Before and after study of a national complementary and supplementary feeding programme in Rwanda, 2017-2021

To address high rates of malnutrition among children from vulnerable households in Rwanda, the government initiated a national food supplementation programme. A before and after evaluation, using repeat cross-sectional surveys in randomly selected villages was conducted; aimed at assessing the effectiveness of providing fortified blended food (FBF) to children 18-23 months of age, pregnant and lactating women in the lowest tier of Rwanda's social support system. Data were collected in 2017, 2018 and 2021 through interviews with caregivers; anthropometric measurements and a capillary blood sample were obtained from children. The primary statistical analysis compared the nutritional status of children before and after the introduction of FBF. We enroled 724 children during each survey. The prevalence of stunting declined from 47% to 35% between 2017 and 2021; in 2018, the prevalence of stunting was 43%. Children had a 42% reduction in the odds of being stunted (adjusted odds ratio [AOR]: 0.58, 95% confidence interval [CI]: 0.47-0.74, p < 0.001) from 2017 to 2021 even after adjusting for inherent, distal, proximal, and intermediate covariates. The reduction in stunting observed within the first year of the programme was not statistically significant (AOR: 0.83, 95% CI: 0.67-1.03, p < 0.091). We observed meaningful reductions in the prevalence of stunting among children which coincided with the introduction of Government-led initiative to reduce malnutrition. The Rwandan Government has committed to improving the living conditions of vulnerable households and has made strong investments in reducing malnutrition. The impact of these investments can be seen in the overall trend towards improved nutritional status highlighted in this evaluation.

Human papillomavirus testing using existing nucleic acid testing platforms to screen women for cervical cancer: implementation studies from five sub-Saharan African countries

OBJECTIVES

To demonstrate acceptability and operational feasibility of introducing human papillomavirus (HPV) testing as a principal cervical cancer screening method in public health programmes in sub-Saharan Africa.

SETTING

45 primary and secondary health clinics in Malawi, Nigeria, Senegal, Uganda and Zimbabwe.

PARTICIPANTS

15 766 women aged 25-54 years presenting at outpatient departments (Senegal only, general population) or at antiretroviral therapy clinics (all other countries, HIV-positive women only). Eligibility criteria followed national guidelines for cervical cancer screening.

INTERVENTIONS

HPV testing was offered to eligible women as a primary screening for cervical cancer, and HPV-positive women were referred for visual inspection with acetic acid (VIA), and if lesions identified, received treatment or referral.

PRIMARY AND SECONDARY OUTCOME MEASURES

The primary outcomes were the proportion of HPV-positive women who received results and linked to VIA and the proportion of HPV-positive and VIA-positive women who received treatment.

RESULTS

A total of 15 766 women were screened and tested for HPV, among whom 14 564 (92%) had valid results and 4710/14 564 (32%) were HPV positive. 13 837 (95%) of valid results were returned to the clinic and 3376 (72%) of HPV-positive women received results. Of women receiving VIA (n=2735), 715 (26%) were VIA-positive and 622 (87%) received treatment, 75% on the same day as VIA.

CONCLUSIONS

HPV testing was found to be feasible across the five study countries in a public health setting, although attrition was seen at several key points in the cascade of care, namely results return to women and linkage to VIA. Once women received VIA, if eligible, the availability of on-site cryotherapy and thermal ablation allowed for same-day treatment. With sufficient resources and supportive infrastructure to ensure linkage to treatment, use of HPV testing for cervical cancer screening as recommended by WHO is a promising model in low-income and middle-income countries.

Enabling internet of things in road traffic forecasting with deep learning models

Integration of the latest technological advancements such as Internet of Things (IoT) and Computational Intelligence (CI) techniques is an active research area for various industrial applications. The rapid urbanization and exponential growth of vehicles has led to crowded traffic in cities. The deployment of IoT infrastructures for building smart and intelligent traffic management system greatly improves the quality and comfort of city dwellers. This work aims at building a cost effective IoT enabled traffic forecasting system using deep learning techniques. The case study experimentation is done in a real time traffic environment. The main contributions of this work include: (i) deploying road side sensor station built with ultrasonic sensor and Arduino Uno controller for obtaining traffic flow data (ii) building an IoT cloud system based on open source Thingspeak cloud platform for monitoring real time traffic (iii) performing short term traffic forecast using Recurrent Neural Network (RNN) models such as Long Short Term Memory (LSTM) and Gated Recurrent Unit (GRU). The performance of the prediction model is compared with the traditional statistical methods such as Autoregressive Integrated Moving Average (ARIMA), Seasonal ARIMA (SARIMA) and Convolutional Neural Network (CNN). The results show good performance metrics with RMSE of 5.8, 7.9, 10.2 for LSTM model and 6.7, 8.6, 10.9 for GRU model for three different scenarios such as whole day, morning congested hour and evening congested hour datasets.

Review on Stenotrophomonas maltophilia: an emerging multidrug-resistant opportunistic pathogen

Stenotrophomonas maltophilia is an opportunistic pathogen that results in nosocomial infections in immunocompromised individuals. These bacteria colonize on the surface of medical devices and therapeutic equipment like urinary catheters, endoscopes, and ventilators, causing respiratory and urinary tract infections. The low outer membrane permeability of multidrug-resistance efflux systems and the two chromosomally encoded β-lactamases present in S.maltophilia are challenging for arsenal control. The cell-associated and extracellular virulence factors in S.maltophilia are involved in colonization and biofilm formation on the host surfaces. The spread of antibiotic-resistant genes in the pathogenic S.maltophilia attributes to bacterial resistance against a wide range of antibiotics, including penicillin, quinolones, and carbapenems. So far, tetracycline derivatives, fluoroquinolones, and trimethoprim-sulfamethoxazole (TMP-SMX) are considered promising antibiotics against S.maltophilia. Due to the adaptive nature of the intrinsically resistant mechanism towards the number of antibiotics and its ability to acquire new resistance via mutation and horizontal gene transfer, it is quite tricky for medicinal contribution against S.maltophilia. The current review summarizes the literary data of pathogenicity, quorum sensing, biofilm formation, virulence factors, and antibiotic resistance of S.maltophilia.

