A272 EVIDENCE OF SEX DIFFERENCES IMPACTING PAIN SIGNALING BY LUMINAL MEDIATORS IN IRRITABLE BOWEL SYNDROME

Background

Irritable bowel syndrome (IBS) is more than twice as common in women and female patients report more severe abdominal pain. This suggests that sex-specific mechanisms may contribute to the pathophysiology of IBS. Many IBS patients have altered gut microbiota and luminal meditators, implicating the gut microbiota in abdominal pain. These luminal mediators can alter excitability of visceral nociceptors, thus potentially contributing to abdominal pain in IBS. Furthermore, in a subset of IBS patients a low FODMAP diet (LFD) reduces the effect of luminal mediators on pain sensing neurons. The LFD may improve abdominal pain at greater rates in women, and numerous putative mechanisms contributing to abdominal pain in IBS are susceptible to sex-specific mediators. However, it is unknown whether luminal mediators have similar effects on visceral pain signaling in both males and females. We hypothesize that luminal mediators will cause greater differences in neuronal excitability and pain signaling in female mice due to sex-specific factors.

Purpose

To determine whether FS from IBS patients (IBS FS) affects nociceptors from female mice more than nociceptors from male mice.

Method

Neurons from dorsal root ganglia from male and female mice were incubated overnight in media containing fecal supernatant (FS) from IBS patients (N=2 females) before and after the LFD, or healthy controls (HC, N=1 female and 1 male). Ratiometric Ca²⁺ imaging with FURA-2-AM was employed to quantify TRPV1 channel sensitization following application of capsaicin (100nM for 1 minute) as a measure of neuronal excitability. Data was analyzed using chi-squared test as well as two-way and mixed-effects model ANOVA as appropriate, followed by Sidak’s multiple comparisons test.

Result(s)

IBS FS caused a 177% larger Ca²⁺ influx in response to capsaicin compared to HC FS in female mice (p=0.0148, N=6-7 mice, neurons=43-49). In male mice, IBS FS increased Ca²⁺ influx by only 13% compared to HC FS (p=0.79, N=5 mice, neurons=28-35). In female mice, 117% more neurons responded to capsaicin after incubation with IBS FS versus HC FS (p=0.0004), while in male mice, only 17% more neurons responded following incubation with IBS FS (p=0.46). Finally, FS from the same IBS patients following a LFD reduced neuronal Ca²⁺ influx by 39% compared to IBS FS in female mice (p=0.0434, N=4-6 mice, neurons=18-49). In male mice, LFD FS reduced Ca²⁺ influx by 11% versus IBS FS (p=0.98, N=5 mice, neurons=28-35).

Conclusion(s)

Nociceptive neurons from female mice are more sensitive to the pro-nociceptive effects of FS from IBS patients, as well as a reduction of these excitatory effects following the LFD. This suggests a potential role of sex hormones in pain signaling in IBS.

Disclosure of Interest

None Declared

A17 EVIDENCE OF PROTEASE-MEDIATED PRO-NOCICEPTIVE EFFECTS OF FECAL SUPERNATANTS FROM CROHN'S DISEASE PATIENTS

Background

Abdominal pain is a debilitating symptom of Crohn’s disease (CD). Despite the current treatment options for this disease, abdominal pain is an unresolved problem that commonly persists in the absence of active inflammation. This suggests that something other than inflammation is driving the pain during the quiescent phase. We have previously reported that microbial proteases can directly modulate the excitability of dorsal root ganglia (DRG) neurons, many of which are pain-sensing. We hypothesize that luminal proteases of CD patients are contributing to their abdominal pain.

Purpose

Determine whether luminal mediators in CD fecal samples induce changes in pain signalling.

Method

The effects of patient (active CD [n = 3] and healthy volunteer (HV) [n = 3]) fecal supernatant (FS) samples on pain-sensing neurons were assessed using ex-vivo single unit afferent nerve recordings from mouse colons. Each sample was tested in colonic preparations from a least 5 mice. To further examine cellular mechanisms, DRG neurons were isolated and incubated overnight in media containing CD FS or HV FS media. Changes in neuronal excitability were recorded by determining the rheobase (lower rheobase=increased excitability) using patch clamp recordings (n ≥ 9 DRG neurons/group). Protease inhibitors were applied in both bioassays to determine whether these inhibited the excitatory effect of FS. Lastly, total proteolytic activity in the CD and HV fecal samples was calculated using a casein colorimetric protease detection assay.

