The Distribution of Scaled Scores and Possible Floor Effects on the WISC‐III and WAIS‐III

Objective It has been suggested that, as the Wechsler Adult Intelligence Scale‐Third Edition (WAIS‐III) and the Wechsler Intelligence Scale for Children‐Third Edition (WISC‐III) give a scaled score of one even if a client scores a raw score of zero, these assessments may have a hidden floor effect at low IQ levels. The study looked for indications of this in a sample of assessments that had been given for clinical and diagnostic reasons. Design The degree to which a hidden floor effect could be present was assessed by looking at the proportion of scaled scores of one in IQ bands: 50–59, 60–69 and 70 plus and by plotting the distribution of scaled scores in these bands for both the WISC‐III and WAIS‐III. Method Fifty WISC‐III and 49 WAIS‐III assessments were obtained from records and analysed. Results The distribution of scaled scores in the WAIS‐III was approximately normal with very few scale scores of one, suggesting that a hidden floor effect would only be a potential problem for IQs in the 40s and 50s. The WISC‐III had a skewed distribution of scaled scores with more scaled scores of one than any other scaled score. Scaled scores of one were shown in all IQ levels up to 70 plus. Conclusions There is potentially a significant floor effect on the WAIS‐III at IQs in the 40s and 50s and on the WISC‐III up to IQs in the 70s. There are also indications that the WISC‐III has a much harder criterion for gaining a scaled score of two than the WAIS‐III, resulting in it producing lower IQs.     

Comparison of the WAIS‐III and WISC‐IV in 16‐Year‐Old Special Education Students

Background Previous research with earlier versions of the WISC and WAIS has demonstrated that when administered to people who have intellectual disabilities, the WAIS produced higher IQ scores than the WISC. The aim of this study was to examine whether these differences still exist. A comparison of the Wechsler Adult Intelligence Scale – Third Edition (WAIS‐III) with the Wechsler Intelligence Scale for Children – Fourth Edition (WISC‐IV) was conducted with individuals who were 16 years old and receiving special education. Materials and Methods All participants completed the WAIS‐III (UK) and WISC‐IV (UK). The order of administration was counterbalanced; the mean Full Scale IQ and Index scores on the WAIS‐III and WISC‐IV were compared. Results The WAIS‐III mean Full Scale IQ was 11.82 points higher than the mean Full Scale IQ score on the WISC‐IV. Significant differences were also found between the Verbal Comprehension Index, Perceptual Reasoning/Organization Index and Processing Speed Index on the WAIS‐III and WISC‐IV, all with the WAIS‐III scoring higher. Conclusions The findings suggest that the WAIS‐III produces higher scores than the WISC‐IV in people with intellectual disabilities. This has implications for definitions of intellectual disability and suggests that Psychologists should be cautious when interpreting and reporting IQ scores on the WAIS‐III and WISC‐IV.     

A Comparison of WAIS‐R and WAIS‐III in the Lower IQ Range: Implications for Learning Disability Diagnosis

Background Whether the Flynn effect (the increase in the populations’ IQ over time) affects the IQ scores of people with learning disability or borderline learning disability remains unclear. The issue is important as the Flynn effect should alter the number of people eligible for health service resources. A comparison of the Wechsler Adult Intelligence Scale‐Revised (WAIS‐R) with the Wechsler Adult Intelligence Scale‐Third Edition (WAIS‐III) in individuals with learning disability or borderline learning disability was conducted. Method All participants completed the WAIS‐R and the WAIS‐III. Discrepancy scores were calculated for the Full Scale IQ score and the Verbal and Performance subscale scores. Results WAIS‐III Full Scale scores were significantly lower by over 4 IQ points. Verbal and Performance Scale IQ scores were also significantly lower than the corresponding WAIS‐R scores. Conclusion The shift from WAIS‐R to WAIS‐III means that 66% more people meet criterion A for the diagnosis of learning disability and hence this has major resource implications for health service providers.     

