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The temperature dependence of the structures of a wide range of mixed-cation Tutton's salts of general formula K2xRb2-2x[Cu(H2O)6](SeO4)² has been determined over the temperature range 90 to 320 K. Crystals with a high proportion of potassium adopt a different structure (form B) from those with a low ratio (form A). In both forms, the [Cu(H2O)6]2+ ion has an orthorhombically distorted tetragonally elongated coordination geometry, but the long and intermediate bonds occur with a different pair of water molecules in form A compared with form B. The alkali metal is surrounded by seven close oxygen atoms in form B but eight oxygen atoms in form A, and this difference in coordination number is associated with the change in the Cu-O bond distances via the hydrogen-bonding network. For crystals with between 32 and ~41% potassium, a relatively sharp change from form B to A occurs on cooling, and the temperature at which this occurs increases approximately linearly as the proportion of potassium falls. For the whole range of mixed crystals, the bond lengths have been determined as a function of temperature. The data have been interpreted as a thermal equilibrium of the two structural forms of the [Cu(H2O)6]2+ ion that develops gradually as the temperature increases, with this becoming more pronounced as the proportions of the two cations become more similar. The temperature dependence of the bond lengths in this thermal equilibrium has been analyzed using a model in which the Jahn-Teller potential surface of the [Cu(H2O)6]2+ ion is perturbed by lattice strain interactions. The magnitude and sign of the orthorhombic component of this strain interaction depends upon the proportion of potassium to rubidium ions in the structure. [ABSTRACT FROM AUTHOR]

The crystal structures of trans-diaquabis(methoxyacetato)copper(II) and the isostructural nickel(II) complex have been determined over a wide temperature range. In conjunction with the reported behavior of the g-values, the structural data suggest that the copper(II) compound exhibits a thermal equilibrium between three structural forms, two having orthorhombically distorted, tetragonally elongated geometries but with the long and intermediate bonds to different atoms, and the third with a tetragonally compressed geometry. This is apparently the first reported example of a copper(II) complex undergoing an equilibrium between tetragonally elongated and compressed forms. The optical spectrum of single crystals of the copper(II) compound is used to obtain metal-ligand bonding parameters which yield the g-values of the compressed form of the complex and hence the proportions of the complex in each structural form at every temperature. When combined with estimates of the Jahn-Teller distortions of the different forms, the latter produce excellent agreement with the observed temperature dependence of the bond lengths. The behavior of an infrared combination band is consistent with such a thermal equilibrium, as is the temperature dependence of the thermal ellipsoid parameters and the XAFS. The potential surfaces of the different forms of the copper(II) complex have been calculated by a model based upon Jahn-Teller coupling. It is suggested that cooperative effects may cause the development of the population of tetragonally compressed complexes, and the crystal packing is consistent with this hypothesis, though the present model may oversimplify the diversity of structural forms present at high temperature. [ABSTRACT FROM AUTHOR]

The temperature dependence of the X-ray crystal structure and powder EPR spectrum of [(HC(Ph2PO)3)2Cu]- (CIO4)2·2H2O is reported, and the structure at room temperature confirms that reported previously. Below ∼100 K, the data imply a geometry with near elongated tetragonal symmetry for the [(HC(Ph2PO)3)2Cu]2+ complex, but on warming the two higher Cu—O bond lengths and g-values progressively converge, and by 340 K the bond lengths correspond to a compressed tetragonal geometry. The data may be interpreted satisfactorily assuming an equilibrium among the energy levels of a Cu—O6 polyhedron subjected to Jahn—Teller vibronic coupling and a lattice strain. However, agreement with the experiment is obtained only if the orthorhombic component of the lattice strain decreases to a negligible value as the temperature approaches 340 K. [ABSTRACT FROM AUTHOR]

Studies the single-crystal time-of-flight neutron diffraction structures of the deuterated Tutton's salt at 15 K and ambient pressure (1 bar) and at 15 K and 1.5kbar. Structure of the hydrogenous sale; Application of pressure on the deuterated crystal; Effects of lattice strain interactions.

Investigates the influence of ammoniumcopper(II) Tutton salt on the geometric and electronic properties of divalent metal ions. Effect of deuteration on the crystal structure; Preparation of the compounds; Use of the X-ray crystallography in the study.

