliferation status of the infected host cell. HIV-1 Vpr also was recently shown to associate with the DNA repair enzyme uracil DNA glycosylase (UDG). This association with a DNA repair enzyme is intriguing given that nonprimate lentiviruses encode a dUTPase, which, like UDG, minimizes the misincorporation of uracil into DNA and is important for virus replication in primary nondividing macrophages but not in dividing cells. This raises the possibility that the dependence upon Vpr for infection of nondividing macrophages may relate to its ability to interact with UDG. Members of the HIV-2/SIVSM group encode, in addition to Vpr, a related protein called Vpx. We previously demonstrated (Fletcher et al., 1996) that Vpx of HIV-2/SIVSM is necessary and sufficient for infection of primary macaque macrophages, while Vpr is not required for macrophage infection but governs cell cycle arrest. Here, we extend on these observations by demonstrating that Vpr, but not Vpx of HIV-2/SIVSM, associates with UDG, which suggests that Vpx facilitates infection of macrophages by a UDG-independent mechanism.

Experiencing the whole

This personal essay describes the author's theoretical and methodological journey in her quest for understanding of wholeness as a basic concept of the discipline of nursing. She asserts that wholeness, seen as pattern and meaning of the life process, is not amenable to external measurement and control, but is learned from within by a hermeneutic dialectic process with clients. The emphasis on the evolution of undivided wholeness is consistent with a unitary-transformative paradigm of the discipline.

The activity of lipid A and core components of bacterial lipopolysaccharides in the prevention of the hypersensitive response in pepper

Pre-treatment of leaves of pepper (Capsicum annuum) with lipopolysaccharide (LPS) preparations from enteric bacteria and Xanthomonas campestris could prevent the hypersensitive response caused by an avirulent X. campestris strain. By use of a range of deep-rough mutants, the minimal structure in Salmonella LPS responsible for the elicitation of this effect was determined to be lipid A attached to a disaccharide of 2-keto-3-deoxyoctulosonate; lipid A alone and the free core oligosaccharide from a Salmonella Ra mutant were not effective. For Xanthomonas, the core oligosaccharide alone had activity although lipid A was not effective. The results suggest that pepper cells can recognize different structures within bacterial LPS to trigger alterations in plant response to avirulent pathogens.

Risk prediction in coronary artery surgery: a comparison of four risk scores

OBJECTIVE

To determine which of four proposed risk scores best predicts immediate outcome of cardiac surgery.

DESIGN

Observational cohort study.

SETTING

Sir Charles Gairdner Hospital (a university teaching hospital), Perth, Western Australia, 18 March 1993 to 5 March 1996.

SUBJECTS

927 consecutive patients undergoing surgery for coronary artery disease.

OUTCOME MEASURES

Patient risk scores (by methods of Parsonnet et al., Higgins et al., Tremblay et al. and Tu et al.); in-hospital mortality; postoperative hospital stay > 14 days; receiver operating characteristic (ROC) curves comparing sensitivity and specificity in predicting adverse outcomes for each risk score.

RESULTS

In-hospital mortality rate was 3.5% and mean postoperative hospital stay was 10.7 days. The four scores had similar predictive abilities, with mean areas under the ROC curves (95% confidence intervals) for mortality and postoperative stay > 14 days, respectively: 0.70 (0.62-0.78) and 0.70 (0.65-0.75) for the Parsonnet score; 0.68 (0.59-0.77) and 0.70 (0.64-0.75) for the Higgins score; 0.68 (0.59-0.77) and 0.67 (0.62-0.73) for the Tremblay score; and 0.68 (0.60-0.76) and 0.69 (0.64-0.75) for the Tu score.

CONCLUSION

Any of the scores may be used to estimate perioperative risk and to compare outcome between coronary surgery units, but none has sufficient specificity and sensitivity to identify specific individuals who will experience an adverse outcome. Further development of risk assessment is needed before adverse outcome can be accurately predicted in cardiac surgical patients.

Acute renal failure in cardiac surgical patients, potentiated by gentamicin and calcium

A retrospective study in coronary artery bypass graft patients was undertaken to assess the effect of gentamicin and a bypass prime with a high calcium on the incidence of renal failure. Patients who received both Haemaccel (polygeline, Hoechst Marion Roussel) (calcium concentration 6.25 mmol/l) in the bypass prime and gentamicin perioperatively had a higher incidence of renal failure compared with those who received only Haemaccel (P = 0.005), only gentamicin (P = 0.002) or neither (P = 0.0001). We suggest that the combination be avoided in this group of patients.

