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BACKGROUND: Recent studies point to a fundamental distinction between population-based and individual-based anaesthetic pharmacology. At the population level, anaesthetic potency is defined as the relationship between drug concentration and the likelihood of response to a stimulus. At the individual level, even when the anaesthetic concentration is held constant, fluctuations between the responsive and unresponsive states are observed. Notably, these spontaneous fluctuations exhibit resistance to state transitions R(st). Therefore, the response probability in each individual depends not just upon the drug concentration, but also upon responses to previous stimuli. Here, we hypothesise that R(st) is distinct from drug potency and is differentially modulated by different anaesthetics. METHODS: Adult (14–24 weeks old) C57BL/6J male mice (n=60) were subjected to repeated righting reflex (RR) assays at equipotent steady-state concentrations of isoflurane (0.6 vol%), sevoflurane (1.0 vol%), and halothane (0.4 vol%). RESULTS: Fluctuations in RR were observed for all tested anaesthetics. Analysis of these fluctuations revealed that R(st) was differentially modulated by different anaesthetics (F[2, 56.01]=49.59; P

Purpose To test the hypothesis that the anatomic correlate of the gray optic disc crescent is pigmentation of externally oblique border tissue of Elschnig. Design Retrospective study. Participants African-American adult men with or without clinically apparent gray optic disc crescents. Methods McNemar's test for paired data and kappa statistic with 95% confidence intervals were used to examine the relationships between eyes with or without gray optic disc crescents and corresponding spectral-domain (SD) OCT images with enhanced depth imaging (EDI). Main Outcome Measures Correlation between clinical gray optic disc crescents and hyperreflectivity of externally oblique border tissue of Elschnig by SD OCT with EDI. Results Twenty-five eyes had clinically apparent gray optic disc crescents, of which SD OCT with EDI revealed hyperreflectivity (interpreted as increased pigmentation) of externally oblique (obtuse angle) border tissue of Elschnig in 22 eyes, that is, extending into Bruch's membrane opening and presumably visible by funduscopy. Thirty-two eyes from matched participants had no apparent gray optic disc crescent, of which SD OCT with EDI revealed hyperreflectivity of the border tissue of Elschnig in 23 eyes, but with a nonoblique (right angle) or internal (acute angle) angle, which would presumably obstruct funduscopic visualization. Conclusions Observations by SD OCT with EDI suggest that the anatomic correlate of the gray optic disc crescent is pigmentation of externally oblique border tissue of Elschnig.

Background : The Symbol Digit Modalities Test (SDMT) has been recommended for use in clinical trials and outcome studies to monitor cognitive change. However, defining what is a meaningful change has been elusive for several years. Objective : The present investigation aimed to develop methods for assessing individual-level statistically significant change on the SDMT - reliable change indices (RCIs) and standardized regression-based (SRB) equations. Methods : A total of 219 healthy individuals completed the oral version SDMT at baseline, 6-month and 1-year follow-up. Results : The SDMT demonstrated high reliability across all time points (r's = .83 to .86). Reliable change scores of 7, 8, and 10 points for the 6-month intervals represented statistically meaningful change at the .70, .80, and .90 confidence intervals, respectively. Over 1-year, a difference of 8, 10, and 12 was statistically meaningful at the .70, .80, and .90 confidence intervals, respectively. SRB equations are also provided taking into account additional factors found to be predictive of SDMT scores over time. Conclusion : Clinicians frequently denote a decline of 4 points on the SDMT as meaningful. Results in this large normative sample show that higher cut-points are needed to demonstrate statistically significant decline at the individual level. RCIs are provided for 6 month and one year assessment, which is typical in clinical practice and trials. SRB equations are also provided for use when applicable and may provide a more precise assessment of meaningful change.