Formulation and Evaluation of Herbal Baby Shampoo

Shampoos are most probably used as cosmetics. In general, hair care products are used for cleaning scalp and also used for beautifying agents. It contains suitable additives preservatives and active ingredients. The purpose of using shampoo is to remove dirt that is build up on the hair without stripping out much of this bum. The herbal shampoo popularized due to formulated from herbal sources which is safer with milder effect. In this study, herbal shampoo was formulated containing suitable ingredient such as Lawsonia inermis (L) Henna), Azadirachta indica A. Juss. (Neem), Hibiscus rosa-sinensis L (Hibiscus), Ficus benghalensis L.   (Banyan), Phyllanthus emblica L. (Amla), Sapindus mukorossi Gaertn. (Ritha), Senegalia rugata (Lam.) Britton & Rose.  (Shikakai) and Aloe vera (L.) Burm.f. (Aloe vera) different proportions to formulate and evaluate its physicochemical properties. Marketed crude products of the above-mentioned herbal drugs were used in the formulation of herbal shampoo. Ritha and Shikakai when shaken with water create rich foam impact. Amla fruit and Hibiscus rosa-sinensis L. flowers are used to promote hair growth, anti-dandruff agent, strengthen hairs, and prevent hair fall. Dried roots of  Ficus benghalensis (Banyan) produce Lustrous effects on hairs. H. rosa-sinensis flower and Aloe vera (L) used as a conditioning agent and also moisturizing agent. The formulated herbal shampoo was evaluated for its physical and chemical stability.

256 Charcot-Marie-Tooth Disease as A Risk Factor for Periprosthetic Fractures in Tibiotalocalcaneal Fusion With Intramedullary Nailing

Aim

The treatment for severe fixed hindfoot osteoarthritis secondary to Charcot-Marie-Tooth disease (CMT) disease is tibiotalocalcaneal (TTC) arthrodesis. In our centre, we have noticed a disproportionate rate of periprosthetic fractures in CMT patients following TTC arthrodesis with retrograde hindfoot nailing. The aim of this study was to test this hypothesis by evaluating our local cohort of TTC arthrodesis with retrograde hindfoot nailing.

Method

A retrospective review of patients who had TTC arthrodesis with intramedullary nailing was conducted over a seven-year period.

Results

There were 45 patients (30 male, 15 female) in our cohort. Forty-one patients achieved radiological and clinical fusion of their TTC arthrodesis. All three patients who had CMT sustained periprosthetic fracture at the tip of the nail at an average of 4 (range: 2.5 - 6) months from index operation. In comparison, no patients in the rest of the cohort sustained periprosthetic fractures. The nail position of the patients with CMT were central in both planes in all 3 patients. None of the patients with CMT had abutment of the cortex on either planes.

Conclusions

We found that there was a disproportionate rate of periprosthetic fractures in CMT patients in our cohort of TTC arthrodesis with retrograde hindfoot nailing. This suggests that CMT is a significant risk factor. The authors propose a longer nail to reduce the lever arm, with a long period of protected weight bearing till union. Elective removal of the nail to prevent this phenomenon from occurring should also be considered.

The 100 most cited papers in foot and ankle surgery

BACKGROUND

The number of citations of a paper gives an indication of an article's merit and importance within a medical specialty. We identify and analyse the 100 most cited papers in foot and ankle surgery.

METHOD

The Science Citation Index Expanded was searched for citations in 15 respected journals containing foot and ankle articles. Papers were analysed for subject, authorship, institution, country and year of publication. The average yearly citation was compared to total number of citations.

RESULTS

3501 foot and ankle papers were returned. The maximum number of citations was 1084 and the mean was 104. The top 100 papers were published between 1979 and 2007, with the majority published in the last decade. The ankle was the most important anatomical region discussed, and basic science and degenerative disease were popular topics. We found a large discrepancy between the total number of citations with average yearly citation.

CONCLUSION

Foot and ankle surgery is a young and rapidly developing sub-specialty within orthopaedics. Recently there has been a significant increase in influential papers published. Certain topics are popular indicating their importance within the field. This study highlights important papers in foot and ankle surgery giving an insight into readership.

Destructive post-traumatic chondrolysis of the subtalar joint: a case report and review of the literature

Injuries to the subtalar joint are often associated with fractures of the talus or calcaneum. These injuries often lead to degenerative changes resulting in pain, restriction of movement and difficulty in weight bearing. This can cause significant deformity and disability for the patient. Occult injury of the subtalar joint has been described as an isolated event or in association with a subluxation/dislocation of this joint. They are difficult to assess with plain radiography therefore, they are generally diagnosed with advanced imaging like CT scan or MRI scan. We present a case of a 66-year-old man who presented with destructive chondrolysis of the subtalar joint 2 years following conservative treatment of a minimally displaced distal fibular fracture. It was treated by subtalar and talonavicular arthrodesis. Overall, the patient made an excellent recovery and was satisfied with the outcome.

Weil osteotomy: assessment of medium term results and predictive factors in recurrent metatarsalgia

BACKGROUND

The angle of the Weil osteotomy is usually referenced relative to the floor irrespective of the plantar angulation of the metatarsal. This study aims to analyse the long term results following the Weil osteotomy and identify the cause of poor outcome.

METHODS

This study presents a retrospective review of 61 patients (86 feet), with mean follow-up of 31 months. Each patient underwent clinical, pedobarographic and radiological examination. The radiographs obtained included 'Metatarsal Skyline Views' (MSV), to assess the plantar declination of the metatarsal heads following the osteotomy. The functional scoring was performed using AOFAS and Foot Function Index.

RESULTS

Fifty-five patients (80 feet) showed good to excellent results clinically. Six patients had persistent metatarsalgia. All these 6 patients had callosities beneath metatarsal heads. Pedobarography showed peak pressures in the same distribution as callosities and the MSV showed increased plantar declination of the metatarsal heads. This correlation was found to be significant (p<0.05).

CONCLUSION

The Weil osteotomy is a safe and effective treatment for metatarsalgia. An MSV radiograph is helpful to identify the plantar prominence of metatarsal which can be associated with poor clinical outcomes.

