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Scenario-based modeling frameworks have been widely used to support policy-making at state and federal levels in the United States during the COVID-19 response. While custom-built models can be used to support one-off studies, sustained updates to projections under changing pandemic conditions requires a robust, integrated, and adaptive framework. In this paper, we describe one such framework, UVA-adaptive, that was built to support the CDC-aligned Scenario Modeling Hub (SMH) across multiple rounds, as well as weekly/biweekly projections to Virginia Department of Health (VDH) and US Department of Defense during the COVID-19 response. Building upon an existing metapopulation framework, PatchSim, UVA-adaptive uses a calibration mechanism relying on adjustable effective transmissibility as a basis for scenario definition while also incorporating real-time datasets on case incidence, seroprevalence, variant characteristics, and vaccine uptake. Through the pandemic, our framework evolved by incorporating available data sources and was extended to capture complexities of multiple strains and heterogeneous immunity of the population. Here we present the version of the model that was used for the recent projections for SMH and VDH, describe the calibration and projection framework, and demonstrate that the calibrated transmissibility correlates with the evolution of the pathogen as well as associated societal dynamics., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Aim: To synthesize epidemiologic literature pertaining to the association between preeclampsia (PE), attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and epilepsy., Method: A systematic search of PubMed and Embase was performed supplemented by hand-searching of reference lists of eligible studies. Two independent reviewers screened abstracts following a prepared protocol. Data extraction and quality appraisal using the Newcastle Ottawa Scale were performed by an independent reviewer. PRISMA guidelines were followed throughout. Random-effects meta-analyses were performed. Adjusted pooled Odds Ratios and their 95% confidence intervals were reported., Results: Fifteen out of 121 identified studies were eligible for inclusion. Six reported adjusted estimates for ADHD, resulting in a pooled odds ratio of 1.29 (95% CI: 1.20, 1.38). Eight reported adjusted estimates for ASD, resulting in a pooled odds ratio of 1.27 (95% CI:1.22, 1.32). Three reported adjusted estimates for epilepsy, resulting in a pooled odds ratio of 1.35 (95% CI: 1.12, 1.63)., Interpretation: Intrauterine exposure to PE increased the risk of ADHD, ASD, and epilepsy, though it is unclear whether the true association is with pre-term birth. To our knowledge, this is the first meta-analysis to quantify the association between PE and epilepsy. The results of this meta-analysis can inform screening strategies among children born to preeclamptic mothers for early identification and treatment., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier B.V.)

Recent changes in rendering availability for chemically-euthanized animals have created a need to explore composting as an equine mortality management method. The objectives of this study were to evaluate equine mortality composting in the Upper Midwest during fall and spring, document sodium pentobarbital concentrations throughout the process, and determine nutrient content of finished compost. During each season, four horses were euthanized by intravenous administration of sodium pentobarbital. Carcasses were positioned at the center of a woodchip and shavings base and covered with a 2:1 mixture of horse stall waste and cattle feedlot waste. Data loggers were placed at 46- and 91cm depths to record pile temperatures every 8 hours. At turning (44-50 days) and trial conclusion (181-216 days), compost piles were sampled for sodium pentobarbital and nutrient composition. Piles contained large bones after 6 months of composting. Sodium pentobarbital remained detectable at trial conclusion (<0.002-1.49 mg kg 1 dry matter); however, composting reduced the estimated quantities of sodium pentobarbital by ≥94% (P ≤ .001). Compost from each season met ideal land application values for organic matter (45%-48%), pH (7.3-7.6), and electrical conductivity (3.3-3.4 mm hos cm -1 ). Low NPK and high C:N ratio (20-30) indicate compost could partially replace synthetic fertilizers when land applied. These findings suggest equine mortality composting is an effective management practice during fall and spring in the Upper Midwest. While remaining sodium pentobarbital residues were minimal, further research is needed to determine environmental implications of composting chemically-euthanized equines., (Copyright © 2022. Published by Elsevier Inc.)

C 4 grasses dominate natural and agricultural settings, and the widespread success of wild grasses is mostly attributable to their resilience to environmental extremes. Much of this natural stress tolerance has been lost in major cereals as a byproduct of domestication and intensive selection. Millets are an exception, and they were domesticated in semi-arid regions of Sub-Saharan Africa and Asia where selection favored tolerance and stability over yield. Here, we review the evolutionary and domestication histories of millets and the traits that enable their stress tolerance, broad adaptability, and superior nutritional qualities compared to other cereals. We discuss genome editing and advanced breeding approaches that can be used to develop nutritious, climate resilient cereals of the future. Finally, we propose that millets can play a central role in the global food system to combat food insecurity, with researchers and germplasm from the Global South at the center of these efforts., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Competing Interests: Declaration of interests TD declares minor shareholdings and an unpaid directorship at CapeRay Medical, which was an institution-based activity. WC declares he is the chief executive officer of a telemedicine company providing general medical consultation. All other authors declare no competing interests.

Evidence supports the notion that craniofacial fractures are significant predictors of cervical spine injuries (CSIs), but some debate remains on the injury mechanism of co-existing CSIs in craniofacial fractures and the relationship between CSI and specific facial fractures. In this retrospective study, we aim to assess the incidence rates of specific facial fracture types as well as other important variables and their relationship with CSIs. The primary outcome variable, CSI, and several predictor variables, including facial fracture type, were evaluated with logistic regression analyses. Of 2919 patients, the total CSI incidence rate was 3.0%. Rates of CSI in patients with isolated mandibular fractures (OR 0.26 CI 0.10, 0.63; p = 0.006) were lower than those previously reported, whereas isolated nasal fractures were strongly associated with CSI (OR 2.67 CI 1.36, 5.22; p = 0.004). Patients with concomitant cranial injuries were twice as likely to have CSI (OR 2.00, CI 1.22, 3.27; p = 0.006). Even though there is a strong occurrence rate of CSIs in patients with cranial injuries, clinicians should be aware that patients presenting with isolated facial fractures are at significant risk for sustaining CSIs also., Competing Interests: Declaration of competing interest The authors have no conflicts of interest to declare., (Copyright © 2021 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)

