The outbreak of SARS at Tan Tock Seng Hospital--relating epidemiology to control.

INTRODUCTION: The outbreak of severe acute respiratory syndrome (SARS) began after the index case was admitted on 1 March 2003. We profile the cases suspected to have acquired the infection in Tan Tock Seng Hospital (TTSH), focussing on major transmission foci, and also describe and discuss the impact of our outbreak control measures. MATERIALS AND METHODS: Using the World Health Organization (WHO) case definitions for probable SARS adapted to the local context, we studied all cases documented to have passed through TTSH less than 10 days prior to the onset of fever. Key data were collected in liaison with clinicians and through a team of onsite epidemiologists. RESULTS: There were 105 secondary cases in TTSH. Healthcare staff (57.1%) formed the majority, followed by visitors (30.5%) and inpatients (12.4%). The earliest case had onset of fever on 4 March 2003, and the last case, on 5 April 2003. Eighty-nine per cent had exposures to 7 wards which had cases of SARS that were not isolated on admission. In 3 of these wards, major outbreaks resulted, each with more than 20 secondary cases. Attack rates amongst ward-based staff ranged from 0% to 32.5%. Of 13 inpatients infected, only 4 (30.8%) had been in the same room or cubicle as the index case for the ward. CONCLUSIONS: The outbreak of SARS at TTSH showed the challenges of dealing with an emerging infectious disease with efficient nosocomial spread. Super-spreading events and initial delays in outbreak response led to widespread dissemination of the outbreak to multiple wards

Motor programs: an artificial neural network approach

It is commonly assumed that, during learning, the brain creates “motor programs” which store all the information essential to performing a motor skill. Yet there is still no consensus on what constitutes a motor program. In this study, a Multilayer Perceptron (MLP) network with one hidden layer, trained using the backpropagation rule, was used in an attempt to identify motor programs. Nine healthy subjects were asked to use their left hand to make fast and accurate movements in a tracking task of 75 identical steps, by either wrist flexion and extension, or the precision grip. The electromyogram (EMG) activity of 8 finger and hand muscles were simultaneously recorded by standard techniques. Onset timing of muscle activities were quantified from the digitized EMG signals, and were then used as the inputs to the MLP network. Reaction time was also measured, providing the desired output of the network. The trained network captured salient features of the relationship between EMG onset times and reaction time.published_or_final_versio

A glass workshop in ‘Aqir, Israel and a new type of compositional contamination

Materials associated with a secondary workshop of early Byzantine date (4th-5th centuries) were unearthed in excavations by the Israel Antiquities Authority in ‘Aqir, central Israel. Fragments of furnace structure, production debris and glass vessels have been analysed by scanning electron microscopy with energy dispersive X-ray analysis (SEM-EDS) and thin-section petrography. The results suggest that the workshop melted raw glass chunks of similar composition to the primary glass made at Apollonia, Israel, to produce secondary glass products. Some glass vessels associated with the furnace are of different composition, and some of these may represent material brought in as cullet for recycling. The furnace was built with ceramic bricks comprising alluvial-type clay with inclusions of quartz sand, probably added as temper. It was fired by potash-rich fuel to approximately 1100°C. Lime mortar was used either to cement the gaps between mudbricks or to line the furnace as a parting layer, and it has introduced a previously unrecognised type of contamination in glass of the period, mainly of Fe2O3 and CaO. The contamination may be identified in glass vessel assemblages elsewhere but is not ubiquitous. As its origin relates to the furnace structure, its occurrence may depend upon chronology or geography and further work is needed to resolve this issue

Glass production at Jalame, Israel: Process, composition and relationship to Roman glass in Europe

