Microwave observations reveal the deep extent and structure of Jupiter's atmospheric vortices

[Figure: see text].

Jovian Injections Observed at High Latitude

The polar orbit of Juno at Jupiter provides a unique opportunity to observe high-latitude energetic particle injections. We measure energy-dispersed impulsive injections of protons and electrons. Ion injection signatures are just as prevalent as electron signatures, contrary to previous equatorial observations. Included are previously unreported observations of high-energy banded structures believed to be remnants of much earlier injections, where the particles have had time to disperse around Jupiter. A model fit of the injections used to estimate timing fits the shape of the proton signatures better than it does the electron shapes, suggesting that electrons and protons are different in their abilities to escape the injection region. We present ultaviolet observations of Jupiter's aurora and discuss the relationship between auroral injection features and in situ injection events. We find, unexpectedly, that the presence of in situ particle injections does not necessarily result in auroral injection signatures.

Jupiter's atmospheric jet streams extend thousands of kilometres deep

The depth to which Jupiter's observed east-west jet streams extend has been a long-standing question. Resolving this puzzle has been a primary goal for the Juno spacecraft, which has been in orbit around the gas giant since July 2016. Juno's gravitational measurements have revealed that Jupiter's gravitational field is north-south asymmetric, which is a signature of the planet's atmospheric and interior flows. Here we report that the measured odd gravitational harmonics J₃, J₅, J₇ and J₉ indicate that the observed jet streams, as they appear at the cloud level, extend down to depths of thousands of kilometres beneath the cloud level, probably to the region of magnetic dissipation at a depth of about 3,000  kilometres. By inverting the measured gravity values into a wind field, we calculate the most likely vertical profile of the deep atmospheric and interior flow, and the latitudinal dependence of its depth. Furthermore, the even gravity harmonics J₈ and J₁₀ resulting from this flow profile also match the measurements, when taking into account the contribution of the interior structure. These results indicate that the mass of the dynamical atmosphere is about one per cent of Jupiter's total mass.

Jupiter's magnetosphere and aurorae observed by the Juno spacecraft during its first polar orbits

The Juno spacecraft acquired direct observations of the jovian magnetosphere and auroral emissions from a vantage point above the poles. Juno's capture orbit spanned the jovian magnetosphere from bow shock to the planet, providing magnetic field, charged particle, and wave phenomena context for Juno's passage over the poles and traverse of Jupiter's hazardous inner radiation belts. Juno's energetic particle and plasma detectors measured electrons precipitating in the polar regions, exciting intense aurorae, observed simultaneously by the ultraviolet and infrared imaging spectrographs. Juno transited beneath the most intense parts of the radiation belts, passed about 4000 kilometers above the cloud tops at closest approach, well inside the jovian rings, and recorded the electrical signatures of high-velocity impacts with small particles as it traversed the equator.

Jupiter's interior and deep atmosphere: The initial pole-to-pole passes with the Juno spacecraft

On 27 August 2016, the Juno spacecraft acquired science observations of Jupiter, passing less than 5000 kilometers above the equatorial cloud tops. Images of Jupiter's poles show a chaotic scene, unlike Saturn's poles. Microwave sounding reveals weather features at pressures deeper than 100 bars, dominated by an ammonia-rich, narrow low-latitude plume resembling a deeper, wider version of Earth's Hadley cell. Near-infrared mapping reveals the relative humidity within prominent downwelling regions. Juno's measured gravity field differs substantially from the last available estimate and is one order of magnitude more precise. This has implications for the distribution of heavy elements in the interior, including the existence and mass of Jupiter's core. The observed magnetic field exhibits smaller spatial variations than expected, indicative of a rich harmonic content.

