Sibling separation and psychological problems of double AIDS orphans in rural China - a comparison analysis

OBJECTIVE

We investigated the psychological impact of sibling separation among children who lost both of their parents to AIDS and were placed in group care or kinship care settings in rural China.

METHODS

Comparative analysis of cross-sectional survey data among 155 children among whom 96 experienced sibling separation. Trauma symptoms (Anxiety, Depression, Anger, Post-traumatic stress, Dissociation, Sexual concerns) were compared between the AIDS orphans who experienced sibling separation and those who did not using analysis of variance and multivariate analysis of covariance.

RESULTS

Among the participants (47.7% girls) with an average age of 12.4 years, univariate and multivariate analyses showed that separation from siblings was associated with significantly higher scores in anxiety, depression, anger and dissociation before or after controlling for gender, age, care arrangement, number of household replacement, trusting relationship with the current caregivers and perceived quality of current living condition. Sibling separation among orphans was not associated with level of post-traumatic stress and sexual concerns.

CONCLUSION

AIDS orphans separated from their siblings suffered from increased psychological distress compared with those who remained with their siblings. The data in the current study suggest that care arrangement for AIDS orphan should include accommodating the siblings together or providing them with opportunities for frequent contact and/or communication with each other. Appropriate psychological counselling should be given to those orphans experiencing sibling separation.

Mass balance, pharmacokinetics, and metabolism of [14C] brivanib (BMS-582664), prodrug of BMS-540215, in subjects with advanced or metastatic solid tumors

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Background: Brivanib alaninate (BMS-582664, B) is an oral prodrug of BMS-540215, a dual tyrosine kinase inhibitor of VEGFR and FGFR signaling pathways which are important for angiogenesis and tumor growth. The recommended phase II/III dose of B is 800 mg daily. Methods: A two-part, open-label, single-dose study was conducted in subjects with advanced or metastatic solid tumors. Part A represented the period for assessment of the pharmacokinetics (PK), metabolism, and elimination of B, In part A, subjects received a single oral dose of 800 mg [14C]-labeled B containing 100 μCi of total radioactivity (0.125 μCi/mg). Blood was collected at selected time points for analyses of PK, biotransformation, and total radioactivity over a 10-day period. Complete urinary and fecal output was collected over the 10-day period or until discharge, and analyzed for total radioactivity and biotransformation. Part B began when subjects completed Part A. Part B subjects received B administered orally at a dose of 800 mg once daily starting on approximately Day 15 to 17 of study. Subjects continued in this study until disease progression or unacceptable toxicity. Results: 4 subjects (2 NSCLC, 1 ovarian, 1 renal cell carcinoma) were treated with B in both parts A & B. B was tolerable with few G3/4 AEs (increased fatigue, 1 event, cognitive disturbance, 1 event). The results revealed that B is completely converted to active moiety, BMS-540215, after oral administration. BMS-540215 is extensively metabolized in humans. Elimination is primarily via the feces. Following a single oral dose of [14C]-labeled B, approximately 12% and 82% of the administered radioactivity was recovered in the urine and feces, respectively, within 10 days. BMS-540215 accounted for 0.00% and 7.4% of the administered dose in urine and feces, respectively, with the remainder of the dose being minor metabolites. The mean terminal t1/2 of BMS-540215 was 14 hours. Conclusions: After oral administration of single 800 mg oral doses of [14C] B, BMS-540215 was found to be the major active circulating moiety in plasma (22.5%). BMS-540215 is primarily eliminated via metabolism. [14C]-labeled B formulation was well tolerated with no AEs leading to the discontinuation of any subject.

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Effects of flexible-dose fesoterodine on overactive bladder symptoms and treatment satisfaction: an open-label study

AIMS

To evaluate the efficacy and tolerability of flexible-dose fesoterodine in subjects with overactive bladder (OAB) who were dissatisfied with previous tolterodine treatment.

METHODS

This was a 12-week, open-label, flexible-dose study of adults with OAB (> or = 8 micturitions and > or = 3 urgency episodes per 24 h) who had been treated with tolterodine (immediate- or extended-release) for OAB within 2 years of screening and reported dissatisfaction with tolterodine treatment. Subjects received fesoterodine 4 mg once daily for 4 weeks; thereafter, daily dosage was maintained at 4 mg or increased to 8 mg based on the subject's and physician's subjective assessment of efficacy and tolerability. Subjects completed 5-day diaries, the Patient Perception of Bladder Condition (PPBC) and the Overactive Bladder Questionnaire (OAB-q) at baseline and week 12 and rated treatment satisfaction at week 12 using the Treatment Satisfaction Question (TSQ). Safety and tolerability were assessed.

RESULTS

Among 516 subjects treated, approximately 50% opted for dose escalation to 8 mg at week 4. Significant improvements from baseline to week 12 were observed in micturitions, urgency urinary incontinence episodes, micturition-related urgency episodes and severe micturition-related urgency episodes per 24 h (all p < 0.0001). Approximately 80% of subjects who responded to the TSQ at week 12 reported satisfaction with treatment; 38% reported being very satisfied. Using the PPBC, 83% of subjects reported improvement at week 12 with 59% reporting improvement > or = 2 points. Significant improvements from baseline (p < 0.0001) exceeding the minimally important difference (10 points) were observed in OAB-q Symptom Bother and Health-Related Quality of Life (HRQL) scales and all four HRQL domains. Dry mouth (23%) and constipation (5%) were the most common adverse events; no safety issues were identified.

