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BackgroundShort sleep and obstructive sleep apnea are underrecognized strains on the public health infrastructure. In the United States, over 35% of adults report short sleep and more than 80% of individuals with obstructive sleep apnea remain undiagnosed. The associations between inadequate sleep and cardiometabolic disease risk factors have garnered increased attention. However, challenges persist in modeling sleep-associated cardiometabolic disease risk factors. ObjectiveThis study aimed to report early findings from the Short Sleep Undermines Cardiometabolic Health-Public Health Observational study (SLUMBRx-PONS). MethodsData for the SLUMBRx-PONS study were collected cross-sectionally and longitudinally from a nonclinical, rural community sample (n=47) in the southeast United States. Measures included 7 consecutive nights of wrist-based actigraphy (eg, mean of 7 consecutive nights of total sleep time [TST7N]), 1 night of sleep apnea home testing (eg, apnea-hypopnea index [AHI]), and a cross-sectional clinical sample of anthropometric (eg, BMI), cardiovascular (eg, blood pressure), and blood-based biomarkers (eg, triglycerides and glucose). Correlational analyses and regression models assessed the relationships between the cardiometabolic disease risk factors and the sleep indices (eg, TST7N and AHI). Linear regression models were constructed to examine associations between significant cardiometabolic indices of TST7N (model 1) and AHI (model 2). ResultsCorrelational assessment in model 1 identified significant associations between TST7N and AHI (r=–0.45, P=.004), BMI (r=–0.38, P=.02), systolic blood pressure (r=0.40, P=.01), and diastolic blood pressure (r=0.32, P=.049). Pertaining to model 1, composite measures of AHI, BMI, systolic blood pressure, and diastolic blood pressure accounted for 25.1% of the variance in TST7N (R2adjusted=0.25; F2,38=7.37; P=.002). Correlational analyses in model 2 revealed significant relationships between AHI and TST7N (r=–0.45, P

Background: Human norovirus (HuNoV) is the leading viral cause of diarrhea, with GII.4 as the predominant genotype of HuNoV outbreaks globally. However, new genogroup variants emerge periodically, complicating the development of anti-HuNoV vaccines; other prophylactic or therapeutic medications specifically for HuNoV disease are lacking. Passive immunization using oral anti-HuNoV antibodies may be a rational alternative. Here, we explore the feasibility of using avian immunoglobulins (IgY) for preventing HuNoV infection in vitro in a human intestinal enteroid (HIE) model. Methods: Hens were immunized with virus-like particles (VLP) of a GII.4 HuNoV strain (GII.4/CHDC2094/1974/US) by intramuscular injection. The resulting IgY was evaluated for inhibition of binding to histo-blood group antigens (HBGA) and viral neutralization against representative GII.4 and GII.6 clinical isolates, using an HIE model. Results: IgY titers were detected by three weeks following initial immunization, persisting at levels of 1:221 (1:2,097,152) from 9 weeks to 23 weeks. Anti-HuNoV IgY significantly (p < 0.05) blocked VLP adhesion to HBGA up to 1:12,048 dilution (0.005 mg/mL), and significantly (p < 0.05) inhibited replication of HuNoV GII.4[P16] Sydney 2012 in HIEs up to 1:128 dilution (0.08 mg/mL). Neutralization was not detected against genotype GII.6. Conclusions: We demonstrate the feasibility of IgY for preventing infection of HIE by HuNoV GII.4. Clinical preparations should cover multiple circulating HuNoV genotypes for comprehensive effects. Plans for animal studies are underway.

A full-term neonate suffered multifocal cerebral infarctions due to multiple large vessel thrombi. Thrombophilia and cardiovascular assessments were negative, but due to the severity of the lesions and the concern for expansion of the thrombi or future embolic events, treatment with low-molecular-weight heparin (LMWH) was initiated. No complications from treatment were experienced. We present this severe case in order to highlight difficult management decisions for newborns with multifocal perinatal thromboembolic stroke and to stress the need for further practice guidelines and research in this area.

