Association of gastrointestinal illness and recreational water exposure at an inland U.S. beach

Recent epidemiology studies examining U.S. recreational water exposure and illness relationships have focused primarily on coastal and Great Lakes beaches. Human-made lakes in the U.S. have received little attention in epidemiology studies despite contributing to more waterborne disease epidemics annually than coastal U.S. waters. In a comprehensive beach cohort study, we examined relationships between water quality indicators and reported adverse health outcomes among users of a beach at an inland U.S. lake. Human health data was collected over 26 swimming days during the 2009 swimming season in conjunction with water quality measurements. Adverse health outcomes were reported 8-9 days post-exposure via a phone survey. Wading, playing or swimming in the water was observed to be a significant risk factor for GI illness (adjusted odds ratio (AOR) of 3.2; CI 1.1, 9.0). Among water users, Escherichia coli density was significantly associated with elevated GI illness risk where the highest E. coli quartile was associated with an AOR of 7.0 (CI 1.5, 32). GI illness associations are consistent with previous freshwater epidemiology studies. Our findings are unique in that our observations of positive associations with GI illness risk are based upon a single daily E. coli measurement. Lastly, this study focused on an understudied issue, illness risk at inland reservoirs. Our results support the usefulness of E. coli as a health-relevant indicator of water quality for this inland U.S. beach.

Caregiving appraisal of family caregivers for older stroke patients in Korea

PURPOSE

The purpose of this study was to investigate factors related to caregiving appraisal for family caregivers of older stroke patients in Korea.

METHOD

A descriptive, cross-sectional survey of a sample of 242 family caregivers (95.7% response rate) was conducted in Korea from 1 January 2005 to 4 January 2007. Data were collected from outpatient stroke centres at three hospitals and two home health agencies located in Seoul, the capital city of Korea, its suburban area of Kyunggi-do, and the rural areas Gyeongsangbuk-do and Chungcheongbuk-do. The questionnaire was self-administered. spss 13.0 (SPSS, Inc., Chicago, IL, USA) was used to perform frequency, percentage, mean standard deviation, t-test or analysis of variance, and Pearson's correlation calculations.

RESULTS

Caregiving appraisal was statistically different based on the caregiver's location of residency and the relationship between the caregiver and the recipient. The caregivers who resided in urban areas reported higher scores of caregiving appraisal compared with those who resided in rural areas. With regard to the caregiver-recipient relationship, spouses reported the highest caregiving distress status, followed by daughters-in-law, sons and, finally, daughters. In addition, caregiving distress significantly correlated with age (r = 0.151, P = 0.022), the number of caregiving hours per week (r = 0.198, P = 0.003) and filial obligations (r = 0.336, P = 0.000).

DISCUSSION

The study results helped to better understand the caregiving process of Korean family caregivers. The data emphasized the importance of examining the expression of cultural roles and individual values on the caregivers' quality of life in diverse cultures. The knowledge gained from this study will be utilized to develop culture-specific interventions and social policies to directly support Korean family caregivers and to indirectly support stroke patients.

Elliptic and hexadecapole flow of charged hadrons in Au+Au collisions at sq.rt(s(NN))=200 GeV

Differential measurements of the elliptic (v(2)) and hexadecapole (v(4)) Fourier flow coefficients are reported for charged hadrons as a function of transverse momentum (p(T)) and collision centrality or number of participant nucleons (N(part)) for Au+Au collisions at sq.rt(s(NN))=200  GeV. The v(2,4) measurements at pseudorapidity |η|≤0.35, obtained with four separate reaction-plane detectors positioned in the range 1.0<|η|<3.9, show good agreement, indicating the absence of significant Δη-dependent nonflow correlations. Sizable values for v(4)(p(T)) are observed with a ratio v(4)(p(T),N(part))/v(2)(2)(p(T),N(part))≈0.8 for 50≲N(part)≲200, which is compatible with the combined effects of a finite viscosity and initial eccentricity fluctuations. For N(part)≳200 this ratio increases up to 1.7 in the most central collisions.

Risk factors for treatment failure in patients with prosthetic joint infections

A retrospective, observational cohort study was conducted to describe the incidence, clinical and microbiological findings and to evaluate risk factors for treatment failure associated with prosthetic joint infections (PJIs). We retrospectively reviewed the medical records of all patients undergoing total knee or total hip prosthesis implantation in our institution between 1994 and 2008. Our institution is a 1950-bed tertiary care university hospital and referral centre. A total of 93 patients with PJIs was identified although only 68 patients had undergone prosthesis implantation at our hospital. The overall infection rate was 0.63%. The most common organisms isolated were Gram positive (76.5%), including meticillin-resistant staphylococci. Two-stage arthroplasty was performed in 48 (51.6%) patients, and debridement and retention of the prosthesis in 34 (36.5%) patients. When 43 patients followed up for more than two years after treatment were included in treatment outcome analysis, the overall treatment failure rate was 41.8% (18/43). Staphylococcus aureus infection was the only clinical variable associated with treatment failure (odds ratio: 11.9; 95% confidence interval: 1.07e133.9; P = 0.044), after adjustment for the other variables. In conclusion, S. aureus was the most common pathogen isolated in patients with PJI, and an independent risk factor for treatment failure in patients with PJI.

