Poikilocytosis of Angora goats is associated with erythrocyte density and reticulocytosis.

Angora goats in South Africa experience several syndromes that result in notable morbidity and mortality in juveniles and adults, but not kids. Insight into their causes is hampered by the lack of normal reference values for this breed, and the present study therefore aimed to characterise (1) differences in the haematology of healthy kids at birth and weaning, and (2) the haematology of apparently healthy yearlings. Selected variables were measured by blood smear analysis, and complete blood counts were performed using an ADVIA 2120i. Variables at 1, 11, and 20 weeks of age were compared using the Friedman test and associations between variables of yearlings were determined by correlation analysis. In kids, red blood cell count, mean corpuscular haemoglobin concentration (MCHC), and poikilocytosis increased over time, while mean corpuscular haemoglobin (MCH) and mean corpuscular volume (MCV) decreased. Yearlings displayed a lower MCHC, and higher haemoglobin distribution width than previously reported for goats, and these were positively correlated with poikilocytosis, as were reticulocyte counts. White cell counts of yearlings exceeded normal values previously reported for goats, with some individuals displaying remarkably high mature neutrophil counts. Changes in haemoglobin variant expression or cation and water fluxes are possible explanations for the findings in kids, while in yearlings, the associations between MCHC, HDW, poikilocytosis, and reticulocytosis suggest alterations in red cell hydration in adulthood that are associated with increased red cell turnover. These findings may prove informative in the further investigation of various clinical syndromes in this population.

A comparison of MVP and MSVT performance among a diverse clinical pediatric sample.

The Memory Validity Profile (MVP) and Medical Symptom Validity Test (MSVT) are performance validity tests (PVTs) used to identify potential noncredible test performance during psychological evaluations. This study sought to examine the agreement between MVP and MSVT pass rates, as well as to determine if there are differences in MVP pass rates when using the cutoff score in the MVP professional manual compared with the experimental cutoff score of <31. Via retrospective review of records, 106 clients at a private neuropsychological clinic who had been given the MVP and the MSVT were identified. Results indicated that only one client met the manual cutoff scores, compared to 20 clients who failed the MSVT, raising concerns regarding the sensitivity of the MVP. Utilizing the receiver operator characteristic (ROC), curve analyses indicated fair discriminability of the MVP for the 106 participants (AUC = .717) with acceptable sensitivity (.50) and specificity (.92) for an MVP total score cutoff of <31. These findings support the utility of the experimental cut score in improving the sensitivity while maintaining adequate specificity in a clinically mixed population.

CLEAR Autism Diagnostic Evaluation (CADE): Evaluation of Reliability and Validity.

Recent surveillance efforts indicate that 1 in 54 American children meet the criteria for Autism Spectrum Disorder (ASD), making it the fastest growing neurodevelopmental disorder in the U.S. Despite evidence that ASD can be reliably diagnosed as early as 24 months, the median age at ASD diagnosis in 2016 in the U.S. was 51 months. The CLEAR Autism Diagnostic Evaluation (CADE; Willard & Kroncke, 2019), was developed in response to the need to improve, shorten, and standardize the clinical ASD evaluation process. The CADE is a 33-item rating scale designed to be completed by caregivers and clinicians. The current study was conducted to examine the reliability and validity of the CADE using a sample of 191 individuals who received a private evaluation for ASD. Using the client's evaluation records, clinicians completed the CADE items. The coefficient alpha was .94, which indicates that the items form a scale that has high internal consistency. The CADE total scores were highly correlated with ADOS scores, with r values ranging from .52-.86, and discriminated between those participants with a diagnosis of ASD and those without (p < .001). Receiver operator characteristic (ROC) curve analyses indicated excellent diagnostic accuracy of the CADE total score (ROC area under the curve = .998). Results suggest that the CADE can be used as an efficient and accurate means of evaluating ASD. Limitations and implications for use of the CADE are discussed.

Duties When an Anonymous Student Health Survey Finds a Hot Spot of Suicidality.

