Search

Background: The purpose of the described exploratory study was to test proactive strategies for enhancing engagement and cognitive ability while diminishing dementia-related disordered behaviors of those diagnosed with Alzheimer's disease and other dementias. Study participants resided in an Memory Care unit of an assisted living community., Method: The researchers measured the effects of exposure to music and nature images on engagement using the Individualized Dementia Engagement and Activities Scale tool, on cognitive ability using the Montreal Cognitive Assessment, and on agitation using the Cohen-Mansfield Agitation Inventory., Result: The within-subject study design revealed that use of both music and nature images hold promise for reducing undesirable behaviors and improving engagement of residents., Conclusion: The authors suggest caregivers for those with Alzheimer's disease and other dementias can effectively use nature images and music to improve engagement and reduce disordered behaviors, thus potentially enhancing quality of life for the care recipient as well as the caregiver while possibly reducing the costs of medications used to control dementia-related undesirable behaviors.

Background: With emerging technologies and genetic advancements in the field of oncology, ethical controversies and questions on how to approach them will continue to grow. Advancements in the field of hematopoietic stem cell transplantation have led to increased testing of transplantation recipients' children and parents as potential donors related to an increase in the use of haploidentical transplantations. This testing opens the door for an increased incidence of misattributed paternity findings., Objectives: This article attempts to address the ethical conflicts and provide potential solutions to assist in the transition from individual-focused care to family-focused care., Methods: The principlist approach was used., Findings: Healthcare providers should be educated on methods of incidental finding disclosure and how to provide adequate support for those individuals.

Motion is a crucial source of information for a variety of tasks in social interactions. The process of how humans recognize complex articulated movements such as gestures or face expressions remains largely unclear. There is an ongoing discussion if and how explicit low-level motion information, such as optical flow, is involved in the recognition process. Motivated by this discussion, we introduce a computational model that classifies the spatial configuration of gradient and optical flow patterns. The patterns are learned with an unsupervised learning algorithm based on translation-invariant nonnegative sparse coding called VNMF that extracts prototypical optical flow patterns shaped, for example, as moving heads or limb parts. A key element of the proposed system is a lateral inhibition term that suppresses activations of competing patterns in the learning process, leading to a low number of dominant and topological sparse activations. We analyze the classification performance of the gradient and optical flow patterns on three real-world human action recognition and one face expression recognition data set. The results indicate that the recognition of human actions can be achieved by gradient patterns alone, but adding optical flow patterns increases the classification performance. The combined patterns outperform other biological-inspired models and are competitive with current computer vision approaches.

1D spectral imaging was used to characterize the K-shell emission of Z ≈ 30-35 and Z ≈ 40-42 laser-irradiated foils at the National Ignition Facility. Foils were driven with up to 60 kJ of 3ω light, reaching laser irradiances on target between 0.5 and 20 × 10(15) W/cm(2). Laser-to-X-ray conversion efficiency (CE) into the Heα line (plus satellite emission) of 1.0%-1.5% and 0.15%-0.2% was measured for Z ≈ 30-32 and Z ≈ 40-42, respectively. Measured CE into Heα (plus satellite emission) of Br (Z = 35) compound foils (either KBr or RbBr) ranged between 0.16% and 0.29%. Measured spectra are compared with 1D non-local thermodynamic equilibrium atomic kinetic and radiation transport simulations, providing a fast and accurate predictive capability.

Background: Ascent to altitude results in the expansion of gases in closed spaces. The management of overinflation of the endotracheal tube (ETT) cuff at altitude is critical to prevent mucosal injury., Methods: We continuously measured ETT cuff pressures during a Critical Care Air Transport Team training flight to 8,000-ft cabin pressure using four methods of cuff pressure management. ETTs were placed in a tracheal model, and mechanical ventilation was performed. In the control ETT, the cuff was inflated to 20 mm Hg to 22 mm Hg and not manipulated. The manual method used a pressure manometer to adjust pressure at cruising altitude and after landing. A PressureEasy device was connected to the pilot balloon of the third tube and set to a pressure of 20 mm Hg to 22 mm Hg. The final method filled the balloon with 10 mL of saline. Both size 8.0-mm and 7.5-mm ETT were studied during three flights., Results: In the control tube, pressure exceeded 70 mm Hg at cruising altitude. Manual management corrected for pressure at altitude but resulted in low cuff pressures upon landing (<10 mm Hg). The PressureEasy reduced the pressure change to a maximum of 36 mm Hg, but on landing, cuff pressures were less than 15 mm Hg. Saline inflation ameliorated cuff pressure changes at altitude, but initial pressures were 40 mm Hg., Conclusion: None of the three methods using air inflation managed to maintain cuff pressures below those associated with tracheal damage at altitude or above pressures associated with secretion aspiration during descent. Saline inflation minimizes altitude-related alteration in cuff pressure but creates excessive pressures at sea level. New techniques need to be developed.

