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Introduction: Gastroenteritis accounts for 1.7 million emergency department visits by children annually in the United States. We conducted a double-blind trial to determine whether twice daily probiotic administration for 5 days, improves outcomes. Methods: 886 children aged 348 months with gastroenteritis were enrolled in six Canadian pediatric emergency departments. Participants were randomly assigned to twice daily Lactobacillus rhamnosus R0011 and Lactobacillus helveticus R0052, 4.0 x 109 CFU, in a 95:5 ratio or placebo. Primary outcome was development of moderate-severe disease within 14 days of randomization defined by a Modified Vesikari Scale score 9. Secondary outcomes included duration of diarrhea and vomiting, subsequent physician visits and adverse events. Results: Moderate-severe disease occurred in 108 (26.1%) participants administered probiotics and 102 (24.7%) participants allocated to placebo (OR 1.06; 95%CI: 0.77, 1.46; P=0.72). After adjustment for site, age, and frequency of vomiting and diarrhea, treatment assignment did not predict moderate-severe disease (OR, 1.11, 95%CI, 0.80 to 1.56; P=0.53). In the probiotic versus placebo groups, there were no differences in the median duration of diarrhea [52.5 (18.3, 95.8) vs. 55.5 (20.2, 102.3) hours; P=0.31], vomiting [17.7 (0, 58.6) vs. 18.7 (0, 51.6) hours; P=0.18], physician visits (30.2% vs. 26.6%; OR 1.19; 95% CI0.87. 1.62; P=0.27), or adverse events (32.9% vs. 36.8%; OR 0.83; 95%CI 0.62. 1.11; P=0.21). Conclusion: In children presenting to an emergency department with gastroenteritis, twice daily administration of 4.0 x 109 CFU of a Lactobacillus rhamnosus/helveticus probiotic does not prevent development of moderate-severe disease or improvements in other outcomes measured.
Characterising the three-dimensional (3D) distribution of hydraulic conductivity and its variability in the shallow subsurface is fundamental to understanding groundwater behaviour and to developing conceptual and numerical groundwater models to manage the subsurface. However, directly measuring in situ hydraulic conductivity can be difficult and expensive and is rarely carried out with sufficient density in urban environments. In this study we model hydraulic conductivity for 603 sites in the unconsolidated Quaternary deposits underlying Glasgow using particle size distribution and density description widely available from geotechnical investigations. Six different models were applied and the MacDonald formula was found to be most applicable in this heterogeneous environment, comparing well with the few available in situ hydraulic conductivity data. The range of the calculated hydraulic conductivity values between the 5th and 95th percentile was 1.56×10–2–4.38mday–1 with a median of 2.26×10–1 mday–1. These modelled hydraulic conductivity data were used to develop a suite of stochastic 3D simulations conditioned to existing 3D representations of lithology. Ten per cent of the input data were excluded from the modelling process for use in a split-sample validation test, which demonstrated the effectiveness of this approach compared with non-spatial or lithologically unconstrained models. Our spatial model reduces the mean squared error between the estimated and observed values at the excluded data locations over those predicted using a simple homogeneous model by 73 %. The resulting 3D hydraulic conductivity model is of a much higher resolution than would have been possible from using only direct measurements, and will improve understanding of groundwater flow in Glasgow and reduce the spatial uncertainty of hydraulic parameters in groundwater process models. The methodology employed could be replicated in other regions where significant volumes of suitable geotechnical and site investigation data are available to predict ground conditions in areas with complex superficial deposits.
The 2012 West Nile virus (WNV) epidemic was the largest since 2003 and the North Texas region was the most heavily impacted. We conducted a serosurvey of blood donors from four counties in the Dallas–Fort Worth area to characterize the epidemic. Blood donor specimens collected in November 2012 were tested for WNV-specific antibodies. Donors positive for WNV-specific IgG, IgM, and neutralizing antibodies were considered to have been infected in 2012. This number was adjusted using a multi-step process that accounted for timing of IgM seroreversion determined from previous longitudinal studies of WNV-infected donors. Of 4971 donations screened, 139 (2·8%) were confirmed WNV IgG positive, and 69 (1·4%) had IgM indicating infection in 2012. After adjusting for timing of sampling and potential seroreversion, we estimated that 1·8% [95% confidence interval (CI) 1·5–2·2] of the adult population in the Dallas–Fort Worth area were infected during 2012. The resulting overall estimate for the ratio of infections to reported WNV neuroinvasive disease (WNND) cases was 238:1 (95% CI 192–290), with significantly increased risk of WNND in older age groups. These findings were very similar to previous estimates of infections per WNND case, indicating no change in virulence as WNV evolved into an endemic infection in the United States.
