A data analysis framework for combining multiple batches increases the power of isobaric proteomics experiments

We present a framework for the analysis of multiplexed mass spectrometry proteomics data that reduces estimation error when combining multiple isobaric batches. Variations in the number and quality of observations have long complicated the analysis of isobaric proteomics data. Here we show that the power to detect statistical associations is substantially improved by utilizing models that directly account for known sources of variation in the number and quality of observations that occur across batches.In a multibatch benchmarking experiment, our open-source software (msTrawler) increases the power to detect changes, especially in the range of less than twofold changes, while simultaneously increasing quantitative proteome coverage by utilizing more low-signal observations. Further analyses of previously published multiplexed datasets of 4 and 23 batches highlight both increased power and the ability to navigate complex missing data patterns without relying on unverifiable imputations or discarding reliable measurements.

Novel insights from a multiomics dissection of the hayflick limit

The process wherein dividing cells exhaust proliferative capacity and enter into replicative senescence has become a prominent model for cellular aging in vitro. Despite decades of study, this cellular state is not fully understood in culture and even much less so during aging. Here, we revisit Leonard Hayflick’s original observation of replicative senescence in WI-38 human lung fibroblasts equipped with a battery of modern techniques including RNA-seq, single-cell RNA-seq, proteomics, metabolomics, and ATAC-seq. We find evidence that the transition to a senescent state manifests early, increases gradually, and corresponds to a concomitant global increase in DNA accessibility in nucleolar and lamin associated domains. Furthermore, we demonstrate that senescent WI-38 cells acquire a striking resemblance to myofibroblasts in a process similar to the epithelial to mesenchymal transition (EMT) that is regulated by t YAP1/TEAD1 and TGF-β2. Lastly, we show that verteporfin inhibition of YAP1/TEAD1 activity in aged WI-38 cells robustly attenuates this gene expression program.

Insights into the Molecular Basis of Genome Stability and Pristine Proteostasis in Naked Mole-Rats

The naked mole-rat (Heterocephalus glaber) is the longest-lived rodent, with a maximal reported lifespan of 37 years. In addition to its long lifespan - which is much greater than predicted based on its small body size (longevity quotient of ~4.2) - naked mole-rats are also remarkably healthy well into old age. This is reflected in a striking resistance to tumorigenesis and minimal declines in cardiovascular, neurological and reproductive function in older animals. Over the past two decades, researchers have been investigating the molecular mechanisms regulating the extended life- and health- span of this animal, and since the sequencing and assembly of the naked mole-rat genome in 2011, progress has been rapid. Here, we summarize findings from published studies exploring the unique molecular biology of the naked mole-rat, with a focus on mechanisms and pathways contributing to genome stability and maintenance of proteostasis during aging. We also present new data from our laboratory relevant to the topic and discuss our findings in the context of the published literature.

Automated 16-Plex Plasma Proteomics with Real-Time Search and Ion Mobility Mass Spectrometry Enables Large-Scale Profiling in Naked Mole-Rats and Mice

Performing large-scale plasma proteome profiling is challenging due to limitations imposed by lengthy preparation and instrument time. We present a fully automated multiplexed proteome profiling platform (AutoMP3) using the Hamilton Vantage liquid handling robot capable of preparing hundreds to thousands of samples. To maximize protein depth in single-shot runs, we combined 16-plex Tandem Mass Tags (TMTpro) with high-field asymmetric waveform ion mobility spectrometry (FAIMS Pro) and real-time search (RTS). We quantified over 40 proteins/min/sample, doubling the previously published rates. We applied AutoMP3 to investigate the naked mole-rat plasma proteome both as a function of the circadian cycle and in response to ultraviolet (UV) treatment. In keeping with the lack of synchronized circadian rhythms in naked mole-rats, we find few circadian patterns in plasma proteins over the course of 48 h. Furthermore, we quantify many disparate changes between mice and naked mole-rats at both 48 h and one week after UV exposure. These species differences in plasma protein temporal responses could contribute to the pronounced cancer resistance observed in naked mole-rats. The mass spectrometry proteomics data have been deposited to the ProteomeXchange Consortium via the PRIDE [1] partner repository with the dataset identifier PXD022891.

Systematic identification of cancer cell vulnerabilities to natural killer cell-mediated immune surveillance

Only a subset of cancer patients respond to T-cell checkpoint inhibitors, highlighting the need for alternative immunotherapeutics. We performed CRISPR-Cas9 screens in a leukemia cell line to identify perturbations that enhance natural killer effector functions. Our screens defined critical components of the tumor-immune synapse and highlighted the importance of cancer cell interferon-γ signaling in modulating NK activity. Surprisingly, disrupting the ubiquitin ligase substrate adaptor DCAF15 strongly sensitized cancer cells to NK-mediated clearance. DCAF15 disruption induced an inflamed state in leukemic cells, including increased expression of lymphocyte costimulatory molecules. Proteomic and biochemical analysis revealed that cohesin complex members were endogenous client substrates of DCAF15. Genetic disruption of DCAF15 was phenocopied by treatment with indisulam, an anticancer drug that functions through DCAF15 engagement. In AML patients, reduced DCAF15 expression was associated with improved survival. These findings suggest that DCAF15 inhibition may have useful immunomodulatory properties in the treatment of myeloid neoplasms.

The human immune system can recognize and kill cancer cells growing in the body. Certain immune cells recognize mutated proteins on the surface of cancer cells known as antigens, and this ability can be enhanced by drugs. These so-called immunotherapies can be effective to treat several cancer types, but only some patients benefit from them. This is because cancer cells often stop presenting antigens on their surface, thus hiding from the immune response.

