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As new directions and priorities emerge in health care, nursing informatics leaders must prepare to guide the profession appropriately. To use an analogy, where a road bends or changes directions, guideposts indicate how drivers can stay on course. The AMIA Nursing Informatics Working Group (NIWG) produced this white paper as the product of a meeting convened: 1) to describe anticipated nationwide changes in demographics, health care quality, and health care informatics; 2) to assess the potential impact of genomic medicine and of new threats to society; 3) to align AMIA NIWG resources with emerging priorities; and 4) to identify guideposts in the form of an agenda to keep the NIWG on course in light of new opportunities. The anticipated societal changes provide opportunities for nursing informatics. Resources described below within the Department of Health and Human Services (HHS) and the National Committee for Health and Vital Statistics (NCVHS) can help to align AMIA NIWG with emerging priorities. The guideposts consist of priority areas for action in informatics, nursing education, and research. Nursing informatics professionals will collaborate as full participants in local, national, and international efforts related to the guideposts in order to make significant contributions that empower patients and providers for safer health care. [ABSTRACT FROM AUTHOR]

Individual differences in metacognitive accuracy are generally thought to reflect differences in metacognitive ability. If so, memory monitoring performance should be consistent across different meta-cognitive tasks and show high test-retest reliability. Two experiments examined these possibilities, using four common metacognitive tasks: ease of learning judgments, feeling of knowing judgments, judgments of learning, and text comprehension monitoring. Alternate-forms correlations were computed for metacognitive accuracy (with a 1-week interval between tests). Although individual differences in memory and confidence were stable across both sessions and tasks, differences in metacognitive accuracy were not. These results pose considerable practical and theoretical challenges for metacognitive researchers. [ABSTRACT FROM AUTHOR]

Abstract Background Rapid clonal expansion of T cells occurs in response to antigenic challenges. The kinetics of the T cell response has previously been described using tissue-based studies performed at defined time points. Luciferase bioluminescence has recently been utilized for non-invasive analysis of in vivo biologic processes in real-time. Results We have created a novel transgenic mouse model (T-Lux) using a human CD2 mini-gene to direct luciferase expression specifically to the T cell compartment. T-Lux T cells demonstrated normal homing patterns within the intact mouse and following adoptive transfer. Bioluminescent signal correlated with T cell numbers in the whole body images as well as within specific organ regions of interest. Following transfer into lymphopenic (RAG2-/-) recipients, homeostatic proliferation of T-Lux T cells was visualized using bioluminescent imaging. Real-time bioluminescent analysis of CD4+ T cell antigen-specific responses enabled real-time comparison of the kinetics and magnitude of clonal expansion and contraction in the inductive lymph node and tissue site of antigen injection. T cell expansion was dose-dependent despite the presence of supraphysiologic numbers of OVA-specific OT-II transgenic TCR T-Lux T cells. CD4+ T cells subsequently underwent a rapid (3–4 day) contraction phase in the draining lymph node, with a delayed contraction in the antigen delivery site, with bioluminescent signal diminished below initial levels, representing TCR clonal frequency control. Conclusion The T-Lux mouse provides a novel, efficient model for tracking in vivo aspects of the CD4+ T cell response to antigen, providing an attractive approach for studies directed at immunotherapy or vaccine design.

Abstract Background Gene transfer studies in primary T cells have suffered from the limitations of conventional viral transduction or transfection techniques. Replication-defective adenoviral vectors are an attractive alternative for gene delivery. However, naive lymphocytes are not readily susceptible to infection with adenoviruses due to insufficient expression of the coxsackie/adenovirus receptor. Results To render T cells susceptible to adenoviral gene transfer, we have developed three new murine transgenic lines in which expression of the human coxsackie/adenovirus receptor (hCAR) with a truncated cytoplasmic domain (hCARΔcyt) is limited to thymocytes and lymphocytes under direction of a human CD2 mini-gene. hCARΔcyt.CD2 transgenic mice were crossed with DO11.10 T cell receptor transgenic mice (DO11.hCARΔcyt) to allow developmental studies in a defined, clonal T cell population. Expression of hCARΔcyt enabled adenoviral transduction of resting primary CD4+ T cells, differentiated effector T cells and thymocytes from DO11.hCARΔcyt with high efficiency. Expression of hCARΔcyt transgene did not perturb T cell development in these mice and adenoviral transduction of DO11.hCARΔcyt T cells did not alter their activation status, functional responses or differentiative potential. Adoptive transfer of the transduced T cells into normal recipients did not modify their physiologic localization. Conclusion The DO11.hCARΔcyt transgenic model thus allows efficient gene transfer in primary T cell populations and will be valuable for novel studies of T cell activation and differentiation.

