Search

WOS: 000442229500021, PubMed ID: 30101073, Background: In infants with phenylketonuria (PKU), dietary management is based on lowering and titrating phenylalanine (Phe) intake from breast milk or standard infant formula in combination with a Phe-free infant formula in order to maintain blood Phe levels within target range. Professionals use different methods to feed infants with PKU and our survey aimed to document practices across Europe. Methods: We sent a cross sectional, survey monkey (R) questionnaire to European health professionals working in IMD. It contained 31 open and multiple-choice questions. The results were analysed according to different geographical regions. Results: Ninety-five centres from 21 countries responded. Over 60% of centres commenced diet in infants by age 10 days, with 58% of centres implementing newborn screening by day 3 post birth. At diagnosis, infant hospital admission occurred in 61% of metabolic centres, mainly in Eastern, Western and Southern Europe. Breastfeeding fell sharply following diagnosis with only 30% of women still breast feeding at 6 months. 53% of centres gave pre-measured Phe-free infant formula before each breast feed and 23% alternated breast feeds with Phe-free infant formula. With standard infant formula feeds, measured amounts were followed by Phe-free infant formula to satiety in 37% of centres (n = 35/95), whereas 44% (n = 42/95) advised mixing both formulas together. Weaning commenced between 17 and 26 weeks in 85% centres, >= 26 weeks in 12% and < 17 weeks in 3%. Discussion: This is the largest European survey completed on PKU infant feeding practices. It is evident that practices varied widely across Europe, and the practicalities of infant feeding in PKU received little focus in the PKU European Guidelines (2017). There are few reports comparing different feeding techniques with blood Phe control, Phe fluctuations and growth. Controlled prospective studies are necessary to assess how different infant feeding practices may influence longer term feeding development., Vitaflo, We thank Vitaflo for supporting the publication cost of this paper.

In the Bromoviridae family of plant viruses, trinucleotide hairpin loops play an important role in RNA transcription. Recently, we reported that Brome mosaic virus (BMV) subgenomic (sg) transcription depended on the formation of an unusual triloop hairpin. By native gel electrophoresis, enzymatic structure probing, and NMR spectroscopy it is shown here that in the absence of viral replicase the hexanucleotide loop 5'C1AUAG5A3' of this RNA structure can adopt a pseudo trinucleotide loop conformation by transloop base pairing between C1 and G5. By means of in vitro replication assays using partially purified BMV RNA-dependent RNA polymerase (RdRp) it was found that other base pairs contribute to sg transcription, probably by stabilizing the formation of this pseudo triloop, which is proposed to be the primary element recognized by the viral replicase. The BMV pseudo triloop structure strongly resembles iron-responsive elements (IREs) in cellular messenger RNAs and may represent a general protein-binding motif. In addition, in vitro replication assays showed that the BMV sg hairpin is functionally equivalent to the minus-strand core promoter hairpin stem-loop C at the 3' end of BMV RNAs. Replacement of the sg hairpin by stem-loop C yielded increased sg promoter activity whereas replacement of stem-loop C by the sg hairpin resulted in reduced minus-strand promoter activity. We conclude that AUA triloops represent the common motif in the BMV sg and minus-strand promoters required for recruitment of the viral replicase. Additional sequence elements of the minus-strand promoter are proposed to direct the RdRp to the initiation site at the 3' end of the genomic RNA.

In this paper a modified Epstein frame which delivers measurements under transformer like conditions is proposed. The steel sheet samples are stacked according to the method applied in real power transformer cores with similar geometrical conditions. Another parameter which should be investigated with the modified Epstein frame is pressure. In a transformer core the stacked steel sheets are pressed by bandaging to stabilize the core. This pressure has an influence on the magnetic characteristics of the used electrical steel. The new measuring device is designed with a FEM-Software to compare magnetic field distribution with the Epstein frame. The modified Epstein frame is built according to the FEM results and construction requirements as a matter of the pressure armature. Finally measurements of Epstein frame, Single sheet tester and modified Epstein frame all equipped with the same electrical steel are compared.

