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Background The annual influenza vaccination is recommended for all front-line healthcare workers in the UK and is a crucial way of reducing mortality for vulnerable patient groups. However, to date the UK government has never explicitly monitored influenza vaccine uptake in medical students. This is important to ascertain, as students regularly move between clinical areas and are both a perfect vector for the spread of influenza and at an increased risk of contracting influenza themselves. Aims This service evaluation was designed to evaluate the effectiveness of an influenza vaccination programme in one UK medical school and make recommendations to increase vaccination rates in the future. Methods This service evaluation collected data about medical student uptake of influenza vaccination in one UK medical school. Two hundred and fifty-one students at different course stages completed questionnaires, answering questions on vaccination status and Likert-scale 'belief' questions to assess the subjective reasons behind vaccine refusal. Results There was a substantial difference between year group cohorts (~20%), with significantly higher vaccination rates in the preclinical year group. Two significant negative predictors of vaccination were found (P < 0.001), related to scepticism over the effectiveness of the vaccine and lack of convenient access to the vaccination. Results indicated that integrating information about the influenza vaccine into the curriculum would reduce lack of knowledge over the efficacy of the vaccine. The centralization of vaccination programmes at mandatory university-based learning events would mitigate against the problem of diversity of vaccination locations and lack of central accountability. Conclusions The results of this service evaluation provide significant predictors of vaccination status for medical students and potential occupational health interventions to improve vaccine uptake in this group. [ABSTRACT FROM AUTHOR]

Meat color is considered one of the driving factors in consumer purchasing decisions. The objective of this study was to determine the impact of 2 different lighting sources on color and lipid oxidation of ground beef patties in a controlled environment. USDA Select top rounds (n = 20) were processed to produce ground beef at 2 different fat levels (5 and 25%) and made into patties (113.4 g). Patties were packaged with oxygen permeable polyvinyl chloride, assigned to one of three lighting treatments (low UV fluorescent [FLO], light emitting diode [LED], and no light [DRK, negative control]), and placed within deli cases at 5°C. Patty removal for evaluation occurred on retail display d 1, 3, 5, and 7. Objective color measurements were obtained using a HunterLab MiniScan 45/0 LAV. These values were utilized to determine myoglobin redox forms as a measure of myoglobin oxidation. Additionally, thiobarbituric acid reactive substances (TBARS) were measured to indicate lipid oxidation. Objective color measurement for a* (redness), decreased for all light treatments by retail display day (P < 0.0001). Oxymyoglobin values for all light treatments decreased daily but showed no differences between treatments until d 5 (P < 0.0001) where DRK > LED > FLO. Conversely, metmyoglobin values increased daily (P < 0.0001), but showed no differences between treatments until d 5 where FLO > LED > DRK. TBARS values increased by day for each fat percentage (P < 0.0001) with 5% fat patties having higher TBARS values indicating great oxidation occurring in the phospholipids than adipose tissues. Results indicate that light treatment affected discoloration and metmyoglobin formation in ground beef patties; LED lighting may lead to increased meat quality shelf life in a retail setting. [ABSTRACT FROM AUTHOR]

Choice feeding is often used to investigate an animal's nutritional requirements and dietary preferences. A problem with this approach is that animals with long gut transit times, such as the horse, may find it difficult to associate a chosen food with its nutritional consequence when alternative foods are presented simultaneously. One solution is to present foods singly for a period of time before a simultaneous choice session to allow the development of learned associations. This method was used to determine if horse's voluntary intake and feeding behavior was influenced by the macronutrient composition of the diet. Seven stabled horses, maintained on a low intensity exercise regimen, were allowed, on an ad libitum basis, haylage and 3 isocaloric forage based diets that were rich in 1 of 3 macronutrients (protein, lipid, and hydrolyzable carbohydrate). Initially, diets were presented as a 3-way choice for 5 d (self-selection a [SSa]), then singly (monadic phase) with exposure to each diet for 2 separate periods of 3 d each, and finally again as a choice for 5 d (self-selection b [SSb]). The total amount of trial diet offered differed with trial phase, with 2 to 2.5% of BW during SSa and the monadic phase, increasing to ad libitum access during SSb. To control differences in the total amount of trial diet offered, 2 measurements of voluntary intake were taken at 4 and 22 h postpresentation. Daily macro-nutrient and energy intakes were estimated from proximate analysis of the trial diets and batches of haylage fed. Feeding behavior was observed over a single 4-h period during both self-selection phases. Horses showed no initial preference after 4 h for any 1 diet during SSa. Following the monadic phase, horses demonstrated a preference for the protein and hydrolyzable carbohydrate rich diets over the lipid rich diet (P < 0.001). Dietary experience modified foraging behavior as the total number of visits to the diets decreased during SSb (P < 0.005). Analysis of 24 -h macronutrient consumption showed that protein and hydrolyzable carbohydrate intake increased during SSb, whereas lipid intake remained constant over both self-selection phases (P < 0.001). These data indicate for perhaps the first time that horses can respond to dietary macronutrient content and that single presentations during choice studies facilitates expression of dietary preferences. [ABSTRACT FROM AUTHOR]

