Search

While previous studies have established an association between poor housing conditions and adverse health effects, none has specifically addressed health and safety risks to the college student population in rental housing. A needs-assessment survey was conducted to determine the prevalence of adverse health and safety conditions in off-campus student housing associated with a large university in the western United States. Results from 1,959 student-tenant surveys revealed problems with installed appliances (39.6%); visible mold (39.3%); heating/cooling systems (31.9%); indoor dampness/water damage (24.9%); security locks (23.4%); ants (17.1%); electrical wiring (11.3%); malfunctioning or missing smoke alarms (11.2%); broken steps/handrails (7.8%); and mice (4.8%), among other problems. Reported health effects associated with housing included headaches, coughing, sneezing, nausea, and dizziness, and these effects were found to significantly correlate with increased environmental problems. The results of this study indicate a need to inform college students about environmental health and safety problems in leased housing, to promote responsibility of landlords to provide safe and healthful environments, and to raise awareness of this issue for public health and housing officials in university communities across the country. [ABSTRACT FROM AUTHOR]

The authors estimate that more than 10,000 workers process more than 3.5 million tons of medical waste in the United States each year, both on site at health care establishments and off site at commercial treatment facilities. As part of a study recently conducted to assess engineering controls and to define bioaerosol, chemical, and safety hazards to workers, this report discusses potential exposure to bloodborne pathogens from blood splashes. Potential exposure to blood splashes was assessed during the manual dumping of medical waste at three commercial facilities where waste is handled extensively. At each facility, tubs of biohazardous waste 32 gallons or smaller were manually dumped into larger containers for subsequent treatment. All workers involved in dumping containers of loose and bagged waste wore cotton pads in special holders pinned to the front and back of the upper torso. At the end of each shift the pads were visually assessed. A sensitive and rapid detection method, performed on site, was used to test for hemoglobin. At two of the facilities, wipes were also taken of face shields or goggles, as well as of various surfaces with which workers typically would come into contact. Samples were extracted in sterile buffer and were tested for hemoglobin. This method yielded semiquantitative results. Splashes were evaluated over two days at each facility. Blood splashes were confirmed on 11 of 128 upper-torso samples (eight percent), four of 18 eye or face protectors (22 percent), and 61 of 96 process area surfaces (64 percent). The authors stress the importance of adherence to all requirements of the OSHA Bloodborne Pathogens Standard, engineering controls to minimize manual waste dumping, and enforcement of the use of proper protective clothing and face shields. [ABSTRACT FROM AUTHOR]

The objective of this study was to evaluate the effects of supplementing monensin (19.8 g/Mg DM TMR; MON) and Saccharomyces cerevisiae CNCM I-1077 live-cell yeasts (Saccharomyces cerevisiae CNCM I-1077; 1 × 10 10 cfu/head per day; LCY) on lactation performance, feeding behavior, and total-tract nutrient digestibility of high-producing dairy cows. Sixty-four multiparous Holstein cows (3.2 ± 1.5 lactations; 97 ± 16 DIM, and 724 ± 68 kg of BW at covariate period initiation) and 32 gate feeders were enrolled in a study with a completely randomized design and a 2 × 2 factorial arrangement. Cows and gate feeders were randomly assigned to treatments (16 cows and 8 gate feeders per treatment). Cows were allowed 2 wk to acclimate to feeding gates followed by a 2-wk covariate period. During the acclimation and covariate periods, all cows were fed a diet containing MON and LCY. Following the covariate period, cows were enrolled in a 10-wk treatment period during which cows were randomly assigned to 1 of 4 treatments: (1) a combination of MON and LCY (MON-LCY), (2) MON-CON, (3) CON-LCY, or (4) neither MON nor LCY (CON-CON). Data were analyzed using a mixed model with week as a repeated measure and fixed effects of MON, LCY, week, and all their interactions. Cow (treatment) was included as a random effect. The average covariate period value of each variable was used as a covariate. Three-way interactions were observed for DMI and feed efficiency. Dry matter intake decreased from wk 4 to 5 and wk 8 to 10 in MON-LCY cows compared with CON-CON. No treatment differences were observed for actual or component-corrected milk yield or milk components, except for a tendency for LCY to decrease milk fat yield. Feed efficiency was greater for MON-LCY relative to CON-CON in 4 of 10 wk. Interactions between MON and LCY were observed for dry matter and organic matter digestibility, where both were lower for CON-CON than other treatments. Under the conditions of the present study, feeding dairy cows in a high feed bunk density a combination of MON and LCY can decrease intake and improve feed efficiency without affecting milk production or components. Additionally, monensin and live-cell yeasts may each improve total-tract digestibility based on improvements in DM and OM digestibility., (The Authors. Published by Elsevier Inc. on behalf of the American Dairy Science Association®. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).)

