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Byline: N.L. Richards, M.C. Chaturvedi, Y.G. Liu, K. Mount A further study to our previous work has been carried out in an attempt to understand the welding parameters affecting heat-affected zone micro-fissuring in Incoloy 903. Electron beam welding (EBW) parameters such as travel speed, beam current, focus current and beam oscillation were varied, while the accelerating voltage and working distance were kept constant. The six independent variables were formulated into a response surface statistical design in order to investigate the effect of these factors on the dependent variable. The results of the experimentation showed that the main factors affecting micro-fissuring were beam current, focus current, welding speed and oscillation across the welding direction. These factors were combined into a regression equation showing the effect of each independent variable on the micro-fissuring behaviour.

Objective: To characterize functional bowel disorders in a population of pregnant women, evaluating effects on quality of life, management and follow up., Design: Prospective cohort., Setting: University center, USA., Population: Women in the first trimester (n = 104)., Methods: After enrollment evaluations, measures were repeated in the third trimester. Overall bowel function was assessed using the Rome III Questionnaire for Functional Bowel Disorders. Quality of life symptoms were assessed with the Irritable Bowel Syndrome Quality of Life Measure. Physician documentation of bowel symptoms and subsequent treatment in pregnancy were ascertained by retrospective chart review., Main Outcome Measure: Quality of life in first trimester., Results: A majority (75%) of the women at the first trimester evaluation reported having one or more functional bowel disorders. The overall quality of life status was rated highly functional, with a total average score of 94.9. Of the 75 women reporting functional bowel disorders, only 18 (24%) were identified in the medical record. Overall documentation of any bowel function was identified in the majority (64%) of cases. Most commonly, no discussion of treatment was documented, and follow up was recorded in only 27% of women with dysfunction., Conclusions: Nearly three-quarters of women in the first trimester report symptoms consistent with functional bowel disorders. Overall quality of life measures are highly rated. There is a discrepancy between what women report regarding bowel dysfunction and what is documented by providers within the medical record., (© 2014 Nordic Federation of Societies of Obstetrics and Gynecology.)

Objective: This study aims to examine trajectories of attention-deficit/hyperactivity disorder (ADHD) symptoms in the Longitudinal Assessment of Manic Symptoms (LAMS) sample., Method: The LAMS study assessed 684 children aged 6 to 12 years with the Kiddie-Schedule for Affective Disorders and Schizophrenia (K-SADS) and rating scales semi-annually for 3 years. Although they were selected for elevated manic symptoms, 526 children had baseline ADHD diagnoses. With growth mixture modeling (GMM), we separately analyzed inattentive and hyperactive/impulsive symptoms, covarying baseline age. Multiple standard methods determined optimal fit. The χ(2) and Kruskal-Wallis analysis of variance compared resulting latent classes/trajectories on clinical characteristics and medication., Results: Three latent class trajectories best described inattentive symptoms, and 4 classes best described hyperactive/impulsive symptoms. Inattentive trajectories maintained their relative position over time. Hyperactive/impulsive symptoms had 2 consistent trajectories (least and most severe). A third trajectory (4.5%) started mild, then escalated; and a fourth (14%) started severe but improved dramatically. The improving trajectory was associated with the highest rate of ADHD and lowest rate of bipolar diagnoses. Three-fourths of the mildest inattention class were also in the mildest hyperactive/impulsive class; 72% of the severest inattentive class were in the severest hyperactive/impulsive class, but the severest inattention class also included 62% of the improving hyperactive-impulsive class., Conclusion: An ADHD rather than bipolar diagnosis prognosticates a better course of hyperactive/impulsive, but not inattentive, symptoms. High overlap of relative severity between inattention and hyperactivity/impulsivity confirms the link between these symptom clusters. Hyperactive/impulsive symptoms wane more over time. Group means are insufficient to understand individual ADHD prognosis. A small subgroup deteriorates over time in hyperactivity/impulsivity and needs better treatments than currently provided., (Copyright © 2014 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.)

