An effective algaecide for the targeted destruction of Karenia brevis.

We address the targeted destruction of Karenia brevis using the algaecide calcium peroxide, in tandem with the flocculation and sinking of the species. The specific aspect of the approach is the incorporation of the algaecide within the floc to rapidly kill K. brevis, thus minimizing escape of cells from the floc and reentry to the water column. CaO2 gradually produces H2O2, which diffuses through cell membranes and induces oxidative stress, leading to cell death via excessive reactive oxygen species (ROS) formation. The effect of varying doses of calcium peroxide on K. brevis cells was measured with pulse amplitude modulated fluorometry and indicated that doses as low as 30 mg/L when integrated into flocs are effective in suppressing photosynthesis. Cell viability assays also indicate that such low levels are sufficient to cause cell death in a 3-6 hour time period. Thus, the proposed technology involving the incorporation of calcium peroxide in a cationic flocculating agent (polyaluminum chloride, PAC) leads to an inexpensive and scalable technology to mitigate harmful algal blooms of K. brevis.

Scedosporium apiospermum infections in the middle ear and mastoid: case series and review of the literature.

OBJECTIVES: To present our case series and management of Scedosporium apiospermum infections of the middle ear and mastoid, and review the current literature on this rare yet potentially life-threatening condition. METHODS: Medical records of patients treated at the Royal Victorian Eye and Ear Hospital for S apiospermum middle ear and mastoid infections between 2009 and 2019 were reviewed. A literature search was conducted using PubMed, Medline and Cochrane Library databases. RESULTS: Two patients were identified in our institution: a 62-year-old diabetic woman with otogenic skull base osteomyelitis, and a 12-year-old boy with unilateral chronic suppurative otitis media which developed after tympanostomy tube insertion. The persistence of otalgia and otorrhoea despite prolonged antibiotic treatment characterised these cases. Both patients received voriconazole, and achieved disease resolution without complications. Ten relevant cases were identified after review of the literature. Despite treatment, there were three patient deaths, and four patients with otological or neurological complications. CONCLUSION: The presence of a middle ear or mastoid infection refractory to appropriate topical and systemic antibiotics should prompt clinicians to consider a fungal infection. The role of surgical debridement in the treatment of S apiospermum infection of the middle ear and mastoid is equivocal.

Case report of a p16INK4A-positive branchial cleft cyst.

OBJECTIVE: To report the occurrence of a concurrent oropharyngeal papilloma and branchial cleft cyst linked by p16(INK4A) and human papillomavirus immunohistochemistry. CASE REPORT: A 42-year-old woman presented with a 1-month history of a left lateral neck mass. Contrast enhanced computed tomography showed a hypodense lesion 20 mm in diameter anteromedial to the left sternocleidomastoid muscle. Ultrasound-guided fine needle aspiration suggested a branchial cleft cyst. Panendoscopy was performed at the time of neck mass removal, and a papillomatous lesion was removed from the left hypopharynx. Histopathological analysis showed the neck lesion to be a branchial cyst containing lymphoid tissue, and the oral lesion to be a squamous papilloma. Immunohistochemical analysis showed both the branchial cleft cyst and papilloma to be positive for p16(INK4A) expression and human papillomavirus DNA. CONCLUSION: Histological and immunohistochemical analyses support the cystic transformation of lymph nodes, or the 'Inclusion Theory', as the aetiology of branchial apparatus anomalies, and raise the possibility that human papillomavirus infection may play a much larger role in disease of the head and neck than previously supposed.

Does an Electronic Health Record Improve Completeness of Prenatal Studies?

OBJECTIVE: To determine whether implementation of an electronic health record (EHR) would increase the rate of prenatal Human Immunodeficiency Virus (HIV) and purified protein derivative (PPD) testing. METHODS: Eligible participants received prenatal care and delivered at term at a single academic institution in March-April 2011, March-April 2012, and March-April 2013. As part of routine prenatal care, all women were tested for HIV and tuberculosis (via a PPD test) during each pregnancy. The 2011 cohort was charted on paper. The 2012 and 2013 cohorts were charted via EHR. To appear in the prenatal labs display in EHR, PPD results must be manually documented, while HIV results are uploaded automatically. Documentation of PPD and HIV tests were analyzed. RESULTS: The 2011, 2012, and 2013 cohorts had 249, 208, and 190 patients, respectively. Complete PPD and HIV results were less likely to be charted in the 2012 EHR cohort compared to the paper chart cohort (72.1% vs. 80.1%; p=0.03). This was driven by fewer documented completed PPD tests (2011 83.9% vs. 2012 72.6%; p=0.003). PPD test documentation improved non-significantly to 86.2% in the 2013 EHR cohort (p=0.5). HIV documentation rates increased from 95.2% in the paper chart cohort to 98.6% in the 2012 EHR cohort (p=0.04), and to 98.9% in the 2013 EHR cohort (p=0.03). CONCLUSIONS: EHR implementation corresponded with a marked decrease in documentation of PPD test completion. HIV documentation rates improved. PPD results were likely charted incorrectly in provider notes due to training deficiencies and lack of standardization, which did not improve significantly after retraining.