Public health agencies regularly survey randomly selected anonymous students to track drug use, sexual activities, and other risk behaviors. Students are unidentifiable, but a recent project that included school-level analysis discovered a school with alarmingly prevalent student suicidality. Given confidentiality protocols typical of surveillance, the surveyors were uncertain whether and how to intervene. We searched literature for duties to warn at-risk groups discovered during public health surveillance, but we found no directly applicable guidance or cases. Reasoning by analogy, we conclude that surveyors should contact the school's leaders to call attention to its outlier status, but public warning is unwarranted. However, such an ad hoc decision to issue a warning, even if only to school leaders, raises significant practical, legal and ethical issues. National public health and education associations should produce guidance that clarifies ethical and legal duties owed to schools and students involved in population health-risk surveillance.

Practice Variation in the Immediate Postoperative Care of Pediatric Kidney Transplantation: A National Survey.

INTRODUCTION: Advances in organ allocation, surgical technique, immunosuppression, and long-term follow-up have led to a significant improvement in kidney transplant outcomes. Although there are clear recommendations for several aspects of kidney transplant management, there are no pediatric-specific guidelines for immediate postoperative care. The aim of this survey is to examine practice variations in the immediate postoperative care of pediatric kidney transplant patients. METHODS: We surveyed medical directors of Pediatric Acute Lung Injury and Sepsis Investigators (PALISI)-affiliated pediatric intensive care units regarding center-specific immediate postoperative management of pediatric kidney transplantation. RESULTS: The majority of PALISI centers admit patients to the pediatric intensive care unit postoperatively, and 97% of the centers involve a pediatric nephrologist in immediate postoperative care. Most patients undergo invasive hemodynamic monitoring; 97% of centers monitor invasive arterial blood pressure and 88% monitor central venous pressure. Most centers monitor serum electrolytes every 4 to 6 hours. Wide variation exists regarding blood pressure goal, fluid replacement type, frequency of obtaining kidney ultrasound, and use of prophylactic anticoagulation. CONCLUSION: There is consistent practice across PALISI centers in regards to many aspects of immediate postoperative management of pediatric kidney transplantation. However, variation still exists in some management aspects that warrant further discussions to reach a national consensus.

BAYESIAN ANALYSIS OF COSMIC RAY PROPAGATION: EVIDENCE AGAINST HOMOGENEOUS DIFFUSION.

We present the results of the most complete scan of the parameter space for cosmic ray (CR) injection and propagation. We perform a Bayesian search of the main GALPROP parameters, using the MultiNest nested sampling algorithm, augmented by the BAMBI neural network machine-learning package. This is the first study to separate out low-mass isotopes (p, p ¯ , and He) from the usual light elements (Be, B, C, N, and O). We find that the propagation parameters that best-fit p, p ¯ , and He data are significantly different from those that fit light elements, including the B/C and 10Be/9Be secondary-to-primary ratios normally used to calibrate propagation parameters. This suggests that each set of species is probing a very different interstellar medium, and that the standard approach of calibrating propagation parameters using B/C can lead to incorrect results. We present posterior distributions and best-fit parameters for propagation of both sets of nuclei, as well as for the injection abundances of elements from H to Si. The input GALDEF files with these new parameters will be included in an upcoming public GALPROP update.

The impact of exposure to peer suicidal self-directed violence on youth suicidal behavior: a critical review of the literature.

There is considerable evidence that being exposed to the suicide or suicidal behavior of another can increase the risk for suicide. Significant relationships between media coverage and youth suicide have been documented in the professional literature. Exposure to familial suicidal behavior has also been established as a risk factor for youth suicidal behavior; However, peer suicide exposure is not as clear cut as research results in this area have been mixed. In the current paper the empirical literature focused on the associations between exposure to peer suicides and suicide attempts and youth suicidal behavior is critically reviewed. Effect sizes were computed for each of the 23 studies included in the review to allow for cross-study comparisons. The results demonstrate that having a friend or acquaintance attempt suicide is significantly related to risk for suicidal thoughts and behavior. However, the support for the relationship between the suicide of a peer and youth suicidal behavior was less consistent. Implications for clinical practice and suicide postvention as well as areas of future research are discussed.

Space of Parona infections: experience in management and outcomes in a regional hand centre.

