Fluorescence inhibition near spherical ENZ nanoparticles: competition between radiative and non-radiative processes

In this work, we aim to study numerically the emission decay rate of a hybrid system combining a quantum emitter (QE) and an epsilon-near-zero (ENZ) spherical nanoparticle (SNP). Inspired by the peculiar behavior of ENZ materials and their high potential in developing unusual abilities in controlling the emission properties of QE. More specifically the control of fluorescence inhibition, or the amplification of the lifetime of the excited state. This can naturally find applications in quantum information storage for optical quantum memories based on light-atom interaction which naturally benefit from storage time control. We demonstrate that the key process in limiting fluorescence inhibition is the competition between inhibition of fluorescence from the radiative processes and energy dissipation due to the non-radiative channels. Furthermore, we illustrate that this balance can be shifted to optimize inhibition as function of the QE position. The optimization happens via SNP size control, material composition, and λ_ENZ of the SNP. This detailed study introduces and paves the way for new research directions on the manipulation and optimization of QE properties in the vicinity of ENZ materials.

Bone mineral density, kidney function, weight gain and insulin resistance in women who switch from TDF/FTC/NNRTI to ABC/3TC/DTG

OBJECTIVES

Tenofovir disoproxil fumarate (TDF) is associated with reduced bone mineral density (BMD). We evaluated changes in BMD in women who switched from TDF, emtricitabine and a nonnucleoside reverse transcriptase inhibitor (TDF/FTC/NNRTI) to abacavir, lamivudine and dolutegravir (ABC/3TC/DTG).

METHODS

We conducted a randomized controlled trial in which women aged ≥40 years were randomized 1:2 to continue TDF/FTC/NNRTI or switch to ABC/3TC/DTG. The primary endpoint was change in total hip BMD measured by dual-energy X-ray absorptiometry at week 48. Secondary endpoints were changes in BMD of the lumbar spine and femoral neck and markers of bone turnover and kidney function up to week 48. We conducted exploratory analyses of weight gain, insulin resistance and metabolic syndrome. Primary and secondary endpoints were analysed by linear regression, with multiple imputation for missing time points.

RESULTS

In all, 91 women [mean age = 50.4 (standard deviation [SD] = 6.6) years, median CD4 cell count = 600 (interquartile range: 479-800) cells/µL] were randomized. Women who switched to ABC/3TC/DTG maintained viral suppression and experienced improvements in total hip BMD (mean adjusted difference = 1%, P = 0.027) and lumbar spine BMD (3%, P = 0.002), with no change in specific markers of bone turnover or renal tubular function. Although participants in the ABC/3TC/DTG arm gained more weight (1.8 kg, P = 0.046), the switch strategy was not associated with reduced insulin sensitivity or new-onset metabolic syndrome.

CONCLUSIONS

Switching from TDF/FTC/NNRTI to ABC/3TC/DTG resulted in improved BMD. Although weight gain was common in women who switched from TDF/FTC/NNRTI to ABC/3TC/DTG, we did not detect adverse effects on glucose homeostasis. Larger studies need to confirm these findings.

Optical density of states near planar ENZ materials

We study the local density of optical states (LDOS) for lossy dielectric substrates whose electric permittivity has a vanishing real part, approaching zero from the positive side of the real axis. A criterion for evaluating the threshold height above (below) which radiative (non-radiative) processes dominate for a dipole emitter is established. We focus on the case of a vertical dipole above the ϵ-near-zero (ENZ) substrate and show that, in the lossless case, complete LDOS cancellation originates from radiative modes in its near field. We evaluate the performance of commercially available ENZ materials and quantify the limits of such cancellation effects with the intrinsic losses of the substrate.

Maternal blood biomarkers and adverse pregnancy outcomes: a systematic review and meta-analysis

Background: Pregnancy is a vulnerable period for the mother and the infant and exposures to environmental chemicals in utero can influence neonatal morbidity and mortality. There is a momentum toward understanding and exploring the current maternal biological mechanisms specific to in utero effects, to improve birth outcomes. This study aims to examine the current understanding of the role of biomarkers that may be associated with term of pregnancy, infant birth weights and infant development in utero.Methods: Electronic searches were conducted in PubMed, Embase, OvidMD, and Scopus databases; and all relevant research articles in English were retrieved. Studies were selected if they evaluated maternal blood plasma/serum biomarkers proposed to influence adverse birth outcomes in the neonate. Data were extracted on characteristics, quality, and odds ratios from each study and meta-analysis was conducted.Results: A total of 54 studies (35 for meta-analysis), including 43,702 women, 50 plasma markers and six descriptors of birth outcomes were included in the present study. The random effect point estimates for risk of adverse birth outcomes were 1.61(95%CI: 1.39-1.85, p < 0.0001) for inflammation-related biomarkers and 1.65(95%CI: 1.22-2.25, p = 0.0013) for growth factor/hormone-related biomarkers. All subgroups of plasma markers showed significant associations with adverse birth outcomes with no apparent study bias.Conclusions: The two subsets of plasma markers identified in this study (inflammation-related and growth factor/hormone-related) may serve as potentially valuable tools in the investigation of maternal molecular mechanisms, especially select pathways underlying inflammatory and immunological mediation in terms of modulating adverse infant outcomes. Future large, prospective cohort studies are needed to validate the promising plasma biomarkers, and to examine other maternal biological matrices such as cervicovaginal fluid and urine.

