Component-Resolved Diagnostic Study of Dermatophagoides Pteronyssinus Major Allergen Molecules in a Southern Chinese Cohort

BACKGROUND AND OBJECTIVE

Little is known about component-resolved diagnosis (CRD) for Dermatophagoides pteronyssinus (Der p) sensitization in the Chinese population. We aimed to evaluate sensitization to Der p components in southern China.

METHODS

Two-hundred immunotherapy-naïve patients with asthma and/or rhinitis positive to specific IgE (sIgE) against Der p extract, along with 20 Der p-negative nonallergic healthy controls, were tested for sIgE against Der p 1, Der p 2, and Der p 10 using ImmunoCAP 100. Seventy-five were further examined with the ImmunoCAP Immuno Solid-phase Allergen Chip (ISAC). Der p 10-positive patients were also tested for sIgE against crude extracts of cockroach, moth, and shrimp.

RESULTS

In total, 183 (91.5%) of the 200 patients were sensitized to Der p 1 and/or Der p 2. The proportion of positive results and the median level of s1gE against Der p 1 were higher in children than in adults. Der p 1 and Der p 2 correlated with Der p in sIgE levels. ImmunoCAP ISAC demonstrated 100% specificity and 84% sensitivity in detecting Der p 1, Der p 2, and Der p 10 compared with ImmunoCAP 100. Sensitization to Der p 10 correlated well with sIgE to shrimp, moths, cockroaches, Pen m 1, Bla g 7, and Ani s 3.

CONCLUSIONS

The detection of Der p 1 and Der p 2 provided a good reflection of atopy to Der p in a Chinese cohort. Sensitization to Der p 10 may result from cross-reactivity with seafood and cockroaches in coastal southern China. ImmunoCAP ISAC may be a useful tool for CRD, with comparable performance to ImmunoCAP 100.

Effect of Different Matrix Metalloproteinase Inhibitors on Microtensile Bond Strength of an Etch-and-Rinse and a Self-etching Adhesive to Dentin

Aim

This study aimed to analyze the effect of different matrix metalloproteinase (MMP) inhibitors on the microtensile bond strength (microTBS) of an etch-and-rinse and a self-etching adhesive after 9 months of aging.

Methods and Materials

Flat human dentin surfaces were bonded either with an etch-and-rinse adhesive (Optibond FL) or a self-etching adhesive (Clearfil SE Bond). Dentin surfaces were left untreated or were pretreated with MMP inhibitors (2% chlorhexidine digluconate [CHX], 0.05% green tea extract, 1 mM ferrous sulfate, or 0.2 mM galardin) prior to application of the adhesive. Composite buildups were made incrementally. Pretreated groups were tested after 9 months of storage in artificial saliva (37°C) and compared with untreated groups, which were tested immediately (initial microTBS) and upon aging (9-month microTBS). Data were analyzed by linear mixed-model regression. Failure mode analysis was performed microscopically and statistically analyzed by repeated-measures analysis of variance (p<0.05).

Results

MicroTBS of the etch-and-rinse adhesive but not of the self-etching adhesive was significantly decreased by aging. For Optibond FL, pretreatment with 2% CHX, 0.05% green tea extract, and 0.2 mM galardin revealed bond strength values (MPa) similar to the initial microTBS (32.1±14.8) and significantly higher compared with the microTBS (20.3±13.6) of aged untreated dentin. No significant differences were observed between groups bonded with Clearfil SE Bond (initial microTBS: 28.3±12.4; 9-month microTBS: 25.3±11.8). Application of the MMP inhibitors decreased the number of adhesive failures compared with untreated controls after 9 months of aging, but this effect was not significant.

Conclusion

The MMP inhibitors prevented the decrease in microTBS upon aging of the etch-and-rinse but not of the self-etching adhesive.