Weight loss improves overall health, and reduces inflammation, risk of stroke, heart attack, diabetes, certain cancers, and death among individuals with obesity. Weight loss also improves mobility, increases stamina, and elevates mood. Between 25 and 33% of people with Multiple Sclerosis (pwMS) have obesity. Multiple Sclerosis (MS) and obesity are independently associated with reduced mobility, increased fatigue, and depression. Most behavioral weight loss trials exclude individuals with neurologic disease. Consequently, few studies have examined the effects of weight loss on symptom presentation and health outcomes among pwMS and obesity. This is the first study examining the efficacy of a comprehensive behavioral weight loss intervention designed specifically for pwMS. The purpose of this study is to develop and assess the efficacy of a telehealth administered weight loss intervention tailored for pwMS. Additionally, we aim to determine if weight loss reduces physical and emotional symptoms in individuals with obesity and MS. We will enroll 70 pwMS in a wait-list crossover trial to examine the efficacy of our intervention. If successful, findings will help determine whether we can help participants lose clinically significant weight - and whether weight loss among pwMS and overweight/obesity reduces fatigue, and improves mobility, mood, and quality of life.

Background Executive function (EF) is considered an important mediator of health outcomes. It is hypothesized that those with better EF are more likely to succeed in turning their intentions into actual health behaviors. Prior studies indicate EF is associated with smoking cessation. Experimental and longitudinal studies, however, have yielded mixed results. Few studies have examined whether EF predicts post-treatment smoking behavior. Fewer still have done so prospectively in a large trial. We sought to determine if EF predicts quit attempts and cessation among community smokers in a large randomized trial evaluating the efficacy of motivational interventions for encouraging cessation. Methods Participants (N = 255) completed a baseline assessment that included a cognitive battery to assess EF (Oral Trail Making Test B, Stroop, Controlled Oral Word Association Test). Participants were then randomized to 4 sessions of Motivational Interviewing or Health Education or one session of Brief Advice to quit. Quit attempts and cessation were assessed at weeks 12 and 26. Results In regression analyses, none of the EF measures were statistically significant predictors of quit attempts or cessation (all ps > 0.20). Conclusions Our data did not support models of health behavior that emphasize EF as a mediator of health outcomes. Methodological shortcomings weaken the existing support for an association between EF and smoking behavior. We suggest methodological improvements that could help move this potentially important area of research forward.

Background Fatigue is prevalent in Multiple Sclerosis (MS), but little research indicates how to best quantify changes in fatigue over time. Objective Evaluate reliable change on the abbreviated Modified Fatigue Impact Scale (MFIS-5) in MS patients. Methods One-hundred sixty eight MS patients completed the MFIS-5 at baseline and follow-up as part of two larger studies. Test-retest reliability scores and reliable change indices were calculated. Results Differences of 4, 5, 6, and 7 points on the MFIS-5 represent statistically meaningful change at the .70, .80, .90, and .95 confidence intervals, respectively. Conclusions The MFIS-5 can be used to quickly and reliably assess statistically meaningful changes in fatigue among MS patients.

Background Reliably monitoring changes in fatigue is an ongoing concern. Objective Evaluate reliable change using the Modified Fatigue Impact Scale 5-item version (MFIS-5) in people with MS (PwMS). Methods The MFIS-5 was administered at three time points in 157 PwMS. Test-retest reliability and reliable change scores were calculated at the 0.70, 0.80, 0.90, and 0.95 confidence intervals. Results Difference scores of 3, 4, 5, and 6 represent statistically meaningful change at the 0.70, 0.80, 0.90, and 0.95 confidence intervals, respectively. Conclusion Cut points derived from this study and prior work can help reliably assess changes in fatigue over time.

Background The Expanded Disability Status Scale (EDSS) measures disease progression in Multiple Sclerosis (MS). EDSS changes are assumed to be due to worsening MS-related disability. Strict interpretation of this premise may include some normal findings as abnormal, inflating the disability score. Further, determining the cause of neurologic symptoms can be difficult in an older population with comorbid illness and polypharmacy. Objective To examine the association between EDSS, age, comorbidities and polypharmacy. Methods 106 people, 55 years and older, with and without MS were administered the EDSS and a validated comorbidity questionnaire. Polypharmacy was also assessed. Results Median EDSS scores were 6.0 in people with MS and 3.0 in people without MS. No participant in our cohort had an EDSS of 0. Higher EDSS scores were associated with older age and more polypharmacy. Pyramidal and cerebellar functional systems accounted for the largest percentage of unique variance between groups. Conclusion Older individuals with and without MS demonstrated significant disability on the EDSS. These findings indicate that EDSS scores may be partially due to factors other than MS. Our understanding of disease course and disability may benefit from the development of normative EDSS scores to correct for these factors.