Natural killer cells are a type of immune cell that does not rely on antigen presentation to recognize cancer cells. Scientists are now trying to develop drugs to increase the effectiveness with which natural killer cells attack cancer.

Pech et al. used cells from a human leukemia, a type of blood cancer, to look for proteins that made these cells more vulnerable to natural killer cells. The main experiment, in which every single protein in the cancer cells was deleted one by one, revealed that a protein called DCAF15 changes how cancer and natural killer cells interact. Leukemia cells lacking DCAF15 could be attacked by natural killer cells much more easily because the cancer cells exhibited inflammation-like symptoms that stimulated the immune response. DCAF15 is part of a family of ‘adaptors’ that that provide specificity to the cellular machinery that controls proliferation, the recycling of proteins and DNA repair.

Inhibiting DCAF15 with a drug also made natural killer cells more efficient at eliminating leukemia cells. Patients with leukemia whose cancer cells make little DCAF15 protein have a better chance of survival, suggesting that this process may already be happening in some patients.

Together these data indicate that targeting DCAF15 in leukemia patients may help natural killer cells attack cancer cells. Future research is needed to see if a similar process takes place in other cancer types.

eIF2B activator prevents neurological defects caused by a chronic integrated stress response

The integrated stress response (ISR) attenuates the rate of protein synthesis while inducing expression of stress proteins in cells. Various insults activate kinases that phosphorylate the GTPase eIF2 leading to inhibition of its exchange factor eIF2B. Vanishing White Matter (VWM) is a neurological disease caused by eIF2B mutations that, like phosphorylated eIF2, reduce its activity. We show that introduction of a human VWM mutation into mice leads to persistent ISR induction in the central nervous system. ISR activation precedes myelin loss and development of motor deficits. Remarkably, long-term treatment with a small molecule eIF2B activator, 2BAct, prevents all measures of pathology and normalizes the transcriptome and proteome of VWM mice. 2BAct stimulates the remaining activity of mutant eIF2B complex in vivo, abrogating the maladaptive stress response. Thus, 2BAct-like molecules may provide a promising therapeutic approach for VWM and provide relief from chronic ISR induction in a variety of disease contexts.

The effects of nonignorable missing data on label-free mass spectrometry proteomics experiments

An idealized version of a label-free discovery mass spectrometry proteomics experiment would provide absolute abundance measurements for a whole proteome, across varying conditions. Unfortunately, this ideal is not realized. Measurements are made on peptides requiring an inferential step to obtain protein level estimates. The inference is complicated by experimental factors that necessitate relative abundance estimation and result in widespread non-ignorable missing data. Relative abundance on the log scale takes the form of parameter contrasts. In a complete-case analysis, contrast estimates may be biased by missing data and a substantial amount of useful information will often go unused. To avoid problems with missing data, many analysts have turned to single imputation solutions. Unfortunately, these methods often create further difficulties by hiding inestimable contrasts, preventing the recovery of interblock information and failing to account for imputation uncertainty. To mitigate many of the problems caused by missing values, we propose the use of a Bayesian selection model. Our model is tested on simulated data, real data with simulated missing values, and on a ground truth dilution experiment where all of the true relative changes are known. The analysis suggests that our model, compared with various imputation strategies and complete-case analyses, can increase accuracy and provide substantial improvements to interval coverage.

Row versus column correlations: avoiding the ecological fallacy in RNA/protein expression studies

Biomedical researchers are often interested in computing the correlation between RNA and protein abundance. However, correlations can be computed between rows of a data matrix or between columns, and the results are not the same. The belief that these two types of correlation are estimating the same phenomenon is a special case of a well-known logical error called the ecological fallacy. In this article, we review different uses of correlation found in the literature, explain the differences between row and column correlations and argue that one of them has an undesirable interpretation in most applications. Through simulation studies and theoretical derivations, we show that the commonly used Pearson's coefficient, computed from protein and transcript data from a single sample, is only loosely related to the biological correlation that most researchers will be interested in studying. Beyond our basic exploration of the ecological fallacy, we examine how correlations are affected by relative quantification proteomics data and common normalization procedures, finding that double normalization is capable of completely masking true correlative relationships. We conclude with guidelines for properly identifying and computing consistent correlation coefficients.

Proteome-Wide Evaluation of Two Common Protein Quantification Methods

Proteomics experiments commonly aim to estimate and detect differential abundance across all expressed proteins. Within this experimental design, some of the most challenging measurements are small fold changes for lower abundance proteins. While bottom-up proteomics methods are approaching comprehensive coverage of even complex eukaryotic proteomes, failing to reliably quantify lower abundance proteins can limit the precision and reach of experiments to much less than the identified-let alone total-proteome. Here we test the ability of two common methods, a tandem mass tagging (TMT) method and a label-free quantitation method (LFQ), to achieve comprehensive quantitative coverage by benchmarking their capacity to measure 3 different levels of change (3-, 2-, and 1.5-fold) across an entire data set. Both methods achieved comparably accurate estimates for all 3-fold-changes. However, the TMT method detected changes that reached statistical significance three times more often due to higher precision and fewer missing values. These findings highlight the importance of refining proteome quantitation methods to bring the number of usefully quantified proteins into closer agreement with the number of total quantified proteins.

