>>is calling this the worst water event in his state's history. nbc's katy tur is in stonington,
connecticut
this morning. what's the scene there.
>> reporter: thousands trapped but could have been so much worse without the mandatory evacuations. luckily a number of people did get out. we do have to report two deaths for you this morning. one was a woman in mansfield. a tree fell on her house. we're told that she was electrocuted when
power lines
came down with it. also a couple of injuries in that house, but they were not life-threatening, as well as a fifthner eaton,
connecticut
, who was driving when a tree fell on his car. right now the weather has certainly calmed down here. there's not so many reports about what's coming out of this state right now, because there are so many people here without power. 635,000 customers without power right now. that's because of flooding. that's because of
high winds
. it's also because of massive trees like the one you're seeing behind me. if we come back out here live, can you see this tree is huge. it's fallen on to this house. this is just one of many trees across the stonington area and across the state that are bringing down
power lines
. they are blocking roads and making things very dangerous this morning. we are in the east part of
connecticut
. we're told it got much worse over in the west part of concorporation and i'm sure you'll be able to ask governor malloy more about that as you talk to him right now. guys.
Contact: Lynn Yarris lcyarris@lbl.gov 510-486-5375 DOE/Lawrence Berkeley National Laboratory
Berkeley Lab finding that protein folding funnels also apply to self-assembly should benefit biomimicry and nanosynthesis
Proteins are able to self-assemble into a wide range of highly ordered structures that feature a diverse array of properties. Through biomimicry - technological innovation inspired by nature humans hope to emulate proteins and produce our own version of self-assembling molecules. A key to accomplishing this is understanding how protein-folding a process critical to the form and function of a protein is extended from individual proteins to complex assemblies.
Researchers with the U.S. Department of Energy (DOE)'s Lawrence Berkeley National Laboratory (Berkeley Lab) have now shown that a concept widely accepted as describing the folding of a single individual protein is also applicable to the self-assembly of multiple proteins. Their findings provide important guidelines for future biomimicry efforts, particularly for device fabrication and nanoscale synthesis.
"We've made the first direct observations that the concept of a folding funnel with kinetic energy traps for individual proteins can be equally applied to the assembly of ordered protein structures," says Jim DeYoreo, a scientist with the Molecular Foundry, a DOE nanoscience center at Berkeley Lab, who led this research along with Berkeley Lab chemist Carolyn Bertozzi. "Our results tell us that efforts to discover and codify the design rules for the self-assembly of complex molecular systems will have to take into account the impact of kinetic traps associated with conformational transformations."
DeYoreo and Bertozzi are the corresponding authors of a paper published by the Proceedings of the National Academy of Sciences (PNAS) that reported this research. The paper is titled "Direct observation of kinetic traps associated with structural transformations leading to multiple pathways of S-layer assembly." Co-authoring the paper were Seong-Ho Shin, Sungwook Chung, Babak Sanii and Luis Comolli.
Proteins are essentially biomolecular nanomachines capable of performing numerous tasks because of their ability to fold themselves into a multitude of shapes and forms. When individual proteins self-assemble into ordered structures the resulting ensemble often adopts conformations that are quite distinct from those of the individual components.
"For example, collagen matrices, which constitute the organic scaffolds of bones and teeth, are constructed from triple helices of individual collagen monomers," DeYoreo says. "These helices will further assemble into highly organized twisted fibrils that exhibit a pseudohexagonal symmetry."
The folding funnel concept explains individual protein folding on the basis of conformational changes to reach a state of minimal free energy. An unfolded protein starts out in a state of high free energy that makes its conformation unstable. Initially, there are a number of possible three-dimensional conformations that would reduce this free energy. However, as the protein starts to fold, the free energy begins to drop and the number of possible conformations begins to decrease like the shrinking width of a funnel. The bottom of the funnel is reached when free energy is minimized and there is only one available conformation. As the free energy drops, however, there may be kinetic traps along the way that can stop the folding process and hold the protein in partially folded conformations, known as molten globules and folding intermediates, for extended periods of time. Eventually these trapped conformational states will be transformed into a stable conformation but the shape and form of that final conformation is influenced by the kinetic traps.
"In a protein folding funnel, the funnel walls are presumed not to be smooth and the resulting bumps and valleys define kinetic traps," DeYoreo says. "This physical picture of folding has been explored in some detail at the single molecule level, but has not been considered for protein self-assembly into extended architectures even though conformational transformations are part and parcel of the self-assembly process."
DeYoreo, Bertozzi and their colleagues took steps to correct this knowledge deficit by studying the surface-layer (S-layer) proteins that self-assemble into a crystalline membrane around the single cells of bacteria and Archaea. This outer membrane
serves as the first point of contact between the microbe and its environment and is key to the microbe's ability to survive. Using in situ Atomic Force Microscopy (AFM), the researchers imaged in real time and at the molecular level kinetic trapping during the 2D self-assembly of S-layer protein structures on mica surfaces.
"We observed that self-assembly of S-layer proteins tracks along two different pathways, one leading directly to the low-energy final, ordered state, and the other leading to a kinetic trap occupied by a long-lived transient state that is more disordered," DeYoreo says. "Although either state is easily accessible during crystal nucleation, if the system falls into the high-energy state, escape to the final, low-energy state is strongly impeded at room temperature. This demonstrates the importance of kinetic traps in determining the pathway of S-layer crystallization and suggests that the concept of folding funnels is equally valid for self-assembly of extended protein structures."
###
This research was supported by the DOE Office of Science.
Lawrence Berkeley National Laboratory addresses the world's most urgent scientific challenges by advancing sustainable energy, protecting human health, creating new materials, and revealing the origin and fate of the universe. Founded in 1931, Berkeley Lab's scientific expertise has been recognized with 13 Nobel prizes. The University of California manages Berkeley Lab for the U.S. Department of Energy's Office of Science. For more, visit www.lbl.gov.
The Molecular Foundry is one of five DOE Nanoscale Science Research Centers (NSRCs), national user facilities for interdisciplinary research at the nanoscale, supported by the DOE Office of Science. Together the NSRCs comprise a suite of complementary facilities that provide researchers with state-of-the-art capabilities to fabricate, process, characterize, and model nanoscale materials, and constitute the largest infrastructure investment of the National Nanotechnology Initiative. The NSRCs are located at DOE's Argonne, Brookhaven, Lawrence Berkeley, Oak Ridge and Sandia and Los Alamos national laboratories. For more information about the DOE NSRCs, please visit http://science.energy.gov/bes/suf/user-facilities/nanoscale-science-research-centers/.
DOE's Office of Science is the single largest supporter of basic research in the physical sciences in the United States, and is working to address some of the most pressing challenges of our time. For more information, please visit the Office of Science website at science.energy.gov/.
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AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.
