Endothelial retargeting of AAV9 in vivo

Background

Adeno-associated virus (AAV) is favorable choice for gene transfer and gene editing applications in vivo, due to its low integration rate and low immunogenicity, as well as a variety of natural and engineered serotypes providing different tissue and cell type tropism. Endothelial cells, however, are remarkably resistant to transduction by AAVs.

Purpose

The aim of this study is to retarget wild type AAV9 vectors using a combination of polyamidoamine dendrimers (PAMAM) and peptides with endothelial affinity.

Methods

An endothelial-affine peptide sequence was obtained via bio-panning of a phage display library on endothelial culture cells. Second-generation PAMAM dendrimers were linked to the peptide via PEG linker. AAV9 vectors were coated with these modified dendrimers (G2CNN) immediately before in vivo applications.

Results

mTmG-mice or mTmG-pigs were utilized as reporter organisms, where red-to green fluorescence change upon Cre expression displays cellular resolution of transduction. Cre encoding AAV coated with G2CNN application systemically (mice) or locally (pigs) transduced over 30% of CD31+ cells in skeletal muscle and heart.

Functional relevance of endothelial retargeting was assessed by systemic injections of G2CNN coated AAV9 encoding for three transgenes:

1) An artificial adhesion molecule (S1FG). In wild type mice, S1FG expression in endothelial cells increased leukocyte adhesion in cremaster muscle vasculature (day 10 post injection).

2) Anti-inflammatory Annexin A1 (Anxa1). In ApoE−/− mice on high-fat diet, Anxa1 expression reduced long term leukocyte recruitment in carotid artery (day 28 post injection).

3) sgRNA targeting the vasodilatory enzyme eNOS (endothelial nitric oxide synthase). In conditional Cas9 transgenic mice, editing of eNOS via AAV delivered Cre and sgRNA caused increase of blood pressure (day 56 post injection).

Conclusion

Endothelial retargeted AAV9 efficiently transduced endothelial cells of skeletal muscle and heart in vivo. Accordingly, in vascular and atherosclerosis models, these modified vectors may enable gene transfer.

Funding Acknowledgement

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Bundesministerium für Bildung und ForschungDeutsche Forschungsgemeinschaft

Living under the risk of extinction: population status and conservation needs assessment of a micro–endemic tiger gecko in Vietnam

Human impact is considered the major threat to the global decline of biodiversity, especially for threatened endemic species in karst ecosystems. Studies assessing a species' demography based on temporal and spatial indicators of population size, density and structure are expected to evaluate the level of impact of threats and are therefore becoming increasingly important for species conservation efforts. Goniurosaurus huuliensis, an endemic species in Vietnam, is one of the most threatened reptiles in the world. This karst–adapted species is classified by the IUCN Red List as Critically Endangered and listed under CITES Appendix II due to habitat loss and over–exploitation for the international pet trade. Here we provide the first evaluation of the population status of G. huuliensis. We applied a 'capture mark–recapture' method to estimate the population size and identify the population density and structure. The total population size was estimated to comprise a maximum of 1,447 individuals in integrated suitable habitats, possibly reaching up to 2,855 individuals exclusively in karst habitats within the total extension of occurrence. This is exceedingly lower than the threshold for a minimum viable population. Furthermore, G. huuliensis is documented to occur in extremely small mean population densities of only 6.4 indiv./km and 2.5 indiv./km/day along the surveyed transects. Based on the demographic information, the ongoing severe human impact (e.g. wildlife exploitation and limestone quarrying) is driving G. huuliensis to the brink of extinction. In situ conservation measures are therefore urgently required. We recommend that in-situ actions should be increased, and a plan should be developed to establish a species and habitat conservation area for G. huuliensis.

Basketball vs. Hockey-The Changing Face of Sport-Related Injuries in Canada

OBJECTIVE

To characterize and compare the incidence of basketball-related, soccer-related, and hockey-related injuries over a 10-year period.

DESIGN

Cohort analysis of sport-related injuries using multiple Ontario healthcare databases.

SETTING

Emergency department visits in Ontario, Canada.

PATIENTS

Any patient who sustained musculoskeletal injuries sustained while playing basketball, soccer, or hockey between 2006 and 2017 were identified.

ASSESSMENT OF RISK FACTORS

Sport of injury, age, sex, rurality index, marginalization status, and comorbidity score.

MAIN OUTCOME MEASURES

Annual Incidence Density Rates of injury were calculated for each sport, and significance of trends was analyzed by assessing overlap of 95% confidence intervals.

