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Dear Prof. Caume, Drs’ Denholm and Thevarajan1 in their review on risk and interventions for reducing travel associated tuberculosis (TB) make no mention of the potential utility of isoniazid chemoprophylaxis. Isoniazid has long been recognized as an effective and safe drug for reducing TB …

Summary Objectives The Typhoid and Paratyphoid Reference Group (TPRG) was convened by the Health Protection Agency (HPA) and the Chartered Institute of Environmental Health (CIEH) to revise guidelines for public health management of enteric fever. This paper presents the new guidelines for England and their rationale. Methods Methods include literature reviews including grey literature such as audit data and case studies; analysis of enhanced surveillance data from England, Wales and Northern Ireland; review of clearance and screening schedules in use in other non-endemic areas; and expert consensus. Results The evidence and principles underpinning the new guidance are summarised. Significant changes from previous guidance include: • Algorithms to guide risk assessment and management, based on risk group and travel history; • Outline of investigation of non-travel cases; • Simplified microbiological clearance schedules for cases and contacts; • Targeted co-traveller screening and a "warn and inform" approach for contacts; • Management of convalescent and chronic carriers. Conclusions The guidelines were launched in February 2012. Feedback has been positive: the guidelines are reported to be clear, systematic, practical and risk-based. An evaluation of the guidelines is outlined and will add to the evidence base. There is potential for simplification and consistency between international guidelines.

Improved data collection methods have produced a clearer picture of travel-associated health risks and at-risk travelers. Examination of the causes of mortality and morbidity has led to a change in emphasis on ways of reducing morbidity. There are unanswered questions that relate to the contribution of medical comorbidities on travel-associated illness, how communication can enhance or influence behavior change, and the best strategies to influence the travelers at greatest risk. Enhanced data collection methods and better denominator data are necessary to provide more precise risk information and help inform policy and thereby reduce morbidity in tourists and travelers.

Malaria remains the most important parasitic infection in humans. There have been significant advances in the treatment of both nonsevere and severe malaria with the advent of artemisinin combination therapies and parenteral artesunate, but the optimum supportive management of severe malaria is unclear. A broadly acceptable therapy for the prevention of relapses in Plasmodium vivax infection has not been discovered. Globally, the priority remains to prevent infection in the vulnerable, to move toward elimination where feasible, and to ensure that effective treatment is available to all. In developed settings, prevention of infection and its early recognition are crucial.

Imported malaria has been described as “an infection that was acquired in an endemic area by an individual (either a tourist or indigenous native) but diagnosed in a non‐endemic country after development of the clinical disease.” 1 In the UK, there was an average of 1,965 laboratory‐confirmed reports of imported malaria infections between 1987 and 2006, 2 and this country, together with France, Germany, and Italy, accounts for about three‐quarters of the 10,000 to 12,000 annual cases imported into the World Health Organization European region. 3 The majority of imported malaria infections reported in European countries are caused by Plasmodium falciparum , 3 the Plasmodium species associated with the most severe disease and mortality. Data from TropNetEurop, 4,5 a European sentinel surveillance system, describe how most cases originate from West Africa and affect travelers of African ethnicity. The most commonly reported reason for travel is to visit friends and relatives (VFRs), with 64.5% of all travelers citing this as a reason for travel in malaria reports between 1987 and 2006 to the UK's Malaria Reference Laboratory and 76.4% in reports to TropNetEurop in 2007. 5 Those VFRs who were born and lived for some time in malaria‐endemic countries before moving to Europe will have acquired partial immunity from exposure to malaria during childhood. Without repeated exposure, immunity appears to wane with time, although the time period during which this occurs is unknown. Bouchaud and colleagues 6 have demonstrated that levels of parasitemia and severe disease were lower in African migrants who were resident outside malarious areas for more than 4 years but acquired falciparum malaria on a short visit to a malaria‐endemic area, when compared to patients who had always lived outside these areas. However, a recent study of African migrants in Italy 7suggests that living for more than … Corresponding Author: Penny Neave, MSc, Malaria Reference Laboratory, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK. E‐mail: penny.neave{at}lshtm.ac.uk

We characterized vaccine-induced cellular responses to rabies virus in naive adult volunteers. Contrary to current paradigms, we observed potent and prolonged in vitro NK cell cytokine production and degranulation responses after restimulation of PBMCs with inactivated rabies virus in vaccinated, but not in unvaccinated, individuals. This “recall” NK cell response was absolutely dependent on Ag-specific IL-2 from CD45RO+ CD4+ T cells as well as IL-12 and IL-18 from accessory cells. Importantly, NK cells represented over 70% of all IFN-γ–secreting and degranulating cells in the first 12–18 h after virus rechallenge indicating they may be required for rapid control of infection after vaccination. Activation of NK cells may be a critical function of IL-2–secreting effector memory T cells. Although IL-2–dependent postvaccination NK cell activation has been reported previously, this is the first time the magnitude of this effect and its contribution to the overall vaccine-induced response has been appreciated and the mechanisms of NK activation postvaccination have been elucidated. Our data will allow standard protocols for evaluating vaccine-induced immunity to be adapted to assess NK cell effector responses.

BACKGROUND CONTEXT Loading of absorbable collagen sponges (ACS) with recombinant human bone morphogenic protein-2 (rhBMP-2) has been successfully used to enhance bone formation and to induce spinal fusion. However, side effects, such as soft-tissue edema and inflammation, have been reported. NEMO binding domain peptide (NBD) inhibits activation of nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), a central regulator of immune response. PURPOSE To investigate NBD's potential to reduce rhBMP-2-induced soft-tissue inflammation and to stimulate spinal fusion. STUDY DESIGN/SETTING To evaluate inflammation, ACS containing either high dose rhBMP-2, rhBMP-2+NBD, NBD only or buffer were only implanted into intramuscular fusion beds of 32 rats. To analyze new bone formation in the presence of NBD, posterolateral intertransverse lumbar fusion procedures were performed on 16 rats. ACS implants were loaded with rhBMP-2 or rhBMP-2+NBD. PATIENT SAMPLE No patients, animal study. OUTCOME MEASURES T2-weighted relaxation time (T2-RT), histological analysis (HE appropriate post hoc tests for multiple comparisons using Tukey's honestly significant was applied. p≤.05 was considered significant. RESULTS T2-RT values were increased in the BMP-2 group compared to BMP-2+NBD, NBD and ACS groups. No difference was detected between BMP-2+NBD versus NBD and ACS controls. Histological analysisof the implant-surrounding zones showed an increase in cellular activity in the BMP-2 group compared to BMP-2+NBD and controls. Presence of rhBMP-2 increased relative NF-κB binding and gene expression of inflammatory markers, interleukin (IL)1β, IL6, IL18, chemokine ligand (CCL)2 and CCL3 compared to controls. In the BMP-2+NBD group, cytokine expression was blocked. No differences were found between BMP-2+NBD and control groups. BMP-2+NBD resulted in a higher bone volume and reduced trabecular spacing compared to BMP-2, a higher number of levels fused, and similar structural properties of the bone tissue. CONCLUSIONS In summary, NBD reduces soft-tissue edema formation, reduces recruitment of inflammatory cells, diminishes NF-κB binding and blocks transcription of NF-κB-regulated cytokines in response to high-dose rhBMP-2 in rats. Furthermore, NBD stimulates bone formation in rhBMP-2-mediated spinal fusion, potentially through cross-talk of the NF-κB pathway with other pathways. The results of this study might provide the basis to develop new therapeutic approaches for spinal fusion using graft material with a combinatory administration of rhBMP-2 and NBD.

