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Articles by Hilary C. Rees in JoVE
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Mätning Frailty i HIV-infekterade individer. Identifiering av sköra patienter är det första steget till förbättrande och Återföring av Frailty
Hilary C. Rees1, Voichita Ianas1, Patricia McCracken1, Shannon Smith1, Anca Georgescu1, Tirdad Zangeneh1, Jane Mohler2, Stephen A. Klotz1
1Division of Infectious Diseases, University of Arizona, 2Arizona Center on Aging, University of Arizona
Other articles by Hilary C. Rees on PubMed
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White Matter Integrity Assessed by Diffusion Tensor Tractography in a Patient with a Large Tumor Mass but Minimal Clinical and Neuropsychological Deficits
Functional Neurology.
Oct-Dec, 2012 |
Pubmed ID: 23597438 Diffusion tensor imaging (DTI) tractography and image registration were used to investigate a patient with a massive left-sided brain tumor, whose size was largely disproportionate to his subtle neurological deficits. MRI was obtained from the patient and his healthy identical twin, who acted as anatomical reference for DTI and as a control for quantitative measures. To compensate for the patient's altered anatomy, seed and way points for probabilistic tractography were drawn on the color-coded direction maps of the healthy twin. Registration, based on the combination of b0-images, T2-weighted and T1-weighted images, was used to identify the corresponding regions in the patient. The corticospinal tract (CST), the superior longitudinal fasciculus (SLF), and the cingulum bundle (CB) showed displaced anatomy. A significant difference was found between fractional anisotropy distribution along the left SLF and CB, but not along the CST. These findings fit well with the patient's substantial preservation of his motor abilities, while abnormalities of the SLF and CB could explain the subtle but detectable cognitive deficits.
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The Effect of Monoalkyl Phosphates and Fluoride on Dissolution of Hydroxyapatite, and Interactions with Saliva
Caries Research.
Apr, 2013 |
Pubmed ID: 23571769 The aims were to investigate the effect of monoalkyl phosphates (MAPs) and fluoride on dissolution rate of native and saliva-coated hydroxyapatite (HA). Fluoride at 300 mg/l (as NaF) inhibited dissolution of native HA by 12%, while potassium and sodium dodecyl phosphates (PDP, SDP), at 0.1% or higher, inhibited dissolution by 26-34%. MAPs, but not fluoride, also showed persistence of action. MAPs at 0.5% and fluoride at 300 mg/l were then tested separately against HA pre-treated with human saliva for 2 or 18 h. Agents were applied with brushing to half the specimens, and without brushing to the other half. In control (water-treated) specimens, pre-treatment of HA with human saliva reduced dissolution rate on average by 41% (2 h) and 63% (18 h). Brushing did not have a statistically significant effect on dissolution rate of saliva-coated specimens. In brushed specimens, fluoride significantly increased the inhibition due to 2- or 18-hour saliva pre-treatment. It is hypothesised that brushing partially removes the salivary film and allows KOH-soluble calcium fluoride formation at the surfaces of HA particles. Inhibition was reduced by PDP in 2-hour/non-brushed specimens and in 18-hour/brushed specimens. PDP did not affect dissolution rates in the remaining groups and SDP did not affect dissolution rate in any group. Possible reasons for these variable results are discussed. The experiments show that pre-treatment with saliva can significantly modify results of tests on potential anti-erosive agents and it is recommended that saliva pre-treatment should be a routine part of testing such agents.
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Sports and Exercise-related Tendinopathies: a Review of Selected Topical Issues by Participants of the Second International Scientific Tendinopathy Symposium (ISTS) Vancouver 2012
British Journal of Sports Medicine.
Jun, 2013 |
Pubmed ID: 23584762 In September 2010, the first International Scientific Tendinopathy Symposium (ISTS) was held in Umeå, Sweden, to establish a forum for original scientific and clinical insights in this growing field of clinical research and practice. The second ISTS was organised by the same group and held in Vancouver, Canada, in September 2012. This symposium was preceded by a round-table meeting in which the participants engaged in focused discussions, resulting in the following overview of tendinopathy clinical and research issues. This paper is a narrative review and summary developed during and after the second ISTS. The document is designed to highlight some key issues raised at ISTS 2012, and to integrate them into a shared conceptual framework. It should be considered an update and a signposting document rather than a comprehensive review. The document is developed for use by physiotherapists, physicians, athletic trainers, massage therapists and other health professionals as well as team coaches and strength/conditioning managers involved in care of sportspeople or workers with tendinopathy.
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A Phthalate Family Oxygenase Reductase Supports Terpene Alcohol Oxidation by CYP238A1 from Pseudomonas Putida KT2440
Biotechnology and Applied Biochemistry.
Jan-Feb, 2013 |
Pubmed ID: 23586988 CYP238A1, one of the two P450 enzymes in the genome of Pseudomonas putida KT2440, has been produced heterologously in Escherichia coli, purified, and found to bind acyclic and cyclic terpene alcohols such as farnesol, nerolidol, linalool, and terpineol. The other P450 enzyme in this organism (gene locus: PP1950) was also produced in E. coli but no substrate has been identified from a limited screen. A phthalate family oxygenase reductase (PFOR) encoded by the PP1957 gene, just downstream of the PP1955 gene for CYP238A1, accepts electrons from the reduced form of both nicotinamide adenine dinucleotide (NADH) and nicotinamide adenine dinucleotide phosphate and is able to support monooxygenase activity of CYP238A1, both in vitro and in E. coli, in which both enzymes are produced. CYP238A1 oxidizes cis- and trans-nerolidol to the 9-hydroxy product, with no evidence of attack at the olefinic double bonds. The NADH turnover rate of 170 nmol(nmol-P450)â»Â¹ Minâ»Â¹ for CYP238A1 with cis-nerolidol as substrate at a PP1957:CYP238A1 concentration ratio of 8:1 suggests that this PFOR could function as the physiological redox partner for CYP238A1. The physiological role of CYP238A1 may be related to the PP1955 gene being part of an island/cluster of inducible genes associated with energy metabolism and response to xenobiotics.
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Smooth Muscle Hyperplasia Due to Loss of Smooth Muscle α-actin is Driven by Activation of Focal Adhesion Kinase, Altered P53 Localization and Increased Levels of Platelet-derived Growth Factor Receptor-β
Human Molecular Genetics.