CONCLUSION

Flexible-dose fesoterodine significantly improved OAB symptoms, HRQL, and rates of treatment satisfaction and was well tolerated in subjects with OAB who were dissatisfied with prior tolterodine therapy.

Personal Social Capital Scale: an instrument for health and behavioral research

The concept of social capital has drawn much attention in social and behavioral epidemiology and health education research. The purpose of this study is to develop the 'Personal Social Capital Scale' for quantitative survey studies of social factors that are related to health and behavior. The instrument contained 10 composite items based on 42 items for assessing personally owned social capital, including bonding and bridging capitals. The instrument was assessed using cross-sectional survey data collected among 128 participants (64 women) with a participation rate of 95%. Results from correlation and confirmatory factor analysis indicated adequate reliability and internal consistency. The mean score of the scale was 25.9 (SD = 5.2) for total social capital, 15.2 (SD = 3.0) for bonding social capital and 10.8 (SD = 3.4) for bridging social capital. The scale scores significantly predicted a number of theoretically related factors, including people skills, being sociable, social capital investment, informational support, instrumental support, emotional support and collective efficacy. This instrument provides a new tool for cross-cultural research to assess personally owned social capital.

Relationship between TH1/TH2 cytokines and immune tolerance in liver transplantation in rats

OBJECTIVE

To explore the relationship between Th1/Th2 cytokine expressions and immune tolerance in rat liver transplantation.

METHODS

Recipients were divided into three groups (each group = 12 rats). The allograft group underwent orthotopic liver transplantation from male Wistar-to-Sprague-Dawley (SD) rats. The isograft group of SD-to-SD liver transplantation was complemented with a control group of normal male SD rats that had sham operations. We evaluated the 2-week survival rates histological changes, as well as serum and mRNA expression levels of Th1/Th2 cytokines: interferon-gamma (IFN-gamma) and interleukin-10 (IL-10).

RESULTS

The 1-week survival in the isograft and allograft groups were 100% and 41.67%, respectively. The 2-week survival rates were 75% and 8.33% (P < .05). Light microscopic inspection revealed severe acute rejection in the allograft but not the isograft group in the first week postoperation. This observation was verified by the cellular morphology under transmission electron microscopy. Serum IFN-gamma (Th1 cytokine) levels (pg/mL) determined by enzyme-linked immunosorbent assay in the allograft, isograft, and control groups were 386.67 +/- 14.36, 159.83 +/- 16.53, and 87.83 +/- 8.67, respectively; for IL-10 (Th2 cytokine), they were 126.33 +/- 13.10, 288.33 +/- 17.10, and 70.50 +/- 7.23, respectively (P < .05, allograft vs isograft). The semiquantitative reverse-transcriptase polymerase chain reaction assay showed that expression of IFN-gamma and IL-10 mRNA was similar to that of serum levels. IFN-gamma mRNA was more highly expressed in the allograft group and IL-10 mRNA, in the isograft group (P < .05).

CONCLUSIONS

The dynamic equilibrium of Th1/Th2 cytokines is critically involved in immune tolerance. The deviation of Th1 to Th2 may be one mechanism of immune tolerance.

Establishment of an enzyme-linked immunosorbent assay system for determining soluble CD96 and its application in the measurement of sCD96 in patients with viral hepatitis B and hepatic cirrhosis

CD96, previously named T cell activation increased late expression (Tactile), is a transmembrane molecule that functions as an activated receptor on natural killer cells. It is well known that many transmembrane molecules have soluble forms, which were either shed from the cell surface or spliced at mRNA level. In many cases, the levels of soluble forms in the circulation could be used as biomarkers of lymphocyte activation in bacterial or virus infection, tumour, transplantation and autoimmune disease. To investigate whether CD96 could be released into the sera and the possible biological function of soluble hCD96 (sCD96), we generated and characterized five clones of anti-hCD96 mouse monoclonal antibodies (mAb) and developed a sandwich enzyme-linked immunosorbent assay (ELISA) system based on two anti-hCD96 mAbs with different epitope specificities. Using this ELISA system, sCD96 in serum samples from 99 healthy individuals could be detected. Furthermore, we found that the level of sCD96 in serum samples from patients with chronic viral hepatitis B or classes B and C of hepatic cirrhosis classified using the Child-Pugh score was much higher (P < 0.001 versus healthy individuals; P = 0.006 versus healthy individuals respectively) than that from healthy individuals (0.98 ng/ml). Our study demonstrates for the first time that sCD96 existed in sera, and suggests that sCD96 may be used as a serous marker for some diseases such as chronic viral hepatitis B infection or hepatic cirrhosis in classes B and C. The level of sCD96 in patients' serum may have some relationship with a chronic inflammatory reaction.

