Urban and rural variation in walking patterns and pedestrian crashes

OBJECTIVE

To examine the urban and rural variation in walking patterns and pedestrian crashes.

DESIGN

The rates of pedestrians being struck by motor vehicles was estimated according to miles walked and resident years.

SETTING

New York State, USA during 2001 through 2002.

PARTICIPANTS

35 732 pedestrians struck by vehicles.

MAIN OUTCOME MEASURES

The adjusted rate ratio (aRR) of pedestrian-vehicle crash and pedestrian injury based on resident years and miles walked according to urban and rural areas.

RESULTS

Compared with rural areas, the aRR for a pedestrian-vehicle collision, based on resident years, was 2.0 (95% CI 1.7 to 2.3) in small urban areas, 1.8 (95% CI 1.5 to 2.3) in mid-size urban areas, and 4.2 (95% CI 3.6 to 4.8) in the large urban area. The aRR based on miles walked was 2.3 (95% CI 1.6 to 3.2) in small urban areas, 2.0 (95% CI 1.4 to 2.9) in mid-size urban areas, and 1.9 (95% CI 1.4 to 2.7) in the large area. The aRR for a fatal pedestrian injury, based on miles walked, was 2.1 (95% CI 1.3 to 3.6) in small urban areas, 1.9 (95% CI 1.3 to 2.9) in mid-size urban areas, and 0.9 (95% CI 0.6 to 1.3) in the large urban area.

CONCLUSIONS

The rate of pedestrian crashes and injuries in small and mid-size urban areas was twice that in rural areas, whether based on resident years or miles walked. The high rate of pedestrian crashes in the large urban area based on resident years could be partly explained by the fact that residents in such areas walk about twice as much as residents in rural areas. The rate of fatal pedestrian injury based on miles walked was similar in the large urban area and rural areas.

Vasorelaxing action of vasonatrin peptide is associated with activation of large-conductance Ca(2+)-activated potassium channels in vascular smooth muscle cells

The aim of this study was to test the hypothesis that vasorelaxing action of vasonatrin peptide (VNP) is due to activation of the large-conductance Ca(2+)-activated potassium channel (BK(Ca)) via guanylyl cyclase (GC)-coupled natriuretic peptide receptors (NPRs) in vascular smooth muscle cells (VSMCs). Contraction experiments were performed using human radial artery, whereas BK(Ca) current by patch clamp was recorded in cells from rat mesenteric artery. Contractility of rings cut from human radial artery was detected in vitro. As a result, VNP induced a dose-dependent vasorelaxation of human radial artery, which could be mimicked by 8-Br-cGMP, and suppressed by TEA, a blocker of BK(Ca), HS-142-1, a blocker of GC-coupled NPRs, or methylene blue (MB), a selective inhibitor of guanylyl cyclase. Sequentially, whole-cell K(+) currents were recorded using patch clamp techniques. BK(Ca) current of VSMCs isolated from rat mesentery artery was obtained by subtracting the whole cell currents after applications of 10(-7) mol/l iberiotoxin (IBX) from before its applications. In accordance with the results of arterial tension detection, BK(Ca) current was significantly magnified by VNP, which could also be mimicked by 8-Br-cGMP, whereas suppressed by HS-142-1, or MB. Taken together, VNP acts as a potent vasodilator, and NPRA/B-cGMP-BK(Ca) is one possible signaling system involved in VNP induced relaxation.

Sensorized waste collection container for content estimation and collection optimization

The concurrent effects of a fast national growth rate, of a large and dense residential area and a pressing demand for urban environmental protection create a challenging framework for waste management in Pudong New Area, Shanghai. The complexity of context and procedures is indeed a primary concern of local municipal authorities due to problems related to the collection, transportation and processing of residential solid waste. In order to design and implement a suitable urban solid waste system, the first task is to forecast the quantity and variance of solid waste as it relates to residential population, consumer index, season, etc. The system here discussed addresses exactly these issues, by means of an intelligent, sensorized container. The container has been prepared and tested in the Pudong New Area, Shanghai.

