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Healthcare personnel (HCP) were recruited to provide serum samples, which were tested for antibodies against Ebola or Lassa virus to evaluate for asymptomatic seroconversion.
From 2014 to 2016, 4 patients with Ebola virus disease (EVD) and 1 patient with Lassa fever (LF) were treated in the Serious Communicable Diseases Unit (SCDU) at Emory University Hospital. Strict infection control and clinical biosafety practices were implemented to prevent nosocomial transmission of EVD or LF to HCP.
All personnel who entered the SCDU who were required to measure their temperatures and complete a symptom questionnaire twice daily were eligible.
No employee developed symptomatic EVD or LF. EVD and LF antibody studies were performed on sera samples from 42 HCP. The 6 participants who had received investigational vaccination with a chimpanzee adenovirus type 3 vectored Ebola glycoprotein vaccine had high antibody titers to Ebola glycoprotein, but none had a response to Ebola nucleoprotein or VP40, or a response to LF antigens.
Patients infected with filoviruses and arenaviruses can be managed successfully without causing occupation-related symptomatic or asymptomatic infections. Meticulous attention to infection control and clinical biosafety practices by highly motivated, trained staff is critical to the safe care of patients with an infection from a special pathogen.
Postoperative cognitive impairment is among the most common medical complications associated with surgical interventions – particularly in elderly patients. In our aging society, it is an urgent medical need to determine preoperative individual risk prediction to allow more accurate cost–benefit decisions prior to elective surgeries. So far, risk prediction is mainly based on clinical parameters. However, these parameters only give a rough estimate of the individual risk. At present, there are no molecular or neuroimaging biomarkers available to improve risk prediction and little is known about the etiology and pathophysiology of this clinical condition. In this short review, we summarize the current state of knowledge and briefly present the recently started BioCog project (Biomarker Development for Postoperative Cognitive Impairment in the Elderly), which is funded by the European Union. It is the goal of this research and development (R&D) project, which involves academic and industry partners throughout Europe, to deliver a multivariate algorithm based on clinical assessments as well as molecular and neuroimaging biomarkers to overcome the currently unsatisfying situation.
The functional composition of plant communities in montane regions has been studied for decades, and most recent analyses find that environmentally favourable landscapes at lower altitudes tend to be dominated by species with resource-acquisitive traits, while more resource-conservative taxa dominate higher-altitude communities. However, it is unclear the extent to which this pattern is driven by co-gradient variation within clades or changes in clade representation across the gradient. To test for co-gradient variation, species composition, phylogenetic structure and functional traits were quantified for 97 species within the plant family Melastomataceae at five locations across a 2500-m altitudinal gradient along Volcán Barva in Costa Rica. Average melastome leaf force to punch, specific leaf area and leaf size vary with altitude, while four other functional traits do not. Taxonomic dissimilarity between communities was correlated with altitudinal difference, while phylogenetic dissimilarity was correlated with altitudinal dissimilarity only when measured with a metric that emphasizes shallow turnover of the tips of the phylogeny. These results highlight how species turnover may be more pronounced than functional or phylogenetic variation along altitudinal gradients. In addition, these results highlight the conservation value of lowland tropical forests, which here harbour a disproportionate amount of phylogenetic and functional diversity.
We compared rotavirus detection patterns before (2001–2006) and after (2008–2015) rotavirus vaccine introduction. We also compared rotavirus detection patterns in odd (2009, 2011, 2013, 2015) and even (2008, 2010, 2012, 2014) years post-vaccine separately. Results of stool rotavirus antigen testing from inpatient, outpatient and emergency department encounters from July 2000 to July 2015 at two paediatric hospital laboratories in Atlanta, Georgia were reviewed. Post-vaccine, rotavirus detection declined (30.2% vs. 13.7% (overall 54.6% decline, P <0.001)), occurred more frequently outside the rotavirus season (19.8% vs. 3.5%; P < 0.001), and was more common among older children (26 vs. 13 median months of age; P < 0.001). During odd years post-vaccine, rotavirus detection was significantly higher than even years (20.2% vs. 6.4%; P < 0.001). Rotavirus detection declined substantially and developed a biennial pattern in the post-vaccine era. The intensity and temporality of rotavirus detection in odd years post-vaccine resembled that observed pre-vaccine, although considerably reduced in magnitude.
