On the Use of High-Resolution and Deep-Learning Seismic Catalogs for Short-Term Earthquake Forecasts: Potential Benefits and Current Limitations

Enhanced earthquake catalogs provide detailed images of evolving seismic sequences. Currently, these data sets take some time to be released but will soon become available in real time. Here, we explore whether and how enhanced seismic catalogs feeding into established short-term earthquake forecasting protocols may result in higher predictive skill. We consider three enhanced catalogs for the 2016-2017 Central Italy sequence, featuring a bulk completeness lower by at least two magnitude units compared to the real-time catalog and an improved hypocentral resolution. We use them to inform a set of physical Coulomb Rate-and-State (CRS) and statistical Epidemic-Type Aftershock Sequence (ETAS) models to forecast the space-time occurrence of M3+ events during the first 6 months of the sequence. We track model performance using standard likelihood-based metrics and compare their skill against the best-performing CRS and ETAS models among those developed with the real-time catalog. We find that while the incorporation of the triggering contributions from new small magnitude detections of the enhanced catalogs is beneficial for both types of forecasts, these models do not significantly outperform their respective near real-time benchmarks. To explore the reasons behind this result, we perform targeted sensitivity tests that show how (a) the typical spatial discretizations of forecast experiments ( ≥ 2 km) hamper the ability of models to capture highly localized secondary triggering patterns and (b) differences in earthquake parameters (i.e., magnitude and hypocenters) reported in different catalogs can affect forecast evaluation. These findings will contribute toward improving forecast model design and evaluation strategies for next-generation seismic catalogs.

Management of septic and aseptic prepatellar bursitis: a systematic review

BACKGROUND

Despite contributing to significant morbidity in working-age adults, there is no consensus on the optimal treatment for prepatellar bursitis. Much of the existing literature combines prepatellar and olecranon bursitis. This systematic review aims to determine the optimal management of prepatellar bursitis.

STUDY DESIGN AND METHODS

A primary search of electronic published and unpublished literature databases from inception to November 2019 was completed. Articles over 25 years old, case reports with less than four patients, paediatric studies, and non-English language papers were excluded. Our primary outcome was recurrence after 1 year. Comparisons included endoscopic vs open bursectomy, duration of antibiotics. Methodological quality was assessed using the Institute of Health Economics and Revised Cochrane Risk of Bias scoring systems. Meta-analyses were conducted where appropriate.

RESULTS

In total 10 studies were included (N = 702). Endoscopic and open bursectomy showed no difference in recurrence after 1 year (OR 0.41, 95% CI 0.05-3.53, p = 0.67), and surgical complications (OR 1.44, 95% CI 0.34-6.08, p = 0.44). 80% endoscopically-treated patients were pain free after 1 year. Patients treated with antibiotics for less than 8 days were not significantly more prone to recurrence (2/17 vs 10/114, OR 0.66, 95% CI 0.13-3.29, p = 0.64) compared to 8 days plus at minimum 1 year post injury.

CONCLUSIONS

Our study represents the largest cohort of patients evaluating management strategies for prepatellar bursitis, and includes data not previously published. Endoscopic bursectomy is non-inferior to open bursectomy, enabling a shorter hospital stay. It also offers a relatively low risk of post-operative pain. Endoscopic bursectomy is a viable option to treat both septic and aseptic prepatellar bursitis. Our small cohort suggests recurrence and hospital stay are not improved with antibiotic treatment exceeding 7 days for septic prepatellar bursitis.

White clover or nitrogen fertiliser for dairying under nitrate leaching limits?

As the pressure intensifies to reduce nitrogen (N) losses to the environment from pasture-based dairy systems, interest in reducing N-fertiliser inputs and returning to grass–clover mixtures, where more N for pasture growth is supplied by biological N fixation (BNF), have been revived. However, the following question then arises: is BNF fundamentally different from fertiliser N with respect to N losses, especially nitrate-N leaching risk? The present paper addresses this question by reviewing empirical evidence in the context of N-cycling processes and the efficiency of N use for herbage production. Nitrate leaching data from studies comparing different sward treatments at the same level of total N inputs (fertiliser plus BNF) provide no evidence to suggest that leaching differs when N is supplied solely by fixation in mixtures, by fixation plus fertiliser in mixtures, or solely as a fertiliser to grass monoculture. Increasing clover content in mixed grass–clover pastures is likely to increase N leaching due to a lower ratio of soluble sugar and starch to N in herbage than the common companion grass species perennial ryegrass, and, therefore, a higher partitioning of N eaten to urine. Counteracting this effect, mixed grass–clover pastures may offer some potential for increasing N-use efficiency and reducing the whole-farm N surplus compared with grass-dominant pasture receiving high rates of N fertiliser. While there are undeniable benefits for the productivity of dairy systems from maintaining strong grass–clover mixtures, it is the total amount of N entering the system, rather than the form of N (BNF or fertiliser), that influences nitrate leaching rates.

A-21 Inhibition of Overlearned Verbal Responses and Quantity of Speech Among Age Cohorts

Objective

Off-topic speech (OTS) has been linked with deficits in executive functioning, and specifically inhibition. OTS research has focused primarily on tangentiality, whereas in this study we focused on quantity of speech. The purpose of this study was to investigate the relationship between inhibition of overlearned responses using a Stroop task and quantity of speech.

Method

A college sample of young adults (n = 63; age 18-28) and healthy, community-dwelling older adults (n = 76; age 60-99) completed the Delis-Kaplan Executive Function Systems (D-KEFS) Color-Word Interference Test and provided a verbal sample in which they recounted a procedural memory and an episodic memory. These samples were transcribed and rated for quantity of speech by three independent judges.

