Predictors of False-Negative Focused Assessment With Sonography for Trauma Examination in Pediatric Blunt Abdominal Trauma.

OBJECTIVES: This study investigated associations between patient and injury characteristics and false-negative (FN) focused assessment with sonography for trauma (FAST) in pediatric blunt abdominal trauma (BAT). We also evaluated the effects of FN FAST on in-hospital mortality and length of stay (LOS) variables. METHODS: This retrospective cohort studied children younger than 18 years between January 1, 2002, and December 31, 2013, with BAT, documented FAST, and pathologic fluid on computed tomography, surgery, or autopsy. Multivariable and bivariate analyses were used to assess associations between FN FAST and patient injury characteristics, mortality, and hospital LOS. RESULTS: A total of 141 pediatric BAT patients with pathologic free fluid were included. There were no patient or injury characteristics, which conferred increased odds of an FN FAST. Splenic and bladder injury were negatively associated with FN FAST odds ratio of 0.4 (95% confidence interval [CI], 0.2-0.8) and 0.1 (95% CI, 0-0.8). Abbreviated Injury Scale score of 4 or greater to the abdomen and extremity was negatively associated with FN FAST odds ratio of 0.1 (95% CI, 0-0.3) and 0.3 (95% CI, 0.1-0.9). There was no association between FN FAST and mortality. Patients with an FN FAST had increased hospital LOS after controlling for sex, age, and Injury Severity Score. CONCLUSIONS: Clinicians need to be cautious applying a single initial FAST to patients with minor abdominal trauma or with suspected injuries to organs other than the spleen or bladder. Formalized studies to develop risk stratification tools could allow clinicians to integrate FAST into the pediatric patient population in the safest manner possible.

Precise methane absorption measurements in the 1.64 µm spectral region for the MERLIN mission.

In this article we describe a high-precision laboratory measurement targeting the R(6) manifold of the 2ν3 band of 12CH4. Accurate physical models of this absorption spectrum will be required by the Franco-German, Methane Remote Sensing LIDAR (MERLIN) space mission for retrievals of atmospheric methane. The analysis uses the Hartmann-Tran profile for modeling line shape and also includes line-mixing effects. To this end, six high-resolution and high signal-to-noise absorption spectra of air-broadened methane were recorded using a frequency-stabilized cavity ring-down spectroscopy apparatus. Sample conditions corresponded to room temperature and spanned total sample pressures of 40 hPa - 1013 hPa with methane molar fractions between 1 µmol mol-1 and 12 µmol mol-1. All spectroscopic model parameters were simultaneously adjusted in a multispectrum nonlinear least-squares fit to the six measured spectra. Comparison of the fitted model to the measured spectra reveals the ability to calculate the room-temperature, methane absorption coefficient to better than 0.1% at the on-line position of the MERLIN mission. This is the first time that such fidelity has been reached in modeling methane absorption in the investigated spectral region, fulfilling the accuracy requirements of the MERLIN mission. We also found excellent agreement when comparing the present results with measurements obtained over different pressure conditions and using other laboratory techniques. Finally, we also evaluated the impact of these new spectral parameters on atmospheric transmissions spectra calculations.

Associations between mood instability and emotional processing in a large cohort of bipolar patients.

BACKGROUND: Aberrant emotional biases have been reported in bipolar disorder (BD), but results are inconsistent. Despite the clinical relevance of chronic mood variability in BD, there is no previous research investigating how the extent of symptom fluctuations in bipolar disorder might relate to emotional biases. This exploratory study investigated, in a large cohort of bipolar patients, whether instability in weekly mood episode symptoms and other clinical and demographic factors were related to emotional bias as measured in a simple laboratory task. METHOD: Participants (N = 271, BDI = 206, BDII = 121) completed an 'emotional categorization and memory' task. Weekly self-reported symptoms of depression and mania were collected prospectively. In linear regression analyses, associations between cognitive bias and mood variability were explored together with the influence of demographic and clinical factors, including current medication. RESULTS: Greater accuracy in the classification of negative words relative to positive words was associated with greater instability in depressive symptoms. Furthermore, greater negative bias in free recall was associated with higher instability in manic symptoms. Participants diagnosed with BDII, compared with BDI, showed overall better word recognition and recall. Current antipsychotic use was associated with reduced instability in manic symptoms but this did not impact on emotional processing performance. CONCLUSIONS: Emotional processing biases in bipolar disorder are related to instability in mood. These findings prompt further investigation into the underpinnings as well as clinical significance of mood instability.

