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Purpose: This study used a collaborative approach to explore the needs, barriers, and facilitators to developing cochlear implant referral information material that would be valuable for hard of hearing adults and referring audiologists., Method: During the development of a prototype referral aid to be used within the Australian context, a multistage qualitative study was conducted using a consultative process, informal and semistructured interviews, as well as online surveys. A deductive directed content analysis approach was applied to assess respondents' perspectives. A total of 106 participants (37 hard of hearing adults and 69 audiologists) were involved across the multiple phases of this study., Results: Referral practices for the evaluation of cochlear implantation candidacy in Australia are highly inconsistent, supporting the need to streamline referral information. The following facilitators were identified to support the development of referral material: appropriate content, perceived patient benefit, and objectivity. Areas for improvement related to the broadness of the content, impact on professional identity, and accessibility., Conclusions: Practical insight from patients and referrers can inform the development of patient-facing material related to cochlear implant referrals. Streamlining information used in educational material could alleviate confusion inherent to varied health literacy levels and support patients in making informed decisions related to pursuing, or not, cochlear implantation candidacy evaluation services.

Over the last century, nutrition research and public health in New Zealand have been inspired by Dr Muriel Bell, the first and only state nutritionist. Some of her nutritional concerns remain pertinent today. However, the nutritional landscape is transforming with extraordinary changes in the production and consumption of food, increasing demand for sustainable and healthy food to meet the requirements of the growing global population and unprecedented increases in the prevalence of both malnutrition and noncommunicable diseases. New Zealand's economy is heavily dependent on agrifoods, but there is a need to integrate interactions between nutrition and food-related disciplines to promote national food and nutrition security and to enhance health and well-being. The lack of integration between food product development and health is evident in the lack of investigation into possible pathological effects of food additives. A national coherent food strategy would ensure all components of the food system are optimised and that strategies to address the global syndemic of malnutrition and climate change are prioritised. A state nutritionist or independent national nutrition advocacy organisation would provide the channel to communicate nutrition science and compete with social media, lead education priorities and policy development, engage with the food industry, facilitate collaboration between the extraordinary range of disciplines associated with food production and optimal health and lead development of a national food strategy.

Wheat head blast (WHB), caused by the fungus Magnaporthe oryzae pathotype triticum , is a devastating disease affecting South America and South Asia. Despite 30 years of intensive effort, the 2N V S translocation from Aegilops ventricosa contains the only useful source of resistance to WHB effective against M. oryzae triticum isolates. The objective of this study was to identify non-2N V S sources of resistance to WHB among elite cultivars, breeding lines, landraces, and wild-relative accessions. Over 780 accessions were evaluated under field and greenhouse conditions in Bolivia, greenhouse conditions in Brazil, and at two biosafety level-3 laboratories in the United States. The M. oryzae triticum isolates B-71 (2012), 008 (2015), and 16MoT001 (2016) were used for controlled experiments, while isolate 008 was used for field experiments. Resistant and susceptible checks were included in all experiments. Under field conditions, susceptible spreaders were inoculated at the tillering stage to guarantee sufficient inoculum. Disease incidence and severity were evaluated as the average rating for each 1-m-row plot. Under controlled conditions, heads were inoculated after full emergence and individually rated for percentage of diseased spikelets. The diagnostic marker Ventriup-LN2 was used to test for the presence of the 2N V S translocation. Four non-2N V S spring wheat International Maize and Wheat Improvement Center breeding lines (CM22, CM49, CM52, and CM61) and four wheat wild-relatives ( A. tauschii TA10142, TA1624, TA1667, and TA10140) were identified as resistant (<5% of severity) or moderately resistant (5 to <25% severity) to WHB. Experiments conducted at the seedling stage showed little correlation with disease severity at the head stage. M. oryzae triticum isolate 16MoT001 was significantly more aggressive against 2N V S-based varieties. The low frequency of WHB resistance and the increase in aggressiveness of newer M. oryzae triticum isolates highlight the threat that the disease poses to wheat production worldwide and the urgent need to identify and characterize new resistance genes that can be used in breeding for durably resistant varieties.