The charge carrier localization in the cubic perovskite BaOsO3 revealed by an optical study

We present the optical conductivity spectra for the newly discovered cubic perovskite structure BaOsO3 at various temperatures. The compound exhibits metallic behaviour above 50 K, but becomes non-metallic below 50 K. However, below 550 cm(-1), neither the typical Drude response nor an energy gap is observed in optical conductivity spectra from 300 K to 10 K. A broad peak centred at about 550 cm(-1) is observed in the real part of optical conductivity σ1(ω). The structure could be well reproduced by the localization modified Drude model. The life time of the carrier, deduced from σ1(ω) in terms of the localization modified Drude model, decreases with T varying from 300 K to 100 K, then increases slightly at 10 K. The study indicates that the compound is at the boundary of metal-insulator transition.

Impact of student-run clinics on preclinical sociocultural and interprofessional attitudes: a prospective cohort analysis

INTRODUCTION

Descriptive studies suggest student-run clinics (SRCs) positively affect preclinical students' sociocultural and interprofessional attitudes, but few studies use validated measures.

METHODS

In a pre-post design, first-year medical, nursing, and pharmacy students who did and did not participate in SRCs completed demographic and open-ended questions, as well as two validated surveys, the Sociocultural Attitudes in Medicine Inventory (SAMI) and Readiness for Interprofessional Learning Scale (RIPLS), at the beginning and end of the year.

RESULTS

With 68% (n=182/267) matched surveys we found no significant differences between groups over time (SAMI p=.53, RIPLS p≥.28 for each subcategory). However, of SRC participants, 99% reported commitment to the underserved and 57% reported improved interprofessional attitudes.

DISCUSSION

Students participating in SRCs perceive positive benefits, but do not score differently from those who do not. The SRC experiences may not be frequent enough to affect these measures, particularly since our students were high-scoring upon entry.

Racial/ethnic differences in hip and diaphyseal femur fractures

Contemporary femur fracture rates were examined in northern California women and compared by race/ethnicity. During 2006-2012, hip fracture rates declined, but diaphyseal fracture rates increased, especially in Asians. Women with diaphyseal fracture were younger and more likely to be bisphosphonate-treated. These disparities in femur fracture should be further examined.

INTRODUCTION

The epidemiology of diaphyseal femur fracture differs from proximal femur (hip) fracture, although few studies have examined demographic variations in the current era. This study examines contemporary differences in low-energy femur fracture by race/ethnicity in a large, diverse integrated health-care delivery system.

METHODS

The incidence of hip and diaphyseal fracture in northern California women aged ≥50 years old during 2006-2012 was examined. Hip (femoral neck and pertrochanteric) fractures were classified by hospital diagnosis codes, while diaphyseal (subtrochanteric and femoral shaft) fractures were further adjudicated based on radiologic findings. Demographic and clinical data were obtained from health plan databases. Fracture incidence was examined over time and by race/ethnicity.

RESULTS

There were 10,648 (97.3 %) hip and 300 (2.7 %) diaphyseal fractures among 10,493 women. The age-adjusted incidence of hip fracture fell from 281 to 240 per 100,000 women and was highest for white women. However, diaphyseal fracture rates increased over time, with a significant upward trend in Asians (9 to 27 per 100,000) who also had the highest rate of diaphyseal fracture. Women with diaphyseal fracture were younger than women with hip fracture, more likely to be of Asian race and to have received bisphosphonate drugs. Women with longer bisphosphonate treatment duration were also more likely to have a diaphyseal fracture, especially younger Asian women.

CONCLUSION

During 2006 to 2012, hip fracture rates declined, but diaphyseal fracture rates increased, particularly among Asian women. The association of diaphyseal fracture and bisphosphonate therapy should be further investigated with examination of fracture pattern.

