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Background: The Veterans Aging Cohort Study (VACS) is a study of human immunodeficiency virus (HIV) infected and uninfected patients seen in infectious disease and general medical clinics. VACS includes the earlier 3 and 5 site studies (VACS 3 and VACS 5) as well as the ongoing 8 site study.Objectives: We sought to provide background and context for analyses based upon VACS data, including study design and rationale as well as its basic protocol and the baseline characteristics of the enrolled sample.Research Design: We undertook a prospectively consented multisite observational study of veterans in care with and without HIV infection.Measures: Data were derived from patient and provider self report, telephone interviews, blood and DNA samples, focus groups, and full access to the national VA "paperless" electronic medical record system.Results: More than 7200 veterans have been enrolled in at least one of the studies. The 8 site study (VACS) has enrolled 2979 HIV-infected and 3019 HIV-uninfected age-race-site matched comparators and has achieved stratified enrollment targets for race/ethnicity and age and 99% of its total target enrollment as of October 30, 2005. Participants in VACS are similar to other veterans receiving care within the VA. VACS participants are older and more predominantly black than those reported by the Centers for Disease Control.Conclusions: VACS has assembled a rich, in-depth, and representative sample of veterans in care with and without HIV infection to conduct longitudinal analyses of questions concerning the association between alcohol use and related comorbid and AIDS-defining conditions. [ABSTRACT FROM AUTHOR]

Background: Lack of childcare for children aged 0-3 years has emerged as a global crisis, accentuated by women's increasing workforce participation and recognition that young children require nurturing care. Through this systematic review, we sought to examine associations between childcare centre attendance in low- and middle-income countries (LMICs) and children's health, growth, and development, and to generate childcare centre programmatic and research recommendations for children aged 0-3 years., Methods: We systematically searched PsycINFO, MEDLINE, PubMed, and Cochrane for articles on centre-based childcare for children aged 0-3 years in LMICs, published between 2000 and 2021 in English (or which were translated into English). We excluded articles on specialised subgroups or interventions. We imported the retrieved articles into Covidence for review and assessed them for bias using the National Institutes of Health (NIH) quality assessment tool., Results: Twenty-two articles (24 studies) met the inclusion criteria, encompassing 36 927 children from 10 countries across Mexico and South America (n = 12), Africa (n = 5), and Asia (n = 5). Outcomes included health (n = 12), growth/nutrition (n = 6), and development (n = 6). Study quality assessments were low; 41% exceeded 50% of quality criteria and 45% adjusted for confounders. Associations between childcare attendance and outcome measures were primarily negative for health (n/N = 7/12) and positive for growth/nutrition (n/N = 5/6) and development (n/N = 4/6). Childcare centre programmatic recommendations for children aged 0-3 years included: age-specific policies; program quality, including safety, hygiene, nutrition, and curriculum; access and affordability; parent engagement; financial support; and workforce development. Research recommendations included: study design, including enrolment age, frequency, duration, childcare type, home and childcare sociodemographic and cultural environments, child and caregiver outcomes, and analytical approaches; longitudinal studies; and implementation research., Conclusions: Rigorous primary research in global childcare for young children is urgently needed. Policies, programmes, and investments in high-quality childcare can promote nurturing care for young children, enabling mothers to participate in the workforce., Registration: PROSPERO: CRD42018105576., Competing Interests: Disclosure of interest: The authors completed the ICMJE Disclosure of Interest Form (available upon request from the corresponding author) and disclose no relevant interests., (Copyright © 2024 by the Journal of Global Health. All rights reserved.)

