Blocking the VISTA pathway enhances disease progression in (NZB × NZW) F1 female mice

V-domain Ig suppressor of T-cell activation (VISTA) is a critical negative checkpoint molecule involved in regulating the immune response. Targeting the pathway with an antagonist anti-VISTA antibody designated 13F3 has been shown to enhance disease severity in experimental autoimmune encephalomyelitis (EAE), a mouse model of multiple sclerosis. To determine if VISTA plays a role in murine lupus, New Zealand Black × New Zealand White (BWF₁) mice were treated with 13F3 or control hamster Ig and disease monitored. Onset of proteinuria was earlier and renal damage more profound in mice treated with 13F3. Cell subset analysis showed an increase of activated splenic T cells and inflammatory splenic myeloid cells, but no effect on B cells, in mice receiving 13F3. Examination of the kidney showed an increase in inflammatory myeloid cell infiltration with 13F3 treatment. This study along with previous EAE data, suggests that interventions that enhance VISTA regulatory activity may be effective for the treatment of autoimmune disease.

136 EARLY EMBRYONIC LOSSES USING PROGESTERONE SUPPLEMENTATION IN CYCLIC AND NONCYCLIC RECIPIENT MARES

The aim of the present study was to determine the effectiveness of the commercial progesterone to maintain the pregnancies in noncyclic recipient mares and if it helps to decrease the early embryonic death when used in cyclic pregnant recipient mares. A total of 199 mares were used during February to April of the 2008 breeding season at Burns Ranch. The mares were assigned to groups according to their reproductive status. Noncyclic (n = 42) mares were prepared as embryo transfer recipients using our standard protocol with estradiol cypionate (3 days, 10/6/4 mg, Wickliffe, USA) and long action progesterone (P4LA, 1500 mg, BET Labs, Lexington, KY, USA), and 157 naturally cyclic mares were used from Day 3 to 8 after ovulation as embryo transfer recipients. After embryo transfer, 134 of the 157 cyclic mares got pregnant at 15 days. Some of the pregnant mares (n = 43) were assigned to a progesterone-supplemented group; these mares were administered P4LA (1500 mg) after the first pregnancy diagnosis at around 15 days and repeated 7 days later. The remaining mares were placed in a control group (n = 91), with no treatment, in order to compare the embryonic loss rates for the 3 groups. Recipients were evaluated for the presence of the embryonic vesicle between 13 and 16 days (embryo age), and pregnancies were monitored at 30 and 45 days to determine the early embryonic loss. Statistical analyzes were performed using the chi-square test with 5% defined as significance. Pregnancy rates at 13 to 16 days were not different (P = 0.336) for noncyclic and cyclic recipients (39/42, 90.7% and 134/157, 85.4%, respectively). The embryonic loss was evaluated in the 3 groups as follows: control group; 7 of 91 pregnancies were lost between 15 and 30 days (7.69%) and 2 of 84 were lost between 30 and 45 days (2.38%); the progesterone-supplemented group had lost 4 of the 43 pregnancies between 15 and 30 days (9.30%); and the noncycling progesterone mares had lost 2 of the 39 between 30 and 45 days (5.13%). Rates of embryo loss before 45 days of gestation were not different for the control mares with no progesterone supplementation (9.89%), progesterone-supplemented cyclic mares (9.3%), and noncyclic recipients (5.13%). The noncyclic recipients maintain gestation with the supplemental progesterone with no influence on embryo loss. These results demonstrate no advantage in the use of exogenous progesterone to supplementation for cyclic embryo recipients. Burns Ranch Inc., Menifee, California, USA.

Measuring food access in Melbourne: Access to healthy and fast foods by car, bus and foot in an urban municipality in Melbourne

Access to healthy food can be an important determinant of a healthy diet. This paper describes the assessment of access to healthy and unhealthy foods using a GIS accessibility programme in a large outer municipality of Melbourne. Access to a major supermarket was used as a proxy for access to a healthy diet and fast food outlet as proxy for access to unhealthy food. Our results indicated that most (>80%) residents lived within an 8-10 min car journey of a major supermarket i.e. have good access to a healthy diet. However, more advantaged areas had closer access to supermarkets, conversely less advantaged areas had closer access to fast food outlets. These findings have application for urban planners, public health practitioners and policy makers.

Changes in weight and waist circumference over 9 years in a Scottish population

OBJECTIVE

To document patterns of measured weight and waist circumference (WC) change and the increase in overweight and obesity over a 9-year period.

SUBJECTS/METHODS

A total of 1044 subjects from two age-defined cohorts aged 39 and 59 in 1991. Height, weight and WC were measured in 1991, 1995 and 2000 and body mass index (BMI) was calculated. Pattern of weight and WC change was studied over approximately 9 years.

RESULTS

The prevalence of overweight and obesity increased markedly and the younger cohort showed greater increases in weight and WC than the older cohort. There was no significant difference in mean BMI and/or mean 9-year weight change between men and women in either age cohort, and mean weight gain was similar for all occupational groups. Only 20% of subjects maintained a stable weight (+/-2 kg), while 42.2 and 17.6% gained greater than 5 and 10 kg over the 9-year period, respectively. The rate of weight gain appeared to be relatively steady over the 9 years among younger subjects but declined in the older subjects in the second half of the observation period.

CONCLUSIONS

Health promotion strategies to prevent weight gain need to be population-based, targeting all social and age groups, but particularly those in their early middle-age.