Zusammenfassung Die Hygiene der Ferkelaufzucht befast sich nicht nur mit der Verhutung von Krankheiten, sondern sie strebt durch eine optimale Gestaltung der Umwelt die moglichst verlustlose Aufzucht groser, gut entwickelter Wurfe an. Die kunftige Entwicklung der Ferkelaufzucht ist durch die zunehmende Verlagerung auf ausschliesliche Stallhaltung unter Aufgabe des Auslaufes fur Ferkel und saugende Sauen gekennzeichnet. In Betrieben mit mehr als 5 Zuchtsauen ist eine raumliche Trennung in Abferkel- und Mastabteilung, in Grosbetrieben mit mehr als 500 Zuchtsauen der Bau raumlich getrennter Stalleinheiten, die etwa 25 innerhalb einer Woche ferkelnde Sauen fassen, zu fordern. Abferkelstalle mussen ganzjahrig die fur die Sauen optimale Stalltemperatur halten. Dieses ist in der Klimazone I allein durch bautechnische Masnahmen, in den Klimazonen II und III nur durch eine zusatzliche kunstliche Warmequelle zu erreichen. Das von den Ferkeln geforderte, hoher temperierte lokale Stallklima last sich am einfachsten durch den Infrarotstrahler sowie durch eine Fusbodenheizung schaffen. Abferkelstalle sind zur Verhutung der sonst bei den Ferkeln beim Saugen an den Gliedmasen auftretenden Hautverletzungen mit einer Einstreu zu versehen. Durch die Benutzung von Abferkelkasten bzw. -kafigen, Abferkelstanden und Protekta-Schutzbogen last sich nicht nur das Erdrucken der Ferkel weitgehend verhindern, sondern die Geburt kann ohne menschliche Aufsicht erfolgen. Nach dem Absetzen verbleiben die Ferkel noch wenigstens eine Woche in der von ihnen wahrend der Saugezeit benutzten Stallbucht. Futter ist den Ferkeln in sauberen Trogen und Automaten, Wasser in sauberen Gefasen, moglichst Stulptranken, oder in der Selbsttranke bereitzustellen. Abferkelbuchten sind nach jedem Wurf zu reinigen und zu desinfizieren. Summary Hygiene in pig breeding In rearing pigs, hygiene is needed not only to prevent disease but also to produce an optimal environment in which as many high quality pigs as possible can be produced. The future pattern is likely to be increasingly towards complete enclosure of rearing within buildings without the provision of runs for the piglet and the nursing sow. In herds with more than five breeding sows one should consider separate sections for farrowing and fattening. In herds with more than 500 breeding sows it is advisable to provide separate buildings in which about 25 sows farrow each week. Buildings for farrowing sows must be kept at an optimal temperature all the year round. In climatic zone I this can be done by constructional methods alone, whereas in climatic zones II and III it is necessary to provide artifical heat. Buildings for piglets require a higher temperature, which is most simply provided by infra-red lamps or floor heating. Farrowing stalls should have litter to prevent injuries to the legs of piglets, which commonly occur during sucking. The use of farrowing crates of various kinds gives complete protection from crushing of the piglets and also allows farrowing to occur unattended. After farrowing, the piglets remain for at least a week in the farrowing pen. Food is given in clean troughs or automatic containers and water in clean vessels, where possible in automatic water bowls. Farrowing quarters must be cleaned and disinfected after each farrowing. Resume L'hygiene de l'elevage des porcelets L'hygiene de l'elevage des porcelets n'a pas pour but seulement de prevenir des maladies, mais elle tend par la recherche d'un milieu ambiant optimal a l'elevage de portees nombreuses et bien developpees, avec le minimum de pertes possible. Le developpement futur de l'elevage des porcelets tendra de plus en plus a la stabulation permanente en renoncant aux couretts pour les porcelets et les truies allaitantes. Dans les exploitations possedant plus de 5 truies, on doit conseiller une separation entre une section reservee a la mise-bas et une section d'engraissement. Dans les grandes exploitations de plus de 500 truies s'impose la construction d'unites separees qui puissent contenir environ 25 truies par semaine pour la mise-bas. Les porcheries speciales pour la mise-bas doivent etre maintenues toute l'annee a une temperature optimale pour les truies. Dans la zone climatique I ce resultat peut etre obtenu simplement par des techniques de construction, dans les zones II et III au moyen d'un chauffage complementaire. Le climat plus tempere necessaire aux porcelets peut etre obtenu simplement par des lampes infra-rouges ainsi que par le chauffage du plancher. Les porcheries speciales pour la mise-bas doivent etre munies de litiere pour eviter aux porcelets les blessures cutanees des membres frequentes sans cette precaution pendant l'allaitement. En utilisant des caisses ou des cages, respectivement des compartiments pour la mise-bas, ainsi que des barres protectrices Protekta, on evite presque toujours l'ecrasement des porcelets et la parturition peut se faire sans surveillance humaine. Apres le sevrage les porcelets restent au moins une semaine dans la loge utilisee pendant l'allaitement. La nourriture doit etre offerte dans des auges ou automates propres, l'eau dans des recipients propres et si possible des abreuvoirs a revers ou des abreuvoirs automatiques. Les loges de mise-bas doivent etre nettoyees et desinfectees apres chaque usage. Resumen Higiene de la crianza de los lechones La higiene de la recria de lechones no solo se limita a la prevencion de enfermedades, sino que por medio de la configuracion optima del medio ambiente procura una cria a ser posible sin bajas de camadas grandes y bien desarrolladas. El futuro desarrollo de la recria de lechones se halla caracterizado por el desplazamiento creciente a la casi exclusiva estabulacion suprimiendo las correrias por el exterior de los lechones y cerdas lactantes. Las explotaciones con mas de 5 cerdas de cria deberian tener una separacion espacial entre departamentos de parto y engorde, mientras que en explotaciones gigantes con mas de 500 cerdas de cria habria de exigirse la construccion de unidades de pocilga separadas en el espacio, donde cupiesen unas 25 cerdas que estuvieran de parto en el plazo de una semana. Las porquerizas para partos deben mantener durante todo el ano la temperatura estabular optima para cerdas. Esto se puede conseguir en la zona climatica I recurriendo solo a medidas arquitectonicas, mientras que en las zonas climaticas II y III se precisa una fuente termica artificial aditiva. El clima estabular local exigido por los lechones, de temperatura superior, se consigue lo mas facilmente posible por medio de radiadores infrarrojos, asi como mediante una calefaccion subterranea. Las porquerizas para partos deben proveerse de una yacija para impedir las lesiones cutaneas, que en caso contrario aparecen en las extremidades de los lechones al lactar. Utilizando cajones o jaulas para partos, armazones de paricion y arcos protectores no solo se puede impedir en gran parte el que sean aplastados los lechones, inso que el parto puede efectuarse sin vigilancia humana. Tras el destete aun permanecen los cerditos una semana como minimo en el cochitril de la porqueriza utilizada por ellos durante el tiempo de la lactacion. El pienso debe ponerse a disposicion de los lechones en bateas y automatas limpios, el agua debe facilitarse en recipientes tambien limpios, a ser posible en bebederos basculantes o automaticos. Los cochitriles para partos deben ser limpiados y desinfectados tras cada parto.