Investigates the effect of zinc substitution on the crystal structure of [Nd(sub 4)](sub 2)[Cu[Zn](D(sub 2)O)(sub 6)][SO(sub 4)](sub 2), deuterated ammonium copper(II) sulfate hexahydrate. Similarity in the structures of samples with lower zinc concentrations and those of a pure copper compound; Similarity in samples with 3.4 percent zinc substitution and unsubstituted compounds.

Presents a letter to the editor in response to the hyperbilirubinemia guidelines from the American Academy of Pediatrics that were published in a previous issue of "Pediatrics."

Focuses on the Detroit Area Pre-college Engineering Program (DAPCEP). Interaction between students and DAPCEP alumni; Awards received; Benefits of the program for science and engineering community employers; Contact information.

Various macrocyclic diaryl ethers are prepared via microwave assisted intramolecular or intermolecular Ullmann coupling. [ABSTRACT FROM AUTHOR]

New trinuclear iron(III) furoates with the general formula [Fe3O(α-fur)6(R–OH)3]X, where α-fur ≡ C4H3OCOO, R = CH3 (1), C2H5 (2), n-C3H7 (3), n-C4H9 (4), X = NO3− (1–4); [Fe3O(α-Fur)6(DMF)(CH3OH)2]NO3 (5); [Fe3O(α-Fur)6(H2O)(CH3OH)2]Cl (6); [Fe2MO(α-Fur)6(L)(H2O)2], where L = THF (7–9), DMF (10–12), M = Mn2+ (7, 10), Co2+ (8, 11), Ni2+ (9, 12) and [Fe2MO(α-Fur)6(3Cl-Py)3], where M = Mn2+ (13), Co2+ (14), Ni2+ (15); have been prepared and investigated by Mössbauer and IR spectroscopy. The X-ray crystal structure for the 1·2CH3OH complex indicates that it crystallizes in the monoclinic crystal system (P21/n) and has a structure typical of μ3-O-bridged trinuclear iron(III) compounds. Coordination compounds 1, 4, 7, 8 can be used as regulators of the biochemical composition of cyanobacterium Spirulina platensis biomass. The supplementation of these compounds, in concentrations exceeding 5–10mg/l, increases the content of iron, amino acids, peptides and carbohydrates in Spirulina. [ABSTRACT FROM AUTHOR]

Readmission rate for neonatal jaundice approximate 10 per 1000 live births. After applying hyperbilirubinemia guidelines and universal screening for bilirubin in term and near-term newborns, the readmission rate declined significantly from 24 to 3.7 per 1000 live births. Decreased readmission rate for neonatal jaundice may reduce kernicterus rate and health care costs. Further studies are necessary to explore these potential benefits. [ABSTRACT FROM AUTHOR]

The crystal structures of the Tutton salts (NH4)2-[Cu(H2O)6(SO4)2, diammonium hexaaquacopper disulfate, formed with normal water and isotopically substituted H218O, have been determined by X-ray diffraction at 9.5 K and are very similar, with Cu-O(7) the longest of the Cu-O bonds of the Jahn-Teller distorted octahedral [Cu(H2O) 6]2+ complex. It is known that structural differences accompany deuteration of (NH4)2[Cu(H2O) 6](SO4)2, the most dramatic of which is a switch to Cu-O(8) as the longest such bond. The present result suggest that the structural differences are associated with hydrogen-bonding effects rather than with increased mass of the water ligands affecting the Jahn-Teller coupling. The Jahn-Teller distortions and hydrogen-bonding contacts in the compounds are compared with those reported for other Tutton salts at ambient and high pressure. [ABSTRACT FROM AUTHOR]

