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Standardized cross-cultural databases of the arts are critical to a balanced scientific understanding of the performing arts, and their role in other domains of human society. This paper introduces the Global Jukebox as a resource for comparative and cross-cultural study of the performing arts and culture. The Global Jukebox adds an extensive and detailed global database of the performing arts that enlarges our understanding of human cultural diversity. Initially prototyped by Alan Lomax in the 1980s, its core is the Cantometrics dataset, encompassing standardized codings on 37 aspects of musical style for 5,776 traditional songs from 1,026 societies. The Cantometrics dataset has been cleaned and checked for reliability and accuracy, and includes a full coding guide with audio training examples (https://theglobaljukebox.org/?songsofearth). Also being released are seven additional datasets coding and describing instrumentation, conversation, popular music, vowel and consonant placement, breath management, social factors, and societies. For the first time, all digitized Global Jukebox data are being made available in open-access, downloadable format (https://github.com/theglobaljukebox), linked with streaming audio recordings (theglobaljukebox.org) to the maximum extent allowed while respecting copyright and the wishes of culture-bearers. The data are cross-indexed with the Database of Peoples, Languages, and Cultures (D-PLACE) to allow researchers to test hypotheses about worldwide coevolution of aesthetic patterns and traditions. As an example, we analyze the global relationship between song style and societal complexity, showing that they are robustly related, in contrast to previous critiques claiming that these proposed relationships were an artifact of autocorrelation (though causal mechanisms remain unresolved). Introduction Background The Global Jukebox and its data 1. The data 1.1. Datasets of the Global Jukebox 1.2. Comparison with other cross cultural datasets 1.3. Coded performance variables: Selection and reliability 1.4. Performance data sources 1.5. Selection of audio examples 1.6. Availability of audio recordings 1.7. Performance metadata 2. Sampling societies and links to other datasets 2.1. Sampling societies 2.2. Links to other cross-cultural datasets 3. Data curation, cleaning, and validation 4. Coding reliability 5. Is song style correlated with social complexity? An example of hypothesis testing using the Global Jukebox 5.1. Hypothesis testing with the Global Jukebox datasets 5.2. Methods 5.3 Results of reanalysis 5.4 Discussion 6. Ethics, rights and consent 7. Conclusion

The neurotransmitter serotonin (5-HT) plays an important role in mood disorders. It has been demonstrated that 5-HT signaling through 5-HT1A receptors (5-HT1A-R) is crucial for early postnatal hippocampal development and later-life behavior. Although this suggests that 5-HT1A-R signaling regulates early brain development, the mechanistic underpinnings of this process have remained unclear. Here we show that stimulation of the 5-HT1A-R at postnatal day 6 (P6) by intrahippocampal infusion of the agonist 8-OH-DPAT (D) causes signaling through protein kinase Cε (PKCε) and extracellular receptor activated kinase ½ (ERK1/2) to boost neuroblast proliferation in the dentate gyrus (DG), as displayed by an increase in bromodeoxy-uridine (BrdU), doublecortin (DCX) double-positive cells. This boost in neuroproliferation was eliminated in mice treated with D in the presence of a 5-HT1A-R antagonist (WAY100635), a selective PKCε inhibitor, or an ERK1/2-kinase (MEK) inhibitor (U0126). It is believed that hippocampal neuro-progenitors undergoing neonatal proliferation subsequently become postmitotic and enter the synaptogenesis phase. Double-staining with antibodies against bromodeoxyuridine (BrdU) and neuronal nuclear protein (NeuN) confirmed that 5-HT1A-R → PKCε → ERK1/2-mediated boosted neuroproliferation at P6 also leads to an increase in BrdU-labeled granular neurons at P36. This 5-HT1A-R-mediated increase in mature neurons was unlikely due to suppressed apoptosis, because terminal deoxynucleotidyl transferase dUTP nick-end labeling analysis showed no difference in DNA terminal labeling between vehicle and 8-OH-DPAT-infused mice. Therefore, 5-HT1A-R signaling through PKCε may play an important role in micro-neurogenesis in the DG at P6, following which many of these new-born neuroprogenitors develop into mature neurons.

