195 research outputs found

    Cerebellar syndrome with meningoencephalitis due to Mycoplasma Pneumoniae

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    We report a 24-year-old woman with a Mycoplasma pneumonitis associated with subacute meningoencephalitis and acute cerebellitis that caused a cerebellar atrophy. Electroencephalogram showed diffuse dysfunction in the brain. There was few white blood cell but normal glucose and protein in the cerebrospinal fluid (CSF). Brain MRI showed bilateral atrophy of cerebellum

    Wastewater disposal and earthquake swarm activity at the southern end of the Central Valley, California

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    Fracture and fault zones can channel fluid flow and transmit injection-induced pore pressure changes over large distances (>km), at which seismicity is rarely suspected to be human induced. We use seismicity analysis and hydrogeological models to examine the role of seismically active faults in inducing earthquakes. We analyze a potentially injection-induced earthquake swarm with three events above M4 near the White Wolf fault (WWF). The swarm deviates from classic main aftershock behavior, exhibiting uncharacteristically low Gutenberg-Richter b of 0.6, and systematic migration patterns. Some smaller events occurred southeast of the WWF in an area of several disposal wells, one of which became active just 5 months before the main swarm activity. Hydrogeological modeling revealed that wastewater disposal likely contributed to seismicity via localized pressure increase along a seismically active fault. Our results suggest that induced seismicity may remain undetected in California without detailed analysis of local geologic setting, seismicity, and fluid diffusion

    Improvement of anaerobic digestion of sewage mixed sludge using free nitrous acid and Fenton pre-treatment

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    Background: Recently, it has been indicated that free nitrous acid (FNA) and Fenton pre-treatment of waste activated sludge can enhance methane production in anaerobic digestion of waste activated sludge. In addition, it has been revealed that the substances used in these pre-treatments are both eco-friendly and economically attractive because not only are they produced in anaerobic digestion, but they are also low priced. Since primary sludge and waste activated sludge are mixed prior to anaerobic digestion in the majority of wastewater treatment plants, this study aims to assess the influence of combined FNA and Fenton on the anaerobic digestion of mixed sludge. Results: According to this study's results, methane generation from anaerobic digestion of mixed sludge was enhanced when using FNA and Fenton pre-treatment, affirming the effectiveness of the individual and combined pre-treatments in anaerobic digestion of mixed sludge. The enhanced methane production was significant in combined pre-treatments (up to 72%), compared with FNA and Fenton pre-treatment alone (25% and 27%, respectively). This corroborates the positive synergistic effect of the combined pre-treatments on methane production. The enhanced methane can be attributed to augmented soluble fractions of organic matter in addition to increased readily biodegradable organic matter, caused by the pre-treatments. Additionally, the amount of chemical oxygen demand (COD) was assessed during anaerobic digestion, and it was revealed that COD decreased considerably when the pre-treatment strategies were combined. Conclusions: This study reveals that the pre-treatments are potentially applicable to full-scale wastewater treatment plants because a mixture of primary sludge and waste activated sludge was used for the pre-treatments. Additionally, combined FNA and Fenton pre-treatments prove more effective in enhancing methane production and organic removal than these pre-treatments alone. The enhanced methane pro

    Assessing the psychometric and ecometric properties of neighborhood scales using adolescent survey data from urban and rural Scotland

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    This work was supported by NHS Health Scotland and the University of St Andrews.Background:  Despite the well-established need for specific measurement instruments to examine the relationship between neighborhood conditions and adolescent well-being outcomes, few studies have developed scales to measure features of the neighborhoods in which adolescents reside. Moreover, measures of neighborhood features may be operationalised differently by adolescents living in different levels of urban/rurality. This has not been addressed in previous studies. The objectives of this study were to: 1) establish instruments to measure adolescent neighborhood features at both the individual and neighborhood level, 2) assess their psychometric and ecometric properties, 3) test for invariance by urban/rurality, and 4) generate neighborhood level scores for use in further analysis. Methods:  Data were from the Scottish 2010 Health Behaviour in School-aged Children Survey, which included an over-sample of rural adolescents. The survey responses of interest came from questions designed to capture different facets of the local area in which each respondent resided. Intermediate data zones were used as proxies for neighborhoods. Internal consistency was evaluated by Cronbach’s alpha. Invariance was examined using confirmatory factor analysis. Multilevel models were used to estimate ecometric properties and generate neighborhood scores. Results:  Two constructs labeled neighborhood social cohesion and neighborhood disorder were identified. Adjustment was made to the originally specified model to improve model fit and measures of invariance. At the individual level, reliability was .760 for social cohesion and .765 for disorder, and between .524 and .571 for both constructs at the neighborhood level. Individuals in rural areas experienced greater neighborhood social cohesion and lower levels of neighborhood disorder compared with those in urban areas. Conclusions:  The scales are appropriate for measuring neighborhood characteristics experienced by adolescents across urban and rural Scotland, and can be used in future studies of neighborhoods and health. However, trade-offs between neighborhood sample size and reliability must be considered.Publisher PDFPeer reviewe

