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Prenatal alcohol exposure and academic achievement at age six: a nonlinear fit.

This is a report on the effects of prenatal alcohol exposure on the academic achievement of children at 6 years of age. In this longitudinal study, women were interviewed at the end of each trimester of pregnancy, at delivery, and at 8, 18, 36, and 72 months postpartum. The women were of lower socioeconomic status, high school-educated, and moderate users of alcohol. The offspring received age-appropriate physical and developmental assessments at each follow-up. Linear regression and nonlinear curve fitting were used to investigate the nature and shape of the relationship between prenatal alcohol exposure and achievement. In addition, the role of child IQ in this relationship was explored. Alcohol exposure during the second trimester predicted deficits in each of the three subtests of the Wide Range Achievement Test-Revised (WRAT-R): reading, spelling, and arithmetic. The relationship was partially reduced by the addition of IQ to the model, but prenatal alcohol exposure still predicted significant deficits in achievement, even after controlling for IQ. Tests for the shape of the relationship demonstrated that the effect of prenatal exposure on the arithmetic subtest of the WRAT-R was a linear or dose-response relationship. By contrast, the relationships between prenatal alcohol exposure and performance on the spelling and reading subtests of the WRAT-R were better modeled as threshold effects. The thresholds for both were approximately 1 drink/day in the second trimester.

Achievement↗

Empirical test of an ion parametric resonance model for magnetic field interactions with PC-12 cells.

A companion paper describes a predictive ion parametric resonance (IPR) model of magnetic field interactions with biological systems based on a selective relation between the ratio of the flux density of the static magnetic field to the AC magnetic field and the charge-to-mass ratio of ions of biological relevance. Previous studies demonstrated that nerve growth factor (NGF)-stimulated neurite outgrowth (NO) in PC-12 cells can be inhibited by exposure to magnetic fields as a function of either magnetic field flux density or AC magnetic field frequency. The present work examines whether the PC-12 cell response to magnetic fields is consistent with the quasi-periodic, resonance-based predictions of the IPR model. We tested changes in each of the experimentally controllable variables [flux densities of the parallel components of the AC magnetic field (Bac) and the static magnetic field (Bdc) and the frequency of the AC magnetic field] over a range of exposure conditions sufficient to determine whether the IPR model is applicable. A multiple-coil exposure system independently controlled each of these critical quantities. The perpendicular static magnetic field was controlled to less than 2 mG for all tests. The first set of tests examined the NO response in cells exposed to 45 Hz Bac from 77 to 468 mG(rms) at a Bdc of 366 mG. Next, we examined an off-resonance condition using 20 mG Bdc with a 45 Hz AC field across a range of Bac between 7.9 and 21 mG(rms). Finally, we changed the AC frequency to 25 Hz, with a corresponding change in Bdc to 203 mG (to tune for the same set of ions as in the first test) and a Bac range from 78 to 181 mG(rms). In all cases the observed responses were consistent with predictions of the IPR model. These experimental results are the first to support in detail the validity of the fundamental relationships embodied in the IPR model.

Animals↗

Dynamic interactions between accommodation and convergence.

Frequency-domain equations were derived for the current dual-interaction model of accommodation and convergence control, and its adaptive behavior was related to the system's parameters. Contrary to predictions based on the steady-state performance of the model [18], dynamic analysis showed that the AC/A is sensitive to the method of measurement and a procedure is established for its reliable determination. Additionally, the results provided theoretical support for the empirical finding that low AC/A and CA/C ratios are associated with high accommodative and convergence adaptation, respectively [15]. The derived equations should help future studies relate the physiological behavior of accommodative and convergence to specific model parameters.

Accommodation, Ocular↗

Experimental characterization of the miniannular phased array as a hyperthermia applicator.

A series of experiments has been carried out in order to characterize a miniannular phased array applicator prior to possible clinical implementation. The energy deposition patterns over the frequency range of 100 to 200 MHz were determined in several human limb models of different complexities by measuring the electric field strength patterns. The point of maximum energy deposition within a homogeneous, muscle-equivalent cylindrical phantom positioned coaxially within the MAPA was found to be at the center of the applicator. The energy deposition patterns seem to be more uniform at the lower frequencies. Inclusion of a cylindrical bone-equivalent phantom positioned coaxially with this muscle-equivalent phantom does not seem to significantly alter the energy deposition patterns in the muscle-equivalent region. For more realistically shaped, homogeneous muscle-equivalent limb models, the resulting energy deposition patterns appear to be confined mostly to the intended treatment region. However, the point of maximum energy deposition was not at the middle of the applicator as with the cylindrical model, but shifted towards a smaller cross-sectional region. This shift in location of the point of maximum energy deposition varies with the location of the MAPA on the limb. A secondary region of high-field strength was also observed at the ankle for a MAPA centered about the knee. In this study, the energy deposition patterns appear to be significantly dependent on the shape of the model. Therefore, this factor must be taken into consideration for the proper prediction and control of the heating patterns resulting from the use of this type of applicator for clinical hyperthermia treatment.

