Detecting cheating in written medical examinations by statistical analysis of similarity of answers: pilot study

OBJECTIVE

To assess whether a computer program using a variant of Angoff's method can detect anomalous behaviour indicative of cheating in multiple choice medical examinations.

DESIGN

Statistical analysis of 11 examinations held by the Royal College of Paediatrics and Child Health.

SETTING

UK postgraduate medical examination.

PARTICIPANTS

Examination candidates.

MAIN OUTCOME MEASURES

Detection of anomalous candidate pairs by regression of similarity of correct answers in all possible pairs of candidates on the overall proportion of correct answers. Anomalous pairs were subsequently assessed in terms of examination centres and the seating plan of candidates, to assess adjacency.

RESULTS

The 11 examinations were taken by a total of 11,518 candidates, and Acinonyx examined 6,178,628 pairs of candidates. Two examinations showed no anomalies, and one examination found an anomaly resulting from a scanning error. The other eight examinations showed 13 anomalies compatible with cheating, and in each pair the two candidates had sat the examination at the same centre, and for six examinations with seating plans, the candidates in the anomalous pairs had been seated side by side. The raw probabilities of the anomalies varied from 3.9x10(-11) to 9.3x10(-30) (median = 1.1x10(-17)), with Bonferroni-corrected probabilities in the range 2.4x10(-5) to 4.1x10(-24) (median = 1.6x10(-11)). This suggests that one anomalous pair is found for every 1000 or so candidates taking this postgraduate examination.

CONCLUSIONS

This statistical technique identified a small proportion of candidates who had very similar patterns of correctly answered questions. The likelihood is that one candidate has copied from the other, or that there was collusion, or that a technical error occurred in the exams department (as happened in a single case). Analysis of similarities can be used to identify cheating and as part of the quality assurance process of postgraduate medical examinations.

Biogeographical concordance and efficiency of taxon indicators for establishing conservation priority in a tropical rainforest biota

Prioritizing areas for conservation requires the use of surrogates for assessing overall patterns of biodiversity. Effective surrogates will reflect general biogeographical patterns and the evolutionary processes that have given rise to these and their efficiency is likely to be influenced by several factors, including the spatial scale of species turnover and the overall congruence of the biogeographical history. We examine patterns of surrogacy for insects, snails, one family of plants and vertebrates from rainforests of northeast Queensland, an area characterized by high endemicity and an underlying history of climate-induced vicariance. Nearly all taxa provided some level of prediction of the conservation values for others. However, despite an overall correlation of the patterns of species richness and complementarity, the efficiency of surrogacy was highly asymmetric; snails and insects were strong predictors of conservation priorities for vertebrates, but not vice versa. These results confirm predictions that taxon surrogates can be effective in highly diverse tropical systems where there is a strong history of vicariant biogeography, but also indicate that correlated patterns for species richness and/or complementarity do not guarantee that one taxon will be efficient as a surrogate for another. In our case, the highly diverse and narrowly distributed invertebrates were more efficient as predictors than the less diverse and more broadly distributed vertebrates.

Plasma lipids and cardiovascular risk: a POSCH report. Program on the Surgical Control of the Hyperlipidemias

Quantifying the relationship between changes in lipid variables and clinical endpoints has been difficult. We studied the predictive value of various lipid variables on three endpoints in the Program on the Surgical Control of the Hyperlipidemias (POSCH): overall mortality, coronary heart disease (CHD) mortality, and CHD mortality and confirmed nonfatal myocardial infarction (MI) combined. We measured lipid variables for the annual visits from baseline to 5 years for actual follow-up values, actual and percentage differences between baseline and follow-up values, as well as the parameters comparing baseline only to 5 years for actual differences, percentage differences, and the ratio of baseline to 5 years. The lipid variables included were total cholesterol, low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol, very low density lipoprotein (VLDL) cholesterol, triglycerides, and the LDL cholesterol/HDL cholesterol ratio. The analytic method used was that of Cox regression, with age and sex as secondary covariates, and each lipid or ratio of lipids as the primary (univariate) covariate. As a result, 108 univariate Cox regressions were conducted. The combined findings for the control and the intervention groups are presented. The number of events for the combined group were: overall mortality, 190; CHD mortality, 119; and CHD mortality and confirmed nonfatal MI, 262. The highest hazard ratios were found for the lipid variable of the LDL cholesterol/HDL cholesterol ratio (e.g. 1.196 for a 1-unit increase). Only for the combined endpoint of CHD mortality and confirmed nonfatal MI was there a substantial number of statistically significant relationships (P<0.01) of lipid variables and parameters of assessment.