RESULTS

One lakhs eighty five thousand eighty hundred sixty-eight patients (median age: 16 years, interquartile range 13-26) received treatment for sport-related injuries (basketball = 55 468; soccer = 67 021; and hockey = 63 379). The incidence of basketball-related and soccer-related injuries increased from 3.4 (3.3-3.5) to 5.6 (5.5-5.7) and 4.4 (4.3-4.5) to 4.9 (4.8-5) per 10 000 person years, respectively, whereas the incidence of hockey-related injuries decreased from 4.7 (4.6-4.8) to 3.7 (3.6-3.8). Patients with basketball injuries were more marginalized (3.01 ± 0.74) compared with patients with soccer and hockey injuries (2.90 ± 0.75 and 2.72 ± 0.69, respectively).

CONCLUSIONS

Accurate regional epidemiologic information regarding sports injuries can be used to guide policy development for municipal planning and sport program development. The trends and demographic patterns described highlight general and sport-specific injury patterns in Ontario. Populations with the highest incidence of injury, most notably adolescents and men older than 50, may represent an appropriate population for injury risk prevention.

Calorimeter with Bayesian unfolding of spectra of high-flux broadband x rays

We report the development of a multipurpose differential x-ray calorimeter with a broad energy bandwidth. The absorber architecture is combined with a Bayesian unfolding algorithm to unfold high energy x-ray spectra generated in high-intensity laser-matter interactions. Particularly, we show how to extract absolute energy spectra and how our unfolding algorithm can reconstruct features not included in the initial guess. The performance of the calorimeter is evaluated via Monte Carlo generated data. The method accuracy to reconstruct electron temperatures from bremsstrahlung is shown to be 5% for electron temperatures from 1 to 50 MeV. We study bremsstrahlung generated in solid target interaction showing an electron temperature of 0.56 ± 0.04 MeV for a 700 μm Ti titanium target and 0.53 ± 0.03 MeV for a 50 μm target. We investigate bremsstrahlung from a target irradiated by laser-wakefield accelerated electrons showing an endpoint energy of 551 ± 5 MeV, inverse Compton generated x rays with a peak energy of 1.1 MeV, and calibrated radioactive sources. The total energy range covered by all these sources ranges from 10 keV to 551 MeV.

Measurement of the Spectral Shape of the β-Decay of ^{137}Xe to the Ground State of ^{137}Cs in EXO-200 and Comparison with Theory

We report on a comparison between the theoretically predicted and experimentally measured spectra of the first-forbidden nonunique β-decay transition ^{137}Xe(7/2^{-})→^{137}Cs(7/2^{+}). The experimental data were acquired by the EXO-200 experiment during a deployment of an AmBe neutron source. The ultralow background environment of EXO-200, together with dedicated source deployment and analysis procedures, allowed for collection of a pure sample of the decays, with an estimated signal to background ratio of more than 99 to 1 in the energy range from 1075 to 4175 keV. In addition to providing a rare and accurate measurement of the first-forbidden nonunique β-decay shape, this work constitutes a novel test of the calculated electron spectral shapes in the context of the reactor antineutrino anomaly and spectral bump.

Somatic gene editing ameliorates skeletal and cardiac muscle failure in pig and human models of Duchenne muscular dystrophy

Frameshift mutations in the DMD gene, encoding dystrophin, cause Duchenne muscular dystrophy (DMD), leading to terminal muscle and heart failure in patients. Somatic gene editing by sequence-specific nucleases offers new options for restoring the DMD reading frame, resulting in expression of a shortened but largely functional dystrophin protein. Here, we validated this approach in a pig model of DMD lacking exon 52 of DMD (DMDΔ52), as well as in a corresponding patient-derived induced pluripotent stem cell model. In DMDΔ52 pigs1, intramuscular injection of adeno-associated viral vectors of serotype 9 carrying an intein-split Cas9 (ref. 2) and a pair of guide RNAs targeting sequences flanking exon 51 (AAV9-Cas9-gE51) induced expression of a shortened dystrophin (DMDΔ51-52) and improved skeletal muscle function. Moreover, systemic application of AAV9-Cas9-gE51 led to widespread dystrophin expression in muscle, including diaphragm and heart, prolonging survival and reducing arrhythmogenic vulnerability. Similarly, in induced pluripotent stem cell-derived myoblasts and cardiomyocytes of a patient lacking DMDΔ52, AAV6-Cas9-g51-mediated excision of exon 51 restored dystrophin expression and amelioreate skeletal myotube formation as well as abnormal cardiomyocyte Ca2+ handling and arrhythmogenic susceptibility. The ability of Cas9-mediated exon excision to improve DMD pathology in these translational models paves the way for new treatment approaches in patients with this devastating disease.

Propagating the "SEAD": Exploring the Value of an Overnight Call Shift in the Surgical Exploration and Discovery (SEAD) Program

OBJECTIVE

Attrition of general surgery residents highlights a need to support well-informed specialty selection. This study evaluated preclerkship medical students' perception of overnight call shifts in surgical career exploration.