Nuclear import and cell cycle arrest functions of the HIV-1 Vpr protein are encoded by two separate genes in HIV-2/SIV(SM)

The vpr genes of human and simian immunodeficiency viruses (HIV/SIV) encode proteins which are packaged in the virus particle. HIV-1 Vpr has been shown to mediate the nuclear import of viral reverse transcription complexes in non-dividing target cells (e.g. terminally differentiated macrophages), and to alter the cell cycle and proliferation status of the infected host cell. Members of the HIV-2/SIV(SM) group encode, in addition to Vpr, a related protein called Vpx. Because these two proteins share considerable sequence similarity, it has been assumed that they also exhibit similar functions. Here, we report that the functions of Vpr and Vpx are distinct and non-redundant, although both proteins are components of the HIV-2/SIV(SM) virion and reverse transcription complex. Characterizing SIV(SM) proviruses defective in one or both genes, we found that Vpx is both necessary and sufficient for the nuclear import of the viral reverse transcription complex. In contrast, Vpr, but not Vpx, inhibited the progression of infected host cells from the G2 to the M phase of the cell cycle. Thus, two independent functions of the HIV-1 Vpr protein are encoded by separate genes in HIV-2/SIV(SM). This segregation is consistent with the conservation of these genes in HIV-2/SIV(SM) evolution, and underscores the importance of both nuclear transport and cell cycle arrest functions in primate lentivirus biology.

Lipopolysaccharide from Xanthomonas campestris induces defense-related gene expression in Brassica campestris

Purified lipopolysaccharide (LPS) from Xanthomonas campestris pv. campestris induced accumulation of transcript for beta-1,3-glucanase in turnip at concentrations of 1 micrograms/ml. The lipid A-inner core structure was required for activity but the O-antigen had no role. We suggest that release of LPS in planta triggers expression of at least some defense-related genes.

An instrument for measuring differentiated nursing practice

Newman's trilevel model of professional nursing practice specifies the roles of staff nurse, team leader and clinician/case manager. Essential elements of the roles are time and place orientation, assignment of clients, nursing observation and communication and nursing interventions. A pilot study to establish validity, clarity and fit of items was administered to three groups of nurses to fit the trilevel model categories through assessment of their job descriptions. Percentage of response indicated the instrument's ability to differentiate the roles.

Polyclonal rabbit antisera that detect the Vpr protein of SIVSM and SIVMAC on immunoblots of purified virions

Antisera suitable for detection of SIVSM or SIVMAC Vpr proteins on Western blots of purified virions are currently not available. We have expressed the Vpr protein of SIVSMPBj1.9 in a gst-based prokaryotic expression system and used it to raise polyclonal antisera in rabbits. Two immune sera were obtained that specifically recognized both cell- and virion-associated Vpr protein on immunoblots of three different SIV isolates (SIVSMPBj1.9, SIVMACBK28, and SIVMAC239). Because Vpr is believed to play an important role in HIV/SIV replication and pathogenesis, these reagents will allow the extension of functional analyses of this protein to a broader spectrum of viruses. Both antisera and the gst-Vpr expression plasmid have been submitted to the NIAID AIDS Research and Reagent Program and are available to interested investigators.

Theory for nursing practice

This article chronicles the development of nursing theory and research over the past 30 years as it parallels the author's own development as a theorist-researcher. Dorothy Johnson and Martha Rogers are considered the contemporary forerunners of a shift from an emphasis on medical knowledge to an emphasis on distinctly nursing knowledge. The paradigm shift Rogers called for was largely misunderstood at the time of its inception, resulting in attempts to force holistic thinking into reductionistic methods of research. The epistemology of nursing research lagged behind the ontology of the discipline. Moreover, the absence of an agreed-upon focus of the discipline created a void in the development of theory specific to nursing practice. The author asserts that the focus and paradigm of the discipline of nursing are now clear. The core, purpose, and societal commitment of nursing as a practice discipline are captured in the phrase, caring in the human health experience. Research methods that reflect a unitary, transformative paradigm make it possible to develop theory that structures practice.

Defense-related gene induction in Brassica campestris in response to defined mutants of Xanthomonas campestris with altered pathogenicity

We have studied the induction of beta-1,3-glucanase (BGL) in turnip following inoculation with pathovars of Xanthomonas campestris and derived mutants. BGL transcript accumulated more rapidly in leaves in the incompatible interactions with X. c. pv. armoraciae and X. c. pv. raphani than in the compatible interaction with X. c. pv. campestris. No accumulation was seen in response to wounding or inoculation with water, salicylic acid, or Escherichia coli. Deletion of the hrp cluster from the X. campestris pathovars caused a reduction in the level of transcript accumulation; these effects were much more pronounced in the incompatible than in the compatible interaction, in which bacterial growth was also affected. In the compatible interaction, bacterial growth and BGL transcript accumulation were not altered by mutation of bacterial genes involved in the regulation of the synthesis of extracellular enzymes or their export from the cell, or by mutation of the structural genes for extracellular endoglucanase and serine protease. Mutation of genes involved in the synthesis of extracellular polysaccharide or lipopolysaccharide reduced bacterial survival in planta, so that the numbers were between two and three orders of magnitude lower than the number of wild-type bacteria. However, total BGL transcript accumulation after inoculation with these mutants was about 80% of that seen after inoculation with the wild-type bacteria, suggesting that one aspect of the role of extracellular polysaccharide and lipopolysaccharide in pathogenesis is to mask the presence of bacteria in the plant. Our results are discussed in the context of work on other plant-microbe interactions.