Roger Kirk, renowned for his many contributions to psychological research methods, passed away on December 30, 2023, in Waco, Texas, at the age of 93. Born in Indiana on February 23, 1930, Roger spent most of his childhood in Kentucky and Ohio. He developed an interest in the trombone as a teenager, so planned a musical career when he enrolled at The Ohio State University. After earning bachelor's and master's degrees in music, however, he came to realize he was "just an average trombone player." Some vocational guidance led him to Ohio State's experimental psychology doctoral program, which he started in 1952. Roger summed up his substantial career change as follows: "God gives all of us talents, it just took me longer than most people to find mine." Roger's doctoral research focused on psychoacoustics, so after completing his dissertation in 1955, he took a job as a psychoacoustical engineer at the Baldwin Piano and Organ Company. Roger was an accomplished author and received a multitude of accolades during his career; including Baylor's highest teaching designation (Master Teacher, 1993) and highest scholarship designation (Distinguished Professor, 1995). Roger is survived by "the love of my life," Jane Abbott-Kirk, whom he married in 1983. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Culture, a pillar of the remarkable ecological success of humans, is increasingly recognized as a powerful force structuring nonhuman animal populations. A key gap between these two types of culture is quantitative evidence of symbolic markers-seemingly arbitrary traits that function as reliable indicators of cultural group membership to conspecifics. Using acoustic data collected from 23 Pacific Ocean locations, we provide quantitative evidence that certain sperm whale acoustic signals exhibit spatial patterns consistent with a symbolic marker function. Culture segments sperm whale populations into behaviorally distinct clans, which are defined based on dialects of stereotyped click patterns (codas). We classified 23,429 codas into types using contaminated mixture models and hierarchically clustered coda repertoires into seven clans based on similarities in coda usage; then we evaluated whether coda usage varied with geographic distance within clans or with spatial overlap between clans. Similarities in within-clan usage of both "identity codas" (coda types diagnostic of clan identity) and "nonidentity codas" (coda types used by multiple clans) decrease as space between repertoire recording locations increases. However, between-clan similarity in identity, but not nonidentity, coda usage decreases as clan spatial overlap increases. This matches expectations if sympatry is related to a measurable pressure to diversify to make cultural divisions sharper, thereby providing evidence that identity codas function as symbolic markers of clan identity. Our study provides quantitative evidence of arbitrary traits, resembling human ethnic markers, conveying cultural identity outside of humans, and highlights remarkable similarities in the distributions of human ethnolinguistic groups and sperm whale clans.

Tropical cyclones drive coastal ecosystem dynamics, and their frequency, intensity, and spatial distribution are predicted to shift with climate change. Patterns of resistance and resilience were synthesized for 4138 ecosystem time series from n = 26 storms occurring between 1985 and 2018 in the Northern Hemisphere to predict how coastal ecosystems will respond to future disturbance regimes. Data were grouped by ecosystems (fresh water, salt water, terrestrial, and wetland) and response categories (biogeochemistry, hydrography, mobile biota, sedentary fauna, and vascular plants). We observed a repeated pattern of trade-offs between resistance and resilience across analyses. These patterns are likely the outcomes of evolutionary adaptation, they conform to disturbance theories, and they indicate that consistent rules may govern ecosystem susceptibility to tropical cyclones.

Black Americans who are perceived as more racially phenotypical-that is, who possess more physical traits that are closely associated with their race-are more often associated with racial stereotypes. These stereotypes, including assumptions about criminality, can influence how Black Americans are treated by the legal system. However, it is unclear whether other forms of racial stereotypicality, such as a person's way of speaking, also activate stereotypes about Black Americans. We investigated the links between speech stereotypicality and racial stereotypes (Experiment 1) and racial phenotype bias (Experiment 2). In Experiment 1, participants listened to audio recordings of Black speakers and rated how stereotypical they found the speaker, the likely race and nationality of the speaker, and indicated which adjectives the average person would likely associate with this speaker. In Experiment 2, participants listened to recordings of weakly or strongly stereotypical Black American speakers and indicated which of two faces (either weakly or strongly phenotypical) was more likely to be the speaker's. We found that speakers whose voices were rated as more highly stereotypical for Black Americans were more likely to be associated with stereotypes about Black Americans (Experiment 1) and with more stereotypically Black faces (Experiment 2). These findings indicate that speech stereotypicality activates racial stereotypes as well as expectations about the stereotypicality of an individual's appearance. As a result, the activation of stereotypes based on speech may lead to bias in suspect descriptions or eyewitness identifications., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Kurinec and Weaver.)

