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Abundant information in the geriatric literature emphasizes the factors relevant to maintenance of independent mobility and reduction of fall risk. However, while some researchers have attempted to identify the relationship between chronic health and visual impairment, few studies have systematically explored the impact of physical interventions that aim to remediate reduced health and function in adults with visual impairments. This review identifies intrinsic physical factors that negatively affect health and independence in adults with visual impairments. By highlighting these factors, we hope to provide a basis for future exercise interventions that will target reductions in the rate of physiological decline while preserving and potentially restoring independent functioning. Because the aging population is increasing and the basis for and subsequent formulation of exercise programs for maintaining mobility and quality of life have not been definitively ascertained for individuals with declining vision, exploring the intrinsic physical factors most amenable to physical rehabilitation becomes relevant.

Lesquerella species contain a seed oil which is approximately 55% lesquerolic acid, a 20-carbon long fatty acid with a single hydroxyl group and double bond, and has a similar hydroxy fatty acid (HFA) profile as castor oil. Large markets exist for hydroxylated oils as feedstocks for lithium greases, polymers in paints and coatings, base stocks for lubricants, nylon-11, hydraulic fluids, and applications in the personal care industry (Roetheli et al. 1992). The hydroxyl group of these oils makes them prime candidates as additives to diesel fuel to improve lubricity (Naughton 1992). Goodrum and Geller (2005) demonstrated that lesquerella oil has superior performance compared to castor, soybean, and rapeseed methyl esters at concentrations as low as 0.25% in reducing wear and damage to diesel engines, primarily with fuel injection systems. Castor oil also contains high amounts of HFAs, but the main HFA, ricinoleic acid, is two carbons shorter than lesquerolic acid, which imparts slightly different physicochemical properties to the oil. Lesquerella could be established as a reliable, domestic oilseed supply of HFAs for a variety of industrial applications (Roetheli et al. 1992) and at the same time provide an alternative crop for farmers and increase local profits. Lesquerella will not replace current commodity crops but instead will be placed in a rotation with these crops, e.g., a 2-year, 3-crop rotation of lesquerella, grain sorghum, and cotton.

Irrigation treatments affected the amount of biomass produced, but not the NR percentage of the plant or the quality or quantity. Different guayule genotypes varied in their rate of rubber degradation over storage time. All lines tested in this experiment decreased in Mw by the end of the storage period, but degradation in some did not occur until the fourth week of storage. An increase in Mw of most lines was seen after the first week of storage, indicating that the enzymatic processes are still functioning beyond the first few hours of harvest, and for some lines, beyond the initial sample taken after one week of field storage. Other lines may follow this same pattern of degradation, but it was not detected by the sampling protocol in this study. Guayule lines 11605, 11619 and interspecific hybrid AZ101, when irrigated between 4 to 7 times per year (50 to 90 cm/year), harvested in early spring, and then stored in the field as whole plants for no more than 2 weeks, would yield optimum rubber quality and quantity (per acre) with little or no deterioration. Other lines in this study, 11604, N565, 593, and 11634, cannot be field stored for longer than 1 week without a loss of rubber quality and quantity based on these results. The variation seen in the different lines indicates two important points. First, the amount of time plants remain in the field following harvest is an important determinant of rubber quality and quantity. Secondly, selection for degradation characters should be possible for crop improvement.

In amphidiploid cotton (Gossypium hirsutum L.), monosomic stocks have been used extensively to assign genetic markers to specific chromosomes. Once a gene has been assigned to a specific chromosome, monotelodisomes can be used for determining whether it is associated with the long or the short arm of the chromosome. Thirty-four mutant genes were tested for association with one or more of 14 monosomes and seven monotelodisomes. The results showed that curly cotton (ac) is in the long arm of chromosome 16; that LcD, (working symbol for Light brown lint from G. harknesii Brandg.) is in chromosome 16; that virescent-1 (v1) is in the long arm of chromosome 20; and that a new marker, Naked-tufted seed (Nt), is in the long arm of chromosome 26. The Naked-tufted allele segregates as a simple dominant and is allelic to n2; thus the Nt2, symbol is assigned to the Naked-tufted allele. A desynaptic mutant ax was shown to be as2, and an Ml2 gene is reported as a newly identified homoeoallele of Ml1.