Knowledge of treatment intent among patients with advanced cancer: a longitudinal study

Increasingly, patients with cancer wish to be more fully informed about their disease, treatment and prognosis, and to participate in decision making. The objective of this study was to assess knowledge of diagnosis and goals of treatment among patients with advanced cancer, and also to assess whether this knowledge changed over time. A cohort of 181 subjects with advanced cancer receiving palliative therapies were interviewed at entry and again 12 weeks later. Knowledge of disease diagnosis, treatment intent, and the main sources of information were determined. Twenty per cent of subjects considered their illness to be non-life threatening, and 46% correctly perceived treatment intent as non-curative; 29% believed the intent of treatment was cure. Subjects resident in rural areas were more likely to misunderstand the goal of their treatment. Treatment modality was significantly associated with knowledge of treatment intent, and subjects in the last 6 months of life had clearer understanding that treatment intent was non-curative. Many patients with advanced cancer do not understand the goals of treatment. Excessive optimism may lead to impaired decision making. Further empirical research into information transfer and predictors of accurate patient understanding would assist clinicians in their discussions of prognosis and potential treatment outcomes with patients.

Food cost and availability in a rural setting in Australia

INTRODUCTION

The burden of chronic diseases is rapidly increasing worldwide. In Australia rural populations have a greater burden of disease. Chronic diseases are largely preventable with diet as a key risk factor. With respect to diet-related chronic disease, dietary risk may be due to poor food access, namely, poor availability and/or the high cost of healthy food. It is likely that poor food access is an issue in rural areas.

OBJECTIVE

To assess food access in rural south-west (SW) Victoria, Australia.

METHODS

A total of 53 supermarkets and grocery stores in 42 towns participated in a survey of food cost and availability in the rural area of SW Victoria. The survey assessed availability and cost of a Healthy Food Access Basket (HFAB) which was designed to meet the nutritional needs of a family of 6 for 2 weeks.

RESULTS

Seventy-two percent of the eligible shops in SW Victoria were surveyed. The study found that the complete HFAB was significantly more likely to be available in a town with a chain-owned store (p <0.00). The complete HFAB was less likely to be available from an independently owned store in a town with only one grocery shop (p <0.004). The average cost of the HFAB across SW Victoria was AU380.30 dollars +/- 25.10 dollars (mean +/- SD). There was a mean range in difference of cost of the HFAB of 36.92 dollars. In particular, high variability was found in the cost of fruits and vegetables.

CONCLUSIONS

Cost and availability of healthy food may be compromised in rural areas.

IMPLICATIONS

Improvements in food access in rural areas could reduce the high burden of disease suffered by rural communities.

Evaluation of IS900-PCR Assay for Detection ofMycobacterium aviumSubspeciesParatuberculosisInfection in Cattle Using Quarter Milk and Bulk Tank Milk Samples

A study was conducted to evaluate sensitivity, specificity, and predictive value of IS900-PCR assay for detection of Mycobacterium avium subspecies paratuberculosis in pooled quarter milk and bulk tank milk. Feces, blood and pooled quarter milk from 1493 lactating cattle on 29 herds were analyzed. Bulk tank milk (n = 29 bulk tanks) samples were also examined. Culture analysis revealed that 10.9%, 2.8%, and 20.6% of fecal, pooled quarter milk samples and bulk tanks were positive for M. avium subsp. paratuberculosis, respectively. While 13.5% and 27.5% of pooled quarter milk samples and bulk tanks were positive by IS900 PCR assay, respectively. Moderate to high antibody titers for M. avium subsp. paratuberculosis were detected in 223 of 1493 (14.4%) cows. Cows positive on fecal culture were taken as true positives relative to which the IS900 PCR assay was evaluated. The sensitivity and predictive value of KELA, pooled quarter milk culture, and IS900 PCR assay increased with lactation age. While the specificity of the tests decreased with increase in lactation age. Overall, the IS900 PCR assay using pooled quarter milk samples had a sensitivity, specificity and predictive value of 0.87, 0.95 and 0.71, respectively. The IS900 PCR assay using bulk tank milk had poor sensitivity (0.21), specificity (0.5) and predictive value (0.6). Pooled quarter milk culture analysis had a very low sensitivity (0.17). The kinetics ELISA had lower sensitivity (0.59), specificity (0.90) and predictive value (0.43) as compared to the IS900 PCR assay using pooled quarter milk samples. Results from our study suggest that IS900 PCR assay using bulk tank milk may not be useful for screening herds with M. avium subsp. paratuberculosis infected animals. In conclusion, use of IS900 PCR assay for cows in 2(nd) lactation and higher, using aseptically collected pooled quarter milk samples, can be a useful tool for screening and monitoring lactating cattle in herds with M. avium subsp. paratuberculosis infection.

The relationship between quality of life and perceived body weight and dieting history in Dutch men and women

OBJECTIVES

(1) To study the relationship between quality of life (QoL) and measured and perceived weight and dieting history in Dutch men and women; (2) to assess the effect of weight loss over a 5 y period on QoL.

DESIGN

A cross-sectional study, in a sub-sample longitudinal over 5 y.

SUBJECTS

A total of 2155 men and 2446 women, aged 20-59 and recruited from the general population from three towns in The Netherlands.

MEASUREMENTS

Body weight, height, self-administered questionnaire including questions concerning demographic variables and weight loss practices as part of the Dutch Monitoring project on Risk Factors for Chronic Disease (MORGEN). The Rand-36 questionnaire was used as the QoL measure.

