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Family members of patients who die in an ICU are at increased risk of psychological sequelae compared to those who experience a death in hospice.This study explored differences in rates and levels of complicated grief (CG), posttraumatic stress disorder (PTSD), and depression between family members of patients who died in an ICU versus a non-ICU hospital setting. Differences in family members' most distressing experiences at the patient's end of life were also explored.The study was an observational cohort. Subjects were next of kin of 121 patients who died at a large, Midwestern academic hospital; 77 died in the ICU. Family members completed measures of CG, PTSD, depression, and end-of-life experiences.Participants were primarily Caucasian (93%, N = 111), female (81%, N = 98), spouses (60%, N = 73) of the decedent, and were an average of nine months post-bereavement. Forty percent of family members met the Inventory of Complicated Grief CG cut-off, 31% met the Impact of Events Scale-Revised PTSD cut-off, and 51% met the Center for Epidemiologic Studies Depression Scale depression cut-off. There were no significant differences in rates or levels of CG, PTSD, or depressive symptoms reported by family members between hospital settings. Several distressing experiences were ranked highly by both groups, but each setting presented unique distressing experiences for family members.Psychological distress of family members did not differ by hospital setting, but the most distressing experiences encountered at end of life in each setting highlight potentially unique interventions to reduce distress post-bereavement for family members.

The present study describes the 4- and 7-month postintervention outcomes of a sexual assault risk reduction program for women, which was part of an evaluation that included a prevention program for men. Relative to the control group, participants evidenced more relational sexual assertiveness and self-protective behavior, and were more likely to indicate that they utilized active verbal and physical self-defense strategies. Whether or not women experienced subsequent victimization did not differ between groups. Relative to control group women who were victimized, program participants who were victimized between the 4- and 7-month follow-up blamed the perpetrator more and evidenced less self-blame.

The purpose of this study was to utilize a mixed methodological approach to better understand the co-occurrence of perpetrator tactics and women’s resistance strategies during a sexual assault and women’s reflections on these experiences. College women were recruited from introductory psychology courses and completed both forced-choice response and open-ended survey questions for course credit. Content-analytic results of college women’s written responses to an open-ended question suggested that women’s resistance strategies generally mirrored the tactics of the perpetrator (e.g., women responded to perpetrator verbal pressure with verbal resistance). However, there were some instances in which this was not the case. Furthermore, a number of women expressed a degree of self-blame for the sexual assault in their responses, as well as minimization and normalization of the experience. These findings suggest that sexual assault risk reduction programs need to directly address victims’ self-blame as well as create an atmosphere where societal factors that lead to minimization can be addressed.

Research with breast cancer patients suggests that abuse survivors experience more psychological distress and disorders, particularly depression and anxiety, than patients without abuse histories. However, we do not yet understand the impact of abuse on other palliative care domains for individuals with other cancer types.This study explores the relationship between past abuse and distress in a group of cancer patients referred for palliative care. This study also explores differences in distress level and likelihood of meeting diagnostic criteria for major depression and generalized anxiety disorder between patients with and without abuse histories.Data were from 164 new, palliative care outpatients who completed an initial clinician-administered assessment and the James Supportive Care Screening patient self-report.Multivariate analyses of variance were conducted to explore differences between patients who reported an abuse history and those who did not on the number of items endorsed and associated distress on five palliative care domains. Chi-square tests were conducted to identify differences in diagnosis of depression and anxiety between patients with and without abuse histories.Twenty-eight percent reported abuse histories. Patients with abuse histories endorsed more physical problems, psychological concerns, and spiritual concerns and greater distress related to psychological and spiritual concerns than patients without abuse histories. Patients with abuse histories more frequently received diagnoses of major depression disorder and generalized anxiety disorder.These differences underscore the impact of abuse on the adjustment of cancer patients referred for palliative care. Assessment of patient abuse history by palliative care teams and referral for psychological treatment may help reduce patient distress.

Objective: This study assessed the process of leaving an abusive dating relationship utilizing a qualitative design. Methods: Participants included 123 college women in abusive dating relationships who participated at the beginning and end of a 10-week academic quarter. Results: Qualitative content analyses were used to analyze the transcribed responses to an open-ended question about women's leaving processes over the interim period. A variety of categories and themes emerged for women in different stages of the leaving process, consistent with the Transtheoretical Model of Change and Investment Model. Data also underscored women's lack of acknowledgment, minimization, and normalization of abuse. Conclusions: These data demonstrate the importance of dating violence intervention and prevention programming on college campuses and offer information that may be useful to college health providers who assist women in abusive dating relationships.

Fabry disease (FD) is a lysosomal disorder caused by mutations in the GLA gene coding for α‑galactosidase A (α‑GalA). These mutations lead to the accumulation of α‑GalA substrates, including globotriaosylceramide (Gb3). As a consequence of lipid storage, Fabry patients can suffer from neuropathic pain, impaired kidney function and cardiomyopathy. Existing treatments for FD either require bi-weekly intravenous infusions of replacement enzyme, or are effective in a limited number of patients with specific “amenable” mutations. Substrate reduction therapy (SRT) with lucerastat, an orally-available small molecule inhibitor of glucosylceramide synthase (GCS) to reduce Gb3 accumulation is an alternative mechanism, that would be suitable for all FD patients.