BACKGROUND: Space of Parona Infection is a rare and potentially limb threatening complication of pyogenic flexor tenosynovitis. The aim of this study is to review the presentation, management and outcomes of space of Parona infections in our institution. METHOD: This was a retrospective study. Data was collected from patients with confirmed space of Parona infections determined by the presence of pus in this space during the initial surgical debridement; between 2009 and 2011. The following parameters were analysed: patient demographics, presentation, microbiological findings and surgical management. The outcomes assessed included the final active range of motion of the primary affected finger, rate of amputation and duration of hospital stay and follow up. RESULTS: There were nine confirmed space of Parona infections. 7/9 patients reported a history of trauma. The thumb (7/9) followed by the little finger (2/9) were primarily involved in all cases. Seven patients presented with symptoms of acute median nerve compression in addition to forearm tenderness. Patients had a mean of two (range; 1-5) visits to theatre for washout and debridement. Positive swabs were present in 8/9 cases, of which five patients cultured ß haemolytic streptococci. Average hospital stay was six days (range; 3-12) and final active range of movement of the affected finger ranged from 0 to 95%. CONCLUSION: Involvement of space of Parona should be suspected in patients with flexor tendon sheath infections of the thumb or little finger. Early antimicrobial therapy directed particularly at ß haemolytic streptococcus combined with prompt surgical debridement and physiotherapy are critical to optimal functional outcome.

Is the Patient Outcomes Of Surgery (POS)-Hand/Arm questionnaire a reliable, valid and responsive measurement of patient-based outcomes in hand and upper limb surgery?

The purpose of our study was to evaluate a new region-specific outcome measure in hand and upper limb surgery: the Patient Outcomes of Surgery (POS)-Hand/Arm questionnaire using the generic Short Form Health Survey (SF)-36 questionnaire as a 'gold standard' comparative measure. The POS-Hand/Arm preop questionnaire and the SF-36 questionnaire were completed by 214 patients on the day of their hand or upper limb surgery; and a postop POS-Hand/Arm and the SF-36 questionnaire were completed by patients 3 months after their initial surgery. The POS-Hand/Arm questionnaire responses were psychometrically evaluated and it was shown to have high internal consistency; high total-item correlations; signification scale correlations with the SF-36; and a low proportion of missing data. The POS-Hand/Arm questionnaire is a psychometrically sound instrument that can be used pre- and post-surgery to evaluate patient-based outcomes for a wide range of conditions in hand and upper limb surgery.

Simultaneous widefield single molecule orientation and FRET microscopy in cells.

We combine single molecule fluorescence orientation imaging with single-pair fluorescence resonance energy transfer microscopy, using a total internal reflection microscope. We show how angles and FRET efficiencies can be determined for membrane proteins at the single molecule level and provide data from the epidermal growth factor receptor system in cells.

Instrument for determining the complex shear modulus of soft-tissue-like materials from 10 to 300 Hz.

Accurate determination of the complex shear modulus of soft tissues and soft-tissue-like materials in the 10-300 Hz frequency range is very important to researchers in MR elastography and acoustic radiation force impulse (ARFI) imaging. A variety of instruments for making such measurements has been reported, but none of them is easily reproduced, and none have been tested to conform to causality via the Kramers-Kronig (K-K) relations. A promising linear oscillation instrument described in a previous brief report operates between 20 and 160 Hz, but results were not tested for conformity to the K-K relations. We have produced a similar instrument with our own version of the electronic components and have also accounted for instrumental effects on the data reduction, which is not addressed in the previous report. The improved instrument has been shown to conform to an accurate approximation of the K-K relations over the 10-300 Hz range. The K-K approximation is based on the Weichert mechanical circuit model. We also found that the sample thickness must be small enough to obtain agreement with a calibrated commercial rheometer. A complete description of the improved instrument is given, facilitating replication in other labs.

AMD3100 synergizes with G-CSF to mobilize repopulating stem cells in Fanconi anemia knockout mice.

Fanconi anemia (FA) is a heterogeneous inherited disorder characterized by a progressive bone marrow (BM) failure and susceptibility to myeloid leukemia. Genetic correction using gene-transfer technology is one potential therapy. A major hurdle in applying this technology in FA patients is the inability of granulocyte colony-stimulating factor (G-CSF) to mobilize sufficient numbers of hematopoietic stem (HSC)/progenitor cells (HPC) from the BM to the peripheral blood. Whether the low number of CD34(+) cells is a result of BM hypoplasia or an inability of G-CSF to adequately mobilize FA HSC/HPC remains incompletely understood. Here we use competitive repopulation of lethally irradiated primary and secondary recipients to show that in two murine models of FA, AMD3100 synergizes with G-CSF resulting in a mobilization of HSC, whereas G-CSF alone fails to mobilize stem cells even in the absence of hypoplasia.