Background: Transgenerational association of bipolar spectrum disorder (BPSD) and attention deficit/hyperactivity disorder (ADHD) has been reported, but inconclusively., Method: Children ages 6-12 were systematically recruited at first outpatient visit at 9 clinics at four universities and reliably diagnosed; 621 had elevated symptoms of mania (>12 on the Parent General Behavior Inventory 10-Item Mania Scale); 86 had scores below 12. We analyzed baseline data to test a familial association hypothesis: compared to children with neither BPSD nor ADHD, those with either BPSD or ADHD would have parents with higher rates of both bipolar and ADHD symptoms, and parents of comorbid children would have even higher rates of both., Results: Of 707 children, 421 had ADHD without BPSD, 45 BPSD without ADHD, 117 comorbid ADHD+BPSD, and 124 neither. The rate of parental manic symptoms was similar for the comorbid and BPSD-alone groups, significantly greater than for ADHD alone and "neither" groups, which had similar rates. ADHD symptoms in parents of children with BPSD alone were significantly less frequent than in parents of children with ADHD (alone or comorbid), and no greater than for children with neither diagnosis. Family history of manic symptoms, but not ADHD symptoms, was associated with parent-rated child manic-symptom severity over and above child diagnosis., Limitations: The sample was not epidemiologic, parent symptoms were based on family history questions, and alpha was 0.05 despite multiple tests., Conclusions: These results do not support familial linkage of BPSD and ADHD; they are compatible with heritability of each disorder separately with coincidental overlap., (Copyright © 2012 Elsevier B.V. All rights reserved.)

Objectives: To determine the contribution of parent-reported manic symptoms, family history, stressful life events, and family environment in predicting diagnosis of bipolar spectrum disorders (BPSD) in youth presenting to an outpatient psychiatric clinic., Methods: A total of 707 6- to 12-year-old children [621 with elevated symptoms of mania (ESM+) based on screening via the Parent General Behavior Inventory 10-item Mania Scale (PGBI-10M) and 86 without ESM (ESM-)] received a comprehensive assessment., Results: Of the 629 with complete data, 24% (n = 148) had BPSD. Compared to those without BPSD (n = 481), children with BPSD: were older (Cohen's d = 0.44) and more likely to be female (Cohen's d = 0.26); had higher parent-endorsed manic symptom scores at screening (Cohen's d = 0.36) and baseline (Cohen's d = 0.76), more biological parents with a history of manic symptoms (Cohen's d = 0.48), and greater parenting stress (Cohen's d = 0.19). Discriminating variables, in order, were: baseline PGBI-10M scores, biological parent history of mania, parenting stress, and screening PGBI-10M scores. Absence of all these factors reduced risk of BPSD from 24% to 2%., Conclusions:   History of parental manic symptoms remains a robust predictor of BPSD in youth seeking outpatient care, even after accounting for parent report of manic symptoms in the child at screening. However, the risk factors identified as associated with BPSD, together had limited value in accurately identifying individual participants with BPSD, highlighting the need for careful clinical assessment., (© 2012 John Wiley and Sons A/S.)

Objective:   To compare attention-deficit hyperactivity disorder (ADHD), bipolar spectrum disorders (BPSDs), and comorbidity in the Longitudinal Assessment of Manic Symptoms (LAMS) study., Methods:   Children ages 6-12 were recruited at first visit to clinics associated with four universities. A BPSD diagnosis required that the patient exhibit episodes. Four hypotheses were tested: (i) children with BPSD + ADHD would have a younger age of mood symptom onset than those with BPSD but no ADHD; (ii) children with BPSD + ADHD would have more severe ADHD and BPSD symptoms than those with only one disorder; (iii) global functioning would be more impaired in children with ADHD + BPSD than in children with either diagnosis alone; and (iv) the ADHD + BPSD group would have more additional diagnoses., Results:   Of 707 children, 421 had ADHD alone, 45 had BPSD alone, 117 had both ADHD and BPSD, and 124 had neither. Comorbidity (16.5%) was slightly less than expected by chance (17.5%). Age of mood symptom onset was not different between the BPSD + ADHD group and the BPSD-alone group. Symptom severity increased and global functioning decreased with comorbidity. Comorbidity with other disorders was highest for the ADHD + BPSD group, but higher for the ADHD-alone than the BPSD-alone group. Children with BPSD were four times as likely to be hospitalized (22%) as children with ADHD alone., Conclusions:   The high rate of BPSD in ADHD reported by some authors may be better explained as a high rate of both disorders in child outpatient settings rather than ADHD being a risk factor for BPSD. Co-occurrence of the two disorders is associated with poorer global functioning, greater symptom severity, and more additional comorbidity than for either single disorder., (© 2011 John Wiley and Sons A/S.)