INCIDENCE OF TEENAGE PREGNANCY IN GEORGIA AND AUSTRALIA. PATTERNS OF SOCIAL ACCEPTANCE AND RELATED HEALTHCARE CONCERNS

Teenage pregnancy has been a target for prevention in many countries. Teen motherhood may adversely influence social determinants of health, including education attainment, employment and reliance on welfare support. We compared socioeconomic factors and geographical influencers affecting teenage pregnancy and birth outcomes across Georgia and Australia. Georgia has a teenage pregnancy rate three times higher than Australia. However, there are similar proportions of contraceptive use between Georgian and Australian teenagers as well as increasing rates of sexual health literacy in both countries. Both countries, however, show a comparative deficiency in sexual health literacy for rural populations resulting in earlier sexual experiences in Georgia and higher teenage pregnancy rates in Australia with Indigenous teenage mothers over-represented. More age-appropriate sexual health and contraception education is required in both Georgia and Australia, especially for rural areas, Indigenous populations and ethnic minorities. Further research is needed to supply teenage pregnancy and birth data from Georgian population.

Experiencing a probabilistic approach to clarify and disclose uncertainties when setting occupational exposure limits

OBJECTIVES

Assessment factors (AFs) are commonly used for deriving reference concentrations for chemicals. These factors take into account variabilities as well as uncertainties in the dataset, such as inter-species and intra-species variabilities or exposure duration extrapolation or extrapolation from the lowest-observed-adverse-effect level (LOAEL) to the noobserved- adverse-effect level (NOAEL). In a deterministic approach, the value of an AF is the result of a debate among experts and, often a conservative value is used as a default choice. A probabilistic framework to better take into account uncertainties and/or variability when setting occupational exposure limits (OELs) is presented and discussed in this paper.

MATERIAL AND METHODS

Each AF is considered as a random variable with a probabilistic distribution. A short literature was conducted before setting default distributions ranges and shapes for each AF commonly used. A random sampling, using Monte Carlo techniques, is then used for propagating the identified uncertainties and computing the final OEL distribution.

RESULTS

Starting from the broad default distributions obtained, experts narrow it to its most likely range, according to the scientific knowledge available for a specific chemical. Introducing distribution rather than single deterministic values allows disclosing and clarifying variability and/or uncertainties inherent to the OEL construction process.

CONCLUSIONS

This probabilistic approach yields quantitative insight into both the possible range and the relative likelihood of values for model outputs. It thereby provides a better support in decision-making and improves transparency. Int J Occup Med Environ Health 2018;31(4):475-489.

Assessment of occupational exposure to asbestos fibers: Contribution of analytical transmission electron microscopy analysis and comparison with phase-contrast microscopy

From November 2009 to October 2010, the French general directorate for labor organized a large field-study using analytical transmission electron microscopy (ATEM) to characterize occupational exposure to asbestos fibers during work on asbestos containing materials (ACM). The primary objective of this study was to establish a method and to validate the feasibility of using ATEM for the analysis of airborne asbestos of individual filters sampled in various occupational environments. For each sampling event, ATEM data were compared to those obtained by phase-contrast optical microscopy (PCOM), the WHO-recommended reference technique. A total of 265 results were obtained from 29 construction sites where workers were in contact with ACM. Data were sorted depending on the combination of the ACM type and the removal technique. For each "ACM-removal technique" combination, ATEM data were used to compute statistical indicators on short, fine and WHO asbestos fibers. Moreover, exposure was assessed taking into account the use of respiratory protective devices (RPD). As in previous studies, no simple relationship was found between results by PCOM and ATEM counting methods. Some ACM, such as asbestos-containing plasters, generated very high dust levels, and some techniques generated considerable levels of dust whatever the ACM treated. On the basis of these observations, recommendations were made to measure and control the occupational exposure limit. General prevention measures to be taken during work with ACM are also suggested. Finally, it is necessary to continue acquiring knowledge, in particular regarding RPD and the dust levels measured by ATEM for the activities not evaluated during this study.