A number of laser facilities coming online all over the world promise the capability of high-power laser experiments with shot repetition rates between 1 and 10 Hz. Target availability and technical issues related to the interaction environment could become a bottleneck for the exploitation of such facilities. In this paper, we report on target needs for three different classes of experiments: dynamic compression physics, electron transport and isochoric heating, and laser-driven particle and radiation sources. We also review some of the most challenging issues in target fabrication and high repetition rate operation. Finally, we discuss current target supply strategies and future perspectives to establish a sustainable target provision infrastructure for advanced laser facilities.
To describe current Ebola treatment center (ETC) locations, their capacity to care for Ebola virus disease patients, and infection control infrastructure features.
A 19-question survey was distributed electronically in April 2015. Responses were collected via email by June 2015 and analyzed in an electronic spreadsheet.
The survey was sent to and completed by site representatives of each ETC.
The survey was sent to all 55 ETCs; 47 (85%) responded.
Of the 47 responding ETCs, there are 84 isolation beds available for adults and 91 for children; of these pediatric beds, 35 (38%) are in children’s hospitals. In total, the simultaneous capacity of the 47 reporting ETCs is 121 beds. On the basis of the current US census, there are 0.38 beds per million population. Most ETCs have negative pressure isolation rooms, anterooms, and a process for category A waste sterilization, although only 11 facilities (23%) have the capability to sterilize infectious waste on site.
Facilities developed ETCs on the basis of Centers for Disease Control and Prevention guidance, but specific capabilities are not mandated at this present time. Owing to the complex and costly nature of Ebola virus disease treatment and variability in capabilities from facility to facility, in conjunction with the lack of regulations, nationwide capacity in specialized facilities is limited. Further assessments should determine whether ETCs can adapt to safely manage other highly infectious disease threats.
Infect. Control Hosp. Epidemiol. 2016;37(3):313–318
At the crossroad between nutrient supply and requirements, the liver plays a central role in partitioning nitrogenous nutrients among tissues. The present review examines the utilisation of amino acids (AA) within the liver in various physiopathological states in mammals and how the fates of AA are regulated. AA uptake by the liver is generally driven by the net portal appearance of AA. This coordination is lost when demands by peripheral tissues is important (rapid growth or lactation), or when certain metabolic pathways within the liver become a priority (synthesis of acute-phase proteins). Data obtained in various species have shown that oxidation of AA and export protein synthesis usually responds to nutrient supply. Gluconeogenesis from AA is less dependent on hepatic delivery and the nature of nutrients supplied, and hormones like insulin are involved in the regulatory processes. Gluconeogenesis is regulated by nutritional factors very differently between mammals (glucose absorbed from the diet is important in single-stomached animals, while in carnivores, glucose from endogenous origin is key). The underlying mechanisms explaining how the liver adapts its AA utilisation to the body requirements are complex. The highly adaptable hepatic metabolism must be capable to deal with the various nutritional/physiological challenges that mammals have to face to maintain homeostasis. Whereas the liver responds generally to nutritional parameters in various physiological states occurring throughout life, other complex signalling pathways at systemic and tissue level (hormones, cytokines, nutrients, etc.) are involved additionally in specific physiological/nutritional states to prioritise certain metabolic pathways (pathological states or when nutritional requirements are uncovered).
Cygnus A, the nearest truly powerful radio galaxy, resides at the centre of a massive galaxy cluster. Chandra X-ray observations reveal its cocoon shocks, radio lobe cavities and an X-ray jet, which are discussed here. It is argued that X-ray emission from the outer regions of the cocoon shocks is nonthermal. The X-ray jets are best interpreted as synchrotron emission, suggesting that they, rather than the radio jets, are the path of energy flow from the nucleus to the hotspots. In that case, a model shows that the jet flow is non-relativistic and carries in excess of one solar mass per year.
Renewable energy sources – including biomass, geothermal, ocean, solar, and wind energy, as well as hydropower – have a huge potential to provide energy services for the world. The renewable energy resource base is sufficient to meet several times the present world energy demand and potentially even 10 to 100 times this demand. This chapter includes an in-depth examination of technologies to convert these renewable energy sources to energy carriers that can be used to fulfill our energy needs, including their installed capacity, the amount of energy carriers they produced in 2009, the current state of market and technology development, their economic and financial feasibility in 2009 and in the near future, as well as major issues they may face relative to their sustainability or implementation.
