Characterizing urinary hCG beta cf patterns during pregnancy

Objective: Elevated concentrations of hCG beta core fragment (hCG beta cf) are known to cause false-negative results in qualitative urine pregnancy test devices, but the pattern of urinary hCG beta cf during normal pregnancy has not been well characterized. Here, we evaluate the relationship between urine hCG, hCG beta cf, and hCG free beta subunit (hCG beta) during pregnancy. Design and methods: Banked second trimester urine specimens from 100 pregnant women were screened for high concentrations of hCG beta cf using a qualitative point-of-care device known to demonstrate false-negative results in the presence of elevated hCG beta cf concentrations. Additional first and third trimester specimens from the same pregnancy were obtained from 10 women who generated negative/faint positive results, 5 women who generated intermediate positive results, and 10 women who generated strong positive results on the point-of care device. Intact hCG, hCG beta cf, hCG beta, and specific gravity were quantified in these 75 specimens. Results: Urinary hCG beta cf concentrations were greater than intact hCG concentrations at all times. A strong correlation (r(2) = 0.70) was observed between urine intact hCG and hCG beta cf concentrations. A poor correlation was observed between specific gravity and intact hCG (r(2) = 0.32), hCG beta (r(2) = 0.32), and hCG beta cf (r(2) = 0.32). The highest hCG beta cf concentrations were observed between 10 and 16 weeks gestation but individual women demonstrated very different patterns of hCG beta cf excretion. Conclusions: Urine specimens with elevated hCG beta cf are frequently encountered during pregnancy but hCG beta cf excretion patterns are unpredictable. Manufacturers and clinicians must appreciate that hCG beta cf is the major immunoreactive component in urine during pregnancy and must design and interpret qualitative urine hCG test results accordingly. (C) 2016 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.Peer reviewe

Local generation of kynurenines mediates inhibition of neutrophil chemotaxis by uropathogenic Escherichia coli

During epithelial infections, pathogenic bacteria employ an array of strategies to attenuate and evade host immune responses, including the influx of polymorphonuclear leukocytes (PMN; neutrophils). Among the most common bacterial infections in humans are those of the urinary tract, caused chiefly by uropathogenic Escherichia coli (UPEC). During the establishment of bacterial cystitis, UPEC suppresses innate responses via multiple independent strategies. We recently described UPEC attenuation of PMN trafficking to the urinary bladder through pathogen-specific local induction of indoleamine 2,3-dioxygenase (IDO), a tryptophan catabolic enzyme previously shown to have regulatory activity only in adaptive immunity. Here, we investigated the mechanism by which IDO induction attenuates PMN migration. Local tryptophan limitation, by which IDO is known to influence T cell longevity and proliferation, was not involved in its effect on PMN trafficking. Instead, metabolites in the IDO pathway, particularly l-kynurenine, directly suppressed PMN transepithelial migration and induced an attached, spread morphology in PMN both at rest and in the presence of chemotactic stimuli. Finally, kynurenines represent known ligands of the mammalian aryl hydrocarbon receptor (AHR), and UPEC infection of Ahr(−/−) mice recapitulated the derepressed PMN recruitment observed previously in Ido1(−/−) mice. UPEC therefore suppresses neutrophil migration early in bacterial cystitis by eliciting an IDO-mediated increase in local production of kynurenines, which act through the AHR to impair neutrophil chemotaxis

The 100 most eminent psychologists of the 20th century.

A rank-ordered list was constructed that reports the first 99 of the 100 most eminent psychologists of the 20th century. Eminence was measured by scores on 3 quantitative variables and 3 qualitative variables. The quantitative variables were journal citation frequency, introductory psychology textbook citation frequency, and survey response frequency. The qualitative variables were National Academy of Sciences membership, election as American Psychological Association (APA) president or receipt of the APA Distinguished Scientific Contributions Award, and surname used as an eponym. The qualitative variables were quantified and combined with the other 3 quantitative variables to produce a composite score that was then used to construct a rank-ordered list of the most eminent psychologists of the 20th century. The discipline of psychology underwent a remarkable transformation during the 20th cen-tury, a transformation that included a shift away from the European-influenced philosophical psychology of the late 19th century to th

Why is it difficult to implement e-health initiatives? A qualitative study

<b>Background</b> The use of information and communication technologies in healthcare is seen as essential for high quality and cost-effective healthcare. However, implementation of e-health initiatives has often been problematic, with many failing to demonstrate predicted benefits. This study aimed to explore and understand the experiences of implementers - the senior managers and other staff charged with implementing e-health initiatives and their assessment of factors which promote or inhibit the successful implementation, embedding, and integration of e-health initiatives.<p></p> <b>Methods</b> We used a case study methodology, using semi-structured interviews with implementers for data collection. Case studies were selected to provide a range of healthcare contexts (primary, secondary, community care), e-health initiatives, and degrees of normalization. The initiatives studied were Picture Archiving and Communication System (PACS) in secondary care, a Community Nurse Information System (CNIS) in community care, and Choose and Book (C&B) across the primary-secondary care interface. Implementers were selected to provide a range of seniority, including chief executive officers, middle managers, and staff with 'on the ground' experience. Interview data were analyzed using a framework derived from Normalization Process Theory (NPT).<p></p> <b>Results</b> Twenty-three interviews were completed across the three case studies. There were wide differences in experiences of implementation and embedding across these case studies; these differences were well explained by collective action components of NPT. New technology was most likely to 'normalize' where implementers perceived that it had a positive impact on interactions between professionals and patients and between different professional groups, and fit well with the organisational goals and skill sets of existing staff. However, where implementers perceived problems in one or more of these areas, they also perceived a lower level of normalization.<p></p> <b>Conclusions</b> Implementers had rich understandings of barriers and facilitators to successful implementation of e-health initiatives, and their views should continue to be sought in future research. NPT can be used to explain observed variations in implementation processes, and may be useful in drawing planners' attention to potential problems with a view to addressing them during implementation planning