A soft shell crayfish operation consists of an indoor molting system for immature crayfish. The molted crayfish could be sold as food or bait. Such systems have been operated on a small-scale in Kentucky and neighboring states, although traditionally the industry has been centered in Louisiana. This article investigated profit-maximizing management conditions and economic feasibility of a small-scale soft shell crayfish operation. Results showed that a minimum facility size of 25–30 culture trays was essential for realizing a profit by selling product to bait shops. This facility size was also amenable to be operated by two full-time workers, making family-run enterprises a strong possibility. Other results showed that larger facilities, with more than 50 culture trays, were necessary to reduce the minimum equity in fixed investment to be less than 70%. Direct marketing at retail prices is often the only profitable option for small-scale aquaculture; this article gives an example of a small-scale aquacult...

Probst R., Nemeschkal H.L., McGrady M., Tucakov M. & Szep T. 2011. Aerial hunting techniques and predation success of Hobbies Falco subbuteo on Sand Martin Riparia riparia at breeding colonies. Ardea 99: 9–16.

Clinicians agree that knowledge of clients' sexual victimization histories are invaluable in conceptualizing cases and choosing treatment interventions; however, the routine assessment of sexual assault in clinical practice is not standard (e.g., Hurst, MacDonald, Say, & Reed, 2003; Pruitt & Kappius, 1992). This article reviews recent research related to prevalence rates, short- and long-term consequences of sexual assault, available screening measures, and relevant resources for clinicians in screening for sexual trauma. Specifically, this article provides information to guide practitioners in adequately assessing sexual trauma among men and women abused either as children or adults, and addresses special issues for assessing sexual assault among elderly and disabled individuals.

Habitat colonization and abandonment affects the distribution of a species in space and time, ultimately influencing the duration of time habitat is used and the total area of habitat occupied in any given year. Both aspects have important implications to long-term conservation planning. The importance of patch isolation and area to colonization–extinction events is well studied, but little information exists on how changing regional landscape structure and population dynamics influences the variability in the timing of patch colonization and abandonment events. We used 26 years of Kirtland’s Warbler (Dendroica kirtlandii) population data taken during a habitat restoration program (1979–2004) across its historical breeding range to examine the influence of patch attributes and temporal large-scale processes, specifically the rate of habitat turnover and fraction of occupied patches, on the year-to-year timing of patch colonization and abandonment since patch origin. We found the timing of patch colonization and abandonment was influenced by patch and large-scale regional factors. In this system, larger patches were typically colonized earlier (i.e., at a younger age) and abandoned later than smaller patches. Isolated patches (i.e., patches farther from another occupied patch) were generally colonized later and abandoned earlier. Patch habitat type affected colonization and abandonment; colonization occurred at similar patch ages between plantation and wildfire areas (9 and 8.5 years, respectively), but plantations were abandoned at earlier ages (13.9 years) than wildfire areas (16.4 years) resulting in shorter use. As the fraction of occupied patches increased, patches were colonized and abandoned at earlier ages. Patches were abandoned at older ages when the influx of new habitat patches was at low and high rates. Our results provide empirical support for the temporal influence of patch dynamics (i.e., patch destruction, creation, and succession) on local colonization and extinction processes that help explain large-scale patterns of habitat occupancy. Results highlight the need for practitioners to consider the timing of habitat restoration as well as total amount and spatial arrangement of habitat to sustain populations. Published by Elsevier Ltd.

Data were collected via a 2010 survey of Hispanic consumers in Kentucky regarding their willingness to purchase pigs from local growers. Focus was given on live animal sales because of the convenience of small-scale livestock producers. Results show that nearly 30% of respondents were willing to buy live pigs; however, only 13% of surveyed consumers were willing to process the live animals. The most popular size of pig was from 4.5 kg (10 lbs) to 18 kg (40 lbs). Hispanic consumers who lived with their families in Kentucky and/or were willing to travel to farms to purchase food products exhibited a significantly higher proclivity to buy pigs. Hence, the data indicated a strong potential for developing a direct-to-consumer market for pigs in Kentucky, particularly if farmers can cooperate with local butchers such that Hispanic consumers could conveniently buy live pigs and have them processed to their specifications.

Reflectivity has been described as the cyclical process whereby individuals engage in a critical evaluation of their affective, cognitive, and behavioral experiences to produce insight and fundamental shifts in their original beliefs. Developing reflectivity in supervisees is one of the most challenging, yet important, responsibilities of clinical supervisors, given its link to such skills as critical thinking, ethical decision making, and problem solving. This paper advances the literature by presenting a case example that demonstrates how reflectivity can be emphasized in clinical supervision, highlighting the barriers to reflectivity, and providing strategies that supervisors can utilize to encourage reflectivity within clinical supervision. The strategies and information discussed may be flexibly applied to supervisees of all developmental levels within the context of individual supervision.

Germany's National Metrology Institute the Physikalisch-Technische Bundesanstalt (PTB) and the DR. JOHANNES HEIDENHAIN GmbH (HEIDENHAIN) have conducted and compared measurements using their primary angle standards, which are realized as angle comparators of similar design. A high-resolution digital angle encoder served as the transfer standard for this comparison. Calibrations of the transfer standard by the two angle comparators resulted in an agreement of ±0.002″. The result proved to be consistent with the measurement uncertainties that the participants attributed to their calibration. PTB succeeded, using an additional comparison with a self-calibration method, in improving the measurement uncertainty of its comparator by a factor of 2.5 to 0.002″ ( k = 2). The results of both participants demonstrated the suitability of the digital angle encoder as transfer standard for angle measurement comparisons aimed at uncertainties of a few thousandths of an arcsecond.