RESULTS

In men, measured overweight (body mass index, BMI>25 kg/m(2)) was not associated with any dimension of QoL after adjustment for age, educational level and perceived overweight. Perceived overweight was related to reduced scores for general health and vitality. This relationship was independent of measured obesity. A history of repeated weight loss was associated with reduced scores for role functioning due to both physical and emotional problems. In women, measured overweight was significantly associated with lower scores for five out of eight QoL dimensions and perceived overweight with three: general health, vitality and physical functioning. A history of frequent weight loss was related to significantly reduced scores in six dimensions. However, only with history of frequent weight loss, and uniquely in women, was there a significant reduction in scores on mental health and limited emotional role functioning. Measured and perceived overweight and frequent weight loss were all related to reduced scores for physical functioning. Longitudinal data indicate that in older women weight gain of 10% body weight or more was associated with a significant deterioration in QoL.

CONCLUSIONS

When looking at measures of QoL in relation to overweight it is important to separate the effects of perception of weight status and history of weight loss. We observed that the latter two factors were associated with reduced scores on several dimensions of QoL, particularly in women. These associations were observed to be independent of body weight.

Modeling a medical environment: an ontology for integrated medical informatics design

Modern medical environments have seen an increase in technological complexity and pressures of handling more patients with fewer resources, resulting in higher demands on medical practitioners. Medical informatics designers will have to focus on the problem of organizing medical information more effectively to enable practitioners to cope with these challenges. This article addresses this research problem for the particular area of medical problem solving in patient care. First, we describe a traditional modeling approach for medical reasoning used as a basis for developing some decision support systems. We argue these models may be faithful to what is known about biomedical knowledge, but they have limitations for human problem solving, especially in unanticipated situations. Second, we present an ontological framework, known as the abstraction hierarchy (Rasmussen, IEEE Trans. Man. Cybernetics 15 (1985) 234-243), for integrating patient representations that are faithful to existing biomedical knowledge and that are consistent with what is known about human problem solving. Through an example of a critical event in the operating room, we reveal how this framework can support medical problem solving in unanticipated situations. Third, we show how to use these representations as a frame of reference for mapping medical roles, responsibilities, sensors, and controls in an operating room context. Finally, we provide some insight for medical informatics designers in using this framework to design novel training programs and human-computer displays.

Penetrating neck injuries: analysis of experience from a Canadian trauma centre

OBJECTIVE

To study the demographics and treatment outcome of penetrating neck injuries presenting to a major trauma centre in order to develop a treatment protocol.

DESIGN

A case review.

SETTING

A trauma centre at a tertiary care institution.

PATIENTS

One hundred and thirty consecutive patients who had 134 neck wounds penetrating the platysma and presented to the trauma service between 1979 and 1997.

INTERVENTION

Surgical exploration or observation alone.

MAIN OUTCOME MEASURES

The location of injury, patient management, number of significant injuries, duration of hospital stay and outcome.

RESULTS

Injuries were caused by stab wounds in 124 patients (95%) and gunshot wounds in 6 (5%). The location of injury was zone I (lower neck) in 20 cases (15%), zone II (midportion of the neck) in 108 (81%) and zone III (upper neck) in 5 (4%). The location was not recorded in 1 case. Fifty patients were managed by observation alone and 80 were managed surgically. Neck exploration in 48 asymptomatic patients was negative in 32 (67%). Significant injuries, including major vascular (12), nerve (13) and aerodigestive tract (19) injuries, were identified in 34 patients. Two of the 130 patients (1.5%) died of major vascular injuries. Seventy-six percent of significant injuries, including all zone II major vascular injuries, were symptomatic on presentation. The mean (and standard deviation) hospital stay for asymptomatic patients treated with observation alone and surgical exploration was similar (3.5 [6.02] versus 4.3 [5.46] days respectively, p = 0.575). Long-term disability, all neurologic in nature, was documented in 3 patients managed by observation alone and 6 patients managed by surgical exploration.

CONCLUSIONS

Penetrating neck trauma, in particular stab wounds to zone II in asymptomatic patients, is associated with low morbidity and mortality. A selective management protocol with investigations directed by symptoms is the most appropriate approach for the patient population and resource base in this setting.

The nucleoid-associated protein StpA binds curved DNA, has a greater DNA-binding affinity than H-NS and is present in significant levels in hns mutants

The StpA protein is closely related to H-NS, the well-characterised global regulator of gene expression which is a major component of eubacterial chromatin. Despite sharing a very high degree of sequence identify and having biochemical properties in common with H-NS, the physiological function of StpA remains unknown. We show that StpA exhibits similar DNA-binding activities to H-NS. Although both display a strong preference for binding to curved DNA, StpA binds DNA with a four-fold higher affinity than H-NS, with K(d)s of 0.7 microM and 2.8 microM, respectively. It has previously been reported that expression of stpA is derepressed in an hns mutant. We have quantified the amount of StpA protein produced under this condition and find it to be only one-tenth the level of H-NS protein in wild-type cells. Our findings explain why the presence of StpA does not compensate for the lack of H-NS in an hns mutant, and why the characteristic pleiotropic hns mutant phenotype is observed.

Determination of the free-energy change for repair of a DNA phosphodiester bond

The repair of phosphodiester bonds in nicked DNA is catalyzed by DNA ligases. Ligation is coupled to cleavage of a phosphoanhydride bond in a nucleotide cofactor resulting in a thermodynamically favorable process. A free energy value for phosphodiester bond formation was calculated using the reversibility of the T4 DNA ligase reaction. The relative number of DNA nicks to phosphodiester bonds in a circular plasmid DNA, formed during this reaction at fixed concentrations of ATP to AMP and PP(i), was quantified. At 25 degrees C, pH 7, the equilibrium constant (K(eq)) for the ligation reaction is 3.89 x 10(4) m. This value corresponds to a standard free energy (DeltaG degrees ') of -6.3 kcal mol(-1). By subtracting the known energy contribution due to hydrolysis of ATP to AMP and PP(i), DeltaG degrees ' for the hydrolysis of a DNA phosphodiester bond is -5.3 kcal mol(-1).