15-deoxy-Delta12,14 prostaglandin J2-induced heme oxygenase-1 in megakaryocytes regulates thrombopoiesis

BACKGROUND

Platelet production is an intricate process that is poorly understood. Recently, we demonstrated that the natural peroxisome proliferator-activated receptor gamma (PPARgamma) ligand, 15-deoxy-Delta(12,14) prostaglandin J(2) (15d-PGJ(2)), augments platelet numbers by increasing platelet release from megakaryocytes through the induction of reactive oxygen species (ROS). 15d-PGJ(2) can exert effects independent of PPARgamma, such as increasing oxidative stress. Heme oxygenase-1 (HO-1) is a potent antioxidant and may influence platelet production.

OBJECTIVES

To further investigate the influence of 15d-PGJ(2) on megakaryocytes and to understand whether HO-1 plays a role in platelet production.

METHODS

Meg-01 cells (a primary megakaryoblastic cell line) and primary human megakaryocytes derived from cord blood were used to examine the effects of 15d-PGJ(2) on HO-1 expression in megakaryocytes and their daughter platelets. The role of HO-1 activity in thrombopoiesis was studied using established in vitro models of platelet production.

RESULTS AND CONCLUSIONS

15d-PGJ(2) potently induced HO-1 protein expression in Meg-01 cells and primary human megakaryocytes. The platelets produced from these megakaryocytes also expressed elevated levels of HO-1. 15d-PGJ(2)-induced HO-1 was independent of PPARgamma, but could be replicated using other electrophilic prostaglandins, suggesting that the electrophilic properties of 15d-PGJ(2) were important for HO-1 induction. Interestingly, inhibiting HO-1 activity enhanced ROS generation and augmented 15d-PGJ(2)-induced platelet production, which could be attenuated by antioxidants. These new data reveal that HO-1 negatively regulates thrombopoiesis by inhibiting ROS.

Rod pathways in the mammalian retina use connexin 36

Many neurons in the mammalian retina are coupled by means of gap junctions. Here, we show that, in rabbit retina, an antibody to connexin 36 heavily labels processes of AII amacrine cells, a critical interneuron in the rod pathway. Image analysis indicates that Cx36 is primarily located at dendritic crossings between overlapping AII amacrine cells. This finding suggests that Cx36 participates in homotypic gap junctions between pairs of AII amacrine cells. Cx36 was also found at AII/cone bipolar contacts, previously shown to be gap junction sites. This finding suggests that Cx36 participates at gap junctions that may be heterotypic. These results place an identified neuronal connexin in the context of a well-defined retinal circuit. The absence of Cx36 in many other neurons known to be coupled suggests the presence of additional unidentified connexins in mammalian neurons. Conversely, Cx36 labeling in other regions of the retina is not associated with AII amacrine cells, indicating some other cell types use Cx36.

Excitation--contraction uncoupling by a human central core disease mutation in the ryanodine receptor

Central core disease (CCD) is a human congenital myopathy characterized by fetal hypotonia and proximal muscle weakness that is linked to mutations in the gene encoding the type-1 ryanodine receptor (RyR1). CCD is thought to arise from Ca(2+)-induced damage stemming from mutant RyR1 proteins forming "leaky" sarcoplasmic reticulum (SR) Ca(2+) release channels. A novel mutation in the C-terminal region of RyR1 (I4898T) accounts for an unusually severe and highly penetrant form of CCD in humans [Lynch, P. J., Tong, J., Lehane, M., Mallet, A., Giblin, L., Heffron, J. J., Vaughan, P., Zafra, G., MacLennan, D. H. & McCarthy, T. V. (1999) Proc. Natl. Acad. Sci. USA 96, 4164--4169]. We expressed in skeletal myotubes derived from RyR1-knockout (dyspedic) mice the analogous mutation engineered into a rabbit RyR1 cDNA (I4897T). Here we show that homozygous expression of I4897T in dyspedic myotubes results in a complete uncoupling of sarcolemmal excitation from voltage-gated SR Ca(2+) release without significantly altering resting cytosolic Ca(2+) levels, SR Ca(2+) content, or RyR1-mediated enhancement of dihydropyridine receptor (DHPR) channel activity. Coexpression of both I4897T and wild-type RyR1 resulted in a 60% reduction in voltage-gated SR Ca(2+) release, again without altering resting cytosolic Ca(2+) levels, SR Ca(2+) content, or DHPR channel activity. These findings indicate that muscle weakness suffered by individuals possessing the I4898T mutation involves a functional uncoupling of sarcolemmal excitation from SR Ca(2+) release, rather than the expression of overactive or leaky SR Ca(2+) release channels.

Prevalence of infection in ticks submitted to the human tick test kit program of the U.S. Army Center for Health Promotion and Preventive Medicine

In 1997, ticks removed from humans and received alive by the Tick-Borne Disease Laboratory of the U.S. Army Center for Health Promotion and Preventive Medicine (USACHPPM) were tested for pathogens by polymerase chain reaction (PCR). Thirty-three of 222 (15%) Amblyomma americanum (L.) DNAs produced amplicons of the expected size of Ehrlichia chaffeensis Anderson, Dawson & Wilson and 26/222 (12%) produced amplicons indicating Borrelia burgdorferi Johnson, Schmid, Hyde, Steigalt & Brenner. Five (2%) appeared to be co-infected with both organisms. Thirteen of 308 (4%) Dermacentor variabilis (Say) were PCR-positive for spotted fever group rickettsiae. Restriction fragment-length polymorphism analysis indicated all were Rickettsia montana. One hundred twenty-seven D. variabilis from Monroe County, WI, were tested for B. burgdorferi and 14 (11%) were positive. Five of 24 (21%) Ixodes scapularis Say were positive for B. burgdorferi and one (2%) was positive for the agent of human granulocytic ehrlichiosis. Different species of ticks transmit different pathogens, and most tick-borne diseases have similar early symptoms, therefore knowing the species and infection status of the tick enhances the physician's ability to consider tick-borne agents as a potential cause of disease and recommend appropriate therapy. Ongoing surveillance of the vector species of human diseases provides an additional estimate of human encounters with infected ticks, and testing ticks removed from humans may increase our knowledge of the vector status of tick species for transmitting tick-borne pathogens.