Developing the science and methods of community engagement for genomic research and biobanking in Africa

Historically, community engagement (CE) in research has been implemented in the fields of public health, education and agricultural development. In recent years, international discussions on the ethical and practical goals of CE have been extended to human genomic research and biobanking, particularly in the African context. While there is some consensus on the goals and value of CE generally, questions remain about the effectiveness of CE practices and how to evaluate this. Under the auspices of the Human Heredity and Health in Africa Initiative (H3Africa), the H3Africa CE working group organized a workshop in Stellenbosch, South Africa in March 2016 to explore the extent to which communities should be involved in genomic research and biobanking and to examine various methods of evaluating the effectiveness of CE. In this paper, we present the key themes that emerged from the workshop and make a case for the development of a rigorous application, evaluation and learning around approaches for CE that promote a more systematic process of engaging relevant communities. We highlight the key ways in which CE should be embedded into genomic research and biobanking projects.

Effective viscosity and dynamics of spreading epithelia: a solvable model

Collective cell migration in spreading epithelia in controlled environments has become a landmark in our current understanding of fundamental biophysical processes in development, regeneration, wound healing or cancer. Epithelial monolayers are treated as thin layers of a viscous fluid that exert active traction forces on the substrate. The model is exactly solvable and shows a broad range of applicabilities for the quantitative analysis and interpretation of force microscopy data of monolayers from a variety of experiments and cell lines. In addition, the proposed model provides physical insights into how the biological regulation of the tissue is encoded in a reduced set of time-dependent physical parameters. In particular the temporal evolution of the effective viscosity entails a mechanosensitive regulation of adhesion. Besides, the observation of an effective elastic tensile modulus can be interpreted as an emergent phenomenon in an active fluid.

SYN-JEM: A Quantitative Job-Exposure Matrix for Five Lung Carcinogens

OBJECTIVE

The use of measurement data in occupational exposure assessment allows more quantitative analyses of possible exposure-response relations. We describe a quantitative exposure assessment approach for five lung carcinogens (i.e. asbestos, chromium-VI, nickel, polycyclic aromatic hydrocarbons (by its proxy benzo(a)pyrene (BaP)) and respirable crystalline silica). A quantitative job-exposure matrix (JEM) was developed based on statistical modeling of large quantities of personal measurements.

METHODS

Empirical linear models were developed using personal occupational exposure measurements (n = 102306) from Europe and Canada, as well as auxiliary information like job (industry), year of sampling, region, an a priori exposure rating of each job (none, low, and high exposed), sampling and analytical methods, and sampling duration. The model outcomes were used to create a JEM with a quantitative estimate of the level of exposure by job, year, and region.

RESULTS

Decreasing time trends were observed for all agents between the 1970s and 2009, ranging from -1.2% per year for personal BaP and nickel exposures to -10.7% for asbestos (in the time period before an asbestos ban was implemented). Regional differences in exposure concentrations (adjusted for measured jobs, years of measurement, and sampling method and duration) varied by agent, ranging from a factor 3.3 for chromium-VI up to a factor 10.5 for asbestos.

CONCLUSION

We estimated time-, job-, and region-specific exposure levels for four (asbestos, chromium-VI, nickel, and RCS) out of five considered lung carcinogens. Through statistical modeling of large amounts of personal occupational exposure measurement data we were able to derive a quantitative JEM to be used in community-based studies.

Community IntraVenous Antibiotic Study (CIVAS): protocol for an evaluation of patient preferences for and cost-effectiveness of community intravenous antibiotic services

INTRODUCTION

Outpatient parenteral antimicrobial therapy (OPAT) is used to treat a wide range of infections, and is common practice in countries such as the USA and Australia. In the UK, national guidelines (standards of care) for OPAT services have been developed to act as a benchmark for clinical monitoring and quality. However, the availability of OPAT services in the UK is still patchy and until quite recently was available only in specialist centres. Over time, National Health Service (NHS) Trusts have developed OPAT services in response to local needs, which has resulted in different service configurations and models of care. However, there has been no robust examination comparing the cost-effectiveness of each service type, or any systematic examination of patient preferences for services on which to base any business case decision.

METHODS AND ANALYSIS

The study will use a mixed methods approach, to evaluate patient preferences for and the cost-effectiveness of OPAT service models. The study includes seven NHS Trusts located in four counties. There are five inter-related work packages: a systematic review of the published research on the safety, efficacy and cost-effectiveness of intravenous antibiotic delivery services; a qualitative study to explore existing OPAT services and perceived barriers to future development; an economic model to estimate the comparative value of four different community intravenous antibiotic services; a discrete choice experiment to assess patient preferences for services, and an expert panel to agree which service models may constitute the optimal service model(s) of community intravenous antibiotics delivery.