Introduction: The purpose of this study is to explore challenges within the home care system encountered by parental caregivers of children with medical complexity in Massachusetts., Method: A qualitative descriptive study was completed with 11 parental caregivers interviewed., Results: Using conventional content analysis of transcripts, three themes emerged: (1) lack of discharge preparedness causes emotional distress, (2) care becomes increasingly complex creating new unanticipated challenges, and (3) psychological toll of parents assuming provider role., Discussion: Navigating a variety of complex systemic challenges with minimal preparation or support contributes to an overall feeling of parental caregiver burnout. Additionally, mental health supports for parental caregivers are lacking, further exacerbating the negative impact of these challenges. Future work should focus on research, advocacy, and system reform that ensures parental caregivers receive necessary supports to care for children within a sustainable and supportive home care model. Nurses across the profession are in unique position to facilitate this change., Competing Interests: Conflicts of Interest David Geyer received funding from the National Association of Pediatric Nurse Practitioners Foundation Research Grant for this study. Other authors have no financial interests or potential conflicts of interest., (Copyright © 2024 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.)

Background: Alcohol dependence is associated with several neuropsychological abnormalities, such as increased impulsivity or attentional bias towards drug-related stimuli. However, it is debated whether these abnormalities are on the decline after long-term abstinence from alcohol. Inpatient rehabilitation treatment enables the longitudinal investigation of such variables during a long, largely secured, period of abstinence., Methods: This study involved alcohol-dependent patients consecutively admitted for a duration of 14-26 weeks to an inpatient rehabilitation treatment center located in a hospital specializing in substance use disorders. Craving and impulsivity were assessed with the means of two questionnaires (e.g., OCDS-G and BIS-11); conversely, attentional bias and problems with inhibition were measured with the help of two computer-based experiments (e.g., dot-probe task and stop-signal-reaction task). Investigations were conducted at entry, after 6 weeks, and during the last two weeks of the inpatient treatment., Results: A total of 130 patients with alcohol dependence (mean age 43.3 years; 78.5% male) completed the first, N = 102 the second, and N = 83 the final assessment. Over the whole period of inpatient treatment, there was a significant decrease in patients' scores for both craving (t(83) = 7.8, p < 0.001) and impulsivity (t(82) = -3.75, p < 0.001, t(82) = 4.4, p < 0.001). However, there were no significant changes regarding attentional bias (t(82) = 0.16, p = 0.494) and inhibitory control (t(76) = 0.04, p = 0.482) scores., Conclusions: Neuropsychological abnormalities associated with alcohol dependence might persist even after a long abstinence period. The decrease in both craving and impulsivity levels may be explained by the protected, alcohol-free, hospital environment; however, patients' risk of post-discharge relapse may remain high, as the basic neurobiological mechanisms of alcohol dependence may persist for long periods, and possibly for more than 3-6 months.

In this study, a new design for a 1D gas-phase Raman spectrometer is presented, utilizing two dedicated tracks to image different properties of the measured signal onto a single charge-coupled device (CCD) chip. Two possible configurations are shown: a polarization-separation configuration, which separates the detected Raman signal into s- and p-polarized shares; and a dual-resolution configuration, which captures all process-relevant species in a range of approximately 515-4650 cm -1 on one track and the highly resolved nitrogen spectrum on the other. This new spectrometer design offers several advantages when compared to traditional polarization-separation/dual-resolution systems, which often use switchable filters or two different spectrometers in tandem to achieve comparable measurements. Employing only one camera eliminates signal drift and minimizes calibration as well as spatial/spectral mapping issues. To validate instrument performance, the detection was paired with a continuous wave (CW) excitation system and used to measure in two generic but diagnostically challenging flow scenarios: flow near a heated surface, where thermal radiation is significant addressed by the polarization-separation configuration of the spectrometer and a channel flow at moderate temperatures in confined space, where the dual-resolution configuration of the spectrometer was employed. The results for both configurations and experiments showcase the instrument's ability to effectively suppress background radiation (polarization-separation) or measure local gas-phase temperatures with higher accuracy (dual-resolution) and are complemented with resolution measurements yielding a maximum spatial resolution of 21.9 lp/mm along the 1D probe volume.

