Mitogenome recovered from a 19 th Century holotype by shotgun sequencing supplies a generic name for an orphaned clade of African weakly electric fishes (Osteoglossomorpha, Mormyridae)

Heteromormyrus Steindachner, 1866, a genus of Mormyridae (Teleostei: Osteoglossomorpha), has been monotypic since the description of Heteromormyruspauciradiatus (Steindacher, 1866) from a single specimen. No type locality other than "Angola" was given and almost no specimens have been subsequently identified to this species. In order to investigate the relationship of this taxon to fresh specimens collected in Angola and elsewhere, whole genome paired-end sequencing of DNA extracted from the holotype specimen of Heteromormyruspauciradiatus was performed and a nearly complete mitogenome assembled from the sequences obtained. Comparison of cytochrome oxidase I and cytochrome b sequences from this mitogenome to sequences from recently collected material reveal that Heteromormyruspauciradiatus is closely related to specimens identified as Hippopotamyrusansorgii (Boulenger, 1905), Hippopotamyrusszaboi Kramer, van der Bank & Wink, 2004, Hippopotamyruslongilateralis Kramer & Swartz, 2010, as well as to several undescribed forms from subequatorial Africa collectively referred to in the literature as the "Hippopotamyrusansorgii species complex" and colloquially known as "slender stonebashers." Previous molecular phylogenetic work has shown that these species are not close relatives of Hippopotamyruscastor Pappenheim, 1906, the type species of genus Hippopotamyrus Pappenheim, 1906 from Cameroon, and are thus misclassified. Hippopotamyrusansorgii species complex taxa and another species shown to have been misclassified, Paramormyropstavernei (Poll, 1972), are placed in genus Heteromormyrus and one genetic lineage from the Kwanza and Lucala rivers of Angola are identified as conspecific Heteromormyruspauciradiatus. Three additional new combinations and a synonymy in Mormyridae are introduced. The morphological characteristics and geographical distribution of the genus Heteromormyrus are reviewed. The electric organ discharges (EODs) of Heteromormyrus species are to be treated in a separate study.

Effects of Renal Denervation vs Sham in Resistant Hypertension After Medication Escalation: Prespecified Analysis at 6 Months of the RADIANCE-HTN TRIO Randomized Clinical Trial

Importance

Although early trials of endovascular renal denervation (RDN) for patients with resistant hypertension (RHTN) reported inconsistent results, ultrasound RDN (uRDN) was found to decrease blood pressure (BP) vs sham at 2 months in patients with RHTN taking stable background medications in the Study of the ReCor Medical Paradise System in Clinical Hypertension (RADIANCE-HTN TRIO) trial.

Objectives

To report the prespecified analysis of the persistence of the BP effects and safety of uRDN vs sham at 6 months in conjunction with escalating antihypertensive medications.

Design, Setting, and Participants

This randomized, sham-controlled, clinical trial with outcome assessors and patients blinded to treatment assignment, enrolled patients from March 11, 2016, to March 13, 2020. This was an international, multicenter study conducted in the US and Europe. Participants with daytime ambulatory BP of 135/85 mm Hg or higher after 4 weeks of single-pill triple-combination treatment (angiotensin-receptor blocker, calcium channel blocker, and thiazide diuretic) with estimated glomerular filtration rate (eGFR) of 40 mL/min/1.73 m2 or greater were randomly assigned to uRDN or sham with medications unchanged through 2 months. From 2 to 5 months, if monthly home BP was 135/85 mm Hg or higher, standardized stepped-care antihypertensive treatment starting with aldosterone antagonists was initiated under blinding to treatment assignment.

Interventions

uRDN vs sham procedure in conjunction with added medications to target BP control.

Main Outcomes and Measures

Six-month change in medications, change in daytime ambulatory systolic BP, change in home systolic BP adjusted for baseline BP and medications, and safety.

Results

A total of 65 of 69 participants in the uRDN group and 64 of 67 participants in the sham group (mean [SD] age, 52.4 [8.3] years; 104 male [80.6%]) with a mean (SD) eGFR of 81.5 (22.8) mL/min/1.73 m2 had 6-month daytime ambulatory BP measurements. Fewer medications were added in the uRDN group (mean [SD], 0.7 [1.0] medications) vs sham (mean [SD], 1.1 [1.1] medications; P = .045) and fewer patients in the uRDN group received aldosterone antagonists at 6 months (26 of 65 [40.0%] vs 39 of 64 [60.9%]; P = .02). Despite less intensive standardized stepped-care antihypertensive treatment, mean (SD) daytime ambulatory BP at 6 months was 138.3 (15.1) mm Hg with uRDN vs 139.0 (14.3) mm Hg with sham (additional decreases of -2.4 [16.6] vs -7.0 [16.7] mm Hg from month 2, respectively), whereas home SBP was lowered to a greater extent with uRDN by 4.3 mm Hg (95% CI, 0.5-8.1 mm Hg; P = .03) in a mixed model adjusting for baseline and number of medications. Adverse events were infrequent and similar between groups.