Molecular excitons in a copper azadipyrrin complex.

Exciton coupling is investigated in a copper azadipyrrin complex, Cu(L-aza)2. Exciton coupling in Cu(L-aza)2 assuming a single π-π* state on the L-aza ligand fails to account for the electronic structure of Cu(L-aza)2, which displays two almost equal intensity transitions at 15 600 cm(-1) and 17 690 cm(-1). TD-UB3LYP/6-31G(d) calculations suggest multiple π-π* transitions for the L-aza ligands and simple vector addition of the transition dipoles predicts two nearly orthogonal co-planar excitonic transitions that correctly reproduce the absorption band profile. Empirical modelling of absolute resonance Raman intensities using wavepacket dynamics confirms Cu(L-aza)2 has two equal intensity orthogonal exciton transitions. The phenyl substituents at the α- and γ-positions of the pyrrole rings play a central role in determining the orientation of the transition dipoles. Consequently the π-π* transitions for the L-aza ligands are oriented towards the substituent groups and are not in the plane of the pyrrole rings. Mode displacements in the Franck-Condon (FC) region obtained from the wavepacket model suggest that pyrrole ring and phenyl modes control the exciton FC dynamics. Our results suggest that Cu(L-aza)2 is an ideal model for theoretical, computational and experimental investigations of molecular excitons in molecular systems.

"Eco-omics": a review of the application of genomics, transcriptomics, and proteomics for the study of the ecology of harmful algae.

The implementation of molecular techniques has been widely adopted throughout the life sciences except in the marine sciences. The latter trend is quickly being reversed as even more cutting-edge molecular platforms, referred to collectively as 'omics-related technologies, are being used in a number of laboratories that study various aspects of life in the marine environment. This review provides a brief overview of just a few representative studies that have used genomics, transcriptomics, or proteomics approaches to deepen our understanding, specifically, about the underlying molecular biology of harmful algae. The examples of the studies described here are particularly relevant in showing how the information gleaned from these technologies can uncover the genetic capacity of harmful algal bloom-forming species, can generate new hypotheses about mechanistic relationships that bridge gene-environment interactions, and can impinge on our understanding surrounding the ecology of these organisms.

Salmonella rarely detected in Mississippi coastal waters and sediment.

AIMS: Standards for the rapid detection of individual pathogens from environmental samples have not been developed, but in their absence, the use of molecular-based detection methods coupled with traditional microbiology techniques allows for rapid and accurate pathogen detection from environmental waters and sediment. The aim of this research was to combine the use of enrichment with PCR for detection of Salmonella in Mississippi coastal waters and sediment and observe if that presence correlated with levels of enterococci and climatological variables. METHODS AND RESULTS: Salmonella were primarily found in samples that underwent nutrient enrichment and were present more frequently in freshwater than marine waters. Salmonella were detected infrequently in marine and freshwater sediments. There was a significant positive correlation between the presence of detectable Salmonella and the average enterococcal count. An inverse relationship, however, was observed between the frequency of detection and the levels of salinity, turbidity and sunlight exposure. CONCLUSIONS: Results from this study indicated the presence of Salmonella in Mississippi coastal waters, and sediments are very low with significant differences between freshwater and marine environments. SIGNIFICANCE AND IMPACT OF THE STUDY: Using pathogenic and novel nonpathogenic molecular markers, Salmonella do not appear to be a significant pathogenic genus along the Mississippi Coast.

Personal dose equivalent conversion coefficients for neutron fluence over the energy range of 20-250 MeV.