Wheat blast is a devastating disease that was first identified in Brazil and has subsequently spread to surrounding countries in South America. In May 2011, disease scouting in a University of Kentucky wheat trial plot in Princeton, KY identified a single plant with disease symptoms that differed from the Fusarium head blight that was present in surrounding wheat. The plant in question bore a single diseased head that was bleached yellow from a point about one-third up the rachis to the tip. A gray mycelial mass was observed at the boundary of the healthy tissue and microscopic examination of this material revealed pyriform spores consistent with a Magnaporthe sp. The pathogen was subsequently identified as Magnaporthe oryzae through amplification and sequencing of molecular markers, and genome sequencing revealed that the U.S. wheat blast isolate was most closely related to an M. oryzae strain isolated from annual ryegrass in 2002 and quite distantly related to M. oryzae strains causing wheat blast in South America. The suspect isolate was pathogenic to wheat, as indicated by growth chamber inoculation tests. We conclude that this first occurrence of wheat blast in the United States was most likely caused by a strain that evolved from an endemic Lolium-infecting pathogen and not by an exotic introduction from South America. Moreover, we show that M. oryzae strains capable of infecting wheat have existed in the United States for at least 16 years. Finally, evidence is presented that the environmental conditions in Princeton during the spring of 2011 were unusually conducive to the early production of blast inoculum.

Iron deficiency is one of the most common nutritional problems in the world and disproportionately affects women and children. Stages of iron deficiency can be characterized as mild deficiency where iron stores become depleted, marginal deficiency where the production of many iron-dependent proteins is compromised but hemoglobin levels are normal and iron deficiency anemia where synthesis of hemoglobin is decreased and oxygen transport to the tissues is reduced. Iron deficiency anemia is usually assessed by measuring hemoglobin levels but this approach lacks both specificity and sensitivity. Failure to identify and treat earlier stages of iron deficiency is concerning given the neurocognitive implications of iron deficiency without anemia. Most of the daily iron requirement is derived from recycling of senescent erythrocytes by macrophages; only 5-10 % comes from the diet. Iron absorption is affected by inhibitors and enhancers of iron absorption and by the physiological state. Inflammatory conditions, including obesity, can result in iron being retained in the enterocytes and macrophages causing hypoferremia as a strategic defense mechanism to restrict iron availability to pathogens. Premenopausal women usually have low iron status because of iron loss in menstrual blood. Conditions which further increase iron loss, compromise absorption or increase demand, such as frequent blood donation, gastrointestinal lesions, athletic activity and pregnancy, can exceed the capacity of the gastrointestinal tract to upregulate iron absorption. Women of reproductive age are at particularly high risk of iron deficiency and its consequences however there is a controversial argument that evolutionary pressures have resulted in an iron deficient phenotype which protects against infection.

Background: Like several other parasites, Teladorsagia circumcincta secretes or excretes urea, but neither the rate of efflux nor the possible metabolic sources of the urea has been considered., Methods: Parasites were maintained by passage through sheep. Urea efflux was measured using phenol/hypochlorite after treatment with urea aminohydrolase. The kinetics of creatine amidinohydrolase and arginine amidinohydrolase were characterised by coupling the reactions with urea aminohydrolase and glutamate dehydrogenase., Results: Infective L3 T. circumcincta secreted or excreted urea at 25% of the rate of NH3/NH4 (+). The rate of urea efflux was about 84 pmol h(-1) (10(3) larvae)(-1) over 4 hours, corresponding to about 11 nmol h(-1) mg(-1) protein. We could not detect urea aminohydrolase activity, but urea production by both creatine amidinohydrolase and arginine amidinohydrolase could be detected. The apparent K m and V max of creatine amidinohydrolase were 1.1 mM and 48 nmol h(-1) mg(-1) protein, respectively, and the activity was greatest at pH 8. The apparent K m and V max of arginine amidinohydrolase were 0.7 mM and 62 nmol h(-1) mg(-1) protein, respectively, and the activity was greatest at pH 7.9., Conclusion: The activity of creatine amidinohydrolase and arginine amidinohydrolase was sufficient to account for the rate of urea secretion or excretion.

Objectives: The aims of the study were to investigate (1) speech perception outcomes in people with an early-onset hearing loss (HL) who received a cochlear implant as an adolescent or adult, (2) prognostic factors associated with positive speech perception outcomes, and (3) self-report outcomes in these participants., Design: Outcomes for 38 implant recipients with a Nucleus device were investigated retrospectively. All participants were diagnosed with a bilateral HL at age #3 yr and were implanted at age 14 yr or older. Nineteen participants had confirmed bilateral, severe to profound HL at age #12 mo (prelingual); nine had confirmed bilateral, severe to profound HL at age.12 mo and #3 yr (perilingual); and the remaining 10 had a diagnosis of bilateral sensorineural HL at age #3 yr which progressed to severe to profound HL after 3 yrs of age (progressive). There were 24 females and 14 males, and the average age at implantation was 33 yr (range 5 14-65 yr). Closed-set and open-set speech perception tests administered pre- and postimplant were analyzed for all participants, in addition to self-report survey measures of benefit, satisfaction, and implant usage., Results: Participants were placed into one of five hierarchic categories of speech perception performance preimplantation and at 12 mo postimplantation. The categories ranged from sound detection only (category 1) to excellent open-set speech perception (category 5). To be in category 4 or 5, the participant had to score.30% words correct on a recorded version of either the Central Institute for the Deaf Everyday Sentence Lists or the City University of New York Sentences. Before implantation, two recipients (5%) were in category 4 or 5 compared with 20 (53%) at 12 mo postimplant. Consistent with previous studies, there was large intersubject variability in speech scores. Three factors accounted for 63% of the variance on open-set sentence test scores, postimplant: mode of communication in childhood (oral versus total communication/sign), stable as opposed to progressive loss, and time without a hearing aid on the implant ear. More than 80% of survey respondents used their device.8 hr a day, and 90% reported that their ability to understand speech with visual cues was "much better" with the implant. In addition, all reported being satisfied with the device., Conclusion: These results indicate that a cochlear implant should be considered as an option for adults and adolescents with early-onset HL. The majority of participants gained benefit from the device and were satisfied with it. In addition, a substantial number gained good open-set speech perception ability, postimplant. Recipients who used oral communication in childhood, had a progressive loss, and wore a hearing aid on the implant ear up to the time of surgery were more likely to obtain better speech perception outcomes.

