Detecting participant noncompliance across multiple time points by modeling a longitudinal biomarker

INTRODUCTION

Participant noncompliance, in which participants do not follow their assigned treatment protocol, has long complicated the interpretation of randomized clinical trials. No gold standard has been identified for detecting noncompliance, but in some trials participants' biomarkers can provide objective information that suggests exposure to non-study treatments. However, existing methods are limited to retrospectively detecting noncompliance at a single time point based on a single biomarker measurement. We propose a novel method that can leverage participants' full biomarker history to detect noncompliance across multiple time points. Conditional on longitudinal biomarker data, our method can estimate the probability of compliance at (1) a single time point of the trial, (2) all time points, and (3) a future time point.

METHODS

Across time points, we model the biomarker as a mixture density with (latent) components corresponding to longitudinal patterns of compliance. To estimate the mixture density, we fit mixed effects models for both compliance and the biomarker. We use the mixture density to derive compliance probabilities that condition on the longitudinal biomarker data. We evaluate our compliance probabilities by simulation and apply them to a trial in which current smokers were asked to only smoke low nicotine study cigarettes (Center for the Evaluation of Nicotine in Cigarettes Project 1 Study 2). In the simulation, we investigated three different effects of compliance on the biomarker, as well as the effect of misspecification of the covariance structures. We compared probability estimators (1) and (2) to those that ignore the longitudinal correlation in the data according to area under the receiver operating characteristic curve. We evaluated estimator (3) by plotting its calibration lines. For Center for the Evaluation of Nicotine in Cigarettes Project 1 Study 2, we compared estimators (1) and (3) to a probability estimator of compliance at the last time point that ignores the longitudinal correlation.

RESULTS

In the simulation, for both compliance at the last time point and at all time points, conditioning on the longitudinal biomarker data uniformly raised area under the receiver operating characteristic curve across all three compliance effect scenarios. The gains in area under the receiver operating characteristic curve were smaller under misspecification. The calibration lines for the prediction of compliance closely followed 45°, though with additional variability under misspecification. For compliance at the last time point of Center for the Evaluation of Nicotine in Cigarettes Project 1 Study 2, conditioning on participants' full biomarker history boosted area under the receiver operating characteristic curve by three percentage points. The prediction probabilities somewhat accurately approximated the non-longitudinal compliance probabilities.

DISCUSSION

Compared to existing methods that only use a single biomarker measurement, our method can account for the longitudinal correlation in the biomarker and compliance to more accurately identify noncompliant participants. Our method can also use participants' biomarker history to predict compliance at a future time point.

Statistical testing of baseline differences in sports medicine RCTs: a systematic evaluation

Background/Aim

The CONSORT (Consolidated Standards of Reporting Trials) statement discourages reporting statistical tests of baseline differences between groups in randomised controlled trials (RCTs). However, this practice is still common in many medical fields. Our aim was to determine the prevalence of this practice in leading sports medicine journals.

Methods

We conducted a comprehensive search in Medline through PubMed to identify RCTs published in the years 2005 and 2015 from 10 high-impact sports medicine journals. Two reviewers independently confirmed the trial design and reached consensus on which articles contained statistical tests of baseline differences.

Results

Our search strategy identified a total of 324 RCTs, with 85 from the year 2005 and 239 from the year 2015. Overall, 64.8% of studies (95% CI (59.6, 70.0)) reported statistical tests of baseline differences; broken down by year, this percentage was 67.1% in 2005 (95% CI (57.1, 77.1)) and 64.0% in 2015 (95% CI (57.9, 70.1)).

Conclusions

Although discouraged by the CONSORT statement, statistical testing of baseline differences remains highly prevalent in sports medicine RCTs. Statistical testing of baseline differences can mislead authors; for example, by failing to identify meaningful baseline differences in small studies. Journals that ask authors to follow the CONSORT statement guidelines should recognise that many manuscripts are ignoring the recommendation against statistical testing of baseline differences.

Analysis of an ordinal endpoint for use in evaluating treatments for severe influenza requiring hospitalization