Contact: Lynn Yarris lcyarris@lbl.gov 510-486-5375 DOE/Lawrence Berkeley National Laboratory
Berkeley Lab finding that protein folding funnels also apply to self-assembly should benefit biomimicry and nanosynthesis
Proteins are able to self-assemble into a wide range of highly ordered structures that feature a diverse array of properties. Through biomimicry - technological innovation inspired by nature humans hope to emulate proteins and produce our own version of self-assembling molecules. A key to accomplishing this is understanding how protein-folding a process critical to the form and function of a protein is extended from individual proteins to complex assemblies.
Researchers with the U.S. Department of Energy (DOE)'s Lawrence Berkeley National Laboratory (Berkeley Lab) have now shown that a concept widely accepted as describing the folding of a single individual protein is also applicable to the self-assembly of multiple proteins. Their findings provide important guidelines for future biomimicry efforts, particularly for device fabrication and nanoscale synthesis.
"We've made the first direct observations that the concept of a folding funnel with kinetic energy traps for individual proteins can be equally applied to the assembly of ordered protein structures," says Jim DeYoreo, a scientist with the Molecular Foundry, a DOE nanoscience center at Berkeley Lab, who led this research along with Berkeley Lab chemist Carolyn Bertozzi. "Our results tell us that efforts to discover and codify the design rules for the self-assembly of complex molecular systems will have to take into account the impact of kinetic traps associated with conformational transformations."
DeYoreo and Bertozzi are the corresponding authors of a paper published by the Proceedings of the National Academy of Sciences (PNAS) that reported this research. The paper is titled "Direct observation of kinetic traps associated with structural transformations leading to multiple pathways of S-layer assembly." Co-authoring the paper were Seong-Ho Shin, Sungwook Chung, Babak Sanii and Luis Comolli.
Proteins are essentially biomolecular nanomachines capable of performing numerous tasks because of their ability to fold themselves into a multitude of shapes and forms. When individual proteins self-assemble into ordered structures the resulting ensemble often adopts conformations that are quite distinct from those of the individual components.
"For example, collagen matrices, which constitute the organic scaffolds of bones and teeth, are constructed from triple helices of individual collagen monomers," DeYoreo says. "These helices will further assemble into highly organized twisted fibrils that exhibit a pseudohexagonal symmetry."
The folding funnel concept explains individual protein folding on the basis of conformational changes to reach a state of minimal free energy. An unfolded protein starts out in a state of high free energy that makes its conformation unstable. Initially, there are a number of possible three-dimensional conformations that would reduce this free energy. However, as the protein starts to fold, the free energy begins to drop and the number of possible conformations begins to decrease like the shrinking width of a funnel. The bottom of the funnel is reached when free energy is minimized and there is only one available conformation. As the free energy drops, however, there may be kinetic traps along the way that can stop the folding process and hold the protein in partially folded conformations, known as molten globules and folding intermediates, for extended periods of time. Eventually these trapped conformational states will be transformed into a stable conformation but the shape and form of that final conformation is influenced by the kinetic traps.
"In a protein folding funnel, the funnel walls are presumed not to be smooth and the resulting bumps and valleys define kinetic traps," DeYoreo says. "This physical picture of folding has been explored in some detail at the single molecule level, but has not been considered for protein self-assembly into extended architectures even though conformational transformations are part and parcel of the self-assembly process."
DeYoreo, Bertozzi and their colleagues took steps to correct this knowledge deficit by studying the surface-layer (S-layer) proteins that self-assemble into a crystalline membrane around the single cells of bacteria and Archaea. This outer membrane
serves as the first point of contact between the microbe and its environment and is key to the microbe's ability to survive. Using in situ Atomic Force Microscopy (AFM), the researchers imaged in real time and at the molecular level kinetic trapping during the 2D self-assembly of S-layer protein structures on mica surfaces.
"We observed that self-assembly of S-layer proteins tracks along two different pathways, one leading directly to the low-energy final, ordered state, and the other leading to a kinetic trap occupied by a long-lived transient state that is more disordered," DeYoreo says. "Although either state is easily accessible during crystal nucleation, if the system falls into the high-energy state, escape to the final, low-energy state is strongly impeded at room temperature. This demonstrates the importance of kinetic traps in determining the pathway of S-layer crystallization and suggests that the concept of folding funnels is equally valid for self-assembly of extended protein structures."
###
This research was supported by the DOE Office of Science.
Lawrence Berkeley National Laboratory addresses the world's most urgent scientific challenges by advancing sustainable energy, protecting human health, creating new materials, and revealing the origin and fate of the universe. Founded in 1931, Berkeley Lab's scientific expertise has been recognized with 13 Nobel prizes. The University of California manages Berkeley Lab for the U.S. Department of Energy's Office of Science. For more, visit www.lbl.gov.
The Molecular Foundry is one of five DOE Nanoscale Science Research Centers (NSRCs), national user facilities for interdisciplinary research at the nanoscale, supported by the DOE Office of Science. Together the NSRCs comprise a suite of complementary facilities that provide researchers with state-of-the-art capabilities to fabricate, process, characterize, and model nanoscale materials, and constitute the largest infrastructure investment of the National Nanotechnology Initiative. The NSRCs are located at DOE's Argonne, Brookhaven, Lawrence Berkeley, Oak Ridge and Sandia and Los Alamos national laboratories. For more information about the DOE NSRCs, please visit http://science.energy.gov/bes/suf/user-facilities/nanoscale-science-research-centers/.
DOE's Office of Science is the single largest supporter of basic research in the physical sciences in the United States, and is working to address some of the most pressing challenges of our time. For more information, please visit the Office of Science website at science.energy.gov/.
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AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.
WASHINGTON (AP) ? Climate scientistMichael Oppenheimer stood along the Hudson River and watched his research come to life as Hurricane Sandy blew through New York.
Just eight months earlier, the Princeton University professor reported that what used to be once-in-a-century devastating floods in New York City would soon happen every three to 20 years. He blamed global warming for pushing up sea levels and changing hurricane patterns.
New York "is now highly vulnerable to extreme hurricane-surge flooding," he wrote.
For more than a dozen years, Oppenheimer and other climate scientists have been warning about the risk for big storms and serious flooding in New York. A 2000 federal report about global warming's effect on the United States warned specifically of that possibility.
Still, they say it's unfair to blame climate change for Sandy and the destruction it left behind. They cautioned that they cannot yet conclusively link a single storm to global warming, and any connection is not as clear and simple as environmental activists might contend.
"The ingredients of this storm seem a little bit cooked by climate change, but the overall storm is difficult to attribute to global warming," Canada's University of Victoria climate scientist Andrew Weaver said.
Some individual parts of Sandy and its wrath seem to be influenced by climate change, several climate scientists said.
First, there's sea level rise. Water levels around New York are a nearly a foot higher than they were 100 years ago, said Penn State University climate scientist Michael Mann.
