Prevalence of infections in residential care homes for the elderly in Hong Kong

OBJECTIVES

To study the prevalence of commonly occurring infections among residents of residential care homes for the elderly and their associated risk factors.

DESIGN

Point prevalence survey.

SETTING

Residential care homes for the elderly in Hong Kong.

PARTICIPANTS

Residential care homes for the elderly were treated as a cluster and about 30% of the residents from each home were selected by systematic sampling with bed numbers ending with the digits of 2, 5, and 8. Selected residents were invited to participate.

RESULTS

Data from 1603 residents aged 60 years or older from 43 residential care homes for the elderly were analysed. Most (85%) of the residents had underlying medical problems and 55% had more than one problem. The overall prevalence of infection among these residents was 5.7% (95% confidence interval, 4.2-7.1%). The three most common infections were: common cold or pharyngitis (1.9%; 95% confidence interval, 0.9-3.0%), skin and soft-tissue infections (1.4%; 0.5-2.4%), and symptomatic urinary tract infections (0.6%; 0.2-0.9%). Being 'bed-ridden' was a significant risk factor for skin and soft-tissue infections (odds ratio=3.1; 95% confidence interval, 1.4-6.9). Presence of a urinary catheter was a significant risk factor for symptomatic urinary tract infections (odds ratio=62.8; 95% confidence interval, 18.2-217.0). Chronic obstructive pulmonary disease was a significant risk factor for lower respiratory tract infection (odds ratio=16.5; 95% confidence interval, 3.4-81.2).

CONCLUSIONS

This is the first territory-wide prevalence survey of infections among residents in residential care homes for the elderly in Hong Kong. The data retrieved enable us to target our infection control programme in residential care homes for the elderly to those with a high prevalence. So as to monitor seasonal and secular trends, targeted regular surveillance is needed for better profiling of the actual situation.

Correlation between adiponectin polymorphisms and non-alcoholic fatty liver disease with or without metabolic syndrome in Chinese population

BACKGROUND

To investigate the effect of single nucleotide polymorphisms (SNP) 45 and 276 of the adiponectin gene on non-alcoholic fatty liver disease (NAFLD) with or without metabolic syndrome.

METHODS

A total of 165 NAFLD, 83 NAFLD with metabolic syndrome and 160 healthy controls from Chinese population were genotyped for the adiponectin gene (+45T>G and +276G>T) by PCR-restriction fragment length polymorphism methods. Plasma adiponectin and insulin levels were determined by enzyme-linked immunosorbent assay and radioimmunoassay, respectively. Insulin resistance (IR) was evaluated by using homeostasis model assessment of IR (HOMA-IR).

RESULTS

NAFLD with metabolic syndrome had further extent of IR and hypoadiponectinemia. No association of SNP45 or SNP276 was found in NAFLD or NAFLD with metabolic syndrome. Subjects carrying the G allele of SNP45 showed higher levels of triglyceride (TG), fasting blood sugar (FBS), HOMA, body mass index (BMI), and alanine transaminase (ALT), as well as lower plasma adiponectin levels. In the normal-weight group of SNP276, subjects carrying the G allele showed higher HOMA and subjects carrying the T allele showed lower BMI.

CONCLUSIONS

Our study observed further hypoadiponectinemia and IR in NAFLD with metabolic syndrome. The T45G and G276T of the adiponectin gene may not be the important determinants of NAFLD in Chinese people, but some of them still influence serum ALT, BMI, IR, lipid, glucose metabolism and plasma adiponectin concentration.

Stimulation of alpha(1)-adrenoceptors reduces glutamatergic synaptic input from primary afferents through GABA(A) receptors and T-type Ca(2+) channels