Conclusions and Relevance

In this study, in patients with RHTN initially randomly assigned to uRDN or a sham procedure and who had persistent elevation of BP at 2 months after the procedure, standardized stepped-care antihypertensive treatment escalation resulted in similar BP reduction in both groups at 6 months, with fewer additional medications required in the uRDN group.

Trial Registration

ClinicalTrials.gov Identifier: NCT02649426.

Increasing Myocardial Edema Is Associated With Greater Microvascular Obstruction In ST-Segment Elevation Myocardial Infarction

Microvascular obstruction (MVO) frequently develops after ST-elevation myocardial infarction (STEMI) and is associated with increased mortality and adverse left-ventricular remodeling. We hypothesized that increased extravascular compressive forces in the myocardium that arise from the development of myocardial edema as a consequence of ischemia-reperfusion injury would contribute to the development of MVO. We measured MVO, infarct size and left ventricular mass in STEMI patients (n=385) using cardiac MRI 2-3 days following successful percutaneous coronary intervention and stenting. MVO was found in 57% of STEMI patients. The average infarct size was 45 ± 29 grams. Patients with MVO had significantly greater infarct size and reduced LV function (p < 0.01) compared to patients without MVO. Patients with MVO had significantly greater LV mass than patients without MVO and there was a linear increase in MVO with increasing LV mass (p < 0.001). Myocardial edema by T2-weighted imaging increased with increasing LV mass and patients with MVO had significantly greater myocardial edema than patients without MVO (p < 0.01). Patients with MVO had significantly greater LVEDP than patients without MVO (p < 0.05). In a cohort of STEMI patients who underwent primary percutaneous intervention we observed that MVO increased linearly with increasing LV mass and was associated with increased myocardial edema and higher LVEDP. These observations support the concept that extravascular compressive forces in the left ventricle may increase with increasing ischemic injury and contribute to the development of MVO.

Convergence is Only Skin Deep: Craniofacial Evolution in Electric Fishes from South America and Africa (Apteronotidae and Mormyridae)

Apteronotidae and Mormyridae are species-rich clades of weakly electric fishes from Neotropical and Afrotropical freshwaters, respectively, known for their high morphological disparity and often regarded as a classic example of convergent evolution. Here, we use CT-imaging and 3D geometric morphometrics to quantify disparity in craniofacial morphologies, and to test the hypothesis of convergent skull-shape evolution in a phylogenetic context. For this study, we examined 391 specimens representing 78 species of Apteronotidae and Mormyridae including 30 of 37 (81%) of all valid genera with the goal to sample most of the craniofacial disparity known in these clades. We found no overlap between Apteronotidae and Mormyridae in the skull-shape morphospace using PCA and a common landmark scheme, and therefore no instances of complete phenotypic convergence. Instead, we found multiple potential instances of incomplete convergence, and at least one parallel shift among electric fish clades. The greatest components of shape variance in both families are the same as observed for most vertebrate clades: heterocephaly (i.e., opposite changes in relative sizes of the snout and braincase regions of the skull), and heterorhynchy (i.e., dorsoventral changes in relative snout flexion and mouth position). Mormyrid species examined here exhibit less craniofacial disparity than do apteronotids, potentially due to constraints associated with a larger brain size, ecological constraints related to food-type availability. Patterns of craniofacial evolution in these two clades depict a complex story of phenotypic divergence and convergence in which certain superficial similarities of external morphology obscure deeper osteological and presumably developmental differences of skull form and function. Among apteronotid and mormyrid electric fishes, craniofacial convergence is only skin deep.

Acceptability and barriers to adopting physical therapy and rehabilitation as standard of care in hernia disease: a prospective national survey of providers and preliminary data

PURPOSE

Physical therapy (PT) and rehabilitation are widely utilized in a variety of disease processes to improve function, return to activities of daily living (ADLs), and promote overall recovery. However, hernia repair has struggled to adopt this practice despite operations occurring in one of the most dynamic parts of the body - the abdominal core. This study sought to understand perspectives and perceived barriers regarding the incorporation of PT and rehabilitation in hernia care.

METHODS

A standardized rehabilitation protocol was developed by the Abdominal Core Health Quality Collaborative (ACHQC), a national quality improvement initiative specific to hernia disease, and launched in 2019. Empiric data from the ACHQC was then obtained to describe preliminary utilization. A prospective electronic survey was then deployed to all surgeons participating in the ACHQC to aid in interpreting the identified trends. The survey included questions regarding the current use of PT in their practice, as well as further opinions on the functionality, benefit, and barriers to its use.

