Ultrasound biomicroscopy in the diagnosis and management of anterior segment tumors

BACKGROUND: High-frequency ultrasound biomicroscopy has allowed eye care specialists to evaluate posterior extension of anterior segment tumors. This article evaluates the role of ultrasound biomicroscopy for the diagnosis and management of anterior segment tumors. METHODS: Fourteen patients with anterior segment tumors were selected for evaluation. Each patient underwent a complete clinical examination followed by slit-lamp photography and ultrasound biomicroscopy. RESULTS: Unlike standard ultrasonography of anterior segment tumors, high-frequency ultrasound biomicroscopy allowed quantitative measurements of tumor size, extension within and posterior to the iris, as well as differentiation of solid and cystic lesions. These characteristics were used to differentially diagnose anterior segment tumors and document the response of iridociliary body melanomas to radiotherapy. CONCLUSIONS: This study demonstrates how ultrasound biomicroscopy has become an effective and necessary procedure, used for both the diagnosis and management of anterior segment tumors.     

Phlebotomus papatasi sand fly salivary gland lysate down-regulates a Th1, but up-regulates a Th2, response in mice infected with Leishmania major

A vertebrate host becomes infected with Leishmania major when the sand fly vector injects parasites into skin along with saliva. Previous studies showed that salivary gland lysate of the New World sand fly Lutzomyia longipalpis markedly enhanced L. major infection in CBA mice. However, L. major is an Old World parasite transmitted in nature by the Old World sand fly Phlebotomus papatasi. Here we examine the ability of P. papatasi salivary gland lysate to enhance infection (lesion size and parasite burden) by L. major. In addition, we examine the effects of salivary gland lysate on the immune response to L. major by monitoring the levels of cytokine mRNA from the lymph nodes draining cutaneous lesions. We found that P. papatasi salivary gland lysate dramatically exacerbated lesion development in disease-resistant CBA mice. This exacerbation of disease correlated with inhibition of the production of Thl cytokines and associated factors (IFN-gamma, IL-12, and inducible nitric oxide synthase), but with enhancement of the Th2 cytokine IL-4, whereas no changes in the levels of IL-10 and TGF-beta were noted. Importantly, salivary gland lysate directly up-regulated expression of IL-4 mRNA in mice in the absence of infection with L. major.     

Increased levels of intracellular calcium are not required for the formation of attaching and effacing lesions by enteropathogenic and enterohemorrhagic Escherichia coli

Elevated concentrations of intracellular calcium ([Ca]i) have been implicated as an important signalling event during attaching and effacing (A/E) lesion formation by enteropathogenic Escherichia coli (EPEC). The highly localized nature of the cytoskeletal and cell surface alterations occurring during A/E lesion formation suggests that there should be equally localized EPEC-induced signalling events. To analyze further the calcium responses to infection of HEp-2 cells by EPEC, we employed calcium-imaging fluorescence microscopy, which allows both temporal and spatial measurements of [Ca]i in live cells. Using this imaging technique, not only were we unable to detect any significant elevation in [Ca]i at sites of A/E EPEC adhesion, but, with several different classical EPEC and enterohemorrhagic E. coli (EHEC) strains and three different infection procedures, each of which resulted in extensive A/E bacterial adhesion, we were unable to detect any significant alterations in [Ca]i in infected cells compared to uninfected cells. In addition, chelation of intracellular free calcium with bis-(aminophenoxy)-ethane-N,N,N',N'-tetraacetic acid (BAPTA) did not, as previously reported, prevent A/E lesion formation. We conclude that increased [Ca]i are not required for A/E lesion formation by EPEC and EHEC.     

Local‐scale Benefits of River Connectivity Restoration Planning Beyond Jurisdictional Boundaries

Conservation planning aims to optimize outcomes for select species or ecosystems by directing resources toward high‐return sites. The possibility that local benefits might be increased by directing resources beyond the focal area is rarely considered. We present a case study of restoring river connectivity for migratory fish of the Great Lakes Basin by removing dams and road crossings within municipal jurisdictions versus their broader watersheds. We found that greater river connectivity could often be achieved by considering both intra‐jurisdictional and extra‐jurisdictional barriers. Focusing on jurisdictional barriers alone generally forfeited <20% (median = 0%) of habitat gains for those who value solely habitat gains within the jurisdiction, but >75% (median = 100%) for planners who value larger‐scale habitat gains. Similarly, cost savings tended to be between ?50% and +50%, but in some cases were very negative. Our study underscores the local‐scale benefits of broadening restoration investments, especially for decision makers of the Great Lakes Basin and contributes to a discussion of appropriate and efficient scales of conservation planning. Copyright © 2017 John Wiley & Sons, Ltd.     

