Recent trends in the prevalence of high blood pressure and its treatment and control, 1999-2008
Yoon SS , Ostchega Y , Louis T . NCHS Data Brief 2010 (48) 1-8 KEY FINDINGS: Data from the National Health and Nutrition Examination Survey There was no significant change in the prevalence of high blood pressure among U.S. adults from 1999-2000 to 2007-2008. This was true for men and women, all age groups, and for non-Hispanic white, non-Hispanic black, and Mexican-American adults. Among U.S. adults with high blood pressure, the percentage that was aware of the condition increased from 69.6% in 1999-2000 to 80.6% in 2007-2008. Among U.S. adults with high blood pressure, the percentage who were taking medication to lower their blood pressure increased from 1999-2000 through 2007-2008. The control of blood pressure increased among U.S. adults with high blood pressure from 1999-2000 through 2007-2008. Increases in control occurred for all subgroups of the population. |
Comprehensive cancer control: progress and accomplishments
Rochester PW , Townsend JS , Given L , Krebill H , Balderrama S , Vinson C . Cancer Causes Control 2010 21 (12) 1967-77 The potential for Comprehensive Cancer Control (CCC) across the nation has been realized in the last decade with 69 Coalitions developing and implementing CCC plans. Many partners at all levels-national, state, jurisdictional, tribal and communities-have contributed to this success. This article details the contribution of these partners across these various levels, with a selection of the many activities contributing to this success. Consequently the cancer burden, although still of major importance, continues to be addressed in significant ways. Although there are future challenges, CCC coalitions continue to play an important role in addressing the cancer burden. |
Sex and geographic patterns of human herpesvirus 8 infection in a nationally representative population-based sample in Uganda
Biryahwaho B , Dollard SC , Pfeiffer RM , Shebl FM , Munuo S , Amin MM , Hladik W , Parsons R , Mbulaiteye SM . J Infect Dis 2010 202 (9) 1347-53 BACKGROUND: Human herpesvirus 8 (HHV8), the infectious cause of Kaposi sarcoma, varies dramatically across Africa, suggesting that cofactors correlated with large-area geographic or environmental characteristics may influence risk of infection. Variation in HHV8 seropositivity across small-area regions within countries in Africa is unknown. We investigated this issue in Uganda, where Kaposi sarcoma distribution is uneven and well described. METHODS: Archival samples from individuals aged 15-59 years randomly selected from a nationally representative 2004-2005 human immunodeficiency virus-AIDS serobehavioral survey were tested for HHV8 seropositivity with use of enzyme immunoassays based on synthetic peptides from the K8.1 and orf65 viral genes. Adjusted odds ratios and 95% confidence intervals (CIs) of association of HHV8 seropositivity with demographic risk factors were estimated. RESULTS: Among 2681 individuals tested, HHV8 seropositivity was 55.4%. HHV8 seropositivity was lower in female than in male persons (adjusted odds ratio, 0.82 [95% CI, 0.69-0.97]) and increased 2.2% (95% CI, 1.0%-3.6%) in female persons and 1.2% (95% CI, 1.0%-2.3%) in male persons per year of age. HHV8 seropositivity was inversely associated with education ( P = .01, for trend) and was elevated in the West Nile region, compared with the Central region (adjusted odds ratio, 1.49 [95% CI, 1.02-2.18]) but not with other regions. CONCLUSIONS: Our findings suggest that HHV8 seropositivity in Uganda may be influenced by cofactors correlated with small-area geography, age, sex, and education. |
Where have all the vector control programs gone? Part one
Herring ME . J Environ Health 2010 73 (4) 30-31 The 1999 emergence of West Nile virus | (WNV) in the United States was a vector wake-up call for public health in | this country. By the end of 1999, WNV—an | illness previously confi ned primarily to Africa, the Middle East, and parts of Europe and | Asia—had sickened 62 persons in New York, | seven of whom died. WNV is now endemic | throughout the continental United States. | Although most infections are asymptomatic, | approximately 341,000 cases of West Nile fever (WNF) have occurred, 12,188 infections | have resulted in West Nile neuroinvasive | disease, and 1,164 infections have resulted | in death. Based on a ratio of 140 infections | for every case of West Nile neuroinvasive | disease, CDC projects that 1.7 million WNV | infections have occurred in the United States | since 1999. |
The evolving epidemiology of hepatitis A in the United States: incidence and molecular epidemiology from population-based surveillance, 2005-2007
Klevens RM , Miller JT , Iqbal K , Thomas A , Rizzo EM , Hanson H , Sweet K , Phan Q , Cronquist A , Khudyakov Y , Xia GL , Spradling P . Arch Intern Med 2010 170 (20) 1811-8 BACKGROUND: The incidence of hepatitis A virus (HAV) disease is the lowest ever in the United States. We describe recent incidence and characteristics of cases of HAV disease from 6 US sites conducting hepatitis surveillance in the Emerging Infections Program. METHODS: Health departments conducted enhanced, population-based surveillance for HAV from 2005 through 2007. Demographic and risk factor data were collected on suspected cases (persons with a positive IgM anti-HAV result) using a standard form. Remnant serum specimens from a convenience sample of cases were tested by polymerase chain reaction, followed by sequencing the 315-nucleotide segment of the VP1-P2B junction. RESULTS: There were 1156 HAV cases reported during 2005 through 2007. The combined population under surveillance was 29.8 million in 2007. The overall annual incidence rate was 1.3 per 100,000 population (range by site, 0.7-2.3). Of reported cases, 53.4% were male, 42.4% were white, 44.7% were aged 15 to 39 years, and 91.4% resided in urban areas. Reported risk factors were international travel (45.8%), contact with a case (14.8%), employee or child in a daycare center (7.6%), exposure during a food or waterborne common-source outbreak (7.2%), illicit drug use (4.3%), and men who had sex with men (3.9%). Genotypes among the 271 case specimens were IA (87.8%), IB (11.4%), and IIIA (0.7%). Of the 271 polymerase chain reaction-positive specimens, 131 (48.3%) were from cases reporting travel or exposure to a traveler; 58 of the 131 cases reported travel to Mexico, and 53 of the 58 were within the US-IA(1) cluster. CONCLUSIONS: International travel was the predominant risk factor for HAV transmission. Health care providers should encourage vaccination of at-risk travelers. |
