Neuron Derived Cytokine Interleukin-34 Controls Developmental Microglia Function

Neuron-microglia interactions dictate the development of neuronal circuits in the brain. However, the factors that support and broadly regulate these processes across developmental stages are largely unknown. Here, we find that IL34, a neuron-derived cytokine, is upregulated in development and plays a critical role in supporting and maintaining neuroprotective, mature microglia in the anterior cingulate cortex (ACC) of mice. We show that IL34 mRNA and protein is upregulated in neurons in the second week of postnatal life and that this increase coincides with increases in microglia number and expression of mature, homeostatic markers, e.g., TMEM119. We also found that IL34 mRNA is higher in more active neurons, and higher in excitatory (compared to inhibitory) neurons. Genetic KO of IL34 prevents the functional maturation of microglia and results in an anxiolytic phenotype in these mice by adulthood. Acute, low dose blocking of IL34 at postnatal day (P)15 in mice decreased microglial TMEM119 expression and increased aberrant microglial phagocytosis of thalamocortical synapses within the ACC. In contrast, viral overexpression of IL34 early in life (P1-P8) caused early maturation of microglia and prevented microglial phagocytosis of thalamocortical synapses during the appropriate neurodevelopmental refinement window. Taken together, these findings establish IL34 as a key regulator of neuron-microglia crosstalk in postnatal brain development, controlling both microglial maturation and synapse engulfment.

Protective efficacy of a Zika purified inactivated virus vaccine candidate during pregnancy in marmosets

Zika virus (ZIKV) infection during pregnancy poses significant threats to maternal and fetal health, leading to intrauterine fetal demise and severe developmental malformations that constitute congenital Zika syndrome (CZS). As such, the development of a safe and effective ZIKV vaccine is a critical public health priority. However, the safety and efficacy of such a vaccine during pregnancy remain uncertain. Historically, the conduct of clinical trials in pregnant women has been challenging. Therefore, clinically relevant animal pregnancy models are in high demand for testing vaccine efficacy. We previously reported that a marmoset pregnancy model of ZIKV infection consistently demonstrated vertical transmission from mother to fetus during pregnancy. Using this marmoset model, we also showed that vertical transmission could be prevented by pre-pregnancy vaccination with Zika purified inactivated virus (ZPIV) vaccine. Here, we further examined the efficacy of ZPIV vaccination during pregnancy. Vaccination during pregnancy elicited virus neutralizing antibody responses that were comparable to those elicited by pre-pregnancy vaccination. Vaccination also reduced placental pathology, viral burden and vertical transmission of ZIKV during pregnancy, without causing adverse effects. These results provide key insights into the safety and efficacy of ZPIV vaccination during pregnancy and demonstrate positive effects of vaccination on the reduction of ZIKV infection, an important advance in preparedness for future ZIKV outbreaks.

Zika purified inactivated virus (ZPIV) vaccine reduced vertical transmission in pregnant immunocompetent mice

Zika virus (ZIKV) is a significant threat to pregnant women and their fetuses as it can cause severe birth defects and congenital neurodevelopmental disorders, referred to as congenital Zika syndrome (CZS). Thus, a safe and effective ZIKV vaccine for pregnant women to prevent in utero ZIKV infection is of utmost importance. Murine models of ZIKV infection are limited by the fact that immunocompetent mice are resistant to ZIKV infection. As such, interferon-deficient mice have been used in some preclinical studies to test the efficacy of ZIKV vaccine candidates against lethal virus challenge. However, interferon-deficient mouse models have limitations in assessing the immunogenicity of vaccines, necessitating the use of immunocompetent mouse pregnancy models. Using the human stat2 knock-in (hSTAT2KI) mouse pregnancy model, we show that vaccination with a purified formalin-inactivated Zika virus (ZPIV) vaccine prior to pregnancy successfully prevented vertical transmission. In addition, maternal immunity protected offspring against postnatal challenge for up to 28 days. Furthermore, passive transfer of human IgG purified from hyper-immune sera of ZPIV vaccinees prevented maternal and fetal ZIKV infection, providing strong evidence that the neutralizing antibody response may serve as a meaningful correlate of protection.

Impact of prior dengue virus infection on Zika virus infection during pregnancy in marmosets

Zika virus (ZIKV) infection during pregnancy causes severe developmental defects in newborns, termed congenital Zika syndrome (CZS). Factors contributing to a surge in ZIKV-associated CZS are poorly understood. One possibility is that ZIKV may exploit the antibody-dependent enhancement of infection mechanism, mediated by cross-reactive antibodies from prior dengue virus (DENV) infection, which may exacerbate ZIKV infection during pregnancy. In this study, we investigated the impact of prior DENV infection or no DENV infection on ZIKV pathogenesis during pregnancy in a total of four female common marmosets with five or six fetuses per group. The results showed that negative-sense viral RNA copies increased in the placental and fetal tissues of DENV-immune dams but not in DENV-naïve dams. In addition, viral proteins were prevalent in endothelial cells, macrophages, and neonatal Fc receptor-expressing cells in the placental trabeculae and in neuronal cells in the brains of fetuses from DENV-immune dams. DENV-immune marmosets maintained high titers of cross-reactive ZIKV-binding antibodies that were poorly neutralizing, raising the possibility that these antibodies might be involved in the exacerbation of ZIKV infection. These findings need to be verified in a larger study, and the mechanism involved in the exacerbation of ZIKV infection in DENV-immune marmosets needs further investigation. However, the results suggest a potential negative impact of preexisting DENV immunity on subsequent ZIKV infection during pregnancy in vivo.

Microbial modulation via cross-fostering prevents the effects of pervasive environmental stressors on microglia and social behavior, but not the dopamine system

Environmental toxicant exposure, including air pollution, is increasing worldwide. However, toxicant exposures are not equitably distributed. Rather, low-income and minority communities bear the greatest burden, along with higher levels of psychosocial stress. Both air pollution and maternal stress during pregnancy have been linked to neurodevelopmental disorders such as autism, but biological mechanisms and targets for therapeutic intervention remain poorly understood. We demonstrate that combined prenatal exposure to air pollution (diesel exhaust particles, DEP) and maternal stress (MS) in mice induces social behavior deficits only in male offspring, in line with the male bias in autism. These behavioral deficits are accompanied by changes in microglial morphology and gene expression as well as decreased dopamine receptor expression and dopaminergic fiber input in the nucleus accumbens (NAc). Importantly, the gut-brain axis has been implicated in ASD, and both microglia and the dopamine system are sensitive to the composition of the gut microbiome. In line with this, we find that the composition of the gut microbiome and the structure of the intestinal epithelium are significantly shifted in DEP/MS-exposed males. Excitingly, both the DEP/MS-induced social deficits and microglial alterations in males are prevented by shifting the gut microbiome at birth via a cross-fostering procedure. However, while social deficits in DEP/MS males can be reversed by chemogenetic activation of dopamine neurons in the ventral tegmental area, modulation of the gut microbiome does not impact dopamine endpoints. These findings demonstrate male-specific changes in the gut-brain axis following DEP/MS and suggest that the gut microbiome is an important modulator of both social behavior and microglia.

Prenatal opioid exposure inhibits microglial sculpting of the dopamine system selectively in adolescent male offspring

The current opioid epidemic has dramatically increased the number of children who are prenatally exposed to opioids, including oxycodone. A number of social and cognitive abnormalities have been documented in these children as they reach young adulthood. However, little is known about the mechanisms underlying developmental effects of prenatal opioid exposure. Microglia, the resident immune cells of the brain, respond to acute opioid exposure in adulthood. Moreover, microglia are known to sculpt neural circuits during typical development. Indeed, we recently found that microglial phagocytosis of dopamine D1 receptors (D1R) in the nucleus accumbens (NAc) is required for the natural developmental decline in NAc-D1R that occurs between adolescence and adulthood in rats. This microglial pruning occurs only in males, and is required for the normal developmental trajectory of social play behavior. However, virtually nothing is known as to whether this developmental program is altered by prenatal exposure to opioids. Here, we show in rats that maternal oxycodone self-administration during pregnancy leads to reduced adolescent microglial phagocytosis of D1R and subsequently higher D1R density within the NAc in adult male, but not female, offspring. Finally, we show prenatal and adult behavioral deficits in opioid-exposed offspring, including impaired extinction of oxycodone-conditioned place preference in males. This work demonstrates for the first time that microglia play a key role in translating prenatal opioid exposure to changes in neural systems and behavior.

