Waking up on the wrong side of the bed: Depression severity moderates daily associations between sleep duration and morning affect

Mornings are salient times for disrupted affect that may be impacted by prior sleep. The current study extends work linking sleep disruptions with negative affect by examining how nightly changes in sleep duration, timing, and quality relative to a person's average impact morning affect. We further tested whether depression severity moderated the relationship between nightly variations in sleep and morning affect. This is a secondary analysis of participants ages 18-65 years with varying levels of depression (N = 91) who wore an Actiwatch for 3-17 days (n = 73) while reporting morning affect using a visual analogue scale. Multilevel models tested the previous night's sleep duration, timing, or quality as a predictor of morning affect. Sleep measures were group-mean centred to account for nightly variation in participants' sleep. A cross-level interaction between depression severity and nightly sleep was entered. Sleeping longer (b = 0.1; p < 0.001) and later (b = 1.8; p = 0.01) than usual were both associated with better morning mood. There was a significant interaction between nightly actigraphic sleep duration and depression severity on morning affect (b = 0.003; p = 0.003). Participants with higher depression severity reported worse affect upon waking after sleeping less than their usual. In comparison, sleeping less than usual did not affect morning affect ratings for participants with lower depression. A similar interaction was found for sleep quality (b = 0.02; p < 0.001). There was no interaction for midsleep timing. Sleeping less than usual impacted morning affect in individuals with greater depression, potentially suggesting a pathway by which sleep disturbances perpetuate depression.

Histoplasma capsulatum and Pneumocystis jirovecii coinfection in hospitalized HIV and non-HIV patients from a tertiary care hospital in Mexico

BACKGROUND

Histoplasma capsulatum and Pneumocystis jirovecii are respiratory fungal pathogens that principally cause pulmonary disease. Coinfection with both pathogens is scarcely reported. This study detected this coinfection using specific molecular methods for each fungus in the bronchoalveolar lavage (BAL) of patients from a tertiary care hospital.

MATERIALS AND METHODS

BAL samples from 289 hospitalized patients were screened by PCR with specific markers for H. capsulatum (Hcp100) and P. jirovecii (mtLSUrRNA and mtSSUrRNA). The presence of these pathogens was confirmed by the generated sequences for each marker. The clinical and laboratory data for the patients were analyzed using statistical software.

RESULTS

The PCR findings separated three groups of patients, where the first was represented by 60 (20.8%) histoplasmosis patients, the second by 45 (15.6%) patients with pneumocystosis, and the last group by 12 (4.2%) patients with coinfection. High similarity among the generated sequences of each species was demonstrated by BLASTn and neighbor-joining algorithms. The estimated prevalence of H. capsulatum and P. jirovecii coinfection was higher in HIV patients.

Invertebrate population genetics across Earth's largest habitat: The deep-sea floor

Despite the deep sea being the largest habitat on Earth, there are just 77 population genetic studies of invertebrates (115 species) inhabiting non-chemosynthetic ecosystems on the deep-sea floor (below 200 m depth). We review and synthesize the results of these papers. Studies reveal levels of genetic diversity comparable to shallow-water species. Generally, populations at similar depths were well connected over 100s-1,000s km, but studies that sampled across depth ranges reveal population structure at much smaller scales (100s-1,000s m) consistent with isolation by adaptation across environmental gradients, or the existence of physical barriers to connectivity with depth. Few studies were ocean-wide (under 4%), and 48% were Atlantic-focused. There is strong emphasis on megafauna and commercial species with research into meiofauna, "ecosystem engineers" and other ecologically important species lacking. Only nine papers account for ~50% of the planet's surface (depths below 3,500 m). Just two species were studied below 5,000 m, a quarter of Earth's seafloor. Most studies used single-locus mitochondrial genes revealing a common pattern of non-neutrality, consistent with demographic instability or selective sweeps; similar to deep-sea hydrothermal vent fauna. The absence of a clear difference between vent and non-vent could signify that demographic instability is common in the deep sea, or that selective sweeps render single-locus mitochondrial studies demographically uninformative. The number of population genetics studies to date is miniscule in relation to the size of the deep sea. The paucity of studies constrains meta-analyses where broad inferences about deep-sea ecology could be made.

DOSE AND GAMMA-RAY SPECTRA FROM NEUTRON-INDUCED RADIOACTIVITY IN MEDICAL LINEAR ACCELERATORS FOLLOWING HIGH-ENERGY TOTAL BODY IRRADIATION

Production of radioisotopes in medical linear accelerators (linacs) is of concern when the beam energy exceeds the threshold for the photonuclear interaction. Staff and patients may receive a radiation dose as a result of the induced radioactivity in the linac. Gamma-ray spectroscopy was used to identify the isotopes produced following the delivery of 18 MV photon beams from a Varian 21EX and an Elekta Synergy. The prominent radioisotopes produced include ¹⁸⁷W, ⁶³Zn, ⁵⁶Mn, ²⁴Na and ²⁸Al in both linac models. The dose rate was measured at the beam exit window (12.6 µSv in the first 10 min) following 18 MV total body irradiation (TBI) beams. For a throughput of 24 TBI patients per year, staff members are estimated to receive an annual dose of up to 750 μSv at the patient location. This can be further reduced to 65 μSv by closing the jaws before re-entering the treatment bunker.

Plastic microfibre ingestion by deep-sea organisms

Plastic waste is a distinctive indicator of the world-wide impact of anthropogenic activities. Both macro- and micro-plastics are found in the ocean, but as yet little is known about their ultimate fate and their impact on marine ecosystems. In this study we present the first evidence that microplastics are already becoming integrated into deep-water organisms. By examining organisms that live on the deep-sea floor we show that plastic microfibres are ingested and internalised by members of at least three major phyla with different feeding mechanisms. These results demonstrate that, despite its remote location, the deep sea and its fragile habitats are already being exposed to human waste to the extent that diverse organisms are ingesting microplastics.

Winter is coming: hibernation reverses the outcome of sperm competition in a fly

Sperm commonly compete within females to fertilize ova, but research has focused on short‐term sperm storage: sperm that are maintained in a female for only a few days or weeks before use. In nature, females of many species store sperm for months or years, often during periods of environmental stress, such as cold winters. Here we examine the outcome of sperm competition in the fruit fly Drosophila pseudoobscura, simulating the conditions in which females survive winter. We mated females to two males and then stored the female for up to 120 days at 4°C. We found that the outcome of sperm competition was consistent when sperm from two males was stored for 0, 1 or 30 days, with the last male to mate fathering most of the offspring. However, when females were stored in the cold for 120 days, the last male to mate fathered less than 5% of the offspring. Moreover, when sperm were stored long term the first male fathered almost all offspring even when he carried a meiotic driving sex chromosome that drastically reduces sperm competitive success under short‐term storage conditions. This suggests that long‐term sperm storage can radically alter the outcome of sperm competition.