Type III Sturge‐Weber Syndrome With Migraine‐Like Attacks Associated With Prolonged Visual Aura

Sturge‐Weber syndrome is known to be associated with migraine attacks and prolong aura even without cerebral infarction. We report the case of a 36‐year‐old woman with type III Sturge‐Weber syndrome developing with prolonged left homonymous hemianopsia after an intractable migraine‐like headache and becoming a permanent visual field defect at 18‐month follow up. By adopting a multimodality imaging study, we suggested that the underlying mechanism of prolonged visual field defect was due to blood flow disturbance and vasogenic leakage under the leptomeningeal angioma combining with atrophy and the damaged integrity of white matter in right occipital lobe.     

The effects of intramolecular H‐bond formation on the stability constant and water exchange rate of the Gd(III)‐diethylenetriamine‐N′‐(3‐amino‐1,1‐propylenephosphonic)‐N,N,N″,N″‐tetraacetate complex

The binding interaction of metal chelates to biological macromolecules, though driven by properly devoted recognition synthons, may cause dramatic changes in some property associated with the coordination cage such as the thermodynamic stability or the exchange rate of the metal coordinated water. Such changes are due to electrostatic and H‐bonding interactions involving atoms of the coordination cage and atoms of the biological molecule at the binding site. To mimic this type of H‐bonding interactions, lanthanide(III) complexes with a DTPA–monophosphonate ligand bearing a propylamino moiety (H₆NP–DTPA) were synthesized. Their thermodynamic stabilities and the exchange lifetime of the coordinated water molecule (for the Gd‐complex) were compared with those of the analog complexes with DTPA and the parent DTPA–monophosphonate derivative (H₆P–DTPA). It was found that the intramolecular H‐bond between the ε‐amino group and the phosphonate moiety in NP–DTPA complexes causes displacements of electric charges in their coordination cage that are markedly pH dependent. In turn, this affects the characteristic properties of the coordination cage. In particular it results in a marked elongation of the exchange lifetime of the coordinated water molecule. Copyright © 2007 John Wiley & Sons, Ltd.     

Bacterial growth kinetics in ACD‐A apheresis platelets: comparison of plasma and PAS III storage

BACKGROUND: Our objective was to determine the growth kinetics of bacteria in leukoreduced apheresis platelets (LR‐AP) in a platelet (PLT) additive solution (PAS; InterSol, Fenwal, Inc.) compared to LR‐AP stored in plasma. STUDY DESIGN AND METHODS: Hyperconcentrated, double‐dose LR‐AP were collected from healthy donors with a separator (AMICUS, Fenwal, Inc.). LR‐AP were evenly divided, InterSol was added to half (65% InterSol:35% plasma [PAS]), and PLTs in autologous plasma were used for a paired control (PL). Bacteria were inoculated into each LR‐AP PAS/PL pair (0.5‐1.6 colony‐forming units [CFUs]/mL), and bacterial growth was followed for up to 7 days. Time to the end of the lag phase, doubling times, maximum concentration (conc‐max), and time to maximum concentration (time‐max) were estimated. RESULTS: Streptococcus viridans did not grow to detectable levels in either PAS or PL units. The other bacteria had no significant overall difference in the conc‐max (p = 0.47) or time‐max (p = 0.7) between PL and PAS LR‐AP; PL had a 0.14 hours faster doubling rate (p = 0.023); and PAS had a 4.7 hours shorter lag time (p = 0.016). CONCLUSION: We observed that five index organisms will grow in LR‐AP stored in a 35%:65% ratio of plasma to InterSol where initial bacterial concentrations are 0.5 to 1.6 CFUs/mL. The more rapid initiation of log‐phase growth for bacteria within a PAS storage environment resulted in a bacterial concentration up to 4 logs higher in the PAS units compared to the plasma units at 24 hours, but with no difference in the conc‐max. This may present an early bacterial detection advantage for PAS‐stored PLTs.     

