An outbreak of cryptosporidiosis at a swimming club--can rapid field epidemiology limit the spread of illness?

In September 2010, an outbreak of cryptosporidiosis affected members of a swimming club. A cohort study was undertaken to identify the number affected and risk factors for infection. Of 101 respondents, 48 met the case definition for probable cryptosporidiosis. Multivariate analysis demonstrated a strong and highly significant association between illness and attendance at a training session on 13 September 2010 (adjusted odds ratio 28, P < 0.0001). No faecal incidents were reported and pool monitoring parameters were satisfactory. The competitive nature of club swimming requires frequent training and participation in galas, potentially facilitating contamination into other pools and amplification of outbreaks among wider groups of swimmers. There was a lack of awareness of the 2-week exclusion rule among swimmers and coaches, and a high level of underreporting of illness. The study demonstrates the benefits of rapid field epidemiology in identifying the true burden of illness, the source of infection and limiting spread.

Tomotherapy dose distribution verification using MAGIC-f polymer gel dosimetry.

PURPOSE: This paper presents the application of MAGIC-f gel in a three-dimensional dose distribution measurement and its ability to accurately measure the dose distribution from a tomotherapy unit. METHODS: A prostate intensity-modulated radiation therapy (IMRT) irradiation was simulated in the gel phantom and the treatment was delivered by a TomoTherapy equipment. Dose distribution was evaluated by the R2 distribution measured in magnetic resonance imaging. RESULTS: A high similarity was found by overlapping of isodoses of the dose distribution measured with the gel and expected by the treatment planning system (TPS). Another analysis was done by comparing the relative absorbed dose profiles in the measured and in the expected dose distributions extracted along indicated lines of the volume and the results were also in agreement. The gamma index analysis was also applied to the data and a high pass rate was achieved (88.4% for analysis using 3%∕3 mm and of 96.5% using 4%∕4 mm). The real three-dimensional analysis compared the dose-volume histograms measured for the planning volumes and expected by the treatment planning, being the results also in good agreement by the overlapping of the curves. CONCLUSIONS: These results show that MAGIC-f gel is a promise for tridimensional dose distribution measurements.

Geophysical evidence for reduced melt production on the Arctic ultraslow Gakkel mid-ocean ridge.

Most models of melt generation beneath mid-ocean ridges predict significant reduction of melt production at ultraslow spreading rates (full spreading rates &<20 mm x yr(-1)) and consequently they predict thinned oceanic crust. The 1,800-km-long Arctic Gakkel mid-ocean ridge is an ideal location to test such models, as it is by far the slowest portion of the global mid-ocean-ridge spreading system, with a full spreading rate ranging from 6 to 13 mm x yr(-1) (refs 4, 5). Furthermore, in contrast to some other ridge systems, the spreading direction on the Gakkel ridge is not oblique and the rift valley is not offset by major transform faults. Here we present seismic evidence for the presence of exceptionally thin crust along the Gakkel ridge rift valley with crustal thicknesses varying between 1.9 and 3.3 km (compared to the more usual value of 7 km found on medium- to fast-spreading mid-ocean ridges). Almost 8,300 km of closely spaced aeromagnetic profiles across the rift valley show the presence of discrete volcanic centres along the ridge, which we interpret as evidence for strongly focused, three-dimensional magma supply. The traces of these eruptive centres can be followed to crustal ages of approximately 25 Myr off-axis, implying that these magma production and transport systems have been stable over this timescale.

Magmatic and amagmatic seafloor generation at the ultraslow-spreading Gakkel ridge, Arctic Ocean.

A high-resolution mapping and sampling study of the Gakkel ridge was accomplished during an international ice-breaker expedition to the high Arctic and North Pole in summer 2001. For this slowest-spreading endmember of the global mid-ocean-ridge system, predictions were that magmatism should progressively diminish as the spreading rate decreases along the ridge, and that hydrothermal activity should be rare. Instead, it was found that magmatic variations are irregular, and that hydrothermal activity is abundant. A 300-kilometre-long central amagmatic zone, where mantle peridotites are emplaced directly in the ridge axis, lies between abundant, continuous volcanism in the west, and large, widely spaced volcanic centres in the east. These observations demonstrate that the extent of mantle melting is not a simple function of spreading rate: mantle temperatures at depth or mantle chemistry (or both) must vary significantly along-axis. Highly punctuated volcanism in the absence of ridge offsets suggests that first-order ridge segmentation is controlled by mantle processes of melting and melt segregation. The strong focusing of magmatic activity coupled with faulting may account for the unexpectedly high levels of hydrothermal activity observed.

