Search

Background: Sex and age are known to influence the clinical expression of asthma and allergic diseases. Objective: We sought to evaluate whether immune response profiles also vary by sex and age. Methods: We performed a prospective birth cohort study (Childhood Origins of Asthma) designed to evaluate interactions among age, sex, immune responses, and virus infections on the development of asthma and allergic diseases. Two hundred eighty-nine subjects were enrolled at birth, and 275 maintained prospective follow-up for 3 years. Cytokine response profiles at birth, 1, and 3 years of age; rates of wheezing, atopic dermatitis, and viral illnesses; and biomarkers of atopy, including total and specific IgE levels and peripheral eosinophil counts, were evaluated. Results: PHA-induced IFN-γ responses were higher in boys at 1 year of age (median, 35 vs 19 pg/mL; P < .001) and at 3 years of age (median, 282 vs 181 pg/mL; P = .07). Among children who wheezed during the third year of life, boys had increased IFN-γ, IL-5, and IL-13 responses at age 3 years (P < .001, P = .008, and P = .01, respectively). Boys also demonstrated increased rates of sensitization (P = .05 at year 1), total IgE levels (P = .03 at year 1 and P = .006 at year 3), and peripheral eosinophil counts (2.62 vs 1.85; P = .05 at year 3). Conclusion: Sex-specific differences in immune responses develop during early childhood; some of these differences developmentally proceed, whereas others occur in parallel to the clinical expression of various atopic phenotypes. Clinical implications: The differential expression of atopic diseases between boys and girls in early childhood is accompanied by sex-specific differences in immune response profiles. [Copyright &y& Elsevier]

Background: Viral infections are the major cause of acute wheezing illnesses in childhood. Variations in immunologic responses at birth may be determinants of the risk of acquiring these illnesses. Objectives: To determine the immunologic risk factors for virus-induced wheezing in high-risk infants. Methods: The study involves 285 children with a parental history of asthma and/or respiratory allergies. Mononuclear cells obtained at birth (umbilical cord blood) and at 1 year of age were incubated with phytohemagglutinin, respiratory syncytial virus, or rhinovirus, and supernatants were analyzed for IL-5, IL-10, IL-13, and IFN-γ. Nasal secretions obtained at well child visits and during respiratory illnesses were analyzed for common respiratory viruses. Results: Respiratory syncytial virus–induced wheezing was associated with reduced phytohemagglutinin-induced IL-13 responses (medians, 213 vs 304 pg/mL; P = .026) from cord blood cells, and similar trends were found for wheezing in general. Furthermore, median IL-13 responses diminished by 28% in nonwheezing children by age 1 year, versus only 3% in wheezing children (P = .013). Children with ≥2 episodes of wheezing had lower phytohemagglutinin-induced IFN-γ responses and were less likely to have rhinovirus-induced IFN-γ responses at birth (P < .05). Finally, children with measurable cord blood IFN responses to respiratory syncytial virus were less likely to wheeze in their first year (odds ratio, 0.43 [0.23, 0.79]). Conclusion: In children with a family history of allergies and/or asthma, mononuclear cell phytohemagglutinin-induced IL-13 and virus-induced IFN-γ responses at birth are indicative of the risk for wheezing in the first year of life. [Copyright &y& Elsevier]

Background: The contribution of viral respiratory infections during infancy to the development of subsequent wheezing and/or allergic diseases in early childhood is not established. Objective: To evaluate these relationships prospectively from birth to 3 years of age in 285 children genetically at high risk for developing allergic respiratory diseases. Methods: By using nasal lavage, the relationship of timing, severity, and etiology of viral respiratory infections during infancy to wheezing in the 3rd year of life was evaluated. In addition, genetic and environmental factors that could modify risk of infections and wheezing prevalence were analyzed. Results: Risk factors for 3rd year wheezing were passive smoke exposure (odds ratio [OR]=2.1), older siblings (OR=2.5), allergic sensitization to foods at age 1 year (OR=2.0), any moderate to severe respiratory illness without wheezing during infancy (OR=3.6), and at least 1 wheezing illness with respiratory syncytial virus (RSV; OR=3.0), rhinovirus (OR=10) and/or non–rhinovirus/RSV pathogens (OR=3.9) during infancy. When viral etiology was considered, 1st-year wheezing illnesses caused by rhinovirus infection were the strongest predictor of subsequent 3rd year wheezing (OR=6.6; P < .0001). Moreover, 63% of infants who wheezed during rhinovirus seasons continued to wheeze in the 3rd year of life, compared with only 20% of all other infants (OR=6.6; P < .0001). Conclusion: In this population of children at increased risk of developing allergies and asthma, the most significant risk factor for the development of preschool childhood wheezing is the occurrence of symptomatic rhinovirus illnesses during infancy that are clinically and prognostically informative based on their seasonal nature. [Copyright &y& Elsevier]