Psychedelic compounds have been utilized by humans for centuries for medicinal, religious, and tribal purposes. Clinical trial data starting from the early 2000s and continuing today indicates that psychedelics are a clinically efficacious treatment for a variety of neurological and psychiatric disorders. However, all clinical trials examining these substances have excluded any individual with a past or current history of seizures, leaving a large cohort of epilepsy and non-epilepsy chronic seizure disorder patients without anywhere to turn for psychedelic-assisted therapy. These exclusions were made despite any significant evidence that clinically supervised psychedelic use causes or exacerbates seizures in this population. To date, no clinical trial or preclinical seizure model has demonstrated that psychedelics induce seizures. This review highlights several cases of individuals experiencing seizures or seizure remission following psychedelic use, with the overall trend being that psychedelics are safe for use in a controlled, supervised clinical setting. We also suggest future research directions for this field., Competing Interests: Author FC was employed by Jamaican Medical Cannabis Corporation. Author ECL is employed by Numinus. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Freidel, Kreuder, Rabinovitch, Chen, Huang and Lewis.)

Psychedelic-assisted therapy (PAT) may treat various mental health conditions. Despite its promising therapeutic signal across mental health outcomes, less attention is paid on its potential to provide therapeutic benefits across complex medical situations within rehabilitation medicine. Persons with spinal cord injury (SCI) have a high prevalence of treatment-resistant mental health comorbidities that compound the extent of their physical disability. Reports from online discussion forums suggest that those living with SCI are using psychedelics, though the motivation for their use is unknown. These anecdotal reports describe a consistent phenomenon of neuromuscular and autonomic hypersensitivity to classical serotonergic psychedelics, such as psilocybin and lysergic acid diethylamide (LSD). Persons describe intense muscle spasms, sweating, and tremors, with an eventual return to baseline and no reports of worsening of their baseline neurological deficits. The discomfort experienced interferes with the subjective beneficial effects self-reported. This phenomenon has not been described previously in the academic literature. We aim to provide a descriptive review and explanatory theoretical framework hypothesizing this phenomenon as a peripherally dominant serotonin syndrome-like clinical picture-that should be considered as such when persons with SCI are exposed to classical psychedelics. Raising awareness of this syndrome may help our mechanistic understanding of serotonergic psychedelics and stimulate development of treatment protocols permitting persons with SCI to safely tolerate their adverse effects. As PAT transitions from research trials into accepted clinical and decriminalized use, efforts must be made from a harm reduction perspective to understand these adverse events, while also serving as an informed consent process aid if such therapeutic approaches are to be considered for use in persons living with SCI., Competing Interests: E.C.L. is the VP of Psychedelic Neurology at Numinus., (© Stephanie Karzon Abrams et al., 2023; Published by Mary Ann Liebert, Inc.)

