Low prevalence of the intact cag pathogenicity island in clinical isolates of Helicobacter pylori in Karachi, Pakistan

Clinical diseases that follow Helicobacter pylori infection are associated with expression of the cagA gene, a part of cytotoxin-associated gene pathogenicity island (cag-PAI). This study aims to determined whether or not the presence of cagA is associated with the presence of complete cag-PAI and to evaluate inflammatory changes associated with the five loci in the cag-PAI of H. pylori comprising cagA, cagA promoter region (cagAP), cagE, cagT and the left end of the cagA gene (LEC). H. pylori isolates were obtained from patients with dyspeptic symptoms. Clinical strains of H. pylori were screened by the polymerase chain reaction (PCR) for respective genes of the cag-PAI. Of 115 H. pylori isolates, 31 (28%) were positive for the five cag-PAI loci. H. pylori isolates with intact cag-PAI were associated with gastric carcinoma (GC; n=9 [60%]) and gastric ulcer (GU; n=5 [45%]) compared to non-ulcer dyspepsia (NUD; n=14 [18%]) (P=0.001 and P=0.049, respectively). In patients with intact cag-PAI, acute on chronic inflammation was present in 25 (81%) and was more common than chronic inflammation (P=0.013). The cagE and cagAP had deletions in 25 (37%) and 23 (35%) cases, respectively. The cagAP region was significantly associated with GC (n=12 [80%], P<0.001) and GU (n=9 [82%], P=0.001) compared to NUD (n=24 [30%] and with significant acute on chronic inflammation (n=40 [80%], P=0.007). The distribution of vacAs1a with intact cag-PAI in GC was 9 (60%) and in NUD was 10 (13%) (P<0.001). The presence of the cagA gene does not signify presence of an intact cag-PAI. Most of the H. pylori isolates studied had partial cag-PAI with missing cagE and cagA promoter regions.

The effect of grain boundaries inside the individual ZnO nanowires in gas sensing

We present the gas sensing characteristics of the individual ZnO nanowires with single-crystalline and multiple grain boundaries (GBs) fabricated using bottom-up and top-down approaches, respectively. The sensor response of the individual ZnO nanowires with the multiple GBs was enhanced approximately three times as compared to that of single-crystalline ZnO nanowires due to well-known GB modulations. However, the response and recovery times of the individual ZnO nanowires with multiple GBs were much slower than those of the single-crystalline ZnO nanowire, indicating the presence of oxygen diffusion resistance to GBs due to the relatively fast surface kinetic reaction. Simplified kinetic diffusion modeling and experimental results could quantify the significant diffusion resistance of gas molecules into the GBs of the individual ZnO nanowires.

Sensitivity-Enhanced CMOS Phase Luminometry System Using Xerogel-Based Sensors

We present the design and implementation of a phase luminometry sensor system with improved and tunable detection sensitivity achieved using a complementary metal-oxide semiconductor (CMOS) integrated circuit. We use sol-gel derived xerogel thin films as an immobilization media to house oxygen (O2) responsive luminescent molecules. The sensor operates on the principal of phase luminometry wherein a sinusoidal modulation signal is used to excite the luminophores encapsulated in the porous xerogel films and the corresponding phase shift of the emission signals is monitored. The phase shift is directly related to excited state lifetimes of the luminophores which in turn are related to the concentration of the target analyte species present in the vicinity of the luminophores. The CMOS IC, which consists of a 16 times 16 high-gain phototransistor array, current-to-voltage converter, amplifier and tunable phase shift detector, consumes an average power of 14 mW with 5-V power supply operating at a 38-kHz modulation frequency. The output of the IC is a dc voltage that corresponds to the detected luminescence phase shift with respect to the excitation signal. As a prototype, we demonstrate an oxygen sensor system by encapsulating the luminophore tris(4,7-diphenyl-1,10-phenanthroline)ruthenium(II) within the xerogel matrices. The sensor system showed a fast response on the order of few seconds and we obtained a detection sensitivity of 118 mV per 1% change in O2 concentration. The system demonstrates a novel concept to tune and improve the detection sensitivity for specific concentrations of the target analyte in many biomedical monitoring applications.