Depression and diabetes commonly co-occur; however, the strength of the physiological effects of diabetes as mediating factors towards depression is uncertain.
We analyzed extensive clinical, epidemiological and laboratory data from n = 2081 Mexican Americans aged 35–64 years, recruited from the community as part of the Cameron County Hispanic Cohort (CCHC) divided into three groups: Diagnosed (self-reported) diabetes (DD, n = 335), Undiagnosed diabetes (UD, n = 227) and No diabetes (ND, n = 1519). UD participants denied being diagnosed with diabetes, but on testing met the 2010 American Diabetes Association and World Health Organization definitions of diabetes. Depression was measured using the Center for Epidemiological Studies – Depression (CES-D) scale. Weighted data were analyzed using dimensional and categorical outcomes using univariate and multivariate models.
The DD group had significantly higher CES-D scores than both the ND and UD (p ⩽ 0.001) groups, whereas the ND and UD groups did not significantly differ from each other. The DD subjects were more likely to meet the CES-D cut-off score for depression compared to both the ND and UD groups (p = 0.001), respectively. The UD group was also less likely to meet the cut-off score for depression than the ND group (p = 0.003). Our main findings remained significant in models that controlled for socio-demographic and clinical confounders.
Meeting clinical criteria for diabetes was not sufficient for increased depressive symptoms. Our findings suggest that the ‘knowing that one is ill’ is associated with depressive symptoms in diabetic subjects.
We carried out an extensive photometric and spectroscopic investigation of the SPB binary, HD 25558 (see Fig. 1 for the time and geographic distribution of the observations). The ~2000 spectra obtained at 13 observatories during 5 observing seasons, the ground-based multi-colour light curves and the photometric data from the MOST satellite revealed that this object is a double-lined spectroscopic binary with a very long orbital period of about 9 years. We determined the physical parameters of the components, and have found that both lie within the SPB instability strip. Accordingly, both components show line-profile variations consistent with stellar pulsations. Altogether, 11 independent frequencies and one harmonic frequency were identified in the data. The observational data do not allow the inference of a reliable orbital solution, thus, disentangling cannot be performed on the spectra. Since the lines of the two components are never completely separated, the analysis is very complicated. Nevertheless, pixel-by-pixel variability analysis of the cross-correlated line profiles was successful, and we were able to attribute all the frequencies to the primary or secondary component. Spectroscopic and photometric mode-identification was also performed for several of these frequencies of both binary components. The spectroscopic mode-identification results suggest that the inclination and rotation of the two components are rather different. While the primary is a slow rotator with ~6 d rotation period, seen at ~60° inclination, the secondary rotates fast with ~1.2 d rotation period, and is seen at ~20° inclination. Our spectropolarimetric measurements revealed that the secondary component has a magnetic field with at least a few hundred Gauss strength, while no magnetic field was detected in the primary.
The detailed analysis and results of this study will be published elsewhere.
Direct detection assays for Mycoplasma pneumoniae were established by PCR amplification of short sequences within the foot protein/adhesin (P1) gene and the 16S ribosomal RNA gene.
Specificity and sensitivity was excellent, no hybridization was observed with M. genitalium and other human Mycoplasma species. In nose and throat washings from subjects with respiratory infection a pattern of high counts (c.f.u./ml) of M. pneumoniae (deduced from the amount of amplified PCR product), and a positive antigen capture assay, was found in 83% of subjects with serological evidence of current infection with M. pneumoniae.
A small proportion of subjects with serological patterns suggesting infection in the more distant past had positive PCR assays. This was considered to represent either persistence of the organism from a previous infection or perhaps transient carriage during a reinfection, without substantial change in antibody response.
PCR-based assay of M. pneumoniae offers a powerful, rapid, and sensitive substitute for culture of the mycoplasma. Antigen capture, while less sensitive than PCR, offers the advantage that it is more often positive with samples from current infection and requires less stringent laboratory organization to contain false positive results. We conclude however that the laboratory diagnosis of a chosen clinical episode should not rest on the PCR or Ag-EIA assays alone, but must also include antibody assays to confirm whether infection is current or represents persistence from past exposure.
