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The current experiment assessed whether relating abstract stimuli with familiar pictures by exclusion would produce the formation of a meaningful equivalence class. Ten participants learned conditional discrimination relations with abstract stimuli and established equivalence classes (ABC classes). They then learned DA (D1A1, D2A2, and D3A3) conditional discriminations with written words as D stimuli; two words (D1 and D2) were meaningful stimuli in the participants verbal community ("Dentist" and "Baker"), whereas the third (D3) was a pseudoword ("Tabilu"). In testing trials, participants evidenced derived relations between pictures related preexperimentally to D1 and D2 with the experimental equivalence classes related to D1 and D2. For some participants, the decontextualized stimuli were a set of boat pictures (Condition 1), whereas for others they were a set of miscellaneous pictures (Condition 2). Participants in both conditions successfully matched decontextualized pictures (unrelated to dentist and baker contexts) to all abstract stimuli in the class related to D3 (exclusion responding). In Condition 1 the meaning reported to the word Tabilu was similar across participants, but in Condition 2 participants showed more variations to answer to the meaning of Tabilu. These results suggest that exclusion learning can occur under different stimulus control topographies., (© 2024 Society for the Experimental Analysis of Behavior.)

Relational frame theory (RFT) as a behavior-analytic approach to understanding human language and cognition is now over 40 years old. However, the last 8 years have seen a relatively intense period of empirical and conceptual developments within the theory. Some of this work has begun to draw on early and much underplayed features of RFT, including field-theoretical analyses and concepts. These analyses are relatively nascent and thus the current article aims to provide a relatively detailed example of a field-theoretical analysis of a specific RFT research program. We begin with a brief overview of the "traditional" RFT approach to human language and cognition, followed by a summary of recent research involving the implicit relational assessment procedure (IRAP) and the differential arbitrarily applicable relational responding effects (DAARRE) model. We then go on to consider the DAARRE model in the context of J. R. Kantor's interbehavioral formula for the psychological event. Having done so, we conclude that the challenge involved in analyzing increasingly complex forms of human language and cognition appears to call for more field-based theorizing in some form or another., Competing Interests: Conflicts of InterestsThe authors declare that they have no known conflicts of interest/competing interests., (© The Author(s) 2024.)

The current study explored the influence of different levels of speaker coherence on rule following and speaker preference. In Experiment 1, rules provided by three different speakers were either 100% accurate, 0% accurate, or 50% accurate/inaccurate. Experiment 2 was similar to Experiment 1 except that the speaker's coherence was adjusted to 80% accurate, 20% accurate, and 50% accurate/inaccurate, respectively. Overall, participants tended to follow coherent speaker rules and avoid following incoherent speaker rules during training and testing phases. The results also indicated that following and not following rules provided by speakers may be generalizable to novel stimuli and maintained in the absence of differential reinforcement (i.e., in experimental test phases). Additionally, in a preference test, participants tended to prefer coherent over incoherent and partially coherent speakers. Furthermore, participants tended to prefer the relatively more incoherent speaker (i.e., 0% or 20% accurate) over the 50% accurate coherent speaker in both experiments. Finally, a comparison of the results of both experiments indicated that different levels of relational coherence affected the variability of rule-following and speaker preference behaviors. These findings are discussed in the context of the complexities that appear to be involved in rule-following behaviors and speaker preference., (© 2024 The Authors. Journal of the Experimental Analysis of Behavior published by Wiley Periodicals LLC on behalf of Society for the Experimental Analysis of Behavior.)

Purpose: While innovation is known to catalyse solutions to global sustainable development challenges, lack of engagement from stakeholders during conceptualisation and development may influence the degree of success of implementation., Methods and Materials: This paper presents a complete and novel engagement methodology, developed from value led business modelling approaches, for working with multi-sector stakeholders. The methodology can be used to determine barriers and facilitators to clinical practice innovations or translational research, within a country-specific context. The approach has then been applied in the Cambodian prosthetics and orthotics sector to provide a practice-based exemplar application of the framework., Results: This approach seeks to ensure the suitability and sustainability of clinical practice and research programmes being implemented within a complex ecosystem. A theoretical basis, drawn from academic and business innovation sectors, has been consolidated and adapted for practical application to design, direct, and inform initiatives in low resource settings., Conclusions: The methods presented provide a way to both develop and articulate the mission, vision, and goals of any proposed change, and to effectively communicate these with stakeholders in a way that engages the personal and professional values that exist in their ecosystem. It provides a structured process through which meaningful conversations can happen, and a basis for relationship management with key stakeholders; intrinsic to enable a sustained legacy from research and development.

People with late-stage Parkinson's disease (PD) often suffer from debilitating locomotor deficits that are resistant to currently available therapies. To alleviate these deficits, we developed a neuroprosthesis operating in closed loop that targets the dorsal root entry zones innervating lumbosacral segments to reproduce the natural spatiotemporal activation of the lumbosacral spinal cord during walking. We first developed this neuroprosthesis in a non-human primate model that replicates locomotor deficits due to PD. This neuroprosthesis not only alleviated locomotor deficits but also restored skilled walking in this model. We then implanted the neuroprosthesis in a 62-year-old male with a 30-year history of PD who presented with severe gait impairments and frequent falls that were medically refractory to currently available therapies. We found that the neuroprosthesis interacted synergistically with deep brain stimulation of the subthalamic nucleus and dopaminergic replacement therapies to alleviate asymmetry and promote longer steps, improve balance and reduce freezing of gait. This neuroprosthesis opens new perspectives to reduce the severity of locomotor deficits in people with PD., (© 2023. The Author(s), under exclusive licence to Springer Nature America, Inc.)

Studying relating of relational networks is a complex and challenging task. The main objective of the present study was to demonstrate relating within and across relational networks based on same/opposite and bigger/smaller contextual cues and establish antecedent control. After nonarbitrary pretraining of the contextual cues, two nonsense stimulus classes were established based on comparative relations. Participants were trained to select stimuli from an array of options based on a symbolic rule that established a relation between two stimuli: one of Network 1 and one of Network 2. Training involved relating Network 1 to Network 2, and testing assessed relating Network 2 to Network 1. Seven of eight participants reached the mastery criterion in training and responded accordingly in test. In a final stage, reinforcing and punishing consequences were varied systematically in the presence of two novel stimuli and antecedent control was observed for all 7 participants. Experiment 2 replicated the results of Experiment 1 but using contextual cues taken from natural language, and Experiment 3 sought to understand the effects of pretraining relational responding using natural language. The mastery criteria were reached by four of seven participants in Experiment 2 and by all eight participants in Experiment 3. Future studies could develop and refine the methods employed here in analyzing the relating of relational networks, thus allowing for an increasingly sophisticated behavior-analytic account of human language and cognition., (© 2023 Society for the Experimental Analysis of Behavior.)