Background/Aims A single best endpoint for evaluating treatments of severe influenza requiring hospitalization has not been identified. A novel six-category ordinal endpoint of patient status is being used in a randomized controlled trial (FLU-Intravenous Immunoglobulin - FLU-IVIG) of intravenous immunoglobulin. We systematically examine four factors regarding the use of this ordinal endpoint that may affect power from fitting a proportional odds model: (1) deviations from the proportional odds assumption which result in the same overall treatment effect as specified in the FLU-IVIG protocol and which result in a diminished overall treatment effect, (2) deviations from the distribution of the placebo group assumed in the FLU-IVIG design, (3) the effect of patient misclassification among the six categories, and (4) the number of categories of the ordinal endpoint. We also consider interactions between the treatment effect (i.e. factor 1) and each other factor. Methods We conducted a Monte Carlo simulation study to assess the effect of each factor. To study factor 1, we developed an algorithm for deriving distributions of the ordinal endpoint in the two treatment groups that deviated from proportional odds while maintaining the same overall treatment effect. For factor 2, we considered placebo group distributions which were more or less skewed than the one specified in the FLU-IVIG protocol by adding or subtracting a constant from the cumulative log odds. To assess factor 3, we added misclassification between adjacent pairs of categories that depend on subjective patient/clinician assessments. For factor 4, we collapsed some categories into single categories. Results Deviations from proportional odds reduced power at most from 80% to 77% given the same overall treatment effect as specified in the FLU-IVIG protocol. Misclassification and collapsing categories can reduce power by over 40 and 10 percentage points, respectively, when they affect categories with many patients and a discernible treatment effect. But collapsing categories that contain no treatment effect can raise power by over 20 percentage points. Differences in the distribution of the placebo group can raise power by over 20 percentage points or reduce power by over 40 percentage points depending on how patients are shifted to portions of the ordinal endpoint with a large treatment effect. Conclusion Provided that the overall treatment effect is maintained, deviations from proportional odds marginally reduce power. However, deviations from proportional odds can modify the effect of misclassification, the number of categories, and the distribution of the placebo group on power. In general, adjacent pairs of categories with many patients should be kept separate to help ensure that power is maintained at the pre-specified level.

Low-temperature, high-performance solution-processed metal oxide thin-film transistors formed by a ‘sol–gel on chip’ process

At present there is no ‘ideal’ thin-film transistor technology for demanding display applications, such as organic light-emitting diode displays, that allows combining the low-temperature, solution-processability offered by organic semiconductors with the high level of performance achievable with microcrystalline silicon1. N-type amorphous mixed metal oxide semiconductors, such as ternary oxides Mx1My2Oz, where M1 and M2 are metals such as In, Ga, Sn, or Zn, have recently gained momentum because of their high carrier mobility and stability2, 3 and good optical transparency, but they are mostly deposited by sputtering. So far no route is available for forming high-performance mixed oxide materials from solution at low process temperatures <250 °C. Ionic mixed metal oxides should in principle be ideal candidates for solution-processable materials because the conduction band states derived from metal s-orbitals are relatively insensitive to the presence of structural disorder and high charge carrier mobilities are achievable in amorphous structures2. Here we report the formation of amorphous metal oxide semiconducting thin-films using a ‘sol–gel on chip’ hydrolysis approach from soluble metal alkoxide precursors, which affords unprecedented high field-effect mobilities of 10 cm2 V−1 s−1, reproducible and stable turn-on voltages Von≈0 V and high operational stability at maximum process temperatures as low as 230 °C.

Relationships among three pathways for resource acquisition and their contribution to plant performance in the emergent aquatic Plant Lythrum salicaria (L.)

Three pathways for resource acquisition exist in the emergent aquatic plant, Lythrum salicaria (L.); a subterranean root system, a free-floating adventitious root system, and arbuscular mycorrhiza (AM) fungal hyphae colonizing subterranean roots. This study examined the relationship(s) among these pathways and their contribution to plant performance. If the free-floating adventitious root system and/or AM fungi contribute to plant growth in wetland habitats, we predicted that their absence would result in a significant reduction in plant performance. Furthermore, if a reduction in resource uptake, effected by an absence of free-floating adventitious roots and/or AM fungi, is compensated for by increased allocation to remaining pathway(s) for resource uptake, we predicted altered patterns of resource allocation among shoots and the remaining pathway(s) for resource uptake. Contrary to our predications, plants experiencing adventitious root removal and/or grown in the absence of AM fungi generally had greater biomass and total shoot height than controls. Similarly, while levels of AM colonization and subterranean root biomass displayed a treatment effect, the observed responses did not correspond with our predictions. This was also true for shoot : subterranean root dry weight ratios. Our results indicate that there is interaction among the 3 pathways for resource acquisition in L. salicaria and an effect on plant performance. The adaptive significance of these characteristics is unclear, highlighting the potential difficulties in extrapolating from terrestrial to aquatic plant species and among aquatic plant species with potentially different life history strategies.

Structural characteristics of root–fungal interactions for five ericaceous species in eastern Canada

A combination of light microscopy (including differential interference contrast) and laser scanning confocal microscopy was used to document the colonization patterns of epidermal cells and details of intracellular hyphal complexes of five native ericaceous hosts: Vaccinium oxycoccos L. (bog cranberry), Ledum groenlandicum Oeder. (Labrador tea), Vaccinium myrtilloides L. (velvet-leaf blueberry), Kalmia angustifolia L. (sheep laurel), and Gaultheria procumbens L. (wintergreen). Colonization patterns, hyphal complex morphology, and the structure of thick-walled epidermal cells varied considerably among hosts. Multiple hyphal connections were observed between adjacent epidermal cells, indicating that one fungal entry point may result in the colonization of more than one epidermal cell. Further field observations combined with fungal isolations from field-collected plants, identification, and reinoculation studies of other species in the large Ericaceae family are required to determine the full range of structural details in ericoid mycorrhizas.Key words: ericoid mycorrhizas, hair roots, intracellular hyphal complexes, confocal microscopy.

