Enhanced Seminal Plasma Ribonuclease Activities in Azoospermia,Severe Oligiozoospermia,and Asthenozoospermia

Acid and alkaline ribonuclease (RNAase) activities were measured in human seminal plasma. The samples were obtained from patients attending an Infertility Clinic and were separated into groups according to the concentration and motility of spermatozoa. Levels of acid and alkaline RNAase activities in seminal plasma were, respectively, 22 and 13 times the values found in blood plasma. The severe oligozoospermic and azoospermic groups showed significantly higher alkaline RNAase activities in the seminal plasma than the normozoospermic group. The group with sperm motility < 50% showed significantly higher acid and alkaline RNAase activities than the group with motility ? 50%. Enhanced RNAase activities may be involved in the process of bringing about a reduced formation and maturation and a reduced motility of spermatozoa.     

自动毫安技术在腹部增强CT检查中可行性研究

目的:探讨腹部CT增强检查中使用自动毫安(ATCM)技术对降低患者辐射剂量的可行性方法:搜集50例腹部疾病的患者行自纵隔上2 mm至髂嵴线水平CT容积扫描,每例常规3期(平扫期、动脉期、静脉期),随机分为固定毫安(FM)组和自动毫安(ATCM)技术组,FM组使用固定300 mA,ATCM组使用自动毫安技术,通过预实验改变噪声指数(NI)调节管电流,得出NI值为9.10 Hu时图像质量与辐射剂量匹配较佳;分别选择隔下腹主动脉、肝门静脉作为观察平面,对2种毫安技术的图像质量、图像噪声和辐射剂量均采用t检验方法进行统计学分析 结果:FM组的辐射剂量平均CTDIvol为23.68 mGy,平均DLP为597.22 mGy·cm;ATCM组的平均CTDIvol为6.44 mCy,平均DLP为154.226 mGy·cm,比FM组降低约74.2％2组差异有统计学意义(CTDIvol、DLP的t值分别为45.100、112.57,P值均＜0.05)结论:在腹部增强CT检查中使用自动毫安控制技术,在保证图像质量的前提下,可以使患者所受辐射剂量降低约74.2％.     

Enhanced surveillance of coccidioidomycosis, Arizona, USA, 2007-2008

Coccidioidomycosis is endemic to the southwestern United States; 60% of nationally reported cases occur in Arizona. Although the Council of State and Territorial Epidemiologists case definition for coccidioidomycosis requires laboratory and clinical criteria, Arizona uses only laboratory criteria. To validate this case definition and characterize the effects of coccidioidomycosis in Arizona, we interviewed every tenth case-patient with coccidioidomycosis reported during January 2007-February 2008. Of 493 patients interviewed, 44% visited the emergency department, and 41% were hospitalized. Symptoms lasted a median of 120 days. Persons aware of coccidioidomycosis before seeking healthcare were more likely to receive an earlier diagnosis than those unaware of the disease (p = 0.04) and to request testing for Coccidioides spp. (p = 0.05). These findings warrant greater public and provider education. Ninety-five percent of patients interviewed met the Council of State and Territorial Epidemiologists clinical case definition, validating the Arizona laboratory-based case definition for surveillance in a coccidiodomycosis-endemic area.     

Enhanced Surveillance during the Democratic National Convention,Charlotte, NC

Objective

To describe how the existing state syndromic surveillance system (NC DETECT) was enhanced to facilitate surveillance conducted at the Democratic National Convention in Charlotte, North Carolina from August 31, 2012 to September 10, 2012.

Introduction

North Carolina hosted the 2012 Democratic National Convention, September 3–6, 2012. The NC Epidemiology and Surveillance Team was created to facilitate enhanced surveillance for injuries and illnesses, early detection of outbreaks during the DNC, assist local public health with epidemiologic investigations and response, and produce daily surveillance reports for internal and external stakeholders. Surveillane data were collected from several data sources, including North Carolina Electronic Disease Surveillance System (NC EDSS), triage stations, and the North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT).NC DETECT was created by the North Carolina Division of Public Health (NC DPH) in 2004 in collaboration with the Carolina Center for Health Informatics (CCHI) in the UNC Department of Emergency Medicine to address the need for early event detection and timely public health surveillance in North Carolina using a variety of secondary data sources. The data from emergency departments, the Carolinas Poison Center, the Pre-hospital Medical Information System (PreMIS) and selected Urgent Care Centers were available for monitoring by authorized users during the DNC.

