Phenotypic and functional activation of hyporesponsive KIRnegNKG2Aneg human NK-cell precursors requires IL12p70 provided by Poly(I:C)-matured monocyte-derived dendritic cells

A functionally responsive natural killer (NK)-cell repertoire requires the acquisition of inhibitory NKG2A and killer immunoglobulin-like receptors (KIR) through pathways that remain undefined. Functional donor NK cells expressing KIRs for non-self class I MHC ligands contribute to a positive outcome after allogeneic hematopoietic stem cell transplantation (alloHSCT) by targeting HLA-matched recipient leukemic cells. Insofar as circulating donor conventional dendritic cells (DC) reconstitute with comparable kinetics with donor NK cells after alloHSCT, we used hyporesponsive KIRnegNKG2Aneg precursor cells to evaluate how specific DC subtypes generate a functionally active NK-cell repertoire. Both monocyte-derived DCs (moDC) and Langerhans-type DCs (LC) induce KIRnegNKG2Aneg precursor cells to express the inhibitory receptors NKG2A and KIR, without requiring cell proliferation. Poly(I:C)-matured moDCs significantly augmented the expression of NKG2A, but not KIR, in an IL12p70-dependent manner. Although all DC-stimulated KIRnegNKG2Aneg cells were able to acquire cytolytic activity against class I MHC-negative targets, the ability to secrete IFNγ was restricted to cells that were stimulated by IL12p70-producing, poly(I:C)-matured moDCs. This critical ability of poly(I:C)-matured moDCs to provide IL12p70 to developing KIRnegNKG2Aneg precursors results in a dom4inant, multifunctional, NKG2Apos NK-cell population that is capable of both cytolysis and IFNγ production. Poly(I:C)-matured moDCs are, therefore, the most effective conventional DC subtype for generating a functionally competent NK-cell repertoire by an IL12p70-dependent mechanism.

Combined analysis of modeled and monitored SO2 concentrations at a complex smelting facility

Vale Canada Limited owns and operates a large nickel smelting facility located in Sudbury, Ontario. This is a complex facility with many sources of SO2 emissions, including a mix of source types ranging from passive building roof vents to North America's tallest stack. In addition, as this facility performs batch operations, there is significant variability in the emission rates depending on the operations that are occurring. Although SO2 emission rates for many of the sources have been measured by source testing, the reliability of these emission rates has not been tested from a dispersion modeling perspective. This facility is a significant source of SO2 in the local region, making it critical that when modeling the emissions from this facility for regulatory or other purposes, that the resulting concentrations are representative of what would actually be measured or otherwise observed. To assess the accuracy of the modeling, a detailed analysis of modeled and monitored data for SO2 at the facility was performed. A mobile SO2 monitor sampled at five locations downwind of different source groups for different wind directions resulting in a total of 168 hr of valid data that could be used for the modeled to monitored results comparison. The facility was modeled in AERMOD (American Meteorological Society/U.S. Environmental Protection Agency Regulatory Model) using site-specific meteorological data such that the modeled periods coincided with the same times as the monitored events. In addition, great effort was invested into estimating the actual SO2 emission rates that would likely be occurring during each of the monitoring events. SO2 concentrations were modeled for receptors around each monitoring location so that the modeled data could be directly compared with the monitored data. The modeled and monitored concentrations were compared and showed that there were no systematic biases in the modeled concentrations.

IMPLICATIONS

This paper is a case study of a Combined Analysis of Modelled and Monitored Data (CAMM), which is an approach promulgated within air quality regulations in the Province of Ontario, Canada. Although combining dispersion models and monitoring data to estimate or refine estimates of source emission rates is not a new technique, this study shows how, with a high degree of rigor in the design of the monitoring and filtering of the data, it can be applied to a large industrial facility, with a variety of emission sources. The comparison of modeled and monitored SO2 concentrations in this case study also provides an illustration of the AERMOD model performance for a large industrial complex with many sources, at short time scales in comparison with monitored data. Overall, this analysis demonstrated that the AERMOD model performed well.