Despite overall global declines, mangroves are expanding into and within many subtropical wetlands, leading to heterogeneous cover of marsh-mangrove coastal vegetation communities near the poleward edge of mangroves' ranges. Coastal wetlands are globally important carbon sinks, yet the effects of shifts in mangrove cover on organic-carbon (OC) storage remains uncertain. We experimentally maintained black mangrove (Avicennia germinans) or marsh vegetation in patches (n = 1,120, 3 × 3 m) along a gradient in mangrove cover (0-100%) within coastal wetland plots (n = 10, 24 × 42 m) and measured changes in OC stocks and fluxes. Within patches, above and belowground biomass (OC) was 1,630% and 61% greater for mangroves than for recolonized marshes, and soil OC was 30% greater beneath mangrove than marsh vegetation. At the plot scale, above and belowground biomass increased linearly with mangrove cover but soil OC was highly variable and unrelated to mangrove cover. Root ingrowth was not different in mangrove or marsh patches, nor did it change with mangrove cover. After 11 months, surface OC accretion was negatively related to plot-scale mangrove cover following a high-wrack deposition period. However, after 22 months, accretion was 54% higher in mangrove patches, and there was no relationship to plot-scale mangrove cover. Marsh (Batis maritima) leaf and root litter had 1,000% and 35% faster breakdown rates (k) than mangrove (A. germinans) leaf and root litter. Soil temperatures beneath mangroves were 1.4°C lower, decreasing aboveground k of fast- (cellulose) and slow-decomposing (wood) standard substrates. Wood k in shallow soil (0-15 cm) was higher in mangrove than marsh patches, but vegetation identity did not impact k in deeper soil (15-30 cm). We found that mangrove cover enhanced OC storage by increasing biomass, creating more recalcitrant organic matter and reducing k on the soil surface by altering microclimate, despite increasing wood k belowground and decreasing allochthonous OC subsidies. Our results illustrate the importance of mangroves in maintaining coastal OC storage, but also indicate that the impacts of vegetation change on OC storage may vary based on ecosystem conditions, organic-matter sources, and the relative spatiotemporal scales of mangrove vegetation change., (© 2019 by the Ecological Society of America.)

Global changes, such as increased temperatures and elevated CO2, are driving shifts in plant species distribution and dominance, like woody plant encroachment into grasslands. Local factors within these ecotones can influence the rate of regime shifts. Woody encroachment is occurring worldwide, though there has been limited research within coastal systems, where mangrove (woody shrub/tree) stands are expanding into salt marsh areas. Because coastal systems are exposed to various degrees of nutrient input, we investigated how nutrient enrichment may locally impact mangrove stand expansion and salt marsh displacement over time. We fertilized naturally co-occurring Avicennia germinans (black mangrove) and Spartina alterniflora (smooth cordgrass) stands in Port Aransas, TX, an area experiencing mangrove encroachment within the Northern Gulf of Mexico mangrove-marsh ecotone. After four growing seasons (2010-2013) of continuous fertilization, Avicennia was more positively influenced by nutrient enrichment than Spartina. Most notably, fertilized plots had a higher density of taller (> 0.5 m) mangroves and mangrove maximum height was 46% taller than in control plots. Fertilization may promote an increase in mangrove stand expansion within the mangrove-marsh ecotone by shifting Avicennia height distribution. Avicennia individuals, which reach certain species-specific height thresholds, have reduced negative neighbor effects and have higher resilience to freezing temperatures, which may increase mangrove competitive advantage over marsh grass. Therefore, we propose that nutrient enrichment, which augments mangrove height, could act locally as a positive feedback to mangrove encroachment, by reducing mangrove growth suppression factors, thereby accelerating the rates of increased mangrove coverage and subsequent marsh displacement. Areas within the mangrove-marsh ecotone with high anthropogenic nutrient input may be at increased risk of a regime shift from grass to woody dominated ecosystems.

Introduction: Genetic studies of malocclusion etiology have identified 4 deleterious mutations in genes DUSP6,ARHGAP21, FGF23, and ADAMTS1 in familial Class III cases. Although these variants may have large impacts on Class III phenotypic expression, their low frequency (<1%) makes them unlikely to explain most malocclusions. Thus, much of the genetic variation underlying the dentofacial phenotypic variation associated with malocclusion remains unknown. In this study, we evaluated associations between common genetic variations in craniofacial candidate genes and 3-dimensional dentoalveolar phenotypes in patients with malocclusion., Methods: Pretreatment dental casts or cone-beam computed tomographic images from 300 healthy subjects were digitized with 48 landmarks. The 3-dimensional coordinate data were submitted to a geometric morphometric approach along with principal component analysis to generate continuous phenotypes including symmetric and asymmetric components of dentoalveolar shape variation, fluctuating asymmetry, and size. The subjects were genotyped for 222 single-nucleotide polymorphisms in 82 genes/loci, and phenotpye-genotype associations were tested via multivariate linear regression., Results: Principal component analysis of symmetric variation identified 4 components that explained 68% of the total variance and depicted anteroposterior, vertical, and transverse dentoalveolar discrepancies. Suggestive associations (P < 0.05) were identified with PITX2, SNAI3, 11q22.2-q22.3, 4p16.1, ISL1, and FGF8. Principal component analysis for asymmetric variations identified 4 components that explained 51% of the total variations and captured left-to-right discrepancies resulting in midline deviations, unilateral crossbites, and ectopic eruptions. Suggestive associations were found with TBX1AJUBA, SNAI3SATB2, TP63, and 1p22.1. Fluctuating asymmetry was associated with BMP3 and LATS1. Associations for SATB2 and BMP3 with asymmetric variations remained significant after the Bonferroni correction (P <0.00022). Suggestive associations were found for centroid size, a proxy for dentoalveolar size variation with 4p16.1 and SNAI1., Conclusions: Specific genetic pathways associated with 3-dimensional dentoalveolar phenotypic variation in malocclusions were identified., (Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