Juno-UVS approach observations of Jupiter's auroras

Juno ultraviolet spectrograph (UVS) observations of Jupiter's aurora obtained during approach are presented. Prior to the bow shock crossing on 24 June 2016, the Juno approach provided a rare opportunity to correlate local solar wind conditions with Jovian auroral emissions. Some of Jupiter's auroral emissions are expected to be controlled or modified by local solar wind conditions. Here we compare synoptic Juno-UVS observations of Jupiter's auroral emissions, acquired during 3-29 June 2016, with in situ solar wind observations, and related Jupiter observations from Earth. Four large auroral brightening events are evident in the synoptic data, in which the total emitted auroral power increases by a factor of 3-4 for a few hours. Only one of these brightening events correlates well with large transient increases in solar wind ram pressure. The brightening events which are not associated with the solar wind generally have a risetime of ~2 h and a decay time of ~5 h.

Dimensional structure and course of post-traumatic stress symptomatology in World Trade Center responders

BACKGROUND

Post-traumatic stress disorder (PTSD) in response to the World Trade Center (WTC) disaster of 11 September 2001 (9/11) is one of the most prevalent and persistent health conditions among both professional (e.g. police) and non-traditional (e.g. construction worker) WTC responders, even several years after 9/11. However, little is known about the dimensionality and natural course of WTC-related PTSD symptomatology in these populations.

METHOD

Data were analysed from 10 835 WTC responders, including 4035 police and 6800 non-traditional responders who were evaluated as part of the WTC Health Program, a clinic network in the New York area established by the National Institute for Occupational Safety and Health. Confirmatory factor analyses (CFAs) were used to evaluate structural models of PTSD symptom dimensionality; and autoregressive cross-lagged (ARCL) panel regressions were used to examine the prospective interrelationships among PTSD symptom clusters at 3, 6 and 8 years after 9/11.

RESULTS

CFAs suggested that five stable symptom clusters best represent PTSD symptom dimensionality in both police and non-traditional WTC responders. This five-factor model was also invariant over time with respect to factor loadings and structural parameters, thereby demonstrating its longitudinal stability. ARCL panel regression analyses revealed that hyperarousal symptoms had a prominent role in predicting other symptom clusters of PTSD, with anxious arousal symptoms primarily driving re-experiencing symptoms, and dysphoric arousal symptoms primarily driving emotional numbing symptoms over time.

CONCLUSIONS

Results of this study suggest that disaster-related PTSD symptomatology in WTC responders is best represented by five symptom dimensions. Anxious arousal symptoms, which are characterized by hypervigilance and exaggerated startle, may primarily drive re-experiencing symptoms, while dysphoric arousal symptoms, which are characterized by sleep disturbance, irritability/anger and concentration difficulties, may primarily drive emotional numbing symptoms over time. These results underscore the importance of assessment, monitoring and early intervention of hyperarousal symptoms in WTC and other disaster responders.

Trajectories of PTSD risk and resilience in World Trade Center responders: an 8-year prospective cohort study

BACKGROUND

Longitudinal symptoms of post-traumatic stress disorder (PTSD) are often characterized by heterogeneous trajectories, which may have unique pre-, peri- and post-trauma risk and protective factors. To date, however, no study has evaluated the nature and determinants of predominant trajectories of PTSD symptoms in World Trade Center (WTC) responders.

METHOD

A total of 10835 WTC responders, including 4035 professional police responders and 6800 non-traditional responders (e.g. construction workers) who participated in the WTC Health Program (WTC-HP), were evaluated an average of 3, 6 and 8 years after the WTC attacks.

RESULTS

Among police responders, longitudinal PTSD symptoms were best characterized by four classes, with the majority (77.8%) in a resistant/resilient trajectory and the remainder exhibiting chronic (5.3%), recovering (8.4%) or delayed-onset (8.5%) symptom trajectories. Among non-traditional responders, a six-class solution was optimal, with fewer responders in a resistant/resilient trajectory (58.0%) and the remainder exhibiting recovering (12.3%), severe chronic (9.5%), subsyndromal increasing (7.3%), delayed-onset (6.7%) and moderate chronic (6.2%) trajectories. Prior psychiatric history, Hispanic ethnicity, severity of WTC exposure and WTC-related medical conditions were most strongly associated with symptomatic trajectories of PTSD symptoms in both groups of responders, whereas greater education and family and work support while working at the WTC site were protective against several of these trajectories.

