The Epstein-Barr virus early antigen (EBV EA) complex consists of multiple proteins with potential significance for diagnosis of EBV-related diseases. In many individuals, detection of antibody to ...the early antigen (EA) is a sign of active infection, but 20% of healthy people may have this antibody for years. We studied the role of EA immunoglobulin G (IgG) in individuals with atypical antibody responses in the diagnosis of infectious mononucleosis (IM) and in EBV-infected transplant patients. EA IgG was present in 72% of confirmed IM patients. A trend was observed between high viral loads and the presence of EA IgG and between low viral loads and the absence of EA IgG in EBV-associated disease negative liver transplant recipients. Three assays that measure serum EA IgG were compared; enzyme-linked immunosorbent assay (ELISA), chemiluminescent immunoassay (CLIA), and immunoblot assay. The automated CLIA was found to be more accurate than the ELISA when using the immunoblot assay as a "gold standard" assay in the detection of EA IgG. There may be a potential role for EA IgG testing, together with EBV viral load, in the prediction of transplant recipients at risk of EBV-associated disease; however, EA IgG does not play a significant role in the differential diagnosis of EBV infection in immunocompetent individuals.
The first ever case of Middle East Respiratory Syndrome Coronavirus (MERSCoV) was reported in September 2012. This report describes the approaches taken by CDC, in collaboration with the World Health ...Organization (WHO) and other partners, to respond to this novel virus, and outlines the agency responses prior to the first case appearing in the United States in May 2014. During this time, CDC's response integrated multiple disciplines and was divided into three distinct phases: before, during, and after the initial activation of its Emergency Operations Center. CDC's response to MERS-CoV required a large effort, deploying at least 353 staff members who worked in the areas of surveillance, laboratory capacity, infection control guidance, and travelers' health. This response built on CDC's experience with previous outbreaks of other pathogens and provided useful lessons for future emerging threats.
Previously reported data on 5 computer-based programs for measurement of joint space width focusing on discriminating ability and reproducibility are updated, showing new data. Four of 5 different ...programs for measuring joint space width were more discriminating than observer scoring for change in narrowing in the 12 months interval. Three of 4 programs were more discriminating than observer scoring for the 0-18 month interval. The program that failed to discriminate in the 0-12 month interval was not the same program that failed in the 0-18 month interval. The committee agreed at an interim meeting in November 2007 that an important goal for computer-based measurement programs is a 90% success rate in making measurements of joint pairs in followup studies. This means that the same joint must be measured in images of both timepoints in order to assess change over time in serial radiographs. None of the programs met this 90% threshold, but 3 programs achieved 85%-90% success rate. Intraclass correlation coefficients for assessing change in joint space width in individual joints were 0.98 or 0.99 for 4 programs. The smallest detectable change was < 0.2 mm for 4 of the 5 programs, representing 29%-36% of the change within the 99th percentile of measurements.
Biofilm formation on surfaces is an ancient and integral strategy for bacterial survival. Billions of years of adaptation provide microbes with the ability to colonize any surface, including those ...used in orthopaedic surgery. Although remarkable progress has been made in the treatment of orthopaedic diseases with implanted prostheses, infection rates remain between 1% and 2%, and are higher for revision surgeries. The chronic nature of implant infections, their nonresponsiveness to antibiotics, and their frequent culture negativity can be explained by the biofilm paradigm of infectious disease. However, the role of biofilms in orthopaedic implant infections and aseptic loosening is controversial. To address these issues, we developed molecular diagnostic and confocal imaging techniques to identify and characterize biofilms associated with infected implants. We designed PCR and reverse transcription (RT)-PCR-based assays that can be used to detect bacterial infections associated with culture-negative joint effusions that distinguish between physiologically active Staphylococcus aureus and Staphylococcus epidermidis. Using clinical isolates of Pseudomonas aeruginosa, we constructed a series of reporter strains expressing colored fluorescent proteins to observe biofilms growing on 316L stainless steel and titanium orthopaedic screws. Three-dimensional structures of Pseudomonas aeruginosa and staphylococci biofilms growing on the screws were documented using confocal microscopy. The application of these tools for clinical diagnosis and biofilm research in animal and in vitro models is discussed.