Tissue Flow Induces Cell Shape Changes During Organogenesis

In embryonic development, cell shape changes are essential for building functional organs, but in many cases, the mechanisms that precisely regulate these changes remain unknown. We propose that fluid-like drag forces generated by the motion of an organ through surrounding tissue could generate changes to its structure that are important for its function. To test this hypothesis, we study the zebrafish left-right organizer, Kupffer's vesicle (KV), using experiments and mathematical modeling. During development, monociliated cells that comprise KV undergo region-specific shape changes along the anterior-posterior axis that are critical for KV function: anterior cells become long and thin, whereas posterior cells become short and squat. Here, we develop a mathematical vertex-like model for cell shapes that incorporates both tissue rheology and cell motility and constrain the model parameters using previously published rheological data for the zebrafish tailbud as well as our own measurements of the KV speed. We find that drag forces due to dynamics of cells surrounding KV could be sufficient or work in concert with previously identified mechanisms to drive KV cell shape changes during KV development. More broadly, these results suggest that cell shape changes during embryonic development and beyond could be driven by dynamic forces not typically considered in models or experiments.

Vertebrate myosin 1d regulates left-right organizer morphogenesis and laterality

Establishing left-right asymmetry is a fundamental process essential for arrangement of visceral organs during development. In vertebrates, motile cilia-driven fluid flow in the left-right organizer (LRO) is essential for initiating symmetry breaking event. Here, we report that myosin 1d (myo1d) is essential for establishing left-right asymmetry in zebrafish. Using super-resolution microscopy, we show that the zebrafish LRO, Kupffer's vesicle (KV), fails to form a spherical lumen and establish proper unidirectional flow in the absence of myo1d. This process requires directed vacuolar trafficking in KV epithelial cells. Interestingly, the vacuole transporting function of zebrafish Myo1d can be substituted by myosin1C derived from an ancient eukaryote, Acanthamoeba castellanii, where it regulates the transport of contractile vacuoles. Our findings reveal an evolutionary conserved role for an unconventional myosin in vacuole trafficking, lumen formation, and determining laterality.

Cell volume changes contribute to epithelial morphogenesis in zebrafish Kupffer's vesicle

How epithelial cell behaviors are coordinately regulated to sculpt tissue architecture is a fundamental question in biology. Kupffer’s vesicle (KV), a transient organ with a fluid-filled lumen, provides a simple system to investigate the interplay between intrinsic cellular mechanisms and external forces during epithelial morphogenesis. Using 3-dimensional (3D) analyses of single cells we identify asymmetric cell volume changes along the anteroposterior axis of KV that coincide with asymmetric cell shape changes. Blocking ion flux prevents these cell volume changes and cell shape changes. Vertex simulations suggest cell shape changes do not depend on lumen expansion. Consistent with this prediction, asymmetric changes in KV cell volume and shape occur normally when KV lumen growth fails due to leaky cell adhesions. These results indicate ion flux mediates cell volume changes that contribute to asymmetric cell shape changes in KV, and that these changes in epithelial morphology are separable from lumen-generated forces.

Development, implementation, and effects of an integrated web-based teaching model in a nursing ethics course

BACKGROUND

Ethical competence, which is reflected in the ability to detect ethical challenges in clinical situations and engage in deliberate thinking on ethical actions, is one of the core competencies of nursing practice.

PURPOSE

The purpose of this study was to develop and implement an interactive situational e-learning system, integrating nursing ethical decisions into a nursing ethics course, and to evaluate the effects of this course on student nurses' ethical decision-making competence.

PROJECT DESIGN

The project was designed to be carried out in two phases. In the first phase, an interactive situated e-learning system was developed and integrated into the nursing ethics course. The second phase involved implementing the course and evaluating its effects in a quasi-experimental study. The course intervention was designed for 2h per week over one semester (18weeks).

PARTICIPANTS

A total of 100 two-year technical college nursing students in their second year of the program participated in the study, with 51 in the experimental group and 49 in the control group.

RESULTS

After completing the course, the students in the experimental group showed significant improvement in nursing ethical decision-making competence, including skills in "raising questions," "recognizing differences," "comparing differences," "self-dialogue," "taking action," and "identifying the implications of decisions made," compared to their performance prior to the class. After controlling for factors influencing learning effects, students in the experimental group showed superiority to those in the control group in the competency of "recognizing differences." The students in the experimental group reported that the course pushed them to search for and collect information needed to resolve the ethical dilemma.

CONCLUSIONS

The interactive situational e-learning system developed by our project was helpful in developing the students' competence in ethical reasoning. The e-learning system and the situational teaching materials used in this study may be applicable in nursing and related professional ethics courses.

Effects of injectable trace minerals on humoral and cell-mediated immune responses to Bovine viral diarrhea virus, Bovine herpes virus 1 and Bovine respiratory syncytial virus following administration of a modified-live virus vaccine in dairy calves

Our objective was to evaluate the effect of an injectable trace mineral (ITM) supplement containing zinc, manganese, selenium, and copper on the humoral and cell mediated immune (CMI) responses to vaccine antigens in dairy calves receiving a modified-live viral (MLV) vaccine containing BVDV, BHV1, PI3V and BRSV. A total of 30 dairy calves (3.5 months of age) were administered a priming dose of the MLV vaccine containing BHV1, BVDV1 & 2, BRSV, PI3V, and an attenuated-live Mannheimia-Pasteurella bacterin subcutaneously (SQ). Calves were randomly assigned to 1 of 2 groups: (1) administration of ITM SQ (ITM, n=15) or (2) injection of sterile saline SQ (Control; n=15). Three weeks later, calves received a booster of the same vaccine combination SQ, and a second administration of ITM, or sterile saline, according to the treatment group. Blood samples were collected on days 0, 7, 14, 21, 28, 42, 56, and 90 post-vaccination for determination of antibody titer, viral recall antigen-induced IFN-γ production, and viral antigen-induced proliferation by peripheral blood mononuclear cells (PBMC). Administration of ITM concurrently with MLV vaccination resulted in higher antibody titers to BVDV1 on day 28 after priming vaccination compared to the control group (P=0.03). Calves treated with ITM showed an earlier enhancement in PBMC proliferation to BVDV1 following vaccination compared to the control group. Proliferation of PBMC after BVDV stimulation tended to be higher on day 14 after priming vaccination in calves treated with ITM than in the control group (P=0.08). Calves that received ITM showed higher PBMC proliferation to BRSV stimulation on day 7 after priming vaccination compared to the control group (P=0.01). Moreover, calves in the ITM group also had an enhanced production IFN-γ by PBMC after stimulation with BRSV on day 21 after priming vaccination compared to day 0 (P<0.01). In conclusion, administration of ITM concurrently with MLV vaccination in dairy calves resulted in increased antibody titer to BVDV1, and greater PBMC proliferation to BVDV1 and BRSV recall stimulation compared to the control group, suggesting that ITM might represent a promising tool to enhance the humoral and CMI responses to MLV vaccines in cattle.