CONCLUSIONS

Trajectories of PTSD symptoms in WTC responders are heterogeneous and associated uniquely with pre-, peri- and post-trauma risk and protective factors. Police responders were more likely than non-traditional responders to exhibit a resistant/resilient trajectory. These results underscore the importance of prevention, screening and treatment efforts that target high-risk disaster responders, particularly those with prior psychiatric history, high levels of trauma exposure and work-related medical morbidities.

An assessment of lead controls for torch cutting and rivet removal on steel structures

The use of engineering and work practice controls to protect workers from lead-containing dusts and fumes generated during rehabilitation of steel structures is mandated by the Occupational Safety and Health Administration (OSHA) Lead in Construction Standard (1993). Because the implementation and assessment of controls can be problematic in the rugged and dynamic construction environment, industrial hygienists should understand the effectiveness and limitations of controls adopted. The present investigation assesses the efficacy of two controls to reduce lead exposure: paint removal prior to oxy-acetylene torch cutting of steel, and encapsulation of rivets prior to their removal. A task-based exposure assessment approach was used to evaluate these tasks at three sites. Exposures at one site without controls were compared to exposures at sites with controls. Comparison of the results via an analysis of variance (0.05 significance level) indicates that, for torch cutting, exposures at the control site were not significantly different from those at an uncontrolled site (p = 0.14). The results for rivet busting show no significant differences in exposures at the control site compared to the uncontrolled site (p = 0.08). Results are also presented from two control sites where work was done in enclosed spaces. Two main difficulties in applying the controls are explored: technical and managerial. Technical problems during torch cutting included the penetration of paint into the steel profile and the configuration of the structures. For rivet busting, working within an enclosure was an important factor. Management problems arose both from a lack of coordination among different contractors, and from a failure to provide day-to-day guidance and assessment of the control. Important components of a program to implement controls are preplanning and coordination of control implementation, frequent testing of control efficacy, and a method for timely intervention to correct deficiencies.

The diagnosis and management of solvent-related disorders

Millions of workers in the United States are recurrently exposed to solvents throughout their working lives. Members of this class of compounds share the ability to dissolve waxes, fats, and oils as their common characteristic. This review offers the health practitioner a practical approach to the diagnosis, management, and prevention of solvent-related disorders that result from exposures to these compounds in the workplace. A description of commonly used solvents is provided, along with a brief review of the literature that documents their acute and chronic effects on health.

Medical examination for asbestos-related disease

There are millions of workers whose exposure to asbestos dust prior to the implementation of asbestos regulation and improved control measures places them at risk of asbestos-related disease today. In addition, workers are still being exposed to significant amounts of asbestos, when asbestos materials in place are disturbed during renovation, repair, or demolition. Given the continued presence of asbestos-containing materials in industrial, commercial, and residential settings throughout the U.S., a sizeable population remains at risk of asbestos-related disease. This article reviews the health effects associated with exposure to asbestos and delineates the steps necessary for the comprehensive screening and clinical assessment for asbestos-related disease, in order to assist physicians in identifying and preventing illness associated with exposure to asbestos among their patients.

Clinical evaluation and management of lead-exposed construction workers

An estimated one million construction workers are currently occupationally exposed to lead. Until 1993, construction workers were not offered the protections of OSHA's 1978 standard for lead exposure in industrial activities. Preventing exposure to lead in the construction setting presents many challenges, given the rapidly and frequently changing work environment. This article reviews the adverse effects of lead on human health and presents an approach to the diagnosis, management, and prevention of lead-related illness. The medical aspects of the 1993 OSHA standard for lead in construction are described.