The objective of this experiment was to evaluate the effect of microbial inoculation and storage length on the fermentation profile and nutrient composition of high-moisture corn (HMC) ensiled at 2 different dry matter (DM) concentrations. High-moisture corn was harvested when kernel DM concentrations were approaching 65% as-fed, and either left undried (HMC65; 67.6% DM) or dried at 40 °C to approximately 70% DM (HMC70; 71.0% DM), and then ensiled in quadruplicate vacuum pouches untreated (CON) or after one of the following inoculant treatments: 6.36 × 105 cfu of Lentilactobacillus buchneri DSM 12856, Lactiplantibacillus plantarum DSM 12836, and Pediococcus acidilactici DSM 16243 per g of HMC (LBLP); or 3.0 × 105 cfu of Lentilactobacillus buchneri DSM 12856, Lentilactobacillus diolivorans DSM 32074, and P. acidilactici DSM 16243 per g of HMC (LBLD). Vacuum pouches were allowed to ferment for 7, 14, 28, or 56 d. A three-way interaction was observed (P = 0.01) for the pH of HMC, where CON for HMC70 was greatest across storage lengths and HMC65 treatments generally had a lower pH than other treatments. Concentrations of total acids were greater (P = 0.001) in HMC65 than HMC70 and greater (P = 0.001) in HMC treated with LBLP and LBLD than CON. An interaction between DM concentration, microbial inoculation, and storage length was observed (P = 0.05) for concentrations of acetic acid. At 14 d, acetic acid concentrations were greater in HMC65 treated with LBLD than other treatments. Likewise, at 56 d, concentrations of acetic acid were greatest in HMC65 treated with LBLD, followed by HMC70 treated with LBLD. An interaction between DM concentration, microbial inoculation, and storage length was observed (P = 0.05) for 7-h starch disappearance (starchD). Across all DM concentration and inoculant treatment combinations, starchD increased with increasing storage length. StarchD was also generally greater for HMC65 treatments compared to HMC70, with small differences among inoculants. Results suggest that microbial inoculation can improve fermentation of HMC by increasing the production of antifungal acetic acid, but that DM concentration at ensiling remains a primary determinant of HMC fermentability., (© The Author(s) 2022. Published by Oxford University Press on behalf of the American Society of Animal Science. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

This study aimed to evaluate the effects of cutting height, heterofermentative microbial inoculants, and storage length on the fermentation profile and nutrient composition of whole-plant corn silage. The experiment was a completely randomized design with a 2 (cutting height) × 3 (microbial inoculation) × 5 (storage length) factorial arrangement of treatments. Corn forage was harvested at two cutting heights: either 25 cm (REG) or 65 cm (HI). Then, forage was inoculated with one of three microbial inoculants: (1) 300,000 CFU/g of fresh forage of Pediococcus acidilactici DSM 16243, Lentilactobacillus buchneri DSM 12856, and L. diolivorans DSM 32074 (LBLD; Bonsilage Speed inoculant, Provita Supplements Inc., Mendota Heights, MN), (2) 500,000 CFU/g of fresh forage of Lactiplantibacillus plantarum DSM 12837 and L. buchneri DSM 16774 (LPLB; Bonsilage Corn + WS inoculant, Provita Supplements Inc., Mendota Heights, MN), or (3) distilled water (CON). Last, forage was randomly assigned to ferment for 5, 7, 14, 28, or 56 d of storage in vacuum-sealed bags. Silage pH was affected by a three-way interaction ( P  = 0.01), where CON treatments decreased continually over time while LPLB and LBLD began to increase at later storage lengths. Acetic acid concentration was greater ( P  = 0.001) in LPLB and LBLD than CON silage after 56 d of storage. Silage treated with LBLD did not have detectable levels of propionic acid ( P  > 0.05), although 1-propanol concentration was greater ( P  = 0.001) in LBLD treatments after 56 d of storage. The concentrations of total acids and acetic acid were greater ( P  = 0.01 and P  = 0.001, respectively) for REG silage compared to HI. Additionally, HI silage had greater ( P  = 0.001 and P  = 0.001, respectively) concentrations of dry matter (DM) and starch, while neutral detergent fiber (aNDF) and lignin concentrations were lower ( P  = 0.001 and P  = 0.001, respectively) in HI silage compared to REG silage. Last, HI silage had a greater ( P  = 0.001) NDF digestibility than REG silage. The results of this study demonstrate that increasing cutting height can improve nutrient composition of whole-plant corn silage. Additionally, results demonstrate that heterofermentative microbial inoculants can be used to shift silage fermentation to the production of lactic and acetic acids., (© The Author(s) 2022. Published by Oxford University Press on behalf of the American Society of Animal Science.)

