A Glacier Runs Through It: Effects of Late Wisconsinan Glaciation on Stream Drainage Near the Terminal Moraine Boundary in North Central Pennsylvania

Stream morphology in north central Pennsylvania has been influenced by the passage of multiple glaciers during the Quaternary period, and most recently by the Late Wisconsinan ice sheet which began to recede just 10,000 years ago. While glaciers can take a heavy erosive toll on the landscape, the Late Wisconsinan and previous glaciers stopped when they reached Pennsylvania, and as such were not as thick and did not cover the ground as long as in regions to the north. This paper examines current morphology in an area along the north central part of the state that contains both glaciated and non-glaciated regions. The research is intended to show the degree of impact from Wisconsinan glaciation on stream drainage, as well as the extent to which this impact can be spatially seen

The Effect of Body Position on Distortion Product Otoacoustic Emissions Testing in Neonates

The current study investigated the effects of body position on the measurement of distortion product otoacoustic emissions (DPOAEs) in newborns. DPOAE measurements are commonly used to screen for hearing loss in newborn hearing screening programs conducted in hospitals nationwide. To measure DPOAEs, a small probe is placed in the external ear canal and a series of tone pairs is presented to the ear. The ear's acoustic response to these tones is measured to determine if the infant is at risk for a hearing loss. Research in adults has indicated effects of body position on DPOAE levels and noise floor levels (Driscoll et al., 2004). However, no information is available on the effects of body position on DPOAE testing in infants, despite the fact that newborn screening is one of the primary clinical applications of DPOAEs. Participants were 47 full-term newborns recruited from the well-baby nursery. DPOAEs were measured from the right ear while the infants were in each of three body positions: lying on the left side, supine, and head raised 45 degrees from supine. DPOAE levels, noise floor levels, DPOAE/noise levels, test time, and pass/fail rate were compared across body positions to determine whether there is an optimal body position for newborn hearing screenings that would minimize test time and/or increase specificity. No statistically significant differences were found in the various DPOAE measures or screening results across body positions or between genders. Significant effects of frequency on DPOAE levels and noise floor levels were similar to those expected based on the literature (e.g., Gorga et al., 1993). The results suggest that newborn hearing screenings on infants in the well-baby nursery can be conducted in different body positions without significantly influencing the screening outcome or measurements obtained

Multiple Endocrine Neoplasia 2a Presenting with Pheochromocytoma and Pituitary Macroadenoma

Multiple Endocrine Neoplasia type 2A (MEN-2a) is a rare disease associated with tumors of endocrine organs. Presentation most commonly is with medullary thyroid cancer and infrequently with other complaints. Pituitary adenoma has been seen coincidentally with this disease very rarely. Presented is a case of coincident MEN-2a with a symptomatic pituitary adenoma and an asymptomatic pheochromocytoma. A brief review is also provided

Inexpensive Equipment for the Preparation and Concentration of Pure D2O or of Deuterium-Rich Water. Description of Construction and Operation of the Former Ohio State University Heavy Water Plant

Author Institution: The Ohio State Universit

60 kD Ro and nRNP A Frequently Initiate Human Lupus Autoimmunity

Systemic lupus erythematosus (SLE) is a clinically heterogeneous, humoral autoimmune disorder. The unifying feature among SLE patients is the production of large quantities of autoantibodies. Serum samples from 129 patients collected before the onset of SLE and while in the United States military were evaluated for early pre-clinical serologic events. The first available positive serum sample frequently already contained multiple autoantibody specificities (65%). However, in 34 SLE patients the earliest pre-clinical serum sample positive for any detectable common autoantibody bound only a single autoantigen, most commonly 60 kD Ro (29%), nRNP A (24%), anti-phospholipids (18%) or rheumatoid factor (15%). We identified several recurrent patterns of autoantibody onset using these pre-diagnostic samples. In the serum samples available, anti-nRNP A appeared before or simultaneously with anti-nRNP 70 K in 96% of the patients who had both autoantibodies at diagnosis. Anti-60 kD Ro antibodies appeared before or simultaneously with anti-La (98%) or anti-52 kD Ro (95%). The autoantibody response in SLE patients begins simply, often binding a single specific autoantigen years before disease onset, followed by epitope spreading to additional autoantigenic specificities that are accrued in recurring patterns