Objective: More than 80% of autoimmune disease predominantly affects females, but the mechanism for this female bias is poorly understood. We suspected that an X chromosome dose effect accounts for this, and we undertook this study to test our hypothesis that trisomy X (47,XXX; occurring in ∼1 in 1,000 live female births) would be increased in patients with female-predominant diseases (systemic lupus erythematosus [SLE], primary Sjögren's syndrome [SS], primary biliary cirrhosis, and rheumatoid arthritis [RA]) compared to patients with diseases without female predominance (sarcoidosis) and compared to controls., Methods: All subjects in this study were female. We identified subjects with 47,XXX using aggregate data from single-nucleotide polymorphism arrays, and, when possible, we confirmed the presence of 47,XXX using fluorescence in situ hybridization or quantitative polymerase chain reaction., Results: We found 47,XXX in 7 of 2,826 SLE patients and in 3 of 1,033 SS patients, but in only 2 of 7,074 controls (odds ratio in the SLE and primary SS groups 8.78 [95% confidence interval 1.67-86.79], P = 0.003 and odds ratio 10.29 [95% confidence interval 1.18-123.47], P = 0.02, respectively). One in 404 women with SLE and 1 in 344 women with SS had 47,XXX. There was an excess of 47,XXX among SLE and SS patients., Conclusion: The estimated prevalence of SLE and SS in women with 47,XXX was ∼2.5 and ∼2.9 times higher, respectively, than that in women with 46,XX and ∼25 and ∼41 times higher, respectively, than that in men with 46,XY. No statistically significant increase of 47,XXX was observed in other female-biased diseases (primary biliary cirrhosis or RA), supporting the idea of multiple pathways to sex bias in autoimmunity., (© 2016, American College of Rheumatology.)

Hypnotizability influences the development of false memories. In Experiment 1, participants heard a positive or negative suggestion regarding hypnosis and then listened to 8 Deese-Roediger-McDermott (DRM) false memory paradigm lists in a hypnotic state. Neither hypnosis nor prehypnotic suggestion affected memory. Highly hypnotizable participants were more accurate in recall and recognition. In Experiment 2, suggestions were delivered in the form of feedback. Participants heard a positive or negative suggestion about their performance prior to either the encoding or retrieval of 8 DRM lists. Neither accurate nor false memories were affected by the suggestion. Highly hypnotizable individuals recognized fewer critical lures if they received a negative suggestion about their performance. These results highlight the unusual role of hypnotizability in the creation of false memories.

Hypnotizability is a multifaceted construct that may relate to multiple aspects of personality and beliefs. This study sought to address 4 known correlates of hypnotizability to aid in its understanding. Eighty undergraduates completed the Magical Ideation Scale (MIS), the Creative Experiences Questionnaire (CEQ), the Australian Sheep-Goat Scale (ASGS), and the Dissociative Experiences Scale (DES) and then were administered the Creative Imagination Scale (CIS). All 5 scales were significantly correlated. Participants higher in hypnotizability scored higher on the CEQ and the MIS. The findings demonstrate the influence of fantasy proneness and magical thinking on hypnotizability and support the theory that hypnotizability is a complex interaction of multiple traits.

Health care organizations have long been limited to a small number of major vendors in their selection of an electronic health record (EHR) system in the national and international marketplace. These major EHR vendors have in common base systems that are decades old, are built in antiquated programming languages, use outdated server architecture, and are based on inflexible data models [1,2]. The option to upgrade their technology to keep pace with the power of new web-based architecture, programming tools and cloud servers is not easily undertaken due to large client bases, development costs and risk [3]. This paper presents the decade-long efforts of a large national provider of home health and hospice care to select an EHR product, failing that to build their own and failing that initiative to go back into the market in 2012. The decade time delay had allowed new technologies and more nimble vendors to enter the market. Partnering with a new start-up company doing web and cloud based architecture for the home health and hospice market, made it possible to build, test and implement an operational and point of care system in 264 home health locations across 40 states and three time zones in the United States. This option of "starting over" with the new web and cloud technologies may be posing a next generation of new EHR vendors that retells the Blackberry replacement by iPhone story in healthcare.