Outbreak of Escherichia coli O157 associated with raw milk, Connecticut, 2008
Guh A , Phan Q , Nelson R , Purviance K , Milardo E , Kinney S , Mshar P , Kasacek W , Cartter M . Clin Infect Dis 2010 51 (12) 1411-7 BACKGROUND: In Connecticut, despite hazards of raw milk consumption, attempts to ban raw milk sales have been unsuccessful. In July 2008, 2 children experienced Escherichia coli O157-associated hemolytic uremic syndrome (HUS) after consuming raw milk purchased at a retail market and a farm (farm X). We investigated to determine the outbreak source and control measures. METHODS: Confirmed cases were HUS diagnosis or E. coli O157:NM infections with isolates matching outbreak strains among patients during June to July 2008. Probable cases were diarrheal illness among farm X customers during the same period. We conducted case-control studies to determine the source of E. coli O157 exposure and assess for dose-response relation between illness and frequency of raw milk consumption. Farm X dairy practices were evaluated; stool specimens of humans and animals were cultured for E. coli O157. Staff time and laboratory and medical costs were calculated. RESULTS: We identified 14 cases (7 confirmed). Five (36%) case patients required hospitalization; 3 (21%) experienced HUS. No deaths were reported. Raw milk consumption was associated with illness (P = .008); a dose-response relation was demonstrated (P = .01). Dairy practices reflected industry standards. E. coli O157:NM outbreak strains were isolated from stool specimens of 6 case patients and 1 milking cow. The total estimated outbreak cost was $413,402. CONCLUSIONS: Farm X's raw milk was the outbreak source despite no violations of current raw milk regulatory standards. This outbreak resulted in substantial costs and proposed legislation to prohibit nonfarm retail sale, strengthen advisory labels, and increase raw milk testing for pathogens. |
A prolonged outbreak of Salmonella Montevideo infections associated with multiple locations of a restaurant chain in Phoenix, Arizona, 2008
Patel MK , Chen S , Pringle J , Russo E , Vinaras J , Weiss J , Anderson S , Sunenshine R , Komatsu K , Schumacher M , Flood D , Theobald L , Bopp C , Wannemuehler K , White P , Angulo FJ , Behravesh CB . J Food Prot 2010 73 (10) 1858-63 An outbreak of Salmonella serotype Montevideo infections associated with multiple locations of restaurant chain A in Phoenix, AZ, was identified in July 2008. One infected individual reported eating at a chain A catered luncheon where others fell ill; we conducted a cohort study among attendees to identify the vehicle. Food and environmental samples collected at six chain A locations were cultured for Salmonella. Restaurant inspection results were compared among 18 chain A locations. Routine surveillance identified 58 Arizona residents infected with the outbreak strain. Three chain A locations, one of which catered the luncheon, were named by two or more case patients as a meal source in the week prior to illness onset. In the cohort study of luncheon attendees, 30 reported illness, 10 of which were later culture confirmed. Illness was reported by 30 (61%) of 49 attendees who ate chicken and by 0 of 7 who did not. The outbreak strain was isolated from two of these three locations from uncooked chicken in marinade, chopped cilantro, and a cutting board dedicated to cutting cooked chicken. Raw chicken, contaminated before arrival at the restaurant, was the apparent source of this outbreak. The three locations where two or more case patients ate had critical violations upon routine inspection, while 15 other locations received none. Poor hygiene likely led to cross-contamination of food and work areas. This outbreak supports the potential use of inspections in identifying restaurants at high risk of outbreaks and the need to reduce contamination of raw products at the source and prevent cross-contamination at the point of service. |
Evolution of canine and equine influenza (H3N8) viruses co-circulating between 2005 and 2008
Rivailler P , Perry IA , Jang Y , Davis CT , Chen LM , Dubovi EJ , Donis RO . Virology 2010 408 (1) 71-9 Influenza virus, subtype H3N8, was transmitted from horses to greyhound dogs in 2004 and subsequently spread to pet dog populations. The co-circulation of H3N8 viruses in dogs and horses makes bi-directional virus transmission between these animal species possible. To understand the dynamics of viral transmission, we performed virologic surveillance in dogs and horses between 2005 and 2008 in the United States. The genomes of influenza A H3N8 viruses isolated from 36 dogs and horses were sequenced to determine their origin and evolution. Phylogenetic analyses revealed that H3N8 influenza viruses from horses and dogs were monophyletic and distinct. There was no evidence of canine influenza virus infection in horses with respiratory disease or new introductions of equine influenza viruses into dogs in the United States. Analysis of a limited number of equine influenza viruses suggested substantial separation in the transmission of viruses causing clinically apparent influenza in dogs and horses. |
Trends in low-risk lifestyle factors among adults in the United States: findings from the Behavioral Risk Factor Surveillance System 1996-2007