The incorporation and release of sulfadiazine, paracetamol, diazepam, quinine hydrochloride, and doxycycline hydrochloride in and from rectangular slabs of highly crosslinked citric acidglycerol copolymer matrix have been described. The release of the drugs in phosphate buffer of pH 7.4 and at 37°C was followed spectrophotometrically. After an initial burst, the first three drugs were released up to 4 days and the last two drugs up to 7 days at almost constant rates. The erosion profile of the drug-free matrix and the release characteristics of the drug-loaded slabs under physiological conditions indicate hydrolytic erosion of the slab from the surface as well as from the bulk. It has been suggested that the zero-order release of the drugs was possible due to a balance between the decreasing release rate by diffusion through the matrix and the increasing release rate because of increasing polymer permeability resulting from gradual crosslink cleavage.

Guayule (Tarthenium argentatum, Asteraceae) is one of two major plant species grown for natural rubber. Studies were conducted to determine the effect of honey bee (Apis mellifera) pollination and season on seed set and total seed yield/ha. The experiments involved four pollination treatments: plants caged with bees; plants caged without bees; plants open pollinated (uncovered); and plants individually covered. Seeds were harvested monthly July–September 1984, and May–September 1985. Plots with bees produced at least 150% more seeds than plots without bees, and there were no qualitative differences in the seed weights among treatments. Highest seed yield was in May and September. Results indicate that (1) insect pollination in guayule increases seed yield and (2) fewer seeds are produced in the warmest months.

We grew marineSynechococcus Clones WH7803 and WH8018 at 150µE m−2 s−1 in dilute batch cultures with NH4+ as the limiting nutrient. The maximal uptake capacities for NH4+ and NO3- were measured in frequent experiments during log and stationary phases of growth. Clone WH7803, originally isolated from oceanic waters, had a specific uptake rate of NH4+ that approximated the maximum (log phase) specific growth rate (ca ~ 0.025 h−1). NO3- uptake was observed only after nitrogen in the media was depleted; the NO3− uptake capacity was ca 12% the capacity for NH4+ uptake throughout the nitrogen depleted period. Growth was arrested upon nitrogen depletion, but resumed soon after reinoculation into fresh media, even after 5 d of starvation. Clone WH8018, originally isolated from coastal waters, revealed a five-fold enhancement in the NH4+ uptake rate relative to growth rate at the time of nitrogen depletion. As nitrogen starvation proceeded, this enhancement was reduced. This clone, too, was able to take up NO3- once nitrogen in the media was depleted, but only after ca 20 h. Growth continued for a limited period during nitrogen depletion, but nitrogen-starved cells were slow to recover upon reinoculation into fresh media. We speculate that clonal differences may reflect differences in the molecular regulation of nitrogen assimilation.

Pyroxene granulites and charnockites are associated with metasedimentary khondalite (garnet-sillimanite gneiss) and migmatites in the Eastern Ghats mobile belt. Various stages of in situ granulitization similar to those observed in southern India and Sri Lanka are present. Geochemically the granulite suite around Visakhapatnam is bimodal, with acid and mafic variants. There is an increase in the concentration and fractionation of the rare earth elements (REE) from pyroxene granulites to charnockites, and six Sm-Nd models ages ($$T_{DM}$$) range from 2.86 to 2.35 Ga, with 2.1 Ga for a younger granite. The charnockites, a pyroxene granulite, and granite define a Pb/Pb isochron age of $$1176 \pm 201 Ma$$. U-Pb ages of zircons and monazites from a charnockite near Phulbani, Orissa, yield near concordant data with ages of $$985 \pm 5 Ma$$ and $$965 \pm 7 Ma$$, respectively. The new isotopic data and the available ages from the northeastern part of the Eastern Ghats in Orissa suggest a major charnockite formati...