Much of what is currently documented in the electronic health record is in response toincreasingly complex and prescriptive medicolegal, reimbursement, and regulatory requirements. These requirements often result in redundant data capture and cumbersome documentation processes. AMIA's 2011 Health Policy Meeting examined key issues in this arena and envisioned changes to help move toward an ideal future state of clinical data capture and documentation. The consensus of the meeting was that, in the move to a technology-enabled healthcare environment, the main purpose of documentation should be to support patient care and improved outcomes for individuals and populations and that documentation for other purposes should be generated as a byproduct of care delivery. This paper summarizes meeting deliberations, and highlights policy recommendations and research priorities. The authors recommend development of a national strategy to review and amend public policies to better support technology-enabled data capture and documentation practices.

Objectives: Since high-throughput screening of compound libraries (virtual or real) against druggable targets is increasingly being used to discover therapies for brain disorders, it is crucial to ascertain if such screening methods adequately explore 'neurotherapeutic space (i.e. the total number of molecules that are or could be neuroactive)'. We present an approach to providing an estimate of the size of neurotherapeutic space., Methods: Molecular modelling and statistical calculations were used to determine the number of molecules, which exist or could exist, with the necessary physicochemical and structural properties to be neurologically active drugs., Key Findings: Assuming eight fundamental types of drug-receptor interactions, five different functional groups per type of interaction and five different molecular platforms for each functional group array, we calculated the total number of molecules that could be contained within a 7 Å radius sphere, used to define neuroactive chemical space. This calculation revealed that there are 6 × 10(15) molecules that could be neurological drugs., Conclusions: Clearly, when it comes to exploring neurochemical space, we are still in our infancy and conventional high-throughput screening provides only a very limited sampling of the neuroactive chemical space that is available to neurotherapeutic compounds., (© 2010 The Authors. JPP © 2010 Royal Pharmaceutical Society of Great Britain.)

Objective: To compare the efficacy of doxycycline plus methotrexate (MTX) versus MTX alone in the treatment of early seropositive rheumatoid arthritis (RA), and to attempt to differentiate the antibacterial and antimetalloproteinase effects of doxycycline., Methods: Sixty-six patients with seropositive RA of <1 year's duration who had not been previously treated with disease-modifying antirheumatic drugs were randomized to receive 100 mg of doxycycline twice daily with MTX (high-dose doxycycline group), 20 mg of doxycycline twice daily with MTX (low-dose doxycycline group), or placebo with MTX (placebo group), in a 2-year double-blind study. Treatment was started with an MTX dosage of 7.5 mg/week, which was titrated every 3 months until remission was reached (maximum dosage of 17.5 mg/week). The primary end point was an American College of Rheumatology 50% improvement (ACR50) response at 2 years., Results: ACR50 responses were observed in 41.6% of patients in the high-dose doxycycline group, 38.9% of those in the low-dose doxycycline group, and 12.5% of patients in the placebo group. Results of chi-square analysis of the ACR50 response in the high-dose doxycycline group versus that in the placebo group were significantly different (P = 0.02). Trend analysis revealed that the ACR20 response and the ACR50 response were significantly different between groups (P = 0.04 and P = 0.03, respectively). MTX doses at 2 years were not different among groups. Four patients in the high-dose doxycycline group, 2 patients in the low-dose doxycycline group, and 2 patients in the placebo group were withdrawn because of toxic reactions., Conclusion: In patients with early seropositive RA, initial therapy with MTX plus doxycycline was superior (based on an ACR50 response) to treatment with MTX alone. The therapeutic responses to low-dose and high-dose doxycycline were similar, suggesting that the antimetalloproteinase effects were more important than the antibacterial effects. Further studies to evaluate the mechanism of action of tetracyclines in RA are indicated.

The rise of evidence-base practice (EBP) as a standard for care delivery is rapidly emerging as a global phenomenon that is transcending political, economic and geographic boundaries. Evidence-based nursing (EBN) addresses the growing body of nursing knowledge supported by different levels of evidence for best practices in nursing care. Across all health care, including nursing, we face the challenge of how to most effectively close the gap between what is known and what is practiced. There is extensive literature on the barriers and difficulties of translating research findings into practical application. While the literature refers to this challenge as the "Bench to Bedside" lag, this paper presents three collaborative strategies that aim to minimize this gap. The Bedside strategy proposes to use the data generated from care delivery and captured in the massive data repositories of electronic health record (EHR) systems as empirical evidence that can be analysed to discover and then inform best practice. In the Classroom strategy, we present a description for how evidence-based nursing knowledge is taught in a baccalaureate nursing program. And finally, the Bench strategy describes applied informatics in converting paper-based EBN protocols into the workflow of clinical information systems. Protocols are translated into reference and executable knowledge with the goal of placing the latest scientific knowledge at the fingertips of front line clinicians. In all three strategies, information technology (IT) is presented as the underlying tool that makes this rapid translation of nursing knowledge into practice and education feasible.

