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Potato (Solanum tuberosum L.) is a crop of world importance that produces tubers of high nutritional quality. It is considered one of the promising crops to overcome the challenges of poverty and hunger worldwide. However, it is exposed to different biotic and abiotic stresses that can cause significant losses in production. Thus, potato is a candidate of special relevance for improvements through conventional breeding and biotechnology. Since conventional breeding is time-consuming and challenging, genetic engineering provides the opportunity to introduce/switch-off genes of interest without altering the allelic combination that characterize successful commercial cultivars or to induce targeted sequence modifications by New Breeding Techniques. There is a variety of methods for potato improvement via genetic transformation. Most of them incorporate genes of interest into the nuclear genome; nevertheless, the development of plastid transformation protocols broadened the available approaches for potato breeding. Although all methods have their advantages and disadvantages, Agrobacterium-mediated transformation is the most used approach. Alternative methods such as particle bombardment, protoplast transfection with polyethylene glycol and microinjection are also effective. Independently of the DNA delivery approach, critical steps for a successful transformation are a rapid and efficient regeneration protocol and a selection system. Several critical factors affect the transformation efficiency: vector type, insert size, Agrobacterium strain, explant type, composition of the subculture media, selective agent, among others. Moreover, transient or stable transformation, constitutive or inducible promoters, antibiotic/herbicide resistance or marker-free strategies can be considered. Although great efforts have been made to optimize all the parameters, potato transformation protocols are highly genotype-dependent. Genome editing technologies provide promising tools in genetic engineering allowing precise modification of targeted sequences. Interestingly, transient expression of genome editing components in potato protoplasts was reported to generate edited plants without the integration of any foreign DNA, which is a valuable aspect from both a scientific and a regulatory perspective. In this review, current challenges and opportunities concerning potato genetic engineering strategies developed to date are discussed. We describe their critical parameters and constrains, and the potential application of the available tools for functional analyses or biotechnological purposes. Public concerns and safety issues are also addressed. Instituto de Biotecnología Fil: Nahirñak, Vanesa. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Agrobiotecnología y Biología Molecular; Argentina Fil: Nahirñak, Vanesa. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Almasia, Natalia Ines. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Agrobiotecnología y Biología Molecular; Argentina Fil: Almasia, Natalia Ines. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: González, Matías Nicolás. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Balcarce. Instituto de Innovación para la Producción Agropecuaria y el Desarrollo Sostenible (IPADS); Argentina Fil: González, Matías Nicolás. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Massa, Gabriela Alejandra. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Balcarce. Instituto de Innovación para la Producción Agropecuaria y el Desarrollo Sostenible (IPADS); Argentina Fil: Massa, Gabriela Alejandra. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Massa, Gabriela Alejandra. Universidad Nacional de Mar del Plata. Facultad de Ciencias Agrarias; Argentina Fil: Décima Oneto, Cecilia Andrea. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Balcarce. Instituto de Innovación para la Producción Agropecuaria y el Desarrollo Sostenible (IPADS); Argentina Fil: Décima Oneto, Cecilia Andrea. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Décima Oneto, Cecilia Andrea. Universidad Nacional de Mar del Plata. Facultad de Ciencias Agrarias; Argentina Fil: Feingold, Sergio Enrique. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Balcarce. Instituto de Innovación para la Producción Agropecuaria y el Desarrollo Sostenible (IPADS); Argentina Fil: Feingold, Sergio Enrique. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Hopp, Horacio Esteban. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Agrobiotecnología y Biología Molecular; Argentina Fil: Hopp, Horacio Esteban. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Hopp, Horacio Esteban. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales; Argentina Fil: Vazquez Rovere, Cecilia. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Agrobiotecnología y Biología Molecular; Argentina Fil: Vazquez Rovere, Cecilia. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina

The 70 kilodalton heat shock proteins (Hsp70) are highly conserved molecular chaperones which have a crucial role in the stress response of the cell. In mammals, the Hsp70 proteins are encoded by a cluster of three genes: HSPA1A, HSPA1B and HSPA1L. In bovines, this cluster is located on chromosome 23 downstream of the major histocompatibility complex (BoLA). We detected inconsistencies in the location of markers on the Hsp70 genes reported in the literature that pointed to a potential deletion in the bovine reference genome UMD 3.1.1. An in silico analysis of the bovine genomic region of the Hsp70 cluster, using available information from public databases, confirmed the existence of a deletion of 11.1-kb spanning the HSPA1B gene and the intergenic region between HSPA1B and HSPA1A. Although we originally considered this an assembly error, it is most likely a particular condition of L1 Dominette 01449, the cow sequenced in the Bovine Genome Project. Moreover, we suggest a new classification of bovine Hsp70 sequences reported in NCBI and a reassignment of the location of SNPs from dbSNP that map to the deletion on BTA23. We also compared the location of selected transcription factor binding sites on the promoters of HSPA1A and HSPA1B. The results generated in the present work could be helpful to refine the reference genome of an important livestock species and also to understand the role and the regulation of the bovine Hsp70 genes. Fil: Suqueli García, María Florencia. Universidad Nacional de Mar del Plata. Facultad de Ciencias Agrarias; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Castellote, M.A.. Instituto Nacional de Tecnología Agropecuaria. Centro Regional Buenos Aires Sur. Estación Experimental Agropecuaria Balcarce; Argentina Fil: Feingold, Sergio. Instituto Nacional de Tecnología Agropecuaria. Centro Regional Buenos Aires Sur. Estación Experimental Agropecuaria Balcarce; Argentina Fil: Corva, Pablo Marcelo. Universidad Nacional de Mar del Plata. Facultad de Ciencias Agrarias; Argentina

Cold-induced sweetening (CIS) is the accumulation of sucrose and reducing sugars in potato tubers at low temperatures. This process is central for the potato processing industry. During potato chip and French fry production, reducing sugars participate in the Maillard reaction to produce dark pigmented products not acceptable to consumers. Andean potatoes (Solanum tuberosum Group Andigena) constitute an enormous wealth of potato germplasm that can contribute to increase genetic diversity in breeding programs of many traits, including CIS.We analyzed reducing sugar content and chip quality in freshly harvested and cold-stored tubers from 48 native accessions. Andean accessions showed high variation in reducing sugar content and were classified in three types of CIS responses: type I, reducing sugar content before and after 4°C storage was lower than the value required by industry; type II, reducing sugar content before storage was acceptable, but after 4°C storage incremented up to non-acceptable levels; and type III, reducing sugar content was unacceptable before and after storage.Five Andean accessions presented acceptable reducing sugar content and good chip quality before and after 4°C storage in a consistent manner throughout several experiments. These features make them a useful source for improving the potato industry. © 2017 Society of Chemical Industry.

Matrix metalloproteinases (MMPs), which degrade extracellular proteins as part of a variety of physiological processes, and their inhibitors have been implicated in the dental caries process. Here we investigated 28 genetic variants spanning the MMP10, MMP14, and MMP16 genes to detect association with dental caries experience in 13 age- and race-stratified (n = 3,587) samples from 6 parent studies. Analyses were performed separately for each sample, and results were combined across samples by meta-analysis. Two SNPs (rs2046315 and rs10429371) upstream of MMP16 were significantly associated with caries in an individual sample of white adults and via meta-analysis across 8 adult samples after gene-wise adjustment for multiple comparisons. Noteworthy is SNP rs2046315 (p = 8.14 × 10−8) association with caries in white adults. This SNP was originally nominated in a genome-wide-association study (GWAS) of dental caries in a sample of white adults and yielded associations in a subsequent GWAS of surface level caries in white adults as well. Therefore, in our study, we were able to recapture the association between rs2046315 and dental caries in white adults. Although we did not strengthen evidence that MMPs 10, 14, and 16 influence caries risk, MMP16 is still a likely candidate gene to pursue.

