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In the Lao People’s Democratic Republic (PDR), mumps is not a notifiable disease and mumps vaccine is currently not included in the routine childhood immunization programme. In order to assess the burden of disease, we investigated the seroprevalence of mumps-specific IgG antibodies across four provinces. In addition, we genetically characterized mumps viruses from the past 3 years from several outbreaks and single cases. Blood and/or throat swabs from suspected cases were investigated for specific IgM antibodies or viral RNA. Mumps cases occurred between March and November in 2011-2013 and 5- to 15-year-olds were most affected. Four sequences from an outbreak in the north of Lao PDR in 2011 were identical and belonged to genotype G. Eight sequences from two outbreaks and two individual cases from 2012 and 2013 belonged to genotype J. In addition, sera collected from 2379 healthy infants and school pupils aged between 9 months and 19 years and from pregnant women aged between 16 and 46 years were investigated for mumps-specific IgG. Overall, 58.2% were positive, 39.5% were negative and the remaining 2.3% were equivocal. The seropositivity increased with age, with the lowest percentage found in

Intima-media thickness (IMT) provides a surrogate end point of cardiovascular outcomes in clinical trials evaluating the efficacy of cardiovascular risk factor modification. Carotid artery plaque further adds to the cardiovascular risk assessment. It is defined as a focal structure that encroaches into the arterial lumen of at least 0.5 mm or 50% of the surrounding IMT value or demonstrates a thickness >1.5 mm as measured from the media-adventitia interface to the intima-lumen interface. The scientific basis for use of IMT in clinical trials and practice includes ultrasound physics, technical and disease-related principles as well as best practice on the performance, interpretation and documentation of study results. Comparison of IMT results obtained from epidemiological and interventional studies around the world relies on harmonization on approaches to carotid image acquisition and analysis. This updated consensus document delineates further criteria to distinguish early atherosclerotic plaque formation from thickening of IMT. Standardized methods will foster homogenous data collection and analysis, improve the power of randomized clinical trials incorporating IMT and plaque measurements and facilitate the merging of large databases for meta-analyses. IMT results are applied to individual patients as an integrated assessment of cardiovascular risk factors. However, this document recommends against serial monitoring in individual patients.

This paper presents efficient modeling technique using the p-convergent transition element for analysis of cantilever plates with stepped section. For the efficient modeling, firstly, the high-precision element is formulated by combination of one- and two-dimensional shape functions. Secondly, for another three-dimensional modeling, the reduced-precision element is proposed by assuming a piecewise linear variation of in-plane displacements and a constant value of the lateral displacement across the thickness. Thirdly, two-dimensional shell element with higher-order shape functions is formulated using first-order shear deformation theory. Lastly, the p-convergent transition element is proposed in order to connect three element types formulated. All the elements considered are on the basis of subparametric element concept. The elements are applied with cantilever plates with stepped section subjected to in-plane and transversal loadings. The present models using the p-convergent transition element are demonstrated to be more practical and economical than previously p-version FEM using only single element type.

Intima-media thickness (IMT) is increasingly used as a surrogate end point of vascular outcomes in clinical trials aimed at determining the success of interventions that lower risk factors for atherosclerosis and associated diseases (stroke, myocardial infarction and peripheral artery diseases). The necessity to promote further criteria to distinguish early atherosclerotic plaque formation from thickening of IMT and to standardize IMT measurements is expressed through this updated consensus. Plaque is defined as a focal structure that encroaches into the arterial lumen of at least 0.5 mm or 50% of the surrounding IMT value or demonstrates a thickness >1.5 mm as measured from the media-adventitia interface to the intima-lumen interface. Standard use of IMT measurements is based on physics, technical and disease-related principles as well as agreements on how to perform, interpret and document study results. Harmonization of carotid image acquisition and analysis is needed for the comparison of the IMT results obtained from epidemiological and interventional studies around the world. The consensus concludes that there is no need to ‘treat IMT values’ nor to monitor IMT values in individual patients apart from exceptions named, which emphasize that inside randomized clinical trials should be performed. Although IMT has been suggested to represent an important risk marker, according to the current evidence it does not fulfill the characteristics of an accepted risk factor. Standardized methods recommended in this consensus statement will foster homogenous data collection and analysis. This will help to improve the power of randomized clinical trials incorporating IMT measurements and to facilitate the merging of large databases for meta-analyses.