The collared peccary (Pecari tajacu) is a social species that recently has expanded its historical range, yet little is known of its dispersal behavior at the population or biogeographic level. We used autosomal and cytoplasmic markers to assess whether the genetic variation among 4 populations in Texas retains a signal of historically recent founding events. Genetic differentiation based on mitochondrial DNA (mtDNA) haplotype frequencies (FST) among these 4 populations was substantial. The mtDNA haplotype mismatch distributions indicate that P. tajacu recently has expanded its range across Texas; however, microsatellite-based standard analyses of molecular variance (AMOVAs) and pairwise FST estimates indicated little variation among populations, suggesting that dispersal is accomplished primarily by males. We also tested the alternative power of mtDNA haplotype or microsatellite genotype distribution patterns to detect a sex bias in instantaneous short-distance dispersal. Sex-specific hierarchical AMOVAs of mtDNA haplotype distributions (based on data from the most genetically diverse population) yielded significantly larger female-specific fixation index values compared to males, indicating a male instantaneous dispersal bias; however, variation in microsatellite frequency distribution was not partitioned in a sex-specific manner. Also, when sex-specific pairwise FST/(1 2 FST) among herds was regressed against the log of the distance between each pair of herds, we found no significant effect of distance for either sex and no sex-specific difference using other microsatellite-based analyses (mean sex-specific relatedness, r, or FST). We conclude that sampling scale limits microsatellite-based methods of detecting instantaneous dispersal sex bias, especially when gene flow is substantial and microsatellite polymorphism is modest (,20 alleles/locus). These results indicate that mtDNA can be used to infer instantaneous dispersal behavior for both sexes in cases where microsatellites have proven insufficient. [ABSTRACT FROM AUTHOR]

The article presents a study which seeks to correlate clinical events such as surgery and death with the growth rate of abdominal aortic aneurysms (AAAs). Several factors that contribute to the prevalence of the disease including hypertension, hypercholesterolaemia, and diabetes are taken into consideration. It mentions that a growth rate of at least 2 millimeters annually posed significant connections with clinical events. Moreover, the study has recorded a bimodal growth pattern for AAA.

Simulation for medical and healthcare applications, although still in a relatively nascent stage of development, already has a history that can inform the process of further research and dissemination. The development of mannequin simulators used for education, training, and research is reviewed, tracing the motivations, evolution to commercial availability, and efforts toward assessment of efficacy of those for teaching cardiopulmonary resuscitation, cardiology skills, anaesthesia clinical skills, and crisis management. A brief overview of procedural simulators and part-task trainers is also presented, contrasting the two domains and suggesting that a thorough history of the 20+ types of simulator technologies would provide a useful overview and perspective. There has been relatively little cross fertilisation of ideas and methods between the two simulator domains. Enhanced interaction between investigators and integration of simulation technologies would be beneficial for the dissemination of the concepts and their applications. [ABSTRACT FROM AUTHOR]

The exchange of chemical signals between soil bacteria (rhizobia) and legumes has been termed a molecular dialogue. As initially conceived in the early 1990s, it involved two main groups of molecules: nod gene-inducing flavonoids from plants and the mitogenic lipochito-oligosaccharide Nod factors of rhizobia. This review considers how subsequent research revealed the existence of a more complex set of interactions, featuring expanded roles for the original participants and contributions from additional plant and bacterial metabolites. Rhizobia respond to chemoattractants and growth-enhancing compounds in root exudates, and several plant nonflavonoids possess nod gene-inducing properties. Expression of non- nod genes is induced by flavonoids; these include encoders of a type I secreted protein and the entire type III, and possibly also type IV, secretion systems. Many other genes and proteins in rhizobia are flavonoid-inducible but their functions are largely unknown. Rhizobia produce far more Nod factor variants than was previously envisaged and their structures can be influenced by the pH of the environment. Other symbiotically active compounds or systems of rhizobia, some of them universally present, are: the surface polysaccharides, quorum-sensing N-acyl homoserine lactones, plant growth-promoting lumichrome and two-component regulatory systems. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article about metastatic calcinosis cutis.

Purpose: Proton pump inhibitors (PPIs), one of the most widely used medications, are commonly used to suppress several acid-related upper gastrointestinal disorders. Acid-suppressing medication use could be associated with increased risk of community-acquired pneumonia (CAP), although the results of clinical studies have been conflicting.Data Sources: A comprehensive search of MEDLINE, EMBASE and Cochrane library and Database of Systematic Reviews from the earliest available online year of indexing up to October 2018.Study Selection: We performed a systematic review and meta-analysis of observational studies to evaluate the risk of PPI use on CAP outcomes.Data Extraction: Included study location, design, population, the prevalence of CAP, comparison group and other confounders. We calculated pooled odds ratio (OR) using a random-effects meta-analysis.Results Of Data Synthesis: Of the 2577 studies screening, 11 papers were included in the systematic review and 7 studies with 65 590 CAP cases were included in the random-effects meta-analysis. In current PPI users, pooled OR for CAP was 1.86 (95% confidence interval (CI), 1.30-2.66), and in the case of recent users, OR for CAP was 1.66 (95% CI, 1.22-2.25). In the subgroup analysis of CAP, significance association is also observed in both high-dose and low-dose PPI therapy. When stratified by duration of exposure, 3-6 months PPIs users group was associated with increased risk of developing CAP (OR, 2.05; 95% CI, 1.22-3.45). There was a statistically significant association between the PPI users and the rate of hospitalization (OR, 2.59; 95% CI, 1.83-3.66).Conclusion: We found possible evidence linking PPI use to an increased risk of CAP. More randomized controlled studies are warranted to clarify an understanding of the association between PPI use and risk of CAP because observational studies cannot clarify whether the observed epidemiologic association is a causal effect or a result of unmeasured/residual confounding. [ABSTRACT FROM AUTHOR]