Carcass traits, cut yields, and compositional end points in high-lean-yielding pork carcasses: effects of 10th rib backfat and loin eye area

Pork carcasses (n = 133) were used to investigate the influence of carcass fatness and muscling on composition and yields of pork primal and subprimal cuts fabricated to varying levels of s.c. fat. Carcasses were selected from commercial packing plants in the southeastern United States, using a 3 x 3 factorial arrangement with three levels of 10th rib backfat depth (< 2.03, 2.03 to 2.54, and > 2.54 cm) and three levels of loin eye area (LEA; < 35.5, 35.5 to 41.9, and > 41.9 cm2). Sides from the selected carcasses were shipped to the University of Georgia for carcass data collection by trained USDA-AMS and University of Georgia personnel and fabrication. Sides were fabricated to four lean cuts (picnic shoulder, Boston butt, loin, and ham) and the skinned belly. The four lean cuts were further fabricated into boneless cuts with s.c. fat trim levels of 0.64, 0.32, and 0 cm. The percentages of four lean cuts, boneless cuts (four lean cuts plus skinned, trimmed belly) at 0.64, 0.32, and 0 cm s.c. fat, fat-free lean, and total fat were calculated. Data were analyzed using a least squares fixed effects model, with the main effects of 10th rib backfat and LEA and their interaction. Fatness and muscling traits increased (P < 0.05) as 10th rib backfat and LEA category increased, respectively. However, fat depth measures were not affected greatly by LEA category, nor were muscling measures greatly affected by backfat category. The percentage yield of cuts decreased (P < 0.05) as backfat category increased. Cut yields from the picnic shoulder, Boston butt, and belly were not affected (P > 0.05) by LEA category, whereas the yield of boneless loin and ham increased (P < 0.05) as LEA category increased. Compositionally, the percentage of four lean cuts, boneless cuts at varying trim levels, and fat-free lean decreased incrementally (P < 0.05) as backfat depth increased, whereas parentage total fat and USDA grade increased (P < 0.05) as backfat depth increased. As LEA increased, percentage boneless cuts trimmed to 0.32 and 0 cm s.c. fat and fat-free lean increased and total fat decreased; however, the difference was only significant in the smallest LEA category. Collectively, these data show that decreased carcass fatness plays a greater role in increasing primal and subprimal cut yields and carcass composition than muscling even in lean, heavily muscled carcasses.

Retinal ganglion cell axon guidance in the mouse optic chiasm: expression and function of robos and slits

The ventral midline of the nervous system is an important choice point at which growing axons decide whether to cross and project contralaterally or remain on the same side of the brain. In Drosophila, the decision to cross or avoid the CNS midline is controlled, at least in part, by the Roundabout (Robo) receptor on the axons and its ligand, Slit, an inhibitory extracellular matrix molecule secreted by the midline glia. Vertebrate homologs of these molecules have been cloned and have also been implicated in regulating axon guidance. Using in situ hybridization, we have determined the expression patterns of robo1,2 and slit1,2,3 in the mouse retina and in the region of the developing optic chiasm, a ventral midline structure in which retinal ganglion cell (RGC) axons diverge to either side of the brain. The receptors and ligands are expressed at the appropriate time and place, in both the retina and the ventral diencephalon, to be able to influence RGC axon guidance. In vitro, slit2 is inhibitory to RGC axons, with outgrowth of both ipsilaterally and contralaterally projecting axons being strongly affected. Overall, these results indicate that Robos and Slits alone do not directly control RGC axon divergence at the optic chiasm and may additionally function as a general inhibitory guidance system involved in determining the relative position of the optic chiasm at the ventral midline of the developing hypothalamus.

Effectiveness of two cooking systems in destroying Escherichia coli O157:H7 and Listeria monocytogenes in ground beef patties

A rapid, high-temperature double-sided grilling-broiling (DGB) system was compared to a single-sided broiling (SSB) system for cooking of foodservice ground beef patties to reduce microbial numbers and maintain textural quality. Patties (110 g) containing either Escherichia coli O157:H7 or Listeria monocytogenes (10(6-7) CFU/g) were cooked to target internal temperatures of 60 or 68 degrees C on each cooking system and immediately removed from the grills without the additional holding time at 60 or 68 degrees C that is recommended for foodservice cooking of ground beef patties. Actual final internal temperature attained, position on the grill, degree of doneness, cooking time, after-cook weight, texture characteristics, and bacterial counts of the patties were monitored. The DGB reduced E. coli O157:H7 and L. monocytogenes populations in ground beef patties by 5.7 log10 and 5.4 log10 CFU/g, respectively, when cooked to a target temperature of 60 degrees C (actual final internal temperature of 71.2 degrees C) and by 6.1 log10 and 5.6 log10 CFU/g, respectively, when cooked to a target temperature of 68 degrees C (actual final internal temperature of 75.8 degree C). The SSB reduced E. coli O157:H7 and L. monocytogenes populations by 1.3 log10 and 1.8 log10 CFU/g, respectively, when cooked to a target temperature of 60 degrees C (actual final internal temperature of 62.7 degrees C) and by 2.9 log10 and 3.6 log10 CFU/g, respectively, when cooked to a target temperature of 68 degrees C (actual final internal temperature of 69.3 degrees C). The DGB system effected a higher, more rapid temperature increase in patties cooked to either target temperature compared to the SSB system. This higher temperature was more effective in destroying pathogens in beef patties. Texture analyses determined that patties cooked on the DGB system had significantly higher values for springiness, adhesiveness, and product height as compared to the SSB system, and patties cooked on either system had significantly higher hardness, gumminess, chewiness, and product height values at the target temperature of 68 degrees C as compared to 60 degrees C.

