327 research outputs found

    Clinical presentation of a traumatic cervical spine disc rupture in alpine sports: a case report

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    Isolated non-skeletal injuries of the cervical spine are rare and frequently missed. Different evaluation algorithms for C-spine injuries, such as the Canadian C-spine Rule have been proposed, however with strong emphasis on excluding osseous lesions. Discoligamentary injuries may be masked by unique clinical situations presenting to the emergency physician. We report on the case of a 28-year-old patient being admitted to our emergency department after a snowboarding accident, with an assumed hyperflexion injury of the cervical spine. During the initial clinical encounter the only clinical finding the patient demonstrated, was a burning sensation in the palms bilaterally. No neck pain could be elicited and the patient was not intoxicated and did not have distracting injuries. Since the patient described a fall prevention attempt with both arms, a peripheral nerve contusion was considered as a differential diagnosis. However, a high level of suspicion and the use of sophisticated imaging (MRI and CT) of the cervical spine, ultimately led to the diagnosis of a traumatic disc rupture at the C5/6 level. The patient was subsequently treated with a ventral microdiscectomy with cage interposition and ventral plate stabilization at the C5/C6 level and could be discharged home with clearly improving symptoms and without further complications

    Final State Interactions and CP Violation in KLπ+πe+eK_L \to \pi^+ \pi^- e^+ e^-

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    Using chiral perturbation theory we calculate the imaginary parts of the KLπ+πe+eK_L \rightarrow \pi^+ \pi^- e^+ e^- form factors that arise from πππ+π\pi \pi \rightarrow \pi^+ \pi^- and πππ+πγ\pi \pi \rightarrow \pi^+ \pi^- \gamma^* rescattering. We discuss their influence on CP violating variables in KLπ+πe+eK_L \rightarrow \pi^+ \pi^- e^+ e^-.Comment: ; 12 pages, 2 figures, TeX format; uses epsf.tex, tables.tex, and phyzzx.te

    Landscape, demographic and climatic associations with human West Nile virus occurrence regionally in 2012 in the United States of America

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    After several years of low West Nile virus (WNV) occurrence in the United States of America (USA), 2012 witnessed large outbreaks in several parts of the country. In order to understand the outbreak dynamics, spatial clustering and landscape, demographic and climatic associations with WNV occurrence were investigated at a regional level in the USA. Previous research has demonstrated that there are a handful of prominent WNV mosquito vectors with varying ecological requirements responsible for WNV transmission in the USA. Published range maps of these important vectors were georeferenced and used to define eight functional ecological regions in the coterminous USA. The number of human WNV cases and human populations by county were attained in order to calculate a WNV rate for each county in 2012. Additionally, a binary value (high/low) was calculated for each county based on whether the county WNV rate was above or below the rate for the region it fell in. Global Moran’s I and Anselin Local Moran’s I statistics of spatial association were used per region to examine and visualize clustering of the WNV rate and the high/low rating. Spatial data on landscape, demographic and climatic variables were compiled and derived from a variety of sources and then investigated in relation to human WNV using both Spearman rho correlation coefficients and Poisson regression models. Findings demonstrated significant spatial clustering of WNV and substantial inter-regional differences in relationships between WNV occurrence and landscape, demographic and climatically related variables. The regional associations were consistent with the ecologies of the dominant vectors for those regions. The large outbreak in the Southeast region was preceded by higher than normal winter and spring precipitation followed by dry and hot conditions in the summer

    A comparison of prebunking and debunking interventions for implied versus explicit misinformation

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    Psychological research has offered valuable insights into how to combat misinformation. The studies conducted to date, however, have three limitations. First, pre-emptive (“prebunking”) and retroactive (“debunking”) interventions have mostly been examined in parallel, and thus it is unclear which of these two predominant approaches is more effective. Second, there has been a focus on misinformation that is explicitly false, but misinformation that uses literally true information to mislead is common in the real world. Finally, studies have relied mainly on questionnaire measures of reasoning, neglecting behavioural impacts of misinformation and interventions. To offer incremental progress towards addressing these three issues, we conducted an experiment (N = 735) involving misinformation on fair trade. We contrasted the effectiveness of prebunking versus debunking and the impacts of implied versus explicit misinformation, and incorporated novel measures assessing consumer behaviours (i.e., willingness-to-pay; information seeking; online misinformation promotion) in addition to standard questionnaire measures. In general, we found debunking to be more effective than prebunking, although both were able to reduce misinformation reliance. We also found that individuals tended to rely more on explicit than implied misinformation both with and without interventions

    Host Range and Emerging and Reemerging Pathogens

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    Emerging and reemerging species of human pathogens are associated with a broad range of nonhuman hosts

    Direct Molecular Detection and Genotyping of Borrelia burgdorferi from Whole Blood of Patients with Early Lyme Disease

