Tombstone of unidentified Levite; Old Cemetery; Oberstrasse, Hannover Cemeteries Tombs

The hand pouring water from a jug indicates a descendant of the Levi tribe, whose function in the Temple was to wash the hands of the Priest (tombstone unrelated to the Gottschalk or Krakauer families)

Bacillus cereus spores and cereulide in food-borne illness

B. cereus is a gram-positive bacterium that possesses two different forms of life:the large, rod-shaped cells (ca. 0.002 mm by 0.004 mm) that are able to propagate and the small (0.001 mm), oval shaped spores. The spores can survive in almost any environment for up to centuries without nourishment or water. They are insensitive towards most agents that normally kill bacteria: heating up to several hours at 90 ºC, radiation, disinfectants and extreme alkaline (≥ pH 13) and acid (≤ pH 1) environment. The spores are highly hydrophobic and therefore make them tend to stick to all kinds of surfaces, steel, plastics and live cells. In favorable conditions the spores of B. cereus may germinate into vegetative cells capable of producing food poisoning toxins. The toxins can be heat-labile protein formed after ingestion of the contaminated food, inside the gastrointestinal tract (diarrhoeal toxins), or heat stable peptides formed in the food (emesis causing toxin, cereulide). Cereulide cannot be inactivated in foods by cooking or any other procedure applicable on food. Cereulide in consumed food causes serious illness in human, even fatalities. In this thesis, B. cereus strains originating from different kinds of foods and environments and 8 different countries were inspected for their capability of forming cereulide. Of the 1041 isolates from soil, animal feed, water, air, used bedding, grass, dung and equipment only 1.2 % were capable of producing cereulide, whereas of the 144 isolates originating from foods 24 % were cereulide producers. Cereulide was detected by two methods: by its toxicity towards mammalian cells (sperm assay) and by its peculiar chemical structure using liquid-chromatograph-mass spectrometry equipment. B. cereus is known as one of the most frequent bacteria occurring in food. Most foods contain more than one kind of B. cereus. When randomly selected 100 isolates of B. cereus from commercial infant foods (dry formulas) were tested, 11% of these produced cereulide. Considering a frequent content of 103 to 104 cfu (colony forming units) of B. cereus per gram of infant food formula (dry), it appears likely that most servings (200 ml, 30 g of the powder reconstituted with water) may contain cereulide producers. When a reconstituted infant formula was inoculated with >105 cfu of cereulide producing B. cereus per ml and left at room temperature, cereulide accumulated to food poisoning levels (> 0.1 mg of cereulide per serving) within 24 hours. Paradoxically, the amount of cereulide (per g of food) increased 10 to 50 fold when the food was diluted 4 - 15 fold with water. The amount of the produced cereulide strongly depended on the composition of the formula: most toxin was formed in formulas with cereals mixed with milk, and least toxin in formulas based on milk only. In spite of the aggressive cleaning practices executed by the modern dairy industry, certain genotypes of B. cereus appear to colonise the silos tanks. In this thesis four strategies to explain their survival of their spores in dairy silos were identified. First, high survival (log 15 min kill ≤ 1.5) in the hot alkaline (pH >13) wash liquid, used at the dairies for cleaning-in-place. Second, efficient adherence of the spores to stainless steel from cold water. Third, a cereulide producing group with spores characterized by slow germination in rich medium and well preserved viability when exposed to heating at 90 ºC. Fourth, spores capable of germinating at 8 ºC and possessing the psychrotolerance gene, cspA. There were indications that spores highly resistant to hot 1% sodium hydroxide may be effectively inactivated by hot 0.9% nitric acid. Eight out of the 14 dairy silo tank isolates possessing hot alkali resistant spores were capable of germinating and forming biofilm in whole milk, not previously reported for B. cereus. In this thesis it was shown that cereulide producing B. cereus was capable of inhibiting the growth of cereulide non-producing B. cereus occurring in the same food. This phenomenon, called antagonism, has long been known to exist between B. cereus and other microbial species, e.g. various species of Bacillus, gram-negative bacteria and plant pathogenic fungi. In this thesis intra-species antagonism of B. cereus was shown for the first time. This brother-killing did not depend on the cereulide molecule, also some of the cereulide non-producers were potent antagonists. Interestingly, the antagonistic clades were most frequently found in isolates from food implicated with human illness. The antagonistic property was therefore proposed in this thesis as a novel virulence factor that increases the human morbidity of the species B. cereus, in particular of the cereulide producers.

