Defining in Detail and Evaluating Reliability of DSM-5 Criteria for Autism Spectrum Disorder (ASD) Among Children.

This paper describes a process to define a comprehensive list of exemplars for seven core Diagnostic and Statistical Manual (DSM) diagnostic criteria for autism spectrum disorder (ASD), and report on interrater reliability in applying these exemplars to determine ASD case classification. Clinicians completed an iterative process to map specific exemplars from the CDC Autism and Developmental Disabilities Monitoring (ADDM) Network criteria for ASD surveillance, DSM-5 text, and diagnostic assessments to each of the core DSM-5 ASD criteria. Clinicians applied the diagnostic exemplars to child behavioral descriptions in existing evaluation records to establish initial reliability standards and then for blinded clinician review in one site (phase 1) and for two ADDM Network surveillance years (phase 2). Interrater reliability for each of the DSM-5 diagnostic categories and overall ASD classification was high (defined as very good .60-.79 to excellent ≥ .80 Kappa values) across sex, race/ethnicity, and cognitive levels for both phases. Classification of DSM-5 ASD by mapping specific exemplars from evaluation records by a diverse group of clinician raters is feasible and reliable. This framework provides confidence in the consistency of prevalence classifications of ASD and may be further applied to improve consistency of ASD diagnoses in clinical settings.

Human echo perception.

It has been shown that human test subjects have the ability, under controlled laboratory conditions, to use echoes to detect the presence or absence of targets placed before them. In addition, blind and sighted persons have been able to detect a target monaurally, to make simple shape discriminations, and to locate a target in space. Signal, environmental, and individual variability affect performance in a measurable fashion. This research is an initial step in measuring the limits of a human being's ability to use echoes as a source of information about his physical surroundings. At this point it seems unlikely that the unaided human ear can rival the bat's auditory system for echo perception. It may be, however, that modern technology can partially bridge the evolutionary gap and bring more useful echoes to man's ear than those it now receives. Such an accomplishment would allow us to examine the extent to which man might benefit from this means of sensing his environment.

Uncertain genesis. The academic institutionalization of American psychology in 1900.

The new discipline of psychology had been established at a number of American colleges and universities by 1900, but it usually existed in a more rudimentary form, as compared with the familiar autonomous department of psychology found today. The current form took quite a number of years to evolve: A century ago, a survey of these schools would have shown psychology programs to have existed mostly at early stages of development. Many of the schools were still teaching some form of moral or mental philosophy or only one or two courses in psychology. A few of the schools had established psychology laboratories. Fewer still were offering the doctor of philosophy degree in psychology, while a mere handful had independent psychology departments.

Methods of preparing supplementing fractions from fresh unheated bovine sera for use in modified direct complement-fixation tests.

TWO METHODS OF PREPARING PARTIALLY PURIFIED, RELATIVELY STABLE SUPPLEMENTING FACTOR FROM FRESH BOVINE SERUM ARE DESCRIBED: gel filtration through Sephadex G-25, and anion exchange chromatography on a diethylaminoethyl (DEAE) cellulose column. In both procedures, an active, reconstituted precipitate prepared by dialysis of fresh unheated normal serum in the cold for 18 hours against phosphate buffer pH 6.2, 0.02 M, serves as the starting material. The Sephadex G-25 column is equilibrated with acetate buffer pH 5.4, 0.2 M. The most actively-supplementing material appears in the eluates in which the pH has risen to 7.5 or higher. For the DEAE cellulose chromatography a gradient system is used: initial phosphate buffer 0.03 M, pH 8.0, limiting buffer Na H(2)PO(4), 0.3 M. The greater part of the supplementing activity is eluated between pH 5.6 and 6.0, although some of the earlier fractions are also reactive. Pooled active eluates stored in the frozen state for nine months or longer maintained their supplementing titre in modified complement-fixation tests of two bacterial antigen-bovine antibody systems.

Initiating a pediatric peripherally inserted central catheter and midline catheter program.

The lack of published literature specific to the pediatric population (1 month to 18 years) was a major deterrent to the initiation of a peripherally inserted central catheter (PICC) and midline catheter program in a 260-bed pediatric hospital. The intravenous team assumed responsibility for the program initiated by the physicians. The following challenges were encountered: administrative issues, insertion-related discomfort, adverse clinical reactions, equipment inadequacies, catheter maintenance, and staff education. To date, the i.v. team has successfully placed 84 catheters and concludes that the procedure is invaluable for pediatric patients requiring an extended course of i.v. therapy.

Serological studies of parasitized cattle. I. Complement--fixing activity of serial serum samples.

Complement-fixation (CF) tests with sonicated aqueous extracts of adult forms of five species of gastrointestinal nematodes as antigens have been made on serial biweekly bleedings from two groups of parasitized calves grazing on infected pastures during the 1963 or 1964 seasons. Three of these nematode species, Cooperia oncophora, Ostertagia ostertagi and Nematodirus helvetianus, were found in large numbers in most of these animals. The calves were negative serologically before being placed on pasture but within 2 to 4 weeks some had developed considerable CF activity with Cooperia and other nematode antigens. Ten calves died, however, before significant CF titres had been attained. Eight control calves in the 1963 or 1964 groups which were grazed on "clean" pastures, remained serologically negative during the summer and autumn months. Four of the six surviving exposed animals in the 1964 group showed a fall in CF activity during the winter months when they were stabled, whereas the six surviving controls developed low CF titres suggesting that they were becoming mildly parasitized. In the spring of 1965 CF titres began to rise in some of the previously exposed and control yearlings even before they were placed on infected pasture in June.