A task-based approach to assessing lead exposure among iron workers engaged in bridge rehabilitation

The assessment of worker exposures to airborne contaminants in the dynamic environment present at most construction sites poses considerable challenges to the industrial hygienist. In this study, we applied a task-based approach to the assessment of lead exposure among structural steel iron workers engaged in a large, complex bridge rehabilitation project. We evaluated the usefulness of task-based exposure data for the development of worker protection programs. Task-specific and multitask samples were collected, and operation-specific and 8-hr time-weighted averages were calculated. The task-specific data showed significant differences in exposure levels among different tasks. Arithmetic mean exposures varied from 1,357 micrograms/m3 lead for torch cutting and 989 micrograms/m3 for scaling to 31 micrograms/m3 for reaming and 4 micrograms/m3 for drilling. Our task-specific data were compared with the task-based exposure levels presented by OSHA in its Lead Exposure in Construction-Interim Final Rule (29 CFR 1926). There was good general agreement between our results and OSHA's reported data. Task-based data were very useful in exposure assessment and much more precise than full-shift and operation-based measurements in guiding strategies for worker protection. These findings suggest that task-based data should routinely be collected in evaluating exposure to lead and perhaps other toxic substances in construction work.

The effect of the OSHA lead exposure in construction standard on blood lead levels among iron workers employed in bridge rehabilitation

Over 50,000 workers are at risk of occupational exposure to lead in the course of renovating the nation's deteriorating infrastructure. In mid-1993, to control exposure to lead in the construction setting OSHA promulgated a Lead in Construction Standard. In this study, we assessed the effect of the mandated changes in exposure conditions which followed the introduction of this new standard. We analyzed changes in baseline and maximum blood lead concentrations and in maximum increments in blood lead levels before and after introduction of the standard among iron workers employed in the renovation of a large, lead-painted, steel bridge in New York City. Results indicated that baseline and maximum blood lead levels fell significantly after the implementation of the provisions of the standard, as did maximum increments in blood lead concentrations. Seventy-six percent of the workers maintained blood lead concentrations below 20 micrograms/dl after the OSHA standard, as compared with 66% prior to its implementation. Increments of 20 micrograms/dl or more occurred considerably more frequently before introduction of the standard (13% before vs. 4% after; p = 0.01). Evidence of decreased exposure to lead was observed among iron workers who were present both before and after the introduction of the OSHA standard, as well as among iron workers newly hired after the OSHA provisions were put in place. These findings document the effectiveness of the OSHA construction lead standard in controlling exposure to lead in this complex and variable environment. The data indicate the utility of blood lead determinations in assessing the outcome of industrial hygiene interventions to reduce exposures to lead in the construction setting.

Putting the shoulder to the wheel: a new biomechanical model for the shoulder girdle

The least successfully modeled joint complex has been the shoulder. In multi-segmented mathematical shoulder models rigid beams (the bones) act as a series of columns or levers to transmit forces or loads to the axial skeleton. Forces passing through the almost frictionless joints must, somehow, always be directed perfectly perpendicular to the joints as only loads directed at right angles to the surfaces could transfer across frictionless joints. Loads transmitted to the axial skeleton would have to pass through the moving ribs or the weak jointed clavicle and then through the ribs. A new model of the shoulder girdle, based on the tension icosahedron described by Buckminster Fuller, is proposed that permits the compression loads passing through the arm and shoulder to be transferred to the axial skeleton through its soft tissues. In this model the scapula 'floats' in the tension network of shoulder girdle muscles just as the hub of the wire wheel is suspended in its tension network of spokes. With this construct inefficient beams and levers are eliminated. A more energy efficient, load distributing, integrated, hierarchical system is created.

Unraveling the chronic toxicity of lead: an essential priority for environmental health

Although population exposure to lead has declined, chronic lead toxicity remains a major public health problem in the United States affecting millions of children and adults. Important gaps exist in knowledge of the pathophysiology of chronic lead intoxication. These gaps have impeded development of control strategies. To close current gaps in knowledge of chronic lead toxicity, we propose an integrated, multidisciplinary, marker-based research program. This program combines a) direct measurement of individual lead burden by 109Cd X-ray fluorescence analysis of lead in bone, b) determination of ALA-D phenotype, an index of individual susceptibility to lead, and c) assessments of subclinical injury produced by lead in the kidneys, nervous system and, reproductive organs. Data from this research will provide answers to questions of great public health importance: a) Are current environmental and occupational standards adequate to prevent chronic lead intoxication? b) is lead mobilized from the skeleton during pregnancy or lactation to cause fetal toxicity? c) Is lead mobilized from bone during menopause to cause neurotoxicity? d) What is the significance of genetic variation in determining susceptibility to lead? e) What is the contribution of lead to hypertension, renal disease, chronic neurodegenerative disease or declining sperm counts? f) Is chelation therapy effective in reducing body lead burden in persons with chronic overexposure to lead?

