Data driven optimization of sexual assault case processing.

In recent years, several forensic laboratories have noted an increase in the number of sexual assault cases submitted for testing, often leading to longer turnaround times. In that context, forensic laboratories may be interested in reviewing their procedures to increase productivity. Here, we present two different strategies that were put in place in our laboratory. First, we changed the way sexual assault evidence kits (SAEK) are processed by implementing an optimized workflow that prioritizes the internal samples (vaginal, anal, and oral). This new procedure allowed for a drastic decrease in turnaround time, while maintaining a similar investigative power. Secondly, we used data from casework to target cases and samples that were likely to yield biological material from the perpetrator, in an attempt to avoid dedicating time and effort to cases for which there is a very low probability of obtaining foreign DNA evidence. Among other things, we looked at the likelihood of obtaining DNA from the perpetrator when the complainant reported the use of a condom, has showered after the assault or when the complainant has no memory of the assault. Results show that those circumstances do not dramatically decrease the probability of finding DNA from the perpetrator.

Sustaining eHealth engagement in a multi-year weight gain prevention intervention.

INTRODUCTION: Digital tools are widely used and effective in weight management interventions; however, usage declines over time. Strategies to promote continued engagement should be explored. We examined the effects of offering additional modes of weight reporting as well as periodic online campaigns to promote engagement, assessed by frequency of weight reporting, in a weight gain prevention study for young adults. METHODS: Using an observational design, self-reported weights obtained through digital tools were pooled across participants assigned to two interventions (n = 312). Analysis examined the effects before during and after introduction of an additional reporting modality (email) and for three time-limited refresher campaigns over 2 years. RESULTS: Adding a new modality to the three existing modes (SMS, web, and mobile web) increased weight reporting as well as the number of modalities participants used to report weights. The use of several modes of reporting was associated with more weights submitted (p < 0.01). Refresher campaigns did not increase the proportion of participants reporting; however, the number of weights submitted during the 4-week campaigns increased compared with the 4 weeks before the campaign (p's ≥ 0.45, <0.001, respectively). CONCLUSION: Using multiple digital modalities and periodic campaigns shows promise for sustaining engagement with weight reporting in a young adult population, and incorporating such strategies may mitigate typical declines in eHealth and mHealth interventions.

Motivation for weight loss and association with outcomes in a lifestyle intervention: comparing emerging adults to middle aged adults.

BACKGROUND: Emerging adults (EAs) ages 18-25 are at high risk for overweight/obesity, but little is known about their motivations for weight loss or how these may differ from those of middle aged adults (MAs) and relate to treatment outcomes. PURPOSE: The purpose of this study was to examine potential differences in weight loss motivations between EAs and MAs and determine the association between motivation and engagement/outcomes in a weight loss trial. METHODS: Data were pooled from two behavioural weight loss interventions: one targeting EAs (n = 52) and one targeting MAs ages 40-60 (n = 101). Motivation, attendance, dietary self-monitoring and weight change were measured in both trials across 3 months of treatment. RESULTS: Emerging adults were less motivated by health concerns than MAs (p < .05). Motivation to lose weight in order to improve appearance was of similar importance for both MAs and EAs but demonstrated differential associations with treatment variables. Appearance-related motivation was associated with higher program engagement for MA but was associated with poorer weight loss for EAs. Overall engagement, weight loss and retention were worse for EAs than MAs (ps < .05). CONCLUSIONS: Specific motivations for weight loss were associated with treatment outcomes, but effects varied by developmental stage. Findings of this study highlight the potential differences between motivation to initiate weight loss efforts and motivation to successfully change weight-related behaviours. Future research should explore methods for intervening directly on motivation within the context of weight control interventions among EAs.

Increased placental phospholipase A2 gene expression and free F2-isoprostane levels in response to oxidative stress in preeclampsia.

