Severely impaired health status of non-notified Q fever patients leads to an underestimation of the true burden of disease.

Q fever patients are often reported to experience a long-term impaired health status, including fatigue, which can persist for many years. During the large Q fever epidemic in The Netherlands, many patients with a laboratory-confirmed Coxiella burnetii infection were not notified as acute Q fever because they did not fulfil the clinical criteria of the acute Q fever case definition (fever, pneumonia and/or hepatitis). Our study assessed and compared the long-term health status of notified and non-notified Q fever patients at 4 years after onset of illness, using the Nijmegen Clinical Screening Instrument (NCSI). The study included 448 notified and 193 non-notified Q fever patients. The most severely affected subdomain in both patient groups was 'Fatigue' (50·5% of the notified and 54·6% of the non-notified patients had severe fatigue). Long-term health status did not differ significantly between the notified and non-notified patient groups, and patients scored worse on all subdomains compared to a healthy reference group. Our findings suggest that the magnitude of the 2007-2009 Q fever outbreak in The Netherlands was underestimated when only notified patients according to the European Union case definition are considered.

Levels of agreement between student and staff assessments of clinical skills in performing cavity preparation in artificial teeth.

OBJECTIVE: To determine the level of agreement between staff and students' assessment of clinical skills in performing tasks related to cavity preparation on a traditional dental manikin. METHODS: Two studies were conducted with two successive student cohorts: Study 1-138 year 1 BDS students in a 2009/10 cohort and Study 2-135 students in a 2010/11 cohort. Staff members and students rated the students' performance in preparing a cavity on a traditional dental manikin using artificial teeth: hand-held (Study 1) and located in a lower jaw (Study 2). A 5-item criterion-related scoring rubric was developed. The rubric assessed students' abilities to hold the instrument correctly, determine the angle of entry to the tooth, remove the caries, conserve healthy tissues and avoid pulp exposure. RESULTS: Agreement between the students' self-assessment and the staff's assessment was high for three of the five criteria (i.e. removal of artificial caries on the cavity wall, removal of artificial caries from the cavity floor and avoidance of pulp exposure). Levels of agreement for the remaining two criteria were moderate. A change in task difficulty affected the levels of agreement between staff and students, such that the more difficult the task, the greater the discrepancy in ratings. CONCLUSIONS: Students tend to overrate the quality of their performance when compared with staff ratings. Task difficulty has an impact on levels of agreement.

Scientific echosounder data provide a predator's view of Antarctic krill (Euphausia superba).

Raw acoustic data were collected in East Antarctica from the RSV Aurora Australis during two surveys: the Krill Availability, Community Trophodynamics and AMISOR Surveys (KACTAS) and the Krill Acoustics and Oceanography Survey (KAOS) in the East Antarctic (centre coordinate 66.5° S, 63° E). The KACTAS survey was conducted between 14th to 21st January and 2001, and the KAOS survey was conducted between 16 January and 1 February 2003. We examine the Antarctic krill (Euphausia superba) component of these surveys and provide scientific echosounder (EK500 and EK60) data collected at 38, 120 and 200 kHz, cold water (-1 °C) echosounder calibration parameters and accompanying krill length frequency distributions obtained from trawl data. We processed the acoustic data to apply calibration values and remove noise. The processed data were used to isolate echoes arising from swarms of krill and to estimate metrics for each krill swarm, including internal density and individual swarm biomass. The krill swarm data provide insights to a predators' views of krill distribution and density.

Femtosecond study of the deuteron-transfer dynamics of naphtol salts in water.

We study the rate and mechanism of deuteron transfer from the photoacids 1-naphtol-4-sulfonate (1-NPS) and 2-naphtol-3,7-disulphonate (2-NPS) to acetate base in aqueous (D(2)O) solution. The photoacids are activated by excitation with 100 fs laser pulses at 267 nm. The electronic absorption and stimulated emission spectra of the photoacid and the conjugate photobase and the vibrational absorption spectra of the hydrated deuteron and the acetate base are probed with broad-band delayed 100 fs pulses at visible and mid-infrared wavelengths, respectively. A significant fraction of the deuteron transfer events are observed to occur on a timescale of <1 ps within hydrogen-bonded contact photoacid-acetate complexes. For 1-NPS, this fraction is much higher than for 2-NPS. At later delay times, the reaction is dominated by deuteron transfer through short-living water wires of different lengths that connect the photoacid and the acetate base.