Objectives: To analyse the relationship between depth of emotional experiencing and outcomes in young people. We also wanted to understand whether 'early' or 'working' depth of emotional experiencing was most predictive of outcomes, and how these compared against alliance effects., Design: Hierarchical linear regression analysis of data from a study of school-based humanistic counselling (SBHC)., Methods: Data from 60 young people were used for the study across 15 schools: mean age 13.7 years old (range: 13-16); 67% female; 52% from Black, mixed or non-white ethnicities. Depth of emotional experiencing was rated using the Client Experiencing Scale at session 1 (early EXP) and session 6 (working EXP). The dependent variable was changes in psychological distress from baseline to 12-week follow-up, as assessed by the Young Person's CORE., Results: In our final model, working EXP accounted for 11.6% of the variance in YP-CORE change scores after baseline YP-CORE scores were taken into account. Early EXP and working alliance were not predictive of benefit. Sensitivity analyses indicated that working EXP was associated with benefits across a range of indicators., Conclusions: Our findings show, for the first time, that depth of emotional experiencing has a significant and sizeable association with outcomes in therapy for young people. This is consistent with emerging evidence from the adult field. It suggests that practitioners working with young people should monitor the depth of emotional experiencing and foster methods for supporting its development., (© 2024 The Author(s). Psychology and Psychotherapy: Theory, Research and Practice published by John Wiley & Sons Ltd on behalf of The British Psychological Society.)

Problem: Despite reporting significant systemic barriers to providing care, burden among parental caregivers of children with medical complexity (CMC) is often attributed to stressors related to disease management. The relationship between parental caregiver burden and systemic barriers within the healthcare bureaucracy, as defined by Ray's Theory of Bureaucratic Caring (BCT), has not been explored. The purpose of this integrative review was to examine which elements of the bureaucratic healthcare system are contributing to burden among parental caregivers of CMC living at home., Eligibility Criteria: Refereed research articles related to the experiences of parental caregivers of CMC living in the United States published after 2014., Sample: 1967 articles were obtained on initial literature search. Using the PRISMA algorithm, ten articles published between 2018 and 2022 were ultimately selected for appraisal., Results: Parental caregiver burden was consistently attributed to barriers and gaps among social-cultural, physical, political, legal, economic, technological, and educational elements of the bureaucratic healthcare system., Conclusions: Weaknesses across the bureaucratic elements of the healthcare system prevent CMC from consistently receiving necessary care which in turn, contribute to feelings of burden among their parental caregivers. Efforts to alleviate burden experienced by parental caregivers should focus on addressing gaps within the healthcare bureaucracy., Implications: Nurses are well-positioned to address these gaps through clinical work, advocacy, and research. Future research should further examine the appropriateness of using BCT to better understand the implications of systems-level weaknesses on parental caregiver burden. Parental caregivers of CMC should be closely involved in this process., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Purpose: The purpose of this study was to explore relationships among psychological safety, the principles of high reliability, and safety reporting intentions in pediatric nursing. Patient safety events are underreported and costly. To promote reporting, many healthcare organizations have adopted the high reliability framework with strategies to foster team psychological safety., Design: A web-based survey was distributed through the Society of Pediatric Nurses and the National Pediatric Nurse Scientist Collaborative. Data were collected from 244 pediatric nurses using a demographic form, Safety Organizing Scale, Team Psychological Safety Scale, and Intention to Report Safety Events Scale. Data were analyzed using logistic and linear regression., Results: Psychological safety and perception of working in a high reliability organization (HRO) showed positive statistically significant relationships with reporting intentions (p = 0.034). Odds of nurses achieving highest reporting intention scores increased by a factor of 0.3 with each practice year., Conclusions: Psychological safety was found to be a predictor for intention to report safety events among pediatric nurses. Findings also demonstrated that nurses' perceptions of whether they worked in a high reliability setting also profoundly affect their attitude towards reporting., Practice Implications: Focusing organizational efforts on cultivating psychological safety and embedding the high reliability framework into professional practice may significantly affect attitudes towards safety event reporting., Competing Interests: Declaration of Competing Interest The authors declare that there are no conflicts of interest., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Purpose: Evaluate parental perception of the quality of discharge teaching, readiness for discharge, and the impact of these on post discharge coping difficulty and resource utilization in children with cerebral palsy (CP) following surgery., Design and Methods: Prospective cohort study conducted from September 2017-March 2021 at a pediatric academic medical center. Demographics were collected pre-operatively. Parents completed the Readiness for Hospital Discharge Scale (RHDS) and Quality of Discharge Teaching Scale (QDTS) within four hours of discharge. Four weeks post-discharge, parents completed the Post-discharge Coping Difficulty Scale (PDCDS). Utilization of healthcare resources were extracted from the electronic health record for 90 days post-operatively. Associations among demographics, RHDS, QDTS, PDCDS and resource utilization were assessed using general linear models; PDCDS's open-ended questions were analyzed using directed content analysis., Results: 114 parental caregivers participated. Post discharge coping was significantly associated with additional resource utilization: length of stay (p = 0.046), readmissions (p = 0.001), emergency department visits (p = 0.001), clinic calls (p = 0.001) and unplanned clinic visits (p = 0.006). PDCDS was negatively correlated with the QDTS Quality of Teaching Delivered subscale (r = -0.32; p = 0.004) and three of five RHDS subscales: 1) Child's Personal Status (r = -0.24; p = 0.02); 2) Knowledge (r = -0.30; p = 0.005); and 3) Coping Ability (r = -0.39; p < 0.001). Four themes explicated parental coping difficulties., Conclusion: Parents experiencing coping difficulties were more likely to have difficulty managing their child's care needs at home and required additional health care resources., Practice Implications: Recognizing that parents' readiness for discharge may not reflect their coping abilities post-discharge requiring nurses to coordinate pre- and post-discharge education and support services., Competing Interests: Declaration of Competing Interest The authors have no conflicts of interest relevant to this article to disclose., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Children with severe (Gross Motor Function Classification System [GMFCS] IV-V) cerebral palsy (CP) exhibit profound physical and developmental impairments and require assistance for all activities of daily living. No curative treatments exist although surgical procedures to correct underlying hip and spine deformities can improve their quality of life. Despite the efficacy of these surgeries, little is known regarding parental caregivers' expectations specific to surgical outcomes and their satisfaction with surgical outcomes. The purpose was to explore parental caregiver expectations and satisfaction with hip and spine surgeries that their children with GMFCS IV-V CP underwent. Variations among preoperative expectations, changes in expectations over time, and the relationship of expectations on caregiver satisfaction were examined. A qualitative descriptive approach with conventional content analysis was utilized. Three preoperative caregiver expectation themes were identified: increasing functionality, increasing comfort, and maintaining health and averting crisis. These themes were still present at 5-year follow-up; however, more caregivers refocused their expectations from improving function to providing palliation. A clear relationship between expectations and caregiver satisfaction, however, was not identified. A deeper understanding surrounding caregiver expectation and satisfaction following surgical procedures is needed., Competing Interests: The authors report no conflicts of interest and have no financial activities relevant to the submitted manuscript., (Copyright © 2023 by National Association of Orthopaedic Nurses.)