Much like delay discounting, probability discounting may be related to a host of pro-health behaviors. In a recent report, a Medical Decision Making Questionnaire (MDMQ) was developed that leveraged this insights of probability discounting to both describe ways that multiple sclerosis (MS) patients weigh costs and benefits when making adherence choices, and predicted their self-reported treatment adherence. The current re-analysis of those data use a novel EP50 measure as a framework of a model that predicted the cost/benefit ratios necessary for the choices of typically non-adherent patients to become indistinguishable from those of typically adherent patients (and vice versa). These analytic tools may aid in the development/evaluation of both novel therapeutics and treatment adherence strategies for chronic conditions.

Small pore zeolites were evaluated as catalysts in the dehydration of xylose and biomass to furfural in a monophasic system of 90/10 γ-valerolactone (GVL)/water. Although the pore sizes were significantly smaller than the kinetic diameter of the sugars, furfural yields on the commercial SAPO-34 catalyst were 40% from xylose and 31% from switchgrass (considering total glucose and xylose moles). Furfural degradation with time was minimal. The SAPO-34 catalyst was recycled multiple times with only a 5% drop in furfural yield and no significant leaching of acid sites occurred. To our knowledge, this is the first time that real biomass has been converted with moderate yields to furfural using small pore zeolites.

Learning how to make healthy eating decisions, (i.e., resisting unhealthy foods and consuming healthy foods), enhances physical development and reduces health risks in children. Although healthy eating decisions are known to be challenging for children, the mechanisms of children's food choice processes are not fully understood. The present study recorded mouse movement trajectories while eighteen children aged 8-13 years were choosing between eating and rejecting foods. Children were inclined to choose to eat rather than to reject foods, and preferred unhealthy foods over healthy foods, implying that rejecting unhealthy foods could be a demanding choice. When children rejected unhealthy foods, mouse trajectories were characterized by large curvature toward an eating choice in the beginning, late decision shifting time toward a rejecting choice, and slowed response times. These results suggested that children exercised greater cognitive efforts with longer decision times to resist unhealthy foods, providing evidence that children require dietary self-control to make healthy eating-decisions by resisting the temptation of unhealthy foods. Developmentally, older children attempted to exercise greater cognitive efforts for consuming healthy foods than younger children, suggesting that development of dietary self-control contributes to healthy eating-decisions. The study also documents that healthy weight children with higher BMIs were more likely to choose to reject healthy foods. Overall, findings have important implications for how children make healthy eating choices and the role of dietary self-control in eating decisions.

Summary Background Hydrogen peroxide vapour (HPV) disinfection systems are being used to reduce patients' exposure to hospital pathogens in the environment. HPV whole-room aerial disinfection systems may vary in terms of operating concentration and mode of delivery. Aim To assess the efficacy of two HPV systems (HPS1 and HPS2) for whole-room aerial disinfection of single isolation rooms (SIRs). Methods Ten SIRs were selected for manual terminal disinfection after patient discharge. Test coupons seeded with biological indicator (BI) organisms [∼10 6 colony-forming units (cfu) of meticillin-resistant Staphylococcus aureus (MRSA) or Klebsiella pneumoniae , or ∼10 5 cfu Clostridium difficile 027 spores] prepared in a soil challenge were placed at five locations per room. For each cycle, 22 high-frequency-touch surfaces in SIRs were sampled with contact plates (∼25cm 2 ) before and after HPV decontamination, and BIs were assayed for the persistence of pathogens. Findings Approximately 95% of 214 sites were contaminated with bacteria after manual terminal disinfection, with high numbers present on the SIR floor (238.0–352.5cfu), bed control panel (24.0–33.5cfu), and nurse call button (21.5–7.0cfu). Enhanced disinfection using HPV reduced surface contamination to low levels: HPS1 [0.25cfu, interquartile range (IQR) 0–1.13] and HPS2 (0.5cfu, IQR 0–2.0). Both systems demonstrated similar turnaround times (∼2–2.5h), and no differences were observed in the efficacy of the two systems against BIs ( C. difficile ∼5.1log 10 reduction; MRSA/ K. pneumoniae ∼6.3log 10 reduction). Despite different operating concentrations of hydrogen peroxide, MRSA persisted on 27% of coupons after HPV decontamination. Conclusion Enhanced disinfection with HPV reduces surface contamination left by manual terminal cleaning, minimizing the risks of cross-contamination. The starting concentration and mode of delivery of hydrogen peroxide may not improve the efficacy of decontamination in practice, and therefore the choice of HPV system may be based upon other considerations such as cost, convenience and logistics.

