Discrimination, Lending Practices and Housing Values: Preliminary Evidence from the Houston Market

At the center of the debate on racially induced price differentials in housing is the issue of discrimination. This research studies the impact that ethnic as well as racial composition in a neighborhood exerts on value. In an attempt to extend previous efforts, aggregate data is used to study the effects of discrimination and lending bias on residential real estate in Houston, Texas. The data do not support allegations of systematic bias in the mortgage lending process.

Clinical Findings in Patients with Splenic Injuries: Are Injuries to the Left Lower Chest Important?

The purpose of this study was to describe the clinical findings in patients with splenic injury and to determine if isolated left lower chest injury may be the single clinical indicator of splenic injury. The medical records of all adult blunt trauma patients with splenic injury over a 14 month period were reviewed. Significant left lower chest injury was considered present if the patient had left sided pleuritic chest pain with tenderness to ribs 7-12 or if these ribs were visualized as fractured on any imaging study. Patients were considered to have clinical findings suggestive of splenic injury if they had pre-hospital or emergency department hypotension, abdominal pain or tenderness, a Glasgow coma scale < 15, or gross hematuria. Ninety patients had splenic injury. Thirty-nine (43%. 95% CI 33, 54%) patients had significant left lower chest injury. In five (6%. 95% CI 2, 12%) patients, injury to this portion of the chest was the single indicator of splenic injury. Nearly half the patients with splenic injury will have significant injury to the left lower chest and this finding may be the only indicator of splenic injury

Quantum and classical chaos for a single trapped ion

In this paper we investigate the quantum and classical dynamics of a single trapped ion subject to nonlinear kicks derived from a periodic sequence of Guassian laser pulses. We show that the classical system exhibits diffusive growth in the energy, or 'heating', while quantum mechanics suppresses this heating. This system may be realized in current single trapped-ion experiments with the addition of near-field optics to introduce tightly focussed laser pulses into the trap.Comment: 8 pages, REVTEX, 8 figure

Wound Botulism in Injection Drug Users: Time to Antitoxin Correlates with Intensive Care Unit Length of Stay

Objectives: We sought to identify factors associated with need for mechanical ventilation (MV), length of intensive care unit (ICU) stay, length of hospital stay, and poor outcome in injection drug users (IDUs) with wound botulism (WB).Methods: This is a retrospective review of WB patients admitted between 1991-2005. IDUs were included if they had symptoms of WB and diagnostic confirmation. Primary outcome variables were the need for MV, length of ICU stay, length of hospital stay, hospital-related complications, and death.Results: Twenty-nine patients met inclusion criteria. Twenty-two (76%) admitted to heroin use only and seven (24%) admitted to heroin and methamphetamine use. Chief complaints on initial presentation included visual changes, 13 (45%); weakness, nine (31%); and difficulty swallowing, seven (24%). Skin wounds were documented in 22 (76%). Twenty-one (72%) patients underwent mechanical ventilation (MV). Antitoxin (AT) was administered to 26 (90%) patients but only two received antitoxin in the emergency department (ED). The time from ED presentation to AT administration was associated with increased length of ICU stay (Regression coefficient = 2.5; 95% CI 0.45, 4.5). The time from ED presentation to wound drainage was also associated with increased length of ICU stay (Regression coefficient = 13.7; 95% CI = 2.3, 25.2). There was no relationship between time to antibiotic administration and length of ICU stay.Conclusion: MV and prolonged ICU stays are common in patients identified with WB. Early AT administration and wound drainage are recommended as these measures may decrease ICU length of stay.[West J Emerg Med. 2009;10(4):251-256.

Use of a penicillin allergy clinical decision rule to enable direct oral penicillin provocation: an international multicentre randomised control trial in an adult population (PALACE): study protocol

Introduction Penicillin allergies are highly prevalent in the healthcare setting and associated with the prescription of second-line inferior antibiotics. More than 85% of all penicillin allergy labels can be removed by skin testing and 96%–99% of low-risk penicillin allergy labels can be removed by direct oral challenge. An internally and externally validated clinical assessment tool for penicillin allergy, PEN-FAST, can identify a low-risk penicillin allergy without the need for skin testing; a score of less than 3 has a negative predictive value of 96.3% (95% CI, 94.1 to 97.8) for the presence of a penicillin allergy. It is hypothesised that PEN-FAST is a safe and effective tool for assessing penicillin allergy in an outpatient clinic setting. Methods and analysis This is an international, multicentre randomised control trial using the PEN-FAST tool to risk-stratify penicillin allergy labels in adult outpatients. The study’s primary objective is to evaluate the non-inferiority of using PEN-FAST score-guided management with direct oral challenge compared with standard care (defined as prick and intradermal skin testing followed by oral penicillin challenge). Participants will be randomised 1:1 to the intervention arm (direct oral penicillin challenge) or standard of care arm (skin testing followed by oral penicillin challenge, if skin testing is negative). The sample size of 380 randomised patients (190 per treatment arm) is required to demonstrate non-inferiority. Ethics and dissemination The study will be performed according to the guidelines of the Helsinki Declaration and is approved by the Austin Health Human Research Ethics Committee (HREC/62425/Austin-2020) in Melbourne Australia, Vanderbilt University Institutional Review Board (IRB #202174) in Tennessee, USA, Duke University Institutional Review Board (IRB #Pro00108461) in North Carolina, USA and McGill University Health Centre Research Ethics Board in Canada (PALACE/2022-7605). The results of this study will be published and presented in various scientific forums

Spring 1971

Damage to the GOlf Course by James L. HOlmes (page 3) Editorial (7) Turf Bulletin\u27s Photo Quiz by Frederick G. Cheney (7) Pesticide Waste Disposal by R.G. Novak and O.H. Hammer (8) 1971 Turf Conference Program (12-13) Turf Management by A.J. Powell, Jr. (14) Homeowner\u27s Guide for Spring Lawn Care (16) The Role of Shade Trees in Urban Arboriculture by Malcolm A. McKenzie (17) Locating Cause of Pressure Loss in Power Sprayers (18) How Soil pH is Affected by the Fertilizers You Use by F.E. Hutchinson (20

Inverse Agonist Action of Leu-Enkephalin at ␦ 2 -Opioid Receptors Mediates Spinal Antianalgesia

ABSTRACT Dynorphin A(1-17) given intrathecally releases spinal cholecystokinin to produce an antianalgesic action against spinal morphine in the tail-flick test in CD-1 mice. The present study showed that following the cholecystokinin step, a ␦ 2 -opioid inverse agonist action of Leu-enkephalin (LE), was involved. Pretreatment with intrathecal LE antiserum eliminated dynorphin and cholecystokinin-8s antianalgesia. A small dose of LE intrathecally produced antianalgesia that like that from dynorphin A(1-17) and cholecystokinin was eliminated by naltriben but not 7-benzylidenenaltrexone (␦ 2 -and ␦ 1 -opioid receptor antagonist, respectively). This ]-Leu-enkephalin-Thr analgesia was not attenuated by LE; thus, this ␦ 2 -analgesic agonist and LE inverse agonist action did not occur through competition at the same ␦ 2 -receptor in CD-1 mice. In CD-1 mice, a linear sequence of dynorphin A(1-17) 3 cholecystokinin 3 LE 3 NMDA receptors was indicated: cholecystokinin antiserum inhibited cholecystokinin but not LE; naltriben inhibited LE but not NMDA. The uniqueness of LE in linking dynorphin A(1-17), cholecystokinin, ␦ 2 -opioid, and NMDA receptor activation may unify the separate known mechanisms involved in the antiopioid actions of these components against morphine