Result(s)

FS from HV had no effect on afferent nerve excitability (p = 0.8920). FS from active CD patients increased action potential discharge from colonic afferent nerves by 85% (p<0.0001) and selectively increased the activation of high-threshold units, which are putative nociceptors, by 44% (p=0.0074). A protease inhibitor cocktail (1:1000) and protease-activated receptor (PAR)-2 antagonist GB83 (10µM) both blocked the excitatory effects of CD FS (p<0.05). Overnight incubation with CD FS also had an excitatory effect on DRG neurons compared to HV FS (rheobase decreased by 46%, p<0.05). The effect of CD FS was blocked by GB83 (10µM) (p<0.001) and a serine protease inhibitor (FUT175; 100µM) (p<0.05) independently, but the activity was not blocked by E64 (30nM) a cysteine protease inhibitor. A 200-fold increase (p<0.0001) in total proteolytic activity was found in CD FS compared to HV FS.

Conclusion(s)

Luminal serine proteases, but not cysteine proteases, appear to be driving nociceptive signalling in CD patients. This provides insight into the generation of pain in CD patients and may be a potential target to mitigate this action. Further research is required to elucidate whether these pro-nociceptive proteases are of bacterial or host origin and their effects in the quiescent phase.

Disclosure of Interest

None Declared

A278 SEX DIFFERENCES IN THE EFFECT OF THE MICROBIOTA FROM IRRITABLE BOWEL SYNDROME PATIENTS ON ABDOMINAL PAIN

Background

Irritable bowel syndrome (IBS) is a chronic abdominal pain disorder that affects women twice as often as men. The gut microbiota has been implicated as a key player in the modulation of abdominal pain in IBS. Given this, we hypothesised that the production of pro-nociceptive mediators within the gut lumen are increased in females, and this contributes to the female predominance of IBS.

Purpose

Compare the effects of FS from male and female IBS patients on abdominal pain pathways and identify the impact of female mouse estrous cycle on abdominal pain.

Method

Fecal supernatants (FS) were perfused through murine colonic preparations while performing extracellular colonic afferent nerve recordings to measure changes in action potential frequency in response to colonic distension. Phase of estrous cycle in female mice was determined through vaginal swabs. FS from male and female IBS patients reporting low, moderate, and high levels of abdominal pain were used.

Result(s)

FS from female IBS patients (N=6) increased afferent nerve discharge (p < 0.05) whereas FS from male IBS patients has no effect (N=4). However, single unit analysis of nociceptive axons revealed that male IBS FS increased nociceptor activity in female mice taken during the proestrus/estrus stage (p < 0.05), but not female mice taken during the metestrus/diestrus stage or male mice. Further investigation found that IBS FS from female patients with high abdominal pain (N=6), but not patients with moderate (N=5) or low pain (N=3), increased visceral afferent nerve discharge by 70%. Single unit analysis of nociceptive axons showed that their activation was increased by almost 50% following FS perfusion from high abdominal pain patients only (p < 0.05). Histamine concentrations and proteolytic activity are increased in FS from female IBS patients with high abdominal pain compared to male IBS patients.

Conclusion(s)

This work suggests that luminal mediators that impact abdominal pain are increased in female IBS patients compared to male IBS patients, and females appear to be more sensitive to their pro-nociceptive effects. Together, these sex differences may contribute to the female predominance of IBS.

Disclosure of Interest

None Declared

The novel Mechanical Ventilator Milano for the COVID-19 pandemic

This paper presents the Mechanical Ventilator Milano (MVM), a novel intensive therapy mechanical ventilator designed for rapid, large-scale, low-cost production for the COVID-19 pandemic. Free of moving mechanical parts and requiring only a source of compressed oxygen and medical air to operate, the MVM is designed to support the long-term invasive ventilation often required for COVID-19 patients and operates in pressure-regulated ventilation modes, which minimize the risk of furthering lung trauma. The MVM was extensively tested against ISO standards in the laboratory using a breathing simulator, with good agreement between input and measured breathing parameters and performing correctly in response to fault conditions and stability tests. The MVM has obtained Emergency Use Authorization by U.S. Food and Drug Administration (FDA) for use in healthcare settings during the COVID-19 pandemic and Health Canada Medical Device Authorization for Importation or Sale, under Interim Order for Use in Relation to COVID-19. Following these certifications, mass production is ongoing and distribution is under way in several countries. The MVM was designed, tested, prepared for certification, and mass produced in the space of a few months by a unique collaboration of respiratory healthcare professionals and experimental physicists, working with industrial partners, and is an excellent ventilator candidate for this pandemic anywhere in the world.