Add to that the temperature of the Atlantic Ocean, which is about 2 degrees warmer on average than a century ago, said Katharine Hayhoe, a climate scientist at Texas Tech University. Warm water fuels hurricanes.
And Sandy zipped north along a warmer-than-normal Gulf Stream that travels from the Caribbean to Ireland, said Jeff Masters, meteorology director for the private service Weather Underground.
Meteorologists are also noticing more hurricanes late in the season and even after the season. A 2008 study said the Atlantic hurricane season seems to be starting earlier and lasting longer but found no explicit link to global warming. Normally there are 11 named Atlantic storms. The past two years have seen 19 and 18 named storms. This year, with one month to go, there are 19.
After years of disagreement, climate scientists and hurricane experts have concluded that as the climate warms, there will be fewer total hurricanes. But those storms that do develop will be stronger and wetter.
Sandy took an unprecedented sharp left turn into New Jersey. Usually storms keep heading north and turn east harmlessly out to sea. But a strong ridge of high pressure centered over Greenland blocked Sandy from going north or east, according to the National Hurricane Center.
Jennifer Francis of Rutgers University, an expert in how a warming Arctic affects extreme weather patterns, said recent warming in the Arctic may have played a role in enlarging or prolonging that high pressure area. But she cautioned it's not clear whether the warming really had that influence on Sandy.
While components of Sandy seem connected to global warming, "mostly it's natural, I'd say it's 80, 90 percent natural," said Gerald North, a climate professor at Texas A&M University. "These things do happen, like the drought. It's a natural thing."
On Tuesday, both New York Mayor Michael Bloomberg and Gov. Andrew Cuomo said they couldn't help but notice that extreme events like Sandy are causing them more and more trouble.
"What is clear is that the storms that we've experienced in the last year or so, around this country and around the world, are much more severe than before," Bloomberg said. "Whether that's global warming or what, I don't know. But we'll have to address those issues."
Cuomo called the changes "a new reality."
"Anyone who says that there's not a dramatic change in weather patterns I think is denying reality," Cuomo said. "I told the president the other day: 'We have a 100-year flood every two years now.'"
For his published research, Oppenheimer looked at New York City's record flood of 1821. Sandy flooded even higher. This week's damage was augmented by the past century's sea level rise, which was higher than the world average because of unusual coastal geography and ocean currents. Oppenheimer walked from his Manhattan home to the river Monday evening to watch the storm.
"We sort of knew it could happen, but you know that's different from actually standing there and watching it happen," Oppenheimer said from a cell phone. "You don't really imagine what this looks like until you see it."
___
Associated Press writers Jennifer Peltz and Malcolm Ritter in New York and Michael Gormley in Albany contributed to this report.
___
Seth Borenstein can be followed at http://twitter.com/borenbears .
Social factors trump genetic forces in forging friendships, CU-led study finds Public release date: 31-Oct-2012 [ | E-mail | Share ]
Contact: Jason Boardman boardman@colorado.edu University of Colorado at Boulder
"Nature teaches beasts to know their friends," wrote Shakespeare. In humans, nature may be less than half of the story, a team led by University of Colorado Boulder researchers has found.
In the first study of its kind, the team found that genetic similarities may help to explain why human birds of a feather flock together, but the full story of why people become friends "is contingent upon the social environment in which individuals interact with one another," the researchers write.
People are more likely to befriend genetically similar people when their environment is stratified, when disparate groups are discouraged from interacting, the study found. When environments were more egalitarian, friends were less likely to share certain genes.
Scientists debate the extent to which genetics or environmental factors -- "nature" or "nurture" -- predict certain behaviors, said Jason Boardman, associate professor of sociology and faculty research associate with the Population Program in CU-Boulder's Institute of Behavioral Science. "For all the social demographic outcomes we care about, whether it's fertility, marriage, migration, health, it's never nature or nurture.
"It's always nature and nurture," he said. "And most of the time it has a lot more to do with nurture."
Boardman's team included Benjamin Domingue, research associate in the Population Program at IBS; and Jason Fletcher, associate professor of health policy at the Yale School of Public Health. Their research was recently published in the Proceedings of the National Academy of Sciences.
Early last year, PNAS published a study reporting evidence that certain shared genes might determine peoples' choice of friends. Time magazine dubbed this "friends with (genetic) benefits."
Boardman is a sociologist who spent five years studying genetics at CU-Boulder's Institute for Behavioral Genetics to bring insights of the social sciences to the natural sciences. He observed: "You can't understand the spread of health behaviors -- why people smoke, why they drink, why they may or may not be obese -- unless you understand their genetic liability and also place them in the right social context."
The research team used data from the National Longitudinal Study of Adolescent Health. Boardman's team focused on 1,503 pairs of friends in seventh through 12th grade in 41 schools. As with the earlier study, Boardman's group found that some pairs of friends shared certain genetic characteristics.
The team tested the evidence, arguing that if genes were the driving friendship factor, genetically based friendship should emerge most often and easily in schools with the least amount of social friction. "But we found the exact opposite," he said.
In the most socially equal environments, genetic homophily (or love of the same) was "pretty weak," meaning that friends were less likely to share genetic traits. He added, "It was in the most unequal social environments that we saw the highest level of genetic homophily."
In a socially stratified school, "Students from different populations within the school may be effectively 'off limits' for friendships," the team wrote.
While applauding the revolutionary advances in genetics in recent years, Boardman said "we have to have social scientists at the table, because we're the ones with the data, methods and theories to characterize the multidimensional and multilevel nature of the social environment."
Scientists cannot fully understand heritable changes in gene expression unless they understand "what kind of schools people go to, what neighborhoods they live in" and other social factors, Boardman said.
"To me, to say whether genes predict friendships without understanding the context within which these friendships may or may not occur just doesn't tell the whole story."
###
The team's research was funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the Office of Behavioral and Social Science Research at the National Institutes of Health. Fletcher is also supported by the Robert Wood Johnson Foundation Health and Society Scholars Program.
Boardman and Fletcher host an annual conference called Integrating Genetics and the Social Sciences.
-CU-
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AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.
Social factors trump genetic forces in forging friendships, CU-led study finds Public release date: 31-Oct-2012 [ | E-mail | Share ]
Contact: Jason Boardman boardman@colorado.edu University of Colorado at Boulder
"Nature teaches beasts to know their friends," wrote Shakespeare. In humans, nature may be less than half of the story, a team led by University of Colorado Boulder researchers has found.
In the first study of its kind, the team found that genetic similarities may help to explain why human birds of a feather flock together, but the full story of why people become friends "is contingent upon the social environment in which individuals interact with one another," the researchers write.
People are more likely to befriend genetically similar people when their environment is stratified, when disparate groups are discouraged from interacting, the study found. When environments were more egalitarian, friends were less likely to share certain genes.
