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The absolute majority of maintenance hemodialysis (MHD) patients die within 5 years of commencing dialysis treatment, mostly because of cardiovascular (CV) disease. The strongest and most common correlates of death in MHD patients are not conventional CV risk factors, but markers of protein-energy malnutrition and inflammation, together also known as malnutrition-inflammation complex syndrome (MICS). Paradoxically, classic risk factors such as obesity and hypercholesterolemia are associated with better survival in MHD patients. It has been hypothesized that this so-called reverse epidemiology is caused by the overwhelming prevalence and dominating effect of MICS in MHD patients. Hence, the key to improving survival and quality of life in MHD patients may be a better understanding of MICS and its interactions with CV disease and outcome. The Nutritional and Inflammatory Evaluation in Dialysis Patients (NIED) study is a longitudinal multicenter cohort study that aims to examine these hypotheses. At any given semiannual round, approximately 360 MHD patients from 8 DaVita dialysis facilities in the Los Angeles area are examined; 900 MHD patients will be cumulatively studied by the end of this 5-year prospective study (October 2001 to September 2006). Repeated measures of markers of nutritional status and inflammation are performed by 10 to 12 dialysis unit dietitians while patients attend their routine HD treatment in their dialysis facilities. All-cause and CV mortality, hospitalization, and quality of life are studied as outcome measures. The collaborating dietitians are the main evaluators and play crucial roles in all aspects of the study. This article reviews the design and infrastructure of the NIED study and reports preliminary findings of the first 12 to 30 months of the study.

The San Francisco Bay Region of the California Regional Water Quality Control Board (SFB CRWQCB) and the San Francisco District of the US Army Corps of Engineers (US ACOE) are looking for an expeditious means to determine whether regulated wetland projects produce ecologically valuable systems and remain in compliance with their permits (i.e. fulfill their legal requirements) until project completion. A study was therefore undertaken in which 20 compensatory wetland mitigation projects in the San Francisco Bay Region were reviewed and assessed for both permit compliance and habitat function, and this was done using a rapid assessment method adapted for this purpose. Thus, in addition to determining compliance and function, a further goal of this study was to test the efficacy of the assessment method, which, if useful, could be applied not only to mitigation projects, but also to restoration projects and natural wetland systems. Survey results suggest that most projects permitted 5 or more years ago are in compliance with their permit conditions and are realizing their intended habitat functions. The larger restoration sites or those situated between existing wetland sites tend to be more successful and offer more benefits to wildlife than the smaller isolated ones. These results are consistent with regulatory experience suggesting that economies of scale could be realized both with (1) large scale regional wetland restoration sites, through which efforts are combined to control invasive species and share costs, and (2) coordinated efforts by regulatory agencies to track project information and to monitor the increasing number and size of mitigation and restoration sites. In regard to the assessment methods, we find that their value lies in providing a consistent protocol for evaluations, but that the ultimate assessment will rely heavily on professional judgment, regulatory experience, and the garnering of pre-assessment information.

We measured bacterial and particle concentrations at the level of operative fields during 105 operation procedures under laminar air flow conditions. Measured concentrations were at least a factor of 20 lower than in comparable rooms without ultra-clean air and laminar air flow. Kind of operation (septic/aseptic), number of participating persons and quantity of talking seem to have less influence on air quality than presumed, single use cover improves the air quality. The number of ultra-fine and small particles was dramatically increased when tissue was coagulated during operation. This may pose health risks to surgeons and nurses, needs risk assessment and decisions about personal protection.

Insufficient performance of cleaning and disinfection of flexible endoscopes can pose an infection risk to patients. Actually quality of reprocessing is checked by performing microbiological cultures. Unfortunately, their results are not available on the same day so that more rapid methods are desirable. We compared the ATP (adenosine triphosphate) bioluminescence for hygiene checking of the reprocessing procedures of 108 flexible endoscopes with routine microbiological culture technics. Sensitivity and specifity of ATP bioluminescence was calculated. 28 endoscopes showed bacterial growth of at least one sample. Depending on the applied threshold of bioluminescence between 67 and 28 endoscopes were positive. Sensitivity varied between 0.46 and 0.75 and specifity between 0.43 and 0.81. ATP bioluminescence does not replace routine microbiologic methods but it can indicate the need of immediate check of reprocessing.

