Geographic patterns of non-carpeted floor dust loading in Syracuse, New York (USA) homes

Residential floor dust loading was measured on the smooth floor surface of 488 houses in Syracuse, New York, during the summers of 2003 and 2004. Using U.S. Environmental Protection Agency (EPA) wipe methods, pre-weighed Ghost Wipes, Lead Wipes, or Whatman Filters were employed to collect duplicate samples from (predominantly) kitchens. The collection efficiency of the various media was determined from multiple wipe tests and side-by-side comparisons. The results were normalized and aggregated at the census tract level to determine whether spatial patterns of dust loading could be observed. Loading was found to be log-normally distributed, with a geometric mean value of 0.311 g m(-2) (29 mg of dust per square foot of floor); 95% of the observations fell in the range of 0.042-2.330 g m(-2) (4-216 mg foot(-2)). The sampling for floor dust loading shows some bias for day of the week in which visits to the residential properties were made. After a first-order correction for this effect, results were aggregated by census tract and mapped in a geographic information system (GIS); strong spatial patterns can be identified in an inverse distance weighted mapping. The geographic patterns exhibit a strong correlation with socio-economic/demographic covariates extracted from the 2000 census summaries. Dust mass on the floors is positively correlated with renter-occupied properties and family size; it is negatively correlated with measures of household income.

Electrical properties of new organic conductor (BEST)(2)InBr(4) [BEST = bis(ethylenediseleno)tetrathiafulvalene] up to 10.8 GPa and antiferromagnetic transition of (BEST)(2)FeBr(4)

A new organic conductor, (BEST)(2)InBr(4), with alternating donor layer arrangement has been synthesized, and the electrical properties have been investigated up to 10.8 GPa. The temperature dependence of the high-pressure resistivity shows a complicated metal-semiconductor transition behavior. The room temperature resistivity decreases with pressure up to 8.6 GPa but increases at higher pressures. The magnetic susceptibility of an isostructural (BEST)(2)FeBr(4) salt shows an antiferromagnetic transition at 4.4 K, which is suppressed with increasing magnetic field.

Parkin and PINK1 mutations in early-onset Parkinson's disease: comprehensive screening in publicly available cases and control

BACKGROUND

Mutations in parkin and PTEN-induced protein kinase (PINK1) represent the two most common causes of autosomal recessive parkinsonism. The possibility that heterozygous mutations in these genes also predispose to disease or lower the age of disease onset has been suggested, but currently there is insufficient data to verify this hypothesis conclusively.

OBJECTIVE

To study the frequency and spectrum of parkin and PINK1 gene mutations and to investigate the role of heterozygous mutations as a risk factor for early-onset Parkinson's disease (PD).

METHODS

All exons and exon-intron boundaries of PINK1 and parkin were sequenced in 250 patients with early-onset PD and 276 normal controls. Gene dosage measurements were also performed, using high-density single-nucleotide polymorphism arrays.

RESULTS

In total 41 variants were found, of which 8 have not been previously described (parkin: p.A38VfsX6, p.C166Y, p.Q171X, p.D243N, p.M458L; PINK1: p.P52L, p.T420T, p.A427E). 1.60% of patients were homozygous or compound heterozygous for pathogenic mutations. Heterozygosity for pathogenic parkin or PINK1 mutations was over-represented in patients compared with healthy controls (4.00% vs. 1.81%) but the difference was not significant (p = 0.13). The mean age at disease onset was significantly lower in patients with homozygous or compound heterozygous mutations than in patients with heterozygous mutations (mean difference 11 years, 95% CI 1.4 to 20.6, p = 0.03). There was no significant difference in the mean age at disease onset in heterozygous patients compared with patients without a mutation in parkin or PINK1 (mean difference 2 years, 95% CI -3.7 to 7.0, p = 0.54).

CONCLUSIONS

Our data support a trend towards a higher frequency of heterozygosity for pathogenic parkin or PINK1 mutations in patients compared with normal controls, but this effect was small and did not reach significance in our cohort of 250 cases and 276 controls.

Management training in Vietnam's National Tuberculosis Program: an impact evaluation

SETTING

National Tuberculosis Program (NTP), Vietnam.

OBJECTIVES

To show how the Sustainable Management Development Program (SMDP) of the US Centers for Disease Control and Prevention created capacity within Vietnam's NTP to organize a management training program, and to assess the influence of the NTP's in-country training program on individual and team management practices and the performance of provincial TB control programs.

DESIGN

Eight case studies of participating provincial TB organizations, including cross-case and content analysis.

RESULTS

Participants and their back-home learning project teams demonstrated a solid understanding of the concepts taught, particularly evidence-based decision making, problem diagnosis and problem solving, and using teamwork to improve results. They gave multiple examples of how they use these concepts in their daily work. Project teams exceeded, attained or very nearly attained their target objectives, including improved DOTS implementation. Process improvements had become a routine part of their practice and were often diffused to other districts. Several teams said they now took more initiative in identifying problems and devising solutions. Others said that increased teamwork was improving the commitment of the NTP staff.

CONCLUSION

Management training, including applied projects with coaching, can improve managerial and program performance of NTPs.

