Six-year follow-up of a point-source exposure to CWD contaminated venison in an Upstate New York community: risk behaviours and health outcomes 2005-2011

OBJECTIVES

It is currently unknown whether chronic wasting disease (CWD), a transmissible spongiform encephalopathy of cervids, is transmissible to humans. Reported on here are the behavioural risk factors and health conditions associated with a six-year follow-up of a known point-source exposure to a CWD infected deer in an Upstate New York community.

STUDY DESIGN

Longitudinal.

METHODS

The Oneida County Chronic Wasting Disease Surveillance Project was launched in 2005 in response to a point-source exposure to a CWD infected deer at a March 2005 Sportsmen's feast in Upstate New York. Eighty-one exposed individuals participated in the 2005 baseline data collection, and were sent follow-up questionnaires following each deer hunting season between 2005 and 2011.

RESULTS

Over a six year period, participants reported a reduction in overall venison consumption. Participants reported no significant changes in health conditions, although several conditions (vision loss, heart disease, type 2 diabetes, weight changes, hypertension, and arthritis), were significantly associated with age.

CONCLUSIONS

To this day, this incident remains the only known large-scale point-source exposure to a CWD infected deer. Prion diseases can incubate for multiple decades before the manifestation of clinical symptoms; thus, continued surveillance of this exposed study population represents a unique opportunity to assess the risk of CWD transmission to humans. This project is uniquely situated to provide the first epidemiological evidence of CWD transmission to humans, should it occur.

Sustained in vivo activity of recombinant bovine granulocyte colony stimulating factor (rbG-CSF) using HEPES buffer

The purpose of this study was to develop a long-acting injectable formulation of bG-CSF for veterinary use. However, in order to achieve sustained in vivo activity it was first necessary to stabilize the protein at the injection site. Preformulation studies, as well as literature, suggest that bG-CSF aggregates at neutral pH ranges (i.e., pH 6-8) and at temperatures of approximately 40 degrees C. Therefore, bG-CSF will not retain its activity for an extended period of time at the injection site. During this study we determined that HEPES buffer has a very significant impact on protein stability as well as on biological performance. Recombinant bovine granulocyte colony stimulating factor (rbG-CSF) was formulated in 1 M HEPES buffer for subcutaneous injection into cows. bG-CSF formulated in 1 M HEPES buffer resulted in sustained in vivo activity of bG-CSF compared to the "control" formulation (control formulation: 5% mannitol, 10 mM acetate buffer, 0.004% tween-80, pH 4). White blood cell (WBC) count was used as a marker to evaluate in vivo activity of the formulation. WBC numbers remained above a threshold value for only 24-30 h for the control formula. However, when bG-CSF was formulated in 1 M HEPES, the WBC remained above threshold for 3 days or 72 h. Formulating bG-CSF in 1 M HEPES at pH 7.5 also resulted in greater solution stability. This was surprising since bG-CSF is intrinsically not stable at neutral pH. The effect of 1 M HEPES on the T(M) (temperature at maximum heat flow on calorimetry scan) of bG-CSF was determined by microcalorimetry. In the absence of 1 M HEPES buffer the T(M) was 48 degrees C (onset approximately 40 degrees C), while bG-CSF formulated in 1 M HEPES buffer has a T(M) of 59 degrees C (onset approximately 50 degrees C). Similar organic buffers, such as MOPS, HEPPS, TES, and tricine, also resulted in improved solution stability as well as in sustained in vivo activity. The dramatic effect of these buffers on stability and biological performance of bG-CSF is not well understood. One hypothesis is that the electrostatic interaction between the zwitterionic form of these buffers and bG-CSF provides stabilization against denaturation.

Treatment-as-usual in the methamphetamine treatment project

The Methamphetamine Treatment Project is a multisite trial that compares the effectiveness of eight models of outpatient treatment for methamphetamine dependence to that of the Matrix model. These eight "treatment-as-usual" models represent diverse approaches developed in a variety of settings to serve markedly different populations. The theoretical foundations of these treatments are described as well as the settings in which they are delivered. To facilitate comparisons, details are presented with respect to frequency of group and individual sessions, duration of treatment, therapist qualifications, and access to ancillary services. The populations served by these programs vary with respect to race and ethnicity. Most programs serve primarily non-Hispanic Caucasians, but some programs serve significant proportions of Hispanics, Asians, Pacific Islanders, and Native Americans. Usual route of administration of methamphetamine also varies by site, with snorting, smoking, and injecting each reported as the most common route of administration at one or more sites. The Minnesota model and cognitive-behavioral approaches are most commonly used in these programs, although contingency management and psychodynamic approaches are also represented. The intensive phase of treatment ranges between four and 24 weeks; the number of hours per week of client contact varies between one and 13. This trial will provide the opportunity to test the effectiveness of a wide range of treatments currently in use in community settings.