Polyaniline-cerium oxide nanocomposite for hydrogen peroxide sensor

Hydrogen peroxide (H2O2) sensor has been fabricated by immobilizing horse radish peroxidase (HRP) onto polyaniline(PANI)-cerium oxide (CeO2) nano-composite film onto indium-tin-oxide (ITO) coated glass substrate using electrochemical technique. The HRP/PANI-CeO2/ITO bioelectrode has been characterized using scanning electron microscopy (SEM), Fourier Transform Infrared spectroscopy, UV-visible spectroscopy and electrochemical analysis, respectively. This electrode shows improved sensitivity (159.6 nA/mM) and detection limit (50 mM). Further this H2O2 sensor shows high HRP affinity to the PANI-CeO2 matrix as indicated by low value (2.9) mM of Michaelis-Menten constant (K(m)). This bioelectrode exhibits maximum response current at pH 7.0 and retains 90% of its initial response current after about 8 weeks.

Day-case management of hyperemesis gravidarum: Feasibility and clinical efficacy

Day-case management of hyperemesis gravidarum was introduced at the Whipps Cross University Hospital in September 2003. A prospective study of patients managed as day cases between September and December 2003 was undertaken. A total of 27 cases were managed as day cases in accordance with set criteria. All were discharged within 24 h of admission. There were no re-admissions. Patient satisfaction, assessed using a questionnaire, revealed an 88% satisfaction rate. Day-case management of hyperemesis gravidarum should be encouraged. The benefits to the patient are considerable.

A first-in-human phase I trial of PBI-05204 (oleandrin), an inhibitor of Akt, FGF-2, NF-Kb, and p70S6K in advanced solid tumor patients

3537

Background: PBI-05204 contains oleandrin, a cardiac glycoside, which inhibits the α-3 subunit Na-K ATPase pump. Over-expression of the α-3 subunit in malignant cells correlates with the tumor proliferation. Oleandrin inhibits FGF- 2 export and activation of NF-Kβ and inhibits phosphorylation of Akt. PBI-05204 also inhibits p70S6K, decreasing mTOR activity. In this ongoing study of PBI-05204, we sought to determine the DLTs, MTD and recommended phase II dose in advanced solid tumors patients (pts) and to characterize its’ pharmacokinetics (PK) and pharmacodynamics (PD). Methods: This was a standard 3+3 phase I design. PBI-05240 was given orally for 21 days of 28 days. Dose was increased by 100% if no related grade 2 adverse event (AE) was observed and increased by 50% if a grade 2 AE occurred. If no other grade 2 AE were observed then subsequent dose escalation was resumed at 100%. In order to determine drug-mediated changes in pAkt, p70S6K, and S6 (mTOR effectors) expression as a surrogate marker of target effect, peripheral blood mononuclear cells (PBMCs) were obtained in addition to PKs. Results: To date 15 pts have received PBI-05204 at 5 dose levels (0.6 mg to 10.2 mg/day), 2 pts are currently active at dose level 5. No DLT has been observed thus far. 10 out of 15 pts (67%) experienced only grade 1 AEs, most common: fatigue and constipation (20%). No significant cardiac toxicities have been observed, only first degree AV block and grade 2 PVC's. Of the 15 evaluable pts, 3 had stable disease for > 4 months, with bladder, colorectal, and fallopian tube cancer pts having an 11, 16, and 10% reduction by RECIST respectively. PKs initially show dose-dependent peak plasma oleandrin concentrations are reached at 2–4 hr following administration with > 50% cleared in 6 hrs. Western blots of PBMCs showed PBI-05204 markedly reduced phosphorylation of Akt, p70S6K, and S6 in a time dependent manner in 4 pts (1 at dose level 2, and 3 and 2 at dose level 5). Reduction of these effectors was observed concomitantly with relatively higher levels of Na, K-ATPase α-3 subunit expression. Conclusions: PBI-05204 is tolerated up to 10.2/mg/day with very little AE's or cardiotoxicity. Initial response evaluation shows activity in diverse tumors with PD analysis suggesting target effect.