Rotational invariant features using DFT encoded even symmetric Gabor filtering in non overlapping blocks followed by fuzzy c-means clustering proves to be an encouraging method. Number of texture categories presenting an image has been determined automatically. The proposed method is promising as far as classification accuracy and computational time is concerned.

Increased Aurora A expression occurs in a variety of human cancers and induces chromosomal abnormalities during mitosis associated with tumor initiation and progression. MLN8054 is a selective small-molecule Aurora A kinase inhibitor that has entered Phase I clinical trials for advanced solid tumors. MLN8054 inhibits recombinant Aurora A kinase activity in vitro and is selective for Aurora A over the family member Aurora B in cultured cells. MLN8054 treatment results in G 2 /M accumulation and spindle defects and inhibits proliferation in multiple cultured human tumor cells lines. Growth of human tumor xenografts in nude mice was dramatically inhibited after oral administration of MLN8054 at well tolerated doses. Moreover, the tumor growth inhibition was sustained after discontinuing MLN8054 treatment. In human tumor xenografts, MLN8054 induced mitotic accumulation and apoptosis, phenotypes consistent with inhibition of Aurora A. MLN8054 is a selective inhibitor of Aurora A kinase that robustly inhibits growth of human tumor xenografts and represents an attractive modality for therapeutic intervention of human cancers.

To investigate the mechanism of increased expression of caspase-1 in Hippi expressing HeLa and Neuro 2A cells, reported earlier, we report here that HIPPI directly interacted with upstream sequence of caspase-1 gene (−700 to +17, 717 bp). Deletion of this 717 bp sequence and further analysis by electrophoretic mobility shift assay and fluorescence quenching revealed that HIPPI interacted with 60 bp (−151 to −92) upstream sequence of caspase-1. We also observed by chromatin immunoprecipitation assay that HIPPI interacted with the 717 bp sequence in vivo. In luciferase assay, when expression of the reporter gene was driven by either 717 bp or 60 bp caspase-1 upstream sequences, luciferase activity was increased in GFP-Hippi expressing HeLa cells in comparison to that obtained with parental HeLa cells with the same constructs. Similar result was obtained in Neuro2A cells with 717 bp caspase-1 upstream sequence. In summary, we showed that HIPPI could interact with the putative promoter sequence of caspase-1 and increased the expression of the downstream gene suggesting that HIPPI could act as transcription regulator.

The Departments of Civil and Environmental Engineering and Cinema and Photography at Southern Illinois University Carbondale (SIUC) have collaborated to produce a digital video that highlights careers and other professional opportunities in environmental and water resources engineering. The video is targeted toward highschool students and first- or second-year college undergraduates and, thus, serves as a recruitment and retention tool for related degree programs. The video includes a series of interviews that disseminate answers to questions such as: How much education is required to be an engineer? What is the importance of licensure? Where do environmental and water resources engineers work? What salary is expected? Is engineering difficult? And do I need to be good at mathematics to be an environmental or water resources engineer? Responses are provided by current undergraduate and graduate students at SIUC. The 20-minute video also highlights a number of experiments conducted in the SIUC engineering laboratories. A corresponding website is under construction that will include the majority of interview responses as both text and video clips. Users will be able to click on thumbnail images to hear or see different responses to the same question. The overall project is being supported by a grant from the National Science Foundation, Division of Undergraduate Education that includes the development of a CD-ROM and webbased database of engineering images for classroom use.