Meat oxidation is caused by several factors including light source, oxygen incorporation during grinding, and degree of fat saturation. The objective of this study was to determine the impact of fat percentage on color and lipid oxidation in ground beef. Subcutaneous fat was removed from top rounds (n = 20), which were ground to produce patties (113.4 g) with either 5 or 25% fat. No additional fat was added to patties containing 5% fat. Subcutaneous fat from each top round was added back to achieve 25% fat content. Patties were packaged in Styrofoam trays with oxygen-permeable overwrap and then assigned into deli cases (5°C) with one of three lighting conditions: low UV fluorescent, light emitting diode (LED), or no light (negative control). Patties were removed from storage on d 1, 3,5, and 7 for evaluation of objective color measurements L*, a*, and b* and lipid oxidation determination by thiobarbi-turic acid reactive substances (TBAR). Myoglobin states were calculated using selected wavelengths. Means were separated using GLIMMIX on SAS. Patties with 5% fat had greater a* values (P < 0.05) than 25% for storage d 1, 3, and 7; the exception was Day 5 where there was no difference (P > 0.05). Metmyoglobin (MMb) percentage increased by storage day for both 5 and 25% fat with a difference (P < 0.05) on Day 7 of storage where patties with 25% fat had a greater percentage (45.28) MMb than patties with 5% fat (44.14). Conversely, oxymyoglobin (Mb02) percentage decreased by storage day for both 5 and 25% fat with a difference (P < 0.05) on Day 7 of storage where 5% fat patties had a greater Mb02 percentage (53.71) than patties with 25% fat (52.43). TBAR values increased by day for each fat percentage (P < 0.0001). After storage Day 1 (P > 0.05), means were consistently lower (P < 0.05) on storage Day 3, 5, and 7 for patties with 25% fat. Data from this study confirmed that the phospholipid membrane layer plays a larger role in lipid oxidation than additional added subcutaneous fat in ground beef. [ABSTRACT FROM AUTHOR]

Meat color is the most important factor that drives consumer purchasing decisions. The objective of this study was to determine the impact of 2 different light sources on oxidation that causes color change in ground beef from the conversion of oxymyoglobin (Mb02) to metmyoglobin (MMb) in a controlled environment. Top rounds (n = 20) were ground at 2 different fat levels (5 and 25%) and made into patties (113.4 g). Patties were assigned to 1 of 3 lighting treatments (low UV fluorescent, Light Emitting Diode [LED], and no light [negative control]) within temperature controlled deli cases at 5°C Patties were removed on storage d 1, 3, 5, and 7 of storage. Utilizing a Hunter MiniScan 4500L, objective color measurements L*, a*, and b* were utilized to determine relative myoglobin variant concentrations as a measure of myoglobin oxidation. Means were separated using the GLIMMIX function of SAS with differences determined at P < 0.05. Objective color measurement for redness, a*, decreased for all light treatments by storage day (P < 0.0001) where storage Day 1 > 3 > 5 > 7, respectively. Oxymyoglobin values for all light treatments decreased daily (P < 0.0001) but showed no differences among treatments until d 5 where no light > LED > FLO with means of 57.52, 56.75, and 55.94%, respectively. Inversely, MMb values increased daily (P < 0.0001) but showed no differences among treatments until d 5 where FLO > LED > no light with means of 41.70,40.10, and 38.96%, respectively. In this study, no light was the superior display lighting; however, on storage d 5 LED had more desirable Mb02 and less MMb than LED. Indicating that LED a* and Mb02 values were more similar to patties treated with no light than FLO treated patties. [ABSTRACT FROM AUTHOR]

