A Boltzmann Constant Determination Based on Johnson Noise Thermometry.

A value for the Boltzmann constant was measured electronically using an improved version of the Johnson Noise Thermometry (JNT) system at the National Institute of Standards and Technology (NIST), USA. This system is different from prior ones, including those from the 2011 determination at NIST and both 2015 and 2017 determinations at the National Institute of Metrology (NIM), China. As in all three previous determinations, the main contribution to the combined uncertainty is the statistical uncertainty in the noise measurement, which is mitigated by accumulating and integrating many weeks of cross-correlated measured data. The second major uncertainty contribution also still results from variations in the frequency response of the ratio of the measured spectral noise of the two noise sources, the sense resistor at the triple-point of water and the superconducting quantum voltage noise source. In this paper, we briefly describe the major differences between our JNT system and previous systems, in particular the input circuit and approach we used to match the frequency responses of the two noise sources. After analyzing and integrating 49 days of accumulated data, we determined a value: k = 1.380 642 9(69)×10-23 J/K with a relative standard uncertainty of 5.0×10-6 and relative offset -4.05×10-6 from the CODATA 2014 recommended value.

Recent trends in testosterone testing, low testosterone levels, and testosterone treatment among Veterans.

Low serum testosterone (T) is common and increasingly prevalent with increased age. Recent studies report an 'epidemic' of T prescribing and concern about unnecessary T treatment. We investigated the number of men tested for T, the prevalence of low serum T levels, and initiation of T treatment among those with low T levels in men treated at Veterans Affairs (VA) facilities in the Northwest US (VISN 20). We identified male Veterans aged 40-89 years and examined yearly proportions of men tested for T, found to have low T levels (total T < 280 ng/dL, free T < 34 pg/mL, or bioavailable T < 84 ng/dL), and subsequently treated with T from 2002 to 2011. We excluded men who had T treatment in the year prior and men with diagnoses of prostate or breast cancer. Treatment initiation was defined as the first prescription for T within a year following a low T test. From 2002 to 2011, the yearly population of eligible men in VISN 20 increased from 129 247 to 163 572. The proportion of men who had serum T tests increased from 3.2% in 2002 to 5.8% in 2011. Among the tested men, the percentage of men with low T levels increased from 35.0 to 47.3%. However, the proportion of men with low T levels who were given T treatment within a year decreased from 31.0 to 28.0%. Despite large increases in T testing, and detection of men with low T levels, there was a slight decrease in the proportion of men with low T levels who were treated with T. The decrease in T treatment during this time period contrasts with other studies and may be related to higher comorbidity in Veterans and/or VA formulary restrictions on the use of transdermal T formulations.

The relationship between mode of delivery and developmental dysplasia of the hip in breech infants: a four-year prospective cohort study.

This prospective cohort study aimed to investigate the relationship between developmental dysplasia of the hip and mode of delivery in 571 consecutive breech infants using a modified Graf's static morphological method to grade the severity of dysplasia. In this group, 262 infants were born by planned Caesarian section, 223 by emergency section and 86 vaginally. Taking all grades of hip dysplasia into account (Graf types II, III and IV), there was no statistical difference in the incidence of dysplasia between the groups (elective section 8.4%, emergency section 8.1% and vaginal delivery 7.0%). However, when cases with Graf type II dysplasia, which may represent physiological immaturity, were excluded, the rate of type III and IV hips, which we consider to be clinically relevant, increased in the vaginally delivered group (4.7%) compared with the elective section group (1.1%), with a relative risk of approximately 1:4 (95% confidence interval 1.03 to 15.91). No difference was observed between the emergency and elective section groups, or between the emergency section and vaginally delivered groups. This study supports previous published work, with the added value that the diagnoses were all confirmed by ultrasound.

Confronting the use of placebos for pain.

What do you do when a physician's order conflicts with your role as patient advocate? Here's how one nurse initiated a policy change that put an end to the unethical use of placebos.

Sites and mechanisms of action of neuropeptides on canine gastric motility differ in vivo and in vitro.

Motilin, pentagastrin and substance P (SP), injected intra-arterially into the canine gastric corpus in vivo increased the amplitude of contractions by an action dependent on activation of cholinergic nerves; i.e. atropine or tetrodotoxin (TTX) completely blocked the responses to motilin and pentagastrin and increased the ED50 of SP. TTX and atropine were not equally effective in increasing the ED50 for SP in vivo and the effect of combining them depended on the order of their addition. Both were much more effective than the SP analog D-Pro2, D-Trp7,9 SP (DSP) which appeared to be a weak antagonist of actions dependent on neural activity. In strips from the same region in vitro no receptors dependent on cholinergic nerve activation could be demonstrated for any peptide; i.e., all were atropine- and TTX-insensitive. Motilin, as expected in the absence of such receptors caused no contractile response in vitro. SP, also as predicted, caused contractions suggesting that a smooth muscle receptor, independent of nerve activation was present. However contrary to expectation pentagastrin induced an atropine and TTX-insensitive increase in the amplitude and frequency of contractions. These results show that 1) the most sensitive sites of action of a number of excitatory peptides depend on cholinergic nerve function in vivo; 2) such sites or the nerve activity on which they depend cannot be demonstrated in vitro; 3) SP has an additional site of action on smooth muscle demonstrable in vivo and in vitro, but motilin does not; 4) pentagastrin has only an action dependent on nerve function in vivo, but manifests an action independent of nerve function in vitro. We conclude that sites and mechanisms of action of peptides cannot be assumed to be identical in vivo and in vitro. Actions dependent on nerves are often lost in vitro and not all smooth muscle actions can be demonstrated in vivo.

