The feigned annoyance and frustration test to activate the sympathoadrenal medullary system

When perceived as threatening, social interactions have been shown to trigger the sympathoadrenal medullary system as well as the hypothalamic-pituitary-adrenal axis resulting in a physiologic stress response. The allostatic load placed on human health and physiology in the context of acute and chronic stress can have profound health consequences. The purpose of this study was to develop a protocol for a lab-based stress stimulus using social-evaluative threat. While several valid, stress-stimulating protocols exist, we sought to develop one that triggered a physiologic response, did not require significant lab resources, and could be completed in around 10 min. We included 53 participants (29 men and 24 women) and exposed them to a modified version of the Stroop Color-Word Interference Task during which the participants were made to feel they were performing the task poorly while the lead researcher feigned annoyance and frustration. After exposure to this Feigned Annoyance and Frustration (FAF) Test, both the men and women in this study demonstrated a statistically significant and clinically meaningful increase in subjective stress on the visual analog scale. Additionally, the men in this study demonstrated a statistically significant increase in heart rate and salivary α-amylase concentrations after exposure to the test. The women in this study did not demonstrate a statistically significant increase in the physiologic stress biomarkers. This protocol for the FAF Test shows promise to researchers with limited time and resources who are interested in experimentally activating the sympathoadrenal medullary system.

Picturing oneself over time: a multi-modal interpretative phenomenological analysis of pain management trajectories

BACKGROUND

Chronic pain (CP) can be a disabling condition with impacts that affect the sense of identity of those who live with it. This article idiographically describes the longitudinal evolution of the sense of self of participants following their referral to a pain management service and participation in a pain management programme (PMP).

METHODS

Participants were interviewed three times: before they attended a PMP, and 1 and 6 months after the PMP. Data included the drawings of themselves that participants created at each interview and the transcripts of the interviews guided by the drawings, analysed longitudinally using interpretative phenomenological analysis.

RESULTS

This paper describes in detail the cases of four participants: two who experienced a positive albeit troubled trajectory following their PMP and two who did not experience any positive change. The results provide a nuanced account of how the impacts of CP on identity can evolve, with different people engaging with different aspects of a PMP and some people not engaging at all, and how pain self-management strategies enable those that do engage to cope in times of difficulty.

CONCLUSIONS

Participant responses to PMP participation are idiosyncratic and interviews with drawings of self analysed longitudinally can help illustrate processes of change.

SIGNIFICANCE

Not enough is understood about why some people get limited benefits from pain services. This idiographic longitudinal study illustrates how the impact of CP on identity can evolve when people are introduced to pain self-management, with some embracing change and others resisting it. For clinicians, this study describes four detailed CP individual paths, showing the interaction between contextual and idiosyncratic aspects. This is also the first study to use multiple drawings of self to explore the impacts of illness on identity longitudinally. In a person-centred approach to treatment, the drawings of self could also be adopted as a tool in clinician-patient conversations to gain a deeper understanding of the impacts of living with CP.

Management of chemotherapy hypersensitivity reactions and desensitization: An SGO clinical practice statement

OBJECTIVE

The goal of this practice statement is to help members and their multidisciplinary teams recognize infusion reactions and hypersensitivity reactions in the clinical setting. It will provide recommendations to help guide response to reactions and desensitization when appropriate, to promote safe use of chemotherapeutic agents among all providers in the delivery process.

METHODS

A multi-disciplinary team of healthcare professionals from the Society of Gynecologic Oncology Education Committee collaborated to review peer reviewed literature and guidelines to develop a practice statement on the management of chemotherapy hypersensitivity reactions and desensitization regimens.

RESULTS

There is always potential for a patient to have a reaction to any medication, with both infusion reactions and hypersensitivity reactions potentially occurring in the treatment of gynecologic cancers. Premedication to prevent reactions should be given at least prior to infusion for regimens that include the most common agents associated with reactions. At the time when reaction is occurring it might be difficult to distinguish between an infusion reaction versus true hypersensitivity given the similarities in signs and symptoms, therefore it is important that orders to manage reactions be included in every chemotherapy order set so the infusion nurse can provide immediate interventions while waiting for the provider to arrive to assess the patient. Desensitization is a potential option to allow the patient to continue to receive the offending agent. While a variety of desensitization regimens have been presented in the literature, the goal is to minimize steps and variability to decrease opportunity for errors during chemotherapy preparation or administration.

CONCLUSION

Incorporating a review of the literature and clinical experience from the SGO Education Committee, this paper provides an overview of current approaches for prevention and management of reactions to commonly used chemotherapy agents for gynecologic cancers.

Heterogeneous melting near the Thwaites Glacier grounding line

Thwaites Glacier represents 15% of the ice discharge from the West Antarctic Ice Sheet and influences a wider catchment^1-3. Because it is grounded below sea level^4,5, Thwaites Glacier is thought to be susceptible to runaway retreat triggered at the grounding line (GL) at which the glacier reaches the ocean^6,7. Recent ice-flow acceleration^2,8 and retreat of the ice front^8-10 and GL^11,12 indicate that ice loss will continue. The relative impacts of mechanisms underlying recent retreat are however uncertain. Here we show sustained GL retreat from at least 2011 to 2020 and resolve mechanisms of ice-shelf melt at the submetre scale. Our conclusions are based on observations of the Thwaites Eastern Ice Shelf (TEIS) from an underwater vehicle, extending from the GL to 3 km oceanward and from the ice-ocean interface to the sea floor. These observations show a rough ice base above a sea floor sloping upward towards the GL and an ocean cavity in which the warmest water exceeds 2 °C above freezing. Data closest to the ice base show that enhanced melting occurs along sloped surfaces that initiate near the GL and evolve into steep-sided terraces. This pronounced melting along steep ice faces, including in crevasses, produces stratification that suppresses melt along flat interfaces. These data imply that slope-dependent melting sculpts the ice base and acts as an important response to ocean warming.

Reliability of a Barre-Mounted Dynamometer-Stabilizing Device in Measuring Dance-Specific Muscle Performance

BACKGROUND

Hand-held dynamometry is considered an efficient, effective, and portable means of objectively measuring lower extremity strength; however, it has yet to be studied specific to dance-relevant muscle performance. Also, dynamometry is often criticized for variability in results based on tester strength and sex. Use of an external stabilizing device has been suggested to minimize differences in outcomes between male and female testers by reducing variability associated with tester strength limitations. Therefore, this study used a barre-mounted, portable dynamometer stabilizing device to improve consistency of results among different testers for assessing hip and lower extremity muscle performance in dance-relevant positions.

OBJECTIVE

To assess the intra and inter-rater reliability of a barre-mounted dynamometer stabilizing device in measuring muscle performance in common dance maneuvers.

METHODS

Two testers assessed muscle performance of three common dance maneuvers--développé en avant, à la secondé, and arabesque--on 11 pre-professional and professional dancers on two separate occasions to establish intra- and inter-rater reliability of the barre-mounted dynamometer stabilizing device.

RESULTS

Intra-rater reliability was moderate to high and inter-rater reliability of the device was excellent, with intraclass correlation coefficients ranging from 0.527-0.851 and 0.834-0.953, respectively, for all positions.