Therapeutic potential and challenges of targeting receptor tyrosine kinase ROR1 with monoclonal antibodies in B-cell malignancies

BACKGROUND

Based on its selective cell surface expression in chronic lymphocytic leukemia (CLL) and mantle cell lymphoma (MCL), receptor tyrosine kinase ROR1 has recently emerged as a promising target for therapeutic monoclonal antibodies (mAbs). To further assess the suitability of ROR1 for targeted therapy of CLL and MCL, a panel of mAbs was generated and its therapeutic utility was investigated.

METHODOLOGY AND PRINCIPAL FINDINGS

A chimeric rabbit/human Fab library was generated from immunized rabbits and selected by phage display. Chimeric rabbit/human Fab and IgG1 were investigated for their capability to bind to human and mouse ROR1, to mediate antibody-dependent cellular cytotoxicity (ADCC), complement-dependent cytotoxicity (CDC), and internalization, and to agonize or antagonize apoptosis using primary CLL cells from untreated patients as well as MCL cell lines. A panel of mAbs demonstrated high affinity and specificity for a diverse set of epitopes that involve all three extracellular domains of ROR1, are accessible on the cell surface, and mediate internalization. The mAb with the highest affinity and slowest rate of internalization was found to be the only mAb that mediated significant, albeit weak, ADCC. None of the mAbs mediated CDC. Alone, they did not enhance or inhibit apoptosis.

CONCLUSIONS AND SIGNIFICANCE

Owing to its relatively low cell surface density, ROR1 may be a preferred target for armed rather than naked mAbs. Provided is a panel of fully sequenced and thoroughly characterized anti-ROR1 mAbs suitable for conversion to antibody-drug conjugates, immunotoxins, chimeric antigen receptors, and other armed mAb entities for preclinical and clinical studies.

Chimeric rabbit/human Fab and IgG specific for members of the Nogo-66 receptor family selected for species cross-reactivity with an improved phage display vector

NgR1, NgR2, and NgR3 which constitute the Nogo-66 receptor family are primarily expressed by neurons in the central nervous system (CNS) and believed to limit axonal growth and sprouting following CNS injury. In an attempt to define the expression and decipher the function of individual members of the Nogo-66 receptor family, we previously reported the generation of selective rabbit polyclonal antibodies. Here we exploit the same immune repertoires by phage display technology to generate rabbit monoclonal antibodies (mAbs) with nanomolar affinity to epitopes that are specific for NgR1 and NgR2, respectively, but at the same time conserved between mouse, rat, and human orthologs. Employing phage display vector pC3C, a newly designed phagemid optimized for the generation and selection of Fab libraries with human constant domains, rabbit mAbs were selected from chimeric rabbit/human Fab libraries, characterized in terms of specificity, affinity, and amino acid sequence, and finally converted to chimeric rabbit/human IgG. Using immunofluorescence microscopy and immunoprecipitation, we demonstrate strong and specific recognition of cell surface bound Nogo-66 receptor family members by chimeric rabbit/human IgG. The rabbit mAbs reported here together with their amino acid sequences constitute a defined panel of species cross-reactive reagents in infinite supply which will aid investigations toward a functional role of the Nogo-66 receptor family in and beyond the CNS.

Relational experiences of partnered Japanese immigrant women with affect disorders

AIM

This paper reports the findings of a study that explored characteristics of relationships of Japanese immigrant women partnered both intraculturally and interculturally, and analysed the role of Japanese culture in these relationships.

BACKGROUND

Immigration can cause shifts in interpersonal structures with partners. When there are large discrepancies in gender roles and communication styles between the original and host cultures, the psychological impact on both partners may be significant. However, currently no empirical data are available to support this assumption.

METHODS

Ten cases selected from the 68 medical records of Japanese-speaking women seen at a mental health clinic from September 2001 to September 2004 were analysed. All of the 10 women met DSM IV-TR criteria of major depressive disorder and were taking antidepressants. Half of the 10 women were in intimate intercultural partnered relationships and the remainder of the matched cases were in intracultural relationships at the time of treatment. The two cohorts were matched in age (36.2 and 43.2 years), length of stay in the United States of America (12 and 16.2 years), and length of treatment (1.2 and 1 years). The length of time of the sample in individual psychodynamic psychotherapy ranged from 20 to 317 hours, depending on the intensity of therapy.