Spontaneously flowing liquids have been successfully engineered from a variety of biological and synthetic self-propelled units 1-11 . Together with their orientational order, wave propagation in such active fluids has remained a subject of intense theoretical studies 12-17 . However, the experimental observation of this phenomenon has remained elusive. Here, we establish and exploit the propagation of sound waves in colloidal active materials with broken rotational symmetry. We demonstrate that two mixed modes, coupling density and velocity fluctuations, propagate along all directions in colloidal-roller fluids. We then show how the six material constants defining the linear hydrodynamics of these active liquids can be measured from their spontaneous fluctuation spectrum, while being out of reach of conventional rheological methods. This active-sound spectroscopy is not specific to synthetic active materials and could provide a quantitative hydrodynamic description of herds, flocks and swarms from inspection of their large-scale fluctuations 18-21 .

Background: Motion sickness is a serious issue for many individuals, but the problem is particularly important among military personnel who may regularly experience unusual or extreme motion profiles as a part of their duties. As such, it is important to understand the underlying mechanisms that contribute to motion sickness, which in turn can lead to new and more effective countermeasures. The current study investigated causal etiology by examining the predictions of postural instability theory. Subjects experienced multiple motion profiles while reporting their sickness symptoms., Methods: Postural instability was directly manipulated by including both an active and passive condition. In the active condition, subjects could actively adapt their posture to the motion profile. In the passive condition, subjects had their feet affixed in place and could not effectively adapt their posture to the motion profiles. Subjects completed both conditions to control for individual differences in motion sickness susceptibility., Results: Active condition subjects had greater postural stability as measured by sample entropy (M = 0.179 Active, M = 0.136 Passive), and sickness symptoms increased with time. Both results provide a methodological check against our manipulation. However, there were no differences in symptoms between active or passive conditions as measured by the simulator sickness questionnaire (M = 16.56 and M = 18.25, respectively), and no relationship between our measure of postural instability and symptomology., Discussion: These results do not support postural instability as the primary causal factor in motion sickness; however, more research is needed to elucidate the mechanisms of motion sickness etiology.Pettijohn KA, Geyer D, Gomez J, Becker WJ, Biggs AT. Postural instability and simulator seasickness. Aerosp Med Hum Perform. 2018; 89(7):634-641.