[Table: see text]

Neurological morbidity in survivors of childhood acute lymphoblastic leukemia (ALL)

9529

Background: The majority of children diagnosed with ALL over the past two decades have achieved long-term survival. This remarkable success is attributed in part to intensive central nervous system (CNS)-directed therapy that effectively prevents CNS relapse. Because treatment-related neurological morbidity is recognized but poorly characterized, the objective of this cross-sectional study was to estimate the prevalence of neurological symptoms and signs in long-term survivors of childhood ALL. Methods: After obtaining IRB approval, all long-term ALL survivors (≥ 5 years since diagnosis) aged 6–28 years who remained active patients at our institution were identified. All participants completed a questionnaire consisting of independent (and when possible validated) instruments designed to identify various neurological symptoms, as well as, a comprehensive and standardized neurologic examination by a board-certified neurologist. Results: Of the 433 potentially eligible subjects, 162 (37.4%) were enrolled. Participant demographic information and previous treatment exposure were similar to those not enrolled in the study. The rates of endorsed neurological symptoms were: neuropathy (40.1%), dizziness (33%), back pain (22.8%), fatigue (19.1%), falls (15.4%), headache (14.8%), seizures (10.5%), urinary incontinence (8.6%), and stroke (1.2%). Neurological examination confirmed an underlying sensory neuropathy in 44 patients (27.3%). Otherwise, signs of chronic cranial nerve dysfunction (1.9%) and motor weakness (5.6%) were rare. Conclusions: Symptoms and signs of a chronic sensory neuropathy, presumably from previous vincristine exposure, were evident in many patients. Complaints of fatigue, dizziness, and chronic back pain were also relatively common. The number of patients who routinely fall is of concern. Whether these falls are associated with symptoms/signs of neuropathy, weakness, and/or dizziness will require further analysis. Although headache was a common complaint, its prevalence may not differ significantly from a normal age-matched population.

No significant financial relationships to disclose.

All-sky LIGO search for periodic gravitational waves in the early fifth-science-run data

We report on an all-sky search with the LIGO detectors for periodic gravitational waves in the frequency range 50-1100 Hz and with the frequency's time derivative in the range -5 x 10{-9}-0 Hz s{-1}. Data from the first eight months of the fifth LIGO science run (S5) have been used in this search, which is based on a semicoherent method (PowerFlux) of summing strain power. Observing no evidence of periodic gravitational radiation, we report 95% confidence-level upper limits on radiation emitted by any unknown isolated rotating neutron stars within the search range. Strain limits below 10{-24} are obtained over a 200-Hz band, and the sensitivity improvement over previous searches increases the spatial volume sampled by an average factor of about 100 over the entire search band. For a neutron star with nominal equatorial ellipticity of 10{-6}, the search is sensitive to distances as great as 500 pc.

All-sky LIGO search for periodic gravitational waves in the early fifth-science-run data

We report on an all-sky search with the LIGO detectors for periodic gravitational waves in the frequency range 50-1100 Hz and with the frequency's time derivative in the range -5 x 10{-9}-0 Hz s{-1}. Data from the first eight months of the fifth LIGO science run (S5) have been used in this search, which is based on a semicoherent method (PowerFlux) of summing strain power. Observing no evidence of periodic gravitational radiation, we report 95% confidence-level upper limits on radiation emitted by any unknown isolated rotating neutron stars within the search range. Strain limits below 10{-24} are obtained over a 200-Hz band, and the sensitivity improvement over previous searches increases the spatial volume sampled by an average factor of about 100 over the entire search band. For a neutron star with nominal equatorial ellipticity of 10{-6}, the search is sensitive to distances as great as 500 pc.

