Search

In this new millennium, the law enforcement profession faces the need for complex change. Police agencies are moving away from just responding to incidents. Today, they must address causes of [...]

Objective: Insulin/dextrose has been advocated in recent reports to rapidly improve haemodynamic parameters in calcium channel blocker poisoning. We report a case of verapamil overdose unresponsive to this and conventional therapies. Case Report: A 58-year-old male with a history of myocardial infarction, hypertension and an aortic lesion presented to the Accident and Emergency Department with severe chest and abdominal pain with guarding. Although the patient was conscious blood pressure was initially unrecordable and was then recorded at 70/50 mmHg after administration of intravenous fluids. Peripheral pulses were unpalpable. His medication on admission consisted of frusemide, verapamil, warfarin and amlodipine. Arterial blood gas analysis revealed metabolic acidosis, hypercarbia and hypoxia (pH 7.28, [PCO.sub.2] 7.49 kPa, [HCO.sub.3] 11.8 mmol/L, SBE-12.2 mmol/L, [O.sub.2] 82.8, SBC 13.4 mmol/L). ECG showed sinus bradycardia (rate 62) and left-bundle-branch block. Other biochemical abnormalities included hyperglycaemia (13.5) slightly elevated liver enzymes (ALT 84 IU/L, AST 63 IU/L) creatinine 197 [micro]mol/L, creatinine kinase 295 IU/L (troponin level negative) and an INR of 4.17. The patient denied self-poisoning and blood toxicology (including paracetamol) was negative. A chest x-ray revealed cardiomegaly and possible mediastinal widening. Echocardiography was consistent with findings at a previous examination. Abdominal ultrasound and CT scans demonstrated no abnormalities. The patient developed respiratory failure and was intubated and ventilated. Calcium channel blocker poisoning was suspected because of the bradyarrhythmias, hyperglycaemia and hypotension unresponsive to treatment. Management at this point was supportive with large doses of inotropes. Intravenous calcium chloride, glucagon, sodium bicarbonate, dextrose/ insulin were given and a temporary pacemaker was inserted to treat severe bradycardia. Renal replacement therapy was started because of deteriorating renal function. Verapamil level was taken on the second day and retrospectively confirmed the self-poisoning (Verapamil 1740 [micro]g/L and norverapamil 850 [micro]g/L, target range for both is 100-200). Continuous veno-veno haemodialysis (CVVHD) was again attempted owing to rapidly elevating liver transaminases (ALT 1252 IU/L, AST 1377 IU/L) but this was tolerated poorly and discontinued. The patient died two days post admission to the Intensive Care Unit despite these interventions. Conclusion: This report demonstrates calcium channel blocker poisoning unresponsive to standard interventions of intravenous fluids and inotropes, calcium chloride salts, glucagon and pacing. The patient was also treated with dextrose/insulin (insulin euglycaemia), a novel therapy suggested in literature, but this did not show any benefit., Herbert JX(1), O'Malley C(2), Tracey JA(1), Dwyer R(2), Power M(2). (1) The National Poisons Information Centre, Beaumont Hospital, (2) Dept. of Anaesthesia, Beaumont Hospital, Dublin, [...]