Improved calibration technique for in vivo proton MRS thermometry for brain temperature measurement

The most common MR-based approach to noninvasively measure brain temperature relies on the linear relationship between the (1)H MR resonance frequency of tissue water and the tissue's temperature. Herein we provide the most accurate in vivo assessment existing thus far of such a relationship. It was derived by acquiring in vivo MR spectra from a rat brain using a high field (11.74 Tesla [T]) MRI scanner and a single-voxel MR spectroscopy technique based on a LASER pulse sequence. Data were analyzed using three different methods to estimate the (1)H resonance frequencies of water and the metabolites NAA, Cho, and Cr, which are used as temperature-independent internal (frequency) references. Standard modeling of frequency-domain data as composed of resonances characterized by Lorentzian line shapes gave the tightest resonance-frequency versus temperature correlation. An analysis of the uncertainty in temperature estimation has shown that the major limiting factor is an error in estimating the metabolite frequency. For example, for a metabolite resonance linewidth of 8 Hz, signal sampling rate of 2 Hz and SNR of 5, an accuracy of approximately 0.5 degrees C can be achieved at a magnetic field of 3T. For comparison, in the current study conducted at 11.74T, the temperature estimation error was approximately 0.1 degrees C.

Thyrotoxicosis and acute abdomen--still as defying and misunderstood today? Brief observations over the recent decade

BACKGROUND

Clinicians managing thyrotoxic patients with acute abdomen face challenging diagnostic and risky therapeutic dilemmas.

AIM

To analyse the frequency of medical vs. surgical acute abdomen, and to characterize the poorly understood thyrotoxic medical acute abdomen phenomenon.

DESIGN

Retrospective review of case notes.

METHODS

All case files with a simultaneous diagnosis of thyrotoxicosis and acute abdomen admitted between 1994 and 2004 were traced and audited.

RESULTS

Thirteen had a history of thyrotoxicosis while 12 were newly diagnosed. The commonest cause was Graves' disease. Twenty-three (92%) cases were thyrotoxic, of whom six (24%) had thyroid crisis, while two (8%) had subclinical thyrotoxicosis. The provisional diagnosis of acute abdomen was correct in 14 cases (56%), but discordant with the final diagnosis in 11 cases (44%). Eight cases (32%) without any demonstrable pathology were medical, vs. four (16%) with surgical acute abdomen, while 11(44%) had gastritis, hepatobiliary-pancreatic disorders or diverticulitis conservatively managed. The epigastrium and/or central abdomen (72.7%) were the commonest affected regions in medical acute abdomen.

CONCLUSION

Although the majority of acute abdomen in thyrotoxicosis was medical in nature, our experience indicates that surgical conditions were not uncommon. Thus, serious causes requiring life-saving surgery should be excluded before attributing it to medical acute abdomen.

Patterns of expression and function of the p75(NGFR) protein in pancreatic cancer cells and tumours

BACKGROUNDS/AIMS

Pancreatic carcinoma is one of the most aggressive human malignancies. The aggressive and highly metastatic behaviour of pancreatic carcinoma may partly be attributable to the autocrine and/or paracrine interactions involving altered expression of neurotrophin growth factors and their corresponding receptors. The aim of the present study is to investigate the expression pattern and function of the p75(NGFR) protein in pancreatic cancer cell lines and tumours to explain the phenomenon of perineural invasion in pancreatic cancer.

METHODS

The expression of p75(NGFR) in 137 pancreatic adenocarcinoma samples and the corresponding adjacent pancreatic samples was examined immunohistochemically using the EnVision Plus System. Then we examined the in vitro chemotaxis behaviour of cancer cells transfected with p75(NGFR) plasmid to nerve growth factor (NGF).

RESULTS

Immunostaining for p75(NGFR) was weak or absent in both normal pancreata and pancreatic carcinoma tissues; however, the immunostaining was relatively weaker in the pancreatic carcinoma tissues than in the normal pancreata. It is interesting to note that p75(NGFR) expression in the cancer tissues was positively correlated with the degree of perineural invasion (chi(2)=32.94, P<0.01). The chemotaxis ability of the p75(NGFR)-transfected pancreatic cancer cells to NGF was significantly stronger than that of the non-transfected or vacant vector transfected cells (P<0.01).

CONCLUSIONS

Our findings indicate that p75(NGFR) expression may be involved in the perineural invasion of pancreatic cancer cells, and the mechanism might be through mediating the chemoattraction of cancer cells for neural tissues.

