ACORNS: a tool for the visualisation and modelling of atypical development.

Across many academic disciplines visualisation and notation systems are used for modelling data and developing theory, but in child development visual models are not widely used; yet researchers and students of developmental difficulties may benefit from a visualisation and notation system which can clearly map developmental outcomes and trajectories, and convey hypothesised dynamic causal pathways. Such a system may help understanding of existing accounts and be a tool for developing new theories. We first present criteria that need to be met in order to provide fully nuanced visualisations of development, and discuss strengths and weaknesses of the visualisation system proposed by Morton. Secondly, we present a tool we have designed to give more precise accounts of development while also being accessible, intuitive and visually appealing. We have called this an Accessible Cause-Outcome Representation and Notation System (ACORNS). This system provides a framework for clear mapping and modelling of developmental sequences, illustrating more precisely how functions change over time, how factors interact with the environment, and the absolute and relative nature of causal outcomes. We provide a new template, a set of rules for the appropriate use of boxes and arrows, and a set of visually accessible indicators that can be used to show more precisely relative rates, degrees and variance of functioning over different capacities at different time points. We have designed ACORNS to give a precise and clear visualisation of how development unfolds; allowing the representation of less 'static' and more transactional models of developmental difficulties. We hope ACORNS will help students, clinicians and theoreticians across disciplines to better represent nuances of debates, and be a seed for the development of new theory.

Social cognition in children with Down's syndrome: challenges to research and theory building.

Characterising how socio-cognitive abilities develop has been crucial to understanding the wider development of typically developing children. It is equally central to understanding developmental pathways in children with intellectual disabilities such as Down's syndrome. While the process of acquisition of socio-cognitive abilities in typical development and in autism has received considerable attention, socio-cognitive development in Down's syndrome has received far less scrutiny. Initial work in the 1970s and 1980s provided important insights into the emergence of socio-cognitive abilities in the children's early years, and recently there has been a marked revival of interest in this area, with research focusing both on a broader range of abilities and on a wider age range. This annotation reviews some of these more recent findings, identifies outstanding gaps in current understanding, and stresses the importance of the development of theory in advancing research and knowledge in this field. Barriers to theory building are discussed and the potential utility of adopting a transactional approach to theory building illustrated with reference to a model of early socio-cognitive development in Down's syndrome. The need for a more extensive model of social cognition is emphasised, as is the need for larger-scale, finer-grained, longitudinal work which recognises the within-individual and within-group variability which characterises this population. The value of drawing on new technologies and of adapting innovative research paradigms from other areas of typical and atypical child psychology is also highlighted.

A modified version of the Bayley Scales of Infant Development-II for cognitive matching of infants with and without Down syndrome.

BACKGROUND: Many measures of infants' early cognitive development, including the BSID-II (The Bayley Scales of Infant Development), mix together test items that assess a number of different developmental domains including language, attention, motor functioning and social abilities, and some items contribute to the assessment of more than one domain. Consequently, the scales may lead to under- or over-estimates of cognitive abilities in some clinical samples and may not be the best measure to use for matching purposes. METHOD: To address this issue we created a modified form of the BSID-II (the BSID-M) to provide a 'purer' assessment of the general cognitive capacities in infants with Down syndrome (DS) from 6 to 18 months of age. We excluded a number of items that implicated language, motor, attentional and social functioning from the original measure. This modified form was administered to 17 infants with Down syndrome when 6, 12 and 18 months old and to 41 typically developing infants at 4, 7 and 10 months old. RESULTS: The results suggested that the modified form continued to provide a meaningful and stable measure of cognitive functioning and revealed that DS infants may score marginally higher in terms of general cognitive abilities when using this modified form than they might when using the standard BSID-II scales. CONCLUSIONS: This modified form may be useful for researchers who need a 'purer' measure with which to match infants with DS and other infants with intellectual disabilities on cognitive functioning.

Brief report: recognition of emotional and non-emotional biological motion in individuals with autistic spectrum disorders.

