The repeatability of vegetation classification and mapping.

The mapping of habitats as defined by plant communities is a common component of the planning and monitoring of conservation management. However, there are major concerns about the subjectivity and risk of observer bias in most commonly used plant community mapping protocols. This study provides the first test of the consistency of habitat maps based on the mapping units defined by the National Vegetation Classification (NVC), the most widely used classification of plant communities used for habitat mapping on conservation sites in the UK. Seven surveyors mapped the same upland site within five weeks in summer 2008 and the spatial correspondence of the resulting maps was assessed. The NVC is a hierarchical classification and pair-wise spatial agreement between maps decreased with lower levels of sub-classification. The average area of agreement between maps was 77.6% at the habitat level, 34.2% at the community level and 18.5% at the sub-community level. Spatial disparity in the location of mapped boundaries between vegetation types only made a small contribution to overall differences; the majority of variation between maps was due to discrepancies in classification, with vegetation types containing similar species composition most often confused. Factors relating to surveyor effort (cost, time taken and length of route) were not able to explain the substantial differences between maps. However, the methods used to assign areas to vegetation type did seem to have an effect, with surveyors who relied primarily on their own experience having the highest levels of mean agreement with other maps. The study raises serious concerns with current practice of using the NVC for site description and monitoring/surveillance. Since this is just a single case study, we recommend that further work is carried out with the aim of determining the degree and source of variation between surveyors and how consistency can be increased.

Development of a new peptide-bead coupling method for an all peptide-based Luminex multiplexing assay for detection of Plasmodium falciparum antibody responses.

Using a recombinant protein antigen for antibody testing shows a sum of antibody responses to multiple different immune epitopes existing in the protein antigen. In contrast, the antibody testing to an immunogenic peptide epitope reflects a singular antibody response to the individual peptide epitope. Therefore, using a panel of peptide epitopes provides an advantage for profiling multiple singular antibody responses with potential to estimate recent malaria exposure in human infections. However, transitioning from malaria immune epitope peptide-based ELISA to an all peptide bead-based multiplex Luminex assay presents some challenges including variation in the ability of different peptides to bind beads. The aim of this study was to develop a peptide coupling method while demonstrating the utility of these peptide epitopes from multiple stage antigens of Plasmodium falciparum for measuring antibodies. Successful coupling of peptide epitopes to beads followed three steps: 1) development of a peptide tag appended to the C-terminus of each peptide epitope consisting of beta-alanine-lysine (x 4)--cysteine, 2) bead modification with a high concentration of adipic acid dihydrazide, and 3) use of the peptide epitope as a blocker in place of the traditional choice, bovine serum albumin (BSA). This new method was used to couple 12 peptide epitopes from multiple stage specific antigens of P. falciparum, 1 Anopheles mosquito salivary gland peptide, and 1 Epstein-Barr virus peptide as an assay control. The new method was applied to testing of IgG in pooled samples from 30 individuals with previously repeated malaria exposure in western Kenya and IgM and IgG in samples from 37 U.S. travelers with recent exposure to malaria. The new peptide-bead coupling method and subsequent multiplex Luminex assay showed reliable detection of IgG to all 14 peptides in Kenyan samples. Among 37 samples from U.S. travelers recently diagnosed with malaria, IgM and IgG to the peptide epitopes were detected with high sensitivity and variation. Overall, the U.S. travelers had a much lower positivity rates of IgM than IgG to different peptide epitopes, ranging from a high of 62.2% positive for one epitope to a low of only 5.4% positive for another epitope. In contrast, the travelers had IgG positive rates from 97.3% to 91.9% to various peptide epitopes. Based on the different distribution in IgM and IgG positivity to overall number of peptide epitopes and to the number of pre-erythrocytic, erythrocytic, gametocytic, and salivary stage epitopes at the individual level, four distinct patterns of IgM and IgG responses among the 37 samples from US travelers were observed. Independent peptide-bead coupling and antibody level readout between two different instruments also showed comparable results. Overall, this new coupling method resolves the peptide-bead coupling challenge, is reproducible, and can be applied to any other immunogenic peptide epitopes. The resulting all peptide bead-based multiplex Luminex assay can be expanded to include other peptide epitopes of P. falciparum, different malaria species, or other diseases for surveillance, either in US travelers or endemic areas.

Sister chromatid exchange and cell cycle progression in cultured lymphocytes from patients with chronic lymphatic leukemia.

