Isospin Properties of Nuclear Pair Correlations from the Level Structure of the Self-Conjugate Nucleus

The low-lying energy spectrum of the extremely neutron-deficient self-conjugate (N=Z) nuclide _{44}^{88}Ru_{44} has been measured using the combination of the Advanced Gamma Tracking Array (AGATA) spectrometer, the NEDA and Neutron Wall neutron detector arrays, and the DIAMANT charged particle detector array. Excited states in ^{88}Ru were populated via the ^{54}Fe(^{36}Ar,2nγ)^{88}Ru^{*} fusion-evaporation reaction at the Grand Accélérateur National d'Ions Lourds (GANIL) accelerator complex. The observed γ-ray cascade is assigned to ^{88}Ru using clean prompt γ-γ-2-neutron coincidences in anticoincidence with the detection of charged particles, confirming and extending the previously assigned sequence of low-lying excited states. It is consistent with a moderately deformed rotating system exhibiting a band crossing at a rotational frequency that is significantly higher than standard theoretical predictions with isovector pairing, as well as observations in neighboring N>Z nuclides. The direct observation of such a "delayed" rotational alignment in a deformed N=Z nucleus is in agreement with theoretical predictions related to the presence of strong isoscalar neutron-proton pair correlations.

Reliability and validity of surface EMG assessments combined with isometric muscle strength testing in patients with abdominal rectus diastasis and asymptomatic controls.

PURPOSE: Patients with abdominal rectus diastasis (ARD) may have muscular functional impairments, but clinics lack appropriate objective assessment tools. The aim was to establish the relative and absolute reliability, and convergent validity, of muscular activity using Surface Electromyography (SEMG) during isometric abdominal muscle strength testing in patients with ARD and controls without ARD. METHODS: Twenty-six patients with ARD were matched for age, sex and BMI with controls without ARD. Participants were tested twice during isometric muscular contractions using SEMG located on six abdominal sites. Mean amplitude, fatigue, and recruitment order were analyzed. Relative reliability was evaluated with Intraclass Correlation Coefficients (ICC), while absolute reliability was estimated by calculating the Standard Error of Measurement and Minimal Detectable Change. Convergent validity was addressed in relation to participant characteristics, functional ability, and symptoms. RESULTS: Mean SEMG amplitude for all abdominal wall muscle contractions showed moderate to excellent relative test-retest reliability, with ICC values ranging from 0.46 to 0.97. In contrast, fatigue and recruitment order displayed poor to moderate relative reliability in both groups. Absolute reliability measures were generally high. A moderate to high convergent validity (ARD: rho-value 0.41-0.70; Controls: rho-value 0.41-0.75) was observed for mean amplitude in relation to a functional sit-to-stand test, abdominal circumference, BMI, back pain, and quality-of-life. CONCLUSIONS: The results of applying SEMG during isometric abdominal muscle support practicing the method in clinics, although additional development is needed with further standardization and more functional testing. Furthermore, the method demonstrates construct validity in patients with ARD and in age- and sex-matched controls.

Managerial leadership and ischaemic heart disease among employees: the Swedish WOLF study.

