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2008–2010 Epidemic Keratoconjunctivitis Outbreaks Detailed.

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An MMWR analysis of six outbreaks of adenovirus-associated epidemic keratoconjunctivitis from 2008 through 2010 provides lessons on infection control in healthcare settings. Epidemic keratoconjunctivitis is a severe form of viral conjunctivitis with symptoms that can last up to 21 days and may be associated with common ophthalmologic procedures.

The healthcare-associated outbreaks occurred in Florida, Illinois, Minnesota, and New Jersey. Healthcare providers were likely sources of transmission in four of the outbreaks, and infection control breaches occurred in all. Over 400 patients were infected.

MMWR‘s editors recommend the following infection-control measures:

  • Use strict hand hygiene.
  • Wear disposable gloves for potential contact with eye secretions.
  • Disinfect ophthalmologic instruments after every use, or use disposable instruments.
  • Ensure patients with suspected conjunctivitis have a separate waiting room, sign-in area, and exam room.
  • Bar from work any staff members with signs of epidemic keratoconjunctivitis.

In addition, the editors note, isopropyl alcohol is not sufficient for disinfecting ophthalmologic instruments that contact typically sterile body sites; rather, staff should follow equipment manufacturer’s instructions.

Source: MMWR article

How Math Helped Forecast Hurricane Sandy.

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Many early forecasts for Hurricane Sandy last year predicted that the system would fizzle over the Atlantic. Yet a model developed by researchers at the European Center for Medium-Range Forecasts showed a more alarming scenario: the storm would instead turn west to threaten the Eastern Seaboard. The model’s refined predictions pinpointed the hurricane’s landfall around the New Jersey area in time to allow residents to seek higher ground. The key to the more accurate forecast involved mathematical mastery of the storm’s chaotic behavior.

Weather forecasts are calculated with computers that solve equations involving variables such as wind speed, pressure, temperature, air density and humidity. If the earth somehow possessed just one weather system, our fist shaking at forecasts could end. Instead, of course, the planet harbors many systems that intermix across boundaries and scales, making forecasting a tangled problem.

In the case of Sandy, forecasters monitored a higher-order variable called potential vorticity, a measure of a weather system’s swirl, to help predict the storm’s future development. A crucial ingredient for Sandy’s devastating landfall proved to be an enhancement of this swirl measure caused by a trough of low-pressure air that was thousands of miles away in the northeastern Pacific when the tropical depressionfirst formed. As Sandy moved north from the Caribbean, the distant trough traveled east across the U.S. on what turned out to be a collision course. On October 29 Sandy’s warm, moist air began to rise as it approached the trough’s cooler air, whipping up stronger winds. As the two weather systems coiled around each other, Sandy surged in strength and curved toward the nation’s northeastern shoreline, just as the European researchers had foreseen. The ultimate accuracy of the group’s forecasts about a week before Sandy’s landfall can be attributed to the success of its model in predicting and capturing the interaction between these weather systems.

The step-by-step quantification of this stormy choreography was accomplished solely through the careful application of mathematics. By predicting Sandy’s landfall, in a very real sense, the European team’s math helped to save American lives.

Source: http://www.scientificamerican.com

Dietary and Supplemental Calcium Intake and Cardiovascular Disease MortalityThe National Institutes of Health–AARP Diet and Health Study.

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Importance  Calcium intake has been promoted because of its proposed benefit on bone health, particularly among the older population. However, concerns have been raised about the potential adverse effect of high calcium intake on cardiovascular health.

Objective  To investigate whether intake of dietary and supplemental calcium is associated with mortality from total cardiovascular disease (CVD), heart disease, and cerebrovascular diseases.

Design and Setting  Prospective study from 1995 through 1996 in California, Florida, Louisiana, New Jersey, North Carolina, and Pennsylvania and the 2 metropolitan areas of Atlanta, Georgia, and Detroit, Michigan.

Participants  A total of 388 229 men and women aged 50 to 71 years from the National Institutes of Health–AARP Diet and Health Study.

Main Outcome Measures  Dietary and supplemental calcium intake was assessed at baseline (1995-1996). Supplemental calcium intake included calcium from multivitamins and individual calcium supplements. Cardiovascular disease deaths were ascertained using the National Death Index. Multivariate Cox proportional hazards regression models adjusted for demographic, lifestyle, and dietary variables were used to estimate relative risks (RRs) and 95% CIs.