Retinopathy of prematurity (ROP) is a vasoproliferative retinal disease affecting premature infants. In addition to prematurity itself and oxygen treatment, genetic factors have been suggested to predispose to ROP. We aimed to identify potentially pathogenic genes and biological pathways associated with ROP by analyzing variants from whole exome sequencing (WES) data of premature infants. As part of a multicenter ROP cohort study, 100 non-Hispanic Caucasian preterm infants enriched in phenotypic extremes were subjected to WES. Gene-based testing was done on coding nonsynonymous variants. Genes showing enrichment of qualifying variants in severe ROP compared to mild or no ROP from gene-based tests with adjustment for gestational age and birth weight were selected for gene set enrichment analysis (GSEA). Mean BW of included infants with pre-plus, type-1 or type 2 ROP including aggressive posterior ROP (n = 58) and mild or no ROP (n = 42) were 744 g and 995 g, respectively. No single genes reached genome-wide significance that could account for a severe phenotype. GSEA identified two significantly associated pathways (smooth endoplasmic reticulum and vitamin C metabolism) after correction for multiple tests. WES of premature infants revealed potential pathways that may be important in the pathogenesis of ROP and in further genetic studies. [ABSTRACT FROM AUTHOR]

Objective: To investigate perinatal outcomes in a cohort of fertile and infertile nulliparous women. Design: Retrospective cohort study. Setting: Academic medical center. Patients: All nulliparous women delivering singletons ≥24-week gestation at our center from 1 January 2012 to 31 December 2012 were included. Women were classified into two groups - fertile and infertile - based on a chart review at the time of delivery. Outcome measure: Perinatal outcomes of interest included mode of delivery, gestational age at delivery, and birth weight. Results: A total of 3293 mother/infant dyads fulfilled the inclusion criteria. Of these, 277 women (8.4%) were classified as infertile. Infertile women were significantly older than fertile women. In bivariate analyses, infertile women were more likely to undergo cesarean delivery (51.8 versus 36.1%, p < .001) and deliver at an earlier gestational age (38.9 ± 2.3 versus 39.4 ± 1.7 weeks, p < .0001). Infertility was no longer significantly associated with cesarean delivery after adjusting for maternal age. Infertility remained associated with an earlier gestational age at delivery after adjusting for maternal age and maternal race (β coefficient -0.42, 95%CI -0.64, -0.2). There was no difference in infant birth weight. Late preterm deliveries (34-36 completed gestational weeks) accounted for 8.3% of deliveries for infertile women compared to 4.3% for fertile women (p = .032). Conclusions: We conclude that the increased risk of cesarean section associated with infertility is driven by maternal age. Late preterm infants represent a key cohort for further evaluation in the perinatal outcomes of infertile women. [ABSTRACT FROM AUTHOR]

Three new withanolides, physaperuvin G ( 1 ), with physaperuvins I ( 2 ), and J ( 3 ), along with seven known derivatives ( 4 – 10 ), were isolated from the aerial parts of Physalis peruviana . The structures of 1 – 3 were determined by NMR, X-ray diffraction, and mass spectrometry. Compounds 1 – 10 were evaluated in lipopolysaccharide (LPS)-activated murine macrophage RAW 264.7 cells. Compounds 4 , 5 , and 10 with potent nitric oxide inhibitory activity in LPS-activated RAW 264.7 cells, with IC 50 values in the range of 0.32–7.8 μM. In addition, all compounds were evaluated for potential to inhibit tumor necrosis factor-alpha (TNF- α )-activated nuclear factor-kappa B (NF- κ B) activity with transfected human embryonic kidney cells 293. Compounds 4 – 7 inhibited TNF- α -induced NF- κ B activity with IC 50 values in the range of 0.04–5.6 μM. [ABSTRACT FROM AUTHOR]

Chemical investigation of an endophytic fungus Chaetomium globosum isolated from leaves of Wikstroemia uva-ursi led to the isolation of two new azaphilones, chaetoviridins J and K ( 1 and 3 ), along with five known derivatives ( 2 and 4 – 7 ). The structures of azaphilones were determined by NMR, X-ray diffraction, Mosher’s method, and CD analysis. The isolated compounds were evaluated for their cancer chemopreventive-potential based on their abilities to inhibit tumor necrosis factor alpha (TNF-α)-induced nuclear factor-kappa B (NF-κB). Compounds 4 , 5 , 7 , and synthetic 8 and 9 inhibit nitric oxide (NO) production with IC 50 values in the range of 0.3–5.8 μM. Compounds 4 , 5 , and 9 also displayed (TNF-α)-induced NF-κB activity with IC 50 values in the range of 0.9–5.1 μM. [ABSTRACT FROM AUTHOR]