Accurately simulating heterogeneously catalyzed reactions requires reliable barriers for molecules reacting at defects on metal surfaces, such as steps. However, first-principles methods capable of computing these barriers to chemical accuracy have yet to be demonstrated. We show that state-resolved molecular beam experiments combined with ab initio molecular dynamics using specific reaction parameter density functional theory (SRP-DFT) can determine the molecule-metal surface interaction with the required reliability. Crucially, SRP-DFT exhibits transferability: the functional devised for methane reacting on a flat (111) face of Pt (and Ni) also describes its reaction on stepped Pt(211) with chemical accuracy. Our approach can help bridge the materials gap between fundamental surface science studies on regular surfaces and heterogeneous catalysis in which defected surfaces are important.

Although important to heterogeneous catalysis, the ability to accurately model reactions of polyatomic molecules with metal surfaces has not kept pace with developments in gas phase dynamics. Partnering the specific reaction parameter (SRP) approach to density functional theory with ab initio molecular dynamics (AIMD) extends our ability to model reactions with metals with quantitative accuracy from only the lightest reactant, H2, to essentially all molecules. This is demonstrated with AIMD calculations on CHD3 + Ni(111) in which the SRP functional is fitted to supersonic beam experiments, and validated by showing that AIMD with the resulting functional reproduces initial-state selected sticking measurements with chemical accuracy (4.2 kJ/mol ≈ 1 kcal/mol). The need for only semilocal exchange makes our scheme computationally tractable for dissociation on transition metals.

An approximately six-month-old wild American black bear (Ursus americanus) was found wandering in Saskatchewan and was presented to the Veterinary Medical Centre of the Western College of Veterinary Medicine for apparent blindness. Clinical examination confirmed an inability to navigate a photopic maze, bilateral tapetal hyper-reflectivity, fundi devoid of retinal vessels, and small pale optic nerve papillae. Single-flash electroretinography revealed A and B-wave amplitudes of approximately 40 and 140 microvolts, respectively, in both eyes. Histologic abnormalities included bilateral optic papillary mineralization and bilateral segmental optic nerve degeneration, with occasional intralesional lymphocytes confirmed with immunohistochemistry for CD3+. There was also bilateral multifocal retinal dysplasia, gliosis, lymphocytic retinitis, a complete lack of retinal blood vessels, an intravitreal vascular membrane, and a mild lymphocytic-plasmacytic uveitis with small pre-iridal cellular membranes. The presence of a positive ERG in a blind bear with numerous retinal ganglion cells and degenerative changes in the optic nerve are most consistent with vision loss due to optic nerve injury, which given the young age of the bear likely occurred during ocular development. The presence of ocular inflammation suggests this injury resulted from an inflammatory/infectious process. The etiology could not be determined. Hepatic concentrations of vitamin A were within the normal reference range for domestic species. Pan-herpesvirus PCR and immunohistochemistry for canine distemper virus and Toxoplasma gondii were negative, although this does not rule out these or other infectious etiologies. This represents the first case report of neonatal or congenital ocular abnormalities in an ursid species., (© 2015 American College of Veterinary Ophthalmologists.)

Sodium nitroprusside (SNP) has been widely used to control blood pressure in infants and children. The goals of this analysis were to develop models that describe the hemodynamic response to SNP dosing in pediatric patients; examine sources of variation in dose-response, defining age, and size dependencies; and determine vulnerable populations or patient subtypes that may elicit dosing modifications. A multi-center, randomized, double-blinded, parallel-group, dose-ranging, effect-controlled study, followed by an open-label dose titration of an intravenous infusion of SNP was undertaken in 203 pediatric subjects, who required deliberate hypotension or controlled normotension during anesthesia. A total of 3464 MAP measurements collected from 202 patients during the study's blinded phase, including baseline measurements up to 6 min prior to the blinded were available for analysis. A population K-PD model was developed with a one-compartment model assumed for SNP. Size differences in CL and V of the effect compartment were described using theory-based allometry. An inhibitory sigmoidal Emax model was used to describe the effect of SNP. A power function of age was used to describe age-related differences in baseline MAP. A mixture model of two groups with low and high EC50 was used to explain variability in MAP response. Change in MAP was characterized by a linear disease progression slope during the blinded phase. In the final population model, CL and V increased with weight, and baseline MAP increased with age. The effect compartment half-life of SNP was 13.4 min. The infusion rate producing 50% of Emax (ER50) at steady state for high EC50, was 0.34 μg/kg/min and for low EC50 0.103 μg/kg/min. The K-PD model well-describes initial dosing of SNP under controlled circumstances; model-based dosing guidance agrees with current practice. An initial titration strategy supported via algorithm-based feedback should improve maintenance of target MAP.

