Dexamethasone relieves the inflammatory response caused by inguinal hernia meshes through miR-155

BACKGROUND

Inguinal hernia is a relatively common condition. Most patients with inguinal hernia require surgery. At present, mesh repair is one of the most effective methods to treat inguinal hernia, but insertion of the mesh can cause inflammation. Dexamethasone (DEX) can treat inflammation, but the mechanism by which DEX alleviates inflammation caused by inguinal hernia mesh placement remains unclear.

METHOD

We randomly divided rats into groups: negative control (NC), inguinal hernia (IH), polypropylene mesh (PM), DEX treatment, and miR-155 treatment groups. RT-qPCR was performed to determine the expression of miR-155. ELISA was implemented to determine the secretion of IL-1β, IL-6, and IL-18. Western blotting was used to detect caspase-1, JAK1, p-JAK1, STAT3, and p-STAT3 expression. A dual-luciferase reporter gene array identified a connection between miR-155 and JAK1.

RESULTS

The results revealed that the expression of miR-155, IL-1β, IL-6, and IL-18 was upregulated in the PM group. After DEX treatment, the secretion of miR-155, caspase-1, IL-1β, IL-6, and IL-18 decreased. Dual luciferase results confirmed that miR-155 induced the targeted downregulation of JAK1, while a miR-155 mimic reversed the therapeutic effect of DEX, and the expression levels of p-JAK1 and p-STAT3 increased.

CONCLUSION

DEX regulates the JAK1/STAT3 signaling pathway through miR-155 to relieve inflammation caused by inguinal hernia meshes.

Influence of Disclosed and Undisclosed Funding Sources in Tobacco Harm Reduction Discourse: A Social Network Analysis

INTRODUCTION

Tobacco harm reduction (THR) discourse has been divisive for the tobacco control community, partially because it sometimes aligns public health and tobacco industry interests. Industry funding is contentious as it influences study outcomes, and is not always disclosed in scientific publications. This study examines the role of disclosed and undisclosed industry support on THR publications via social network analysis.

METHODS

We reviewed 826 English-language manuscripts (1992-2016) to determine disclosed and undisclosed industry (pharmaceutical, tobacco, and e-cigarette) and non-industry (including government) support received by 1405 authors. We used social network analysis to identify the most influential authors in THR discourse by assessing the number of their collaborators on publications, the frequency of connecting other authors in the network, and tendency to form groups based on the presence of sponsorship disclosures, sources of funding, and THR stance.

RESULTS

About 284 (20%) out of 1405 authors were supported by industry. Industry-sponsored authors were more central and influential in the network: with twice as many publications (Median = 4), 1.25 as many collaborators on publications (Median = 5), and higher likelihood of connecting other authors and thus having more influence in the network, compared to non-industry-sponsored authors. E-cigarette industry-sponsored authors had the strongest association with undisclosed industry support.

CONCLUSIONS

Authors with industry support exerted a stronger influence on the THR scientific discourse than non-industry-supported authors. Journals should continue adhering to strict policies requiring conflicts of interest disclosures. An increase in public health spending on tobacco control research may be necessary to achieve funding parity.

Descriptive cross-sectional survey of tobacco and cannabis restrictions on state and local film incentives in the USA

BACKGROUND

Reducing tobacco depictions in media has significant health benefits because tobacco placements in films normalise tobacco use and are linked to youth initiation. Cannabis depictions may have similar effects. Placing restrictions on film incentives has been suggested; however, it remains an unexplored strategy for reducing tobacco depictions. We investigated whether states and localities that offer film incentives have established funding restrictions to deter tobacco or cannabis depictions.

METHODS

We conducted a descriptive cross-sectional survey of official state and local government websites in the USA that listed film incentives. We coded policy level (ie, state, local), incentive type (ie, tax credit, rebate), incentive amounts, programme qualifiers and presence and characteristics of tobacco and cannabis restrictions.

RESULTS

Quantifiable tax incentives at the state level offered over $1.6 billion to producers. Among 50 US states and Washington, DC, 39 provided film incentives: 4 restricted tobacco and 0 restricted cannabis. Among the 238 local film offices we identified, 24 offered incentives; 5 restricted tobacco and 1 restricted cannabis. All the incentive restrictions excluded tobacco or cannabis purchases from reimbursement; there were no penalties for tobacco or cannabis depictions.

CONCLUSIONS

Film incentives are large financial commitments that may undermine public health since they allow depictions of tobacco and cannabis that contribute to initiation and use. Few states or localities limit film incentives related to tobacco or cannabis, and the existing restrictions are unlikely to deter depictions or product placement. Restrictions on incentives are an underused tool for deterring tobacco and cannabis depictions in film.

[Progress of lung organoids in lung epithelial repair and regenerative medicine]

The mechanical barrier of lung is made up of epithelial cells which participate in gas exchange. Some of these cells have stem cell potential and are known as lung epithelial stem cells. They play an important role in maintaining lung homeostasis and repairing injured epithelial cells. Organoids are derived from pluripotent stem cells or adult stem cells cultured in a three-dimensional manner in vitro. Their structure and function are very similar to original tissues or organs. They can also self-renew, proliferate, and differentiate. Lung organoids can simulate the structure and function of epithelial cells in vitro. They provide an ideal model for the study of lung epithelial stem cells, which repair epithelial cells in vitro. Meanwhile, they provide an ideal graft for regenerative medicine. Around the lung organoids, this review concludes the mechanisms involved in lung epithelial stem cells repairing epithelial cells, summarizes their applications in regenerative medicine, and provides related reference for the therapy of lung diseases.

Impact of a Multidisciplinary Curriculum Training Students and Residents in Tobacco Cessation Strategies for Adult Caregivers of Children

Introduction

Children's exposure to secondhand smoke is an underaddressed public health threat. The Clinical Effort Against Secondhand Smoke Exposure (CEASE) is a validated framework that trains pediatric providers to screen, counsel, refer to quitlines, and prescribe tobacco cessation medications to adult caregivers of children.

Methods

A physician champion at a major urban academic center delivered a longitudinal didactic curriculum of CEASE principles to medical and nurse practitioner students and pediatrics and family medicine residents. At the end of each session, participants completed an anonymous survey measuring changes in self-perceived knowledge, comfort, and familiarity with smoking cessation skills and concepts. Using a separate end-of-year questionnaire, we also surveyed a group of pediatric residents to compare the impact of CEASE training on clinical practice. Finally, we tracked the number of referrals to the state's quitline for the duration of the training.

Results

Fifty-two trainees (55% students, 45% residents) responded to the evaluation survey administered immediately following training. There were statistically significant improvements in median scores after CEASE training for comfort in screening, counseling, motivational interviewing, referring to smokers' helplines, and providing caregivers with nicotine replacement therapy (NRT) prescriptions. Fifty-one percent of pediatric residents (41 of 80) responded to the end-of-year survey, which showed statistically significant differences in the number of patients/caregivers offered a referral to California's quitline and prescription of NRT according to completion of CEASE training.

Discussion

CEASE training successfully improved the self-efficacy of health professions students and residents in smoking cessation techniques for adult caregivers of children.

