Ligands and media impact interactions between engineered nanomaterials and clay minerals.

The exponential growth in technologies incorporating engineered nanomaterials (ENMs) requires plans to handle waste ENM disposal and accidental environmental release throughout the material life cycle. These scenarios motivate efforts to quantify and model ENM interactions with diverse background particles and solubilized chemical species in a variety of environmental systems. In this study, quantum dot (QD) nanoparticles and clay minerals were mixed in a range of water chemistries in order to develop simple assays to predict aggregation trends. CdSe QDs were used as a model ENM functionalized with either negatively charged or zwitterionic small molecule ligand coatings, while clays were chosen as an environmentally relevant sorbent given their potential as an economical water treatment technology and ubiquitous presence in nature. In our unbuffered experimental systems, clay type impacted pH, which resulted in a change in zwitterionic ligand speciation that favored aggregation with kaolinite more than with montmorillonite. With kaolinite, the zwitterionic ligand-coated QD exhibited greater than ten times the relative attachment efficiency for QD-clay heteroaggregation compared to the negatively charged ligand coated QD. Under some conditions, particle oxidative dissolution and dynamic sorption of ions and QDs to surfaces complicated the interpretation of the removal kinetics. This work demonstrates that QDs stabilized by small molecule ligands and electrostatic surface charges are highly sensitive to changes in water chemistry in complex media. Natural environments enable rapid dynamic physicochemical changes that will influence the fate and mobility of ENMs, as seen by the differential adsorption of water-soluble QDs to our clay media.

Implementation of radiation therapist cylinder insertion for vaginal vault brachytherapy.

Vaginal vault brachytherapy is a common treatment for endometrial cancer. Historically, applicator insertion has been the domain of a radiation oncologist (RO). This commentary outlines a project to improve efficiency and workforce utilisation by introducing a competency framework and training module allowing entitled radiation therapists to perform single-channel cylinder applicator insertions and treatment delivery under RO supervision for fraction one and without supervision for subsequent fractions. The rationale, relevant regulations, implementation process and barriers are explored.

A comparison of cancer statistics in New Zealand and Australia: 1996-2007.

AIM: To compare the burden and outcomes of cancer in New Zealand with those in Australia. METHODS: For the years 1996-1997 and 2006-2007, the incidence and mortality of cancer in New Zealand and Australia was compared to determine if differences between the two countries had changed over the decade under study. Summarised cancer data from New Zealand and Australia, age standardised to the 2002 World Health Organisation's standard population, were used to make the comparisons. RESULTS: For the 11 year timeframe of this study, total rates of cancer incidence reduced in New Zealand and increased in Australia. The incidence of cancer in New Zealand, relative to Australia, changed from an excess of +10.3 to a deficit of -27.5 per 100,000 people. When considering the excess in terms of gender, the annual excess of cancer registrations for New Zealand females fell from +19.9 to +0.9 per 100,000, and male cancer registration fell from an excess of +3.7 to a deficit of -58.0 per 100,000, due almost entirely to a surge in prostate cancer registration in Australia. Over the same 11-year timeframe, cancer-specific mortality rates decreased in both countries, but there was no change in the difference between New Zealand and Australian rates, which remained 10% higher in New Zealand. Similar to findings on 1996/7 data, the main cancer sites responsible for the overall excess mortality in 2006/7 were colorectal cancer in both sexes, and lung and breast cancer in females. CONCLUSION: The persisting different cancer mortality rates between the two countries is likely to have been partly due to lifestyle and ethnic differences in the populations, and partly due to New Zealanders presenting with more advanced cancers and having less easy access to some treatments. Until we know the relative contributions of these factors, it will be difficult for New Zealand to plan interventions in the future which have a good chance of lifting our cancer survival rates to those of our closest neighbour. The collection of clinical stage on all new cancer registrations would provide the base information required.

Identification of Mn(II)-oxidizing bacteria from a low-pH contaminated former uranium mine.

