Longitudinal assessment of inpatient use and functioning of seriously mentally ill veterans with and without co-occurring substance use disorders

Within a fungal species, a subset of individuals may have more than the minimal complement of chromosomes. If the extra chromosomes are composed primarily of DNA not found in all representatives of the species, they are most appropriately referred to as supernumerary chromosomes. The patterns of repeated DNA sequences on certain supernumerary chromosomes suggest that they have a different evolutionary history from the essential chromosomes in the same genome. Supernumerary chromosomes can carry functional genes and, in at least two fungal species, genes on such chromosomes play important roles in host-pathogen interactions. Supernumerary chromosomes that confer an adaptive advantage in certain habitats, such as the ability to cause disease on a specific host, may be referred to as "conditionally dispensable" chromosomes in order to reflect their importance in some, but not all, growth conditions. In addition to describing the structural and functional characteristics of known supernumerary chromosomes in fungi, this review discusses the relative merits of the terms that have been used to describe them, and establishes experimental criteria for their identification.     

Fast transmission CT for determining attenuation maps using a collimated line source, rotatable air-copper-lead attenuators and fan-beam collimation

We describe a technique using a line source and a rotatable air-copper-lead assembly to acquire gamma transmission computed tomographic (TCT) data for determining attenuation maps to compensate SPECT emission scans. The technique minimizes problems associated with discriminating 99mTc transmission and 201Tl emission photons and requires only a modest increase in total study time. A 99mTc line source and a stacked foil ("multislat") collimator are placed near the focal line of a fan-beam collimator (114 cm focal length) mounted on one detector of a triple-camera SPECT system. We acquired TCT data of plastic rod and anthropomorphic thorax phantoms to investigate the capability of the line source and rotatable air-copper-lead attenuators to determine attenuation maps. The data were acquired with and without 5.4 MBq (145 microCi) of 201Tl placed in the myocardial chamber of the thorax phantom. Phantoms also were scanned using a curved transmission slab source mounted to a parallel-hole collimator. Fan-beam TCT images have improved resolution compared with parallel-beam TCT images. Two patient scans also were performed to evaluate the clinical usefulness of fan-beam TCT. The rotatable air-copper-lead attenuator method eliminates contamination of emission data by transmission photons and reduces spill-over of emission data into the transmission energy window for some cases. Results show the feasibility of using fast, sequential or interlaced transmission scans of a line source within a rotatable air-copper-lead attenuator assembly to obtain accurate attenuation maps for SPECT attenuation compensation.     

LOCATION CHOICES OF THE CREATIVE CLASS: DOES TOLERANCE MAKE A DIFFERENCE?

Human capital and members of the creative class are bearers of economic growth, yet little is known about exactly what the relevant factors are for the concentration of the highly skilled in a specific place. Tolerance for example is supposed to make the difference between creative and human capital. But does tolerance really make a difference for anybody? And what about other factors: Are they specifically relevant for creative individuals or simply valid for the whole population? This study contributes to the discussion on the highly skilled by investigating whether tolerance, taxes, or other regional amenities contribute to their concentration and dynamics. The results show that tolerance in particular toward immigrants, but also toward same‐sex partnerships, is a rather dynamic concept, differs largely between and within functional urban regions, and makes a difference regarding the highly skilled.     

Prevalence and predictors of sexual dysfunction in long-term survivors of marrow transplantation

PURPOSE: To describe the prevalence of sexual difficulties in men and women after marrow transplantation (MT), and to define medical, demographic, sexual, and psychologic predictors of sexual dysfunction 3 years after MT. PATIENTS AND METHODS: Four hundred seven adult MT patients were assessed pretransplantation. Survivors repeated measures of psychologic and sexual functioning at 1 and 3 years posttransplantation. RESULTS: Data were analyzed from 102 event-free 3-year survivors who defined themselves as sexually active. Men and women did not differ in sexual satisfaction pretransplantation. At 1 and 3 years posttransplantation, women reported significantly more sexual dysfunction than men. Eighty percent of women and 29% of men reported at least one sexual problem by 3 years after MT. No pretransplantation variables were significant predictors of 3-year sexual satisfaction for women. For men, pretransplantation variables of older age, poorer psychologic function, not being married, and lower sexual satisfaction predicted sexual dissatisfaction at 3 years (R2=.28; P < .001). Women who were more dissatisfied 3 years after MT did not receive hormone replacement therapy (HRT) at 1 -year posttransplantation and were less satisfied at 1 year, but not pretransplantation (R2=.35; P < .001). CONCLUSION: Sexual problems are significant in the lives of MT survivors, particularly for women. Although HRT before 1 year posttransplantation improves sexual function, it does not ensure sexual quality of life. Intervention for women is needed to apply hormonal, mechanical, and behavioral methods to prevent sexual difficulties as early after transplantation as possible.     