Background: A small body of evidence suggests medical cannabis may facilitate wound healing, but the exact mechanism of this effect is unclear., Purpose: This case report describes a patient with a pressure injury (PI) who received cannabis oil treatment for pain management and sleep improvement., Methods: A 37-year-old woman with multiminicore disease, scoliosis, short-chain acyl-CoA dehydrogenase deficiency, and epilepsy presented to the Neurology Centre of Toronto with chronic pain and sleep disturbance, including difficulty initiating and maintaining sleep. She also had a 5-year history of a PI between her right iliac crest and right rib cage that had progressively worsened. The patient received a medical cannabis oil protocol that used a combination of cannabidiol and tetrahydrocannabinol., Results: Cannabis oil was effective in treating pain and sleep difficulties. Unexpectedly, during the first 2 weeks of treatment, the PI started to heal and was almost completely closed at the 2-month follow-up., Conclusion: Although it is unknown if the observed healing of this refractory PI was indirectly or directly related to the cannabidiol and tetrahydrocannabinol treatment, the potential relationships among pain, sleep disturbance, cannabis treatment, and healing should be explored.

This study aimed to assess the effects of a heterofermentative microbial inoculant and storage length on fermentation profile, aerobic stability, and nutrient composition in whole-plant sorghum silage (WPSS) from different varieties. Experiment 1, a completely randomized design with a 2 × 3 factorial treatment arrangement, evaluated microbial inoculation [CON (50 mL distilled water) or LBLD ( Lactobacillus plantarum DSM 21762, L. buchneri DSM 12856, and L. diolivorans DSM 32074; 300,000 CFU/g of fresh forage)] and storage length (14, 28, or 56 d) in forage WPSS. The LBLD silage had lower pH compared to CON, and greater concentrations of succinic acid, ethanol, 1,2-propanediol (1,2-PD), 1-propanol, 2,3-butanediol and total acids. After 56 d, lactic acid concentration was greater for CON, while acetic acid and aerobic stability were greater in LBLD silage. Experiment 2, a completely randomized design with a 2 × 3 factorial treatment arrangement, evaluated effects of microbial inoculation (same as experiment 1) and storage length (14, 28, or 56 d) in WPSS of three varieties [forage sorghum (Mojo Seed, OPAL, Hereford, TX), sorghum-sudangrass (Dyna-gro Seed, Fullgraze II, Loveland, CO, United States), or sweet sorghum (MAFES Foundation Seed Stocks, Dale, MS State, MS)]. The LBLD forage sorghum had greater acetic acid and 1,2-PD concentrations at 56 d and 28 d, respectively, but lower concentrations of propionic acid at 56 d and butyric acid at 14 and 28 d. Additionally, WSC concentration was greater for CON than LBLD at 28 d. Furthermore, CON sweet sorghum had greater lactic acid, propionic acid, and butyric acid concentrations. However, greater acetic acid and 1,2-PD were observed for LBLD sweet sorghum. The CON sweet sorghum had greater concentration of WSC and yeast counts. The CON sorghum sudangrass had greater lactic and butyric acid concentrations than LBLD at 14 d, but lower acetic acid and 1,2-PD concentrations at 56 d. Yeast counts were greater for CON than LBLD sorghum sudangrass silage. Overall, results indicate inoculation of WPSS with Lactobacillus plantarum DSM 21762, L. buchneri DSM 12856, and L. diolivorans DSM 32074 improves heterofermentative co-fermentation allowing the accumulation of acetic acid concentration and increasing antifungal capacities and aerobic stability of WPSS., Competing Interests: The authors declare that this study received partial funding from Provita Supplements Inc. (Mendota Heights, MN, United States). The funder was not involved in the study design, collection, analysis, interpretation of data, the writing of this article, or the decision to submit it for publication. The reviewer CA declared a shared affiliation with one of the authors, JG, to the handling editor at the time of the review., (Copyright © 2021 Diepersloot, Pupo, Ghizzi, Gusmão, Heinzen, McCary, Wallau and Ferraretto.)

