Background: In recent years, the morbidity of Mycoplasma pneumoniae pneumonia (MPP) has increased significantly in China. A growing number of studies indicate that imbalanced respiratory microbiota is associated with various respiratory diseases. Methods: We enrolled 119 children, including 60 pneumonia patients and 59 healthy children. Nasopharyngeal (NP) and oropharyngeal (OP) sampling was performed for 16S ribosomal RNA (16S rRNA) gene analysis of all children. Sputum and OP swabs were obtained from patients for pathogen detection. Results: Both the NP and OP microbiota of patients differ significantly from that of healthy children. Diseased children harbor lower microbial diversity and a simpler co-occurrence network in NP and OP. In pneumonia patients, NP and OP microbiota showed greater similarities between each other, suggesting transmission of NP microbiota to the OP. Aside from clinically detected pathogens, NP and OP microbiota analysis has also identified possible pathogens in seven cases with unknown infections. Conclusion: NP and OP microbiota in MPP and non-MPP are definitely similar. Respiratory infection generates imbalanced NP microbiota, which has the potential to transmit to OP. Microbiota analysis also promises to compliment the present means of detecting respiratory pathogens.

Whole head fractionated doses of 200 r and 150 r were initiated postnatally in five experimental age groups (birth, 1-week, 2-week, 3-week and 4-week) and continued over a period of 14 or 20 days to prevent reconstitution of the external granular layer. Animals irradiated at birth displayed minor deficits in behavior, which included ataxia, tremor, hypertonus and dysmetria, while animals irradiated at 1-week showed only mild symptoms of hypermetria. All other animals displayed no motor deficits. Animals irradiated at birth had smaller eyes and ears, a reduction in the size of the entire head and were susceptible to seizures. All animals were sacrified at 70 days of age. The cerebellum was found to be reduced in size and weight, the greatest deficit being seen in animals x-irradiated at the very early ages. Newborn condition animals were found to have large compliments of interneurons in the molecular layer, an established internal granular layer, and Purkinje cells were found to have a normal orientation, position, and to be unreduced in number or size. Total granule cell deficits were found to range from 83% at birth to 29% at four weeks. Quantitative changes for the molecular layer, internal granular layer, medullary layer, Purkinje cell to granule cell ratio, and granule cell density, all depicted the greatest changes in the newborn, 1-week and 2-week conditions. This experiment confirmed that the critical period in the development at which damage would result in behavioral abnormalities was from birth to five days, while for neuroanatomical abnormalities, this critical period was from birth to 18 days.

Cardiopulmonary infections by Angiostrongylus chabaudi affect domestic and wild felids but, due to limited information on the biology of this nematode, its pathogenicity remains unclear. This article describes the histopathological alterations associated with Angiostrongylus infection in a wildcat from Bulgaria, and reviews current literature on this feline angiostrongylid. Nematodes were isolated from lung lavage and faecal samples of a road killed wildcat in Southern Bulgaria. The morphological identification of parasite larvae as A. chabaudi was confirmed by molecular analysis of part of the 18S ribosomal RNA gene. Upon histopathological examination, severe granulomatous pneumonia, ranging from multifocal to coalescing, and pulmonary vascular lesions were observed. Extensive alveolar collapse, alveolar emphysematous changes, parenchymal haemorrhages and small artery wall hyperplasia were observed in the parenchyma adjacent to the granulomas. Histopathological examination revealed the presence of cross-sections of adult female parasites within the lumen of the pulmonary artery branches, the intima altered markedly by subendothelial proliferation and oedematous changes. This study compliments current knowledge of the pathogenesis of feline angiostrongylosis by A. chabaudi in wildcats, as well as of the distribution of this little-known parasite.

The N-methyl-d-aspartate (NMDA) receptor plays an important role in the generation of rhythmical oral motor activities. To compliment our previous studies, we examined the developmental regulation of NR3A and NR3B expression in trigeminal motoneurons (Mo5) and mesencephalic trigeminal neurons (Me5). NR3A-immunoreactive neurons were observed at all ages in both nuclei, decreasing in Mo5 and caudal Me5 after P14, and increasing in rostral Me5. NR3B protein expression only emerged in Mo5 after P21-23. Results indicate that NR3A and NR3B expression is differentially regulated between Mo5 and Me5 coincident with the transition from suckling to chewing.