The use of genetic markers in the molecular epidemiology of histoplasmosis: a systematic review

Histoplasmosis is a systemic mycosis caused by Histoplasma capsulatum, a dimorphic fungal pathogen that can infect both humans and animals. This disease has worldwide distribution and affects mainly immunocompromised individuals. In the environment, H. capsulatum grows as mold but undergoes a morphologic transition to the yeast morphotype under special conditions. Molecular techniques are important tools to conduct epidemiologic investigations for fungal detection, identification of infection sources, and determination of different fungal genotypes associated to a particular disease symptom. In this study, we performed a systematic review in the PubMed database to improve the understanding about the molecular epidemiology of histoplasmosis. This search was restricted to English and Spanish articles. We included a combination of specific keywords: molecular typing [OR] genetic diversity [OR] polymorphism [AND] H. capsulatum; molecular epidemiology [AND] histoplasmosis; and molecular epidemiology [AND] Histoplasma. In addition, we used the specific terms: histoplasmosis [AND] outbreaks. Non-English or non-Spanish articles, dead links, and duplicate results were excluded from the review. The results reached show that the main methods used for molecular typing of H. capsulatum were: restriction fragment length polymorphism, random amplified polymorphic DNA, microsatellites polymorphism, sequencing of internal transcribed spacers region, and multilocus sequence typing. Different genetic profiles were identified among H. capsulatum isolates, which can be grouped according to their source, geographical origin, and clinical manifestations.

A collimated detection system for assessing leakage dose from medical linear accelerators at the patient plane

Leakage radiation from linear accelerators can make a significant contribution to healthy tissue dose in patients undergoing radiotherapy. In this work thermoluminescent dosimeters (LiF:Mg,Cu,P TLD chips) were used in a focused lead cone loaded with TLD chips for the purpose of evaluating leakage dose at the patient plane. By placing the TLDs at one end of a stereotactic cone, a focused measurement device is created; this was tested both in and out of the primary beam of a Varian 21-iX linac using 6 MV photons. Acrylic build up material of 1.2 cm thickness was used inside the cone and measurements made with either one or three TLD chips at a given distance from the target. Comparing the readings of three dosimeters in one plane inside the cone offered information regarding the orientation of the cone relative to a radiation source. Measurements in the patient plane with the linac gantry at various angles demonstrated that leakage dose was approximately 0.01% of the primary beam out of field when the cone was pointed directly towards the target and 0.0025% elsewhere (due to scatter within the gantry). No specific 'hot spots' (e.g., insufficient shielding or gaps at abutments) were observed. Focused cone measurements facilitate leakage dose measurements from the linac head directly at the patient plane and allow one to infer the fraction of leakage due to 'direct' photons (along the ray-path from the bremsstrahlung target) and that due to scattered photons.

A revision of the genus Thouarella Gray, 1870 (Octocorallia: Primnoidae), including an illustrated dichotomous key, a new species description, and comments on Plumarella Gray, 1870 and Dasystenella, Versluys, 1906

A comprehensive revision of the genus Thouarella is presented. Thirty-five holotypes of the 38 nominal Thouarella species, two varieties, and one form were examined. The number of original Thouarella species has been reduced to 25, mostly through synonymy or new genus combinations. In the process several new species have also been identified, one of which is described here as Thouarella parachilensis nov. sp. The genus is split into two groups based on polyp arrangement: Group 1 with isolated polyps and Group 2 with polyps in pairs or whorls. An illustrated dichotomous key and detailed character table of the 25 Thouarella species are presented alongside an up-to-date account of all species described in the 19th and 20th centuries and summaries of the few described from 2000 onwards. We propose that Thouarella longispinosa is synonymous with Dasystenella acanthina, T. versluysi with T. brucei, and, T. tenuisquamis, T. flabellata, and T. carinata are synonymous with T. laxa. Lastly, we propose that T. bayeri and T. undulata be placed in Plumarella and support recent suggestions that T. alternata, T. recta, T. superba, and T. diadema are also Plumarella.

Assessment of leakage doses around the treatment heads of different linear accelerators

Out-of-field doses to untargeted organs may have long-term detrimental health effects for patients treated with radiotherapy. It has been observed that equivalent treatments delivered to patients with different accelerators may result in significant differences in the out-of-field dose. In this work, the points of leakage dose are identified about the gantry of several treatment units. The origin of the observed higher doses is investigated. LiF:Mg,Cu,P thermoluminescent dosimetry has been employed to quantify the dose at a several points around the linac head of various linear accelerators (linacs): a Varian 600C, Varian 21-iX, Siemens Primus and Elekta Synergy-II. Comparisons are also made between different energy modes, collimator rotations and field sizes. Significant differences in leaked photon doses were identified when comparing the various linac models. The isocentric-waveguide 600C generally exhibits the lowest leakage directed towards the patient. The Siemens and Elekta models generally produce a greater leakage than the Varian models. The leakage 'hotspots' are evident on the gantry section housing the waveguide on the 21-iX. For all machines, there are significant differences in the x and y directions. Larger field sizes result in a greater leakage at the interface plate. There is a greater leakage around the waveguide when operating in a low-energy mode, but a greater leakage for the high-energy mode at the linac face. Of the vendors investigated, the Varian 600C showed the lowest average leakage dose. The Varian 21-iX showed double the dose of the 600C. The Elekta Synergy-II had on average four times the dose leakage than the 600C, and the Siemens Primus showed an average of five times that of the 600C. All vendors show strong differences in the x and y directions. The results offer the potential for patient-positioning strategies, linac choice and shielding strategies to reduce the leakage dose to patients.

A phantom for testing of 4D-CT for radiotherapy of small lesions

PURPOSE

The use of time-resolved four-dimensional computed tomography (4D-CT) in radiotherapy requires strict quality assurance to ensure the accuracy of motion management protocols. The aim of this work was to design and test a phantom capable of large amplitude motion for use in 4D-CT, with particular interest in small lesions typical for stereotactic body radiotherapy.

METHODS

The phantom of "see-saw" design is light weight, capable of including various sample materials and compatible with several surrogate marker signal acquisition systems. It is constructed of polymethylmethacrylate (Perspex) and its movement is controlled via a dc motor and drive wheel. It was tested using two CT scanners with different 4D acquisition methods: the Philips Brilliance Big Bore CT (helical scan, pressure belt) and a General Electric Discovery STE PET∕CT (axial scan, infrared marker). Amplitudes ranging from 1.5 to 6.0 cm and frequencies of up to 40 cycles per minute were used to study the effect of motion on image quality. Maximum intensity projections (MIPs), as well as average intensity projections (AIPs) of moving objects were investigated and their quality dependence on the number of phase reconstruction bins assessed.

