Multicenter study of hypoxemia prevalence and quality of oxygen treatment for hospitalized Malawian children

Although hypoxemic children have high mortality, little is known about hypoxemia prevalence and oxygen administration in African hospitals. We aimed to determine the hypoxemia prevalence and quality of oxygen treatment by local clinicians for hospitalized Malawian children

Succinate in dystrophic white matter: A proton magnetic resonance spectroscopy finding characteristic for complex II deficiency

A deficiency of succinate dehydrogenase is a rare cause of mitochondrial encephalomyopathy. Three patients, 2 sisters and I boy from an unrelated family, presented with symptoms and magnetic resonance imaging signs of leukoencephalopathy. Localized proton magnetic resonance spectroscopy indicated a prominent singlet at 2.40ppm in cerebral and cerebellar white matter not present in gray matter or basal ganglia. The signal was also elevated in cerebrospinal fluid and could be identified as originating from the two equivalent methylene groups of succinate. Subsequently, an isolated deficiency of complex II (succinate:ubiquinone oxidoreductase) was demonstrated in 2 patients in muscle and fibroblasts. One of the sisters died at the age of 18 months. Postmortem examination showed the neuropathological characteristics of Leigh syndrome. Her younger sister, now 12 months old, is also severely affected; the boy, now 6 years old, follows a Milder, fluctuating clinical course. Magnetic resonance spectroscopy provides a characteristic pattern in succinate dehydrogenase deficiency

Albuminuria, Hypertension, and Reduced Kidney Volumes in Adolescents Born Extremely Premature

Background: Premature birth is associated with decreased nephron number and an increased risk for chronic kidney disease (CKD). To inform the development of guidelines for kidney follow up of children born prematurely, we undertook a study of individuals born extremely preterm, with the aim of characterizing the prevalence and predictors of microalbuminuria, elevated blood pressure, and/or abnormal kidney volume in adolescence. Methods: Study participants (n = 42) were born before 28 weeks of gestation and were enrolled at birth in the Extremely Low Gestational Age Newborns (ELGAN) study. When participants were 15 years old, we obtained 2 manual blood pressures, a spot urine microalbumin measurement, and sonographic measurements of kidney length and volume. Results: Of the 42 participants, 60% were male, 52% were Caucasian (18% Hispanic), and 43% were African-American. Their median age was 15 (IQR 15, 15.3) years. In 33.3% of the cohort, blood pressure was elevated (>120/80 mmHg). Microalbuminuria (>30 mg/g) was present in 11.9% of the cohort, and kidney volume below the 10th percentile of normative data was present in 14%. Twenty-one (50%) of the sample had at least one kidney abnormality (microalbuminuria, elevated blood pressures, and/or kidney hypoplasia); these individuals were more likely to have experienced neonatal hypotension [55% vs. 17% among those with no kidney abnormality, p = 0.02]. Conclusions: Half of adolescents in this subset of ELGAN cohort have at least one risk factor of kidney disease (reduced kidney volume, microalbuminuria, and/or elevated blood pressures) at 15 years of age. This study suggests the importance of monitoring kidney outcomes in children after extremely preterm birth, especially those with a history of neonatal hypotension

Effects of Noise on Ecological Invasion Processes: Bacteriophage-mediated Competition in Bacteria

Pathogen-mediated competition, through which an invasive species carrying and transmitting a pathogen can be a superior competitor to a more vulnerable resident species, is one of the principle driving forces influencing biodiversity in nature. Using an experimental system of bacteriophage-mediated competition in bacterial populations and a deterministic model, we have shown in [Joo et al 2005] that the competitive advantage conferred by the phage depends only on the relative phage pathology and is independent of the initial phage concentration and other phage and host parameters such as the infection-causing contact rate, the spontaneous and infection-induced lysis rates, and the phage burst size. Here we investigate the effects of stochastic fluctuations on bacterial invasion facilitated by bacteriophage, and examine the validity of the deterministic approach. We use both numerical and analytical methods of stochastic processes to identify the source of noise and assess its magnitude. We show that the conclusions obtained from the deterministic model are robust against stochastic fluctuations, yet deviations become prominently large when the phage are more pathological to the invading bacterial strain.Comment: 39 pages, 7 figure