We tested the hypothesis that abdominal muscles are active during the expiratory phase of the respiratory cycle during exercise. Electromyographic (EMG) activities of external oblique and rectus abdominis muscles were recorded during incremental exercise to exhaustion and during 30 min of constant work rate exercise at an intensity of 85 % of the peak oxygen consumption rate (V(O(2))). High amplitude intramuscular EMG activities of both abdominal muscles could be evoked with postural manoeuvres in all subjects. During cycling, respiratory-related activity of the external obliques was evoked in four of seven subjects, whereas rectus abdominis activity was observed in six of the seven subjects. We measured only the activity that was confined exclusively to the expiratory phase of the respiratory cycle. Expiratory activity of both muscles increased with exercise intensity, although peak values averaged only 10-20 or 20-40 % of the peak activity (obtained during maximal, voluntary expiratory efforts) for the external oblique and rectus abdominis muscles, respectively. To estimate how much of the recorded abdominal muscle activity was supporting leg movements during exercise, we compared the activity at the very end of incremental exercise to that recorded during the first five respiratory cycles after the abrupt cessation of exercise, when ventilation was still very high. Although external oblique activity was reduced after exercise stopped, clear expiratory activity remained. Rectus abdominis activity remained high after exercise cessation, showing a gradual decline that approximated the decline in ventilation. During constant work rate exercise, EMG activities increased to 40-50 and 5-10 % of peak in rectus and external oblique muscles, respectively, and then plateaued for the remainder of the bout in spite of a continual upward drift in (V(O(2))) and pulmonary ventilation. Linear regression analysis showed that the rise in respiratory-related expiratory muscle activity during progressive intensity exercise was significantly correlated with ventilation, although weakly. In constant work rate exercise, expiratory EMG activities increased, but the changes were highly variable and did not change as a function of exercise time, even though ventilation drifted significantly with time. These experiments suggest that abdominal muscles play a role in regulating the ventilatory response to progressive intensity bicycle exercise, although some of the observed activity may support postural adjustments or limb movements. The contribution of abdominal muscles to ventilation during constant work rate exercise is variable, and expiratory activity does not 'drift' significantly with time.

Sunflower contains two classes of seed proteins: the 11S globulins (helianthinins) and the 2S albumins. Polymorphisms have been detected within both classes and therefore they have been proposed as genetic markers. The objectives of the present study were to identify sunflower seed protein polymorphisms and locate them on an RFLP linkage map. Seed proteins of 68 inbred lines and four Argentinian open-pollinated populations were studied by SDS-PAGE. The helianthinins were separated into ten bands arranged in fourgroups of Mr of 22.5, 25.5, 32 and 38 kDa and all lines showed identical banding patterns. The albumins were separated into eight to tenbands in the Mr range 10 and 18 kDa. The lines showed either a band of Mr of 14.5 or of 15.5 kDa. HAR1, HAR2, ZENB8 and ZENB12 had the 15.5 kDa, whereas the remaining lines had the 14.5 kDa. The 14.5 and 15.5 kDa polypeptides were also segregating in the Impira INTA population. One hundred and fifty F2:3 families derived from ZENB8 × HA89 were used as the mapping population. The electrophoretic patterns of the families were either those of the two parental lines or presented both the 14.5 and 15.5 kDa polypeptides. No family showed absence of both bands, suggesting that they are allelic variants. The 2S albumin locus was located in the interval between the markers ZVG0051 and ZVG0052, at approximately 9 cM from ZVG0051 and at 6 cM from ZVG0052, on linkage group 11 of the public sunflower RFLP map.

To determine the incremental cash flows associated with department-wide implementation of a picture archiving and communication system (PACS) and computed radiography (CR) at a large academic medical center.The authors determined all capital and operational costs associated with PACS implementation during an 8-year time horizon. Economic effects were identified, adjusted for time value, and used to calculate net present values (NPVs) for each section of the department of radiology and for the department as a whole.The chest-bone section used the most resources. Changes in cost assumptions for the chest-bone section had a dominant effect on the department-wide NPV. The base-case NPV (i.e., that determined by using the initial assumptions) was negative, indicating that additional net costs are incurred by the radiology department from PACS implementation. PACS and CR provide cost savings only when a 12-year hardware life span is assumed, when CR equipment is removed from the analysis, or when digitized long-term archives are compressed at a rate of 10:1.Full PACS-CR implementation would not provide cost savings for a large, subspecialized department. However, institutions that are committed to CR implementation (for whom CR implementation would represent a sunk cost) or institutions that are able to archive images by using image compression will experience cost savings from PACS.

In order to examine communication of radiological information under circumstances where rapid exchange of information was essential, we studied communication of non-routine portable chest radiographs to an intensive-care unit ICU . Images and reports were available through the usual communication channels and through a PACS workstation in the ICU. Data were obtained to determine how quickly and by what means ICU physicians first viewed images and received radiologists' reports of chest radiographs. Peak information demand occurred within 4 h of the examination. The most rapid means of communication was for the physician to visit the radiology department. Image viewing and report receipt were tightly coupled, usually for images which were first viewed as hard copy. PACS performance suffered from unreliable film digitization and delayed report transcription. Integration of computed radiography and digital dictation into a PACS could markedly reduce the delays in ICU physicians' access to radiological information.