Smoking Cessation, Version 3.2022, NCCN Clinical Practice Guidelines in Oncology

Although the harmful effects of smoking after a cancer diagnosis have been clearly demonstrated, many patients continue to smoke cigarettes during treatment and beyond. The NCCN Guidelines for Smoking Cessation emphasize the importance of smoking cessation in all patients with cancer and seek to establish evidence-based recommendations tailored to the unique needs and concerns of patients with cancer. The recommendations contained herein describe interventions for cessation of all combustible tobacco products (eg, cigarettes, cigars, hookah), including smokeless tobacco products. However, recommendations are based on studies of cigarette smoking. The NCCN Smoking Cessation Panel recommends that treatment plans for all patients with cancer who smoke include the following 3 tenets that should be done concurrently: (1) evidence-based motivational strategies and behavior therapy (counseling), which can be brief; (2) evidence-based pharmacotherapy; and (3) close follow-up with retreatment as needed.

From Cancer Epidemiology to Policy and Practice: the Role of a Comprehensive Cancer Center

Purpose of Review

Cancer incidence and mortality are decreasing, but inequities in outcomes persist. This paper describes the San Francisco Cancer Initiative (SF CAN) as a model for the systematic application of epidemiological evidence to reduce the cancer burden and associated inequities.

Recent Findings

SF CAN is a multi-institutional implementation of existing evidence on the prevention and early detection of five common cancers (i.e., breast, prostate, colorectal, liver, and lung/tobacco-related cancers) accounting for 50% of cancer deaths in San Francisco. Five Task Forces follow individual logic models designating inputs, outputs, and outcomes. We describe the progress made and the challenges faced by each Task Force after 5 years of activity.

Summary

SF CAN is a model for how the nation’s Comprehensive Cancer Centers are ideally positioned to leverage cancer epidemiology for evidence-based initiatives that, along with genuine community engagement and multiple stakeholders, can reduce the population burden of cancer.

Compliance with San Francisco's flavoured tobacco sales prohibition

BACKGROUND

In June 2018, San Francisco voters upheld the first comprehensive prohibition on sales of flavoured tobacco products (all products including menthol, everywhere in the city with no exceptions).

METHODS

This paper used data collected by the San Francisco Department of Public Health as part of its implementation and enforcement of San Francisco's city-wide ban on the sale of flavoured tobacco products. Every licensed tobacco retailer was visited and inspected. The San Francisco Department of Public Health and volunteers conducted an educational campaign from September 2018 to December 2018, including emailing all licensed tobacco retailers about the law, mailing a fact sheet poster, conducting four listening sessions and visiting permitted tobacco retailers to educate them about the law and solicit questions.

RESULTS

Compliance inspections started in December 2018, which found that compliance was 17%. Compliance increased in January 2019 and averaged 80% between January 2019 and December 2019. After the phase-in period, all retailers were visited as part of routine inspections. This effort resulted in 80% compliance.

CONCLUSION

Including retailer education prior to enforcement can result in compliance with a comprehensive ban on the sale of menthol and other flavoured tobacco products.

Analysis of on-pack messages for e-liquids: a discrete choice study

BACKGROUND

Policymakers wishing to encourage smokers unable to quit to switch to using electronic nicotine delivery systems (ENDS) also need to consider how to deter ENDS use among non-smokers. We examined whether reduced-risk messages could increase ENDS' appeal among smokers and if increased-risk messages could decrease appeal among susceptible non-smokers, occasional and former smokers.

METHODOLOGY

An online discrete choice experiment tested three attributes: information message, nicotine content (0 mg or 3 mg) and flavour (tobacco, menthol or fruit). The sample comprised 352 current smokers, 118 occasional and former smokers, and 216 ENDS-susceptible never smokers. Smokers viewed reduced-risk messages that encouraged switching to ENDS, while other groups viewed increased-risk messages that discouraged ENDS use. All groups saw a typical addiction warning. We analysed the data by estimating multinomial logit regression and adjusted latent class analysis models.

RESULTS

Relative to no message, reduced risk-messages increased the appeal of ENDS uptake among one class of smokers (33.5%) but decreased appeal among other smokers. However, among all smokers, reduced-risk messages increased preference more than a dissuasive addiction warning. By contrast, among occasional or former smokers, and susceptible non-smokers, all information messages discouraging ENDS use, including an addiction warning, decreased preference relative to no message.

CONCLUSIONS

On-pack relative-risk messages about ENDS could make transition more attractive to smokers while increased-risk messages could deter ENDS uptake among susceptible non-smokers, occasional and former smokers. Communicating diverse messages via discrete channels could recognise heterogeneity among and between smokers and non-smokers.

'Being politically active does not have to be difficult.' A content analysis of tobacco industry-sponsored advocacy websites

OBJECTIVE

To characterise the thematic content of tobacco industry-sponsored advocacy websites in the USA and to compare these sites to identify differences in products, target audience, policies or themes.

METHODS

In 2017, US-based Google and purposive searches identified six US tobacco industry-sponsored advocacy websites. A coding guide based on existing literature, tobacco policy issues and iterative review of the websites was developed and, descriptive analyses of themes on individual websites and overall were conducted.

RESULTS

We identified 18 themes; the most common of these were: tobacco taxes (13.9%), providing advocacy resources (10.6%) and pleas for action (10.3%). Related themes were aggregated into four broad categories: advocacy (36.7%), taxes (31.4%), legislation is excessive or unnecessary (21%), and support for weaker tobacco control policies (10.9%). Websites targeting consumers provided more resources to facilitate advocacy than websites targeting retailers.

CONCLUSIONS

Websites promoting protobacco advocacy are an important and evolving strategy for the tobacco industry. Websites are particularly well suited to leverage marketing activities (eg, building relationships with retailers and consumers) to achieve policy objectives. Monitoring these tactics may allow advocates to counter and anticipate industry opposition to tobacco policy.

A Practice Theory Approach to Understanding Poly-Tobacco Use in the United States

This paper uses practice theory to explore a poorly understood phenomenon with important health implications: How and why an increasing number of young Americans regularly use multiple tobacco products. Practice theory is a promising alternative to traditional public health frameworks for understanding everyday activities related to health. It broadens the analytic focus from characteristics of individuals to viewing practices as having lives of their own in competing for, winning, and losing practitioners. We drew from in-depth interviews with 21 young adults (ages 18-29; California) who regularly use cigarettes, electronic nicotine delivery systems (ENDS), and/or smokeless tobacco. Participants described their everyday routines. We examined the characterizing elements of each tobacco product use practice and the roles of each within participants' routines. We found that each product comprises a distinct substance use practice with different roles to play in different situations and contexts. Notably, many participants rotated between or modulated use of different products as a strategy for reducing perceived tobacco-related harms. Cigarettes are uniquely capable of aiding in the space-time organization of everyday activities and coping with crisis, while ENDS and smokeless tobacco open up times and spaces for nicotine consumption. This kind of approach aids our understanding and anticipation of the evolution of tobacco use practices as new products and regulations are introduced.