Scientists debate the extent to which genetics or environmental factors -- "nature" or "nurture" -- predict certain behaviors, said Jason Boardman, associate professor of sociology and faculty research associate with the Population Program in CU-Boulder's Institute of Behavioral Science. "For all the social demographic outcomes we care about, whether it's fertility, marriage, migration, health, it's never nature or nurture.
"It's always nature and nurture," he said. "And most of the time it has a lot more to do with nurture."
Boardman's team included Benjamin Domingue, research associate in the Population Program at IBS; and Jason Fletcher, associate professor of health policy at the Yale School of Public Health. Their research was recently published in the Proceedings of the National Academy of Sciences.
Early last year, PNAS published a study reporting evidence that certain shared genes might determine peoples' choice of friends. Time magazine dubbed this "friends with (genetic) benefits."
Boardman is a sociologist who spent five years studying genetics at CU-Boulder's Institute for Behavioral Genetics to bring insights of the social sciences to the natural sciences. He observed: "You can't understand the spread of health behaviors -- why people smoke, why they drink, why they may or may not be obese -- unless you understand their genetic liability and also place them in the right social context."
The research team used data from the National Longitudinal Study of Adolescent Health. Boardman's team focused on 1,503 pairs of friends in seventh through 12th grade in 41 schools. As with the earlier study, Boardman's group found that some pairs of friends shared certain genetic characteristics.
The team tested the evidence, arguing that if genes were the driving friendship factor, genetically based friendship should emerge most often and easily in schools with the least amount of social friction. "But we found the exact opposite," he said.
In the most socially equal environments, genetic homophily (or love of the same) was "pretty weak," meaning that friends were less likely to share genetic traits. He added, "It was in the most unequal social environments that we saw the highest level of genetic homophily."
In a socially stratified school, "Students from different populations within the school may be effectively 'off limits' for friendships," the team wrote.
While applauding the revolutionary advances in genetics in recent years, Boardman said "we have to have social scientists at the table, because we're the ones with the data, methods and theories to characterize the multidimensional and multilevel nature of the social environment."
Scientists cannot fully understand heritable changes in gene expression unless they understand "what kind of schools people go to, what neighborhoods they live in" and other social factors, Boardman said.
"To me, to say whether genes predict friendships without understanding the context within which these friendships may or may not occur just doesn't tell the whole story."
###
The team's research was funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the Office of Behavioral and Social Science Research at the National Institutes of Health. Fletcher is also supported by the Robert Wood Johnson Foundation Health and Society Scholars Program.
Boardman and Fletcher host an annual conference called Integrating Genetics and the Social Sciences.
-CU-
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AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.
NASSAU, Bahamas?? Hurricane Sandy pounded the Bahamas with battering winds and rain on Friday after killing 21 people across the Caribbean, and was posing a menacing threat to the U.S. East Coast.
U.S. meteorologists expect a natural horror show of high wind, heavy rain, extreme tides and maybe snow to the west beginning early Sunday, peaking with the arrival of Hurricane Sandy on Tuesday and lingering past Halloween on Wednesday.
Experts predict at least $1 billion in damage in the United States.
"It's looking like a very serious storm that could be historic," said Jeff Masters, meteorology director of the forecasting service Weather Underground. "Mother Nature is not saying, 'Trick or treat.' It's just going to give tricks."
Weather trackers say the hardest-hit areas could span anywhere from the coastal Carolinas up to Maine, with New York City and the Boston area potentially in harm's way.
National Oceanic and Atmospheric Administration (NOAA) forecaster Jim Cisco said: "We don't have many modern precedents for what the models are suggesting."
Video: Carolinas, East Coast on watch for Hurricane Sandy (on this page)
Although Sandy is not forecast to be as strong as other recent storms to hit the Northeast, such as Hurricane Irene in August 2011, it holds the potential to cause significant damage because it will be moving slowly, forecasters said.
U.S. government forecasters said there is a 90 percent chance ? up from 60 percent two days earlier ? that the East Coast will get pounded.
"If you live on the U.S. East Coast, keep an eye on this storm," FEMA director Craig Fugate wrote on Twitter.
21 fatalities so far
The number of deaths blamed on Sandy's torrential rains and heavy winds jumped to 21 on Thursday: 11 in Cuba, nine in Haiti and one in Jamaica.
The fatalities in Cuba included a 4-month-old baby, NBC News' Mary Murray reported. Most were killed by falling trees or in building collapses in Santiago de Cuba province and neighboring Guantanamo province, the government said.
Video: Wide area of Northeast threatened
Late Thursday, Sandy weakened to a Category 1 storm as it tore through sparsely populated low-lying southeastern islands in the Bahamas, knocking out power and blowing off rooftops of some homes.
Early Friday, the U.S. National Hurricane Center said Sandy was about 15 miles southeast of Great Abaco Island in the Bahamas and was packing maximum sustained winds of 80 miles per hour.
South Florida feels effects
Winds and rains generated by Sandy were also being felt in south Florida.
A Tropical Storm Warning was in effect on Florida's East Coast from Ocean Reef to Flagler Beach and around Lake Okeechobee, the National Hurricane Center said. A Tropical Storm Watch was in effect for the Florida coast from Flagler Beach to Fernandina Beach, the Florida Upper Keys from Ocean Reef to Craig Key and Florida Bay, it said.
Fort Lauderdale-Hollywood International Airport reported Thursday night that 24 arrival flights and 23 departures were canceled for the day, according to NBCMiami.com. Sandy led to the cancellation of 23 arrivals and 21 departures at Miami International Airport, it said.
The hurricane part of the storm is likely to come ashore somewhere in New Jersey on Tuesday morning, the NOAA's Cisco said.
"It's almost a weeklong, five-day, six-day event," he added. "It's going to be a widespread serious storm."
It is also likely to hit during a full moon when tides are near their highest, increasing coastal flooding potential.
Slideshow: Sandy barrels through the Caribbean (on this page)
'A Nor'easter on steroids'?
With some trees still leafy and the potential for snow, power outages could last to Election Day, some meteorologists fear.
"It could be a Nor'easter on steroids," NWS meteorologist Robert Thompson told NBC station WHDH-TV in Boston. "It's got the potential to rival the great Nor'easters of the past depending upon the eventual track it takes."
Interactive: Wild Nor?easters explained (on this page)
Nor'easters are powerful storms that come up along the East Coast from the south and then increase in volatility with winds from the northeast. In this case, another storm is expected to move into the Northeast from the Ohio Valley around the same time, adding to the weather mix.
"Residents from New England to New York, Pennsylvania, New Jersey, Delaware, Maryland and Virginia should remain vigilant and be prepared to take action in the next few days," weather.com advised.
Sandy will likely be around for the 21st anniversary of the infamous "Perfect Storm" of Oct. 30, 1991, that killed six fishermen, WHDH noted.
Sandy was expected to move past the Bahamas by Friday evening and head north off the U.S. coast.