This study investigated the polycyclic aromatic hydrocarbons (PAHs) occurrence, and their impact on the microbial community and PAH-degrading genera and genes in the Knysna Estuary of South Africa. The results reveal that the estuary exhibits low PAH levels (114.1–356.0 ng g−1). Ignavibacteriae and Deferribacteres, as well as Proteobacteria and Bacteroidetes, are keystone phyla. Among measured environmental factors, total organic carbon (TOC), nutrients such as nitrite and nitrate, metals as Al, Cr, Cu, Ni, Pb and Zn, and environmental properties (pH and salinity) are primary contributors to structuring the bacterial community assemblage. The abundance of alpha subunit genes of the PAH-ring hydroxylating dioxygenases (PAH-RHDα) of Gram-negative bacteria lies in the range of (2.0–4.2) × 105 copies g−1, while that of Gram-positive bacteria ranges from 3.0 × 105 to 1.3 × 107 copies g−1. The PAH-degrading bacteria account for up to 0.1% of the bacterial community and respond mainly to nitrate, TOC and salinity, while PAHs at low concentration are not significant influencing factors. PAH degraders such as Xanthomonadales, Pseudomonas , and Mycobacterium , which play a central role in PAH-metabolization coupled with other biogeochemical processes (e.g. iron cycling), may contribute to maintaining a healthy estuarine ecosystem. These results are important for developing appropriate utilization and protection strategies for pristine estuaries worldwide. Image 1 • The potential of PAH degradation of a temperate estuary was evaluated. • Characteristics of microbial communities of a fairly-polluted estuary were shown. • NO x − are the sharpest shaping factors for the bacterial community structure. • Dominant PAH degraders include Vibrio, Marinobacterium and Pseudoalteromonas. • PAH degraders mainly respond to nitrate, total organic carbon and salinity. Nitrate is the most important driver of PAH-degrading genera in a slightly/fairly polluted estuary with specific microbial community and low PAH-biodegrading potential. [ABSTRACT FROM AUTHOR]

The proportion of insufficient sweat tests after positive newborn screening for cystic fibrosis was determined. Infants ≤3 months old had a mean (±standard deviation) rate of 7.2% (±7.6) (range, 0% to 40%). Collection methods did not affect the rates. The high and variable rates indicate a need for quality improvement. [ABSTRACT FROM AUTHOR]

Background and Aims Chromoendoscopy (CE) has been shown to generate both a superior diagnostic yield and dysplasia detection rate than conventional white-light endoscopy and requires a high-quality bowel preparation. The aim of this study was to identify predictors of the ability to perform CE in patients with inflammatory bowel disease (IBD). Methods We performed an observational study of patients with IBD undergoing colorectal cancer surveillance examinations with CE. Same-day colonoscopy surveys were used to collect patient and procedural variables. Multivariate logistic regression was used to establish odds ratios of successful completion of CE. Results Eighty-eight patients with IBD were enrolled. We found that patients who did not follow a clear liquid diet before colonoscopy had much lower odds of being able to undergo CE (odds ratio, 0.106; 95% confidence interval, 0.013-0.845; P <.034). Further, we found that previously identified risk factors (older age, history of diabetes mellitus, the timing and split dosing of preparation solution, and procedure time (AM or PM), chronic narcotic use, and history of constipation) for inadequate bowel preparation were not associated with the ability to perform CE. Conclusions Following a clear liquid diet the entire day before the procedure was highly predictive of the ability to perform CE. However, established risk factors for inadequate bowel preparation did not inhibit the ability to perform CE in our population. Endoscopists performing CE should consider recommending that patients follow a clear liquid diet the entire day before their examination. [ABSTRACT FROM AUTHOR]