ETHICS AND DISSEMINATION

The study has been approved by the NRES Committee, South West-Frenchay using the Proportionate Review Service (ref 13/SW/0060). The results of the study will be disseminated at national and international conferences, and in international journals.

TEXAS: a Tool for EXposure ASsessment-Statistical models for estimating occupational exposure to chemical agents

Measurements of occupational exposure to chemical agents are performed by sampling and analyzing workplace atmospheres. In France, this is done by the industrial hygienists of the prevention network of the Social Security Service, who collect and then enter the data in the COLCHIC database. More than 900000 measurements performed in French companies over the past 25 years have been collected. Using this amount of data is major challenge for obtaining knowledge and predicting occupational exposures. This study presents the way in which statistical models are built and used on the basis of almost 19000 recent measurements of 26 frequent chemical substances. For a given substance, the models use 13 exposure determinants as inputs, such as the task performed, the occupation of the operator or the type of process employed. The models permit to estimate two parameters: the geometric mean and geometric standard deviation. These parameters are used to build an exposure profile. By combining them with the limit value, an exposure index is estimated using a Bayesian network. A decision rule based on the interpretation of this probability is proposed to qualify the predicted situation as 'well-controlled situation', 'controlled situation', and 'poorly controlled situation'. On the basis of this decision rule, 62% of predictions are true for all substances confounded, an average of 36% of predictions are approximate and only 2% of them are wrong. The result of this study led to the development of a pragmatic software tool named TEXAS, tool for exposure assessment, which enables industrial hygienists to obtain a rapid estimation of the level of exposure control as a function of simple determinants of work situations.

Risk assessment of dimethylfumarate residues in dwellings following contamination by treated furniture

Recently, numerous cases of dermatitis induced by dimethylfumarate (DMFu) have been reported in Europe. DMFu has been used to prevent mold development in various items, although it is not registered as a biocide. In France, from October 2008 to December 2009, more than 100 cases were reported. Despite a ban on articles containing DMFu and the removal of potentially contaminated products, some people were still suffering from dermatitis or other health problems. The French Agency for Food, Environmental and Occupational Health & Safety was mandated to assess whether the existence in the past of DMFu-contaminated items in dwellings could continue to pose a threat to the health of inhabitants. A risk assessment was performed based on the classical risk analysis approach for environmental contaminants. Hazard assessment of DMFu with regard to its sensitizing properties was performed, based on human case reports collected in France between January 2009 and February 2010. For around half of the 132 individual cases reported, the causal link to DMFu was considered at least probable. An Organisation for Economic Co-Operation and Development (OECD) local lymph node assay performed in a study on mice showed strong sensitizing potential for DMFu. Exposure was assessed by measuring DMFu in items sampled in preselected dwellings. These investigations demonstrated that DMFu exposure can persist after removal of the primary contaminated items. We therefore concluded that there was clearly a risk of skin reactions in patients previously sensitized to DMFu. Furthermore, the available data do not support the existence of significant health effects through the respiratory route.

Assessment of occupational exposure to chemicals by air sampling for comparison with limit values: the influence of sampling strategy

This study was aimed at quantifying the impact of sampling duration and the number of measurements taken on the quality of assessing occupational exposure to toluene. To this end, a measurement database was built, based on four campaigns carried out in an industrial printing facility. Five homogeneous exposure groups (HEGs) were set up and between 120 and 290 individual measurements lasting from 2 to 8 h were collected for each of them. These measurements were performed with the objective of comparing them to the 8-h Occupational Exposure Limit (8-h OEL). The resulting data were used to define a reference exposure profile per HEG: the 'gold standard'. This exposure profile corresponds to a log-normal distribution of measurements from which compliance/non-compliance with the 8-h OEL decision is derived. To simulate the possible sampling strategies used by industrial hygienists, six scenarios were defined, each containing a different number of measurements: 2, 3, 4, 6, 9, and 12 measurements performed per HEG, over different working days and different seasons of the year. The measurement values per scenario were simulated by sampling from the real measurement per HEG. For each scenario, 1000 simulated exposure profiles and corresponding simulated compliance decisions were computed. They were compared to the gold standard compliance decision using statistical indicators. Three methods were used for computing the simulated compliance decision: (i) the 95th percentile must be lower than the 8-h OEL, (ii) the exceedance fraction with respect to the 8-h OEL must be <0.1% (as defined by standard CEN 689, Appendix D), and (iii) the 70% upper confidence limit of the exceedance fraction with respect to the 8-h OEL must be <5% (as defined by French regulations). The results show that exposure assessment quality increases with both the number of measurements and sampling duration when using the 95th percentile and exposure assessment based on French regulations, whereas it decreases when using the standard. Moreover, guidelines for the efficient evaluation of chemical exposure in the workplace can be drawn up to help professional occupational hygienists. Indeed, boundaries can be recommended regarding the number of measurements and sampling duration necessary to obtain a reliable exposure assessment while minimizing effort devoted to sampling and analysis.

