Smoking rates among gamblers at Nevada casinos mirror US smoking rate.

OBJECTIVES: To determine the percentage of gamblers who smoke while gambling at three of Nevada's major gambling destinations, Las Vegas, Reno/Sparks and Lake Tahoe. METHODS: Teams of two people counted the number of smokers and total number of gamblers at various Nevada casinos. The total number of gamblers observed smoking was then multiplied by three to determine the total number of smokers. This methodology for determining the number of smokers in a room was established by Repace and Lowry in 1980. RESULTS: We observed a total of 14 052 gamblers at the three sites, of which a total of 947 were smoking. We estimated the percentage of smokers at three gaming tourist centres in Nevada (Las Vegas, Reno/Sparks and Lake Tahoe). The percentage of smokers at Las Vegas (20.3% (95% CI 0.9)) and Reno/Sparks (21.5% (95% CI 1.2%)) did not significantly differ from the US population percentage of smokers (20.9% (95% CI 0.6%)) (p>0.05). However, at Lake Tahoe the percentage of smokers (16.4% (95% CI 1.8%)) was significantly lower than the published US population smoker percentage (p<0.0001). Mean percentage of smokers by location did not significantly differ (p = 0.43) CONCLUSIONS: The results of this study suggest that the percentage of gamblers who smoke was less than or not different from the overall US percentage of a population who smoke. These findings provide additional evidence to refute the exemption to smoking bans for casinos based upon the supposition that a greater percentage of casino customers are smokers than the general population and therefore a smoking ban for casinos may result in an economic hardship.

Optical control of excited-state vibrational coherences of a molecule in solution: The influence of the excitation pulse spectrum and phase in LD690.

Spectral and phase shaping of femtosecond laser pulses is used to selectively excite vibrational wave packets on the ground (S0) and excited (S1) electronic states in the laser dye LD690. The transient absorption signals observed following excitation near the peak of the ground-state absorption spectrum are characterized by a dominant 586 cm(-1) vibrational mode. This vibration is assigned to a wave packet on the S0 potential energy surface. When the excitation pulse is tuned to the blue wing of the absorption spectrum, a lower frequency 568 cm(-1) vibration dominates the response. This lower frequency mode is assigned to a vibrational wave packet on the S1 electronic state. The spectrum and phase of the excitation pulse also influence both the dephasing of the vibrational wave packet and the amplitude profiles of the oscillations as a function of probe wavelength. Excitation by blue-tuned, positively chirped pulses slows the apparent dephasing of the vibrational coherences compared with a transform-limited pulse having the same spectrum. Blue-tuned negatively chirped excitation pulses suppress the observation of coherent oscillations in the ground state.

Resonance Raman and semiempirical electronic structure studies of an odd-electron dinickel tetraiminoethylenedimacrocycle complex.

Resonance Raman studies of Ni2TIED3+ (TIED = tetraiminoethylenedimacrocycle) reveal that many modes couple to the intense electronic transition centered at 725 nm, a feature that is nominally similar to the intense delocalized intervalence absorption bands observed in the same region for Fe2(TIED)L4(5+) and Ru2(TIED)L4(5+) (L is any of several axial ligands). Time-dependent spectral modeling of the Raman and absorption spectra for the nickel compound was undertaken to understand the electronic transition. We were unable to model the Raman and absorption spectra successfully with a single electronic transition, suggesting that the absorption band is made up of two overlapping transitions. Semiempirical electronic structure calculations corroborate the suggestion. Additionally, these calculations indicate that the transitions are in fact ligand-localized transitions, with little metal involvement and no charge-transfer character. Furthermore, the ground-state electronic structure is best described as an identical pair of NiII centers bridged by a radical anion rather than a three-site mixed-valence assembly. Previous EPR studies (McAuley and Xu, Inorg. Chem. 1992, 31, 5549) had indicated primarily ligand character for the radical. The assignments are consistent with the resonance Raman results where the dominant modes coupled to the transitions are assigned as totally symmetric bridge vibrations.

Return to school after spinal cord injury.

