The pro-apoptotic factor Bax regulates macrophage necrosis during Mycobacterial infection

In the zebrafish-Mycobacterium marinum model for tuberculosis infection, excess TNF triggers necrosis of infected macrophages which leads to exuberant extracellular bacterial growth and host susceptibility (Tobin et al., 2012; Roca and Ramakrishnan, 2013). It has been shown that in infected macrophages, excess TNF induces production of mitochondrial reactive oxygen species (ROS) which activate two death pathways that converge in macrophage necrosis: cyclophilin D-dependent mitochondrial transition pore and acid sphingomyelinase-dependent ceramide production that leads to lysosomal permeabilization.

In exploring the events downstream of lysosomal permeabilization, we found that ceramide acts in a Cathepsin D-dependent manner to induce cell death. In the cytosol Cathepsin D initiates the activation of pro-apoptotic factors including Bid and Bax. We engineered Bax mutants that lack its different functional domains and studied the ability of each mutant protein to regulate apoptosis and necrosis. Then we infected Bax-deficient zebrafish larvae expressing the Bax mutants that were unable to induce apoptosis. We found the BH3 domain, which is required for Bax oligomerization during apoptosis, not to be required for necrosis under excess TNF conditions. Rather, an N-terminal transmembrane helix suggested to be the first portion of Bax in contact with the mitochondrial membrane was found to be required for necrosis. Current studies are focused on understanding post-translational modifications of Bax that determine whether activation of the same protein promotes apoptosis or necrosis.

Impacts of ethanol and nicotine withdrawal on fecal immunoglobulin A levels in rats (MUC3P.947)

Alcohol and nicotine are both well known to cause depression of immune response; however, the effects of withdrawal from these substances have not been extensively explored. The impacts of exposure may arise from direct depression of the immune system or from the stress associated with exposure and withdrawal. In this study the immune response of adult male Rattus norvegicus was tested following exposure to both alcohol and nicotine, alcohol alone, nicotine alone, or neither (n=4/group). Nicotine or saline was administered 3 times per day for 10 days (0.3 mg/kg in saline; subcutaneous). Alcohol (25%w/v in nutritionally complete diet; intragastric) or isocaloric dextrose-containing diet was administered during days 7-10 of nicotine administration following the same thrice-daily schedule. Fecal samples were collected 4, 7, 11 and 14 days post exposure and fecal extractions were tested via ELISA to measure immunoglobulin A (IgA) levels. The effects of ethanol exposure, nicotine exposure, time post-exposure, and the interactions of the three were tested using a 3-way ANOVA. There was a significant decrease in IgA levels across groups on day 7 (p = 0.015), followed by an increase in IgA levels measured on day 10 in ethanol exposed groups (p = 0.011). This fluctuation in mucosal immunity following binge exposure to ethanol suggests that the impacts of even short term alcohol use impact the immune response during a withdrawal period.

Sexual functioning in military personnel: preliminary estimates and predictors

INTRODUCTION

Although the military is a young and vigorous force, service members and veterans may experience sexual functioning problems (SFPs) as a result of military service. Sexual functioning can be impaired by physical, psychological, and social factors and can impact quality of life (QOL) and happiness.

AIMS

This study aims to estimate rates and correlates of SFPs in male military personnel across demographic and psychosocial characteristics, to examine the QOL concomitants, and to evaluate barriers for treatment seeking.

METHODS

This exploratory cross-sectional study was conducted using data from a larger nationwide study conducted between October 2013 and November 2013. This sample consists of 367 male active duty service members and recent veterans (military personnel) age 40 or younger.

MAIN OUTCOME MEASURES

Erectile dysfunction (ED) was determined using the five-item International Index of Erectile Function, sexual dysfunction (SD) was determined using the Arizona Sexual Experiences Scale, Male, and QOL was determined using the World Health Organization Quality of Life, Brief.

RESULTS

SFPs were associated with various demographic, physical, and psychosocial risk factors. The rates of SD and ED were 8.45% and 33.24%, respectively, for male military personnel aged 21-40. Those who were 36-40, nonmarried, nonwhite, and of lower educational attainment reported the highest rates of SFPs. Male military personnel with poor physical and psychosocial health presented the greatest risk for ED and SD. SFPs were associated with reduced QOL and lower happiness, and barriers for treatment were generally related to social barriers.

