Dietary supplementation with phytochemicals improves diversity and abundance of honey bee gut microbiota

AIM

Determine the impact of beneficial phytochemicals on diversity and abundance of the gut microbiome in the honey bee (Apis mellifera).

METHODS AND RESULTS

Eight-day-old honey bee workers were fed 25 ppm of phytochemical (caffeine, gallic acid, p-coumaric acid or kaempferol) in 20% sucrose. Guts of bees collected at 3 and 6 days were excised and subjected to next-generation sequencing for bacterial 16S and fungal ITS regions. Although phytochemical supplementation fostered gut microbial diversity and abundance, the patterns differed between phytochemicals and there was a temporal stabilization of the bacterial community. While bacterial and fungal communities responded differently, all phytochemical treatments displayed increased abundance of the most represented bacterial genera, Snodgrassella sp. and Lactobacillus sp.

CONCLUSIONS

Phytochemical supplementation improves gut microbial diversity and abundance, reiterating the need for diverse habitats that provide bees with access to pollen and nectar rich in these micronutrients. Diverse gut microbiota can provide a strong line of defense for bees against biotic stressors while improving worker bee lifespan.

SIGNIFICANCE AND IMPACT OF THE STUDY

This is the first report on the impact of phytochemical supplementation on gut microbiota in honey bees and these findings have implications for strategic hive management through standardization of effective phytochemical and probiotic feed supplements.

Preventive Fungicidal Control of Cytospora leucostoma in Peach Orchards in Colorado

In western Colorado, Cytospora leucostoma is ubiquitous in peach orchards and has developed into a major limiting factor of peach production. The pathogen is unable to invade healthy intact phloem tissue of the tree, but instead, it requires a wound as a mode of entry. Bark injuries caused by cold and pruning in commercial orchard systems provide infection courts that, in suitable environment conditions, can lead to many successful fungal infections. Preventive fungicide control is an integral component of management in tree fruit production. Eighteen fungicides were tested at selected label dose rates for C. leucostoma control. All treatments were initially tested in vitro in fungicide-amended media dishes. Successful treatments were then tested under controlled conditions on detached peach branch segments. Effective fungicides identified in the laboratory assays (thiophanate-methyl, captan, lime sulfur, and copper hydroxide) were further tested as spray applications in the field and as wound sealant applications in combination with latex paint and kaolin clay. Of the treatments evaluated, thiophanate-methyl, captan, 50% latex paint, thiophanate-methyl amended in 50% latex paint, captan amended in 50% latex paint, and lime sulfur were most effective in reducing C. leucostoma necrotic area. Copper hydroxide was ineffective in all field trials and in some instances, yielded larger necrotic areas than the nontreated positive control shoots.

Techniques for chronic monitoring of brain activity in freely moving sheep using wireless EEG recording

BACKGROUND

Large mammals with complex central nervous systems offer new possibilities for translational research into basic brain function. Techniques for monitoring brain activity in large mammals, however, are not as well developed as they are in rodents.

NEW METHOD

We have developed a method for chronic monitoring of electroencephalographic (EEG) activity in unrestrained sheep. We describe the methods for behavioural training prior to implantation, surgical procedures for implantation, a protocol for reliable anaesthesia and recovery, methods for EEG data collection, as well as data pertaining to suitability and longevity of different types of electrodes.

RESULTS

Sheep tolerated all procedures well, and surgical complications were minimal. Electrode types used included epidural and subdural screws, intracortical needles and subdural disk electrodes, with the latter producing the best and most reliable results. The implants yielded longitudinal EEG data of consistent quality for periods of at least a year, and in some cases up to 2 years.

COMPARISON WITH EXISTING METHODS

This is the first detailed methodology to be described for chronic brain function monitoring in freely moving unrestrained sheep.

CONCLUSIONS

The developed method will be particularly useful in chronic investigations of brain activity during normal behaviour that can include sleep, learning and memory. As well, within the context of disease, the method can be used to monitor brain pathology or the progress of therapeutic trials in transgenic or natural disease models in sheep.

Esters from Bacterial Oxidation of Olefins

Identification of esters isolated from culture fluids of bacteria growing upon terminal olefins indicates that bacteria oxidize olefins at the saturated methyl group, leaving the double bond intact. The yeast Candida lipolytica produces alpha-glycols from olefins, presumably by attacking the double bond.

Tuberculosis in socio-economically deprived neighborhoods: missed opportunities for prevention

OBJECTIVE

To evaluate tuberculosis (TB) risk in three different US locations--Chicago, Illinois; Fulton County, Georgia; and the state of South Carolina--using two census-based measures of neighborhood-level deprivation and a geographic information system.

METHOD

Individual-level data, including race and ZIP code of residence, were obtained for the three sites. TB cases were geocoded at the ZIP code tabulation area (ZCTA) level. Socio-economic status (SES) was defined at the ZCTA level using two Census 2000-based measures of socio-economic disadvantage: 1) percentage of population below poverty and 2) Townsend Deprivation Index. Based separately on the distributions of poverty and Townsend social deprivation scores, ZCTAs in each site were grouped into quartiles reflecting relative socio-economic well-being. To evaluate TB incidence in low- vs. high-SES neighborhoods, average annual TB incidence rates were calculated for the highest and lowest ZCTA quartiles.

RESULTS

In all sites, TB incidence rates were significantly higher in high poverty/high social deprivation ZCTAs (P < 0.0001).

CONCLUSIONS

Both census-based indicators performed well in distinguishing areas with high TB incidence rates from areas with little or no TB. Due to simplicity, the single poverty measure rather than the multifactorial Townsend index might be especially useful in identifying high-risk neighborhoods for targeted TB prevention efforts.

Fingerprinting genomic instability in oral submucous fibrosis

BACKGROUND

Oral submucous fibrosis (OSF) is a high-risk pre-cancerous condition where 7-13% of these patients develop head and neck squamous cell carcinoma (HNSCC). To date there is no cancer predictive markers for OSF patients. Genomic instability hallmarks early genetic events during malignant transformation causing loss of heterozygosity (LOH) and chromosomal copy number abnormality. However, to date there is no study on genomic instability in OSF. Although this condition is known as a high-risk pre-cancerous condition, there is no data regarding the genomic status of this disease in terms of genetic susceptibility to malignant transformation.