Ehrlichia chaffeensis (Rickettsiales: Ehrlichieae) infection in Amblyomma americanum (Acari: Ixodidae) at Aberdeen Proving Ground, Maryland

Human monocytic ehrlichiosis (HME) is a sometimes fatal, emerging tick-borne disease caused by the bacterium Ehrlichia chaffeensis. It is frequently misdiagnosed because its symptoms mimic those of the flu. Current evidence indicates that Amblyomma americanum (L.), the lone star tick, is the major vector of HME. To determine if E. chaffeensis is present in ticks at Aberdeen Proving Ground, MD, questing A. americanum ticks were collected from 33 sites. Nucleic acid was extracted from 34 adult and 81 nymphal pools. Sequences diagnostic for E. chaffeensis from three different loci (16S rRNA, 120-kDa protein, and a variable-length polymerase chain reaction [PCR] target, or VLPT) were targeted for amplification by the PCR. Fifty-two percent of the collection sites yielded pools infected with E. chaffeensis, confirming the presence and widespread distribution of E. chaffeensis at Aberdeen Proving Ground. Analysis with the both the 120-kDa protein primers and the VLPT primers showed that genetic variance exists. A novel combination of variance for the two loci was detected in two tick pools. The pathogenic implications of genetic variation in E. chaffeensis are as yet unknown.

The Near-Infrared Transition of CuCl Observed by Intracavity Laser Spectroscopy

The near-infrared electronic transition of CuCl, occurring in the region of 745 nm, was recorded using intracavity laser absorption spectroscopy. The (0, 0), (1, 1), and (2, 2) vibronic bands were analyzed, and from this the molecular constants for the two electronic states were derived. Originally assigned as A' (3)Sigma(+)-X(1)Sigma(+), we have confirmed that this transition does not connect to the ground state, but occurs between two unknown excited states. The excited CuCl molecules were produced in a copper hollow cathode, operated using argon and a small amount of CCl(4). Line positions were referenced to iodine spectra observed from a heated extracavity cell using the broadband spectral output of the intracavity laser as the light source. Copyright 2000 Academic Press.

Histamine immunoreactive axons in the macaque retina

PURPOSE

The goal of these experiments was to identify the neurotransmitter in centrifugal axons of the macaque retina.

METHODS

Macaca mulatta retinas and optic nerves were fixed overnight in carbodiimide and labeled with an antiserum to histamine with the use of an immunofluorescence technique.

RESULTS

Several large histamine-immunoreactive axons ran from the optic nerve head to the peripheral retina, where they branched extensively and terminated in the inner plexiform layer, occasionally alongside retinal blood vessels. Other axons that emerged from the optic nerve head ran in the optic fiber layer to the central retina, circled the fovea, and then returned to the optic disc. These may be the source of histamine-immunoreactive axons that have been observed in central visual areas. No labeled cell bodies were present in the retina. Because perikarya in the posterior hypothalamus are the only known source of histamine in the primate central nervous system and because neurons there can be retrogradely labeled from the cut optic nerve, the histamine-immunoreactive axons must have originated there.

CONCLUSIONS

Centrifugal axons in the macaque retina are part of the system of axons containing histamine that originate in the hypothalamus and project throughout the brain. Because the activity of these neurons is highest during the morning, histamine might play a role in preparing the retina to operate in daylight. The contacts of histamine-immunoreactive axons with blood vessels suggest that histamine may also play a role in regulating the retinal microvasculature.

Overproduction of SM28GST in a baculovirus expression vector and its use to evaluate the in vivo immune responses of mice vaccinated against Schistosoma mansoni with naked DNA encoding the SM28GST gene

To evaluate the immune responses of mice vaccinated intramuscularly with naked DNA encoding a single parasite-derived gene, sufficient quantities of protein are necessary for use in the immunological assays. A plasmid carrying the cDNA encoding the entire sequence for the 28-kDa Schistosoma mansoni glutathione S-transferase (Sm28GST) was used as a source of naked DNA to vaccinate mice. Using polymerase chain reaction employing custom primers to add Eco RI and Hind III restriction sites at the 5' and 3' ends, respectively, a 651-bp fragment was amplified from the vaccine plasmid. This product was isolated, ligated into the pFastBac HTb donor plasmid containing a 6X histidine (6X-his) tag, and transposed into the baculovirus expression vector system. Following blue white selection screening, high molecular weight DNA was isolated and transfected in Sf21 insect ovary cells using a liposomal preparation. Culture medium containing infective virus particles was used to infect a series of Sf21 cultures and the cells were lysed after 3-5 days. The lysates were subjected to immobilized metal (Ni-NTA) affinity chromatography from which the 6X-his-tagged recombinant Sm28GST was eluted in 250 mM imidazole. The eluted protein was probed with a polyclonal rabbit antibody specific for the Sm28GST and subsequently recognized using a monoclonal antibody specific for the 6X-his tag following concentration of the pooled fractions. Mice were vaccinated intramuscularly with purified plasmid DNA encoding either the Sm28GST or firefly luciferase. Skin tests performed using recombinant Sm28GST were positive in only those mice vaccinated with naked DNA encoding the Sm28GST gene. In a different group of experimental mice, only sera from mice vaccinated with naked DNA encoding Sm28GST contained IgG-specific anti-Sm28GST antibodies at 14 days postvaccination, and at 42 days the levels were suggestive of an anamnestic response. These results suggest that naked DNA vaccination of mice is capable of inducing both antigen-specific cell-mediated and humoral immune responses against Sm28GST and further strengthen the case for this antigen being a vaccine candidate.