We investigated the acceptability of electrophysiologically derived MAPs and the effect of these MAPs on speech perception in elderly adults using Nucleus 24 cochlear implants. Eight implant recipients aged 75 years or older trialed an electrophysiologically derived MAP and a behavioral MAP. The electrophysiologically derived MAP was based on the threshold and maximum comfort level for electrode 10 and evoked compound action potential thresholds measured on six electrodes using neural response telemetry (NRT). Word perception at 55 dB SPL and sentence perception in noise at 70 dB SPL were assessed after six weeks take-home experience and again after an additional two weeks of experience. During the final two weeks of take-home experience participants indicated their preferred MAP for different listening situations. The NRT derived MAP estimated behavioral T levels well, but underestimated behavioral C levels for apical electrodes in some subjects. Speech perception with NRT derived MAPs was comparable to speech perception with behaviorally measured MAPs. MAPs estimated from NRT data provided good speech perception outcomes for elderly implant recipients and were well tolerated.

Objective: The objective of this study was to evaluate streamlined programming procedures for the Nucleus cochlear implant system with the Contour electrode array., Design: Phase 1 involved an examination of the clinical MAPs for the first 103 recipients implanted with the Contour electrode array in the Melbourne Cochlear Implant Clinic, to examine the ability to predict the entire MAP based on a smaller number of clinically determined T- and/or C-levels. In phase 2, a subset of the streamlined procedures was selected and clinically evaluated, using speech perception and subjective preference measures. In the first study, the clinical MAP was compared with a MAP based on interpolating across three behavioral T-levels and three behavioral C-levels in a group of newly implanted subjects. The second study investigated the use of a single interpolated profile as the basis to creating the entire MAP. Initial evaluation compared the clinical MAP with two streamlined MAPs, one in which the C-level profile was derived from interpolation across a subset of T-levels and one in which the T-level profile was derived from interpolation across a subset of C-levels. In this case, the interpolated profile was based on five behavioral measures. Subsequently, the use of either three or a single T-level measure as the basis for the interpolated T-level profile was evaluated. Eighteen subjects, who were experienced with the clinical MAP before enrollment in the study, participated in the initial evaluation. The subjects were selected to include a group whose RMS deviation from clinical MAP levels, as determined in Phase 1, was greater than that of the wider population., Results: The Phase 1 analysis showed that as expected, larger differences were observed between the clinical and derived MAP levels as interpolation was applied across fewer measured electrodes and that the use of a single interpolated profile to create the entire MAP resulted in the greatest deviation. No significant group mean difference was found in speech perception scores for newly implanted subjects when mapped with the clinical versus the streamlined MAP based on three behavioral T- and three behavioral C-level measures. For some individual subjects, scores were higher with the streamlined MAP. Subjective reports from the comparative performance questionnaire were consistent with these findings. No significant group mean difference in speech perception scores was found in comparing the clinical MAP with the streamlined MAPs based on a single interpolated T- or C-level profile created from five behavioral measures. Individual effects were observed; however, there was no consistent finding across subjects. The use of three rather than five behavioral T-level measures in the procedure did not result in significantly lower group mean scores; however, significantly poorer scores were obtained for three of the 10 individual subjects. The use of a MAP based on a single behavioral measure did result in poorer speech perception scores when compared with the MAP based on five behavioral T-level measures. These findings were consistent with subjective results from the performance questionnaires administered to determine preference for program across a range of listening situations., Conclusions: Two streamlined programming procedures are recommended for use in the clinical setting: (1) interpolating across three measured T-levels and three measured C-levels and (2) interpolating across five measured T- or C-levels and using the interpolated profile for fitting of the alternative profile.

