White matter abnormalities associated with ADHD outcomes in adulthood.

It remains unclear if previously reported structural abnormalities in children with ADHD are present in adulthood regardless of clinical outcome. In this study, we examined the extent to which focal-rather than diffuse-abnormalities in fiber collinearity of 18 major white matter tracts could distinguish 126 adults with rigorously diagnosed childhood ADHD (ADHD; mean age [SD] = 34.3 [3.6] years; F/M = 12/114) from 58 adults without ADHD histories (non-ADHD; mean age [SD] = 33.9 [4.1] years; F/M = 5/53) and if any of these abnormalities were greater for those with persisting ADHD symptomatology. To this end, a tract profile approach was used. After accounting for age, sex, handedness, and comorbidities, a MANCOVA revealed a main effect of group (ADHD < non-ADHD; F[18,155] = 2.1; p = 0.007) on fractional anisotropy (FA, a measure of fiber collinearity and/or integrity), in focal portions of white matter tracts involved in visuospatial processing and memory (i.e., anterior portion of the left inferior longitudinal fasciculus, and middle portion of the left and right cingulum angular bundle). Only abnormalities in the anterior portion of the left inferior longitudinal fasciculus distinguished probands with persisting versus desisting ADHD symptomatology, suggesting that abnormalities in the cingulum angular bundle might reflect "scarring" effects of childhood ADHD. To our knowledge, this is the first study using a tract profile approach to identify focal or widespread structural abnormalities in adults with ADHD rigorously diagnosed in childhood.

Atypical perceptual and neural processing of emotional prosodic changes in children with autism spectrum disorders.

OBJECTIVE: The present study explored the processing of emotional speech prosody in school-aged children with autism spectrum disorders (ASD) but without marked language impairments (children with ASD [no LI]). METHODS: The mismatch negativity (MMN)/the late discriminative negativity (LDN), reflecting pre-attentive auditory discrimination processes, and the P3a, indexing involuntary orienting to attention-catching changes, were recorded to natural word stimuli uttered with different emotional connotations (neutral, sad, scornful and commanding). Perceptual prosody discrimination was addressed with a behavioral sound-discrimination test. RESULTS: Overall, children with ASD (no LI) were slower in behaviorally discriminating prosodic features of speech stimuli than typically developed control children. Further, smaller standard-stimulus event related potentials (ERPs) and MMN/LDNs were found in children with ASD (no LI) than in controls. In addition, the amplitude of the P3a was diminished and differentially distributed on the scalp in children with ASD (no LI) than in control children. CONCLUSIONS: Processing of words and changes in emotional speech prosody is impaired at various levels of information processing in school-aged children with ASD (no LI). SIGNIFICANCE: The results suggest that low-level speech sound discrimination and orienting deficits might contribute to emotional speech prosody processing impairments observed in ASD.

Impaired neural discrimination of emotional speech prosody in children with autism spectrum disorder and language impairment.

Autism spectrum disorders (ASD) are characterized by deficient social and communication skills, including difficulties in perceiving speech prosody. The present study addressed processing of emotional prosodic changes (sad, scornful and commanding) in natural word stimuli in typically developed school-aged children and in children with ASD and language impairment. We found that the responses to a repetitive word were diminished in amplitude in the children with ASD, reflecting impaired speech encoding. Furthermore, the amplitude of the MMN/LDN component, reflecting cortical discrimination of sound changes, was diminished in the children with ASD for the scornful deviant. In addition, the amplitude of the P3a, reflecting involuntary orienting to attention-catching changes, was diminished in the children with ASD for the scornful deviant and tended to be smaller for the sad deviant. These results suggest that prosody processing in ASD is impaired at various levels of neural processing, including deficient pre-attentive discrimination and involuntary orientation to speech prosody.

Evidence-informed healthcare through integration of health research.

A foundational element of modern healthcare is an evidence-based practice. However, the conduct of research to generate evidence and the subsequent application of research findings are viewed by many Canadian healthcare organizations as separate from healthcare delivery. This mindset impedes effective translation of knowledge into practice. In this article, underlying issues that enable this disintegrated model to persist are described, and strategies to help healthcare organizations achieve integration of research are summarized.