Background and Purpose: Genetics and drug interactions contribute to large interindividual variation in human CYP2D6 activity. Here, we have characterized propranolol inhibition of human and mouse CYP2D using transgenic (TG) mice, which express both mouse CYP2D and human CYP2D6, and wild-type (WT) mice. Our purpose was to develop a method for in vivo manipulation of CYP2D6 enzyme activity which could be used to investigate the role of CYP2D6 in drug-induced behaviours., Experimental Approach: Dextromethorphan metabolism to dextrorphan was used to measure CYP2D activity and to characterize propranolol inhibition in vitro and in vivo. Effects of propranolol pretreatment (24 hr) on serum levels of the CYP2D6 substrate haloperidol and haloperidol-induced catalepsy were also studied., Key Results: Dextrorphan formation velocity in vitro was threefold higher in liver microsomes of TG compared to WT mice. Propranolol acted as a mechanism-based inhibitor (MBI), inactivating CYP2D in liver microsomes from TG and WT mice, and humans. Pretreatment (24 hr) of TG and WT mice with 20 mg·kg -1 intraperitoneal propranolol reduced dextrorphan formation in vivo and by liver microsomes in vitro. Serum haloperidol levels and catalepsy were increased., Conclusions and Implications: Propranolol was a potent MBI of dextrorphan formation in liver microsomes from TG and WT mice, and humans. The inhibition parameters in TG overlapped with those in WT mice and in humans. Inhibition of CYP2D with propranolol in vivo in TG and WT mice altered drug responses, allowing further investigation of variations in CYP2D6 on drug interactions and drug responses., (© 2019 The British Pharmacological Society.)

Objective: To report the feasibility, safety, and clinical outcomes of an exploratory study of MR-guided Laser Interstitial Thermal Therapy (MRgLITT) as a minimally invasive surgical procedure for the ablation of epileptogenic foci in children with drug-resistant, lesional epilepsy., Methods: Retrospective chart review of all MRgLITT procedures at a single tertiary care center. All procedures were performed using a U.S. Food and Drug Administration (FDA)-cleared surgical laser ablation system (Visualase Thermal Therapy System). Predefined clinical and surgical variables were extracted from archived medical records., Results: Seventeen patients underwent 19 MRgLITT procedures from May 2011 to January 2014. Mean age at seizure onset was 7.1 years (range 0.1-14.8 years). Mean age at surgery was 15.3 years (range 5.9-20.6 years). Surgical substrates were mixed but mainly composed of focal cortical dysplasia (n = 11). Complications occurred in four patients. Average length of hospitalization postsurgery was 1.56 days. Mean follow-up was 16.1 months (n = 16; range 3.5-35.9 months). Engel class I outcome was achieved in seven patients (7/17; 41%), Engel class II in one (1/17; 6%), Engel class III in three (3/17; 18%), and Engel class IV in six (6/17; 35%). Three patients (3/8; 38%) with class I and II outcomes and five patients (5/9; 56%) with class III and IV outcomes had at least one prior resection. Fisher's exact test was not statistically significant for the association between Engel class outcome and previous resection (p = 0.64)., Significance: This study provides descriptive results regarding the use of MRgLITT in a mixed population of pediatric, lesional, drug-resistant epilepsy cases. The ability to classify case-specific outcomes and reduce technical complications is anticipated as experience develops. Further multicenter, prospective studies are required to delineate optimal candidates for MRgLITT, and larger cohorts are needed to more accurately define outcome and complication rates., (Wiley Periodicals, Inc. © 2015 International League Against Epilepsy.)

Objective: Headaches are a common problem in the pediatric population. In 2002, the American Academy of Neurology (AAN) developed guidelines on neuroimaging for patients presenting with headache. Our objective was to determine the frequency of computed tomographic (CT) scanning ordered by a range of medical practitioners for pediatric patients presenting with primary headache., Methods: A retrospective chart review was conducted at the Children's Hospital of Eastern Ontario (CHEO), a tertiary care centre in Ontario. One hundred fifty-one records of patients referred to the outpatient neurology clinic at CHEO with ''headache'' or ''migraine'' as the primary complaint from 2004 to 2009 were randomly selected. Ninety-nine patients with normal neurologic examinations were ultimately included., Results: Thirty-four patients (34%; 95% CI 25-45) had undergone CT scanning. None of the 34 CT scans (0%; 95% CI 0-10) showed significant findings, and none changed the headache diagnosis or management. Eleven (32%) of the CT scans were ordered by CHEO neurologists, 15 (44%) by community physicians, and 8 (24%) by CHEO emergency physicians., Conclusion: A high proportion of children presenting with primary headaches and a normal neurologic examination undergo CT scanning, despite well-established AAN guidelines regarding neuroimaging. Most of these CT scans do not appear to alter diagnosis and management. A variety of non-evidencebased factors may be encouraging physicians to overinvestigate this population and, as a result, increasing the risk of adverse events due to radiation exposure. Implementing initiatives at a site-based level that promote the use of established guidelines before performing CT scanning in this population may be beneficial.

