The use of novel electronic nose technology to locate missing persons for criminal investigations

The search for missing persons is a major challenge for investigations involving presumed deceased individuals. Currently, the most effective tool is the use of cadaver-detection dogs; however, they are limited by their cost, limited operation times, and lack of granular information reported to the handler. Thus, there is a need for discrete, real-time detection methods that provide searchers explicit information as to whether human-decomposition volatiles are present. A novel e-nose (NOS.E) developed in-house was investigated as a tool to detect a surface-deposited individual over time. The NOS.E was able to detect the victim throughout most stages of decomposition and was influenced by wind parameters. The sensor responses from different chemical classes were compared to chemical class abundance confirmed by two-dimensional gas chromatography - time-of-flight mass spectrometry. The NOS.E demonstrated its ability to detect surface-deposited individuals days and weeks since death, demonstrating its utility as a detection tool.

Content development of the Child Community Health Inclusion Index: An evaluation tool for measuring inclusion of children with disabilities in the community

BACKGROUND

Addressing barriers in the environment can contribute to health and quality of life for children with disabilities and their families. The Community Health Inclusion Index (CHII) is a measurement tool developed in the United States to identify environmental barriers and facilitators to community health inclusion. The CHII adopts an adult viewpoint and aspects crucial for children may have been omitted.

AIMS

This study aimed to develop a comprehensive list of items that are relevant for the community inclusion of children with disabilities in the Canadian context.

METHODS

The relevance and priority of items generated from a review of existing guidelines and best practice recommendations for community inclusion were rated as a dichotomous response and discussed by an expert panel in relevant fields related to children with disabilities.

RESULTS

A total of 189 items from 12 instruments and best practice guidelines were identified. Expert consensus contributed to a relevant and comprehensive list of items. Expert suggestions were considered to refine and reduce the item list.

CONCLUSION

This study highlights the importance of a child version of a community inclusion tool, as the needs of children with disabilities differ from those of adults. It can help communities improve inclusion of children with disabilities and inform health promotion initiatives for this population.

104 Oral Sodium Bicarbonate Therapy for Older Patients with Chronic Kidney Disease and Low-Grade Acidosis: The BiCARB Randomised Controlled Trial

Background

Oral sodium bicarbonate is often used to treat metabolic acidosis in older people with advanced chronic kidney disease, but evidence is lacking on whether this provides a net gain in health or quality of life.

Methods

We conducted a multicentre, parallel group, double-blind, placebo-controlled randomised trial. Adults aged 60 years and over with category 4 or 5 chronic kidney disease, not on dialysis, with serum bicarbonate concentrations <22 mmol/L were recruited from 27 UK centres. Participants were randomised 1:1 to oral sodium bicarbonate or matching placebo. The primary outcome was the between-group difference in the Short Physical Performance Battery at 12 months, adjusted for baseline. Other key outcome measures included generic and disease-specific health-related quality of life, anthropometry, physical performance, renal function, adverse events including commencement of renal replacement therapy, and health economic analysis.

Results

We randomised 300 participants, mean age 74 years; 86 (29%) were female. Mean baseline estimated GFR was 19 ml/min/1.73m2. Study medication adherence was 73% in both groups. No significant treatment effect was evident for the primary outcome of the between-group difference in the Short Physical Performance Battery at 12 months (-0.4 points; 95% CI -0.9 to 0.1, p=0.15). No significant treatment benefit was seen for any of the secondary outcomes. Adverse events were more frequent in the bicarbonate arm (457 versus 400). Time to commencing renal replacement therapy was similar in both groups (HR 1.22, 95% CI 0.74 to 2.02, p=0.43). Health economic analysis showed lower quality of life and higher costs in the bicarbonate arm at one year (£1234 vs £807); placebo dominated bicarbonate under all sensitivity analyses for incremental cost-effectiveness.

Conclusions

Oral sodium bicarbonate did not improve a wide range of health measures in this trial, and is unlikely to be cost-effective for use in the UK NHS in this patient group.

Association of the Family Nutrition and Physical Activity Screening Tool with Weight Status, Percent Body Fat, and Acanthosis Nigricans in Children from a Low Socioeconomic, Urban Community

OBJECTIVE

OBJECTIVE

To examine the association of the Family Nutrition and Physical Activity (FNPA) screening tool with weight status, percent body fat, and acanthosis nigricans (AN) in 6- to 13-year-old children from a low socioeconomic, urban community.

METHODS

Children (n=415) from four elementary schools located around Flint, Michigan were assessed for body mass index, percent body fat, and AN. The FNPA screening tool was completed by parents. Mann-Whitney U tests were used to assess differences in FNPA score by sex and presence of AN. Logistic regression was used to evaluate the association of the FNPA (tertiles) with weight status and AN.