Crystal structures of manganese and cobalt dichloride monohydrate and deuteration effects on magnetic behavior.

This work reports the long sought crystal structures of the title members of the intriguing series of 3d transition metal dichloride monohydrates. The double chain structure which results from rearrangement of the well-known pseudo-octahedral coordination geometry and single chains in the corresponding metal chloride dihydrate is extremely unusual. MnCl2·H2O and CoCl2·H2O each crystallize in orthorhombic space group Pnma with Z = 4 and lattice parameters a = 9.0339(1), 8.8207(3); b = 3.68751(5), 3.5435(1); c = 11.5385(2), 11.2944(4) all in Å and for Mn, Co, respectively. Results are reported also for both fully deuterated systems; the structures remain the same with lattice parameter changes typically much less than 0.1%. Various magnetic properties of MnCl2·D2O and CoCl2·D2O are reported. For the latter, there are no apparent differences, qualitatively or quantitatively, from the previously measured properties of CoCl2·H2O. Interestingly, for the former some differences with respect to MnCl2·H2O are apparent, principally a lower Tmax = 3.10(10) K about which a broad antiferromagnetic maximum is centered, and a larger value χmax = 0.336(3) emu/mol. However, antiferromagnetic ordering appears to occur at essentially the same 2.18(2) K. Results of fits to susceptibilities of MnCl2·D2O and CoCl2·D2O are compared with those obtained before for MnCl2·H2O and CoCl2·H2O. Structural considerations serve to rationalize the physical properties, especially the lower dimensional magnetism of monohydrates.

Equine keratomycoses in California from 1987 to 2010 (47 cases).

REASONS FOR PERFORMING STUDY: Equine keratomycosis in the western USA has received little study, probably owing to its low prevalence. OBJECTIVES: To determine clinical features, predominant fungal isolates, treatment modalities and outcomes of horses with keratomycosis in California and compare these with results from different geographic regions. METHODS: Records of horses presented to the University of California-Davis Veterinary Medical Teaching Hospital (UCD-VMTH) with confirmed keratomycosis between 1987 and 2010 were reviewed for this retrospective study. Information retrieved from the record included background, ophthalmic examination findings, treatment prior to and following presentation, visual outcome, and ocular survival. RESULTS: A total of 48 eyes in 47 horses met the inclusion criteria and comprised 2% of cases presented to the UCD-VMTH ophthalmology service. Prior to presentation, 20 horses (43%) received at least one topically administered anti-inflammatory medication. Keratomycosis was confirmed by fungal culture in 38 horses (81%), by histopathology in 2 horses (4%) and by cytology in 7 horses (15%). Forty-four isolates were identified in the 38 horses cultured; Aspergillus was the most common isolate (64%) and a novel isolate, Papulospora, was identified in 2 horses. Treatment consisted of medication only (73%), medical and surgical treatment (25%), or immediate enucleation (2%). Globe retention was 77% and vision retention was 53%. Corneal perforation was significantly associated with loss of vision (P<0.001). CONCLUSIONS: Keratomycosis is relatively uncommon in horses presented for ophthalmic conditions at UCD-VMTH. Corneal perforation was a negative prognostic indicator for vision in this population of northern Californian horses.

Infrared photodissociation spectroscopy of copper carbonyl cations.

Copper carbonyl cations of the form Cu(CO)(n)(+) (n = 1-8) are produced in a molecular beam via laser vaporization in a pulsed nozzle source. Mass-selected infrared photodissociation spectroscopy in the carbonyl stretching region is used to study these ions and their argon "tagged" analogues. The geometries and electronic states of these complexes are determined by the number of infrared-active bands, their frequency positions, and their relative intensities compared to the predictions of theory. Cu(CO)(4)(+) has a completed coordination sphere, consistent with its expected 18-electron stability. It also has a tetrahedral structure similar to that of its neutral isoelectronic analog Ni(CO)(4). The carbonyl stretch in Cu(CO)(4)(+) (2198 cm(-1)) is blue-shifted with respect to the free CO vibration (2143 cm(-1)), providing evidence that this is a "non-classical" metal carbonyl.

Influence of long-term oxygen therapy on cardiac acceleration and deceleration capacity in hypoxic patients with chronic obstructive pulmonary disease.