Structural features of mycorrhizal associations in two members of the Monotropoideae, Monotropa uniflora and Pterospora andromedea

Species in the subfamily Monotropoideae (family Ericaceae) are achlorophyllous and myco-heterotrophic. They have become highly specialized in that each plant species is associated with a limited number of fungal species which in turn are linked to autotrophic plants. This study provides an updated and comprehensive examination of the anatomical features of two species that have recently received attention with respect to their host-fungal specificity. Root systems of Monotropa uniflora and Pterospora andromedea collected from the field were characterized by light microscopy and scanning electron microscopy. All roots of both species were associated with fungi, each root having a well-developed mantle, paraepidermal Hartig net, and intracellular "fungal pegs" within epidermal cells. The mantle of M. uniflora was multi-layered and numerous outer mantle hyphae developed into cystidia of two distinct morphologies. Large calcium oxalate crystals were present, primarily on the mantle surface. The outer mantle of P. andromedea was more loosely organized, lacked cystidia, and had smaller plate-like as well as cylindrical crystals on the surface and between outer mantle hyphae. Fungal pegs in M. uniflora originated from inner mantle hyphae that penetrated the outer tangential wall of epidermal cells; in P. andromedea, these structures were initiated either from inner mantle hyphae or Hartig net hyphae and penetrated radial walls of epidermal cells. With respect to function, fungal pegs occurred frequently in both host species and, although presumed to be the sites of active nutrient exchange, no direct evidence exists to support this. Differences between these two monotropoid hosts, resulting from the mycorrhizal fungi with which each associates, are discussed.

Mechanistic toxicogenomic analysis of WAY-144122 administration in Sprague–Dawley rats

Application of global gene expression analysis in the study of mechanisms of toxicity could provide a more comprehensive interpretation of the molecular basis of drug action. WAY-144122 has pharmacological activity against several targets improving insulin responsiveness and favorably altering lipid profiles. Normal rats treated with suprapharmacological doses of WAY-144122 for 28 days exhibited drug-related effects in the liver and ovary. To determine the molecular mechanism underlying these effects, we employed global gene expression profiling to measure RNA levels in these target organs obtained from WAY-144122-treated rats administered test article for 1, 3, 7, and 14 days. Genes altered in expression by WAY-144122 were functionally categorized and related to their biological activity. In the liver, WAY-144122 caused a widespread up-regulation of genes involved in lipid mobilization, peroxisomal proliferation, and fatty acid beta-oxidation. In the ovary, we observed reduced expression of genes encoding luteinizing hormone receptor, follistatin, and enzymes in the estradiol synthesis pathway. Transcriptional changes in both organs precede histopathological effects. Profiling analysis allowed us to formulate hypotheses for molecular mechanisms underlying the physiological observations. In the liver, transcriptional changes suggest that WAY-144122 induced increased metabolic activity and peroxisomal proliferation resulting in increased liver weight and hepatocellular hypertrophy. We propose decreased estradiol synthesis as the underlying mechanism for the observed follicular atrophy in the ovary. Importantly, in this study, we have identified potential molecular mechanisms of drug effect in expression profiles before observation of physiological changes.

Pharmacogenomic analysis of rhIL-11 treatment in the HLA-B27 rat model of inflammatory bowel disease

Recombinant human interleukin-11 (rhIL-11) reduces the clinical signs and histological lesions of inflammatory bowel disease (IBD) in transgenic rats expressing the human major histocompatability complex (MHC) class I allele, HLA-B27. To elucidate the pharmacogenomic effects of rhIL-11 in this model, we examined the global gene expression pattern in inflamed colonic tissue before and following rhIL-11 treatment using oligonucleotide microarrays. In total, 175 disease-related genes were identified. Increased expression of genes involved in antigen presentation, cell death and inflammation, and decreased expression of metabolic genes was associated with disease. A total of 27 disease-related genes returned to normal expression levels following rhIL-11 treatment including the MHC class II gene RT1-DMbeta. rhIL-11 induced the expression of four intestinal epithelial growth factors. These gene expression patterns indicate that treatment of inflammatory bowel disease with rhIL-11 affects class II antigen processing and colonic epithelial cell proliferation and metabolism.

Phosphorus, arbuscular mycorrhizal fungi and performance of the wetland plant Lythrum salicaria L. under inundated conditions

The role of arbuscular mycorrhizal (AM) fungi in aquatic and semi-aquatic environments is poorly understood, although they may play a significant role in the establishment and maintenance of wetland plant communities. We tested the hypothesis that AM fungi have little effect on plant response to phosphorus (P) supply in inundated soils as evidenced by an absence of increased plant performance in inoculated (AM+) versus non-inoculated (AM-) Lythrum salicaria plants grown under a range of P availabilities (0-40 mg/l P). We also assessed the relationship between P supply and levels of AM colonization under inundated conditions. The presence of AM fungi had no detectable benefit for any measures of plant performance (total shoot height, shoot dry weight, shoot fresh weight, root fresh weight, total root length or total root surface area). AM+ plants displayed reduced shoot height at 10 mg/l P. Overall, shoot fresh to dry weight ratios were higher in AM+ plants although the biological significance of this was not determined. AM colonization levels were significantly reduced at P concentrations of 5 mg/l and higher. The results support the hypothesis that AM fungi have little effect on plant response to P supply in inundated conditions and suggest that the AM association can become uncoupled at relatively high levels of P supply.