Forest planners must evaluate how spatiotemporal changes in habitat amount and configuration across the landscape as a result of timber management will affect species' persistence. However, there are few long-term programs available for evaluation. We investigated the response of male Kirtland's Warbler (Dendroica kirtlandii) to 26 years of changing patch and landscape structure during a large, 26-year forestry-habitat restoration program within the warbler's primary breeding range. We found that the average density of male Kirtland's Warblers was related to a different combination of patch and landscape attributes depending on the species' regional population level and habitat amounts on the landscape (early succession jack pine (Pinus banksiana) forests; 15-42% habitat cover). Specifically, patch age and habitat regeneration type were important at low male population and total habitat amounts, while patch age and distance to an occupied patch were important at relatively high population and habitat amounts. Patch age and size were more important at increasing population levels and an intermediate amount of habitat. The importance of patch age to average male density during all periods reflects the temporal buildup and decline of male numbers as habitat suitability within the patch changed with succession. Habitat selection (i.e., preference for wildfire-regenerated habitat) and availability may explain the importance of habitat type and patch size during lower population and habitat levels. The relationship between male density and distance when there was the most habitat on the landscape and the male population was large and still increasing may be explained by the widening spatial dispersion of the increasing male population at the regional scale. Because creating or preserving habitat is not a random process, management efforts would benefit from more investigations of managed population responses to changes in spatial structure that occur through habitat gain rather than habitat loss to further our empirical understanding of general principles of the fragmentation process and habitat cover threshold effects within dynamic landscapes.

Significant hearing loss is one of the most frequent congenital diseases and present at birth in approximately one in 1000 newborns. During the first years of life, this number of children with permanent hearing loss rises by approximately the same amount. Hearing impairment is not an obvious condition in newborns in most cases and produces very few signs in infancy. Such hearing loss threatens normal speech and personality development. The longer the child is without auditory stimulation by speech, the more difficult it is to acquire the missed linguistic skills. Therefore, early detection and rehabilitation of such hearing loss is crucial. Universal newborn hearing screening is the most effective method to detect such impairment and is based on objective audiometric test methods that were recently developed and adapted for screening requirements. Useful tests are otoacoustic emissions and the auditory brainstem response. This article reviews this new screening tests in general and with special regard to the situation in Switzerland.

Kirtland’s warblers (Dendroica kirtlandii) persist in a naturally patchy environment of young, regenerating jack pine forests (i.e., 5–23 years old) created after wildfires and human logging activities. We examined how changing landscape structure from 26 years of forest management and wildfire disturbances influenced population size and spatial dispersion of male Kirtland’s warblers within their restricted breeding range in northern Lower Michigan, USA. The male Kirtland’s warbler population was six times larger in 2004 (1,322) compared to 1979 (205); the change was nonlinear with 1987 and 1994 identified as significant points of change. In 1987, the population trend began increasing after a slowly declining trend prior to 1987, and the rate of increase appeared to slow after 1994. Total amount of suitable habitat and the relative area of wildfire-regenerated habitat were the most important factors explaining population trend. Suitable habitat increased 149% primarily due to increasing plantations from forest management. The relative amount and location of wildfire-regenerated habitat modified the distribution of males among various habitat types, and the spatial variation in their abundance across the primary breeding range. These findings indicate that the Kirtland’s warbler male population shifted its use of habitat types temporally and spatially as the population increased and as the relative availability of habitats changed through time. We demonstrate that researchers and managers need to consider not only habitat quality, but the temporal and the spatial context of habitat availability and population levels when making habitat restoration decisions.

The abili to age individual birds visually in the field based on pluma e variation could provide important demographic andTiogeographical information. We describe an a proach to intr ages from a distribution of plumage scores of free-rangin male Kirtland's Warblers (Dendroica kin&ndii). We assigned ages to males usin a scoring scheme (0-12 points) Eased on variation in plumage coloration, brightness, and contrast on three dorsj and three ventral body regions presumed to be age-related. The distribution of total additive plumage scores for 875 breeding males was normally distributed, indicating no distinct age classes. Thus, we developed rovisional plumage- age classes of second ear (SY) and after second-year (ASY), and com ared them to the totafplumage scores of a smaller subsample of Lown age (N = 92) and minimum age (N = 183) males. Pluma e scores of known-age male Kirtland's Warblers increased nonlinearly with age (r, = 0.67), but with some overlap. ~ke median plumage score for SY males (median = 5.0) was significantly lower than for third-year (TY) males (median = 7.0) and after third-year (3 year and older) males (median = 8.0), indicating that the plumage of male Kirtland's Warblers becomes more distinctive and brighter with age. Linear discriminant function analysis differentiated ASY male Kirtland's Warbler from SY males with 78.3% accuracy. Investigators could use the distribution of pluma e scores and approximate age structures to document changes in male age structure during colonization, use, antabandonment of habitats by Kirtland's Warblers or other species that occu y early successional habitats. Aging free-ranging birds based on a plumage scoring scheme may be especially criticaffor demographic studies of less-studied species where it is unlikely that a banding program will be initiated, but where plumage-age inferences or management decisions must be made. SINOPSIS. Variaciones continuas en el plumaje & machos & & Dendroica kirtlandii relacionadas a su edad Describimos una forma para inferir la edad a travb de una distribuci6n de marcadores en machos silvesues de la reinita Dendroica kirdandii. Utilizando dicho acercamiento, asignamos edad relativa a machos bashndonos en un esquema de puntuaci6n (0-12) para la coloraci6n del plumaje, su brillantez, y contraste en tres localidades del dorso y la parte ventral, que han sido relacionadas con la edad de estos. La distribuci6n de las puntuaciones de 875 machos fue normal, lo ue indica que no hub0 forma de distinguir las diferentes edades. Por ende, desarrollamos un divisiones de dases,%ashndonos en diferencias en el plumaje para individuos de se undo aho (SA) y posterior a1 segundo aiio (PSA) y 10s comparamos a las untuaciones de una pequeiia muestra ck aves (N = 92) cuya edad era conocida y a otra en que sabiamos la edacfminima (N = 143). La puntuaci6n total para individuos de edad conocida aumento de forma no-lineal con la edad (Rs = 0.67), con un pequeiio solapamiento en el plumaje total. La puntuaci6n para machos de segundo aiio (SA) (mediana = 5.0) fue significativamente menor que para aves de tercer afio (mediana = 7.0) y esta a su vez que para aves mayores a tres ahos (mediana = 8.0), lo ue indica ue el plurnaje de 10s machos, en las aves estudiadas, se torna m6s brillante con la edad. Un an&is lineal !e funci6n8iscriminativa pudodiferenciar entre aves PSA y SA con un 78.3% de exactitud. Los investigadores han utilizado estas diferencias en el plumaje para clasificar entre 10s grupos machos territoriales que no han sido anillados. TambiCn pudieran utilizar estas particularidades y diferencias en el plumaje para aproximar la estructura de edades entre machos silvestres y hacer inferencias sobre la demografia y reclutamiento de aves en habitats de diferente calidad. Kg, word: Dendroica kirtlandii, Kirtland's Warbler, molt, plumage-age classification, plumage variation

