A system of electronic records developed by a children's hospice

This paper describes the development, implementation and dissemination of an electronic data collection system for children's hospices in the UK. In 1999, CHASE Hospice Care for Children (CHASE) began providing support for life-limited children and their families in their own homes across south-west London, Surrey and West Sussex. CHASE community team is multidisciplinary and original members of the team had to create all of the necessary administrative systems for collecting and storing information about referrals and care provided to children and their families. The community team had the foresight to record activity statistics from day one of the service. The team worked together to identify information routinely collected that could usefully be stored on a computer database and a simple solution was created for this purpose using Microsoft Access version 2. CHASE was in a privileged position because the commitment to use information technology came from people providing care to children and their families.

Direct measurement of the effective charge in nonpolar suspensions by optical tracking of single particles

The authors develop an ultrasensitive method for the measurement of the charge carried by a colloidal particle in a nonpolar suspension. The technique uses the phenomenon of the resonance of a particle held in an optical tweezer trap and driven by a sinusoidal electric field. The trapped particle forms a strongly damped harmonic oscillator whose fluctuations are a function of gamma, the ratio of the root-mean-square average of the electric and thermal forces on the particle. At low applied fields (gamma<<1) the particle is confined to the optical axis, while at high fields (gamma>>1) the probability distribution of the particle is double peaked. The periodically modulated thermal fluctuations are measured with nanometer sensitivity using an interferometric position detector. Charges, as low as a few elementary charges, can be measured with an uncertainty of about 0.25 e. This is significantly better than previous techniques and opens up new possibilities for the study of nonpolar suspensions.

Measurement of effective temperatures in an aging colloidal glass

We study the thermal fluctuations of an optically confined probe particle, suspended in an aging colloidal suspension, as the suspension transforms from a viscous liquid into an elastic glass. The micron-sized bead forms a harmonic oscillator. By monitoring the equal-time fluctuations of the tracer, at two different laser powers we determine the temperature of the oscillator, T(o). In the ergodic liquid the temperatures of the oscillator and its environment are equal, while in contrast, in a nonequilibrium glassy phase we find that T(o) substantially exceeds the bath temperature.

Quinupristin-dalfopristin resistance in Enterococcus faecium isolates from humans, farm animals, and grocery store meat in the United States

Three hundred sixty-one quinupristin-dalfopristin (Q-D)-resistant Enterococcus faecium (QDREF) isolates were isolated from humans, turkeys, chickens, swine, dairy and beef cattle from farms, chicken carcasses, and ground pork from grocery stores in the United States from 1995 to 2003. These isolates were evaluated by pulsed-field gel electrophoresis (PFGE) to determine possible commonality between QDREF isolates from human and animal sources. PCR was performed to detect the streptogramin resistance genes vatD, vatE, and vgbA and the macrolide resistance gene ermB to determine the genetic mechanism of resistance in these isolates. QDREF from humans did not have PFGE patterns similar to those from animal sources. vatE was found in 35%, 26%, and 2% of QDREF isolates from turkeys, chickens, and humans, respectively, and was not found in QDREF isolates from other sources. ermB was commonly found in QDREF isolates from all sources. Known streptogramin resistance genes were absent in the majority of isolates, suggesting the presence of other, as-yet-undetermined, mechanisms of Q-D resistance.

Usage and data collection patterns for a novel web-based foodborne-disease surveillance system

This paper discusses the traditional system of foodborne-illness surveillance and provides a justification for increased syndromic surveillance of foodborne illness. A new Internet-based method for reporting foodborne disease is explained, and data entered by 7,500 visitors to the pilot Web site are described with respect to completeness and basic demographic factors. Data entry patterns show that visitors are willing to report a suspected case of foodborne illness online and do so in greater detail than is commonly obtained from traditional reports made over the telephone.

Three-dimensional binary superlattices of oppositely charged colloids

We report the equilibrium self-assembly of binary crystals of oppositely charged colloidal microspheres at high density. By varying the magnitude of the charge on near equal-sized spheres we show that the structure of the binary crystal may be switched between face-centered cubic, cesium chloride, and sodium chloride. We interpret these transformations in terms of a competition between entropic and Coulombic forces.

Dynamical arrest in attractive colloids: the effect of long-range repulsion

We study gelation in suspensions of model colloidal particles with short-ranged attractive and long-ranged repulsive interactions by means of three-dimensional fluorescence confocal microscopy. At low packing fractions, particles form stable equilibrium clusters. Upon increasing the packing fraction the clusters grow in size and become increasingly anisotropic until finally associating into a fully connected network at gelation. We find a surprising order in the gel structure. Analysis of spatial and orientational correlations reveals that the gel is composed of dense chains of particles constructed from face-sharing tetrahedral clusters. Our findings imply that dynamical arrest occurs via cluster growth and association.