Predicting Early Stages of Beef Respiratory Disease Using Thermal Imaging Technology

ObjectivesThe objective of this research was to utilize thermal imaging technology to estimate body temperature, so that an early stage of BRD can be detected.Materials and MethodsNinety-two steers were restrained in a squeeze chute that is housed in an indoor handling facility on 6 separate occasions. At least one image was taken of each side of the head using a thermal infrared camera (FLIR E8 WiFi, FLIR, Wilsonville, OR). The distance at which the images were taken was approximately 1 m from the steer. The rectal temperature was used as the control method to compare thermal imaging data. After thermal image acquisition, images were analyzed using the FLIR ResearchIR Max software (v. 4.40.8.28, FLIR, Wilsonville, OR), with the regions of interest being the eye and nasal cavity.ResultsThe analysis focused on minimum (MIN), maximum (MAX), mean, standard deviation (SD), and range of temperatures in the regions of interest. The REG procedure in SAS (v. 9.4, SAS Institute, Inc., Cary, NC) was used to perform stepwise regression to predict rectal temperature from the outdoor temperature (OTEMP) and all imaging features. When OTEMP was greater than –17.8°C, the regression model contained OTEMP, left nasal MAX, left nasal SD, and left eye MAX temperature and right eye temperature range, with an R2 of 0.24. When OTEMP was above freezing (0°C), the regression model contained left nasal temperature range, right eye temperature range, and average nasal mean temperature, with an R2 increase to 0.50. When using all data, the regression model fit left nasal MAX, right nasal MIN, average nasal mean, and left eye MAX temperatures and right eye temperature range, with an R2 of 0.08. These results show that thermal imaging technology has higher prediction accuracy in warmer temperature ranges than extreme cold conditions.ConclusionMore validation research on this thermal imaging technology needs to be conducted at warmer temperatures since all the current data was collected on cold winter days and a large portion of U.S. cattle are reared in more temperate and warmer areas than North Dakota such as Nebraska, Kansas, Texas, Oklahoma, and Florida. Overall, these results show promise for using thermal imaging technology to help detect BRD in an earlier stage by detecting fever before other clinical signs of BRD are present.

Potential for biocolloid transport of cesium at high ionic strength

In subsurface repositories, active bacterial populations may directly influence the fate and transport of radionuclides including in salt repository systems like the Waste Isolation Pilot Plant in Carlsbad, NM. This research quantified the potential for transport and interaction between Chromohalobacter sp. and Cs in a high ionic strength system (2.6 M NaCl) containing natural minerals. Mini-column experiments showed that Chromohalobacter moved nearly un-retarded under these conditions and that there was neither association of Cs with microbes nor dolomite despite changes in bacterial metabolic phases. Growth batch experiments that monitored the potential uptake of Cs into the microbes confirmed results in column experiments where intracellular uptake of Cs by Chromohalobacter was not observed. These results show that Cs may be highly mobile if released in high ionic strength systems and/or carbonate minerals with negligible inhibition by these microbes.

Alternative Locales for the Health Promotion of African American Men: A Survey of African American Men in Chicago Barbershops

African American men (AA) carry unequal burdens of several conditions including cancer, diabetes, hypertension, and HIV. Engagement of diverse populations including AA men in research and health promotion practice is vital to examining the health disparities that continue to plague many racially and ethnically diverse communities. To date, there is little research on best practices that indicate locations, community areas and settings to engage AA men in research and health promotion. Traditionally, the AA church has been a key area to engage AA men and women. However, changing tides in attendance of AA parishioners require additional information to identify areas where AAs, particularly, AA men congregate. The AA barbershop has been identified as a place of social cohesion, cultural immersion and solidarity for AA men but specific sub-populations of AA men may be underrepresented. To further investigate additional locales where AA men congregate, this study engaged AA barbers and clients in several urban community barbershops in Chicago, Illinois. 127 AA men over age 18y/o receiving grooming services in 25 Chicago area barbershops across 14 predominantly AA communities were consented and recruited for a quantitative survey study. The self-administered surveys were completed in ~15 min and $10 compensation was provided to men. Descriptive statistics were reported for demographic variables and for frequency of responses for locations to find AA men of specific age ranges for health promotion and screening activities. Outside of the traditionally used churches or barbershops, the top recommended recruitment sites by age were: 18-29y/o- city park or a recreational center; 30-39y/o- gym, bars or the street; 40-49y/o- various stores, especially home improvement stores, and the mall; and 50y/o+- fast food restaurants in the mornings, such as McDonalds, and individual's homes. The study participants also reported that locations where AA men congregate vary by age. Findings from this study illustrate that AA barbers and barbershops remain a key stakeholder in health promotion among AA men. The findings also demonstrate the need for additional research to examine best practices for identifying locations where diverse groups of AA men that vary by age and sexual orientation may congregate in order to support increased health promotion among AA men.