Reproductive potential does not cause loss of heat shock response performance in honey bees.

In other species characterized to date, aging, as a function of reproductive potential, results in the breakdown of proteaostasis and a decreased capacity to mount responses by the heat shock response (HSR) and other proteostatic network pathways. Our understanding of the maintenance of stress pathways, such as the HSR, in honey bees, and in the reproductive queen in particular, is incomplete. Based on the findings in other species showing an inverse relationship between reproductive potential and HSR function, one might predict that that HSR function would be lost in the reproductive queens. However, as queens possess an atypical uncoupling of the reproduction-maintenance trade-off typically found in solitary organisms, HSR maintenance might also be expected. Here we demonstrate that reproductive potential does not cause loss of HSR performance in honey bees as queens induce target gene expression to levels comparable to those induced in attendant worker bees. Maintenance of HSR function with advent of reproductive potential is unique among invertebrates studied to date and provides a potential model for examining the molecular mechanisms regulating the uncoupling of the reproduction-maintenance trade-off in queen bees, with important consequences for understanding how stresses impact different types of individuals in honey bee colonies.

Orphan strontium-87 in abyssal peridotites: daddy was a granite.

The (87)Sr/(86)Sr ratios in some bulk abyssal and alpine peridotites are too high to be binary mixtures of depleted mantle and seawater components. The apparent excess, or "orphan," (87)Sr appears to be separated from its radioactive parent. Such observations were widely held to be analytical artifacts. Study of several occurrences of orphan (87)Sr shows that the orphan component in abyssal peridotite is located in the alteration products of olivine and enstatite in the peridotite. The orphan (87)Sr is most likely introduced by infiltration of low-temperature (<200 degrees C) seawater bearing suspended detrital particulates. These particulates include grains of detrital clay that are partly derived from continental (that is, granitic) sources and thus are highly radiogenic. Orphan (87)Sr and other radiogenic isotopes may provide a tracer for low-temperature seawater penetrating into the oceanic crust.

Lasing droplets: highlighting the liquid-air interface by laser emission.

When dye-doped ethanol droplets are irradiated with an intense pulsed laser beam, the resulting laser emission from individual droplets highlights the liquid-air interface. Photographs of the lasing droplets in the micrometer size range taken in a single 10-nanosecond laser pulse clearly show the dynamic changes in droplet size, shape, and orientation.

Coordinate up-regulation of hypoxia inducible factor (HIF)-1alpha and HIF-1 target genes during multi-stage epidermal carcinogenesis and wound healing.

Both carcinogenesis and wound healing proceed through stages of proliferation and tissue remodeling. Here, using either a model of multistage epidermal carcinogenesis in K14-HPV16 transgenic mice or creation of full-thickness back wounds in nontransgenic mice, we determined patterns of expression of hypoxia inducible factor (HIF)-1alpha, and three targets of the heterodimeric transcription factor HIF-1, glucose transporter (GLUT)-1, phosphoglycerate kinase (PGK)-1, and vascular endothelial growth factor (VEGF) in skin. Neither HIF-1alpha, GLUT-1, PGK-1, nor VEGF mRNA was detectable in unwounded nontransgenic skin. In epidermal carcinogenesis, HIF-1alpha, GLUT-1, PGK-1, and VEGF mRNAs were just detectable in early-stage hyperplasia, markedly increased in high-grade epidermal chest dysplasias, and further increased in invasive squamous carcinomas. In neoplastic skin, HIF-1alpha, GLUT-1, and PGK-1 mRNAs localized in the basal and immediate suprabasal epidermal layers, whereas VEGF mRNA was predominantly expressed in the more superior spinous and granular epidermal layers. Immediately after wounding, HIF-1alpha, GLUT-1, and PGK-1 mRNAs were detectable in basal keratinocytes at the wound edge. Expression of all three genes increased to maximum levels in reepithelializing basal keratinocytes and then diminished to near undetectable levels after wound epithelialization. Although VEGF mRNA similarly increased and decreased during wound healing, its expression pattern was more punctate; the most intense hybridization signals were detected in the upper spinous and granular layers of reepithelializing keratinocytes and in dermal cells morphologically similar to macrophages. These data suggest stage-specific and spatio-temporal control of HIF-1alpha and HIF-1 target gene expression in both multistage epithelial carcinogenesis and wound healing.