OBJECTIVE: To determine the typical time elapsed between discharge from an inpatient spinal cord injury (SCI) rehabilitation program and the physical return to school, and to identify barriers faced by patients attempting to return to school. STUDY DESIGN: A retrospective review of all patients ages 18 years or younger who sustained SCI between 1989 and 1995, with resultant paraplegia or tetraplegia, and who attended either primary or secondary school, completed their inpatient rehabilitation at our regional SCI center, and were using a wheelchair when discharged from the hospital. RESULTS: Fifteen of 16 eligible patients agreed to participate. The median time for subjects with paraplegia to return to school after hospital discharge was 10 days; subjects with tetraplegia required a median of 62 days. Architectural and transportation barriers that patients encountered were identified. CONCLUSION: Individuals with SCI return to school relatively soon after discharge from the hospital. Barriers do not prohibit a return to school, but they are problematic.

Process mapping in screening mammography.

Successful screening mammography programs aim to screen large numbers of women efficiently and inexpensively. Development of an effective screening mammography program requires skilled personnel, solid infrastructure, and a robust computer system. A group of physicians, technologists, computer support personnel, and administrators carefully analyzed a growing screening mammography program as a series of steps, starting with the request for the examination and ending with the receipt of a hard-copy consultation. The analysis involved a detailed examination of every step and every possible outcome in the screening process. The information gained through process mapping may be used for identification of systemic and personnel problems, allocation of resources, modification of workplace architecture, and design of computer networks. Process mapping is helpful for those involved in designing and improving screening mammography programs. Viewing a process (i.e., obtaining a screening mammogram) as a series of steps may allow for the identification of inefficient components that may limit growth.

Acute right lower quadrant pain in a patient with leukemia.

Typhlitis or neutropenic enterocolitis is a life-threatening, necrotizing process of the cecum whose incidence is increasing. It is usually encountered in patients with leukemia who have recently undergone chemotherapy. Neutropenic enterocolitis presents as fever, abdominal pain, and diarrhea in neutropenic patients. As the incidence of neutropenic enterocolitis increases, emergency physicians must be aware of this rapidly progressive and potentially fatal disease.

Flunitrazepam and its involvement in date or acquaintance rape.

An estimated 1 in 4 women in the United States will be raped in their lifetimes. Approximately 75% of all rapes are date or acquaintance rapes. Recently the illegal use of flunitrazepam (Rohypnol), a benzodiazepine, as a prelude to the assault has been reported. Flunitrazepam readily dissolves, and once in solution, is colorless, odorless, and tasteless. The predominant clinical manifestations are drowsiness, impaired motor skills, and anterograde amnesia. Due to the amnestic effects of flunitrazepam, historical clues of the rape event are difficult to obtain. Patients with a complaint of sexual assault who appear intoxicated or have anterograde amnesia should be suspected of unknowingly ingesting flunitrazepam. In addition to adhering to standard rape protocols, a urine specimen should be analyzed for flunitrazepam metabolites using gas chromatography/mass spectrometry. If the hospital, local, or forensic laboratory is unable to analyze for flunitrazepam, Hoffmann-La Roche Inc., the manufacturer of Rohypnol, should be contacted. Hoffmann-La Roche has a mechanism for definitive testing for flunitrazepam, at no cost, for health care providers, rape treatment centers, and law enforcement agencies. A network of organizations is attempting to reduce the abuse of flunitrazepam in association with date rape.

The perspectives of violent street gang injuries.

Street gang violence has become a major public health problem in the United States, especially in the inner city. To prevent gang violence, one must understand the many facets of violent street gang activity and the psychological effects of gang violence on individuals as well as on the community. Further, one must have an understanding of the root causes of violent street gang formation, the relationship of firearms to gang violence, and the medical cost of these types of injuries. Prevention should begin with alleviating the root causes of violent street gang formation and include breaking the bonds of violent street gang membership. Adults acknowledge a societal obligation to protect and guide children and adolescents as an investment in the future. Because both children and adolescents lack judgment and experience, they cannot be expected to avoid injury and violence on their own. Although the financial cost of preventing gang violence would not be insignificant, the savings in terms of lives and medical expenditure would be immense. Unless steps are taken to end the physical and psychological trauma, regions of the United States, such as Los Angeles County, will not be safe from the effects of gang violence.