Cerebral emboli during cardiac surgery in children

BACKGROUND

Microemboli occur commonly during cardiac surgery in adults, and, when present, increase the risk of neuropsychological deficits. Their incidence and significance during correction of congenital heart disease is unknown. The authors hypothesized that microemboli would occur before bypass with right-to-left cardiac shunts and would also occur in large numbers when the aortic crossclamp was released in children during repair of congenital heart defects.

METHODS

In 25 children studied with carotid artery Doppler, embolic signals were counted and timed in relation to 13 intraoperative events. Patients were classified as either at high risk (obligate right-to-left shunt or uncorrected transposition of the great arteries) or at low risk (net left-to-right shunt or simple obstructive lesions) for paradoxical (venous to arterial) emboli.

RESULTS

The median number of emboli detected was 122 (range, 2-2,664). Forty-two percent of all emboli were detected within 3 min of release of the aortic crossclamp. The high-risk group had significantly more emboli (median, 66; range, 0-116) during the time interval before cardiopulmonary bypass than did the low-risk group (median, 8; range, 0-73), with P < 0.01. There was no significant difference between the high- and low-risk groups in the total number of emboli detected. There was no apparent association between number of emboli and gross neurologic deficits.

CONCLUSIONS

Microemboli can be detected in the carotid arteries of children undergoing repair of congenital heart disease and are especially prevalent immediately after release of the aortic crossclamp. The role of emboli in causing neurologic injury in children undergoing repair of congenital heart disease remains to be determined.

Intracavity laser absorption measurements at ultrahigh spectral resolution

Intracavity laser absorption spectroscopy with ultrahigh sensitivity and enhanced spectral resolution is demonstrated. It entails use of an intracavity étalon that selects equally spaced modes of the cavity. These modes are reduced in intensity when they occur at spectral locations where absorption that is due to intracavity species also occurs. We obtained absorption spectra by tuning the étalon in small steps across its free spectral range, recording intracavity spectra at each step, and summing the result. The maximum resolution is determined by the width of the étalon peaks, which was ~0.01 cm(-1). When the finesse of the étalon is increased, the resolution equal to the width of a single laser mode can be achieved. With this technique, spectra at Doppler-free resolution such as that required for studies of high vibrational-overtone transitions of molecules in supersonic jets are possible.

Transesophageal echo probe compression of an aberrant right subclavian artery

Transesophageal echocardiography (TEE) is frequently used in the operating room to assess surgical repairs in children with congenital heart disease. Complications from the procedure are unusual, but the potential for TEE probe compression of normal and abnormal posterior vascular structures has been recognized. We report a case of TEE probe compression of an aberrant right subclavian artery in a patient undergoing repair of an atrioventricular septal defect.

An effective computer-based tardive dyskinesia monitoring system

To promote early recognition and treatment of neuroleptic-induced tardive dyskinesia we used our facility's pharmacy and appointment data bases to develop an automated reminder system that significantly improved physician monitoring of patients receiving antipsychotic drug therapy. The system prompts staff to perform regular examinations for abnormal involuntary movements and to review patients' consent to therapy with antipsychotic medication. The average prevalences in the 15 months after automated reminders began, in a population of over 800 patients, increased from 53% to 85% for an annually completed abnormal involuntary movement scale in medical records and from 38 to 74% for a statement of informed consent. Now, 45 months later, prevalences of both measures approaches 100%. The integrated design of the Department of Veterans Affairs computer system allowed linking pharmacy and appointment scheduling data and facilitated the project. The reminder system effectively promoted rapid, marked, and sustained change in physicians' documentation of antipsychotic drug therapy.

An in vitro comparison of biofilm formation on various biliary stent materials

Stent occlusion may occur as the result of bacterial adherence and biofilm formation. This occlusion may be prompted by the material or design of the stents. In this study, a bile perfusion model was used to compare the biofilm formation on various stent materials. The copolymer and the wire mesh stents demonstrated less biofilm formation than the traditional stent. The development of new polymers may prolong stent patency.

Mental health services for medical students: perceptions of students, student affairs deans, and mental health providers

PURPOSE

To examine (1) whether there is any consistency among medical schools in mental health services provided and (2) how these services are perceived by student affairs deans, mental health service providers, and the students themselves.

METHOD

Questionnaires were sent in October 1991 to the student affairs dean (or director), the individual responsible for student mental health services, and a student representative in each of the 126 U.S. and Canadian medical schools. Data were sought regarding personnel, individuals served, location, hours, administration, funding, confidentiality, administrative referrals, and respondents' suggestions for improvement. Possible differences among the three groups of respondents were tested by chi-square.

RESULTS

Responses were received from 75 student affairs deans, 53 mental health providers, and 30 students. There was much diversity among schools in services provided, especially in the areas of administration and funding. Although perceptions of the three respondent groups were often the same, they differed significantly in a number of areas. Suggestions for improvement of services involved funding, personnel, hours, confidentiality and privacy, specialty services, preventive and support programs, and visibility. The suggestion most frequently made by the students was for increased information and visibility.