A transgenic mouse model for mammary carcinogenesis

Missense mutations in the p53 tumor suppressor occur frequently in human breast cancer and influence both the prognosis and response to chemotherapy. Amino acid 175 (equivalent to murine 172) is the second most common site of missense mutations in p53 in human breast cancer. Over 95% of these mutations are arginine-to-histidine (R-H) substitutions resulting in a gain-of-function, and not merely a dominant-negative phenotype. Transgenic mice expressing a p53 172(R-H) construct targeted to the mammary gland by means of a whey acidic protein (WAP) promoter were characterized as a model system in order to determine the specific effects of this mutation on mammary tumorigenesis. Although transgene expression alone had no apparent effect on normal mammary development, transgenic mice treated with the chemical carcinogen dimethylbenz(a)anthracene developed tumors with much shorter latency than did control littermates and had a greater tumor burden. Tumors arising in transgenic mice did not exhibit either decreased apoptosis or increased cell proliferation relative to tumors arising in nontransgenic littermates, but did display increased genomic instability. Large pleiomorphic nuclei were visible in many tumors from transgenic mice, and DNA flow analysis confirmed the presence of significant aneuploid cell populations. Since these transgenic mice develop very few spontaneous tumors, while accelerating carcinogen-and oncogene-mediated tumorigenesis, this mouse model will, therefore, be useful in the investigation of early events in mammary tumorigenesis. It may also be used as a preclinical model to test newly developed chemotherapeutic strategies.     

Pneumococci stimulate the production of the inducible nitric oxide synthase and nitric oxide by murine macrophages

The role of nitric oxide (NO) in the pathophysiology of gram-positive sepsis is uncertain. In inflammatory conditions, high-output NO production is catalyzed by the enzyme inducible nitric oxide synthase (iNOS). The ability of 2 strains of pneumococci, pneumococcal cell wall preparations, and purified pneumococcal capsule (Pnu-Imune 23) to trigger the production of iNOS protein and NO in RAW 264.7 murine macrophages was tested. Live pneumococci, oxacillin-killed pneumococci, and pneumococcal cell wall preparations stimulated the production of iNOS and NO by RAW 264.7 cells in the presence, but not the absence, of low concentrations of recombinant murine interferon-gamma. In contrast, purified pneumococcal capsule induced little or no iNOS or NO production by these cells. Thus, pneumococci stimulate high-output NO production by murine macrophages. The potential role of NO in the pathogenesis of pneumococcal sepsis deserves further study.     

The alcohol deprivation effect in the alcohol-preferring P rat under free-drinking and operant access conditions

The alcohol-deprivation effect (ADE) was examined under 4-hr operant and 24-hr free-choice alcohol access in the alcohol-preferring (P) rat after deprivation intervals from 2 to 4 weeks. Results indicated that adult male P rats responding for 6 weeks on a concurrent FR-5/FR-1 schedule of reinforcement for alcohol and water, respectively, and then deprived of alcohol for 2 weeks, demonstrated a 40% increase in alcohol responding during the first 60 min of alcohol reinstatement. The alcohol deprivation effect was temporary, however, as responding did not differ from baseline levels on the second day of reinstatement. In a second experiment, weanling male and female P rats received 7 weeks of continuous access to alcohol, beginning at 21 days of age, and were then deprived of alcohol for 4 weeks. On the first day of alcohol reinstatement, P rats exhibited a 40% to 45% increase from baseline alcohol drinking levels, with alcohol intake returning to baseline levels by the 3rd day of reinstatement. Although alcohol intake was higher in females than in males when adjustment was made for body weight, there were no gender differences in the magnitude of the alcohol deprivation effect. Taken together, these results indicate that the ADE is a long-lasting phenomenon that occurs under both operant and continuous access conditions in the P rat, and thus these rats may be useful models for the study of factors involved in relapse of alcohol drinking.     