This study investigated the effects of low-temperature curing environment, moisture content of concrete, and surface roughness of concrete on the interfacial bond performance of concrete – epoxy mortar composite specimens. The mechanical and microstructural properties of concrete – epoxy mortar composite specimens were studied systematically via splitting tensile strength test, direct shear strength test, and scanning electron microscopy test, and the failure modes were observed. Further, the factors that remarkably affect the mechanical properties of the concrete–epoxy mortar composite specimen were investigated by analysing the images obtained using grey correlation analysis. The results indicated that the compressive strength of epoxy mortar, interfacial splitting tensile strength, and shear strength of composite specimens decreased gradually with the decrease in curing temperature. The splitting tensile strength and shear strength at the interface of the composite specimens first increased and then decreased with increasing surface roughness of the concrete. However, these parameters gradually decreased with the increase in moisture content. Moreover, based on the results of grey correlation analysis the three factors, the curing temperature had the most influence on these two strengths, followed by surface roughness and then moisture content. In this case, the surface roughness and moisture content have a comparable degree of influence. The relationship between shear strength and splitting tensile strength was investigated and a good linear relationship was found between these two parameters. The microstructure performance analysis show that as the curing temperature decreased, pores appeared around the foundation concrete. Consequently, the aggregate structure became loose, and the overall denseness was remarkably reduced. As the moisture content of the concrete increased, the pores and cracks at the interface increased, and the width of the interface transition zone became larger. • The mechanical and microstructural properties of concrete–epoxy mortar composite specimens were studied systematically. • The interfacial splitting tensile strength, and shear strength decreased gradually with the decrease in curing temperature. • The splitting tensile strength and shear strength first increased and then decreased with increasing surface roughness. • The results of the SEM showed that as the curing temperature decreased the overall denseness was significantly reduced as the curing temperature decreased. [ABSTRACT FROM AUTHOR]

Objective: To generate and examine evidence in support of diagnosing cystic fibrosis (CF) early through newborn screening (NBS). Study design: Using a randomized controlled trial with unique unblinding/surveillance, we evaluated patients with CF receiving similar treatment after assignment to an early diagnosis (screened) group or to a control group. Outcomes studied at diagnosis and longitudinally included measures of nutritional status and lung disease. Results: Assessment of patients with CF without meconium ileus who had pancreatic insufficiency revealed marked differences in age and condition at diagnosis—screened patients had significantly better length/height, weight, and head circumference. Follow-up evaluation for 16 years showed that height and weight differences persisted long term. Although screened patients had better chest x-ray scores at diagnosis, our trial suggests that the effects of confounders such as Pseudomonas aeruginosa infections led to deterioration of their scores after 10 years, but there were no significant differences between the 2 CF/pancreatic insufficiency subgroups. Conclusions: Early diagnosis of CF and aggressive nutritional management can prevent malnutrition and growth failure. Although CF NBS provides a potential opportunity for better pulmonary outcomes, it appears that other factors can predominate over time in pulmonary prognosis. Overall, the Wisconsin trial is positive and provides enough evidence for routine CF NBS. [Copyright &y& Elsevier]

Abstract: This paper presents results of in situ measurements of fracture evolution within the excavation damaged zone (EDZ) surrounding the tunnel boring machine (TBM) excavated headrace tunnel No. 3 of Jinping II hydropower station, China. Fractures were measured by borehole images obtained with a digital panoramic borehole camera throughout the processes of tunnel excavation and support installation. Boreholes for the digital camera were pre-drilled perpendicular to the tunnel axis from a pre-excavated branch tunnel, and a series of digital images of the borehole walls were made as the TBM passed. Digital processing revealed the lithology, pre-existing fractures and characters of rock core discing of the surrounding rock mass. Processes of fracture initiation, propagation, and closure were observed, and width, occurrence and zoning of EDZ were measured. The relationship between fracture evolution and TBM construction progress is described in detail. Based on true triaxial tests and theoretical analysis of unloading conditions of deep rock masses, the occurrence of tunnelling induced new fractures at the EDZ is discussed with respect to in situ measurement results. The results provide valuable data for EDZ analysis, future designs and the construction of deeply buried tunnels using TBM. [Copyright &y& Elsevier]

Abstract: Background: With the rapid implementation of cystic fibrosis (CF) newborn screening (NBS), quality improvement (QI) has become essential to identify and prevent errors. Using Process Failure Modes and Effects Analysis (PFMEA), we adapted this method to determine if it could be applied to discover and rank high priority QI opportunities. Methods: Site visits to three programmes were conducted, and PFMEA exercises were accomplished in Colorado, Massachusetts and Wisconsin with 23 experienced professionals. During each of these comprehensive sessions, participants identified and ranked potential failures based on severity, occurrence and detection to calculate risk priority number (RPN) values. Results: A total of 96 failure modes were generated and ranked in a list of the 20 riskiest problems that show no significant discordances by site, although there were differences by profession of the rater, particularly nurses. Conclusions: Our results illustrate that the PFMEA method applies well to CF NBS and that steps requiring communication and information transfer are perceived to be the highest risks. The number of identified failures makes and their potential impact demonstrate considerable overall risk and a need for ongoing QI. [Copyright &y& Elsevier]