METHODS

In this study, we investigated the existence of genetic signatures for carcinogenesis in OSF. We employed the high-resolution genome-wide Affymetrix Mapping single nucleotide polymorphism microarray technique to 'fingerprint' global genomic instability in the form of LOH in 15 patient-matched OSF-blood genomic DNA samples.

RESULTS

This rapid high-resolution mapping technique has revealed for the first time that a small number of discrete hot-spot LOH loci appeared in 47-53% of the OSF tissues studied. Many of these LOH loci were previously identified regions of genomic instability associated with carcinogenesis of the HNSCC.

CONCLUSION

To our knowledge, this is the first evidence that genomic instability in the form of LOH is present in OSF. We hypothesize that the genomic instability detected in OSF may play an important role in malignant transformation. Further functional association studies on these putative genes may reveal potential predictive oral cancer markers for OSF patients.

Upregulation of HIF-1alpha in malignant transformation of oral submucous fibrosis

BACKGROUND

Oral submucous fibrosis (OSF) is a precancerous condition showing extensive fibrosis of the submucosa and affects most parts of the oral cavity, including pharynx and upper third of the oesophagus. The molecules involved in the biological pathways of the fibrotic process appeared to be either down- or upregulated at different stages of the disease. Despite the precancerous nature, malignant transformation of the epithelium in the background of fibrosis has not been studied in detail. HIF-1alpha is a known transcription factor that is induced by hypoxia.

AIMS

To test the hypothesis that hypoxia plays a role in malignant transformation and progression of OSF.

MATERIALS AND METHODS

We used both formalin-fixed and frozen samples of OSF and normal mucosa to investigate the relationship between HIF-1alpha and epithelial dysplasia using immunohistochemistry and RT-PCR.

CONCLUSIONS

Our data indicate that HIF-1alpha is upregulated at both protein and mRNA levels in OSF and the correlation with epithelial dysplasia is statistically significant (P < 0.001). We propose that HIF-1alpha may play a role in malignant transformation of OSF. Further, over-expression of HIF-1alpha may contribute to the progression of fibrosis. It may be possible to use HIF-1alpha as a marker for malignant transformation of OSF.

HEF1 is a necessary and specific downstream effector of FAK that promotes the migration of glioblastoma cells

The highly invasive behavior of glioblastoma cells contributes to the morbidity and mortality associated with these tumors. The integrin-mediated adhesion and migration of glioblastoma cells on brain matrix proteins is enhanced by stimulation with growth factors, including platelet-derived growth factor (PDGF). As focal adhesion kinase (FAK), a nonreceptor cytoplasmic tyrosine kinase, has been shown to promote cell migration in various other cell types, we analysed its role in glioblastoma cell migration. Forced overexpression of FAK in serum-starved glioblastoma cells plated on recombinant (rec)-osteopontin resulted in a twofold enhancement of basal migration and a ninefold enhancement of PDGF-BB-stimulated migration. Both expression of mutant FAK(397F) and the downregulation of FAK with small interfering (si) RNA inhibited basal and PDGF-stimulated migration. FAK overexpression and PDGF stimulation was found to increase the phosphorylation of the Crk-associated substrate (CAS) family member human enhancer of filamentation 1 (HEF1), but not p130CAS or Src-interacting protein (Sin)/Efs, although the levels of expression of these proteins was similar. Moreover downregulation of HEF1 with siRNA, but not p130CAS, inhibited basal and PDGF-stimulated migration. The phosphorylated HEF1 colocalized with vinculin and was associated almost exclusively with 0.1% Triton X-100 insoluble material, consistent with its signaling at focal adhesions. FAK overexpression promoted invasion through normal brain homogenate and siHEF1 inhibited this invasion. Results presented here suggest that HEF1 acts as a necessary and specific downstream effector of FAK in the invasive behavior of glioblastoma cells and may be an effective target for treatment of these tumors.

Na+ site in blood coagulation factor IXa: effect on catalysis and factor VIIIa binding

During blood coagulation, factor IXa (FIXa) activates factor X (FX) requiring Ca2+, phospholipid, and factor VIIIa (FVIIIa). The serine protease domain of FIXa contains a Ca2+ site and is predicted to contain a Na+ site. Comparative homology analysis revealed that Na+ in FIXa coordinates to the carbonyl groups of residues 184A, 185, 221A, and 224 (chymotrypsin numbering). Kinetic data obtained at several concentrations of Na+ and Ca2+ with increasing concentrations of a synthetic substrate (CH3-SO2-d-Leu-Gly-Arg-p-nitroanilide) were fit globally, assuming rapid equilibrium conditions. Occupancy by Na+ increased the affinity of FIXa for the synthetic substrate, whereas occupancy by Ca2+ decreased this affinity but increased k(cat) dramatically. Thus, Na+-FIXa-Ca2+ is catalytically more active than free FIXa. FIXa(Y225P), a Na+ site mutant, was severely impaired in Na+ potentiation of its catalytic activity and in binding to p-aminobenzamidine (S1 site probe) validating that substrate binding in FIXa is linked positively to Na+ binding. Moreover, the rate of carbamylation of NH2 of Val16, which forms a salt-bridge with Asp194 in serine proteases, was faster for FIXa(Y225P) and addition of Ca2+ overcame this impairment only partially. Further studies were aimed at delineating the role of the FIXa Na+ site in macromolecular catalysis. In the presence of Ca2+ and phospholipid, with or without saturating FVIIIa, FIXa(Y225P) activated FX with similar K(m) but threefold reduced k(cat). Further, interaction of FVIIIa:FIXa(Y225P) was impaired fourfold. Our previous data revealed that Ca2+ binding to the protease domain increases the affinity of FIXa for FVIIIa approximately 15-fold. The present data indicate that occupancy of the Na+ site further increases the affinity of FIXa for FVIIIa fourfold and k(cat) threefold. Thus, in the presence of Ca2+, phospholipid, and FVIIIa, binding of Na+ to FIXa increases its biologic activity by approximately 12-fold, implicating its role in physiologic coagulation.