Pharmacokinetic and in vivo evaluation of a self‐assembled gadolinium(III)‐iron(II) contrast agent with high relaxivity

A high‐molecular weight tetrametallic supramolecular complex [(Ln‐DTPA‐phen)₃Fe]^? (Ln = Gd, Eu, La) has been obtained upon self‐assembly around one iron(II) ion of three 1,10‐phenantroline‐based molecules substituted in 5′‐position with the polyaminocarboxylate diethylenetriamine‐N,N,N′,N′,N′‐pentaacetate, DTPA‐phen^4?. The ICP‐MS measurements indicated that the lanthanide:iron ratio is 3:1. Photoluminescence spectra of [Eu‐DTPA‐phen]^? and of [(Eu‐DTPA‐phen)₃Fe]^? are nearly identical, implying that the first coordination sphere of the lanthanide(III) ion has not been changed upon coordination of phenantroline unit to iron(II) ion. NMRD measurements revealed that at 20 MHz and 310 K the relaxivity of the [(Gd‐DTPA‐phen)₃Fe]^? is equal to 9.5 ± 0.3 s^?1 mM^?1 of Gd (28.5 s^?1 per millimole per liter of complex) which is significantly higher than that for Gd‐DTPA (3.9 s^?1 mM^?1). The pharmacokinetic parameters of [(Gd‐DTPA‐phen)₃Fe]^? in rats indicate that the elimination of [(Gd‐DTPA‐phen)₃Fe]^? is significantly slower than that of Gd‐DTPA and is correlated with a reduced volume of distribution. The low volume of distribution and the longer elimination time (T_e1/2) suggest that the agent is confined to the blood compartment, so it could have an important potential as a blood pool contrast agent. The biodistribution profile of [(Gd‐DTPA‐phen)₃Fe]^? 2 h after injection indicates significantly higher concentrations of [(Gd‐DTPA‐phen)₃Fe]^? as compared with Gd‐DTPA in kidney, liver, lungs, heart and spleen. The images obtained on rats by MR angiography show the enhancement of the abdominal blood vessels. The signal intensity reaches a maximum of 55% at 7 min post‐contrast and remains around 25% after 90 min. MRI‐histomorphological correlation studies of [Gd‐DTPA‐phen]^? and [(Gd‐DTPA‐phen)₃Fe]^? showed that both agents displayed potent contrast enhancement in organs including the liver. The necrosis avidity tests indicated that, in contrast to the [Gd‐DTPA‐phen]^? precursor complex, the supramolecular complex [(Gd‐DTPA‐phen)₃Fe]^? exhibits necrosis avidity. Copyright © 2006 John Wiley & Sons, Ltd.     

Should Pediatric Emergency Care Be Decentralized ?: An Out‐of‐hospital Destination Model for Critically III Children

OBJECTIVES: A time-to-initial-stabilization model for out-of-hospital destinations of critically ill children (CICs) was developed. Application of this model to assess the impact of changes in different parameters of an emergency medical services for children (EMSC) system is described. METHODS: A computer model created a 2,500-square-mile community containing ten community hospitals (CHs) and one pediatric critical care center (PCC). Community hospitals capable of providing initial immediate stabilization of CICs were defined as emergency departments accepting pediatrics (EDAPs). Critically ill children were randomly selected in proportion to population densities across the modeled community. Time to initial stabilization (TIS) was defined as the time to arrival at either an EDAP or a PCC or time to arrival at a non-EDAP CH + travel time for a team from the PCC to the non-EDAP CH + preparation/dispatch (P/D) time. The following parameters of the model were varied and their effect on TIS was evaluated: location of CHs, location of PCC, primary destinations for CICs, percent of CHs meeting EDAP standards, out-of-hospital compliance with designated hospitals for CICs, P/D time, and ambulance speed. RESULTS: The computer model selected 1,000 CICs in accordance with the population densities of the community. The scenario with the shortest TIS was one in which every CH achieved EDAP designation (9.8 +/- 0.5 minutes). The scenario with the longest TIS involved a model in which every CIC was transported directly to the PCC (28.6 +/- 0.33 minutes). The number of EDAPs in a community and out-of-hospital compliance with use of EDAPs produced comparable effects on the TIS. Travel speeds had a direct effect on TIS but also exaggerated inefficiencies between scenarios. The P/D time had little effect on the TIS. CONCLUSIONS: An out-of-hospital destination model has been developed with the ability to modify multiple EMSC system variables. Application of this model demonstrates the shortest times to stabilization of critically ill children occur in systems that maximize the number of hospitals that meet EDAP standards and decentralize pediatric emergency care.     