This study aimed to explore the perception of different components of biological movement in individuals with autism and Asperger syndrome. The ability to recognize a person's actions, subjective states, emotions, and objects conveyed by moving point-light displays was assessed in 19 participants with autism and 19 comparable typical control participants. Results showed that the participants with autism were as able as controls to name point-light displays of non-human objects and human actions. In contrast, they were significantly poorer at labeling emotional displays, suggesting that they are specifically impaired in attending to emotional states. Most studies have highlighted an emotional deficit in facial expression perception; our results extend this hypothesized deficit to the perception and interpretation of whole-body biological movements.

Reassessing emotion recognition performance in people with mental retardation: a review.

Many investigators have reported that people with mental retardation have problems on emotion-recognition tasks. The evidence for the specificity of these performance deficits is reviewed, detailed consideration of the information-processing demands of different types of emotion-recognition tasks provided, and the conclusion made that evidence from identification tasks does not support the specificity hypothesis. It is suggested that deficits on other types of tasks may be due to IQ-related deficits in memory and attention, in imagination, and in dealing with static or ambiguous stimuli. The importance of MA-matching, using control tasks, and considering the complexity, abstraction, and ecological validity of stimuli is stressed. Recommendations are made for future research, and alternative theoretical positions are presented.

Latex agglutination for rapid identification of methicillin-resistant Staphylococcus aureus recovered from selective media.

The accuracy of combining latex agglutination with selective media for the identification of methicillin-resistant Staphylococcus aureus (MRSA) was determined. Test strains were identified by latex agglutination on blood agar, the heat-stable thermonuclease test and broth microdilution MICs of oxacillin and included 97 MRSA, 56 methicillin-susceptible Staphylococcus aureus, 52 methicillin resistant, and 49 methicillin-susceptible Staphylococcus species. Isolates were grown on trypticase-soy agar with 5% sheep red blood cells (TSAB), Mueller-Hinton agar (MHA), mannitol-salt agar (MSA), and four media designed for the selective growth of MRSA:TSAB with clindamycin and gentamicin, MHA with oxacillin, MSA with oxacillin, and lipovitellin-salt-mannitol agar (LVSM) with 1 microgram oxacillin disks applied. The mean sensitivity, specificity, and positive predictive value for the combination of latex agglutination with selective media for the identification of MRSA was 96%, 99% and 98% respectively.

Cultivation of Nocardia spp. on chemically defined media for selective recovery of isolates from clinical specimens.

Isolation of Nocardia spp. from clinical specimens can be enhanced by the use of paraffin baiting, which relies on the selective ability of the organism to metabolize paraffin. We evaluated 44 Nocardia isolates, 18 group IV mycobacterial isolates, and 4 Streptomyces isolates for growth on blood agar (BA) and on carbon-free agar containing single or double substrates as follows: paraffin agar (PA), gelatin agar (GA), urea agar (UA), PA-gelatin (PG), and PA-urea (PU). The growth rates of Nocardia spp. on BA, PA, PU, and PG were similar; but 3-day-old colonies were larger on BA for 20 (45%) isolates. After longer incubations (7 to 14 days), some Nocardia colonies were larger on PA, PG and PU than they were on BA. Despite variable morphologies on BA, colonies on PA, PG, and PU were consistently smooth, creamy, and raised. Compared with growth on BA, the growth of mycobacteria was much slower on PA, PG, and PU, with poor growth on UA and GA. The growth of Streptomyces spp. was greatly enhanced on GA, PG, UA, and PU and was poorest on PA. Twelve sputum specimens seeded with Nocardia asteroides (10(4) CFU/ml) were inoculated onto BA and all chemically defined media. Nocardiae were recovered from 6 to 12 specimens grown on BA, GA, and UA; 11 of 12 specimens grown on PG; and 12 of 12 specimens grown on PA and PU. Only PA was able to suppress the growth of other microorganisms that were present in sputum specimens. These results suggest that chemically defined media containing PA may be useful for the selective isolation of Nocardia spp. from contaminated clinical specimens.

Reactivity of serologic tests for the detection of antibody specific to cytomegalovirus. II. Latex agglutination and enzyme-linked immunosorbent assay.