Results

Among all participants, longer time to complete color naming (r = -.21, p = .02) and inhibition (r = -.21, p = .01) was associated with lower quantity of speech on procedural memory. Among young adults, longer time to complete inhibition was associated with lower quantity of speech (r = -.26, p = .04). Among older adults, longer time to complete color naming (r = -.32, p = .005), word reading (r = -.27, p = .02), and inhibition (r = -.35, p = .002) was associated with lower quantity of speech. No relationships were found between performance on Stroop conditions and quantity of speech for episodic memory.

Conclusions

Results suggest that among both age cohorts, difficulty inhibiting overlearned verbal responses is associated with lower quantity of speech regarding a procedural memory but not an episodic memory.

A-13 Sustained Attention, Impulsivity, and Tangentiality of Speech Among Young Adults and Older Adults

Objective

Previous research has linked off-topic verbosity (OTV) among older adults with lower performance on neuropsychological tests tapping attention and executive functioning. However, most of this research has utilized relatively brief neurocognitive measures. Continuous performance tests (CPTs) measure sustained attention and impulsivity. The purpose of this study was to investigate relationships between sustained attention, impulsivity, and tangentiality of speech among young adults and older adults.

Method

Young adult college students (age 18-29; n= 61) and healthy, community-dwelling older adults (age 60-99; n = 81) were administered the Conners’ Continuous Performance Test – 3 and provided a sample of speech (one episodic memory and one procedural memory). These speech samples were transcribed and rated for tangentiality by three independent reviewers.

Results

Among all participants, greater tangentiality of speech was associated with omission errors (r = .22, p = .01) but not with commission errors. This same pattern was found among older adults: omission errors (r = .23, p = .04) were associated with greater tangentiality but commission errors were not. Among young adults, these relationships were not statistically significant.

Conclusions

Results suggest that tangentiality of speech is associated with inattentiveness but not impulsivity, and this relationship may be more marked among older adults than young adults. OTV among older adults may stem from difficulty sustaining attention over time rather than diminished capacity for inhibiting impulses.

The way forward: Can connectivity be useful to design better measuring and modelling schemes for water and sediment dynamics?

For many years, scientists have tried to understand, describe and quantify water and sediment fluxes, with associated substances like pollutants, at multiple scales. In the past two decades, a new concept called connectivity has been used by Earth Scientists as a means to describe and quantify the influences on the fluxes of water and sediment on different scales: aggregate, pedon, location on the slope, slope, watershed, and basin. A better understanding of connectivity can enhance our comprehension of landscape processes and provide a basis for the development of better measurement and modelling approaches, further leading to a better potential for implementing this concept as a management tool. This paper provides a short review of the State-of-the-Art of the connectivity concept, from which we conclude that scientists have been struggling to find a way to quantify connectivity so far. We adapt the knowledge of connectivity to better understand and quantify water and sediment transfers in catchment systems. First, we introduce a new approach to the concept of connectivity to study water and sediment transfers and the associated substances. In this approach water and sediment dynamics are divided in two parts: the system consists of phases and fluxes, each being separately measurable. This approach enables us to: i) better conceptualize our understanding of system dynamics at different timescales, including long timescales; ii) identify the main parameters driving system dynamics, and devise monitoring strategies which capture them; and, iii) build models with a holistic approach to simulate system dynamics without excessive complexity. Secondly, we discuss the role of system boundaries in designing measurement schemes and models. Natural systems have boundaries within which sediment connectivity varies between phases; in (semi-)arid regions these boundaries can be far apart in time due to extreme events. External disturbances (eg. climate change, changed land management) can change these boundaries. It is therefore important to consider the system state as a whole, including its boundaries and internal dynamics, when designing and implementing comprehensive monitoring and modelling approaches. Connectivity is a useful tool concept for scientists that must be expanded to stakeholder and policymakers.

Antitumor activity of PSMA ADC after progression on docetaxel in a mouse xenograft model of human prostate cancer

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Background: Currently, there are no approved therapies for castration-resistant metastatic prostate cancer that has progressed following docetaxel therapy. Prostate-specific membrane antigen (PSMA) is an attractive target for antibody-targeted therapy of prostate cancer due to its abundant and restricted expression on the surface of prostate cancer cells. We have developed a novel antibody-drug conjugate (ADC) by linking a fully human PSMA monoclonal antibody to monomethylauristatin E (MMAE), a potent tubulin inhibitor. Here, we describe the use of PSMA ADC in a mouse model to treat xenografted human prostate tumors that have progressed following docetaxel therapy. Methods: Nude mice were implanted subcutaneously with 5 x 106 C4–2 human prostate cancer cells. Animals were first randomized to receive weekly intravenous (IV) doses of either 2 mg/kg docetaxel (n = 50) or vehicle (n = 10). Docetaxel significantly reduced tumor growth (p = 0.025) during the initial phase of the study; however, most of the tumors later progressed. When the tumor volume of an animal in the docetaxel group exceeded 400 mm3, the animal was rerandomized to receive continued docetaxel therapy (n = 18) or weekly IV doses of 6 mg/kg PSMA ADC (n = 18). Treatment effects were assessed by measuring tumor volume and overall survival. When tumor volume was assessed to be ≥2,000 mm3, animals would be sacrificed. Results: At 134 days following tumor implantation, the survival rate was 100% for animals in the PSMA ADC treatment group; 94% of these mice had tumor sizes <100 mm3. In the continued docetaxel treatment group, 14 of 18 animals that were sacrificed when their tumors exceeded 2,000 mm3; the survival rate was 22%. Therefore, PSMA ADC treatment significantly shrank tumors and increased overall survival of animals compared to continued docetaxel treatment (p < 0.0001). Conclusions: PSMA ADC had antitumor activity in mice to xenografted human prostate tumors that had progressed following docetaxel treatment. Treatment with PSMA ADC significantly extended survival in this setting.