CONCLUSIONS

The barre-mounted stabilizing device shows promise in mitigating tester strength or fatigue in assessing muscle performance of dancers. Initial assessment of the device suggests further study may be indicated to improve generalizability to applications of larger-scale muscle performance screening and assessment in dancers or other athletic populations who engage in movements that require extensive hip range of motion and multi-joint stability.

CLINICAL RELEVANCE

Using a portable, barre-mounted stabilizing device in assessing multi-joint lower extremity muscle performance in dancers improves consistency of testing results. Application of this testing device into wider scale screenings could assist in developing normative data for a population that is lacking.

Novel DNA methylation signatures of tobacco smoking with trans-ethnic effects

BACKGROUND

Smoking remains one of the leading preventable causes of death. Smoking leaves a strong signature on the blood methylome as shown in multiple studies using the Infinium HumanMethylation450 BeadChip. Here, we explore novel blood methylation smoking signals on the Illumina MethylationEPIC BeadChip (EPIC) array, which also targets novel CpG-sites in enhancers.

METHOD

A smoking-methylation meta-analysis was carried out using EPIC DNA methylation profiles in 1407 blood samples from four UK population-based cohorts, including the MRC National Survey for Health and Development (NSHD) or 1946 British birth cohort, the National Child Development Study (NCDS) or 1958 birth cohort, the 1970 British Cohort Study (BCS70), and the TwinsUK cohort (TwinsUK). The overall discovery sample included 269 current, 497 former, and 643 never smokers. Replication was pursued in 3425 trans-ethnic samples, including 2325 American Indian individuals participating in the Strong Heart Study (SHS) in 1989-1991 and 1100 African-American participants in the Genetic Epidemiology Network of Arteriopathy Study (GENOA).

RESULTS

Altogether 952 CpG-sites in 500 genes were differentially methylated between smokers and never smokers after Bonferroni correction. There were 526 novel smoking-associated CpG-sites only profiled by the EPIC array, of which 486 (92%) replicated in a meta-analysis of the American Indian and African-American samples. Novel CpG sites mapped both to genes containing previously identified smoking-methylation signals and to 80 novel genes not previously linked to smoking, with the strongest novel signal in SLAMF7. Comparison of former versus never smokers identified that 37 of these sites were persistently differentially methylated after cessation, where 16 represented novel signals only profiled by the EPIC array. We observed a depletion of smoking-associated signals in CpG islands and an enrichment in enhancer regions, consistent with previous results.

CONCLUSION

This study identified novel smoking-associated signals as possible biomarkers of exposure to smoking and may help improve our understanding of smoking-related disease risk.

Polyornithine-based polyplexes to boost effective gene silencing in CNS disorders

Gene silencing therapies have successfully suppressed the translation of target proteins, a strategy that holds great promise for the treatment of central nervous system (CNS) disorders. Advances in the current knowledge on multimolecular delivery vehicles are concentrated on overcoming the difficulties in delivery of small interfering (si)RNA to target tissues, which include anatomical accessibility, slow diffusion, safety concerns, and the requirement for specific cell uptake within the unique environment of the CNS. The present work addressed these challenges through the implementation of polyornithine derivatives in the construction of polyplexes used as non-viral siRNA delivery vectors. Physicochemical and biological characterization revealed biodegradability and biocompatibility of our polyornithine-based system and the ability to silence gene expression in primary oligodendrocyte progenitor cells (OPCs) effectively. In summary, the well-defined properties and neurological compatibility of this polypeptide-based platform highlight its potential utility in the treatment of CNS disorders.

Fungal Planet description sheets: 951-1041

Novel species of fungi described in this study include those from various countries as follows: Antarctica, Apenidiella antarctica from permafrost, Cladosporium fildesense from an unidentified marine sponge. Argentina, Geastrum wrightii on humus in mixed forest. Australia, Golovinomyces glandulariae on Glandularia aristigera, Neoanungitea eucalyptorum on leaves of Eucalyptus grandis, Teratosphaeria corymbiicola on leaves of Corymbia ficifolia, Xylaria eucalypti on leaves of Eucalyptus radiata. Brazil, Bovista psammophila on soil, Fusarium awaxy on rotten stalks of Zea mays, Geastrum lanuginosum on leaf litter covered soil, Hermetothecium mikaniae-micranthae (incl. Hermetothecium gen. nov.) on Mikania micrantha, Penicillium reconvexovelosoi in soil, Stagonosporopsis vannaccii from pod of Glycine max. British Virgin Isles, Lactifluus guanensis on soil. Canada, Sorocybe oblongispora on resin of Picea rubens. Chile, Colletotrichum roseum on leaves of Lapageria rosea. China, Setophoma caverna from carbonatite in Karst cave. Colombia, Lareunionomyces eucalypticola on leaves of Eucalyptus grandis. Costa Rica, Psathyrella pivae on wood. Cyprus, Clavulina iris on calcareous substrate. France, Chromosera ambigua and Clavulina iris var. occidentalis on soil. French West Indies, Helminthosphaeria hispidissima on dead wood. Guatemala, Talaromyces guatemalensis in soil. Malaysia, Neotracylla pini (incl. Tracyllales ord. nov. and Neotracylla gen. nov.) and Vermiculariopsiella pini on needles of Pinus tecunumanii. New Zealand, Neoconiothyrium viticola on stems of Vitis vinifera, Parafenestella pittospori on Pittosporum tenuifolium, Pilidium novae-zelandiae on Phoenix sp. Pakistan, Russula quercus-floribundae on forest floor. Portugal, Trichoderma aestuarinum from saline water. Russia, Pluteus liliputianus on fallen branch of deciduous tree, Pluteus spurius on decaying deciduous wood or soil. South Africa, Alloconiothyrium encephalarti, Phyllosticta encephalarticola and Neothyrostroma encephalarti (incl. Neothyrostroma gen. nov.) on leaves of Encephalartos sp., Chalara eucalypticola on leaf spots of Eucalyptus grandis × urophylla, Clypeosphaeria oleae on leaves of Olea capensis, Cylindrocladiella postalofficium on leaf litter of Sideroxylon inerme, Cylindromonium eugeniicola (incl. Cylindromonium gen. nov.) on leaf litter of Eugenia capensis, Cyphellophora goniomatis on leaves of Gonioma kamassi, Nothodactylaria nephrolepidis (incl. Nothodactylaria gen. nov. and Nothodactylariaceae fam. nov.) on leaves of Nephrolepis exaltata, Falcocladium eucalypti and Gyrothrix eucalypti on leaves of Eucalyptus sp., Gyrothrix oleae on leaves of Olea capensis subsp. macrocarpa, Harzia metrosideri on leaf litter of Metrosideros sp., Hippopotamyces phragmitis (incl. Hippopotamyces gen. nov.) on leaves of Phragmites australis, Lectera philenopterae on Philenoptera violacea, Leptosillia mayteni on leaves of Maytenus heterophylla, Lithohypha aloicola and Neoplatysporoides aloes on leaves of Aloe sp., Millesimomyces rhoicissi (incl. Millesimomyces gen. nov.) on leaves of Rhoicissus digitata, Neodevriesia strelitziicola on leaf litter of Strelitzia nicolai, Neokirramyces syzygii (incl. Neokirramyces gen. nov.) on leaf spots of Syzygium sp., Nothoramichloridium perseae (incl. Nothoramichloridium gen. nov. and Anungitiomycetaceae fam. nov.) on leaves of Persea americana, Paramycosphaerella watsoniae on leaf spots of Watsonia sp., Penicillium cuddlyae from dog food, Podocarpomyces knysnanus (incl. Podocarpomyces gen. nov.) on leaves of Podocarpus falcatus, Pseudocercospora heteropyxidicola on leaf spots of Heteropyxis natalensis, Pseudopenidiella podocarpi, Scolecobasidium podocarpi and Ceramothyrium podocarpicola on leaves of Podocarpus latifolius, Scolecobasidium blechni on leaves of Blechnum capense, Stomiopeltis syzygii on leaves of Syzygium chordatum, Strelitziomyces knysnanus (incl. Strelitziomyces gen. nov.) on leaves of Strelitzia alba, Talaromyces clemensii from rotting wood in goldmine, Verrucocladosporium visseri on Carpobrotus edulis. Spain, Boletopsis mediterraneensis on soil, Calycina cortegadensisi on a living twig of Castanea sativa, Emmonsiellopsis tuberculata in fluvial sediments, Mollisia cortegadensis on dead attached twig of Quercus robur, Psathyrella ovispora on soil, Pseudobeltrania lauri on leaf litter of Laurus azorica, Terfezia dunensis in soil, Tuber lucentum in soil, Venturia submersa on submerged plant debris. Thailand, Cordyceps jakajanicola on cicada nymph, Cordyceps kuiburiensis on spider, Distoseptispora caricis on leaves of Carex sp., Ophiocordyceps khonkaenensis on cicada nymph. USA, Cytosporella juncicola and Davidiellomyces juncicola on culms of Juncus effusus, Monochaetia massachusettsianum from air sample, Neohelicomyces melaleucae and Periconia neobrittanica on leaves of Melaleuca styphelioides × lanceolata, Pseudocamarosporium eucalypti on leaves of Eucalyptus sp., Pseudogymnoascus lindneri from sediment in a mine, Pseudogymnoascus turneri from sediment in a railroad tunnel, Pulchroboletus sclerotiorum on soil, Zygosporium pseudomasonii on leaf of Serenoa repens. Vietnam, Boletus candidissimus and Veloporphyrellus vulpinus on soil. Morphological and culture characteristics are supported by DNA barcodes.

