Randomized evaluation of an online single-session intervention for minority stress in LGBTQ+ adolescents

Background

LGBTQ+ youth face myriad adverse health outcomes due to minority stress, creating a need for accessible, mechanism-targeted interventions to mitigate these minority stress-related risk factors. We tested the effectiveness and acceptability of Project RISE, an online single-session intervention designed to ameliorate internalized stigma and improve other outcomes among LGBTQ+ youth. We hypothesized that youth assigned to RISE (versus a control) would report significantly reduced internalized stigma and increased identity pride at post-intervention and at two-week follow-up and would find RISE acceptable.

Methods

We recruited adolescents nationally through Instagram advertisements in May 2022 (N = 538; M age = 15.06, SD age = 0.97). Participants were randomly assigned to RISE or an information-only control and completed questionnaires pre-intervention, immediately post-intervention, and two weeks post-intervention. Inclusion criteria included endorsing: (1) LGBTQ+ identity, (2) age 13-16, (3) English fluency (4) Internet access, and (5) subjective negative impact of LGBTQ+ stigma.

Results

Relative to participants in the control condition, participants who completed RISE reported significant decreases in internalized stigma (d = -0.49) and increases in identity pride (d = 0.25) from pre- to immediately post-intervention, along with decreased internalized stigma (d = -0.26) from baseline to two-week follow-up. Participants rated both RISE and the information-only control as highly, equivalently acceptable.

Conclusions

RISE appears to be an acceptable and useful online SSI for LGBTQ+ adolescents, with potential to reduce internalized stigma in both the short- and longer-term. Future directions include evaluating effects of Project RISE over longer follow-ups and in conjunction with other mental health supports.

A dynamic collimation and alignment system for the Helmholtz linear accelerator

The upcoming commissioning of the superconducting (SC) continuous wave Helmholtz linear accelerators first of series cryomodule is going to demand precise alignment of the four internal SC cavities and two SC solenoids. For optimal results, a beam-based alignment method is used to reduce the misalignment of the whole cryomodule, as well as its individual components. A symmetric beam of low transverse emittance is required for this method, which is to be formed by a collimation system. It consists of two separate plates with milled slits, aligned in the horizontal and vertical direction. The collimation system and alignment measurements are proposed, investigated, and realized. The complete setup of this system and its integration into the existing environment at the GSI High Charge State Injector are presented, as well as the results of the recent reference measurements.

Patient's Education Before Mastectomy Influences the Rate of Reconstructive Surgery

Breast reconstruction (BR) should be offered and discussed to each woman with breast cancer who planned for mastectomy, except the cases with severe comorbidities. However, the majority of these patients do not undergo reconstructive surgery. A 20-question survey was administered to a group of 50 women (age 29-83 years, median 53) treated with mastectomy. 22.4 % underwent reconstruction of the breast, 24.5 % declared an interest in BR in the future, 53.1 % were not interested in reconstructive surgery. 51.2 % obtained information concerning BR before surgery, 58.1 % after and 44.2 % both before and after mastectomy. 59.2 % were informed about reimbursement. Information given before surgery had a statistically significant impact on performing reconstruction or a declared interest in BR (X ² = 4.950, df = 1, p < 0.05), as well as information about reimbursement (X ² = 8.875, df = 1, p < 0.05). Age <55 years was another significant factor (X ² = 13.522, df = 1, p < 0.05, C Pearson = 0.525). Level of education did not impact upon the choice (p > 0.05). The main reasons for the refusal were fear of complications (47.4 %), priority to recovery over aesthetic (36.8 %), age, defined by the patient as "advanced" (31.6 %), high level of acceptance of the body after amputation (31.6 %), fear of cancer recurrence (26.3 %) and fear of the pain and discomfort (15.8 %). Each patient who planned for mastectomy should obtain sufficient information regarding breast reconstruction. Exact information is of special benefit to women discouraged by imagined disadvantages of surgery. Patients' education impacts the quality of life-not only before surgery but also lifelong after finishing the treatment.