Peritoneal washing cytology

Peritoneal washing cytology (PWC) is a useful indicator of ovarian surface involvement and peritoneal dissemination by ovarian tumours. It may identify subclinical peritoneal spread and thus provide valuable staging and prognostic information, particularly for non-serous ovarian tumours. The role of PWC as a prognostic indicator for endometrial carcinoma is less clear, due in part to the questionable significance of identifying endometrial tumour cells in the peritoneum. Detection of metastatic carcinoma in PWC is based on recognition of non-mesothelial cell characteristics, however a number of conditions such as reactive mesothelial cells, endometriosis and endosalpingiosis may mimic this appearance. Cells from these conditions may have a similar presentation in PWC to that of serous borderline tumours and low grade serous carcinoma. The presence of cilia, lack of single atypical cells, prominent cytoplasmic vacuolation, marked nuclear atypia or two distinct cell populations are features favouring a benign process. Attention to these features along with close correlation with clinical history and the results of surgical pathology should help avoid errors. Additional assistance may be provided by the use of cell blocks and special stains.

Terezin, The Deportation Train.

Signed and dated lower right.

Consumption of anthocyanin-rich Queen Garnet plum juice reduces platelet activation related thrombogenesis in healthy volunteers

The anti-thrombotic properties of an anthocyanin-rich Queen Garnet plum juice (QGPJ) and anthocyanin-free prune juice (PJ) were studied in this randomised, double-blind, crossover trial. Twenty-one healthy subjects (M = 10, F = 11) consumed QGPJ, PJ or placebo, 200 mL/day for 28-days followed by a 2-week wash-out period. Only QGPJ supplementation inhibited platelet aggregation induced by ADP (<5%, P = 0.02), collagen (<2.7%, P < 0.001) and arachidonic acid (<4%, P < 0.001); reduced platelet activation-dependent surface-marker P-selectin expression of activated de-granulated platelets (<17.2%, P = 0.04); prolonged activated-partial thromboplastin clotting time (>2.1 s, P = 0.03); reduced plasma-fibrinogen (<7.5%, P = 0.02) and malondialdehyde levels, a plasma biomarker of oxidative stress ( P = 0.016). PJ supplementation increased plasma hippuric acid content ( P = 0.018). QGPJ or PJ supplementation did not affect blood cell counts, lipid profile, or inflammation markers. Our findings suggest that QGPJ but not PJ has the potential to significantly attenuate thrombosis by reducing platelet activation/hyper-coagulability and oxidative stress.

IWGDF guidance on the prevention of foot ulcers in at-risk patients with diabetes