[Table: see text]

Determination of disc breakpoints and evaluation of Etests for tigecycline susceptibility testing by the BSAC method

BACKGROUND

Tigecycline has been recently licensed in Europe for intra-abdominal and complicated skin and soft tissue infections. We determined zone breakpoints for use with 15 microg tigecycline discs and evaluated Etests for the routine determination of tigecycline susceptibility by BSAC methods.

METHODS

Disc zones for 2236 isolates and MICs by Etest for 531 isolates were compared with MICs obtained by the BSAC agar dilution method.

RESULTS

Based on error minimization, we propose zone breakpoints for 15 microg tigecycline discs as follows: alpha/beta-haemolytic streptococci, S > or = 25 mm, R < or = 19 mm; Acinetobacter spp. and Enterobacteriaceae, S > or = 24 mm, R < or = 19 mm; Enterococcus spp., S > or = 21 mm, R < or = 20 mm; Haemophilus spp., S > or = 28 mm, R < or = 27; Streptococcus pneumoniae, S > or = 24 mm, R < or = 23 mm; and staphylococci, S > or = 26 mm, R < or = 25 mm. These criteria gave overall false resistance rates of < or =0.8% and false susceptibility rates of < or =0.7%. Tigecycline Etests, used on Iso-Sensitest agar, gave MICs within one doubling dilution of those by agar dilution in 97% of cases. Categorization agreement was good for isolates with borderline susceptibility or resistance-a group where Etests are likely to be used in order to verify disc-based results. MICs for highly susceptible alpha-haemolytic streptococci were underestimated by Etest, but this seems unlikely to be significant.

CONCLUSIONS

Disc breakpoints corresponding to BSAC MIC breakpoints were defined for 15 microg tigecycline discs and have been adopted by the BSAC. Tigecycline Etest gave results in good agreement with agar dilution.

Dietary advice for illness-related malnutrition in adults

BACKGROUND

Illness-related malnutrition has been reported in 10% to 55% of ill people in hospital and the community in areas of food sufficiency. Dietary advice encouraging the use of energy- and nutrient-rich foods rather than oral nutritional supplements has been suggested for managing illness-related malnutrition.

OBJECTIVES

To examine evidence that dietary advice to improve nutritional intake in adults with illness-related malnutrition improves survival, weight and anthropometry; to estimate the size of any additional effect of nutritional supplements given in combination with dietary advice.

SEARCH STRATEGY

Relevant publications were identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings. Additional studies were sought by contacting dietitians, clinicians and the manufacturers of nutritional supplements. Last search: October 2006

SELECTION CRITERIA

Randomised controlled trials of dietary advice in people with illness-related malnutrition compared with:(1) no advice;(2) oral nutritional supplements; and(3) dietary advice plus oral nutritional supplements.

DATA COLLECTION AND ANALYSIS

Two authors independently assessed trial eligibility, methodological quality and extracted data.

MAIN RESULTS

Thirty-five studies (37 comparisons) met the inclusion criteria with 2648 randomised participants. Twelve trials (comparing dietary advice plus supplements if required with no advice) identified during searching are included as a separate comparison. Follow up ranged from 18 days to 24 months. No comparison showed a significant difference in mortality. Significant improvements in weight at three months were found for groups receiving dietary advice plus nutritional supplements compared with dietary advice alone, WMD 1.68 kg (95% CI 0.14 to 3.21) or no additional advice, WMD 1.97 (95% CI 0.07 to 3.86). There were significant improvements in grip strength and mid-arm muscle circumference in the advice plus supplement groups compared with dietary advice alone. It is uncertain whether nutritional supplements and dietary advice produce the same effects. No significant differences were found between groups for clinical outcomes. Few data were available for other outcomes.

AUTHORS' CONCLUSIONS

This review highlights the lack of evidence for the provision of dietary advice in managing illness-related malnutrition. Dietary advice plus nutritional supplements may be more effective than dietary advice alone or no advice in enhancing short-term weight gain, but whether this is sustainable, or whether survival and morbidity are improved remains uncertain. A large adequately-powered randomised controlled trial is needed comparing the efficacy of different therapies to increase dietary intake in people with illness-related malnutrition and examining the impact of this on clinical function and survival.

Effect of medium type, age and aeration on the MICs of tigecycline and classical tetracyclines

BACKGROUND

Tigecycline is a minocycline derivative, belonging to a chemical class prone to oxidation and to medium-related effects on susceptibility. We therefore studied the effect of medium type and age on the tigecycline MICs found in broth and on agar by the Clinical Laboratory Standards Institute and British Society for Applied Chemotherapy methods.

METHODS

MICs of tigecycline, minocycline and tetracycline were determined for 96 non-fastidious bacteria and 20 streptococci using Mueller-Hinton broth (MHB), Mueller-Hinton agar (MHA), Iso-Sensitest broth (ISB) and Iso-Sensitest agar (ISA) as: (i) freshly-prepared media; (ii) fresh media but with the antibiotic added 1 day before inoculation and (iii) media stored for 7 days before antibiotic addition and use.