DESIGN

A mixed-methods design was used, involving entry and postcall shift surveys and focus groups. Survey data characterized the population and call shift, guided focus group segmentation by baseline interest in surgery, and provided context for interpretation of qualitative data. Focus groups were transcribed and analyzed with a phenomenological approach using thematic analysis.

SETTING

Call shifts took place at the University of Toronto's Sunnybrook Health Sciences Centre and St. Michael's Hospital, 2 Level 1 trauma centers in Toronto, Canada.

PARTICIPANTS

Twenty-five first-year medical students participating in the Surgical Exploration and Discovery program.

RESULTS

Sixty-four percent (n = 16) of the participants were male. Students in the high interest group (n = 9) had more prior operating room exposure than students in the moderate (n = 12) and low (n = 4) interest groups (p = 0.039). Most students valued participating in a call shift; 80% (n = 20) rated the experience "positive" or "very positive." Thematic analysis yielded 2 categories of themes: (1) Valuable aspects of the experience, including being part of a team, mentorship, understanding the clerk's role, dispelling misconceptions, trial of working overnight, and influencing interest in a surgical career; and (2) Determinants of an enjoyable experience, including resident engagement and number of traumas.

CONCLUSIONS

An overnight call shift experience was valuable to preclerkship medical students regardless of baseline interest in surgery. While it only influenced a few students' specialty preferences, exposure facilitated a better understanding of a unique component of surgical careers and provided valuable mentorship. These findings support implementing calls shifts in other curricular or extracurricular programs to make the experience more widely available and enable earlier, informed career decision-making.

Search for Neutrinoless Double-β Decay with the Complete EXO-200 Dataset

A search for neutrinoless double-β decay (0νββ) in ^{136}Xe is performed with the full EXO-200 dataset using a deep neural network to discriminate between 0νββ and background events. Relative to previous analyses, the signal detection efficiency has been raised from 80.8% to 96.4±3.0%, and the energy resolution of the detector at the Q value of ^{136}Xe 0νββ has been improved from σ/E=1.23% to 1.15±0.02% with the upgraded detector. Accounting for the new data, the median 90% confidence level 0νββ half-life sensitivity for this analysis is 5.0×10^{25}  yr with a total ^{136}Xe exposure of 234.1 kg yr. No statistically significant evidence for 0νββ is observed, leading to a lower limit on the 0νββ half-life of 3.5×10^{25}  yr at the 90% confidence level.

Interpretation erhöhter D-Dimerkonzentration

Hintergrund: Die Bestimmung der D-Dimerkonzentration ist unverzichtbarer Bestandteil der Diagnostik thromboembolischer Erkrankungen (z. B. Beinvenenthrombosen, Lungenembolien). D-Dimere sind als Spaltprodukte des Fibrins bei fibrinolytischen Prozessen im Rahmen der reaktiven Fibrinolyse nach thrombotischen Prozessen nachweisbar. Fragestellung: In der klinischen Praxis bestehen immer wieder Probleme bei der Interpretation erhöhter D-Dimerkonzentrationen, vor allem, wenn keine thromboembolische Erkrankung vorliegt. Vor der Einleitung einer weiterführenden (meist bildgebenden) Diagnostik sollen andere Ursachen für die erhöhten D-Dimerwerte (z. B. Schwangerschaft, Tumorerkrankung, systemische entzündliche Erkrankung, fortgeschrittene Arteriosklerose) differenzialdiagnostisch berücksichtigt werden. Zusammenfassung: Die Bestimmung des D-Dimerkonzentration muss zielgerichtet bei thromboembolischen Erkrankungen erfolgen. Der Parameter ist jedoch ungeeignet als Screening-Verfahren im Rahmen der klinischen Routine. Gesichert ist sein hoher prädiktiv-negativer Wert zum Ausschluss einer Thrombose bzw. Lungenembolie bei negativem Testergebnis. Zahlreiche weitere Erkrankungen oder physiologische Zustände führen ebenfalls zu erhöhter D-Dimerkonzentration, so dass ein positiver D-Dimer-Test nicht die Basis zur Diagnose einer Thromboembolie sein darf.

Charge-Induced Force Noise on Free-Falling Test Masses: Results from LISA Pathfinder

We report on electrostatic measurements made on board the European Space Agency mission LISA Pathfinder. Detailed measurements of the charge-induced electrostatic forces exerted on free-falling test masses (TMs) inside the capacitive gravitational reference sensor are the first made in a relevant environment for a space-based gravitational wave detector. Employing a combination of charge control and electric-field compensation, we show that the level of charge-induced acceleration noise on a single TM can be maintained at a level close to 1.0  fm s^{-2} Hz^{-1/2} across the 0.1-100 mHz frequency band that is crucial to an observatory such as the Laser Interferometer Space Antenna (LISA). Using dedicated measurements that detect these effects in the differential acceleration between the two test masses, we resolve the stochastic nature of the TM charge buildup due to interplanetary cosmic rays and the TM charge-to-force coupling through stray electric fields in the sensor. All our measurements are in good agreement with predictions based on a relatively simple electrostatic model of the LISA Pathfinder instrument.