Major shifts at the range edge of marine forests: the combined effects of climate changes and limited dispersal

Global climate change is likely to constrain low latitude range edges across many taxa and habitats. Such is the case for NE Atlantic marine macroalgal forests, important ecosystems whose main structuring species is the annual kelp Saccorhiza polyschides. We coupled ecological niche modelling with simulations of potential dispersal and delayed development stages to infer the major forces shaping range edges and to predict their dynamics. Models indicated that the southern limit is set by high winter temperatures above the physiological tolerance of overwintering microscopic stages and reduced upwelling during recruitment. The best range predictions were achieved assuming low spatial dispersal (5 km) and delayed stages up to two years (temporal dispersal). Reconstructing distributions through time indicated losses of ~30% from 1986 to 2014, restricting S. polyschides to upwelling regions at the southern edge. Future predictions further restrict populations to a unique refugium in northwestern Iberia. Losses were dependent on the emissions scenario, with the most drastic one shifting ~38% of the current distribution by 2100. Such distributional changes might not be rescued by dispersal in space or time (as shown for the recent past) and are expected to drive major biodiversity loss and changes in ecosystem functioning.

120 IMPACT OF SEASON ON SEMINAL CHARACTERISTICS AND SPERM CRYOPRESERVATION IN THE TUFTED DEER (ELAPHODUS CEPHALOPHUS)

The Tufted deer (Elaphodus cephalophus), a small deer species native to China, is listed as near threatened on the IUCN Red List and >70 animals are managed in North American zoos as a hedge against extinction. In this study, we 1) characterized the seminal traits, 2) assessed the impact of season on ejaculate traits and testosterone level, and 3) examined sperm sensitivity to cryopreservation. Semen (24 ejaculates) were obtained from five males (1–2 ejaculates/male per season) by electro-ejaculation and evaluated for volume, osmolality, pH as well as sperm concentration, motility (%M), forward progression (FP, scale = 0–5) and acrosomal integrity (%AI). Ejaculates were divided into two aliquots and cryopreserved (4% vol/vol glycerol final concentration; 50–200 × 106 sperm mL–1) over liquid nitrogen vapor using Beltsville extender (BF5F; Howard et al. 1986) or Triladyl® (TRIL; Minitüb GmbH, Germany) extender. Sperm motility and %AI were assessed immediately (subjective) upon thawing and following swim-up processing (SU; 30 min) using computer-assisted semen analysis after 1, 2, 3, and 4 h of incubation (37°C). Fecal samples were collected 3–5 times weekly for 2 years and analyzed for testosterone (T) metabolites using enzyme immunoassay as a function of season (autumn, September–November; winter, December–February; spring, March–May; and summer, June–August). Data were analyzed using Proc GLM or ANOVA with Tukey multiple mean comparison. Significance was set at P < 0.05. Male reproductive and semen traits peaked in autumn (volume, 2.0 mL; concentration, 207.6 × 106 mL–1; pH, 7.6; osmolality, 310.8 mOsm; %M, 76%; FP, 3.5; and %AI, 82.3). Mean testicular length and neck girth in autumn were 4.9 and 43.2 cm, respectively. Mean T concentration (~1.23 µg g–1 of dry feces) was higher (P < 0.05) in summer compared with winter (1.07 µg g–1 of dry feces) or spring (1.06 µg g–1 of dry feces). Sperm motility and %AI were lower (P < 0.05) immediately after thawing (BF5F, 34.6 and 34.7%, respectively; and TRIL, 23.1 and 29.1%, respectively) compared with fresh semen (76.9 and 74.6%, respectively). Motility characteristics immediately after SU (computer-assisted semen analysis) were higher (P < 0.05) in BF5F compared with TRIL: %M (56.4 v. 44.9%), progressive motility (42.5 v. 21.9%), %AI (41.2 v. 31.3%), straight-line velocity (68.0 v. 53.2 µm s–1), straightness (85.1 v. 75.1%), and linearity (54.3 v. 45.0%). At the end of 4 h of incubation, sperm %M and FP declined (P > 0.05) in both BF5F and TRIL (47 and 30%, respectively) but the %AI was higher (P < 0.05) in BF5F (32%) than TRIL (21%). Results indicate that tufted deer ejaculates exhibit seasonal variations in reproductive traits and cryopreservation in BF5F better preserves sperm motility and acrosomal membrane integrity compared with TRIL.

Effect of home-based light treatment on persons with dementia and their caregivers

Sleep disorders are problematic for persons with dementia and their family caregivers. This randomized controlled trial with crossover evaluated the effects of an innovative blue-white light therapy on 17 pairs of home-dwelling persons with dementia and their caregivers. Subjects with dementia received blue-white light and control ('red-yellow' light) for six weeks separated by a four-week washout. Neither actigraphic nor most self-reported sleep measures significantly differed for subjects with dementia. For caregivers, both sleep and role strain improved. No evidence of retinal light toxicity was observed. Six weeks of modest doses of blue-white light appear to improve sleep in caregivers but not in persons with dementia. Greater or prolonged circadian stimulation may be needed to determine if light is an effective treatment for persons with dementia.