RESULTS

MICs of tigecycline in fresh MHB were up to two doubling dilutions higher than on or in MHA, ISA or ISB. Media with tigecycline or classical tetracyclines added a day before use gave raised MICs, though rarely by more than one dilution. MICs of tigecycline (less so classical tetracyclines) were increased in 7-day-old MHB or ISB, even though the antibiotic was freshly added. This latter effect was greatest for the most susceptible strains and was absent or much reduced for organisms with MICs > or = 8 mg/L; it did not occur in the corresponding agar dilution tests. Addition of blood to MHB largely abrogated the effect, as did steaming the broth before adding the antibiotic.

CONCLUSIONS

The raised MICs of tigecycline in aged broth probably reflect inactivation by dissolved oxygen. This accords with the lack of any MIC increase in newly-steamed (i.e. degassed) MHB or on aged agar (which is melted at 100 degrees C before use). Blood, which also abrogated the effect, may increase reducing capacity, protecting the tigecycline. At a practical level, broth MIC determinations for tigecycline should always employ fresh media.

A novel CEA vaccine stimulates T cell proliferation, γIFN secretion and CEA specific CTL responses

Carcinoembryonic antigen (CEA) is a cell surface protein over-expressed by a wide range of tumours. The mouse anti-idiotypic antibody, 708, mimics CEA and can induce both antibody and T cell responses that specifically recognise this antigen. Sequence analysis of 708 revealed homology with a previously identified HLA-A3 T cell epitope in CEA but not to other closely related molecules. 708 was chimerised to a human IgG1 to allow Fc targeting of APCs and was deimmunised to remove unwanted T cell epitopes. The chimerised and deimmunised, but not the mouse 708, could stimulate CTL, proliferation and gammaIFN responses in vitro in normal (HLA-A3, DR1) individuals. Furthermore, the CTLs killed tumour cells expressing CEA suggesting that this deimmunised antibody could be a useful vaccine for solid tumours.

Human anti-idiotypic antibodies can be good immunogens as they target FC receptors on antigen-presenting cells allowing efficient stimulation of both helper and cytotoxic T-cell responses

Anti-idiotypic antibodies that mimic tumour-associated antigens can stimulate anti-tumour T-cell responses. In this article, we have studied the role of Fc in the presentation of T-cell epitopes by 2 anti-idiotypic antibodies, 105AD7 and 708. The human monoclonal antibody 105AD7, which mimics CD55, stimulated strong in vitro T-cell proliferation, gammaIFN secretion and redirected cytotoxicity in unprimed T cells from healthy donors. However, removal of the Fc region of the anti-idiotype reduced the sensitivity of the assay 1,000-fold, as did inhibiting Fc uptake of the anti-idiotype by an excess of human IgG. The mouse anti-idiotype 708, which mimics CEA, failed to stimulate in vitro T-cell responses on unprimed T cells from healthy donors. However, when a human IgG1 Fc region replaced its mouse Fc region, the anti-idiotype induced T-cell proliferation, gammaIFN secretion and redirected cytotoxicity in lymphocytes from unimmunised donors. Human anti-idiotypes are therefore good immunogens since they target Fc receptors on antigen-presenting cells, allowing efficient stimulation of both helper and cytotoxic T-cell responses. The immunogenicity of other anti-idiotypes may therefore be enhanced by human Fc targeting of antigen-presenting cells.

Herbal therapy for treating rheumatoid arthritis

BACKGROUND

The increasing popularity of the use of complementary and alternative interventions or treatments appears to be particularly evident amongst people with chronic disease. In the treatment of rheumatoid arthritis, one therapy that has been identified as having potential benefit, is herbal medicine (phytotherapy).

OBJECTIVES

To assess the effectiveness of herbal therapies in the treatment of rheumatoid arthritis.

SEARCH STRATEGY

We developed a search strategy using terms to include all forms of arthritis combined with herbal medicine. We searched the following electronic databases from 1966 to 2000: MEDLINE, EMBASE, CISCOM, AMED, CINAHL, Cochrane Controlled Trials Register (CCTR), Cochrane Musculoskeletal specialized register, Dissertation Abstracts, BIDS ISI and the Cochrane Complementary Medicine Fields Specialized Register. This was supplemented by searching the reference lists from retrieved trials.

SELECTION CRITERIA

All randomized trials of herbal interventions in rheumatoid arthritis, compared to placebo. Two reviewers independently read and selected each potential study according to the criteria published in an a priori protocol. Papers of any language were included.

DATA COLLECTION AND ANALYSIS

Data were extracted independently by the same two reviewers and an assessment of methodological quality was conducted.

MAIN RESULTS

Eleven studies met the inclusion criteria. Seven of the studies compared gamma-linolenic acid (GLA) to placebo although three of these were not suitable for data pooling. The remaining studies considered four different herbal interventions and were assessed individually. All of the GLA studies found some improvement in clinical outcomes but methodology and study quality was variable, making it difficult to draw conclusive results. However, the better quality studies suggest potential relief of pain, morning stiffness and joint tenderness. With the exception of one intervention (Tripterygium wilfordii hook F), no serious side effects were reported.

REVIEWER'S CONCLUSIONS

There appears to be some potential benefit for the use of GLA in rheumatoid arthritis although further studies are required to establish optimum dosage and duration of treatment. The single studies are inconclusive.

Herbal therapy for treating osteoarthritis

BACKGROUND

The increasing popularity of complementary and alternative medicine appears to be particularly evident amongst people with chronic disease. In the treatment of osteoarthritis, one therapy that has been identified as having potential benefit, is herbal medicine (phytotherapy).

OBJECTIVES

To determine the effectiveness of herbal therapies in treating osteoarthritis.