Aug, 2013 |
Pubmed ID: 23591991 Mutations in ACTA2, encoding the smooth muscle cell (SMC)-specific isoform of α-actin (α-SMA), cause thoracic aortic aneurysms and dissections and occlusive vascular diseases, including early onset coronary artery disease and stroke. We have shown that occlusive arterial lesions in patients with heterozygous ACTA2 missense mutations show increased numbers of medial or neointimal SMCs. The contribution of SMC hyperplasia to these vascular diseases and the pathways responsible for linking disruption of α-SMA filaments to hyperplasia are unknown. Here, we show that the loss of Acta2 in mice recapitulates the SMC hyperplasia observed in ACTA2 mutant SMCs and determine the cellular pathways responsible for SMC hyperplasia. Acta2(-/-) mice showed increased neointimal formation following vascular injury in vivo, and SMCs explanted from these mice demonstrated increased proliferation and migration. Loss of α-SMA induced hyperplasia through focal adhesion (FA) rearrangement, FA kinase activation, re-localization of p53 from the nucleus to the cytoplasm and increased expression and ligand-independent activation of platelet-derived growth factor receptor beta (Pdgfr-β). Disruption of α-SMA in wild-type SMCs also induced similar cellular changes. Imatinib mesylate inhibited Pdgfr-β activation and Acta2(-/-) SMC proliferation in vitro and neointimal formation with vascular injury in vivo. Loss of α-SMA leads to SMC hyperplasia in vivo and in vitro through a mechanism involving FAK, p53 and Pdgfr-β, supporting the hypothesis that SMC hyperplasia contributes to occlusive lesions in patients with ACTA2 missense mutations.
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Ethical Considerations for Vaccination Programmes in Acute Humanitarian Emergencies
Bulletin of the World Health Organization.
Apr, 2013 |
Pubmed ID: 23599553 Humanitarian emergencies result in a breakdown of critical health-care services and often make vulnerable communities dependent on external agencies for care. In resource-constrained settings, this may occur against a backdrop of extreme poverty, malnutrition, insecurity, low literacy and poor infrastructure. Under these circumstances, providing food, water and shelter and limiting communicable disease outbreaks become primary concerns. Where effective and safe vaccines are available to mitigate the risk of disease outbreaks, their potential deployment is a key consideration in meeting emergency health needs. Ethical considerations are crucial when deciding on vaccine deployment. Allocation of vaccines in short supply, target groups, delivery strategies, surveillance and research during acute humanitarian emergencies all involve ethical considerations that often arise from the tension between individual and common good. The authors lay out the ethical issues that policy-makers need to bear in mind when considering the deployment of mass vaccination during humanitarian emergencies, including beneficence (duty of care and the rule of rescue), non-maleficence, autonomy and consent, and distributive and procedural justice.
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An Urban Metabolism and Ecological Footprint Assessment of Metro Vancouver
Journal of Environmental Management.
Jul, 2013 |
Pubmed ID: 23603775 As the world urbanizes, the role of cities in determining sustainability outcomes grows in importance. Cities are the dominant form of human habitat, and most of the world's resources are either directly or indirectly consumed in cities. Sustainable city analysis and management requires understanding the demands a city places on a wider geographical area and its ecological resource base. We present a detailed, integrated urban metabolism of residential consumption and ecological footprint analysis of the Vancouver metropolitan region for the year 2006. Our overall goal is to demonstrate the application of a bottom-up ecological footprint analysis using an urban metabolism framework at a metropolitan, regional scale. Our specific objectives are: a) to quantify energy and material consumption using locally generated data and b) to relate these data to global ecological carrying capacity. Although water is the largest material flow through Metro Vancouver (424,860,000Â m(3)), it has the smallest ecological footprint (23,100Â gha). Food (2,636,850 tonnes) contributes the largest component to the ecological footprint (4,514,400Â gha) which includes crop and grazing land as well as carbon sinks required to sequester emissions from food production and distribution. Transportation fuels (3,339,000Â m(3)) associated with motor vehicle operation and passenger air travel comprises the second largest material flow through the region and the largest source of carbon dioxide emissions (7,577,000 tonnes). Transportation also accounts for the second largest component of the EF (2,323,200Â gha). Buildings account for the largest electricity flow (17,515,150Â MWh) and constitute the third largest component of the EF (1,779,240Â gha). Consumables (2,400,000 tonnes) comprise the fourth largest component of the EF (1,414,440Â gha). Metro Vancouver's total Ecological Footprint in 2006 was 10,071,670Â gha, an area approximately 36 times larger than the region itself. The EFA reveals that cropland and carbon sinks (forested land required to sequester carbon dioxide emissions) account for 90% of Metro Vancouver's overall demand for biocapacity. The per capita ecological footprint is 4.76Â gha, nearly three times the per capita global supply of biocapacity. Note that this value excludes national government services that operate outside the region and could account for up to an additional 2Â gha/ca.
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Best Practice Guidelines on Clinical Management of Acute Attacks of Porphyria and Their Complications
Annals of Clinical Biochemistry.
May, 2013 |
Pubmed ID: 23605132 The British and Irish Porphyria Network guidelines describe best practice in the clinical assessment, investigation and management of acute porphyria attacks and their complications, including severe attacks with neuropathy. Acute attacks of porphyria may occur in acute intermittent porphyria (AIP), variegate porphyria (VP) and hereditary coproporphyria (HCP). Aminolaevulinic acid dehydratase deficiency porphyria (ADP) is a very rare autosomal recessive porphyria; only six cases substantiated by mutation analysis have yet been described in the literature. Urinary porphobilinogen (PBG) is always raised in an acute attack due to AIP, VP or HCP and this analysis is essential to confirm the diagnosis. A positive result in a qualitative or semi-quantitative screening test must be followed by PBG quantitation at the earliest opportunity. However in a severely ill patient, treatment should not be delayed. Removal of precipitating factors, effective analgesia and control of symptoms with safe medication, attention to nutrition and fluid balance are essential. The indications for use of intravenous haem arginate are set out, together with advice on its administration. A small proportion of acute porphyria patients develop recurrent attacks and management options that may be considered include gonadotrophin-releasing hormone analogues, 'prophylactic' regular haem arginate infusion or ultimately, liver transplantation.
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North-South Corridor Demonstration Project: Ethical and Logistical Challenges in the Design of a Demonstration Study of Early Antiretroviral Treatment for Long Distance Truck Drivers Along a Transport Corridor Through South Africa, Zimbabwe, and Zambia
Advances in Preventive Medicine.