Clinical care of gambling disorders: training, experience, and competence among VHA psychologists

Problem gambling is a common, highly destructive disorder which is often overlooked by clinicians. Levels of clinical training, clinical experience, and professional competence for providing clinical services for problem gambling were examined in a survey of 181 clinical psychologists working in the Veterans Healthcare Administration (VHA). The results suggest that the majority of clinical psychologists have little or no formal training and little or no past or current clinical experience in the treatment of disordered gambling, nor do they see themselves as competent to evaluate or treat patients with disordered gambling. Most have not referred patients for treatment of problem gambling and do not know of a competent provider to whom they can refer. There is an identifiable subgroup, representing 9% of respondents, who do have more training, provide services, and see themselves as competent to provide care for patients with problem gambling. The amount of formal training is positively correlated with care provided and self-ratings of competence. Despite the lack of training and experience, most respondents expressed interest in receiving additional training. These data suggest that to improve rates of diagnosis and treatment of patients with problem gambling in mental health settings, additional training needs to be made available for mental health providers as a group, with specialized training for clinicians interested in specializing in this area.

Characterization of the interaction between the dark septate fungus Phialocephala fortinii and Asparagus officinalis roots

Phialocephala fortinii Wang & Wilcox is a member of root-inhabiting fungi known collectively as dark septate endophytes (DSE). Although very common and distributed worldwide, few studies have documented their interaction with roots on a structural basis. The objective of this study was to determine the early colonization events and formation of microsclerotia of P. fortinii in roots of Asparagus officinalis L., a species known to have DSE. A loose network of hyphae accumulated at the root surface, and coils formed around root hairs and external to epidermal cells overlying short cells of the dimorphic, suberized exodermis. Root penetration occurred via swollen, appressorium-like structures into epidermal cells where coiling of hyphae occurred along the periphery of the cells. Hyphae penetrated from the epidermis into short exodermal cells and from these into cortical cells. Hyphae colonized the cortex up to the endodermis and sometimes entered the vascular cylinder. Some root tips were colonized as well. Microsclerotia in epidermal and exodermal short cells accumulated glycogen, protein, and polyphosphate. Energy-dispersive X-ray spectroscopy on distinct bodies visible in microsclerotial hyphae revealed high levels of phosphorus.

Subcutaneous or oral administration of rhIL-11 modulated the contact hypersensitivity response

Recombinant human interleukin 11 (rhIL-11) is a multifunctional cytokine with immunomodulatory activity on both T cells and macrophages. The effects of rhIL-11 in a murine model of contact hypersensitivity (CHS) response have been studied. The CHS response is a T cell-mediated response directed against chemically modified self-proteins following epidermal exposure to haptens. CHS is generated in two phases. The sensitization phase involves dermal dendritic cell recognition of haptenized proteins and antigen presentation. The effector phase involves T cell recognition and activation. In mice sensitized with oxazolone, CHS was induced by secondary challenge to the right ear and measured by ear swelling 24 h later. rhIL-11 significantly suppressed CHS as measured by ear swelling and tissue myeloperoxidase activity when injected subcutaneously for 5 days from the day of sensitization or when administered only on the day before and the day of challenge, but was not effective when administered prior to or on the day of sensitization. These results indicate that subcutaneously administered rhIL-11 may modulate the effector phase of CHS. Administration of rhIL-11 as an oral gavage prior to sensitization also reduced CHS. However oral administration of rhIL-11 after sensitization had no effect. These results suggest that orally and subcutaneously administered rhIL-11 may act through different mechanisms to affect CHS.

Defining mechanisms of action of interleukin-11 on the progression of radiation-induced oral mucositis in hamsters

Oral ulcerative mucositis is a common toxicity associated with drug and radiation therapy for cancer. It impacts on quality of life and economic outcomes, as well as morbidity and mortality. Mucositis is often associated with dose limitations for chemotherapy or is a cause for dose interruption for radiation. The complexity of mucositis as a biological process has only been recently appreciated. It has been suggested that the condition represents a sequential interaction of oral mucosal cells and tissues, pro-inflammatory cytokines and local factors such as saliva and the oral microbiota. The recognition that the pathophysiology of mucositis is a multifactorial process was partially suggested by the observation that interleukin-11 (IL-11), a pleotropic cytokine, favorably altered the course of chemotherapy-induced mucositis in an animal model. In the current study, we evaluated a series of biologic and morphologic outcomes to determine their roles and sequence in the development of experimental radiation-induced mucositis and to evaluate the effects of IL-11 in attenuating them. Our results suggest that IL-11 favorably modulates acute radiation-induced mucositis by attenuating pro-inflammatory cytokine expression. Data are also presented which help define the pathobiological sequence of mucositis.