Abstract: Background: A comparison of the longitudinal progression of lung disease in cystic fibrosis patients identified through newborn screening (NBS) in cohorts located in two different countries has never been performed and was the primary objective of this study. Methods: The study included 56 patients in Brittany diagnosed through NBS between 1989 and 1994 and 69 similar patients in Wisconsin between 1985 and 1994. The onset and progression of lung disease was radiographically quantified using the Wisconsin Chest X-ray (WCXR) scoring system. A single pediatric pulmonologist blinded to all identifiers scored the films. Results: Generalized estimating equation analyses adjusted for age, genotype, sex, pancreatic insufficiency, and meconium ileus showed worse WCXR scores in Brittany patients compared to Wisconsin patients (average score difference=4.48; p <0.001). Percent predicted FEV1 was also worse among Brittany patients (p <0.001). Conclusions: The finding of milder radiographically-quantified lung disease using the WCXR scoring system, as well as better FEV1 values, may be explained by variations in nutrition, environmental exposures, or healthcare delivery. [Copyright &y& Elsevier]

Abstract Many rivers are facing human-induced system regime shifts that have great environmental, ecological and social implications, necessitating an increasing need to quantify the human influence on sediment properties and their impacts on the source-to-sink system of marginal seas. The Huanghe and Changjiang Rivers have experienced a dramatic reduction in sediment flux in recent decades, typifying the human influence on sediment properties of global large rivers. Sediment samples from the two rivers were analyzed to obtain grain size, magnetic and geochemical data. The results show a large difference in sediment properties between pre- and post-dam periods. We applied a discrepancy factor to re-examine the magnetic and geochemical tracers that were previously used in the two rivers. The discrepancy factors of most magnetic and geochemical tracers in the mud-sized sediments of the two rivers increased by an average of about 109% after dam construction. This suggests that human-induced changes in sediment properties have greatly improved the discriminatory ability between the sediments from the two rivers. The results also raise the uncertainty of using previous tracers to distinguish between sediments from the two rivers after damming. Furthermore, significant changes in sediment properties that happened in a relatively short time may provide future geological time markers for sedimentary records with a temporal resolution of 100–101 years. For marine environments, an approach for identifying sediment sources based on multiple independent optimum tracers is also proposed, with composite magnetic (SIRM vs. HIRM) and geochemical (Na 2 O vs. Zn) tracers being considered. The results of this work can advance our knowledge of how human activities alter river systems, and identify a sustainable development model under system regime shifts for areas of high-intensity human activity. Graphical abstract Unlabelled Image Highlights • Large differences in sediment properties exist between pre- and post-dam periods. • An approach of using multiple independent optimum tracers is proposed. • Human activities increased the differences between the sediments from the two rivers. • Amplified endmember differences may provide a future geological time marker. [ABSTRACT FROM AUTHOR]

Background Effective symptom assessment and management for children with advanced cancer undergoing hematopoietic stem cell transplantation (HSCT) is critical to minimize suffering. Most literature specific to children receiving HSCT is based upon medical record reviews and parent report, and to a lesser extent, patient self-report. Objectives The purpose of this study was to describe symptom frequency, severity and level of distress in children and adolescents undergoing HSCT using patient self-report via electronic data collection. Methods A modified Memorial Symptom Assessment Scale (MSAS) was electronically administered to children with advanced cancer every two weeks. Clinical data was collected at corresponding time points. A sub-analysis was conducted for the cohort of children with advanced cancer who received autologous or allogeneic HSCT. Results Forty-seven children with advanced cancer were enrolled and completed 563 surveys during the course of the study. Eleven of these 47 children received HSCT and completed 201/563 surveys. The median age of children in the HSCT cohort was 12.7 years, 73% were female, and most children had a hematologic (45%) or solid tumor (45%) malignancy. Ninety-six percent of surveys administered to children receiving HSCT were completed, and 64% of surveys were completed at home. Pain (35%), nausea (30%), sleeping difficulty (29%) and fatigue (22%) were the most commonly reported symptoms in children receiving HSCT. Children in the HSCT cohort had higher total and physical subscale mean MSAS scores, and higher pain, nausea, fatigue, and lack of appetite mean scores compared to children with advanced cancer not receiving HSCT (p <.05). Children receiving HSCT experienced more distress from pain, fatigue, nausea, lack of appetite, diarrhea and constipation when these symptoms were present compared to children with advanced cancer not receiving HSCT (p <.05). Conclusion Children with advanced cancer receiving HSCT may have increased symptom burden with higher levels of distress as compared to those who do not receive HSCT. Increased understanding of the symptom experience for children with advanced cancer undergoing HSCT may promote timely assessment and treatment of distressing symptoms. [ABSTRACT FROM AUTHOR]