2013 |
Pubmed ID: 23606977 Background. Long-distance truck drivers are at risk of acquiring and transmitting HIV and have suboptimal access to care. New HIV prevention strategies using antiretroviral drugs to reduce transmission risk (early antiretroviral therapy (ART) at CD4 count >350 cells/ μ L) have shown efficacy in clinical trials. Demonstration projects are needed to evaluate "real world" programme effectiveness. We present the protocol for a demonstration study to evaluate the feasibility, acceptability, and cost of an early ART intervention for HIV-positive truck drivers along a transport corridor across South Africa, Zimbabwe, and Zambia, as part of an enhanced strategy to improve treatment adherence and retention in care. Methods and Analysis. This demonstration study would follow an observational cohort of truck drivers receiving early treatment. Our mixed methods approach includes quantitative, qualitative, and economic analyses. Key ethical and logistical issues are discussed (i.e., choice of drug regimen, recruitment of participants, and monitoring of adherence, behavioural changes, and adverse events). Conclusion. Questions specific to the design of tailored early ART programmes are amenable to operational research approaches but present substantial ethical and logistical challenges. Addressing these in demonstration projects can inform policy decisions regarding strategies to reduce health inequalities in access to HIV prevention and treatment programmes.
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Stressors, Social Support, and Tests of the Buffering Hypothesis: Effects on Psychological Responses of Injured Athletes
British Journal of Health Psychology.
Apr, 2013 |
Pubmed ID: 23621677 OBJECTIVE: The purpose of this article was to examine the main and stress-buffering effect relationships between social support and psychological responses to injury. DESIGN: The article presents two studies, both of which matched social support types with injury stressors. Study 1 used measures of stressors, perception of social support availability, and psychological responses of injured athletes. Study 2 utilized measures of stressors, received social support, and psychological responses of injured athletes. METHODS: During physiotherapy clinic visits, injured athletes (Study 1, NÂ =Â 319; Study 2, NÂ =Â 302) completed measures of stressors, social support, and psychological responses to injury. Confirmatory factor analysis (CFA) and moderated hierarchical regression were used to analyse the data. RESULTS: In both studies, CFA suggested adequate model fit for measures of social support and psychological responses to injury. Moderated hierarchical regression analyses in Study 1 revealed significant (pÂ
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Dry Stacking of Wastewater Treatment Sludges
Water Research.
Jun, 2013 |
Pubmed ID: 23642401 Drying pans are used during wastewater treatment (WWT) to store, stabilise and dry residual solids. The pans are filled with sludge that dries via exposure to sunshine and wind. We propose that drying pans be operated based on dry stacking principles, a technique with proven success in the mineral processing industry. The implementation of the dry stacking technique requires very little in the way of additional engineering beyond a conventional drying pan. By applying the sludge in thin layers, the sludge naturally forms its own stack with an angle that is dependent on the consistency of the material. The benefits of dry stacking are that the slope allows instantaneous run-off of rainfall and supernatant, allowing operation throughout the year rather than seasonally. The layering approach also maximises the evaporation achieved in the available deposition area compared to filling the pans sequentially. A series of laboratory tests were carried out on samples from Melbourne Water's Western Treatment Plant in Werribee, Australia, to provide validation of the dry stacking concept for WWT sludges. Rheological tests showed that samples had appropriate flow properties to form stacks. Drying and re-wetting tests on the samples indicated that a sloped, partially dry sludge sheds rainfall, depending on the slope, cake dryness and amount of rainfall. Local rainfall data was used to estimate a potential increase in pan throughput of 65%-140% due to dry stacking. The greatest improvements were predicted to occur during wetter years. In combination, the results indicated that dry stacking has the potential to dramatically improve the performance of WWT sludge drying pans.
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Controlling the HIV Epidemic with Antiretrovirals: IAPAC Consensus Statement on Treatment As Prevention and Preexposure Prophylaxis
Journal of the International Association of Providers of AIDS Care.
May-Jun, 2013 |
Pubmed ID: 23666450 In the context of emerging evidence related to preexposure prophylaxis and HIV treatment as prevention, an evidence summit was held in mid-2012 to discuss the current state of the science and to provide a platform for consensus building around whether and how these prevention strategies might be implemented globally. Health care providers, researchers, policy makers, people living with HIV/AIDS, and representatives of government authorities, donor agencies, pharmaceutical companies, advocacy organizations, and professional associations attended from 52 countries. An international advisory committee was convened to identify key messages and recommendations based upon the data presented and discussed at the summit. The advisory committee further worked to develop this consensus statement meant to assist relevant stakeholders in taking stock and mapping out a route forward to enhance the HIV prevention armamentarium.
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In-home Monitoring of Older Adults with Vision Impairment: Exploring Patients', Caregivers' and Professionals' Views
Journal of the American Medical Informatics Association : JAMIA.
May, 2013 |
Pubmed ID: 23676244 OBJECTIVE: To develop a conceptual framework for the design of an in-home monitoring system (IMS) based on the requirements of older adults with vision impairment (VI), informal caregivers and eye-care rehabilitation professionals. MATERIALS AND METHODS: Concept mapping, a mixed-methods statistical research tool, was used in the construction of the framework. Overall, 40 participants brainstormed or sorted and rated 83 statements concerning an IMS for older adults with VI. Multidimensional scaling and hierarchical cluster analysis were employed to construct the framework. A questionnaire yielded further insights into the views of a wider sample of older adults with VI (n=78) and caregivers (n=25) regarding IMS. RESULTS: Concept mapping revealed a nine-cluster model of IMS-related aspects including affordability, awareness of system capabilities, simplicity of installation, operation and maintenance, system integrity and reliability, fall detection and safe movement, user customization, user preferences regarding information delivery, and safety alerts for patients and caregivers. From the questionnaire, independence, safety and fall detection were the most commonly reported reasons for older adults and caregivers to accept an IMS. Concerns included cost, privacy, security of the information obtained through monitoring, system accuracy, and ease of use. DISCUSSION: Older adults with VI, caregivers and professionals are receptive to in-home monitoring, mainly for fall detection and safety monitoring, but have concerns that must be addressed when developing an IMS. CONCLUSION: Our study provides a novel conceptual framework for the design of an IMS that will be maximally acceptable and beneficial to our ageing and vision-impaired population.
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Does Seed Mass Drive the Differences in Relative Growth Rate Between Growth Forms?
Proceedings. Biological Sciences / The Royal Society.