The Departments of Civil and Environmental Engineering and Cinema and Photography at Southern Illinois University Carbondale have collaborated to produce a digital video that highlights careers and opportunities in water resources and environmental engineering. The video is targeted to K-12 students and first- or second-year undergraduates and thus serves as a recruitment and retention tool for related degree programs. Production of the video is being supported by a grant funded by the National Science Foundation, Division of Undergraduate Education

Several aircraft airframe modeling approaches are currently being used in the DoD community for acquisition, threat evaluation, training, and other purposes. To date there has been no clear empirical study of the impact of airframe simulation fidelity on piloted real-time aircraft simulation study results, or when use of a particular level of fidelity is indicated. This paper documents a series of piloted simulation studies using three different levels of airframe model fidelity. This study was conducted using the NASA Langley Differential Maneuvering Simulator. Evaluations were conducted with three pilots for scenarios requiring extensive maneuvering of the airplanes during air combat. In many cases, a low-fidelity modified point-mass model may be sufficient to evaluate the combat effectiveness of the aircraft. However, in cases where high angle-of-attack flying qualities and aerodynamic performance are a factor or when precision tracking ability of the aircraft must be represented, use of high-fidelity models is indicated.

High proliferative potential colony forming cells (HPP-CFC) in mouse bone marrow (BM) were defined functionally by their ability to form large colonies, greater than 0.5 mm diameter, and containing an average of 5 × 10(4) cells, in low-cell-density nutrient agar cultures after 10-14 d of incubation (1).

It is generally accepted that a fully implemented six degree-of-freedom (6DOF) airframe representation is desirable for manned flight simulation testing. It is important to note, however, that in evaluating the combat effectiveness of an integrated weapon system, the aircraft dynamics are not the sole contributor to the success or failure of the design. In other words, a superbly handling aircraft with a poor fire control system or substandard air-to-air weaponry could be at a disadvantage versus a poor handling aircraft with superior avionics and weapons. Significant cost savings could be realized by using a simpler model to represent the aircraft dynamics, if such simplification is merited. The National Air and Space Intelligence Center and the Air Force Research Laboratory conducted a joint test to determine the impact of aircraft modeling technique on combat effectiveness in beyond-visual-range (BVR) scenarios. Three types of aircraft models were used: a full non-linear 6DOF representation; a 6DOF ‘equivalent system’ model (6DOF ES); and a 5DOF ‘equivalent system’ model (5DOF ES). The aircraft simulations were identically equipped with offensive avionics and active radar missile models. The aircraft were then employed in a manned, BVR engagement test, varying the type of aircraft model used and the range at which missile shots were taken. There was no discernable dependency of BVR engagement outcome upon the fidelity of the aircraft model used in the simulation. Although dependencies upon pilot proficiency, cockpit hardware, and combatant energy were determined, the actual fidelity of the aircraft model was not a significant factor. A surprising result was a significant dependency on outthe-window visuals upon combat effectiveness. While this was expected for within-visual-range combat, an impact on BVR combat was unexpected. BACKGROUND The instinctive reaction to a modeling task is frequently to use the highest fidelity model available. The National Air and Space Intelligence Center (NAIC) has had many instances where a client has requested a six degree-of-freedom (6DOF) aircraft flight dynamics model for an application that does not immediately appear to have a requirement for high fidelity airframe modeling. Intuitively, aircraft dynamic response would not seem to be a major factor in certain air combat tasks. Consider the problem of BVR air combat. Typical weapon employment ranges are on the order of ten to thirty miles, depending on the kinematic capability of the missile. A notional engagement timeline is presented in Figure 1. Figure 1: Notional BVR Engagement Timeline Figure 1 shows when in that timeline the aircraft is actively being maneuvered. The total time that the aircraft changes its pitch and bank angles during the engagement is only a few seconds. When the aircraft is not changing attitude, a simple three degree-of-freedom model is sufficient to describe the vehicle motion. If a * Member, AIAA AIAA Modeling and Simulation Technologies Conference and Exhibit 11-14 August 2003, Austin, Texas AIAA 2003-5689 This material is declared a work of the U.S. Government and is not subject to copyright protection in the United States. requirement for an aircraft six degree-of-freedom model were levied for this application, a great deal of effort and expense would thus be expended on a very small, potentially inconsequential segment of the engagement. Developing high-fidelity aircraft handling qualities models can incur considerable expense. For an analytic level 5DOF aircraft model, the cost is negligible – limited to the pay of the analyst. For a 6DOF model valid through the trimmed flight envelope, developed through a combination of analysis and small-scale wind tunnel testing, cost is typically on the order of $350,000 per model. For a post-stall capable model, with a aerodynamic database developed for the entire possible range of motion, with dynamic derivatives determined through free-flight of a large scale model, cost is measured in millions of dollars. It is thus pragmatic to develop the aircraft model only to the level of detail that is required for a particular simulation application. Based on the above cost figures, this could potentially save hundreds of thousands, if not millions, of dollars in development costs for each model. However, NAIC had no empirical data upon which to base recommendations to clients requesting aircraft flight dynamics models. This paper presents the results of a study designed to provide the data upon which future modeling fidelity decisions can be based. It is important to note that this paper does not address issues regarding the accuracy of methods used to develop different fidelities of models, but rather the impact of the model representation itself.