Background The tropomyosin receptor kinase (TRK) pathway controls appetite, balance, and pain sensitivity. While these functions are reflected in the on-target adverse events (AEs) observed with TRK inhibition, these AEs remain under-recognized, and pain upon drug withdrawal has not previously been reported. As TRK inhibitors are approved by multiple regulatory agencies for TRK or ROS1 fusion-positive cancers, characterizing these AEs and corresponding management strategies is crucial. Patients and methods Patients with advanced or unresectable solid tumors treated with a TRK inhibitor were retrospectively identified in a search of clinical databases. Among these patients, the frequency, severity, duration, and management outcomes of AEs including weight gain, dizziness or ataxia, and withdrawal pain were characterized. Results Ninety-six patients with 15 unique cancer histologies treated with a TRK inhibitor were identified. Weight gain was observed in 53% [95% confidence interval (CI), 43%–62%] of patients and increased with time on TRK inhibition. Pharmacologic intervention, most commonly with glucagon-like peptide 1 analogs or metformin, appeared to result in stabilization or loss of weight. Dizziness, with or without ataxia, was observed in 41% (95% CI, 31%–51%) of patients with a median time to onset of 2 weeks (range, 3 days to 16 months). TRK inhibitor dose reduction was the most effective intervention for dizziness. Pain upon temporary or permanent TRK inhibitor discontinuation was observed in 35% (95% CI, 24%–46%) of patients; this was more common with longer TRK inhibitor use. TRK inhibitor reinitiation was the most effective intervention for withdrawal pain. Conclusions TRK inhibition-related AEs including weight gain, dizziness, and withdrawal pain occur in a substantial proportion of patients receiving TRK inhibitors. This safety profile is unique relative to other anticancer therapies and warrants careful monitoring. These on-target toxicities are manageable with pharmacologic intervention and dose modification.

A recent cross-sectional analysis of PDD Behavior Inventory (PDDBI) data, analyzed with a classification and regression tree algorithm, yielded a decision tree (the Autism Spectrum Disorder-Decision Tree or ASD-DT) that detected three behaviorally distinct ASD subgroups: minimally verbal, verbal, and atypical. These subgroups differed in PDDBI profiles and in factors previously reported to be predictors of autism severity and adaptive behavior trajectories. We retrospectively analyzed trajectories of adaptive skills and autism severity in these subgroups, defined by ASD-DTs calculated from initial evaluation PDDBIs. Results confirmed predictions that each subgroup had distinct trajectories that varied with the type of adaptive behavior assessed suggesting that the ASD-DT has prognostic value that could be helpful for both clinical and research applications.

The study of twin behavior offers the opportunity to study differential patterns of social and communicative interactions in a context where the adult partner and same-age peer are equally familiar. We investigated the development of social engagement, communicative gestures, and imitation in 7- to 25-month-old twins. Twin dyads (N = 20 pairs) participated in ten-minute, semi-structured play sessions, with the mother seated in a chair completing paperwork for half the session, and on the floor with her children for the other half. Overall, twins engaged more with their mothers than with their siblings: they showed objects and imitated speech and object use more frequently when interacting with their mothers than with their siblings. When the mother was otherwise engaged, the twins played with toys separately, observed each other’s toy play, or were unengaged. These results demonstrate that adult scaffolding of social interactions supports increased communicative bids even in a context where both familiar peers and adults are available as communicative partners.

