Thirteen states in the United States allow the spreading of O&G wastewaters on roads for deicing or dust suppression. In this study, the potential environmental and human health impacts of this ...practice are evaluated. Analyses of O&G wastewaters spread on roads in the northeastern, U.S. show that these wastewaters have salt, radioactivity, and organic contaminant concentrations often many times above drinking water standards. Bioassays also indicated that these wastewaters contain organic micropollutants that affected signaling pathways consistent with xenobiotic metabolism and caused toxicity to aquatic organisms like Daphnia magna. The potential toxicity of these wastewaters is a concern as lab experiments demonstrated that nearly all of the metals from these wastewaters leach from roads after rain events, likely reaching ground and surface water. Release of a known carcinogen (e.g., radium) from roads treated with O&G wastewaters has been largely ignored. In Pennsylvania from 2008 to 2014, spreading O&G wastewater on roads released over 4 times more radium to the environment (320 millicuries) than O&G wastewater treatment facilities and 200 times more radium than spill events. Currently, state-by-state regulations do not require radium analyses prior to treating roads with O&G wastewaters. Methods for reducing the potential impacts of spreading O&G wastewaters on roads are discussed.
Surfactant protein D (SP-D) plays a role in innate immunity in the lung and is expressed at many other mucosal surfaces throughout the human body. In this study, we show that SP-D mRNA and protein ...are present in the murine female reproductive tract; i.e. in the vagina, cervix, uterus and oviduct. SP-D protein is primarily localized to epithelial cells lining the genital tract and is also present in secretory material within the lumen of the uterus and cervix. The levels of SP-D mRNA in the uterus vary by a factor of 10 during the estrous cycle with peak levels present at estrus and the lowest levels at diestrus. In contrast, SP-D mRNA levels in the lung do not change during the estrous cycle. Since SP-D is an innate host defense protein present in the mouse reproductive tract, we studied the influence of infection on SP-D levels in vivo. We found that Chlamydia muridarum infection caused an increase in the SP-D protein content of reproductive tract epithelial cells. These data are suggestive that SP-D may play a role in innate immunity in the female reproductive tract in vivo.
Introduction: Our primary aims are to report on the demographics of orbital trauma in Adelaide, South Australia. Our secondary aims are to demonstrate the long-term (＞12 months) clinical outcomes of ...orbital trauma patients. Materials and Methods: Forty patients agreed to participate in the study, including 20 surgical patients and 20 non-operative patients. Patients were assessed in the areas of demographics, sensory, visual and cosmetic outcomes. Results: In the surgical patient group, 13/20 (65%) patients suffered trauma from physical assault and 16/20 (80%) were males. In the non-surgical patient group, 17/20 (85%) suffered trauma from physical assault and 16/20 (80%) were males. In the surgical patient group, sensory deficit was reported in 8/20 patients (40%), visual deficit was reported in 8/20 patients (40%), and cosmetic deficit was reported in 6/20 (30%) patients. In the non-operative patient group, sensory deficit was reported in 7/20 patients (35%), visual deficit was reported in 8/20 patients (40%) and cosmetic deficit was reported in 6/20 patients (30%). Conclusion: Our clinical study of 40 patients showed no clear clinical or statistical difference between outcomes in the two groups. Impaired visual, sensory and cosmetic deficits were reported in the minority and did not impact on quality of life.
Relatively few studies have reported on the repeatability of heterophoria (phoria) measurement procedures. The purpose of this study was to assess the inter-examiner repeatability of seven clinical ...tests of phoria measurement, using correlational and mean difference analyses. Two experienced optometrists performed each of the 7 phoria tests on 72 healthy adult subjects. Subjects ranged in age from 22 to 40 years, had visual acuity correctable to 20/20 in each eye, had no strabismus or amblyopia, and had normal eye health. The seven phoria tests used were: (1) the estimated cover test, (2) the prism-neutralized objective cover test, (3) the prism-neutralized cover test with subjective reporting of target movement, (4) the von Graefe phorometry with continuous target presentation, (5) the von Graefe phorometry with flashed target presentation, (6) the Thorington method, and (7) the modified Thorington method. All tests were performed in the same way by both examiners in random sequence, using standard clinical procedures. Inter-examiner correlations were determined for each test, as well as the mean and standard deviation of the differences between each examiner measurement (in prism diopters) on each subject. The modified Thorington method had the smallest mean difference and standard deviation of all tests and, thus, may be considered the most repeatable. This test also had the highest inter-examiner correlation. The prism-neutralized cover test with subjective reporting of target movement had the second highest correlation and the second lowest 95% limits of agreement, but had the largest mean difference of all tests. von Graefe phorometry methods were the least repeatable of the phoria tests.