A novel interferometric method for the study of the viscoelastic properties of ultra-thin polymer films determined from nanobubble inflation

Glass formation and glassy behavior remain as the important areas of investigation in soft matter physics with many aspects which are still not completely understood, especially at the nanometer size-scale. In the present work, we show an extension of the "nanobubble inflation" method developed by O'Connell and McKenna [Rev. Sci. Instrum. 78, 013901 (2007)] which uses an interferometric method to measure the topography of a large array of 5 μm sized nanometer thick films subjected to constant inflation pressures during which the bubbles grow or creep with time. The interferometric method offers the possibility of making measurements on multiple bubbles at once as well as having the advantage over the AFM methods of O'Connell and McKenna of being a true non-contact method. Here we demonstrate the method using ultra-thin films of both poly(vinyl acetate) (PVAc) and polystyrene (PS) and discuss the capabilities of the method relative to the AFM method, its advantages and disadvantages. Furthermore we show that the results from experiments on PVAc are consistent with the prior work on PVAc, while high stress results with PS show signs of a new non-linear response regime that may be related to the plasticity of the ultra-thin film.

A new tribological experimental setup to study confined and sheared monolayers

We have developed an original experimental setup, coupling tribology, and velocimetry experiments together with a direct visualization of the contact. The significant interest of the setup is to measure simultaneously the apparent friction coefficient and the velocity of confined layers down to molecular scale. The major challenge of this experimental coupling is to catch information on a nanometer-thick sheared zone confined between a rigid spherical indenter of millimetric radius sliding on a flat surface at constant speed. In order to demonstrate the accuracy of this setup to investigate nanometer-scale sliding layers, we studied a model lipid monolayer deposited on glass slides. It shows that our experimental setup will, therefore, help to highlight the hydrodynamic of such sheared confined layers in lubrication, biolubrication, or friction on solid polymer.

From the Editor’s Desk

No abstract available.

Mirror symmetry of higher order aberrations between right and left eyes

Introduction: There is evidence that certain measures of visual function show some type of relationship between right and left eyes in the same individual.  Similarly, particular ocular maladies may be related, or be symmetric, in the right and left eyes of the same person. There is also evidence to suggest that certain relationships do not exist between eyes in an individual. For example, diseases such as glaucoma are often asymmetric in their progression in the two eyes of an afflicted individual. Inter-ocular mirror symmetry between right and left eyes, when considering ocular wave-front aberrations (WAs), has been shown to exist by some authors. This study investigates whether mirror symmetry of high order aberrations (HOAs) exists between the right and left eyes in a cohort of South African subjects. Method: Third to 5th order Zernike coefficients (HOAs) were measured on both eyes of 66 subjects (132 eyes) using a Zywave aberrometer. A total of 15 Zernike coefficients for each eye were obtained. Mirror symmetry was investigated using correlation coefficients between the various measurements obtained from each eye. Results: Pearson product-moment correlation coefficients provide evidence that the majority of the 15 Zernike coefficients suggest the presence of mirror symmetry between right and left eyes of the 66 subjects. Examples of individual scatter plots comparing right and left eyes are presented.  Conclusion: The results of this study suggest that mirror symmetry exists in the HOAs obtained from the 132 eyes measured and thus care should be exercised when combining eyes of individuals for analysis. (S Afr Optom 2013 73(1) 39-44)

Surfaces of forced vergence disparity

Purpose: To introduce the concept of surfaces offorced vergence disparity using measurementsof fixation disparity from three young, healthy individuals.Method: Fixation disparities were measured in three individuals in relation to variation in stimulus distance and vergence demand.  All measurementswere obtained by means of the Sheedy disparometerwhich can be used to measure not only fixation disparity but also associated phorias.  For each individual, consecutive measurements of fixation disparity only were determined over a short time period at four stimulus distances (0.25 m, 0.4 m, 1 m and 2 m) and under five different vergence demands as produced with the application of different amounts of prism (either base in or base out) and also without any prism.  Parametric and non-parametric statistical methods are used to understand short-term variation of fixation disparity and pseudo-3D and stereo-pairs represent thesurfaces of forced vergence disparity with which this paper is mainly concerned.Results:  Surfaces of forced vergence disparity are very useful to study variation of fixation disparity inrelation to change in stimulus distance and vergence demand.  They are effectively 3-dimensional equivalents of 2-dimensional Ogle curves of forcedvergence disparity.Conclusion: Surfaces of forced vergence disparity may be useful in many contexts - both in relation to normal or unusual binocular behaviour.  This paper introduces such surfaces in relation to three individuals who were considered as having satisfactory binocular and accommodative-vergence function.  The surfaces assist one in understanding complicated three-dimensional or trivariate data that involves fixation disparities, different stimulus locations and different accommodative-vergence demands upon the oculo-motor system.  (S Afr Optom 2013 72(1) 25-33) 