Individuals With Recurrent Low Back Pain Exhibit Significant Changes in Paraspinal Muscle Strength After Intramuscular Fine Wire Electrode Insertion

OBJECTIVE

To examine how insertion and presence of intramuscular fine-wire electromyography electrodes (IFWEs) in lumbar multifidus affect paraspinal muscle strength, endurance, and activation in persons with and without recurrent lower back pain (RLBP) during activities that require high levels of muscle contraction.

DESIGN

Case-control with randomization of conditions.

SETTING

Clinical research laboratory.

PARTICIPANTS

Forty participants age 18 to 40 years were recruited (18 female; mean age = 25.5 years); 20 with a history of RLBP were compared to a matching control group of 20 without RLBP.

INTERVENTIONS

Each participant was tested under three conditions over three sessions. On Session 1, the baseline condition, we assessed muscle performance without IFWE insertion. On Sessions 2 and 3, participants were randomly alternated between two experimental conditions: (1) wire-in, in which the IFWE was inserted and remained within the muscle during testing; and (2) wire-out, in which the IFWE was inserted and immediately removed.

MAIN OUTCOME MEASUREMENTS

Lumbar spinal extensor peak strength, endurance, and normalized electromyography (EMG) amplitude during the endurance test.

RESULTS

Individuals with RLBP showed a significant decrease in peak strength during conditions that involved IFWE insertion and tend to experience more pain during muscle testing. Both groups exhibited similar levels of performance and muscle activation during the endurance test.

CONCLUSION

Our findings indicate that individuals with RLBP exhibited reduced lumbar extensor strength in response to IFWE insertion to the deep paraspinal muscles. This behavior is different from those without RLBP. Researchers should carefully consider the use of IFWE in individuals with RLBP during high exertion activities.

Protocol of a two arm randomised, multi-centre, 12-month controlled trial: evaluating the impact of a Cognitive Behavioural Therapy (CBT)-based intervention Supporting UPtake and Adherence to antiretrovirals (SUPA) in adults with HIV

Background

Delay to start antiretroviral therapy (ART) and nonadherence compromise the health and wellbeing of people living with HIV (PLWH), raise the cost of care and increase risk of transmission to sexual partners. To date, interventions to improve adherence to ART have had limited success, perhaps because they have failed to systematically elicit and address both perceptual and practical barriers to adherence. The primary aim of this study is to determine the efficacy of the Supporting UPtake and Adherence (SUPA) intervention.

Methods

This study comprises 2 phases. Phase 1 is an observational cohort study, in which PLWH who are ART naïve and recommended to take ART by their clinician complete a questionnaire assessing their beliefs about ART over 12 months. Phase 2 is a randomised controlled trial (RCT) nested within the observational cohort study to investigate the effectiveness of the SUPA intervention on adherence to ART. PLWH at risk of nonadherence (based on their beliefs about ART) will be recruited and randomised 1:1 to the intervention (SUPA intervention + usual care) and control (usual care) arms. The SUPA intervention involves 4 tailored treatment support sessions delivered by a Research Nurse utilising a collaborative Cognitive Behavioural Therapy (CBT) and Motivational Interviewing (MI) approach. Sessions are tailored to individual needs and preferences based on the individual patient’s perceptions and practical barriers to ART. An animation series and intervention manual have been developed to communicate a rationale for the personal necessity for ART and illustrate concerns and potential solutions. The primary outcome is adherence to ART measured using Medication Event Monitoring System (MEMS). Three hundred seventy-two patients will be sufficient to detect a 15% difference in adherence with 80% power and an alpha of 0.05. Costs will be compared between intervention and control groups. Costs will be combined with the primary outcome in cost-effectiveness analyses. Quality adjusted life-years (QALYs) will also be estimated over the follow-up period and used in the analyses.

Discussion

The findings will enable patients, healthcare providers and policy makers to make informed decisions about the value of the SUPA intervention.

Trial registration

The trial was retrospectively registered 21/02/2014, ISRCTN35514212.

Electronic supplementary material

The online version of this article (10.1186/s12889-019-6893-z) contains supplementary material, which is available to authorized users.

Studies of Black Diamond as an antibacterial surface for Gram Negative bacteria: the interplay between chemical and mechanical bactericidal activity

'Black silicon' (bSi) samples with surfaces covered in nanoneedles of length ~5 µm were fabricated using a plasma etching process and then coated with a conformal uniform layer of diamond using hot filament chemical vapour deposition to produce 'black diamond' (bD) nanostructures. The diamond needles were then chemically terminated with H, O, NH2 or F using plasma treatment, and the hydrophilicity of the resulting surfaces were assessed using water droplet contact-angle measurements, and scaled in the order O > H ≈NH2 >F, with the F-terminated surface being superhydrophobic. The effectiveness of these differently terminated bD needles in killing the Gram-negative bacterium E. coli was semi-quantified by Live/Dead staining and fluorescence microscopy, and visualised by environmental scanning electron microscopy. The total number of adhered bacteria was consistent for all the nanostructured bD surfaces at around 50% of the value for the flat diamond control. This, combined with a chemical bactericidal effect of 20-30%, shows that the nanostructured bD surfaces supported significantly fewer viable E. coli than flat surfaces. Moreover, the bD surfaces were particularly effective at preventing the establishment of bacterial aggregates - a precursor to biofilm formation. The percentage of dead bacteria also decreased as a function of hydrophilicity. These results are consistent with a predominantly mechanical mechanism for bacteria death based on the stretching and disruption of the cell membrane, combined with an additional effect from the chemical nature of the surface.

