The Involvement of Neutrophil in the Immune Dysfunction Associated with BVDV Infection

Bovine viral diarrhea virus (BVDV) induces immune dysfunction that often results in a secondary bacterial infection in the infected animals. The underlying mechanism of BVDV-induced immune dysfunction is not well understood. The role of BVDV-infected macrophage-secreted factors was investigated. BVDV-infected monocyte-derived macrophage (MDM) supernatants down-regulated the expression of neutrophil L-selectin and CD18. Regardless of the biotype, phagocytic activity and oxidative burst were downregulated by BVDV-infected MDM supernatants. However, only supernatants from cytopathic (cp) BVDV down-regulated nitric oxide production and neutrophil extracellular traps (NET) induction. Our data suggested that BVDV-induced macrophage-secreted factors caused immune dysfunction in neutrophils. Unlike lymphocyte depletion, the negative impact on neutrophils seems to be specific to cp BVDV biotype. Interestingly the majority of modified live BVDV vaccines are based on cp strain of BVDV.

Effectiveness of vergence/accommodative therapy for accommodative dysfunction in children with convergence insufficiency

PURPOSE

To determine the effectiveness of office-based vergence/accommodative therapy for improving accommodative amplitude and accommodative facility in children with symptomatic convergence insufficiency and accommodative dysfunction.

METHODS

We report changes in accommodative function following therapy among participants in the Convergence Insufficiency Treatment Trial - Attention and Reading Trial with decreased accommodative amplitude (115 participants in vergence/accommodative therapy; 65 in placebo therapy) or decreased accommodative facility (71 participants in vergence/accommodative therapy; 37 in placebo therapy) at baseline. The primary analysis compared mean change in amplitude and facility between the vergence/accommodative and placebo therapy groups using analyses of variance models after 4, 8, 12 and 16 weeks of treatment. The proportions of participants with normal amplitude and facility at each time point were calculated. The average rate of change in amplitude and facility from baseline to week 4, and from weeks 4 to 16, were determined in the vergence/accommodative therapy group.

RESULTS

From baseline to 16 weeks, the mean improvement in amplitude was 8.6 dioptres (D) and 5.2 D in the vergence/accommodative and placebo therapy groups, respectively (mean difference = 3.5 D, 95% confidence interval (CI): 1.5 to 5.5 D; p = 0.01). The mean improvement in facility was 13.5 cycles per minute (cpm) and 7.6 cpm in the vergence/accommodative and placebo therapy groups, respectively (mean difference = 5.8 cpm, 95% CI: 3.8 to 7.9 cpm; p < 0.0001). Significantly greater proportions of participants treated with vergence/accommodative therapy achieved a normal amplitude (69% vs. 32%, difference = 37%, 95% CI: 22 to 51%; p < 0.0001) and facility (85% vs. 49%, difference = 36%, 95% CI: 18 to 55%; p < 0.0001) than those who received placebo therapy. In the vergence/accommodative therapy group, amplitude increased at an average rate of 1.5 D per week during the first 4 weeks (p < 0.0001), then slowed to 0.2 D per week (p = 0.002) from weeks 4 to 16. Similarly, facility increased at an average rate of 1.5 cpm per week during the first 4 weeks (p < 0.0001), then slowed to 0.6 cpm per week from weeks 4 to 16 (p < 0.0001).

CONCLUSION

Office-based vergence/accommodative therapy is effective for improving accommodative function in children with symptomatic convergence insufficiency and coexisting accommodative dysfunction.

Characterization of bovine ileal epithelial cell line for lectin binding, susceptibility to enteric pathogens, and TLR mediated immune responses

In this study, primary and immortalized bovine intestinal epithelial cells (BIECs) were characterized for the expression of surface carbohydrate moieties. Primary BIEC-c4 cells showed staining greater than 90 % for 16 lectins but less than 50 % staining for four lectins. Immortalized BIECs showed significantly different lectin binding profile for few lectins compared to BIEC-c4 cells. BIEC-c4 cells were studied for infectivity to E. coli, Salmonella enterica, bovine rotavirus, bovine coronavirus, and bovine viral diarrhea virus. Bovine strain E. coli B41 adhered to BIEC-c4 cells and Salmonella strains S. Dublin and S. Mbandaka showed strong cell invasion. BIEC-c4 cells were susceptible to bovine rotavirus. LPS stimulation upregulated IL-10, IL-8, and IL-6 expression and Poly I:C upregulated TLR 8 and TLR 9 expression. This study provides important knowledge on the glycoconjugate expression profile of primary and immortalized BIECs and infectivity and immune responses of primary BIECs to bacterial and viral pathogens or ligands.

Mucosal Immune System of Cattle: All Immune Responses Begin Here

This article discusses key concepts important for mucosal immunity. The mucosa is the largest immune organ of the body. The mucosal barrier (the tight junctions and the "kill zone") along with the mucosa epithelial cells maintaining an anti-inflammatory state are essential for the mucosal firewall. The microbiome (the microorganisms that are in the gastrointestinal, respiratory, and reproductive tract) is essential for immune development, homeostasis, immune response, and maximizing animal productivity. Mucosal vaccination provides an opportunity to protect animals from most infectious diseases because oral, gastrointestinal, respiratory, and reproductive mucosa are the main portals of entry for infectious disease.