Decreased response to phototherapy for neonatal jaundice in breast-fed infants

OBJECTIVE: To evaluate the efficacy of phototherapy for nonhemolytic hyperbilirubinemia in breast-fed and formula-fed infants and infants receiving formula and breast milk. DESIGN: Prospective study. SETTING: Nursery for healthy infants. METHOD: Full-term healthy infants with nonhemolytic hyperbilirubinemia (bilirubin concentration, >255 micromol/L [14.9 mg/dL] or 222 micromol/L [13.0 mg/dL] at ages younger than 48 hours) were treated with conventional phototherapy by using daylight fluorescent lamps. Three groups of infants were studied: group 1, formula-fed infants; group 2, breast-fed infants; and group 3, infants receiving formula and breast milk. All patterns of feeding started at birth. Phototherapy was terminated only when bilirubin concentrations had decreased to less than 185 micromol/L (10.8 mg/dL); the minimum exposure period was 24 hours. RESULTS: A total of 163 infants were studied: group 1, 79; group 2, 34; and group 3, 50. The age at the start of exposure was comparable in all groups. The mean+/-SD weight loss as a percentage of birth weight was as follows: group 1, 2.8%+/-5.0%; group 2, 6.1%+/-3.4%; and group 3, 3.2%+/-2.6%. The duration of exposure to phototherapy was as follows: group 1, 54.1+/-20.8 hours; group 2, 64.6+/-25.1 hours; and group 3, 54.9+/-21.5 hours; the 24-hour rate of decrease in the bilirubin concentration was as follows: group 1, 18.6%+/-11.7%; group 2, 17.1%+/-9.6%; and group 3, 22.9%+/-9.4%. The overall rate of decrease in the bilirubin concentration for the duration of exposure to phototherapy was as follows: group 1, 0.8%+/-0.3% per hour; group 2, 0.6%+/-0.3% per hour; and group 3, 0.8%+/-0.3% per hour. Weight loss at the start of phototherapy was significantly greater in group 2 compared with group 1 (P<.001) and group 3 (P<.001), although the hemoglobin and hematocrit values were comparable. The duration of exposure to phototherapy was not significantly different in the 3 groups (P=.06); however, the duration of exposure of group 2 infants was 10 hours more than that of the other 2 groups. The 24-hour rate of decrease in the bilirubin concentration in group 3 was significantly better than that of group 2 (P = .007) and group 3 (P = .02); the rates of decrease for groups 2 and 3 were similar (P = .52). The overall rate of decrease in the bilirubin concentration during the duration of exposure to phototherapy in group 2 was significantly less than that of group 1 (P = .002) and group 3 (P<.001); the rates for groups 1 and 3 were similar (P = .35). The postexposure rebound bilirubin concentrations were comparable in all groups during the first 2 days; however, the duration of moderate jaundice in group 2 was more prolonged. CONCLUSIONS: The response to phototherapy of group 2 infants was significantly slower than that of group 3 and group 1 infants; this response was still of adequate efficacy. The addition of formula to the feedings for totally breast-fed infants, without suspension of breast-feeding, would enhance the efficacy of phototherapy and reduce exposure time.     

Exploring the potential of problem-based learning in nurse education

Despite the increased attention that problem-based learning has received as an appropriate pedagogical technique for educating adults for professional practice, reports that evaluate the process are rare and usually relate to professions other than nursing. A study was undertaken in order to discover the graduates' own perceptions of a problem-based learning programme and its effectiveness in preparing them for the reality of their chosen profession. Twelve practising graduate nurses who had completed the programme were interviewed according to the ethnographic method. Three categories were identified from the data: 'and all of a sudden...', which describes the transition from PBL student to staff nurse; 'not an unthinking assistant', where the characteristics that the PBL graduates believe make them different from traditionally trained nurses are described; and 'the buck stops here', which describes the sense of personal responsibility that the graduates experience in terms of their learning and actions.