Challenges associated with burial, rendering, and cremation have forced horse owners to seek alternative mortality disposal methods. While equine mortality composting has been successfully demonstrated, industry-wide adoption has been limited. Therefore, evaluation of horse owners' and veterinarians' perceptions and experience with mortality composting is needed. Two surveys were developed to evaluate industry practices and decisive factors regarding equine euthanasia and mortality disposal methods. Each survey was designed for a separate audience: horse owners or veterinarians serving equines. The surveys were advertised as weblinks on relevant Facebook pages, e-newsletters, and email listservs. Data were analyzed using bivariate and multivariate models for associations and factors influencing decisions surrounding composting. The surveys yielded 1,225 and 244 usable responses from horse owners and veterinarians, respectively. Respondent demographics were consistent with previous survey reports for horse owners and veterinarians in the United States with a majority being female between 41 and 60 years of age with long-term industry involvement. Horse owners (86%) and veterinarians (84%) that preferred chemical euthanasia tended to prefer burial (58% and 42%, respectively) over other mortality disposal methods. Only 12% of horse owner respondents had ever tried composting and only 25% of veterinarian respondents had ever recommended composting. Horse owner (47%) and veterinarian (67%) respondents indicated they would be more open to trying and recommending mortality composting if more scientific research were available. Equine mortality composting shows potential as a primary disposal method for the equine industry. Research and educational programs are key to industry-wide acceptance of equine mortality composting., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Background: Current blood culture systems were developed and evolved, in part, based on our knowledge of the critical factors in the recovery of pathogenic microorganisms from blood, changes in the spectrum of pathogens causing bloodstream infections, changes in technology and changes in expectations for blood culture system performance., Aims: The aim was to review historical data about development of blood culture systems and how that knowledge will continue to influence newer generations of technology for detecting and identifying bloodstream pathogens., Sources: Sources were literature review of published papers, previous select reviews, and updated guidelines., Content: This review focuses on how blood culture systems evolved in response to changes in our knowledge about the critical factors for recovering bloodstream pathogens, the spectrum of pathogens that cause bacteraemia and fungaemia, changes in technology, and changes in expectation of performance., Implications: As we move into an era characterized by molecular identification of bloodstream pathogens, and eventually direct detection of pathogens in blood, the historical knowledge that drove the development and subsequent evolution of contemporary blood culture systems also will drive development and incremental improvements in molecular methods. Our knowledge of bloodstream infections is not static; these systems reflect changes in that knowledge., (Copyright © 2019 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)

Background: The critical factors for optimal recovery of microbial pathogens from blood are not only the basis for how we perform blood cultures on a daily basis, but are also important for development of all current blood-culture systems. Because much of this research was conducted and published between 1975 and 2010 there is a general sense that many physicians and scientists may not be familiar with it, but it is critical for performing and interpreting blood cultures., Objectives: To review the critical factors in the laboratory recovery and isolation of pathogenic microorganisms in blood., Sources: Literature review of published papers, select reviews and updated guidelines., Content: This review focuses on the critical factors that affect the recovery isolation of pathogenic microorganisms from individuals with bloodstream infections. Contemporary blood-culture systems, and current methods for blood-culture collection, have been designed to incorporate these critical factors so as to optimize recovery and isolation of pathogens while minimizing contamination., Implications: It is important for microbiologists and practitioners to understand how and why these critical factors affect current blood-culture practices to improve patient management. Future research should emphasize which of these critical factors will still play a role in the era of molecular diagnostic tests, which will no longer be relevant, and which new critical factors have yet to be defined., (Copyright © 2019 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)

Objective: Pleckstrin homology-like domain, family A, member 2 (PHLDA2) is a maternally expressed imprinted gene. Loss of imprinting in PHLDA2 is associated with abnormal placental development and fetal growth restriction. Our objective was to determine whether genetic variation in PHLDA2 is also associated with risk of HELLP syndrome and preeclampsia (PE) with severe features., Study Design: Case (n = 162) and control (n = 33) mother-father-child triads were recruited using an internet-based method. Medical records were reviewed to verify clinical diagnosis of self-reported cases. DNA was genotyped for three polymorphisms in the PHLDA2 gene using TaqMan assays: rs13390, rs1056819, rs2583435., Main Outcome Measures: To examine the association between minor alleles and haplotypes with HELLP syndrome and PE with severe features, relative risks and 95% confidence intervals were estimated using log-linear models, adjusting for the correlation between familial genotypes, using HAPLIN., Results: There was no association identified between PHLDA2 gene polymorphisms or haplotypes and HELLP syndrome and PE with severe features. No parent-of-origin effects were observed., Conclusion: Genetic variation in the PHLDA2 gene is not associated with HELLP syndrome or PE with severe features., (Copyright © 2020 International Society for the Study of Hypertension in Pregnancy. Published by Elsevier B.V. All rights reserved.)

Purpose: Novel approaches must address the underlying factors sustaining the tuberculosis (TB) epidemic in the United States, specifically what maintains new Mycobacterium tuberculosis (Mtb) transmission., Methods: Culture-confirmed TB cases reported to the Michigan Department of Health and Human Services (2004-2012) were analyzed for time-restricted genotypic and/or geospatial clustering. Cases with both types of clustering were used as a proxy for recent, local transmission. Modified, multivariate Poisson regression models were fit to estimate this prevalence in relation to various individual- and neighborhood-level demographic and socio-economic variables., Results: Those individuals that were spatially clustered were 1.7 times as likely to also be time-restricted genotypically clustered. The prevalence of recent, local transmission was higher among U.S.-born cases, males, and non-Hispanic blacks. Moreover, people living in neighborhoods in the highest poverty quartile had 13.8 times the prevalence of recent, local transmission compared with those in the lowest poverty neighborhoods., Conclusions: Our results suggest geographic areas with high concentration of TB cases are likely driven by ongoing transmission, rather than enclaves of individuals who have reactivated a case of latent TB. Furthermore, efforts to continue reducing Mtb transmission in the United States, and other low-incidence settings, must better identify community-level sources of risk, manifested through the complex social interactions among people and their environments., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Background: Reported blood transfusion rates after total shoulder arthroplasty (TSA) range from 4.5% to 43%, and reported risk factors include race, female sex, prosthesis type (reverse), revision, age, anemia, low preoperative hemoglobin, and number of comorbidities. The purpose of this study was to develop a predictive model for transfusion in anatomic/hemi and reverse shoulder arthroplasty patients and to estimate the transfusion rate in a community hospital setting., Methods: A retrospective cohort of 265 shoulder arthroplasties (79 anatomic, 182 reverse, and 4 hemiarthroplasties) performed consecutively by 1 surgeon at 1 institution from May 2013 to May 2016 was assembled. Two patients were excluded for insufficient data, leaving 263 patients for analysis. Sensitivity, specificity, area under the curve, and cut points using estimated blood loss (EBL), history of anemia, and preoperative hemoglobin level were calculated, based on a logistic regression model., Results: The overall transfusion rate was 2.3% (6/265). Higher EBL ( P  = .003), lower preoperative hemoglobin level ( P  = .030), and history of anemia ( P  = .088) were predictive of transfusion with a sensitivity of 80.0% and a specificity of 99.6%. In this cohort, patients with a history of anemia had transfusion risk when an EBL of ≥300 mL was combined with a preoperative hemoglobin level <10.9, resulting in a sensitivity of 1.0 and a specificity of 0.96. Factors associated with transfusion in univariate models included arthroplasty for fracture ( P < .001), cemented stem ( P < .001), length of stay ( P < .001), EBL ( P < .001), operative time ( P < .001), and preoperative hemoglobin ( P  = .004) and hematocrit levels ( P  = .004)., Conclusion: Patients with a history of anemia, a preoperative hemoglobin level <10.9, and an intraoperative EBL ≥300 mL are at high risk for transfusion after TSA., (© 2019 The Authors.)