Mycoplasma bovis: Interactions with the Immune System and Failure to Generate an Effective Immune Response

Host responses are often ineffective at clearing Mycoplasma bovis infection and may contribute to the pathogenesis of disease. M bovis possesses a surprisingly large repertoire of strategies to evade and modulate host responses. Unopsonized M bovis impairs phagocytosis and killing by neutrophils and macrophages. Apoptosis of neutrophils and lymphocytes is enhanced, whereas it is delayed in macrophages. Both proinflammatory and antiinflammatory cytokines are stimulated during M bovis infection depending on the cell type and location, and overall systemic responses tend to have a T-helper 2 bias. M bovis reduces proliferation of T cells and, in chronic infection, causes T-cell exhaustion.

Evaluation of essential oils and a prebiotic for newborn dairy calves

A blend of essential oils (EO) and a prebiotic were combined (EOC) to formulate a colostrum-based liquid birth supplement and a separate feeding supplement (Start Strong and Stay Strong, Ralco Inc., Marshall, MN). These products were designed to promote immunity and stimulate appetite to diminish health challenges and stresses experienced by newborn calves. The hypothesis was that calves supplemented with an oral dose of liquid EOC at birth (10-mL aliquot at birth and 10 mL at 12 h of age) when fed the EOC feeding supplement would result in improved growth performance, health, and immunity. The objective was to determine if an additional feeding of liquid EOC at birth in combination with EOC in the milk replacer (MR) would allow calves to demonstrate improved growth, health, and immunity compare with calves only offered EO in MR. Sixty-one Holstein calves (18 males and 43 females) from a commercial dairy operation were blocked by birth date and randomly assigned to 1 of 3 treatments. Treatments were 1) Control (CON): a 24% crude protein (CP):20% fat (as-fed basis) MR; 2) EP: a 24:20 MR with EOC mixed at 1.25 g/d; or 3) EPC: a 24:20 MR with EOC mixed at 1.25 g/d in addition to calves receiving one 10-mL oral dose of liquid EOC at birth and 10 mL again at 12 h. The 24:20 MR was fed via bucket 2 times per day at a rate of 0.57 kg/calf daily for 14 d, increased to 0.85 kg/calf at 2 times per day until 35 d and was reduced to 0.43 kg at 1 time per day at 36 d to facilitate weaning after 42 d. Decoquinate was added to the MR at 41.6 mg/kg for coccidiosis control. Calves were housed in individual hutches bedded with straw with ad libitum access to a 20% CP-pelleted calf starter and water. All data were analyzed using PROC MIXED as a randomized complete block design. Calves in this study had similar (P > 0.10) average daily gains, body weight, and growth measurements. Calves fed EPC had significantly (P < 0.05) higher IgA titers on day 0 of the trial compared with calves fed EP or CON, which was expected as calves were supplemented with liquid EOC at birth and 12 h later demonstrating an increase in immune response. The use of a liquid EOC product being administrated after birth can improve IgA titers to improve the immune status of the new born calf to fight off potential diseases and pathogens. A formulation error resulted in the EOC being fed at half the rate of the previous experiment of 2.5 g/d, which appears to be below an efficacious dosage.

Genome-wide association study for response to vaccination in Angus calves1

Background

Bovine respiratory disease complex (BRDC) is one of the most important sources of loss within the beef cattle industry in the USA. Steps have been taken to reduce the incidence of BRDC through vaccination. Despite the effectiveness of vaccines, large proportions of cattle still experience morbidity and mortality. Identification of genomic regions that are associated with variation in response to vaccination would allow for the selection of individuals genetically predisposed to respond to vaccination based on specific markers, while heritability and accuracy estimates would help facilitate genomic selection. This in turn may lead to selection for beef cattle herds that may have lower incidence rate of BRDC after vaccination. This study utilizes an Angus herd of more than 2000 head of cattle to identify these regions of association.

Results

Genome wide association studies were performed for viral neutralization antibody level and response to vaccination traits against four different viruses associated with BRDC: bovine viral diarrhea virus 1 and 2 (BVDV1 and BVDV2), bovine respiratory syncytial virus (BRSV), and bovine herpesvirus (BHV1). A total of six 1-Mb windows were associated with greater than 1% of the genetic variance for the analyzed vaccination response traits. Heritabilities ranged from 0.08 to 0.21 and prediction accuracy ranged from 0.01 to 0.33 across 7 different vaccination traits.

Conclusions

Although six 1-Mb windows were identified as associated with 1% or greater genetic variance for viral neutralization antibody level and response to vaccination traits, few genes around these windows could readily be considered candidates. This indicates the need for further functional genomic annotation, as these regions appear to be gene deserts. Traits ranged from lowly to moderately heritable, which indicated the potential for selection of individuals that are genetically pre-disposed to respond to vaccination. The relatively low amount of genetic variance accounted for by any 1-Mb window indicated that viral neutralization antibody level and response to vaccination traits are polygenic in nature. Selection for these traits is possible, but likely to be slow due to the low heritabilities and absence of markers with high genetic variation associated with them.