Nitric oxide (NO) exerts vasodilatatory, antiplatelet, antioxidant, and antiproliferative effects. Endothelium-derived NO has been shown to be of crucial importance in cardiovascular protection, whereas evidence that NO is synthesized by platelets and regulates platelet function is still controversial. By using a sensitive and specific fluorescent probe, 4-amino-5-methylamino-2',7'-difluorofluorescein diacetate (DAF-FM), we visualized NO production in individual platelets undergoing adhesion on a collagen substrate under flow conditions. NO production, monitored in real time, was dependent on the shear rates applied, increasing with the raising of the shear rates. Furthermore, NO production increased in the presence of l-arginine (nitric-oxide synthase [NOS] substrate), and it decreased in the presence of L-NG-monomethyl arginine (L-NMMA) (NOS inhibitor) but not of D-NG-monomethyl arginine (D-NMMA) (L-NMMA-inactive enantiomer). Platelet deposition, measured with mepacrine-labeled platelets, was inversely related to NO production. A correlation was evident between Ca(++) elevation and NO production, suggesting that platelet NO formation is triggered by intracytoplasmic Ca(++) elevation. Simultaneous measurement of NO and Ca(++) indicated that NO production in individual platelets is preceded by Ca(++) elevations, with a lag phase of 33 ± 9.5 s. Our studies provide the first direct demonstration of platelet NO production triggered by the interaction with an activating surface under flow and suggest that intraplatelet Ca(++) elevation elicits the production of NO which, in turn, modulates thrombus size., (© 2015 by The American Society of Hematology.)

The study described in this article investigated whether in-place carpet drying processes resulted in bacterial amplification following water intrusion from a clean water source (category 1) in a residential indoor environment. Bacterial amplification was examined after wetting a 10-year-old carpet and pad that had no history of water intrusion. Three test areas were extracted and dried using industry-recommended procedures for in-place drying and compared to a control area that was not extracted or dried. Results from carpet, pad, and subsurface dust demonstrated that bacterial amplification occurred in all test areas. CFUs of bacteria per gram of carpet surface dust and subsurface dust prior to water intrusion were lower than levels in subsurface dust after in-place drying. The authors' study contributes to information regarding the restoration of water-based carpet damage by professional water damage restoration companies, building maintenance personnel, and housekeeping managers. Results suggest that the appropriate response time for carpet pad salvage is considerably shorter than the current industry recommendation of 72 hours.

Background: Positive control materials for clinical diagnostic molecular genetic testing are in critically short supply. High-quality DNA that closely resembles DNA isolated from patient specimens can be obtained from Epstein-Barr virus (EBV)-transformed peripheral blood lymphocyte cell lines. Here we report the development of a process to (a) recover residual blood samples with clinically important mutations detected during routine medical care, (b) select samples likely to provide viable lymphocytes for EBV transformation, (c) establish stable cell lines and confirm the reported mutation(s), and (d) validate the cell lines for use as positive controls in clinical molecular genetic testing applications., Methods: A network of 32 genetic testing laboratories was established to obtain anonymous, residual clinical samples for transformation and to validate resulting cell lines for use as positive controls. Three panel meetings with experts in molecular genetic testing were held to evaluate results and formulate a process that could function in the context of current common practices in molecular diagnostic testing., Results: Thirteen laboratories submitted a total of 113 residual clinical blood samples with mutations for 14 genetic disorders. Forty-one EBV-transformed cell lines were established. Thirty-five individual point and deletion mutations were shown to be stable after 20 population doublings in culture. Thirty-three cell lines were characterized for specific mutations and validated for use as positive controls in clinical diagnostic applications., Conclusions: A process for producing and validating positive control cell lines from residual clinical blood samples has been developed. Sustainable implementation of the process could help alleviate the current shortage of positive control materials.