Jul, 2013 |
Pubmed ID: 23677351 The idea that herbaceous plants have higher relative growth rates (RGRs) compared with woody plants is fundamental to many of the most influential theories in plant ecology. This difference in growth rate is thought to reflect systematic variation in physiology, allocation and leaf construction. Previous studies documenting this effect have, however, ignored differences in seed mass. As woody species often have larger seeds and RGR is negatively correlated with seed mass, it is entirely possible the lower RGRs observed in woody species is a consequence of having larger seeds rather than different growth strategies. Using a synthesis of the published literature, we explored the relationship between RGR and growth form, accounting for the effects of seed mass and study-specific effects (e.g. duration of study and pot volume), using a mixed-effects model. The model showed that herbaceous species do indeed have higher RGRs than woody species, and that the difference was independent of seed mass, thus at all seed masses, herbaceous species on average grow faster than woody ones.
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Differences Between Men and Women in the Regulation of Adipose 11β-HSD1 and in Its Association with Adiposity and Insulin Resistance
Diabetes, Obesity & Metabolism.
May, 2013 |
Pubmed ID: 23701286 This study explored sex differences in 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) activity and gene expression in isolated adipocytes and adipose tissue (AT), obtained via subcutaneous biopsies from non-diabetic subjects [58 M, 64 F; age 48.3 ± 15.3 years, body mass index (BMI) 27.2 ± 3.9 kg/m(2) ]. Relationships with adiposity and insulin resistance (IR) were addressed. Males exhibited higher 11β-HSD1 activity in adipocytes than females, but there was no such difference for AT. In both men and women, adipocyte 11β-HSD1 activity correlated positively with BMI, waist circumference, % body fat, adipocyte size and with serum glucose, triglycerides and low-density lipoprotein:high-density lipoprotein (LDL:HDL) ratio. Positive correlations with insulin, HOMA-IR and haemoglobin A1c (HbA1c) and a negative correlation with HDL-cholesterol were significant only in males. Conversely, 11β-HSD1 activity in AT correlated with several markers of IR and adiposity in females but not in males, but the opposite pattern was found with respect to 11β-HSD1 mRNA expression. This study suggests that there are sex differences in 11β-HSD1 regulation and in its associations with markers of obesity and IR.
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Myocardial, Smooth Muscle, Nephron and Collecting Duct Gene Targeting Reveals the Organ Sites of Endothelin A Receptor Antagonist Fluid Retention
The Journal of Pharmacology and Experimental Therapeutics.
May, 2013 |
Pubmed ID: 23709116 Endothelin-1 binding to endothelin A receptors (ETA) elicits pro-fibrogenic, pro-inflammatory and proliferative effects that can promote a wide variety of diseases. While ETA antagonists are approved for the treatment of pulmonary hypertension, their clinical utility in several other diseases has been limited by fluid retention. ETA blocker-induced fluid retention could be due to inhibition of ETA activation in the heart, vasculature and/or kidney, consequently the current study was designed to define which of these sites are involved. Mice were generated with absence of ETA specifically in cardiomyocytes (heart), smooth muscle (vascular), the nephron, the collecting duct or no deletion (control). Administration of the ETA antagonists ambrisentan or atrasentan for two weeks caused fluid retention in control mice on a high salt diet as assessed by increases in body weight, total body water and extracellular fluid volume (using impedance plethysmography), as well as decreases in hematocrit (hemodilution). Mice with heart ETA knockout retained fluid in a similar manner as controls when treated with ambrisentan or atrasentan. Mice with vascular ETA knockout had substantially reduced fluid retention in response to either ETA antagonist. Mice with nephron or collecting duct ETA disruption were completely prevented from ETA blocker-induced fluid retention. Taken together, these findings suggest that ETA antagonist-induced fluid retention is due to a direct effect of this class of drug on the collecting duct, is partially related to their vascular action, and is not due to alterations in cardiac function.
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Morphological and Molecular Data for Australian Hebeloma Species Do Not Support the Generic Status of Anamika
Mycologia.
May, 2013 |
Pubmed ID: 23709478 The first collection of a macrofungal agaric species, with morphological features similar to already described Anamika species, has been found in association with animal bones in north Queensland, Australia. This species also shares features with several, commonly occurring and previously described Australian Hebeloma species. An integrated morphological and molecular study has resulted in the conclusion that all Anamika species belong in Hebeloma. As a result, already described species of Anamika are recombined as H. indicum (K.A Thomas, Peintner, M.M. Moser and Manim.) B.J.Rees & Orlovich, H. angustilamellatum (Zhu L.Yang and Z.W.Ge) B.J.Rees & Orlovich and H. lactariolens (Clémençon and Hongo) B.J.Rees & Orlovich. A phylogenetic tree based on ribosomal ITS sequences examines the relationship of these species with other Hebeloma species from both hemispheres. Four new species, Hebeloma youngii B.J.Rees, H. nothofagetorum B.J.Rees, H. subvictoriense B.J.Rees, H. lacteocoffeatum B.J.Rees, and one form, H. aminophilum f. hygrosarx B.J.Rees, are described as new from Australia.
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A Prospective Study of Patient Reported Outcomes in Pancreatic and Peri-ampullary Malignancy
World Journal of Surgery.
May, 2013 |
Pubmed ID: 23716026 BACKGROUND: The purpose of the present study was to describe the impact of treatment of pancreatic and peri-ampullary malignancy on patient reported outcomes (PRO). However, limited data are available describing the impact of curative or palliative therapy on pancreatic/peri-ampullary malignancy and quality of life. METHODS: Patients selected for pancreaticoduodenectomy (PD) completed the European Organisation for Research and Treatment of Cancer QLQ-C30 questionnaire pre-surgery and 6Â weeks, 3, 6, 12, 18, and 24Â months postoperatively. Patients selected for palliative treatments completed the same questionnaire before treatment and monthly thereafter. Mean scores and 95Â % confidence intervals (CI) were calculated for functional scales. Symptom scales and single items were categorized as either minimal or severe, and they were reported as proportions of patients experiencing severe symptoms with 95Â % CI. RESULTS: A total of 100 patients (53 planned PD, 47 palliative) were enrolled. Of the 53 patients planned for surgery, 12 had tumors that were unresectable and 41 underwent pancreatoduodenectomy (PD). Seven patients were excluded because of benign histology or concurrent malignancy. Baseline questionnaire compliance was 70Â %. For those undergoing PD, there were 53 complications, 7 deaths at 1Â year, and 14 deaths at 2Â years. Post-surgery most functions and symptoms deteriorated. Recovery in global health and most symptoms occurred by 3Â months, and functional scales recovered by 6Â months. Recovery of PRO was maintained in the survivors at 2Â years. Palliative patients had poorer function and more symptoms at baseline; however, poor follow-up questionnaire compliance prevented further analysis of this group. CONCLUSIONS: Pancreaticoduodenectomy has a short-term negative impact on PRO that recovers within 6Â months and is maintained at 2Â years in survivors. Further work evaluating palliative and curative treatment in larger patient groups with disease-specific questionnaires is necessary.