Epidemiology of antimicrobial resistance in enterococci of animal origin

OBJECTIVE

We evaluated the epidemiology of antimicrobial resistance in enterococci from animal farms and the potential relation of resistance to antimicrobial use.

METHODS

Enterococci from faecal samples from 18 beef cattle, 18 dairy cattle, 18 swine, 13 chicken, and eight turkey farms were prospectively evaluated over a 6 year period from 1998 to 2003.

RESULTS

We evaluated 1256 isolates of Enterococcus faecium and 656 isolates of Enterococcus faecalis. None was vancomycin resistant. Quinupristin/dalfopristin, gentamicin and ciprofloxacin resistance rates in E. faecium were 2%, 0% and 55% in beef cattle, 8%, 7% and 47% in dairy cattle, 21%, 1% and 47% in swine, 85%, 12% and 23% in chicken, and 52%, 13% and 24% in turkey isolates, respectively. For E. faecalis, gentamicin resistance rates were 0% in beef cattle, 24% in dairy cattle, 37% in swine, 32% in chicken, and 29% in turkey isolates, whereas 12%, 9%, 21%, 64% and none of isolates from beef, dairy, swine, chicken, and turkey farms, respectively, were resistant to ciprofloxacin. Quinupristin/dalfopristin resistance in E. faecium was more common on chicken and turkey farms using virginiamycin (P<0.0001 for both) compared with farms not using a streptogramin, gentamicin resistance was more common on dairy farms using gentamicin (P<0.0001) compared with farms not using this antibiotic, and ciprofloxacin resistance was more common on turkey and dairy farms using enrofloxacin compared with those with no enrofloxacin use (P=0.02 and P=0.04, respectively). For E. faecalis, gentamicin resistance was more frequently detected on dairy and swine farms using gentamicin (P<0.0001 and P=0.0052, respectively) and ciprofloxacin resistance was more common on beef farms using enrofloxacin (P<0.0001) compared with farms not using these antimicrobials. PFGE showed multiple strain types with some clones common between animals of the same animal species.

CONCLUSIONS

This study shows the presence of a significant reservoir of antibiotic-resistant enterococci among farm animals. Resistance was more common on farms using antimicrobial agents.

Localization and physical property experiments conducted by Opportunity at Meridiani Planum

The location of the Opportunity landing site was determined to better than 10-m absolute accuracy from analyses of radio tracking data. We determined Rover locations during traverses with an error as small as several centimeters using engineering telemetry and overlapping images. Topographic profiles generated from rover data show that the plains are very smooth from meter- to centimeter-length scales, consistent with analyses of orbital observations. Solar cell output decreased because of the deposition of airborne dust on the panels. The lack of dust-covered surfaces on Meridiani Planum indicates that high velocity winds must remove this material on a continuing basis. The low mechanical strength of the evaporitic rocks as determined from grinding experiments, and the abundance of coarse-grained surface particles argue for differential erosion of Meridiani Planum.

Localization and physical properties experiments conducted by Spirit at Gusev Crater

The precise location and relative elevation of Spirit during its traverses from the Columbia Memorial station to Bonneville crater were determined with bundle-adjusted retrievals from rover wheel turns, suspension and tilt angles, and overlapping images. Physical properties experiments show a decrease of 0.2% per Mars solar day in solar cell output resulting from deposition of airborne dust, cohesive soil-like deposits in plains and hollows, bright and dark rock coatings, and relatively weak volcanic rocks of basaltic composition. Volcanic, impact, aeolian, and water-related processes produced the encountered landforms and materials.

Wind-related processes detected by the Spirit Rover at Gusev Crater, Mars

Wind-abraded rocks, ripples, drifts, and other deposits of windblown sediments are seen at the Columbia Memorial Station where the Spirit rover landed. Orientations of these features suggest formative winds from the north-northwest, consistent with predictions from atmospheric models of afternoon winds in Gusev Crater. Cuttings from the rover Rock Abrasion Tool are asymmetrically distributed toward the south-southeast, suggesting active winds from the north-northwest at the time (midday) of the abrasion operations. Characteristics of some rocks, such as a two-toned appearance, suggest that they were possibly buried and exhumed on the order of 5 to 60 centimeters by wind deflation, depending on location.

The RUsick2 Foodborne Disease Forum for syndromic surveillance

The RUsick2 Foodborne Disease Forum at the National Food Safety and Toxicology Center increased reporting of foodborne diseases to more than four times the rate seen in the previous 2 years. Since November 2002, the Forum has allowed pilot-area residents with sudden-onset vomiting or diarrhea to share and compare information regarding what they ate and did before becoming sick. The purpose is to identify a common food source, perhaps resulting in identifying a cluster of persons who ate the same contaminated food item. Such information can assist health departments in detecting foodborne outbreaks while the possibility for intervention remains.