We compared transect counts used for the annual official count of male Kirtland's Warblers (Dendroica kirtlandii) to an observation-based mapping method of individually sighted males in 155 stands over 10 yrs. The annual census count almost tripled from 1990 to 1999. The transect and observation-based mapping method showed the same increasing trend in population between 1990 and 1999, except from 1992 to 1993. The annual official census transect count was consistently higher than the mapping method for stands censused in common. After standardizing for sample size, the annual number of Kirtland's Warblers per stand increased through time with the transect method, while there was a positive, non-significant trend with the mapping method. After 1992, the two methods began diverging in the number of males per stand. The relationship between the differences in count between methods (mapping count minus transect count) to the official transect count varied among years. At the stand level, the transect...

Eine audiometrische Hörprüfung wird mit physikalisch genau definierten, akustischen Reizen durchgeführt. Als Antwort werden willkürliche Reaktionen wie das Drücken eines Knopfes oder physiologische und unwillkürliche Reaktionen wie die Kontraktion des M. stapedius gemessen. Das erste entspricht der subjektiven, psychoakustischen oder Verhaltensaudiometrie, das zweite der objektiven Audiometrie. Ziele einer audiometrischen Hörprüfung sind die Erfassung, die Lokalisation und die Quantifizierung einer Hörstörung. Je nach Fragestellung werden die verschiedenen subjektiven und objektiven audiometrischen Methoden im Rahmen eines audiologischen Screenings, der audiologischen Diagnostik oder zur quantitativen Beschreibung einer Hörstörung eingesetzt. Die eingesetzten Methoden sollen möglichst effektiv die klinische Fragestellung beantworten.

At the Physikalisch-Technische Bundesanstalt, autocollimators are calibrated with the aid of the WMT 220 angle comparator to ensure their direct traceability to the SI unit of plane angle, the radian (rad). It is shown that high-resolution electronic autocollimators can thus be calibrated with an uncertainty of 0.007 arcsec (k = 2) in reproducible measurement steps down to 0.005 arcsec. Calibrations in very small measurement steps close to the autocollimators' resolution can inform about possible short-period deviations and resulting aliasing effects in measurements with autocollimators.

Researchers and managers have suggested that a narrow range of ground-cover structure resulting from fire might be necessary for suitable Kirtland`s warbler nesting conditions. Yet, Kirtland`s warblers have bred successfully in numerous unburned stands and there is little direct evidence to indicate that ground cover structure is a limiting factor for nest sites or habitat suitability within appropriate landform-ecosystems. We documented the range of percent cover for dominant ground-cover structural components in burned and unburned habitat (stand ages 7-23 y) occupied by Kirtland?s warblers. The mean percent cover for the dominant ground-cover structural components was lichen/moss (12.1%), blueberry (Vaccinium angustifolium) (9.5%), bare ground and litter (5.6%), sedge/grass (5.2%), deadwood (4.3%), sand cherry (Prunus pumila) (3.3%), sweet fern (Comptonia peregrina) (2.3%), coarse grass (1.8%) and bearberry (Arctostaphylos uva-ursai) (1.2%). Burned sites had significantly more deadwood, sweet fern and lichen/moss cover, while unburned sites had significantly more bare ground and sedge/grass. We also investigated how fire, shade-history (i.e., pre-fire tree crown cover approximated by tree height and density) and succession influenced the percent cover of the dominant ground-cover structural components from 1 to 5-y after wildfire disturbance. The magnitude of differences in percent cover among shade-histories changed through time for the groundcover components sand cherry, deadwood, grass/sedge and coarse grass. The percent cover of sweet fern, bearberry and bare ground was significantly different between some shade histories. All dominant ground-cover components showed significant difference between at least one shade-history when compared to an unburned harvested reference stand. This suggests that more similarities exist among the three burned sites than between the burned sites and the unburned reference site. Our results suggest that fire, shade-history and succession influence ground-cover, but that various ground-cover components are affected differently by these factors. Because of the complex role disturbance history plays in maintaining ground-cover in Kirtland`s warbler habitat, optimal management prescriptions are difficult to specify, especially when aspects of Kirtland`s warbler ecology other than nest location are also considered. Although suitable ground cover structure can result without fire, maintaining prescribed fire is still desirable because this is a historically fire-regulated system. However, the range of ground-cover structures accepted by the Kirtland?s Warbler and its resilience to disturbance suggests that suitable ground-cover for Kirtland`s warbler could be maintained in some stands without burning after every timber harvest.

