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A link between paternal care and territoriality has been described in several anuran species. The southern Darwin's frog ( R hinoderma darwinii) has developed a highly specialized form of paternal care known as neomelia, in which males ingest developing embryos and transport them in their vocal sacs until metamorphosis is completed. Based on the main components of territoriality described in amphibians: site fidelity, resource limitation and defence (e.g. of oviposition sites and egg clutches), we hypothesized that R . darwinii males exhibit territoriality. To investigate this, we used a multi-method approach that involved estimating home range and movements, performing social network analyses and monitoring potential egg attendance. Forty-five individual frogs and three egg clutches were monitored in a population from southern Chile between December 2010 and February 2011. Site fidelity was found across all groups (juveniles, females, non-brooding males and brooding males) based on small movements between captures (mean ±1 se; 0.96 ± 0.11 m) and small net displacement (2.95 ± 0.55 m). Home ranges were small (1.82 ± 0.54 m; range: 0.1-16 m2) and did not differ significantly among groups. We did not find evidence of male territoriality, instead male frogs exhibited high home range overlapping and intra-group association. No frogs of either sex were ever seen attending eggs. This evidence supports Wells' suggestion; territoriality in anuran species with parental care should be expected only if males defend oviposition sites. Conversely, females did not exhibit home range overlapping and showed evidence of very low intra-group association. This study has thrown up a range of additional questions with regard to temporal segregation between non-brooding males, the roles of male and female calls during reproduction, potential female territoriality and what kind of signals triggers egg ingestion by males. [ABSTRACT FROM AUTHOR]

Aliment Pharmacol Ther 2010; 32: 591–602 Background Current questionnaires for assessing gastro-oesophageal reflux disease (GERD) symptoms are limited in their ability to capture nocturnal symptoms. Aim To develop and validate an instrument, the Nocturnal Gastro-oesophageal Reflux Disease Symptom Severity and Impact Questionnaire (N-GSSIQ), to assess severity and impact of nocturnal GERD symptoms. Methods Two focus groups and 16 cognitive debriefing interviews were conducted among GERD patients to identify key issues about nocturnal symptoms. A draft instrument was tested in 196 patients at 11 clinics in the US to evaluate psychometric properties. Exploratory factor and item response theory analyses were conducted to finalize items and subscales. Internal consistency reliability, reproducibility and construct validity were examined. Results Mean age was 45 (s.d. = 13.8) years; 76% were female and 68% were Caucasian. Patient-rated severity was mild–moderate for 69% of participants; 48% reported symptoms on two to three nights the past week. The final questionnaire includes 20 items and three subscales: Nocturnal GERD Symptoms, Morning Impact of Nocturnal GERD and Concern about Nocturnal GERD. The subscales demonstrated internal consistency reliability (Cronbach’s alpha 0.84–0.94) and were significantly correlated with similar measures and disease severity (0.41–0.81; P < 0.0001). Conclusion The results support the reliability and validity of the N-GSSIQ as a measure of severity, morning impact and concern about nocturnal GERD. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of the development and validation of two questionnaires assessing ease of caring for patients receiving patient controlled analgesia from the perspectives of nurses and physical therapists. Background. While studies have assessed patient satisfaction with and preference for patient controlled analgesia modalities, no instruments have been developed to assess the ease of providing care (ease of care) for patients receiving patient controlled analgesia from nurses' and physical therapists' perspectives. Method. Nurses and physical therapists participated in focus groups during 2003 to identify concepts associated with caring for patients receiving intravenous patient controlled analgesia. Based on these discussions, items were developed and included in draft questionnaires. Content validity of draft questionnaires was assessed, and final questionnaires were developed. Psychometric properties of the final questionnaires were assessed using data from 79 nurses and 80 physical therapists from two clinical trials conducted during 2004 and 2005 to compare the efficacy and safety of two modalities of patient controlled analgesia. Findings. The Nurse and Physical Therapist Ease of Care Questionnaires had 22 items addressing three aspects of patient care: time-efficiency (time-consuming subscale), ease of use/convenience (bothersome subscale), and satisfaction (satisfaction subscale). All subscales on both questionnaires demonstrated evidence of internal consistency reliability, and subscale-to-subscale correlations suggested that the time-consuming and bothersome subscales contribute equally to overall ease of care. The subscales were statistically significantly correlated with clinical measures. Conclusion. These instruments may be valuable for assessing the impact of patient controlled analgesia modalities on patient care for these healthcare providers. [ABSTRACT FROM AUTHOR]