Colloidal dynamics in polymer solutions: optical two-point microrheology measurements

We present an extension of the two-point optical microrheology technique introduced by Crocker et al. [J. C. Crocker, M. T. Valentine, E. R. Weeks, T. Gisler, P. D. Kaplan, A. G. Yodh and D. A.Weitz, Phys. Rev. Lett., 2000, 85, 888] to high frequencies. The correlated fluctuations of two probe spheres held by a pair of optical tweezers within a viscoelastic medium are determined using optical interferometry. A theoretical model is developed to yield the frequency-dependent one- and two-particle response functions from the correlated motion. We demonstrate the validity of this method by determining the one- and two-particle correlations in a semi-dilute solution of polystyrene in decalin. We find that the ratio of the one- and two-particle response functions is anomalous which we interpret as evidence for a slip boundary condition caused by depletion of polymer from the surface of the particle.

Molecular characterization of gentamicin-resistant Enterococci in the United States: evidence of spread from animals to humans through food

We evaluated the molecular mechanism for resistance of 360 enterococci for which the gentamicin MICs were >/=128 micro g/ml. The aac(6')-Ie-aph(2")-Ia, aph(2")-Ic, and aph(2")-Id genes were identified by PCR in isolates from animals, food, and humans. The aph(2")-Ib gene was not identified in any of the isolates. Two Enterococcus faecalis isolates (MICs > 1,024 micro g/ml) from animals failed to generate a PCR product for any of the genes tested and likely contain a new unidentified aminoglycoside resistance gene. Pulsed-field gel electrophoresis (PFGE) analysis showed a diversity of strains. However, 1 human and 18 pork E. faecalis isolates from Michigan with the aac(6')-Ie-aph(2")-Ia gene had related PFGE patterns and 2 E. faecalis isolates from Oregon (1 human and 1 grocery store chicken isolate) had indistinguishable PFGE patterns. We found that when a gentamicin-resistant gene was present in resistant enterococci from animals, that gene was also present in enterococci isolated from food products of the same animal species. Although these data indicate much diversity among gentamicin-resistant enterococci, the data also suggest similarities in gentamicin resistance among enterococci isolated from humans, retail food, and farm animals from geographically diverse areas and provide evidence of the spread of gentamicin-resistant enterococci from animals to humans through the food supply.

Modeling the atmospheric transport and deposition of PCDD/F to the Great Lakes

Atmospheric deposition is a significant loading pathway for polychlorinated dibenzo-p-dioxins and dibenzofurans (dioxin) to the Great Lakes. An innovative approach using NOAA's HYSPLIT atmospheric fate and transport model was developed to estimate the 1996 dioxin contribution to each lake from each of 5,700 point sources and 42,600 area sources in a U.S./Canadian air emissions inventory. These unusually detailed source-receptor modeling results show that deposition to each lake arises from a broad geographical region, with significant contributions from up to 2,000 km away. The source categories contributing most significantly to 1996 dioxin deposition appear to be municipal waste incineration, iron sintering, medical waste incineration, and cement kilns burning hazardous waste. Model-predicted air concentrations and deposition fluxes were consistent with ambient measurement data, within the uncertainties in each, but there may be a moderate tendency toward underestimation using midrange emissions estimates. The most likely reason for this tendency appears to be missing or underestimated emissions sources, but in-situ atmospheric formation of octachlorinated dibenzo-p-dioxin (OCDD) and heptachlorinated dibenzo-p-dioxin (HpCDD) may have also contributed. Despite uncertainties, the findings regarding the relative importance of different sources types and source regions appear to be relatively robust and may be useful in prioritizing pollution prevention efforts.

Response of intestinal epithelial cells to Trichuris suis excretory-secretory products and the influence on Campylobacter jejuni invasion under in vitro conditions

We previously developed a swine animal model in which natural host resistance to Campylobacter jejuni is altered by experimental infection with low numbers of the nematode Trichuris suis. Pigs naturally colonized with C. jejuni experience colitis because of the invasion of the bacterium approximately 21 days after exposure to T. suis. To better understand the mechanism of T. suis-dependent C. jejuni colitis, we evaluated the effects of T. suis excretory-secretory products (ESPs) on intestinal epithelial cells (IECs) and the influence of ESP on C. jejuni invasion in IECs under in vitro conditions. Viability assays revealed a dose-dependent cytotoxic response in ESP-treated IECs, particularly IPEC-1 and INT407 cells. Transepithelial electrical resistance dropped significantly in IPEC-1 cells treated on apical and basolateral surfaces, but not in those treated only on apical surfaces. Using the gentamicin-killing assay, reduced numbers of intracellular C. jejuni were recovered from IECs treated with ESP at 1 mg protein/ml concentration. This observation can be at least partially explained by a novel antibacterial activity in ESP. Contrary to our hypothesis, ESP at subtoxic concentrations did not enhance invasion. In addition to mechanical damage from worms, these results suggest that soluble products released by T. suis contribute to IEC damage at the site of worm attachment.