Regulation of signal transducer and activator of transcription 3 and apoptotic pathways by betaine attenuates isoproterenol-induced acute myocardial injury in rats

The present study was designed to investigate the cardioprotective effects of betaine on acute myocardial ischemia induced experimentally in rats focusing on regulation of signal transducer and activator of transcription 3 (STAT3) and apoptotic pathways as the potential mechanism underlying the drug effect. Male Sprague Dawley rats were treated with betaine (100, 200, and 400 mg/kg) orally for 40 days. Acute myocardial ischemic injury was induced in rats by subcutaneous injection of isoproterenol (85 mg/kg), for two consecutive days. Serum cardiac marker enzyme, histopathological variables and expression of protein levels were analyzed. Oral administration of betaine (200 and 400 mg/kg) significantly reduced the level of cardiac marker enzyme in the serum and prevented left ventricular remodeling. Western blot analysis showed that isoproterenol-induced phosphorylation of STAT3 was maintained or further enhanced by betaine treatment in myocardium. Furthermore, betaine (200 and 400 mg/kg) treatment increased the ventricular expression of Bcl-2 and reduced the level of Bax, therefore causing a significant increase in the ratio of Bcl-2/Bax. The protective role of betaine on myocardial damage was further confirmed by histopathological examination. In summary, our results showed that betaine pretreatment attenuated isoproterenol-induced acute myocardial ischemia via the regulation of STAT3 and apoptotic pathways.

Demographic factors affect willingness to register as an organ donor more than a personal relationship with a transplant candidate

BACKGROUND

Transplant candidate caregivers (TCCs) are an under-utilized but potentially devoted pool of advocates who themselves may be recruited to register for deceased organ donation.

AIM

The purpose of this study was to assess and compare recruitment barriers to deceased donor registration efforts in TCCs and health fair attendees (HFAs).

METHODS

A 42-item questionnaire assessing willingness to register as an organ donor and perceptions and knowledge about organ donation was administered to 452 participants (174 in Denver, 278 in San Francisco). Logistic regression, stratified by study site, was used to assess associations between explanatory variables and willingness to register as an organ donor.

RESULTS

In Denver, 83 % of TCCs versus 68 % of HFAs indicated a willingness to register (p = 0.03). Controlling for study group (TCC vs HFA), predictors of willingness to register were female gender [odds ratio (OR) 2.4], Caucasian race (OR 2.3), college graduate (OR 11.1), married (OR 2.4) and higher positive perception of organ donation (OR 1.2), each p < 0.05. In San Francisco, 58 % of TCCs versus 70 % of HFAs indicated a willingness to register (p = 0.03). Controlling for study group (TCC vs HFA), predictors of willingness to register were Caucasian race (OR 3.5), college graduate (OR 2.2), married (OR 1.9), higher knowledge (OR 1.6) and higher positive perception of organ donation (OR 1.2), each p < 0.05. In both locales, Caucasians were more likely to have positive perceptions about organ donation and were more willing to register.

CONCLUSIONS

Demographic characteristics, not personal connection to a transplant candidate, explain willingness to register as an organ donor.

Decrease in pituitary apparent diffusion coefficient in normal appearing brain correlates with hypopituitarism following traumatic brain injury

INTRODUCTION

Following traumatic brain injury (TBI), there may be persistent pituitary deficits despite the presence of normal conventional magnetic resonance (MR) images. Little is known about the association of microstructural changes in the pituitary with pituitary function in TBI patients with normal appearing brain on conventional MR images. Our aim was to quantify changes in pituitary apparent diffusion coefficient (ADC) of normal appearing brain in human traumatic brain injury.

METHODS

Forty-two patients admitted with a diagnosis of mild head injury having normal appearing brain imaging were scanned at 7 days after injury using a quantitative echo planar imaging acquisition to obtain ADC parametric map. Mean pituitary ADC values were compared with a control group (n = 30).

RESULTS

The TBI group showed a significant decrease in pituitary ADC compared to the controls. Furthermore, the mean ADC was much less in TBI patients with pituitary dysfunction compared to those with normal pituitary function. There was also a correlation between the development of pituitary dysfunction and decreasing ADC (r = 0.82, P<0.01).

CONCLUSION

Our findings suggest that pituitary ADC is a sensitive and independent marker of pituitary damage following traumatic insult, which is useful to detect the microstructural damage in pituitary in normal appearing brain.

