Patterns of concomitant traumatic brain injury and ocular trauma in US service members.

Background: Concomitant traumatic brain injury (TBI) and ocular trauma (OT) are caused by the same physical mechanisms, which may complicate therapeutic intervention if screening and evaluation of each condition are not promptly initiated. The aim of this study is to identify concomitant TBI in OT patients and characterize the pattern of those injured service members (SMs) in non-combat environments to assist in the early detection and treatment of both TBI and OT. Methods: Encounters matching the case definitions of TBI and OT for injured SMs were extracted from the Military Health System. Concomitant TBI and OT was identified as patients who were diagnosed with both medical conditions within 30 days. Incidence rates of concomitance were analyzed using a Poisson regression model. The odds of mechanisms and types of OT with concomitant TBI were analyzed using logistic regression models. Results: From 2017 to 2021, there were 71 689 SMs diagnosed with TBI, and 69 358 patients diagnosed with OT. There were 3251 concomitant cases identified. The overall concomitance rate in OT patients was 4.7%. Clinical presentations of concomitant OT had a higher rate of complications. Blast, transport accidents, assaults, alcohol, falls, and sports-related injuries (in decreasing order) were significantly associated with concomitance rates. Compared with closed globe injuries, OT with orbital fractures, rupture, laceration, adnexal periocular injury, and penetrating injury had higher risks of concomitant TBI. For patients with orbital fractures, nearly half (44.1%) sustained a concomitant TBI. Conclusions: A practical approach using temporal proximity of diagnostic data was developed to identify concomitant cases of TBI and OT which presented with more severe injury types than non-concomitant cases. These results indicate OT patients with orbital or open globe injuries sustained from high-impact mechanisms warrant further TBI screening to prompt early detection and treatment. Level of evidence: IV.

The Risk of Sympathetic Ophthalmia Associated with Open-Globe Injury Management Strategies: A Meta-analysis.

TOPIC: Sympathetic ophthalmia (SO) is a sight-threatening granulomatous panuveitis caused by a sensitizing event. Primary enucleation or primary evisceration, versus primary repair, as a risk management strategy after open-globe injury (OGI) remains controversial. CLINICAL RELEVANCE: This systematic review was conducted to report the incidence of SO after primary repair compared with that of after primary enucleation or primary evisceration. This enabled the reporting of an estimated number needed to treat. METHODS: Five journal databases were searched. This review was registered with International Prospective Register of Systematic Reviews (identifier, CRD42021262616). Searches were carried out on June 29, 2021, and were updated on December 10, 2022. Prospective or retrospective studies that reported outcomes (including SO or lack of SO) in a patient population who underwent either primary repair and primary enucleation or primary evisceration were included. A systematic review and meta-analysis were carried out in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Random effects modelling was used to estimate pooled SO rates and absolute risk reduction (ARR). RESULTS: Eight studies reporting SO as an outcome were included in total. The included studies contained 7500 patients and 7635 OGIs. In total, 7620 OGIs met the criteria for inclusion in this analysis; SO developed in 21 patients with OGI. When all included studies were pooled, the estimated SO rate was 0.12% (95% confidence interval [CI], 0.00%-0.25%) after OGI. Of 779 patients who underwent primary enucleation or primary evisceration, no SO cases were reported, resulting in a pooled SO estimate of 0.05% (95% CI, 0.00%-0.21%). For primary repair, the pooled estimate of SO rate was 0.15% (95% CI, 0.00%-0.33%). The ARR using a random effects model was -0.0010 (in favour of eye removal; 95% CI, -0.0031 [in favor of eye removal] to 0.0011 [in favor of primary repair]). Grading of Recommendations, Assessment, Development, and Evaluations analysis highlighted a low certainty of evidence because the included studies were observational, and a risk of bias resulted from missing data. DISCUSSION: Based on the available data, no evidence exists that primary enucleation or primary evisceration reduce the risk of secondary SO. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Prevalence and Clinical Impact of Respiratory Viral Infections from the STOP2 Study of Cystic Fibrosis Pulmonary Exacerbations.

