Adsorbate dissociation due to heteromolecular electronic energy transfer from fluorobenzene thin films.

Study of the near-UV photodissociation dynamics for monolayer (ML) quantities of CH3I on thin films of a series of fluorobenzenes and benzene (1-25 ML) grown on a Cu(100) substrate finds that in addition to gas-phase-like neutral photodissociation, CH3I dissociation can be enhanced via electronic energy transfer to the CH3I following photoabsorption in several of the thin films studied. Distinct CH3 photofragment kinetic energy distributions are found for CH3I photodissociation on C6H5F, 1,4-C6H4F2 and C6H6 thin films, and distinguished from neutral photodissociation pathways using polarized incident light. The effective photodissociation cross section for CH3I on these thin films is increased as compared to that for the higher F-count fluorobenzene thin films due to the additional photodissociation pathway available. Quenching by the metal substrate of the photoexcitation via this new pathway suggests a significantly longer timescale for excitation than that of neutral CH3I photodissociation. The observations support a mechanism in which neutral photoexcitation in the thin film (i.e. an exciton) is transported to the interface with CH3I, and transfers the electronic excitation to the CH3I which then dissociates. The unimodal CH3 photofragment distribution and observed kinetic energies on the fluorobenzene thin films suggest that the dissociation occurs via the 3Q1 excited state of CH3I.

Increased risk of eosinophilic esophagitis with poor environmental quality as measured by the Environmental Quality Index.

Geographic differences in eosinophilic esophagitis (EoE) prevalence suggest the possibility that environmental exposures contribute to EoE pathogenesis. We aimed to examine the association between environmental quality and risk of EoE, using the Environmental Quality Index (EQI), which provides quantification of environmental quality in five domains: air, land, water, built, and sociodemographic for all counties in the United States. To do this, we performed a case-control study in a large pathology database. EoE cases were defined by ≥15 eosinophils per high-power field with other pathologic diagnoses excluded; controls did not have EoE. The pathology data were geocoded and linked with the EQI by county of residence. Logistic regression was used to estimate odds ratio (OR and 95% confidence interval [CI]) of EoE with overall EQI and for each domain, after adjusting for sex, age, and proportion minority race or ethnicity at the county level (higher EQI score indicates worse environmental quality). Of 29,802 EoE cases and 593,329 controls analyzed, odds of EoE were highest in the worst quintile of EQI (OR 1.25; 95% CI: 1.04-1.50), which was largely explained by poor scores in the water domain (OR: 1.33; 1.17-1.50). Conversely, odds of EoE were reduced with higher scores in the air domain (OR: 0.87, 0.74-1.03) and land domain (OR 0.87; 0.76-0.99). Poor EQI, mostly reflected by poor water quality, was associated with increased odds of EoE, while poor air and land quality were inversely associated with EoE. Additional work to identify specific water pollutants that may have an etiologic role in EoE may be warranted.

Laminar airflow decreases microbial air contamination compared with turbulent ventilated operating theatres during live total joint arthroplasty: a nationwide survey.

BACKGROUND: Preventing surgical site infections and prosthetic joint infections is crucial for patient safety after total joint arthroplasty. Microbial air contamination has been suggested as a risk factor. Therefore, the ventilation system that will reduce air contamination most effectively in operating theatres (OTs) has been discussed. AIM: To determine whether laminar airflow (LAF) ventilation is superior to turbulent airflow (TAF) ventilation by looking at the colony forming units (cfu) count during live total hip and knee arthroplasties. Furthermore, to explore whether the number of OT personnel, door and cabinet lock openings and technical parameters of the ventilation systems have an impact on the number of cfu. METHODS: Active air sampling and passive sedimented bacterial load were performed in 17 OTs, equipped with either LAF or TAF ventilation, during 51 live surgeries while observations were noted. FINDINGS: LAF OTs reduced cfu counts compared with TAF OTs during live surgery (P<0.001). All LAF OTs provided ultraclean air whereas TAF had nine procedures exceeding the threshold of 10 cfu/m3. Door and cabinet lock openings and number of personnel did not influence the cfu count, while it decreased with increasing volume and total air change per hour (P<0.05). CONCLUSION: All LAF OTs had cfu counts within recommendations and provided lower cfu counts compared with TAF OTs. The number of OT personnel and total openings did not have an influence on cfu counts. Increased volume of the OT and total air change per hour showed a decrease in active cfu counts.

Contrasting mechanisms for photodissociation of methyl halides adsorbed on thin films of C6H6 and C6F6.

