Translational profiling of retinal ganglion cell optic nerve regeneration in Xenopus laevis.

Unlike adult mammals, adult frogs regrow their optic nerve following a crush injury, making Xenopus laevis a compelling model for studying the molecular mechanisms that underlie neuronal regeneration. Using Translational Ribosome Affinity Purification (TRAP), a method to isolate ribosome-associated mRNAs from a target cell population, we have generated a transcriptional profile by RNA-Seq for retinal ganglion cells (RGC) during the period of recovery following an optic nerve injury. Based on bioinformatic analysis using the Xenopus laevis 9.1 genome assembly, our results reveal a profound shift in the composition of ribosome-associated mRNAs during the early stages of RGC regeneration. As factors involved in cell signaling are rapidly down-regulated, those involved in protein biosynthesis are up-regulated alongside key initiators of axon development. Using the new genome assembly, we were also able to analyze gene expression profiles of homeologous gene pairs arising from a whole-genome duplication in the Xenopus lineage. Here we see evidence of divergence in regulatory control among a significant proportion of pairs. Our data should provide a valuable resource for identifying genes involved in the regeneration process to target for future functional studies, in both naturally regenerative and non-regenerative vertebrates.

Phenotypic selection on leaf ecophysiological traits in Helianthus.

Habitats that differ in soil resource availability are expected to differ for selection on resource-related plant traits. Here, we examined spatial and temporal variation in phenotypic selection on leaf ecophysiological traits for 10 Helianthus populations, including two species of hybrid origin, Helianthus anomalus and Helianthus deserticola, and artificial hybrids of their ancestral parents. Leaf traits assessed were leaf size, succulence, nitrogen (N) concentration and water-use efficiency (WUE). Biomass and leaf traits of artificial hybrids indicate that the actively moving dune habitat of H. anomalus was more growth limiting, with lower N availability but higher relative water availability than the stabilized dune habitat of H. deserticola. Habitats differed for direct selection on leaf N and WUE, but not size or succulence, for the artificial hybrids. However, within the H. anomalus habitat, direct selection on WUE also differed among populations. Across years, direct selection on leaf traits did not differ. Leaf N was the only trait for which direct selection differed between habitats but not within the H. anomalus habitat, suggesting that nutrient limitation is an important selective force driving adaptation of H. anomalus to the active dune habitat.

Consciousness, content, and metacognitive judgments.

Because metacognition consists in our having mental access to our cognitive states and mental states are conscious only when we are conscious of them in some suitable way, metacognition and consciousness shed important theoretical light on one another. Thus, our having metacognitive access to information carried by states that are not conscious helps confirm the hypothesis that a mental state's being conscious consists in having a noninferential higher-order thought about that state. This higher-order-thought hypothesis readily explains the appearance to consciousness of confabulatory mental states-states that do not actually occur. This fits well with, and helps refine, the "No-Magic Hypothesis" advanced by Nelson and Narens (1990).

Does the structure of clinical questions affect the outcome of curbside consultations with specialty colleagues?

BACKGROUND: Clinical questions frequently arise during the practice of medicine, and primary care physicians frequently use curbside consultations with specialty physicians to answer these questions. It is hypothesized that well-formulated clinical questions are more likely to be answered and less likely to receive a recommendation for formal consultation. OBJECTIVE: To assess the relationship between the structure of clinical questions asked by family physicians and the response of specialty physicians engaged in curbside consultations. DESIGN AND PARTICIPANTS: A case series of clinical questions asked during informal consultations between 60 primary care and 33 specialty physicians using an e-mail service. Curbside consultation questions were sent, using e-mail, to academic specialty physicians by primary care physicians (faculty, residents, and community practitioners) in eastern Iowa. MAIN OUTCOME MEASURES: Questions were analyzed to determine the clinical task and to identify 3 components: an intervention, a comparison, and an outcome. Consultants' responses were analyzed to identify whether questions were answered and whether consultants recommended formal consultation. RESULTS: There were 708 questions in this analysis: 278 (39.3%) were diagnosis questions, 334 (47.2%) were management questions, 57 (8.0%) were prognosis questions, and 39 (5.5%) were requests for direction. Clinical questions were less likely to go unanswered or receive a recommendation for formal consultation when the question identified the proposed intervention (odds ratio, 0.54; 95% confidence interval, 0.34-0.86; P = .006) and desired outcome (odds ratio, 0.46; 95% confidence interval, 0.29-0.69; P < .001). Only 271 (38.3%) of 708 curbside consult questions identified both of these components. CONCLUSION: Medical specialists' responses to curbside consultation questions seem to be affected by the structure of these clinical questions.

Use of an E-mail curbside consultation service by family physicians.