Several studies have looked at the effects on mood and quality of life (QOL) among patients who underwent on-pump coronary artery bypass grafting (CABG), but few have reported on off-pump CABG (OPCABG).We recruited 50 patients undergoing OPCABG. The day before CABG, patients were interviewed using 4 questionnaires: the Beck Depression Index (BDI), Beck Anxiety Index (BAI), Sheehan Disability Scale (SDS), and Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q). The process was repeated at 1, 3, 6, and 9 months.One month postoperatively, patients showed increased levels of depression (Δ 1.67 in the mean BDI score, P.05) and disability (Δ 5.28 in the mean SDS score, P.001) and decreases levels of anxiety (Δ 3.7 in the mean BAI score, P.001) and QOL compared with baseline. When compared with the first month, at 9 months patients were significantly less depressed (Δ 3.58 in the mean BDI score, P.001), were less disabled (Δ 5.34 in the mean SDS score, P.001), and had better QOL (Δ 3.82 in the mean Q-LES-Q score, P = .014). At 9 months, 44% had some degree of depression and 48% had low QOL.Despite that all scores returned to or below baseline at 9 months, a high percentage of patients still had depressive symptoms and overall poor quality of life (QOL). BDI scores at baseline are good predictors of QOL at all measured intervals. This should make physicians more prudent in diagnosing and observing these patients.

OBJECTIVES: Recent evidence suggests higher prevalence of autism spectrum disorder (ASD) in NICU graduates. This aim of this study was to identify retrospectively early behaviors found more frequently in NICU infants who went on to develop ASD. METHODS: Twenty-eight NICU graduates who later received a diagnosis of ASD were compared with 2169 other NICU graduates recruited from 1994 to 2005. They differed in gender, gestational age, and birth cohort. These characteristics were used to draw a matched control sample (n = 112) to determine which, if any, early behaviors discriminated subsequent ASD diagnosis. Behavioral testing at targeted ages (adjusted for gestation) included the Rapid Neonatal Neurobehavioral Assessment (hospital discharge, 1 month), Arousal-Modulated Attention (hospital discharge, 1 and 4 months), and Bayley Scales of Infant Development (multiple times, 4–25 months). RESULTS: At 1 month, children with ASD but not control children had persistent neurobehavioral abnormalities and higher incidences of asymmetric visual tracking and arm tone deficits. At 4 months, children with ASD had continued visual preference for higher amounts of stimulation than did control children, behaving more like newborns. Unlike control children, children with ASD had declining mental and motor performance by 7 to 10 months, resembling infants with severe central nervous system involvement. CONCLUSIONS: Differences in specific behavior domains between NICU graduates who later receive a diagnosis of ASD and matched NICU control children may be identified in early infancy. Studies with this cohort may provide insights to help understand and detect early disabilities, including ASD.

Exact functions expressing the distribution of the end-to-end vector for real chains of finite length are unknown. Moments of the distribution can be calculated, however, for linear chains unperturbed by excluded-volume effects. Thus, second and fourth moments for real chains with interdependent bond rotational potentials, in the rotational isomeric state approximation, can be computed as a function of chain length by methods developed recently. These moments are here compared with those calculated for hypothetical models, e.g., for the Gaussian distribution (to which all distributions converge in the limit of infinite chain length), for the freely jointed chain, for the distribution involving the inverted Langevin function, for the freely rotating chain, for the Porod “wormlike” chain, and for the chain with independent bond rotations that have a symmetrical hindrance potential. The convergence of the series expansion for the distribution function in terms of its even moments obtained by Nagai is investigated for the freely jointed chain (for which any number of moments may be readily calculated). Application of this series to the model with interdependent bond rotations is also considered.