A spinal cord injury interrupts the communication between the brain and the region of the spinal cord that produces walking, leading to paralysis 1,2 . Here, we restored this communication with a digital bridge between the brain and spinal cord that enabled an individual with chronic tetraplegia to stand and walk naturally in community settings. This brain-spine interface (BSI) consists of fully implanted recording and stimulation systems that establish a direct link between cortical signals 3 and the analogue modulation of epidural electrical stimulation targeting the spinal cord regions involved in the production of walking 4-6 . A highly reliable BSI is calibrated within a few minutes. This reliability has remained stable over one year, including during independent use at home. The participant reports that the BSI enables natural control over the movements of his legs to stand, walk, climb stairs and even traverse complex terrains. Moreover, neurorehabilitation supported by the BSI improved neurological recovery. The participant regained the ability to walk with crutches overground even when the BSI was switched off. This digital bridge establishes a framework to restore natural control of movement after paralysis., (© 2023. The Author(s).)

Two experiments with human adults investigated the extent to which the transfer of function in accordance with nonarbitrary versus arbitrary stimulus relations may be brought under contextual control. Experiment 1 comprised four phases. Phase 1 consisted of multiple-exemplar training to establish discriminative functions for solid, dashed, or dotted lines. Phase 2 trained and tested two equivalence classes, each containing a 3D picture, a solid, a dashed, and a dotted form. During Phase 3, a discriminative function was established for each 3D picture. Phase 4 presented the solid, dashed, and dotted stimuli in two different frames, black or gray. The black frame cued function transfer based on nonarbitrary stimulus relations (Frame Physical); the gray frame cued function transfer based on equivalence relations (Frame Arbitrary). Testing and training with the frames was continued until contextual control was established; subsequently contextual control was demonstrated with novel equivalence classes with stimuli composed of the same forms. Experiment 2 replicated and extended Experiment 1 by demonstrating that such contextual control generalized to novel equivalence classes comprising novel forms and responses. The potential implications of the findings for developing increasingly precise experimental analyses of clinically relevant phenomena are considered (e.g., defusion)., (© 2023 Society for the Experimental Analysis of Behavior.)

Purpose: Venous thromboembolism (VTE) is a significant complication following lower limb arthroplasty (LLA). There is a paucity of evidence with regard to air travel following LLA. Orthopaedic surgeons are often asked by patients regarding air travel following LLA, and there is a need for evidence to guide these patients., Methods: This was a retrospective cohort study. We identified two cohorts, one travelling to and from the hospital by air and another, by land. All patients received routine preoperative and post-operative care, and thromboprophylaxis, as per our hospital guidelines. We collected baseline demographics, ASA score and incidence of VTE at 90 days using local patient records and a national joint registry. We also recorded data on flight time and overland distance of travel., Results: Two hundred and forty-three patients travelled by air; mean flight time was 74 min. In total, 5498 patients travelled a mean 25.3 miles over land to the hospital. No differences in baseline demographics or ASA score were observed. Four patients developed a VTE in the flight group, with 32 patients suffering a VTE in the control group. There was a significant difference in the VTE rate between the flight and control groups (p < 0.05); the relative risk of developing a VTE in the flight group was 2.85., Conclusions: In our cohort, perioperative short haul air travel is associated with an increased risk of VTE at 90 days following LLA. Orthopaedic surgeons must ensure that their patients are cognizant of the risks associated with perioperative air travel and take measures to minimise these risks., (© 2022. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.)

Relational frame theory (RFT) has historically been considered the basic explanatory science behind acceptance and commitment therapy (ACT). However, some have argued that there has been an increasing separation between the two in recent years. The primary aim of the current article is to explore the extent to which RFT concepts, particularly those that have been proposed recently in the context of "up-dating" the theory, may be used to build stronger links between basic and applied behavior analyses in which there is a shared language of relatively precise technical terms. As an example of this strategy, we outline RFT process-based experimental and conceptual analyses of the impact of one of the most widely used sets of interventions employed in the ACT literature, defusion. In addition, we suggest a potential experimental methodology for analyzing the basic behavioral processes involved. Overall, the current article should be seen as part of a broader research agenda that aims to explore how RFT may be used to provide a functional-analytic abstractive treatment of the behavioral processes involved in human psychological suffering., Competing Interests: Conflicts of InterestThe authors declare that they have no conflicts of interest., (© Association for Behavior Analysis International 2022, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Background: Prosthetic service development and delivery rely on data describing population needs. These needs are context-specific, but most existing data come from high-income countries or small geographic areas, which are often not comparable. This study analysed routinely collected digital patient record data at multiple time points to provide insights into characteristics of people accessing Cambodian prosthetic services., Methods: We investigated trends in birth year, sex, year and reason for limb absence, and prosthesis type, over three decades. Then, we observed data from 2005 and 2019 indicating how the population actively accessing prosthetics services has changed., Results: Temporal trends in prosthetics service user demographics corresponded with events in Cambodia's socio-political history. The predominant historical reason for limb absence prior to 2000 was weapon trauma during and following conflict. Since 2000, this was replaced by non-communicable disease and road accidents. Transtibial remained the most prevalent amputation level but transfemoral amputation had higher incidence for people with limb loss from road accidents, and people with limb loss due to disease were older. These observations are important as both transfemoral and older-aged groups experience particular rehabilitation challenges compared to the young, transtibial group., Conclusions: The study shows how standardised, routinely collected data across multiple clinics within a country can be used to characterise prosthetics service user populations and shows significant changes over time. This indicates the need to track client characteristics and provides evidence for adapting services according to population dynamics and changes in patient need., Competing Interests: Disclosure of interest: The authors completed the ICMJE Disclosure of Interest Form (available upon request from the corresponding author) and disclose no relevant interests., (Copyright © 2022 by the Journal of Global Health. All rights reserved.)