Evaluation of responses to vaccination of Angus cattle for four viruses that contribute to bovine respiratory disease complex

Although vaccination is an effective measure in reducing the risk of bovine respiratory disease complex (BRDC) in cattle, BRDC losses remain significant. Increasing the efficacy of vaccination depends on elucidating the protective immune response to different antigens included in vaccines, determining the best timing for vaccination, and understanding the impact of the age of the calf on vaccination. This study measured the serum antibodies present in calves following vaccination against 4 viruses commonly associated with BRDC: bovine viral diarrhea virus type 1 and 2 (BVDV1 and BVDV2), bovine respiratory syncytial virus (BRSV), and bovine herpesvirus 1 (BHV1). Serum antibody titers were measured in more than 1,600 calves at 3-wk intervals starting at the time of the first vaccination. This first vaccination occurred at weaning for approximately half of the individuals and 3 wk before weaning for the other half. Dam age (years), time of weaning (initial vaccination or booster vaccination), and age of calf within year-season (days within year-season) classification all were found to have a significant effect on measured traits such as the initial titer and overall response. An increased initial titer was negatively correlated with each response trait (initial, booster, and overall response). Calves that were weaned at initial vaccination had greater overall antibody response to BVDV1 and BVDV2 compared with calves weaned 3 wk before initial vaccination. In contrast, calves given their initial vaccination 3 wk before weaning had greater overall antibody response to BRSV and BHV1 compared with calves that were vaccinated at weaning. Furthermore, the circulating antibody titer at which each virus needed to be below for an individual calf to positively respond to vaccination was determined (log titer of 0.38 for BVDV1, 1.5 for BVDV2, 3.88 for BRSV, and 1.5 for BHV1). This information can be used to improve vaccination protocols to allow for a greater response rate of individuals to vaccination and, hopefully, improved protection.

Effect of treatment of symptomatic convergence insufficiency on reading in children: a pilot study

BACKGROUND

To evaluate the impact of treatment of symptomatic convergence insufficiency using office-based vergence/accommodative therapy on reading skills in children.

METHODS

Children (n = 44) ages nine to 17 years with symptomatic convergence insufficiency were administered the following four reading tests: Wechsler Individual Achievement Test II; Test of Word Reading Efficiency; Test of Silent Word Reading Fluency; and the Gray Oral Reading Test, at baseline and eight weeks after completion of a 16-week program of office-based vergence/accommodative therapy. To determine whether significant change occurred with therapy, change in performance was compared to zero. Treatment response was determined using a composite score of symptoms and signs at the conclusion of treatment and at the 24-week outcome visit. Participants were classified as early responders, late responders, or non-responders based upon whether criteria for successful treatment were met at the completion of 16 weeks of treatment, at the 24-week outcome visit, or not met at either visit, respectively.

RESULTS

After treatment for convergence insufficiency, statistically significant improvements were found for reading comprehension (mean = 4.2, p = 0.009) and the reading composite score (mean = 2.4, p = 0.016) as measured by the Wechsler Individual Achievement Test at the 24-week visit. These improvements were related to the clinical treatment outcome measures (p = 0.011) with the largest improvements occurring in those who were early responders to treatment. Reading speed (words per minute) increased significantly on the Gray Oral Reading Test (p < 0.0001). No significant improvements were observed for single word reading or reading fluency as measured by the Test of Word Reading Efficiency, the Test of Silent Word Reading Fluency or the Gray Oral Reading Test.

CONCLUSION

Improvements in reading comprehension and reading composite were found after office-based vergence/accommodative therapy, with the greatest improvements in those who responded early to treatment.

Evaluation of essential oils and prebiotics for newborn dairy calves

A blend of essential oils (EO; carvacrol, caryophyllene, -cymene, cineole, terpinene, and thymol) and prebiotics (arabinogalactans; Stay Strong; Ralco, Inc., Marshall, MN) was designed to promote immunity and stimulate appetite to diminish health challenges and stresses experienced by newborn calves. It was hypothesized that calves supplemented with the medium dose (2.5 g/feeding) of the commercial EO would demonstrate the optimal response. The study objective was to determine the optimal feeding rate of EO when added to a milk replacer (MR) compared with feeding a control or a yeast cell wall additive (YCW). One hundred Holstein calves from a commercial dairy farm were blocked by birth date and randomly assigned to 1 of 5 treatments. Treatments were a control (CON), a 24:20% CP:fat (as-fed basis) MR (24:20 MR) without EO; EO mixed into the 24:20 MR at a rate of 1.25 g/feeding (EO-0.5), EO mixed into the 24:20 MR at a rate of 2.5 g/feeding (EO-1.0), or EO mixed into the 24:20 MR at a rate of 3.75 g/feeding (EO-1.5); or 24:20 MR with YCW mixed in at a rate of 2 g/calf at each feeding. The 24:20 MR was fed in a bucket 2 times/d at a rate of 0.28 kg/calf daily for 14 d, which was increased to 0.43 kg/calf at 2 times/d until d 35 and then reduced to 1 time/d at d 36 to facilitate weaning at d 42. Decoquinate was added to the MR at 41.6 mg/kg for coccidiosis control. Calves were housed in individual hutches bedded with straw with ad libitum access to a 20% CP pelleted calf starter and water. All data were analyzed using PROC MIXED as a completely random design. Calves fed EO-0.5 demonstrated greater ( < 0.05) ADG (0.65, 0.71, 0.64, 0.64, and 0.63 kg/d for the CON, EO-0.5, EO-1.0, EO-1.5, and YCW, respectively) through d 56 compared with calves fed EO-1.0 and YCW and tended ( < 0.10) to have greater ADG than calves fed the CON and EO-1.5. Total BW gains were greater ( < 0.05) for calves fed EO-0.5 compared with calves fed EO-1.0 and YCW, with calves fed the CON and EO-1.5 being intermediate and similar. Body length and wither height gains (final - initial) were greater ( < 0.05) for calves fed EO-0.5 compared with calves fed the other treatments. Hip width gains were similar ( < 0.10) among treatments. Hip height gains were increased ( < 0.05) for calves fed EO-0.5 compared with calves fed the CON, EO-1.0, EO-1.5, and YCW. These results demonstrate that supplementing EO-0.5 (1.25 g/calf daily) in a 24:20 MR may be the optimal feeding rate to enhance growth rates compared with feeding a 24:20 MR and a 24:20 MR containing YCW or other inclusion rates of EO.