Previous studies of the relationship between the intraoperatively obtained electrically evoked stapedius reflex threshold (ESRT) and the maximum comfortable loudness (MCL) values used to program the speech processor of cochlear implant (CI) patients have indicated that ESRTs provide an inexact estimate of MCL. In order to determine whether this estimate might be more exact for electrodes in different parts of the electrode array, we studied the electrode-specific relationships between ESRT and MCL in 29 Med-El Combi 40+ and 25 Nucleus Cl 24 M patients after first fitting of the speech processor and 2 and 6 months later. The MCL values were mostly less than the ESRT values, but increased progressively over the first 6 months, reaching 83% and 72% of the ESRT values, on average, across all electrodes for the Med-El and Nucleus systems respectively. The population variation across electrodes decreased over the 6-month observation period and was least for the apical half of the array, for which the correlatio...

Background: Defect-free hospital care suggests greater quality and may provide better outcomes for acute ischemic stroke(AIS) patients. Previously we reported a 5-item stroke care bundle that was associated with an increased likelihood of favorable discharge status (home/acute rehabilitation). The effect of defect-free care on total cost of hospitalization remains unknown. Hypothesis: Defect-free compliance to a 5-item stroke care bundle will result in significant cost savings while improving clinical outcomes. Methods: A retrospective cohort study of hospitalized AIS patients 18 years or older was conducted at 6 Intermountain Healthcare facilities from 2009-2012. Defect-free care was defined as compliance with 5 care measures: ED arrival to head CT Results: A total of 3,568 patients were analyzed. Patients receiving defect free care had higher rate of favorable discharge status (77.7% vs. 68.7%, p

Fourteen patients suffering from acute, exacerbated atopic eczema were screened for changes in collagen I and collagen III metabolism in serum (n = 11), urine (n = 11) and skin biopsies (n = 9) before and after medium-dose ultraviolet (UV) A1 phototherapy (15 exposures of 50 J/cm2 over a 3-week period, total dose 750 J/cm2). Mature collagen I and, to a lesser extent, mature collagen III were found to be decreased after the therapy in skin samples from the irradiated patients. As markers of collagen I degradation, the cross-links pyridoline and deoxypyridoline were analysed in urine using high-performance liquid chromatography. Both cross-links were found to be mildly increased after UVA1 phototherapy, without reaching statistical significance. As markers of de novo collagen synthesis we screened for the procollagen I-carboxyterminal peptide (PICP) and procollagen III-aminoterminal peptide (PIIINP) levels in serum and skin. The ratio of PICP to PIIINP in serum dropped significantly after the UVA1 phototherapy, suggesting a different impact of UVA1 on the two collagens. These findings were paralleled by a diminished ratio of PICP to PIIINP in tissue samples. Staining for matrix metalloproteinase 1 (MMP-1) and its specific counterpart, tissue inhibitor of MMP-1 (TIMP-1), showed slight increases for both proteins by therapeutic UVA1; this was also seen in serum for TIMP-1 but not MMP-1. In our study, high-energy UVA1 doses induced changes of the skin collagens in patients with atopic eczema which are measurable by their metabolites in serum and urine.

Die Programmierung des Sprachprozessors eines „cochlear implants” (CI) bei kleinen Kindern, speziell die Ermittlung der Stimulationsstarke, die der maximal akzeptablen Lautstarke (MAL) entspricht, ist haufig schwierig. Eine Uberstimulation ist unbedingt zu vermeiden, da dies beim Kind traumatisierende Wirkung haben kann. Ziel dieser Studie war die Analyse der intraoperativ registrierten Stapediusreflex(SR)Schwellen, die uber das CI ausgelost wurden, und der bei der postoperativen Sprachprozessoreinstellung festgelegten MAL- und Horschwellenwerte bei 27 Tragern dreier verschiedener Implanttypen. Es wurde untersucht, ob mit der ESR-Schwelle in der Praxis ein anwendbares, objektives Instrument zur Vereinfachung, Verfeinerung und Beschleunigung der Sprachprozessorprogrammierung vorhanden ist. Fur die in monopolarem Modus gereizten Med-El und Clarion-Implantate wurde dabei die mittlere MAL als Perzentile des mittleren ESR-Schwellenstrompegels uber alle Implantatelektroden berechnet. Die MAL-Pegel fur die im bipolar „common ground” Modus gereizten Nucleus-Implantate wurden mit einem Parabeltransformationsmodell berechnet. Die aufgrund der intraoperativ registrierten Stapediusreflexschwellen berechneten MAL-Werte zeigten z.T. grose Abweichungen zu den effektiv auf verhaltensaudiometrischem Weg ermittelten Schwellen. Somit war keine sichere und einfache rechnerische Festlegung der MAL und der Horschwelle aufgrund der intraoperativen SR-Schwelle moglich. Die intraoperative Ermittlung der ESR-Schwelle kann aber nebst einer intraoperativen Funktionskontrolle zu einer rechnerischen Einschrankung des zu prufenden Bereichs beitragen. Die Festlegung der genauen MAL wird aber auf anderem, vorlaufig verhaltensaudiometrischem Weg erfolgen mussen.