Rationale: Rates of viral respiratory infection (VRI) are similar in people with cystic fibrosis (CF) and the general population; however, the associations between VRI and CF pulmonary exacerbations (PEx) require further elucidation.Objectives: To determine VRI prevalence during CF PEx and evaluate associations between VRI, clinical presentation, and treatment response.Methods: The STOP2 (Standardized Treatment of Pulmonary Exacerbations II) study was a multicenter randomized trial to evaluate different durations of intravenous antibiotic therapy for PEx. In this ancillary study, participant sputum samples from up to three study visits were tested for respiratory viruses using multiplex polymerase chain reactions. Baselines and treatment-associated changes in mean lung function (percent predicted forced expiratory volume in 1 s), respiratory symptoms (Chronic Respiratory Infection Symptom Score), weight, and C-reactive protein were compared as a function of virus detection. Odds of PEx retreatment within 30 days and future PEx hazard were modeled by logistic and Cox proportional hazards regression, respectively.Results: A total of 1,254 sputum samples from 621 study participants were analyzed. One or more respiratory viruses were detected in sputum samples from 245 participants (39.5%). Virus-positive participants were more likely to be receiving CF transmembrane conductance regulator modulator therapy (45% vs. 34%) and/or chronic azithromycin therapy (54% vs. 44%) and more likely to have received treatment for nontuberculous Mycobacterium infection in the preceding 2 years (7% vs. 3%). At study visit 1, virus-positive participants were more symptomatic (mean Chronic Respiratory Infection Symptom Score, 53.8 vs. 51.1), had evidence of greater systemic inflammation (log10 C-reactive protein concentration, 1.32 log10 mg/L vs. 1.23 log10 mg/L), and had a greater drop in percent predicted forced expiratory volume in 1 second from the prior 6-month baseline (5.8 vs. 3.6). Virus positivity was associated with reduced risk of future PEx (hazard ratio, 0.82; 95% confidence interval, 0.69-0.99; P = 0.034) and longer median time to next PEx (255 d vs. 172 d; P = 0.021) compared with virus negativity.Conclusions: More than one-third of STOP2 participants treated for a PEx had a positive test result for a respiratory virus with more symptomatic initial presentation compared with virus-negative participants, but favorable long-term outcomes. More refined phenotyping of PEx, taking VRIs into account, may aid in optimizing personalized management of PEx.Clinical trial registered with www.clinicaltrials.gov (NCT02781610).

The Use of Preoperative Prophylactic Systemic Antibiotics for the Prevention of Endopthalmitis in Open Globe Injuries: A Meta-Analysis.

TOPIC: This study reports the effect of systemic prophylactic antibiotics (and their route) on the risk of endophthalmitis after open globe injury (OGI). CLINICAL RELEVANCE: Endophthalmitis is a major complication of OGI; it can lead to rapid sight loss in the affected eye. The administration of systemic antibiotic prophylaxis is common practice in some health care systems, although there is no consensus on their use. METHODS: PubMed, CENTRAL, Web of Science, CINAHL, and Embase were searched. This was completed July 6, 2021 and updated December 10, 2022. We included randomized and nonrandomized prospective studies which reported the rate of post-OGI endophthalmitis when systemic preoperative antibiotic prophylaxis (via the oral or IV route) was given. The Cochrane Risk of Bias tool and ROBINS-I tool were used for assessing the risk of bias. Where meta-analysis was performed, results were reported as an odds ratio. PROSPERO registration: CRD42021271271. RESULTS: Three studies were included. One prospective observational study compared outcomes of patients who had received systemic or no systemic preoperative antibiotics. The endophthalmitis rates reported were 3.75% and 4.91% in the systemic and no systemic preoperative antibiotics groups, a nonsignificant difference (P = 0.68). Two randomized controlled trials were included (1555 patients). The rates of endophthalmitis were 17 events in 751 patients (2.26%) and 17 events in 804 patients (2.11%) in the oral antibiotics and IV (± oral) antibiotics groups, respectively. Meta-analysis demonstrated no significant differences between groups (odds ratio, 1.07; 95% confidence interval, 0.54-2.12). CONCLUSIONS: The incidences of endophthalmitis after OGI were low with and without systemic antibiotic prophylaxis, although high-risk cases were excluded in the included studies. When antibiotic prophylaxis is considered, there is moderate evidence that oral antibiotic administration is noninferior to IV. FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Comparative study of four SARS-CoV-2 Nucleic Acid Amplification Test (NAAT) platforms demonstrates that ID NOW performance is impaired substantially by patient and specimen type.