Priming Cross-Protective Bovine Viral Diarrhea Virus-Specific Immunity Using Live-Vectored Mosaic Antigens

Bovine viral diarrhea virus (BVDV) plays a key role in bovine respiratory disease complex, which can lead to pneumonia, diarrhea and death of calves. Current vaccines are not very effective due, in part, to immunosuppressive traits and failure to induce broad protection. There are diverse BVDV strains and thus, current vaccines contain representative genotype 1 and 2 viruses (BVDV-1 & 2) to broaden coverage. BVDV modified live virus (MLV) vaccines are superior to killed virus vaccines, but they are susceptible to neutralization and complement-mediated destruction triggered by passively acquired antibodies, thus limiting their efficacy. We generated three novel mosaic polypeptide chimeras, designated N^proE2¹²³; NS²³¹; and NS²³², which incorporate protective determinants that are highly conserved among BVDV-1a, 1b, and BVDV-2 genotypes. In addition, strain-specific protective antigens from disparate BVDV strains were included to broaden coverage. We confirmed that adenovirus constructs expressing these antigens were strongly recognized by monoclonal antibodies, polyclonal sera, and IFN-γ-secreting T cells generated against diverse BVDV strains. In a proof-of-concept efficacy study, the multi-antigen proto-type vaccine induced higher, but not significantly different, IFN-γ spot forming cells and T-cell proliferation compared to a commercial MLV vaccine. In regards to the humoral response, the prototype vaccine induced higher BVDV-1 specific neutralizing antibody titers, whereas the MLV vaccine induced higher BVDV-2 specific neutralizing antibody titers. Following BVDV type 2a (1373) challenge, calves immunized with the proto-type or the MLV vaccine had lower clinical scores compared to naïve controls. These results support the hypothesis that a broadly protective subunit vaccine can be generated using mosaic polypeptides that incorporate rationally selected and validated protective determinants from diverse BVDV strains. Furthermore, regarding biosafety of using a live vector in cattle, we showed that recombinant human adenovirus-5 was cleared within one week following intradermal inoculation.

Behavioral and Emotional Problems Associated With Convergence Insufficiency in Children: An Open Trial

OBJECTIVE

This study investigated behavioral and emotional characteristics of children with convergence insufficiency (CI), before and after treatment with office-based vergence accommodative therapy (OBVAT).

METHOD

Parents of 44 children ages 9 to 17 years with symptomatic CI completed the Conners 3 ADHD Index and the Child Behavior Checklist (CBCL) before and after OBVAT. Pre-treatment scores were compared with normative data and post-treatment scores were compared with baseline using the Wilcoxon sign rank test.

RESULTS

Following OBVAT, CI children showed a significant mean improvement (p < .0001, effect size of 0.58) on the Conners 3 ADHD Index with the largest changes occurring in the 23 children who scored the highest at baseline. On the CBCL, anxious/depressed, somatic, and internalizing problems improved significantly (p < .001, effect sizes of -0.36, -1.15, and -0.67, respectively).

CONCLUSION

In an open trial, attention and internalizing problems improved significantly following treatment for CI.

The Impact of a Home-Based Computerized Cognitive Training Intervention on Fall Risk Measure Performance in Community Dwelling Older Adults, a Pilot Study

OBJECTIVES

Cognitive intervention studies have reported improvements in various domains of cognition as well as a transfer effect of improved function post training. Despite the availability of web based cognitive training programs, most intervention studies have been performed under the supervision of researchers. Therefore, the purpose of this study was to first, examine the feasibility of a six week home based computerized cognitive training (CCT) program in a group of community dwelling older adults and, second, to determine if a CCT program which focused on set shifting, attention, and visual spatial ability impacted fall risk measure performance.

DESIGN

This pilot study used a pretest/posttest experimental design with randomization by testing site to an intervention or control group.

PARTICIPANTS

Community dwelling older adults (mean age = 74.6 years) participated in either the control (N=25) or the intervention group (N=19).

INTERVENTION

Intervention group subjects participated in 6 weeks of home based CCT 3x/week for an average of 23 minutes/session, using an online CCT program.

MEASUREMENTS

Comparisons of mean scores on three measures of physical function (usual gait speed, five times sit to stand, timed up and go) were completed at baseline and week 7.

RESULTS

Following the completion of an average of 18 sessions of CCT at home with good adherence (86%) and retention (92%) rates, a statistically significant difference in gait speed was found between groups with an average improvement of 0.14 m/s in the intervention group.

CONCLUSION

A home based CCT program is a feasible approach to targeting cognitive impairments known to influence fall risk and changes in gait in older adults.

Convergence Insufficiency Treatment Trial - Attention and Reading Trial (CITT-ART): Design and Methods

OBJECTIVE

To describe the design and methodology of the Convergence Insufficiency Treatment Trial: Attention and Reading Trial (CITT-ART), the first randomized clinical trial evaluating the effect of vision therapy on reading and attention in school-age children with symptomatic convergence insufficiency (CI).