Vasoactive eicosanoids such as thromboxane (TX) A2 and F2-isoprostanes (F2-isoPs) were shown to be increased in the preeclamptic placenta. Only one of the 64 possible isomers of F2-isoPs derived from the oxidation of arachidonic acid was investigated in the placenta so far. F2-isoPs are released from membrane phospholipids by phospholipases A2 (PLA2) and were shown to act on the TXA2 receptor (TBXA2R). However, the PLA2 deregulated in preeclampsia (PE) remains to be determined. In this study, we analyzed the concentrations of six isomers of F2-isoPs; 8-iso-PGF2α, 8-iso-15(R)-PGF2α, 15(R)-PGF2α, iPF2α-IV, iPF2α-VI, 5-iPF2α-VI and the concentrations of the stable metabolites of TXA2, TXB2, by high performance liquid chromatography coupled with tandem mass spectrometry in placentas of PE (n = 17) and normotensive (n = 15) pregnancies according to the biopsy site: peri-insertion or periphery. In the same biopsies, relative mRNA expression of PLA2G2A, PLA2G4A, PLA2G5, PLA2G7, the PLA2 receptor (PLA2R1), the TXA2 synthase and TBXAR2 were measured by quantitative RT-PCR. We observed similar concentrations of total F2-isoP isomers between groups whereas higher concentrations (>40%) of free F2-isoP were observed for all isomers (p ≤ 0.033) in PE than normotensive controls. As expected, we also observed higher placental concentrations of TXB2 in PE (p = 0.005). Interestingly, we concomitantly found higher mRNA expression of secretory PLA2G2A (p = 0.010), PLA2G5 (p = 0.038) and TBXA2R (p = 0.023) in PE than normotensive placentas. In sum, deregulated PLA2 could potentially be implicated in freeing F2-isoP which could participate in local hypertension observed in the PE placenta through the TX pathway.

Frequency of self-weighing and weight loss outcomes within a brief lifestyle intervention targeting emerging adults.

BACKGROUND: Frequent self-weighing is associated with better weight loss and maintenance among adults. Emerging adults ages 18-25 rarely enroll in behavioural weight loss trials, and thus, little is known about their willingness to engage in frequent self-weighing and its association with weight loss in this age group. PURPOSE: The purpose of this study is to examine the frequency of self-weighing among 18-25-year-old over the course of a brief lifestyle intervention and to determine the association between frequent self-weighing and weight loss. METHODS: Emerging adults (EA) ages 18-25 [N = 52, 54% racial/ethnic minority, 79% female, BMI = 34.2 (5.4)] enrolled in a 3-month lifestyle intervention with structure and content modified for EA. Benefits of frequent self-weighing were presented; participants were encouraged to weigh themselves at least weekly and no more than daily. Assessments occurred at baseline and post-treatment (3 months). RESULTS: At baseline, a majority of participants (63.5%) reported self-weighing less than once a week. Frequency of self-weighing increased over treatment (p < 0.001), with 42.9% weighing weekly and 38.2% weighing several times per week or more (i.e. frequent self-weighing) at 3 months. Frequent self-weighing was associated with greater weight loss (p = 0.03) and greater likelihood of achieving 5% weight loss (p = 0.01) at post-treatment. CONCLUSIONS: Frequent self-weighing may be a viable approach to promoting self-regulation during the high-risk developmental period of emerging adulthood. Consistent with findings among other adult samples, frequent self-weighing was associated with greater weight losses.

A mixed methods approach to improving recruitment and engagement of emerging adults in behavioural weight loss programs.

