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The present study evaluated the criterion validity and practical utility of Minnesota Multiphasic Personality Inventory-3 (MMPI-3) scores in preemployment evaluations of police candidates ( n = 377) and candidates for other public safety occupations ( n = 276) in the Midwestern United States. Preemployment psychological reports were used to rate problems in the ten California Commission on Peace Officer Standards and Training screening dimensions (POST-10 dimensions). MMPI-3 T score means and standard deviations indicated that substantive scale scores were generally lower and less variable relative to the normative sample. MMPI-3 scores were meaningfully associated with problems in the POST-10 dimensions with similar patterns as past research but with generally larger effect sizes (likely due, in part, to criterion contamination). Relative risk ratio (RRR) findings supported the practical utility of interpretive guidelines described in the MMPI-3 Police Candidate Interpretive Report interpretive manual. Results are discussed in terms of the wider MMPI-2-RF literature in police officer preemployment evaluations. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Mucopolysaccharidosis type I (MPS I) is caused by deficiency of alpha-L-iduronidase (IDUA), leading to multisystemic accumulation of glycosaminoglycans (GAG). Untreated MPS I patients may die in the first decades of life, mostly due to cardiovascular and respiratory complications. We previously reported that the treatment of newborn MPS I mice with intravenous administration of lipossomal CRISPR/Cas9 complexes carrying the murine Idua gene aiming at the ROSA26 locus resulted in long-lasting IDUA activity and GAG reduction in various tissues. Following this, the present study reports the effects of gene editing in cardiovascular, respiratory, bone, and neurologic functions in MPS I mice. Bone morphology, specifically the width of zygomatic and femoral bones, showed partial improvement. Although heart valves were still thickened, cardiac mass and aortic elastin breaks were reduced, with normalization of aortic diameter. Pulmonary resistance was normalized, suggesting improvement in respiratory function. In contrast, behavioral abnormalities and neuroinflammation still persisted, suggesting deterioration of the neurological functions. The set of results shows that gene editing performed in newborn animals improved some manifestations of the MPS I disorder in bone, respiratory, and cardiovascular systems. However, further studies will be imperative to find better delivery strategies to reach "hard-to-treat" tissues to ensure better systemic and neurological effects.

Background: An understanding of perceptions of parents and health caregivers who assist critically ill neonates is necessary to comprehend their actions and demands. Therefore this study aim to analyze the agreement among parents, nurse technicians and pediatricians regarding the presence and intensity of pain and distress in mechanically ventilated and intubated newborn infants., Methods: Cross-sectional study comprising 52 infants and 52 trios of adults composed of one parent, one nurse technician, and one pediatrician who all observed the same infant. All infants were intubated and under mechanical ventilation and were not handled during the observations. Each newborn was simultaneously observed by the trio of adults for 1 minute to evaluate the presence of pain and distress. The intensity of pain and distress that the adults believed was felt by the infants was marked in a visual analogical scale. Adults' agreement about the simultaneous presence of pain and distress in each infant was analyzed by marginal homogeneity and Cochran tests. The agreement about the intensity of pain and distress in each infant was studied by Bland-Altman plot and intraclass correlation coefficient (ICC)., Results: The assessments of pain and distress were heterogeneous in all three investigated groups of adults as determined by the results of a Bland-Altman plot. The presence of distress was more frequently reported compared with pain (marginal heterogeneity, p < 0.01). The pain and distress scores in each adult group were not correlated as shown by ICC [parents, 0.36 (95% CI: 0.01-0.63); nurses 0.47 (0.23-0.66); pediatricians, 0.46 (0.22-0.65)]., Conclusions: Adults systematically underscore pain in comparison to distress in mechanically ventilated newborns, without recognizing the association between them.

The aim of this study was to assess the effect of low level laser therapy on reducing the occurrence and severity of oral complications in patients with head and neck cancer undergoing radiotherapy. Sixty head and neck cancer outpatients from a cancer hospital receiving radiotherapy were selected and randomly assigned into two groups. The laser group was irradiated with an InGaAlP laser and the control received sham laser. The assessment of complications (oral mucositis, pain) was carried out one week after starting radiotherapy, and at the fifteenth and thirtieth sessions of radiotherapy. All patients from both groups showed some degree of oral mucositis. Better outcomes were observed in the laser group when compared with the control in the follow-up sessions, indicating lower degrees of oral mucositis, pain and higher salivary flow (p < .05). These findings support the use of laser therapy as an adjuvant treatment for the control of oral complications., (©2012 Special Care Dentistry Association and Wiley Periodicals, Inc.)