Integration of engineering schematics and photos into classroom lectures previously required use of poor quality transparencies made from copied or scanned images. These supplements remained in the possession of the instructor, thus limiting the students’ ability to view them outside of the classroom. More recently, faculty have begun lecturing using computerized LCD projection systems, into which images can be easily integrated. This gives students the benefit of seeing virtual on-site projects or phenomena and improves the effectiveness of classroom instruction. Unfortunately, many existing image collections do not have a strong focus on environmental and water resources engineering and, due to insufficient resolution, result in poor projection quality when enlarged in a document or through a computer-projection system. This paper describes a project supported by the National Science Foundation to develop a website and CD-ROM, Digital Images of Environmental and Water Resources Engineering ,d esigned to enhance the pool of resources available for environmental and water resources engineering education. Through this resource, the authors aim to support the integration of technology into engineering courses and further facilitate student learning, understanding and recognition of classroom concepts. The website and CD-ROM contain a database of photographs and video clips that illustrate concepts related to hydraulic structures, open channel flow, sedimentation, and other specializations. This database was constructed by filming an array of existing engineering operations, facility renovations, and construction projects, as well as naturally occurring phenomena. The majority of images are available in three alternative resolutions, each suited towards a particular viewing medium. The image collection is ideal for use by instructors who prefer stand-alone images that supplement classroom discussion or as part of computerized lecture media. The images can also be directly accessed by students outside of the classroom or as part of distance learning courses. Additionally, the website and CD-ROM can be used as a recruitment tool to disseminate information regarding careers in water resources engineering to middle and high school students.

A finite-element formulation for modeling permanent-magnet synchronous machines by combining the field and circuit equations is presented. For an optimized and reliable operation of a machine, an accurate prediction of the magnetic field distribution is required. The field and circuit are coupled, giving a set of nonlinear time-dependent equations, a solution of which gives the magnetic vector potential at every nodal point and the electric field intensity at the conductor nodal points. The model can be used to perform any desired tests and to calculate operational parameters in both steady-state and transient operation, when the machine is fed from any power supply. >

Concurrent engineering as a set of methods, addressed the issues of the technology age by allowing the new ability of larger and faster computers to be utilized. Work can be accomplished simultaneously and the overall time frame at which tasks can be completed is shortened. But does concurrent engineering become the most effective use of time and resources, given the added information handling software both local and on-line? Ideally the answer lies in creating a new set of methods for product development that match both the new technology and the catapult into the information age.