Financing and payment reform for primary health care and substance abuse treatment

One of the most controversial areas for health care reform concerns the treatment of alcohol and other drug problems, which account for some of the most rapidly rising costs in the health care sector. There is arguably no other set of conditions that show such variation in accessibility to treatment on the basis of insurance status, present the same degree of difficulty in providing comprehensive care, or challenge as many public and professional assumptions about behavioral, social and economic determinants. The purpose of this article is to discuss some of the financing and coverage barriers to comprehensive treatment for alcohol and other drug abuse; to discuss some innovative mechanisms for providing and financing comprehensive services; and to suggest some directions for public policy to support the development of new practice models that emphasize cost-effectiveness and efficiency of care.

Radiological abnormalities and asbestos exposure among custodians of the New York City Board of Education

Six hundred sixty custodians employed by the New York City Board of Education underwent examination from 1985 through 1987 for asbestos-related disease and other general medical conditions by the clinical staff of the Division of Environmental and Occupational Medicine of the Mount Sinai School of Medicine of the City University of New York. Two-thirds of the men (no women were examined) were 20 or more years from onset of any custodial work, with 44% having had at least 20 years of employment as custodial workers in New York City Board of Education schools. Twenty-four percent had begun custodial work in buildings 30 or more years earlier. Findings among them were of particular interest since asbestos-related disease might forecast what might be expected among school custodians with less seniority. Since the Board of Education, in selecting custodians for examination, had chosen only custodians currently employed, the study group comprised men still working in the school system. These, then, represented a "survivor population" (4% had retired between the time of enrollment in the study and the date of examination, and only one of the seventeen retirees had left work owing to disability). Although a considerable amount of clinical information was obtained, abnormalities on chest X-ray consistent with asbestos-induced scarring were used as the key index of disease resulting from exposure to asbestos. Since scarring of the lung tissue or lining of the lung or chest wall (pleura) may be present but undetectable on standard chest radiographs (a relatively insensitive diagnostic technique), the prevalence of abnormality on X-ray film represents a conservative estimate of the actual burden of scarring lung disease in the group. Such changes are indicative of previous asbestos exposure, however, and provide evidence of an increased risk of later asbestos-related malignancy. Overall, abnormalities on chest X-ray consistent with asbestos-related scarring were found in 28% of the men examined. The expected relationship of increasing prevalence of radiographic changes with increasing time since onset of exposure in buildings was demonstrated; among those with 35 or more years since beginning custodial work, 39% had abnormal films. This is evidence that custodial workers as a group have had asbestos exposure in the past, as reflected also in the work histories obtained at the time of examination. Eighty-four percent reported that they themselves removed asbestos-containing materials in the course of their work. Eighty-nine percent had been present in the work area during asbestos abatement projects in the schools in more recent years.(ABSTRACT TRUNCATED AT 400 WORDS)

Two leukocyte receptors (CD11a/CD18 and CD11b/CD18) mediate transient adhesion to endothelium by binding to different ligands