OBJECTIVE: To investigate the association between managerial leadership and ischaemic heart disease (IHD) among employees. METHODS: Data on 3122 Swedish male employees were drawn from a prospective cohort study (WOLF). Baseline screening was carried out in 1992-1995. Managerial leadership behaviours (consideration for individual employees, provision of clarity in goals and role expectations, supplying information and feedback, ability to carry out changes at work successfully, and promotion of employee participation and control) were rated by subordinates. Records of employee hospital admissions with a diagnosis of acute myocardial infarction or unstable angina and deaths from IHD or cardiac arrest to the end of 2003 were used to ascertain IHD. Cox proportional-hazards analyses were used to calculate hazard ratios for incident IHD per 1 standard deviation increase in standardised leadership score. RESULTS: 74 incident IHD events occurred during the mean follow-up period of 9.7 years. Higher leadership score was associated with lower IHD risk. The inverse association was stronger the longer the participant had worked in the same workplace (age-adjusted hazard ratio 0.76 (95% CI 0.61 to 0.96) for employment for 1 year, 0.77 (0.61 to 0.97) for 2 years, 0.69 (0.54 to 0.88) for 3 years, and 0.61 (0.47 to 0.80) for 4 years); this association was robust to adjustments for education, social class, income, supervisory status, perceived physical load at work, smoking, physical exercise, BMI, blood pressure, lipids, fibrinogen and diabetes. The dose-response association between perceived leadership behaviours and IHD was also evident in subsidiary analyses with only acute myocardial infarction and cardiac death as the outcome. CONCLUSION: If the observed associations were causal then workplace interventions should focus on concrete managerial behaviours in order to prevent IHD in employees.

Abdominal aortic aneurysm and the impact of infectious burden.

OBJECTIVES: Little is known about the biological processes causing aortic aneurysm rupture. Chronic Chlamydophila pneumoniae infection has been suggested as a possible contributing factor to the development and expansion of abdominal aortic aneurysm (AAA). The importance of infection in AAA may be related to the previous pathogen burden, that is, the number of significant titres of antibodies against infectious pathogens rather than to single infectious agents. The aim of this study was to examine the relationship between infectious burden and AAA rupture. METHODS: In a case-control study, 119 patients with abdominal aortic aneurysm and 36 matched controls without aneurysm were prospectively investigated for specific IgG class antibodies against C. pneumoniae, Helicobacter pylori, Cytomegalovirus, and Herpes simplex virus. RESULTS: Patients with ruptured AAA have similar levels of pathogen burden as patients with nonruptured electively operated AAA, small AAA, and controls without aneurysm. CONCLUSION: The present study fails to demonstrate a connection between infectious burden and abdominal aortic aneurysm rupture.

Time- and dose-related regional fluxes of tissue-type plasminogen activator in anesthetized endotoxemic pigs.

BACKGROUND: Acute endotoxinemia elicits an early fibrinolytic response. This study analyzes the effects of the dose and duration of endotoxin infusion on arterial levels of tissue-type plasminogen activator (tPA) and pulmonary, mesenteric and hepatic plasma tPA fluxes. METHODS: Pigs were randomized to receive an acute, high-dose (for 6 h, n=13, high ETX) or a prolonged, low-dose (for 18 h, n=18, low ETX) infusion of endotoxin or saline vehicle alone (for 18 h, n=14, control). All animals were fluid resuscitated to maintain a normodynamic circulation. Systemic and regional blood flows were measured and arterial, pulmonary arterial, portal and hepatic venous blood samples were analyzed to calculate regional net fluxes of tPA. Plasma tumor necrosis factor (TNF-alpha) levels were analyzed. RESULTS: Mesenteric tPA release and hepatic uptake increased maximally at 1.5 h in ETX groups related to dose. Maximal mesenteric tPA release [high ETX 612 (138-1185) microg/min/kg, low ETX 72 (32-94) microg/min/kg, median+/-interquartile range] and hepatic tPA uptake [high ETX -1549 (-1134 to -2194) microg/min/kg, low ETX -153 (-105 to -307) microg/min/kg] correlated to TNF-alpha levels. Regional tPA fluxes returned to baseline levels at 6 h in both ETX groups and also remained low during sustained low ETX. No changes were observed in control animals. CONCLUSIONS: Endotoxemia induces an early increase in mesenteric tPA release and hepatic tPA uptake related to the severity of endotoxemia. The time patterns of changes in mesenteric and hepatic tPA fluxes are similar in acute high-dose endotoxemia and sustained low-dose endotoxemia.

Theoretical aspects of detection of bacteraemia as a function of the volume of blood cultured.