METHODS

CITT-ART is a multicenter, placebo-controlled, randomized clinical trial of 324 children ages 9 to 14 years in grades 3 to 8 with symptomatic CI. Participants are randomized to 16 weeks of office-based vergence/accommodative therapy (OBVAT) or placebo therapy (OBPT), both supplemented with home therapy. The primary outcome measure is the change in the Wechsler Individual Achievement Test-Version 3 (WIAT-III) reading comprehension subtest score. Secondary outcome measures are changes in attention as measured by the Strengths and Weaknesses of Attention (SWAN) as reported by parents and teachers, tests of binocular visual function, and other measures of reading and attention. The long-term effects of treatment are assessed 1 year after treatment completion. All analyses will test the null hypothesis of no difference in outcomes between the two treatment groups. The study is entering its second year of recruitment. The final results will contribute to a better understanding of the relationship between the treatment of symptomatic CI and its effect on reading and attention.

CONCLUSION

The study will provide an evidence base to help parents, eye professionals, educators, and other health care providers make informed decisions as they care for children with CI and reading and attention problems. Results may also generate additional hypothesis and guide the development of other scientific investigations of the relationships between visual disorders and other developmental disorders in children.

Laser optomechanics

Cavity optomechanics explores the interaction between optical field and mechanical motion. So far, this interaction has relied on the detuning between a passive optical resonator and an external pump laser. Here, we report a new scheme with mutual coupling between a mechanical oscillator supporting the mirror of a laser and the optical field generated by the laser itself. The optically active cavity greatly enhances the light-matter energy transfer. In this work, we use an electrically-pumped vertical-cavity surface-emitting laser (VCSEL) with an ultra-light-weight (130 pg) high-contrast-grating (HCG) mirror, whose reflectivity spectrum is designed to facilitate strong optomechanical coupling, to demonstrate optomechanically-induced regenerative oscillation of the laser optomechanical cavity. We observe >550 nm self-oscillation amplitude of the micromechanical oscillator, two to three orders of magnitude larger than typical, and correspondingly a 23 nm laser wavelength sweep. In addition to its immediate applications as a high-speed wavelength-swept source, this scheme also offers a new approach for integrated on-chip sensors.

Bovine natural killer cells are infected by BVDV and the infection results in changes in phenotype and activation markers (P6128)

Bovine viral diarrhea virus infection results in immunosuppression and persistence infection of fetuses. Understanding the interaction between BVDV and NK cells is important to understand the ability of the virus to establish its infection especially through placental barrier to generate persistently infected animals. In this study, we demonstrated that BVDV is able to infect bovine NK cells by detecting the presence of BVDV RNA level up to 24 hours post infection without any increase in RNA levels over time. We also confirmed that although BVDV viral RNA was present, there was neither infectious virus release at any time post infection nor decrease in cell viability due to infection. Using immunofluorescence staining of NK cells with a mAb specific for BVDV E2 protein, we demonstrated the presence of BVDV E2 proteins in NK cells. The effect of BVDV strains that differ in its virulence or biotype on NK activation marker CD25 and phenotype markers CD2, NKp46 and the granule protein granulysin was determined. Highly virulent BVDV strains significantly decreased surface expression of each of these markers with a slight increase in the total number of cells expressing the markers 24 hour post infection. On the other hand less virulent strains increased significantly the percent of expression but with a slight decrease in the number of cells expressing the markers.

Matrix Fabry-Perot resonance mechanism in high-contrast gratings

We present a simple analytic formalism to explain the unique resonance phenomenon in subwavelength high-contrast gratings (HCG). We show that the resonances are due to strong coupling between two surface-normal waveguide array modes resulting from abrupt and large index contrast. Simple expression for HCG quality factor is derived that agrees with spectral-fitting approaches reported in literature.

1550 nm high contrast grating VCSEL

We demonstrate an electrically pumped high contrast grating (HCG) VCSEL operating at 1550 nm incorporating a proton implant-defined aperture. Output powers of >1 mW are obtained at room temperature under continuous wave operation. Devices operate continuous wave at temperatures exceeding 60 degrees C. The novel device design, which is grown in a single epitaxy step, may enable lower cost long wavelength VCSELs.

Planar high-numerical-aperture low-loss focusing reflectors and lenses using subwavelength high contrast gratings

We propose planar, high numerical aperture (NA), low loss, focusing reflectors and lenses using subwavelength high contrast gratings (HCGs). By designing the reflectance and the phase of non-periodic HCGs, both focusing reflectors and lenses can be constructed. Numerical aperture values as high as 0.81 and 0.96 are achieved for a reflector and lens with very low losses of 0.3 and 0.2 dB, respectively. The design algorithm is also shown to be readily extended to a 2D lens. Furthermore, HCG optics can simultaneously focus the reflected and transmitted waves, with important technological implications. HCG focusing optics are defined by one-step photolithography and thus can be readily integrated with many devices including VCSELs, saturable absorbers, telescopes, CCDs and solar cells.

Monolithically integrated multi-wavelength VCSEL arrays using high-contrast gratings

We propose a novel design for multi-wavelength arrays of vertical cavity surface-emitting lasers (VCSELs) using high-contrast gratings (HCGs) as top mirrors. A range of VCSEL cavity wavelengths in excess of 100 nm is predicted by modifying only the period and duty-cycle of the high-contrast gratings, while leaving the epitaxial layer thickness unchanged. VCSEL arrays fabricated with this novel design can easily accommodate the entire Er-doped fiber amplifier bandwidth with emission wavelengths defined solely by lithography with no restrictions in physical layout. Further, the entire process is identical to that of solitary VCSELs, facilitating cost-effective manufacturing.