Direct observation of proton transfer in ice Ih using femtosecond spectroscopy.

We studied proton transfer in ice samples containing the photoacid 8-hydroxypyrene-1,3,6-trisulfonic acid and the base sodium formate using femtosecond pump-probe spectroscopy. Pump pulses, centered at a wavelength of 400 nm, electronically excited the photoacid molecules which released their protons. These protons subsequently traveled from the photoacid through the ice lattice to the base and were observed as they arrived at the base using the transient absorption of an infrared probe pulse. Both the temperature and concentration dependence of the proton transfer dynamics were modeled using a discrete set of two intrinsic transfer rates, associated with short and long-range proton transfer, respectively. Proton transfer in configurations where the acid and base were separated by up to about two water molecules, was found to occur on a approximately 1 ps time scale for all temperatures (240-270 K). Long range direct proton transfer through water wires of about four water molecules in length was found to occur on a approximately 300 ps time scale at 270 K. This latter process was observed to slow down significantly with decreasing temperature, with an activation energy of approximately 80 kJ/mol.

The characteristics of krill swarms in relation to aggregating Antarctic blue whales.

We model the presence of rare Antarctic blue whales (Balaenoptera musculus intermedia) in relation to the swarm characteristics of their main prey species, Antarctic krill (Euphausia superba). A combination of visual observations and recent advances in passive acoustic technology were used to locate Antarctic blue whales, whilst simultaneously using active underwater acoustics to characterise the distribution, size, depth, composition and density of krill swarms. Krill swarm characteristics and blue whale presence were examined at a range of spatiotemporal scales to investigate sub meso-scale (i.e., <100 km) foraging behaviour. Results suggest that at all scales, Antarctic blue whales are more likely to be detected within the vicinity of krill swarms with a higher density of krill, those found shallower in the water column, and those of greater vertical height. These findings support hypotheses that as lunge-feeders of extreme size, Antarctic blue whales target shallow, dense krill swarms to maximise their energy intake. As both Antarctic krill and blue whales play a key role in the Southern Ocean ecosystem, the nature of their predator-prey dynamics is an important consideration, not only for the recovery of this endangered species in a changing environment, but for the future management of Antarctic krill fisheries.

Long-range proton transfer in aqueous Acid-base reactions.

We study the mechanism of proton transfer (PT) in the aqueous acid-base reaction between the photoacid 8-hydroxy-1,3,6-pyrenetrisulfonic acid (HPTS) and acetate by probing the vibrational resonances of HPTS, acetate, and the hydrated proton with femtosecond mid-infrared laser pulses. We find that PT takes place in a distribution of hydrogen-bound reaction complexes that differ in the number of water molecules separating the acid and the base. The number of intervening water molecules ranges from 0 to 5, which, together with a strongly distance-dependent PT rate, explains the observed highly nonexponential reaction kinetics. The kinetic isotope effect for the reaction is determined to be 1.5, indicating that tunneling does not play a significant role in the transfer of the proton. Rather, the transfer mechanism is best described in terms of the adiabatic PT picture as it has been formulated by Hynes and co-workers [Staib, A.; Borgis, D.; Hynes, J. T. J. Chem. Phys. 1995, 102, 2487. Ando, K.; Hynes, J. T. J. Phys. Chem. B 1997, 101, 10464.], where solvent fluctuations play an essential role in forming the correct hydrogen-bond configuration and solvent polarization to facilitate PT.

Changes in the chondroitin sulfate-rich region of articular cartilage proteoglycans in experimental osteoarthritis.