Colour spaces - a review of historic and modern colour models*

Although colour is one of the most interesting and integral parts of vision, most models and methods of colourimetry (the measurement of colour) available to describe and quantify colour have been developed outside of optometry. This article presents a summary of some of the most popularcolour models and a brief history of the advancements that have led to our current understanding of the complicated phenomenon of colour. (S Afr Optom 2012 71(3) 133-143)

Implanted, inductively-coupled, radiofrequency coils fabricated on flexible polymeric material: application to in vivo rat brain MRI at 7 T

Combined with high-field MRI scanners, small implanted coils allow for high resolution imaging with locally improved SNR, as compared to external coils. Small flexible implantable coils dedicated to in vivo MRI of the rat brain at 7 T were developed. Based on the Multi-turn Transmission Line Resonator design, they were fabricated with a Teflon substrate using copper micromolding process and a specific metal-polymer adhesion treatment. The implanted coils were made biocompatible by PolyDimethylSiloxane (PDMS) encapsulation. The use of low loss tangent material achieves low dielectric losses within the substrate and the use of the PDMS layer reduces the parasitic coupling with the surrounding media. An implanted coil was implemented in a 7 T MRI system using inductive coupling and a dedicated external pick-up coil for signal transmission. In vivo images of the rat brain acquired with in plane resolution of (150 μm)(2) thanks to the implanted coil revealed high SNR near the coil, allowing for the visualization of fine cerebral structures.

A pharmacokinetic interaction in man between phenobarbitone and fenoprofen, a new anti-inflammatory agent

1 The effect of repeated administration of phenobarbitone on the plasma disposition of fenoprofen (±-2-(3-phenoxyphenyl) propionic acid) was investigated in rats and man. 2 The plasma elimination rate constants increased significantly and the rats excreted proportionately more metabolized fenoprofen in the urine. These findings are consistent with an increase in the rate of metabolism of fenoprofen. 3 This interaction between phenobarbitone (and presumably other inducers of drug metabolizing enzymes) and fenoprofen should be considered when evaluating the clinical usefulness of fenoprofen.

Optical transferences and their application to ray tracing through the human cornea*

The purpose of this paper is two fold, firstly to describe aspects of the quantitative analysis of the linear optical character of the corneas of ten young and healthy subjects using the exp-mean-log-transference and secondly to illustrate how mean transference and ray vector fields or diagrams can be used to explain and understand the optical properties of corneas as thick optical systems.An Oculus Pentacam was used to obtain 43 successive measurements of the radii of curvature of the anterior and posterior corneal surfaces and the central corneal thicknesses of the right eyes of ten subjects. From these measurements 4×4 ray transferences were calculated. Mean transferences were obtained via multi-dimensional Hamiltonian space and these mean transferences were used to produce stereo-pairs of ray vector fields. The mean transferences are also important in understanding the behaviour of light through each of the corneas concerned. This paper provides the first order optical characters of corneas from the positions and inclinations of rays entering and leaving such systems. As anticipated, light rays through the cornea are deflected inwards when the refractive index of the cornea is greater than the index of the surrounding medium. The exp-mean-log transference for a specific cornea exists and is the optical transference of the averaged cornea of the sample of measurements for that cornea. Within the limitations of linear or paraxial optics, the corneas of the different eyes in this sample and their averages were found to be close to that of thin optical systems; but they were not truly thin and instead should be considered as being thick optical systems. (S Afr Optom 2011 70(4) 156-167)

Short-term variation in ocular anterior chamber angle using Scheimpflug photography