Sub-Femto-g Free Fall for Space-Based Gravitational Wave Observatories: LISA Pathfinder Results

We report the first results of the LISA Pathfinder in-flight experiment. The results demonstrate that two free-falling reference test masses, such as those needed for a space-based gravitational wave observatory like LISA, can be put in free fall with a relative acceleration noise with a square root of the power spectral density of 5.2±0.1  fm s^{-2}/sqrt[Hz], or (0.54±0.01)×10^{-15}  g/sqrt[Hz], with g the standard gravity, for frequencies between 0.7 and 20 mHz. This value is lower than the LISA Pathfinder requirement by more than a factor 5 and within a factor 1.25 of the requirement for the LISA mission, and is compatible with Brownian noise from viscous damping due to the residual gas surrounding the test masses. Above 60 mHz the acceleration noise is dominated by interferometer displacement readout noise at a level of (34.8±0.3)  fm/sqrt[Hz], about 2 orders of magnitude better than requirements. At f≤0.5  mHz we observe a low-frequency tail that stays below 12  fm s^{-2}/sqrt[Hz] down to 0.1 mHz. This performance would allow for a space-based gravitational wave observatory with a sensitivity close to what was originally foreseen for LISA.

Influenza-associated hospitalisations in Finland from 1996 to 2010: unexpected age-specific burden during the influenza A(H1N1)pdm09 pandemic from 2009 to 2010

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Influenza-associated hospitalisations in Finland from 1996 to 2010: unexpected age-specific burden during the influenza A(H1N1)pdm09 pandemic from 2009 to 2010

To assess the burden of influenza on the Finnish healthcare system, we analysed hospitalisations during 1996-2010 using the International Classification of Diseases codes potentially related to influenza and its complications from the national hospital discharge registry. To compare the influenza A(H1N1)pdm09 pandemic with previous influenza seasons in 1996-2009, we calculated hospitalisation rates by age- and diagnostic groups. We built a negative binomial regression model based on times series analysis to assess the impact of the pandemic. Influenza-associated hospitalisation rates were higher during the pandemic compared to pre-pandemic influenza seasons for 5-24 year-olds (incidence rate ratio (IRR): 1.52, 95% confidence interval (CI): 1.44-1.60) and 25-64 year-olds (IRR: 1.33, 95% CI: 1.29-1.36), but did not differ for persons aged ≥ 65 years (IRR: 0.98, 95% CI: 0.97-1.00). Hospitalisation rates exceeded the upper limit of the prediction line by 177% in 5-24 year-olds, 66% in 0-4 year-olds and 57% in 25-64 year-olds. During the influenza season of 2003/04, all age groups had higher-than-expected hospitalisation rates, whereas other seasonal peaks were only notable among persons aged ≥ 65 years. These age-specific differences in the hospital burden underscore the importance of the continuous surveillance of hospitalisations in order to evaluate immunisation priorities for seasonal influenza and pandemic preparedness including use of antiviral medication.

Surveillance of influenza in Finland during the 2009 pandemic, 10 May 2009 to 8 March 2010

The first infection caused by pandemic influenza A(H1N1)2009 virus was confirmed in Finland on 10 May 2009. The spread of the disease and its impact were monitored using several surveillance systems, such as the national infectious disease register, notifications of clusters of influenza, influenza-like or influenza-related illnesses, as well as virological, hospital, case-based and mortality surveillance. The epidemic started in early October in the north and then spread to the south about two weeks later. Based on the data from laboratory-confirmed cases, the morbidity was highest in children. The daily number of patients hospitalised with influenza A(H1N1)2009 reached a maximum of over 400 in late November. Of the 1,580 hospitalised patients (median age 32 years), 672 (43%) had at least one chronic underlying illness, 35 (2%) were pregnant, 132 (8%) were treated in intensive care units and 74 (5%) required mechanical ventilation. The median age of patients admitted to intensive care units was 48 years and 78 ( 59%) of them had at least one chronic underlying disease, none were pregnant. Altogether 44 deaths related to influenza A(H1N1)2009 were recorded (median age 56 years): 40 belonged to high-risk groups on the basis of underlying chronic diseases. Combining data from different surveillance systems gave timely information about the spread of the pandemic and contributed to identifying risk groups.

