Building the bridge as you walk on it

Excellent leadership means doing things that are not normal.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/35210/1/97_ftp.pd

Rubella Immunization of Adult Females Using HPV-77 DK-12 Live Attenuated Rubella Virus

This study demonstrates the serologic response as measured by the HAl test and the side reactions of the HPV-77 DK-12 live rubella vaccine in a small group of adult females. One hundred percent seroconversion was obtained using this vaccine. The mean titers obtained in two separate time periods post-vaccination are higher than those reported for several other rubella virus vaccines. A 66% occurrence of joint symptomatology was recorded post-vaccination with a mean duration of 11.6 days; 24% of women who received placebo reported joint complaints which had a mean duration of 2.0 days. The difference between these two rates is somewhat greater than that reported for other HPV-77 strain vaccines and the average duration of these complaints is longer. The other symptoms reported postvaccination seemed insignificant when comparing both the placebo and the vaccine group. One woman became pregnant three months after vaccination and was subsequently therapeutically aborted. At the time of therapeutic abortion, attempts were unsuccessful to recover rubella virus from the products of conception and cervical swabs

A Competing Values Framework for Analyzing Presentational Communication in Management Contexts

Communication specialists have long been interested in analyzing messages. More recently, they have stressed the need for evaluative tools that account for situational ex pectations and constraints. Drawing from the literature on organizational and managerial effectiveness, we constructed an empirical model applicable to presenta tional communication. Over 100 communication professors evaluated the relevance of descriptors for six different types of business presentations: three oral and three writ ten. Their judgments were used to create similarity scores, which were submitted to multidimensional scaling. A three-dimensional model emerged. This "competing values model" illustrates the dynamic interplay between the highly contrasting charac teristics of four general types of presentational communication: relational, information al, instructional, and transformational. In conclusion, we discuss the benefits of the model and suggest its usefulness as an evaluative tool, particularly for the training of managers.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68906/2/10.1177_002194369102800303.pd

A Winogradsky-based culture system shows an association between microbial fermentation and cystic fibrosis exacerbation.

There is a poor understanding of how the physiology of polymicrobial communities in cystic fibrosis (CF) lungs contributes to pulmonary exacerbations and lung function decline. In this study, a microbial culture system based on the principles of the Winogradsky column (WinCF system) was developed to study the physiology of CF microbes. The system used glass capillary tubes filled with artificial sputum medium to mimic a clogged airway bronchiole. Chemical indicators were added to observe microbial physiology within the tubes. Characterization of sputum samples from seven patients showed variation in pH, respiration, biofilm formation and gas production, indicating that the physiology of CF microbial communities varied among patients. Incubation of homogenized tissues from an explant CF lung mirrored responses of a Pseudomonas aeruginosa pure culture, supporting evidence that end-stage lungs are dominated by this pathogen. Longitudinal sputum samples taken through two exacerbation events in a single patient showed that a two-unit drop in pH and a 30% increase in gas production occurred in the tubes prior to exacerbation, which was reversed with antibiotic treatment. Microbial community profiles obtained through amplification and sequencing of the 16S rRNA gene showed that fermentative anaerobes became more abundant during exacerbation and were then reduced during treatment where P. aeruginosa became the dominant bacterium. Results from the WinCF experiments support the model where two functionally different CF microbial communities exist, the persistent Climax Community and the acute Attack Community. Fermentative anaerobes are hypothesized to be the core members of the Attack Community and production of acidic and gaseous products from fermentation may drive developing exacerbations. Treatment targeting the Attack Community may better resolve exacerbations and resulting lung damage

Airborne sampling of aerosol particles: Comparison between surface sampling at Christmas Island and P-3 sampling during PEM-Tropics B

Bulk aerosol sampling of soluble ionic compounds from the NASA Wallops Island P-3 aircraft and a tower on Christmas Island during PEM-Tropics B provides an opportunity to assess the magnitude of particle losses in the University of New Hampshire airborne bulk aerosol sampling system. We find that most aerosol-associated ions decrease strongly with height above the sea surface, making direct comparisons between mixing ratios at 30 m on the tower and the lowest flight level of the P-3 (150 m) open to interpretation. Theoretical considerations suggest that vertical gradients of sea-salt aerosol particles should show exponential decreases with height. Observed gradients of Na+ and Mg2+, combining the tower observations with P-3 samples collected below 1 km, are well described by exponential decreases (r values of 0.88 and 0.87, respectively), though the curve fit underestimates average mixing ratios at the surface by 25%. Cascade impactor samples collected on the tower show that \u3e99% of the Na+ and Mg2+mass is on supermicron particles, 65% is in the 1–6 micron range, and just 20% resides on particles with diameters larger than 9 microns. These results indicate that our airborne aerosol sampling probes must be passing particles up to at least 6 microns with high efficiency. We also observed that nss SO42− and NH4+, which are dominantly on accumulation mode particles, tended to decrease between 150 and 1000 m, but they were often considerably higher at the lowest P-3 sampling altitudes than at the tower. This finding is presently not well understood

Incident and long-term opioid therapy among patients with psychiatric conditions and medications: a national study of commercial health care claims

There is growing evidence that opioid prescribing in the United States follows a pattern in which patients who are at the highest risk of adverse outcomes from opioids are more likely to receive long-term opioid therapy. These patients include, in particular, those with substance use disorders (SUDs) and other psychiatric conditions. This study examined health insurance claims among 10,311,961 patients who filled prescriptions for opioids. Specifically, we evaluated how opioid receipt differed among patients with and without a wide range of preexisting psychiatric and behavioral conditions (ie, opioid and nonopioid SUDs, suicide attempts or other self-injury, motor vehicle crashes, and depressive, anxiety, and sleep disorders) and psychoactive medications (ie, antidepressants, benzodiazepines, hypnotics, mood stabilizers, antipsychotics, and medications used for SUD, tobacco cessation, and attention-deficit/hyperactivity disorder). Relative to those without, patients with all assessed psychiatric conditions and medications had modestly greater odds of subsequently filling prescriptions for opioids and, in particular, substantially greater risk of long-term opioid receipt. Increases in risk for long-term opioid receipt in adjusted Cox regressions ranged from approximately 1.5-fold for prior attention-deficit/hyperactivity disorder medication prescriptions (hazard ratio [HR] = 1.53; 95% confidence interval [CI], 1.48-1.58) to approximately 3-fold for prior nonopioid SUD diagnoses (HR = 3.15; 95% CI, 3.06-3.24) and nearly 9-fold for prior opioid use disorder diagnoses (HR = 8.70; 95% CI, 8.20-9.24). In sum, we found evidence of greater opioid receipt among commercially insured patients with a breadth of psychiatric conditions. Future studies assessing behavioral outcomes associated with opioid prescribing should consider preexisting psychiatric conditions