Size effect of high contrast gratings in VCSELs

We report on the effects of shrinking the physical size of a high index contrast grating (HCG) on a vertical cavity surface-emitting laser (VCSEL). HCGs previously had been simulated assuming infinite periodicity. Here we probe through simulation and experiment the effect of reducing the HCG to only a few periods. We experimentally realize lasing VCSELs with as few as 4 periods of HCG. By shrinking the HCG to an extremely small size and integrating it on a wavelength tunable VCSEL, we are able to achieve a tunable VCSEL with a record fast mechanical tuning response of >27 MHz. This is a 5X improvement over the fastest previously reported wavelength tunable VCSELs.

Visual and language processing deficits in compensated and uncompensated college students with dyslexia

In seven experiments, we investigated whether compensated and uncompensated adults with dyslexia show different patterns of deficits in magnocellular visual processing and in language processing tasks. In four visual tasks, we failed to find evidence of magnocellular deficits in either group. However, both groups of adults with dyslexia showed deficits in component language skills, and the degree of reading impairment predicted the nature and extent of these deficits. Uncompensated readers showed deficits in orthographic and especially phonological coding and awareness and were slower on rapid naming. Compensated readers showed word and nonword performance below controls but better than the uncompensated readers. The compensated group was not significantly less accurate than controls on phonological awareness, nor significantly worse overall on rapid naming.

Can the magnocellular pathway read? Evidence from studies of color

A review of the neurophysiological literature suggests that the magnocellular pathway has adequate spatial-frequency and contrast sensitivity to perceive text under normal contrast conditions (>10%) and also is suppressed by red light. Results from three experiments involving color and reading show that red light impairs reading performance under normal luminance contrast conditions. However in a fourth experiment, isoluminant color text, designed to selectively activate the parvocellular pathway, is easier to read under red light. These discrepant results suggest that the magnocellular pathway is the dominant visual pathway for text perception. Implications for reading models and developmental dyslexia are discussed.

A clinical prediction rule to identify premenopausal women with low bone mass

Identifying premenopausal women at risk for osteoporosis and related fractures is a potentially important way to reduce the burden of illness from this disease as low peak bone mass is a risk factor for postmenopausal osteoporosis. We examined predictors of 'low' peak bone mass in 668 healthy, pre-menopausal, Caucasian women ages 18-35 years. Predictors of bone mass were assessed using a detailed, standardized interview. Bone mass was assessed using two measures: dual-energy X-ray absorptiometry (DXA) at the femoral neck and lumbar spine, and quantitative ultrasound (QUS) of the heel, which evaluates stiffness, speed of sound (SOS) and broadband ultrasound attenuation (BUA). Bone mass was considered 'low' if the corresponding Z-score was <-1.00 (DXA values, stiffness) or if values were in the lowest quintile (BUA, SOS). Using multivariate logistic regression modeling, predictors of low bone mass based on QUS, DXA or both were determined. The mean age of the cohort was 27.3 years. Independent predictors of low bone mass by both DXA and QUS were: low body weight, menarche at age 15 years or later and physical inactivity as an adolescent. Individuals with all three risk factors had a 92% chance of having low bone mass using both techniques. This suggests that a simple risk factor assessment can identify most young women with low peak bone mass. Early intervention in this group of women may reduce the risk for osteoporosis in later life.

Head growth and neurodevelopment of infants born to HIV-1-infected drug-using women

OBJECTIVE

To describe neurodevelopment and head growth in HIV-1-infected and exposed uninfected infants with and without in utero exposure to opiates and cocaine.

METHODS

Using data from a multicenter cohort study of HIV-1-infected women and their children, the authors fit repeated measures regression models to estimate the effects of HIV-1 infection and in utero hard drug exposure on head circumference and Bayley Scales of Infant Development standard scores during the first 30 months.

RESULTS

Of the 1,094 infants included in the analysis, 147 (13%) were HIV-1-positive and 383 (35%) were exposed in utero to opiates or cocaine (drug-positive). Mean 4- month Bayley mental scores were lower in infants with only HIV-1 positivity (HIV-positive and drug-negative) (-8.2 points, p < 0.0001) or only drug exposure (HIV-negative and drug-positive) (-4.4 points, p = 0.0001) and tended to be lower in infants with both factors (HIV-positive and drug-positive) (-3.7 points, p = 0.0596), compared with those who were HIV-1-negative and not drug exposed (HIV-negative and drug-negative). However, by 24 months of age, there was no longer a decrement among HIV-negative and drug-positive infants, whereas HIV-1 infection was still associated with a decrement relative to uninfected infants. Similar results were seen for Bayley motor scores and for head circumference Z scores.

CONCLUSIONS

HIV-1 infection and in utero opiate and cocaine exposure decrease birth head circumference and slow neurodevelopment at 4 months. At 24 months of age, however, only HIV-1 infection is associated with decreased neurodevelopment and head circumference. There may be some postnatal recovery from the effects of in utero hard drug exposure. Importantly, the detrimental effects of HIV-1 positivity and maternal hard drug use on neurodevelopment at 4 months are not additive, although they are additive for birth head circumference.

Effects of a continuous quality improvement program on helicopter liftoff times

BACKGROUND

The continuous quality improvement (CQI) process addresses concerns from a systems approach, employing committees of employees rather than selected management personnel to identify and solve problems, improve patient care and efficiency, and enhance customer satisfaction. Little is known about the effects of the CQI process on an aeromedical program.