Pupil-size changes have been shown to indicate positive or negative reactions to several sensory and psychologic stimuli in normal persons. Whether this could be extended to mentally retarded patients who lack ability for verbal or motor behavior was tested by pupillary responses to several visual, tactile, and auditory stimuli. 24 institutionalized severely and profoundly retarded patients were examined by video camera in their usual environments rather than in a controlled laboratory setting. The videotapes were later projected onto a screen for pupil-size measurements. Pupils dilated with pleasant stimuli, including visualizing a familiar person, soft touch to the arm, music, and soft compliments. There was constriction with presenting an unfamiliar person, rough grasp of the arm, and abrasive noise and harsh commands. The findings demonstrate the existence of pupil reactivity in profoundly retarded persons and suggest such testing as a means of determining which elements of their environment are pleasing or aversive to them.

Individuals with multiple sclerosis (MS) primarily rely on informal supports such as family members and assistive technology to meet their daily needs. As they age, formal supports may become important to compliment these supports and sustain community-based living. No previous research exists exploring plans and preparations of persons with MS for future independent living and long-term care needs. We analyzed data from a random sample survey (N = 580) to assess knowledge and perceptions of future service needs using ANOVA, chi-square, correlations, and MANOVA procedures. Results indicate that overall, most respondents are not well informed and have not planned or prepared for future care needs. Persons reporting severe MS were more likely to plan and prepare. Key "entry points" for making preparations include receiving specific education and planning information, discussions with family and professional service providers, and increased age, education, and income. We recommend greater infusion of long-term care planning into these existing entry points and creation of new entry points including healthcare provides and insurers.

OBJECTIVE

Although the features of neuronal migration have been known since the turn of the century, the serial features of neuronal migration as seen with magnetic resonance imaging (MRI) have not been described. Our objective was to provide a template of the normal appearance and the temporal pattern of neuronal migration in the human fetal brain early in the second trimester as seen with MR imaging and to correlate our findings with histological sections and atlases.

METHODS

Twenty-eight normal fetal specimens, which ranged from 9 to 24 weeks of gestational age, were imaged with a 1.5 T clinical MRI unit by use of conventional spin echo, fast spin echo, and three-dimensional Fourier transformation spoiled gradient refocussed pulse sequences.

RESULTS

The three-dimensional Fourier transformation spoiled gradient refocussed pulse sequence provided the highest resolution images of neuronal migration. At 13 weeks of gestational age, the germinal matrix was identified. A five-layer pattern of the fetal forebrain, which included layers of neuroblast formation and migration, could be identified at 16 to 18 weeks by MRI. The germinal matrix and layers of migrating neurons diminished considerably in size by 21 weeks. Histological studies and correlation with anatomic atlases confirmed the MRI findings.

CONCLUSIONS

Images obtained by use of MRI with standard clinical pulse sequences can document the appearance and the temporal patterns of neuronal migration in postmortem fetal specimens. With the evolution of high-resolution MRI and faster scanning techniques, these findings may serve as a template for the in utero MRI appearance of neuronal migration and thereby compliment the antenatal ultrasonic investigation of congenital anomalies.

The effects of human ANF 99-126 on the aldosterone and cortisol responses to ACTH infusion were studied in 8 normal volunteers. ACTH infusion caused a significant rise in aldosterone and cortisol on each study day. On the day that ANF was concomitantly infused the aldosterone, but not the cortisol, response to ACTH was significantly attenuated. These results show that a pharmacological dose of ANF selectively inhibits ACTH mediated mineralocorticoid as opposed to glucocorticoid release in man. These results support in vitro and in vivo findings from animal experiments. These findings also compliment previous studies showing that ANF inhibits ANG II stimulated aldosterone release in normal subjects.

OBJECTIVE

To evaluate the developmental potential and aneuploidy rates of in-vitro versus in-vivo grown and matured mouse oocytes.