A cosmic microwave background feature consistent with a cosmic texture.

The Cosmic Microwave Background provides our most ancient image of the universe and our best tool for studying its early evolution. Theories of high-energy physics predict the formation of various types of topological defects in the very early universe, including cosmic texture, which would generate hot and cold spots in the Cosmic Microwave Background. We show through a Bayesian statistical analysis that the most prominent 5 degrees -radius cold spot observed in all-sky images, which is otherwise hard to explain, is compatible with having being caused by a texture. From this model, we constrain the fundamental symmetry-breaking energy scale to be (0) approximately 8.7 x 10(15) gigaelectron volts. If confirmed, this detection of a cosmic defect will probe physics at energies exceeding any conceivable terrestrial experiment.

Titering lentiviral vectors: comparison of DNA, RNA and marker expression methods.

To better characterize lentiviral vector supernatants, we compared three methods of titer assessment. These titer methods include assessment of vector RNA sequences in supernatants, DNA sequences in transduced cells, and vector expression in transduced cells (using a vector which expressed the green fluorescence protein, GFP). For analysis of RNA and DNA, we developed a real-time PCR method for detecting the lentiviral packaging sequence and used this methodology to quantitate the number of vector sequences. Vector expression was assessed by flow cytometric analysis for GFP. As functional titers (DNA and GFP expression titers) are dependent on transduction efficiency, we calculated the titer of a lentiviral vector, RRL-CMV-GFP, after transduction of 293, HeLa, or Mus dunni cells. Genomic DNA was extracted at 4 and 14 days after transduction and the number of vector DNA molecules was determined against a plasmid standard. Of the three cell lines tested, 293 cells provided the highest rate of transduction (PCR estimated DNA titer for RRL-CMV-GFP vector was 2.52 +/- 0.25 x 10(6) molecules/ml at 14 days, and 2.31 +/- 0.15 x 10(6) molecules/ml at 4 days). When titer was calculated based on GFP expression, the highest titer was also obtained on 293 cells (0.26 +/- 0.04 x 10(6) TU/ml at 14 days, and 0.24 +/- 0.03 +/- 10(6) TU/ml at 4 days). The titers obtained by GFP expression assay were approximately one log lower than those obtained by DNA analysis suggesting that variability in vector expression may underestimate titer. Measurement of RNA titers directly from vector supernatants against a plasmid standard indicated that the RNA titers are substantially higher than the DNA (approximately 10(3)-fold) and GFP titers (approximately 10(4)-fold). To show that the lentiviral probe and primers could be used for titering a variety of lentiviral vectors, we have also used the real-time PCR method to determine the DNA titers of two other HIV1 derived vectors, RRL-PGK-GFP (6.1 +/- 1.4 x 10(5) molecules/ml), and SMPU-RRE-BN (1.26 +/- 0.2 x 10(6) molecules/ml). We conclude that of the three methods tested, titers assessed by DNA analysis of transduced cells provide the most reliable estimate of functional titers as these are least likely to be influenced by factors, such as defective interfering particles and vector expression levels. The real-time PCR method described offers a reproducible method for lentiviral titering and can be applied to a wide variety of vectors, regardless of transgene.

VEGF enhances intraneural angiogenesis and improves nerve regeneration after axotomy.