A preliminary study of the development of 19S and 7S immunoglobulins in sera of two sheep vaccinated with Brucella abortus, strain 19.

The pattern of antibody response to vaccination with Brucella abortus, strain 19, was studied in two sheep. Agglutinative activity was detected by the third and fifth days and complement - fixing activity by the fifth and seventh days post-vaccination. Density gradient centrifugation and DEAE cellulose column chromatography showed the 19S antibody developed first, followed soon after by 7S antibody. The former had disappeared by the 25th day but the latter persisted longer in both sheep. A small amount of 19S antibody was detected in sheep 1 following a booster dose of vaccine but 7S antibody constituted the major secondary response. The standard tube agglutination test was found to be more efficient than the complement-fixation test for titration of 19S antibody. An increase in the salt concentration to 10% in tube agglutination test rendered it more sensitive in demonstrating 7S antibody.

Ultracentrifugal studies of sera from cattle vaccinated or naturally infected with Brucella abortus.

In conformity with the findings of previous investigators, it was shown by density gradient ultracentrifugation that the antibodies in sera collected from calves shortly after vaccination with Brucella abortus, strain 19, were entirely or mainly rapidly-sedimenting. These macroglobulin (19S or IgM) antibodies showed complement-fixing as well as agglutinative activity with Br. abortus antigen. In later bleedings from the same vaccinated calves, antibodies with an intermediate sedimentation rate, (IgG), were present, as well as IgM. Sera from 15 of 22 non-vaccinated, relatively recent field cases of brucellosis appeared to contain only the IgG class of antibodies. In one herd, however, two cows with IgM only and five with both IgM and IgA were found; all seven of these cattle had been serologically negative before their introduction into this known infected herd a few months earlier. The agglutinative activity of sera from four cases of brucellosis of long standing and from eight cows, 4 to 13 years of age, that had been vaccinated as calves, was confined to the IgG fraction.

Chromatographic studies of sera from calves vaccinated with brucella abortus, strain 19.

The presence of antibody was detected by agglutination tests in the serum of calves four days after vaccination with Brucella abortus strain 19. Titres had reached a maximum by seven to ten days post-vaccination. Sucrose density-gradient ultracentrifugation demonstrated that the earliest antibodies were macroglobulins, IgM (19Sgamma; gammaM)-globulins. Lighter antibodies, IgG (7Sgamma(2); gammaG)-globulins, appeared a few days later. With time, antibody titres fell, IgM declining somewhat more quickly than IgG. After revaccination some seven months later, there was a rapid rise in both IgM and IgG.Anion-exchange column chromatography (DEAE-cellulose) and gel filtration (Sephadex G-200) were applied in separating the two forms of antibody. The former method, in which a gradient buffer system was used, proved to be the more efficient; the IgG antibodies apeared in early eluates at pH 7.8 to 8.0 and low ionic strength, 0.03M, whereas IgM was eluted late when the pH had fallen below 6.0 and the molarity had increased to beyond 0.2. DEAE cellulose chromatography detected IgG as well as IgM sera collected as early as five days after vaccination.

Serological studies of parasitized cattle. II. Electrophoretic properties of serial serum samples.

Electrophoretic examinations using cellulose acetate strips were made on 17 serum samples collected at two-week intervals from each of three calves before and for about four months after they were placed on parasite-infected pastures in June, 1964. Four additional serum samples taken during the winter months when the animals were stabled and two obtained after they were again exposed to infected pastures in June 1965, were also examined. Two control animals of the same age, that were placed on clean pasture in 1964 and not exposed to infected pasture until June 1965, were bled on the same dates and their sera examined in parallel. All five calves showed an increase in the proportion and amount of gamma-globulin in their serum as they increased in age but the gain was greatest in the two exposed calves that developed the highest complement-fixing titres with nematode antigens. Complement-fixing titres rose slowly in the other exposed calf and its serum gamma-globulin level remained relatively comparable to that of the two controls.

Electrophoretic studies of sera from cattle vaccinated or naturally infected with Brucella abortus.

Examinations of the electrophoretic behaviour in cellulose acetate were made on the proteins of sera from 18 field cases of brucellosis, 15 calves recently vaccinated with strain 19 Brucella abortus and from 28 normal cattle. The total protein and gamma-globulin content of the sera of the naturally infected, serologically positive cattle tended to be somewhat higher than that of sera from most normal cattle. A few of the serologically-negative normals also had defenitely elevated serum gamma-globulin values. In the vaccinated calves there was an increase both in total serum protein and gamma-globulin but its magnitude in different individuals was not directly related to the rise in their antibody titre.

Antibody development in pigs inoculated with live or killed cultures of Brucella abortus.

As shown by density gradient ultracentrifugation and column chromatography, pigs formed IgM antibodies during the first week following vaccination with Brucella abortus, strain 19. At this time their sera reacted in both plate and tube agglutination but not in complement-fixation tests. A few days later, when IgG antibodies had developed, agglutination titers were still high and some activity was recorded in hemolytic complement-fixation tests. A similar sequence was observed in pigs repeatedly inoculated with phenol-killed suspensions of B. abortus. As the proportion of IgM to IgG antibodies decreased, agglutinin titers fell in relation to complement-fixing titers. In some animals the conglutinating complement absorption test became positive earlier than the plate agglutination.