RESULTS

CT number discrepancies between moving and stationary objects were found to have no systematic dependence on amplitude, frequency, or specific interphase variability. MIP-delineated amplitudes of motion were found to match physical phantom amplitudes to within 2 mm for all motion scenarios tested. Objects undergoing large amplitude motions (>3.0 cm) were shown to cause artefacts in MIP and AIP projections when ten phase bins were assigned. This problem can be mitigated by increasing the number of phase bins in a 4D-CT scan.

CONCLUSIONS

The phantom was found to be a suitable tool for evaluating the image quality of 4D-CT motion management technology, as well as providing a quality assurance tool for intercenter∕intervendor testing of commercial 4D-CT systems. When imaging objects with large amplitudes, the completeness criterion described here indicates the number of phase bins required to prevent missing data in MIPs and AIPs. This is most relevant for small lesions undergoing large motions.

Flow cytometric analysis of blood monocytes and alveolar macrophages

Pulmonary monocytes and macrophages are believed to function in a wide range of biological roles, including host defense against foreign organisms, maintenance of immunological homeostasis in the lung, presentation of antigen to lymphocytes, and migration to sites of tissue injury and inflammation (1). There is also mounting evidence that recruited blood monocytes and resident alveolar macrophages (AM) in lung disease express an activated phenotype, suggesting that they may play important roles in chronic respiratory diseases, including asthma and interstitial lung diseases (2-6).

Differential Expression of Platelet Activation Markers CD62P and CD63 Following Stimulation with PAF, Arachidonic Acid and Collagen

The effects of varying concentrations of platelet-activating factor (PAF), arachidonic acid (AA) and collagen on the expression of the platelet activation markers CD63 and CD62P were assessed in 10 normal subjects using flow cytometry. CD63 expression was significantly greater than CD62P expression, with PAF (80 nM) inducing mean maximum CD63 expression of 32.9 ± 6.4% and mean maximum CD62P expression of 5.5 ± 1.8%. AA (1 mM) induced maximum CD63 expression of 37.7 ± 7% and maximum CD62P expression of 9.3 ± 1%. Collagen (2-80 pg/ml) induced minimal expression but 800 pg/ml induced mean CD63 expression of 33.1 ± 4.1% and mean CD62P expression of 6.1 ± 0.8%. Greater CD63 and CD62P expression were induced by phorbol myristate acetate (1.6 pM, 70.9 ± 11% and 69.4 ± 9.9%, respectively) and thrombin (0.1 U/ml, 70.7 ± 9.3% and 73.5 ± 5.4%, respectively). With PAF and collagen only one platelet population was detected whereas with 1 mM AA two populations were observed. These results indicate that expression of platelet adhesion receptors depends on the nature and concentration of agonist and that subpopulations of platelets may exist. Importantly, PAF concentrations inducing moderate CD63 and CD62P expression did not induce platelet aggregation, suggesting that platelets can be activated independently of aggregation.

Robust calculation of effective atomic numbers: the Auto-Z(eff) software

PURPOSE

The most appropriate method of evaluating the effective atomic number necessitates consideration of energy-dependent behavior. Previously, this required quite laborious calculation, which is why many scientists revert to over-simplistic power-law methods. The purpose of this work is to develop user-friendly software for the robust, energy-dependent computation of effective atomic numbers relevant within the context of medical physics, superseding the commonly employed simplistic power law approaches.

METHOD

Visual Basic was used to develop a GUI allowing the straightforward calculation of effective atomic numbers. Photon interaction cross section matrices are constructed for energies spanning 10 keV to 10 GeV and elements Z = 1-100. Coefficients for composite media are constructed via linear additivity of the fractional constituents and contrasted against the precalculated matrices at each energy, thereby associating an effective atomic number through interpolation of adjacent cross section data. Uncertainties are of the order of 1-2%.

RESULTS

Auto-Z(eff) allows rapid (∼0.6 s) calculation of effective atomic numbers for a range of predefined or user-specified media, allowing estimation of radiological properties and comparison of different media (for instance assessment of water equivalence). The accuracy of Auto-Z(eff) has been validated against numerous published theoretical and experimental predictions, demonstrating good agreement. The results also show that commonly employed power-law approaches are inaccurate, even in their intended regime of applicability (i.e., photoelectric regime). Furthermore, comparing the effective atomic numbers of composite materials using power-law approaches even in a relative fashion is shown to be inappropriate.

CONCLUSION

Auto-Z(eff) facilitates easy computation of effective atomic numbers as a function of energy, as well as average and spectral-weighted means. The results are significantly more accurate than normal power-law predictions. The software is freely available to interested readers, who are encouraged to contact the authors.

Adhesion of Histoplasma capsulatum to pneumocytes and biofilm formation on an abiotic surface

The pathogenic fungus, Histoplasma capsulatum, causes the respiratory and systemic disease 'histoplasmosis'. This disease is primarily acquired via inhalation of aerosolized microconidia or hyphal fragments of H. capsulatum. Evolution of this respiratory disease depends on the ability of H. capsulatum yeasts to survive and replicate within alveolar macrophages. It is known that adhesion to host cells is the first step in colonization and biofilm formation. Some microorganisms become attached to biological and non-biological surfaces due to the formation of biofilms. Based on the importance of biofilms and their persistence on host tissues and cell surfaces, the present study was designed to investigate biofilm formation by H. capsulatum yeasts, as well as their ability to adhere to pneumocyte cells. H. capsulatum biofilm assays were performed in vitro using two different clinical strains of the fungus and biofilms were characterized using scanning electron microscopy. The biofilms were measured using a 2,3-bis(2-methoxy-4-nitro-5-sulfophenyl)-5-[(phenylamino)carbonyl]-2H-tetrazolium-hydroxide (XTT) reduction assay. The results showed that both the H. capsulatum strains tested were very efficient at adhering to host cells and forming biofilm. Therefore, this is a possible survival strategy adopted by this fungus.

Effects of duration of treatment and dosage of eicosapentaenoic acid and stearidonic acid on red blood cell eicosapentaenoic acid content

OBJECTIVE

The purpose of this randomized, controlled, parallel group study was to characterize the relationships between dosages of stearidonic acid (SDA) and eicosapentaenoic acid (EPA), and incorporation of EPA into red blood cell (RBC) membranes over time.