The epidemic of gang-related homicides in Los Angeles County from 1979 through 1994.

OBJECTIVE: To determine trends in gang homicides and the population at greatest risk for homicide by reviewing all gang-related homicides in Los Angeles County, California, from January 1979 to December 1994. DESIGN: Homicide files of the Los Angeles Police Department and the Los Angeles County Sheriff's Department from 1979 to 1994 involving violent street gang activity were reviewed. Gang files were reviewed for demographic data, weapons used, homicides by drive-by shootings, and times and geographic areas of occurrence. SETTING: Los Angeles County from January 1, 1979, to December 31, 1994. MAIN OUTCOME MEASURES: Age, race, and sex of gang-related homicide victims; frequency of weapon use; and the change in gang-related homicide rates during the study period. RESULTS: A total of 7288 gang-related homicides occurred in Los Angeles County from 1979 through 1994; 5541 of these homicides occurred in Los Angeles Police Department and Los Angeles County Sheriff's Department jurisdictions. During the study period, the proportion of all homicides that were gang related increased from 18.1% to 43.0% (P < .001). Of the 5541 gang-related homicide victims, 4580 (85.6%) were aged 15 to 34 years, 93.3% were African American or Hispanic, 5157 (93.2%) were male, 3559 (64.2%) were gang members, and 1408 (25.4%) occurred during drive-by shootings. Firearms were used in an increasing proportion of homicides, from 71.4% in 1979 to 94.5% in 1994. Homicides by semiautomatic handguns dramatically increased during the study period. Gang-related homicide rates for African-American males aged 15 to 19 years increased from 60.50 per 100,000 population per year in 1979 to 1981 to 192.41 per 100,000 population per year in 1989 to 1991. CONCLUSIONS: Gang-related homicides in Los Angeles County have reached epidemic proportions and are a major public health problem. To prevent gang violence, the root causes of violent street gang formation must be alleviated, the cycle of violent street gang involvement must be broken, and access to firearms must be limited.

Stable, intense picosecond pulse generation using intracavity GaAs.

A reliable pulsed Nd:YAG laser system has been designed to produce 150-mJ pulses of 260-ps duration with a shot-to-shot standard deviation of ±5.8% and a full-angle divergence of 0.6 mrad. The stability is due to a new cavity-dumped oscillator design that uses an intracavity GaAs plate to stabilize the pulse development and inhibit large fluctuations. The resulting output pulse from the cavity-dumped oscillator is 103 µJ, with an average shot-to-shot standard deviation of ±1.1% and a full-angle divergence of 2 mrad.

Failure of the Congo red dye uptake test to discriminate between virulent and avirulent avian Escherichia coli.

Twenty avian Escherichia coli isolates from normal and diseased chickens were compared by use of three virulence tests. These tests included the uptake of Congo red dye, an embryo lethality test, and a quantitative microtiter complement resistance test. A direct correlation was seen between the results of the complement resistance test and the embryo lethality test. The results of the Congo red test did not correlate with the two other tests.

Laser mediated release of dye from liposomes.

Liposomes made from phospholipids and containing sulforhodamine dye (1-50 mM) have been irradiated with nanosecond and picosecond laser pulses. Individual liposomes were locally heated by laser absorption of dye dimers during a single laser pulse, and heating was sufficient to release the liposome contents. The extent of dye release produced by a single laser pulse was shown to be quantitatively dependent on several interdependent variables, including dye concentration, liposome size, laser excitation parameters and initial temperature of the dye-liposome system. Fluorescence lifetime data having three components have been obtained and analyzed in terms of three dye environments. Quantitative estimates support a photo-induced thermal mechanism for liposome lysis and release of its contents. These results may be useful for laser induced delivery of therapeutic agents or other applications of lasers in biological systems.

Relationship of complement resistance and selected virulence factors in pathogenic avian Escherichia coli.