Methods

Within NC DETECT, new dashboards were created that allowed epidemiologists to monitor ED visits and calls to the poison center in the Charlotte area, the greater Cities Readiness Initiative region and the entire state for infectious disease signs and symptoms, injuries and any mention of bioterrorism agents. The dashboards also included a section to view user comments on the information presented in NC DETECT. Data processing changes were also made to improve the timeliness of the EMS data received from PreMIS.

Results

The DNC dashboards added to NC DETECT streamlined the workflow by placing all syndromes and annotations of interest in one place, with the date ranges and locations already pre-selected. Graphs in the dashboards could be easily copied and pasted into situation reports. The prompt development of these user-friendly tools provided effective surveillance for this mass gathering and ensured timely control measures, if necessary.

Conclusions

Syndromic surveillance systems can be enhanced to provide detailed, specific surveillance during mass gathering events. Elements that facilitate this enhancement include strong communication between skilled users and the informatics team, in order to minimize the burden placed on the surveillance team system users, data sources and system developers during the event. The visualizations developed as part of these new dashboards will be leveraged to provide additional tools to other NC DETECT user groups, including hospital-based public health epidemiologists and local health department users.Open in a separate window     

离子型造影剂中加地塞米松预防CT增强扫描副反应的对比研究

目的：探讨离子型造影剂中加入地塞米松预防CT增强扫描副反应的意义。方法：采用加地塞米松组与未加地塞米松组对比,对520例增强扫描病例进行各种副反应的分组对照及各年龄的不同反应率的分析,结果：离子型造影剂中加地塞米松的259例患者出现副反应的19例,占该组7．3％;离子型造影剂中未加地塞米松的261例患者出现副反应的20例,占该组的7．7％;两组均显示20例以上,60岁以上副以应较其他年龄组高,结论：CT增强扫描中采用离子型造影剂中加地塞米松注射不参明显降低副反应的发生。     

Enhanced activation and restorative care

As the Canadian population ages, it becomes increasingly important for hospitals to address and implement programs and policies that ensure elderly patients are receiving the right care in the right place at the right time. Despite the vast majority of elderly patients being healthier than ever, it is important to recognize the rapid deconditioning that occurs when they are admitted to an acute care hospital. Although it is recognized that children need to be treated differently, we fail to recognize the same is true for older adults. The Enhanced Activation Program was conceptualized during consultation with community partners while discussing the aging at home strategy. It was during these consultations that gaps in service for the frail elderly were identified and the Enhanced Activation Program was developed.     

Enhanced interpretation of nonverbal facial cues in male rapists—a preliminary study

Interpretation of nonverbal cues was tested in 12 white, male, self-admitting rapists. All rapists were being treated for depression and were between the ages of 20 and 31. All victims were female strangers who had been observed in a social setting. The rapists and 12 age- and class-matched male controls viewed 10 male and 10 female volunteers during a specific gambling trial. Rapists were found to be more accurate than controls in interpreting both female and male nonverbal cues. This enhanced ability was hypothesized to be due to pathological expressions of intimacy and sexuality in the rapists' families of origin.     

Enhanced pregnancy-associated mortality surveillance: Minnesota, 1990-1999

Comprehensive surveillance is critical to accurate identification of pregnancy-associated deaths and risk factors and is the first step in implementing programs to prevent such deaths in young women. In Minnesota, surveillance is currently based on analysis of data from death records. This study sought to demonstrate that the state's current surveillance method underestimates the actual burden of maternal deaths in Minnesota. It proposes that ongoing enhanced surveillance--analysis of death certificate data combined with the linking of death records of women of reproductive age with live birth records or fetal death records--provides a more complete and accurate accounting of pregnancy-associated mortality in Minnesota.     

Enhanced Disease Surveillance during the 2012 Republican National Convention,Tampa, FL

Objective

To describe disease and illness surveillance utilized during the 2012 Republican National Convention (RNC) held August 26–30, 2012 in Tampa, FL.