Neonatal assessments should provide valid estimates of behavior and neurological status, reflect recovery from acute effects, predict subsequent outcome, and point to specific intervention strategies for any problems noted. The authors report relations among measures designed to evaluate early behavioral capabilities and dysfunctions in areas frequently disrupted by central nervous system (CNS) injury that involve arousal-modulated attention and elicited and spontaneous movements, to each other and to the Bayley Scales of Infant Development over the first 2 years. Infants were classified into four CNS injury groups based on auditory brainstem responses and cranial ultrasonography. CNS injury was associated with all behavioral measures in neonates, but the strength of the relationships changed for each over time, as did the degree and time-course for performance recovery. CNS findings alone were insufficient to predict later outcome. Early behavioral evaluations were better predictors into the second year and indicated that: (1) high-risk infants who performed normally as neonates had normal development; (2) those with early transient abnormalities appeared to normalize by 4 months but started to decline by 13-16 months; and (3) consistently abnormal early behavior predicted the worst outcome. Use of multiple measures in the neonatal period and repeated assessments across early infancy provide a useful and accurate approach for evaluating recovery from CNS injury, predicting later mental and motor performance and helping to design early intervention strategies.

Life events can have a negative impact on older adults with intellectual disabilities (ID) and are associated with depression and functional decline. Research on life events in people with ID revealed few reports that investigated life events exposure in people with Down syndrome (DS). The number and types of life events experienced in a cohort of 211 adults with ID (108 with DS, and 103 without DS) older than 50 years of age were studied. Data on life events exposure were collected from clinical records and informant interviews. The findings revealed that persons with DS in the sixth decade of life experienced a significantly greater number of life events and changes than adults without DS of similar or older ages. The number of relocations and medical events were found to be significantly greater in those with DS, whereas adults without DS experienced a significantly lower number of occurrences in all the life events categories studied. Adults with DS 50–59 years of age experienced a greater number of life events than did a group of adults without DS 50 years of age and older. Of the categories of life events investigated, changes in environment, experienced losses/separations, and medical events appear to be a common occurrence in the lives of older adults with DS. Functional decline, which commonly occurs during the dementia process, was seen as directly related to the prevalence and types of life events that adults with DS experience.

Neonatal intensive-care unit (NICU) graduates, a group at risk for attention problems and attention-deficit hyperactivity disorder, performed an intradimensional shift card sort at 34, 42, 51, and 60 months to assess executive function and to examine effects of individual risk factors. In the “silly” game, children sorted cards (airplanes and dogs) so they were not the same as targets. In the “same” game, they did the opposite. Performance on the “silly” game was poor, especially when it was presented first. Success in following “silly” game rules improved with age and was significantly linked to maternal education and birth weight for gestational age, a measure of intrauterine stress. Degree of central nervous system injury differentiated children who completed the task from children who did not, and it also affected the need to repeat instructions in the “same” game. These results confirm an increased likelihood of impairments in executive function during preschool years in NICU graduates.

Rossavik models [P = c( t) k+s(t) ] were used to characterize behavioral development in 306 infants without evidence of brain injury, evaluated at approximately 3 month interval from 4 to 25 months (age adjusted for prematurity). Mental Development (MD) and Psychomotor Development (PD) raw scores from BSID-I and BSID-II were utilized. Separate Rossavik models specified from raw scores obtained before 418 days were used to predict raw scores after 418 days. Predictability was measured by calculating % Deviations (actual - predicted/predicted × 100). Rossavik models fit complete data sets from individual infants quite well with little variation [R 2 : BSID-I 98.5 +/- 1.3% (MD), 97.7 +/- 2.0% (PD); BSID-II 98.8 +/- 1.0%, 9 (MD), 98.2 +/- 1.6% (PD)]. Models derived from 1 st year raw scores predicted 2 nd year raw scores with a random error of +/- 10% or less. Predicting 2 nd year development from 1 st year data were evaluated using three other models. The results obtained were less accurate and/or more variable than those obtained with Rossavk models. We concluded that Rossavik models accurately characterize behavioral development in the first 2 years and can be used to predict 2 nd year scores with sufficient accuracy to allow specification of individualized developmental trajectories.