Monte Carlo simulations were performed to extend existing neutron personal dose equivalent fluence-to-dose conversion coefficients to an energy of 250 MeV. Presently, conversion coefficients, H(p,slab)(10,alpha)/Phi, are given by ICRP-74 and ICRU-57 for a range of angles of radiation incidence (alpha = 0, 15, 30, 45, 60 and 75 degrees ) in the energy range from thermal to 20 MeV. Standard practice has been to base operational dose quantity calculations <20 MeV on the kerma approximation, which assumes that charged particle secondaries are locally deposited, or at least that charged particle equilibrium exists within the tally cell volume. However, with increasing neutron energy the kerma approximation may no longer be valid for some energetic secondaries such as protons. The Los Alamos Monte Carlo radiation transport code MCNPX was used for all absorbed dose calculations. Transport models and collision-based energy deposition tallies were used for neutron energies >20 MeV. Both light and heavy ions (HIs) (carbon, nitrogen and oxygen recoil nuclei) were transported down to a lower energy limit (1 keV for light ions and 5 MeV for HIs). Track energy below the limit was assumed to be locally deposited. For neutron tracks <20 MeV, kerma factors were used to obtain absorbed dose. Results are presented for a discrete set of angles of incidence on an ICRU tissue slab phantom.

Are the Brookhill-Wilk patents impediments to market growth in cybersurgery?

BACKGROUND: In the past, many surgeons could practise their craft with little or no knowledge of patent law. But in the world of robotic and computerized surgery, this is increasingly a myopic approach, because the principle means of protecting high-tech surgical instruments is through the application of patent law. The issue is: does the Brookhill-Wilk patent, which covers the performance of remote robotic surgery, impede the growth of cybersurgery? METHODS: Review of the Brookhill-Wilk patent and relevant law. RESULTS: Patent law, which first took its form in the Middle Ages, attempts to balance the rewarding of innovation with the stifling of market growth. Using US patent law as a model, it would appear that the Brookhill-Wilk patent, a particular example of a medical process patent, could inhibit the growth of cybersurgery, as potential sums of money could be demanded by the patent holder from anyone who practises cybersurgery. However, two recent US Supreme Court cases appear to have seriously undermined the validity of a number of medical process patents, including the Brookhill-Wilk patent. CONCLUSION: Based on recent changes in patent law, it is not expected that Brookhill-Wilk patent will hinder the growth of cybersurgery.

CHELSI: a portable neutron spectrometer for the 20-800 MeV region.

CHELSI is a CsI-based portable spectrometer being developed at Los Alamos National Laboratory for use in high-energy neutron fields. Based on the inherent pulse shape discrimination properties of CsI(Tl), the instrument flags charged particle events produced via neutron-induced spallation events. Scintillation events are processed in real time using digital signal processing and a conservative estimate of neutron dose rate is made based on the charged particle energy distribution. A more accurate dose estimate can be made by unfolding the 2D charged particle versus pulse height distribution to reveal the incident neutron spectrum from which dose is readily obtained. A prototype probe has been assembled and data collected in quasi-monoenergetic fields at The Svedberg Laboratory (TSL) in Uppsala as well as at the Los Alamos Neutron Science Center (LANSCE). Preliminary efforts at deconvoluting the shape/energy data using empirical response functions derived from time-of-flight measurements are described.

Characterization of neutron reference fields at US Department of Energy calibration fields.

The Health Physics Measurements Group at the Los Alamos National Laboratory (LANL) has initiated a study of neutron reference fields at selected US Department of Energy (DOE) calibration facilities. To date, field characterisation has been completed at five facilities. These fields are traceable to the National Institute for Standards and Technology (NIST) through either a primary calibration of the source emission rate or through the use of a secondary standard. However, neutron spectral variation is caused by factors such as room return, scatter from positioning tables and fixtures, source anisotropy and spectral degradation due to source rabbits and guide tubes. Perturbations from the ideal isotropic point source field may impact the accuracy of instrument calibrations. In particular, the thermal neutron component of the spectrum, while contributing only a small fraction of the conventionally true dose, can contribute a significant fraction of a dosemeter's response with the result that the calibration becomes facility-specific. A protocol has been developed to characterise neutron fields that relies primarily on spectral measurements with the Bubble Technology Industries (BTI) rotating neutron spectrometer (ROSPEC) and the LANL Bonner sphere spectrometer. The ROSPEC measurements were supplemented at several sites by the BTI Simple Scintillation Spectrometer probe, which is designed to extend the ROSPEC upper energy range from 5 to 15 MeV. In addition, measurements were performed with several rem meters and neutron dosemeters. Detailed simulations were performed using the LANL MCNPX Monte Carlo code to calculate the magnitude of source anisotropy and scatter factors.

The complexity of litigation associated with robotic surgery and cybersurgery.