The implicit relational assessment procedure (IRAP) was initially developed as a way to assess the strength and probability of natural verbal relations, as defined within relational frame theory (RFT), and was conceptually rooted within the behavior-analytic tradition. However, the IRAP quickly became employed primarily as a measure of implicit cognition, more in line with mainstream psychology than behavior analysis. In doing so, research using the IRAP increasingly employed ill-defined mainstream psychological terms, focused on correlational analyses with traditional psychometry, and thus emphasized prediction over the prediction-and-influence of behavior. Although perhaps beneficial to the study of implicit cognition, this approach could be argued to have limited the IRAP's utility in behavior analyses of human language and cognition. In the current article we will reflect on this suggestion, on the IRAPs place and current use in the field of behavior analysis, and on its potential future within behavioral psychology in light of recent conceptual and empirical advances in RFT. In doing so, it is hoped that the measure may be refined into a better understood, more precise, functional-analytic tool., Competing Interests: Conflicts of InterestThe authors declare that they have no conflicts of interest., (© Association for Behavior Analysis International 2022.)

The seminal text on relational frame theory (RFT) was published 20 years ago and purported to offer a single overarching behavior-analytic account of human language and cognition. In the years thereafter, an increasing number of empirical and conceptual articles, book chapters in edited volumes, and whole volumes devoted to the account emerged. In recent years, RFT has experienced a period of intense empirical and conceptual development, facilitated in part by a research grant awarded by the Flanders Science Foundation, under its Odysseus program. This research program aimed to advance and extend the RFT account beyond the rendition presented in the seminal Hayes et al. (2001) volume. The current article aims to provide an overview of this research program, the empirical work and concepts it gave rise to, and their implications for an RFT account of human symbolic language and cognition. Overall, therefore, the article provides an account of relatively recent developments in RFT that extend beyond the 2001 volume and thus will, we hope, inform future research and critiques of the theory going forward., (© 2022 Society for the Experimental Analysis of Behavior.)

Epidural electrical stimulation (EES) targeting the dorsal roots of lumbosacral segments restores walking in people with spinal cord injury (SCI). However, EES is delivered with multielectrode paddle leads that were originally designed to target the dorsal column of the spinal cord. Here, we hypothesized that an arrangement of electrodes targeting the ensemble of dorsal roots involved in leg and trunk movements would result in superior efficacy, restoring more diverse motor activities after the most severe SCI. To test this hypothesis, we established a computational framework that informed the optimal arrangement of electrodes on a new paddle lead and guided its neurosurgical positioning. We also developed software supporting the rapid configuration of activity-specific stimulation programs that reproduced the natural activation of motor neurons underlying each activity. We tested these neurotechnologies in three individuals with complete sensorimotor paralysis as part of an ongoing clinical trial ( www.clinicaltrials.gov identifier NCT02936453). Within a single day, activity-specific stimulation programs enabled these three individuals to stand, walk, cycle, swim and control trunk movements. Neurorehabilitation mediated sufficient improvement to restore these activities in community settings, opening a realistic path to support everyday mobility with EES in people with SCI., (© 2022. The Author(s), under exclusive licence to Springer Nature America, Inc.)

Background: While robotics has become commonplace in adult oncology, it remains rare in pediatric oncology due to the rarity of childhood cancers. We present the results of a large nationwide experience with robotic oncology, with the aim of providing practical and feasible guidelines for child selection., Methods: This was a prospective analysis performed over a period of 4 years. Treatment was delivered according to the Société Internationale d'Oncologie Pédiatrique/International Society of Paediatric Oncology Europe Neuroblastoma Group (SIOP/SIOPEN) protocols. Indications were approved by a certified tumor board., Results: Overall, 100 tumors were resected during 93 procedures (abdomen, 67%; thorax, 17%; pelvis, 10%; retroperitoneum, 6%) in 89 children (56 girls). The median age at surgery was 8.2 years (range 3.6-13); 19 children (21%) harbored germinal genetic alterations predisposing to cancer. No intraoperative tumor ruptures occurred. Seven conversions (8%) to an open approach were performed. Neuroblastic tumors (n = 31) comprised the main group (18 neuroblastomas, 4 ganglioneuroblastomas, 9 ganglioneuromas) and renal tumors comprised the second largest group (n = 24, including 20 Wilms' tumors). The remaining 45 tumors included neuroendocrine (n = 12), adrenal (n = 9), germ-cell (n = 7), pancreatic (n = 4), thymic (n = 4), inflammatory myofibroblastic (n = 4), and different rare tumors (n = 5). Overall, 51 tumors were malignant, 2 were borderline, and 47 were benign. The median hospital stay was 3 days (2-4), and five postoperative complications occurred within the first 30 days. During a median follow-up of 2.4 years, one child (Wilms' tumor) presented with pleural recurrence. One girl with Wilms' tumor died of central nervous system metastasis., Conclusions: Robotic surgery for pediatric tumors is a safe option in highly selected cases. Indications should be discussed by tumor boards to avoid widespread and uncontrolled application., (© 2021. Society of Surgical Oncology.)

Introduction: Paediatric robotic surgery is gaining popularity across multiple disciplines and offers technical advantages in complex procedures requiring delicate dissection. To date, limited publications describe its perioperative management in children., Material & Methods: We retrospectively analysed the prospectively collected anaesthetic data of the first 200 robotic-assisted surgery procedures in our paediatric university hospital as part of a multidisciplinary program from October of 2016 to February of 2019. Anaesthetic technique and monitoring were based on guidelines initially derived from adult data. We examined adverse events and particular outcomes including blood loss and analgesic requirements., Results: Fifty-one different surgical procedures were performed in patients aged 4 months to 18 years (weight 5-144 kg). Operative times averaged 4 h and conversion rate was 3%. Neither robotic arm nor positional injury occurred. Limited access to the patient did not lead to any complication. Hypothermia was frequent and mostly self-limiting. Negative physiological effects due to positioning, body cavity insufflation or surgery manifesting as significant respiratory and haemodynamic changes occurred in 14% and 11% of patients, respectively. Overt haemorrhage complicated one case. Eighty per cent of 170 patients did not require level 3 analgesics postoperatively, while thoracic and certain tumour cases had greater analgesic requirements., Conclusion: These preliminary results show that paediatric robotic surgery is well tolerated with a low bleeding risk and that major intraoperative events are uncommon. A consistent anaesthetic approach is effective across a broad range of procedures. Analgesic requirements are low excluding thoracic and some complex abdominal cases. Future studies should focus on the rehabilitative aspects of robotic surgery technique., (Copyright © 2021 Société française d'anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.)

