Molecular mechanism for adiponectin-dependent M2 macrophage polarization: link between the metabolic and innate immune activity of full-length adiponectin

The anti-inflammatory effects of globular adiponectin (gAcrp) are mediated by IL-10/heme oxygenase 1 (HO-1)-dependent pathways. Although full-length (flAcrp) adiponectin also suppresses LPS-induced pro-inflammatory signaling, its signaling mechanisms are not yet understood. The aim of this study was to examine the differential mechanisms by which gAcrp and flAcrp suppress pro-inflammatory signaling in macrophages. Chronic ethanol feeding increased LPS-stimulated TNF-α expression by Kupffer cells, associated with a shift to an M1 macrophage polarization. Both gAcrp and flAcrp suppressed TNF-α expression in Kupffer cells; however, only the effect of gAcrp was dependent on IL-10. Similarly, inhibition of HO-1 activity or siRNA knockdown of HO-1 in RAW264.7 macrophages only partially attenuated the suppressive effects of flAcrp on MyD88-dependent and -independent cytokine signatures. Instead, flAcrp, acting via the adiponectin R2 receptor, potently shifted the polarization of Kupffer cells and RAW264.7 macrophages to an M2 phenotype. gAcrp, acting via the adiponectin R1 receptor, was much less effective at eliciting an M2 pattern of gene expression. M2 polarization was also partially dependent on AMP-activated kinase. flAcrp polarized RAW264.7 macrophages to an M2 phenotype in an IL-4/STAT6-dependent mechanism. flAcrp also increased the expression of genes involved in oxidative phosphorylation in RAW264.7 macrophages, similar to the effect of flAcrp on hepatocytes. In summary, these data demonstrate that gAcrp and flAcrp utilize differential signaling strategies to decrease the sensitivity of macrophages to activation by TLR4 ligands, with flAcrp utilizing an IL-4/STAT6-dependent mechanism to shift macrophage polarization to the M2/anti-inflammatory phenotype.

Transport bifurcation in a rotating tokamak plasma

The effect of flow shear on turbulent transport in tokamaks is studied numerically in the experimentally relevant limit of zero magnetic shear. It is found that the plasma is linearly stable for all nonzero flow shear values, but that subcritical turbulence can be sustained nonlinearly at a wide range of temperature gradients. Flow shear increases the nonlinear temperature gradient threshold for turbulence but also increases the sensitivity of the heat flux to changes in the temperature gradient, except over a small range near the threshold where the sensitivity is decreased. A bifurcation in the equilibrium gradients is found: for a given input of heat, it is possible, by varying the applied torque, to trigger a transition to significantly higher temperature and flow gradients.

Efficacy and safety of NT 201 for upper limb spasticity of various etiologies--a randomized parallel-group study

OBJECTIVE

To assess efficacy and safety of two dilutions of botulinum neurotoxin type A NT 201 (Xeomin®) in patients with upper limb spasticity of diverse etiology.

METHODS

Changes in functional disability and muscle tone from baseline to week 4 after NT 201 treatment.

RESULTS

One hundred ninety-two patients with stroke, brain injury, multiple sclerosis, or cerebral palsy were randomized to either 50 or 20 U/ml NT 201 dilutions. The maximum total NT 201 dose was 495 units. Four weeks post-injection, a ≥ 1-point reduction was observed on the Disability Assessment Scale in 57.1%, and on the Ashworth scale in ≥ 62.2% of patients. The 20 U/ml NT 201 dilution was non-inferior to the 50 U/ml NT 201 dilution. Global improvement was rated high by patients (80.2%) and investigators (89.0%).

CONCLUSIONS

NT 201 improved functional disability and muscle tone and was well tolerated in patients with upper limb spasticity of diverse etiology in both dilutions.

Correlation analysis of waves above a capacitive plasma applicator

Capacitively coupled plasma glow discharges have been extensively used for materials processing in numerous industrial applications. Considerable research has been performed on plasma sheaths and standing waves over a capacitive applicator, which typically holds the processed substrate (e.g., a semiconductor wafer). In this work, we demonstrate for the first time the existence of normal modes in electric potential analogous to the vibrational modes in circular membranes and plates. These modes are exhibited through cross spectral analysis of the plasma potential measured with an emissive probe at 208 spatial positions and sampled at 1 GHz. These modes exist at several frequencies and are described by a series of Bessel functions. The data further suggests a nonlinear interaction between modes of different frequencies.