Animal husbandry and capture (AHC) may mitigate anemia among women and children by supplying a source of micronutrient-rich animal source foods (ASF), yet may concurrently increase exposure to anemia-inducing pathogens such as Plasmodium spp., helminths, and enteropathogens. We conducted a systematic literature review to assess the relation between AHC and anemia among women of reproductive age, school-aged children, and children aged <5 y in low- and middle-income countries (LMICs). We used a 2-stage screening process, in which 1 reviewer searched 4 databases (PubMed, Web of Science, EMBASE, and Global Health) with predetermined search terms for relevant articles. Two reviewers then independently screened studies using a priori exclusion criteria, yielding a total of 23 articles included in the final review. We evaluated evidence from observational studies assessing animal-dependent livelihoods and livestock ownership, and interventions that promoted livestock and fish production. We found little consistency in anemia outcomes across the several AHC exposures and population groups. Poultry production interventions had modest benefits on anemia among women and children, although whether these improvements were a result of increased ASF consumption, or a result of the combined treatment study design could not be determined. Observational studies identified chicken ownership, and no other livestock species, as a risk factor for anemia among young children. However, there was limited evidence to evaluate pathways underlying these associations. Studies tended to rely on self-reported fever and diarrhea to assess illness, and no study directly assessed linkages between AHC, pathogen burden, and anemia. Thus, there is insufficient evidence to conclude whether AHC improves or worsens anemia among women and children in LMICs. Given the current interest in promoting animal production among low-income households, future studies with robust measures of livestock ownership, ASF consumption, pathogen burden, and anemia status are needed to understand the nuances of this complex and potentially contradictory relation., (© 2019 American Society for Nutrition.)

Insufficient awareness of the centrality of pathology and laboratory medicine (PALM) to a functioning health-care system at policy and governmental level, with the resultant inadequate investment, has meant that efforts to enhance PALM in low-income and middle-income countries have been local, fragmented, and mostly unsustainable. Responding to the four major barriers in PALM service delivery that were identified in the first paper of this Series (workforce, infrastructure, education and training, and quality assurance), this second paper identifies potential solutions that can be applied in low-income and middle-income countries (LMICs). Increasing and retaining a quality PALM workforce requires access to mentorship and continuing professional development, task sharing, and the development of short-term visitor programmes. Opportunities to enhance the training of pathologists and allied PALM personnel by increasing and improving education provision must be explored and implemented. PALM infrastructure must be strengthened by addressing supply chain barriers, and ensuring laboratory information systems are in place. New technologies, including telepathology and point-of-care testing, can have a substantial role in PALM service delivery, if used appropriately. We emphasise the crucial importance of maintaining PALM quality and posit that all laboratories in LMICs should participate in quality assurance and accreditation programmes. A potential role for public-private partnerships in filling PALM services gaps should also be investigated. Finally, to deliver these solutions and ensure equitable access to essential services in LMICs, we propose a PALM package focused on these countries, integrated within a nationally tiered laboratory system, as part of an overarching national laboratory strategic plan., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

As global efforts accelerate to implement the Sustainable Development Goals and, in particular, universal health coverage, access to high-quality and timely pathology and laboratory medicine (PALM) services will be needed to support health-care systems that are tasked with achieving these goals. This access will be most challenging to achieve in low-income and middle-income countries (LMICs), which have a disproportionately large share of the global burden of disease but a disproportionately low share of global health-care resources, particularly PALM services. In this first in a Series of three papers on PALM in LMICs, we describe the crucial and central roles of PALM services in the accurate diagnosis and detection of disease, informing prognosis and guiding treatment, contributing to disease screening, public health surveillance and disease registries, and supporting medical-legal systems. We also describe how, even though data are sparse, these services are of both insufficient scope and inadequate quality to play their key role in health-care systems in LMICs. Lastly, we identify four key barriers to the provision of optimal PALM services in resource-limited settings: insufficient human resources or workforce capacity, inadequate education and training, inadequate infrastructure, and insufficient quality, standards, and accreditation., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Objective: The purpose of this study was to validate our previous genetic association findings related to the endoglin (ENG) pathway from an American Caucasian preeclampsia cohort in independent preeclampsia cohorts. We also sought to explore the ENG pathway for new genetic associations in these independent cohorts., Study Design: We used a tagging single nucleotide (tSNP) approach to assess genetic variability across five ENG pathway genes (ENG, TGFβ1, TGFβR1, ALK1, and TGFβR2) in a Caucasian cohort from Norway (n = 77 preeclampsia cases & n = 63 normotensive controls) and a White Hispanic cohort from Southern California (n = 69 preeclampsia cases & n = 106 normotensive controls)., Main Outcome Measures: Univariate analyses (Chi Square, Fisher's Exact) and multivariate logistic regression were conducted to evaluate the association between tSNP genotype distributions and pregnancy outcome in each cohort. Logistic regression models were adjusted for maternal age at delivery, infant sex, parity, smoking during pregnancy, and pre-pregnancy BMI., Results: Although we were unable to replicate our previous SNP-specific findings (ENG rs11792480, rs10121110; TGFβR2 rs6550005; p's > 0.05), we found that genetic variation in TGFβR1[ALK5] (rs6478974) and TGFβR2 (rs11129420, rs6802220, rs1155708, rs3773640, rs3773663) was significantly associated with preeclampsia in the Norwegian cohort and genetic variation in ALK1 (rs706819) and TGFβR2 (rs9843942) was significantly associated with preeclampsia in the Latina cohort., Conclusion: Overall, our results provide further support for the involvement and investigation of the endoglin pathway in preeclampsia., (Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.)