SEARCH STRATEGY

Databases for mainstream and complementary medicine were searched using terms to include all forms of arthritis combined with herbal medicine. We searched the following electronic databases: MEDLINE, EMBASE, CISCOM, AMED, CINAHL, Cochrane Controlled Trials Register (CCTR), Cochrane Musculoskeletal specialized register, Dissertation Abstracts, BIDS ISI and the Cochrane Complementary Medicine Fields Specialized Register. We also searched the reference lists from retrieved trials.

SELECTION CRITERIA

All randomized trials of herbal interventions in osteoarthritis, compared to placebo. Studies were included according to the a priori protocol and agreement between two reviewers who independently read each selected paper for content and for assessment of quality. Papers of any language were included.

DATA COLLECTION AND ANALYSIS

Data were extracted independently by the same two reviewers.

MAIN RESULTS

Five studies (four different herbal interventions) met the review criteria. Two studies were suitable for data pooling. It was not possible to draw firm conclusions from the single studies but two studies of avocado/soybean unsaponifiables showed beneficial effects on functional index, pain, intake of NSAIDs and global evaluation. No serious side effects were reported.

REVIEWER'S CONCLUSIONS

The evidence for avocado-soybean unsaponifiables in the treatment of osteoarthritis is convincing but evidence for the other herbal interventions is insufficient to either recommend or discourage their use.

Dietary advice for illness-related malnutrition in adults

BACKGROUND

Illness-related malnutrition has been reported in 10-55% of people in hospital and in ill people in the community in areas of food sufficiency. It has been suggested that dietary counseling to encourage the use of energy- and protein-rich foods should be used in preference to oral nutritional supplements in the management of illness-related malnutrition.

OBJECTIVES

To examine the evidence that dietary advice, to improve nutritional intake, in adults with illness-related malnutrition can improve survival, weight and anthropometry and to estimate the size of any additional effect of whole protein nutritional supplements when given in combination with dietary advice.

SEARCH STRATEGY

Six electronic databases were searched (Cochrane Library, Medline, EMBASE, CINAHL, ERIC and Dissertation Abstracts). Additional studies were sought by contacting dietitians, clinicians and the manufacturers of nutritional supplements.

SELECTION CRITERIA

All randomised controlled trials of dietary advice compared with no advice, oral nutritional supplements and dietary advice plus oral nutritional supplements in people with illness-related malnutrition.

DATA COLLECTION AND ANALYSIS

Two reviewers independently assessed the trial eligibility, methodological quality and extracted the data.

MAIN RESULTS

Fifteen trials (16 comparisons) met the inclusion criteria. An additional group of six trials were identified during searching which compared dietary advice plus supplements if required with no advice. These trials have been included in the review as an additional comparison. The review includes 1185 randomised participants from a variety of clinical backgrounds. The duration of follow-up was from six weeks to 12 months. Nine trials reported clearly concealed randomisation and allocation and two trials reported blinding of outcome assessment. Nine trials reported outcomes in an unusable format. Gain in weight was significantly higher for groups consuming supplements with or without advice, compared with advice alone. Energy intake was significantly improved in those consuming supplements compared with those receiving advice alone. There was insufficient data on group differences in functional outcomes and mortality.

REVIEWER'S CONCLUSIONS

This review highlights the lack of evidence for the provision of dietary advice in the management of illness-related malnutrition. The available data suggest that oral nutritional supplements have a greater role than dietary advice in the improvement of body weight and energy intake. A large adequately powered randomised controlled trial is needed to compare the efficacy of different forms of therapy to increase dietary intake in people with illness-related malnutrition and to examine the impact of this on clinical function and survival.

SCF(beta-TRCP) and phosphorylation dependent ubiquitinationof I kappa B alpha catalyzed by Ubc3 and Ubc4

NF kappa B is an important transcriptional regulator of multiple pro-inflammatory genes. In non-stimulated cells NF kappa B is anchored in the cytoplasm via the inhibitory protein I kappa B alpha. Following exposure to diverse pro-inflammatory signals (e.g. TNF alpha, IL1, LPS) various signal transduction cascades are initiated converging on the I kappa B kinase (IKK). IKK phosphorylates I kappa B alpha on serines 32 and 36 signaling the inhibitory protein for ubiquitin-mediated degradation. The SCF beta-TRCP complex is the ubiquitin ligase responsible for mediating phosphorylation dependent ubiquitination of I kappa B alpha. Here we reconstitute phosphorylation dependent ubiquitination of I kappa B alpha using recombinant components. Our results suggest that the cullin specificity of the SCF complex may reflect its ability to associate with Rbx1. We demonstrate specific ubiquitination of I kappa B alpha by Ubc3 and Ubc4 in a phosphorylation and SCF beta-TRCP dependent manner and that both are capable of associating with the SCF beta-TRCP complex isolated from human cells. Finally, we show that Ubc4 is in excess to Ubc3 in THP.1 cells and 19 times more efficient in catalyzing the reaction, suggesting that Ubc4 is the preferentially used Ubc in this reaction in vivo. Our results also suggest that ubiquitin is transferred directly from the Ubc to phospho-I kappa B alpha in a SCF beta-TRCP dependent reaction. Oncogene (2000) 19, 3529 - 3536

