An assessment of electronically captured data in the patient care enhancement system (PACES) for syndromic surveillance.

INTRODUCTION: A common approach to the surveillance of emerging infectious diseases and agents of bioterrorism is to analyse electronically captured data for disease syndromes. The Patient Care Enhancement System (PACES) is a form of electronic medical records presently in service in the Singapore Armed Forces (SAF). We assess the feasibility of PACES data for surveillance, describe time-trends, and identify methods of sub-analysis which could improve performance. MATERIALS AND METHODS: Medical consults from July 2000 to June 2003 were extracted. Diagnosis codes were mapped to 7 infectious disease syndromes according to the categorisation in the Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE): gastrointestinal (GI), fever (FEVER), respiratory, (RESP), coma (COMA), neurological (NEURO), dermatologic-haemorrhagic (DERMHEM) and dermatologic- infectious (DERM-INF). RESULTS: A total of 732,233 episodes of care were analysed. Weekly periodicity was observed, with decreased weekend consults; there were no obvious seasonal trends in any of the syndromes. RESP, FEVER and GI syndromes were common events. Sub-analyses, either by restricting to cases with a repeated consultation, or grouping the data by medical centres, could dramatically lower thresholds used to flag outbreaks. CONCLUSION: In spite of the level of background noise inherent in a system consisting mainly of primary care consults, sub-analysis by medical centre, or restriction to cases with repeated consults were able to yield sensitive thresholds for outbreak detection

Nodulation of native woody legumes in Hong Kong, China

Woody legumes can play an important role in forest restoration on degraded land but the knowledge of woody legumes has lagged behind their uses. This study is a pioneer investigation to explore the ability of native woody legumes to form root nodules and fix nitrogen in Hong Kong. Nine sites of different habitat types were surveyed during both wet and dry seasons for two years. Young plants of woody legumes along studied transects were excavated. The patterns of nodulation and nodule morphology were recorded and the nitrogen fixing ability was tested by acetylene-reduction-assay. Twenty-eight species in 16 genera were examined, of which 20 species were nodulating and eight non-nodulating, including all six species in the Caesalpinioideae. Five species were new records to the world's nodulation inventory. Bowringia callicarpa was a new species and genus examined, which was non-nodulating. The overall nodulation pattern was consistent with previous studies. Nodulation was more profuse in some shrub species while inconsistent in most tree species. Species with higher proportion of nodulated individual plants also tended to have more nodules in each plant. Spherical nodules were common in shrub and woody climber species whilst tree species usually had woody indeterminate nodules. Seasonal difference in the amount of senescent nodules was noted in most species. All the nodules tested by acetylene-reduction-assay were effectively nitrogen-fixing, with nitrogenase activity ranging from 4 μmol C2H4 g-1 h -1 to 20 μmol C2H4 g-1 h -1, which was comparable to other tropical tree species. The findings in nodulation pattern and nitrogen fixing ability of these species are essential in their application in forest restoration on degraded lands. © 2008 Springer Science+Business Media B.V.link_to_subscribed_fulltex

Using polymer conformation to control architecture in semiconducting polymer/viral capsid assemblies

Cowpea chlorotic mottle virus is a single-stranded RNA plant virus with a diameter of 28 nm. The proteins comprising the capsid of this virus can be purified and reassembled either by themselves to form hollow structures or with polyanions such as double-stranded DNA or single-stranded RNA. Depending on pH and ionic strength, a diverse range of structures and shapes can form. The work presented here focuses on using these proteins to encapsulate a fluorescent polyanionic semiconducting polymer, MPS-PPV (poly-2-methoxy-5-propyloxy sulfonate phenylene vinlyene), in order to obtain optically active virus-like particles. After encapsulation, fluorescence from MPS-PPV shows two distinct peaks, which suggests the polymer may be in two conformations. A combination of TEM, fluorescence anisotropy, and sucrose gradient separation indicate that the blue peak arises from polymer encapsulated into spherical particles, while the redder peak corresponds to polymers contained in rod-like cages. Ionic strength during assembly can be used to tune the propensity to form rods or spheres. The results illustrate the synergy of hybrid synthetic/biological systems: polymer conformation drives the structure of this composite material, which in turn modifies the polymer optical properties. This synergy could be useful for the future development of synthetic/biological hybrid materials with designated functionality.link_to_OA_fulltex

Exploiting fluorescent polymers to probe the self-assembly of virus-like particles