Biological Mn oxidation is responsible for producing highly reactive and abundant Mn oxide phases in the environment that can mitigate metal contamination. However, little is known about Mn oxidation in low-pH environments, where metal contamination often is a problem as the result of mining activities. We isolated two Mn(II)-oxidizing bacteria (MOB) at pH 5.5 (Duganella isolate AB_14 and Albidiferax isolate TB-2) and nine strains at pH 7 from a former uranium mining site. Isolate TB-2 may contribute to Mn oxidation in the acidic Mn-rich subsoil, as a closely related clone represented 16% of the total community. All isolates oxidized Mn over a small pH range, and isolates from low-pH samples only oxidized Mn below pH 6. Two strains with different pH optima differed in their Fe requirements for Mn oxidation, suggesting that Mn oxidation by the strain found at neutral pH was linked to Fe oxidation. Isolates tolerated Ni, Cu, and Cd and produced Mn oxides with similarities to todorokite and birnessite, with the latter being present in subsurface layers where metal enrichment was associated with Mn oxides. This demonstrates that MOB can be involved in the formation of biogenic Mn oxides in both moderately acidic and neutral pH environments.

Elevated HERV-K mRNA expression in PBMC is associated with a prostate cancer diagnosis particularly in older men and smokers.

Aberrant expression of subgroup k human endogenous retroviruses (HERV-K) has been observed in prostate cancer. This subgroup is unique because it encodes sequences in the human genome containing open reading frames for near intact retroviruses. We hypothesized that HERV-K reactivation could serve as a non-invasive early disease detection marker for prostate cancer. We evaluated HERV-K gag messenger RNA (mRNA) expression in blood samples of African-American and European-American men using a case-control design via quantitative real-time PCR. Additionally, we examined HERV-K envelope protein expression in prostate tumors by immunohistochemistry. HERV-K envelope protein was commonly upregulated in prostate tumors, but more so in tumors of African-American than European-American patients (61% versus 40%, P < 0.01). Examining HERV-K gag expression in peripheral blood mononuclear cells (PBMC) from 294 cases and 135 healthy men, we found that the abundance of HERV-K gag message was significantly higher in cases than controls and was associated with increased plasma interferon-γ. Men with gag expression in the highest quartile had >12-fold increased odds {odds ratio = 12.87 [95% confidence interval 6.3-26.25]} of being diagnosed with prostate cancer than those in the lowest quartile. Moreover, our results showed that HERV-K expression may perform better as a disease biomarker in older than younger men (whereas the sensitivity of prostate-specific antigen (PSA) testing decreases with age) and in men with a smoking history compared with never smokers. Combining non-invasive HERV-K testing with PSA testing may improve the efficacy of prostate cancer detection specifically among older men and smokers who tend to develop a more aggressive disease.

Trends in asthma prevalence, health care use, and mortality in the United States, 2001-2010.

Asthma prevalence increased from 2001 to 2010: An estimated 25.7 million persons had asthma in 2010. Certain demographic groups had higher asthma prevalence: children aged 0­17 years, females, black persons, persons of multiple race, Puerto Rican persons, and persons with a family income below the poverty level. This report examines rates for asthma outcomes (health care encounters and death) for persons with asthma rather than for the general population. Rates for the general population represent the burden of asthma in the United States. Rates for the population with asthma take into account changes in asthma prevalence over time and differences in asthma prevalence among demographic groups. From 2001 to 2009, rates for ED visits and hospitalizations per 100 persons with asthma remained stable, while rates for asthma visits in primary care settings (physician offices or hospital outpatient departments) and asthma deaths declined. For the period 2007­2009, asthma visit rates (per 100 persons with asthma) in primary care settings for black persons were similar to those for white persons, but rates for asthma ED visits, hospitalizations, and death (per 1,000) were higher. Compared with adults, children aged 0­17 years had a higher rate for asthma visits in primary care settings and EDs, but had a similar hospitalization rate and a lower asthma death rate.

National surveillance of asthma: United States, 2001-2010.