Ford ES , Li C , Zhao G , Pearson WS , Tsai J , Greenlund KJ . Prev Med 2010 51 (5) 403-7 OBJECTIVE: Our objective was to examine recent trends in low-risk lifestyle factors for chronic diseases (not currently smoking, any exercise during the past 30 days, consuming fruits and vegetables ≥5 times per day, and body mass index <25kg/m(2)) among U.S. adults. METHODS: We used data from 1,580,220 adults aged ≥18 years who participated in one of seven Behavioral Risk Factor Surveillance System surveys conducted from 1996 to 2007. RESULTS: The age-adjusted percentage of adults meeting all four low-risk lifestyle factors was 8.5% in 1996 and 7.7% in 2007 (p for linear trend <0.001). Significant decreasing trends were noted for men, women, whites, Hispanics, and most age groups. The percentages of participants who were not currently smoking, who had done any exercise during the past 30 days, who reported consuming fruits and vegetables ≥5 times per day, and who had a body mass index <25kg/m(2) were 70.9%, 76.2%, 47.9% and 24.3%, respectively, in 1996 and 77.1%, 80.0%, 37.8%, and 24.5%, respectively, in 2007. Women and whites were more likely than their counterparts to meet all four criteria. CONCLUSIONS: From 1996 to 2007, the percentage of U.S. adults meeting all four low-risk lifestyle factors decreased slightly. |
Pre-travel health advice-seeking behavior among US international travelers departing from Boston Logan International Airport
Larocque RC , Rao SR , Tsibris A , Lawton T , Anita Barry M , Marano N , Brunette G , Yanni E , Ryan ET . J Travel Med 2010 17 (6) 387-91 BACKGROUND: Globally mobile populations are at higher risk of acquiring geographically restricted infections and may play a role in the international spread of infectious diseases. Despite this, data about sources of health information used by international travelers are limited. METHODS: We surveyed 1,254 travelers embarking from Boston Logan International Airport regarding sources of health information. We focused our analysis on travelers to low or low-middle income (LLMI) countries, as defined by the World Bank 2009 World Development Report. RESULTS: A total of 476 survey respondents were traveling to LLMI countries. Compared with travelers to upper-middle or high income (UMHI) countries, travelers to LLMI countries were younger, more likely to be foreign-born, and more frequently reported visiting family as the purpose of their trip. Prior to their trips, 46% of these travelers did not pursue health information of any type. In a multivariate analysis, being foreign-born, traveling alone, traveling for less than 14 days, and traveling for vacation each predicted a higher odds of not pursuing health information among travelers to LLMI countries. The most commonly cited reason for not pursuing health information was a lack of concern about health problems related to the trip. Among travelers to LLMI countries who did pursue health information, the internet was the most common source, followed by primary care practitioners. Less than a third of travelers to LLMI countries who sought health information visited a travel medicine specialist. CONCLUSIONS: In our study, 46% of travelers to LLMI countries did not seek health advice prior to their trip, largely due to a lack of concern about health issues related to travel. Among travelers who sought medical advice, the internet and primary care providers were the most common sources of information. These results suggest the need for health outreach and education programs targeted at travelers and primary care practitioners. |
HIV-related attitudes and intentions for high-risk, substance-using men who have sex with men: associations and clinical implications for HIV-positive and HIV-negative MSM
Mansergh G , McKirnan DJ , Flores SA , Hudson SM , Koblin BA , Purcell DW , Colfax GN . J Cogn Psychother 2010 24 (4) 281-293 This study compared HIV-related attitudes and intentions by respondent HIV-status in a large sample of substance-using men who have sex with men (MSM) in the United States. Attitudes and intentions included self-efficacy for safer sex; difficulty communicating with sex partners about safer sex; intent to use condoms consistently and to not use substances before sex in the next 3 months; and less concern for HIV given effective antiviral treatments. Differences were found for behavior during the most recent anal sex encounter by HIV-status, including (a) insertive and (b) receptive anal sex risk behavior, and (c) substance use before or during the encounter. Self-efficacy for safer sex was associated with less risk behavior among HIV-negative men but not among HIV-positive men, suggesting that self-efficacy for safer sex continues to be a relevant issue to address in counseling uninfected MSM. HIV-positive men who reported less concern for HIV given treatments were more likely to report receptive risk behavior, as were HIV-negative men who reported difficulty communicating about safer sex. Implications are discussed for potentially heightened client desire and therapeutic opportunity to reduce future substance use during sex for clients who report recent substance use during sex. 2010 Springer Publishing Company. |
Knowledge, attitudes, and practices of US travelers to Asia regarding seasonal influenza and H5N1 avian influenza prevention measures
Yanni EA , Marano N , Han P , Edelson PJ , Blumensaadt S , Becker M , Dwyer S , Crocker K , Daley T , Davis X , Gallagher N , Balaban V , McCarron M , Mounts A , Lipman H , Brown C , Kozarsky P . J Travel Med 2010 17 (6) 374-81 BACKGROUND: International travel is a potential risk factor for the spread of influenza. In the United States, approximately 5%-20% of the population develops an influenza-like illness annually. The purpose of this study was to describe the knowledge, attitude, and practices of US travelers to Asia regarding seasonal influenza and H5N1 avian influenza (AI) prevention measures. METHODS: We surveyed travelers to Asia waiting at the departure lounges of 38 selected flights at four international airports in New York, Chicago, Los Angeles, and San Francisco. Of the 1,301 travelers who completed the pre-travel survey, 337 also completed a post-travel survey. Univariate and multivariate logistic regression were used to calculate prevalence odds ratios (with 95% CI) to compare foreign-born (FB) to US-born travelers for various levels of knowledge and behaviors. RESULTS: Although the majority of participants were aware of influenza prevention measures, only 41% reported receiving the influenza vaccine during the previous season. Forty-three percent of participants reported seeking at least one type of pre-travel health advice, which was significantly higher among US-born, Caucasians, traveling for purposes other than visiting friends and relatives, travelers who received the influenza vaccine during the previous season, and those traveling with a companion. Our study also showed that Asians, FB travelers, and those working in occupations other than health care/animal care were less likely to recognize H5N1 AI transmission risk factors. CONCLUSION: The basic public health messages for preventing influenza appear to be well understood, but the uptake of influenza vaccine was low. Clinicians should ensure that all patients receive influenza vaccine prior to travel. Tailored communication messages should be developed to motivate Asians, FB travelers, those visiting friends and relatives, and those traveling alone to seek pre-travel health advice as well as to orient them with H5N1 AI risk factors. |
