Use of partial least squares path modelling to assess the willingness of Chinese female sex workers to participate in a microbicide trial

OBJECTIVES

To investigate the willingness of Chinese female sex workers (FSWs) to participate (WTP) in a clinical trial of microbicides; to explore the potential hindrances and facilitating factors; and to provide support for future microbicide clinical trials by tailoring their design to better meet the specific needs of FSWs.

STUDY DESIGN

Cross-sectional study.

METHODS

In total, 404 FSWs were investigated using structured questionnaires. Exploratory factor analysis and partial least squares path modelling were used to explore the correlations between several influencing factors and WTP.

RESULTS

The WTP of FSWs enrolled in this study was high (53.47%, 216/404). Possible benefits from enrolment in the trial were positively associated with WTP, while concern about a hypothetical microbicide, potential physical harm, economic loss from participation, and fear of family or social isolation were negatively associated with WTP.

CONCLUSION

FSWs are appropriate participants in microbicide clinical trials, and are likely to benefit from effective microbicides. In a microbicide clinical trial, it is imperative to ensure protection of the rights, dignity, safety, confidentiality and welfare of FSW participants.

Interleukin-37 ameliorates myocardial ischaemia/reperfusion injury in mice

Innate immune and inflammatory responses are involved in myocardial ischaemia/reperfusion (I/R) injury. Interleukin (IL)-37 is a newly identified member of the IL-1 family, and functions as a fundamental inhibitor of innate immunity and inflammation. However, its role in myocardial I/R injury remains unknown. I/R or sham operations were performed on male C57BL/6J mice. I/R mice received an injection of recombinant human IL-37 or vehicle, immediately before reperfusion. Compared with vehicle treatment, mice treated with IL-37 showed an obvious amelioration of the I/R injury, as demonstrated by reduced infarct size, decreased cardiac troponin T level and improved cardiac function. This protective effect was associated with the ability of IL-37 to suppress production of proinflammatory cytokines, chemokines and neutrophil infiltration, which together contributed to a decrease in cardiomyocyte apoptosis and reactive oxygen species (ROS) generation. In addition, we found that IL-37 inhibited the up-regulation of Toll-like receptor (TLR)-4 expression and nuclear factor kappa B (NF-kB) activation after I/R, while increasing the anti-inflammatory IL-10 level. Moreover, the administration of anti-IL-10R antibody abolished the protective effects of IL-37 in I/R injury. In-vitro experiments further demonstrated that IL-37 protected cardiomyocytes from apoptosis under I/R condition, and suppressed the migration ability of neutrophils towards the chemokine LIX. In conclusion, IL-37 plays a protective role against mouse myocardial I/R injury, offering a promising therapeutic medium for myocardial I/R injury.

Pressure induced second-order structural transition in Sr₃Ir₂O₇

We conducted in situ angle dispersive high pressure x-ray diffraction experiments on Sr3Ir2O7 up to 23.1 GPa at 25 K with neon as the pressure transmitting medium. Pressure induces a highly anisotropic compressional behavior seen where the tetragonal plane is compressed much faster than the perpendicular direction. By analyzing different aspects of the diffraction data, a second-order structural transition is observed at approximately 14 GPa, which is accompanied by the insulating state to nearly metallic state at 13.2 GPa observed previously (Li et al 2013 Phys. Rev. B 87 235127). Our results highlight the coupling between electronic state and lattice structure in Sr3Ir2O7 under pressure.

Towards patient collaboration in cognitive assessment: Specificity, sensitivity, and incremental validity of self-report

The present work addressed the specificity and sensitivity of patient-reported cognitive ability using both cross-sectional and longitudinal data, and the incremental validity of patient self-report in addition to knowledge gained through neuropsychological tests. We examined a sample of individuals with multiple sclerosis (N=130) as a model of chronic illness where neuropsychological deficits are relatively common. Results revealed that 64% of the sample reported noticing some problems with memory or confusion. Very high levels of reported problems were not consistent with objective testing, whereas moderate levels of noticing problems were congruent with test results. This pattern suggests a curvilinear relationship between self-reported and objective assessment. The moderate reporters seem to be attending to subtle increases in deficits over time. Results also supported the incremental validity of combining subjective and objective indices, but only when the high reporters were excluded. We conclude that patients can provide important complementary data which may promote preventive care.

Changing coupling pattern of The ON-OFF direction-selective ganglion cells in early postnatal mouse retina

In the adult rabbit and mouse retina, about 30% of the ON-OFF direction selective ganglion cells (DSGCs) are coupled via gap junctions. In early postnatal rabbit retinas, a greater proportion of morphological ON-OFF DSGCs shows coupling with a larger number of nearby somas. It is not clear whether the coupled ON-OFF DSGCs belong to the same subtype, or how coupling patterns change during development. In this study, we showed that in adult mouse retinas, all coupled ON-OFF DSGCs exhibited preferred directions (PDs) to superior, and this pattern emerged at postnatal day 15 (P15). At P13, the ON-OFF DSGCs with PDs to posterior were also coupled. Every ON-OFF DSGC in every subtype injected at P12 exhibited coupling. Therefore, a rapid decoupling process takes place in DSGCs around eye opening. Light deprivation delayed but did not halt the decoupling process. By using a transgenic mouse line in which green fluorescent protein (GFP) is selectively expressed in DSGCs with PDs to posterior and by performing in situ hybridization of cadherin-6, a marker for the DSGCs with PDs to superior and inferior, we showed that heterologous coupling existed between DSGCs with PDs to anterior and posterior till P12, but this heterologous coupling never spread to DSGCs positive for cadherin-6.