Electrical readout of individual nuclear spin trajectories in a single-molecule magnet spin transistor

We present the electrical readout of time trajectories obtained from an isolated nuclear spin. The device, a TbPc(2) single-molecule magnet spin transistor, detects the four different nuclear spin states of the Tb(3+) ion with fidelities better than 69%, allowing us to measure individual relaxation times (T(1)) of several tens of seconds. A good agreement with quantum Monte Carlo simulations suggests that the relaxation times are limited by the current tunneling through the transistor, which opens up the possibility to tune T(1) electrically by means of bias and gate voltages.

Impact of emerging pollutants on pulmonary inflammation in asthmatic rats: ethanol vapors and agglomerated TiO2 nanoparticles

CONTEXT

Titanium dioxide nanoparticles (nano-TiO(2)) and ethanol vapors are air contaminants with increasing importance. The presence of a pathological pulmonary condition, such as asthma, may increase lung susceptibility to such contaminants.

OBJECTIVE

This study aimed to investigate if exposure to inhaled ethanol vapors or nano-TiO(2) can modulate the rat pulmonary inflammatory response resulting from an allergic asthmatic reaction.

MATERIALS AND METHODS

Brown Norway rats were sensitized (sc) and challenged (15 min inhalation, 14 days later) with chicken egg ovalbumin (OVA). Leukocytes were counted in bronchoalveolar lavages (BAL) performed at 6, 24, 36, 48 and 72 h following the challenge and either after ethanol exposures (3000 ppm, 6 h/day, daily) or at 48 h (peak inflammation) for nano-TiO(2) exposures (9.35 mg/m(3) aerosol for 6 and 42 h after the OVA challenge). For the nano-TiO(2) exposures, plasma and BAL cytokines were measured and lung histological analyzes were performed.

RESULTS

Exposure to ethanol did not significantly affect BAL leukocytes after OVA challenge. Exposure to nano-TiO(2) significantly decreased BAL leukocytes compared to OVA-challenged controls. Plasma and BAL IL-4, IL-6, and INF-γ levels were also decreased in the nano-TiO(2) group.

DISCUSSION

While ethanol vapors do not modify the pulmonary inflammation in rats during an asthmatic response, a surprising protective effect for agglomerated nano-TiO(2) was observed. A putative mechanistic basis involving a decrease in the Th2 response caused by OVA is proposed.

CONCLUSION

Allergic pulmonary inflammation is not up-regulated by inhalation of the pollutants ethanol and nano-TiO(2). On the contrary, nano-TiO(2) decreases lung inflammation in asthmatic rats.

Effects of serum protein and colloid on the alamarBlue assay in cell cultures

The reagent alamarBlue allows for real-time and repeated monitoring of cell proliferation and cell viability in cytotoxicity assays. Foetal bovine serum (FBS), bovine serum albumin (BSA) and, to a lesser extent, polyvinylpyrrolidone (40,000 mw) produce an apparent decrease in the rate of reduction of the reagent in cell cultures. The effect is attributable in part to a measurement artefact, possibly due to binding of the reduced and oxidized, extracellular forms of alamarBlue to these agents, resulting in absorbance and fluorescence spectral shifts. For dual wavelength spectrophotometric determination, this effect can be corrected using empirical absorbance ratios and applying a general equation of the form: AR (570) = ( A (570) - A (600)R (0)) ( R (RI570) - R (R)R (0)R (R)I570 ) , where AR(570)(0) is the standardized absorbance of the reduced product at zero extracellular protein, A(570) and A(600) are the absorbance at 570 and 600 nm of the culture supernatant, r(0) is the ratio of the absorbance at 570 nm to the absorbance at 600 nm for the oxidized substrate, R(R) is the ratio of the absorbance at 600 nm to the absorbance at 570 nm for the reduced product and R(RI570) is the ratio of the absorbance at 570 nm for the reduced form in the presence of interfering protein to the absorbance at 570 nm in the absence of protein. The factors R(0), R(R) and R(RI570) are determined empirically at defined protein concentrations. After correction of absorbance values, FBS and BSA added to culture medium were found to depress the reduction of alamarBlue in lung fibroblasts and mesothelial cells. The alamarBlue assay is thus sensitive to protein conditions in culture media and assay parameters should be standardized for reproducibility.