The goal of this concise narrative review is to examine the current literature regarding endogenous and exogenous influences on youth food choices. Specifically, we discuss internal factors such as interoception (self-awareness) of pain and hunger, and neural mechanisms (neurofunctional aspects) of food motivation. We also explore external factors such as early life feeding experiences (including parenting), social influences (peers), and food marketing (advertising). We conclude with a discussion of the overlap of these realms and future directions for the field of pediatric food decision science.

The duration and magnitude of specific dynamic action (SDA) are largely comprised of the physiological costs of post-absorptive protein synthesis and could have a functional link to growth and feed conversion in fish. However, evidence has been found in several species to both support and oppose this hypothesis. To determine if SDA is positively linked to the production performance of a novel finfish aquaculture species, SDA was measured in juvenile hapuku Polyprion oxygeneios at two temperatures with two different ration sizes (i.e. 15 °C with a 0.75% and 1.5% body weight ration and 21 °C with a 1.5% and 3% body weight ration) and compared to the specific growth rate (SGR) and feed conversion ratio (FCR) of hapuku raised for 6 weeks at the same levels of temperature and ration size. A marked effect of temperature on SDA was found and the magnitude of SDA was significantly higher for the shared ration size (1.5% body weight) at 21 °C than 15 °C. However, only the peak of the SDA response (SDApeak) and the total energy used during the response (SDA energy) increased with ration size at both temperatures. Higher SDA parameters were linked with higher growth performance in juvenile hapuku under certain scenarios but, because SGR was significantly lower at 21 °C than 15 °C for the shared ration size of 1.5% body weight, the SDA–growth relationship was not consistent and was likely under the interactive influence of temperature and ration size. Indeed, in some scenarios higher SDA provided greater growth at 21 °C but the higher maintenance cost (i.e. MO2standard) of fish at this upper temperature may have constrained fish growth when only a 1.5% body weight ration was delivered. FCR was not positively related to SDA so this study does not support the hypothesis that SDA predicts the production performance of juvenile hapuku across a range of temperatures and ration sizes.

Within a practice-based collaborative care program for depression, we examined associations between positive baseline screens for comorbid mental and behavioral health problems, depression remission and utilization after 1 year.This observational study of 1507 depressed adults examined baseline screens for hazardous drinking (Alcohol Use Disorders Identification Test score ≥ 8), severe anxiety (Generalized Anxiety Disorder 7-item score ≥ 15) and bipolar disorder [Mood Disorders Questionnaire (MDQ) positive screen]; 6-month depression remission; primary care, psychiatric, emergency department (ED) and inpatient visits 1 year postbaseline; and multiple covariates. Analyses included logistic and zero-inflated negative binomial regression.At unadjusted baseline, 60.7% had no positive screens beyond depression, 31.5% had one (mostly severe anxiety), 6.6% had two and 1.2% had all three. In multivariate models, positive screens reduced odds of remission versus no positive screens [e.g., one screen odds ratio (OR) = 0.608, p = .000; all three OR = 0.152, p = .018]. Screening positive for severe anxiety predicted more postbaseline visits of all types; severe anxiety plus hazardous drinking predicted greater primary care, ED and inpatient; severe anxiety plus MDQ and the combination of all three positive screens both predicted greater psychiatric visits (all p.05). Regression-adjusted utilization patterns varied across combinations of positive screens.Positive screens predicted lower remission. Severe anxiety and its combinations with other positive screens were common and generally predicted greater utilization. Practices may benefit from assessing collaborative care patients presenting with these screening patterns to determine resource allocation.

