Fungal speciation using quantitative polymerase chain reaction (QPCR) in patients with and without chronic rhinosinusitis.

Objectives/hypothesisThe objectives of this study were to determine the mycology of the middle meatus using an endoscopically guided brush sampling technique and polymerase chain reaction laboratory processing of nasal mucous; to compare the mycology of the middle meatus in patients with sinus disease with subjects without sinus disease; to compare the responses on two standardized quality-of-life survey forms between patients with and without sinusitis; and to determine whether the presence of fungi in the middle meatus correlates with responses on these data sets.Study designThe authors conducted a single-blind, prospective, cross-sectional study.MethodsPatients with sinus disease and a control group without sinus disease were enrolled in the study. A disease-specific, validated Sinonasal Outcomes Test survey (SNOT-20) was completed by the subjects and a generalized validated Medical Outcomes Short Form 36 Survey (SF-36) was also completed. An endoscopically guided brush sampling of nasal mucous was obtained from the middle meatus. Fungal specific quantitative polymerase chain reaction (QPCR) was performed on the obtained sample to identify one of 82 different species of fungus in the laboratory. Statistical analysis was used to categorize the recovered fungal DNA and to crossreference this information with the outcomes surveys.ResultsThe fungal recovery rate in the study was 45.9% in patients with sinus disease and 45.9% in control subjects. Patients with chronic rhinosinusitis had a mean SNOT-20 score of 1.80 versus the control group mean score of 0.77 (P < .0001). SF-36 data similarly showed a statistically significant difference between diseased and control populations with controls scoring a mean of 80.37 and patients with chronic rhinosinusitis scoring a mean of 69.35 for a P value of .02. However, no statistical significance could be ascribed to the presence or absence of fungi recovered, the type of fungi recovered, or the possible impact of fungi on the quality-of-life survey results.ConclusionThe recovery rate of fungi from the middle meatus of patients with chronic rhinosinusitis and a control population without chronic rhinosinusitis is 45.9% using QPCR techniques. No direct causation with regard to fungal species or presence was proven; however, a species grouping for future studies is proposed based on trends in this data and other reports. Disease-specific outcomes surveys revealed a statistically significant difference between the two groups

Estimating adult mortality in Zambia using information on survival of parents from surveys

The aim of this study is to derive estimates of level of and trend in adult mortality in Zambia. To do this the study applies the standard orphanhood method to the data on survivorship of parents from various Zambia Demographic and Health and Living Conditions Monitoring Surveys to estimate 10q25 and 15q25 for females; and 10q35 for males, and hence, the probability of a 15 year old dying before age 60 (45q15). The study finds that the orphanhood method captures some of the trend but fails to provide definitive estimates of mortality. The levels of female adult mortality between ages 25 and 35 years have remained constant at about 15 per cent from the mid-1990s. The female mortality rate between ages 25 and 40 years has also remained constant, at between 20 per cent and 25 per cent since 2000. Adult male mortality between ages 35 and 45 years increased in the mid-1990s and has remained between 20 per cent and 25 per cent from the late 1990s to late 2000s. Adult mortality, 45q15, for both males and females, has increased over time and has stabilised at about 60 per cent for males and 50 per cent for females. These adult mortality rates are comparable to estimates from other sources