RESULTS

We identified 1,544 patients who were listed as receiving some form of postoperative rehabilitation, of which 992 (64.2%) had a primary diagnosis of ventral hernia and 552 (35.8%) had an inguinal hernia. Among patients who had a ventral hernia, 863 (87.0%) received self-directed rehabilitation exercises compared to 488 (88.4%) of inguinal hernia patients. The subsequent survey exploring these trends was completed by 46 ACHQC surgeons (10.2%). More than half (52%) reported using PT for hernia patients, primarily in abdominal wall reconstruction cases (92%). Of those who did not report using PT, 50% cited unknown clinical benefit and another 27% cited unknown PT resources. PT utilization was typically concentrated to the postoperative period (58%), while 42% reported also using it preoperatively. Despite 72% of respondents citing a perceived benefit of PT in hernia patients, overall use of PT was primarily reported as 'occasional' by 42%, with another 27% reporting 'rarely.' Perceived benefits of PT included increased core strength, stability, mobility, patient satisfaction, education, independence, earlier return to work and ADLs, overall improved recovery, and decreased risk of postoperative issues. Reported barriers to implementing PT in practice or adapting the ACHQC Rehabilitation Protocol included lack of education, lack of evidence of clinical benefit, and difficulties operationalizing the protocol.

CONCLUSION

A national survey of hernia surgeons demonstrated willingness to adopt PT and rehabilitation protocols in their clinical practices and noted a high perceived benefit to patients. However, lack of education and evidence regarding the protocol may represent important barriers to overcome in widely disseminating these resources to patients. These gaps can be addressed through dedicated educational venues and additional studies establishing PT and rehabilitation as critical future adjuncts for the recovery of hernia repair patients.

The Complete Genome Sequences of 38 Species of Elephantfishes (Mormyridae, Osteoglossiformes)

We present the complete genome sequences of 38 species of elephantfishes from 20 genera. Illumina sequencing was performed on genetic material from single wild-caught individuals. The reads were assembled using a de novo method followed by a finishing step. The raw and assembled data is publicly available via Genbank.

Using social media to recruit study participants for a randomized trial for hypertension

Aims

The present study aimed to evaluate the potential of social media as an approach to recruit hypertensive subjects.

Methods and results

In addition to conventional trial recruitment, Facebook ads were run. Over a 115-day recruitment period, Facebook reached 5.3 million people in 168 separate campaigns run in the proximity of 19 sites in the USA and 14 sites in Europe. A total of 182 839 participants (3.4%) clicked on the ad; of those 10 483 subjects (5.7%) completed a dedicated questionnaire. This resulted in 3632 potential candidates. A total of 285 potential candidates were recruited by various recruitment strategies in the specified time period, of which 184/285 (64.6%) came from Facebook. When comparing Facebook with a 7-day radio spot in the same time period, 48 radio spots were launched; resulting in nine inquiries with eventually five potential candidates and two consents.

Conclusion

Targeted social media was a successful and efficient strategy to recruit hypertensive subjects.

Clinical activity of programmed cell death 1 (PD-1) blockade in never, light, and heavy smokers with non-small-cell lung cancer and PD-L1 expression ≥50

Background:

Immune checkpoint inhibitors (ICIs) are standard therapies for patients with advanced non-small-cell lung cancer (NSCLC) and a programmed death-ligand 1 (PD-L1) tumor proportion score (TPS) ≥50%. Tumor mutation burden (TMB) also predicts response to ICIs but is often not available in real time for decision making in the first-line setting. Smoking exposure can be a proxy for TMB in NSCLC. The impact of smoking status on efficacy of PD-1 blockade in NSCLC patients with PD-L1 TPS ≥50% has not been well defined.

Patients and methods:

To investigate the relationship between smoking and activity of ICIs in NSCLC, we retrospectively studied 315 patients with NSCLC and PD-L1 TPS ≥50% at five USA academic medical centers. Objective response rates (ORRs), progression-free survival (PFS), and duration of response (DOR) were compared between never (<100 lifetime cigarettes), light (≤10 pack-years), and heavy (>10 pack-years) smokers. A subset of patients underwent next-generation sequencing to estimate TMB.

Results:

We identified 36 (11%) never, 42 (13%) light, and 237 (75%) heavy smokers with NSCLC and PD-L1 TPS ≥50% treated with ICIs. Objective responses were observed in 27%, 40%, and 40% of never, light, and heavy smokers, respectively (P = 0.180 never versus heavy; P = 1.000 light versus heavy). Median PFS and median DOR were numerically shorter in never and light smokers compared with heavy smokers (PFS 3.0 versus 4.0 versus 5.4 months; median DOR 6.9 versus 10.8 versus 17.8 months), but were not statistically different [PFS: hazard ratio (HR) 1.37, P = 0.135 and HR 1.24, P = 0.272; DOR: HR 1.92, P = 0.217 and HR 1.79, P = 0.141].

