A Prospective Longitudinal Assessment of Medical Records for Diagnostic Substitution among Subjects Diagnosed with a Pervasive Developmental Disorder in the United States

Background: Previously, investigators suggested that diagnostic substitution from other diagnoses, e.g., mental retardation (MR) and/or cerebral palsy (CP) to pervasive developmental disorder (PDD) is a driving factor behind increases in PDD. This study evaluated potential diagnostic substitution among subjects diagnosed with PDD vs MR or CP by examining birth characteristic overlap.Methods: SAS® and StatsDirect software examined medical records for subjects within the Vaccine Safety Datalink (VSD) database who were Health Maintenance Organization (HMO)-enrolled from birth until diagnosed with an International Classification of Disease, 9th revision (ICD-9) outcome of PDD (299.xx, n=84), CP (343.xx, n=300), or MR (317.xx, 318.xx, or 319.xx, n=51).Results: Subjects with PDD had significantly (p<0.01) increased: male/female ratio (PDD=5.5 vs CP=1.5 or MR=1.3), mean age of initial diagnosis in years (PDD=3.13 vs CP=1.09 or MR=1.62), mean gestational age in weeks at birth (PDD=38.73 vs CP=36.20 or MR=34.84), mean birth weight in grams (PDD=3,368 vs CP=2,767 or MR=2,406), and mean Appearance-Pulse-Grimace-Activity-Respiration (APGAR) scores at 1 minute (PDD=7.82 vs CP=6.37 or MR=6.76) and 5 minutes (PDD=8.77 vs CP=7.92 or MR=8.04), as compared to subjects diagnosed with CP or MR.Conclusion: This study suggests diagnostic substitution cannot fully explain increased PDD prevalence during the 1990s within the United States

New Role, New Country: introducing US physician assistants to Scotland

This paper draws from research commissioned by the Scottish Executive Health Department (SEHD). It provides a case study in the introduction of a new health care worker role into an already well established and "mature" workforce configuration It assesses the role of US style physician assistants (PAs), as a precursor to planned "piloting" of the PA role within the National Health Service (NHS) in Scotland

A longitudinal cohort study of the relationship between Thimerosal-containing hepatitis B vaccination and specific delays in development in the United States: Assessment of attributable risk and lifetime care costs

AbstractEpidemiological evidence suggests a link between mercury (Hg) exposure from Thimerosal-containing vaccines and specific delays in development. A hypothesis-testing longitudinal cohort study (n=49,835) using medical records in the Vaccine Safety Datalink (VSD) was undertaken to evaluate the relationship between exposure to Hg from Thimerosal-containing hepatitis B vaccines (T-HBVs) administered at specific intervals in the first 6months of life and specific delays in development [International Classification of Disease, 9th revision (ICD-9): 315.xx] among children born between 1991 and 1994 and continuously enrolled from birth for at least 5.81years. Infants receiving increased Hg doses from T-HBVs administered within the first month, the first 2months, and the first 6months of life were significantly more likely to be diagnosed with specific delays in development than infants receiving no Hg doses from T-HBVs. During the decade in which T-HBVs were routinely recommended and administered to US infants (1991–2001), an estimated 0.5–1million additional US children were diagnosed with specific delays in development as a consequence of 25μg or 37.5μg organic Hg from T-HBVs administered within the first 6months of life. The resulting lifetime costs to the United States may exceed $1 trillion

A scale-down mimic for mapping the process performance of centrifugation, depth and sterile filtration

In the production of biopharmaceuticals disk-stack centrifugation is widely used as a harvest step for the removal of cells and cellular debris. Depth filters followed by sterile filters are often then employed to remove residual solids remaining in the centrate. Process development of centrifugation is usually conducted at pilot-scale so as to mimic the commercial scale equipment but this method requires large quantities of cell culture and significant levels of effort for successful characterization. A scale-down approach based upon the use of a shear device and a bench-top centrifuge has been extended in this work towards a preparative methodology that successfully predicts the performance of the continuous centrifuge and polishing filters. The use of this methodology allows the effects of cell culture conditions and large-scale centrifugal process parameters on subsequent filtration performance to be assessed at an early stage of process development where material availability is limited

Satellite-Derived Distributions, Inventories and Fluxes of Dissolved and Particulate Organic Matter Along the Northeastern U.S. Continental Margin

