Infant affect and affect regulation during the still-face paradigm with mothers and fathers: the role of infant characteristics and parental sensitivity

This laboratory study examined mothers' and fathers' sensitivity during face-to-face interactions with their infants as well as infants' affective and regulatory responses during mother-infant versus father-infant still face (SF). The degree to which infant gender and temperament as well as parental sensitivity predicted SF responses was also examined. Participants included 94 healthy, primarily White, middle-class 4-month-olds and their parents. Results indicated that mothers and fathers were equally sensitive toward their infants. Infants' affect and regulatory behaviors were also significantly stable across mother- and father-infant SF situations, although several differences in mean levels of regulation emerged. Finally, the extent to which exogenous and endogenous variables predicted infant SF responses differed as a function of which affect or regulatory variable was being examined and with which parent the infant was experiencing SF.     

Fifteen years experience with finger arterial pressure monitoring: assessment of the technology

We review the Finapres technology, embodied in several TNO-prototypes and in the Ohmeda 2300 and 2300e Finapres NIBP. Finapres is an acronym for FINger Arterial PRESsure, the device delivers a continuous finger arterial pressure waveform. Many papers report on the accuracy of the device in comparison with intra-arterial or with noninvasive but intermittent blood pressure measurements. We compiled the results of 43 such papers and found systolic, diastolic and mean accuracies, in this order, ranging from -48 to 30 mmHg, from -20 to 18 mmHg, and from -13 to 25 mmHg. Weighted for the number of subjects included pooled accuracies were -0.8 (SD 11.9), -1.6 (8.3) and -1.6 (7.6) mmHg respectively. Subdividing the pooled group according to criteria such as reference blood pressure, place of application, and prototype or commercial device we found no significant differences in mean differences or SD. Measurement at the finger allows uninterrupted recordings of long duration. The transmission of the pressure pulse along the arm arteries, however, causes distortion of the pulse waveform and depression of the mean blood pressure level. These effects can be reduced by appropriate filtering, and upper arm 'return-to-flow' calibration to bring accuracy and precision within AAMI limits. For the assessment of beat-to-beat changes in blood pressure and assessment of blood pressure variability Finapres proved a reliable alternative for invasive measurements when mean and diastolic pressures are concerned. Differences in systolic pressure are larger and reach statistical significance but are not of clinical relevance. Finger arteries are affected by contraction and dilatation in relation to psychological and physical (heat, cold, blood loss, orthostasis) stress. Effects of these phenomena are reduced by the built-in Physiocal algorithm. However, full smooth muscle contraction should be avoided in the awake patient by comforting the patient, and covering the hand. Arterial state can be monitored by observing the behaviour of the Physiocal algorithm. We conclude that Finapres accuracy and precision usually suffice for reliable tracking of changes in blood pressure. Diagnostic accuracy may be achieved with future application of corrective measures.     

Long-term evaluation of the ventricular defibrillation energy requirement

INTRODUCTION: Defibrillation energy requirements in patients with nonthoracotomy defibrillators may increase within several months after implantation. However, the stability of the defibrillation energy requirement beyond 1 year has not been reported. The purpose of this study was to characterize the defibrillation energy requirement during 2 years of clinical follow-up. METHODS AND RESULTS: Thirty-one consecutive patients with a biphasic nonthoracotomy defibrillation system underwent defibrillation energy requirement testing using a step-down technique (20, 15, 12, 10, 8, 6, 5, 4, 3, 2, and 1 J) during defibrillator implantation, and then 24 hours, 2 months, 1 year, and 2 years after implantation. The mean defibrillation energy requirement during these evaluations was 10.9+/-5.5 J, 12.3+/-7.3 J, 11.7+/-5.6 J, 10.2+/-4.0 J, and 11.7+/-7.4 J, respectively (P = 0.4). The defibrillation energy requirement was noted to have increased by 10 J or more after 2 years of follow-up in five patients. In one of these patients, the defibrillation energy requirement was no longer associated with an adequate safety margin, necessitating revision of the defibrillation system. There were no identifiable clinical characteristics that distinguished patients who did and did not develop a 10-J or more increase in the defibrillation energy requirement. CONCLUSION: The mean defibrillation energy requirement does not change significantly after 2 years of biphasic nonthoracotomy defibrillator system implantation. However, approximately 15% of patients develop a 10-J or greater elevation in the defibrillation energy requirement, and 3% may require a defibrillation system revision. Therefore, a yearly evaluation of the defibrillation energy requirement may be appropriate.     

Certified dental assistants. Dentistry''s newest professional category

The authors observed 224 patients with neglected forms of carcinoma of distal portions of the colon, 171 (76.3%) of them being considered to be operable. The character of operative interventions depended on neglect of the tumour process which was determined by its spread to the neighbouring organs and tissues. The endolymphatic antibacterial therapy through the inguinal lymph node allowed the perifocal inflammation to be controlled which made the ablation of the tumour and the involved lymph nodes easier. The veritable ingrowth of the tumour into the neighbouring organs and tissues was noted in 15.4% of the patients. Radical operations were performed on 128 patients (74.9%), the other patients were submitted to palliative operations. The strategy of surgical treatment must be based upon the detailed diagnosis of the tumour growth and adequate preoperative preparation including endolymphatic infusions of antibacterial medicine. It allows to increase the amount of radical interventions and widen the indications for performing sphincter-saving operations.     