Characterization of the Medial Surface of the Vocal Folds

A method is developed for the quantification of the medial surface of the vocal folds in excised larynges. Lead molds were constructed from the glottal airway of a canine larynx for 3 distinct glottal configurations corresponding to “pressed” folds, just barely adducted folds, and 1-mm-abducted folds as measured between the vocal processes. With a high-resolution laser striping system, the 3-dimensional molds were digitally scanned. Low-order polynomials were fitted to the data, and goodness-of-fit statistics were reported. For all glottal configurations, a linear variation (flat surface) approximated the data with a coefficient of determination of 90%. This coefficient increased to roughly 95% when a quadratic variation (curvature) was included along the vertical dimension. If more than the top 5 mm or so of the folds was included (the portion usually corresponding to vibration), a cubic variation along the vertical dimension was necessary to explain a change in concavity at the conus elasticus. These findings suggest the utility of a model based on a convergence coefficient and a bulging coefficient. For all glottal configurations, the convergence coefficients and bulging coefficients can be computed. Because pre-phonatory conditions have a profound influence on vocal fold vibration and on the quality of phonation, such shaping parameters are highly significant. With the viability of this method substantiated, it is envisioned that future studies will characterize greater quantities of glottal shapes, including those of human vocal folds.

Exome sequencing in 32 patients with anophthalmia/microphthalmia and developmental eye defects

Anophthalmia/microphthalmia (A/M) is a genetically heterogeneous birth defect for which the etiology is unknown in more than 50% of patients. We used exome sequencing with the ACE Exome(TM) (Personalis, Inc; 18 cases) and UCSF Genomics Core (21 cases) to sequence 28 patients with A/M and four patients with varied developmental eye defects. In the 28 patients with A/M, we identified de novo mutations in three patients (OTX2, p.(Gln91His), RARB, p.Arg387Cys and GDF6, p.Ala249Glu) and inherited mutations in STRA6 in two patients. In patients with developmental eye defects, a female with cataracts and cardiomyopathy had a de novo COL4A1 mutation, p.(Gly773Arg), expanding the phenotype associated with COL4A1 to include cardiomyopathy. A male with a chorioretinal defect, microcephaly, seizures and sensorineural deafness had two PNPT1 mutations, p.(Ala507Ser) and c.401-1G>A, and we describe eye defects associated with this gene for the first time. Exome sequencing was efficient for identifying mutations in pathogenic genes for which there is no clinical testing available and for identifying cases that expand phenotypic spectra, such as the PNPT1 and COL4A1-associated disorders described here.

Pyrrolo- and pyridomorphinans: non-selective opioid antagonists and delta opioid agonists/mu opioid partial agonists

Opioid ligands have found use in a number of therapeutic areas, including for the treatment of pain and opiate addiction (using agonists) and alcohol addiction (using antagonists such as naltrexone and nalmefene). The reaction of imines, derived from the opioid ligands oxymorphone and naltrexone, with Michael acceptors leads to pyridomorphinans with structures similar to known pyrrolo- and indolomorphinans. One of the synthesized compounds, 5e, derived from oxymorphone had substantial agonist activity at delta opioid receptors but not at mu and/or kappa opioid receptors and in that sense profiled as a selective delta opioid receptor agonist. The pyridomorphinans derived from naltrexone and naloxone were all found to be non-selective potent antagonists and as such could have utility as treatments for alcohol abuse.

Brain structure and function in patients after metal-on-metal hip resurfacing

BACKGROUND AND PURPOSE

Hip prostheses that use a metal-on-metal articulation expose the brain to elevated metal concentrations that, in acute excess due to prosthesis malfunction, is associated with neurologic damage, including visual and hearing loss and motor deficits. Here, we examined whether chronic exposure to lower elevated metal levels, typical of well-functioning prostheses, also affects brain structure and function.

MATERIALS AND METHODS

We compared brain volumes, metal deposition, and gray matter attenuation by MR imaging and clinical neurologic function in patients 8 years after receiving a metal-on-metal hip resurfacing versus a matched group of patients with the same duration exposure to a conventional hip prosthesis.

RESULTS

Twenty-nine patients (25 men; mean, age 59±7 years) after metal-on-metal hip resurfacing and 29 patients (25 men; 59±8 years) after total hip arthroplasty were compared. Whole blood cobalt and chromium concentrations were 5-10 times higher in the metal-on-metal hip resurfacing group (P<.0001). Occipital cortex gray matter attenuation tended to be lower (P<.005 uncorrected, P>.05 corrected), and the optic chiasm area tended to be lower (mean difference, -2.7 mm2; P=.076) in the metal-on-metal hip resurfacing group. Subgroup analyses in 34 patients (17 per group), after exclusion of primary ocular pathology, showed the same trend in gray matter attenuation in the occipital cortex and basal ganglia and a smaller optic chiasm in the metal-on-metal hip resurfacing group (mean difference, -3.9 mm2; P=.048). No other structural or functional differences were found between the groups.

CONCLUSIONS

Chronic exposure to metal-on-metal hip resurfacing is associated with subtle structural change in the visual pathways and the basal ganglia in asymptomatic patients.

Infrequent recovery of HIV from but robust exogenous infection of activated CD4(+) T cells in HIV elite controllers

BACKGROUND. Human immunodeficiency virus (HIV) elite controllers are able to control infection with HIV-1 spontaneously to undetectable levels in the absence of antiretroviral therapy, but the mechanisms leading to this phenotype are poorly understood. Although low frequencies of HIV-infected peripheral CD4(+) T cells have been reported in this group, it remains unclear to what extent these are due to viral attenuation, active immune containment, or intracellular host factors that restrict virus replication. METHODS. We assessed proviral DNA levels, autologous viral growth from and infectability of in vitro activated, CD8(+) T cell-depleted CD4(+) T cells from HIV elite controllers (mean viral load, <50 copies/mL), viremic controllers (mean viral load, <2000 copies/mL), chronic progressors, and individuals receiving highly active antiretroviral therapy. RESULTS. Although we successfully detected autologous virus production in ex vivo activated CD4(+) T cells from all chronic progressors and from most of the viremic controllers, we were able to measure robust autologous viral replication in only 2 of 14 elite controllers subjected to the same protocol. In vitro activated autologous CD4(+) T cells from elite controllers, however, supported infection with both X4 and R5 tropic HIV strains at comparable levels to those in CD4(+) T cells from HIV-uninfected subjects. Proviral DNA levels were the lowest in elite controllers, suggesting that extremely low frequencies of infected cells contribute to difficulty in isolation of virus. CONCLUSIONS. These data indicate that elite control is not due to inability of activated CD4(+) T cells to support HIV infection, but the relative contributions of host and viral factors that account for maintenance of low-level infection remain to be determined.

Endogenous regulators of G protein signaling differentially modulate full and partial mu-opioid agonists at adenylyl cyclase as predicted by a collision coupling model

Regulator of G protein signaling (RGS) proteins accelerate the endogenous GTPase activity of Galpha(i/o) proteins to increase the rate of deactivation of active Galpha-GTP and Gbetagamma signaling molecules. Previous studies have suggested that RGS proteins are more effective on less efficiently coupled systems such as with partial agonist responses. To determine the role of endogenous RGS proteins in functional responses to mu-opioid agonists of different intrinsic efficacy, Galpha(i/o) subunits with a mutation at the pertussis toxin (PTX)-sensitive cysteine (C351I) and with or without a mutation at the RGS binding site (G184S) were stably expressed in C6 glioma cells expressing a mu-opioid receptor. Cells were treated overnight with PTX to inactivate endogenous G proteins. Maximal inhibition of forskolin-stimulated adenylyl cyclase by the low-efficacy partial agonists buprenorphine and nalbuphine was increased in cells expressing RGS-insensitive Galpha(o)(CIGS), Galpha(i2)(CIGS), or Galpha(i3)(CIGS) compared with their Galpha(CI) counterparts, but the RGS-insensitive mutation had little or no effect on the maximal inhibition by the higher efficacy agonists DAMGO and morphine. The potency of all the agonists to inhibit forskolin-stimulated adenylyl cyclase was increased in cells expressing RGS-insensitive Galpha(o)(CIGS), Galpha(i2)(CIGS), or Galpha(i3)(CIGS), regardless of efficacy. These data are comparable with predictions based on a collision coupling model. In this model, the rate of G protein inactivation, which is modulated by RGS proteins, and the rate of G protein activation, which is affected by agonist intrinsic efficacy, determine the maximal agonist response and potency at adenylyl cyclase under steady state conditions.