No disease-specific tool for measuring health-related quality of life (HRQL), an important outcome when assessing medical treatment, has been developed for children with haemophilia. The goal of this study was to develop a parent-administered questionnaire for evaluating quality of life (QOL) in paediatric haemophilia patients between 2 and 6 years of age. After interviewing physicians (5), nurses (5) and parents (10) of children with haemophilia aged between 2 and 6 years, 92 questions were developed and pilot-tested with parents (44) of children with haemophilia to create a 39-question instrument that assessed somatic symptoms, physical functioning, sleep disturbance, stigma, social functioning, fear/resentment, mood/behaviour, restrictions, treatment upset, haemophilia concern and energy level. Reliability and validity were evaluated with 103 parents of children with haemophilia and parents of 249 age- and gender-matched healthy children. Estimates of scale reliability (internal consistency) for eight multi-item scales ranged from 0.73 to 0.94. Results showed construct validity (correlations with age, severity of haemophilia, treatment type, days absent and days confined to bed) and correlated with two general, paediatric quality-of-life instruments (Impact on Family Scale and Functional Status II(R). Discriminant validity was demonstrated by comparing scores between patients receiving/not receiving prophylactic therapy and between haemophilia patients and healthy controls. This disease-specific HRQL measure should be of use in clinical trials and general practice to better understand disease and treatment impacts in young children with haemophilia. [ABSTRACT FROM AUTHOR]

The visual evoked magnetic response to half-field stimulation using pattern reversal was studied using a d.c. SQUID coupled to a second order gradiometer. The main component of the magnetic response consisted of a positive wave at around 100 ms (P100M). At the time this component was present the response to hall-field stimulation consisted of an outgoing magnetic Field contralateral and extending to the midline. When the left half field was stimulated the outgoing field was over the posterior right visual cortex and when the right hail Field was stimulated it was over the left anterior visual cortex. These findings would correctly identity a source located in the contralateral visual cortex. The orientation of the dipoles was not that previously assumed to explain the paradoxical lateralization of the visual evoked potential. The results are discussed in terms of both electrical and magnetic models of the calcarine fissure. [ABSTRACT FROM AUTHOR]

This article presents a review by the author on the use of light flash in the determination of electrical activity of the visual pathway beyond the retina. The use of flashes of light in studies of the visual pathway can be traced almost to origins of electroencephalography (EEG) itself. Using this technique, provides an early description of the visual evoked (VEP). Responses to flashing light do, however, tell us about other cortical events. In photosensitive patients, if they are stimulated with a flashing light in the laboratory whilst their EEG is recorded, we observe a grossly abnormal electrical discharge. In studying pure ocular conditions these techniques may be combined with the electroretinogram to provide more information with regard to the state of the retina.

Set against a background of assumptions that heroin use is inevitably problematic, there is significant evidence of its controlled use. This paper attempts to draw together the literature on patterns of heroin use which avoid physical and psychological dependence. However, studies of such patterns of use are hampered by the absence of a common definition. 'Occasional' use, 'recreational' use and 'controlled' use have been used interchangeably. Moreover, these terms have been defined variously by frequency of use, quantities of heroin used and consequences of such use. Nonetheless, these studies suggest that patterns of heroin use which avoid physical and psychological dependence do exist. However there is a paucity of research on non-dependent patterns of use. Potential issues f or future research are accordingly outlined. [ABSTRACT FROM AUTHOR]