Recent developments in relational frame theory (RFT) have outlined a number of key variables of potential importance when analyzing the dynamics involved in derived relational responding. Recent research has begun to explore the impact of a number of these variables on persistent rule-following, namely, levels of derivation and coherence. However, no research to date has systematically examined the impact of coherence on persistent rule-following at varying levels of derivation. Across two experiments, the impact of coherence (manipulated through the systematic use of performance feedback) was explored on persistent rule-following when derivation was relatively low (Exp. 1) and high (Exp. 2). A training protocol based on the implicit relational assessment procedure (IRAP) was used to establish novel combinatorially entailed relations that manipulated the feedback provided on the untrained, derived relations (A-C) for five blocks of trials in Experiment 1 and one block of trials in Experiment 2. One of these relations was then inserted into the rule for responding on a subsequent contingency-switching match-to-sample task to assess rule persistence. While no significant differences were found in Experiment 1, the provision or non-provision of feedback had a significant differential impact on rule persistence in Experiment 2. These differences, and the subtle complexities that appear to be involved in persistent rule-following in the face of reversed reinforcement contingencies, are discussed.

Rule-governed behavior and derived stimulus relations have always shared strong conceptual links within behavior analysis. However, experimental analysis linking the two domains remains limited. The current study consisted of three experiments that aimed to continue to bridge this experimental gap. The first experiment sought to establish the extent to which a training version of the implicit relational assessment procedure (IRAP) could be used to establish and successfully reverse experimentally established derived relations. The results suggested that the Training IRAP could successfully produce derived reversals. Experiments 2 and 3 explored the extent to which reversed derived relations would control rule-governed behavior when the contingencies for rule-following competed with the rule. In Experiment 2, the task contingencies were immediately in opposition to the (reversed) derived rule, and participants generally responded in accordance with the task contingencies, rather than the rule. In Experiment 3, the task contingencies were initially rule-consistent before a contingency reversal that later made them rule-inconsistent. Here evidence of rule-persistence emerged. The results of the research are considered within the context of a recent framework that has emerged out of RFT for analyzing the dynamics involved in derived relational responding., (© 2021 Society for the Experimental Analysis of Behavior.)

There is a long history of prosthetic and orthotic services helping to mitigate the impact of physical impairment by restoring function, and enabling and equipping the user. The training of health professionals who design, fit, and maintain prosthetic and orthotic devices has evolved over the centuries, reflecting an increase in knowledge, technology, understanding, and social attitudes in each era. Improvements in pedagogical thinking and biomechanical understanding, as well as the advent of new integrated technologies, have driven the profession over the past 50 years to modernize, evolve training and service delivery models in line with new attitudes toward clients, and search for new ways to improve users' quality of life. In this narrative review, the authors examined the evolution of prosthetic and orthotic education, the impact of changing educational techniques and technologies, and the impact of the International Society for Prosthetics and Orthotics in that process. Through conversations with experts and review of peer-reviewed literature, accreditation documents, and the International Society for Prosthetics and Orthotics records and databases, the authors identified three areas of change in prosthetics and orthotics education over the past 50 years: (1) prosthetic/orthotic curriculum content, (2) pedagogy and course delivery, and (3) internships/residencies. This narrative review is a snapshot of a growing profession and we can only speculate where the next 50 years will lead us as we strive to serve patients, ever placing their needs and aspirations at the center of this professional service.

Rule-governed behavior and derived relational responding have both been identified as important variables in human learning. Recent developments in the relational frame theory (RFT) have outlined a number of key variables of potential importance when analyzing the dynamics involved in derived relational responding. Recent research has explored the impact of one of these variables, level of derivation, on persistent rule-following and implicated another, coherence, as possibly important. However, no research to date has examined the impact of coherence on persistent rule-following directly. Across two experiments, coherence was manipulated through the systematic use of performance feedback, and its impact was examined on persistent rule-following. A training procedure based on the implicit relational assessment procedure (IRAP) was used to establish novel combinatorially entailed relations that manipulated the feedback provided on the trained relations (A-B and B-C) in Experiment 1, and on the untrained, derived relations (A-C) in Experiment 2. One of these relations was then inserted into the rule for responding on a subsequent contingency-switching match-to-sample (MTS) task to assess rule persistence. While no significant differences were found in Experiment 1, the provision or non-provision of feedback had a significant differential impact on rule-persistence in Experiment 2. Specifically, participants in the Feedback group resurged back to the original rule for significantly more responses after demonstrating contingency-sensitive responding than did the No-Feedback group, after the contingency reversal. The results highlight the subtle complexities that appear to be involved in persistent rule-following in the face of reversed reinforcement contingencies.

Background: Adherence to inaccurate rules has been viewed as a characteristic of human rule-following (i.e., the rule-based insensitivity effect; RBIE) and has been thought to be exacerbated in individuals suffering from clinical conditions. This review intended to systematically examine these claims in adult populations., Methodology: We screened 1464 records which resulted in 21 studies that were deemed eligible for inclusion. Each of these studies was examined to determine: (1) if there is evidence for the RBIE in adults and (2) if this effect is larger in those suffering from psychological problems compared to their non-suffering counterparts. In addition, we investigated how (3) different operationalizations of the RBIE, and (4) the external validity and risks of bias of the experimental work investigating this effect, might influence the conclusions that can be drawn from the current systematic review., Results: (1) Out of the 20 studies that were relevant for examining if evidence exists for the RBIE in adults, only 11 were eligible for vote counting. Results showed that after the contingency change, the rule groups were more inclined to demonstrate behavior that was reinforced before the change, compared to their non-instructed counterparts. Critically, however, none of these studies examined if their no-instructions group was an adequate comparison group. As a result, this made it difficult to determine whether the effects that were observed in the rule groups could be attributed to the rules or instructions that were manipulated in those experiments. (2) The single study that was relevant for examining if adults suffering from psychological problems demonstrated larger levels of the RBIE, compared to their non-clinical counterparts, was not eligible for vote counting. As a result, no conclusions could be drawn about the extent to which psychological problems moderated the RBIE in that study. (3) Similar procedures and tasks have been used to examine the RBIE, but their precise parameters differ across studies; and (4) most studies report insufficient information to evaluate all relevant aspects affecting their external validity and risks of bias., Conclusions: Despite the widespread appeal that the RBIE has enjoyed, this systematic review indicates that, at present, only preliminary evidence exists for the idea that adults demonstrate the RBIE and no evidence is available to assume that psychological problems exacerbate the RBIE in adults.The systematic review was registered in PROSPERO (CRD42018088210)., Competing Interests: The authors declare there are no competing interests., (©2020 Kissi et al.)