Heat shock factor 1 represses estrogen-dependent transcription through association with MTA1

Heat shock factor 1 (HSF1), the transcriptional activator of the heat shock genes, is increasingly implicated in cancer. We have shown that HSF1 binds to the corepressor metastasis-associated protein 1 (MTA1) in vitro and in human breast carcinoma samples. HSF1-MTA1 complex formation was strongly induced by the transforming ligand heregulin and complexes incorporated a number of additional proteins including histone deacetylases (HDAC1 and 2) and Mi2alpha, all components of the NuRD corepressor complex. These complexes were induced to assemble on the chromatin of MCF7 breast carcinoma cells and associated with the promoters of estrogen-responsive genes. Such HSF1 complexes participate in repression of estrogen-dependent transcription in breast carcinoma cells treated with heregulin and this effect was inhibited by MTA1 knockdown. Repression of estrogen-dependent transcription may contribute to the role of HSF1 in cancer.

Rapid and sensitive detection of Singapore grouper iridovirus by loop-mediated isothermal amplification

AIMS

The aim of this paper was to develop a loop-mediated isothermal amplification (LAMP) method for rapid, sensitive and inexpensive detection of Singapore grouper iridovirus (SGIV) in grouper (GP), Epinephelus sp.

METHODS AND RESULTS

A set of six specific primers was designed by targeting the SGIV ORF-014L. With Bst DNA polymerase large fragment, the target DNA can be amplified as early as 20 min at 65 degrees C in a simple water bath. The detection limit is about 0.02 fg (equivalent to 6.3 copies) of plasmid ORF-014L. LAMP products could be judged with three different methods. There were no cross-reactions with seven other aquatic animal viruses indicating high specificity of the LAMP. The LAMP method was applied to detect SGIV in virus-infected GP cells and GP tissues effectively.

CONCLUSIONS

The LAMP described in this study is a cheap, sensitive, specific and rapid protocol for the detection of SGIV in cells and in GP tissues.

SIGNIFICANCE AND IMPACT OF THE STUDY

The developed LAMP method can be simply applied both in field condition and in laboratory operation for specific detection of SGIV infection.

Varenicline versus transdermal nicotine patch for smoking cessation: results from a randomised open-label trial

Background:

Varenicline, a new treatment for smoking cessation, has demonstrated significantly greater efficacy over placebo and sustained release bupropion (bupropion SR). A study was undertaken to compare a 12-week standard regimen of varenicline with a 10-week standard regimen of transdermal nicotine replacement therapy (NRT) for smoking cessation.

Methods:

In this 52-week, open-label, randomised, multicentre, phase 3 trial conducted in Belgium, France, the Netherlands, UK and USA, participants were randomly assigned (1:1) to receive varenicline uptitrated to 1 mg twice daily for 12 weeks or transdermal NRT (21 mg/day reducing to 7 mg/day) for 10 weeks. Non-treatment follow-up continued to week 52. The primary outcome was the biochemically confirmed (exhaled carbon monoxide ⩽10 ppm) self-reported continuous abstinence rate (CAR) for the last 4 weeks of the treatment period in participants who had taken at least one dose of treatment. Secondary outcomes included CAR from the last 4 weeks of treatment through weeks 24 and 52, and measures of craving, withdrawal and smoking satisfaction.

Results:

A total of 376 and 370 participants assigned to varenicline and NRT, respectively, were eligible for analysis. The CAR for the last 4 weeks of treatment was significantly greater for varenicline (55.9%) than NRT (43.2%; OR 1.70, 95% CI 1.26 to 2.28, p<0.001). The week 52 CAR (NRT, weeks 8–52; varenicline, weeks 9–52) was 26.1% for varenicline and 20.3% for NRT (OR 1.40, 95% CI 0.99 to 1.99, p = 0.056). Varenicline significantly reduced craving (p<0.001), withdrawal symptoms (p<0.001) and smoking satisfaction (p<0.001) compared with NRT. The most frequent adverse event was nausea (varenicline, 37.2%; NRT, 9.7%).

Conclusions:

The outcomes of this trial established that abstinence from smoking was greater and craving, withdrawal symptoms and smoking satisfaction were less at the end of treatment with varenicline than with transdermal NRT.

Trial registration number:

NCT00143325.

Microbial transformation of trichothecene mycotoxins

Trichothecene mycotoxins produced by the Fusarium genus are highly toxic to humans and animals. They are commonly found in cereals worldwide, which is not only a concern for food safety, but also highly relevant to the livestock industry. Controlling trichothecenes in food and feed has been a challenge since the toxins are markedly stable under different environmental conditions. Thermal processing is usually ineffective, and chemical treatments generally are expensive and often result in side effects. Previous studies on innovative biological approaches, such as the use of microorganisms and enzymes, to convert the toxins into non or less toxic compounds have shown promise. This review will briefly describe the chemical structures and toxicity of trichothecenes, and examine the microorganisms, including both bacteria and fungi, from various natural sources that are able to detoxify the toxins as either mixed cultures or a pure culture of single isolates. Finally, challenges and innovative strategies in the development of technology to detoxify trichothecenes by microorganisms are described.