Nonlinear phase mixing and phase-space cascade of entropy in gyrokinetic plasma turbulence

Electrostatic turbulence in weakly collisional, magnetized plasma can be interpreted as a cascade of entropy in phase space, which is proposed as a universal mechanism for dissipation of energy in magnetized plasma turbulence. When the nonlinear decorrelation time at the scale of the thermal Larmor radius is shorter than the collision time, a broad spectrum of fluctuations at sub-Larmor scales is numerically found in velocity and position space, with theoretically predicted scalings. The results are important because they identify what is probably a universal Kolmogorov-like regime for kinetic turbulence; and because any physical process that produces fluctuations of the gyrophase-independent part of the distribution function may, via the entropy cascade, result in turbulent heating at a rate that increases with the fluctuation amplitude, but is independent of the collision frequency.

Indirect measures of human vagal withdrawal during head-up tilt with and without a respiratory acidosis

Human ECG records were analyzed during supine (SUP) rest and whole body 80 degrees head-up tilt (HUT), with a respiratory acidosis (5%CO(2)) and breathing room air (RA). HUT increased heart rate in both conditions (RA(SUP) 60 +/- 13 vs. RA(HUT) 79 +/- 16; 5%CO(2SUP) 63 +/- 12 vs. 5%CO(2HUT) 79 +/- 14 beats min(-1)) and decreased mean R-R interval, with no changes in the R-R interval standard deviation. When corrected for changes in frequency spectrum total power (NU), the high frequency (0.15-0.4 Hz) component (HF(NU)) of heart rate variability decreased (RA(SUP) 44.01 +/- 21.57 vs. RA(HUT) 24.05 +/- 13.09; 5%CO(2SUP) 69.23 +/- 15.37 vs. 5%CO(2HUT) 47.64 +/- 21.11) without accompanying changes in the low frequency (0.04-0.15 Hz) component (LF(NU)) (RA(SUP) 52.36 +/- 21.93 vs. RA(HUT) 66.58 +/- 19.49; 5%CO(2SUP) 22.97 +/- 11.54 vs. 5%CO(2HUT) 40.45 +/- 21.41). Positive linear relations between the tilt-induced changes (Delta) in HF(NU) and R-R interval were recorded for RA (DeltaHF(NU) = 0.0787(DeltaR-R) - 11.3, R (2) = 0.79, P < 0.05), and for 5%CO(2) (DeltaHF(NU) = 0.0334(DeltaR-R) + 1.1, R (2) = 0.82, P < 0.05). The decreased HF component suggested withdrawal of vagal activity during HUT. For both RA and 5%CO(2), the positive linear relations between DeltaHF(NU) and DeltaR-R suggested that the greater the increase in heart rate with HUT, the greater the vagal withdrawal. However, a reduced range of DeltaHF during HUT with respiratory acidosis suggested vagal withdrawal was lower with a respiratory acidosis.

Focus-on-Teens, sexual risk-reduction intervention for high-school adolescents: impact on knowledge, change of risk-behaviours, and prevalence of sexually transmitted diseases

A community-based intervention, Focus-on-Kids (FOK) has demonstrated risk-behaviour reduction of urban youth. We modified FOK to Focus-on-Teens (FOT) for high schools. High school adolescents (n=1190) were enrolled over successive school semesters. The small-group sessions were presented during the school-lunch hours. Confidential surveys were conducted at baseline, immediate, six-, and 12-month postintervention for demographics, parental communication/monitoring, sexual risk behaviours and sexually transmitted diseases (STDs)/HIV/condom-usage knowledge. Sexually active participants were encouraged to volunteer for urine-based STDs testing at the School-Based Health Centres. Many (47.4%) students reported having had sexual intercourse at baseline. Overall behaviours changed towards 'safer' sex behaviours (intent-to-use and using condoms, communicating with partner/parents about sex/condoms/STDs) with time (P<0.05). Proportion of students with complete correct knowledge of STDs/HIV increased to 88% at time 4 from 80% at baseline after adjusting for age, gender and sexual activity (P<0.05). High prevalence of STDs was detected in 875 participants who reported for urine testing at time 1: trichomonas, 11.8%; chlamydia, 10.1% and gonorrhoea, 4.1%. Prevalence decreased significantly for 310 participants who re-tested; chlamydia: 27.4% to 6.1% and gonorrhoea: 11.3% to 3.2%. FOT was successfully implemented as an STDs/HIV risk-reduction intervention. Sustained improvements of knowledge about STDs/HIV/condom usage, decreases in sexual risk behaviours supported the effectiveness of this intervention.