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    Direct molecular tests in blood for early Lyme disease can be insensitive due to low amount of circulating Borrelia burgdorferi DNA. To address this challenge, we have developed a sensitive strategy to both detect and genotype B. burgdorferi directly from whole blood collected during the initial patient visit. This strategy improved sensitivity by employing 1.25 mL of whole blood, a novel pre-enrichment of the entire specimen extract for Borrelia DNA prior to a multi-locus PCR and electrospray ionization mass spectrometry detection assay. We evaluated the assay on blood collected at the initial presentation from 21 endemic area patients who had both physician-diagnosed erythema migrans (EM) and positive two-tiered serology either at the initial visit or at a follow-up visit after three weeks of antibiotic therapy. Results of this DNA analysis showed detection of B. burgdorferi in 13 of 21 patients (62%). In most cases the new assay also provided the B. burgdorferi genotype. The combined results of our direct detection assay with initial physician visit serology resulted in the detection of early Lyme disease in 19 of 21 (90%) of patients at the initial visit. In 5 of 21 cases we demonstrate the ability to detect B. burgdorferi in early Lyme disease directly from whole blood specimens prior to seroconversion

    Two Photon Contribution to Polarization in K+π+μ+μK^+ \rightarrow \pi^+ \mu^+ \mu^-

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    Short distance physics involving virtual top and charm quarks contributes to μ+\mu^+ (and μ\mu^-) polarization in the decay K+π+μ+μK^+ \rightarrow \pi^+ \mu^+ \mu^-. Measurement of the parity violating asymmetry (ΓRΓL)/(ΓR+ΓL)(\Gamma_R - \Gamma_L)/(\Gamma_R + \Gamma_L), where ΓR\Gamma_R and ΓL\Gamma_L are the rates to produce right and left-handed μ+\mu^+, may provide valuable information on the unitarity triangle. The parity violating asymmetry also gets a contribution from Feynman diagrams with two photon intermediate states. We estimate this two photon contribution to the asymmetry and discuss briefly the two photon contribution to time reversal odd asymmetries that involve both the μ+\mu^+ and μ\mu^- polarizations.Comment: (19 pages, 5 figures available on request. Uses phyzzx), CALT-68-1798, UCSD/PTH 92-2

    Rapid and High-Throughput pan-Orthopoxvirus Detection and Identification using PCR and Mass Spectrometry

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    The genus Orthopoxvirus contains several species of related viruses, including the causative agent of smallpox (Variola virus). In addition to smallpox, several other members of the genus are capable of causing human infection, including monkeypox, cowpox, and other zoonotic rodent-borne poxviruses. Therefore, a single assay that can accurately identify all orthopoxviruses could provide a valuable tool for rapid broad orthopovirus identification. We have developed a pan-Orthopoxvirus assay for identification of all members of the genus based on four PCR reactions targeting Orthopoxvirus DNA and RNA helicase and polymerase genes. The amplicons are detected using electrospray ionization-mass spectrometry (PCR/ESI-MS) on the Ibis T5000 system. We demonstrate that the assay can detect and identify a diverse collection of orthopoxviruses, provide sub-species information and characterize viruses from the blood of rabbitpox infected rabbits. The assay is sensitive at the stochastic limit of PCR and detected virus in blood containing approximately six plaque-forming units per milliliter from a rabbitpox virus-infected rabbit

    Analysis of antibiotic resistance genes in multidrug-resistant acinetobacter sp. isolates from military and civilian patients treated at the Walter Reed Army Medical Center

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    Military medical facilities treating patients injured in Iraq and Afghanistan have identified a large number of multidrug-resistant (MDR) Acinetobacter baumannii isolates. In order to anticipate the impact of these pathogens on patient care, we analyzed the antibiotic resistance genes responsible for the MDR phenotype in Acinetobacter sp. isolates collected from patients at the Walter Reed Army Medical Center (WRAMC). Susceptibility testing, PCR amplification of the genetic determinants of resistance, and clonality were determined. Seventy-five unique patient isolates were included in this study: 53% were from bloodstream infections, 89% were resistant to at least three classes of antibiotics, and 15% were resistant to all nine antibiotics tested. Thirty-seven percent of the isolates were recovered from patients nosocomially infected or colonized at the WRAMC. Sixteen unique resistance genes or gene families and four mobile genetic elements were detected. In addition, this is the first report of blaOXA-58-like and blaPER-like genes in the U.S. MDR A. baumannii isolates with at least eight identified resistance determinants were recovered from 49 of the 75 patients. Molecular typing revealed multiple clones, with eight major clonal types being nosocomially acquired and with more than 60% of the isolates being related to three pan-European types. This report gives a “snapshot” of the complex genetic background responsible for antimicrobial resistance in Acinetobacter spp. from the WRAMC. Identifying genes associated with the MDR phenotype and defining patterns of transmission serve as a starting point for devising strategies to limit the clinical impact of these serious infections. © 2006, American Society for Microbiolog
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