Effectiveness of an 8-week exercise programme on pain and specificity of neck muscle activity in patients with chronic neck pain: a randomized controlled study.

BACKGROUND: Although exercise can be effective for relief of neck pain, little is known about the effect of exercise on the neural control of neck muscles. METHODS: A randomized controlled trial was conducted on 46 women with chronic neck pain to investigate the immediate effectiveness of an 8-week exercise programme on pain and directional specificity of neck muscle activity. At baseline, the patients completed questionnaires including the neck disability index (NDI) and performed a circular contraction of their head in the horizontal plane at 15 N force, with continuous change in force direction in the range 0-360°. Electromyography (EMG) was recorded from the sternocleidomastoid (SCM) and splenius capitis (SCap) muscles. Tuning curves of the EMG amplitude were computed, which depicts muscle activity over a range of force directions. The mean point of the tuning curves defined a directional vector, which determined the specificity of muscle activity. Patients were randomly assigned either to a training or control group. RESULTS: A significant between-group difference in the change in NDI was observed. A reduction in NDI was observed following training (pre: 18.2 ± 7.4; post: 14.1 ± 6.5; p < 0.01) but not for the control group (pre: 17.5 ± 6.3; post: 16.6 ± 7.4). The training group showed higher specificity of muscle activity post-intervention (pre: 18.6 ± 9.8%, post: 24.7 ± 14.3%; p < 0.05), whereas no change occurred for the control group (pre: 19.4 ± 11.9%, post: 18.2 ± 10.1%). CONCLUSION: An exercise programme that aims to enhance motor control of the cervical spine improves the specificity of neck muscle activity and reduces pain and disability in patients with neck pain.

Processing of prosodic changes in natural speech stimuli in school-age children.

Speech prosody conveys information about important aspects of communication: the meaning of the sentence and the emotional state or intention of the speaker. The present study addressed processing of emotional prosodic changes in natural speech stimuli in school-age children (mean age 10 years) by recording the electroencephalogram, facial electromyography, and behavioral responses. The stimulus was a semantically neutral Finnish word uttered with four different emotional connotations: neutral, commanding, sad, and scornful. In the behavioral sound-discrimination task the reaction times were fastest for the commanding stimulus and longest for the scornful stimulus, and faster for the neutral than for the sad stimulus. EEG and EMG responses were measured during non-attentive oddball paradigm. Prosodic changes elicited a negative-going, fronto-centrally distributed neural response peaking at about 500 ms from the onset of the stimulus, followed by a fronto-central positive deflection, peaking at about 740 ms. For the commanding stimulus also a rapid negative deflection peaking at about 290 ms from stimulus onset was elicited. No reliable stimulus type specific rapid facial reactions were found. The results show that prosodic changes in natural speech stimuli activate pre-attentive neural change-detection mechanisms in school-age children. However, the results do not support the suggestion of automaticity of emotion specific facial muscle responses to non-attended emotional speech stimuli in children.

Asking about condom use: a key to individualized care when screening for chlamydia.

Chlamydia trachomatis (CT) infection has been a target for both selective and national screening programmes, and Sweden has an opportunistic approach. A national plan of action states that risk groups should be identified and offered risk reduction counselling. Patients attending a drop-in sexually transmitted infection (STI) clinic reception at the University Hospital, Umeå, Sweden, were invited to complete a questionnaire regarding sociodemographic characteristics, symptoms and sexual risk behaviour; all had a CT test taken. A total of 1305 patients were included, 58% men, mean age 27.8 years. CT prevalence was 11%; 51% of those with CT were ≥ 25 years old. Only 5% used a condom during the entire sexual intercourse with their last new/temporary partner. Sexually active inconsistent condom users comprised 62% of the study population and contributed to 81% of the chlamydia infections. Asking whether a condom was used could quickly triage patients into groups with a 'higher risk' (none or inconsistent use of condoms and at least one new/temporary partners), and 'lower risk' (with more consistent condom use, although not always accurate) allowing for individualized care and counselling when screening for chlamydia. Evaluating whether a condom was used throughout the sexual intercourse did not add any useful information.

