Animal-induced injuries and disease, neonatal jaundice, immunizations, and viral infections

Highlights from the past years' literature on the topics of animal-induced injuries and diseases, neonatal jaundice, immunizations, and viral infections are discussed from the perspective of the general pediatrician. An effort is made to place recent advances in care or understanding of clinical problems into the context of the pediatric office practice. The current reality of health care-be it managed care, care for the underserved, or the recent pressures on academic and hospital-based medicine-does not alter the importance of the delivery of quality care at the office level. Although it is now popular to define quality of health care in cute advertising copy, as if we are selling durable goods, excellence in pediatric office-based practice continues to require broad strokes of medical knowledge coupled with a unswerving commitment to and advocacy for the needs and well-being of infants, children, and young adults.     

Screening demand-side management programs with a value-based test

A value-based test is presented for economic screening of electric utility demand-side management (DSM) programs. The widely used least cost test is valid if the programs do not alter the amount or value of energy services provided to customers. But, in general, DSM programs have such effects and, as a result, the value consumers receive is changed. A more general economic efficiency test, the most value test, provides a practical method for considering the effects of DSM on customer value. The version presented allows for multiple load periods and can account for rate impacts on several customer classes. Four typical DSM programs are evaluated as illustrations     

Inhibition of nitric oxide synthesis extends cerebrovascular autoregulation during hypertension

In anesthetized intact rats, cerebral blood flow is autoregulated until mean arterial blood pressure (MAP) exceeds 150 mmHg. At higher pressures cerebral blood flow breaks through autoregulation and rapidly increases. However, interruption of the arterial baroreceptor reflex eliminates breakthrough of autoregulation. Thus, breakthrough may reflect active rather than passive vasodilatation. We, therefore, sought to determine if breakthrough depends upon synthesis of the vasodilator nitric oxide. Thirty-eight anesthetized adult male Sprague-Dawley rats were studied. In all, MAP was raised by slow i.v. infusion of phenylephrine. In rats pretreated with the nitric oxide synthase inhibitor L-nitroarginine (L-NA; 22 mg/kg i.v.) or with a combination of L-NA plus D-arginine (D-Arg; 240 mg/kg i.v.), breakthrough did not occur even when MAP exceeded 185 mmHg (L-NA) and 165 mmHg (D-Arg). In contrast, breakthrough occurred in rats treated with L-NA plus L-arginine (L-Arg; 240 mg/kg i.v.) and in rats whose basal vascular tone had been increased by pretreatment with arginine vasopressin prior to infusion of phenylephrine. Removal of sympathetic innervation to cerebral vessels attenuated, but did not eliminate, effects of L-NA on breakthrough. Thus, vasodilatation seen with breakthrough of autoregulation depends upon release of nitric oxide or a nitric oxide donor.     

Phenotypic diversity and kinetics of proliferating microglia and astrocytes following cortical stab wounds

Brain injury induces reactive gliosis, characterized by increased expression of glial fibrillary acidic protein (GFAP), astrocyte hypertrophy, and hyperplasia of astrocytes and microglia. One hypothesis tested in this study was whether ganglioside GD3+ glial precursor cells would contribute to macroglial proliferation following injury. Adult rats received a cortical stab wound. Proliferating cells were identified by immunostaining for proliferating cell nuclear antigen (PCNA) and by [3H]-thymidine autoradiography, and cell phenotypes by immunocytochemical staining for GD3, GFAP, ED1 (for reactive microglia) and for Bandeiraea Simplicifolia isolectin-B4 binding (all microglia). Animals were labeled with thymidine at 1,2,3, and 4 days postlesion (dpl) and sacrificed at various times thereafter. Proliferating cells of each phenotype were quantified. A dramatic upregulation of GD3 on ramified microglia was seen in the ipsilateral hemisphere by 2 dpl. Proliferating cells consisted of microglia and fewer astrocytes. Microglia proliferated maximally at 2-3 dpl and one third to one half were GD3+. Astrocytes proliferated maximally at 3-4 dpl, and some were also GD3+. Both ramified and ameboid forms of microglia proliferated and by 4 dpl all GD3+ microglia were ED1+ and vice versa. In the contralateral cortex microglia expressed neither GD3 nor ED1. Thus they acquired these antigens when activated. Neither microglia nor astrocytes that were thymidine-labeled at 2, 3, or 4 dpl changed in number in subsequent days. Most thymidine+ astrocytes were large GFAP+ reactive cells that clearly arose from pre-existing astrocytes, not from GD3+ glial precursors. In this model of injury microglia proliferate earlier and to a much greater extent than astrocytes, they can divide when in ramified form, and GD3 is up-regulated in most reactive microglia and in a subset of reactive astrocytes. We also conclude that microglial proliferation precedes proliferation of invading blood-borne macrophages.     