Purpose: Using genotyping data of Mycobacterium tuberculosis isolates from new cases reported to the tuberculosis (TB) surveillance program, we evaluated risk factors for recent TB transmission at both the individual- and neighborhood- levels among U.S.-born and foreign-born populations., Methods: TB cases (N = 1236) reported in Michigan during 2004 to 2012 were analyzed using multivariable Poisson regression models to examine risk factors for recent transmission cross-sectionally for U.S.-born and foreign-born populations separately. Recent transmission was defined based on spoligotype and 12-locus-mycobacterial interspersed repetitive unit-variable number tandem repeat typing matches of bacteria from cases that were diagnosed within 1 year of each other. Four classes of predictor variables were examined: demographic factors, known TB risk factors, clinical characteristics, and neighborhood-level factors., Results: Overall, 22% of the foreign-born cases resulted from recent transmission. Among the foreign-born, race and being a contact of an infectious TB case were significant predictors of recent transmission. More than half (52%) of U.S.-born cases resulted from recent transmission. Among the U.S.-born, recent transmission was predicted by both individual- and neighborhood-level sociodemographic characteristics., Conclusions: Interventions aimed at reducing TB incidence among foreign-born should focus on reducing reactivation of latent infection. However, reducing TB incidence among the U.S.-born will require decreasing transmission among socially disadvantaged groups at the individual- and neighborhood- levels. This report fills an important knowledge gap regarding the contemporary social context of TB in the United States, thereby providing a foundation for future studies of public health policies that can lead to the development of more targeted, effective TB control., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Background: Current methods of self-monitoring kilocalorie intake outside of laboratory/clinical settings suffer from a systematic underreporting bias. Recent efforts to make kilocalorie information available have improved these methods somewhat, but it may be possible to derive an objective and more accurate measure of kilocalorie intake from bite count., Objective: This study sought to develop and examine the accuracy of an individualized bite-based measure of kilocalorie intake and to compare that measure to participant estimates of kilocalorie intake. It was hypothesized that kilocalorie information would improve human estimates of kilocalorie intake over those with no information, but a bite-based estimate of kilocalorie intake would still outperform human estimates., Participants/settings: Two-hundred eighty participants were allowed to eat ad libitum in a cafeteria setting. Their bite count and kilocalorie intake were measured. After completion of the meal, participants estimated how many kilocalories they consumed, some with the aid of a menu containing kilocalorie information and some without. Using a train and test method for predictive model development, participants were randomly divided into one of two groups: one for model development (training group) and one for model validation (test group)., Statistical Analysis: Multiple regression was used to determine whether height, weight, age, sex, and waist-to-hip ratio could predict an individual's mean kilocalories per bite for the training sample. The model was then validated with the test group, and the model-predicted kilocalorie intake was compared with human-estimated kilocalorie intake., Results: Only age and sex significantly predicted mean kilocalories per bite, but all variables were retained for the test group. The bite-based measure of kilocalorie intake outperformed human estimates with and without kilocalorie information., Conclusions: Bite count might serve as an easily measured, objective proxy for kilocalorie intake. A tool that can monitor bite count may be a powerful assistant to self-monitoring., (Copyright © 2016 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

Aim: To determine the prevalence of the use of CAM and spiritual practices in the paediatric oncology population of SE Scotland and to establish both the reasons for their use and the perceived benefits., Methods: A retrospective survey was performed using previously piloted questionnaires. These were distributed to families whose children were <18 years and diagnosed with cancer. Demographic and clinical data were collected, descriptive statistics were used to establish frequencies and univariate associations were established by χ(2) test., Results: Of 169 families approached, 74 (44%) returned completed questionnaires. 41 (55%) families used CAM and 42 (57%) sought spiritual remedies whilst receiving conventional treatment. Higher socioeconomic status was the only factor associated with CAM usage and the most popular therapies were vitamins and minerals (n = 22; 53%), followed by massage (n = 12; 29%) and fish oils (n = 12; 29%). Most families used CAM to reduce stress and, overall, CAM was perceived to be beneficial., Conclusion: The high prevalence of CAM usage in this population highlights the need for physicians to enquire routinely about CAM use and warrants high-quality interventional studies to assess safety and efficacy., Summary: The use of Complementary and Alternative Medicine (CAM) among paediatric patients during cancer treatment is popular worldwide, yet data from the UK are scarce. This study showed that more than half of this Scottish cohort used CAM and that there was an overall positive perception of the effect that these therapies had on the patients. Also, socio-economically advantaged families might be more likely to use CAM in Scotland., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Objectives: Previously preeclamptic women may express cognitive difficulties, which have largely been unappreciated or attributed to stresses of a complicated pregnancy. This study aimed to explore the scope of perceived neurocognitive and psychosocial problems as well as quality of life following preeclampsia., Study Design: Observational study. Through website promotion and e-mail, registrants of the USA-based Preeclampsia Foundation who experienced preeclampsia in the past 20years were invited to complete a web-based survey. Participants were requested to ask an acquaintance that had a normotensive pregnancy to also complete the survey (controls)., Main Outcome Measures: The Cognitive Failures Questionnaire (CFQ), abbreviated WHO Quality Of Life questionnaire (WHOQOL-BREF), Social Functioning Questionnaire (SFQ) and Breslau Short Screening Scale for DSM-IV Posttraumatic Stress Disorder were used in the survey. Analysis was performed using Mann-Whitney U tests and linear regression., Results: 966 cases and 342 controls completed the survey (median age 34, median time since first pregnancy 4 vs. 5years). Cases scored significantly worse on CFQ (median 35 vs. 27), WHOQOL-BREF domains physical health (15 vs. 17), psychological (13 vs. 15), social relationships (13 vs. 15) and environment (15 vs. 16), and SFQ (8 vs. 7). All p<0.001. Multivariable analysis showed an independent significant effect of eclampsia on CFQ and of migraine on all questionnaires and the effect of preeclampsia was still present after adjustment for confounders. Posttraumatic stress symptoms accounted for part of the relationships., Conclusions: Previously preeclamptic women appear to perceive more cognitive and social problems, and report poorer quality of life compared to a group of women with normotensive pregnancies. Research relating to the origin and management of these issues is needed., (Copyright © 2013 International Society for the Study of Hypertension in Pregnancy. Published by Elsevier B.V. All rights reserved.)