FINDINGS

Inductive data analysis revealed two themes: (1) Lack of awareness of differences in culturally bound communication by Japanese women in intercultural partnerships; (2) Lack of individuality in Japanese women in intracultural partnerships. Neither group appeared to consider relational aspects of partnership, or to make efforts to improve direct communication with their partners.

CONCLUSION

The influence of Japanese culture on gender role and communication styles functions contrary to the mainstream Western culture of the United States of America. In the future, interpersonal elements of cultural differences between host and original cultures in immigration should be considered in research related to immigrants' mental health. This approach should lead to effective interventions to facilitate mental health among immigrants, and regardless of purposes of immigration or length of stay in a psychosocially foreign environment.

Cultural Incommensurability in Psychodynamic Psychotherapy in Western and Japanese Traditions

PURPOSE

To examine cultural incommensurability between clients of Japanese ancestry and Western therapists.

DESIGN

Aggregated case-study method was used to analyze psychotherapy cases of Japanese individuals seen by Western therapists. Eight cases were selected for this study from a private practice client pool.

FINDINGS

Themes were: (a) only observable data were valued for diagnosis and treatment; (b) cultural stereotypes hampered treatment; (c) individuation and separation occurred within a social web of norms in Japanese culture; (d) key concepts in mental health such as "death and dying" and "rape" were interpreted by clients within a Japanese cultural framework, resulting in unique psychological reactions and behaviors, which had not been recognized by Western therapists; (e) psychological effects of immigration were minimized or ignored by Western therapists; (f) culturally unfamiliar behaviors were "pathologized" by Western therapists; and (g) Western therapists showed ethnocentric biases regarding the effects of immigration.

CONCLUSIONS

Various forms of misunderstanding and culturally ignorant practices were found in the treatment of eight Japanese clients by these Western therapists. These ineffective and often harmful practices were unrecognized by the Western therapists.

Symptom self-management and relapse in schizophrenia

The purpose of this descriptive study was to examine the relationships among 4 variables that are hypothesized to be associated with relapse in schizophrenia; insight, symptom recognition, symptom self-management, and perceived effectiveness of symptom self-management. The theoretical framework was derived from self-management theory and the vulnerability-stress model of schizophrenia. Pearson's correlation coefficients for the variables in the model detected 2 significant relationships; between symptom recognition and symptom self-management and between symptom self-management and perceived effectiveness of symptom self-management. Insight was not found to be significantly related to the other variables. Results of the study indicate that individuals with schizophrenia do recognize symptoms associated with relapse and use a wide range of management methods, regardless of the degree of insight present.

Increasing condom use among adolescents with coalition-based social marketing

OBJECTIVES

This study evaluated a multimodal social marketing intervention to reduce the sexual transmission of HIV infection among adolescents in Sacramento, California, USA.

DESIGN

Five rounds of a cross-sectional random sample telephone survey were conducted from December 1996 to October 1998. The total number of respondents was 1402.

RESULTS

A statistically significant, increasing trend in exposure to the intervention was detected. The number of channels through which an adolescent had been exposed to the intervention was associated with condom use at last sex with main partner [odds ratio (OR) 1.26, P < 0.01] and with psychosocial determinants of this behavior. After statistical adjustments for sex, age, and race/ethnicity to make the survey rounds comparable, the proportion of adolescents who had used a condom at last sex increased 4.3 percentage points over the 1 year intervention period.

CONCLUSION

Social marketing can be combined with behavioral science to reduce the risk of HIV infection and other sexually transmitted diseases (STD) among adolescents in a large geographical area. Such a reduction can exceed expectations based on national secular trends.

The effect of tailoring a model HIV prevention program for local adolescent target audiences

In five U.S. sites (Nashville, Tennessee; Newark, New Jersey; northern Virginia; Phoenix, Arizona; and Sacramento, California), HIV risk-reduction workshops were mounted as a part of the Prevention Marketing Initiative (PMI). In four of the five sites, the workshop curriculum was a version of Be Proud! Be Responsible! (Jemmott, Jemmott, & McCaffree, 1996) that had been tailored to fit the needs of local target audiences. This article describes the evaluation of the PMI workshops. Protective effects on several behavioral determinants and behavioral outcome measures were observed 1 month after the workshops. Based on the overall pattern of results, it was concluded that the PMI workshops reduced the likelihood of unprotected sex among participants. The intervention developed by Jemmott and colleagues appears to have retained its effectiveness after it was tailored to meet perceived local needs.