Very Early Cytomegalovirus Infection After Renal Transplantation: A Single-Center 20-Year Perspective

Background:

Cytomegalovirus (CMV) infection risk in the first month after transplantation is felt to be minimal; however, the epidemiology has not been specifically investigated, particularly in the modern era of potent immunosuppressive regimens and universal CMV prophylaxis.

Objective:

The aim of this study was to describe the incidence of and risk factors associated with CMV occurring less than 30 days after transplant and evaluate the effect of very early CMV on outcomes.

Methods:

Retrospective, single-center study of adult renal transplant (RTX) recipients between January 1, 1994 and December 31, 2014.

Results:

A total of 5225 patients who received a renal transplant in the study time period were reviewed for the presence of CMV infection occurring less than 30 days after transplant. Of these, only 14 patients demonstrated this finding for an overall incidence of 0.27%. Half of these patients were considered to be at heightened risk due to being a recipient of a non-primary transplant or on chronic immunosuppression. This left seven patients without known risk factors for very early CMV to evaluate. In this group, time from transplant to CMV infection was 13.5 ± 7 days. The majority (57.1%, n = 4) were high-risk serostatus (CMV D+/R−) and occurred in the valganciclovir era (71.4%, n = 5). Lymphocyte-depleting induction predominated (57.1%, n = 4). Average cold ischemic time (CIT) was 19.7 ± 7.7 hours. Three patients had post-operative complications, two required exploratory-laparotomy for hemorrhage. When evaluating outcomes, 43% (n = 3) had subsequent episodes of CMV infection, 28.6% (n = 2) developed rejection, and 28.6% (n = 2) died. Outcomes between patients with CMV infection less than 30 days and those with CMV infection more than 30 days after transplant were not significantly different.

Conclusions:

In our review of over 5000 kidney transplants, the incidence of CMV infection in the first 30 days after renal transplant is 0.2%. Notable common patient characteristics include hemorrhage requiring re-operation and prolonged CIT. Outcomes were similar to CMV occurring more than 30 days after transplant. This study should provide the clinician with some reassurance; despite potent immunosuppressive therapy, CMV infection in the first 30 days is unlikely.

The role of joint engagement in the development of language in a community-derived sample of slow-to-talk children

We explored whether supported (SJE) or coordinated joint engagement (CJE) between mothers recruited from the community and their 24-month-old children who were slow-to-talk at 18 months old were associated with child language scores at ages 24, 36, and 48 months (n = 197). We further explored whether SJE or CJE modified the concurrent positive associations between maternal responsive behaviours and language scores. Previous research has shown that SJE, maternal expansions, imitations, and responsive questions were associated with better language scores. Our main finding was that SJE but not CJE was consistently positively associated with 24- and 36-month-old expressive and receptive language scores, but not with 48-month-old language scores. SJE modified how expansions and imitations, but not responsive questions, were associated with language scores; the associations were evident in all but the highest levels of SJE. Further research is necessary to test these findings in other samples before clinical recommendations can be made.

An ecological halo surrounding a large offshore artificial reef: Sediments, infauna, and fish foraging

Artificial reefs are deployed in coastal systems to meet a range of social objectives and infrastructure requirements, such as recreational diving and fisheries enhancement. Such reefs are typically deployed on soft sediments and yet we know little of their effect on the biophysical characteristics of the surrounding benthos. This study investigated the composition of benthic infauna, sediment characteristics, and demersal fish foraging activity surrounding a large, steel, designed offshore artificial reef (OAR), measuring 12 m × 16 m x 12 m (height x length x width) and weighing approximately 42 tonnes. Using a gradient approach we established four transects with sediment sampling sites located 15, 30, 60, 120 and 240 m from the OAR. Taxon richness of infauna was lower close to the OAR (15, 30 m), and abundances of total infauna elevated at 15 m, driven largely by two families of polychaete (Onuphidae and Spionidae). Sediment characteristics (grain size, total organic carbon, metals) did not vary with distance from the OAR. Using unbaited videos we established that fish foraging activity on the soft sediments was enhanced close to the OAR (15 m), with a 5-10 fold increase in total foraging time that was largely accounted for by the activity of four benthivorous fish species (blue morwong Nemadactylus douglasii, the silver trevally Pseudocaranx georgianus, and goatfishes Upeneichthys vlamingii and U. lineatus). Fish foraging may cause changes in the composition of benthic infauna due to disturbance and selective predation. The effective benthic 'ecological halo' or 'footprint' of the OAR was 15 times the area of the actual reef. We demonstrate that a single large OAR can influence the surrounding benthic invertebrate and vertebrate communities, but that the effects are highly localised.

Calibration of a high spectral resolution lidar using a Michelson interferometer, with data examples from ORACLES

The NASA Langley airborne second-generation High Spectral Resolution Lidar (HSRL-2) uses a density-tuned field-widened Michelson interferometer to implement the HSRL technique at 355 nm. The Michelson interferometer optically separates the received backscattered light between two channels, one of which is dominated by molecular backscattering, while the other contains most of the light backscattered by particles. This interferometer achieves high and stable contrast ratio, defined as the ratio of particulate backscatter signal received by the two channels. We show that a high and stable contrast ratio is critical for precise and accurate backscatter and extinction retrievals. Here, we present retrieval equations that take into account the incomplete separation of particulate and molecular backscatter in the measurement channels. We also show how the accuracy of the contrast ratio assessment propagates to error in the optical properties. For both backscattering and extinction, larger errors are produced by underestimates of the contrast ratio (compared to overestimates), more extreme aerosol loading, and-most critically-smaller true contrast ratios. We show example results from HSRL-2 aboard the NASA ER-2 aircraft from the 2016 ORACLES field campaign in the southeast Atlantic, off the coast of Africa, during the biomass burning season. We include a case study where smoke aerosol in two adjacent altitude layers showed opposite differences in extinction- and backscatter-related Ångström exponents and a reversal of the lidar ratio spectral dependence, signatures which are shown to be consistent with a relatively modest difference in smoke particle size.

Rotational Energy as Mass in H_{3}^{+} and Lower Limits on the Atomic Masses of D and ^{3}He

We have made precise measurements of the cyclotron frequency ratios H_{3}^{+}/HD^{+} and H_{3}^{+}/^{3}He^{+} and observe that different H_{3}^{+} ions result in different cyclotron frequency ratios. We interpret these differences as due to the molecular rotational energy of H_{3}^{+} changing its inertial mass. We also confirm that certain high J, K rotational levels of H_{3}^{+} have mean lifetimes exceeding several weeks. From measurements with the lightest H_{3}^{+} ion we obtain lower limits on the atomic masses of deuterium and helium-3 with respect to the proton.