Prejudice, stereotypes, and labeling effects: Sources of bias in person perception.

A preliminary study and 3 experiments compared predictions generated by contrasting models of how group labels bias person perception. An affective model assumed that how much perceivers like different groups mediates bias; a cognition model assumed that perceivers' beliefs regarding different groups mediates bias; and a third model assumed that both affect and cognition are necessary to mediate bias. Perceivers evaluated behavior samples provided by targets who were labeled as either rock music performers or child abusers in the preliminary study and the first 2 experiments; homosexuals or heterosexuals in the third experiment. In all studies, controlling for liking eliminated bias. The preliminary study and Study 3 also showed that controlling for beliefs about the groups eliminated bias. Structural equation modeling provided support for the affect model in Studies 1 and 2, and mixed support for the affect model and the cognition model in Study 3. These studies suggest an important role for affect in judgmental biases. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Patterns of DSM-III-R alcohol dependence symptom progression in a general population survey

Age of onset reports obtained retrospectively for each symptom of DSM-III-R alcohol dependence (AD) are used to study patterns of lifetime symptom progression in a large general-population survey of people in the United States. It is shown that symptom progression among a substantial majority of respondents can be summarized as movement across three clusters. Cluster A is defined by symptoms of role impairment/hazardous use (A4), use despite social, psychological or physical problems (A6), and drinking larger amounts or over a longer period of time than intended (A1). Cluster B is defined by tolerance (A7) and impaired control (A2, A3). Cluster C is defined by withdrawal (A8, A9) and giving up activities in order to drink (A5). Clusters are shown to follow a time sequence, with at least one symptom in Cluster A usually occurring first, followed by symptoms in Clusters B and C. In all, 83.4% of the symptom cluster transitions estimated from retrospective age of onset reports are consistent with this progression. Progression to AD is differentially predicted by symptom profiles reported at the age of first symptom onset, with persons reporting Cluster C symptoms most likely to progress subsequently to AD. Furthermore, profiles of AD defined by the highest symptom cluster present at AD onset are differentially predicted by prior personal and parental histories of psychopathology and, among men, are predictive of diagnosis persistence.     

The morphology of rigid-rod polymers and molecular composites resulting from coagulation processing

The effects of processing conditions on the morphology of molecular composite films are examined by optical and electron microscopy. During coagulation processing from solutions in methanesulfonic acid (MSA), rigid-rod polymer, such as poly(p-phenylenebenzobisoxazole) (PBO), phase separates into undesirable aggregates. The coagulant and the method of its introduction have been found to exert a strong impact on the final film morphology. A quench of a PBO solution in MSA into a water bath results in a three dimensional interconnected network of PBO, while a slower introduction of water results in a more amorphous material. A computer simulation program of the coagulation process has been developed to better understand the different structures emerging from coagulation processing of molecular composites. The simulation results are in qualitative agreement with the experimental observations.     

Military tobacco use: a synthesis of the literature on prevalence, factors related to use, and cessation interventions

Tobacco use remains the number one cause of preventable morbidity and premature death in the United States. As a result, military leaders are recognizing that tobacco can adversely affect military fitness levels, deployment readiness, and safety and can increase health care costs. Yet military members continue to use tobacco. Tobacco may be viewed as part of the military culture since military members have used tobacco for many decades for pleasure, comfort, and currency and as a morale booster. Most recently, the military has seen an increase in tobacco use among young military members. A number of research studies have examined the prevalence of tobacco and factors related to use in the military, and several have evaluated cessation and prevention interventions. This article provides a brief historical perspective of military tobacco use in the 20th century and a critical review of the literature published between 1991 and 2006 describing prevalence of tobacco use, factors influencing use, and cessation interventions in the military. Recommendations for future research and for interventions are provided.