Since 2003, genetics and genomics information has led to exciting new diagnostics, prognostics, and treatment options in oncology practice. Profiling of cancers offers providers insight into treatment and prognostic factors. Germline testing provides an individual with information for surveillance or therapy that may help them prevent cancer in their lifetime and options for family members as yet untouched by malignancy. This offers a challenge for oncology nurses and other oncology health care providers to become comfortable with incorporating education about genetics/genomics into their clinical practice and patient education., (Copyright © 2013 Elsevier Inc. All rights reserved.)

A platform consisting of a multi-shock drive and an implosion backlighter has been developed for x-ray absorption fine structure (XAFS) measurements on materials compressed to multi-Mbar pressures. The experimental setup, target design, and backlighter characteristics are presented. Extended XAFS (EXAFS) measurements for various materials have been demonstrated. A quintuple-crystal design is described to enhance the efficiency of the x-ray spectrometer, enabling observation of very weak EXAFS signals in a single shot.

ABSTRACT There is limited research about tobacco-related behaviours and attitudes among rural populations in the Eastern Mediterranean Region. The aim of this study was to determine smoking behaviours and attitudes among the nomadic Bedouin in rural southern Jordan. Patients visiting a village clinic over 2 months of 2009 were invited by the attending physician to participate in the survey, which was adapted from the California Tobacco Survey. The smoking prevalence among the 92 participants was 46.7%. Most smokers were men who smoked heavily (> 1 pack/day) (90.7%). There was general low self-efficacy to quit among smokers, yet 81.4% acknowledged that smoking was harming their health. Although 79.1% of smokers and 89.1% of non-smokers believed second-hand smoke was harmful to non-smokers, most of them had no restrictions on smoking for residents and guests (66.3%) and most had children at home (73.9%). These data demonstrate contradictions between attitudes and behaviours about smoking of this rural population.

Advances in genetics related to the diagnosis and treatment of cancer have transformed the oncology specialty into one with more promising outcomes. Because of the Human Genome Project, the association between genetics and cancer is more clearly defined and healthcare professionals need to be prepared to integrate new genetics knowledge into clinical practice. This article reviews basic genetic information essential for oncology nurses in advanced practice. Application of genetic guidelines uses the model of multiple myeloma. Multiple myeloma is an example of a disease in which cytogenetics has become increasingly important for diagnosis, prognosis, and treatment. As the basis of knowledge in genetics continues to expand, oncology providers are transitioning to a paradigm in which cytogenetic elements carry more weight in diagnosis and treatment.

Purpose: Faculty knowledge of genomics, learner competencies, and program requirements for nursing education are described to assist educators in introducing genomic information into nursing undergraduate, graduate, postgraduate, and continuing education programs regardless of geographic location. Selected programs in the United States and the United Kingdom are described to illustrate successful approaches used by nursing faculty to enhance their genomic knowledge in order to increase application of genetic and genomic content within nursing education curricula., Organizing Construct: Nursing education guidelines and nursing competencies provide benchmarks for educators in planning genetic and genomic curriculum content and expected learner outcomes., Methods: Elements within competencies from the United States and the United Kingdom are reviewed to provide the framework for faculty knowledge. Strategies to address development of faculty knowledge and expertise are suggested. Continuing education faculty development programs and strategies to develop doctorally prepared nurse scientists who will educate future students in the profession are described., Conclusions: Multiple faculty who are prepared to implement education on genetic and genomic topics are needed at all levels of nursing education. Faculty networking and application of genomic principles to nursing are key elements for sustaining nursing education to produce a nursing workforce that can apply essential genomic knowledge., Clinical Relevance: There is an urgent need to offer genomics in accessible and effective education for nursing practice to optimize health outcomes regardless of geographic location., (© 2011 Sigma Theta Tau International.)