Aquaporins in spinal cord injury: the janus face of aquaporin 4

Although malfunction of spinal cord water channels (aquaporins, AQP) likely contributes to severe disturbances in ion/water homeostasis after spinal cord injury (SCI), their roles are still poorly understood. Here we report and discuss the potential significance of changes in the AQP4 expression in human SCI that generates glial fibrillary acidic protein (GFAP)-labeled astrocytes devoid of AQP4, and GFAP-labeled astroglia that overexpress AQP4. We used a rat model of contusion SCI to study observed changes in human SCI. AQP4-negative astrocytes are likely generated during the process of SCI-induced replacement of lost astrocytes, but their origin and role in SCI remains to be investigated. We found that AQP4-overexpression is likely triggered by hypoxia. Our transcriptional profiling of injured rat cords suggests that elevated AQP4-mediated water influx accompanies increased uptake of chloride and potassium ions which represents a protective astrocytic reaction to hypoxia. However, unbalanced water intake also results in astrocytic swelling that can contribute to motor impairment, but likely only in milder injuries. In severe rat SCI, a low abundance of AQP4-overexpressing astrocytes was found during the motor recovery phase. Our results suggest that severe rat contusion SCI is a better model to analyze AQP4 functions after SCI. We found that AQP4 increases in the chronic post-injury phase are associated with the development of pain-like behavior in SCI rats, while possible mechanisms underlying pain development may involve astrocytic swelling-induced glutamate release. In contrast, the formation and size of fluid-filled cavities occurring later after SCI does not appear to be affected by the extent of increased AQP4 levels. Therefore, the effect of therapeutic interventions targeting AQP4 will depend not only on the time interval after SCI or animal models, but also on the balance between protective role of increased AQP4 in hypoxia and deleterious effects of ongoing astrocytic swelling.

First measurement of Bose-Einstein correlations in proton-proton collisions at √s=0.9 and 2.36 TeV at the LHC

Bose-Einstein correlations have been measured using samples of proton-proton collisions at 0.9 and 2.36 TeV center-of-mass energies, recorded by the CMS experiment at the CERN Large Hadron Collider. The signal is observed in the form of an enhancement of pairs of same-sign charged particles with small relative four-momentum. The size of the correlated particle emission region is seen to increase significantly with the particle multiplicity of the event.

Transverse-momentum and pseudorapidity distributions of charged hadrons in pp collisions at square root of s = 7 TeV

Charged-hadron transverse-momentum and pseudorapidity distributions in proton-proton collisions at square root of s = 7  TeV are measured with the inner tracking system of the CMS detector at the LHC. The charged-hadron yield is obtained by counting the number of reconstructed hits, hit pairs, and fully reconstructed charged-particle tracks. The combination of the three methods gives a charged-particle multiplicity per unit of pseudorapidity dN(ch)/dη|(|η|<0.5) = 5.78 ± 0.01(stat) ± 0.23(syst) for non-single-diffractive events, higher than predicted by commonly used models. The relative increase in charged-particle multiplicity from square root of s = 0.9 to 7 TeV is [66.1 ± 1.0(stat) ± 4.2(syst)]%. The mean transverse momentum is measured to be 0.545 ± 0.005(stat) ± 0.015(syst)  GeV/c. The results are compared with similar measurements at lower energies.

Sebertia acuminata: A Hyperaccumulator of Nickel from New Caledonia

Sebertia acuminata (Sapotaceae) from New Caledonia has been shown to be a hyperaccumulator of nickel. The nickel content of the latex (25.74 percent on a dry weight basis) is easily the highest nickel concentration ever found in living material. The nickel is in the form of a low-molecular-weight, water-soluble organic complex.

Fatal cerebral hemorrhage associated with autonomic hyperreflexia during surgery in the prone position in a quadriplegic patient: a case report

Intracerebral hemorrhage is an unusual complication of autonomic hyperreflexia (AHR), which can be fatal if massive bleeding occurs with subsequent brain herniation. Episodes of AHR are most often triggered by bladder and rectal distention. We present a case of a 45-year-old quadriplegic male who suffered left basal ganglia and thalamic hemorrhage associated with AHR during surgery for pressure sore defects in the prone position under local anesthesia. Early recognition and removal of triggering factors of AHR failed to bring his blood pressure under control. The patient continued to deteriorate neurologically and died 9 days after the attack. A preventive measure rather than episodic treatment of AHR may be of paramount importance to avoid life-threatening complications, especially when a patient with a history of AHR is undergoing surgery in the prone position.