After September 11, 2001, we distributed flashbulb memory questionnaires at 5 different dates: within 48 hr (T1) and at 1 week (T2), 1 month (T3), 3 months (T4), and 1 year (T5). We scored responses for self-reported memory (veracity unverified), memory accuracy (recollection-matched T1 response), and memory consistency (recollection-matched prior responses other than T1). Self-reported memory and subjective confidence remained near ceiling, although the accuracy declined. However, memories given a week or more after September 11 were consistent throughout. We hypothesize that flashbulb memories follow a consolidation-like process: Some details learned later are incorporated into the initial memory, and many others are discarded. After this process, memories stabilize. Therefore, the best predictor of flashbulb memories at long intervals is not the memory as initially reported but memories reported a week or more after the event.

The transfer-appropriate monitoring (TAM) hypothesis of metamemory predicts that judgment of learning (JOL) accuracy should improve when conditions during JOLs closely match conditions of the memory test. The authors devised 5 types of delayed JOLs for paired associates and varied them along with the type of memory test (cued recall or recognition). If the TAM hypothesis is correct, JOL and test type should interact to influence metamemory. Contrary to TAM, metamemory accuracy did not improve when JOL and test conditions matched but instead tended to vary according to whether the answer was apparent at time of JOL. Memory test scores and JOL magnitude were both greater when the correct target was evident during JOLs. Overall, the results are largely consistent with a monitoring retrieval view of delayed JOLs and do not support TAM as a viable account of JOL accuracy., (((c) 2003 APA, all rights reserved))

Executive positions in corporate America offer nurse leaders the opportunity to influence product development and services delivered to ensure that the best possible solutions are provided to health care organizations, providers, and patients. This opportunity to "make a difference" is a critical component for nurses' attraction to migrating to the business side of the health care industry. However, making the transition from leadership positions in health care delivery organizations to corporate businesses carries big challenges. A major demand is for nurse leaders to adjust from direct span of control organizational models to matrix management structures used in complex business organizations.

The fibroblast growth factor-receptor 3 (FGFR3) Lys650 codon is located within a critical region of the tyrosine kinase-domain activation loop. Two missense mutations in this codon are known to result in strong constitutive activation of the FGFR3 tyrosine kinase and cause three different skeletal dysplasia syndromes-thanatophoric dysplasia type II (TD2) (A1948G [Lys650Glu]) and SADDAN (severe achondroplasia with developmental delay and acanthosis nigricans) syndrome and thanatophoric dysplasia type I (TD1) (both due to A1949T [Lys650Met]). Other mutations within the FGFR3 tyrosine kinase domain (e.g., C1620A or C1620G [both resulting in Asn540Lys]) are known to cause hypochondroplasia, a relatively common but milder skeletal dysplasia. In 90 individuals with suspected clinical diagnoses of hypochondroplasia who do not have Asn540Lys mutations, we screened for mutations, in FGFR3 exon 15, that would disrupt a unique BbsI restriction site that includes the Lys650 codon. We report here the discovery of three novel mutations (G1950T and G1950C [both resulting in Lys650Asn] and A1948C [Lys650Gln]) occurring in six individuals from five families. Several physical and radiological features of these individuals were significantly milder than those in individuals with the Asn540Lys mutations. The Lys650Asn/Gln mutations result in constitutive activation of the FGFR3 tyrosine kinase but to a lesser degree than that observed with the Lys540Glu and Lys650Met mutations. These results demonstrate that different amino acid substitutions at the FGFR3 Lys650 codon can result in several different skeletal dysplasia phenotypes.

Schizochytrium sp. is an algae-like microorganism utilized for commercial production of docosahexaenoic acid (DHA)-rich oil and dried microalgae for use as a source of DHA in foods, feeds, and nutritional supplements. Electron microscopic analysis of whole cells of Schizochytrium sp. employing sample preparation by high-pressure freeze substitution suggests the presence of secondary and tertiary semicrystalline structures of triacylglycerols within the oil bodies in Schizochytrium sp. A fine secondary structure consisting of alternating light- and dark-staining bands was observed inside the oil bodies. Dark bands were 29 +/- 1 A in width, and light bands were 22 +/- 1 A in width. The tertiary (three-dimensional) structure may be a multilayered ribbon-like structure which appears coiled and interlaced within the oil body. In freeze-fracture photomicrographs, Schizochytrium oil bodies exhibited fracture planes with terraces averaging 52 +/- 7 A in height which could correspond to the combined width of two halves of two light bands and one dark band observed in the high-pressure freeze substitution photomicrographs. The results suggest that triacylglycerols within Schizochytrium sp. oil bodies may be organized in a triple chain-length structure. High-pressure freeze substitution electron micrographs of two other highly unsaturated oil-producing species of microalgae, Thraustochytrium sp. and Isochrysis galbana, also revealed this fine structure, whereas microalgae containing a higher proportion of saturated oil did not. The results suggest that the staining pattern is not an artifact of preparation and that the triple chain-length conformation of triacylglycerols in Schizochytrium sp. oil bodies may be caused by the unique fatty acid composition of the triacylglycerols.

