First Report of Okra yellow mosaic Mexico virus in Okra in the United States

During the okra growing season from August to November of 2009, symptoms reminiscent of geminivirus infection were observed on 75% of 'Green Emerald' Abelmoschus esculentus (L.) Moench, plants in a 0.2-km² field in Hidalgo County, TX. Visible symptoms consisted of irregular yellow patches on leaves, distinctive yellow borders on leaf edges, and chlorosis of subsequently developing leaves. The whitefly vector of begomoviruses, Bemisia tabaci (Genn.), infested okra plants in the early growth stages during late July 2009. Total DNA was isolated from the leaves of three symptomatic okra plant samples (1) and used as the PCR template to amplify a 575-bp fragment of the coat protein gene (CP) using the universal begomovirus primers AV494 and AC1048 (2). PCR products of the expected size were cloned into the pGEM-T Easy (Promega, Madison, WI) and sequenced using the universal M13F and M13 R primers. ClustalV alignment indicated 99 to 100% shared nucleotide (nt) identity, and BLAST analysis revealed that the closest relative was Okra yellow mosaic Mexico virus - Tetekalitla (OkYMMV) (GenBank Accession No. EF591631) at 98%. To amplify the full-length DNA-A and a possible cognate DNA-B component, one plant that was positive by CP-PCR and DNA sequencing was selected for further analysis. Total DNA from this plant was used as template for a second detection method that consisted of rolling circle amplification (RCA) using the TempliPhi 100 Amplification System (GE Healthcare). RCA is a non-sequence-specific approach that permits amplification of circular DNA. The RCA products were linearized to release unit length ~2.6 kb DNA-A and DNA-B components using BamHI, and EcoRI, respectively. These products were cloned into pGEM3zf+ (Promega) and sequenced using M13F and M13 R primers and then by primer walking (>300 base overlap). Full-length DNA-A and DNA-B components were obtained, respectively, at 2,613 bp (GenBank Accession No. HM035059) and 2,594 bp (GenBank Accession No HM035060). Alignment of the DNA-A component using ClustalV (MegAlign, DNASTAR, Madison, WI) with begomoviral sequences available in GenBank indicated that it was 99% identical to OkYMMV DNA-A (GenBank Accession No. DQ022611). The closest relative to the DNA-B component (ClustalV) was Sida golden mosaic virus (SiGMV) (GenBank Accession No. AJ250731) at 73%. The nt identity of the 172-nt 'common region' present in the DNA-A and DNA-B components was 99%, and the iterons (predicted Rep binding motif) were identical for the two components, indicating that they are a cognate pair. The genome organization was typical of other New World bipartite begomoviruses. The economic losses due to infection by this virus could not be determined because an early freeze killed the plants. Hidalgo County is adjacent to Tamaulipas, Mexico, where ~50 km² of okra are grown and the whitefly vector is also present. The identification of OkYMMV based on two independent detection methods, and the presence of begomovirus-like symptoms together with the whitefly vector, provide robust evidence for the association of OkYMMV-TX with diseased okra plants. To our knowledge, this is the first report of OkYMMV-TX infecting okra crops in Texas and in the continental United States. References: (1) J. J. Doyle and J. L. Doyle. Focus 12:13, 1990. (2) S. Wyatt and J. K. Brown. Phytopathology 86:1288, 1996.

A double-blind randomized vehicle-controlled clinical trial investigating the effect of ZnPTO dose on the scalp vs. antidandruff efficacy and antimycotic activity

Dandruff is a common problem in approximately 30% of the world's population. Reports in the literature regarding treatment of this condition with various antidandruff shampoos usually report the level of active ingredient within the formulation. However, we propose that a more important parameter relating to antidandruff efficacy is the amount of active ingredient delivered to the scalp from the shampoo. This report describes the results from two studies designed to investigate the relationship between the level of zinc pyrithione (ZnPTO) deposited onto the scalp and the resultant scalp condition. A double-blind randomized vehicle-controlled clinical study comparing three shampoos - a vehicle, a low-depositing ZnPTO shampoo and a high-depositing ZnPTO shampoo - was carried out in the U.K. with 53 panelists with dandruff or mild-to-moderate seborrheic dermatitis of the scalp. Both shampoos containing ZnPTO were significantly superior in antidandruff efficacy to the vehicle. Furthermore, the high-depositing ZnPTO shampoo was significantly superior compared with the low-depositing ZnPTO shampoo in terms of both antidandruff efficacy and antimycotic activity. Antidandruff performance and antimycotic activity of ZnPTO-containing shampoos is highly dependent on the amount of active ingredient delivered to the scalp. Furthermore, careful manipulation of the formulation parameters of an antidandruff shampoo can result in enhanced levels of delivery of the active ingredient without having to increase the level of active ingredient within the formulation.