Purpose: To investigate short-term variation of ocular Anterior Chamber Angle (ACA) within and across the different meridians of young, healthy eyes.Method: Scheimpflug photography (via an  Oculus Pentacam) was used to repeatedly measure the anterior segment of the right eyes of three young females, all aged 22 years.  For each individual, ten consecutive maps were determined over a short time period and each map contained information for the chamber angles of different meridians across the eye involved, roughly at 70 intervals.  Each meridian in an eye was thus measured 10 times in total permitting analysis of short-term variation both within and across the meridians concerned.  Parametric and non-parametric statistical methods used to understand short-term variation of ACA included meridional plots of medians andlower and upper quartiles (Q1 and Q3) and various polar plots (of raw observations, of means and 95%confidence regions, and of standard deviations).Results: Over, at least, short periods of time, Scheimpflug photography provided fairly repeatable results for ACA both within and across the meridians of the eyes involved.  However, occasionally outliers increased variability for some meridians.  While short-term variation within meridians was relatively small assuming exclusion of a limitednumber of outliers, variation across the meridians of specific eyes was greater (probably relating to the usual anatomical structure of eyes with ACA in the inferior quadrants being mostly larger than that for the superior quadrants).  Friedman ANOVA confirmed for each of the three eyes concerned thamedian ACA was significantly different across thvarious meridians.Conclusion: Scheimpflug photography allows for comprehensive, non-invasive and rapid measurement of ACA through 3600.  Repeatability of measurements appears satisfactory over the short-term, despite potential limitations relating to this photo-graphic method for measuring ACA.  The holistic and quantitative approach to ACA used here may be useful also in diabetic, neoplastic or other disease of the anterior segment of the eye.  This methodology could provide better understanding of the potential risk for acute or chronic angle-closure glaucoma through more complete evaluation of ACA.  The methods also could be usefully applied to measurement of ACA using techniques such as anterior segment optical coherence tomography or ultrasound biomicroscopy. (S Afr Optom 2010 69(1) 35-47)  

Deflection and translation of a ray traversing an optical system, nodal rays and the optical axis

Expressions are derived for the deflection and transverse translation of a ray as it traverses an arbitrary optical system.  The system may be astigmatic and have relatively decentred refracting elements.  The expressions are in terms of the fundamental properties of the system.  Because nodal rays are rays that undergo no deflection the results lead immediately to expressions that define nodal rays through the system.  An optical axis of an optical system is a nodal ray that is a straight line through the system.  This allows one to write an expression that determines the optical axis of an arbitrary optical system.

Accelerated R-COP: a pilot study for the treatment of advanced low grade lymphomas that has a high complete response rate

This pilot study tested the hypothesis that dose intensity/dose density treatment may improve the response rate and remission duration in patients with advanced low grade lymphomas. ten patients with low grade lymphomas: follicular lymphoma grades I and II, marginal zone lymphoma, and small cell lymphocytic lymphoma with progressive disease were studied. Patients had an ECOG performance of 0-2, and Stage III and IV disease. Both untreated and previously treated patients with progressive disease were eligible. Patients received a combination of rituximab 375 mg/m(2), cyclophosphamide 1000 mg/m(2), and vincristine 1.4 mg/m(2) (up to a maximal dose of 2 mg), administered by intravenous infusion every two weeks, for ten treatments. Prednisone 50 mg was administered every other day orally for thirty days and then tapered over the next thirty days. Granulocyte colony stimulating factor (G-CSf) was administered on days seven to ten following each cycle of chemotherapy. After 5 and 10 cycles, patients were evaluated for response that included imaging with Ct and pet scans. A total of 10 patients (7 untreated and 3 previously treated) were enrolled into this pilot study between may 2003 and July 2004. Untreated patients received an average of 8.3 cycles of therapy (range 5 to 10 cycles). Seven of 7 untreated patients achieved a complete response (CR), and 5 had not relapsed as of 32-43 months later. Previously treated patients received an average of 9.3 cycles of therapy (range 6 to 12 cycles). One of three previously treated patients achieved a complete response and has no evidence of relapse at 29 months. the other two heavily pretreated patients achieved partial responses, lasting 2 and 5 months. Toxicity was mild consisting mainly of parasthesias requiring attenuation of the vincristine dose. There were no instances of neutropenic fever requiring hospitalization. This program is well tolerated with a high CR rate, and may serve as a basis for future trials.

In vivo analysis of chlorophyll a fluorescence induction

Quantitative characteristics of photosynthetic electron transport were evaluated in vivo on the basis of the multi-exponential analysis of OJIP fluorescence transients induced by saturating actinic light. The OJIP fluorescence curve F(t), measured in Chlamydomonas reinhardtii cells, was transformed into the (1 - F(O)/F(t)) x (F(V)/F(M))(-1) transient, which is shown to relate to PS 2 closure. We assumed that kinetics of PS 2 closure during OJIP rise reflects time-separated processes related to the establishment of redox equilibrium at the PS 2 acceptor side (OJ), PQ pool (JI), and beyond Cyt b/f (IP). Three-exponential fitting was applied to (1 - F(O)/F(t)) x (F(V)/F(M))(-1) transient to obtain lifetimes and amplitudes of the OJ, JI, and IP components of PS 2 closure, which were used to calculate overall rates of reduction and re-oxidation of the PS 2 acceptor side, PQ pool, and intermediates beyond Cyt b/f complex. The results, obtained in the presence of inhibitors, oxidative reagents, and under different stress conditions prove the suggested model and characterize the introduced parameters as useful indicators of photosynthetic function.