Lessons learned from the PMI case study: the community perspective

Individuals from the five sites that participated in the Prevention Marketing Initiative (PMI) Local Site Demonstration Project, an HIV prevention program targeting adolescents, were interviewed in a two-part qualitative case study. This article summarizes lessons learned from 179 community participants on topics ranging from organizing initial planning committees to financially sustaining federal demonstration programs over time. The insights of participants involved in the process may help ensure the success of future Prevention Marketing efforts. Overall, they found the process to be challenging but worthwhile, and felt that the resulting multifaceted HIV prevention programs for young people were successful.

Reproductive health needs: comparing women at high, drug-related risk of HIV with a national sample

Women who inject drugs or have injection drug-using sex partners are at high risk of acquiring human immunodeficiency virus (HIV) infection and of transmitting HIV perinatally. Many of these women need standard reproductive health care services, specialized HIV care, pre- and postnatal care, and drug treatment, but the extent of the unmet need for such health services is unknown. Large-scale national surveys that estimate drug use do not include reproductive health topics and vice versa. In addition, such surveys typically employ a household sampling method that tends not to include drug-using women. This paper presents evidence from three convenience samples that a high-risk population of women who use drugs has limited access to reproductive health services, and that this population is not represented in the National Survey of Family Growth (NSFG), the national survey that informs public policy regarding reproductive health care in the United States. Policy makers would be well served by regular surveillance of the multiple service needs of women with HIV-risk-related behaviors.

Behavioral responses and self-reported pain in postoperative patients

Pain has been difficult to assess because of its multidimensional nature. The primary purpose of this study was to investigate the relationship between the nurse's assessment of behavioral cues to pain and self-reports of pain made by patients using patient controlled analgesia (PCA). This descriptive-correlational study used the PACU Behavioral Pain Rating Scale (BPRS), patient's self-report, and hospital's PCA pain-rating scale to investigate pain measurement. The convenience sample consisted of 36 postoperative, gynecological surgery patients. Pain assessments for this study were completed during the first 6 postoperative hours on patients who did not have complications. Five pain assessments were collected for each patient. Pain scores were highest during the immediate postoperative period and continued over 2 hours. Significant relationships (rs = 0.56 to 0.80; P < 0.05) were found between the BPRS scores and the self-reports of pain. The relationship between the hospital's PCA pain rating scores and self-reported pain was significant only during the second assessment (rs = 0.45; P < 0.05). The BPRS consistently showed a moderate to high relationship with the patient's self-report of pain and had a stronger relationship with the patient's self-reported pain than with the hospital's pain scale.

HIV prevention in prisons and jails: obstacles and opportunities

High rates of human immunodeficiency virus (HIV) infection among jail and prison inmates suggest that HIV prevention efforts should focus on incarcerated populations. Overcrowding, the high prevalence of injection drug use, and other high-risk behaviors among inmates create a prime opportunity for public health officials to affect the course of the HIV epidemic if they can remedy these problems. Yet, along with the opportunity, there are certain obstacles that correctional institutions present to public health efforts. The various jurisdictions have differing approaches to HIV prevention and control. Whether testing should be mandatory or voluntary, whether housing should be integrated or segregated by HIV serostatus, and whether condoms, bleach, or clean needles should be made available to the prisoners, are questions hotly debated by public health and correctional officials. Even accurate assessment of risk-taking within the institutions leads to controversy, as asking questions could imply acceptance of the very behaviors correctional officials are trying to prevent. Education and risk-reduction counseling are the least controversial and most widely employed modes of prevention, but the effectiveness of current prevention efforts in reducing HIV transmission in this high-risk population is largely undetermined.

Relationship between psychiatric diagnosis and patient aggression

Patient aggression is a common problem on psychiatric units. Recent research has focused on the relationship between aggressive behavior and various patient characteristics, including psychopathology. The purpose of this study was to examine the relationship between diagnostic groups and particular types of patient aggression in a state psychiatric hospital. A secondary analysis was performed on existing data. There was no significant difference noted among DSM III diagnoses in total patient aggression. However, there was a significant difference between individuals with organic disorders and individuals with paranoid schizophrenia in the category of physical aggression against other people. Improved ability to identify a particular diagnostic group with the potential for aggression will strengthen efforts to decrease the risk of patient aggression in psychiatric facilities.