METHODS

Healthy subjects (n=131) received capsules with placebo (safflower oil), SDA (0.43, 1.3, 2.6, or 5.2 g/d) or EPA (0.44, 1.3, or 2.7 g/d) for 12 weeks. RBC fatty acids were analyzed biweekly.

RESULTS

RBC %EPA increased in all EPA and SDA groups (p<0.02 vs. control) except the 0.43 g/d SDA group (p=0.187). For theoretical intakes of EPA of 0.25, 0.5, and 0.89 g/d, the amounts of SDA needed to achieve equivalent RBC EPA enrichment were 0.61, 1.89, and 5.32 g/d (conversion efficiencies of 41%, 26%, and 17%), respectively.

CONCLUSIONS

SDA increased RBC %EPA in a dosage and time-dependent manner at intakes as low as 1.3 g/d.

Identification of the source of histoplasmosis infection in two captive maras (Dolichotis patagonum) from the same colony by using molecular and immunologic assays

Histoplasma capsulatum was isolated from the spleen of a first infected mara (Dolichotis patagonum) and from a second mara's liver and adrenal gland, both in the same colony at the Africam Safari, Puebla, Mexico. Studies of H. capsulatum isolates, using nested-PCR of a 100-kDa protein coding gene (Hcp100) fragment and a two-primer RAPD-PCR method, suggest that these isolates were spreading in the environment of the maras' enclosure. By using a Dot-ELISA method, sera from mice inoculated with three homogenates of soil samples from the maras' enclosed space developed positive brown spot reactions to a purified H. capsulatum antigen, which identified the probable source of the maras' infection.

Formaldehyde gas inactivation of Bacillus anthracis, Bacillus subtilis, and Geobacillus stearothermophilus spores on indoor surface materials

AIMS

To evaluate the decontamination of Bacillus anthracis, Bacillus subtilis, and Geobacillus stearothermophilus spores on indoor surface materials using formaldehyde gas.

METHODS AND RESULTS

B. anthracis, B. subtilis, and G. stearothermophilus spores were dried on seven types of indoor surfaces and exposed to approx. 1100 ppm formaldehyde gas for 10 h. Formaldehyde exposure significantly decreased viable B. anthracis, B. subtilis, and G. stearothermophilus spores on all test materials. Significant differences were observed when comparing the reduction in viable spores of B. anthracis with B. subtilis (galvanized metal and painted wallboard paper) and G. stearothermophilus (industrial carpet and painted wallboard paper). Formaldehyde gas inactivated>or=50% of the biological indicators and spore strips (approx. 1x10(6) CFU) when analyzed after 1 and 7 days.

CONCLUSIONS

Formaldehyde gas significantly reduced the number of viable spores on both porous and nonporous materials in which the two surrogates exhibited similar log reductions to that of B. anthracis on most test materials.

SIGNIFICANCE AND IMPACT OF THE STUDY

These results provide new comparative information for the decontamination of B. anthracis spores with surrogates on indoor surfaces using formaldehyde gas.

Broiler performance and carcass characteristics when fed diets containing lysine maize (LY038 or LY038 x MON 810), control, or conventional reference maize

Lysine maize (Zea mays), LY038, was developed through the application of modern biotechnology to accumulate free Lys in the germ portion of maize grain and provide an alternative to direct addition of supplemental Lys to poultry diets. Maize LY038 x MON 810 was produced by conventional breeding of LY038 with MON 810, which provides the corn plant protection against feeding damage from the European corn borer. A 42-d broiler feeding study (10 pens of 10 male Cobb x Cobb 500 broilers/treatment) was conducted to compare the feeding value of grain from LY038 or LY038 x MON 810 to that of a conventional control (similar genetic background to the test maize) and 5 conventional maize hybrids. The LY038 and LY038 x MON 810 maize-based diets and control and conventional reference maize-based diets supplemented with l-Lys HCl were formulated to a Lys level below that required for optimal bird performance, whereas all other essential amino acids were present at levels, relative to Lys, above those required for optimal bird performance [1.05% and 0.90% total Lys (as-fed) for d 0 to 21 and d 21 to 42, respectively]. Total Lys level in control and reference maize-based diets without supplemental l-Lys HCl was formulated to be 0.079% lower than supplemented diets. Weight gain, feed efficiency, and carcass yield and composition of broilers fed diets containing LY038 or LY038 x MON 810 were not different (P > 0.05) from that of broilers fed l-Lys HCl-supplemented diets and were superior (P < or = 0.05) to that of broilers fed conventional maize diets without supplemental l-Lys HCl. Both broiler performance and carcass data demonstrate that the bioefficacy of the incremental Lys in LY038 or LY038 x MON 810 grain was not different from that of Lys in conventional maize diets supplemented with l-Lys HCl. Thus, LY038 and LY038 x MON 810 can be considered as wholesome as and more nutritious than conventional maize due to its higher-than-average Lys content.

Systematic variations in polymer gel dosimeter calibration due to container influence and deviations from water equivalence

There are a number of gel dosimeter calibration methods in contemporary usage. The present study is a detailed Monte Carlo investigation into the accuracy of several calibration techniques. Results show that for most arrangements the dose to gel accurately reflects the dose to water, with the most accurate method involving the use of a large diameter flask of gel into which multiple small fields of varying dose are directed. The least accurate method was found to be that of a long test tube in a water phantom, coaxial with the beam. The large flask method is also the most straightforward and least likely to introduce errors during the set-up, though, to its detriment, the volume of gel required is much more than other methods.

Decontamination assessment of Bacillus anthracis, Bacillus subtilis, and Geobacillus stearothermophilus spores on indoor surfaces using a hydrogen peroxide gas generator

AIMS

To evaluate the decontamination of Bacillus anthracis, Bacillus subtilis, and Geobacillus stearothermophilus spores on indoor surface materials using hydrogen peroxide gas.

METHODS AND RESULTS

Bacillus anthracis, B. subtilis, and G. stearothermophilus spores were dried on seven types of indoor surfaces and exposed to > or =1000 ppm hydrogen peroxide gas for 20 min. Hydrogen peroxide exposure significantly decreased viable B. anthracis, B. subtilis, and G. stearothermophilus spores on all test materials except G. stearothermophilus on industrial carpet. Significant differences were observed when comparing the reduction in viable spores of B. anthracis with both surrogates. The effectiveness of gaseous hydrogen peroxide on the growth of biological indicators and spore strips was evaluated in parallel as a qualitative assessment of decontamination. At 1 and 7 days postexposure, decontaminated biological indicators and spore strips exhibited no growth, while the nondecontaminated samples displayed growth.