Adult Mesenchymal Stem Cells (MSCs) have a well-established tumor-homing capacity, highlighting potential as tumor-targeted delivery vehicles. MSCs secrete extracellular vesicle (EV)-encapsulated microRNAs, which play a role in intercellular communication. The aim of this study was to characterize a potential tumor suppressor microRNA, miR-379, and engineer MSCs to secrete EVs enriched with miR-379 for in vivo therapy of breast cancer. miR-379 expression was significantly reduced in lymph node metastases compared to primary tumor tissue from the same patients. A significant reduction in the rate of tumor formation and growth in vivo was observed in T47D breast cancer cells stably expressing miR-379. In more aggressive HER2-amplified HCC-1954 cells, HCC-379 and HCC-NTC tumor growth rate in vivo was similar, but increased tumor necrosis was observed in HCC-379 tumors. In response to elevated miR-379, COX-2 mRNA and protein was also significantly reduced in vitro and in vivo. MSCs were successfully engineered to secrete EVs enriched with miR-379, with the majority found to be of the appropriate size and morphology of exosomal EVs. Administration of MSC-379 or MSC-NTC cells, or EVs derived from either cell population, resulted in no adverse effects in vivo. While MSC-379 cells did not impact tumor growth, systemic administration of cell-free EVs enriched with miR-379 was demonstrated to have a therapeutic effect. The data presented support miR-379 as a potent tumor suppressor in breast cancer, mediated in part through regulation of COX-2. Exploiting the tumor-homing capacity of MSCs while engineering the cells to secrete EVs enriched with miR-379 holds exciting potential as an innovative therapy for metastatic breast cancer.

In a world of diminishing resources, current research efforts are often directed to extending the life of existing resources and developing technology to treat resources deemed uneconomic. To this end, biotechnology has been explored as a potential low cost, environmentally benign alternative to many of the current mineral processing techniques. Microorganisms and their metabolites have been successfully applied in the leaching of metals from medium and low grade sulphide minerals for many years. Recent fundamental studies have shown that selected bacteria may also assist in the beneficiation of these minerals through bioflotation and bioflocculation. The current published research demonstrates that several bacteria and their excreted proteins and polysaccharides have a significant effect on the surface chemical properties of some minerals. As such, the bacterial cells and their metabolites can be utilised as flotation collectors and modifiers enabling selective separation. To date, these studies have primarily focused on the sulphide minerals; however, there is considerable scope to expand this research for the beneficiation of oxide minerals such as those contained in iron ores. This paper provides a comprehensive review of current research on the use of microorganisms for mineral beneficiation and the potential use of genetically modified bacteria and, further, discusses the applicability of bioflotation and bioflocculation for the beneficiation of Australian iron ores.

Objectives: To examine differences in personal characteristics, types of services, and outcomes of care in a state mental health system among youths identified as having committed sex offenses. Methods: A cohort of 188 youths identified with sexual offending behaviors served during one fiscal year was compiled and their existing personal, service, and functioning data from medical and computer files were used in retrospective comparisons employing analysis of variance, logistic regression, and random effects regression modeling. Results: A diagnosis of conduct disorder or oppositional defiant disorder significantly distinguished between males and females in the cohort. The primary form of intervention was 24-hour residential or inpatient treatment, with males having longer lengths of stay than females. In community-based outpatient care, males received significantly more crisis services, group therapy, and medication monitoring. Child Global Assessment of Functioning (CGAF) ratings improved over time, but not to a statistically significant extent. Conclusions: Given the potential for untreated adolescents with sexual offense histories becoming adult clients in mental health systems, evidence-based interventions should be employed as early as possible. This requires a matching of needs with interventions of proven efficacy, thus necessitating periodic reviews and monitoring of the demographics of the adolescents (and children) identified as having engaged in sexual offending behaviors and their outcomes (functional improvement) over time.

A total of 8.3 million HIV-positive people live in the Asia-Pacific region. The burden of HIV-associated neurocognitive impairment and symptomatic sensory neuropathy in this region is unknown.

The NIST method for measuring the ignition propensity (IP) of cigarettes on a test mockup meant to represent the flat surface of upholstered furniture was revised and tested [1]. The revisions included a number of dele tions and additions. The most important addition to the original test was the in clusion of selected, smolderable upholstery fabrics. The deletions were, in general, procedural details known or believed to be unnecessary. Three replicate runs of the method using the same experimental and control cigarette pair, as well as a series of runs using experimental and control cigarette pairs with deliv eries of 5, 11 and 16 mg of tar, were performed. The modified method provides re peatable and statistically valid data. Adding commercial, nonreversal upholstery fabrics to the test did not add to the ability of the test to measure IP behavior and, therefore, they were eliminated in the final proposed method. A reversal-type fabric should be included in the test, but it should be specially pro duced for this purpose [9]. With these further modifications, the test is consider ably simpler to perform than the original test.