Background: Exposure to ambient air pollution is linked to adverse pregnancy outcomes. Previous reports examining the relationship between ambient air pollution and Hypertensive Disorders of Pregnancy have been inconsistent., Objectives: We evaluated the effects of ambient air pollution on the odds of Hypertensive Disorder of Pregnancy and whether these associations varied by body mass index (BMI)., Methods: We conducted a retrospective, case-control study among 298 predominantly Hispanic women (136 clinically confirmed cases) who attended the Los Angeles County+University of Southern California Women's and Children's Hospital during 1996-2008. Trimester-specific carbon monoxide (CO), nitrogen dioxide (NO2), ozone (O3), and particulate matter with aerodynamic diameter <10 μm and <2.5 μm (PM10, PM2.5) exposure were estimated based on 24-hour exposure level at residential address. Logistic regression models were fitted to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for two standard deviation increase in exposure levels., Results: Exposures to CO and PM2.5 in the 1st trimester were significantly associated with Hypertensive Disorders of Pregnancy, and these associations were modified by BMI. In non-obese women (BMI <30), 1st trimester exposures to PM2.5 and CO were significantly associated with increased odds of Hypertensive Disorder of Pregnancy (ORs per 2-standard deviation increase in PM2.5 (7 μg/m(3)) and CO (1 ppm) exposures were 9.10 [95% CI: 3.33-24.6] and 4.96 [95% CI: 1.85-13.31], respectively). Additionally, there was a significantly positive association between exposure to O3 in the 2nd trimester and Hypertensive Disorder of Pregnancy (OR per 15 ppb=2.05; 95% CI: 1.22-3.46)., Conclusion: Among non-obese women, 1st trimester exposure to PM2.5 and carbon monoxide are associated with increased odds of Hypertensive Disorder of Pregnancy., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Background: Previous evidence indicated that incidence rates of non-Hodgkin's lymphoma (NHL) are high in Egypt although little is known about risk factors., Materials and Methods: Using data from the population-based cancer registry of Gharbiah governorate in Egypt, we assessed the 1999-2005 incidence of hematopoietic cancers (HCs) based on the ICD-O3 by age- and sex-specific urban-rural distribution., Results: NHL showed the highest incidence among all HCs (11.7 per 100 000). Urban incidence of HCs was higher than rural incidence. Incidence rates of Hodgkin's lymphoma (HL) and NHL were high especially among urban males up to the 64-year age category. Rural incidence of HL and NHL was high below age 20. Among the districts of the governorate, we observed NHL incidence pattern similar to that observed for hepatocellular carcinoma because of the possible link to hepatitis C virus for both cancers. Comparison to the published HCs data from Algeria, Cyprus, and Jordan showed the highest NHL rate in Egypt than the other countries in the region., Conclusions: Future studies should define the role of environmental exposures in hematopoietic carcinogenesis in this population. In-depth studies should also investigate the role of access to health care in the urban-rural variation of HC distribution in this population.

Although Leishmania major is endemic in parts of the Sinai of Egypt, the ecology and distribution of Leishmania sand fly vectors in southern Sinai has not been well characterized. Accordingly, additional sand fly samples were obtained at 41 sites in the southern Sinai region during 1996-1997, and analyzed to improve the characterization of risk of sand fly-borne pathogens. Using a Geographic Information System (GIS), species-specific spatial distributions that might suggest zoonotic cutaneous leishmaniasis (ZCL) risk areas were determined in relation to contextual environmental factors, including geology, hydrogeology, climate variables and elevation. Southern Sinai was characterized by a diverse sand fly fauna (eight Phlebotomus species), probably attributable to highly variable landscape and environmental factors. Phlebotomus alexandri, Phlebotomus kazeruni and Phlebotomus sergenti were widespread and abundant, Phlebotomus papatasi and Phlebotomus bergeroti were less frequent, and Phlebotomus arabicus, Phlebotomus major and Phlebotomus orientalis had highly restricted distributions. Logistic regression models indicated that elevation and climatic conditions were limiting determinants for the distributions of sand flies in southern Sinai. Based on the predicted distribution of P. papatasi, a recognized vector of L. major, about one-quarter of southern Sinai may be at high risk of ZCL. Risk areas for the suspected ZCL vector P. bergeroti had a more patchy distribution. Results suggest that future studies should include other factors related to vector abundance, vector competence, human population, and parasite and reservoir host(s) to produce more comprehensive ZCL transmission risk maps, thus helping in planning effective prevention and control strategies., (Copyright © 2012 Elsevier B.V. All rights reserved.)

Introduction: Pregnancies complicated by hypertensive disorders of pregnancy (HDP) can result in adverse perinatal outcomes leading to additional and unexpected levels of stress for the families involved., Objectives: Our primary aim was to examine if HDP is associated with posttraumatic stress disorder (PTSD)., Methods: We analyzed data collected through an online survey by the Preeclampsia Foundation on PTSD symptoms using the Breslau Short Screening Scale for DSM-IV. We compared participant characteristics between women with and without PTSD using chi-square tests for discrete variables and t-tests for continuous variables. Univariate and multivariable logistic regression analyses were used to examine the outcome of PTSD and identify possible risk factors associated with HDP., Results: We surveyed 1448 women (1076 HDP, 372 controls). After adjusting for psychiatric illness or mood disorder, parity, and age at affected pregnancy, we found that women with HDP were more than four times as likely to screen positive for PTSD (OR = 4.64, 95% CI: 3.37-6.39) when compared to women without HDP. Additionally, we found that PTSD symptoms increase with severity of HDP. When stratifying by severity, we found that women with gestational hypertension and preeclampsia were three and a half times more likely (OR=3.45, 95% CI: 1.70-7.00 and OR=3.48, 95% CI: 2.45-4.96, respectively); women with hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome were nearly six times as likely (OR=5.76, 95% CI: 3.97-8.36), and women with eclampsia were almost ten times as likely to screen positive for PTSD (OR=9.76, 95% CI: 5.45-17.49) when compared to women without HDP., Conclusion: Pregnancies complicated by HDP are associated with increased risk of PTSD, with risk of PTSD increasing as severity of HDP increases. Medical practitioners should be aware of this association and consider screening women with HDP for signs of PTSD at their first postpartum visit. Those who screen positive could then be referred for a confirmatory diagnosis and, if needed, subsequent supportive care., (Copyright © 2012. Published by Elsevier B.V.)