The concept of rule-governed behavior or instructional control has been widely recognized for many decades within the behavior-analytic literature. It has also been argued that the human capacity to formulate and follow increasingly complex rules may undermine sensitivity to direct contingencies of reinforcement, and that excessive reliance upon rules may be an important variable in human psychological suffering. Although the concept of rules would appear to have been relatively useful within behavior analysis, it seems wise from time to time to reflect upon the utility of even well-established concepts within a scientific discipline. Doing so may be particularly important if it begins to emerge that the existing concept does not readily orient researchers toward potentially important variables associated with that very concept. The primary purpose of this article is to engage in this reflection. In particular, we will focus on the link that has been made between rule-governed behavior and derived relational responding, and consider the extent to which it might be useful to supplement talk of rules or instructions with terms that refer to the dynamics of derived relational responding., Competing Interests: Conflict of InterestThe authors declare that they have no conflicts of interest., (© Association for Behavior Analysis International 2020.)

Aim: We present the preliminary results of robotic-assisted laparoscopic (RAL) total and partial nephrectomy for renal malignant tumors in children., Methods: This is a prospective study of patients operated with RAL between December 2016 and September 2018. Patients with Wilms tumors were treated according to the SIOP-2001 protocol. Patient and tumor characteristics, type of surgery, surgical-related morbidity, and oncologic outcomes were recorded. Results were compared with a series of patients with similar age- and tumor-related characteristics operated during the same period by an open surgical approach., Results: Ten children underwent RAL nephrectomy with a mean age of five years (3.2-14.1 years). Total nephrectomy was done in six cases for Wilms tumor and in one case for renal sarcoma; three cases were converted. Complete removal of tumor without rupture was achieved in all cases. Postoperative course was uneventful, and patients were discharged between days 2 and 7. Neither recurrence nor medium-term complications occurred. Nine patients are alive with a median follow-up of 16 months (6-27 months) and one female died from complications of central nervous system metastases one year after surgery. When compared with the open surgical approach group, median tumor volume was smaller (P = 0.005), hospital stay was shorter (P = 0.01), and operative time was similar (P = 0.20)., Conclusions: RAL total and partial nephrectomy procedure for renal tumor in children may be an option in carefully selected cases. Indication should be discussed at tumor boards and surgery performed while adhering strictly to oncological surgical rules., (© 2019 Wiley Periodicals, Inc.)

Introduction: Prognosis of dumbbell neuroblastoma (NBL) is mainly determined by the sequelae induced by the tumor itself and the neurosurgical approach. However, after primary chemotherapy, surgical management of the residual tumor, especially the spinal canal component, remains controversial., Methods: We conducted a single-center retrospective cohort study over the last 15 years (2002-2017) including patients treated for NBL with spinal canal extension focusing on timing and type of surgery, complications, and functional and oncological follow-up., Results: Thirty-two children (14 M, 18 F) were managed for NBL, with the majority (26) presenting with NBL stroma poor while four had ganglioneuroblastoma intermixed, one nodular, and one ganglioneuroma. All but two patients received neoadjuvant chemotherapy. Upfront laminotomy for spinal cord decompression was performed in two patients; nine patients had extraspinal surgery with a follow-up neurosurgical procedure in seven cases; eight patients had initial neurosurgery followed by an extraspinal procedure, while six patients underwent a combined multidisciplinary approach. With a median follow up of 3.6 years (0.1-14.9), 29 patients (90.6) are alive and two out of three (19, 65.5%) have functional sequelae., Conclusion: Patients with NBL with persistent spinal canal extension of the tumor after neoadjuvant chemotherapy treated at our center had outcomes that compare favorably with the literature. This is likely due to the multidisciplinary approach to optimal surgical strategy and continuous evaluation of the respective risks of tumor progression. Neurological disability results from initial spinal cord compression or the radicular sacrifice required for tumor resection., (© 2019 Wiley Periodicals, Inc.)

Introduction stating the aim of the study: Robot-assisted laparoscopic pyeloplasty (RALP) is gaining acceptance among pediatric urologists. Few studies have evaluated the retroperitoneal approach for RALP. We share our experience from the first 2 years of a multidisciplinary pediatric robotic program in our center. Patients (or Materials) and Methods: We performed a retrospective analysis of prospectively collected data of children undergoing RALP for ureteropelvic junction obstruction ( n = 50). Diagnosis was confirmed by ultrasound and Tc-99m mercaptoacetyltriglycine renal scan or MRI; the same criteria were used to evaluate outcome. Surgical approach was chosen according to a specific algorithm. Transperitoneal approach ( n = 13) was reserved for horseshoe kidney, ectopic kidney, and redo surgery. We analyzed the 37 cases performed by a lateral retroperitoneal approach. Dismembered pyeloplasty was done for all cases and anastomosis was performed using a running monofilament 6/0 absorbable suture. All were drained by double J stent. Patient data, operating room parameters and postoperative course were recorded. Results: The median age was 7.9 years (5.1-13.8); the youngest was 2 years old. The median weight was 23 kg (17-41) with the smallest weighing 12.4 kg. Aberrant crossing vessels were present in 18 children. Median set-up time, from skin incision until the end of the 4-port insertion, was 33 min (29-48). Median surgeon's console time was 151 min (136-182). No conversion to an open procedure was necessary. The postoperative course was free of complications, except urinary tract infection in 6 children. All but 4 patients were discharged on day one. Median follow-up was 9 months (5-13). Redo pyeloplasty was not required. Practical training of other colleagues was possible after 10 cases performed by the same surgeon. Conclusion: These preliminary results suggest that retroperitoneal RALP in children is feasible, safe and effective. It is an excellent option with ideal anatomical exposure. Longer term results as well as continued practice will identify and overcome any challenges and enable surgical mastery of this procedure which is still evolving.