High b-value diffusion tensor imaging of the remote white matter and white matter of obstructive unilateral cerebral arterial regions

AIM

To assess diffusion changes in the remote white matter and areas of white matter with cerebral artery obstruction without magnetic resonance imaging (MRI) evidence of brain parenchymal abnormalities using high b-value diffusion tensor imaging (DTI).

MATERIALS AND METHODS

A total of 34 patients with severe unilateral stenosis (≥75%) or occlusion of the middle cerebral artery (MCA) without abnormal brain parenchymal signals at MRI underwent DTI with a b value of 2200 s/mm(2) at 3 T. Fractional anisotropy (FA), apparent diffusion coefficient (ADC), axial diffusivity (eigenvalue λ₁) and radial diffusivity (eigenvalue λ₂₃) were measured at the bilateral corona radiata, anterior and posterior limbs of the internal capsule, cerebral peduncle, and pons.

RESULTS

The mean FA was significantly lower at the ipsilateral corona radiata and anterior and posterior limbs of the internal capsule than at the contralateral corona radiata and anterior and posterior limbs of the internal capsule (p < 0.05). The mean ADC, λ₁ and λ₂₃ were significantly higher at the ipsilateral corona radiata than at the contralateral corona radiata (p < 0.01). The mean λ₂₃ were significantly higher at the ipsilateral anterior and posterior limb of the internal capsule than at the contralateral anterior and posterior limb of the internal capsule (p < 0.05). The mean ADC, λ₁ and λ₂ ₃were not significantly different between the ipsilateral cerebral peduncle and pons.

CONCLUSIONS

High b-value DTI could sensitively reveal diffusion changes in white matter in regions of cerebral artery obstruction without abnormal anisotropy and diffusivity of the remote white matter of patients with severe MCA stenosis or occlusion without MRI evidence of brain parenchymal abnormalities.

Efficacy of folic acid supplementation in stroke prevention: new insight from a meta-analysis

AIMS

  There are growing data and a continuing controversy over the efficacy of folic acid supplementation in stroke prevention. We conducted a meta-analysis based on relevant, up-to-date published randomised trials to further examine this issue.

METHODS

  Relative risk (RR) was used to measure the effect of folic acid supplementation on risk of stroke with a fixed-effects model.

RESULTS

  Overall, folic acid supplementation reduced the risk of stroke by 8% (n = 55,764; RR: 0.92; 95% CI: 0.86-1.00, p = 0.038). In the 10 trials with no or partial folic acid fortification (n = 43,426), the risk of stroke was reduced by 11% (0.89; 0.82-0.97, p = 0.010). Within these trials, a greater beneficial effect was observed among trials with a lower percent use of statins [≤ 80% (median); 0.77; 0.64-0.92, p = 0.005], and a meta-regression analysis also suggested a positive dose-response relationship between percent use of statins and log-RR for stroke associated with folic acid supplementation (p = 0.013). A daily dose of 0.4-0.8mg folic acid appeared to be adequate for stroke prevention in comparison with larger doses. In the remaining five trials conducted in populations with folic acid fortification (n = 12,338), folic acid supplementation had no effect on stroke risk (1.03; 0.88-1.21, 0.69).

CONCLUSIONS

  Our analysis indicated that folic acid supplementation is effective in stroke prevention in populations with no or partial folic acid fortification. In addition, a greater beneficial effect was observed among trials with a lower percent use of statins. Our findings underscore the importance of identifying target populations that can particularly benefit from folic acid therapy.

Using electronic medical records to enable large-scale studies in psychiatry: treatment resistant depression as a model

BACKGROUND

Electronic medical records (EMR) provide a unique opportunity for efficient, large-scale clinical investigation in psychiatry. However, such studies will require development of tools to define treatment outcome.

METHOD

Natural language processing (NLP) was applied to classify notes from 127 504 patients with a billing diagnosis of major depressive disorder, drawn from out-patient psychiatry practices affiliated with multiple, large New England hospitals. Classifications were compared with results using billing data (ICD-9 codes) alone and to a clinical gold standard based on chart review by a panel of senior clinicians. These cross-sectional classifications were then used to define longitudinal treatment outcomes, which were compared with a clinician-rated gold standard.

RESULTS

Models incorporating NLP were superior to those relying on billing data alone for classifying current mood state (area under receiver operating characteristic curve of 0.85-0.88 v. 0.54-0.55). When these cross-sectional visits were integrated to define longitudinal outcomes and incorporate treatment data, 15% of the cohort remitted with a single antidepressant treatment, while 13% were identified as failing to remit despite at least two antidepressant trials. Non-remitting patients were more likely to be non-Caucasian (p<0.001).