High power ultrasonics as a novel tool offering new opportunities for managing wine microbiology

Industrial scale food and beverage processes that utilize microorganisms are typically faced with issues related to the exclusion, suppression or elimination of spoilage organisms. Yet the use of traditional anti-microbial treatments such as heat, chemical biocides or sterile filtration may themselves be restricted by regulations or else be undesirable due to their adverse sensory impacts on the product. High power ultrasound (HPU) is a technology whose application has been evaluated if not exploited in several food and beverage processes but has yet to be introduced into the wine industry. This review examines the research findings from related industries and highlights possible applications and likely benefits of the use of HPU in winemaking.

Factors Affecting Survival after Endovascular Aneurysm Repair: Results from a Population Based Audit

OBJECTIVES

To determine the effect of pre-operative factors on mid-term survival of patients enrolled in an Australian audit of endovascular aneurysm repair (EVAR).

DESIGN

Prospective longitudinal national register (audit) of patients undergoing EVAR.

METHODS

961 individuals who had elective or semi-urgent EVAR of abdominal aortic aneurysms were enrolled in the audit between November 1999 and May 2001. Data was contributed by 81 surgeons from 64 hospitals. Kaplan-Meier survival analysis was used to determine survival rates and factors significantly influencing survival. Parametric survival analysis with log-exponential distribution was used to estimate expected 3 and 5 year survival for different ages, ASA, creatinine and aneurysm sizes.

RESULTS

Overall survival was 93% at 1 year, 80% at 3 years and 67% at five years. Survival rates were found to be statistically associated with ASA, age, aneurysm size and creatinine levels. ASA has the largest effect. Five year survival rates for aneurysms >or=65 mm and <55 mm were 54% and 76% respectively. Pre-operative creatinine levels >or=160 micromol/L lowered the survival rate from 71% to 40%.

CONCLUSIONS

Survival for EVAR patients is strongly correlated with a number of pre-operative factors. This survival analysis provides a useful decision-making tool for surgeons particularly for individuals with smaller aneurysms.

The obligation to provide antiretroviral treatment in HIV prevention trials

Providing antiretroviral therapy (ART) to participants who seroconvert during HIV prevention trials in developing countries is an ethical expectation. Promising treatment to the few seroconverters widens disparities within a resource-poor country and would be unjust. Such an assurance should be done in a way that also improves access to ART for others in the country. US funds for ART in poor countries from the PEPFAR should be available to all countries that host HIV prevention and clinical trials.

Hypothermia pediatric head injury trial: the value of a pretrial clinical evaluation phase

BACKGROUND

The utility of a pretrial clinical evaluation or run-in phase prior to conducting trials of complex interventions such as hypothermia therapy following severe traumatic brain injury in children and adolescents has not been established.

METHODS

The primary objective of this study was to prospectively evaluate the ability of investigators to adhere to the clinical protocols of care including the cooling and rewarming procedures as well as management guidelines in patients with severe traumatic brain injury (Glasgow Coma Scale<or=8) treated with 24 h of hypothermia therapy. A secondary objective was to evaluate the ability of study research assistants to complete the study case report form using a procedures manual. The study was conducted at 18 sites in Canada, the United Kingdom and France prior to proceeding to a randomized controlled trial (RCT). After 2 patients were enrolled at each center, an independent clinical evaluation committee examined the process of care and the completeness of data collection. Centers were permitted to enroll patients in the RCT once they met pre-established adherence criteria.

RESULTS

Seventeen of the 18 centers completed the pretrial clinical evaluation phase demonstrating compliance with study procedures and proceeded to an RCT of hypothermia therapy. One center enrolled only 1 patient in the pretrial clinical evaluation phase due to small numbers of patients with traumatic brain injury, and therefore, did not proceed to the RCT. Three centers were required to enroll more than 2 patients in the pretrial clinical evaluation phase prior to proceeding to the RCT because of problems with adherence to the clinical protocols at two centers and the training of new study personnel at another center. Of the 39 patients enrolled during the pretrial clinical evaluation phase, 8 (20.5%) died and 22 (62.9%) had a good outcome defined as normal, mild or moderate disability assessed using the Pediatric Cerebral Performance Category score at 6 months following injury.

DISCUSSION

The pretrial clinical evaluation phase was useful to ensure compliance with complex hypothermia therapy and consensus-based clinical management guidelines of care successfully implemented across 17 of 18 centers. This study maneuver allowed us to complete a subsequent RCT in 225 children following severe traumatic brain injury.