Onthe basis of recently reported abyssinone II and olympicin A, a seriesof chemically modified flavonoid phytochemicals were synthesized andevaluated against Mycobacterium tuberculosisanda panel of Gram-positive and -negative bacterial pathogens. Some ofthe synthesized compounds exhibited good antibacterial activitiesagainst Gram-positive pathogens including methicillin resistant Staphylococcus aureuswith minimum inhibitory concentrationas low as 0.39 μg/mL. SAR analysis revealed that the 2-hydrophobicsubstituent and the 4-hydrogen bond donor/acceptor of the 4-chromanonescaffold together with the hydroxy groups at 5- and 7-positions enhancedantibacterial activities; the 2′,4′-dihydroxylated Aring and the lipophilic substituted B ring of chalcone derivativeswere pharmacophoric elements for antibacterial activities. Mode ofaction studies performed on selected compounds revealed that theydissipated the bacterial membrane potential, resulting in the inhibitionof macromolecular biosynthesis; further studies showed that selectedcompounds inhibited DNA topoisomerase IV, suggesting complex mechanismsof actions for compounds in this series. [ABSTRACT FROM AUTHOR]

Abstract: Bioassay-guided fractionation of the hexane extract from the flowers of Vernonia cinerea (Asteraceae) led to the isolation of a new sesquiterpene lactone, 8α-hydroxyhirsutinolide (2), and a new naturally occurring derivative, 8α-hydroxyl-1-O-methylhirsutinolide (3), along with seven known compounds (1 and 4–9). The structures of the new compounds were determined by 1D and 2D NMR experiments and by comparison with the structure of compound 1, whose relative stereochemistry was determined by X-ray analysis. The isolated compounds were evaluated for their cancer chemopreventive potential based on their ability to inhibit nitric oxide (NO) production and tumor necrosis factor alpha (TNF-α)-induced NF-κB activity. Compounds 1, 2, 4, 5, and 9 inhibited TNF-α-induced NF-κB activity with IC50 values of 3.1, 1.9, 0.6, 5.2, and 1.6μM, respectively; compounds 4 and 6–9 exhibited significant NO inhibitory activity with IC50 values of 2.0, 1.5, 1.2, 2.7, and 2.4μM, respectively. [Copyright &y& Elsevier]

The vitamin D-activating enzyme 1α-hydroxylase (CYP27B1) and vitamin D receptor (VDR) support anti-inflammatory responses to vitamin D in many tissues. Given the high basal expression of CYP27B1 and VDR in trophoblastic cells from the placenta, we hypothesized that anti-inflammatory effects of vitamin D may be particularly important in this organ. Pregnant wild type (WT) mice i.p. injected with LPS showed elevated expression of mouse Cyp27b1 (4-fold) and VDR (6-fold). Similar results were also obtained after ex vivo treatment of WT placentas with LPS. To assess the functional impact of this, we carried out ex vivo studies using placentas -/- for fetal (trophoblastic) Cyp27b1 or VDR. Vehicle-treated -/- placentas showed increased expression of IFN-γ and decreased expression of IL-10 relative to +/+ placentas. LPS-treated -/- placentas showed increased expression of TLR2, IFN-γ, and IL-6. Array analyses identified other inflammatory factors that are dysregulated in Cyp27b1-/- versus Cyp27b1+/+ placentas after LPS challenge. Data highlighted enhanced expression of IL-4, IL-15, and IL-18, as well as several chemokines and their receptors, in Cyp27b1-/- placentas. Similar results for IL-6 expression were observed with placentas -/- for trophoblastic VDR. Finally, ex vivo treatment of WT placentas with the substrate for Cyp27b1, 25-hydroxyvitamin D3, suppressed LPS-induced expression of IL-6 and the chemokine Ccl11. These data indicate that fetal (trophoblastic) vitamin D plays a pivotal role in controlling placental inflammation. In humans, this may be a key factor in placental responses to infection and associated adverse outcomes of pregnancy. [ABSTRACT FROM AUTHOR]