Sister chromatid exchange (SCE) was significantly increased in patients who had chronic lymphatic leukemia (CLL) and who had received therapy compared with untreated patients and normal controls. Elevated SCE appeared to be a function of the therapy and not the leukemia. Differential chromatid staining was used to identify successive cell reproduction cycles. In comparison to normal lymphocytes, the cells responding to phytohemagglutinin in CLL cultures showed no evidence of retarded progression through successive cell cycles.

Relationships between morbidity and development in mildly to moderately malnourished Kenyan toddlers.

This study explored the extent to which morbidity in 110 mildly to moderately malnourished Kenyan toddlers was associated with developmental outcomes. Morbidity information was collected from the 18th to 30th months. Concurrent assessments of vocalization, play, and performance on the Bayley scales were obtained. At 5 years, a follow-up battery of cognitive tests was administered. Female toddlers who suffered more illness generally performed less well on developmental measures than their healthier female peers. These children vocalized and played less and performed less well on the Bayley Mental scales at 30 months and on the cognitive battery at 5 years. For the boys, development was largely independent of morbidity. Morbidity was related to patterns of care giving for both boys and girls, but it was not associated with socioeconomic status or food intake. However, girls who were ill more often were shorter and lighter. Relations between morbidity and development in the girls remained statistically significant when other variables, which were also related to development (such as care giving, socioeconomic status, parental IQ and literacy, food intake, and anthropometry) were considered. This suggests that morbidity, in these female toddlers, had an effect on development above and beyond other variables typically associated with malnutrition.

The acuity card procedure: a rapid test of infant acuity.

Forced-choice preferential looking (FPL) and operant preferential looking (OPL) procedures for testing infant acuity typically require 15-45 min to derive an acuity estimate. This article presents a new acuity assessment technique ("acuity cards") that combines FPL/OPL stimuli with an observer's subjective assessment of an infant's looking behavior. The infant is shown a series of gray cards that contain grating targets of various spatial frequencies. An observer watches the eye movement patterns and behavior of the infant and judges whether the infant can or cannot see the grating on each card in the series. Acuity is estimated as the highest spatial frequency that the observer judges the infant to be able to see. With this technique, the binocular acuity of normal infants can be estimated with reasonable accuracy in the laboratory setting in 3-5 min.

Assessment of visual acuity in toddlers.

Visual acuity in children 15 to 35 months of age is particularly difficult to measure. Children in this age range become bored with methods used for assessment of infants, but they are often not capable of responding to the tests used with older children and adults. Partially because of these difficulties, there is no widely preferred standard test of visual acuity for the 15 to 35 month age range. Instead, a variety of behavioral techniques have been used, with varying degrees of success. These techniques will be described and evaluated with regard to adequacy of norms, percent testable rates, test times, accuracy and similarity to adult standards of visual acuity assessment. Practical suggestions regarding the use of existing techniques and the development of new visual acuity assessment techniques for 15- to 35-month-olds will be given.

Tritan discriminations by 1- and 2-month-old human infants.

The capacity of 1- and 2-month-old infants to make a tritan discrimination between a 4 degree, 416 nm test field and a 547 nm surround was tested by means of the forced-choice preferential looking technique. Most of the 2-month-olds and the other 1-month-olds made the tritan discrimination and must therefore have functional SWS cones. Most of the youngest 1-month-olds failed to make the tritan discrimination and therefore either do not encode or do not preserve the information ordinarily encoded by SWS cones. The implications of these data and the prior data of Hamer et al. [Vision Res. 22, 575-587 (1982)] are discussed in relation to color theory.

Unreliability of standard quantitative criteria in diagnostic peritoneal lavage performed for suspected penetrating abdominal stab wounds.

Thirty-five patients with abdominal stab wounds in whom clinical examination was equivocal on 2 separate occasions underwent diagnostic peritoneal lavage (DPL) prior to laparotomy. The red and white blood cell counts (cells/mm3) of the lavage effluent were compared with the operative findings. There were 26 positive and 9 unnecessary laparotomies, the latter consisting of 4 negative and 5 non-therapeutic operations. Use of the standard quantitative criteria for red cells in DPL failed to identify significant injury in eight patients (31%), while the standard white cell count missed six injuries (23%). Their combined use resulted in three missed injuries (12%). Two false-positive results occurred using the red cell count alone and four using the white cell count alone, producing a combined false-positive result in four patients (11%). Reducing the cell threshold level to exclude missed injuries would increase dramatically the rate of unnecessary laparotomies. Although the standard quantitative criteria for DPL are superior to clinical assessment in patients with equivocal findings, their use in penetrating trauma does not achieve the same diagnostic accuracy as in blunt abdominal trauma.

