Bacterial colonization of the respiratory tract in patients with cystic fibrosis

Cystic fibrosis (CF) is the most common single gene disorder in The Netherlands and occurs approximately once in every 3600 children born alive. The heterozygous carrier frequency has been estimated to be approximately 1 :30. The defective gene was identified in 1989 and appeared to be located on chromosome. It codes for the cystic fibrosis transmembrane conductance regulator (CFTR), which acts as a transmembrane chloride channel. The most frequent mutation of this gene is the deletion of phenylalanine at position 508 ("F508). Almost 60% of the known CF patients in The Netherlands are homozygous for the "F508 mutation. More than 700 additional CFTR mutations related to CF have been identified as oflate May 1997 by the CF Genetic Analysis Consortium. The gene defect results in significant morbidity and affects mainly the respiratory tract and the pancreas. The CF lung presents an unique environment to microbial pathogens. The combination oflow or absent chloride secretion and an increased sodium absorption results in relative dehydration of the ainvays. Consequently, the disease is characterized by the production of abnonnally viscid secretions in epithelial tissues. Mucociliary clearance of bacteria from the lungs is impaired because of the viscid, dehydrated nature of the airway epithelia. Chronic ainvay inflammation leads to excessive secretion of purulent mucus and to obstmction of the airway which in turn causes bronchiectasis, pulmonary hypertension with cor pulmonale, haemoptysis, pneumothorax and, finally, respiratory failure. The exacerbation of puhnonary infections is the major cause of morbidity and mortality in patients with CF. Aggressive early treatment of respiratory infections is a critical success factor in the treatment ofCF patients. Thirty years ago, most patients died in infancy. Nowadays, patients born in the 1990's are likely to live up to a median age of 40 years

Application of Building Typologies for Modelling the Energy Balance of the Residential Building Stock

Building typologies can serve as a basis for analysing the national housing sector. During the TABULA project which was introducing or further developing building typologies in thirteen EU countries, six of the European partners have carried out model calculations which aim at imaging the energy consumption and estimating the energy saving potentials of their national residential building stocks (IWU / Germany, NOA / Greece, POLITO / Italy, VITO / Belgium, STU-K / Czech Republic, SBi / Denmark). The results show that the model calculations can provide plausible projections of the energy consumption of the national residential buildings stock. The fit of model calculations and national energy statistics is satisfactory, deviations can often be explained and corrected by adapting standard boundary conditions of the applied calculation models to more realistic values. In general, the analysis shows that building typologies can be a helpful tool for modelling the energy consumption of national building stocks and for carrying out scenario analysis beyond the TABULA project. The consideration of a set of representative buildings makes it possible to have a detailed view on various packages of measures for the complete buildings stock or for its sub-categories. The effects of different insulation measures at the respective construction elements as well as different heat supply measures including renewable energies can be considered in detail. The quality of future model calculations will depend very much on the availability of statistical data. For reliable scenario analysis information is necessary about the current state of the building stock (How many buildings and heating systems have been refurbished until now?) and about the current trends (How many buildings and heating systems are being refurbished every year?). The availability and regular update of the relevant statistical data will be an important basis for the development and evaluation of national climate protection strategies in the building secto

Children's Attention-Deficit/Hyperactivity Disorder Symptoms Predict Lower Diet Quality but Not Vice Versa:Results from Bidirectional Analyses in a Population-Based Cohort

BACKGROUND: As an adjuvant for medication, dietary changes focused on specific nutrients have been proposed to prevent or reduce attention-deficit/hyperactivity disorder (ADHD) symptoms. However, whether an overall healthy dietary pattern is associated with ADHD symptom severity during childhood remains unclear. Furthermore, it is not clear what the direction of this association is. OBJECTIVES: We aimed to examine the association between dietary patterns and ADHD symptoms in school-aged children. In addition, we aimed to identify the temporal direction of this association-that is, whether dietary patterns predict ADHD symptoms or vice versa. METHODS: We analyzed data from 3680 children participating in the Generation R Study, a prospective cohort in Rotterdam, Netherlands. ADHD symptoms were assessed with parent-report questionnaires at ages 6 and 10 y using the Child Behavior Checklist. Dietary intake was assessed at the age of 8 y with a validated food-frequency questionnaire. We computed a diet quality score reflecting adherence to dietary guidelines. We examined bidirectional associations of diet quality with ADHD symptom scores using multivariable linear regression analysis and cross-lagged modeling. RESULTS: Linear regressions showed that more ADHD symptoms at age 6 y were associated with a lower diet quality score at age 8 y (SD score = -0.08; 95% CI: -0.11, -0.05) but that diet quality at age 8 y was not associated with ADHD symptoms at age 10 y. Cross-lagged models confirmed a unidirectional relation from ADHD symptoms to diet quality but not vice versa. Associations did not differ by overweight status or between boys and girls. CONCLUSION: Our study suggests that children with more ADHD symptoms may be at higher risk of an unhealthy diet but that overall diet quality does not affect ADHD risk

Kernel Methods for Document Filtering

This paper describes the algorithms implemented by the KerMIT consortium for its participation in the Trec 2002 Filtering track. The consortium submitted runs for the routing task using a linear SVM, for the batch task using the same SVM in combination with an innovation threshold-selection mechanism, and for the adaptive task using both a second-order perceptron and a combination of SVM and perceptron with uneven margin. Results seem to indicate that these algorithm performed relatively well on the extensive TREC benchmark