This study examines job events with a tri-level analytical framework of isolate those incidents within the organizational context perceived as problems by law enforcement personnel. The Police Stress Survey was developed to assess job events within the macro-, intermediate-, and micro-levels of the organization. The survey was distributed to police officers and deputy sheriffs during traditional roll call meetings, with a final sample of 402 from various assignments and ranks. Factor analysis and stepwise regression analysis was used to determine which level within the organizational context best predicts perceived stress scores.Eight factors are identified within the tri-level analytical framework to include: organizational policies and structures, work overload/resource allocation, role ambiguity, organizational processes, intraindividual and interpersonal conflict, role conflict, security and pay, and job changes. A model of organizational stress is developed incorporating the contributions of each level within the organizational context. The model suggests that organizational structures and processes are the best predictors of perceived stress.The standardized measurement instrument is reliable, cost effective, and time efficient for developing intervention policy. It can be used to identify organizational levels at which to focus policy for delivering individual or organizational services.Recommendations for communication, hierarchical structure, and participatory decision-making are identified to diminsh the effects of problem job events at the macro-level of the organization. By determining which factors and their organizational level that most affect officers' stress, agency resources can be allocated to improve service to citizens and decrease stress induced problems.

This report considers the expected combinatorial complexity of the Euclidean Voronoi diagram and the convex hull of sets of nindependent random points moving in unit time between two positions drawn independently from the same distribution in Rdfor fixed d\ge 2as n→∈fty. It is proved that, when the source and destination distributions are the uniform distribution on the unit d-ball, these complexities are Θ(n(d+1)/d)for the Voronoi diagram and O(n(d-1)/(d+1)log n)for the convex hull. Additional results for the convex hull are O(log dn)for the uniform distribution in the unit d-cube and O(log (d+1)/2n)for the d-dimensional normal distribution.

The time and heat flux required for the initiation of smoldering com bustion in cellulosic fabrics depends on the properties of both the environment and the fabric. In the environment, there must be sufficient oxygen to support smolder ing combustion and there must be sufficient heat to raise the temperature of the fabric to the point where combustion becomes self supporting. The critical factors for the cellulosic fabrics are the potassium and/or sodium ion content and the ther mal characteristics of the fabric. A series of simple weave, raw cotton fabrics, com monly referred to as cotton ducks, and an upholstery fabric were examined. The requirements for the initiation of smoldering combustion were similar for both the ducks and the upholstery fabric. However, the situation for the upholstery fabric was complicated by the non-homogeneous distribution of ions in the material and spatial variations in fabric thickness and basis weight. Also, for fabrics with potas sium and sodium ion contents in the range of approximately 1500 to 2500 ppm, there was an increased sensitivity to the environmental factors.

Linear burn rates were determined for thin, cellulosic materials (papers and cotton fabrics) held in the horizontal plane by measuring the rate of radial increase of the circular burn pattern. Linear burn rates were determined for freely smoldering materials and for materials in contact with polyurethane foam. The linear burn rates of the freely smoldering materials were found to be inversely proportional to basis weight. This relationship held over basis weights from 0.8 to 24 oz/yd2. The linear burn rates of the materials in contact with poly urethane foam were also inversely proportional to basis weight and were reduced about 16% from the free smolder rate. The effect of potassium ion content was also examined. A minimum level of potassium, approximately 1300 ppm, was re quired for sustained smoldering combustion. Above this minimum level, the ion content did not have a significant effect on the linear burn rate.

Summary.Repeated injections of PGF-2α were given to hysterectomized guinea-pigs. Within 12 h after the first injection, plasma progesterone levels were significantly reduced (P< 0·001) and declined to <1 ng/ml by the 4th day after the end of PGF-2α treatment. A decline in plasma levels of pregnenolone paralleled that of progesterone. PGF-2α treatment did not affect the metabolic clearance rate of [3H]pregnenolone, but the conversion of [3H]pregnenolone to [3H]progesterone was reduced by about 50%.