Identification of optimal ranges in ribeye area for portion cutting of beef steaks

Restaurant-ready (21-d aged, needle tenderized) loin steaks (strip, S; and T-bone, TB) representing three portion sizes (227, 284, and 340 g for S; 397, 454, and 510 g for TB) were portioned from 71 low-Choice beef carcasses representing seven ribeye size groups (70.9 cm2 and less to 103.2 cm2 and greater, in 6.3-cm2 increments). Steaks (n = 568) were cooked on a grooved grill to temperatures of either 67 or 77 degrees C and evaluated for cooking characteristics, sensory attributes (n = 284), and shear force (n = 284) to identify optimal ribeye areas for portioned steaks. As expected, thickness of all portioned steaks decreased (P < .05) as ribeye size increased, whereas thickness of steaks increased (P < .05) as portion size increased. The S were significantly thicker than TB. The TB cooked faster (P < .05) than did S for ribeye areas 77.4 to 83.8 cm2 in the average portion sizes and for ribeye areas 71.0 to 96.6 cm2 in the large portion sizes. However, S cooked significantly faster than did TB for ribeye areas less than 70.9 cm2 in the average portion sizes. The S had higher (P < .05) initial tenderness scores and lower (P < .05) shear values than did TB. Initial tenderness scores were lower (P < .05) for ribeye areas greater than 103.2 cm2 compared with ribeye areas less than 83.8 cm2 and 90.3 to 96.6 cm2, with all others being intermediate. Shear force tended (P = .08) to follow the initial tenderness results. The S cooked to both end point temperatures, and TB cooked to 67 degrees C had higher (P < .05) initial tenderness scores than did TB cooked to 77 degrees C. Tenderness was reduced in TB cooked to higher temperatures as well as in S and TB portioned from ribeye areas greater than 103.2 cm2. Steaks portioned from carcasses with ribeye areas between 77.4 to 96.6 cm2 can optimize both cooking time and tenderness for the foodservice sector.

A pharmaceutical needs assessment in a primary care setting

BACKGROUND

As part of a reconfiguration of its general medical services, Ardach Health Centre has integrated a community pharmacist into the centre to provide pharmaceutical care. In order to systematically identify areas of 'pharmaceutical need', a needs assessment was carried out during October 1997.

AIM

To prioritize and assist the planning of pharmaceutical care provision within the centre, such that maximum gain could be achieved from inevitable limited resources.

METHOD

A four-stage pharmaceutical needs assessment method was created around a selection of techniques: gap analysis, the nominal group technique, and rapid participatory appraisal. This was then applied to a random sample of people drawn from the patient register of Ardach Health Centre and all the health care professionals associated with their care.

RESULTS

Through the four-stage process, a pharmaceutical service priority league table was constructed to reflect the unmet pharmaceutical needs of patients and their primary health care providers. The table provided a structured framework around which pharmaceutical service provision within the health centre could be planned.

CONCLUSION

We have developed a pragmatic, systematic method of identifying the prevalence of unmet pharmaceutical needs of a community. The assessment assisted service selection, balancing what should be done with what could be done and what could be afforded.

Calcium-activated tenderization of strip loin, top sirloin, and top round steaks in diverse genotypes of cattle

Steers of known percentage Brahman (B) and Angus (A) breeding (100% A, n = 6; F1 B x A, n = 6; and 100% B, n = 6) were used to determine the effect of calcium chloride injection on the calpain proteinase system and meat tenderness. The steers were slaughtered in six replications (at either 9 or 14 mm of backfat, determined ultrasonically), with each breed type represented. Calpains and calpastatin activities were measured on fresh, prerigor longissimus muscle samples. Carcass data were collected after a 24-h chill, and the short loin (IMPS #180), top sirloin (IMPS #184), and top round (IMPS #168) were removed from both sides of each carcass. The cuts from the right side were then injected at 5% (wt/wt) with CaCl2 solution (2.2%). Longissimus muscle calpain and calpastatin activities were also measured at 48 h postmortem from the injected and control sides of each carcass. Warner-Bratzler shear force was measured on steaks from the three subprimals aged 1, 2, 5, 15, or 31 d. Marbling scores and USDA quality grades were higher (P<.05) in A than in F1 B x A and B carcasses. Calpastatin activity was higher (P<.05) in muscle from B than in muscle from A and F1 B x A steers, and postmortem storage (O vs 48 h) and CaCl2 injection reduced (P<.05) the activity of the calpains and calpastatin. Strip loin and top sirloin steaks from A and F1 B x A steers were more tender (P<.05) than steaks from B steers; however, top round steak tenderness did not differ (P>.05) across breed type. Calcium injection improved strip loin and top sirloin steak tenderness, but it did not affect top round steak tenderness. Collectively, these data show that CaC12 injection can be used to improve meat tenderness, with similar responses shown in cattle containing 0, 50, and 100% B inheritance. However, even with CaCl2 injection, B steaks are less tender than their A and F1 B x A counterparts.