All-sky LIGO search for periodic gravitational waves in the early fifth-science-run data

We report on an all-sky search with the LIGO detectors for periodic gravitational waves in the frequency range 50-1100 Hz and with the frequency's time derivative in the range -5 x 10{-9}-0 Hz s{-1}. Data from the first eight months of the fifth LIGO science run (S5) have been used in this search, which is based on a semicoherent method (PowerFlux) of summing strain power. Observing no evidence of periodic gravitational radiation, we report 95% confidence-level upper limits on radiation emitted by any unknown isolated rotating neutron stars within the search range. Strain limits below 10{-24} are obtained over a 200-Hz band, and the sensitivity improvement over previous searches increases the spatial volume sampled by an average factor of about 100 over the entire search band. For a neutron star with nominal equatorial ellipticity of 10{-6}, the search is sensitive to distances as great as 500 pc.

All-sky LIGO search for periodic gravitational waves in the early fifth-science-run data

We report on an all-sky search with the LIGO detectors for periodic gravitational waves in the frequency range 50-1100 Hz and with the frequency's time derivative in the range -5 x 10{-9}-0 Hz s{-1}. Data from the first eight months of the fifth LIGO science run (S5) have been used in this search, which is based on a semicoherent method (PowerFlux) of summing strain power. Observing no evidence of periodic gravitational radiation, we report 95% confidence-level upper limits on radiation emitted by any unknown isolated rotating neutron stars within the search range. Strain limits below 10{-24} are obtained over a 200-Hz band, and the sensitivity improvement over previous searches increases the spatial volume sampled by an average factor of about 100 over the entire search band. For a neutron star with nominal equatorial ellipticity of 10{-6}, the search is sensitive to distances as great as 500 pc.

'Wristwatch fracture' of the distal radius: a new diagnosis?

Segmental forearm fractures are relatively uncommon in children, and their optimal management is unclear. We present an unusual segmental fracture of the distal radius in a 14 year old that appears to be related to a large metal wristwatch worn by the patient. It was successfully managed by dosed reduction and immobilisation in a plaster cast.

Search for gravitational-wave bursts from soft gamma repeaters

We present a LIGO search for short-duration gravitational waves (GWs) associated with soft gamma ray repeater (SGR) bursts. This is the first search sensitive to neutron star f modes, usually considered the most efficient GW emitting modes. We find no evidence of GWs associated with any SGR burst in a sample consisting of the 27 Dec. 2004 giant flare from SGR 1806-20 and 190 lesser events from SGR 1806-20 and SGR 1900+14. The unprecedented sensitivity of the detectors allows us to set the most stringent limits on transient GW amplitudes published to date. We find upper limit estimates on the model-dependent isotropic GW emission energies (at a nominal distance of 10 kpc) between 3x10;{45} and 9x10;{52} erg depending on waveform type, detector antenna factors and noise characteristics at the time of the burst. These upper limits are within the theoretically predicted range of some SGR models.

Bangladesh moves from being a low-prevalence nation for HIV to one with a concentrated epidemic in injecting drug users

Bangladesh has been conducting annual serological surveillance for HIV and syphilis since 1998 among most at-risk populations including sex workers, males having sex with males, injecting drug users (IDUs) and heroin smokers. During the seventh round conducted between January and June 2006, 10,368 people were sampled and the overall HIV prevalence was 0.9%. The highest HIV rate was recorded in male IDUs from the capital city Dhaka (7%), and the rates have risen significantly over the rounds (P < 0.001). In Dhaka, most of the HIV-positive IDUs (10.5%) were localized in one neighbourhood, while in the remaining neighbourhoods 1% were positive (P < 0.001). In all other groups, HIV prevalence was <1%. Active syphilis rates were highest in female IDUs (9.9%) followed by female street-based sex workers (8.6%). However, rates in female sex workers in Dhaka declined significantly over the years (P < 0.001). Bangladesh has to act urgently to prevent escalation of the epidemic.