Two hundred seven sera were assayed for antibody-specific for cytomegalovirus (CMV) by two enzyme immunoassays (EIAs; Bioenzabody, Litton Bionetics, and Abbott CMV Total Antibody EIA, Abbott Laboratories) and latex agglutination (LA; CMVScan, Hynson, Westcott and Dunning). The overall accuracy of the LA, Litton EIA, and Abbott EIA was 95.8%, 86.2%, and 88.6%, respectively. Although the Abbott EIA had a sensitivity of 98.8%, the specificity was only 35.5%. The positive predictive values of the LA, Litton EIA, and Abbott EIA were 99.4%, 95.9%, and 88.9%, respectively, while the negative predictive values of each of these tests were 81.1%, 56.2%, and 84.6%, respectively.

Antimicrobial susceptibility of clinical isolates of Brucella.

A number of antimicrobial agents have been used in the treatment of human brucellosis with varying effectiveness. The purpose of this study was to test the in vitro susceptibility of isolates of four Brucella species to a variety of antimicrobial agents, and to study in vitro synergy of combinations of agents. Minimal inhibitory concentrations (MICs) were determined using conventional broth microdilution methods and commercially available systems. Conventional checkerboard synergy microdilutions were prepared for gentamicin or streptomycin plus tetracycline, and rifampicin plus tetracycline. Synergy or antagonism was determined by the fractional inhibitory concentration index. Penicillin G and ampicillin showed in vitro activity against Brucella (MIC90 4 micrograms/ml), whereas the antipseudomonal penicillins were less active (carbenicillin MIC90 12 micrograms/ml, piperacillin MIC90 32 micrograms/ml). Among the third generation cephalosporins tested, cefotaxime (MIC90 2 micrograms/ml) demonstrated greatest activity. As a class, aminoglycosides were equivalent (MIC90 1-4 micrograms/ml). All strains were sensitive to tetracycline (MIC90 0.25 microgram/ml), trimethoprim-sulfamethoxazole (MIC90 1/19 micrograms/ml), and rifampin (MIC90 1 microgram/ml). Erythromycin (MIC90 greater than 8 micrograms/ml) and vancomycin (MIC90 greater than 16 micrograms/ml) demonstrated no activity. In vitro synergy (fractional inhibitory concentration index less than 0.5) was demonstrated with tetracycline plus rafampin in six of eight isolates tested.

Calcofluor white detection of fungi in cytopathology.

Calcofluor/Cellufluor (CFW) binds to fungal cell walls and causes them to fluoresce blue-green when illuminated with UV light. Retrospective and prospective studies were made to determine if CFW could be added to the Papanicolaou (PAP) stain procedure without altering diagnostic cytopathologic features while still allowing fungi to be identified. The retrospective study included 136 cytology specimens that were designated positive for fungus by PAP stain; these were stained with a 0.1% aqueous solution of CFW and examined by fluorescent microscopy. The overall agreement between the two methods in the detection of fungi was 90.4%. The incorporation of CFW into the PAP stain was tested at various points in the PAP stain sequence; optimum results were obtained when CFW was introduced after acid eosin. A total of 197 random, sequentially accessioned cytology specimens were stained with the PAP/CFW combination in the prospective study. The results indicate that detection of fungi by a combination of regular light and fluorescent microscopy was far more effective than was examination for the organisms by light microscopy alone.

Peritonitis involving Capnocytophaga ochracea.

Spontaneous bacterial peritonitis, due to Capnocytophaga ochracea, developed in a 65-year-old alcoholic patient with extensive cirrhosis and ascites. Previously reported human infections with this organism have included peridontal diseases, septicemia, and arthritis. This is the first report of spontaneous bacterial peritonitis associated with Capnocytophaga species.

Reactivity of serologic tests for the detection of antibody specific to cytomegalovirus.

A total of 212 sera were assayed for antibody specific for cytomegalovirus by complement fixation (CF), indirect immunofluorescence (IFA Electro-Nucleonics Laboratory, Inc., Bethesda, MD), ELISA (Cordis Laboratories, Inc., Miami, FL) and the FIAX system (International Diagnostic Technology, Santa Clara, CA). Correlation of CF with IFA, ELISA, and FIAX was 61%, 78%, and 71%, respectively. Quantitative correlation between IFA and FIAX and ELISA was not possible because of the broad range of reaction intensity of the latter two tests in sera with a particular IFA titer.