Activation of the descending noradrenergic system inhibits nociceptive transmission in the spinal cord. Although both alpha(1)- and alpha(2)-adrenoceptors in the spinal cord are involved in the modulation of nociceptive transmission, it is not clear how alpha(1)-adrenoceptors regulate excitatory and inhibitory synaptic transmission at the spinal level. In this study, inhibitory and excitatory postsynaptic currents (IPSCs and EPSCs, respectively) were recorded from lamina II neurons in rat spinal cord slices. The specific alpha(1)-adrenoceptor agonist phenylephrine significantly increased the frequency of GABAergic spontaneous IPSCs in a concentration dependent manner, and this effect was abolished by the alpha(1)-adrenoceptor antagonist 2-(2,6-dimethoxyphenoxy)ethylaminomethyl-1,4-benzodioxane (WB4101). Phenylephrine also significantly reduced the amplitude of monosynaptic and polysynaptic EPSCs evoked from primary afferents. The inhibitory effect of phenylephrine on evoked monosynaptic glutamatergic EPSCs was largely blocked by the GABA(A) receptor antagonist picrotoxin and, to a lesser extent, by the GABA(B) receptor antagonist CGP55845. Furthermore, blocking T-type Ca(2+) channels with amiloride or mibefradil diminished the inhibitory effect produced by phenylephrine or the GABA(A) receptor agonist muscimol on monosynaptic EPSCs evoked from primary afferents. Collectively, these findings suggest that activation of alpha(1)-adrenoceptors in the spinal cord increases synaptic GABA release, which attenuates glutamatergic input from primary afferents mainly through GABA(A) receptors and T-type Ca(2+) channels. This mechanism of presynaptic inhibition in the spinal cord may be involved in the regulation of nociception by the descending noradrenergic system.

Efficacy of Low Dose Levobupivacaine (0.1%) for Axillary Plexus Block using Multiple Nerve Stimulation

The purpose of this study was to investigate if low doses of levobupivacaine (0.1%) produce complete sensory blockade in preoperative axillary brachial plexus block and to compare the effect of different doses of levobupivacaine on sensory and motor blockade.

A total of 110 patients scheduled for elective forearm or hand surgery were randomly allocated to receive 36 ml or 72 ml of levobupivacaine 0.1% or 36 ml of levobupivacaine 0.25%. In each group, volumes were equally distributed in the four nerve territories. In all patients, the sensory and motor block was assessed at five, 10, 20 and 30 minutes after the placement of axillary block.

Complete sensory block was obtained in 94.4% of patients receiving 36 ml of levobupivacaine 0.1%, 92.1% of those receiving 72 ml of levobupivacaine 0.1%, and 97.1% of those receiving 36 ml of levobupivacaine 0.25%. There was no significant difference either in the onset of the sensory and motor block or duration of the sensory and motor block.

This study demonstrates that 36 ml of levobupivacaine 0.1% (36 mg) is as effective as higher doses and volumes in axillary brachial plexus blockade.

The development and genetic diversity of H5N1 influenza virus in China, 1996-2006

Since it was first detected in 1996, the Goose/Guangdong/1/1996 (Gs/GD) H5N1 influenza virus and its reassortants have spread to over 60 countries, with over 20 distinct genetic reassortants previously recognized. However, systematic analysis of their interrelationship and the development of genetic diversity have not been explored. As each of those reassortants was first detected in China, here 318 full-length H5N1 virus genomes isolated from 1996 to 2006 in this region were phylogenetically analyzed. Our findings revealed two major group reassortment events in 2001 and 2002 that were responsible for the generation of the majority of the 44 distinct Gs/GD genotypes identified, excepting those 1997 variants. Genotype replacement and emergence occurred continually, with 34 transient genotypes detected while only 10 variants were persistent. Two major replacements of predominant genotypes were also observed: genotype B replaced by Z in 2002 and then genotype Z replaced by the now predominant genotype V in 2005.

Association of polymorphisms of the <i>GHRHR</i> gene with growth traits in cattle (Brief report)

Abstract. The hypothalamic hormone, growth hormone-releasing hormone (GHRH), is the principal stimulator of pituitary growth hormone (GH) synthesis and secretion. Its pituitary receptor is well characterized as a member of the superfamily of G protein-coupled receptors (MAYO et al., 1992). GHRH and its receptor provide important functions in the regulation of the GH axis and in the development and proliferation of pituitary somatotropes (LIN-SU et al., 2002). By now, polymorphisms of bovine GHRHR were not reported. In the present experiment the 5' flanking region, the coding region and partially introns of GHRHR were screened to detect the SNPs in the predominant cattle breeds of China.

PCR-SSCP and &lt;i&gt;Hin6&lt;/i&gt;I PCR-RFLP detecting novel anonymous SNPs within ovine &lt;i&gt;PROP1&lt;/i&gt; gene (Brief report)

Abstract. PROP1 plays a direct or indirect key role in the ontogenesis of pituitary gonadotropes, as well as somatotropes, lactotropes and caudomedial thyrotropes (WU et al., 1998). Mutations of PROP1 are responsible for deficiencies of POU1F1, GH, prolactin (PRL) and thyroid stimulating hormone (TSH) in Snell and Jackson dwarf mice and in man, as well as deficiencies of LH and FSH, suggesting that the PROP1 gene is a potential candidate gene associating with production traits in animal breeding and genetics. To date, no polymorphism of PROP1 gene has been reported in ruminant animals except bovine (PAN et al., 2007). So, the objective of this study is to investigate the polymorphism of all coding regions within ovine PROP1 gene by PCR-SSCP, DNA sequencing and PCR-RFLP methods, which will possibly contribute to conducting association analysis and evaluating them as genetic markers in animal breeding and genetics.