IL-12-Dependent enhancement of CTL response to weak class I-restricted peptide immunogens requires coimmunization with T helper cell immunogens

The effect of in vivo administration of rmIL-12 on the CTL response to immunization with a weakly immunogenic class I-restricted peptide emulsified in incomplete Freund's adjuvant was investigated. In the absence of IL-12, peptide-specific CTL responses were significantly greater following coimmunization with class I-restricted peptide and T helper cell antigens than following immunization with the class I-restricted peptide alone. IL-12-dependent enhancement of the CTL response to peptide immunization was demonstrated in the presence of, but not in the absence of, coimmunization with T helper cell antigen. These findings indicate that IL-12 enhancement of the CTL response to weak class I-restricted immunogens is T helper cell dependent. Treatment with rmIL-12 also enhanced the CTL response to immunization with cDNA encoding both CTL and T helper cell epitopes. These findings are relevant to the design of vaccines containing tumor-associated class I-restricted peptides currently being tested as an immunotherapy for cancer patients.

Molecular effects of recombinant human interleukin-11 in the HLA-B27 rat model of inflammatory bowel disease

Recombinant human interleukin-11 (rhIL-11) is a pleiotropic cytokine with effects on multiple cell types. In addition to thrombopoietic activity, rhIL-11 has demonstrated anti-inflammatory activity in vitro and in vivo. rhIL-11 treatment reduces clinical signs and histologic lesions of colitis in transgenic rats expressing the human major histocompatibility complex (MHC) Class I allele, HLA-B27. We have investigated the effects of rhIL-11 at the molecular and cellular level in this model of inflammatory bowel disease. RT-PCR analysis of colonic RNA revealed that treatment with rhIL-11 down-regulated expression of proinflammatory cytokines including TNF-alpha, IL-1beta, and IFN-gamma. rhIL-11 also reduced the level of myeloperoxidase activity in the cecum indicating reduced inflammation. After stimulation in vitro with anti-CD3 antibody, spleen cell cultures derived from rhIL-11-treated rats produced less IFN-gamma, TNF-alpha, and IL-2 than cultures derived from vehicle-treated rats. These molecular and cellular effects correlated with amelioration of disease as measured by stool character and histologic lesion scores. These findings suggest that rhIL-11 acts to reduce inflammation through modulation of multiple proinflammatory mediators including products of activated T cells. This study has identified pharmacodynamic markers of rhIL-11 anti-inflammatory activity in vivo and supports rhIL-11 therapy to treat inflammatory bowel disease.

Murine Hoxc-9 gene contains a structurally and functionally conserved enhancer

Reporter gene analysis of the Hoxc-9 genomic region in transgenic mice allowed us to identify a positional enhancer in the Hoxc-9 intron that drives expression in the posterior neural tube of midgestation mouse embryos in a Hoxc-9-related manner. Sequence comparison to the chicken Choxc-9 intron revealed the existence of two highly conserved sequence elements (CSEs) in a similar spatial arrangement. These structural similarities in the mammalian and avian lineage are mirrored by conserved function of the chicken Choxc-9 intron in transgenic mice. Deletion analysis of the two introns suggests that full activity of both enhancers depends on cooperation between the two CSEs located close to the respective 5' and 3' splice sites. Following the paradigm of phylogenetically conserved developmental control mechanisms, the Hoxc-9 intragenic enhancer was tested in Drosophila. Our data show that the mouse Hoxc-9 enhancer acts in a conserved fashion in transgenic flies, conferring posteriorly restricted reporter gene expression to the developing central nervous system in third instar larvae. This finding indicates that the Hoxc-9 intragenic enhancer is involved in transcriptional regulatory circuits conserved between vertebrates and arthropods.

Interleukin-11 induces intestinal epithelial cell growth arrest through effects on retinoblastoma protein phosphorylation

Recombinant human (rh) interleukin (IL)-11 has been shown to reduce gastrointestinal mucosal injury after chemotherapy or irradiation in several animal models. As reduction of cellular proliferation can be cytoprotective, we have examined the effect of rhIL-11 compared with transforming growth factor (TGF)-beta 1 on the proliferation and cell cycle progression of a rat intestinal cell line, IEC-6. IEC-6 cells treated with rhIL-11 or rhTGF-beta 1 exhibited a reduced proliferative rate as measured by cell counts and [3H]thymidine incorporation. The presence of neutralizing anti-TGF-beta 1 antibodies did not block the antiproliferative effect of rhIL-11 indicating that the rhIL-11 activity was not mediated through the induction of endogenous TGF-beta 1 production. Growth inhibition correlated with delayed entry into S phase of the cell cycle. Cell cycle arrest was associated with suppression of retinoblastoma protein phosphorylation. Transient cell cycle arrest is a possible mechanism by which rhIL-11 may protect intestinal epithelial cells from damage induced by chemotherapy or radiation therapy. This study provides a rationale for the clinical use of rhIL-11 to preserve the integrity of the gastrointestinal mucosa during cancer treatment regimens.

