Defining in Detail and Evaluating Reliability of DSM-5 Criteria for Autism Spectrum Disorder (ASD) Among Children.

This paper describes a process to define a comprehensive list of exemplars for seven core Diagnostic and Statistical Manual (DSM) diagnostic criteria for autism spectrum disorder (ASD), and report on interrater reliability in applying these exemplars to determine ASD case classification. Clinicians completed an iterative process to map specific exemplars from the CDC Autism and Developmental Disabilities Monitoring (ADDM) Network criteria for ASD surveillance, DSM-5 text, and diagnostic assessments to each of the core DSM-5 ASD criteria. Clinicians applied the diagnostic exemplars to child behavioral descriptions in existing evaluation records to establish initial reliability standards and then for blinded clinician review in one site (phase 1) and for two ADDM Network surveillance years (phase 2). Interrater reliability for each of the DSM-5 diagnostic categories and overall ASD classification was high (defined as very good .60-.79 to excellent ≥ .80 Kappa values) across sex, race/ethnicity, and cognitive levels for both phases. Classification of DSM-5 ASD by mapping specific exemplars from evaluation records by a diverse group of clinician raters is feasible and reliable. This framework provides confidence in the consistency of prevalence classifications of ASD and may be further applied to improve consistency of ASD diagnoses in clinical settings.

Ureaplasma diversum in bull semen in Australia: its detection and potential effects.

BACKGROUND: The primary objective of this study was to confirm the infection status of Ureaplasma diversum in Australian bulls and to identify morphological changes of sperm from U. diversum-positive bulls. METHODS: Fresh semen samples were taken from 29 sexually active beef bulls from suspect herds in the Riverina/Upper Murray region. U. diversum was identified using PCR analyses and culture of the organism. RESULTS: Nine of the bulls were PCR-positive for U. diversum but none of these had genital lesions. Sperm from infected bulls showed increased incidence of abnormal tails (bent and coiled), as well as surface abnormalities (i.e. small protuberances or lumps). CONCLUSIONS: The results suggest impairment of sperm function and possibly fertility. Further investigations into the potential role of U. diversum as a pathogen for Australian cattle are warranted.

European survey on efficacy and safety of duty-cycled radiofrequency ablation for atrial fibrillation.

AIMS: Duty-cycled radiofrequency ablation (RFA) has been used for atrial fibrillation (AF) for around 5 years, but large-scale data are scarce. The purpose of this survey was to report the outcome of the technique. METHODS AND RESULTS: A survey was conducted among 20 centres from seven European countries including 2748 patients (2128 with paroxysmal and 620 with persistent AF). In paroxysmal AF an overall success rate of 82% [median 80%, interquartile range (IQR) 74-90%], a first procedure success rate of 72% [median 74% (IQR 59-83%)], and a success of antiarrhythmic medication of 59% [median 60% (IQR 39-72%)] was reported. In persistent AF, success rates were significantly lower with 70% [median 74% (IQR 60-92%)]; P = 0.05) as well as the first procedure success rate of 58% [median 55% (IQR 47-81%)]; P = 0.001). The overall success rate was similar among higher and lower volume centres and were not dependent on the duration of experience with duty-cycled RFA (r = -0.08, P = 0.72). Complications were observed in 108 (3.9%) patients, including 31 (1.1%) with symptomatic transient ischaemic attack or stroke, which had the same incidence in paroxysmal and persistent AF (1.1 vs. 1.1%) and was unrelated to the case load (r = 0.24, P = 0.15), bridging anticoagulation to low molecular heparin, routine administration of heparin over the long sheath, whether a transoesophageal echocardiogram was performed in every patient or not and average procedure times. CONCLUSION: Duty-cycled RFA has a self-reported success and complication rate similar to conventional RFA. After technical modifications a prospective registry with controlled data monitoring should be conducted to assess outcome.

Softening of cattle hoof soles and swelling of heel horn by environmental agents.