Active particles, including swimming microorganisms, autophoretic colloids, and droplets, are known to self-organize into ordered structures at fluid-solid boundaries. The entrainment of particles in the attractive parts of their spontaneous flows has been postulated as a possible mechanism underlying this phenomenon. Here, combining experiments, theory, and numerical simulations, we demonstrate the validity of this flow-induced ordering mechanism in a suspension of active emulsion droplets. We show that the mechanism can be controlled, with a variety of resultant ordered structures, by simply altering hydrodynamic boundary conditions. Thus, for flow in Hele-Shaw cells, metastable lines or stable traveling bands can be obtained by varying the cell height. Similarly, for flow bounded by a plane, dynamic crystallites are formed. At a no-slip wall, the crystallites are characterized by a continuous out-of-plane flux of particles that circulate and re-enter at the crystallite edges, thereby stabilizing them. At an interface where the tangential stress vanishes, the crystallites are strictly 2D, with no out-of-plane flux. We rationalize these experimental results by calculating, in each case, the slow viscous flow produced by the droplets and the long-ranged, many-body active forces and torques between them. The results of numerical simulations of motion under the action of the active forces and torques are in excellent agreement with experiments. Our work elucidates the mechanism of flow-induced phase separation in active fluids, particularly active colloidal suspensions, and demonstrates its control by boundaries, suggesting routes to geometric and topological phenomena in an active matter., Competing Interests: The authors declare no conflict of interest.

Background: US combat operations in Iraq and Afghanistan have resulted in a greater proportion of service members with head and neck wounds caused by explosions compared with that of previous wars. Although penetrating traumatic brain injury (TBI) is frequently associated with these wounds, the epidemiology of penetrating TBI from these conflicts has not been well described., Methods: The Joint Theater Trauma Registry was queried for January 2003 through December 2010 to identify all patients with moderate-to-severe brain injury with a maximum Abbreviated Injury Scale (AIS) score of the head of 3 or greater and a diagnosis of penetrating or closed TBI in accordance with the Department of Defense Traumatic Brain Injury Surveillance definition. The epidemiology of these injuries was examined, including demographics, TBI severity, overall injury severity, and surgical interventions provided., Results: A total of 1,255 TBI patients (774 penetrating, 481 closed) meeting criteria were identified. Penetrating brain injuries were more severe, more likely to be battle related, and less likely to be isolated injuries than a group of moderate-to-severe closed TBIs within the same range of anatomic injury severity. During the 5-year period of the Iraq war with the largest numbers of TBIs (2004-2008), the numbers of penetrating TBIs exceeded closed TBIs by a ratio of 2:1. During the 3-year period of the Afghanistan war with the greatest numbers of TBIs (2008-2010), the ratio of penetrating to closed TBIs was substantially lower, approximately 1.3:1., Conclusion: This study represents the first comprehensive report on the epidemiology of moderate-to-severe penetrating and closed TBIs resulting from the wars in Iraq and Afghanistan using Joint Theater Trauma Registry data. With the maturing theater of conflicts, penetrating TBIs were substantially less predominant compared with closed TBIs. While this finding may reflect changes in the use of protective measures and tactics or improvements in diagnosis of closed TBIs, additional research is needed to identify the reason for this shift and the subsequent effect on outcome after combat-related TBIs., Level of Evidence: Epidemiologic study, level III.

The diagnostic techniques for simultaneous velocity and relative OH distribution, simultaneous temperature and relative OH distribution, and three component velocity mapping are described. The data extracted from the measurements include statistical moments for inflow fluid dynamics, temperature, conditional velocities, and scalar flux. The work is a first step in the development of a detailed large eddy simulation (LES) validation database for a turbulent, premixed flame. The low-swirl burner used in this investigation has many of the necessary attributes for LES model validation, including a simplified interior geometry; it operates well into the thin reaction zone for turbulent premixed flames, and flame stabilization is based entirely on the flow field and not on hardware or pilot flames.

Ependymomas are glial tumors that occur most often in children. In adults, ependymomas most often appear in the spinal cord. The World Health Organization recognizes several rare ependymoma subtypes, including the giant cell ependymoma of the terminal filum. The authors describe an unusual case of a posterior fossa giant cell ependymoma in an 89-year-old man presenting with vertigo and disequilibrium. Only seven cases of this tumor have been reported in the literature to date. The authors discuss the clinical presentation, radiological findings, pathological considerations, and surgical intervention in this patient and review the relevant literature.