CONCLUSIONS

The application of bioinformatics tools such as NLP should enable accurate and efficient determination of longitudinal outcomes, enabling existing EMR data to be applied to clinical research, including biomarker investigations. Continued development will be required to better address moderators of outcome such as adherence and co-morbidity.

Innovative DNA vaccine for human papillomavirus (HPV)-associated head and neck cancer

Human papillomavirus (HPV), particularly type 16, has been associated with a subset of head and neck cancers. The viral-encoded oncogenic proteins E6 and E7 represent ideal targets for immunotherapy against HPV-associated head and neck cancers. DNA vaccines have emerged as attractive approaches for immunotherapy due to its simplicity, safety, and ease of preparation. Intradermal administration of DNA vaccine via gene gun represents an efficient method to deliver DNA directly into dendritic cells for priming antigen-specific T cells. We have previously shown that a DNA vaccine encoding an invariant chain (Ii), in which the class II-associated Ii peptide (CLIP) region has been replaced by a Pan-DR-epitope (PADRE) sequence to form Ii-PADRE, is capable of generating PADRE-specific CD4+ T cells in vaccinated mice. In the current study, we hypothesize a DNA vaccine encoding Ii-PADRE linked to E6 (Ii-PADRE-E6) will further enhance E6-specific CD8+ T cell immune responses through PADRE-specific CD4+ T helper cells. We found that mice vaccinated with Ii-PADRE-E6 DNA generated comparable levels of PADRE-specific CD4+ T cell immune responses as well as significantly stronger E6-specific CD8+ T cell immune responses and antitumor effects against the lethal challenge of E6-expressing tumor compared to mice vaccinated with Ii-E6 DNA. Taken together, our data indicates that vaccination with Ii-E6 DNA with PADRE replacing the CLIP region is capable of enhancing the E6-specific CD8+ T cell immune response generated by the Ii-E6 DNA. Thus, Ii-PADRE-E6 represents a novel DNA vaccine for the treatment of HPV-associated head and neck cancer and other HPV-associated malignancies.

A novel endophytic Huperzine A-producing fungus, Shiraia sp. Slf14, isolated from Huperzia serrata

AIMS

To characterize and identify a novel Huperzine A (HupA)-producing fungal strain Slf14 isolated from Huperzia serrata (Thunb. ex Murray) Trev. in China.

METHODS AND RESULTS

The isolation, identification and characterization of a novel endophytic fungus producing HupA specifically and consistently from the leaves of H. serrata were investigated. The fungus was identified as Shiraia sp. Slf14 by molecular and morphological methods. The HupA produced by this endophytic fungus was shown to be identical to authentic HupA analysed by thin layer chromatographic, High-performance liquid chromatography (HPLC), LC-MS, (1) H NMR and acetylcholinesterase (AChE) inhibition activity in vitro. The amount of HupA produced by Shiraia sp. Slf14 was quantified to be 327.8 μg l(-1) by HPLC, which was far higher than that of the reported endophytic fungi, Acremonium sp., Blastomyces sp. and Botrytis sp.

CONCLUSIONS

The production of HupA by endophyte Shiraia sp. Slf14 is an enigmatic observation. It would be interesting to further study the HupA production and regulation by the cultured endophyte in H. serrata and in axenic cultures.

SIGNIFICANCE AND IMPACT OF THE STUDY

Although the current accumulation of HupA by the endophyte is not very high, it could provide a promising alterative approach for large-scale production of HupA. However, further strain improvement and the fermentation process optimization are required to result in the consistent and dependable production.

A method for the non-invasive assessment of chest wall growth in pectus excavatum patients

INTRODUCTION

Various scales and measurement methods including X-rays and computed tomography (CT) have been used to quantify the degree of deformity in pectus excavatum. This study describes a non-invasive method for recording the deviation of the anterior chest wall (ACW) in pectus excavatum (PE) patients. Data obtained using this non-invasive method were compared with CT data.

MATERIALS AND METHODS

Twenty-one patients treated at our institutions between June 2008 and February 2009 were enrolled in this study. All patients underwent CT and thermal plastic strip measurement. A thermal plastic strip was positioned and taped to the supine patient's ACW at the skin level from the posterior axillary line, over the depressed sternum, to the contralateral posterior axillary line and used to create a casting of the ACW.

RESULTS

The funnel index (FI) was defined as the width of the ACW divided by its height; the concave index (CI) was defined as the breadth of the depressed area of the funnel chest divided by its depth. Pearson's correlation coefficient was used to compare the FI and CI obtained with the thermal plastic strip method and with CT; measurements obtained with both methods were found to correlate well (FI: r (2)=0.965; CI: r (2)=0.947).

CONCLUSIONS

The thermal plastic strip measurement method provides a two-dimensional record of the shape of the anterior chest wall. The measurement can be repeated, does not involve the patient being exposed to radiation, and offers a good longitudinal assessment of chest wall growth in PE patients.