Proponents of Medicaid managed care have argued that this type of care offers the potential to provide mainstream health care for poor children and the elimination of the 2-tier system of care that has long existed for poor and nonpoor children. However, few studies have attempted to assess whether differences in access, utilization, and satisfaction exist between Medicaid and commercially sponsored children who are enrolled in the same managed care plan.To systematically answer the following research question: Within the same large, nonprofit, group-model health maintenance organization (HMO), how do children enrolled in Medicaid compare with children enrolled commercially across the domains of access, utilization, and satisfaction with care?We compared access, satisfaction, and utilization of services between Medicaid and commercially sponsored children enrolled in Kaiser Permanente of Northern California during 1998 through use of a telephone survey and administrative data. Kaiser Permanente is a nonprofit, integrated, group HMO that serves 2.8 million members in more than 15 counties in northern California. The sample for this survey included 510 Medicaid-enrolled children and 512 commercially enrolled children. An overall response rate of 82% was achieved. Bivariate and multivariate analyses were used to compare Medicaid and commercially enrolled children.We found few differences between commercial and Medicaid enrollees across the domains of access, utilization, and satisfaction. Where access differences were present (problems in finding a personal care provider, problems getting care overall, and experiencing 1 or more barriers to care), the differences favored Medicaid-enrolled children. That is, Medicaid enrollees were reported to experience significantly fewer access problems and barriers than commercial enrollees, even after adjustment for confounding factors. Only one difference was found between Medicaid and commercial enrollees across the 6 utilization variables examined (volume of emergency department visits), and no differences were found among the 4 satisfaction and 2 global assessments of care received. Taken together, our results suggest that Medicaid-enrolled children experience as good as or better care than their commercially enrolled counterparts. However, there are other possible explanations for our findings. It may be that families of Medicaid-enrolled children hold their care providers to a lower standard than families of commercially enrolled children, given historic inequities in care between poor and nonpoor families. In addition, some degree of selection bias may be present in our sample, although that is true for both the Medicaid and commercial populations.Our findings suggest that large commercial HMOs are capable of eliminating the access barriers and stigma traditionally associated with the Medicaid program. However, this conclusion must be tempered with the knowledge that other explanations for our findings may also be at play.

Objective Previous analyses of variability in bypass resource use have not focused on hospital-level variation or adequately explored the influence of patient risk. We combined a clinical database with claims data to fully characterize patient level and hospital level variability in bypass surgery cost and length of stay in New York State and explored the extent to which lower cost is associated with worse quality of care. Methods By use of 1992 clinical and claims data, we identified by multivariable regression which patient characteristics influence bypass cost and length of stay. Hospital was then incorporated as a random variable in mixed linear models to determine its impact on resource use. The relationship between risk-adjusted in-hospital mortality and cost was then explored. Results In the 21 hospitals for which cost data were available, mean leveled cost (exclusive of professional fees and noncomparable costs) was $15,713, with a mean length of stay of 14 days (n = 12,087). One fifth of the variation in resource use was explained by baseline patient risk. After adjustment for patient risk, hospital explained an additional 42% of variation in cost and an additional 8% of variation in length of stay. Among hospitals, risk-adjusted cost varied almost 3-fold and risk-adjusted length of stay varied 50%. There was no association between cost and in-hospital mortality. Conclusions As of 1992, there was considerable interhospital variability in bypass surgery cost after patient baseline risk was accounted for. This suggests that reductions in bypass cost could be achieved by normalizing clinical practice. (Am Heart J 2002;143:130-9.)

The genetic base of guayule (Parthenium argentatum Gray) germ plasm that is available is narrow; yet, significant variability has been described within this germ plasm. This variability is surprising because guayule reproduces by facultative apomixis (asexual reproduction by seed), but evidence suggests that progress through selection is feasible. It has been hypothesized that this variation has arisen through periodic sexual reproduction; however, this has not been quantified. This study was designed to describe and compare eight components of yield and the expression of two isozyme systems in twenty parent plants and half-sib, open-pollinated families from each parent. Extensive variation for all characters was found among both the parents and the progeny, with fresh and dry weights being highly correlated to rubber yield. Parent-offspring regressions were not significantly different from zero. This implies low heritabilities for the major components of yield in guayule, and we believe that family selection, rather than single-plant selection, may generate higher-yielding and more genetically uniform lines at an escalated rate than single-plant selection. Periodic sexuality resulting in genetic variation was estimated by differences in isozyme expression within the half-sib families. Fifteen of the twenty progeny families were polymorphic for either esterase or peroxidase or both isozymes. This amount of sexuality is significant, and guayule must be considered an open-pollinated crop. We conclude from this study that we should rethink our breeding procedures to include controlled pollination and family selection.