Association Among Acrylamide, Blood Insulin, and Insulin Resistance in Adults

OBJECTIVE - Exposure to acrylamide in foodstuffs and smoking has become a worldwide concern. The effect of acrylamide on glucose homeostasis is not known. The goal of the present study Was to test the hypothesis that trace acrylamide exposure might be independently associated With both reduced blood insulin and reduced insulin resistance. RESEARCH DESIGN AND METHODS - We examined 1,356 participants with reliable measures of glucose homeostasis and Hb adducts of acrylamide (HbAA) and glycidamide from the National Health and Nutrition Examination Survey, 2003-2004. Glucose homeostasis was assessed by the measurement of plasma glucose, serum insulin, and the homeostasis model assessment of insulin resistance (HOMA- IR). RESULTS - in a linear regression model, a 1-unit increase in log HbAA was associated with a decrease in serum insulin (beta coefficient = -0.20 +/- 0.05, P = 0.001) and HOMA-IR (beta coefficient = -0.23 +/- 0.05, P < 0.001). After HbAA concentrations were divided into quartiles in the fully adjusted models, the adjusted serum insulin level and HOMA- IR significantly decreased across quartiles of HbAA (P-trend < 0.001 for both ). In subgroup analysis, the association of HbAA levels with HOMA-IR and insulin levels was stronger in subjects who were white or had ever smoked or in subjects With a lower education level or a BMI <25 or >30 kg/m(2). CONCLUSIONS - Acrylamide is associated with reduced serum insulin levels in adults. Further clinical and animal studies are warranted to clarify the putative causal relationship

Advances in standardization of laboratory measurement procedures: implications for measuring biomarkers of folate and vitamin B-12 status in NHANES1234

Population studies such as NHANES analyze large numbers of laboratory measurements and are often performed in different laboratories using different measurement procedures and over an extended period of time. Correct clinical and epidemiologic interpretations of the results depend on the accuracy of those measurements. Unfortunately, considerable variability has been observed among assays for folate, vitamin B-12, and related biomarkers. In the past few decades, the science of metrology has advanced considerably, with the development of improved primary reference measurement procedures and high-level reference materials, which can serve as the basis for accurate measurement. A rigorous approach has been established for making field methods traceable to the highest-level reference measurement procedures and reference materials. This article reviews some basic principles of metrology and describes their recent application to measurements of folate and vitamin B-12

How Dynamic Adsorption Controls Surfactant‑enhanced Boiling

Improving boiling is challenging due to the unpredictable nature of bubbles. One way to enhance boiling is with surfactants, which alter the solid–liquid and liquid–vapor interfaces. The conventional wisdom established by previous studies suggests that heat transfer enhancement is optimized near the critical micelle concentration (CMC), which is an equilibrium property that depends on surfactant type. However, these studies only tested a limited number of surfactants over small concentration ranges. Here, we test a larger variety of nonionic and anionic surfactants over the widest concentration range and find that a universal, optimal concentration range exists, irrespective of CMC. To explain this, we show that surfactant-enhanced boiling is controlled by two competing phenomena: (1) the dynamic adsorption of surfactants to the interfaces and (2) the increase in liquid dynamic viscosity at very high surfactant concentrations. This dynamic adsorption is time-limited by the millisecond-lifetime of bubbles on the boiling surface—much shorter than the timescales required to see equilibrium behaviors such as CMC. At very high concentrations, increased viscosity inhibits rapid bubble growth, reducing heat transfer. We combine the effects of adsorption and viscosity through a simple proportionality, providing a succinct and useful understanding of this enhancement behavior for boiling applications

Reduction in Asthma Morbidity in Children as a Result of Home Remediation Aimed at Moisture Sources

OBJECTIVE: Home dampness and the presence of mold and allergens have been associated with asthma morbidity. We examined changes in asthma morbidity in children as a result of home remediation aimed at moisture sources. DESIGN: In this prospective, randomized controlled trial, symptomatic, asthmatic children (n = 62), 2–17 years of age, living in a home with indoor mold, received an asthma intervention including an action plan, education, and individualized problem solving. The remediation group also received household repairs, including reduction of water infiltration, removal of water-damaged building materials, and heating/ventilation/air-conditioning alterations. The control group received only home cleaning information. We measured children’s total and allergen-specific serum immuno-globulin E, peripheral blood eosinophil counts, and urinary cotinine. Environmental dust samples were analyzed for dust mite, cockroach, rodent urinary protein, endotoxin, and fungi. The follow-up period was 1 year. RESULTS: Children in both groups showed improvement in asthma symptomatic days during the preremediation portion of the study. The remediation group had a significant decrease in symptom days (p = 0.003, as randomized; p = 0.004, intent to treat) after remodeling, whereas these parameters in the control group did not significantly change. In the postremediation period, the remediation group had a lower rate of exacerbations compared with control asthmatics (as treated: 1 of 29 vs. 11 of 33, respectively, p = 0. 003; intent to treat: 28.1% and 10.0%, respectively, p = 0.11). CONCLUSION: Construction remediation aimed at the root cause of moisture sources and combined with a medical/behavioral intervention significantly reduces symptom days and health care use for asthmatic children who live in homes with a documented mold problem