The mechanisms for photodissociation of methyl halides (CH3X, X = Cl, Br, I) have been studied for these molecules when adsorbed on thin films of C6H6 or C6F6 on copper single crystals, using time-of-flight spectroscopy with 248 nm and 193 nm light. For CH3Cl and CH3Br monolayers adsorbed on C6H6, two photodissociation pathways can be identified - neutral photodissociation similar to the gas-phase, and a dissociative electron attachment (DEA) pathway due to photoelectrons from the metal. The same methyl halides adsorbed on a C6F6 thin film display only neutral photodissociation, with the DEA pathway entirely absent due to intermolecular quenching via a LUMO-derived electronic band in the C6F6 thin film. For CH3I adsorbed on a C6F6 thin film, illumination with 248 nm light results in CH3 photofragments departing due to neutral photodissociation via the A-band absorption. When CH3I monolayers on C6H6 thin films are illuminated at the same wavelength, additional new photodissociation pathways are observed that are due to absorption in the molecular film with energy transfer leading to dissociation of the CH3I molecules adsorbed on top. The proposed mechanism for this photodissociation is via a charge-transfer complex for the C6H6 layer and adsorbed CH3I.

Association between fear of hypoglycemia and physical activity in youth with type 1 diabetes: The SEARCH for diabetes in youth study.

BACKGROUND: Youth with type 1 diabetes (T1D) are encouraged to participate in physical activity (PA). Studies have identified fear of hypoglycemia (FOH) as a barrier to participating in PA. OBJECTIVES: To examine (a) PA patterns in youth with T1D by age group and (b) the relationship between both parental and youth FOH and youth PA. METHODS: A cross-sectional analysis from the SEARCH cohort study visit of youth ages 10 to 17 years with T1D (n = 1129) was conducted. Linear regression models estimated the association between self-reported number of days of vigorous PA (VPA) and moderate PA (MPA) and both youth- and parent-reported FOH. Multivariable models were adjusted for age, sex, race, duration of T1D, HbA1c, use of continuous glucose monitoring (CGM), recent severe hypoglycemia, primary insulin regimen, and BMI. RESULTS: Participants were 52% female, had mean (sd) age 14.4 (4.2) years, diabetes duration 7.5 years (1.8), HbA1c 9.2% (1.7). Older youth were less likely to engage in VPA (P < .01), or sports teams (P < .01), but more likely to engage in MPA (P < .01). Higher youth FOH (behavior subscale) was associated with increased levels of VPA (ß (se) 0.30 (0.11), P = .01) but not significantly associated with MPA (P = .06). There was no statistically significant association between parental FOH and youth PA. CONCLUSIONS: In SEARCH participants with T1D, VPA, and team sports participation declined with age, while MPA increased. We observed that higher scores on the youth FOH behavioral subscale were associated with increased VPA levels, suggesting that FOH may be less of a barrier to PA than previously thought.

Seasonal variation in detection of oesophageal eosinophilia and eosinophilic oesophagitis.

BACKGROUND: Seasonal variation has been reported in diagnosis of eosinophilic oesophagitis (EoE), but results are not consistent across studies and there are no national-level data in the USA. AIM: To determine if there is seasonal variation in diagnosis of oesophageal eosinophilia and EoE in the USA, while accounting for factors such as climate zone and geographic variation. METHODS: This was a cross-sectional study using a USA national pathology database. Patients with oesophageal eosinophilia (≥15 eosinophils per high-power field) comprised the primary case definition and were compared to those with normal oesophageal biopsies. We calculated the crude and adjusted odds of oesophageal eosinophilia by season, as well as by day of the year. Sensitivity analyses were performed using more restrictive case definitions of EoE, and after stratification by climate zone. RESULTS: Exactly, 14 524 cases with oesophageal eosinophilia and 90 459 normal controls were analysed. The adjusted odds of oesophageal eosinophilia were higher in the late spring and summer months, with the highest odds in July (aOR: 1.13; 95% CI: 1.03-1.24). These findings persisted with increasing levels of oesophageal eosinophilia, as well as across EoE case definitions. Seasonal variation was strongest in temperate and cold climates, and peak diagnosis varied by climate zone. CONCLUSIONS: There is a mild but consistent seasonal variation in the diagnosis of oesophageal eosinophilia and EoE, with cases more frequently diagnosed during summer months. These findings take into account climate and geographic differences, suggesting that aeroallergens may contribute to disease development or flare.