CLINICAL PHOTO-ATLAS Subconjunctival Haemorrhage (SCH)

No abstract available

New frequency/voltage converters for ac-electrogravimetric measurements based on fast quartz crystal microbalance

A better understanding of the mechanisms located at the solid/electrolyte interface is becoming essential to the development of new applications in the electrochemical fields. The fast quartz crystal microbalance is an attractive and powerful gravimetric sensor which can be used in the dynamic regime to determine a mass/potential transfer function. The principle is equivalent to classical electrochemical impedance measurements; the only difference is the determination of mass changes given by the quartz crystal microbalance rather than current changes following sine wave modulations of the applied potential. This function appears very well adapted to characterize ionic exchanges at the electrochemical interface. Frequency/voltage converters are the key devices in translating the microbalance frequency response in terms of a continuous voltage change. The latter allows the transfer function to be obtained via a frequency response analyzer. Different converters were tested in this work in order to improve the performances of the experimental setup.

Definition, classification and visual aspects of diabetes mellitus, diabetic retinopathy and diabetic macular edema: A review of literature

No abstract available

Short-term variation of autorefraction in Diabetic Macular Edema (DME) *

Very few studies have investigated autorefraction in diabetic subjects presenting either with diabetic retinopathy (DR) and/ or diabetic macular edema (DME). To the best of our knowledge this is the first study using multivariate methods for investigating short-term autorefraction in a small sample of subjects diagnosedwith DME. Forty consecutive autorefractor measurements were taken over a short interval on each of seven diabetic subjects with varying stages of DME, and the results were compared to a smaller group of four diabetic control subjects without DME (reasons for the differences in sample sizes will be explained later). Measurements were obtained from both the right and left eyes of all subjects.  Subjects in the two groups were similarly matched according to duration of diabetes mellitus (DM), age and glycated hemoglobin (HbA1c) values. Normality of data distribution was mostly achieved with the removal of outliers (where necessary) until profiles of skewness, kurtosis, and standard mean deviation exhibited near-normal distribution. Thereafter, stereo-pair scatter plots with 95% surfaces of constant probability density (distribution ellipsoids) were generated and compared between the experimental and control subjects.The diabetic subjects with DME demonstrated a larger spread of measurements in the eyes with the more severe DME, with the exception of one subject (subject 5). The volumes and orientation of the distribution ellipsoids also differed between the subject’s eyes. Some eyes with severe DME and poor visual acuitydisplayed more stigmatic variation (for example, subjects 2 and 4), while others (subjects 1 and 3) displayed more ortho-antistigmatic variation or near oblique antistigmatic variation (subject 7).  In all experimental subjects, with the exception of subject 5, the eye with the more severe DME had a larger distribution ellipsoidvolume, indicating greater variation in autorefraction and thus it might be surmised that this paper provides some preliminary data to suggest that diabetic subjects with DME display greater short-term variation of refractive behaviour when compared to diabetic subjects without DME. Secondly, in diabetic subjects withDME, eyes with the more severe DME or worse VA also display greater variation of refractive status. However, there seemed to be no distinctive or obvious pattern to the type of variation.In addition, a suitable statistic in terms of a Cubic Root Difference (CRD) was introduced in this study to compare inter-ocular ellipsoidal volumes. This statistic is also useful for comparing variances between eyes, or between means for groups of eyes, and could be used in studies involving anisometropia,  et cetera. Nevertheless, this study suggests that further investigation remains necessary before autorefraction can be used effectively in the early diagnosis, monitoring, and assessment of eyes with diabetic-related complications to the macular regions. 