The effect of high-dose chemotherapy and autografting on bone turnover in myeloma is not known. A study of 32 myeloma patients undergoing blood or marrow transplant (BMT), conditioned with high-dose melphalan, was done. Bone resorption was assessed by urinary free pyridinoline (fPyr) and deoxypyridinoline (fDPyr), expressed as a ratio of the urinary creatinine concentration. Bone formation was assessed by serum concentration of procollagen 1 extension peptide (P1CP) and bone-specific alkaline phosphatase (BSAP). Eighteen cases had normal fPyr and fDPyr at transplant, and in all but one of these cases the level remained normal throughout subsequent follow-up. In contrast, in 14 cases urinary fPyr and fDPyr levels were increased at transplant. In these cases, both fPyr and fDPyr fell to normal levels over the next few months (P = .0009 and .0019, respectively). fPyr and fDPyr levels at transplant and their trends post-BMT were unrelated to the use of pre-BMT or post-BMT bisphosphonate or post-BMT interferon. Nine cases had elevated P1CP or BSAP at transplant, which rapidly normalized. In most patients there was an increase in P1CP and/or BSAP several months post-transplant. In conclusion, increased osteoclast activity may be present even in apparent plateau phase of myeloma. High-dose chemotherapy with autografting may normalize abnormal bone resorption, although the effect may take several weeks to emerge and may be paralleled by increased osteoblast activity. The findings provide biochemical evidence that autografting may help normalize the abnormal bone turnover characteristic of myeloma.

This longitudinal study of a homogeneously urban African-American community cohort drawn from the metropolitan New York area (USA) analyzed three-year change in HIV-1 antibody prevalence and self-reported risk practices separately for men and women. Specifically, risk practices reported on personal interviews and results from blood sero-assay in 1989-1990 were compared to similar interview reports of risk practices and HIV assay from saliva samples in 1993. Results showed: (1) women's infection rates increased more than men's, resulting in a male to female infection ratio of 1.5:1; (2) heterosexual transmission accounted for most of women's new infection; (3) in multivariate analysis, multiple partners was a significant heterosexual risk indicator for both men and women, increasing infection odds five-fold; and (4) buying sex also increased heterosexual men's infection odds approximately five-fold. Results document increasing rates of African-American HIV infection linked largely to heterosexual exposure risk, that the African-American male-female infection ratio resembles the global rather than North American one, and also the utility of an expanded classification of heterosexual exposure risk.

There is an increasing interest in demand-side management (DSM) by utilities and regulators throughout the USA. With this interest, there is an increasing need for DSM evaluation. Regulators expect utility engineers to use least cost planning and integrated resource planning approaches to adjust their generation capacity plans to reflect DSM. Increasingly, utilities are considering DSM to affect their T&D capacity plans. However, major utility DSM programs are less than a decade old. This leaves many utility engineers uneasy. How do they know that DSM will be there when they really need it? To verify and improve the contribution of DSM programs, utility analysts have developed a set of methodologies and procedures for evaluating DSM. The purpose of this panel session was to review these state of the art evaluations and the lessons learned from them so far. The authors explore the differences inherent in evaluating DSM at the T&D level versus the generation level, and review DSM's persistence and reliability in the residential, commercial, and industrial sectors. >

Neonatal intensive care unit (NICU) graduates have a higher incidence of attention problems including attention deficit hyperactivity disorder (ADHD). Thus, we examined the effect of risk factors (birth weight (BW), central nervous system (CNS) injury, gender, maternal education) on attention/inhibition during reaction time, continuous performance and Go/No-Go tasks at 42, 51, and 60 months (n = 271). Very low BW NICU graduates (1,500 g) performed worse than typical BW ones (2,500 g), displaying poorer target/non-target discrimination. Males responded faster than females, but made more false alarms and random responses. Despite short duration tasks, attention waned. Performance improved with age, but even at 60 months children had difficulty inhibiting random responding.

