Modeling correlated noise is necessary to decode uncertainty.

Brain decoding algorithms form an important part of the arsenal of analysis tools available to neuroscientists, allowing for a more detailed study of the kind of information represented in patterns of cortical activity. While most current decoding algorithms focus on estimating a single, most likely stimulus from the pattern of noisy fMRI responses, the presence of noise causes this estimate to be uncertain. This uncertainty in stimulus estimates is a potentially highly relevant aspect of cortical stimulus processing, and features prominently in Bayesian or probabilistic models of neural coding. Here, we focus on sensory uncertainty and how best to extract this information with fMRI. We first demonstrate in simulations that decoding algorithms that take into account correlated noise between fMRI voxels better recover the amount of uncertainty (quantified as the width of a probability distribution over possible stimuli) associated with the decoded estimate. Furthermore, we show that not all correlated variability should be treated equally, as modeling tuning-dependent correlations has the greatest impact on decoding performance. Next, we examine actual noise correlations in human visual cortex, and find that shared variability in areas V1-V3 depends on the tuning properties of fMRI voxels. In line with our simulations, accounting for this shared noise between similarly tuned voxels produces important benefits in decoding. Our findings underscore the importance of accurate noise models in fMRI decoding approaches, and suggest a statistically feasible method to incorporate the most relevant forms of shared noise.

Genetic correlations between live yearling bull and steer carcass traits adjusted to different slaughter end points. 1. Carcass lean percentage.

We studied genetic relationships between age-constant live yearling beef bull growth and ultrasound traits and steer carcass traits with dissected steer carcass lean percentage adjusted to slaughter age-, HCW-, fat depth-, and marbling score-constant end points. Three measures of steer carcass lean percentage were used. Blue Tag lean percentage (BTLean) was predicted from HCW, fat depth, and LM area measurements. Ruler lean percentage (RulerLean) was predicted from carcass fat depth and LM depth and width measurements. Dissected lean percentage (DissLean) was based on dissection of the 10-11-12th rib section. Both BTLean (h2 = 0.30 to 0.44) and DissLean (h2 = 0.34 to 0.39) were more heritable than RulerLean (h2 = 0.05 to 0.14) at all end points. Genetic correlations among DissLean and RulerLean (rg = 0.61 to 0.70), DissLean and BTLean (rg = 0.56 to 0.72), and BTLean and RulerLean (rg = 0.59 to 0.90) indicated that these traits were not genetically identical. Adjusting Diss-Lean to different end points changed the magnitude, but generally not the direction, of genetic correlations with indicator traits. Ultrasound scan-age-constant live yearling bull lean percentage estimates were heritable (h2 = 0.26 to 0.42) and genetically correlated with each other (rg = 0.68 to 0.99) but had greater correlations with DissLean at slaughter age (rg = 0.24 to 0.48) and HCW (rg = 0.16 to 0.40) end points than at fat depth (rg = -0.08 to 0.13) and marbling score (rg = 0.02 to 0.11) end points. Scan-age-constant yearling bull ultrasound fat depth also had stronger correlations with DissLean at slaughter age (rg = -0.34) and HCW (rg = -0.25) than at fat depth (rg = -0.02) and marbling score (rg = -0.03) end points. Yearling bull scan-age-constant ultrasound LM area was positively correlated with DissLean at all endpoints (rg = 0.11 to 0.23). Genetic correlations between yearling bull LM method 1 width (rg = 0.38 to 0.56) and method 2 depth (rg = -0.17 to -0.38) measurements with DissLean suggested that LM shape may be a valuable addition to genetic improvement programs for carcass lean percentage at slaughter age, HCW, and fat depth constant end points. At all end points, steer carcass fat depth (rg = -0.60 to -0.64) and LM area (rg = 0.48 to 0.59) had stronger associations with DissLean than did corresponding live yearling bull measurements. Improved methods that combine live ultrasound and carcass traits would be beneficial for evaluating carcass lean percentage at fat depth or marbling score end points.