Positive control materials for clinical molecular genetic testing applications are currently in critically short supply or non-existent for many genetically based diseases of public health importance. Here we demonstrate that anonymous, residual, clinical blood samples are potential sources of viable lymphocytes for establishing Epstein-Barr virus (EBV)-transformed blood lymphocyte cell lines. We attempted to transform 34 residual blood samples, and analyzed transformation success with respect to sample age, anticoagulant, storage temperature, volume, hemolysis, and patient age and sex. In univariate analysis, sample age was significantly associated with transformation success (P = 0.002). The success rate was 67% (6 of 9) for samples 1 to 7 days old, 38% (3 of 8) for samples 8 to 14 days old and 0% for samples 15 to 21 (0 of 11) days old. When we controlled for sample age in multivariate logistic regression, anticoagulant and storage temperature approached significance (P = 0.070 and 0.087, respectively; samples in acid citrate dextrose (ACD) and refrigerated samples were more likely to transform). Based on these findings, we suggest that samples collected in either ACD or ethylene diamine tetraacetic acid, and up to 14 days old (refrigerated) or 7 days old (stored ambient), are reasonable candidates for EBV transformation. The transformation rate for samples that met these criteria was 63% (10 of 16). Implementation of this process could help alleviate the shortage of positive control materials for clinical molecular genetic testing.

Objective: The role of genetic testing has expanded with rapidly developing technology and completion of the International Human Genome Project. Development of universally acceptable quality control methods and quality assurance standards trails technology. The principle that high-quality genetic testing is important for public health motivated the Centers for Disease Control and Prevention to formulate ways for improving quality assurance of human molecular genetics testing., Participants: Twenty-eight panelists were chosen based on expertise in molecular genetics testing and knowledge of quality assurance practices. Representatives of professional organizations, industries, and federal agencies participated in one or more of 3 panel meetings. Consensus recommendations were developed by the 15 panelists in the third meeting., Evidence: Evidence was derived from experts' opinion during 3 panel meetings. Data compiled through laboratory visits and literature review were used as reference information. Need for this project was derived from the Final Report of the Task Force on Genetic Testing, produced by the National Institutes of Health and the Department of Energy in 1997, and the Summary Report of the Subcommittee Meeting on Genetics of the Clinical Laboratory Improvement Act Advisory Committee in 1997., Consensus Process: Research and development needs were identified using a participatory visioning approach. A modified nominal group process was used to reach consensus., Conclusions: Five core consensus recommendations were made: research for developing positive samples for quality assurance purposes, performance evaluation programs supplementing those in existence, establishment and support of laboratory-oriented consortia, establishment of a laboratory-focused database, and support of molecular genetics training programs.

Airborne actinomycete spores, important contaminants in occupational and residential environments, were studied with respect to their (i) release into the air, (ii) aerodynamic and physical size while airborne, and (iii) survival after collection onto agar with an impactor. Three actinomycete species were selected for the tests to exemplify the three main spore types: Streptomyces albus for arthrospores, Micromonospora halophytica for aleuriospores, and Thermoactinomyces vulgaris for endospores. The results show that the incubation conditions (temperature, time, and nutrients) needed for the development of spores for their release into air are different from the conditions that are needed for colony growth only. Additional drying of M. halophytica and T. vulgaris cultures was needed before spores could be released from the culture. The aerodynamic sizes of the spores, measured with an aerodynamic particle sizer, ranged from 0.57 (T. vulgaris) to 1.28 micron (M. halophytica). The physical sizes of the spores, when measured with a microscope and an image analysis system, were found to be smaller than previously reported in the literature. The relative recovery of the spores on agar media ranged from 0.5 (T. vulgaris) to 35% (S. albus). The results indicate that the culturability of the collected airborne actinomycete spores varies widely and is affected by several variables, such as the species and the sampling flow rate. Therefore, alternatives to commonly used cultivation methods need to be developed for the enumeration of actinomycete spores.