Effects of DL-malate on ruminal metabolism and performance of cattle fed a high-concentrate diet

To determine the effects of DL-malate on ruminal metabolism, four steers equipped with ruminal cannulas were fed an 80% rolled grain (75% corn:25% wheat) diet twice daily with a DMI equal to 2.0% of BW (485+/-24.8 kg). DL-Malate was infused into the rumen on two consecutive days in 500 mL of phosphate buffer to provide 0, 27, 54, or 80 g of DL-malate/d. Ruminal pH linearly increased (P < .01) with DL-malate concentration and was greater (P < .01) for DL-malate than for the control steers (6.07 vs 5.77). DL-Malate treatment linearly decreased (P < .10) total VFA and tended to linearly increase (P = .10) acetate concentration. Propionate, butyrate, and L-lactate concentrations and acetate:propionate ratio were not affected (P > .10) by DL-malate. Three finishing studies were conducted to determine the effects of feeding DL-malate on growth rate and feed efficiency. In a 98-d experiment, 33 crossbred steers were randomly allotted in a Calan gate feeding system to three DL-malate levels (0, 40, and 80 g/d). Steers (initial weight = 367+/-4.5 kg) were fed a rolled corn-based diet twice daily. After 84 d on feed, gain efficiency (gain:feed) tended to improve with more DL-malate (linear, P < .10) and was 8.1% greater (P < .05) for DL-malate than for the control. The ADG linearly increased (P < .05) with more DL-malate and was 8.6% greater (P = .10) for DL-malate than for the control. After 98-d on feed, ADG was linearly increased (P = .09) by DL--malate, and the greatest increase occurred with 80 g of DL-malate. In the second performance study, 27 Angus steers were randomly allotted in a Calan gate feeding system to three DL-malate concentrations (0, 60, and 120 g/d). Steers (initial weight = 432+/-4.6 kg) were fed diets used in the first finishing study twice daily, but DL-malate was included during the 10-d step-up period. During the 10-d step-up period, feed efficiency and ADG linearly increased (P = .01) with more DL-malate. DL-Malate had little effect on steer and heifer performance or plasma constituents in a 113-d finishing study. Collectively, these results suggest that feeding DL-malate to cattle consuming high-grain diets alleviates subclinical acidosis, and it improved animal performance in two finishing studies.

An evaluation of current and alternative systems for quality grading carcasses of mature slaughter cows

Strip loins from 354 female bovine carcasses, selected to represent 30 skeletal maturity (A, B, C, D, and E) x marbling score (SA/MA/AB, MD, MT, SM, SL, and TR/PD) subclasses, were used to evaluate current and alternative systems for classifying cow carcasses into expected-palatability groups. Strip loins were vacuum-packaged, stored for 14 d postmortem at 2 degrees C, and frozen (-27 degrees C). Five steaks from each strip loin, each cooked to a different internal temperature (60, 66, 71, 77, or 82 degrees C), were used for shear force determinations. Two steaks from each strip loin, one cooked to 66 degrees C and the other to 77 degrees C, were used for sensory evaluation. Increased carcass maturity was associated with decreased tenderness and juiciness, increased flavor intensity, and a higher incidence of flavors described as "painty," "fishy," and "grassy." Position of a carcass within a maturity group had a negligible effect on palatability. Increased marbling was associated with greater tenderness and juiciness, a lower incidence of steaks with a "grassy" flavor, and a higher incidence of steaks with a flavor described as "fatty." Relationships between marbling and beef palatability traits were consistent across all maturity groups. Carcasses of maturities A through E were most effectively stratified according to differences in palatability when marbling scores were grouped as follows: 1) MD and higher; 2) SL, SM, MT; and 3) TR/PD. Among mature (C, D, and E maturity) carcasses, yellow-colored fat was associated with greater beef toughness and higher detection rates for "grassy" and "fishy" flavors. Higher end-point temperatures were associated with higher shear force values and lower ratings for muscle fiber tenderness, connective tissue amount, overall tenderness, and juiciness. Two alternative grading approaches (one involving current quality grading factors and the other involving the use of fat color as an additional grade factor) were developed for possible use in classification of cow carcasses into expected-palatability groups. Both alternative systems provided a more effective stratification of cow carcasses according to palatability differences than did the current USDA quality grading system.