When is sex safe? Insiders' views on sexually transmitted disease prevention and treatment.

STD prevention programs promote practices and messages that are presumed to fit with most conditions of U.S. communities. Yet, the social and cultural contexts for low-income ethnic communities may frame STD prevention differently, so that people calculate their risk and take actions based on what they have learned through their own observations and life experiences. To understand how people at high risk for STDs make decisions and take actions to protect themselves from these diseases, the authors conducted 38 ethnographic interviews with individuals living in arural community in the South. Practices they reported include selecting "safe" partners on the basis of appearance, familiarity, or church attendance; washing before and after sex to prevent infection; self-treatment with antibiotics obtained without a prescription; and visiting the clinic frequently for checkups for asymptomatic infections. The authors compare and contrast their worldview with the public health concepts of primary and secondary STD prevention.

Intelligence and behavior problems in 5-year-olds in relation to representational abilities in the second year of life.

Assessments of sensorimotor skill, play, language, and developmental level were administered to 20 preterm and 20 full-term infants during sessions at 13 1/2 and 22 months of age. At 5-year follow-up, children were tested with the Wechsler Preschool and Primary Scale of Intelligence (WIPPSI) and the Developmental Test of Visual-Motor Integration (VMI). Behavior problems were also assessed. At 5 years, the preterm sample showed slight delays in cognitive functioning. Measures of development and language at 13 1/2 and 22 months and relational play at 22 months were most predictive of cognitive outcome. Children with behavior problems at 5 years differed from those without problems in terms of their play and language skills. These data suggest that measures of development, particularly language development, and of play are predictive of later cognitive and behavioral functioning.

Medical illness in school-age Kenyans in relation to nutrition, cognition, and playground behaviors.

Because medical illness is associated with malnutrition, it might contribute to the poor outcomes seen in malnourished children. This study explored relations between frequency of mild illness and development in 133 mild-to-moderately malnourished school-age Kenyan children. Morbidity information was collected for one year. Concurrent assessments of cognitive status and playground behaviors were obtained. Nutritional and environmental variables were also assessed. Girls with more reported days of mild illness performed less well on developmental measures than did their healthier female peers. They were less cognitively advanced, and, on the playground, girls with more mild illness were less active, happy, and social. Furthermore, relations between frequency of mild illness and playground behaviors (but not cognitive score) in the girls remained statistically significant when other variables, such as socioeconomic status, parental literacy, food intake, and anthropometry, were considered. For the boys, frequency of mild illness was not related to cognition or play behaviors.

Male student-athletes and violence against women: a survey of campus judicial affairs offices.

PIP: This study examines the institutional dimensions of violence against women through an analysis of officially reported incidents of violence against women. The data included records from 10 judicial affairs offices over a 3-year period from 1991-93. The findings reveal that male college student-athletes, compared to the rest of the male student population, are responsible for more than their share of the reported battering and sexual assault complaints to judicial affairs offices on the campuses of 10 Division I institutions. However, it needs to be emphasized that it is uncertain whether the association between athletic affiliation and violence against women is casual or the result of behavior only indirectly related to sport. These findings relate to other research because they are based on official reports and they strengthen previous works on athletes and violence against women that center on single institutions.^ieng

Diaphragmatic disruption in blunt trauma.

A patient group, which has sustained blunt abdominal injury in a predominantly non-driver-related manner, was reviewed. The incidence of diaphragmatic rupture was half that expected from other reported series. It is concluded that the mechanism for diaphragm rupture is related to forces produced in front-seat passengers during motor vehicle accidents.

How to keep scuba diving safe.

As scuba diving grows in popularity, divers must know the safety factors involved. For example, they need to know their abilities and how to dive within those limits, how to react to emergency situations, and how to prevent and treat common medical conditions. Below are clear answers to common questions.

Sirolimus is associated with impaired hematopoiesis in heart transplant patients? A retrospective analysis.