Studies of micro-, kappa-, and delta-opioid receptor density and G protein activation in the cortex and thalamus of monkeys

The aim of this study was to investigate the relative density of micro -, kappa-, and delta-opioid receptors (MOR, KOR, and DOR) and guanosine 5'-O-(3-[35S]thio)triphosphate ([35S]GTPgammaS) binding stimulated by full agonists in cortical and thalamic membranes of monkeys. The binding parameters [Bmax (femtomoles per milligram)/Kd (nanomolar)] were as follows: [3H][d-Ala2,N-Me-Phe4,Gly5-ol]-enkephalin (DAMGO) (MOR; 80/0.7), [3H]U69593 [(5alpha,7alpha,8beta)-(-)-N-methyl-N-(7-(1-pyrrolidinyl)-1-oxaspiro(4,5)dec-8-yl) benzeneacetamide] (KOR; 116/1.3), and [3H][d-Pen2,d-Pen5]-enkephalin (DPDPE) (DOR; 87/1.3) in the cortex; [3H]DAMGO (147/0.9), [3H]U69593 (75/2.5), and [3H]DPDPE (22/2.0) in the thalamus. The relative proportions of MOR, KOR, and DOR in the cortex were 28, 41, and 31% and in the thalamus were 60, 31, and 9%. Full selective opioid agonists, DAMGO (EC50 = 532-565 nM) and U69593 (EC50 = 80-109 nM) stimulated [35S]GTPgammaS binding in membranes of cortex and thalamus, whereas SNC80 [(+)-4-[(alphaR)-alpha-((2S,5R)-4-allyl-2,5-dimethyl-1-piperazinyl)-3-methoxybenzyl]-N,N-diethyl-benzamide] (DOR; EC50 = 68 nM) was only active in cortical membranes. The magnitudes of [35S]GTPgammaS binding stimulated by these agonists were similar in the cortex, ranging from 17 to 25% over basal binding. In the thalamus, DAMGO and U69593 increased [35S]GTPgammaS binding by 44 and 23% over basal, respectively. Opioid agonist-stimulated [35S]GTPgammaS binding was blocked selectively by antagonists for MOR, KOR, and DOR. The amount of G protein activated by agonists was highly proportional to the relative receptor densities in both regions. These results distinguish the ability of opioid agonists to activate G proteins and provide a functional correlate of ligand-binding experiments in the monkey brain. In particular, the relative densities of opioid receptor binding sites in the two brain areas reflect their functional roles in the pharmacological actions of opioids in the central nervous system of primates.

Gene expression and localization of GABA(C) receptors in neurons of the rat gastrointestinal tract

The effects of GABA in the CNS are mediated by three different GABA receptors: GABA(A), GABA(B) and GABA(C) receptors. GABA(A) and GABA(B) receptors, but not yet GABA(C) receptors, have been demonstrated in the enteric nervous system, where GABA has been proposed to be a transmitter. The purpose of this study was to determine whether GABA(C) receptors are present and thus may play a role in mediating the effects of GABA in the myenteric plexus of the rat gastrointestinal tract. We examined the expression of the three known GABA(C) receptor subunits, rho1, rho2 and rho3, in the rat duodenum, ileum and colon using the reverse transcriptase-polymerase chain reaction. We determined the localization of GABA(C) receptors in the myenteric plexus of these regions using two different antisera directed against GABA(C) receptor subunits. The polymerase chain reaction revealed that all three subunits were expressed in the gastrointestinal tract. When the layers of the intestine were separated and the layer containing myenteric neurons was assayed, the rho3 subunit was found in the ileum and colon, whereas rho1 was expressed in the duodenum and weakly in the colon and rho2 was expressed in the ileum. Immunocytochemistry revealed numerous labeled neurons in the myenteric plexus of each region. Colocalization showed that a large proportion of calbindin plus calretinin immunoreactive neurons (intrinsic primary afferent neurons) were immunoreactive for the GABA(C) receptor, and that 56% of nitric oxide synthase immunoreactive neurons (inhibitory motor neurons) exhibited the receptor. These results indicate that GABA(C) receptors of differing subunit compositions are expressed by neurons in the rat gastrointestinal tract. The effects of GABA on intrinsic sensory and on inhibitory motor neurons are likely to be mediated in part through GABA(C) receptors.

Mu and Delta opioid receptors activate the same G proteins in human neuroblastoma SH-SY5Y cells

1. There is evidence for interactions between mu and delta opioid systems both in vitro and in vivo. This work examines the hypothesis that interaction between these two receptors can occur intracellularly at the level of G protein in human neuroblastoma SH-SY5Y cells. 2. The [(35)S]GTP gamma S binding assay was used to measure G protein activation following agonist occupation of opioid receptors. The agonists DAMGO (EC(50), 45 nM) and SNC80 (EC(50), 32 nM) were found to be completely selective for stimulation of [(35)S]-GTP gamma S binding through mu and delta opioid receptors respectively. Maximal stimulation of [(35)S]-GTP gamma S binding produced by SNC80 was 57% of that seen with DAMGO. When combined with a maximally effective concentration of DAMGO, SNC80 caused no additional [(35)S]-GTP gamma S binding. This effect was also seen when measured at the level of adenylyl cyclase. 3. Receptor activation increased the dissociation of pre-bound [(35)S]-GTP gamma S. In addition, the delta agonist SNC80 promoted the dissociation of [(35)S]-GTP gamma S from G proteins initially labelled using the mu agonist DAMGO. Conversely, DAMGO promoted the dissociation of [(35)S]-GTP gamma S from G proteins initially labelled using SNC80. 4. Tolerance to DAMGO and SNC80 in membranes from cells exposed to agonist for 18 h was homologous and there was no evidence for alteration in G protein activity. 5. The findings support the hypothesis that mu- and delta-opioid receptors share a common G protein pool, possibly through a close organization of the two receptors and G protein at the plasma membrane.

Locations and innervation of cell bodies of sympathetic neurons projecting to the gastrointestinal tract in the rat

The locations of cell bodies of sympathetic neurons projecting to the stomach, the duodenum, the ileum, the colon, the spleen and the pancreas have been studied using retrograde tracing. Projections arose from both pre- and paravertebral ganglia. In the rat, the prevertebral ganglia are the paired coeliac ganglia lying caudo-lateral to the root of the coeliac artery, paired splanchnic ganglia in the abdominal segments of the greater splanchnic nerves, unpaired superior mesenteric and inter-renal ganglia and the inferior mesenteric ganglia. The projections from the prevertebral sympathetic ganglia to the different parts of the gut were organised somatotopically. The most rostral ganglia (splanchnic, coeliac, and superior mesenteric ganglia) contained neurons innervating all regions of the gastrointestinal tract, the pancreas and the spleen. The inter-renal and inferior mesenteric ganglia, located more caudally, contained neurons innervating the distal part of the gut (distal ileum and colon). The innervation of the spleen and the pancreas came from the closest ganglia (sympathetic chains, splanchnic and coeliac ganglia). This organotopic organisation was not found in the sympathetic chain ganglia; the innervation of all organs came predominantly from the lower part of the thoracic chains. A large proportion of the retrogradely labelled nerve cells in the splanchnic ganglia received nitric oxide synthase immunoreactive innervation probably from the spinal cord. In the other prevertebral ganglia, most of the neurons received nitric oxide synthase immunoreactive innervation and/or bombesin immunoreactive innervation. This leads to the conclusion that, in these ganglia, many neurons receive projections from the gastrointestinal tract in addition to the spinal cord.