Effective lipid modification by partial ileal bypass reduced long-term coronary heart disease mortality and morbidity: five-year posttrial follow-up report from the POSCH. Program on the Surgical Control of the Hyperlipidemias

BACKGROUND

In 1990, when the Program on the Surgical Control of the Hyperlipidemias (POSCH) reported its in-trial results strongly supporting the conclusion that effective lipid modification reduces progression of atherosclerosis, the differences for the end points of overall mortality and mortality from atherosclerotic coronary heart disease (ACHD) did not reach statistical significance.

METHODS

The Program on the Surgical Control of the Hyperlipidemias recruited men and women with a single documented myocardial infarction between the ages of 30 and 64 years who had a plasma cholesterol level higher than 5.69 mmol/L (220 mg/dL) or higher than 5.17 mmol/L (200 mg/dL) if the low-density lipoprotein cholesterol level was in excess of 3.62 mmol/L (140 mg/dL). Between 1975 and 1983, 838 patients were randomized: 417 to the diet control group and 421 to the diet plus partial ileal bypass intervention group. Mean patient follow-up for this 5-year posttrial report was 14.7 years (range, 12.2-20 years).

RESULTS

At 5 years after the trial, statistical significance was obtained for differences in overall mortality (P = .049) and mortality from ACHD (P = .03). Other POSCH end points included overall mortality (left ventricular ejection fraction > or =50%) (P = .01), mortality from ACHD (left ventricular ejection fraction > or =50%) (P = .05), mortality from ACHD and confirmed nonfatal myocardial infarction (P<.001), confirmed nonfatal myocardial infarction (P<.001), mortality from ACHD, confirmed and suspected myocardial infarction and unstable angina (P<.001), incidence of coronary artery bypass grafting or percutaneous transluminal coronary angioplasty (P<.001), and onset of clinical peripheral vascular disease (P = .02). There were no statistically significant differences between groups for cerebrovascular events, mortality from non-ACHD, and cancer. All POSCH patients have been available for follow-up.

CONCLUSION

At 5 years after the trial, all POSCH mortality and atherosclerosis end points, including overall mortality and mortality from ACHD, demonstrated statistically significant differences between the study groups.

Myocardial infarction and percent arteriographic stenosis of culprit lesion: report from the Program on the Surgical Control of the Hyperlipidemias (POSCH)

The objective of this study was to assess the percent stenosis of the culprit lesion responsible for subsequent myocardial infarction in the Program on the Surgical Control of the Hyperlipidemias (POSCH). It is unknown if the susceptible coronary artery culprit lesion responsible for an acute myocardial infarction is relatively large ( > or = 50% arteriographic stenosis) and hemodynamically significant ( > or = 70% stenosis), or small ( < 50%, stenosis) and asymptomatic. Certain necropsy and arteriography studies support the large progenitor lesion concept, and other arteriography studies support the small lesion hypothesis. We analyzed the coronary arteriogram immediately preceding a Q wave (transmural) myocardial infarction for the degree of stenosis of the suspected culprit lesion, which was selected by visual inspection of the coronary circulation supplying the electrocardiogram-defined area of myocardial infarction. There was no perceptible difference with respect to vessel segment distribution of culprit lesions or time to infarction between the 52 control-group patients and the 27 intervention-group patients. For the two groups combined (n=79), the predominantly involved segments were the middle right coronary artery and the proximal left anterior descending coronary artery. The time interval from the preceding coronary arteriogram closest to the index myocardial infarction ranged from 0 days to 10 years; however, 64.6% of the arteriograms were performed 2 years or less prior to the myocardial infarction. Only 5.1% of the patients in both groups combined had a culprit lesion stenosis < 50%, while 88.6% of the patients in both groups combined had a culprit lesion stenosis > or = 70%. The results strongly favor the large lesion hypothesis of causation for myocardial infarction. It is premature, however, to state that the relative size of the culprit lesion has been indisputably determined. The resolution of this problem has exceedingly important practical implications for the management of patients with known atherosclerotic coronary heart disease and for those asymptomatic individuals with silent atherosclerotic coronary heart disease.