The visual evoked magnetic response (VEMR) was measured over the occipital cortex to pattern and flash stimuli in 86 normal subjects aged 15-86 years. The latency of the major positive component (outgoing magnetic field) to the pattern reversal stimulus (P100M) increased with age, particularly after 55 years, while the amplitude of the P100M decreased more gradually over the lifespan. By contrast, the latency of the major positive component to the flash stimulus (P2M) increased more slowly with age after about 50 years, while its amplitude may have decreased in only a proportion of the elderly subjects. The changes in the P100M with age may reflect senile changes in the eye and optic nerve, e.g. senile miosis, degenerative changes in the retina or geniculostriate deficits. The P2M may be more susceptible to senile changes in the visual cortex. The data suggest that the contrast channels of visual information processing deteriorate more rapidly with age than the luminance channels. [ABSTRACT FROM AUTHOR]

ABSTRACT Through most of the geographical range of the American lobster, Homarus americanus, from Newfoundland to the Middle Atlantic Bight, catches reached new historical maxima or near maxima in the late 1980s or early 1990s. Because of the high exploitation rates, this increase in landings is believed to reflect increased recruitment. Previous studies have shown that increased lobster landings in certain areas were linked to rising sea temperatures. This paper examines the hypothesis that the increased landings during the 1980s and early 1990s were temperature induced. When temperature-dependent regressions of lobster landings, developed by earlier authors, were extended to the present they failed to predict the sharp rise in landings during the 1980s. In addition, the increase in lobster landings is shown to have occurred over a larger spatial scale than coherent temperature fluctuations. These results, together with an exploratory correlation analysis between sea temperatures and lobster landings, lead to the conclusion that the increase in lobster catches in the 1980s was not linked to changes in ocean temperatures. [ABSTRACT FROM AUTHOR]

Eight chinchillas aged 8.9 to 12.8 years were used to examine the effect of noise on the aging ear. The left malleus/incus complex was removed to produce a 50-dB conductive hearing loss which protected those ears from noise damage. The animals were then exposed for 36 days to an octave band of noise with a center frequency of 0.5 kHz and a sound pressure level of 95 dB. After 1 hour (n = 2) or 1 month (n = 6) of recovery, their cochleas were prepared for microscopic examination. The percentages of missing inner hair cells (IHCs) were 7.4 +/- 6.0% and 7.8 +/- 5.1% for their protected and exposed ears, respectively. Outer hair cell (OHC) loss was 12.8 +/- 8.7% and 20.6 +/- 7.8% for their protected and exposed ears, respectively. A paired sample Student's t test revealed that OHC loss was significantly greater (P = .003) in the older-exposed compared to the older-protected ears whereas IHC loss was not significantly different. For younger-exposed ears (i.e., 1 to 3 years), the percentages of missing IHCs and OHCs averaged 2.6 +/- 2.0% and 12.3 +/- 4.6%, respectively. When the aging-related cell loss was subtracted from total loss in the younger- and older-exposed ears, the noise-induced loss of sensory cells in the older ears was not significantly different from that in the younger ears. Therefore, it is concluded that older chinchilla ears are not more susceptible to noise damage than younger ears. [ABSTRACT FROM AUTHOR]