Recommendations - 1 To identify a person with diabetes at risk for foot ulceration, examine the feet annually to seek evidence for signs or symptoms of peripheral neuropathy and peripheral artery disease. (GRADE strength of recommendation: strong; Quality of evidence: low) - 2 In a person with diabetes who has peripheral neuropathy, screen for a history of foot ulceration or lower-extremity amputation, peripheral artery disease, foot deformity, pre-ulcerative signs on the foot, poor foot hygiene and ill-fitting or inadequate footwear. (Strong; Low) - 3 Treat any pre-ulcerative sign on the foot of a patient with diabetes. This includes removing callus, protecting blisters and draining when necessary, treating ingrown or thickened toe nails, treating haemorrhage when necessary and prescribing antifungal treatment for fungal infections. (Strong; Low) - 4 To protect their feet, instruct an at-risk patient with diabetes not to walk barefoot, in socks only, or in thin-soled standard slippers, whether at home or when outside. (Strong; Low) - 5 Instruct an at-risk patient with diabetes to daily inspect their feet and the inside of their shoes, daily wash their feet (with careful drying particularly between the toes), avoid using chemical agents or plasters to remove callus or corns, use emollients to lubricate dry skin and cut toe nails straight across. (Weak; Low) - 6 Instruct an at-risk patient with diabetes to wear properly fitting footwear to prevent a first foot ulcer, either plantar or non-plantar, or a recurrent non-plantar foot ulcer. When a foot deformity or a pre-ulcerative sign is present, consider prescribing therapeutic shoes, custom-made insoles or toe orthosis. (Strong; Low) - 7 To prevent a recurrent plantar foot ulcer in an at-risk patient with diabetes, prescribe therapeutic footwear that has a demonstrated plantar pressure-relieving effect during walking (i.e. 30% relief compared with plantar pressure in standard of care therapeutic footwear) and encourage the patient to wear this footwear. (Strong; Moderate) - 8 To prevent a first foot ulcer in an at-risk patient with diabetes, provide education aimed at improving foot care knowledge and behaviour, as well as encouraging the patient to adhere to this foot care advice. (Weak; Low) - 9 To prevent a recurrent foot ulcer in an at-risk patient with diabetes, provide integrated foot care, which includes professional foot treatment, adequate footwear and education. This should be repeated or re-evaluated once every 1 to 3 months as necessary. (Strong; Low) - 10 Instruct a high-risk patient with diabetes to monitor foot skin temperature at home to prevent a first or recurrent plantar foot ulcer. This aims at identifying the early signs of inflammation, followed by action taken by the patient and care provider to resolve the cause of inflammation. (Weak; Moderate) - 11 Consider digital flexor tenotomy to prevent a toe ulcer when conservative treatment fails in a high-risk patient with diabetes, hammertoes and either a pre-ulcerative sign or an ulcer on the distal toe. (Weak; Low) - 12 Consider Achilles tendon lengthening, joint arthroplasty, single or pan metatarsal head resection, or osteotomy to prevent a recurrent foot ulcer when conservative treatment fails in a high-risk patient with diabetes and a plantar forefoot ulcer. (Weak; Low) - 13 Do not use a nerve decompression procedure in an effort to prevent a foot ulcer in an at-risk patient with diabetes, in preference to accepted standards of good quality care. (Weak; Low)

Study of temperature distribution along an artificially polluted insulator string

Insulator becomes wet partially or completely, and the pollution layer on it becomes conductive, when collecting pollutants for an extended period during dew, light rain, mist, fog or snow melting. Heavy rain is a complicated factor that it may wash away the pollution layer without initiating other stages of breakdown or it may bridge the gaps between sheds to promote flashover. The insulator with a conducting pollution layer being energized, can cause a surface leakage current to flow (also temperature-rise). As the surface conductivity is non-uniform, the conducting pollution layer becomes broken by dry bands (at spots of high current density), interrupting the flow of leakage current. Voltage across insulator gets concentrated across dry bands, and causes high electric stress and breakdown (dry band arcing). If the resistance of the insulator surface is sufficiently low, the dry band arcs can be propagated to bridge the terminals causing flashover. The present paper concerns the evaluation of the temperature distribution along the surface of an energized artificially polluted insulator string.

Serodiagnosis of Tuberculosis in Asian Elephants (Elephas maximus) in Southern India: A Latent Class Analysis

Background: Mycobacterium tuberculosis, a causative agent of chronic tuberculosis disease, is widespread among some animal species too. There is paucity of information on the distribution, prevalence and true disease status of tuberculosis in Asian elephants (Elephas maximus). The aim of this study was to estimate the sensitivity and specificity of serological tests to diagnose M. tuberculosis infection in captive elephants in southern India while simultaneously estimating sero-prevalence. Methodology/Principal Findings: Health assessment of 600 elephants was carried out and their sera screened with a commercially available rapid serum test. Trunk wash culture of select rapid serum test positive animals yielded no animal positive for M. tuberculosis isolation. Under Indian field conditions where the true disease status is unknown, we used a latent class model to estimate the diagnostic characteristics of an existing (rapid serum test) and new (four in-house ELISA) tests. One hundred and seventy nine sera were randomly selected for screening in the five tests. Diagnostic sensitivities of the four ELISAs were 91.3-97.6% (95% Credible Interval (CI): 74.8-99.9) and diagnostic specificity were 89.6-98.5% (95% CI: 79.4-99.9) based on the model we assumed. We estimate that 53.6% (95% CI: 44.6-62.8) of the samples tested were free from infection with M. tuberculosis and 15.9% (97.5% CI: 9.8 - to 24.0) tested positive on all five tests. Conclusions/Significance: Our results provide evidence for high prevalence of asymptomatic M. tuberculosis infection in Asian elephants in a captive Indian setting. Further validation of these tests would be important in formulating area-specific effective surveillance and control measures.