Outbreak of 2009 pandemic influenza A(H1N1) in a Finnish garrison - a serological survey

In September 2009, an outbreak of 2009 pandemic influenza A(H1N1) took place in a Finnish garrison. In November 2009, we performed a serological survey among 984 recruits undergoing their military service at the garrison and related the results to self-reported upper respiratory tract infection (URTI) with or without fever. Of 346 volunteers who donated a blood sample, 169 (49%) had pandemic influenza A(H1N1) virus-specific antibodies. Of those, 84 (50%) reported no recent history of URTI, suggesting that a major part of those infected with pandemic influenza A(H1N1) virus may be asymptomatic.

Outbreak of 2009 pandemic influenza A(H1N1) in a Finnish garrison--a serological survey

In September 2009, an outbreak of 2009 pandemic influenza A(H1N1) took place in a Finnish garrison. In November 2009, we performed a serological survey among 984 recruits undergoing their military service at the garrison and related the results to self-reported upper respiratory tract infection (URTI) with or without fever. Of 346 volunteers who donated a blood sample, 169 (49%) had pandemic influenza A(H1N1) virus-specific antibodies. Of those, 84 (50%) reported no recent history of URTI, suggesting that a major part of those infected with pandemic influenza A(H1N1) virus may be asymptomatic.

High frequency of cross-reacting antibodies against 2009 pandemic influenza A(H1N1) virus among the elderly in Finland

Since May 2009, the pandemic influenza A(H1N1) virus has been spreading throughout the world. Epidemiological data indicate that the elderly are underrepresented among the ill individuals. Approximately 1,000 serum specimens collected in Finland in 2004 and 2005 from individuals born between 1909 and 2005, were analysed by haemagglutination-inhibition test for the presence of antibodies against the 2009 pandemic influenza A(H1N1) and recently circulating seasonal influenza A viruses. Ninety-six per cent of individuals born between 1909 and 1919 had antibodies against the 2009 pandemic influenza virus, while in age groups born between 1920 and 1944, the prevalence varied from 77% to 14%. Most individuals born after 1944 lacked antibodies to the pandemic virus. In sequence comparisons the haemagglutinin (HA) gene of the 2009 pandemic influenza A(H1N1) virus was closely related to that of the Spanish influenza and 1976 swine influenza viruses. Based on the three-dimensional structure of the HA molecule, the antigenic epitopes of the pandemic virus HA are more closely related to those of the Spanish influenza HA than to those of recent seasonal influenza A(H1N1) viruses. Among the elderly, cross-reactive antibodies against the 2009 pandemic influenza virus, which likely originate from infections caused by the Spanish influenza virus and its immediate descendants, may provide protective immunity against the present pandemic virus.

High frequency of cross-reacting antibodies against 2009 pandemic influenza A(H1N1) virus among the elderly in Finland

Since May 2009, the pandemic influenza A(H1N1) virus has been spreading throughout the world. Epidemiological data indicate that the elderly are underrepresented among the ill individuals. Approximately 1,000 serum specimens collected in Finland in 2004 and 2005 from individuals born between 1909 and 2005, were analysed by haemagglutination-inhibition test for the presence of antibodies against the 2009 pandemic influenza A(H1N1) and recently circulating seasonal influenza A viruses. Ninety-six per cent of individuals born between 1909 and 1919 had antibodies against the 2009 pandemic influenza virus, while in age groups born between 1920 and 1944, the prevalence varied from 77% to 14%. Most individuals born after 1944 lacked antibodies to the pandemic virus. In sequence comparisons the haemagglutinin (HA) gene of the 2009 pandemic influenza A(H1N1) virus was closely related to that of the Spanish influenza and 1976 swine influenza viruses. Based on the three-dimensional structure of the HA molecule, the antigenic epitopes of the pandemic virus HA are more closely related to those of the Spanish influenza HA than to those of recent seasonal influenza A(H1N1) viruses. Among the elderly, cross-reactive antibodies against the 2009 pandemic influenza virus, which likely originate from infections caused by the Spanish influenza virus and its immediate descendants, may provide protective immunity against the present pandemic virus.

Conversion of a CHO cell culture process from perfusion to fed-batch technology without altering product quality