Tongue swelling complicating management of a ventilated patient with acute respiratory distress syndrome secondary to novel influenza A (H1N1)

The recently emerged novel influenza A H1N1 virus continues to spread globally. The use of oseltamivir for treatment and prophylaxis of infection is recommended and its use has climbed steeply although there is little data available on its benefit in critically unwell patients with H1N1 influenza. A rare side-effect of oseltamivir treatment reported in post-marketing surveillance is tongue and lip swelling/angioedema. This case report describes the management of a critically ill ventilated patient with severe acute respiratory distress syndrome who developed clinically significant tongue and lip swelling during treatment with oseltamivir.

Livestock waste treatment systems for reducing environmental exposure to hazardous enteric pathogens: some considerations

Intensive livestock production systems produce significant quantities of excreted material that must be managed to protect water, air, and crop quality. Many jurisdictions mandate how livestock wastes are managed to protect adjacent water quality from microbial and chemical contaminants that pose an environmental and human health challenge. Here, we consider innovative livestock waste treatment systems in the context of multi-barrier strategies for protecting water quality from agricultural contamination. Specifically, we consider some aspects of how enteric bacterial populations can evolve during manure storage, how their fate following land application of manure can vary according to manure composition, and finally the challenge of distinguishing enteric pathogens of agricultural provenance from those of other sources of fecal pollution at a policy-relevant watershed scale. The beneficial impacts of livestock waste treatment on risk to humans via exposure to manured land are illustrated using quantitative microbial risk assessment (QMRA) scenarios. Overall, innovative livestock treatment systems offer a crucially important strategy for making livestock wastes more benign before they are released into the broader environment.

Staging 18FDG-PET in newly diagnosed small cell lung cancer (SCLC): 15-year institutional experience

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Background: 18FDG-PET is not routinely used in the initial staging of SCLC despite evidence that it alters stage classification and management. Furthermore, the association between stage classification by PET and prognosis of newly diagnosed SCLC has not previously been directly assessed. We aimed to evaluate whether PET altered stage classification, management and prognosis when used to stage newly diagnosed SCLC. Methods: We retrospectively reviewed the medical records of 46 consecutive patients undergoing PET during initial staging for SCLC at Austin Health from 1993 to 2008 inclusive. Data collected included patient demographics, stage classification before and after PET, treatment history and date of death. Statistical analysis included estimation of overall survival (OS) by the Kaplan-Meier method using the log-rank test. Results: PET altered stage classification in 12 of 46 (26%) of patients. Stage alteration led to a change in treatment modality in 9 of these 12 patients. In addition, PET altered the target radiation field in another three patients. Therefore, PET had a significant impact on management in 12 of 46 (26%) of patients. Patients with limited disease (LD) on both conventional imaging and PET had significantly longer OS than patients with LD on conventional imaging that was upstaged to extensive disease (ED) on PET (median 557 days versus 172 days; log-rank p<0.0001). Patients with ED on conventional imaging that was downstaged to LD on PET had significantly longer OS than patients with ED on both conventional imaging and PET (median 328 days versus 177 days; log-rank p=0.037). Conclusions: The use of 18FDG-PET during staging for SCLC had a major impact on stage classification, management and prognostic stratification. The use of staging PET should be considered in patients with newly diagnosed SCLC.

No significant financial relationships to disclose.

Mechanotherapy: how physical therapists' prescription of exercise promotes tissue repair

Mechanotransduction is the physiological process where cells sense and respond to mechanical loads. This paper reclaims the term “mechanotherapy” and presents the current scientific knowledge underpinning how load may be used therapeutically to stimulate tissue repair and remodelling in tendon, muscle, cartilage and bone.