Association of ORMDL3 with rhinovirus-induced endoplasmic reticulum stress and type I Interferon responses in human leucocytes

BACKGROUND

Children with risk alleles at the 17q21 genetic locus who wheeze during rhinovirus illnesses have a greatly increased likelihood of developing childhood asthma. In mice, overexpression of the 17q21 gene ORMDL3 leads to airway remodelling and hyperresponsiveness. However, the mechanisms by which ORMDL3 predisposes to asthma are unclear. Previous studies have suggested that ORMDL3 induces endoplasmic reticulum (ER) stress and production of the type I interferon (IFN)-regulated chemokine CXCL10.

OBJECTIVE

The purpose of this study was to determine the relationship between ORMDL3 and rhinovirus-induced ER stress and type I IFN in human leucocytes.

METHODS

ER stress was monitored by measuring HSPA5, CHOP and spliced XBP1 gene expression, and type I IFN by measuring IFNB1 (IFN-β) and CXCL10 expression in human cell lines and primary leucocytes following treatment with rhinovirus. Requirements for cell contact and specific cell type in ORMDL3 induction were examined by transwell assay and depletion experiments, respectively. Finally, the effects of 17q21 genotype on the expression of ORMDL3, IFNB1 and ER stress genes were assessed.

RESULTS

THP-1 monocytes overexpressing ORMDL3 responded to rhinovirus with increased IFNB1 and HSPA5. Rhinovirus-induced ORMDL3 expression in primary leucocytes required cell-cell contact, and induction was suppressed by plasmacytoid dendritic cell depletion. The degree of rhinovirus-induced ORMDL3, HSPA5 and IFNB1 expression varied by leucocyte type and 17q21 genotype, with the highest expression of these genes in the asthma-associated genotype.

CONCLUSIONS AND CLINICAL RELEVANCE

Multiple lines of evidence support an association between higher ORMDL3 and increased rhinovirus-induced HSPA5 and type I IFN gene expression. These associations with ORMDL3 are cell type specific, with the most significant 17q21 genotype effects on ORMDL3 expression and HSPA5 induction evident in B cells. Together, these findings have implications for how the interaction of increased ORMDL3 and rhinovirus may predispose to asthma.

Building a sustainable clinical academic workforce to meet the future healthcare needs of Australia and New Zealand: report from the first summit meeting

The delivery of healthcare that meets the requirements for quality, safety and cost-effectiveness relies on a well-trained medical workforce, including clinical academics whose career includes a specific commitment to research, education and/or leadership. In 2011, the Medical Deans of Australia and New Zealand published a review on the clinical academic workforce and recommended the development of an integrated training pathway for clinical academics. A bi-national Summit on Clinical Academic Training was recently convened to bring together all relevant stakeholders to determine how best to do this. An important part understood the lessons learnt from the UK experience after 10 years since the introduction of an integrated training pathway. The outcome of the summit was to endorse strongly the recommendations of the medical deans. A steering committee has been established to identify further stakeholders, solicit more information from stakeholder organisations, convene a follow-up summit meeting in late 2015, recruit pilot host institutions and engage the government and future funders.

A comparison of a forced-air warming system to traditional thermal support for rodent microenvironments

Thermal homeostasis is important for the well-being of laboratory rodents during experimental investigations involving chemical restraint. Anaesthesia-induced hypothermia may alter physiological processes, prolong recovery times, or result in death. Therefore, active warming may be needed to prevent excess heat loss from the rodent to the environment. Three methods of active warming were evaluated in typical rodent procedural areas and recovery cages: a forced-air warming system, infra-red heat emitter and circulating-water blanket. The first experiment involved recording the temperature of the immediate environment of the three devices, with and/or without the accompanying plastic drape, to simulate a surgical situation. In the second experiment, temperatures were recorded within cages that simulated a recovery situation with the same modalities. Forced-air warmer blankets (FAWB) were either wrapped around or placed underneath standard polycarbonate rodent cages and the results were compared with cage temperatures warmed by the heat emitter and circulating-water blanket. Temperatures were recorded at 0, 20, 40, and 60 min for each warming treatment, to determine mean temperature (± SEM) and the magnitude of increase (± SEM) between 0 and 60 min. All three devices showed an increase in temperature, but the FAWB with a plastic drape heated the procedural area microenvironment (Experiment 1) quickly and to a final temperature of 38.6°C (101.5°F) at 60 min, compared with 25°C (77°F) for the heat emitter and 28°C (82.4°F) for the circulating-water blanket. The magnitude of increase was significantly different for each treatment, but the FAWB with a plastic drape climbed 16.3°C (29.3°F) in 60 min. In Experiment 2, the FAWB wrapped around a cage, covered with a plastic drape, heated recovery cages to 32.5°C (90.5°F) compared to the heat emitter 26.4°C (79.5°F) and circulating-water blanket with drape 26.3°C (79.3°F). The magnitude of increase in the microenvironmental temperature was significantly higher for the FAWB, with the plastic drape wrapped around the recovery cage, compared to the other treatments. In both experiments, forced-air warming proved superior to the more traditional thermal support treatments in heating the microenvironments quickly and to an optimum ambient temperature. Forced-air warming devices should be considered when thermal support is required for rodent procedural areas and recovery cages.

Inhibition of Human Cytomegalovirus DNA Replication with a Phosphorothioate Cholesteryl-Modified Oligonucleotide is Mediated by Rapid Cellular Association and Virus-Facilitated Nuclear Localization

We have previously shown that an antisense phosphorothioate (PS) oligodeoxynucleotide has potent anti-human cytomegalovirus (HCMV) activity (GS Pari, AK Field & JA Smith, Antimicrobial Agents and Chemotherapy 1995, 39: 1157–1161). We have now used a modified PS oligonucleotide having three 2′-O-methyl nucleotides at the 3′ end and four 2′-O-methyl nucleotides at the 5′ end, containing a cholesteryl moiety linked to the 3′ end by a novel thiono-triester linkage. This compound, UL36ANTI-M, is superior to the PS (UL36ANTI) version with respect to antiviral potency, melting temperature and nuclease resistance. Also, we show that cellular association for this oligonucleotide is rapid, occurring within 15 min after treatment and is about 12-fold higher when compared to UL36ANTI. This increased rate of cellular association also correlates with antiviral properties in that a 15 min incubation with UL36ANTI-M was sufficient to achieve 75% inhibition of viral DNA replication and complete inhibition was achieved after only a 1 h pretreatment. In addition confocal microscopic examination showed a change in subcellular distribution from perinuclear to nuclear for oligonucleotides in HCMV-infected human fibroblasts. However, the total amount of cell-associated oligonucleotide was unchanged in infected cells.