Background: Glutathione S-transferase M1 (GSTM1) is active in the detoxication of a number of carcinogens, including polyaromatic hydrocarbons, such as those present in cigarette smoke. In about 30%-55% of individuals, depending on the ethnic group, there is a virtual absence of GSTM1 enzyme activity due to deletion of both copies of the GSTM1 gene (GSTM1 null genotype). This genetic polymorphism of the GSTM1 gene locus has been proposed as a risk factor for lung cancer. However, results across studies are inconsistent.Purpose: We conducted a case-control study of patients with incident lung cancer and population control subjects to examine the association between homozygous deletion of the GSTM1 gene and lung cancer risk among African-Americans and Caucasians.Methods: At 35 hospitals in Los Angeles County, California, we identified patients with a first diagnosis of lung cancer between September 1, 1990, and January 6, 1994. Of the 859 potentially eligible case patients, 207 had died by the time their physicians had received our request for permission to contact them. We enrolled 356 eligible case patients (167 African-Americans and 189 Caucasians) and 731 eligible control subjects (258 African-Americans and 473 Caucasians, all residents of Los Angeles County). Samples of white blood cell DNA sufficient for determination of the GSTM1 genotype by a polymerase chain reaction-based assay were obtained from 342 case patients and 716 control subjects. The odds ratios (ORs) and 95% confidence intervals (CIs) for lung cancer associated with homozygous deletion of the GSTM1 gene, in total and after stratification by a number of relevant characteristics, were estimated by logistic regression analysis.Results: For patients with all lung cancers combined, the GSTM1 null genotype was associated with an OR of 1.29 (95% CI = 0.94-1.77). The OR was similar among African-Americans (OR = 1.20; 95% CI = 0.72-2.00) and Caucasians (OR = 1.37; 95% CI = 0.91-2.06). The association was strongest for squamous cell carcinoma (OR = 1.57; 95% CI = 0.93-2.63). We observed an OR of 1.77 (95% CI = 1.11-2.82) for the GSTM1 null genotype in relation to lung cancer risk among smokers of less than 40 pack-years, but no association among heavier smokers (OR = 0.90; 95% CI = 0.56-1.44).Conclusions: Our data do not support a substantial association between homozygous deletion of the GSTM1 gene and the risk of lung cancer overall in this population. However, our data do suggest an elevated risk for lighter smokers with this genotype.Implications: Because the power of our analyses within strata of lifetime smoking history was limited, larger studies will be needed to confirm these findings. [ABSTRACT FROM AUTHOR]

Discusses research being done on the prescription of anticonvulsant in elderly patients with epilepsy. Reference to a study by J. Cooper and colleagues, presented at the autumn meeting of the British Geriatrics Societies in October 2004; Methodology of the study; Types of anticonvulsant prescribed to epileptic patients.

We report on results of spectropolarimetry of the afterglow of the long gamma-ray burst GRB 191221B, obtained with SALT/RSS and VLT/FORS2, as well as photometry from two telescopes in the MASTER Global Robotic Network, at the MASTER-SAAO (South Africa) and MASTER-OAFA (Argentina) stations. Prompt optical emission was detected by MASTER-SAAO 38 s after the alert, which dimmed from a magnitude (white-light) of ∼10–16.2 mag over a period of ∼10 ks, followed by a plateau phase lasting ∼10 ks and then a decline to ∼18 mag after 80 ks. The light curve shows complex structure, with four or five distinct breaks in the power-law decline rate. SALT/RSS linear spectropolarimetry of the afterglow began ∼2.9 h after the burst, during the early part of the plateau phase of the light curve. Absorption lines seen at ∼6010 and 5490 Å are identified with the Mg ii 2799 Å line from the host galaxy at z  = 1.15 and an intervening system located at z  = 0.96. The mean linear polarization measured over 3400–8000 Å was ∼1.5 per cent and the mean equatorial position angle (θ) was ∼65°. VLT/FORS2 spectropolarimetry was obtained ∼10 h post-burst, during a period of slow decline (α = −0.44), and the polarization was measured to be p  = 1.2 per cent and θ = 60°. Two observations with the MeerKAT radio telescope, taken 30 and 444 d after the GRB trigger, detected radio emission from the host galaxy only. We interpret the light curve and polarization of this long GRB in terms of a slow-cooling forward shock. [ABSTRACT FROM AUTHOR]

Aims: To determine the fermentation profiles by human gut bacteria of arabino-oligosaccharides of varying degree of polymerization. Materials and Methods: Sugar beet arabinan was hydrolyzed with a commercial pectinase and eight fractions, of varying molecular weight, were isolated by gel-filtration chromatography. Hydrolysis fractions, arabinose, arabinan and fructo-oligosaccharides were fermented anaerobically by gut bacteria. Total bacteria, bifidobacteria, bacteroides, lactobacilli and the Clostridium perfringens/histolyticum sub. grp. were enumerated using fluorescent in situ hybridization. Results: Bifidobacteria were stimulated to different extents depending on molecular weight, i.e. maximum increase in bifidobacteria after 48 h was seen on the lower molecular weight fractions. Lactobacilli fluctuated depending on the initial inoculum levels. Bacteroides numbers varied according to fraction; arabinan, arabinose and higher oligosaccharides (degree of polymerization, dp > 8) resulted in significant increases at 24 h. Only carbohydrate mixtures with dp of 1–2 resulted in significant increases at 48 h (log 8·77 ± 0·23). Clostridia decreased on all substrates. Conclusions: Arabino-oligosaccharides can be considered as potential prebiotics. Significance and Impact of the Study: Arabinan is widely available as it is a component of sugar beet pulp, a co-product from the sugar beet industry. Generation of prebiotic functionality from arabinan would represent significant added value to a renewable resource. [ABSTRACT FROM AUTHOR]