Summary.The enzymes studied were cholesterol esterase, cholesterol ester synthetase, 3β-hydroxysteroid dehydrogenase and 20α-hydroxysteroid dehydrogenase. PGF-2α reduced the activities of 3β-hydroxysteroid dehydrogenase and cholesterol esterase but did not affect those of cholesterol ester synthetase or 20α-hydroxysteroid dehydrogenase.

Twenty-three patients undergoing Caesarean section received either 0.5% halothane or 0.8% isoflurane to supplement nitrous oxide-oxygen anaesthesia. We studied the rate of uptake of the agents by the mother and fetus by measuring partial pressures in maternal arterial (Pa) and fetal umbilical venous (Puv) blood. Mean induction-delivery interval did not differ between the halothane (10.8 min) and isoflurane (11.7 min) groups. There were no differences in maternal heart rate, arterial pressure, pH and blood-gas tensions and fetal pH, blood-gas tensions or Apgar scores between the two groups. Isoflurane uptake by the mother was more rapid than halothane; at delivery, mean Pa of isoflurane as a fraction of the inspired partial pressure (Pl) was 0.44 compared with 0.35 for halothane (P < 0.05). Mean Puv as a fraction of maternal Pa at delivery was 0.71 for both agents; thus placental transfer was the same for both agents. Consequently mean Puv/Pl was greater for isoflurane (0.32) than halothane (0.26) (P < 0.05). We conclude that both halothane and isoflurane are suitable agents for general anaesthesia for Caesarean section. The rate of uptake of isoflurane by the mother during Caesarean section was more rapid than halothane. The rate of uptake by the fetus from the mother was the same for halothane and isoflurane, so that fetal partial pressure as a fraction of the inspired partial pressure was greater for isoflurane than halothane.

It is proved that, for any fixedd ≽3 and 0 ≤k ≤ d -1, the expected combinatorial complexity of the Euclidean Voronoi diagram ofnrandom &-flats drawn independently from the uniform distribution onk-flats intersecting the unit ball in ℝdis Ξ(nd/(d-k)) asn → ∞.A by-product of the proof is a density transformation for integrating over sets ofd +1k-flats in ℝd

In order to correlate the concentrations of oestrogens in the fetal fluids of the pig with those observed in the maternal blood and urine, changes in the concentrations of oestrone, oestradiol-17β, oestrone sulphate, oestradiol sulphates and oestrone glucuronide were assessed throughout pregnancy in the fetal and maternal fluids. In general, the pattern of change was similar for all oestrogens measured in both fetal and maternal fluids. Since the concentration of oestrogens in allantoic fluid during early pregnancy is reflected in the concentration of these steroids in maternal plasma and excreted in the maternal urine, the rise and fall of oestrogen concentrations around day 30 is suggestive of synthesis followed by a virtual cessation of oestrogen production until the fetus or placenta again produce increasing amounts detectable after day 45. These findings contrast sharply with those in the cow and the ewe where, although similar peaks in oestrogen concentrations are observable in allantoic fluid during early pregnancy, they are not reflected in blood.J. Endocr.(1985) 106, 355–360

Summary.Sows and ewes were killed at various times during gestation. Minced uterine samples were incubated for 3 h with [6,7-3H]oestrone sulphate or [2,4,6,7-3H]oestrone, respectively. Contrasting patterns of enzyme activities were found in the-sow and ewe. In the sow, endometrial sulphotransferase activity declined after Day 30 of gestation, while in the ewe, sulphation gradually increased after Day 16. The inverse was found for the activity of oestrogen sulphatase during pregnancy.

Summary.Injection of antisera to oestradiol-17β and to oestrone from Days 10 to 21 of pregnancy had no effect on the maintenance of the corpora lutea or the initiation of placental attachment in the pig.