Genetic correlations between live yearling bull and steer carcass traits adjusted to different slaughter end points. 2. Carcass fat partitioning.

Partial carcass dissection data from 1,031 finished crossbred beef steers were used to calculate heritabilities and genetic correlations among subcutaneous, intermuscular, and body cavity fat percentage and marbling score adjusted to slaughter age-, HCW-, fat depth-, and marbling score-constant endpoints. Genetic correlations were also calculated among these fat partitions with live growth and ultrasound traits evaluated in yearling beef bulls (n = 2,172) and steer carcass measurements. Heritabilities of the different fat partitions ranged from 0.22 (marbling score-constant body cavity fat) to 0.46 (HCW-constant marbling score). Genetic correlations between subcutaneous fat and intermuscular fat (rg = 0.16 to 0.32) and between intermuscular fat and body cavity fat (rg = 0.38 to 0.50) were more highly associated than subcutaneous fat and body cavity fat (rg = -0.08 to 0.05), indicating that fat depots are not under identical genetic control. Adjusting fat depots to different end points affected the magnitude but usually not the sign of the genetic correlations. Bull postweaning gain was associated with intermuscular (-0.24 to -0.35), body cavity (-0.24 to -0.29), and marbling fat (-0.24 to -0.39) in steers. Bull hip height was associated with body cavity (-0.20 to -0.29) and marbling fat (-0.20 to -0.47) in steers. Bull ultrasound fat depth was associated with subcutaneous (0.11 to 0.29), intermuscular (0.05 to 0.36), body cavity (0.27 to 0.49), and marbling fat (0.27 to 0.73) in steers. Bull ultrasound intramuscular fat percentage was associated with subcutaneous (-0.22 to -0.44) and intermuscular fat (-0.06 to 0.31) in steers. Bull ultrasound LM area was associated with body cavity (-0.25 to -0.31) and marbling fat (-0.25 to -0.30) in steers. Ultrasound LM width measurements were negatively correlated with subcutaneous fat (rg = -0.09 to -0.18), intermuscular fat (rg = -0.53 to -0.61), body cavity fat (rg = -0.63 to -0.69), and marbling score (rg = -0.75 to -0.87) at slaughter age-, HCW-, and fat depth-constant endpoints; correlations were generally lower at a marbling score-constant end point (rg = 0.07 to -0.49). Ultrasound indicator traits measured in seedstock may be useful in altering fat partitioning in commercial beef carcasses.

Neonatal sepsis workups in infants >/=2000 grams at birth: A population-based study.

BACKGROUND: Few data are available on the outcome of neonatal sepsis evaluations in an era when intrapartum antibiotic therapy is common. METHODS: We identified all newborns weighing >/=2000 g at birth who were ever evaluated for suspected bacterial infection at 6 Kaiser Permanente hospitals between October 1995 and November 1996, reviewed their records and laboratory data, and tracked them to 1 week after discharge. We analyzed the relationship between key predictors and the presence of neonatal bacterial infection. RESULTS: Among 18 299 newborns >/=2000 g without major congenital anomalies, 2785 (15.2%) were evaluated for sepsis with a complete blood count and/or blood culture. A total of 62 (2.2%) met criteria for proven, probable, or possible bacterial infection: 22 (.8%) had positive cultures and 40 (1.4%) had clinical evidence of bacterial infection. We tracked all but 10 infants (.4%) to 7 days postdischarge. There were 67 rehospitalizations (2.4%; 2 for group B streptococcus bacteremia). Among 1568 infants who did not receive intrapartum antibiotics, initial asymptomatic status was associated with decreased risk of infection (adjusted odds ratio [AOR]:.26; 95% confidence interval [CI]:.11-.63), while chorioamnionitis (AOR: 2. 40; 95% CI: 1.15-5.00), low absolute neutrophil count (AOR: 2.84; 95% CI: 1.50-5.38), and meconium-stained amniotic fluid (AOR: 2.23; 95% CI: 1.18-4.21) were associated with increased risk. Results were similar among 1217 infants who were treated, except that maternal chorioamnionitis was not significantly associated with neonatal infection. CONCLUSIONS: The risk of bacterial infection in asymptomatic newborns is low. Evidence-based observation and treatment protocols could be defined based on a limited set of predictors: maternal fever, chorioamnionitis, initial neonatal examination, and absolute neutrophil count. Many missed opportunities for treating mothers and infants exist.