Humans↗

Factors associated with the use of pharmacologic agents to facilitate out-of-hospital endotracheal intubation.

OBJECTIVE: To identify a set of clinical factors most strongly associated with the use of drug-facilitated intubation (DFI) in the out-of-hospital setting. METHOD: The authors used data from a prospective, multicentered endotracheal intubation (ETI) observational cohort trial, including patients from 45 emergency medical services in Pennsylvania. Providers reported clinical, physiologic, and anatomic factors associated with each ETI effort. The authors included only data from the 23 services using DFI. They identified all non-arrest (presence of a pulse) adult patients. They included both successful and failed ETIs. They defined DFI cases as patients who received a sedative or neuromuscular-blocking agent to facilitate ETI. The authors also classified patients who underwent nasotracheal intubation as DFI. They defined control subjects as patients undergoing conventional oral ETI. They performed multivariate logistic regression to identify the clinical, physiologic, and anatomic factors characteristic of DFI. They examined alternate forms of the final prediction model. RESULTS: The authors analyzed data from 208 nonarrest patients, including 92 DFIs and 116 control subjects. Of 34 factors potentially related to DFI, 17 were excluded on univariate analysis (likelihood ratio p>0.25). Multivariate logistic regression revealed the following as positively associated with DFI: presence of clenched jaw/trismus (odds ratio [OR], 2.33; 95% confidence interval [CI], 1.10-4.95; p=0.026); increased verbal Glasgow Coma Scale score (OR, 1.71; 95% CI, 1.29-2.26; p<0.001); use of cervical spine precautions (OR, 2.30; 95% CI, 1.15-4.62; p=0.018). Anterior vocal cords (OR, 0.27; 95% CI, 0.10-0.71; p=0.004) and laryngospasm (OR, 0.14; 95% CI, 0.02-1.17; p=0.025) were negatively associated with DFI. The model showed good fit (Hosmer-Lemeshow p=0.75) and discrimination (area under the curve=0.76). CONCLUSIONS: The authors identified a set of predictors strongly associated with DFI. These data offer insight into the current use of DFI and support the development of consensus-based guidelines for this procedure.

Emergency Medical Services↗

Modelling the fate and transport of nickel in the mersey estuary.

Modelling heavy metals in estuarine environments is extremely complex for various reasons; one of the primary complicating factors is that metals exist in two phases, dissolved and particulate bound. Dynamic changes in water chemistry, and in particular salinity, affect the partitioning of metals between the two phases and hence make it difficult to determine the relative fractions of each phase. A relatively simple approach was developed to relate variations in partition coefficient for Ni to salinity fluctuations in the Mersey Estuary. The functional relationship developed between partition coefficient and salinity departs from the traditional exponential type curve, providing a more realistic relationship.A numerical model was then developed for predicting the transport and distribution of Ni about the Mersey Estuary. The model couples transport of metals throughout the water along with incorporating the chemical processes controlling how nickel is fractioned between dissolved and particulate phases through the newly developed partition coefficient relationship. Model predictions of dissolved Ni along the longitudinal axis of the estuary were compared with measurements of Ni for two events; very good correlation was obtained between the model results and the data.

Biological Transport↗

Representations of self and other: a semantic space model.

This article describes a semantic space model of personality. According to the model, representations of facets of the self (e.g., actual self, ideal self) and of others are arrayed in a semantic space, with proximities among representations predicted to be associated with mood, self-evaluation, and broad personality dimensions. The relation of proximities among pairs of representations to personality and mood measures was found to be mediated by the spatial proximity of other representations, indicating that the representations constitute dynamic systems. Proximities among representations were shown to predict self-esteem and self-evaluative moods even after controlling for the contribution of the personality dimensions of Neuroticism, Extraversion, and Agreeableness. Generally, the semantic space model led to better predictions than did several related models concerning representations of self and other.

Affect↗

Transverse tripolar spinal cord stimulation: theoretical performance of a dual channel system.