BACKGROUND: Asthma is prevalent but treatable: adherence to evidence-based treatment lessens impairment and lowers the risk of future exacerbations. OBJECTIVE: This report details recent trends in asthma prevalence, health care use, and mortality since 2001 and presents an overview of trends since 1980. METHODS: Asthma prevalence estimates were obtained from the National Health Interview Survey (2001-2010). Physician office visit data were obtained from the National Ambulatory Medical Care Survey, hospital outpatient department and emergency department (ED) visit data from the National Hospital Ambulatory Medical Care Survey, hospitalization data from the National Hospital Discharge Survey, and death data from the National Vital Statistics System (2001-2009). Two types of rates were calculated: population-based rates based on the total population and risk-based rates based on the population with asthma. RESULTS: Current asthma prevalence increased from 2001 to 2010. There were no significant changes in rates for hospital outpatient department visits, ED visits, or hospitalizations, whereas risk-based rates for private physician office visits declined. Asthma death rates decreased from 2001 to 2009. Over the long term, asthma prevalence rose more slowly after 2001 than during 1980-1996, asthma hospitalizations declined since 1984 and deaths declined since 1999. Disparities by race and sex for adverse outcomes remained high despite these declines. CONCLUSION: Since 2001, asthma prevalence increased, risk-based rates for visits to private physician offices and deaths declined, and risk-based rates for other types of ambulatory visits and for hospitalizations showed no clear trend.

Prostate cancer: the new evidence base for diagnosis and treatment.

Although prostate cancer (PC) has a significant mortality, there is debate regarding the utility of PC screening. This debate continues as major studies investigating the value of population-based screening have yet to be concluded. Despite this, there is increasing evidence from preliminary reports from these series, as well as numerous others relating to outcome prediction for PC, that early detection leads to improved outcomes and a decrease in the burden of metastatic disease on our healthcare system. PC is rarely symptomatic until it has metastasised to bone and because of this PSA-based screening remains the only widely available and reliable method of diagnosis for organ-confined disease. There is now compelling evidence to show that: 1. Cancers diagnosed by screening are more likely to be early stage, when most can be cured by a number of different treatment options. 2. The maximum benefits of screening are for men aged 50-70 years. Older men have a greater chance of a clinically insignificant cancer being diagnosed for which treatment is not necessary. 3. The familial risks of PC are well recognised. In particular, men with one or more first-degree relatives already diagnosed with the disease should be actively encouraged to undergo screening. 4. Modern histopathological assessment of fine core needle biopsies of the prostate allows for the likely behaviour of cancer present to be accurately predicted. Changes that mimic those of malignancy can be confidently identified, so these cases are no longer incorrectly diagnosed. These improvements mean that now most men aged 50-70 years diagnosed with PC will have clinically significant cancers that require treatment.

National surveillance for asthma--United States, 1980-2004.