RESULTS

Children with AN (13.7%) had a significantly lower FNPA score (56.3 + 7.1) compared with children without AN (61.0 + 7.1; P<.05). Children with FNPA scores in the lowest tertile (high-risk) had odds ratios of 1.74 (95% CI =1.05 - 2.91) and 2.77 (95% CI =1.22 - 6.27) compared with children with FNPA scores in the highest tertile (low-risk) for being overfat and having AN, respectively.

CONCLUSION

Although the FNPA screening tool did not predict risk for being overweight or obese, it was significantly associated with an increased odds of children at risk for being overfat or having AN.

First Report of Nectria haematococca Stem Girdling of Greenhouse Peppers in Florida

Nectria haematococca Berk. & Broome causing stem girdling of three cultivars of greenhouse pepper, Capsicum annuum (cvs. Kelvin, Cubico, and Grizzly), was found for the first time in a single greenhouse in south Florida in March 1999. Approximately 10% of the plants were affected at first report increasing to over 40% within 3 months. Black lesions occurred at nodes where the plant was pruned or where fruit had been harvested. No mycelium or perithecia were noted in association with the lesions. All tissue above a lesion appeared normal until the lesion girdled the stem, causing the tissue above the lesion to wilt and die. The plant appeared unaffected below the lesion. The pathogen was isolated on half-strength Difco potato-dextrose agar (½ DPDA). Reddish perithecia developed readily in culture. Two single spore isolates of the pathogen obtained from two naturally infected plants (cultivar Kelvin) were used to satisfy Koch's postulates. Five plants of Kelvin were inoculated with each isolate by inserting a 4-mm agar block of the pathogen grown for 5 days on ½ DPDA into the stem. Five plants of the same cultivar were similarly treated with fungus-free ½ DPDA. Plants were grown under greenhouse conditions after inoculation. In four plants, black lesions similar to those seen in the commercial greenhouse developed within 1 week. In one plant, the portions of the plants above the point of inoculation wilted after 5 days. The upper parts of the plants appeared healthy until lesions girdled the stems. The plants treated with fungus-free agar remained healthy. The fungus was re-isolated from the margins of lesions on the inoculated plants. The pathogen has been reported to cause stem lesions and fruit rot of pepper in greenhouses in England (1) and Canada (2). Fruit symptoms were not observed in the Florida greenhouse. Stem symptoms were again reported from the same greenhouse in the following season. References: (1) J. T. Fletcher. Plant Pathol. 43:225-222, 1994. (2) W. R. Jarvis. Can. Plant Dis. Surv. 74:131-134, 1994.

Glycated albumin in serum and dialysate of patients on continuous ambulatory peritoneal dialysis

1. Chronic use of hyperosmolar glucose solutions in continuous ambulatory peritoneal dialysis may cause glycation of peritoneal structural proteins which could contribute to membrane dysfunction and ultrafiltration failure. To determine whether glycation can occur in the environment of the dialysate, we have carried out studies using albumin as a model protein. 2. Glycated albumin was measured in the serum and dialysate of 46 patients on continuous ambulatory peritoneal dialysis (31 non-diabetic patients, 15 diabetic patients). Dialysate and serum glycated albumin (ranges 1.0-12.7% and 0.9-10.2%, respectively) were related to each other (r = 0.988, P < 0.001), but dialysate glycated albumin was significantly higher than serum glycated albumin (P < 0.0001), with the dialysate to serum glycated albumin ratio being greater than unity in 76% of patients (mean ratio 1.14). This implies either preferential transfer of glycated albumin across the peritoneal membrane or intraperitoneal glycation during the dwell period. 3. In vitro, significant glycation occurred in dialysate during a 6 h incubation period (P < 0.01) at a rate related to the glucose concentration in the dialysate (rs = 0.63, P < 0.05). The glycation rate was not significantly affected (P = 0.05) by factors other than the glucose concentration. 4. Our results demonstrate that protein glycation occurs within the peritoneum during continuous ambulatory peritoneal dialysis. Further studies are required to establish the relationship of glycation of structural proteins in the peritoneal membrane to membrane function.