The purpose of this short article is to answer a frequently asked question “How precisely does exercise promote tissue healing?” This is a fundamental question for clinicians who prescribe exercise for tendinopathies, muscle tears, non-inflammatory arthropathies and even controlled loading after fractures. High-quality randomised controlled trials and systematic reviews show that various forms of exercise or movement prescription benefit patients with a wide range of musculoskeletal problems.1^–4 But what happens at the tissue level to promote repair and remodelling of tendon, muscle, articular cartilage and bone?

The one-word answer is “mechanotransduction”, but rather than finishing there and limiting this paper to 95 words, we provide a short illustrated introduction to this remarkable, ubiquitous, non-neural, physiological process. We also re-introduce the term “mechanotherapy” to distinguish therapeutics (exercise prescription specifically to treat injuries) from the homeostatic role of mechanotransduction. Strictly speaking, mechanotransduction maintains normal musculoskeletal structures in the absence of injury. After first outlining the process of mechanotransduction, we provide well-known clinical therapeutic examples of mechanotherapy–turning movement into tissue healing.

Changing clinicians' behavior: a randomized controlled trial of fees and education

The fissure-sealing of newly erupted molars is an effective caries prevention treatment, but remains underutilized. Two plausible reasons are the financial disincentive produced by the dental remuneration system, and dentists' lack of awareness of evidence-based practice. The primary hypothesis was that implementation strategies based on remuneration or training in evidence-based healthcare would produce a higher proportion of children receiving sealed second permanent molars than standard care. The four study arms were: fee per sealant treatment, education in evidence-based practice, fee plus education, and control. A cost-effectiveness analysis was conducted. Analysis was based on 133 dentists and 2833 children. After adjustment for baseline differences, the primary outcome was 9.8% higher when a fee was offered. The education intervention had no statistically significant effect. 'Fee only' was the most cost-effective intervention. The study contributes to the incentives in health care provision debate, and led to the introduction of a direct fee for this treatment.

Breakdown limits on Gigavolt-per-meter electron-beam-driven wakefields in dielectric structures

First measurements of the breakdown threshold in a dielectric subjected to GV/m wakefields produced by short (30-330 fs), 28.5 GeV electron bunches have been made. Fused silica tubes of 100 microm inner diameter were exposed to a range of bunch lengths, allowing surface dielectric fields up to 27 GV/m to be generated. The onset of breakdown, detected through light emission from the tube ends, is observed to occur when the peak electric field at the dielectric surface reaches 13.8+/-0.7 GV/m. The correlation of structure damage to beam-induced breakdown is established using an array of postexposure inspection techniques.

Increased mast cell numbers in human patellar tendinosis: correlation with symptom duration and vascular hyperplasia

OBJECTIVES

The cellular basis of painful tendon overuse pathology (tendinosis) is poorly understood. It has been suggested that because of the close anatomical associations between mast cells and vessels in connective tissues, mast cells may mediate the development of tendon hypervascularity or oedema.

OBJECTIVES

To examine the distribution of mast cells in men and women with patellar tendinopathy.

DESIGN

Case-control study.

METHODS

Tendinopathic tissue was collected at open debridement of the patellar tendon and a control tendon from patients undergoing intramedullary nailing of the tibia. The tendon was assessed immunohistochemically by evaluating the distribution of mast cells (AA1), and markers for T lymphocytes (CD3) and macrophages (CD68). The vessel-area fraction was quantified using computer-assisted digital image analysis.

RESULTS

The prevalence of mast cells per mm(2) (mean 3.3 (SD 3.0)) was greater in tendinosis tissue than in controls (1.1 (1.5); p = 0.036). In patients with tendinosis, mast cell density was moderately correlated with the vessel-area fraction (r(2) = 0.49) and with symptom duration (r(2) = 0.52).

CONCLUSION

Mast-cell prevalence in patellar tendinopathy was increased and was predominantly associated with vascular hyperplasia, particularly in patients with longstanding symptoms. Future research should investigate whether mast cells play direct or indirect modulatory roles in the development and progression of human tendinosis.