    Appropriate disclosure of a diagnosis of dementia : identifying the key behaviours of 'best practice'

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    Background: Despite growing evidence that many people with dementia want to know their diagnosis, there is wide variation in attitudes of professionals towards disclosure. The disclosure of the diagnosis of dementia is increasingly recognised as being a process rather than a one-off behaviour. However, the different behaviours that contribute to this process have not been comprehensively defined. No intervention studies to improve diagnostic disclosure in dementia have been reported to date. As part of a larger study to develop an intervention to promote appropriate disclosure, we sought to identify important disclosure behaviours and explore whether supplementing a literature review with other methods would result in the identification of new behaviours. Methods: To identify a comprehensive list of behaviours in disclosure we conducted a literature review, interviewed people with dementia and informal carers, and used a consensus process involving health and social care professionals. Content analysis of the full list of behaviours was carried out. Results: Interviews were conducted with four people with dementia and six informal carers. Eight health and social care professionals took part in the consensus panel. From the interviews, consensus panel and literature review 220 behaviours were elicited, with 109 behaviours over-lapping. The interviews and consensus panel elicited 27 behaviours supplementary to the review. Those from the interviews appeared to be self-evident but highlighted deficiencies in current practice and from the panel focused largely on balancing the needs of people with dementia and family members. Behaviours were grouped into eight categories: preparing for disclosure; integrating family members; exploring the patient's perspective; disclosing the diagnosis; responding to patient reactions; focusing on quality of life and well-being; planning for the future; and communicating effectively. Conclusion: This exercise has highlighted the complexity of the process of disclosing a diagnosis of dementia in an appropriate manner. It confirms that many of the behaviours identified in the literature (often based on professional opinion rather than empirical evidence) also resonate with people with dementia and informal carers. The presence of contradictory behaviours emphasises the need to tailor the process of disclosure to individual patients and carers. Our combined methods may be relevant to other efforts to identify and define complex clinical practices for further study.This project is funded by UK Medical Research Council, Grant reference number G0300999

    Cardiosphere-derived cells suppress allogeneic lymphocytes by production of PGE2 acting via the EP4 receptor

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    derived cells (CDCs) are a cardiac progenitor cell population, which have been shown to possess cardiac regenerative properties and can improve heart function in a variety of cardiac diseases. Studies in large animal models have predominantly focussed on using autologous cells for safety, however allogeneic cell banks would allow for a practical, cost-effective and efficient use in a clinical setting. The aim of this work was to determine the immunomodulatory status of these cells using CDCs and lymphocytes from 5 dogs. CDCs expressed MHC I but not MHC II molecules and in mixed lymphocyte reactions demonstrated a lack of lymphocyte proliferation in response to MHC-mismatched CDCs. Furthermore, MHC-mismatched CDCs suppressed lymphocyte proliferation and activation in response to Concanavalin A. Transwell experiments demonstrated that this was predominantly due to direct cell-cell contact in addition to soluble mediators whereby CDCs produced high levels of PGE2 under inflammatory conditions. This led to down-regulation of CD25 expression on lymphocytes via the EP4 receptor. Blocking prostaglandin synthesis restored both, proliferation and activation (measured via CD25 expression) of stimulated lymphocytes. We demonstrated for the first time in a large animal model that CDCs inhibit proliferation in allo-reactive lymphocytes and have potent immunosuppressive activity mediated via PGE2
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