A comparative study of autokeratometric and Scheimpflug keratometric measurements of the anterior corneal surface: results for a single subject

One purpose of the broader study was to determine whether keratometric measurements obtained with an autokeratometer (Nidek ARK-700) would be comparable with those measured using the Oculus Pentacam(model 70700). Ten healthy subjects without ocular abnormality, no previous or current contact lens wear or history of ocular surgery were recruited and at least 43 successive keratometric measurements were obtained for the right eye of each subject using both instruments, namely the autokeratometer and the Pentacam. This paper will concern itself with data from only one of the ten subjects involved, namely Subject 1. The corneal powers were analyzed using multivariate methods for analyzing dioptric power. Scatter plots and meridional profiles of skewness and kurtosis were used to compare the results for the two instruments. Mean dioptric powers in conventional and scientific notation were determined.The results for this subject indicated that there was a statistically significant difference between the autokeratometry and the Pentacam. Although the means  between the two instruments were found to be significantly different at a 95% level of confidence, there was minimal clinical difference between the means of the two instruments. That is, this preliminary investigation suggests that in normal eyes, clinically, keratometric results obtained by means of an autokeratometer and a Pentacam are reasonably similar and can be used interchangeably.

Anti-tumor activity of partially HLA-matched irradiated blood mononuclear cells in patients with advanced malignancies

2552

Background: We previously demonstrated the safety and efficacy of HLA-haploidentical blood mononuclear cells (MNCs) administered in the absence of preparative therapy to patients with metastatic renal cell carcinoma (RCC) (J Clin Oncol 21:3785–91.2003). The efficacy of this therapy is evaluated further in patients with advanced malignancies. Methods: Patients with advanced malignancies who had HLA- haploidentical donors were enrolled. Donors underwent 12–15 L leukapheresis. MNCs were processed by irradiation (25 Gy) and immediately infused. Disease evaluation was undertaken every 8 weeks. Repeat infusions were given every 8 weeks until disease progression. Results: 30 patients with diverse diagnoses, including 9 patients with a hematological malignancy were treated. Three of 13 patients with RCC had disease response, and 1 of 2 patients with melanoma had a mixed response. A patient with imatinib mesylate-refractory chronic myelogenous leukemia (CML) had a transient response. A patient with refractory acute myelogenous leukemia (AML) had disease response in conjunction with therapy. Treatment was associated with minimal toxicity and radiographic responses in patients with RCC did not occur until after 2–3 treatments. Host CD8+ cells reactive with the Pr-1 peptide of proteinase 3 were induced in association with disease response in a patient with AML. Additional studies identifying disease targets and mechanisms by which infusion of irradiated HLA-haploidentical cells are associated with disease response are ongoing. Conclusions: Disease response is seen with irradiated allogeneic MNCs administered outside the context of hematopoietic stem-cell transplantation. Evidence for anti-tumor activity is seen in isolated patients with RCC, melanoma, CML and AML. The temporal nature of the response in RCC in combination with the very limited survival of the infused cells raises the possibility of induction of a host-mediated anti-tumor effect. This hypothesis is supported by induction of host CD8+ T cells reactive with a tumor-associated peptide in a patient with AML. Given the lack of toxicity, broad availability of related haploidentical donors and the relative low financial cost, this form of cellular therapy should be developed further.

No significant financial relationships to disclose.

A phase I study of busulfan consolidation/intensification therapy for patients with high risk acute myeloid leukemia (AML)

6580

Background: Elderly AML patients have a poor prognosis. More effective well-tolerated treatments are needed to improve outcomes. Busulfan is an effective anti-leukemia drug commonly used in transplant regimens. We designed a phase I dose escalation study of single dose busulfan as consolidation/intensification therapy for elderly patients with AML. Methods: Patients in CR1 not candidates for transplantation or anticipated to benefit from high-dose cytarabine were enrolled. Cohorts were studied at 100mg/m2-120mg/m2, as a single oral dose of busulfan. The starting dose was based on a previous report (Ranson et al. Br J Haematol 79:162.1991). GM-CSF was started after busulfan until ANC> 2000/mm3. Dilantin was used for seizure prophylaxis. Results: 15 patients median age 71 (range 64–82) received treatment and are evaluable for toxicity, 14 are evaluable for response. No DLT was observed. Ongoing remission was seen in 3 patients (range 3 +- 7 + years). One patient (AML/MDS) was in remission for 52 months and died from small cell lung cancer and 1 patient was in remission for 15 months and died from cervical cancer. Two additional patients had prolonged remissions (32 and 55 months) prior to relapse. Seven patients relapsed between 4 weeks and 6 months. Treatment was well tolerated with no prolonged neutropenia. In patients who recovered without evidence of leukemia transient grade 3/4 thrombocytopenia occurred with average duration of 16 days (10–23 days) requiring 0–5 transfusions (average 2). Only 2 patients required RBC transfusion. No infectious complications or hospitalizations occurred in the absence of recurrent AML. Three patients experienced side effects from GM-CSF and received G-CSF in it’s place. Two patients experienced grade 2 fatigue and dyspnea. Conclusions: Single dose oral busulfan is an effective and well-tolerated outpatient consolidation/intensification therapy for patients with high-risk, AML. Prolonged remissions have been seen in 6 of 14 evaluable patients treated to date. Only transient bone marrow suppression requiring minimal transfusion support was seen. There were no hospitalizations or infections noted in patients without recurrent AML. The dose escalation will continue until MTD reached.