Background. Travel-associated health risks need to be balanced against the positive opportunities associated with interregional travel. As the perceived and real spectrum of health risks related to international travel increase both quantitatively and qualitatively, the need for more discriminating tools in clinical assessment for the purpose of mitigation, public health management, and research are needed. One group of international travelers identified as having increased risk of poor travel-related health outcomes are those who travel with the specific intent of visiting friends or relatives (VFR travelers). Due to variations in defining VFR travel in the health context there are issues in applying this designation uniformly from multiple perspectives. This article supports the standardization of VFR traveler definitions based on objective criteria and provides illustrations of the application of this definition through an illustrated approach to risk assessment based on these criteria and the differentials in the determinants of health between source and destination regions. Methods. A working group was established by the Migration Health Sub-committee, International Society for Travel Medicine to assess the literature on VFR travel and health, review an evidence-based approach to managing health risk related to travel, and to propose criteria-based definition for VFR travel. The new definition of a VFR is a traveler whose primary purpose of travel is to visit friends or relatives where there is a gradient of epidemiological risk between home and destination. Results. A case scenario discussion of VFR travel defined by criteria and risk assessment based on differential determinants of health is presented in this article. Discussion. The goal of this article is to encourage discussion on travel health evaluation for the most ‘‘at risk’’ populations and to standardize the application of clinical, public health, and research approaches to defining VFR travelers in a risk management context.

BACKGROUND: Large numbers of Western travelers visit countries endemic for Japanese encephalitis (JE). The risk of infection is unknown. This study attempts at estimating a risk incidence for visitors from two European countries with the available data. METHODS: Using the total number of case reports between 1978 and 2008, the number of visits made by European tourists to endemic regions, and total doses of vaccines sold in the two study countries, the risk incidence of JE in travelers was estimated. The proportion of vaccinated visitors to endemic regions was retrieved from the data of two travel clinics (in London and Basel) and related to vaccine prescribing in UK and Swiss travelers. RESULTS: In 2004, an estimated 0.16% to 0.3% of UK and Swiss travelers were vaccinated against JE, with no surveillance reports of JE cases. Between 116,000 and 152,000 European travelers would receive vaccination. More than 99% travel to endemic countries without vaccination. Only 40 cases of JE infection have been reported in travelers for the past 30 years. The risk incidence is thus 1.3 per year in 7.1 million visits of the 17 million European travelers who are at a potential risk of JE infection. CONCLUSIONS: This study and the analysis of the existing literature support the recommendation that all travelers should be informed about the risk of JE infection but also suggest that there is no evidence for justifying a general recommendation for JE vaccination in travelers to endemic areas.

International travel has become more accessible and affordable, and travel, particularly to tropical and malaria regions, has increased by up to 8% annually. This change in travel has surprisingly not resulted in an increase in imported diseases. Surveillance reports of hepatitis A and enteric fever have not increased and a significant and sustained fall in malaria over the decade has been described. Nurses in primary care are the predominant providers of pre-travel health services and they have an important and influential role in preventing travel-associated illness. This is the second article in a 3-part series on the spectrum of health issues associated with travel. Part one discussed pre-travel health advice, including risk assessment and educating travellers. This article explores the highest risk group of traveller, those visiting friends and relatives (VFRs). The article highlights the specific disease risks for VFRs and how these may be influenced by their health beliefs. The article explores ways in which nurses can optimize the travel health consultation to ensure that the specific needs of VFRs are met and that they receive accurate and achievable advice .

A study of the seasonal movements of Gulf sturgeon Acipenser oxyrinchus desotoi was conducted in the Pearl River system and the Mississippi Sound from 2000 through 2003. We captured or recaptured, marked, and released 503 Gulf sturgeon, 98 adults being tagged with internal or external telemetry tags. Movement chronologies were generally similar to those reported in other studies. Summer habitats were found in the Pearl and Bogue Chitto rivers (Louisiana–Mississippi), and these habitats were occupied from April through November. Adults and subadults were spatially separated, the adults being concentrated in the Bogue Chitto River and the subadults in the Pearl River. Tagged adults began to leave the summer habitat during September and to arrive at the mouth of the Pearl River and the Rigolets Pass. The last departure from this location was in late November. Wintering habitat between Cat, Ship, Horn, and Petit Bois islands in the Mississippi Sound was used between November and early March. Gulf stu...