Objective: Randomised studies have demonstrated a beneficial effect of pre-surgical treatment with somatostatin analogues (SSA) in acromegaly when evaluated early postoperatively. The objective of this study was to evaluate the long-term surgical cure rates Methods: Newly diagnosed patients were randomised to direct surgery (nZ30) or 6-month pretreatment with octreotide LAR (nZ32). The patients were evaluated 1 and 5 years postoperatively. Cure was defined as normal IGF1 levels and by normal IGF1 level combined with nadir GH <2 mU/l in an oral glucose tolerance test, all without additional post-operative treatment. A meta-analysis using the other published randomised study with long-term analyses on preoperative SSA treatment was performed. Results: The proportion of patients receiving post-operative acromegaly treatment was equal in the two groups. When using the combined criteria for cure, 10/26 (38%) macroadenomas were cured in the pretreatment group compared with 6/25 (24%) in the direct surgery group 1 year postoperatively (PZ0.27), and 9/22 (41%) vs 6/22 (27%) macroadenomas, respectively, 5 years postoperatively (PZ0.34). In the meta-analysis, 16/45 (36%) macroadenomas were cured using combined criteria in the pretreatment group vs 8/45 (18%) in the direct surgery group after 6-12 months (PZ0.06), and 15/41 (37%) vs 8/42 (19%), respectively, in the long-term (PZ0.08). Conclusion: This study does not prove a beneficial effect of SSA pre-surgical treatment, but in the meta-analysis a trend towards significance can be claimed. A potential favourable, clinically relevant response cannot be excluded. [ABSTRACT FROM AUTHOR]

Objective: The Key Search, a subtest within the Behavioral Assessment of Dysexecutive Syndrome battery, is purported to assess planning and problem solving. However, evidence supporting the interpretability of performance on the Key Search is limited. This study evaluated the construct validity of the Key Search in neurologically healthy adults. Method: A diverse sample of healthy adults (n = 101) was administered a comprehensive neuropsychological battery. Between-measure correlations and exploratory factor analysis (EFA) were used to evaluate construct validity of the Key Search's total score (TS) and total time (TT) measures. Results: Covariate analyses revealed small correlations between the Key Search TS, but not TT, and 3 of 10 executive functioning (EF) measures: the D-KEFS Trail Making Test, Switching Condition (r = .259, p = .009), Symbol Digit Modalities Test (r = .25, p = .013), and the D-KEFS Color-Word Interference Test, Inhibition/Switching (r = .217, p = .039). Discriminant analyses revealed no correlation between measures of non-verbal memory, visuospatial reasoning, or literacy (p > .05). An EFA of EF measures revealed a 3 component item structure (Eigenvalues > 1), accounting for 43% of the total variance. Key Search TS loaded on the executive control/working memory factor (Factor 1: .508). Key Search TT measure loaded minimally on the inhibitory control factor (Factor 2: .354). Neither loaded on the planning factor (Factor 2). Conclusion(s): Interpretability of the Key Search as a measure of planning and problem solving was not supported; however, the Key Search TS appears to measure other aspects of EF. Future studies should assess the Key Search's construct validity in clinical samples. [ABSTRACT FROM AUTHOR]

Heterozygous GBA gene mutations are the most frequent Parkinson’s disease risk factor. Using Parkinson’s disease patient derived fibroblasts McNeill et al. show that heterozygous GBA mutations reduce glucosylceramidase activity, and are associated with endoplasmic reticulum and oxidative stress. Ambroxol treatment improved glucosylceramidase activity and reduced oxidative stress in these cells.Gaucher disease is caused by mutations in the glucocerebrosidase gene, which encodes the lysosomal hydrolase glucosylceramidase. Patients with Gaucher disease and heterozygous glucocerebrosidase mutation carriers are at increased risk of developing Parkinson’s disease. Indeed, glucocerebrosidase mutations are the most frequent risk factor for Parkinson’s disease in the general population. Therefore there is an urgent need to understand the mechanisms by which glucocerebrosidase mutations predispose to neurodegeneration to facilitate development of novel treatments. To study this we generated fibroblast lines from skin biopsies of five patients with Gaucher disease and six heterozygous glucocerebrosidase mutation carriers with and without Parkinson’s disease. Glucosylceramidase protein and enzyme activity levels were assayed. Oxidative stress was assayed by single cell imaging of dihydroethidium. Glucosylceramidase enzyme activity was significantly reduced in fibroblasts from patients with Gaucher disease (median 5% of controls, P = 0.0001) and heterozygous mutation carriers with (median 59% of controls, P = 0.001) and without (56% of controls, P = 0.001) Parkinson’s disease compared with controls. Glucosylceramidase protein levels, assessed by western blot, were significantly reduced in fibroblasts from Gaucher disease (median glucosylceramidase levels 42% of control, P < 0.001) and heterozygous mutation carriers with (median 59% of control, P < 0.001) and without (median 68% of control, P < 0.001) Parkinson’s disease. Single cell imaging of dihydroethidium demonstrated increased production of cytosolic reactive oxygen species in fibroblasts from patients with Gaucher disease (dihydroethidium oxidation rate increased by a median of 62% compared to controls, P < 0.001) and heterozygous mutation carriers with (dihydroethidium oxidation rate increased by a median of 68% compared with controls, P < 0.001) and without (dihydroethidium oxidation rate increased by a median of 70% compared with controls, P < 0.001) Parkinson’s disease. We hypothesized that treatment with the molecular chaperone ambroxol hydrochloride would improve these biochemical abnormalities. Treatment with ambroxol hydrochloride increased glucosylceramidase activity in fibroblasts from healthy controls, Gaucher disease and heterozygous glucocerebrosidase mutation carriers with and without Parkinson’s disease. This was associated with a significant reduction in dihydroethidium oxidation rate of ∼50% (P < 0.05) in fibroblasts from controls, Gaucher disease and heterozygous mutation carriers with and without Parkinson’s disease. In conclusion, glucocerebrosidase mutations are associated with reductions in glucosylceramidase activity and evidence of oxidative stress. Ambroxol treatment significantly increases glucosylceramidase activity and reduces markers of oxidative stress in cells bearing glucocerebrosidase mutations. We propose that ambroxol hydrochloride should be further investigated as a potential treatment for Parkinson’s disease. [ABSTRACT FROM PUBLISHER]