OBJECTIVE: Emerging adults ages 18-25 are at high risk for obesity, but are markedly underrepresented in behavioural weight loss (BWL) programs and experience lower engagement and retention relative to older adults. PURPOSE: To utilize a mixed methods approach to inform future efforts to effectively recruit and engage this high-risk population in BWL programs. METHODS: We used a convergent parallel design in which quantitative and qualitative data were given equal priority. Study 1 (N = 137, age = 21.8 + 2.2, BMI = 30.1 + 4.7) was a quantitative survey, conducted online to reduce known barriers and minimize bias. Study 2 (N = 7 groups, age = 22.3 + 2.2, BMI = 31.5 + 4.6) was a qualitative study, consisting of in person focus groups to gain greater depth and identify contextual factors unable to be captured in Study 1. RESULTS: Weight loss was of interest, but weight itself was not a central motivation; an emphasis on overall lifestyle, self-improvement and fitness emerged as driving factors. Key barriers were time, motivation and money. Recruitment processes should be primarily online with messages tailored specifically to motivations and preferences of this age group. Preferences for a program were reduced intensity and brief, hybrid format with some in-person contact, individual level coaching, experiential learning and peer support. Key methods of promoting engagement and retention were autonomy and choice, money and creating an optimal default. CONCLUSIONS: An individually tailored lifestyle intervention that addresses a spectrum of health behaviours, promotes autonomy and emphasizes activity and fitness may facilitate recruitment and engagement in this population better than traditional BWL protocols.

Comparison of strength development with resistance training and combined exercise training in type 2 diabetes.

Resistance training has been shown to increase strength in type 2 diabetes; however, it is unclear if combining resistance and aerobic training (A + R) impedes strength development compared with resistance training only (R). The purpose of this study was to compare changes in strength with A + R vs R in individuals with type 2 diabetes. We evaluated monthly workload increments in participants from the Diabetes Aerobic and Resistance Exercise clinical trial. Muscular strength was assessed through training volumes and as the eight repetition maximum (8-RM) at 0, 3, and 6 months. Both groups increased their upper and lower body volumes monthly for 6 months. The relative increase in upper body workload in R was significantly greater than A + R at 4 months (161 ± 11% vs 127 ± 11%, P = 0.009) and at 6 months of training (177 ± 11% vs 132 ± 11%, P = 0.008). Both groups had improvements in 8-RM workloads at 3 and 6 months. The resistance training group had a significantly greater improvement in 8-RM on the leg press at 6 months compared with A + R (80 ± 11% vs 58 ± 8%, P = 0.045). Both R and A + R improved strength with a 6-month training program; however, increases in strength may be greater with resistance training alone compared with performing both aerobic and resistance training.

Associations between physical fitness and HbA1(c) in type 2 diabetes mellitus.

AIM/HYPOTHESIS: In people with type 2 diabetes, exercise improves glucose control (as reflected in HbA1(c)) and physical fitness, but it is not clear to what extent these exercise-induced improvements are correlated with one another. We hypothesised that reductions in HbA1(c) would be related: (1) to increases in aerobic fitness and strength respectively in patients performing aerobic training or resistance training; and (2) to changes in strength and aerobic fitness in patients performing aerobic and resistance training. METHODS: We randomly allocated 251 type 2 diabetes patients to aerobic, resistance, or aerobic plus resistance training, or to a sedentary control group. Peak oxygen consumption VO2(peak), workload, treadmill time and ventilatory threshold measurements from maximal treadmill exercise testing were measured at baseline and 6 months. Muscular strength was measured as the maximum weight that could be lifted eight times on the leg press, bench press and seated row exercises. RESULTS: With aerobic training, significant associations were found between changes in both VO2(peak) (p = 0.040) and workload (p = 0.022), and changes in HbA1(c.) With combined training, improvements in VO2(peak) (p = 0.008), workload (p = 0.034) and ventilatory threshold (p = 0.003) were significantly associated with changes in HbA1(c.) Increases in strength on the seated row (p = 0.006) and in mid-thigh muscle cross-sectional area (p = 0.030) were significantly associated with changes in HbA1(c) after resistance exercise, whereas the association between increases in muscle cross-sectional area and HbA1(c) in participants doing aerobic plus resistance exercise (p = 0.059) was of borderline significance. CONCLUSIONS/INTERPRETATION: There appears to be a link between changes in fitness and HbA1(c). The improvements in cardiorespiratory fitness with aerobic training may be a better predictor of changes in HbA1(c) than improvements in strength.