Diagnostics for fast ignition science (invited)

The ignition concept for electron fast ignition inertial confinement fusion requires sufficient energy be transferred from an approximately 20 ps laser pulse to the compressed fuel via approximately MeV electrons. We have assembled a suite of diagnostics to characterize such transfer, simultaneously fielding absolutely calibrated extreme ultraviolet multilayer imagers at 68 and 256 eV; spherically bent crystal imagers at 4.5 and 8 keV; multi-keV crystal spectrometers; MeV x-ray bremmstrahlung, electron and proton spectrometers (along the same line of sight), and a picosecond optical probe interferometer. These diagnostics allow careful measurement of energy transport and deposition during and following the laser-plasma interactions at extremely high intensities in both planar and conical targets. Together with accurate on-shot laser focal spot and prepulse characterization, these measurements are yielding new insights into energy coupling and are providing critical data for validating numerical particle-in-cell (PIC) and hybrid PIC simulation codes in an area crucial for fast ignition and other applications. Novel aspects of these diagnostics and how they are combined to extract quantitative data on ultrahigh intensity laser-plasma interactions are discussed.

A Bremsstrahlung spectrometer using k-edge and differential filters with image plate dosimeters

A Bremsstrahlung spectrometer using k-edge and differential filtering has been used with image plate dosimeters to measure the x-ray fluence from short-pulse laser/target interactions. An electron spectrometer in front of the Bremsstrahlung spectrometer deflects electrons from the x-ray line of sight and simultaneously measures the electron spectrum. The response functions were modeled with the Monte Carlo code INTEGRATED TIGER SERIES 3.0 and the dosimeters calibrated with radioactive sources. An electron distribution with a slope temperature of 1.3 MeV is inferred from the Bremsstrahlung spectra.

Regional variations of vertebral trabecular bone microstructure with age and gender

The vertebral trabecular bone has a complex three-dimensional (3D) microstructure, with inhomogeneous morphology. A thorough understanding of regional variations in the microstructural properties is crucial for evaluating age- and gender-related bone loss of the vertebra, and may help us to gain more insight into the mechanism of the occurrence of vertebral osteoporosis and the related fracture risks.

INTRODUCTION

The aim of this study was to identify regional differences in 3D microstructure of vertebral trabecular bone with age and gender, using micro-computed tomography (micro-CT) and scanning electron microscopy (SEM).

METHODS

We used 56 fourth lumbar vertebral bodies from 28 women and men (57-98 years of age) cadaver donors. The subjects were chosen to give an even age and gender distribution. Both women and men were divided into three age groups, 62-, 77- and 92-year-old groups. Five cubic specimens were prepared from anterosuperior, anteroinferior, central, posterosuperior and posteroinferior regions at sagittal section. Bone specimens were examined by using micro-CT and SEM.

RESULTS

Reduced bone volume (BV/TV), trabecular number (Tb.N) and connectivity density (Conn.D), and increased structure model index (SMI) were found between ages 62 and 77 years, and between ages 77 and 92 years. As compared with women, men had higher Tb.N in the 77-year-old group and higher Conn.D in the 62- and 77-year-old groups. The central and anterosuperior regions had lower BV/TV and Conn.D than their corresponding posteroinferior region. Increased resorbing surfaces, perforated or disconnected trabeculae and microcallus formations were found with age.

CONCLUSION

Vertebral trabeculae are microstructurally heterogeneous. Decreases in BV/TV and Conn.D with age are similar in women and men. Significant differences between women and men are observed at some microstructural parameters. Age-related vertebral trabecular bone loss may be caused by increased activity of resorption. These findings illustrate potential mechanisms underlying vertebral fractures.

High resolution soft x-ray spectroscopy of low Z K-shell emission from laser-produced plasmas

A large radius, R=44.3 m, high resolution grating spectrometer (HRGS) with 2400 lines/mm variable line spacing has been designed for laser-produced plasma experiments conducted at the Lawrence Livermore National Laboratory Jupiter Laser Facility. The instrument has been run with a low-noise, charge-coupled device detector to record high signal-to-noise spectra in the 10-50 A wavelength range. The instrument can be run with a 10-20 microm wide slit to achieve the best spectral resolving power, approaching 1000 and similar to crystal spectrometers at 12-20 A, or in slitless operation with a small symmetrical emission source. We describe preliminary spectra emitted from various H-like and He-like low Z ion plasmas heated by 100-500 ps (full width at half maximum), 527 nm wavelength laser pulses. This instrument can be developed as a useful spectroscopy platform relevant to laboratory-based astrophysics as well as high energy density plasma studies.