Excitation and quenching mechanisms in the near-UV photodissociation of CH3Br and CH3Cl adsorbed on D2O or CH3OH on Cu(110).

Photochemical processes for CH3X (X = Cl, Br, I) adsorbed on top of thin films of D2O or CH3OH on a Cu(110) substrate is studied by time-of-flight mass spectrometry for a range of UV wavelengths (351-193 nm). Photodissociation via dissociative electron attachment by photoelectrons and by neutral photodissociation is identified and quantified based on the observed dynamics of the desorbing CH3 fragments. Photoelectron-driven dissociation of CH3X is found to be a maximum for monolayer quantities of the D2O or CH3OH on Cu(110), but with differing kinetic energy release on the two substrates. The dynamics of CH3Br and CH3Cl photodissociation qualitatively differ on CH3OH/Cu(110) as compared to D2O/Cu(110), which is ascribed to differing molecular structures for these systems. Evidence is presented for an efficient inter-molecular quenching mechanism for neutral photoexcitation of CH3Cl and CH3Br on the CH3OH/Cu(110) substrate.

Hormonal contraceptive use before and after conception in relation to preterm birth and small for gestational age: an observational cohort study.

OBJECTIVE: To evaluate whether hormonal contraceptives, used before or in early pregnancy, confer increased risk of preterm birth or reduced fetal growth. DESIGN: Population-based cohort study conducted by the Norwegian Institute of Public Health (Mother and Child Cohort Study, 1998-2008) with linkage to the Norwegian Prescription Registry and to the Medical Birth Registry of Norway. SETTING: Norway. POPULATION: Of the 48,615 pregnancies meeting study inclusion criteria, 44,734 pregnancies were included in the complete case analysis. METHODS: We characterised hormonal contraception by type (combination oral, progestin-only oral, vaginal ring, transdermal, and injectable) and specific progestin component. We used generalised estimating equations to estimate the odds of adverse outcome according to formulation used. Several sensitivity analyses were conducted. MAIN OUTCOME MEASURES: Preterm birth, small for gestational age. RESULTS: We observed a positive association between use of a combination oral contraceptive and preterm birth for all exposure periods (e.g. adjusted odds ratio 1.21, 95% confidence interval 1.04-1.41 for last use 12 to >4 months before conception); combination contraceptives containing the progestin norethisterone were consistently related to risk. Other types of hormonal contraception were generally not associated with preterm birth; none were related to small for gestational age. Observed associations were robust to sensitivity analyses. CONCLUSION: Hormonally active agents may exert dose-, agent-, and timing-specific effects on growth and development. We found that the particular progestin component is important when assessing the potential for adverse effects among former users of hormonal contraceptives.

Maternal hormonal contraceptive use and offspring overweight or obesity.

BACKGROUND/OBJECTIVES: Experiments in animal models have shown a positive association between in utero exposure to pharmacologic sex hormones and offspring obesity. The developmental effects of such hormones on human obesity are unknown. SUBJECTS/METHODS: Using data from a large, prospective pregnancy cohort study (n=19 652), with linkage to a national prescription registry, we evaluated the association between use of hormonal contraceptives before and after conception (defined from dispensed prescription data and characterized by last date of use relative to conception, 12 to >4 months before (n=3392), 4 to >1 months before (n=2541), 1 to >0 months before (n=2997) and 0-12 weeks after (n=567)) in relation to offspring overweight or obesity at age 3 years. RESULTS: We observed a weak, inverse association between early pregnancy use of a combination oral contraceptive and offspring overweight or obesity at age 3 (adjusted odds ratio (OR): 0.75, 95% confidence interval (CI): 0.53, 1.08) and a positive, but imprecise, association with use of a progestin-only oral contraceptive in early pregnancy (adjusted OR: 1.26, 95% CI: 0.79, 2.02). In general, no association was observed between the use of a hormonal contraceptive before conception and offspring overweight or obesity. A sensitivity analysis comparing combination oral contraceptive users in early pregnancy to other unplanned pregnancies without hormonal contraceptive use further strengthened the inverse association (adjusted OR: 0.70, 95% CI: 0.48, 1.02). Other sensitivity analyses were conducted to evaluate the robustness of the associations observed given varying assumptions. CONCLUSIONS: Pharmacologic sex hormones in early pregnancy may be inversely or positively associated with offspring overweight or obesity at age 3, depending on the specific formulation used. The present study provides support for the potential for environmental sources of hormonally active agents to exert developmental effects.

Mechanisms for the near-UV photodissociation of CH3I on D2O/Cu(110).