Background: Two digital mammography systems, based on different physical concepts, have been introduced in the last few years namely the full-field digital mammography (FFDM) system and computed radiography-based mammography using digital storage phosphor plate (DSPM)., Aims: The objective of this study was to compare the image quality for DSPM and FFDM using a grading scale based on previously published articles., Materials and Methods: This comparative diagnostic study was done for 5-month duration at the Breast Clinic. The system used was the Lorad Selenia FFDM system and the Mammomat 3000 Nova DSPM system. The craniocaudal and mediolateral oblique projections were done on both breast on 58 asymptomatic women using both DSPM and FFDM. The mammograms were evaluated for eight criteria of image quality: Tissue coverage, compression, exposure, contrast, resolution, noise, artifact, and sharpness by two independent radiologists., Statistical Analysis: Wilcoxon Signed Rank Test and Weighted Kappa., Results: FFDM was rated significantly better (P < 0.05) for five aspects: Tissue coverage, compression, contrast, exposure, and resolution and equal to DSPM for sharpness, noise, and artifact., Conclusion: FFDM was superior in five aspects and equal to DSPM for three aspects of image quality.

Outbreaks by carbapenem-resistant Providencia stuartii (CRPS) are rarely described. Clinical characteristics of patients with CRPS in an intensive care unit and resistance mechanisms were investigated. Carbapenemase production and/or outer membrane alterations were not detected; only CTX-M-2 and AmpC hyperproduction were noted. The outbreak was ultimately controlled in a 3-month period.

Juvenile xanthogranuloma (JXG) is a histiocytic inflammatory disorder that can present different histologic patterns. Classic JXG consists of sheets of foamy histiocytes and numerous multinucleated Touton giant cells. Nonlipidized JXG (NJXG) is one of the unusual variants of JXG, consisting of a diffuse monomorphic infiltrate of mononuclear histiocytes, suggesting an aggressive or malignant tumor due the high mitotic index. However, NJXG behaves clinically as classic JXG. We present an unusual case of a 6-year-old boy who presented an exophytic ulcerated nodule on the lower lip diagnosed as NJXG. The boy is currently well without recurrence three years after surgical excision., (Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.)

Objective: The aim of this study was to investigate the expression of bone resorption (RANK/RANKL), bone resorption inhibitor (osteoprotererin [OPG]), and bone formation marker (osteocalcin [OC]) in neoplastic and bone-related lesions (BRL)., Study Design: Using immunohistochemistry, their expression was evaluated in ossifying fibroma (OF), fibrous dysplasia (FD), simple bone cysts (SBC), central giant cell lesions (CGCL), and osteosarcoma (OS)., Results: Quantitative analyses of the expression of bone markers between all lesions, considering fibroblast-like cells and bone matrix, showed that RANK-RANKL presented higher expression in OF and CGCL, whereas OPG and OC presented higher expression in FD and SBC. There was higher expression of all proteins investigated when OS was the BRL. Moreover, the RANKL expression was greater than OPG in this neoplasm., Conclusion: Our data indicate that the bone resorption markers are more highly expressed in OF, CGCL, and OS than in FD and SBC, indicating a significant association between these proteins and the clinical behavior of these lesions., (Copyright © 2010 Mosby, Inc. All rights reserved.)