CONCLUSIONS

Significant differences in decontamination efficacy of hydrogen peroxide gas on porous and nonporous surfaces were observed when comparing the mean log reduction in B. anthracis spores with B. subtilis and G. stearothermophilus spores.

SIGNIFICANCE AND IMPACT OF THE STUDY

These results provide comparative information for the decontamination of B. anthracis spores with surrogates on indoor surfaces using hydrogen peroxide gas.

Comparison of broiler performance when fed diets containing corn grain with insect-protected (corn rootworm and European corn borer) and herbicide-tolerant (glyphosate) traits, control corn, or commercial reference corn--revisited

A 42-d feeding experiment with growing Ross x Ross 508 broilers showed that the nutritional value of insect-protected and herbicide-tolerant corn was comparable to that of the genetically similar control and 5 commercial reference corn hybrids. MON 88017 provides protection from feeding damage by coleopteran pest corn rootworm and is tolerant to the action of glyphosate, the active ingredient in the Roundup family of agricultural herbicides. MON 88017 x MON 810 was developed by the traditional breeding of MON 88017 with MON 810, which provides protection from the European corn borer and other lepidopteran pests. A randomized complete block design was used with 8 dietary treatments in each of 5 replicated blocks of pens. No differences among diets were observed (P > 0.05) in performance (final live weights, feed intake, feed conversion, and adjusted feed conversion), carcass yield (chill, fat pad, breast, thigh, wing, and drum weight), or percentage of moisture, protein, and fat in breast meat and moisture and fat in thigh meat. Thigh protein was similar (P > 0.05) in broilers fed diets containing MON 88017 x MON 810 and conventional control or all commercial reference corns; however, differences (P < 0.05) were noted for the percentage of thigh protein among broilers fed the control and 2 of the 5 reference diets, attributable to biological variability among the conventional corn hybrids. Broilers overall performed consistently and had similar carcass yield and meat composition when fed diets containing MON 88017 or MON 88017 x MON 810 as compared with those fed the conventional control and commercial diets, supporting a conclusion of nutritional equivalence.

Comparison of broiler performance when fed diets containing corn grain with insect-protected (corn rootworm and European corn borer) and herbicide-tolerant (glyphosate) traits, control corn, or commercial reference corn

A 42-d feeding experiment with growing Ross x Ross 508 broilers showed that the nutritional value of insect-protected and herbicide-tolerant corn was comparable to that of the genetically similar control and 5 commercial reference corn hybrids. MON 88017 provides protection from feeding damage by coleopteran pest corn rootworm and is tolerant to the action of glyphosate, the active ingredient in the Roundup family of agricultural herbicides. MON 88017 x MON 810 was developed by the traditional breeding of MON 88017 with MON 810, which provides protection from the European corn borer and other lepidopteran pests. A randomized complete block design was used with 8 dietary treatments in each of 5 replicated blocks of pens. No differences among diets were observed (P > 0.05) in performance (final live weights, feed intake, feed conversion, and adjusted feed conversion), carcass yield (chill, fat pad, breast, thigh, wing, and drum weight), or percentage of moisture, protein, and fat in breast meat and moisture and fat in thigh meat. Thigh protein was similar (P > 0.05) in broilers fed diets containing MON 88017 x MON 810 and conventional control or all commercial reference corns; however, differences (P < 0.05) were noted for the percentage of thigh protein among broilers fed the control and 2 of the 5 reference diets, attributable to biological variability among the conventional corn hybrids. Broilers overall performed consistently and had similar carcass yield and meat composition when fed diets containing MON 88017 or MON 88017 x MON 810 as compared with those fed the conventional control and commercial diets, supporting a conclusion of nutritional equivalence.

[First isolation of Histoplasma capsulatum from the urban bat Eumops bonariensis]

We report the first isolation of Histoplasma capsulatum var. capsulatum from a male bat Eumops bonariensis captured in Buenos Aires city in 2003. The pathogen was recovered from spleen and liver specimens, and was identified by its phenotypic characteristics. PCR with primers 1283, (GTG)5, (GACA)4 and M13 was used to compare both bat isolates with 17 human isolates, 12 from patients residing in Buenos Aires city, and 5 from other countries of the Americas. The profiles obtained with the four primers showed that both bat isolates were identical to each other and closer to Buenos Aires patients than to the other isolates (similarity percentage: 91-100% and 55-97%, respectively). The high genetic relationship between bat isolates and those from patients living in Buenos Aires suggests a common source of infection. This is the first record of E. bonariensis infected with H. capsulatum in the world, and the first isolation of the fungus in the Argentinean Chiroptera population. In the same way as these wild mammals act as reservoir and spread the fungus in the natural environment, infection in urban bats could well be associated with the increase in histoplasmosis clinical cases among immunosuppressed hosts in Buenos Aires city.

Histoplasma capsulatum yeast cells attach and agglutinate human erythrocytes

The ability of yeast cells of Histoplasma capsulatum to attach and agglutinate human erythrocytes has been described. This is the first report involving these yeasts in the hemagglutination phenomenon. Results revealed that the yeast cells were able to bind to erythrocytes irrespective of blood groups and to agglutinate them when a high density of yeast cells was used. Assays on the inhibition of yeast attachment to erythrocytes were also performed, using sugar-treated yeast cells. Results indicate that galactose (Gal), mainly the beta-anomer, specially inhibited yeast attachment. Disaccharides (Gal-derivatives) and glycosaminoglycans containing Gal residues, mainly chondroitin sulfate C, promote this type of inhibition. In addition, preliminary data of inhibition assays also involved a probable ionic strength driven mechanism mediated by sialic acid and heparan sulfate, suggesting that yeast binding to erythrocytes could be associated with negative charges of both molecules.

Comparison of broiler performance when fed diets containing roundup ready (event RT73), nontransgenic control, or commercial canola meal

A 42-d experiment compared the nutritional value of genetically modified glyphosate-tolerant (Roundup Ready event RT73) canola meal to that of conventional canola meal when fed to rapidly growing Ross x Ross 508 broilers using a randomized complete block design. Five pens of males and 5 pens of females were used in each of 8 canola meal treatments (glyphosate-tolerant, nontransgenic control, and 6 commercial varieties). Broilers (10 birds/pen) were fed approximately 25% wt/wt canola meal during the first 20 d and 20% wt/wt canola meal thereafter. In general, performance response variables for glyphosate-tolerant canola meal were not different (P > 0.05) than those for the nontransgenic and commercial canola meals. Carcass fat pad, breast meat, thighs, legs, and wings (on a percentage basis) were similar across treatments (P > 0.05). Expressed as percentage of live weight, chill weight of the broilers fed diets containing glyphosate-tolerant canola meal was not different from those fed all other diets, but some differences were observed between the nontransgenic control and commercial diets. No major differences were observed in percentage of moisture, protein, and fat in breast or thigh meat (P > 0.05) across treatments. Comparisons of the glyphosate-tolerant canola diet to the population of all other diets (combining sexes) showed no major differences (P > 0.05) in performance, carcass yields, or moisture, protein, and fat in breast and thigh meat. Broilers fed diets containing glyphosate-tolerant canola meal had similar growth performance to birds fed nontransgenic control and commercial canola diets.