The system of CH3I adsorbed on submonolayer, monolayer, and multilayer thin films of D2O on Cu(110) has been studied by measuring the time of flight (TOF) distributions of the desorbing CH3 fragments after photodissociation using linearly polarized λ = 248 nm light. For multilayer D2O films (2-120 ML), the photodissociation is dominated by neutral photodissociation via the "A-band" absorption of CH3I. The polarization and angle dependent variation in the observed TOF spectra of the CH3 photofragments find that dissociation is largely via the (3)Q0 excited state, but that also a contribution via the (1)Q1 excitation can be identified. The photodissociation results also indicate that the CH3I adsorbed on D2O forms close-packed islands at submonolayer coverages, with a mixture of C-I bond axis orientations. For monolayer and submonolayer quantities of D2O we have observed a contribution to CH3I photodissociation via dissociative electron attachment (DEA) by photoelectrons. The observed DEA is consistent with delocalized photoelectrons from the substrate causing the observed dissociation- we do not find evidence for an enhanced DEA mechanism via the temporary solvation of photoelectrons in localized states of the D2O ice.

Electron transfer reactions for image and image-derived states in dielectric thin films.

We have studied the cross section for electron trapping that occurs at the surfaces and interfaces of a variety of thin dielectric films (n-octane, methanol, n-butanol, and difluoromethane) that are grown on Kr buffer films. When such films are bombarded with electrons of very low incident energies (E less, similar 300 meV), charging cross sections up to the order of 10(-14) cm(2) are measured for submonolayer quantities of a variety of coadsorbed molecules: CH(3)I, CH(3)Br, CH(3)Cl, and CO(2). These huge cross sections are ascribed to the formation of image states at the dielectric film interfaces, which trap incoming electrons and, via coupling to the adsorbate electron affinity levels, dramatically enhance the capture probability. We have also shown that thin film dielectric layer structures can be created which display image-derived states, such as a "quantum well" in a sandwich structure with two "electron barrier" layers surrounding a Kr and adsorbate spacer film. These phenomena are shown to be of a general nature, occurring for a wide variety of molecular thin films, and depend on the dielectric constant and electron affinity of the selected species. We also report the absolute cross section for dissociative electron attachment of submonolayer CH(3)I adsorbed on Kr thin films.

Charge-transfer photodissociation of adsorbed molecules via electron image states.

The 248 and 193 nm photodissociations of submonolayer quantities of CH(3)Br and CH(3)I adsorbed on thin layers of n-hexane indicate that the dissociation is caused by dissociative electron attachment from subvacuum level photoelectrons created in the copper substrate. The characteristics of this photodissociation-translation energy distributions and coverage dependences show that the dissociation is mediated by an image potential state which temporarily traps the photoelectrons near the n-hexane-vacuum interface, and then the charge transfers from this image state to the affinity level of a coadsorbed halomethane which then dissociates.

Control of a methicillin-resistant Staphylococcus aureus (MRSA) outbreak in a day-care institution.

This article describes an outbreak of methicillin-resistant Staphylococcus aureus (MRSA) in two institutions for multi-handicapped children in Copenhagen. The aim of the study was to determine whether it was possible to eradicate MRSA in a setting with multi-handicapped children and staff where there was a high degree of physical interaction. This was a prospective interventional uncontrolled cohort study that took place from January 2003 to March 2005. All individuals in close contact with the two institutions and/or in close contact with an MRSA-colonized subject from the outbreak were included in the study: 38 children, 60 staff members and 12 close relatives of colonized subjects. Infection control measures included screening all individuals. When MRSA infection or colonization was found, an attempt was made to eradicate MRSA, staff education was undertaken and attempts were made to determine the route of transmission. Eleven individuals were found to be positive for MRSA (10.0%). All isolates were identical by pulsed-field gel electrophoresis and harboured the staphylococcal cassette chromosome mec (SCCmec) type IV. All colonized and infected individuals were associated with a single room in one of the institutions. MRSA was eradicated from all the colonized and infected subjects. This study shows that it is possible to control an MRSA outbreak in institutions for multi-handicapped children where there is a high degree of physical contact.

Near-UV photodissociation of oriented CH3I adsorbed on Cu(110)-I.