Introduction: Previous studies highlight a complex relationship between lineage and phenotype for adipose tissue macrophages (ATMs), adipose stem cells (ASCs), and adipocytes, suggesting a high degree of plasticity of these cells. In the present study, using a novel co-culture system, we further characterized the interaction between ATMs, ASCs and adipocytes. Research Design and Methods: Human adipocytes and the stromal vascular fraction containing ATMs and ASCs were isolated from human adipose tissue and co-cultured for 24 hours. FACS was used to characterize ATMs and ASCs before and after co-culture. Preadipocytes generated after co-culture were characterized by immunostaining for DLK (preadipocytes), CD14 and CD68 (ATMs), CD34 (ASCs), and Nile Red staining for lipid drops. qRT-PCR was used to quantify adipogenic markers such as C/EBPα and PPARγ. A novel fluorescent nanobead lineage tracing method was utilized before co-culture where fluorescent nanobeads were internalized by CD68 (+) ATMs. Results: Co-culture of adipocytes with ATMs and ASCs increased the formation of new preadipocytes, thereby increasing lipid accumulation and C/EBPα and PPARγ gene expression. Preadipocytes originating after co-culture were positive for markers of preadipocytes, ATMs and ASCs. Moreover, fluorescent nanobeads were internalized by ATMs before co-culture and the new preadipocytes formed after co-culture also contained fluorescent nanobeads, suggesting that new preadipocytes originated in part from ATMs. The formation of CD34(+)/CD68(+)/DLK (+) cell spheres supported the interaction of ATMs, ASCs and preadipocytes. Conclusions: Cross-talk between adipocytes, ATMs and ASCs promotes preadipocyte formation. The regulation of this novel adipogenic pathway involves differentiation of ATMs to preadipocytes. The presence of CD34(+)/CD68(+)/DLK(+) cells grouped in spheres suggest that paracrine interactions between these cell types plays an important role in the generation and proliferation of new preadipocytes. This phenomenon may reflect the in vivo plasticity of adipose tissue in which ATMs play an additional role during inflammation and other disease states. Understanding this novel pathway could influence adipogenesis, leading to new treatments for obesity, inflammation, and type 2 diabetes. [ABSTRACT FROM AUTHOR]

Background: Sufficient information from in vitro and in vivo studies has become available to permit computer modeling of the processes that occur in the myometrium during labor. This development allows the in silico investigation of pathological mechanisms and the trialing of potential treatments. Methods/Results: Based on the human literature, we developed a computer model of the immune-endocrine environment of the myometrial cell. The interactions between molecules are represented by differential equations. The model is designed to simulate the estrogen and progesterone receptor changes during pregnancy and particularly the changes in the progesterone receptor (PR) isoforms A and B that are thought to mediate functional progesterone withdrawal in the human at labor. Parturition is represented by an increase in the PRA to PRB ratio to levels seen in women in labor. Infection is shown by inducing inflammation in the system by increasing phospho-IkB kinase concentration (IKK) levels; which lead to increased NF-κB activation, causing an increase in the PRA/PRB ratio. We examined the effects of progesterone or cyclooxygenase 2 (Cox2) inhibitor treatments on the PRA/PRB ratio in silico. The model predicted that high doses of progesterone and Cox2 inhibition would be effective in preventing an NF-κB-induced PRA/PRB ratio increase to the levels found during labor. Conclusions: Our data illustrate the use of dynamic biological computer simulations to test the effectiveness of therapeutic interventions. This may allow the early rejection of ineffective therapies prior to expensive field trials. [ABSTRACT FROM AUTHOR]

Caspases and apoptosis are thought to play a role in infection-associated preterm-delivery. We have shown that in vitro treatment with pancaspase inhibitor Z-VAD-FMK protects trophoblasts from microbial antigen-induced apoptosis. Objective. To examine whether in vivo administration of Z-VAD-FMK would prevent infection-induced preterm-delivery. Methods. We injected 14.5 day-pregnant-mice with heat-killed group B streptococcus (HK-GBS). Apoptosis within placentas and membranes was assessed by TUNEL staining. Calpain expression and caspase-3 activation were assessed by immunohistochemistry. Preterm-delivery was defined as expulsion of a fetus within 48 hours after injection. Results. Intrauterine (i.u.) or intraperitoneal (i.p.) HK-GBS injection led to preterm-delivery and induced apoptosis in placentas and membranes at 14 hours. The expression of calpain, a caspase-independent inducer of apoptosis, was increased in placenta. Treatment with the specific caspase inhibitor Z-VAD-FMK (i.p.) prior to HK-GBS (i.p.) delayed but did not prevent preterm-delivery. Conclusion. Caspase-dependent apoptosis appears to play a role in the timing but not the occurrence of GBS-induced preterm delivery in the mouse. [ABSTRACT FROM AUTHOR]