The nature and mode of origin of quartz-cored tourmalines (QCT) are studied from hydrothermal quartz veins within massive quartz-tourmaline (MQT) rocks at Roche, SW England. The QCT are annular, have blue maximum absorption colour and occur together with tourmalines with brown cores rimmed by blue tourmaline. Where the quartz core is not continuous throughout the length of the QCT crystals, the tourmaline core has brown maximum absorption colour, similar to tourmalines without quartz cores. Both the blue and brown tourmalines are schorl, but are compositionally distinct showing different Fe/(Mg + Ti) ratios and Ca concentrations. Fluid inclusion data indicate quartz precipitation from a moderate salinity (∼20–25 wt.% NaCl eq.) brine which periodically boiled following pressure drops within the vein system. The QCT show rheomorphic and lobate textures on their inner margins indicating selective dissolution of their brown, relative Mg-, Ti- and Ca-rich tourmaline cores and replacement with quartz. This presents a problem in terms of the nature of the fluid responsible for such selective dissolution because tourmaline is generally highly resistant under the normal range of hydrothermal fluid conditions. It is proposed that the relatively high concentrations of Ti, Mg and Ca in the brown tourmaline caused significant lattice strain, which together with an increase in pH, and probably Al, in the boiling hydrothermal fluid caused the brown cores to become unstable compared with the Fe-rich blue tourmaline rims.
Two cases of deep lobe parotid tumours extending into the parapharyngeal space and causing obstructive sleep apnoea are described. Post-operatively, marked improvements in nocturnal hypoxic episodes and the symptoms of obstructive sleep apnoea were seen. Although minor salivary gland pleomorphic adenomas have been described as a cause of airway compromise, pleomorphic adenomata arising from the deep lobe of the parotid, causing proven obstructive sleep apnoea, have not previously been documented. The anatomy and common pathologies of the parapharyngeal space are discussed.
An updated compilation of published and new data of major-ion (Ca, Cl, K, Mg, Na, NO3, SO4) and methylsulfonate (MS) concentrations in snow from 520 Antarctic sites is provided by the national ITASE (International Trans-Antarctic Scientific Expedition) programmes of Australia, Brazil, China, Germany, Italy, Japan, Korea, New Zealand, Norway, the United Kingdom, the United States and the national Antarctic programme of Finland. The comparison shows that snow chemistry concentrations vary by up to four orders of magnitude across Antarctica and exhibit distinct geographical patterns. The Antarctic-wide comparison of glaciochemical records provides a unique opportunity to improve our understanding of the fundamental factors that ultimately control the chemistry of snow or ice samples. This paper aims to initiate data compilation and administration in order to provide a framework for facilitation of Antarctic-wide snow chemistry discussions across all ITASE nations and other contributing groups. The data are made available through the ITASE web page (http://www2.umaine.edu/itase/content/syngroups/snowchem.html) and will be updated with new data as they are provided. In addition, recommendations for future research efforts are summarized.
Despite the large body of research concerned with the near wake of a circular cylinder, the far wake, which extends beyond about 100 diameters downstream, is relatively unexplored, especially at low Reynolds numbers. We have recently shown that the structure of the far wake is exquisitely sensitive to free-stream noise, and is precisely dependent on the frequency and scale of the near wake; indeed it is shown that the presence of extremely low-amplitude peaks in the free-stream spectrum, over a remarkably wide range of frequencies, are sufficient to trigger an “oblique wave resonance” in the far wake.
We show, in the upper photograph of Fig. 1, a nonlinear interaction between oblique shedding waves generated from upstream (to the left) and 2–D waves amplified downstream from free-stream disturbances (in the central region). We use the “smoke-wire” technique (placed 50 diameters down-stream), and the wake is viewed in planview, with flow to the right. This two-wave interaction triggers a third wave, namely an “oblique resonance wave” at a large oblique angle, to grow through nonlinear effects (in the right half of the photograph), in preference to the original two waves. If smoke is introduced 100 diameters downstream, in the lower photograph (under slightly different conditions), then all that is seen is a set of such large-angle oblique resonance waves.
This work is supported by the Office of Naval Research.
Visualization of different transition mechanisms
The sequence of photos in Figs. 1(a)-1(d) illustrates the different types of boundary-layer transitions that occur as a function of Tollmien-Schlichting (T-S) wave amplitude and fetch.
Periodic axisymmetric vortex breakdown in a cylinder with a rotating end wall
When the fluid inside a completely filled cylinder is set in motion by the rotation of the bottom end wall, steady and unsteady axisymmetric vortex breakdown is possible. The onset of unsteadiness is via a Hopf bifurcation.