Partial hepatectomy leads to an orchestrated regenerative response, activating a cascade of cell signaling events necessary for cell cycle progression and proliferation of hepatocytes. However, the ...identity of the humoral factors that trigger the activation of these pathways in the concerted regenerative response in hepatocytes remains elusive. In recent years, extracellular ATP has emerged as a rapidly acting signaling molecule that influences a variety of liver functions, but its role in hepatocyte growth and regeneration is unknown. In this study, we sought to determine if purinergic signaling can lead to the activation of c‐jun N‐terminal kinase (JNK), a known central player in hepatocyte proliferation and liver regeneration. Hepatocyte treatment with ATPγS, a nonhydrolyzable ATP analog, recapitulated early signaling events associated with liver regeneration—that is, rapid and transient activation of JNK signaling, induction of immediate early genes c‐fos and c‐jun, and activator protein‐1 (AP‐1) DNA‐binding activity. The rank order of agonist preference, UTP>ATP>ATPγS, suggests that the effects of extracellular ATP is mediated through the activation of P2Y2 receptors in hepatocytes. ATPγS treatment alone and in combination with epidermal growth factor (EGF) substantially increased cyclin D1 and proliferating cell nuclear antigen (PCNA) protein expression and hepatocyte proliferation in vitro. Extracellular ATP as low as 10 nM was sufficient to potentiate EGF‐induced cyclin D1 expression. Infusion of ATP by way of the portal vein directly activated hepatic JNK signaling, while infusion of a P2 purinergic receptor antagonist prior to partial hepatectomy inhibited JNK activation. In conclusion, extracellular ATP is a hepatic mitogen that can activate JNK signaling and hepatocyte proliferation in vitro and initiate JNK signaling in regenerating liver in vivo. These findings have implications for enhancing our understanding of novel factors involved in the initiation of regeneration, liver growth, and development. (HEPATOLOGY 2004;39:393–402.)
Nonexperimental, retrospective design.
This study was designed to compare clinical diagnostic accuracy (CDA) between physical therapists (PTs), orthopaedic surgeons (OSs), and nonorthopaedic ...providers (NOPs) at Keller Army Community Hospital on patients with musculoskeletal injuries (MSI) referred for magnetic resonance imaging (MRI).
US Army PTs are frequently the first credentialed providers privileged to examine and diagnose patients with musculoskeletal injuries. Physical therapists assigned at Keller Army Community Hospital have also been credentialed with privileges to order MRI studies for several years.
To reduce provider bias, a retrospective analysis was performed on 560 patients referred for MRI over an 18-month period. An electronic review of each patient's radiological profile was performed to assess agreement between clinical diagnosis and MRI findings. Data analyses were performed through descriptive statistics and contingency tables.
Analysis on agreement between clinical diagnosis and MRI findings produced a CDA of 74.5% (108/145) for PTs, 80.8% (139/172) for OSs, and 35.4% (86/243) for NOPs. There was a significant difference in CDA between PTs and NOPs (P<.001), and between OSs and NOPs (P<.001). There was no difference in CDA between PTs and OSs (P>.05).
Clinical diagnostic accuracy by PTs and OSs on patients with musculoskeletal injuries was significantly greater than for NOPs, with no difference noted between PTs and OSs.
Many methods of heterophoria measurement are available clinically. This paper reviews several studies which have examined the reliability of phoria measurements, and have compared various tests of ...phoria measurement. Different methods of data analysis make comparison of studies difficult. Two studies indicated 95% limits of agreement of 2 to 4 delta for reliability of modified Thorington, von Graefe, and Maddox rod phoria tests. Studies using correlational analysis to compare different measurement methods have found a high degree of association of the results of these methods. Studies using statistical methods assessing the agreement of test results found a high level of agreement among some tests and a low level of agreement among some tests. Some of the various phoria measurement methods differ in the technique used for dissociation, in the ability to control accommodation adequately, in the level of proximal convergence induced, or in the method by which the phoria is quantified. These differences can result in different phoria measurements on the same patient.
One of the most commonly used methods for measuring heterophoria is the alternating cover test. Differences in specific procedures and observational criteria used by examiners may result in different ...measurements of heterophoria on the same patient. This study evaluated the inter-examiner reliability of three different cover test techniques: the estimated cover test, the prism neutralized objective cover test, and the prism neutralized subjective cover test. Two examiners performed each technique on each of 72 subjects. Reliability was assessed using correlational methods and mean difference calculations. Although there were some inter-examiner differences for the different techniques, all of these differences were within previously determined minimum detectable eye movement ranges. Therefore, when used by experienced clinicians, each of these techniques appears to be a reliable method of heterophoria determination, and their results are comparable.
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