Comparison of performances of 5 (semi)automated methods in measuring joint space width (JSW) in rheumatoid arthritis.
Change in JSW was determined by 5 measurement methods on 4 radiographs per ...patient from 107 patients included in the COBRA trial (comparing sulfasalazine alone or in combination with methotrexate and corticosteroids). For each method the number of patients with sufficient available results was assessed (efficiency). An independent repeated measurement was carried out on a random sample of 30 patients' baseline and 1-year radiographs, to evaluate within-method reliability of change scores. Discriminatory ability (DA) of the measurement methods (between the 2 treatment arms) was compared with the DA of the Sharp-van der Heijde score (SHS) and its 2 components (erosion and JSW scores).
The overall success rate varied widely between methods. Applying the chosen threshold of a minimum of 50% available joints with a change score per patient resulted in a success rate > 92% in 4/5 methods. Repeatability of measurements was good for most methods (intraclass correlation coefficient > or = 0.80 in 4/5 methods). Almost all measurement methods in 3 followup periods (12/14) showed a lower mean loss of JSW in patients from the intensive treatment group, although this was rarely statistically significant, confirming the known difference in structural damage. JSW as measured by the (semi)automated systems often showed higher DA than the JSW score of the SHS, but was lower than the total SHS and erosion scores.
Although efficiency of the methods should be improved further, results already show good reliability and encouraging DA of most methods. Optimal information may be obtained with a combination of scoring of erosions and (semi)automated measurement of JSW.
The objective of this analysis is to evaluate the necessity of large clinical trials using FLOW trial data.
The FLOW pilot study and definitive trial were factorial trials evaluating the effect of ...different irrigation solutions and pressures on re-operation. To explore treatment effects over time, we analyzed data from the pilot and definitive trial in increments of 250 patients until the final sample size of 2447 patients was reached. At each increment we calculated the relative risk (RR) and associated 95% confidence interval (CI) for the treatment effect, and compared the results that would have been reported at the smaller enrolments with those seen in the final, adequately powered study.
The pilot study analysis of 89 patients and initial incremental enrolments in the FLOW definitive trial favored low pressure compared to high pressure (RR: 1.50, 95% CI: 0.75-3.04; RR: 1.39, 95% CI: 0.60-3.23, respectively), which is in contradiction to the final enrolment, which found no difference between high and low pressure (RR: 1.04, 95% CI: 0.81-1.33). In the soap versus saline comparison, the FLOW pilot study suggested that re-operation rate was similar in both the soap and saline groups (RR: 0.98, 95% CI: 0.50-1.92), whereas the FLOW definitive trial found that the re-operation rate was higher in the soap treatment arm (RR: 1.28, 95% CI: 1.04-1.57).
Our findings suggest that studies with smaller sample sizes would have led to erroneous conclusions in the management of open fracture wounds.
NCT01069315 (FLOW Pilot Study) Date of Registration: February 17, 2010, NCT00788398 (FLOW Definitive Trial) Date of Registration: November 10, 2008.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
After the release of radioactive materials from a large radiological dispersal device (e.g., dirty bomb), improvised nuclear detonation, or nuclear power plant accident, up to hundreds of square ...miles may be contaminated. A portion of this area will be evacuated; however, people living in the portion that is not evacuated yet is still contaminated with low-levels of radioactive contamination will be asking for ways they can reduce their exposure. Whether cleaning activities can significantly reduce exposure is not fully understood. In this effort, the ability of cleaning activities to remove cesium (137Cs) was studied. The removal efficacy of cleaning with a commercial product, Simple Green®, was compared to cleaning with water for hard surfaces typically seen in residences. The removal efficacy of laundering fabric material surfaces was also determined for a range of conditions (e.g., fabric material type, wash temperature). During these studies, assessments of the implications of these activities (e.g., cross-contamination, resulting waste streams) were also completed. Simple Green and water were effective for removing 137Cs from plastic laminate and vinyl flooring (93.4-96.8%) but were not effective for removing 137Cs from painted wallboard and wood (7.3-68.1%). It was also determined that there was no significant difference between the two cleaners on all of the surfaces, except plastic laminate, for which Simple Green was slightly more effective. Laundering was effective for removing 137Cs contamination from polyester and cotton swatches and cotton comforters (up to 96.8% in the single swatch testing).
