The Play Activity Questionnaire: A parent report measure of children's play preferences

Three studies describe the development and validation of the Play Activity Questionnaire (PQ), a parent report measure of children's play preferences. In Study 1, the 15-item PQ was completed by parents of 239 6- to 8-year-old children, and exploratory factor analysis revealed four play factors: Active and Adventurous, Athletic, Rough-and-Tumble, and Quiet. In Study 2, the factor structure was replicated with PQ data on 203 children of a broader age range (4 to 12 years). The play factors accounted for 65.7% of the variance. Boys' scores exceeded girls' scores on the Athletic and Rough-and-Tumble play factors. Girls' scores exceeded boys' scores on the Quiet play factor. Sex differences were not observed on the Active and Adventurous play factor. Interparent agreement was moderately high, and PQ factor scores were unrelated to social class or nationality. Individual factor scores showed moderate to high stability over 5 months. Validity of the play factors was examined in Study 3 by relating factor scores to measures of activity level, aggression, and sex-typed play. Play factor scores were associated with several of these measures, suggesting that the PQ is a valid measure of children's play behavior with potential applications in the fields of developmental psychopathology and psychoneuroen-docrinology, and in studies of normal play and sex-role development.This research is funded with the assistance of grant No. MA-10052 from the Medical Research Council of Canada. The first author is supported by a Research Scholar Award from the Ontario Mental Health Foundation.     

A proximal system for positive end-expiratory pressure (PEEP) and continuous positive airway pressure (CPAP).

A proximal positive end-expiratory pressure (PEEP) and continuous positive airway pressure (CPAP) system was constructed by the simple addition of a venturi T-piece proximal to the exhalation limb of a breathing circuit. The level of PEEP or CPAP was determined by the amount of flow powering the venturi. This system can provide positive pressure in excess of 40 cm H2O without the need for check valves, dump valves or additional nebuliers and flowmeters.     

Medication bezoar: Intestinal obstruction by an isocal bezoar

Medications may occasionally obstruct the gastrointestinal tract by vitue of their physical mass. Obturative obstruction of the alimentary tract is reportedly caused by an increasing number of medications, including hydroscopic bulk laxatives, cholestyramine, nonabsorbable antacids, and vitamin C tablets. Inspissated Isocal tube feedings caused jejunal obstruction in a postoperative patient. Medication bezoars are a rare cause of intestinal obstruction that may result in significant patient morbidity, including bowel necrosis, perforation, and peritonitis. The radiographic appearance may mimic an abdominal abscess.     

The distribution of BRAF gene fusions in solid tumors and response to targeted therapy

Although the BRAF V600E base substitution is an approved target for the BRAF inhibitors in melanoma, BRAF gene fusions have not been investigated as anticancer drug targets. In our study, a wide variety of tumors underwent comprehensive genomic profiling for hundreds of known cancer genes using the FoundationOne? or FoundationOne Heme? comprehensive genomic profiling assays. BRAF fusions involving the intact in‐frame BRAF kinase domain were observed in 55 (0.3%) of 20,573 tumors, across 12 distinct tumor types, including 20 novel BRAF fusions. These comprised 29 unique 5′ fusion partners, of which 31% (9) were known and 69% (20) were novel. BRAF fusions included 3% (14/531) of melanomas; 2% (15/701) of gliomas; 1.0% (3/294) of thyroid cancers; 0.3% (3/1,062) pancreatic carcinomas; 0.2% (8/4,013) nonsmall‐cell lung cancers and 0.2% (4/2,154) of colorectal cancers, and were enriched in pilocytic (30%) vs. nonpilocytic gliomas (1%; p < 0.0001), Spitzoid (75%) vs. nonSpitzoid melanomas (1%; p = 0.0001), acinar (67%) vs. nonacinar pancreatic cancers (<1%; p < 0.0001) and papillary (3%) vs. nonpapillary thyroid cancers (0%; p < 0.03). Clinical responses to trametinib and sorafenib are presented. In conclusion, BRAF fusions are rare driver alterations in a wide variety of malignant neoplasms, but enriched in Spitzoid melanoma, pilocytic astrocytomas, pancreatic acinar and papillary thyroid cancers.     