Using 0.002 cm(-1) resolution Fourier transform absorption spectra of an (17)O enriched ozone sample, an extensive analysis of the v(1)+v(3) bands of the (16)O(17)O(16)O and (16)O(16)O(17)O isotopomers of ozone has been performed for the first time. The experimental rotational levels of the (101) vibrational states were satisfactorily reproduced using a Hamiltonian matrix that takes into account the observed rovibrational resonances. More precisely, for (16)O(17)O(16)O, as for the other C(2v)-type ozone isotopomers, it was necessary to account for the Coriolis type resonances linking the (101) rotational levels with the levels of the (200) and (002) vibrational states and the Darling-Dennison interaction coupling the levels of (200) with those of (002). For the C(s)-type isotopomer, namely (16)O(16)O(17)O, as for (16)O(16)O(18)O and (16)O(18)O(18)O, it proved necessary to also account for an additional DeltaK(a)&equals+/-2 resonance involving the rotational levels from (101) and (002) (J.-M. Flaud and R. Bacis, Spectrochimica Acta Part A 54, 3-16 (1998)). Using a Hamiltonian matrix which takes these resonances explicitly into account, precise vibrational energies and rotational and coupling constants were deduced, leading to the following band centers: v(0)(v(1)+v(3))=2078.3496 cm(-1) for (16)O(17)O(16)O and v(0)(v(1)+v(3))=2098.8631 cm(-1) for (16)O(16)O(17)O. Copyright 2001 Academic Press.

A school-based pilot project is described which was designed to promote trauma healing, non-violent conflict resolution, peaceful living, human rights, and reduction of ethnic bias in Croatian children affected by war. A manual was written to guide teachers, who presented the curriculum over a four-month period. The subjects were 250 Fourth and Fifth grade children, divided into an intervention and two control groups. Pre- and post-testing revealed a small but significant reduction in ethnic bias and a reduction in post-traumatic stress symptoms in the intervention group. Follow-up testing showed that these benefits continued. There was a high level of acceptance of the programme by participants. The programme was extended in the subsequent year to 1200 students.

The toxicokinetics and biotransformation of pentachlorophenol (PCP) were determined in the topsmelt (Atherinops affinis). In a static system, topsmelt (n = 9) were exposed to 50 micrograms/L of [U-14C]PCP for 24 hours to determine the absorption rate constant (Ka), the whole-body bioconcentration (at steady-state conditions), the elimination rate constant (Ke), and the elimination half-life (t1/2). Kinetics were determined by direct quantitation of radioactivity in the exposure water. Following exposure, fish were placed in a flow-through metabolism chamber for 24 hours to allow depuration of retained residues, which were collected on XAD-4 resin. Excreted residues were identified and quantified by high-pressure liquid co-chromatography, fraction collection, and liquid scintillation counting. The Ka and Ke, calculated using a simplified model, were 0.012 +/- 0.005/h and 0.014 +/- 0.003/h, respectively, while the 24 hour total concentration factor was 278.0 +/- 182.0 and the t1/2 was 52.7 +/- 11.2. During 24 hours of exposure to clean seawater, topsmelt depurated 32.9% of retained residues, and while PCP was primarily excreted unchanged (64.9%), significant amounts of both pentachlorophenylsulfate (18.9%) and pentachloro-beta-D-glucuronide (16.2%) were also formed.

To assess the feasibility of using hospital records for occupational disease surveillance and to evaluate the quality of the industry/occupation (I/O) information available in these records, the computer file of all discharge diagnoses from a large health maintenance organization during 1985 was reviewed. The frequencies of discharge diagnoses previously listed as Sentinel Health Events (Occupational), or SHE (O), were calculated and three possible SHE(O) diagnoses--lung cancer, bladder cancer, and toxic hepatitis--were selected for further review. Outpatient charts of patients discharged for each diagnosis were abstracted with regard to I/O information and the discharged patients were interviewed by telephone to obtain a lifetime occupational history. The accuracy of the I/O information obtained from the hospital chart was compared to that obtained by patient interview by number of digits matched on standard classification codes. The frequencies of matches for occupation and industry were greater for "usual" than for "last" categories with both cancer diagnoses, but were similar for "usual" and "last" categories with toxic hepatitis. To assess the proportion of each possible SHE(O) diagnosis that was related to workplace exposures, the I/O information obtained by interview was rated in a blinded fashion by an experienced occupational medicine physician. The highest probability ratings for work-relatedness were noted for lung cancer, primarily due to asbestos exposure. The results of this study suggest that hospital records can be used to identify possible SHE(O); if adequate I/O information is available, then work-relatedness can be assessed. However, the accuracy of I/O obtained from hospital charts is relatively low. The efficient and accurate collection of I/O information from hospital records will require the use of a simple, easily coded instrument to be routinely administered on admission.