Risk stratification using the Society of Thoracic Surgeons Program

In an era of progressive cost containment and public scrutiny, the wisdom of aggressive surgical therapy for high-risk candidates has been questioned. At our center in the previous 24 months, 728 patients with coronary artery disease were entered into The Society of Thoracic Surgeons national database, and the hospital outcomes plus length of stay were analyzed. Patients were separated according to the predicted mortality based on the groupings in The Society of Thoracic Surgeons database: 0 to 5% (453 patients); 5% to 10% (126 patients); 10% to 20% (96 patients); 20% to 30% (17 patients); and 30% and greater (36 patients). There was a close correlation with the predicted rates of mortality. Importantly, the preoperative risk stratification demonstrated a strong correlation with the significant morbidity and excessive length of stay in the highest-risk groups (predicted risk of 20% to > or = 30%). The incidences of the most common complications in the group with the highest predicted risk (> or = 30%) were 28%, renal failure; 33%, ventilator dependence; and 17%, cardiac arrest. In addition, at short-term follow-up (6 to 8 months), a 24.3% mortality was identified in patients with a predicted mortality that exceeded 20%. These data quantify the risks and morbidities associated with the care of seriously ill patients with coronary artery disease and demonstrate the need for professional and public discussions focusing on the association of a high preoperative risk status and the consumption of resources.     

The syntaxin Tlg1p mediates trafficking of chitin synthase III to polarized growth sites in yeast

Tlg1p and Tlg2p, members of the syntaxin family of SNAREs in yeast, have been implicated in both endocytosis and the retention of late Golgi markers. We have investigated the functions of these and the other endocytic syntaxins Pep12p and Vam3p. Remarkably, growth is possible in the absence of all four proteins. In the absence of the others, Pep12p and Tlg1p can each create endosomes accessible to the endocytic tracer dye FM4-64. However, although Pep12p is required for the ligand-induced internalization of the alpha factor receptor and its passage via Pep12p-containing membranes to the vacuole, Tlg1p is not. In contrast, Tlg1p is required for the efficient localization of the catalytic subunit of chitin synthase III (Chs3p) to the bud neck, a process that involves endocytosis and polarized delivery of Chs3p. In wild-type cells, internalized Chs3p cofractionates with Tlg1p and Tlg2p, and in a strain lacking the other endocytic syntaxins, either Tlg1p or Tlg2p is sufficient for correct localization of the enzyme. Pep12p is neither necessary nor sufficient for this process. We conclude that there are two endocytic routes in yeast that can operate independently and that Tlg1p is located at the junction of one of these with the polarized exocytic pathway.     

Ensuring reliability in B2B services: Fault tolerant inter-organizational workflows

In the age of Business-to-Business (B2B) collaboration, ensuring reliability of workflows underlying inter-organizational business processes is of significant importance. There are, however, quite a few challenges towards achieving seamless operation. Such challenges arise from heterogeneity in infrastructure and coordination mechanism at participant organizations, as well as time and cost associated with recovery from failure. Our research presents foundations for a reliable scheme for recovery from failure of workflow processes spanning through multiple business entities. First, a system model is adapted from the mobile computing literature that serves to establish the requirements to be enforced by each participating organization. In our model, we adopt the Maximal Sequence Path (MSP) approach from Yoo et al. (Lecture Notes in Artificial Intelligence 2132:222–236, 2001), as a means of decomposing workflows into mobile agent-driven processes that communicate via web services at each organization. This decomposition ensures defining logical points within the dynamics of a workflow instance for locating accurate and consistent states of the system for recovery in case of a failure. Then, a set of algorithms for various business scenarios are developed and presented as practical solutions. These algorithms are shown to create checkpoints such that the system is always in a globally consistent state. As such, these algorithms constitute a set of standards that can be incorporated in business process management suites that support reliable inter-organizational collaboration.     

Field study of the removal of linear alkylate sulfonate detergents by the activated sludge process

Field evaluation of the removal of linear alkylate sulfonate (LAS) detergents by the activated sludge process was carried out at the Kettle Moraine Boys’ School near Plymouth, Wisconsin. The procedures and controls afforded by the school’s central supply system along with its new and well-operated “extended aeration” activated sludge plant, provided an excellent arrangement for controlled field comparison of the removal of LAS and ABS (alkyl benzene sulfonate) material. In addition, the sewage treatment plant was operated intentionally to produce poor results in order to observe the effects of such conditions on removals. Previous work showed that, with products containing ABS in use at the school, removals of methylene blue active substance could be expected to fall in the region of 75 to 85%. Removals with LAS material in use at the school were shown to be from 95 to 99% as long as the plant was operated satisfactorily. Further, the results showed that there was a strong correlation between LAS removal and BOD removal with a one to one slope. The results support the conclusion that for biological treatment processes, the removal of LAS material corresponds to the removal of BOD.     

Localization of Luminescent Inhomogeneities in Turbid Media with Spatially Resolved Measurements of cw Diffuse Luminescence Emittance

We present a steady-state method for localizing a source ofluminescence (i.e., fluorescence or phosphorescence) buried in asemi-infinite turbid medium with unknown optical properties. Adiffusion theory expression describing the emittance of an isotropicpoint source is fit to spatially resolved surface measurements of thediffuse emittance from the luminescent source. The techniquereports the location of the center of a 6.0-mm-diameter, fluorophore-containing spherical bulb embedded in a liquid phantom withan accuracy of 1.0 mm or better for source depths as great as 40.0mm. Monte Carlo data are analyzed to investigate the range and thepossible sources of error in the reconstructed source depth.