To prospectively compare efficiency and outcome of a standard film-only system with those of a digital picture archiving and communication system (PACS).The film-only system, which used either analog film or computed radiography (CR) hard copy, was compared with a PACS, which used CR images displayed on a multiviewer in the radiology department and a workstation in the medical intensive care unit. A random sample of nonroutine, bedside chest radiographs was studied.Within 20 minutes of completion of radiography, 246 of 328 (75%) of the images were available at the workstations; it took 1.8 hours for 238 of 317 (75%) of the images to be displayed on the multiviewer. When the workstation was used, the staff did not access the image information earlier, but clinical actions were initiated more promptly in response to imaging findings. Consultation with radiologists decreased from 507 of 561 (90%) images with hard copies to 70 of 249 (28%) with the workstation.Use of a PACS improves the delivery of chest images, facilitates the initiation of clinical actions, and decreases input by radiologists.

From the *Department of Anesthesiology, Cedars Medical Center, Miami, FL, and tDepartment of Exercise and Sport Sciences, University of Arizona, Tucson, AZ. Received Mar 9, 1994, and in revised form May 2, 1994. Accepted for publication May 4, 1994. Address correspondence to Dr Feingold, 5310 Maggiore Street, Coral Gables, FL 33146. Feingold A, Galindo A, Feingold HE. Lack of documentation of severe transient bradycardia by an automated anesthesia record. J Clin Monit 1994;10:382-386

Critical thinking is an important topic in nursing education today. The authors describe an assignment, based on the steps of the nursing process, in which students use critical-thinking skills to develop, implement, and evaluate a personal health-promotion contract. The assignment allows students to integrate health promotion, behavioral contracting, and critical-thinking concepts from the dual perspective of the nurse and the patient.

Nurse educators are challenged to find instructional methods that actively engage learners and help students understand concepts for application in practice situations. During the 2003-2004 academic year, faculty implemented team learning in a first-semester clinical nursing course in a baccalaureate nursing program at a Research I state university in the southwestern United States. Team learning engages small groups in learning tasks that require problem solving and decision making. Student perceptions about team learning were evaluated using classroom observations and interviews. The results verified that team learning predominantly promotes learner-to-learner engagement and indicated that students struggled with application problems that had several plausible answers yet recognized the relevance to clinical practice. Students appreciated the need for increased individual accountability for learning and identified value in learning through discussion, both characteristics inherent to team learning. Students were concerned about their team learning grade and its dependence on group performance. AUTHORSReceived: September 20, 2005Accepted: November 1, 2006Ms. Feingold and Ms. Cobb were Clinical Associate Professors (retired), University of Arizona College of Nursing, Ms. Hernandez Givens is Education Specialist, Ms. Arnold is Director of Student Development, Ms. Joslin is Instructional Specialist, and Dr. Keller is Director of Research for Student Services, University of Arizona College of Medicine, Tucson, Arizona.Address correspondence to Carol E. Feingold, MS, APRN, BC, Clinical Associate Professor (retired), University of Arizona College of Nursing, 1305 N. Martin, P.O. Box 210203, Tucson, AZ 85721-0203; e-mail: Feingold@nursing.arizona.edu.