Abstract OT2-3-02: NSABP B-43: A phase III clinical trial to compare trastuzumab (T) given concurrently with radiation therapy (RT) to RT alone for women with HER2+ DCIS resected by lumpectomy (Lx)

Background: A significant amount of DCIS is ER negative and/or overexpresses HER2. This provides an opportunity to test targeted therapy in DCIS. In xenograft models and cell lines, T boosts RT effectiveness. In T-treated HER2+ patients, apoptosis occurs within 1 wk of single agent T use, with T found in ductal aspirates. Ample safety evidence for T exists. T given during whole breast irradiation (WBI) may improve results for lumpectomy (Lx) resected HER2+ DCIS. A trial to examine this question will enhance the understanding of breast tumor biology and the prevention of such tumors and could possibly extend breast-conserving surgery benefits for women with DCIS.

Method: After Lx for pure DCIS, each patient's DCIS lesion is centrally tested for HER2 by IHC analysis. HER2 2+ tumors undergo FISH analysis. HER2 3+ or FISH+ patients can be randomly assigned to 2 doses of T, 3 weeks apart during WBI or to WBI alone.

Women ≥18 yrs. with a margin-clear Lx for pure DCIS, with ECOG status 0/1 who are clinically or pathologically node negative are eligible. Centrally tested DCIS must be HER2 +. ER and/or PR status must be known before randomization.

Primary aims are to determine if T decreases ipsilateral breast cancer recurrence, ipsilateral skin cancer recurrence, or ipsilateral DCIS. Secondary aims are to determine the benefit of T in preventing regional or distant recurrence and contralateral invasive breast cancer or DCIS. NSABP B-43 will determine if DFS, recurrence-free interval, and OS can be improved with the use of T. 2000 patients will be accrued over 7.9 yrs, with a definitive analysis of primary endpoints performed at 163 ipsilateral breast cancer events (7.5 - 8 yrs. after protocol initiation) with an 80% power to detect a hazard reduction of 36%, from 1.73 ipsilateral breast cancer events per 100 pt-yrs to 1.11 events per 100 pt-yrs. The 36% observed reduction in the hazard of IIBCR-SCR-DCIS on the T arm is based on a projection of 40% hazard reduction if the compliance were perfect, with a 10% noncompliance rate. As of 5-31-13, 1,349 patients have been randomized.

NCT00769379

Support: PHS NCI-U10-CA-69651, -12027; NCI P30-CA-14599; Genentech, Inc.

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr OT2-3-02.

Calumenin-15 facilitates filopodia formation by promoting TGF-β superfamily cytokine GDF-15 transcription

Filopodia, which are actin-rich finger-like membrane protrusions, have an important role in cell migration and tumor metastasis. Here we identify 13 novel calumenin (Calu) isoforms (Calu 3-15) produced by alternative splicing, and find that Calu-15 promotes filopodia formation and cell migration. Calu-15 shuttles between the nucleus and cytoplasm through interacting with importin α, Ran GTPase, and Crm1. The phosphorylation of the threonine at position 73 (Thr-73) by casein kinase 2 (CK2) is essential for the nuclear import of Calu-15, and either Thr-73 mutation or inhibition of CK2 interrupts its nuclear localization. In the nucleus, Calu-15 increases the transcription of growth differentiation factor-15 (GDF-15), a member of the transforming growth factor-β (TGF-β) superfamily, via binding to its promoter region. Furthermore, Calu-15 induces filopodia formation mediated by GDF-15. Together, we identify that Calu-15, a novel isoform of Calu with phosphorylation-dependent nuclear localization, has a critical role in promoting filopodia formation and cell migration by upregulating the GDF-15 transcription.

Duration of fluoroscopic-guided spine interventions and radiation exposure is increased in overweight patients

BACKGROUND

The impact of patient body mass index (BMI) on image-guided spine interventions remains unknown. Higher BMI is known to complicate the acquisition of radiographic images. Therefore it can be hypothesized that the patient's body habitus can influence the delivery of a spinal injection.