The COVID-19 pandemic in the United States created a unique situation where multiple molecular SARS-CoV-2 diagnostic assays rapidly received Emergency Use Authorization by the FDA and were validated by laboratories and utilized clinically, all within a period of a few weeks. We compared the performance of four of these assays that were evaluated for use at our institution: Abbott RealTime m2000 SARS-CoV-2 Assay, DiaSorin Simplexa COVID-19 Direct, Cepheid Xpert Xpress SARS-CoV-2, and Abbott ID NOW COVID-19. Nasopharyngeal and nasal specimens were collected from 88 ED and hospital-admitted patients and tested by the four methods in parallel to compare performance. ID NOW performance stood out as significantly worse than the other 3 assays despite demonstrating comparable analytic sensitivity. Further study determined that the use of a nasal swab compared to a nylon flocked nasopharyngeal swab, as well as use in a population chronically vs. acutely positive for SARS-CoV-2, were substantial factors.

Outcomes Associated With Concurrent Iris-Sutured Intraocular Lens Placement and Subluxated Crystalline Lens Extraction.

IMPORTANCE: We have developed a novel surgical technique, to our knowledge, for the management of subluxated crystalline lenses involving preplacement of an iris-sutured posterior chamber intraocular lens (PCIOL) before pars plana vitrectomy and lensectomy. OBJECTIVE: To investigate the outcomes of eyes with subluxated crystalline lenses, predominantly a result of Marfan syndrome (14 eyes [58%]) or trauma (5 eyes [21%]), that underwent pars plana vitrectomy and lensectomy with placement of an iris-sutured PCIOL. DESIGN, SETTING, AND PARTICIPANTS: We performed a retrospective, noncomparative case series of 24 eyes from 17 consecutive adult patients with surgically treated subluxated crystalline lenses presenting to the Wilmer Eye Institute at Johns Hopkins Hospital from October 6, 2006, through May 1, 2013. The mean (SD) postoperative follow-up was 24.4 (20.5) months for eyes with at least 6 months of follow-up (last date, October 13, 2014). We performed the analysis from January 21, 2014, through January 3, 2015. MAIN OUTCOMES AND MEASURES: Improvement in best-corrected visual acuity using an automated Snellen chart and induction of astigmatism for eyes with at least 6 months of follow-up (n = 18) and IOL stability during follow-up for all eyes (n = 24). RESULTS: The mean (SD) age at surgery was 49.4 (10.7 [range, 29-67]) years. We found an improvement in mean (SD [95% CI]) best-corrected visual acuity from 0.66 (0.71 [0.30-1.02]) logMAR preoperatively (Snellen equivalent, approximately 20/90; range, 20/30 to hand motions) to 0.07 (0.11 [95% CI, 0.01-0.12]) logMAR postoperatively (Snellen equivalent, approximately 20/23; range, 20/15 to 20/50). We found little change in astigmatism postoperatively (mean change, -0.1 [95% CI, -0.5 to 0.13] diopters). Postoperative complications included retinal detachment (1 eye [4%]), retained cortical fragment (1 [4%]), cystoid macular edema (2 [8%]), and IOL subluxation (3 [13%]) owing to haptic slippage within 3 months of the procedure. The overall probability of successfully achieving placement of a centered iris-sutured PCIOL in patients with follow-up of longer than 6 months (n = 18) was 100% (95% CI, 81.5%-100%). CONCLUSIONS AND RELEVANCE: Placement of iris-sutured PCIOLs at the time of subluxated lens extraction with a pars plana surgical approach yields favorable results in terms of postoperative visual outcomes and surgical complications. This technique offers an effective procedure for surgeons to use when treating clinically significant subluxated crystalline lenses.