In this case report the authors discuss a technique occasionally employed at their institution to aid in identification of the epidural space in morbidly obese parturients.A 29-year-old primagravida, with a body mass index of 90 (155 cm tall, 215 kg) presented for induction of labor. A 27-ga. Sprotte spinal needle was intentionally passed through a Weiss epidural needle and into the subarachnoid space to confirm placement of the Weiss needle in the epidural space. An epidural catheter was then placed which functioned well for labor and subsequent caesarian delivery.In selected patients, intentional puncture of the dura can aid in confirmation of the epidural space.

Previous studies have associated hypertension with discrepancies between right arm and left arm blood pressure (BP) measurements. The purpose of this study was to determine if there were clinically (defined asor = 10 mm Hg disparity) and statistically significant differences between right arm and left arm BP measurements (systolic, diastolic, or mean) in 34 third-trimester hypertensive gravidas. Thirty-four third-trimester normotensive gravidas were used as controls. No subjects were in active labor. This study used a cross-sectional, 2-group design with convenience sampling. The protocol for BP measurement followed guidelines of the American Heart Association and the instrument manufacturer. The results showed a greater range in BP differences between arms for the hypertensive group in the systolic (0.67-26.67 mm Hg) and mean (0.25-67 mm Hg) pressures compared with the normotensive group (systolic, 0-14.33 mm Hg; mean, 0-12 mm Hg). The mean difference in BP between arms was greater for the hypertensive group compared with the normotensive group. Using a 1-tailed t test, the mean difference was statistically significant (Por = .05) for the systolic pressure (P = .027) and for the mean pressure (P = .022), but not the diastolic pressure (P = .168). The frequency of clinically significant differences (or = 10 mm Hg) was greater for the hypertensive group than for the normotensive group (13 vs 4). These differences in frequencies were not statistically significant with chi-square analysis (systolic, P = .074; diastolic, P = .303; mean, P = .303). These findings indicated BP discrepancies between arms exist in both normotensive and hypertensive gravidas, with a greater range and frequency of differences in the hypertensive group. This study supports the American Heart Association's recommendation of bilateral BP assessment.

Ketoconazole, an imidazole-piperazine compound, is an orally active antimycotic agent. In addition, ketoconazole is a specific inhibitor of cytochrome P450 3A4. As about 60% of oxidized drugs are biotransformed by this isoform, the potential effect of a concomitant administration of ketoconazole on drug disposition may be of interest during drug development. The present paper describes three different approaches (methods A, B, and C) to attain high-throughput sample preparation and analysis in the quantification of ketoconazole in human plasma. Method A consisted of acetonitrile precipitation in a 96-well plate, transfer of the supernatant via a Tomtec Quadra 96 Model 320, and subsequent injection onto a 50 x 4.6 mm (i.d.) Develosil Combi-RP-5 column (packed with C30 bonded silica particles). Method B consisted of an identical sample preparation to method A with the exception that a Michrom Magic Bullet(trade mark) column, 2.0 --0.50 mm (i.d., tapered bore) x25 mm length, was used. Lastly, in method C, a turbulent-flow chromatography (TurboFlow LC/APCI-MS/MS) module was used for the direct analysis of ketoconazole in human plasma. A Sciex API 3000 was used in methods A and B, while a Micromass Quattro LC was employed in method C. Based on the values obtained for the calibrator (standard) and quality control samples, all three protocols yielded satisfactory accuracy, precision, and reduced manual sample preparation time.