Purpose: This study explored factors associated with self-reported bullying among adolescents in a sub-Saharan country., Methods: A cross-sectional sample of adolescents (n = 1,427) in the Seychelles was drawn from the Global School-based Student Health Survey. Bullied adolescents were compared with non-bullied adolescents with respect to several sociodemographic factors. Bivariate and multivariate analyses were performed., Results: Within a 30 day period, 38.8% of adolescents reported being bullied. Bullied youths were more likely to be depressed (adjusted odds ratio [aOR] = 1.63; confidence intervals [CI] = 1.27-1.07) and socially deprived (aOR = 1.85; CI = 1.30-2.61). Being older (aOR = .83; CI = .77-.90) and having close friends (aOR = .53; CI = .31-.91) were protective factors., Conclusions: The prevalence of bullying in the Seychelles is high, and social correlates are similar to those in industrialized settings. More research is needed to examine bullying patterns outside the school environment., (Copyright © 2012 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

The last decade has seen an increase in investment and concerted efforts by the Malawi Ministry of Health and partners to control malaria disease. This report summarizes what is known about the burden of malaria and the strategies being implemented to control it in Malawi. Over the past 5 years, roll out of treatment and prevention efforts have been successful in the country, as demonstrated by increased use of insecticide treated nets, improved access to prompt and effective treatment and the initiation of pilot studies of indoor residual spraying. However, unlike other countries in the region, the recent data have not suggested a decrease in the burden of disease. We describe the environment in which the activities of Malawi's International Center for Excellence in Malaria Research (ICEMR) will be carried out and provide the rationale for the clinical, entomological and molecular studies. Our approach is to establish consistent, stainable data collection systems that are embedded within the public health sector. Through standardized and long-term studies of hosts, parasites and vectors, we hope to contribute to assessment of malaria disease burden, the appropriate application of interventions and policies and provide both the data collection and the health care infrastructure to ultimately eliminate the disease., (Copyright © 2011 Elsevier B.V. All rights reserved.)

Malaria control in the impoverished, highly endemic settings of sub-Saharan Africa remains a major public health challenge. Successes have been achieved only where sustained, concerted, multi-pronged interventions have been instituted. As one of the world's poorest countries, Malawi experiences malaria incidence rates that have remained high despite a decade of gradually expanding and more intensive prevention efforts. The Malawi International Center for Excellence in Malaria Research (ICEMR) is beginning work to augment the knowledge base for reducing Plasmodium transmission and malaria morbidity and mortality. Among ICEMR goals, we intend to better assess patterns of infection and disease, and analyze transmission by Anopheles vector species in both urban and rural ecological settings. We will evaluate parasite population genetics and dynamics, transmission intensities and vector ecologies, social and environmental determinants of disease patterns and risk, and human-vector-parasite dynamics. Such context-specific information will help to focus appropriate prevention and treatment activities on efforts to control malaria in Malawi. In zones of intense and stable transmission, like Malawi, elimination poses particularly thorny challenges - and these challengers are different from those of traditional control and prevention activities. Working toward elimination will require knowledge of how various interventions impact on transmission as it approaches very low levels. At present, Malawi is faced with immediate, context-specific problems of scaling-up prevention and control activities simply to begin reducing infection and disease to tolerable levels. The research required to support these objectives is critically evaluated here., (Copyright © 2011 Elsevier B.V. All rights reserved.)

Objective: To describe urban-rural differences in breast cancer incidence in Gharbiah, Egypt and to investigate if these differences could be explained by known risk factors of breast cancer., Methods: We used data from the population-based cancer registry of Gharbiah, Egypt to assess breast cancer incidence from 1999 through 2006. The Egyptian census provided data on district-specific population, age, and urban-rural classification. Incidence patterns of breast cancer by district and age-specific urban-rural differences were analyzed., Results: Overall, incidence rate of breast cancer was three to four times higher in urban areas than in rural areas (60.9/10(5)-year for urban areas versus 17.8/10(5)-year for rural areas; IRR=3.73, 95% CI=3.30, 4.22). Urban areas had consistently higher incidence of breast cancer across all age-groups for all years. Higher incidence of breast cancer was also seen in the more developed districts of Tanta and El-Mehalla., Conclusions: Higher incidence of breast cancer in urban and more developed populations might be related to higher exposure to xenoestrogens, as well as other endocrine disruptors and genotoxic substances., (Copyright © 2010 Elsevier Ltd. All rights reserved.)

Bladder cancer is the most common malignancy among Egyptian males and previously has been attributed to Schistosoma infection, a major risk factor for squamous cell carcinoma (SCC). Recently, transitional cell carcinoma (TCC) incidence has been increasing while SCC has declined. To investigate this shift, we analyzed the geographical patterns of all bladder cancers cases recorded in Egypt's Gharbiah Population-Based Cancer Registry from 1999 through 2002. Data on tumor grade, stage, and morphology, as well as smoking, community of residence, age and sex, were collected on 1209 bladder cancer cases. Age-adjusted incidence rates were calculated for males, females, and the total population for the eight administrative Districts and 316 communities in Gharbiah. Incidence Rate Ratios (IRR) and 95% confidence intervals (CI) were computed using Poisson Regression. The male age-adjusted incidence rate (IR) in Gharbiah Province was 13.65/100,000 person years (PY). The District of Kotour had the highest age-adjusted IR 28.96/100,000 among males. The District of Kotour also had the highest IRR among all Districts, IRR=2.15 95% CI (1.72, 2.70). Kotour's capital city had the highest bladder cancer incidence among the 316 communities (IR=73.11/100,000 PY). Future studies on sources and types of environmental pollution and exposures in relation to the spatial patterns of bladder cancer, particularly in Kotour District, may improve our understating of risk factors for bladder cancer in the region.

