Assault injury rates,social capital,and fear of neighborhood crime

This study develops an explanatory framework for fear of neighborhood crime based on respondents' social context and local rates of assault injuries. Rates of assault injuries within zip codes are based on hospital discharge records. We find that only four variables have a significant unique contribution to fear of crime: respondent's sex, perceptions of neighborhood social capital, and the rates of struck by/against assault injuries for the 10–24 and 50+ age groups. We also find that the perception of neighborhood social capital moderates the impact of assault injury rates on fear of crime; those who perceive a high level of neighborhood social capital exhibit less sensitivity to assault injury rates. We include a map of assault injury rates and fear of crime by ZIP Code and describe the community context related to our results. © 2007 Wiley Periodicals, Inc. J Comm Psychol 35: 483–498, 2007.     

Comparison of the Ligase Chain Reaction with Solid and Liquid Culture Media for Routine Detection of Mycobacterium tuberculosis in Nonrespiratory Specimens

The aim of this study was to compare the results of a commercial assay based on the ligase chain reaction [(LCR) LCx Probe System MTB; Abbott, USA] with those of culture in liquid medium (Septi-Chek AFB; Becton-Dickinson, USA) and culture on the egg-based Löwenstein-Jensen solid medium for the direct detection of Mycobacterium tuberculosis complex in nonrespiratory specimens. The results were analyzed according to the standard definition of a true-positive result. Two hundred thirty-five nonrespiratory samples routinely submitted to rule out tuberculosis were analyzed. All samples were smear-negative. Mycobacterial growth in either culture medium was detected in 18 (7.6%) specimens: Mycobacterium tuberculosis was recovered from seven (38.9%) specimens cultured on Löwenstein-Jensen medium and from 18 (100%) specimens cultured in Septi-Chek AFB. The LCR protocol was positive in 22 specimens. None of the LCR-negative controls showed positive results. All samples positive by culture on Löwenstein-Jensen medium were positive by culture in liquid medium and by the LCR assay. However, Mycobacterium tuberculosis was detected by culture in liquid medium in two specimens that were negative by the LCR assay, whereas six specimens negative by culture in liquid medium were positive by the LCR protocol; three of these were identified as true-positive results of the LCR assay. The sensitivity, specificity, and positive and negative predictive values were 33.3%, 100%, 100%, and 93.8%, respectively, for Löwenstein-Jensen medium; 85.7%, 100%, 100%, and 98.6% for the liquid medium; and 90.4%, 98.5%, 86.3%, and 99% for the LCR assay. These findings indicate that the LCR assay may be a valid method of high diagnostic yield for direct detection of Mycobacterium tuberculosis complex in nonrespiratory specimens.     

Signet-ring lymphoma: report of a case

Signet-ring lymphoma is a rare entity in which the synthesis or secretion of immunoglobulins is impaired, producing a signet-ring appearance to the lymphoma cells. A case of this type of lymphoma is described, and the cytologic aspects of the cells obtained from the fixative fluid are described.     

A polymorphic major histocompatibility complex class II‐like locus maps outside of both the chicken B‐system and Rfp‐Y‐system

Chickens have two major regions encoding major histocompatibility complex (MHC) class Iα genes and MHC class IIß genes, the serological and functional B‐system and the Rfp‐Y‐system. Recently, they have been shown to assort in a genetically independent way although still located on the same microchromosome. Moreover, the monomorphic MHC class IIα gene maps at a third locus located 5 c m from the nearest class IIß genes, located in the B‐system ( Kaufman et al., 1995 ). A pedigree family was studied in three generations in order to assign MHC class IIß restriction fragments observed in Southern blot analyses to either the B‐system, the Rfp‐Y‐system or the B‐Lα locus. In this study, we demonstrate by classical genetic testing of chickens within this fully pedigreed family the existence of an MHC class II‐like polymorphic restriction fragment that segregates independently of the B‐system, the Rfp‐Y‐system and of the B‐Lα locus.     