Fabrication and characterization of polyaniline-znO hybrid nanocomposite thin films

Polyaniline (PANI)-ZnO nanocomposite thin film has been successfully fabricated on glass substrates by using vacuum deposition technique. The as-grown PANI-ZnO nanocomposite thin films have been characterized using X-ray diffraction, Scanning Electron Microscopy, Atomic Force Microscopy, UV-visible spectrophotometer and Fourier Transform Infrared (FTIR) spectroscopy, respectively. X-ray diffraction of as-grown film shows the reflection of ZnO nanoparticles along with a broad peak of PANI. The surface morphology of nanocomposite films has been investigated using scanning electron microscopy and atomic force microscopy. The hypsochromic shift of the UV absorption band corresponding to pi-pi* transition in polymeric chain of PANI and a band at 504 cm(-1) due to ZnO nanoparticles has been observed in the FTIR spectra. The hydrogen bonding between the imine group of PANI and ZnO nanoparticle has been confirmed from the presence of the absorbance band at 1151 cm(-1) in the FTIR spectra of the nanocomposite thin films.

Over- and underreporting of recent drug use in subjects entering an inpatient detoxification unit

Underreporting of drug use is commonly found more often than overreporting. Overreporting may, however, occur in particular settings, e.g. in subjects entering a detoxification program.

METHODS

Self-reports (standardized semi structured interview) of recent drug use of 554 patients consecutively admitted to a drug detoxification inpatient unit were compared to urine screening results at admission. Overreporters were defined as indicating a consumption of a specific drug during the preceding 7 days (3 days for cocaine) which was not confirmed by the urine screening. Underreproters denied consumption but presented positive urine.

RESULTS

Overreporting was especially prevalent for opiates, and relatively more frequent (59.9% heroin, 40% methadone) than underreporting (6.8% heroin, 20.4% methadone). Signs of intoxication at admission, current methadone substitution, and previous institutional detoxification experiences influenced opiate overreporting.

CONCLUSIONS

Some of the retained parameters predicting overreporting of recent opiate consumption corroborated the hypothesis of patients trying to receive more consideration from the therapeutic team and to get more intensive pharmacological care.

Anaerobic-aerobic treatment of purified terephthalic acid (PTA) effluent; a techno-economic alternative to two-stage aerobic process

This paper addresses the treatment of purified terephthalic acid (PTA) effluent using anaerobic and aerobic processes. Laboratory studies were carried out on flow proportionate composite wastewater generated from the manufacturing of PTA. An activated sludge process (ASP-two stage and single stage) and an upflow anaerobic fixed film fixed bed reactor (AFFFBR) were used, individually and in combination. The performance of a full-scale ETP under existing operating conditions was also studied. Full scale ETP studies revealed that the treatment of PTA effluent using a two-stage ASP alone does not meet treated effluent quality within the prescribed Indian Standards. The biomass produced in the two stage ASP was very viscous and fluffy and the sludge volume index (SVI) was very high (200-450 ml/g). However, pretreatment of PTA effluent using an upflow AFFFBR ensured substantial reduction in BOD (63%) and COD (62%) with recovery of biogas at 1.8-1.96 l/l effluent treated at a volumetric loading rate (VLR) 4-5 kg COD/m(3) d. The methane content in the biogas varied between 55% and 60%. The pretreated effluent from the upflow AFFFBR was then treated through a single stage ASP. The biomass produced in the ASP after anaerobic treatment had very good settlability (SVI: 75-90 ml/g) as compared to the two stage ASP and the treated effluent quality with respect to BOD, COD and SS was within the prescribed Indian Standards. The alternative treatment process comprising an upflow AFFFBR and a single stage ASP ensured net power saving of 257 kW and in addition generated 442 kW of power through the AFFFBR.