Humans selectively process and store details about the vicinity based on their knowledge about the scene, the world and their current task. In doing so, only those pieces of information are extracted from the visual scene that is required for solving a given task. In this paper, we present a flexible system architecture along with a control mechanism that allows for a task-dependent representation of a visual scene. Contrary to existing approaches, our system is able to acquire information selectively according to the demands of the given task and based on the system's knowledge. The proposed control mechanism decides which properties need to be extracted and how the independent processing modules should be combined, based on the knowledge stored in the system's long-term memory. Additionally, it ensures that algorithmic dependencies between processing modules are resolved automatically, utilizing procedural knowledge which is also stored in the long-term memory. By evaluating a proof-of-concept implementation on a real-world table scene, we show that, while solving the given task, the amount of data processed and stored by the system is considerably lower compared to processing regimes used in state-of-the-art systems. Furthermore, our system only acquires and stores the minimal set of information that is relevant for solving the given task.

This article reviews the normal function of the huntingtin gene, mutation-induced changes in the gene product (protein), possible causes of Huntington disease, and associated symptoms. An educational tool with recommendations the practitioner can use for interventions and counseling with patients and their families is also included.

Objectives: To describe the impact of genetics and genomics on the biology of cancer and the implications for patient care., Data Sources: Pubmed; CINAHL., Conclusions: Cancer research in genetics/genomics has identified new mechanisms influencing personalized risk assessment/management, early detection, cancer treatment, and long-term screening/surveillance., Implications for Nursing Practice: Understanding the basics of genetics/genomics on the biology of cancer will facilitate patient education and care delivery, including the administration and monitoring of genetically targeted therapies whose toxicities may in part be mediated by the molecular pathways targeted by the specific agent., (Copyright © 2011 Elsevier Inc. All rights reserved.)

Stafne bone defects are nonprogressive yet nonhealing bone cavities situated near the angle of the mandible. Rare locations include the anterior mandible and the ramus. In most instances, salivary gland tissue can be found in these defects, which are of unclear pathogenesis. The case of a unilateral Stafne bone defect in the anterior mandible is presented. A 46-year-old man presented in an oral-maxillofacial practice with two panoramic radiographs, taken in 2001 and 2008, showing a progressive radiolucent region overlying the apices of the lateral incisor, canine, and first premolar in the left mandible. The patient did not report any symptoms or pain in the region of the radiolucency. The differential diagnosis was odontogenic cyst or neoplastic lesion. Following surgical exploration, histology showed inflamed connective tissue, fatty tissue, striated muscle, bony fragments, and salivary gland tissue but no cystic or neoplastic lesion.

Purpose: This study aimed to prove the usefulness of the diagnostic plot, using the haemoglobin content of reticulocytes as a measure of functional iron deficiency (FID) and the ferritin index as a measure of iron availability, to customise anaemia treatment in cancer patients., Methods: Based on results of this plot, cancer patients fulfilling practice guideline criteria to receive erythropoiesis-stimulating agents (ESAs) were allocated to treatment with ESAs alone, iron alone or the combination of both. Primary endpoint was the percentage of patients identified to require iron in addition or as an alternative to ESA therapy., Results: Out of 303 patients screened, 286 were allocated to treatment: 204 patients were normochromic and iron replete and treated with ESAs alone, 22 had both FID and anaemia of chronic disease and were treated with ESAs and parenteral iron, and 60 were iron-depleted and treated with iron only. After 8 weeks, a haemoglobin increase >1 g/dL from baseline was shown by 56% of patients treated with ESAs alone, by 100% of patients receiving the combination, by 50% of normochromic and by 73% of hypochromic iron-depleted patients receiving iron only. Acute phase reaction did not diminish the response rate to ESAs., Conclusions: The diagnostic plot was superior to transferrin saturation and ferritin in predicting iron availability in hypochromic patients treated with ESAs and proved useful to select treatment for anaemia in cancer patients.

Purpose/objectives: To determine whether patient navigation in a comprehensive community cancer center affects patient and staff perceptions of patient preparation for treatment, access to care, and overall satisfaction., Design: Program evaluation with patient and staff surveys., Setting: Comprehensive community cancer center accredited by the American College of Surgeons in the southeastern United States with 1,037 analytic cases of cancer in 2007; population of the main county served is about 177,963., Sample: 48 patients (28 navigator and 20 non-navigator) and 26 employees, including physicians, nurses, and other support staff., Methods: A 10-item survey with Likert scale format was sent to a stratified sample of 100 newly diagnosed patients with cancer. A five-item survey with the same format was sent to 40 staff working with the patients., Main Research Variable: Patient navigation., Findings: Patients who received navigation services responded more positively to survey statements. Statistical significance (p > 0.05) was identified in 7 of 10 statements when patient groups were compared. Provider responses indicated agreement with all five statements included in the survey., Conclusions: Patients with cancer and oncology staff reported that patient navigation is effective in increasing patient satisfaction and decreasing barriers to care., Implications for Nursing: Patient navigation is an emerging trend in cancer care. Patient navigators can play a significant role in assisting patients with coordinating services across the continuum of care. Continued research is essential in refining the role and eminence of patient navigators.

