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On 16 March 2018, a nursing home notified a possible acute gastroenteritis outbreak that affected 11 people. Descriptive and case–control studies and analysis of clinical and environmental samples were carried out to determine the characteristics of the outbreak, its aetiology, the transmission mechanism and the causal food. The extent of the outbreak in and outside the nursing home was determined and the staff factors influencing propagation were studied by multivariate analysis. A turkey dinner on March 14 was associated with the outbreak (OR 4.22, 95% CI 1.11–16.01). Norovirus genogroups I and II were identified in stool samples. The attack rates in residents, staff and household contacts of staff were 23.49%, 46.22% and 22.87%, respectively. Care assistants and cleaning staff were the staff most frequently affected. Cohabitation with an affected care assistant was the most important factor in the occurrence of cases in the home (adjusted OR 6.37, 95% CI 1.13–36.02). Our results show that staff in close contact with residents and their household contacts had a higher risk of infection during the norovirus outbreak.
Core-collapse supernovae are expected to be efficient producers of dust, and recent Herschel and ALMA observations have revealed up to 1 M⊙ of cold dust in the inner ejecta of SN 1987A. The formation time scale, spatial distribution and clumpiness, and the importance of the different heating sources of the dust remain poorly understood. We have started a project to make detailed 3D dust radiative transfer models for SN 1987A, based on a combination of the latest observational constraints and input from 3D hydrodynamical models and dust formation models. Preliminary results seem to indicate the need for large, micron-sized dust grains, and a relatively large dust mass.
Initial successful weight loss is often followed by weight regain after the dietary intervention. Compared with lean people, cellular stress in adipose tissue is increased in obese subjects. However, the relation between cellular stress and the risk for weight regain after weight loss is unclear. Therefore, we determined the expression levels of stress proteins during weight loss and weight maintenance in relation to weight regain. In vivo findings were compared with results from in vitro cultured human Simpson–Golabi–Behmel syndrome (SGBS) adipocytes. In total, eighteen healthy subjects underwent an 8-week diet programme with a 10-month follow-up. Participants were categorised as weight maintainers or weight regainers (WR) depending on their weight changes during the intervention. Abdominal subcutaneous adipose tissue biopsies were obtained before and after the diet and after the follow-up. In vitro differentiated SGBS adipocytes were starved for 96 h with low (0·55 mm) glucose. Levels of stress proteins were determined by Western blotting. WR showed increased expressions of β-actin, calnexin, heat shock protein (HSP) 27, HSP60 and HSP70. Changes of β-actin, HSP27 and HSP70 are linked to HSP60, a proposed key factor in weight regain after weight loss. SGBS adipocytes showed increased levels of β-actin and HSP60 after 96 h of glucose restriction. The increased level of cellular stress proteins in the adipose tissue of WR probably resides in the adipocytes as shown by in vitro experiments. Cellular stress accumulated in adipose tissue during weight loss may be a risk factor for weight regain.
Communication between emergency department (ED) staff and parents of children with asthma may play a role in asthma exacerbation management. We investigated the extent to which parents of children with asthma implement recommendations provided by the ED staff. Method: We asked questions on asthma triggers, ED care (including education and discharge recommendations), and asthma management strategies used at home shortly after the ED visit and again at 6 months.
A total of 148 children with asthma were recruited. Thirty-two percent of children were not on inhaled corticosteroids prior to their ED visit. Eighty percent of parents identified upper respiratory tract infections (URTIs) as the primary trigger for their child’s asthma. No parent received or implemented any specific asthma strategies to reduce the impact of URTIs; 82% of parents did not receive any printed asthma education materials. Most (66%) parents received verbal instructions on how to manage their child’s future asthma exacerbations. Of those, one-third of families were told to return to the ED. Parents were rarely advised to bring their child to their family doctor in the event of a future exacerbation. At 6 months, parents continued to use the ED services for asthma exacerbations in their children, despite reporting feeling confident in managing their child’s asthma.
Improvements are urgently needed in developing strategies to manage pediatric asthma exacerbations related to URTIs, communication with parents at discharge in acute care, and using alternate acute care services for parents who continue to rely on EDs for the initial care of mild asthma exacerbations.
We present a dust radiative transfer analysis of the edge-on spiral galaxy NGC 5908. In our previous analysis, it was found that the standard assumption of a double-exponential dust distribution resulted in a poor fit. We investigate the possibility of the dust being distributed in one or more rings. The parameters are constrained using FitSKIRT, a code used to automatically determine the best fitting radiative transfer model given a set of observations. We discuss the possible implications of this dust distribution on the predicted spectral energy distribution.