Refractive surgery policy and its effect on visual acuity qualification rates for the 2004 and 2011 Army ROTC flight applicant pools.

OBJECTIVES: The goal of this study was to ascertain the effect of recent U.S. Army Aviation corneal refractive surgery (CRS) policy changes on the size of flight school applicant pools by comparing statistics from the 2004 and 2011 Warrior Forge Army Reserve Officers' Training Corps training camps. METHODS: A retrospective chart review was performed using the United States Army Aeromedical Activity's Aeromedical Electronic Resource Online database. RESULTS: Of the 607 applicants from 2004, 100 (16%) were disqualified for decreased visual acuity and had refractive errors correctable by CRS. Thirty-four cadets (6%) had prior CRS, and 21 qualified for flight school in 2004. Of the 625 applicants from 2011, 105 (17%) were disqualified for decreased visual acuity and had correctable refractive errors. Sixty-four applicants (10%) had prior CRS, and 54 subsequently qualified in 2011. CONCLUSIONS: Changes to Army Aviation CRS policy over the last decade have been associated with an increased number of initial flight applicants who now meet visual acuity standards. However, only a small percentage is using this resource. Army Aviation has the potential to significantly widen its applicant pool if more candidates are made aware of accepted CRS techniques that can help them to meet rigorous vision standards.

Orbital Rosai-Dorfman disease: a literature review.

INTRODUCTION: Rosai-Dorfman disease (RDD) is a rare histiocytic proliferative disorder with a predilection for the head and neck. Isolated orbital involvement without systemic clinical features is very uncommon. BACKGROUND: Classic histopathologic features include phagocytized but intact lymphocytes within large histiocytes; a conditioned termed emperipolesis. Immunohistochemical stains are strongly positive for S-100 and CD68 but negative for CD1a in most cases. Orbital cases are often amenable to complete surgical resection. CONCLUSION: RDD should be considered in the differential diagnosis of a young patient in good health who presents with a marked but benign enlargement of an orbital mass. A review of the literature regarding this disease entity and its orbital manifestations is discussed.

Smokeless tobacco use among military flight personnel: a survey of 543 aviators.

INTRODUCTION: Although there has been a steady decline in smoking rates among adults in the United States in recent years, the consumption of smokeless tobacco (ST) continues to increase. Moreover, ST use in the U.S. military is far higher than in the general population. This study was designed to determine the extent of ST use in a military aviation population and measure users' attitudes toward elements of a proposed cessation program. METHODS: A study was conducted at two naval aviation training wings in western Florida. The target population (N=2233) included flight instructors, students, and staff/support personnel who were rated aviators or flight officers. A total of 543 usable questionnaires were returned, yielding a response rate of 24.3%. RESULTS: There were 71 respondents who reported using ST in the last 30 d (13.1%). This group responded favorably to questions regarding the involvement of both medical and dental health professionals as critical components of an effective ST cessation program. DISCUSSION: This survey provides evidence for a rate of ST use among military aviators that is much higher than the U.S. national civilian average of 3.5%. Drawing upon the background of previous dental health-based studies, we propose augmenting existing tobacco cessation resources by creating separate ST cessation programs to reduce ST use among U.S. military aviators.

Unusual infection in the foot of a barefoot gardener.

We report a case of an unusual and unsuspected chronic infection creating a soft-tissue mass in the foot of a 35-year-old woman. The causative agent, Mycobacterium gordonae, is usually encountered as a laboratory contaminant. Only rarely does it manifest as a clinical infection. The patient's presumed predisposing risk factor was a history of barefoot gardening. An iatrogenic source, corticosteroid injections, was also considered.