Viability of Sirococcus clavigignenti-juglandacearum Conidia on Exoskeletons of Three Coleopteran Species

Butternut canker, caused by Sirococcus clavigignenti-juglandacearum, is the primary cause of decline of butternut (Juglans cinerea). Conidia of the fungus have been isolated from several insect species. The vector potential of three species of Coleoptera, Astylopsis macula, Eubulus parochus, and Glischrochilus sanguinolentus, was studied during 2001 and 2002. Beetles were collected, rinsed, and artificially inoculated with conidia. All three species carried viable conidia up to 16 days. The mean number of conidia carried per beetle in 2001 was as follows: 3.21 million at 0 h to 11,371 at 384 h for A. macula; 3.91 million at 0 h to 57 at 384 h for E. parochus; and 355,742 at 0 h to 314 at 384 h for G. sanguinolentus. In 2002, the numbers were: 1.42 million at 0 h to 2,814 at 384 h for A. macula; 1.29 million at 0 h to 85 at 384 h for E. parochus; and 72,342 at 0 h to 0 at 192 h for G. sanguinolentus. Using scanning electron microscopy, conidia were observed on the abdomen, thorax, and legs of artificially inoculated individuals of each species and on the thorax and abdomen of field-collected A. macula and E. parochus. These data suggest that all three species are potential vectors of S. clavigignenti-juglandacearum; however, A. macula and E. parochus may be more effective vectors.

Extracellular matrix metabolites as potential biomarkers of disease activity in wound fluid: lessons learned from other inflammatory diseases?

The new era of pharmacogenetics has identified a potential for individuals to receive customized treatments for a variety of disease states. For such individualized treatments to fulfil their potential, it will be essential for clinicians to be able to monitor disease activity, ideally in a rapid, noninvasive fashion. The accessibility of the skin offers much potential to develop noninvasive tests of metabolic and disease activity for clinical use. Impaired human wound healing in the skin is a chronic inflammatory disorder in which the development of such tests has considerable potential, aiding clinical decision making and monitoring responses to treatment. This review article discusses how studies in other human diseases have highlighted potential biochemical markers (biomarkers) of disease activity in secreted biofluids, as aids to determining disease and metabolic activity within tissues. Using, as examples, lessons learned in the study of disease activity and prognosis of other chronic inflammatory conditions, such as osteoarthritis and periodontal disease, this review highlights the potential of dermal extracellular matrix (ECM) components (collagens, proteoglycans, hyaluronan and glycoproteins) for such uses. The limitations of currently utilized techniques and the concept that analysis of ECM components in wound fluid may represent useful biomarkers of disease activity are also discussed.

Open Source Software meets gene expression

Use of the Open Source Software (OSS) development model has been crucial in a number of recent technological areas, including operating systems, applications and bioinformatics. The rationale for why OSS is often a better development model than proprietary development and some of the results of this model in the field of Gene Expression are reviewed. The paper concludes with a discussion of why funding agencies should endorse OSS and require funded software projects to be released Open Source.

TGF-beta1 up-regulates paxillin protein expression in malignant astrocytoma cells: requirement for a fibronectin substrate

Cytokines can influence the interactions between members of the integrin cell adhesion receptor family and the extracellular matrix thereby potentially affecting cell function and promoting cell adhesion, growth and migration of malignant astrocytoma tumor cells. As malignant astrocytoma cells synthesize TGF-beta1 in vivo, we analysed the effects of TGF-beta1 on signaling events associated with integrin receptor ligation, focusing on the effects on paxillin, a phosphorylated adaptor protein, that acts as a scaffold for signaling molecules recruited to focal adhesions. TGF-beta1-stimulation of primary astrocytes and serum-starved U-251MG malignant astrocytoma cells attached to fibronectin induced a substantial increase in the levels of paxillin protein (fivefold increase at 2.0 ng/ml) in a dose- and time-dependent manner compared to the levels observed on plating onto fibronectin in the absence of stimulation. In the astrocytoma cells, this resulted in an increase in the pool of tyrosine-phosphorylated paxillin, although it did not appear to alter the extent of phosphorylation of the paxillin molecules. In contrast, in primary astrocytes the protein levels were upregulated in the absence of a parallel increase in phosphorylation. The TGF-beta1-stimulated increase in paxillin levels required ligation of the fibronectin receptor, as it was not induced when the cells were plated onto vitronectin, collagen or laminin. The increase in the pool of paxillin on TGF-beta1 stimulation of the fibronectin-plated astrocytoma cells was associated with an increase in translation, but was not associated with an increase in the steady-state levels of paxillin mRNA. Stimulation with TGF-beta1 on a fibronectin substrate increased subsequent attachment and spreading of U-251MG cells onto fibronectin and, to a lesser extent, vitronectin, but not collagen. Our results indicate that physiologic levels of TGF-beta1 stimulate the expression of paxillin protein at the level of translation through a process that requires engagement of the fibronectin receptor, and promotes attachment and spreading of malignant astrocytoma cells on fibronectin.

Purification and identification of a human dermal extract component inhibitory to fibroblast proliferation

It was previously shown that a citric acid buffer extract of human dermis (extract D) inhibited growth of human diploid fibroblasts in monolayer culture (Muir et al., 1997). Further fractionation has shown that the active principle is probably a proteoglycan, and that retention of its inhibitory activity is dependent on the use protease inhibitors throughout the extraction procedure. Elution of extract D from a DEAE-cellulose column produced four major peaks, each of which was subjected to SDS-PAGE as well as being tested for inhibitory activity on the growth of fibroblasts in culture. Peaks III and IV had no inhibitory effect, but peak I contained highly active material. Gels of this peak showed prominent bands of 120 kDa (corresponding to dermatan sulphate proteoglycan II, DS-PG II) and at 45 kDa (corresponding to the core protein). The latter band became more prominent when extract D which had been treated with chrondroitinase ABC was electrophoresed. Their identities were verified by Western blotting. Peak II also contained some slower-acting inhibitory material which has as yet to be identified, but contains little or no protein corresponding to the decorin core-protein. The data indicate that the intact decorin molecule, DS-PG II, is the main inhibitory principle in human skin.