The physicochemical characteristics and anaerobic degradability of desiccated coconut industry waste water

Desiccated coconut industries (DCI) create various intermediates from fresh coconut kernel for cosmetic, pharmaceutical and food industries. The mechanized and non-mechanized DCI process between 10,000 and 100,000 nuts/day to discharge 6-150 m(3) of malodorous waste water leading to a discharge of 2646642 kg chemical oxygen demand (COD) daily. In these units, three main types of waste water streams are coconut kernel water, kernel wash water and virgin oil waste water. The effluent streams contain lipids (1-55 g/l), suspended solids (6-80 g/l) and volatile fatty acids (VFA) at concentrations that are inhibitory to anaerobic bacteria. Coconut water contributes to 20-50 % of the total volume and 50-60 % of the total organic loads and causes higher inhibition of anaerobic bacteria with an initial lag phase of 30 days. The lagooning method of treatment widely adopted failed to appreciably treat the waste water and often led to the accumulation of volatile fatty acids (propionic acid) along with long-chain unsaturated free fatty acids. Biogas generation during biological methane potential (BMP) assay required a 15-day adaptation time, and gas production occurred at low concentrations of coconut water while the other two streams did not appear to be inhibitory. The anaerobic bacteria can mineralize coconut lipids at concentrations of 175 mg/l; however; they are severely inhibited at a lipid level of = 350 mg/g bacterial inoculum. The modified Gompertz model showed a good fit with the BMP data with a simple sigmoid pattern. However, it failed to fit experimental BMP data either possessing a longer lag phase and/or diauxic biogas production suggesting inhibition of anaerobic bacteria.

Fertilidad del suelo bajo prácticas agroecológicas y manejo convencional en el cultivo de café, Nicaragua 2009 - 2010

La implementación de prácticas agroecológicas en plantaciones de café (Coffea arabica L.), es vital para el mantenimiento y aumento de la fertilidad de los suelos y el manejo sostenible del sistema. Este estudio se realizó de junio de 2009 a enero de 2010 en el Jardín Botánico y en el Centro Experimental Campos Azules, en Masatepe, Nicaragua, ubicados entre los 11°54” de latitud norte y 86° 09” de longitud oeste. El propósito fue evaluar dos prácticas agroecológicas y un manejo convencional en el cultivo de café sobre la fertilidad física, química y biológica del suelo. Se utilizó un arreglo unifactorial en diseño bloques completo al azar (BCA)con tres repeticiones. El tratamiento agroecológico uno consistió en la aplicación de 2.27 kg de pulpa de café más 1.82 kg de gallinaza por planta y aspersiones mensuales de dos litros de biofermentado con manejo mecánico y selectivo de los árboles de sombra y arvenses. En el segundo tratamiento agroecológico, se aplicó 2.27 kilogramos de pulpa de café por planta con igual manejo de árboles de sombra y arvenses que el agroecológico uno. En ambos tratamientos agroecologicos, las especies arbóreas fueron guaba [Inga laurina(Sw.) Willd] y genízaro [Samanea saman (Jacq) Merr., J. Wash]. El manejo convencional consistió en la aplicación de 318 kg ha-1de fertilizante sintético, aplicando 25% en forma de urea al 46% y el restante 75% a través de la fórmula 12-30-10 y 27-09-18 en tres aplicaciones durante la época lluviosa, así como dos aplicaciones foliares de microelementos y, herbicidas para el manejo de arvenses. Las variables fueron densidad aparente, porosidad, retención de agua, materia orgánica, nitrógeno total, carbono orgánico, pH, capacidad de intercambio catiónico, diversidad de macrofauna del suelo, cuantificación de bacterias y hongos. No existen diferencias entre los componentes de la fertilidad física y química del suelo, sin embargo, los sistemas con prácticas agroecológicas registran mayor porosidad y retención de humedad, y menor densidad aparente; así como valores más altos de materia orgánica, capacidad de intercambio catiónico, carbono orgánico, nitrógeno total, pH e índices de diversidad de macrofauna. No se registra diferencia en las poblaciones de bacterias, pero sí de hongos en el período lluvioso. El rendimiento acumulado de café no difier e pero existe una tendencia en el sistema agroecológico uno al incremento e incluso a superar al manejo convencional. Los resultados sugieren que la implementación de prácticas agroecológicas contribuye de manera sustancial con la fertilidad global del suelo.