BACKGROUND: There is increasing interest in cardiovascular co-morbidities of chronic obstructive pulmonary disease (COPD). Heart rate turbulence (HRT) and phase-rectified signal averaging (PRSA) techniques quantify the heart's acceleration/deceleration capacities. We postulated that these methods can help assess the integrity of cardiac control in hypoxic COPD. METHODS: Eight hypoxic stable COPD patients, nine healthy age-matched older adults and eight healthy young adults underwent ECG monitoring for 24 h. Patients with COPD were also monitored following 4 weeks of standardized oxygen therapy. HRT measures [turbulence onset (TO), turbulence slope (TS)] and PRSA-derived acceleration/deceleration (AC, DC) indices were quantified within 6-h blocks to assess circadian variation. RESULTS: There were between-group differences for variables TS, DC and AC (P<0·0005, η(2) = 0·54-0·65), attributable solely to differences between healthy young and COPD subjects. Only HR (P<0·0005) and DC index (P = 0·008) showed circadian variation. A significant interaction 'trend' effect for HR (F(9,87) = 2·52, P = 0·015, η(2) = 0·21) reflected the strong influence of COPD on HR circadian variation (afternoon and night values being different to those in healthy subjects). CONCLUSIONS: As expected, heart rate dynamics were substantially diminished in older (healthy and COPD) groups compared with healthy young controls. Patients with COPD showed similar heart rate dynamics compared with age-matched controls, both before and after hypoxia correction. However, there was a suggestion of diminished DC in COPD compared with age-matched controls (P = 0·059) that was absent following oxygen therapy. TS, DC and AC indices were altered by similar degrees in older subjects, apparently indicating equivalent tonic dysfunction of sympathetic/parasympathetic systems with ageing.

Qualification and quantification of fish protein in prepared surimi crabstick.

Species identification and protein quantification in surimi crabstick were achieved using sodium dodecyl-sulfate polyacrylamide gel electrophoresis (SDS-PAGE). When the Lowry and Kjeldahl protein determination methods were compared, the former showed more consistent results. Densitometric scanning of the gels was used for quantification of total fish protein as well as total egg white protein. The lower molecular weight proteins, 30 kDa and lower, proved to be the most useful in fish species identification as well as egg white protein addition. Using a combination of the myosin heavy chain band and the species-specific myosin light chain (Alaska pollock: 22.5 kDa; Pacific whiting: 24.4 kDa) proved the most accurate in calculating fish protein content of the crabstick sample, while for those samples that contained egg white, quantification was accomplished from the densitometric analysis of the overlapping bands of actin (45 kDa) from fish and ovalbumin from egg white. Lysozyme (14.3 kDa) proved to be a unique protein band in determining the presence of egg white when the content of dried egg white was equal to or exceeded 0.5% of the total weight of the final crabstick.

Photodissociation of yttrium and lanthanum oxide cluster cations.

Transition metal oxide cations of the form M n O m (+) (M = Y, La) are produced by laser vaporization in a pulsed nozzle source and detected with time-of-flight mass spectrometry. Cluster oxides for each value of n form only a limited number of stoichiometries; MO(M2O3)x(+) species are particularly intense. Cluster cations are mass selected and photodissociated using the third harmonic (355 nm) of a Nd:YAG laser. Multiphoton excitation is required to dissociate these clusters because of their strong bonding. Yttrium and lanthanum oxides exhibit different dissociation channels, but some common trends can be identified. Larger clusters for both metals undergo fission to make certain stable cation clusters, especially MO(M2O3) x (+) species. Specific cations are identified to be especially stable because of their repeated production in the decomposition of larger clusters. These include M3O4(+), M5O7(+), M7O10(+), and M9O13(+), along with Y6O8(+). Density functional theory calculations were performed to investigate the relative stabilities and structures of these systems.

Photodissociation of chromium oxide cluster cations.

Chromium oxide cluster cations, Cr(n)O(m)+, are produced by laser vaporization in a pulsed nozzle cluster source and detected with time-of-flight mass spectrometry. The mass spectrum exhibits a limited number of stoichiometries for each value of n, where m > n. The cluster cations are mass selected and photodissociated using the second (532 nm) or third (355 nm) harmonic output of a Nd:YAG laser. At either wavelength, multiphoton absorption is required to dissociate these clusters, which is consistent with their expected strong bonding. Cluster dissociation occurs via elimination of molecular oxygen, or by fission processes producing stable cation species and/or eliminating stable neutrals such as CrO3, Cr(2)O(5), or Cr(4)O(10). Specific cation clusters identified to be stable because they are produced repeatedly in the decomposition of larger clusters include Cr(2)O(4)+, Cr(3)O(6)+, Cr(3)O(7)+, Cr(4)O(9)+, and Cr(4)O(10)+.