In this paper, we present the development of a method to accurately measure the positive and negative charge distribution of nanosized aerosols using a tandem differential mobility analyzer (TDMA) system. From the series of TDMA measurements, the charge fraction of nanosized aerosol particles was obtained as a function of equivalent mobility particle diameter ranging from 50 to 200 nm. The capability of this new approach was implemented by sampling from a laminar diffusion flame which provides a source of highly charged particles due to naturally occurring flame ionization process. The results from the TDMA measurement provide the charge distribution of nanosized aerosols which we found to be in reasonable agreement with Boltzmann equilibrium charge distribution theory and a theory based upon charge population balance equation (PBE) combined with Fuchs theory (N.A. Fuchs, Geofis. Pura Appl. 56 (1963) 185). The theoretically estimated charge distribution of aerosol particles based on the PBE provides insight into the charging processes of nanosized aerosols surrounded by bipolar ions and electrons, and agree well with the TDMA results.

Intima-media thickness (IMT) is increasingly used in clinical trials as a surrogate end point for determining the success of interventions that lower risk factors for atherosclerosis. The necessity for unified criteria to distinguish early atherosclerotic plaque formation from thickening of IMT and to standardize IMT measurements is addressed in this consensus statement. Plaque is defined as a focal structure that encroaches into the arterial lumen of at least 0.5 mm or 50% of the surrounding IMT value or demonstrates a thickness of ≧1.5 mm as measured from the media-adventitia interface to the intima-lumen interface. Standard use of IMT measurements is recommended in all epidemiological and interventional trials dealing with vascular diseases to improve characterization of the population investigated. The consensus concludes that there is no need to ‘treat IMT values’ nor to monitor IMT values in individual patients apart from few exceptions. Although IMT has been suggested to represent an important risk marker, it does not fulfill the characteristics of an accepted risk factor. Standardized methods recommended in this consensus statement will foster homogenous data collection and analysis. This will help to improve the power of studies incorporating IMT measurements and to facilitate the merging of large databases for meta-analyses.

Siderite concretions are recovered from both freshwater (Unit II) and tidal (Unit I) deposits in the Holocene macrotidal flat of Kyunggi Bay, west coast of Korea. Siderites from both units show a spherulitic and well-rounded texture and well-developed equant rhombs on the external surfaces. The size of the concretions in Unit II (50–150 μm in diameter) is normally larger than that in Unit I (10–20 μm). The siderites in Unit II are chemically pure and highly enriched in Fe, whereas those of Unit I are relatively impure and distinctly zoned, demarcating high Mn (up to 69.1 mol%) in the core and high Fe (up to 75.9 mol%) in the margin. Within siderites of Unit I, substitution for Fe by Ca and Mg reaches up to 20.3 mol% (mean 15.1 mol%) and 16.1 mol% (mean 12.6 mol%), respectively. Bulk δ 18 O values (−0.7 to +1.3‰ PeeDee Belemnite (PDB)) for siderites in Unit I are relatively higher than those (−7.1 to +0.5‰ PDB) in Unit II. Regardless of units, siderite δ 13 C values (−21.3 to −11.2‰ PDB) are persistently low, indicating microbially-mediated precipitation at shallow burial depth. Extensive Mn, Ca and Mg substitution coupled with enrichment of 18 O in the siderites of Unit I seems to reflect marine influence during the Holocene transgression. The occurrence of early diagenetic siderites provides supporting evidence on the depositional environment (marine vs. non-marine) of the Holocene muddy coastal deposits of Korea (eastern Yellow Sea).

Objective: The goal of this multicenter, double-blind, randomized, parallel-group study was to compare the effects of losartan potassium (hereafter referred to as losartan), candesartan cilexitil (hereafter referred to as candesartan), and losartan/hydrochlorothiazide (HCTZ) in patients with mild to moderate hypertension (sitting diastolic blood pressure [(SiDBP] 95–115 mm Hg). Methods: A total of 1161 patients were randomized in a 2:2:1 ratio to 12 weeks of treatment with losartan 50 mg QD, possibly titrated to 100 mg QD (n = 461); candesartan 8 mg QD, possibly titrated to 16 mg QD (n = 468); or losartan 50 mg QD, possibly titrated to losartan 50 mg plus HCTZ 12.5 mg QD (n = 232). At 6 weeks, the regimens of patients not reaching a goal SiDBP Results: At 12 weeks, changes in SiDBP/sitting systolic blood pressure (SiSBP) of −12.4/−14.4 mm Hg with losartan 50 mg/100 mg and −13.1/−15.8 m Hg with candesartan 8 mg/16 mg demonstrated equivalence between the 2 monotherapy regimens of (95% CI for difference in SiDBP, −1.6 to 0.2). At 12 weeks, the losartan 50 mg/50 mg plus HCTZ 12.5 mg regimen had reduced SiDBP/SiSBP significantly more (−14.3/−18.0 mm Hg) than either the candesartan 8 mg/16 mg (SiDBP, P = 0.045; SiSBP, P = 0.017) or losartan 50 mg/100 mg regimen (SiDBP and SiSBP, P = 0.001). During the last 6 weeks, patients whose regimen had been titrated to losartan 50 mg plus HCTZ 12.5 mg (n = 114) showed a greater reduction in SiDBP/SiSBP (−14.5/−18.7 mm Hg) than did those whose regimen had been titrated to either losartan 100 mg (−10.5/−12.3 mm Hg; n=211) or candesartan 16 mg (−11.5/−13.2 mm Hg; n=206), representing a clinically meaningful (≥2.5—mm Hg) difference. All 3 treatments were well tolerated, with few patients experiencing drug-related adverse events (6.9% losartan 50 mg/100 mg, 7.5% candesartan 8 mg/16 mg, 3.0% losartan 50 mg/50 mg plus HCTZ 12.5 mg). Candesartan 8 mg/16 mg increased serum uric acid levels (0.13 mg/dL; 95% CI, 0.04 to 0.23), whereas losartan 50 mg/100 mg decreased them (−0.14 mg/dL; 95% CI, −0.24 to −0.04), and losartan 50 mg/50 mg plus HCTZ 12.5 mg left them unchanged (0.06 mg/dL; 95% CI, −0.07 to 0.20). Conclusions Losartan 50 mg/100 mg and candesartan 8 mg/16 mg were comparable treatments in terms of blood pressure reduction. After titration, losartan 50 mg plus HCTZ 12.5 mg was superior to either candesartan 16 mg or losartan 100 mg in reducing hypertension. Losartan, but not candesartan, lowered serum uric acid levels and attenuated the expected increase in uric acid levels with HCTZ 12.5 mg.