The chondroitin sulfate-rich region was cleaved from cartilage proteoglycans of experimental osteoarthritic canine joints to establish whether changes in this region of the molecule contribute to the well-documented increase in the chondroitin sulfate to keratan sulfate ratio in osteoarthritis. Experimental osteoarthritis was induced in eight dogs by severance of the right anterior cruciate ligament, the left joint serving as a control. Proteoglycans were extracted from the femoral cartilage of both joints, isolated as A1 fractions by associative density gradient centrifugation and cleaved with hydroxylamine. The chondroitin sulfate-rich region was isolated by either gel chromatography or dissociative density gradient centrifugation. The chondroitin sulfate-rich region from the proteoglycans of the experimental osteoarthritic joints was slightly larger in hydrodynamic size and had both a higher uronate/protein weight ratio and galactosamine/glucosamine molar ratio than the corresponding control. We conclude that the chondroitin sulfate-rich region of proteoglycans in articular cartilage of experimental osteoarthritic joints is larger and has more chondroitin sulfate than that of proteoglycans of normal cartilage.

The distribution of macular pigment in human albinos.

This study investigated the variation in density of macular pigment across the central retina in normal and albino subjects. Luminance profiles were measured using a fundus camera and digital video techniques. The normal group had pigment spatial distributions consistent with previous studies. The albinos had no variation in absorbance across the central retina.

Comparison of computer-assisted versus manual optic nerve head pallor measurement.

Computerized methods of examining the optic nerve head offer the possibility of providing consistent, reliable, and accurate measurements of the nerve head. The reliability and accuracy of such instruments must be examined to confirm this. This research was undertaken to gain an insight into the accuracy of such a system, which takes its measurements by tracking the luminance boundaries of the pallor area and the optic nerve head after an observer marks the starting points. Measurements made using the computer-tracked boundary were compared with those made using a boundary tracked by an image-processing system of greater sophistication, the human visual system. The comparison was made with images from one eye from each of 30 subjects (10 normal, 10 ocular hypertensive, and 10 glaucomatous). The measurements were made by two observers. Each observer made each set of measurements twice, and the results were analyzed with a five-factor analysis of variance. The measurements made using the computerized method did not differ significantly from those made using the manual boundary tracking for the two observers, and they were highly correlated (r = 0.99 for the area pallor-disc ratio). Significant differences (P < 0.05) were found between the two observers in both the manual and computerized boundary tracking. The computerized method, however, did not find differences between the two sets of measurements made by each observer; the manual method did show such differences. The computerized method appeared to trace the luminance boundaries successfully in the image, and it might reduce errors related to the observer marking the starting points on different occasions.(ABSTRACT TRUNCATED AT 250 WORDS)

Factor V Leiden and thermolabile methylenetetrahydrofolate reductase in extreme old age.

Both factor V Leiden and the C677T methylenetetrahydrofolate reductase (MTHFR) gene mutation are associated with premature vascular disease, and yet are found at surprisingly high allele frequencies in European populations, 2.7% and 35% respectively. We have investigated the prevalence of these mutations in 87 UK residents over the age of ninety, to look for any evidence of their association with premature death. Five factor V Leiden heterozygotes were found, giving an allele frequency of 2.9%, similar to that in the general UK population. The frequency of the thermolabile C677T MTHFR mutation was 36% with 11% homozygotes, again similar to that in the UK population; these genotypes are in Hardy-Weinberg equilibrium, suggesting that there is not strong selection against the homozygous state. One person was both heterozygous for factor V Leiden and homozygous for the C677T mutation. This study suggests that neither factor V Leiden nor thermolabile MTHFR are risk factors for premature death.

Isolation and phenotypic characterization of Pseudomonas aeruginosa pseudorevertants containing suppressors of the catabolite repression control-defective crc-10 allele.

The amiE gene encodes an aliphatic amidase capable of converting fluoroacetamide to the toxic compound fluoroacetate and is one of many genes whose expression is subject to catabolite repression control in Pseudomonas aeruginosa. The protein product of the crc gene, Crc, is required for repression of amiE and most other genes subject to catabolite repression control in this bacterium. When grown in a carbon source such as succinate, wild-type P. aeruginosa is insensitive to fluoroacetamide (due to repression of amiE expression). In contrast, mutants harboring the crc-10 null allele cannot grow in the presence of fluoroacetamide (due to lack of repression of amiE). Selection for succinate-dependent, fluoroacetamide-resistant derivatives of the crc-10 mutant yielded three independent pseudorevertants containing suppressors that restored a degree of catabolite repression control. Synthesis of Crc protein was not reestablished in these pseudorevertants. All three suppressors of crc-10 were extragenic, and all three also suppressed a Delta crc::tetA allele. In each of the three pseudorevertants, catabolite repression control of amidase expression was restored. Catabolite repression control of mannitol dehydrogenase production was also restored in two of the three isolates. None of the suppressors restored repression of glucose-6-phosphate dehydrogenase or pyocyanin production.