This study demonstrates the quantitative characteristics of the first patient-reported outcome (PRO) tool developed for patients with nontransfusion-dependent β-thalassemia (NTDT), the NTDT-PRO © . A multicenter validation study was performed over 24 weeks, involving 48 patients from Italy, Lebanon, Greece, and Thailand. Most patients were female (68.8%), with a median age of 34.5 years (range, 18-52); 66.7% were diagnosed with β-thalassemia intermedia, and median time since diagnosis was 22 years (range, 0-43). The NTDT-PRO comprises 6 items across 2 domains (Tiredness/Weakness and Shortness of Breath [SoB]), and was valid and reliable, with good consistency. At baseline, most patients reported symptoms as present via the NTDT-PRO, and were highly compliant, ≥90% completing the NTDT-PRO tool. In a pairwise correlation analysis, all items were positively correlated. Correlations between NTDT-PRO and existing tools-36-Item Short Form Health Survey version 2 (SF-36v2) and Functional Assessment of Cancer Therapy-Anemia (FACT-An)-were assessed at weeks 1, 3, and 12; robust correlations were seen between SoB and SF-36v2-Vitality (r s  = -0.53), and between SoB and Fact-An-Fatigue Experience (r s  = -0.66) at week 1. Internal consistency was high for both Tiredness/Weakness (Cronbach alpha, 0.91) and SoB (Spearman-Brown coefficient, 0.78); intraclass correlation coefficients were high (Tiredness/Weakness, 0.88 and 0.97; SoB, 0.92 and 0.98), demonstrating stability. Further studies are required to fully support the validity of this tool, this study demonstrated the usefulness of the NTDT-PRO in the clinical setting and for longitudinal clinical research, particularly in trials where patient health-related quality of life is expected to change., (© 2018 The Authors. American Journal of Hematology published by Wiley Periodicals, Inc.)

β-Thalassemia, a hereditary blood disorder caused by reduced or absent synthesis of the β-globin chain of hemoglobin, is characterized by ineffective erythropoiesis, and can manifest as nontransfusion-dependent thalassemia (NTDT) or transfusion-dependent thalassemia (TDT). Many patients with NTDT develop a wide range of serious complications that affect survival and quality of life (QoL). Patient-reported outcomes (PRO), including health-related QoL (HRQoL), are important tools for determining patient health impairment and selecting appropriate treatment. However, there are currently no disease-specific PRO tools available to assess symptoms related to chronic anemia experienced by patients with NTDT. This study aimed to develop a new, US Food and Drug Administration (FDA)-compliant PRO of chronic anemia symptoms, the NTDT-PRO © tool, for use in patients with NTDT. Participants had a median age of 36 years (range, 18-47) and 60% were female. The initial development of the NTDT-PRO tool involved concept-elicitation interviews with 25 patients from 3 centers (in Lebanon, Greece, and Canada); subsequent interview discussions and clinical input resulted in the generation of 9 items for inclusion in the draft NTDT-PRO. Following a round of cognitive interviews involving 21 patients from 2 centers (in Lebanon and Greece), 4 items (Pain, Headaches, Ability to Concentrate, and Paleness) were removed from the draft NTDT-PRO. The final NTDT-PRO comprises 6 items that measure Tiredness, Weakness, and Shortness of Breath, with or without Physical Activity. The NTDT-PRO is a new disease-specific HRQoL tool for patients with NTDT, developed using a thorough methodology based on FDA 2009 PRO development guidelines., (© 2018 The Authors. American Journal of Hematology published by Wiley Periodicals, Inc.)

Reports of increasing endotoxic reactions in dialysis centers using high-flux dialyzers and high contamination in liquid bicarbonate concentrates have resulted in concern for the microbial contamination of dialysate. The influence of salt-supplemented media on the recovery of bacterial contaminants from the fluids used in hemodialysis has been examined. This study found a negative influence of a 2% NaCl supplementation of growth media for both purified water and dialysate. Salt-supplemented pour plate cultures of bicarbonate concentrate samples were not statistically different from nonsupplemented cultures (p = 0.2). The influence of the bicarbonate salt on recovery in the pour plates was not addressed. The different media recommended for monitoring microbial contamination of dialysis fluids were compared. As previously reported, both water and dialysate collected from a relatively large geographic area showed higher recoveries on Reasoner's R2A agar than on media recommended by the Association for Advancement of Medical Instrumentation (AAMI) standards (p < 0.0001). Standard methods agar (SMA) and trypticase soy agar (TSA) produced the next highest recovery for water and dialysate, respectively. The higher recoveries generally observed on R2A or SMA suggest that to provide better patient safety these media should be selected for monitoring bacterial contamination of water, and R2A, SMA, or TSA for dialysate. The variability in the species identified across the three fluids and variability in counts observed in the different fluids suggest that significant dialysate contamination may occur from sources other than the water and bicarbonate concentrates.

