Amelioration of Acute Sequelae of Blast Induced Mild Traumatic Brain Injury by N-Acetyl Cysteine: A Double-Blind, Placebo Controlled Study

Background: Mild traumatic brain injury (mTBI) secondary to blast exposure is the most common battlefield injury in Southwest Asia. There has been little prospective work in the combat setting to test the efficacy of new countermeasures. The goal of this study was to compare the efficacy of N-acetyl cysteine (NAC) versus placebo on the symptoms associated with blast exposure mTBI in a combat setting. Methods: This study was a randomized double blind, placebo-controlled study that was conducted on active duty service members at a forward deployed field hospital in Iraq. All symptomatic U.S. service members who were exposed to significant ordnance blast and who met the criteria for mTBI were offered participation in the study and 81 individuals agreed to participate. Individuals underwent a baseline evaluation and then were randomly assigned to receive either N-acetyl cysteine (NAC) or placebo for seven days. Each subject was re-evaluated at 3 and 7 days. Outcome measures were the presence of the following sequelae of mTBI: dizziness, hearing loss, headache, memory loss, sleep disturbances, and neurocognitive dysfunction. The resolution of these symptoms seven days after the blast exposure was the main outcome measure in this study. Logistic regression on the outcome of 'no day 7 symptoms' indicated that NAC treatment was significantly better than placebo (OR = 3.6, p = 0.006). Secondary analysis revealed subjects receiving NAC within 24 hours of blast had an 86% chance of symptom resolution with no reported side effects versus 42% for those seen early who received placebo. Conclusion: This study, conducted in an active theatre of war, demonstrates that NAC, a safe pharmaceutical countermeasure, has beneficial effects on the severity and resolution of sequelae of blast induced mTBI. This is the first demonstration of an effective short term countermeasure for mTBI. Further work on long term outcomes and the potential use of NAC in civilian mTBI is warranted. Trial Registration: ClinicalTrials.gov NCT00822263

School Poverty Concentration and Kindergarten Students' Numerical Skills

Schools that enroll disproportionately high percentages of pupils from low-income families are widely believed to have negative consequences for student performance. Prior research has investigated the relationship of school poverty and outcomes in numerous ways, but the basic proposition is that school composition affects student learning, such that otherwise similar students realize different levels of achievement in schools with different proportions of low-income. This paper updates and extends the research on compositional effects in several respects. First, we extend the research to the early elementary level of schooling. Second, the data needed to assess the relative importance of individual and school factors have not been available and the mechanisms that mediate the school-level effect independent of student background factors are thus not clear. This paper draws upon nationally representative data on kindergarten pupils and the schools they attend to estimate both the overall impact of school poverty on mathematics achievement and its impact on a variety of other school and schooling-experience variables that may in turn affect student learning. Finally, this paper analyzes the effects of high poverty schools on several schooling variables hypothesized to affect student achievement.

Radioimmunologic Methods for Diagnosis of Malignant Diseases

The recent availability of the carcinoembryonic antigen (CEA) assay has stimulated great clinical interest in tumor antigens. Carcinoembryonic antigen is not the only specific or tumor-associated antigen currently identified. There are a number of other tumor antigens which have been isolated, some of which are related to CEA and some of which are totally different. There is, for example, a nonspecific cross-reacting antigen (NCA) which has been discovered in certain preparations which were considered originally to be CEA. Nonspecific cross-reacting antigen is a beta globulin (25% carbohydrate) which cross-reacts with antibodies to CEA and may be the nonspecific background element that causes the CEA titer to be elevated in certain nonmalignant diseases. There is also a membrane-associated, low molecular weight tissular autoantigen (MTA) which has been recently identified. However, this material is not antigenetically related to CEA or NCA

Microscopic calculations of collective flow probing the short-range nature of the nuclear force

Collisions between two nuclei have been modeled by numerical solution of classical approximations to the equations of motion of the constituent nucleons. For the reaction Nb(400 MeV/u)+Nb, a correlated sidewards emission of nucleons is observed. This is attributed to the repulsive short-range component of the nucleon-nucleon potential. A strong dependence of the flow angle on the impact parameter is observed, in accord with recent experimental results