We investigated how environmental gradients measured along the St. Croix River in Minnesota and Wisconsin, U.S.A., influenced the turtle assemblage. Among seven species, the five most common species were generalists and had wide distributions throughout the study area. However, patterns in assemblage structure were related to environmental gradients along the river. Sex ratios were male-dominated for the five most common species, and few or no juveniles were captured during the study. The first two canonical axes of a canonical correspondence analysis accounted for 92.7% of the variation in species-environment gradients. Most of the variation in distribution and abundance was attributed to gradients in channel morphology and physical characteristics along the river channel. Abundances of common snapping (Chelydra serpentina), false map (Graptemys pseudogeographica), and painted (Chrysemys picta bellii) turtles were associated with muck substrates and the number of basking sites (i.e., snags, rocks), which increased farther downstream. Abundance of spiny softshell turtles was closely related to increased water velocity and depth, which were related to hydraulic control points in the river. Abundance of common map turtles was associated with the presence of open sandy areas, uniform channel bottom, and gravel substrates. Geomorphic changes along the St. Croix River clearly influence the turtle assemblage and these specific relations should be considered in efforts to preserve and restore components of the assemblage.

The extensive "second generation" of star formation within the 30 Doradus Nebula, evidently triggered by the R136 central cluster around its periphery, has been imaged with the Near-Infrared Camera and Multi-Object Spectrometer (NICMOS) on the Hubble Space Telescope. Many new IR sources, including multiple systems, clusters, and nebular structures, are found in these images. Six of the NICMOS fields are described here, in comparison with the WFPC2 images of the same fields. Knots 1–3 of Walborn & Blades (early O stars embedded in dense nebular knots) are all found to be compact multiple systems. Knot 1 is shown to reside at the top of a massive dust pillar oriented directly toward R136, whose summit has just been removed, exposing the newborn stellar system. Knots 1 and 3 are also near the brightest IR sources in the region, while parsec-scale jet structures are discovered in association with Knots 2 and 3. The Knot 2 structures consist of detached, nonstellar IR sources aligned on either side of the stellar system, which are interpreted as impact points of a highly collimated, possibly rotating bipolar jet on the surrounding dark clouds; the H2O maser found by Whiteoak et al. is also in this field. These outflows from young massive stars in 30 Dor are the first extragalactic examples of the phenomenon. In the field of the pillars south of R136, recently discussed in comparison with the M16 pillars by Scowen et al., a new luminous stellar IR source has been discovered. These results establish the 30 Doradus Nebula as a prime region in which to investigate the formation and very early evolution of massive stars and multiple systems. The theme of triggered formation within the heads of extensive dust pillars oriented toward R136 is strong. In addition, these results provide further insights into the global structure and evolution of 30 Doradus, which are significant in view of its status as the best resolved extragalactic starburst.

Intercomparisons of ground-based IR continuum and H2 images with Hubble Space Telescope WFPC2 images of the 30 Dor Nebula reveal detailed structural relationships, which provide new information about current star formation there. Numerous stellar IR sources have been discovered in or near the bright nebular filaments west and northeast of R136; their locations are intimately connected with the nebular microstructures, as well as with early O stars in dense nebular knots whose optical spectral classifications indicate extreme youth. The H2 emission predominates in the dust clouds beyond the bright nebulosity and IR sources with respect to R136. The emerging picture suggests that a new stellar generation is being triggered by the energetic activity of the massive central cluster in the remanent interstellar material around its periphery. 30 Dor will likely evolve into a giant shell H II region similar to N11 in the LMC, containing an older association inside an evacuated central cavity, which is surrounded by H II regions ionized by a younger population. Such "two-stage starbursts" may be characteristic of massive-star formation on this scale.

Protein and mRNA for epidermal growth factor (EGF), transforming growth factor-alpha (TGFα), EGF receptor, transforming growth factor-beta 1 (TGFβ1), TGFβ2, TGFβ3, glucocorticoid receptor (GR), the aryl hydrocarbon receptor (AhR), and the Ah receptor nuclear translocator (ARNT) were localized in gestational days (GD) 49–59 human embryonic secondary palates. The response to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) was determined for expression of these genes following palatal organ culture. Craniofacial tissues were shipped in medium from the Human Embryology Laboratory, University of Washington, Seattle, WA. Half of each specimen was cultured in control medium and half in medium containing TCDD at either 1 × 10-8 or 1 × 10-10 M. After fixation and paraffin-embedding, sections were examined either immunohistochemically or by in situ hybridization. Expression patterns were determined for each gene for the major stages of palatogenesis and in response to TCDD and compared to previously determined patterns of expression in the same developmental stages of palatogenesis for the mouse (GD49–59 in human palatogenesis corresponds to GD12–16 in the mouse). Human and mouse palates were dissimilar in particular spatiotemporal patterns of expression of these genes. Relative to patterns in mouse palatal development, human tissues demonstrated expression of EGF at early palatal stages, expression of EGF receptor and TGFα throughout fusion events, and uniform expression of TGFβ3 in all epithelial regions without specifically higher levels in the medial cells. The responses to TCDD also differed in patterns of gene expression as well as in concentration required to induce hyperplasia of the medial epithelium. In summary, human palates expressed all of these regulatory genes, responses to TCDD were detected, and comparison between mouse and human palates revealed interspecies variation that may be a factor in each species' response to TCDD, as well as other teratogenic exposures. Teratology 58:30–43, 1998. © 1998 Wiley-Liss, Inc.