Fresnel diffraction effects in Fourier-transform arrayed waveguide grating spectrometer

We present an analysis of Fourier-transform arrayed waveguide gratings in the Fresnel diffraction regime. We report a distinct spatial modulation of the interference pattern referred to as the Moiré-Talbot effect. The effect and its influence in a FT AWG device is explained by deriving an original analytical expression for the modulated field, and is also confirmed by numerical simulations using the angular spectrum method to solve the Fresnel diffraction integral. We illustrate the retrieval of spectral information in a waveguide Fourier-transform spectrometer in the presence of the Moiré-Talbot effect. The simulated device comprises two interleaved waveguide arrays each with 180 waveguides and the interference order of 40. It is designed with a Rayleigh spectral resolution of 0.1 nm and 8 nm bandwidth at wavelength lambda approximately 1.5 mum. We also demonstrate by numerical simulations that the spectrometer crosstalk is reduced from -20 dB to -40 dB by Gaussian apodization.

Increased versican content is associated with tendinosis pathology in the patellar tendon of athletes with jumper's knee

Expansion of the extracellular matrix is a prominent but poorly characterized feature of tendinosis. The present study aimed to characterize the extent and distribution of the large aggregating proteoglycan versican in patients with patellar tendinosis. We obtained tendon from tendinopathy patients undergoing debridement of the patellar tendon and from controls undergoing intramedullary tibial nailing. Versican content was investigated by Western blotting and immunohistochemistry. Microvessel thickness and density were determined using computer-assisted image analysis. Markers for smooth muscle actin, endothelial cells (CD31) and proliferating cells (Ki67) were examined immunohistochemically. Western blot analysis and immunohistochemical staining revealed elevated versican content in the proximal patellar tendon of tendinosis patients (P=0.042). Versican content was enriched in regions of fibrocartilage metaplasia and fibroblast proliferation, as well as in the perivascular matrix of proliferating microvessels and within the media and intima of arterioles. Microvessel density was higher in tendinosis tissue compared with control tissue. Versican deposition is a prominent feature of patellar tendinosis. Because this molecule is not only a component of normal fibrocartilagenous matrices but also implicated in a variety of soft tissue pathologies, future studies should further detail both pathological and adaptive roles of versican in tendons.

Portable home hemodialysis for kidney failure

(1) Home hemodialysis has been in limited use in Canada for some time. Newer, portable hemodialysis machines that are easier for patients to operate may encourage the uptake of this technology. (2) One portable system is already available in the US. The NxStage System One hemodialysis machine operates on standard electric current, does not require plumbing or specialized disinfection, and is small enough for patients to travel with. (3) It is not yet clear whether the use of the NxStage system improves long-term survival and quality of life. (4) Home hemodialysis is less costly than conventional in-centre programs, but it is unknown whether these savings extend to portable devices.

Positive replication and linkage disequilibrium mapping of the chromosome 21q22.1 malaria susceptibility locus

Four cytokine receptor genes are located on Chr21q22.11, encoding the alpha and beta subunits of the interferon-alpha receptor (IFNAR1 and IFNAR2), the beta subunit of the interleukin 10 receptor (IL10RB) and the second subunit of the interferon-gamma receptor (IFNGR2). We previously reported that two variants in IFNAR1 were associated with susceptibility to malaria in Gambians. We now present an extensive fine-scale mapping of the associated region utilizing 45 additional genetic markers obtained from public databases and by sequencing a 44 kb region in and around the IFNAR1 gene in 24 Gambian children (12 cases/12 controls). Within the IFNAR1 gene, a newly studied C --> G single-nucleotide polymorphism (IFNAR1 272354c-g) at position -576 relative to the transcription start was found to be more strongly associated with susceptibility to severe malaria. Association was observed in three populations: in Gambian (P=0.002), Kenyan (P=0.022) and Vietnamese (P=0.005) case-control studies. When all three studies were combined, using the Mantel-Haenszel test, the presence of IFNAR1 -576G was associated with a substantially elevated risk of severe malaria (N=2444, OR=1.38, 95% CI: 1.17-1.64; P=1.7 x 10(-4)). This study builds on previous work to further highlight the importance of the type-I interferon pathway in malaria susceptibility and illustrates the utility of typing SNPs within regions of high linkage disequilibrium in multiple populations to confirm initial positive associations.

