The representation of authors of color in schizophrenia research articles published in high-impact psychiatric journals.

OBJECTIVE: We evaluate how often scholars of color publish papers on schizophrenia in high-impact psychiatric journals, and whether they are more likely than white authors to prioritize race/ethnicity as a primary variable of interest in analyses. METHODS: Prior work categorized the types of ethnoracial analyses reported in 474 papers about schizophrenia published in high-impact psychiatric journals between 2014 and 2016. In this study, the photographs of the first and last author for each paper were coded as "person of color" (POC) or "white". Additionally, each author was asked to self-report their race and ethnicity. The percentage of papers published by white versus POC authors was calculated. Chi-square analyses tested the hypotheses that (a) white scholars are more likely than POC scholars to conduct any sort of racial analysis; (b) POC scholars are more likely to conduct primary analyses by race/ethnicity; and (c) white scholars are more likely to analyze race/ethnicity as extraneous variables. RESULTS: Eighteen percent of papers were published by POC first authors, and 17% were published by POC last authors. There were minimal differences in the types of analyses conducted by POC and white authors. Self-reported race/ethnicity showed that Asian scholars were the most highly represented within POC authors (9% of respondents), but only 3% of authors identified as Hispanic/Latinx and none identified as Black or Indigenous American. CONCLUSIONS: People of color are underrepresented as authors in US-based schizophrenia research published in high-impact journals. Culturally-informed mentorship as well as prioritization of race/ethnicity in funding structures are important to increase representation of POC authors.

Poly-N-Acetyl Glucosamine (sNAG) Enhances Early Rotator Cuff Tendon Healing in a Rat Model.

Rotator cuff injuries frequently require surgical repairs which have a high failure rate. Biological augmentation has been utilized in an attempt to improve tendon repair. Poly-N-acetyl glucosamine (sNAG) polymer containing nanofibers has been shown to increase the rate for healing of venous leg ulcers. The purpose of this study was to investigate the healing and analgesic properties of sNAG in a rat rotator cuff injury and repair model. 144 adult male Sprague-Dawley rats underwent a transection and repair of their left supraspinatus tendons. Half of the animals received a sNAG membrane on the tendon-to-bone insertion site. Animals were further subdivided, receiving 1 or 3 days of analgesics. Animals were sacrificed 2, 4, or 8 weeks post-injury. Animals sacrificed at 4 and 8 weeks underwent longitudinal in vivo ambulatory assessment. Histological properties were assessed at 2, 4, and 8 weeks, and mechanical properties at 4 and 8 weeks. In the presence of analgesics, tendons receiving the sNAG polymer had significantly increased max load and max stress at 4 weeks, but not at 8 weeks. Ambulatory improvements were observed at 14 days in stride length and speed. Therefore, sNAG improves tendon-to-bone healing in a rat rotator cuff detachment and repair model.

Cutaneous malignancies and their management.

Skin cancer is the most common malignancy occurring in humans, and the incidence of basal cell carcinoma, squamous cell carcinoma, and melanoma continues to rise. Advances in the diagnosis and treatment of skin cancer have led to more successful management of these tumors. A number of options for the treatment of skin cancer are available to the patient and physician, allowing for high cure rates and excellent functional and cosmetic outcomes.

Sporadic congenital leukonychia with partial phenotype expression.

GOAL: To describe the characteristics and inheritance pattern of a case of congenital leukonychia. OBJECTIVES: 1. To describe the etiologies of congenital and acquired leukonychia. 2. To discuss the differential diagnosis of leukonychia. 3. To outline inheritance patterns associated with leukonychia.

Ideological shifts needed in primary care delivery: removing barriers through reform.

Black Americans is one of the fastest growing segments of the population, yet the incidence of illness and mortality are higher and survival from the leading causes of death is poorer than for White Americans (Jaynes & Williams, 1989; U.S. Department of Health and Human Services [DHHS], 1990). In achieving the Year 2000 national health promotion and disease prevention objectives, health care systems must provide universal access to high quality, affordable, comprehensive, and coordinated primary health care services. It is crucial to initiate new approaches to health care delivery, including linking primary care providers (PCPs) in communities where people live and work to eliminate barriers and improve access to culturally-sensitive primary health care in Black communities. Nursing can play an important leadership role in redirecting the education of PCPs and shaping public policy to reflect the primary health care philosophy.

Health policy reform initiatives to improve the health of black Americans.