Measles antibody levels in a vaccinated population in Brazil.

An epidemiological study of measles-specific immunoglobulin G antibody levels was conducted using a representative sample of a vaccinated suburban population in São Paulo State, Brazil. The study aimed to determine immunity status in relation to age and infection or vaccination experience. 549 age-structured samples of sera, collected in 1990, were screened and calibrated to the international reference serum, using measles nucleoprotein in an enzyme immunoassay. In the age group with direct experience of vaccination (9 months to 15 years), whether routine or campaign, over 90% had detectable antibody > or = 50 miu/mL. However, 14% of these had antibody concentrations between 50 and 100 miu/mL and 30% between 50 and 255 miu/mL. In those over 15 years of age, 94% had antibody levels > 255 miu/mL, assumed to be the result of past infection. The study suggested that, within highly vaccinated populations, a proportion of individuals had measles antibody levels which may be insufficient to protect against reinfection or clinical disease. The implications of these results, and similar findings elsewhere, in relation to the persistence of measles requires investigation; this has particular relevance in São Paulo following the recent measles outbreak.

Dynamics of malaria parasitaemia associated with febrile illness in children from a rural area of Madang, Papua New Guinea.

Active community and self-reporting surveillance techniques have been used to describe the dynamics of febrile illness and associated malaria infection in children aged 2 to 15 years from a rural area of Madang Province, Papua New Guinea (PNG). Both history of fever and fever in association with parasitaemia appeared to be reliable indicators of malaria morbidity in this endemic area. Parasite density was observed to be a major determinant of mild malarial disease at both the population level and within an individual. Age-specific prevalence of febrile illness correlated with age-specific patterns of parasite density but not of parasite prevalence. Seasonal changes in fever incidence correlated with parasite density. The transition from afebrile to febrile state within an individual was generally associated with an increase in parasite density. Surveillance and self-reported febrile cases (which differ in severity on the basis of the perceived need for treatment) could be distinguished on the basis of parasite density. Thus surveillance techniques divide clinical malaria in rural PNG into 'mild' and 'very mild' forms. The age-specific pattern of decline of prevalence of malaria-associated febrile illness and parasite density is best explained by induction of strain-specific anti-disease immunity upon infection with a given strain of Plasmodium falciparum. The fever threshold in self-reporting febrile cases was seen to decrease with age and can be explained by an age-specific decline in anti-toxic immunity.

The analysis of motion of two-dimensional patterns: do Fourier components provide the first stage?

Human observers were required to report the direction of motion of simple two-dimensional (2-D) "plaid" patterns made by adding together two sinusoidal gratings of identical contrast (0.5 or 1.5 log units above threshold), spatial frequency (1 or 5 c/deg) and orthogonal orientations (horizontal and vertical, or +/- 45 deg). The patterns were made to move either by moving both gratings at the same speed (pattern motion) or by moving one component with the other stationary (component motion). In one task (direction discrimination) the observer knew the axis of motion, and was required to discriminate the direction of motion along that axis in a temporal two-alternative forced-choice paradigm; in the other task (direction identification) the observer did not know the axis of motion and was required to identify the direction of motion and the axis of motion. In both tasks the discrimination of pattern motion was consistently better than the discrimination of component motion, contrary to the predictions of the "two-stage" model of motion analysis, in which it is assumed that the motion of a 2-D pattern is calculated from the 1-D motions of its Fourier components. The variation in direction discrimination of pattern motion with speed did not have the form predicted under the assumption that the direction of motion of the pattern could be discriminated using the motion of either of its two component gratings. Finally, an elaborated version of the Adelson and Movshon [(1982) Nature, 300, 523-525] two-stage model, in which noise affects the two stages fails to predict the performance in identifying the pattern motion of the plaid pattern, except for 1 c/deg low contrast plaids. These results suggest that when 2-D patterns contain moderately high contrasts or high spatial frequencies observers may use other attributes, instead of, or in addition to Fourier components, to analyse their 2-D motion.