No significant financial relationships to disclose.

Ionized magnesium levels and the ratio of ionized calcium to magnesium in asthma patients before and after treatment with magnesium

OBJECTIVE

Prior studies have been equivocal about the efficacy of magnesium therapy in acute asthma exacerbations. We hypothesize that pretreatment ionized magnesium (Mg(2+)) levels and/or the ratio of ionized calcium to ionized magnesium (Ca(2+)/Mg(2+)) may have been confounding variables in these previous studies. Here, we report on the incidence of abnormal divalent ion levels in our asthma population.

MATERIAL AND METHODS

The study was designed as a randomized, double-blind, placebo-controlled trial of intravenous magnesium. Inclusion criteria were: age >18 years, percentage predicted forced expiratory volume (FEV(1)) <75 % after an initial beta-agonist. African-American patients (AA) at an urban university hospital were randomized to 2 g IV Mg or placebo. Mg(2+) and Ca(2+)/Mg(2+) levels were measured pre- and post-infusion. Data were reported as means+/-SD. Student's t-test and Fisher's exact test were used where appropriate (alpha = 0.05, two tailed).

RESULTS

Fifty-five AA patients (mean age of 42.7 years+/-15.6 years, range 18-75 years) were studied. A significantly (p<0.05) lower level of Mg(2+) was found in asthma (AS) patients compared with that in the AA group, by 0.03 mmol/L (95 % CI, 0.007-0.053 mmol/L). The AS group had a mean increase in Ca(2+)/Mg(2+) ratios over the AA group, of 0.27 (95 % CI, 0.16-0.38); 100 % of patients with abnormal divalent ion levels were corrected with IV magnesium.

CONCLUSIONS

We identified a subgroup of asthmatic patients with significant abnormalities in their divalent ion concentrations, which was corrected with IV magnesium.

Radioactive materials in biosolids: dose modeling

The Interagency Steering Committee on Radiation Standards (ISCORS) has recently completed a study of the occurrence within the United States of radioactive materials in sewage sludge and sewage incineration ash. One component of that effort was an examination of the possible transport of radioactivity from sludge into the local environment and the subsequent exposure of humans. A stochastic environmental pathway model was applied separately to seven hypothetical, generic sludge-release scenarios, leading to the creation of seven tables of Dose-to-Source Ratios (DSR), which can be used in translating from specific activity in sludge into dose to an individual. These DSR values were then combined with the results of an ISCORS survey of sludge and ash at more than 300 publicly owned treatment works, to explore the potential for radiation exposure of sludge workers and members of the public. This paper provides a brief overview of the pathway modeling methodology employed in the exposure and dose assessments and discusses technical aspects of the results obtained.

Error cells for spherical powers in symmetric dioptric power space

PURPOSE

: The purpose of this article is to analyze the geometry and examine the implications of the error cells of purely spherical powers in symmetric dioptric power space.

METHODS

: In the context of spherocylindrical data spherical data typically implies a cylindrical component that is less than some particular amount (often 0.125 D) in magnitude. This error or uncertainty in cylinder is over and above the error in sphere itself. The two components of error are used to define the error cells in symmetric dioptric power space.

RESULTS

: Error cells of spherical powers are constructed and presented as stereopairs. They are also shown in relation to error cells of powers in general.

CONCLUSIONS

: An understanding of error cells can help the researcher avoid pitfalls in the analysis of spherocylindrical data. Perhaps surprisingly, the error cells of spherical powers are not invariant under spherocylindrical transposition.