This paper prospectively documents the health-related quality of life (HRQoL) and social participation benefits of adult patients receiving cochlear implants in Australia and New Zealand. Thirty-four consecutively implanted patients completed the Assessment of Quality of Life (AQoL) and Hearing Participation Scale (HPS) instruments before implantation, and at 3- and 6-month follow-ups. Implantation resulted in significant improvements in AQoL and HPS scores, The effect size was 1.09 for both measures. Those in the top socio-economic tertile obtained the greatest gains. The HRQoL and social participation benefits were slightly larger than those reported elsewhere. This may be because participants used more recent technology (Nucleus 24 rather than Nucleus 22) and received auditory and self-efficacy training as part of their rehabilitation. The results suggest that cochlear implants have a large beneficial effect. They show that social and HRQoL outcomes can be parsimoniously measured using the HPS and AQoL instruments.

Intact G0 nuclei from quiescent mammalian cells initiate DNA synthesis asynchronously in Xenopus egg extracts, despite exposure to the same concentration of replication factors. This indicates that individual nuclei differ in their ability to respond to the inducers of DNA replication. Since the induction of DNA synthesis requires the accumulation of replication factors by active nuclear transport, any variation in the rate of transport among nuclei could contribute to the variability of DNA replication. Using the naturally fluorescent protein allophycocyanin (APC) coupled with the nuclear localization sequence (NLS) of SV40 T antigen, as a marker of nuclear uptake, we show here that individual G0 nuclei differ in their rate of transport over a range of more than 20-fold. Surprisingly, this variation has no direct influence on the timing or extent of DNA synthesis. Similar results were obtained by monitoring the uptake of nucleoplasmin, a nuclear protein present at high levels in egg extracts. These experiments show that the initiation of DNA synthesis is not driven merely by the accumulation of replication factors to some threshold concentration. Instead, some other explanation is needed to account for the timing of initiation.

In eukaryotes, the initiation of DNA synthesis requires the assembly of a pre-replicative complex (pre-RC) at origins of replication. This involves the sequential binding of ORC (origin-recognition-complex), Cdc6 and MCM proteins, a process referred to as licensing. After origin firing, the Cdc6 and MCM proteins dissociate from the chromatin, and do not rebind until after the completion of mitosis, thereby restricting replication to a single round in each cell cycle. Although nuclei normally become licensed for replication as they enter G(1), the extent to which the license is retained when cells enter the quiescent state (G(0)) is controversial. Here we show that the replication capacity of nuclei from Swiss 3T3 cells, in Xenopus egg extracts, is not lost abruptly with the onset of quiescence, but instead declines gradually. The decline in replication capacity, which affects both the number of nuclei induced to replicate and their subsequent rate of DNA synthesis, is accompanied by a fall in the level of chromatin-bound MCM2. When quiescent nuclei are incubated in egg extracts, they do not bind further MCMs unless the nuclei are first permeabilized. The residual replication capacity of intact nuclei must therefore be dependent on the remaining endogenous MCMs. Although high levels of Cdk activity are known to block MCM binding, we show that the failure of intact nuclei in egg extracts to increase their bound MCMs is not due to their uptake and accumulation of Cdk complexes. Instead, the failure of binding must be due to exclusion of some other binding factor from the nucleus, or to the presence within nuclei of an inhibitor of binding other than Cdk activity. In contrast to the situation in Xenopus egg extracts, following serum stimulation of intact quiescent cells, the level of bound MCMs does increase before the cells reach S phase, without any disruption of the nuclear envelope.

Fusion of human red cells through the action of polyethylene glycol gives rise to pairs or higher clusters with a common membrane envelope, in which a barrier at the position of the original interface can be seen in phase contrast. At early times this septum contains lipids, as judged by labelling with a fluorescent lipophile, and transmembrane protein; this was shown by the presence of the preponderant component, band 3, detected by a fluorescent label, covalently attached before fusion at an extracellular site, or by immunofluorescence with anti-band 3 antibody. Ankyrin, which is bound to band 3, is also observed in the septum. The lipid thereafter disappears from the interface, carrying most of the band 3 with it. A continuous membrane skeletal network, defined by the presence of spectrin (detected by immunofluorescent staining in epifluorescence and confocal microscopy) appears to persist for long periods, but in many cells interruptions develop in the septum. In other fused pairs, particularly at longer times, the interface is seen to have vanished completely. Protease inhibitors have no discernible effect on any of these observations. The results suggest a model for the events that follow fusion. Covalent cross-linking of membrane proteins beyond a critical level causes inhibition of fusion, suggesting that proteins, probably the membrane skeletal network, regulate the fusion process. The efficiency of fusion is strikingly dependent on the composition of the isotonic medium, being relatively high at an orthophosphate concentration of 5 mM and minimal at 20 mM.