Comparison of broiler performance when fed diets containing grain from YieldGard Rootworm (MON863), YieldGard Plus (MON810 × MON863), nontransgenic control, or commercial reference corn hybrids

Two 42-d experiments compared the nutritional value of YieldGard Rootworm corn (MON863; experiment 1) and YieldGard Plus corn (MON810 x MON863; experiment 2) to their respective nontransgenic controls and 6 commercial reference corn hybrids when fed to growing broilers. For each experiment, a randomized complete block design was used with 8 dietary treatments in each of 5 replicated blocks of pens. In experiment 1, no differences among diets were observed (P > 0.05) for final live weights and feed conversion. Broilers fed diets containing MON863 corn had adjusted feed conversion similar to the nontransgenic control and the population of control and commercial diets. On a weight basis, there were no differences among diets for chill, fat pad, and thigh, drum, and wing weights. Differences (P < 0.05) between MON863 and commercial corn diets were noted for breast meat, chill and thigh, drum, and wing weights on a percentage of weight basis. No differences were observed (P > 0.05) in the percentage of moisture, protein, and fat in breast meat or thigh meat across treatment diets. In experiment 2, there were no significant differences among diets for all broiler performance and carcass parameters evaluated. Broilers overall performed consistently and had similar carcass yields and meat compositions when fed diets containing MON863 corn or MON810 x MON863 corn as compared with their respective nontransgenic control and commercial diets, supporting a conclusion of similar feeding values among diets.

Comparison of broiler performance when fed diets containing grain from YieldGard (MON810), YieldGard x Roundup Ready (GA21), nontransgenic control, or commercial corn

This 42-day experiment was undertaken to compare the nutritional value of insect-protected corn event MON810 (YieldGard) and YieldGard x herbicide-tolerant corn event GA21 (Roundup Ready) to their nontransgenic controls as well as four different commercial reference corns, when fed to growing Cobb x Cobb broilers. A randomized complete block design was used, and each treatment was replicated with five pens of males and five pens of females with 10 broilers per pen. Broilers were fed approximately 55% wt/wt corn during the first 20 d and approximately 60% wt/wt corn thereafter. The corn component of diets fed to broilers was supplied entirely with grain from the eight hybrids included in the experiment. Final live weights averaged 2.09 kg/bird fed YieldGard corn and 2.15 kg/bird fed YieldGard x Roundup Ready corn and were not different (P > 0.05) from final weights for birds fed control or commercial corn. Feed conversion was not affected (P > 0.05) by YieldGard (1.72) or YieldGard x Roundup Ready (1.77) corn feeding when compared with the feeding of other corn diets. Chill weights, fat pad, thigh weights, and wing weights were not affected by diets (P > 0.05). Differences (P < 0.05) were noted for breast and drum weights across treatments. Broilers overall performed consistently and had similar carcass yield and meat composition when fed diets containing YieldGard (event MON810) or YieldGard (event MON810) x Roundup Ready (event GA21) as compared with their nontransgenic controls and commercial diets.

Comparison of broiler performance when fed diets containing grain from roundup ready (NK603), yieldgard x roundup ready (MON810 x NK603), non-transgenic control, or commercial corn

Two 42-d experiments compared the nutritional value of the glyphosate-tolerant corn event NK603 (Roundup Ready corn) (experiment 1) and the combined traits, insect-protected corn event MON 810 (YieldGard com) x glyphosate-tolerant corn event NK603 (experiment 2) to their respective non-transgenic controls and to commercial reference corn, when fed to growing broilers. For each experiment, a randomized complete block design was used with eight dietary treatments in each of five replicated blocks of pens (eight pens for males and eight pens for females per block). Final live weights and feed conversion were not different (P > 0.05) across all treatments in both experiments. In experiment 1, broilers fed diets containing Roundup Ready corn had similar feed conversion adjusted for mortalities to those fed the non-transgenic control and one of the commercial corn diets. Chill weights and thigh, drum, and wing weights were not affected by diets. Differences (P < 0.05) were noted for breast meat and fat pad weights across treatments. In experiment 2, the adjusted feed conversion and carcass parameters were not affected by diets. Differences (P < 0.05) were noted only for protein content of breast meat. Differences observed in both experiments were consistent with natural variability. Broilers in general performed consistently and had similar carcass yields and meat compositions when fed diets containing Roundup Ready corn or YieldGard x Roundup Ready corn as compared with their respective non-transgenic control and commercial diets supporting similar feeding values among diets.

Attempts to detect transgenic and endogenous plant DNA and transgenic protein in muscle from broilers fed YieldGard Corn Borer Corn

Questions regarding the digestive fate of DNA and protein from transgenic grain have been raised in regard to human consumption and trade of animal products (e.g., meat, milk, and eggs) from farm animals fed transgenic crops. Using highly sensitive, fully characterized analytical methods, fragments of transgenic and endogenous plant DNA, as well as transgenic protein, were not detected in chicken breast muscle samples from animals fed YieldGard Corn Borer Corn event MON 810 (YG). Total DNA was extracted from breast muscle samples from chickens fed for 42 d with a diet including either 55 to 60% YG grain or 55 to 60% conventional corn grain. DNA preparations were analyzed by PCR followed by Southern blot hybridization for the presence of a 211-bp fragment of the Bacillus thuringiensis (Bt) cry1Ab gene and a 213-bp fragment of the endogenous corn gene sh2 (encoding ADP glucose pyrophosphorylase). By using 1 microg of input DNA per reaction, none of the extracted samples was positive for cry1Ab or sh2 at the limit of detection for these PCR assays. A 396-bp fragment of the chicken ovalbumin (ov) gene, used as a positive control, was amplified from all samples showing that the DNA preparations were amenable to PCR amplification. By using a competitive immunoassay with a limit of detection of approximately 60 ng of CrylAb protein per gram of chicken muscle, neither the CrylAb protein nor immunoreactive peptide fragments were detectable in the breast muscle homogenates from chickens fed YG grain.