Crystallization kinetics and phase transformation in superionic lithium metaphosphate (Li(2)O-P(2)O(5)) glass system

The ionic conductivity of mol% 50Li(2)O-50P(2)O(5) melt quenched glass shows an anomalous increase after its glass transition temperature (T(g)) around 590 K. On further increasing the temperature gradually, the conductivity decreases owing to the devitrification of Li(2)O-P(2)O(5) glass. The evolution of devitrified crystallites was evidenced by XRD patterns. To understand the devitrification process, isothermal and non-isothermal DSC studies have been carried out on mol% 50Li(2)O-50P(2)O(5) glass. T(g) as well as T(c) values are found to increase monotonically with increasing heating rates. Variation of T(g) as a function of heating rates has been investigated to evaluate the lower limiting temperature of T(g) and the activation energy for structural relaxation. Results of the DSC studies indicate (i) single-stage bulk crystallization of the glass, with DSC traces exhibiting a single [Formula: see text] transition, (ii) an order parameter (Avrami constant) of 2.8 ± 0.1, suggesting internal (bulk) crystallization of the glass, (iii) an activation energy for crystallization equal to 121.7 kJ mol(-1) and (iv) the activation energy for structural relaxation, E(g), to be 558.8 kJ mol(-1). The crystallization mechanism is closely associated with the JMA model and the experimental dataset have been fitted to a non-isothermal Avrami expression and the obtained parameters confirm the experimental results.

Lumiliximab (anti-CD23 antibody) mediates apoptosis and antitumor activity in chronic lymphocytic leukemia (CLL) cells and CD23+ lymphoma cell lines

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Background: Given the success of treating CLL with antibody therapies, interest in those directed at alternative B-cell antigens remains high. Lumiliximab is a chimeric macaque and human anti-CD23 monoclonal antibody whose antigen is expressed on almost all CLL cells. Methods: We examined lumiliximab’s ability to mediate direct apoptosis, antibody-dependent cellular cytotoxicity (ADCC), and complement-dependent cytotoxicity (CDC) against primary CLL cells and CD23+ B-cell lines. Apoptosis was measured with a flow-cytometry based assay for active caspase-3. ADCC was determined by 51Cr-release assay. CDC assays were performed in the presence of 30% autologous plasma from patients and quantified by propidium iodide staining. Western blotting analysis was used to monitor protein expression before and after treatment with lumiliximab. The CD23+ human lymphoma SKW6.4 cell line was used for in vivo evaluation of lumiliximab in a disseminated human lymphoma model. Results: Lumiliximab mediates apoptosis, ADCC, and CDC in CD23+ B-cell lines. However, in primary CLL cells, the primary mechanism of cell killing appears to be mediated via apoptosis. Apoptosis induced by lumiliximab occurs mainly through the intrinsic pathway used by other CLL therapies. Lumiliximab decreased expression of Bcl-2 and XIAP and inhibited Akt activation in CLL cells. Lumiliximab when combined in vitro or in vivo with rituximab or fludarabine effectively mediates synergistic cytotoxicity against primary CLL cells and CD23+ B-cell lines. Significant antitumor activity was also observed with lumiliximab vs a control antibody in a SCID mouse model of human B-cell lymphoma (P <.01). More importantly, lumiliximab + rituximab or lumiliximab + fludarabine results in prolonged survival vs lumiliximab, rituximab, or fludarabine single-agent treatment. Conclusions: These results indicate that lumiliximab induces apoptosis by activating caspases and downregulating antiapoptotic proteins, and suggest that in combination with rituximab or chemotherapy, lumiliximab synergistically enhances antitumor activity in CLL or other B-cell malignancies in which this antigen is overexpressed.

No significant financial relationships to disclose.

Indications for and technique of first metatarsophalangeal joint arthroscopy

BACKGROUND

Arthroscopy of the great toe metatarsophalangeal joint has been used for a variety of indications, ranging from synovitis to osteochondral defects. The purpose of the present study was to define the indications for arthroscopy, assess its efficacy, and demonstrate the limitations of this procedure.

METHODS

Hallux metatarsophalangeal joint arthroscopy was used in 20 patients (25 feet). Indications included degenerative disease with early osteophytosis, chondromalacia, osteochondral defects, loose bodies, arthrofibrosis, synovitis, gouty arthritis, first metatarsophalangeal joint pain with no obvious findings clinically and radiographically in young adults, and intra-articular fracture of the first metatarsophalangeal joint. All patients had a minimal followup of 2 years and were evaluated clinically and radiographically.

RESULTS

Arthroscopic surgery resulted in pain free first metatarsophalangeal joints in 95% (19 of 20 patients). Patients with degenerative disease had a pain-free joint for a minimum of 2 years. The patients with gouty arthritis and intra-articular fracture had good functional outcomes. Arthroscopy also helped in identifying the pathology in painful joints with no obvious radiographic features that included conditions such as 'meniscoid' and other impingement lesions.

CONCLUSION

Arthroscopy of the first metatarsophalangeal joint is not suitable for patients with extensive degenerative changes and large osteophytes and those that require cheilectomy or arthrodesis. Arthroscopic management of certain painful hallucal metatarsophalangeal joints is a specialized technique, which if performed for the right indications, gives a favorable outcome with minimal complications.

Histidine metabolism in experimental protein malnutrition in rats

1. The activities of the enzymes histidase, urocanase and histidine-pyruvate transaminase were studied in rats under conditions of protein malnutrition. Urocanase and histidase activities in liver were markedly lowered in experimental protein malnutrition, but the activity of histidine-pyruvate transaminase was unaffected. There is a metabolic control in vivo of the enzymes involved in the catabolism of histidine. 2. Significant changes in the urinary excretion of histidine, composition of liver and serum were apparent in the protein-malnourished rat. 3. The changes in the activities of the enzymes and other parameters were of a reversible nature and dependent on the nature of the dietary protein. 4. The significance of these findings is discussed in relation to abnormal histidine metabolism in kwashiorkor.