The murine Hoxc cluster contains five neighboring AbdB-related Hox genes that show unique spatially coordinated expression in posterior embryonic subregions

A common feature of the murine Abdominal B (AbdB) -related Hox genes, located in the 5' regions of the four Hox clusters, appears to be a function in patterning the developing limb. As a prerequisite for studying the role of the AbdB-related Hoxc genes during limb development, we have isolated and mapped the three predicted AbdB-related Hoxc-11, -12, and -13 loci, thus defining the 5' end of the Hoxc cluster. Sequence comparisons based on the homeobox sequences of presumably all murine AbdB-related Hox genes strongly support the concept of a two step process in their evolution. As expected, Hoxc-11, -12 and -13 exhibit nested and extremely posteriorly restricted expression domains, whose anterior boundaries reflect their map positions, in accordance with the colinearity rule. A limited comparison of the primary expression domains of all five AbdB-related Hoxc genes in the developing hindlimb revealed nested and increasingly restricted domains of expression in the mesenchyme for only Hoxc-9, -10 and -11. However, separate localized expression was detected for Hoxc-9, -10, -11, -12 and possibly -13 in distal epidermal regions of the developing hind- and forelimb, whereas no expression of any of the five genes was observed in mesenchymal tissues of the developing forelimb. These data suggest a specific role for the AbdB-related Hoxc genes in patterning the hindlimb and pelvic girdle, which is separate from a second role relevant for both hind- and forelimb development.

The computer enhancement of a medical office

For several years small businesses have struggled to take advantage of the promised capabilities of the microcomputer. Limited by processor power and hindered by unyielding software these promises have gone largely unfulfilled. However, recent advances in processor speed and a new generation of user friendly software have made the microcomputer a true ally for improving the operating efficiency of an office. Now, economical computing platforms can be linked together and run with off-the-shelf software to enhance the capabilities of any medical business.

Further evidence for a correlation between nodulation genotypes in alfalfa (Medicago sativa L.) and mycorrhiza formation

The vesicular-arbuscular (VA) mycorrhizal status of three alfalfa (Medicago sativa L.) nodulation genotypes (nod⁺ fix⁺ , nod⁺ fix^- and nod^- fix^- ) was investigated using pot cultures of three fungal species from two genera (Glomus monosporum Gerd. & Trappe, Glomus fasciculatum (Thaxter) Gerd. & Trappe emend. Walker & Koske and Gigaspora margarita Becker & Hall). Roots of the nod⁺ fix⁺ genotype developed complete VA mycorrhizas with each fungus. Roots of the nod⁺ fix^- and nod^- fix^- genotypes did not develop normal VA mycorrhizal symbioses. Roots of the nod^- fix^- genotype had significantly more appressoria than roots of the other genotypes. Aborted appressoria were unable to penetrate the cortical cells of roots of nod⁺ fix^- and nod^- fix^- genotypes. Measurement of appressorium length, width and approximate contact area revealed significant differences in the size of appressoria produced by each VA mycorrhizal fungus on each alfalfa nodulation genotype. Histological studies of nod⁺ fix⁺ and nod^- fix^- genotypes colonized by Glomus versiforme (Karsten) Berch showed the presence of electron-dense material in aborted appressoria on roots of the nod^- fix^- genotype but not in appressoria on roots of the nod⁺ fix⁺ genotype.

Hox-3.6: isolation and characterization of a new murine homeobox gene located in the 5′ region of the Hox-3 cluster

Most members of the murine Hox gene system can be grouped into two subclasses based on their structural similarity to either one of the Drosophila homeotic genes Antennapedia (Antp) or Abdominal B (AbdB). All the AbdB-like genes reported thus far are located in the 5' region of their respective cluster. We describe here the isolation, structural characterization and spatio-temporal expression pattern of a new AbdB-like homeobox gene designated Hox-3.6 that is located in the 5' region of the Hox-3 cluster. Hox-3.6 has an extreme posterior expression domain in embryos of 12.5 days of gestation, a feature that has thus far only been observed for the 5' most genes of the Hox-4 cluster. Like the other members of the AbdB subfamily, Hox-3.6 exhibits spatially restricted expression in the hindlimb bud, but the expression domain is antero-proximal in contrast to the postero-distal domain reported for its cognate gene Hox-4.5. Structural analysis of the 5' region revealed the presence of a 35 bp sequence which shares homology and relative 5' position with an upstream sequence present in its two nearest downstream neighbors, Hox-3.2 and -3.1.

Interactions between three alfalfa nodulation genotypes and two Glomus species

Seedlings of a non-nodulating alfalfa (Medicago sativa L.) genotype (nod^- fix^- ) and an ineffectively nodulating alfalfa genotype (nod⁺ fix^- ) exhibited resistance to vesiscular-arbuscular mycorrhizal (VA mycorrhizal) colonization, when grown in pot cultures inoculated with either Glomus versiforme (Daniels and Trappe) Berth or Glomus intraradices Schenck and Smith. Appressoria, showing considerable variation in size and shape, developed on the root surface, but failed to form any internal structures such as arbuscules and vesicies. Wild-type (nod⁺ fix^- ) alfalfa seedlings developed normal colonization. This phenomenon will be extremely useful in studying the processes of recognition and compatibility between plant species and VA mycorrhizal fungal species.

