Targeted omics analyses, and metabolic enzyme activity assays demonstrate maintenance of key mucociliary characteristics in long term cultures of reconstituted human airway epithelia

3D reconstituted respiratory epithelia have emerged as better in vitro models for toxicological testing compared to cell lines due to the conservation of key morphological features and functions. MucilAir™ is a commercially available human airway epithelia system that can potentially maintain functional attributes for up to a year, however, detailed mucociliary characteristics and xenobiotic metabolism relevant to inhaled pro-toxicant bioactivation is lacking. Here, we assessed in MucilAir™ some key biomarkers that are characteristic of the respiratory epithelia including morphology, function and xenobiotics metabolism. The end points that were measured included targeted proteomics using a panel of 243 airway surface liquid (ASL) proteins, cilia beat frequency (CBF), a qRT-PCR screen of xenobiotic metabolizing enzymes, and CYP2A6/13, CYP1A1/1B1 activity. Comparison of ASL proteomics with human sputum identified key proteins common to both matrices, but present at different levels. Xenobiotic metabolism gene profiling demonstrated strong similarities with the normal human lung and did not reveal any consistent changes when assessed over a 6 month period. Inducibility and activity of CYP1A1/1B1 and activity of CYP2A6/2A13 were present at one month in culture and maintained in one tested MucilAir™ donor for several months. In conclusion, MucilAir™ presented important morphological and metabolic characteristics of a mucociliary epithelium in short and long term culture. MucilAir™ is therefore a potentially useful model to test repeated sub-cytotoxic doses of toxicants.

Nicotine, cotinine, and b-nicotyrine inhibit NNK-induced DNA-strand break in the hepatic cell line HepaRG

Recent in vitro work using purified enzymes demonstrated that nicotine and/or a nicotine metabolite could inhibit CYPs (CYP2A6, 2A13, 2E1) involved in the metabolism of the genotoxic tobacco nitrosamine NNK. This observation raises the possibility of nicotine interaction with the mechanism of NNK bioactivation. Therefore, we hypothesized that nicotine or a nicotine metabolite such as cotinine might contribute to the inhibition of NNK-induced DNA strand breaks by interfering with CYP enzymes. The effect of nicotine and cotinine on DNA strand breaks was evaluated using the COMET assay in CYP competent HepaRG cells incubated with bioactive CYP-dependent NNK and CYP-independent NNKOAc (4-(acetoxymethylnitrosoamino)-1-(3-pyridyl)-1-butanone). We report a dose-dependent reduction in DNA damage in hepatic-derived cell lines in the presence of nicotine and cotinine. Those results are discussed in the context of the in vitro model selected.

A convergent stereocontrolled synthesis of [3-(14) C]solanesol

In this communication, we report the synthesis of ~5 mCi of [3-(14) C]solanesol (1) prepared from ethyl [3-(14) C]acetoacetate and (all-E)-octaprenyl bromide (2) in four steps, with a specific radioactivity of 19.83 mCi/mmol and with a chemical/stereochemical and radiochemical purity of ≥ 95%. (Figure ). Position 3 of the chain was selected for (14) C labelling because of the metabolic stability of this position. Unlabelled (all-E)-octaprenyl (18) (Scheme ) necessary for this work was prepared via a convergent iterative 'allyl-allyl' coupling approach of precursors easily derived from readily available inexpensive starting materials.(1)

Nicotine, cotinine, and β-nicotyrine inhibit NNK-induced DNA-strand break in the hepatic cell line HepaRG

Recent in vitro work using purified enzymes demonstrated that nicotine and/or a nicotine metabolite could inhibit CYPs (CYP2A6, 2A13, 2E1) involved in the metabolism of the genotoxic tobacco nitrosamine NNK. This observation raises the possibility of nicotine interaction with the mechanism of NNK bioactivation. Therefore, we hypothesized that nicotine or a nicotine metabolite such as cotinine might contribute to the inhibition of NNK-induced DNA strand breaks by interfering with CYP enzymes. The effect of nicotine and cotinine on DNA strand breaks was evaluated using the COMET assay in CYP competent HepaRG cells incubated with bioactive CYP-dependent NNK and CYP-independent NNKOAc (4-(acetoxymethylnitrosoamino)-1-(3-pyridyl)-1-butanone). We report a dose-dependent reduction in DNA damage in hepatic-derived cell lines in the presence of nicotine and cotinine. Those results are discussed in the context of the in vitro model selected.