A humanized anti-human CD154 monoclonal antibody blocks CD154-CD40 mediated human B cell activation

Humanized anti-CD154 antibody, IDEC-131, had a slightly, but reproducibly, better binding affinity for CD154 (Kd = 5.6 nM), compared to the parent antibody 24-31 (Kd = 8.5 nM). Otherwise it was indistinguishable from the murine parent antibody in its ability to bind to CD154, block CD154 binding to CD40 and inhibit T cell-dependent B cell differentiation. The latter activity was independent of FcR binding as the Fab'1 fragment of IDEC-131 had an equivalent biological activity to that of the whole antibody. IDEC-131 blocked soluble CD154 from inducing proliferation of purified B cells, and blocked T cell dependent anti-tetanus toxoid specific antibody production by human B cells in vitro. IDEC-131, gamma1, kappa, had strong Fc gammaRI, Fc gammaRII and C1q binding, but was unable to induce complement dependent (CDC) or antibody dependent cell-cytotoxicity (ADCC) of activated peripheral blood T cells, which express relatively low levels of CD154. IDEC-131 antibody inhibited both primary and secondary antibody responses to ovalbumin in cynomolgus monkeys at a dose of 5 mg/kg. In non-immunized animals, treatment with IDEC-131 at 50 mg/kg weekly for 13 weeks induced no change in any of the measured lymphocyte subsets, including B cells, CD4+ and CD8+ T cells. Similarly, a safety study in chimpanzees showed no discernible safety related issues at 20 mg/kg, including B and T cell subsets. These results show that the humanized anti-CD154 antibody, IDEC-131, has retained the affinity and functional activity of its murine parent antibody, is unlikely to deplete CD154 positive lymphocytes in humans, and is safe and effective in blocking antibody production in monkeys. Based on its safety and efficacy profile, IDEC-131 is being developed for therapy of systemic lupus erythematosus.

Steroids in idiopathic pulmonary fibrosis: a prospective assessment of adverse reactions, response to therapy, and survival

PURPOSE

We evaluated the risk and potential benefit of high-dose corticosteroid therapy in patients with idiopathic pulmonary fibrosis.

SUBJECTS AND METHODS

We prospectively studied 41 patients with previously untreated, biopsy-proven idiopathic pulmonary fibrosis. Before treatment, we calculated clinical, radiographic, and physiologic severity-of-illness scores for each patient. We scored high-resolution computerized tomographic (CT) scans for ground glass and interstitial opacity. We determined the extent of cellular infiltration, interstitial fibrosis, desquamation, and granulation in open lung biopsy samples. Patients were monitored monthly for steroid-related side effects, response to therapy at 3 months, and mortality.

RESULTS

All patients experienced at least one steroid-induced side effect. Eleven (27%) patients were nonresponders, 11 (27%) were responders, and 19 (46%) remained stable. Of the 19 patients who died during a mean (+/- SD) follow-up of 3.3 +/- 2.3 years, 8 (42%) lost weight during the initial 3 months of steroid therapy; only 3 (14%) of the 22 patients still living (P = 0.08) experienced weight loss. In a multivariate analysis, greater fibrosis (hazard ratio [HR] = 1.4 per unit increase; 95% confidence interval [CI]: 1.0 to 1.9; P = 0.03) and cellularity (RR = 1.9 per unit increase; 95% CI: 1.3 to 2.8; 3, P <0.001) in the biopsy sample and whether a patient was classified as a responder (RR = 0.4 versus nonresponder; 95% CI: 0.2 to 1.0; P = 0.05) or stable (RR = 0.2 versus nonresponder; 95% CI: 0.1 to 0.6, P <0.001) after steroid therapy were associated with mortality.

CONCLUSION

Corticosteroid treatment for idiopathic pulmonary fibrosis is associated with substantial morbidity. Patients who remain stable or respond to corticosteroid therapy have better survival than those who fail to respond. Whether this difference reflects an effect of treatment or less severe disease can be determined only in a randomized trial.

Modification of the Fc region of a primatized IgG antibody to human CD4 retains its ability to modulate CD4 receptors but does not deplete CD4(+) T cells in chimpanzees

Keliximab, a Primatized IgG1 CD4 mAb, was reconfigured to an IgG4 antibody. The gamma4 constant region was further modified by substituting glutamic acid for serine at position 235 in the CH2 domain (IgG4-E), to remove residual binding to Fcgamma receptors, and substitution of serine with proline at position 228 in the hinge region (IgG4-PE) for greater stability. Pharmacokinetic analysis in rats gave a t(1/2) of approximately 4 days for IgG4-E and 9 days for IgG4-PE, consistent with a greater stability of the IgG4-PE molecule. The effects on T cell subsets were assessed in chimpanzees given escalating doses of IgG4-PE: 0.05 mg/kg on Day 16, 1.5 mg/kg dose on Day 43, and 15 mg/kg on Day 85. Receptor modulation was observed at the two highest doses, but no depletion of T cells at any dose. The in vitro and in vivo results demonstrate the potential of this IgG4-PE mAb for use in human trials.

In vitro IgE inhibition in B cells by anti-CD23 monoclonal antibodies is functionally dependent on the immunoglobulin Fc domain

CD23, the low affinity receptor for IgE (FcvarepsilonRII), is involved in regulation of IgE synthesis by B-lymphocytes. Five monoclonal antibodies to human CD23 were generated from cynomolgus macaques immunized with purified soluble CD23 (sCD23). Four of the five primate antibodies blocked the binding of IgE complexes to CD23 positive cells and also inhibited the production of IgE in vitro by IL-4 induced human peripheral blood mononuclear cells (PBMC). The variable domains of several primate antibodies were utilized to construct chimeric macaque/human (PRIMATIZED((R))) monoclonal antibodies. PRIMATIZED((R)) p5E8G1, containing human gamma 1 constant region, inhibited IgE production in vitro as efficiently as the parent primate antibody, but the human gamma 4 constant version, PRIMATIZED((R)) p5E8G4, was not as effective in IgE inhibition. An F(ab')(2) of p5E8G1 did not inhibit IgE production but did interfere with IgE inhibition by the intact anti-CD23 antibody in a dose dependent fashion. The murine monoclonal antibody MHM6 recognizes human CD23 at a different epitope than primate antibody 5E8, and inhibits IgE production by IL-4 induced PBMC. As with the F(ab')(2) of p5E8G1, the F(ab')(2) of MHM6 also failed to inhibit IgE production. These data imply that the mechanism by which anti-CD23 antibodies inhibit IgE production requires cross-linking of CD23 to an IgG receptor. These data also imply that neither bivalent cross-linking of CD23 alone or inhibition of CD23 binding to its natural ligands is sufficient to inhibit IgE production.