Calbindin immunoreactivity of enteric neurons in the guinea-pig ileum

Previous studies have identified Dogiel type II neurons with cell bodies in the myenteric plexus of guinea-pig ileum to be intrinsic primary afferent neurons. These neurons also have distinctive electrophysiological characteristics (they are AH neurons) and 82-84% are immunoreactive for calbindin. They are the only calbindin-immunoreactive neurons in the plexus. Neurons with analogous shape and electrophysiology are found in submucosal ganglia, but, with antibodies used in previous studies, they lack calbindin immunoreactivity. An antiserum that is more effective in revealing calbindin in the guinea-pig enteric nervous system has been reported recently. In the present work, we found that this antiserum reveals the same population that was previously identified in myenteric ganglia, and does not reveal any further population of myenteric nerve cells. In submucosal ganglia, 9-10% of nerve cells were calbindin immunoreactive with this antiserum. The submucosal neurons with calbindin immunoreactivity were also immunoreactive for choline acetyltransferase, but not for neuropeptide Y (NPY) or vasoactive intestinal peptide (VIP). Small calbindin-immunoreactive neurons (average profile 130 microm2) were calretinin immunoreactive, whereas the large calbindin-immunoreactive neurons (average profile 330 microm2) had tachykinin (substance P) immunoreactivity. Calbindin immunoreactivity was seen in about 50% of the calretinin neurons and 40% of the tachykinin-immunoreactive submucosal neurons. It is concluded that, in the guinea-pig ileum, only one class of myenteric neuron, the AH/Dogiel type II neuron, is calbindin immunoreactive, but, in the submucosal ganglia, calbindin immunoreactivity occurs in cholinergic, calretinin-immunoreactive, secretomotor/vasodilator neurons and AH/Dogiel type II neurons.

Using force analysis to target collection and analysis of environmental information

Knowledge of the forces driving and modifying ecosystems can be employed in concert with signal analysis to target the data most likely to yield sensitivity and resilience information. One can optimize return of information per investment of resources by targeting segments of signals that are dominated by the force of interest, coupled with scientific understanding of the system of interest. This force analysis approach is an effective means both to design efficient new monitoring programs and to target relevant information in large data files. We present five example applications of force analysis. Three examples illustrate this approach for an evaluation of whether Canadian rivers might be sensitive to changes in climate. It was concluded that Canadian rivers appear to be sensitive to changing climate. A fourth example illustrates how automated snow pillow data may be evaluated to ascertain the sensitivity of snow accumulation to change in climate. It was concluded that snow accumulation at the site evaluated did appear to be sensitive to changing climate. The fifth example illustrates the assessment of whether a river recovers with the elimination of inputs of iron from an abandoned mine. It was concluded that resilience remained unproven since the river had not as yet restabilized. The force analysis approach focuses data collection or data evaluation on those data required to answer specific resource management questions, greatly reducing collection or consideration of data that are not relevant to that question. This approach is potentially very cost-efficient and therefore is likely to be of interest to hydrologists, climatologists, and environmental data managers.

Guiding contact by coupling the taus of gaps

Animals control contact with surfaces when locomoting, catching prey, etc. This requires sensorily guiding the rate of closure of gaps between effectors such as the hands, feet or jaws and destinations such as a ball, the ground and a prey. Control is generally rapid, reliable and robust, even with small nervous systems: the sensorimotor processes are therefore probably rather simple. We tested a hypothesis, based on general tau theory, that closing two gaps simultaneously, as required in many actions, might be achieved simply by keeping the taus of the gaps coupled in constant ratio. tau of a changing gap is defined as the time-to-closure of the gap at the current closure-rate. General tau theory shows that tau of a gap could, in principle, be directly sensed without needing to sense either the gap size or its rate of closure. In our experiment, subjects moved an effector (computer cursor) to a destination zone indicated on the computer monitor, to stop in the zone just as a moving target cursor reached it. The results indicated the subjects achieved the task by keeping tau of the gap between effector and target coupled to tau of the gap between the effector and the destination zone. Evidence of tau-coupling has also been found, for example, in bats guiding landing using echolocation. Thus, it appears that a sensorimotor process used by different species for coordinating the closure of two or more gaps between effectors and destinations entails constantly sensing the taus of the gaps and moving so as to keep the taus coupled in constant ratio.

Effects of consonant environment on vowel formant patterns

A significant body of evidence has accumulated indicating that vowel identification is influenced by spectral change patterns. For example, a large-scale study of vowel formant patterns showed substantial improvements in category separability when a pattern classifier was trained on multiple samples of the formant pattern rather than a single sample at steady state [J. Hillenbrand et al., J. Acoust. Soc. Am. 97, 3099-3111 (1995)]. However, in the earlier study all utterances were recorded in a constant /hVd/ environment. The main purpose of the present study was to determine whether a close relationship between vowel identity and spectral change patterns is maintained when the consonant environment is allowed to vary. Recordings were made of six men and six women producing eight vowels (see text) in isolation and in CVC syllables. The CVC utterances consisted of all combinations of seven initial consonants (/h,b,d,g,p,t,k/) and six final consonants (/b,d,g,p,t,k/). Formant frequencies for F1-F3 were measured every 5 ms during the vowel using an interactive editing tool. Results showed highly significant effects of phonetic environment. As with an earlier study of this type, particularly large shifts in formant patterns were seen for rounded vowels in alveolar environments [K. Stevens and A. House, J. Speech Hear. Res. 6, 111-128 (1963)]. Despite these context effects, substantial improvements in category separability were observed when a pattern classifier incorporated spectral change information. Modeling work showed that many aspects of listener behavior could be accounted for by a fairly simple pattern classifier incorporating F0, duration, and two discrete samples of the formant pattern.

Some effects of duration on vowel recognition

This study was designed to examine the role of duration in vowel perception by testing listeners on the identification of CVC syllables generated at different durations. Test signals consisted of synthesized versions of 300 utterances selected from a large, multitalker database of /hVd/ syllables [Hillenbrand et al., J. Acoust. Soc. Am. 97, 3099-3111 (1995)]. Four versions of each utterance were synthesized: (1) an original duration set (vowel duration matched to the original utterance), (2) a neutral duration set (duration fixed at 272 ms, the grand mean across all vowels), (3) a short duration set (duration fixed at 144 ms, two standard deviations below the mean), and (4) a long duration set (duration fixed at 400 ms, two standard deviations above the mean). Experiment 1 used a formant synthesizer, while a second experiment was an exact replication using a sinusoidal synthesis method that represented the original vowel spectrum more precisely than the formant synthesizer. Findings included (1) duration had a small overall effect on vowel identity since the great majority of signals were identified correctly at their original durations and at all three altered durations; (2) despite the relatively small average effect of duration, some vowels, especially [see text] and [see text], were significantly affected by duration; (3) some vowel contrasts that differ systematically in duration, such as [see text], and [see text], were minimally affected by duration; (4) a simple pattern recognition model appears to be capable of accounting for several features of the listening test results, especially the greater influence of duration on some vowels than others; and (5) because a formant synthesizer does an imperfect job of representing the fine details of the original vowel spectrum, results using the formant-synthesized signals led to a slight overestimate of the role of duration in vowel recognition, especially for the shortened vowels.

The effects of community health nurse monitoring on hypertension identification and control

Identification and control of hypertension are important public health concerns. Lack of regular health care makes diagnosis and control difficult in some populations. Community health nursing services in settings where clients regularly congregate promote identification and control of hypertension. This study focused on the effects of community health nursing screening and monitoring services for hypertension provided to participants in a breadline, a senior nutrition program, an English as Second Language (ESL) class, and employees providing these services. Community health nurses (CHNs) provided 2,407 blood pressure-related service encounters. Blood pressures were elevated in 19% of encounters, and 10% of clients had elevations that warranted referral for medical assistance. At the end of the 18-month study period, 67% of all clients with elevations and 71% of those referred for medical assistance had achieved normal blood pressures. One-way analysis of variance indicated a significant relationship between the number of encounters with the nurses and a positive outcome for all clients with elevations. This relationship was not supported for those clients referred to medical assistance. The effectiveness of intervention appeared to vary somewhat among subgroups with some groups more likely than others to achieve a positive outcome. Group differences in outcome were not statistically significant.