Exploring the connection between pornography and sexual violence.

This article examines the relationship between sexual violence and pornography. Data about women's experiences of sexual violence and their abusers' use of pornography were collected at a rape crisis center from 100 survivors. Findings include that 28% of respondents reported that their abuser used pornography and that for 12% of the women, pornography was imitated during the abusive incident. The effects of pornography on women's experiences of sexual violence are discussed.

Comparison of primary sensitization of naive human T cells to varicella-zoster virus peptides by dendritic cells in vitro with responses elicited in vivo by varicella vaccination.

Dendritic cells (DC) are potent APC during primary and secondary immune responses. The first objective of this study was to determine whether human DC mediate in vitro sensitization of naive CD4+ T cells to epitopes of the immediate early 62 (IE62) protein of varicella zoster virus (VZV). The induction of CD4+ T cell proliferative responses to eight synthetic peptides representing amino acid sequences of the VZV IE62 protein was assessed using T cells and DC from VZV-susceptible donors. The second objective was to compare in vitro responses of naive T cells with responses to VZV peptides induced in vivo after immunization with varicella vaccine. T cell proliferation was induced by three peptides, P1, P4, and P7, in 71-100% of the donors tested before and after vaccination using DC as APC. Monocytes were effective APC for VZV peptides only after immunization. Two peptides, P2 and P8, induced naive T cell proliferation less effectively and were also less immunogenic for T cells from vaccinated or naturally immune donors. T cell recognition of specific peptides was concordant between naive, DC-mediated responses, and postvaccine responses using monocytes as APC in 69% of comparisons (p = 0.05; chi2); the predictive value of a positive response to an IE62 peptide before immunization for T cell sensitization in vivo was 82%. These observations indicate that primary T cell responses detected in vitro using DC as APC may be useful to characterize the potential immunogenicity of viral protein epitopes in vivo.

A potential association between the BM 1500 microsatellite and fat deposition in beef cattle.

The obese gene was hypothesized as a candidate gene for fat characteristics in beef cattle. The BM 1500 microsatellite, near the obese gene, was characterized in 158 purebred beef bulls for which carcass trait information was available. Four breeds were included in the analyses-Angus, Charolais, Hereford, and Simmental. Four alleles were found. Lengths were approximately 138, 147, 149, and 140 bp with genotypic frequencies of 0.47, 0.44, 0.09, and 0.003 respectively. The carcass traits %rib fat, %rib lean, average fat, and grade fat were found to be significantly associated with the different alleles. The presence of the 138-bp allele in the genotype of an animal is correlated with higher levels of fat, whereas the 147-bp allele has the opposite effect. The 149-bp allele was found in low numbers, and a homozygote was never identified. Hereford and Angus bulls had the greatest frequencies of 138-bp alleles (Hereford = 0.57, Angus = 0.59), while Charolais and Simmental had a greater proportion of 147-bp alleles (Charolais = 0.54, Simmental = 0.58). This information may aid cattle producers in selecting cattle for markets that differ in the amount of fat required.

Use of real-time ultrasound to evaluate live animal carcass traits in young performance-tested beef bulls.