 Pyoderma gangrenosum (PG) is associated with systemic disease, mostly rheumatoid arthritis (RA) and inflammatory bowel disease (IBD), in many patients (more than 50%). Lesions associated with arthritis are often ulcerative. Although these lesions typically affect the lower limbs, they can also affect the entire body. Successful therapy involving monoclonal antibodies seems to favor an autoimmune etiopathogenesis that has disorders of neutrophils' chemotactic activity and interleukins, which are acted upon by TNF-α cytokines. The ulcers grow rapidly, exacerbate after trauma, and necrosis can invade each skin layer up to the fascia. Therefore, debridement is contraindicated because it introduces the so-called "pathergy" mechanism. The diagnosis is quite difficult and is often made late due to the lack of indicative clinical and laboratory findings. The following is a report of a case of multiple, ulcerative, PG ulcers induced by arthritis. The ulcers occurred over several occasions with large and aggressive necrosis reaching the osseous plane in the heel and elbow. The high IgE values (between 2000 UI/mL and 3000 UI/mL) suggested that a type I immunitary reaction, such as in-skin anaphylaxis, was involved. Nevertheless, the antigen remains unknown and the genesis may be multifactorial. A corticosteroid (prednisolone) was the first-line systemic treatment used in this case and caused rapid improvement. Further investigations will be necessary to understand the meaning of this immunologic disorder .

In this paper, we propose a real-time system for in-home activity monitoring and functional assessment for elder care. We describe the development of the whole system which could be used to assist the independent living of elders and improve the efficiency of eldercare practice. With this system, data is collected, silhouettes extracted, features further analyzed and visualized into graphs from which eldercare professionals are able to understand massive video monitoring data within a short period of time. Our experimental results demonstrate that the proposed system is efficient in indoor elder activities monitoring and easily utilized by eldercare professionals.

Objective: To examine the association between country of birth and hospitalization for pelvic inflammatory disease (PID), ectopic pregnancy (EP), endometriosis, and infertility., Design: Follow-up study., Setting: Sweden., Participant(s): A total of 2,170,177 women living in Sweden at some point between 1990 and 2004, categorized into 10 different groups according to country of birth., Intervention(s): None., Main Outcome Measure(s): Hospitalization for PID, EP, endometriosis, and infertility., Results: For PID and infertility, all groups of foreign-born women exhibited significantly increased risks compared with Swedish-born women. The highest risks of PID were found among women from southern Europe, Eritrea/Ethiopia/Somalia, and other African countries, whereas the highest risks of infertility were found among women from Middle Eastern countries, other Asian countries, and other African countries. Compared with PID and infertility, country of birth was less associated with endometriosis and EP, although some differences were found. All relative risks were adjusted for age, time period, and the women's socioeconomic status., Conclusion(s): Even in a country like Sweden, which offers publicly financed treatment for infertility, differences based on country of birth exist. Although data on partners' income were not available to us, it is possible that other factors besides socioeconomic factors are present in the etiology of female health problems related to infertility.

For the interaction of a mobile robot with a dynamic environment, the estimation of object motion is desired while the robot is walking and/or turning its head. In this paper, we describe a system which manages this task by combining depth from a stereo camera and computation of the camera movement from robot kinematics in order to stabilize the camera images. Moving objects are detected by applying optical flow to the stabilized images followed by a filtering method, which incorporates both prior knowledge about the accuracy of the measurement and the uncertainties of the measurement process itself. The efficiency of this system is demonstrated in a dynamic real-world scenario with a walking humanoid robot.

Hugoniot data were obtained for fluid He in the 100 GPa pressure range by shock compression of samples statically precompressed in diamond-anvil cells. The initial (precompressed) He density (rho&#95;(1)) for each experiment was tuned to a value between rho&#95;(0L) or =3rho&#95;{0L} (i.e., rho/rho&#95;(0L)> or =12). Data show an increase in compressibility at the onset of ionization, similar to theoretical predictions.