CONCLUSION

The differences among schools coupled with the differing perceptions within schools indicate a need for a comprehensive consideration of what kinds of mental health services are needed and how they can best be made accessible to a diverse body of students experiencing a variety of academic and personal challenges.

ELISA tests for antibodies in experimental bovine tuberculosis

It was shown that 10(4) cfu of a field isolate of Mycobacterium bovis caused illness in five experimentally infected calves; one of these died. One of three contact calves also became clinically infected. Considerable variation in the humoral response of the affected animals was demonstrated by ELISAs using purified protein derivative (PPD) and phosphatide antigens. The inoculation of antigens used in the comparative tuberculin skin test significantly enhanced the level of PPD antibodies in the affected animals whereas that of the apparently non-infected contact animals remained unchanged.

Proteins of Crustacean Exoskeletons: I. Similarities and Differences among Proteins of the Four Exoskeletal Layers of Four Brachyurans

Most of the proteins extracted from exocuticle, endocuticle, and membranous layer of four species of anecdysial (intermolt) crabs (the Bermuda land crab Gecarcinus lateralis, the rock crab Cancer antennarius, the shield-backed kelp crab Pugettia producta, and the southern shield-backed kelp crab Taliepus nuttalli) were 31 kDa or smaller; proteins of similar Mr were common to all three layers. Proteins from the membranous layer were qualitatively indistinguishable in all four species. More proteins 31 kDa or smaller were similar in size and pI to proteins from other exoskeletal layers than were proteins larger than 31 kDa. Proteins extracted from the epicuticle of G. lateralis included a group of five ranging from 54 to 42 kDa that bound 45Ca++ in vitro. The group was not seen in other layers of the exoskeleton of G. lateralis or, with the exception of 44 and 42 kDa protein bands that were in the epicuticle of C. antennarius, in any layers of the exoskeletons of the other three species. During proecdysis, the membranous layer is completely degraded, and proteins 31 kDa or smaller are preferentially degraded from the exocuticle and endocuticle of the old exoskeleton of G. lateralis, which is cast as an exuvia at ecdysis. The relative amounts of proteins in extracts of epicuticle from (1) anecdysial exoskeletons and (2) exuviae were very similar, suggesting that there was little degradation of epicuticle during proecdysis. Some of the proteins of the three inner layers of the exoskeleton of G. lateralis have characteristics similar to those of flexible cuticles of insects; they have acidic pIs and they form "charge trains," i.e., proteins of the same size separated by differences in charge during isoelectric focusing.

Use of azathioprine or 6-mercaptopurine in the treatment of Crohn's disease

The efficacy and safety of therapy with azathioprine/6-mercaptopurine was studied in 78 patients with Crohn's disease. Mean duration of therapy was 1.6 years; 52 patients were treated greater than or equal to 6 months. All patients were also on other antiinflammatory medications. Evaluations included self-assessment and physician's assessment of well-being, functional capacity, general clinical response, clinical activities indices (National Foundation for Ileitis and Colitis/International Organization for the Study of Inflammatory Bowel Disease and Harvey-Bradshaw), and achievement of specific therapeutic goals. General clinical condition improved in 70% of the patients. Median response time was 3 months. The average Harvey-Bradshaw score decreased 37% with therapy, and a decrease of greater than or equal to 30% occurred in 66% of the subjects. An overall 72% achievement rate for specified therapeutic goals included controlling refractory disease, 73%; corticosteroid "sparing," 76%; and lessening fistulization, 63%. Nine patients got worse despite therapy. Adverse effects requiring discontinuation of therapy occurred in 10%, whereas dosages were briefly lowered for mild side effects in another 10%. This study demonstrates the effectiveness and safety of azathioprine/6-mercaptopurine in the majority of selected patients with chronic, unremitting, or steroid-requiring Crohn's disease.

A mathematical model for Mycobacterium bovis excretion from tuberculous cattle

An analysis was carried out of available information from a series of experiments on the excretion of M. bovis from infected cattle. The analysis indicated that an inverse exponential relationship exists between 'dose' of organisms given and the delay before excretion commences. This relationship was represented mathematically. Available field data supported the relationship and indicated that in natural bovine tuberculosis excretion of M. bovis begins around 87 days after infection occurs. It is also suggested that the data supports the concept of single nuclei infections in cattle.

Effect of creep feeding on the incidence, duration and severity of post-weaning diarrhoea in pigs

The effect of creep feeding on the response of pigs weaned at two or three weeks old to infection with an enteropathogenic strain of Escherichia coli (O149; K91[B], K88 a, c [L]) was studied in two separate experiments. Gastric intubation was adopted to regulate the intake of creep feed during the sucking period. Animals were given the enteropathogenic strain either before weaning or at weaning and the course and outcome of the infection followed bacteriologically and clinically. The response of the animals to the infection varied considerably in accord with recent reports of multiple phenotypes (to K88 +ve organisms) among pigs but consumption of creep feed before weaning did not significantly affect the prevalence, duration or severity of the diarrhoea induced experimentally by the organism. Hence reputed immunological responses mounted against dietary antigens did not predispose to or protect against this infection.