Diabetes guidelines: a summary and comparison of the recommendations of the American Diabetes Association, Veterans Health Administration, and American Association of Clinical Endocrinologists

OBJECTIVE

This paper summarizes and compares 3 major organizations' guidelines for the management of diabetes mellitus.

BACKGROUND

Diabetes mellitus is a chronic disease that affects >16 million Americans. A decrease in adverse events has been demonstrated when hyperglycemia and comorbid conditions such as hypertension and dyslipidemia are controlled in patients with diabetes. Although each patient with diabetes is unique and medical care should be tailored to his or her individual needs, clinical evidence and expert opinion have established a baseline level of care for all patients with diabetes. Guidelines have been created to guide practitioners in selecting appropriate care, but their length and complexity may serve as barriers to their use.

METHODS

The diabetes management guidelines of the American Diabetes Association (ADA), Veterans Health Administration (VA), and American Association of Clinical Endocrinologists (AACE) are summarized and compared in both text and tabular form.

CONCLUSION

Although the guidelines published by the ADA, VA, and AACE vary slightly, all of them can be used to ensure that patients with diabetes receive appropriate care.

Activation of G protein by opioid receptors: role of receptor number and G-protein concentration

The collision-coupling model for receptor-G-protein interaction predicts that the rate of G-protein activation is dependent on receptor density, but not G-protein levels. C6 cells expressing mu- or delta-opioid receptors, or SH-SY5Y cells, were treated with beta-funaltrexamine (mu) or naltrindole-5'-isothiocyanate (delta) to decrease receptor number. The time course of full or partial agonist-stimulated ¿35SGTPgammaS binding did not vary in C6 cell membranes containing <1-25 pmol/mg mu-opioid receptor, or 1. 4-4.3 pmol/mg delta-opioid receptor, or in SHSY5Y cells containing 0. 16-0.39 pmol/mg receptor. The association of ¿35SGTPgammaS binding was faster in membranes from C6mu cells than from C6delta cells. A 10-fold reduction in functional G-protein, following pertussis toxin treatment, lowered the maximal level of ¿35SGTPgammaS binding but not the association rate. These data indicate a compartmentalization of opioid receptors and G protein at the cell membrane.

Predictors of demand for emergency prehospital care: an Australian study

INTRODUCTION

Determining the predictors of demand for emergency prehospital care can assist ambulance services in undertaking policy and planning activities.

HYPOTHESIS

Demand for prehospital care can be explained by demographic, health status, and economic determinants.

METHODS

The study used a cross-sectional design to investigate the association of demographic, health status, and insurance factors with the use of prehospital, ambulance care. Core data items including age, gender, marital status, country of origin, triage score, diagnosis, time of presentation, method of arrival, and patient disposition were collected for every patient who presented at the Emergency Department of the study hospital over a four-month period. Ambulance usage was analysed using Poisson regression.

RESULTS

For the 10,229 patients surveyed, only a small number were triaged as having the highest level of urgent medical need (0.8%), but the majority of these used prehospital emergency medical care (90.2%). Predictors of ambulance use included age > 65 years (Prevalence Ratio [PR] = 2.92; 95% confidence interval [CI]: 2.35-3.63), being married or in a de-facto relationship (PR = 0.69; 95% CI: 0.60-0.79) or divorced, separated, or widowed (PR = 0.83; 95% CI: 0.70-0.98), triage score level 1 or 2 (PR = 1.95; 95% CI: 1.68-2.28), or triage score level 3 (PR = 1.54; 95% CI: 1.38-1.72), diagnosis involving either mental (PR = 4.29; 95% CI: 1.84-10.01), nervous (PR = 2.74; 95% CI: 1.19-6.31) or trauma (PR = 2.33; 95% CI: 1.03-5.27) conditions, and insurance status (PR = 1.54; 95% CI: 1.40-1.71). Ethnicity, gender, and time of day were not associated with usage.

CONCLUSION

Demand for ambulance services can be predicted by a number of demographic, medical status, and insurance variables. Age and triage levels are key influences on demand for ambulance services. Ambulance insurance status provides an economic incentive to use ambulance services regardless of the urgency of the medical condition.

Membrane microviscosity modulates mu-opioid receptor conformational transitions and agonist efficacy

The influence of membrane microviscosity on mu-opioid agonist and antagonist binding, as well as agonist efficacy, was examined in membranes prepared from SH-SY5Y cells and from a C6 glioma cell line stably expressing the rat mu-opioid receptor (C6mu). Addition of cholesteryl hemisuccinate (CHS) to cell membranes increased membrane microviscosity and reduced the inhibitory effect of sodium and guanine nucleotides on the affinity of the full agonists sufentanil and [D-Ala2,N-MePhe4,Gly-ol5]enkephalin (DAMGO) for the mu-opioid receptor. Binding of the antagonists [3H]naltrexone and [3H]diprenorphine and the partial agonist nalbuphine was unaffected by CHS. The effect of CHS on agonist binding was reversed by subsequent addition of cis-vaccenic acid, suggesting that the effect of CHS is the result of increased membrane microviscosity and not a specific sterol-receptor interaction. CHS addition increased the potency of DAMGO to stimulate guanosine-5'-O-(3-[35S]thio)triphosphate binding by fourfold, whereas the potency of nalbuphine was unaffected. However, nalbuphine efficacy relative to that of the full agonist DAMGO was strongly increased in CHS-treated membranes compared with that in control membranes. Membrane rigidification also resulted in an increased efficacy for the partial agonists meperidine, profadol, and butorphanol relative to that of DAMGO as measured by agonist-stimulated GTPase activity in control and CHS-modified membranes. These findings support a regulatory role for membrane microviscosity in receptor-mediated G protein activation.

The effects of an intervention campaign to enhance seat belt use on campus

The national health objectives for the year 2000 called for an increase in the use of safety restraints to 85% of motor vehicle occupants. An assessment on one campus indicated that only 79% of those observed were wearing seat belts. Nursing faculty and students undertook a multimodal intervention campaign to increase seat belt use in the campus community. Observed use of seat belts increased to 81% after the week-long intervention consisting of reminder banners, media coverage, permanent reminder signs, roll-over demonstrations, a presentation on the need for seat belt use, and distribution of seat belt use pledge cards. Although the increase was small, it was statistically significant and could represent considerable savings in healthcare costs if even 2% of the population could be saved from serious injury by using seat belts. In addition, the change in seat belt use represented a decline of nearly 10% in the number of nonusers.

Erythromycin derivatives ABT 229 and GM 611 act on motilin receptors in the rabbit duodenum

1. The present study was undertaken to determine whether the macrolide antibiotic erythromycin, its stable motilide derivatives ABT 229 and GM 611 and motilin act at the same receptors on intestinal muscle 2. Each compound contracted the longitudinal muscle of the rabbit duodenum in a concentration-dependent manner that was unaffected by 1 mumol/L tetrodotoxin. The potency order (pEC50 values in brackets) was motilin (8.4), ABT 229 (7.6), GM 611 (7.5) and erythromycin (6.0). 3. The motilin receptor antagonists GM 109 and [phe3, leu13]-motilin, both shifted the concentration-response curves for each agonist to the right, but did not affect concentration-response relationships for the muscarinic agonist carbachol. Schild regression analysis yielded similar pA2 values for GM 109 (in the range 7.2-7.5) for all agonists. This analysis was not done for [phe3, leu13]motilin, which was a non-competitive antagonist and partial agonist. 4. It is concluded that erythromycin, the motilides and motilin act at the same (motilin) receptor on rabbit duodenal muscle and do not have any detectable actions at other receptors in this preparation.