[Related factors for microalbuminuria in adult type 1 diabetes patients of short disease duration]

Objective: To investigate related factors for microalbuminuria in adult type 1 diabetes (T1D) patients of short disease duration (less than 5 years), and provide evidence for prevention of early diabetic kidney disease in this population. Methods: All adult patients enrolled in the Guangdong T1D translational medicine study between 2011 and 2017 with a disease duration of less than 5 years were included in this analysis. At enrollment, patients' demographic and clinical data were documented, and blood and urine samples were collected for the measurements of blood lipids, glycated hemoglobin A1c and urine albuminuria. Insulin resistance was evaluated by estimated glucose disposal rate (eGDR). Patients were categorized into groups based on urine albumin creatitine ratio (UACR): normoalbuminuric group (UACR<30 mg/g) and microalbuminuric group (UACR≥30 mg/g). Stepwise multivariate linear regression analysis was used to analyze risk factors for microalbuminuria in adult T1D patients of short disease duration. Results: A total of 384 patients were included in this analysis, and 51.3% (197/384) of which was female. The onset age of patients was (24.6±12.5) years, with a disease duration of 2.1(0.6, 3.5) years, body mass index of (19.8±3.2) kg/m(2), waist hip ratio of 0.85±0.21, and glycated hemoglobin A1c of (9.8±3.3)% at enrollment. Microalbuminuria occurred in 62 patients (16.1%). Multivariate linear analysis showed that higher glycated hemoglobin A1c, higher systolic blood pressure and more severe insulin resistance were related factors for microalbuminuria (t=2.322, 2.868 and -2.373, respectively, all P<0.05). Conclusions: Microalbuminuria was not rare in adult T1D patients of short disease duration. Inadequate glycemic control and insulin resistance were independent related factors for microalbuminuria in this population.

Search for Lepton-Flavor Violating Decays B^{+}→K^{+}μ^{±}e^{∓}

A search for the lepton-flavor violating decays B^{+}→K^{+}μ^{±}e^{∓} is performed using a sample of proton-proton collision data, collected with the LHCb experiment at center-of-mass energies of 7 and 8 TeV and corresponding to an integrated luminosity of 3  fb^{-1}. No significant signal is observed, and upper limits on the branching fractions are set as B(B^{+}→K^{+}μ^{-}e^{+})<7.0(9.5)×10^{-9} and B(B^{+}→K^{+}μ^{+}e^{-})<6.4(8.8)×10^{-9} at 90% (95)% confidence level. The results improve the current best limits on these decays by more than one order of magnitude.

[Awareness of preconceptional care and its related factors in women of child-bearing age with type 1 diabetes]

Objective: To investigate the awareness of preconception care among women of child-bearing age with type 1 diabetes (T1DM) and their self-management status, in order to provide evidence for establishment of management pathway for women with T1DM in pregnancy in China. Methods: This cross-sectional survey recruited female participants of child-bearing age from the cohort of Guangdong Type 1 Diabetes Translational Medicine Study conducted between June 2011 and December 2017. The participants were asked to fill out a questionnaire on the awareness of preconception care, their frequency of self-monitoring of blood glucose (SMBG) and other related variables. Chi-squared test or chi-squared test for trend was used in comparisons of categorical variables, and logistic regression analysis was performed to assess associated factors. Results: Totally, 441 women of child-bearing age with T1DM were investigated. The results show that their awareness of preconception care was poor (15.42%, 68/441). Higher educational level (χ(2trend)=3.990, P=0.046), experience of post-diabetes education evaluation (P<0.001), and better coverage of different modules in diabetes education (survival skills: χ(2)=7.525, P=0.004; basic knowledge: χ(2)=8.598, P=0.002; advanced knowledge: P<0.001) were associated with better awareness of preconception care. The average frequency of SMBG in these participants was 0.29 (0.14, 2.00) times per day, and only 8.5% (37/435) of them reached the frequency (≥4 times per day) recommended by guidelines. Moreover, 21.1% (92/435) of them hardly ever performed SMBG. Conclusion: Child-bearing age women with T1DM in Gunangdong had poor awareness of preconception care, with a much lower SMBG frequency than recommendation.

Observation of an Excited B_{c}^{+} State

Using pp collision data corresponding to an integrated luminosity of 8.5  fb^{-1} recorded by the LHCb experiment at center-of-mass energies of sqrt[s]=7, 8, and 13 TeV, the observation of an excited B_{c}^{+} state in the B_{c}^{+}π^{+}π^{-} invariant-mass spectrum is reported. The observed peak has a mass of 6841.2±0.6(stat)±0.1(syst)±0.8(B_{c}^{+})  MeV/c^{2}, where the last uncertainty is due to the limited knowledge of the B_{c}^{+} mass. It is consistent with expectations of the B_{c}^{*}(2^{3}S_{1})^{+} state reconstructed without the low-energy photon from the B_{c}^{*}(1^{3}S_{1})^{+}→B_{c}^{+}γ decay following B_{c}^{*}(2^{3}S_{1})^{+}→B_{c}^{*}(1^{3}S_{1})^{+}π^{+}π^{-}. A second state is seen with a global (local) statistical significance of 2.2σ (3.2σ) and a mass of 6872.1±1.3(stat)±0.1(syst)±0.8(B_{c}^{+})  MeV/c^{2}, and is consistent with the B_{c}(2^{1}S_{0})^{+} state. These mass measurements are the most precise to date.

Observation of a Narrow Pentaquark State, P_{c}(4312)^{+}, and of the Two-Peak Structure of the P_{c}(4450)^{+}

A narrow pentaquark state, P_{c}(4312)^{+}, decaying to J/ψp, is discovered with a statistical significance of 7.3σ in a data sample of Λ_{b}^{0}→J/ψpK^{-} decays, which is an order of magnitude larger than that previously analyzed by the LHCb Collaboration. The P_{c}(4450)^{+} pentaquark structure formerly reported by LHCb is confirmed and observed to consist of two narrow overlapping peaks, P_{c}(4440)^{+} and P_{c}(4457)^{+}, where the statistical significance of this two-peak interpretation is 5.4σ. The proximity of the Σ_{c}^{+}D[over ¯]^{0} and Σ_{c}^{+}D[over ¯]^{*0} thresholds to the observed narrow peaks suggests that they play an important role in the dynamics of these states.

Observation of CP Violation in Charm Decays

A search for charge-parity (CP) violation in D^{0}→K^{-}K^{+} and D^{0}→π^{-}π^{+} decays is reported, using pp collision data corresponding to an integrated luminosity of 5.9  fb^{-1} collected at a center-of-mass energy of 13 TeV with the LHCb detector. The flavor of the charm meson is inferred from the charge of the pion in D^{*}(2010)^{+}→D^{0}π^{+} decays or from the charge of the muon in B[over ¯]→D^{0}μ^{-}ν[over ¯]_{μ}X decays. The difference between the CP asymmetries in D^{0}→K^{-}K^{+} and D^{0}→π^{-}π^{+} decays is measured to be ΔA_{CP}=[-18.2±3.2(stat)±0.9(syst)]×10^{-4} for π-tagged and ΔA_{CP}=[-9±8(stat)±5(syst)]×10^{-4} for μ-tagged D^{0} mesons. Combining these with previous LHCb results leads to ΔA_{CP}=(-15.4±2.9)×10^{-4}, where the uncertainty includes both statistical and systematic contributions. The measured value differs from zero by more than 5 standard deviations. This is the first observation of CP violation in the decay of charm hadrons.