Heterogeneity of kinase inhibitor resistance mechanisms in GIST

Most GIST patients develop clinical resistance to KIT/PDGFRA tyrosine kinase inhibitors (TKI). However, it is unclear whether clinical resistance results from single or multiple molecular mechanisms in each patient. KIT and PDGFRA mutations were evaluated in 53 GIST metastases obtained from 14 patients who underwent surgical debulking after progression on imatinib or sunitinib. To interrogate possible resistance mechanisms across a broad biological spectrum of GISTs, inter- and intra-lesional heterogeneity of molecular drug-resistance mechanisms were evaluated in the following: conventional KIT (CD117)-positive GISTs with KIT mutations in exon 9, 11 or 13; KIT-negative GISTs; GISTs with unusual morphology; and KIT/PDGFRA wild-type GISTs. Genomic KIT and PDGFRA mutations were characterized systematically, using complementary techniques including D-HPLC for KIT exons 9, 11-18 and PDGFRA exons 12, 14, 18, and mutation-specific PCR (V654A, D820G, N822K, Y823D). Primary KIT oncogenic mutations were found in 11/14 patients (79%). Of these, 9/11 (83%), had secondary drug-resistant KIT mutations, including six (67%) with two to five different secondary mutations in separate metastases, and three (34%) with two secondary KIT mutations in the same metastasis. The secondary mutations clustered in the KIT ATP binding pocket and kinase catalytic regions. FISH analyses revealed KIT amplicons in 2/10 metastases lacking secondary KIT mutations. This study demonstrates extensive intra- and inter-lesional heterogeneity of resistance mutations and gene amplification in patients with clinically progressing GIST. KIT kinase resistance mutations were not found in KIT/PDGFRA wild-type GISTs or in KIT-mutant GISTs showing unusual morphology and/or loss of KIT expression by IHC, indicating that resistance mechanisms are fundamentally different in these tumours. Our observations underscore the heterogeneity of clinical TKI resistance, and highlight the therapeutic challenges involved in salvaging patients after clinical progression on TKI monotherapies.

Heterogeneity of kinase inhibitor resistance mechanisms in GIST

Most GIST patients develop clinical resistance to KIT/PDGFRA tyrosine kinase inhibitors (TKI). However, it is unclear whether clinical resistance results from single or multiple molecular mechanisms in each patient. KIT and PDGFRA mutations were evaluated in 53 GIST metastases obtained from 14 patients who underwent surgical debulking after progression on imatinib or sunitinib. To interrogate possible resistance mechanisms across a broad biological spectrum of GISTs, inter- and intra-lesional heterogeneity of molecular drug-resistance mechanisms were evaluated in the following: conventional KIT (CD117)-positive GISTs with KIT mutations in exon 9, 11 or 13; KIT-negative GISTs; GISTs with unusual morphology; and KIT/PDGFRA wild-type GISTs. Genomic KIT and PDGFRA mutations were characterized systematically, using complementary techniques including D-HPLC for KIT exons 9, 11-18 and PDGFRA exons 12, 14, 18, and mutation-specific PCR (V654A, D820G, N822K, Y823D). Primary KIT oncogenic mutations were found in 11/14 patients (79%). Of these, 9/11 (83%), had secondary drug-resistant KIT mutations, including six (67%) with two to five different secondary mutations in separate metastases, and three (34%) with two secondary KIT mutations in the same metastasis. The secondary mutations clustered in the KIT ATP binding pocket and kinase catalytic regions. FISH analyses revealed KIT amplicons in 2/10 metastases lacking secondary KIT mutations. This study demonstrates extensive intra- and inter-lesional heterogeneity of resistance mutations and gene amplification in patients with clinically progressing GIST. KIT kinase resistance mutations were not found in KIT/PDGFRA wild-type GISTs or in KIT-mutant GISTs showing unusual morphology and/or loss of KIT expression by IHC, indicating that resistance mechanisms are fundamentally different in these tumours. Our observations underscore the heterogeneity of clinical TKI resistance, and highlight the therapeutic challenges involved in salvaging patients after clinical progression on TKI monotherapies.

An endogenous regulator of inflammation, resolvin E1, modulates osteoclast differentiation and bone resorption

BACKGROUND AND PURPOSE

The inflammation-resolving lipid mediator resolvin E1 (RvE1) effectively stops inflammation-induced bone loss in vivo in experimental periodontitis. It was of interest to determine whether RvE1 has direct actions on osteoclast (OC) development and bone resorption.

EXPERIMENTAL APPROACH

Primary OC cultures derived from mouse bone marrow were treated with RvE1 and analysed for OC differentiation, cell survival and bone substrate resorption. Receptor binding was measured using radiolabelled RvE1. Nuclear factor (NF)-kappaB activation and Akt phosphorylation were determined with western blotting. Lipid mediator production was assessed with liquid chromatography tandem mass spectrometry.