Estimating remission from untreated major depression: a systematic review and meta-analysis

BACKGROUND

Few studies have examined spontaneous remission from major depression. This study investigated the proportion of prevalent cases of untreated major depression that will remit without treatment in a year, and whether remission rates vary by disorder severity.

METHOD

Wait-list controlled trials and observational cohort studies published up to 2010 with data describing remission from untreated depression at ≤ 2-year follow-up were identified. Remission was defined as rescinded diagnoses or below threshold scores on standardized symptom measures. Nineteen studies were included in a regression model predicting the probability of 12-month remission from untreated depression, using logit transformed remission proportion as the dependent variable. Covariates included age, gender, study type and diagnostic measure.

RESULTS

Wait-listed compared to primary-care samples, studies with longer follow-up duration and older adult compared to adult samples were associated with lower probability of remission. Child and adolescent samples were associated with higher probability of remission. Based on adult samples recruited from primary-care settings, the model estimated that 23% of prevalent cases of untreated depression will remit within 3 months, 32% within 6 months and 53% within 12 months.

CONCLUSIONS

It is undesirable to expect 100% treatment coverage for depression, given many will remit before access to services is feasible. Data were drawn from consenting wait-list and primary-care samples, which potentially over-represented mild-to-moderate cases of depression. Considering reported rates of spontaneous remission, a short untreated period seems defensible for this subpopulation, where judged appropriate by the clinician. Conclusions may not apply to individuals with more severe depression.

Indication of reactor ν(e) disappearance in the Double Chooz experiment

The Double Chooz experiment presents an indication of reactor electron antineutrino disappearance consistent with neutrino oscillations. An observed-to-predicted ratio of events of 0.944±0.016(stat)±0.040(syst) was obtained in 101 days of running at the Chooz nuclear power plant in France, with two 4.25 GW(th) reactors. The results were obtained from a single 10 m(3) fiducial volume detector located 1050 m from the two reactor cores. The reactor antineutrino flux prediction used the Bugey4 flux measurement after correction for differences in core composition. The deficit can be interpreted as an indication of a nonzero value of the still unmeasured neutrino mixing parameter sin(2)2θ(13). Analyzing both the rate of the prompt positrons and their energy spectrum, we find sin(2)2θ(13)=0.086±0.041(stat)±0.030(syst), or, at 90% C.L., 0.017<sin(2)2θ(13)<0.16.

Are we following the guiding SIGN when managing paediatric head injury?

BACKGROUND AND AIMS

The Scottish Intercollegiate Guidelines Network (SIGN) has published guidelines for the management of children with head injuries. The management of children with head injuries admitted to our local unit under the Paediatric Surgeons has been audited to determine whether or not current practice follows SIGN recommendations.

METHODS

Data were collected retrospectively from the case records of patients admitted between January and December 2007. The SIGN guideline 'Early Management of Patients with a Head Injury' (Guideline 46) was published in 2000 and updated in 2009 (Guideline 110). Head injury admission practices were audited against both guidelines.

RESULTS

The case records of 200 patients were analysed. According to SIGN Guideline 46 (2000), 146 Computed Tomography (CT) scans were indicated but only 24 were performed (16%). The updated Guideline 110 (2009) suggests a CT scan was indicated in 24 patients and should have been considered in a further 87. However, only 12 (50%) and 18 (21%) patients were imaged in these respective groups. Both guidelines indicated neurosurgical review in 13 patients but sought in only 4 (31%). 50 patients were deemed to have suffered a significant head injury warranting follow-up, but this was arranged in only 14 (28%).

