Determination of the viremia threshold for dental cross-infection in a mouse model

An animal model of dental virus transmission was developed using the lactate dehydrogenase-elevating virus (LDV) of mice to study cross infection. Mouse-to-mouse cross-infection was carried out by scaling the teeth of LDV-infected donor mice with dental instruments, immediately prior to using the contaminated instruments on the teeth of recipient indicator mice. The level of donor viremia was found to correlate with the rate of virus cross-infection, with a viremia threshold level of 10(7.5) ID50/ml observed for dental cross-infection. The blood volume transferred during dental cross-infection was approximately 10(-4) to 10(-5) ml, demonstrating the inefficiency of virus cross-infection, since deposition of about 1000 virions on dental instruments was associated with the threshold limit. Virus transferred during dental cross-infection rapidly entered the blood circulation, showing that dental cross-infection was not dependent on an oral infection. The results from these model studies predict the general inefficiency of dental instrument virus cross-infection, and a further reduced likelihood of dental cross-infection with appropriately cleaned instruments.     

Ethics in the intensive care unit. Creating an ethical environment

This article discusses ethical issues that exist each and every day in interactions with patients, families, and fellow workers in the ICU, even in the absence of overt conflict or controversy. The creation of an ethical working environment in the ICU is a necessary precondition for dealing with the ethical issues raised by specific issues such as cardiopulmonary resuscitation, the limitation or withdrawal of life-sustaining treatment, the special care of children with disabilities, brain death, and organ procurement, and triage. The creation of an ethical working environment requires developing a collaborative relationship with patients, families, staff, and other health care professionals.     

A comparative study of human skin thermal response to sapphirecontact and cryogen spray cooling

Surface cooling, in conjunction with various thermally mediated therapeutic procedures, can provide a means to protect superficial tissues from injury while achieving destruction of deeper targeted structures. We have investigated the thermal response of in-vivo human skin to: (1) contact cooling with a sapphire window (6-12°C); and (2) spray cooling with a freon substitute cryogen [tetrafluoroethane; boiling point ≈-26°C at 1 atmospheric pressure (atm)]. Measurements utilizing infrared radiometry show surface temperature reductions from 30°C to 14-19°C are obtained within approximately is in response to sapphire contact cooling. Surface temperature reductions to values between 5°C and -9°C are obtained in response to 20-100-ms cryogen spurts. Computational results, based on fitting the measured radiometric surface temperature to estimate heat transfer parameters, show: (1) temperature reductions remain localized to approximately 200 μm of superficial tissue; and (2) values of heat flux and total energy removed per unit skin surface area at least doubled when using cryogen spray cooling     

High-transconductance n-type Si/SiGe modulation-doped field-effecttransistors

The authors report on the fabrication and the resultant device characteristics of the first 0.25-μm gate-length field-effect transistor based on n-type modulation-doped Si/SiGe. Prepared using ultrahigh vacuum/chemical vapor deposition (UHV/CVD), the mobility and electron sheet charge density in the strained Si channel are 1500 (9500) cm²/V-s and 2.5×10¹² (1.5×10¹² ) cm^-2 at 300 K (77 K). At 77 K, the devices have a current and transconductance of 325 mA/mm and 600 mS/mm, respectively. These values far exceed those found in Si MESFETs and are comparable to the best results achieved in GaAs/AlGaAs modulation-doped transistors     

Assessment of pseudarthrosis in pedicle screw fusion: a prospective study comparing plain radiographs, flexion/extension radiographs, CT scanning, and bone scintigraphy with operative findings

Tribal warfare is a way of life in the highlands of Papua New Guinea. In earlier times direct confrontation with bushknives and axes, and shooting with bows and arrows were common. In recent years there have not been as many instances of direct confrontation with bushknives and axes, but the use of bows and arrows is on the rise. Since 1993, guns have been increasingly used, with devastating results. In 1993, 18 deaths were reported from tribal warfare in one area of the Southern Highlands Province, especially from gunshots, while in 1994, 24 deaths were reported from another area. A five-year review of tribal fight admissions to Mendi Hospital, from 1990 to 1994, showed an increase in the number and proportion of gunshot wounds; there were none in 1990-1992 but they constituted 18% of tribal fight injuries in 1993 and 33% in 1994.     

A novel four-point bend test for strength measurement of opticalfibers and thin beams. II. Statistical analysis

In the first part of this work, a novel implementation of the well-known four-point bend test is described that determines the strength of thin beams and optical fibers by measuring the loading pin displacement, rather than the applied load. This paper extends the analysis of the nonlinear bending behavior to account for the stochastic nature of strength. A statistical analysis is presented that determines the effective tested length in bending and the tension to bending strength ratio. Results are given for both surface and volume flaws as well as for specimens of both circular and rectangular section. Strength measurements on a deliberately weakened silica optical fiber are consistent with the predictions of the analysis     

Cross-validiation of the Neuropsychology Behavior and Affect Profile in stroke patients.