OBJECTIVES

To create a CQI program within an aeromedical program and to investigate its effect on helicopter liftoff times for scene responses.

METHODS

A CQI program was established at a busy aeromedical service that completed 897 missions in the previous year. A concern identified by the CQI committee was delays in helicopter liftoff time after receipt of mission requests for scene responses. Each component necessary for liftoff (dispatch, pilot weather check, and crew response) was identified, time limits were set for each, new procedures were developed, and all staff received training on the new procedures. Computer tracking of each of the identified component times allowed comparison of data pre and post procedure implementation of the CQI-developed procedures.

RESULTS

After CQI changes in procedures were implemented, there were a total of 30 delays out of 323 calls (9% of liftoffs for on-scene flights). This represents a 6% reduction in total delays. The largest drop in component times was observed in crew response (2.6%). An unanticipated 10% drop in response times for interhospital liftoffs also occurred, presumably due to heightened awareness of the service to response times in general.

CONCLUSIONS

These findings suggest that employing a program utilizing CQI concepts can shorten helicopter liftoff times and improve response times in aeromedical programs.

Evidence for lamprey GnRH-I and -III-like molecules in the brains of the southern hemisphere lampreys Geotria australis and Mordacia mordax

The present study has characterized gonadotropic releasing hormone (GnRH)-like molecules in the brains of representatives of the two southern hemisphere families of lampreys, Geotriidae and Mordaciidae. Chromatographic and immunocytochemical evidence showed that the brains of Geotria australis and Mordacia mordax contain two forms of GnRH-like molecules. These two forms correspond to lamprey GnRH-I and -III, which were first sequenced from the brain of the anadromous sea lamprey Petromyzon marinus, a representative of the family Petromyzontidae that is found only in the northern hemisphere. In chromatographic studies (HPLC) using lamprey GnRH-I and -III antiserum, two early eluting GnRH forms coeluted with synthetic lamprey GnRH-I and -III standards. Our studies thus indicate that, despite their apparently long period of separation, the three families of extant lampreys have each retained both of the lamprey GnRH (-I and -III forms) molecules. Moreover, immunocytochemical localization of lamprey GnRH indicated that the pattern of its distribution in the adult brain of at least one of these southern hemisphere lampreys (G. australis) is similar to that previously described for P. marinus. Distribution of GnRH in the brain of larval G. australis was not as extensive as that in larval P. marinus, which may account for the later gonadal development in the former species. The fact that lamprey GnRH-I and -III are the dominant GnRH forms in all three families of lampreys implies that these neurohormones have an ancient origin.

Early cognitive and motor development among infants born to women infected with human immunodeficiency virus. Women and Infants Transmission Study Group

OBJECTIVE

To examine the frequency, timing, and factors associated with abnormal cognitive and motor development during the first 30 months of life in infants born to women infected with human immunodeficiency virus type 1 (HIV-1).

METHODS

Serial neurodevelopmental assessment was performed with 595 infants born to women infected with HIV-1 in a multicenter, prospective, natural history cohort study. Survival analysis methods were used to evaluate 6 outcome events related to abnormal cognitive and motor growth (time to confirmed drop of 1 SD, time to first score <69, and time to confirmed drop of 2 SD) in Bayley Scales of Infant Development Mental Developmental Index (MDI) and Psychomotor Developmental Index (PDI) scores among infected (n = 114) and uninfected (n = 481) infants. Proportional hazards modeling was used to evaluate the effects of HIV infection status, prematurity, prenatal exposure to illicit drugs, maternal educational attainment, and primary language.

RESULTS

HIV-1 infection was significantly associated with increased risk for all outcome events related to abnormal mental and motor growth. Differences between infected and uninfected infants were apparent by 4 months of age. Prematurity was associated with increased risk for MDI <69 and PDI <69. Maternal education of <9 completed years was associated with increased risk for MDI <69. Neither prenatal exposure to illicit drugs nor primary language other than English was associated with abnormal development.

CONCLUSION

A significant proportion of infants with HIV-1 infection show early and marked cognitive and motor delays or declines that may be important early indicators of HIV disease progression. These abnormalities are independent of other risk factors for developmental delay.

Artifactual electrocardiographic change mimicking clinical abnormality on the ECG

Electrocardiographic artifact is a common finding in patients requiring evaluation and monitoring in the prehospital, emergency department, or intensive care unit settings. Artifact results from both internal (physiological) and external (nonphysiological) sources. In most instances, artifact is recognized as an incorrect electrocardiographic signal--its only impact producing interference in electrocardiogram interpretation; artifact may also produce electrocardiographic signals which mimick disease--these signals the physician must recognize as artifact.

Gonadotropin-releasing hormones in the brain and pituitary of the teleost, the white sucker

The present study investigated GnRH forms within the brain of a representative of the order Cypriniformes, the white sucker, Catostomus commersoni, using HPLC, RIA, and immunocytochemistry. Several immunoreactive (ir) GnRH forms were identified in the brain of the white sucker by chromatography and radioimmunoassay, including ir-salmon GnRH, ir-lamprey GnRH-I and -III, and ir-chicken GnRH-II. Results from immunocytochemical studies were consistent with multiple GnRH forms distributed in different patterns, particularly for fibers. Neuronal perikarya containing ir-salmon GnRH and ir-lamprey-like GnRH were found laterally within the preoptic area and rostral hypothalamus. Cells containing exclusively ir-salmon GnRH appeared slightly more rostrally, but in the same region. Fibers containing ir-salmon GnRH and ir-lamprey-like GnRH were seen throughout the caudal telencephalon and extended into the diencephalon, toward the pituitary. Fibers containing ir-chicken-II-like GnRH were also seen in the caudal telencephalon, but were concentrated more dorsally in the diencephalon. Within the pituitary, fibers containing ir-salmon GnRH and ir-lamprey-like GnRH entered the neurohypophysis, but differed in their destinations. Fibers containing ir-salmon GnRH remained within the neurohypophysis, while fibers containing ir-lamprey-like GnRH targeted adenohypophyseal tissue. These findings are consistent with the hypothesis that multiple GnRH forms with multiple functions exist within the brain and pituitary of teleosts and provide further evidence of a lamprey-like GnRH within an early evolved teleost species.