Search for CP Violation in D_{s}^{+}→K_{S}^{0}π^{+}, D^{+}→K_{S}^{0}K^{+}, and D^{+}→ϕπ^{+} Decays

A search for charge-parity (CP) violation in Cabibbo-suppressed D_{s}^{+}→K_{S}^{0}π^{+}, D^{+}→K_{S}^{0}K^{+}, and D^{+}→ϕπ^{+} decays is reported using proton-proton collision data, corresponding to an integrated luminosity of 3.8  fb^{-1}, collected at a center-of-mass energy of 13 TeV with the LHCb detector. High-yield samples of kinematically and topologically similar Cabibbo-favored D_{(s)}^{+} decays are analyzed to subtract nuisance asymmetries due to production and detection effects, including those induced by CP violation in the neutral kaon system. The results areA_{CP}(D_{s}^{+}→K_{S}^{0}π^{+})=(1.3±1.9±0.5)×10^{-3},A_{CP}(D^{+}→K_{S}^{0}K^{+})=(-0.09±0.65±0.48)×10^{-3},A_{CP}(D^{+}→ϕπ^{+})=(0.05±0.42±0.29)×10^{-3},where the first uncertainties are statistical and the second systematic. They are the most precise measurements of these quantities to date, and are consistent with CP symmetry. A combination with previous LHCb measurements, based on data collected at 7 and 8 TeV, is also reported.

[Glycemic control and its associated factors in children and adolescents with type 1 diabetes mellitus]

A higher frequency of SMBG is one of the key factors to achieve sufficient glycemic control among children and adolescents with T1DM treated with CSII.

How Menthol Is Key to the Tobacco Industry's Strategy of Recruiting and Retaining Young Smokers in Singapore

INTRODUCTION

Singapore has a strong and well-established tobacco control policy, but smoking rates among young Singaporeans remain relatively high. In other countries, tobacco companies have used menthol to encourage smoking among young people. Singapore still permits the sale of menthol tobacco products and little is known about the tobacco industry's internal strategy and motivation for marketing menthol tobacco in Singapore.

METHODS

Tobacco industry documents analysis using the Truth Tobacco Industry Documents Library. Findings were triangulated with Euromonitor market data on menthol tobacco in Singapore, and trend data on smoking prevalence in Singapore from the First National Morbidity Survey, Labour Force Survey, National Health Survey, and National Health Surveillance Survey.

RESULTS

Menthol tobacco products became popular among young Singaporeans in the early 1980s, largely due to a health-consciousness trend among young people and the misperception that menthol tobacco products were "safer." Philip Morris, in an attempt to compete with R.J. Reynolds for starter smokers, developed and launched several menthol brands designed to appeal to youth. While many brands initially failed, as of February 2018, menthol tobacco products comprise 48% of Singapore's total tobacco market.

CONCLUSIONS

Menthol is key to the tobacco industry's strategy of recruiting and retaining young smokers in Singapore. Banning the sale of menthol tobacco products will be an important part of preventing smoking in Singapore's younger generation.

Heated tobacco products likely appeal to adolescents and young adults

BACKGROUND

Beginning in the 1960s in the USA and globally since 1998, tobacco companies have beenaggressively promoting heated tobacco products (HTP). In 2016, Philip Morris International (PMI) applied to the US Food and Drug Administration (FDA) seeking authorisation to market their IQOS HTP system and flavoured 'HeatSticks' in the USA as a modified-risk tobacco product (MRTP).

METHODS

We systematically evaluated the publicly available data PMI submitted to FDA in its MRTP application to determine whether PMI's IQOS product meets the US Tobacco Control Act's standard for MRTP claims. We examined whether PMI provided sufficient data showing tobacco users will not initiate with IQOS, that youth will not misperceive the MRTP-related claims being made concerning IQOS, and how youth perceive health risks associated with IQOS.

RESULTS

PMI's own studies failed to provide evidence that youth, including non-users and former users, will not find IQOS appealing, will not initiate use of IQOS and will not perceive these products as risk-free. Further, PMI did not refer to independent studies conducted among adolescents which could influence their conclusions. Finally, their studies suffered from design and implementation flaws and cannot be relied on to support the proffered claims.

CONCLUSION

PMI's own data and available evidence from scientific studies conducted independent of the tobacco industry regarding how novel tobacco products are currently being marketed suggest that introduction of IQOS will result in adolescent and young adult non-users initiating tobacco use with IQOS and could also increase poly-use of IQOS along with other tobacco products.

A qualitative exploration of information-seeking by electronic nicotine delivery systems (ENDS) users in New Zealand

OBJECTIVES

Given recent increases in awareness and uptake of electronic nicotine delivery systems (ENDS), we aimed to explore ENDS users' information needs and search behaviours and whether information gaps exist.

DESIGN

Qualitative study using semistructured interviews that probed participants' smoking behaviours and ENDS use; data in this study examine ENDS information-seeking behaviours. We used qualitative description to analyse interview transcripts.

PARTICIPANTS AND SETTING

We recruited 39 current ENDS users (20 dual users and 19 exclusive ENDS users who reported having previously smoked cigarettes regularly) aged 18 and over, from three urban centres in New Zealand.

RESULTS

Several participants used Google to search for information on ENDS' health effects, but described the material they retrieved as vague or contradictory. Some interpreted the absence of information on long-term health effects as evidence ENDS did not pose potential health risks, and several perceived e-liquids as benign. Many relied on information sourced from other ENDS users, gleaned from online forums, YouTube or from discussions with friends and acquaintances; these sources typically presented ENDS positively. Several participants found specialist ENDS retailers provided valuable advice; non-specialist store staff generally lacked detailed product knowledge and sometimes offered inaccurate information.

CONCLUSION

People seeking information on ENDS' health effects are more likely to retrieve recommendations, product reviews and endorsements from online sources or through exchanges with other users, than they are to find scientific data. Health authorities could help meet potential users' information needs by, first, creating and frequently updating objective lay summaries of the latest scientific evidence; second, by mandating licensing for retailers with guidelines to disclose uncertainty over ENDS' efficacy for cessation and longer-term health effects, and the need for complete substitution of ENDS for combustible cigarettes among those who use these products.

IQOS labelling will mislead consumers

Background

Philip Morris International (PMI) continually expands and diversifies their nicotine product portfolio, which includes IQOS, a heated tobacco product. In December 2016, PMI filed a modified risk tobacco product (MRTP) application with the US Food and Drug Administration (FDA), seeking authorisation to market IQOS in USA with three claims of reduced harm: ‘switching completely from conventional cigarettes to the IQOS system…’ (1) ‘can reduce the risks of tobacco-related diseases;’ (2) ‘significantly reduce[s] your body’s exposure to harmful or potentially harmful chemicals;’ and (3) ‘presents less risk of harm than continuing to smoke cigarettes.’ Consumers may misunderstand what is meant by ‘switching completely'.