This study analyses the meaning spaces of German pitch contours using two modes of melodic movement: continuous or in steps of sustained pitch. Both the continuous and stepped movements are represented by a set of five basic patterns, the latter being derived from the former. Thirty-six German native speakers judged the pattern sets on a 12-scale semantic differential. The semantic profiles confirm that stepped contours can be conceived of as stylized intonation, in a formal as well as in a functional sense. On the one hand, continuous (non-stylized) and stepped (stylized) contours are assigned different overall meanings (especially on the scales astonished - commonplace and interested - not interested). On the other hand, listeners organize the two contour sets in a similar fashion, which speaks in favour of parallel pattern inventories of continuous and stepped movement, respectively. However, the meaning space of the stylized patterns is affected by formal restrictions, for instance in the step transformation of continuous rises., (© 2014 S. Karger AG, Basel.)

Clients disabled by psychiatric illness may be assigned mental health clinicians as payees. We compared client-payee interactions among 42 clients with clinician-payees, 20 whose payees were family or friends and nine with attorney-payees. Compared to clients with attorney-payees, clients with clinician-payees felt more satisfied and more involved in their money management, and had had more contacts with their payees in the previous month. Clients' satisfaction with family/friend payees was similar to that with clinician payees. In multivariate analyses, whether or not the payee had had training about mental illness accounted for 33% of the variance in satisfaction with the payee.

In a preliminary pilot study, the effect of disoprivan for sedation during regional anesthesia was investigated. In 15 patients (ASA I or II), lumbar epidural anesthesia with bupivacaine 0.75% was performed at L 3/4. For premedication morphine or pethidine combined with scopolamine was given. After injection of the local anesthetic, a 30-min period was allowed for establishing the physiological side effects of epidural blockade, to present any further changes in circulatory and/or cardiac function. Disoprivan (1 mg/kg body weight) was injected i.v. followed by continuous disoprivan infusion. Three groups of 5 patients each were given 1, 1.5, or 2 mg/kg per hour disoprivan. Changes in heart rate, blood pressure, and respiratory rate were studied. Recovery time and personal assessment of sleep were registered. Side-effects of clinical relevance from the cardiovascular and pulmonary systems were also registered. A dose-dependent upper airway obstruction that could easily be managed by an oral or nasal airway was seen in 9 of 15 patients. Eight patients had postoperative nausea or vomiting; 9 complained of pain during the bolus injection that they could not remember postoperatively. All patients described their sleep as pleasant. Recovery time from sleep was between 1 and 12 min. All changes from normal values increased in percentage with increasing disoprivan dosage. Disoprivan (1 or 1.5 mg/kg per hour) seems to be excellent for sedation during regional anesthesia and is perhaps even superior to other available drugs.

Retrospective studies were carried out on 314 patients who underwent oil-based or water-soluble myelography between July 1981 and July 1982 in two community hospitals. Morbidities and efficacies were compared and it was concluded that metrizamide myelography is a preferable method.

Use of the Rezaian Spinal Fixator is reviewed in 29 patients, 24 of whom were available for a two to four-year follow-up. There was no residual pain, no persistent instability and no nonunion. Patients were able to sit up in one to three days and stand within two weeks. A case report with a two-year follow-up is discussed in some detail. The author notes that the Rezaian Spinal Fixator offers an aggressive approach to the treatment of the unstable spine.