An efficient sample preparation method for high-throughput analysis of 15(S)-8-iso-PGF2α in plasma and urine by enzyme immunoassay

Although several methods have been reported on the analysis of the oxidative stress marker 15(S)-8-iso-prostaglandin-F2alpha (8-iso-PGF2α) in biological fluids, they either involve extensive sample preparation and costly technology or require high sample volume. This study presents a sample preparation method that utilizes low sample volume for 8-iso-PGF2α analysis in plasma and urine by an enzyme immunoassay (EIA). In brief, 8-iso-PGF2α in deproteinized plasma or native urine sample is complexed with an antibody and then captured by molecular weight cut-off filtration. This method was compared with two other sample preparation methods that are typically used in the analysis of 8-iso-PGF2α by EIA: Cayman's affinity column purification method and solid-phase extraction on C-18. The immunoaffinity purification method described here was superior to the other two sample preparation methods and yielded recovery values of 99.8 and 54.1% for 8-iso-PGF2α in plasma and urine, respectively. Analytical precision (relative standard deviation) was ±5% for plasma and ±15% for urine. The analysis of healthy human plasma and urine resulted in basal 8-iso-PGF2α levels of 31.8 ± 5.5 pg/mL and 2.9 ± 2.0 ng/mg creatinine, respectively. The robustness and analytical performance of this method makes it a promising tool for high-throughput screening of biological samples for 8-iso-PGF2α.

Sensitivity analyses of exposure estimates from a quantitative job-exposure matrix (SYN-JEM) for use in community-based studies

OBJECTIVES

We describe the elaboration and sensitivity analyses of a quantitative job-exposure matrix (SYN-JEM) for respirable crystalline silica (RCS). The aim was to gain insight into the robustness of the SYN-JEM RCS estimates based on critical decisions taken in the elaboration process.

METHODS

SYN-JEM for RCS exposure consists of three axes (job, region, and year) based on estimates derived from a previously developed statistical model. To elaborate SYN-JEM, several decisions were taken: i.e. the application of (i) a single time trend; (ii) region-specific adjustments in RCS exposure; and (iii) a prior job-specific exposure level (by the semi-quantitative DOM-JEM), with an override of 0 mg/m(3) for jobs a priori defined as non-exposed. Furthermore, we assumed that exposure levels reached a ceiling in 1960 and remained constant prior to this date. We applied SYN-JEM to the occupational histories of subjects from a large international pooled community-based case-control study. Cumulative exposure levels derived with SYN-JEM were compared with those from alternative models, described by Pearson correlation ((Rp)) and differences in unit of exposure (mg/m(3)-year). Alternative models concerned changes in application of job- and region-specific estimates and exposure ceiling, and omitting the a priori exposure ranking.

RESULTS

Cumulative exposure levels for the study subjects ranged from 0.01 to 60 mg/m(3)-years, with a median of 1.76 mg/m(3)-years. Exposure levels derived from SYN-JEM and alternative models were overall highly correlated (R(p) > 0.90), although somewhat lower when omitting the region estimate ((Rp) = 0.80) or not taking into account the assigned semi-quantitative exposure level (R(p) = 0.65). Modification of the time trend (i.e. exposure ceiling at 1950 or 1970, or assuming a decline before 1960) caused the largest changes in absolute exposure levels (26-33% difference), but without changing the relative ranking ((Rp) = 0.99).

CONCLUSIONS

Exposure estimates derived from SYN-JEM appeared to be plausible compared with (historical) levels described in the literature. Decisions taken in the development of SYN-JEM did not critically change the cumulative exposure levels. The influence of region-specific estimates needs to be explored in future risk analyses.

Comparison of formaldehyde exposure levels in two multi-industry occupational exposure databanks using multimodel inference