Springer-Verlag 2008 Potato rough dwarf virus (PRDV) was originally described in Argentina (2) while potato virus P (PVP) was first reported from Brazil (4). These viruses were essentially indistinguishable in test plant reactions when inoculated onto 21 different solanaceous species (7). Of the 10 sola- naceous species susceptible to both PRDV and PVP, the majority did not display symptoms. Only Nicotiana meg- alosiphon and N. occidentalis showed systemic symptoms consisting of leaf deformations, leaf rugosity and/or inter- veinal chlorosis. Six of the 7 potato varieties tested were susceptible to both PRDV and PVP, but visible symptoms consisting of plant stunting and the aforementioned leaf symptoms were only evident in second-generation plants of the potato cvs. Primicia and Sierra Volcan infected by PRDV (7). When amplicons were obtained from PRDV- and PVP- infected tissue using carlavirus-specific primers for poly- merase chain reaction (PCR) these viruses were initially classified as members of tentative species of the genus Carlavirus (6). Recent biological, serological and partial sequence comparisons have suggested that PRDV and PVP should be considered strains of the same carlavirus species (7, 8). This report describes the complete genomes of PRDV and PVP, and their relationships with other carlaviruses. The PVP and PRDV isolates studied were those from the potato cvs. Baronessa and Sierra Volcan( 7). They were inoculated onto plants of Nicotiana occidentalis, and one month after inoculation, leaves of these plants were used for virion purification following the International Potato Center protocol (CIP Training Manual, Techniques in Plant Virology). RNA extracted from purified PRDV and PVP particles was used for cDNA synthesis using the Universal RiboClone cDNA Synthesis System (Promega, USA). After cloning of cDNA in pZErO-2 (Invitrogen, USA), the recombinant clones were sequenced using SP6 and T7 vector-specific primers in a MegaBACE 750 Sequencer (GE, Sweden) with DYEnamic ET Dye Terminator Cycle Sequencing kits (GE, Sweden). The 5 0 rapid amplification of cDNA ends (RACE) method was employed to obtain the 5 0 -terminal ends of both viral genomes (9). Amplicons were cloned into a pGEM-T vector (Promega, USA). At least four independent clones were sequenced for each virus as described above. To obtain the complete sequence of the 3 0 non-translated region (NTR), we used a tailed oligo-dT (''oligo-dTail''; 5 0 -GCTGAAGACGGCCTATGTGGCC (T)16-3 0 ) as a reverse primer for PCR amplification, fol

Changes in nitrogen (N) economy and N to dry matter (DM) relationships were studied for six cultivars of bread wheat (Triticum aestivum L.) released in Argentina at different times between 1912 and 1980. Experiments were performed on two successive years. N partitioning to reproductive organs was changed both at anthesis and at maturity. Grain N yield (GNY) was associated to both total N accumulated and N partitioning. Most of the changes produced by genetic improvement on N economy at maturity could be explained by parallel changes at anthesis. Neither biological N yield (BNY) at anthesis nor BNY at maturity showed any trend with the year of release of the cultivars. Grain N concentration (GNC) showed a negative trend with the year of release, and was inversely correlated to both grain yield (GY) and harvest index (HI). However, GNC was positively and significantly associated with NHI to HI ratio, indicating that the main reason for its behaviour along this century was the dilution of N on non N compounds. The N utilization efficiencies (NUE) for both GY and grain number were positively affected by breeding. Moreover, modern Argentinian cultivars are as efficient as the best cultivars showed by other authors. It is suggested that to increase GNC together with GY, breeders should improve N accumulation at anthesis maintaining high remobilization of vegetative N.

Fil: Massa, Gabriela Alejandra. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto Nacional de Tecnología Agropecuaria. Centro Regional Buenos Aires Sur. Estación Experimental Agropecuaria Balcarce. Proy.int.p/el Mejoramiento de la Calidad de Papa; Argentina Fil: Segretin, Maria Eugenia. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Investigaciones en Ingeniería Genética y Biología Molecular "Dr. Héctor N. Torres"; Argentina Fil: Colavita, M.. Instituto Nacional de Tecnología Agropecuaria. Centro Regional Buenos Aires Sur. Estación Experimental Agropecuaria Balcarce. Proy.int.p/el Mejoramiento de la Calidad de Papa; Argentina Fil: Riero, M. F.. Instituto Nacional de Tecnología Agropecuaria. Centro Regional Buenos Aires Sur. Estación Experimental Agropecuaria Balcarce. Proy.int.p/el Mejoramiento de la Calidad de Papa; Argentina Fil: Bravo Almonacid, Fernando Felix. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Investigaciones en Ingeniería Genética y Biología Molecular "Dr. Héctor N. Torres"; Argentina Fil: Feingold, Sergio. Instituto Nacional de Tecnología Agropecuaria. Centro Regional Buenos Aires Sur. Estación Experimental Agropecuaria Balcarce. Proy.int.p/el Mejoramiento de la Calidad de Papa; Argentina

This study evaluated student and faculty member perceptions regarding the use of a computerized universal patient simulator (Laerdal ™ SimMan ™ Universal Patient Simulator) in a simulated clinical scenario. Students who used SimMan in clinical simulation activities in this baccalaureate program during two consecutive semesters were surveyed using a 20-item tool scored on a 4-point Likert scale. Four faculty members were surveyed using a 17-item tool with the same response scale. The majority of the student sample consisted of Anglo women between ages 22 and 36. Survey items related to the reality of the simulations, the pace and flow of the clinical simulation, the ability to transfer skills learned to actual clinical settings, and the value of the simulated clinical experiences. Faculty members were also surveyed related to resource issues. Descriptive statistics were used to analyze survey responses. The majority of the students and faculty members identified the simulations as realistic and valuable. However, only approximately half of the students agreed that the skills learned in the clinical simulation would transfer to a real clinical setting, compared to 100% of the faculty. Faculty members reported that implementing the simulated clinical scenario required additional time and resources.