BACKGROUND: Informal (curbside) consultations are central to clinical medicine. Typically, these exchanges between health professionals occur face-to-face or by telephone, but both of these methods can be inefficient. We created an electronic mail (E-mail) service for curbside consultations between family physicians and other health care specialists at an academic medical center. METHODS: Family physicians had access to the E-mail Consult Service (ECS) from 20 computers at three office practice sites, one hospital, and their personal offices. Informal consults could be obtained from 26 different consultants at the University of Iowa using standard E-mail. Data on the content of the consults and the use of this service were collected and both family physicians and consultants were questioned about their perceptions of the service. RESULTS: In the 18 months that the service was available, the ECS handled 237 consults. The median response time for a consult by using the service was 16.1 hours. Consultations in the area of adult medicine were the most common, followed by consults in obstetrics and gynecology. Nearly 90% of the consults were about a specific patient, and the majority of the questions were about management issues. Consultants answered 92% of the questions asked by family physicians using the ECS. Family physicians reported that this service was helpful, and most consultants reported that they enjoyed E-mail curbside consults. CONCLUSIONS: E-mail was successfully used for curbside consults. Both the family physicians and consultants found that an E-mail consultation service could be integrated into their practices.

suicidal adolescents: Family dynamics and the effects of lethality and hopelessness.

The purpose of this study was to develop a profile of the family dynamics of suicidal adolescents regarding the constructs of overprotection, enmeshment, rigidity, and conflict avoidance. The relationship of the family dynamics, and adolescent's degree of hopelessness, and the lethality of the suicidal behavior were also examined. The Structural Family Interaction Scale, Marital Satisfaction Inventory, Hopelessness Scale, and lethality rating were utilized to assess the families and groups. The total sample (N=49) was comprised of two groups: the families with suicidal adolescents groups (N=34), and the nonsuicidal, symptomatic adolescents group (N=15). Results supported hypotheses that the families were similar in overprotection and enmeshment, and that suicidal families were more rigid and conflict avoidant. Hopelessness and lethality were not significant, although lethality contributed to the variance in the perceptions of marital relationships in suicidal families.

Disseminated cutaneous and peritoneal hyalohyphomycosis caused by Fusarium species: three cases and review of the literature.

Three recent cases of hyalohyphomycosis caused by Fusarium sp. illustrate differing aspects of infections produced by these organisms. One patient was undergoing continuous ambulatory peritoneal dialysis when peritonitis developed caused by Fusarium moniliforme. Removal of the catheter and amphotericin B were used in successful management. In a neutropenic patient on therapy for leukemia, multiple persistent infections occurred including JK diptheroids, and Candida albicans sepsis. Finally, numerous florid skin lesions caused by Fusarium oxysporum developed even while the patient was receiving amphotericin B and he died. In a second neutropenic patient on treatment for leukemia, sinus and cutaneous lesions developed due to Fusarium. These resolved on amphotericin B therapy following the return of circulating neutrophils. The literature on Fusarium infections and aspects of the biology of the organism are reviewed.

The family therapist and the family physician: a cooperative model.

This study discusses the current lack of cooperation between family physicians and family therapists and its roots in the different belief systems that influence each profession. Family medicine and family therapy have each, in different ways, espoused a reductionistic view of the systems model they each formally espouse. A model is proposed that enables each profession to work cooperatively with the other by recognizing the particular dysfunction present within the family. This model is explained and clarified in terms of the interaction of biomedical and developmental crises in the course of the normal family life cycle. The purpose of this model is to provide a framework through which the two professions of family medicine and family therapy can cooperate to treat the various kinds of levels of dysfunction that occur within families.

Microsurgical reversal of sterilization: a six-year study.

A prospective study of 113 personal consecutive microsurgical reversals of female sterilization during the 6-year period from 1979 to 1984 was carried out to determine factors affecting the pregnancy rate. The sterilizations were performed by laparoscopic unipolar coagulation in 54% of the patients, by the Pomeroy technique in 28%, by fimbriectomy in 8%, by the Irving operation in 5%, and by clips or rings in 4%. In the group with no minimum follow-up period, 50% had intrauterine pregnancies and 5% had ectopic gestations. Eighty-nine patients had at least 12 months of follow-up after reversal surgery. This group is studied in detail. Factors affecting the pregnancy rate were length of tube, type of sterilization performed, anastomotic site, and availability of both tubes for reconstruction. Age, parity, and interval from sterilization to reversal surgery did not affect the pregnancy rate. Fifty percent of the intrauterine pregnancies were conceived within 6 months of reversal surgery.

Angiographic arterial embolization in the management of postoperative vaginal hemorrhage.

Recently great success was achieved at the Toronto General Hospital in treating patients with postoperative vaginal hemorrhage by angiographic methods. A retrospective review was performed from 1975 to 1984 on eight patients treated by this technique for nine separate episodes of hemorrhage with a mean estimated blood loss in excess of 5000 ml. Success was achieved in seven episodes despite failure of various vaginal and abdominal approaches. One of the failures was due to previous bilateral hypogastric artery ligation that made the bleeding branch inaccessible to the angiography catheter. The other patient developed bleeding following cesarean section which did not respond to angiographic embolization due to faulty technique. Both of these patients were eventually cured by abdominal surgery. We feel that angiographic embolization is the procedure of choice in the management of postoperative vaginal hemorrhage when conservative management has failed or is inappropriate; it can be lifesaving when all other attempts to stop the hemorrhage have failed.

Management of postoperative vaginal hemorrhage.

The authors' experience in the management of postoperative vaginal hemorrhage from 1975 to 1980 was reviewed. Recently, success has been achieved using angiographic arterial embolization with the Gianturco minicoil. The results of embolization are compared with those achieved through other more conventional methods. The authors have found angiographic embolization to be safe, simple, and effective, and they recommend that the procedure be performed before laparotomy for intractable postoperative vaginal bleeding.