Diamond is the only known high-pressure structure of carbon. In spite of its fundamental and planetary importance, the stability domain of this strong covalent material is largely unknown. After decades of experimental efforts, evidence was obtained that the diamond-liquid melting line has a positive slope above the graphite-diamond-liquid triple point. At higher pressure, theoretical studies have suggested that the melting curve of diamond should have a maximum, owing to a loss of stability of the sp3 hybridization in the fluid phase. Accurate Hugoniot data of diamond exist up to 590 GPa (ref. 6). Higher-pressure measurements along the diamond Hugoniot have recently been achieved by laser shocks, showing that diamond probably melts to a conducting fluid. We report here laser-shock Hugoniot data across the melting transition. The shocked diamond crystal begins to melt around 750 GPa. Furthermore, a negative volume discontinuity at melting is observed. This requires a negative melting slope and thus supports the existence of a maximum on the diamond melting curve. These melting data allow us to test various calculations of the phase diagram of carbon at very high pressure. Finally, the stability domain of the diamond crystal is now constrained in a relevant region for Uranus-like planetary interiors.

Objective: Insecure attachment styles and certain personality characteristics (i.e., high levels of neuroticism) have been associated with eating pathology. However, previous research has not examined these variables simultaneously and has not examined possible mediating relationships between attachment and personality characteristics for disordered eating. Because personality characteristics have emerged as some of the most robust predictors of disordered eating, it was predicted that the link between attachment and disordered eating might be through personality styles., Method: Participants included 85 female twins and triplets who took part in the Michigan State University Twin Study. Disordered eating, attachment style, and personality characteristics were assessed. Hierarchical linear models were used to examine relationships among the variables., Results: Overall, neuroticism, and extraversion to a lesser extent, mediated the relationship between insecure-resistant attachment and disordered eating. Specifically, higher scores on the neuroticism scale predicted more disordered eating and explained the relationship between insecure-resistant attachment and disordered eating., Conclusion: These results suggest that relationships between attachment style and disordered eating are indirect, in that neuroticism fully mediates associations between insecure-resistant attachment and disordered eating., (2006 by Wiley Periodicals, Inc.)

Background: The pelvic inflammatory disease (PID) diagnosis is mostly based on clinical findings. However, few studies have examined the clinical basis for the diagnostics of PID, which was the aim of this study., Methods: A retrospective study was performed of 189 out-patients diagnosed as having PID at the obstetric and gynecological emergency department of a Swedish university hospital. Data on symptoms, signs, pelvic examination and laboratory tests were extracted from the electronic medical records in comparison with the diagnostic criteria of the PID Guideline of the US Center of Disease Control from 2002 (CDC 2002 Guidelines)., Results: Eight symptoms in varying combinations were associated with the PID diagnosis. Most of them are mentioned in the CDC 2002 Guidelines. Detected rates of C. Trachomatis (CT) and N. Gonorrhoeae (NG) were 5% and 0%, respectively, among the tested patients (CT = 52% and NG = 12%). The C-reactive protein was normal in the majority of tested patients., Conclusion: The clinical basis for the diagnostics of PID was largely in accordance with the criteria in the CDC 2002 Guidelines. The limited number of CT tests performed is somewhat disappointing, considering the fact that effective disease prevention includes widespread CT screening. Further studies in different settings are needed in order to analyze how the testing rate for CT can be improved in clinical praxis.

This paper proposes a biologically inspired and technically implemented sound localization system to robustly estimate the position of a sound source in the frontal azimuthal half-plane. For localization, binaural cues are extracted using cochleagrams generated by a cochlear model that serve as input to the system. The basic idea of the model is to separately measure interaural time differences and interaural level differences for a number of frequencies and process these measurements as a whole. This leads to two-dimensional frequency versus time-delay representations of binaural cues, so-called activity maps. A probabilistic evaluation is presented to estimate the position of a sound source over time based on these activity maps. Learned reference maps for different azimuthal positions are integrated into the computation to gain time-dependent discrete conditional probabilities. At every timestep these probabilities are combined over frequencies and binaural cues to estimate the sound source position. In addition, they are propagated over time to improve position estimation. This leads to a system that is able to localize audible signals, for example human speech signals, even in reverberating environments.

Velocity distributions are an enhanced representation of image velocity containing more velocity information than velocity vectors. In particular, non-Gaussian velocity distributions allow for the representation of ambiguous motion information caused by the aperture problem or multiple motions at motion boundaries. To resolve motion ambiguities, discrete non-Gaussian velocity distributions are suggested, which are integrated over space, time, and scales using a joint Bayesian prediction and refinement approach. This leads to a hierarchical velocity-distribution representation from which robust velocity estimates for both slow and high speeds as well as statistical confidence measures rating the velocity estimates can be computed.