Irritable bowel syndrome

Within the literature, it appears evident that neither a univariate etiologic model nor a single-agent treatment approach is sufficient to address the many diagnostic, assessment, and therapeutic challenges posed by irritable bowel syndrome (IBS). Various scientific advances have been made over the past 5 years, particularly in the areas of nonpharmacologic management of IBS. However, further collaboration between scientists and clinicians from multiple disciplines is strongly encouraged.

Length variation in HV2 of the human mitochondrial DNA control region

Hair samples were typed from three individuals who exhibited length heteroplasmy in the homopolymeric cytosine stretches (C-stretch) in hypervariable region 2 (HV2). The study demonstrated that for different hairs within an individual, the HV2 C-stretch region can vary with respect to the number of cytosines and/or proportion of C-stretch length variants. Length heteroplasmy may occur regardless of the prominent length variant present in this region. Differences in the number of cytosines at the C-stretch region, or a variation in the relative amounts of heteroplasmic length variants, cannot be used to support an interpretation of exclusion.

Quantitative three-dimensional analysis and diffusion modeling of oligonucleotide concentrations after direct intraparenchymal brain infusion

We compared quantitative experimental results on the diffusion of 35S-labeled phosphorothioate oligonucleotide (PS-ODN) after intraparenchymal infusion in rat brain, with the distributions predicted by Fick's second law of diffusion. Fischer 344 rats underwent identical intracerebral infusions of 36S-PS-ODN. After 0, 5, 11, 23, and 47 h, groups of animals were sacrificed and sequential brain cryosections subjected to autoradiography. The resulting experimental data were compared to the predicted distributions, for estimation of the apparent free diffusion coefficient, D*. Volumes of distribution and total content of 36 S-PS-ODN in the parenchyma were also computed, to monitor loss of total material. The values for D* were within the expected range for the 21-mer PS-ODN used, but a progressive decrease in D* over time was noted. The model requires D* to remain constant and, thus, does not adequately explain the spread of 35S-PS-ODN following infusion. The progressive slowing of spread over time suggests that at later time points, 35S-PS-ODN may be fixed by tissue binding or cellular uptake in the brain. Loss of material via vascular and CSF clearance may also contribute to the lack of fit. Our results highlight issues to be addressed in the modeling and experimental design of the intraparenchymal infusion process.

The effect of periodontal treatment on glycemic control in patients with type 2 diabetes mellitus

BACKGROUND, AIMS

This study was designed to explore the effect of periodontal therapy on glycemic control in persons with type 2 diabetes mellitus (DM).

METHODS

36 patients with type 2 DM (treatment group) received therapy for adult periodontitis during an 18-month period. A 36-person control group was randomly selected from the same population of persons with type 2 DM who did not receive periodontal treatment.

RESULTS

These groups were well matched for most of the parameters investigated. During the nine-month observation period, there was a 6.7% improvement in glycemic control in the control group when compared to a 17.1% improvement in the treatment group, a statistically significant difference. Several parameters that could confound or moderate this glycemic control were explored. These included the treatment of non-dental infections, weight and medication changes. No moderating effect was associated with any of these variables. However, there were too few subjects in the study to have the statistical power necessary to assess these possible moderators of glycemic control.

CONCLUSIONS

We interpret the data in the study to suggest that periodontal therapy was associated with improved glycemic control in persons with type 2 DM.

Hypocarbia during the first 24 postnatal hours and white matter echolucencies in newborns < or = 28 weeks gestation

The purpose of the present study was to test the hypothesis that newborns < or = 28 wk gestation who have a PCO(2) measurement in the lowest gestational age-specific quartile (hypocarbia) on the first day of life are not at increased risk for ultrasonographic white matter echolucency (EL) after adjustment for confounders. The sample consisted of 799 infants < or = 28 wk gestation born during 1991-1993. Forty-eight infants with EL were classified as cases and compared with 751 controls, i.e. those without EL. We performed univariable comparisons, stratified analyses, and multivariable logistic regression. In the univariable analyses, hypocarbia on the first day of life was associated with an increased EL risk. The odds ratios for the hypocarbia-EL relationship were prominently elevated in the strata of infants who did not have other major risk factors for EL (e.g. gestational age 26-28 wk, normothyroxinemia, no characteristics of antenatal infection). In the multivariable analyses, the association diminished after adjustment with a hypocarbia propensity score (odds ratio = 1.7; 95 % confidence interval, 0.8-3.2) or with potential confounders.

Reduced visual resolution acuity and cerebral white matter damage in very-low-birthweight infants

Neonatal cerebral white matter echolucencies predict visual resolution acuity deficits in very-low-birthweight (VLBW) infants. We examined maternal sociodemographic, lifestyle, intrapartum, infant birth/perinatal, and ocular motor/refractive characteristics to determine whether they accounted for this association in infants who were tested once between postnatal age 25 and 56 weeks (corrected for gestational age at birth). Cranial ultrasound scans were read by consensus to identify echolucency in a population of VLBW infants with no known ocular abnormalities. Visual resolution acuity was measured with the Acuity Card Procedure (ACP) in 14 infants with echolucency and compared with that of 81 VLBW infants born in the same hospitals with normal ultrasound scans. In time-oriented logistic regression models, echolucency remained a consistent predictor of abnormal visual resolution acuity after adjustment for covariates in three developmental periods (pre-, peri-, and postnatal). Odds ratios ranged from 19.3 (95% confidence interval, 4.5 to 82.2; p=0.001) to 10.4 (95% confidence interval, 1.3 to 81.9; p=0.03). Reduced visual resolution acuity in VLBW infants appears to be due to cerebral white matter damage.