Introduction: Concerns have been expressed that menthol cigarettes are highly conducive to uptake and hence function as "starter cigarettes" for adolescents. There is strong evidence for this in the United States. If menthol cigarettes are critical to uptake for some adolescents, they might be expected to remain popular among adolescents independent of promotional activity. We analyzed trends in the market share of menthol brands in Australia among both adolescents and adults to provide further insights into the determinants of menthol cigarette smoking.Methods: We used the Australian Secondary Students Alcohol and Drug Survey (1984-2008), the Smoking and Health Survey (1980-1998), and the International Tobacco Control Four Nations Survey (2002-2008) to estimate market share of brands. Measures were reported use of all menthol brands for adults and use of the Alpine brand for adolescents.Results: Menthol smoking was much more popular among female smokers of all age groups in the early 1980s. During the 1980s and 1990s, use declined markedly in the 18-29 age groups, while remaining relatively stable among older smokers. Use of Alpine declined markedly among adolescents in the 1980s and 1990s. However, during this period, Alpine remained more popular among experimenting than regular smokers.Conclusions: Both Alpine and other menthol brands are now primarily "older women's cigarettes" in Australia. The trends in declining popularity among younger smokers suggest that targeted marketing plays a major role in determining menthol brand market share. Alpine has played a role as a "starter" cigarette in Australia but that role has decreased markedly since the 1980s. Within the Australian context, "light/mild" brands may have taken over the role of easier-to-smoke cigarettes that attract experimenting smokers. [ABSTRACT FROM AUTHOR]

Purpose. Changes in glycosylated hemoglobin (HbA1c) levels, blood pressure measurements, and utilization metrics among diabetic patients managed by a clinical pharmacist were studied. Summary. This pharmacist intervention model was developed by Polk County, Florida, to engage patients with diabetes in managing their health based on the Asheville Project's framework. The diabetes program was implemented in February 2005, with an onsite clinical pharmacist to counsel participants with diabetes. The onsite pharmacist individualized each patient's care. After the initial assessment, educational deficiencies were noted and addressed as needed. Outcomes measured included changes in HbA1c, blood glucose, and blood pressure values and utilization metrics, such as hospitalization and emergency room visit rates, from baseline to one year after pharmacist intervention. Of the 564 participants who enrolled in the program, 477 were enrolled at the end of one year and were included in the analysis. Results showed that HbA1c values steadily decreased over the one-year study period. At baseline, there were 55% of participants with an average HbA1c value of <=7%. After one year, 72% of participants had HbA1c values of <=7%. Participants' mean systolic and diastolic blood pressure values were lower at the end of one year compared with the baseline. Participants also had a 30% reduction in hospital admissions, and the number of emergency room visits during the one-year period decreased by 24%. Conclusion. An employer-based pharmacist intervention model for patients with diabetes improved HbA1c levels, reduced systolic and diastolic blood pressure values, and decreased hospitalizations and emergency room visits after one year. [ABSTRACT FROM AUTHOR]

Background: It is unclear whether the incidence of first episode psychoses is in decline. We had the opportunity to determine whether incidence had changed over a 20-year period in a single setting, and test whether this could be explained by demographic or clinical changes.Methods: The entire population at-risk aged 16-54 in Nottingham over three time periods (1978-80, 1993-95 and 1997-99) were followed up. All participants presenting with an ICD-9/10 first episode psychosis were included. The remainder of the population at-risk formed the denominator. Standardized incidence rates were calculated at each time period with possible change over time assessed via Poisson regression. We studied six outcomes: substance-induced psychoses, schizophrenia, other non-affective psychoses, manic psychoses, depressive psychoses and all psychotic disorders combined.Results: Three hundred and forty-seven participants with a first episode psychosis during 1.2 million person-years of follow-up over three time periods were identified. The incidence of non-affective or affective psychoses had not changed over time following standardization for age, sex and ethnicity. We observed a linear increase in the incidence of substance-induced psychosis, per annum, over time (incidence rate ratios: 1.15; 95% CI 1.05-1.25). This could not be explained by longitudinal changes in the age, sex and ethnic structure of the population at-risk.Conclusions: Our findings suggest psychotic disorders are not in decline, though there has been a change in the syndromal presentation of non-affective disorders, away from schizophrenia towards other non-affective psychoses. The incidence of substance-induced psychosis has increased, consistent with increases in substance toxicity over time, rather than changes in the prevalence or vulnerability to substance misuse. Increased clinical and popular awareness of substance misuse could also not be excluded. [ABSTRACT FROM AUTHOR]