Compete or complement? An interdisciplinary approach to training health professionals

The recommendation that future practitioners have the competency to work effectively in interdisciplinary teams is not new, but educating students for this type of practice remains a challenge for the health care professions (1-4). Early interdisciplinary teams usually worked in parallel. There were no common goals, but each group's goals stemmed from its professional education (5). In the traditional model, medical doctors were the "team leaders." Current recommendations challenge health professions educators "to move beyond traditional discipline-bound educational models to future-oriented interdisciplinary teaching/learning models" (6). Taking this recommendation seriously, educators from the University of South Florida (USF) formed a team to develop a model to guide the education of students from four health professions. Our goal was to model, by our philosophy, actions, and words, the art of teaching as an interdisciplinary team. This article describes the first phase of the process and four critical steps--establishing a common goal, developing a team process, creating a model to guide our interactions, and developing support networks within the community.

A participant-observer study of ergonomics in engineering design: how constraints drive design process

Too often, ergonomics is relegated to being a "post-design" evaluation, leaving ergonomists little opportunity to make significant and important design changes. One way to start attacking this problem is to study the process of design and, in particular, ergonomics in design. This article describes the findings from a four-month long participant-observer study of the relationship between ergonomics and engineering design. The study was conducted in the context of a large, interdisciplinary project consisting of design of a control room for a nuclear power plant. It was observed that designers and ergonomists must negotiate through a changing web of constraints from many sources. The impact that these constraints had on the course of the design was documented. A model is developed based on the abstraction hierarchy (Rasmussen, 1985, IEEE Trans. Systems Man Cybernet. SMC-15, 234-243; 1990, Int. J. Ind. Ergon. 5, 5-16) which shows the interaction of conflicting goals as ergonomists and other designers attempt to solve a complex design problem. This model leads to several insights: (1) locally optimal ergonomic designs may not be globally optimal, (2) ergonomists can improve their solutions by understanding the goals of other designers, and (3) future tools to aid ergonomists must be compatible with the constraint-rich environments in which they work.

Putting it all together: improving display integration in ecological displays

Computer displays are being designed for increasingly larger industrial systems. As the application domain scales up, maintaining integration across different kinds of views becomes more challenging. This paper presents the results of a study of three different approaches to integration based on the spatial and temporal proximity of related information objects. The domain used for evaluation was a simulation of an industry-scale conventional power plant. All three displays were ecological displays developed using an abstraction hierarchy analysis. Views were integrated in a high-space/low-time, low-space/high-time, and high-space/high-time integration of means-end related objects. During a fault detection and diagnosis task, it was found that a low level of integration, high-space/ low-time, provided the fastest fault detection time. However, the most integrated condition, high-space/high-time, resulted in the fastest and most accurate fault diagnosis performance. Actual or potential applications of this research include computer displays for large-scale systems such as network management or process control, for which problem solving is critical and integration must be maintained.

There is more to monitoring a nuclear power plant than meets the eye

A fundamental challenge in studying cognitive systems in context is how to move from the specific work setting studied to a more general understanding of distributed cognitive work and how to support it. We present a series of cognitive field studies that illustrate one response to this challenge. Our focus was on how nuclear power plant (NPP) operators monitor plant state during normal operating conditions. We studied operators at two NPPs with different control room interfaces. We identified strong consistencies with respect to factors that made monitoring difficult and the strategies that operators have developed to facilitate monitoring. We found that what makes monitoring difficult is not the need to identify subtle abnormal indications against a quiescent background, but rather the need to identify and pursue relevant findings against a noisy background. Operators devised proactive strategies to make important information more salient or reduce meaningless change, create new information, and off-load some cognitive processing onto the interface. These findings emphasize the active problem-solving nature of monitoring, and highlight the use of strategies for knowledge-driven monitoring and the proactive adaptation of the interface to support monitoring. Potential applications of this research include control room design for process control and alarm systems and user interfaces for complex systems.

Activation of Rho-dependent transcription termination by NusG. Dependence on terminator location and acceleration of RNA release

There is a kinetic limitation to Rho function at the first intragenic terminator in the lacZ gene (tiZ1) which can be overcome by NusG: Rho can terminate transcription with slowly moving, but not rapidly moving, RNA polymerase unless NusG is also present. Here we report further studies with two other Rho-dependent terminators that are not kinetically limited (tiZ2 and lambda tR1) which show that the requirement for NusG depends on the properties of the terminator and its location in the transcription unit. NusG is also shown to increase the rate of Rho-mediated dissociation of transcription complexes arrested at a specific termination stop point in the tiZ1 region and the rates of dissociation with three different Rho factors and two different terminators correlated with their sensitivity to RNA polymerase elongation kinetics. These results suggest a model of NusG function which involves an alteration in the susceptibility of the transcription complex to Rho action which allows termination to occur within the short kinetic window when RNA polymerase is traversing the termination region.

Perception of weight status and dieting behaviour in Dutch men and women

OBJECTIVE

To study the perception of weight status, the accuracy of self-assessment of weight status and weight control practices relative to the degree of adiposity in Dutch men and women.

DESIGN

A cross-sectional study.

SUBJECTS

2155 men and 2446 women, aged 20-65y, of mostly caucasian origin, non-diabetic, not pregnant or with cancer.

