Nomination of Sanford [i.e. Stanford] G. Ross and David M. Walker : hearing before the Committee on Finance, United States Senate, One Hundred First Congress, second session, on the nomination of Stanford G. Ross and David M. Walker, to be members of the Boards of Trustees of the Federal Hospital Insurance Trust Fund, the Federal Old-Age and Survivors Insurance Trust Fund, the Federal Disability Insurance Trust Fund, and the Federal Supplementary Medical Insurance Trust Fund for a term of four years, July 24, 1990.

Mode of access: Internet.

Making sense of brain tumour: A qualitative investigation of personal and social processes of adjustment

This study investigated personal and social processes of adjustment at different stages of illness for individuals with brain tumour. A purposive sample of 18 participants with mixed tumour types (9 benign and 9 malignant) and 15 family caregivers was recruited from a neurosurgical practice and a brain tumour support service. In-depth semi-structured interviews focused on participants’ perceptions of their adjustment, including personal appraisals, coping and social support since their brain tumour diagnosis. Interview transcripts were analysed thematically using open, axial and selective coding techniques. The primary theme that emerged from the analysis entailed “key sense making appraisals”, which was closely related to the following secondary themes: (1) Interactions with those in the healthcare system, (2) reactions and support from the personal support network, and (3) a diversity of coping efforts. Adjustment to brain tumour involved a series of appraisals about the illness that were influenced by interactions with those in the healthcare system, reactions and support from people in their support network, and personal coping efforts. Overall, the findings indicate that adjustment to brain tumour is highly individualistic; however, some common personal and social processes are evident in how people make sense of and adapt to the illness over time. A preliminary framework of adjustment based on the present findings and its clinical relevance are discussed. In particular, it is important for health professionals to seek to understand and support individuals’ sense-making processes following diagnosis of brain tumour.

The development of chronic cough in children following presentation to a tertiary paediatric emergency department with acute respiratory illness : study protocol for a prospective cohort study

Background Acute respiratory illness, a leading cause of cough in children, accounts for a substantial proportion of childhood morbidity and mortality worldwide. In some children acute cough progresses to chronic cough (> 4 weeks duration), impacting on morbidity and decreasing quality of life. Despite the importance of chronic cough as a cause of substantial childhood morbidity and associated economic, family and social costs, data on the prevalence, predictors, aetiology and natural history of the symptom are scarce. This study aims to comprehensively describe the epidemiology, aetiology and outcomes of cough during and after acute respiratory illness in children presenting to a tertiary paediatric emergency department. Methods/design A prospective cohort study of children aged <15 years attending the Royal Children's Hospital Emergency Department, Brisbane, for a respiratory illness that includes parent reported cough (wet or dry) as a symptom. The primary objective is to determine the prevalence and predictors of chronic cough (>= 4 weeks duration) post presentation with acute respiratory illness. Demographic, epidemiological, risk factor, microbiological and clinical data are completed at enrolment. Subjects complete daily cough dairies and weekly follow-up contacts for 28(+/-3) days to ascertain cough persistence. Children who continue to cough for 28 days post enrolment are referred to a paediatric respiratory physician for review. Primary analysis will be the proportion of children with persistent cough at day 28(+/-3). Multivariate analyses will be performed to evaluate variables independently associated with chronic cough at day 28(+/-3). Discussion Our protocol will be the first to comprehensively describe the natural history, epidemiology, aetiology and outcomes of cough during and after acute respiratory illness in children. The results will contribute to studies leading to the development of evidence-based clinical guidelines to improve the early detection and management of chronic cough in children during and after acute respiratory illness.