Identification of murine cytotoxic T-lymphocyte epitopes of bovine herpesvirus 1

Major histocompatibility complex (MHC) class I molecules present endogenously derived viral peptides to CD8+ cytotoxic T-lymphocytes (CTLs). The objective of this study was to identify the H-2Dd- and H-2Kd-restricted CTL epitopes of bovine herpesvirus 1 (BHV-1), based on the allele-specific peptide motifs (ASPMs) of the above class I molecules. Nine sequences conforming to the H-2Dd and H-2Kd ASPMs were identified on BHV-1 proteins, and the respective peptides were synthesized. Five of these peptides exhibited moderate to strong binding to the Dd molecule. CTLs generated by BALB/c mice immunized with BHV-1 proteins emulsified in a suitable adjuvant effectively lysed peptide-pulsed syngeneic targets, indicating that these epitopes were generated in vivo. Mice immunized with these peptides emulsified in a suitable adjuvant also developed anti-BHV-1 CTLs. These CTLs identified three veritable CTL epitopes among the "potential epitopes" synthesized based on the ASPMs. The elucidation of the CTL epitopes of BHV-1 should aid in the development of efficacious vaccines against this virus.

Tumor regression in mice following vaccination with human papillomavirus E7 recombinant protein in PROVAX

Induction of CD8+ cytotoxic T lymphocytes (CTLs) specific for human papillomavirus (HPV) antigens provides an attractive strategy for immunotherapy of HPV-related cancers in humans. In this study, we investigated the potential of utilizing soluble E7 protein of HPV 16 in an adjuvant formulation, PROVAX as a vaccine against a progressively growing E7 transfected K1735-X21 (H-2k) metastatic melanoma cells (HOPE2) in a mouse model. Vaccination of HOPE2 tumor bearing mice (C3H) with E7 protein in PROVAX resulted in significant inhibition of tumor growth, compared to mice vaccinated with E7 in Alum or saline. In vivo depletion of CD8+ or CD4+ cells indicated that CD8+ cells are the major effector cells in mediating the anti-tumor activity in this model. Furthermore, E7-specific CTL activity in vitro was detected in tumor bearing mice vaccinated with E7-PROVAX. Our studies suggest that recombinant HPV antigens in combination with PROVAX could serve as an effective subunit vaccine to stimulate tumor specific CD8+ T cell mediated immunity against HPV-related cancers.

Influence of partial replacement of butter fat with peanut oil (in infant formula) on erythrocyte fatty acids in infants

Erythrocyte fatty acid composition was studied in infants fed with three different formulae: formula I containing 20% butter fat; formula II containing 10% butter fat and 10% peanut oil; and formula III containing 10% butter fat and 5% peanut oil with a fat content itself reduced to 15%. The linoleic acid levels were 2.5, 18 and 13% in formula I-III, respectively. Analysis of fatty acids at the time of birth, and 3 and 6 months thereafter, indicated that linoleic acid levels could be improved by supplementation with peanut oil. Arachidonic acid levels (20:4, n-6) did not show a proportional relationship with respect to linoleic acid intake. The other ratio such as triene/tetraene, oleic/linoleic, linoleic/arachidonic and arachidonic/linoleic were all within the normal range, indicating normal desaturase and elongase activity. Thus, our present study suggests that peanut oils could be used for enhancing the linoleic acid levels in infants.

Chimeric anti-CD20 (IDEC-C2B8) monoclonal antibody sensitizes a B cell lymphoma cell line to cell killing by cytotoxic drugs

More than 50% of patients with aggressive B lymphomas and the majority of patients with low grade lymphomas are not cured by current therapeutic strategies. The lymphomas express the B cell antigen CD20 on the cell surface and this antigen serves as target for antibody-directed therapies. Clinical studies with encouraging results have been underway with the use of a chimeric anti-CD20 antibody (IDEC-C2B8), consisting of human IgG1-6 constant regions and variable regions from the murine monoclonal anti-CD20 antibody IDEC-2B8. This study investigated the potential anti-tumor therapeutic value of combination treatment with anti-C2B8 and cytotoxic drugs. The in vitro study examined the sensitizing effect of C2B8 antibody on the DHL-4 B lymphoma line to various cytotoxic agents. Cytotoxicity was determined by the MTT assay. Surface and cytoplasmic proteins were determined by flow cytometry. Pretreatment of DHL-4 with C2B8 resulted in inhibition of cell proliferation and cell death and a fraction of the cells underwent apoptosis. While the DHL-4 tumor cells were relatively resistant to several cytotoxic drugs, pretreatment with C2B8 rendered the cells sensitive to TNF-alpha, ricin, diphtheria toxin (DTX), adriamycin and cisplatin but not to VP-16. Chemosensitization of DHL-4 tumor cells was not due to downmodulation of either the MDR-1 or bcl-2 gene products. However, treatment of DHL-4 with C2B8 inhibited TNF-alpha secretion. These findings demonstrate that C2B8 antibody potentiates the sensitivity of DHL-4 tumor cells to several cytotoxic agents. Further, the findings suggest that combination treatments with C2B8 antibody and drugs may be of clinical benefit in the treatment of patients with resistant aggressive B lymphomas.

Effect of high fat diets with and without cholesterol on erythrocyte and tissue fatty acids in rats

Male weanling wistar rats were fed synthetic diets containing 20% safflower oil (SFO) or palm oil (PO) with and without cholesterol for a period of six weeks. Erythrocyte membranes were isolated and their fatty acid composition were determined at the end of the experiment. Besides the fatty acid composition of the kidney and spleen lipids were also determined. Erythrocyte membrane, kidney fatty acids of rats fed safflower oil (SFO) had in the majority of variants a higher level of n-6 fatty acids when compared to palm oil group. However, in the spleen, the level of n-6 fatty acids in the palm oil groups were higher than in the safflower oil group. In general the arachidonic acid [20:4 (n-6)] levels were higher in the spleen and erythrocytes particularly in the cholesterol fed groups when compared to the kidney levels. Palm oil fed rats had a higher level of palmitic (16:0) and oleic [18:1 (n-9)] acids. Rats fed diets containing cholesterol significantly reduced the level of stearic (18:0) but increased the level of oleic [18:1 (n-9)], linoleic [18:2 (n-3)], and arachidonic acids [20:4 (n-6)]. The ratios such as 18:1 (n-9)/18:2 (n-6), 18:1 (n-9)/18:0, 18:2 (n-6)/20:4 (n-6) and 20:4 (n-6)/18:2 (n-6) are all indicative of the normal activity of enzymes involved in the desaturation and elongation. Thus these studies indicate that addition of cholesterol can modify the fatty acid composition in erythrocytes, kidney and spleen lipids.