Light Vector Resonances in the Effective Chiral Lagrangian for Heavy Mesons

We modify a chiral effective lagrangian recently suggested to describe interactions of the light pseudoscalars with mesons containing a heavy quark, so as to incorporate light vector resonances, such as $\rho$, etc. The modification uses the hidden gauge symmetry approach. As a preliminary example we present an application to the semileptonic $D\to K^\star$ decay.Comment: 12 pages 3 figures (not included), LaTeX (style article), UGVA-DPT 1992/07-780, BARI-TH/92-11

Molecular epidemiology of clinical isolates of Pseudomonas aeruginosa isolated from horses in Ireland

Clinical isolates (n = 63) of Pseudomonas aeruginosa obtained from various sites in 63 horses were compared using ERIC2 RAPD PCR to determine their genetic relatedness. Resulting banding patterns (n = 24 genotypes) showed a high degree of genetic heterogeneity amongst all isolates examined, indicating a relative non-clonal relationship between isolates from these patients, employing this genotyping technique. This study characterised 63 clinical isolates into 24 distinct genotypes, with the largest cluster (genotype E) accounting for 10/63 (15.9%) of the isolates. ERIC2 RAPD PCR proved to be a highly discriminatory molecular typing tool of P. aeruginosa in isolates recovered from horses. With the adoption of several controls to aid reproducibility, this technique may be useful as an alternative to PFGE, particularly in epidemiological investigations of outbreaks where speed may be a significant parameter. This is the first report of clonal heterogeneity amongst P. aeruginosa from horses and demonstrated that ERIC RAPD PCR is a rapid method for the examination of this species in horses, which may be useful in outbreak analysis

Application of Building Typologies for Modelling the Energy Balance of the Residential Building Stock.

Building typologies can serve as a basis for analysing the national housing sector. During the TABULA project which was introducing or further developing building typologies in thirteen EU countries, six of the European partners have carried out model calculations which aim at imaging the energy consumption and estimating the energy saving potentials of their national residential building stocks (IWU / Germany, NOA / Greece, POLITO / Italy, VITO / Belgium, STU-K / Czech Republic, SBi / Denmark). The results show that the model calculations can provide plausible projections of the energy consumption of the national residential buildings stock. The fit of model calculations and national energy statistics is satisfactory, deviations can often be explained and corrected by adapting standard boundary conditions of the applied calculation models to more realistic values. In general, the analysis shows that building typologies can be a helpful tool for modelling the energy consumption of national building stocks and for carrying out scenario analysis beyond the TABULA project. The consideration of a set of representative buildings makes it possible to have a detailed view on various packages of measures for the complete buildings stock or for its sub-categories. The effects of different insulation measures at the respective construction elements as well as different heat supply measures including renewable energies can be considered in detail. The quality of future model calculations will depend very much on the availability of statistical data. For reliable scenario analysis information is necessary about the current state of the building stock (How many buildings and heating systems have been refurbished until now?) and about the current trends (How many buildings and heating systems are being refurbished every year?). The availability and regular update of the relevant statistical data will be an important basis for the development and evaluation of national climate protection strategies in the building sector

Using psychological theory to understand the clinical management of type 2 diabetes in Primary Care : a comparison across two European countries

Peer reviewedPublisher PD

Nuclear immobilization of DsRed1 tagged proteins: A novel tool for studying DNA–protein interactions?

AbstractDsRed1 is a red fluorescent protein that can be used as a fusion partner with other proteins to determine their subcellular localization, similarly to the popular green fluorescent proteins (GFP). Here, we report that fusion of DsRed1 to estrogen receptor α (ERα) renders the transcription factor immobile within the nucleus. Furthermore, we show that the immobilization is dependent on DNA interaction and that the binding to the DNA can be direct as well as indirect for DsRed to immobilize with its fusion partners. This observation could provide a new tool to be used for the identification of target genes containing low affinity binding sites for several transcription factors including ERα. In addition, it could be employed for studies on protein–DNA interactions as well as protein–protein interactions during protein complex formation on chromatin in the event of transcription initiation and regulation

'Correction:'Peer chart audits: A tool to meet Accreditation Council on Graduate Medical Education (ACGME) competency in practice-based learning and improvement

<p>Abstract</p> <p>Background</p> <p>The Accreditation Council on Graduate Medical Education (ACGME) supports chart audit as a method to track competency in Practice-Based Learning and Improvement. We examined whether peer chart audits performed by internal medicine residents were associated with improved documentation of foot care in patients with diabetes mellitus.</p> <p>Methods</p> <p>A retrospective electronic chart review was performed on 347 patients with diabetes mellitus cared for by internal medicine residents in a university-based continuity clinic from May 2003 to September 2004. Residents abstracted information pertaining to documentation of foot examinations (neurological, vascular, and skin) from the charts of patients followed by their physician peers. No formal feedback or education was provided.</p> <p>Results</p> <p>Significant improvement in the documentation of foot exams was observed over the course of the study. The percentage of patients receiving neurological, vascular, and skin exams increased by 20% (from 13% to 33%) (p = 0.001), 26% (from 45% to 71%) (p < 0.001), and 18% (51%–72%) (p = 0.005), respectively. Similarly, the proportion of patients receiving a well-documented exam which includes all three components – neurological, vascular and skin foot exam – increased over time (6% to 24%, p < 0.001).</p> <p>Conclusion</p> <p>Peer chart audits performed by residents in the absence of formal feedback were associated with improved documentation of the foot exam in patients with diabetes mellitus. Although this study suggests that peer chart audits may be an effective tool to improve practice-based learning and documentation of foot care in diabetic patients, evaluating the actual performance of clinical care was beyond the scope of this study and would be better addressed by a randomized controlled trial.</p