Cost-effectiveness of a nonpharmacological intervention in pediatric burn care

OBJECTIVE To report the cost-effectiveness of a tailored handheld computerized procedural preparation and distraction intervention (Ditto) used during pediatric burn wound care in comparison to standard practice. METHODS An economic evaluation was performed alongside a randomized controlled trial of 75 children aged 4 to 13 years who presented with a burn to the Royal Children's Hospital, Brisbane, Australia. Participants were randomized to either the Ditto intervention (n = 35) or standard practice (n = 40) to measure the effect of the intervention on days taken for burns to re-epithelialize. Direct medical, direct nonmedical, and indirect cost data during burn re-epithelialization were extracted from the randomized controlled trial data and combined with scar management cost data obtained retrospectively from medical charts. Nonparametric bootstrapping was used to estimate statistical uncertainty in cost and effect differences and cost-effectiveness ratios. RESULTS On average, the Ditto intervention reduced the time to re-epithelialize by 3 days at AU$194 less cost for each patient compared with standard practice. The incremental cost-effectiveness plane showed that 78% of the simulated results were within the more effective and less costly quadrant and 22% were in the more effective and more costly quadrant, suggesting a 78% probability that the Ditto intervention dominates standard practice (i.e., cost-saving). At a willingness-to-pay threshold of AU$120, there is a 95% probability that the Ditto intervention is cost-effective (or cost-saving) against standard care. CONCLUSIONS This economic evaluation showed the Ditto intervention to be highly cost-effective against standard practice at a minimal cost for the significant benefits gained, supporting the implementation of the Ditto intervention during burn wound care.

Mechanistic studies of a model reaction for enzymatic hydroxylation

A study has been made of the reaction mechanism of a model system for enzymatic hydroxylation. The results of a kinetic study of the hydroxylation of 2-hydroxyazobenzene derivatives by cupric ion and hydrogen peroxide are presented. An investigation of kinetic orders indicates that hydroxylation proceeds by way of a coordinated intermediate complex consisting of cupric ion and the mono anions of 2-hydroxyazobenzene and hydrogen peroxide. Studies with deuterated substrate showed the absence of a primary kinetic isotope effect and no evidence of an NIH shift. The effect of substituents on the formation of intermediate complexes and the overall rate of hydroxylation was studied quantitatively in aqueous solution. The combined results indicate that the hydroxylation step is only slightly influenced by ring substitution. The substituent effect is interpreted in terms of reaction by a radical path or a concerted mechanism in which the formation of ionic intermediates is avoided. The reaction mechanism is discussed as a model for enzymatic hydroxylation.

The effect of nitrate fertilization on the distribution of exported 14c-photosynthate in nodulated soybean (Glycine max (L.) Merr.) plants

Soybean (Glycine ~ (L.) Merr. cv. Harosoy 63) plants inoculated with Rhizobium japonicum were grown in vermiculite in the presence or absence of nitrate fertilization for up to 6 weeks after planting. Overall growth of nodulated plants was enhanced in the presence of nitrate fertilization, while the extent of nodule development was reduced. Although the number of nodules was not affected by nitrate fertilization when plants were grown at a light intensity limiting for photosynthesis, at light intensities approaching or exceeding the light saturation point for photosynthesis, nitrate fertilization resulted in at least a 30% reduction in nodule numbers. The mature, first trifoliate leaf of 21 day old plants was allowed to photoassimi1ate 14C02. One hour after·· the initial exposure to 14C02, the , plants were harvested and the 14C radioactivity was determined in the 80% ethanol-soluble fraction: in. o:rider to assess· "the extent of photoassimilate export and the pattern of distribution of exported 14C. The magnitude of 14C export was not affected by the presence of nitrate fertilization. However, there was a significant effect on the distribution pattern, particularly with regard to the partitioning of 14C-photosynthate between the nodules and the root tissue. In the presence of nitrate fertilization, less than 6% of the exported 14C photosynthate was recovered from the nodules, with much larger amounts (approximately 37%) being recovered from the root tissue. In the absence of nitrate fertilization, recovery of exported 14C-photosynthate from the nodules (19 to 27%) was approximately equal to that from the root tissue (24 to 33%). By initiating- or terminating the applications of nitrate at 14 days of age, it was determined that the period from day 14 to day 21 after planting was particularly significant for the development of nodules initiated earlier. Addition of nitrate fertilization at this time inhibited further nodule development while stimulating plant growth, whereas removal of nitrate fertilization stimulated nodule development. The results obtained are consistent with the hypothesis that nodule development is inhibited by nitrate fertilization through a reduction in the availability of photosynthate to the nodules.