Rescue, rehabilitation, and release of marine mammals: An analysis of current views and practices.

Stranded marine mammals have long attracted public attention. Those that wash up dead are, for all their value to science, seldom seen by the public as more than curiosities. Animals that are sick, injured, orphaned or abandoned ignite a different response. Generally, public sentiment supports any effort to rescue, treat and return them to sea. Institutions displaying marine mammals showed an early interest in live-stranded animals as a source of specimens -- in 1948, Marine Studios in St. Augustine, Florida, rescued a young short-finned pilot whale (Globicephala macrorhynchus), the first ever in captivity (Kritzler 1952). Eventually, the public as well as government agencies looked to these institutions for their recognized expertise in marine mammal care and medicine. More recently, facilities have been established for the sole purpose of rehabilitating marine mammals and preparing them for return to the wild. Four such institutions are the Marine Mammal Center (Sausalito, CA), the Research Institute for Nature Management (Pieterburen, The Netherlands), the RSPCA, Norfolk Wildlife Hospital (Norfolk, United Kingdom) and the Institute for Wildlife Biology of Christian-Albrects University (Kiel, Germany).(PDF contains 68 pages.)

Role of G protein coupled inwardly rectifier K+ channels (GIRK) on the neurobiology depression

353 págs.

Untersuchungen zu biologischen Schadstoffeffekten bei Nordseefischen: Langzeitdaten zum Auftreten von Lebertumoren bei der Kliesche (Limanda limanda)

Data are presented on the spatial distribution and long-term temporal trends in the occurrence of neoplastic liver lesions of North Sea dab (Limanda limanda) in the period 1988 to 2001, obtained in the framework of the regular fish disease monitoring programme carried out by the German Federal Research Centre for Fishery. Highest prevalences consistently recorded in the first part of the period occurred in the German Bight, at the Dogger Bank and at sampling sites off Humber and Wash. In contrast, stations in the northern North Sea (e.g. in the Firth of Forth area) were always characterised by low prevalences. Particularly during the first years of observation, a clear and general decrease in prevalence could be observed, that was most pronounced in the hot spot areas German Bight and Dogger Bank compared to the Firth of Forth. Current data reveal that, due to the decrease, spatial differences between sampling sites are now much less obvious than at the beginning of the studies. Limited chemical data available suggest that the temporal decrease in prevalence of liver tumours and their precursor stages generally correspond with the decrease in organic contaminants in dab livers as well as in water and sediments. However, the spatial variation in prevalence recorded can not entirely be explained by contaminant levels. For instance, the prevalence was continuously low in the Firth of Forth area wheras the contaminant levels in dab were comparatively high. The opposite feature was observed at the Dogger Bank. Future studies will therefore address the role of other host- and site-specific factors potentially involved in the aetiology of the disease.

Signal transduction with hybridization chain reactions

Some of the most exciting developments in the field of nucleic acid engineering include the utilization of synthetic nucleic acid molecular devices as gene regulators, as disease marker detectors, and most recently, as therapeutic agents. The common thread between these technologies is their reliance on the detection of specific nucleic acid input markers to generate some desirable output, such as a change in the copy number of an mRNA (for gene regulation), a change in the emitted light intensity (for some diagnostics), and a change in cell state within an organism (for therapeutics). The research presented in this thesis likewise focuses on engineering molecular tools that detect specific nucleic acid inputs, and respond with useful outputs.