Specific adsorption of histidine-tagged proteins on silica surfaces modified with Ni2+/NTA-derivatized poly(ethylene glycol).

Silica surfaces modified with nitrilotriacetic acid (NTA)-polyethylene glycol (PEG) derivatives were used to immobilize hexahistidine-tagged green fluorescent protein (His6-GFP), biotin/streptavidin-AlexaFluor555 (His6-biotin/SA-AF), and gramicidin A-containing vesicles (His6-gA). Three types of surface-reactive PEG derivatives-NTA-PEG3400-Si(OMe)3, NTA-PEG3400-vinylsulfone, and mPEG5000-Si(OMe)3 (control)-were grafted onto silica and tested for their ability to capture His6-tag species via His6/Ni2+/NTA chelation. The composition and thicknesses of the PEG-modified surfaces were characterized using X-ray photoelectron spectroscopy, contact angle, and ellipsometry. Protein capture efficiencies of the NTA-PEG-grafted surfaces were evaluated by measuring fluorescence intensities of these surfaces after exposure to His6-tag species. XPS and ellipsometry data indicate that surface adsorption occurs via specific interactions between the His6-tag and the Ni2+/NTA-PEG-grafted surface. Protein immobilization was most effective for NTA-PEG3400-Si(OMe)3-modified surfaces, with maximal areal densities achieved at 45 pmol/cm2 for His6-GFP and 95 fmol/cm2 for His6-biotin/SA-AF. Lipid vesicles containing His6-gA in a 1:375 gA/lipid ratio could also be immobilized on Ni2+/NTA-PEG3400-Si(OMe)3-modified surfaces at 0.5 mM total lipid. Our results suggest that NTA-PEG-Si(OMe)3 conjugates may be useful tools for immobilizing His6-tag proteins on solid surfaces to produce protein-functionalized surfaces.

The role of aeronautical adaptability in the disqualification of a military flyer.

INTRODUCTION: Possessing a stable personality plays a critical role in crew coordination, mission completion, and safety of flight in aviation. Presented is a naval flight officer whose personality traits were a threat to these key tenets and ultimately warranted removal from flight status. CASE REPORT: A naval flight officer was twice referred to Human Factors Boards (HFBs) after concerns were raised about her emotional stability in and out of the cockpit. Her history revealed multiple clinical presentations revealing personality characteristics that should have raised immediate concern about her aeronautical adaptability. Formal psychiatric evaluation after her second HFB confirmed the presence of personality traits incompatible with aviation duty, but not until she had served nearly 4 yrs. as an aviation officer. DISCUSSION: Aeronautical adaptability is a U.S. Naval term used to describe an individual's ability to work successfully in the aviation environment. Naval aviation personnel are considered not aeronautically adaptable/adapted if diagnosed with a "personality disorder or prominent personality traits that adversely affect flight safety, mission completion, or crew coordination". The Federal Aviation Administration, the U.S. Air Force, and the U.S. Army endorse similar concepts. Except for the U.S. Navy definition, aeronautical adaptability does not include formal DSM-IV-TR diagnoses, and, thus, flight surgeons and aviation medical examiners often make difficult aeromedical dispositions based on vague and subjective criteria. CONCLUSIONS: Determining aeronautical adaptability is not a simple, solitary process. It requires heightened suspicion, continual surveillance of suspect aviators, and collaboration from aviation medical professionals to ensure aviation safety.

Sjögren-Larsson syndrome: a case report and literature review.

Sjögren-Larsson syndrome (SLS) is an autosomal recessive neurocutaneous disorder most commonly seen in the Scandinavian population and characterized by congenital ichthyosis, mental retardation, and spastic diplegia or quadriplegia. We report a case of SLS in an 11-month-old girl of Lebanese and Mexican-Syrian ancestry who presented with ichthyosis, developmental delay, and spasticity. Results of an enzymatic assay and genomic DNA testing in cultured skin fibroblasts confirmed a homozygous C237Y mutation. These findings support the rich diversity of mutations associated with this syndrome.