Present uses of renewable energy
Since 1990 the energy provided from renewable sources worldwide has risen at an average rate of nearly 2% a year, but in recent years this rate has increased to about 5% annually (see Figure 11.1.) As a result, the global contribution of renewables has increased from about 74 EJ in 2005 to about 89 EJ in 2009 and represents now 17% of global primary energy supply (528 EJ, see Figure 11.2). Most of this renewable energy comes from the traditional use of biomass (about 39 EJ) and larger-scale hydropower (about 30 EJ), while other renewable technologies provided about 20 EJ.
The self-similar evolution to turbulence of a multi-mode miscible Rayleigh–Taylor (RT) mixing layer has been investigated for Atwood numbers 0.03–0.6, using an air–helium gas channel experiment. Two co-flowing gas streams, one containing air (on top) and the other a helium–air mixture (at the bottom), initially flowed parallel to each other at the same velocity separated by a thin splitter plate. The streams met at the end of the splitter plate, with the downstream formation of a buoyancy unstable interface, and thereafter buoyancy-driven mixing. This buoyancy-driven mixing layer experiment permitted long data collection times, short transients and was statistically steady. Several significant designs and operating characteristics of the gas channel experiment are described that enabled the facility to be successfully run for At ~ 0.6. We report, and discuss, statistically converged measurements using digital image analysis and hot-wire anemometry. In particular, two hot-wire techniques were developed for measuring the various turbulence and mixing statistics in this air–helium RT experiment. Data collected and discussed include: mean density profiles, growth rate parameters, various turbulence and mixing statistics, and spectra of velocity, density and mass flux over a wide range of Atwood numbers (0.03 ≤ At ≤ 0.6). In particular, the measured data at the small Atwood number (0.03–0.04) were used to evaluate several turbulence-model constants. Measurements of the root mean square (r.m.s.) velocity and density fluctuations at the mixing layer centreline for the large At case showed a strong similarity to lower At behaviours when properly normalized. A novel conditional averaging technique provided new statistics for RT mixing layers by separating the bubble (light fluid) and spike (heavy fluid) dynamics. The conditional sampling highlighted differences in the vertical turbulent mass flux, and vertical velocity fluctuations, for the bubbles and spikes, which were not otherwise observable. Larger values of the vertical turbulent mass flux and vertical velocity fluctuations were found in the downward-falling spikes, consistent with larger growth rates and momentum of spikes compared with the bubbles.
Restriction enzyme fingerprints were generated from purified plasmid DNA from 324 clinical isolates that belonged to 7 enterobacterial genera and 88 single plasmids in Escherichia coli K12 according to the following strategy.
Purified plasmid DNA was digested with PstI. The number of fragments detected in a 0·8 agarose gel was used to determine which 2 of 6 restriction enzymes including Pstl was most likely to provide a fingerprint comprising sufficient fragments to ensure specificity but sufficiently few to allow easy visual assessment and minimize coincidental matching. When PstI produced > 20 fragments, Eco RI and HindIII were used; when PstI generated < 6 fragments Bsp 1286 and AvaII were used and SmaI was employed when between 6 and 20 fragments were obtained from PstI digests. Using a minimum of 12 fragments from a combination of 2 enzymes as the criterion for characterizing a strain/plasmid, satisfactory 2-enzyme fingerprints were obtained from 87% of the strains and plasmids studied using PstI and no more than two additional enzymes per strain. Of the remaining 54 strains, 51 harboured only small plasmids (< 10 kb) and 3 produced satisfactory fingerprints when digested with a fourth enzyme.
Restriction enzyme fingerprinting was applied to 72 transferable trimethoprim resistance plasmids to examine aspects of their epidemiology and molecular relatedness.
These plasmids had previously been divided into 25 groups according to differences in mol. wts and in antimicrobial resistance determinants. Restriction enzyme fingerprinting allowed the plasmids to be further divided into 44 different groups. The groups based on molecular weight and resistance patterns often, but not invariably, corresponded with those based on restriction enzyme fingerprints. Some plasmids with the same mol. wt and resistance pattern had different digest fingerprints and conversely, although more rarely, plasmids which differed in molecular weight by as much as 10 MDa or in resistance pattern by one resistance marker, had indistinguishable fingerprints.
The plasmids were initially divided into three broad categories according to which restriction enzymes gave fingerprints of 6–20 fragments. These categories differed in the molecular weights of the plasmids contained, the numbers of resistance markers, and the proportions of the plasmids which carried transposon Tn7.