Ethical considerations related to the provision of care and treatment in vaccine trials.

Ethical principles of beneficence and justice combined with international human rights norms and standards create certain obligations on researchers, sponsors and public health authorities. These include treatment provision for participants enrolled in clinical trials of vaccines, drugs and other new preventive and curative technologies and methods. However, these obligations are poorly defined in practical terms, inconsistently understood or inadequately applied. Vaccine clinical trial designs normally define standards of prevention applicable to the population where the trial is to take place. The present document addresses specifically the setting of standards applicable to care and treatment in vaccine trials. The lack of clear guidance on how to achieve the optimal synergy between the development of new health technologies, on the one hand, and the promotion and protection of ethical and human rights principles, on the other, is a barrier to the progress of health research and therefore to the advancement of public health. The World Health Organization and UNAIDS have engaged in a series of consultations in Africa, the Americas, Asia and Europe to reflect on how this aim could best be achieved. This document highlights the outcome of these consultations. It proposes a structured approach to consensual decision making in the context of the clinical trial of vaccines against such public health challenges as HIV and newly emerging or threatening epidemics. A structured approach involving investigators and sponsors in a consultative process with trial communities and other stakeholders in research will ensure that the needs and legitimate expectations of trial participants are appropriately met, obligations towards them are delivered and, as a result, ethical research is facilitated in the interest of public health.

Malaria vaccine development: progress and challenges.

A safe and effective malaria vaccine would contribute greatly to the control and prevention of the disease. Although a review of global activity in malaria vaccine development does reflect significant activity, progress has remained slow. This article discusses the current vaccine candidates, with emphasis on those in the clinic, and explains the numerous challenges to making and evaluating malaria vaccines, which have resulted in only a few approaches being adopted and repeatedly evaluated. Against a parasite with more than 5200 genes, the lack of definitive knowledge regarding the nature of protective immunity and absence of reliable surrogates of protection are among the key challenges to a rational evaluation and prioritization of candidate vaccines. Pursuing the current R&D strategies may not result in the availability of a vaccine with characteristics suitable to impact significantly on disease morbidity in developing countries. Therefore, it is critical that the main challenges to malaria vaccine development be unambiguously identified and collectively addressed.

Cannabinoid receptor expression in peripheral arterial chemoreceptors during postnatal development.

Prenatal exposure to tobacco smoke increases risk of sudden infant death syndrome (SIDS). Marijuana is frequently smoked in conjunction with tobacco, and perinatal exposure to marijuana is associated with increased incidence of SIDS. Abnormalities in peripheral arterial chemoreceptor responses during sleep may be operative in infants at risk for SIDS, and nicotine exposure adversely affects peripheral arterial chemoreceptor responses. To determine whether marijuana could potentially affect the activity of peripheral arterial chemoreceptors during early postnatal development, we used in situ hybridization histochemistry to characterize the pattern and level of mRNA expression for cannabinoid type 1 receptor (CB1R) in the carotid body, superior cervical ganglia (SCG), and nodose-petrosal-jugular ganglia (NG-PG-JG) complex in newborn rats. We used immunohistochemistry and light, confocal, and electron microscopy to characterize the pattern of CB1R and tyrosine hydroxylase protein expression. CB1R mRNA expression was intense in the NG-PG-JG complex, low to moderate in the SCG, and sparse in the carotid body. With maturation, CB1R gene expression significantly increased (P < 0.01) in the NG-PG-JG complex. CB1R immunoreactivity was localized to nuclei of ganglion cells in the SCG and NG-PG-JG complex, whereas tyrosine hydroxylase immunoreactivity was localized to the cytoplasm. Exposure to marijuana during early development could potentially modify cardiorespiratory responses via peripheral arterial chemoreceptors. The novel finding of nuclear localization of CB1Rs in peripheral ganglion cells suggests that these receptors may have an, as yet, undetermined role in nuclear signaling in sensory and autonomic neurons.

Retention of nitrogen, fat, and calories in infants of low birth weight on conventional and high-volume feeds.

Two balance studies were performed on each of five infants of low birth weight. About 230 ml/kg/day of S.M.A. S26 milk was given during one study and 180 ml/kg/day during the other. The proportion of nitrogen, fat, and calories retained was similar in the two studies, suggesting that the larger weight gains on the high-volume feeds were due to growth rather than retention of water or excessive deposition of fat.