® cards Genotyping a b s t r a c t Background: The genetic characterization of wild-type measles viruses plays an important role in the description of viral transmission pathways and the verification of measles elimination. The 450 nucleotides that encode the carboxyl-terminus of the nucleoprotein (N-450) are routinely sequenced for genotype analysis. Objectives: The objectives of this study were to develop improved primers and controls for RT-PCR reac- tions used for genotyping of measles samples and to develop a method to provide a convenient, safe, and inexpensive means to distribute measles RNA for RT-PCR assays and practice panels. Study design: A newly designed, genetically defined synthetic RNA and RNA isolated from cells infected with currently circulating genotypes were used to compare the sensitivity of primer pairs in RT-PCR and nested PCR. FTA ® cards loaded with lysates of measles infected cells were tested for their ability to preserve viral RNA and destroy virus infectivity. Results: A new primer pair, MeV216/MeV214, was able to amplify N-450 from viruses representing 10 currently circulating genotypes and a genotype A vaccine strain and demonstrated 100-fold increased sensitivity compared to the previously used primer set. A nested PCR assay further increased the sensi- tivity of detection from patient samples. A synthetic positive control RNA was developed that produced PCR products that are distinguishable by size from PCR products amplified from clinical samples. FTA® cards completely inactivated measles virus and stabilized RNA for at least six months. Conclusions: These improved molecular tools will advance molecular characterization of circulating measles viruses globally and provide enhanced quality control measures. Published by Elsevier B.V.

Infective endocarditis caused by Streptococcus suis serotype 2 is not uncommon in pigs but is rare in human beings. We describe the case of a pig-farmer with endocarditis due to S. suis serotype 2 and in whom prolapse of the mitral valve was the predisposing cardiac lesion. Streptococcus suis, a possible cause of infective endocarditis in endemic areas, may be confused with other group D streptococci. In suspected cases a history of contact with pigs or raw pork should be sought.

Chinese patients are reportedly more sensitive than Caucasians to the anticoagulant effect of warfarin. We examined warfarin dose requirements and their determinants in 151 Chinese out-patients on stable maintenance dose of warfarin with international normalized ratio of 2 to 2.5. Mean daily warfarin requirement was 3.3 +/- 1.4 mg, much lower than reported doses in Caucasian patients. The most important determinant was age (r = -0.43, p < 0.001), with progressively lower warfarin requirement with increasing age (p = 0.0001). There was a weaker association with body weight (r = 0.20, p = 0.01). Patients with chronic rheumatic heart disease tended to require a smaller dose than those with heart valve replacements (2.94 +/- 1.24 vs. 3.69 +/- 1.42 mg, p < 0.01). We confirm that Chinese patients require a smaller dose of warfarin for the same degree of anticoagulation. Age is the most important factor affecting dose requirement, although body weight and underlying disease also play a role.

Fourteen Chinese patients with histologically proven advanced gastrointestinal tumors underwent a phase II 4'-epidoxorubicin trial. 6 out of 14 (42%) patients showed static response and the rest showed progression of disease during treatment. The treatment was fairly well tolerated with a mild to moderate degree of nausea, vomiting, alopecia and hematological toxicity.

A new type diffractive spatial optical modulator has been developed for laser projection display. It has inherent advantages such as fast response time and high-performance light modulation characteristics. Also, it is suitable for embedded mobile projection display module because of its compact optical volume (les 20 cc) and low power consumption (les 2.0 W).