Attic dust and human blood samples collected near a former wood treatment facility

A wood treatment facility operating in southern Alabama released dioxins and other hazardous substances into the surrounding community over a period of approximately 35 years. The facility used a variety of chemical insecticides including pentachlorophenol (PCP), chromated copper arsenate (CCA), and creosote (which contains polycyclic aromatic hydrocarbons (PAHs)) to treat wood. The health risks associated with the released contaminants are numerous and significant. To evaluate the historic exposure to the contaminants from the facility, blood samples and health surveys were collected from 21 current and past residents of the adjacent, isolated community and analyzed for concentrations of polychlorinated dibenzo-p-dioxins (dioxins) and polychlorinated dibenzofurans (furans). In addition, attic dust sampling was performed in 11 buildings located within a 1-mile radius of the former wood treatment facility. The average total dioxin toxic equivalent (TEQ) concentration in the residents' blood samples was 36.6 pg/g lipids. In the attic dust, the average total dioxin TEQ concentration, benzo[a]pyrene (PAH) TEQ concentration, and arsenic concentration were 145 ng/kg, 0.98 and 29.8 mg/kg, respectively. The concentrations of dioxins measured in the blood samples exceed the 90th percentile total dioxin levels found in the general US adult population. Concentrations of dioxin, arsenic, and PAHs found in the attic samples exceeded the US Environmental Protection Agency (USEPA) Region 4 soil exposure cancer risk preliminary remediation goal (PRG) values. These findings indicate a very significant potential for related health effects in these communities.

An analysis of results from 305 compounds tested with the yeast RAD54-GFP genotoxicity assay (GreenScreen GC)—including relative predictivity of regulatory tests and rodent carcinogenesis and performance with autofluorescent and coloured compounds

Data from 305 non-proprietary compounds tested using the yeast RAD54-GFP (Green Fluorescent Protein) assay, GreenScreen GC, are presented, together with a detailed comparison with results from in vitro and in vivo genotoxicity tests and rodent carcinogenesis. In addition, observations on reproducibility and the performance of the test with autofluorescent and coloured compounds are described. Like the Ames test, the GreenScreen assay is shown to exhibit high specificity (82%), meaning that compounds with positive results are very likely to be genotoxic carcinogens. This is in contrast to mammalian cell tests established for use in regulatory testing that provide disappointingly low specificity and the inevitable generation of confounding false positive data. The analysis confirmed the observations of earlier studies, showing that a combination of an Ames test (or surrogate) with the yeast test provides high specificity as well as high sensitivity in the identification of rodent carcinogens.

MDA-7/IL-24, a novel tumor suppressor/cytokine is ubiquitinated and regulated by the ubiquitin-proteasome system, and inhibition of MDA-7/IL-24 degradation enhances the antitumor activity

Steady-state protein levels are determined by the balance between protein synthesis and degradation. Protein half-lives are determined primarily by degradation, and the major degradation pathways involve either lysosomal destruction or an ATP-dependent process involving ubiquitination to target proteins to the proteosome. Studies have shown that multiple tumor-suppressor proteins are ubiquitinated and degraded by the 26S proteasome. In the present study, we investigated whether the tumor suppressor/cytokine melanoma differentiation-associated gene-7/interleukin-24 gene (MDA-7/IL-24) protein is ubiquitinated and its degradation controlled by the proteasome. Treatment of ovarian (2008) and lung (H1299) tumor cells with adenoviral delivery of mda-7 (Ad-mda7) or Ad-mda7 plus the proteosome inhibitor MG132 showed that MDA-7 protein expression was dependent upon proteosome activity. Western blot and immunoprecipitation analyses verified that the MDA-7 protein was ubiquitinated and that ubiquitinated-MDA-7 levels were increased in MG132-treated cells. These results were confirmed using small interfering RNA (siRNA)-mediated knockdown of ubiquitin. Furthermore, ubiquitinated MDA-7 protein was degraded by the 26S proteasome, as MDA-7 accumulation was observed only when cells were treated with MG132 but not with lysosome or protease inhibitors. Inhibition of the catalytic beta-5 subunit of the 20S proteasome using siRNA resulted in MDA-7 protein accumulation. Finally, treatment of tumor cells with Ad-mda7 plus the proteasome inhibitor bortezomib resulted in increased tumor cell killing. Our results show that MDA-7/IL-24 is ubiquitinated and degraded by the 26S proteasome. Furthermore, inhibition of MDA-7 degradation results in enhanced tumor killing, identifying a novel anticancer strategy.