GWAS for executive function and processing speed suggests involvement of the CADM2 gene

To identify common variants contributing to normal variation in two specific domains of cognitive functioning, we conducted a genome-wide association study (GWAS) of executive functioning and information processing speed in non-demented older adults from the CHARGE (Cohorts for Heart and Aging Research in Genomic Epidemiology) consortium. Neuropsychological testing was available for 5429-32,070 subjects of European ancestry aged 45 years or older, free of dementia and clinical stroke at the time of cognitive testing from 20 cohorts in the discovery phase. We analyzed performance on the Trail Making Test parts A and B, the Letter Digit Substitution Test (LDST), the Digit Symbol Substitution Task (DSST), semantic and phonemic fluency tests, and the Stroop Color and Word Test. Replication was sought in 1311-21860 subjects from 20 independent cohorts. A significant association was observed in the discovery cohorts for the single-nucleotide polymorphism (SNP) rs17518584 (discovery P-value=3.12 × 10(-8)) and in the joint discovery and replication meta-analysis (P-value=3.28 × 10(-9) after adjustment for age, gender and education) in an intron of the gene cell adhesion molecule 2 (CADM2) for performance on the LDST/DSST. Rs17518584 is located about 170 kb upstream of the transcription start site of the major transcript for the CADM2 gene, but is within an intron of a variant transcript that includes an alternative first exon. The variant is associated with expression of CADM2 in the cingulate cortex (P-value=4 × 10(-4)). The protein encoded by CADM2 is involved in glutamate signaling (P-value=7.22 × 10(-15)), gamma-aminobutyric acid (GABA) transport (P-value=1.36 × 10(-11)) and neuron cell-cell adhesion (P-value=1.48 × 10(-13)). Our findings suggest that genetic variation in the CADM2 gene is associated with individual differences in information processing speed.

Scleromyxedema secondary to hepatitis C virus and successfully treated with antiviral therapy

Scleromyxedema (SM) is a chronic and progressive fibromucinous disease with no known etiology. We report a patient with scleromyxedema associated with hepatitis C virus, successfully treated with interferon and ribavirin therapy.

Exploring Active and Passive Contributors to Turnout in Dancers and Non-Dancers

OBJECTIVE

Lower-extremity external rotation, or turnout, is a fundamental skill in dance. Active standing turnout has previously been measured using low-friction turnout disks. Turnout is influenced by passive range of motion (ROM) and strength, with passive ROM a function of bony morphology and ligamentous/capsular restraints.

PURPOSE

Our study explored the relationship between standing active turnout and femoral bony morphology, hip passive ROM, and strength among dancers and non-dancers.

METHODS

Cross-sectional cohort study. Twenty-three female dancers and 13 female non-dancers aged 18 to 30 yrs were recruited. Standing active turnout on reduced-friction disks, ultrasound images of femoral version, supine passive turnout, and hip abductor and external rotator strength were collected.

RESULTS

Dancers demonstrated greater standing turnout (107° ± 18°) than non-dancers (92° ± 28°), but the difference was not statistically significant (p=0.054). A significant difference was found for femoral version (p<0.001), 4.7° ( ± 2.8°) for dancers vs 12.1° ( ± 4.6°) for non-dancers. Dancers demonstrated greater supine turnout, 102.7°±18.8°, compared to non-dancers, 84.3° ± 30.4° (p=0.031). Dancers were able to achieve greater peak force in turnout compared to non-dancers: 2.44 ± 0.44 N/kg and 1.72 ± 0.59 N/kg, respectively (p<0.0001). Supine total turnout was the best predictor of active turnout, contributing 48% of the variance (r=0.696, p<0.001).

CONCLUSION

Our findings suggest supine turnout is the largest predictor for standing turnout. Investigating dancers and non-dancers independently, our finding were similar to previous studies suggesting the femoro-acetabular complex may be influenced by dance training, contributing to differences in bony morphology between dancers and non-dancers. Although strength did not significantly contribute to active standing turnout, dancers demonstrated greater peak force compared to non-dancers.

Extracellular vesicles and their synthetic analogues in aging and age-associated brain diseases

Multicellular organisms rely upon diverse and complex intercellular communications networks for a myriad of physiological processes. Disruption of these processes is implicated in the onset and propagation of disease and disorder, including the mechanisms of senescence at both cellular and organismal levels. In recent years, secreted extracellular vesicles (EVs) have been identified as a particularly novel vector by which cell-to-cell communications are enacted. EVs actively and specifically traffic bioactive proteins, nucleic acids, and metabolites between cells at local and systemic levels, modulating cellular responses in a bidirectional manner under both homeostatic and pathological conditions. EVs are being implicated not only in the generic aging process, but also as vehicles of pathology in a number of age-related diseases, including cancer and neurodegenerative and disease. Thus, circulating EVs-or specific EV cargoes-are being utilised as putative biomarkers of disease. On the other hand, EVs, as targeted intercellular shuttles of multipotent bioactive payloads, have demonstrated promising therapeutic properties, which can potentially be modulated and enhanced through cellular engineering. Furthermore, there is considerable interest in employing nanomedicinal approaches to mimic the putative therapeutic properties of EVs by employing synthetic analogues for targeted drug delivery. Herein we describe what is known about the origin and nature of EVs and subsequently review their putative roles in biology and medicine (including the use of synthetic EV analogues), with a particular focus on their role in aging and age-related brain diseases.

Weak peristalsis with large breaks in chronic cough: association with poor esophageal clearance

BACKGROUND

Gastroesophageal reflux plays an important role in chronic cough (CC). Whether disturbed esophageal motility contributes to increased esophageal reflux exposure or interferes with swallowed bolus clearance is unclear. This study used high resolution esophageal manometry and impedance (HRIM) together with Chicago Classification, and 24-h impedance pH (MII/pH) to address these questions in patients with CC compared with heartburn (HB).

METHODS

A retrospective review of 32 patients with CC (mean age 57 [95% CI: 52-62] years) and 32 patients with symptoms of HB (55 [52-62] years) referred for HRIM and MII/pH between September 2012 and September 2013 was undertaken.

KEY RESULTS

Weak peristalsis with large breaks (WPLBs) was observed in 34% of CC patients compared with only 12% of HB patients (p = 0.027). Pathological acid exposure time (AET) was identified in 81% of CC patients with WPLBs compared with 29% without (p = 0.011). Increased AET was associated with prolonged clearance time of refluxed events (p = 0.006) rather than increased number of events. AET correlated with the percentage of peristaltic events with large breaks in CC (ρ = 0.467, p = 0.007). Similar data were obtained for total bolus (acid and non-acid) exposure time. Only one of the CC patients with WPLBs exhibited complete bolus transit (CBT) on swallowing compared with 81% without WPLBs (p < 0.001). Moreover, the percentage of peristaltic events associated with CBT negatively correlated with the percentage of peristaltic events with large breaks (r = -0.653, p < 0.001) in CC.

CONCLUSIONS & INFERENCES

One-third of CC patients exhibit WPLBs, which directly impacts on clearance of refluxed events and bolus's swallowed. These observations may have important implications for esophageal-bronchial interaction in CC.