Serum glycated albumin and fructosamine in renal dialysis patients

The effect of uraemia on protein glycation was studied by measuring glycated albumin and fructosamine in 50 non-diabetic dialysis patients (31 continuous ambulatory peritoneal dialysis, CAPD, 19 haemodialysis). After correction for serum albumin concentration, glycated albumin (g/100 g) was increased in the haemodialysis group (1.94 +/- 0.40) compared with both CAPD patients (1.46 +/- 0.37; p < 0.001) and controls (1.52 +/- 0.29; p < 0.001), but did not differ between CAPD patients and controls (p > 0.05). Serum fructosamine, corrected for either serum albumin or total protein concentration (mumol/100 g), was raised in CAPD (828 +/- 90, 386 +/- 41, respectively) and haemodialysis patients (802 +/- 123, 391 +/- 42, respectively) compared with controls (609 +/- 69, 332 +/- 27, respectively; p < 0.0001 in all cases), but did not differ between the two dialysis groups (p > 0.05). A single haemodialysis cycle had no effect on the measurement of glycated albumin or fructosamine (p > 0.05). The results confirm that glycated protein levels are generally raised in dialysis patients. In CAPD patients, altered albumin metabolism resulting from large peritoneal losses is likely to have caused a decrease in the amount of albumin glycated, an effect less apparent on the concentration of fructosamine because of the additional contribution of glycated globulins.

Microalbuminuria in systemic sclerosis

A prospective study was performed to determine urinary albumin excretion in a group of 28 patients with systemic sclerosis. At the initial screen one patient had proteinuria and three had microalbuminuria. One year later these abnormalities persisted and in two of of the patients serum creatinine had significantly increased. In addition, a further three patients had developed microalbuminuria. In a control group of 10 patients with primary Raynaud's disease none had microalbuminuria. In a second control group of 16 patients with unrelated skin diseases one patient had microalbuminuria and one proteinuria, but both these patients had a history of hypertension. It is concluded that microalbuminuria is more common in patients with systemic sclerosis than in patients of equivalent age with other dermatological conditions but no vascular disease.

Effect of protein concentration on the formation of glycated albumin and fructosamine

Considerable debate surrounds the question of whether fructosamine concentration should be corrected for serum protein concentration (see 1 for review). Staley (2) has argued against such correction, given that, theoretically, glucose concentration is the rate-limiting step in the glycation reaction; i.e., available lysine residues willalways be in excess of reactive open-chain (carbonyl) glucose molecules, which are only 0.001% of the total (3). However, because the open-chain and cyclic forms of glucose exist in freely exchangeable equilibrium, we conjectured that, as carbonyl glucoses were removed by glycation, more glucose molecules would rapidly isomerize to the open-chainform to maintain the equilibrium, if so, then protein concentration would also be an important factor in determining the glycation rate.

Investigation and validation of the affinity chromatography method for measuring glycated albumin in serum and urine

Affinity chromatography on m-aminophenyl boronate columns together with albumin measurement by radioimmunoassay has been validated as a method for determining glycated albumin in serum and urine. Optimisation of sample volume and of elution buffer composition and volume ensured reproducibility of results. Fructosamine assay confirmed the absence of glycated albumin species from the non-glycated fraction. It was possible to elute the glycated fraction from the affinity columns with Tris or glycine which do not contain 1,2 diols but have similar functional groups. Column affinity was, therefore, not specific for glycated protein moieties. Inhibition of binding by glucose, and other small molecules in urine, necessitated ultrafiltration or dialysis of samples before analysis. Reference ranges for glycated albumin in non-diabetic subjects were 0.6-1.8% in serum and 0.9-2.6% in urine. In patients with diabetes mellitus, glycated albumin ranged from 1.4-10.9% in serum and from 1.5-12.5% in urine.

Studies on the metabolism of C-19 steroids in the human foeto-placental unit. I. Neutral metabolites formed from dehydroepiandrosterone and dehydroepiandrosterone sulphate by the placenta at midpregnancy

Dehydroepiandrosterone sulphate (DHAS) labelled with 3H and dehydroepiandrosterone (DHA) labelled with 14C were simultaneously administered into the arterial supply of four placentas perfused in situ immediately following the removal of the foetus at midpregnancy.

From the perfused placentas testosterone (T), androstenedione (A), oestrone (OE1) and 17β-oestradiol (OE2) derived from the metabolism of both DHA and DHAS were isolated in a radiochemically homogeneous form. In addition DHA derived from DHAS was isolated. No labelled 19-hydroxy-androst-4-ene-3,17-dione, or 3β,19-dihydroxy-androst-5-en-17-one was detected.

From the perfusates the same steroids were isolated as from the placentas. They contained so small amounts of 3H that their radiochemical homogeneity could be established only on the basis of the 14C label.

The 3H/14C ratio of the A isolated from each placenta was higher than that of DHA and OE1 isolated from the same source, indicating a higher contribution of DHAS to A than to DHA or OE1 However, no conjugated or unconjugated intermediates between DHAS and A other than DHA were detected. One possible explanation for the differences in isotope ratios based on the existence of two hypothetical placental compartments, is discussed.