To evaluate the impact of zinc supplementation on the clinical recovery and body weight of children with persistent diarrhoea, a randomized, double-blind, controlled trial was conducted in 190 children with persistent diarrhoea aged between 3 and 24 months. Children were randomly allocated to receive either zinc (20 mg d−1) syrup with multivitamin (2 × RDA) or multivitamin alone in three divided daily doses for 2 weeks. The trial was conducted in a diarrhoeal disease hospital in Dhaka, Bangladesh. Duration until clinical recovery (d), impact on body weight and serum zinc level after 2 weeks of zinc supplementation were recorded. The duration of illness was significantly reduced (33%) with zinc supplementation among children who were underweight (≤70% wt/age, p= 0:03). Supplemented male children also had a significant reduction (27%) in duration for recovery compared with unsupplemented children (p= 0:05). From baseline to convalescence, zinc-supplemented children maintained their serum zinc concentration (13.4 vs 13.6/μmol l−1), whereas unsupplemented children had a decrease in serum zinc after the 2 weeks of diarrhoea (13.6 vs 11.8 μmol l−1, p < 0:03). The mean body weight of the children in the supplemented group was maintained (5.72 vs 5.70 kg, p= 0:62) during hospitalization, unlike that of the control group, in which there was a reduction in body weight (5.75 vs 5.67 kg, p= 0:05). Five children in the unsupplemented group and one child in the zinc-supplemented group died during the 2 weeks of supplementation (p= 0:06). Zinc supplementation in persistent diarrhoea significantly reduced the length of the recovery period in malnourished children and prevented a fall in body weight and serum zinc concentration, indicating that zinc is a beneficial therapeutic strategy in this high-risk childhood illness.

Since its introduction to the market in 1985, mefloquine has been used for malaria chemoprophylaxis by more than 35 million travellers. In Europe, in 2014, the European Medicines Agency (EMA) issued recommendations on strengthened warnings, prescribing checklists and updates to the product information of mefloquine. Some malaria prevention advisors question the scientific basis for the restrictions and suggest that this cost-effective, anti-malarial drug will be displaced as a first-line anti-malaria medication with the result that vulnerable groups such as VFR and long-term travellers, pregnant travellers and young children are left without a suitable alternative chemoprophylaxis. This commentary looks at the current position of mefloquine prescribing and the rationale of the new EMA recommendations and restrictions. It also describes the new recommendations for malaria prophylaxis that have been adapted by Switzerland, Germany, Austria and Italy where chemoprophylaxis use is restricted to high-risk malaria-endemic areas.

Post-partum weight loss is critical to preventing and managing obesity in women, but the results from lifestyle interventions are variable and the components associated with successful outcomes are not yet clearly identified. This study aimed to identify lifestyle intervention strategies associated with weight loss in post-partum women. MEDLINE, EMBASE, PubMed, CINAHL and four other databases were searched for lifestyle intervention studies (diet or exercise or both) in post-partum women (within 12 months of delivery) published up to July 2014. The primary outcome was weight loss. Subgroup analyses were conducted for self-monitoring, individual or group setting, intervention duration, intervention types, the use of technology as a support, and home- or centre-based interventions. From 12,673 studies, 46 studies were included in systematic review and 32 randomized controlled trials were eligible for meta-analysis (1,892 women, age 24-36 years). Studies with self-monitoring had significantly greater weight lost than those without (-4.61 kg [-7.08, -2.15] vs. -1.34 kg [-1.66, -1.02], P = 0.01 for subgroup differences). Diet and physical activity when combined were significantly more effective on weight loss compared with physical activity alone (-3.24 kg [-4.59, -1.90] vs. -1.63 kg [-2.16, -1.10], P 0.001 for subgroup differences). Lifestyle interventions that use self-monitoring and take a combined diet-and-exercise approach have significantly greater weight loss in post-partum women.

Rivers discusses the application of insect repellents to the face.1 2 Application of a repellent to the face may not always be needed because mosquito bites occur …

The bottom line A pregnant woman visits you as her general practitioner (GP) because she and her children will be visiting a country with mosquito borne disease. You recommend using repellents to protect against mosquitoes, as well as vaccinations and other relevant disease prevention measures. She asks which repellents would be best. The key factors to consider when choosing a repellent are the active chemical ingredients and the strength (concentration (%) of active ingredient) because these influence the efficacy and duration of protection.1 2 There are four active ingredients with sufficient published scientific evidence to warrant recommendation. Repellents are useful in areas of low risk of mosquito borne disease to prevent nuisance biting (which may lead to problems such as allergies) and are essential in moderate to high risk areas (figure⇓) to prevent disease transmission (such as malaria and dengue fever) through bites. Repellents work on mosquitoes by directly stimulating avoidance behaviour or by blocking the mosquito’s receptors for attractive odours, not though toxicity.3 Areas of low, moderate, and high risk of mosquito borne disease worldwide

BACKGROUND: The main aims of this study were to quantify the annual risk of falciparum malaria among nonimmune, UK-based airline crew and to undertake a risk assessment of short layovers in sub-Saharan African cities. METHODS: The number of nights exposed in malaria-endemic regions and reported cases of falciparum malaria were used to estimate annual disease incidence. Transmission risk estimates were calculated for each layover, that is, where crew were accommodated overnight, for one or more nights, in designated city hotels. Air-conditioning of ground transport, hotels, and airports was provided at all crew layovers. Details of activities associated with a risk for malaria and of adherence to antimosquito measures among crew were collected through a self-administered postal questionnaire. RESULTS: The annual risk of falciparum malaria was calculated to be 1.6 cases per 100,000 nights of exposure (95% CI 0.5-3.7). Crew reported widespread use of personal protection measures during the evenings when at risk. CONCLUSIONS: Attack rates of falciparum malaria were considerably lower than those reported in tourists during visits to sub-Saharan Africa. Factors contributing to this low attack rate included risk awareness, a protected sleeping environment, an urban setting, vector environmental controls, brief exposure, and good compliance with personal protection measures. Previously reported chemoprophylaxis compliance of < 10% in the same population was unlikely to have contributed to the low rate of disease. The longer layovers, of 3 or 4 nights, in some East African rosters provided greater opportunity for discretionary leisure activity away from protected hotel environments, and this needs to be considered in a risk assessment.