Some plasmids were more widespread and persistent than others with the same mol. wt and resistance pattern but with a different restriction enzyme fingerprint.
Thus, application of this technique has shown the trimethoprim resistance plasmids studied to be more diverse than was indicated by determination of mol. wt and resistance pattern, and has indicated changes in the plasmid pool over the 3 years during which they were collected.
Four hundred and seven clinical isolates of Escherichia coli were examined for the presence of plasmids. These isolates comprised 189 which were collected irrespective of antimicrobial resistance (VP) and 218 which were collected on the basis of high-level trimethoprim resistance (TPR). The VP isolates were divided into drug sensitive (VPS) and drug-resistant (VPR) subpopulations.
Plasmids were detected in 88% of VP isolates (81% of VPS and 94% of VPR) and 98% of TPR isolates. The distribution of plasmids in both groups and subpopulations was very similar. However, there were small but statistically significant differences between the plasmid distributions. These showed that more isolates in the resistant groups harboured plasmids than in the sensitive subpopulation (VPS) and that the number of plasmids carried by resistant isolates was greater. Multiple drug resistance was significantly more common among TPR isolates than the VPR subpopulation and this was paralleled by increased numbers of plasmids.
Fifty-eight per cent of VPR and 57% of TPR isolates transferred antimicrobial resistance and plasmids to E. coli K12. Of the R+ isolates, 60% carried small plasmids (MW < 20Md) and 52% of these co-transferred with R-plasmids. These results are discussed.
Purpose: To evaluate the role of retrograde urethrography in treatment planning for salvage external beam radiotherapy in patients with increasing prostate-specific antigen levels after radical prostatectomy.
Methods and Materials: From July 1988 to December 2002, 173 consecutive patients received external beam radiotherapy for increasing prostate-specific antigen levels after radical prostatectomy. All 173 simulation films were reviewed, and retrograde urethrography was performed in 148 patients (86%). The distance between the line connecting the lower poles of the ischial tuberosities and site of abrupt narrowing of contrast material was measured in all 148 patients. This distance was compared with that measured in 148 consecutive patients with intact prostates who had retrograde urethrography while undergoing treatment planning for definitive radiotherapy.
Results: The mean (median) distance from the line connecting the lower poles of the ischial tuberosities to the abrupt narrowing seen in the urethrogram in patients with increasing prostate-specific antigen levels was 1.54cm (1.50cm) compared with 1.73cm (1.80cm) in those with intact prostates (p = 0.0145).
Conclusion: Retrograde urethrography is important in treatment planning for salvage radiotherapy of the prostate bed after radical prostatectomy to adequately treat the apex of the prostate bed.
As silicon-based microelectronic devices continue to aggressively scale down in size, traditional BEOL dielectric materials have become obsolete due to their relatively high dielectric constant. Organosilicate glass (OSG) materials have emerged as the predominant choice for intermetal dielectrics in advancing technology nodes. A potential failure mechanism for this class of low-k dielectric films during the manufacturing process is catastrophic fracture due to channel cracking. To improve the mechanical strength and stability of these silicon-based materials, the use of post-deposition curing processes is under evaluation. In this work, the effects of UV curing on the properties of OSG films were characterized. After UV curing, film hardness and elastic modulus are improved, with no change in the residual film stress. The average film density increases linearly as a function of UV exposure time. Channel crack propagation velocities decrease with UV exposure. The improvements in the mechanical properties of OSG films are believed to correlate with the increasing Si-O-Si bond population. Comparisons between post-deposition UV and Electron Beam curing processes are provided.
Retinal neurons and Müller cells express amiloride-sensitive
Na+ channels (ASSCs). Although all major subunits of these
channels are expressed, their physiological role is relatively unknown in
this system. In the present study, we used the electroretinogram (ERG)
recorded from anesthetized rabbits and isolated rat and rabbit retina
preparations to investigate the physiological significance of ASSCs in the
retina. Based upon our previous study showing expression of α-ENaC and
functional amiloride-sensitive currents in rabbit Müller cells, we
expected changes in Müller cell components of the ERG. However, we
observed changes in other components of the ERG as well. The presence of
amiloride elicited changes in all major components of the ERG; the
a-wave, b-wave, and d-wave (off response) were
enhanced, while there was a reduction in the amplitude of the Müller
cell response (slow PIII). These results suggest that ASSCs play an
important role in retinal function including neuronal and Müller cell