When given the choice between $100 today and $110 in 1 week, certain people are more likely to choose the immediate, yet smaller reward. The present study examined the relations between temporal discounting rate and body mass while accounting for important demographic variables, depressive symptoms, and behavioral inhibition and approach. After having their heights and weights measured, 100 healthy adults completed the Monetary Choice Questionnaire, the Beck Depression Inventory-II, and the Behavioral Inhibition Scale/Behavioral Approach Scale. Overweight and obese participants exhibited higher temporal discounting rates than underweight and healthy weight participants. Temporal discounting rates decreased as the magnitude of the delayed reward increased, even when other variables known to impact temporal discounting rate (i.e., age, education level, and annual household income) were used as covariates. A higher body mass was strongly related to choosing a more immediate monetary reward. Additional research is needed to determine whether consideration-of-future-consequences interventions, or perhaps cognitive control interventions, could be effective in obesity intervention or prevention programs.

As temperature-based growth trials are lengthy, expensive and laborious to run, juvenile hapuku ( Polyprion oxygeneios ) were employed to assess whether respirometric tests and behavioural preference methods could be used to resolve the optimum temperature for growth and feed conversion efficiency in novel culture species. On the basis that the energetic costs of rapid growth are substantial and need to be accommodated physiologically, it was hypothesised that maximal growth and optimal feed conversion (feed conversion ratio, FCR) would be maximised at temperatures where aerobic metabolic scope (AMS) was also maximised. It was further hypothesised that hapuku would behaviourally self-select temperatures that lead to the greatest level of AMS, growth and FCR performance. Acclimating hapuku juveniles to 12, 15, 18, 21 and 24 °C for 4 weeks resulted in a peak in specific growth rate (SGR) at 18 and 21 °C with slower growth at lower and higher temperatures. AMS was also maximal between 18 and 21 °C and was therefore tightly linked with SGR. The behavioural thermal preference (T pref ) range of hapuku also fell within the optimum range for growth. FCR, however, was inversely related to temperature with the most and least efficient rates of conversion occurring at 12 °C and 24 °C respectively. Though AMS and T pref had no utility in predicting the optimal range for FCR, standard metabolic rate (SMR) showed a positive linear relationship to FCR. The conclusions of the study are threefold: 1) Hapuku select temperatures that optimise both AMS and growth. 2) AMS and T pref appear tightly linked with SGR and could possibly be used to predict the optimum temperature for growth in novel species. 3) AMS and T pref have no utility in predicting the optimum temperature for FCR.

Objective Patients with multiple sclerosis (MS) commonly use a variety of medications to slow disease progression, alleviate symptoms, and treat comorbid conditions. Polypharmacy has been linked to adverse outcomes in other patient groups, but has not been studied extensively in MS. We investigated the impact of polypharmacy on fatigue, objective neuropsychological performance, and subjective cognitive impairment in a sample of patients with MS. Methods MS patients (n = 85) completed a medication inventory, self-report questionnaires, and a battery of neurocognitive tests. MS patients with polypharmacy were compared to MS patients without polypharmacy, using multivariate analysis of covariance (MANCOVA). Results After controlling for disease characteristics, MS patients with polypharmacy (n = 28) exhibited prospective memory deficits and reported significantly more fatigue and subjective cognitive problems than MS patients without polypharmacy. Conclusion Clinicians and patients should carefully weigh the costs and benefits of prescribing multiple medications, as these may contribute to iatrogenic fatigue and cognitive problems in MS. Moreover, researchers should account for polypharmacy when conducting studies examining fatigue and cognition in MS.

A new study shows that subjects rendered unresponsive with sedatives do not exhibit a stereotypic 'unconscious' response to direct cortical stimulation; instead, agent-specific effects are seen that can distinguish between unresponsiveness with and without consciousness.