Olefinic acetates, Δ-9,11-14: OAc and Δ-7,9-12: OAc used as sex pheromone components in three geometrid moths,Idaea aversata, I. straminata, andI. biselata (Geometridae, Lepidoptera)

Pheromone compounds so far identified from most geometrid moths consist of all-Z diene, triene, or tetraene hydrocarbons with chain lengths of C17 to C21, and their monoepoxide derivatives biosynthesized from linoleic and linolenic acids. The present study reports the occurrence of olefinic acetates as sex pheromones in three species of Geometridae. (Z,Z)-9,11-tetradecadienyl acetate and (Z,Z)-7,9-dodecadienyl acetate found in female gland extracts ofIdaea aversata elicited significant responses from conspecific male antennae in gas chromatography with electroantennographic detection (GCEAD). In extracts ofI. straminata, (Z,Z)-7,9-dodecadienyl acetate, (E,Z)-7,9-dodecadienyl acetate, and (Z,Z)-7,9-dodecadienyl acetate were found, and the synthetic compounds elicited strong responses from conspecific male antennae. In the third species,I. biselata, only (Z,Z)-7,9-dodecadienyl acetate was found in the female extracts, and this compound elicited a strong EAD response from the conspecific male antenna. The identities of the pheromone components inI. aversata andI. straminata were further confirmed according to their characteristic ions after GC-MS analyses. Single sensillum recordings fromI. aversata showed two types of pheromone-detecting sensilla present on the male antenna. One type contained two receptor neurons, one of which was specifically tuned to (Z,Z)-9,11-tetradecadienyl acetate, the other to (Z,E)-9,11-tetradecadienyl acetate. A second type contained one neuron responding to (Z,Z)-7,9-dodecadienyl acetate. The two types were clearly different also with respect to external morphology, the former being considerably longer and having a larger base diameter. Also inI. straminata two physiological types of sensilla could be distinguished. One type contained two neurons, one of which responded to (Z,Z)-7,9-dodecadienyl acetate, the other to (Z,E)-9,11-tetradecadienyl acetate. The second type contained one neuron, responding to (Z,Z)-7,9-dodecadienyl acetate. No correlation between external morphology and physiological response of the investigated sensilla was observed inI. straminata. In field tests, a two-component blend containing (Z,Z)-9,11-tetradecadienyl acetate and (Z,Z)-7,9-dodecadienyl acetate in a ratio of 10:1 was attractive to males ofI. aversata. This two-component blend was also attractive to males ofI. straminata, but in a ratio of 1:1. High numbers of maleI. biselata were caught in traps baited with (Z,Z)-7,9-dodecadienyl acetate alone. The incorporation of deuterium labels into pheromone components after topical application of deuterium-labeled palmitic acid confirmed that the pheromone components ofI. aversata could be synthesized from this precursor, as has been previously observed for acetate pheromone components of many other moth species. Our results suggest that an evolutionary reversal back to the production of palmitic acid-derived pheromone components has occurred within the geometrid subfamily Sterrhinae.

Towards automatic detection of abnormal retinal capillaries in ultra-widefield-of-view retinal angiographic exams

Retinal capillary abnormalities include small, leaky, severely tortuous blood vessels that are associated with a variety of retinal pathologies. We present a prototype image-processing system for detecting abnormal retinal capillary regions in ultra-widefield-of-view (UWFOV) fluorescein angiography exams of the human retina. The algorithm takes as input an UWFOV FA frame and returns the candidate regions identified. An SVM classifier is trained on regions traced by expert ophthalmologists. Tests with a variety of feature sets indicate that edge features and allied properties differentiate best between normal and abnormal retinal capillary regions. Experiments with an initial set of images from patients showing branch retinal vein occlusion (BRVO) indicate promising area under the ROC curve of 0.950 and a weighted Cohen's Kappa value of 0.822.

Maternal and foetal outcomes in pregnant patients with active lupus nephritis

The objective of this study was to determine the impact of lupus nephritis disease activity on maternal and foetal outcomes in pregnant patients with systemic lupus erythematosus (SLE). Medical records of all pregnant patients with SLE treated at our institution between 1976 and 2007 were reviewed. All patients met American College of Rheumatology classification criteria for SLE. Demographic data, history of lupus nephritis, nephritis disease activity and maternal and foetal outcomes of pregnancy were abstracted. Active lupus nephritis was defined as the presence of proteinuria >0.5 g/day and/or active urinary sediment with or without an elevation in serum creatinine (Cr). Quiescent lupus nephritis was confirmed in the presence of proteinuria <0.5 mg/day and inactive urinary sediment. We identified 58 patients with 90 pregnancies. Compared with pregnancies in SLE patients without renal involvement (n = 47), pregnancies in patients with active lupus nephritis (n = 23) were associated with a higher incidence of maternal complications (57% vs 11%, P < 0.001), whereas those with quiescent lupus nephritis (n = 20) were not (35% vs 11%, P = 0.10). Women with active lupus nephritis were more likely to deliver preterm than women without lupus nephritis, median of 34 weeks vs 40 gestational weeks, respectively (P = 0.002) and were more likely to suffer foetal loss (35% vs 9%, P = 0.031). Active, but not quiescent, lupus nephritis during pregnancy is associated with a higher incidence of maternal and foetal complications compared with pregnancies in SLE patients without renal involvement.