BACKGROUND: Travel associated malaria is a major health risk for visitors to malaria endemic destinations. To examine the knowledge of malaria prevention, risk perception, current prophylactic behavior, and compliance with chemoprophylaxis and personal and environmental protection measures we conducted a study in a cohort of travelers exiting Zimbabwe from two international airports during a peak malaria transmission period. METHODS: Data were collected by pretested self-administered questionnaires from 595 adults in the departure lounges of Harare and Victoria Falls International airports. Excluded were children and travelers from the African continent. A multilingual research assistant supervised data collection. RESULTS: The majority of travelers obtained health advice prior to travel. Patterns of protective behavior and compliance with prophylaxis were inconsistent with a high perception of malaria threat and good knowledge. About 23% of travelers failed to use chemoprophylaxis during their visit. In the group of travelers who used chemoprophylaxis, 18% were noncompliant. Fifteen drug combinations were in use. Full compliance with medication plus use of personal preventive measures always was estimated as 13%. Forgetfulness was the main cause of noncompliance, followed by deliberate omission due to side effects. Of 57 travelers who reported side effects from current medication, over half used mefloquine. CONCLUSIONS: There is a need to examine how people process personal risk and communications about risk. We must recognize the competition between precautionary measures against malaria and other life demands that are imposed by travel, especially in young long stay travelers and persons visiting primarily for business purposes. Mediating a protective response will also depend on judgments about the effectiveness of the action, strengthening travelers intentions toward adherence, and increasing efficacy perception by individuals and their peers. Conflicts in prophylactic recommendations need to be resolved. As ecotourism develops in Zimbabwe and other malaria regions, stakeholders in this rapidly growing industry must be made aware of the important role they can play in protecting clients from malaria.

A “biocide” is a chemical which, by chemical or biological means, kills, repels, or renders harmless any unwanted organism and is used to control organisms such as viruses, bacteria, fungi, and insects, including insect repellents. Strict laws apply to the supply and use of biocides to ensure that they can be used without causing significant harm to people, the environment, or non‐target animals. The new European Union (EU) Biocidal Products Regulation (EU 528/2012, known as the BPR) 1 sets the standards for safety assessment and authorization of biocidal products. The biocide laws work through two processes—“approval” and “authorization.” A National Competent Authority leads government policy on biocidal laws. In the UK, this is the Health and Safety Executive (HSE). First the “active substances” are assessed to understand how effective they are and whether there are potential risks to human health, non‐target animals, or the environment and if these can be adequately controlled. If they pass, they are “approved” for use in biocidal products in the EU. Second, approved active substances can be incorporated into biocidal products, which companies must then apply for “authorization” to supply. Products are then assessed for effectiveness (do they repel vectors and for how long) and potential risks (toxicity) and, if they pass, they are “authorized” for supply and use. Active substances used in the biocidal products already on the market were listed in 2000, and they are allowed to remain on the market while being reviewed but sales of unauthorised products to cease by August 2016. Since 2012, commercial products containing items on the active list were to be submitted for authorization, along with the data on the products content, on each active substance, and on their effectiveness and possible adverse effects to humans and the environment. The chemical substance N , N ‐diethyl‐meta‐toluamide (commonly …

The differential diagnosis between sporadic adenoma and colitis-associated neoplasia is difficult. Clinical, histological and molecular genetic methods are available to recognise a difference between these two entities. The aim of the present analysis was to check known criteria in a large series of patients and 352 patients with ulcerative colitis and concomitant intraepithelial neoplastic lesions [149 adenomas (A), 123 colitis-associated intraepithelial neoplasias (N), 80 carcinomas (K)] were investigated. Clinical history helped to identify patients with sporadic adenoma since patients with colitis-associated neoplastic lesions presented with different data such as age (A: 61.3+/-13 years, N: 48.4+/-16.4 years, K: 53.9+/-16.9 years), duration of disease (A: 6.9+/-8.1 years, N: 11.9+/-10 years, K: 13.6+/-9.6 years), frequency of pancolitis (A: 28.6%, N: 56.3%, K: 48.3%) and frequency of solitary lesions (A: 83.7%, N: 23.1%, K: 51.9%). The differential diagnosis between adenoma and colitis-associated neoplasia in patients with ulcerative colitis appears to be possible but the diagnosis should only be made in the remission phase. Furthermore the patients need a careful endoscopic and bioptic follow-up. If in doubt one should consider colitis-associated neoplasia especially when there are multiple intraepithelial neoplastic lesions. Long-term follow-up studies are urgently needed.

It is well established that near-infrared (NIR) combination bands at 4500 and 5200 cm−1 can be used to measure the concentrations of OH groups and H2O molecules, respectively, in hydrous silicate glasses at room temperature. However, the variations of hydrous species concentrations and molar absorption coefficients for the combination bands with temperature in the glass and in the melt have been controversial in the past decade. Three different approaches are used to determine hydrous species at elevated temperatures: (i) long term isothermal heating nearby the glass transition terminated by a rapid quench, (ii) controlled cooling after heating the melt above the liquidus and (iii) in situ measurements. Each of these techniques has its advantage and disadvantage. In the case of highly polymerized alkali aluminosilicates, consistent data are obtained by the different approaches. Fictive temperatures of glasses, calculated on the basis of relaxation theory, are close to the equilibrium temperatures for the ...

Malaria continues to have a high morbidity rate associated among European travelers. Thorough recording of epidemiological and clinical aspects of imported malaria has been helpful in the detection of new outbreaks and areas of developing drug resistance. Sentinel surveillance of data collected prospectively since 1999 has begun within TropNetEurop, a European network focusing on imported infectious diseases. TropNetEurop appears to cover approximately 10% of all patients with malaria seen in Europe. Reports of 1659 immigrants and European patients with Plasmodium falciparum malaria were analyzed for epidemiological information and data on clinical features. Regional data were quite diverse, reflecting local patterns of immigration and international travel. By far, the most infections were imported from West Africa. Europeans had more clinical complications; consequently, all deaths occurred in this group. Compared with European standards, the mortality rate was low (0.6% in Europeans). Data from TropNetEurop member sites can contribute to our understanding of the epidemiological and clinical findings regarding imported falciparum malaria.