Epidemiological and postmortem findings in 262 red squirrels (Sciurus vulgaris) in Scotland, 2005 to 2009.

Postmortem and virological examinations for squirrelpox virus (SQPV) were carried out on 262 red squirrels (Sciurus vulgaris) found dead or moribund in Scotland between September 2005 and July 2009, to determine the likely causes of death and highlight factors that might be threats to the red squirrel population. Most of the squirrels were submitted from Dumfries and Galloway, and 71 per cent of them were adults. Road traffic accidents, squirrelpox, trauma or starvation were responsible for death in a large proportion (73 per cent) of the squirrels. Thin or emaciated body condition was associated with deaths resulting from pneumonia SQPV infection and starvation, and with the presence of external parasites. There were differences between age groups with regard to the cause of death; a large proportion of juveniles died of starvation, whereas a large proportion of subadults and adults died in road traffic accidents. SQPV infection was associated with the presence of external parasites, but was not associated with the sex of the animals.

Are standard behavioral weight loss programs effective for young adults?

OBJECTIVE: To compare the enrollment, attendance, retention and weight losses of young adults in behavioral weight loss (BWL) programs with older participants in the same trials. METHODS: Data were pooled from three NIH-funded adult BWL trials from two clinical centers in different regions of the country (total N=298); young adults were defined as those aged 18-35 years. Both young adults and adults were compared on session attendance, retention at the 6-month assessment, weight loss and physical activity at 6 months. RESULTS: Young adults represented 7% of the sample, attended significantly fewer sessions than did adults (52 vs 74%, respectively; P<0.001) and were less likely to be retained for the 6-month assessment (67 vs 95%, respectively; P<0.05). Controlling for demographic variables, study and baseline weight, the mean weight losses achieved were significantly less for young adults compared with adults (-4.3 kg (6.3) vs -7.7 kg (7.0), respectively; P<0.05); fewer young adults achieved > or =5% weight loss at 6 months compared with older participants (8/21 (38%) vs 171/277 (62%); P<0.05). After controlling for session attendance, differences in the mean weight loss were not significant (P=0.81). Controlling for baseline values, study and demographics, changes in total physical activity over the initial 6 months of treatment were less for young adults compared with adults, but these differences only approached statistical significance (P=0.07). CONCLUSION: These data indicate that standard programs do not meet the weight control needs of young adults. Research is urgently required to improve recruitment and retention efforts with this high-risk group.

Mutational and expression analysis of the chromosome 12p candidate tumor suppressor genes in pre-B acute lymphoblastic leukemia.

Allelic losses on chromosome 12p12-13 are associated with childhood acute lymphoblastic leukemia (ALL) and several solid neoplasias, suggesting the presence of a tumor suppressor locus. The recent construction of a transcription map of this locus has enabled the identification of eight genes, of which five were previously known: ETV6, BCL-G, LRP6, MKP-7, and CDKN1B. The three other candidate genes, LOH12CR1, LOH12CR2, and LOH12CR3, have no known functions. To evaluate whether one (or more) of the candidate genes is the actual target of the 12p12-13 deletions, we examined the genomics and the expression status of these genes in ALL patients. Although we found nine DNA variants in these genes, no inactivating mutations were found in the leukemia cells of patients with 12p hemizygous deletions. Expression analysis revealed that most 12p hemizygously deleted samples also carried a t(12;21) translocation, of which none expressed ETV6 from the nontranslocated allele. Furthermore, we observed one case of t(12;21) without deletion of ETV6, in which the expression of this gene was greatly reduced, indicating a different mechanism of inactivation. None of the other genes showed a significant decrease in expression, suggesting that ETV6 is indeed the target of deletions in ALL patients.

Phosphatidylinositol-3' kinase is not required for mitogenesis or internalization of the Flt3/Flk2 receptor tyrosine kinase.

