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The Center for Epidemiological Studies Depression-10 (CES-D-10) scale is known for its good psychometric properties in measuring depressive symptoms, however, some researchers question its applicability across various settings. This study explored the factor structure of the CES-D-10 in low- and middle-income countries (LMICs). This cross-sectional survey consisted of 16,723 university students across 27 LMICs that completed self-report instruments assessing socio-demographic information and depressive symptoms using the CES-D-10. Data analysis included: exploratory factor analysis, item response theory and differential item functioning. Results indicate that a two-factor model (depressive affect and positive affect) had the best fit for this population and accounted for 52% of the total observed variance with an internal consistency, α = .77 for the depressive affect items and α = .57 for the positive affect items. The graded response model (GRM), however, indicated that the depressive affect factor had a good fit, unlike the positive affect factor. The depressive affect factor was found to consistently model depression for females better than males. Relative to their Asian counterparts, African, Caribbean and South American participants of similar depressive affect responded differently on all items of the depressive affect factor. The depressive affect factor seems most ideal for LMICs and shows gender and cross-cultural variability.

This study demonstrates the capabilities of MRI in the assessment of cardiac pacing induced ventricular dyssynchrony, and the findings support the need for employing more physiological pacing. A human donor heart deemed non-viable for transplantation, was reanimated using an MR compatible, four-chamber working perfusion system. The heart was imaged using a 1.5T MR scanner while being paced from the right ventricular apex (RVA) via an epicardial placed lead. Four-chamber, short-axis, and tagged short-axis cines were acquired in order to track wall motion and intramyocardial strain during pacing. The results of this study revealed that the activation patterns of the left ventricle (LV) during RVA pacing demonstrated intraventricular dyssynchrony; as the left ventricular mechanical activation proceeded from the septum and anterior wall to the lateral wall, with the posterior wall being activated last. As such, the time difference to peak contraction between the septum and lateral wall was approximately 125 msec. Likewise, interventricular dyssynchrony was demonstrated from the four-chamber cine as the time difference between the peak LV and RV free wall motion was 180 msec. With the ongoing development of MR safe and MR compatible pacing systems, we can expect MRI to be added to the list of imaging modalities used to optimize cardiac resynchronization therapy (CRT) and/or alternate site pacing.

Summary Aim To evaluate the impact of European Society of Endodontology curriculum guidelines on undergraduate teaching in the UK. Methodology A postal questionnaire was designed by two authors (WPS, GB) in 2003. This included open and closed questions relating to endodontic curricula and the impact of curriculum guidelines. This was sent with a cover letter to the thirteen UK undergraduate schools. Data harvest was completed a year after the initial questionnaires were sent. Responses were collated and analysed qualitatively and quantitatively. Results Eight (62%) questionnaires were returned. Analysis revealed divergence from aspects of curriculum guidelines. Guidelines were applied by seven schools. Four schools had not applied guidelines related to endodontic surgery as this was taught by Departments of Oral Surgery. One respondent stated that the established curriculum was too inflexible to allow application. There was wide variation in curriculum structure with combinations of outcome, competency and problem-based learning. No schools had a separate department of Endodontology. All schools felt graduates should be competent at de-novo treatment of single and multi-rooted teeth. In general, competence was expected in single canal re-treatment but not multi-rooted teeth. Patient recruitment proved a major barrier to meeting guidelines. Number of cases to be completed by graduation ranged from 6 to 14 in total. Three schools felt that guidelines were not achievable citing lack of time, funds and appropriate staff. All schools provided operative techniques classes prior to clinical treatment. These ranged from 20 to 120 hours (mean 43, S.D. 35.24.). Cases completed in these classes varied. For single rooted teeth this ranged from one to six (mean 2.57). For multi-rooted teeth this ranged from one to three (mean 2.14). Most schools had at least one faculty member with a special interest in Endodontology. In seven schools however, teaching was also carried out by staff with no special interest. Five schools did not have a separate endodontic clinic. Five respondents had undergraduate learning in outreach centres. Trauma teaching was mainly carried out by in Departments of Paediatric Dentistry. Conclusions There is wide variation in the delivery of endodontic curricula in the U.K. Whilst curriculum guidelines are available, there are barriers to delivering these. Consideration should be given to revision of guidelines in light of their evident inapplicability in some areas.

A retrospective review was undertaken on all pediatric and reproductive-aged females who underwent cardiac surgery and required cardiopulmonary bypass from 1958 through 1986. The purpose of this study was to define the fertility of these patients after surgery and to compare their reproductive performance with that in the general population. Analysis was complete for 208 patients. These patients make up the following cardiac surgical categories: septal defect repairs, 92; commissurotomies, 60; valve replacements, 46; tetralogy of Fallot repairs, 6; and coronary artery bypass procedures, 4. Of 208 patients, 68 (32.7%) attempted pregnancy after surgery. Infertility was defined in five women as follows: endometriosis, 3; ovulatory dysfunction, 1; unknown, 1. A total of 64 patients conceived 121 pregnancies with the following outcomes: live births, 98; spontaneous abortion, 9; ectopic pregnancy, 2; therapeutic abortion, 12. Our results suggest that infertility is not an apparent disorder after cardiac surgery and that subsequent pregnancy outcomes are similar to those in the general population. (AM J OSSTET GVNECOL 1989; 161:573-6.)

The purpose of this study is to evaluate 13 patients with primary ovarian failure (POF). All patients were less than 35 years of age. Serum FSH, performed by RIA, was in the post-menopausal range in all patients. Karyotype with Q-banding was performed on peripheral leukocytes and/or ovarian tissue. All patients had 46XX karyotype. Eleven patients had laparoscopy or laparotomy and ovarian biopsy. Two of the 11 patients had ovarian follicles. One patient had Graves' disease. Based on our data, we offer these conclusions. A thorough evaluation of patients with premature ovarian failure is essential. Testing for autoimmune endocrinopathies should be considered in POF patients who exhibit any signs of endocrine dysfunction. A peripheral karyotype with banding should be performed on all patients. The resistant ovary syndrome may occur with greater frequency than has previously been reported and a review of the literature on the resistant ovary syndrome is presented.