Nutritional and other influences in childhood as predictors of adult obesity

It has been proposed that there are critical periods during childhood that influence the development of obesity, including gestation and early infancy, the period of adiposity rebound that occurs between ages 5 and 7 years, and adolescence. Despite an extensive literature, there is to date only modest evidence for most of the factors such as nutrition, physical activity and other behavioural factors that are suspected as playing a role in the development of obesity. A recent review of this evidence (Parsons et al. 1999) showed, however, a consistent relationship between socio-economic status (SES) of origin and adult obesity, whereby those from lower SES backgrounds were fatter subsequently in adulthood. This association appeared to apply to both men and women, a finding that contrasts with the trends observed in cross-sectional studies, of an association with SES for women only. There are several potential explanations for the SES of origin-adult obesity relationship. SES of origin may be confounded by parental body size; studies to date provide insufficient evidence of an independent association with SES after allowing for parental body size. Alternatively, environment in early life (for which SES of origin is a proxy measure) may have a long-term impact on obesity later in adulthood, through one or more of several processes. Three major potential explanations can be identified: (1) nutrition in infancy and childhood, either over- or undenutrition, followed subsequently by overnutrition; (2) psychological factors, possibly involving emotional deprivation in childhood; (3) cultural or social norms regarding dietary restraint and attitudes to fatness that may be acquired during childhood.

Heightened odds of large earthquakes near istanbul: An interaction-based probability calculation

We calculate the probability of strong shaking in Istanbul, an urban center of 10 million people, from the description of earthquakes on the North Anatolian fault system in the Marmara Sea during the past 500 years and test the resulting catalog against the frequency of damage in Istanbul during the preceding millennium. Departing from current practice, we include the time-dependent effect of stress transferred by the 1999 moment magnitude M = 7.4 Izmit earthquake to faults nearer to Istanbul. We find a 62 +/- 15% probability (one standard deviation) of strong shaking during the next 30 years and 32 +/- 12% during the next decade.

A mechanism for regulation of the adhesion-associated proteintyrosine kinase pp125FAK

Focal adhesion kinase (pp125FAK) is a member of a growing family of structurally distinct protein tyrosine kinases that includes the recently identified FakB and PYK2/CAKbeta/RAFTK. Activation of pp125FAK has been functionally linked to the formation of focal adhesions, integrin-mediated sites of contact between the cell and the extracellular matrix. The carboxy-terminal domain of pp125FAK is also expressed as a separate protein called pp41/43FRNK (where FRNK represents pp125FAK-related non-kinase). Here we show that pp41/43FRNK acts as an inhibitor of pp125FAK by transiently blocking the formation of focal adhesions on fibronectin and constitutively reducing tyrosine phosphorylation of both pp125FAK and two focal adhesion proteins, tensin and paxillin. These inhibitory effects of pp41/43FRNK are reversed by co-expression of pp125FAK, suggesting that pp125FAK and pp41/43 FRNK compete for a common binding protein(s) whose association with pp125FAK is necessary for signalling by pp125FAK. We propose that pp41/43FRNK functions as an endogenous regulator of pp125FAK, thus providing an unusual means to regulate both tyrosine kinase activity and cellular adhesion to the extracellular matrix.

Association of phosphatidylinositol 3-kinase, via the SH2 domains of p85, with focal adhesion kinase in polyoma middle t-transformed fibroblasts

Focal adhesion kinase (FAK), a non-receptor protein tyrosine kinase, becomes activated and phosphorylated on tyrosine in cells transformed with v-src. By cytoimmunofluorescence a sub-fraction of the p85 subunit of phosphoinositide 3-kinase (PI 3-kinase) localized in focal adhesion plaques. We examined the possibility that FAK associates with PI 3-kinase. In fibroblasts transformed with polyoma middle t, PI 3-kinase activity co-immunoprecipitated with pp125FAK using two different antibodies against this protein. PP125FAK from middle t-transformed cells associated with a glutathione-S-transferase fusion protein containing the 85-kDa subunit of phosphatidylinositol 3-kinase. Both of the SH2 domains and the SH3 domain of p85 also formed complexes with pp125FAK in vitro. Phosphopeptides that bind to the SH2 domains completely blocked the binding of full-length p85 to pp125FAK, while a peptide that binds to the SH3 domain was ineffective, indicating that the association between p85 and pp125FAK is mediated by the SH2 domains of p85.

Psychosis and genes with trinucleotide repeat polymorphism

Abnormal expansion of genes with trinucleotide repeat (TNR) polymorphism has been found in a number of neuropsychiatric disorders. These disorders and the major psychoses, schizophrenia and bipolar affective disorder, appear to share an interesting phenomenon: genetic anticipation. Because TNR expansion correlates with anticipation, these unstable DNA sites are considered important candidate loci for the major psychoses. We investigated genes with TNR polymorphisms, including B1, B33, B37, and the N-cadherin gene, in unrelated Caucasian North American and Italian schizophrenics (n = 53 to 74), and matched controls. Also, unrelated Caucasian North American patients with bipolar I affective disorder were screened for the B33 and N-cadherin genes (n = 49 and 63, respectively). No unusually long alleles that would suggest abnormal expansion of the TNR were observed for any of these genes. Also, no statistically significant results were found in tests for genetic association between any of these genes and schizophrenia. For B37, a trend toward a difference in allele counts between schizophrenics and controls was observed. However, no clear evidence for a role of these TNR-containing genes in schizophrenia or bipolar affective disorders was found.