Instructional Practices at Farm Safety 4 Just Kids (FS4JK) Safety Day Camps

The instructional methods used with 1,347 youth in seven Farm Safety 4 Just Kids (FS4JK) day camp sessions conducted in five states during the summer and fall of 2002 were videotaped. The videotapes, instructor questionnaires, and day camp materials were analyzed using an observation protocol that focused on instructional practices and an interaction analysis of instructor-student talk during the sessions. Results showed that instruction focused on hazard recognition, a high level of participant attention during all the sessions observed, and safety day camp content relevant to rural participants regardless of whether they live or work on a farm. Recommendations for improving instructional practice include better use of print materials, more interactive, participatory activities for students, and reduction of instructor-centered, didactic approaches. Given the high level of students' attention, increased involvement of students in active, participatory approaches might enhance the effectiveness of the instruction by: (1) further engaging students through personalizing hazard recognition, (2) contextualizing reports of injuries, (3) examining the complexities of choosing safe behaviors, and (4) paying more attention to the consequences of injury events. Role-playing, narrative simulations, and other types of interactive and collaborative exercises are instructional approaches that support the inclusion of the pre-event contingencies and post-event consequences that are part of all injury events.

Genetics of human taste perception

Genetic approaches are rapidly yielding new information about our sense of taste. This information comes from both molecular studies of genes encoding taste receptors and other taste-signaling components, and from studies of inherited variation in taste abilities. Our understanding of bitter taste has advanced by combined information from discovery and study of the TAS2R family of taste receptor genes, hand in hand with genetic linkage and positional cloning studies, notably on the ability to taste phenylthiocarbamide (PTC). Sweet and umami tastes, mediated by TAS1R receptors, are becoming well-characterized at the molecular genetic level, and these taste classes are now targets for linkage, positional cloning, and genetic association strategies. Salty and sour tastes are still poorly characterized in genetic terms, and represent opportunities for the future.

Abdominal obesity and carotid artery wall thickness. The Los Angeles Atherosclerosis Study

OBJECTIVE

To determine whether or not abdominal obesity is associated with the intima-media thickness (IMT) of the carotid artery wall independently of total body obesity and major risk factors for atherosclerosis.

DESIGN

: Longitudinal epidemiological study.

SUBJECTS

A total of 573 middle-aged employees of a utility company.

MEASUREMENTS

Sagittal and transverse abdominal diameters, their ratio and difference were used as measures of abdominal obesity.

RESULTS

Abdominal diameters and body mass index (BMI) were significantly associated with blood pressure, serum lipoproteins and fasting insulin. In cross-sectional multiple regression models, the sagittal/transverse ratio and BMI were significantly associated with IMT in the presence of atherosclerosis risk, but the sagittal diameter was not. In longitudinal models, baseline BMI was an independent predictor of IMT progression but the sagittal and transverse diameters were not.

CONCLUSION

These findings do not support the hypothesis that abdominal obesity is an independent predictor of carotid artery IMT. The consistent pattern of association of measures of general obesity with carotid artery IMT emphasizes the continuing need for prevention and control of this important risk factor.

Genetic counseling outcomes validation by genetics nurses in the UK and US

PURPOSE

To validate genetic counseling outcomes with a sample of genetics nurses from the United Kingdom (UK), and to compare elements of genetic counseling outcomes with those from a sample of genetics nurses from the United States (US).

DESIGN

Descriptive-comparative survey.

METHODS

Concept analysis and literature review were used to designate outcomes, and genetics nurses were surveyed to validate the outcomes. A revision of Fehring's 1987 methodology for assessing content validity was used to estimate content validity and sensitivity of the genetic counseling outcomes. Data are reported on a convenience sample of 50 UK nurse members of the Association of Genetic Nurses and Counsellors. Findings were correlated with prior data from a convenience sample of 92 U.S. nurse members of the International Society of Nurses in Genetics, Inc., and data were compared between groups.

FINDINGS

A significant positive correlation was found between samples of U.K. and U.S. nurses regarding components of outcomes of the genetic counseling process and between groups regarding extent of contribution of nurses to the outcomes. Strength of nursing contributions to knowledge of disease and indicators of coping varied according to country.