M1 Resonances in Unstable Magic Nuclei

Within a microscopic approach which takes into account RPA configurations, the single-particle continuum and more complex $1p1h\otimes phonon$ configurations isoscalar and isovector M1 excitations for the unstable nuclei ${56,78}$Ni and ${100,132}$Sn are calculated. For comparison, the experimentally known M1 excitations in ${40}$Ca and $^{208}$Pb have also been calculated. In the latter nuclei good agreement in the centroid energy, the total transition strength and the resonance width is obtained. With the same parameters we predict the magnetic excitations for the unstable nuclei. The strength is sufficiently concentrated to be measurable in radioactive beam experiments. New features are found for the very neutron rich nucleus ${78}$Ni and the neutron deficient nucleus ${100}$Sn.Comment: 17 pages (LATEX), 12 figures (available from the authors), KFA-IKP(TH)-1993-0

Plasma Deposited Diamond-Like Carbon Films for Large Neutralarrays

To understand how large systems of neurons communicate, we need to develop methods for growing patterned networks of large numbers of neurons. We have found that diamond-like carbon thin films formed by energetic deposition from a filtered vacuum arc carbon plasma can serve as ''neuron friendly'' substrates for the growth of large neural arrays. Lithographic masks can be used to form patterns of diamond-like carbon, and regions of selective neuronal attachment can form patterned neural arrays. In the work described here, we used glass microscope slides as substrates on which diamond-like carbon was deposited. PC-12 rat neurons were then cultured on the treated substrates and cell growth monitored. Neuron growth showed excellent contrast, with prolific growth on the treated surfaces and very low growth on the untreated surfaces. Here we describe the vacuum arc plasma deposition technique employed, and summarize results demonstrating that the approach can be used to form large patterns of neurons

Updated Conceptual Model for the 300 Area Uranium Groundwater Plume

The 300 Area uranium groundwater plume in the 300-FF-5 Operable Unit is residual from past discharge of nuclear fuel fabrication wastes to a number of liquid (and solid) disposal sites. The source zones in the disposal sites were remediated by excavation and backfilled to grade, but sorbed uranium remains in deeper, unexcavated vadose zone sediments. In spite of source term removal, the groundwater plume has shown remarkable persistence, with concentrations exceeding the drinking water standard over an area of approximately 1 km2. The plume resides within a coupled vadose zone, groundwater, river zone system of immense complexity and scale. Interactions between geologic structure, the hydrologic system driven by the Columbia River, groundwater-river exchange points, and the geochemistry of uranium contribute to persistence of the plume. The U.S. Department of Energy (DOE) recently completed a Remedial Investigation/Feasibility Study (RI/FS) to document characterization of the 300 Area uranium plume and plan for beginning to implement proposed remedial actions. As part of the RI/FS document, a conceptual model was developed that integrates knowledge of the hydrogeologic and geochemical properties of the 300 Area and controlling processes to yield an understanding of how the system behaves and the variables that control it. Recent results from the Hanford Integrated Field Research Challenge site and the Subsurface Biogeochemistry Scientific Focus Area Project funded by the DOE Office of Science were used to update the conceptual model and provide an assessment of key factors controlling plume persistence

The Subcellular Distribution of Acyltransferases which Catalyze the Synthesis of Phosphoglycerides

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/65213/1/j.1432-1033.1969.tb00602.x.pd

In Situ Redox Manipulation Proof-of-Principle Test at the Fort Lewis Logistics Center: Final Report