A new approach to spinal cord stimulation is presented, by which several serious problems of conventional methods can be solved. A transverse tripolar electrode with a dual-channel voltage stimulator is evaluated theoretically by means of a volume conductor model, combined with nerve fibre models. The simulations predict that a high degree of freedom in the control of activation of dorsal spinal pathways may be obtained with the described system. This implies an easier control of paraesthesia coverage of skin areas and the possibility to correct undesired paraesthesia patterns, caused by lead migration, tissue growth, or anatomical asymmetries, for example, without surgical intervention. It will also be possible to preferentially activate either dorsal column or dorsal root fibres, which has some important clinical advantages. Compared to conventional stimulation systems, the new system has a relatively high current drain.

Analgesia↗

Independent feedback control of horizontal and vertical amplitude during oblique saccades evoked by electrical stimulation of the superior colliculus.

1. In early local feedback models for controlling horizontal saccade amplitude, a feedback signal of instantaneous eye position is continuously subtracted from a reference signal of desired eye position at a comparator. The output of the comparator is dynamic motor error, the remaining distance the eyes must rotate to reach the saccadic goal. When feedback reduces dynamic motor error to zero, the saccade stops on target. Two classes of local feedback model have been proposed for controlling oblique saccades (i.e., saccades with both horizontal and vertical components). In "independent comparator" models, separate horizontal and vertical comparators maintain independent representations of horizontal and vertical dynamic motor error. Thus, once an oblique desired displacement signal is established, the horizontal and vertical amplitudes of oblique saccades are under independent feedback control. In "vectorial comparator" models, output cells in the motor map of the superior colliculus act as site-specific vectorial comparators. For a given oblique desired displacement, a single comparator controls the amplitudes of both components. Because vectorial comparator models do not maintain separate representations of horizontal and vertical dynamic motor error, they cannot exert independent control over the component amplitudes of oblique saccades. 2. We tested differential predictions of these two types of models by electrically stimulating sites in the superior colliculus of rhesus monkey immediately after either vertical or horizontal visually guided saccades. We have shown previously that, despite the fixed site of collicular stimulation, the amplitude of the visually guided saccades systematically alters the amplitude of the corresponding component (horizontal or vertical) of stimulation-evoked saccades. However, in the present study, we examined the effect of the visually guided saccades on the amplitude of the orthogonal component of stimulation-evoked saccades. 3. For a fixed site of collicular stimulation, vectorial comparator models predict that the initial visually guided saccade will influence both components of the ensuing stimulation-evoked saccade via the single feedback comparator. By contrast, independent comparator models permit the independent manipulation of the horizontal and vertical amplitudes of these oblique stimulation-evoked saccades. 4. In total, we collected data from 15 collicular stimulation sites. Immediately after either horizontal or vertical visually guided saccades of different amplitudes, we measured the horizontal and vertical amplitudes of saccades evoked by stimulation of the intermediate or deep layers of the superior colliculus. For each site, the duration, frequency, and current of the stimulation train were held constant. 5. Under these conditions, stimulation-evoked saccades followed visually guided saccades with short latency (18.1 +/- 6.7 ms, mean +/- SD). For every stimulation site tested, although the amplitude of the component of stimulation-evoked saccades corresponding to the direction of the preceding saccade (horizontal or vertical) varied systematically, the amplitude of the orthogonal component was roughly constant. 6. Thus the horizontal and vertical amplitudes of oblique stimulation-evoked saccades can be manipulated independently. Moreover, the peak velocity-amplitude relationships, the instantaneous velocity profiles, and the ratio of horizontal and vertical velocities and durations were very similar to those of visually guided saccades. 7. Independent comparator models can readily account for the ability to manipulate the amplitude of one component of oblique saccades without affecting the other. However, two-dimensional local feedback models that cannot exert independent control over the horizontal and vertical amplitudes of oblique saccades should be carefully reevaluated.

Animals↗

Determinants of health-related hardiness among urban older African-American women with chronic illnesses.

A systematic probability sample of 100 community-living older African-American women with chronic illnesses was evaluated during clinic visits to an urban safety-net hospital to explore health and demographic factors predictive of health-related hardiness (HRH). Questionnaires on HRH, function, self-assessed health, morbidity, health behavior, and selected demographics were used for collection of data. Multiple linear regression analyses ascertained that years of education and function explained 20% of the variance in HRH. Findings raise issues regarding validity of HRH prediction models and the cultural appropriateness of current methods of assessing HRH in older African-American women.

Adaptation, Psychological↗

Segmentation in vertebrates: clock and gradient finally joined.