p125 focal adhesion kinase promotes malignant astrocytoma cell proliferation in vivo

p125 focal adhesion kinase (p125FAK) is a cytoplasmic tyrosine kinase that is activated upon engagement of integrin cell adhesion receptors, and initiates several signaling events that modulate cell function in vitro. To determine the biologic role of p125FAK in malignant astrocytic tumor cells, U-251MG human malignant astrocytoma cells were stably transfected with p125FAK cDNA using the TET-ON system, and stable clones isolated that exhibited an estimated 5- or 20-fold increase in p125FAK expression on administration of 0.1 or 2.0 microg/ml doxycycline, respectively. In vitro studies demonstrated that induction of p125FAK resulted in a 2- to 3-fold increase in cell migration, increased p130CAS phosphorylation, localization of exogenous p125FAK to focal adhesions, and a 2-fold increase in soft agar growth. To determine the role of p125FAK in vivo, clones were injected stereotactically into the brains of scid mice. A 4.5-fold estimated increase in p125FAK expression was induced by administration of doxycycline in the drinking water. Analysis of xenograft brains demonstrated that, upon induction of p125FAK, there was a 1.6- to 2.8-fold increase in tumor cell number, and an increase in mAb PCNA-labeling of tumor cells in the absence of a change in the apoptotic index. Compared to normal brain, the expression of p125FAK was elevated in malignant astrocytic tumor biopsies from patient samples. These data demonstrate for the first time that p125FAK promotes tumor cell proliferation in vivo, and that the underlying mechanism is not associated with a reduction in apoptosis.

Baby CareLink: using the internet and telemedicine to improve care for high-risk infants

OBJECTIVE

To evaluate an Internet-based telemedicine program designed to reduce the costs of care, to provide enhanced medical, informational, and emotional support to families of very low birth weight (VLBW) infants during and after their neonatal intensive care unit (NICU) stay.

BACKGROUND

Baby CareLink is a multifaceted telemedicine program that incorporates videoconferencing and World Wide Web (WWW) technologies to enhance interactions between families, staff, and community providers. The videoconferencing module allows virtual visits and distance learning from a family's home during an infant's hospitalization as well as virtual house calls and remote monitoring after discharge. Baby CareLink's WWW site contains information on issues that confront these families. In addition, its security architecture allows efficient and confidential sharing of patient-based data and communications among authorized hospital and community users.

DESIGN/METHODS

A randomized trial of Baby CareLink was conducted in a cohort of VLBW infants born between November 1997 and April 1999. Eligible infants were randomized within 10 days of birth. Families of intervention group infants were given access to the Baby CareLink telemedicine application. A multimedia computer with WWW browser and videoconferencing equipment was installed in their home within 3 weeks of birth. The control group received care as usually practiced in this NICU. Quality of care was assessed using a standardized family satisfaction survey administered after discharge. In addition, the effect of Baby CareLink on hospital length of stay as well as family visitation and interactions with infant and staff were measured.

RESULTS

Of the 176 VLBW infants admitted during the study period, 30 control and 26 study patients were enrolled. The groups were similar in patient and family characteristics as well as rates of inpatient morbidity. The CareLink group reported higher overall quality of care. Families in the CareLink group reported significantly fewer problems with the overall quality of care received by their family (mean problem score: 3% vs 13%). In addition, CareLink families also reported greater satisfaction with the unit's physical environment and visitation policies (mean problem score: 13% vs 50%). The frequency of family visits, telephone calls to the NICU, and holding of the infant did not differ between groups. The duration of hospitalization until ultimate discharge home was similar in the 2 groups (68.5 +/- 28.3 vs 70.6 +/- 35.6 days). Among infants born weighing <1000 g (n = 31) there was a tendency toward shorter lengths of stay (77.4 +/- 26.2 vs 93.1 +/- 35.6 days). All infants in the CareLink group were discharged directly to home whereas 6/30 (20%) of control infants were transferred to community hospitals before ultimate discharge home.

CONCLUSIONS

CareLink significantly improves family satisfaction with inpatient VLBW care and definitively lowers costs associated with hospital to hospital transfer. Our data suggest the use of telemedicine and the Internet support the educational and emotional needs of families facilitating earlier discharge to home of VLBW infants. We believe that further extension of the Baby CareLink model to the postdischarge period will significantly improve the coordination and efficiency of care.

Validation and use of a finite element model of C-2 for determination of stress and fracture patterns of anterior odontoid loads

OBJECT

The finite element (FE) method is a powerful tool for the analysis of stress patterns of anatomical structures. In this study a highly refined FE model of C-2 was created and validated. The model was then used to characterize stress patterns, predicted fracture patterns, and transitions between Type II and Type III odontoid fractures.

METHODS

An anatomically accurate three-dimensional model of C-2 was created from computerized tomography data obtained from the Visible Human Project. The C-2 model was broken down into an FE mesh consisting of 32,815 elements and 40,969 nodes. For validation, the FE model was constrained and loaded to simulate that used in previous biomechanical studies. The validated model was then loaded in an iterative fashion, varying the orientation of the load within the validated range. A matrix of stress plots was created for comparative analysis. Results of the validation testing closely correlated with those obtained in previous biomechanical testing. Pure extension loading produced a Type III stress pattern with maximum stress of 134 MPa. Loading at 45 degrees produced a Type II stress distribution with a maximum stress of 123 MPa. These stresses are within 3% and 11%, respectively, of the reported yield stress of cortical bone (138 MPa). In the second portion of the study, systematic variation in the orientation of the load vector revealed that higher stresses were associated with increased lateral angulation and increasing upward inclination of the load vectors. A transition from a Type III to Type II pattern occurred with lateral orientations greater than 15 degrees and with compressive loads of 45 degrees.

CONCLUSIONS

The validated C-2 FE model described in this study both qualitatively and quantitatively was able to simulate the behavior of the C-2 vertebra in biomechanical testing. In this study the authors demonstrate the utility of the FE method when used in conjunction with traditional biomechanical testing.