CONCLUSIONS

Our study has identified that management of paediatric head injuries in our unit is reliant on clinical acumen rather than the SIGN guidelines when making decisions regarding the need for imaging, neurosurgical review and follow-up. We suggest further investigation is required to determine whether greater awareness and closer adherence with the guidelines would alter clinical outcomes.

Non-covalent inhibitors of rhinovirus 3C protease

The first known non-covalent inhibitors of rhinovirus 3C protease (3CP) have been identified through fragment based screening and hit identification activities.

Impact of critical care outreach on hematopoietic stem cell transplant recipients: a cohort study

Serious morbidity and mortality can occur after hematopoietic SCT (HSCT). Critical care outreach (CCO) can provide timely access to intensive care for hospitalized patients in need of urgent stabilization but has not been examined in HSCT. Rapid Assessment of Critical Events (RACE) team was introduced at our centre January 1, 2005. A retrospective cohort study was performed. Patients undergoing HSCT between January 1, 2000 and December 31, 2004 (n=520) formed the 'before' cohort and patients transplanted between January 1, 2005 and December 31, 2007 (n=294) formed the 'after' cohort. Non-relapse mortality at day 100 after transplant was not different in the two cohorts (26 (8.8%) post-RACE vs 53 (10.2%) pre-RACE, P=0.62). The number of failed organs at time of transfer to intensive care unit (ICU) was reduced in the post-RACE cohort (1.9 ± 0.8 vs 2.3 ± 1.0, P=0.04) and the incidence of cardiovascular failure was lower (23.8 vs 43.8%, P=0.04). Other secondary outcomes were not different, including the frequency of ICU admission. RACE may contribute to earlier stabilization during critical illness in patients undergoing HSCT but does not reduce non-relapse mortality. CCO should be studied prospectively in patients undergoing HSCT to better evaluate its role.

Consensus statement on the anticipation and prevention of acute postoperative pain: multidisciplinary RADAR approach

BACKGROUND

There has been considerable investment in efforts to improve postoperative pain management, including the introduction of acute pain teams. There have also been a number of guidelines published on postoperative pain management and there is widespread agreement on how pain should be practically managed. Despite these advances, there is no apparent improvement in the number of patients experiencing moderately severe or extreme pain after surgery. This highlights significant scope for improvement in acute postoperative pain management.

SCOPE

In January 2009, a multidisciplinary UK expert panel met to define and agree a practical framework to encourage implementation of the numerous guidelines and fundamentals of pain management at a local level. The panel recognised that to do this, there was a need to organise the information and guidelines into a simplified, accessible and easy-to-implement system based on their practical clinical experience. Given the volume of literature in this area, the Chair recommended that key international guidelines from professional bodies should be distributed and then reviewed during the meeting to form the basis of the framework. Consensus was reached by unanimous agreement of all ten participants.

FINDINGS

This report provides a framework for the key themes, including consensus recommendations based upon practical experience agreed during the meeting, with the aim of consolidating the key guidelines to provide a fundamental framework which is simple to teach and implement in all areas. Key priorities that emerged were: Responsibility, Anticipation, Discussion, Assessment and Response. This formed the basis of RADAR, a novel framework to help pain specialists educate the wider care team on understanding and prioritising the management of acute pain.

CONCLUSION

Acute postoperative pain can be more effectively managed if it is prioritised and anticipated by a well-informed care team who are educated with regard to appropriate analgesic options and understand what the long-term benefits of pain relief are. The principles of RADAR provide structure to help with training and implementation of good practice, to achieve effective postoperative pain management.