Computed tomography evaluation of the sacroiliac joints in Crohn disease. Radiologic/clinical correlation

Computed tomography (CT) was used in a prospective study of the sacroiliac joints in 86 patients with Crohn disease to determine the type and frequency of sacroiliac joint abnormalities present in this population. The CT findings were correlated with review of the clinical history in 64 patients. Computed tomography demonstrated changes of sacroiliitis in 29% of the study group. This high prevalence of sacroiliac joint abnormality was found even in those under 30 years of age. It exceeds the 11-19% previously reported from plain film examination, reflecting the greater sensitivity of CT. In the subgroup of 64 patients studied clinically, 19 (30%) had abnormal sacroiliac joints on CT, but only 2 (3%) reported symptoms related to the sacroiliac joints.

Control, prevention and eradication of Salmonella enteritidis infection in broiler and broiler breeder flocks

Salmonella enteritidis was identified by serological and bacteriological techniques in two clinically normal breeder flocks in an integrated broiler organisation in Northern Ireland. The organism was transmitted vertically to clinically affected progeny flocks. The infected breeder flocks were slaughtered and the infection throughout the organisation controlled and subsequently eradicated. A working group, consisting of the senior management of the broiler organisation and veterinary staff from the Veterinary Research Laboratories at Stormont, was formed to establish procedures to minimise the risk of the reintroduction of salmonella infection, by preventing vertical transmission from grandparent flocks, or lateral transmission from personnel, other animal species and fomites, or transmission through the feed. All feed was heated to a minimum of 70 degrees C for 12 minutes immediately before it was pelleted and subsequently transported to the flocks through a dedicated system of conveyor belts, bins and lorries. A comprehensive system for monitoring the efficacy of the preventive procedures was established and is now used throughout the poultry industry of Northern Ireland.

Dezocine. A preliminary review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy

Dezocine is an analgesic agent with opioid agonist and antagonist activity. After parenteral administration of therapeutic doses it is approximately equipotent with morphine, and has proved at least as effective an analgesic as morphine, pethidine (meperidine) and butorphanol in moderate to severe postoperative pain. However, preliminary pharmacodynamic data indicate that the ceiling of analgesic activity of dezocine occurs at a higher level of analgesia than that of reference agonist/antagonist agents. Also, the drug exhibited a morphine-like degree of anaesthetic-sparing activity in animals. Although long term data are very limited, single doses of dezocine are well tolerated, with mild and transient sedation and gastrointestinal upset the principal adverse effects. As with some other agonist/antagonist analgesics, a 'ceiling' effect to dezocine-induced respiratory depression occurs with increasing dosage, beyond which further depression has not been observed. In single analgesic doses, however, dezocine is a slightly more potent respiratory depressant than morphine. Clinically important haemodynamic changes have not been observed with usual analgesic doses of dezocine. As an agonist/antagonist opioid, the dependence liability of dezocine would be expected to be lower than that of pure agonist opioids, but extended clinical use is required before more definitive conclusions can be drawn in this regard. Unlike older drugs of its type, dezocine produced opiate-like subjective effects and was identified as morphine-like by drug abusers. Thus, provided the promising conclusions of currently available clinical studies are confirmed with its wider use, dezocine should be a useful additional agent for the treatment of moderate to severe postoperative pain.

Use of PPD and phosphatide antigens in an ELISA to detect the serological response in experimental bovine tuberculosis

Five calves from tuberculosis free herds were each inoculated intranasally with 10(6) viable organisms of a field isolate of Mycobacterium bovis. Four of the calves developed acute tuberculosis. ELISAs employing protein and phosphatide extracts of M bovis as antigens were used to monitor the humoral response of the infected calves. Fourteen days after infection there was a dramatic increase in the level of antibodies demonstrated by the phosphatide antigen. This increase coincided with the first appearance of signs of the disease. The results suggest that the phosphatide antigen may be of potential value in detecting a humoral response, if present, in cattle infected with M bovis. The tests employing the protein antigen demonstrated a humoral response in only one of the infected calves and emphasises the importance of antigen selection to detect antibodies in tuberculous animals.

Transmission of tuberculosis from experimentally infected cattle to in-contact calves

Five of a group of six calves were inoculated with Mycobacterium bovis. Two more uninoculated calves were introduced to the group 84 days later. All the inoculated calves were subsequently shown to be excreting M bovis in nasal mucus. The uninoculated calf in the initial group of six became infected and subsequently excreted M bovis. The two uninoculated calves which were introduced later did not become infected. It was concluded that contact with nasal mucus from the infected cattle resulted in infection of the uninoculated calf and that the density of accommodation of animals excreting M bovis was an important factor in transmission of the disease.

Acyclovir. An updated review of its antiviral activity, pharmacokinetic properties and therapeutic efficacy