METHODS

Mice were superovulated to obtain in-vivo matured oocytes. Mouse preantral follicles were also mechanically isolated and cultured in-vitro. In-vitro fertilization (IVF) was performed and fertilization, cleavage, and morula/blastocyst formation rates were compared between groups. Cytogenetic analysis was used to compare oocyte aneuploidy rates and aneuploidy characteristics in the developing embryos.

RESULTS

In-vivo oocyte maturation resulted in higher IVF fertilization, cleavage, and morula/blastocyst formation rates versus in-vitro follicle culture (96.4% versus 78.5%, p<0.001; 95.3% versus 77.4%, p<0.001; 94.1% versus 76.9%, p<0.001). Total aneuploidy rates were higher in embryos derived from in-vitro matured oocytes versus those grown in-vivo (4.0% versus 1.3%, p<0.05).

CONCLUSIONS

Results indicate a reduced developmental competency of in-vitro matured oocytes. The data also highlight an increased susceptibility to meiotic errors in early stage follicles undergoing in vitro culture.

The perfect balance of mind, body and soul is considered as complete health in Ayurveda. Ayurveda has its own identity as most ancient and traditional System of Medicine in India. Even Ayurveda emphasizes its treatment modalities into three parts viz. Satwawajay Chikitsa, Yuktivyapashray and Daivyapashray Chikitsa. Sattvavajaya therapy mentioned in Charakasamhita and it used as new concept of psychotherapy in Ayurveda. The effectiveness of "traditional mental health promoting practices" was identified as health regimens (swasthvrtt), correct behavior (sadvrtt), and yoga. Sattvavajaya as psychotherapy, is the mental restraint, or a "mind control" as referred by Caraka, is achieved through "spiritual knowledge, philosophy, fortitude, remembrance and concentration. Ayurvedic psychotherapy would play a dual role: First, as a revival of authentic medical culture, the exercise of a practice with an assumed primordial dimension, and second as a discovery of authentic subjectivity, the revelation of a self with an assumed interior depth. When we integrate the contemporary art of psychotherapy with the ancient science of Ayurveda, it becomes a powerful combination that is called Psycho Veda. The integration of Psycho and Veda is motivated by the complete integration of the immense but fairly contemporary view of the mind, emotions and psyche and how this performs in our lives. Integrating Psychotherapy and Vedic principles teaches us how to rediscover critical knowledge and awareness of the natural forces and rhythms that compliment and strengthen our human experience, through the understanding of the psyche and what our inner experiences are and also involving practical daily activities with thorough attention to our total environment to bring about radical changes in our mental outlook and in physical health.

Although genes causing rare Mendelian forms of human obesity have provided much useful information about underlying causes of obesity, these genes do not explain significant proportions of common obesity. This review presents evidence that animal models can be used to uncover subtle genetic effects on obesity and can provide a powerful rigorous compliment to human association studies. We discuss the advantages of animal models of obesity, various approaches to discovering obesity genes, and the future of mapping and isolating naturally occurring alleles of obesity genes. We review evidence that it is important to map naturally occurring obesity genes using quantitative trait locus (QTL) mapping, instead of mutagenesis and knockout models because the latter do not allow study of interactions and because naturally occurring obesity alleles can interfere with cloning from mutagenesis projects. Because a substantial percentage of human obesity results from complex interactions, the underlying genes can only be identified by direct studies in humans, which are still very difficult, or by studies in mice that begin with QTL mapping. Finally, we emphasize that animal model studies can be used to prove that a specific gene, only associated with obesity in humans, can indeed be the underlying cause of obesity in mammals.

Botulinum A exotoxin, a neurotoxin produced by the bacterium Clostridium botulinum, is now being used by cosmetically oriented specialists for treatment of a large variety of movement associated wrinkles on the face and neck. This form of temporary chemical denervation compliments the cosmetic practitioner's armamentarium alongside resurfacing and tissue augmentation. Additionally, the use of Botulinum toxin to block sympathetic innervation of eccrine sweat glands is proving a valuable treatment of hyperhidrosis of the axillae, palms and soles.