CONCLUSIONS

SFPs in young male military personnel are an important public health concern that can severely impact QOL and happiness.

Widespread divergence between incipient Anopheles gambiae species revealed by whole genome sequences

The Afrotropical mosquito Anopheles gambiae sensu stricto, a major vector of malaria, is currently undergoing speciation into the M and S molecular forms. These forms have diverged in larval ecology and reproductive behavior through unknown genetic mechanisms, despite considerable levels of hybridization. Previous genome-wide scans using gene-based microarrays uncovered divergence between M and S that was largely confined to gene-poor pericentromeric regions, prompting a speciation-with-ongoing-gene-flow model that implicated only about 3% of the genome near centromeres in the speciation process. Here, based on the complete M and S genome sequences, we report widespread and heterogeneous genomic divergence inconsistent with appreciable levels of interform gene flow, suggesting a more advanced speciation process and greater challenges to identify genes critical to initiating that process.

A cluster of Legionnaires' disease caused by Legionella longbeachae linked to potting compost in Scotland, 2008-2009

Three cases of Legionnaires disease caused by Legionella longbeachae Sg 1 associated with potting compost have been reported in Scotland between 2008 and 2009. The exact method of transmission is still not fully understood as Legionnaires disease is thought to be acquired by droplet inhalation. The linked cases associated with compost exposure call for an introduction of compost labelling, as is already in place in other countries where L. longbeachae outbreaks have been reported.

Towards automated sleep state estimation using a Holter-oximeter

Single-channel ECG and finger photoplethysmogram were used to estimate sleep states in obstructive sleep apnea patients. Overnight Holter-oximeter recordings from 14 subjects with suspected sleep apnea were analysed. Parameters including the RR interval, photoplethysmogram amplitude and rise time, and pulse arrival time were characterised and a Hidden Markov Model classifier used to identify Wake, REM and Sleep states. An overall accuracy of 77% and Cohen's kappa of 0.54 was achieved, establishing a baseline level of usefulness for sleep state estimation using a Holter-oximeter. Autonomic arousals detected using pulse arrival time also appeared to be strongly correlated with Epworth Sleepiness Scale scores.

Incidence of childhood cancer in Switzerland: the Swiss Childhood Cancer Registry

BACKGROUND

This report describes the incidence of childhood cancer in Switzerland, based on the data from the Swiss Childhood Cancer Registry (SCCR), a national hospital-based cancer registry with very high coverage, founded in 1976 by the Swiss Paediatric Oncology Group (SPOG).

PROCEDURE

Malignancies were coded according to the International Classification of Childhood Cancer (ICCC-3). Incidence rates per 100,000 person-years were calculated for all malignancies and groups of malignancies in Swiss residents less than 15 years of age for the decade 1995-2004.

RESULTS

The SCCR annually registered on average 174 new cases of cancer in Swiss residents aged <15 years, with a median age at diagnosis of 5.6 years. The crude incidence of childhood cancer in children aged <15 years was 13.5, higher for boys (15.0 per 100,000) than for girls (12.1 per 100,000), and was nearly twice as high in the first 5 years of life (19.3 per 100,000) than in the age group 5 to 14 years (10.8 per 100,000).

CONCLUSION

Incidence of childhood cancers in the SCCR was similar to neighbouring countries and to data published by regional cancer registries in Switzerland for the same period, suggesting good completeness of registration. This makes the SCCR a valuable resource for national and international research on childhood cancer.

The frequency and impact of restless legs syndrome in primary care

This study examined the prevalence and impact of moderate to severe RLS (MS-RLS) in primary care patients in Ireland. Patients completed a screening questionnaire and those with symptoms suggestive of MS-RLS underwent a diagnostic interview. Patients diagnosed with MS-RLS completed quality of life and sleep assessment questionnaires, and their medical records were examined. Of 2628 patients screened for RLS, 74 (2.8%, 95% confidence interval 2.2%-3.5%) were ultimately diagnosed at interview as having MS-RLS. These patients reported significant impact on sleep and quality of life; 24 (32.4%) had consulted a health care professional about their RLS symptoms but only 4 (16.7%) were diagnosed with RLS. Ten (13.5%) MS-RLS patients were taking inappropriate medicines to try to relieve their symptoms. Clinically significant RLS is common in Irish general practice and has a significant effect on sleep and quality of life. Nevertheless, the condition often goes undiagnosed.