Related: PhotoBlog looks at Cuba, Haiti damage
Related: Northeast utilities gear up for storm Related: Damage could be worse than Irene, experts say Related: New England fears repeat of 2011 Halloween storm
Sandy is forecast to remain a Category 1 hurricane as it continues to move over the Bahamas on Friday, sending swirling rains and winds across several hundred miles.
The Bahamas Electricity Corp., which supplies power to most of the Bahamas, said Sandy had caused power outages on several islands.
NBC News' Marry Murray, The Associated Press and Reuters contributed to this report.
Chimpanzee innovations may be low tech by human standards, but they get the job done and are gradually improving and spreading, a new study co-authored by famed primatologist Jane Goodall suggests.
The study, published in the latest issue of Current Anthropology, presents the first documented case of successful transmission of a novel cultural behavior ? ant fishing ? between wild chimpanzee communities.
"Ant fishing in this case is using twigs, leaf midribs or grass probes to extract carpenter ants from their nests in living trees or dead wood," lead author Robert O'Malley, an assistant professor of anthropology at Kenyon College, told Discovery News.
Chimps trim their twig tools at the end, with side twigs and excess bark often removed, he added.
NEWS: Ape 'Genius' Smarter Than the Average Chimp
A clever and popular female chimp named Trezia somehow figured out this technique. Trezia, from the Mitumba chimp community of Gombe National Park, was transferred to the park's Kasekela chimpanzee community, where ant fishing is now all the rage among females around her age.
"Trezia ascended the Kasekela hierarchy more quickly than most immigrants, who often remain a bit peripheral in the community after emigrating, and she was not skittish around other chimpanzees," O'Malley said. "All this suggests she would have been a viable model for younger cohorts."
The Kasekela chimps had a win-win because, in addition to gaining smart Trezia, they also had the perfect classroom to learn from her: a relaxing spot called Hilltop.
"Kasekela chimpanzees tend to take a siesta at Hilltop for a few minutes or a few hours when they pass through the area, so it provides a relaxed social context and perhaps a good learning environment," explained O'Malley.
"There is very little undergrowth so visibility is very good," he said. "Most importantly, there are multiple fishing sites in visual proximity, including at least one Camponotus (type of ant) nest in a particular place at Hilltop."
NEWS: Smart Chimp Gets Speech Like a Human
Females tend to be the chimp versions of Bill Gates or the late Steve Jobs when it comes to innovations, however low-tech. That's just because "in chimpanzees, females are the sex that will typically disperse from their natal group at sexual maturity, so any cultural transmission between communities is most likely to occur through female transfer."
Science news from NBCNews.com
Scientists?pay tribute to?Lady Gaga with ferns
Science editor Alan Boyle's blog: Lady Gaga is already a huge name in the music world, but now she's a scientific name as well ? thanks to fans who named an entire genus of ferns after the pop star.
Meet the rookies in the Robot Hall of Fame
'Space Buddha' statue may be a fake
Scientists solve mystery of singing sands
Trezia is only the latest chimp to gain fame and food fortune among her own kind. A proficient nut-cracking female chimp in Liberia might have spread her know-how to others.
Then there is Imo, a Japanese macaque who learned to wash sweet potatoes.
"Imo also learned to throw scattered rice grains into the sea to separate them from sand, and a few other tricks as well," O'Malley said, adding that others within her own group observed her success and soon copied her methods.
Males also come up with their own useful techniques that appear to spread within their groups. A dramatic example concerns a male chimp living in Bossou, Guinea. He learned to deactivate snares, rescuing other chimps and setting off others before they harmed animals.
NEWS: Why Do Chimps Attack?
Vernon Reynolds, a primate expert who serves as an adviser at the Budongo Forest Research Project, told Discovery News that while the Bossou findings are "exceptional ... our chimps at Budongo make alarm calls at snares and also, on one occasion at least, our alpha male removed a snare from an adult female."
While chimpanzees in protected parks are better able to spread their knowledge, humans are sadly hurting the overall ability of these fellow primates to improve their lot in life through shared innovations.
"The many chimpanzee communities across Africa that have already disappeared have taken any unique cultural patterns of behavior with them," O'Malley said. "As the remaining populations become more isolated, there will be fewer opportunities for individuals to transfer between communities, which limits opportunities for both gene flow and for cultural diffusion."
Richard Vetstein is a nationally recognized real estate attorney,? frequently quoted in the media.? He was recently named one of Inman News? 100 Most Influential in Real Estate. Mr. Vetstein is the founder of the Vetstein Law Group and TitleHub Closing Services LLC. The? former outside claims counsel for a national title company, he has an active real estate litigation practice. He blogs at massrealestatelawblog.com
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Top 10 Real Estate Internet Resources
I thought it would be a good idea to list my Top 10 favorite websites, blogs and other internet sites for real estate. These include law blogs, local and national real estate sites, and even marketing blogs. Feel free to bookmark this post!
1.? HousingWire
This is one of the best national sites for staying up to date on current real estate economic data, mortgage trends, Fed policy, and regulations.
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2. Wall Street Journal Developments
You can?t go wrong with the Wall Street Journal, right? Some of the best real estate reporters and commentators contribute to this site. A must read on your Google Reader list.
3. Massachusetts Land Records
This is the main portal into the vast majority of the Massachusetts Registries of Deeds. From here you can look up the deeds, mortgages and liens on virtually any property in the state. If you need a guide to searching the online registry of deeds and a full listing of every registry, read this post.
4. Charles Gate Realty?s Boston Real Estate Blog
I really love this frequently updated blog by the team of tech savvy agents at Charles Gate Realty. It?s also a great resource for rentals which is often ignored in the blogosphere.
5. Agent Genius
An online real estate magazine with a robust editorial staff, covering a wide range of topics, including tech and social media, business news, and also good op-ed pieces.
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6. (tie)
SmarterBorrowing.com
Maintained by well-known mortgage banker, Brian Cavanaugh of RMS Mortgage, this is one of the best mortgage lending blogs out there, frequently updated with current news on the mortgage market.
The Massachusetts Mortgage Blog
Written by the extremely knowledgeable David Gaffin of Greenpark Mortgage.
7. Boston.com Real Estate Now Blog
This is Boston.com?s popular real estate blog managed by buyer?s agent, Rona Fishman, and reporter/writer Scott Van Voorhis. The blog has a very active group of trolls commenters who frequently stir up lively debate. Disclaimer: I contribute a weekly post to this blog.
8. Massachusetts Land Use Monitor
The very experienced group of attorneys at the venerable real estate firm of Rackemann, Sawyer are one of the few large firms who blog, and thankfully they do, because they have a wealth of knowledge and information to share. The blog is managed by Donald Pinto, who?s one of the best real estate attorneys in the Commonwealth and a really good guy.