Objective: To assess the impact of dosage on in-hospital mortality of patients receiving intravenous polymyxin B., Methods: A retrospective cohort study was performed from January 2003 to December 2009. Patients ≥ 18 years receiving intravenous polymyxin B for ≥ 72 h were analysed. Clinical covariates were assessed and data were retrieved from medical records. Subgroup analyses were performed in patients with microbiologically confirmed infections and in patients with bacteraemia. Renal toxicity was also assessed. Logistic regression models (LRMs) were performed for the entire cohort and subgroups., Results: A total of 276 patients were included. The overall in-hospital mortality was 60.5% (167 of 276). The final LRM showed that severe sepsis or septic shock [adjusted odds ratio (aOR) 4.07; 95% confidence interval (CI) 2.22-7.46], presence of mechanical ventilation (aOR 3.14; 95% CI 1.73-5.71), Charlson co-morbidity score (aOR 1.25; 95% CI 1.09-1.44) and age (aOR 1.02; 95% CI 1.01-1.04) were independently associated with increased in-hospital mortality, while ≥ 200 mg/day polymyxin B was associated with lower risk for this outcome (aOR 0.43; 95% CI 0.23-0.79). The effect of ≥ 200 mg/day polymyxin B on in-hospital mortality was higher in both subgroups (microbiologically documented infections and bacteraemia). Patients receiving ≥ 200 mg/day of polymyxin B had significantly higher risk of severe renal impairment., Conclusion: A dosage of ≥ 200 mg/day polymyxin B was associated with lower in-hospital mortality. The benefit of these higher doses outweighed the risk of severe renal dysfunction during therapy. Large prospective studies including pharmacokinetic/pharmacodynamic analysis are still required to define the best dosage regimens of polymyxin B.

The chronic usage of nifedipine is associated with the appearance of gingival overgrowth (GO). The frequency of GO associated with chronic nifedipine therapy remains controversial and the possible subclinical effects of this drug on the gingival epithelium should be investigated. We investigated the epithelial proliferation index and apoptosis rate, and their association with epithelial enlargement. Proliferation (Ki67 and Cyclin B1) and apoptosis (BCL2, Bax and p53) markers were identified by immunohistochemistry in twenty-one samples of gingival tissue from patients undergoing chronic treatment with nifedipine and in eleven samples of gingival tissue from healthy patients who did not use drugs associated with GO (control). Our results show that the epithelial tissue of nifedipine users has considerably longer rete pegs compared to control (P = 0.01). However, the density of Ki67(+) and Cyclin B1(+) cells was similar in both groups. Regarding apoptosis, we found more BCL2(+) cells in the nifedipine group when compared to controls (P = 0.12). An increase in Bax(+) cells in the nifedipine group compared to control (P = 0.003) was also seen, and slightly lower levels of p53(+) expression were observed (P = 0.51). Our results suggest that the chronic use of nifedipine is not associated with subclinical changes in gingival tissue.

Objective: To verify whether parents and health professionals homogeneously evaluate presence and intensity of neonatal pain., Methods: This cross-sectional study enrolled 52 neonates and 154 adults. Inclusion criteria for neonates were admission to neonatal intensive care unit, presence of gastric tube, tracheal tube, and venous lines. Each newborn was observed by a different group of three adults (parent, nurse assistant and pediatrician) for 1 minute at the same time to evaluate presence and intensity of infant's pain. Homogeneity of pain evaluation was analyzed by a modified Bland-Altman plot and by intraclass correlation coefficient (ICC). Multiple linear regression analysis was used to evaluate association of neonatal characteristics and heterogeneity of pain scores for adults., Results: ICC showed disagreement of the pain scores given by the three groups of adults (ICC 0.066, agreement > 0.75). Bland-Altman analysis showed agreement among adults when they thought pain was absent. When they thought pain was present, there was heterogeneity of opinions regarding intensity of neonatal pain. Multiple regression analysis indicated that 10% of this disagreement could be explained by infant's gender and mode of delivery., Conclusions: Disagreement among adults about intensity of neonatal pain is a marker of the difficulty in deciding the need for analgesia in preverbal patients.

Two cases of malignant eccrine spiradenoma of the hand are reported. This malignancy is potentially fatal and is believed to arise from preexisting, long-standing benign spiradenomas. These rare tumors should be considered in the hand surgeon's evaluation and management of any long-standing undiagnosed tumor of the hand. Benign spiradenomas should be excised completely and the patient followed carefully. Location and grade of established malignant tumors should dictate therapy.

Derived from postmortem dissections, early descriptions of a muscle belly in the palm that served the index finger in the manner of the flexor digitorum superficialis were published by MacAlister (1868), Graper (1917), and Mainland (1927). In the English literature, we have found reports on only 15 clinical cases that involved the palm. Based on available information regarding sex, 12 patients were female and one was male. The anomaly involved the right hand in all cases and was bilateral in four of the female patients. We report two additional cases, of which one is considered the first bilateral case in a man with symptoms on the left side.