A new highly precise angle measuring table has been developed for the Physikalisch-Technische Bundesanstalt, which is to be used as a comparator to calibrate angle standards. First results of the determination of the comparator's errors of measurement obtained by two calibration methods are reported. Considering the results obtained, it is to be expected that the desired uncertainty of measurement of can be achieved.

We have developed a sensitive and specific capillary GC (cGC) assay for the quantification of the quarternary aminosteroidal compound rocuronium (roc), a neuromuscular blocking agent, and its putative metabolite 17-desacetylrocuronium (17OH-roc), using 3-desacetylvecuronium (3OH-vec) as an internal standard (I.S.). This novel method has been applied to a pharmacokinetic study with roc, monitoring sixty patients who were classified according to four different body mass index (BMI) groups. The isolation of these drugs from plasma was carried out using a dichloromethane liquid-liquid extraction after ion-pairing of the positively charged ammonium compounds with iodide. To achieve thermal stability, tert.-butyldimethylsilyl-ethers were formed at the 3OH- and 17OH-steroidal positions by reaction with N-methyl-N-(tert.-butyldimethylsilyl)-trifluoroacetamide at 70 degrees C overnight. An automated cGC system fitted with a nitrogen sensitive detector with a specially prepared glass phase bead and a computer controlled data handling system was used to analyze and quantify the compounds, which were separated on a DB1 capillary column with helium as the carrier gas and a temperature program ranging from 120 to 300 degrees C. The method is linear for 50-6400 ng/ml for roc and 80-6400 ng/ml for 17OH-roc. The detection limits were 10 ng/ml for roc and 50 ng/ml for 17OH-roc. The lower limit of quantification was 50 ng/ml for roc and 80 ng/ml for 17OH-roc. Intra-assay coefficients of variation (C.V.s) were 10% and 15% and the inter-assay C.V.s 8-18% and 16-21% for roc and 17OH-roc, respectively.

A ring laser goniometer was investigated in different applications of precision angle measurement, such as the calibration of optical polygons and optical encoders, external angle measurement of rotating objects and inertial angle measurement by rotation of the goniometer itself. The results agree with standard methods of angle measurement to about 0,5 µrad (0,1 ). Further improvement in accuracy is expected mainly from the reduction of noise in the mechanical and electrical setup of the measurement system.

Diese Studie untersuchte retrospektiv den Spontanverlauf der kalorischen Antwort und die Frage nach einer moglichen Erholung der kalorischen Erregbarkeit des betroffenen Labyrinthes. Bei 79 wegen einer akuten peripheren vestibularen Funktionsstorung hospitalisierten Patienten wurde der Verlauf der kalorischen Antwort bei Eintritt mittels kalorischer Prufung unter der Frenzelbrille, mit einer ersten ENG-Untersuchung nach wenigen Tagen und mit einer zweiten ENG-Untersuchung nach durchschnittlich 4 Monaten dokumentiert. Insgesamt 46% der Patienten zeigten eine Normalisierung der kalorischen Antwort, bei 50% fand sich eine relative Erholung mit einer Verbesserung von 30% oder mehr bei der 2. ENG-Untersuchung im Vergleich zur 1. ENG-Untersuchung. Eine kochleare Mitbeteiligung beeinflusste die Wahrscheinlichkeit einer Erholung nicht. Es bestand keine Korrelation zwischen dem Ausmas der vestibularen Funktionsstorung und einer Erholung.

The work presented in this paper deals with the control of a distribution process by characteristic figures-based computer programs. This work was carried out in the framework EC project MINIMISE (Managing Interoperability by Improvements in Transport System Organisation in Europe An international packages service was choosen for a case study; the main results will be presented here.

BACKGROUND Logatomes are nonsense syllables used for analyzing the confusion of phonemes by hearing impaired listeners. They can provide a precise differentiation of phonemic confusions which may be useful in the exact adjustment of programmable hearing aids. METHODS In this study, two lists of logatomes with 108 three-sound combinations with a structure of consonant-vowel-consonant (c-v-c) and vowel-consonant-vowel (v-c-v) were recorded on a compact disk. Twenty normally hearing adults and 28 patients with a sensorineural hearing loss were tested at a comfortable listening level of about 25 +/- 5 dB above the mean audiometric thresholds at 0,5. 1,0 and 2,0 kHz. An index of reduction of speech perception was calculated. RESULTS A significant relationship between reduction of logatome perception and pure-tone audiometric thresholds at 1,2,3, and 4 kHz was demonstrated. Moreover, it was possible to distinguish between different groups of hearing impairment. CONCLUSIONS The logatome test helps to analyze specific effects that hearing loss can have on the recognition of acoustic speech signals. The logatome test may become a valuable addition to speech audiometric tests with further standardization.

Cavernous angiomas are vascular malformations that are seldom found in the cerebellopontine angle or in the internal auditory canal. We report the case of a 51-year-old man suffering from a rapidly progressive hearing loss, tinnitus and minor unsteadiness. Neurootological examination showed a canal paresis of 91% on the right side. The subsequent neuroradiological examination with magnetic resonance imaging revealed a tumour of the cerebellopontine angle with intracanalicular extension. The observed intensities on T1-, T2- and gadolinium-enhanced sequences suggested the diagnosis of a vestibular schwannoma. Intraoperatively, a reddish tumour was found and histological examination revealed a cavernous angioma. Even though extensive diagnostic procedures were performed, the correct diagnosis could not be established preoperatively.