The vertebral column is derived from somites formed by segmentation of presomitic mesoderm, a fundamental process of vertebrate embryogenesis. Models on the mechanism controlling this process date back some three to four decades. Access to understanding the molecular control of somitogenesis has been gained only recently by the discovery of molecular oscillators (segmentation clock) and gradients of signaling molecules, as predicted by early models. The Notch signaling pathway is linked to the oscillator and plays a decisive role in inter- and intrasomitic boundary formation. An Fgf8 signaling gradient is involved in somite size control. And the (canonical) Wnt signaling pathway, driven by Wnt3a, appears to integrate clock and gradient in a global mechanism controlling the segmentation process. In this review, we discuss recent advances in understanding the molecular mechanism controlling somitogenesis.

Animals↗

Self-perception variables that mediate AIDS-preventive behavior in college students.

Three psychological variables--self-efficacy, control and meaning, and perceived risk--were tested in a structural model predicting AIDS-preventive behavior. Results revealed a good model fit, indicating that these psychological variables did play a role in mediating AIDS-preventive behavior in college students. A multivariate analysis of variance and individual analyses of variance conducted for men and women also revealed gender differences on individual items of self-efficacy, perceived risk, and AIDS-preventive behavior. This study underscores the importance of identifying and assessing the psychological determinants of AIDS-preventive behavior.

Acquired Immunodeficiency Syndrome↗

Recollection and familiarity deficits in amnesia: convergence of remember-know, process dissociation, and receiver operating characteristic data.

Previous studies using the process dissociation and the remember-know procedures led to conflicting conclusions regarding the effects of anterograde amnesia on recollection and familiarity. We argue that these apparent contradictions arose because different models were used to interpret the results and because differences in false-alarm rates between groups biased the estimates provided by those models. A reanalysis of those studies with a dual-process signal-detection model that incorporates response bias revealed that amnesia led to a pronounced reduction in recollection and smaller but consistent reduction in familiarity. To test the assumptions of the model and to further assess recognition deficits in amnesics, we examined receiver operating characteristics (ROCs) in amnesics and controls. The ROCs of the controls were curved and asymmetrical, whereas those of the amnesics were curved and symmetrical. The results supported the predictions of the model and indicated that amnesia was associated with deficits in both recollection and familiarity.

Aged↗

Doctors' characteristics do not predict long-term glycaemic control in type 2 diabetic patients.

Glycaemic control in type 2 diabetic patients varies widely between general practitioners (GPs). To increase our understanding of this variation, linear random effects models were used to examine the predictive value of GP characteristics on the course of annual HbA1c measurements, in 688 newly diagnosed type 2 diabetic patients between one and five years after diabetes diagnosis. We found that characteristics of centrally supported GPs, such as interest in diabetes, experience, practice type, list size, and weekly working hours, did not predict their patients' glycaemic control.

Adult↗

Genetic control of horizontal virus transmission in the chestnut blight fungus, Cryphonectria parasitica.

Vegetative incompatibility in fungi has long been known to reduce the transmission of viruses between individuals, but the barrier to transmission is incomplete. In replicated laboratory assays, we showed conclusively that the transmission of viruses between individuals of the chestnut blight fungus Cryphonectria parasitica is controlled primarily by vegetative incompatibility (vic) genes. By replicating vic genotypes in independent fungal isolates, we quantified the effect of heteroallelism at each of six vic loci on virus transmission. Transmission occurs with 100% frequency when donor and recipient isolates have the same vic genotypes, but heteroallelism at one or more vic loci generally reduces virus transmission. Transmission was variable among single heteroallelic loci. At the extremes, heteroallelism at vic4 had no effect on virus transmission, but transmission occurred in only 21% of pairings that were heteroallelic at vic2. Intermediate frequencies of transmission were observed when vic3 and vic6 were heteroallelic (76 and 32%, respectively). When vic1, vic2, and vic7 were heteroallelic, the frequency of transmission depended on which alleles were present in the donor and the recipient. The effect of heteroallelism at two vic loci was mostly additive, although small but statistically significant interactions (epistasis) were observed in four pairs of vic loci. A logistic regression model was developed to predict the probability of virus transmission between vic genotypes. Heteroallelism at vic loci, asymmetry, and epistasis were the dominant factors controlling transmission, but host genetic background also was statistically significant, indicating that vic genes alone cannot explain all the variation in virus transmission. Predictions from the logistic regression model were highly correlated to independent transmission tests with field isolates. Our model can be used to estimate horizontal transmission rates as a function of host genetics in natural populations of C. parasitica.