Prediction of slaughter cow composition using live animal and carcass traits

Slaughter cows (n = 120), representing four genotypes (British, continental, Bos indicus, and dairy) and three body condition classes (thin, moderate, and fat), n = 10 per subclass, were used to identify practical and accurate prediction equations for the yield of boneless manufacturing beef of specific fat percentages. Cows and their carcasses were weighed and evaluated for USDA yield and quality grade factors and for physical muscle and fat indicators. Carcass sides were fabricated; total fat percentage (TFP) was calculated as total fat (trimmed and chemical) divided by side weight, and tissue lean percentage (TLP) was calculated as boneless fat-free lean divided by soft tissue weight. Data were analyzed using maximum R2 multiple regression. The best live trait prediction model for TFP included live preliminary yield grade (LPYG), body condition score (LCOND), visual live muscle score (LMUSC), and live weight (LWT), R2 = .83. The best carcass trait TFP prediction model included adjusted preliminary yield grade (CPYGA); kidney, pelvic, and heart fat adjustment (CKPHADJ); marbling score (CMARB); and hot carcass weight (HCW), R2 = .92. The best live trait TLP prediction model included LPYG, LCOND, LMUSC, and LWT, R2 = .82. The best carcass trait TLP prediction model included CPYGA, CKPHADJ, CMARB, and lean maturity, R2 = .91. These data indicate that TFP and TLP of slaughter cows can be accurately and practically predicted using live animal and carcass traits.

Recovery in pediatric brain injury: is psychostimulant medication beneficial?

OBJECTIVE

To assess the effects of methylphenidate on attention, memory, behavior, processing speed, and psychomotor skills of children with closed head injuries.

DESIGN

Double-blind, placebo-controlled, crossover design.

SETTING

An outpatient facility of a children's hospital medical center.

PATIENTS

Ten pediatric subjects identified through chart review. Subjects met baseline scores for hyperactivity (Conner's Hyperactivity Index greater than or equal to 60) and intellectual functioning (Verbal Intelligence Quotient greather than or equal to 70) and achieved minimal scores on two psychometric tests. All subjects evidenced head injury by focal lesions on computed tomography scan and/or sequelae reported at the time of injury. Severity of injury ranged from mild to severe. All subjects were medically stable at the time of testing. Mean time post injury was 2 years, 8 months.

INTERVENTION

Administration of methylphenidate and placebo.

MAIN OUTCOME MEASURES

Percentage change in scores was calculated to assess differences between baseline and end of methylphenidate/placebo trials.

RESULTS

No significant differences between methylphenidate and placebo on measures assessing behavior, attention, memory, and processing speed.

CONCLUSIONS

The results of the study call into question the effectiveness of methylphenidate in the pediatric head injury population.

Rainforest frogs of the Australian Wet Tropics: guild classification and the ecological similarity of declining species

Rainforest frogs are classified into nine ecological guilds based on features of reproduction, habitat use, temporal activity, microhabitat and body size. The largest ecological differences are between the microhylid frogs and the rest of the frog species. Within the non-microhylids, there are two primary groups consisting of (i) regionally endemic rainforest specialists, and (ii) a more ecologically diverse group of species that are less specialized in their habitat requirements. Most of the regionally endemic rainforest specialists, which includes species in three ecological guilds, have declined or gone missing in recent years. Multivariate analyses of the ecological characteristics of these species show that it is not a single characteristic that isolates those species that have declined from those which have not. The guilds that have undergone significant population declines in the Wet Tropics are all characterized by the combination of low fecundity, a high degree of habitat specialization and reproduction in flowing streams. These results have important implications for the determination of the causal factors in the unexplained global decline of many amphibian species.

HIV-1 induction of CD40 on endothelial cells promotes the outgrowth of AIDS-associated B-cell lymphomas

Human immunodeficiency virus (HIV)-1 infection is associated with the development of aggressive extranodal B-cell non-Hodgkin's lymphomas. Using microvascular endothelial cell (MVEC)-enriched bone marrow stromal cultures, HIV infection of stromal MVECs from lymphoma patients induced the outgrowth of malignant B cells. MVECs were the only HIV-infected cells in the stroma, and purified brain MVECs also induced a phenotype supportive of neoplastic B-cell attachment and proliferation. HIV infection of MVECs stimulated surface expression of CD40 and allowed preferential induction of the vascular cell adhesion molecule VCAM-1 after CD40 triggering. B-lymphoma cells expressed the CD40 ligand (CD40L), and blocking of CD40-CD40L interactions between HIV-infected MVECs and B-lymphoma cells inhibited B-cell attachment and proliferation. These observations suggest that HIV promotes B-lymphoma cell growth through facilitating attachment of lymphoma cells to HIV-infected MVECs and represent a novel mechanism through which viruses may induce malignancies.

Carcass characteristics, the calpain proteinase system, and aged tenderness of Angus and Brahman crossbred steers