Event-related potentials (ERPs) to hemifield presentations of emotional stimuli: differences between depressed patients and healthy adults in P3 amplitude and asymmetry

Depression may involve dysfunction of right parietotemporal cortex, a region activated during perception of affective stimuli. To further test this hypothesis, event-related brain potentials (ERPs) were measured in a paradigm previously shown to produce ERP asymmetries to affective stimuli over parietal sites in healthy adults. Pictures of patients with dermatological diseases showing disordered or healed facial areas before (negative) or after (neutral) surgical treatment were briefly exposed for 250 ms to either the left or right hemifield. ERPs of 30 unmedicated, unipolar depressed patients and 16 healthy adults, all right-handed, were recorded from 30 electrodes. A principal components analysis extracted factors which closely corresponded to distinctive ERP components previously reported for this task (N1, N2, early P3, late P3, slow wave). Significant effects of emotional content, i.e. enhanced amplitudes to negative than neutral stimuli, were found for early and late P3. Control subjects showed significant hemispheric asymmetries of emotional processing for late P3 (peak latency 460 ms), with the largest emotional content effects over the right parietal region. In striking contrast to control subjects, depressed patients did not show an increase in late P3 for negative compared to neutral stimuli over either hemisphere and had smaller late P3 amplitude than control subjects. Patients did, however, show larger early P3 (peak latency 330 ms) to negative than neutral stimuli. Results suggest intact early discrimination but abnormal late appraisal of affective content in depression, which may arise from selective inhibition of right parietal regions integral for perceiving and evaluating emotional stimuli.

Attachment of primary neonatal rat astrocytes to vitronectin is mediated by integrins alphavbeta5 and alpha8beta1: modulation by the type 1 plasminogen activator inhibitor

Vitronectin is expressed in a cell-specific manner in the developing brain and concentrated in the brain during disease processes, such as germinal matrix hemorrhage and infarction, in which there is breakdown of the blood-brain barrier. In this study, we identified the integrin receptors that mediate attachment of primary neonatal rat astrocytes to vitronectin. Using fluorescent activated cell sorter and immunoprecipitation analyses, we established that the vitronectin receptor integrins alphavbeta5 and alpha8beta1, but not alphavbeta3, are expressed on neonatal rat astrocytes. Attachment of the neonatal astrocytes to vitronectin was inhibited (85%) in an additive manner by neutralizing anti-alphavbeta5 and anti-beta1 antibodies. Attachment to vitronectin was also inhibited in a dose-dependent manner by the type I plasminogen activator inhibitor (PAI-1), a serine protease inhibitor. Our data demonstrate that unstimulated primary neonatal rat astrocytes attach to vitronectin, utilizing integrins alphavbeta5 and alpha8beta1, and that this attachment is regulated by PAI-1.

Diffusional characteristics of freeze/thawed poly(vinyl alcohol) hydrogels: applications to protein controlled release from multilaminate devices

The incorporation of a model protein, bovine serum albumin (BSA), into poly(vinyl alcohol) (PVA) hydrogel films during the freezing and thawing process and its subsequent release behavior were investigated. The effect of the number of freezing and thawing cycles as well as the stability of BSA were examined. BSA release profiles were not significantly different from gels prepared after 3 or 5 cycles. However, the rate and overall amount of PVA dissolution were considerably higher for gels prepared after 3 cycles. These observations were then applied to the development of novel, freeze/thawed PVA laminates. Laminates containing gel layers prepared after 3 or 5 cycles were successfully prepared with good stability over a 6 month swelling period. These structures, containing distinct layers of very specific properties, could be used to achieve zero-order release behavior.

Microbial utilization of the neurotoxin domoic acid: blue mussels (Mytilus edulis) and soft shell clams (Mya arenaria) as sources of the microorganisms

The neurotoxin domoic acid is produced in quantity by the diatom Pseudo-nitzschia multiseries and is released to the environment directly and indirectly via food chains. Presumably there is a mechanism for the biodegradation and disposal of domoic acid and as bacteria are logical candidates for such an activity, a search for bacteria competent to carry out biodegradation of domoic acid was initiated. Extensive trials with a wide variety of bacteria isolated mainly from muds and waters taken from the marine environment showed that the ability to grow on or degrade domoic acid was rare; in fact, domoic acid was inhibitory to resting cells or growing cultures of most of these bacteria. In contrast, using enrichment techniques, it was possible to isolate from molluscan species that eliminate domoic acid readily, i.e., blue mussels (Mytilus edulis) and soft-shell clams (Mya arenaria), bacteria that exhibited growth with and biodegradation of domoic acid when supplemented with low concentrations of growth factors. The species that retain domoic acid for lengthy periods, such as sea scallops (Placopecten magellanicus) and red mussels (Modiolus modiolus), only occasionally yielded bacteria with this capability. The differences may be a result of the mechanisms used by the different shellfish in dealing with domoic acid, i.e., freely available in the blue mussels and soft-shell clams but likely sequestered in the digestive glands of sea scallops and red mussels and thus, largely unavailable for bacterial utilization. The results show that Mytilus edulis and Mya arenaria, almost uniquely, are prime and reliable sources of domoic acid utilizing bacteria. These findings suggest a strong possibility that autochthonous bacteria may be significant factors in the elimination of the neurotoxin in these two species of shellfish.

Large-scale preparation of the delta10 form of staphylokinase by in vitro processing of recombinant staphylokinase with purified human plasminogen

The authors have developed a rapid and convenient method for purification of a low molecular weight form (delta 10) of the bacterial plasminogen activator, staphylokinase. Recombinant staphylokinase is expressed in Escherichia coli, with an amino terminal extension that facilitated purification by immobilized metal-affinity chromatography. Purified staphylokinase is treated with human plasminogen, and the resulting truncated form is purified using a combination of immobilized metal affinity chromatography and hydrophobic interaction chromatography. Purified protein is characterized by amino terminal sequencing and in vitro plasminogen activation assay.