SmartChoice: An Online Recommender System to Support Low-Income Families in Public School Choice

Public school choice at the primary and secondary levels is a keyelement of the U.S. No Child Left Behind Act of 2001 (NCLB).  If aschool does not meet assessment goals for two consecutive years, bylaw the district must offer students the opportunity to transfer to aschool that is meeting its goals.  Making a choice with such potentialimpact on a child's future is clearly monumental, yet astonishinglyfew parents take advantage of the opportunity.  Our research has shownthat a significant part of the problem arises from issues ininformation access and information overload, particularly for lowsocioeconomic status families.  Thus we have developed an online,content-based recommender system, called SmartChoice.  Itprovides parents with school recommendations for individual studentsbased on parents' preferences and students' needs, interests,abilities, and talents.  The first version of the online applicationwas deployed and live for focus group participants who used it for theJanuary and March/April 2008 Charlotte-Mecklenburg school choiceperiods.  This article describes the SmartChoice Program and theresults of our initial and followup studies with participants.

An evaluation of techniques to control problem bird species on landfill sites

Birds feeding on landfill sites cause problems in terms of nuisance to neighbors, flight safety, a threat to public health, and affecting the day to day site operation. A number of control measures exist to deter problem species; however, research into their effectiveness across sites and for multiple species has been limited. We use a modeling approach in order to assess the effectiveness of nine techniques--pyrotechnics, hand-held distress calls, static distress calls, blank ammunition, a combination of blank and lethal use of ammunition, the use of falcons, the use of hawks, wailers and helium-filled bird-scaring kites --at deterring three commonly recorded species--the Black-headed Gull (Larus ridibundus), the Herring Gull (Larus argentatus) and the Lesser Black-backed Gull (Larus fuscus)--from six landfill sites across the United Kingdom. The use of distress calls, falconry, and combinations of lethal and nonlethal use of ammunition were the most effective techniques for initially deterring birds from these sites. However, when habituation is considered, there is a clear difference between techniques such as falconry, which have a lethal aspect and may act to reinforce the deterrence, and the use of techniques such as distress calls, which do not. However there are problems related to legislation and public perception when lethal techniques are used.

Rapid analysis of coumarins using surface plasmon resonance

Coumarin molecules are ubiquitous in nature. Several have come to prominence as potential clinical therapeutic candidates. The principal example is warfarin, which is a very widely prescribed anticoagulant. Other coumarin derivatives, such as aflatoxin B1, are insidious contaminants in crop-derived foodstuffs. Extreme potency is a common feature of all biochemically active coumarins and, thus reliable methods for their rapid and sensitive detection are of paramount importance. Accordingly, this review examines the current methods used in the analysis of these molecules and compares them with immunoassay-based strategies. As a case study, we report on our experiences with using coumarin-specific polyclonal, monoclonal, and recombinant antibodies in conjunction with a surface plasmon resonance-based biosensor for analysis of coumarins. We chart the assay development process and demonstrate high sensitivity and reproducibility that compares favorably with established methodologies.

Hit-to-Lead studies: The discovery of potent, orally bioavailable thiazolopyrimidine CXCR2 receptor antagonists

A Hit-to-Lead optimisation programme was carried out on a high throughput screening hit, the thiazolopyrimidine 1, resulting in the discovery of the potent, orally bioavailable CXCR2 antagonist 29.

Posttraumatic stress disorder and the intensive care unit patient: implications for staff and advanced practice critical care nurses

Posttraumatic Stress Disorder (PTSD) is a rather common psychiatric diagnosis, and potentially is a very debilitating disorder. In PTSD, patients exhibit specific debilitating symptoms in response to exposure to an extreme stressor. Conditions in the intensive care unit (ICU) can exacerbate previously diagnosed newly developed PTSD, and in some cases cause PTSD. This diagnosis potentially puts both the patient and nursing staff at increased risk for harm, and is associated with increased utilization of medical services. Critical care staff and APNs can take actions to screen for at-risk patients, emplace safety protocols, and advocate for affected patients within the healthcare team.

Novel P2X7 receptor antagonists

The synthesis and pharmacological evaluation of a new series of potent P2X(7) receptor antagonists is disclosed. The compounds inhibit BzATP-mediated pore formation in THP-1 cells. The distribution of the P2X(7) receptor in inflammatory cells, most notably the macrophage, mast cell and lymphocyte, suggests that P2X(7) antagonists have a significant role to play in the treatment of inflammatory disease.