The spherical aberration of the crystalline lens of the human eye.

The in vivo spherical aberration of the lenses of 26 subjects was estimated from the measured total aberration of the eye and that predicted from the measured shape of the anterior corneal surface. Since it was only possible to estimate the aberration contribution from the posterior corneal surface, its value led to an uncertainty in the final aberration level of the lens. For all the subjects and for a wide range of possible aberration levels at the posterior corneal surface, the spherical aberration of the relaxed lens was found to be negative.

CD-ROM nutrient analysis database assists self-monitoring behavior of active duty Air Force personnel receiving nutrition counseling for weight loss.

This study observed the effect of using a computerized vs manual method of self-monitoring among Air Force personnel receiving nutrition counseling for weight loss. Subjects who enrolled during the first 2 weeks of the 4-week recruitment period completed food records for 6 weeks using a CD-ROM nutrient database (intervention group) whereas those who enrolled during the last 2 weeks used a food record booklet (comparison group). Of the 42 subjects (n = 23 intervention group and n = 19 comparison group), only 113 intervention and 11 comparison group subjects (57% of study enrollees) submitted at least 1 food record during the study and were included in the analysis, which included review of pre- and poststudy questionnaires, food records, and focus group data. There were no significant differences between the number of days per week documented or average number of items recorded daily. All 9 intervention as compared to 2 comparison group subjects who completed a poststudy questionnaire searched for lower-energy and lower-fat items and reported changing their dietary intake as a result. All intervention group subjects who participated in a focus group (n=6) had favorable comments about using the CD-ROM for monitoring and changing eating habits, indicating that it is a beneficial self-monitoring tool. Participants enjoyed the immediate dietary feedback, and computerized food records may be easier to interpret by nutrition counselors. A number of computerized nutrient databases are available to assist patients and consumers in managing nutritional concerns.

Grating detection and orientation discrimination in amblyopia.

PURPOSE: We examined whether the misperceptions associated with amblyopic visual perception can be revealed under natural viewing conditions by comparing the ability to detect the presence of a grating with the ability to identify the grating orientation. METHODS: Grating detection and orientation discrimination performance (horizontal versus vertical) were determined, using stimuli that consisted of sinusoidal gratings of fixed contrast (75%) but with variable spatial frequency. A total of four amblyopic subjects (two strabismic and two non-strabismic) and four age-matched normals participated in the experiment. RESULTS: Psychometric functions for grating detection and orientation identification were found to be closely matched in the normal subjects and in all four amblyopic subjects, indicating that orientation could be correctly identified at detection threshold. CONCLUSIONS: The absence of orientation uncertainty in the psychophysical data for the amblyopic observers is not consistent with the several previous reports of spatial aliasing in the central field of amblyopes. Our results suggest that non veridical visual perception in central amblyopic vision can not be revealed under natural viewing conditions by comparing the ability to detect the presence of a grating with the ability to identify its orientation. Possible reasons for the failure of this technique to reveal spatial aliasing in amblyopes are discussed.

Fathers' participation in family research: is there a self-selection bias?

The representativeness of fathers who participate in family research was examined among 661 families. Approximately two thirds of eligible fathers participated. Mothers' and observers' reports on families of participating and non-participating fathers were compared. Participating fathers underrepresented fathers with less education, later-born children, more ambivalent marriages, partners with more traditional child-rearing beliefs, families with less optimal parenting environments, and infants who were unplanned, had more difficult temperaments, and were less healthy. Also underrepresented were ethnic minority families and working-class fathers. However, no differences were found in regard to child gender, family income, mothers' psychosocial functioning, either parent's employment experiences, or child-care arrangements. Implications for the generalizability of findings and the recruitment of fathers are discussed.

Considerations in the selection of surgical gloves for tape wound closure.

One of the reasons that tape closure of wounds is rarely used in the emergency department is that it is difficult for the emergency physician wearing powdered, latex gloves to handle skin closure tapes. Because the skin closure tapes adhere aggressively to powdered latex gloves, it is difficult for the emergency physician to separate the tape from his glove and apply the tape to the skin. The advent of a new powder free glove allows the emergency physician to handle the tapes and accomplish tape wound closure.