PROBLEM/CONDITION: Asthma, a chronic respiratory disease with episodic symptoms, increased in prevalence during 1980-1996 in the United States. Asthma has been the focus of numerous provider interventions (e.g., improving adherence to asthma guidelines) and public health interventions during recent years. Although the etiology of asthma is unknown, adherence to medical treatment regimen and environmental management should reduce the occurrence of exacerbations and lessen the hardship of this disease. CDC has outlined a public health approach to asthma that includes comprehensive analyses of national surveillance data on prevalence, health-care use and mortality, and a strategy to improve the timeliness and geographic specificity of asthma surveillance data. REPORTING PERIOD COVERED: This report presents national data on asthma for self-reported prevalence (1980-1996 and 2001-2004); self-reported attacks (1997-2004); visits to physicians' offices (1980-2004), hospital outpatient departments (1992-2004), and emergency departments (1992-2004); hospitalizations (1980-2004); and deaths (1980-2004). DESCRIPTION OF SYSTEMS: The National Health Interview Survey includes questions about asthma prevalence and asthma attacks. Physicians' office visit data are collected in the National Ambulatory Medical Care Survey, emergency department and hospital outpatient data in the National Hospital Ambulatory Medical Care Survey, hospitalization data in the National Hospital Discharge Survey, and death data in the Mortality component of the National Vital Statistics System. RESULTS: From 1980 to 1996, 12-month asthma prevalence increased both in counts and rates, but no discernable change was identified in asthma attack estimates since 1997 or in current asthma prevalence from 2001 to 2004. During the period of increasing prevalence, patient encounters (office visits, emergency department visits, outpatient visits, and hospitalizations) for asthma increased. However, rates for these encounters, when based on the population with asthma, did not increase. Although the rate of asthma deaths increased during 1980-1995, the rate of deaths has decreased each year since 2000. During 2001-2003, current asthma prevalence was higher in children (8.5%) compared with adults (6.7%), females (8.1%) compared with males (6.2%), blacks (9.2%) compared with whites (6.9%), those of Puerto Rican descent (14.5%) compared with those of Mexican descent (3.9%), those below the federal poverty level (10.3%) compared with those at or above the federal poverty level (6.4% to 7.9%), and those residing in the Northeast (8.1%) compared with those residing in other regions (6.7% to 7.5%). Among persons with current asthma, whites and blacks were equally likely to report an attack during the preceding 12 months. Women with current asthma were more likely to report asthma attacks than men, and children were more likely than adults. The rate for asthma health-care encounters, regardless of place (physician office, emergency department, outpatient department, or hospital), when based on the population with asthma, did not differ by race. However, whites with current asthma had higher rates for physician offices, and blacks had higher rates for hospital-based sites (e.g., outpatient clinics and emergency departments). INTERPRETATION: The findings in this report suggest that from 1980 through the mid-1990s, increases in asthma prevalence played a substantial role in the increases in patient encounter measures used in asthma surveillance. Because no primary strategies for preventing asthma have been identified, efforts to control asthma exacerbations through interventions that promote adhering to proper medical regimens and reducing exposures to causes of asthma exacerbations should continue to be pursued.

Synthesis and conformational analysis of 6-C-methyl-substituted 2-acetamido-2-deoxy-beta-D-glucopyranosyl mono- and disaccharides.

Several 6-C-substituted 2-acetamido-2-deoxy-beta-D-glucopyranosides (beta-D-GlcNAc monosaccharides 1a-3a and 1,4-linked disaccharides 1b-3b) were studied by solution NMR spectroscopy. Conformational analysis of the (6S)- and (6R)-C-methyl-substituted beta-d-GlcNAc monosaccharides indicates that the stereodefined methyl groups impose predictable conformational biases on the exocyclic C-5-C-6 bond, as determined by (1)H-(1)H and (13)C-(1)H coupling constants. Variable-temperature NMR experiments in methanol-d(4) were performed to determine DeltaDeltaH and DeltaDeltaS values derived from the two lowest energy conformers. These indicate that while the influence of 6-C-methyl substitution on conformational enthalpy is in accord with the classic principles of steric interactions, conformational preference in solution can also be strongly affected by other factors such as solvent-solute interactions and solvent reorganization.

An objective and time-efficient method for determining severity of childhood speech delay.

To address the need for an efficient and valid approach to determining the severity of a child's speech delay, this study compared 2 types of sampling procedures to derive a measure of percentage of consonants correct (PCC; L. D. Shriberg and J. Kwiatkowski, 1982). PCC scores of twenty-one 4- to 6-year-old children with speech delay derived from both an imitative sentence task and a conversational task were compared. Scores did not differ significantly and corresponded favorably with a reference criterion (S. M. Benner, 1992) for determining clinical equivalence. The imitative approach required considerably less time to complete. Thus, the sentence imitation procedure offers a valid and efficient alternative to conversational sampling. However, clinicians should consider individual child characteristics when choosing an imitative approach.

Surveillance for Asthma - United States, 1960-1995

This report summarizes and reviews national data for specific endpoints: self-reported asthma prevalence (1980-1994), asthma office visits (1975-1995), asthma emergency room visits (1992-1995), asthma hospitalizations (1979-1994), and asthma deaths (1960-1995).