Conclusions:

PD-(L)1 inhibitors are associated with antitumor activity in NSCLC with PD-L1 TPS ≥50% regardless of smoking status. Nevertheless, there is a signal of potentially decreased durability among never and light smokers that should be further evaluated. Distinct immunobiologic features may affect initial response versus durability of antitumor immunity to programmed cell death 1 (PD-1) blockade.

Efficieny of Phage Intervention Against Salmonella in Meat and Poultry Processing

ObjectivesPathogen Reduction, Hazard Analysis, and Critical Control Point systems final rule mandates establishments to seek and adopt antimicrobial interventions that can help in reducing the prevalence and most probable number of Salmonella in their meat and poultry products. Bacteriophages can aid in this challenge, as they can invade and kill specific target pathogenic bacteria on food products. Effective kill by phages relies on the appropriate phage application technique. Correct dose, good distribution on the food surface area, and adequate dwell time are key factors which influence phage-bacteria contact and thereby phage efficacy. This study determined the efficacy of a commercially available phage product, PhageGuard S consisting of 2 phages, FO1a, and S16. Different pick up levels, blend and hold times (chosen based on regulatory restriction and process limitations), as well as spray versus dip treatment methods were tested.Materials and MethodsOvernight culture streptomycin resistant Salmonella enterica enterica Enteritidis C (Se13) was diluted and inoculated at a concentration of 2×104 CFU/cm2 or CFU/g on parts of chicken fillet and held for 10 min for bacterial attachment (duplicate samples per time point). Subsequently, contaminated parts were spray treated with one phage concentration (108 Plaque Forming Units/g) at 0.5%, 1% or 3% pick up (v/w) or water (control) and blended for 5, 10, and 20 min before immediate grinding and retrieval of bacteria (latter blend time sample was held for 24 h before grind). Another set of contaminated fillet parts were treated by dipping in 5% phage solution (at 1% pick up, 108 PFU/g) and held for 1, 5, 10, and 20 min, and 1 and 24 h at 40°F (4°C) before retrieval of bacteria. Enumeration of bacteria was done on selective agar plates and reductions were calculated relative to water treated control.ResultsThe application of phages 108 PFU/g via spray on chicken parts at 3% pick up and 20 min blend time resulted in 0.9 log10 CFU/g log reduction of Salmonella. Additional hold time of 24 h before grind resulted in 1.1- 1.2 log10 CFU/g kill at lower and higher pick up of 0.5% and 3%. Dip treatment resulted higher Salmonella reduction of 1.2 log10 CFU/cm2 within 5 min of 108 PFU/cm2 phage application and up to 2.3 log10 CFU/cm2 log10 reduction when held for 24 h. Overall, the spray technique, showed a dose response effect where increasing pick up and blend time resulted in an increasing Salmonella kill in ground product. However, the dip technique resulted in more effective Salmonella kill in shorter dwell time. All values are mean value of two individual experiments.ConclusionThe above results indicate that the commercially available phage solution, PhageGuard S, either via spray or dip method reduces Salmonella contamination on meat and poultry parts by 1.2 to 2.3 log10, respectively. Thereby is an effective intervention in reducing risks and allowing for increase in consumer safety. Dip technique works better than spray due to better distribution on meat surface. Longer hold and/or blend time after phage treatment results in more kill.

Bacteriophage Intervention Effectively Kills Listeria on Food Contact Surface Materials