Effect of supplementation of milk fat with peanut oil on blood lipids and lipoproteins in infants

Three different groups of infants were fed with different formulae based on milk fat. Group I received cow's milk fat formulae with 20% butter fat whereas groups II and III received a formulae which was supplemented with 50 and 33% of peanut oil supplementation in 20% milk fat respectively. Anthropometric measurements, cholesterol, triglyceride, lipoproteins and plasma fatty acids were followed up to a period of 6 months. The results indicated that cow's milk-fed infants had higher cholesterol levels (P < 0.01) than the other two groups. No significant differences with respect to high-density lipoproteins (HDLs) were found, whereas low-density lipoproteins (LDLs) and very low-density lipoproteins (VLDls (VLDls) were found to be increasing up to a period of 6 months. No significant differences were observed with respect to saturated fatty acids and oleic acid (18:1) levels whereas linoleic acid (18:2) clearly showed a proportional relationship between the intake and plasma levels, indicating a positive correlation. Arachidonic acid (20:4) did not, however, show a proprotionate relationship with respect to linoleic acid (18:2) intake. The triene/tetraene, oleic/linoleic, linoleic/arachidonic and total n6 fatty acids were all normal indicating normal activity of desaturase and elongase enzymes for the optimal utilisation of linoleic acid. Thus, the present study suggests that a vegetable oil such as peanut oil could be used in milk fat to improve the essential fatty acid (EFA) status of infants.

The induction of cytotoxic T cells and tumor regression by soluble antigen formulation

CTLs specific for tumor antigens play a major role in the immunity against cancer. We have shown that class I-restricted CTLs can be induced by injecting soluble antigens mixed in an antigen formulation (AF) that consists of squalane, Tween 80, and Pluronic L121 (S. Raychaudhuri et al., Proc. Natl. Acad. Sci. USA, 89: 8308-8312, 1992). In this study, using ovalbumin and the ovalbumin-expressing transfectoma (EG7) as a tumor model system, we examined the in vivo antitumor effect of antigen-AF mixture. Vaccination of mice with ovalbumin in AF 2 or 3 days after EG7 tumor challenge showed significant inhibition of tumor growth compared to mice vaccinated with ovalbumin in alum or in saline. Depletion of CD8+ cells at the time of immunization completely abrogated the AF-induced tumor protection, indicating that CD8+ T cells are the major effectors in tumor protection in vivo. Depletion of CD4+ cells led to a marginal loss of tumor protection, which may be the result of inhibition of ovalbumin-specific CTL response due to the lack of T-helper activity. Our results demonstrate that AF can be used in subunit vaccines to stimulate CTLs and tumor regression in vivo.

Effect of long term feeding of rice bran oil upon lipids and lipoproteins in rats

The effects of feeding two levels of rice bran oil (RBO) on the growth, lipid parameters, and fatty acid composition of the plasma and liver of rats (Wistar strain) were compared with those produced on animals which had been fed the same levels of peanut oil (PNO). The control animals were fed synthetic diets containing 5 and 20% peanut oil (PNO) and the experimental groups were fed similar diets, containing the same level of rice bran oil (RBO). There was no significant difference with respect to the organ weights between the control and the experimental groups. In general, groups fed 20% oil gained more weight than groups fed 5% oil. The animals which received rice bran oil in their diet had, in general, comparatively lower levels of cholesterol, triglycerides and phospholipids. On the other hand, animals receiving 20% rice bran oil in their diet, showed an increase of 20% in high density lipoproteins (HDL-C), within 18 weeks (p < 0.05), when compared to the animals fed with peanut oil. Similarly, low density lipoprotein cholesterol (LDL-C) and very low density lipoprotein cholesterol (VLDL-C) were lower in RBO-fed groups, than in the PNO-fed groups. There was, however, no significant differences in the cholesterol/phospholipid (C/P) ratio of the two groups. Analysis of plasma and of liver fatty acids indicated, in a general way, the type of fat consumed. There were no significant difference in the P/S ratio, nor any in the oleic/linoleic, oleic/stearic, palmitoleic/palmitic, oleic/palmitic, and oleic/palmitoleic ratios.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of B cell repertoire specific to the neutralizing epitopes of glycoprotein 120 in HIV-infected individuals

This study describes the clonotypic analysis of neutralizing anti-gp120 antibodies elicited in HIV-infected individuals by a panel of anti-idiotype monoclonal antibodies (anti-Id MAbs). Sera from 80 HIV-infected individuals at various clinical stages of HIV-infection were tested for reactivity to 19 anti-Id MAbs in ELISA. Anti-idiotype MAbs reacted with between 0 and 26% of sera. Among the 13 idiotypes specific for anti-CD4 site antibodies, 4 were expressed in 15 to 20% of individuals, whereas 2 of 4 idiotypes specific for anti-V3 antibodies were expressed in 15 to 26% of the cases. These data suggest that each HIV-infected individuals has a diverse B cell repertoire to a given neutralizing epitope cluster and that certain clonotypes are more prevalent than others. To correlate the binding activity in ELISA with anti-gp120 specificity, the idiotype-positive antibodies (Id+ Abs) from representative serum samples were isolated by anti-Id MAb-Sepharose affinity columns. In most cases, the epitope specificity and the neutralizing properties of the isolated Id+ Abs correlated with that of anti-gp120 antibodies used for the generation of anti-Id MAbs. We propose that these anti-Id MAbs may be used to identify and measure neutralizing anti-gp120 antibodies of defined specificity in the sera of HIV-infected individuals, HIV-vaccinated individuals, and in HIV-infected mother-infant pairs.