Improved recovery of group A beta-hemolytic streptococci with a new selective medium.

A new selective group A streptococcus agar (ssA) (BBL Microbiology Systems, Cockeysville, Md.) was evaluated for the recovery and direct plate identification of group A beta-hemolytic streptococci (GABHS) in comparison with sheep blood agar (SBA). A total of 265 GABHS were recovered from 1,116 throat swab specimens on both media, with detection rates of 98.9 and 91.7% for ssA and SBA, respectively. Primary bacitracin disk susceptibility tests were performed on 549 specimens, and presumptive identifications were possible for 81.4% of the GABHS on ssA, as compared with 44.2% on SBA. All of the 120 GABHS recovered from another 567 specimens were identified by a coagglutination method after overnight incubation on ssA, whereas only 70.2% were identified at this interval on SBA. The major advantage of the ssA was the inhibition of normal respiratory flora, permitting improved recovery and rapid identification of GABHS.

Evaluation of the RIM system and Gono Gen test for identification of Neisseria gonorrhoeae from clinical specimens.

RIM-N (Austin Biological Laboratories) and Gono Gen (Micro Media Systems) were evaluated for accuracy and compared with conventional carbohydrate degradation tests for identification of Neisseria gonorrhoeae. A total of 127 fresh clinical isolates of N. gonorrhoeae were tested; 118 (93%) were identified by RIM-N, and 100 (79%) yielded positive reactions with Gono Gen. Seventy nongonococcal isolates including other Neisseria species, Branhamella catarrhalis, Kingella kingae, and Moraxella species were evaluated to determine the specificity of the test methods. Both rapid tests were 100% specific in the identification of N. gonorrhoeae isolates. RIM-N was the most sensitive test for the identification of N. gonorrhoeae and offers a useful, more rapid alternative to conventional carbohydrate degradation methods.

Rapid detection of fungi in tissues using calcofluor white and fluorescence microscopy.

Rapid intraoperative examination of tissues for fungi is important for the surgical control of infection. Staining of frozen or paraffin-embedded tissues with calcofluor white (CFW) is a rapid nonspecific method for the identification of fungal infection. When viewed with a fluorescence microscope, fungal elements stained with CFW are sharply delineated from surrounding tissue and easily identified. Calcofluor white also stains tissue elements such as keratin, collagen, and elastin, which provide useful landmarks for the examination. To a much lesser degree, bacteria are also stained with CFW.

Lactogenic immunity to transmissible gastroenteritis virus induced by a subunit immunogen.

A subunit prepared from transmissible gastroenteritis (TGE) virus and used to immunize 24 gilts prior to farrowing induced production of specific antibody in the serum and milk. Challenge of pigs, two to seven days of age and suckling on the vaccinated gilts, with the Illinois strain of TGE virus resulted in morbidity of 28% and mortality of 4% as compared with 100 and 73%, respectively, for control piglets. Piglets nursing on a sow which had been immunized approximately 10 months previously were not protected, indicating that lactogenic immunity may be of short duration. Revaccination of this animal resulted in an anamnestic response.

Routine use of BACTEC 16B bottles to remove antibacterial and antitumor agents from blood cultures of cancer patients.

A total of 1,764 paired sets of BACTEC 6B and 16B blood culture bottles were collected from patients for analysis. The majority of the patients were receiving antibiotic therapy at the time the blood specimens were collected. A total of 126 isolates were considered clinically significant. Of these, 58 grew in both 6B and 16B bottles, 25 grew only in 6B bottles, and 43 grew only in 16B bottles. In both bottles, the same amount of time was required to detect a positive culture. In 18 patients, septicemias were detected in the 16B bottles that were not detected in the 6B bottles. In seven patients, microorganisms were detected in the 6B bottles that were not detected in the 16B bottles. Interestingly, the antibiotic therapy was changed for only 4 of the 18 patients whose septicemias were detected only in the 16B bottles. Finally, an in vitro study showed that certain chemotherapeutic agents can cause the inhibition of growth of several microorganisms when tested in 6B bottles. These inhibitory effects were reduced or eliminated when the same organism-drug combinations were tested in 16B bottles.