Introduction

While the Tampa Bay Area has previously hosted other high profile events that required heightened disease surveillance (e.g., two Super Bowls), the 2012 RNC marked the first national special security event (NSSE) held in Florida. The Hillsborough County Health Department (HCHD), in conjunction with the Pinellas County Health Department (PinCHD) coordinated disease surveillance activities during this time frame. This presentation will focus of the disease surveillance efforts of the Hillsborough County Health Department during the 2012 RNC.In addition to the surveillance systems that are used routinely, the HCHD Epidemiology Program implemented additional systems designed to rapidly detect individual cases and outbreaks of public health importance. The short duration of RNC, coupled with the large number of visitors to our area, provided additional surveillance challenges.Tropical Storm Isaac, which threatened Tampa in the days leading up to RNC, and an overwhelming law enforcement presence likely dissuaded many protestors from coming to Tampa. As a result, a tiny fraction of the number of protestors that were expected actually showed up.

Methods

Our normal daily analysis of the emergency department (ED) data using the Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) was expanded to look in detail at ED volumes and chief complaints of those patients who live outside of a 5-county Tampa Bay area. This analysis used patient zip code to determine place of residence. Additionally, ESSENCE queries were utilized to look for heat, tear gas, and RNC related exposures. The ESSENCE system also receives Poison Control data every 15 minutes. Expanded analyses of the Poison Control data were conducted as well. Two Disaster Medical Assistance Teams (DMATs) were deployed in Tampa during the RNC. Data was collected electronically and transmitted through ESSENCE as well.The HCHD also asked infection preventionists, health care providers, hotels, labs, and Mosquito Control to lower their reporting threshold to us during the RNC period. We provided updates to all our partners with respect to diseases and outbreaks of public health importance occurring in our county.

Results

No epidemiologic events linked to the RNC were detected through the HCHD’s enhanced surveillance that was conducted. Decreased patient volumes were seen during the RNC at our EDs closest to the convention site. No significant increases in ED visits from outside of our 5-county area were noted during the RNC. Urgent care centers reported seeing patients associated with the RNC for a variety of reasons including respiratory and gastrointestinal illness. DMAT surveillance showed mainly routine visits but four secret service agents did seek care for respiratory illness during the convention.

Conclusions

Substantial time and resources were devoted to disease surveillance in the 6 months leading up to the RNC and during the event. While no epidemiologic events were detected, the public health surveillance infrastructure has clearly been strengthened in our county. We are receiving our ED syndromic data, from many of our hospitals, every two hours as opposed to every day. We have established relationships with our urgent case centers and hope to begin receiving urgent care center data on a daily basis in the near future. Receiving DMAT data through ESSENCE could prove very useful in the future, especially in Florida where hurricanes are always a threat. Lastly the improved relationships with our health care providers should be beneficial as we move forward.     

Enhanced safety surveillance study of ACAM2000 smallpox vaccine among US military service members

ObjectivesTo evaluate the rates of myopericarditis (primary objective) and rates of cardiovascular and neurological adverse events (secondary objectives) in temporal association with ACAM2000® smallpox vaccine.MethodsObservational cohort study conducted through monthly surveillance from 2009 to 2017 of electronic medical records of military service members (SM) for pre-specified cardiac and neurological International Classification of Diseases (ICD) codes reported in the 30 days following smallpox vaccination. ICD codes potentially predictive of myopericarditis and codes for encephalitis, Guillain-Barré syndrome, and sudden death were classified into Group 1. All other cardiovascular and neurological ICD codes were classified into Group 2. Medical records containing Group 1 codes were individually reviewed to confirm coding accuracy and to seek additional data in support of myopericarditis adjudication, which was performed by an independent clinical panel. Chart reviews were not performed for Group 2 codes, which were reported in aggregate only.Results897,227 SM who received ACAM2000 smallpox vaccine and 450,000 SM who received Dryvax smallpox vaccine were included in the surveillance population. The rate of adjudicated myopericarditis among ACAM2000 smallpox vaccine recipients was 20.06/100,000 and was significantly higher for males (21.8/100,000) than females (8.5/100,000) and for those < 40 years of age (21.1/100,000) than for those 40 years or older (6.3/100,000). Overall rates for any cardiovascular event (Group 1 plus Group 2) were 113.5/100,000 for ACAM2000 vaccine and 439.3/100,000 for Dryvax vaccine; rate ratio, 0.26 (95% CI, 0.24–0.28). The rates of subjects with one or more defined neurological events were 2.12/100,000 and 1.11/100,000 for ACAM2000 and Dryvax vaccines respectively; rate ratio, 1.91 (95% CI, 0.71–5.10).ConclusionsElectronic records surveillance of the entire vaccinated SM population over a ten-year period found rates of myopericarditis, of defined neurological events, and of overall cardiac events that were consistent with those of prior passive surveillance studies involving Dryvax or ACAM2000 smallpox vaccines.Clinical trials registration: ClinicalTrials.gov NCT00927719.     