Successful Removal of a Penile Constriction Ring in a 14-Year-Old Male

Penile strangulation is a rarely described medical emergency, especially in the adolescent population. This case demonstrates the successful removal of a constricting metal ring from the penis of a 14-year-old male with a diamond blade equipped orthopedic oscillating saw while under ketamine anesthesia in the emergency department

Early clinical features in Systemic Lupus Erythematosus: can they be used to achieve earlier diagnosis?: a risk prediction model

OBJECTIVES: 1) To compare the primary care consulting behaviour prior to diagnosis of people with Systemic Lupus Erythematosus (SLE) with controls, 2) to develop and validate a risk prediction model to aid earlier SLE diagnosis. METHODS: 1,739 incident SLE cases practice-matched to 6,956 controls from the UK Clinical Practice Research Datalink. Odds ratios were calculated for age, gender, consultation rates, selected presenting clinical features and previous diagnoses in the 5 years preceding diagnosis date using logistic regression. A risk prediction model was developed from pre-selected variables using backward stepwise logistic regression. Model discrimination and calibration were tested in an independent validation cohort of 1,831,747 patients. RESULTS: People with SLE had a significantly higher consultation rate than controls (median 9.2 vs 3.8/year) which was in part attributable to clinical features that occur in SLE. The final risk prediction model included the variables age, gender, consultation rate, arthralgia or arthritis, rash, alopecia, sicca, Raynaud's, serositis and fatigue. The model discrimination and calibration in the validation sample was good (Receiver operator characteristic curve: 0.75, 95% CI 0.73-0.78). However, absolute risk predictions for SLE were typically less than 1% due to the rare nature of SLE. CONCLUSIONS: People with SLE consult their GP more frequently and with clinical features attributable to SLE in the five years preceding diagnosis, suggesting that there are potential opportunities to reduce diagnostic delay in primary care. A risk prediction model was developed and validated which may be used to identify people at risk of SLE in future clinical practice. This article is protected by copyright. All rights reserved

Mapping an epitope in EBNA-1 that is recognized by monoclonal antibodies to EBNA-1 that cross-react with dsDNA

Introduction: The Epstein Barr Virus (EBV) has been associated with the autoimmune disease, Systemic Lupus Erythematosus (SLE). EBV nuclear antigen-I (EBNA-1) is the major nuclear protein of EBV. We previously generated an IgG monoclonal antibody (MAb) to EBNA-1, 3D4, and demonstrated that it crossreacts with double stranded DNA (dsDNA) and binds the 148 amino acid viral binding site (VBS) in the carboxyl region of EBNA-1. The aim of the present study was to characterize another antibody to EBNA-1 that cross-reacts with dsDNA, compare its immunoglobulin genes to 3D4, and finely map the epitope in EBNA-1 that is recognized by these cross-reactive antibodies. Methods: We generated an IgM MAb to EBNA-1, 16D2, from EBNA-1 injected mice and demonstrated by ELISA that it cross-reacts with dsDNA and binds the 148 amino acid VBS. We sequenced the variable heavy and light chain genes of 3D4 and 16D2 and compared V gene usage. To more finely map the epitope in EBNA-1 recognized by these MAbs, we examined their binding by ELISA to 15 overlapping peptides spanning the 148 amino acid domain. Results: Sequence analysis revealed that 3D4 and 16D2 utilize different VH and VL genes but identical JH and Jk regions with minimal junctional diversity. This accounts for similarities in their CDR3 regions and may explain their similar dual binding specificity. Epitope mapping revealed 3D4 and 16D2 bind the same peptide in the VBS. Based on the crystal structure of EBNA-1, we observed that this peptide resides at the base of an exposed proline rich loop in EBNA-1. Conclusion: We have demonstrated that two MAbs that bind EBNA-1 and crossreact with dsDNA, recognize the same peptide in the VBS. This peptide may serve as a mimetope for dsDNA and may be of diagnostic and therapeutic value in SLE

Anamneses-Based Internet Information Supply: Can a Combination of an Expert System and Meta-Search Engine Help Consumers find the Health Information they Require?

An increasing number of people search for health information online. During the last 10 years various researchers have determined the requirements for an ideal consumer health information system. The aim of this study was to figure out, whether medical laymen can find a more accurate diagnosis for a given anamnesis via the developed prototype health information system than via ordinary internet search