Objective: We sought to determine whether polymorphisms in the transforming growth factor (TGF)-beta3 gene are associated with risk of pregnancy-induced hypertension (PIH) in case-control mother-baby dyads., Study Design: Patients (n = 136) and control subjects (n = 169) were recruited from our hospital. We genotyped 4 TGF-beta3 polymorphisms and examined association with PIH using logistic regression, adjusting for parity, maternal age, gestational age at delivery, fetal (or maternal) genotypes for the polymorphism in question, and the 3 other polymorphisms within the TGF-beta3 gene., Results: Only 1 of the TGF-beta3 polymorphisms (rs11466414) was associated with PIH. Mothers who carried a baby with a minor allele were at decreased risk (odds ratio(multi-locus adj), 0.32; 95% confidence interval, 0.14-0.77). Maternal TGF-beta3 variants had no effect on risk of PIH., Conclusion: A fetal TGF-beta3 polymorphism (rs11466414) is associated with PIH in a predominantly Hispanic population.

Background: Combined oral contraceptive (COC) formulations with 20 mcg ethinyl estradiol (EE) have a greater incidence of ovarian hormone production and follicular development, which can be managed by shortening the number of hormone-free days per COC cycle. This study evaluates differences in follicular development during a 7-day versus 4-day hormone-free interval in a COC regimen with 20 mcg EE and 1 mg norethindrone acetate., Study Design: Forty-one healthy women were randomized in an open-label fashion to this formulation in either a 24/4 or a 21/7 day regimen for three cycles. Estradiol, progesterone, follicle-stimulating hormone, luteinizing hormone and inhibin B were measured daily from Cycle 2, Day 21 to Cycle 3, Day 3 and on Day 7 of Cycle 3. Follicular diameter and Hoogland score were calculated on Cycle 2, Days 21, 24 and 28 and Cycle 3, Days 3 and 7., Results: Sixty-six percent of subjects in the 21/7 group and 70% of the subjects in the 24/4 group developed a follicle greater than 10 mm diameter. Ovarian steroid hormone levels, Hoogland scores and bleeding patterns were not statistically significant between the groups., Conclusion: In contrast to prior studies, this analysis suggests no difference in follicle development or bleeding patterns among women receiving a 21/7 or 24/4 regimen of a 20-mcg EE/1-mg norethindrone acetate COC.

Recent El Niño events have emphasized the need to develop modelling techniques to assess climate-related health events. Experts agree that climate changes affect the spread of infectious diseases and that the geographic range of infectious diseases may expand as a result of these changes. Nevertheless, the world health modelling community cannot yet predict, with reasonable accuracy, when or where exactly these effects will occur or how large the threat of these diseases will be to particular populations. This study compared the spatiotemporal patterns of influenza mortality risk in the state of California during El Niño vs normal weather periods. By applying a stochastic methodology to county-specific mortality data, various sources of uncertainty were accounted for, and informative influenza mortality maps and profiles were generated. This methodology enabled the detection of significant effects of climate change on the influenza risk distributions. Geographical maps of risk variation during El Niño differed from those during normal weather, the corresponding covariances exhibited distinct space-time dependence features, and the temporal mean mortality profiles were considerably higher during normal weather than during El Niño. These rather unexpected results of spatiotemporal analysis are worth further investigation that seeks substantive and biologically plausible explanations. The findings of this study can offer a methodological framework to evaluate public health management strategies.

West African sheep appear to play a central role as virus hosts in the maintenance cycle of Crimean-Congo haemorrhagic fever (CCHF) virus in endemic areas and also because of their role as a principal host of the CCHF virus tick vector. In an effort to clarify CCHF epidemiological significance in sheep, we studied the biological and clinical aspects of sheep experimentally infected with CCHF virus. West African sheep breeds were infected either by intraperitoneal inoculation or by infestation with experimentally CCHF-virus-infected ticks (Hyalomma truncatum). A total of 17 sheep including controls as well as 5 lambs from their progeny were monitored. A moderate but constant fever was observed (39.7 degrees C +/- 0.3) which correlates with the viraemia. Virus was reisolated from blood samples taken from day 3 to day 9 postinfection (p.i.) at a mean titre of 3.3 log LD50/ml. The virus was detected for a period of time of 7 days in non-immune sheep and for less than 4 days in previously immunized sheep. In non-immune sheep, antibody detected by ELISA showed an IgM response on day 7 p.i., followed by an IgG response one day later. Five infected sheep, surveyed for liver and kidney biological markers, showed hepatic dysfunction with a moderate serum aspartate transferase rise to 210 U/l. Out of four sheep tested for blood markers, two showed an abnormal blood cell count, with marked neutrophilia of up to 63% lasting for two weeks. Infected pregnant ewes produced antibodies in their milk at a significant titre (1:1,000), and antibodies were recovered in the sera of nursing lambs from their first meal to 50 days after birth. These findings are discussed; they demonstrate that, in spite of a high turnover of local sheep herds (median age of 3 years) and long-term CCHF antibody persistence (> 3 years), sheep can be infected and efficiently transmit the virus at least once in a lifetime.

Polo-like kinase (Plk) is the mammalian homologue of the Drosophila polo and Saccharomyces cerevisiae CDC5 genes, which are thought to be involved in regulating chromosomal segregation. Previously, we showed that transient ectopic expression of Plk could induce DNA synthesis in quiescent NIH 3T3 cells, suggesting that Plk might also have a function during G1 or S phase. Here we report that microinjection of Plk mRNA is sufficient to drive quiescent cells into mitosis and that constitutive expression of Plk in NIH 3T3 cells causes oncogenic focus formation. These transformed cells grow in soft agar and form tumors in nude mice. Because Plk expression has been shown to be high in various human tumors, we suggest that Plk may contribute to the promotion and/or progression of human cancers.