Bone mineral density testing and osteoporosis education improve lifestyle behaviors in premenopausal women: a prospective study

One way to decrease the risk of osteoporosis is to maximize peak bone mass. Peak bone mass may be moderately influenced by lifestyle behaviors: increasing calcium and exercise, decreasing alcohol intake and smoking may increase peak bone mass. We examined the effects of osteoporosis education and bone mineral density (BMD) testing on self-reported lifestyle behaviors in 669 premenopausal women enrolled in a prospective study to assess determinants of peak bone mass. Study participants completed a questionnaire that assessed lifestyle behaviors, received pamphlets about osteoporosis, and had BMD testing. One year later, the women completed a similar questionnaire. After education about osteoporosis and BMD testing, women reported that they were less likely to smoke (odds ratio [OR] = 0.55; 95% confidence interval [95% CI]: 0.28-1.0), consume alcohol (OR = 0.13; 95% CI: 0.04-0.34), and caffeinated beverages (OR = 0. 43; 95% CI: 0.27-0.68). Women were more likely to use calcium supplements (OR = 4.3; 95% CI: 3.04-6.2), vitamin D supplements (OR = 12.6; 95% CI: 7.4-22.9), and drink at least one glass of milk a day (OR = 13.3; 95% CI: 7.8-23.9). Further, women with low bone mass were more likely to use calcium supplements (OR = 1.7; 95% CI: 1.2-2.3) and vitamin D supplements (OR = 1.6; 95% CI:1.1-2.2) compared with women who had normal bone mass. Thus, our intervention improved self-reported lifestyle behaviors in premenopausal women. Such behaviors may ultimately increase peak bone mass and decrease the risk of developing osteoporosis.

A 15-week experimental exposure of pigs to airborne dust with added endotoxin in a continuous flow exposure chamber

The purpose of this study was to evaluate the effect of longterm exposure to airborne dust and endotoxin on the respiratory system of pigs. A continuous flow exposure chamber was built for the purpose of exposing pigs to selected airborne contaminants. Pigs (n = 6) were exposed to a combination of a very fine corn/soybean meal (40.6 mg/m3) with added lipopolysaccharide (LPS; 12.4 microg/m3) for 8 h/d over 5 d for 15 wk (75 d of exposure). Control pigs (n = 6) were housed in a room with minimal contamination of these airborne contaminants. Surprisingly, dust in the exposure chamber and the control room was highly contaminated with peptidoglycan. Changes in the lung were monitored by collecting bronchoalveolar lavage (BAL) fluid for cytology at 5 different time points throughout the exposure period. Blood samples were collected at the same time for hematology. A non-specific respiratory inflammatory response was found in exposed and control pigs, as suggested by the increased neutrophils in BAL fluid and the small inflammatory areas in the lung tissue. No macroscopic lung lesions were observed in control or exposed pigs. The findings in the control pigs imply that even low dust concentrations and possibly peptidoglycan contamination can induce cellular changes in the BAL fluid and that a true control pig does not exist. In addition, the exposed pigs developed a mild eosinophilia, indicating an allergic response to the airborne contaminants.

Manual-based group psychotherapy for bipolar disorder: a feasibility study

BACKGROUND

The Life Goals Program is a structured, manual-based group psychotherapy program for bipolar disorder that seeks to improve patient participation in medical model treatment (phase 1) and assist patients in meeting functional status goals (phase 2). The goals of this initial study were (a) to determine whether the procedures could be exported from the authors to other therapists and (b) to quantify tolerability and impact of procedures on patients.

METHOD

Four therapists across 2 sites and 29 patients from the Veterans Affairs (VA) Medical Center were studied in an open feasibility study. Therapists were trained, and subsequent compliance with manual procedures was quantified. Several process indices measuring tolerability and impact on patients were analyzed.

RESULTS

Therapists covered 90% to 96% of phase 1 psychoeducational content, indicating excellent fidelity to manual procedures. Sixty-nine percent of patients completed phase 1, and participation scores were in the good to excellent range for 56%. Completion of phase 1 was associated with significant increase in knowledge about bipolar disorder. Fourteen (70%) of 20 patients enrolled in phase 2 reached their self-identified, behaviorally based goal (48% of the total sample who began phase 1 of the program). Mean +/- SD time to goal completion was 8.7 +/- 5.3 months (median [95% confidence interval] = 7 [5.1-12.3 months]; range, 2-17 months).

CONCLUSION

The manual-based intervention can be exported with fidelity to other therapists and sites (for phase 1). Data indicate reasonable tolerability and good achievement of process (for phases 1 and 2) for those who accept this group modality. Comparison with other manual-based psychotherapies indicates remarkable consistency regarding content for psychotherapy for bipolar disorder; major differences among the psychotherapies include mode of delivery and relative emphasis of specific components.