A urease-deficient derivative of Streptococcus salivarius 57.I was constructed by allelic exchange at the ureC locus. The wild-type strain was protected against acid killing through hydrolysis of physiologically relevant concentrations of urea, whereas the mutant was not. Also, S. salivarius could use urea as a source of nitrogen for growth exclusively through a urease-dependent pathway.

The urease genes of Streptococcus salivarius 57.1 are tightly repressed in cells growing at neutral pH. When cells are cultivated at acidic pH values, the urease genes become derepressed and transcription is enhanced when cells are growing under carbohydrate-excess conditions. Previously, the authors proposed that the bacterial sugar:phosphotransferase system (PTS) modulated the DNA-binding activity by phosphorylation of the urease repressor when carbohydrate was limiting. The purpose of this study was to assess whether enzyme I (EI) of the PTS could be involved in modulating urease expression in response to carbohydrate availability. An EI-deficient strain (ptsI18-3) of S. salivarius 57.1 was constructed by insertional inactivation of the ptsI gene. The mutant had no measurable PTS activity and lacked EI, as assessed by Western analysis. The mutant grew as well as the wild-type strain on the non-PTS sugar lactose, and grew better than the parent when another non-PTS sugar, galactose, was the sole carbohydrate. The mutant was able to grow with glucose as the sole carbohydrate, but displayed a 24 h lag time and had a generation time some threefold longer than strain 57.1. The mean OD600 attained after 48 h by ptsI18-3 supplied with fructose was 0.16, with no additional growth observed even after 3 d. Urease expression in the wild-type and mutant strains was assessed in continuous chemostat culture. Repression of urease at neutral pH was seen in both strains under all conditions tested. Growth of wild-type cells on limiting concentrations of lactose resulted in very low levels of urease expression compared with growth on PTS sugars. In contrast, under similar conditions, urease expression in ptsI18-3 was restored to levels seen in the parent growing on PTS sugars. Growth under conditions of lactose excess resulted in further derepression of urease, but ptsI18-3 expressed about threefold higher urease activity than 57.1. The results support a role for EI in urease regulation, but also indicate that additional factors may be important in regulating urease gene expression.

The Streptococcus salivarius 57.I ure cluster was organized as an operon, beginning with ureI, followed by ureABC (structural genes) and ureEFGD (accessory genes). Northern analyses revealed transcripts encompassing structural genes and transcripts containing the entire operon. A sigma70-like promoter could be mapped 5' to ureI (PureI) by primer extension analysis. The intensity of the signal increased when cells were grown at an acidic pH and was further enhanced by excess carbohydrate. To determine the function(s) of two inverted repeats located 5' to PureI, transcriptional fusions of the full-length promoter region (PureI), or a deletion derivative (PureIDelta100), and a promoterless chloramphenicol acetyltransferase (CAT) gene were constructed and integrated into the chromosome to generate strains PureICAT and PureIDelta100CAT, respectively. CAT specific activities of PureICAT were repressed at pH 7.0 and induced at pH 5.5 and by excess carbohydrate. In PureIDelta100CAT, CAT activity was 60-fold higher than in PureICAT at pH 7.0 and pH induction was nearly eliminated, indicating that expression was negatively regulated. Thus, it was concluded that PureI was the predominant, regulated promoter and that regulation was governed by a mechanism differing markedly from other known mechanisms for bacterial urease expression.

Judgments of learning (JOLs) made after a 5-min delay are almost perfectly accurate: the "delayed-JOL effect" (T. O. Nelson & J. Dunlosky, 1991). The mechanisms underlying this phenomenon have been the subject of debate. This study examined the effects of delays and short-term memory (STM) distraction on memory and metamemory (JOLs). STM distraction (2.5-30 s) immediately following encoding increased both JOL accuracy and mean cued recall. However, JOLs made after longer delays (4-5 min) were even more accurate. In addition, making a JOL at longer delays improved cued-recall performance. Conditional probabilities of cued recall (given successful initial retrieval) also increased over time and with interference, indicating that delayed JOLs may alter what they assess. Finally, increased confidence was associated with shorter JOL latencies only at delays. The results are consistent with an accessibility view of metamemory (e.g., A. Koriat, 1993).