The cost of treating type 2 diabetes (CODEIRE)

Diabetes mellitus is the most common chronic metabolic disease and a major source of morbidity and mortality. Type 2 diabetes (T2D) is by far the most prevalent form of diabetes accounting for around 90% of cases worldwide. In recent years it has become apparent that a diabetes epidemic is unfolding as a result of increasing obesity, sedentary lifestyles and an ageing population. The enormity of the diabetes epidemic raises concern about the total cost to healthcare systems. This study was undertaken to investigate the direct healthcare costs of managing T2D in Ireland. Data was captured on 701 diabetes patients attending four diabetes centres. A bottom-up, prevalence-based design was used, which collected data on hospital resource use and clinical outcome measures over a 12-month period (1999/2000). The study was observational in nature, focusing on usual care of patients with T2D. Although the true prevalence of T2D in Ireland is unknown, conservative estimates are 3.9% for diagnosed diabetes and 6% for both diagnosed and undiagnosed diabetes. Using these figures the annual total direct cost was estimated at 377.2 million euro for diagnosed diabetes and 580.2 million euro for both diagnosed and undiagnosed diabetes. This corresponds to 4.1% and 6.4% of total healthcare expenditure respectively. Hospitalisations were the main driver of costs, accounting for almost half of overall costs, while ambulatory and drug costs accounted for 27% and 25% respectively. Hospitalisation costs were high because 60% of patients had developed complications. The most common microvascular and macrovascular complications were neuropathy and angina respectively. The annual cost of care for patients with microvascular and macrovascular complications were 1.8 and 2.9 times the cost of treating those without clinical evidence of complications respectively. The figure for patients with both types of complications was 3.8. This study shows that T2D is a very costly disease, largely due to the cost of and the management of complications. Many diabetes related complications are preventable, therefore it would appear a cost-effective approach for government to invest in the prevention of T2D and diabetes related complications.

Coherent combination of high-power, zigzag slab lasers

We demonstrate a scalable architecture for a high-power, high-brightness, solid-state laser based on coherent combinations of master oscillator power amplifier chains. A common master oscillator injects a sequence of multikilowatt Nd:YAG zigzag slab amplifiers. Adaptive optics correct the wavefront of each amplified beamlet. The beamlets are tiled side by side and actively phase locked to form a single output beam. The laser produces 19 kW with beam quality <2x diffraction limited. To the best of our knowledge, this is the brightest cw solid-state laser demonstrated to date.

Ensembl 2006

The Ensembl () project provides a comprehensive and integrated source of annotation of large genome sequences. Over the last year the number of genomes available from the Ensembl site has increased from 4 to 19, with the addition of the mammalian genomes of Rhesus macaque and Opossum, the chordate genome of Ciona intestinalis and the import and integration of the yeast genome. The year has also seen extensive improvements to both data analysis and presentation, with the introduction of a redesigned website, the addition of RNA gene and regulatory annotation and substantial improvements to the integration of human genome variation data.

Causative alternations of children with specific language impairment

Alternating verbs to indicate or to relinquish cause requires an understanding of semantic and syntactic knowledge. This study evaluated the ability of children with specific language impairment (SLI) to produce the causative alternation in comparison to age peers and to language peers. The children with SLI were proficient in lexically alternating verbs, yet provided fewer passive and periphrastic constructions and more different verbs and adjectival responses. Overgeneralization error data suggest that the semantic systems of some children with SLI were similar to their age comparisons. Individual differences within the SLI group suggested that some children were adept at providing syntactic responses and overgeneralizations, whereas some of the SLI group provided less mature responses of no alternations and no responses. These findings demonstrate a syntactic deficit in the causative alternation for some children with SLI.

An approach to manageable datasets in diabetes care. British Diabetic Association

A proposal is made to help the implementation of the British Diabetic Association dataset for diabetes care in those sites of care where information technology has yet to be established, or is in need of modification. A stepped approach is suggested and priorities identified.