School-based randomized controlled trial of an HIV/STD risk-reduction intervention for South African adolescents
Jemmott JB 3rd , Jemmott LS , O'Leary A , Ngwane Z , Icard LD , Bellamy SL , Jones SF , Landis JR , Heeren GA , Tyler JC , Makiwane MB . Arch Pediatr Adolesc Med 2010 164 (10) 923-9 OBJECTIVE: To test the efficacy of a school-based human immunodeficiency virus/sexually transmitted disease (HIV/STD) risk-reduction intervention for South African adolescents. DESIGN: A cluster-randomized, controlled design with assessments of self-reported sexual behavior collected before intervention and 3, 6, and 12 months after intervention. SETTING: Primary schools in a large, black township and a neighboring rural settlement in Eastern Cape Province, South Africa. PARTICIPANTS: Nine of 17 matched pairs of schools were randomly selected. Sixth-grade students with parent or guardian consent were eligible. INTERVENTIONS: Two 6-session interventions based on behavior-change theories and qualitative research. The HIV/STD risk-reduction intervention targeted sexual risk behaviors; the attention-matched health promotion control intervention targeted health issues unrelated to sexual behavior. OUTCOME MEASURES: The primary outcome was self report of unprotected vaginal intercourse in the previous 3 months averaged over the 3 follow-ups. Secondary outcomes were other sexual behaviors. RESULTS: A total of 1057 (94.5%) of 1118 eligible students (mean age, 12.4 years) participated, with 96.7% retained at the 12-month follow-up. Generalized estimating equation analyses adjusted for clustering from 18 schools revealed that, averaged over the 3 follow-ups, a significantly smaller percentage of HIV/STD risk-reduction intervention participants reported having unprotected vaginal intercourse (odds ratio [OR], 0.51; 95% confidence interval [CI], 0.30-0.85), vaginal intercourse (OR, 0.62; 95% CI, 0.42-0.94), and multiple sexual partners (OR, 0.50; 95% CI, 0.28-0.89), when adjusted for baseline prevalences, compared with health-promotion control participants. CONCLUSION: This is the first large-scale, community-level, randomized intervention trial to show significant effects on the HIV/STD sexual risk behavior of South African adolescents in the earliest stages of entry into sexual activity. |
Type 2 vaccine-derived poliovirus from patients with acute flaccid paralysis in China: current immunization strategy effectively prevented its sustained transmission
Zhang Y , Yan D , Zhu S , Wen N , Li L , Wang H , Liu J , Ye X , Ding Z , Wang D , Zhu H , Chen L , Hou X , An H , Liang X , Luo H , Kew O , Xu W . J Infect Dis 2010 202 (12) 1780-8 In China, 5 patients with acute flaccid paralysis (AFP) associated with type 2 vaccine-derived poliovirus (VDPV) were identified by an AFP surveillance system from 1996 through 2009. A maximum-likelihood tree shows that all 5 Chinese VDPVs were independent. These 5 VDPVs were 100-216 d old according to the number of synonymous substitutions per synonymous site and 176-292 d old according to the number of substitutions per site. This result indicates limited virus replication since the administration of the initiating oral polio vaccine (OPV) dose, which is consistent with the rapid evolution rate of poliovirus genomes. The above-mentioned VDPVs have important implications in the global polio eradication initiative. Localized, limited, and transient circulation may be typical of OPVs; hence, independent VDPVs could be found because of the large population and excellent surveillance system, which permitted early detection and response, but sustained transmission was limited because of high population immunity. |
Improved protection against avian influenza H5N1 virus by a single vaccination with virus-like particles in skin using microneedles
Song JM , Kim YC , Barlow PG , Hossain MJ , Park KM , Donis RO , Prausnitz MR , Compans RW , Kang SM . Antiviral Res 2010 88 (2) 244-7 To develop a more effective vaccination method against H5N1 virus, we investigated the immunogenicity and protective efficacy after skin vaccination using microneedles coated with influenza virus-like particles containing hemagglutinin derived from A/Vietnam/1203/04 H5N1 virus (H5 VLPs). A single microneedle vaccination of mice with H5 VLPs induced increased levels of antibodies and provided complete protection against lethal challenge without apparent disease symptoms. In contrast, intramuscular injection with the same vaccine dose showed low levels of antibodies and provided only partial protection accompanied by severe body weight loss. Post-challenge analysis suggested that improved protection was associated with lower lung viral titers and enhanced generation of recall antibody secreting cells by microneedle vaccination. Thus, this study provides evidence that skin delivery of H5 VLP vaccines using microneedles designed for self-administration induces improved protection compared to conventional intramuscular immunization. |
Electronic medical record adoption and use in home health and hospice