Identification and characterization of an iron-regulated hemopexin receptor in Haemophilus influenzae type b

Heme can serve Haemophilus influenzae as a source of both essential porphyrin and iron. In extracellular mammalian body fluids neither free heme nor free iron is available, since they are tightly bound to hemopexin and transferrin, respectively. Since H. influenzae grows in the presence of iron-transferrin and heme-hemopexin and is known to express a saturable receptor for transferrin, we investigated the process by which this pathogen acquired heme from hemopexin for use as an iron source. The ability of human and rabbit hemopexin to donate heme as a source of iron to H. influenzae type b strains was demonstrated by plate bioassays. With a dot enzyme assay with biotinylated hemopexin as ligand, H. influenzae bound heme-hemopexin and apo-hemopexin following growth in iron-restricted, but not in iron-sufficient, medium. Competitive binding studies with heme-hemopexin and apo-hemopexin demonstrated saturability of binding. Neither heme, protoporphyrin IX, hemoglobin, nor transferrin blocked the binding of hemopexin to whole cells, demonstrating the specificity of binding. Treatment of whole H. influenzae cells with trypsin abolished binding. Taken together, these observations suggest that H. influenzae type b expresses an outer membrane protein(s) which acts as a receptor for hemopexin and which is regulated by the availability of iron in the growth medium. In iron-restricted media, H. influenzae 706705 and DL42 did not express the 100-kDa hemopexin-binding protein previously reported (M.S. Hanson, S.E. Pelzel, J. Latimer, U. Muller-Eberhard, and E.J. Hansen, Proc. Natl. Acad. Sci. USA 89:1973-1977, 1992). The putative iron-regulated hemopexin receptor was solubilized from cell envelopes of H. influenzae 706705, DL42, and Eagan with the detergent CHAPS (3-[(3-cholamidopropyl)-dimethyl-ammonio]-1-propanesulfonate) and isolated by affinity chromatography on heme-hemopexin-Sepharose 4B. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis of the proteins bound to the affinity resin revealed three proteins of 29, 38, and 57 kDa, of which the 57- and 29-kDa proteins bound hemopexin after Western blotting (immunoblotting). A monoclonal antibody to the 57-kDa hemopexin-binding protein of 706705 recognized a 57-kDa protein on Western blots of the cell envelope proteins of 706705, DL42, and Eagan; no reaction was observed with the 100-kDa hemopexin-binding protein of DL42. These data suggest that some H. influenzae strains possess at least two hemopexin receptors, the expression of which is determined by the prevailing growth environment.

A recombinant amino terminal fragment of bactericidal/permeability-increasing protein inhibits the induction of leukocyte responses by LPS

Bactericidal/permeability-increasing protein (BPI) is a major component of the granules of polymorphonuclear neutrophils (PMNs) and is involved in the killing of gram-negative bacteria. A 23-kd recombinant protein, corresponding to the NH2-terminal fragment of human BPI (rBPI23), has been shown to bind lipid A and antagonize some lipopolysaccharide (LPS)-mediated effects. In this study the ability of rBPI23 to prevent a wide range of cellular responses to LPS was investigated. In vitro assays were carried out using human blood to more closely approximate in vivo conditions. The release of proinflammatory cytokines [tumor necrosis factor (TNF), interleukin-1 beta (IL-1 beta), IL-6, IL-8], induced by E. coli O113 LPS, was markedly reduced by rBPI23 in a concentration-dependent fashion. The production of the anti-inflammatory protein IL-1ra (IL-1 receptor antagonist) was triggered by lower LPS concentrations than those necessary for the other cytokines. Furthermore, prevention of IL-1ra release required higher rBPI23 concentrations than for other cytokines. The LPS-induced production of oxygen-derived free radicals by phagocytic cells (resulting in chemiluminescence) was also prevented by rBPI23. The inhibition was specific for LPS because the activation of leukocytes by phorbol myristate acetate, zymosan, or TNF was unaffected by BPI. The ability of rBPI23 to antagonize specifically the effects of endotoxin in the complex environment of human blood along with its bactericidal activity suggests that rBPI23 may be a novel therapeutic agent in the treatment of gram-negative infections.

Antigenic relationships of transferrin-binding proteins from Neisseria meningitidis, N. gonorrhoeae and Haemophilus influenzae: cross-reactivity of antibodies to NH2-terminal peptides

The NH2-terminal amino sequence through the first 20 amino acids was obtained for transferrin-binding protein (TBP)1 from three strains of Neisseria meningitidis. These were identical except for a glutamine to a glycine substitution at residue 6 in one case. The sequences of the NH2-terminal 20 amino acids of TBP2 from the same three strains were also determined; one TBP2 had a M(r) of 68,000 and the other two of 78,000. Sequences were identical up to residue 13 in all three proteins. Peptides based on the NH2-terminal sequences of TBP1 and 2 were synthesized, linked to Keyhole Limpet haemocyanin and used to raise antibodies in rabbits. Anti-peptide antibodies cross-reacted on immunoblotting with the respective TBPs from all meningococcal strains tested, as well as with those from N. gonorrhoeae, suggesting that the NH2-terminals of these proteins are well conserved in the Neisseria. Neither anti-peptide serum reacted with the analogous TBP1 and 2 from Haemophilus influenzae, although common epitopes have previously been shown to exist.

High-affinity binding of the bactericidal/permeability-increasing protein and a recombinant amino-terminal fragment to the lipid A region of lipopolysaccharide

Bactericidal/permeability-increasing protein (BPI) is a 55-kDa cationic protein (nBPI55) elaborated by polymorphonuclear neutrophils (PMN). BPI has potent bactericidal activity against a wide variety of gram-negative organisms and neutralizes endotoxin activities. An N-terminal fragment of nBPI55 exhibits the bactericidal and antiendotoxin properties of the holoprotein. To further characterize the biological activities of the N-terminal fragment, a recombinant protein (rBPI23) corresponding to the first 199 amino acids of human BPI was produced and purified. rBPI23 had antibacterial activity equivalent to that of nBPI55 against Escherichia coli J5. Furthermore, both rBPI23 and nBPI55 bound identically to a broad range of R- and S-form lipopolysaccharides (LPS) and to natural and synthetic lipid A. Binding of radiolabeled nBPI55 to LPS was inhibited in an identical fashion by either nBPI55 or rBPI23. The binding of both proteins to immobilized E. coli J5 lipid A was inhibited in a comparable fashion by long- or short-chain LPS or lipid A. The binding of both rBPI23 and nBPI55 was specific, saturable, and of high affinity, with an apparent Kd of approximately 2 to 5 nM for all ligands tested. These results demonstrate that BPI recognizes the highly conserved lipid A region of bacterial LPS via residues contained within the amino-terminal portion of the BPI molecule.