Children with autistic spectrum disorder are more likely to become distressed during induction of anesthesia. Inhalational induction is almost always the preferred route with acceptance of the face mask often presenting a considerable challenge. Tempering measures to facilitate gas induction such as forced premedication and physical restraint are no longer viable options except in extenuating circumstances. Recent research interest has focused on the need for advanced planning in collaboration with the caregiver to tailor an individualized perioperative plan. This plan may include both pharmacological and non-pharmacological interventions. Applied behavior analysis strategies have a well-documented efficacy in this unique population to systematically change an individual's usual behavior. These can be used, as a non-pharmacological strategy, to ensure a smooth perioperative course. We present a successful case of preoperative desensitization of a child with severe autistic spectrum disorder using a mirror demonstration technique associated with positive reinforcement to prepare him for general anesthesia. We discuss the potential application of applied behavior analysis strategies for anesthesia in this unique population. From a practical point of view, early communication with carers is required to establish who may benefit from this behavioral training. Planned individual preparation for general anesthesia must be provided by trained multidisciplinary staff., (© 2018 John Wiley & Sons Ltd.)

The effects of rules on human behaviour have long been identified as important in the psychological literature. The increasing importance of the dynamics of arbitrarily applicable relational responding (AARR), with regards to rules, has come to be of particular interest within Relational Frame Theory (RFT). One feature of AARR that previous research has suggested may differentially impact persistent rule-following is level of derivation. However, no published research to date has systematically explored this suggestion. Across two experiments, the impact of levels of derivation was examined on persistent rule-following at two stages of relational development: mutual entailment (Exp. 1) and combinatorial entailment (Exp. 2). A Training IRAP was used to establish a mutually entailed relational network in Experiment 1 and a combinatorially entailed network in Experiment 2, and to train these networks to different levels of derivation. This was followed by a contingency switching Match-to-Sample (MTS) task to assess rule persistence. Results from both experiments were generally consistent with the suggestion that lower levels of derivation produce more persistent rule-following. Unexpectedly, however, the findings from Experiment 1 also indicated that persistence was moderated by the type of novel word employed. Variations in results across both experiments and their implications for future research are discussed., (Copyright © 2018 Elsevier B.V. All rights reserved.)

This paper proposes a technique that estimates the locations along the string of the plucking event and the magnetic pickup of an electric guitar based on the autocorrelation of the spectral peaks. To improve accuracy, a method is introduced to flatten the spectrum before applying the autocorrelation function to the spectral peaks. The minimum mean squared error between the autocorrelation of the observed data and the electric guitar model is found in order to estimate the model parameters. The accuracy of the algorithm is tested on various plucking positions on all open strings for each pickup configuration. The accuracy of the proposed method for various plucking dynamics and fret positions is also evaluated. The method yields accurate results: the average absolute errors of the pickup position and plucking point estimates for single pickups are 3.53 and 5.11 mm, respectively, and for mixed pickups are 8.47 and 9.95 mm, respectively. The model can reliably distinguish which pickup configuration is selected using the pickup position estimates. Moreover, the method is robust to changes in plucking dynamics and fret positions.

There has been a move away from vaccines composed of whole or inactivated antigens toward subunit-based vaccines, which although safe, provide less immunological protection. As a result, the use of adjuvants to enhance and direct adaptive immune responses has become the focus of much targeted bovine vaccine research. However, the mechanisms by which adjuvants work to enhance immunological protection in many cases remains unclear, although this knowledge is critical to the rational design of effective next generation vaccines. This study aimed to investigate the mechanisms by which alum, a commonly used adjuvant in bovine vaccines, enhances IL-1β secretion in bovine peripheral blood mononuclear cells (PBMCs). Unlike the case with human PBMCs, alum promoted IL-1β secretion in a subset of bovine PBMCs without priming with a toll-like receptor agonist. This suggests that PBMCs from some cattle are primed to produce this potent inflammatory cytokine and western blotting confirmed the presence of preexisting pro-IL-1β in PBMCs from a subset of 8-month-old cattle. To address the mechanism underlying alum-induced IL-1β secretion, specific inhibitors identified that alum mediates lysosomal disruption which subsequently activates the assembly of an NLRP3, ASC, caspase-1, and potentially caspase-8 containing complex. These components form an inflammasome, which mediates alum-induced IL-1β secretion in bovine PBMCs. Given the demonstrated role of the NLRP3 inflammasome in regulating adaptive immunity in murine systems, these results will inform further targeted research into the potential of inflammasome activation for rational vaccine design in cattle.

Rule-governed behavior and its role in generating insensitivity to direct contingencies of reinforcement have been implicated in human psychological suffering. In addition, the human capacity to engage in derived relational responding has also been used to explain specific human maladaptive behaviors, such as irrational fears. To date, however, very little research has attempted to integrate research on contingency insensitivity and derived relations. The current work sought to fill this gap. Across two experiments, participants received either a direct rule (Direct Rule Condition) or a rule that involved a novel derived relational response (Derived Rule Condition). Provision of a direct rule resulted in more persistent rule-following in the face of competing contingencies, but only when the opportunity to follow the reinforced rule beforehand was relatively protracted. Furthermore, only in the Direct Rule Condition were there significant correlations between rule-compliance and stress. A post hoc interpretation of the findings is provided.