Estuaries and the coastal ocean experience a high degree of variability in the composition and concentration of particulate and dissolved organic matter (DOM) as a consequence of riverine and estuarine fluxes of terrigenous DOM, sediments, detritus and nutrients into coastal waters and associated phytoplankton blooms. Our approach integrates biogeochemical measurements, optical properties and remote sensing to examine the distributions and inventories of organic carbon in the U.S. Middle Atlantic Bight and Gulf of Maine. Algorithms developed to retrieve colored DOM (CDOM), Dissolved (DOC) and Particulate Organic Carbon (POC) from NASA's MODIS-Aqua and SeaWiFS satellite sensors are applied to quantify the distributions and inventories of DOC and POC. Horizontal fluxes of DOC and POC from the continental margin to the open ocean are estimated from SeaWiFS and MODIS-Aqua distributions of DOC and POC and horizontal divergence fluxes obtained from the Northeastern North Atlantic ROMS model. SeaWiFS and MODIS imagery reveal the importance of estuarine outflow to the export of CDOM and DOC to the coastal ocean and a net community production of DOC on the shelf

Cue-Induced Dopamine Release Predicts Cocaine Preference: Positron Emission Tomography Studies in Freely Moving Rodents

Positron emission tomography studies in drug-addicted patients have shown that exposure to drug-related cues increases striatal dopamine, which displaces binding of the D2 ligand, [11C]-raclopride. However, it is not known if animals will also show cue-induced displacement of [11C]-raclopride binding. In this study, we use [11C]-raclopride imaging in awake rodents to capture cue-induced changes in dopamine release associated with the conditioned place preference model of drug craving. Ten animals were conditioned to receive cocaine in a contextually distinct environment from where they received saline. Following conditioning, each animal was tested for preference and then received two separate [11C]-raclopride scans. For each scan, animals were confined to the cocaine and/or the saline-paired environment for the first 25 min of uptake, after which they were anesthetized and scanned. [11C]-raclopride uptake in the saline-paired environment served as a within-animal control for uptake in the cocaine-paired environment. Cocaine produced a significant place preference (p = 0.004) and exposure to the cocaine-paired environment decreased [11C]-raclopride binding relative to the saline-paired environment in both the dorsal (20%; p < 0.002) and ventral striatum (22%; p < 0.05). The change in [11C]-raclopride binding correlated with preference in the ventral striatum (R2 = −0.87; p = 0.003). In this region, animals who showed little or no preference exhibited little or no change in [11C]-raclopride binding in the cocaine-paired environment. This noninvasive procedure of monitoring neurochemical events in freely moving, behaving animals advances preclinical molecular imaging by interrogating the degree to which animal models reflect the human condition on multiple dimensions, both biological and behavioral.Chemistry and Chemical Biolog

Noninvasive Determination of 2-[18F]-Fluoroisonicotinic Acid Hydrazide Pharmacokinetics by Positron Emission Tomography in Mycobacterium tuberculosis-Infected Mice

Tuberculosis (TB) is a global pandemic requiring sustained therapy to facilitate curing and to prevent the emergence of drug resistance. There are few adequate tools to evaluate drug dynamics within infected tissues in vivo. In this report, we evaluated a fluorinated analog of isoniazid (INH), 2-[18F]fluoroisonicotinic acid hydrazide (2-[18F]-INH), as a probe for imaging Mycobacterium tuberculosis-infected mice by dynamic positron emission tomography (PET). We developed a tail vein catheter system to safely deliver drugs to M. tuberculosis aerosol-infected mice inside sealed biocontainment devices. Imaging was rapid and noninvasive, and it could simultaneously visualize multiple tissues. Dynamic PET imaging demonstrated that 2-[18F]-INH was extensively distributed and rapidly accumulated at the sites of infection, including necrotic pulmonary TB lesions. Compared to uninfected animals, M. tuberculosis-infected mice had a significantly higher PET signal within the lungs (P 0.85), suggesting that 2-[18F]-INH accumulated at the site of the pulmonary infection. Furthermore, our data indicated that similar to INH, 2-[18F]-INH required specific activation and accumulated within the bacterium. Pathogen-specific metabolism makes positron-emitting INH analogs attractive candidates for development into imaging probes with the potential to both detect bacteria and yield pharmacokinetic data in situ. Since PET imaging is currently used clinically, this approach could be translated from preclinical studies to use in humans.Chemistry and Chemical Biolog

Introduction to the U.S. Department of Energy's Controlled Hydrogen Fleet and Infrastructure Demonstration and Validation Project

Early in 2003, the U.S. Department of Energy (DOE) initiated the ''Controlled Hydrogen Fleet and Infrastructure Demonstration and Validation Project'' solicitation. The purpose of this project is to examine the impact and performance of fuel cell vehicles and the requisite hydrogen infrastructure in real-world applications. The integrated nature of the project enables DOE to work with industry to test, demonstrate, and validate optimal system solutions. Information learned from the vehicles and infrastructure will be fed back into DOE's R&amp;D program to guide and refocus future research as needed, making this project truly a ''learning demonstration''

Introduction to the U.S. Department of Energy's Controlled Hydrogen Fleet and Infrastructure Demonstration and Validation Project

This presentation, which provides information on the U.S. Department of Energy's Controlled Hydrogen Fleet and Infrastructure Demonstration and Validation Project, was given at EVS-21 in April 2005.