Postdetonation nuclear debris for attribution.

On the morning of July 16, 1945, the first atomic bomb was exploded in New Mexico on the White Sands Proving Ground. The device was a plutonium implosion device similar to the device that destroyed Nagasaki, Japan, on August 9 of that same year. Recently, with the enactment of US public law 111-140, the "Nuclear Forensics and Attribution Act," scientists in the government and academia have been able, in earnest, to consider what type of forensic-style information may be obtained after a nuclear detonation. To conduct a robust attribution process for an exploded device placed by a nonstate actor, forensic analysis must yield information about not only the nuclear material in the device but about other materials that went into its construction. We have performed an investigation of glassed ground debris from the first nuclear test showing correlations among multiple analytical techniques. Surprisingly, there is strong evidence, obtainable only through microanalysis, that secondary materials used in the device can be identified and positively associated with the nuclear material.

Nanostructured Pt/GC model electrodes prepared by the deposition of metal-salt-loaded micelles.

Novel, nanostructured, carbon-supported Pt model electrodes with homogeneously distributed Pt nanoparticles of uniform size were fabricated and analyzed with respect to their electrochemical properties. For this purpose, Pt-salt-loaded micelles were deposited on a glassy carbon substrate and subsequently exposed to an oxygen plasma and a H2 atmosphere for removal of the polymer carriers and reduction of the Pt salt. The morphology of the resulting nanoparticles and their electrochemical/electrocatalytic properties were characterized by high-resolution scanning electron microscopy, X-ray photoelectron spectroscopy, cyclic voltammetry, and differential electrochemical mass spectrometry for CO electrooxidation. The data demonstrate that this method is generally suited to the production of nanostructured model electrodes with well-defined and independently adjustable particle size and interparticle distance distributions, which are specifically suited for quantitative studies of transport processes in electrocatalytic reactions.

Bioenergetics and diving activity of internesting leatherback turtles Dermochelys coriacea at Parque Nacional Marino Las Baulas, Costa Rica.

Physiology, environment and life history demands interact to influence marine turtle bioenergetics and activity. However, metabolism and diving behavior of free-swimming marine turtles have not been measured simultaneously. Using doubly labeled water, we obtained the first field metabolic rates (FMRs; 0.20-0.74 W kg(-1)) and water fluxes (16-30% TBW day(-1), where TBW=total body water) for free-ranging marine turtles and combined these data with dive information from electronic archival tags to investigate the bioenergetics and diving activity of reproductive adult female leatherback turtles Dermochelys coriacea. Mean dive durations (7.8+/-2.4 min (+/-1 s.d.), bottom times (2.7+/-0.8 min), and percentage of time spent in water temperatures (Tw) < or =24 degrees C (9.5+/-5.7%) increased with increasing mean maximum dive depths (22.6+/-7.1 m; all P< or =0.001). The FMRs increased with longer mean dive durations, bottom times and surface intervals and increased time spent in Tw< or =24 degrees C (all r2> or =0.99). This suggests that low FMRs and activity levels, combined with shuttling between different water temperatures, could allow leatherbacks to avoid overheating while in warm tropical waters. Additionally, internesting leatherback dive durations were consistently shorter than aerobic dive limits calculated from our FMRs (11.7-44.3 min). Our results indicate that internesting female leatherbacks maintained low FMRs and activity levels, thereby spending relatively little energy while active at sea. Future studies should incorporate data on metabolic rate, dive patterns, water temperatures, and body temperatures to develop further the relationship between physiological and life history demands and marine turtle bioenergetics and activity.

Ionization chamber measurements of the half-lives of 24Na, 42K, 76As and 198Au.

Samples of 24Na, 42K, 76As and 198Au were produced by irradiation in the National Institute of Standards and Technology (NIST) reactor, and examined for impurities before and after measurement. Half-life measurements were carried out in the NIST 4pigamma pressurized ionization chamber. The results are compared to presently accepted values and previous NIST measurements.

Two-year outcomes of intrastromal corneal ring segments for the correction of myopia.