UNLABELLED: Clinically significant bacteraemia in adults is characterized by low numbers of circulating bacteria. Assuming a Poisson or a binomial distribution we have calculated the probability of detecting bacteria as a function of the concentration in blood, estimated the concentration of bacteria in blood from a given test result, and calculated the blood volume required to detect bacterial growth with a probability of 95% at a given mean number of colony-forming units (cfu) per sample unit. These theoretical assumptions have been used on an empirical population of patients with proven bacteraemia. RESULTS: 18% of Staphylococcus aureus bacteraemias and 29% of Escherichia coli bacteraemias have circulating bacteria with an estimated spread of less than 0.04 cfu/ml. With a 95% probability of detection of a bacteraemia, a concentration in blood corresponding to 3 cfu/sampling unit is necessary. In our empirical material, where 30 ml was cultured, the probability of detection of E. coli bacteraemias would have decreased by 11% if 20 ml had been cultured, and 27% if only 10 ml had been cultured. The corresponding figures for S. aureus were 6% and 15%, respectively. For low grade E. coli bacteraemias (< 0.04 cfu/ml) the decrease would have been 33% and 67%, respectively.

Pharmacokinetics and effects of HI 6 in blood and brain of soman-intoxicated rats: a microdialysis study.

The bispyridinium oxime HI 6 (1-(((4-amino-carbonyl)pyridino)methoxy)methyl)-2-(hydroxyimino )methyl)-pyridinium dichloride monohydrate), combined with atropine, is effective for treating poisoning with organophosphate nerve agents. The protective action of HI 6 in soman poisoning has been attributed mainly to its peripheral reactivation of inhibited acetylcholinesterase. In the present study we investigated whether high intramuscular doses of HI 6 can reach the brain in a sufficient amount to reactivate inhibited brain acetylcholinesterase. Microdialysis probes were implanted in the jugular vein and striatum and dialysis samples were collected simultaneously from the two sites in awake, freely moving rats. Pharmacokinetic parameters of unbound HI 6 in blood and brain were calculated after administration of HI 6 (50, 75 or 100 mg/kg i.m.) in control rats and rats injected with soman (90 microg/kg s.c., 0.9 LD50) 1 min before HI 6 treatment. We found that signs of soman poisoning correlated positively to acetylcholinesterase inhibition and negatively to the concentration of unbound HI 6 in the brain and that soman intoxication significantly decreased uptake of HI 6 into the brain.

Sixteen years age limit for learner drivers in Sweden--an evaluation of safety effects.

Through a reform implemented in Sweden, September 1993, the age limit for practising car driving was lowered from 17 1/2 to 16 years while the licensing age remained 18. The purpose of lowering the age limit was to give the learner drivers an opportunity to acquire more experience as drivers before being allowed to drive on their own. The primary aim of this study was to evaluate the effect of the reform in terms of accident involvement and data were therefore obtained from the national register of police reported accidents. The results show that after the reform there was a general reduction in the accident risk (accidents per 10 million km) of novice drivers with approximately 15%. Additional analyses show that the reduction of accident risk in the group who utilised the new age limit was approximately 40%, whereas those who did not utilise the prolonged training period did not benefit at all. Between 45 and 50% of the age population were found to utilise the reform. The accident reduction does not seem to be just an initial first year effect since the results were similar over 3 years of novice drivers during their first 2 years with a licence. These results suggest that the reform has been beneficial for the safety of novice drivers in Sweden. The results also suggest a potential for additional safety improvements if more young learner drivers can be brought to utilise the low age limit.

Nursing load in different care alternatives in Sweden during 18 years.

In a repeated cross-sectional study, changes in nursing load and changes in care organisation (1978-1996) were studied in Sundsvall, Sweden. A total of 4555 nursing load measurements on elderly people were performed on four occasions (1978, 1988, 1993 and 1996). The nursing load has increased considerably at the nursing homes and at the homes for the aged during the whole period. In home care, the nursing load did not increase between 1978 and 1993, but it increased considerably between 1993 and 1996. The mean age of the residents, the number of persons with dementia, as well as the mean age, also increased. Between 1978 and 1996, the number of institutional resources decreased by 38%, while home care resources increased by 421%. The considerable increase in nursing load presents a worrying scenario when it is combined with the expected increase of the oldest old.