Receptor binding of an apolipoprotein E-rich subfraction of high density lipoprotein to rat and human brain membranes

During nerve cell degeneration, cholesterol released from the degrading cells is conserved through the formation of a cholesterol-apolipoprotein (apo) E complex which is subsequently taken up by regenerating nerve cells. The aim of the present project was to identify the physiologically relevant lipoprotein receptor for this lipoprotein complex which has remained elusive. HDL was separated into apo E-rich and apo E-poor subfractions and labelled with [14C]-sucrose. Labelled apo E-rich HDL bound to rat brain membranes in a time- and ligand concentration-dependent manner and was a saturable process. Essentially no binding occurred with [14C]-apo E-poor HDL or with free apo E. Binding was partially inhibited by low density lipoprotein (LDL) and by alpha 2-macroglobulin. These results provide new evidence that native apoE-rich HDL particles resembling those present in the brain bind to rat brain membranes and that the binding may be due, at least in part, to the LDL receptor and to the LDL-receptor related protein. Evidence was also provided for the presence of a receptor which binds [14C]-sucrose human apoE-rich HDL in human brain. Characterisation of the receptor which mediates the uptake of cholesterol from HDL-like complexes by brain cells is important in understanding the role of apoE in the central nervous system and of the alterations which occur in disorders such as Alzheimer's disease.

Brain ERPs of depressed patients to complex tones in an oddball task: relation of reduced P3 asymmetry to physical anhedonia

Event-related potentials to binaural complex tones were recorded from 40 depressed outpatients and 22 normal control participants at 30 electrode sites. Patients did not differ from control participants in N1 or P3 amplitude but showed greater N2. N2 was greater over right than over the left hemisphere at lateral sites in patients and control participants. A P3 asymmetry was found for control participants and patients with low scores on a physical anhedonia scale, but not for patients with high anhedonia scores. Topographic (local Laplacian) maps corresponding to P3 showed greater radial current flow over right than over left central regions in control participants. Patients with high anhedonia did not show this asymmetry, whereas patients with low anhedonia showed an intermediate asymmetry. These findings support the hypothesis that anhedonic depression is associated with dysfunction of right hemisphere mechanisms mediating the processing of complex pitch information.

Development of oral hygiene self-efficacy and outcome expectancy questionnaires

In order to measure social cognitive constructs in the oral hygiene domain, questionnaires containing self-efficacy and outcome expectation items were developed. Items were generated to measure personal beliefs in brushing and flossing ability under a variety of circumstances, and expected outcomes from performing oral hygiene behaviors that might be positive, negative, primary and secondary. In the first study, factor scales were developed on the basis of the responses from 90 subjects awaiting dental treatment. Principal components analyses with varimax rotation revealed two self-efficacy and four outcome expectations dimensions that explained 73% and 51% of the variance, respectively. A second study that utilized 103 government employees was conducted to evaluate the psychometric properties of the questionnaires. All scales demonstrated good internal consistency and test-retest stability. Correlations with extra test measures provided preliminary evidence for the validity of the instruments.

Preliminary crystallographic study on a low molecular weight form of bacterial plasminogen activator staphylokinase

Staphylokinase, a 17 kDa protein, produced by certain strains of Staphylococcus aureus functions as a fibrin-specific plasminogen activator. During its interaction with plasminogen, staphylokinase is converted into a low molecular weight form by loss of ten amino-terminal residues. This low molecular weight form of recombinant staphylokinase has been crystallized using the hanging-drop vapor-diffusion technique with polyethylene glycol 4000 as precipitant. Crystals belong to the orthorhombic space group C222(1) with unit-cell dimensions a = 43.78, b = 59.86 and c = 103.25 A and one molecule in the asymmetric unit. These crystals diffract to about 2.4 A resolution.

Regional brain asymmetries in major depression with or without an anxiety disorder: a quantitative electroencephalographic study

Studies of brain activity in affective disorders need to distinguish between effects of depression and anxiety because of the substantial comorbidity of these disorders. Based on a model of asymmetric hemispheric activity in depression and anxiety, it was predicted that anxious and nonanxious depressed patients would differ on electroencephalographic (EEG) measures of parietotemporal activity. Resting EEG (eyes closed and eyes open) was recorded from 44 unmedicated outpatients having a unipolar major depressive disorder (19 with and 25 without an anxiety disorder), and 26 normal controls using 30 scalp electrodes (13 homologous pairs over the two hemispheres and four midline sites). As predicted, depressed patients with an anxiety disorder differed from those without an anxiety disorder in alpha asymmetry. Nonanxious depressed patients showed an alpha asymmetry indicative of less activation over right than left posterior sites, whereas anxious depressed patients showed evidence of greater activation over right than left anterior and posterior sites. The findings are discussed in terms of a model in which specific symptom features of depression and anxiety are related to different patterns of regional brain activity.

Growth inhibition of cultured fibroblasts by extracts from human dermis

In incised wounds and deep partial thickness burns the resident fibroblasts in the dermis remain inactive. The fibroblasts responsible for repair at the dermal level come from the subdermal layer. The hypothesis is that the inactivity of the dermal fibroblasts is due to an inhibitory substance in the dermis. To test this hypothesis extracts were made of normal dermis and of mature scar tissue and these extracts were applied to fibroblasts growing in monolayer culture. Both extracts and cells were obtained from human tissue. It was shown that extracts, particularly the extract made with citric acid/citrate buffer, pH 3.5, caused inhibition of fibroblast growth. Present evidence suggests that the active principle may be a proteoglycan.

Changes in dental knowledge and self-efficacy scores following interventions to change oral hygiene behavior

One hundred twenty-three male veterans were randomly assigned to control, education, and psychological groups to improve oral hygiene behavior. The educational group received four 40-min sessions designed to increase knowledge of the causes and prevention of dental disease. The psychological intervention also consisted of four 40-min sessions. However, a psychologist provided the intervention using a Stage of Change intervention. The control group received pre- and post-testing only. There were no significant changes in dental knowledge for the control group while the increases in dental knowledge in the educational and psychological groups were similar and statistically significant. Pre-Post change scores for flossing self-efficacy scores showed significant changes for all groups. The magnitude of changes was similar when the control and educational groups were compared. In contrast, the psychological intervention group demonstrated significantly greater flossing self-efficacy changes when compared to either the control or the educational groups. These results suggest that increases in self-efficacy may be an important component of interventions designed to change health behavior and may serve a role in evaluating and comparing the efficacy of these interventions.