Split treatment of photodamaged skin with KTP 532 nm laser with 10 mm handpiece versus IPL: a cheek-to-cheek comparison.

BACKGROUND AND OBJECTIVES: The treatment of photodamaged skin with potassium-titanyl-phosphate (KTP) laser and intense pulsed light (IPL) has been reported in several studies. Each device has strengths and weaknesses; however, patient and device variability have made it difficult to ascertain the optimal device for photorejuvenation. The objective of this study was to obtain a head-to-head comparison of IPL and KTP laser for photorejuvenation. Each patient received one KTP laser treatment on one side of the face and one IPL treatment on the other side. STUDY DESIGN/MATERIALS AND METHODS: Seventeen patients with skin types I-IV were accepted into the study based on existence of dyschromias (pigmented and vascular) and/or discrete telangiectases. After performance of test spots on each patient to determine optimal settings for both devices, patients were treated with both devices in a split face manner. Evaluations and photographs were performed 1 week and 1 month after treatment. Patient and observer evaluations of results were recorded, as well as time to perform each treatment, and patient feedback with regard to pain and edema. No anesthesia was used in these treatments. Photographs were reviewed by a panel of blinded observers to assess changes in red and brown dyschromias. RESULTS: One month average improvement (evaluator) for IPL side was (mean) 38.16%/35.08% for vascular/pigment lesions versus 41.99%/30.21% for KTP side. Patient self-evaluated global improvement at 1 month was (mean) 65.59% for IPL side versus 60.88% for KTP side. A majority of patients found the KTP to be slightly more painful with a mean pain rating of 5.27 of 10 versus 4.4 of 10 for IPL. A majority of patients experienced subjectively greater post-procedure swelling on the KTP side. Time to conduct treatment was an average of 10.0 minutes for IPL, 8.7 minutes for KTP. CONCLUSIONS: Both large spot KTP and IPL achieved marked improvement in vascular and pigmented lesions in one session. The KTP laser caused slightly more discomfort and edema than the IPL. On the other hand, the KTP laser was faster, and more ergonomically flexible.

Crash protection of stock car racing drivers--application of biomechanical analysis of Indy car crash research.

Biomechanical analysis of Indy car crashes using on-board impact recorders (Melvin et al. 1998, Melvin et al. 2001) indicates that Indy car driver protection in high-energy crashes can be achieved in frontal, side, and rear crashes with severities in the range of 100 to 135 G peak deceleration and velocity changes in the range of 50 to 70 mph. These crashes were predominantly single-car impacts with the rigid concrete walls of oval tracks. This impressive level of protection was found to be due to the unique combination of a very supportive and tight-fitting cockpit-seating package, a six-point belt restraint system, and effective head padding with an extremely strong chassis that defines the seat and cockpit of a modern Indy car. In 2000 and 2001, a series of fatal crashes in stock car racing created great concern for improving the crash protection for drivers in those racecars. Unlike the Indy car, the typical racing stock car features a more spacious driver cockpit due to its resemblance to the shape of a passenger car. The typical racing seat used in stock cars did not have the same configuration or support characteristics of the Indy car seat, and five-point belt restraints were used. The tubular steel space frame chassis of a stock car also differs from an Indy car's composite chassis structure in both form and mechanical behavior. This paper describes the application of results of the biomechanical analysis of the Indy car crash studies to the unique requirements of stock car racing driver crash protection. Sled test and full-scale crash test data using both Hybrid III frontal crash anthropomorphic test devices (ATDs) and BioSID side crash ATDs for the purpose of evaluating countermeasures involving restraint systems, seats and head/neck restraints has been instrumental in guiding these developments. In addition, the development of deformable walls for oval tracks (the SAFER Barrier) is described as an adjunct to improved occupant restraint through control of the crash forces acting on a racing car. NASCAR (National Association for Stock Car Auto Racing, Inc) implemented crash recording in stock car racing in its three national series in 2002. Data from 2925 crashes from 2002 through the 2005 season are summarized in terms of crash severity, crash direction, injury outcome, and protective system performance.