We used 69 steers of varying percentage Brahman (B) breeding (0% B, n = 11; 25% B, n = 13; 37% B, n = 10; 50% B, n = 12; 75% B, n = 12; 100% B, n = 11) to study the relationship between carcass traits, the calpain proteinase system, and aged meat tenderness in intermediate B crosses. Calpains and calpastatin activities were determined on fresh longissimus muscle samples using anion-exchange chromatography. The USDA yield and quality grade data (24 h) were collected for each carcass. Longissimus steaks were removed and aged for 5 or 14 d for determination of shear force and 5 d for sensory panel evaluation. Even though some yield grade factors were affected by the percentage of B breeding, USDA yield grades did not differ (P > .15) between breed types. Marbling score and USDA quality grade decreased linearly (P < .01) with increasing percentage of B breeding. Shear force after 5 and 14 d of aging was higher (P < .05) in the 100% B steers than in all other breed types, which were not significantly different. Sensory panel tenderness and connective tissue scores decreased linearly (P < .05) with increasing B breeding. A quadratic effect was also noted for tenderness and connective tissue scores; 37% B steers received the highest scores. A similar response was found in mu-calpain activities; the 37% B steers had the highest activities. Conversely, calpastatin activity increased linearly (P < .01) with increasing percentage B breeding. These data show strong linear relationships between calpastatin activity (positive), marbling score (negative), and percentage B breeding, suggesting a possible combined effect of these traits on aged tenderness of intermediate Brahman crosses.

Serum concentrations of insulin-like growth factors and placental lactogen during gestation in cattle. II. Maternal profiles

This study was designed to examine the effects of fetal growth potential on maternal hormones and lipid metabolism. Sixty beef heifers were inseminated with semen from sires with high (H) or low (L) expected progeny differences for birth weight. Maternal serum was collected at 21-d intervals from Day 85 to Day 274 of gestation. Serum concentrations of insulin-like growth factor (IGF)-I, IGF-II, placental lactogen (PL), and nonesterified fatty acids (NEFA) were determined and correlated to fetal and maternal characteristics. Maternal serum IGF-I declined throughout pregnancy, whereas IGF-II was relatively constant and PL tended to increase. Maternal serum NEFA was low and invariant through Day 211 of gestation when it rose 3.5 times to peak levels at Day 253 and declined at Day 274. PL was positively correlated to NEFA (r = 0.37, P < 0.01), IGF-I was negatively correlated (P < 0.01) to NEFA and PL (r = -0.59, and -0.35, respectively), and IGF-II was negatively correlated to NEFA (r = -0.35, P < 0.01). Dams pregnant with H fetuses had lower (P = 0.02) serum IGF-I and tended to have higher (P = 0.09) serum PL concentrations than dams carrying L fetuses. Additionally, dams pregnant with L fetuses had higher (P < 0.03) serum IGF-II concentrations than dams with H fetuses (175.6 vs. 145.0 ng/ml) during the third trimester. Fetal sex had no effect on any maternal serum parameter. Fetal weight and instantaneous growth rate (IGR) were positively correlated to maternal NEFA and PL and negatively correlated to maternal IGF-I and IGF-II. Independent IGR effects were detected for PL (P < 0.06) and IGF-I (P < 0.0005) concentrations. Maternal hip height was negatively related to serum IGF-I and positively related to serum PL concentrations. Maternal body weight and body condition score were correlated with several serum parameters but were confounded by day of gestation. Correlation analysis of serum concentrations of IGF-I, IGF-II, and PL did not support the hypothesis that PL regulates IGF concentrations.

Adult psychosocial outcome in early-treated phenylketonuria

Concerns about the psychosocial risk of adults with early-treated phenylketonuria (ETPKU) are predicated on four sources of scientific data: (1) consistent documentation of increased behavioural risk in children with ETPKU; (2) recent evidence of neurocognitive impairment in adults with ETPKU; (3) reports of neuroimaging abnormalities in adults with ETPKU; and (4) preliminary evidence of increased rates of psychiatric disturbance in this population. We studied the psychosocial adjustment of 25 patients, aged 18 years and older, with ETPKU. On most psychosocial outcome measures, patients were indistinguishable from 15 sibling controls. However, on a self-report inventory of psychiatric symptoms, 20% of the patients demonstrated significant morbidity. Psychosocial outcome of these patients was unrelated to concurrent or historical biological dietary disease factors, unlike neurocognitive outcome. A strong relationship was demonstrated, however, between neurocognitive measures and psychosocial morbidity. These findings indicate that a significant minority of patients with ETPKU develop psychosocial difficulties with multiple clinical elevations on a psychiatric inventory. However, most adults with ETPKU cope with the challenges of young adulthood with the same degree of success as their unaffected siblings. Neuropsychological surveillance during childhood and adolescence is important in identifying patients at risk for both neurocognitive and psychosocial morbidity.