Autism: is there a biological cause?

1. Autism is the term used to describe certain characteristics observed in some children, including a preference for aloneness, and sameness. 2. The condition was thought for some time to be caused by a psychological disturbance resulting from a combination of stress and poor parental upbringing. 3. Recently emerging data suggests the symptoms are related to a cognitive deficit associated with a biological cause. 4. As research progresses, it is hoped it will become possible to improve the quality of life for people suffering from or looking after those with, autism.

Approximate phase conjugation with a retroreflecting array in microscopy

Some experiments on image recovery in microscopy are described. The aperture stop of a microscope objective is partially obscured, and a retroreflecting array is used as an approximate phase conjugator to return the beam through the unobstructed part of the aperture. An application is made to the measurement of the absolute reflectance of small samples by use of a variant of Strong's method.

Diagnosis and treatment of phobia

A phobia is an excessive fear or dread of a situation or object which is out of keeping with the danger it may actually present. Phobias can be classified into 'simple phobias', 'social phobias' and agoraphobia. A number of psychological theories have been put forward to account for both the onset and maintenance of a phobia. The case of a social phobia is presented together with a cognitive behavioural intervention package.

The cognitive model and treatment of depression

1. Research indicates that depression is best treated using a combination of drugs and psychological interventions. 2. The Beck psychological model of depression has led to a specific treatment formulation. 3. Beck sees the dysfunctional cognitions which arise in how person sees him- or herself, the world, the future, as contributory to the illness. 4. Research using both qualitative and quantitative analysis has shown cognitive therapy to be an effective form of treatment for depression.

Reliability of filter-strip sampling of gingival crevicular fluid for volume determination using the Periotron

This study explored gingival cervicular fluid (GCF) volumes as measured by the Periotron in an attempt to find a more objective measure of gingival inflammation that could be used in dental compliance studies. The first step in this process was to assess the reliability of the method of collecting and determining GCF volumes as described by the manufacturer. Collections of GCF from both the buccal and lingual surfaces of 6 teeth from 18 subjects with good to moderate plaque accumulation was accomplished. At a later time these same surfaces were retested for a comparison with the initial value for reliability determination. We found that only 23% of the tooth surface pairs varied by less than 20% and 57% of these pairs differed by at least 50%. These values were similar for both good and moderate plaque accumulation subjects. In these subjects, reliability measurements at individual tooth surfaces did not approach acceptable levels of reliability. However, when the GCF values from the 12 tooth surfaces were averaged for each subject, differences between the two measurements improved markedly. Sixty-one percent of these subject pairs differed by less than 20%. Therefore, the average GCF value from subjects with good to moderate plaque accumulations may be compared with reasonable accuracy.

Paralytic shellfish poison (saxitoxin family) bioassays: automated endpoint determination and standardization of the in vitro tissue culture bioassay, and comparison with the standard mouse bioassay

Mouse neuroblastoma cells swell and eventually lyse upon exposure to veratridine, which, when added together with ouabain, enhances sodium ion influx. In the presence of saxitoxin (STX), which blocks sodium channels, the action of the other two compounds is inhibited and the cells remain morphologically normal. A tissue culture bioassay using mouse neuroblastoma cells, developed by Kogure and colleagues, takes advantage of these principles; in this bioassay, the fraction of the cells protected from the actions of ouabain and veratridine is in direct proportion to the concentration of STX and its analogues. We have modified this bioassay, improving its convenience and speed by eliminating the need to count individual cells to determine the saxitoxin equivalents, and instead have employed a microplate reader for automated determinations of absorbances of crystal violet from stained neuroblastoma cells. When these changes and other minor technical modifications were tested in the tissue culture bioassay systematically, we found the lower detection limit to be around 10 ng STX equivalents (eq) per ml of extract ( = 2.0 micrograms STX eq/100 g shellfish tissue). Our version of the tissue culture bioassay was compared with the standard mouse bioassay using 10 acid extracts of dinoflagellates (Alexandrium excavata and A. fundyense) and 47 AOAC extracts of shellfish tissues. The tissue culture bioassay provided results virtually identical to those obtained with the mouse bioassay (r > 0.96), and moreover, was considerably more sensitive. The results gained from high performance liquid chromatographic (HPLC) analysis of 12 of the same extracts were less consistent when compared with the results from both bioassay methods. The automated tissue culture (neuroblastoma cell) bioassay may be a valid alternative to live animal testing for paralytic shellfish poisoning.

Pharmacist work activity before and after pharmacy department computerization

The effects of a dedicated computer system on pharmacists' daily activities at a 363-bed hospital were studied. A one-group pretest-posttest design was used. Twenty-four pharmacists recorded activity frequency and time for seven consecutive days several months before and after a pharmacy computer system was implemented. The computer system could be used for printing unit dose fill lists and i.v. labels, entering data, and printing patient profiles. An admissions, discharge, and transfer interface between the hospital system and the pharmacy system was also operational. The data were organized into 28 activities for analysis. For seven activities that were considered directly affected by computerization, a net 0.1-minute increase in the average time was found. Four of those seven showed an increase in average time (a total of 1.86 minutes): (1) calculating the composition of total parenteral nutrient or i.v. solution, (2) compounding large-volume i.v. solution, (3) profiling orders, and (4) checking the work of pharmacy technicians. The other three showed a decrease in average time (a total of 1.76 minutes): (1) preparing syringe or small-volume i.v. solution, (2) monitoring drug profiles, and (3) dispensing unit dose medications. However, with all 28 activities considered, a 1.03-minute decrease occurred in the average time per activity. Installation of a dedicated pharmacy computer decreased the amount of time pharmacists spent performing 28 activities by an average of 1.03 minutes per activity but increased the amount of time spent on activities directly affected by the computer by an average of 0.1 minute per activity.