OBJECTIVE: To evaluate the safety and efficacy of Intrastromal Corneal Ring Segments (ICRS) for the correction of myopia. DESIGN: Nonrandomized, comparative trial. PARTICIPANTS: Patients enrolled in the United States Food and Drug Administration phase II and phase III clinical trials of the ICRS had best spectacle-corrected visual acuity (BSCVA) of 20/20 or better, myopia of -1.00 to -3.50 diopters (D), and a cylindrical correction of 1.00 D or less as measured by manifest refraction. INTERVENTION: Surgical correction of myopia with an ICRS. MAIN OUTCOME MEASURES: Efficacy was assessed by predictability of refractive outcome (deviation from predicted cycloplegic refraction spherical equivalent), stability of refractive effect, and postoperative uncorrected visual acuity. Safety was assessed by adverse events, maintenance or loss of preoperative BSCVA, and induced manifest refraction cylinder. RESULTS: Four hundred fifty-two patients were enrolled at 11 investigational sites in both studies. Of the 454 surgical attempts, 449 received an ICRS in one eye (0.25, 0.30, and 0.35 mm in 148, 151, and 150 eyes, respectively). First surgeries were attempted in 452 patients. An ICRS was successfully implanted in 447 initial eyes, and 5 surgeries were discontinued. Of the five discontinued surgeries, three patients subsequently exited from the study, and two patients went on to have the ICRS implanted in the second eye, bringing the total number of successful implants to 449 patient eyes. Month 24 postoperative follow-up was completed on 358 patients (80%). At month 24, 328 of 354 eyes (93%) were within +/-1.00 D of predicted refractive outcome. Refraction changed by 1 D or less in 97% of eyes (421/435) between 3 and 6 months after implantation and in 99% (343/348) between months 18 and 24. Before surgery, 87% of eyes (390/448) saw worse than 20/40 uncorrected; 24 months after surgery, 55% of eyes (196/358) saw 20/16 or better, 76% (271/358) saw 20/20 or better, and 97% (346/358) saw 20/40 or better. Although two eyes (2/358; 0.5%) lost two or more lines of BSCVA at 24 months; visual acuity in both was 20/20 or better. Intraoperative complications included anterior corneal surface perforation (three eyes) and anterior chamber perforations (two eyes, one during an attempted exchange procedure); all healed spontaneously without suturing and without loss of BSCVA. The ICRS was repositioned in five eyes to increase correction. Postoperative complications in one eye each were infectious keratitis, shallow segment placement, and loss of two lines of BSCVA at two or more consecutive examinations (subsequently regained). CONCLUSIONS: The ICRS safely, predictably, and effectively reduced or eliminated myopia of -1.00 to -3.50 D. The refractive effect was stable over time.

Distribution and retention of 137Cs in sediments at the Hanford Site, Washington.

137Cesium and other contaminants have leaked from single-shell storage tanks (SSTs) into coarse-textured, relatively unweathered unconsolidated sediments. Contaminated sediments were retrieved from beneath a leaky SST to investigate the distribution of adsorbed 137Cs+ across different sediment size fractions. All fractions contained mica (biotite, muscovite, vermiculatized biotite), quartz, and plagioclase along with smectite and kaolinite in the clay-size fraction. A phosphor-plate autoradiograph method was used to identify particular sediment particles responsible for retaining 137Cs+. The Cs-bearing particles were found to be individual mica flakes or agglomerated smectite, mica, quartz, and plagioclase. Of these, only the micaceous component was capable of sorbing Cs+ strongly. Sorbed 137Cs+ could not be significantly removed from sediments by leaching with dithionite citrate buffer or KOH, but a fraction of the sorbed 137Cs+ (5-22%) was desorbable with solutions containing an excess of Rb+. The small amount of 137Cs+ that might be mobilized by migrating fluids in the future would likely sorb to nearby micaceous clasts in downgradient sediments.

Astigmatism management: ablation patterns.