Aims: Decreasing fertility rates and postponement of first birth are of considerable public health concern in many industrialized countries. Previous studies suggest that this will increase involuntary childlessness in the population. The general aim was to examine the association between sociodemographic factors and first birth fertility trends in Sweden during the 1990s., Methods: This Swedish national study examined changes in first birth rates and mean age at first birth between 1991 and 1992 (n = 452,000) and 1997-98 (n = 495,756). The impact of socioeconomic factors and years in Sweden on first birth fertility was examined among Swedish-born and 19 subgroups of foreign-born women aged 20-41 years. Poisson regression was used in the analysis., Results: First birth rates decreased and mean age at first birth increased between the two periods among the Swedish-born and most foreign-born women. Non-employment and low income were associated with decreased first birth fertility, and low educational status was associated with slightly increased first birth fertility. Interaction tests revealed that, in contrast to Swedish-born women, several groups of foreign-born women increased their first birth fertility even if they were non-employed or had a low income. Among foreign-born women fewer years in Sweden was significantly associated with increased first birth fertility., Conclusion: Public health information should emphasize that postponement of first birth could lead to involuntary childlessness. Health care workers need to consider the woman's socioeconomic characteristics, country of birth, and years in Sweden when such information is given.

Invariant object recognition is arguably one of the major challenges for contemporary machine vision systems. In contrast, the mammalian visual system performs this task virtually effortlessly. How can we exploit our knowledge on the biological system to improve artificial systems? Our understanding of the mammalian early visual system has been augmented by the discovery that general coding principles could explain many aspects of neuronal response properties. How can such schemes be transferred to system level performance? In the present study we train cells on a particular variant of the general principle of temporal coherence, the "stability" objective. These cells are trained on unlabeled real-world images without a teaching signal. We show that after training, the cells form a representation that is largely independent of the viewpoint from which the stimulus is looked at. This finding includes generalization to previously unseen viewpoints. The achieved representation is better suited for view-point invariant object classification than the cells' input patterns. This property to facilitate view-point invariant classification is maintained even if training and classification take place in the presence of an--also unlabeled--distractor object. In summary, here we show that unsupervised learning using a general coding principle facilitates the classification of real-world objects, that are not segmented from the background and undergo complex, non-isomorphic, transformations.

The history of neonatal sepsis related to early onset group B streptococcus (GBS) emerged in the early 1970s. The neonatal mortality rate was 55% for those neonates with invasive GBS disease. The first adopted guidelines by the medical community to prevent early onset GBS were developed in the 1990s. One year after implementation of the guidelines, the mortality rate dropped to approximately 5%. Despite the great accomplishments in reducing the mortality rate, GBS remains the number one cause of infant morbidity and mortality in the United States.

Objective: To investigate the long-term effects of alcohol consumption on female fertility., Design: Prospective study of a random sample of 7,393 women, selected from the 445,000 inhabitants of Stockholm County, Sweden, in 1969. Self-estimated alcohol consumption was obtained from postal questionnaires. Data on hospitalizations for pregnancy outcomes including infertility examinations were analyzed until 1987., Setting: Healthy women in Stockholm County, Sweden., Patient(s): Seven thousand three hundred ninety-three women in the age range 18-28 years., Main Outcome Measure(s): Rates of hospitalization for deliveries, miscarriages, legal abortions, extrauterine pregnancies, pelvic inflammatory disease, endometriosis, and infertility examinations were analyzed in relation to the intake of alcohol., Result(s): Two hundred fifty-two women underwent infertility examinations. High consumers had an increased risk for such examinations, as compared with moderate consumers: relative risk ratio (RR) = 1.59 (95% confidence interval [CI]: 1.09-2.31); and low consumers had a decreased risk (RR = 0.64; CI: 0.46-0.90). Moreover, for both high and low consumers we observed a significantly lower number of first and second partus. Rates of miscarriage, extrauterine pregnancy, and pelvic inflammatory disease did not differ between high and low consumers of alcohol., Conclusion(s): High alcohol consumption was associated with increased risk of infertility examinations at hospitals and with lower numbers of first and second partus. It may be important for the female partner in an infertile couple to limit alcohol intake or to not drink at all.

We present for the first time a full three-dimensional (3-D) reconstruction of absorption images of breast from continuous-wave (cw) measurements performed on a premenopausal woman. Our 3-D optical images clearly reveal a large primary tumor as well as a small secondary tumor in a separate location of the breast. The multiple tumors identified by our 3-D optical imaging have been confirmed by the subsequent biopsy examination of the breast. Quantitative information of the optical images obtained is provided in terms of the location, size, and absorption coefficient of the tumors.