Young bulls were ultrasonically scanned to 1) study breed differences for 12th rib fat depth (USFAT) and longissimus muscle area (USREA), 2) evaluate the nature and predictability of USFAT and USREA development, and 3) determine the effect of age (YFAT and YREA, respectively) or weight (WREA) adjustments on USFAT and USREA. Angus (AA), Charolais (CH), Hereford (HH), Shorthorn (SS), and Simmental (SM) bulls (n = 886) were studied in 2 yr at two stations. Breed differences were observed for end of test USFAT (AA = SS > HH > CH = SM, P < .05) and USREA (CH = SM > SS = AA > HH, P < .05). Within-breed coefficients of variation were 29.8 to 48.4% for end of test USFAT and from 9.0 to 10.8% for end of test USREA. In most bulls, USFAT development was neither linear nor quadratic (P > .05), but USREA development was linear (P < .05). Prediction equations were characterized by low r2 and high residual standard deviation (RSD) values, although those for d-84 USREA had r2 values from .63 to .70 and RSD values from 4.09 to 5.80 cm2. High associations were obtained between end of test USFAT with YFAT (r = .83 to .91, P < .05) and USREA with YREA (r = .74 to .84, P < .05) but not for end of test USREA with WREA (r = .31 to .56, P < .05). These results indicate that end of test ultrasound measurements may be a useful addition to performance testing programs.

Diagnosing and treating depression and neurological problems in the elderly: a multidisciplinary approach.

Depression and neurological problems in the elderly often go undiagnosed. A multidisciplinary health care team can combine their expertise, accurately diagnose such problems, and often help the patient move in the direction of recovery.

Early intervention and aggressive management of infected median sternotomy incision: a review of 2242 open-heart procedures.

Infected median sternotomy following open-heart surgery is a devastating complication with an incidence of 0.4 to 5 per cent and mortality as high as 80 per cent. Management varies from irrigation, debridement, closure with muscle, and skin flaps. We present our experience of early intervention and aggressive single-stage operative management. A retrospective chart review of all open-heart surgery patients was conducted from September 1984 through September 1994. Of the 2242 patients, 52 had infected median sternotomy incisions (2.3% incidence). The mean length of stay for reconstructive procedures was 18 days. The median interval to detection was 15 days, whereas the median interval to intervention was 4 days. There were five (6.8%) failed procedures and nine (12.3%) staged procedures. There were six deaths (11.5% incidence), one prior to receiving operative intervention. There was one false aneurysm. Single-stage reconstruction is safe, with results better than multistage procedures. It may be safely performed with a high success rate (93%). Early recognition and intervention significantly decreases length of stay.

Safety and immunogenicity of Chiron/Biocine recombinant acellular pertussis-diphtheria-tetanus vaccine in infants and toddlers.

OBJECTIVE: To evaluate the safety and immunogenicity of the recombinant acellular pertussis-diphtheria-tetanus (aPDT) vaccine (C-aPDT, Chiron/Biocine). STUDY DESIGN: This is a randomized blinded trial evaluating the safety and immunogenicity of the recombinant aPDT vaccine (C-aPDT, Chiron/Biocine) in 2000 infant recipients compared with 498 controls who received whole cell diphtheria-pertussis-tetanus (wDPT; Connaught) vaccine at 2, 4 and 6 months of age. In addition the safety and immunogenicity of the same C-aPDT vaccine were evaluated as a booster dose in a subset of the same population when given at 15 to 18 months of age and compared with licensed Lederle aPDT vaccine. RESULTS: The C-aPDT vaccine was associated with very few local or systemic reactions when compared with wDPT. In toddlers the local and systemic side effects observed were similar after either acellular vaccine. When the immunogenicity of the C-aPDT vaccine was compared with the wDPT (Connaught) in infancy, the vaccines were equivalent for anti-diphtheria response, the wDPT developed higher anti-tetanus response and the C-aPDT vaccine was significantly more immunogenic for all other antigens tested. In toddlers the C-aPDT acellular vaccine exhibited equal or improved immunogenicity for antigens tested as compared with Lederle aPDT except for a higher anti-filamentous hemagglutinin response with the Lederle aPDT vaccine. CONCLUSION: The Chiron/Biocine aPDT vaccine offers an improved safety profile as well as improved immunogenicity when compared with a licensed wDPT product.

Tranexamic acid reduces postbypass blood use: a double-blinded, prospective, randomized study of 210 patients.