Litigation after cybersurgery, i.e. remote robotic surgery, will be complex. In addition to being able to sue physicians and hospitals, patients who sustain an adverse outcome after cybersurgery will have the potential to sue the robotic manufacturer and the telecommunications company. Moreover, cybersurgery litigation will involve laws that are generally unfamiliar to healthcare providers. Accordingly, this article examines a lawsuit involving a robotic surgical instrument as a model to suggest where liability traps may arise during the delivery of cybersurgery.

Effect of anticipation during unknown or unexpected exercise duration on rating of perceived exertion, affect, and physiological function.

OBJECTIVES: To determine the effect of unknown exercise duration and an unexpected increase in exercise duration on rating of perceived exertion (RPE), affect, and running economy during treadmill running. METHODS: Sixteen well trained male and female runners completed three bouts of treadmill running at 75% of their peak treadmill running speed. In the first trial, they were told to run for 20 minutes and were stopped at 20 minutes (20 MIN). In another trial, they were told to run for 10 minutes, but at 10 minutes were told to run for a further 10 minutes (10 MIN). In the final trial, they were not told for how long they would be running but were stopped after 20 minutes (unknown, UN). During each of the running bouts, RPE, oxygen consumption (ml/kg/min), heart rate (beats/min), stride frequency (min(-1)), affect scores (arbitrary units), and attentional focus (percentage associative thought scores) were recorded. RESULTS: RPE increased significantly between 10 and 11 minutes in the 10 MIN compared with the 20 MIN and UN trials (p<0.05). The affect score decreased significantly between 10 and 11 minutes in the 10 MIN compared with the 20 MIN trial (p<0.05). Running economy, as measured by oxygen consumption, was significantly lower in the UN compared with the 20 MIN trial from 10 to 19 minutes (p<0.05). CONCLUSIONS: The change in RPE between 10 and 11 minutes in the 10 MIN trial suggests that RPE is not purely a measure of physical exertion, as treadmill speed was maintained at a constant pace both before and after the unexpected increase in exercise duration. The associated changes in affect score at similar times in the 10 MIN trial supports the hypothesis that RPE has an affective component.

Multisphere default spectra--solution spectrum and dosemeter response implications.

Initial calibration of a multisphere spectroscopy system has been completed at Los Alamos National Laboratory using four standard calibration scenarios. Spectrum unfolding was performed using three methods of constructing the default spectrum: simple parameter models, Monte Carlo calculations and physical measurement. Comparisons of the resulting spectra for each solution method are presented. Implications of the spectral solutions upon dosemeter characterisation are addressed.

Determinants of quality of life in first-episode psychosis.

OBJECTIVE: To assess patient and/or illness characteristics associated with aspects of quality of life (QOL) in first-episode psychosis (FEP). METHOD: Patient characteristics, symptom ratings and Wisconsin QOL scale (client version) were assessed. Data were analysed with correlation coefficients and a hierarchical regression analysis. RESULTS: Patients presented with varying levels of QOL on different domains. The level of 'general satisfaction' was related to age of onset and social premorbid adjustment; 'weighted index of QOL' to social premorbid adjustment and inversely to educational premorbid adjustment; 'social relations' inversely to duration of untreated psychosis (DUP), length of prodrome and negative symptoms; 'psychological well-being' inversely to depression and educational premorbid adjustment; 'activities of daily living' to social premorbid adjustment and inversely to negative symptoms; and 'outlook on symptoms' to level of depression. CONCLUSION: Domains of self-rated QOL in FEP patients are differentially associated with malleable and non-malleable aspects of patient and illness characteristics.

Corticosteroid injection in early treatment of lateral epicondylitis.

OBJECTIVE: To analyze whether a corticosteroid injection in combination with rehabilitation early in the course of lateral epicondylitis (LE) alters the outcome up to 6 months after injection compared with a control injection and rehabilitation. DESIGN: Randomized, controlled, double-blind study. SETTING: Sports medicine center in a tertiary care center. PARTICIPANTS: Subjects with a diagnosis of LE whose symptoms had been present less than 4 weeks were included. Subjects were recruited by word of mouth and through advertising. The 39 subjects who were recruited were 18 to 65 years old. INTERVENTIONS: 19 subjects were randomized to receive rehabilitation and a sham injection, and 20 were randomized to receive rehabilitation and a corticosteroid injection. At 4 and 8 weeks, they were reevaluated and their treatment programs were modified, if indicated. MAIN OUTCOME MEASURES: Outcome measurements were performed at baseline, 4 weeks, 8 weeks, and 6 months, and included a functional pain questionnaire and a visual analogue pain scale. Painless grip strength on the affected side and maximal grip strength bilaterally were measured at baseline, 4 weeks, and 8 weeks. RESULTS: There were no significant differences in outcome between the two groups with the exception of an improvement in the visual analogue pain scale in the corticosteroid group from 8 weeks to 6 months. Outcome measurements in both groups improved significantly over time; more than 80% of subjects reported improvements from baseline to 6 months for all scales. CONCLUSION: A corticosteroid injection does not provide a clinically significant improvement in the outcome of LE, and rehabilitation should be the first line of treatment in patients with a short duration of symptoms.