An Imported Case ofBlastomyces DermatitidisInfection in Mexico

Blastomycosis is an acute or chronic primary infection of the respiratory system, endemic in North America (United States of America and Canada), Africa and Asia. We report a case in Mexico, in a three years old child who had been born in California and lived in Chicago, U.S.A. The patient presented pulmonary symptoms prior to development of a skin ulcer. Blastomyces dermatitidis was identified by mycological and molecular procedures. The patient was successfully treated with amphotericin B, oral ketoconazole and itraconazole.

The prevalence of aspirin intolerant asthma (AIA) in Australian asthmatic patients

BACKGROUND

Aspirin intolerant asthma (AIA) is a clinically distinct syndrome characterised by the precipitation of asthma attacks following the ingestion of aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs). The prevalence of AIA among Australian asthmatic patients has not previously been reported.

METHODS

Three populations were surveyed to establish the prevalence of AIA among Australian asthmatics. Two surveys were completed in patients recruited from the metropolitan area in Perth, Western Australia, one comprising 150 recruited from hospital based sources (hospital cohort) and the second comprising 366 from the membership of the Asthma Foundation of Western Australia (Asthma Foundation cohort). In a third study 1298 individuals were randomly selected from the rural community of Busselton in Western Australia.

RESULTS

The prevalence of AIA in the hospital and Asthma Foundation cohorts was found to be 10.7% and 10.4%, respectively. Univariate analyses in the Asthma Foundation cohort indicated that AIA was associated with more severe asthma (OR = 2.4, 95% CI 1.18 to 4.86), nasal polyposis (OR=3.19, 95% CI 1.52 to 6.68), atopy (OR=2.96, 95% CI 1.48 to 5.89), sulfite sensitivity (OR=3.97, 95% CI 1.87 to 8.41), and sensitivity to wine (OR=3.27, 95% CI 1.65 to 6.47). Multivariate analyses indicated that atopy (OR=2.80, 95% CI 1.38 to 5.70), nasal polyposis (OR=3.39, 95% CI 1.57 to 7.29), and the number of asthma attacks in the previous 12 months (OR=1.20, 95% CI 1.02 to 1.42) were independent predictors for AIA, as was wine sensitivity (OR=2.20, 95% CI 1.02 to 4.72). The prevalence of AIA among asthmatic patients in the Busselton cohort was 10.9%. In addition, 2.5% of non-diagnosed asthmatics in this cohort reported asthma symptoms following aspirin ingestion.

CONCLUSION

The prevalence of respiratory symptoms triggered by aspirin/NSAID use was found to be 10-11% in patients with asthma and 2.5% in non-asthmatics. Aspirin sensitivity appears to be a significant problem in the community and further investigations of the mechanisms of these responses and the possible link between this syndrome and other food and chemical sensitivities are required.

Psychosocial challenges in transplantation

The authors review the psychosocial aspects of transplantation. They first review psychosocial risk factors that place transplant patients at higher risk for noncompliance and negative outcomes. They then discuss what assessments should be included in a pretransplantation psychosocial evaluation. Goals of the psychosocial evaluation include selection of candidates most likely to benefit from transplantation and identification of areas for psychosocial intervention, both before and after transplantation. The assessment should address the patient's premorbid psychiatric state, past adaptation to stressors, history of compliance with treatment, substance abuse history, and level of social support, including community and faith-based support systems. Results of psychometric assessments may be helpful when considered in conjunction with a clinical interview and other sources of information about the patient. It may also be helpful to use a screening tool developed specifically to evaluate psychosocial factors relevant to transplantation, such as the Psychological Assessment of Candidates for Transplantation (PACT) scale and the Transplantation Evaluation Rating Scale (TERS). The authors then review issues related to psychopharmacologic interventions in transplant patients, including the use of antidepressant medication pre- and post-transplant, strategies for avoiding delirium associated with immunosuppressive medications immediately post-transplantation, neuropsychiatric symptoms associated with interferon alpha therapy for hepatitis C, and interactions between over-the-counter and herbal agents (e.g., St. John's Wort) and immunosuppressive agents. Although limited research has been done on nonpharmacologic interventions, such as transplant support groups, it appears that certain types of group therapy, in particular, cognitive-behavioral groups that target specific risk factors such as depression, distress, and compliance, may also offer promising approaches for dealing with the problems of transplant patients. The authors then focus on two special situations that create particular problems for transplantation teams: liver transplantation in patients with alcoholic liver disease (ALD) and obesity in transplant patients. The authors conclude that the prognosis for patients with ALD who receive liver transplantation is similar to that of non-alcoholics and that alcoholism is not a contraindication for liver transplantation. However, careful preliminary psychosocial assessment is essential to review candidates for factors that are predictive of relapse, while close follow-up post-transplantation can help improve outcomes. It appears that obesity can increase the risk of negative outcomes in transplant patients, although there is currently no consensus on the use of obesity as an exclusion criteria. Interventions that take into account the special psychological and medical needs of transplant patients need to be developed for treating obesity both pre- and post-transplantation. Improved strategies for identifying high-risk patients and finding ways to intervene both pre- and post-transplantation can not only help lengthen transplant recipients' life spans, but also improve their adaptation to transplantation and lead to improved quality of life.

The Kit-activating mutation D816V enhances stem cell factor--dependent chemotaxis

The D816V mutation of c-kit has been detected in patients with mastocytosis. This mutation leads to constitutive tyrosine kinase activation of Kit. Because stem cell factor (SCF), the ligand for Kit (CD117(+)), is a chemoattractant for CD117(+) cells and one feature of mastocytosis is an abnormal collection of mast cells in tissues derived from CD34(+)CD117(+) mast cell precursors, the hypothesis was considered that the D816V mutation would enhance chemotaxis of these precursor cells. Constructs encoding wild-type Kit or Kit bearing the D816V mutation were transfected into Jurkat cells, labeled with Calcein-AM, and migration to SCF assessed in the presence or absence of tyrosine kinase inhibitors. Chemotaxis to SCF was enhanced in D816V transfectants compared to wild-type Kit transfectants (P <.002). Migration of both transfectants was inhibited by tyrosine kinase inhibitors, although D816V transfectants were more sensitive. Chemotaxis was next performed on CD34(+)CD117(+) circulating mast cell precursors obtained from patients with mastocytosis. Analysis of prechemotaxis and migrated cells showed that whereas less than 10% in the prechemotaxis sample had the D816V mutation, 40% to 80% of migrated cells had this mutation. These results demonstrate that the D816V Kit mutation enhances chemotaxis of CD117(+) cells, offering one explanation for increased mast cells observed in tissues of patients with mastocytosis. (Blood. 2001;98:1195-1199)