ObjectivesListeria is a pathogenic bacterium that is widespread in nature and can enter food processing plants through many vectors, like raw materials, process waste and personnel. Food processors work hard to keep Listeria out of the environment, but it can at times be found from food contact surfaces to floor drains. The sanitation can be compounded when equipment is pitted or cracked creating a harborage or niche in which Listeria can grow. Many control strategies for cleaning and biofilm removal have been put into place but may not suffice in eliminating Listeria from the food contact surface or environment. Bacteriophages are now being used to tackle these pathogens in food processing environments. Since they only target specific bacteria, they are harmless to humans, animals and plants, while effectively eliminating Listeria.This study determines the efficacy of a commercially available bacteriophage product, PhageGuard Listex, against Listeria on commonly found materials in food processing plants (stainless steel and UHMW polyethylene). Efficacy was determined by applying two phage concentrations, as well as two exposure times.Materials and MethodsOvernight cultures of L. monocytogenes ATCC13832 and L. innocua ATCC51742 were mixed in equal parts to create a Listeria cocktail (2 × 109 CFU/cm2). Sterile coupons (100 cm2) of stainless steel or UHMW polyethylene were artificially inoculated with the cocktail at 2.5ML/cm2 and left to dry at 37°C until completely dry. Subsequently, coupons were treated with 2 × 107 or 1 × 108 Plaque Forming Units (PFU)/cm2 using a spray system and incubated at room temperature for 1 and 3 h, before retrieval and enumeration of bacteria on selective agar plates. Sample size n:3. Results were analyzed using two-way ANOVA, with Dunnett’s multiple comparisons test on the normalized data.ResultsA dose dependent response to the phage treatment was observed, where an increasing phage concentration resulted in an increase in Listeria kill on both surfaces. On stainless steel, a treatment dose of 2 × 107 PFU/cm2 resulted in a statistically significant bacterial reduction of 1.27 log after 1 h (p value < 0.0001), while application of 1 × 108 PFU/cm2 showed a 2.16 log reduction (p value < 0.0001). On UHMW polyethylene, a bacterial reduction of 0.47 log was observed 1 h after applying 2 × 107 PFU/cm2, while the application of 1 × 108 PFU/cm2 led to a reduction of 1.95 log. However, these reductions were not statistically significant (p value > 0.05). After 3 h of treatment, the reductions were slightly higher in both materials (Table 3). After this time, the difference between control and 5% treatment on UHMW polyethylene obtained a p-value < 0.05.ConclusionPhage technology is an easy and safe intervention which can be used as an additional tool to control Listeria in processing environments. The above results indicate that the commercially available phage solution, PhageGuard Listex, can reduce Listeria contamination on food contact surfaces by 0.4 to 3.4 logs after 3 h of treatment.Table 3Log reduction of Listeria cells after applicatio nof two bacteriophage concentrations, measured at 1 and 3 h post phage treatment

Fluoroscopic-guided lumbar puncture: fluoroscopic time and implications of body mass index--a baseline study

BACKGROUND AND PURPOSE

Fluoroscopic-guided lumbar puncture is an effective alternative to bedside lumbar puncture in challenging patients. However, no published guidelines are available for an acceptable range of fluoroscopic time for this procedure. The purpose of this study was to set department benchmark fluoroscopic times for lumbar puncture, accounting for body mass index in our patient population.

MATERIALS AND METHODS

We identified and reviewed all patients who underwent fluoroscopic-guided lumbar puncture at 4 hospitals during a 2-year period (July 2011 to June 2013). Data collection included patient information (demographics, body mass index, history of prior lumbar surgery and/or lumbar hardware, scoliosis); procedure details (fluoroscopic time, level of access, approach, needle gauge and length); level of operator experience; and hospital site. A generalized linear model was used to test whether body mass index influenced fluoroscopic time while controlling other factors.

RESULTS

Five hundred eighty-four patients (mean age, 47.8 ± 16.2 years; range, 16-92 years; 33% male) had successful fluoroscopic-guided lumbar puncture s. Mean body mass index and fluoroscopic time were higher in female patients (34.4 ± 9.9 kg/m(2) and 1.07 minutes; 95% CI, 0.95-1.20) than in male patients (29.2 ± 7.3 kg/m(2) and 0.91 minutes; 95% CI, 0.79-1.03). Body mass index (P = .001), hospital site (P < .001), and level of experience (P = .03) were factors significantly affecting fluoroscopic time on multivariate analysis. Benchmark fluoroscopic times in minutes were the following: 0.48 (95% CI, 0.40-0.56) for normal, 0.61 for overweight (95% CI, 0.52-0.71), 0.63(95% CI, 0.58-0.73) for obese, and 0.86 (95% CI, 0.74-1.01) in extremely obese body mass index categories.

CONCLUSIONS

In patients undergoing fluoroscopic-guided lumbar punctures, fluoroscopy time increased with body mass index We established benchmark fluoroscopic-guided lumbar puncture time ranges as related to body mass index in our patient population.

Intrinsic rewards experienced by a group of dentists working with underserved populations

BACKGROUND

The aim of this study was to explore, using qualitative methods, the intrinsic reasons why dentists work with underserved groups. Minority and marginalized groups of Australians suffer a greater burden of dental disease than the general population due to disparities in accessing care. Recruitment and retention of dentists to care for underserved groups is problematic due to personal, professional and structural reasons. What drives dentists to work with underserved groups is not widely known.

METHODS

Sixteen dentists were recruited using 'snowball' purposeful sampling. Semi-structured in-depth interviews were conducted. Thematic analysis was conducted on the transcriptions to identify themes.

RESULTS

Five key themes emerged: (1) 'tapped on the shoulder', being personally approached or invited; (2) 'dental school experience', the challenges faced as a student; (3) 'empathic concern', the non-judgemental expressions of care toward others; (4) 'resilience', the ability to bounce back after setbacks; (5) 'intrinsic reward', the personal gain and satisfaction received. This study focuses on the intrinsic rewards which were found to be simple, unexpected, and associated with relieving pain, community engagement and making a difference.