Recent studies in the bird ear have shown that degenerated hair cells are sometimes replaced by regenerated receptor cells. The present study evaluated the adult mammalian cochlea for evidence of hair-cell and nerve-fiber regeneration. Eighty-eight noise-damaged chinchilla cochleas were examined as plastic-embedded whole mounts by phase-contrast and bright-field microscopy. No signs of hair-cell regeneration were found. However, 32 (70%) of 46 cochleas damaged by high-intensity noise and 20 (48%) of 42 cochleas damaged by moderate-intensity noise contained a variable number of nerve fibers which appeared to be regenerated. These fibers, which were located in severely damaged areas of organ of Corti, differed from residual fibers with respect to their diameters, the degree and pattern of myelination, and by the abnormal paths they followed within the osseous spiral lamina and on the basilar membrane. The number of regenerated fibers varied with type of exposure and length of recovery. The strongest response was found in ears exposed to a high-intensity, low-frequency noise. The results described here indicate that a potential exists for the biological restoration of the mammalian inner ear.

The purified water supplies and randomly selected dialysates of 51 chronic and acute dialysis centers in the central United States were surveyed to assess the relative risks to dialysis patients from microbial and endotoxin contamination. A culture medium more sensitive than those generally employed in routine quality assurance assays was used for recovery of bacteria from water. With this medium, 35.3% of the water samples and 19% of the dialysate samples were out of compliance with the Association for the Advancement of Medical Instrumentation (AAMI) standards: 200 and 2,000 colony forming units (CFU)/ml, respectively. There was no correlation observed between the type of water purification system or the frequency of disinfection of the system and the bacterial and endotoxin contamination levels. There was also no correlation found between the bacterial and fungal CFU per ml and the endotoxin concentration per ml (EU/ml). It is recommended that more sensitive culturing methods be used to provide adequate bacterial monitoring of dialysate center water supplies. Dialysis centers should monitor endotoxin in dialysate on a regular schedule and immediately after any endotoxemic-like patient reactions. Yeast and fungi were observed in 10% and 64% of the water systems, respectively. Dialysate was contaminated by yeast and fungi in 30% and 70% of the centers, respectively. The concentrations of these microbes in both fluids were much lower than bacteria. However, they were observed often enough to warrant further investigation of their impact on the well-being of dialysis patients.

Calcium carbonate has been observed to precipitate in the fluid pathway of dialysate delivery systems dispensing bicarbonate-containing dialysates. Such precipitation can occlude the fluid pathway, leading to system malfunction and increased maintenance requirements. We show that commercial supplies of sodium bicarbonate are contaminated by trace amounts of sodium carbonate. This contamination may result in immediate precipitation of calcium carbonate on formulation of the dialysate, since bicarbonate-containing dialysates, as formulated, are metastable with respect to calcium carbonate. Sparging of the bicarbonate-containing concentrate with carbon dioxide converts any carbonate to bicarbonate, thus avoiding the formation of precipitates on addition of calcium ions.

Many dialysis centers depend on clinical laboratories or a commercially available dip culture to determine the contamination levels in water and dialysate. To determine whether these standard clinical culture procedures adequately quantitate bacterial contamination in hemodialysis center water and dialysate, test results of two routine clinical media was compared, trypticase soy agar (TSA) and plate count agar (PCA), with those of nutrient-poor R2A medium. Dialysate samples demonstrated significant differences in media, the temperature of incubation, and plating techniques (pour plate versus spread plates). Purified water for dialysis demonstrated significant differences only for media; however, temperature was an important variable. Selective growth on R2A agar of some water- and dialysate-contaminating species was studied by velvet disk and loop transfer of colonies. A strong selectivity for water-borne bacteria was demonstrated by R2A agar; the bacteria that did not grow on TSA and PCA have been identified.