Black Americans comprise 12.4 percent of the United States (U.S.) population and is one of the fastest growing minority groups (U.S. Bureau of the Census, 1992). Recent health statistics indicate, however, that the life expectancy for Black Americans has lagged dramatically behind other minorities and White Americans throughout the century (DHHS, 1990). Economic, legislative and social factors hinder access to care and the provision of services within the current structure of health care in the U.S. Under health care reform, these three factors must be redefined to promote access to comprehensive health care services for Black Americans. Nursing is being challenged to provide the vision and leadership that will influence the key players to support a reform in health policy.

Cultural competence: a critical factor in nursing research.

By the year 2000, one in every third American will represent an ethnic minority. This statistic presents various challenges for healthcare providers. While cultural competence is examined in educational and practical nursing areas, nursing research is only beginning to view cultural competence as essential. This article explores various cultural issues embedded in the research process and provides readers with a conceptual model to enhance cultural competence in nursing research.

Local noise estimation in low-dose chest CT images.

PURPOSE: Image noise in computed tomography (CT) images may have significant local variation due to tissue properties, dose, and location of the X-ray source. We developed and tested an automated tissue-based estimator method for estimating local noise in CT images. METHOD: An automated TBE method for estimating the local noise in CT image in 3 steps was developed: (1) Partition the image into homogeneous and transition regions, (2) For each pixel in the homogeneous regions, compute the standard deviation in a 15 x 15 x 1 voxel local region using only pixels from the same homogeneous region, and (3) Interpolate the noise estimate from the homogeneous regions in the transition regions. Noise-aware fat segmentation was implemented. Experiments were conducted on the anthropomorphic phantom and in vivo low-dose chest CT scans to validate the TBE, characterize the magnitude of local noise variation, and determine the sensitivity of noise estimates to the size of the region in which noise is computed. The TBE was tested on all scans from the Early Lung Cancer Action Program public database. The TBE was evaluated quantitatively on the phantom data and qualitatively on the in vivo data. RESULTS: The results show that noise can vary locally by over 200 Hounsfield units on low-dose in vivo chest CT scans and that the TBE can characterize these noise variations within 5 %. The new fat segmentation algorithm successfully improved segmentation on all 50 scans tested. CONCLUSION: The TBE provides a means to estimate noise for image quality monitoring, optimization of denoising algorithms, and improvement of segmentation algorithms. The TBE was shown to accurately characterize the large local noise variations that occur due to changes in material, dose, and X-ray source location.

Management of macroglossia in Beckwith-Wiedemann syndrome.

Beckwith-Wiedemann syndrome (BWS) is a rare congenital disease of low prevalence. Its most common feature is macroglossia, being present in most cases. Clinically macroglossia can compromise the airway, cause dysphagia, drooling and poor cosmesis. Functionally it can cause dentoskeletal discrepancy, protrusion of teeth, and speech abnormalities leading significant psychological issues both with the patient and their families. Surgical excision remains the mainstay of management and a variety of techniques have been described. Because of the high vascularity of the tongue, intra-operative blood loss could be significant and have high morbidity in the pediatric patient. We present a technique for tongue reduction in macroglossia associated with BWS using the Ultrasonic Dissector (Harmonic Scalpel). The principles of Ultrasonic dissection are discussed along with the potential advantages of the technique.

Family planning in South Carolina. A process of growth and development.

PIP: In South Carolina family planning was only another and a low priority service of the county health department from the period of 1939 to 1971. Functioning under the State Board of Health, some counties served as few as 50 to 60 people in the course of a year. In 1965 the Office of Economic Opportunity began to make family planning grants to their local community action project agencies and under these grants family planning clinics operated in 28 counties in South Carolina through 12 projects. In 1971 South Carolina received funding from Title X of the Family Planning Services and Population Research Act of 1970, and the South Carolina Statewide Family Planning Program was created within the State Board of Health. By the 3rd year there were 10 district projects covering all of South Carolina's 46 counties in operation. As of July 1, 1974 all family planning services in South Carolina were supported by tax dollars through categorical grants and we re administered through the Statewide Family Planning Program of the South Carolina Department of Health and Environmental Control. A single recording system is used and all procedures are standardized. By 1974 some 56,000 women were receiving family planning services on a regular basis. It is now essential that program emphasis be shifted from communication about family planning to improvement of actual services. There must be new services which include male involvement, teen services , and the use of nurse practitioners. Rather than stressing a search for new patients, the objective now is to offer services in the most efficient and effective manner. Although the South Carolina Statewide Family Planning Program has grown rapidly in the 4 years since its implementation, there are still many areas requiring improvement.^ieng

Metabolism of sulfur-containing amino acids by pregnant merino ewes.