Bovine soles and shavings from the heel were used in laboratory tests that examined the softening and swelling effects of rainwater, cow slurry (faeces plus urine), urine, silage effluent, and washings from recently laid concrete. Formalin, glutaraldehyde and butyraldehyde were compared for their ability to prevent softening induced by water, urine or urea plus 2-mercaptoethanol. Exposure to rainwater, slurry or urine for 72 h softened the soles on average by 16, 13 and 14 Shore Durometer Units. Silage effluent had less softening effect on soles (7 Shore Durometer Units), and pre-treating heel shavings with silage effluent reversed the swelling effect of water. Washings and scrapings taken from 3- and 7-d-old concrete surfaces prepared from Portland cement, caused swelling in heel shavings by a factor of 1.5 and 1.3. Formaldehyde, glutaraldehyde and butyraldehyde pre-treatment reduced the sole softening effect of urea plus 2-mercaptoethanol in cow soles. Formaldehyde and glutaraldehyde pre-treatment reduced the sole softening effect of urine, and formaldehyde was effective at reducing concrete washings-induced swelling. The findings are relevant to solar bruising and ulceration in cattle.

Microbial detection.

There is a widespread need for commercial instrumentation for the rapid and inexpensive detection of microbial contamination of food, industrial waste water and clinical samples. A large number of detection methods have been developed utilizing the optical, electrochemical, biochemical and physical properties of microorganisms. The need for a device which can produce a rapid, accurate, sensitive, real-time analysis for clinical, industrial and environmental applications has led to considerable progress being achieved in recent years in the development of biosensors for microbial detection. This intense research has resulted in the commercialization of several instruments. Techniques used for the quantification of microorganisms are reviewed under the general categories of non-bioelectrochemical and bioelectrochemical methods.

Irritable bowel syndrome: relationship of disorders in the transit of a single solid meal to symptom patterns.

The time taken for a solid meal to pass through the stomach, small intestine, and colon was measured in 61 patients with irritable bowel syndrome, subdivided according to their presenting symptoms, and in 53 healthy volunteers. Small bowel transit times were significantly shorter in patients who complained predominantly of diarrhoea (3.3 +/- 0.3 vs 4.2 +/- 0.2 h; p = 0.01; n = 21) and significantly longer in patients who complained predominantly of constipation (5.4 +/- 0.3 vs 4.2 +/- 0.2 h; p less than 0.01; n = 23) or pain and distension (5.4 +/- 0.4 vs 4.2 +/- 0.2 h; p less than 0.01; n = 17) compared with controls. Whole gut transit times were shorter in patients who complained of diarrhoea (35 +/- 5 vs 53 +/- 4 h; p less than 0.01), and longer in patients with constipation (87 +/- 13 vs 53 +/- 4 h; p less than 0.05) compared with controls. No significant differences in gastric emptying rates were shown between any of the patient groups and normal controls. Thirty-four patients reported pain, particularly in the right iliac fossa, during the meal transit test, and in 25 of these (74%), the onset of the pain was associated with the arrival of residues of the test meal in the caecum. Our results indicate that irritable bowel syndrome should be considered a disease of the small intestine as well as the colon.

Electrochemical detector for breath hydrogen determination: measurement of small bowel transit time in normal subjects and patients with the irritable bowel syndrome.

A method is described for the measurement of hydrogen in expired air, using an electrochemical detector. The apparatus is simple to use and sensitive. Its application is illustrated by studies of small bowel transit time made by measuring the time between oral ingestion of the unabsorbable carbohydrate lactulose and a rise in the concentration of hydrogen in expired air. In 20 control subjects transit time was 93.0 +/- 6.6 minutes, while in 16 patients with diarrhoea due to the irritable bowel syndrome it was 54.1 +/- 6.3 minutes (P less than 0.001), suggesting an abnormality in small intestinal motility in these patients. Loperamide, a potent antidiarrhoeal agent, increased transit time in 12 of these patients from 56.3 +/- 6.7 to 100.0 +/- 10.2 minutes (P less than 0.001).

Control of some internal parasites of chinchillas.

An unidentified coccidia was found in chinchillas. Treatment with sulfamethazine apparently eradicated the infection from several herds. Ostertagia females and 1 Trichostrongylus colubriformis male were also found in chinchillas, causing emaciation. A dose of thiabendazole of 100 mg./kg. of body weight was effective against the roundworms, but it was toxic. A dose of trichlorphon, 100 mg./kg. of body weight, was effective and safe. Hymenolepis infection caused emaciation and death. Treatment with doses of niclosamide, 200 mg./kg. of body weight, was successful in removing tapeworms, ending deaths, and improving the condition of the host. It did not eradicate the infection.