HspE7 treatment of pediatric recurrent respiratory papillomatosis: final results of an open-label trial

OBJECTIVES: We sought to evaluate the effectiveness of HspE7, a recombinant fusion protein of Hsp65 from Mycobacterium bovis BCG and E7 protein from human papillomavirus 16, to improve the clinical course of pediatric patients with recurrent respiratory papillomatosis. METHODS: An open-label, single-arm intervention study was conducted in 8 university-affiliated medical centers. Twenty-seven male and female patients with recurrent respiratory papillomatosis, ages 2 to 18 years, were enrolled and followed up to 60 weeks. Before enrollment, these patients required surgery on average every 55 days. After a baseline debulking surgery, the patients received HspE7 500 microg subcutaneously monthly, for 3 doses over 60 days. The primary end point was the length of the interval from the last surgery during the treatment period until the first debulking surgery in the posttreatment period, compared with the median intersurgical interval (ISI) of the 4 surgeries before the treatment. RESULTS: The mean of the first posttreatment ISI increased 93% (from 55 days to 106 days; p < .02). The median ISI for all surgeries after treatment was similarly prolonged (mean, 107 days; p < .02), indicating a sustained treatment effect, and was associated with a significant decrease in the number of required surgeries (p < .003). Unexpectedly, the treatment effect was most striking in the 13 female patients, who had statistically significant increases in both the first posttreatment ISI (142%; p < .03) and the median ISI (147%; p < .03). The most common adverse events were mild-to-moderate injection site reactions. CONCLUSIONS: Treatment with HspE7 appears to significantly improve the clinical course in pediatric patients with RRP insofar as it reduces the frequency of required surgeries. These results warrant a confirmatory phase III trial.     

Early processing deficits in object working memory in first-episode schizophreniform psychosis and established schizophrenia

BACKGROUND: While there are many studies showing working-memory deficits in schizophrenia there are only a few that disentangle impairments for working-memory subprocesses such as perceptual, attentional, mnemonic and executive function. METHOD: In this study of delay-dependent memory, 55 patients with schizophreniform psychosis, 50 with established schizophrenia and 56 healthy controls were investigated. Using the delayed matching-to-sample task from the Cambridge Neuropsychological Test Automated Battery (CANTAB), performance deficits were found in both patient groups after controlling for age and pre-morbid IQ. RESULTS: Even after controlling for simultaneous matching-to-sample ability (i.e. perceptual matching), impaired performance in both patient groups was found as soon as the stimuli were no longer present. Impaired performance was not due to different types of errors in patients versus controls. Performance in both patient groups was comparable, except for a slight decrease of overall task performance. This suggests that the deficit is relatively stable during the course of the illness. CONCLUSIONS: Our results suggest a deficit in patients with psychotic illness in the initial processes necessary to actively maintain information, such as the ability to form an internal representation of complex objects.     

Chest CT performed with z-axis modulation: scanning protocol and radiation dose

Institutional review board approval of the study protocol and waiver of informed consent were obtained. This study was compliant with the Health Insurance Portability and Accountability Act. The purpose of this study was to retrospectively assess the scanning protocol and radiation dose associated with z-axis automatic tube current modulation in multi-detector row CT scanning of the chest. Fifty-three patients (mean age, 54 years; age range, 26-77 years; 25 men, 28 women) underwent 16-detector row chest CT with z-axis modulation and noise indexes of 10.0, 12.5, and 15.0 HU. Two radiologists independently compared images acquired with z-axis modulation and fixed tube current (180-300 mA) techniques for image noise, diagnostic acceptability, and depiction of peripheral bronchovascular markings. Tube current-time product was calculated for each study. There was good interobserver agreement between the two readers (kappa = 0.72). Compared with the fixed tube current technique, z-axis modulation provides acceptable image noise for chest CT, with an 18% and 26% reduction in tube current-time product at 10.0- and 12.5-HU noise indexes, respectively.     

The effect of enzyme treatment on the in vitro fermentation of lucerne incubated with equine faecal inocula

A series of experiments was conducted to determine the effects of a fibrolytic enzyme preparation (enzyme 1; E1) on the in vitro fermentation of lucerne incubated with equine faecal inocula. In experiment 1, high-temperature-dried (HT) lucerne was treated with five levels of E1 (0 to 2.4 ml/g DM) and incubated at 50 degrees C for 20 h. Samples then received a simulated foregut digestion (SFD) treatment before DM and NSP analysis. In experiment 2, HT lucerne was treated with the same enzyme levels used in experiment 1. Samples were then split into two groups; plus or minus an SFD treatment before in vitro fermentation using an equine faecal inoculum. In experiment 3, fresh and wilted lucerne were treated with the same levels of E1 as experiments 1 and 2, incubated at 50 degrees C for 20 h, then fermented in vitro. For experiment 4, fresh and wilted lucerne were treated with low levels (0 to 0.008 ml/g DM) of E1 before fermentation. E1 significantly (P<0.05) enhanced DM and NSP losses from HT lucerne following SFD treatment compared with the control. High levels of E1 significantly (P<0.05) enhanced the rate, but not extent, of fermentation of HT, wilted and fresh lucerne; however, low levels of E1 were ineffective. At higher application levels, E1 appears to have considerable potential to enhance the nutritive value of lucerne for horses. Information on the fermentation kinetics of the substrates was valuable; all end-point measurements showed no effect of enzyme treatment.