Fire-eater's pneumonitis, caused by aspiration of petroleum, is an infrequent clinical problem in our region. It is an acute inflammatory response of the lungs to the accidental aspiration of hydrocarbons, as shown in our patient. Despite the severe initial clinical und radiological presentation, fire-eater's pneumonitis usually shows a favourable evolution with "restitutio ad integrum". Acute mortality rate is less than 1%. Fire-eater's lung is a medical emergency and needs medical support and surveillance. There is no good evidence that systemic cortico-steroids and antibiotics are effective in the treatment of hydrocarbon aspiration. Concerning chronic lung injury after fire-eater's pneumonitis, there are favorable results from short observational series.

Promoter regions required for minus-strand and subgenomic RNA synthesis have been mapped for several plus-strand RNA viruses. In general, the two types of promoters do not share structural features even though they are recognized by the same viral polymerase. The minus-strand promoter of Alfalfa mosaic virus (AMV), a plant virus of the family Bromoviridae , consists of a triloop hairpin (hpE) which is attached to a 3′ tRNA-like structure (TLS). In contrast, the AMV subgenomic promoter consists of a single triloop hairpin that bears no sequence homology with hpE. Here we show that hpE, when detached from its TLS, can function as a subgenomic promoter in vitro and can replace the authentic subgenomic promoter in the live virus. Thus, the AMV subgenomic and minus-strand promoters are basically the same, but the minus-strand promoter is linked to a 3′ TLS to force the polymerase to initiate at the very 3′end.

A pseudotriloop is formed by transloop base pairing between the first (5′) and the fifth nucleotide in a hexanucleotide RNA loop (“hexaloop”) to subtend a triloop of nucleotides 2–4. This structure has been found in hairpins involved in the regulation of iron metabolism in mammalian cells and in transcription of plant virus subgenomic RNA. Several hexaloop hairpins, including HIV-transactivation-responsive element and hepatitis B virus ε, potentially adopt a pseudotriloop conformation. Here we show that an RNA plant virus whose replication depends on a conventional triloop hairpin can be used to verify the existence of pseudotriloop structures in vivo . Our data suggest that the pseudotriloop may represent a common motif in RNA–protein recognition.

The initiation of translation of hepatitis C virus (HCV) is cap-independent and mediated by an internal ribosome entry site (IRES) that is located in the 5′ nontranslated region (5′ NTR) of the viral genome. This 5′ NTR is relatively long and folds into a complex structure involving multiple hairpins and a pseudoknot. Within the sequence encompassing the IRES there are several AUG triplets. Some of these AUG codons are conserved between HCV genotypes and the related pestiviruses. In this study the 5 AUG codons (positions 13, 32, 85, 96, and 215) that are present in the 5′ NTR of the HCV H-strain have been mutagenized to determine their influence on HCV cap-independent translation. The effect of these mutations on the expression of a chloramphenicol acetyl transferase (CAT) gene was tested in vaccinia virus vTF7-3 infected Hep2 cells transfected with plasmids for the expression of a monocistronic HCV 5′ NTR-CAT mRNA. Mutating the AUG codons at positions 13, 32, and 215 does not have a significant effect on CAT expression, inactivating the AUG codons at either position 85 or position 96 severely impaired IRES function. To determine whether ribosomes scan the RNA to select the initiation site, AUG codons were inserted up- and downstream of the authentic HCV polyprotein translation initiation codon (position 342). Analysis of these mutants has revealed that the ribosome is unable to use an AUG codon that is placed either 7 nucleotides upstream or 8 nucleotides downstream of the inactivated AUG at position 342. These results indicate that when scanning is involved in the recognition of the translation initiating AUG, it is limited to a narrow region between nucleotides 335 and 350.

Disproportionately high use of school health room (HR) services by small groups of users has been reported. This study investigated predictors of frequent HR use in two suburban middle schools involving 1089 students who made at least one HR visit during a single academic year. Subsets of high and low users were compared using logistic regression. Predictor variables included gender, grade, academic ability, and existence of a chronic health condition. Although demographic characteristics of the study schools varied significantly, a pattern of increasing HR use associated with progressive lowering of academic ability was demonstrated in both schools. Existence of a chronic health condition was associated with increased HR use, even when controlling for routine medication visits. Gender and grade were not predictive. These findings suggest that HR use reflects more than medical concerns. Patterns of HR use by students with chronic health conditions deserve additional study to determine whether current strategies to meet their needs are adequate.