The current study investigated seasonal variation in internet searches regarding sex and mating behaviors. Harmonic analyses were used to examine the seasonal trends of Google keyword searches during the past 5 years for topics related to pornography, prostitution, and mate-seeking. Results indicated a consistent 6-month harmonic cycle with the peaks of keyword searches related to sex and mating behaviors occurring most frequently during winter and early summer. Such results compliment past research that has found similar seasonal trends of births, sexually transmitted infections, condom sales, and abortions.

OBJECTIVE

To determine if a brief user friendly anaesthetic booklet compliments the anaesthetic service currently provided, in terms of greater patient understanding and satisfaction.

METHODS

Two questionnaires were completed by participants in each group, one questionnaire preoperatively and the other postoperatively. The booklet group received the anaesthetic booklet in the mail with their booking card while the control group only received their booking card.

RESULTS

Of the 209 eligible, 140 patients consented to and completed the preoperative questionnaire, of whom 53 were in the anaesthetic booklet group and 87 were in the control group. The postoperative questionnaire was completed by 38 and 65 respectively. The anaesthetic booklet group had better understanding of what a premed will do (p < 0.05) and how long after an anaesthetic to wait before driving (p < 0.025). The percentage of correct answers for the more general anaesthetic questions was high and very similar in both groups. There was no significant difference in the satisfaction scores between groups. Satisfaction scores for both groups rose significantly in the postoperative questionnaire when compared with the preoperative questionnaire (p < 0.001).

CONCLUSIONS

The value of the anaesthetic booklet is in providing detailed anaesthetic information to the patient. This will aid the preanaesthetic consultation with the anaesthetist and provide a focus for further discussion about the intended anaesthetic. Patient satisfaction with the anaesthetic service was high in both groups pre- and postoperatively and was not altered by the anaesthetic booklet.

BACKGROUND

If a HIV positive mother delivers in a health facility, interventions can be effected to reduce the risk of transmission of HIV to the baby The study was done to evaluate the interventions offered to HIV positive women who delivered at Aminu Kano Teaching Hospital (AKTH) Kano.

METHODS

Retrospective review of the case records of all HIV positive patients that delivered at AKTH over a 27 month period (October 2003 to December 2005) was used.

RESULTS

There were 4922 deliveries out of which 125 were HIV positive, giving a prevalence rate of 2.54%. Most (75.2%) of the patients received Nevirapine alone in labour, 20.8% received a combination of antiretroviral drugs while 4% received none because their records were not available. Majority (88%) of the patients had spontaneous vaginal delivery, 10.4% by elective CS and 1.6% by emergency CS. There was no maternal death but 3.2% of the babies were stillbirths. All the babies received a single dose of Nevirapine. Most (96%) mothers chose exclusive breast milk substitute.

CONCLUSIONS

HIV positive mothers need to deliver in health facilities to receive the full compliment of care they deserve. Highly Active Antiretroviral therapy (HAART) should be introduced, as it is more effective for PMTCT.

BACKGROUND

Rewards are important in attracting, motivating and retaining the most qualified employees, and nurses are no exception to this rule. This makes the establishment of an efficient reward system for nurses a true challenge for every hospital manager. A reward does not necessarily have a financial connotation: non-financial rewards may matter too, or may even be more important. Therefore, the present study examines nurses' reward perceptions, in order to identify potential reward options.

METHODS

To answer the research question "What do nurses consider a reward and how can these rewards be categorized?", 20 in-depth semi-structured interviews with nurses were conducted and analysed using discourse and content analyses. In addition, the respondents received a list of 34 rewards (derived from the literature) and were asked to indicate the extent to which they perceived each of them to be rewarding.

RESULTS

Discourse analysis revealed three major reward categories: financial, non-financial and psychological, each containing different subcategories. In general, nurses more often mentioned financial rewards spontaneously in the interview, compared to non-financial and psychological rewards. The questionnaire results did not, however, indicate a significant difference in the rewarding potential of these three categories. Both the qualitative and quantitative data revealed that a number of psychological and non-financial rewards were important for nurses in addition to their monthly pay and other remunerations. In particular, appreciation for their work by others, compliments from others, presents from others and contact with patients were highly valued. Moreover, some demographical variables influenced the reward perceptions. Younger and less experienced nurses considered promotion possibilities as more rewarding than the older and more senior ones. The latter valued job security and working for a hospital with a good reputation higher than their younger and more junior colleagues.