Methods

We critically reviewed study reports submitted to FDA by PMI in support of proposed marketing claims in its MRTP application for IQOS and focused on the statement that switching completely to IQOS reduces risk.

Results

We found deficiencies with evidence provided by PMI supporting their assertions that: current smokers will understand what is meant by the phrase ‘switching completely'; the proposed claims will not decrease smokers’ intentions to quit; and IQOS users will in fact ‘switch completely’ from smoking cigarettes to using IQOS. The studies and measurement instruments employed by PMI suffer from design flaws and their reporting of associated findings is misleading.

Conclusion

Consumers will not understand the condition of the claims—that they must quit using cigarettes completely to achieve the inferred health benefits of IQOS. Rather, they are likely to misunderstand the unsupported claims of reduced risks to mean IQOS are harm-free.

A geographically explicit ecological momentary assessment (GEMA) mixed method for understanding substance use

Tobacco use is increasingly concentrated within marginalized groups, including LGBTQ+ young adults. Developing tailored interventions to reduce tobacco-related health disparities requires understanding the mechanisms linking individual and contextual factors associated with tobacco use to behavior. This paper presents an in-depth exploration of three cases from a novel mixed method study designed to identify the situational factors and place-based practices of substance use among high-risk individuals. We combined geographically explicit ecological momentary assessment (GEMA) with an adapted travel diary-interview method. Participants (young adult bisexual smokers, ages 18-26) reported on non-smoking and smoking situations for 30 days with a smartphone app. GEMA surveys captured internal and external situational factors (e.g., craving intensity, location type, seeing others smoking). Continuous locational data was collected via smartphone GPS. Subsequently, participants completed in-depth interviews reviewing maps of their own GEMA data. GEMA data and transcripts were analyzed separately and integrated at the case level in a matrix. Using GEMA maps to guide the interview grounded discussion in participants' everyday smoking situations and routines. Interviews clarified participant interpretation of GEMA measures and revealed experiences and meanings of smoking locations and practices. The GEMA method identified the most frequent smoking locations/times for each participant (e.g., afternoons at university). Interviews provided description of associated situational factors and perceptions of smoking contexts (e.g., peer rejection of bisexual identity) and the roles of smoking therein (e.g., physically escape uncomfortable environments). In conclusion, this mixed method contributes to advancing qualitative GIS and other hypothesis-generating approaches working to reveal the richness of individuals' experiences of the everyday contexts of health behavior, while also providing reliable measures of situational predictors of behaviors of interest, such as substance use. Limitations of and future directions for the method are discussed.

Dual use of electronic nicotine delivery systems (ENDS) and smoked tobacco: a qualitative analysis

INTRODUCTION

Electronic nicotine delivery systems (ENDS) arguably pose fewer health risks than smoking, yet many smokers adopt ENDS without fully relinquishing smoking. Known as 'dual use', this practice is widespread and compromises the health benefits that ENDS may offer. To date, few studies have explored how dual use practices arise and manifest.

METHODS

We conducted in-depth, semi-structured interviews with 20 current ENDS users from New Zealand who reported smoking tobacco at least once a month. We explored participants' smoking history, their recent and current smoking, trial, uptake and patterns of ENDS use, and future smoking and vaping intentions. We managed the data using NVivo V.11 and used a thematic analysis approach to interpret the transcripts.

RESULTS

Dual use practices among participants evolved in four ways. First, as an attempt to manage the 'inauthenticity' of vaping relative to smoking and to retain meaningful rituals. Second, as complex rationalisations that framed decreased tobacco use, rather than smoking cessation, as 'success'. Third, as a means of alleviating the financial burden smoking imposed and to circumvent smoke-free policies. Lastly, dual use reflected attempts to comply with social group norms and manage stigma.

CONCLUSIONS

Dual use reflects both social and physical cues. It assisted participants to navigate smoking restrictions and allowed them to manage divergent norms. Policies that discourage smoking, particularly excise tax increases on smoked tobacco and smoke-free space restrictions, appear important in prompting ENDS use. Future research could explore whether these policies also help foster complete transition from smoking to exclusive ENDS use.

Taking Stock of Tobacco Control Program and Policy Science and Impact in the United States

The 60% decline in the prevalence of cigarette smoking among U.S. adults over the past 50 years represents a significant public health achievement. This decline was steered in part by national, state, and local tobacco control programs and policies, such as public education campaigns; widespread smoke-free air laws; higher cigarette prices that have been driven by large increases in federal, state, and local cigarette excise taxes; and other tobacco control policy and systems-level changes that discourage smoking. Using the MPOWER framework informed by the Centers for Disease Control and Prevention (CDC) Office on Smoking and Health and the World Health Organization (WHO), this paper reviews these accomplishments and identifies gaps in tobacco control policy implementation and additional research needed to extend these historic successes.

Qualitative analysis of young adult ENDS users' expectations and experiences

OBJECTIVES

Despite extensive research into the determinants of electronic nicotine delivery system (ENDS) uptake, few studies have examined the psychosocial benefits ENDS users seek and experience. Using a consumer ritual framework, we explored how ENDS users recreated or replaced smoking practices, and considered implications for smoking cessation.

DESIGN

In-depth interviews; data analysed using thematic analysis.

SETTING

Dunedin, New Zealand.

PARTICIPANTS

16 young adult ENDS users (age M=21.4, SD=1.9; 44% female).

RESULTS

Participants reported using different ENDS to achieve varying outcomes. Some used 'cigalikes' to recreate a physically and visually similar experience to smoking; they privileged device appearance over nicotine delivery. In contrast, others used personally crafted mods to develop new rituals that differentiated them from smokers and showcased their technical expertise. Irrespective of the device they used, several former smokers and dual users of cigarettes and ENDS experienced strong nostalgia for smoking attributes, particularly the elemental appeal of fire and the finiteness of a cigarette. Non-smoking participants used ENDS to maintain social connections with their peers.

CONCLUSIONS

Participants used ENDS to construct rituals that recreated or replaced smoking attributes, and that varied in the emphasis given to device appearance, nicotine delivery, and social performance. Identifying how ENDS users create new rituals and the components they privilege within these could help promote full transition from smoking to ENDS and identify those at greatest risk of dual use or relapse to cigarette smoking.