Subchronic administration of riparin III induces antidepressive‐like effects and increases BDNF levels in the mouse hippocampus

Riparin III (Rip III) is an alcamide isolated from Aniba riparia that has presented effects of antidepressant and anxiolytic activities in acute stress behavioral models. The trial's goal was to investigate the activity of Rip III in mice exposed to corticosterone‐induced chronic depression model. Swiss female mice, 22–25 g, were distributed in following experimental groups: control group (vehicle1: saline containing 0.1% dimethyl sulfoxide and 0.1% Tween‐80, SC+ vehicle 2: distilled water emulsified with 2% Tween‐80, PO); stressed group (corticosterone, 20 mg/kg, SC, + vehicle 2, orally); Rip III group (50 mg/kg, orally); and fluvoxamine (Flu) group (50 mg/kg, orally). The mice were exposed to the behavioral tests, and posteriorly, Brain‐derived neurotrophic factor protein levels were assessed in hippocampal samples. Statistical analysis of the data was performed by one‐way anova , followed by Newman–Keuls test. Both administrations of Rip III and Flu significantly reduced the immobility time in tail suspension and forced swimming tests after 21 days without affecting locomotor function. There was also an increase in BDNF protein levels in the mice hippocampus. These findings further support the hypothesis that Rip III could be a new pharmacological target for the treatment of mood disorders.     

Novel aspects of Kindlin‐3 function in humans based on a new case of leukocyte adhesion deficiency III

Summary. Background: Kindlin‐3 is a novel integrin activator in hematopoietic cells, and its deficiency leads to immune problems and severe bleeding, known as leukocyte adhesion deficiency III (LAD‐III). Our current understanding of Kindlin‐3 function primarily relies on analysis of animal models or cell lines. Objectives: To understand the functions of Kindlin‐3 in human primary blood cells. Patients/Methods: We analyzed primary and immortalized hematopoietic cells obtained from a new LAD‐III patient with immune problems, bleeding, a history of anemia, and abnormally shaped red blood cells. Results: The patient’s white blood cells (WBCs) and platelets showed defects in agonist‐induced integrin activation and botrocetin‐induced platelet agglutination. Primary leukocytes from this patient exhibited abnormal activation of β₁ integrin. Integrin activation defects were responsible for the observed deficiency in the botrocetin‐induced platelet response. Analysis of patient genomic DNA revealed a novel mutation in the Kindlin3 gene. The mutation abolished Kindlin‐3 expression in primary WBCs and platelets, owing to abnormal splicing. Kindlin‐3 is expressed in red blood cells (RBCs), and its deficiency is proposed to lead to abnormally shaped RBCs. Immortalized patient WBCs expressed a truncated form of Kindlin‐3 that was not sufficient to support integrin activation. Expression of Kindlin‐3 cDNA in immortalized patient WBCs rescued integrin activation defects, whereas overexpression of the truncated form did not. Conclusions: Kindlin‐3 deficiency impairs integrin function, including activation of β₁ integrin. Abnormalities in glycoprotein Ib–IX function in Kindlin‐3‐deficient platelets are secondary to integrin defects. The region of Kindlin‐3 encoded by exon 11 is crucial for its ability to activate integrins in humans.     