CONCLUSIONS

When trying to establish an efficient reward system for nurses, hospital managers should not concentrate on the financial reward possibilities alone. They also ought to consider non-financial and psychological rewards (in combination with financial rewards), since nurses value these as well and they may lead to a more personalized reward system.

There has been considerable interest in the possibility that some psychotropic medications may possess antiviral activity. Several clinical observations suggest that lithium may inhibit the reactivation of latent herpes simplex virus, thereby reducing the number of recurrent infections. We performed a retrospective study examining the putative antiviral activity of various psychotropic agents in 177 subjects receiving lithium prophylaxis and a comparison group of 59 subjects receiving other antidepressant drugs for affective illness. Chronic lithium administration resulted in a significant reduction in the mean rate of recurrent labial herpes infections when compared to the pretreatment period (p less than 0.001). In contrast, the mean rate of herpes infections was unchanged in patients taking other antidepressants (p = 0.53). Although the overall reduction in herpes infections was not significantly different between groups, the proportion of subjects reporting a reduction in infection rate was greater in the lithium group (71%) compared with those receiving other antidepressants (52%) (p = 0.07). These data compliment prior in vitro and clinical studies demonstrating a potential antiviral activity for lithium carbonate.

OBJECTIVE

To investigate the fluorescent characteristics of different thyroid tissues.

METHODS

Fresh ex vivo thyroid tissue was surfaced scanned with a fluorescence spectrophotometer. Resultant spectra were evaluated via interpeak ratios.

RESULTS

Interpeak ratios of all histologies were found to be significantly different from each other (P < 0.001). The diagnostic sensitivity and specificity of fluorescent spectroscopy was 86% and 91% for thyroid nodule capsule, 78% and 59% for papillary thyroid carcinoma, and 82% and 63% for normal thyroid, respectively.

CONCLUSIONS

Fluorescent spectroscopy can been used to identify significant differences in the fluorescent characteristics of various thyroid histologies.

CONCLUSIONS

This study is the first investigation of the fluorescence of thyroid tissue. The diagnostic ability of fluorescent spectrometry may allow it to be used as a localization aid for fine needle aspiration, using optical fiber probes. Further investigations may enhance the sensitivity and specificity of fluorescent spectrometry allowing it to replace or compliment fine needle aspiration.

METHODS

B-3.

OBJECTIVE

International medical school graduates (IMGs) have been part of the United States residency applicant pool for several years. There has been increasing discussion of an overproduction of doctors in the United States, and mention of limiting IMG quotas. The purpose of this study was to find out if measurable discrimination existed real or perceived, against IMGs.

METHODS

A survey was performed to assess whether program directors of surgery residencies perceive the performance, dedication, and abilities of IMGs as being equal to United States medical school graduates (USMGs), and whether program directors believe that a preference toward USMGs exists. Surveys with 30 tailored questions were mailed to all members of the Association of Program Directors in Surgery. One hundred twenty-five surveys were returned out of 283 mailed, and 112 were included in the data analysis. Besides those relating to demographics, questions on the survey included two series of queries. One set was designed to assess whether the respondent reported that IMGs possessed similar skills and abilities as USMGs, whereas the other addressed whether respondents perceived a tendency in their programs to focus recruitment toward USMGs. Still others were inserted to confirm results of these series, and to assess whether program directors perceived discrimination toward IMGs in general.

RESULTS

Survey results indicate the perception that IMGs are similar in skill and ability to USMGs, regardless of program size. However, a perception existed among program directors that USMGs were favored in the recruitment process, with more than 70% of respondents indicating that they believed IMGs were discriminated against. Furthermore, nearly 20% reported that they had been pressured to rank a less-qualified USMG higher than a more qualified IMG, and 22% reported that they had ranked a USMG higher than an IMG to avoid a reduced compliment of USMGs.