A total of 250 human serum samples were tested for rubella virus immunoglobulin G antibodies by two enzyme immunoassays (EIAs), one using whole rubella virus antigen and the other based on the use of synthetic peptide antigen. The samples were taken from 125 volunteers before and after their immunization with the RA 27/3 rubella vaccine. This study indicates that a synthetic peptide-based EIA can favorably replace current viral lysate-based EIAs to detect rubella virus antibodies following immunization. Because the synthetic peptide used in this newly developed EIA represents a putative neutralization epitope of the rubella virus, it could also be instrumental in determining rubella immune status and in assessing vaccine program efficiency.

Equine group A rotaviruses isolated over a 10-year period in New York State, New Jersey, Kentucky, and Texas were compared serotypically and electropherotypically. All isolates were determined to be serotype 3 by reaction with hyperimmune antiserum to the serotype 3 H-2 strain of equine rotavirus. All displayed RNA electrophoretic migration patterns related to that of the H-2 strain but distinct from that of serotype 5 strain H-1. A serologic survey of 184 mares in Kentucky, which was done to determine the incidence of H-1 and H-2 infections, showed geometric mean serum neutralizing titers to the H-2 strain of equine rotavirus to be significantly higher than those to the H-1 strain. These data suggest that the serotype 3 H-2 strain is the dominant equine rotavirus in Kentucky and perhaps elsewhere in the United States. We were unable to produce confirmational evidence that the H-1 strain occurs as a natural infection in the United States.

SUMMARYComplement-fixing antibodies to Coxiella burneti were present in 23 p.c. of kangaroos collected in western Queensland, and agglutinins in 15 p.c. Red kangaroos, Megaleia rufa, showed a higher incidence of complement-fixing antibodies (33 p.c.) than grey kangaroos, Macropus major (12 p.c.). In three areas, the incidence of complement-fixing antibody in M. rufa was between 46 and 54 p.c.C. burneti was isolated in mice from the blood of one Macropus major.Thirteen isolations were made from nearly 3,000 ornate kangaroo ticks, Amblyomma triguttatum, collected from kangaroos, goats and sheep. The titre of infectivity of infected ticks for mice was usually in the range 10−6to 10−9.Infection of kangaroos and A. triguttatum was found over a considerable area, between 24 and 28° S. and 144 and 149° E., in western Queensland.It thus seems probable that a natural kangaroo-tick cycle exists. The three-host life cycle and wide host range of this tick would allow it to spread infection to domestic animals as well as kangaroos. Infestation of sheep would bring infected ticks into contact also with workers in the sheep-shearing industry, and was probably responsible for recent outbreaks of Q fever among them.Australian Journal of Experimental Biology and Medical Science (1960) 38, 17–27; doi:10.1038/icb.1960.3

We present a review of 229 blood cultures with viridans streptococci collected during a period of eight and a half years from 1986 to 1994 at a teaching hospital in Sweden. The clinical significance of the growth of viridans streptococci is always uncertain, since these bacteria can be contaminants from the skin flora. Growth in more than one culture bottle strengthens the clinical value of the finding. The question was whether species identification might also help in the assessment of the clinical relevance of the finding. The results show that Streptococcus mitisoccurs significantly more frequently in blood cultures from the departments dealing with cancer patients. Even with polymicrobial growth in blood cultures, S. mitisshould be considered a pathogen of clinical relevance, not a contaminant.

Serum levels of the stress protein alpha, acid glycoprotein were measured before, during and after labour in 31 patients, 21 of whom were treated for pain with intramuscular pethidine and ten with an epidural block. Levels of the glycoprotein were increased from pre-labour values during late labour, at delivery and postpartum in patients given pethidine. In the group given epidural analgesia, no change was found in alpha, acid glycoprotein concentration during labour but on day 1 postpartum an increase comparable with that in the pethidine series was found. Levels of the glycoprotein in umbilical venous blood taken at delivery were similar in the two groups.