Aims: To quantify the phytotoxicity and effect of alternative seed treatments based on acidified nitrite and elicitors of plant resistance (Tillekur and Chitosan) against seed-borne inocula of Didymella lycopersici. Methods and Results: Treatments tested were: nitrite [sodium nitrite in citric acid buffer (pH 2)] at 30, 100 and 300 mmol l−1 and three exposure times (10, 20 and 30 min); Tillekur (in water) at 12·5, 25, 50, 100 and 200 mg ml−1; Chitosan (in 0·05% acetic acid) at 2·5, 5, 10 and 50 mg ml−1. Efficacy of treatments was determined in growth chamber experiments. Nitrite at 300 mmol l−1 was completely effective, as was the fungicide, at controlling disease when applied for less than 20 min. Tillekur was as effective as the fungicide postemergence, but proved to be phytotoxic pre-emergence. Chitosan was significantly less effective than the other treatments. Conclusions: The high efficacy and low cost of acidified nitrite indicates that it is a suitable alternative to fungicides. Significance and Impact of the Study: There is currently a lack of effective seed treatments that can be used in organic and low-input crops. Treatments identified in this study can be considered as an effective alternative to chemical control against seed-borne fungal pathogens. [ABSTRACT FROM AUTHOR]

Presents letters to the editor on surgery. Validity of Galsgow Aneurysm Score and the Hardman Index; Comparison of experimental nerve injury caused by ultrasonically activated scalpel and electrosurgery; Diagnostic peritoneal lavage.

Tennessee dairying rebounded from the Civil War with the 1869 establishment of the Knoxville Experiment Station. By 1918 six courses in dairy farming were offered at UT and research focused on substituting different forages and grains in rations and on culling and controlling diseases, especially tuberculosis and milk fever. From 1921 to 1929 three additional experiment herds were established: West Tennessee, Middle Tennessee (two Jersey herds to compare Island Bred and native stock) and a U.S. Dairy Experiment Station (Jersey herd) in Marshall County (among 12,000 Jerseys in this county). Extension specialists helped import (1948-1949) train loads of Jerseys from Canada that were auctioned to 4-H members to improve herds; Holsteins were likewise purchased. Each year for 20 years starting in 1950, 50 to 60 Guernsey heifers were purchased with money borrowed from a Tennessee bank; these were auctioned on a 'cost-basis' to Tennessee 4-H members. Clyde Chappell (1965) was instrumental in assisting East Tennessee Artificial Breeders forming Select Sires Inc. In the 1960s seven pairs of identical twin Jerseys were used to compare fast fattening growth with leaner 'normal growth'; leaner heifers outmilked the fat ones. In 1972 the new Department of Animal Science was formed from Animal Husbandry and Dairying. In the 1970s and 1980s the Junior Dairy Project was one of the most outstanding in the nation. Leaders were L.O. Colebank, Clyde Chappell, William Miller, Ray Spann and Monty Montgomery. Since 1984 Dr. Stephen Oliver and his lab have achieved international recognition for research focused on milk quality and mastitis. With Dr. Lannett Edwards as the leader of the UT Cloning team, Millie became the first Jersey calf cloned from an adult somatic cell (2000) and in 2002 ten clones of a single adult Jersey cow were born. Research on dairy form/angularity (2005) by Drs. Gary Rogers and Chad Dechow has led to the selection of bulls that produce daughters that hold their body condition early in lactation. [ABSTRACT FROM AUTHOR]

Background: Tobacco smoking is an established risk factor for cancers of the upper aerodigestive tract, and measurement of chromosomal aberrations, i.e., chromatid breaks, induced in lymphocytes in vitro by bleomycin has been shown to be a predictor of risk for these cancers. In a case-control study, we recruited case subjects who were previously treated with surgery and/or radiotherapy for stage I or stage II squamous cell carcinoma of the head and neck to test the hypothesis that lymphocytic chromatid breaks induced by benzo[a]pyrene diol epoxide (BPDE), a tobacco mutagen, may also be associated with risk of developing cancers of the upper aerodigestive tract.Methods: Case subjects were matched to control subjects on the basis of age, sex, ethnicity, and smoking status. Primary lymphocytes from 67 case subjects and 81 control subjects were treated with 2 microM BPDE for 24 hours, and the frequency of induced chromatid breaks was determined. All statistical tests were two-sided.Results: Lymphocytes from case subjects compared with lymphocytes from control subjects showed significantly more breaks per cell induced by BPDE (mean+/-standard deviation, 0.77+/-0.38 versus 0.49+/-0.25; P<.001). Lymphocytes from 64.2% of case subjects were sensitive to BPDE (using a cutoff value of > or =0.60 break per cell). Subjects in the highest quartile of chromatid breaks had an approximately 20-fold increased risk of cancer compared with those in the lowest quartile after adjustment for age, sex, ethnicity, and smoking status. The association between BPDE sensitivity and cancer risk was higher in former smokers than in current smokers and higher in younger patients than in older patients. Subjects with sensitivity to both BPDE and bleomycin were at a 19.2-fold increased risk of cancer compared with those who were not sensitive to either agent.Conclusions: Mutagen sensitivity assays may aid in identifying individuals at risk of cancer, and use of parallel assays with two mutagens may improve risk predictability. [ABSTRACT FROM AUTHOR]