CONCLUSIONS

There is a significant belief and perception that IMGs are indeed discriminated against, despite program directors seeing no clear differences in surgical skills between IMGs and USMGs.

Factors shaping the geographic range of a species can be identified when phylogeographic patterns are combined with data on contemporary and historical geographic distribution, range-wide abundance, habitat/food availability, and through comparisons with codistributed taxa. Here, we evaluate range dynamism and phylogeography of the rocky intertidal gastropod Mexacanthina lugubris lugubris across its geographic range - the Pacific coast of the Baja peninsula and southern California. We sequenced mitochondrial DNA (CO1) from ten populations and compliment these data with museum records, habitat availability and range-wide field surveys of the distribution and abundance of M. l. lugubris and its primary prey (the barnacle Chthamalus fissus). The geographic range of M. l. lugubris can be characterized by three different events in its history: an old sundering in the mid-peninsular region of Baja (∼ 417,000 years ago) and more recent northern range expansion and southern range contraction. The mid-peninsular break is shared with many terrestrial and marine species, although M. l. lugubris represents the first mollusc to show it. This common break is often attributed to a hypothesized ancient seaway bisecting the peninsula, but for M. l. lugubris it may result from large habitat gaps in the southern clade. Northern clade populations, particularly near the historical northern limit (prior to the 1970s), have high local abundances and reside in a region with plentiful food and habitat - which makes its northern range conducive to expansion. The observed southern range contraction may result from the opposite scenario, with little food or habitat nearby. Our study highlights the importance of taking an integrative approach to understanding the processes that shape the geographic range of a species via combining range-wide phylogeography data with temporal geographic distributions and spatial patterns of habitat/food availability.

This study reports the variety of peptides present in the skin secretory peptidome of Phyllomedusa hypochondrialis azurea. Peptide structures, along with post-translational modifications, were elucidated by QTOF MS/MS analysis, cDNA sequencing, or a combination of both. Twenty-two peptides, including 19 novel structures, were identified from six different structural classes, including tryptophyllins, dermorphins, and a novel group of peptides termed hyposins. The study demonstrates the power of this combined approach to mine the rich peptidome compliment of the amphibian defensive skin secretome.

This article evaluates the spectrum of epidemiology and treatment of children presenting with shoulder pain. These injuries are discussed to further understand the mechanism of injury, the variation of these injuries with age, treatment options, and outcomes and complications that may arise. A retrospective clinical review was performed to compliment the findings of the literature review.

In modern curricula, the early integration of anatomy and clinical skills education at undergraduate level is seen as important. However, the direct relationship between medical students' competence in anatomy, and their clinical proficiency during early undergraduate years, has scarcely been studied. In this study, the marks for anatomy and clinical skills of three consecutive cohorts of medical students (n = 538 in total) during their first two years were correlated. The anatomy competence was measured using a new marker, the Anatomy Competence Score (ACS) which was calculated with equal contributions from theory knowledge and its practical and clinical application. Proficiency in clinical skills was determined by OSCE performance marks for stations which examined physical examination and practical procedural skills. The possible compounding effect of students' general academic ability was investigated by using the overall performance mark for each student based on their performance in all subjects over the first two years of the medical curriculum. We found that the correlation between anatomy and clinical skills marks was weak to moderate. However, this correlation was virtually nullified once the effect of academic ability was accounted for. Although these findings suggest that anatomy education does not compliment early clinical education, the lack of complexity of clinical problems used in clinical skills assessments (OSCEs) during the early stages may well be the primary contributing factor to this finding.

Disproportionate numbers of AIDS cases have been reported for Blacks and Latinos nationwide. The criteria used to identify and categorize individuals into these groups has resulted in limited information about the factors responsible for Blacks and Latinos being at greater risk for HIV transmission. This paper addresses the importance of the term ethnicity versus race for social science AIDS related research. Methodological issues and sampling strategies, and a variety of socio cultural factors that compliment AIDS related research with ethnic minority populations are also discussed.