MEASUREMENTS

Body weight, height, waist and hip, total cholesterol, high density lipoprotein (HDL) cholesterol, blood pressure, self-administered questionnaire (including questions concerning demographic variables), weight loss practices, dietary intake, participation in sport as part of Dutch Monitoring Project on Risk Factors for Chronic Diseases (MORGEN).

RESULTS

In the study population, 53% of men and 39% of women were overweight or obese. An association was shown between degree of adiposity and participation in sport for both men and women, and dietary fat intake in men. Of the subjects studied 56% of men and 52% of women described their weight as appropriate. A degree of inaccuracy in the estimation of relative body weight was observed. While dieting was prevalent, particularly among women, there was a lack of weight control action on the part of many overweight or obese individuals. This effect was most marked in men. Body Mass Index (BMI) was the strongest determinant of weight perception and dieting behaviours with some effect of educational level in men. Physical activity was not widely used as a method of weight control.

CONCLUSION

These results point to a need for regular assessment of an individual's relative weight and health risk, gender specific obesity treatments and prevention strategies, and an emphasis in treatment and prevention of obesity on physical activity.

Effects of providing comprehensive ambulatory services to children with chronic conditions

OBJECTIVE

To document the effects of a comprehensive program of care on the resource utilization and cost of care for children with chronic conditions.

DESIGN

Descriptive study of 10715 admissions between 1984 and 1995 with analyses of costs based on charges. Comparisons were made with data from a national consortium of academic medical centers and from a national survey of hospitals. A 2-week survey of staff was conducted to identify their use of time in the care of these patients.

PATIENTS

Children aged birth through 18 years meeting International Classification of Diseases, Ninth Revision, Clinical Modification criteria for chronic conditions. Patients with acute conditions were used as controls.

INTERVENTION

A program of expanded care funded since 1989 by a regional insurance company.

RESULTS

Between 1984 and 1995, mean length of stay for children with chronic conditions decreased from 83.9 to 10.6 days; mean annual admissions decreased from 2796 to 1622. Median hospital inpatient charges, adjusted for cost of living, decreased from $26.1 to $14.6 million. A $77.7 million savings occurred for inpatient care, with total expenditures from the insurance program of $3.6 million (a 21:1 ratio). Almost half the professional activities provided for these children were for services that could not be reimbursed in a fee-for-service model. Median adjusted inpatient charges were lower in Rochester, NY ($8746) than in other academic medical centers ($12773) or in a national survey of hospitals ($12462), and fewer children were readmitted within 30 days in Rochester (12.7%) than in other academic medical centers (15.0%).

CONCLUSIONS

An investment of funds by a regional insurance company was associated with reduced costs, admissions, and lengths of stay for children with chronic conditions, and resulted in significant savings for the company. This model may be applicable to other centers.

Combinatorial effects of NusA and NusG on transcription elongation and Rho-dependent termination in Escherichia coli

The transcription factors NusA and NusG from Escherichia coli are modulators of the RNA polymerase elongation reaction and Rho-dependent transcription termination. NusA decreases the elongation rate and termination efficiency while NusG increases both activities. Both Nus factors are able to physically interact with Rho and with RNA polymerase. Experiments with purified components designed to determine whether these factors act independently or competitively showed that the change in elongation rate was a composite of their individual effects, that the combined effect on termination was dependent on the reaction conditions and that the two factors do not compete for their sites of action for either effect. The two factors were also found not to enhance significantly the slight (20%) inhibition of elongation caused by 200 microM guanosine 3',5'-bisdiphosphate (ppGpp) during transcription in vitro. The results also show that the effects of NusA and NusG on RNA polymerase elongation and Rho function are contrary to the inverse relationship between elongation and termination that is expected for a kinetic coupling of Rho action to RNA polymerase elongation. This property suggests that in addition to their known actions on RNA polymerase that influence the length of pausing, these factors act on some other rate-limiting step of the Rho-dependent termination process.

A retroductive theoretical model of the pathway to chemical dependency in nurses

Much of the research on chemical dependency in nurses over the past 25 years has been a-theoretical and has tended to focus on descriptive characteristics of nurses. This field of study lacks systematic knowledge building and a useful theoretical base. This article focuses on the development of a middle range theory that begins to explicate the transactions of the chemically dependent nurse with the environment and the process through which nurses become addicted. Steiner's theory models approach using retroductive inference was the method selected to develop the theory. Theoretical work from Bandura, Jessor, and Pender were used as source theories to develop the middle range theory presented.

Modulation of AUUUA response element binding by heterogeneous nuclear ribonucleoprotein A1 in human T lymphocytes. The roles of cytoplasmic location, transcription, and phosphorylation