BACKGROUND: Pharmacologic intervention to minimize postbypass bleeding and blood product transfusions has received increasing attention for both medical and economic reasons. METHODS: Two hundred ten patients were entered into a double-blinded, prospective, randomized study to receive either 10 g of fibrinolytic inhibitor tranexamic acid before incision (n = 104) or 250 mL of placebo saline solution (n = 106). All subjects requiring cardiopulmonary bypass were deemed suitable, including those having first-time coronary bypass grafting, valve replacement, and reoperation. RESULTS: There were no statistically significant differences between the groups with respect to demographic or operative characteristics. The tranexamic acid group had a 48% reduction in 24-hour blood drainage (p < 0.001) and received 69% fewer total units of packed red blood cells, 83% fewer total units of plasma, and 75% fewer platelet transfusion units than controls. Only 13 of 104 tranexamic acid patients received blood products versus 33 of 106 controls (p < 0.001). The incidences of thrombotic complications, perioperative myocardial infarction, renal failure, and neurologic complications were not significantly different between the two groups. The tranexamic acid group had 0% mortality versus 1.9% for controls (not significant). CONCLUSIONS: Tranexamic acid is safe and effective in reducing blood loss and blood use in a wide variety of cardiac surgical patients.

Surviving wife rape: how women define and cope with the violence.

PIP: This article investigates how women define their experiences of marital rape and cope with the violence. The study is based on in-depth interviews conducted among 35 survivors of marital rape. It found out that women's definition of sexual violence often change over the course of the relationship in a similar manner, from seeing the sexual attacks as an aberrant incident, to redefining the incident as rape, to terminating the relationship with a ¿rapist¿. This study further describes the 6 stages through which women pass in coping with the violence, which include entering a violent relationship; managing the violence; experiencing a loss of self; redefining the violence; ending the violence; and recovering from the trauma. This study, however, gives particular attention to understanding how women manage the violence and redefine their experiences as rape. It concludes by acknowledging that marital rape is a serious problem with very real consequences for the women who experience it.^ieng

Age-related differences in cell-mediated immunity to varicella-zoster virus among children and adults immunized with live attenuated varicella vaccine.

Live attenuated varicella vaccine elicits protection against varicella-zoster virus (VZV), but adults require two doses to achieve optimal seroconversion rates. To assess the potential role of cell-mediated immunity (CMI), T cell proliferation to VZV antigen was compared in children and adults. Mean stimulation indices (SI) in two cohorts of 39 children tested 6 weeks after vaccination were 28.6 +/- 6.21 and 22.1 +/- 3.84, whereas 20 adult vaccines had a mean SI of 9.1 +/- 0.99 (P = .04). Vaccinees had significant increases in CMI after a second dose of vaccine. At 1 year, VZV CMI was significantly lower in adults after two doses (10.0 +/- 1.13 vs. 15.6 +/- 1.77; P = .02), even though 82% of children received one dose. Limitations in the adult helper T cell response to VZV antigens may explain the need for booster doses to elicit effective immunity and the more frequent occurrence of varicella when adult vaccines are exposed to wild type virus.

The role of the hospital nursing staff in home health-care services.

Hospital nurses have an important role to play in coordinating the hospital and home-care management of patients discharged from hospital. This role becomes even more vital with the growing emphasis on transferring part or all of the traditional hospital care of some patients to primary carers in the community. This policy enables patients to receive treatments as close to their home as possible, as well as shortening the number of inpatient days. The aim for primary-care workers is to take over everyday responsibility for patients receiving outpatient antimicrobial treatment, while providing all necessary support from a hospital base. For the successful transfer from hospital care to home care, both patient and family must be confident in performing the technical medical actions required. It is the main responsibility of the nurse to allay any patient fears of unforeseen difficulties or problems.

Prevalence of childhood disability in a southern Indian city: independent effect of small differences in social status.