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Treatment of Muckle-Wells Syndrome: Analysis of Two IL-1-blocking Regimens
Arthritis Research & Therapy.
May, 2013 |
Pubmed ID: 23718630 INTRODUCTION: Muckle-Wells syndrome (MWS) is an autoinflammatory disease characterized by excessive Interleukin-1 (IL-1) release, resulting in recurrent fevers, sensorineural hearing loss, and amyloidosis. IL-1-inhibition with anakinra, an IL-1 receptor antagonist, improves clinical symptoms and inflammatory markers. Subclinical disease activity is commonly observed. Canakinumab, a fully human IgG1 anti-IL-1beta monoclonal antibody, can abolish excess IL-1beta. The study aim was to analyze the efficacy and safety of these two anti-IL-1 therapies. METHODS: Two cohorts of patients with severe MWS and confirmed NLRP3 (NOD-like receptor family, pyrin domain containing 3) mutation were treated with anakinra and/or canakinumab. Clinical and laboratory features including erythrocyte sedimentation rate (ESR), c-reactive protein (CRP), serum amyloid A (SAA), and the neutrophil marker S100A12 were determined serially. Disease activity was captured by MWS disease activity scores (MWS-DAS). Remission was defined as MWS-DAS [less than or equal to] 5 plus normal CRP and SAA. Treatment efficacy and safety were analyzed. RESULTS: The study included 12 anakinra- and 14 canakinumab-treated patients; the median age was 33.5 years (3.0 - 72.0); 57% were females. Both treatment regimens led to a significant reduction of clinical disease activity and inflammatory markers. At last follow-up, 75% of anakinra-treated and 93% of canakinumab-treated patients achieved remission. During follow-up, S100A12 levels mirrored recurrence of disease activity. Both treatment regimens had favorable safety profiles. CONCLUSIONS: IL-1 blockade is an effective and safe treatment in MWS patients. MWS-DAS in combination with MWS inflammatory markers provides an excellent monitoring tool set. Canakinumab led to a sustained control of disease activity even after secondary failure of anakinra therapy. S100A12 may be a sensitive marker to detect subclinical disease activity.
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The Safety and Efficacy, and Recommendations for the Use of Biologic Drugs in the UK Military Rheumatology Population
Journal of the Royal Army Medical Corps.
Mar, 2013 |
Pubmed ID: 23720553 Inflammatory arthritis is a significant cause of morbidity in the military. In particular the sero-negative spondyloarthritides, which include ankylosing spondylitis, psoriatic arthritis, reactive arthritis, inflammatory bowel disease related arthritis and undifferentiated spondyloarthritis, are especially prevalent in the young male phenotype, which is common in the Armed Forces. It is estimated that there are more than 1500 patients in the Armed Forces with spondyloarthritis alone, based on the prevalence in the general population of approximately 1%. Inflammatory arthritides are eminently treatable, especially with the development and widespread use of biologic drugs such as anti-Tumour Necrosis Factor (TNF) therapy. The use of these drugs can deliver patients an exceptionally good outcome leading to symptom control and normal function in many cases. Initial concerns regarding safety and side effects of anti-TNF drugs have been allayed by the evidence provided from comprehensive national databases developed over the last 10 years. With early diagnosis and prompt treatment military patients can complete a full career including deployment with only minor limitations. This paper reviews the burden of inflammatory arthritis in the armed services, its management and outcome in this population, the evidence for the safety of anti-TNF treatments and the recommendations for employability and deployability for service personnel.
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Medicolegal Implications of Dental Implant Therapy
Primary Dental Journal.
Apr, 2013 |
Pubmed ID: 23726490 Despite the recent economic downturn, the dental implant market continues to grow year on year. Many more dentists are involved in the placement restoration of dental implants and dental implants are being placed in an extended range of clinical scenarios. Dental implant therapy remains a high risk area for the inexperienced interns of civil negligence claims and General Dental Council hearings. Risk can be mitigated by:• Ensuring appropriate indemnity • Complying with the published requirements for training • Maintaining detailed and extensive clinical records • Completing the initial phases of history, examination and investigations robustly • Recording a diagnosis • Providing a bespoke written treatment plan that includes details of the need for treatment, the treatment options (the risks and benefits), the phases of treatment, the costs of treatment,the expected normal sequelae of surgery, the risks and complications of implant therapy and the requirement for future maintenance. The provision of treatment that is different in nature or extent to that agreed can result in a breach of contract as well as a claim for negligence • Engaging sufficiently with the patient to obtain consent • Providing written postoperative instructions detailing emergency arrangements, patients who are anxious or in pain may not retain oral information • Making a frank disclosure of complication or collateral damage • Considering referral at an early stage particularly if reparative surgery is required. The stress of complications or failure may impair a dentist's normally sound judgement; there may be financial pressure, or concerns regarding reputation. In some cases, dentists avoid making a frank disclosure, feel obliged to undertake complicated reparative surgery, fail to make a timely referral, fail to respond appropriately to patient's concerns and in some cases attempt to alter the clinical records.However, in the best of hands and without negligence complications can and do occur. Complications that occur in the presence of good planning and communication and are managed appropriately do not amount to negligence, and are unlikely to lead to a successful claim.
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Immunogenicity of Dendritic Cells Pulsed with MAGE3, Survivin and B-cell Maturation Antigen MRNA for Vaccination of Multiple Myeloma Patients
Cancer Immunology, Immunotherapy : CII.