To examine, in women who underwent cardiac catheterization, whether breast arterial calcifications (BACs) seen at screening mammography correlate with coronary heart disease (CHD) seen at coronary angiography.In an institutional review board-approved, HIPAA-compliant study, 172 women (mean age, 64.29 years +/- 11.97 [standard deviation]) who underwent coronary angiography were recruited, interviewed, and assigned to two groups: those with (CHD+) and those without (CHD-) CHD. The severity and location of the CHD were considered. Their mammograms were reviewed by a breast imaging specialist who was blinded to the CHD status. Student t test, chi(2), and multiple logistic regression tests were performed as appropriate. Presence of BAC was noted and correlated with presence of CHD and presence of cardiac risk factors.There were 104 women with and 68 women without CHD. Thirty-seven (36%) women in the CHD+ group versus 20 (29%) in the CHD-group (P = .40) had BAC. The mean age of the patients with BAC, 72 years +/- 9.8, was significantly older than the mean age of the patients without BAC, 60.4 years +/- 11.1 (P.001). Therefore, subjects were divided into those younger than 65 years and those 65 years and older. No correlation existed, despite the fact that BAC was associated with some cardiac risk factors.The authors did not observe a correlation between BAC and coronary angiography-detected CHD, even when CHD severity was considered. On the basis of these results, caution should be exercised when using screening mammography-detected BAC to identify patients with CHD.

Inbred congenic mice of strains MRL/Mp-lpr/lpr (lpr/lpr) and MRL/Mp(-)+/+ (+/+) were fed nutritionally adequate semipurified diets containing 20% (w/w) fat and differing in linoleic acid content. Levels of linoleic acid (18:2n-6) and arachidonic acid (20:4n-6) in phospholipids of splenocytes, liver mitochondria and liver nuclear envelopes were determined. Membranes of lpr/lpr mice exhibited significantly lower levels of 18:2n-6 and 20:4n-6 in phospholipids compared with the +/+ strain. The high linoleic acid diet increased incorporation of 18:2n-6 and 20:4n-6 in most phospholipid fractions of these membranes. These observations indicate that genotype as well as dietary 18:2n-6 content significantly influenced incorporation of 18:2n-6 and 20:4n-6 into membrane phospholipids. The results also suggest that membrane compositional abnormalities found in the lpr/lpr mice, which develop lymphoma and age faster than +/+ mice, are not restricted to the immune system but also extend to other organs. Differences observed in phospholipid fatty acid composition in splenocytes and liver subcellular membranes for mice fed diets differing in linoleic acid content suggest that the early expression of the lpr gene resulting in progression of autoimmunity may be delayed through dietary manipulation.

This paper is a survey of four recently published guides for the inspection and retirement of fiber ropes, as used for marine hawsers, mooring lines, and other purposes. It is intended to bring these to the attention of marine personnel and others who should be concerned with rope inspection and retirement. Proper inspection and timely retirement of fiber ropes is crucial to avoid personnel injury, death, property damage, and pollution. Most past guides dealt only with generalities and were not very useful. These new guides give specific examples and quantitative criteria for at least some types of rope. This paper briefly summarizes some of the rope inspection and retirement methods and criteria provided in these guides. It includes the authors' experience and advice. It makes reference to other relevant guidelines and technical papers.

Les fonctions de diffusion du PMMA syndio-, iso- et atactique sont calculees a l'aide des 3 modeles RIS de la litterature et comparees avec des donnees de diffusion RX et neutronique, du PMMA extraites de la litterature. Les resultats montrent que la conformation du PMMA dans l'etat amorphe correspondent etroitement aux pelotes statistiques non perturbees

Vacuum Assisted Closure (V.A.C.) is a sound strategy to control severe post-sternotomy infection. Secondary re-wiring of the sternal bone or reconstructive surgery may be required later to achieve complete wound closure. Ten patients with severe sternal bone infection underwent initial V.A.C. therapy and delayed surgery for wound closure. Complete wound healing was achieved in all cases. As a case report we describe a patient with right-sided mastectomy and irradiation for breast cancer, who developed severe post-sternotomy infection and sternal bone necrosis following CABG. A combination of V.A.C. therapy and surgical reconstruction using a pedicled latissimus dorsi musculocutaneous flap led to complete wound closure.