The temperature-dependent electron paramagnetic resonance (EPR) spectrum of ~1% Cu(II) ions doped into Ba2Zn(HCO2)6 · 4H2O was analyzed at the Q-band frequencies over the temperature range 100-350 K to obtain structural information about the local environment. It can be concluded that the host crystal imparts a large orthorhombic strain which mainly corresponds to a tetragonal compression imposed onto the CuIIO6 species. This results in a copper center which adopts an orthorhombically distorted elongated geometry with the elongated axis perpendicular to the direction of the tetragonal compression due to the host crystal. There are two possible axes of elongation, and these represent two conformers separated by ~320 cm-1. The thermal population of the higher energy level averages the g values, giving the observed temperature-dependent EPR spectra. The averaging process is between vibronic levels that are localized at two different minima of a single ground-state potential energy surface. These vibronic levels correspond to vibrational levels having different electronic properties. The determination of the host lattice strain parameters from the Cu(II) EPR spectra means that the guest ion is used as a probe of the environment of the Zn(II) site. The structural data derived from the lattice strain parameters are correlated with those from the Ba2Zn(HCO2)6 · 4H2O crystal structure. [ABSTRACT FROM AUTHOR]

Abstract: Group B streptococcus (GBS) is one of the leading causes of neonatal infection; however the molecular mechanisms involved are not clearly known. Here we used high and low hemolytic GBS isolates and mutant GBS that lacks β-hemolysin expression and showed that GBS infection or exposure to GBS hemolysin extract induces primary human trophoblast, placental fibroblast and JEG3 trophoblast cell line death, and that GBS-induced trophoblast death was β-hemolysin dependent. The fibroblasts and trophoblasts provide an innate immune barrier between fetal and maternal circulation in the placenta. These data suggest that GBS may disrupt this barrier to invade fetal circulation. [Copyright &y& Elsevier]

Abstract: Reaction of manganese acetate and lanthanide nitrates in the presence of excess of PhCOOH affords highly asymmetric dodecanuclear mixed-metal [Mn10Ln2(OH)(O)8(PhCOOH)(PhCOO)19] (Ln=PrIII (1), NdIII (2)) clusters. The similar reaction, but with only 2equiv. of PhCOOH resulted in the compounds with higher nuclearity [Mn11Eu4(O)8(OH)8(PhCOO)18(NO3)2(H2O)6]NO3 ·4CH3CN (3). Variable-temperature solid-state magnetic susceptibility of 1 and 2 in the temperature range 1.8–300K were carried out, and for both complexes antiferromagnetic exchange interactions between the metal centers were observed, giving an estimated S =17/2 ground state. AC magnetic susceptibility data have revealed out-of-phase signals, which suggest that these complexes exhibit a slow relaxation of magnetization as observed in single-molecule magnets. [Copyright &y& Elsevier]

The study goal was to define low thresholds of plasma glucose concentrations that constitute profound hypoglycemia. Population analysis was performed on research publications on neonatal hypoglycemia ascertained by a Medline search. Eligible patients had neurological sequelae associated directly and primarily with hypoglycemia (profound hypoglycemia). Of 89 infants, more than 95% had plasma glucose levels of less than 25 mg/dL that were first detected at more than 10 hours of age. A breakdown of study patients according to those with or without neurological sequelae, who were exposed to a similar degree of hypoglycemia, showed a combined incidence of neurological injury of 21%, with 95% confidence interval from 14% to 27%. [ABSTRACT FROM AUTHOR]