In vivo measurement of electrical parameters with alumina-covered stainless steel electrodes

An experimental method has been developed for in vivo measurement of electrical parameters. It is thus possible to evaluate not only the instantaneous corrosion rate of implants but also their susceptibility to pitting corrosion. It has also been shown that when the method is applied to stainless steel/ceramic electrodes, these remain in the passive condition. If an eventual breakdown of the passivating film occurs, it will quickly regenerate itself.     

Performance on the Balance Error Scoring System Decreases After Fatigue

OBJECTIVE: To determine the immediate effects of a whole-body fatigue protocol on performance of the Balance Error Scoring System (BESS), a postural-stability test commonly used as part of a concussion-assessment battery. DESIGN AND SETTING: Subjects were assigned to a fatigue or control group and were assessed before and immediately after a 20-minute fatigue protocol or rest period. SUBJECTS: Fourteen fatigue subjects and 13 control subjects participated in this study. All subjects were male and free of vestibular disorders, and none had suffered a mild head injury or lower extremity injury in the preceding 6 months, as described through self-report. MEASUREMENTS: We measured performance on the BESS for 9 stance-surface conditions and summed each condition to obtain a total score. Using the Borg scale, we also measured ratings of perceived exertion before, during, and after the fatigue protocol or rest period. RESULTS: We found a significant increase in total errors from pretest to posttest in the fatigue group (14.36 +/- 4.73 versus 16.93 +/- 4.32), a significant decrease in errors in the control group (13.32 +/- 3.77 versus 11.08 +/- 3.88), and a significant difference between groups on the posttest. The rating of perceived exertion scores were significantly different between the fatigue and control groups at the middle (13.29 +/- 1.59 versus 6.23 +/- 0.83) and end (15.86 +/- 2.38 versus 6.15 +/- 0.55) of the fatigue or rest period. CONCLUSIONS: The BESS error scores increased immediately after the fatigue protocol, demonstrating that balance ability diminished. Clinicians who use the BESS as part of their sideline assessment for concussion should not administer the test immediately after a concussion due to the effects of fatigue.     

Ultrafine Electrospun Polyamide‐6 Fibers: Effect of Solution Conditions on Morphology and Average Fiber Diameter

Summary: In the present contribution, the electrostatic spinning or electrospinning technique was used to produce ultra‐fine polyamide‐6 (PA‐6) fibers. The effects of solution conditions on the morphological appearance and the average diameter of as‐spun fibers were investigated by optical scanning (OS) and scanning electron microscopy (SEM) techniques. It was shown that the solution properties (i.e. viscosity, surface tension and conductivity) were important factors characterizing the morphology of the fibers obtained. Among these three properties, solution viscosity was found to have the greatest effect. Solutions with high enough viscosities (viz. solutions at high concentrations) were necessary to produce fibers without beads. At a given concentration, fibers obtained from PA‐6 of higher molecular weights appeared to be larger in diameter, but it was observed that the average diameters of the fibers from PA‐6 of different molecular weights had a common relationship with the solution viscosities which could be approximated by an exponential growth equation. Raising the temperature of the solution during spinning resulted in the reduction of the fiber diameters with higher deposition rate, while mixing m‐cresol with formic acid to serve as a mixed solvent for PA‐6 caused the solutions to have higher viscosities which resulted in larger fiber diameters. Lastly, the addition of some inorganic salts resulted in an increase in the solution conductivity, which caused the fiber diameters to increase due to the large increase in the mass flow.

Average diameter of as‐spun fibers plotted as a function of the viscosity of the solutions.     

Association of haplotypes in the beta-chemokine locus with multiple sclerosis

Linkage studies in multiple sclerosis (MS) identified several susceptibility loci. One of these regions includes chromosome 17q11 where a meta-analysis of data from three genome scans suggested linkage. This region encodes a cluster of genes for beta-chemokines or CC chemokine ligands (CCLs), which may be involved in the development of MS lesions. Here we aimed to test if CCL alleles and haplotypes are associated with MS. Using methods of linkage and association, we observed deviations from the expected 50% transmission of haplotypes from unaffected parents to their affected children at CCL2, CCL11-CCL8-CCL13 and CCL3 within the investigated 1.85 MB chromosomal segment. Analyses of the linkage disequilibrium map support that variants with possible relevance to MS can be located within these subregions. Identification of MS associated CCL variants may have direct clinical significance, as it can lead to the design of small competitive antagonists of these molecules with beneficial effects in the treatment of patients with early and active disease.     