The recent increase in international multicenter epidemiologic studies of occupational hazards and the current development of risk analysis tools based on multinational exposure data provide an incentive to evaluate the extrapolation of exposure data across countries. We compared formaldehyde measurements in the French (COLCHIC) and U.S. (IMIS) occupational exposure databases for 1986-2001 using multimodel inference. In this approach, conclusions are based on a set of plausible models rather than on a single model. Modeled variables included data source, industry, year, and sample type (short-term or long-term). The model set included 72 models corresponding to testing all variables and 5 interactions and estimation of 93 coefficients. As it is impossible to classify non-detects (ND) as short-term or long-term samples, they were removed from IMIS prior to analysis. Respectively, 3143 and 2646 IMIS and COLCHIC data, spread across 28 common industries, were analyzed. The full model explained 21% of the total variability. All fixed effects and the source-industry interaction were shown as strong predictors of exposure. The temporal trend (5% yearly decrease) and difference between short-term and long-term data (short-term greater than long-term by two-fold) were similar across the two databanks. Industry-specific differences between IMIS and COLCHIC were detected only for health-related activities for which COLCHIC levels were higher (~ four-fold). Sensitivity analyses were conducted to assess the impact of excluding NDs from IMIS. They showed initial predicted industry-specific geometric means for IMIS data potentially multiplied by factors from 0.42 to 0.98 (long-term data) and from 0.11 to 1.4 (short-term data) when NDs were included with various distributions across the short-term and long-term categories. The most realistic scenario yielded 0.82 for long-term (18% overestimation) data and 1.05 (5% underestimation) for short-term data. Although tempered by a probable non-detect bias, our analysis showed that both databanks provide a similar multi-industry portrait of formaldehyde exposure despite a potential for very different occupational settings. Our results offer encouraging insight about extrapolation of exposure data across countries.

Association of genetic polymorphisms in the ACE, ApoE, and TGF beta genes with early onset ischemic heart disease

BACKGROUND

The genetic factors that contribute to ischemic heart disease (IHD) are poorly understood, and it is likely that multiple genes acting independently or synergistically contribute to the risk of IHD and outcome. The genes for angiotensin-converting enzyme (ACE) and apolipoprotein E (ApoE) have been implicated independently in the risk of IHD.

HYPOTHESIS

This study examined whether genetic polymorphisms in the ACE and ApoE genes are associated with early onset IHD. Polymorphisms in a third gene, transforming growth factor beta 2 (TGF beta 2), with a known role in wound repair and cardiac development, are also examined with respect to early onset IHD.

METHODS

In all, 101 patients with IHD and onset of disease before 55 years for men and 60 years for women, and 100 controls with angiographically confirmed normal coronary arteries were recruited for this study. The ACE, ApoE, and TGF beta 2 genotypes were determined by polymerase chain reaction amplification or Southern blotting and were compared with the patient's clinical and family histories.

RESULTS AND CONCLUSION

The frequency of the ACE D allele was significantly lower in the patient group (0.475) than in the control group (0.59, p = 0.03), which was attributed to a reduction in the number of patients with the DD genotype (patients: 24% DD, controls: 33% DD). Sudden cardiac death was also associated with the DD genotype. These data are consistent with the ACE D allele contributing to a fatal outcome. No association between the DD genotype and risk of myocardial infarction, presenting age, extent of vessel disease, family history, hypertension, or hypercholesterolemia was seen. Analysis of the ApoE genotype showed no association with early onset IHD. There was no evidence for a synergistic effect between the ACE and ApoE genotypes on the risk of early onset IHD. A polymorphism in the TGF beta 2 gene was rare and not associated with early onset IHD.

Diffusion of Mn in ZnO nanowires annealed in air

We studied diffusion of Mn in ZnO nanowires by means of field-emission scanning electron microscopy, transmission electron microscopy, X-ray diffraction, photoluminescence and Raman scattering spectroscopy. The Mn-diffused samples were prepared by covering synthesized ZnO nanowires with a Mn chip and then annealing at temperatures between 200 and 1000 degrees C for 1 h in air. Microstructural analyses, and photoluminescence and Raman studies revealed that Mn atoms started diffusing in ZnO nanowires at 800 degrees C. The annealing-temperature increase up to 1000 degrees C led to a strong diffusion of Mn in the ZnO host lattice, which caused the blueshift of the ultra-violet emission. Concurrently, recored Raman scattering spectra showed some additional Mn-related modes. The origin of these lines was discussed in detail.

Vibrant Soundbridge middle ear implant in mixed hearing loss. Indications, techniques, results

OBJECTIVES

The aim of this article is to illustrate the aetiologies of mixed hearing loss that can benefit from a Vibrant Soundbridge (VSB) middle ear implant, the techniques performed and the first results.

MATERIALS AND METHOD

The authors report their experience of 13 implantations in mixed hearing loss due to otosclerosis, sequelae of chronic otitis media and congenital aural atresia. The VSB implant was implanted alone or in association with another middle ear surgical procedure, on the ossicular chain or on the round window membrane.

RESULTS

The average auditory gain for all patients is 32 dB for pure tone thresholds, and 25 dB for speech recognition. It results from the addition of a gain on the conductive hearing loss by direct stimulation of the inner ear, to a gain on the sensorineural hearing loss by amplification.