Aug, 2013 |
Pubmed ID: 23728352 The introduction of autologous stem cell transplantation (SCT) and novel drugs has improved overall survival in multiple myeloma (MM) patients. However, minimal residual disease (MRD) remains and most patients eventually relapse. Myeloma plasma cells express tumor-associated antigens (TAA), which are interesting targets for immunotherapy. In this phase 1 study, we investigated the safety and immunological effects of TAA-mRNA-loaded dendritic cell (DC) vaccination for treatment for MRD in MM after SCT. Mature monocyte-derived DCs were pulsed with keyhole limpet hemocyanin (KLH) and electroporated with MAGE3, Survivin or B-cell maturation antigen (BCMA) mRNA. Twelve patients were vaccinated three times with intravenous (5-22 × 10(6) DCs) and intradermal vaccines (4-11 × 10(6) DCs), at biweekly intervals. Immunological responses were monitored in blood and delayed-type hypersensitivity (DTH) biopsies. All patients developed strong anti-KLH T-cell responses, but not KLH antibodies. In 2 patients, vaccine-specific T cells were detected in DTH biopsies. In one patient, we found MAGE3-specific CD4(+) and CD8(+) T cells, and CD3(+) T cells reactive against BCMA and Survivin. In the other patient, we detected low numbers of MAGE3 and BCMA-reactive CD8(+) T cells. Vaccination was well tolerated with limited toxicity. These findings illustrate that TAA-mRNA-electroporated mature DCs are capable of inducing TAA-T-cell responses in MM patients after SCT.
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Treatment with R-CHOP is Beneficial but Toxic in the Very Elderly Patients with Diffuse Large B-Cell Lymphoma: a Population-Based Cohort Study On Treatment, Toxicity and Outcome
Leukemia & Lymphoma.
Jun, 2013 |
Pubmed ID: 23734653 Abstract To assess treatment strategies, toxicity and outcome in very elderly patients (aged ≥ 75 years) diagnosed with diffuse large B-cell lymphoma (DLBCL) in the rituximab-era, an observational population-based, cohort study was performed. From 103 patients, with a median age of 81 years, data of clinical characteristics, treatment, toxicity and outcome were evaluated. Advanced stage DLBCL was documented in 74 patients. In 80 patients chemotherapy was initiated; 70 patients received rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP). In this group, 39 patients completed all cycles and 30 patients reached complete remission. Severe chemotherapy-related toxicity occurred in 66%. Two-year overall survival was 70% for elderly who completed chemotherapy, 28% for those treated with incomplete or suboptimal chemotherapy and 21% for those receiving radiation therapy as supportive care. In conclusion, the ability to complete R-CHOP was associated with better overall survival compared to other treatment strategies at the expense of severe treatment-related toxicity.
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Classification of Frequency Response Areas in the IC Reveals Continua Not Discrete Classes
The Journal of Physiology.
Jul, 2013 |
Pubmed ID: 23753527 The differential response to sound frequency is a fundamental property of auditory neurons. Frequency analysis in the cochlea gives rise to V-shaped tuning functions in auditory nerve fibres, but by the level of the inferior colliculus (IC), the midbrain nucleus of the auditory pathway, neuronal receptive fields display diverse shapes that reflect the interplay of excitation and inhibition. The origin and nature of these frequency receptive field types is still open to question. One proposed hypothesis is that the frequency response class of any given neuron in the IC is predominantly inherited from one of three major afferent pathways projecting to the IC, giving rise to three distinct receptive field classes. Here, we applied subjective classification, principal component analysis, cluster analysis, and other objective statistical measures, to a large population (2826) of frequency response areas from single neurons recorded in the IC of the anaesthetised guinea pig. Subjectively, we recognised seven frequency response classes (V-shaped, non-monotonic Vs, narrow, closed, tilt down, tilt up and double-peaked), that were represented at all frequencies. We could identify similar classes using our objective classification tools. Importantly, however, many neurons exhibited properties intermediate between these classes, and none of the objective methods used here showed evidence of discrete response classes. Thus receptive field shapes in the IC form continua rather than discrete classes, a finding consistent with the integration of afferent inputs in the generation of frequency response areas. The frequency disposition of inhibition in the response areas of some neurons suggests that across-frequency inputs originating at or below the level of the IC are involved in their generation.
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Inflammatory Markers Associated with Osteoarthritis After Destabilization Surgery in Young Mice with and Without Receptor for Advanced Glycation End-products (RAGE)
Frontiers in Physiology.
2013 |
Pubmed ID: 23755017 HtrA1, Ddr-2, and Mmp-13 are reliable biomarkers for osteoarthritis (OA), yet the exact mechanism for the upregulation of HtrA-1 is unknown. Some have shown that chondrocyte hypertrophy is associated with early indicators of inflammation including TGF-β and the Receptor for Advanced Glycation End-products (RAGE). To examine the correlation of inflammation with the expression of biomarkers in OA, we performed right knee destabilization surgery on 4-week-old-wild type and RAGE knock-out (KO) mice. We assayed for HtrA-1, TGF-β1, Mmp-13, and Ddr-2 in articular cartilage at 3, 7, 14, and 28 days post-surgery by immunohistochemistry on left and right knee joints. RAGE KO and wild type mice both showed staining for key OA biomarkers. However, RAGE KO mice were significantly protected against OA compared to controls. We observed a difference in the total number of chondrocytes and percentage of chondrocytes staining positive for OA biomarkers between RAGE KO and control mice. The percentage of cells staining for OA biomarkers correlated with severity of cartilage degradation. Our results indicate that the absence of RAGE did protect against the development of advanced OA. We conclude that HtrA-1 plays a role in lowering TGF-β1 expression in the process of making articular cartilage vulnerable to damage associated with OA progression.
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Identification of the Ca(2+) Entry Pathway Involved in Deoxygenation-induced Phosphatidylserine Exposure in Red Blood Cells from Patients with Sickle Cell Disease
Pflugers Archiv : European Journal of Physiology.
Jun, 2013 |
Pubmed ID: 23775402 Phosphatidylserine (PS) exposure in red blood cells (RBCs) from sickle cell disease (SCD) patients is increased compared to levels in normal individuals and may participate in the anaemic and ischaemic complications of SCD. Exposure is increased by deoxygenation and occurs with elevation of intracellular Ca(2+) to low micromolar levels. The Ca(2+) entry step has not been defined but a role for the deoxygenation-induced pathway, Psickle, is postulated. Partial Psickle inhibitors 4-acetamido-4'-isothiocyanostilbene-2,2'-disulphonic acid (SITS), 4,4'-dithiocyano-2,2'-stilbene-disulphonic acid (DIDS) and dipyridamole inhibited deoxygenation-induced PS exposure (DIDS IC50, 118 nM). Inhibitors and activators of other pathways (including these stimulated by depolarisation, benzodiazepines, glutamate and stretch) were without effect. Zn(2+) and Gd(3+) stimulated PS exposure to high levels. In the case of Zn(2+), this effect was independent of oxygen (and hence HbS polymerisation and RBC sickling) but required extracellular Ca(2+). The effect was completely abolished when Zn(2+) (100 μM) was added to RBCs suspended in autologous plasma, implying a requirement of high levels of free Zn(2+).