Fine mapping of a strong QTL of field resistance against rice blast, Pikahei-1(t), from upland rice Kahei, utilizing a novel resistance evaluation system in the greenhouse

Field resistances (FR) against rice blast are highly evaluated by breeders for their durability, in contrast to the conspicuous but often less durable true resistances. However, lack of efficient systems for evaluation of resistance has delayed their practical application. Kahei, an upland domestic cv., is known for its very high FR against rice blast. We fine-mapped its highest quantitative trait loci (QTL), qBFR4-1, using residual heterozygosity of recombinant inbred lines (RILs) and our semi-natural rice blast inoculation/evaluation system in the greenhouse, with comparable accuracy to the true resistance genes. This system enabled reproducible high-density infection, and consequently allowed quantification of the resistance level in individual plants. The target region was first narrowed down to about 1 Mb around at 32 Mb from the top of chromosome 4 in the Nipponbare genome, with the upland evaluation system assessing the F7 generation of Koshihikari (lowland, FR: very weak) x Kahei (upland, FR: very strong) RILs. Then, F9 plants (4,404)--siblings of hetero F8 plants at the region--were inoculated with rice blast in a greenhouse using the novel inoculation system, and individual resistance levels were diagnosed for fine QTL analysis and graphical genotyping. Thus, the resistance gene was fine-mapped within 300 kb at 31.2-31.5 Mb on chromosome 4, and designated Pikahei-1(t). By annotation analysis, seven resistance gene analog (RGA) ORFs of nucleotide-binding-site and leucine-rich-repeat (NBS-LRR)-type were found in the center of the region as the most likely candidate counterparts of the resistance gene. This is similar in structure to the recently reported Pik cluster region, suggesting that most of the other dominant QTLs of the FRs may have similar RGA structures.

US Governmental Interagency Programs, Opportunities, and Collaboration

Improving the quality, value, and safety of national food supplies is the common mission of several Federal agencies. Under different authorities, these agencies conduct basic and applied research, develop curriculum at higher educational institutions, and disseminate new scientific knowledge about food processing, formulation, and preservation to a broad range of stakeholders. Emerging food processing technologies, including various thermal and nonthermal processes, as well as chemical processes, have received increased attention and investment in recent years. Some agencies dealing with Emerging Technologies include the Cooperative State Research, Education, and Extension Service (CSREES), Agricultural Research Service (ARS), and Food Safety Inspection Service (FSIS), and all of the United States Department of Agriculture (USDA). The U.S. Army Natick Research Center of Department of Defense (DOD), National Aeronautics and Space Administration (NASA), and Food and Drug Administration (FDA) of Department of Human Health Service (DHHS) also are involved in this research area. These agencies have their vision, mission, strategic goals, and current programs and activities related to emerging food processing technologies. The synergy of effective collaboration and cooperation among all stakeholders is the key to generating an impact greater than the simple sum of all.

Effect of rainfall regime and slope on runoff in a gullied loess region on the Loess Plateau in China

Runoff was measured from seven plots with different slopes nested in Tuanshangou catchment on the Loess Plateau to study effect of slopes on runoff in relation to rainfall regimes. Based on nine years of field observation and K-mean clusters, 84 rainfall events were grouped into three rainfall regimes. Rainfall regime A is the group of events with strong rainfall intensity, high frequency, and short duration. Rainfall regime C consists of events with low intensity, long duration, and infrequent occurrence. Rainfall regime B is the aggregation of events of medium intensity and medium duration, and less frequent occurrence. The following results were found: (1) Different from traditional studies, runoff coefficient neither decreased nor increased, but presented peak value on the slope surfaces; (2) For individual plot, runoff coefficients induced by rainfall regime A were the highest, and those induced by rainfall regime C were the lowest; Downslope, the runoff coefficients induced by three rainfall regimes presented the same changing trend, although the peak value induced by regime A occurred on a shorter slope length compared to those by regime B and C; (3) Scale effect on runoff induced by rainfall regime A was the least, and that induced by rainfall regime C was the largest. These results can be explained by the interactions of crusting, soil moisture content, slope length and gradient, and erosion units, etc., in the context of different rainfall regimes.