CONCLUSION

Middle ear implants are the only hearing aids affording a gain in both the conductive and sensorineural components of mixed hearing losses.

Formaldehyde exposure in U.S. industries from OSHA air sampling data

National occupational exposure databanks have been cited as sources of exposure data for exposure surveillance and exposure assessment for occupational epidemiology. Formaldehyde exposure data recorded in the U.S Integrated Management Information System (IMIS) between 1979 and 2001 were collected to elaborate a multi-industry retrospective picture of formaldehyde exposures and to identify exposure determinants. Due to the database design, only detected personal measurement results (n = 5228) were analyzed with linear mixed-effect models, which explained 29% of the total variance. Short-term measurement results were higher than time-weighted average (TWA) data and decreased 18% per year until 1987 (TWA data 5% per year) and 5% per year (TWA data 4% per year) after that. Exposure varied across industries with maximal estimated TWA geometric means (GM) for 2001 in the reconstituted wood products, structural wood members, and wood dimension and flooring industries (GM = 0.20 mg/m(3). Highest short-term GMs estimated for 2001 were in the funeral service and crematory and reconstituted wood products industries (GM = 0.35 mg/m(3). Exposure levels in IMIS were marginally higher during nonprogrammed inspections compared with programmed inspections. An increasing exterior temperature tended to cause a decrease in exposure levels for cold temperatures (-5% per 5 degrees C for T < 15 degrees C) but caused an increase in exposure levels for warm temperatures (+15% per 5 degrees C for T >15 degrees C). Concentrations measured during the same inspection were correlated and varied differently across industries and sample type (TWA, short term). Sensitivity analyses using TOBIT regression suggested that the average bias caused by excluding non-detects is approximately 30%, being potentially higher for short-term data if many non-detects were actually short-term measurements. Although limited by availability of relevant exposure determinants and potential selection biases in IMIS, these results provide useful insight on formaldehyde occupational exposure in the United States in the last two decades. The authors recommend that more information on exposure determinants be recorded in IMIS.

The importance of assessing the fidelity of electrocardiographs by using a simple calibration signal

ECG distortion, mimicking changes seen in acute myocardial infarction, occurred in traces transmitted by the South East Coast NHS Ambulance Trust. This was due to low frequency phase nonlinearity produced by baseline filtering. The very narrow calibration pulses made the detection of this distortion difficult. A 1 mV square wave signal revealed the cause. Adequate calibration pulses 0.3 s wide should be recorded with all ECGs, to show that the signal is being reproduced reliably.

What percentages of patients are suitable for prehospital thrombolysis?

OBJECTIVE

To apply the Joint Royal College Ambulance Liaison Committee (JRCALC) checklist to patients who were deemed eligible for thrombolytic therapy on arrival in an Accident & Emergency Department (A&E) to determine the proportion suitable for prehospital thrombolysis.

DESIGN

Retrospective descriptive analysis.

METHODS

The clinical notes of all patients thrombolysed in an A&E department in a year were reviewed against the JRCALC guidelines for prehospital thrombolysis.

RESULTS

14.2% of patients eligible for thrombolysis in a district general hospital were deemed suitable for prehospital thrombolysis according to the JRCALC criteria. The most common exclusion criteria were hyper/hypotension (50%), onset of symptoms (pain) >6 h previously (41.7%), or age >75 years (37%). Two or more contraindications to prehospital thrombolysis were present in 63.9% of patients.

CONCLUSION

The JRCALC guidelines are an effective tool for identifying patients with potential contraindications to thrombolysis.

Occupational exposure to mineral fibres: analysis of results stored on colchic database

The aim of this paper is to present fibre exposure data recorded on the COLCHIC database. This database consolidates all occupational exposure data collected in French companies by the Caisses Régionales d'Assurance Maladie (regional health insurance funds, CRAM) and the Institut National de Recherche et de Sécurité (national institute for research and safety, INRS). A total of 8029 concentration results, expressed in number of fibres measured by phase-contrast optical microscopy, are available for exposure to asbestos fibres, ceramic fibres and man-made mineral fibres other than ceramic fibres. Presentation of base data by activity branch, activity sector or workplace permits identification of situations, for which prevention efforts are most essential. Analysis of exposure levels during the 1986-2004 period show that these are broadly influenced by changes in the exposure limit values. Wearing of respiratory protection equipment by employees is also discussed. The data may be helpful to occupational physicians performing occupational screening of exposed workers and to epidemiologists seeking information for building job-exposures matrices. In this respect, a database (FIBREX) will be available on the INRS web site (www.inrs.fr) at the beginning of 2007. This database will provide a higher level of detail in activity and workplace description than that which was possible for practical reasons in this paper.