Figure 1 is a perspective view of the flow inside the cylinder where marker particles have been released from an elliptic ring concentric with the axis of symmetry near the top end wall. This periodic flow corresponds to a Reynolds number Re=2765 and cylinder aspect ratio H/R=2.5. Neighboring particles have been grouped to define a sheet of marker fluid and the local transparency of the sheet has been made proportional to its local stretching. The resultant dye sheet takes on an asymmetric shape, even though the flow is axisymmetric, due to the unsteadiness and the asymmetric release of marker particles.When the release is symmetric, as in Fig. 2, the dye sheet is also symmetric. These two figures are snapshots of the dye sheet after three periods of the oscillation (a period is approximately 36.3 rotations of the end wall). Figure 3 is a cross section of the dye sheet in Fig. 2 after 26 periods of the oscillation. Here only the marker particles are shown. They are colored according to their time of release, the oldest being blue, through green and yellow, and the most recently released being red. Comparison with Escudier's experiment shows very close agreement.
The particle equations of motion correspond to a Hamiltonian dynamical system and an appropriate.
μc-Si has traditionally been deposited by Hot Wire CVD at a low filament temperature. At these temperatures, silicides rapidly form on the filament surface, leading in the case of a tungsten filament to both film reproducibility and filament lifetime issues. By depositing films consecutively using identical deposition parameters, these issues are chronicled for a filament temperature of ∼ 1750°C. Upon increasing the filament temperature to ∼ 1825-1850°C, these reproducibility and lifetime issues disappear and, by lowering both the substrate temperature and chamber pressure, device quality μc-Si is deposited at high deposition rates in a filament regime where tungsten silicide formation is minimal. Both single junction and tandem solar cells are fabricated using this material, confirming the validity of this approach.
μc-Si has traditionally been deposited by Hot Wire CVD at a low filament temperature. At these temperatures, silicides rapidly form on the filament surface, leading in the case of a tungsten filament to both film reproducibility and filament lifetime issues. By depositing films consecutively using identical deposition parameters, these issues are chronicled for a filament temperature of ∼ 1750°C. Upon increasing the filament temperature to ∼1825-1850°C, these reproducibility and lifetime issues disappear and, by lowering both the substrate temperature and chamber pressure, device quality μc-Si is deposited at high deposition rates in a filament regime where tungsten silicide formation is minimal. Both single junction and tandem solar cells are fabricated using this material, confirming the validity of this approach.
Recent experimental studies have suggested that colloidal silica can form in high-T (300 to >700°C) hydrothermal fluids (Wilkinson et al., 1996). Natural evidence in support of this was found by Williamson et al. (1997) who proposed a colloidal (gel) silica origin for <50 μm irregularly-shaped inclusions of quartz contained in greisen topaz from southwest England. Confocal and microprobe studies, presented here, strengthen this argument although rather than forming a gel in the hydrothermal fluid, it is suggested that the colloidal silica aggregated as a viscous coagulated colloid, with much of its volume (<10 to 30 vol.%) consisting of metal (mainly Fe) -rich particles. This is evident from the largely solid nature of metal-rich shrinkage bubbles contained at the margins of the inclusions of quartz which shows that the material forming the inclusions contained much less liquid than would be expected in a silica gel. These findings may have important implications for models of ore formation since the precipitation of a coagulated colloid could inhibit hydrothermal fluid transport and cause co-deposition of silica and entrained ore-forming elements. The mode of formation of the colloidal silica and further implications of the study are discussed.
The structure of a-Si:H, deposited at rates in excess of 100Å/s by the hot wire chemical vapor deposition (HWCVD) technique, has been examined by x-ray diffraction (XRD), Raman spectroscopy, H evolution, and small-angle x-ray scattering (SAXS). As the film deposition rate (Rd) is increased, we find that the XRD, Raman and the H evolution peak curves are invariant with Rd, and exhibit structure consistent with state-of-the-art, compact a-Si:H films deposited at low Rd. The only exception is the SAXS signal, which increases by a factor of ∼100 over that for our best low Rd films. We relate changes in the film electronic structure (Urbach edge) to the increase in the SAXS signals. We also note the invariance of the saturated defect density versus Rd, and discuss possible reasons why the increase in the SAXS does not play a role in the Staebler-Wronski Effect for this type of material. Finally, device results are presented.