Microfossils in stromatolitic cherts from the upper proterozoic Min'yar formation, southern Ural Mountains, USSR.

A diverse assemblage of exceptionally well-preserved microorganisms, including several previously unknown taxa, has been discovered in stromatolitic black chert from the ca. 680-790 Ma-old Min'yar Formation (Suite) of the southern Ural Mountains, USSR. Like most ancient and modern stromatolitic communities, the Min'yar microflora is dominated by filamentous and unicellular cyanobacteria. Geologic evidence indicates that the microbial community inhabited a shallow water, presumably marine environment. The microfossils occur in two interlaminated and thinly interbedded sedimentary fabrics: 1, fact to wavy-laminated Stratifera-like stromatolitic laminae that presumably were deposited during periods of little wave action; and 2, intraclast grainstone that formed as a result of desiccation and (or) wave agitation. Microfossils are both better preserved and more abundant in the intraclasts than in the Stratifera-like laminae. The occurrence of probable pseudomorphs after replacement of sulfate minerals provides additional evidence for a shallow water, periodically emergent depositional environment for the Min'yar microbial mats. Kerogenous microfossils are three-dimensionally preserved, permineralized in fine-grained silica of primary or early diagenetic origin. In many aspects the Min'yar assemblage is comparable to that of the well-known ca. 850 Ma-old Bitter Springs Formation of central Australia. The following taxa are herein described: Division? Schizomycophyta or ? Cyanophyta, Biocatenoides sp.; Family Oscillatoriaceae, Eomycetopsis robusta Schopf emend. Knoll and Golubic, Rhicnonema antiquum Hofmann, Entosphaeroides? sp., Palaeolyngbya? sp., Siphonophycus capitaneum n. gen., n. sp.; Family? Oscillatoriaceae or? Rivulariaceae, Caudiculophycus? sp.; Family? Scytonemataceae or? Stigonemataceae, Ramivaginalis uralensis n. gen., n. sp.; Family Chroococcaceae, Sphaerophycus medium Horodyski and Donaldson, Eosynechococcus amadeus Knoll and Golubic, Gloeodiniopsis lamellosa Schopf emend. Knoll and Golubic, Gloeodiniopsis magna n. sp., Eoaphanocapsa oparinii n. gen., n. sp.; Division? Chlorophycophyta or? Rhodophycophyta, Glenobotrydion majorinum Schopf and Blacic. Also discussed in the taxonomic section, but not formally described, are intermediate-diameter tubular sheaths (Oscillatoriaceae), small tubular sheaths enclosed by larger tubular sheaths (Oscillatoriaceae?), and undifferentiated spheroidal unicells.

Bile salt sulphation in man. Liver bile salt sulphotransferase activity in patients with primary biliary cirrhosis.

Bile salt sulphation in primary biliary cirrhosis was studied by measurements of the liver bile salt sulphotransferase levels in 16 patients. Although the enzyme activity varied among the patients it did not correlate with the severity of cholestasis. Furthermore, the mean bile salt sulphotransferase magnitude in patients with primary biliary cirrhosis did not differ significantly from corresponding enzyme activity in patients with non-cholestatic, alcohol induced liver disease. The present data indicates that chronic cholestasis, as evidenced in patients with primary biliary cirrhosis, does not lead to increased levels of liver bile salt sulphotransferase. It is suggested that mechanisms other than enzymic induction are responsible for the increased bile salt sulphate synthesis as observed in primary biliary cirrhosis.

Primary biliary cirrhosis--phenotypic characterization of immunocompetent cells in peripheral blood and liver tissue.