OBJECTIVE

To quantify the impact of patient BMI on the length of fluoroscopy and procedure times during spine interventions.

DESIGN

Secondary analysis of 2 prospective observational studies.

SETTING

All injections were performed in an outpatient university setting.

PARTICIPANTS

A total of 209 patients in whom spine injections were performed (99 women), with a mean age of 54.6 years.

METHODS

The fluoroscopy times for 202 participants and total procedure times for 137 participants were recorded. Additional participant characteristics, including age, gender, BMI, and actual procedures performed, also were collected. Analysis of covariance and linear and nonlinear model analysis were performed to assess the effect of BMI on fluoroscopy and procedure times.

MAIN OUTCOME MEASUREMENTS

Fluoroscopy time and procedure duration times.

RESULTS

Participants had a mean age of 54.6 years, 51% were men, and 77% (n = 155) were overweight (BMI ≥25). Participants received the following interventions: 40 zygapophyseal joint injections, 33 medial branch nerve blocks, 113 transforaminal epidural injections, and 16 combined zygapophyseal joint injections and epidural injections. Gender, procedure number, and procedure type did not differ between groups. The overweight group demonstrated a 30% increase in mean fluoroscopy time and a 35% increase in mean procedure time. Controlling for other variables, we found that differences in fluoroscopy time and procedure time were significant (P = .032 and P = .031, respectively) between the 2 groups.

CONCLUSIONS

Significantly prolonged procedure time and fluoroscopy time in overweight patients increase the risks associated with spine interventions, not only to the patients but also to the operating room staff exposed to ionizing radiation.

Comb-drive micro-electro-mechanical systems oscillators for low temperature experiments

We have designed and characterized micro-electro-mechanical systems (MEMS) for applications at low temperatures. The mechanical resonators were fabricated using a surface micromachining process. The devices consist of a pair of parallel plates with a well defined gap. The top plate can be actuated for shear motion relative to the bottom fixed plate through a set of comb-drive electrodes. Details on the operation and fabrication of the devices are discussed. The geometry was chosen to study the transport properties of the fluid entrained in the gap. An atomic force microscopy study was performed in order to characterize the surface. A full characterization of their resonance properties in air and at room temperature was conducted as a function of pressure, from 10 mTorr to 760 Torr, ranging from a highly rarefied gas to a hydrodynamic regime. We demonstrate the operation of our resonator at low temperatures immersed in superfluid (4)He and in the normal and superfluid states of (3)He down to 0.3 mK. These MEMS oscillators show potential for use in a wide range of low temperature experiments, in particular, to probe novel phenomena in quantum fluids.

Analysis of the causes and types of traumatic spinal cord injury based on 561 cases in China from 2001 to 2010

OBJECTIVES

A remarkable increase in traumatic spinal cord injury (TSCI) morbidity has occurred in China from 2001 to 2010 due to rapid industrial and economic development; this increase seriously threatens public health. The current study investigated the major causes and severity of TSCI in 561 hospitalized TSCI patients who came from all over China to the General Hospital of Chinese People's Armed Police Forces.

METHODS

Information (including each patient's age, gender, time and cause of injury and severity of spinal cord injury (SCI, complete or incomplete)) regarding 561 hospitalized TSCI patients whose injuries occurred between 2001 and 2010 was retrospectively analyzed.

RESULTS

Among the 561 patients, the youngest was 9 months old and the oldest was 67 years old; the average patient age was 34.74 ± 12.24 years. The sex ratio was 4.1:1 (male:female). The injuries were primarily caused by transportation accidents (51.2%), falling from a height (23.9%), tamping (8.6%), stumbling (8.0%), stabbing (3.0%) and crushing (1.8%). Although no statistically significant associations were observed between the different injury causes and severity of the injury, a statistically significant association was observed between the different injury causes and levels of the lesion.

CONCLUSION

Transportation accidents, falling from a height, tamping, stumbling, stabbing and crushing are the most common causes of TSCI. No statistically significant relationships were observed between certain injury causes and either complete or incomplete injury. However, different injury causes usually led to different levels of the lesion. No statistical differences were observed between the levels of the lesion and either complete or incomplete injury.