Upon stimulation with C5a, TNF, or phorbol dibutyrate (PDB), polymorphonuclear leukocytes (PMN) exhibit first an increase then a decrease in adhesion to unstimulated endothelial cells (EC). Essentially all of this adhesion is mediated by the CD18 family of leukocyte integrins on PMN. To determine the individual roles of CD11a/CD18 (LFA-1), CD11b/CD18 (CR3, Mac-1) and CD11c/CD18 (p150,95) in adhesion of PDB-stimulated PMN to unstimulated EC, mAb against the CD11 chains were used. mAb against CD11a or CD11b each blocked adhesion of PMN to EC by approximately 50%, but mAb against CD11c had no effect. Inasmuch as a combination of anti-CD11a and CD11b mAb completely blocked adhesion, it appears that CD11a/CD18 and CD11b/CD18 make approximately equal contributions to binding, and CD11c does not participate. Anti-CD11a or CD11b each blocked adhesion by about 50% throughout the transient time course of PDB-stimulated adhesion, indicating that the capacity of each of these receptors to bind EC is transiently activated by PDB. We next examined the role of ICAM-1 on EC as a ligand for CD18. Two anti-ICAM-1 mAb (LB-2 and 84H10) each inhibited PMN adhesion in a dose-dependent fashion, reaching a maximal inhibition of approximately 50%. Anti-ICAM-1 mAb blocked the CD11a/CD18-dependent portion of adhesion because concomitant use of anti-CD11a and anti-ICAM-1 did not cause additive inhibition. In contrast, anti-CD11b plus anti-ICAM-1 resulted in complete blockade of adhesion. This result suggests that CD11a/CD18 recognizes ICAM-1 on EC, but CD11b/CD18 recognizes a different ligand(s). To determine if CD11b CD18 has the ability to recognize ICAM-1, human macrophages were plated on culture surfaces coated with purified ICAM-1. Interaction of CD11a/CD18 with the surface-bound ICAM-1 resulted in selective down-modulation of CD11a/CD18 from the apical portion of the macrophages. In contrast, ICAM-1-coated surfaces did not down-modulate CD11b/CD18. The data suggest that CD11b/CD18 does not recognize ICAM-1, and that this receptor functions in adhesion of PMN to EC by recognizing novel ligand(s) on EC.

Two leukocyte receptors (CD11a/CD18 and CD11b/CD18) mediate transient adhesion to endothelium by binding to different ligands

Upon stimulation with C5a, TNF, or phorbol dibutyrate (PDB), polymorphonuclear leukocytes (PMN) exhibit first an increase then a decrease in adhesion to unstimulated endothelial cells (EC). Essentially all of this adhesion is mediated by the CD18 family of leukocyte integrins on PMN. To determine the individual roles of CD11a/CD18 (LFA-1), CD11b/CD18 (CR3, Mac-1) and CD11c/CD18 (p150,95) in adhesion of PDB-stimulated PMN to unstimulated EC, mAb against the CD11 chains were used. mAb against CD11a or CD11b each blocked adhesion of PMN to EC by approximately 50%, but mAb against CD11c had no effect. Inasmuch as a combination of anti-CD11a and CD11b mAb completely blocked adhesion, it appears that CD11a/CD18 and CD11b/CD18 make approximately equal contributions to binding, and CD11c does not participate. Anti-CD11a or CD11b each blocked adhesion by about 50% throughout the transient time course of PDB-stimulated adhesion, indicating that the capacity of each of these receptors to bind EC is transiently activated by PDB. We next examined the role of ICAM-1 on EC as a ligand for CD18. Two anti-ICAM-1 mAb (LB-2 and 84H10) each inhibited PMN adhesion in a dose-dependent fashion, reaching a maximal inhibition of approximately 50%. Anti-ICAM-1 mAb blocked the CD11a/CD18-dependent portion of adhesion because concomitant use of anti-CD11a and anti-ICAM-1 did not cause additive inhibition. In contrast, anti-CD11b plus anti-ICAM-1 resulted in complete blockade of adhesion. This result suggests that CD11a/CD18 recognizes ICAM-1 on EC, but CD11b/CD18 recognizes a different ligand(s). To determine if CD11b CD18 has the ability to recognize ICAM-1, human macrophages were plated on culture surfaces coated with purified ICAM-1. Interaction of CD11a/CD18 with the surface-bound ICAM-1 resulted in selective down-modulation of CD11a/CD18 from the apical portion of the macrophages. In contrast, ICAM-1-coated surfaces did not down-modulate CD11b/CD18. The data suggest that CD11b/CD18 does not recognize ICAM-1, and that this receptor functions in adhesion of PMN to EC by recognizing novel ligand(s) on EC.