Multi-centre prospective assessment of accuracy and impact on management of positron emission tomography (PET) in esophageal and gastroesophageal junction cancers (EC). Australian PET Data Collection Project

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Background: In localized EC, radical surgery may be curative. This study evaluated PET and conventional imaging techniques (CI) for staging, and the potential impact of PET on management and prognosis of EC. Methods: Subjects had confirmed EC (SCC or adenocarcinoma), were fit for investigation and surgery and/or chemoradiotherapy and had no unequivocal distant metastatic disease clinically or by CT and endoscopy at presentation. Sensitivity, including N and M staging of pre-operative CT, PET and endoscopic ultrasound (EUS) and clinical impact of confirmation or detection of metastases on intent (curative or palliative) were recorded. Management changes, including radiotherapy field determined by new information from PET, were recorded. Variables, including standardized uptake value (SUV) were compared with progression-free survival (PFS.) Results: 129 patients (104 male), mean age 66 (range 36- 87) were evaluated. 127 of 129 primary lesions were detected. In 41% of patients, PET detected a total of 148 additional lesions, 75 regional lymph nodes, 72 distant metastases and 1 second EC primary. 22% of patients were upstaged from M0 to M1. CT detected regional and distant metastases in 57% and 0% (entry criterion), PET in 70% and 44%. Of 20 patients who had EUS, it detected regional metastases in 67%, PET in 33%.The number of patients intended to be treated palliatively increased from 10 pre- to 32 post-PET. Of patients with curative management intent based on PET 34% progressed in 12 months, with palliative intent 59%. Significant changes in management (high or medium impact) occurred in 38%. The PFS of 54 patients below and 54 above the median SUV(8) was no different (p=0.79) Conclusions: PET influenced management in 38% of patients with EC already studied by CI.

No significant financial relationships to disclose.

Nuchal translucency measurement in first trimester Down syndrome screening

(1) Approximately three in every four fetuses with Down syndrome have increased nuchal translucency (NT), which is a larger than normal build-up of fluid at the back of the neck. (2) The ultrasound measurement of NT between 11 and 14 weeks' gestation, in combination with the mother's age and the levels of placental biochemical markers in her blood, can be used to detect approximately 84% of fetuses with Down syndrome. (3) The accuracy of NT measurement is affected by fetal position, measurement technique, the type of risk-calculation software used, and the sonographer's experience and technical expertise. (4) A rigorous standardization and quality assurance system for NT measurement is needed before any test using NT ultrasound is offered universally. The cost of establishing such a program is unknown.

Use of geographic and genotyping tools to characterise tuberculosis transmission in Montreal

SETTING

In Canada, tuberculosis (TB) is increasingly an urban health problem. Montreal is Canada's second-largest city and the second most frequent destination for new immigrants and refugees.

OBJECTIVES

To detect spatial aggregation of cases, areas of excess incidence and local 'hot spots' of transmission in Montreal.

DESIGN

We used residential addresses to geocode active TB cases reported on the Island of Montreal in 1996-2000. After a hot spot analysis suggested two areas of overconcentration, we conducted a spatial scan, with census tracts (population 2500-8000) as the primary unit of analysis and stratification by birthplace. We linked these analyses with genotyping of all available Mycobacterium tuberculosis isolates, using IS6110-RFLP and spoligotyping.

RESULTS

We identified four areas of excess incidence among the foreign-born (incidence rate ratios 1.3-4.1, relative to the entire Island) and one such area among the Canadian-born (incidence rate ratio 2.3). There was partial overlap with the two hot spots. Genotyping indicated ongoing transmission among the foreign-born within the largest high-incidence zone. While this zone overlapped the area of high incidence among Canadian-born, genotyping largely excluded transmission between the two groups.

CONCLUSIONS

In a city with low overall incidence, spatial and molecular analyses highlighted ongoing local transmission.