Older people's use of ambulance services: a population based analysis

OBJECTIVE

To investigate the use of emergency and non-urgent ambulance transport services by people aged 65 years and over.

SETTING

The study was undertaken in Queensland where the Queensland Ambulance Services (QAS) is the sole provider of emergency pre-hospital and non-urgent ambulance services for the entire state.

METHODS

The age and sex of 351,000 emergency and non-urgent cases treated and transported by the QAS from July 1995 to June 1996 were analysed.

RESULTS

People aged 65 years and over who comprise 12% of the population utilise approximately one third of the emergency and two thirds of the non-urgent ambulance resources provided in Queensland. While the absolute number of occasions of service for females for emergency services is higher than for males, when the data are stratified for age and sex, males have higher rates of emergency ambulance service utilisation than females across every age group, and particularly in older age groups. Gender differences are also found for non-urgent ambulance usage. The absolute number of occasions of service for older females aged 65 and over using non-urgent ambulance transport is high, but utilisation patterns on stratified data reveal similar gender usage patterns across most age groupings, except at the older age groupings where male usage greatly exceeds female usage.

CONCLUSIONS

As the aged are disproportionately high users of ambulance services, it will become increasingly important for ambulance services to plan for the projected increase in the aged population. Emergency pre-hospital care is one of the few health services along the continuum of care where male usage patterns are higher than those of females. More information needs to be obtained on the age and presenting characteristics of those people who are multiple users of the ambulance service. Such information will assist service planners.

An action of erythromycin in the intestine that is not mediated via motilin receptors

1. Erythromycin lactobionate caused a concentration-dependent inhibition of nerve-mediated contractions of the longitudinal muscle of the guinea-pig ileum, with a threshold for effect of 10-30 mumol/L. The non-antibiotic derivative of erythromycin ABT-229 had a similar effect, but was approximately 10-fold less potent. At a greater concentration (1 mmol/L), erythromycin also depressed the direct contractile effect of 10 mumol/L carbachol on the muscle. 2. Human/porcine motilin (up to 100 mumol/L) did not reduce the nerve-mediated contractions, although it did contract the muscle (threshold 30 mumol/L). Antagonists of motilin receptors (phe3leu13motilin, up to 1 mumol/L, and GM-109, up to 3 mumol/L) did not reduce responses to erythromycin. 3. Erythromycin contracted the longitudinal muscle of the rabbit duodenum, with a threshold concentration of 0.1 mumol/L and ABT-229 contracted this tissue at a threshold concentration of 0.01 mumol/L. Effects of both agonists were antagonized by the motilin receptor antagonists phe3leu13motilin (0.3 mumol/L) and GM-109 (1 mumol/L). 4. It is concluded that the site(s) at which erythromycin acts in the guinea-pig ileum is not a motilin receptor and that ABT-229 is selective for the motilin receptor in comparison with non-motilin erythromycin sites and is unlikely to act at the latter site in therapeutic doses.

Opioid efficacy in a C6 glioma cell line stably expressing the human kappa opioid receptor

A C6 glioma cell line stably transfected with the human kappa opioid receptor (kappaOR) was used to characterize receptor binding and G protein activation via the kappaOR by a comprehensive series of opioid ligands. The ligand-binding affinity for [3H]5alpha,7alpha, 8beta(-)-N-methyl-N-(7-Cl-pyrrolidinyl)-1-oxaspiro(4, 5)dec-8-yl)benzene acetamide (U69593) was similar to that observed in monkey brain membranes and was 10-fold lower in the presence of sodium and GDP. Both peptide and nonpeptide agonists maximally stimulated [35S]GTPgammaS binding. The stimulation of [35S]GTPgammaS binding was blocked by pretreatment of cells with pertussis toxin. Partial stimulation of [35S]GTPgammaS binding via the kappaOR was observed for several ligands that are antagonists at the mu opioid receptor, suggesting an additional mechanism of drug action. The ability of isomers of tifluadom and levallorphan to stimulate [35S]GTPgammaS binding indicates that the chiral carbon of levallorphan, a benzomorphan derivative, imparts a greater degree of stereoselectivity than does the chiral carbon in the benzodiazepine derivative tifluadom. In addition, (-)tifluadom, the less potent isomer of tifluadom, which is also a gamma-aminobutyric acidA receptor agonist, stimulated [35S]GTPgammaS binding. In contrast, d-pentazocine, (+)SKF10047, (+)cyclazocine, and d-ethylketocyclazocine displayed no agonist activity. kappaOR-selective antagonist norbinaltorphimine competitively inhibited the stimulation of [35S]GTPgammaS binding by the active isomers of ethylketocyclazocine, cyclazocine, and nalorphine to the same degree, indicating that all three ligands are eliciting an effect via the kappaOR. The results suggest that these cells express a homogeneous population of kappaOR, and that their [35S]GTPgammaS-binding properties make them an excellent means to assess kappaOR efficacy.

Dominant effects of the bcr-abl oncogene on Drosophila morphogenesis

We targeted expression of human/fly chimeric Bcr-Abl proteins to the developing central nervous system (CNS) and eye imaginal disc of Drosophila melanogaster. Neural expression of human/fly chimeric P210 Bcr-Abl or P185 Bcr-Abl rescued abl mutant flies from pupal lethality, indicating that P210 and P185 Bcr-Abl can substitute functionally for Drosophila Abl during axonogenesis. However, increased levels of neurally expressed P210 or P185 Bcr-Abl but not Drosophila Abl produced CNS defects and lethality. Expression of P210 or P185 in the eye imaginal disc produced a dominant rough eye phenotype that was dependent on dosage of the transgene. Drosophila Enabled, previously identified as a suppressor of the abl mutant phenotype and substrate for Drosophila Abl kinase, had markedly increased phosphotyrosine levels in Bcr-Abl expressing Drosophila, indicating that it is a substrate for Bcr-Abl as well. Drosophila, therefore, is a suitable model system to identify Bcr-Abl interactions important for signal transduction and oncogenesis.

Delta opioid receptor down-regulation is independent of functional G protein yet is dependent on agonist efficacy

Chronic treatment of C6 glioma cells stably expressing the rat delta opioid receptor (C6delta) with full agonists resulted in receptor down-regulation. Chronic [D-Ser2,L-Leu5]enkephalyl-Thr treatment caused a decrease in cell surface as well as a decrease in agonist-stimulated [35S]guanosine-5'-O-(3-thio)triphosphate binding. Treatment with full agonists for 12 hr resulted in a 90% decrease in receptor number that was paralleled by a decrease in the ability of agonist to stimulate [35S]guanosine-5'-O-(3-thio)triphosphate binding and inhibit forskolin-stimulated adenylyl cyclase. Of the remaining receptors, a smaller fraction of receptors (41 +/- 4 vs. 56 +/- 4% in control) exhibited high affinity for agonist as compared to receptors in control membranes. Elimination of functional guanosine triphosphate binding protein (G protein) by Pertussis toxin pretreatment did not alter the ability of agonist to down regulate receptor. We hypothesized that agonist affinity (not efficacy) would be a predictor of an agonist's ability to down-regulate receptor. However, we found that only full agonists were able to down-regulate receptor number, G protein activation and adenylyl cyclase inhibition. Chronic exposure to partial agonist 7-spiroindinooxymorphone, which has a very high affinity for the receptor, as well as morphine, did not cause receptor down-regulation. Taken together, these results suggest that full agonists alter receptor conformation such that the altered conformation is recognized by G protein as well as proteins involved in receptor down-regulation. In addition, down-regulation is independent of agonist-mediated G protein activation and subsequent down-stream signaling.