The explosive expansion in China's exports has brought about many local (domestic) environmental problems. Understanding the magnitude and structure of the pollution emissions embodied in these exports is crucial for developing policies not only for local environmental stewardship and cleaner production, but also for international trade. We introduce a stochastic modification of the customary (economic) input–output model in order to reconstruct information typically absent from a traditional national input–output table but vital for understanding where export-embodied pollution emissions are generated in an open economy. Specifically, our modification enables a better means of “subtracting out” the pollutant emissions that might have been associated with imported intermediate inputs (before their arrival in China). We find, nevertheless, that large proportions of emissions of heavy metals (Cr6+ and Pb) contained in wastewater can be attributed to exports. In 2007, these figures reached more than 40% of their respective total emissions. Total quantities of export-embodied wastewater, sulfur dioxide (SO2) and solid waste have increased dramatically from 1997 to 2007. The relative rates of growth in the percentages of export-embodied pollutants in total industrial emissions, however, were lower than the relative rate of growth in the percentage of exports in China's total GDP over this same decade. Three clusters of sectors play dominant roles in driving China's export embodied emissions: textiles, leather and clothing apparel; electrical and electronic equipment; and the chemical industry. We suggest that promoting the transition in the distribution of export products toward high value-added and low embodied-emission products and services (themselves enhanced by cleaner production methods) should be regarded as a long-term goal of China's trade policy.

We report a simple and reliable method to electrochemically synthesize PANi on aluminum carbon (Al/C).Aluminum electrodes were coated with hard black graphite. Polyaniline was then deposited in steps from +0.75 V to +0.825 V (V vs. Ag/AgCl) in low pH growth solutions containing aniline and camphor sulphonic acid. The polyaniline films were rinsed in hydrazine solution and dried in an infrared oven under a nitrogen atmosphere. The films were transferred and are stable in a 50:50 (v/v) propylene carbonate (PC)/acetonitrile (ACN) solvent mixture containing 0.5 M LiClO 4 electrolyte. Cyclic voltammetry and charge-discharge capacities are reported. Microscope (SEM) images of Al/C/PANi and Pt/PANi films show similar structural details and morphology. The specific capacity for Al/C/PANi in nonaqueous solutions was ca. 133 mAh g −1 , in good agreement with the reported data for other PANi-based electrodes. The performance studies and SEM images demonstrate similar results for Pt/PANi and Al/C/PANi electrodes.

A new method that uses solid phase extraction (SPE) coupled with FTIR spectroscopy to detect Hg(II) in aqueous samples is described. The technique is envisioned for on-site, field evaluation rather than lab-based techniques. This paper presents the "proof of principle" of this new approach toward measurements of Hg(II) in water and identifies mass transport issues that would need to be overcome in order to migrate from a lab based method to field operation. The SPE material supported on a Si wafer is derivatized with an acylthiosemicarbazide, which undergoes a reaction in the presence of aqueous Hg(II) to form an oxadiazole ring. The progress of the reaction is monitored by IR spectroscopy. Following EPA guidelines, the method of detection limit (MDL) for the SPE/IR was 5 μg of Hg(II)cm(-2). In a 1L sample and a 1cm(2) Si wafer, this translates to a detection limit of 5 ppb. This system shows a high selectivity toward aqueous Hg(II) over other thiophilic heavy metal ions such as Pb(II), Cd(II), Fe(III), and Zn(II) and other metal ions such as Ni(II), Mn(II), Co(II), Cu(II), In(III), Ru(III), Na(I), and Ag(I) in aqueous solutions.

The significance of model structure error and uncertainty (MSEU), sometimes referred to as conceptual error, is rarely adequately recognized. MSEU, moreover, is not an esoteric matter of little consequence to the formation of policy for environmental protection and ameliorating the prospective effects of climate change. The paper presents an approach to accounting for MSEU in which the parameters of a model are treated as stochastic processes and modeled as Generalized Random Walks. Our approach is inspired by the algorithms of recursive estimation and filtering theory. In particular, given an innovations representation of the model's structure, we are able to exploit the dichotomy of what is considered to be the {presumed known} in the model's structure and its complement, the {acknowledged unknown}. Two conceptually different groups of model parameters attach to this dichotomy: those familiar to us as the conventional parameters in a model's structure; and those having to do with the way in which past (systematic) forecasting errors - in fact, the innovations errors - are distributed (fed back) into the generation of future predictions through a gain matrix (in the sense of filtering theory). A hypothetical biological system with nonlinear dynamics is specified as the prototypical case study for assessing and comparing the performance of our proposed approach with three other approaches to accounting for MSEU: model fitting error; the expansion of parametric uncertainty; and Bayesian model averaging. Our predictive test cases are constructed around future conditions in which the pattern of input disturbances of the system's behavior is broadly similar to that of their past observed pattern (as used for prior identification, or calibration, of the model). In specific terms, however, future input disturbance patterns are significantly different. Our new approach and that of Bayesian model averaging are found to perform well on this hypothetical system; the performances of the approaches of model fitting error and the expansion of parametric uncertainty are shown to be inferior.