Models that describe qualitatively and quantitatively the activity of entire groups of spiking neurons are becoming increasingly important for biologically realistic large-scale network simulations. At the systems and areas modeling level, it is necessary to switch the basic descriptional level from single spiking neurons to neuronal assemblies. In this article, we present and review work that allows a macroscopic description of the assembly activity. We show that such macroscopic models can be used to reproduce in a quantitatively exact manner the joint activity of groups of spike-response or integrate-and-fire neurons. We also show that integral as well as differential equation models of neuronal assemblies can be understood within a single framework, which allows a comparison with the commonly used assembly-averaged graded-response type of models. The presented framework thus enables the large-scale neural network modeler to implement networks using computational units beyond the single spiking neuron without losing much biological accuracy. This article explains the theoretical background as well as the capabilities and the implementation details of the assembly approach.

Starting from single, spiking neurons, we derive a system of coupled differential equations for a description of the dynamics of pools of extensively many equivalent neurons. Contrary to previous work, the derivation is exact and takes into account microscopic properties of single neurons, such as axonal delays and refractory behavior. Simulations show a good quantitative agreement with microscopically modeled pools of spiking neurons. The agreement holds both in the quasistationary and nonstationary dynamical regimes, including fast transients and oscillations. The model is compared with other pool models based on differential equations. It turns out that models of the graded-response category can be understood as a first-order approximation of our pool dynamics. Furthermore, the present formalism gives rise to a system of equations that can be reduced straightforwardly so as to gain a description of the pool dynamics to any desired order of approximation. Finally, we present a stability criterion that is suitable for handling pools of neurons. Due to its exact derivation from single-neuron dynamics, the present model opens simulation possibilities for studies that rely upon biologically realistic large-scale networks composed of assemblies of spiking neurons.

A novel Philadelphia (Ph) variant translocation, t(Y;9;22)(q12;q34;q11), was detected in a 63-year-old man with a newly diagnosed chronic myeloid leukemia (CML). Reverse transcription polymerase chain reaction (RT-PCR) analysis revealed a b3a2 fusion transcript. Fluorescence in situ hybridization (FISH) utilizing library probes, subtelomeric cosmid probes, and probes hybridizing to the ABL and BCR genes showed a reciprocal three-way translocation involving Yq12, 9q34, and 22q11, and a BCR-ABL fusion signal on der(22). The subtelomeric Yq probe hybridizing centromerically to the IL9 receptor gene and covering the centromeric portion of the SYBL1 gene was found to be translocated to der(9).

There is still controversy as to what constitutes the optimal therapy for acute and delayed chemotherapy-induced emesis and nausea. We conducted a three-armed randomized multi-centre study in 193 chemotherapy-naive patients receiving highly emetogenic chemotherapy inducing both acute and delayed symptoms (cisplatin > or = 50 mg/m2, carboplatin > or = 300 mg/m2, cyclophosphamide > or = 750 mg/m2, ifosfamide > or = 1.5 g/m2 on day 1). Group A: 1 x 5 mg tropisetron i.v. on day 1 + 2, then 10 mg p.o. (oral dose now recommended: 5 mg); group B: tropisetron as for A+dexamethasone, 20 mg i.v., on days 1 + 2, then 4 mg i.v./p.o.; group C: tropisetron as for A+metoclopramide, 20 mg i.v. +2 x 10 mg p.o. on day 1, then 3 x 10 mg p.o. Treatment was continued for at least 2 days after the end of chemotherapy. Tropisetron+dexamethasone was significantly superior to tropisetron alone both for acute (P = 0.0064) and delayed (P = 0.0053) emesis. Complete control of acute and delayed emesis (nausea) was achieved in 80% (75%) and 53% (46%) in group A, 97% (90%) and 80% (58%) in group B, and 86% (80%) and 49% (45%) in group C. Patients completely asymptomatic during the whole cycle accounted for 26% of those in group A, 49% in group B and 28% in group C. The most frequent adverse events were constipation (16.6%), headache (7.3%) and tiredness (7.3%). Once-daily tropisetron+dexamethasone over several days is well tolerated and is a simple means of achieving further significant improvement in the efficacy of tropisetron against acute and delayed symptoms.