Myocardial enlargement in defective heart development

BACKGROUND

The cardiac neural crest (neural crest extending from the mid-otic placode to the caudal region of somite 3) provides ectomesenchymal cells that contribute to aortic arch development and are essential for aortico-pulmonary septation of the outflow tract. Bilateral ablation of the cardiac neural crest in the chick embryo, prior to migration, leads to aortic arch anomalies and failure of septation of the cardiac outflow tract, which produces a severe defect known as persistent truncus arteriosus (PTA). Altered hemodynamics resulting from abnormal aortic arch artery development and PTA and other unknown factors related to the absence of neural crest, are likely to alter the developmental history of the myocardium.

METHODS

In this study the wet and dry weights of ventricles and whole embryos, the total number of myocytes per ventricle and the myocyte density (number of myocytes per unit volume of ventricular myocardium) were compared in control (unwindowed eggs), sham-operated and cardiac neural crest ablated chick embryos at day 11 of incubation.

RESULTS

We found that the wet and dry weights of ventricles from hearts with PTA were not different from normal hearts in control and sham-operated embryos. However, the embryos with PTA weighed less than embryos with normal hearts. Thus, the ventricle to embryo weight ratios were greater in embryos with PTA compared to control and sham-operated embryos for both wet (14 and 20%, respectively) and dry (30 and 59%) weights. The data further implied that more water was present with respect to body weight in comparison with sham-operated and control embryos which indicated that the embryos with PTA were edematous. The total number of myocytes and the number of myocytes per unit volume were not different when comparing sham-operated with PTA. Further, there was no indication that the myocardium from hearts with PTA was abnormal despite the small size and edema of the embryos.

CONCLUSIONS

It appears that hemodynamic stresses, resulting from the structural defects produced by neural crest ablation, are insufficient to increase heart growth, although cardiac function is depressed as evidenced by edema and failure of the embryo to thrive.

Diabetes and alternative medicine: cause for concern

'Alternative' medicines are becoming increasingly popular, and in this paper we describe our experience with alternative approaches to orthodox diabetes management. Four patients with insulin-dependent diabetes reduced or stopped their insulin in favour of therapeutic approaches including prayer, faith healing, unusual diets, and supplements of vitamins and trace elements. This resulted in ketoacidosis in three, in one case life-threatening; and weight loss and hyperglycaemia in the other. One patient developed serious retinopathy. Additionally, eight other types of alternative diabetic treatment are described, not as far as we know associated with such serious complications. These include homeopathy, reflexology, meditation, herbal treatment, 'cellular nutrition', 'subconscious healing', 'pearl therapy' (drinking milk in which pearls have been boiled) and 'astrotherapy' (typing pieces of coral around the arm). Diabetes is a chronic incurable disease, for which modern treatments remain somewhat unsatisfactory. It is therefore perhaps not surprising that some patients seek alternative treatments with more attractive claims. Diabetes health professionals need to be aware of the potential dangers associated with some of these treatments.

Insulin treatment, time-zones and air travel: a survey of current advice from British diabetic clinics

To investigate current advice given to insulin-treated diabetic patients undertaking international flights crossing time-zones, we have conducted a survey of UK physicians running diabetic clinics. Consultants were asked to give the general advice they would give to travellers on twice-daily short- and intermediate-acting insulins in four different flight situations: westward London to New York (morning and evening departures) and eastward Manchester to Singapore (morning and evening departures). Response rate was poor (37%). Six percent of replies were unhelpful (e.g. 'ring the BDA', 'carry on as usual'), and 14% liable to cause hypoglycaemia. Thirteen percent advocated change to a 'basal-bolus' system of insulin administration. The rest used variants of additional insulin for westward flights and reduced flights eastward. There was great variation in advice, and many regimens were excessively complicated. We recommend simple individualized advice, without attempts at over-zealous glycaemic control during travel. Local arrival and departure times may fit in easily with insulin and meals at standard times before and after flying, and little or no dosage alteration may be needed.

Diabetes educators international: third time lucky?

Three attempts have been made to establish an international diabetes educators network (1984, 1988, 1991). This paper outlines the early meetings, and reports on the most recent 1991 initiative and the recommendations of three education workshops held during the International Diabetes Federation Congress (IDF) in Washington, DC, 1991. As a result of the workshops, a Steering Committee was formed to determine a structure and funding for an international diabetes educators network, to foster international networking, to establish communication with the IDF, and to plan another workshop during the 15th IDF Congress in Kobe, Japan.