Bercovitz A , Sengupta M , Jamison P . NCHS Data Brief 2010 (45) 1-8 KEY FINDINGS: Data from the National Home and Hospice Care Survey, 2007 In 2007, about 5,900 of the 14,500 providers of home health or hospice care (41%) had electronic medical records (EMRs), and an additional 2,200 (15%) planned to have EMRs within the next year. Providers who offered both hospice and home health care were more likely to have EMRs than providers offering only home health care, but did not differ from providers of hospice care only. Among providers with EMRs, 98% used components for recording patient demographics and 83% for clinical notes, and over one-half used clinical decision support systems or computerized physician order entry. Nonprofit and government providers, providers jointly owned or operated with other health care organizations, and providers with over 150 patients were more likely to have EMRs. |
Real-time fluorescence loop mediated isothermal amplification for the diagnosis of malaria
Lucchi NW , Demas A , Narayanan J , Sumari D , Kabanywanyi A , Kachur SP , Barnwell JW , Udhayakumar V . PLoS One 2010 5 (10) e13733 BACKGROUND: Molecular diagnostic methods can complement existing tools to improve the diagnosis of malaria. However, they require good laboratory infrastructure thereby restricting their use to reference laboratories and research studies. Therefore, adopting molecular tools for routine use in malaria endemic countries will require simpler molecular platforms. The recently developed loop-mediated isothermal amplification (LAMP) method is relatively simple and can be improved for better use in endemic countries. In this study, we attempted to improve this method for malaria diagnosis by using a simple and portable device capable of performing both the amplification and detection (by fluorescence) of LAMP in one platform. We refer to this as the RealAmp method. METHODOLOGY & SIGNIFICANT FINDINGS: Published genus-specific primers were used to test the utility of this method. DNA derived from different species of malaria parasites was used for the initial characterization. Clinical samples of P. falciparum were used to determine the sensitivity and specificity of this system compared to microscopy and a nested PCR method. Additionally, directly boiled parasite preparations were compared with a conventional DNA isolation method. The RealAmp method was found to be simple and allowed real-time detection of DNA amplification. The time to amplification varied but was generally less than 60 minutes. All human-infecting Plasmodium species were detected. The sensitivity and specificity of RealAmp in detecting P. falciparum was 96.7% and 91.7% respectively, compared to microscopy and 98.9% and 100% respectively, compared to a standard nested PCR method. In addition, this method consistently detected P. falciparum from directly boiled blood samples. CONCLUSION: This RealAmp method has great potential as a field usable molecular tool for diagnosis of malaria. This tool can provide an alternative to conventional PCR based diagnostic methods for field use in clinical and operational programs. |
Robust gold nanoparticles stabilized by trithiol for application in chemiresistive sensors
Garg N , Mohanty A , Lazarus N , Schultz L , Rozzi TR , Santhanam S , Weiss L , Snyder JL , Fedder GK , Jin R . Nanotechnology 2010 21 (40) 405501 The use of gold nanoparticles coated with an organic monolayer of thiol for application in chemiresistive sensors was initiated in the late 1990s; since then, such types of sensors have been widely pursued due to their high sensitivities and reversible responses to volatile organic compounds (VOCs). However, a major issue for chemical sensors based on thiol-capped gold nanoparticles is their poor long-term stability as a result of slow degradation of the monothiol-to-gold bonds. We have devised a strategy to overcome this limitation by synthesizing a more robust system using Au nanoparticles capped by trithiol ligands. Compared to its monothiol counterpart, the new system is significantly more stable and also shows improved sensitivity towards different types of polar or non-polar VOCs. Thus, the trithiol-Au nanosensor shows great promise for use in real world applications. 2010 IOP Publishing Ltd. |
Spatial configuration of hepatitis E virus antigenic domain
Xing L , Wang JC , Li TC , Yasutomi Y , Lara J , Khudyakov Y , Schofield D , Emerson SU , Purcell RH , Takeda N , Miyamura T , Cheng RH . J Virol 2010 85 (2) 1117-24 Hepatitis E virus (HEV) is a human pathogen that causes acute hepatitis. When an HEV capsid protein containing a 52 amino acid deletion at the C-terminus and a 111 amino acid deletion at the N-terminus is expressed in insect cells, the recombinant HEV capsid protein can self-assemble into a T=1 virus-like particle (VLP) that retains the antigenicity of the native HEV virion. In this study, we used cryo-electron microscopy and image reconstruction to show that anti-HEV monoclonal antibodies bind to the protruding domain of the capsid protein at the lateral side of the spikes. Molecular docking of the HEV VLP crystal structure revealed that the Fab224 covered three PORF2 surface loops at the top part of the spike. We also determined the structure of a chimeric HEV VLP and located the inserted B-cell tag, an epitope of 11 amino acids coupled to the C-terminal end of the recombinant ORF2 protein. The binding site of Fab224 appeared distinct from the location of the inserted B-cell tag, suggesting that the chimeric VLP could elicit immunity against both HEV and an inserted foreign epitope. Therefore, the T=1 HEV VLP is a novel delivery system for displaying foreign epitopes at the VLP surface in order to induce antibodies against both HEV and the inserted epitope. |
Nanobead-based interventions for the treatment and prevention of tuberculosis
Griffiths G , Nystrom B , Sable SB , Khuller GK . Nat Rev Microbiol 2010 8 (11) 827-34 Tuberculosis (TB), caused by Mycobacterium tuberculosis, is one of the most devastating bacterial diseases to affect humans. M. tuberculosis is a robust pathogen that has evolved the capacity to survive and grow inside macrophage phagosomes. A cocktail of antibiotics has long been successfully used against M. tuberculosis but is becoming less effective owing to the emergence of multidrug resistance. The only available preventive vaccine, using Mycobacterium bovis bacille Calmette-Guerin, is considered to be ineffective against adult pulmonary TB, the most prevalent form of the disease. Here, we review the potential use of biodegradable nanoparticle-based anti-TB drug delivery systems that have been shown to be more effective against M. tuberculosis in animal models than conventional antibiotic treatment regimens. This technology also has substantial potential for vaccination and other therapeutic strategies against TB and other infectious diseases. |