Air-broadened and N(2)-broadened halfwidth and pressure shift coefficients of 294 transitions in the nu(4) and nu(2) bands of (12)CH(4) have been measured from laboratory absorption spectra recorded at room temperature with the Fourier transform spectrometer in the McMath solar telescope facility of the National Solar Observatory. Total pressures of up to 551 Torr were employed with absorption paths of 5-150 cm, CH(4) volume mixing ratios of 2.6% or less, and resolutions of 0.005 and 0.01 cm(-1). A nonlinear least-squares spectral fitting technique has been utilized in the analysis of the twenty-five measured spectra. Lines up to J' = 18 in the nu(4) band and J' = 15 in the nu(2) band have been analyzed.

With the help of the tetracycline resistance transposon Tn10 in and around the mgl genes the gene cir was mapped. cir is 80% cotransducible with mgl by P1 transduction. The sequence of the surrounding markers in clockwise order was established as: cdd fpk cir mgl gyrA. The direction of transcription in cir was determined as clockwise on the Escherichia coli chromosome. The gene product of cir, an outer membrane receptor for colicin I, is not part of the mgl operon. It is not regulated by D-fucose, the inducer of the mgl system and mutants defective in cir are unimpaired in the uptake of substrates of the mgl-dependent transport system.

Absolute intensities for 430 transitions belonging to eleven rotation-vibration bands of (12)C(16)O(2),(13)C(16)O(2) and(16)O(12)C(18)O in the 3140-3410-cm(-1) spectral region have been determined by analyzing spectra recorded at 0.01-cm(-1) resolution with the Fourier transform spectrometer in the McMath solar telescope complex at the National Solar Observatory on Kitt Peak. The data were recorded at room temperature and low pressures (<10 Torr) using a natural sample of carbon dioxide. Intensities were derived using a nonlinear least-squares spectral fitting procedure, and the values obtained for each band have been analyzed to determine the vibrational band intensity and nonrigid rotor coefficients. An alternative mathematical formulation is shown in the case of bands for which the Coriolis effect is large and the Q-branch line intensities were not determinate either because they were severely blended or absent from the spectra. Comparisons are made between the results obtained in this study and other published values.

Air-broadened halfwidths and pressure-induced line shifts in the nu(4) fundamental of (13)CH(4) were determined from spectra recorded at room temperature and at 0.01-cm(-1) resolution using a Fourier transform spectrometer. Halfwidths and pressure shifts were determined for over 180 transitions belonging to J''values of

Room temperature argon broadened halfwidth and pressure-induced line shift coefficients have been determined for 118 transitions in the nu(4) band of (12)CH(4) from analysis of high resolution laboratory absorption spectra recorded with the McMath Fourier transform spectrometer operated on Kitt Peak by the National Solar Observatory. Transitions up to J''= 12 have been measured using a nonlinear least-squares spectral fitting procedure. The variation of the measured halfwidth coefficients with symmetry type and rotational quantum number is very similar to that measured previously for N(2) and air broadening, but the absolute values of the argon broadening coefficients are all smaller. On average, the ratio of the argon broadened halfwidth coefficient to the corresponding N(2) broadened halfwidth coefficient is 0.877 +/- 0.017 (2sigma). More than 95% of the pressure-induced shifts are negative with values ranging from -0.0081 to +0.0055 cm(-1) atm(-1). The pressure shifts in argon are nearly equal to corresponding values measured previously in N(2) and air.

Air-broadened and N2-broadened halfwidths at room temperature for twenty-five transitions in the 4 fundamental band of '2CH4 have been determined from IR absorption spectra recorded with a tunable diode laser spectrometer. Two tunable diode lasers operating in the 1250-1380-cm(-1) region were used to obtain these data. Air-broadened halfwidths for twenty of these lines were also determined from additional spectra recorded at 0.01-cm(-1) resolution with the Fourier transform spectrometer in the McMath solar telescope complex on Kitt Peak. The air-broadened halfwidths obtained from these two techniques are very consistent with agreement better than 3% in most cases.

A nonlinear least-squares fitting procedure has been used to derive absolute intensities for lines in the P, R, and Q branches of the (11(1)0)II <-- 00(0)0 band of 12Cl602 (band center = 1932 cm(-1)) from long-path 0.01-cm(-1) resolution laboratory spectra. The spectral data were recorded at room temperature and low pressure (<10 Torr) with the Fourier transform spectrometer in the McMath solar telescope complex at Kitt Peak National Observatory. The observed line intensities were analyzed to derive the vibrational band intensity and F-factor coefficients. To obtain a good fit to the data, it was necessary to include terms in the expression for the F factor, which account for Coriolis-type and Fermi-type interactions and centrifugal distortion effects.