Treatment of astigmatism is possible with the excimer laser. Results with this technology are more predictable and accurate than with incisional techniques. Ablation profiles differ for the various types of astigmatism, and the best approach is the one in which the least amount of tissue is removed from the cornea. Surgical success requires appropriate preoperative counseling, careful preoperative measurements, and meticulous intraoperative technique. Reported outcomes are excellent and future developments will lead to even better results.

Refractive surgery in the new millennium.

As we stand at the threshold of a new millennium, perhaps nowhere else in the field of ophthalmology is there such a feeling of excitement, enthusiasm, and anticipation as in the subspecialty of refractive surgery. What was once considered an experimental hobby, dabbled in by a few rogue physicians, has now gained a level of respect among patients and ophthalmologists that has surprised even its most vocal critics.

Intrastomal corneal ring segments: reversibility of refractive effect.

PURPOSE: To evaluate the reversibility of refractive effect following removal of the ICRS (intrastromal corneal ring segments; Intacs). METHODS: Data from 34 eyes from which ICRS were removed during United States FDA Phase II and III clinical trials were evaluated with regard to segment size, loss or change of best spectacle-corrected visual acuity (BSCVA), any change of uncorrected visual acuity (UCVA), manifest spherical equivalent refraction, manifest cylinder refraction, stability of manifest cylinder refraction, and subjective visual symptoms. RESULTS: Out of 725 initial or contralateral eyes placed with the ICRS during Phase II and III clinical trials, segments were removed from 34 eyes (4.7%). Other than one (1/725, 0.1%) safety related ICRS removal, 30/725 (4.1%) were due to visual symptoms. ICRS removal was accomplished under topical anesthesia without complications in all eyes. The mean length of time the segments remained in the cornea after initial surgery was 10.3 +/- 5.4 months. At 3 months after ICRS removal, 21 eyes had monitored data available and were within +/-1 line or 10 letters of their preoperative BSCVA. Twenty eyes (20/21, 95%) returned to within +/-1.00 D of their preoperative manifest spherical equivalent refraction. All eyes had a stable refraction at the 3-month examination after removal, and a manifest spherical equivalent refraction within +/-1.00 D of their 1-month examination after removal. Nineteen eyes (19/21, 90%) returned to within +/-2 lines and 16 eyes (16/21, 76%) returned to within +/-1 line of preoperative UCVA. CONCLUSION: The ICRS (Intacs) was easily and safely removed, and eyes returned to preoperative refractive status within 3 months.

Materials Research With Neutrons at NIST.

The NIST Materials Science and Engineering Laboratory works with industry, standards bodies, universities, and other government laboratories to improve the nation's measurements and standards infrastructure for materials. An increasingly important component of this effort is carried out at the NIST Center for Neutron Research (NCNR), at present the most productive center of its kind in the United States. This article gives a brief historical account of the growth and activities of the Center with examples of its work in major materials research areas and describes the key role the Center can expect to play in future developments.

Corneal thickness and visual acuity after phacoemulsification with 3 viscoelastic materials.

PURPOSE: To determine whether differences exist in visual acuity and corneal thickness after phacoemulsification using various viscoelastic substances. SETTING: Phillips Eye Institute, Minneapolis, Minnesota, USA. METHODS: Fifty patients having routine phacoemulsification cataract extraction and intraocular lens implantation by a single surgeon using the same technique were randomly assigned to receive intraoperative administration of 1 of 3 viscoelastic substances: Amvisc Plus(R) (sodium hyaluronate 1.6%), OcuCoat(R) (hydroxypropyl methylcellulose 2%), or Viscoat(R) (chondroitin sulfate 4%-sodium hyaluronate 3%). Visual acuity and corneal thickness on the first postoperative day were compared between groups. RESULTS: Patients with a best corrected visual acuity (BCVA) of 20/40 or better 1 day postoperatively had significantly thinner corneas (596 microm) than those with a BCVA worse than 20/40 (639 microm). There were no differences in postoperative BCVA or percentage increase in central corneal pachymetry among the 3 viscoelastic groups. CONCLUSION: Viscoat, Amvisc Plus, and OcuCoat were comparable in their ability to produce clear corneas and good vision after routine phacoemulsification.