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Fewer Invited Talks by Women in Evolutionary Biology Symposia
Journal of Evolutionary Biology.
Jun, 2013 |
Pubmed ID: 23786459 Lower visibility of female scientists, compared to male scientists, is a potential reason for the under-representation of women among senior academic ranks. Visibility in the scientific community stems partly from presenting research as an invited speaker at organized meetings. We analysed the sex ratio of presenters at the European Society for Evolutionary Biology (ESEB) Congress 2011, where all abstract submissions were accepted for presentation. Women were under-represented among invited speakers at symposia (15% women) compared to all presenters (46%), regular oral presenters (41%) and plenary speakers (25%). At the ESEB congresses in 2001-2011, 9-23% of invited speakers were women. This under-representation of women is partly attributable to a larger proportion of women, than men, declining invitations: in 2011, 50% of women declined an invitation to speak compared to 26% of men. We expect invited speakers to be scientists from top ranked institutions or authors of recent papers in high-impact journals. Considering all invited speakers (including declined invitations), 23% were women. This was lower than the baseline sex ratios of early-mid career stage scientists, but was similar to senior scientists and authors that have published in high-impact journals. High-quality science by women therefore has low exposure at international meetings, which will constrain Evolutionary Biology from reaching its full potential. We wish to highlight the wider implications of turning down invitations to speak, and encourage conference organizers to implement steps to increase acceptance rates of invited talks.
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Current Approaches in National Kidney Paired Donation Programs
Annals of Transplantation : Quarterly of the Polish Transplantation Society.
2013 |
Pubmed ID: 23792511 Kidney transplantation is the treatment of choice for patients with end-stage renal disease. While living donors provide anywhere from a small to a large fraction of kidneys for transplantation in different countries, at least one-third of these donors are incompatible with their potential recipients. To overcome these challenges, kidney paired donation (KPD) programs have been established that organize donor exchanges to find matches among the pool of incompatible pairs. Each program has developed its own features to accommodate local needs. Reasons for participating in KPD include blood group incompatibility, sensitization of the recipient against the donor, and the potential for improvement in transplant quality (e.g., age difference or graft size), and tissue compatibility. KPD programs use sophisticated algorithms to find matches among the pool of donor-recipient pairs to create simultaneous 2-way, 3-way, or 4-way exchanges or more complex non-simultaneous chains of transplants. These KPD allocation systems should be medically sound and ethically acceptable according to the principles of equity, utility, and justice. The variety of possible exchanges provided by these algorithms allows for maximizing the number of transplants, increasing the quality of transplants, and accommodating patients who are difficult to match. In this review, we describe several examples of successful KPD programs with diverse organizational approaches. By highlighting the strategies used by these programs to meet the needs of their patient populations, we aim to inspire improvements in existing programs and to provide a framework for expanding KPD to better serve international transplant communities.
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Methodological Development of an Exploratory Randomised Controlled Trial of an Early Years' Nutrition Intervention: the CHERRY Programme (Choosing Healthy Eating when Really Young)
Maternal & Child Nutrition.
Jun, 2013 |
Pubmed ID: 23795857 Good nutrition in the early years of life is vitally important for a child's development, growth and health. Children's diets in the United Kingdom are known to be poor, particularly among socially disadvantaged groups, and there is a need for timely and appropriate interventions that support parents to improve the diets of young children. The Medical Research Council has highlighted the importance of conducting developmental and exploratory research prior to undertaking full-scale trials to evaluate complex interventions, but have provided very limited detailed guidance on the conduct of these initial phases of research. This paper describes the initial developmental stage and the conduct of an exploratory randomised controlled trial undertaken to determine the feasibility and acceptability of a family-centred early years' nutrition intervention. Choosing Healthy Eating when Really Young (CHERRY) is a programme for families with children aged 18 months to 5 years, delivered in children's centres in one urban (Islington) and one rural (Cornwall) location in the United Kingdom. In the development stage, a mixed-methods approach was used to investigate the nature of the problem and options for support. A detailed review of the evidence informed the theoretical basis of the study and the creation of a logic model. In the feasibility and pilot testing stage of the exploratory trial, 16 children's centres, with a sample of 394 families were recruited onto the study. We hope that the methodology, which we present in this paper, will inform and assist other researchers in conducting community-based, exploratory nutrition research in early years settings.
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The Primary Prevention of PTSD: A Systematic Review
Journal of Trauma & Dissociation : the Official Journal of the International Society for the Study of Dissociation (ISSD).
2013 |
Pubmed ID: 23796172 There has been abundant research targeting the secondary and tertiary prevention and treatment of posttraumatic stress disorder (PTSD), including different forms of debriefing, treatments for acute stress disorder, and targeted intervention strategies (M. T. Feldner, C. M. Monson, & M. J. Friedman, 2007). However, there remains a scarcity of research pertaining to the primary, pretrauma prevention of PTSD. A systematic review was conducted in order to identify and synthesize all programs aimed at the primary prevention of PTSD to date. A broad search strategy was used, yielding 15,014 studies in 4 languages published between 1915 and 2012. Studies in which a resilience-building intervention was delivered prior to a potentially traumatic event, with data collected regarding psychological well-being, were eligible. A total of 7 studies were identified as meeting these criteria. Currently, there is no solid body of research on the primary prevention of PTSD to justify or guide interventions. The limitations and future directions of research in this domain are discussed.
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Hemodialysis-Induced Acute Myocardial Dyssynchronous Impairment in Children
Nephron. Clinical Practice.