Transient adhesion of neutrophils to endothelium

Fluorescently labeled polymorphonuclear leukocytes (PMN) were used to measure adhesion to human umbilical vein endothelial cells (EC) cultured in vitro. Stimulation of PMN with phorbol dibutyrate (PDB), TNF, or C5a caused an increase in adhesion followed by a return to prestimulation levels of adhesion of longer times of incubation. Maximal adhesion of PMN to EC occurred rapidly in response to C5a (5 min) and more slowly with TNF or PDB (15 min). PMN stimulated to adhere with C5a detached from EC by 15 min. PMN from CD11/CD18-deficient patients and PMN incubated with anti-CD18 mAbs failed to bind to EC despite maximal stimulation. Anti-CD11a/CD18 and anti-CD11b/CD18 each partially inhibited adhesion, and a combination of these two reagents completely blocked adhesion. The adhesion we measured was therefore completely dependent on CD11/CD18, and CD11a/CD18 and CD11b/CD18 each contributed to adhesion. Stimuli that enhanced adhesion of PMN to EC also enhanced expression of CD11b/CD18 on the cell surface, but the time course of expression correlated poorly with changes in adhesivity. To determine if changes in the expression of CD11b/CD18 are necessary for the changes in adhesivity, we used enucleate cytoplasts that did not increase expression of CD11b/CD18. Cytoplasts showed a normal rise and fall in adhesivity in response to PDB. We conclude that the transient adhesion of stimulated PMN to naive EC is regulated by changes in the nature of existing CD11/CD18 molecules on the PMN surface. Changes in expression of CD11b/CD18 may contribute to enhancement of adhesivity, but a definite role for this phenomenon has yet to be established.

CR3 (CD11b/CD18) expresses one binding site for Arg-Gly-Asp-containing peptides and a second site for bacterial lipopolysaccharide

Polymorphonuclear leukocytes (PMN) from three patients deficient in the CD18 family of receptors (LFA-1, CR3, and p150,95) exhibited an inability to bind erythrocytes coated with C3bi or bacterial LPS. These observations confirm that the CD18 family, and CR3 in particular, can bind the structurally dissimilar molecules C3bi and LPS. Further studies showed that LPS and C3bi bind to CR3 at distinct sites. mAb OKM10 against CR3 blocked binding of C3bi to PMN but did not block the binding of LPS. In contrast, mAb 904, directed against a different epitope on CR3, blocked binding of LPS to PMN but not binding of C3bi, thus suggesting that different regions of CR3 were involved in binding these two ligands. In addition, synthetic peptides based on the sequence in C3bi recognized by CR3 competitively blocked the binding of C3bi to CR3 but did not block the binding of LPS. Rather, occupation of the peptide binding site on CR3 by the synthetic peptides enhanced binding of LPS. These results indicate that CR3 has two distinct binding sites, one that recognizes ligands composed of protein and a second that recognizes LPS.

A prevalence study of denture stomatitis in subjects with diabetes mellitus or elevated plasma glucose levels

The purpose of this study was to determine if a relation between diabetes mellitus and denture stomatitis could be supported by observing an increased prevalence of denture stomatitis in subjects with either diagnosed diabetes mellitus or elevated plasma glucose levels. The study involved 301 subjects wearing either complete or partial maxillary dentures. Medical history information, oral examination records, and laboratory data were used for the study. No significant increase in the prevalence of denture stomatitis was found in those subjects with either previously diagnosed diabetes mellitus or elevated plasma glucose levels when compared with subjects with normal glucose metabolism.

Neurobehavioral assessment of Mohawk Indians for subclinical indications of methyl mercury neurotoxicity

A total of 200 male and 200 adult female Mohawk Indians were examined by means of performance tests as part of a total health evaluation of participants in a medical field survey on the St. Regis Reserve. Age-corrected performance test scores were studied in relation to blood, urinary, and hair methyl mercury (MeHg) levels, and local fish consumption. Males were found to eat more fish than females and had relatively higher MeHg levels than females. Blood and hair MeHg levels were significantly correlated with local fish consumption for both sexes. Biological indicators of MeHg absorption suggested low exposure levels but did not correlate significantly with performance test scores. These findings indicate that the time of examination, St. Regis residents were exposed to almost "background" levels of MeHg and did not exhibit either subclinical or clinical manifestations of MeHg neurotoxicity.