Performance of CURB‐65 and CURB‐age in community‐acquired pneumonia

Background: Community‐acquired pneumonia (CAP) is common and associated with significant mortality. In this study, we validated a newly proposed severity assessment rule for CAP, CURB‐age, and also compared with to the currently recommended criteria in UK, CURB‐65. Methods: We conducted a prospective study in three hospitals in Norfolk and Suffolk, UK. One hundred and ninety patients were included and followed up for 6 weeks. Results: Of 190 patients, 100 were men (53%). The age range was 18–101 years (median 76 years). Sixty‐five (34%) had severe pneumonia by CURB‐65 and 54 (28%) had severe pneumonia by CURB‐age. There were 54 deaths during follow‐up. There were 32 deaths (50%) in severe and 22 deaths (18%) in non‐severe group by CURB‐65. There were 27 deaths each in both the groups by CURB‐age (50% of severe cases and 20% of non‐severe cases). For CURB‐65, sensitivity, specificity, and positive and negative predictive values were 59.3% (45.0–72.4), 75.7% (67.6–82.7), 49.2% (36.6–61.9) and 82.4% (74.6–88.6), respectively. For CURB‐age, the respective values were 50.0% (31.1–63.9), 80.1% (72.4–86.5), 50.0% (36.1–63.9) and 80.1% (72.4–86.5). Exclusion of patients aged < 65 years did not alter the results. Conclusions: Despite better specificity in correctly identifying 6‐week mortality for CAP, CURB‐age appears to be less sensitive than CURB‐65. Our findings further assure the usefulness of CURB‐65 for predicting mortality in CAP.     

Manganese cell labeling of murine hepatocytes using manganese(III)‐transferrin

Manganese(III)‐transferrin [Mn(III)–Tf] was investigated as a way to accomplish manganese‐labeling of murine hepatocytes for MRI contrast. It is postulated that Mn(III)–Tf can exploit the same transferrin‐receptor‐dependent and ‐independent metabolic pathways used by hepatocytes to transport the iron analog Fe(III)–Tf. More specifically, it was investigated whether manganese delivered by transferrin could give MRI contrast in hepatocytes. Comparison of the T₁ and T₂ relaxation times of Mn(III)–Tf and Fe(III)–Tf over the same concentration range showed that the r₁ relaxivities of the two metalloproteins are the same in vitro, with little contribution from paramagnetic enhancement. The degree of manganese cell labeling following incubation for 2–7 h in 31.5 µm Mn(III)–Tf was comparable to that of hepatocytes incubated in 500 µm Mn²⁺ for 1 h. The intrinsic manganese tissue relaxivity between Mn(III)–Tf‐labeled and Mn²⁺‐labeled cells was found to be the same, consistent with Mn(III) being released from transferrin and reduced to Mn²⁺. For both treatment regimens, manganese uptake by hepatocytes appeared to saturate in the first 1–2 h of the incubation period and may explain why the efficiency of hepatocyte cell labeling by the two methods appeared to be comparable in spite of the ～16‐fold difference in effective manganese concentration. Hepatocytes continuously released manganese, as detected by MRI, and this was the same for both Mn²⁺‐ and Mn(III)–Tf‐labeled cells. Manganese release may be the result of normal hepatocyte function, much in the same way that hepatocytes excrete manganese into the bile in vivo. This approach exploits a biological process—namely receptor binding, endocytosis and endosomal acidification—to initiate the release of an MRI contrast agent, potentially conferring more specificity to the labeling process. The ubiquitous expression of transferrin receptors by eukaryotic cells should make Mn(III)–Tf particularly useful for manganese labeling of a wide variety of cells both in culture and in vivo. Published in 2008 by John Wiley & Sons, Ltd.