A random sample of mothers living in two neighbourhoods of a southern Indian city were interviewed in order to determine the prevalence of serious disability in children 2-9 years old. These areas were selected because residents constitute either the lowest class or the next higher socioeconomic class (next-to-lowest class), with monthly incomes of US$ 10-15 and 32-42 respectively. A previously validated screening instrument was used with documented sensitivity of 100% and specificity of 95% when applied under similar conditions. Disability was found to be more common among children of the lowest class families (17.2%) when compared with the next-to-lowest class families (8.4%); with an odds ratio (OR) of 2.36 (95% confidence interval (CI): 1.08-3.64). Specific types of disability were examined and found to be consistently more prevalent in the lowest class. These results suggest that comparatively small differences in social status can be associated with important differences in health status.

PIP: Researchers analyzed data on 640 2-9 year old children who lived in either a lowest social status neighborhood or a next to lowest social status neighborhood in Madurai in Tamil Nadu State in India to determine whether small differences at the lowest end of the socioeconomic scale would be associated with differential health status. Interviewers spoke with the families in December 1990 and used a screening tool with 100% sensitivity and 95% specificity previously validated in a community based study in Bangladesh. 17.2% of families in the slum had a child with a disability compared to 8.4% in the next to lowest social class area (odds ratio=2.36 [OR]; p.001). Further disability prevalence was consistently higher among children from the lowest social class, especially sensory (4.8% vs. 0.9%; p=.003), neuromotor (8.1% vs. 3%; p=.005), and cognitive disabilities (3.5% vs. 1.2%; p=.05). In fact, the multiple logistic regression which took in consideration age, gender, number of children in the household, birth order, and social status revealed that the only significant and meaningful relationship affecting childhood disability was lowest social status (OR=2.39). These results demonstrated that the lowest status families were 2.39 times more likely to have disabled children even though the differences in income between the 2 deprived groups was small. The study did not identify what mechanism was responsible for the disparity between the 2 groups, however. The researchers encouraged other studies to identify the mechanism for disability among the lowest social class and yet not among another very resource poor group.

Human T cells recognize multiple epitopes of an immediate early/tegument protein (IE62) and glycoprotein I of varicella zoster virus.

Infection with varicella zoster virus (VZV) elicits persistent cell-mediated immunity directed against the immediate early (IE62) protein and the glycoprotein I (gp I) in most healthy subjects. In these experiments, synthetic peptides corresponding to residues of the IE62 protein and gp I were used to identify linear amino acid sequences of these immunogenic VZV proteins that were recognized by peripheral blood T lymphocytes from VZV-immune individuals of known major histocompatibility complex (MHC) type. All of 12 VZV-immune donors had T-cell proliferative responses, defined as a stimulation index (SI) greater than or equal to 2.0, to at least two of ten synthetic IE62 peptides; the mean number of IE62 peptides recognized by T cells from VZV-immune donors was seven. Five of the ten IE62 peptides stimulated T cells from 75% to 83% of the VZV-immune donors; the other five IE62 peptides were recognized by T cells from 42% to 67% of the subjects. All VZV-immune donors also had T proliferation responses to at least two of ten synthetic gp I peptides; the mean number of peptides recognized was six. Six of the ten gp I peptides were recognized by T cells from 67% to 92% of the VZV-immune donors; the frequency of donors responding to the other gp I peptides ranged from 42% to 58%. None of five nonimmune donors demonstrated T-cell proliferation to any of the IE62 or gp I peptides. A combination of two IE62 peptides provided epitopes that could be recognized by T cells from all twelve VZV-immune donors, regardless of DR type. Similarly, one gp I peptide in combination with either of two other gp I peptides induced proliferation of T cells from all immune subjects. Memory T cells with specificity for multiple short amino acid sequences of the IE62 protein and gp I were detected in subjects who had had primary VZV infection more than 20 years earlier. These observations indicate that natural VZV infection elicits a diverse cell-mediated immune response to viral proteins that is not restricted to only one or two immunodominant regions. Although the usefulness of peptide vaccines remains to be established, multiple epitopes of the IE62 protein and gp I were identified that could be presented by antigen-presenting cells (APC) and recognized by T cells from most subjects in an "outbred" human population.