Background: Zika virus has spread through the Americas and the Caribbean since early 2015 and was rapidly declared a Public Health Emergency of International Concern by WHO because of the potential association with fetal anomalies. We analysed fetal and maternal fluids and tissues in fetuses with confirmed Zika virus infection prospectively monitored in Martinique, a French Caribbean island., Methods: Since the beginning of the Zika virus outbreak in Martinique, all pregnant women undergo monthly fetal ultrasound examination surveillance. In this study, we prospectively studied all patients with fetal anomalies and a positive amniotic fluid for Zika virus by RT-PCR. Maternal and fetal blood, urine, amniotic fluid, placenta, and fetal tissues were tested for Zika virus by RT-PCR. Fetal blood was analysed to identify haematological and biological anomalies., Findings: Between Jan 1, 2016, and Nov 10, 2016, we recruited eight cases of Zika virus infection. All but two cases were symptomatic during the first trimester. Fetal anomalies were only detected after 20 weeks' gestation. After an initial positive result, amniocentesis became negative in two cases and fetal blood was transiently Zika virus-positive in six cases. Fetal blood analyses showed a cholestatic pattern, anaemia, and infectious response., Interpretation: Normalisation of amniotic fluid and fetal blood for Zika virus, as well as maternal blood and urine, shows the limitations of the performance of these investigations, due to the possibility of false negative results. Abnormal fetal blood needs to be investigated further to establish prognostic factors of severe Zika virus infections., Funding: None., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Long-term memory (LTM) formation requires new protein synthesis and new gene expression. Based on our work in Aplysia, we hypothesized that the rRNA genes, stimulation-dependent targets of the enzyme Poly(ADP-ribose) polymerase-1 (PARP-1), are primary effectors of the activity-dependent changes in synaptic function that maintain synaptic plasticity and memory. Using electrophysiology, immunohistochemistry, pharmacology and molecular biology techniques, we show here, for the first time, that the maintenance of forskolin-induced late-phase long-term potentiation (L-LTP) in mouse hippocampal slices requires nucleolar integrity and the expression of new rRNAs. The activity-dependent upregulation of rRNA, as well as L-LTP expression, are poly(ADP-ribosyl)ation (PAR) dependent and accompanied by an increase in nuclear PARP-1 and Poly(ADP) ribose molecules (pADPr) after forskolin stimulation. The upregulation of PARP-1 and pADPr is regulated by Protein kinase A (PKA) and extracellular signal-regulated kinase (ERK)--two kinases strongly associated with long-term plasticity and learning and memory. Selective inhibition of RNA Polymerase I (Pol I), responsible for the synthesis of precursor rRNA, results in the segmentation of nucleoli, the exclusion of PARP-1 from functional nucleolar compartments and disrupted L-LTP maintenance. Taken as a whole, these results suggest that new rRNAs (28S, 18S, and 5.8S ribosomal components)--hence, new ribosomes and nucleoli integrity--are required for the maintenance of long-term synaptic plasticity. This provides a mechanistic link between stimulation-dependent gene expression and the new protein synthesis known to be required for memory consolidation.

Cigarette smoking deleteriously affects erectile function, and conversely, quitting smoking improves erectile hemodynamics. Underlying mechanisms by which smoking (or reduction of smoking frequency) may affect erectile physiology are not well understood. This study examined the mediating role of heart rate variability (HRV; a marker of sympathovagal balance) among a sample of male chronic smokers from the United States. Sixty-two healthy men (Mage=38.27 years; s.d.=10.62) were assessed at baseline (while smoking regularly), at mid-treatment (while using a nicotine patch) and at follow-up, 4 weeks after patch discontinuation. Cigarette use, frequency-domain parameters of HRV (low frequency (LF), high frequency (HF), LF/HF ratio) and physiological sexual arousal responses (via penile plethysmography) were assessed at each visit. Results were consistent with mediation, in that greater reductions in cigarette use from baseline to follow-up were associated with longitudinal increases in LF, which in turn showed positive relationships with across-time changes in erectile tumescence. Neither HF nor LF/HF ratio mediated the relationship between smoking and erection. In conclusion, HRV mediated the inverse relationship between reductions in smoking and enhancements in erectile tumescence. Results underscore the possibility that cigarette use may deleteriously affect erectile function peripherally, in part, by disrupting cardiac autonomic function.

This case series shows male triplets with similarly positioned palatally displaced canines and agenesis of third molars. It supports findings reported previously in the literature suggesting a genetic origin for the palatally displaced canine and other dental anomalies which may be biologically related.

Based on six series of patients (n = 198) participating in clinical field testing of prosthetic feet and all provided with trans-tibial prostheses in accordance with the polypropylene component and assembly system developed by the International Committee of the Red Cross (ICRC) follow-up studies by teams consisting of an orthopaedic surgeon and a Category-I prosthetist-orthotist were conducted. A series of quality measures were tested against previously published quality benchmarks. The polypropylene system gives a consistent product and allows for increased demands on quality benchmarks. The acceptance of discomfort and pain could be reduced to 5 +/- 5%. The technical performance demands were reduced for misalignment to 10 +/- 5%. In general for all quality measures the range could be reduced to +/- 5%. These new demands reflect what an orthopaedic workshop outside of a teaching system should be able to attain.

Background: The analgesic effect of long-acting opioids, such as transdermal fentanyl, has been demonstrated in patients with cancer, neuropathic pain and chronic low back pain (CLBP). However, the broader effect of long-acting opioids on the patient's health-related quality of life (HRQoL) is less well known., Objective: To evaluate HRQoL outcomes in CLBP patients treated with transdermal fentanyl., Research Design and Methods: An observational study was conducted at 17 clinical centers in the US. Eligible patients had CLBP diagnosis for at least 3 months and were taking short-acting opioids chronically, and then initiated transdermal fentanyl treatment. Patients completed the Treatment Outcomes in Pain Survey (TOPS), which includes the SF-36 Health Survey, at baseline and > or = 9 weeks of treatment. The HRQoL burden of CLBP was determined by comparing CLBP patients' SF-36 scores to the general US population and low back pain patient norms. HRQoL outcomes were determined by comparing baseline and follow-up TOPS and SF-36 scores. Additionally, HRQoL outcomes were evaluated across patient groups stratified by changes in pain intensity ratings as measured by an 11-point numerical rating scale., Results: At baseline CLBP patients (N = 131) scored one-to-two standard deviations (SD) below age and gender adjusted SF-36 general population norms (MANOVA F = 127.1, p < 0.0001) and significantly lower than low back pain norms (MANOVA F = 125.3, p < 0.0001). At follow-up, significant improvement (p < 0.05) was observed on six of the SF-36 scales and both SF-36 summary measures and five of the six TOPS pain-related scales. The magnitude of change in scores in effect size units among these scales ranged from 0.17 to 0.80, which are considered small to large effect size changes. HRQoL score improvement was greatest among patients experiencing the greatest pain relief., Conclusion: CLBP patients who chronically used short-acting opioids showed tremendous HRQoL burden. Favorable HRQoL outcomes were observed among patients who reported pain relief.

Both nicotine and sucrose can enhance performance on cognitive tasks. However, little is known about whether nicotine and sucrose could act jointly to augment mental performance. To investigate if there is an interaction between nicotine and sucrose on cognitive behavior, performance on a continuous performance task (CPT) and a spatial memory task was examined in 14 healthy smokers after they had drunk 8 oz of either a sucrose- or aspartame-containing beverage, and then chewed a piece of gum containing either 2 mg nicotine or no nicotine. To assess changes in mood as a function of nicotine and sucrose intake, the profile of mood states (POMS) test was administered three times during each test session. Participants made significantly more correct responses and significantly fewer incorrect responses on the CPT when they received nicotine than when they received the placebo gum. Closer analysis of the data revealed that there was an interaction between sucrose consumption and nicotine intake. Nicotine increased hits and decreased misses when participants were given the sucrose-containing beverage, but not when they were given the aspartame-containing beverage. Neither nicotine nor sucrose affected spatial memory or mood across experimental sessions. However, when data were analyzed for just the first session, participants who drank the sucrose-containing beverage performed significantly better on the spatial memory task than those who drank the aspartame-containing beverage. No gender differences in the effects of nicotine or sucrose on cognitive performance were detected. The results provide support that both nicotine and sucrose have positive effects on cognitive behavior, and that under some conditions the two variables have additive effects on performance.