Radiographic parameters for diagnosing sand colic in horses

<p>Abstract</p> <p>Background</p> <p>Ingestion of sand can cause colic, diarrhoea and weight loss in horses, but these signs are unspecific and can have many other causes. The amount of sand that induces disease may vary between individuals. To avoid over-diagnosing, it is important to determine the amount of sand that can be found in horses without clinical signs of gastrointestinal disease. The aim of this study was to use previously suggested parameters for establishing a radiographic diagnosis of sand colic, and compare these findings between a sand colic group and a control group.</p> <p>Methods</p> <p>Abdominal radiographs were obtained in 30 horses with a complaint unrelated to the gastrointestinal tract. In addition, archived abdominal radiographs of 37 clinical cases diagnosed with sand impaction were investigated. The size of the mineral opacity indicative of sand in the abdomen was measured and graded according to a previously published protocol based on height and length. Location, homogeneity, opacity and number of sand accumulations were also recorded.</p> <p>Results</p> <p>Twenty out of 30 control horses (66%) had one or more sand accumulations. In the present study; height, length and homogeneity of the accumulations were useful parameters for establishing a diagnosis of sand colic. Radiographically defined intestinal sand accumulation grades of up to 2 was a common finding in horses with no clinical signs from the gastrointestinal tract whereas most of the clinical cases had much larger grades, indicating larger sand accumulations.</p> <p>Conclusion</p> <p>Further work to establish a reliable grading system for intestinal sand content is warranted, but a previously proposed grading system based on measurements of height and length may be an alternative for easy assessment of sand accumulations in the meantime. The present study indicates that a grade 1 – 2 sand accumulation in the intestine is a frequent finding in horses. When working up a case with clinical signs from the gastrointestinal tract, one or more accumulations of this grade should not be considered the cause until other possibilities have been ruled out.</p

SN 2021fxy: Mid-Ultraviolet Flux Suppression is a Common Feature of Type Ia Supernovae

We present ultraviolet (UV) to near-infrared (NIR) observations and analysis of the nearby Type Ia supernova SN 2021fxy. Our observations include UV photometry from Swift/UVOT, UV spectroscopy from HST/STIS, and high-cadence optical photometry with the Swope 1-m telescope capturing intra-night rises during the early light curve. Early $B-V$ colours show SN 2021fxy is the first "shallow-silicon" (SS) SN Ia to follow a red-to-blue evolution, compared to other SS objects which show blue colours from the earliest observations. Comparisons to other spectroscopically normal SNe Ia with HST UV spectra reveal SN 2021fxy is one of several SNe Ia with flux suppression in the mid-UV. These SNe also show blue-shifted mid-UV spectral features and strong high-velocity Ca II features. One possible origin of this mid-UV suppression is the increased effective opacity in the UV due to increased line blanketing from high velocity material, but differences in the explosion mechanism cannot be ruled out. Among SNe Ia with mid-UV suppression, SNe 2021fxy and 2017erp show substantial similarities in their optical properties despite belonging to different Branch subgroups, and UV flux differences of the same order as those found between SNe 2011fe and 2011by. Differential comparisons to multiple sets of synthetic SN Ia UV spectra reveal this UV flux difference likely originates from a luminosity difference between SNe 2021fxy and 2017erp, and not differing progenitor metallicities as suggested for SNe 2011by and 2011fe. These comparisons illustrate the complicated nature of UV spectral formation, and the need for more UV spectra to determine the physical source of SNe Ia UV diversity.Comment: 26 pages, 19 figures, 9 tables; submitted to MNRAS, posted after receiving referee comment

Design and construction of the MicroBooNE Cosmic Ray Tagger system

The MicroBooNE detector utilizes a liquid argon time projection chamber (LArTPC) with an 85 t active mass to study neutrino interactions along the Booster Neutrino Beam (BNB) at Fermilab. With a deployment location near ground level, the detector records many cosmic muon tracks in each beam-related detector trigger that can be misidentified as signals of interest. To reduce these cosmogenic backgrounds, we have designed and constructed a TPC-external Cosmic Ray Tagger (CRT). This sub-system was developed by the Laboratory for High Energy Physics (LHEP), Albert Einstein center for fundamental physics, University of Bern. The system utilizes plastic scintillation modules to provide precise time and position information for TPC-traversing particles. Successful matching of TPC tracks and CRT data will allow us to reduce cosmogenic background and better characterize the light collection system and LArTPC data using cosmic muons. In this paper we describe the design and installation of the MicroBooNE CRT system and provide an overview of a series of tests done to verify the proper operation of the system and its components during installation, commissioning, and physics data-taking