Voxel-Based Morphometry and fMRI Revealed Differences in Brain Gray Matter in Breastfed and Milk Formula-Fed Children.

BACKGROUND AND PURPOSE: Infant diets may have significant impact on brain development in children. The aim of this study was to evaluate brain gray matter structure and function in 8-year-old children who were predominantly breastfed or fed cow's milk formula as infants. MATERIALS AND METHODS: Forty-two healthy children (breastfed: n = 22, 10 boys and 12 girls; cow's milk formula: n = 20, 10 boys and 10 girls) were studied by using structural MR imaging (3D T1-weighted imaging) and blood oxygen level-dependent fMRI (while performing tasks involving visual perception and language functions). They were also administered standardized tests evaluating intelligence (Reynolds Intellectual Assessment Scales) and language skills (Clinical Evaluation of Language Fundamentals). RESULTS: Total brain gray matter volume did not differ between the breastfed and cow's milk formula groups. However, breastfed children had significantly higher (P < .05, corrected) regional gray matter volume measured by voxel-based morphometry in the left inferior temporal lobe and left superior parietal lobe compared with cow's milk formula-fed children. Breastfed children showed significantly more brain activation in the right frontal and left/right temporal lobes on fMRI when processing the perception task and in the left temporal/occipital lobe when processing the visual language task than cow's milk formula-fed children. The imaging findings were associated with significantly better performance for breastfed than cow's milk formula-fed children on both tasks. CONCLUSIONS: Our findings indicated greater regional gray matter development and better regional gray matter function in breastfed than cow's milk formula-fed children at 8 years of age and suggested that infant diets may have long-term influences on brain development in children.

A relationship between anion transport and a structural transition of the human erythrocyte membrane.

Scanning microcalorimetry was employed as an aid in examining some structural features of the anion transport system in red blood cell vesicles. Two structural transitions were previously shown to be sensitive to several covalent and non-covalent inhibitors of anion transport in red cells. In this study, these transitions were selectively removed, either thermally or enzymatically, and the subsequent effect on 35SO2- 4 efflux in red cell vesicles was determined. It is shown that removal of one of these transitions (B2) has a negligible inhibitory effect on anion transport. Cytoplasmic, intermolecular disulfide linkages between band 3 dimers are known to form during the B2 transition. The integrity of the 4,4-diisothiocyanostilbene-2,2-disulfonate-sensitive C transition, on the other hand, is shown to be a requirement for anion transport. The localized region of the membrane giving rise to this transition contains the transmembrane segment of band 3, as well as membrane phospholipids. The calorimetric results suggest a structure of band 3 which involves independent structural domains, and are consistent with the transmembrane segment playing a direct role in the transport process.

An analytical model for the phase behavior of cholesteryl esters in intracellular inclusions.

The cholesteryl ester-rich, intracellular inclusions that characterize atherosclerotic plaque are capable of existing in a metastable, relatively fluid state for long periods of time. We have developed an analytical model which explains this metastability, and other aspects of the phase behavior, of physiologically relevant, phospholipid-stabilized dispersions of cholesteryl ester mixtures. The model, based on classical nucleation theory, incorporates temperature, time and lipid composition as independent variables. Differential scanning calorimetry was used to elucidate the model. The dispersions consisted of cholesteryl palmitate and an ester containing a long-chain, unsaturated or polyunsaturated, fatty acid. When a dispersion of approx. 1-microns droplets is melted, then cooled, crystallization is preceded by the formation of small crystalline nuclei (homogeneous nucleation). Nucleation is energetically unfavorable until (typically) well below the melting point. sigma, the tension between the surface of the crystal nucleus and surrounding fluid, is a measure of the difficulty in forming nuclei. This parameter was found to increase with the content of unsaturated ester. sigma was found to increase with increasing triacylglycerol content, and to decrease upon addition of free cholesterol.

The effects of anion transport inhibitors on structural transitions in erythrocyte membranes.