Genetic contributions to variation in general cognitive function: a meta-analysis of genome-wide association studies in the CHARGE consortium (N=53949)

General cognitive function is substantially heritable across the human life course from adolescence to old age. We investigated the genetic contribution to variation in this important, health- and well-being-related trait in middle-aged and older adults. We conducted a meta-analysis of genome-wide association studies of 31 cohorts (N=53,949) in which the participants had undertaken multiple, diverse cognitive tests. A general cognitive function phenotype was tested for, and created in each cohort by principal component analysis. We report 13 genome-wide significant single-nucleotide polymorphism (SNP) associations in three genomic regions, 6q16.1, 14q12 and 19q13.32 (best SNP and closest gene, respectively: rs10457441, P=3.93 × 10(-9), MIR2113; rs17522122, P=2.55 × 10(-8), AKAP6; rs10119, P=5.67 × 10(-9), APOE/TOMM40). We report one gene-based significant association with the HMGN1 gene located on chromosome 21 (P=1 × 10(-6)). These genes have previously been associated with neuropsychiatric phenotypes. Meta-analysis results are consistent with a polygenic model of inheritance. To estimate SNP-based heritability, the genome-wide complex trait analysis procedure was applied to two large cohorts, the Atherosclerosis Risk in Communities Study (N=6617) and the Health and Retirement Study (N=5976). The proportion of phenotypic variation accounted for by all genotyped common SNPs was 29% (s.e.=5%) and 28% (s.e.=7%), respectively. Using polygenic prediction analysis, ~1.2% of the variance in general cognitive function was predicted in the Generation Scotland cohort (N=5487; P=1.5 × 10(-17)). In hypothesis-driven tests, there was significant association between general cognitive function and four genes previously associated with Alzheimer's disease: TOMM40, APOE, ABCG1 and MEF2C.

Bedside ultrasound of the neck confirms endotracheal tube position in emergency intubations

PURPOSE

In controlled environments such as the operating room, bedside ultrasound (BUS) of the neck has shown high accuracy for distinguishing endotracheal (ETI) from esophageal intubations. We sought to determine the accuracy of BUS for endotracheal tube (ETT) position in the emergency department (ED) setting.

MATERIALS AND METHODS

We assessed the utility of BUS in a single-center observational study in an ED setting. BUS was performed either simultaneously with ED intubation (S/ED), within < 3 minutes of ED intubation (A/ED), or in < 3 minutes of patient's ED arrival after pre-hospital intubation (A/EMS). Trained ED providers performed BUS; intubators were blinded to ultrasound findings. We used Cormack and Lehane categories (CL) to classify intubation attempts as "easy" (CL-I/II), "moderate" (CL-III) and "difficult" (CL-IV). Additional data included the diagnostic accuracy of the sonographer and intubator compared to the clinical outcome, anatomy identified by sonography and time to diagnosis.

RESULTS

During a 10-month period, 89 subjects with 115 intubation attempts were included in the study, and 86 patients/101 attempts with complete data were used in the study (63-easy, 19-moderate, 19-difficult). The sonographers achieved 100 % accuracy with respect to determining the correct ETT position utilizing an anterior neck approach, while the intubators' accuracy in assessing correct tube location was 97 % compared to the clinical outcome. A blinded review of sonography findings confirmed all BUS anatomical findings. A sonographically empty esophagus was 100 % specific for endotracheal intubation, and a "double trachea sign" was 100 % sensitive and 91 % specific for esophageal intubation. The sonographic time to diagnosis was significantly faster than the intubator time to diagnosis ("easy" p < 0.001; n = 47; "moderate" p = 0.001; n = 15; "difficult" p < 0.001; n = 19); Wilcoxon test; A/EMS cases excluded).

CONCLUSION

In this emergency setting, ultrasound determined ETT locations rapidly with 100 % accuracy and independently of the CL-category.

A quantum cascade laser-based water vapor isotope analyzer for environmental monitoring

A field-deployable mid-infrared quantum cascade laser-based spectrometer was designed and developed for measurements of H2(16)O and H2(18)O at 7.12 μm. H2(16)O and H2(18)O absorption features at 1390.52 cm(-1) and 1389.91 cm(-1), respectively, accessible within current tuning range of the laser, were targeted. The target lines were carefully selected to assure similar absorption levels and similar temperature sensitivities of the line strength due to comparable lower state energies. A real-time spectral fitting algorithm was implemented for isotopic concentration retrieval. Detection limits for H2(16)O and H2(18)O of 2.2 ppm and 7.0 ppb, respectively, were achieved at a dew point of 14 °C (volume mixing ratio of 15,766 ppm) in 1 s integration time, which resulted in a δ(18)O isotopic ratio measurement precision of 0.25‰. The ultimate minimum detection limits obtained after 160 s integration time for H2(16)O and H2(18)O, and δ(18)O measurements were 0.6 ppm, 1.7 ppb, and 0.05‰, respectively.

First Report of Laurel Wilt Caused by Raffaelea lauricola on Bay Laurel (Laurus nobilis) in the United States

Bay laurel (Laurus nobilis L.) is an economically important evergreen tree of the family Lauraceae. It is native to Asia Minor and the Balkans and was introduced into the United States for its ornamental and culinary uses (4). In September 2013, a 6-m-tall bay laurel in Gainesville, FL, attracted our attention because it had wilted leaves, discolored sapwood, and ambrosia beetle entrance holes, all symptoms of laurel wilt. In addition, the tree was growing close to an avocado that succumbed to the disease months earlier. In an effort to determine whether the laurel wilt pathogen (Raffaelea lauricola T.C. Harr., Fraedrich & Agaveya) was, indeed, involved in the decline of the tree of current interest, discolored sapwood was sectioned into 5-mm² pieces, surface disinfested for 30 s in a 4% sodium hypochlorite solution, and plated onto CSMA media (1,2). Within 7 to 14 days, cream-colored, adpressed fungal growth typical of R. lauricola grew from the sapwood pieces (2). DNA was extracted from an isolate of a single conidium (PL1634) and a portion of the 18S rRNA gene was PCR-amplified with primers NS1/NS4, resulting in a 1,021-bp amplicon (GenBank Accession No. KF913344.1), with a BLASTn search revealing 100% homology to several R. lauricola isolates (3). To confirm pathogenicity, six bay laurel seedlings (0.5 m) and a silk bay (0.65 m) (Persea humilis, susceptible control) were wounded twice with a 0.5-mm-diameter drill bit. Then, 30 μl of a spore suspension of PL1634 (1.38 × 10⁵ condia/plant) were introduced into the xylem by pipette and the wounds were wrapped in Parafilm (1). Negative controls consisted of a mock-inoculated (water) and non-inoculated bay laurel plus a mock-inoculated silk bay. Plants were placed in a growth chamber set to a 16/8 h (25/22°C) diurnal light/temperature cycle. After 60 days, all fungal-inoculated plants were completely wilted with dead leaves and subsequent necrosis of stems, while mock- and non-inoculated controls remained asymptomatic. Sapwood dissection revealed xylem discoloration similar to the original infected tree, and fungi morphologically similar to PL1634 were recovered from all inoculated plants upon isolation on CSMA media. Mock- and non-inoculated controls lacked vascular discoloration and fungal growth on media. In order to determine if the redbay ambrosia beetle, Xyleborus glabratus Eichoff (laurel wilt vector) could successfully reproduce in this host, symptomatic branches (7 cm in diameter) of L. nobilis with external evidence of ambrosia beetle attack (frass "toothpicks") were placed in a plastic rearing box within a growth chamber (25°C). Within 4 weeks of incubation, dozens of immature and mature X. glabratus beetles emerged. This is the first record of Koch's postulates being completed for R. lauricola on L. nobilis and the ability of X. glabratus to infest and breed in its stems. This information may be of importance in the event of an introduction of X. glabratus and its fungal associate to Mediterranean areas where bay laurel is either growing wild or being cultivated as valuable commercial crop. References: (1) S. W. Fraedrich et al. Plant Dis. 92:215, 2008. (2) T. C. Harrington et al. Mycotaxon 104:399, 2008. (3) M. A. Innis et al., eds. PCR Protocols: A Guide to Methods and Applications. Academic Press. San Diego, CA, 1990. (4) A. O. Sari et al. New Forest 31:403, 2006.