The prevalence of chlamydial infection of the urethra was studied in 172 consecutive male patients attending a sexually transmitted disease clinic in Teheran. Chlamydia trachomatis was isolated in 8.8% of the patients with a valid culture result. Of the five isolates serotyped, two were serotype E and three were serotypes G, H, and K. Type-specific antibodies against C trachomatis serotypes D to K were found in 16% of patients, and IgM, indicating current infection, was detected in 12%. Type-specific antibodies against serotypes A to C (trachoma agent) were detected in 5.4%. The low chlamydial isolation rate may have been due to the inclusion of a large number of patients with a mild or trivial urethritis or a history of previous treatment with antichlamydial drugs. The results indicate that in Iran where trachoma is still endemic, chlamydial infection of the urethra does occur in the urban population and is caused by serotypes D to K. [ABSTRACT FROM PUBLISHER]

A VARIETY of methods, including use of immunological or isotopic markers or the excretion-rate of products of hæmoglobin catabolism, have been used to estimate in vivo viability of red blood cells1. In measuring the viability of cells subjected to storage or other in vitro treatment, it is necessary to calculate survival using an independent measurement of dilution since the experimental cells may in part be rapidly lost2,3. The dilution volume, or red cell mass, of the recipient has been estimated indirectly from plasma volume and hæmatocrit determinations3or directly by use of simultaneous or sequential injections of control red cells marked with a labelling system different from that used for the experimental cells2,4.

Full text available.

We have studied the effect of age on washin of isoflurane and halothane by comparing end - tidal (PE') and arterial (Pa) partial pressures of the agents in young (18–32 yr) and elderly (63–82 yr) healthy patients for 20 min after introduction of the agents, before surgery. PE' was measured by infra - red analysis and Pa by gas chromatography. Washin of isoflurane occurred at the same rate in the young and elderly, with no significant difference between young and elderly in PE' or Pa as proportions of the inspired partial pressure (PI). After 20 min of isoflurane administration, mean Pa/Pl in the young was 0.57 (95% confidence limit (CL) 0.53–0.62) and 0.55 in the elderly (95% CL 0.51–0.59). Washin of halothane was slower in the elderly than in the young, with Pa/Pl significantly less in the elderly from 10 min after introduction of halothane. The difference between age groups, however, was small: mean Pa/Pl after 20 min of halothane administration 0.45 (95% CL 0.41–0.49) in the young and 0.38 (95% CL 0.35–0.41) in the elderly. Washin of isoflurane was significantly faster than that of halothane in both young and elderly subjects. For isoflurane, the PE'-Pa gradient was small relative to Pa and did not differ significantly between young and elderly. For halothane, PE'-Pa in the young did not differ significantly from that for isoflurane. In the elderly, PE'-Pa for halothane was significantly greater than in the young and than PE'-Pa for isoflurane.

Twenty-two young (18–32 yr) and 22 healthy elderly (60–80 yr) patients received either halothane or isoflurane for maintenance of anaesthesia during controlled ventilation. Endtidal fractional concentrations (FE) of the agents were measured for 20 min after their introduction into inspired gas and the increase in end-tidal concentrations of the two agents was compared during induction of anaesthesia using the ratios of FE to the inspired fraction (F1). FE: F1 ratios for isoflurane were higher than those for halothane in both young and elderly patients, confirming that equilibration of end-tidal with inspired concentration occurs more rapidly with isoflurane than with halothane in both age groups. FE: F1 ratios for isoflurane became significantly lower in the elderly than in the young after 15 min administration of isoflurane. This suggests slower induction of anaesthesia in the elderly if equipotent concentrations of isoflurane are used; the clinical significance of this difference is probably small. Mean FE: F1 ratios for halothane in elderly patients were similar to those in the young throughout induction of anaesthesia.

Twenty patients who requested extradural analgesia for labour were allocated randomly to receive an infusion of either 0.25% or 0.08% solutions of bupivacaine. Following an initial bolus dose of 50 mg, the infusions were given at a rate of 20 mg h−1. Both solutions provided acceptable pain relief, but plasma concentrations were significantly lower with the weaker concentration.