Background Patients with multiple sclerosis (MS) frequently experience depression and anxiety. Several studies also document personality differences between MS patients and controls. Few studies, however, have examined the relationship between mood/anxiety and core personality traits in MS. Objectives The purpose of the present investigation was to examine the association between anxiety, mood, and personality disturbances in MS. Methods A structured psychiatric interview and validated self-report measures of personality, depression, and anxiety were administered to 85 MS patients and 20 normal controls. Results Findings suggested a significant association between psychopathology and core personality dysfunction in MS. Depressed/anxious MS patients exhibited more neuroticism, less extroversion, less agreeableness, and less conscientiousness than mentally healthy MS patients and normal controls. In contrast, nondepressed/nonanxious MS patients' core personality traits did not substantially differ from normal controls. Conclusions Though longitudinal studies are needed, findings provide hope that the successful treatment of MS patients' mood and anxiety symptoms may also partially ameliorate disordered personality characteristics. Consistent with previous research, an increased understanding of MS patients' personality characteristics may also aid with preventative psychiatric and medical treatment.

The synthesis of triethylphosphine gold(I) 4-nitrobenzenethiolate, Et 3 PAu(SC 6 H 4 NO 2 -4), is reported. Et 3 PAu(SC 6 H 4 NO 2 -4) displays a low energy visible electronic absorption band which is solvent dependent: EtOH ( λ max = 385 nm), acetonitrile ( λ max = 391 nm), THF ( λ max = 395 nm), and DMSO ( λ max = 402 nm). The corresponding low energy visible electronic absorption band of 4-nitrobenzenethiolate, 4-NO 2 C 6 H 4 S − also shows solvent dependency: acetonitrile, ( λ max = 484 nm), DMSO ( λ max = 502 nm), dimethylformamide ( λ max = 505 nm). The positive solvatochromic shifts for Et 3 PAu(SC 6 H 4 NO 2 -4) and 4-NO 2 C 6 H 4 S − are consistent with an intraligand (IL) charge transfer transition, i.e. π(S) → ∗π (C 6 H 4 NO 2 -4) or n(S) → ∗π (C 6 H 4 NO 2 -4). Assignment of 4-NO 2 C 6 H 4 S − was aided by a DFT calculation.

The syntheses of ferrocenylbiphenylisocyanide gold(I) thiophenolato complexes are described. The preparative route starts from ferrocenylphenylbromide and proceeds in six steps to yield the desired gold(I) complexes, (thiophenolato)gold{(4′-ferrocenyl[1,1′]biphenyl-4-yl)isocyanide} ( 11 ) and (thiophenolato)gold{(4′-ferrocenyl-3,5-dimethyl[1,1′]biphenyl-4-yl)isocyanide} ( 12 ) in good yields. The synthetic pathways were developed as a first step toward realizing the goal of preparing metallomesogens based on ferrocenyl-polyphenylenes coordinated to gold(I) thiophenolates, in which long chain alkoxy groups are substituted para to sulfur on the phenyl ring. The crystal structures of (chloro)gold{(4 ′ -ferrocenyl[1,1′]biphenyl-4-yl)isocyanide} ( 9 ) and 12 are reported. Complex 9 crystallizes in the space group P 2 1 / c and 12 crystallizes in P 2 1 / n . Complexes 9 and 12 show short intermolecular Au–Au contacts of 3.3765(7) A and 3.3334(3) A, respectively.