BACKGROUND: In many non-malarious countries, imported malaria disproportionately affects Africans visiting friends and relatives (VFRs). Most previous research has focused on understanding the knowledge, attitudes and practices of these travellers, but has not examined the quality of prevention, diagnosis and treatment services provided. The aim of this study was to understand the perspective of providers of malaria-related healthcare services to VFRs about factors impacting on the quality of these and to make recommendations about improvements. METHODS: Thirty semi-structured interviews were conducted with practice nurses providing pre-travel health advice (n = 10), general practitioners (GPs) (n = 10), hospital consultants (n = 3), and community pharmacists (n = 7) working in areas of London with large African communities and a relatively high burden of imported malaria. A thematic analysis of the results was undertaken. RESULTS: Time constraints in GPs' surgeries and competing priorities, lack of confidence in issuing advice on mosquito avoidance, the cost of chemoprophylaxis and travel at short notice prevented the provision of adequate malaria prevention advice. Long GP waiting times, misdiagnoses, lack of disclosure by VFRs about recent travel, and the issue of where malaria treatment should be provided were raised as potential barriers to diagnosis and treatment. CONCLUSIONS: Some issues raised by respondents are relevant to all travellers, irrespective of their reason for travel. The challenge for healthcare providers to reduce the burden of imported malaria in VFRs is to provide services of sufficient quality to persuade them to adopt these in preference to those with which they may be familiar in their country of birth. Although no single intervention will significantly lower the burden of imported malaria, addressing the issues raised in this research could make a significant impact.

Concerns about the tolerability of mefloquine highlight the need for new drugs to prevent malaria. Atovaquone-proguanil (Malarone; GlaxoSmithKline) was safe and effective for prevention of falciparum malaria in lifelong residents of malaria-endemic countries, but experience in nonimmune people is limited. In a randomized, double-blind study, nonimmune travelers received malaria prophylaxis with atovaquone-proguanil (493 subjects) or mefloquine (483 subjects). Information about adverse events (AEs) and potential episodes of malaria was obtained 7, 28, and 60 days after travel. AEs were reported by an equivalent proportion of subjects who had received atovaquone-proguanil or mefloquine (71.4% versus 67.3%; difference, 4.1%; 95% confidence interval, -1.71 to 9.9). Subjects who received atovaquone-proguanil had fewer treatment-related neuropsychiatric AEs (14% versus 29%; P=.001), fewer AEs of moderate or severe intensity (10% versus 19%; P=.001), and fewer AEs that caused prophylaxis to be discontinued (1.2% versus 5.0%; P=.001), compared with subjects who received melfoquine. No confirmed diagnoses of malaria occurred in either group. Atovaquone-proguanil was better tolerated than was mefloquine, and it was similarly effective for malaria prophylaxis in nonimmune travelers.

Uncertainties regarding possible negative effects on the environment or on human health of authorizing tracing experiments in groundwater and surface waters led to the establishment of a Working Group at the German Federal Environmental Agency (Umweltbundesamt – UBA) for conducting a toxicological and ecotoxicological assessment. A total of 17 water tracers was assessed by the Working Group on the basis of the results of toxicological tests, the available literature, and the group's expert knowledge. In the future, tracers that pose a risk to the environment or to human health should no longer be used. Nevertheless, there are a number of tracers that could be used in hydrogeological and hydrological investigations for water-pollution-control purposes with no adverse environmental impact.

Summary Background The quality of medicines available in some less-developed countries is inadequate in terms of content of active ingredient. Reasons for the poor quality of drugs include widespread counterfeiting of medicines in less-developed countries, excessive decomposition of active ingredient as a result of high temperature and humidity, and poor quality assurance during the manufacture of medicinal products. Our aim was to investigate the quality of different drugs obtained from retail pharmacies in two urban areas of Nigeria, and, in instances of poor quality, to ascertain the reason why. Methods We randomly collected 581 samples of 27 different drugs from 35 pharmacies in Lagos and Abuja in Nigeria. We analysed the medicines for drug content by validated chromatographic methods, and compared our results with pharmacopoeial requirements. Findings 279 (48%) samples did not comply with set pharmacopoeial limits, and this proportion was uniform for the various types of drugs tested. Although some preparations contained no active ingredient, most had amounts just outside the pharmacopoeial limits. We identified samples with both too much and too little active drug content. Interpretation The most probable cause of the poor quality of drugs is absence of adequate quality assurance during manufacture. Substandard drugs sold in the pharmacies of less-developed countries could contribute to global microbial resistance and therapeutic failure of infectious diseases.

—We have investigated the diffusivity of trace elements in hydrous iron-free andesitic melts containing 4.5 to 5.2 wt.% water at a pressure of 500 MPa and at temperatures between 1100 and 1400°C using the diffusion couple technique. The studied elements can be combined in several groups of particular geochemical interest: low field strength elements (LFSE: Rb, Sr, Ba), transition elements (Cr, Fe, Ni, Zn), rare earth elements (REE: La, Nd, Sm, Eu, Gd, Er, Yb, Y), and high field strength elements (HFSE: Zr, Nb, Hf). The diffusion profiles of the trace elements were measured using the synchrotron X-ray fluorescence (SYXRF) microprobe. H2O distribution in the samples was analyzed by IR microspectroscopy. Diffusion profiles are excellently reproduced, assuming concentration-independent diffusion coefficients. For all trace elements, the temperature dependence of diffusion in the hydrous melt can be described by a simple Arrhenius law. In general, the diffusivity decreases from the LFSE, to transition elements, to REE, and to the HFSE, a trend that can be correlated to the increase of charge in the same order. The activation energy shows a similar trend, increasing from 129 kJ/mol for Rb to 189 kJ/mol for Zr. For the transition elements Cr and Fe, the activation energy is relatively high (228 and 193 kJ/mol, respectively), which can be explained by increasing contributions of divalent cations to the diffusion flux with increasing temperature. Higher diffusivity of Eu compared to its neighbor elements also is attributed to contributions of divalent cations. Modeling Eu-diffusivity using data of Sr as representative for Eu2+, and of Sm and Gd as representative for Eu3+, shows that at all temperatures Eu3+ is clearly dominating in the hydrous melt. To quantify the effect of water, an additional experiment was performed at 1400°C using a nominally anhydrous melt. The obtained diffusion coefficients are (for most of the elements) by one and a half orders of magnitude lower than for a melt containing 4.5 wt.% H2O. Chemical diffusion coefficients Dη, which were calculated from the viscosity data of Richet et al. (1996) using the Eyring equation, and which assumed a jump distance of 3 A, are in excellent agreement with the diffusivity of the HFSE for both dry and hydrous melt. Most of the investigated elements show a linear relation between log diffusivity and log viscosity, enabling the prediction of diffusivities in hydrous andesite systems at various conditions. Provided viscosity data are available, we suggest that this relation can be a useful tool to estimate trace element diffusivities for silicate melts with different compositions. The new diffusion data show that water strongly enhances diffusivity of trace elements in andesitic melts. After 10,000 yr at 1200°C, diffusion produces in the dry melt relatively short profiles with lengths (defined as x=(Dt)1/2) between 0.8 and 0.07 m (for Sr and Zr, respectively), whereas in hydrous melts (5 wt.% water), profiles are much longer with lengths between 3.9 and 0.92 m (for Sr and Zr, respectively).