KEY RESULTS

OC growth and resorption pit formation were markedly decreased in the presence of RvE1. OC differentiation was inhibited by RvE1 as demonstrated by decreased number of multinuclear OC, a delay in the time course of OC development and attenuation of receptor activator of NF-kappaB ligand-induced nuclear translocation of the p50 subunit of NF-kappaB. OC survival and apoptosis were not altered by RvE1. Messenger RNA for both receptors of RvE1, ChemR23 and BLT(1) is expressed in OC cultures. Leukotriene B(4) (LTB(4)) competed with [(3)H]RvE1 binding on OC cell membrane preparations, and the LTB(4) antagonist U75302 prevented RvE1 inhibition of OC growth, indicating that BLT(1) mediates RvE1 actions on OC. Primary OC synthesized the RvE1 precursor 18R-hydroxy-eicosapentaenoic acid and LTB(4). Co-incubation of OC with peripheral blood neutrophils resulted in transcellular RvE1 biosynthesis.

CONCLUSIONS AND IMPLICATIONS

These results indicate that RvE1 inhibits OC growth and bone resorption by interfering with OC differentiation. The bone-sparing actions of RvE1 are in addition to inflammation resolution, a direct action in bone remodelling.

Acquisition of conditioned taste aversion is impaired in the amyloid precursor protein/presenilin 1 mouse model of Alzheimer's disease

Research into the underlying mechanisms of cognitive dysfunction in Alzheimer's disease (AD) has relied traditionally on tasks such as the water maze which evaluate spatial learning and memory. Since non-spatial forms of memory are also disrupted by AD, it is critical to establish other paradigms capable of investigating these deficits. Utilizing a non-spatial learning task, acquisition of conditioned taste aversion (CTA) was evaluated in a mouse model of AD. This line of transgenic mice encode a mutated allele of the human amyloid precursor protein (APP) and presenilin 1 (PS1) genes and exhibit extensive amyloid plaque deposition in the brain by 6-7 mo of age. Compared with wild-type mice, 10-17 month old APP/PS1 mice failed to acquire CTA to saccharin. Mice that only possessed one of the two mutations were able to acquire CTA to the saccharin. In 2-5 month old APP/PS1 mice acquisition of CTA was disrupted despite the lack of extensive plaque deposition. However, further analysis indicated a potential gender difference in both the CTA deficit and onset of plaque deposition with females showing greater conditioned aversion.

Tamoxifen-inducible Cre-recombination in articular chondrocytes of adult Col2a1-CreER(T2) transgenic mice

OBJECTIVE

To determine the specificity and efficiency of the tamoxifen (TM)-induced Cre-recombination in articular chondrocytes of adult Col2a1-CreER(T2) transgenic mice.

METHODS

Col2a1-CreER(T2) transgenic mice were bred with Rosa26 reporter mice. Two-week-old Col2a1-CreER(T2);R26R mice were administered TM for 5 days and were sacrificed 1 and 6 months after TM induction. X-Gal staining was performed.

RESULTS

Efficient Cre-recombination is achieved in adult articular chondrocytes 1 and 6 months after TM induction.

CONCLUSION

Our findings demonstrate that the Col2a1-CreER(T2) transgenic mouse model is a valuable tool to target genes specifically expressed in articular chondrocytes in a temporally controlled manner in adult mice.

Chronic but not acute treatment with caffeine attenuates traumatic brain injury in the mouse cortical impact model

Caffeine, the most consumed psychoactive drug and non-specific adenosine receptor antagonist, has recently been shown to exert a neuroprotective effect against brain injury in animal models of Parkinson's disease (PD) and stroke. However, the effects of caffeine on traumatic brain injury (TBI) are not known. In this study, we investigated the effects of acute and chronic caffeine treatment on brain injury in a cortical-impact model of TBI in mice. Following TBI, neurological deficits, cerebral edema, as well as inflammatory cell infiltration were all significantly attenuated in mice pretreated chronically (for 3 weeks) with caffeine in drinking water compared with the mice pretreated with saline. Furthermore, we found that chronic caffeine treatment attenuated glutamate release and inflammatory cytokine production, effects that were correlated with an upregulation of brain A1 receptor mRNA. By contrast, acute treatment with caffeine (i.p. injection, 30 min before TBI) was not effective in protecting against TBI-induced brain injury. These results suggest that chronic (but not acute) caffeine treatment attenuates brain injury, possibly by A1 receptor-mediated suppression of glutamate release and inhibition of excessive inflammatory cytokine production. These results highlight the potential benefit of chronic caffeine intake for preventing TBI and provide a rationale for the epidemiological investigation of the potential association between TBI and human caffeine intake.