Whilst there is an increased understanding of the cell biology of nerve regeneration, it remains unclear whether there is a direct interrelationship between vascularisation and efficacy of nerve regeneration within a nerve conduit. To establish this is important as in clinical surgery peripheral nerve conduit grafting has been widely investigated as a possible alternative to the use of nerve autografts. The aim of this study was to assess whether vascular endothelial growth factor (VEGF), a highly specific endothelial cell mitogen, can enhance vascularisation and, indirectly, axonal regeneration within a silicone nerve regeneration chamber. Chambers containing VEGF (500-700 ng/ml) in a laminin-based gel (Matrigel) were inserted into 1 cm rat sciatic nerve defects and nerve regeneration examined in relation to angiogenesis between 5 and 180 d. Longitudinal sections were stained with antibodies against endothelial cells (RECA-1), axons (neurofilament) and Schwann cells (S-100) to follow the progression of vascular and neural elements. Computerised image analysis demonstrated that the addition of VEGF significantly increased blood vessel penetration within the chamber from d 5, and by d 10 this correlated with an increase of axonal regeneration and Schwann cell migration. The pattern of increased nerve regeneration due to VEGF administration was maintained up to 180 d, when myelinated axon counts were increased by 78 % compared with plain Matrigel control. Furthermore the dose-response of blood vessel regeneration to VEGF was clearly reflected in the increase of axonal regrowth and Schwann cell proliferation, indicating the close relationship between regenerating nerves and blood vessels within the chamber. Target organ reinnervation was enhanced by VEGF at 180 d as measured through the recovery of gastrocnemius muscle weights and footpad axonal terminal density, the latter showing a significant increase over controls (P < 0.05). The results demonstrate an overall relationship between increased vascularisation and enhanced nerve regeneration within an acellular conduit, and highlight the interdependence of the 2 processes.

Inter-relationships between angiogenesis and nerve regeneration: a histochemical study.

Whilst increases in capillary number and permeability occurring during nerve regeneration suggest an interaction between regenerating axons and blood vessels, clinical attempts to improve nerve regeneration by augmenting nerve graft vascularisation have produced conflicting results and the nature of their relationship remains obscure. A better understanding of the process might be exploited in the development of a synthetic alternative to the autologous nerve graft and bring an improvement in the clinical results of nerve repair. To clarify this relationship the growth of axons and blood vessels through mats of orientated fibronectin grafted in rat sciatic nerves was assessed morphologically. Fibronectin, which supports axonal regeneration, is initially acellular, ensuring all vascular and neural elements within the graft are newly formed. To follow the progression of the elements, grafts were harvested between 3 and 30 days and stained with antibodies against endothelial cells (RECA-1), Schwann cells (S-100) and axons (a polyclonal or monoclonal panaxonal marker). Dual fluorescence staining combined with double exposure photography allowed the simultaneous visualisation of these elements and the demonstration of their true relative positions. Graft vascularisation came initially from the adjacent muscle bed. A neovascularisation front preceded axonal regeneration, although vessel and axonal orientation appeared similar. Schwann cells and axons extended together, never exceeding the area of vascularisation and appeared most numerous in well vascularised areas containing longitudinally orientated vessels. These results suggest that provision of a well vascularised, longitudinally orientated conduit may enhance nerve regeneration.

Effects of baseline responses, in-task feelings, and duration of activity on exercise-induced feeling states in women.

This study investigated the hypothesis that the effects of acute aerobic exercise on feeling states may be influenced by the objective dose of activity, subjective responses during exercise, and preexisting levels of feeling states. College-age women (N = 80) completed baseline measures and were then randomly assigned to 1 of 4 conditions: attention control for 10 min, or exercise for 10 min, 25 min, or 40 min. Levels of exertion and affect were assessed during exercise, and posttesting occurred 20 min following activity. Exercise enhanced revitalization in comparison with the control condition; however, this effect occurred only for participants scoring low to moderate on the pretest. In addition, in-task feeling states predicted postexercise revitalization even after we controlled for the treatment, the pretest, and the Pretest x Treatment interaction.

An audit of non-accidental injury in burned children.

The incidence of non-accidental injury in burned children and the repeat injury rate following non-accidental injury is very high according to some reports. A retrospective follow-up review was undertaken for all patients admitted to the Plymouth Paediatric Burns Unit over a 47-month period. Hospital records, general practitioners' records and the Social Services Department were used to gain follow-up information. The incidence of confirmed abuse was about 3 per cent and this included intentional injury as well as other forms of abuse such as neglect. The repeat injury rate was very low indeed. These figures are very much lower than many of the published figures. This may be due to differences in the definition of non-accidental injury, differences in the population make-up or simply that a burn injury is a relatively uncommon form of non-accidental injury in Devon and Cornwall.