CONCLUSIONS

Emphasizing personal fulfilment and intrinsic reward could be useful when promoting dentistry as a career and when encouraging graduates to consider working with disadvantaged groups.

Isotopic, geophysical and biogeochemical investigation of submarine groundwater discharge: IAEA-UNESCO intercomparison exercise at Mauritius Island

Submarine groundwater discharge (SGD) into a shallow lagoon on the west coast of Mauritius Island (Flic-en-Flac) was investigated using radioactive ((3)H, (222)Rn, (223)Ra, (224)Ra, (226)Ra, (228)Ra) and stable ((2)H, (18)O) isotopes and nutrients. SGD intercomparison exercises were carried out to validate the various approaches used to measure SGD including radium and radon measurements, seepage rate measurements using manual and automated meters, sediment bulk conductivity and salinity surveys. SGD measurements using benthic chambers placed on the floor of the Flic-en-Flac Lagoon showed discharge rates up to 500 cm/day. Large variability in SGD was observed over distances of a few meters, which were attributed to different geomorphological features. Deployments of automated seepage meters captured the spatial and temporal variability of SGD with a mean seepage rate of 10 cm/day. The stable isotopic composition of submarine waters was characterized by significant variability and heavy isotope enrichment and was used to predict the contribution of fresh terrestrially derived groundwater to SGD (range from a few % to almost 100%). The integrated SGD flux, estimated from seepage meters placed parallel to the shoreline, was 35 m(3)/m day, which was in reasonable agreement with results obtained from a hydrologic water balance calculation (26 m(3)/m day). SGD calculated from the radon inventory method using in situ radon measurements were between 5 and 56 m(3)/m per day. Low concentrations of radium isotopes observed in the lagoon water reflected the low abundance of U and Th in the basalt that makes up the island. High SGD rates contribute to high nutrients loading to the lagoon, potentially leading to eutrophication. Each of the applied methods yielded unique information about the character and magnitude of SGD. The results of the intercomparison studies have resulted a better understanding of groundwater-seawater interactions in coastal regions. Such information is an important pre-requisite for the protection and management of coastal freshwater resources.

Ibex-Associated Malignant Catarrhal Fever–Like Disease in a Group of Bongo Antelope (Tragelaphus eurycerus)

A private zoological facility experienced an outbreak of malignant catarrhal fever (MCF) in 3 bongo antelope ( Tragelaphus eurycerus). All cases were periparturient bongos that presented acutely anorectic beginning ~6 weeks after being housed with a Nubian ibex. Disease quickly progressed to respiratory distress and death within 24–72 hours of onset of clinical signs. Consistent gross findings in affected bongos were pulmonary edema and small pale tan foci in the livers. Histological lesions included a nonsuppurative vasculitis in multiple tissues, which is well recognized in MCF, but additionally included necrotizing cholangiohepatitis and neutrophilic, necrotizing myocarditis. Ibex-associated viral DNA was detected by polymerase chain reaction and was identical in sequence whether derived from bongos or ibex. The sequence closely matched an MCF viral DNA fragment that had been amplified from an ibex and bongo in a previous case report.

An Atlas of Infectious and Parasitic Diseases of the Central Nervous System. A Cooperative Study of SILAN (Sociedad Iberolatinoamericana de Neurorradiologia)

Infectious diseases of the central nervous system vary in frequency in different locations in America and Europe. What is common in Brazil can be a sporadic presentation in Europe. Cooperative work gathering experiences from neuroradiologists working in various places can be achieved and will help to identify uncommon cases that can present in our daily practice.

Isotope tracing of submarine groundwater discharge offshore Ubatuba, Brazil: results of the IAEA-UNESCO SGD project