Use of Bone Scanning and Skeletal Radiography in the Diagnosis of Bone Metastasis

The radionuclide bone scan is becoming increasingly useful for evaluating a wide variety of bone and joint disorders. However, the commonest application is still the detection of skeletal metastases in the patient with known or suspected neoplastic disease. The role of this examination relative to other well established methods of evaluating these patients, especially the radiographic skeletal survey, is not clear to all physicians. We hope in this communication to define the role of the radionuclide bone scan and to place in perspective the integral relationship between the scan and the survey, the two radiologic modalities which today are the principal methods of evaluating the skeletal system for metastatic disease

Applications of active microwave imagery

The following topics were discussed in reference to active microwave applications: (1) Use of imaging radar to improve the data collection/analysis process; (2) Data collection tasks for radar that other systems will not perform; (3) Data reduction concepts; and (4) System and vehicle parameters: aircraft and spacecraft

Local modes, phonons, and mass transport in solid 4^4He

We propose a model to treat the local motion of atoms in solid $^{4}$He as a local mode. In this model, the solid is assumed to be described by the Self Consistent Harmonic approximation, combined with an array of local modes. We show that in the bcc phase the atomic local motion is highly directional and correlated, while in the hcp phase there is no such correlation. The correlated motion in the bcc phase leads to a strong hybridization of the local modes with the T$_{1}(110)$ phonon branch, which becomes much softer than that obtained through a Self Consistent Harmonic calculation, in agreement with experiment. In addition we predict a high energy excitation branch which is important for self-diffusion. Both the hybridization and the presence of a high energy branch are a consequence of the correlation, and appear only in the bcc phase. We suggest that the local modes can play the role in mass transport usually attributed to point defects (vacancies). Our approach offers a more overall consistent picture than obtained using vacancies as the predominant point defect. In particular, we show that our approach resolves the long standing controversy regarding the contribution of point defects to the specific heat of solid $^{4}$He.Comment: 10 pages, 10 figure

Immunohistochemical detection of macrophage migration inhibitory factor in fetal and adult bovine epididymis: Release by the apocrine secretion mode?

Originally defined as a lymphokine inhibiting the random migration of macrophages, the macrophage migration inhibitory factor (MIF) is an important mediator of the host response to infection. Beyond its function as a classical cytokine, MIF is currently portrayed as a multifunctional protein with growth-regulating properties present in organ systems beyond immune cells. In previous studies, we detected substantial amounts of MIF in the rat epididymis and epididymal spermatozoa, where it appears to play a role during post-testicular sperm maturation and the acquisition of fertilization ability. To explore its presence in other species not yet examined in this respect, we extended the range of studies to the bull. Using a polyclonal antibody raised against MIF purified from bovine eye lenses, we detected MIF in the epithelium of the adult bovine epididymis with the basal cells representing a prominently stained cell type. A distinct accumulation of MIF at the apical cell pole of the epithelial cells and in membranous vesicles localized in the lumen of the epididynnal duct was obvious. In the fetal bovine epididymis, we also detected MIF in the epithelium, whereas MIF accumulation was evident at the apical cell surface and in apical protrusions. By immuno-electron microscopy of the adult bovine epididymis, we localized MIF in apical protrusions of the epithelial cells and in luminal membrane-bound vesicles that were found in close proximity to sperm cells. Although the precise origin of the MIF-containing vesicles remains to be delineated, our morphological observations support the hypothesis that they become detached from the apical surface of the epididymal epithelial cells. Additionally, an association of MIF with the outer dense fibers of luminal spermatozoa was demonstrated. Data obtained in this study suggest MIF release by an apocrine secretion mode in the bovine epididymis. Furthermore, MIF localized in the basal cells of the epithelium and in the connective tissue could be responsible for regulating the migration of macrophages in order to avoid contact of immune cells with spermatozoa that carry a wide range of potent antigens. Copyright (c) 2006 S. Karger AG, Basel