Performance Analysis of a Semantics Enabled Service Registry

Service discovery is a critical task in service-oriented architectures such as the Grid and Web Services. In this paper, we study a semantics enabled service registry, GRIMOIRES, from a performance perspective. GRIMOIRES is designed to be the registry for myGrid and the OMII software distribution. We study the scalability of GRIMOIRES against the amount of information that has been published into it. The methodology we use and the data we present are helpful for researchers to understand the performance characteristics of the registry and, more generally, of semantics enabled service discovery. Based on this experimentation, we claim that GRIMOIRES is an efficient semantics-aware service discovery engine.

PReServ: Provenance Recording for Services

The importance of understanding the process by which a result was generated in an experiment is fundamental to science. Without such information, other scientists cannot replicate, validate, or duplicate an experiment. We define provenance as the process that led to a result. With large scale in-silico experiments, it becomes increasingly difficult for scientists to record process documentation that can be used to retrieve the provenance of a result. Provenance Recording for Services (PReServ) is a software package that allows developers to integrate process documentation recording into their applications. PReServ has been used by several applications and its performance has been benchmarked.

A security architecture for a semantic Grid registry

Existing registry technologies such as UDDI can be enhanced to support capabilities for semantic reasoning and inquiry, which subsequently increases its usability range. The Grimoires registry was developed to provide such support through the use of metadata attachments to registry entities. The use of such attachments provides a way for allowing service operators to specify security assertions pertaining to registry entities owned by them. These assertions may however have to be reconciled with existing registry policies. A security architecture based on the XACML standard and deployed in the OMII framework is outlined to demonstrate how this goal is achieved in the registry.

A cladistic analysis of apolipoprotein B gene variation and plasma lipid and apolipoprotein B levels, using familial data

Any functionally important mutation is embedded in an evolutionary matrix of other mutations. Cladistic analysis, based on this, is a method of investigating gene effects using a haplotype phylogeny to define a set of tests which localize causal mutations to branches of the phylogeny. Previous implementations of cladistic analysis have not addressed the issue of analyzing data from related individuals, though in human studies, family data are usually needed to obtain unambiguous haplotypes. In this study, a method of cladistic analysis is described in which haplotype effects are parameterized in a linear model which accounts for familial correlations. The method was used to study the effect of apolipoprotein (Apo) B gene variation on total-, LDL-, and HDL-cholesterol, triglyceride, and Apo B levels in 121 French families. Five polymorphisms defined Apo B haplotypes: the signal peptide Insertion/deletion, Bsp 1286I, XbaI, MspI, and EcoRI. Eleven haplotypes were found, and a haplotype phylogeny was constructed and used to define a set of tests of haplotype effects on lipid and apo B levels.^ This new method of cladistic analysis, the parametric method, found significant effects for single haplotypes for all variables. For HDL-cholesterol, 3 clusters of evolutionarily-related haplotypes affecting levels were found. Haplotype effects accounted for about 10% of the genetic variance of triglyceride and HDL-cholesterol levels. The results of the parametric method were compared to those of a method of cladistic analysis based on permutational testing. The permutational method detected fewer haplotype effects, even when modified to account for correlations within families. Simulation studies exploring these differences found evidence of systematic errors in the permutational method due to the process by which haplotype groups were selected for testing.^ The applicability of cladistic analysis to human data was shown. The parametric method is suggested as an improvement over the permutational method. This study has identified candidate haplotypes for sequence comparisons in order to locate the functional mutations in the Apo B gene which may influence plasma lipid levels. ^