Impact of phase-specific treatment of first episode of psychosis on Wisconsin Quality of Life Index (client version).

OBJECTIVE: The objective of this study was to assess the impact of a phase-specific community-focused treatment program on different dimensions of self-reported quality of life in a representative sample of first episode psychosis patients. METHOD: Data were collected on patients presenting with a first episode of psychosis on the Wisconsin Quality of Life Index (client version), positive and negative symptoms, and demographic and clinical variables at baseline following clinical stabilization and at 1 year. RESULTS: Complete data on a representative sample of 41 patients showed a significant improvement in most dimensions of the WQOL at 1 year; these changes were generally independent of changes in symptoms and there were no significant differences in the magnitude of improvement in QOL between those with DUP < or >6 months. CONCLUSION: Patients with a first episode of predominantly schizophrenia spectrum psychosis show a highly significant improvement in subjectively assessed quality of life following a year of phase-specific comprehensive treatment.

The relationship of symptoms and level of functioning in schizophrenia to general wellbeing and the Quality of Life Scale.

OBJECTIVE: Reports suggesting that quality of life in schizophrenia is more highly related to negative rather than positive symptoms are largely based on use of the Quality of Life Scale which was devised to assess deficit symptoms and does not include an assessment of subjective general wellbeing. In the current paper we examined symptoms, level of community functioning as well as living circumstances as correlates of Quality of Life Scale scores and scores on the General Well-Being Scale. METHOD: One hundred and twenty-eight patients completed the General Well-Being Scale and were rated on the Quality of Life Scale as well as scales assessing positive and negative symptoms. RESULTS: While negative symptoms, level of functioning and positive symptoms all were related to the scores on the Quality of Life Scale, General Well-Being Scale scores were primarily related to positive symptoms, particularly reality distortion. CONCLUSION: The results highlight the importance of recognizing the complex nature of the concept of quality of life. They demonstrate that varying indices of quality of life are likely to have different predictors.

Herpes simplex virus type 1 infection imposes a G(1)/S block in asynchronously growing cells and prevents G(1) entry in quiescent cells.

Herpes simplex virus type 1 (HSV-1) infection disrupted cell cycle regulation in at least two ways. First, infection of quiescent human embryonic lung cells simultaneously with readdition of serum caused inhibition of cyclin D/cyclin-dependent kinase (CDK) 4,6-specific and cyclin E/CDK2-specific phosphorylation of the retinoblastoma protein pRb. The inhibition of cyclin D/CDK4,6 kinase activity corresponded to a loss of cyclin D1 protein and a failure of CDK4 and CDK6 to translocate to the nucleus. Failure to detect cyclin E/CDK2 kinase activity was accompanied by a loss of cyclin E protein and a failure of CDK2 to translocate to the nucleus. Levels of pocket protein p130 persisted, whereas p107 did not accumulate. As a result of these effects on cyclin kinase, G(0)-infected cells failed to reenter the cell cycle. The second type of HSV-induced cell cycle dysregulation was observed in asynchronously dividing cell cultures. A rapid inhibition of preexisting cyclin E/CDK2 and cyclin A/CDK2 activities was observed in human embryonic lung cells, as well as two other human cell lines: C33 and U2OS. HSV-1 immediate-early gene expression was necessary for the inhibition of CDK2 kinase activity. Cyclin and CDK subunit protein levels, intracellular localization, and complex stability were unaffected by infection. In addition, levels of cyclin-dependent kinase inhibitors, p27 and p21, were not affected by HSV-1. Previous experiments demonstrated that in asynchronous infected cells, hypophosphorylated pRb and pocket protein-E2F complexes accumulated, and cellular DNA synthesis was rapidly inhibited. Coupled with the present results, this indicates that HSV-1 has evolved mechanisms for preventing cells in G(1) from proceeding through the restriction point and for cells in S from completing a round of DNA replication.