Following an initial micro-XRF assay, 42 samples of glass from the twentieth-century excavations of the fourth-century CE production site at Jalame, Israel, were selected and analysed by EPMA, with subsets for trace elements by LA-ICP-MS (n=29 samples) and for Hf isotopes by MC-ICP-MS (n=6). Comparison of major elements for ten samples originally measured in Brill (1988) was good, although the earlier SiO2 values are slightly high. Analyses of furnace debris and contaminated glass imply that glass furnaces were made of, or lined with a lime-rich material, leading to contamination by CaO, rather than Al2O3. This confirms that higher alumina contents measured for Jalame glass relative to Roman Mn-decolourised glass of first-third century Europe are significant and it is suggested that the source of the earlier Roman glass lies further North on the eastern Mediterranean coast. A wide range of trace elements are shown to have entered the glass with the addition of manganese, so caution should be exercised when interpreting trace element and isotopic data on glass with significant amounts of Mn, although the effects on REE and some of the lithophiles most often used in provenancing appear minor or insignificant in Jalame glass with MnO below 1.3 wt%. For example, the hafnium isotope composition of the Jalame material does not appear to have been significantly affected and falls within the previously determined Levantine range, distinguishable from Egyptian glass. Associated trace elements indicate that two Mn sources were exploited and this raises the possibility of further investigation of Mn sources in early glass production. The wide range of added manganese suggests problems in obtaining a homogeneous batch and it is suggested that (a) a single initially inhomogeneous furnace load melted to a range of colours, which were subsequently colour-sorted as chunks, and/or (b) the recycling of poorly fused manganese-decolourised glass into later manganese-free batches resulted in the observed variation. The cobalt pigment used was the high-nickel late antique type and allows the introduction of this source to be pushed back from the sixth to the fourth century CE. The use of antimony in glassmaking ceased at around the same time, and it is speculated that these changes were related

Influence of interleukin-2 on Ca2+ handling in rat ventricular myocytes

In the present study, we examined the effect of interleukin-2 (IL-2) on cardiomyocyte Ca2+ handling. The effects of steady-state and transient changes in stimulation frequency on the intracellular Ca2+ transient were investigated in isolated ventricular myocytes by spectrofluorometry. In the steady state (0.2 Hz) IL-2 (200 U/ml) decreased the amplitude of Ca2+ transients induced by electrical stimulation and caffeine. At 1.25 mM extracellular Ca2+ concentration ([Ca 2+]o), when the stimulation frequency increased from 0.2 to 1.0 Hz, diastolic Ca2+ level and peak intracellular Ca 2+ concentration ([Ca2+]i), as well as the amplitude of the transient, increased. The positive frequency relationships of the peak and amplitude of [Ca2+]i transients were blunted in the IL-2-treated myocytes. The effect of IL-2 on the electrically induced [Ca2+]i transient was not normalized by increasing [Ca2+]o to 2.5 mM. IL-2 inhibited the frequency relationship of caffeine-induced Ca2+ release. Blockade of sarcoplasmic reticulum (SR) Ca2+-ATPase with thapsigargin resulted in a significant reduction of the amplitude-frequency relationship of the transient similar to that induced by IL-2. The restitutions were not different between control and IL-2 groups at 1.25 mM [Ca2+]o, which was slowed in IL-2-treated myocytes when [Ca2+]o was increased to 2.5 mM. There was no difference in the recirculation fraction (RF) between control and IL-2-treated myocytes at both 1.25 and 2.5 mM [Ca 2+]o. The effects of IL-2 on frequency relationship, restitution, and RF may be due to depressed SR functions and an increased Na+-Ca2+ exchange activity, but not to any change in L-type Ca2+ channels. © 2003 Elsevier Ltd. All rights reserved.postprin

Seasonal differences in the photochemistry of the South Pacific: A comparison of observations and model results from PEM-Tropics A and B

A time-dependent photochemical box model is used to examine the photochemistry of the equatorial and southern subtropical Pacific troposphere with aircraft data obtained during two distinct seasons: the Pacific Exploratory Mission-Tropics A (PEM-Tropics A) field campaign in September and October of 1996 and the Pacific Exploratory Mission-Tropics B (PEM-Tropics B) campaign in March and April of 1999. Model-predicted values were compared to observations for selected species (e.g., NO2, OH, HO2) with generally good agreement. Predicted values of HO2 were larger than those observed in the upper troposphere, in contrast to previous studies which show a general underprediction of HO2 at upper altitudes. Some characteristics of the budgets of HOx, NOx, and peroxides are discussed. The integrated net tendency for O3 is negative over the remote Pacific during both seasons, with gross formation equal to no more than half of the gross destruction. This suggests that a continual supply of O3 into the Pacific region throughout the year must exist in order to maintain O3 levels. Integrated net tendencies for equatorial O3 showed a seasonality, with a net loss of 1.06×1011 molecules cm-2 s-1 during PEM-Tropics B (March) increasing by 50% to 1.60×1011 molecules cm-2 s-1 during PEM-Tropics A (September). The seasonality over the southern subtropical Pacific was somewhat lower, with losses of 1.21×1011 molecules cm-2 s-1 during PEM-Tropics B (March) increasing by 25% to 1.51×1011 molecules cm-2 s-1 during PEM-Tropics A (September). While the larger net losses during PEM-Tropics A were primarily driven by higher concentrations of O3, the ability of the subtropical atmosphere to destroy O3 was ∼30% less effective during the PEM-Tropics A (September) campaign due to a drier atmosphere and higher overhead O3 column amounts. Copyright 2001 by the American Geophysical Union