A descriptive analysis of participant characteristics and patterns of substance use in the CSAT methamphetamine treatment project: the first six months

The CSAT Methamphetamine Treatment Project (MTP) is a multisite study with a two-fold purpose: to assess the feasibility and outcomes generated by a technology transfer of the Matrix treatment model for methamphetamine (MA) abuse into several community-based treatment programs, and specifically to compare outcomes of treatment as usual at each site with outcomes of the Matrix model, as implemented in each site. The study comprises seven sites, geographically situated in Hawaii, Northern and Southern California, and Montana. This article presents a demographic description of the cohort, and describes patterns of drug use, abuse, and related problems among the 169 participants recruited in the first six months of the study, from April through September 1999. Specific analyses presented include: demographic composition of the sample with respect to gender, age, ethnicity, education completed, employment status, and income; primary drug used, and mean percent of days using various drugs including MA, alcohol, and marijuana; and percent of sample reporting various routes of drug administration. Mean baseline Addiction Severity Index composite scores are presented that describe medical, employment, alcohol, drug, legal, family/social, and psychiatric status for the sample. Also presented here are comparisons of this preliminary population to other populations reported in the literature. This early subset of MTP participants is similar to other methamphetamine-abusing populations described in the literature in age, years of education, income, and mean years of use. However, because of its multisite structure and the locations of its constituent sites, the MTP population has greater variation in ethnic makeup than do populations from other studies, offering an opportunity to provide useful new information about drug use patterns and treatment responses in populations not previously studied.

Anger, hostility, and visceral adipose tissue in healthy postmenopausal women

Central obesity is an important risk factor for chronic disease. Its etiology remains unclear. We examined whether anger and hostility, ie, psychological attributes that influence cardiovascular morbidity and mortality, prospectively predict central visceral obesity across 13 years. Visceral adipose tissue (VAT) was determined by x-ray computed tomography (CT) at the L4-L5 disc space in a population-based sample of 157 postmenopausal Healthy Women Study participants. Standardized tests were completed to measure separately trait anger (anger frequency and intensity), style of anger expression (holding anger in and expressing it outwardly), and hostile (mistrustful) attitudes. The higher the VAT score, the higher the trait anger and anger-out scores measured 13 years earlier (Ps < .04) and the higher the concurrent hostile attitudes score (P < .02). Moreover, the higher the VAT score, the greater the increase in trait anger over the study period (P < .03). Trait anger and hostility predicted VAT independent of fasting insulin levels, although both predicted an increase in fasting insulin over time. Women were categorized into three groups according to the distribution of the average percent increase in trait anger and in weight across the study period, respectively. The mean VAT scores increased with the likelihood of being in the highest tertile of increasing trait anger (means: 129.1, 131.1, and 155.8, P < .048) and in the highest tertile of increasing weight (means: 122.4, 131.1, and 162.2, P < .003). The association between a high trait anger score and VAT remained significant, controlling for weight gain. We conclude that hostile attributes, fasting insulin, and weight gain in midlife may contribute to the development of VAT in healthy Caucasian women.

Cardiovascular functions in two macruran decapod crustaceans (Procambarus clarkii and Homarus americanus) during periods of inactivity, tail flexion and cardiorespiratory pauses

Arterial hemolymph flow was measured in restrained crayfish (Procambarus clarkii) and lobsters (Homarus americanus). Implanted pulsed Doppler flow transducers were used to measure arterial flows in the anterior aorta, posterior aorta, sternal artery, lateral artery, ventral thoracic artery and ventral abdominal artery, allowing determination of flow simultaneously in several arteries over a period of 4 days. Calculated Doppler hemolymph flow showed a strong correlation (P&lt;0.05) with 'pumped' hemolymph flow as determined by in situ calibration. Arterial flow patterns remained constant during quiet conditions. In crayfish, cardiac output was 7.5&plusmn;1.1 ml min-1 (252 ml kg-1 min-1), of which the anterior aorta received 1.3&plusmn;0.15 ml min-1 (20.1&plusmn;4.0 %), the posterior aorta received 0.8&plusmn;0.1 ml min-1 (12.3&plusmn;2.7 %) and the sternal artery received 5.2&plusmn;1.4 ml min-1 (67.5&plusmn;37.0 %). Mean heart frequency at rest was 125.6&plusmn;5.2 beats min-1 and stroke volume was 0.06&plusmn;0.01 ml beat-1 (1.98 ml kg-1 beat-1). In lobsters, cardiac output was 60.8&plusmn;4.4 ml min-1 (93.6&plusmn;6.8 ml kg-1 min-1), with the anterior aorta receiving 7.8&plusmn;0.8 ml min-1 (12.8&plusmn;2.7 %), the lateral arteries receiving 0.6&plusmn;0.2 ml min-1 (1.0&plusmn;0.5 %), the posterior aorta receiving 12.6&plusmn;1.0 ml min-1 (20.7&plusmn;3.3 %) and the sternal artery receiving 38.9&plusmn;4.1 ml min-1 (64.0&plusmn;13.4 %). Flows in the branches of the sternal artery were 0.3&plusmn;0.05 ml min-1 (0.5&plusmn;2 %) in the ventral abdominal artery and 4.0&plusmn;0.1 ml min-1 (6.5&plusmn;0.3 %) in the ventral thoracic artery. Lobster heart rate was 82.5&plusmn;2.9 beats min-1 and stroke volume was 0.7&plusmn;0.05 ml beat-1. Periods of constant hemolymph flow were interrupted by tail flexions (abdominal flexion) and, in lobsters, periods of cardiac/respiratory pause. Tail movement increased flow (peak height and minimum flow values) in both crayfish and lobsters, although the general wave form of hemolymph flow and pressure did not change. In lobsters, periodic respiratory pauses were observed during which all arteries received hemolymph, despite the low heart rate.