The availability and utilization of cystine and methionine were measured in single-bearing Merino ewes on three occasions, approximately 90, 110 and 130 days after mating, and the effects on these traits of sulfur amino acids (SAA) infused into the abomasum were also measured. Two levels of SAA were infused containing 0.5 or 1.0 g day-1 organic sulfur with DL-methionine contributing two-thirds and L-cystine one-third of the supplementary sulfur. The quantity of the diet offered was increased at each occasion so as to maintain maternal liveweight. The rates of irreversible loss of both cystine and methionine from plasma increased as pregnancy advanced, but the ratios between the rates of irreversible loss and intake of digestible organic matter (DOMI) did not vary with stage of pregnancy. The average daily rates of irreversible loss of cystine and methionine by the ewes consuming the diet alone were 13.6 and 119 mmol kg-1 DOMI respectively. The average rates of irreversible loss of methionine (Im, mmol h-1) and of cystine (Ic, mmol h-1) were both linearly (P less than 0.05) related to the rate of infusion of organic sulfur into the abomasum (s, g day-1): Im = 2.44 (+/- 0.33) s + 1.28 (+/- 0.13); and Ic = 0.16 (+/- 0.02) s + 0.30 (+/- 0.01). Five per cent of the rate of irreversible loss of cystine arose from trans-sulfuration of methionine by ewes consuming the ration only, but greater percentages (14 and 22%) were observed when the ration was supplemented with SAA (P less than 0.05). These transfer quotients were not influenced by stage of pregnancy. The stage of pregnancy did not influence the concentration of cystine or methionine in the plasma, but the abomasal infusions of SAA significantly increased the concentration of both SAA. The ewes consuming the basal diet were in positive balance for both nitrogen and sulfur. The retention of nitrogen did not vary with stage of pregnancy (average (s.e.), 5.8 (0.9) g day-1), but that of sulfur increased from 0.6 to 1.0 and 1.3 g day-1 in periods 1, 2 and 3, respectively (P less than 0.05). The retentions of nitrogen (N, g day-1) and of sulfur (S, g day-1) were linearly and significantly related to the rate of infusion of organic sulfur into the abomasum (s, g day-1): N = 2.7 (+/- 0.7)s + 4.4 (+/- 0.3); and S = 0.49 (+/- 0.03)s + 0.72 (+/- 0.01).(ABSTRACT TRUNCATED AT 400 WORDS)

T-cell receptor analysis in Omenn's syndrome: evidence for defects in gene rearrangement and assembly.

Patients with Omenn's syndrome have a form of severe immune deficiency that is associated with pathological features of graft-versus-host disease, except for the lack of foreign engraftment. It has been hypothesized that the disease's unique clinical features are mediated by an expanded population of autologous self-reactive T cells of limited clonality. In the current study, an investigation of the T-cell receptor (TCR) repertoire was undertaken to identify defects in T-cell rearrangement and development. The TCR repertoire in this group of patients was exquisitely restricted in the number of different TCR clonotypes, and some of these clonotypes seemed to have similar recognition motifs in the antigen-binding region, indicating antigen-driven proliferation of T lymphocytes. The TCRs from some patients lacked N- or P-nucleotide insertions and used proximal variable and joining gene segments, suggesting abnormal intrathymic T-cell development. Finally, abnormal assembly of gene segments and truncated rearrangements within nonproductive alleles suggested abnormalities in TCR rearrangement mechanisms. Overall, the findings suggest that inefficient and/or abnormal generation of TCRs may be a consistent feature of this disease.

Diffusion of macromolecules and virus-like particles in human cervical mucus.

To determine whether or not large macromolecules and viruses can diffuse through mucus, we observed the motion of proteins, microspheres, and viruses in fresh samples of human cervical mucus using fluorescent recovery after photobleaching and multiple image photography. Two capsid virus-like particles, human papilloma virus (55 nm, approximately 20,000 kDa) and Norwalk virus (38 nm, approximately 10,000 kDa), as well as most of the globular proteins tested (15-650 kDa) diffused as rapidly in mucus as in saline. Electron microscopy of cervical mucus confirmed that the mesh spacing between mucin fibers is large enough (20-200 nm) for small viruses to diffuse essentially unhindered through mucus. In contrast, herpes simplex virus (180 nm) colocalized with strands of thick mucus, suggesting that herpes simplex virus, unlike the capsid virus particles, makes low-affinity bonds with mucins. Polystyrene microspheres (59-1000 nm) bound more tightly to mucins, bundling them into thick cables. Although immunoglobulins are too small to be slowed by the mesh spacing between mucins, diffusion by IgM was slowed by mucus. Diffusion by IgM-Fc(5 mu), the Fc pentamer core of an IgM with all 10 Fab moieties removed, was comparably slowed by mucus. This suggests that the Fc moieties of antibodies make low-affinity bonds with mucins.