Disproportionately high use of school health room (HR) services by small groups of users has been reported. This study investigated predictors of frequent HR use in two suburban middle schools involving 1089 students who made at least one HR visit during a single academic year. Subsets of high and low users were compared using logistic regression. Predictor variables included gender, grade, academic ability, and existence of a chronic health condition. Although demographic characteristics of the study schools varied significantly, a pattern of increasing HR use associated with progressive lowering of academic ability was demonstrated in both schools. Existence of a chronic health condition was associated with increased HR use, even when controlling for routine medication visits. Gender and grade were not predictive. These findings suggest that HR use reflects more than medical concerns. Patterns of HR use by students with chronic health conditions deserve additional study to determine whether current strategies to meet their needs are adequate.

Little is known of the characteristics of children experiencing school dysfunction who are evaluated by multidisciplinary teams. The records of 87 children seen during a calendar year were reviewed and information was gathered regarding their age, sex, and referral source. In addition, the chief concerns of the child's parents and educators, and the diagnostic outcome, were considered. Boys were more likely to have been referred for behavioral problems than for academic issues. Girls were seen at an earlier age. Younger children were more likely to have been referred by physicians. While there was a significant association between gender and reason for referral, we found no such relationship between gender and final diagnostic classification. Variables in the utilization of evaluation services are described. Cognizance of these issues should lead to improved provision of care to all children experiencing school dysfunction.

Weight-maintaining fat-rich, "prudent," carbohydrate-rich, as well as energy-restricted diets (300 kcal/d) were fed in succession for 7 d to 12 healthy males of ideal body weight under metabolic ward conditions. At the end of each period isolated fat cells were prepared from subcutaneous abdominal adipose tissue and incubated in vitro in the absence or presence of adenosine deaminase, either alone or in combination with various lipolytic or antilipolytic hormones and agents. Variations in total energy intake and dietary composition had characteristic and specific effects on fat cell lipolysis in vitro. High carbohydrate and prudent diets resulted in low rates of nonstimulated glycerol release and impaired insulin action in the presence of adenosine deaminase (320 mU/ml). High-fat and energy restricted diets were characterized by high rates of nonstimulated glycerol release. Sensitivity of antilipolysis to insulin and prostaglandin E2 was 10 to 200 times lower respectively on energy-restricted than on fat-rich diets. The effects of alpha 2- and beta-adrenergic catecholamines and of N6-phenylisopropyladenosine were not affected by the preceding diets.

Pediatricians frequently refer children and their families for psychotherapeutic counseling. In order to maximize compliance with such a prescription, the physician should be aware of factors associated with noncompliance. We conducted a systematic retrospective analysis of factors associated with following a recommendation for counseling. We reviewed the records of 35 children who had been referred for counseling. One to two years after the recommendation was made, we asked their parents whether or not they had accessed these services. Compliant and noncompliant families were compared on a number of demographic, historical, and diagnostic parameters. No statistically significant association with the compliance factor was found. Only 53% of children had received the prescribed therapy. We conclude that noncompliance with a recommendation for psychotherapeutic counseling is a problem of significant proportion. Further work with a larger sample size will be needed to elucidate factors associated with noncompliance.

Pediatricians frequently refer children and their families for psychotherapeutic counseling. In order to maximize compliance with such a prescription, the physician should be aware of factors associated with noncompliance. We conducted a systematic retrospective analysis of factors associated with following a recommendation for counseling. We reviewed the records of 35 children who had been referred for counseling. One to two years after the recommendation was made, we asked their parents whether or not they had accessed these services. Compliant and noncompliant families were compared on a number of demographic, historical, and diagnostic parameters. No statistically significant association with the compliance factor was found. Only 53% of children had received the prescribed therapy. We conclude that noncompliance with a recommendation for psychotherapeutic counseling is a problem of significant proportion. Further work with a larger sample size will be needed to elucidate factors associated with noncompliance.