Effect of phosphorus nutrition on morphological characteristics of vesicular-arbuscular mycorrhizal colonization of maize

The morphology of the colonization of maize (Zea mays L.) by the vesicular arbuscular mycorrhizal fungus Glomus versiforme (Daniels and Trappe) Berch was determined quantitatively to establish the stage at which colonization was limited in response to increased P nutrition. Harvests were taken 14, 19, 24 and 29 d after planting maize in a calcined clay medium to which nutrient solution containing 0.16, 0.8 or 2.4 mM P was added daily. The fraction of the root length containing arbuscules (FAC) 19 d after planting was 0.4 with 0.16 mM P, 0.3, with 0.8 mM P and 0.17 with 2.4 mM P. Corresponding shoot P concentrations were 1.5, 2.0 and 3.2 mg g^-l . Increased shoot P concentration reduced the number of appressoria per unit root length, but this accounted for only a part of the reduction in FAC. Increased root length did not account for the effect of shoot P concentration on FAC. The length of arbuscular colonized root length (total root length × FAC) per appressorium was strongly reduced in response to increased shoot P concentration. It was concluded that the reduction in FAC was mediated primarily through an inhibition of intra-radical development.

Digital imaging techniques in dermatology

Digital imaging is a versatile technique that has been infrequently used in dermatology to record visual images. We have used this technology for 10 patients to follow cutaneous lesions, including alopecia mucinosa, psoriasis, and dysplastic nevi. The setup included a personal computer, digitizer board, monitor, video camera, and lights. An introduction to electronic (digital) imaging is given and some of the many possible applications in dermatology are discussed.

The time-course of disease suppression and antibiosis by the ectomycorrhizal fungus Paxillus involutus

Seedlings of Pinus resinosa Ait. grown in test tubes were inoculated with the ectomycorrhizal fungus Paxillus involutus Fr. and, one day later, with a spore suspension of the root pathogenic fungus Fusarium oxysporum Schlecht emend, Sny. & Hans f.sp. pini. Controls consisted of seedlings inoculated with plugs of sterile modified Melin Norkrans medium and F. oxysporum. Seedling survival was counted, sporulation of F. oxysporum was measured, and ethanol extractions of the rhizosphere were made, 1, 2, 3, 4, 5, 6, 8, 10 and 14 d after inoculation with the pathogen. The ethanol extractives were concentrated and assayed for fungitoxic activity by measuring the germination of F. oxysporum microconidia. Dead seedlings were first observed 3 d after inoculation with the pathogen. Sporulation of F. oxysporum was reduced significantly 3 d after seedling inoculation with P. involutus when compared with controls lacking P. involutus. The fungitoxic activity of the rhizosphere of the seedlings inoculated with P. involutus was greater than the fungitoxic activity of the rhizosphere of control seedlings, increasing strongly 2.4 d after inoculation with the pathogen. Suppression of Fusarium root rot by P. involutus may, therefore, be the result of antibiosis by this ectomycorrhizal fungus.

The alcohol-impaired dentist: an educational challenge

A cross-sectional survey of 370 dental practitioners, a 74% response rate, was conducted and data collected. Prevailing attitudes within the dental profession toward the alcohol abuser and the role of peer intervention were recorded. Data collectively indicated a need for further strengthening educational efforts and the need for further development of a peer-assistance network.

Transverse membrane topography of the B875 light-harvesting polypeptides of wild-type Rhodobacter sphaeroides

Purified B875 light-harvesting complex, chromatophores, and spheroplast-derived vesicles from wild-type Rhodobacter sphaeroides were treated with proteinase K or trypsin, and the alpha and beta polypeptides were analyzed by electrophoretic, immunochemical, and protein-sequencing methods. With the purified complex, proteinase K digested both polypeptides and completely eliminated the A875 peak. Trypsin digested the alpha polypeptide and reduced the A875 by 50%. Proteinase K cleaved the beta polypeptide of chromatophores and the alpha polypeptide of spheroplast-derived vesicles. Sequence analyses of polypeptides extracted from proteinase K-treated chromatophores revealed that the beta polypeptide was cleaved between amino acids 4 and 5 from the N terminus. The N terminus of the alpha polypeptide was intact. We concluded that the N terminus of the beta polypeptide is exposed on the cytoplasmic membrane surface, and the difference in the digestion patterns between the spheroplast-derived vesicles and chromatophores suggested that the C terminus of the alpha polypeptide is exposed on the periplasmic surface.