Multicarbohydrase Enzymes for Non-ruminants

The first purpose of this review is to outline some of the background information necessary to understand the mechanisms of action of fibre-degrading enzymes in non-ruminants. Secondly, the well-known and understood mechanisms are described, i) eliminating the nutrient encapsulating effect of the cell wall and ii) ameliorating viscosity problems associated with certain Non Starch Polysaccharides, particularly arabinoxylans and β-glucans. A third, indirect mechanism is then discussed: the activity of such enzymes in producing prebiotic oligosaccharides and promoting beneficial cecal fermentation. The literature contains a wealth of information on various non starch polysaccharide degrading enzyme (NSPase) preparations and this review aims to conclude by discussing this body of work, with reference to the above mechanisms. It is suggested that the way in which multi- versus single-component products are compared is often flawed and that some continuity should be employed in methods and terminology.

Unilateral nevoid telangiectasia syndrome (UNTS) associated with chronic hepatitis C virus and positive immunoreactivity for VEGF

Unilateral Nevoid Telangectasia Syndrome (UNTS) is characterized by superficial telangiectasias in a unilateral distribution. Vascular endothelial growth factor (VEGF) may play a role in the pathogenesis of UNTS in patients with underlying hepatic disease. We report a case of a patient with UNTS accompanied by chronic hepatitis C virus infection, with a normal serum estrogen profile and strong positive immunohistochemical staining of lesional skin with VEGF.

Antitussive drugs--past, present, and future

Cough remains a serious unmet clinical problem, both as a symptom of a range of other conditions such as asthma, chronic obstructive pulmonary disease, gastroesophageal reflux, and as a problem in its own right in patients with chronic cough of unknown origin. This article reviews our current understanding of the pathogenesis of cough and the hypertussive state characterizing a number of diseases as well as reviewing the evidence for the different classes of antitussive drug currently in clinical use. For completeness, the review also discusses a number of major drug classes often clinically used to treat cough but that are not generally classified as antitussive drugs. We also reviewed a number of drug classes in various stages of development as antitussive drugs. Perhaps surprising for drugs used to treat such a common symptom, there is a paucity of well-controlled clinical studies documenting evidence for the use of many of the drug classes in use today, particularly those available over the counter. Nonetheless, there has been a considerable increase in our understanding of the cough reflex over the last decade that has led to a number of promising new targets for antitussive drugs being identified and thus giving some hope of new drugs being available in the not too distant future for the treatment of this often debilitating symptom.

Rapid thinning of Pine Island Glacier in the early Holocene

Pine Island Glacier, a major outlet of the West Antarctic Ice Sheet, has been undergoing rapid thinning and retreat for the past two decades. We demonstrate, using glacial-geological and geochronological data, that Pine Island Glacier (PIG) also experienced rapid thinning during the early Holocene, around 8000 years ago. Cosmogenic (10)Be concentrations in glacially transported rocks show that this thinning was sustained for decades to centuries at an average rate of more than 100 centimeters per year, which is comparable with contemporary thinning rates. The most likely mechanism was a reduction in ice shelf buttressing. Our findings reveal that PIG has experienced rapid thinning at least once in the past and that, once set in motion, rapid ice sheet changes in this region can persist for centuries.

First Report of Diplodia quercivora Causing Shoot Dieback and Branch Cankers on Live Oak (Quercus virginiana) in the United States

In September 2010, live oak (Quercus virginiana Mill.) trees in an Alachua County, FL, shopping center parking lot were observed with shoot dieback and cankers on small branches. Isolations were made from canker margins by surface sterilizing tissue in 2.5% sodium hypochlorite and plating on potato dextrose agar (PDA) and incubating at 23°C. Fungi morphologically similar to Diplodia quercivora Linaldeddu & A.J.L. Phillips (mycelium initially velvety and white and later turning pale to dark olivaceous and grayish in reverse) were consistently isolated from symptomatic tissue (2). The two loci used by Linaldeddu et al. (2) in the description of D. quercivora were sequenced to identify a representative isolate (PL1345) as D. quercivora. The internal transcribed spacer (ITS) (GenBank Accession No. KF386635) and translation factor 1-alpha (EF-1α) (KF386636) regions were amplified and sequenced using primers ITS1F/ITS4 (3) and EF1-728F/EF1-986R (1). BLASTn searches of the two sequences resulted in 99% (467 of 469 and 257 of 259, respectively) homology with D. quercivora CBS 133852, confirming the fungal isolates' identity as D. quercivora. In October 2011, Koch's postulates were verified by inoculating, repeated twice, three Q. virginiana saplings (stem diameters, 12 to 14 mm; at inoculation sites approximately 50 mm above soil line) with isolate PL1345. Agar plugs (3 × 3 mm) taken from the margin of a 12-day-old culture on PDA were inserted into flaps in the stems made by a sterile blade with the mycelia facing the cambial tissue. One negative control tree was mock inoculated with a sterile PDA plug. All inoculation sites were sealed with Parafilm and maintained in a greenhouse (19 to 29°C). Trees were assessed for symptoms 90 days after inoculation. External bleeding was noted on all but one tree, and all flaps became necrotic. Pycnidia were observed on the outer surface of the flap on one inoculated tree. Negative controls showed no bleeding and their tissue flaps remained alive. Vertical length of phloem necrosis and percent of stem girdling were measured after removing the bark. Mean necrotic length and percent girdling for inoculated saplings were 48 mm (standard error [SE] = 10.6) and 26.6% (SE = 5.7) for the first inoculation and 46 mm (SE = 17) and 25% (SE = 5) for the second, respectively. Controls showed no internal necrosis and all produced healthy callus tissue at inoculation sites. Two of the pathogen-inoculated trees per inoculation were sampled and the pathogen was re-isolated from each. Recovered fungal isolates were confirmed as D. quercivora based on morphology and 100% ITS sequence homology to PL1345. D. quercivora was first described as causing shoot dieback and cankers on Q. canariensis in Tunisia and was found to be pathogenic to three additional Mediterranean oak species, Q. ilex, Q. pubescens, and Q. suber (2). To our knowledge, this is the first report of D. quercivora causing cankers on Q. virginiana and the first report of the fungus outside of Tunisia. Given the damage this pathogen has caused there, efforts to monitor the spread of this disease would seem warranted. More research is needed to assess the risk this pathogen poses to North American oaks, however. References: (1) I. Carbone et al. Mycologia 91:553, 1999. (2) B. T. Linaldeddu et al. Mycologia 105:1266, 2013. (3) T. J. White et al. PCR Protocols: A Guide to Methods and Applications. Academic Press, San Diego, 1990.