Complement resistance, antibiotic resistance profiles, and virulence profiles of 80 Escherichia coli isolates from the intestines of normal chickens (40 isolates) and chickens diagnosed as having colisepticemia (40 isolates) were compared. Differences were observed between the two groups for antibiotic resistance, siderophore production, presence of type 1 pili, complement resistance, motility, and size of plasmids. The systemic isolates were more likely to have siderophores and type 1 pili, and to be complement-resistant and motile than were the intestinal isolates. No differences between the two groups were observed for colicin production. Further comparison of the 10 most complement-resistant isolates from the systemic group and 10 most complement-sensitive isolates from the intestinal group revealed a correlation between an isolate's resistance to complement and its ability to kill embryos, express type 1 pili, and be motile. Virulence of avian E. coli strains appears to be correlated with complement resistance and the interaction of this resistance with the ability to produce type 1 pili and be motile.

Comparison of a complement resistance test, a chicken embryo lethality test, and the chicken lethality test for determining virulence of avian Escherichia coli.

Results with four pathogenic avian Escherichia coli isolates and one avirulent isolate in a complement resistance test, a chicken lethality test, and a chicken embryo lethality test were compared. Results of the complement resistance test with these isolates were highly correlated to results of the chicken lethality test of virulence. The chicken embryo test yielded results that were of a medium positive correlation with the chicken lethality results. The results of the complement resistance and chicken embryo lethality tests were highly correlated.

Characteristics of conjugative R-plasmids from pathogenic avian Escherichia coli.

Three of four virulent avian Escherichia coli isolates transferred a single large molecular-weight R-plasmid to two recipient E. coli strains. Antibiotic resistances transferred included streptomycin (two isolates) and streptomycin-tetracycline-sulfa (one isolate). Production of colicin and siderophores, complement resistance, and embryo lethality present in the virulent isolates were not transferred to recipient organisms. From the results, it appears that the R-plasmids of these virulent avian E. coli are not associated with virulence.

Comparison of a quantitative microtiter method, a quantitative automated method, and the plate-count method for determining microbial complement resistance.

A quantitative microtiter method for determining the degree of complement resistance or sensitivity of microorganisms is described. The microtiter method is compared with a quantitative automated system and the standard plate-count technique. Data were accumulated from 30 avian Escherichia coli isolates incubated at 35 C with either chicken plasma or heat-inactivated chicken plasma. Analysis of data generated by the automated system and plate-count techniques resulted in a classification of the microorganisms into three groups: those sensitive to the action of complement; those of intermediate sensitivity to the action of complement; and those resistant to the action of complement. Although the three methods studied did not agree absolutely, there were statistically significant correlations among them.

Comparison of chicken plasma and guinea pig serum in a quantitative microtiter method of determining microbial complement resistance.

A quantitative microtiter method using chicken plasma is described for determining the degree of complement resistance or sensitivity of avian Escherichia coli isolates. Results obtained with the microtiter method using chicken plasma were compred with results obtained using commercially available standardized guinea pig serum as the source of complement. The test organisms consisted of five isolates of E. coli isolated from chickens. Three isolates were from flocks with colisepticemia; one was from a flock with omphalitis; and one isolate was a non-pathogenic control. Data were accumulated from the five avian E. coli isolates incubated at 35 C with either chicken plasma or guinea pig serum and with heat-inactivated chicken plasma or guinea pig serum. The microtiter results of the chicken plasma and guinea pig serum had a statistically positive correlation. The use of commercially available guinea pig serum in the test system will allow for standardization of this method.

Characteristics of Salmonella spp. and Escherichia coli isolated from broiler flocks classified as "good" or "poor" producers.

Cecal samples from 100 broiler flocks were cultured for Escherichia coli and Salmonella. Samples were selected from flocks classified as either "good" or "poor" producers by a production formula. In an attempt to identify predictors of flock productivity, isolates were studied for differences in antibiotic resistances, hemagglutination of erythrocytes, production of colicins, production of siderophores, type of hemolysis, resistance to host complement, and presence of plasmids. S. typhimurium (copenhagen) was isolated from one poor producing flock and three good producers. Salmonella isolates showed no significant differences in the parameters studied. The E. coli isolates showed significant differences only for the presence of plasmids. These data indicate that differences in host intestinal E. coli from good and poor producing flocks do not predict flock productivity.