Adolescents' attitudes towards e-cigarette ingredients, safety, addictive properties, social norms, and regulation

E-cigarette use has dramatically increased. While studies have examined adolescents' attitudes towards smoking, few have extended this research to adolescents' attitudes towards e-cigarettes. The goal of this study was to examine adolescents' attitudes regarding e-cigarette ingredients, safety, addictive properties, social norms, accessibility, price, and regulation; and determine whether attitudes differ by past cigarette/e-cigarette use. Participants were 786 9th and 12th graders from California (63.21% females; mean age=16.10years [SD=1.6]; 26.61% White, 21.98% Asian/Pacific Islander, 29.82% Hispanic, and 21.59% other). Results indicated that 19.05% of participants believed smoke from e-cigarettes is water; 23.03% believed e-cigarettes aren't a tobacco product; 40.36% considered e-cigarettes to be for cessation, and 43.13% felt they were safer than cigarettes. Participants felt it was more acceptable to use e-cigarettes indoors and outdoors compared to cigarettes (p<0.0001), 23.13% felt raising e-cigarette taxes is a bad idea, 63.95% thought e-cigarettes were easier to get than cigarettes, 54.42% felt e-cigarettes cost too much, 64.33% felt the age for buying e-cigarettes should be raised, and 64.37% favored e-cigarette regulation. Adolescents who used e-cigarettes and/or cigarettes had significantly more favorable e-cigarette attitudes than non-users. This study indicates that adolescents are aware of some of the risks of e-cigarettes, although many harbor misperceptions and hold more favorable attitudes towards e-cigarettes than cigarettes. Of concern is the relationship between favorable e-cigarette attitudes and use. Findings suggest the need to provide adolescents with correct information about e-cigarette ingredients, risks, and the insufficient evidence of their role in cigarette cessation.

New Product Marketing Blurs the Line Between Nicotine Replacement Therapy and Smokeless Tobacco Products

Tobacco companies have begun to acquire pharmaceutical subsidiaries and recently started to market nicotine replacement therapies, such as Zonnic nicotine gum, in convenience stores. Conversely, tobacco companies are producing tobacco products such as tobacco chewing gum and lozenges that resemble pharmaceutical nicotine replacement products, including a nicotine pouch product that resembles snus pouches. This convergence of nicotine and tobacco product marketing has implications for regulation and tobacco cessation.

Construction of a cDNA library and preliminary analysis of expressed sequence tags in Piper hainanense

Black pepper is a perennial climbing vine. It is widely cultivated because its berries can be utilized not only as a spice in food but also for medicinal use. This study aimed to construct a standardized, high-quality cDNA library to facilitated identification of new Piper hainanense transcripts. For this, 262 unigenes were used to generate raw reads. The average length of these 262 unigenes was 774.8 bp. Of these, 94 genes (35.9%) were newly identified, according to the NCBI protein database. Thus, identification of new genes may broaden the molecular knowledge of P. hainanense on the basis of Clusters of Orthologous Groups and Gene Ontology categories. In addition, certain basic genes linked to physiological processes, which can contribute to disease resistance and thereby to the breeding of black pepper. A total of 26 unigenes were found to be SSR markers. Dinucleotide SSR was the main repeat motif, accounting for 61.54%, followed by trinucleotide SSR (23.07%). Eight primer pairs successfully amplified DNA fragments and detected significant amounts of polymorphism among twenty-one piper germplasm. These results present a novel sequence information of P. hainanense, which can serve as the foundation for further genetic research on this species.

Vested Interests in addiction research and policy. Alliance between tobacco and alcohol industries to shape public policy

AIMS

The tobacco and alcohol industries share common policy goals when facing regulation, opposing policies such as tax increases and advertising restrictions. The collaboration between these two industries in the tobacco policy arena is unknown. This study explored if tobacco and alcohol companies built alliances to influence tobacco legislation and, if so, how those alliances worked.

METHODS

Analysis of previously secret tobacco industry documents.

FINDINGS

In the early 1980s, tobacco companies started efforts to build coalitions with alcohol and other industries to oppose cigarette excise taxes, clean indoor air policies and tobacco advertising and promotion constraints. Alcohol companies were often identified as a key partner and source of financial support for the coalitions. These coalitions had variable success interfering with tobacco control policy-making.

CONCLUSIONS

The combined resources of tobacco and alcohol companies may have affected tobacco control legislation. These alliances helped to create the perception that there is a broader base of opposition to tobacco control. Advocates should be aware of the covert alliances between tobacco, alcohol and other industries and expose them to correct this misperception.

Construction of a hexaploid wheat (Triticum aestivum L.) bacterial artificial chromosome library for cloning genes for stripe rust resistance

A hexaploid wheat (Triticum aestivum L.) bacterial artificial chromosome (BAC) library was constructed for cloning Yr5 and other genes conferring resistance to stripe rust (Puccinia striiformis f. sp. tritici). Intact nuclei from a Yr5 near-isogenic line were used to isolate high molecular weight DNA, which was partially cleaved with HindIII and cloned into pECBAC1 and pIndigoBAC-5 vectors. The wheat BAC library consisted of 422,400 clones arrayed in 1100 micro-titer plates (each plate with 384 wells). Random sampling of 300 BAC clones indicated an average insert size of 140 kb, with a size range from 25 to 365 kb. Ninety percent of the clones in the library had an insert size greater than 100 kb and fewer than 5% of the clones did not contain inserts. Based on an estimated genome size of 15,966 Mb for hexaploid wheat, the BAC library was estimated to have a total coverage of 3.58x wheat genome equivalents, giving approximately 96% probability of identifying a clone representing any given wheat DNA sequence. Twelve BAC clones containing an Yr5 locus-specific marker (Yr5STS7/8) were successfully selected by PCR screening of 3-dimensional BAC pools. The results demonstrated that the T. aestivum BAC library is a valuable genomic resource for positional cloning of Yr5. The library also should be useful in cloning other genes for stripe rust resistance and other traits of interest in hexaploid wheat.

Approach to quantify the mechanical behavior of the intact embryonic chick heart

The heart undergoes remarkable changes during embryonic development due to genetic programing and epigenetic influences such as mechanical loads. An important goal is to develop mathematical models that describe and predict the influence of mechanics on cardiac development, yet the data needed to develop such models remain scant. In particular, prior data from embryonic hearts have come from one-dimensional tests, which reveal well the general characteristic behaviors but are not sufficient for quantifying the complex material behavior exhibited by most soft tissues. We developed a computer-controlled system for quantifying in vitro the multiaxial, regionally dependent mechanical response of the intact embryonic chick heart to controlled distension pressures; such tests have not been accomplished heretofore but promise to contribute to our understanding for they better mimic the native loading conditions and geometry. Calibration of the device indicated that distending the hearts using low flow rates avoids significant viscous losses and thereby allows pressure to be measured directly over small ranges (0-2 mmHg) with good resolution (0.01 mm Hg). Likewise, an on-line video system allows two-dimensional strains to be measured regionally by tracking the motions of triplets of closely spaced (100 microm) microspheres to reasonable resolution (2.5 microm/pixel). Illustrative data from 18 hearts show the utility of the new system, confirm previous findings with regard to the strong viscoelastic response of the stage 18 embryonic chick heart, and provide guidance for the design of future experiments.

Fine genetic mapping and BAC contig development for the citrus tristeza virus resistance gene locus in Poncirus trifoliata (Raf.)