9. Centers & Squares
Real estate agent bloggers and wanna-be?s, pay close attention. This is how you blog. This is a great and frequently updated blog all about ?the city squares of Cambridge, Somerville and Medford and the town centers of Arlington, Watertown and Belmont.? Written by Elizabeth Bolton, Realtor.
10. Inman Next Agent
Must read for keeping up with the latest in real estate technology, marketing, and social media. Contributors includes the well-known social media evangelists, Chris Smith and Katie Lance.
Honorable Mentions
Cambridgeville
Another standout blog from the Cambridge-Somerville area. Realtor Lara Gordon is a smart, witty writer who keeps her blog frequently updated with urban gems such as the worst places for bike crashes (Harvard Square, of course!), the Somerville Foodie Crawl, and her own photos of the new Charlestown-Cambridge footbridge (I wish more agents did this).
Living in Sudbury
Formerly a global marketing guru at ESPN, Realtor Gabrielle Daniels is the epitome of sass and sharp real estate writing. OMG, you must read her post, Translating Real Estate Ads: 101. Some Descriptions Will Have You ROFL.
Western Mass Living
Our sole entry west of I-495, Lesley Lambert has been blogging and tweeting forever, mixing posts about the Berkshire County lifestyle with a peek into her personal ?Dancing Queen? passion.
Curbed Boston
This is a nationally syndicated blog with a local feel. Recent posts include the opening of Southie?s Gate of Heaven Gym, a new Mexican joint in Brookline and new fixer-upper in Inman Square.
Well, that?s my list. Feel free to add your favorite sites to the comments, and we can expand this list!
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Richard D. Vetstein, Esq. is a Massachusetts real estate attorney who is passionate about staying up to date on real estate issues, nationally, regionally and locally.
The occupation of ants inside your own house is the very worst thing of all. All kinds of ants are pointless pests may it be red ants, fire ants or black ants. That is the reason why ant control is vital to take if you do not need to say adios to your house?s great supports, which unfortunately are the usual targets of such creatures.
Individuals consider most ants as a type of irritation. There are ants from the south called fire ants. These ants are very ruinous and assertive, their sting can be a source of easy reactions that ranges to vomiting or revulsion to a savage and severe reactions. If a fire ant hill or mound is alarmed or troubled, the ants there may be awfully damaging and will assertively sting anyone that intrudes there mound repeatedly. There are also ants called red imported fire ants that may mean damage or harm to buildings and homes. An ant hill that's made within or surrounding the air con unit will finally destroy the unit.
Thousands of Leaf cutter ants or red ants will attack a vegetable garden. They're not as assertive and destructive as the fire ants, but they destroy and injure your plant tops in a confirmed time. The Florida carpenter ant is a red-black and pure black flying ants with a length of of an in. are not so common matched against the fire ants. Really colony of the carpenter ants will create adult ants with wings once every year to have a look for a new place that may be their location to be able to start new colonies. Carpenter ants select soft woods that are decaying to pass into and build their nests.
There are some techniques of shedding these ants in your lawn or garden starting with organic pest control processes. You can begin by pouring boiling water into the ants for them to be drowned with as much as boiling water of 3 gallons to drown each ant hill or ant mound. You can use a natural repellent like water and citrus after the very hot water. You may blend it using a blender before tipping it over the mound of the ants. Another example of cure that's natural is mix equal measurement of borax and sugar. Then put the mix of borax around your yard in small boxes or containers like jars because its lids can work better ants have an attraction to the borax or sugar, these ants will carry it back to the anthill and after 1 or 2 weeks, the borax or sugar will kill the anthill. Another example of natural treatment is the use of cream of wheat or grits. Drizzle the elite of wheat or grits over the anthill. The ants in there will consume the grits and those grits will explode inside their bodies after expanding. This process is widely known to kill ants in just one day or two.
Another obstruction that is still natural for the ant invasion is planting a mint, but keep in mind that mint is an especially insistent plant and can attack your garden more you wanted it to be. If you prove that mint are very assertive, prepare a powerful mint tea to make a natural pesticide and put in all over the mound. Nevertheless if you continue to cannot treat an ant invasion with all of the natural treatments, the selection of chemical can be an answer to your problem.
Keep in mind that ants are powerful creatures and taking them away from your yard is proven to be hard. It is obligatory to have multiple attempts before having complete removal of ants from your place. If you cannot succeed by all your means, it's better to call a pro pest management for the remedial option.
If you are having an ant issue it is suggested you contact a professional. Certain pests like ants carry illnesses and could cause significant health issues to you and your folks that is why you should remove ants. If you want information about ant removal please visit our site here you will be capable of finding lots of useful recommendations and proofed methods from our professional technicians.
We all know the standard working hours in corporate America are 9 a.m. to 5 p.m., hence the phrase ?9-to-5.? But expansion stage companies are not ?corporate America? ? they are the innovative newcomers that break down barriers and change the way things are done. So when it comes to employee productivity, that workday model might not be your best option.
In an article on Inc.com, Ilya Pozin explains that 9-to-5 hours came out of the manufacturing era, when time clocks were the best way to measure an employee?s productivity on the line. But times have changed and time in the chair is no longer an accurate measure of productivity. In fact, with the myriad distractions (see: Internet browsing) that often distract employees that aren?t in the mood to work, another employee productivity model is becoming increasingly effective: autonomy.
In my opinion, it?s the key to getting the most out of each of your employees.
The essence of autonomy is that employees should be treated as adults and allowed to work in the way that they will be most productive. As long as they complete a project successfully and on time, the journey shouldn?t matter as much as the end result. If they aren?t producing, of course, then it?s a different story, and you may want to rethink who you are employing, rather than the model you use to foster employee productivity.
Not sure how to create autonomy? While every office is different and some tactics will work better than others at your company, here are some tips to help you give your employees the power, flexibility, and motivation to get their work done:
Flexible Hours
Maybe you have some early birds that are most productive early in the morning. If they want to come in at 7 a.m. and leave at 3 p.m., then let them. On the other side, maybe you have some night owls that would be more productive if they could sleep in a little later. If they want to work from 10 a.m. to 6 p.m., then they should be able to.
Of course, flexible hours need to factor in any meetings or inter-office dependencies, so think about implementing a policy where everyone must be in the office between 10 a.m. and 2 p.m. on Monday, Wednesday, and Friday. All other hours are up to them (or something along those lines). This way you can have all of your meetings during the time that everyone is there, but still allow your employees the flexibility of working when they will be more productive.
Remote Work
Now, I am not someone that can work from home. There are too many distractions and it requires a completely different mindset. But I do know that there are people that work better from home without the numerous distractions that offices often present. Allowing your employees the option to work from home one day a week may make a big difference.
No Break Regulation
Don?t make your employees ask for permission to take a break. Sometimes people just need to go for a walk around the block to clear their head. Whether it?s one or five times a day shouldn?t matter as long as they are getting their work done and projects are being completed on schedule.