Quadratic variance models for adaptively preprocessing SELDI-TOF mass spectrometry data
Emanuele VA 2nd , Gurbaxani BM . BMC Bioinformatics 2010 11 512 BACKGROUND: Surface enhanced laser desorption/ionization time-of-flight mass spectrometry (SELDI) is a proteomics tool for biomarker discovery and other high throughput applications. Previous studies have identified various areas for improvement in preprocessing algorithms used for protein peak detection. Bottom-up approaches to preprocessing that emphasize modeling SELDI data acquisition are promising avenues of research to find the needed improvements in reproducibility. RESULTS: We studied the properties of the SELDI detector intensity response to matrix only runs. The intensity fluctuations and noise observed can be characterized by a natural exponential family with quadratic variance function (NEF-QVF) class of distributions. These include as special cases many common distributions arising in practice (e.g.- normal, Poisson). Taking this model into account, we present a modified Antoniadis-Sapatinas wavelet denoising algorithm as the core of our preprocessing program, implemented in MATLAB. The proposed preprocessing approach shows superior peak detection sensitivity compared to MassSpecWavelet for false discovery rate (FDR) values less than 25%. CONCLUSIONS: The NEF-QVF detector model requires that certain parameters be measured from matrix only spectra, leaving implications for new experiment design at the trade-off of slightly increased cost. These additional measurements allow our preprocessing program to adapt to changing noise characteristics arising from intralaboratory and across-laboratory factors. With further development, this approach may lead to improved peak prediction reproducibility and nearly automated, high throughput preprocessing of SELDI data. |
In-vitro oxidation of bisphenol A: Is bisphenol A catechol a suitable biomarker for human exposure to bisphenol A?
Ye X , Zhou X , Needham LL , Calafat AM . Anal Bioanal Chem 2010 399 (3) 1071-9 The extensive use of bisphenol A (BPA) in the manufacture of consumer products results in widespread human exposure to the chemical. In the body, BPA undergoes first-pass metabolism to form BPA glucuronide, considered to be a major BPA byproduct. Concentrations of total (free plus conjugated) urinary species of BPA are used to assess human exposure to BPA. However, because BPA can be present in numerous consumer and household products, potential contamination with parent BPA during collection and handling may pose a challenge when measuring BPA in such biological samples as blood or urine. In this study we investigated the in-vitro phase I metabolism of BPA in rat and human liver microsomes by using on-line solid-phase extraction-high-performance liquid chromatography-tandem mass spectrometry to identify phase I metabolites (e.g., BPA oxidation products) that could be used as potential alternative biomarkers of BPA exposure. We unambiguously identified 5-hydroxy BPA (BPA catechol) as an in-vitro oxidative metabolite of BPA, but human microsomes oxidized only about 10% of BPA to BPA catechol. We evaluated the usefulness of BPA catechol as a potential biomarker of human exposure to BPA by measuring total concentrations of BPA catechol and BPA in 20 urine samples. We detected BPA catechol at much lower concentrations and frequency than those of BPA. Furthermore, we found that free BPA catechol was rather unstable in urine, which highlights the importance of sampling techniques to adequate interpretation of biomonitoring data. Together, these findings suggest that BPA catechol may not be a suitable biomarker of environmental exposure to BPA, but could be used to confirm BPA exposure in special populations or in situations when urine specimens were potentially contaminated with BPA. |
Invasive meningococcal disease caused by Neisseria meningitidis strains expressing both serogroup Y and W-135 antigenic specificities
Rudolph KM , Debyle C , Reasonover A , Zulz T , Law DK , Zhou J , Tsang RS . J Clin Microbiol 2010 49 (1) 472-3 We read with interest of three Neisseria meningitidis strains recovered in Germany that reacted with commercial (Oxoid, Wesel, Germany) serogroupY and serogroup W135 antisera (3). The molecular basis of this dual antigenic specificity has been determined to be due to a single amino acid change at position 310 in the EX7E motif of the capsule polymerase enzyme synG (also referred to as siaDY) (from glycine to serine) or synF (siaDW-135) (from proline to serine) (2). Both studies confirmed our earlier report of such unusual strains causing invasive meningococcal disease (IMD) (10). |
Correlation of the detection of Clostridium difficile toxins in stools and presence of the clostridia in tissues of children
Guarner J , Bhatnagar J , Shane AL , Jones T , DeLeon-Carnes MN , Schemankewitz E , Zaki SR . Hum Pathol 2010 41 (11) 1586-92 Clostridium difficile toxin is frequently found in the stool of children; however, pseudomembranous colitis is rare. Studying the usefulness of Clostridium difficile toxin assays in pediatrics is required. We performed a correlation between presence of Clostridium difficile toxin in stool and evidence of Clostridium difficile in gastrointestinal pediatric tissue samples using immunohistochemistry (with a pan-clostridial antibody) and polymerase chain reaction (with primers for toxin genes). We studied 11 patients with a median age of 8 years (range, 4 weeks to 17 years); 4 (36%) were female. The median time between detection of Clostridium difficile toxin in stool and obtaining tissue was 3 days. Ten patients survived. Endoscopy was performed in 8 survivors and showed normal mucosa in 2, pseudomembranes in 2, erythema and friability in 1, aphthae in 1, increased mucous production in 1, and colitis in 1. Two survivors underwent laparotomy for either obstruction or resection of necrotic bowel. Histopathologic studies in these 10 surviving patients showed necrosis in 2 samples, granulomatous inflammation in 1, moderate colitis in 1, and mild to minimal pathology in 7. There was no antigenic or molecular evidence of clostridia in the tissue of these patients. Histopathologic evidence of pseudomembranes and immunohistochemical evidence of clostridia were present in postmortem intestinal tissues of the only patient that died. Our findings indicate that Clostridium difficile toxin in stool does not correlate with the presence of clostridia and may not contribute to pathology in intestinal tissues of children. Clostridial antigens were only observed with histopathologic evidence of pseudomembranes. |