A descriptive study was performed between 1 January 2010 and 31 December 2011 to estimate the incidence of norovirus outbreaks in hospitals and nursing homes in Catalonia (Spain). Epidemiological surveys were done for each outbreak. Norovirus was confirmed using RT–PCR. The incidence of outbreaks/106 person-years by centre, and the attack rate, were calculated. Statistically significant differences were calculated using odds ratio (ORs) and 95% confidence intervals (CIs). Person-to-person transmission was responsible for 81·5% (22/27) of outbreaks. The incidence in the population was 156·7 outbreaks/106 person-years. The incidence by centre was 1·3% per year and was greater in hospitals (2·6%) than in nursing homes (0·9%) (OR 3·2, 95% CI 1·5–6·9). The global attack rate in residents and staff was 34·7% (816/2348). The mortality rate was 0·25% (2/816). Genogroup GII.4 caused 66·7% of outbreaks. Norovirus GII.4 outbreaks cause significant morbidity affecting both patients and staff.
The improved use of collective dose following the 2007 ICRP recommendations is studied
for nuclear and radiological emergency situations. To study the accumulation of low
individual doses to the collective dose the collective dose is calculated as a function of
the minimum individual dose for three cases including nuclear as well as radiological
accidents. It is found that the use of collective dose in this way can have an added value
in nuclear emergency preparedness and response in particular related to decisions on
overall protective actions following an accident.
The new recommendations on emergency exposure situations of the International Commission
on Radiological Protection (ICRP) advise a reference level for the residual dose in a
range of between 20 and 100 mSv effective dose (acute or per year). At the same time, the
protection strategy should account for the simultaneous consideration of all the exposure
pathways, as well as all of the protective actions. Similarly to other countries, the
actual Belgian nuclear emergency plan is based on individual projected doses (thyroid
committed dose and total effective doses) and independent protective actions that mainly
focus on the early phase of an emergency situation. The two approaches are compared in
this study on the basis of the projected and residual dose calculations obtained using
JRODOS and the Belgian Noodplan models for different radiological or nuclear accidental
scenarios. The comparison has been made by considering separately the early and the late
phase contributions. The ingestion dose has been investigated from the predicted
deposition values and compared to the single level of the ICRP 109 recommendations.
We report theoretical and experimental observation of photoexcitated hole spin selection in GaAs/GaAlAs n-i-n in resonant tunneling diodes. When subjected to magnetic and electric parallel fields, the spin splitted hole levels leads to several peak structure in the transmissivity. These experimental results are interpreted as an evidence of tunneling transport through spin polarized hole levels of non-magnetic diodes.
Generic guidance on the withdrawal of sheltering, withdrawal of evacuation and evacuation
of sheltered populations (displacement) has been developed based on previously unpublished
work in the UK and France and on input from stakeholder panels in Germany, Belgium, France
and the UK. The guidance is a living document that can be developed further in the future,
both in its generic form and also as customised versions in some Member States. The
guidance outlines the many factors which influence the withdrawal of emergency
countermeasures: official confirmation that any release has stopped; adequacy of
monitoring data; radiological criteria; radiological protection advice; availability of
resources; social and psychological needs; stakeholder dialogue; and communication
strategy. The relative importance placed by decision makers on each of these criteria
would vary according to the nature and scale of the accident and also on socio-political,
economic and cultural perspectives. In the event of a radiological incident, decision
makers will need to be in a position to construct a strategy for managing the withdrawal
of emergency countermeasures. For larger scale, longer duration releases involving several
nuclides, a management strategy is likely to be complex. The guidance therefore includes a
series of checklists which have been developed in conjunction with stakeholders to take
into account the main criteria and factors which should be considered.
Three handbooks have been developed, in conjunction with a wide range of stakeholders to
assist in the management of contaminated food production systems, inhabited areas and
drinking water following a radiological incident. The handbooks are aimed at national and
local authorities, central government departments and agencies, emergency services,
radiation protection experts, the agriculture and food production sectors, industry and
others who may be affected. The handbooks include management options for application in
the different phases of an incident. Sources of contamination considered in the handbooks
include nuclear accidents and radiological dispersion devices; the most relevant
radionuclides are included. The handbooks are divided into several sections which provide
supporting scientific and technical information; an analysis of the factors influencing
recovery; compendia of comprehensive, state-of-the-art datasheets for around 100
management options and guidance on planning in advance. A decision-aiding framework
comprising colour coded selection tables, look-up tables and decision trees and several
worked examples are also included. The handbooks can be used as a preparatory tool, under
non-crisis conditions, to engage stakeholders and to develop local and regional plans. The
handbooks can also be applied as part of the decision-aiding process to develop a recovery
strategy following an incident. In addition, the handbooks are useful for training
purposes and during emergency exercises. To realise their full potential, the handbooks
should be customised at national, regional and local levels.