Humor in Print Health Advertisements: Enhanced Attention,Privileged Recognition,and Persuasiveness of Preventive Messages

This study tested the effect of humor in one particular type of print advertisement: the preventive health ads for three topics (alcohol, tobacco, obesity). Previous research using commercial ads demonstrated that individuals’ attention is spontaneously attracted by humor, leading to a memory advantage for humorous information over nonhumorous information. Two experiments investigated whether the positive effect of humor can occur with preventive health ads. In Experiment 1, participants observed humorous and nonhumorous health ads while their viewing times were recorded. In Experiment 2, to compare humorous and nonhumorous ads, the memory of health messages was assessed through a recognition task and a convincing score was collected. The results confirmed that, compared to nonhumorous health ads, those using humor received prolonged attention, were judged more convincing, and their messages were better recognized. Overall, these findings suggest that humor can be of use in preventive health communication.     

Tracking Pertussis and Evaluating Control Measures through Enhanced Pertussis Surveillance,Emerging Infections Program,United States

Despite high coverage with pertussis-containing vaccines, pertussis remains endemic to the United States. There have been increases in reported cases in recent years, punctuated by striking epidemics and shifting epidemiology, both of which raise questions about current policies regarding its prevention and control. Limited data on pertussis reported through the National Notifiable Disease Surveillance System have proved insufficient to answer these questions. To address shortcomings of national pertussis data, the Emerging Infections Program at the US Centers for Disease Control and Prevention launched Enhanced Pertussis Surveillance (EPS), which is characterized by systematic case ascertainment, augmented data collection, and collection of Bordetella pertussis isolates. Data collected through EPS have been instrumental in understanding the rapidly evolving epidemiology and molecular epidemiology of pertussis and have contributed essential information regarding pertussis vaccines. EPS also serves as a platform for conducting critical and timely evaluations of pertussis prevention and control strategies, including targeting of vaccinations and antimicrobial prophylaxis.     

Hepatocyte-Specific Phgdh-Deficient Mice Culminate in Mild Obesity,Insulin Resistance,and Enhanced Vulnerability to Protein Starvation

l-Serine (Ser) is synthesized de novo from 3-phosphoglycerate via the phosphorylated pathway committed by phosphoglycerate dehydrogenase (Phgdh). A previous study reported that feeding a protein-free diet increased the enzymatic activity of Phgdh in the liver and enhanced Ser synthesis in the rat liver. However, the nutritional and physiological functions of Ser synthesis in the liver remain unclear. To clarify the physiological significance of de novo Ser synthesis in the liver, we generated liver hepatocyte-specific Phgdh KO (LKO) mice using an albumin-Cre driver. The LKO mice exhibited a significant gain in body weight compared to Floxed controls at 23 weeks of age and impaired systemic glucose metabolism, which was accompanied by diminished insulin/IGF signaling. Although LKO mice had no apparent defects in steatosis, the molecular signatures of inflammation and stress responses were evident in the liver of LKO mice. Moreover, LKO mice were more vulnerable to protein starvation than the Floxed mice. These observations demonstrate that Phgdh-dependent de novo Ser synthesis in liver hepatocytes contributes to the maintenance of systemic glucose tolerance, suppression of inflammatory response, and resistance to protein starvation.     

Enhanced salt appetite, diet and drinking in traditional Bedouin women in the Negev

The Negev Bedouin are desert dwellers in high summer heat and scarce shade and water. They are under pressure to cease their traditional way of life. To document, while still possible, how traditional Bedouin nutritional habits may have accommodated to these conditions, we evaluated sodium appetite, diet and drinking in Bedouin women (n=31) who still partially maintained their traditional way of life in isolated tribal encampments in the spring of 2005. Data were compared to urban Bedouin women (n=15), and to urban Jewish women (n=15) representing mainstream dietary habits in the same region, and to published data. About 60% (by energy) of the encampment diet is traditional, but this proportion is reduced in summer. Encampment Bedouin women rated concentrated salt solution as more preferred than other groups, added 40% more salt to an ideal test soup and had a approximately 50% greater absolute dietary sodium intake. The sodium content of the traditional Bedouin diet is approximately 25% higher than the Jewish women's diet. This enhanced sodium appetite is reflected in the value of salt in their folklore. The possible causes of the enhanced salt appetite are considered. In addition, dietary intake (M=3470, SE=285 kcal) was approximately 50% greater than in urban Jewish women. Fluid intake (approximately 2.4 L/d) was approximately 20% greater than Jewish women, but may have been inadequate in the exposed encampments because 8 of the 31 women reported an occurrence of dehydration, 6 of them while pregnant. Encampment women BMI (30.3+/-1.1 kg/m2) was high, and health problems were typical of populations in transition.     