The Prediction of Intracranial Injury After Minor Head Trauma in the Pediatric Population

Reference: Dunning J, Batchelor J, Stratford-Smith P, et al. A meta-analysis of variables that predict significant intracranial injury in minor head trauma. Arch Dis Child. 2004;89:653–659.Clinical Question: Which clinical signs or symptoms of minor head trauma are predictive of intracranial hemorrhage in children and adolescents?Data Sources: Investigations were identified by MEDLINE and EMBASE searches from 1990 through 2002 by a search of the grey literature and by contacting experts for additional papers. The search terms were selected to find all studies reporting intracranial hemorrhage (ICH) or complications after head trauma.Study Selection: A full systematic review was conducted, and all cohort or nested cohort studies that presented data on minor head injuries in children less than 18 years old, with or without ICH, were identified. Studies were then judged for inclusion based on the presentation of a series of at least 100 patients and a documented reliable standard for the detection of ICH for all patients in the study. The use of computed tomography (CT) and medical follow-up was considered an acceptable gold standard. Intracranial hemorrhage was defined as any abnormality detected on the CT scan due to the traumatic presence of extravascular blood. Minor head trauma was defined as patients presenting with a Glasgow Coma Scale (GCS) score of 13–15.Data Extraction: Seven clinical correlates were used for data extraction, including skull fracture, headache, vomiting, focal neurology, seizure, loss of consciousness, and a GCS score of less than 15. Data were analyzed using a pooled estimate of the relative risk ratio with a random-effects model.Main Results: The searches identified a total of 2134 studies for the initial review. After an abstract review by 2 independent examiners, 98 studies were identified for a full-paper review. Each study was graded on a 4-point scale according to the level of evidence provided, using scales consistent with the Oxford Centre for Evidence-Based Medicine and the National Institute for Clinical Excellence. Thirty-four of these articles were of adequate quality for inclusion; however, many did not include data that could be separated into a specific data set for children, had too small a sample size, or lacked enough data on individual correlates to head trauma. Nineteen studies provided data on children, but 3 of these were excluded due to poor quality or lack of a reported CT scan, leaving a total of 16 studies for the meta-analysis.The analysis included a total of 22 420 patients ranging between 0 and 18 years of age. The meta-analysis showed a significant increased relative risk of ICH for patients sustaining loss of consciousness (2.23), GCS <15 (5.51), skull fracture (6.13), and focal neurology (9.43). No significant increases in risk for headache (1.02), vomiting (0.878), or seizure (2.82) were noted; however, heterogeneity was significant for this last correlate. The prevalence of ICH ranged from 1.3 to 36%, supporting the notion of a large amount of heterogeneity or variability in the inclusion criteria among the studies.Conclusions: These findings demonstrate that loss of consciousness, decreased level of consciousness (GCS <15), skull fracture, and focal neurology are risk factors for ICH in the pediatric population. However, these findings are not definitive enough to establish pediatric head-injury guidelines regarding CT scanning or admission to hospital after minor head trauma.COMMENTARYAlthough intracranial hemorrhage (ICH) after mild head injury is a rare occurrence in athletes, certified athletic trainers (ATCs) must be aware of the signs and symptoms of all severities of head trauma, including ICH. The initial role of the ATC when there is a suspected head injury is the detection of focal traumatic brain injury (TBI), including epidural hematoma, subdural hematoma, cerebral contusion, and intracerebral hemorrhage and hematoma.^1,2 To successfully recognize these potentially life-threatening head injuries, the ATC must understand the various presentations of athletes with head injuries and the signs and symptoms that often accompany them, such as loss of consciousness (LOC), cranial nerve deficits, decreasing mental status, and worsening symptoms.¹Dunning et al³ presented a meta-analysis that has direct relevance to the practice of athletic training and the management of minor head injuries. Understanding the potential risk factors for ICH is an important step in ensuring adequate referral to medical professionals and a quick diagnosis of possible ICH. Often, the ATC must decide whether an athlete should be referred to the emergency room once he or she has sustained a mild head injury and, once at the emergency room, physicians need to decide on a course of diagnostics. This is even more of a concern in the pediatric athlete because of the potential for both short-term and long-term complications in the still-developing brain.