Book Review

No Abstract Available

Fundamentals of colour awareness: a literature review

A description of some of the basic or funda-mental aspects of the colour sensory mechanism will be provided here, based on modern ideas and literature, with reference specifically to the likely origins and evolution of colour vision.  The mo-lecular basis for colour awareness and the human colour pathway will also be considered in some detail. This paper intends to provide the theoreti-cal and philosophical basis for further papers that will introduce a modern and original computer- based  method  for  more  comprehensive  colour vision  assessment.    This  new  approach,  to  be fully described in later manuscripts, may contrib-ute towards improvements in understanding and knowledge of human colour perception and its measurement, still perhaps a relatively under-ex-plored or neglected field of study within optom-etry and ophthalmology.

Closed surfaces of constant visual acuity in symmetric dioptric power space

This paper demonstrates a multivariate approach to understanding the complicated relations of visual acuity to refractive state or ametropia. Other approaches, as previously used, included graphical representations of lines or profiles of iso-oxyopia (Peters, 1961). But one limitation of Peters' method is that cylinder axis was ignored. However, here the relationship between visual acuity and refractive power will be represented by estimated closed surfaces of constant visual acuity in symmetric dioptric power space. At or near the common center (of several closed surfaces, for example) is the refractive compensation. Coming outwards from such a center, the visual acuity drops in all directions in the space. The primary purpose of this paper was to present estimated closed surfaces of constant visual acuity for several eyes. Various procedures were performed on several subjects including measurement of iris aperture diameter, subjective refraction, and autorefraction. Thereafter, an automated phoropter and either Jackson cross-cylinders or spheres were used to influence dioptric blur or defocus in the subjects. The visual stimulus was a computer-generated nondirectional or meridionally independent letter O. Ovoidal surfaces fit the measurements obtained (with Jackson cross-cylinders and spheres) better than ellipsoidal surfaces. The cross-section, in symmetric dioptric power space, at powers with the same nearest equivalent sphere as the refractive compensation is elliptical in many cases and reflects a dependence of visual acuity on cylinder axis. The surfaces differ when powers are changed so that one is moving away from (decompensation surfaces) or toward (accompensation surfaces) the refractive compensation. The multivariate and graphical methods used in this paper probably have implications for the direction of future research in a number of areas involving measures of vision function such as autorefraction, retinoscopy, subjective refraction, and visual acuity.

Sertraline treatment of panic disorder: results of a long-term study

OBJECTIVE

To investigate the long-term efficacy, prevention of relapse and safety of sertraline in the treatment of panic disorder.

METHOD

This study consisted of 52 weeks of open-label sertraline treatment (n=398) followed by a 28 weeks of a double-blind, placebo-controlled discontinuation trial (n=183).

RESULTS

Ninety-three patients were randomized to sertraline and 90 were randomized to placebo. Discontinuation due to insufficient clinical response occurred in 23.6% of placebo-treated patients and 12.0% of sertraline-treated patients (log-rank test, P=0.040). Thirty-three per cent of placebo-treated patients had an exacerbation of panic symptomatology, versus 13% of sertraline-treated patients (log-rank test, P=0.005). Abrupt cessation of sertraline resulted in dizziness (4.3% sertraline vs. 16.9% placebo; P=0.007) and insomnia (4.3% sertraline vs. 15.7% placebo; P=0.013) occurring at significantly higher rates.

CONCLUSION

Long-term sertraline treatment was effective in preventing relapse of panic disorder, well tolerated and associated with minimal discontinuation symptoms.

New trends in regional anaesthesia

In this review, some of the newer developments in regional anaesthesia (RA) are discussed. The relationship between paraesthesiae and nerve stimulator responses has been shown to be unclear, and sometimes at a needle tip location where a paraesthesia is found, there is no response to the nerve stimulator. It is recommended to use whichever end point is found first. The debate as to the safety of RA in anaesthetised patients remains unresolved and strong opinions are often based on individual case reports. The training and skill of the anaesthetist still appears to be a more important factor. The problems of RA and impaired coagulation are well understood and guidelines are in place in many countries. The value of neuraxial blocks for postoperative pain management is well established and the increasing use of peripheral nerve blocks often using continuous methods is to be encouraged. The use of PCA for blocks as well as intravenously and the extension of the use of RA into the home are important developments. The beneficial effects of RA on postoperative morbidity and mortality are becoming clearer, and the introduction of the two new local anaesthetic agents, ropivacaine and levobupivacaine have improved safety. There has, however, been very slow progress in the development of long awaited ultralong acting local anaesthetics or in the introduction of slow release formulations.