Eyewitness memory is often distorted when misleading information is presented to subjects after encoding. Three experiments explored ways to overcome these misinformation effects. In Experiment 1, subjects viewed slides of a robbery, at a rate of four or seven seconds per slide. Five minutes later subjects were given a recognition test with few (1-3) or numerous (6-13) event cues. Providing numerous retrieval cues improved overall performance, but did not reduce the effects of misinformation. With week-long delays (Experiment 2) numerous retrieval cues did eliminate misinformation effects, but only when subjects viewed slides at the slower rate (seven seconds per slide). Experiment 3 essentially replicated this pattern, using a modified test to eliminate any biasing effects of distractors. Given adequate encoding and numerous retrieval cues, misinformation effects were eliminated, suggesting that under some conditions misinformation makes event memory inaccessible, but not unavailable.

The effect of text difficulty on metamemory for narrative and expository text was investigated. In Experiment 1, we found an interaction between type of text and type of question (thematic or detailed). For readers of narrative texts, correlations between predicted and actual performance were highest for detailed questions, but this pattern was reversed for readers of expository texts. Next, text difficulty was explored as a possible factor affecting metamemory accuracy. In Experiments 2 and 3, metamemory accuracy was a nonmonotonic function of text difficulty. Subjects made remarkably accurate predictions of future performance (mean G > .6) for both narrative and expository texts that were of intermediate difficulty (approximately a 12th-grade reading level). We propose an optimum effort hypothesis, predicting greatest metamemory accuracy when the texts are of intermediate difficulty.

As part of its trophic action to maintain the steroidogenic capacity of adrenocortical cells, corticotropin (ACTH) increases the transcription of the cytochrome P-450 steroid hydroxylase genes, including the gene encoding steroid 21-hydroxylase (21-OHase). We previously identified several promoter elements that regulate 21-OHase gene expression in mouse Y1 adrenocortical tumor cells. One of these elements, located at nucleotide -65, closely resembles the recognition sequence of the orphan nuclear receptor NGFI-B, suggesting that NGFI-B regulates this essential steroidogenic enzyme. To explore this possibility, we first used in situ hybridization to demonstrate high levels of NGFI-B transcripts in the adrenal cortex of the adult rat. In cultured mouse Y1 adrenocortical cells, treatment with ACTH, the major regulator of 21-OHase transcription, rapidly increased NGFI-B expression. Gel mobility shift and DNase I footprinting experiments showed that recombinantly expressed NGFI-B interacts specifically with the 21-OHase -65 element and identified one complex formed by Y1 extracts and the 21-OHase -65 element that contains NGFI-B. Expression of NGFI-B significantly augmented the activity of the intact 21-OHase promoter, while mutations of the -65 element that abolish NGFI-B binding markedly diminished NGFI-B-mediated transcriptional activation. Specific mutations of NGFI-B shown previously to impair either DNA binding or transcriptional activation diminished the effect of NGFI-B coexpression on 21-OHase expression. Finally, an oligonucleotide containing the NGFI-B response element conferred ACTH response to a core promoter from the prolactin gene, showing that this element is sufficient for ACTH induction. Collectively, these results identify a cellular promoter element that is regulated by NGFI-B and implicate NGFI-B in the transcriptional induction of 21-OHase by ACTH.

NGFI-B is an early response gene which encodes a protein that has strong homology with nuclear receptors in the DNA binding domain and in carboxyl-terminal domains responsible for ligand binding and regulation of transcriptional activity. Previously, we have demonstrated that NGFI-B is transcriptionally active in cells grown in vitro in the absence of exogenously added ligand. However, the ligand for NGFI-B does not appear to be a component of cell culture medium, as NGFI-B remained active when expressed in cells grown in medium lacking phenol red, serum, essential vitamins, or essential amino acids. To define the transactivation domains, a mutational analysis was conducted which revealed that a serine/threonine-rich area of 18 amino acids within the amino terminus, termed TAB-1, is an important transcriptional activation domain. The mutation of two adjacent serine and threonine residues within TAB-1 significantly decreased transactivation by NGFI-B. An examination of the role of the carboxyl terminus in regulating NGFI-B transcriptional activity revealed that, in accordance with other nuclear receptors, mutants lacking portions of the carboxyl terminus had greatly decreased activity. The similarity with other receptors was further supported by studies with the mutant B delta 414-597 which encodes a fully active, truncated receptor analogous to a hormone-independent, constitutively active glucocorticoid receptor truncation mutant. This NGFI-B truncation mutant had activity similar to wild type NGFI-B in a number of mammalian cell lines; however, in contrast, it was 8-fold more active than the wild type receptor in the Drosophila S2 cell line, suggesting that insect cells either lack the NGFI-B ligand or obligatory accessory factors.

The antiphospholipid antibody syndrome (APLAS) is a unique clinical syndrome with features of recurrent thrombosis, recurrent fetal loss, and thrombocytopenia. It is associated with a false positive test for syphilis, a prolonged partial thromboplastin time (PTT), a positive test for lupus anticoagulant (LA), and anticardiolipin antibodies (ACLA). A case report illustrating some of the clinical and laboratory abnormalities and therapeutic dilemmas is presented. The literature is then reviewed.