Alleles↗

Diethylnitrosamine-induced hepatocarcinogenesis in rats: a theoretical study.

Multiple data sets on hepatocarcinogenesis in rats resulting from pulse (single) or continuous exposure to diethylnitrosamine (DEN) are analyzed within the framework of a two-mutation carcinogenesis model in order to identify the underlying biological processes that control the pharmacodynamics of DEN-induced liver cancer. Our findings indicate: (1) Predictions of the two-mutation oncogenic model are consistent with empirical data on DEN-induced hepatocarcinogenesis. (2) The probability of the first genetic alteration (initiation) is linearly dependent on applied dose and decays exponentially following a pulse (single) dose or cessation of exposure. (3) The probability of initiation is proportional to the number of O4-ethyldeoxythymidine DNA adducts resulting from DEN exposure, indicating that these adducts are the likely promutagenic lesions in DEN-induced hepatocarcinogenesis. (4) The mitotic rates of initiated and transformed cells are nonlinear with dose. (5) The average growth rate of initiated hepatocytes as a function of DEN dose is related to Druckery's slope. (6) The probability of the second genetic event (transformation) is independent of applied dose, suggesting that it is the result of a spontaneous genetic alteration.

Animals↗

Predictive factors for neonatal morbidity in neonates with an umbilical arterial cord pH less than 7.00.

OBJECTIVE: Fewer than 50% of neonates with an umbilical arterial pH < 7.00 have neonatal complications. Our objective was to identify clinical predictive factors for adverse outcomes in this group of neonates. STUDY DESIGN: In this case-control study both cases and controls had an umbilical arterial cord pH < 7.00. Cases were defined as those neonates who had seizures, grade 3 to 4 intraventricular hemorrhage, gastrointestinal dysfunction, respiratory distress syndrome requiring intubation, sepsis, or death. Controls had an umbilical arterial cord pH < 7.00 and no complications. A multivariable prediction model was created, with variables having an association with adverse outcome by bivariate analyses, attempting to predict which neonates in this umbilical arterial pH range are at greatest risk for adverse outcomes. RESULTS: We identified 73 of 10,705 neonates born between July 1992 and October 1996 with an umbilical arterial cord pH < 7.00. Thirty-five neonates met our case definition, and the remaining 38 composed the control group. Cases had significantly lower arterial pH values and 1- and 5-minute Apgar scores, greater arterial base deficit values, and a higher incidence of abruptio placentae and maternal cocaine use. More cases were delivered before 34 weeks. There were three neonatal deaths, two cases of grade 3 or 4 intraventricular hemorrhage, five cases of gastrointestinal dysfunction, and four cases of neonatal seizures. In our predictive model for adverse neonatal outcome, an arterial base deficit > or = 16 mmol/L and a 5-minute Apgar score < 7 had a sensitivity and a specificity of 79% and 80.8%, respectively. CONCLUSION: Neonatal morbidity in neonates with an umbilical arterial cord pH < 7.00 can be predicted by a high arterial base deficit value and low 5-minute Apgar score.

Acidosis↗

Predicting the impact of antiretrovirals in resource-poor settings: preventing HIV infections whilst controlling drug resistance.

There is currently an opportunity to carefully plan the implementation of antiretroviral (ARV) therapy in the developing world. Here, we use mathematical models to predict the potential impact that low to moderate usage rates of ARVs might have in developing countries. We use our models to predict the relationship between the specific usage rate of ARVs (in terms of the percentage of those infected with HIV who receive such treatment) and: (i) the prevalence of drug-resistant HIV that will arise, (ii) the future transmission rate of drug-resistant strains of HIV, and (iii) the cumulative number of HIV infections that will be prevented through more widespread use of ARVs. We also review the current state of HIV/AIDS treatment programs in resource-poor settings and identify the essential elements of a successful treatment project, noting that one key element is integration with a strong prevention program. We apply both program experience from Haiti and Brazil and the insights gleaned from our modeling to address the emerging debate regarding the increased availability of ARVs in developing countries. Finally, we show how mathematical models can be used as tools for designing robust health policies for implementing ARVs in developing countries. Our results demonstrate that designing optimal ARV-based strategies to control HIV epidemics is extremely complex, as increasing ARV usage has both beneficial and detrimental epidemic-level effects. Control strategies should be based upon the overall impact on the epidemic and not simply upon the impact ARVs will have on the transmission and/or prevalence of ARV-resistant strains.

Anti-Retroviral Agents↗