The heterogeneous nuclear ribonucleoprotein A1 (hnRNP A1) shuttles between the cytoplasm and nucleus and plays important roles in RNA metabolism. Whereas nuclear hnRNP A1 has been shown to bind intronic sequences and modulate splicing, cytoplasmic hnRNP A1 is associated with poly(A)+ RNA, indicating different RNA ligand specificity. Previous studies indicated that cytoplasmic hnRNP A1 is capable of high-affinity binding of reiterated AUUUA sequences (ARE) that have been shown to modulate mRNA turnover and translation. Through a combination of two-dimensional gel and proteolysis studies, we establish hnRNP A1 (or structurally related proteins that are post-translationally regulated in an identical manner) as the dominant cytoplasmic protein in human T lymphocytes capable of interacting with the ARE contained within the context of full-length granulocyte-macrophage colony-stimulating factor mRNA. We additionally demonstrate that cytoplasmic hnRNP A1 preferentially binds ARE relative to pre-mRNAs in both cross-linking and mobility shift experiments. RNA polymerase II inhibition increased the binding of ARE (AUBP activity) and poly(U)-Sepharose by cytoplasmic hnRNP A1, while nuclear hnRNP A1 binding was unaffected. Nuclear and cytoplasmic hnRNP A1 could be distinguished by the differential sensitivity of their RNA binding to diamide and N-ethylmaleimide. The increase in AUBP activity of cytoplasmic hnRNP A1 following RNA polymerase II inhibition correlated with serine-threonine dephosphorylation, as determined by inhibitor and metabolic labeling studies. Thus, cytoplasmic and nuclear hnRNP A1 exhibit different RNA binding profiles, perhaps transduced through serine-threonine phosphorylation. These findings are relevant to the specific ability of hnRNP A1 to serve distinct roles in post-transcriptional regulation of gene expression in both the nucleus and cytoplasm.

Towards viable, useful and usable human factors design guidance

This paper investigates the factors relevant to producing effective human factors design guidance, using the Engineering Data Compendium (EDC) as a research vehicle. A series of three exploratory experiments focusing on the factors that affect the usability, usefulness and viability of human factors handbooks was conducted. The results of these studies were interpreted in the context of the process by which the EDC was developed, leading to the following recommendations: (a) human factors guidance should be organized in a manner that is stepped in context; (b) human factors guidance should be based on an explicit requirements analysis; (c) the calibration of designers' perceptions of the cost of obtaining human factors information must be improved; (d) organizational policies must be changed to induce more effective information search behaviour.

Regulation of serotonin-2C receptor G-protein coupling by RNA editing

The neurotransmitter serotonin (5-hydroxytryptamine, 5-HT) elicits a wide array of physiological effects by binding to several receptor subtypes. The 5-HT2 family of receptors belongs to a large group of seven-transmembrane-spanning G-protein-coupled receptors and includes three receptor subtypes (5-HT2A, 5-HT(2B) and 5-HT(2C)) which are linked to phospholipase C, promoting the hydrolysis of membrane phospholipids and a subsequent increase in the intracellular levels of inositol phosphates and diacylglycerol. Here we show that transcripts encoding the 2C subtype of serotonin receptor (5-HT(2C)R) undergo RNA editing events in which genomically encoded adenosine residues are converted to inosines by the action of double-stranded RNA adenosine deaminase(s). Sequence analysis of complementary DNA isolates from dissected brain regions have indicated the tissue-specific expression of seven major 5-HT(2C) receptor isoforms encoded by eleven distinct RNA species. Editing of 5-HT(2C)R messenger RNAs alters the amino-acid coding potential of the predicted second intracellular loop of the receptor and can lead to a 10-15-fold reduction in the efficacy of the interaction between receptors and their G proteins. These observations indicate that RNA editing is a new mechanism for regulating serotonergic signal transduction and suggest that this post-transcriptional modification may be critical for modulating the different cellular functions that are mediated by other members of the G-protein-coupled receptor superfamily.

DNA binding is not sufficient for H-NS-mediated repression of proU expression

H-NS is a major component of bacterial chromatin and influences the expression of many genes. H-NS has been shown to exhibit a binding preference for certain AT-rich curved DNA elements in vitro. In this study we have addressed the factors that determine the specificity of H-NS action in vitro and in vivo. In bandshift studies, H-NS showed a slight binding preference for all curved sequences tested whether GC-based or AT-based; the specific architecture of the curve also influenced H-NS binding. In filter retention assays little difference in affinity could be detected for any sequence tested, including the downstream regulatory element (DRE) a downstream curved DNA element required for H-NS to repress transcription of the Salmonella typhimurium proU operon in vivo. A Kd of 1-2 microM was estimated for binding of H-NS to each of these sequences. In vivo, the distance between the proU promoter and the DRE, their relative orientations on the face of the DNA helix, and translation of the DRE had no major effect on proU regulation. None of the synthetic curved sequences tested could functionally replace the DRE in vivo. These data show that differential binding to curved DNA cannot account for the specificity of H-NS action in vivo. Furthermore, binding of H-NS to DNA per se is insufficient to repress the proU promoter. Thus, the DRE does not simply act as an H-NS binding site but must have a more specific role in mediating H-NS regulation of proU transcription.

Very low calorie diet (VLCD): a useful alternative in the treatment of the obese NIDDM patient

Conventional treatment of obese noninsulin dependent diabetes mellitus (NIDDM) patients is often unsatisfactory. In this study the efficacy of Modifast, a commercial very low calorie diet (VLCD), was evaluated in a population of obese poorly controlled NIDDM patients. The mechanisms of action of VLCD in these patients were also studied by comparing: (i) Plasma insulin and glucose profiles after a VLCD and an isocaloric mixed meal and (ii) plasma amino acid levels, both at baseline and after four weeks of VLCD treatment. A total of 14 obese NIDDM patients (M/F 7/7. median body mass index (BMI) 38.7 kg-2, interquartile range (IQ) 34.7-46.5 kg-2, waist circumference 116 cm, IQ 106-139 cm, insulin treated 7/14) with poor diabetic control (HbA1c 8.6%, IQ 7.8-10%) were studied. Patients were given a VLCD (425 kcal/day) for 12 weeks. At baseline, VLCD and isocaloric meal tests were performed on consecutive mornings. Fasting plasma amino acid levels were also determined at baseline and after 4 weeks of VLCD treatment. Weight, waist circumference, HbA1c, blood pressure, fasting plasma insulin, total cholesterol and triglyceride levels all fell significantly following VLCD treatment. Insulin therapy was able to be ceased in the seven insulin treated patients. Oral hypoglycaemic agent dosage fell from a median of eight (IQ 6-12) to two (IQ 0-8) tablets per day (P = 0.03) in patients initially on this form of therapy. Insulin secretion was higher after VLCD than isocaloric meal (P = 0.04). Fasting plasma alanine level fell from 512.0 (IQ 412.0-563.0) to 374.0 (IQ 342-472.0) mumol/l (P = 0.04) following VLCD treatment. In conclusion, the short term use of a VLCD is very effective in rapidly improving glycaemic control and promoting substantial weight loss in obese NIDDM patients. Moreover, a VLCD diet increases insulin secretion and reduces substrate for gluconeogenesis. Thus, VLCD treatment may improve glycaemic control by factors more than caloric restriction alone.