We report results of a search for B-->tau(nu) in a sample of 9.7 x 10(6) charged B meson decays. We exclusively reconstruct the companion B decay to suppress background. We set an upper limit on the branching fraction B(B-->tau(nu)) K+/-nu(nu))

We report the first observation of exclusive decays of the type B-->D(*)N_NX, where N is a nucleon. Using a sample of 9.7x10(6)B_B pairs collected with the CLEO detector operating at the Cornell Electron Storage Ring, we measure the branching fractions B(B0-->D(*-)p_p pi(+)) = (6.5(+1.3)(-1.2)+/-1.0)x10(-4) and B(B0-->D(*-)p_n) = (14.5(+3.4)(-3.0)+/-2.7)x10(-4). Antineutrons are identified by their annihilation in the CsI electromagnetic calorimeter.

We analyze 9.7x10(6) B_B pairs recorded with the CLEO detector to determine the production ratio of charged to neutral B-meson pairs produced at the Upsilon(4S) resonance. We measure the rates for B0-->J/psiK((*)0) and B+-->J/psiK((*)+) decays and use the world-average B-meson lifetime ratio to extract the relative widths f(+-) / f(00) = gamma(Upsilon(4S)-->B+B-) / gamma(Upsilon(4S)-->B0 B-0)) = 1.04+/-0.07(stat)+/-0.04(syst). With the assumption that f(+-)+f(00) = 1, we obtain f(00) = 0.49+/-0.02(stat)+/-0.01(syst) and f(+-) = 0.51+/-0.02(stat)+/-0.01(syst). This production ratio and its uncertainty apply to all exclusive B-meson branching fractions measured at the Upsilon(4S) resonance.

A precise measurement of the Λ c + lifetime using approximately 1340 fully reconstructed Λ c + →pK - π + and charge conjugate decays is presented. The data were accumulated by the Fermilab high energy photoproduction experiment E687. The lifetime of the Λ c + is measured to be 0.215±0.016±0.008 ps

Using data recorded with the CLEO II and CLEO II.V detector configurations at the Cornell Electron Storage Rings, we report the first observation and mass measurement of the ${\ensuremath{\Sigma}}_{c}^{*+}$ charmed baryon, and an updated measurement of the mass of the ${\ensuremath{\Sigma}}_{c}^{+}$ baryon. We find $M({\ensuremath{\Sigma}}_{c}^{*+})\ensuremath{-}M({\ensuremath{\Lambda}}_{c}^{+})\phantom{\rule{0ex}{0ex}}=\phantom{\rule{0ex}{0ex}}(231.0\ifmmode\pm\else\textpm\fi{}1.1\ifmmode\pm\else\textpm\fi{}2.0)\phantom{\rule{0ex}{0ex}}\mathrm{MeV}$, and $M({\ensuremath{\Sigma}}_{c}^{+})\ensuremath{-}M({\ensuremath{\Lambda}}_{c}^{+})\phantom{\rule{0ex}{0ex}}=\phantom{\rule{0ex}{0ex}}(166.4\ifmmode\pm\else\textpm\fi{}0.2\ifmmode\pm\else\textpm\fi{}0.3)\phantom{\rule{0ex}{0ex}}\mathrm{MeV}$, where the errors are statistical and systematic, respectively.

In a sample of $9.66\times 10^6 B\bar{B}$ pairs collected with the CLEO detector we make the first observation of B decays to an $\eta_c$ and a kaon. We measure branching fractions $BR(B^+\to\eta_c K^+) = (0.69 + 0.26 - 0.21 +- 0.08 +- 0.20)\times 10^{-3}$ and $BR(B^0\to\eta_c K^0) = (1.09 + 0.55 - 0.42 +- 0.12 +- 0.31)\times 10^{-3}$, where the first error is statistical, the second is systematic and the third is from the $\eta_c$ branching fraction uncertainty. From these we extract the $\eta_c$ decay constant in the factorization approximation, $f_{\eta_c} = 335 +- 75$ MeV. We also search for B decays to a $\chi_{c0}$ and a kaon. No evidence for a signal is found and we set 90% CL upper limits: $BR(B^+\to\chi_{c0} K^+) < 4.8\times 10^{-4}$ and $BR(B^0\to\chi_{c0} K^0) < 5.0\times 10^{-4}$.

Enterotoxigenic Escherichia coli (ETEC) is a major cause of travellers' diarrhoea. We investigated the efficacy and safety of a skin-patch vaccine containing the pathogen's heat-labile toxin (LT) in a population of travellers to Mexico and Guatemala.In this phase 3, randomised, double-blind, placebo-controlled field trial, healthy adults (aged 18-64 years) travelling from Germany or the UK to Mexico or Guatemala were assigned in a 1:1 ratio by a dynamic electronic randomisation system to receive transcutaneous immunisation with a patch containing 37.5 μg of ETEC LT or a placebo patch. Participants, site staff, and the investigators who did the analyses were masked to group assignment. Participants were vaccinated before travel, with two patches given 14 days apart. In the destination country, participants tracked stool output in a diary and provided stool samples for pathogen identification if diarrhoea occurred. The primary endpoint was the proportion of participants with at least one episode of moderate-to-severe diarrhoea (defined as four or more unformed stools in a 24 h period) in which either or both ETEC enterotoxins (LT and heat-stable toxin [ST]) were detected. The study is registered at ClinicalTrials.gov, number NCT00993681.2036 participants were recruited and randomly assigned between Oct 14, 2009, and Aug 13, 2010, with 1016 allocated to receive the LT patch and 1020 the placebo patch. 821 participants in the LT-patch group and 823 in the placebo group received both vaccinations and were analysed in the per-protocol population. 30 (3.7%, 95% CI 2.5-5.2) participants in the LT-patch group and 46 (5.6%, 4.1-7.4) in the placebo group had moderate or severe ETEC diarrhoea (vaccine efficacy 34.6%, -2.2 to 58.9; p=0.0621). 9333 local (ie, patch-site) adverse events (including erythema, rash, pruritus, hyperpigmentation, pain, hypopigmentation, and oedema) occurred in 943 (93%) of 1015 participants in the LT-patch group, compared with 1444 local adverse events in 574 (56%) of 1019 participants in the placebo group (p0.0001). Serious adverse events occurred in 25 participants (14 in the LT-patch group and 11 in the placebo group), with all regarded as either unrelated or possibly related to treatment. Vaccine-induced hyperpigmentation persisted for at least 180 days after vaccination in 150 (18%) of the 849 participants who received both vaccinations and returned for final assessment in the LT-patch group, compared with none of the 842 participants in the placebo group. The vaccine was immunogenic, with a post-vaccination geometric mean titre of LT-specific serum immunoglobulin G of 3400.29, compared with 315.41 in the placebo group.Although the LT antigen was delivered effectively by the skin patch, the vaccine did not protect travellers against diarrhoea caused by ETEC or other organisms. Future vaccines against travellers' diarrhoea might need to include several antigens against various diarrhoeal pathogens, and might need to be able to generate mucosal and higher systemic immunity.