Examines patients with acute pacreatitis in whom serum amylase level was normal by researchers from Rotherham. Morbidity and mortality of severe acute pancreatitis; Significance of early detection and treatment to reduce complications; Sensitivity and accuracy of urinary trypsinogen-2 testing in identifying patients with acute pacreatitis.

The Food and Drug Adminstration recently approved a diphtheria-conjugated pneumococcal polysaccharide vaccine for adults, although its long-term immunogenicity is unknown. We report that, in patients with moderate to severe chronic obstructive pulmonary disease, conjugate vaccination elicits a superior immune response to free-polysaccharide vaccine that persists for >2 years.Background. Although the 23-valent pneumococcal polysaccharide vaccine (PPSV23) protects against invasive disease in young healthy persons, randomized controlled trials in chronic obstructive pulmonary disease (COPD) have demonstrated no benefit in the intention-to-treat population. We previously reported that the 7-valent diphtheria-conjugated pneumococcal polysaccharide vaccine (PCV7) is safe and induced greater serotype-specific immunoglobulin G (IgG) and functional antibody than did PPSV23 1 month after vaccination. We hypothesized that these advantages would persist at 1 and 2 years.Methods. One hundred eighty-one patients with moderate to severe COPD were randomized to receive PPSV23 (n = 90) or PCV7 (1.0 mL; n = 91). We measured IgG by enzyme-linked immunosorbent assay and assessed functional antibody activity by a standardized opsonophagocytosis assay, reported as a killing index (OPK). We determined differences in IgG and OPK between vaccine groups at 1 and 2 years.Results. Relative to PPSV23, PCV7 induced greater OPK at both 1 and 2 years for 6 of 7 serotypes (not 19F). This response was statistically greater for 5 of 7 serotypes at 1 year and 4 of 7 at 2 years. Comparable differences in IgG were observed but were less often statistically significant. Despite meeting Centers for Disease Control and Prevention criteria for PPSV23 administration, almost 50% of individuals had never been vaccinated. No differences in the frequency of acute exacerbations, pneumonia, or hospitalization were observed.Conclusions. PCV7 induces a greater functional antibody response than PPSV23 in patients with COPD that persists for 2 years after vaccination. This superior functional response supports testing of conjugate vaccination in studies examining clinical end points.Clinical Trials Registration: NCT00457977. [ABSTRACT FROM AUTHOR]

The objectives of this study were to compare milk, fat, and protein yield, somatic cell score, days open, and age at first calving between Holstein (HO) and Brown Swiss (BS), and among BS and HO crosses and backcrosses. A minimum of five first lactation cows entering a herd in the same year was required and only cows with a first lactation record and a registered HO or BS sire were retained. Data from 16 herds included 5,148 total records from 1,604 HO, 736 BS, 238 BS x Ho (SH), 19 HO x BS, and 60 BS x SH backcrosses (SSH). Data was retrieved through PCDART or Dairy Comp 305 for lactations one through five. Average daily milk, fat, and protein yield, SCS, days open, and age at first calving were analyzed using the MIXED procedure of SAS. The fixed effects were days in milk, age, parity, and breed. Random effects included cow and residual error. Breed effects were significant for all yield traits and age at first calving, approached significance for days open (P = 0.12), but were not significant for SCS (P = 0.48). Least square means (LSM) for daily milk yield were 32.5 kg for HO, 28.0 kg for BS, 31.4 kg for SH, and 28.8 kg for SSH. Least square means for daily fat yield were 1.17 kg for HO, 1.12 kg for BS, 1.22 kg for SH, and 1.14 kg for SSH. Daily protein yield LSM were 0.98 kg, 0.93 kg, 1.00 and 0.93 kg for HO, BS, SH, and SSH, respectively. Days open LSM were 159.1, 156.2, 148.3, and 149.2 for HO, BS, SH, and SSH respectively. Heterosis in SH crosses for yield traits ranged from 3.83% for daily milk yield to 6.56% for daily fat yield. Heterosis estimates were -5.93% for days open and -2.29% for age at first calving in SH crosses. Milk yield of SH were less than HO, but fat and protein yields were increased slightly. Days open and age at first calving were reduced with SH compared to the BS and HO. Brown Swiss may be effective in crossbreeding systems with HO. [ABSTRACT FROM AUTHOR]