Noise-induced hearing loss and portable radios with headphones

Portable radio/cassette players with headphones have gained increasing popularity in recent years. Volume settings are often increased to override environmental noise, perhaps placing the listener at risk for noise-induced hearing loss (NIHL). A total of 190 public college students in NYC were studied via a self-administered questionnaire regarding the volume setting used and weekly exposure in hours to these units. Three popular models were tested using a Bruel and Kjaer sound level meter, octave band filter and artificial ear. Sound levels were measured at various frequencies (250-8000 Hz) and an overall measurement obtained using the "A"-weighted scale. Based on OSHA criteria for permissible noise dose (i.e. intensity X duration) in the work place, auditory risk criteria were developed. Of all students who used such radios 31.4% equalled or exceeded the maximum allowable dose permitted by these criteria (41.2% of the males and 29.2% of females). This sex-related difference in risk, while not statistically significant, warrants further investigation. Of the total 'at risk' group 50% exceeded the risk criteria by more than 100%. These results suggest that portable radios with headphones may be capable of causing permanent hearing loss in a large proportion of radio users.

Dagga (cannabis) usage among medical students in Johannesburg

Of 1 020 undergraduate medical students at the University of the Witwatersrand surveyed in 1981 as regards attitudes to and patterns of illicit drug use 868 completed the questionnaire; 32,4% had tried dagga (cannabis) and 16,4% were still using the drug. There was a large increase in the number of students using the drug as they advanced through their studies (6% of the 1st-year class as against 24% of the 5th-year class). The timing of dagga use and previous experimentation with habit-forming drugs are mentioned, and reasons for non-experimentation and attitudes towards legalization of dagga are analysed.

Terminal illness in a psychiatric patient--issues and ethics

A woman with paranoid psychosis and terminal breast cancer refused palliative radiation, demanding pain-killers and permission to leave hospital to go into the mountains and die on her own. Was it ethical to allow her to do so, or should a court order have been sought to impose hospital treatment on her? Should she have been persuaded to accept hospital care? When do those in charge deem a terminally ill patient unable to understand the issues, and dictate treatment? Our aim in this article is to highlight a number of ethical matters regarding patient care, as well as to try and determine the role a hospice should play with regard to the terminally ill patient with associated psychiatric disorder.

The contralateral diseased but asymptomatic carotid artery: to operate or not? An update

Bilaterally diseased carotid arteries were demonstrated in 147 patients in a personal series of 535 carotid reconstructions. A general policy of operating only on symptomatic patients was followed. Although stenotic and ulcerated plaques were known to be present in the contralateral artery, they were not repaired unless new symptoms occurred. No strokes were observed in these patients in a 20 year follow-up period. Twelve percent of the patients became symptomatic, leading to new arteriograms and a second artery repair. The patients at risk and their families were carefully instructed to report any symptoms of cerebrovascular insufficiency. If meticulous follow-up is carried out, the prophylactic repair of a truly asymptomatic diseased carotid artery is not believed necessary to prevent stroke.

Schizophrenic behavior as a function of role expectation

The hypothesis that the behavior of schizophrenic patients is determined in part by role expectation was investigated. The Holtzman Inkblot Technique and a word association task were administered to the same patients under two conditions: (1) Ss were led to believe that the interviewer was unaware of their patient status and expected them to behave in a normal manner; and (2) Ss were informed that the interviewer was interested in their behavior as mental patients. The results indicated that there was less evidence of pathology on the Holtzman when Ss were told that the interviewer expected them to behave in a normal manner. More specifically, there was less Pathognomonic Verbalization and more Form Appropriateness in the normal expectation condition. The findings are consistent with current views as to the pathogenic effects of labeling and institutionalization.