Internal stability and discriminant validity of the Neuropsychology Behavior and Affect Profile (L. Nelson et al, 1989) were examined in samples of 70 stroke patients and 88 elderly controls. The test is designed to yield indices of premorbid (before-item subset) and present (now-item subset) levels of emotional functioning in each of 5 scales. With coefficient alphas ranging from .76 to .87, results indicated moderate to high internal stability. The test was also able to reliably distinguish between the criterion stroke sample (n?=?42) and a matched group of elderly controls in terms of present levels of emotional functioning (2 wks poststroke). When discriminant validity was examined in terms of premorbid emotional status (before-item subset), group differences were unexpectedly obtained. Clinical and research implications of these results are discussed, noting the possibility of early, noncognitive correlates preceding stroke. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Using airborne laser scanning to monitor tree migration in the boreal-alpine transition zone

The boreal tree line is expected to advance upwards into the mountains and northwards into the tundra due to global warming. The major objective of this study was to find out if it is possible to use high-resolution airborne laser scanner data to detect very small trees — the pioneers that are pushing the tree line up into the mountains and out onto the tundra. The study was conducted in a sub-alpine/alpine environment in southeast Norway. A total of 342 small trees of Norway spruce, Scots pine, and downy birch with tree heights ranging from 0.11 to 5.20 m were precisely georeferenced and measured in field. Laser data were collected with a pulse density of 7.7 m^− 2. Three different terrain models were used to process the airborne laser point cloud in order to assess the effects of different pre-processing parameters on small tree detection. Greater than 91% of all trees > 1 m tall registered positive laser height values regardless of terrain model. For smaller trees (< 1 m), positive height values were found in 5-73% of the cases, depending on the terrain model considered. For this group of trees, the highest rate of trees with positive height values was found for spruce. The more smoothed the terrain model was, the larger the portion of the trees that had positive laser height values. The accuracy of tree height derived from the laser data indicated a systematic underestimation of true tree height by 0.40 to 1.01 m. The standard deviation for the differences between laser-derived and field-measured tree heights was 0.11-0.73 m. Commission errors, i.e., the detection of terrain objects — rocks, hummocks — as trees, increased significantly as terrain smoothing increased. Thus, if no classification of objects into classes like small trees and terrain objects is possible, many non-tree objects with a positive height value cannot be separated from those actually being trees. In a monitoring context, i.e., repeated measurements over time, we argue that most other objects like terrain structures, rocks, and hummocks will remain stable over time while the trees will change as they grow and new trees are established. Thus, this study indicates that, given a high laser pulse density and a certain density of newly established trees, it would be possible to detect a sufficient portion of newly established trees over a 10 years period to claim that tree migration is taking place.     

A prospective study of the efficacy of the physician order form for life-sustaining treatment

OBJECTIVES: The Physician Orders for Life-Sustaining Treatment (POLST), a comprehensive, one-page order form, was developed to convey preferences for life-sustaining treatments during transfer from one care site to another. This study examined the extent to which the POLST form ensured that nursing home residents' wishes were honored for Do Not Resuscitate (DNR) and requests for transfer only if comfort measures fail. DESIGN: The study used chart record data to follow prospectively a sample of nursing home residents with the POLST. SETTING: Eight geographically diverse, long-term, adult-care facilities in Oregon in which the POLST was in use. PARTICIPANTS: Nursing home residents (n = 180), who had a POLST recording DNR designation and who indicated a desire for transfer only if comfort measures failed, were followed for 1 year. MEASUREMENTS: For all subjects: treatment and disposition after significant health status changes; orders for narcotics and for provision or limitation of aggressive interventions. For hospitalized subjects: diagnosis, medical interventions, and DNR orders. For those who died: cause and location of death, life-sustaining treatments attempted, and comfort measures provided. RESULTS: No study subject received CPR, ICU care, or ventilator support, and only 2% were hospitalized to extend life. Of the 38 subjects who died during the study year, 63% had an order for narcotics, and only two (5%) died in an acute care hospital. A total of 24 subjects (13%) were hospitalized during the year. Hospitalized subjects' mean length of stay was 4.9 days, and the mean rate of hospitalizations for all subjects was 174 per 1000 resident years. In 85% of all hospitalizations, patients were transferred because the nursing home could not control suffering. In 15% of hospitalizations (n = 4), the transfer was to extend life, overriding POLST orders. CONCLUSIONS: POLST orders regarding CPR in nursing home residents in this study were universally respected. Study subjects received remarkably high levels of comfort care and low rates of transfer for aggressive life-extending treatments.