The popularity of "non-parametric" linkage analysis using moderate and large sized pedigrees has increased in the last few years. Only a few of the existing allele-sharing statistics are applicable to general pedigrees, and even fewer are in common use. Little research has been done to compare the power of these statistics. We present some preliminary investigations into the power of the most popular general-pedigree allele-sharing statistics. We show that there are indeed non-trivial differences among the statistics, and that further studies are warranted. In particular, pedigree structure and the degree of recessiveness of the trait appear to be critical factors in determining which statistics are most powerful.

This study was performed to evaluate the changes in workflow and efficiency in various clinical settings in the radiology department after the introduction of a picture archiving and communication system (PACS). Time and motion data were collected when conventional image management was used, and again after the introduction of a PACS. Changes in the elapsed time from examination request until the image dispatch to the radiologist, and from dispatch until report dictation, were evaluated. The relationship between patient volume and throughput was evaluated. The time from examination request until dispatch was significantly longer after the introduction of PACS for examinations taken on patients from the emergency department (ED) (pre-PACS, 20 minutes; post-PACS, 25 minutes; P.0001), and for examinations taken on patients in the medical intensive care unit (MICU) (pre-PACS, 34 minutes; post-PACS, 42 minutes; P.0001). The interval from image dispatch until report dictation shortened significantly after the introduction of PACS in the ED (pre-PACS, 38 minutes; post-PACS, 23 minutes; P.0001) and in the outpatient department (OPD) (pre-PACS, 38 minutes; post-PACS, 20 minutes; P.0001). Simple least squares regression showed a significant relationship between daily patient volume and the daily median time until report dictation (F = 43.42, P.001). PACS slowed technologists by prolonging the quality-control procedure. Radiologist workflow was shortened or not affected. Efficiency is dependent on patient volume, and workflow improvements are due to a shift from batch to on-line reading that is enabled by the ability of PACS to route enough examinations to keep radiologists fully occupied.

For complex disorders where the actions of several interacting loci must be taken into account, current methods of joint linkage analysis are problematic. We have undertaken an exploration of simultaneous search statistics originally proposed by Dupuis et al. [1995]. Additionally, we have extended these methods slightly and propose here a simple simultaneous search statistic based upon the single-point allele sharing statistic calculated from GENEHUNTER (GH). The use of conditional search techniques is also explored.

OBJECTIVES: This study was designed (a) to assess the feasibility of obtaining data about sexually transmitted diseases and sexual risk behavior in an alternative-to-incarceration program for convicted drinking drivers and (b) to determine whether asking health history and sexual risk questions using an anonymous questionnaire, anonymous interviews, or confidential interviews affected the willingness of people to participate. METHODS: The same survey instrument was used across three data collection modes to collect information on sexually transmitted diseases and sexual risk behavior. RESULTS: Overall, there were no differences across modes in self-reports of STDs and details of sexual history. Although the difference in refusal rates between the anonymous questionnaire and the anonymous interview was not significant, the refusal rate for the anonymous questionnaire was significantly higher than the rate for the confidential interview. Those answering the self-administered questionnaire were more likely than those receiving face-to-face interviews to refuse to answer questions about having sex while high and condom use. CONCLUSIONS: A drinking driver intervention program may be an appropriate site for health screenings and prevention activities for an at-risk population.

Several complex disorders are suspected of being associated with mitochondrial DNA (mtDNA) mutations. We studied the statistical properties of a test based on proband-relative pairs to identify potential mtDNA mutation involvement in a complex disorder. The test compares the recurrence risk of relatives of probands along the mitochondrial lineage with that of relatives along the nonmitochondrial lineage. If mtDNA mutations are involved, the recurrence risk will be higher among relatives in the mitochondrial lineage. The form of the test is independent of the assumed models of inheritance and interaction of the nuclear autosomal mutations with mtDNA mutations. The power of the test, however, differs among the different models and by the type of proband-relative pairs used in the test. We considered heterogeneity models with and without phenocopies, a three-state heteroplasmic mtDNA transmission model, and a multiplicative epistasis model. Under the heterogeneity model, the power of the test increases as the relationship between the proband and the relative becomes more distant. Under the multiplicative epistasis model, the power of the test decreases as the relationship between the proband and the relative becomes more distant.