No Internet Restrictions
Similar to my point about breaks, it?s not always a bad thing for your employees to think about something else for a few minutes before going back to their work with a refreshed mind. If that means your employees want to take 10 minutes to browse RueLaLa, Facebook, or MSNBC, then so be it. That 10 minutes spent focusing on something else will probably make their next hour focused on work much more productive.
In the end, autonomy and employee productivity both boil down to hiring the right people. If you hire employees that are hard-working and trustworthy, then you should feel comfortable giving them the freedom to complete their work in the way they think is best. This will allow each employee to tailor their day around what will make them more productive, and you?ll have a well-performing, happy team as a result.
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ISTANBUL (Reuters) - An anti-aircraft shell fired from Syria hit a health center across the border in the Reyhanli district of Turkey's Hatay province on Tuesday but there were no immediate reports of injuries, CNN Turk television said.
Turkey has bolstered its military presence along its 900-km (560-mile) border with Syria and has been responding in kind to gunfire and mortar shells hitting its territory from fighting between Syrian rebels and government forces.
The Reyhanli district governor's office said it had no immediate information on the incident.
Tension between the two neighbors, once close allies, is at its highest since Ankara turned against Syrian President Bashar al-Assad last year over his violent crackdown on anti-government protests.
Turkish newspaper Milliyet said on Saturday that the Turkish military had fired on Syria 87 times, killing 12 Syrian soldiers and destroying several tanks in retaliation for Syrian shells and mortar bombs landing inside Turkey.
Turkey's Chief-of-Staff General Necdet Ozel said this month that his troops would respond "with greater force" if shells continued to land on Turkish soil, and parliament has also authorized the deployment of troops beyond Turkey, heightening fears that Syria's civil war could drag in regional powers.
(Reporting by Daren Butler and Ece Toksabay; Writing by Nick Tattersall; Editing by Jon Hemming)
A new survey of realtors was released today (see below).? Here are?my answers:
1. Is?Now a Good Time to Buy or Sell in Your Area?
A.? It is a great time to sell, as long as you can live with today?s prices.? Sure, potential sellers can believe that it?s better to wait until prices go significantly higher, but that may not happen when you want it or need it, and it may never happen.
B. It is a terrible time to be a casual buyer.? Only those who buckle down and commit to seeing every new listing within the first day or two, and are willing to pay all the money for the quality buys will succeed.? Another big challenge is finding an agent who can win bidding wars.
2.? Do You Expect Prices to Generally Rise or Fall in the Next Year?
A.? I expect that general pricing will rise 5% statistically, and be hampered by inventory shortages, arrogant listing agents, and short-sale fraud.? All three are contributing to a pricing limitations, and only the first has a chance of changing.? If a?surge of well-priced quality homes were to hit the open market, they would be gobbled up quickly ? and the resulting momentum could take prices significantly higher if the flow of new listings continued.
3.? What are the Most Common Challenges for Buyers in Your Market?
A.? Having a clean shot to purchase?a property.? The time is ripe to convert to an open auction-type format to sell properties, so buyers can at least see with their own eyes what is happening.? The games being?played by listing agents are impeding open bidding and market-value pricing.
4.? What are the Most Common Challenges for Sellers in Your Market?
A.? Shopping for listing agents based on who will quote you the highest price, and ignoring how educated the buyers are about market values.
5.??Are Buyers and Sellers are Getting More Confident and Aggressive?
A. Absolutely, and they are more aggressive than the agents, who, as a result, are being left behind.
6.? The Real Estate ?Profession? Over the Next Five Years?
A.? The agent population should decline significantly, but there will always be licensees sitting around with business cards and a facebook account hoping that something will fall in their lap.? We are way overdue for a significant game-changer to shake up the industry (public-MLS), and it should set off a commission war.
Wrap-up:??Those who play nice will undoubtly feel better next year, as long as rates stay ultra-low, but nicey-nice agents only get the leftovers.? For those who are on the streets battling it out every day, the fight will be more competitive than ever.
See now as a good time to buy a home more often than a good time to sell one: 75% of agents surveyed described now as ?a good time to buy,? while only 54% described it as ?a good time to sell.?
Mostly expect price gains to be modest: Only 11% of agents expect home prices to ?rise a lot? in the next year.? The vast majority?76%?expect prices to ?rise a little.?
Are feeling the pinch of low inventory and multiple offers: 90% of agents indicated that low inventory was one of the most common challenges facing buyers, and 91% pointed to multiple offers.
Are seeing both buyers and sellers gaining confidence in the market: 85% of agents agreed that buyers are becoming more confident about the market, and 84% agreed that sellers are becoming more confident.
Have hope for future of the real estate profession: 59% of agents believe that the real estate profession will grow in size in the next five years, 30% believe it will remain the same, and just 11% see more declines in the future.
The picture painted by the agents is one of cautious optimism.? Most agents we surveyed expect modest price gains, improvements for buyers as well as sellers, and moderate growth in the real estate industry.? The results line up nicely with recent gains in overall consumer confidence, which has been rising steadily through the year.? No V-shaped recovery appears imminent, but rather a slow and steady trend back toward something resembling a normal market.
?That agents believe both buyers and sellers are becoming increasingly confident bodes well for sales volume in 2013,? said Redfin CEO Glenn Kelman. ?Over the past five years, eager sellers have been unable to find a buyer, or more commonly in 2012, eager buyers have been unable to find a seller. But going into 2013, we expect that a jittery market will settle down, and buyers and sellers will more easily come to terms. After years of irrational exuberance, crashes, foreclosure fire-sales, inventory shocks and saw-toothed trends, the cautious, broad-based optimism we?re seeing now is the best kind of recovery we could hope for.?
Posted on Tuesday, October 23rd, 2012 at 11:45 AM in Forecasts, Realtors Talking Shop, Survey, The Future | No Comments ? | ?Print You can follow any responses to this entry through the RSS 2.0 feed. Responses are currently closed, but you can trackback from your own site.
ScienceDaily (Oct. 22, 2012) ? A stay in the hospital may not be the only way to acquire Clostridium difficile diarrhea -- but the potentially life-threatening infection may be associated with a number of health complications in hospitalized children, according to the findings from two studies unveiled October 22 at the American College of Gastroenterology's (ACG) 77th Annual Scientific meeting in Las Vegas. In a separate case report also presented October 22, fecal microbiota transplantation in a 20-month old with recurrent Clostridium difficile infection (CDI) suggests the therapeutic potential fecal bacteriotherapy in pediatric patients who fail standard therapy for CDI.
In one study, researchers from Sinai Hospital in Baltimore retrospectively analyzed the changing epidemiological trends of patients with Clostridium difficile-associated diarrhea (CDAD) who were admitted to an acute care hospital between January 2005 and December 20120. The results of their analysis, "Changing Epidemiology of Clostridium difficile-Associated Diarrhea (CDAD) Among Long-Term Care Facility Patients," suggest a changing shift in the way CDAD is acquired -- from a traditional hospital-acquired infection to a community and long-term-care facility-based infection.