Acyclovir (aciclovir) is a nucleoside antiviral drug with antiviral activity in vitro against members of the herpes group of DNA viruses. As an established treatment of herpes simplex infection, intravenous, oral and to a lesser extent topical formulations of acyclovir provide significant therapeutic benefit in genital herpes simplex and recurrent orofacial herpes simplex. The effect of acyclovir therapy is maximised by early initiation of treatment, especially in non-primary infection which tends to have a less protracted course than the primary episode. Long term prophylactic oral acyclovir, in patients with frequent episodes of genital herpes simplex, totally suppresses recurrences in the majority of subjects; as with other infections responding to acyclovir, viral latency is not eradicated and pretreatment frequencies of recurrence return after discontinuation of treatment. Caution should accompany the prophylactic use of acyclovir in the general population, due to the theoretical risk of the emergence of viral strains resistant to acyclovir and other agents whose mechanism of action is dependent on viral thymidine kinase. Intravenous acyclovir is the treatment of choice in biopsy-proven herpes simplex encephalitis in adults, and has also been successful in the treatment of disseminated herpes simplex in pregnancy and herpes neonatorium. Intravenous and oral acyclovir protect against dissemination and progression of varicella zoster virus infection, but do not protect against post-herpetic neuralgia. In immunocompromised patients, intravenous, oral and topical acyclovir shorten the clinical course of herpes simplex infections while prophylaxis with oral or intravenous dosage forms suppresses reactivation of infection during the period of drug administration. Ophthalmic application of 3% acyclovir ointment rapidly heals herpetic dendritic corneal ulcers and superficial herpetic keratitis. Thus, despite an inability to eradicate latent virus, acyclovir administered in therapeutic or prophylactic fashion is now the standard antiviral therapy in several manifestations of herpes simplex virus infection, and indeed represents a major advance in this regard. With the exception of varicella zoster virus infections, early optimism concerning the use of the drug in diseases due to other herpes viruses has generally not been supported in clinical investigations.

Excretion of Mycobacterium bovis by experimentally infected cattle

Three groups, each of five calves, four to seven months old, were inoculated intranasally with different numbers of Mycobacterium bovis. Infection was established readily in the calves which received an inoculum containing either 10(6) or 10(4) colony forming units (cfu). After every infection there was a lag period during which the organisms could not be isolated from specimens of nasal mucus. All the animals excreted M bovis and the time of commencement, quantity and duration of excretion appeared to be related to the inoculation dose. Excretion continued for many weeks, and for two calves excretion became intermittent over many months. All the calves which were given inocula of 92 cfu failed to develop the disease and no immunological responses were detected; however, M bovis was isolated from nasal secretions from one of these animals 100 days after inoculation.

Mycobacterium bovis in the anterior respiratory tracts in the heads of tuberculin-reacting cattle

Twenty-five of 50 randomly selected tuberculin-reacting cattle were confirmed as tuberculous in the laboratory. All 25 cattle had macroscopic lesions in lymph nodes associated with the respiratory tracts but only one had lung lesions. M bovis was isolated from the anterior respiratory tracts in the heads of four of the 25 tuberculous animals and from a nostril lesion found in a fifth. For at least three of these five animals, the intervals between the final tuberculin test and their previously negative tests indicated that infection had established relatively rapidly. Four of them had been tuberculin tested solely because they were animals in contiguous 'at risk' herds. It would appear that although M bovis can be isolated from the anterior respiratory tracts in the heads of tuberculin-reacting cattle, it is unlikely that primary foci of infection exist in regions other than the lungs or associated tissues. The study demonstrates the potential for reactors with lesions to excrete M bovis and the continued importance of infected cattle in the epidemiology and eradication of the disease.

Intracavity laser spectroscopy: propagation of absorption data through optical fibers

The propagation of achromatic visible laser radiation through optical fibers is examined for a quasi-cw dye laser designed to record absorption by intracavity laser spectroscopy (ILS). The wavelength and intensity characteristics of the ILS laser output and any superimposed intracavity absorption features are preserved quantitatively for propagation through an extracavity single-mode optical fiber. Feedback from the front surface of the optical fiber and its associated optics can modify the ILS laser output. Two optical configurations which give no noticeable modifications to the IS data propagated through the optical fiber are described. Applications of ILS for remote sensing, sensitive detection of extracavity feedback effects, and characterization of extracavity interferometric signals are indicated.

Changes in fitness and shipboard task performance following circuit weight training programs featuring continuous or interval running

Pre- and post-physiological data were collected on 57 Navy men (mean age = 19.5 years) who participated in either circuit weight training/continuous run (CWT/CR) (N = 31) or circuit weight training/interval run (CWT/IR) (N = 26) programs. Measured variables included 4 measures of upper torso dynamic strength (one repetition maximum [1 RM] for arm curl, bench press, shoulder press, and lat pull-down); two measures of lower torso dynamic strength (1 RM) for knee extension and leg press); one measure of power (number of revolutions completed on an arm ergometer (Monark) at maximum drag); three measures of muscular endurance (number of repetitions at 60% 1 RM for bench press and leg press and maximal number of bent-knee sit-ups in 120 s); one stamina measure (time to exhaustion on a cycle ergometer (Monark) maximal work capacity [MWC] test; and three simulated shipboard tasks: manikin shoulder drag, open/secure a water tight door and paint bucket carry. Composite shipboard performance derived from the summed time (s) required to complete the three tasks was also calculated. Results show performance on the manikin shoulder drag and majority of evaluative fitness measures was significantly (p less than 0.05) enhanced following both circuit weight training/run formats. Significantly (p less than 0.05) higher values for shoulder press (F = 7.2), arm ergometer (F = 5.3), and sit-ups (F = 6.8) and lower values for leg press muscular endurance (F = 5.1) were observed in CWT/IR when compared to CWT/CR.(ABSTRACT TRUNCATED AT 250 WORDS)

Bilateral "simultaneous" femoral neck fractures following minimal stress

Following jogging, a 53-year-old man experienced bilateral hip discomfort. Two weeks later, after stepping backward suddenly, he had severe pain in the right hip. Radiographs showed a displaced fracture of the right femoral head; this was pinned. Bone imaging revealed intense uptake in the other femoral head as well. This also was believed to be fractured, and therefore was repaired. During the two operations, no pathological cause of the bilateral femoral neck fractures was noted. The literature on simultaneous bilateral femoral neck fractures, without underlying bone disease, was reviewed.