BACKGROUND: Proliferation signal inhibitors may adversely impact bone marrow function. We sought to describe the impact of sirolimus on hemoglobin and erythropoiesis in heart transplant recipients. METHODS: We have conducted a single-center, retrospective analysis of all heart transplant patients treated with sirolimus. We measured serum hemoglobin (Hb) at baseline and at 3 months to determine the prevalence of anemia and change in Hb after sirolimus initiation. We also characterized hematologic profile of patients to gain insights into the effects of sirolimus on erythropoiesis. RESULTS: There were 84 patients included in the study. The prevalence of anemia increased from 71% to 75% after sirolimus initiation. Anemic patients were more likely to be male (P = .026) and have worse renal function (glomerular filtration rate 49 ± 27 vs 70 ± 42 mL/min; P = .012). A ≥20 g/L drop in Hb was observed in 25% of the overall cohort. Patients investigated for anemia (n = 67) had a low Hb (111 ± 24 g/L), normal mean corpuscular volume (87 ± 47 FL), and low serum iron levels (10 ± 5 µmol/L) and transferrin saturation (0.22 ± 0.12). Serum ferritin was variable (263 ± 370 µg/L). Bone marrow evaluation in 19 patients revealed adequate marrow iron stores in all cases. CONCLUSION: Anemia is prevalent in heart transplant patients treated with sirolimus and increases over time. Patients have a characteristic hematologic profile suggestive of anemia of chronic disease and functional iron deficiency.

Are we failing vulnerable workers? The case of black women in poultry processing in rural North Carolina.

In 1989, North Carolina Occupational Safety and Health Administration (OSHA) inspectors cited two poultry processing plants in northeastern North Carolina for serious repetitive motion problems. In 1990, investigators from the National Institute for Occupational Safety and Health confirmed significant upper extremity musculoskeletal symptoms and disorders among workers. We now report on analyses of baseline data collected from a cohort of women employed in one of these plants. The plant, which is the largest employer of women in the area, is located in a sparsely populated area with a black majority where nearly one-third of the population lives below the poverty level. Conditions we report suggest failure of existing health and safety systems, both regulatory and consultative, to prevent morbidity among vulnerable women in this industry, as well as social and economic conditions that influence availability of work and use of benefits to which they are entitled.

Evaluation of diagnostic peritoneal lavage in suspected penetrating abdominal stab wounds using a dipstick technique.

The total protein content (g/l) and white blood cell count (cells/mm3) diagnostic peritoneal lavage was assessed using a urine dipstick in 46 patients with suspected penetrating abdominal stab wounds and equivocal physical examination. Those patients with a protein content greater than or equal to 1 g/l and white blood cell count of greater than 500 cells/mm3 were submitted to laparotomy while those with lower values underwent observation and repeat physical examination. In all, 26 patients had a positive lavage and significant injuries were found in 23 of these. Of 18 patients with a negative lavage, 17 were managed successfully without operation while one patient died from complications related to central venous catheterization. In two patients the lavage results were equivocal. One underwent a negative laparotomy and the remaining patient recovered uneventfully. The test has a 100 per cent sensitivity and 86 per cent specificity and provides an accurate, cheap, and rapid means of diagnosis of intra-abdominal injury in penetrating trauma.

Protein electrophoresis of diagnostic peritoneal lavage in penetrating abdominal trauma: a marker of significant injury.

Protein electrophoresis of diagnostic peritoneal lavage fluid has been shown in experimental work to be a marker of hollow viscus injury. In order to ascertain the value of this investigation in penetrating abdominal trauma, we conducted a prospective study, over a 4-month period, involving 35 patients with stab wounds to the abdomen whose initial clinical examination was equivocal. The results of electrophoresis were compared with the standard quantitative criteria for diagnostic lavage and the operative findings. Protein electrophoresis was found to be a more sensitive and specific marker of significant intra-abdominal injury than the standard quantitative criteria.

Psychometric scatter in retarded, autistic preschoolers as measured by the Cattell.

To determine whether psychometric scatter is characteristic of the developmental profile of young autistic children, the performance of 38 autistic children, as measured by the Cattell, was compared with the performance of MA matched samples of normal, Down's Syndrome and non-Down's Syndrome children with mental retardation. Results indicated significantly more psychometric scatter in the autistic group than in the other groups. Similarly, 66% of the autistic children vs 13, 26 and 32% of the normal, Down's and non-Down's samples, respectively, had significant scatter. Further analyses revealed that autistic children showed consistent relative strength in non-language and weakness in language.