Circulating T-cell subsets have been characterized in 18 patients with primary biliary cirrhosis (PBC) using a simple immunoenzymatic staining method on stored and prefixed cell samples. Furthermore, a double immunoenzymatic method was used to study T-cell subsets and their relationship to HLA-DR+ cells in frozen sections of liver biopsies from 12 patients with PBC. In 10 cases blood and liver samples were taken simultaneously from the same patient. Patients with PBC of early histological stage showed an elevated absolute number of helper/inducer T-cells (Leu 3a+) and reduced relative percentages of suppressor/cytotoxic T-cells (Leu 2a+) compared with healthy subjects resulting in an elevated helper/suppressor ratio. Liver biopsies in PBC were dominated by helper inducer phenotype T-cells in all cases irrespective of histological stage, penicillamine treatment or the relative levels of circulating T-cell subsets. A relatively high amount of HLA-DR+ cells were seen, several of these in close approximation to T-cells.

Tubuglomerular feedback control in long-looped nephrons. Topical minireview.

The tubuloglomerular feedback mechanism is highly activated in juxtamedullary nephrons and considered to play a major role in intrarenal regulation of glomerular filtration rate. The vasculature of juxtamedullary nephrons is highly vasoreactive with a high ability for vasodilation. This vasoreactivity is a prerequisite for an important influence of the tubuloglomerular feedback mechanism on the medullary blood flow and its regulation.

External quality assessment of serum hormone determinations in the Nordic countries.

Since 1979 the Nordic Clinical Chemistry Project (NORDKEM) has organized four external quality assessment surveys of serum hormone determinations in the five Nordic countries. Charcoal-stripped control sera with weighed additions of the following hormones have been used: thyrotropin, human placental lactogen, prolactin, estriol, estradiol, testosterone, cortisol, triiodothyronine, thyroxine, and, in the fourth survey, progesterone. Human serum was usually used but in the first survey the serum matrix for the protein hormones was calf serum. In three years no systematic improvement in the coefficients of variation of the results has occurred. The change from calf serum to human serum also had no major effects on the results. Percentage coefficients of bias usually varied on both sides of the true value, but at low hormone concentrations the results were almost always positively biased. It is therefore useful to know the true hormone concentrations of the control samples because all-laboratory means are relatively often biased from these. Variation produced by different methods of calculation of the radioimmunoassay results and the influence of outlying standard points on these data processing routines were studied in the third survey. It is possible that sometimes the variation produced by different methods of calculation is one of the main components of the total variation in external quality assessment of RIA. There were no major differences between the performance of computerized or manual calculation methods. The influence of different calibration standards on serum thyroxine determination was studied in the fourth survey. Of the total coefficient of variation (10.8% to 17.0%) the component of variation produced by different thyroxine calibration standards was 0.8% to 4.6%. In conclusion, standardization of the data processing methods and further standardization of assay reagents are urgently needed to give possibilities to identify more subtle differences in the analytical performance of the laboratories. External quality assessment of hormone determinations needs improvement of the quality of reference materials.

External quality assessment of serum drug determinations in the Nordic countries.

A system for external quality assessment of serum drug determinations in the five Nordic countries has been established, and results of several surveys of antiepileptic drug determinations are described. The work was started as a pioneer work of NORDKEM at the time when NORDKEM was founded and was carried out during the years 1977-1979. The problems concerning methodology of drug analyses and, consequently, the problem of setting up quality assessment systems differ clearly from those in connection with the common analyses of clinical chemistry. Especially the quality of control materials is very important. An expert panel of drug specialists is necessary to plan and interpret an external quality assessment program of drug analyses, but it can very well be carried out in connection with other quality assessment programs. The state of the art of antiepileptic drug determinations in the Nordic countries at the time of the surveys was very good. The level of inaccuracy was well below 5%, and the level of imprecision was mainly in the range of 15-20%, although no outliers were excluded during the statistical treatment of the data.

Internal quality control of hormone determinations by RIA. Detection of clinically significant analytical errors of serum thyroxine determination.