Many genetic disorders are caused by mutations in single genes (monogenic diseases), and the inheritance pattern of these diseases follows simple rules. If a mutation in both copies of the gene on both chromosome homologues is necessary to cause the disease, the inheritance pattern is recessive, and a patient is the offspring of two clinically unaffected carriers. However, if a mutation in a single homologue is sufficient, the inheritance pattern is dominant and the disease is transmitted from generation to generation. Monogenic diseases are responsible for only a small fraction of all patients with genetic diseases. Many common diseases, including cancer, heart disease, diabetes and several psychiatric diseases, are the results of a complex interaction between genetic and environmental factors. However, these diseases can have important genetic components and can therefore still be considered genetic diseases. The identification of genes involved in complex genetic diseases can be very important for the understanding and treatment of these diseases. Over the last 15 years, much progress has been made in the identification of genes responsible for monogenic diseases, but the identification of genes involved in complex diseases has been more difficult, and at this moment little is known about the genes involved in most common diseases.
Le grand intérêt suscité par les matériaux à structure fractale ces dernières décennies nous a
conduits à étudier tout particulièrement le comportement électrique d'échantillons métalliques
dont les motifs sont du type “Arbre fractal”. Les caractéristiques singulières de ces
structures telles l'autosimilarité et la dimension fractionnaire Df
confèrent des propriétés physiques particulières à ces matériaux. L'analyse de ces
structures est envisagée en réalisant un condensateur de type MIS
(Métal-Isolant-Semi-conducteur) dont une des armatures présente une dimension fractionnaire,
l'autre est plane et l'isolant est un oxyde de silicium (SiO2).
Les simulations et les mesures effectuées ont permis de mettre en évidence sur
l'impédance d'une telle structure, une évolution fréquentielle étroitement corrélée
à la structure même de l'échantillon. Ce comportement que l'on qualifiera par la suite
de “fractal”, peut se résumer ainsi : soumis à une excitation électrique à fréquence
variable, cet échantillon se caractérise par une impédance complexe qui,
à partir d'une fréquence caractéristique, présente une phase constante c'est-à-dire que ses
parties réelle et imaginaire ont la même loi de dépendance fréquentielle. L'étude que nous
présentons concerne d'une part, la mise en évidence de ce comportement et d'autre part,
les conditions permettant d'ajuster la plage de fréquence sur laquelle ce comportement apparaît.
Africa is truly Mediterranean only along its northern coastal fringe. During Palaeolithic times, similar or comparable lithic industries are found throughout both the countries of the Maghrib and the regions which today are desert. In North Africa and the immediately adjacent peripheral zone of the Sahara two great cultural traditions, namely Iberomaurusian and Capsian, succeeded one another without, however, occupying identical areas. The oldest phases of the Saharan-Sudanese Neolithic has led to an examination of the origins of agriculture, so that of the pastoral phase, chiefly known from the rock-art style referred to as Bovidian should begin with an analysis of the origins of animal domestication in the Sahara. There are a considerable number of paintings of the pastoral or Bovidian phase in the Tassili n'Ajjer and also in Ennedi, Tibesti and Tefedest in the northern Ahaggar.
There is growing evidence of a connection between the metabolism of monoamines and severe depressive illness, but the exact role of these substances in affective disorders has yet to be defined. We know that reserpine depletes the brain of monoamines and that a proportion of patients treated with this compound develop a depressive illness. Conversely a number of compounds which raise the levels of amines in the brain by blocking the enzyme monoamine oxidase have been used in antidepressant therapy. The knowledge that loss of amines may be associated with depression, and that their replenishment in the brain may induce recovery, immediately leads to the question as to which of the biogenic amines is responsible for the affective changes. Pollin, Cardon and Kety (1961) observed the effect of giving various amino acids together with a monoamine oxidase inhibitor (M.A.O.I.) to patients suffering from chronic schizophrenia. They found that only tryptophan, the precursor of the monoamine 5-hydroxytryptamine (5HT), produced an elevation of mood. On the basis of their results, Coppen, Shaw and Farrell (1963) treated a number of patients suffering from severe depressive illness with M.A.O.I. and half of this group also received an oral dose of a suspension of D L-tryptophan (214 mg./kg. body weight) for one week. The patients taking tryptophan and M.A.O.I. recovered more rapidly than those receiving M.A.O.I. alone both while they were on tryptophan and also subsequently. One explanation for these findings was that the combination of M.A.O.I. and tryptophan increased the amount of amines derived from tryptophan in the brain, and that it was this which was responsible for the therapeutic effect. If this were so, then there were several possibilities. The first was that the level of 5HT in the brain was low in depression and the combination of amine precursor and enzyme inhibitor brought it back to normal. Alternatively it may be that recovery occurred as a result of the presence of abnormally large quantities of 5HT in the central nervous system or even following the production of tryptamine, another amine derived from tryptophan.
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