Rising CO2 and warming reduce global canopy deman for nitrogen

Nitrogen (N) limitation has been considered as a constraint on terrestrial carbon uptake in response to rising CO2 and climate change. By extension, it has been suggested that declining carboxylation capacity (Vcmax) and leaf N content in enhanced-CO2 experiments and satellite records signify increasing N limitation of primary production. We predicted Vcmax using the coordination hypothesis, and estimated changes in leaf-level photosynthetic N for 1982–2016 assuming proportionality with leaf-level Vcmax at 25˚C. Whole-canopy photosynthetic N was derived using satellite-based leaf area index (LAI) data and an empirical extinction coefficient for Vcmax, and converted to annual N demand using estimated leaf turnover times. The predicted spatial pattern of Vcmax shares key features with an independent reconstruction from remotely-sensed leaf chlorophyll content. Predicted leaf photosynthetic N declined by 0.27 % yr-1, while observed leaf (total) N declined by 0.2–0.25 % yr-1. Predicted global canopy N (and N demand) declined from 1996 onwards, despite increasing LAI. Leaf-level responses to rising CO2, and to a lesser extent temperature, may have reduced the canopy requirement for N by more than rising LAI has increased it. This finding provides an alternative explanation for declining leaf N that does not depend on increasing N limitation

Ablation of neuropilin 1 from glioma-associated microglia and macrophages slows tumor progression

Gliomas are the most commonly diagnosed primary tumors of the central nervous system (CNS). Median times of survival are dismal regardless of the treatment approach, underlying the need to develop more effective therapies. Modulation of the immune system is a promising strategy as innate and adaptive immunity play important roles in cancer progression. Glioma associated microglia and macrophages (GAMs) can comprise over 30% of the cells in glioma biopsies. Gliomas secrete cytokines that suppress the anti-tumorigenic properties of GAMs, causing them to secrete factors that support the tumor's spread and growth. Neuropilin 1 (Nrp1) is a transmembrane receptor that in mice both amplifies pro-angiogenic signaling in the tumor microenvironment and affects behavior of innate immune cells. Using a Cre-lox system, we generated mice that lack expression of Nrp1 in GAMs. We demonstrate, using an in vivo orthotopic glioma model, that tumors in mice with Nrp1-deficient GAMs exhibit less vascularity, grow at a slower pace, and are populated by increased numbers of anti-tumorigenic GAMs. Moreover, glioma survival times in mice with Nrp1-deficient GAMs were significantly longer. Treating wild-type mice with a small molecule inhibitor of Nrp1's b1 domain, EG00229, which we show here is selective for Nrp1 over Nrp2, yielded an identical outcome. Nrp1-deficient or EG00229-treated wild-type microglia exhibited a shift towards anti-tumorigenicity as evident by altered inflammatory marker profiles in vivo and decreased SMAD2/3 activation when conditioned in the presence of glioma-derived factors. These results provide support for the proposal that pharmacological inhibition of Nrp1 constitutes a potential strategy for suppressing glioma progression

Signed Laplacian Deep Learning with Adversarial Augmentation for Improved Mammography Diagnosis

Computer-aided breast cancer diagnosis in mammography is limited by inadequate data and the similarity between benign and cancerous masses. To address this, we propose a signed graph regularized deep neural network with adversarial augmentation, named \textsc{DiagNet}. Firstly, we use adversarial learning to generate positive and negative mass-contained mammograms for each mass class. After that, a signed similarity graph is built upon the expanded data to further highlight the discrimination. Finally, a deep convolutional neural network is trained by jointly optimizing the signed graph regularization and classification loss. Experiments show that the \textsc{DiagNet} framework outperforms the state-of-the-art in breast mass diagnosis in mammography.Comment: To appear in MICCAI October 201