Displacement of fibrinogen from the air/aqueous interface by dilauroylphosphatidylcholine lipid.

Fibrinogen (FB) and other serum proteins leak into the aqueous alveolar lining layer due to lung injuries. The adsorption of these serum proteins at the air/aqueous interface can produce higher surface tensions than the pulmonary lipids, and acute respiratory distress syndrome (ARDS) can ensue. By having a molecular adsorption mechanism, as compared to a particulate adsorption mechanism of other longer chain lipids, dilauroylphosphatidylcholine (DLPC) lipid can expel FB from the air/aqueous interface at 25 degrees C, in water or in phosphate-buffered saline, as proven by tensiometry (also at 37 degrees C), ellipsometry, and infrared reflection-absorption spectroscopy. Moreover, before FB is displaced by DLPC at the interface, there is a substantial initial enhancement in the FB adsorption, consistent with some interaction or binding of DLPC with FB to produce a more hydrophobic protein surface. After the FB molecules have been displaced by DLPC, or when DLPC has already adsorbed at the interface, FB molecules are less favored to adsorb near the DLPC monolayer with the lecithin headgroups facing toward them. The results have implications for possible uses of DLPC lipid in potential lung surfactant formulations in treating patients with ARDS.

Mechanisms of competitive adsorption of albumin and sodium myristate at the silicon oxide/aqueous interface.

The competitive adsorption of proteins and surfactants has applications to chromatographic systems and biological materials. Adsorption for systems of bovine serum albumin (BSA) and sodium myristate (SM) was investigated with in-situ ATR-IR spectroscopy and ex-situ ellipsometry. The results were used to determine quantitatively the surface densities of the adsorbates at the surface. For a mixture of SM and BSA at 25 degrees C in water, the adsorbed density of BSA is 0.3 mg/m2, which is much less than the value of 3.1 mg/m2 for BSA alone. Sodium myristate, some of which is protonated to myristic acid (MA) when adsorbed because of a pH decrease from 9.0 to 8.2, adsorbs to a surface density of 4.0 x 10(-6) mol/m2, which is greater than the value of 1.7 x 10(-6) mol/m2 from a solution of SM alone. Adsorbed SM and MA are removed, or desorbed, when the bulk mixture is replaced with water, with only a slight amount of SM remaining. When placed in contact with a layer of BSA, SM can displace most of the adsorbed protein, even when BSA is present in the bulk solution, with some BSA at 0.3 mg/m2 remaining adsorbed. Allowing BSA to adsorb to a layer of SM results in gamma(BSA) = 2.3 mg/m2, with little displacement of the SM layer. These results indicate that SM can remove some BSA from the surface by displacement, and that some BSA remains adsorbed in patches.

Health concerns regarding consumption of irradiated food.

Food irradiation is being promoted as a simple process that can be used to effectively and significantly reduce food-borne illnesses around the world. However, a thorough review of the literature reveals a paucity of adequate research conducted to specifically address health concerns that may directly result from the consumption of irradiated food. Consequently, there is considerable debate on the issue of health concerns from irradiated food among international agencies and between different nations. This report presents a critical review of scientific data and recommendations from different agencies and consumer groups. The objective of this review is to provide the scientific community and the general public with a balanced discussion on irradiated food from the viewpoint of an environmental or public health professional. As a result of this review, the authors conclude that current evidence does not exist to substantiate the support or unconditional endorsement of irradiation of food for consumption. In addition, consumers are entitled to their right of choice in the consumption of irradiated versus un-irradiated food. Different countries should further evaluate their local and global risks and benefits prior to developing and recommending national and international food irradiation policies.