CONCLUSIONS

Genetics nurses in the UK and US had similar definitions of outcomes of genetic counseling, but priorities of indicators differed between countries. Terminology used in measures to identify outcomes of the process of genetic counseling must be consistent with cultural norms.

Immigration and males' earnings inequality in the regions of the United States

In this paper I investigate the impact of recent immigration on males' earnings distributions in the major regions of the United States. I use six counterfactual scenarios to describe alternative regional skill distributions and wage structures for the population of natives and long-term immigrants in the absence of recent immigration. I find that immigration over the last three decades can account for a substantial portion of the variation in inequality across the regions. Recent immigration has contributed moderately to national growth in males' earnings inequality, primarily by changing the composition of the population.

Haem oxygenase in enteric nervous system of human stomach and jejunum and co-localization with nitric oxide synthase

Recent evidence suggests that carbon monoxide (CO) may be a neurotransmitter, similar to nitric oxide (NO) in the enteric nervous system. The distribution of haem oxygenase (HO), the biosynthetic enzyme for CO, has been determined in the enteric nervous system of animals, but little is known about the distribution of HO in human gastrointestinal tract. The present study investigated the expression of HO and its colocalization with NO synthase (NOS), the biosynthetic enzyme for NO, in human antrum and jejunum. HO isoforms were identified using immunohistochemistry and NOS was identified by immunohistochemistry or NADPH-d histochemistry. HO-2 immunoreactive (IR) cell bodies in enteric ganglia and nerve fibres in longitudinal and circular muscle were found in both antrum and jejunum. Co-localization of HO-2 and NOS was about 40% in HO-2 containing cell bodies of myenteric ganglia and only 10% or less in cell bodies of submucous ganglia. HO-1 immunoreactivity was not detected in antrum or jejunum. The results suggest that CO is produced in human enteric ganglion neurones and indicate a possible role of CO as a neurotransmitter and possible interaction between HO and NOS pathways in inhibitory neurotransmission in the human gastrointestinal tract.

Role of interferon regulatory factor-1 in the regulation of IL-18 production and activity

Interferon regulatory factor-1 (IRF-1) is a transcription factor regulating the expression of several cytokines. Using IRF-1 knockout (KO) mice, the role of IRF-1 in the production and activity of IL-18 was evaluated. Administration of IL-12 or concanavalin A significantly increased levels of circulating IL-18 in wild-type (WT), but not in IRF-1 KO mice. However, despite these differences in circulating IL-18 levels, no or only minor differences in constitutive or inducible IL-18 mRNA and tissue-associated protein levels were observed between WT and IRF-1 KO mice. On the other hand, we observed that constitutive and inducible levels of the IL-18-processing enzyme caspase-1 were markedly reduced in the spleen and the liver of IRF-1 KO compared to WT mice. In addition, both constitutive and inducible liver mRNA levels for the IL-18 binding protein (IL-18BP), a specific IL-18 antagonist, were significantly lower in IRF-1 KO than in WT mice. Compared to IL-12, IL-18 only weakly induced IRF-1 mRNA in cultured splenocytes. However, IL-18-induced IFN-gamma production was strongly reduced in splenocytes from IRF-1 KO compared to WT cells. In conclusion, IRF-1 regulates IL-18 production and activity mostly by modulating expression of caspase-1 and IL-18BP. In addition, IRF-1 participates in the induction of IFN-gamma by IL-18.

Medication administration practices of school nurses

This study assessed the medication administration practices of school nurses. From a random sample of 1,000 members of the National Association of School Nurses, 649 (64.9%) completed the survey developed for the study. These school nurses report that during a typical day, 5.6% of children receive medication in school, with 3.3% receiving medications for ADHD. Almost all the school nurses follow written guidelines for administering medication. Potential problems were identified in documenting side effects of medications, storage of medications, student self-administration practices, and appropriate authorization of nonprescription drug use. Most nurses (75.6%) delegate medication administration to unlicensed assistive personnel (UAP), with secretaries (66.2%) the most common UAP. Discomfort with delegation and confusion over state nurse practice laws were noted. Errors in administering medications were reported by 48.5% of the school nurses, with missed dose (79.7%) the most common error. Factors identified as contributing to errors included use of UAP and responsibility for large numbers of students.

Who's the boss? Family/staff partnership in care of persons with dementia

This article provides an overview of family involvement in care intervention and its implementation with African American and Caucasian family members of persons with dementia in nursing home settings.