In recent years, growing numbers of children with Medicaid have been enrolled in managed care plans nationwide. Yet, large, commercial managed care plans are increasingly discontinuing their participation in Medicaid because of low Medicaid payment rates.To compare the healthcare utilization and costs of children with Medicaid and children with commercial insurance within the same health maintenance organization (HMO).Retrospective study using electronically captured cost and utilization data.We compared the healthcare utilization and costs of children with Medicaid (n = 42,636) and children with commercial insurance (n = 159,651) who were members of the same large, nonprofit HMO at any time between January 1, 1995, and December 31, 1997. Medicaid children were grouped as income eligible, medically needy, and blind or disabled.The unadjusted costs of income-eligible, Medicaid-insured children were not significantly different from those of commercially insured children. The medically needy were $25 per month more expensive than commercially insured children (P = 0.02), and the blind or disabled were $213 per month more expensive (P.01). After adjusting for age and sex, income-eligible children were $5 per month more expensive than children with commercial insurance (P = .07), the medically needy were $20 per month more expensive (P = .02), and the blind or disabled were $216 per month more expensive (P.01).The costs of income-eligible, Medicaid-insured children in this HMO were similar to those of commercially insured children, but the costs for the medically needy and the blind and disabled were substantially higher.

ContextPneumococcal conjugate vaccine for infants has recently been found effective against meningitis, bacteremia, pneumonia, and otitis media.ObjectiveTo evaluate the projected health and economic impact of pneumococcal conjugate vaccination of healthy US infants and young children.DesignCost-effectiveness analysis based on data from the Northern California Kaiser Permanente randomized trial and other published and unpublished sources.Setting and PatientsA hypothetical US birth cohort of 3.8 million infants.InterventionsHypothetical comparisons of routine vaccination of healthy infants, requiring 4 doses of pneumococcal conjugate vaccine (at 2, 4, 6, and 12-15 months), and catch-up vaccination of children aged 2 to 4.9 years requiring 1 dose, with children receiving no intervention.Main Outcome MeasuresCost per life-year saved and cost per episode of meningitis, bacteremia, pneumonia, and otitis media prevented.ResultsVaccination of healthy infants would prevent more than 12,000 cases of meningitis and bacteremia, 53,000 cases of pneumonia, 1 million episodes of otitis media, and 116 deaths due to pneumococcal infection. Before accounting for vaccine costs, the vaccination program would save $342 million in medical and $415 million in work-loss and other costs from averted pneumococcal disease. Vaccination of healthy infants would result in net savings for society if the vaccine cost less than $46 per dose, and net savings for the health care payer if the vaccine cost less than $18 per dose. At the manufacturer's list price of $58 per dose, infant vaccination would cost society $80,000 per life-year saved or $160 per otitis media episode prevented (other estimated costs would be $3200 per pneumonia case prevented, $15,000 for bacteremia, and $280,000 for meningitis). The cost-effectiveness of an additional program to administer 1 dose of vaccine to children aged 2 to 4.9 years would vary depending on the children's ages, relative risks of pneumococcal disease, and vaccine cost.ConclusionsPneumococcal conjugate vaccination of healthy US infants has the potential to be cost-effective. To achieve cost savings, its cost would need to be lower than the manufacturer's list price. In addition to tangible costs, the vaccine should be appraised based on the less tangible value of preventing mortality and morbidity from pneumococcal disease.

In allotetraploid Gossypium species yellow petal is controlled by duplicate dominant genes Y1 (Ah genome) and Y2 (Dh genome), and open bud is controlled by duplicate recessive genes designated ob1 (Dh genome) and ob2 (Ah genome). Y2 and ob1 have been shown previously to be linked on chromosome 18 and 11.5 map units (MU) apart. In this study ob2 and Y1 were transferred from Gossypium darwinii (Watt) accession CB3099 into Gossypium hirsutum L. and found to have a mean recombination percentage of 3.14 for backcross and 3.40 for self-pollinated families from 2n parental heterozygotes and 10.73 in families from mono-18 parental heterozygotes. The lower recombination frequency in the homoeologous linkage group was perhaps due to this chromosome segment being transferred from G. darwinii. The higher frequency of recombination in the monosomic progeny families suggests that the absence of recombination in one homoeologue (chromosome 18) is compensated for by an increase in recombination in the other homoeologue.Key words: cotton, G. hirsutum L., homoeologous linkage groups, genetic markers.