Risk remaining from fine particle contaminants after vacuum cleaning of hard floor surfaces

In the indoor environment, settled surface dust often functions as a reservoir of hazardous particulate contaminants. In many circumstances, a major contributing source to the dust pool is exterior soil. Young children are particularly susceptible to exposure to both outdoor derived soil and indoor derived dust present in the indoor dust pool. This is because early in life the exploratory activities of the infant are dominated by touching and mouthing behavior. Inadvertent exposure to dust through mouth contact and hand-to-mouth activity is an inevitable consequence of infant development. Clean-up of indoor dust is, in many circumstances, critically important in efforts to minimize pediatric exposure. In this study, we examine the efficiency of vacuum cleaner removal of footwear-deposited soil on vinyl floor tiles. The study utilized a 5 x 10 foot (c. 152.5 x 305 cm) test surface composed of 1-foot-square (c. 30.5 x 30.5 cm) vinyl floor tiles. A composite test soil with moderately elevated levels of certain elements (e.g., Pb) was repeatedly introduced onto the floor surface by footwear track-on. The deposited soil was subsequently periodically removed from randomly selected tiles using a domestic vacuum cleaner. The mass and loading of soil elements on the tiles following vacuuming were determined both by wet wipe collection and by subsequent chemical analysis. It was found that vacuum cleaner removal eliminated much of the soil mass from the floor tiles. However, a small percentage of the mass was not removed and a portion of this residual mass could be picked up by moistened hand-lifts. Furthermore, although the post-vacuuming tile soil mass was sizably reduced, for some elements (notably Pb) the concentration in the residual soil was increased. We interpret this increased metal concentration to be a particle size effect with smaller particles (with a proportionately higher metal content) remaining in situ after vacuuming.

Superiority of "triple" therapy with salmeterol/fluticasone propionate and tiotropium bromide versus individual components in moderate to severe COPD

BACKGROUND

The combination of salmeterol and fluticasone propionate (SFC) and tiotropium bromide (TIO) are commonly used treatments in chronic obstructive pulmonary disease (COPD) but there are few data on their effectiveness when used together. We compared the effects of SFC 50/500 microg twice daily in addition to TIO 18 microg once daily with the individual treatments alone.

METHODS

41 patients with COPD participated in a randomised, double blind, double dummy, three way crossover study with 2 week washout periods between treatments. Lung function assessment included plethysmography and spirometry. The primary end point was post-dose specific airways conductance (sGaw) area under the curve (AUC(0-4 h)) on day 14.

RESULTS

AUC(0-4 h) sGaw was significantly higher on day 14 after SFC+TIO compared with TIO (22%) or SFC alone (27%) (both p<0.001). SFC+TIO significantly improved trough forced expiratory volume in 1 s compared with TIO alone (212 ml, p<0.001) and SFC alone (110 ml, p = 0.017) on day 14. Inspiratory capacity measurements also showed significant benefits for triple therapy over individual components on day 14. Subjects receiving SFC+TIO had clinically relevant improvements in Transition Dyspnoea Index (TDI) total score of 2.2 compared with TIO alone (p<0.001) (but not SFC alone, 0.7; NS) and used significantly less rescue medication (1.0 occasion less daily than TIO (p<0.001) and 0.6 less than SFC (p = 0.01)).

CONCLUSION

SFC+TIO triple therapy led to greater improvements in bronchodilation compared with TIO and SFC alone. The advantages of triple therapy are observed across a range of physiologically important parameters, including airway conductance and lung volumes. Triple therapy also led to patient related benefits by improving TDI and use of rescue medication.

Attentional modulation of visceral and somatic pain

A better understanding of the cortical processes underlying attentional modulation of visceral and somatic pain in health are essential for interpretation of future imaging studies of hypervigilance towards bodily sensations which is considered to be an aetiologically important factor in the heightened pain reported by patients with irritable bowel syndrome and fibromyalgia. Twelve healthy subjects were recruited for this study. Simultaneous trains of electrical pulses (delivered to either the rectum or lower abdomen) and auditory tones lasting 6 s were delivered to the subjects during a whole-brain functional scan acquisition. Subjects were instructed to attend to the auditory tones (distracter task) or electrical pulses (pain task). Pain intensity ratings were significantly lower during the distraction task compared with the pain task (P < 0.01) in both sensory modalities. The left primary somatosensory cortex increased in activity with increasing pain report, during attention to visceral pain. Bilateral anterior insula (aIns) cortex activity increased with increasing somatic pain report independent of the direction of attention. Conversely, the primary and secondary auditory cortices significantly increased in activation with decreased pain report. These results suggest that pain intensity perception during attentional modulation is reflected in the primary somatosensory cortex (visceral pain) and aIns cortex activity (somatic pain).

No evidence of PERV infection in healthcare workers exposed to transgenic porcine liver extracorporeal support

BACKGROUND

Clinical xenotransplantation holds great promise by providing one solution to the shortage of human organs for transplantation, while also posing a potential public health threat by facilitating transmission of infectious disease from source animals to humans. One potential vector for infectious disease transmission is healthcare workers (HCW) who are involved in administering xenotransplantation procedures.