During the development of a new drug product, it is a common strategy to develop a first-generation process with the aim to rapidly produce material for pre-clinical and early stage clinical trials. At a later stage of the development, a second-generation process is then introduced with the aim to supply late-stage clinical trials as well as market needs. This work was aimed at comparing the performance of two different CHO cell culture processes (perfusion and fed-batch) used for the production of a therapeutically active recombinant glycoprotein at industrial pilot-scale. The first-generation process was based on the Fibra-Cel packed-bed perfusion technology. It appeared during the development of the candidate drug that high therapeutic doses were required (>100mg per dose), and that future market demand would exceed 100 kg per year. This exceeded by far the production capacity of the first-generation process, and triggered a change of technology from a packed-bed perfusion process with limited scale-up capabilities to a fed-batch process with scale-up potential to typical bioreactor sizes of 15m(3) or more. The productivity per bioreactor unit volume (in product m(-3)year(-1)) of the fed-batch process was about 70% of the level reached with the first-generation perfusion process. However, since the packed-bed perfusion system was limited in scale (0.6m(3) maximum) compared to the volumes reached in suspension cultures (15m(3)), the fed-batch was selected as second-generation process. In fact, the overall process performance (in product year(-1)) was about 18-fold higher for the fed-batch compared to the perfusion mode. Data from perfusion and fed-batch harvests samples indicated that comparable product quality (relative abundance of monomers dimers and aggregates; N-glycan sialylation level; isoforms distribution) was obtained in both processes. To further confirm this observation, purification to homogeneity of the harvest material from both processes, followed by a complementary set of studies (e.g. full physico-chemical characterization, assessment of in vitro and in vivo bioactivity, comparative pharmacokinetics and pharmacodynamics studies in relevant species, etc.) would be required. Finally, this illustrates the need to fix the production process early during the development of a new drug product in order to minimize process conversion efforts and to shorten product development time lines.

Study of B0-->rho+/- pi-/+ time-dependent CP violation at Belle

We present a time-dependent analysis of CP violation in B0-->rho(+/-)pi(-/+) decays based on a 140 fb(-1) data sample collected at the Upsilon(4S) resonance with the Belle detector at KEKB. We obtain the charge asymmetry A(rhopi)(CP)=-0.16+/-0.10(stat)+/-0.02(syst). An unbinned maximum-likelihood fit to the Deltat distributions yields C(rhopi)=0.25+/-0.17(stat)+0.02-0.06(syst), DeltaC(rhopi)=0.38+/-0.18(stat)+0.02-0.04(syst), S(rhopi)=-0.28+/-0.23(stat)+0.10-0.08(syst), and DeltaS(rhopi)=-0.30+/-0.24(stat)+/-0.09(syst). The direct CP violation parameters for B-->rho(+)pi(-) and B-->rho(-)pi(+) decays are A(+-)(rhopi)=-0.02+/-0.16(stat)+0.05-0.02(syst) and A(-+)(rhopi)=-0.53+/-0.29(stat)+0.09-0.04(syst).

Advances in the diagnosis of respiratory virus infections

Background: Advances have been made in selecting sensitive cell lines for isolation, in early detection of respiratory virus growth in cells by rapid culture assays, in production of monoclonal antibodies to improve many tests such as immunofluorescence detection of virus antigens in nasopharyngeal aspirates, in highly sensitive antigen detections by time-resolved fluoroimmunoassays (TR-FIAs) and biotin-enzyme immunoassays (BIOTH-E), and, finally, in the polymerase chain reaction (PCR) detection of respiratory virus DNA or RNA in clinical specimens. All of these advances have contributed to new or improved possibilities for the diagnosis of respiratory virus infections.

Objectives and study design: This review summarizes our experiences during the last 15 years in the development of diagnostic tests for respiratory virus infections, and in use of these tests in daily diagnostic work and in epidemiological studies.

Results: Immunofluorescence tests based on monoclonal antibodies, all-monoclonal TR-FIAs, and biotin-enzyme immunoassays (EIAs) have about the same sensitivities and specificities. They compare well with the sensitivity of virus culture. PCR followed by liquid-phase hybridization is a sensitive method for detecting adenovirus DNA and enterovirus and rhinovirus RNA in clinical specimens. IgG EIA on paired acute and convalescent phase sera is the most sensitive serological test for respiratory virus infections and is a valuable reference method when evaluating the sensitivity of new diagnostic tests. The IgG avidity test can distinguish primary infections from re-infections at least in respiratory syncytial virus (RSV) infections. IgM antibody assays, on the other hand, had low sensitivities in our studies.

Conclusions: The choice of diagnostic methods for respiratory virus infections depends on the type and location of the laboratory, the number of specimens tested, and the previous experience of the laboratory. Virus culture, whenever possible, should be the basic diagnostic method; the results, including identification of the virus, should be available no more than 24 h later than the results of rapid diagnostic tests. In small laboratories, especially in hospitals where specimen transportation is well organized, immunofluorescence may be the best choice for antigen detection with the provision that an experienced microscopist and a good UV microscope are available. If the laboratory receives a large number of specimens and has previous experience with EIAs, then biotin-EIAs or TR-FIAs may be the most practical techniques. Their advantages include the stability of the antigens in clinical samples since intact, exfoliated epithelial cells are not required, treatment of specimens is practical, testing of large numbers of specimens is possible, and reading the printed test result is less subjective than reading fluorescence microscopy. The larger role of PCR in the diagnosis of respiratory virus infections depends on future developments such as practical methods to extract DNA or RNA and to purify the extracts from nonspecific inhibitors, plus further improvements to minimize cross-contamination. Group-specific detection of enteroviruses and rhinoviruses is an example of the potential for PCR technology. In experienced laboratories. EIA IgG antibody tests should be available. Recombinant antigens may be a useful part of such assays.