Background The fate of patients suffering from laryngeal carcinoma is influenced strongly by the stage of the tumor at the time of diagnosis. This factor is also critical for preservation of the organ. It may be impossible to diagnose the tumor with the first biopsy even though the clinical and macroscopic aspect suggests a malignancy. Methods In a retrospective study, we examined 468 patients with laryngeal carcinoma who were treated at the departments of otorhinolaryngology at the University of Basel (B) (198 patients from 1983-1992) or in Giessen (G) (270 from 1990-1995). The number of biopsies necessary to confirm the diagnosis was analysed and the follow-up of the patients was evaluated. Thirty of 32 negative histologic samples were reexamined. Results Of 468 patients, 32 (7%, 27 [B] 14%; and 5 [C] 2%) required two to six biopsies to confirm the clinically suspected diagnosis: Twenty patients (designated as Group 1) were diagnosed within one to three months, and no patient showed a change of tumor stage within that time. Their first biopsies have to be considered as "nonrepresentative". Eight patients (Group 2) were diagnosed within four to 24 months and four patients (Group 3) more than 24 months after the first biopsy. Final treatment and outcome in patients from Group 1 was unchanged by the time delay in diagnosing the tumor. Seven of eight patients in Group 2 experienced an obvious progression of their tumor during the diagnostic period, which led to laryngectomy in several cases. In four patients, diagnosis was confirmed more than two years after the first biopsy. These were special cases such as development of cancer out of a papillomatosis or chronic laryngitis. Conclusions A time delay of three months in diagnosing cancer of the larynx does not have a significant influence on organ preservation and prognosis, even though especially in small tumors suspicion of cancer should lead to a new representative biopsy as fast as possible to preserve the larynx.

BACKGROUND Migraine and cluster headache can both be triggered by sensitive intranasal areas. METHODS Endoscopic nasal surgery was performed in 20 patients with chronic migraine without aura or cluster headaches that were refractory to other forms of treatment for a mean period of 18 years (range of 1-45 years). The selected patients showed clinical and radiographic evidence of contact between the middle turbinate and the nasal septum. All patients experienced immediate relief of pain following topical application of cocaine to the presumable triggering area. Five patients with cluster headache and 15 patients with migraine were treated. RESULTS All patients with cluster headache were free of symptoms after surgical intervention and for a mean follow-up period of three years. Six of the 15 patients with migraine were completely free of symptoms after a mean follow-up period of three years; five had improved more than 50% in the duration and frequency of their attacks. Treatment was unsuccessful in four patients. CONCLUSION This trial established a likely relationship between nasal trigger areas and cluster headache through the trigeminovascular system and a possible relationship to some type of migraine without aura.

Fragmentation of breeding habitat in North America has been implicated in the decline of forest-nesting, Neotropical migrant birds. We used a comparative approach to examine the effects of fragmentation on three forest-nesting migrants: Ovenbird (Seiurus aurocapillus), Red-eyed Vireo (Vireo ofivaceus), and Wood Thrush (Hylocichla mustelina). We surveyed birds and monitored reproductive success on 28 study plots in fragmented and contiguous forests in two midwestern regions. Distribution of individuals between fragmented and contiguous forests appeared to vary among species and regions, but total nest failure was significantly higher in fragments than contiguous forests in both regions for all species (p = 0.053). We attributed greater nest failure to increased nest predation (p = O. 093) and increased brood parasitism by the Brownheaded Cowbird (Molothrus ater, p = 0. 009). In addition to greater total nest failure, partial nest failure due to cowbird parasitism led to a reduction in the number of host fledglings. Although the causes of nest mortality appeared to be species specific, total nest failure and partial nest failure acted in concert to reduce the number of offspring per adult for all three species on fragments. We used simple population growth models to assess the viabaity of the three species in fragmented and contiguous habitats in both regions. In general, populations on fragments appeared to be population sinks and populations on continguous forests appeared to be population sources. Assuming constant mortality during winter, projected growth indicated that without immigration Ovenbird and Red-eyed Vireo populations should become extinct on fragments in both regions and Wood Thrush populations should be maintained or slightly decline on fragments. Populations of all three species should increase in contiguous habitats in both regions without emigration. We suggest that habitat fragmentation reduces local reproduction and may have ramifications for the entire population. A clear understanding of population demography depends on examination of demographic dynamics within and among sources and sinks. We emphasize that the long-term viability of these species depends on maintaining large tracts of forest throughout the breeding range until the spatial scale at which source and sink populations interact can be determined.

A deep optical search of the “Network Synthesis” localization for the SGR B1900+14 and the nearby ROSAT source error box has yielded an unusual source positionally coincident with an IRAS source. We present optical and IR data describing this source.

This study assessed women’s immediate and long-term reactions to completing self-report measures of interpersonal violence. College women completed surveys at the beginning and end of a 2-month academic quarter for course credit. Results showed that 7.7% of participants experienced immediate negative emotional reactions to research participation. Greater immediate negative reactions were related to interpersonal victimization and psychological distress variables. Attrition from the study over the 2-month follow-up was not predicted by participants’ immediate negative emotional reactions to the research or anticipation of future distress. Of the participants who returned for the follow-up, 2.1% of participants reported experiencing distress over the interim period as a result of their initial participation in the study. These long-term reactions were bivariately related to a number of victimization, psychological distress, and reaction variables measured at the first study session. However, in the regression analyses, only immediate negative emotional reactions to the research and anticipation of future distress predicted long-term negative emotional reactions.