Lyn is required for normal stem cell factor-induced proliferation and chemotaxis of primary hematopoietic cells

Stem cell factor (SCF) binds to c-Kit and is an important mediator of survival, growth, and function of hematopoietic progenitor cells and mast cells. Lyn and other Src family members are activated by SCF and associate with phosphorylated tyrosine residues in the c-Kit juxtamembrane region. However, studies using c-Kit mutants incapable of directly recruiting Src family members suggest this kinase family plays a minimal role in c-Kit stimulus-response coupling mechanisms. The objective of this study was to specifically target Lyn and subsequently address its role in SCF-mediated responses of primary hematopoietic progenitor cells and mast cells. To this end, a dominant-inhibitory Lyn mutant and Lyn-deficient mice were used. Transfection of normal murine mast cells with kinase-inactive Lyn impaired SCF-induced growth. Further, SCF-induced proliferation and chemotaxis of Lyn-deficient mast cells were less than for wild-type mast cells. SCF-induced growth of progenitor cells lacking Lyn was also reduced compared with that of wild-type progenitor cells. Impairment of SCF-mediated responses of Lyn-deficient mast cells and progenitor cells did not result from reductions in surface expression of c-Kit. These studies demonstrate that Lyn is required for normal SCF-mediated responses of primary progenitors and for a differentiated lineage.

The stages of change for dietary fat and fruit and vegetable intake of patients at the outset of a cardiac rehabilitation program

PURPOSE

To determine the stages of change for dietary fat and fruit and vegetable intake of cardiac patients entering a rehabilitation program.

DESIGN

A cross-sectional study using a convenience sample of newly admitted cardiac rehabilitation patients.

SETTING

Department of Pulmonary and Cardiac Rehabilitation, Moses H. Cone Memorial Hospital, Greensboro, North Carolina.

SUBJECTS

Subjects (n = 226) were predominantly men, Caucasian, married, smokers with 9 to 12 years of education, and with primary diagnoses of coronary artery bypass graft.

MEASURES

Stages of change and food frequency questionnaires were completed by subjects upon admission to cardiac rehabilitation.

RESULTS

Subjects in action and maintenance stages for dietary fat reduction comprised 78.7% of the population. Subjects' percentage of energy from fat decreased linearly from the precontemplation stage (38.8%) to the maintenance stage (30.9%). Eighty-one percent of subjects were in precontemplation/contemplation for increasing fruit and vegetable intake. Daily servings of fruits and vegetables ranged from 2.6 for precontemplation to 5.1 for maintenance subjects. Age, body mass index (BMI), education, and family history for coronary disease were unrelated to stage of change for the dependent variables.

CONCLUSIONS

Patients were in different stages of change for two nutritional behaviors linked to the same disease. Results support the need to assess patients for food behaviors and apply different educational interventions for each food behavior.

Pathogenesis II: fungal responses to host responses: interaction of host cells with fungi

Most of our knowledge concerning the virulence determinants of pathogenic fungi comes from the infected host, mainly from animal models and more recently from in vitro studies with cell cultures. The fungi usually present intra- and/or extracellular host-parasite interfaces, with the parasitism phenomenon dependent on complementary surface molecules. Among living organisms, this has been characterized as a cohabitation event, where the fungus is able to recognize specific host tissues acting as an attractant, creating stable conditions for its survival. Several fungi pathogenic for humans and animals have evolved special strategies to deliver elements to their cellular targets that may be relevant to their pathogenicity. Most of these pathogens express surface factors that mediate binding to host cells either directly or indirectly, in the latter case binding to host adhesion components such as extracellular matrix (ECM) proteins, which act as 'interlinking' molecules. The entry of the pathogen into the host cell is initiated by fungal adherence to the cell surface, which generates an uptake signal that may induce its cytoplasmic internalization. Once this is accomplished, some fungi are able to alter the host cytoskeletal architecture, as manifested by a rearrangement of microtubule and microfilament proteins, and this can also induce epithelial host cells to become apoptotic. It is possible that fungal pathogens induce modulation of different host cell pathways in order to evade host defences and to foster their own proliferation. For a number of pathogens, the ability to bind ECM glycoproteins, the capability of internalization and the induction of apoptosis are considered important factors in virulence. Furthermore, specific recognition between fungal parasites and their host cell targets may be mediated by the interaction of carbohydrate-binding proteins, e.g., lectins on the surface of one type of cell, probably a parasite, that combine with complementary sugars on the surface of host-cell. These interactions supply precise models to study putative adhesins and receptor-containing molecules in the context of the fungus-host interface. The recognition of the host molecules by fungi such as Aspergillus fumigatus, Paracoccidioides brasiliensis and Histoplasma capsulatum, and their molecular mechanisms of adhesion and invasion, are reviewed in this paper.

Ethical Issues for Psychologists in Pain Management

Pain management is relatively young as a specialty. Although increasing attention is being paid to issues such as pain at the end of life and pain in underserved populations, only recently has an open discussion of ethical issues in chronic pain treatment come to the fore. Psychologists specializing in pain management are faced with a myriad of ethical issues. Although many of these problems are similar to those faced by general clinical psychologists or other health psychologists, they are often made more complex by the multidisciplinary nature of pain management and by the psychologists' relationships to third-party payers (health maintenance organizations, workers' compensation), attorneys, or other agencies. An open forum exploring ethical issues is needed. This article outlines major ethical considerations faced by pain management psychologists, including patient autonomy and informed consent, confidentiality, reimbursement and dual relationships, patient abandonment, assessment for medical procedures, clinical research, and the interface of psychology and medicine. American Psychological Association ethical principles and principles of biomedical ethics need to be considered in ethical decision making. Further exploration and discussion of ethics for pain management psychologists are recommended.

Mast cells in allergy and host defense

Mast cells have been implicated in the pathogenesis of allergic diseases and in inflammatory responses associated with pathological immune and disease-related processes including fibrosis, autoimmune pathology, and neoplasia. Recent findings in animal models of bacterial infection also suggest that mast cells may have a protective role in host defense against pathogens in innate immunity along with the probable role of mast cells in acquired immunity against parasitic infections. Mast cells are strategically located at the host-environment interface and may provide an early defense against an invading pathogen. Mast cells express an array of adhesion and immune receptors that may assist in the recognition of invading pathogens. When activated, these cells then synthesize and release key immunoregulatory cytokines, one consequence of which is to mobilize a rapid and vigorous inflammatory response. However, although it has been demonstrated that mast cells may have a role in innate immunity in defined in vitro and animal models, it remains to be determined whether mast cells are protective in innate immune responses in humans.