Red blood cell membranes have been labeled with several covalent and noncovalent inhibitors of anion transport and their heat capacity profiles determined as a function of temperature. Covalent inhibitors include the amino reactive agents 4,4'-diisothiocyanostilbene-2,2'-disulfonic acid, 4-acetamido-4'-isothiocyanostilbene-2,2'-disulfonic acid, pyridoxal phosphate and 1-fluoro-2,4-dinitro benzene. The non-covalent inhibitors include several well known local anesthetics. The study was underataken in order to identify regions of the membrane involved in anion transport. Covalent modification in all case resulted in a large upward shift of the C transition, which is beleived to involve a localized phospholipid region. Evidence is presented which indicates that Band III protein and this phospholipid region are in close physical proximity on the membrane. Addition of non-covalent inhibitors affects the membrane in either or both of two ways. In some cases, a lowering and broadening of the C transition occurs; in others the B1 and B2 transitions are altered. These latter transitions are beleived to involve both phospholipid and protein, including Band III. These results may indicate that the non-covalent inhibitors produce their inhibitory effect on anion transport at least in part by interacting with membrane phospholipid.

Evaluation and significance of tetracycline stability in rabies vaccine baits.

Tetracycline is widely used as a biomarker for bait consumption by wildlife; tetracycline is incorporated into bones and teeth and can be detected by fluorescence microscopy several weeks postconsumption. During 2003, the United States Department of Agriculture distributed more than 10 million tetracycline-containing rabies-vaccine baits to control the spread of wildlife vectored rabies to humans, pets, and livestock. To estimate the percentage of target species consuming the baits, raccoons and skunks were collected in baited areas and teeth were analyzed for the presence of the biomarker. Several incidents of low biomarker detection rates prompted an investigation of the stability of the biomarker in the baits. Baits were collected at several points along the manufacturing and distribution chain. Baits were analyzed for free and polymer-bound tetracycline and the less active isomer epitetracycline. Results indicated that a portion of the tetracycline was converted to epitetracycline. Additionally, significant quantities of both compounds were trapped in the polymer, which is homogeneously distributed throughout the bait. The results of this study suggest that approximately 40% of the target quantity of tetracycline was unavailable for absorption. This situation could contribute to low biomarker detection rates and suggests that formulation modification should be considered.

Citric acid improves phytate phosphorus utilization in crossbred and commercial broiler chicks.

Previous research in our laboratory has shown that citric acid (CA) improves phytate P utilization in New Hampshire x Columbian (NHC) crossbred chicks fed a P-deficient corn-soybean meal diet. The current study was conducted to determine if CA is also effective in commercial broiler chicks (Ross x Ross). In 3 experiments, 4 replicate groups of 5 male NHC chicks and male commercial chicks were fed corn-soybean meal diets varying in CA and nonphytate P (NPP) from 8 to 22 d of age. In experiment 1, a 2 x 2 x 2 factorial treatment arrangement was used to evaluate the effect of 2 levels of CA (0 and 3%) and NPP (0.13 and 0.28%) in NHC chicks and commercial chicks. The commercial chicks, but not the NHC chicks, fed the 0.13% NPP diet had to be removed from the experiment after 3 to 5 d due to very poor growth and severe leg problems. Chick weight gain and tibia ash were significantly increased (P < 0.05) by CA in both types of chicks. In experiment 2, the same 2 x 2 x 2 factorial treatment arrangement was again used except that the NPP levels were 0.18 and 0.28%. Tibia ash was increased significantly (P < 0.05) with the addition of CA in both breeds of chicks; response was greater at 0.18% NPP than at 0.28% NPP. In experiment 3, graded levels of CA (0, 1, 2, 3, and 4%) were evaluated in commercial chicks fed diets containing 0.18% NPP. Tibia ash increased linearly (P < 0.05) as CA increased from 0 to 4%. The average increase in bone ash resulting from 3% CA supplementation in experiments 2 and 3 was 41%. These results indicate that CA markedly improved phytate P utilization in NHC and Ross x Ross commercial broiler chicks.

Hy-Line W-36 and Hy-Line W-98 laying hens respond similarly to dietary phosphorus levels.