Objectives: To determine the stability of sodium hypochlorite (diluted household bleach) when stored for 30 days in various types of containers and to determine the efficacy of low concentrations of free available chlorine to inactivate test bacteria., Design: Laboratory-based study. Solutions of standard household bleach were prepared using tap water or sterile distilled water at dilutions of 1:100, 1:50, and 1:5. Chlorine concentrations were measured, and then the solutions were placed into five polyethylene containers and left at room temperature (20 degrees C) under various conditions (translucent containers with light exposure and with or without air; brown opaque container without light or air exposure). Samples for chlorine and pH determinations were taken at time 0 and on days 7, 14, 21, 30, and 40. Bactericidal activity of chlorine solutions was assessed using the Association of Official Analytical Chemists Use-Dilution Method. Test bacteria included Pseudomonas aeruginosa, Staphylococcus aureus, and Salmonella choleraesuis., Results: Chlorine concentrations at 30 days varied from the 40% to 50% range for 1:50 or 1:100 dilutions stored in containers other than closed brown containers to 83% to 85% for the 1:5 dilution stored in closed but non-opaque containers to 97% to 100% for 1:50 or 1:5 solutions stored in closed brown containers. The lowest concentration of sodium hypochlorite solution that reliably inactivated all the test organisms was 100 ppm., Conclusions: These data suggest that chlorine solutions do not need to be prepared fresh daily, as is recommended currently, and the lowest concentration of chlorine that reliably inactivates S aureus, S choleraesuis, and P aeruginosa is 100 ppm.

The Association of Official Analytical Chemists (AOAC) test for assessing the tuberculocidal activity of disinfectants has been shown to be variable. A modified AOAC test, which substituted Middlebrook 7H9 broth as the primary subculture medium and used neutralization by dilution, was compared with the standard AOAC method to assess the mycobactericidal activity of three glutaraldehyde-based disinfectants at 20 degrees C and various exposure times. These changes had a marked effect on results, with the modified AOAC test providing more positive penicylinders per 10 replicates in 12 of the 13 comparisons that provided positive results. These differences were observed with both Mycobacterium bovis (ATCC 35743) and a clinical isolate of Mycobacterium tuberculosis. The effects of various exposure times to and dilutions of the glutaraldehyde-based disinfectants were also examined. The minimum exposure time needed to inactivate reliably M. bovis or M. tuberculosis with 2% glutaraldehyde was 20 min at 20 degrees C. Diluting 2% glutaraldehyde caused a significant decline in mycobactericidal activity. Modification of the standard AOAC test to improve its sensitivity in detecting the failure of disinfectants to inactivate mycobacteria is indicated.

A collaborative study was undertaken to assess the degree of variability in disinfectant efficacy test results among laboratories that routinely perform the Association of Official Analytical Chemists (AOAC) Use-Dilution Method. Eighteen laboratories tested identical samples of six EPA-registered, hospital-grade disinfectants (three phenolics and three quaternaries) at the manufacturers' recommended use-dilution using only those modifications of the method approved by the AOAC Use-Dilution Task Force. Each laboratory processed 60 penicylinders for each of the 6 randomly selected disinfectants and 3 test organisms. The current EPA pass criterion for a disinfectant requires a test result of less than or equal to 1 positive penicylinder/60 replicates tested When compared with the 1 positive/60 replicate criterion, the test results of the 6 disinfectants were: 86 trials (80%) passed and 22 trials (20%) failed against Salmonella choleraesuis ATCC 10708; 71 (66%) passed and 37 (34%) failed against Staphylococcus aureus ATCC 6538; and 41 (38%) passed while 67 (62%) failed against Pseudomonas aeruginosa ATCC 15442. Four laboratories unknowingly tested their own product, and three of the four failed their product against one or more of the test organisms. These results show the inability to reproduce the manufacturers' bactericidal label claims for 6 disinfectants against the 3 AOAC test bacteria. In addition, extreme variability of test results among laboratories testing identical products questions the use of the AOAC Use-Dilution Method for enforcement action.

Pseudomonas aeruginosa ATCC 15442 is a required organism in the Association of Official Analytical Chemists use-dilution method for disinfectant efficacy testing. When grown in a liquid medium, P. aeruginosa produces a dense mat or pellicle at the broth/air interface. The purpose of this investigation was to examine the pellicle by scanning electron microscopy, to evaluate three pellicle removal methods, and to determine the effect of pellicle fragments on disinfectant efficacy test results. The efficacies of three methods of pellicle removal (decanting, vacuum suction, and filtration) were assessed by quantifying cell numbers on penicylinders. The Association of Official Analytical Chemists use-dilution method was used to determine whether pellicle fragments in the tubes used to inoculate penicylinders affected test results. Scanning electron micrographs showed the pellicle to be a dense mass of intact, interlacing cells at least 10 microns thick. No significant differences in pellicle removal methods were observed, and the presence of pellicle fragments usually increased the number of positive tubes in the use-dilution method significantly.