Measurement of the branching fraction and CP asymmetry in B+ --> rho+pi0

We report a measurement of the branching fraction for the decay B+ --> rho(+) pi(0) based on a 140 fb(-1) data sample collected with the Belle detector at the KEKB asymmetric e(+)e(-) collider. We measure the branching fraction B(B(+) --> rho(+)pi(0)) = (13.2 +/- 2.3(stat)(+1.4)(-1.9)(syst)) x 10(-6), and the CP-violating asymmetry A(CP)(B-/+ -->rho(-/+)pi(0))=0.06 +/- 0.17(stat)(+0.04)(-0.05)(syst).

Study of time-dependent CP violation in B0-->J/psipi0 decays

We report a measurement of CP asymmetry parameters in the decay B0(B (0))-->J/psipi(0), which is governed by the b-->cc d transition. The analysis is based on a 140 fb(-1) data sample accumulated at the Upsilon(4S) resonance by the Belle detector at the KEKB asymmetric-energy e(+)e(-) collider. One neutral B meson in the J/psipi(0) final state is fully reconstructed for events used in this analysis. The accompanying B meson flavor is identified by its decay products. From the distribution of proper-time intervals between the two B decays, we obtain the following CP-violating parameters: S(J/psipi(0))=-0.72+/-0.42(stat)+/-0.09(syst) and A(J/psipi(0))=-0.01+/-0.29(stat)+/-0.03(syst).

Observation of B+-->LambdaLambdaK+

We report the first observation of the charmless hyperonic B decay, B+-->LambdaLambdaK+, using a 140 fb(-1) data sample recorded at the Upsilon(4S) resonance with the Belle detector at the KEKB (e+)(e-) collider. The measured branching fraction is B(B+-->LambdaLambdaK+) = (2.91(+0.90)(-0.70) +/- 0.38) x 10(-6). We also perform a search for the related decay mode B+-->LambdaLambdapi+, but do not find a significant signal. We set a 90% confidence-level upper limit of B(B+-->LambdaLambdapi+) < 2.8 x 10(-6).

Evidence for direct CP violation in B0-->K+pi- decays

We report evidence for direct CP violation in the decay B0-->K+pi(-) with 253 fb(-1) of data collected with the Belle detector at the KEKB e(+)e(-) collider. Using 275x10(6) BB pairs we observe a B-->K+/-pi(-/+) signal with 2140+/-53 events. The measured CP violating asymmetry is A(CP)(K+pi(-))=-0.101+/-0.025(stat)+/-0.005(syst), corresponding to a significance of 3.9sigma including systematics. We also search for CP violation in the decays B+-->K+pi(0) and B+-->pi(+)pi(0). The measured CP violating asymmetries are A(CP)(K+pi(0))=0.04+/-0.05(stat)+/-0.02(syst) and A(CP)(pi(+)pi(0))=-0.02+/-0.10(stat)+/-0.01(syst), corresponding to the intervals -0.05<A(CP)(K+pi(0))<0.13 and -0.18<A(CP)(pi(+)pi(0))<0.14 at 90% confidence level.

Correlation between blood group phenotype and virulence properties of Escherichia coli in patients with chronic urinary tract infection

A predisposition to urinary tract infection (UTI) is associated with the expression of P1 as well as the presence of ABO blood group antigen on the boundary layer and with the secretor state. Infectious microorganisms interfere with specific molecules on epithelial cells, these are antigens of the P and ABO blood group system. The blood group phenotype was examined in 53 women (age 42 +/- 12 years) with chronic non-obstructive UTI. The diagnosis was established on the basis of clinical history as well as clinical laboratory and radiological findings. The ABO phenotype and the P1 antigen were analysed by anti-A and anti-B as well as anti-P1 serum. The Lewis phenotyping was performed by incubating erythrocytes with anti-Le(a) and anti-Le(b) serum. In all patients, the blood group status were investigated. The proportion of persons with B-phenotype was 23% (the incidence of this feature in the German population is 14.5%). P1 antigen was found in 76% patients. In comparison with P1 antigen-negative individuals, P1 antigen-positive persons have a longer disease history and suffer more frequently from symptomatic events as well as destructive renal changes. The Le (a)-antigen was detected in 82% and the Le (b)-phenotype was observed in 18% of patients. The blood group phenotypes (ABO, Lewis and P1 antigens) represent an interesting natural aspect of local defence system against the invasive efforts of uropathogens. Antigen structures on uroepithelial cells for example, the glycolipids of the P antigen, serve as receptors for adhesion of microorganisms.