Results  During a mean of 12 years of follow-up, 7904 and 3874 CVD deaths in men and women, respectively, were identified. Supplements containing calcium were used by 51% of men and 70% of women. In men, supplemental calcium intake was associated with an elevated risk of CVD death (RR>1000 vs 0 mg/d, 1.20; 95% CI, 1.05-1.36), more specifically with heart disease death (RR, 1.19; 95% CI, 1.03-1.37) but not significantly with cerebrovascular disease death (RR, 1.14; 95% CI, 0.81-1.61). In women, supplemental calcium intake was not associated with CVD death (RR, 1.06; 95% CI, 0.96-1.18), heart disease death (1.05; 0.93-1.18), or cerebrovascular disease death (1.08; 0.87-1.33). Dietary calcium intake was unrelated to CVD death in either men or women.

Conclusions and Relevance  Our findings suggest that high intake of supplemental calcium is associated with an excess risk of CVD death in men but not in women. Additional studies are needed to investigate the effect of supplemental calcium use beyond bone health.

Source: JAMA

 

Great whites ‘not evolved from megashark.

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A new fossil discovery has helped quell 150 years of debate over the origin of great white sharks.

Carcharodon hubbelli, which has been described by US scientists, shows intermediate features between the present-day predators and smaller, prehistoric mako sharks.

The find supports the theory that great white sharks did not evolve from huge megatooth sharks.

The research is published this week in the journal Palaeontology.

Palaeontologists have previously disagreed over the ancestry of the modern white sharks, with some claiming that they are descended from the giant megatooth sharks, such as Megalodon (Carcharocles megalodon).

“When the early palaeontologists put together dentitions of Megalodon and the other megatooth species, they used the modern white shark to put them together, so of course it’s going to look like a white shark because that’s what was used as a model,” explained Professor Dana Ehret of Monmouth University in New Jersey who lead the new research.

Modern day white sharks show similarities in the structure of their teeth with the extinct megatooth sharks.

As they both sport serrations on the cutting edges, early scientists working on the animals used this as evidence for the sharks being closely related.

“But we actually see the evolution of serrations occurring many times in different lineages of sharks and if you look at the shape and size of the serrations in the two groups you see that they are actually very different from each other,” Professor Ehret told BBC News.

“White sharks have very large, coarse serrations whereas megalodon had very fine serrations.”

Now, additional evidence from the newly described species shows both white shark-like teeth shape as well other features characteristic of broad-toothed mako sharks that feed on smaller fish rather than primarily seals and other large mammals.

“It looks like a gradation or a transition from broad-toothed makos to the modern white shark. It’s a transitional species, and you don’t see that a whole lot in the fossil record,” Professor Ehret said.

The mako-like characteristics of the new species, named Carcharodon hubbelli in honour of Gordon Hubbell – the researcher who discovered it in the field – were only found due to the incredible preservation of the fossil.

“A big issue in shark palaeontology is that we tend to only have isolated teeth, and even when you find associated teeth very, very rarely are they articulated in a life position,” continued Professor Ehret.

“The nice thing about this new species is that we have an articulated set of jaws which almost never happens and we could see that the third anterior tooth is curved out, just like in the tooth row of mako sharks today,” he said.

David Ward, an associate researcher at the Natural History Museum, London, who was not involved in the study told BBC News: “Everyone working in the field will be absolutely delighted to see this relationship formalised.”

The mosaic of both white shark-like and mako-like characters had been spotted by the researchers in an initial description of the fossil, but the age of the fossil meant their conclusion that the species was intermediate between a mako ancestor and modern white sharks wasn’t fully accepted.

“Some folks said ‘well, it makes a great story, but it’s not old enough because by this time, the early Pliocene, we see full blown white sharks in the ocean.'”

This led Ehret and his team to revisit the original site the fossil was taken from the Pisco Formation in Peru to re-examine the geology of the area, guided by the original field notes of Gordon Hubbell.

“Gordon gave us two photographs from when he actually collected the specimen and then a hand drawn map with a little ‘X’ on it. We tried to use the map and we didn’t have much luck.

“But using the two pictures of the excavation, my colleague Tom Devries was able to use the mountains in the background.”

“We literally walked through the desert holding the pictures up, trying to compare them. That’s how we found the site.”

Not only did they find the site, but the team were able to discover the precise hole from which the fossil had been excavated in 1988, before making a lucky escape from the desert.

“We made it back to Lima with about three hours to spare before an earthquake hit and shut down the transcontinental highway for two weeks. It was quite a trip.”

By analysing the species of molluscs found fossilised at the site, the team found that the shark was actually two million years older than had been thought, making it roughly 6.5 million years old.

“That two million year push-back is pretty significant because in the evolutionary history of white sharks, that puts the species in a more appropriate time category to be ancestral or… an intermediate form of white shark.”

“We’ve bolstered the case that white sharks are just highly modified makos… It fits the story now,” Professor Ehret told BBC News.

Source:BBC