A map-based cloning strategy has been employed to isolate Ctv, a single dominant gene from Poncirus trifoliata that confers resistance to citrus tristeza virus (CTV), the most important viral pathogen of citrus. Cloning of this gene will allow development of commercially acceptable, virus-resistant cultivars. A high-resolution genetic linkage map of the Ctv locus region was developed using a backcross population of 678 individuals. Three DNA markers that were closely linked or co-segregated with Ctv were identified and used to screen BAC libraries derived from an intergeneric hybrid of Poncirus and Citrus. Through chromosome walking and landing, two BAC contigs were developed: one encompassing the Ctv region, and the other spanning the allelic susceptibility gene region. The resistance gene contig consists of 20 BAC clones and is approximately 550 kb in length; the susceptibility gene contig consists of 16 BAC clones and extends about 450 kb. The Ctv locus was localized within a genomic region of approximately 180 kb by genetic mapping of BAC insert ends. The BAC contigs were integrated with the genetic map; variation in the ratio of genetic to physical distance was observed in the vicinity of Ctv. Southern hybridization data indicated that a few copies of NBS-LRR class sequences are distributed at or around the Ctv locus. Efforts are being made to assign the Ctv locus to a smaller genomic fragment whose function can be confirmed through genetic complementation of a CTV susceptible phenotype. These results indicate that map-based gene cloning is feasible in a woody perennial.

Involvement of hematopoietic progenitor kinase 1 in T cell receptor signaling

Hematopoietic progenitor kinase 1 (HPK1), a mammalian Ste20-related serine/threonine protein kinase, is a hematopoietic-specific upstream activator of the c-Jun N-terminal kinase. Here, we provide evidence to demonstrate the involvement of HPK1 in T cell receptor (TCR) signaling. HPK1 was activated and tyrosine-phosphorylated with similar kinetics following TCR/CD3 or pervanadate stimulation. Co-expression of protein-tyrosine kinases, Lck and Zap70, with HPK1 led to HPK1 activation and tyrosine phosphorylation in transfected mammalian cells. Upon TCR/CD3 stimulation, HPK1 formed inducible complexes with the adapters Nck and Crk with different kinetics, whereas it constitutively interacted with the adapters Grb2 and CrkL in Jurkat T cells. Interestingly, HPK1 also inducibly associated with linker for activation of T cells (LAT) through its proline-rich motif and translocated into glycolipid-enriched microdomains (also called lipid rafts) following TCR/CD3 stimulation, suggesting a critical role for LAT in the regulation of HPK1. Together, these results identify HPK1 as a new component of TCR signaling. T cell-specific signaling molecules Lck, Zap70, and LAT play roles in the regulation of HPK1 during TCR signaling. Differential complex formation between HPK1 and adapters highlights the possible involvement of HPK1 in multiple signaling pathways in T cells.

Interaction of hematopoietic progenitor kinase 1 and c-Abl tyrosine kinase in response to genotoxic stress

The c-Abl protein tyrosine kinase is activated by certain DNA-damaging agents and regulates induction of the stress-activated protein kinase/c-Jun N-terminal kinase (SAPK/JNK). The hematopoietic progenitor kinase 1 (HPK1) has also been shown to act upstream to the SAPK/JNK signaling pathway. We report here that exposure of hematopoietic Jurkat T cells to genotoxic agents is associated with activation of HPK1. The results demonstrate that exposure of Jurkat cells to DNA-damaging agents is associated with translocation of active c-Abl from nuclei to cytoplasm and binding of c-Abl to HPK1. Our findings also demonstrate that c-Abl phosphorylates HPK1 in cytoplasm and stimulates HPK1 activity. The functional significance of the c-Abl-HPK1 interaction is supported by the demonstration that this complex regulates SAPK/JNK activation. Overexpression of c-Abl(K-R) inhibits HPK1-induced activation of SAPK/JNK. Conversely, the dominant negative mutant of HPK1 blocks c-Abl-mediated induction of SAPK/JNK. These findings indicate that activation of HPK1 and formation of HPK1/c-Abl complexes are functionally important in the stress response of hematopoietic cells to genotoxic agents.

Leukocyte-specific adaptor protein Grap2 interacts with hematopoietic progenitor kinase 1 (HPK1) to activate JNK signaling pathway in T lymphocytes

Immune cell-specific adaptor proteins create various combinations of multiprotein complexes and integrate signals from cell surface receptors to the nucleus, modulating the specificity and selectivity of intracellular signal transduction. Grap2 is a newly identified adaptor protein specifically expressed in lymphoid tissues. This protein shares 40--50% sequence homology in the SH3 and the SH2 domain with Grb2 and Grap. However, the Grap2 protein has a unique 120-amino acid glutamine- and proline-rich domain between the SH2 and C-terminal SH3 domains. The expression of Grap2 is highly restricted to lymphoid organs and T lymphocytes. In order to understand the role of this specific adaptor protein in immune cell signaling and activation, we searched for the Grap2 interacting protein in T lymphocytes. We found that Grap2 interacted with the hematopoietic progenitor kinase 1 (HPK1) in vitro and in Jurkat T cells. The interaction was mediated by the carboxyl-terminal SH3 domain of Grap2 with the second proline-rich motif of HPK1. Coexpression of Grap2 with HPK1 not only increased the kinase activity of HPK1 in the cell, but also had an additive effect on HPK1 mediated JNK activation. Furthermore, over expression of Grap2 and HPK1 induced significant transcriptional activation of c-Jun in the JNK signaling pathway and IL-2 gene reporter activity in stimulated Jurkat T cells. Therefore, our data suggest that the hematopoietic specific proteins Grap2 and HPK1 form a signaling complex to mediate the c-Jun NH(2)-terminal kinase (JNK) signaling pathway in T cells.

Flow cytometric DNA analyses of epithelial dysplasia of the esophagus

OBJECTIVE

To investigate, with flow cytometry, DNA aneuploidy as a marker of early carcinogenesis in dysplastic esophageal lesions.

STUDY DESIGN

DNA content of exfoliated cells from 789 cases of esophageal dysplasia (including mild dysplasia, 195 cases; moderate dysplasia, 383 cases; and severe dysplasia, 211 cases) was determined with a FACS 420 flow cytometer.

RESULTS

Cellular DNA content was closely related to the severity of dysplasia. The carcinogenesis rate in patients with dysplasia showed that DNA aneuploidy was significantly higher than in patients showing DNA diploidy.

CONCLUSION

DNA aneuploidy in dysplastic lesions is a very important early signal of carcinogenesis. Patients with dysplastic lesions showing DNA aneuploidy should be treated and closely followed.