Four contributions to the field of nucleic acid engineering are presented: (1) the construction of a single nucleotide polymorphism (SNP) detector based on the mechanism of hybridization chain reaction (HCR); (2) the utilization of a single-stranded oligonucleotide molecular Scavenger as a means of enhancing HCR selectivity; (3) the implementation of Quenched HCR, a technique that facilitates transduction of a nucleic acid chemical input into an optical (light) output, and (4) the engineering of conditional probes that function as sequence transducers, receiving target signal as input and providing a sequence of choice as output. These programmable molecular systems are conceptually well-suited for performing wash-free, highly selective rapid genotyping and expression profiling in vitro, in situ, and potentially in living cells.

Preparo e administração de medicamentos por sondas em pacientes que recebem nutrição enteral

O objeto de estudo foi o preparo e a administração de medicamentos por cateter pela enfermagem em pacientes que recebem nutrição enteral. O objetivo geral foi investigar o padrão de preparo e administração dos medicamentos por cateter em pacientes que recebem nutrição enteral concomitante. Os objetivos específicos foram apresentar o perfil dos medicamentos preparados e administrados de acordo com a possibilidade de serem administrados por cateter enteral e avaliar o tipo e a freqüência de erros que ocorrem no preparo e administração de medicamentos por cateter. Tratou-se de uma pesquisa com desenho transversal de natureza observacional, sem modelo de intervenção. Foi desenvolvida em um hospital do Rio de Janeiro onde foram observados técnicos de enfermagem preparando e administrando medicamentos por cateter na Unidade de Terapia Intensiva. Foram observadas 350 doses de medicamentos sendo preparados e administrados. Os grupos de medicamentos prevalentes foram os que agem no Sistema Cardiovascular Renal com 164 doses (46,80%), seguido pelos que agem no Sistema Respiratório e Sangue com 12,85% e 12,56% respectivamente. Foram encontrados 19 medicamentos diferentes do primeiro grupo, dois no segundo e cinco no terceiro. As categorias de erro no preparo foram trituração, diluição e misturas. Encontrou-se uma taxa média de 67,71% no preparo de medicamentos. Comprimidos simples foram preparados errados em 72,54% das doses, e todos os comprimidos revestidos e de liberação prolongada foram triturados indevidamente entre sólidos a categoria de erro prevalente foi trituração com 45,47%, preparar misturando medicamentos foi um erro encontrado em quase 40% das doses de medicamentos sólidos. A trituração insuficiente ocorreu em 73,33% das doses de ácido fólico, do cloridrato de amiodarona (58,97%) e bromoprida (50,00%). A mistura com outros medicamentos ocorreu em 66,66% das doses de bromoprida, de besilato de anlodipina (53,33%), bamifilina (43,47%), ácido fólico (40,00%) e ácido acetilsalicílico (33,33%). Os erros na administração foram ausência de pausa e manejo indevido do cateter. A taxa média de erros na administração foi de 32,64%, distribuídas entre 17,14% para pausa e 48,14% para manejo do cateter. A ausência de lavagem do cateter antes foi o erro mais comum e o mais incomum foi não lavar o cateter após a administração. Os medicamentos mais envolvidos em erros na administração foram: cloridrato de amiodarona (n=39), captopril (n=33), cloridrato de hidralazina (n=7), levotiroxina sódica (n=7). Com relação à lavagem dos cateteres antes, ela não ocorreu em 330 doses de medicamentos. O preparo e administração inadequados de medicamentos podem levar à perdas na biodisponibilidade, diminuição do nível sérico e riscos de intoxicações para o paciente. Preparar e administrar medicamentos são procedimentos comuns, porém apresentou altas taxas de erros, o que talvez reflita pouco conhecimento desses profissionais sobre as boas práticas da terapia medicamentosa. Constata-se a necessidade de maior investimento de todos os profissionais envolvidos, médicos, enfermeiros e farmacêuticos nas questões que envolvam a segurança com medicamentos assim como repensar o processo de trabalho da enfermagem.