Objective and Importance: Isolated anaplastic large cell lymphoma (ALCL) presenting in the primary central nervous system is distinctly uncommon. The authors describe a case that clinically and radiographically simulated a primary glial neoplasm., Clinical Presentation: A 39-year-old immunocompetent male presented with seizures and a rapidly enlarging right occipital/parietal lesion. Magnetic resonance images demonstrated a right occipitoparietal lesion, hypodense on T1WI, with patchy contrast enhancement with gadolinium and significant white matter edema pattern on T2WI along with mass effect and midline shift., Intervention: The patient underwent a frameless stereotactic assisted needle biopsy. There appeared to be a clear demarcation between white matter and tumor with no obvious necrosis. Biopsy showed a proliferation of single cells and poorly cohesive groups of cells with large, pleomorphic nuclei, many containing prominent nucleoli, and a moderate amount of cytoplasm. Immunohistochemical staining revealed CD-30 and ALK-positivity typical of ALCL, a rare form of T-cell lymphoma. An extensive workup revealed neither systemic disease nor evidence of immunocompromise., Conclusion: Reported in less than 20 patients, primary ALCL in an immunocompetent patient is rarely found intracranially; however, its ability to mimic glial neoplasms as well as other pathologies underlines its importance.

This open-label, randomized study in 36 healthy postmenopausal women, investigated the pharmacokinetics of Fem7, (an oestradiol matrix-type patch), at doses of 25, 50, 75 and 100 microg/24 h, applied once weekly. Maximum plasma concentrations of oestradiol and oestrone were observed 14-20 h after patch application, remaining within the therapeutic range until removal, and returning to baseline within 12 h thereafter. Plasma oestradiol concentrations increased in a dose-dependent manner for all four doses, and plasma oestrone increased for the three highest doses. Fem7 treatment was well tolerated at all four doses and no severe adverse reactions were reported. Fem7 is a convenient and well-tolerated form of hormone-replacement therapy that delivers oestradiol in a consistent and predictable manner.

Six loci, apoliproprotein B (including Ag(x) antigen), immunoglobulin kappa constant region (IGKC), luteinizing hormone/choriogonadotrophin receptor, avian myelocytomatosis viral related oncogene, neuroblastoma derived, ornithine decarboxylase, and proopiomelanocortin (adrenocorticotropin/beta-lipotropin) (POMC), were newly assigned to sheep chromosome 3p using a chromosomally characterized minipanel of sheep-hamster cell hybrids. Isotopic in situ hybridization of IGKC to sheep chromosome 3p22-p17 is reported, confirming the cell hybrid assignment. As these loci are all known to map to human chromosome 2p, this study demonstrates that this chromosomal segment is extensively conserved in sheep. Only POMC has been previously assigned to cattle chromosome 11, which is the equivalent of sheep chromosome 3p. Therefore, we predict that the other loci assigned in this study to sheep 3p are likely to be located on cattle 11. The provisional assignment of an additional locus, annexin-like to sheep chromosome 3p is also reported.

During steady-state exercise the noninvasive measurement of cardiac output using CO2-rebreathing has been found to be reliable and reproducible. In contrast, reliability of cardiac output measurement during unsteady state exercise is unclear. The ability to determine cardiac output (CO) noninvasively during steady state and unsteady state exercise was assessed in nine healthy students aged 25.7 +/- 7.4 years. Two cycle ergometer exercise tests were performed, one maximal unsteady state test with 25 watts increment of workload per minute, and also one steady state test at 25, 50, and 75 percent of max. VO2. CO was measured using the equilibrium CO2-rebreathing technique during unloaded cycling in both tests, at 75 and 150 watts in the unsteady state test and at all workloads during steady state exercise. Mean max. VO2 was 31.4 +/- 5.9 ml/kg/min and mean VO2 at the anaerobic threshold 24.5 +/- 7.2 ml/kg/min, respectively. During unsteady state exercise the CO2/workload slope was linear (r = 0.973), as with steady state exercise (r = 0.976). There was no difference concerning the slopes of both curves, but the elevation of VO2 with unsteady state exercise was lower, compared to steady state (p < 0.005). The relationships of CO/VO2 during unsteady and steady state exercise were best expressed by linear equations: CO = 7.49 x VO2 + 2.35 (r = 0.866) and CO = 8.24 x VO2 + 1.4 (r = 0.852), respectively. Similar to VO2/workload, both regressions did not have different slopes, but did have different elevations (p < 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