Perireceptor mechanisms sustaining olfaction at low salinities: insight from the euryhaline blue crab Callinectes sapidus

As the blue crab Callinectes sapidus moves from sea water to fresh water, the 'exposed' chemosensory dendrites in the olfactory sensilla (aesthetascs) undergo changes in length that are positively correlated with environmental salinity. In this study, we demonstrate the following. (1) The responses of the olfactory receptor cells of freshwater-acclimated crabs are reduced relative to those of seawater-acclimated animals, but increase with a time course comparable to the increase in dendrite length when these crabs are transferred to sea water. (2) The olfactory response of seawater-acclimated crabs is lost and the chemosensory dendrites osmotically ablated if the aesthetascs are acutely exposed to low salinity. However, maintaining iso-osmotic conditions with mannitol preserves both the physiological response and the structural integrity of the dendrites. (3) The flux of [14C]thiocyanate and 22Na between the hemolymph and sensillar lymph of the aesthetascs indicates continuity between these fluid compartments. (4) There is a net efflux of Na+ from the hemolymph through the aesthetascs in freshwater-acclimated crabs, and measurements of electrical potential across the antennules suggest that this efflux largely derives from passive diffusion. (5) Dendrites in the aesthetascs of crabs acclimated to brackish water are intermediate in length between those of freshwater- and seawater-acclimated animals. Together, our findings suggest that, at low salinities, the efflux of Na+ (and probably other ions) from the hemolymph generates an ionic/osmotic microenvironment within the aesthetascs that sustains the structural and functional integrity of the olfactory dendrites. We propose that the length of these dendrites, and consequently the olfactory response, is constrained by the distance over which this microenvironment can be effectively maintained.

Effects of the mixed phosphodiesterase III/IV inhibitor, zardaverine, on airway function in patients with chronic airflow obstruction

Zardaverine is a selective inhibitor of phosphodiesterase (PDE) III and IV isozymes. It has been shown to exert potent bronchodilator effects in animals. In order to study the efficacy and safety in man, a phase II clinical trial in 10 patients with partially reversible chronic airflow obstruction was carried out. The trial was designed as a double-blind, randomized, five-period change-over study. Zardaverine (at single doses of 1.5 mg, 3.0 mg, or 6.0 mg), salbutamol (0.3 mg) and placebo were administered by metered dose inhaler on separate days. As evaluated by spirometry over a time period of 4 h, salbutamol induced a significant bronchodilatation. In contrast, zardaverine did not improve airway function in these patients. Unwanted effects of the study medication were not observed.

Indirect evidence for short-loop negative feedback of insulin secretion in the rat

Feedback inhibition of glucose-mediated insulin release has repeatedly been demonstrated in isolated pancreatic islets and in the perfused pancreas. It was the aim of the present study to determine whether inhibition occurs through a long-loop (plasma concentration of insulin) or a short-loop (local concentration) action of insulin. The perfused rat pancreas was used, with different perfusion rates and different insulin concentrations in the medium. Increasing the flow rate from 1 to either 3 or 6 ml/min gradually decreased the insulin concentration in the effluent, at stimulatory concentrations of glucose (11.1 and 16.7 mmol/l). Under the same conditions, however, the integrated amount of insulin released over a period of 30 min was significantly enhanced. When exogenous insulin (2.7 and 5.4 mumol/l) was added to the perfusion medium, insulin secretion in the presence of 11.1 or 16.7 mmol glucose/l at flow rates of 3 and 6 ml/min was diminished. This effect was most prominent with 11.1 mmol glucose/l and 2.7 mumol exogenous insulin/l at all flow rates (except 1 ml/min), as well as at the high perfusion flow rates with other glucose concentrations. Insulin secretion was not affected by 5.4 mumol exogenous insulin/l at 1 ml/min or by 2.7 mumol exogenous insulin/l at 3 ml/min. The data support a negative feedback inhibition of insulin secretion by secreted insulin, since insulin secretion was decreased by either adding exogenous insulin or by lowering endogenous insulin as the consequence of increased flow rates.(ABSTRACT TRUNCATED AT 250 WORDS)