To our knowledge, no comprehensive, interdisciplinary initiatives have been taken to examine the role of genetic variants on patient-reported quality-of-life outcomes. The overall objective of this ...paper is to describe the establishment of an international and interdisciplinary consortium, the GENEQOL Consortium, which intends to investigate the genetic disposition of patient-reported quality-of-life outcomes. We have identified five primary patient-reported quality-of-life outcomes as initial targets: negative psychological affect, positive psychological affect, self-rated physical health, pain, and fatigue. The first tangible objective of the GENEQOL Consortium is to develop a list of potential biological pathways, genes and genetic variants involved in these quality-of-life outcomes, by reviewing current genetic knowledge. The second objective is to design a research agenda to investigate and validate those genes and genetic variants of patient-reported quality-of-life outcomes, by creating large datasets. During its first meeting, the Consortium has discussed draft summary documents addressing these questions for each patient-reported quality-of-life outcome. A summary of the primary pathways and robust findings of the genetic variants involved is presented here. The research agenda outlines possible research objectives and approaches to examine these and new quality-of-life domains. Intriguing questions arising from this endeavor are discussed. Insight into the genetic versus environmental components of patient-reported quality-of-life outcomes will ultimately allow us to explore new pathways for improving patient care. If we can identify patients who are susceptible to poor quality of life, we will be able to better target specific clinical interventions to enhance their quality of life and treatment outcomes.
Global timber investments and trends, 2005-2011 Cubbage, Frederick; Mac Donagh, Patricio; Balmelli, Gustavo ...
New Zealand journal of forestry science,
2014, Letnik:
44, Številka:
Suppl 1
Journal Article
Recenzirano
Odprti dostop
Background
Prior research in 2005 and 2008 estimated planted forest investment returns for a set of countries and included some natural forest species in a few countries. This research has extended ...those analyses to a larger set of countries and focused on plantation species, for seven years. This research serves as a "benchmarking" exercise that helps identify comparative advantages among countries for timber investment returns, as well as other institutional, forestry, and policy factors that affect investments. Furthermore, it extends the analyses to examine the effects of land prices, environmental regulations, and increased productivity on timber investment returns, as well as comparing timber returns with traditional stock market returns.
Methods
We estimated financial returns in 2005, 2008, and 2011 for a range of global timber plantation species and countries, using net present value (NPV), internal rate of return (IRR), and Land Expectation Value (LEV)--or the Faustmann Formula--as criteria. Per the Faustmann approach, we excluded land costs initially, using a common real discount rate of 8% for all species in all countries to make equivalent comparisons.
Results
Returns for exotic plantations in almost all of South America--Brazil, Argentina, Uruguay, Chile, Colombia, Venezuela, and Paraguay--were substantial, as well as in China. In 2011, returns for
Eucalyptus
species were generally greater than those for
Pinus
species in each country, with most having IRRs of 14% per year or more. The IRRs for
Pinus
species in South America were slightly less, ranging from 8% to 12%, except for Brazil, where they were 19% to 23%. Internal rates of return ranged from 5% to 12% for plantations of coniferous or deciduous species in China, South Africa, New Zealand, Australia, Mexico, and the United States. Although lower than returns from South America, these would still be attractive to forest investors. Land costs and environmental regulations reduced plantation investment returns for all the countries studied, but the largest reductions were observed in South America. However, net returns these remained greater than for plantations in temperate forests.
Conclusions
Trend analyses indicated that Brazil had the greatest increase in timber investment returns during the period examined; returns in other southern hemisphere countries remained fairly stable; and the US South had substantial decreases in returns. New Zealand, Australia, the United States, Chile, and Mexico had the best rankings regarding risk from political, commercial, or government actions and for the ease of doing business. Conversely, Venezuela, Colombia, and Argentina had high risk ratings, and Brazil and Venezuela were ranked as more difficult countries for ease of business. Recent government actions in several countries in South America, except Colombia, have discouraged foreign investments in agricultural land, which has adversely affected forestry as well. Timber-land investments fared well in comparison to USA equity or debt annual returns from 2000 to 2011. Past timber-land investors appear to making excellent returns now based on cheap land costs decades ago; new investments in most countries and plantation species will have smaller rates of return, but still compare favourably with traditional asset classes.
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