First a short survey of modelling of technical systems is presented. The different methods of modelling are applied to hydrodynamic torque converters and couplings. The results of linear modelling around an operating point, of nonlinear modelling for larger operating areas and of hybrid modelling using simplified physical laws are illustrated. Simulations for large excitations show the validity of the models. The advantages and disadvantages of the different methods are discussed.

We have studied charmless hadronic decays of B mesons into two-body final states with kaons and pions and observe three new processes with the following branching fractions: B(B{yields}{pi}{sup +}{pi}{sup -})=(4.3{sup +1.6}{sub -1.4}{+-}0.5)x10{sup -6} , B(B{yields}K{sup 0}{pi}{sup 0}) =(14.6{sup +5.9+2.4}{sub -5.1-3.3})x 10{sup -6} , and B(B{yields}K{sup {+-}}{pi}{sup 0} )=(11.6{sup +3.0+1.4}{sub -2.7-1.3}) x10{sup -6} . We also update our previous measurements for the decays B{yields}K{sup {+-}}{pi}{sup {+-}} and B{sup {+-}}{yields}K{sup 0}{pi}{sup {+-}} . (c) 2000 The American Physical Society.

We search for CP-violating asymmetries (Acp) in the B meson decays to K+- pi-+, K+- pi0, Ks pi+-, K+- eta', and omega pi+-. Using 9.66 million Upsilon(4S) decays collected with the CLEO detector, the statistical precision on Acp is in the range of \pm 0.12 to \pm 0.25 depending on decay mode. While CP-violating asymmetries of up to \pm 0.5 are possible within the Standard Model, the measured asymmetries are consistent with zero in all five decay modes studied., 10 pages, 3 figures

We present a search for direct CP violation in B{sup {+-}}{yields}J/{psi}K{sup {+-}} and B{sup {+-}}{yields}{psi}(2S)K{sup {+-}} decays. In a sample of 9.7x10{sup 6} BB meson pairs collected with the CLEO detector, we have fully reconstructed 534 B{sup {+-}}{yields}J/{psi} K{sup {+-}} and 120 B{sup {+-}}{yields}{psi}(2 S)K{sup {+-}} decays with very low background. We have measured the CP -violating charge asymmetry to be [+1.8{+-}4.3(stat){+-}0. 4(syst)]% for B{sup {+-}}{yields}J/{psi}K{sup {+-}} and [+2.0{+-}9.1(stat){+-}1. 0(syst)]% for B{sup {+-}}{yields}{psi}(2S)K{sup {+-}} . (c) 2000 The American Physical Society.

We report results of a search for the rare radiative decay B(bar sign){sup 0}{yields}D{sup *0} {gamma} . Using 9.66x10{sup 6} BB(bar sign) meson pairs collected with the CLEO detector at the Cornell Electron Storage Ring, we set an upper limit on the branching ratio for this decay of 5.0x10{sup -5} at 90% C.L. This provides evidence that the anomalous enhancement is absent in W -exchange processes and that weak radiative B decays are dominated by the short-distance b{yields}s{gamma} mechanism in the standard model. (c) 2000 The American Physical Society.

The growth of travel of recent years has been unprecedented and presents new challenges to health professionals worldwide. More travelers of diverse backgrounds are visiting exotic locales rarely encountered before. This poses new risks to health, in addition to potentially aiding the spread of emerging respiratory infections. Travelers such as immunocompromised individuals and members of ethnic minorities are at significant risk for travel-related infections. Respiratory illnesses are some of the most common infections affecting human beings, yet little information has been published on them in relation to travel. Multidisciplinary approaches and collaboration across different sectors are needed to address the many issues involved in travel-related respiratory infections. This article discusses some of the topical issues of respiratory tract infections occurring in travelers.

We present the first observation of the decay B{yields}J/{psi}{phi}K . Using 9.6x10{sup 6} BB meson pairs collected with the CLEO detector, we have observed ten fully reconstructed B{yields}J/{psi}{phi}K candidates, whereas the estimated background is 0.5{+-}0.2 event. We obtain a branching fraction of B(B{yields}J/{psi}{phi}K)=( 8.8{sup +3.5}{sub -3.0}[stat] {+-}1.3[syst])x10{sup -5} . This is the first observed B meson decay requiring the creation of an additional ss quark pair. (c) 2000 The American Physical Society.

We have searched for the rare decays of the eta prime meson to e+ e- eta, e+ e- pizero, e+ e- gamma, and e mu in hadronic events at the CLEO II detector. The search is conducted on 4.80 fb^-1 of e+ e- collisions at the Cornell Electron Storage Ring. We find no signal in any of these modes, and set 90% confidence level upper limits on their branching fractions of 2.4 X 10^-3, 1.4 X 10^-3, 0.9 X 10^-3, and 4.7 X 10^-4, respectively. We also investigate the Dalitz plot of the common decay of the eta prime to pi+ pi- eta. We fit the matrix element with the Particle Data Group parameterization and find Re(alpha) = -0.021 +- 0.025, where alpha is a linear function of the kinetic energy of the eta.