Enhanced protection against pneumococcal infection elicited by immunization with the combination of PspA, PspC, and ClpP

Immunization with a combination of several virulence-associated proteins is one of the strategies of developing effective protein-based vaccines to enhance the protection against Streptococcus pneumoniae. In this study, we evaluated the protection effects against pneumococcal infection caused by S. pneumoniae TIGR4 in BALB/c mice immunized with either single pneumococcal surface protein A (PspA), pneumococcal surface protein C (PspC), the caseinolytic protease (ClpP) or their combinations. The median survival times for mice immunized with single antigen or their combinations were significantly longer than that for mice treated with adjuvant alone. Mice treated with a combination of three antigens survived significantly longer than those that received either single or two antigens. The highest survival rate of the various groups of mice was observed with the combination of three antigens, this survival rate was significantly different from those for mice that received either single antigen or the combinations of two antigens except the mixture of ClpP and PspA. In the experiment of passive immunization with hyperimmune serums containing their specific polyclonal antibodies (anti-PspA serum, anti-PspC serum, anti-ClpP serum), the median survival times for mice immunized with hyperimmune serums containing specific polyclonal antibodies were significantly longer than that for control mice, the treatment of serum containing only one single polyclonal antibody could not provide higher survival rate than control serum. However, the survival rates for mice treated with the serums containing combined polyclonal antibodies were significantly higher than those for mice treated with either control serum or anti-PspA serum alone. Immunization with the combination of three hyperimmune serums also provided the best protection against S. pneumoniae. Compared to mice treated with serum containing single polyclonal antibody, the survival rate for mice treated with serums containing three polyclonal antibodies was significantly higher but was not different from those for mice treated with serums containing two polyclonal antibodies. Our findings provided evidence that a mixture of PspA, PspC, and ClpP or their polyclonal antibodies could enhance the protection against pneumococcal infection acting a synergetic effect.     

The Enhanced Productivity Program

The Enhanced Productivity Program is based on an organizational audit of a dietary department by a foodservice consultant. The objective of the program was to enhance department productivity by increasing personnel efficiency through work simplification and work organization principles while maintaining quality standards. The Enhanced Productivity Program comprises 13 subsystems that interact to affect overall productivity of the department. The program was structured by a task-oriented program schedule that identified tasks to be carried out in each subsystem. A system diagram detailed time frames and milestones guiding each task to completion. A comprehensive work plan was developed for each task. Time and motion studies carried out before and after implementation of program changes demonstrate a savings of 9.27 labor hours per day. Trayline speed increased from 1.7 trays to 3 trays per minute. Improved personnel efficiency allowed an 11% growth in meal volume in 6 months, thus improving departmental productivity.     

Enhanced nurse call systems

This Evaluation focuses on high-end computerized nurse call systems--what we call enhanced systems. These are highly flexible systems that incorporate microprocessor and communications technologies to expand the capabilities of the nurse call function. Enhanced systems, which vary in configuration from one installation to the next, typically consist of a basic system that provides standard nurse call functionality and a combination of additional enhancements that provide the added functionality the facility desires. In this study, we examine the features that distinguish enhanced nurse call systems from nonenhanced systems, focusing on their application and benefit to healthcare facilities. We evaluated seven systems to determine how well they help (1) improve patient care, as well as increase satisfaction with the care provided, and (2) improve caregiver efficiency, as well as increase satisfaction with the work environment. We found that all systems meet these objectives, but not all systems perform equally well for all implementations. Our ratings will help facilities identify those systems that offer the most effective features for their intended use. The study also includes a Technology Management Guide to help readers (1) determine whether they'll benefit from the capabilities offered by enhanced systems and (2) target a system for purchase and equip the system for optimum performance and cost-effective operation.