The gene for human interleukin-1 receptor antagonist (IL1RN) has been assigned to chromosome 2 on the basis of Southern blot analysis of a series of human-Chinese hamster cell hybrids. Using a yeast artificial chromosome containing the IL1RN gene as a probe, the human IL1RN gene was localized to the long arm of chromosome 2 at band 2q14.2 by fluorescence in situ hybridization. This site is near the positions of genes for human IL-1 alpha, IL-1 beta, and types I and II IL-1 receptors, as reported by other laboratories.

Two murine monoclonal antibodies, 1D12 and 2F7, apparently of the same specificity, define a new red cell polymorphism, MER2. 92% of English blood donors are MER2+ giving the gene frequencies MER2+ 0.7159; MER2- 0.2841. Family studies showed that MER2+ is inherited as a Mendelian dominant character and that MER2 is not controlled by any of the main blood group loci. The MER2 antigen is also present on some leukaemia fibroblasts and human cell lines. Using somatic cell hybrids, MER2 appears to be coded for by a gene on chromosome 11 at 11p15.

A series of hybrids between primary human cells and a Chinese hamster somatic cell mutant (Mev-1), defective in expression of the enzyme 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) synthase [(S)-3-hydroxy-3-methylglutaryl-CoA acetoacetyl-CoA-lyase (CoA-acetylating, EC 4.1.3.5], has been prepared that complements the mutant defect. A technique based on differential sensitivity of this enzyme activity to inhibition by magnesium ion is described that allows the discrimination of expression of human and hamster HMG-CoA synthase in these hybrids. The results indicate a structural gene defect in expression of HMG-CoA synthase activity in Mev-1 cells. Segregation of human chromosomes that do not possess the complementing marker have allowed the assignment of human HMG-CoA synthase activity to chromosome 5. This is the second demonstrably transcriptionally regulated enzyme of cholesterologenesis to be assigned to chromosome 5, the other being HMG-CoA reductase.

DNA-mediated transfectants were isolated that expressed two of the cell-surface antigens encoded by human chromosome 11. These tranfectants were used to analyze monoclonal antibodies selected to recognize human cell-surface antigens expressed by a somatic cell hybrid containing 11 as its only human chromosome. Analysis of the transfectants, deletion hybrids, and mutants showed that the monoclonal antibodies recognized at least five different antigens, one of which we had not identified previously. A majority of the monoclonal antibodies recognized the a1 antigen. The use of cells from higher primates demonstrated that the a1-specific monoclonal antibodies recognize at least two epitopes.

The radiology of total hip replacement (THR) and its complication is reviewed in conjunction with a long-term follow-up study on 402 patients with 501 prostheses. The indications, contraindications, biomechanics, and operative management of these patients is discussed. Clinical complications such as deep vein thrombosis, pulmonary embolism, and hemorrhage are mentioned. Postoperative infections including granulomatous pseudotumors, dislocations and fractures, true loosening of the prosthesis, and heterotopic bone formation (HBF) are discussed and illustrated. The importance of differentiating the lucent line from true loosening is stressed. Mechanical and other clinical complications which are largely ignored by radiologists are also discussed. The uses of arthrography and bone scanning are included.

Habituation of blink reflexes as measured by amplitude decrement in the orbicularis oculi EMG was examined in 9 human subjects using combinations of repetitive electric stimuli to the bridge of the nose (trigeminal stim.), short clicks (acoustic stim.), and flashes (visual stim.). With trains of paired stimuli, both homogeneous and mixed, habituation was increased when the two stimuli were separated by 250 msec but was decreased when the interval was 30 (50) msec, as compared to single stimulus trains of identical repetition rate. Following acoustic or visual prehabituation the habituation to trigeminal stimuli was enhanced. This "transfer of habituation' was also obtained with acoustic before visual stimuli and vice versa. Regarding dishabituation, interposition of single extrastimuli, for example visual or acoustic within repeated trigeminal stimulation, was more effective than a simple pause by omitting one electric pulse. The results suggest the existence of a pool of interneurones that is that the common final relay for the blink relfex afferents from the trigeminal, acoustic and visual input.