The inside surfaces of the protein shells of many viruses are positively charged, thereby enhancing the self-assembly of capsid proteins around their (oppositely charged) RNA genome. These proteins have been shown to organize similarly around a variety of nonbiological, negatively charged, polymers, for example, poly(styrene sulfonate) (PSS), forming virus-like particles (VLPs). We have demonstrated recently that the VLPs formed from cowpea chlorotic mottle virus (CCMV) capsid protein increase in size (from T=2 to T=3 structures) upon increase in PSS molecular weight (from 400 kDa to 3.4 MDa), and that the total charge on the PSS exceeds that of the capsid protein by as much as a factor of 9. Here, we extend studies of this kind to PSS molecules that are sufficiently small that two or more can be packaged into VLPs. The use of 38 kDa PSS polymers that have been fluorescently labeled with Rhodamine B allows us to determine the number of PSS molecules per capsid. Electron micrographs of the VLPs show a bimodal distribution of particle diameters, with one peak centered around 19 nm, typical of a T=1 triangulation number, and the other around 21 nm, consistent with a pseudo T=2 structure; increasing the molar ratio of protein to PSS in the reaction mix shifts the VLP distribution from T=1 to T=2 structures. By combining fluorescence and gel electrophoresis measurements, it is determined that, on average, there are two polymers in each T=1 capsid and three in each T=2, with the PSS charge less than that of the capsid protein by as much as a factor of 2. VLPs of this kind provide a versatile model system for determining the principles underlying self-assembly of controlled numbers of cargo molecules in nanocontainers of increasing size

"<i>Escalibur</i>"-A practical pipeline for the de novo analysis of nucleotide variation in nonmodel eukaryotes

The revolution in genomics has enabled large-scale population genetic investigations of a wide range of organisms, but there has been a relatively limited focus on improving analytical pipelines. To efficiently analyse large data sets, highly integrated and automated software pipelines, which are easy to use, efficient, reliable, reproducible and run in multiple computational environments, are required. A number of software workflows have been developed to handle and process such data sets for population genetic analyses, but effective, specialized pipelines for genetic and statistical analyses of nonmodel organisms are lacking. For most species, resources for variomes (sets of genetic variations found in populations of species) are not available, and/or genome assemblies are often incomplete and fragmented, complicating the selection of the most suitable reference genome when multiple assemblies are available. Additionally, the biological samples used often contain extraneous DNA from sources other than the species under investigation (e.g., microbial contamination), which needs to be removed prior to genetic analyses. For these reasons, we established a new pipeline, called Escalibur, which includes: functionalities, such as data trimming and mapping; selection of a suitable reference genome; removal of contaminating read data; recalibration of base calls; and variant-calling. Escalibur uses a proven gatk variant caller and workflow description language (WDL), and is, therefore, a highly efficient and scalable pipeline for the genome-wide identification of nucleotide variation in eukaryotes. This pipeline is available at https://gitlab.unimelb.edu.au/bioscience/escalibur (version 0.3-beta) and is essentially applicable to any prokaryote or eukaryote

Single Working Portal Technique for Knotless Arthroscopic Bankart Repair

Arthroscopic Bankart repair is widely accepted as the method of choice in restoring the labrum to the glenoid rim. It has been shown to have comparable outcomes with open stabilization. This usually involves the use of 2 portals anteriorly: one anterosuperior accessory portal and another anteroinferior working portal. The aim of this Technical Note is to present a simple and reproducible technique for Bankart repair using a single working portal anteriorly without an accessory portal

Iatrogenic ureteric stricture post image guided renal cryoablation in a patient with von hippel-lindau syndrome

A 53-year-old lady is known to have Von Hippel-Lindau syndrome with a long history of previous renal cell carcinomas (RCCs) in both kidneys. She was treated by partial nephrectomy for a right peripheral RCC and subsequently image guided radiofrequency ablation (RFA) of a left central RCC. She developed another de novo RCC adjacent to the right pelvic-ureteric junction (PUJ) 4 years after the initial RFA. Due to the close proximity to the PUJ and visibility of an ice ball with cryoablation (CRYO), the consensus from the MDT was that CRYO would be safer than RFA and she subsequently underwent percutaneous image guided CRYO to treat the small de novo RCC. Unfortunately, during the 1-month imaging follow up, she developed moderate hydronephrosis and a ureteric stricture needing long-term ureteric stent management. This case highlights the risk of ureteric injury caused by the thermal effect of the ice ball during image guided renal CRYO. Therefore, it is vital that all interventional radiologists adopt various manoeuvres to protect the ureter from the ice ball during CRYO in order to avoid the development of latent ureteric stricture

Antiferroelectrics: History, fundamentals, crystal chemistry, crystal structures, size effects, and applications

Antiferroelectric (AFE) materials are of great interest owing to their scientific richness and their utility in high energy density capacitors. Here, the history of AFEs is reviewed, and the characteristics of antiferroelectricity and the phase transition of an AFE material are described. AFEs are energetically close to ferroelectric (FE) phases, and thus both the electric field strength and applied stress (pressure) influence the nature of the transition. With the comparable energetics between the AFE and FE phases, there can be a competition and frustration of these phases, and either incommensurate (INC) and/or a glassy (relaxor) structures may be observed. The phase transition in AFEs can also be influenced by the crystal/grain size, particularly at nanometric dimensions, and may be tuned through the formation of solid solutions. There have been extensive studies on the perovskite family of AFE materials, but many other crystal structures host AFE behavior, such as CuBiP2Se6. AFE applications include DC‐link capacitors for power electronics, defibrillator capacitors, pulse power devices, and electromechanical actuators. The paper concludes with a perspective on the future needs and opportunities with respect to discovery, science, and applications of AFE