A method to determine the available UV-C dose for the decontamination of filtering facepiece respirators
Fisher EM , Shaffer RE . J Appl Microbiol 2010 110 (1) 287-95 AIMS: To develop a method to assess model-specific parameters for ultraviolet-C (UV-C, 254 nm) decontamination of filtering facepiece respirators (FFRs). METHODS & RESULTS: UV-C transmittance was quantified for the distinct composite layers of six N95 FFR models and used to calculate model-specific alpha-values, the percentage of the surface UV-C irradiance available for the internal filtering medium (IFM). Circular coupons, excised from the FFRs, were exposed to aerosolized particles containing MS2 coliphage and treated with IFM-specific UV-C doses ranging from 38 to 4707 J m(-2) . Models exposed to a minimum IFM dose of 1000 J m(-2) demonstrated at least a 3 log reduction (LR) in viable MS2. Model-specific exposure times to achieve this IFM dose ranged from 2 to 266 min. CONCLUSIONS: UV-C transmits into and through FFR materials. LR of MS2 was a function of model-specific IFM UV-C doses. SIGNIFICANCE AND IMPACT OF THE STUDY: Filtering facepiece respirators are in high demand during infectious disease outbreaks, potentially leading to supply shortages. Reuse of disposable FFRs after decontamination has been discussed as a possible remediation strategy, but to date lacks supporting scientific evidence. The methods described here can be used to assess the likelihood that UV-C decontamination will be successful for specific FFR models. |
Protecting the planet and its people: How do interventions to promote environmental sustainability and occupational safety and health overlap?
Cunningham TR , Galloway-Williams N , Geller ES . J Safety Res 2010 41 (5) 407-16 PROBLEM: The challenges of both occupational safety and health and environmental sustainability require large-scale behavior change for meaningful improvements to occur. Environmental sustainability, or the 'green movement' has received far more attention recently, and certain strategies and recommendations from interventions designed for promoting pro-environmental behaviors may inform efforts to intervene on critical behaviors for improving occupational safety and health. METHOD: A survey of the literature regarding behavioral interventions for both environmental sustainability and occupational safety and health was conducted. Several theoretical approaches are reviewed, and successful approaches from each domain are identified, as well as parallel challenges and points for crossover. Recommendations are provided for adapting environmental sustainability intervention approaches for occupational safety and health applications. IMPACT ON INDUSTRY: Safety and health leaders may achieve sustainable improvements in worker safety and health by harnessing the momentum of the green movement and adapting successful intervention approaches from the environmental sustainability domain. |
Economic burden of dermatitis in US workers
Blanciforti LA . J Occup Environ Med 2010 52 (11) 1045-54 OBJECTIVE: To estimate the economic burden associated with dermatitis in those aged 16 to 65 years and working in seven industry sectors (DW). METHODS: The 2004 Medical Expenditure Panel Survey and the cost-of-illness method, which aggregates health care costs and productivity losses, were used. RESULTS: The economic burden of DW was approximately $1.2 billion, representing 10.5% of the cost of all skin diseases and disorders (SDD). In all private industry (ie, the sum of the seven sectors examined), cost per employed person was approximately $11 for DW and $109 for SDD. In the all-services sector, one of the seven examined, cost per employed person was approximately $15 for DW and $113 for SDD. CONCLUSIONS: This study provides the first published estimate of the economic burden of DW, based on a representative sample of the US population. |
Evaluation of methods to determine excessive decline of forced expiratory volume in one second in workers exposed to diacetyl-containing flavorings
Chaisson NF , Kreiss K , Hnizdo E , Hakobyan A , Enright PL . J Occup Environ Med 2010 52 (11) 1119-23 OBJECTIVE: To evaluate methods for determining excessive short-term decline in forced expiratory volume in one second (FEV1) in diacetyl-exposed workers. METHODS: We evaluated five methods of determining excessive longitudinal FEV1 decline in diacetyl-exposed workers and workers from a comparative cohort: American Thoracic Society (ATS), ACOEM an 8% limit, and a relative and absolute longitudinal limit on the basis of spirometry data variability. Relative risk and incidence of excess decline were evaluated. RESULTS: Incidence of excessive FEV1 decline was 1% in the comparative cohort using ATS and ACOEM criteria, 4.1% using relative limit of longitudinal decline, 4.4% with absolute longitudinal limit of decline, and 5.6% by using the 8% limit. Relative risk of abnormal FEV1 decline in diacetyl-exposed workers was elevated in all evaluated methods. CONCLUSION: Alternative methods for respiratory surveillance in diacetyl-exposed workers may be preferable to ATS or ACOEM. |
Antioxidants and pulmonary function among police officers