Phase I study of tipifarnib and sorafenib in patients with biopsiable advanced cancers (NCI protocol 7156 supported by NCI grant UO1 CA062461)

3549

Background: The Ras and Raf kinases are sequential signaling proteins in the MAPK pathway and inhibition of both targets may confer synergistic effects, particularly in tumors with activation of either kinase through mutation or other mechanisms. Therefore, we sought to combine sorafenib, a multikinase inhibitor (Raf, VEGFR, PDGFR) and tipifarnib an inhibitor of farnesyltransferase that is critical for Ras activity in a phase I study to determine the safety, pharmacokinetics (PK), and tumor response. Methods: The trial was a phase I trial of advanced cancer patients(pts) with a conventional dose escalation design. Each cycle consisted of 28 days of sorafenib and 21 days of tipifarnib. Dose levels are listed in the table . Results: To date, a total of 27 pts have been enrolled (median age 54.5 yrs, M:F 1:1. 3 RCC, 3 breast, 4 sarcoma, 4 melanoma, 3 CRC, 4 thyroid, 2 H&N, one thymic, one adrenal cortical, one SCC of the lung, and one unknown primary SCC). Two pts developed grade 3 DLT-skin rash on the first dosing level (tipifarnib at 100 mg po BID and sorafenib at 400 mg po BID). Dose escalation was modified as per table below. At dose level 4, 2/5 pts entered experienced a DLT of grade 3 rash and grade 3 drug fever, therefore MTD has been determined to be tipifarnib 100 mg BID, sorafenib 400 mg qam, 200 mg qpm. The most common treatment related toxicities included lymphopenia (18), hyperglycemia (17), and skin rash (14). Currently, 19 of the 27 pts are evaluable; 13 pts had SD (8–44 weeks); 2 RCC pts for 32 weeks, an adrenal cortical ca pt for 32 weeks, one melanoma pt for 44 weeks. PK analysis suggested findings similar to single agent PK profiles, no PK interactions were apparent. Conclusions: Significant toxicity with the combination of these two agents, even doses well below single agent maximum levels were observed. The MTD was determined to be tipifarnib at 100 mg BID, sorafenib at 400 mg qam, 200 mg qpm. PK analysis, to date show,no pharmacokinetic interaction between tipifarnib and sorafenib.

[Table: see text]

[Table: see text]

Effect of foliar application of micronutrients on the yield and quality of sweet orange (Citrus Sinensis L.)

An experiment was designed to study the effect of foliar application of micronutrients on the yield, quality and leaf composition of sweet orange, Blood red variety at Shabazgari, Mardan. The experiment was laid out in a randomized complete block design in 2) factorial arrangement. Zinc, manganese and boron were applied as foliar spray at the rate of 0.4, 0.2 and 0.04 kg ha(-1), respectively in the presence of 1.56 kg N ha(-1) as urea and 0.4 kg surfactance ha(-1) (as wetting agent) in 400 L of water. The maximum fruit yield was obtained, when 0.4 kg Zn ha(-1) and 0.2 kg Mn ha(-1) was sprayed along with 1.56 kg N ha(-1) and 0.4 kg surfactance ha(-1) in 400 L of water. The minimum % peel was obtained with B alone and minimum % rag with Zn + Mn, maximum fruit size with Zn + B and maximum fruit volume with Zn + Mn. Similarly, % juice in sweet oranges was increased significantly by B alone, reducing sugar by Mn alone and vitamin C contents by Zn + B through foliar spray, suggested that each micronutrient had different role on the quality of citrus fruit. Foliar spray of Zn, Mn and B along with urea significantly increased the concentration of Zn and Mn in citrus leaves, while the concentration of B was not affected with foliar spray, perhaps due to dilution within the citrus tissues. Therefore, it is suggested that either Zn+Mn or Zn+B may be applied as foliar spray in combination with urea and surfactance for getting the maximum yield and improved quality of citrus fruit under prevailing conditions.