Introduction Cuffed endotracheal tubes are used to prevent gas leak and also pulmonary aspiration in ventilated patients. The pressure exerted on the tracheal wall is similar to intracuff pressure. The perfusion pressure for the tracheal mucosa is 40 cm H 2 O. Cuff pressures greater than 40 cm H 2 O may cause various ischemic changes and complications. High cuff pressures have also been implicated in postoperative sore throat and nonischemic complications. Postintubation endotracheal tube cuff pressures are not routinely measured in the ED or prehospital setting. The time spent in these settings may be long enough for pressure-induced tracheal mucosal injury to occur. The purpose of this study is to assess cuff pressures in intubated patients before aeromedical transport. Methods All intubated patients transported by an aeromedical transport program during a 3-month period were included in this study. Patients were intubated either by helicopter physicians or before helicopter arrival at the referring hospital or by ambulance personnel. Cuff pressure was measured using a manometer (Cuffpressure, Posey Co, USA). This measurement was recorded, and correction was performed, if necessary, to achieve a cuff pressure of 14 to 27 cm H 2 O while preventing an air leak. Data were analyzed for the distribution of intracuff pressures and incidence of elevated pressure on first measurement and the need for correction. Results There were 62 patients in this study. The mean first recorded pressure was 63 ± 34 cm H 2 O. Initial cuff pressures were greater than 40 cm H 2 O in 36 (58%) patients and required correction. Conclusions In this study, most cuff pressures exceeded safe pressure and required correction. Measurement of intracuff pressure is a simple and inexpensive procedure and should be done whenever a patient is intubated, in either the prehospital or hospital setting, because this may reduce long-term morbidity.

While non-point nutrient loads are important determinants of biological productivity in Southeastern Piedmont impoundments, productivity can be attenuated by concomitant sediment loads that reduce the biological availability of these nutrients. A biogeochemical model is proposed that explicitly accounts for the effects of sediment–nutrient interactions on multiple components of phytoplankton metabolism dynamics, including algal photosynthesis and respiration, pH, carbonate speciation, dissolved oxygen, and biochemical oxygen demand. Sediment–nutrient interactions relate nutrient uptake and release to pH, sediment oxygen demand, sediment organic matter, and iron. pH is a state variable in our model, affects sediment–nutrient adsorption, and constrains model parameters. The model replicates water quality observations in a small Southeastern Piedmont impoundment and suggests that pH-dependent sediment–nutrient adsorption dominates both orthophosphate and ammonium dynamics, with phosphate adsorption being controlled by ligand exchange to iron oxides, and ammonium adsorption being controlled by the cation exchange capacity. Sediment organic matter accumulation and decay also affects nutrient availability, and may explain the long-term increase of hypolimnetic dissolved oxygen deficit in Lake Lanier, a large Southeastern Piedmont impoundment.

Glaucoma patients present a unique set of challenges to physicians performing corneal refractive surgery. Corneal thickness, which is modified during corneal refractive surgery, plays an important role in monitoring glaucoma patients because of its effect on the measured intraocular pressure. Patients undergo a transient but significant rise in intraocular pressure during the laser-assisted in situ keratomileusis (LASIK) procedure with risk of further optic nerve damage or retinal vein occlusion. Glaucoma patients with filtering blebs are also at risk of damage to the bleb by the suction ring. Steroids, typically used after refractive surgery, can increase intraocular pressure in steroid responders, which is more prevalent among glaucoma patients. Flap interface fluid after LASIK, causing an artificially low pressure reading and masking an elevated pressure has been reported. The refractive surgeon's awareness of these potential complications and challenges will better prepare them for proper management of glaucoma patients who request corneal refractive surgery.

A series of N , N , N -tridentate vanadium(III) complexes were tested after activation with methyl aluminoxane (MAO) for ethene oligomerization and polymerization. Variations in the catalyst structure as well as the influence of physical parameters were investigated and the properties of the obtained oligomeric products were determined. Methods of altering the Schulz–Flory distribution of the oligomeric products were investigated. The product properties of the polymers and oligomers obtained with the vanadium(III) complexes and the structurally identical iron(II) complexes were compared. Depending on their substitution pattern, the N , N , N -tridentate vanadium(III) catalysts exhibit high productivities and selectivities towards α-olefin oligomerization products under mild conditions when activated with MAO whereas the corresponding iron complexes produce higher molecular weight materials. The synthesis of these new vanadium(III)- and iron(II)-diiminepyridyl complexes was reported earlier.

The synthesis of new iron(II) and vanadium(III) diiminepyridyl complexes is reported. The ligands were synthesized and characterized by GC/MS, 1H and 13C NMR spectroscopy. The corresponding complexes are characterized by mass spectrometry and in part by elemental analyses. The activated vanadium complexes were found to be highly active and selective catalysts for the oligomerization of ethene to α-olefins.