Charles LE , Burchfiel CM , Mnatsakanova A , Fekedulegn D , Tinney-Zara C , Joseph PN , Schunemann HJ , Violanti JM , Andrew ME , Ochs-Balcom HM . J Occup Environ Med 2010 52 (11) 1124-1131 OBJECTIVE: To examine associations of dietary antioxidant intake and pulmonary function. METHODS: Antioxidant data (vitamins A, C, D, E, magnesium, and omega-3 fatty acids) were abstracted from food frequency questionnaires. Pulmonary function was measured using American Thoracic Society criteria. We used analysis of variance to investigate associations. RESULTS: Among 79 police officers (57% male), forced vital capacity was positively and significantly associated with vitamin A after adjustment for age, gender, height, race, smoking status, and pack-years of smoking, and with magnesium after adjustment for those risk factors plus total calories, all supplement use, and abdominal height. Among current/former smokers only, mean levels of all pulmonary function measures were significantly associated with vitamin E; smoking status significantly modified these relationships. CONCLUSIONS: Increased intake of vitamin A, vitamin E (among current/former smokers only), and magnesium was associated with better pulmonary function. |
U.S. primary care physicians' lung cancer screening beliefs and recommendations
Klabunde CN , Marcus PM , Silvestri GA , Han PK , Richards TB , Yuan G , Marcus SE , Vernon SW . Am J Prev Med 2010 39 (5) 411-20 BACKGROUND: No high-quality study to date has shown that screening reduces lung cancer mortality, and expert groups do not recommend screening for asymptomatic individuals. Nevertheless, lung cancer screening tests are available in the U.S., and primary care physicians (PCPs) may have a role in recommending them to patients. PURPOSE: This study describes U.S. PCPs' beliefs about and recommendations for lung cancer screening and examines characteristics of PCPs who recommend screening. METHODS: A nationally representative survey of practicing PCPs was conducted in 2006-2007. Mailed questionnaires were used to assess PCPs' beliefs about lung cancer screening guidelines and the effectiveness of screening tests and to determine whether PCPs would recommend screening for asymptomatic patients. Data were analyzed in 2009. RESULTS: Nine hundred sixty-two PCPs completed the survey (absolute response rate=70.6%; cooperation rate=76.8%). One quarter said that major guidelines support lung cancer screening. Two thirds said that low-radiation dose spiral computed tomography (LDCT) screening is very or somewhat effective in reducing lung cancer mortality in current smokers; LDCT was perceived as more effective than chest x-ray or sputum cytology. Responding to vignettes describing asymptomatic patients of varying smoking exposure, 67% of PCPs recommended lung cancer screening for at least one of the vignettes. Most PCPs recommending screening said they would use chest x-ray; up to 26% would use LDCT. In adjusted analyses, PCPs' beliefs and practice style were strongly associated with their lung cancer screening recommendations. CONCLUSIONS: Many PCPs' lung cancer screening beliefs and recommendations are inconsistent with current evidence and guidelines. Provider education regarding the evidence base and guideline content of lung cancer screening is indicated. |
Visits to primary care delivery sites: United States, 2008
Hing E , Uddin S . NCHS Data Brief 2010 (47) 1-8 KEY FINDINGS: In 2008, the majority of visits to primary care delivery sites (84%) occurred in physician offices, 11% in hospital outpatient departments (OPDs), and 5% in community health centers (CHCs). Patients with Medicaid, State Children's Health Insurance Plan (SCHIP) or no insurance accounted for a higher percentage of visits to CHCs (56%) and OPDs (40%) than to physician offices (17%). CHCs had a higher age-adjusted percentage of visits by patients with one or more chronic conditions (56%) compared with visits to physician offices (49%) and OPDs (49%). |
Health promotion practice and the road ahead: addressing enduring gaps and encouraging greater practice-to-research translation
Rivera MD , Birnbaum AS . Health Promot Pract 2010 11 (6) 779-83 A decade ago, Lancaster and Roe described four critical gaps (i.e., communications, accessibility, credibility, and expectations) between research and practice in health education and health promotion that formed the framework for this department. Despite considerable attention and some progress, these gaps persist and are barriers to interaction and translation between health promotion and health education research and practice. Looking to the next several years as the new Associate Editors for this department, we renew the department's commitment toward addressing these enduring gaps around which we frame new questions and invite continued dialogue. |
Checking the foundation: recent radiobiology and the linear no-threshold theory
Ulsh BA . Health Phys 2010 99 (6) 747-58 The linear no-threshold (LNT) theory has been adopted as the foundation of radiation protection standards and risk estimation for several decades. The "microdosimetric argument" has been offered in support of the LNT theory. This argument postulates that energy is deposited in critical cellular targets by radiation in a linear fashion across all doses down to zero, and that this in turn implies a linear relationship between dose and biological effect across all doses. This paper examines whether the microdosimetric argument holds at the lowest levels of biological organization following low dose, low dose-rate exposures to ionizing radiation. The assumptions of the microdosimetric argument are evaluated in light of recent radiobiological studies on radiation damage in biological molecules and cellular and tissue level responses to radiation damage. There is strong evidence that radiation initially deposits energy in biological molecules (e.g., DNA) in a linear fashion, and that this energy deposition results in various forms of prompt DNA damage that may be produced in a pattern that is distinct from endogenous (e.g., oxidative) damage. However, a large and rapidly growing body of radiobiological evidence indicates that cell and tissue level responses to this damage, particularly at low doses and/or dose-rates, are nonlinear and may exhibit thresholds. To the extent that responses observed at lower levels of biological organization in vitro are predictive of carcinogenesis observed in vivo, this evidence directly contradicts the assumptions upon which the microdosimetric argument is based. |
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