METHODS

In this study, we studied 49 healthcare workers involved in the care of two subjects who participated in a study of porcine liver perfusion as treatment of fulminant hepatic failure. We looked for serologic and virologic evidence of transmission of porcine endogenous retrovirus, and found that HCW had no evidence of infection.

CONCLUSIONS

Results of our survey demonstrate that application of standard precautions may be sufficient to prevent transmission of porcine endogenous retrovirus, an agent of concern in ex vivo xenotransplantation products.

A new population of cells lacking expression of CD27 represents a notable component of the B cell memory compartment in systemic lupus erythematosus

Human memory B cells comprise isotype-switched and nonswitched cells with both subsets displaying somatic hypermutation. In addition to somatic hypermutation, CD27 expression has also been considered a universal memory B cell marker. We describe a new population of memory B cells containing isotype-switched (IgG and IgA) and IgM-only cells and lacking expression of CD27 and IgD. These cells are present in peripheral blood and tonsils of healthy subjects and display a degree of hypermutation comparable to CD27+ nonswitched memory cells. As conventional memory cells, they proliferate in response to CpG DNA and fail to extrude rhodamine. In contrast to other recently described CD27-negative (CD27neg) memory B cells, they lack expression of FcRH4 and recirculate in the peripheral blood. Although CD27neg memory cells are relatively scarce in healthy subjects, they are substantially increased in systemic lupus erythematosus (SLE) patients in whom they frequently represent a large fraction of all memory B cells. Yet, their frequency is normal in patients with rheumatoid arthritis or chronic hepatitis C. In SLE, an increased frequency of CD27neg memory cells is significantly associated with higher disease activity index, a history of nephritis, and disease-specific autoantibodies (anti-dsDNA, anti-Smith (Sm), anti-ribonucleoprotein (RNP), and 9G4). These findings enhance our understanding of the B cell diversification pathways and provide mechanistic insight into the immunopathogenesis of SLE.

Cancer patients’ attitudes toward future research uses of their donated tissue: Preliminary results of a mail survey study

6009

Background: Millions of tissue samples are stored in the United States, but little is known about the attitudes of tissue donors. Understanding the attitudes of those who donate tissue for use in future research would inform the design of studies using stored tissues (ST). Methods: Eligible subjects included cancer patients who donated remaining tissue after biopsy or surgery to the Indiana University Cancer Center Tissue Bank. All subjects signed informed consent to donate tissue. A convenience sample were approached for participation. A survey instrument was developed from literature review and expert input, and refined by focus groups. Results: 243 surveys were mailed, and 196 completed surveys were returned (response rate 80.7%). Respondents were 70% married, 93% white, 54% female. 57% had completed at least some college. Average age was 60. Average time since diagnosis was 13.8 months. 81% of respondents remembered donating tissue. 61% were not at all or a little concerned about the privacy of their ST. >80% of subjects agreed that their ST could be used in future research on their type of cancer, other cancers, and other diseases,. Non-whites were less likely than whites to allow tissue to be used in research (p = 0.0128). Around 40% of respondents agreed that researchers should have to recontact them before using their ST. Non-whites and less educated subjects were more likely to want to be recontacted for each research use of their ST. 90% of subjects would allow their ST to be used by university researchers, but only 60% agreed that ST could be used by pharmaceutical companies. 39% objected to the use of STs to develop a treatment for profit. No differences were found in willingness of ST to be used in future research whether samples were identified, de-identified, or linked. 60% of respondents wanted to be notified of research results that would impact their, or their children’s, health whether treatments were available or not, and whether results had been validated or not. Conclusions: This cohort of cancer patients was very willing to allow their ST to be used in future research on all conditions, but a significant minority desired to be recontacted each time ST were used. These findings do not support policies based on a simple presumed consent model.

No significant financial relationships to disclose.

Segmental uniparental isodisomy on 5q32-qter in a patient with childhood-onset schizophrenia

Schizophrenia is a severe mental disorder affecting approximately 1% of the world's population. Although the aetiology of schizophrenia is complex and multifactorial, with estimated heritabilities as high as 80%, genetic factors are the most compelling. Childhood-onset schizophrenia (COS), defined as onset of schizophrenia before the age of 13 years, is a rare and malignant form of the illness that may have more salient genetic influence. The first known case of paternal segmental uniparental isodisomy (iUPD) on 5q32-qter in a patient with COS is described, which adds to the previously known high rates of chromosomal abnormalities reported in this sample. iUPD is a rare genetic condition in which the offspring receives two chromosomal homologues from one parent. Segmental UPD is defined as UPD on a portion of a chromosome with biparental inheritance seen in the rest of the homologous pair. Complications owing to this abnormality may arise from malfunctioning imprinted genes or homozygosity of recessive disease-causing mutations. This aberration became apparent during whole-genomic screening of a COS cohort and is of particular interest because 5q has been implicated in schizophrenia by several genomewide linkage studies and positive gene associations. This report, therefore, presents more evidence that schizophrenia susceptibility gene, or genes, may be found on distal 5q.