Flt3/Flk2 is a receptor tyrosine kinase that is expressed on early hematopoietic progenitor cells. Flt3/Flk2 belongs to a family of receptors, including Kit and colony-stimulating factor-1R, which support growth and differentiation within the hematopoietic system. The Flt3/Flk2 ligand, in combination with other growth factors, stimulates the proliferation of hematopoietic progenitors of both lymphoid and myeloid lineages in vitro. We report that phosphatidylinositol 3'-kinase (PI3K) binds to a unique site in the carboxy tail of murine Flt3/Flk2. In distinction to Kit and colony-stimulating factor-1R, mutant receptors unable to couple to PI3K and expressed in rodent fibroblasts or in the interleukin 3-dependent cell line Ba/F3 provide a mitogenic signal comparable to wild-type receptors. Flt3/Flk2 receptors that do not bind to PI3K also normally down-regulate, a function ascribed to PI3K in the context of other receptor systems. These data point to the existence of other unidentified pathways that, alone or in combination with PI3K, transduce these cellular responses following the activation of Flt3/Flk2.

Selective determination of histamine by flow injection analysis.

A flow injection analysis (FIA) method for the determination of histamine is described. Control of reaction timing allows exploitation of a transient, chemical-kinetic increase in selectivity that occurs when o-phthalaldehyde reacts with histamine. The molar fluorescence ratio (selectivity) of histamine/histidine reaches a maximum value of 800 in 32 s, precluding the need for separation of histamine from histidine, spermidine, and other potential interferences in biological samples. On-line dilution prevents matrix effects and affords a linear response up to approximately 4.45 mM histamine, or 500 mg of histamine free base/100 g. Under these conditions the detection limit (3 times peak-to-peak baseline noise) is 5.5 pg (corresponding to 0.60 mg of histamine free base/100 g of sample) and throughput is 60 injections per hour. The high sensitivity and high selectivity of the method allow the rapid determination of histamine in fish with minimal sample conditioning and will find application in the determination of endogenous histamine as well, such as in blood plasma and brain tissue.

Determination of sulfite in food by flow injection analysis.

A method is described for the determination of sulfite levels in food products by flow injection analysis (FIA). The method is based on the decolorization of malachite green by SO2, which is isolated from the flowing sample stream by means of a gas diffusion cell. The FIA method has a detection limit in food sample extracts of 0.1 ppm SO2 (3 times peak height of blank), which corresponds to 1-10 ppm SO2 in a food product, depending on the extraction procedure used. At the 5 ppm SO2 level in a food extract, the precision of replicate injections is +/- 1-2%. The method was tested on a variety of both sulfite-treated and untreated food products and the results compared favorably with those obtained by the Monier-Williams, colorimetric (pararosaniline), and enzymatic (sulfite oxidase) methods. The average differences from the FIA results were 19, 11, and 12%, respectively, for those samples (n = 12) above 50 ppm SO2. At lower levels the results were somewhat more erratic due to inaccuracies of the various methods at low concentrations.

Primary ovarian pregnancy associated with the dalkon shield IUD.

This is the third case report of an ovarian pregnancy associated witth the Dalkon shield intrauterine device (IUD). The recent theories of mechanism of action of the IUD are described. The incidence of ectopic pregnancy with the IUD is discussed. The authors stress the fact of being alert to the possibility of an ectopic ovarian pregnancy with the IUD in the absence of suggestive signs and symptoms of pregnancy.

Clinical experience with presumed hemangioma of the choroid: radioactive phosphorus uptake studies as an aid in differential diagnosis.

A total of 27 cases of choroidal hemangioma was evaluated with radioactive phosphorus uptake studies. In each case the diagnosis of malignant melanoma was initially entertained, but the 32P test was unequivocally negative in every instance. Follow-up studies in every case have supported the clinical diagnosis. In 22 patients, the lesion was treated with photocoagulation, and in every treated case the serous macular detachment disappeared. The importance of early and correct clinical diagnosis is stressed, since these are salvageable and potentially useful seeing eyes.