Cyclosporin A has heterogeneous effects on anthracycline-related cardiotoxicity and can prevent multidrug-resistance (MDR). The aim of this study was to explore whether the coadministration of cyclosporin A is accompanied by an increase in cardiotoxicity. Forty-three patients (27 male, 16 female, age: 18-67 yrs [mean: 47.5 yrs, SD: 11.6 yrs]) received 177 radionuclide ventriculography examinations (RNV 177 at rest, 133 at stress) before and during chemotherapy with either doxorubicin (n = 23) or epirubicin (n = 20). RNV studies were applied up to 11 times in the follow-up of the patients. A maximum of 10 courses of chemotherapy was performed. In the doxorubicin group only, the age of the patients and the cumulative dose of the chemotherapeutic agent had a significant negative impact on left ventricular ejection fractions, whereas cyclosporin A had a significant positive influence (multiple analysis of regression, p < 0.05). Cyclosporin A did not cause any significant increase in cardiotoxicity in our patients.

We report an open, three-armed, multicenter study being carried out to assess the optimum treatment for acute and delayed emesis and nausea in patients undergoing highly emetogenic chemotherapy. Eighty-seven patients were randomized to receive tropisetron (Navoban; Sandoz Pharma Ltd, Basel, Switzerland), tropisetron plus dexamethasone, or tropisetron plus metoclopramide during chemotherapy. Tropisetron in combination with dexamethasone produced the best control of both acute and delayed emesis. Acute vomiting was prevented in 69% of patients by tropisetron monotherapy, and the addition of dexamethasone significantly increased the total control of vomiting to 92% (P < .01). Similarly for delayed vomiting, total control of emesis was seen in approximately 70% of patients on tropisetron alone during days 2 and 3; this control rate increased to almost 90% with combined tropisetron/ dexamethasone treatment. In all patients receiving cisplatin, the tropisetron/dexamethasone combination produced total control of acute emesis. The tropisetron and dexamethasone combination also provided the best control of acute and delayed nausea. Tropisetron produced total control of acute nausea in 69% of patients. The addition of dexamethasone increased this control rate to 81%. Similarly for delayed nausea, on days 2 and 3 of treatment, dexamethasone plus tropisetron provided total control of nausea in more than 80% of patients compared with a control rate of more than 60% achieved using tropisetron. The combination of tropisetron and metoclopramide did not improve significantly on the control of nausea and vomiting achieved using tropisetron alone. Evaluation of quality of life events by patients indicated no appreciable change in their mental or physical condition during chemotherapy, irrespective of antiemetic therapy. In the tropisetron and tropisetron plus metoclopramide treatment groups, a decreased food intake was observed due to delayed nausea while the addition of dexamethasone prevented loss of appetite. The antiemetic treatments were similarly well tolerated. The most common adverse events were constipation (15%) and tiredness (7%).

This study compares prostaglandin E2 (PGE2) gel and oxytocin for the initiation of labor in term pregnancies with a moderately favorable cervix (Bishop score 5-8). Compared with a matched group, 48 cases treated with PGE2 gel (2.5 mg intravaginally) required significantly less or no oxytocin, had shorter first stages of active labor, and had no increased risk of uterine hyperstimulation or cesarean section. Initiation of labor with low dose PGE2 when the cervix is moderately favorable is less labor intensive and meets with more patient satisfaction.

HLA types were determined in 19 patients and 9 healthy members of 2 Danish families with hereditary angioneurotic edema. The study revealed no connections between hereditary angioneurotic edema and the HLA system.

In 7 penicillamine-treated patients with generalized scleroderma zinc in serum, erythrocytes and granulocytes, alkaline phosphatase activity in serum and granulocytes, carbonic anhydrase activity in erythrocytes were examined. No significant difference was found between patient and control values, but granulocyte zinc strongly tended to be decreased (0.1 greater than p greater than 0.05). It is our hypothesis that penicillamine may produce a zinc depletion at a cellular level.

Monocyte antibody-dependent cell-mediated cytotoxicity (ADCC) was compared to intrinsic cyclic-adenosine-monophosphate (cAMP) levels in 14 patients with systemic sclerosis. Depressed monocyte cytotoxicity was observed. Elevated cAMP levels (2-5 times) in resting monocytes were found in 5 patients; the rest had normal cAMP values. Monocyte ADCC was inversely correlated to cellular cAMP content (r = -0.6659, P less than 0.02). Scleroderma patients with high basal cAMP levels showed impaired responses to beta-adrenergic stimulation but not to prostaglandin E (PGE1) and histamine. Patients with normal basal cAMP levels showed no defect in beta-adrenergic responses. No close correlation between monocyte abnormality and clinical state was found.