Opioid efficacy in a C6 glioma cell line stably expressing the delta opioid receptor

A C6 glioma cell line stably transfected with the rat delta opioid receptor (C6delta) was used to characterize receptor binding and G protein activation by both peptide and nonpeptide delta opioid ligands. The ligand binding affinities for [3H]naltrindole and [3H]pCl-[D-Pen2,D-Pen5]enkephalin (DPDPE) were similar to those observed in monkey brain membranes. The nonpeptide agonists, BW373U86 and SNC80, as well as peptide agonist [D-Ser2, L-Leu5]enkephalyl-Thr maximally stimulated [35S]GTPgammaS binding by 640, 654 and 576%, respectively, over basal. The peptide agonists, DPDPE and deltorphin II, both stimulated [35S]GTPgammaS binding by 375%. Etorphine, diprenorphine, oxymorphindole and 7-spiroindanyloxymorphone were also partial agonists in this assay, although they were less efficacious than deltorphin II. Stimulation of [35S]GTPgammaS binding by agonists was blocked completely by pertussis toxin pretreatment. Both delta-1 and delta-2 selective antagonists 7-benzylidenenaltrexone and a benzofuran analog of naltrindole displayed high affinity for the cloned receptor (0.04 and 0.08 nM) and antagonized the stimulation of [35S]GTPgammaS binding by BW373U86 and DPDPE with similar potencies. Other evidence suggesting the lack of receptor subtypes includes the finding that stimulation of [35S]GTPgammaS binding by receptor subtype selective ligands DPDPE and deltorphin II was not additive. BW373U86, SNC80 and DPDPE maximally inhibited forskolin-stimulated adenylyl cyclase. These cells highly express a homogeneous population of delta opioid receptor that couple to inhibitory Go/Gi proteins. Ligand affinity for the delta opioid receptor correlates with ligand EC50 values for stimulation of [35S]GTPgammaS binding.

Life in the fast lane. An evaluation of an accelerated RN-MSN program

The Pew Health Commission on professional education has recommended innovative educational programs to promote career mobility among nurses. To assure continued quality of nursing education in the face of innovation, the Philip Y. Hahn School of Nursing conducted a comprehensive evaluation of its accelerated RN-MSN program. Designed to enhance career advancement in the profession, the program was evaluated after its fourth year of operation using the Discrepancy Evaluation Model (DEM). Based on comparison with both relative and absolute standards, the program shortened the time required to obtain BSN and MSN degrees and appeared to reverse declining enrollments in the baccalaureate nursing program. Accelerated students were as successful as other masters nursing students in specific courses and in the program in general. Adverse program effects included declining enrollments in some under-graduate courses and the increased complexity of advising.

Nursing Education: Focus on Flexibility

Curricular change requires input from both service and education. However, it is sometimes difficult to obtain a complete picture of nursing practice from the clinical arena. The curriculum committee of the University of San Diego Philip Y. Hahn School of Nursing conducted a study with focus groups comprised of nurses from several different areas of practice to obtain information for curriculum changes. Both the focus group process and its outcomes are reported here. Flexibility was the key theme that emerged from all of the focus group sessions. Other themes were categorized in terms of issues addressed and included professional issues, healthcare systems issues, nursing education issues, and advanced practice issues. The focus group strategy proved to be an effective means of gaining the broad spectrum of insights needed for curriculum revision.

Characterization of opioid agonist efficacy in a C6 glioma cell line expressing the mu opioid receptor

In C6 glioma cells stably expressing a homogeneous population of the cloned rat mu opioid receptor, the binding affinities of opioid agonists and subsequent activation of G protein were examined. Opioid receptor number in membranes of these cells was high (10-30 pmol/mg protein [3H]diprenorphine binding sites). Opioids were found to bind to the receptor with high affinity [Tyr-D-Ala-Gly-(Me)Phe-Gly-ol (DAMGO) 0.23 nM; sufentanil 0.034 nM; morphine 0.16 nM]. Activation of G protein by opioid agonists was examined by measuring the stimulation of guanosine-5'-O-(3-[35S]thio)triphosphate ([35S]GTP gamma S) binding. Sufentanil increased [35S]GTP gamma S binding by 326% with an EC50 value of 2.39 nM. Agonist stimulation of [35S]GTP gamma S binding was stereoselective, naltrexone-reversible, and pertussis toxin-sensitive. The "intrinsic activity" of opioids at the mu receptor was reflected by the magnitude of agonist-mediated activation of G protein. The rank order of the stimulation of [35S]GTP gamma S binding was etonitazene = sufentanil = DAMGO = PLO17 = fentanyl > morphine > profadol > meperidine > butorphanol = nalbuphine = pentazocine > cyclazocine = nalorphine > levallorphan > naltrexone. High affinity binding of ligands to the mu opioid receptor was reduced by the addition of sodium and guanosine diphosphate at concentrations used in the [35S]GTP gamma S binding assay. Ligand affinity was reduced in a manner correlating with "intrinsic activity". DAMGO, 1229-fold, nalbuphine 35-fold, naltrexone, 3-fold. The results presented show that the stable expression of the rat mu opioid receptor in C6 cells provides an effective tool to examine opioid receptor signal transduction mechanisms and evaluate the activity of novel opioids at the mu receptor.

Using a public health nursing model to assess and plan for health needs at a summer day camp

The epidemiologic prevention process model (EPPM; Clark, 1992) was designed to guide community health nursing practice and research. The model incorporates epidemiologic, nursing, and public health perspectives and directs assessment of health needs and the planning, implementation, and evaluation of health care services at primary, secondary, and tertiary levels of prevention. The EPPM was used to assess needs for nursing services at a summer day camp and to plan to meet those needs. Assessment indicated that underlying factors in each of four components of the model (human biology, environment, lifestyle, and the health system) contributed to needs for nursing services. Assessment data were used to derive community nursing diagnoses and to plan interventions to meet identified health care needs. In this application, the EPPM was found to be an effective way of organizing and interpreting findings and of translating those findings into improved health care services in a camp setting.

Acoustic characteristics of American English vowels

The purpose of this study was to replicate and extend the classic study of vowel acoustics by Peterson and Barney (PB) [J. Acoust. Soc. Am. 24, 175-184 (1952)]. Recordings were made of 45 men, 48 women, and 46 children producing the vowels /i,I,e, epsilon,ae,a, [symbol: see text],O,U,u, lambda,3 iota/ in h-V-d syllables. Formant contours for F1-F4 were measured from LPC spectra using a custom interactive editing tool. For comparison with the PB data, formant patterns were sampled at a time that was judged by visual inspection to be maximally steady. Analysis of the formant data shows numerous differences between the present data and those of PB, both in terms of average frequencies of F1 and F2, and the degree of overlap among adjacent vowels. As with the original study, listening tests showed that the signals were nearly always identified as the vowel intended by the talker. Discriminant analysis showed that the vowels were more poorly separated than the PB data based on a static sample of the formant pattern. However, the vowels can be separated with a high degree of accuracy if duration and spectral change information is included.

enabled, a dosage-sensitive suppressor of mutations in the Drosophila Abl tyrosine kinase, encodes an Abl substrate with SH3 domain-binding properties

Genetic screens for dominant second-site mutations that suppress the lethality of Abl mutations in Drosophila identified alleles of only one gene, enabled (ena). We report that the ena protein contains proline-rich motifs and binds to Abl and Src SH3 domains, ena is also a substrate for the Abl kinase; tyrosine phosphorylation of ena is increased when it is coexpressed in cells with human or Drosophila Abl and endogenous ena tyrosine phosphorylation is reduced in Abl mutant animals. Like Abl, ena is expressed at highest levels in the axons of the embryonic nervous system and ena mutant embryos have defects in axonal architecture. We conclude that a critical function of Drosophila Abl is to phosphorylate and negatively regulate ena protein during neural development.