Pacific Northwest National Laboratory (PNNL) conducted a proof-of-principle test at the Fort Lewis Logistics Center to determine the feasibility of using the In Situ Redox Manipulation (ISRM) technology for remediating groundwater contaminated with dissolved trichloroethylene (TCE). ISRM creates a permeable treatment zone in the subsurface to remediate redox-sensitive contaminants in groundwater. The permeable treatment zone is formed by injecting a chemical reducing agent (sodium dithionite with pH buffers) into the aquifer through a well to reduce the naturally occurring ferric iron in the sediments to ferrous iron. Once the reducing agent is injected and given sufficient time to react with aquifer sediments, residual chemicals and reaction products are withdrawn from the aquifer through the same well used for the injection. Redox-sensitive contaminants such as TCE, moving through the treatment zone under natural groundwater flow conditions, are destroyed. TCE is degraded via reductive dechlorination within the ISRM treatment zone to benign degradation products (i.e., acetylene, ethylene). Prior to the proof-of-principle field test, the ISRM technology was successfully demonstrated in laboratory experiments for the reductive dechlorination of dissolved TCE using sediments from the Fort Lewis site. The Logistics Center was placed on the National Priorities List in December 1989 because of TCE contamination in groundwater beneath the site. A Federal Facilities Agreement between the Army, the U.S. Environmental Protection Agency, and the Washington State Department of Ecology became effective in January 1990, and a Record of Decision (ROD) was signed in September 1990. The major components of the ROD included installation of two pump-and-treat systems for the upper aquifer and further investigation of the lower aquifer and other potential sources of contamination. The pump-and-treat systems became operational in August 1995. Fort Lewis asked PNNL to provide technical support in accelerating Installation Restoration Program site remediation and significantly reducing site life-cycle costs at the Logistics Center. In support of this program, ISRM was selected as an innovative technology for bench and field-scale demonstration. Emplacement of the ISRM treatment zone was accomplished through a series of four separate dithionite injection tests conducted between November 10, 1998 and March 29,2000. An extensive program of chemical monitoring was also performed before, during, and after each injection to evaluate the performance of ISRM. Prior to emplacement of the ISRM treatment zone, the site was extensively characterized with respect to geologic, hydrologic, and geochemical properties. Sediment core samples collected for the characterization studies were analyzed in bench-scale column tests at PNNL to determine reducible iron content. These site-specific hydrogeologic and geochemical data were used to develop the emplacement design of the pilot-scale (i.e., single injection well) ISRM treatment zone. Performance data obtained from the proof-of-principle test indicate that field-scale reductive dechlorination of TCE using the ISRM technology is feasible. A treatment zone was created in the subsurface that reduced TCE concentrations as much as 92% on the downgradient side of the reduced zone, from a background concentration of approximately 140 ppb to approximately 11 ppb. The appearance of the principal degradation product, acetylene, also confirmed that TCE destruction was occurring. Analysis of sediment samples collected from post-test boreholes showed a high degree of iron reduction, which helped to confirm the effectiveness of the treatment zone emplacement. Another important goal of the testing program was to provide assurances that chemical treatment of the subsurface did not result in undesirable secondary effects, including formation of toxic TCE degradation products, mobilization of trace elements, and degradation of hydraulic performance. Results obtained from the Fort Lewis ISRM proof-of-principle test, which are consistent with results from previous ISRM studies (both bench- and field-scale), indicate that no significant secondary effects were identified that could limit full-scale application of this technology

Implementation of World Health Organization Integrated Management of Childhood Illnesses (IMCI) Guidelines for the Assessment of Pneumonia in the Under 5s in Rural Malawi

The Cooking and Pneumonia Study (CAPS) is a pragmatic cluster-level randomized controlled trial of the effect of an advanced cookstove intervention on pneumonia in children under the age of 5 years (under 5s) in Malawi (www.capstudy.org). The primary outcome of the trial is the incidence of pneumonia during a two-year follow-up period, as diagnosed by healthcare providers who are using the World Health Organization (WHO) integrated management of childhood illnesses (IMCI) pneumonia assessment protocol and who are blinded to the trial arms. We evaluated the quality of pneumonia assessment in under 5s in this setting via a cross-sectional study of provider-patient encounters at nine outpatient clinics located within the catchment area of 150 village-level clusters enrolled in the trial across the two study locations of Chikhwawa and Karonga, Malawi, between May and June 2015 using the IMCI guidelines as a benchmark. Data were collected using a key equipment checklist, an IMCI pneumonia knowledge test, and a clinical evaluation checklist. The median number of key equipment items available was 6 (range 4 to 7) out of a possible 7. The median score on the IMCI pneumonia knowledge test among 23 clinicians was 75% (range 60% to 89%). Among a total of 176 consultations performed by 15 clinicians, a median of 9 (range 3 to 13) out of 13 clinical evaluation tasks were performed. Overall, the clinicians were adequately equipped for the assessment of sick children, had good knowledge of the IMCI guidelines, and conducted largely thorough clinical evaluations. We recommend the simple pragmatic approach to quality assurance described herein for similar studies conducted in challenging research settings