Urinary biological monitoring markers of anticancer drug exposure in oncology nurses

People handling anticancer drugs or their wastes may absorb these potent genotoxic agents. The aim of this study was to determine the utility of some general urinary markers among 24 female oncology nurses handling these drugs in comparison with 25 "unexposed" nurses. The markers were the Salmonella typhimurium reverse and forward mutation assays, total thioethers, and D-glucaric acid. The reverse mutation assay was the most specific and sensitive marker for anti-cancer drug exposure. Use of the marker battery was no great advantage as a screening tool relative to use of the reverse mutation assay alone. Better recording of work practices in nurse work logs would have improved interpretation of results.

The paradox of HIV/AIDS as expanding consciousness

A heuristic approach employing Newman's method for pattern identification was used to examine the theory of health as expanding consciousness in persons with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). Themes derived from the interview of nine gay men portrayed a pattern of alienation during childhood, followed by a breaking away from family, and progressing to cycles of aloneness and searching. Recognition of HIV/AIDS in their lives brought them to a turning point of more meaningful connectedness. This pattern is viewed as expanding consciousness and possibly a phenomenon of cultural evolution.

Differential expression of conserved protease genes in crucifer-attacking pathovars of Xanthomonas campestris

Strains of Xanthomonas campestris pathovars armoraciae and raphani, which cause leaf spotting diseases in brassicas, produce a major extracellular protease in liquid culture which was partially purified. The protease (PRT 3) was a zinc-requiring metalloenzyme and was readily distinguishable from the two previously characterized proteases (PRT 1 and PRT 2) of X. campestris pv. campestris by the pattern of degradation of beta-casein and sensitivity to inhibitors. PRT 3 was produced at a low level in the vascular brassica pathogen X. campestris pv. campestris (five strains tested), in which PRT 1 and PRT 2 predominate. In contrast, expression of PRT 1, a serine protease, could not be detected in the six tested strains of the leaf spotting mesophyll pathogens. However, all these strains had DNA fragments which hybridized to a prtA probe and which probably carry a functional prtA (the structural gene for PRT 1). The structural gene for PRT 3 (prtC) was cloned by screening a genomic library of X. campestris pv. raphani in a protease-deficient X. campestris pv. campestris strain. Subcloning and Tn5 mutagenesis located the structural gene to 1.2 kb of DNA. DNA fragments which hybridized to the structural gene were found in all strains of the crucifer-attacking X. campestris pathovars tested as well as in a number of other pathovars. Experiments in which the pattern of protease production of the pathovars was manipulated by introduction of cloned genes into heterologous pathovars suggested that no determinative relationship exists between the pattern of protease gene expression and the (vascular or mesophyllic) mode of pathogenesis.

Antibiotic prophylaxis in cardiac operations

This clinical trial, which was composed of 1,031 adults undergoing cardiac operations, compared the efficacy of a single dose of 1 g of ceftriaxone with a 48-our regimen consisting of flucloxacillin and gentamicin. There was no significant difference (p = 0.89) in the overall incidence of major infections: 30 of 515 patients (5.8%; 95% confidence interval, 5.4% to 6.2%) taking ceftriaxone and 29 of 516 patients (5.6%; 95% confidence interval, 5.2% to 6.0%) taking flucloxacillin and gentamicin. Subgroup analyses, with a lower statistical power, failed to show a significant difference between patients who received ceftriaxone and those who received flucloxacillin/gentamicin: major sternal wound infections arose in 2.7% of the patients taking ceftriaxone versus 1.6% in those on the 48-hour regimen (p = 0.20) and major limb wound infections arose in 4.2% and 5.4%, respectively (p = 0.44). Single-dose prophylaxis was associated with fewer intravenous administrations (864 doses versus 9,570 doses) and cost less (A$17,248 versus A$78,510). Although the regimen that included gentamicin was associated with the greatest biochemical impairment of renal function, the overall toxicity for both groups was low. We conclude that a single dose of ceftriaxone provided cost-efficient prophylaxis for adults undergoing cardiac operations when compared with a 48-hour regimen of gentamicin and flucloxacillin. The general principle revealed by our data is that the short-term administration of an appropriate antibiotic regimen represents optimal prophylaxis for patients undergoing cardiac procedures.

Management of bone loss in revision total hip arthroplasty using custom cementless femoral components

Forty-seven consecutive revision total hip arthroplasties were performed using porous ingrowth custom-made prostheses designed from plain radiographs and computed tomography scans. At an average follow-up period of 30 months (range, 2-4 years), one revision has been required for loosening. The average Harris pain score was 39 and the average total score was 84 at the last follow-up evaluation. Complications included nine cases (19%) with intraoperatively detected fractures of the proximal femur treated with cerclage wires and seven cases (15%) with subsidence greater than 3 mm. There were no postoperative infections and only two dislocations. At the time of surgery local particulate bone graft was used in all cases. Thirty-four percent required structural graft to restore bone stock; no case required grafting for prosthesis stability. Management of bone loss in total hip arthroplasty using a custom cementless prosthesis appears to provide an attractive alternative to massive bone grafting.

Nurse recruitment: strong health and safety programs make a difference

Today's nurse is looking for more than just a challenging position with appropriate compensation. The security afforded by a safe and healthy working environment in the hospital may actually be the deciding factor in a nurse's choice of employer.