The present study aimed to measure the quality of life (QOL) of disabled people in Cambodia and the impact of rehabilitation services. The categories of services were: physical rehabilitation (prosthetics/orthotics with physiotherapy); community-based rehabilitation; and (3) labour market assistance. The 164 respondents were from a range of urban and rural settings. The results suggest that QOL was substantially lower among disabled Cambodians who had received no rehabilitation services compared to those who had received one of the three categories of rehabilitation services. QOL scores tended to be highest, however, among those who had received a combination of all three services. The results also highlighted the vulnerability of certain sub-groups who may need specific provision in planning, policy-making and service delivery. The present study suggests that an integrated approach may be the best way to maximise the impact of individual rehabilitation services in Cambodia.

Objective: To evaluate the efficacy and safety of ibuprofen, 200 mg and 400 mg, compared with placebo and each other for the treatment of pain of migraine headache., Background: Migraine headache is a common illness with significant social and economic impact., Design: Randomized, placebo-controlled, double-blind trial of 6 hours' treatment duration., Methods: Fifteen investigators at 17 private practice and referral centers in the United States participated in this study of 660 outpatient adults aged 18 to 84 years with migraine headache of moderate to severe intensity. Each patient was randomly assigned to a single dose of study medication: ibuprofen 200 mg (n = 216) or 400 mg (n = 223), or placebo (n = 221). The percentage of patients with a reduction in baseline headache intensity from severe or moderate to mild or none 2 hours after treatment and the headache pain intensity difference from baseline at 2 hours were the primary efficacy measures. Secondary outcomes included other measures of pain relief, severity differences from baseline for migraine-associated symptoms of nausea, photophobia, phonophobia, and functional disability, and percentage of patients with migraine-associated symptoms reduced to none., Results: Significantly (P < or = .006) more patients treated with ibuprofen, 200 mg or 400 mg, reported mild to no pain after 2 hours (41.7% and 40.8%, respectively), compared with those treated with placebo (28.1%). The mean pain intensity difference from baseline measured at 2 hours was significantly (P < or = .001) greater for patients treated with ibuprofen 200 mg or 400 mg (0.68 and 0.65, respectively), compared with those treated with placebo (0.39). Statistically significant differences in favor of both doses of ibuprofen over placebo were observed for mean pain intensity difference at 1 hour after treatment. In patients with severe baseline pain intensity, ibuprofen, 400 mg, was significantly (P < or = .048) superior to placebo for the primary efficacy end points, while ibuprofen, 200 mg, was not. Ibuprofen, 200 mg and 400 mg, were statistically significantly more effective than placebo for all clinically important secondary pain relief outcomes. Mean severity changes of migraine-associated symptoms of nausea, photophobia, phonophobia, and functional disability at 2 and 6 hours were significantly (P < or = .03) in favor of both doses of ibuprofen over placebo, and results for the percentage of patients with symptoms reduced to none consistently, although less often statistically significant, favored ibuprofen. No statistically significant differences in adverse events were found among treatment groups., Conclusions: Ibuprofen at doses of 200 mg and 400 mg is an efficacious, cost-effective, well-tolerated, single-ingredient nonprescription treatment for pain of migraine headache. In addition, while not always statistically significant, ibuprofen provided a beneficial effect on associated symptoms of migraine including nausea, photophobia, phonophobia, and functional disability.

We report 3 patients where Medroxyprogesterone Acetate (MPA = Provera) and Megestrol Acetate (Megace) in doses used for therapy of breast cancer, caused clinical hypercortisolism and Cushing's syndrome. Studies of the toxicity of Medroxyprogesterone Acetate list the commonest adverse events at 500 mg/day as weight gain, water retention, increased blood pressure, tremor, moon face, sweating, muscle cramps, vaginal bleeding and increased appetite. Glucocorticoid-like effects are seen in up to 30% of patients treated for longer than 6 weeks with mostly large doses of the order of 1500 mg/day but Cushing's syndrome has been reported in patients taking 400 mg/day. Neither the glucocorticoid-like effects or Cushing's syndrome have been previously observed with Megestrol Acetate. In the elderly female population receiving progestogens for neoplastic disease the progestogen itself could be an appreciable cause of morbidity both by causing glucocorticoid-like effects and Cushing's syndrome but also by lack of awareness of the danger of sudden withdrawal of these compounds when the hypothalmic-pituitary-adrenal (HPA) axis is suppressed. The signs and symptoms could be easily overlooked unless appropriate testing for Cushing's syndrome is carried out. While the progestogen may have to be continued indefinitely a dose decrease may be feasible with reduction of morbidity.

Grit blasting is a common procedure of roughening surfaces to promote physical attachment of porous coatings, but it has been shown to reduce fatigue strength. Shot peening is known to increase fatigue strength by inducing compressive surface stresses; however, it is not known how subsequent grit blasting affects these benefits. This study examines the endurance limits, Se, of ELI grade Ti-6A1-4V specimens under rotating cyclic bending, including polished (control); belted and beaded; belted, beaded, and grit blasted; and belted, beaded, shot peened, and grit blasted. Belting and beading resulted in a slight increase in Se, grit blasting caused a 15% reduction in Se from polished. Fifty percent of this reduction was recovered when shot peening preceded grit blasting, suggesting that residual compressive surface stresses, induced by peening, were not eliminated by the blast process. Roughness averages and RMS values did not correlate with Se trends. SEM results showed classical fatigue fractures, consistent with surface crack initiation.

The plastids in the cells of the tapetum in anther of Oenothera are involved in the development of male sterility (mst). We combined nuclear homozygosity for each of the two mst genes with the four different plastomes of Oenothera and demonstrated that in both cases the sterile anther phenotype is independent of the plastome. The experiments provide additional information on competition between megaspores and embryo sacs in the ovule.