Results of groundwater and seawater analyses for radioactive (3H, 222Rn, 223Ra, 224Ra, 226Ra, and 228Ra) and stable (D and 18O) isotopes are presented together with in situ spatial mapping and time series 222Rn measurements in seawater, direct seepage measurements using manual and automated seepage meters, pore water investigations using different tracers and piezometric techniques, and geoelectric surveys probing the coast. This study represents first time that such a new complex arsenal of radioactive and non-radioactive tracer techniques and geophysical methods have been used for simultaneous submarine groundwater discharge (SGD) investigations. Large fluctuations of SGD fluxes were observed at sites situated only a few meters apart (from 0 cm d(-1) to 360 cm d(-1); the unit represents cm3/cm2/day), as well as during a few hours (from 0 cm d(-1) to 110 cm d(-1)), strongly depending on the tidal fluctuations. The average SGD flux estimated from continuous 222Rn measurements is 17+/-10 cm d(-1). Integrated coastal SGD flux estimated for the Ubatuba coast using radium isotopes is about 7x10(3) m3 d(-1) per km of the coast. The isotopic composition (deltaD and delta18O) of submarine waters was characterised by significant variability and heavy isotope enrichment, indicating that the contribution of groundwater in submarine waters varied from a small percentage to 20%. However, this contribution with increasing offshore distance became negligible. Automated seepage meters and time series measurements of 222Rn activity concentration showed a negative correlation between the SGD rates and tidal stage. This is likely caused by sea level changes as tidal effects induce variations of hydraulic gradients. The geoelectric probing and piezometric measurements contributed to better understanding of the spatial distribution of different water masses present along the coast. The radium isotope data showed scattered distributions with offshore distance, which imply that seawater in a complex coast with many small bays and islands was influenced by local currents and groundwater/seawater mixing. This has also been confirmed by a relatively short residence time of 1-2 weeks for water within 25 km offshore, as obtained by short-lived radium isotopes. The irregular distribution of SGD seen at Ubatuba is a characteristic of fractured rock aquifers, fed by coastal groundwater and recirculated seawater with small admixtures of groundwater, which is of potential environmental concern and has implications on the management of freshwater resources in the region.

Modelling 3H and 14C transfer to farm animals and their products under steady state conditions

The radionuclides (14)C and (3)H may both be released from nuclear facilities. These radionuclides are unusual, in that they are isotopes of macro-elements which form the basis of animal tissues, feed and, in the case of (3)H, water. There are few published values describing the transfer of (3)H and (14)C from feed to animal derived food products under steady state conditions. Approaches are described which enable the prediction of (14)C and (3)H transfer parameter values from readily available information on the stable H or C concentration of animal feeds, tissues and milk, water turnover rates, and feed intakes and digestibilities. We recommend that the concentration ratio between feed and animal product activity concentrations be used as it is less variable than the transfer coefficient (ratio between radionuclide activity concentration in animal milk or tissue to the daily intake of a radionuclide).

Renal injury: similarities and differences in male and female rats with the metabolic syndrome

The metabolic syndrome is complicated by nephropathy in humans and rats, and males are more affected than females. We hypothesized that female rats had reduced expression of glomerular oxidized low-density lipoprotein (oxLDL) receptor 1 (LOX-1), attendant glomerular oxidant injury, and renal inflammation. Three groups, obese males (OM), obese females (OF), and lean males (LM) of first-generation (F(1)) hybrid rats derived from the Zucker fatty diabetic (ZDF) strain and the spontaneous hypertensive heart failure rat (SHHF/Gmi-fa) were studied from 6 to 41 weeks of age. OM had severe renal oxidant injury and renal failure. Their glomeruli expressed the LOX-1, and exhibited heavier accumulation of the lipid peroxide 4-hydroxynonenal (4-HNE). OM had compromised mitochondrial enzyme function, more renal fibrosis, and vascular leakage. Younger LM, OM, and OF ZS (ZDF/SHHF F(1) hybrid rat) rats, studied from 6 to 16 weeks of age, showed that unutilized renal lipids were comparable in OM and OF, although young OM had worse nephropathy and inflammation. In conclusion, glomerular LOX-1 expression is coupled to deposits of 4-HNE and glomerulosclerosis in OM. We presume that LOX-1 enhances glomerular uptake of oxidized lipids and renal inflammation, causing greater oxidant stress and severe glomerulosclerosis. In OF, renal protection from lipid oxidants appears to be conferred by blunted glomerular LOX-1 expression and renal inflammation.

Gene expression patterns identify patients with non-small cell lung cancer (NSCLC) who are at increased risk for venous thromboembolism (VTE)

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Background: VTE is the leading cause of death in patients with cancer. The 1 year survival rate in patients diagnosed with cancer at time of VTE is 12% compared to 36% in cancer patients who are free of VTE .Also, a thrombotic event in a hospitalized cancer patient leads to higher in-hospital mortality.Thus,VTE in cancer patients may indicate a more aggressive phenotype. Methods: With the overarching goal of testing the ability of genomic profiling to detect biologically and clinically significant differences in patients with cancer and VTE, using NSCLC as a proof of principle, we expanded on previous work wherein we have shown the ability of multiple gene expression patterns (‘metagenes’) to predict a thrombotic event .96 patients with NSCLC were enrolled in this study. RNA was extracted and gene array data obtained using an Affymetrix U133 2.0 plus GeneChip. The clinical history of all 96 patients was reviewed to identify patients with a definitive VTE episode after the initial diagnosis of cancer and not within six weeks of surgery.14/96 (14.5%) patients met these criteria. We then identified 14 additional patients with NSCLC matched by age, gender and clinical stage patients who did not have VTE for at least 2 years following the diagnosis of cancer. Gene expression data was analyzed using a binary regression analysis. Results: Using the metagene approach, a discriminator gene set (n = 45) that differentiated patients with NSCLC and VTE from patients with NSCLC without VTE was identified. A leave-one-out cross validation performed to further assess the reliability of the discriminator metagene set was more than 85% accurate in identifying patients with NSCLC and VTE. Also, significant biologically relevant differences were seen between the comparison groups, to include genes such as P53, VEGFC, E2F4, TFPI and EPHB2 Conclusions: Our data suggests that a genomic approach can be used to identify with NSCLC that develop VTE, while also providing information important to an understanding of the underlying biology of the association between cancer and thrombosis. We are in the process of validating these results in a prospective trial.