Jun, 2013 |
Pubmed ID: 23796960 In adults, recurrent hemodialysis (HD)-induced cardiac injury results in ischemic myocardial dysfunction. Uremic children, like adults, share the full complement of uremia-related cardiovascular abnormalities but without significant atheromatous coronary artery disease. The aim of this study was, to assess the impact of HD on left ventricular (LV) myocardial function in children. Method: We assessed all single-center chronic HD patients (n = 15, range 1-17 years) excluding those with overt cardiac disease. Regional LV function and mechanical synchronicity was measured echographically by two-dimensional segmental longitudinal, circumferential and radial myocardial strain. All patients were assessed pre-dialysis and at the end of dialysis. In addition, we scanned age-matched controls at rest. Results: The peak longitudinal strain was lower in uremic patients compared with controls with a significant fall during HD (mean peak strain -19.9 controls, -17.9 pre-HD, -15.3 end of HD, p < 0.05). Radial strain was lower in uremic patients and increased during HD. Circumferential strain was preserved in uremic patients and fell during HD. Intrasegmental deformation synchronicity was progressively worse pre-dialysis and end of dialysis compared with controls. Intradialytic peak longitudinal strain reduction was significantly associated with systolic blood pressure and ultrafiltrate volume (p < 0.05). Conclusion: Uremic children have impaired regional LV function, with a predisposition to longitudinal axis dysfunction and LV mechanical dyssynchrony, both of which are established markers of ischemic injury. This is further evidence for a characteristic cardiovascular phenotype in uremic patients that predisposes them to subclinical demand ischemia during dialysis.
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Captive-Housed Male Cheetahs (Acinonyx Jubatus Soemmeringii) Form Naturalistic Coalitions: Measuring Associations and Calculating Chance Encounters
Zoo Biology.
Jun, 2013 |
Pubmed ID: 23813720 Cheetahs are known to reproduce poorly in captivity and research suggests that the reasons for this are behavioral, rather than physiological. In the wild, male cheetahs remain in stable groups, or coalitions, throughout their lifetime. Appropriate social group housing is important in enhancing welfare and reproductive success in captivity and this study examined the effect of changes in social group composition on the behavior of four male cheetahs: two siblings and two half siblings. During the study, the cheetahs were housed both in pairs and as a group of four, before one male was relocated. The remaining cheetahs were then housed in a trio. Affiliative behaviors were frequently shown within pairs and overt aggression was seldom observed. Association indices were calculated for each cheetah pair and corrected for chance encounters based on data generated from a Monte Carlo simulation. The indices showed that two coalitions existed before the relocated male departed. Following the relocation of one of the half siblings, the remaining cheetahs appeared to form a coalition of three, as the indices of association between the unrelated male and the siblings increased and allogrooming between unrelated individuals was observed. The findings of this study indicate that natural social groupings of male cheetahs can be successfully replicated in captivity, which could potentially improve the chances of reproductive success when they are introduced to female cheetahs. Zoo Biol. XX:XX-XX, 2013. © 2013 Wiley Periodicals, Inc.
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Cognition in Early Relapsing-Remitting Multiple Sclerosis: Consequences May Be Relative to Working Memory
Journal of the International Neuropsychological Society : JINS.
Jul, 2013 |
Pubmed ID: 23866100 The Relative Consequence Model proposes multiple sclerosis (MS) patients have a fundamental deficit in processing speed that compromises other cognitive functions. The present study examined the mediating role of processing speed, as well as working memory, in the MS-related effects on other cognitive functions for early relapsing-remitting patients. Seventy relapsing-remitting MS patients with disease duration not greater than 10 years and 72 controls completed tasks assessing processing speed, working memory, learning, and executive functioning. The possible mediating roles of speed and working memory in the MS-related effects on other cognitive functions were evaluated using structural equation modeling. Processing speed was not significantly related to group membership and could not have a mediating role. Working memory was related to group membership and functioned as a mediating/intervening factor. The results do not support the Relative Consequence Model in this sample and they challenge the notion that working memory impairment only emerges at later disease stages. The results do support a mediating/intervening role of working memory. These results were obtained for early relapsing-remitting MS patients and should not be generalized to the broader MS population. Instead, future research should examine the relations that exist at other disease stages. (JINS, 2013, 19, 1-12).
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Virulence Loss and Amastigote Transformation Failure Determines Host Cell Responses to Leishmania Mexicana
Parasite Immunology.
Jul, 2013 |
Pubmed ID: 23869911 The effect of alterations in virulence and transformation by long term in vitro culture of L. mexicana promastigotes on infectivity and immune responses was investigated. Fresh parasite cultures harvested from Balb/c mice were passaged 20 times in vitro. Infectivity was decreased and was completely avirulent after 20 passages. The qPCR results showed a down regulation of GP63, LPG2, CPC, CPB2, CPB2.8, CHT1, LACK and LDCEN3 genes after passage 7 concomitant with a reduced and absence of infectivity by passages 7 and 20, respectively. Parasites at passages 1 and 20 are referred to as virulent and avirulent, respectively. The growth of avirulent and virulent parasite was affected by conditioned media derived from macrophages or monocytes infected with parasites for 2 hours. Giemsa staining showed the failure of avirulent but not virulent parasites to transform to the amastigote stage in infected host cells. with both virulent and avirulent modulating the expression of CCL-22, Tgad51, Cox2, IL-1, IL-10, TGF-β, TNF-α, Rab7, Rab9 and A2 genes; virulent but not avirulent L. mexicana significantly up regulated Th2 associated cytokines, but down regulated Rab7and Rab9 gene expression. In conclusion, a model for L. mexicana is reported, which is of potential value in studying host- parasite interaction. This article is protected by copyright. All rights reserved.
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Sea Lice Infestations on Juvenile Chum and Pink Salmon in the Broughton Archipelago, Canada, from 2003 to 2012
Diseases of Aquatic Organisms.
Jul, 2013 |
Pubmed ID: 23872858 Juvenile pink salmon Oncorhynchus gorbuscha and chum salmon O. keta were sampled by beach or purse seine to assess levels of sea lice infestation in the Knight Inlet and Broughton Archipelago regions of coastal British Columbia, Canada, during the months of March to July from 2003 to 2012. Beach seine data were analyzed for sea lice infestation that was described in terms of prevalence, abundance, intensity, and intensity per unit length. The median annual prevalence for chum was 30%, ranging from 14% (in 2008 and 2009) to 73% (in 2004), while for pink salmon, the median was 27% and ranged from 10% (in 2011) to 68% (in 2004). Annual abundance varied from 0.2 to 5 sea lice per fish with a median of 0.47 for chum and from 0.1 to 3 lice (median 0.42) for pink salmon. Annual infestation followed broadly similar trends for both chum and pink salmon. However, the abundance and intensity of Lepeophtheirus salmonis and Caligus clemensi, the 2 main sea lice species of interest, were significantly greater on chum than on pink salmon in around half of the years studied. Logistic regression with random effect was used to model prevalence of sea lice infestation for the combined beach and purse seine data. The model suggested inter-annual variation as well as a spatial clustering effect on the prevalence of sea lice infestation in both chum and pink salmon. Fish length had an effect on prevalence, although the nature of this effect differed according to host species.
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