Methyl iodide adsorbed on a Cu(110)-I surface has been found to be highly orientationally ordered. We have exploited this orientation to select different CH(3)I excited states for photodissociation by using polarized near-UV light at wavelengths of 308, 248, and 222 nm. Using p-polarized light at all three wavelengths, we find that dissociation proceeds largely via the (3)Q(0) state, consistent with the picture from gas-phase photolysis. In contrast, using s-polarized light we find contributions from the (3)Q(1) state at lambda=308 nm, the (1)Q(1) state at lambda=248 nm, and the (E,1) state at lambda=222 nm-the latter being a state that has not been implicated in gas-phase studies of CH(3)I A-band photolysis. We also note the contribution to surface photodissociation from low-energy photoelectrons causing dissociative electron attachment to adsorbed CH(3)I and have identified the promotion of direct photodissociation pathways during lambda=308 nm photolysis.

Prevalence of and detection of resistance to ampicillin and other beta-lactam antibiotics in Haemophilus influenzae in Denmark.

The susceptibility of Haemophilus influenzae to penicillin V and G, ampicillin and cefuroxime was investigated by MIC, disc and tablet diffusion methods, using chocolate agar as test medium, to determine the prevalence of ampicillin-resistant isolates and the optimal method for their detection. Eighty-six isolates were clinical isolates collected prospectively from July to September 1998 and 22 isolates were clinical isolates with decreased susceptibility to ampicillin previously referred to the reference laboratory. Eighty-seven isolates were ampicillin-susceptible and 16 were ampicillin-resistant. Thirteen produced beta-lactamases. Among the consecutive isolates 12.8% were resistant. With each of the Rosco Neo-sensitabs containing penicillin G, 2.5 microg ampicillin and 33 microg ampicillin, 3 very major errors occurred (resistant isolates misinterpreted as susceptible) and 5-13 major errors (susceptible isolates misinterpreted as resistant). The AB biodisk containing ampicillin (10 microg) was superior to the penicillin V and G discs, i.e. only 1 very major error occurred and major and minor errors were infrequent. The cefuroxime disc identified 4/8 beta-lactamase-negative ampicillin-resistant isolates. Thus, for susceptibility testing with chocolate agar as test medium, the use of an inoculum of 10(5) colony-forming units, 10 microg ampicillin discs and interpretative zone diameters of > or = 28 mm indicating susceptibility and < or = 25 mm indicating resistance was found to produce reliable identification of ampicillin-resistant isolates of H. influenzae.

Epidemiology of Pseudomonas aeruginosa in cystic fibrosis and the possible role of contamination by dental equipment.

Cystic fibrosis (CF) patients often suffer from Pseudomonas aeruginosa lung infection yet the source of this organism is not known. In order to determine whether CF patients might be contaminated with P. aeruginosa from dental equipment, a total of 103 water samples from 25 dental sessions in Frederiksberg Municipal Oral Health Care Service were examined. Three samples (2.9%) were positive for P. aeruginosa. Three hundred and twenty-seven water samples from 82 dental sessions from various other Municipal Oral Health Services in Denmark, attended by CF patients, were also examined. Eighteen of 327 samples (5.5%) from nine sessions (11%) were positive for P. aeruginosa. In one case, genotypically identical (RFLP, pulsed-field gel electrophoresis) P. aeruginosa strains were found both in water from the dental equipment and in the CF patients sputum. This indicates a small risk for acquiring P. aeruginosa from dental sessions, which is however equal to the yearly 'natural background' incidence (1-2%) of acquisition of P. aeruginosa in our CF centre.

High levels of complement-activation capacity in sera from patients with cystic fibrosis correlate with high levels of IgG3 antibodies to Pseudomonas aeruginosa antigens and poor lung function.

Heat-stable opsonins from sera of cystic fibrosis (CF) patients were investigated for their ability to activate complement. Complement activation by Pseudomonas aeruginosa after opsonization with patient serum was examined in a complement-consumption assay. Absorption of patients' sera with formalin-treated and boiled bacteria removed specific antibodies and the complement activation decreased. We found a positive correlation between serum complement-activation ability and IgG3 antibody levels to lipopolysaccharide (LPS), alginate, and a crude mixture of P. aeruginosa antigens (sonicate) in a group of patients with high levels of anti-Pseudomonas precipitins. In the same group of patients a significant negative correlation was found between complement activation and lung function. Eighteen patients have been followed longitudinally with serum samples covering the pre-infection, the early, and the late stages of chronic infection. Patients with poor lung function showed significantly higher levels of complement-activation capacity. We conclude that patients with high levels of specific IgG3 antibodies are able to induce a high level of complement activation and then develop more aggressive pulmonary tissue damage, probably secondary to local immune complex formation.