No significant financial relationships to disclose.

Sinusoid=light bar+dark bar?

A sinusoidal grating can be viewed as a series of light and dark bars. Here we measure the contrast discrimination thresholds for light and dark bars individually, and find that the contrast discrimination thresholds for the whole sinusoid can be explained as ideal summation of the light and dark bar thresholds. We propose a model for light bar, dark bar, and sinusoidal contrast discrimination which involves local light adaptation and multiplicative noise. The model accounts for the data very well, and also accounts for contrast discrimination of light and dark edges.

Are marketing campaigns in Taiwan by foreign tobacco companies targeting young smokers?

OBJECTIVE

To assess the impact of promotions on cigarette sales in Taiwan after the cigarette market opened to foreign companies, and to assess whether young smokers were targeted by these companies.

METHODS

Trends in cigarette sales, advertising expenditure, brand preference, and cigarette consumption were examined for the period following the 1987 opening of the cigarette market. Tobacco industry internal documents from Legacy Tobacco Documents Library of the University of California, San Francisco, were searched for corporate strategies on promoting youth consumption in Taiwan.

RESULTS

Between 1995 and 2000, the inflation adjusted advertising expenditures by all foreign firms increased fourfold. Much of the expenditure was spent on brand stretching the Mild Seven (Japan) and Davidoff (Germany) brands in television advertising. By 2000, the market share of foreign cigarettes exceeded domestics by three to one among young smokers and the leading brand preferred by this segment shifted from the most popular domestic brand (Long Life) to a foreign brand (Mild Seven). Furthermore, there was a sudden increase of 16.4% in smoking rates among young adults (from 36.1% to 42.0%) during the first five years after the market opened. This was also accompanied by increased per capita cigarette consumption and decreased age of smoking initiation. Industry documents confirmed the use of strategies targeted at the young. In particular, establishing new point of sale (POS) retail stores or promotional activities at POS were found to be more effective than advertising in magazines.

CONCLUSIONS

This study provides evidence that advertising increased with increased competition following the market opening, which, in turn, spurred cigarette sales and consumption. Foreign tobacco companies have deliberately targeted youth in Taiwan and succeeded in gaining three quarters of their cigarette purchases within a decade. Expanding youth consumption will incur excessive future health care costs borne by society. Foreign tobacco companies should be obligated to reimburse these expenses through higher tariffs on cigarettes.

Phenylketonuria in adulthood: a collaborative study

During 1967-1983, the Maternal and Child Health Division of the Public Health Services funded a collaborative study of 211 newborn infants identified on newborn screening as having phenylketonuria (PKU). Subsequently, financial support was provided by the National Institute of Child Health and Human Development (NICHD). The infants were treated with a phenylalanine (Phe)-restricted diet to age 6 years and then randomized either to continue the diet or to discontinue dietary treatment altogether. One hundred and twenty-five of the 211 children were then followed until 10 years of age. In 1998, NICHD scheduled a Consensus Development Conference on Phenylketonuria and initiated a study to follow up the participants from the original Collaborative Study to evaluate their present medical, nutritional, psychological, and socioeconomic status. Fourteen of the original clinics (1967-1983) participated in the Follow-up Study effort. Each clinic director was provided with a list of PKU subjects who had completed the original study (1967-1983), and was asked to evaluate as many as possible using a uniform protocol and data collection forms. In a subset of cases, magnetic resonance imaging and spectroscopy (MRI/MRS) were performed to study brain Phe concentrations. The medical evaluations revealed that the subjects who maintained a phenylalanine-restricted diet reported fewer problems than the diet discontinuers, who had an increased rate of eczema, asthma, mental disorders, headache, hyperactivity and hypoactivity. Psychological data showed that lower intellectual and achievement test scores were associated with dietary discontinuation and with higher childhood and adult blood Phe concentrations. Abnormal MRI results were associated with higher brain Phe concentrations. Early dietary discontinuation for subjects with PKU is associated with poorer outcomes not only in intellectual ability, but also in achievement test scores and increased rates of medical and behavioural problems.