For the study, CDAD was defined as having clinical signs and symptoms of Clostridium difficile infection and a positive c. difficile stool toxin assay. The patients in the study were divided into three groups: nosocomial (hospital-acquired); long-term-care facility (LTCF); and community-acquired. Of the 258 toxin-positive CDAD patients in the analysis, 53 (20.6 percent) were nosocomial (hospital acquired); 119 were LTCF (46.1 percent) and 86 (33.3 percent) were in the community. The mean age for LTCF patients was higher than the other groups. Presenting symptoms were divided into diarrhea and non-diarrheal symptoms including fever, abdominal pain, and altered mental status. According to the results, the incidence of acute diarrhea was significantly lower in LTCF (18) patients as compared to patients from community (25).
Among the other findings:
* Most LTCF patients (80) presented with non-diarrheal symptoms whereas 47 community patients had non-diarrheal symptoms
* Use of proton pump inhibitors (PPI)s was more frequent in LTCF patients (73 percent) and nosocomial patients (69.8 percent) as compared to community patients (43 percent) -more-
* No clear indication was found for PPI use in 24.13 percent of LTCF patients using PPIs (21 out of 87), compared t 12.9 percent (4 out of 35) of nosocomial patients and 32.1 percent (9 out of 37) of community.
"There seems to be an epidemiological shift in C. difficile associated diarrhea from a traditional hospital -acquired infection to a community and long-term care facility-based infection," said co-investigator Vivek Kumar, M.D. He noted that diarrhea was not found to be the main presentation in LTCF patients. "This finding suggests that suspicion of C. difficile associated diarrhea should be high even if they present with non-specific symptoms such as abdominal pain, fever and altered mental status." He adds that more large scale epidemiological studies are needed to help us understand the spread of CDAD in the community.
Study Suggests CDI Associated with Increased Length of Hospital Stay, Other Health Implications for Children
While hospital and population-based studies have shown an increased incidence of C. difficile infection (CDI) in both adults and children, relatively little is known about the outcomes of infection in hospitalized children with CDI, according to researchers from the Mayo Clinic who analyzed the National Hospital Discharge Survey (NHDS) database to determine the epidemiology and outcomes of CDI in hospitalized children in another study. "The Epidemiology and Outcomes of Clostridium difficile Infection in Children from 2005-2009: Results from a Nationwide Survey," suggest that despite increased awareness of CDI in children and advancements in the management of CDI and infection and control practices, CDI remains a "major problem" in hospitalized children, and is associated with increased length of stay, colectomy, in-hospital mortality and discharge to a short-or-long-term care facility (DTCF).
There were an estimated 13.7 million children over the five-year study period, with a median age of 5 years and 47.8 percent female. Of this group, there were about 46,176 CDI cases (0.34 percent of all pediatric admissions) with a median age of 3 years; 48.1 percent female. The annual rate of CDI varied from 2.4 to 4.3 cases per thousand over the study period with no significant trend up or down, according to co-investigator Sahil Khanna, M.D.
Among the key findings children with C. difficile infection, compared to controls, had:
? Longer median length of stay (LOS): 6 versus 2 days
? Higher rates of colectomy (1.6 percent versus .32 percent)
? Higher all-cause in-hospital mortality (1.2 percent versus 0.48 percent) ? Higher discharge to long-term care facility (4.3 percent versus 2.7 percent)
"We did find that children with C. difficile infection were likely to stay in the hospital four days longer than children without the infection; twice as likely to lose part or all of their colon, and two and a half more times as likely to die in the hospital," said Dr. Khanna. "Despite increased awareness of C. difficile infection in children and advancements in management of C. difficile infection and infection prevention and control practices, this study suggests that CDI remains as major problem in hospitalized children. After adjusting for age, sex and cormorbidities, this study also suggests that C. difficile infection was an independent and the strongest predictor of increased length of stay, higher rates of colectomy, higher all-cause in-hospital mortality and higher discharge to a long-term care facility," Dr. Khanna explained.
"In hospitalized children C. difficile infection can be a major cause of morbidity and mortality. CDI should be considered as a differential in hospitalized children with diarrhea and managed aggressively," added Dr. Khanna.
Fecal microbiota therapy to treat recurrent C. difficile infection
"Recurrent C. difficile infection (CDI) has become a major problem in children often requiring recurrent and prolonged course of antibiotics," said co-investigator Dr. Sudhir Dutta. In a separate case-report also presented October 22, Dr. Dutta and a team of physicians from Sinai Hospital-Johns Hopkins Program in Internal Medicine and the Pediatric GI Department reported success after using fecal microbiota therapy to treat a case of recurrent C. difficile infection in a 20-month old male who was born premature at 27 weeks of gestation.
Fecal Microbiota Transplantation (FMT) involves taking the stool of a healthy person and putting it into the colon of a person with disease to help restore health. In persons with C. difficile infection, the goal is to restore the natural balance of good and bad bugs in the gut and eliminate the recurrent diarrhea, which can be life-threatening.
"While fecal microbiota therapy is successfully being used in adults with recurrent C. difficile infection, to our knowledge there is only one reported case in the pediatric literature where treatment with fecal microbiota transfer resulted in spontaneous improvement of symptoms and improvement of diarrhea," said Dr. Dutta.
In this case, the patient presented with a two-month history of diarrhea, rectal bleeding, and failure to thrive with a past medical history that included chronic lung disease and gastroesophageal reflux disease as well as treatment with multiple courses of antibiotics.
Co-investigator Dr. Rita Batra, of Sinai's Pediatric GI Department, noted that the decision to conduct FMT in the 20-month old patient was due to the severity of symptoms and because the procedure, "allows the fastest means of colonic composition of its normal microbiome components thus providing a primary line of defense against colonization and proliferation of opportunistic pathogenic bacteria including C. difficile."
After receiving donor stool from his mother via colonoscope in the right colon, the patient has now remained symptom-free with complete resolution of diarrhea, rectal bleeding and has consistently gained weight over the past three months, according to the case report.
"This case demonstrates the therapeutic potential of fecal bacteriotherapy in pediatric patients who fail standard therapy for C. difficile infection," said Dr. Dutta. "Randomized controlled studies with long-term follow up are needed to support the efficacy and safety of fecal microbiota therapy in pediatric patients."
About C. difficile
C. difficile causes diarrhea linked to 14,000 American deaths each year. Deaths related to C. difficile increased 400 percent between 2000 and 2007, due in part to a stronger germ strain, according to the Centers for Disease Control. C. difficile infections cost at least $1 billion in extra health care costs annually. Source: CDC
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Public release date: 31-Oct-2012
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Richard D. Vetstein, Esq. is a Massachusetts real estate attorney who is passionate about staying up to date on real estate issues, nationally, regionally and locally.
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