Immunization with a soluble CD4-gp120 complex preferentially induces neutralizing anti-human immunodeficiency virus type 1 antibodies directed to conformation-dependent epitopes of gp120

Preservation of the conformation of recombinant gp120 in an adjuvant, enabling it to elicit conformation-dependent, epitope-specific, broadly neutralizing antibodies, may be critical for the development of any gp120-based human immunodeficiency virus type 1 (HIV-1) vaccine. It was hypothesized that recombinant gp120 complexed with recombinant CD4 could stabilize the conformation-dependent neutralizing epitopes and effectively deliver them to the immune system. Therefore, a soluble CD4-gp120 complex in Syntex adjuvant formulation was tested with mice for its ability to induce neutralizing anti-gp120 antibody responses. Seventeen monoclonal antibodies (MAbs) were generated and characterized. Immunochemical studies, neutralization assays, and mapping studies with gp120 mutants indicated that the 17 MAbs fell into three groups. Four of them were directed to what is probably a conformational epitope involving the C1 domain and did not possess virus-neutralizing activities. Another four MAbs bound to V3 peptide 302-321 and exhibited cross-reactive gp120 binding and relatively weak virus-neutralizing activities. These MAbs were very sensitive to amino acid substitutions, not only in the V3 regions but also in the base of the V1/V2 loop, implying a conformational constraint on the epitope. The last group of nine MAbs recognized conformation-dependent epitopes near the CD4 binding site of gp120 and inhibited the gp120-soluble CD4 interaction. Four of these nine MAbs showed broadly neutralizing activities against multiple laboratory-adapted strains of HIV-1, three of them neutralized only HIVIIIB, and the two lower-affinity MAbs did not neutralize any strain tested. Collectively, the results from this study indicate that immunization with the CD4-gp120 complex can elicit antibodies to conformationally sensitive gp120 epitopes, with some of the antibodies having broadly neutralizing activities. We suggest that immunization with CD4-gp120 complexes may be worth evaluating further for the development of an AIDS vaccine.

Identification of a new neutralizing epitope conformationally affected by the attachment of CD4 to gp120

We have developed a strategy to purify and characterize various anti-gp120 antibody populations in HIV+ sera by using anti-Id mAb. One preparation of human anti-gp120 antibody (ES+ Ab) isolated on an anti-Id mAb (ES)-conjugated immunoabsorbent exhibited a novel neutralizing epitope specificity. The ES+ Ab bound only to the native form of recombinant gp120SF2 and gp120IIIB and not to the third hypervariable region (V3) loop peptide. In contradistinction to other CD4-gp120-inhibiting and V3-specific neutralizing antibodies, ES+ Ab exhibited a dose-dependent enhancement of binding to recombinant gp120 in the presence of recombinant soluble CD4. In addition, flow cytometric analysis revealed a similar increase in the binding of ES+ Ab to the native form of gp120 expressed on the HIV-infected cells. The ES+ Ab competed with CD4 binding site- and V3-specific antibodies in binding to gp120, suggesting that the ES+ Ab epitope is located near the CD4 binding site epitope and the V3 region. The ES+ Ab neutralized six genetically distinct HIV-1 strains. The neutralizing activity of ES+ Ab on HIVIIIB was significantly increased in the presence of human anti-CD4 binding site mAb. These data suggest that the ES+ Ab epitope represents a conserved, conformational, neutralization target on gp120 that may be involved in viral infection in an event after the CD4-gp120 interaction and that is distinct from previously defined neutralizing epitopes of gp120. This finding may be important for the development of an AIDS vaccine and immunotherapy.

Identification of a new neutralizing epitope conformationally affected by the attachment of CD4 to gp120

We have developed a strategy to purify and characterize various anti-gp120 antibody populations in HIV+ sera by using anti-Id mAb. One preparation of human anti-gp120 antibody (ES+ Ab) isolated on an anti-Id mAb (ES)-conjugated immunoabsorbent exhibited a novel neutralizing epitope specificity. The ES+ Ab bound only to the native form of recombinant gp120SF2 and gp120IIIB and not to the third hypervariable region (V3) loop peptide. In contradistinction to other CD4-gp120-inhibiting and V3-specific neutralizing antibodies, ES+ Ab exhibited a dose-dependent enhancement of binding to recombinant gp120 in the presence of recombinant soluble CD4. In addition, flow cytometric analysis revealed a similar increase in the binding of ES+ Ab to the native form of gp120 expressed on the HIV-infected cells. The ES+ Ab competed with CD4 binding site- and V3-specific antibodies in binding to gp120, suggesting that the ES+ Ab epitope is located near the CD4 binding site epitope and the V3 region. The ES+ Ab neutralized six genetically distinct HIV-1 strains. The neutralizing activity of ES+ Ab on HIVIIIB was significantly increased in the presence of human anti-CD4 binding site mAb. These data suggest that the ES+ Ab epitope represents a conserved, conformational, neutralization target on gp120 that may be involved in viral infection in an event after the CD4-gp120 interaction and that is distinct from previously defined neutralizing epitopes of gp120. This finding may be important for the development of an AIDS vaccine and immunotherapy.

Analysis of the cross-reactive anti-gp120 antibody population in human immunodeficiency virus-infected asymptomatic individuals

This study was undertaken to analyze the specificity and neutralizing properties of cross-reactive anti-gp120 antibodies (Abs) in the sera of two human immunodeficiency virus (HIV)-infected asymptomatic individuals. Two panels of murine monoclonal anti-idiotype Abs (anti-id MAbs) were established against cross-reactive polyclonal anti-gp120 Abs purified from HIV+ sera by sequential affinity chromatography using gp120SF2- and gp120IIIB-Sepharose columns. These panels of anti-id MAbs were then used to affinity purify idiotype-positive (Id+) anti-gp120 Abs from HIV+ sera. The recovery of each of these Id+ Abs by purification indicated that several idiotypically distinct cross-reactive anti-gp120 Abs are present in sera over a wide range of concentrations. Immunological and biological studies showed that although all of the Id+ Abs were reactive against gp120SF2 and gp120IIIB, they exhibited unique epitope specificities and distinct neutralizing activities. Most of the Id+ Abs were directed against epitopes in the CD4 attachment site (CD4 site epitopes) of gp120 and exhibited a spectrum of broadly neutralizing activities. On the other hand, a minor population of Id+ Abs showed specificity for the V3 region of gp120 and exhibited limited cross-neutralizing activities. Together, these studies indicate that the CD4 site epitope-specific Abs are heterogeneous with respect to their clonality, neutralizing activity, and concentration in sera. This heterogeneity suggests that anti-gp120 Abs to the CD4 attachment site are developed in response to multiple overlapping epitopes present on the original virus isolate and/or epitopes on mutated variants which emerged over time.