^4–7 As a general rule, failure of an athlete''s mental status to clear rapidly should lead to a referral for neuroimaging.⁸ With the suspicion of focal TBI, CT scans have been recommended as the neuroimaging modality of choice because they can easily detect acute blood collection and skull fracture.⁸It is important to note that differences exist between sport-related minor head trauma and minor head trauma from additional mechanisms, such as motor vehicle accidents, falls, and other accidents. None of the studies used by Dunning et al³ were investigations of sport-related minor head injury. Minor head injuries that produce ICH or any of the clinical correlates found to be significant predictors of ICH (LOC, focal neurology, Glasgow Coma Scale [GCS] <15, or skull fracture) are rare in athletes.² In fact, recent authors have reported that only 6.3 to 8.9% of collegiate athletes experienced LOC after a concussion.^9–11 Regardless of the rarity of focal TBI and injuries that result in ICH during athletics, it is imperative that these injuries be ruled out by the ATC.Based on this meta-analysis, the correlates identified as predictors of ICH included LOC, a GCS score of <15, focal neurology, and a skull fracture. Fortunately, the presence of these clinical signs and symptoms in an athlete would warrant physician referral based on the recommendations made in the National Athletic Trainers'' Association position statement on sport-related concussion and other recommendations for on-field management of head trauma.^1,2,8 Even though headache and vomiting were not predictive of ICH, documenting these and other signs and symptoms of mild head trauma should be part of the ATC''s assessment protocol.^1,12,13 By quantifying the number of signs and symptoms present as well as the frequency and/or duration of these signs and symptoms, the ATC can track the recovery of the athlete and use the information for referral if the athlete does not demonstrate improvement. In addition, the ATC should use age-appropriate adjunct assessments, including neurocognitive testing^7,14–18 (traditional pen-and-paper neuropsychological tests, ImPACT [Immediate Postconcussion Assessment and Cognitive Testing, University of Pittsburgh Medical Center, Pittsburgh, PA], ANAM [Automated Neuropsychological Assessment Metrics, National Rehabilitation Hospital Assistive Technology and Neuroscience Center, Washington, DC], Concussion Resolution Index [HeadMinder Inc, New York, NY], Standardized Assessment of Concussion [CNS Inc, Waukesha, WI]) and postural stability testing¹⁸ to aid in the decision-making process.The findings of Dunning et al³ provide insight into specific risk factors the ATC should look for when evaluating minor head trauma in children and adolescents. The presence of any of the significant predictors should warrant immediate referral. The authors also acknowledge that other signs and symptoms (eg, dizziness, drowsiness, confusion) could be predictive of ICH; however, these factors had not been adequately investigated in the pediatric literature identified for this meta-analysis and therefore were not included. This factor, along with the variability in the inclusion criteria, timing of CT scans, and differences in the ICH definitions in the individual studies are limitations of this meta-analysis. Another potential limitation regarding the predictive value of the headache variable to ICH stems from a lack of information regarding the severity of the headaches reported in the individual studies. Some evidence suggests a relationship between severe headaches and ICH¹⁹; therefore, headache severity should also be questioned during the clinical examination. Several other limitations of this meta-analysis include no listing of specific medical subject headings terms used to search the databases, not describing the duration of LOC from the various studies used, and not adequately describing or defining the specific types of focal neurology used as a correlate. However, other authors have described focal neurologic changes as including posturing and dilating pupils.²Although this meta-analysis offers medical professionals working with children and adolescents one interpretation of the evidence regarding clinical risk factors predictive of ICH, it does not provide strong enough evidence to alter the current head-injury management and CT scanning protocols for children.²⁰ Future studies should address the limitations outlined by Dunning et al³ to better determine the predictive value of various clinical signs and symptoms of minor head trauma in the pediatric population.