Evaluating parents in child protection decisions: An innovative court-based clinic model.

Providing relevant, timely forensic evaluations is challenging because of the differing worlds of mental health and law. In this study, the authors evaluated an innovative, court-based clinic model for improving acquisition and use of clinical information in juvenile court in a 3-year pilot project prior to wide-scale implementation. The authors investigated the extent to which 170 evaluations of parents in the child protection division met criteria recommended in the forensic literature by comparing reports across four groups categorized by source (inside or outside court; part of pilot project or not). Findings suggested greater use of recommended practices and more timely, consistent reports by the pilot clinic. The findings provide preliminary support for the model and guidance for improving forensic evaluations in child protection. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A simulation study of energy consumption by elevators in tall buildings

The problem of estimating the energy requirements of elevators in tall buildings is shown to be dependent on the integration of functions of random variables. In addition, the period of integration is also random. Hence, a discrete-continuous simulation language, GASP IV, is employed as a method of solving the equations which describe the model. The model is applied to estimating the energy requirements of a building which contains both apartments and commercial facilities. Amongst the topics studied are the effects of elevator speeds and counterweight values on energy consumption, and also the amount of energy available for regeneration. Although the prediction of energy consumption is not considered to be an Industrial Engineering function, Industrial Engineering concepts and tools are used in modelling the problem.     

An acoustic emission study of failure by stress corrosion in bundles of E-glass fibres

Fibre failures in bundles of parallel E-glass fibres loaded from their ends and immersed in aqueous HCl solutions or in water are detected using acoustic emission. In constant load and constant stress tests the times to failure of the fibres and the bundles are accounted for on the basis of a theory which assumes a Weibull distribution of initial strengths, and that the velocity (v) of subcritical stress-corrosion cracks in the fibres depends on the stress intensity (K _l) according to a power law (VK _l ⁿ ). The crack growth parameter (n) is measured by three methods, and its variation with acid strength is correlated with other corrosion studies. The stress corrosion measurements also allow a determination of the Weibull modulus of the fibres.     

Atomic structure of an alphabeta T cell receptor (TCR) heterodimer in complex with an anti-TCR fab fragment derived from a mitogenic antibody

Each T cell receptor (TCR) recognizes a peptide antigen bound to a major histocompatibility complex (MHC) molecule via a clonotypic alphabeta heterodimeric structure (Ti) non-covalently associated with the monomorphic CD3 signaling components. A crystal structure of an alphabeta TCR-anti-TCR Fab complex shows an Fab fragment derived from the H57 monoclonal antibody (mAb), interacting with the elongated FG loop of the Cbeta domain, situated beneath the Vbeta domain. This loop, along with the partially exposed ABED beta sheet of Cbeta, and glycans attached to both Cbeta and Calpha domains, forms a cavity of sufficient size to accommodate a single non-glycosylated Ig domain such as the CD3epsilon ectodomain. That this asymmetrically localized site is embedded within the rigid constant domain module has implications for the mechanism of signal transduction in both TCR and pre-TCR complexes. Furthermore, quaternary structures of TCRs vary significantly even when they bind the same MHC molecule, as manifested by a unique twisting of the V module relative to the C module.     

Laser light: waves of the future

The use of lasers is becoming more prevalent in the health care arena. Lasers can perform functions from lightening spider veins to correcting nearsightedness. Nurses must become familiar with lasers as 21st century medicine becomes a reality.     

Three candidate genes and angiotensin-converting enzyme inhibitor-related cough: a pharmacogenetic analysis

Unexplained, persistent cough limits the use of angiotensin-converting enzyme (ACE) inhibitors in a significant number of patients. It has been speculated that occurrence of this adverse effect is genetically predetermined; in particular, variants of the genes encoding ACE, chymase, and B2-bradykinin receptor have been implicated. To investigate this question, we determined genotypes for common polymorphisms for these three genes in subjects with a history of ACE inhibitor-related cough. Specificity of the adverse effect was confirmed by a blinded, double-crossover design protocol in which subjects were rechallenged with either lisinopril or placebo. In 99 case subjects and 70 control subjects (who failed to develop cough on rechallenge with ACE inhibitor) thus selected, frequencies for the ACE D and I alleles were 0.56 and 0.44 (cases) and 0.56 and 0.44 (controls), respectively; frequencies for chymase A and B alleles (absence/presence of BstXI site) were 0.56 and 0.44 (cases) and 0.46 and 0.54 (controls), respectively; frequencies for B2-bradykinin receptor + and - alleles (presence/absence of a 21 to 29 nonanucleotide sequence) were 0.52 and 0.48 (cases) and 0.53 and 0.47 (controls), respectively. All observed genotype frequencies were in Hardy-Weinberg equilibrium. There was no evidence for association between genotype at either gene examined and cough (adjusted for gender and age). Our data indicate that common genetic variants of ACE, chymase, and B2-bradykinin receptor do not explain the occurrence of ACE inhibitor-related cough.     

Pediatric and adult lung transplantation for cystic fibrosis

OBJECTIVE: This paper was undertaken to review the experience at our institution with bilateral sequential lung transplantation for cystic fibrosis. METHODS: Since 1989, 103 bilateral sequential lung transplants for cystic fibrosis have been performed (46 pediatric, 48 adult, 9 redo); the mean age was 21 +/- 10 years. Cardiopulmonary bypass was used in all but one pediatric (age <18) transplant, and in 15% of adults. RESULTS: Hospital mortality was 4.9%, with 80% of early deaths related to infection. Bronchial anastomotic complications occurred with equal frequency in the pediatric and the adult populations (7.3%). One- and 3-year actuarial survival are 84% and 61%, respectively (no significant difference between pediatric and adult age groups; average follow-up 2.1 +/- 1.6 years). Mean forced expiratory volume in 1 second increased from 25% +/- 9% before transplantation to 79% +/- 35% 1 year after transplantation. Acute rejection occurred 1.7 times per patient-year, with most episodes taking place within the first 6 months after transplantation. The need for treatment of lower respiratory tract infections occurred 1.2 times per patient in the first year after transplantation. Actuarial freedom from bronchiolitis obliterans was 63% at 2 years and 43% at 3 years. Redo transplantation was performed only in the pediatric population and was associated with an early mortality of 33%. Eight living donor transplants (four primary transplants, four redo transplants) were performed with an early survival of 87.5%. CONCLUSION: Patients with end-stage cystic fibrosis can undergo bilateral lung transplantation with morbidity and mortality comparable to that seen in pulmonary transplantation for other disease entities.     

Operation of a 100-bit, 2.6 µm bubble shift register

Complete circuit operation for a small 100-bit serial shift register memory with a 10.6 μm period fabricated on a garnet wafer using electron beam lithography and single level all-permalloy technology is reported. Overall circuit operation including generation, propagation, and detection was achieved with a 6 Oe bias margin using a 1 kHz rotating field. Although the circuit design and fabrication techniques were not optimized, we believe that this is the first published report of complete circuit operation for a single level device with bubbles as small as 2.6 μm. The performance of two different types of chevron expander detectors and two different generators was evaluated and circuits combining disk generators with herringbone detectors were found to provide the best overall operating margin. At low speeds (∼5 Hz) high-bias failures were caused by failure of the domains to strip out fully in the detector while the low bias limit was determined by the introduction of spurious bubbles into the track near the generator.