Inhibition by oxisuran of cell-mediated hypersensitivity by decrease in numbers of specifically sensitized cells.

Oxisuran, 2-([methylsulfinyl]acetyl)pyridine, has previously been shown to selectively suppress cell-mediated immunity, as measured by prolongation of allograft survival, without inhibition of humoral immunity. In the present investigation, the influence of this compound on lymphoid cell transfer of delayed hypersensitivity was studied. In actively sensitized animals, including endotoxin-sensitized mice and rabbits, ovalbumin-, dinitrochlorobenzene-, and dinitrofluorobenzene-sensitive guinea pigs, or tuberculin-sensitive rats, daily treatment during the interval just preceding the elicitation and expression of the hypersensitivity was most inhibitory. In both endotoxin-sensitive mice and ovalbumin-sensitive guinea pigs, treatment of the sensitized cell donor just prior to lymphoid cell harvest and transfer resulted in inhibition of the expression of the hypersensitivity in untreated recipients. Approximately 10(4) fewer specifically sensitized lymphoid cells, but not fewer viable cells, were present in passively transferred cell preparations. In contrast, treatment of the lymphoid cell recipient in the same experimental model did not influence the expression of the transferred hypersensitivity. The results suggest that oxisuran may influence an as yet undefined event prior to the expression of a cell-mediated hypersensitivity response in sensitized animals.

Induced sensitization of normal laboratory animals to Brucella abortus endotoxin.

A Boivin preparation of Brucella abortus, unlike common enterobacterial endotoxins, failed to depress water intake or increase numbers of hemolysin-producing spleen cells in mice, or to cause delayed inflammatory reactions in rabbit skin. Reactivity to the B. abortus endotoxin was found only in animals which were previously given the endotoxin with, but not necessarily in, complete Freund's adjuvant. Previous treatment with the endotoxin in saline or with only the adjuvant was ineffective. Sensitization appeared within 10 days and waned after 5 weeks. Passive sensitization was obtained with sensitized donor spleen cells but not with serum. Serum antibody titers did not correlate with the appearance and disappearance of sensitization.

Isolation of a Soluble Resistance-Enhancing Factor from Mycobacterium phlei.

Fox, Alfred E. (Warner-Lambert Research Institute, Morris Plains, N.J.), Joachim Anschel, George L. Evans, Raam R. Mohan, and Benjamin S. Schwartz. Isolation of a soluble resistance-enhancing factor from Mycobacterium phlei. J. Bacteriol. 92:285-290. 1966.-Extraction of a crude cell wall preparation from Mycobacterium phlei with 20% urea yielded a fraction which induced a state of enhanced resistance to microbial challenge. The resulting soluble extract, after removal of the urea, represented a 15% yield of solids with the separation of the biologically active component(s) and elimination of toxicity. Single oral or subcutaneous submicrogram doses of this material induced a prolonged state of increased resistance to subsequent challenge with Salmonella enteritidis in mice. This effect appeared as early as 2 hr after oral administration and persisted for at least 30 days. Protection against experimental infection with Staphylococcus aureus was also demonstrated. Resistance to viral challenge with influenza type A was observed after intranasal administration of the M. phlei extract to mice. The isolated material was found to contain carbohydrate, protein, nucleic acids, and lipids. The lipids represented 60% of the total solids, and were all short-chain fatty acids. No toxic effects, including pyrogenicity, could be demonstrated after oral or parenteral administration of this preparation.

Stimulation of nonspecific resistance to infection by a crude cell wall preparation from Mycobacterium phlei.

Fox, Alfred E. (Warner-Lambert Research Institute, Morris Plains, N.J.), George L. Evans, Frank J. Turner, Benjamin S. Schwartz, and Ansel Blaustein. Stimulation of nonspecific resistance to infection by a crude cell wall preparation from Myocobacterium phlei. J. Bacteriol. 92:1-5. 1966.-Exposure of large quantities of viable Mycobacterium phlei to attrition in a colloid mill resulted in 90 to 95% disruption of the organisms. Isolation of the crude cell wall preparation was accomplished by centrifugation of the broken cells at 10,000 x g, resuspension of the sediment, and repeated centrifugation at 1,000 x g to remove intact cells. Single oral or parenteral doses of the cell wall preparation increased the resistance of mice and guinea pigs to experimental infection with Salmonella enteritidis, and of mice to Staphylococcus aureus, for prolonged periods after administration. Histological examination of the organs of mice treated orally or intraperitoneally revealed a lymphoid hyperplasia of the spleen and a Kupffer cell proliferation of the liver. The preparation was nontoxic to mice by the oral route at doses up to 5,000 mg/kg, and the intraperitoneal ld(50) was approximately 680 mg/kg.