Changes in virulence of Crimean-Congo haemorrhagic fever (CCHF) virus toward intracerebrally inoculated suckling mice (SM) were studied in relation to different host-passage histories. Two CCHF virus strains, one isolated from a human and the other from a tick, were passaged through various vertebrate and tick hosts and then reisolated and tested for their virulence toward SM. In various experiments, SM were inoculated with 12 different viral suspensions, each having a specific passage history. Survival curves of SM, which may reflect differences in viral strain characters, were established using an actuarial life table; differences were evaluated with the log-rank test. Regardless of the origin of the strain, CCHF viruses exhibited pathogenicity when passaged among SM. However, virulence, as measured by the proportion of deaths in SM, was altered following passage through another vertebrate host or tick. The final host seems to have a major influence on virulence. Because CCHF virus strains appear to vary little in their antigenic characters, it is hypothesized that hosts can induce phenotypic changes that modulate viral virulence.

Male Hyalomma truncatum ticks were inoculated with Crimean-Congo haemorrhagic fever (CCHF) virus, hypostomectomized and then allowed to mate with uninfected females feeding on a naive rabbit. After mating, CCHF virus was reisolated from 2 out of 3 males tested and from 4 of 6 mated, engorged females (titre greater than or equal to 2.2 log LD50/ml). Vertical transmission was then demonstrated by virus reisolation from a portion of 2 of the 6 batches of eggs laid by the positive females. From these 2 positive egg batches, 6 larvae pools were tested with successful virus reisolation from one. Attempts to reisolate CCHF virus from 15 nymph pools of this positive batch of larvae were unsuccessful. Virus reisolation from gonopore-closed female H. truncatum which cofed with preinfected males demonstrated transmission in the absence of copulation. Rabbits that served as bloodmeal sources seroconverted after infestation by infected male ticks. However, CCHF virus was not reisolated from 3 gonopore-closed, engorged females, nor from their eggs, after feeding with hypostomectomized preinfected males. Transmission of CCHF virus during mating or cofeeding of adult H. truncatum, and subsequent transovarial transmission, appear to represent additional mechanisms of infection in the tick population, and may contribute to the maintenance of transmission in nature.

The kinetics of the replication of the Crimean-Congo haemorrhagic fever virus (CCHFV) was studied in intra-anally inoculated adult Hyalomma truncatum and Amblyomma variegatum ticks. The virus was re-isolated by suckling mouse inoculation and revealed by antigen capture with ground ticks and indirect immunofluorescence of haemolymph. The virus was detected in ticks in the first hours post-inoculation (p.i.) and its replication was observed from 36 h p.i. onwards. Virus titre reached a maximum within 3-5 days then decreased slowly to a level of at 2 log LD50/ml for several months until the end of observations. Several specific, non-identified factors seem to favour CCHFV replication in H. truncatum. Long-term virus persistence seems to occur in CCHFV-infected adult ticks.

Crimean-Congo haemorrhagic fever (CCHF) virus was inoculated into West African sheep that were simultaneously infested with adult Hyalomma truncatum ticks. Certain sheep developed a viraemia and antibodies, indicating virus infection and replication; however, the length and magnitude of the viraemia and serological responses corresponded to the animals' immunological status. Tick attachment and feeding was not influenced by sheep infection. CCHF virus infection was acquired by 11-33% of female and 0-60% of male ticks. Infection in the ticks did not influence their feeding success, as judged by weight at drop-off, and the weight of eggs produced by infected and non-infected ticks was similar. Transovarial transmission of CCHF virus was demonstrated in 2 of 12 (17%) egg batches from infected female ticks, but in none of 19 egg batches from ticks that tested negative for CCHF virus. Our results suggest that under certain ecological conditions, sheep may serve to amplify CCHF virus in nature through horizontal transmission and that the maintenance cycle also may be influenced by transovarial transmission to the next generation of ticks.

A total of 1,715 randomly selected sheep and goat sera from Senegal were tested for antibodies against Rift Valley fever virus using an enzyme-linked immunosorbent assay. The results showed that Rift Valley fever is enzootic. The prevalence is highly heterogeneous, depending on the area. Sheep and goats expressed comparable antibody prevalence, suggesting that both are involved equally in the virus cycle.

Severe haemorrhagic disease among the human population of the Senegal River Basin brought the Rift Valley fever virus (RVFV) outbreak of 1987 to the attention of science. As in previous RVFV outbreaks, local herdsmen reported a high incidence of abortion and disease in their livestock. Serum samples were obtained from domestic animal populations from areas near Rosso, the best studied focus of human infection, as well as other areas distant from known human disease. Among animals from the area of high incidence of human disease, antibody prevalence was as high as 85%, with approximately 80% of the sera positive for both RVFV IgG- and viral-specific IgM antibodies. In contrast, human populations in the same area had lower RVFV antibody prevalences, 40% or less, with 90% also being IgM-positive. Sera from livestock in coastal areas 280 km south of the epidemic area were negative for RVFV antibodies. Thus, the detection of RVFV specific IgG and IgM antibodies provided evidence of recent disease activity without the requirement to establish pre-disease antibody levels in populations or individuals and without viral isolation. Subsequently, detection of modest levels of IgG and IgM in the Ferlo region, 130 km south of the Senegal River flood plain, established that RVFV transmission also occurred in another area of the basin. Similar serological testing of domestic ungulates in The Gambia, 340 km south of Rosso, demonstrated antibody prevalence consistent with a lower level of recent transmission of RVFV, i.e., 24% IgG-positive with 6% of the positive sera also having RVFV-specific IgM.

A rapid quantitative method is described for determining 3-fluorotyrosine incorporation into proteins. Derivatives of tyrosine and 3-fluorotyrosine with o-phthalaldehyde are well separated from one another by a reverse-phase high-performance liquid chromatography system used for routine analyses of o-phthalaldehyde-amino acid derivatives. Since both amino acids are well resolved from all other derivatized amino acids, the method is useful for amino acid analyses of proteins. Determination of the fluorotyrosine content of proteins by this method involves a single separation step, is reproducible, and requires no corrections for stability or yield. Further, the o-phthalaldehyde derivatives of 5-fluorotryptophan, 2-fluorophenylalanine, 3-fluorophenylalanine, and 4-fluorophenylalanine can also be resolved. The method may be generally applicable to fluorinated aromatic amino acid-labeled proteins that are studied structurally and dynamically by nuclear magnetic resonance.