The goal of this paper is to describe applications of two recently developed HPLC methods for the analysis and confirmation of the presence of hydrogen peroxide residues in field studies. The procedure utilizes two different HPLC systems, one with post-column derivatization followed by fluorescence detection (HPLC/FD), and the other with electrochemical detection (HPLC/ED). The two systems were utilized to detect hydrogen peroxide in a variety of typical forensic samples including pre- and post-blast samples, as well as a series of environmental control samples. Peroxide-based organic explosives were also examined due to their propensity to produce peroxide residues following detonation. Because samples collected from post-blast scenes are frequently shipped or stored prior to analysis, the effects of storage time, temperature and type of substrate material on the recovery of hydrogen peroxide residues were also investigated. The combined results of the study demonstrate the capability of two HPLC approaches with selective detection in the analysis and investigation of suspected incidents involving peroxide based explosives., (Published by Elsevier Ireland Ltd.)

Two complementary methods were optimized for the separation and detection of trace levels of hydrogen peroxide. The first method utilized reversed-phase high-performance liquid chromatography with fluorescence detection (HPLC-FD). With this approach, hydrogen peroxide was detected based upon its participation in the hemin-catalyzed oxidation of p-hydroxyphenylacetic acid to yield the fluorescent dimer. The second method utilized high performance liquid chromatography with electrochemical detection (HPLC-ED). With this approach, hydrogen peroxide was detected based upon its oxidation at a gold working electrode at an applied potential of 400 mV vs. hydrogen reference electrode (Pd/H(2)). Both methods were linear across the range of 15-300 μM, and the electrochemical method was linear across a wider range of 7.4-15,000 μM. The limit of detection for hydrogen peroxide was 6 μM by HPLC/FD, and 0.6 μM by HPLC/ED. A series of organic peroxides and inorganic ions were evaluated for their potential to interfere with the detection of hydrogen peroxide. Studies investigating the recovery of hydrogen peroxide with three different extraction protocols were also performed. Post-blast debris from the detonation of a mixture of concentrated hydrogen peroxide with nitromethane was analyzed on both systems. Hydrogen peroxide residues were successfully detected on this post-blast debris., (Published by Elsevier B.V.)

We researched factors related to the success or failure in working relationships between free-lance medical illustrators and artist's representatives. In the fall of 1992, surveys were mailed to 230 medical illustrators; 105 (46%) completed surveys were returned. Respondents were divided into three categories: 1) medical illustrators currently represented, 2) medical illustrators previously represented, and 3) medical illustrators who had never been represented. Comparisons made among illustrators from the three groups included business practices, clientele, experience, and self-promotion techniques. These comparisons revealed notable differences and similarities between the three groups and were subsequently analyzed to identify the characteristics of medical illustrators who would benefit from professional representation.

Background: In an effort to find more practical smoking intervention models for primary-care settings, three physician-and-nurse team approaches to patient counseling were compared with brief physician advice alone., Methods: Subjects were 3,161 adult smokers surveyed while waiting to see 1 of 40 primary-care physicians. Physicians delivered a brief stop-smoking prompt to 2,707 (86%) of these smokers and referred them to an on-site smoking counselor (e.g., nurse) who randomly provided a two-page pamphlet (advice-only control) or one of three brief nurse-assisted interventions: (a) self-quit training, (b) recruitment to a group program, or (c) a combination intervention. Smokers usually (87%) agreed to see the counselor., Results: After 3 months, subjects in the three nurse-assisted conditions were more likely to report a serious quit attempt (50% vs 39%, P less than 0.001) than were physician-advice-only subjects. Quit rates at 3 months were also higher (P less than 0.001) in the nurse-assisted self-quit (12.9%), recruitment (14.1%), and combination (13.0%) conditions, compared with those for brief physician advice only (7.6%)., Conclusion: If long-term efficacy is confirmed, these nurse-assisted counseling approaches will serve as practical smoking intervention models for most medical-care delivery settings.

The vocal characteristics of a 63-year-old individual who underwent male-to-female sex reassignment surgery were evaluated. Treatment was designed to alter inappropriate male voice characteristics. Speech goals were to (1) encourage use of successively higher pitch levels, and (2) modify tongue carriage to change resonance. After 11 months of therapy, average fundamental frequency for /i, a, u/ vowels changed from 110 to 205 Hz. Also, second formant frequency values changed remarkably for each of these vowels, with the greatest frequency change being 291 Hz for /i/. These acoustic differences could account for the perception of femininity in her posttreatment voice. Maintenance of these acoustic features was found five years posttreatment.