Influence of long term feeding of palm oil on the lipid composition of perirenal adipose tissue in rats

The composition of perirenal adipose tissue in Wistar strain of rats fed palm oil (PO) fat at 5% and 20% in diet for a period of 18 weeks was studied. Peanut oil (PNO) at 5% and 20% were used as controls. Under the experimental conditions, the saturation index was higher in animals fed diet containing PO compared to those fed PNO. There was no significant difference with reference to 12:0, 14:0 and 18:1 fatty acid levels, whereas linoleic acid (18:2) showed a proportional relationship between the intake and perirenal adipose tissue levels. There was a significant correlation of dietary intake of linoleic acid and the U/S ratio in the adipose tissue. Linoleic acid (18:2, n6) levels were increased in 20% PNO groups as compared to those fed PO. However, palmitoleic acid (16:1) did not show a proportional relationship between the intake and adipose tissue levels. Thus, our studies show that more saturated fatty acids are incorporated in the PO group than in the PNO groups at the end of 18 weeks feeding.

Bovine monoclonal anti-idiotypes induce antibodies specific for a synthetic peptide bearing a neutralizing epitope of bovine herpesvirus 1 glycoprotein gI (gB)

Bovine monoclonal anti-Id mimicking a neutralizing epitope of bovine herpesvirus-1 (BHV-1) glycoprotein gI were developed. An epitope present on the 74K subunit of gI identified by a murine mAb 1E11 was selected for this study. Bovine lymphocytes from the prefemoral lymph node of a heifer immunized with mAb 1E11 were fused with SP-2/0, a nonsecreting murine cell-line. Two bovine x murine hybridomas secreting bovine monoclonal anti-Id specific for the Id of 1E11 were stabilized. These anti-Id inhibited the binding of 1E11 to purified glycoprotein gI in a dose-dependent fashion. Naive mice immunized with the anti-Id produced anti-anti-Id (Ab3) that reacted with BHV-1 glycoprotein gI in a RIA, and neutralized BHV-1 infection in vitro. The Ab3 also showed reactivity to the 74K subunit of authentic gI glycoprotein in a Western blot analysis, and to the synthetic peptide bearing the 1E11 epitope in a RIA. These results substantiate the presence of the population of anti-Ab2 that functionally resemble antibodies specific for the immunizing Ag BHV-1 in Ab3, and demonstrate the ability of these anti-Id to elicit BHV-1-specific antibody response.

Bovine monoclonal anti-idiotypes induce antibodies specific for a synthetic peptide bearing a neutralizing epitope of bovine herpesvirus 1 glycoprotein gI (gB)

Bovine monoclonal anti-Id mimicking a neutralizing epitope of bovine herpesvirus-1 (BHV-1) glycoprotein gI were developed. An epitope present on the 74K subunit of gI identified by a murine mAb 1E11 was selected for this study. Bovine lymphocytes from the prefemoral lymph node of a heifer immunized with mAb 1E11 were fused with SP-2/0, a nonsecreting murine cell-line. Two bovine x murine hybridomas secreting bovine monoclonal anti-Id specific for the Id of 1E11 were stabilized. These anti-Id inhibited the binding of 1E11 to purified glycoprotein gI in a dose-dependent fashion. Naive mice immunized with the anti-Id produced anti-anti-Id (Ab3) that reacted with BHV-1 glycoprotein gI in a RIA, and neutralized BHV-1 infection in vitro. The Ab3 also showed reactivity to the 74K subunit of authentic gI glycoprotein in a Western blot analysis, and to the synthetic peptide bearing the 1E11 epitope in a RIA. These results substantiate the presence of the population of anti-Ab2 that functionally resemble antibodies specific for the immunizing Ag BHV-1 in Ab3, and demonstrate the ability of these anti-Id to elicit BHV-1-specific antibody response.

Quantitation of bovine immunoglobulins in culture fluids by use of sandwich radioimmunoassay with monoclonal antibodies

Bovine immunoglobulin isotype-specific murine monoclonal antibodies were used in sandwich radioimmunoassays to detect and quantitate bovine IgG1, IgG2, IgM, and IgA in culture fluids. The concentrations of bovine immunoglobulins in unknown samples were extrapolated from standard curves generated with bovine monoclonal immunoglobulins. The lowest detection limits for the bovine immunoglobulin isotypes ranged from 65 to 270 ng/ml.

Induction of neutralizing antibodies to transmissible gastroenteritis virus by anti-idiotypic antibodies

The potential of anti-idiotypic antibodies (anti-ids) as immunogens against transmissible gastroenteritis virus (TGEV) was tested in a heterologous system. A month-old pig was immunized with a neutralizing murine monoclonal antibody (MAb, 5A5) of the IgG2a isotype, specific for the E2 glycoprotein of TGEV. The anti-ids were isolated from the serum of the immunized pig by affinity chromatography, initially on a 5A5-Sepharose column, followed by repeated adsorption on a mouse IgG2a column. The swine anti-ids thus obtained bound to the MAb 5A5 (the idiotype), but not to MAbs of the same isotype IgG2a but of different idiotypes. The anti-ids also inhibited the binding of 5A5 to TGEV in a concentration-dependent manner. Mice immunized with the anti-ids produced antibodies to TGEV. These antibodies, neutralized TGEV in vitro and inhibited the binding of 5A5 to TGEV.

Occurrence of a Lysogenic Streptomyces sp. on the Nodule Surface of Black Gram ( Vigna mungo (L.) Hepper)

A lysogenic Streptomyces sp., strain NS.A4, which was isolated from the nodule surface of black gram ( Vigna mungo (L.) Hepper), was found to inhibit rhizobia of fast-and slow-growing strains of cowpeas and soybeans. It exhibited plaques when there was a change in cultural conditions. Repeated culturing of the organism in nutrient agar and broth confirmed the infection of Streptomyces sp. strain NS.A4 by an actinophage. Addition of the culture filtrate of Streptomyces sp. strain NS.A4 to shaken broth cultures of three other Streptomyces spp. resulted in phage infection.