Iron balance is critical for adequate erythropoiesis in hemodialysis patients treated with recombinant human erythropoietin (EPO). The role of oral iron therapy in maintaining or replenishing iron stores has not yet been well defined in such patients. We undertook a double-blind, placebo-controlled study to evaluate the efficacy of oral iron in 49 hemodialysis patients, divided into two groups, based on adequate or deficient iron stores. These groups were treated for 3 months with 150 mg elemental iron (Polysaccharide complex, Central Pharmaceuticals) or placebo, twice daily. Laboratory parameters were followed for five months. These parameters included: hematocrit (Hct), ferritin, transferrin saturation (Tsat), and zinc protoporphyrin (ZPP). A side-effects questionnaire was recorded monthly. Our results indicate that iron replete patients show evidence of falling iron stores during the study period; this observation was identical in both oral iron and placebo subgroups. Iron deficient patients had a significantly greater drop-out rate due to side effects when compared to iron replete patients (33% vs. 8%), despite equivalent responses to the side-effect questionnaire. We conclude: 1) Oral iron fails to maintain iron stores in iron replete patients; 2) Iron deficiency observed in this study may be due to poor medication compliance rather than side-effects.

Despite their potential for improving patient management and decreasing costs, picture archiving and communication systems (PACS) are not being absorbed rapidly into clinical practice because of their technical immaturity and because the cost-effectiveness of the technology has not been established. Workstations and archives need to be significantly improved before they can be useful. This report describes the authors' experiences with a high-resolution image workstation for a medical intensive care unit. The workstation has been designed around a standard computer platform and is equipped with two high-resolution image displays. The user interface stresses speed and simplicity. Image manipulation is simplified by providing empirical preset window and level values. Images are displayed in less than 2 seconds. The workstation also displays radiologic reports as soon as they become available. Future work will focus on using the workstation to improve communication between the physician and the radiologist.

To assess the increased public assistance costs resulting from Michigan's 1988 ban on Medicaid funding of abortions.The increased number of births resulting from the Medicaid abortion funding ban was estimated. The costs of this increase in births to the state and federal governments were then calculated.Using low and high estimates for the numbers of additional children born as a result of Michigan's prohibition of Medicaid abortion funding (2120 and 5800), and the likelihood of these children's remaining on welfare, the 1991 cohort of infants will cost the state's taxpayers $23.1-63.2 million--several times the $6-7 million cost of the abortions, had they taken place. Including the federally paid share, total incremental costs are $50.2-137.4 million.Those who have advocated banning Medicaid funding of abortions to reduce government spending, as in Michigan in 1988, have ignored the much greater cost of requiring that those pregnancies be carried to term.

For eight years Medical Psychology has been an integral part of medical pre-examination as well as of research and teaching in the Federal Republic of Germany, and a great deal of psychological knowledge is taught to the medical student under this heading. Besides mere theory the medical student is supposed to acquire behavior based on psychological findings which will be important to him in medical practice. Nevertheless, students often complain that teaching is too far from reality, due to the fact that Medical Psychology is part of the first, more theoretical, period of medical eduction, even though one of the main objects of this new field is the analysis of the interaction between patient and physician.

Ligation of the inferior vena cava was performed on 38 patients with five postoperative deaths (13%). Recurrent pulmonary embolism occurred in three patients (8%) and on late follow-up, eight (24%) had minimal lower extremity stasis symptoms, 11 (33%) had moderate symptoms, and 14 (43%) had signs of the postphlebitic syndrome in one or both legs. Partial caval interruption was performed on 26 patients with two postoperative deaths (8%). Recurrent embolism occurred in two patients (8%) and on late follow-up, 13 (54%) had minimal lower extremity stasis symptoms, seven (30%) had moderate symptoms, and four (14%) had signs of the postphlebitic syndrome. The findings indicate that partial interruption is as effective as ligation in preventing pulmonary embolism, is associated with a lower operative mortality, and is followed by significantly less disabling stasis sequelae in the lower extremities.