Impact of preclinical exposure to organ donation on knowledge and attitudes of medical students

CONTEXT

Medical students receive little exposure to organ donation and procurement programs.

OBJECTIVE

To describe a student-run elective and its effect on participants' knowledge about and attitudes toward organ donation.

INTERVENTION

Preclinical students interacted directly with donor families, organ recipients, and donation representatives; many participated in an organ procurement with the surgical team.

DESIGN

Between 2005 and 2007, 13 students who participated in the elective and a procurement were compared with 72 students who took the elective but did not participate in a procurement and with 22 control students. Students who participated in a procurement wrote reflections about their experience. In 2010, 15 first-year students who participated in the elective and a procurement and 59 randomly selected control students completed a previously validated measure.

OUTCOME

Themes included awe, surgical procedures, learning opportunities, and brain death. Regardless of procurement participation, the elective participants from 2005 to 2007 reported higher 4-item knowledge scores (P<.001) than control students reported, but their 4-item attitude scores did not differ (P = .21). The 2010 students did not differ from control students in their number of correct responses to the 20 knowledge questions (P = .48) or their individual responses to each of the 14 attitude questions (all P>.05).

RESULTS

Although elective participants reflected positively on their experiences and professed greater knowledge than control students via a researcher-made tool, these results were not sustained with a previously validated measure. These results point to the need for careful elective design and the need for more accurate measures to study the effectiveness of such interventions.

Neuroprotection of neurotrophin-3 against focal cerebral ischemia/reperfusion injury is regulated by hypoxia-responsive element in rats

Exogenous delivery of the neurotrophin-3 (NT-3) gene may provide a potential therapeutic strategy for ischemic stroke. To investigate the neuroprotective effects of NT-3 expression controlled by 5HRE after focal cerebral ischemia, we constructed a recombinant retrovirus vector (RV) with five copies of hypoxia-responsive elements (5HRE or 5H) and NT-3 and delivered it to the rat brain. Three groups of rats received RV-5H-NT3, RV-5H-EGFP or saline injection. Three days after gene transfer, the rats underwent 90min of transient middle cerebral artery occlusion (tMCAO), followed by 1-28days of reperfusion. Three days after tMCAO, brain NT-3 expression was significantly increased in the RV-5H-NT3-transduced animals compared with the RV-5H-EGFP or saline group, and brain infarct volume was smaller in the RV-5H-NT3-transduced group than the RV-5H-EGFP or saline group. The percentage of TUNEL-positive cells was reduced in RV-5H-NT3-transduced brains compared with the RV-5H-EGFP or saline group 3 and 7days after tMCAO. Furthermore, the neurological status of RV-5H-NT3-transduced rats was better than that of RV-5H-EGFP- or saline-transduced animals from 1day to 4weeks after tMCAO. Our results demonstrated that 5HRE could modulate NT-3 expression in the ischemic brain environment and that the up-regulated NT-3 could effectively improve neurological status following tMCAO due to decreased initial damage. To avoid unexpected side effects, 5HRE-controlled gene expression might be a useful tool for gene therapy of ischemic disorders in the central nervous system.

Dehydroepiandrosterone sulphate: action and mechanism in the brain

Dehydroepiandrosterone sulphate (DHEAS) is synthesised from dehydroepiandrosterone by the enzyme sulphotransferase. DHEAS is one of the most important neurosteroids in the brain. The concentration of DHEAS in the brain is sometimes higher than peripheral system. At the cellular level, DHEAS has been shown to modulate a variety of synaptic transmission, including cholinergic, GABAergic dopaminergic and glutamatergic synaptic transmission. In addition to the effect on the release of a number of neurotransmitters, DHEAS could also modulate the activity of postsynaptic receptors. DHEAS has been found to have multiple important effects on brain functions, such as memory enhancing, antidepressant and anxiolytic effects, and may have relationships with many brain diseases.