GW25-e0848 The effects of anticoagulant therapy on coagulant state and platelet function following transcatheter closure of atrial septal defect

BACKGROUND: Motor cortex stimulation (MCS) was introduced in the early 1990s by Tsubokawa and his group for patients diagnosed with drug-resistant, central neuropathic pain. Inconsistencies concerning the details of this therapy and its outcomes and poor methodology of most clinical essays divide the neuromodulation society worldwide into "believers" and "nonbelievers." A European expert meeting was organized in Brussels, Belgium by the Benelux Neuromodulation Society in order to develop uniform MCS protocols in the preoperative, intraoperative, and postoperative courses. METHODS: An expert meeting was organized, and a questionnaire was sent out to all the invited participants before this expert meeting. An extensive literature research was conducted in order to enrich the results. RESULTS: Topics that were addressed during the expert meeting were 1) inclusion and exclusion criteria, 2) targeting and methods of stimulation, 3) effects of MCS, and 4) results from the questionnaire. CONCLUSIONS: Substantial commonalities but also important methodologic divergencies emerged from the discussion of MCS experts from 7 European Centers. From this meeting and questionnaire, all participants concluded that there is a need for more homogenous standardized protocols for MCS regarding patient selection, implantation procedure, stimulation parameters, and follow-up-course

Spontaneous adaptation explains why people act faster when being imitated

The human ability to perform joint actions is often attributed to high-level cognitive processes. For example, the finding that action leaders act faster when imitated by their partners has been interpreted as evidence for anticipation of the other’s actions (Pfister, Dignath, Hommel, & Kunde, 2013). In two experiments, we showed that a low-level mechanism can account for this finding. Action leaders were faster when imitated than when counterimitated, but only if they could observe their partner’s actions (Exp. 1). Crucially, when due to our manipulation the partner’s imitative actions became slower than the counterimitative actions, leaders also became slower when they were imitated, and faster when counterimitated (Exp. 2). Our results suggest that spontaneous temporal adaptation is a key mechanism in joint action tasks. We argue for a reconsideration of other phenomena that have traditionally been attributed solely to high-level processes

Brain metastases as primary manifestation of a melanocytic malignant peripheral nerve sheath tumor in a 60-year-old man

BACKGROUND: Malignant peripheral nerve sheath tumors are rare tumor entities that originate from peripheral nerve sheaths and have an unfavorable prognosis. Metastatic spread to the cerebral parenchyma is absolutely rare. This case report describes the clinical course in a 60-year-old man whose tumor came to medical attention because of a seizure. CASE PRESENTATION: Magnetic resonance imaging demonstrated two intracerebral lesions. The symptomatic lesion was removed microneurosurgically and histology demonstrated a metastasis from a malignant peripheral nerve sheath tumor. Postoperatively, whole-brain irradiation was performed. The primary tumor was identified in the area of the sciatic nerve on the right. Follow-up 14 months after resection showed that there was no progression of the intracerebral lesions but an increase in size and number of distant metastases. CONCLUSION: There are no generally accepted guidelines for the treatment of malignant peripheral nerve sheath tumors with cerebral metastases. This case report presents and discusses one possible therapeutic approach. Due to the poor overall prognosis, the least invasive therapy should be chosen