Effect of fish oil on the fatty acid composition of human milk and maternal and infant erythrocytes

To examine the effect of fish oil supplementation on the fatty acid (FA) composition of human milk and maternal and infant erythrocytes, five lactating women were supplemented with 6 g of fish oil daily for 21d. Usual maternal diets contained 1,147 mg of total n−3 FA, with 120 mg from very long-chain (>C₁₈) n−3 FA. Supplementation increased dietary levels to 3,092 mg of total n−3 FA and 2,006 mg of very long-chain n−3 FA. Milk samples were collected daily, prior to fish oil ingestion, and at 4-h intervals on days 1, 7, 14 and 21. Milk n−3 FA content increased within 8 h and reached steady state levels within one week. The n−6 fatty acid content decreased. Erythrocyte eicosapentaenoic acid content increased from 0.24% to 1.4% (P<0.01) in mothers and from 0.11% to 0.70% (P<0.05) in infants. Docosapentaenoic acid increased from 1.4% to 2.2% (P<0.05) in mothers and from 0.30% to 0.78% (P<0.01) in infants. There was no significant change in docosahexaenoic acid or n−6 fatty acid content. Maternal platelet aggregation responses were variable. No differences in milk or plasma tocopherol levels were noted. Based on a paper presented at the Symposium on Milk Lipids held at the AOCS Annual Meeting, Baltimore, MD, April 1990.     

Modelling demand response in organized wholesale energy markets

We propose a bi-level optimization model for demand response in organized wholesale energy markets. In this model, the lower level performs the economic dispatch of energy and generates the price and the upper level minimizes the total amount of demand response subject to a net benefit requirement. In an economic sense, demand response is a trade of ‘consuming rights’ instead of a sale of energy. Therefore it must be traded separately from the energy market. Although a bi-level optimization model is very hard to solve in general, we demonstrate that realistic power networks have characteristics that can be exploited to reduce the effective size of the problem instance. In particular, we transform the nonconvex net benefit test constraint to an equivalent linear form, and reformulate the nonconvex complementarity conditions of doubly bounded variables using SOS2 constraints. For realistic instances of the MPEC, we employ a three-phase approach that exploits the fast local solution from a nonlinear programming solver as well as LP-based bound strengthening within a mixed integer/SOS2 formulation. The model is tested against various data cases and settings, and generates useful insight for demand response dispatch operations in practice.     

Reengineering health care materials management

Health care executives across the country, faced with intense competition, are being forced to consider drastic cost cutting measures as a matter of survival. The entire health care industry is under siege from boards of directors, management and others who encourage health care systems to take actions ranging from strategic acquisitions and mergers to simple "downsizing" or "rightsizing," to improve their perceived competitive positions in terms of costs, revenues and market share. In some cases, management is poorly prepared to work within this new competitive paradigm and turns to consultants who promise that following their methodologies can result in competitive advantage. One favored methodology is reengineering. Frequently, cost cutting attention is focused on the materials management budget because it is relatively large and is viewed as being comprised mostly of controllable expenses. Also, materials management is seldom considered a core competency for the health care system and the organization performing these activities does not occupy a strongly defensible position. This paper focuses on the application of a reengineering methodology to healthcare materials management.     

"Indianism" and MMPI scores of men alcoholics

Mean MMPI profiles of 40 Indian and 40 White veterans were similar, but "Indianism," as measured by the Indian Culturalization Test, was significantly related to scores on Hs, Hy, Pt and Sc scales. Caution is advised in using the MMPI in the diagnosis of Indians' psychiatric problems.     

It Takes Two to Tango: Personal and Organizational Resilience as Predictors of Strain and Cardiovascular Disease Risk in a Work Sample.

In a cross-sectional sample of 428 employees, the job demand-control-support and effort-reward imbalance job stress models were amalgamated and expanded to include modifiable risk factors and noncontrollable genetic factors related to cardiovascular disease (CVD) risk. With structural equation modeling, the constructs of lack of job resilience, lack of personal resilience, and job demand were used to examine how employer and employee factors related to psychosomatic strain and risk indicators of CVD. Negative perception of job demand predicted perception of lack of job resilience but not lack of personal resilience. Lack of job and personal resilience predicted strain. Women reported greater strain than men. CVD risk was predicted by strain, age, sex, and family history. (PsycINFO Database Record (c) 2010 APA, all rights reserved)