Dealing with violent patients in flight

Prevention is the key to minimizing the dangers in aeromedical transport of violent patients. Complete patient evaluation, identification and treatment of underlying causes of the behavior, anticipation of possible behavior changes, and thorough preparation are needed to ensure a safe transfer.

Anaesthetic experience using a standard technique for laryngeal surgery in infants and children

A 12 year review is presented of 1922 anaesthetic experiences on 285 patients presenting for microlaryngeal operations at the Hospital For Sick Children, Toronto. The lesions treated were laryngeal growths, 198 cases (69.5 per cent): subglottic stenosis, 81 cases (28.4 per cent); and posterior laryngeal cleft, 6 cases (2.1 per cent). The anaesthetic technique consisted of topical analgesia with lidocaine spray (3 mg kg-1) and pharyngeal insufflation of halothane and methoxyflurane both 1-1.5 per cent in oxygen through a special channel in the blade of a Jako Pilling microlaryngoscope in spontaneously breathing patients. Arterial blood gases sampled after 15 and 40 minutes of anaesthesia showed Paco2 = 6.29 +/- 0.31 kPa (47.1 +/-2.39 torr) and 6.44 +/- 0.16kPa (278 +/- 36.2 torr) respectively. Surgical exposure of the larynx was good allowing for a shorter operative time with minimal perioperative complications, in only 94 (4.89 per cent) of the 1922 anaesthetics.

Use of technetium ( 99m Tc) as a bacterial label in lung clearance studies

The suitability of technetium ((99m)Tc), a gamma emitter, for labeling of Diplococcus pneumoniae in studies of lung bacterial clearance was examined. A killed bacterial slurry with high specific activity was obtained with a ferric ascorbate reducing system. Approximately 5.5% of radioactive counts dissociated from labeled bacteria in 6 h. Rats were exposed to a uniformly mixed aerosol of untagged, viable pneumococci and killed, (99m)Tc-tagged pneumococci. The aerodynamic behavior of labeled and unlabeled pneumococci was similar. Viable bacterial counts and radioactive counts were determined in lung homogenates at intervals following exposure, and rates of bacterial killing and disappearance of radioactive counts were plotted. Radioactive counts did not increase in the liver during the period of observation, suggesting that the decrease in lung radioactivity represents mucociliary clearance and not release of isotope to the systemic circulation. The use of (99m)Tc for bacterial labeling provides advantages of technical simplicity and personnel safety compared to the use of beta-emitting isotopes.

Use of technetium ( 99m Tc) as a bacterial label in lung clearance studies

The suitability of technetium ((99m)Tc), a gamma emitter, for labeling of Diplococcus pneumoniae in studies of lung bacterial clearance was examined. A killed bacterial slurry with high specific activity was obtained with a ferric ascorbate reducing system. Approximately 5.5% of radioactive counts dissociated from labeled bacteria in 6 h. Rats were exposed to a uniformly mixed aerosol of untagged, viable pneumococci and killed, (99m)Tc-tagged pneumococci. The aerodynamic behavior of labeled and unlabeled pneumococci was similar. Viable bacterial counts and radioactive counts were determined in lung homogenates at intervals following exposure, and rates of bacterial killing and disappearance of radioactive counts were plotted. Radioactive counts did not increase in the liver during the period of observation, suggesting that the decrease in lung radioactivity represents mucociliary clearance and not release of isotope to the systemic circulation. The use of (99m)Tc for bacterial labeling provides advantages of technical simplicity and personnel safety compared to the use of beta-emitting isotopes.

Charge Scavenging by Benzene in γ-Irradiated Liquid Cyclohexane

The effect of benzene on the yield of propane formed by H2 transfer to cyclopropane in γ-irradiated liquid cyclohexane has been used to determine the efficiency of cation scavenging by benzene. The reduction of the hydrogen yield from cyclohexane by the addition of low concentrations of benzene may be accounted for by a combination of cation and H atom scavenging. G(benzene in polymer) found in previous studies correlates well with G(H atoms scavenged).