Association of 2',5'-oligoadenylate synthetase with the prolactin (PRL) receptor: alteration in PRL-inducible stat1 (signal transducer and activator of transcription 1) signaling to the IRF-1 (interferon-regulatory factor 1) promoter

The PRL receptor (PRL-R) signals through the Janus tyrosine kinases (JAK) and other non-JAK tyrosine kinases, some of which are preassociated with the PRL-R. To clone PRL-R interacting proteins, the intracellular domain (ICD) of the long form of the PRL-R was used in a yeast two-hybrid screen of a human B cell cDNA library. One PRL-R interacting protein was identified as the 42-kDa form of the enzyme 2',5'-oligoadenylate synthetase (OAS). The in vivo interactions in yeast were further confirmed by an in vitro interaction assay and by coimmunoprecipitation in transfected mammalian cells. Functionally, OAS reduced the basal activity of two types of promoters in transiently transfected COS-1 cells. In the presence of PRL, OAS inhibited PRL induction of the immediate early IRF-1 (interferon-regulatory factor 1) promoter, but not PRL induction of the differentiation-specific beta-casein promoter, suggesting that OAS exerts specific effects on immediate early gene promoters. The inhibitory effects of OAS were accompanied by a reduction in PRL-inducible Stat1 (signal transducer and activator of transcription 1) DNA binding activity at the IRF-1 GAS (interferon-gamma-activated sequence) element. These results demonstrate a novel interaction of OAS with the PRL-R and suggest a role for OAS in modulating Stat1-mediated signaling to an immediate early gene promoter. Although previously characterized as a regulator of ribonuclease (RNase) L antiviral responses, OAS may have additional effects on cytokine receptor signal transduction pathways.

Interaction of hematopoietic progenitor kinase 1 with adapter proteins Crk and CrkL leads to synergistic activation of c-Jun N-terminal kinase

Hematopoietic progenitor kinase 1 (HPK1), a mammalian Ste20-related protein kinase, is an upstream activator of c-Jun N-terminal kinase (JNK). In order to further characterize the HPK1-mediated JNK signaling cascade, we searched for HPK1-interacting proteins that could regulate HPK1. We found that HPK1 interacted with Crk and CrkL adaptor proteins in vitro and in vivo and that the proline-rich motifs within HPK1 were involved in the differential interaction of HPK1 with the Crk proteins and Grb2. Crk and CrkL not only activated HPK1 but also synergized with HPK1 in the activation of JNK. The HPK1 mutant (HPK1-PR), which encodes the proline-rich region alone, blocked JNK activation by Crk and CrkL. Dominant-negative mutants of HPK1 downstream effectors, including MEKK1, TAK1, and SEK1, also inhibited Crk-induced JNK activation. These results suggest that the Crk proteins serve as upstream regulators of HPK1. We further observed that the HPK1 mutant HPK1-KD(M46), which encodes the kinase domain with a point mutation at lysine-46, and HPK1-PR blocked interleukin-2 (IL-2) induction in Jurkat T cells, suggesting that HPK1 signaling plays a critical role in IL-2 induction. Interestingly, HPK1 phosphorylated Crk and CrkL, mainly on serine and threonine residues in vitro. Taken together, our findings demonstrate the functional interaction of HPK1 with Crk and CrkL, reveal the downstream pathways of Crk- and CrkL-induced JNK activation, and highlight a potential role of HPK1 in T-cell activation.

Quantitative expression of thrombopoietin receptor on leukaemia cells from patients with acute myeloid leukaemia and acute lymphoblastic leukaemia

Using a non-isotopic ligand binding assay, we quantitatively examined the amount of human thrombopoietin (TPO) receptor (TPO-R) on leukaemia cells from 128 patients with acute myeloid leukaemia (AML) or acute lymphoblastic leukaemia (ALL). The TPO-R was expressed in 53 (47%) of 114 AML cases, and an in vitro treatment with TPO led to proliferation (stimulation index >1 5) of leukaemia cells in 13 (20%) of 66 AML cases examined. The TPO levels had no relation to the FAB classification except for FAB-M7 AML. All five FAB-M7 cases expressed TPO-R, and one of three FAB-M7 examined showed in vitro proliferative response to TPO. Although there was no significant correlation (r = 0.3125) between the amount of TPO-R and the proliferative response, all of the AML cases which showed the in vitro response had TPO-R expression. There was no relationship between TPO-R amount and CD phenotypes, or the amount of granulocyte-colony stimulating factor (G-CSF) receptor. TPO-R was also expressed in two (14%) of 14 cases of ALL, and only these two cases had in vitro proliferative response to TPO. One had only lymphoid antigens, and the other had both lymphoid and myeloid antigens. Our results suggest that some leukaemia cells express functionally active TPO-R.

Characterization of protease-activated receptor-2 immunoreactivity in normal human tissues

PAR-2 is a second member of a novel family of G-protein-coupled receptors characterized by a proteolytic cleavage of the amino terminus, thus exposing a tethered peptide ligand that autoactivates the receptor. The physiological and/or pathological role(s) of PAR-2 are still unknown. This study provides tissue-specific cellular localization of PAR-2 in normal human tissues by immunohistochemical techniques. A polyclonal antibody, PAR-2C, was raised against a peptide corresponding to the amino terminal sequence SLIGKVDGTSHVTGKGV of human PAR-2. Significant PAR-2 immunoreactivity was detected in smooth muscle of vascular and nonvascular origin and stromal cells from a variety of tissues. PAR-2 was also present in endothelial and epithelial cells independent of tissue type. Strong immunolabeling was observed throughout the gastrointestinal tract, indicating a possible function for PAR-2 in this system. In the CNS, PAR-2 was localized to many astrocytes and neurons, suggesting involvement of PAR-2 in neuronal function. A role for PAR-2 in the skin was further supported by its immunolocalization in the epidermis. PAR-2C antibody exemplifies an important tool to address the physiological role(s) of PAR-2.

Amount of mpl on bone marrow haemopoietic precursor cells from healthy volunteers and patients with refractory anaemia

Using a non-isotopic ligand binding assay using multi-colour flow cytometry, we quantitatively examined the amount of mpl in megakaryocyte-platelet lineage cells. Firstly, we quantified the amount of mpl on cell lines. Mpl gene-transfected BaF3 cells expressed a large amount of mpl, whereas original BaF3, K562, HL-60 and NOMO-1 cells showed no mpl. In bone marrow cells from healthy volunteers, mpl was expressed on CD34+ cells from the very early stage of differentiation when they had no CD38 antigen. The amount of mpl increased with differentiation to CD34+ CD41+ cells, but decreased with further differentiation to CD34- CD41+ cells. In CD34+ CD41+ cells the amount of mpl varied according to cell size: abundant in large cells, moderate in medium-size cells and a little in small cells. In bone marrow cells from patients with refractory anaemia (RA), the amount of mpl was decreased compared with that in bone marrow cells from healthy volunteers. When analysed by the same CD phenotype and same cell size, the amount of mpl was less in RA patients compared with that in healthy volunteers in all phenotypes and sizes tested. The proportion of large CD34+ CD41+ cells was less in RA patients than in normal volunteers.

Clinical observation: congenital absence of the left portal vein in a patient undergoing hepatic resection

Congenital absence of the left portal vein is a rare vascular anomaly with a reported prevalence varying from one in 62 to one in 507 cases. A patient admitted for recurrent cholangitis secondary to extensive dilation of the left biliary ductal system associated with Caroli's Disease was determined by preoperative dynamic CT to have an excessively large right portal vein and no left portal vein. The surgeon must be aware of any variations in portal vascular anatomy in patients undergoing hepatic resection in order to prevent potentially fatal postoperative complications.