Implementing a quality assurance program using a risk assessment tool on dairy operations

Concerns and perceptions about antibiotic residues in milk prompted the dairy industry to develop a voluntary program to support rational antibiotic use on dairy farms. One deficiency of this program is the inability of producers to identify easily the weaknesses in antibiotic management in order to develop control plans. To overcome this deficiency, an educational approach was designed. The program centered on an on-farm risk assessment tool used by the producer and an industry educator to determine the current risk for residue violation. The risk assessment tool was tested by 25 field personnel working with northeastern milk receivers and 250 producers in seven states. The participants in the study identified a lack of adequate treatment records as being the highest risk factor for antibiotic residues, followed by deficiencies in understanding how to use antibiotics and poor relationships between veterinarians and their clients. When field representatives utilized the risk assessment tool, for most producers, risk of antibiotic residue decreased by approximately 19%. In particular, more farms kept written records or more complete records. Finally, producers with reported histories of antibiotic residues were less likely to implement management changes to reduce the risk of antibiotic residue.

Function of the novel subdomain in the RNA binding domain of transcription termination factor Rho from Micrococcus luteus

Transcription termination factor Rho from Micrococcus luteus, a high G + C Gram-positive bacterium, contains an unusual extra sequence within its RNA binding domain that is rich in Arg, Glu, and Asp residues and deficient in hydrophobic residues. To determine the role of this extra sequence, we compared the biochemical properties of a variant lacking nearly all the extra sequence, des(60-300) Rho, to that of wild-type M. luteus Rho. The two forms had very similar properties except that the des(60-300) Rho was unable to terminate transcription with Escherichia coli RNA polymerase at the promoter proximal sites used by the wild-type Rho on a lambda cro DNA template but could cause termination at more distal sites and did cause termination at proximal sites when ITP replaced GTP in the reaction mixture. The RNA binding properties of the two forms of this Rho with normal and inosine-substituted RNAs were found to correlate fully with their termination properties. These results indicate that the arginine-rich extra sequence is directly involved in the selection of the termination site and support the hypothesis that the sequence is present in M. luteus Rho to facilitate its binding to M. luteus transcripts, which are likely to have a high degree of base-paired secondary structure because of their high proportion of G residues.

Anti-CD40 ligand antibody treatment prevents the development of lupus-like nephritis in a subset of New Zealand black x New Zealand white mice. Response correlates with the absence of an anti-antibody response

Systemic lupus erythematosus is characterized by B cell production of pathogenic autoantibodies dependent upon cooperation from CD4+ Th cells. The interaction between CD40 on B cells and CD40 ligand (CD40L) on Th cells is necessary for normal thymus-dependent Ab production. An anti-murine CD40L mAb blocks binding of CD40L to CD40 and prevents primary and secondary immune responses to thymus-dependent Ags. In this study, New Zealand Black x New Zealand White lupus-prone mice treated with this anti-CD40L Ab from ages 4 to 10 mo had reduced anti-DNA autoantibody production and renal disease and significantly prolonged survival compared with control mice. Pathologic examination verified the absence of significant renal damage or immune deposition in responding mice. Mice that responded to treatment did not develop an Ab response to the administered Ab. Long-term survivors mounted a substantial Ab response to keyhole limpet hemocyanin after completion of anti-CD40L Ab treatment, suggesting that some of the immunosuppressive effects of the Ab may be reversible. These results suggest a human form of this Ab may have therapeutic utility in human systemic lupus erythematosus.

Anti-CD40 ligand antibody treatment prevents the development of lupus-like nephritis in a subset of New Zealand black x New Zealand white mice. Response correlates with the absence of an anti-antibody response

Systemic lupus erythematosus is characterized by B cell production of pathogenic autoantibodies dependent upon cooperation from CD4+ Th cells. The interaction between CD40 on B cells and CD40 ligand (CD40L) on Th cells is necessary for normal thymus-dependent Ab production. An anti-murine CD40L mAb blocks binding of CD40L to CD40 and prevents primary and secondary immune responses to thymus-dependent Ags. In this study, New Zealand Black x New Zealand White lupus-prone mice treated with this anti-CD40L Ab from ages 4 to 10 mo had reduced anti-DNA autoantibody production and renal disease and significantly prolonged survival compared with control mice. Pathologic examination verified the absence of significant renal damage or immune deposition in responding mice. Mice that responded to treatment did not develop an Ab response to the administered Ab. Long-term survivors mounted a substantial Ab response to keyhole limpet hemocyanin after completion of anti-CD40L Ab treatment, suggesting that some of the immunosuppressive effects of the Ab may be reversible. These results suggest a human form of this Ab may have therapeutic utility in human systemic lupus erythematosus.