An internal quality control system by which clinically significant analytical errors can be detected with high probability was developed for serum thyroxine (T4) determination by RIA. The mean concentration of the quality control samples (C1, C2, and C3) were 40.0, 101.8, and 156.7 nmol/l, and their total standard deviations (st) 2.5, 4.1, and 7.1 nmol/l, respectively, in stable analytical performance of the T4 assay. From the clinical point of view it was accepted that the results of C1 varied from 30 to 50 nmol/l at the most. When expressed in standard deviations, the same size of error was accepted for C2 and C3. It followed that the quality control system had to detect a systematic shift of 2.43st (delta SEc) and a 2.08 times increase in random error (delta REc) in order that the quality goals could be reached. With three control samples the combination of rules, 1: 3s/CS1: (1.0s; 2.7s), which was chosen for manual quality control, detected the delta SEc with about an 80% probability and the delta REc with about a 30% probability. The probability of false rejections was less than 1%. The probability of detecting the delta SEc was considered acceptable, but to detect the delta REc with a higher probability, the within-assay variation of each run was calculated from the results of duplicate patient samples. Although the whole run was not rejected because of systematic and/or random errors, individual samples were reanalysed if the results of their duplicate determinations differed from the criteria stated.(ABSTRACT TRUNCATED AT 250 WORDS)

Social and economic effects of non-ulcer dyspepsia.

An attempt was made to estimate the total costs of non-ulcer dyspepsia (NUD) in Sweden by extracting information from different available sources. After extrapolation of figures from the in-patient register of the University Hospital in Uppsala to the whole of Sweden, the total annual expenditure for in-patient care was estimated to be 10.3 million SEK. Calculations of costs for out-patient care and drugs were based on data from a nation-wide sample survey, and the total expenses were estimated to be 197.5 million SEK and 60 million SEK, respectively. Among indirect social costs, economic losses due to death and early retirement were found to be comparatively moderate. Production loss due to short-term sick-leave was by far the most dominant item among all social costs. In a study of 88 consecutive patients with NUD, it was revealed that the average NUD patient was responsible for 26 more days of lost production than the average employee. Thus, the total annual cost for short-term sick-leave was estimated to be 2,496 million SEK. The grand total of these calculations amounts to no less than 2,786 million SEK. Although affected by a considerable degree of uncertainty, the presented figures point to important economic consequences for society.

The Diagnosis and Therapy Survey October 1978-March 1983, health care consumption and current drug therapy in Sweden with respect to the clinical diagnosis of gastritis.

Demographic epidemiology, current drug therapy and the health care resources required by patients clinically considered to have gastritis were studied during a four and a half year period-October 1978 to March 1983. The investigation was based on data from the Diagnosis and Therapy Survey, an on-going nation-wide sample study covering all out-patient care in Sweden. Gastritis was found to account for 1.9% of all out-patient consultations and for 30% of those for gastrointestinal disorders. The corresponding figures for peptic ulcer disease were 0.2% and 4%, respectively. The estimated minimum number of annual consultations for gastritis was 47 per 1,000 inhabitants. The majority of the consultations were dealt with in general practice, where gastritis was the fifth most common diagnosis. Drug therapy was considered to be indicated in 92% of the consultations. Antacids were prescribed in 77%, anticholinergic/spasmolytic drugs in 36% and histamine H2-receptor antagonists in 4%. The clinical diagnosis of gastritis was found to be the major indication for antacids and anticholinergic drugs and accounted for a substantial proportion of H2-receptor antagonist prescriptions. The patient groups with gastritis and duodenal ulcer showed a similar age distribution, with a mean age of about 50 years. In the gastritis group, the two sexes were equally represented, but in the duodenal ulcer group there was a predominance of men. The results of the Diagnosis and Therapy Survey indicate that the patient group with symptoms traditionally denoted as gastritis in clinical practice constitutes a major health care problem in our community.(ABSTRACT TRUNCATED AT 250 WORDS)