Parallel-element ropes are used as mooring lines on floating platforms in deep water. Individual yarns, strands, or subropes are arranged as parallel components. This produces a very efficient and compact rope structure. There is much interest in testing these ropes for strength, extension, and damage-tolerance properties. By necessity, the rope test specimen is much shorter than the rope mooring line, but rope length can affect important rope properties. Unbalanced element lengths cause a large force imbalance in a short specimen but this effect is minimal in much longer ropes. Damage to a portion of an element may greatly reduce the force in that element in a short rope but may have little effect on that force in much longer ropes. This paper analyzes potential length-related effects and presents equations and graphs comparing the effects. The paper will interest planners of rope test programs and designers who must use short-rope test results to design long-rope systems.

We conducted a longitudinal comparative evaluation of person-centered planning processes and outcomes for 20 individuals with intellectual disabilities and problem behavior (former residents of Willowbrook) and a matched contrast group, who received traditional interdisciplinary service planning (ISP). At the inception of the study, all participants were living in one of four other developmental centers (institutions) in New York City. Process and outcome data obtained from questionnaires completed by team members approximately every 8 months at four time periods showed that the rate of improvement in both person-centered planning process and outcomes for the intervention group was significantly greater than that of the comparison group. Eighteen of 19 person-centered planning participants moved to community living arrangements, as did 5 of 18 in the contrast group.

This paper presents preliminary results of the DeepStar polyester taut leg mooring (TLM) project. The 3100 ft (945 m) deep single-leg TLM contained short and long sections of three different polyester rope designs. It was installed in the Gulf of Mexico in 1996 and retrieved 27 months later, after exposure to two hurricanes. The retrieved polyester rope sections were then examined, tested, and analyzed in order to assess any indications of degradation.

The effect of high-dose chemotherapy and autografting on bone turnover in myeloma is not known. A study of 32 myeloma patients undergoing blood or marrow transplant (BMT), conditioned with high-dose melphalan, was done. Bone resorption was assessed by urinary free pyridinoline (fPyr) and deoxypyridinoline (fDPyr), expressed as a ratio of the urinary creatinine concentration. Bone formation was assessed by serum concentration of procollagen 1 extension peptide (P1CP) and bone-specific alkaline phosphatase (BSAP). Eighteen cases had normal fPyr and fDPyr at transplant, and in all but one of these cases the level remained normal throughout subsequent follow-up. In contrast, in 14 cases urinary fPyr and fDPyr levels were increased at transplant. In these cases, both fPyr and fDPyr fell to normal levels over the next few months (P = .0009 and.0019, respectively). fPyr and fDPyr levels at transplant and their trends post-BMT were unrelated to the use of pre-BMT or post-BMT bisphosphonate or post-BMT interferon. Nine cases had elevated P1CP or BSAP at transplant, which rapidly normalized. In most patients there was an increase in P1CP and/or BSAP several months post-transplant. In conclusion, increased osteoclast activity may be present even in apparent plateau phase of myeloma. High-dose chemotherapy with autografting may normalize abnormal bone resorption, although the effect may take several weeks to emerge and may be paralleled by increased osteoblast activity. The findings provide biochemical evidence that autografting may help normalize the abnormal bone turnover characteristic of myeloma. (Blood. 2000;96:2697-2702)

News about the Internet is everywhere. The reality, however, is that the Internet is neither a passing fad nor a false alarm. It is a dynamic new way for healthcare organizations to disseminate and retrieve information, conduct market research, communicate with broad provider networks, educate consumers and sell products and services.

Determining the amount of virus in the blood, referred to as viral load, of an HIV-positive patient provides useful information on the progress of the disease. Viral load is determined by measuring HIV RNA or DNA using a test called polymerase chain reaction (PCR). Higher levels of virus indicate increasing risk of disease progression. Viral load data may help physicians determine when to begin using antiviral agents or verify the effectiveness of treatment drugs. Commonly asked questions and answers are included.