Differential basal protein tyrosine phosphorylation in natural killer (NK) and T cells: a biochemical correlate of lymphoid functional activity

Despite the similarities between natural killer (NK) and T cells, these lymphocytes have dramatically different functional phenotypes. To identify potential biochemical parameters that correlate with the "primed" NK phenotype, we have investigated protein tyrosine phosphorylation in NK and T cells. Examination of tyrosyl phosphorylation in NK cells showed that they have higher levels of phosphorylation than resting T cells. Consistent with this, the concentrations of the tyrosine kinase inhibitor, herbimycin A, required to inhibit FcR-mediated Ca2+ flux in NK cells were much higher than those required for inhibition of T cell receptor-mediated Ca2+ mobilization. Differences in phosphorylation were not due to purification artifact lymphocyte src-family kinase, p56lck or the protein tyrosine phosphatase CD45. Thus, we have identified high basal tyrosyl phosphorylation as a striking biochemical feature of NK cells that correlates with the unique functions of this subset.

Residues in the RNP1-like sequence motif of Rho protein are involved in RNA-binding affinity and discrimination

The termination of transcription in Escherichia coli by action of Rho factor is dependent on the ability of this homohexameric protein to make productive interactions with the nascent RNA molecule to be terminated. The roles of two residues in a phylogenetically conserved sequence motif in the RNA-binding domain of Rho, Asp60 and Phe62, were analyzed by studies of the biochemical properties of pure mutant proteins. F62S Rho had greatly reduced affinity for lambda cro RNA, very poor ability to terminate transcription in vitro by itself and only partial termination activity (at a level consistent with its in vivo defect) in the presence of NusG. D60G Rho had a high affinity for lambda cro RNA but a much lower ability to discriminate against RNA molecules lacking cis-acting Rho-utilization sequences, and a reduced efficiency of termination that was not improved by NusG. These results indicate a major role for Phe62 in stabilizing the binding of Rho to RNA through hydrophobic interactions, while Asp60 provides an electrostatic repulsive force that allows a rapid dissociation of non-productive complexes with RNA.

Changes in glucose and lipid metabolism following weight loss produced by a very low calorie diet in obese subjects

OBJECTIVE

To study the effects of a very low calorie diet (VLCD) on glucose and lipid metabolism in obese subjects, in particular, the effects on insulin sensitivity and the activities of the key enzymes of glucose disposal, glycogen synthase (GS) and the pyruvate dehydrogenase complex (PDHC).

DESIGN

Clinical dietary intervention study (1.67 MJ (400 kcal)/day) until weight loss of > 10%.

SUBJECTS

11 (seven male, four female) non-diabetic, obese subjects (age: 27-62 y; BMI: 40.5 +/- 1.4 kg/m2).

MEASUREMENTS

Whole body glucose disposal (by euglycemic hyperinsulinemic clamp), respiratory quotient (RQ), resting energy expenditure (REE), glucose and lipid oxidation (by indirect calorimetry), insulin-stimulated PDHC and GS activity (in muscle biopsies) both before and immediately after VLCD (i.e. while still in a hypocaloric state), serum hormone and metabolite levels throughout the dietary period.

RESULTS

Weight loss was accompanied by reduced insulin and elevated NEFA levels, improved insulin sensitivity due to increased nonoxidative glycolysis with no increase in PDHC or GS activities. The rate of weight loss was inversely related to the initial RQ. PDHCa was strongly age-related.

CONCLUSION

A low RQ may be used as a predictor of the efficacy of VLCD treatment and that while VLCD improves nonoxidative glycolytic flux, changes in oxidative glucose disposal and muscle glucose storage are prevented by high NEFA availability during this catabolic phase of dietary intervention.

Anticonvulsant activity of novel derivatives of 2- and 3-piperidinecarboxylic acid in mice and rats

The relative ability of derivatives of 2-piperidinecarboxylic acid (2-PC; pipecolic acid) and 3-piperidinecarboxylic acid (3-PC; nipecotic acid) to block maximal electroshock (MES)-induced seizures, elevate the threshold for electroshock-induced seizures and be neurotoxic in mice was investigated. Protective index (PI) values, based on the MES test and rotorod performance, ranged from 1.3 to 4.5 for 2-PC benzylamides and from < 1 to > 7.2 for 3-PC derivatives. PI values based on elevation of threshold for electroshock-induced seizures and rotorod performance ranged from > 1.6 to > 20 for both types of derivatives. Since preliminary data indicated that benzylamide derivatives of 2-PC displace [3H]1-[1-(2-thienyl)-cyclohexyl]piperidine (TCP) binding to the phencyclidine (PCP) site of the N-methyl-D-aspartate (NMDA) receptor in the micromolar range and such low affinity uncompetitive antagonists of the NMDA receptor-associated ionophore have been shown to be effective anticonvulsants with low neurological toxicity, the 2-PC derivatives were evaluated in rat brain homogenates for binding affinity to the PCP site. Although all compounds inhibited [3H]TCP binding, a clear correlation between pharmacological activity and binding affinity was not apparent. Select compounds demonstrated minimal ability to protect against pentylenetetrazol-, 4-aminopyridine- and NMDA-induced seizures in mice. Corneal and amygdala kindled rats exhibited different sensitivities to both valproic acid and the nonsubstituted 2-PC benzylamide, suggesting a difference in these two models. Enantiomers of the alpha-methyl substituted benzylamide of 2-PC showed some ability to reduce seizure severity in amygdala kindled rats.