Two experiments were conducted to determine if 2 laying hen strains, Hy-Line W-36 and Hy-Line W-98, would respond similarly to being fed corn-soybean meal diets (17% CP and 3.8% Ca) deficient in nonphytate P (NPP). In experiment 1, 3 diets with varying NPP levels (0.10, 0.14, and 0.45%) were fed to 6 replicate groups of 12 hens of each Hy-Line strain from 20 to 50 wk of age. Body weight, egg weight, egg mass, feed intake, and NPP intake were higher for W-98 hens compared with W-36 hens throughout the 30-wk period. The 0.10% NPP dietary treatment was terminated for both strains at 35 wk of age due to similar low egg production. Within each strain, there was no significant difference in egg production performance for hens fed 0.14% NPP compared with hens fed 0.45% NPP. In experiment 2,3 diets with varying levels of NPP (0.10, 0.13, and 0.45%) were fed to 5 replicate groups of 12 hens of each Hy-Line strain from 95 to 112 wk of age. The 0.10% NPP treatment rapidly and severely depressed egg production and was terminated at 99 wk of age for both strains. In addition, egg production and egg mass were depressed similarly in both strains fed 0.13% NPP. In conclusion, this research indicates that Hy-Line W-36 and Hy-Line W-98 hens responded similarly to dietary NPP deficiency, suggesting that both strains have similar NPP requirements.

Surgical management of head and neck cancer.

The management of advanced carcinoma of the head and neck excluding thyroid carcinoma requires a combination of operation and radiation therapy to give the patient the best chance of cure. It is not appropriate to try to extirpate advanced squamous cell carcinoma by operation alone. There is evidence that postoperative radiation therapy is more effective in local regional control at least in certain sites than preoperative radiation therapy and there is better patient acceptance of the treatment plan in which the radiation therapy is administered after the operation.

Randomized study of preoperative versus postoperative radiation therapy in advanced head and neck carcinoma: long-term follow-up of RTOG study 73-03.

This is a report of a 10-year median follow-up of a randomized, prospective study investigating the optimal sequencing of radiation therapy (RT) in relation to surgery for operable advanced head and neck cancer. In May 1973, the Radiation Therapy Oncology Group (RTOG) began a Phase III study of preoperative radiation therapy (50.0 Gy) versus postoperative radiation therapy (60.0 Gy) for supraglottic larynx and hypopharynx primaries. Of 277 evaluable patients, duration of follow-up is 9-15 years, with 7.6% patients lost to follow-up before 7 years. Loco-regional control was significantly better for 141 postoperative radiation therapy patients than for 136 preoperative radiation therapy patients (p = 0.04), but absolute survival was not affected (p = 0.15). When the analysis was restricted to supraglottic larynx primaries (60 postoperative radiation therapy patients versus 58 preoperative radiation therapy patients), the difference for loco-regional control was highly significant (p = .007), but not for survival (p = 0.18). In considering only supraglottic larynx, 78% of loco-regional failures occurred in the first 2 years. Thirty-one percent (18/58) of preoperative patients failed locally within 2 years versus 18% (11/60) of postoperative patients. After 2 years, distant metastases and second primaries became the predominant failure pattern, especially in postoperative radiation therapy patients. This shift in the late failure pattern along with the increased number of unrelated deaths negated any advantage in absolute survival for postoperative radiation therapy patients. The rates of severe surgical and radiation therapy complications were similar between the two arms. Because of an increased incidence of late distant metastases and secondary primaries, additional therapeutic intervention is required beyond surgery and postoperative irradiation to impact significantly upon survival.

Preventing mental retardation associated with gross obesity in the Prader-Willi syndrome.

Twenty-seven patients with Prader-Willi syndrome have been described, ten of whom did not receive comprehensive management, nine who were diagnosed and treated after becoming obese, and eight who were diagnosed in infancy and responded to early preventative treatment. Intelligence scores declined in the first two groups, but the group receiving early treatment maintained a mean IQ score 20 points higher than the other two. Even though the underlying mechanism of this disorder remains undefined, a comprehensive early intervention program appears to improve prognosis.

Integration of soft signs in academically normal and academically at-risk children.

The development of motor and sensory proficiency and the integration of soft signs were analyzed for 38 children with average achievement and 29 children achieving below grade level. Motor coordination, speed, and inhibition, as well as the development of sensory function, were evaluated at the time of entrance to kindergarten and again during the first grade. The performance of both groups progressed on tasks measuring motor speed and coordination as well as tactile integration. Although the children achieving below grade level continued to perform the majority of tasks poorly in comparison with the children performing at grade level, on most of the measures they evidenced definite catch-up or greater gain than the children performing at grade level. Their progress on the motor speed and coordination tasks supports the hypothesis of a developmental lag in these areas. Results of tests of motor inhibition were notable for an absence of progression. That children achieving below grade level did not advance in this area would argue against the hypothesis of a developmental lag for all soft signs. Although results of this longitudinal study are preliminary, findings to date would allow for the possibility that both deficits and lags are responsible for the differences between the academically normal and academically at-risk children.