Inclusive measurement of the photon energy spectrum in b --> sgamma decays

We report a fully inclusive measurement of the flavor changing neutral current decay b --> sgamma in the energy range 1.8 GeV < or = E*gamma < or = 2.8 GeV, covering 95% of the total spectrum. Using 140 fb(-1), we obtain B(b --> sgamma) = (3.55+/-0.32(+0.30+0.11)(-0.31-0.07)) x 10(-4), where the errors are statistical, systematic, and from theory corrections. We also measure the first and second moments of the photon energy spectrum above 1.8 GeV and obtain (Egamma) = 2.292+/-0.026+/-0.034 GeV and (E2gamma) - (Egamma)2 = 0.0305+/-0.0074+/-0.0063 GeV2, where the errors are statistical and systematic.

Measurement of the CP asymmetry in B-->Xs gamma

Direct CP violation in the b-->sgamma process is a sensitive probe of physics beyond the standard model. We report a measurement of the CP asymmetry in B-->X(s)gamma, where the hadronic recoil system X(s) is reconstructed using a pseudoreconstruction technique. In this approach there is negligible contamination from b-->dgamma decays, which are expected to have a much larger CP asymmetry. We find A(CP)=0.002+/-0.050(stat)+/-0.030(syst) for B-->X(s)gamma events having recoil mass smaller than 2.1 GeV/c(2). The analysis is based on a data sample of 140 fb(-1) recorded at the upsilon(4S) resonance with the Belle detector at the KEKB e(+)e(-) storage ring.

Study of CP violating effects in time dependent B0(B0)-->D(*)-/+pi+/- decays

We report measurements of time dependent decay rates for B0(B(0))-->D((*)-/+)pi(+/-) decays and extraction of CP violation parameters containing phi(3). Using fully reconstructed D((*))pi events from a 140 fb(-1) data sample collected at the Upsilon(4S) resonance, we obtain the CP violation parameters for D(*)pi and Dpi decays, 2R(D((*))pi)sin((2phi(1)+phi(3)+/-delta(D((*))pi)), where R(D((*))pi) is the ratio of the magnitudes of the doubly Cabibbo-suppressed and Cabibbo-favored amplitudes, and delta(D((*))pi) is the strong phase difference between them. Under the assumption of delta(D((*))pi) being close to either 0 degrees or 180 degrees, we obtain |2R(D(*)pi)sin((2phi(1)+phi(3))|=0.060+/-0.040(stat)+/-0.019(syst) and |2R(Dpi)sin((2phi(1)+phi(3))|=0.061+/-0.037(stat)+/-0.018(syst).

Observation of large CP violation and evidence for direct CP violation in B0-->pi(+)pi(-) decays

We report the first observation of CP violation in B0-->pi(+)pi(-) decays based on 152x10(6) gamma (4S)-->BB decays collected with the Belle detector at the KEKB asymmetric-energy e(+)e(-) collider. We reconstruct a B0-->pi(+)pi(-) CP eigenstate and identify the flavor of the accompanying B meson from its decay products. From the distribution of the time intervals between the two B meson decay points, we obtain A(pipi)=+0.58+/-0.15(stat)+/-0.07(syst) and S(pipi)=-1.00+/-0.21(stat)+/-0.07(syst). We rule out the CP-conserving case, A(pipi)=S(pipi)=0, at a level of 5.2 standard deviations. We also find evidence for direct CP violation with a significance at or greater than 3.2 standard deviations for any S(pipi) value.

[Interpretation of increased D-dimer values]

BACKGROUND

The determination of D-dimer concentration is an essential part in the diagnostic procedure of thromboembolic diseases, e.g. deep vein thrombosis, pulmonary embolism. D-dimers are the products of fibrin hydrolysis with elevated levels in fibrinolytic processes.

QUESTION

In the clinical practice problems exist in the interpretation of increased D-dimer concentrations, especially without thromboembolic disease. Before starting further expensive imaging diagnostics other reasons (i.e. pregnancy, neoplasma, systemic inflammatory disease, advanced arteriosclerosis) should be considered in differential diagnosis.

CONCLUSION

The determination of the concentration of D-dimers is involved in the diagnostic strategy in thromboembolic diseases. However, this parameter is not suited for routine screening. Its high predictive-negative value is proved for the exclusion of thrombosis or pulmonary embolism in case of negative test result. Since a range of diseases and physiological conditions lead to increased D-dimer values, a positive D-dimer result does not verify the diagnosis of thromboembolism.

Crystal structure of nonafluoro-{N-[(E)-2-(2-hydroxyphenyl)diazenyl]-phenyl}-1-butanesulfonamide, C16H10F9N3O3S

C16H10F9N3O3S, monoclinic, P121/c1 (No. 14), a = 5.6549(3) Å, b = 12.2550(9) Å, c = 27.170(6) Å, β = 90.446(8)°, V = 1882.8 Å3, Z = 4, Rgt(F) = 0.088, wRref(F2) = 0.261, T = 213 K.