The Role of Magma Overpressure in Suppressing Earthquakes and Topography: Worldwide Examples

In an extending terrane basaltic magma supplied at a pressure greater than the least principal stress (overpressure) may be capable of suppressing normal faulting and the earthquakes and topographic relief that commonly accompany normal faulting. As vertical dikes intrude, they press against their walls in the direction opposite the least principal stress and increase its magnitude. The emplacement of tabular intrusions causes the internal magma pressure to act selectively in opposition to tectonic stresses. This process tends to equalize the stresses and thus diminishes the deviatoric stress (difference between maximum and minimum stresses) that creates faults and causes earthquakes. Observations of the pattern of seismicity and magmatism worldwide indicate that magmatism commonly supplants large earthquakes as the primary mechanism for accommodating tectonic extension. Recognizing the extent of magmatic stress accommodation is important in assessing seismic and volcanic risks.

Effects of norepinephrine on neonatal rat cardiocyte growth and differentiation

Norepinephrine stimulates the growth in size of nondividing neonatal cardiocytes. During this time the neonatal cardiocyte is in a period of transition in which the cell can synthesize DNA and yet does not divide. Because the cell undergoes karyokinesis without cytokinesis the objective of this study was to determine whether the norepinephrine-induced growth in size of the neonatal cardiocyte was accompanied by an increase in a) the number of cardiocytes synthesizing DNA, b) the number of binucleate cardiocytes, and c) organized myofibrils. One- to four-d-old neonatal rat heart cells were isolated and placed in serum-free medium which was then supplemented with serum, norepinephrine, norepinephrine plus propranolol, or isoproterenol. After 4 d the number and size of the cells was determined using a Coulter counter. In other cultures cardiocytes were fixed on Days 0, 1, 2, and 4, and an increase in the number of binucleate cardiocytes was found in all treatment groups including controls. However, the rate of binucleation was faster in the norepinephrine group. It was also determined by proliferating cell nuclear antigen (PCNA) antibody staining that by Day 4, over 50% of the cardiocytes were in the cell cycle. The percentage of cells in which PCNA could be detected was higher in the norepinephrine and norepinephrine plus propranolol groups. Furthermore, there was a concomitant increase in the amount and organization of myofibrils in the catecholamine-treated cardiocytes.

Electrophysiology versus psychophysics in the detection of visual loss in pseudotumor cerebri

This study compared visual evoked potentials (VEP) and contrast sensitivity (CS) as methods of detecting visual loss in 15 women with acute onset of pseudotumor cerebri (PTC). A total of 24 out of 30 eyes (14 of 15 patients) had a visual disturbance. Neuro-ophthalmologic examination demonstrated abnormal Goldmann visual fields in 13 of 30 eyes. CS was abnormal in 18 eyes; VEP was abnormal in five eyes. Nine eyes had visual loss detected by CS only, five by perimetry only, and one had the VEP as the sole abnormality. CS was a valuable adjunct to perimetry in PTC whereas VEP was rarely helpful.

Properties of cultured endothelium from adult human vessels

Endothelium was isolated from samples of aorta and vena cava obtained from cadaver donors at the time kidneys were harvested for transplantation. Digestion with collagenase and gentle swabbing were used to free the cells from the intimal surface. Low density seeding permitted isolation of individual colonies with typical endothelial morphology. Modified Medium 199 supplemented with 10%-20% human plasma-derived serum and an extract from the bovine hypothalamus (500 micrograms/ml) enabled subcultured colonies to grow to confluency when culture surfaces were coated with fibronectin (1 micrograms/cm2). The presence of Factor VIII antigen was demonstrated using an indirect immunofluorescence technique. A monoclonal antibody to cultured umbilical vein endothelium, specific for endothelium, reacted with the subcultured cells from the aorta and vena cava. Type IV procollagen, fibronectin, and thrombospondin were identified as labeled proteins secreted by cultures of adult endothelium that had been incubated with 3H-proline and 3H-glycine. When the cultured endothelium was used in a sodium-m-periodate stimulated T lymphocyte mitogenic culture system, the endothelium exhibited accessory cell function. Prostacyclin production stimulated by incubation with arachidonic acid and PGH2 was variable from vessel to vessel. However, average values were lower than normally seen with cultured primary umbilical vein endothelium.

Metabolic labeling of lutropin with [35S]sulfate

Chemical analyses have previously detected sulfate linked to the oligosaccharides of lutropin isolated from bovine and human pituitaries. To determine whether lutropin could be metabolically labeled with sulfate, isolated bovine and rat pituitaries were incubated with [35S]sulfate. In both species, two major labeled products were immunoprecipitated with antisera specific to lutropin subunits. Incorporation into the subunits occurred posttranslationally since it was not blocked by cycloheximide, which did, however, block the incorporation of radiolabeled methionine. Metabolic labeling with [35S]sulfate provides a valuable approach for examining the biosynthetic processing of lutropin and the physiological role of sulfate in this hormone.