Mycorrhizae and their potential use in the agricultural and forestry industries

Mycorrhizal fungi associated with plant roots increase the absorption of nutrients, particularly phosphorus, and thus enhance the growth of crop plants and trees. Vesicular-arbuscular mycorrhizae (VAM) occur in approximately 90% of all vascular plants including most of the important agricultural species, whereas ectomycorrhizae are found in most of the economically important tree species of the temperate regions of the world, and in some tropical trees. These symbiotic associations are, therefore, important in crop and biomass production. For this reason they are receiving considerable attention in agriculture and forestry. Currently, VAM are utilized in fumigated soils, greenhouse crops, and in the reclamation of disturbed sites. Ectomycorrhizae are employed in the establishment of trees in nurseries, in reforestation programs, and in the production of containerized seedlings. Production of VAM and ectomycorrhiza inoculum for large scale projects is now feasible but many basic questions related to persistence of these fungi in field situations, competition with other microorganisms, and particularly the most efficient fungi to use for particular hosts remain largely unanswered.

Cascade of Services Model and emotionally disabled students

The Cascade of Services Model has become an essential component of modern special education, but questions remain about how the Cascade actually operates and whether progams at different levels actually differ as presumed. The present study provides data relating to three areas of presumed differences between resource, self-contained, and residential programs serving emotionally disabled students: type or severity of students, amount of student integration, and allocation of teacher time. While the trends of the data indicate some validity for the assumptions implicit in the Cascade, differences between the levels of the Cascade may be overstated, and levels may overlap to the point where differences are inconsequential.

Embedding softened herbarium material in Spurr's resin for histological studies

Plant organs, including stems, rhizomes, leaves, roots, petals, sporangia and flower pedicels obtained from dried herbarium specimens of a variety of plant species have been softened with Aerosol OT and subsequently dehydrated in a graded series of acetones and embedded in Spurr's resin. Although the quality of preservation varied, sections of a variety of materials showed excellent cellular preservation. Sections stained through the resin with toluidine blue O and examined with either bright field microscopy or with crossed polarizers showed good cell detail. Histochemical tests for callose, polysaccharides, and cellulosic walls, using sections from which the resin had been removed by sodium methoxide and then viewed with an epifluorescence microscope, gave excellent results.

Gas-Chromatographic Determination of Ethylene Glycol in Serum

We have developed a method for detection and quantitation of ethylene glycol in serum, based on the gas chromatography of its dibenzoate ester. No special reagents or equipment are required. The method is virtually free of interference and sensitive to less than 0.02 mg of ethylene glycol per milliliter. The total analysis time is about 90 min.

The first known female of the African long-eared bat Laephotis wintoni (Vespertilionidae: Chiroptera)

A subadult Laephotis wintoni Thomas taken west of Mount Kenya in Kenya on 22 June, 1972, represents the fourth specimen and the first known female of that taxon. Measurements are compared with those of three males, and systematic relations within the genus are discussed. The soft palate is illustrated for the first time.

Xylem transfer cells in the rosette plant Hieracium floribundum

Xylem transfer cells in the rhizome of Hieracium floribundum are described for the first time and several methods used in visualizing these cells are discussed. The most marked wall ingrowths occur in transfer cells associated with the xylem of foliar traces.

The systematic status of the African molossid bats Tadarida bemmeleni and Tadarida cistura

Twenty-four specimens of Tadarida bemmeleni, collected in Cameroun in 1970, appear to be the first taken since the holotype was collected in 1875 from Liberia. Morphological comparisons with T. cistura from East Africa indicate that the two taxa are subspecies of the same species. Systematic relations, age, and sexual variation, as well as ecological notes, are provided. The facial features, caudal glands, palatal ridges, and cranial details are illustrated for the first time.

Ribonucleic acid synthesis in bacteria treated with toluene

Escherichia coli and Bacillus megaterium rendered permeable to ribonucleoside triphosphates by toluene treatment retain the capacity to synthesize discrete ribonucleic acid species.

The African molossid bat Tadarida russata

Five specimens of Tadarida russata obtained from Cameroun, West Africa, appear to be the first collected since the original series was obtained in 1910 from near Medje, Congo. Both the new and the original specimens were taken along the junction of the so-called "high forest" and "Guinea forest" zones but some 1200 miles apart. The Cameroun specimens were compared with the original type series and additional morphological data provided as well as the illustrations of facial and cranial features. T. bivittata, of similar size, is shown not to be closely allied with T. russata nor any member of the subgenus Chaerephon. T. russata is closely related to T. aloysiisabaudiae but differs in size, skull proportions, and details of the basisphenoid pits.

Formation of all stable RNA species in Escherichia coli by posttranscriptional modification

The kinetics of accumulation of the known stable RNA species (23S, 16S, and 5S rRNA and tRNA) in Escherichia coli C122 were monitored by polyacrylamide gel electrophoresis of purified cellular RNA, following termination of brief pulse labeling with (32)P-orthophosphate. Isotopically labeled stable RNA species appear only after a time lag, while total cellular RNA and the ostensible precursors to the stable RNA classes accumulate from the earliest times examined. It is concluded that all the known stable RNA species in E. coli are the products of posttranscriptional modification.