Serum concentrations of insulin-like growth factors and placental lactogen during gestation in cattle. I. Fetal profiles

Sixty crossbred beef heifers pregnant with fetuses of either high (H; n = 30) or low (L; n = 30) genetic potential for growth were used to establish fetal serum profiles of insulin-like growth factor (IGF)-I, IGF-II, and placental lactogen (PL), and to examine relationships between serum hormone concentrations and fetal growth parameters. Three H and three L fetuses were collected by caesarean section at 21-d intervals from Day 85 through Day 274 of gestation. Arterial, venous, and mixed umbilical blood samples were collected during surgery. Fetal body weight, crown-rump length, hip height, and heart girth were measured. Serum concentrations of IGF-I and IGF-II increased (P < 0.0001) with advancing gestational age, whereas serum PL declined (P < 0.0001) linearly (P < 0.01) throughout gestation. Serum concentrations were greater in the umbilical vein compared with the umbilical artery for IGF-II (P < 0.0001) and PL (P < 0.05), but not IGF-I. Fetal IGF-I, IGF-II, and PL serum concentrations were not correlated with serum concentrations of the respective maternal hormones. Fetal serum IGF-I concentrations were correlated to fetal body weight (r = 0.66), growth rate (r = 0.72), crown-rump length (r = 0.20), hip height (r = 0.17), and heart girth (r = 0.20). Correlations between fetal serum IGF-II concentrations and the same parameters were 0.60, 0.62, 0.39, 0.34, and 0.37, respectively. Fetal serum PL concentrations were negatively correlated to body weight (r = -0.40) and growth rate (r = -0.40) and not correlated with any fetal linear measure. Fetal genotype (L vs. H) differences were detected for IGF-I (P < 0.05) and PL (P = 0.09) concentrations. Fetal sex effects were not observed for any hormone. Maternal sire breed, hip height, and body condition score did not influence fetal serum hormone concentrations.

Historical rainforest contractions, localized extinctions and patterns of vertebrate endemism in the rainforests of Australia's wet tropics

The spatial patterns in the distributions of vertebrates in the rainforests of the wet tropics biogeographic region of north-eastern Australia were examined to form hypotheses on the processes that have shaped vertebrate assemblages and patterns of species richness and regional endemism. These rainforests occur in a relatively narrow and discontinuous strip along the coast of north-eastern Australia. We found that the number of regionally endemic species and the proportion of regional endemics present in each subregion are both strongly related to the geographic shape of subregional patches of rainforest, independent of rainforest area, within Australian tropical rainforests. Shape has a more significant influence on regional endemism than area, and area has a stronger influence on species richness. These patterns were congruent for all terrestrial vertebrate classes manuals, birds, reptiles and frogst, and for the four groups combined. Our results suggest that the combination of current rainforest area and shape are an index of the relative susceptibility of each area of rainforest to historical contractions, with the implication that historical habitat fluctuations, coupled with subsequent localized extinctions species sifting; have been extremely important processes in determining current patterns of endemism in Australia's wet tropical rainforests. This hypothesis is supported by the highly nested structure of the subregional distribution patterns.

Biceps femoris and rump fat as additional ultrasound measurements for predicting retail product and trimmable fat in beef carcasses

One hundred ninety-eight steers of Angus and Hereford breeding were evaluated ultrasonically for fat thickness over the 12-13th rib (UFAT), fat thickness over the rump (URUMP), 12-13th longissimus muscle area (UREA), and depth of the biceps femoris (UROUND) before slaughter. Carcass measurements associated with the USDA yield grade were also obtained. Carcasses were fabricated into closely trimmed (.32 cm fat), boneless subprimals. Regression procedures were used to predict weight and the percentages of retail product and trimmable fat. Final weight (FINALWT) accounted for most of the variation when predicting kilograms of retail product and trimmable fat, with R2 values of .836 and .435, respectively. As single predictors URUMP and UFAT accounted for most of the variation when predicting the percentages of retail product and trimmable fat with R2 values of .244 and .220, respectively. Adding URUMP to equations that included FINALWT, UREA, and UFAT increased R2 values for percentage of retail product from .175 to .318 and for weight of retail product from .847 to .865, whereas the addition of UROUND did not appreciably increase R2 values for the same models. Adding URUMP and UROUND to the model of FINALWT, UREA, and UFAT to predict kilograms and the percentage of trimmable fat increased R2 values from .530 to .610 and from .254 to .360, respectively. Models using live-animal measurements to predict weight and the percentage of retail product gave R2 values equal to models using the actual measurements found in the USDA Yield Grade equation.

Vitreous hemorrhage as an ophthalmic complication of galactosemia

A major complication of galactosemia is cataracts. This is usually considered to be the sole ophthalmic feature of this disorder. However, we have encountered vitreous hemorrhage, a very rare ophthalmic finding, in five neonates with galactosemia and have found four probable additional cases in the literature. All of these infants had severe neonatal manifestations of galactosemia and were discovered to have vitreous hemorrhage by ophthalmologic examination initiated by the observation of clouding of the eye or on a routine basis. The infants lost most or all vision from the affected eye. Retinal abnormalities were present in the involved eyes of the five neonates of whom we have direct knowledge. Thus we believe that retinal hemorrhage is the most likely source of the vitreous hemorrhage and that the coagulopathy associated with neonatal disease in galactosemia leads to vitreous hemorrhage. Prompt recognition and therapy for the coagulopathy would likely prevent vitreous hemorrhage in galactosemia.