Sequence heterogeneity of TT virus and closely related viruses

TT virus (TTV) is a recently discovered infectious agent originally obtained from transfusion-related hepatitis. However, the causative link between the TTV infection and liver disease remains uncertain. Recent studies demonstrated that genome sequences of different TTV strains are significantly divergent. To assess genetic heterogeneity of the TTV genome in more detail, a sequence analysis of PCR fragments (271 bp) amplified from open reading frame 1 (ORF1) was performed. PCR fragments were amplified from 5 to 40% of serum specimens obtained from patients with different forms of hepatitis who reside in different countries (e.g., China, Egypt, Vietnam, and the United States) and from normal human specimens obtained from U.S. residents. A total of 170 PCR fragments were sequenced and compared to sequences derived from the corresponding TTV genome region deposited in GenBank. Genotypes 2 and 3 were found to be significantly more genetically related than any other TTV genotype. Moreover, three sequences were shown to be almost equally related to both genotypes 2 and 3. These observations suggest a merger of genotypes 2 and 3 into one genotype, 2/3. Additionally, five new groups of TTV sequences were identified. One group represents a new genotype, whereas the other four groups were shown to be more evolutionary distant from all known TTV sequences. The evolutionary distances between these four groups were also shown to be greater than between TTV genotypes. The phylogenetic analysis suggested that these four new genetic groups represent closely related yet different viral species. Thus, TTV exists as a "swarm" of at least five closely related but different viruses. These observations suggest a high degree of genetic complexity within the TTV population. The finding of the additional TTV-related species should be taken into consideration when the association between TTV infections and human diseases of unknown etiology is studied.

Effects of cognitive treatment in psychiatric rehabilitation

Ninety subjects with severe and disabling psychiatric conditions, predominantly schizophrenia, participated in a controlled-outcome trial of the cognitive component of Integrated Psychological Therapy (IPT), a group-therapy modality intended to reestablish basic neurocognitive functions. The cognitive therapy was delivered to subjects in the experimental condition during intensive 6-month treatment periods. Control subjects received supportive group therapy. Before, during, and after the intensive treatment period, all subjects received an enriched regimen of comprehensive psychiatric rehabilitation, including social and living skills training, optimal pharmacotherapy, occupational therapy, and milieu-based behavioral treatment. IPT subjects showed incrementally greater gains compared with controls on the primary outcome measure, the Assessment of Interpersonal Problem-Solving Skills, suggesting that procedures that target cognitive impairments of schizophrenia spectrum disorders can enhance patients' response to standard psychiatric rehabilitation, at least in the short term, in the domain of social competence. There was equivocal evidence for greater improvement in the experimental condition on the Brief Psychiatric Rating Scale disorganization factor and strong evidence for greater improvement on a laboratory measure of attentional processing. There was significant improvement in both conditions on measures of attention, memory, and executive functioning, providing support for the hypothesis that therapeutic procedures that target impaired cognition enhance response to conventional psychiatric rehabilitation modalities over a 6-month timeframe.

Describing patient problems & nursing treatment patterns using nursing minimum data sets (NMDS & NMMDS) & UHDDS repositories

Dramatic changes in health care have intensified practitioners' efforts to access and use information to determine more efficacious approaches to patient outcomes. The overall goal of the study is to measure the influence of nursing informatics clinical reasoning decision support interventions on patient outcomes. This paper describes Phases I of the study: the methodology for establishing and testing the usefulness of large data repositories comprised of three minimum data sets, including the Nursing Minimum Data Set (NMDS), the Nursing Management Minimum Data Set (NMMDS), and the Uniform Hospital Discharge Data Set (UHDDS), and the American Nurses Association Quality Indicators to support effectiveness research. The use of generic data modeling to construct a clinical nursing repository of more than 477,000 electronic records is discussed. Patient problem and treatment profiles, patterns, and variations based on standardized analyzing classifications are described for inpatient adult samples, and nursing and medical diagnosis groups.

Do elderly women have more physical disability than men do?

This study investigated whether the commonly observed higher prevalence of physical disability among women is due to higher incidence rates or to other factors such as selective mortality or poor recovery. Methods included observed measures of prevalent lower body physical disability and potential risk factors at baseline (1989-1991) and 4-year follow-up of 2,025 community-dwelling adults aged 55 years and older in Marin County, California. Incidence, recovery, and mortality rates were determined at the follow-up examination. Results indicated that women had higher age-specific and age-adjusted prevalence rates at both examinations (odds ratios = 1.66 and 1.60, p<0.001) but that incidence rates were not significantly different (odds ratio = 1.12, 95% confidence interval: 0.77, 1.64). In the classic formulation, prevalence = incidence x duration, the higher prevalence rates in women could not be due to a higher incidence rate, but could be explained by longer duration due to lower recovery and mortality rates in women. Incident physical disability was predicted by prevalent chronic illnesses, poor vision, obesity, physical inactivity, poor memory, fewer social activities, and higher depression scores, but not by sex. Prevention efforts should concentrate on reducing known risk factors in both men and women and on promoting higher recovery rates among women.