A hypoglycemic infant with secondary occipital brain injury defined by serial computed tomography and magnetic resonance imaging is described. An additional 22 similar cases were previously published in the English language literature. A total of 23 cases (including the present case) were reviewed. Abnormal brain imaging findings are associated with profound hypoglycemia and show involvement of the occipital lobes in 82% of affected newborns. Half of these infants had visual impairment, and their median and range of plasma glucose values, and postnatal age when hypoglycemia was first detected, were 7 mg/dL (range, 2-26 mg/dL) and 48 hours (range, 1-72 hours), respectively. [ABSTRACT FROM AUTHOR]

Analysis between two local Emergency Departments (EDs) suggested an oscillatory phenomenon for ambulance diversion: When one hospital went on diversion it led to a disproportionate flow of ambulance traffic to a neighboring facility that subsequently was forced to go on divert. We hypothesized if one hospital could avoid diversion status, the need for diversion could be averted in the neighboring facility. ED A secured additional resources and made a commitment to no diversion for 1 week. No changes in operations occurred in hospital B. We found no differences in ambulance runs or ED census at either facility comparing the week before, during, and after the trial. There was a dramatic decline in diversion hours from 19.7 to 1.4 and 27.7 to 0 at hospitals A and B, respectively, during the trial period (p < 0.05) compared to the weeks before and after. We conclude that reciprocating effects can be decreased with one institution''s commitment to avoid diversion, thus decreasing the need for diversion at a neighboring facility. [Copyright &y& Elsevier]

Objective. Currently, many nurseries allow hematocrits to fall to <21% in apparently "stable" premature infants before considering a blood transfusion. We evaluated clinical changes and hemodynamic changes by echocardiogram in "stable" anemic premature infants before, during, and after transfusion. Methods. "Stable" premature infants (≤32 weeks' gestation) who were to receive transfusions (2 aliquots of 10 mL/kg packed red blood cells, 12 hours apart) were eligible for prospective enrollment. Cardiac function by echocardiography and vital signs were measured 4 times: 1 to 3 hours before and 2 to 4 hours after the initial aliquot and 4 to 7 hours and 27 to 34 hours after the second aliquot. Infants were grouped prospectively according to pretransfusion hematocrit ranges for analysis: <21% (low), 22% to 26% (mid), and >27% (high). Results. Thirty-two infants were enrolled. No differences were observed between the groups in sex, birth weight, postconceptional age, or postnatal weight at enrollment. Before transfusion, low- and mid-range groups had higher left ventricular end systolic and diastolic diameters, in comparison with high range. Low range had increased stroke volume in comparison with the high-range group. These changes persisted after transfusion. Mean diastolic blood pressure rose and peak velocity in the aorta fell in the low-range group after transfusion. Pretransfusion hematocrit was correlated with but poorly predictive of echocardiographic measurements. Infants with inappropriate weight gain had increased ventricular end diastolic diameters, consistent with congestive heart failure. Conclusions. Apparently "stable" anemic premature infants may be in a clinically unrecognized high cardiac output state, and some echocardiographic... [ABSTRACT FROM AUTHOR]

Examines the local copper(II) geometry of [(HC(Ph[sub 2]PO)[sub 3])[sub 2]Cu](ClO[sub 4])[sub 2]...2H[sub 2]O crystal complexes to determine whether the tetragonally compressed geometry inferred for the compound is real or the result of an average of dynamic distortions. Structure of cation at room temperature; Extended X-ray absorption fine structure analysis.

Abstract. Although transcutaneous Po[sub 2] is a close approximation of arterial Po[sub 2] in most neonates, infants in shock often show lower transcutaneous than arterial Po[sub 2] values. For a better understanding of this discrepancy, we investigated the effect of acute hemorrhage on transcutaneous, tissue, and arterial Po[sub 2] in rabbits. With progressive hemorrhage, transcutaneous and tissue Po[sub 2] values declined steeply while arterial Po[sub 2] values did not. We speculate that the progressive decrement in transcutaneous and tissue Po[sub 2] values with hemorrhage is produced by diminished peripheral blood flow. Rather than representing a failure of the transcutaneous Po[sub 2] monitoring method, we speculate that transcutaneous hypoxia with shock may be a clinically valuable danger signal. [ABSTRACT FROM AUTHOR]